m m mm V '<:'■ WM Gass Book. COPYRIGHT DEPOSIT The Germicide Twentieth Century Practice of Medicine AND Dictionary of Diseases The Germicide Twentieth Century Practice OF Medicine AND Dictionary of Diseases THEIR TREATMENT WITH NEWER REMEDIES . BY R. R. Russell, M. D Editor of "The Germicide" NEW YORK Lock Box No. 431 1901 Library of Congress ^wo Copies Received FEB 21 1901 _ Copyright «try 36 <2_ ^WtfS^. SK0NDC0PY DEDICATED TO ANDREJV CARNEGIE The Philanthropist of the World The Author Copyright, 1901, by R. R. RUSSELL, New York AVIL PRINTING CO. Medical Printers and Publishers 3941 Market Street Philadelphia, Pa. • THE TWENTIETH GEHTUBY PBHGTIGE A Dictionary of Diseases, Their Treatment With Newer Remedies. ABDOMEN. — The belly or lower portion of the body is separated from the chest by the diaphragm. For the purpose of description, it is divided into three anterior regions, naming them from above downwards, viz., epigastric, umbilical, and hypogastric; each of which is divided into three, making it nine regions, the upper three being the epigastric, with the right and left hypochondriac regions on each side of it. Below this the umbilical region, with the right and left lumbar on either side of it, and the lowest of all the hypogastric regions with the right and left iliac regions. The abdomen contains the stomach, in- testines, liver, pancreas, spleen, kidneys, bladder, and is lined with a fine delicate membrane, of the white fibrous tissue class, termed the peritoneum, which is reflected on all the organs contained therein. a s> ABLUTION. — Washing or bathing the entire body should be performed daily. The skin at all times is throwing off toxical agents, gaseous, alkaline, carbonaceous matter, so that when it is caked over with perspiration and dirt it is unable to eliminate. Neglect ablution, or thorough washing off, addi- tional work is thrown upon both liver and kidneys and other excretory organs ; then languor, low spirits, headache from the presence of effete matter accumulated in the blod; then gout, rheumatism, If the function of the skin w r ere arrested, death would result. Cleanse the skin — a thorough purification once daily of the entire body with an alkaline wash ; for the healthy, cold water on rising ; for the delicate, tepid water. A proper reaction must be the guide, never to be chilled nor languid after the bath. The majority of human kind are but imperfectly washed in both city and country, which gives them a predisposition to (5) 6 Twentieth Century Practice. disease. Healthy and happy results follow cleanliness, which is a matter of public interest. Sanitary science teaches that dirt, filth, and effete matter are the enemies of public health, no matter how and where it exists. The toxicity of human sweat is admitted; besides the skin is at all times excreting effete matter, in the form of a gaseous, saline oleaginous substance, which is indispensable for the health of the body. If the function of the skin be impaired, the liver and kidneys must do its work; if not, auto-intoxication, with its languor, low spirits, severe headaches, uric acid gout, gravel, will result ; consequently for good health the entire sur- face of the body should be cleansed daily, with soft water, if possible with soap, good brown or castile soap; with that a thorough purification of the entire surface of the body should be effected. All medicated soaps are poisonous; nearly all con- tain either the bichloride of mercury, or formalin, or asepsin, or salicylate of soda. Beware of them, all — germicide, anti- septic, aseptic, so technically called — are bad. After ablution it is always desirable to rub the surface thoroughly with a dry towel until a warm glow is produced and the capillaries well dilated. Thorough ablution is most requisite. The temperature of the water should be regulated by the status of vital force. ABORTION. — Miscarriage ; the expulsion of the foetus be- fore the seventh month of utero-gestation, or before it is viable. The causes of this accident are referable either to the mother, and particularly to the uterus, or to the foetus and its depend- encies. The causes in the mother may be extreme nervous sus- ceptibility, great debility, toxins of disease germs, plethora, faulty conformation; frequently induced by intense mental emotion, rectal irritation, violent exercise. The causes located in the foetus are its death, rupture of the membranes, degenerative changes in the placenta. The period at which it is most liable to occur is about the fourth month of gestation. The symptoms of abortion are uterine hemorrhage, with or without flakes of decidua, with intermitting pain of a bearing- down character. Its occurrence predisposes to a tendency to recur again and again in subsequent pregnancies, about the same period. The treatment consists in perfect rest in the re- cumbent position in bed. the avoidance of all hot or stimulating drinks. Twentieth Century Practice. 7 The best remedies for either prevention or cure are the com- pound syrup of partridge berry, or wine of aletris farinosa. If neither of these are convenient, tincture opii, small doses, re- peated. ABRASION. — A superficial excoriation with loss of sub- stance. Cleanse, dry, then dust on formal-gelatine — cover. Instantaneous cicatrization takes place. ABRUS PRECATORIUS.— Jequirity, small oval scarlet seeds or beans, which grow abundantly in Brazil. The seeds, reduced to a powder and infused, when cold, dropped into an eye covered with an opacity of effused lymph, repeated on several occasions, will cause a peeling or exfolia- tion of the mucous membrane in which the effusion has taken place. By incorporating the powder in butter of coca and mould- ing it into a crayon suppository or pastil, inserted into either the rectum or vagina, permitted to remain over night, will cause a complete exfoliation of the mucous membrane with any thick- ening vegetation, wart thickening, polypoid, cancerous infiltra- tion, leaving the mucous membrane in its original healthy con- dition. A distillate of jequirity has been found of much value in the cicatrization of cancers when they are removed by either the ozone, or chloride of chromium paste. ABSCESS. — The accumulation of pus in a cavity or in the tissues of the body, a result of the effusion of lymph, which is liable to occur in acute and chronic inflammation. The lymph r owing to some adverse condition, breaks down and forms pus, living matter, a disease germ. Streptococcus pyogenes. The formation of pus may take place during either the active or passive stage of inflammation, or subsequently if effused. The indications of such a change would be shivering or rigors, with general constitutional dis- turbance and rise of temperature, moist skin, soft pulse, tongue coated, prevented secretions. If there be pain, it changes to that of the dull, throbbing character. The effusion or swelling, which at first is hard and firm, softens, fluctuation can be de- tected by the touch ; if vital force is average it forces it to the surface, and probably evacuates itself— ^-if not, it must be aided by heat and moisture, in the shape of poultices. 8 Twentieth Century Practice. The severity of symptoms usually depends much on the char- acter of the inflammation that gives rise to it, its intensity, its deep-seated nature, bone or tissue affected. Abscess of the liver is exceedingly dangerous; whereas, in or near the skin, causes little trouble. If there be no tendency to break and evacuate itself, aided, by heat and moisture, an evacuation should be made by the knife, a free opening and counter-opening, and peroxide of hydrogen applied and re-applied until every pus microbe is annihilated. Pus, in whatever form is occurs, is simply a mass of disease germs. Streptococcus pyogenes in its growth creates a deadly poison. Other germs are recognized as associates ; two of these are Staphylococci, which occur in groups, which, under the microscope, resemble a fish roe or a bunch of grapes, which, when cultivated, give us the .S\ pyogenes aureus, golden or yel- low opaque colonies, and the other the 5*. pyogenes albus, white vopaque masses. Thse septic organisms closely resemble each other, and are sometimes found all together and often singly. In whatever form we find pus, serous, muco-purulent, sanies or laudable, the pathogenic microbe is there, consisting of slender ends, linked two or three together, or else collected in regular masses. It is a microbe of great growth by spore formation on liquid gelatine at a temperature of ioo° F. ABSINTHIUM.— (Wormwood; leaves and tops of Arte- mesia absinthium.) It has properties of a tonic, antispas- modic, anthelmintic character, that render it useful in dyspep- sia, gout, dropsy. An enema of a decoction is of efficacy in ascarides. Besides being prescribed as a stomachic, it is quite extensively used by the French in the preparation of liqueurs, such as absinthe, the use of which gives rise to a species of alcoholism with predominant nervous symptoms. The absinthe habit gives rise to gastric derangements, night terrors, terrific abdominal pains, hallucinations, tremors, paralysis. A state of mental chaos and bankruptcy cured by the use of ozonized passiflora incarnata in large doses. ABSORBENTS. — Small, delicate vessels, which take up fluids and gases with which they come in contact and carry them into the blood. A general division is made of external and internal; other subdivisions are made. The principal agents of external ab- Twentieth Century Practice. 9 sorption are the veins and chyliferous vessels. Any fluid, medi- cated or otherwise,, possessing the necessary tenuity, passes through the coats of the vessels by endosmosis, and proceeds along the torrent of the circulation, and, if medicated, finds the organ or tissue for which it has an affinity. The internal embraces the entire alimentary canal, vagina, urethra, all lit- erally studded with absorbents. ACETIC ACID. — A colorless acid liquid obtained from wood by destructive distillation. A caustic and counter-irri- tant. It contains 33 per cent of pure acetic acid. It is largely used in medicine and pharmacy, principally in conjunction with other drugs. There are two other Pharmacopceial acetic acids — dilute acetic acid (one part of acetic acid to seven of water) and glacial acetic acid (concentrated acetic acid, containing 99 per cent of acetic acid) . Salts, formed by the union of acetic acid with a suitable base, as soda, zinc, etc., are termed acetates, and are very soluble in water. Vinegar should contain 5.41 per cent of acetic acid, which, when taken, excites an alkaline secretion in all the glands of the body, destroys all disease germs, is a refrigerant, diuretic, in doses from one dram upwards. Added to water, of great efficacy as a sponge bath in all fevers twice daily; passes freely by endosmosis into the blood, increasing its alka- line constituents. Besides, it is a bactericide of some value in sore throat ; a valuable lotion in burns, sprains, bruises ; ex- cellent as an eye lotion when lime has found access to it. ACIDS. — A numerous class of chemical bodies which have the property of uniting with bases to form salts. They have a great affinity for, and are soluble in, water. They have a sour taste, and turn most vegetable blues, such as litmus, red. Oxyacids are those containing oxygen. Hydracids are formed by hydrogen. Anhydrous acids contain no water. Mineral acids are those formed from the mineral kingdom. Organic acids contain carbon, and are formed from the organic king- dom. The syllables ous and ic, which are affixed to acid com- pounds, denote different acids which vary only in the amount of oxygen in each. Thus sulphun'c acid contains more oxygen than sulphured acid. The principal acids used in medicine are acetic, hydrochloric, nitric, sulphuric, phosphoric, nitro- hydrochloric, citric, trataric. benzoic, carbolic, and salicylic io Twentieth Century Practice. acids. In concentrated form acids are mostly caustic. In medicinal doses they diminish acid and increase alkaline secre- tions. Hence their utility in the treatment of disease. Benzoic acid, in 30-grain doses, repeated at proper intervals, annihilates the micrococcus urea. Carbolic acid, a powerful bactericide, must be used with great care, as it is prone to paralyze the heart, the respiratory centres, and cause embolism of the blood. Chromic acid, never used internally; excellent as a painless caustic to destroy warts, piles. Never use over a large area of surface, as there is liability of absorption into the blood, giv- ing rise to inflammation of the liver and stomach and speedy death. As a lotion for painting ulcers, 5 to 10 grains to the ounce of water. The acid explodes if brought in contact with alcohol, glycerin. Lactic acid, strong; good for painting on in cancer of the neck of the uterus. The dilute acid given in dyspepsia in form of a lemonade, a few drops to sweeten the water. Nitric acid. — Muriatic and nitric acids are of great value in blood and liver diseases. ACHOLIA. — A suppression of the secretion of bile. A symptom of paralysis of the liver, due to the toxin of the ma- larial parasite, of the common bacillus, fungus of yellow fever, poisons of mercury and alcohol — inhalation of sewer gas. Give periodate aurum, under and on the tongue, small but fre- quent doses, till relieved. ACNE. — A chronic skin disease in which the sebaceous glands are affected; four different varieties are recognized: acne punctata, the mildest form, sebum is retained ; being unable to escape, an elevation is formed, the tip of which is marked by a black spot, indicating the opening of the follicle. As a result of irritation inflammation may occur, causing thickening in- duration of the follicles, and when this takes place it is termed acne indurata; inflammation still more severe, suppuration may take place — acne pustulatum. These three varieties are com- mon among young people of both sexes on face, neck, cheek, back. The fourth variety, acne rosacea, or grog blossom^ occurs on the nose, tips of cheeks and adjacent parts, characterized by an increased formation of connective tissue, very vascular, in- tensely red, and caused by derangements of the digestive organs. Twentieth Century Practice. ii In the treatment, nutritious, but non-carbonaceous food; keep bowels open with kola nut paste; daily bathing. Ozone tablets are excellent alternated with 15-drop doses of ozonized tine, lycopodium three times a day. Two of the best remedies ever introduced for the purpose of rousing the sebaceous fol- licles into healthy action. Local remedies. — Jelly of violets excellent to get rid of thickening pustules; two grains of bichloride of mercury to one ounce of ozone ointment is also of efficacy; salicylate of soda ointment; one ounce of lactic acid, c. p., to half pint rose water. Another form is, lemon juice, 2 ounces; powdered borax, 50 grains ; 60 grains sugar ; 5 drops of formalin ; mix. Before any local application is applied the face should be washed with hot water. ACONITE (Folia et Radix). — A mother tincture of either the leaves or the root, very valuable as a cerebral and arterial sedative in all fevers and inflammations, especially if the heart be weak, and there be obstruction to the circulation of the blood. Dose. — 5 to 10 drops to 4 ounces of water, a teaspoonful of this dilution every hour, or more frequent, till the skin be- comes moist and temperature lowers. ACTINOMYCOSIS OR RAY FUNGUS.— Throughout various sections of the country this malady has prevailed in an epidemic form. What is it? A pathogenic microbe which originates chiefly among cows, in particular pastures, in which the fodder is rough, sharp, causing an abrasion in the mouth, hence it is usually found upon the tongue and mucous mem- brane. In this crack, or breach, the evolution of this bacillus takes place, and then propagates itself by contagion and infec- tion. It is not conceded that the flesh of the cow causes the infec- tion, for the microbe is destroyed the moment it is immersed in water or even very slightly cooked. Milk of the infected ani- mal is the chief means of communicating the microbe to man. In the human being it has a special affinity to localize in the mouth, either in the mucous membrane through some erosion, or in the exposed pulp of a carious tooth. Once located, it soon enters the blood, and then its select location is the lungs, liver, blood-forming glands. Once the microbe is in the mouth it is readily communicated by kissing, by the dental forceps, 12 Twentieth Century Practice. then if not killed it sets up irritation, inflammation, in which a fungous growth is formed, made up of round cells, which may- break down or go on, increasing in size, forming nodules, with fibrous growths between. The nodules by and by become ex- cavations or cavities, abscesses rilled with purulent, germ-laden matter ; if the germ does not find an abiding place in the mouth, it selects the lungs, where it produces great havoc, destroying their substance, giving rise to fetid expectoration, exhausting sweats. The liver, pink marrow, lymphatics, tonsils, often be- come invaded by the fungus. The microscopical appearances, with a power of two hundred and fifty diameters, are rosettes of pyriform or club-shaped masses, which are arborescent, pure white or of a yellowish hue. The microbe is pathogenic of the malady, bears cultivation well in blood-serum or beef- tea. Cultures injected hypoderm- ically into any mammalia give us the disease in twenty-four hours. Those usually affected with it are butchers, milkmen, cattle- dealers, goat-milk consumers, and frequenters of dental offices. Before any remedies are applied, all abscesses should be freely opened, and counter openings made, so that the bactericide can reach the microbial nest. Then select either peroxide of hy- drogen, or a solution of boroglyceride, or anti-microbe powder, or salicylate of soda, or tincture of siegesbeckie — these should be used freely. There is little doubt, whether located in the oral cavity or the lungs, the best remedy for internal administration is the sul- phide of calcium, one grain every hour; as symptoms ameli- orate less frequently. ACUPRESSURE — A means of arresting hemorrhage from a cut artery by passing a needle or pin under the artery, and producing pressure by means of a ligature passed in the form of a figure-8 fashion from one end of the needle to the other. It is of great utility, whenever disease of the coats of a vessel is suspected, such as exists in arteriosclerosis, thick- ening, hardening, and other senile changes. ACUPUNCTURE.— A method of local stimulation or counter-irritation, which has been extensively practiced. It consists essentially in the formation of a group of either steel, silver, or gold needles, arranged on a block, which are brought down upon the part to be stimulated, repeated all over the af- Twentieth Century Practice. 13 fected area. It must never be used over any bony projection, never to the depth of drawing blood. The instrument dotted over with needles is sometimes used to conduct electricity into the parts, but better still is the application of the oil of mustard over the points of penetration. The treatment has been of spe- cial advantage in spinal irritation, sciatica, ataxia, neuralgia. ACROMEGALY. — This is a hyperplasia of the most diverse kind, first seen in the bones, brain, nerves, with altera- tions in the thyroid and thymus, characterized by widespread tissue growth. The etiology of the malady is still in doubt. There is an irri- tation; whether it be chemical or bacteriological, or some tro- pho-neurotic influence from a degenerated brain, diseased nerves, chaotic, sympathetic, or some chemical agent irritating the tissue, it is impossible to say. Many justly believe it to be a morbid state of the thyroid — a vitiated sensation. The initial symptoms, which either precede or accompany the enlargement of the extremities and head, are debility, nerve tire, drowsiness, headache, severe attacks of migrain, pain throughout the entire body, but the most striking symptom in all cases is the advancing enlargement of the extremities — the colossal development of the hands and feet — legs and fore- arms, in the regions of the wrists and ankles. It may be sym- metrical all over, or one half of the body clear down may only partake of the enlargement, or it may be confined to the feet, or some other part. In an examination of the bones, the enlargement is found to be an overgrowth of the bones, especially in their breadth and thickness. In addition to those bones enumerated, bones of the face, lower jaw, cheek, and with them other tissue, such as en- largement of the under lip, nose, tongue; sometimes the ear, eyelids, larynx ; more rarely thickening of the femur, humerus, scapula, ribs. The progres of the malady is slow, stationary for decades. Many bony diseases resemble acromegaly superficially, but it must be borne in mind that in acromegaly there is no deform- ity of joints, no tenderness, no grating, no exudate. No remedy, so far available, but alteratives, tonics, a con- structive course of treatment in which the glycerin extract of the lamb plays an important part, usually relieves the weakness and nervousness. 34 Twentieth Century Practice. ADHESION. — A result of inflammatory action, of effusion of plastic lymph from the blood, by which parts of the body, naturally separated, become united, or adherent to each other. All the various structures of the body are thus, if severed, capable of being united or repaired. Undesirable adhesions often take place in the serous membranes, in pleurisy, peri- tonitis, pericarditis, membranes of the brain. In synovial membranes, which line joints, especially in chronic rheumatism, giving rise to partial or complete ankylosis. In the ligation of blood-vessels, or acupressure, the internal coats of the artery unite by adhesion. Nerves will unite, if placed in perfect apposition, both motion and sensation be re- stored, and the sheath of a nerve often unites with the nerve itself in sciatica. Mucous membranes will unite, if lacerated or torn. The skin, if all foreign bodies be removed and perfect apposition maintained ; raw surfaces, if kept in contact, as in burns of the fingers, often adhere. Adhesion of bones takes place under perfect apposition and rest. Adhesions give rise to deformities and are the cause of much chronic disease of vital organs, as brain, lungs, heart. When it is desirable to get an effusion of lymph for repair of tissue, keep vital force normal by diet, bathing/fest, blood vital- izes ; when effusion of lymph is not the aim, stimulate the parts more actively, so as to induce leukocytosis. The treatment of adhesions in joints requires great tact, good judgment, and a long, persevering use of comp. saxifraga. ADENITIS. — Inflammation of the lymphatic glands. Its etiology is either some toxin in the blood or some local irri- tation — the former embraces the absorption of septic matter, toxins of disease germs, the debris of bacterial growth, such as the toxins of tubercle, syphilis, cancer, bubonic plague, etc. ; the latter local irritation. Treatment. — It may be advisable in some cases to hasten sup- puration, with either frequently changed lye poultices, until it points, or, in other words, until the lympth in which the toxins are effused breaks down entirely, and the skin ruptures, its con- tents escape, or make free crucial incisions into it, which can be adopted. Peroxide of hydrogen will play an important part as a local remedy, while echinacea or other antiseptics internally. A constitutional course should be adopted based on the pro- ducing cause. Twentieth Century Practice. 15 ADENOMA. — Pseudo-leucocythaemia is a peculiar disease of the blood, like leucocythsemia dependent upon an enlarge- ment or hypertrophy of lymphatic glands ; glands of neck, ax- illa, groin symmetrically enlarged, not inflamed or fused to- gether; thoracic and abdominal glands also affected. Patient becomes weak, loses flesh, soon out of breath on exertion, symp- toms of pressure at base of chest or abdomen, gradually increas- ing debility. It is also called Hodgkin's disease. It is well known that the lymphatics preside over or are car- riers of nutrition or lymph, but how they influence the blood in the production of white cells is unknown. The spleen, lymphatics, mesentery, suprarenal capsules, and the pink mar- row of the bones constitute the great lymph channels ; in each or all of them when obstructed, damaged or diseased, there is the prevailing characteristic cropping out — excess of white cor- puscles. Alterative and tonics should be persevered with. ADIPOSE TISSUE. — There are drugs, when properly ad- ministered, of real merit in the removal of superfluous fat from the human body; we enumerate the two leading remedies, namely, the ozonized juice or succus of the ripe phytolacca ber- ries and the ozonized extract of fucus vesiculosus, both excel- lent alteratives, inimical and destructive to adipose tissue, and still both remedies fail in certain cases. When there is a decided failure of action of either or both those remedies in obesity, close observation will show that there is a cirrosed liver as the cause, a liver that is either blighted with alcohol or malaria, or degenerated by mercury or syphilis ; remove this condition by the proper remedies, and all will go well. In the selection of the pokeberry juice, it must be genuine ozonized, no patent nostrum in which mercurials are loaded up. The juice of the phytolacca berries need no adjuvant to aid their action in wiping out adipose tissue. The fucus vesiculosus must also be well guarded, the ozo- nized extract must be selected and administered in such doses as to affect the liver ; then it will soon be visible, a disappearance of all superabundant matter. To be effective, it must be pre- pared from the fresh bladder wrack, and its properties extracted by a special menstruum. If either of the two remedies do not act promptly, take it for granted that there is either a sluggish or indurated liver, and 1 6 Twentieth Century Practice. administer from five to ten grains of the periodate aurum every other night; this aids matters materially at all events; it is worthy of a trial in all cases in which non-success has followed the original treatment. The ozonized extract of the thyroid gland is one of the most effective, most reliable of all anti-fat remedies; it has a most powerful influence in reducing adipose tissue. AIR. — The atmosphere which surrounds the globe on which we dwell, and extends to a height of about forty-five miles, con- sists of a mixture of oxygen and nitrogen in the following pro- portions : by volume, 21 of oxygen to 79 of nitrogen ; by weight, 23 of oxygen to 77 of nitrogen. Although oxygen and ni- trogen make up the bulk of the atmosphere, yet small quantities of other substances may be present; some of these are impuri- ties, whilst others are useful constituents. The other useful constituents of the air besides oxygen and nitrogen are water (in the shape of aqueous vapor, clouds, or mists), carbonic acid gas, and ozone. The impurities which may exist in the air in small quantities are nitrogen tetroxide, nitric acid, sul- phur dioxide, sulphurous and sulphuric acids, chlorine, sul- phuretted hydrogen, carbonic acid gas (in excess), soot, fun- goid, and bacterial micro-organisms. The ox)^gen of the air supports combustion and animal life. The nitrogen is only- useful as a diluent of the oxygen. If it were not present ani- mals would live too fast and would soon die. The carbonic acid gas is useful, for on its presence the life of plants depends. When in excess, however, it becomes a dangerous impurity, not so much from its own poisonous properties as from the fact that it affords an index of the amount of highly poisonous effete organic material which is present. Thus air containing .04 per cent of carbonic acid gas is pure, but if the quantity amounts to .06 per cent the air becomes stuffy and foul because of the putrefiable organic matter excreted from the lungs with the carbonic acid gas. Ozone does not, as a rule, exist in towns, and is found in greatest amount near the sea. The im- purities of air are chiefly derived from the combustion of fuel, from chemical works and sewer gas. The inhabitants of our large cities are often the victims of inhaling sewer gas, owing to some sanitary defect, deficient connection or crumbling of pipes, permitting sewage and its deadly microbic emanations to permeate the earth. In sewage there is to be found every pathogenic and non- Twentieth Century Practice. 17 pathogenic germ, the gases from which the most toxical agents can be isolated. The denizens of all our cities breathe these poisons; conse- quently none are well. Every man, woman and child com- plains of languor, lassitude, debility, headache, stiffness in the joints, bad odor of the breath, and coated tongue. Our popu- lation feel aged ; our city physicians call this malaria, whereas it is sewer-gas poisoning. Feeble women, more dilapidated children, often succumb to its influence, die from its effects. Quite a number of deaths can be traced to this source. They die with all the symptoms of blood poisoning, symptoms peculiar to itself, neither present nor described as existing in any other disease. The microbicide from which the most signal benefit can be derived is ozone water, that great scavenger to diseased, germ- laden blood. The dose is two drams to one tumberful of water, of which one tablespoonful is given at intervals, half an hour apart. Its effects upon all cases are marvelous. Under it, pain in the head, back and calves disappears, tongue cleaned, temperature and pulse subside; every symptom yields to its magical power, besides it exerts a renewal of life in every structure. For sewer-gas poisoning, ozone water is superior to peroxide of hydrogen or any other remedy, and it would be prudent for any physician in a city to keep it in all the families over which he presides, as their guardian angel of health. Under the influence of protonuclein. my patients made an excellent and rapid recovery. ALBINOS. — A term applied to individuals who have a white skin, with white or yellowish white hair, the iris very pale, bordering on red, and the eyes so sensitive to light that they cannot bear daylight. The condition is congenital, and is common among all races of men. As a rule, there is a great lack of mentality. Cause unknown. ALBUMINURIA. — The presence of albumin in the urine may be either temporary or permanent ; the former, when due to either the toxins of disease germs, or the microbes themselves passing through the kidneys, which is invariably the case in scarlet fever, erysipelas, smallpox, cholera, typhoid fever, pneumonia, etc. ; the latter, in all pathological states of the kidney, as chronic inflammation, diabetes, cardiac disease, tu- berculosis and cancer. 1 8 Twentieth Century Practice. The best method to detect albumin in the urine is to boil it, add nitric acid to it, which will coagulate all the albumin. If due to the presence of disease germs and their toxins in the kidney, administer nitrite of sodium, with large doses of passiflora; if due to degenerative changes (Bright), celery comp., nitroglycerin and protonuclein ; if due to the glucose fungus, jambul and peroxide of hydrogen; if due to cardiac disease, digitalis and creatinin ; if due to the bacillus tubercle, saturate the system with guaiacol ; if to the cancer neoplasm, Chian turpentine mistura. ALCOHOL. — A colorless liquid obtained by the distillation of fermented saccharine liquids. It is pungent to the taste and smell, is very inflammable, burning without smoke, and is miscible with water in all proportions. It possesses great solvent properties, particularly with regard to resinous sub- stances. It is, therefore, used largely in medicine in the prepa- ration of drugs, as in tinctures and alcoholic extracts. There are a large number of alcohols known to chemists, but that generally referred to under the name alcohol is ethylic alcohol. ALCOHOLISM. — A disease, or rather a series of diseases, caused by the use and abuse of alcoholic drinks. Its ordinary course is to give rise first to digestive disorders, morning sickness, nausea, vomiting, loss of appetite — troubles of mo- tility, muscular debility, cramps — then nervous affections, in- somnia, hallucinations, paralysis, idiocy, epilepsy — mental and moral derangement, loss of memory and will-power, an abro- gation or at least a diminution of the moral sense. All drugs have a primary and secondary action, but here the nervous system is primarily affected, and a better division is acute and chronic. In the acute, symptoms immediately or soon after the ingestion of the alcohol, ordinary beastly drunk- enness ; mental states closely allied to hysteria ; apoplectic form, comatose condition, frequently terminating fatally. Alcoholic libations carried to inebriation act with energy on the nerves of special sense : vision is dimmed ; hearing blunted ; anesthesia sets in, the reflexes are palsied, and ataxia of the voluntary muscles follow, want of muscular control, usually followed by unconsciousness. In the chronic there are a larger number of victims at- tacked; its effects are widespread, not only on the individual, but his familv, societv, civilization are affected by it. He im- Twentieth Century Practice. 19 plants degeneracy on himself and offsprings ; he takes in the nation as a type of physical and moral degeneracy ; diminished mental power, vertigo, all sorts of mental disorders, involun- tary oscillation of body when standing, difficulties in walking ; stuttering; lack of co-ordination of muscular movement, a general diminution of strength and muscular contractility. The daily use of alcohol anticipates age ; in the drunkard as in the aged we have atrophy of the brain, an increase of the cerebro-spinal fluid — fatty degeneration of blood-vessels, of heart-muscle, of liver and kidneys ; dilatation of the pulmonary air cells (emphysema) ; ossification of the costal and laryngeal cartilages. A rarefaction of bony substance, in which adipose tissue enters its place. Degeneracy does not disappear with the drunkard; he en- grafts it on his children in the idiocy of alcoholic conception — diseases of a lower type, suicides, madness, crime, epilepsy. In the chronic form the drink habit is acquired and other changes in the nervous system of great importance. The first action of alcohol is to stimulate the circulation and brain; it borrows from the vital resources a sufficient amount of force to make a display of apparent strength, but at a great cost to the organism, and a too frequent repetition of the draft must eventuate in physical bankruptcy. But, unfortunately, the very process which enables a man to make this display of seem- ing health and energy soon destroys his ability to correctly gauge his vital reserve, and the neurotic taint, sole inheritance of many, clamors more and more violently for the stimulant which shall make its unfortunate possessor the momentary peer of any man. The inception of the drink habit is the first step in the process of mental, moral, and physical suicide; and the physician has faulty judgment who recommends alcohol in any form. The quality and composition of the alcohol the peculiar bev- erage, constitute an eminently variable factor in the kind and quality of the degenerative changes induced. Alcohol is not a food, but a poison, an arrester of normal metamorphosis. It never assists in building up tissue. It is fal- lacious to suppose that even small doses are not injurious, even small it diminishes vital power, renders the user unfit for the struggle of life. Its direct action is cell death, liver cirrhosis — heart and kidney disease exerts its most baneful influence on vital organs — paralyzes nerves, deranges all functions, spoils temper, shortens life. 20 Twentieth Century Practice. In all persons addicted to the use of alcohol, the brain be- comes indurated and anemic, and persistent insomnia sets in, A very satisfactory prescription to give in all cases of acute alcoholism is the following, which meets nicely all the indica- tions: Passiflora, ozonized, two ounces; one ounce tincture capsicum ; half an ounce of green root tincture gelsemium ; half an ounce of chloral hydrate, and the same quantity of bromide of potassa. Mix, administer in small doses. Note effects, and continue, guided by indications and susceptibility. Shortly after taking a few doses, patient becomes very quiet and falls into a restful sleep, which usually lasts a considerable time. As soon as he wakes up, the prescription can be again continued, as it is of special value in all cases of cerebral ansemia, regardless of cause. Small and oft-repeated doses are best in making an inroad upon the pathological condition. As soon as the mania passes off, give kephalin and oats, administered in the form of granules, one thrice daily. Owing to their selective affinity for the nerve cells of man, have proved of inestimable value. The use of alcohol in the parents arrests normal metamor- phosis, and racial progress; if it does not create deaf-mutism, idiocy in the offspring ; it gives a tendency, an impetus to neu- rotic affections, nerve disease of a brain type. One of the numerous actions of alcohol is to increase the serum of the blood, which hinders the growth of germs and has a direct inhibitory action upon all bacteria ; and this is de- pendent upon the quantity and quality of the albumin in it. It is the main factor, the salts only serving to keep it in good con- dition. Germs in the blood of an inebriate are never active, but as a rule seek privacy in his liver, spleen and marrow of bones. The administration of the thyroid extract to the drunkard is a failure, but give it to his feeble-minded, deformed, idiotic, deaf-mute, myxedematous offspring, its use is invariably at- tended with a perfect restoration to health. ALCOHOL A POISON. — Neurologists agree that the hab- itual use of alcohol in its various forms is the chief cause in the production of nervous diseases, such as neuralgia, neuritis, epi- lepsy, spinal sclerosis, idiocy, insanity. The constant use of whisky, brandy, wine, beer or other spirituous beverages, causes first a chronic congestion and irritability of all the organs, fol- lowed by inflammatory thickening and gradual loss of function. Even the moderate drinker cannot wholly escape. A single Twentieth Century Practice. 21 daily glass of whisky taken for some years will, as a man grows older, bring about a renal and vesical irritability with prostatic congestion, which might have been avoided by total abstinence. It is a mistake to suppose that as a man ages he must necessarily suffer from too frequent and difficult micturition. Nine times out of ten the trouble is due to the habitual, if temperate, use of alcoholic liquors. The evil effects of alcoholic drinks are chiefly manifested in the nervous system and the kidneys, although every tissue in the body is more or less injured. It has been figured that, if the use of alcohol in the form of artificial stimulants were entirely abandoned, the life of the race would advance at least thirty years. There is no especial benefit to be derived from even the me- dicinal use of alcohol which can counteract its disadvantages. We have other stimulants, such as nitroglycerin, strychnia, atropia, capsicum, etc., which give the desired results and can be discontinued at our pleasure. Alcohol is not a necessity for old people. It may warm them up and increase appetite tem- porarily, but there are other drugs which will do the same, thing, and in the long run alcohol makes the condition of the aged less tolerable. Alcohol is not a necessity. It is not a desirable remedy. It is chiefly responsible for the physical degeneracy of the race. Its use often develops an appetite which, in many persons, be- comes an insatiable craving. Its place in our materia medica is readily taken by other less dangerous drugs, and the physi- cain has no legitimate excuse to prescribe alcoholic stimulants. Not only should he taboo the use of alcohol, but he should ex- ert himself to educate people concerning the irremediable physi- cal damage which it causes. Most men are willing to do right, once they are made to clearly see it, and it is part of the physician's duty to show them the vital importance of absti- nence. Alcohol should never be used in medicine except as a medium to hold drugs in solution. It is the best solvent yet known for the active principles of plant remedies, and medi- cated tablets do not give the same satisfactory results obtained from fluid preparations, but the amount of alcohol thus con- sumed is so small and so soon discontinued, it produces no ap- preciable ill effect. While we do not believe that there is ever a real need for the use of alcoholic stimulants, yet, we understand that prohibition 22 Twentieth Century Practice. will never be successful in abolishing alcohol. People must first be convinced that it is a curse to them and to posterity; then and then only will they let it alone. 1. Alcohol acts primarily on the nerve cells, changing their granular matter, breaking up their nutrition and changing their dynamic force. 2. This action is followed by contraction of the dentrites, swelling and atrophy of these fibres, also shrinking of cell walls, as in fatigue, and coalescing and disappearance of the granular matter of protoplasm. 3. The special injury from alcohol seems to be on protoplasm and terminal fibres of nerve trunks. The irritation and inflam- mation of the nerve walls and fibres ending in slorosis are common. 4. Alcohol acts on the leukocytes of the blood, checking their activity, and destroying their function. These are driven in masses by the increasing rapidity of the heart, and become blocked up in the capillaries, forming centres of obstruction and injury. 5. The use of alcohol is found to be followed by diminution of the carbon dioxide and all waste elimination, with a marked sensorial palsy of the senses, and a slowing up of all the mental operations. These are the results of measurements with in- struments of precision, and cannot be mistaken. 6. The action of alcohol in the light of modern research dif- fers widely from the theories and current beliefs of the day. ALKALI. — A class of chemical substances which are recog- nized by the following properties : They unite with acids with avidity, thus forming salts; they do not turn litmus blue into red, but will change reddened litmus back to its former color. Most of them have acrid, caustic properties. The most import- ant alkalies used in medicine are caustic soda and potash, with their carbonates, bicarbonates, acetates, and citrates ; ammonia, and magnesia, with their numerous preparations. Taken in- ternally, they have the power of checking alkaline secretions, and stimulating or increasing acid secretions. They produce their effect either indirectly through the blood, or directly by their action on the mucous membranes. When used to coun- teract the acidity of the contents of the stomach, they receive the name antacids. — Their constant use is injurious. Twentieth Century Practice. 23 ALKALOIDS. — Certain chemical bodies, active principles extracted from vegetable substances, which form salts when combined with acids. They are generally crystalline. Alkaloids, and their salts, are the most powerful medicinal agents we possess with which to combat morbid action, as the smallest fraction of a grain taken internally, or applied locally, produces marked physiological results. They are all violent poisons, sparingly soluble in water, but more so in dilute acids and alcohol. Alkaloids, animal, from decomposing tissue, cadaveric, are even more deadly poisons than those extracted from the vege- table kingdom. Some physicians claim that all the virtue of a drug resides in its alkaloid ; others that the crude drug contains its real medicinal properties. Both are right. The crude drug and the alkaloid have different indications, and cannot be successfully exchanged. Take cinchona — Peruvian bark — for example. A tincture, or infusion of this bark, is the finest all-round tonic in the ma- teria medica, but its antiperiodic powers are feeble. On the other hand, quinine — the alkaloid of cinchona — is a powerful antiperiodic, but an inferior tonic. Opium is another illustration of the variance between alka- loids and the crude drug. The combination of tinctures, opium and ipecac, is a much better diaphoretic than morphia and ipecac, although morphia acts more quickly as a pain-re- lieving agent. Apomorphia is another derivative of opium, having a distinctive field of its own, widely different from both morphia and opium. Nux vomica and strychnia cannot be used interchangeably without a loss of some of the subtlest properties of the drug. Tincture of nux vomica gives most satisfaction in atonic con- ( ditions of the digestive organs, while strychnine exerts its in- fluence upon respiration and the cerebrospinal system generally, erally. Aletris is the best remedy known in the treatment of female troubles, but aletrin has proved disappointing. Neither does gelsemin give the prompt and decided effects produced by a good green root tincture of gelsemium. ALIMENTATION.— The stomach, with its thirty-two feet of intestines, is an evolutional body. Man is in a great measure what his digestive organism makes him, as this has much to do with the development of both mind and body. 24 Twentieth Century Practice. Adulterated food, the origin, growth and use of which is do- ing much to depreciate the modern man, was unknown to our forefathers. Primitive man was strong, full of vital power, commanding in stature, and lived to a good old age, untroubled by tuberculosis, appendicitis, nervous prostration, toothache, headache, locomotor-ataxia, and a thousand other ills which shorten his life to-day. Every indication goes to show that while the race has been gradually advancing in knowledge and experience, it has just as surely been degenerating physically. It is generally admitted that all the tissues of the body are elaborated from food eaten, and it is well known that for the past one hundred years our people do not eat the proper kind of food to make the best brain and blood. They are ig- norant of nutrition and assimilation ; they have cultivated and created abnormal tastes ; demoralized natural instincts. Intellect is a cerebral secretion ; it is the function of the brain to secrete it. The activity of the secretion depends upon the soundness of the organ and the character of the blood that supplies it ; the quality of the blood is determined by the food eaten, the nature and extent of its assimilation. In other words, a man is what his stomach makes him. Certain foods are introduced; from these tissues are manufactured. If the nutrition is bad, mal-assimilation ; his body is full of ptomains ; his brain secretes an inferior quality of mind, and he transmits both a physical and mental constitution weaker than his own. If he does not eat enough, if the food is not nutritious, does not supply the proper elements, he may become anemic, im- poverished in brain and blood. Food either excessively stimulates, or, in excess, modifies character. Animal food gives rise to a dangerous accumula- tion of uric acid in the body. Appetite, food, digestion, modifies races, as we see in the Anglo-Saxon, on his diet, an aggressive race; in the Mon- golian, on his rice diet, with lack of energy, enterprise. Let us, by the use of good food, provide an inheritance of blood and brain for the coming race ; better conditions for the whole human family by recognizing the evolutional power of the stomach. . Diet in dyspepsia and indigestion should be limited only temporarily or to a slight degree. It is proper enough to for- bid such beverages as tea and coffee, which are positively, though mildly toxic, and such achievements of culinary art as cakes, pastry and heavy vegetables, which scarcely deserve the Twentieth Century Practice. 25 name of food. But almost all patients need some warm bev- erage, fruit, sugar, a variety of meats, breadstuffs, and con- centrated vegetable nourisment. Chocolate with milk, cocoa chips, or some of the cereal sub- stitutes for coffee may be allowed as beverages. As to fruits, a good general rule is to forbid the patient to swallow anything of the nature of skin, core, or seed — with the possible exception of grapes, which are not palatable if the outer sweet coating is penetrated — but to allow a moderate quantity of the pulp or juice of any fruit desired, after meals. In the selection of meats, we naturally turn first to beef, but idiosyncrasies must be respected. Some persons relish lamb, others poultry, a few even pork, better than beef. In con- ditions of true subacidity — the common cause or result of almost all cases of dyspepsia, whether organic or functional — there is at least a theoretical indication for sodium chloride and some antiseptic, which may be fulfilled by giving salted and smoked meats. Ham — crisp, not soggy — salt pork, raw salt codfish, perhaps slightly toasted, halibut, etc., may be proper food, though not so quickly digested as fresh meats. It is wise, whenever the patient is well enough to have his impressions and experiences considered, to ask him as to likes and dislikes, to be guided by his appetites and by his antipa- thies, to explain what foods he may take and why he may not take others, yet always to leave as wide a choice as possible, and even if the staple must remain the same, to vary the flavor from one meal to the next. AMYL NITRITE. — Two to five drops inhaled is a power- ful cardiac stimulant, reducing the blood pressure, by dilating the blood-vessels, increasing the heart's action. Its use affords instantaneous relief in that terrible, agonizing spasm of the heart known as agina pectoris. It is also frequently of great efficacy in epilepsy, asthma, seasickness, convulsions, headache, gout. The nitrite of sodium has the same action — dilates all the blood-vessels, relieves the heart. Nitrite of glycerin has precisely the same properties, and in the form of a suppository gives immediate and wonderful re* lief in headache, epilepsy, asthma, seasickness, convulsions. ALIMENTARY CANAL.— The intestinal tract is the habitat of an incredible number of bacteria and fungi, elab- 26 Twentieth Century Practice. orated in the process of food disintegration, which, if there be a passage of the bowels every twenty-four hours, no untoward result takes place, but if there be retention over that period functional disturbance of the intestines is excited by the toxic products present, and by and by these toxins begin to affect the nervous system. Habitual constipation, with its prodigious growth of germs and toxins, is liable to give rise to headache, insomnia, hal- lucinations, and a certain form of insanity is the direct outcome of the absorption of those poisons. A retention, therefore, of the contents of the bowels gives rise to auto-intoxication and grave central nervous trouble. This is especially true if there be any pathogenic microbes in the blood, such as tubercle, syphilis, and cancer. If there exists either temporary or habitual inertia of the in- testines, it should be promptly overcome by some remedy that will destroy the bacteria, neutralize their toxins, increase per- istaltic action, at the same time strengthen and vitalize the towels. This remedy we have in an extract prepared from the kola nut, which is an invigorator of the nervous system, imparting special tonicity to the bowels. The practice of prescribing glycerin, either orally or by the rectum in suppository form, is a grave mistake, as the dail use of glycerin exhausts both the mucous and serous coats of the bowels, and is productive of cancer. The kola nut extract, paste or lozenge, is the best remedy we have for habitual constipation. No other therapeutic agent can compare with it. ANIMAL EXTRACTS.— Of all the animal extracts, there are three never-failing in their action, that is, the ozonized ex- tract of the thyroid gland of the lamb, kephalin and c. p. solu- tion of spermin — all others are of doubtful utility. The thyroid extract favors growth, development, perfection in construction, and repair; whereas the c. p. solution of spermin possesses an elective action upon the nutrition of the nervous system and is of the utmost efficacy in all forms of nervous exhaustion. The vitality which it increases, animates into healthy activity, accelerates all vital functions and even stays the sclerosis of ataxia. Administered in all diseases of the nervous system, the af- flicted individual soon complains of less vertigo, headache and Twentieth Century Practice. 27 insomnia; less muscular and mental fatigue, or rather it eradi- cates neurasthenia. Administered in diabetes, the general condition improves rapidly, the quantity of glucose diminishes, often disappears, the general health greatly benefited. Anemia, chlorosis, chronic gout and rheumatism, pulmonary, tuberculosis, senility are greatly benefited by its fertilization of the central nervous system. Its action is unequal in all cases of impotency and sterility. Kephalin, as a vital constructor, is a powerful remedy for toning up the brain and preventing senility. In the hands of a careful practitioner, a judicious adminis- tration of these two extracts will promote a higher type of man- hood and the cure of very many nervous diseases. ANTIDOTES. — Medicines which either relieve or counter- act or annihilate the symptoms produced by poisons. They may be chemical, either counteracting, or neutralizing, or alter- ing the nature of the poison, forming a harmless compound with it ; or physiological, wiping out its physiological action ; or vital \ stamping out the poison, in the progress of morbid action. ALOPECTA. — Baldness more or less complete.- The mi- croscope shows that the hair is developed from the skin, and may be regarded (with the nails) as appendages to it. Even- hair consists of two parts, a root and shaft. The shaft is cylin- drical and is covered by an outer layer of overlapping scales, which project over each other, like slates on a roof, the project- ing edges looking upwards. The main substance of the hair consists of fibres, or elongated cells, packed closely together, whilst in the coarser hairs of the body the centre is occupied by the medulla, or pith, which is made up of small angular cells, granules of fat, and coloring matter. The root of the hair swells into a knob, and is received in a recess in the skin which is called a hair-follicle. The hair-follicles consist of two coats, an outer or dermic coat, continuous with the deep layers of the skin, and an inner, which is continuous with the superficial layers of the skin, and is called the root-sheath. When the hair is pulled out, the root-sheath comes away with it — hence its name. The outer coat is made up of three layers: (a) formed of connective tissue, blood-vessels, and nerves; (b) corpuscles in a fibrous matrix ; (c) an inner homogeneous mem- brane. The inner coat or root-sheath has two lavers, the inner 28 Twentieth Century Practice. and outer root-sheath. The outer of these is made up of large cells and is thicker than the other ; it corresponds to the deepest layer of the epidermis (rete mucosum). The inner root- sheath corresponds to the outer horny layer of the skin. The bulbous root of the hair fits on to a papilla. The papilla is at the bottom of the bulb. In addition each hair has a small muscle which connects the deep skin with the root of the hair. When this muscle contracts from cold, fright, or other causes, it gives rise to "goose-skin," or makes the hair "stand on end." It may also help in the excretion of sebaceous matter. In connection with each hair-follicle is a cluster of sacculated glands, which secrete fatty matters, and opens into the follicle by a small canal or duct. These are the sebaceous glands. The fatty matter they secrete lubricates the hairs. Occasionally, from various causes, the duct gets closed, and the sebaceous matter collects in the gland, thus enlarging it, and forming a sebaceous tumor. With regard to the chemical composition of hair. It is composed of albuminous and nitrogenous complex substances (keratin, etc.), and usually contains sulphur, which is said to be present in larger quantities in red hair. When burnt, the ash contains oxide of iron and manganese. The ash of white hair contains phosphate of magnesium and alumina. The hair is more resistant of decay than any tissue in the body. They may be an excessive growth, or a deficiency, or a falling off. Alopecia may be divided into four groups, atrophic or senile; structural; pigmentary ; parasitic. i. Senile or Atrophic. — Is not confined to the aged, but is too frequently met with among young men, masturbators, guilty of sexual excesses, suffering from spermatorrhea, the hair nutrition is drained off. It is often attributed to mental exertion, strain, worry, fret, wearing light hats. 2. Structural. — A perversion of the nutritive process going on in the hair, due to the presence of microbes in the blood and their toxins in the hair- follicles ; the microbes of typhoid fever, the bacillus of syphilis and tubercle are most toxical to their nutrition and growth. Usually it is not perma- nent; after recovery or elimination of the poison, the hair grows again. 3. Pigmentary. — Under this head alopecia areata is classed as due to nervous diseases, in which the root is atrophied and bulb absent. Twentieth Century Practice. 29 4/ Parasite. — A peculiar fungus often attacks the hair, gases form with its bulbs and sheath and the hair ruptures— in other cases the fungus attaches itself to the hair and un- sheaths it, causes it to become knotty. Tinea induces degen- erative changes. The general treatment of alopecia in all its different forms, to place the patient upon a course of alteratives, tonics, local stimulants, and a diet calculated to promote the nourishment of the hair. The best alteratives are comp. saxifraga; ozone tablets; periodate aurum. As tonics, comp. matricaria; kephalin, oats. As local stimulants one of the following hair lotions : Ozone Hair Restorer, Ozone Golden Tonic, etc. A very generous diet, especially oatmeal, which seems to have a remarkable influence in promoting the nutrition of the hair. ALETRIS FARINOSA.— The root of the Aletris farinosa, or star-grass, is a uterine tonic and restorative, and of unexcelled value in amenorrhea, dysmenorrhea and menor- rhagia, intrauterine catarrh, sterility, ulceration of neck of uterus; prevents miscarriage, renders labor painless, mitigates all the suffering at change of life. It is a remedy of priceless value to all ladies whose uterine system is dilapidated, and at the climacteric period of life. Preparation and Doses. — A wine, prepared from the re- cently coarsely ground root is the most eligible and definite preparation, in doses of one or two tablespoonfuls every three hours, or as indicated. All other preparations are worthless. So many and varied are the causes which give rise either to inertia, or weakness, or relaxation of the nerves and muscular fibres of the uterus, that there is in some cases a perfect in- ability to contract after labor has terminated. Imperfect contraction of the uterus in and during parturi- tion is the main factor in the production of septicaemia so called, but properly speaking the evolution of the microbe of puerperal fever. A devitalized or relaxed uterus, then, is the common predis- posing cause of microbic evolution — self-infection, as it favors the formation of clots in the uterus. The muscular fibres have not imparted to them the necessary nerve stimulant; they do not contract, as they should; they leave the mouths of the uterine sinuses open ; the denuded placental site, instead of 30 Twentieth Century Practice. being coated over with healthy lymph, is but a mass of deadly germs. Metria, then, or puerperal septicaemia, is a preventable affec- tion by simply keeping a thoroughly vitalized uterus. This is indispensable in all child-bearing women — they should see to it, that its vital integrity is in no way impaired. Every phy- sician who has prescribed the wine of the Aletris farinosa asserts that it is the greatest uterine restorative in the materia medica. ALUMEN.— Alum, astringent and bactericide. Useful in painter's colic, optthalmia, leukorrhea, etc. Two drams of alum boiled in a pint of milk, strained, ex- cellent eye wash. White of egg beat up in alum till it coagu- lates, a good remedy in inflammation of the eye. Various preserving fluids are made with alum ; used by bak- ers to whiten their bread ; it destroys the phosphates in the flour, hence the increase of rickets and premature loss of teeth from eating bakers' bread; burnt alum useful to destroy exuberant granulations. The sulphate powerfully antiseptic and astrin- gent. ALUMINUM (Aceto-Tartrate).— Dose: Local; a tea- spoonful of a fifty per cent solution to teaspoonful of water once and repeat. An antiseptic of great value, and the remedy occupies a prominent position in the cure of ozaena. A weak solution for syringing the nose. Its action is rapid and safe. In laryngeal phthisis it may be used by a vaporizer with great success. A three per cent solution of acetate of alumina is a powerful germicide and disinfectant. It is greatly to be pre- ferred to any other agent in surgical practice as it is efficient and free from all objections. It is inodorous, and it should be diluted with from two to five times its volume of water when used as an injection or by irrigation. It promptly destroys all disease germs on foul or gangrenous sores, and is one of the best antiseptic injections in puerperal septicaemia. Useful in some skin affections. AMAUROSIS. (Blindness). — One of the great misfor- tunes of the present age is impaired vision, which is becoming excessively common. Many cases are due to infantile oph- thalmia, some to the purulent form ever present in all large schools; others to the abnormal methods of teaching, which Twentieth Century Practice. * 31 first give rise to myopia, then to impaired vision. In more ad- vanced life, masturbation in both sexes, draining the nervo- vital fluid. Insanitary condition and deleterious trades are hurtful to healthy vision, also the toxins of disease germs. It must ever be remembered that the eye is but an optical in- strument through which the brain sees the external, and there are numerous conditions always existing which render the cerebrum inoperative, as anemia, congestion, poisons, reflex states, white softening, so that in the treatment of all cases of amaurosis a division must be made, conforming to one or other of the five causes that give rise to it. Loss of sight, at least what is termed amaurosis, more or less complete, then, is always due to some affection of the optic nerve, or of the brain, not to any lesion in the eye. If It Be Due to Anemia. — The most common causes of a want or imperfect vision from impoverished or deficiency of blood in the brain are hemorrhages, acute chronic diseases, long-continued lactation, imperfect nutrition, meagre or bad food. Removal of causes, generous diet, give abundance of fresh air, sunlight, rest, every constructive agent that is obtainable. Matricaria before meals; protonuclein and tonics. We have found the following very efficacious : Hydrastine and quinine sulphate; iron and hydrogen, of each one grain; extract of mix vomica, one-quarter of a grain. Mix; make one pill, which amount should be given three times a day. If Due to Congestion. — If from any cause there be a de- termination of blood to the brain, sufficient to obscure vision, the treatment must consist of rest in bed, head and shoulders elevated; cloths wrung out of hot water to the head; rollers saturated with mustard applied from toes to the knee ; dry cups to nape of neck and shoulders, over them a guaiacol plaster. Adminster veratrum viride a few drops added to water, every few minutes, till the pulse is at sixty, then at intervals of three hours. Causes must be removed, and then place patient on either a solution of spermin or kephalin granules to restore the integrity of the brain. If It Be Due to Reflex Causes, as we meet with fre- quently in the young, whose reflex centre is highly impressible, and the fact that the fibres of the optic nerve originate in the cervical portion of the spinal cord and pass through the medulla oblongata, renders the individual susceptible to impaired vision 32 Twentieth Century Practice. from worms, which should be promptly removed; from mas- turbation, which must be abandoned ; from gastric catarrh, the sarcinae must be annihilated ; from gall stones, which should be disintegrated by the administration of olive oil and matricaria. If It Be Due to the Action of Poisons or Toxins. We must ever remember that nearly all alkaloid remedies are- cerebral poisons. They are often prescribed, often injudiciously administered in morbid conditions, too frequently acting most disastrously on brain and optic nerve, such as atropia, quinine,, nicotine, etc., etc. Tobacco, although a sedative in itself, its alkaloidal principle, nicotine, is a cerebral irritant, and its habitual or excessive use interferes with the vasomotor centres of the brain to such an extent that the vessels fail to adjust themselves to a normal condition. The toxins of all disease-germs affect the brain, and with it the optic nerve. We witness their action in syphilis, diabetes,, typhoid, in all microbial diseases. It may come on suddenly or gradually, giving rise to obscurity of vision. The toxin of measles often induces amaurosis, which is speedily relieved by an emetic. An excess of uric acid in the blood is undoubtedly the source of much of the blindness of the present age. If Due to White Softening of the Brain. Defective vision, intellectual apathy are not always due to masturbation and excesses. Neither can every case be traced to the uric acid diathesis, nor to the toxins of unrecognized disease-germs in the blood. A question which should receive- very serious consideration in every case of blindness is the in- fluence of the hydra-headed microbe syphilis as a factor in pro- ducing atrophy of the optic nerve and degenerative changes in the brain itself. If this be suspected, five grains of sulphate of quinine with fifteen grains of iodide of potassium, both in solu- tion, thrice daily, together with stimulation over the origin of the optic nerve in the medulla oblongata, will have a most beneficial action on the case. If this plan of treatment fail, then such a course as the following may be adopted : Rest, change of scene, most nutritious diet, bathing twice daily, fol- lowed each time by one or two hours' massage by a highly vitalized attendant; continued stimulation over nape of neck; then try thyroid extract or protonuclein, matricaria before meals, glycerite of kephalin after eating, for ten days. Then for the next ten days, change to avena sativa after eating.. Twentieth Century Practice. 33 Select the best of remedies to create a renewal of life in brain substance, as spermin, kephalin granules, etc. For the preservation of milk and other food products formula is often used, which produces in the consumer atrophy of the optic nerve, irreparable blindness. Uremic Amaurosis is caused by anemia of the brain, the result of edema of the brain tissue, due to the circulation of urea in the blood. The loss of vision is often sudden and com- plete; in other cases slight, but associated with a group of symptoms incidental to the uric acid diathesis. In the early stages there is no intraocular change, but later on edema of the retina, serous infiltration with retinal separation and amaurosis. The ozonized uric acid solvent in alternation with the compound tincture of matricaria are most effective in ridding the system of this poison. The dose of the uric acid solvent should be such as will operate very slightly on the bowels. AMBROSIA ORIENT ALIS.— This remedy has now been brought to the attention of our profession, thoroughly tested in a large number of cases, with unparalleled success. The general conclusions reached in all cases are : That it is an aphrodisiac of priceless value; an invigorator of great efficacy ; a tonic to every tissue of the body. It is safe to say that if the demand for a remedy be a criterion of its intrinsic worth, then this one is away ahead of every known remedy. True, for functional impotency, it exerts a peculiar specific, vitalizing effect on the function of the reproductive organs of "both sexes; for physical and nervous exhaustion, it is a great rebuilder of vital force; for producing a change, a revitalization •of nerve cells, it is invaluable in effacing all habits, such as tobacco, opium, alcohol, etc., from the brain — not only removes them, but effects a radical change for the betterment of the race, reinvigoration of the entire body, a higher type of being. As a medicament in chronic spinal disease, it exerts a most salutary bracing influence. In uncomplicated cases of impotency, it is never-failing, in re-awaking the lethargic or dormant sexual function; but if there be complications, organic changes in the brain and spinal cord ; changes which involve diabetes, enlarged prostate, stric- ture, diseased bladder, toxins in the blood — these, or whatever they may be. must be removed before the action of the remedy Is visible. 34 Twentieth Century Practice. When sexually drained out or exhausted men are placed upon this remedy, the first sign of improvement is increased strength in micturition, dribbling and all leakages cease ; erec- tions improve, become stronger and lasting, a very rapid in- crease in vigor takes place, and continues, until the object of treatment is obtained. One peculiar action of the comp. tinct. ambrosia is that it is cumulative, the longer it is continued, the better its action be- comes, never loses its effect, but keeps adding strength and life to the entire body. The dose of the remedy to begin with should be half a tea- spoonful thrice daily, increased during the first week to a tea- spoonful as often. The pill or tablet form, one only thrice daily. A suppository is best used on retiring to bed, but in cases of complete nervous bankruptcy they may be used three times during the day pro- vided the patient lies down after their insertion. The bougie should be used only every other night. AMENORRHEA.— An absence of the menstrual flow. It is met with under two forms : i. Retention of Menses. — This may depend on a variety of congenital conditions, as arrested development, organic affections, malformations, such as absence or atrophy of ovaries, uterus. Those organs may be present, but vagina may be absent, or suffer occlusion, so that if the menses are secreted they cannot find their way out. It may depends on some disease of brain, spinal cord, or blood. A large percentage of such cases can be rectified either with medical treatment or some surgical proceeding. 2. Suppression of Menses. — This is the most common form of amenorrhea. The flow having appeared, been properly established, for a longer or shorter time, has, from some cause, become suddenly arrested. The front part of the uterus being very profusely supplied with branches of the sympathetic nerve in highly-civilized females, the menses, while on, are liable to cease or stop from violent emotion, grief, anxiety, or from cold, damp, exposure. Instead of ceasing suddenly, as in those cases, it may disap- pear gradually, returning at the proper time, but becoming less and less, and then entirely stopping. It is liable to cease in acute and chronic disease, as in fevers, blood-disease, especially anemia, cancer, tuberlosis, albuminuria. In all cases the Twentieth Century Practice. 35 greatest care should be observed, so as not to overlook preg- nancy. The suppression is always attended with some consti- tutional disturbance; great,, if sudden; not so well marked, if slow and gradual. Treatment. — If the case is seen at once during an attack of acute suppression, there should be an effort made to re-estab- lish the flow, by alcoholic vapor-bath, with hot mustard foot- bath ; put to bed between blankets, with hot bricks to feet, and dry heat to vulva or over bladder, consisting of baked bran, or hops, or chamomile flowers, in bags. Aconite, with com- pound tincture of serpentaria, administered internally, with infusion of pennyroyal ; no cold drinks nor ice. If several days have elapsed, it is useless to try the above, or any other means, but begin at once and prepare patient for next period. Bowels should be regulated, clothing warm flannel round waist and hips, warm foot- and hip-baths, nourishing food. If there is any special disease it should be attended to, especially anemia, with acetate of iron three times daily, with cinchona and min- eral acids ; and about a week before the expected period, begin with the compound betin pill, one or two three times a day: and if the case is stubborn, put mustard plasters on the nip- ples for a short time before bedtime, for one or two nights. The compound betin pills excel all drugs in their mildness, efficacy, and certainty; they arouse the inert, sluggish uterus into active life, restore its natural movements, and impart tone and vigor ; they are our best emmenagogues, and excel all other drugs in their prompt action. They supersede entirely those old and deleterious drugs, such as cotton-root, savin, aloes, ergot. As soon as the flow is established they are to be stopped, and resumed the following month about seven days before the expected period. Ladies who suffer from habitual suppression, or where the flow is scanty, or who dread early suppression. can maintain menstrual activity for a long length of years, and thus keep the freshness of youth in their nervous system and skin indefinitely. Vicarious menstruation may occur as a form of amenorrhea : fhat is, the menses may be suppressed at the vaginal orifice, but are thrown off by the nose, mouth, eyes, ears, or blood-stains by the skin, by ulcers or by necrosis, if present, or by odors about umbilicus, or eruptions. The real cause of vicarious menstruation is either inertia or atrophy of the uterus ; so great that the uterine wave is abol- ished or abrogated. The cure consists in stimulating the 36 Twentieth Century Practice. uterus with hip-baths, horseback exercise, or moderate walking exercises, the betin pill, narcotics, iron, pulsatilla, cinchona, and most nourishing food. THE AMIDO-BENZENE SERIES (C 6 ; H*; N. Hi).— There are many reasons why coal tar derivatives should not be prescribed by American physicians. Every man, either born or dumped on American soil, be- comes neurotic, suffers from cardiac failure or weakness. This is greatly aggravated by the use of tobacco, and breathing a highly oxygenized atmosphere, and a state of nervous tension which pervades the nation. All coal tar derivatives are cardiac paralyzers. Their ad- ministration increases the mortality of every disease in which they are used. The nervous system is made up of nerve cells, possessing a cylinder axis, with prolongation and protoplasmic processes, so that each nerve-cell is a minute reflex apparatus, with terminal fibril. The transmission of impulses of the gray matter is effected by contact, one cell with that of another. Now when antipyrin, exalgine, antikamnia, phenacetin, or any other of the numerous coal tar products are administered, these nerve cells are paralyzed. Pain may be instantaneously relieved, but the relief is too often that of death. To this class of drugs we owe the increased mortality in all diseases in which they are ad- ministered. The comp. tincture of coal tar pessesses trustworthy and uni- form therapeutical and pharmaceutical properties. It is pre- pared as follows : Make a saturated tincture of the powdered soap tree bark (quillaia) by maceration, adding coal tar, one to six parts of the tincture. The resultant product is a dark brown black tincture, a small quantity of it added to water forms a clear yellow emulsion. The color may vary according to the quality of the tar. This tincture can be still improved by the addition of the peroxide of hydrogen. With or without this, it is very stim- ulating and germicidal. Prescribed as a wash by adding it to water, in variable strengths, its action is unexcelled in eczema, psoriasis, prurigo. AMMON^EMIA. — The prolonged retention of urine in the bladder over a definite time results in its decomposition, in a change of its constituent elements, the most prominent of which Twentieth Century Practice. 37 are a fungus and carbonate of ammonia, which are taken up into the circulation, producing a special form of blood-poison- ing. The retention of the urea and its conversion into car- bonate of ammonia give rise to cystitis, a catarrhal and dysen- teric state of the bowels, in which a greenish, alkaline yellow fluid is passed from the bowels, with abundant spores of the fungus. The causes which give rise to this state of the fungous growth and decomposition are stricture, enlarged prostate, par- alysis of atony of the bladder, pyelitis, sacculated kidney, cys- titus, etc. Old or young men, with enlarged prostates, are the victims of this malady. It is an affection which cannot be mistaken, even by the most superficial observer : the retention of urine, or, if a dribbling, its ammoniacal odor, alkaline reaction, containing immense amounts of phosphates ; the breath and skin are also highly ammoniacal. If no relief is afforded, there are rigors, vomit- ing, fever, with strong typhoid aspect; tongue dry, brown, shining; complexion sallow, dingy brown ; headache ; insomnia ; and, as the blood becomes more crowded with the spores and carbonate of ammonia, insomnia is more persistent ; restlessness gives rise to somnolence, lethargy, with low, muttering delirium, with the ammoniacal odor more intense. The most important point in the treatment is the removal of the cause ; but as atony of the bladder and enlarged prostate are the common causes, time is needed. The patient must have immediate relief, or death will ensue. Relief is best afforded by the introduction of a catheter and draining off every drop of the ammoniacal urine, subsequently injecting the bladder with a tepid germicidal solution of either boroglyceride or peroxide of hydrogen; if the latter, a few drops to the pint. This pro- ceeding must be resorted to even when the patient seems to be sinking, because the moment the bladder is washed out a rapid improvement takes place. The bladder must thus be emptied and washed out daily, and the patient placed upon the proper doses of either peroxide of hydrogen, or ozone water, or comp. oxygen, to neutralize the excess of ammonia present in the blood. Virginia stone crop operates well in alternation with the uric acid solvent; the pichi in that last compound operates in all cases most favorably ; they should be used persistently. The enlarged prostate must be got rid of. and till that is effected the urine must be drawn 38 Twentieth Century Practice. regularly off. I have found the following -formula to be un- excelled to get rid of an enlarged prostate : thus, say about 7 p. m. insert one cocaine suppository; allow it to remain; before retiring wash out the rectum with about half-a-pint tepid solu- tion of boroglyceride, which is to be passed off ; as soon as that is effected, inject one tablespoonful of the following: Ozonized distillation of hamamelis, four drams; papoid, thirty-two grains. Mix. This is to be permitted to remain over night. This mixture of ozonized hamamelis and papoid acts energetically upon the effused lymph which, in the process of chronic inflammation,, has been effused into the interstitial structure of the prosjtate. To be effective it must be applied as above. The cocain suppository produces anesthesia of the prostate — a state most favorable for the dissolution or absorption of lymph. Follow it in about two or three hours with the papoid mixture. ANALIN OIL. — A germicide, which is very beneficial in many aural affections, especially in arresting inflammation and suppuration by dehydrating the parts to which it is applied. Its power of abstracting water from the tissues is quite con- siderable, and being a stable remedy, its effects are permanent. Equal parts of mullein and analin oil mixed is a very suitable preparation; dropped into the ear and left there in the usual way, once or twice daily, they have a marked effect in curing very many forms of deafness. It effects this by its remarkable power of penetration, its action as a solvent upon effused lymph upon the membrana tympanum, in softening all substances effused within the aural cavity, breaking them down by its power of dissolving fats and acids. In ankylosis of joints, analin oil, added to either alcohol or concentrated ozone, or olive oil, has not only immense, deep, penetrating power, but has a solvent action. Analin oil is an excellent solvent for cocain, that with its power of penetration, its dehydrating property, renders it valuable. ANAL FISSURE. — Cracks, lacerations, abrasions, fissures in and around the verge of the sphincter muscles of the rectum are usually caused by either constipation or worms, giving rise to spasmodic action of the muscles, or from laceration by hard- ened feces or foreign bodies. It is usually associated with most excruciating pain in de- Twentieth Century Practice. 39 fecation, pus, blood and innumerable bacteria being present. Under old methods extremely difficult to heal, but with modern remedies quite amenable to treatment. The bowels should be regulated with the kola-nut paste, about half a teaspoonful be- fore retiring. An excellent method to commence with is to wash the ex- ternal parts night and morning with soap and water, and at the same time wash out the contents of the rectum with a warm solution of boroglyceride. As soon as passed. insert a cocain suppository, in one hour subsequently a krameria suppository. Repeat this morning and night. During the day paint on or apply every three hours a small piece of the jelly of violets right into the fissure. This will kill every germ in it and cicatriza- tion will be rapid. The cocain suppository relaxes, anesthetizes the nerves of the sphincter. The krameria suppository contracts the fissure amazingly, the violet jelly eradicates every germ and promotes rapid healing. I have tried cleansing the ulcer, using the same injection and suppositories, and dusting the fissure with formal-gelatin powder. The results were not nearly so satisfactory. I have also tried a suppository made of periodate aurum ; still even that was tardy in healing. ANESTHETICS. — Anesthetics are a class of agents that are used by inhalation to blunt the sensibilities of the patient to pain, and thus prevent shocks, and obviate, or ward off to a very great extent, surgical fever, in all great operations. There are a great number of agents of this class; but three, viz., nitrous oxide gas, ether, and chloroform, are what may be termed safe and reliable. Nitrous oxide gas is used solely for very short operations, as the opening of abscesses, making incisions, and extracting teeth — where anything can be done in a few seconds; for a prolonged use of the anesthetic is dangerous, and it should never be given more than once on one day, and not for several days afterwards. It is useless in operations of any magnitude. Ether is a good anesthetic, from six or seven years of age up to sixty, because of its great safety, and the fact that it in- creases the heart's action. Chloroform is best for children or elderly persons whose hearts are in good condition; but it must be watched, as it decreases the action of the heart. 40 Twentieth Century Practice. The inhalation of ether by aged persons excites immense activity and congestion of the bronchial glands, so that it is very apt to prove fatal. It has the same effect in children, although they, as a rule, take any anesthetic well. The process of anesthesia may be divided into three stages : the first being that of cerebral excitement, or loss of conscious- ness; the second, accompanied by loss of sensibility; and the third, by loss of motion. Beyond this it is unnecessary to go ; it is the final stage — total paralysis o/f the nerve-centres. Generally speaking, the second stage is sufficient for most operations. ANESTHESIA. — General anesthesia produced by inhaling either ether or chloroform, or nitrous oxide gas, or what is better, the ABC mixture — one part alcohol, two parts sulphuric ether, and three parts chloroform — can be prolonged indefinitely provided a hypodermic injection of one quarter of a grain sulphate of morphia be given either over the deltoid or at the nape of neck, at least for an hour, affording sufficient time for a major operation. The above method is perfectly safe. It is now proposed, for the purpose of local anesthesia, to inject a minute quantity of a one-half of one per cent solution of cocain hyperchlorate into the spinal canal, to paralyze the spinal accessory roots and ganglia, a proceeding which is by no means safe. Better by far to dissolve cocain in the con- centrated ozone and apply, which produces anesthesia away down to deep-seated parts, even to the bone. The jelly of violets ranks next as a safe local anesthetic. Anesthesia in parturition need not be general; sufficient if applied over the abdomen and lumbar portion of the spinal cord. If so applied, and ten or twelve obstetric cones be used, labor will be perfectly painless and no rigidty of the os uteri can exist. Local anesthesia may be either induced by the ether or rigoline spray, or by applying for a few hours over the part to be operated on the ozonized jelly of violets. As a local anesthetic, it is found to be as efficacious as cocain, with the decided advantage over that remedy that it never affects the respiration or mental faculties; besides it has no toxical properties, and is a. powerful bactericide. It fills a place in the materia medica practically unoccupied by all other anesthetics. Jelly of violets is of immense utility in the cure of Twentieth Century Practice. 41 some cancers. It often blights and arrests their growth, renders them painless, and in many cases causes their complete ob- literation. Invaluable in the treatment of all ulcers, all breaches of con- tinuity, whether malignant, venereal or others. Excellent to arrest inflammatory action. In toothache, extraction of teeth without pain, it operates like a charm. It is non-poisonous, non-irritating, affords complete im- munity to pain ; when applied, its action is profound and pro- longed ; absolute freedom from pain for several hours is the rule when applied. It is true many medicaments are now in use for the produc- tion of local anesthesia, besides the evanescent ether and rigo- line. Very many of these -have been introduced by the Ger- mans from our own coal, and sent here to soothe the aches and pains of the Yankee, and at the same time paralyze his heart. In a very extensive clinical experience I have prescribed them all to their fullest extent, but none of them has served my purpose so well as the jelly of violets, a natural product without a rival as a means of allaying excruciating pain. Digesting all the advantages and disadvantages of the coal tar derivatives, heart-paralysis, and recent synthetical compounds, jelly of violets excels all ; besides it is a germicide, non-toxic, prompt in action, penetrating deeply, arrests inflammatory action wher- ever it exists. It neither affects the heart nor disorders the nervous system. It is a typical local anesthetic, and so highly antiseptic that it prevents fermentation and even putrefaction. Permanent solu- tions can be formed with it, and can be combined with other remedies which render it of great efficacy in many diseases, such as ulcers, chancres, and especially in cancer. Painted on in its full strength, it will efface pain from twelve to twenty-four hours. Many successful cases of cancer of the stomach might be cited, in which the jelly in a papoid solution has effected brilliant results. ANEMIA. — Is either a deficiency of red corpuscles or a shrinkage of them in size, or both, clue either to defective assimilation, disease, hemorrhages, meagre or adulterated food, or want of sunlight, solitary confinement, deleterious trades, factory labor, breathing the vitiated air of tenements, improper nutrition, a true scarcity of elements necessary to maintain and restore the daily wants, to keep brain and muscle healthy. 42 Twentieth Century Practice. The natural consequences of such, and of neglecting the fun- damental laws of health, are a paleness or pallor of the skin and mucous membrane, soft muscles, lassitude, debility, feeble cir- culation, muscse volitantes, aural vertigo, cardiac irritability, general coldness, albumin in urine. Our remedies are rest in the recumbent posture, pure air, nourishing food, as raw eggs, juice of beef, sunlight, bathing, massage. Select and push cinchona and mineral acids, comp. hypophos- phites of lime, soda and iron, spermin, matricaria, coca; passi- flora for an irritable heart ; protonuclein. Pernicious Anemia is a fatal form which progressively advances to a fatal termination, yet it is difficult to assign a cause for the profound alteration which the blood undergoes, nor can its origin be detected. Continued train of dyspeptic symptoms, diarrhea, protracted hemorrhages, incessant worry, excessive debility from exces- sive child-bearing — such like are reckoned as causes. It can- not originate without a cause, although the real cause is still unknown. The blood presents changes, the red corpuscles being dimin- ished, but there is no constant lesion of the blood-forming glands adequate to explain the steady and destructive impover- ishment of the vital fluid. The structure of the spleen and lymphatic glands are not altered; neither is the pink marrow of bones, but fatty degeneration of the heart and inner coat of the large arteries can readily be detected. In an extensive clinical practice we have used abundance of fresh air, avoidance of all insanitary conditions, good nutritious food, rest and massage. The old routine remedies are not available to do good ; ozonized phytolacca berry juice in small doses, alternated with comp. tincture matricaria, seem to be the most effective agents to save life and rid the system of such elements of de- generacy. These two remedies influence the vital, centres in the medulla oblongata. ANEURISM. — A pulsating tumor, synchronously with the action of the heart, communicating with an artery, formed by dilation or expansion of the coats of an artery through which the blood circulates. It may consist either of a dilatation of the entire three coats of a vessel, or of two or of one. Its causes are numerous, as inherent weakness of organiza- tion; diseases of the vessels, such as calcareous degeneration, syphilis. Twentieth Century Practice. 43 The exciting causes are straining, lifting, coughing, hoisting, jumping, running. A false aneurism is generally the result of mechanical violence, followed by extravasation of blood in the surrounding tissues. Ligation of the artery on the cardiac side away from the tumor. The coagulation of the contents of the aneurism either by injecting a solution of carbolic acid or the insertion of needles attached to a battery, are extremely dangerous ; better to enjoin perfect rest, administer digitalis to slow the heart's action ; increase fibrin in the blood with an animalized diet, and administer either cinchona and mineral acids, or guaiacol mis- tura. ANGINA PECTORIS.— Spasm of the heart muscle. De- velopment or growth can be induced in any organ, in every tissue and gland in the human body, but this has a limit, a point, which if carried beyond an adequate nerve supply degenerative changes will set in. For example, a blacksmith may by arduous toil develop the muscles of the arm and side until there is not nerve supply sufficient, - when fatty degeneration sets in. A lady with atrophy of the breasts may by bathing, massage and inunction of the saw palmetto ointment twice daily cause their normal size to be restored, but if she persists in the restorative process of enlargment beyond the original, degenerative changes set in. The penis, the testes, if shrunk to nothingness, can be restored by the use of the kephalin granules and proto- nuclein. Even the brain, the great sympathetic, may suffer a partial atrophy and recovery take place upon the use of the thyroid extract and avena sativa. The great sympathetic, whose branches cover the anterior portion of the heart, subject to every conceivable — either depressing or vitalizing — agencies in emotions, desires, affections, passions, under our present status of civilization. Overstimulation of the great sym- pathetic invariably gives rise to heart trouble, exhaustion, failure, followed by neuralgia, severe pain in the heart oc- curring in paroxysms, with numbness in the left arm ; on seizure of pain the action of the heart-muscle is arrested by the induced spasm ; fainting, collapse, pulse imperceptible at the wrist, sus- pended respiration. The duration of these symptoms may be a few minutes to some days. The predisposing causes are conditions which favor depres- sion of the grand sympathetic, especially its cardiac branches. It is a condition seldom if ever met with among the poor, its 44 Twentieth Century Practice. victims being the rich, the eminent, the great. It attacks more wise men than fools. Great poverty of nerve force is present in every case ; standard of vitality is lowered. The exciting causes are the toxins of rheumatism and other disease germs, the lithiate of soda of gout, such heart-depres- sants as tobacco, tea, coffee. A division is thus made, true and false ; in the former organic disease of the heart is invariably found, whereas in the latter simply an enfeeblement, a neurotic vasomotorial condition — in the true the causes act directly, in the false mostly reflex. The pain incidental to angina is one of intense mental anguish. The occurrence of the seizures are most likely to take place when the electrical forces of the atmosphere are lowered. If patient is seen during an attack place him in a comfortable position ; abundance of fresh air ; loose clothing ; dry heat over breast. Endeavor to break spasm and relieve pain, which is intense. Select from drugs most easily procured either the nitrate of amyl by inhalation, an dthe nitroglycerin supposi- tory ; try lobelia, passiflora, aconite, chloroform or concentrated ozone over heart. When paroxysm is completely broken keep mind and body quiescent ; forbid all fret, worry, passion, all excesses, no sexual excitement under any consideration, and the use of tea, coffee, tobacco. If no fatty degeneration of the heart muscles has taken place a curative treatment should be inaugurated. This requires rare tact and skill, but, generally speaking, we might state that guaiacol plasters should be kept on and off over the region of the heart for some months, just as the patient can with comfort bear it. Then scrutinize the case for causes; if the toxins of rheumatism and lithiate soda of gout, administer the ozonized uric acid solvent; if it be the toxins of malaria, give concen- trated tincture of kurchicin; if the toxin of syphilis, the periodate aurum; if the toxin of epidemic influenza, con- centrated tincture of kurchicine. In all cases of angina pectoris the nitrite of sodium should be given independent of cause. It dilates the entire arterial sys- tem and relieves the heart. In addition, keep stimulating the heart with a special cardiac vitalizer, selecting from the following list two of the best : Protonuclein, creatinin, thryroid extract, passiflora incarnata, digitalis, strophanthus, lily of the valley, cactus, spartein, adonin, quinine, nitrites, coca, kephalin, amyl. Twentieth Century Practice. 45 Passiflora and creatinin, protonuclein and kephalin do ad- mirable work in neuralgia of the heart; thyroid extract and quinine, coca and the nitrites are extremely efficacious. A one per cent solution of nitroglycerin in one-drop doses, as indicated, has proved itself to be our best drug to overcome the paroxysms of angina pectoris where amyl nitrite has failed, and by exhibiting it in gradually increasing doses between the attacks the severity of the paroxysm is reduced. It has proved highly valuable in migraine, neuralgia of the fifth pair of cranial nerves, reflex vomiting, epilepsy, seasickness, gastralgia, hiccough, laryngismus stridulus, tetanus, hydrophobia, hepatic colic, spasmodic, uremic and cardiac asthma, simple and per- nicious anemia, acute and chronic Bright's disease, puerperal and uremic convulsions. In the late epidemic of scarlet fever in which interstitial nephritis was so common, suppression of urine and uremia so fatal, it rescued every patient from the jaws of death to whom it was adminstered. These two winters past nearly all of our devitalized popula- tion have suffered from the microbe of epidemic influenza ; without a thought as to its results our physicians have rushed to antipyrin and other coal tar derivatives, which have left a large portion of our people suffering from weak heart. To over- come this condition nitroglycerin is the remedy. The special reasons for the good effects of nitroglycerin in weak heart are the following : ( 1 ) It lowers the vascular ten- sion by dilating the arterioles; (2) it increases the rate of the heart's movements; (3) it lessens that irritability of the nervous system which finds expression in spasm, especially of the nervous system of organic life. Under no plan of treatment have I seen so rapid and thor- ough improvement in the condition of the weak, the anemic, and the ill-nourished. I prescribe the one per cent solution, beginning with one drop, and adding one drop at each dose until the characteristic effects are produced. The susceptibility to its action varies greatly. The amount required ranges from one to ten drops for the largest number. When the patient feels the least degree of the action (pain in the forehead and flushing of the face) the dose is sufficient, and that quantity should be continued, the intervals being from two to six hours, according to the character of the symptoms and the persistence of the effects. Light, nutritious food, generous to a fault; bathing, massage, rest. 46 Twentieth Century Practice. ANILINE. — A substance which is obtained from coal tar. It is chemically a compound ammonia, and may be prepared by the action of nascent hydrogen on nitrobenzene. When first prepared it is a colorless liquid, but afterwards turns brown. The aniline dyes are obtained from aniline by oxidizing it. Aniline dyes possess marked antiseptic properties, and have been used in surgery. Methyl-violet has been injected into sarcomata and other tumors, and appears to lessen the rapidity of their growth. When used as antiseptic lotions, the aniline preparations must be pure. Ethyl-violet may contain arsenic, and grave accidents have followed its use. Owing to their staining properties they are unlikely to come into much use as antiseptics. Aniline dyes are used in staining microscopic specimens. ANISE. — Aniseed, the fruit of Pimpinella anisum. An oil is obtained by distillation, the dose of which is one to four drops on sugar. Aniseed water is made by distilling one pound of the fruit with a gallon of water. Its dose is one to two teaspoonfuls for a child one year old. Essence of aniseed is a mixture of the oil and rectified spirit (dose, 10 to 20 drops: for a child one year old, 3 drops). Aniseed is a carminative and antispasmodic — that is, it prevents griping and pain in the stomach. Star-anise (or Chinese aniseed) is obtained from a different plant, has a star-like form, and possesses similar properties to ordinary aniseed. ANKYLOSIS-ANCHILOSIS.— Term applied to a joint when it is fixed in position owing to adhesions or bony union between the bones forming the joint. It is a result of inflam- mation of the joint, and its commonest cause is rheumatism. Treatment. — Surgical operation in some cases. In others, the patient should be given an anesthetic, and the joint then moved forcibly so as to break down the adhesions. These are the cases of cripples which are so often cured by the rough treatment of quacks, by faith-healing, hypnotism, fright, etc. ANTAGONISM (Between Man and Microbes).— They are everywhere, in the air which we breathe, in the water which we drink, in the food which we swallow for nourish- ment; dust contains innumerable quantities of them; our garments are covered with them; our hair affords an Twentieth Century Practice. 47 asylum for legions of these tiny creatures. It is idle to say that among the countless variety of microbes there are some good ones which are not harmful and do not engender mala- dies, for the most recent researches have demonstrated that there are some inoffensive microbes which can become very dangerous if they can manage to traverse several times in succession the animal organism. That is the truth. What is true, moreover, is that it has been proved beyond contradiction that microbes cause the most terrible maladies, those which decimate populations, like phthisis, the plague, cholera, typhoid fever, typhus, yellow fever, scarlatina, to mention only the best known and most murderous diseases. When the part played by microbes began to be recognized, it was asked how organized forms of dimensions so small that it requires great enlargements of the microscope (enlargements of a thousand and fifteen hundred diameters) to distinguish their morphological characteristics can get the better of indi- viduals of a height which, in comparison with the attacking force, is enormous. This question was answered by pointing- out the incalculable number of the microbes and by recalling that the human body is but a considerable collection of micro- scopic elements, the cells, so that what was at first thought to be a war between a pigmy and a giant is, in fact, one between individuals of about the same size. By reason also of the extremely rapid multiplication of microbes, they soon find themselves sufficiently numerous to win the battle. This point of view has not lost its value, but to-day we know something more. It is not only and especially in the place where they are present that microbes exercise a melancholy influence over the organisms they invade. The principal cause of their harmfulness is in the products of their life in the midst of the tissues. These products ex- creted by the microbes are, in truth, energetic poisons which, physically or chemically, provoke reactions in their surround- ings, and which can cause profound alterations in the organ. It is not essentially necessary for the microbes to invade the entire organism and multiply there with rapidity in order that the poisonous manifestations due to their excretions shall be felt. Thus it is that the microbe of diphtheria, often located on the tonsils and throat, produces in the organism grave dis- orders in the veins, the joints, and other parts far away from the place where the microbe is encamped. There is, in a word, poisoning at a distance, which proves sufficiently the prepon- 48 Twentieth Century Practice. derating part played by the poisons excreted by the microbes. This fact, of course, does not weaken the effect of their number, since it is very evident that the more abundant the producers of poisons are the greater the quantity of poison which will be produced. All this being so, let us see how it comes about that we are able to resist the attacks of so many enemies, apart that is from all medical treatment. It is my duty, alongside of the very dis- couraging picture I have just sketched, without exaggerating anything, to place, with the same care to keep within the abso- lute limits of truth, a more comforting picture, pointing out the means with which we are naturally provided to repel invasion. Suppose a legion of microbes which, coming from the out- side, attacks us. Some fasten on the skin, others penetrate by the mouth or the nose. Before reaching us they have already encountered conditions which put them, in a certain measure, in a state of inferiority. The oxygen of the air and light are agents which injure the vitality of the microbes. From this fact results the elementary principle of hygiene to keep the apartments in which we live well aired, and to admit into them floods of light. Having reached the skin, microbes find an efficacious barrier in the cells of the epidermis, of which those directly on the outside are horny, and thus in the best condition for not being- traversed easily, and are, moreover, in a continual state of desquamation or scaling off. This may be called the physical defence of the epidermis. That is not all. The skin contains glands producing sweat and oily matter. These matters are eminently unfavorable for keeping up life in microbes. If some of them, however, availing themselves of the openings of these glands, get within and think that they have overcome the obstacles which prevent them from reaching the internal tissues which are the object of their travels, they are mistaken, for as soon as the glands work a little actively, in consequence of labor provoking perspiration or the active secretion of the oily matter, the microbes, borne on this current of secretion, find themselves promptly turned out of doors. Hence the effi- caciousness, from a hygienic point of view, of care of the skin, of active perspiration, and the like. Returning now to the microbes which have entered the open cavities, the mouth and nostrils (I do not speak of the ears, which can defend themselves by their epidermis and the secre- tion of wax), there also the surfaces are clothed with a mem- Twentieth Century Practice. 49 brane formed of little cells not unlike the cells of the epidermis of the skin, and this membrane is constantly moistened with liquids (nasal mucus, saliva) which are not at all favorable to the development of the assailant. If he, continuing his march, manages to get into the oesophagus and to reach the stomach, he finds there conditions which are not good for his health in the shape of gastric secretions, such as chlorhydric, lactic, and other acids. This is so true that many microbes are absolutely incapable of getting through the stomach and pene- trating the intestines, for they have been so battered and knocked about and their vitality has been so much lowered by their troubles on the road, that they end by being destroyed and even digested in the stomach. It has been proved, however, that mucous surfaces are not always an obstacle to the penetration of the microbes, even when these surfaces are intact. Supposing the microbes man- age to penetrate the tissues, there they meet with new obstacles ; there they find, in the first place, what are called phagocytes, that is, cells which are eaters, or elements of the lymph, which show surprising activity, swallowing the microbes and digest- ing them. It should be remarked that these phagocytes are most abundant at threatened points. If, in spite of phagocytes, the microbes get into the blood, they have not won the battle. The serum of the blood has microbe-killing properties ; the oxygen that is carried into the blood disagrees with many of the microbes, as carbonic acid does with others, and thus it is that the blood is rarely invaded by microbes in the course of the maladies they engender. Driven then from vessels which do not offer them a satisfactory field of culture, they can only take up their residence in the heart of the organs, and even there they meet with elements of resistance which are often effica- cious, such as defensive proteins and other antitoxic substances produced by these organs. To sum up, the human body is perfectly organized to resist the different phases of the microbes. This explains how it is that, in spite of their multitude and their bad temper, microbes have not yet annihilated the human race. It must be kept in mind, nevertheless, that the success of the resistance depends upon the quality of the tissue into which the vigilant and ill-tempered microbe strives to penetrate. I have told how things go on when the organism is healthy. If, however, before the microbe reaches the haven where he would be, the general functions of the system are troubled, either 50 Twentieth Century Practice. hereditarily or by reason of an acquired abnormal state, such as gout, diabetes, visceral, pulmonary, or hepatic inflamma- tion (to speak of a few states only), the conditions of resist- ance are changed, for these, by vitiating the regular functions of the organs, affect the vitality of the tissues which are par- ticularly the phagocytic elements. The microbes are destroyed in much smaller quantities, and they no longer find antitoxic products which ought normally to oppose their development and neutralize the effects of their own poisons. In a word, they find a field of culture in which they cannot fail to flourish and multiply. The consequences are immediate and fatal. The infection of the tissues begins; the poisons produced by the microbes are spread through the organisms. Such is the mechanism of the origin of diseases called infectious. From all this it is plain that everything which enfeebles our vitality is a dangerous condition, and exposes us to invasion. For that it is not necessary that there be deep injuries, affecting this or that organ. The most varied influence can come in play to create in us a state of inferiority, which will oblige us to surrender to our foe. Privations, great fatigue, the ingestion into the system of toxic substances, intoxication by lead or alcohol, atmospheric conditions, excessive heat, intense cold, are so many elements which must be reckoned with. There is no warrant, then, for neglecting microbes and con- sidering them as an enemy of slight importance. It would be folly to think that we may fold our arms and trust to our natu- ral powers of resistance. On the contrary, we should always keep in mind that we have in microbes terrible adversaries, always on the alert to surprise us, and against which we are bound to maintain as intact as possible the natural defences with which our organism can oppose them. ANTHELMINTICS. — Vermifuges, a class of medicines which either destroy or cause the expulsion of intestinal worms, such as santonine, for the round worm; valdevine, kousso kamala, male-fern, oil of pumpkin seed, papoid, pomegranate root bark for the tape and broad worms. Taenia solium; and injections, containing either peroxide of hydrogen, or fluid extract of golden seal, or even a pinch of common salt into the lower bowel for the thread worm Ascarides ( See Intestinal Parasites). Twentieth Century Practice. 51 ANTHEMIS (Chamomile). — Matricaria comp. tinc- ture., highly ozonized. This compound consists of a solution of the glucosides of the most highly ozone-generating plants, so perfectly blended together as to form a great vitalizing tonic and an active scavenger to germ-laden blood. It is indicated in all anemic states of the brain, and great sympathetic, as in neurasthenia, paralysis, brain softening and atrophy; impaired intellect, imperfect memory, vertigo, faint- ness, disinclination for mental and physical exertion, numb- ness, headache, even in structural lesions, weakness, anorexia. It is specially indicated when the eighth pair of nerves, the vagus and pneumogastric are much weakened, as in indiges- tion, pains in the stomach, fulness, flatulence, eructations, con- stipation, jaundice, with an inactive, sluggish liver, where the bile elements commingling with the blood, poisoning the brain : in gall-stones — a general unstrung condition, incidental to care, worry, or to the use of tobbacco, opium, whisky, chloral habits, antidotes, insomnia. Has a marvelous tonic action upon the heart and lungs. Directions for use : dose, 5 to 10 drops in a glass of water before meals. ANTHRAX. — Place the cow, the sheep, goat, in insanitary conditions, states inimical to health, there is a strong liability for the evolution of a microbe in their blood of the most deadly character, the bacillus anthrax, which first sets up inflamma- tion of the spleen, then destructive blood changes, and latterly death. Like all diseases due to the presence of a microbe it is both contagious and infectious. Transmitted to man by their breath, hair, milk and by their excrementitious discharge con- taminating water or vegetables which man may consume. This pathogenic microbe is the most easily recognized and cultivated of all disease germs, provided there is a pustule ; it consists merely of rods, long and broad, and threads with spore formation, of a very active character. These rods are found straight or curved, rigid or motionless : vary in size in different animals. The bacillus anthrax is the most tenacious of life of all dis- ease germs : it is the most active breeder, throwing off millions of spores every hour, literally loading the blood, overcrowding the capillaries over the entire body, engorging the lungs, brain, liver, spleen, causing infraction of the kidneys : in the process 52 Twentieth Century Practice. of bacterial growth it excretes one of the most deadly of all alkaloidal toxins. It is a microbe we ever have in our midst. Although this is the most easily recognized and cultivated, the diagnosis of its presence in the human subject is often dif- ficult. The history of the case may be of advantage: A wool- sorter, a tanner, a butcher are most suggestive. The milk of an affected cow may be taken and death ensue in a few hours, without a spot being perceptible on the skin ; if there be a pus- tule or pustules, recognition is easy, which can be readily con- firmed by a microscopical examination of the saliva, blood, urine, feces. Cultures of the germ, injected into any mam- malia, reproduce the disease in all its malignancy. The toxin of this germ causes rapid death by embolism and decomposition of all the tissues, often before any symptoms of morbid action are visible. The complete annihilation of this pathogenic microbe is most difficult, even prior to and after it has set up destructive meta- morphosis. Once recognized, push the best bactericides internally and lo- cally. For internal use try first chlorine and quinine combined, peroxide of hydrogen, ozonized sulphur water, Chian turpen- tine mistura. Locally, free crucial incisions into the pustules, encourage free bleeding by douches of hot water, follow this with either a wash of ozonized jequirity or formalin, one tablespoonful to the quart of water. Jelly of violets works admirably. The following case is worthy of recital : W. F. Terrhune, a butcher, aged twenty-seven years, was engaged by the health inspector in his locality to cut up an ox that had been killed, owing to the fact that there had been several suspicious cases in the vicinity. The inspector made him aware of the danger. He was instructed to be careful. Both before and subsequent to the examination he had his hands immersed in a strong so- lution of chlorinated soda, and all seemed to pass off well, when suddenly, on the ninth day, a small spot of discoloration made its appearance on the right forearm and one on the left elbow. But no attention was paid to these. Three days later he had violent rigors, with diarrhea, nausea, vomiting and a high grade of fever, temperature 105 F. Simultaneously with the rigors the right arm from the hand to the shoulder became enormously swollen, which was followed by the same Twentieth Century Practice. 53 in the left, but not so great. The pustule on the right forearm became much indurated in the base, and its edges were sur- rounded with blebs containing a transparent liquid, great pain, distension in the arm ; lymphatics in the axilla much engorged, with a doughy swelling down the side. Constitutional symptoms becoming worse, tongue coating heavily, sore enlarging, a crucial incision was made into both pustules, free bleeding encouraged by the use of hot water, and subsequently they were both dressed with compresses saturated with the peroxide of hydrogen ; internally, chlorine and quinine were administered every hour. On these remedies the case progressed well, rapidly to re- covery. ANTIFEBRIN. — Acetanilid. a coal tar derivative, a heart paralyzer, a crystalline substance, sparingly soluble in water, but readily dissolved in alcohol, ether, or chloroform. Dose, three to ten grams in wine or brandy. It is a dangerous rem- edy, powerful as a cardiac sedative — a paralyzing agent which robs the blood of vital elements, indispensable to calorification and incompatible with life. Alarming cyanosis is apt to follow its exhibition. ANTI-FAT. — It is quite unnecessary to take up space in describing the causes which are productive of an excess of fat in the human body, such as drinking, amylaceous and sac- charine food, inertia of the glandular system, etc. It is suf- ficient for me to state that in an extensive practice of over forty years I have only found in the entire materia medica three remedies, without the use of massage and baths, that can be depended on for the removal of adipose tissue, without in any way impairing the vital integrity of the individual, and these are: 1. The ozonized juice of Phytolacca berries, gathered on the first frost, in the salubrious valleys of North Carolina, com- pressed and saturated with negative ozone, is undoubtedly one of the best of all remedies for the removal of obesity. This remedy has a wonderful effect in rousing up the functions of the liver, in stimulating the lymphatic system, and thus pre- venting fatty deposits ; at the same time, by some innate action, it actually strips the body of this non ? vital element. Sometimes a dose of two drops added to a glass of water thrice dailv will be sufficient : in other cases in which there is 54 • Twentieth Century Practice. inertia of the glandular system, the dose, to have an effect, may be from ten to twenty drops as frequent. It is a remedy which should in all cases be prescribed and administered by an experienced physician. 2. Fucus vesiculosus, the ozonized extract of bladder wrack, made from the fresh plant, containing a very large percentage of iodine and potassa — an invaluable remedy, definite in action, never failing in ridding the body of fatty elements. It is an excellent alterative; acts chiefly upon the glandular system. No extract, no other preparation, but what I have mentioned of this plant is of any value. 3. The ozonized extract of the thyroid gland of the lamb is a remedy of great power ; its primary action is to increase all the vital elements of the body ; its secondary action to annihilate and eliminate all the non-vital. In this way adipose tissue, a non-vital element, is removed. The highest possible degree of life is attained ; all non-vital elements cease to exist. These results are only to be obtained from the ozonized ex- tract, never from dried, shredded or tablets. Use the genuine article. ANTIKAMNIA. — Careful analysis of this compound shows it to consist of about 90 per cent of acetanilid and 10 per cent of bicarbonate of soda, thoroughly triturated together. The addition of the soda to the acetanilid makes it very soluble, easy of absorption and prompt in action. Like all coal tar derivatives, it induces muscle failure of the heart. It is a dangerous toxic agent, causing death by paraly- sis of the heart, hence the cyanosis. ANTIPYRIN. — A white, crystalline powder, prepared syn- thetically from certain constituents of coal tar. Soluble in water in less than an equal weight, and freely soluble in alcohol and chloroform. It is said to lower the temperature of fever patients as much as from 3^° to 5^°R, and produce a refreshing sleep for five or six hours by administer- ing fifteen grains at 9 p. m. and seven and one-half grains each at 10 and 11 p.m., dissolved in water or wine when taken. As much as seventy-five grains have been given in three divided doses, proportioned as above. The following mixture has been of utility in typhoid fever*: Antipyrin, 20; Jamaica rum, 30; water, 150, and syrup, 150 parts. Dose, a teaspoonful three times a day. The dose for children is from one to one and one- Twentieth Century Practice. 00 half grains for each year of a child's age. Incompatible with spirit of nitrous ether. Antifebrin and antipyrin are powerful poisons, cardiac de- pressants, and lower temperature by inducing muscle failure of the heart, which is generally permanent. ANTRUM. — The antrum is much more frequently affected by disease than is generally supposed. Abscess of the Antrum. — Is very common, as the result or blows on the cheek, and from decayed stumps of teeth in the jaw. It has been caused in new-born infants from injuries during parturition. The symptoms are aching, uneasiness of the cheek, preceded by acute throbbing, pain, rigors, fever, fol- lowed by slow and progressive enlargement. If unrelieved, there will be bulging of the cheek, extrusion of the eye, obstruc- tion of the lachrymal duct, depression of the hard palate, loos- ening and dropping out of the teeth, and closure of the nostril. In some cases it will burst into the nostril or mouth. Treatment. — A free aperture should be made into the an- trum by extracting either of the molar teeth and a trocar pushed up through the empty socket into the antrum. If the teeth are all sound, then an opening should be made through the membrane of the mouth above the alveoli of the molar teeth, and the bone be pierced by a strong trocar. After the pus has been evacuated, it should be syringed out with an antiseptic wash, as borax or carbolic acid. Dropsy of the Antrum. — The antrum may become enor- mously distended with its own natural, clear, mucous secretion, if the aperture into the nostril be obliterated. An opening to relieve the difficulty is best made through the molar teeth. Its evacuation should be followed by a stimulating injection of carbolic acid and glycerin. Tumors of the Antrum, — In addition to abscess and dropsy the antrum is often filled up with bony matter, exosto- sis, and fibroplastic tumor of the consistence and form of brain or liver; often the color of the latter, and difficult to recognize from cancer. Others have the color and consistence of kidney. We meet with fibrous tumors, very dense and en- cysted tumors, and other deformities that may be mistaken for enlarged antrum. With all diseases of the teeth and nose the antrum has much to do. The incessant tinkering about old stumps, filling with amalgam loaded with mercury, sets up irritation and effusion. 56 Twentieth Century Practice. The ignorant extraction of teeth has also much to do with it. Catarrh and its disease germ, amoeba, often block up the nasal opening. The trouble seems to be that when its lining membrane becomes irritated it will secrete an endless va- riety of substances, which, when liquid, semi-liquid and glan- dular, are easily got rid of by an opening, stirring up the con- tents, and washing out the antrum daily with a stimulating wash. ARBOR VIT^E (Thuja Occident alls).— Oil and fluid ex- tract; dose from five to thirty drops of the former, thirty to sixty drops of the latter, destroys the micrococci of smallpox and warts; excellent externally for the destruction of simple and venereal warts, also for corns. The ozonized oil of arbor vitse is one of the most remarkable remedies ever presented to the medical profession, with an exceedingly wide range of ac- tion. Extracted by polarized light and negative ozone from the fresh leaves. An invaluable germicide. Taken internally it cleanses the blood by annihilating the spores of many disease germs. Indicated in all papular microbic diseases, as warts, variola, polypi, cauliflower and vascular excrescences, cancerous infil- trations, tumors. Dosage, from one to two up to from ten to thirty drops, added to water, every three hours, so as to keep the system saturated and prevent spores from germinating. Very excellent results are also obtained from incorporating the oil in an ozonized gelatin bougie. Papilloma in the urethra are much more common than is generally sup- posed; passed as a recurring stricture, so that by the use of these bougies we often rid the urethra from stubborn obstruc- tions. This same oil incorporated in butter of coca and make into a rectal and vaginal suppository. Indicated, as a rectal suppository, in prolapse of the rectum ; hemorrhoids ; fissures ; enlarged prostate, with weeping from the penis ; warts ; cancerous infiltration ; polypus. Indicated, as a vaginal pastil, in follicular inflammation of the mucous membrane of the vagina; uterine catarrh; warts and polypi ; vaginismus ; vascular excrescences ; granular cer- vix; erosions or ulcers of the os uteri; cancer; cauliflower growths ; tumors of all kinds ; hypertrophy of the uterus ; hem- orrhages. Twentieth Century Practice. 57 ATHLETICS. — Popular opinion, which is often wrong, has settled in favor of athletic exercises, although we are extremely doubtful of their utility. Gymnastic training develops con- siderable changes in the human body. It enlarges the muscles and glands, produces dilatation of the heart, structural and functional derangement, degenerative changes in the muscles, brain atrophy, bordering on idiocy; at least mental alertness of a low type. An athlete takes his place in the nation to which he belongs, in vital deterioration, because his exercise is destructive to brain nutrition. It wipes out the typical fissures of thought. Their tenacity of life is cut short. The nerve sup- ply which is essential to longevity is inadequate. He is short- lived even if his effete matter after exercise is removed. Over- training, excess, in which all are guilty, increased development, degeneration or deterioration follow of vital organs. Finally he resorts to tobacco or alcohol or both to allay his perverted desire. AN ANTI-MICROBE POWDER.— This is prepared by the action of ozone gas on boracic acid, forming a rose red powder of extraordinary germicidal power. It was specially prepared for surgical practice for dusting on wounds, obtaining in all cases in which it was applied union by first intention. Later on it has acquired quite a reputation in hospital and private practice, as a local germicide. It is especially adapted for the requirements of the nursery, as a dusting powder, and as a substitute for the villainous powders palmed off on mothers, here it has been used with signal success. As a toilet powder for ladies' use, it possesses great advantages over the poisonous cosmetic powders of zinc and bismuth so much in use, preparations which are very incautiously resorted to, and which cannot be too strongly condemned. In the management of cases of incontinence of urine, and in all urinary complaints, as a dusting powder it has proved in- valuable; by its use the urine is deodorized and the skin pro- tected against bacteria with soreness and excoriation. In chafing, in which bacteria are always evolved, its action is instantaneous, affording prompt relief. In erythema, roseola, urticaria, in which the bacteria are on the skin in search of free oxygen, its application is instan- taneous, in the removal of the burning, tingling in the skin. In bed sores in which the oidium albicans are present, this powder instantly kills the entire colony, and cicatrization takes place. 58 Twentieth Century Practice. It annihilates disease germs wherever they exist and can be reached. As a snuff, it will destroy the amceba of nasal catarrh; as a dentifrice or tooth or mouth application, all germs in the oral cavity will disappear if applied there; it is inimical to all forms of tinea, it will kill the cryptogamic growth of sycosis, if dusted on after the face is washed and dried. ANTITOXIN. — Is thus prepared : The streptococcus of diphtheria is taken from the throat of a child affected with the disease, and injected into the cellular tissue of a horse. This is followed by a febrile condition, which occupies a week ; this is repeated again and again, until no febrile reaction is ex- perienced. Later on, the animal is bled, and the serum of the blood is collected, to which carbolic acid is added, making a one-eighth per cent solution. This is injected into the cellular tissue of children who have the diphtheria, with the intention of arresting the growth of he germ, sterilizing the tissues, arresting the disease. Such a hypodermic injection produces degenerative changes in the blood, heart, kidneys. The whole affair is a delusion and a fraud — a money grab, for there is no warrant in nature for the assumption that animal cells secrete an antitoxin for a disease which may be used to induce an immunity in another animal. Cells secrete normal or perverted products, according to con- ditions under which they labor, and these conditions are modi- fied by pure drugs, habits, environments, modes of life. Antitoxin is simply glandered horse serum and carbolic acid, made up of scientific humbug. Parties desirous of testing the hypodermic treatment of diphtheria, without the abominable glandered serum of the horse, ass, or goat, etc., should try the germicide itself, pure and simple carbolic acid. As near as we can analyze it, it is as follows : Ten drops of carbolic acid to one pint of distilled water ap- proximates the strength of antitoxin, and is the solution in most general use. Of this solution a syringeful (sixteen minims) may be injected, and it may be repeated in one or two hours, or less often, as indicated. The dose is so small that, though a powerful drug, no danger need be apprehended from its use. The first effect of carbolic acid, hypodermically, is on the cir- culation, acting something like aconite. This is the effect we Twentieth Century Practice. 59 strive for in diphtheria, and therefore, must use it early. It re- lieves the congestion of the throat and head before the integrity of the tissues is materially injured. After the tissues are in a semi-gangrenous condition, the chances for a cure are not so good with any remedy. APHONIA. — Partial or complete loss of voice is more fre- quently caused by the toxins of disease germs, circulating in the blood, than by any other condition — paralyzing the nerves of the larynx, because they are weak, or their origin in the medulla oblongata being devitalized. Much of the non-success in treatment is due to a want of proper landmarks — a proper division. The first point to de- termine is to ascertain whether it be induced by the toxin of the microbe of tuberculosis, or syphilis, or bronchitis, or pneu- monia, or cancer, or croup, or diphtheria ; or to the depressing action of cold or wet, or to a lack of cohesion in the nerve cells, induced by a non-action of the will, in harmony with volition, such as we see in the ranting of some clergymen (laryngitis clericorum). Possibly (the medulla oblongata) the reflex nerve centre may be weak, very impressible, then either teething, worms, masturbation in either sex often a cause. APTH^E. — The evolution of the oidium albicans, a disease germ on mucous membrane of the human mouth, which may be communicated by local contact or infection to any other de- vitalized mucous membrane. The mouth is the superior orifice of the alimentary canal, and is the great cavity from which this passage is reached. The mouth is bounded by the palate, and at the back by the false palate, it is circumscribed by the cheeks, and closed by the lips. We commonly divide the mouth into two parts, the mouth proper and the interior mouth. The mouth extends just to the root of the tongue ; it contains the tongue, the gums and the teeth, and is moistened by the saliva secreted by three pairs of glands. 1. The parotid gland is situated at the angle of the jaw and the auditory canal, the canal of the gland that conducts the saliva to the mouth near the second eye-tooth. 2. The sub- maxillary gland excretes at every movement of the tongue. 3. The sublingual gland is placed behind the anterior part of 6o Twentieth Century Practice. the tongue, to supply it with moisture. The interior mouth is separated from the mouth proper by the rise of the palate. Mastication and primary digestion are the most important functions of this part of our organism. The evolution of this microbe is due to very many conditions. Malnutrition, inflammation. It may exist in the mouth alone, or travel backwards to the fauces, such as we have from an ordinary cold, or a sore mouth or throat. Usually commences with simple redness, slight puffiness of the membrane, which may subside in a few days, and leave the affected parts in their original condition. This may occur again and again, the in- dividual paying little or no attention to it; but each attack weakens, devitalizes, giving rise to an increased liability to a re- currence, and finally the evolution takes place in the follicles of the mucous membrane. If both mouth and fauces are involved,' there is considerable dryness and irritation, with fetor of breath, difficulty of swal- lowing, and pain. Mouth and fauces are studded over with these enlarged follicles, appearing rough and uneven, either in irregular patches or distinct. Vesicles rupture and the full- fledged microbe escapes, leaving the patches exposed in an ul- cerated condition. Spread from the lips to the fauces, the follicles of the mucous membrane of the fauces become involved, and the condition designated aphthae is apt to terminate in aphonia, with husk- iness, hoarseness and loss of voice. The microbe oidium albi- cans, an active worker, in this ulcerated state of the mucous membrane, throws off necrosed tissue in abundance, which is thick, sticky, and expectorated with difficulty. One remarkable feature of the evolution of the oidium albi- cans in all partial deaths of a mucous membrane is, whether it arises, from perverted nutrition or inflammation, that the evolu- tion of the germ in the mucous follicle invariably carries with it any other microbe which may be present in the blood of the in- dividual. For example, if the bacillus of syphilis, of tubercle, of rheumatism, of cancer, lurks in the blood, the oidium albicans will carry it, nay, transmit it, if opportunity offers; hence the terms simple aphthae, tubercular aphthae, syphilitic aphthae, rheumatic aphthae, cancerous aphthae, are appropriate. 'improperly speaking, aphthae is never purely a local affection, for v its |toxin in all cases is to be found in the blood. Aggra- vatefi l}y. insanitary conditions, as an atmosphere reeking with $iseas£ germs, overcrowding, absence of sunlight, meagre and Twentieth Century Practice. 61 deleterious food, as we have in large cities, it may assume a gangrenous form. All affections of the mouth and throat should be treated with warm, soothing, germicidal remedies. For local use, warm solutions of either ozonized boroglycer- ide or chlorate of carbon are unexcelled, used frequently, every two or three hours. If patient is old enough, or the parts are admissible, as the nipple or vulva, mouth, fauces, painting each patch over with jelly of violets, is most effectual in annihilating every vestige of a microbe in a mucous membrane, rapid cicatrization taking place. A few applications may be necessary. If it be the purpose to prolong treatment, solutions of either wild indigo, echinacea or siegesbeckie may be used. In some cases our readers will find a rapid and most effica- cious treatment in atomizing (warm) a spray of ozonized sul- phur water. This has been found highly beneficial, used thrice daily in stamping out the germ. ASPERMIA. — Absence of semen, a condition in which the patient, whether in coitus or other sexual excitement, is unable to ejaculate semen. This is met with either as a congenital or acquired affection; in the former it concerns men who have never discharged semen; in the latter, or acquired form, it is brought about by affections of the prostate, most frequently in- flammation, with effusion of lymph, occluding and obliterating the glandular structure and extensive nervous plexi of that gland. The largest number of cases of acquired aspermia which I meet with are married men who have resorted to unnatural methods of intercourse or congress with harlots, which give rise to prostatorrhea, occlusion of the ejaculatory ducts and hy- pertrophy of the prostate. The ozonized thyroid juice, solu- tion of spermin, kephalin, do excellent service, but iodol tab- lets, two grains, thrice daily internally, aristol suppositories and iodol bougies must be called into requisition to absorb the infiltration of lymph. The use of these animal extracts mark a new era of treat- ment. APIOL. — A solution of the pure active principle of parsley, a plant which has long enjoyed a world-wide reputation as a most trustworthy emmenagogue. It is largely employed to 62 Twentieth Century , Practice. regulate the menstrual function, in cases of scanty flow, amen- orrhea, dysmenorrhea, by reason of its stimulating effect on the intestinal and genital vasomotor system and, secondarily, on the utero-ovarian apparatus. Apiol, ozonized solution, should be carefully distinguished from all other preparations and from the essential oil ; it is a preparation of uniform composi- tion and may be relied upon to give results which cannot be ob- tained from the variable and uncertain products usually dis- pensed. APIS MELLIFICA. — Honey ; a liquid of a muco-saccharine nature, secreted in the nectarines of flowers, collected by the Apis mellifica, or common bee, and deposited in the cells of the combs ; a vegetable product, used both as a food and medicine; for the former it needs no digestion, as it is prepared for prompt assimilation, thus saving the digestive machinery; for the latter it is a demulcent, aperient, diuretic, germicide. As a food, decidedly nutritive; as a remedial agent, it de- pends much on the source whence it is derived. Procured from sections of the country in which buckwheat is the main source of supply, exceedingly nutritious; in California and Florida, remarkable for its intense sweetness and demulcent properties, the source being flowers ; whereas Australian honey is remarkable for the oil of eucalyptus it contains. This latter is of decided therapeutic value, especially in scarlet fever. Eucalyptus honey, a fresh importation can be obtained from the wholesale drug trade. Some physicians imagine that a tincture of the poison of the honey bee, obtained by maceration of the entire bee, is of ef- ficacy as a diuretic and diaphoretic, and in irritable bladder. As we have remedies of much more certainty of action, it is not worthy of clinical study. APPENDICITIS. — The caecum or its appendix, situated in the right iliac fossa, and covered by peritoneum only anteriorly, may be seriously diseased, without any other part of the intes- tines being affected. Thus severe colic, and even fatal ileitis, may arise from the lodgment in this part of the canal of hard, fecal matter, skins and stones of fruit, orange-seeds, gallstones, fish-bones, foreign bodies, balls of intestinal worms. Some- times fecal matters accumulate to such an extent as to form a very large mass, and many cases of recovery might be cited which took place upon the passages of a large quantity of feces, Twentieth Century Practice. 63 when the fecal enlargement had been pronounced a tumor by an ignorant practitioner. When any morbid matters get im- pacted in the vermiform appendix of the caecum, they are very apt to give rise to inflammation, ending in abscess. Symptoms. — In the acute form there is fever, nausea, con- stipation; fulness and tenderness about the right iliac region; pain rendered exquisite by pressure. Position on right side se- lected, with trunk somewhat bent, and knees drawn up to relax abdominal muscles so as not to press on painful tissues. If peritoneal coat becomes involved, may have general peritonitis ; or areolar tissue around caecum may become inflamed, and re- sult in suppuration and abscess; when this takes place, it is called perityphlitis. The treatment which has been successful in our hands has been the administration of very large doses of green root tincture of gelsemium, alternated with Dover's powder — per- severingly given, so as to induce narcotism — applying over the caecum concentrated ozone, and every hour a copious enema of a mixture of glycozone and infusion of lobelia herb. Just as soon as possible five to ten grains of periodate aurum — ener- getic treatment, bearing in mind that all operations are a de- lusion, for if not fatal at the time are so subsequently — medi- cinal treatment, avoiding the popular hobby, the knife. APOCYNUM CANNABINUM.— The root of the Ameri- can hemp. Physiological action: Has a special vitalizing action on all the serous, mucous, and synovial membranes of the body — as well as upon the walls of blood-vessels and nerves; hence valuable in rheumatism, neuralgia, etc., but above all it has a most decided action in all cases of dropsy. Therapeutical action : Used as a diuretic and hydragogue in all cases of dropsy. Preparations and dose : Decoction, fluid extract and tincture. The latter is the best, made of one part of the root to ten of alcohol. Dose, five minims to one dram, added to water, as indicated. Many physicians prefer the infusion. APOPLEXY. — Apoplexy is generally understood to be the effusion of blood into, or on; or under the brain within the cranium (the skull) ; this is called sanguineous apoplexy, There are, however, two other kinds of aploplexy : one called serous, where the fluid so effused is clear and straw-colored, or else very slightly tinged with blood ; the other kind of apoplexy 04 Twentieth Century Practice. is by some called the most perfect, that is, when there is no ef- fusion or extravasation of blood or other tlnid, but when the whole oi the blood-vessels are so inordinately distended with blood that the entire brain is pressed upon in consequence of the heart propelling the blood through the arteries with great force, the veins do not return the blood from the brain with sufficient quickness, and then, as the skull is unyielding, the substance of the brain is pressed upon throughout ; and unless this is speedily relieved the patient dies. This is held to be the most fatal form of apoplexy; because when blood is effused it may be small in quantity and perhaps slowly poured out, the pressure therefore is more partial, death occurs more slowly, or is sometimes averted for a considerable period. The effusion oi blood may occur in any part of the brain, as between its membranes, between the inner surfaces of the skull and the membrane called the dura mater, which lines it; it may be poured into any part of the substance of the brain, or into the cavities called venticles; it may happen between the base (the under part) oi the brain and the floor of the skull; and here, be it remarked, it would be more certainly and more quickly fatal. If it were to happen in the lesser brain (the cerebellum), it would be certainly fatal, and at once. Having thus furnished an outline of the nature of the dis- ease, we come to the causes that are supposed to predispose to its occurrence ; these are numerous. Intemperance of all kinds, whether in fermented liquors, gluttony, excessive amatory in- dulgence, violent passions and strong emotions, very high tem- perature, tight collars, tight lacing, a long depending position oi the head, severe cold long applied to the body, improper use of narcotic drugs, inhalation of some gases, blows on the head, violent straining, incessant coughing, great distention of the stomach and intestines with food or flatus, and in different de- grees perhaps any cause that tends to derangement of the health. The recital of the occasional causes will, to a certain extent, point out the means oi avoidance ; in addition we will give some directions for the management of those who are prone to the disease. Moderation in the indulgence of all the appetites should be en joined, and indeed it would be better if a total abstinence from all those gratifications which tend to excite the circulation were observed. Animal food to be taken in the smallest quan- tities, but if the patient be of a full and robust habit he should Twentieth Century Practice. 65 avoid it altogether, and take no beverage but tea, coffee, toast- water or spring-water. Wine, spirits, and beer are poisons in such cases, ay, even the smallest quantities. The hair should be closely cut, and the head kept very cool ; discard nightcaps and all headgear, wear the lightest of hats. Keep the feet warm and the body agreeably so. Discard all garments that nave the effect of tight ligatures on the body. Take as much exercise as the strength will permit, and as little sleep as pos- sible, avoid the siesta or after-dinner nap, retire early and rise soon in the morning. It must not be forgotten that depressing passions and emotions are as adverse to the welfare of the pa- tient as the exciting ones. Let the bowels be kept freely open : never neglect them. These general results will be frequently followed by the best results ; more particular ones can only be supplied by a judicious surgeon, because they will be determined by the exigencies of the case, the age, habits, and other circumstances of the patient. No age has been exempt from this appalling disease, but it is most frequent in its occurrence after forty-five. The idle, the intemperate, and the luxurious furnish the greatest number of examples. In some families it would seem to be hereditary, but it is perhaps connected with other peculiarities of constitu- tion. Families that in their succession afford the largest num- ber of instances are rarely exempt from tuberculosis gout, or insanity. The excessive wear and tear of the nervous system, inci- dental to a high state of civilization, excess in eating and drink- ing, peculiar formation of body, give rise to an impaired vitality of the cerebrum, called apoplexy, in which there is a sudden loss of consciousness, power of voluntary motion ; coma, from which no exertion can rouse, with heavy stertorous breathing; frothy saliva blown from the mouth, with a full bard pulse. Three varieties met with in practice, ( 1 ) nervous, in which no appreciable lesion can be detected in the brain; (2) san- guineous, in which an effusion of blood has taken place into the substance of the brain, usually forming a clot; (3) serous, the pouring out of the watery portion of the blood, which finds its level upon the base of the brain, and gives rise to paralysis. The sanguineous is the most common, an attack of which may be brought on either by a flow of blood to the head, or by anything that prevents or retards its return, such as violent fits •of passion, great or violent muscular exercise, stooping, study, 66 Twentieth Century Practice. wearing tight articles of dress around the neck, overloading the stomach, excessive use of highly seasoned food and malt liquors, inhaling the fumes of sulphur, opium, mercury, char- coal ; concussions, blows, and by drugs as overdoses of quinine. The young and middle-aged of a plethoric habit of body are most liable to the sanguineous form; those of an intensely nervous diathesis, spare habit, impaired constitution, to the serous and nervous. In the three varieties the attack is ushered in with vertigo,, a sense of pressure or weight in the head, choking sensation, drowsiness ; confusion of the senses and ideas, loss of sight and memory. During the seizure in the sanguineous form the face flushes, congested pupils are contracted ; in the other forms, pale, pulse variable, coma, stertorous breathing; pupils either dilated or contracted or one dilated, the other contracted; difficulty in swallowing ; incontinence of urine. Any of those symptoms calls for immediate, energetic treat- ment, calculated to ward off an attack, such as cutting the hair and applying hot packs to the head; dry cupping neck, shoulders ; mustard to the extremities from the toe to the knee, free purgation — little drink, spare diet, but nutritious. If an attack has taken place, loosen all tight clothing about the neck ; remove the patient to a cool place ; keep the head and shoulders elevated; abundance of fresh air. As soon as he rallies, free action of bowels is necessary; meagre diet; he must carefully avoid fits of excitement, passion and sexual congress, exertion and changes of temperature, especially exposure to hot sun, hot baths, overheated rooms and violent exercise. If the patient can swallow remedies, passiflora incarnata, with veratrum viride to keep the pulse at sixty, are most bene- ficial. Dry cupping to be repeated every forty-eight hours, mustard on the calves of the legs and soles of the feet, free- purgation. In the serous and sanguineous forms, hot packs to the head, enemata of chloral hydrate; passiflora suppositories to restore sensibility. ASEPTOL. — This term is applied to a 33^2 per cent solu- tion of orthoxyphenol sulphonic acid. It has been recom- mended as a substitute for carbolic and salicylic acids. It pos- sesses their antiseptic properties and is soluble in water, alcohol, and glycerin in all proportions. It is free from the irritant: Twentieth Century Practice. 67 and toxic properties of carbolic acid, and is therefore recom- mended in extensive surgical operations (opening of the ab- dominal cavity, etc.). It is not escharotic when applied to delicate tissues. It has antiseptic properties in a solution of 1 in 1,000. The internal dose is intermediate between carbolic and salicylic acids. ARISTOL. — A combination of iodine and thymol, is a valu- able, inodorous, and non-toxic bactericide, equal if not superior to iodoform, iodol. Aristol is insoluble in water and glycerin, slightly so in alcohol, but readily so in ether. Soluble in oils by thorough friction without heat. Used like iodoform or iodol, for the cure of chancres, ulcers; by dusting on, excites rapid cicatrization; also excellent in parasitical skin affections. It has acquired quite a reputation as a peculiar and powerful absorbent. In the form of a suppository, containing two and a half grains of the aristol, it has wrought wonders in procur- ing absorption of the fibrous and connective tissue of an en- largement of the prostate gland. We might, if our space permitted, cite case after case, in which the aristol suppository has effected a radical cure. Old, very chronic, indurated cases that have resisted every remedy yield to this. The best exhibition or method is at 3 p. m. insert a cocain suppository. This induces complete anesthesia. Three hours later empty the rectum by an administration of an enamae of either flaxseed or slippery elm tea ; when that passes off, insert the aristol suppository pretty well up in the rectum, and permit it to remain over night. ARAROBA, OR GOA POWDER.— The tree Angeline amarjose, growing from 80 to 100 feet high, in Brazil, whose heart wood, under certain conditions, undergoes a peculiar cel- lular metamorphosis into what is termed goa powder, the active principle of which is chrysarobin, forming chrisophanic acid under the influence of moist air and ammonia ; a powerful bactericide. This acid is generally used instead of the crude powder. Therapeutic action : As an external microbicide in psoriasis, lupus, all forms of tinea, eczema, and parasitical cutaneous af- fections, it is of rare value. It is also administered internally. Preparations and doses: From 10 to 20 grains of the acid added to an ounce of ozone ointment is exceedingly valuable. 68 Twentieth Century Practice. Internally the dose should be small, i-io of a grain triturated in sugar of milk; larger doses are liable to cause irritation, vomiting, purging. AMERICAN ASH.— Specially indicated in all types of the uric acid diathesis, rheumatism, and gout in ladies. The chemical composition of this remedy is such — lime, colchicin, lithia, hydrastin, cocain — that it is pre-eminently a drug for the ladies of the near future; extremely efficacious in mem- branous dysmenorrhea. Dose: From a half to one teaspoonful, to be increased, if necessary, every three hours, or more frequently, if advisable. ASPIDIUM FILIX-MAS.— The root of the male fern is useful in expelling tape-worm. Preparations and dose, 8 to 20 drops, to be repeated as the case requires. ASPHYXIA. — Suspended animation or arrest of the phe- nomena of respiration and circulation ; suffocation by the non- conversion of the venous blood in the lungs into arterial, owing to the supply of air being cut off ; the unchanged venous blood of the pulmonary artery passes into the minute radicles of the pulmonary vein. Their peculiar physiological construc- tion requires arterial blood to excite them. Stagnation takes place in the pulmonary capillaries ; death follows from want of arterial blood. Whatever be the cause, drowning, strangulation, hanging, inhalation of noxious gases, first clear the mouth and nose of mucus or other substances; expose face and chest to the air; elevate the head; pull forward the tongue; resort to artificial respiration at once; this is most useful and should be perse- vered with; don't give any drink till breathing has been re- stored. Then select whatever is most speedily and easily pro- cured of one, or two, or more of the following: Friction to the entire body with hot towels; hpodermic injections of either brandy or ether, or nitroglycerin; drop doses of one per cent solution of nitroglycerin on the tip of the tongue, a supposi- tory of the same in the rectum ; electrical, positive pole over the nape of the neck (medulla oblongata), negative over the dia- phragm ; enemata of either comp. oxygen, or glucozone, or per- oxide of hydrogen, or infusion of capsicum, or brandy, or an emulsion of turpentine. Use the most easily procured. As Twentieth Century Practice. 69 soon as he breathes, give comp. oxygen, either by inhalation or orally. In the newly born, if asphyxiated, place child in a hot, then into a cold bath, alternately for five or ten minutes ; use brisk friction to spine, then entire body, artificial respiration, loss of a few drops of blood from the umbilical cord ; injections con- taining a little brandy. The following rules are excellent : Rule i. — Remove all obstructions to breathing. Instantly loosen or cut apart all neck and waist bands ; turn the patient on his face, with the head down hill ; stand astride the hips with your face toward his head, and, locking your fingers together under his belly, raise the body as high as you can without lifting the forehead oft" the ground and give the body a smart jerk to remove mucus from the throat and water from the windpipe; hold the body suspended long enough to slowly count one, two. three, four, five, repeating the jerk more gently two or three times. Then act by Rule 2. Rule 2. — Keep the patient face downward and maintaining all the while your position astride the body, grasp the points of the shoulders by the clothing, or, if the body is naked, thrust your fingers into the armpits, clasping your thumbs over the points of the shoulders, and raise the chest as high as you can without lifting the head quite off the ground, and hold it long enough to slowly count one, two, three. Replace him on the ground with his forehead on his flexed arm, the neck straight- ened out, and the mouth and nose free. Place your elbows against your knees and your hands upon the sides of his chest over the lower ribs and press downward and inward with in- creasing force long enough to slowly count one, two. Then suddenly let go, grasp the shoulders as before and raise the chest ; then press upon the ribs, etc. These alternate movements should be repeated ten to fifteen times a minute for an hour at least, unless breathing is restored sooner. Use the same regu- larity as in natural breathing. Do not give up too soon. You are working for life. Any time within two hours you may be on the very threshold of success without there being any sign of it. Rule 3. — After breathing has commenced, restore the ani- mal heat. Wrap him in warm blankets, apply bottles of hot water, hot bricks, or anything to restore heat. Warm the head nearly as fast as the body, lest convulsions come on. Rubbing the body with warm cloths or the hand, and slapping the fleshy yo Twentieth Century Practice. parts, may assist to restore warmth, the circulation of the blood and breathing also. The rubbing of the limbs should always be from the extremities toward the body. If the patient can surely swallow, give hot coffee, tea, milk, or a little hot sling. Give spirits sparingly, lest they produce depression. Place the patient in a bed, ancl give him plenty of fresh air; keep him quiet. Avoid delay. A moment may turn the scale for life or death. Dry ground, shelter, warmth, stimulants, etc., at this moment are nothing; artificial breathing is everything — is the one remedy ; all others are secondary. Do not stop to remove wet clothing. Precious time is wasted, and the patient may be fatally chilled by exposure of the naked body even in summer. Give all your attention and effort to restore breathing by forcing air into, and out of, the lungs. If the breathing had just ceased, a smart slap on the face, or a vigorous twist of the hair, will sometimes start it again, and may be tried incidentally, as may also, pressing the finger upon the root of the tongue. Before natural breathing is fully restored do not let the pa- tient lie on his back, unless some person holds the tongue for- ward. The tongue by falling back may close the windpipe and cause fatal choking. If several persons are present, one may hold the head steady, keeping the neck nearly straight ; others may remove wet cloth- ing, replacing at once by clothing which is dry and warm ; they may also chafe the limbs, rubbing toward the body, and thus promote the circulation. Prevent friends from crowding around the patient and ex- cluding fresh air; also from trying to give stimulants before the patient can swallow. The first causes suffocation; the second, fatal choking. In suffocation by smoke or any poisonous gas, as also by hanging, proceed the same as for drowning, omitting effort to expel water and the like from windpipe. In suspended breath- ing from effects of chloroform, hydrate of chloral, electric shock, and the like, proceed by Rule 2, taking especial pains to keep the head very low, and preventing closure of the wind- pipe by the tongue falling back. The insertion of one or two nitroglycerin suppositories or a 3; or 4 drop on the tongue, will often resume instantaneous re- susication. Twentieth Century Practice. 71 ATAXIA. — Locomotor ataxia, a disease of the spinal cord in which there is an excessive formation of connective tissue, a true sclerosis of the posterior columns, with wasting and disin- tegration of the nerve fibres emanating therefrom. The dorsal and lumbar portions of the cord are usually implicated. Be- coming a common malady among men addicted to sexual ex- cesses, and who are so unfortunate as to have either the mi- crobe or toxin of syphilis in their blood. It may also be hereditary, in which case the lateral and pos- terior columns of the cord are affected. In these cases, the child exhibits oscillations of the eyelids ; very jerky, speech much impaired, ataxic gait. When acquired in adults it has the following well-defined characteristics : Impaired vision, incipient amaurosis, or changes in the reaction of the pupil to light, but not to accom- modation ; squint, sharp, shooting, stabbing pains in the muscles of the limbs; inco-ordination of muscular movements, exhib- ited chiefly in the peculiar manner in which the feet are thrown out and the heels brought sharply to the ground; inability to stand with the eyes closed; muscular jerking, spasm, numbness, followed by loss of sensation in the lower limbs; by and by, paralysis, with bladder and rectal trouble. Usually slow, insidious; lasting many years before ataxia comes on. Unless some accidental condition sets in, death is due to grave organic changes in the brain. Although unable to effect a cure in locomotor ataxia, much can be done to ameliorate, retard its onward progress and pro- long life. As' valuable aids to accomplish this, daily bathing, followed by massage by a highly vitalized manipulator for at least one hour and a half, morning and night — then faradization of the entire body, and latterly inunction of guaiacol. Diet most nutritious ; an excess of highly animalized food. Much efficacy is derived from wearing a large guaiacol plas- ter over the lumbar portion of the spine, removed and reapplied after every act of massage. Suspension is absurd ; the fallacy of ignorance ; a sea voyage, change of scene, excellent. We grant the incurability of the disease, but claim that it could be arrested or stayed, life prolonged. We have tried the following, and make a suggestion to a. host of anxious, half-hoping, half-doubting sufferers — that the expressed juice of the Phytolacca berry, administered in doses. 72 Twentieth Century Practice. of from 2 to 15 drops thrice daily, diluted in water, has a most remarkable action upon blood formation, upon the pink marrow and like glands ; that when steadily administered it restores the vital fluid to a normal standard, checks the formation of the connective tissue elements in the blood, keeping the blood at a high standard. The ozonized Phytolacca berry juice is at least twenty times more active, hence better results now than could be obtained thirty years ago. It relieves the lightning pains in this affection and effects considerable improvement in gait and general condition of the patient. Chloride of aluminium in 5-grain doses thrice daily is another remedy of some merit, and often effects considerable improvement. Cacodylate of sodium is being used quite extensively in loco- motor ataxia with much benefit, so far, greatly increasing nu- trition and arresting the growth of connective tissue. ATMOSPHERIC DISINFECTION.— The value of disin- fectants in cities contaminated by sewer gas, and in the pres- ence of such affections as cancer, syphilis, tuberculosis, diph- theria, typhoid fever, whooping-cough, and the eruptive fevers, cannot be duly appreciated. The time has arrived when old methods of disinfection must be discarded, as not far-reaching enough, and newer, more powerful, deeply penetrating means take their place. One large tablespoonful of formalin added to one quart of water, distributed in shallow plates around a room, the at- mosphere of the apartment at a temperature of 75 degrees F., the formalin will not irritate the most delicate individuals, but will volatilize sufficiently to completely annihilate every disease germ present. There is no necessity either to boil the water or apply heat, as it will vaporize sufficiently to destroy any microbe it comes in contact with on any material object in the apartment. Physicians should use this brand only, as it is C. P. ; it is no cheap, inferior, watered down stuff. They should see that it is kept in every house ; it is unexcelled, admits of ready volatiliza- tion. The vapor so generated is pure formalin attenuated; thoroughly competent to act as a most efficient bactericide and ozonizing agent. Placed in every house, renewed every few days, there would be much less disease, and what would be •would suffer great amelioration, likely break it up. Words are Twentieth Century Practice. 73 inadequate to describe its great efficacy in throat and lung mala- dies, especially when the tubercle bacillus is present. House, school, church, theatre sanitation is important; va- rious forms of fungi can be detected in all these structures, whether frequently occupied or not, which can readily be ef- faced by the exposure of formalin. In this preparation of formalin, we have an ideal germicide — an agent possessing greater bactericidal properties than we possess in any other drug, which makes it specially valuable for sterilizing the epithelial scales in scarlet fever, which contain the spores of the micrococcus. If the formalin is exposed in the apartment, it matters little where they drift, for from them similar life cannot spring, for the scales on desquamation are so altered by this agent that the germ never propagates again. Formalin approaches the ideal germicide, and as such its ex- posure in the apartment during the desquamative stage of scar- let fever is to be commended. As a disinfectant formalin has no deleterious effect ; it is only when it gets into the body by the stomach that it causes atrophy of the optic nerve. ATROPHY. — A wasting, a shriveling up of any tissue, structure or organ. Brain Atrophy. — A shrinkage of the brain is an incident of modern civilization — common in old age, when it becomes small, intellectual faculties childish— modern precosity gives us atrophy in the young — a draining of the nervo-vital fluid, either in masturbation or sexual excesses at any period of life; our present system of instruction in schools; the tension; the use of beer or any alcoholic beverage; excessive study, long, profound ; a diminution of sleep or insomnia ; and above and be- yond all, the toxins of disease germs. Before any remedies can be successful in eradicating brain atrophy, the cause must be removed, then select from the fol- lowing remedies, some two of them, of the greatest efficacy, should be administered : comp. tincture matricaria, kephalin granules, cerebrin, avena sativa, coca passiflora incarnata, c. p. solution of spermin, protonuclein, thyroid ext, massage, elec- tricity. The best food for wasting of the cerebrum is oatmeal, wheaten grits, broiled white fish, with abundance of animal and vegetable substances. 74 Twentieth Century Practice. Atrophy of the Heart. — The heart muscle, from want of nutrition, as it is very abundantly, nay, profusely supplied with branches of the great sympathetic, it loses under depressing- emotions, desires, affections, passions. The toxins of disease germs in the blood act disastrously upon all involuntary mus- cles, especially the toxins of diphtheria, epidemic influenza, ty- phoid fever, syphilis, pneumonia, etc. Tobacco, tea, acro-narcotic drugs predispose to a feeble heart. Atrophy of the heart is very easily recognized by the feeble pulse, from forty to sixty beats per minute; lowered tempera- ture, lassitude, debility, vertigo, muscae volitantes, tinnitus, area of dullness on percussion much diminished ; sounds very feeble, often inaudible, with anemia, defective metabolism, malnutri- tion, the function of every gland is very much impaired. In the case of atrophy of the heart, or cardiac failure, first forbid the use of tea, beer, alcohol, tobacco and all acro-nar- cotics. Anemia, an exhausted nerve centre, is at the origin of every case. Therefore, we must bear in mind that massage stimulates the heart, the arterial circulation in the muscle has- tens the nervous currents, promotes the passage of lymph through the lymphatic vessels. Under systematized massage the metabolism of the body is maintained — digestion much improved; it aids cardiac nutrition, relieves the stagnant circu- lation, then a wonderful improvement in every organ, gland, in motor and sensient nerves takes place. Matricaria is the best cardiac stimulant in those cases. Kephalin granules are unexcelled — avena sativa, good; cin- chona and mineral acids are of rare value, passiflora. Use thy- roid extract with care. Local stimulation over region of heart. The best of all remedies is the muscle alkaloid creatinin. Diet, light, generous; give stomach rest, time to recuperate. Atrophy of the Mammary Gland. — The larynx, mam- mary gland, the uterus and its appendages, are linked as one, by a chain of nerves that bind and anastomose together, so that any shock, concussion, jar, injury to one, implicates the others. A shock to the uterus, from cold during menstruation, causes the breast to collapse, and aphonia to supervene. A woman guilty of masturbation causes brain, uterus, breasts and larynx to atrophy. Prostitution loose, varied, blights the entire gen- erative system. Absolute celibacy, as in elderly maidens, gives rise to uterine, ovarian, mammary and laryngeal shrinkage, hence the peculiar modulation of voice. As the entire repro- Twentieth Century Practice. 75 ductive system, anteriorly is covered with branches of the great sympathetic, depression to her moral nature rebounds upon her breasts. It may be congenital or due to the toxins of disease germs. In order to establish a growth or regrowth of the mammary gland, all causes that produced it must be removed, and patient by means of bathing, nutrition, be placed in as good a condition as possible. Internally select one or two of the following and administer — matricaria before meals, either kephalin, avena sativa, malt extract, thyroid extract, protonuclein c. p. solution of spermin, creatinin, saw palmetto. Locally, bathing the breasts once or twice daily, friction, electricity, saw palmetto ointment. No compression. Diet, generous to a fault, oatmeal, broiled fish, cream, ani- mal and vegetable diet of the best. Atrophy of Muscles. — Muscles lose their contractility either by non-use, or injury to their nerves, or the non-exercise of the will with the act of volition, to the paralyzing action of the toxins, of disease germs; then if any of those conditions be present, the fibres of the muscle or muscles will become pale, inelastic, and if not arrested will pass into fatty degeneration. So long, however, as vital contractility is manifest by bring- ing the electric current upon the muscle and its exhibiting the proper test, hopes may be entertained of a cure, otherwise there is none. If there be the slightest response to the electrical current, the individual should be braced up by every possible means — best of nutrition, bathing, systematic massage, passive motion, fric- tion, kneading, patting, followed by judicious faradization, not only of the affected muscles, but of the entire body. , Internally tonics are the most available remedies, such as will aid blood formation, thyroid extract, protonuclein, cinchona and mineral acids; from 3 to 6 grains of creatinin daily; malt extracts are inoperative remedies for muscle growth, those with tobacco and other narcotic remedies forbid. Atrophy of the Spinal Cord. — Aside from all forms. of mechanical violence, shock, ajrs, concussions, blows, mastur- bation, sexual excesses, etc., the toxin of the bacillus of syph- ilis heads the list as the grand cause of spinal atrophy and palsy. The symptomatology of the atrophy of the cord is very varied and protean — spastic paralysis of the lower ex- tremities is common; disturbance of sensation, involvement of j6 Twentieth Century Practice. bladder and rectum, complete impotence, tremors, burning sen- sations in skin — usually pain in the abdomen, hips, knees, legs and intercostal region. The great object to be attained by any treatment is to destroy the active neoplasms in and around the cord and overcome the degeneracy. For this purpose and to overcome the wasting, starting new elements of life, a guaiacol plaster, four inches wide, reaching from the medulla oblongata to the sacrum, kept on forty-eight hours, off the same length of time, and then re-applied again and again, it works wonders when this vitalized structure is smitten — when off, a linimentum of guaiacol and chloroform should be rubbed in. Internally most nutritious diet and the same remedies as for atrophy of the brain, especially thyroid extract, proto- nuclein and spermin, are excellent. Comp. saxifraga with an excess of iodide potass, in alternation with quinine. Daily bathing, followed with massage for one or two hours, never to be omitted. Atrophy of the Testes. — Exceedingly common; produc- tive of phrenal degeneracy; may be congenital; blows on the head and back in early, life, later on masturbation, varicocele, excessive sexual indulgence will cause them to waste, especially if there be incompatibility; or the participant a prostitute; or addicted to loose and varied congress, celibacy. The toxins of many of the pathogenic microbes, such as the gonococcus, the bacillus of syphilis, tubercle, mumps, give rise to a blight of the testes. Bicycle exercise damages the prostate, seminal ducts, gives rise to a constant leakage, dwarfs the testes, subsequently imbecility and mild insanity follow. Dime novels are a moral poison, inaugurate a wasting of the testes. All the causes being removed, the growth of these glands can be promoted, often radically restored, by prescribing matri- caria, saw palmetto, kephalin, avena sativa, passiflora, thyroid extract, protonuclein, ambrosia orientalis. Occasionally comp. saxifraga and quinine. C. p. solution of spermin. This latter remedy merits the attention of all who have either small or shrunken testes. It being the pure alkaloidal spermin extracted from the testes of the bull, it fills the bill, a direct nutrient to the testes ; an invigorator of the brain. Locally bathing, saw palmetto ointment, electricity. A diet of the most nutritious character, eggs, shell fish, wheaten grits, poultry, rare broiled steak. Twentieth Century Practice. 77 Atrophy of the Uterus. — This may be either congenital or due to retarded development ; or to blows, falls, shocks, falls on back of head, violence of some kind, or to depressing pas- sions, toxins of disease germs ; fevers, morbid blood stream, as in syphilis, menstrual suppression. Removal of the ovaries causes of the body of the uterus to disappear entirely. Atrophy of the uterus between fifteen and forty-five years of age is best treated by the removal of causes. A generous diet, moderate exercise, flannel clothing, bathing, massage, and faradization of the uterus daily. If it be due to ovarian and uterine blight, thyroid extract, protonuclein c. p. solution of spermin, are valuable remedies; work wonders as uterine vitalizers and tonics. The most gratifying results are obtained from the kephalin granules, which are usually prompt and decisive in their action. The wine of aletris farinosa should never be overlooked in the general treatment. The best success in ovaro-uterine atrophy, is to stimulate their functional activity by invigorating the nervous system. ASTHMA. — This term is very vaguely used to designate a malady characterized by wheezing respiration — a difficulty of breathing occurring in paroxysms, but the genuine disease in- cludes those cases only in which there is an irritation either in the origin of the vagus or some part of its course. The causes which are supposed by many to give rise to this are peculiar types of conformation, non-acclimatization, morbid states of the blood, toxins of disease germs, peculiar affinity for certain locations, certain idiosyncracies to the aroma of plants, flowers, grasses. Attacks or seizures are most liable to take place when the electrical condition of the atmosphere is lowered. This con- dition is blended with a neurosis, a reflex impressibility, irrita- bility and hyperemia of the bronchial mucous membrane, which seem to be an essential part of the disease. Structural changes are rare in simple asthma, common in the genuine. True or nervous asthma consists in a paroxysmal spasm of longer or shorter duration, brought on by some of the causes enumerated and by others unknown, which irritate the nerves that supply the circular muscular fibres of the bronchi, causing contraction usually after an inspiration; the air is retained in the air cells; there is an impending sense of suffocation, gasp- y8 Twentieth Century Practice. ing for breath, profuse sweating; relaxation usually follows, and the spasm is relieved. As a rule, the spasm is ushered in with languor, drowsiness, anxiety, wheezing respiration. If patient anticipates an attack let him take a tablespoonful of the ozonized tincture of euphor- bia pilulifera, add to it half a tumbler of hot water, and take half a teaspoonful every five minutes until it has checked or broken up the attack. This is most efficient, safe ; no harm can come from a large or overdose ; better by far than inhaling the fumes of stramonium, nitrate paper, or even the nitrite of amyl. Euphorbia pil. is a curative drug in asthma ; as such it is best taken in the form of a tablet or lozenge, one every three hours. If the patient is not promptly placed upon this remedy, then one or other of either of the following should be selected and the patient placed upon it : Musk root, rosin weed, coca, eryth- roxylon, grindelia, nitrites of glycerin, amyl, sodium, glycerite of sulphur, passiflora incarnata, Calabar bean, bromid. If the toxins of disease germs be the cause, a combination of iodide of potass, and quinine, 5 of the former to 1 of the latter; increase in these proportions. A nutritious diet, with a careful regulation of every article, is important ; flannel clothing. In the neurosis of hay, roses, ragweed, grape asthma, paint the fauces and tonsils of the nostrils freely with the jelly of violets daily. This anesthetic completely wipes out all at- tacks. Fortify the vital forces with matricaria and kephalin granules. In spasmodic contraction of the circular muscular fibres of the bronchi, no matter what its causation may be, there is always to be found an evolution of a microbe, pathogenic of the disease. Inhalation of narcotics affords relief by sterilizing the germ. If, at the very moment of an attack, the chest and back be lightly but rapidly sprayed with the chloride of methyl, the at- tack will at once cease, and remain so for twenty-four hours. The euphorbia pil., in tincture form, has great power in re- laxing bronchial spasm, best administered by adding two tea- spoonful to a cup of hot water, of which one teaspoonful every few minutes is a dose; it is an excellent remedy to ward off nocturnal attacks. The euphorbia has great power in relieving bronchial spasm administered by the mouth or rectum. A very popular, successful method of relieving the urgent Twentieth Century Practice. 79 symptoms of asthma is in prescribing the following : Chloral Trydrate, 1 ounce; ozonized syrup of tolu, 1 ounce; tincture euphorbia pil., 2 drams; fennel water, 2 ounces; mix. Dose, teaspoonful doses at first every half hour; as soon as relief comes, every three hours. Paint nasal fossa as far in as pos- sible with glycerin, half an ounce; hydrochlorate of cocain, 10 grains ; dissolve by the aid of heat, or, what is even better, paint both the nasal cavity and fauces with jelly of violets, when there is immediate relief of the spasm. AURUM (Gold). — Preparations of this metal are bacteri- cides. The pure chloride of gold, dissolved in nitric acid to the point of saturation, makes a valuable caustic for the de- struction of the hybrid germ of lupus. The chloride of gold and soda, one-thirtieth of a grain, triturated in sugar of milk, destroys the germs of syphilis and cancer. The periodate is a new chemical compound of a definite com- position, a product of the union of iodine and gold — a most powerful germicide, especially destructive to the syphilitic germ, being neither caustic nor corrosive. The only remedy capable of staying the never-ceasing on- ward march of syphilis, for when administered in that malady it yields brilliant results. Syphilis, contagious and infectious, the affected individual is a social danger. Prophylaxis is a failure all over the world ; self-denial, moral and religious scruples a failure; even licens- ing brothels has in no way diminished the number of cases, but vastly increased the clandestine centres of prostitution. Here, then, is the treatment of the greatest venereal specialist of the lungs and heart in health, and are aided in forming a •cinchona alkaloid as a tonic; late in the evening from 5 to 10 grains periodate aurum, with slight intermissions, is main- tained for six months. AUSCULTATION. — The method of recognizing disease "by listening to internal sounds. Thus we listen to the sounds of the lungs and heart in health, and are aided in forming a •diagnosis in disease. Modern methods of examination of those two organs are by the stethoscope (see Diagnosis). AUTO-INTOXICATION.— The human body may be poisoned by products of its own making, as well as by the toxins of bacterial life. 80 Twentieth Century Practice. In the normal process of digestion, there may be elements thrown into the circulation which may produce alarming^ symptoms, even death. The urinary tract, from the tubuli to the meatus, is covered with a non-urea absorbing surface. Rob it of that epithelial covering, speedy intoxication follows. In the whole range of animal existence, waste products are highly toxical. Man himself is but a laboratory of poisons; the sweat is intensely toxical, the feces possess great toxicity; if retained a considerable auto-intoxication follows. The feeling of languor after exercise ; the comatose, drowsy feeling after meals, is due to the absorption of toxins derived from proteids. Auto-intoxication often arises from imper- fectly digested products. So great is the amount of toxins generated within the human body, that we would all die, were it not for the excretory action of the liver. The liver is a safeguard, a sentinel ever on guard to arrest toxins from entering the circulation. The liver destroys a certain amount of toxic matter, and arrests ptomains from en- tering the circulation. The blood current, that carries everything absorbable through the liver, meets within this gland an important func- tion, namely, arresting all poisons in alimentary canal on their way into the general circulation. The portal blood, often loaded with poisons, reaches the liver, where it is at once arrested and thrown back into the bowel. This happens again and again, until this entero-hepatic circulation of ptomains grows smaller and smaller and finally reaches the colon, and, mixed with other excrementitious matter, it leaves the body. Some poisons, like tyrotoxicon and the pus microbe, have re- markable lethal effects. AVENA SATIVA. — By a newly discovered, elaborated chemical process, the avenine, an alkaloidal body, has been iso- lated, chiefly from Scotch oats, in great abundance. The finest Midlothian oats, coarsely crushed covered with water and kept at a temperature of 100 degrees F. for six weeks, permitted to undergo acetous fermentation, then sub- mitted to the action of glycerin, alcohol, and ozone, liberates an immense amount of vegetable phosphorus. This hydro-alcoholic phosphorized tincture is rich in phos- phorus. Twentieth Century Practice. 8i Indicated. — In all forms of weakness of whatever kind in children or grown persons ; in retarded dentition ; all diseases, especially nervous exhaustion, physical, mental debility; nerv- ousness, nerve tire, loss of memory, deafness and blindness, vertigo, insomnia, headache, white softening, paralysis, loss of vigor, impotency. It is the Great Desideratum of the age, composed of the phosphates of the Scotch oats, the life-giving property of the brain, a brain and nerve food, a pabulum upon which the brain feeds, a remedy which contains the essential elements of being, of life, of thought, and organization. To the user it imparts great intellectual vigor; brilliancy and vivacity of thought, a redundancy and freshness of ideas, great mental and physical strength, and endurance ; besides it creates a higher and nobler type of manhood, deepens the typical fis- sures of thought. Every human being should use it. Dose : For adults, from 15 to 30 drops in a little water every four hours; for children, 1 drop for every year of their age as fre- quent. BACTERIA. — A few years ago this term was applied to all disease germs; at the present time the name is restricted to that germinal mass present on the tongue, in malassimila- tion, in disordered states of the alimentary canal, in wounds, or breeches of continuity. It is identical with the bacillus me- gatherium, whfch is invariably found on decaying vegetables. The microbe consists of large rods like small sausages, four or five times longer than wide, usually somewhat curved. In the process of sprouting, transverse division occurs, each seg- ment attaining the same length as the original rod. When first seen, with a power of 1250 diameters, they appear non-articu- lated, but when a drop of alcohol is placed on them, the seg- ments are clearly seen. The rods are motile and form irregu- lar chains of a disjointed appearance. The bacteria are the most common of all the disease germs, being nothing more than the degraded elements of nutrition in man, and plants, changed, altered, under some adverse condi- tions. It is found in all deranged or perverted states, as well as in wounds, ulcers, and the like. Like all other disease germs, it has, in a favorable media, most marvelous powers of reproduction. Bacteria are pathogenic of perverted nutrition, they bear culture well on slightly acid nutrient agar, and nutrient gela- tin. Cultures injected into animals produce profound malnutri- 82 Twentieth Century Practice. tion; tongue coats heavily; spore formation takes place in the salivary glands, mouth, fauces; germ-evolution takes place in the usual manner. If not sterilized or annihilated, it becomes an immense and prolific breeder, its ptomain giving rise to colic, abdominal flatus. Bacteria are either sterilized or completely annihilated by the administration or application of either of the following rem- edies — peroxide of hydrogen, sulphur water ozonized, comp. tincture matricaria, acetic acid, which creates an alkaline secre- tion ; boroglyceride. The best illustration that could be given of the presence of bacteria, is that of gastric fever, which is so common among children; usually caused by eating or drinking articles which are indigestible, that offend, irritate or depress the stomach. It is ushered in with lassitude, chilliness, fever, violent head- ache, loss of appetite, great thrist, the very thick white coating on the tongue, nausea, vomiting, pain over region of stomach and abdomen, with constipation. Later on the tongue becomes dry and brown, fever high, pale face, cold extremities, vertigo, nausea or vomiting, splitting headache, fetid breath, vomiting, or else constant nausea, with disposition to vomit; debility increases. Treatment. — Emetic of wine of lobelia, followed by the neu- tralizing cordial to open the bowels ; aconite for fever, steam or stew wormwood in hops in vinegar, add dioxide of hydrogen and apply hot over the stomach and abdomen ; change fre- quently. Antiseptics should be commenced early and administered all through the case; small closes of nitromuriatic acid or ozone water are very beneficial. The diet for some time must be carefully guarded. BACTERICIDES VERSUS THE SKIN.— Collodion and solutions of gutta-percha have been quite extensively used for the purpose of keeping in close contact germicides to kill the various microbes on the cutaneous surface. More recently we have introduced gelatin in which an active bactericide is incorporated, a clean and convenient dress- ing, thus obviating the necessity for bandages or plaster to re- tain the application. It affords a most excellent means of ap- plying creolin, chrysarobin, resorcin, and other germicides. Thev are dissolved in definite proportions in a fluid state and Twentieth Century Practice. 83 the applied by means of a brush. The mode of application and medicament are to be selected for each case. Formerly in such cases we were obliged to apply an ointment or plaster to any one part alone. This required time and skill, for when an ointment was applied to one part, before the other part was finished the former was rubbed off ; it was also neces- sary to bandage the entire body of the patient. This required time and skill, and annoyed the patient, and ointments always soil the underclothes, etc. By using the gelatin preparations, all inconveniences are avoided. Following this plan of treatment, these inconveniences are avoided. Following this plan of treat- ment, I have used other gelatin preparations with advantage — pyrogallic, naphthol (the active principle obtained from tar), iodoform, salicylic and carbolic acids. The mode of applying is the same as with other preparations. The patient, after having* been bathed in water, a heated solution of gelatin is applied to the parts with a small brush. As soon as it becomes dry, a small quantity of glycerin is applied to the surface to prevent coating from cracking or peeling off. This coating being transparent, allows you to see the progress of the treatment without removing it. In severe cases this procedure is to be re- peated every second day ; in milder ones it is sufficient to do so twice or thrice a week. These preparations can be applied by patients on themselves, and do not necessitate their being con- fined to a hospital or to their home. It is a clean preparation, can be easily removed, does not soil the clothes, or prevent motion when applied over a joint; it is not expensive, does not crack or peel off. It is prepared in the following manner : — Dissolve twelve and a half drams of dry white gelatin in twenty-five drams of distilled water by a water bath, and while stirring add goa powder, pyrogallic acid, naphthol, iodo- form, carbolic or salicylic acids, in whatever quantity necessary, allow it to cool, and the cake will take the form of the capsule in which it was prepared (a porcelain capsule is preferred). You can then direct the patient to take the necessary quantity, place it in a china saucer, apply heat to it, and when in a fluid state apply to the parts with a brush. It can be removed and re-applied as frequently as it is deemed advisable. BACTERURIA. — Whenever disease germs are present in the blood (pathogenic microbes), they are in the very nature of things liable to become engorged in the kidneys, where they" give rise to irritation and organic changes. Usually, the first. 84 Twentieth Century Practice. symptom is the presence of albumin in the urine, with pain in the back and aching in the thighs. We see this in an early period and all through a case of scar- latina, where the germ literally blocks up the kidneys and gives rise to desquamative nephritis ; also in erysipelas, in which the micrococci give rise to great congestion and albumin. In cancer, syphilis and tubercula, the bacilli give rise to peculiar lesions through an inflammatory process, by the germ forming nests in the kidneys. No matter therefore what the character of the microbe may be, attention should in all cases be directed to the kidneys. They should be kept flushed with an active germicide, as the uric acid solvent, strophanthus, nitroglycerin. BALANITIS. — Consists of an irritation, inflammation, with a shining, glistening redness, or excoriation of the covering of the glans penis and inner aspect of the prepuce. Some call it balanitis when the glans only is affected, and balanitis-posthitis when both glans and internal lining membrane of prepuce are involved. The distinction is unnecessary and altogether un- called for, as the two conditions are essentially the same. Causes. — Excessive sebaceous secretions around corona glandis often gives rise to it in boys and virtuous young men, and causes anxiety, which ignorant or knavish physicians will magnify into something venereal, so as to extort a fee. Rubbing of clothes, chafing in hot weather, masturbation, a natural rankness in some women, will cause it in highly-or- ganized and susceptible men; catamenial discharge, and the venereal germs. From whatever cause it arises, it can be com- municated to the opposite sex by contact ; as the parts, whether dry or freely exuding muco-purulent matter, are freely covered or filled with the bacillus of smegma and bacteria. So, in dressing, the cleaning of vessels, destruction of dressing, use great cleanliness, especially about hands, lest any of the matter reaches the eye. Symptoms. — Heat, redness, itching about the glans. In some cases it is of a smooth, shining redness; in others, a muco-purulent discharge. On uncovering the glans, by draw- ing back the prepuce or foreskin, patches of redness and ex- coriations are perceived, with flakes of curd-like matter. If there be swelling of the foreskin, or if its sphincter fibres are irritated, it may be contracted, so that it cannot be drawn back Twentieth Century Practice. 85 over the head of the penis, so that retraction is impossible, and then there is phimosis. There are many reasons why the fore- skin should he drawn back in cases of this kind ; there may be a perforating ulcer, a chancre, or an abscess, or mortification may be taking place ; bubo from the irritation may take place ; there may be a gonorrhea, or an indurated or infecting chancre. Vulvitis in women is an analogous affection. Treatment. — Draw the foreskin gently back, and apply a lotion of peroxid of hydrogen or one ounce of the ozonized tincture of echinacea to four water; or simply lime water reduced in strength by adding a little water to it. BALDNESS. — The head being the most elevated part of the body is most liable to become the seat of micro-organisms from the atmosphere. Baldness, or alopecia, as it is technically called, means loss of hair. It may be partial or general, temporal or permanent. It is best known in the form of calvities or senile baldness, which is one of the changes indicating general structural decay and advancing age. In some individuals the head becomes bald during middle life, and in others it is well covered by hairs even at a very old age. These differences depend upon two in- fluences : that of general health and strength of constitution, and that of hereditary peculiarities. In this form of baldness, whether due to senile or premature decay, the hairs first become gray and then white ; they no longer present their usual appear- ance, but are short, split, and very dry and crisp. The scalp at the same time becomes thin and tense. At last the white hairs are shed, and no others are formed ; complete baldness is then produced, and the thin scalp becomes smooth and shining. These changes always begin on, and are very often limited to the vertex of the head ; they are due to senile shrinking of the tissues of the scalp and obliteration of the follicles — those small depressions on the skin in which hair originates. Baldness has been observed in newly-born infants, although this form is very rare. The growth of the hair may be retarded for one or two years, or it may never take place. Of accidental baldness there are several varieties. The most common form, perhaps, is that general thinning which is caused by exhausting diseases, as, for instance, microbes of fevers, by bodily decay, and by great mental emotion. Some extensive thinning, or even total loss of hair, may be seen in children and young adults, apparently 86 Twentieth Century Practice. in good health, and without any affection of the scalp to ac- count for this serious condition. It has been suggested that this early loss of hair may be due to failure of nervous power, or to cessation of the natural reproducing function of the hair- bulbs and hair-forming apparatus. . Accidental baldness is also very frequently produced by parasitic diseases of the scalp, such as favus and the different forms of tinea. According to the nature of the disease it is general or partial : in favus the whole scalp is affected, and in tinea decalvans there is complete baldness only over small circumscribed patches. Thinning of the hair is a symptom of venereal disease ; in some instances the patient becomes quite bald. This affection, however, is usually temporary, and the hair grows again after the course of the general disease has been averted by suitaable remedies. The congenital and senile varieties of baldness are not amenable either to local or general treatment. In the former class of cases, one must wait patiently until the formative organs of the hair are well developed, and in the latter class the loss of hair is to be regarded, like many other concurrent phenomena, as an inevitable result of advancing age. The application of stim- ulating washes only irritates the skin, and may do much mis- chief. In baldness, occurring during convalescence from fever or other exhausting maladies, the hair usually grows again as» the patient recovers. In cases where the hair becomes thin and loose in consequence of debility or want of tone, washing the scalp with tepid water and castile soap, and drying well and subsequently damping the hair and scalp with the Ozone Hair Restorer is most advantageous. Undoubtedly the best remedy to increase the growth of hair on the scalp is the tincture of oats thrice daily. BALSAMS. — A name given to natural vegetable substances, concrete or liquid, but odorous, somewhat bitter, piquant, com- posed of rosin, benzoic acid and as esential oil, which permits benzoic acid to be disengaged by the action of the heat ; readily dissolved in volatile oil, alcohol, and ether. Peru, tolu, ben- zoin, storax, llaretta, differ essentially in their composition and properties, but all are valuable microbicides, whether nat- ural or artificial. BANDAGES. — Bandages consist of strips of linen, calico, or flannel, of various breadths, from one to six inches, and of any length, from one to ten or twelve yards. The best material Twentieth Century Practice. 87 is stout unbleached calico ; but a strip of sheeting, or strips of an old petticoat or dress are very serviceable. They should be rolled up firmly for use, as they are applied by unrolling them over the part to be bandaged. There are some few plain rules which ought to be attended to in the application even of the simplest bandage which can be used ; as the manner in which it is bound round the limb makes all the difference to the comfort of the patient. It will be found most convenient to hold the roller on the inner side of the limb (if it be a limb) to be bandaged, so that in case of the right side being operated on, the bandage is held in the operator's right hand, and vice versa, and for expedition in application the portion which is still un- wound should be underneath that which is being wound round the limb, in fact, that the bandage should form a sort of con- tinuous figure of eight. On first starting off, rather more than the circumference of the limb should be unwound and cast around the part, and the hand not employed in holding the bandage made to tuck the free end under the first complete turn. If this slight maneuvre be dexterously done, the bandage will never slip, unless purposely unwound. It is then lightly but firmly wound round the limb by a series of turns as far as re- quired. Now it is evident that, in the case of a well-shaped, muscular limb, this winding cannot be made evenly, as it will not lie flatly; the simple device of "reversing" is then em- ployed; it consists of taking a "turn" in its application, and bending it upon itself by changing the surface of the roller which is applied to the skin by making an acute angle or reverse at each turn, and giving it a sharp "twitch" at each. In ban- daging the arm or leg, it is best to commence with a few turns round the hand or foot first, whether it be for the reten- tion of splints or dressings. Bandages should always be ap- plied with an equable pressure throughout and not too tightly. Bandages, such as the above, may be rendered hard and strong by smearing their successive turns with gum, plaster of Paris, glue, paste, or white of egg, which speedily sets, serving the double purpose of bandage and splints. BAPTISIA TINCTORIA.— Wild indigo weed, an ozonized tincture best form for internal administration. It is an active microbicide, sterilizes, and annihilates disease germs in both the solids and fluids of the body; its range of action is most ex- tensive, wherever bioplasm is changed, altered, degraded into other living matter, hence its value in ulceration. 88 Twentieth Century Practice. BARIUM SULPHURET.— Mixed with starch; and apply locally once. Hair depilatory. BATHS. — The body is made of cells ; they may be regarded as the material, the brick or stone, out of which the human 1 'temple wherein a God may dwell" is constructed. This tene- ment in which the soul lives for a few short years has to un- dergo continual repairs, we sleep so that the worn-out cells can be taken up and replaced by new ones, which are continually being manufactured out of the food that we eat and of the air or oxygen which we breathe, and water is the vehicle which conveys the new material needed for repairs, and which re- moves the old worn-out tissues from the system. Water thus be- comes in the body, as it is in all nature, the great agent of purification, and since all disease is caused by, or in some way connected with, impurity, the uses or rationale of water as a remedial agent can be readily understood. The body is not only made of cells, but these cells are all so arranged as to form tubes. Even the bones and the hairs are composed entirely of tubes, in which there is a continual circu- lation, a constant flow of fluids, of which water is the principal part. The skin contains many millions of these tubes, and in a full grown man their united length, it has been carefully es- timated, would amount to not less than twenty-eight miles. Through these tubes not less than one pound or two pounds of matter pass daily from the body in the form of insensible perspiration. Bathing, oiling, and rubbing the skin keeps these little tubes open and active, and permits impurities to escape, which, if retained, would render the blood dark-colored and charge it with catarrhal phlegm, which would tend to retard the circulation, cause congestion, lay the foundation for consumption and many other forms of disease. Not only should we regularly bathe the surface of our bodies for the purpose of cleanliness, as above indicated, but the entire tubing of the whole body should be abundantly supplied with this natural agent of purification. Pure, ripe, juicy fruits furnish the best, most wholesome, and agreeable supply of water for the system, and there are few people who use a quarter as much fruit as a state of perfect health would indicate or demand ; but this fruit should be taken at, or form the principal part of, our meals, and never be eaten between meals, especially so if more than two regular meals are taken daily. Hot water drinking, which has amounted almost Twentieth Century Practice. 89 to a mania in many places during the past few years, is nothing more nor less than internal bathing. Suppose the system is rilled with some form of impurity causing congestion and disease, the. patient drinks one, two, or even three quarts of water daily, as many do who visit the springs and watering- places. The same quantity of water must pass out of the system through the skin, kidneys, or some other emunctories of the body, and in no case does it pass out as pure water, but becomes loaded with effete matter which it takes up and expels. There are many people who go to great expense to visit these resorts, who would have been equally as much benefited, if not far more so, had they remained at home and practised daily bathing of their bodies, both internally and externally, by the use of this great natural therapeutic combined with sun-bath- ing, out-door exercise, rest, recreation, with abundance of oxygen in the form of pure, fresh air, by day and night. The remedial effects of bathing are generally underrated. This non-appreciation is oftener due to the improper manner in which it is performed than to an insufficiency of curative virtues. The term bathing, not only implies a cleansing of the body or certain portions of it, but also the application of water in such a manner as to influence the nervous sys- tem, and regulate the functions of the secretory organs. Cleanliness, while it preserves health and promotes recovery, considers only the hygienic influences of water, and overlooks its curative effects. The cold bath used at a temperature of from 30 degrees to 60 degrees F., is powerfully sedative, and employed for its tonic effects. If the vital powers are low, or the individual remains in it too long (two or three minutes should be the limit), the reaction will be slow and its effects injurious. While it is highly invigorating to robust persons, its employment by those who have a low standard of vitality should be cautious. A local employment may be followed by beneficial results, when its general application would be inadmissible. For these rea- sons we advise the general use of the cold bath at a temperature of from 60 degrees to 75 degrees F. If, in any instance, the reaction is slow, we recommend the temperate bath, at a temperature of from 75 degrees to 80 degrees F. The time of remaining in the bath must be regulated by the strength of the invalid. As a rule it should not exceed three minutes, and the colder the water the less time should the patient be im- mersed. Immediately after emerging from any bath, the body 90 Twentieth Century Practice. should be thoroughly dried, and rubbed with a moderately coarse towel until a glow is experienced and reaction is fully established. The attempt to toughen children by exposing them to low temperatures of either air or water, cannot be too emphatically condemned. This caution, however, does not apply to the employment of moderately cool water, for ablu- tions. The cold or cool bath should be taken in the early part of the day, but never during digestion. Whenever reaction does not follow bathing, artificial means must be resorted to, as stimulating drinks, dry warmth or exercise. The tepid bath, the temperature of which is from 85 degrees to 92 degrees F., is generally used for cleansing the body. It is prescribed in fevers and inflammatory affections for its cool- ing effects. It is usually medicated with some acid or alkali. The latter unites with the oily secretion of the skin and forms a soapy compound easily removed by the water. The tempera- ture should be regulated according to the vitality of the patient, and the bath may be repeated two or three times a day. It removes superfluous heat, and keeps the skin in a good condi- tion for excretion. The warm bath, at a temperature varying from 92 degrees to 98 degrees F., is always agreeable and refreshing. It equalizes the circulation and softens the skin, by removing all impurities. It moderates pain and soothes the whole system. It does not weaken or debilitate the person, but is in every way beneficial. It is an efficient remedial agent in many chronic diseases, convulsions, spasmodic affections, of the bowels, rup- ture, rheumatism, and derangement of the urino-genital organs. It should be employed immediately before retiring, unless urgent symptoms demand it at other times. It may be medi- cated or not, as circumstances require, but should always be taken in a warm room. The hot bath, at a temperature of from 98 degrees to no degrees F., is a powerful stimulant. It excites the nerves, and through them the entire system. It causes a sense of heat and a constriction of the secretory organs; but perspiration, languor and torpor soon follow. In the sudden retrocession of cutaneous diseases, it restores the eruptions to the surface and insures speedy relief. The hot bath may be applied locally when circumstances require. Medicated Baths. — Any of the above baths may be medi- cated by the addition of drugs, or by the use of sea or mineral waters, according to the disease from which the patient is Twentieth Century Practice. 91 suffering. In syphilis the sulphur vapor bath is very valuable. Sea baths are stimulating and invigorating. Brine baths are valuable in cases of chronic rheumatism. The following rules may be regarded as applicable to all cases, but more especially so to invalids and all who are not possessed of robust health and vital energy : — 1. Never bathe just before or immediately after eating; a full bath should not be taken less than an hour before, and two or three hours after, partaking of a hearty meal. 2. Before taking a cold bath, always see that the feet are made warm by hot water, by the fire, or by exercise, but do not become fatigued before bathing, which might prevent a reaction. 3. Avoid drinking cold water or becoming chilled before taking any cold bath. While taking a hot bath cold water may be supped freely, but in most cases, hot water is preferable, especially if the object of the bath is to produce perspiration. 4. After bathing, the whole body should be rubbed with the hand, using a very little oil ; three parts olive and one part each of cajeput, sassafras, and wintergreen, flavored with oil of cedar or to suit the fancy, makes a good mixture. 5. Care should be taken not to allow the' feet to become cold or to become chilled after bathing. Patients, if not able to exercise after bathing, should be warmly covered up in bed for an hour or two. 6. Persons who are naturally delicate, and all invalids who are feeble and debilitated, should carefully avoid all very cold, very hot, very long, or unpleasant baths, especially severe shocks of shower or douche baths. 7. Local baths taken by sitting in a bath tub or common wash tub tipped over on one edge, with only a pailful of warm, cool, or cold water in it, with the feet in a pail filled with hot water, taken as often as once or twice a day. using at the same time a weak solution of the sulphite of soda, as an injection, will cure one of woman's worst complaints when all the doctor's drugs are unavailing. 8. A wet bandage made out of an old sheet or two or three yards of cotton flannel, one half wet in hot, cool, or cold water and wrapped about the hips at bedtime, surrounded with the dry part to protect the bedding, has cured the worst cases of seminal and female weakness, of spermatorrhea and leukor- rhea, after a few weeks' or months' trial, in cases where all other remedies failed to benefit. 92 Twentieth Century Practice. 9. Whatever the form of bath, when taken regularly, it should be omitted once or twice a week, and the temperature of the bath should be carefully regulated ; where a tonic effect is desired, the less heat the better, always avoiding any very disagreeable sensations. 10. Particular attention should be paid to the temperature of the bathing room, and also to the ventilation. For invalids, the temperature should be about 75 degrees. BED SORES. — Sores which form on the bodies of patients who have been confined to bed for long periods, and who have been unable to change their positions occasionally. They are liable to occur after any long debilitating illness, such as typhoid fever. The parts generally affected are the prominent parts of the spine. First an area of redness appears, then the inflammation becomes more acute, and, finally, an ulcer forms. Bed sores are in many cases preventable by careful nursing, but in others they appear to be due to some trophic nervous dis- turbance, and are not preventable. In all cases of severe sick- ness the back and prominent parts of the body exposed to pres- sure should be examined daily, and washed with a little spirit lotion. When the redness appears the bathing with spirit should be followed by a dusting with oxide of zinc powder. When the ulcer has once formed it is hard to cure. It should be kept perfectly clean, and dressed daily with either resin or zinc ointment. In all bed-ridden cases, besides the above treat- ment, a water or air bed should be provided as soon as the slightest redness appears, for in this way the weight of the body is more evenly distributed, and undue pressure does not come upon any one particular part. As a general rule, bed sores are a result of neglect and bad nursing. As a rule they are more likely to occur in the aged, debilitated, paralyzed, or in those suffering from fevers — whenever the blood is vitiated, circu- lation retarded, constitutional powers feeble. Pressure, un- cleanness and moisture hasten their appearance. As a preventive, sprinkle on all parts liable to pressure anti- microbe powder freely. Observe rigid sanitary measures, patient clean and dry, when practicable change position, keep extremities warm, assist circulation in exposed parts. BILE. — A peculiar viscid, greenish, or yellowish-brown, bitter-tasting fluid secreted in the liver, from which it passes into the gall-bladder and then on into the small intestines. It Twentieth Century Practice. 93 bears an important part in the phenomena and processes which are associated with digestion. It has a slight action in con- verting starch into sugar. It emulsifies and saponifies fats, rendering them more easily assimilated, and assists in their absorption. It stimulates the passage of food along the in- testines and prevents putrefactive changes. About fifty ounces are secreted by the liver in twenty-four hours. When, owing to liver disease, gall-stones, etc., there is an obstruction to the flow of bile through the bile ducts, the bile collects and passes into the blood, giving rise to the symptom called jaundice. BITUMINOUS COAL.— A ton of this yields about one hundred and fifty pounds of gas tar; in olden times a waste product, that surpassed its uselessness only by its offensiveness, but to-day is the source whence nearly all the synthetical remedies are derived, aniline and phenol, the output of which is colossal. It furnishes antipyrin, acetalinda, exalgin, ammonal, asparol, carbolic acid, creolin, izal, diuretin, dulcin, euphorin, hypnol, malarin, naphthalin, phenacetin, salol, sulphonal, trional, hylene and a host of others, to meet every ache and pain of the in- corrigible Yankee. It is made to provide us with nearly all the essential oils, cassia, gaultheria, almonds, creosote, vanilla ; also many gums, as camphor, thymol, menthol, paraffin and saccharin, a sub- stance 300 times sweeter than sugar. The chemical genealogy of all synthetical complex com- pounds, atoms and molecules show them to be related to aniline and phenol, and when any one is prescribed as a remedy, it is directly destructive to the red corpuscles of the blood, causes cyanosis and dyspnea; thromboses in the large blood-vessels, paralysis of the heart, grave lesions of the gray and white matter of the brain and cord. The rapid and apparently endless production of these toxical and dangerous remedies is bewildering to the profession, de- structive to human life. It is a remarkable fact that the toxins of the pneumococcus produce the same pathological condition of the blood, a destruc- tion of the red corpuscles, embolism, cyanosis, the same kind of paralysis of the heart muscle, as is produced by administer- ing antipyrin and phenacetin, two of the leaders of the syn- thetical group. On the ground of a common humanity these preparations 94 Twentieth Century Practice. should be eliminated from the legitimate practice of the heal- ing art. BLACK WILLOW BARK.— This remedy, whether it be administered in the form of an extract, or applied locally in the shape of a bougie or suppository, is a vitalizing tonic, as- tringent and sedative to the generative organs of both sexes — a valuable remedy to restore tone and vigor to debilitated parts. Specially indicated in all devitalized states of the testes and seminal ducts, whether there be a leakage or oozing of semen either by day or night, or at stool, with or without erection. Of extreme efficacy when the brain and spinal cords are shat- tered, chaotic, when the semen is thin, rank, infertile and passed off on the slightest excitement. It is generally conceded that spermatorrhea or loss of semen is due either to masturbation, perversion of the sexual act, con- gress with harlots, incompatibility, gonorrhea, fissure of the anus, ascarides, rectal ulcer, contraction of prepuce and like causes; but there is another latent cause in which we have a discharge at stool, large quantities of a glairy, tenacious fluid ; true it is not all an evacuation of semen, great part of it is from the prostate, nevertheless there are many spermatozoa blended through it as it comes from the seminal vesicles. Such cases demand immediate attention ; a course of the ozonized extract of black willow meets every indication ; give it orally ; use both bougie and suppository; push it before it ripens up into some cerebral affection, before it drains away the nervo-vital fluid upon which the brain rests. This preparation of black willow orally, by bougie and sup- pository, controls every case of spermatorrhea where physical and mental weakness is the prevailing or leading symptom. Ozonized extract of black willow bark will cure all cases of spermatorrhea, but it is often necessary to aid its action ; for ex- ample, if there be violent, painful erections, a tendency to spasmodic stricture, seminal plethora, several emissions in a night, green root tincture of gelsemium and ozonized passiflora extract should be adminstered with a liberal hand freely to obtain the object aimed at — a quiescent state of the genital tract. Gelsemium and passiflora for rest. Prostatic catarrh, when present, requires ichthyol and boro- glyceride suppositories in addition. Twentieth Century Practice. 95 Constipation must be overcome by small doses of the kola nut paste. Case recovers with partial impotency, protonuclein, c. p. solution, spermin and matricaria. Strict attention to bathing, clothing ; plain, nutritious food. General directions : bowels must be opened once daily, black willow to the extent of from a half to one teaspoonful thrice daily; a suppository and bougie of black willow should be in- serted every night and retained. Spermatorrhea can be cured; if neglected, it will, in time, give rise to structural change, either in the genito-urinary tract or in other vital organs, giving rise to impotence, paralysis, tuberculosis. Impotence dependent on disease of the spinal cord and brain brought about by spermatorrhea may be bene- fited, often cured only on well-defined principles; steady per- severance in a rational plan of constructive treatment. Spermatorrhea, incontinence of semen, whether it be noc- turnal, diurnal, or in the urine, is but an evidence of debility — or it might be explained as a motor neurosis of the sexual ap- paratus, with spasm of the muscular coat of the seminal vesicles, and when it exists sometimes paresis of the ejacula- tory ducts takes place, then an oozing or weeping all the time. Associated with this genital ability, or irritability, there is invariably a central neurosis in the reproductive centre in the brain and spinal cord. The prevalence of seminal incontinence among our young men is eighty out of one hundred are af- fected. This exceeding high rate is due to exalted vascular tension of the uro-genital system, produced either by masturba- tion, sexual excesses, withdrawal, venereal diseases, bicycle riding, the perusal of immoral works of fiction, degrading amusements, or incompatibility in married life. For the prompt and effective cure of spermatorrhea the pro- ducing causes must be removed, dietetic, hygienic rules laid down, and a suitable quantity of the ozonized extract of black willow bark administered at proper intervals, so as to get the system thoroughly under its astringent anesthetic effect. As this remedy has no deleterious action, but is a bracing tonic, it may be with much benefit taken for an indefinite period — months, year. When pursuing the internal use of this remedy a salix nigra suppository should be inserted into the rectum before retir- ing, the affected individual eating lightly of his evening meal, sleeping carefully on his right side. 96 Twentieth Century Practice. If the prostrate urethra is tender to the insertion of a me- tallic bougie, or the prostate gland sensitive to a digital ex- amination per rectum, then a few drops of the green root tinc- ture of gelsemium should be taken while retiring. Some in- dividuals are very susceptible to this drug and require only a few drops added to water, while another class may require as much as thirty or forty drops to be effective. There has been much foolish prattle regarding this me- dicament by a set of ignorant charlatans. Suffice it to say that our green root tincture is prepared from the fresh root in Florida. When you find it not acting as a true genital sedative in doses of ten or fifteen drops, better, rather than increase it, to add to it thirty drops of the ozonized tincture of passi- flora incarnata. Then a definite action is the result. If, in spite of all these remedies, there still exist a slight oozing or weeping, then in addition to the treatment already laid down a salix nigra soluble bougie should be inserted and retained until completely dissolved and partly absorbed. The erroneous method of treating spermatorrhea by the bromide of potass must be eliminated from practice. It is a. drug essentially destructive to reproductive vitality, destroys cellular growth, gives rise to a shrinkage of the testes, atrophy- of the cord, a blight to the brain. Once a case of spermatorrhea is cured a selection from one or two of the following remedies will be found of great efficacy in reconstructing the weakened genital organs; proto- nuclein, kephalin granules, c. p. solution of spermin, matri- caria. BLADDER. — The bladder is the receptacle for some of the waste products of the body which are usually floated off in the urine. In all deviations from health, pathogenic microbes and their toxins are found here in abundance. Modern methods, the great prevalence of gonorrhea, mas- turbation, sexual excesses, perversion of the sexual act, bicycle exercise, the heating of motor cars underneath the seat, and then the lumbar portion of the body being exposed to cold, uric acid diathesis, the introduction of catheters, etc., all act disastrously on the prostate and bladder, and are liable to give rise to irritation, inflammation, continence or inconti- nence of urine, and the evolution of the micrococci urea. In all conditions of partial death of the bladder these mi- Twentieth Century Practice. 97 crobes, the micrococci urea, are abundant in both urine and on the walls of the bladder, and aid in the aggregation of solid products into calculi, in the formation of fungi and other morbid conditions. The increasing prevalence of genito-urinary trouble im- peratively calls upon the profession to exercise more care in the diagnosis of all bladder trouble, at least a cystoscopical examination in all cases — especially in those of difficult or frequent micturition, with or without hemorrhage, with or without micrococci urea, and look out for mould or fungi ; and if found inject the bladder with the following: Distilled water 98 degrees F., four ounces; ozonized oil of thuja, from thirty to sixty drops. Mix, which will effectually "kill all fungi. Cystitis. — The causation of either acute or chronic inflammation of the bladder is quite elaborate and varied, embracing mechanical violence, urine loaded with the toxins of disease germs, the metastasis of the bacillus amylobacta, the gonococcus, overdistention, deficient power to expel the last drop of urine, and evolution of the micrococcus urea, which sets up decomposition, and carbonate of ammonia is produced, which adds considerable irritation, and with the precipitation of the earthy and triple phosphates, active in- flammation is set up. The diagnosis is easy. The frequent and painful micturi- tion, accompanied with tenesmus of the bladder. The pain at first local, pelvic, perineal, radiates to the umbilicus, breast, loins. The urine, at first pale, of a low specific gravity, acid, becomes alkaline, turbid from blood, mucus, pus, micrococcus urea and precipitation of phosphates, and if permitted to progress it may extend up the ureter to the kidneys and renal abscess result. The bladder itself may take on diphtheric or gangrenous deposit. Once recognized, early and prompt treatment. Administer internally just as large doses as can be toler- ated of the green root tincture of gelsemium .and passiflora incarnata, and inject bladder every two or three hours, ac- cording to the urgency, with a warm saturated solution of "boroglyceride, enemata of the same. Administer periodate aurum in doses four to six grains every three hours, to have a free portal circulation maintained. Four ounces of linseed tea, in which one teaspoonful of the uric acid solvent is in- corporated every three hours. Moist heat over bladder. To 98 Twentieth Century Practice. relieve the severe pain and tenesnus gelsemium and passi- flora, with a cocain suppository, every three hours, works wonders; most efficacious. The washing out of the bladder at stated intervals is of the greatest value — fountain syringe, gravity being the injecting force, together with rest. Acute and chronic cystitis are terms employed to denote the intensity and duration of an inflammatory process rather than, the character of the lesion present. Modern thought, scientific research, enables us to state that in all its varied phases cystitis is simply a local bladder infec- tion by bacterial germs. Normal urine is an aseptic fluid, characterized by the absence of septic germs, while cystitis is- always associated with the presence of septic organisms in greater or less abundance. Impaired vitality of the bladder offers a favorable soil for the evolution of the micrococci urea and other organisms pos- sessing pyogenic powers. There is probably no organ in the body exposed to such varied and intense depressing influences as the urinary blad- der, hence the etiological factors which favor evolution and infection are retention of urine from exposure to cold and wet, reflex irritation, deep gonorrhea, stricture of the urethra, prostatitis; calculus, morbid growths, sexual excesses, gout, paraplegia, whatever be the etiological factors in any case of inflammation of the bladder, there is always present frequent micturition, pain and fever; symptoms vary much acccording- to the intensity of the disease and sensitiveness of the organ. In the acute form, the desire to micturate is continuous — increased by standing and walking; is relieved by rest. Pain is variable in intensity, urine highly ammoniacal, loaded with micrococcus urea and its toxin, extremely sensitive to the rectal touch. Hematuria is the rule, sometimes merely a few drops; in other cases considerable; increased by exercise; re- lieved by recumbent position. Independent, of causes, large or frequent small doses of the green root tincture of gelsemium, until its physiological effects are obtained acts magically in mitigating its prominent symp- toms; maintain its action for a few days, beginning with the uric acid solvent and immediate amelioration takes place. A four ounce warm injection of a solution of ozonized boro- glyceride.to which is added thirty grains of jelly of violets,, let it be retained a few minutes, promptly causes all inflamma- Twentieth Century Practice. 99 tory symptoms to subside, add to this a cocain suppository in rectum; a bladder once the object of vital depression is liable to a recurrence. For prolonged use in chronic cystitis, with the micrococcus urea; we may set aside all that class of vegetable diuretic, as- tringent, such as buchu, uva ursi, queen of the meadows, and grasp more efficient remedies, such as the uric acid solvent, and the ozonized tincture of lycopodium. This latter remedy has a special action on the walls of the bladder, in toning and astringing; it kills the micrococcus urea, relieves spasmodic retention of urine. Take it all in all, it is our best remedy in vesical catarrh. Besides, if such conditions exist, as constipa- tion, enteritis, chronic bronchial catarrh, or any cutaneous affection, its use effects a speedy cure. The dose of lycopodium curative in catarrh of the bladder is from ten to thirty drops, added to a glass of water thrice daily. A boroglyceride suppository invariably affords prompt relief in all cases. In inflammation of the bladder the prevention of the de- composition of the urine and the evolution of the micrococcus urea is the most important point in treatment, as the toxin of the micro-organism increases the vesical irritation, aug- ments the inflammation, thus favors the elaboration of more muco-purulent material for septic organisms. Recently, with the green root tincture of gelsemium, I have been prescribing mistura llaretta with fifteen-drop doses of apiol, one tea- spoonful of the llaretta. I have found that these three reme- dies have a remarkable effect in all cases of vesical catarrh, so much so that muco-purulent matter, the breeding pond of the micrococcus, is at once wiped out. Given in tubercular cystitis, three doses per day, it operates admirably in a notable diminution in the number of bacteria as well as in the suf- fering. Ozonized Oil of Thuja Occidentals. — This remedy, administered both locally and internally, has demonstrated itself to be a most remarkable germicide. Many eminent cancer specialists use it with success in the cure of malignant disease. This oil, given internally, or painted over warts, genital or otherwise, is a most effective treatment, being preferable to all others, there being no risk of infection or excoriation. In cystitis from any cause, the urine literally loaded with the micrococcus urea ; if five drops of this oil, added to water, LofC. ioo Twentieth Century Practice. be given every two hours, the germs promptly disappear, re- covery is rapid. Administered internally with care and persist- ence, its action is most thorough and efficient as a germicide, that it will kill the micrococci of variola at any stage of its ex- istence. Rarely do we meet with inflammation of the bladder dependent upon conditions which directly affect its vitality. More generally it is but a symptom of the toxin of some disease germ, such as malaria, rheumatism, papilloma. Within a single decade the management of this system has risen from the plane of empiricism. This change has come about chiefly as a result of investigation of its causes, includ- ing the identification of the role which bacteria play, and of improved instruments for direct inspection. Many of the causes which were formerly considered as prime factors in the production of this disease are now relegated to their proper places as predisposing conditions. All forms of cystitis are now traceable to pathogenic bacteria as the direct exciting cause. Alkalinity of urine depends upon the action of certain bacteria, notably proteus vulgaris, or micrococcus urea in the decomposition of urea. The bacillus coli communis is a germ which frequently causes cystitis, but as it does not decompose the urea, the urine does not become alkaline. In many cases of cystitis, perhaps the majority, the urine is not alkaline, but acid. If it becomes alkaline, it is frequently due to secondary infection of the bladder. The diagnosis should not only de- termine the character of the infection of the bladder, but, what is of more importance, it must thoroughly identify the char- acter and source of the inflammation. Simple and uncom- plicated inflammation of the bladder is rare. The endoscope and cystoscope are valuable agents in diagnosis and in guid- ing to a correct treatment the toxin of malaria, if it be due to the hematuria is usually so great that there is little use in wash- ing out the bladder, but great results are obtained by the administration of concentrated kurchicin and the cocain sup- pository. If rheumatism be the cause, the internal exhibition of the uric acid solvent, with gelsemium, and a boroglyceride suppository every three hours. If due to papilloma, wash out the bladder with a solution of the oil of thuja every other day, besides use thrice daily a cocain suppository. According to this mode of treatment we effect results. For localized cystitis our most valuable agents are green root tincture of gelsemium. Warm solutions of boroglyceride as injections, together with the cocain suppository. Twentieth Century Practice. ioi Chronic cystitis and the evolution of the micrococcus urea in the bladder of elderly men, arising from enlargement of the prostate, acts very much like a stricture. The indica- tions for treatment are, the bladder must be completely emp- tied at proper intervals of time, and the micrococcus urea com- pletely annihilated. If the hypertrophy be excessive, natural evacuation may be impossible; then catheterization with a double-current cath- eter, so that when the urine is drawn a warm solution of boro- glyceride can be passed and permitted to flow off. If the patient be placed upon the boroglyceride and ichthyol suppository, one every two hours alternately, and small doses of tincture of gelsemium and passiflora, these remedies exer- cise such a blighting effect upon the prostate, when enlarged, that the patient will soon be able to lay aside all catheters and urinate spontaneously. Papilloma of the bladder presents nothing special at the outset, unless it be a little undue frequency of micturition, which is probably the only sign which excites suspicion. But early in the progress of the papilloma, or all villous growths, there is an important sign, characteristic of it, throughout its entire course, and common to most other tumors at a later period, namely, the appearance of blood in the urine. Hem- orrhage occurs after exercise, much more abundant than what would come from the presence of a calculus, and it is unac- companied with pain and irritation of the bladder. As the papilloma increases in size, hemorrhage becomes more pro- fuse; still pain is absent. A microscopic examination of the urine will reveal the characteristic appearance of papillomatous structure and the presence of a fungus. Better still, a cystoscopic examination, or the injection into the bladder of a few drops of the oil of thuja in distilled water, as described under the article Bladder Trouble. The bladder should, in all cases, be washed out with a tepid solution of boroglyceride ; an examination made with a sound, which reveals a soft, flimsy tissue, springing from a thick base. On those outgrowths, papoid or trypsin has a well-de- fined action as solvents. The papilla is simply a slender fold or extension of the mucous membrane, not an adventitious tissue, and, as such, can be dissolved by the aid of either agent. The method to adopt is to wash out the bladder daily with either a weak solution of boroglyceride or peroxide of hydro- 102 Twentieth Century Practice. gen ; after this has been permitted to remain about ten minutes, it should be either passed or drawn off, then a No. 3 catgut bougie coated up to the thickness of a No. 12 with the papoid or trypsin plant. This procedure is most effective in obtaining a thorough eradication of those growths, and an excellent cure without the risk of any operative procedure. All civilized men with a well-developed great sympathetic, when they reach the time of life between fifty and sixty years of age, commence to feel degenerative changes, first in irrita- bility of the prostate gland at the neck of the bladder, drag- ging sensation in the back, loins, thighs, seminal weakness and impotency, and seminal losses; as the seminal ducts pass through the body of the prostate and seminal vesicles lie be- hind the bladder, the latter organ invariably becomes impli- cated. An irritable prostate gives to the lining or mucous coat of the bladder the same condition, but which may be in- tensified by walking, blows, falls, cold, exposure, rheumatism, uric acid, stricture, gleet, straining, sexual excesses, mastur- bation. When the bladder is thus involved pain over the or- gan, incessant desire to urinate, dribbling, suppression, very high colored deposits, urine muco-purulent, in which there is an evolution of the micrococcus urea, the toxins of which in- tensify all the distressing symptoms. In such cases our readers will find the administration of the ozonized uric acid solvent in alternation with green root tinc- ture of gelsemium most effectual. If not immediate relief add passiflora, which intensifies the action of the gelsemium amaz- ingly. Ambrosia orientalis, in suppository form, is an invaluable remedy in these cases, once the distress is relieved. Matri- caria is a most efficacious tonic, alternating with the c. p. solu- tion of spermin. Constructive treatment in all cases is attended with the best results. Spasm of the Bladder. — All muscular structures are liable to attacks of spasmodic action ; the bladder having such a coat is frequently affected with spasm. Spasmodic attacks are accompanied with great pain, as well as contraction. Causes. — The presence of a stone in the bladder ; disease of the rectum or uterus ; abscess of kidney ; an inordinate amount of uric acid ; ulceration of the walls of bladder ; disease of prostate gland; excessive sexual congress; hysteria; the use Twentieth Century Practice. 103 of drastic diuretics or emmenagogues, as oil of turpentine, juniper, cantharides, savin. Symptoms. — Severe pain in the lower part of the abdomen, extending to urethra. There is either continence or inconti- nence, or dribbling of urine. The difficulty is not so great when the urine flows involuntarily; when there is retention, with urgent desire to micturate, and tenesmus, with inability to do so, suffering is great. If allowed to continue, may ter- minate fatally. Our best remedies are large doses of the green root tincture of gelsemium alternate with belladonna. Copius warm injec- tions, medicated with the hydro-alcoholic tincture of lobelia, and as soon as passed a cocain suppository every three hours. These remedies when energetically pushed afford prompt re- lief. Irritable Bladder. — Irritability of the bladder is said to exist when there is an unnaturally frequent desire to pass urine. It may arise from organic disease of the spinal cord, kid- neys, bladder, prostate gland, or urethra; vascular tumors in the female urethra; pressure of the gravid uterus; irritation of piles, or intestinal worms ; presence of a tumor or stone in the bladder; catarrh and ulceration of bladder; acid urine, or functional derangement of the kidneys, bladder, stomach; and to shock to sympathetic nerve, and irritation of adjacent or- gans. Symptoms. — The desire to micturate comes on suddenly, frequently, and irresistibly ; urine may have to be passed every fifteen minutes — an inability to resist the desire; if attempted, great uneasiness or aching pain. The total amount of urine passed in the twenty-four hours very rarely increases in quan- tity; bladder diminishes in size; the general health begins to suffer. Treatment. — If possible, remove the cause, and in order to do that the urine must be examined to see if it is acid or alka- line; if loaded with urates, or phosphates, or oxalates; or if it contain albumin, or pus, or sugar, or any morbid material, and disease traced to its origin, which remove. Patient's bathing, diet and drink regulated to nature of malady at the base of difficulty. Alteratives and tonics, irrespective of cause, changed weekly, and persevered with; suppositories of cocain every night. Then try special drugs to act on the nerves of the bladder. Green root tincture gelsemium in al- ternation with passiflora. 104 Twentieth Century Practice. BLINDNESS, COLOR.— An inability to discriminate be- tween certain colors is a condition that seems to be coming more common, and is of especial interest to the general public as regards an avoidance of accident by excluding affected persons from the offices of engine-drivers, signalmen, pilots, and it is fortunate the class of individuals affected rarely seek such employment. Quakers are much affected with it, so are Jews. In the former it is brought about by a marked charac- teristic, a general coalescence of the typical fissures of the brain, induced by monotony, sameness, isolation; a condition often present in insanity, epilepsy and other low types of the human brain; in the latter class relationship or consanguinity wipes out the mental characteristics and obliterates the convo- lutions. This in-and-in breeding, as well as solitariness, pre- disposes to suicidal mania and causes color blindness. Among the remarkable phenomena connected with vision is that of an inability to distinguish certain colors and shades of color. People are color blind when their retina will not perceive some of the rays of light. Light is made up of three primary colors, and these, when overlapping in the spectrum, are known as the colors of the rainbow. When mixed, white light is produced. Now each color has a different velocity, light being supposed to be made up of imponderable particles traveling at a vast speed through space. The eye can only see those colors which have a certain velocity, and in ordinary persons these colors are red, blue, and yellow, with their com- pounds — green (blue and yellow), orange (red and yellow), and purple or violet (red and blue). In some cases the retina may not be able to see one or other of these colors. The blu- ish tinge seen in solutions of quinine and horse-chestnut is called fluorescence, and is due to the fact that extra rays of the spectrum are then made visible to the human eye. The average per cent of color blindness among any given people will depend upon the preponderance among them of Friends and Jews, or persons who possess the same charac- teristics. It always diminishes as we ascend the social or edu- cational scale. Among deaf mutes the percentage is even greater than the two classes mentioned. Intermarriage is not only a great factor, but the same law extends to temper- ment and races. Intermarriage not only creates the defect, but aggravates it, causing the most intractable form, which is red blindness. There is also to be found an unusually high average of color defects among the children of either fathers Twentieth Century Practice. 105 or mothers who work among colors. Trades requiring great concentration of sight, as engraving and watchmaking, seem to bring it about. Women are equally affected with men. The average percentage in people of low civilization or culture is great ; among deaf mutes ten per cent, and among Friends and Jews about six per cent. Color blindness is a defect which is quite compatible with perfect vision in other respects. Color blindness is found to exist in three forms : 1. Inability to distinguish any color, properly so called — black or white, or light and shade. 2. Inability to distinguish between nicer shades of more composite colors, as brown, gray, and neutral tints. 3. Inabilty to distinguish between primary colors — red, blue, yellow; or secondary and tertiary colors, as green, purple, orange. In the latter form there is a defective appreciation of all colors. Little good results from any treatment, and as there is about one per cent of the entire population affected, care should be exercised by railroad officials, pilot boards, etc., that no affected person be employed, so as to avoid serious acci- dents. BLISTERS, OR VESICANTS.— Medicinal substances which, when applied to the skin, irritate it, and cause a collec- tion of serous fluid under the cuticle, thus giving rise to a blister. The chief are — cantharides, croton oil, strong am- monia, mustard, and boiling water. They are used as counter- irritants; that is, to excite inflammatory action away from a part not within the reach of direct treatment. They should be applied during all stages of vital depression, and should not be left on for too long a time, as they are apt to cause 'great depression, and, in the case of cantharides, distressing bladder symptoms. Recent pathological teaching says useful to promote a re- newal of life in a devitalized part, to excite a growth of leu- kocytes. BLOOD. — This fluid is the great pasture field for all disease germs, and scientific investigators have now their attention directed to microscopical and spectroscopic examination of that fluid. Valuable facts, thus far, have been elucidated. The micro-organisms of cancer, syphilis and tubercle are defi- io6 Twentieth Century Practice. nitely settled. The brain, the great sympathetic, all the com- plicated mechanism of nerve nutrition, support the belief that the disease germ, the "vibrios," is the degraded bioplasm of primary nerve molecules — that that germ is present in the blood in all stages or degrees of poverty of nerve force in all nervous diseases, from epilepsy to the most aggravated types of insanity. That all nervous diseases, as a result, are pre- eminently contagious and infectious — that during the exacer- bation of any nervous affection, as the fit of epilepsy, the paroxysyms of mania, the germs are literally crowded in the blood. This can be easily tested by drawing blood from the neck with an ordinary cupping glass. This teaches us the great value of such germicides as the glycerite of kephalin, phosphated tincture of oats, ozone water in all states or conditions of depreciated nerve force. The Blood is the Life. — A fair average of the number of red corpuscles of the blood in a healthy individual of aver- age, size and weight is 5,000,000; the hemoglobulin is from thirteen to fourteen per cent. No known remedy increases the number of red corpuscles in the animal organism so effectually as ozone, the great scav- enger of germ-laden blood. The next in succession is the cacodylate of sodium, whose action is irresistible in causing a marvelous increase of highly vitalized corpuscles. Protonuclein is next in efficacy. Anemia is the product of action of the ptomains of nearly all microbes upon that vital fluid; ozone is the great remedy in all states in which the blood is depreciated, as in the conva- lescent stages of all severe illness from any malady. BLOOD-POISONING. — Pyemia, septicemia u and blood- poisoning are terms used synonymously to denote a morbid condition of the blood, attended with fever, consequent on in- fection from wounds ; absorption of the toxins of suppuration ; pus in cavities; absorption of the lochial discharge; dissection wounds, surgical operations. The blood is poisoned by the absorptions of the products of bacterial life, and abscesses form in the lungs, liver, kidneys, brain, joints, cellular tissue. Pyemia is usually an acute and alarmingly fatal malady; in rare cases chronic, continuing for months with any wound or visible injury, but accompanied with rigors, fever, followed by copious perspiration, insomnia, restlessness, and great de- pression. Twentieth Century Practice. 107 With an abscess, small or large ; with a wound or an abrasion, there is danger of a vital catastrophe, because the poison-de- stroying function of the liver and the poison-eliminating ca- pacity of the kidneys are so impaired by the ptomains and leukomains, they are unable to perform their vital functions The invasion of the body with some of the pathogenic mi- crobes is productive of it. BODY, HUMAN. — The human body is composed of the same elements as are found entering into the composition of the mineral substances found on the earth's surface. The following is a list of the quantities of the various elements found in a human body weighing 154 pounds: Lbs. Oz. Grs. Oxygen in o o Hydrogen 15 o o Carbon 20 o o Nitrogen 3 9 o Phosphorus 1 12 190 Sulphur o 2 217 Calcium 2 o o Fluorine o 2 o Chlorine o 2 382 Sodium o 2 116 Iron o o 100 Potassium o o 290 Magnesium o o 12 Silicon o o 2 The number of bones in the human skeleton is 246. Sixty- three of these are in the head and face, twenty-four in the ribs, sixteen in the wrists, fourteen in the ankles, and 108 in the feet and hands, each of these containing twenty-seven. The heart is six inches long and four inches in diameter ; it palpitates sev- enty times a minute, 1,200 an hour, 100,800 times a day, or 36,792,000 times in a year, and each time launches two and one-half ounces of blood, 175 ounces per minute, 656 ounces per hour, or seven and three-fourths tons a day ; the whole of the blood of the body passes through the heart in the space of three minutes. The skin is composed of three layers, and var- ies from a quarter to an eighth of an inch in thickness ; each square inch contains 3,500 pores for the escape of the perspira- 108 Twentieth Century Practice. tion, which may be compared to little drainage tubes, a quarter of an inch long, which have a total length in the superficies of the body of 201,166 feet, or a little trench to draw off the water of the body extending to forty miles. The blood of the human body weighs thirty to forty pounds, it makes a complete circula- tion in no seconds; the lungs receive in twenty-four hours 11,000 pints of blood. The hair grows in two years from twelve to sixteen inches. Man grows to twenty years and lives 100 years or more. The maximum of sleep required by an adult is eight hours. The food of man is regulated by his own experience as regards what digests well or badly. The time required to digest food of a mixed nature is three hours and one-half. Exercise, cleanliness, and a cheerful and contented mind are the best medicaments supplied by nature to secure good health and a long life. BOILS are directly due to infection of the tissues with germs. There are always found upon the skin germs capable of producing boils and other forms of suppurative processes if introduced into the system. Ordinarily, however, the body does not suffer from the close proximity of these noxious ele- ments, for the reason that the tissues are able to destroy, in various ways, the small number of bacteria which penetrate the skin. When, however, by any means the vitality is lowered to a sufficient degree, invasion by those parasitic microbes through a scratch, a pin prick, or any other abrasion of the skin may give rise to the multiplication of germs and the production of pus, with the accompanying swelling, pain, and suppuration. Some of the most common causes of the tissue degeneration which renders the production of boils possible are auto-intoxica- tion poisons generated in the body from flesh eating, the free use of fats, constipation, and indigestion. Repeated attacks of boils can be averted only by removing the cause, whatever it may be; probably maldigestion, perverted nutrition, in which there is an abundant evolution of bacteria, which produce boils and degeneration. True the vitality of the system is lowered ; it enables the evolution of parasites and microbes to progress. General depression, headache, coated tongue, fetid breath, constipation, auto-intoxication. The best internal remedies for boils is the sulphide of calcium, half a grain every hour; it de- strovs the bacteria, thereby lessens the inflammation, reduces the area of the boil ; it liquefies the core ; draws a line of de- marcation, causes it to separate speedily. If the skin is not Twentieth Century Practice. 109 broken, the sulphide converts it into an abscess without delay ; but if it is taken early, it will cause it promptly to dry up, and inflammatory action ceases. Besides, the sulphide of calcium exerts a marked influence upon the general health, in restoring vitality, wiping out debility, keeping the blood pure, preventing the formation of others. Another excellent remedy is the ozo- nized tincture lycopodium in fifteen-drop doses every three hours. The only class of boils in which this remedy fails are those deep-seated, dependent upon a diabetic diathesis. An almost exclusive fruit diet should be adopted for a few days, and the plan of making one meal of the day entirely of fruit should be followed for a few weeks at least. A daily warm bath, followed by a short cold bath, plenty of out-of-door exercise, and care to secure prompt, regular, daily movement of the bowels, are other measures of importance. A boil may generally be avoided by injecting into it a few drops of a one to twenty per cent solution of carbolic acid. Hot applications are useful in relieving the pain. BONES. — The bony framework of the body, upon which the muscles, arteries, veins, nerves and skin are attached, is a structure of very low organization. Nevertheless it is liable to be influenced by adverse conditions, its vital integrity im- paired by morbid states of the blood, by mechanical injuries. by defects in nutrition. Periostitis. — The coverings of bones are called the perios- teum, and is a fine, white, fibrous tissue, which covers the bones like the bark of a tree, for if it is stripped off by accident and by matter burrowing under it, separating it from the bone, and thus depriving the latter of its nutrition, the bone dies. The periosteum of any bone in the body may suffer a partial death, but it is more liable to occur on the subcutaneous aspect of those bones that are thinly covered, as the fingers, tibia, ulna, clavicle, and cranium. Causes. — The chief causes are the syphilitic taint, in which case the germs give rise to round or oval swellings, called nodes; which is an infiltration of lymph and serum into the periosteum, or between it and the bone; tuberculi, mercury, rheumatism, which cause an inflammation and swelling of the entire length and circumference of the periosteum. It may also be due to injuries, punctures. Symptoms. — The pain in inflammation of the covering of the bone is sharp, lancinating, very intense ; if of the syphilitic no Twentieth Century Practice. type, the pain at night is unbearable ; pain still more severe if the bone is involved ; tenderness ; there is always some consti- tutional disturbance, greater or less. Fever, restless nights, mental depression. Rigors and throbbing indicate the forma- tion of pus. Treatment. — If seen early, before the pain changes to a throbbing, a strenuous effort should be made to avert suppura- tion, for that event is equivalent to the death of the bone unless well managed. Fever must be controlled with aconite, and large doses of hyoscyamus and opium, to relieve pain. Powerful local stimulants should be applied, such as immersion of the finger, or part, in water nearly at the boiling point; the appli- cation of hot alcohol, or a fly blister, or the oil of lobelia; or, try compression; apply a bandage from the tip of the finger, up, as tight as can be borne, so as to control the circulation of blood to the part. Keep it very tight, so as to be almost un- bearable, and on all the time. When used, it must be before the throbbing has begun. Bowels and skin actively stimulated — the former with antibilious physic, the latter with Dover's powder. Internally, iodide of potassium, in the saxifraga compound. If rigors and throbbing have taken place, do not wait for the formation of an abscess, but open early, clean down to the bone, soak in peroxide of hydrogen, then follow with hot fomentation and poultices. An early opening, free and deep, is the only means of saving the bone from destruction. After matter has been evacuated, poultice, and then follow with ozone ointment as a dressing; if it is syphilitic, mercurial, tubercular, rheumatic, follow in with the treatment necessary for each. Nodes, as a result of periostitis, never form, only in syphilitic poisoning. They may be absorbed with iodide of potass, when soft, but if hard, forming an ivory exostosis, they may have to be chiseled off. Whitlow, or felon, is simply periostitis of the periosteum of the fingers. Ostitis; or, Inflammation of Bone. — Inflammation of bones may arise from injuries, syphilis, tuberculi, mercury, phosphorus, rheumatism, and may be followed by effusion of lymph, breaking down of lymph, abscess, caries, or necrosis, or ulceration of bone. Symptoms. — There is a deep-seated, severe, dull pain, with swelling of the soft parts, rigors, and a fever ; if acute, the parts slowly enlarge, tenderness increases, with weight and pain. If it proceed to ulceration (caries or necrosis), there are rigors, and pain changes to a throbbing. Twentieth Century Practice. hi The treatment embraces rest, control fever, keep bowels •open, and skin active ; local stimulants in the form of hot packs during the day, and the chloroform liniment at night. As soon as fever is controlled, iodidie of potass in compound saxifraga ; keep patient under it for some months. If rigors and a throbbing have taken place, poultice, and as soon as indications of pus formation are clear, free openings. If an opening, or several openings, have taken place, run them into one, so as to give nature as little work to do as possible. Abscess is rare, the condition being a breaking down of lymph in the substances ■of the bone, giving us caries or necrosis. Either of these con- ditions can be easily detected, by a gritty or sandy feel of the pus. In all cases general alteratives and tonics; best of diet, with an excess of phosphates, as oatmeal porridge, cream, and boiled white-fish. Caries and Necrosis. — Those two terms are used to signify ulceration or gangrene of bone — conditions that may follow inflammation, softening, molecular degeneration, and suppuration of surrounding soft parts. It is called caries when it takes place in the spongy bones, as the vertebrae, or the ends of the long bones ; necrosis, when it occurs in the hard, cancel- lated structure, or when shaft is involved in the gangrene. There are various forms of the latter : if the shaft of a cylin- drical bone dies, and is enclosed in a case of new bone, it is called osteo-gangrene ; exfoliation is a term applied to necrosis, or modification of the superficial layer, which is not encased in any shell of new bone. Caries attacking bones of a spongy texture, as the vertebrae and articular ends of bones, involves a less hopeful condition of repair than necrosis; whereas the latter, being in the middle of the bone, leaves the two ends of the bone in good condition, so that repair will take place even under the most unfavorable circumstances, because it is from the two extremities that the long bones receive their principal nutrition. Symptoms. — Inflammation of bone, with suppuration and formation of sinuses, through which matter flows in which gritty or sandy particles can be detected — bony granules. In- troduce a probe through one of the openings; the bare, dead l)one, or its exfoliated, or broke-down portions, can be detected. Discharge very fetid; disease very chronic, and usually great constitutional disturbance. Treatment. — If the parts admit of it, run the sinuses into •one opening clean down to the bone, and wash out the cavity ii2 Twentieth Century Practice. with four ounces of tepid water, in which one dram of caustic potassa has been dissolved. In caries there is nothing to hope for but a healing of the bone, with deformity ; whereas in ne- crosis, everything is to be gained by a speedy removal of dis- eased bone; so the above injection should be used every day, if no irritation is producd, so as to soften down the diseased structure. Poultices of linseed; enjoin rest; push a general alterative and tonic course, and a most liberal diet. Lymph breaking down, a suppurative process established, there is found in the discharge a microbic evolution, the bacillus saphrogenes, which is found in all putrefactive changes or gangrene of bone. All inflammatory states of bone, whether due to injuries or the toxins of disease germs, have the same evolution, where lymph is effused and breaks down. It is present even in phosphorous poisoning, when the su- perior and inferior maxillary become necrosed. In the manufacturing of lucifer matches, in which large quantities of phosphorus are used, many of the operatives suffer from its absorption, owing chiefly to the avaricious propensities of the owner. The are two kinds of phosphorus, ( i ) ordinary phosphorus in sticks, yellow, luminous in the dark, has a peculiar odor, very inflammable, apt to ignite when handled, and when exposed to the air gives off white fumes, and it is the absorption of these that give a toxical result; (2) amorphous phosphorus is red in color, not luminous, in powder form, non-poisonous, may be handled with impunity and costs usually much more than the first mentioned, the poisonous form. Safety matches, as they are termed, are tipped with a mix- ture of red lead, black sulphide of antimony and chlorate of potassa, and the phosphorus used in them is usually of the non- poisonous form. On close investigation of the secret working of our match factories it will be found that poisonous phos- phorus is used, and the operatives exposed to its fumes, and these fumes, by a selective influence, attack the bony structure of the upper and lower jaw. The result of this influence is necrosis of those bones (the evolution of the pathogenic mi- crobe), the lower more frequently than the upper. In all cases the necrosis is slow, insidious, progressive and the extent of bone affected is quite considerable. The soft structures resemble scurvy, bleed freely on the slightest touch ; soon the bone becomes spongy, and resembles pumice stone, breaking down and coming away in pieces. Twentieth Century Practice. 113 Remove the individual from its influence, the vital force alone unaided will get rid of the dead bone, and even further, will cause a new bone to take its place, not so perfect as the original, but better than none at all. As the discharge is a living mass, highly infectious, the oral cavity should be washed with a solution of chlorate of carbon every two or three hours and expectorated, and the patient careful that none be swallowed. The best internal treatment for caries and necrosis is a tonic, alterative course, embracing in the list of remedies thyroid ex- tract, protonuclein, c. p. solution of spermin, matriacaria, etc. Locally, poultices, if parts admit of it, with alkaline ingredients until sinuses form openings, and injection of solution of chlorate of carbon. Phosphorous poisoning affords an excellent example of ne- crosis, and is a matter for congressional investigation. Atrophy of Bone. — Atrophy of bone is marked by a dimi- nution of their weight, size, bulk; involve the whole bone, or a part of it — one side of the bones of the face, or entire side ; bones may waste to a mere shell. Atrophy may be caused by want of nutrition, nerve-supply; by disease, want of exercise; by disease, either in the bone or adjacent parts, and morbid states of the blood. The treatment consists in removal of cause; general altera- tives and tonics, with local stimulation. Hypertrophy of Bone. — It sometimes happens that one or more bones increase in length, breadth, and thickness. This may occur in any bone in the body. The deviation from or- dinary nutrition, on which such enlargement depends, is rarely controlled by any drug. Exostosis. — Is a tumor formed by the irregular hyper- trophy of bone. Such tumors are hard, painless, and globular, and mostly situated on the long bones. Their structure is that of ordinary bone, but usually more dense and compact. In some cases they are porous, in others of an ivory consistence. They cause no pain unless they press on nerves. On the inside of the skull they press upon the brain, and give rise to epilepsy ; in the orbit they cause the eye to protrude. Their cause is irritation, and effusion of lymph, which be- comes organized into bone. Treatment. — If not too dense, they can often be got rid of by absorption, by alteratives, and by iodide of potassa, with the local application of the ozonized clay; when hard, of the con- H4 Twentieth Century Practice. sistence of ivory, they can be cut down upon and chiseled off. Mollities Ossium. — Osteomalacia, or softening of the bones. A peculiar constitutional affection, in which all or a part of the bones of the body may be affected by softening, which gives rise to distressing and remarkable deformity. Women beyond the age of forty are most obnoxious to it. The pelvis is sometimes alone attacked in child-bearing women, and in some cases the limbs. The characteristic of the disease is the absence of the earthy phosphates in the bones, so that they are unusually flexible. Associated with, or probably dependent on, this condition or the cause of it, is very remarkable nervous depression, the health hopelessly impaired, with gradual loss of flesh and strength. The urine is loaded with large quantities of phos- phates ; severe pain soon follows, and spontaneous fractures are liable to take place. No treatment of any utility. In old age we meet with the opposite condition, where the bones have an excess of phosphates, owing to which fact they become extremely brittle, and are liable to give, or even break, upon the least violence. There are also other morbid states of bone, in which certain elements are wanting, owing to special germs being present in the blood, as in rickets, bow-legs, spinal curvature, etc. ; states in which the bones are soft, flexible, easily bent ; conditions due to the want of the phosphates. Rickets. — Essentially a tubercular disease of the bones of the entire body, the spongy bones being chiefly the seat of migration of the tubercular bacilli, besides it is a disease in which the bones are deficient in their earthy constituents, and consequently lose their natural hardness ; they become soft like gristle, and somewhat brittle, so that they are not only easily bent, but easily broken. The term "rickets" is usually applied to this softening when it occurs in childhood, but a similar disease also attacks adults, especially females. Rickets is a constitutional disease, and is very generally associated with a tendency to scrofula either hereditary or engendered by poor living and unhealthy influences, such as deficient ventilation and light, impure damp air, and bad food. Rickets presents well-marked external characteristics, and a tendency to certain peculiar manifestations of disease. It most commonly shows itself in a child aged from six months to two years.- The face is generally pale, but plump and broad. The head is large in proportion to the face, is flat and misshapen, Twentieth Century Practice. 115 the f organelles (openings between the bones of the skull) widely open, and the forehead prominent. The chest is flattened at the sides, and the breast bones pushed forward. The wrists and ankles are large and swollen, owing to the bones being late in development. The teeth are cut late. The bones ar soft and cartilaginous owing to the lack of the earthy con- stituents, hence when the infant begins to walk the legs become bent under the weight of the body, and often the spine becomes curved. This defect in the process of bone formation is the leading characteristic of the disease. The same treatment should be pursued as in tuberculosis : tonics and alteratives with a special course of glycerite of ozone, mistura guaiacol, thyroid extract, inunction with olive oil and guaiacol. It is a disease which is perhaps more frequently acquired from improper feeding, bad nursing, impure air, and general want of cleanliness. BOROGLYCERIDE, OZONIZED.— Ozone; Boric Acid; C. P. Glycerin. A chemical compound, powerful germicide, hemostatic, pre- vents and arrests fermentative and putrefactive changes. Its use is indicated internally and locally in nearly all mi- crobial diseases. When the cutaneous surface becomes invaded with the micro- organisms of erysipelas; burns, eczema, lichen, prurigo and there is intense burning, tingling, itching, the greatest possible relief is immediately experienced, and the microbe killed, by the application of a lotion of two ounces of boroglyceride to the pint of tepid water, kept constantly moist, covered over with oiled silk ; so with parasite skin affections. Applied to wounds, if the ordinary indications are observed, union by first intention is promoted. Ulcers which resist the ordinary remedies are speedily cured by the application of a 50 per cent solution. It sterilizes the microbe syphilitica, hence in its pure state it is an invaluable application to chancres (superior to iodol) ; makes a splendid germicidal injection in female gonorrhea, radically rooting out the gonococcus; besides it is of great efficacy in metria, in washing out the uterine cavity, and render- ing it aseptic; of utility in metritis, endometritis, vaginitis, catharrhal states of the neck, and undoubtedly our best remedy in all form of leukorrhea. To an indurated or hypertrophied uterine neck, packing the vagina, embedding the indurated parts lib Twentieth Century Practice. into the boroglyceride past, for twelve hours at a time, effects a marked revolution in the parts. As a mouth wash or gargle, it destroys all germs in the oral cavity ; hence it is of value in all throat affections, in tonsillitis ; laryngitis; in variable strengths it is very efficacious in nasal catarrh. Its vitalizing action on the skin of the face is superb ; here the boroglyceride oil, applied on retiring, removes all tan, freckles, rendering the skin soft, velvety. In ocular affections, the boroglyceride lotion excels all known germicides in the various forms of ophthalmia. Kills the microbes of the common, acute, the purulent, the gonor- rheal, and to the granular form it makes an excellent applica- tion. To this latter it is used thus : the lids being thoroughly everted, the boroglyceride heated into an oily consistency, is spread all over the conjunctival surface with a camel's hair brush. It is generously applied, readily gains access to the cracks, crevices, and into the granulations themselves. The immediate effect is to increase lacrimation, with a painful gritty sensation, which passes off in ten minutes fol- lowed by an amelioration of all the symptoms, the granulations look pale and less prominent. Ozonized boroglyceride is incomparable as an antiseptic and germicide, active, efficient, still innocuous to highly organized living matter — pre-eminently destructive to all microscopic life. It has been lately demonstrated that every can of milk that enters this city has either the microbes of scarlatina or diph- theria, or of tubercle, or of syphilis, or of cancer, or of anthrax, or of typhoid in it. The addition of a very small amount of ozonized boro- glyceride to each can will completely annihilate these germs; besides, it will preserve the milk indefinitely without any organic change or fermentation, without ice being used for the purpose, in our hottest weather. Variations in temperature in milk give rise to the evolution of tyrotoxicon, a deadly poison. All this is prevented by the use of boroglyceride in the lactiferous fluid. Milk preserved by the addition of boroglyceride is free from all germs. As a medicament, ozonized boroglyceride is invaluable. As a mouth wash and gargle, it will destroy all germs in the mouth and throat ; renders the breath sweet, all odors disap- pear. From a half to one teaspoonful dissolved in half a Twentieth Century Practice. 117 tumbler of hot water. It should be used first in the morning, before and after each meal; preservative to the enamel, pre- vents tartar formations, keeps the teeth brilliantly white. After the ozone and chlorine has cleaned out every germ in nasal catarrh, nightly douches of solution of ozonized boro- glyceride complete the cure. A hot, saturated solution of boroglyceride applied over the erysipelous blush completely kills the streptococcus. Dissolved in hot glycerin, and at once applied over perios- titis, the germ is killed, inflammatory action ceases, for in this form it penetrates to the bone marrow. For burns and cutaneous diseases, it is best to rub it up in ozone ointment in definite proportions. Tepid solutions in chronic cystitis, completely wipe out the micrococcus urea — injections of the same kill the gonococcus. In gynecological practice a pastil of ozonized boroglyceride is very popular, as it cures all forms of leukorrhea, whatever may be its cause; heals erosions about the uterine neck; ab- sorbs indurations; blots out mechanical dysmenorrhea; kills every germ that enters the vaginal orifice ; as a suppository, it ameliorates every disease of the rectum, cures many ; it absorbs •stricture; heals ulcerations and fissures; subdues inflammation by promoting a renewal of life in the lower bowel. BORACIC ACID. — The only known compound of oxygen and boron, is unexcelled as an unirritating antiseptic in wounds, devoid of smell and antagonistic to the toxin of sweat; to the pidium albicans of aphthae, micrococcus urea it is of immense efficacy; as a dressing powder, equal parts of the acid com- bined with pulverized starch ; combined with orris root and one drop of attar of roses make a good tooth powder ; lint soaked in a hot saturated solution and dried, applied to wounds, promotes union by first intention. Still more active, of more decided efficacy, when prepared as ozonized boroglyceride, then it is a microbicide of greater power, killing germs of great potency. It is in this form that it is largely used as a food preserver to prevent chemical change in warm weather, to either delay or prevent decomposition. The quantity added to canned fish, to butter, to milk, is too great : 3 per cent or 26 grains to the pint ; too large a dose for either an infant or an invalid, harmful to any one with weak kidneys, very apt to give rise to fatal re- sults, eA^en cautiously dealt with. In ordering milk diet for pa- n8 Twentieth Century Practice. tients physicians must see to it that there is no boroglyceride in the milk and no kidney disease. Our population suffers from poisoning from this cause much more than from tuberculosis. Cases of intoxication from this source are very common. Ozonized boroglyceride is invaluable as a medicament, not as a food. A tampon of this agent introduced into the vagina will promptly unload a congested uterus. A suppository of the same chemical compound will in a few weeks reduce an en- larged prostate. Excellent as a medicine, bad as a food. BOUGIES. — A flexible, cylindrical body, variable in size, to be introduced either into the urethra, or esophagus, or rectum, etc, for the purpose of either dilating or medicating them, when contracted or suffering from some morbid action. A simple bougie is composed of solid and insoluble substances, as silver, rubber, gutta-percha; they act, of course, mechani- cally. Medicated bougies are usually made of gelatin, butter of cocoa substances soluble at the temperature of the body. The medicament introduced may be arbor oil, to destroy warts in the urethra and check leakages — the remedy introduced may be thallin, which annihilates the gonococcus; or it may be sulphocarbolate of zinc, Avhich dries up all leakages in the urethra; or it may be the glucoside of the salix nigra, which effectually arrests all seminal incontinence; or it may be the solid extract of the true damiana, or the compound known as ambrosia, which inspires new life into the genital nerves, and often cures impotency. Those composed of iodol will oblit- erate obstinate strictures. Stricture of the urethra is the result of irritation, inflam- mation, due to the presence of the gonococcus; masturba- tion in early life and sexual excess at a later period produce congestion, spasmodic action, effusion of lymph, stricture, ulceration. Very prevalent, therefore, are organic and spasmodic stric- tures, and much of the spermatorrhea and impotence now so common are due to those conditions, states that lead to sexual incapacity. Strictures of the bulb are more refractory than those in the deep urethra into which the seminal ducts open. In every case of seminal weakness it is well to examine for stricture up to the neck of the bladder, for there is nothing so effective in relieving Twentieth Century Practice. 119 the irritation of the seminal ducts as the occasional passage of a No. 12 metallic bougie. Upon the introduction of this the drain of vital fluid often ceases, the dilated mouths of the ducts contract, semen becomes thicker, healthier, more fertile, organs increase in size, distressing nervous symptoms subside. For effused lymph organic stricture absorption is the only idea which ought to pervade all our procedures, for if dilata- tion be tried, even cauterization and excision, there is invariably a recurrence. Absorption with or by the iodol bougie is the most successful of all modern methods, and when properly ef- fected there is never a recurrence. The effective method of curing all urethral diseases is direct treatment with bougies. There is never a stricture in gonorrhea when the thallin bougie is used as a means of killing the gonococcus; there is never a stricture in spermatorrhea when the salix nigra bougie is used as a means of cure ; in hopeless cases of impotency how often does the ambrosia orientalis create a renewal of life; in dwarfed or atrophied testes how frequently does rejuvenation and growth take place when the saw palmetto bougie is used daily for some months. BRAIN. — Our knowledge of the structure and function of the human brain is very limited, especially as to the soul seat, and its various manifestations: intrinsically the most valuable structure in nature — susceptible of much modification, change, development, culture. The force which operates it is the life principle which energizes every cell and tissue in the body. The life in man, which comes from God, is the unseen force in every vital movement. The human brain, perfect in structure, complex, highly or- ganized, stands at the head and controls every function of the body, made up of two tissues, gray and white matter, sensient and motor; gray or cineritious on the surface; the white nerve « fibres, which connect the brain with every .part of the body. The surface of the brain is not smooth, but divided up by fis- sures into longitudinal ridges. The brain is first divided into two halves or hemispheres by a deep groove called the longi- tudinal fissure. The centres for all the functions of the body are duplicated, being alike situated on the surface of each half of the brain. Nerves from the centre of the left side of the brain go to the right side of the body, and vice versa, in each half of the brain. We have the frontal, middle and posterior 120 Twentieth Century Practice. lobes. Each of these are divided into convolutions or ridges having deep furrows between them. In the frontal lobe we have the superior, middle, inferior, and ascending convolu- tions ; in the parietal lobes we have the ascending and inferior convolutions, etc. This uneven surface of the brain gives a larger area, and hence increases the amount of gray matter or nerve cells which are located in its substance. People who have the most well-developed brains have these convolutions most marked, and the fissures are more deeply situated. From point of localization of function we find the position grows more important as we go from the back of the brain for- ward, until in the foremost part we have the functions of the mind located. The prominent development of the frontal lobe is a feature which marks the development of the brain of man as above that of other animals. A lack of mentality of the in- dividual, especially if it is inherited, will show a poor develop- ment of this part of the brain. The brain of man is of divine mechanism, perfect formation ; on it depends the healthy performance of every organ in the body; mental as well as physical. Diseases of the brain are all of vital importance, and will be the leading factors of all maladies of the twentieth century. Brain of man, not only highly vitalized, rich in cineritious matter, but delicate, the most resisting, the most difficult to depress, or to produce a partial death in its structure of any other tissue. , In inflammation of the brain we have the origin of all cere- bral disease. This condition may be induced by mechanical violence, falls, blows on the head, sunstroke; the toxins of all microbial diseases in the blood; use of stimulants, improper use of certain drugs, narcotics, great mental strain or effort, extreme emotional conditions. Reflexly the brain may suf- fer a partial death, by or through irritation of other organs, as the kidneys, heart, digestive and generative organs., Easily recognized by the pain in the forehead, which is ag- gravated in all cases by noise, light, heat, motion ; flushed face, contracted pupils in the acute form; great increase of tempera- ture; arrested secretion; add to these, usually nausea, vomit- ing, stupor or delirium — later on convulsions. It may, if the lesion be reparable, terminate in recovery; if grave, non-reparable, red ramollisment, with extravasation of blood into its substance, and with violent contortions, or convulsions, and death; or it may be guided into a chronic con- Twentieth Century Practice. 121 dition, in which recovery may take place, or it may run into white remillisment, softening, and paralysis — symptoms vari- able with pathological condition. The treatment of all cases of partial death of the brain re- quires much good, common sense. The patient should be kept in a nice, cool, airy room, free from noise, light. The first indication is to shave the head and keep hot water constantly applied ; then free purgation, aided with enemata : mustard rollers to the feet and calves of the legs ; perfect rest in bed, recumbent position ; then administer one grain of the solid extract of hyoscyamus every hour, well triturated in one teaspoonful of passiflora; procure sleep at all hazards. BRAIN EXHAUSTION.— Excessive brainwork; cerebral bankruptcy. Continual mental strain, under artificial hackneyed condi- tions of life, causes a tremendous draft upon the brain forces, wearing deep channels and making barren certain areas. Every thought and act requires an effort, nothing is spontaneous, bub- bling up from a spring fed by a spirit living in harmony with nature's decrees, and though experience may have made such efforts second nature, the strain exists just the same, and all too soon the time comes when the cable of life, worn to a single strand, parts suddenly, and the exhausted brain is forever at rest. The sooner our leading men get closer to nature, have less artificial, become naturalized to rest, innocent recreations, homely pursuits, which refresh the brain, furnish food for new thought, revivifying the brain, leading it into new impulses, and motives, and so enable it to go on growing and developing. The profession must sound a note of warning against a too one-sided life. Physical salvation, perfect brain rest, may be ensured by a periodical return to first principles. Hunting, fishing, felling trees, golf, going to bed physically worn out at nightfall, sleeping in the fresh, woodland air, and rising with the sun. If all our leading men could be induced to take out- ings of this kind for six weeks, twice a year, there would be no more cases of heart failure or apoplexy, so far as they are con- cerned. Among the highly intellectual brainworkers of our present modern civilization, and all suffering from neurasthenia, in- somnia is very common — the brain cells being morbidly active, generally owing to the presence of some toxin in the blood. 122 Twentieth Century Practice. The effect will disappear with the removal of the cause. When sleeplessness has become a habit under such a condition, from I o to 30 drops of the ozonized extract of passiflora incarnata, three times a day, will do what no other remedy can, give nine or ten hours of refreshing sleep. Many leaders in our profession entertain the idea that the brain, under the pressure and vices of our modern civilization, wears out sooner than under a degree of lethargy, a semi- torpid condition. Sexual excesses are undoubtedly productive, above all other causes, of a failure of brain power. The brain is strengthened by moderate activity in intellectual pursuits — not exhausted. If we scan carefully the mental horizon, we can clearly see that nearly all the failure of brain power is due to ihe presence of the bacillus of syphilis. BRAIN, WIPING OUT ITS TYPICAL FISSURES.— The human race, from certain abnormal conditions, may suf- fer vital deterioration and the evolution of the tubercle bacilli, but even this, when it reaches its highest point of intensity, ends in non-procreation, so that no permanent deterioration can exist, no establishment of a morbid race, our stock being virtually the same as during the palmy days of Greece and Rome. Still, there are elements at work which tend to depre- ciate, lower, nay, efface the typical fissures of the brain. Look at the effects of isolation, monotony, sameness, soli- tariness, as they exist in some of our so-called philanthropic in- stitutions, in which five or six hundred lads are confined ; every one, as time grows, loses the normal depth of brain fissure ; they become shallow, and assume the non-intellectual condition of a crank, sneak, coward, knave, cur, give rise to masturbation, and finally suicidal mania. The outcome of all is masturbation, which is sapping the very vitals of our nation, the victims of which are seen in the streets, counting-rooms, workshops, and our insane asylums are full of them ; besides, it brings premature death to a considerable pro- portion of our population, while to others despair and suicide. Our profession must arouse from their lethargy with keener perceptions, recognize and be prepared to treat a class of cases which simply fade away, become weaker, more nerveless and hopeless day by day, and finally drop into a grave yawning to receive them, without any other diagnostic mark. The man or woman who commits masturbation destroys the essential elements of their being, blight their own lives ; if either Twentieth Century Practice. 123 be unfortunate to marry, infelicity, unfaithfulness and misery are their lot, and if they have an offspring, it will be a poor, puny, fledgling, with aged, wasted face, epileptic, choreic, im- becile, idiotic, with some form of tubercular disease. Once the imperative law of nature be violated, the terrible vice established, lost health and vitality are the sexual, as is seen in the wasted hands, the doughy skin, the scanty locks, the blackened rings around the lack-lustre eyes, the heavy lips, the labored breath, unstable gait. , No use in any asserting that the practice is harmless, or its sufferings imaginary; no, our profession must come boldly to the front and stem the current which is undermining our na- tion. Such cases can all be cured, even in their worst stages, by modern remedies and restoratives; but to procure that, a due appreciation of the affection, skill, and great tact in manage- ment are necessary. Alcohol not only effaces the typical fissures, and induces in- duration of substance, precisely in the same manner as if the brain were steeped in alcohol, so that the inebriate, anticipating the anatomist, begins the indurating process before death — begins it while the brain remains the consecrated temple of the soul, while its delicate and gossamer tissues still throb with the pulse of heaven-born life. What an extraordinary infatuation thus to desecrate the God-like! What madness to dry up the fountain of generous feeling, petrifying all the tender hu- manities and sweet charities of life, leaving only a brain of lead and a heart of stone ! A very important pathological discovery has recently been made, in cases of suicidal mania, namely that the typical fis- sures of thought are almost entirely obliterated, and a general atrophy of the cineritious portion of the brain has taken place, clearly demonstrating the disease of self-destruction is a mental act, due to cerebral wreckage. The condition is identical with the brain of an habitual masturbator, or one who practices a perversion of the sexual act. Indeed, every case of suicide is associated with or dependent on either a sexual basis, or failure, or self-indulgence in some way. The mental irregularity is due to sexual chaos — the internal testicular secretion being cut off. A man who attempts to destroy his existence is not sane, neither is his judgment sound. This morbid condition is amenable to treatment, whether.ex- 124 Twentieth Century Practice. pressed or implied. Place him upon ozonized thyroid extract^ once or twice daily, for some months, and administer c. p. solution of spermin thrice daily. These two remedies, in some mysterious manner, completely overcome the suicidal tendency and bring about a healthy equi- librium. The same remedies are efficacious in all conditions of arrested development, retarded evolution, idiocy, imbecility. BRAIN STARVED.— A tissue-starved brain is the most common malady of our age and country, and few are aware of the fearful destruction of intellect and life that are caused by it. Softening of the brain is a justly dreaded disease, and a va- riety of theories have lately been laid down as to its great preva- lence and cause, as adulterated food, the wear and tear of civ- ilization, study, care, worry, struggle for existence, syphilis and sexual excesses, perversion, irregularities. The substances of the brain and of the nervous system gen- erally are essentially different, both in their structure and com- position, from all other parts of the body, and therefore they require to be nourished in a different way and by different material from any other part. All the vital organs may be perfect, and the muscular system well developed and supported, owing to their special nutrition being complete, and yet the nervous system may be in a state of decay. It is true that decay of the nervous system is soon followed by decay of all other parts, but it may commence independently of any imperfection in them, and even while they are healthy. The actual material or substance of the nervous system is intrinsically the most valuable in animated nature, and is al- most identical with that of the seminal fluid in man and of the ovae in woman, and its composition is also very similar. In all probability the same vital action which calls forth the generative elements also creates, at the same time, the nervous substance. Whenever, therefore, the production or nutrition of the one is imperfect, so is that of the other. There is like- wise not only a close sympathy, but a real coincidence of origin and mutual dependence of existence between these two most mysterious portions of our being. The brain and the sexual apparatus are placed at the opposite extremities of the body, like the two poles of a galvanic pile, each being connected with the spinal marrow which unites them. When one of these pole^s is overcharged with vital power, the other is under- Twentieth Century Practice. 125 charged; and when one is exhausted, the other is soon in the same condition. This explains at once why excessive mental exertion is often followed by sexual impotence ; and why, on the contrary, sexual abuse so often destroys the intellect. Softening of the brain is an actual deficiency of some of the substances composing it, and these substances are precisely those that are carried off by the seminal discharge. When a man expends too much semen, he does the same thing as if he totally destroyed a portion of his brain, because he takes away that which is necessary to nutrify it. Nature will .not produce enough of these substances to make brains and to allow of licentious indulgence at the same time. BRAIN GROWTH.— At birth the* brains of boys weigh more than girls. Men of great intellectual power have brains that weigh sixty-six ounces; while the brain of imbeciles do not average over thirty ounces in weight. The average weight of the brain of an adult is forty-nine and one-half ounces. Very many of our intellectual giants have exceedingly small brains ; it is the richness in cineritious matter and depth of the fissures of thought that makes the man ; quality outranks quan- tity at all times. The most active period of brain growth in man is between the twentieth and fortieth years ; while in woman the brain attains its maximum of growth at thirty years of age. From forty to fifty slight diminution, greater between sixty and seventy. The shrinkage is quite great, decreases with the intelligence. The use of alcohol gives rise to atrophy. Moderate brain exercise among the learned preserves the brain to extreme old age in all the fullnes and vigor of their faculties and it loses little of weight which belonged to it in the prime of life. The occasional administration of the thyroid extract to the growing youth imparts an impetus to brain growth, an idea worthy of consideration in the imbecile ; a diet largely of cereals and fish is very productive of cerebral nutrition. Our best remedies for brain growth are kephalin, avena c. p. solution of spermin. BRAIN DEGENERATION OF THE MODERN CHILD. — Much of the defective brain nutrition of children is due to hereditary causes, the child being the victim of parental defect, the vice of intemperance, being transmitted to the offspring in 126 Twentieth Century Practice. the form of cerebral malformation or neurosis. Same con- dition gives rise to insanity, imbecility, feeble-mindedness, mel- ancholia, suicidal mania, and epilepsy. Statistics show us that 20 per cent of all children who reach the second year have either in the spring or fall a sporadic at- tack of cerebro-spinal meningitis, often unnoticed by the pa- rents, which has too often for a sequela a loss of hearing, terminating in deaf-mutism. Modern adulteration of food products, alum-saturated bread, retards and renders dentition difficult and impoverishes the brain. Besides, our school system, abnormal and defective ; women teachers, reflexly stamping effeminacy upon boys, overtask- ing, etc. Until recently, the medical profession had no resources, no remedies to meet and overcome this great national disaster. Within these few years past, the thyroid extract and c. p. solution of spermin have wrought a most remarkable change in curing a very large percentage of these cases. Thyroid ex- tract, administered to such children, increases the activity, growth, and stamina of brain substance; it has a stimulating influence over all the cerebral functions. C. p. solution of spermin acts as a brain food, exerts an inhibitory action over waste of the body. A judicious, honest physician, with these two remedies, will seldom fail to cure all forms of cerebral disease in children, from imbecility to paralysis, from malformation to deaf- mutism. The thyroid extract to be efficacious must be in the form of an ozonized extract from young lambs, not from sheep ; never dried nor in tablet form, as the two latter contain ca- daveric alkaloids. As a result of degeneracy, child-suicide is increasing, al- though this is chiefly caused by overpressure in education, which produces precocious development of the reflective facul- ties. Anticipate such states by thyroid. BRAIN WORKERS.— Neurasthenia, poverty of nerve force, cerebral softening, paralysis and other states are the se- quel of exhausted nerve force ; whether by mental work or sex- ual excess, it brings about the state of an organ tissue- starved. Following this, glandular deposits on the arachnoid, adhesion of the emmbranes to the surface of the convolutions, crystalline granulations in the lining membranes of the ven- Twentieth Century Practice. 127 tricles, with an unusual amount of fluid in the sac of the arach- noid and in the lateral ventricles are found in the brain of those who devitalize an organ. A tissue-starved brain gives rise to inflammation of the cortical part of the brain, ending in its de- generation of the nerve cells of the hemisphere, structural change in the convolutions, the cells of which lose their integ- rity and look like an irregular heap of particles ready to fall asunder. The brain of man owes its healthy existence to the quantity of phosphorus it contains ; if this is economized, independent of its scantiness in modern food, it might sustain him probably as long as life lasts and health holds out; but let the brain starve, health fails, nature can suppply no more; then, unless the patient can obtain phosphated food, or ozonized tincture of oats, or the animal phosphorus of kephalin, degenerative changes will take place in the gray substance of the cerebrum — the cells of that part will become granular and deposits of granules scat- tered through its substance — that these changes take place in all parts of the brain and spinal cord, when the phosphorus in the brain is exhausted. Brainworkers, merchants, professional men, know this ; they feel it in their languor, tired brain — those are the victims of excessive brain exhaustion. How far this granular change in the nerve cell is compatible with healthy mental action, we cannot yet say. But we do say, and nothing can invalidate it, that, unless our brainworkers obtain more phosphorus, white softening, paralysis and insanity will become more common. With a high graded fluid extract of coca to stimulate cohesion, and phosphated tincture of oats, and ozonized glycerite of kephalin to supply the brain food, we have elements of true brain nutrition, the means of creating a higher type of manhood. These remedies penetrate the brain, every fibre of it, invigorate it, nourish. This is scientific medication, positive curative for our na- tional ills — and they are the remedies which are superseding all others in nervous or vital power. The eminent members of the profession speak of the ozonized glycerite of kephlin thus : This is a true brain food, a nerve-vital essence; it entirely supersedes comp. hyphophorus as a reconstructor of shat- tered nerve force — invaluable in all forms of loss of brain power, as loss of memory, paralysis, white softening; very re- freshing to the nerves when tired by worry, when in neuralgia they cry for richer food, purer blood. Eminent authority says : 128 Twentieth Century Practice. "That it invigorates the body, refreshes the mind, repairs lost sexual power. For brainworkers it is food ; it increases intel- lectual capacity, gives a higher, holier appreciation of nature, a higher stratum, a transcendentalism in the beauty of earth, sky, sea— in the varied hues of gems and flowers, in the bright- ness of sunshine, in the iridescence of the rainbow, in the rip- pling stream, in the flash and war of storm and tempest. It replenishes the storehouse of the poet, philosopher, artist, orator, novelist, historian, divine — it soothes the tired brain, brings solace to the careworn heart, braces the unstrung nerves,, gives elasticity to the weary step." Such is kephalin. This nervo-vital essence is prepared thus: The phosphorus is a distillation from the natural brain of the ox, and from the best Canadian oats, wheat, and barley, and is altogether a dif- ferent agent from the phosphorus of commerce; besides, the life-giving ozone is added, which is a stimulant to the molecu- lar energy of the brain, nervous system, with a special action on the lymphatics and pink marrow; blood-forming, blood- raising glands, and especially and above all, the seat of sexual power in the brain. "Ozone is a powerful nerve-stimulant, retards waste of tissue; vivifies, increases strength and endurance; removes fatigue and languor due to prolonged physical or mental work. "We do not pretend to subdivide the elements of each cereal, as the oats give us a rugged stratum of brain growth; barley and wheat a finer mental vigor ; one thing we are certain of is, that they contain a vast amount of phosphorus in an assimilable form, which renders them of pre-eminent value and worthy of national importance. Wherever there is a deficiency of life in nerve-tissue, give ozonized kephalin — a nerve essence. The amount of brain matter it contains is immense ; if there is head- ache, prostration, mental strain, worry, insomnia, epilepsy, chorea, neuralgia, paralysis, hysteria, melancholia, neuras- thenia, mental strain, loss of sexual power, give kephalin — give it because it contains blood-making force, generates life-sus- taining properties ; because it is pre-eminently calculated to sup- port the system under the exhausting and wasting process of disease ; it rebuilds and recruits the tissues and forces, whether lost in the destructive march of disease, or induced by over- work, nerve tire, debility, excesses, exhaustion ; give it, because it is the most congenial, friendly, helpful remedy ever offered to the most delicate or fastidious stomach; it is ever construc- tive, a builder, suitable to reconstruct the most delicate." Twentieth Century Practice. 129 BRIGHT'S DISEASE OF THE KIDNEYS ; ITS RAPID INCREASE. — Persistent albuminuria, irrespective of its eti- ology, or present condition, constitutes Bright's disease. The great increase of diseases of the kidneys of late years is in a great measure due to those causes which augment the uric acid diathesis; besides the toxins of disease germs, the debris of inflammatory action; calculi, with other excretory products; irritating action of some diuretics, etc., weaken and relax the capillaries so as to permit an exosmosis of albumin from the blood to take place. The introduction of comp. ozonized celery extract, and its persistent administration in all kidney affections marks a new era in the rejuvenation of our race. Give ozonized celery compound in proper doses. It enters the blood, sweeps the uric acid from the system. It neutralizes all toxical products of microbic growth; flushes the kidneys, washes away all effused lymph that blocks up their intestinal structure. The ozonized comp. celery extract is a true kidney renovator, bracing and vitalizing, operates well and favorably in all weak- ened or relaxed conditions of these glands, unless a decided or- ganic change has taken place. Even in amyloid and fatty degeneration, which are so com- mon, the former in malarial poisoning, the latter in chronic al- coholism, the use of this remedy retards destructive metamor- phosis and prolongs life. It stays degeneration, whether it be associated with atrophy or hypertrophy. The remedy is worthy of a trial. Try it alone, or combine it with passiflora, gelsemium and digitalis. Give in simple elixir. Small doses, but freuently, are best. At all events every three hours, so as to keep the system under its influence. In all morbid conditions, in which a micro-organism is the agent of destructive change, pathological states in which toxins the excreta of germinal growth are literally crowded into the excretory ducts of the kidneys, blocking them up, preventing elimination; it is then that the ozonized celery compound ex- hibits its wonderful power as a kidney scavenger. Hence its efficacy when toxins of the micrococcus of scarlet fever are dammed up in the tubules, giving rise to desquamative nephritis. It acts promptly in arresting the hematuria of ma- laria ; in relieving the congested state of the kidneys in erysipe- las, dihptheria, typhoid fever, rheumatism, pneumonia, etc. A more general use of ozonized celery compound would do much to diminish the mortality of microbic maladies, prevent albuminuria and other complications. 130 Twentieth Century Practice. BRONCHOCELE. — This is characterized by an enlarge- ment of the thyroid gland. The entire gland may be affected, or its centre, or either lobe. The swelling is usually unasso- ciated with pain, and causes little inconvenience, beyond the deformity it produces, unless it presses upon the adjacent parts. Causes are very varied. It may be due to water impreg- nated with lime or magnesia; to tuberculi; to irritation, re- flected from the organs of generation to the nerves that supply the thyroid, causing enlargement and congestion; to uterine disease, or an anemic condition of the blood. It is a true hypertrophy and is divided into three forms, ac- cording as the vascular, glandular or connective tissues are in- volved. Various etiological theories have been advanced with refer- ence to enlargement of the thyroid gland, none of which are worthy of consideration. It is often complicated with a con- stitutional neurosis, in which epilepsy, chorea, diabetes play a part. The thyroid in goitre undergoes alteration in function, as well as size, and produces a toxic substance which acts deleteri- ously on all parts of the nervous system, slows the action of the heart, produces mental apathy, obesity. The old treatment of hypertrophy of the thyroid preponderated in favor of alteratives and tonics with preparations of iodine and bromine ; the modern and more successful management consists in the admin- istration of the ozonized thyroid extract, which acts on all parts of the nervous system, clears up the mental horizon; locally, the use of the ozonized clay breaks up the interstitial effused lymph. No irritation must be produced by its application; all at- tempts to localize the cause of the enlargement in the vagus and sympathetic have failed ; nevertheless, all cases are much bene- fited by the exhibition of large doses of passiflora, with matri- caria before meals. BRONCHITIS (ACUTE AND CHRONIC). THE CONFERVA. — In all conditions of partial death of the lining membrane of the bronchi, there is an evolution of the patho- genic microbe, conferva, which, together with its toxin, gives rise to depression of the vital powers, cough, expectoration, dif- ficulty of breathing and imperfect oxygenation of the blood. The presence of the microbe on and in the lining membrane of the bronchi gives rise to an incessant hacking cough,. Twentieth Century Practice. 131 dyspnea, rhoncus, and sibilus, which later on change to large and small crepitations, with very copious expectoration ; slate- colored sputum and nails, due to the imperfect aeration and toxins in the blood. The microbe is most abundant in chronic cases, found in the sputum. It bears cultivation well in liquid gelatin; cultures injected into any mammalia give rise to irritating cough of a cadaverous sound, ropy expectoration, prostration, and death. The microbe is imbedded in the bronchial follicles, in tufts or patches, rather difficult to reach by inhalation, but with a little tact and perseverance this is overcome. Acute bronchitis is generally due to exposure to cold, damp, irritants, and is confined to the lining membrane of the bronchi. In a well-marked case, there is usually catarrh, rigors, fever, lassitude, debility, sense of soreness in the chest, nervousness, uneasiness, constriction of the chest, cough dry at first, but as the inflammatory stage merges into effusion, moist, but expectoration thin at first, viscid mucus, then muco-puru- lent, distinctly audible rhonchus over large trunk ; sibilant over small tubes before effusion takes place ; subsequently large and small crepitation. Deficient aeration of blood in all cases. Administer veratrum viride and euphorbia pil, one teaspoon- ful of each in four ounces of water. Mix. One teaspoonful frequently until there be a subsidence of fever. At the same time, but in alternation, add one teaspoonful of passiflora, half a teaspoonful of green root tincture gelsemium to four ounces of water, and give in teaspoonful doses, as indicated, one grain of the sulphide of lime every two hours. Either a solution of muriate of ammonia or pine-tree tablets. Take the whites of a dozen eggs, and stir in mustard suf- ficient to make a plaster nine by five inches, and apply and re- tain over the anterior portion of the chest, otherwise same treat- ment as the chronic form. Chronic bronchitis may be a sequel of an acute attack, and then it is designated simple, but if the diagnosis reveals either the toxins or the active microbe of syhpilis, tubercle, gout, rheu- matism, cancer, mine dust, cotton, it must be so classified and treated, as one or other of those conditions exist. In the chronic form, much irritating cough, with expectora- tion of viscid muco-purulent matter, often greenish; great tightness of the chest, emaciation, debility. If not complicated by tuberculosis, lungs clear from apex to base. The treatment of chronic bronchitis requires skill and con- 132 Twentieth Century Practice. siderable tact as to the proper remedy to be employed, but an excellent selection might be made from the following list : two being used, one alternately with the other, as yerba santa and coca et celerina, operate well for a week; then pine-tree syrup and tablets alternated with chloride of ammonia ; then kephalin and prunia do well in alternation; avena sativa and sumbul, with a general alterative and tonic course ; saxifraga alternated with mineral acids and cinchona. In the adaptation of remedies to any one given case, as to cause, if there be tubercle, mistura guaiacol ; if syphilis, saxi- fraga; if mercury, iodide potass; if rheumatism, uric acid solvent and glycerite of sulphur. In old obstinate cases, great good results from the adminis- tration of either tannic acid or the following: acetic syrup of sanguinaria, acetic syrup of lobelia, of each four ounces, to which add four drams each of chlorate of potassa and pulver- ized alum. Mix. Dose, from one-half to one teaspoonful added to water every three hours. Comp. oxygen is often of utility. Inhalation is of great efficiency in bronchitis. Take one or two tablesspoonfuls of formalin to one pint of water, add thy- mol, menthol and chloride of ammonia, a few grains of each. The instant this spray is brought in contact with the living tis- sue, the formalin is liberated and every microbe on the bronchial mucous membrane is killed and a renewal of life in the tissue is established ; cough expectoration, diminish and disappear. The same formula, by inhalation, arrests the paroxysms of whoop- ing cough and asthma — it is invaluable. Inhalation of other inicrobicides, such as chlorate and permanganate of potassa, guaiacol, sulphate hydrastin, distillate of the pine needles, iodol, in a steam atomizer several times daily, cause the rattling rales to disappear speedily and respiration to become normal. Great difficulty of breathing is often relieved in the acute form by hot fermentations ; in the chronic form egg mustard or guaiacol plaster. Nutrition generous. Eminent authority says : Neurasthenia acts as a predispos- ing, and local irritation as an exciting cause of bronchitis, met with in two forms, acute and chronic. In the former there is fever, pain, heat, redness, swelling, an evolution of the microbe conferva, which can be found in the frothy mucus or muco- purulent sputum. In the chronic form there is an effusion of lymph, which Twentieth Century Practice. 133 produces thickening in the different coats of the bronchi, owing to which the tubes are usually constricted ; but in other cases there is dilatation with pouches. In both the acute and chronic form there is invariably cough, difficulty of breathing, an im- pending sense of suffocation. Once the bronchial structure is weakened, any microbe which may be accidentally in the blood will aggregate there, localize and impart to the bronchial lesion a type, a characteristic wholly its own. Bronchitis is essentially one of our maladies. Best treated by an alcoholic vapor bath, rest in bed, local stimulation over the bronchi so as to stimulate leukocytosis. Even proto- nuclein may be tried. The best medicament in acute bron- chitis is the euphorbia pilulifera, one teaspoonful added to four ounces of sweetened water, mixed. One teaspoonful of this repeated every ten minutes until temperature and pulse are normal, the difficulty of breathing relieved. But the cough, for which give one pine-tree tablet every hour. With this treatment we make short work of bronchitis. Gradually leave remedies off as symptoms subside. Euphorbia is immense in the acute form, and exceedingly valuable in the chronic. Although in this latter form, an alterative (saxifraga) and a tonic (matricaria) are indicated in all cases, allay cough with the pine-tree tablets. The varieties of the chronic form are numerous. The tuber- cular must be treated with the glycerite of ozone, mistura guaicacol and creosote, and the pine-tree tablets for cough. The syphilitic with that invaluable alterative, saxifraga. The cancerous by the Chian turpentine mistura, with the pine-tree tablets for the cough. The difficulty of breathing, the sense of suffocation, that goneness incidental to bronchitis are promptly relieved by these tablets. Even reflex and winter cough are amenable to their use. Quite an extensive experience in the treatment of bronchitis in children has taught me that persistent stimulation over the chest is of vital importance, especially if there be much dyspnea. The very best form is to bathe the child well, dry off, then rub the entire chest over with sweet olive oil, then rub into the skin of the child's chest in front, under the arms and between the shoulder blades concentrated ozone. This must be done gently and by the fingers. It is important that it be 134 Twentieth Century Practice. well rubbed into. the skin. Simultaneous with this, the cough becomes easier, expectoration more free, dyspnea less — a most remarkable change is brought about. It can be repeated if necessary. BRONCHO-PNEUMONIA.— Inflammation of the smaller bronchi and patches of the lung often comes on as a sequel to croup, measles, or acute bronchitis. The febrile disturbance is greater, and there is more lividity, otherwise the symptoms are those of acute bronchitis. It is most commonly met with among children, and is often fatal. BRUISE, OR ECCHYMOSIS.— A painful and livid swelling at or near the surface of the body, which is caused by external violence, as a fall or blow inflicted by some blunt ob- ject. It is met with in most cases of contusion, and also with fractures and dislocations, and is caused by the rupture of blood-vessels and the pouring out into the subcutaneous soft tissues of blood or blood-stained fluid. Bruises vary very much in extent, color, size, and situation. In the slightest form there is a small and superficial patch of a light- or dark-red color, and attended with very little swelling. In the most severe cases a soft swelling is formed as large as a child's head, or the whole of a limb is swollen and of a black or dark-blue color. The rapidity with which a bruise is formed varies according to the situation of the injured part. Where the skin is in close proximity to subjacent bone, and is bound down by unyielding tissue, the blood is effused slowly, but in a blow upon the eye- lids or upon the breast a large livid swelling is rapidly formed. In fractures of the bones of the leg and forearm there is often extensive bruising, which is associated with the formation of large blebs on the surface of the skin, which are distended by black or purple fluid. In contusions of the scalp in children a large circumscribed collection of blood is often formed under the skin ; this is usually soft at the centre and very hard at its margin, and feels very much like a depression in the skull. Sometimes in cases of contusion the bruise does not show itself at the part actually injured, but at some distance from this. A large bruise when fully developed is of a purple color, mot- tled with yellow and greenish-yellow patches. As the blood becomes absorbed and the bruise fades, the purple gives way to changing shades of brownish-red, green, and light yellow. These changes commence at the margins of the bruise. The Twentieth Century Practice. 135 rapidity with which the disappearance takes place varies. The effused blood, even in very extensive bruises, is usually wholly removed 1 by absorption, but occasionally a collection of fluid blood caused by an injury to an unhealthy individual, instead of becoming absorbed, sets up inflammation in the surrounding tissues, and forms an abscess, which bursts and discharges un- healthy, ill-smelling matter or pus mixed with soft clots of blood. In the treatment of recent bruise, the first object is to check further effusion of blood. This may be best done by applying cold, and by elevating, if possible, the injured part above the level of the body, in order to retard the circulation. If the bruised parts be very tense and painful, some leeches may be applied near the margins of the dark-blue patch. After the acute stage of pain and heat has passed off, the treatment should be directed so as to favor absorption of the fluids and to remove the swelling; for this purpose the most useful agents are the tincture of arnica montana, a lotion composed of two ounces of spirits of wine to twelve ounces of water, or a solu- tion of sulphurous acid. The large transparent blebs which form over very extensively bruised surfaces should be pricked with a sharp needle, and then covered over with cotton-wool, which will absorb the dark-colored fluid which is thus allowed to trickle away. BURNS AND SCALDS.— A partial or complete death of a portion of the body to which excessive heat is applied ; burns being caused by dry heat, or strong acids, or alkalies ; whereas scalds are the result of moist or fluid heat — the instant either is applied, living is degraded, microbic growth supervenes. There are several classifications, the simplest being erythema, vesication, ulceration. Many dangers attend every grade of burns. The shock, the local irritation may be transmitted to the medulla oblongata, and there may be intensified reflex action, spasms, convulsions ; danger from the arrest of the sensible and insensible perspira- tion, which may give rise to congestion of the serous mem- branes of the brain, of the chest, abdomen; danger from the process of suppuration, toxins, disastrously implicating the blood and brain. Whatever be its nature, superficial or deep, overcome col- lapse by the administration ■ of diffusible stimulants and promptly relieve pain. All local remedies must be stimulating and strongly en- dowed with microbic properties. 136 Twentieth Century Practice. The jelly of violets, painted over any burn or scald, in any one of its three degrees, promptly establishes complete resolu- tion, perfect freedom from pain. This is the best of all local applications, but may not be at hand when required. Bicarbonate of soda, always at hand, either in powder or made into a paste and applied to the abraded surface, covered by compresses to exclude the atmosphere, often answers a valu- able purpose. An excellent application, if procurable and burn extensive, is water, one pint; tincture of cantharides, one teaspoonful; formalin, one ounce. Mix. Applied by simply saturating cloths, compresses, or bandages, to exclude the atmosphere. This can be worn without changing for several days, kept saturated, and subsequently an ointment of either ozone or marigold or thyme, applied and continued, changing twice daily till healed. We do not endorse the use of clay, white-lead paint, lard, and flour, cotton-batting, albumen, and the like. Burns received from alcohol, caustic potassa, and other alkalies are best treated at first with free saturation with vine- gar, later on with olive oil and carbolic acid. Strength, ten of the former to one of the latter. Burns received from acids should be freely deluged with water. BURS^E. — Small membranous sacs, situated about joints, lying under tendons, their function being to oil and lubricate the parts over which the tendons play. Pressure, bruises, sprains, irritation of all kinds, cause them to secrete im- mensely. They become oval, or round, and very large. A re- moval of the cause, the source of irritation, and the applica- tion of the concentrated ozone speedily cause their disappear- ance. When, however, tubercle is a denizen of the blood, mat- ters are very different. CACHEXIA, or DIATHESIS.— A characteristic appear- ance which the body assumes after exposure to the ravages of certain diseases for a long period. The patient is very pale and anemic-looking, complexion generally sallow, and there is usually emaciation more or less marked. It is very common in those who have been exposed to the malarial poison for a long time, even though they have never had an attack of ma- larial fever. In cancerous, tuberculous, and other chronic wasting diseases cachexia is usual. Twentieth Century Practice. 137 , CACTUS GRANDIFLORUS.—A saturated tincture, pre- pared from the root, leaves, flowers, of the night blooming" cereus. Dose, from a few drops to 20 or 30, added to water ; administered every three hours; of utility as a tonic in heart failure. In sexual exhaustion it gives speedy relief, for it strengthens the cardiac plexus of the sympathetic, and improves cardiac nutrition. The glucoside, in one-fiftieth to one-hundredth of a grain in pill form is the most reliable form in which to administer this remedy. The active priciple of this remedy (the glucoside) exerts a powerful tonic action upon the heart, less so upon the blood- vessels. The precise therapeutic action is a tonic in all cases of heart failure. In weak heart, in all embarrassments of the circulation dependent upon a central cause, this remedy acts directly upon the weak organ. Our clinical experience with this drug is, that after it has been administered some time, the patient experiences a sense of well-being ; the oppression which has so long haunted him diminishes, respiration becomes better, pulse regular, fuller and stronger. There is, so to speak, a greater filling of the arterial system. The cardiac area becomes normal, edema, if it exists, lessens ; the volume of the liver di- minishes; symptoms of pulmonary statis disappear. The car- diac impulse is increased, the sounds become audible and the rythim more regular. Besides, it always increases the urinary secretion, nearly doubles it, and albumin, if present, disappears completely. It is a true cardiac tonic, indicated in all cases of 2 weak or irregular action of the heart. It is best adminis- tered in pill form in dose of i-iooth of a grain thrice daily. CADMIUM (Sulphate). — Dose: From l / 2 to 5 grains to an ounce of water locally, every three hours. Whenever lymph has been effused, and we are desirous of absorbing it, as in opacities of the cornea, chronic ulcers, indurated glands, stiff joints; not so efficacious as the clay. The iodide of cadmium possesses the same properties. OVARIAN SECTION.— A dangerous obstetrical opera- tion by which the child is taken from the womb by means of an incision through the abdominal wall. It is only justifiable in those rare cases in which, from deformity, death of the mother, or great size of the child, there are no other means of saving the child or the mother. 138 Twentieth Century Practice: CALLOSITY. — Hardness, induration; "thickening, often as- suming a horny consistence, the ordinary results of pressure, v old ulcers, from repeated failures in the process of cicatrization^ take on callosity, especially around their edges. Alkalies, especially a lye poultice, wipes out degenerated tissue. ':; -ii .::. CALCULUS. — A concretion of inorganic matter forming in one or other of the organs or tissues of the body, and from its hardness and other characters resembling stone. Calculi are named from the parts of the body in which they occur- — salivary j in the salivary glands; biliary, in the gall-bladder or bile-ducts (commonly called "gall-stones") ; intestinal, in the intestines; renal, in the kidneys, and cystic, or urinary, in the bladder. It will be noticed that the calculi form in each of these cases in connection with one or other of the secretions, the * urine, bile, etc. ; and in their formation is due to an excess of j inorganic solid material in those secretions. Calculi biliary are generally found in the gall-bladder, more rarely in the liver and branches of the hepatic duct. The principal ingredients of gall-stories are cholesterin, ; chlorate of soda, carbonate of lime, and magnesia, together >. with bile salts, and granules, precipitated, which combine to H form concretions or calculi. Their number in individual ^cases - vary much (single ones being rare), from a few up to several ' hundred; in size from a pin's head up to a goose-egg; in form, globular, ovoid, pear-shaped; when numerous and pressing against each other, become variable in form, usually have num- erous polished facets. They may be solid, or hollow, ithe former being the most common ; in color, a light or dark brown, sometimes greenish. Gritty sand-like deposits in the excretory ducts of the liver, consisting of minute calculi or powdered » form of cholesterin, colochrome, biliary acids, constituting biliary gravel. The chemical constituents of biliary calculi are 80 per cent of crystalline cholestrin, the coloring matter of bile, bilerresin, lime-salts, mucus, epithelia, biliary acids, margarin and traces of iron. All gall-stones in their initial state have a nucleus, and later on an external crust or shell — the intermediate portion is often Wanting. The nucleus or centre of attraction may be crystals of cholesterin, cholate of lime, mucus, di stoma, blood- clot or worm, foreign body. Most nuclei are -formed in the = Twentieth Century Practice. 139' hyepatic duct; the general make-up of the calculi consists largely of decomposed bile, with the external crust of pure cholesterin, which varies in tickness from fine tissue-paper up to quite a considerable degree. The gall-bladder in which those calculi form may be normal in size, or it may be distended, or enlarged or sacculated — usually its walls are thickened, affording evidence of catarrhal inflammation, or fibroid contraction, or calcareous degenera- tion. Anything that interferes with or retards the functional ac- tivity of the liver, as solar heat, malaria, alcohol, tobacco, fatty, starchy saccharine food; anything which will prevent a due decarbonization of the blood by lungs and skin, as a monot- onous life, solitariness, confinement, sedentary habits, tight- lacing, pre-potent influences, which render the liver sluggish, bile thick and black — long retention in the gall-duct, and its crystallization into calculi. Gall-stones may be presumed to exist when there are dull pains about the liver, shooting to the shoulder ; when symptoms of ill-defined malaria are present; gastric disturbance, nausea, attacks of vomiting, yellow skin, copper taste in the mouth, fetor of the breath, brown-coated tongue, yellow tingue of the conjunctiva; pain in the back of the head, right shoulder, and' hips; loss of appetite, indigestion, constipation, and,'reflexly, vertigo, specks and spots before the eyes, stupor, prostration. They are almost certain to exist, when there are sudden seizures of excessively severe pain in the right side, beneath the border of the ribs, accompanied with nausea, vomiting, jaun- dice,, showing that some obstruction exists to the flow of bile; absolute proof is wanting, unless the stones are found in the stools ; still the diagnosis of the passage of a moderately sized stone from the gall-bladder into the duodenum may be pretty accurately made out by the following well-marked symptoms : Nausea, indigestion, a sudden seizure of pain in the gall-duct, profound prostration, a doubled-up position; pain moves and instantaneous relief the instant it drops into the duodenum. CALCULI, URINARY.— These concretions are found in the kidneys, bladder, and follicles of the prostate gland ; when found in the ureters or urethra; they have floated there from the other parts. Calculous disease is much more common in males than in females, probably owing to the anatomical char- acter of urethra ; in women, being short, from one and a quarter 140 Twentieth Century Practice. to two and a half inches long, and very dilatable; whereas, in men, it is long, and not dilatable to any great extent. The cause is the uric acid, phosphatic or oxalic acid diathesis; so that these concretions are usually found to consist of uric acid, urate of ammonia, fusible calculus (phosphate of lime, mag- nesia, and ammonia) ; mulberry calculus (oxalate of lime), carbonate of lime, and, very rare forms, cystic and xanthic oxides. Calculi may consist of only one substance, or be made up of layers of different salts ; they may vary in size from grains of sand-like bodies to gritty gravel, up to the size of an orange; once a nucleus being formed, they increase in size by aggre- gation. Small aggregations, or stones in the kidney, if not much larger than a kidney-bean, may pass from the pelvis of the kidney into the ureters, and thence into the bladder. The suf- fering which takes place in the transit of the stone is very great, and popularly known as an attack of gravel. As soon as calculus reaches the bladder, instant relief. Urinary Calculi — gravel, renal calculi, and ston e in the bladder. — These are all concretions varying in size and number forming in some part of the urinary apparatus. In the kidney they may cause inflammation, abscess, and even death. If they pass from the kidney into the ureter they give rise to symptoms similar to those of gall-stones, with the addition of the char- acteristic symptoms of frequent micturition. The immediate treatment is large doses of green root tincture gelsemium. In the bladder they may become very large, often weighing fifteen or sixteen ounces. Large stones in this situation can only be got rid of by operative procedures. These operations are of two kinds — Lithotrity, or crushing of the stone within the bladder by means of special instruments; and Lithotomy, sl cutting operation by which the stone is removed through an in- cision into the bladder. The operation performed depends greatly on the surgeon who operates, but the crushing operation is coming more and more into favor. Urinary calculi vary in their composition and appearance. In order of frequency, uric acid, oxalate of lime (the "mulberry calculus"), triple or ammonio-magnesium phosphate, phosphate of lime, and mixed calculus, are the chief ones met with. The dissolving of calculi in kidneys by means of remedies administered orally is rather a lame affair, although occasionally successful; the ozonized uric acid solvent, infusion of hydrangea and saxifraga are Twentieth Century Practice. 141 the remedies that have met with success. One thing is certain, if they do not effect disintegration of the calculi they certainly diminish their size. CANNABIS INDICA. — Indian hemp in all its forms is a valuable sedative, but administered in excess acts as a powerful narcotic. It therefore resembles in its action alcohol, opium, and other narcotics which are attended by excitement, intoxica- tion, and, finally, narcosis. It is a powerful aphrodisiac. It is useful in neuralgia, migraine, renal and hepatic colic, and in dysmenorrhea as a means of relieving pain and spasm. As an hypnotic it is used in acute mania and delirium tremens. Con- tinuous headache often yields to it. It has also been given in hydrophobia and tetanus. Dose — of the extract, one-quarter to one grain. Of the tincture, five to twenty minims. CANCRUM ORIS. — The evolution of the oidium albicans, on the mucous membrane of the mouth, fostered, aggravated and intensified by overcrowding, insanitary conditions, sewer- gas poisoning; the patient an ill-nourished, debilitated child, often the victim of some other malady. If not seen to promptly it assumes either a phagedenic or gangrenous form, and causes great destruction of tissue, with an intense odor. Usually great constitutional disturbance, and death is apt to follow from exhaustion. Treatment. — Most nutritious food, skin and bowels stim- ulated. Either peroxide of hydrogen, or solution of chlorate of carbon are excellent. Echinacea, concentrated tincture, ozonized, one of the best remedies for use as an internal anti- septic. CANTHARIDES. — Used locally in any of its varied forms as a local stimulant, is one of the best of all external agents to excite leukocytosis, and it is this property alone that has rendered it invaluable in paralysis and baldness. Not used now as a vesicant or irritant — that idea has exploded itself — modern scientific thought calls simply for erythema, to produce leukocytosis. CAPSICUM ANNUUM.— A powerful, diffusible stimu- lant, beneficially used in rheumatism, paralysis, sciatica, One dram of the oil to four ounces of alcohol; makes a good lini- ment. 142 ; . Twentieth Century Practice. The compound tincture frequently repeated in doses of one teaspoqnful in hot tea. A gargie of salt, capsicum and vinegar is of great value in sore throat. Cotton medicated with a base of capsicum is an excellent local stimulant; it can be applied and prolonged indefinitely without any deleterious results. It contains no injurious or poisonous substance. CARRIERS OF CONTAGION.— All domestic animals, and household pets, so called, possess an affinity to become in- fected with microbes peculiar to the human race. Placed under unnatural conditions of life, as are entailed upon them by indoor life, they become diseased and short-lived ; besides they, one and all, become the carriers of disease germs, such as tuberculosis, pneumonia, diphtheria, variola, etc. They are a fruitful, but too often an unsuspected source of contagion and infection. The many millions of canaries over our entire country dis- seminate tuberculosis ; parrots spread the pneumococcus ; doves, rabbits, cats, mice, distribute the streptococcus of diphtheria in all directions ; rats carry the plague. The same danger exists in fowl-roosts near a dwelling. In truth, a home is safer, freer from disease germs, and insanitary conditions, without any of those pets. Insects, such as the ordinary house-fly, are a frequent carrier of the bacilli of typhoid fever; the mosquito, the malarial germ, and other small fry carry about with them and distribute among the human family many more ills and evils than we would be willing to recognize, leaving the question of harboring them entirely out of discussion. CARBOLIC ACID. — Phenol is obtained from coal tar and is a valuable antiseptic and deodorant. One great disadvan- tage to its use, it is highly poisonous, rapidly causing paralysis of the heart. It is, however, destructive to all microscopic life, arrests fermentation, and precipitates albumin. In high dilutions, taken internally it checks diarrhea and vomiting. As an external remedy it is largely used, as a dress- ing to wounds. Inhaled from an atomizer, it has been found useful in hay asthma, chronic bronchitis, gangrene of the lung and influenza. An ointment has been used in parasitic skin affections, but there is always danger in its use. Twentieth ^Century Practice. ... 143 . CARBOLATES.— The sulphocarbolates of ammonia, cal- cium, sodium, zinc, . singly or in combination, are remarkable: microbicides and disinfectants. Administered to children, from one to two grains; to adults, three to four grains every three or four hours, either added to water, dry on the tongue, or in- serted into the rectum, are perfectly innocuous, but at the same time so powerful germicides that they will destroy all disease germs with which they come in contact,; such as the oidium al- bicans, the streptococcus of diphtheria, the microbe of smallpox, the bacillus of typhoid fever, the micrococcus of erysipelas, the microbes of boils. All combined, or singly, when introduced into the blood, ren- ders that fluid aseptic, a habitat into which no germ will enter while the patient is taking it. The sulphocarbolate of zinc is made into an ozonized urethral bougie and, in troduced into the urethra, checks all seminal and gleety discharges. CARBON CHLORATE.— Dose : Five grains, added to some alterative syrup, or water, every three hours. Specially indicated in cancer, syphilis, tuberculi, all fevers, and when- ever there are disease germs in the human blood. This remedy has acquired a world-wide reputation in the cure of cancer. Its high repute is well merited. It is introduced into the ozonized saxifraga and Phytolacca, to render those invaluable alteratives most extremely efficacious as a germicide in the radical cure of all morbid states of the blood. Locally, it can be introduced into all cancer plasters, being compatible with extracts of sheep sorrel and red clover tips, with bichloride of mercury, arsenic, chloride of zinc plasters, and the chloride of chromium, ozonized. CARBUNCLE. — A microbic malady due to malnutrition, the toxins of the microbe giving rise to embolism and sudden death. .-, Invariably associated with a broken down, vitiated state of the blood. There are many remedies of great value in carbuncle, or boil, but it is doubtful whether modern therapeutics have sup- plied one so efficient as the ozonized tincture of lycopodium. It not only wipes out the germ in the blood, in the sebaceous sac in which it has aggregated, but it corrects certain patholog- ical conditions which aid bacterial evolution and promote riepatic activity. 144 Twentieth Century Practice. It is a morbid condition which requires powerful and ener- getic treatment. If surgical, a crucial incision at once; if a topical treatment to follow the incision, no remedy can excel the jelly of violets over night and ichthyol during the day — the former an effective local anesthetic, or sedative, relieving all pain and irritability, a remedy that succeeds admirably in any case. The latter I have found it good practice, if there be much induration around the base, to apply either pure or in the form of a jelly; ichthyol jelly all over the hardened base, up and over the crater-like summit. Apply twice daily, with the violet jelly over night. This treatment destroys all microbes, removes necrosed tissue, and promotes rapid cicatrization. Ozonized tincture lycopodium in fifteen-drop doses, added to a glass of water and taken every three hours, is an excellent germicide in all cutaneous affections, its use at the present being much neglected. CARCINOMA. — Cancer may be defined as a morbid condi- tion of the nervous system in which the bacillus of cancer is evolved in the blood, and assumes the diagnostic heart-shaped,, spindle-shaped rods. They originate from degraded bioplasm, or irritated proto- plasm. Such irritation may be either direct or indirect, through the medium of the central nervous system. If there be no local weakness, or irritation, this microbe may exist in the blood indefinitely, poisoning the streams of life,, but when any part is damaged, or weakened, blood-vessels relaxed, the microbe passes by exosmosis through its walls, into the adjacent parts, in which it grows with varying degrees of rapidity, depending a good deal upon the amount of local depression, and on the presence of certain adventitious sub- stances. When this bacillus is exuded, or deposited, or effused into any part, pain, of a sharp lancinating character, occurring in paroxysms is present — the intensity of the pain, its frequency of occurrence and duration depend upon the amount and activity of the microbe. The lymphatics, in close proximity to the germ mass, tumor or infiltration, affords an excellent criterion, index or barometer of the malignancy of the bacillus. Germ aggregation, or tumor receives different names according to its composition — presence of certain constituents : scirrhus, when the germ is tangled up in fibrous tissue; Twentieth Century Practice. 145 medullary, soft like brain, consisting almost exclusively of can- cer cells; sarcoma, fleshy; when thrown out with a large network of blood-vessels, fungous hematodes; epithelioma, where skin and mucous membrane meet; black pigment, melanotic. The bacillus of cancer in the blood is best recognized with a high microscopic power of 2500 diameters, heart and spindle- shaped forms, ovoid bodies, arranged in pairs or heaps, their length being a fourth less than a blood-corpuscle. The microbe is pathogenic of all forms of carcinoma, bears culture well on coagulated blood kept at the temperature of the body. Cultures injected into animals give rise to a typical form of cancer. It is therefore highly contagious and infectious, very prevalent among our domestic animals, in precisely the same forms as the human being. The microbe is difficult to sterilize and annihilate. Its local destruction should be effected either with chloride of chromium paste ; or ozone paste ; resorcin ointment ; lactic acid c. p. liquid chloride of chromium. The bacillus in the blood should be sterilized with either saxifraga, phytolacca, Chian turpentine mistura, glycerite of sulphur, dioxide of hydrogen, red clover. The diagnosis rests chiefly upon the paroxysmal attacks of pain of a sharp lancinating character — slight in degree and at long intervals apart, if few micro-organisms be present; but if there be a very large aggregation of germs present in the infiltration or swelling, the pain is intense and of frequent occurrence — if the cancer be open, a sense of soreness or raw- ness also exists ; if the colony of cancer germs be in the chest or abdomen, pain anterior and posterior over the part. When this pathogenic microbe is present in the blood, it gives rise to anemia, pearly conjunctiva; sallow, dry, husky skin; an indefinable sense of debility or goneness ; very irritable heart ; clay-colored stools. Cancer microbes in the breath and dis- charge emit a peculiar odor resembling the hydrosulphate of ammonia. Prognosis. — In forming a prognosis of any given case of cancer, we must bear in mind that, up to the present date, the tendency of all cases is to death — that the medullary form, being acute, is especially malignant and rapid in its course — that all cancerous growths are more rapidly fatal when such vital and vascular organs as the stomach, tongue, uterus, 146 Twentieth Century Practice. rectum, are the seat of deposit. The size or degree of enlarge- ment of the lymphatics in closest proximity to the infiltration is the best criterion to go by; if they are no larger than a pea,, the future progress of the case under ordinary bactericide remedies is likely to be favorable, whereas, if they are as large as a pigeon's egg, decidedly unfavorable. As cancer is a microbial affection it is necessarily both con- tagious and infectious. The indications of treatment of all cases of cancer are to either destroy the bacillus in the blood ; to correct the defect by which the neoplasm is evolved in the blood ; to build up vital force, and if there be an infiltration or tumor, get rid of it either by the local or internal exhibitions of bactericides. In the observing of these indications the general health must: be improved by every means : change of locality ; daily baths, plain and medicated, with either iodine or nitromuriatic acid ; bowels should be kept regular ; appetite stimulated and a diet rich in all the elements of blood should be the standard — even the use of either malt liquors or wines, at meals, is to be commended; if indigestion prevail, ozonized pepsin and other digestive ferments administered. There are a few bactericides which, when administered in- ternally, have a marked destructive action upon the microbes in the blood; two of those should be selected and given in alter- nately appropriate doses, say for one week, and two selected for the following week. Those which act most energetically to be preferred; our best remedies are comp. saxifraga and Phytolacca, ozonized Chian turpentine mistura; condurango, glycerite of sulphur, dioxide of hydrogen, resorcin. With regard to local treatment, if the aggregation of germs be small, skin sound, not discolored, an effort might be made by the endosmosis of remedies to either sterilize, kill, and absorb the mass. For this purpose some one of the following might be selected, and applied either continuously or in alterna- tion, viz. : Belladonna ointment and salicylate soda; boroglycer- ide and papoid; ozone ointment and resorcin; succus Phyto- lacca, red clover, sheep sorrel ; a plaster of clover root and hydrastin, with chromium, ozonized iodine; siegesbeckie ; even spraying with peroxide of hydrogen. All cancerous infiltrations or tumors, if not removed by some of the above or other methods, must be removed by a bactericide sufficiently powerful to destroy the germ colony, either by uniting with it, or oxidizing it, and causing a line of Twentieth Century Practice. 147 demarcation to form between the healthy tissue and the can- cerous mass; such a process is effected by the chloride of chromium paste ; or ozone paste, lactic acid. The use of arsenic, chloride of zinc, platinum, bichloride of mercury and other escharotics is now discarded by all scien- tific specialists. Cancer of the Arm. — When an effusion of the bacilli of cancer takes place on the arm, shoulder, leg, etc., its location permits of the most energetic course of treatment. Either the chloride of chromium or the ozone paste should be applied fresh every morning until it drops out entire. During this process the adjacent parts should be carefully protected, and the sensibilities of the patient blunted by the administration of the comp. conium pill. If it does not drop out freely, the roots or prolongations should be touched with a camel-hair brush, dipped in a little of the same paste made liquid by adding a few drops of water. If the cavity is large, strips of salicylate plaster should be applied over it, so as to aid rapid cicatrization. Ozone ointment makes a useful dressing for all cases. Cancer of the Breast. — Most common among ladies nearby, and during and after the change of life; more rarely met with among men, and when it takes place in the latter sex, generally a scirrhous infiltration around the nipple due to the irritation of the buckle of the suspender. The left breast of the female being the weaker, covered freely with the sympathetic, the bacilli make an entrance into it and breed with a rapidity corresponding to the vital in- tegrity of the part. All forms of cancer are met with here, epithelioma of the nipple, scirrhous and medullary. Easily diagnosed by the pain, enlargement of the lymphatics in the axillae, numbness of the arm of the affected side, retrac- tion and oozing from the nipple, cachexia. Constitutional treatment with bactericides, — if small, reme- dies by endosmosis to kill and absorb the germ; if tumor is large, it must be removed with chloride of chromium or ozone paste, blunting the patient's sensibilities with comp. conium pill. Cancer of the Eye. — Usual treatment constitution- ally ; small tumors may be got rid of by going round it with a pen dipped in the supersulphate of zinc, touching the parts daily but lightly, producing no irritation. In the interim apply- ing lotion of boroglyceride, when it drops out. 148 Twentieth Century Practice. Patches on the forehead and face may be removed in the same manner. Cancer of the Lips and Face. — Careful removal with either the chloride of chromium, or ozone paste; or with the supersulphate of zinc, going round it every morning. After it is completely removed, one or two or more hair-lip pins to keep the parts in apposition and promote cicatrization. Usual internal treatment. Cancer of the Esophagus.- — Digest the cancerous infil- tration of the circular rings by the introduction of a paste of boroglyceride and papoid in a strength suitable for the purpose. Cancer of Penis. — As cancer is both contagious and infectious, it follows that men having sexual congress with ladies, who either have the cachexia or, worse still, who have a cancerous* infiltration of the neck of the uterus, the germs dur- ing coition are apt to migrate from the microbe-smitten uterus to the corona glandis, which is one of the most sensitive, highly organized and actively absorbent tissues in the whole body. Nearly all cases of cancer of the penis can be traced to direct inoculation. The victims are usually the old devotees of mas- turbation, or dalliance in the sexual act. It is generally ushered in with a hard, brawny state of the corona, which assumes the form of large scales ; later scirrhous and medullary infiltration, involving the entire organ. Most amenable to treatment with bactericides, boroglycer- ide paste, resorcin ointment, brushing with lactic acid. All means failing, its removal with the chloride of chromium or ozone paste. The usual internal remedies. Cancer of the Rectum. — In the early stages the mi- crobe puts in an appearance in the form of an epithelioma, at the verge of the anus ; later on in the form of vertical streaks of scirrhus, and later still the entire rectum becomes filled with a medullary or adenoid substance. The pain anterior and posterior, diarrhea, hemorrhages, cachexia and other land- marks, which are readily seen and felt. The most excellent results have followed the introduction daily of rectal bougies, composed of papoid and boroglyceride; creolin and lactic acid have also been successful ; aristol and the glucoside of stone crop. The powdered jequirity by insufflation is often of utility in causing an exfoliation of the mass of diseased germs — iodol and other remedies used in the same manner. The rectum, before any powder is applied, should be well Twentieth Century Practice. 149 washed out; the dry or powdered treatment is most successful in a large number of cases. Cancer of Stomach. — This is recognized by cachexia; the pain anterior and posterior; aausea, vomiting; in vomit cancer germs. No case of cancer of the stomach should be given up until the local application of the ozonized clay and conium pill has been thoroughly tested and a fair trial of papoid of trypsin. The very remarkable solvent powers of these two remedies upon diphtheric effusions, upon all recently organized tumors or excrescences, merit the attention of the profession and mark a new era in therapeutics. With the ozonized clay externally, giving out its germicidal properties by endosmosis, and either of those remedies inter- nally, cancer of the stomach becomes amenable to treatment. A liquid, highly animalized diet should be given. Cancer of the Tongue. — Most generally appears among men who are inveterate smokers. All forms are met with — epithelioma, scirrhous, medullary. Each form requires the application of special remedies adapted to the special microbial condition present. When the tongue is patchy, exfoliates large or small scales, brushing it over with either dilute lactic acid or an ozonized distillation of jequirity, or steeping it in a saturated solution of chlorate of carbon for twenty minutes thrice daily, or a solu- tion of hydrastinin; peroxide of hydrogen has also proved itself of utility. When the case has proceeded onwards to ulceration, either of its centre or edges, the c. p. lactic acid formalin may be tried ; that failing, and the cancerous mass accessible, the ozone paste might be applied with great care. In the more aggravated types a portion or the entire tongue may be removed. When this is deemed advisable, to be at- tended with success, it must be done early. Cancer of the Uterus. — Common at all periods of uter- ine activity, but especially so at the cessation of the menses. It is met with in a variety of forms, as adenoma, springing from some part of the internal walls, often filling the entire cavity of the uterus and passing off in glandular pieces, often accompanied with violent hemorrhage and anemic conditions — epithelioma, scirrhous infiltration, or medullary exudation at os and neck, penetrating upwards to the body of the uterus. It is easily recognized by the pain anterior and posterior; 150 Twentieth Century Practice. mucopurulent discharge loaded with cancer cells; the peculiar odor of the discharge; often sanguineous — at other times ex- hausting hemorrhages. Ocular and digital examination of the os, neck and body, as far as practicable, reveals the true state of the parte. Nearly all cases admit of great palliation, if not of cure. The Chian turpentine mixture and the glycerite of sulphur are most admirable and effective remedies in all forms of uterine cancer. Cases in which the cancer bacilli imbedded in a glandular mass sprout from and occupy the cavity of the uterus are much, very much, ameliorated by the introduction of gelatined bougies, prepared from either resorcin, or iodol, or creolin, introduced into the cavity of the uterus and permitted to remain — same remedies could be introduced into the cavity of the uterus with a siphon syringe — introduced and withdrawn. If the microbe has invaded the os and neck, pastils of boro- glyceride and cocain might be tried ; where it is deemed advis- able to cause exfoliation, the jequirity paste, or, better still, the powder by insufflation, is better if there be an erosion of the os and cervix. The dry treatment of cancerous infiltration is good. The vagina should in all cases be washed out to remove the secretion thoroughly, previous to the application of the powder, and the dry powder laid right on the affected part ; repeated applica- tions about every five days will gradually cause exfoliation of the germ mass. If the germs have infiltrated the os, neck and body of the uterus, the application of the jequirity may not be sufficient to cause it to exfoliate, then about every five or seven days c. p. lactic acid may be brushed over it, and every night the vagina packed with boroglycerite paste, or if the germs are still deeper seated, some more penetrating application should be utilized, as the chloride of chromium or ozone paste liquefied to the consistence of cream and applied. Great care must be exercised not to touch the sound parts ; peroxide of hydrogen as a local application is often invaluable. Papoid, if the case admits of its use. Hemorrhage in all cases most effectually controlled by the administration of ergot. With a liberal use of the Chian turpentine mixture and glycerite of sulphur, vaginal injections of resorcin, no physician need fear to do wonders in the wav of cure. Twentieth Century Practice. 151 Cancer of the Bladder. — The great majority of all morbid growths of the bladder are simple in their initial stage, but gradually become malignant under conditions of irri- tation ; carcinoma of the bladder is usually deposited in the base of the organ, and has a tendency to remain quiescent or latent for many years. This is said to be due to the absence of lymphatic in its walls. Pain and hematuria are its leading symptoms — although augmentation of the normal quantity of urine is considerable — profound anemia increasing with the progress of the malady. Shreds or detached pieces of the neoplasm are found in the urine. In such cases the walls of the bladder are dotted over with papillomata. The pain is excru- ciating, precedes the hematuria, sharp, lancinating, radiating to the thighs, from the symphysis pubes; local tenderness, patches of induration. Papillomata are the most frequent of all bladder growths — proliferations of the natural structure of the vesicle mucosa, forming papillae or protrusions covered over with cylindrical epithelium — commence from a base, form a stalk. CARIES ET NECROSIS. — Caries, a molecular disintegra- tion of the spongy or soft bones ; necrosis, an analogous condi- tion attacking the hard bones — conditions corresponding to ulceration and mortification. There might exist a predisposing cause in tubercle, syphilis, cancer; the exciting cause is mechanical violence, an injury of some kind. Inflammation, with dull, aching pain, follows; an abscess forms, which may burrow into the neighboring parts, and, if not arrested, finally bursts, discharging a thin, watery pus containing the debris of bone, which feels gritty. In the treatment, free incisions and a liberal use of glucozone, ozonized echinacea and other intiseptics. Good air, the best of nursing and diet are indispensable re- quisites. Another method is to dress the ulcer with hydrochloric acid of a strength sufficiently great to dissolve the lime salts con- tained in the exposed bone at its base, i. e., ten per cent. This is applied on a double fold of lint, cut to the shape of the necrosed area, and covered with a layer of gutta-percha tissue; over this is placed lint smeared with boracic ointment, a pad of absorbent wool, and a bandage. This is left on for twenty- four hours, then removed, and the ulcer washed with boracic acid, and pepsin in the powdered form dusted lightly over the sur- 152 Twentieth Century Practice. face. The lint, impregnated with a 0.2 per cent solution of hydrochloric acid, is applied as before. The dressing is re- moved next day, and replaced by the strong acid dressing, and so on alternately. By this means the bone is slowly dissolved, the necrosed parts are cast off, and a healthy granulating sur- face is left. The boracic acid dressing is used, cicatrization proceeds, and the ulcer becomes covered with epithelium. CARUNCLE. — A fleshy excrescence often met with on or adjacent to the female urethra. It is quite amenable to the ozonized oil of thj|ia. Cotton saturated with the same and applied, it speedily dRappears. CARYOPHYLLUS.— A variety of plants of the natural order, myrtaceae. The most important is the clove-tree Cloves are the immature flower buds of this plant. They pos- sess valuable aromatic, carminative, and stimulant properties. Oil of cloves is a volatile oil obtained from the clove. It sinks in water, and has a burning, acrid taste. This oil is used fre- quently to stop the pain of toothache, but acts better in com- bination with cocain. Pulverized cloves is often an effective remedy in malaria, combined with cinchona and capsicum. CASCARA SAGRADA.— The bark of a small tree in- digenous to the Pacific Coast. Chemistry. — Contains red and light yellow resins, tannic, oxalic and malic acids, some starch and a crystallizable alka- loid. Physiological Action. — Stimulates the pneumogastric and vagus, and motor cells and ganglia of the sympathetic which supplies the intestinal tract, aids the general process of diges- tion. Therapeutical Action. — Useful in habitual constipation of the alimentary canal, in hepatic torpor and deficiency of in- testinal secretion, in an abrogation of the peristaltic wave. Preparations and Doses. — A decoction is used, half an ounce of the ground bark to one pint of water ; fluid extract from ten to thirty drops ; a lozenge in which the bitter principle is elimi- nated; excellent form; two after each meal. Is very generally recognized as a remedy for habitual con- stipation, dependent on a torpid liver and intestinal tract. Twentieth Century Practice. 153 In this lozenge the bitter principle is perfectly eliminated, but in no way does it impair its therapeutical properties, but rather intensifies its action, while overcoming habitual consti- pation exerts a permanent tonic or vitalizing action upon the intestines. Every physician bears testimony to the fact that these lozenges are superior to any other preparation of the plant. Another most reliable remedy for chronic constipation is ozonized extract of kola nut, either in a paste or lozenge. CASTRATION ET SPAYING.— The testes make the man, the ovaries the woman. Castration is an operation for the re- moval of the testicles, which may be incomplete by the removal of one only, or complete by the removal of both. If the latter the individual is rendered incapable of reproduction, and the brain, deprived of its vitalizing elements of nutrition, suffers, while ramollisment, that is its substance, both gray and white, softens, its typical fissures of thought become obliterated, the mental calibre evaporates, all the attributes of effeminacy and degeneration seize the victim; latterly insanity, or complete migration of the soul. The leading lights of modern scientific medicine urge the imperative necessity of this operation as a cure for epilepsy due to masturbation and spermatorrhea; as a cure for enlarged prostate, with difficulty of micturition. In all cases insanity is the sequel. Spaying, castration, removal of one or both ovaries, de- prives a woman's brain of all her divine attributes, her finer sensibility. When both are removed she becomes uncouth, her features, coarse, a vacancy instead of brilliancy in her eye ; her voice masculine, repulsive, loathing, unattractive ; a demon, in- stead of a mother of herself. Very eminent members of our noble profession urge the removal of the ovaries for certain uterine diseases, such as cancer tumors, neuralgia, inter- menstrual dysmneorrhea, neurotic affections. In this city we have professors with private hospitals, drawing an annual in- come of over one hundred thousand dollars from spaying women with no uterine disease whatever — performed simply to escape the responsibilities of motherhood. CATARACT. — Consists of an opacity of the crystalline lens, or its capsule, or both; the effect being to intercept the rays of light on their way to the retina. Three forms are usu- 154 Twentieth Century Practice. ally recognized according to situation of opacity, viz., lenticu- lar, capsular, and capsulo-lenticular. Causes. — The causes that give rise to opacity of the crystal- line lens are either inflammation or degeneration of structure. Symptoms. — Hard or lenticular cataract, or degeneration is the most common form met with in both sexes between fifty and seventy years of age. It causes objects to be seen as if through a thick cloud or gauze ; allows vision to be more clear when pupil is dilated with atropine, or by turning back to light. In advanced cases vision is reduced to distinguishing light from darkness. Commonly, one eye becomes affected first, then the other. Movement of iris natural; when pupil is dilated with atropia cataract can be distinctly seen with a glass of small focus ; when cataract forms, lenticular opacities can be readily seen by ophthalmoscope. Soft, or lenticular cataract of young people, may occur at any time of life. Congenital cataract is of this kind, due to disintegration of the whole substance of lens, which becomes opaque and swollen. Symptoms are the same as the hard, only vision more imperfect. This form often depends, or is caused, by a defect in the co-ordinating chemical centre in the brain; hence it is common in diabetes and other diseases connected with that part of the brain. Capsular cataract is more especially the result of chronic inflammation and effusion of lymph into its covering; opacity of a dead white capsule; it may react any portion of capsule. Opacity of capsule always leads to opacity of lens, so that cap- sulo-lenticular cataract is very common. CATALEPSY. — This very rare disease is found almost ex- clusively among women, though occasional examples are met with in the other sex. It is marked by the recurrence of fits, which may be repeated several times in the same day. The features of the fit or convulsion are the following : The patient may experience headache, lassitude, dizziness, or trembling, and be suddenly stricken motionless, so that, if he be engaged in walking or using either the upper or lower extremities in any way, they become fixed, and remain in whatever position they may be in, no matter how constrained. It is possible, how- ever, for another person to bend the limb in a new position, in which it stays until the muscles become fatigued. The limbs feel semi-rigid, and as if made of wax or some half-resisting material, so peculiar is the contraction. The patient is utterly Twentieth Century Practice. 155 unconscious during the seizure, and remains so during its con- tinuance, which lasts, perhaps, for an hour or two, or even for several days, but this is rare. The skin is numb and insensitive, so that pins may be thrust in to some distance without produc- ing pain. Cases of trance usually come under this head, and religious history is full of examples of what was simply ecstasy or cata- lepsy. Fright, malarial poisoning, anemia, or other impoverished states of the blood, enter into the production of catalepsy, and it is commonly a disease of early life. The prospect of cure is discouraging unless it be of malarial or emotional origin, and not connected with hereditary nervous disease or insanity. Cold water douches may be used during the attack, and the patient must be kept perfectly quiet. CATARRH. — A superficial inflammation of the follicles of a mucous membrane, with an excessive discharge of mucus', in which the primary elements of nutrition are changed, de- graded into other living matter, with a new and independent existence. Generally met with in an acute and chronic form. Nasal catarrh, in the acute form, generally owes its exist- ence to cold, damp, exposure, congestive chill ; also due to the inhalation of dust, gases ; idiosyncrasy to certain drugs, as io- dine, ipecac. Nasal Catarrh, Chronic. — Physiologically and patho- logically the nose is an organ of much importance. Its posi- tion and functions expose it to injury, to variable temperatures, chemical and mechanical irritants, which excite inflammatory states. In all cases of chronic nasal catarrh there is a thickening of its internal lining membrane, which to a certain extent gives rise to some obstruction, not an occlusion, but simply a thick- ening or contraction. Removal of the cause is the first step to a cure. Local medi- cation is of much value in all cases of this form of catarrh. Ozone et chlorine, when used in any strength from one to two drams to the pint of tepid water by a douche, is far reaching in its effects, ridding the nostrils of all morbid tissue and excit- ing a healthy action, at the same time destroying germinal matter. At the commencement of the treatment of all cases of nasal 156 Twentieth Century Practice. catarrh, one application of the nasal douche charged with ozone et chlorine will do an immense amount of good, destroys all germs, removes thickening, establishes a healthy base upon which the renewal of tissue can be built. Subsequently a cure can be established by the use of anti- septic solutions, of which resorcin and siegesbeckie is the best ; internally saxifraga comp. Some cases are complicated by ulcers on the nasal septum, which are often the source of its chronicity, and epistaxis. If such exist apply permanganate of potassa in solid form, thus : A probe wrapped in cotton, slightly moist, is dipped in finely powdered permanganate of potassa, and applied to the affected surface, the surplus being washed away. Varicosities of the septum often yield to this procedure. Dry catarrh is an atrophic state of the nasal mucous mem- brane, in which the amoeba sporulates, and forms a very te- nacious secretion, which dries upon the surface. In addition to the douche or spray of the ozone et chlorine, much good is obtained by improving nutrition, not only of the mucous mem- brane, but the general health. Sponge baths, massage, warm clothing, most nutritious diet. A disinfectant spray of ozonized boroglyceride should be used every evening, and occasionally a spray of the following : Aqua distilled, four ounces; oil of eucalyptus, thirty drops; menthol, ten grains ; tincture iodine and formalin, of each five drops ; mix. Use in atomizer. All catarrhs are contagious and infectious. No doubt of their being influenced by certain atmospheric and meteoro- logical conditions. The chief cause of all catarrhs is a deficient vitality, extreme excitability or neuroses of mucous membranes from some cause. The function of all mucous membranes are essentially iden- tical, but in the process of their partial death, or gather in their germinal evolution they differ much. In chroni£ nasal catarrh there is an evolution of the "amoeba" on the Schneider ian mem- brane; in the bronchial, the "conferva;" in the urethra the "gonococcus ;" in the bladder, the "mitrococcus urese;" in the uterus, a special germ; in the stomach, the "sarcinse;" on the membranes of the brain a "diplococcus." In the treatment of all forms of catarrh, they all require improved nutrition and bracing tonics, and local vitalizing germicides. For a bracing tonic no drug can excel the concentrated tine- Twentieth Century Practice. 157 ture kurchicin. It is extremely valuable, administered thrice daily in sufficient doses. It is a drug that affords immediate results which are invariably beneficial. It is a remedy given in the initial stage that will break it up. In the advanced stage curative. Inhalation of liquid ozone may cure a recent case, but for all chronic cases of nasal catarrh, either a douche or spray of ozone et chlorine is indispensable. In some instances iodol snuff helps; gargles of chlorate of carbon prove serviceable; one teaspoonful of a saturated solution of this in a tumbler of tepid water. If there be cough, much laryngeal-irritation, the pine-tree tablets afford speedy relief. The term catarrh is applied to all weak, relaxed, devitalized conditions of a mucous membrane. In whatever location this exists it is characterized by the evolution of a special patho- genic microbe ; in nasal catarrh the amceba ; in gastric and in- testinal catarrh the sarcinae ventriculi; if relaxation pervades the mucous coat of the bladder the micrococcus urae; and so with the uterus, vagina, rectum. From the fact of its bacterial origin, all catarrhs are infectious and contagious. Each form may have an acute stage, ushered in with rigors, febrile reaction, suggestive of the presence of an organism or its toxin in the blood. Nasal catarrh is predisposed to by our very variable climate, sudden heats and colds, sudden gusts of a highly oxygenized atmosphere, etc. It is, therefore, the most prevailing malady of our country. The nasal discharge may be either profuse or scanty. If the frontal sinus be invaded it may trickle down the fauces, giving rise to laryngeal and lung trouble. In cases, nasal, head sinuses, laryngeal, bronchial or aural, the toxins enter the blood, give rise to languor, debility, prostration, general mis- ery, whereas their elimination by the ozone et chlorine or other germicides is attended by cheeriness and restoration to health. One thorough douching with ozone et chlorine in all cases will bring away the entire colony of germs, and if constitu- tional treatment is pushed with vigor so as to prevent a further evolution of germs in the respiratory tract, a good cure is the result. But where the germ and its toxins have involved the larynx and there is aphonia, or the Eustachian tube and there is deaf- ness, or the bronchi and there is difficulty of breathing with ir- 158 Twentieth Century Practice. ritative cough, other remedies besides the douche of ozone et chlorine must be resorted to. In our present germicidal treatment of catarrh, no remedy stands by a physician so well as a good alterative, which we have in saxifraga. The remedy was only introduced a few years ago, but is now very generally used in a diversified num- ber of diseases, with uniform success, that it is now a standard. It is not only a potent germicide, but acts energetically upon the nerves of nutrition, and can be relied upon in all germ dis- eases, as tuberculosis, cancer and syphilis. After it enters the blood and annihilates germs its renovating action upon the lymphatic granular system has a most salu- tary effect when new blood is needed for repair. All physicians who prescribe it advise its exhibition in about half a teaspoon- ful doses thrice daily. Inhalations are of great utility in the laryngeal, bronchial and aural forms. Probably c. p. guaiacol is the most efficient. I have been much pleased with the action of the ozonized dis- tillate of witch hazel. It certainly is a most invaluable remedy for either douche or gargling. Since the introduction of the pine-tree tablets, I have invari- ably prescribed them in all my cases of nasal catarrh. I have the patient merely keeps one in the mouth, swallows it as it dis- solves. By adopting this method the volatile ozoniferous prin- ciple of the pine diffuses itself in every direction, even to the sinuses of the head, larynx, bronchi, ear, and as it does this, symptom by symptom vanishes — the headache and trickling down the fauces, the hoarseness and loss of voice, the cough and difficulty of breathink, even the hearing improves. Here then is a harmless method of amelioration, at least. Inherent weakness of organization, together with some de- pressing agent, as exposure to variations of temperature, cold and wet, give rise to the evolution in the mucous membrane, which lines the nasal cavity, the pathogenic microbe, the amoeba, which when fully fledged renders common nasal ca- tarrh contagious ; every individual, if in feeble health, in close proximity is liable to become its victim. With the evolution of the germ the mucous membrane swells, becomes inflamed, which gives rise to a feeling of stuffiness in the nose ; if microbic growth be great in the frontal sinus the eyes will be affected ; if in the vicinity of the Eustachian tubes they will be closed and deafness results ; if in the throat and air passages there will be hoarseness, probably aphonia. Twentieth Century Practice. 159 After a few days the mucous discharge becomes thicker, more opaque and profuse. This may continue for some time, during which time the patient is extremely liable to fresh at- tacks. Epidemic catarrh, or influenza, being due to certain elec- trical and meteorological atmospheric conditions, with an at- mospheric germ, is usually ushered in with great depression of vital force, rigors, sneezing, water discharge, eyes suffused, cough, gone feeling, congestion of lungs, aphonia, difficulty of breathing, loss of flesh and strength, hectic. The toxins of the amoeba give rise to a cachexia, debility, pasty complexion, headache, many cases of epilepsy seizure, neuralgia. The toxins of epidemic catarrh are alarmingly prostrating to the nervous system, and it frequently leaves that portion of our bodies in a state of chaos. What have we got to annihilate these two foes to human existence? If it be true that the toxins of these two germs give rise to all the trouble, and that the skin is an important emunctory, a ra- tional basis of treatment is the use of the alcoholic vapor bath. Sweating assists in the elimination of the toxins, leaving less poison behind in the body. Normal sweat is toxical if reab- sorbed, but the sweat of catarrh, of epidemic influenza, phthisis pulmonalis, pneumonia, diphtheria, typhoid fever, tetanus, is deadly if injected under the skin of any domestic animal. The sweat is the main vehicle for skin excretion, and if aided by other remedies will break up catarrh. The body, both in its normal and pathological state, is a re-, ceptacle, as well as a laboratory, for the generation of poisons. Ozone, the great scavenger of nature, is the remedy locally and internally. As a rule, the best remedy in epidemic influenza or catarrh is the ozonized concentrated tincture of passiflora incarnata, administered in moderate doses, but frequently, until the pa- tient is thoroughly under its influence, with confinement to bed. For a tonic in all cases, matricaria. The chronic form of catarrh, which is so common in our Western States, is best treated by washing out the nasal organ, fauces, with a weak solution of ozone et chlorine, once or twice a week. Here the best internal remedy is comp. saxifraga, which should be administered for several months. The leading medical authority in America says : Individuals suffering from neurasthenia, exposed to the vicissitudes of 160 Twentieth Century Practice. rapid changes of temperature, sudden heats and colds, intense atmospheric, changes, greater in North America than any other nation in the world, very naturally have frequent attacks of acute catarrh, liable at any time to either terminate in chronic catarrh, in ozena, chronic laryngitis, or bronchitis. In the passing from the acute to the chronic form, the evolu- tion of the amoeba is most prodigious, much greater than in the acute or well-established chronic. The amoeba, when once thoroughly established in the air passages, sporulates freely, and migrates into every nook and corner; especially are they prone to penetrate the Eustachian tube, and give rise to ear trouble, deafness, aphonia. All stages of nasal catarrh are contagious and infectious. Its toxin, whether the germ be in the nose, ear, throat or bronchi, enters the blood, impairs the function of cell nutri- tion, damages the nervous system, induces such pathological conditions as chorea, vertigo and epilepsy, besides giving rise to a pasty or doughy appearance of the skin, debility, goneness, a special cachexia. The grand fields of germicidal growth, toxin excreta, ul- ceration, with a complete metamorphosis of normal tissue, are in the nose, Eustachian tube, fauces, larynx, bronchi — a patho- logical condition which bears great care, good food, alteratives and tonics ; but we are very doubtful if the entire list of such remedies ever cure a single case. Nevertheless, such a course fortifies the vital forces to resist the ingress and prevent the evolution of this germ, which is something. Ozone et chlorine is the specific germicide for the amoeba. If it can be applied it will annihilate the germ, and, as an active scavenger, antidote its ptomain, wipe it from the tissues. It also rouses up in the patient the vital elements of a new exist- ence. The remedy has a natural affinity for the germ, which is common in all cavities and hollow organs when vitally de- pressed. The treatment for a radical cure must be direct, to the nose. Eustachian tube and larynx, by the nasal douche; to the bron- chial tubes by atomized vapor. The treatment in all cases must be administered by a physi- cian, a believer in bacteriology, the remedy he uses in from thirty drops up to two drams to the pint of tepid water, vari- able in strength according to his judgment. In all cases, before applying, the fauces should be painted with the remedy in about half its strength. Twentieth Century Practice. 161 Taking all into account, a progressive course is the best, be- ginning with thirty drops to the pint and increasing up to two drams. Still, if desirable, a positive cure in one treatment can be effected; that is, a cure that will drive every amoeba from the air passages. But for general practice a slower method affords more permanent results. Another form of chronic catarrh commences with distinct evidence of disease of the nose or naso-pharynx, and in chil- dren and young persons it is very often due to and kept up by the presenece of post-natal adenoid growths. The occurrence of tinnitus is not constant, nor is it so marked a feature at the onset of the disease ; there is usually distinct evidence of Eus- tachian narrowing, with generally considerable improvement on inflation. This is chronic moist catarrh of the middle ear. In most instances it has originated in a recognizable acute at- tack of naso-pharyngeal and Eustachian catarrh, and it is most amenable to the ozone et chlorine in the same strength as for nasal catarrh. The ozone et chlorine, either by spray (atomizer) or by douche, is the most effective remedy ever discovered for eradi- cating this germ from the body. The destruction of the germ must be followed up by the exhibition of comp. matricaria be- fore meals, with thyroid extract and c. p. solution of spermin. If nasal catarrh be not either cured by drug or effaced by a restoration of vital force, it is bound to terminate in ozena. We read a great deal, see a great deal, and hear a great deal about nasal catarrh, one of the prevailing infectious and con- tagious maladies of the present age. In the treatment of nasal catarrh, internal or constitutional remedies do not do much good ; that is, you cannot depend on them for a cure. They benefit simply by improving the gen- eral health. Alteratives and tonics help, but their action in all cases must be aided by a local treatment, either in the form of atomized fluids or solutions in a douche. As a rufe there is little use in supplying the patient with either, for he is unable to use them with precision; never can get more than a temporary benefit. He is unable, either with the spray or douche, to get the remedy far enough back; he simply gets it over the anterior ends of the turbinated bones, very seldom reaching the seat of the disease where the microbes are at work. This should be performed by a physician of skill, and as the entire Schneiderian member is either thickly cov- 1 62 Twentieth Century Practice. ered with a germ-laden mucus, or incrustation, a medicament of sufficient potency should be used to penetrate the mucus or incrustations. Such a remedy we have in the ozone et chlorine used in either of two methods. For this purpose the remdy at first should be applied weak, but thorough, cleansing the diseased tissues ; there must be no irritation. After cleansing one nostril and then the other, wait a few minutes, then blow out and re-apply. Much good can be accomplished. The strength of the solution, as strong as possible so it does not irritate, tepid, and in quantity about a pint. If the patient is to use it himself, he should be instructed to hold the nosepiece so that the current will pass directly back through the nose, thus covering the turbinates through their full length, and reach the posterior nares, and by holding the breath well, will pass down the other nostril. As the case progresses, for ozone et chlorine is never failing in its action, other agents, such as resorcin, permanganate po- tass may be used in weak solutions. Don't wase time, neither get swindled by the use of nasal bougies nor other clap-trap pushed forward by unscrupulous drug houses. Give the patient an honest deal. Gastric Catarrh. — The causes which give rise to it are either gross carelessness on the part of the afflicted individual in hasty eating, drinking excessively of fluids, adulterated food, improper medication. Indiscretion in eating, excessive drinking, account for a very large percentage of cases. It is by far the most common form of dyspepsia or indiges- tion; the mucous membrane of the stomach is damaged, de- vitalized ; there is always, in all cases, an excessive secretion of mucus, in which an evolution of the sarcinse ventriculi takes place ; here it sporulates and grows, with more or less activity, according to the intensity of the depression and the amount of mucus excreted. In this state of bacterial life and growth, toxins are freely elaborated, which are absorbed into the blood, which give rise to cerebral depression, headache, weakness, ver- tigo, impairment of the senses, general deterioration from im- perfect digestion, want of nutrition, anemia. Although not essentially a water-bourne malady, the use of fluids aggravates its intensity, and promotes an extraordinary volume of mi- crobic growth. A most essential point in the treatment of any case is to limit Twentieth Century Practice. 163 the use of fluids, especially before and during meals. The diet should be most nutritious, solid, and be thoroughly masticated. The use of ordinary doses of comp. tincture matricaria before meals has a most happy effect in toning up the walls of a re- laxed stomach ; one of the best and most efficacious of all reme- dies, its use never should be omitted. Immediately after eating, either ozone water or peroxide of hydrogen should be administered, to inhibit germ growth, and annihilate old spores or pockets. The sarcinse in gastric catarrh make germ lesions in the stomach walls, favorite sites for cancer deposit. There should, therefore, be a thorough eradication of the germ, a strengthen- ing and bracing up of tissues, to efface all weak spots which are favorable to the lodgment of the cancer neoplasm. To effect this the patient should be encouraged to drink at all times, and under all circumstances, an infusion of kaki, which has such a remarkable tonic action on the stomach walls. Ichthyol is a favorite remedy by many in gastric catarrh. It is usually administered as follows : Make a mass by rubbing up ichthyol in gum tragacanth to the consistency of putty, then inserting in five grain capsules is about the best mode of admin- istration. It not only kills the sarcinse. neutralizes toxins, but has a happy effect in increasing digestive activity; bowels are regu- lated, a freshness and elasticity is imparted to the whole body. One or two capsules, thrice daily, is the dose that effaces the sarcinse ventriculi, and cures cases of gastro-intestinal catarrh of twenty and thirty years' standing. The sulphocarbolate of zinc and soda are not of much utility in gastric catarrh, although exceedingly valuable in fermenta- tive diarrhea. The relaxation of the mucous coat of the stomach, and an excessive secretion of mucus, in which an evolution of the sar- cinse ventriculi takes place. It is in this mucus this micro- organism grows and is nourished, and in it it sometimes ac- quires prodigious proportions, and even endangers life. The causes which give rise to this very prevalent form of stomach trouble are extremely numerous, and likely in the near future to be more common as food contamination becomes more persistent. Drinking excessively of liquids, especially beer, most productive of it; imperfect or hasty mastication, nasal catarrh. The use of alkalies and other drugs, etc. 164 Twentieth Century Practice. The destruction of the sarcinae ventriculi in the stomach, and the prevention of repeated crops have, since the Thompsonian era, been a stumbling block in the medical arena. Samuel Thompson administered emetics of lobelia, and fol- lowed it up by copious draughts of a decoction of bayberry, and cured all his cases, but both people and the profession have be- come fastidious and dropped the emetic and bayberry tea, and for a century the people have been the sufferers, and the victims of unscrupulous charlatans. The trouble has been to completely annihilate the sarcinae without in any way injuring the coats of the stomach. According to the extensive clinical experience of every bac- teriologist in these States, some twenty thousand men of great ability and truth, men who abhor ignorance and the miserable twaddle of specifics, the perfect destruction of this micro-or- ganism in the stomach, and the production of a vitalizing action on the different coats of the stomach can be effected in every case by administering the ozonized jelly of ichthyol in doses of from fourteen to thirty grains one hour before meals in any suitable vehicle. The remedy should be given, although simple and harmless, under the guidance of an honest physician. Meals should be solid, well masticated, and with them an avoidance of all liquids. After commencing with the remedy, do not expect big results the first twenty-four hours. Sooner or later, however, the expected improvement begins ; the nausea and vomiting cease, the constipation or diarrhea is improved; the flatulence is no longer troublesome ; the headache becomes less frequent ; and, of more real value than these, the improve- ment in the general condition of the patient becomes evident. The color, the weight, the appetite, the sleep, the spirits of the patient, all show a change for the better. Of all the symptoms, the pain is the one which is apt to persist the longest, and that also disappears. The toxin of the sarcinae is one of the chief causes of the pres- ent neurasthenia and so-called nervousness ; besides in all cases digestion is imperfect; the fermentation induced by this germ evolves toxins from decaying food, which enter the circulation, giving rise to strange nervous sensation, disturbance of thought, irritability. Catarrh of the Stomach in Children. — Until within these few years back the sarcinae ventriculi was not met with in childhood, now it is one of the commonest derangements of Twentieth Century Practice. 165 rhat period of life among rich and poor. It is a constant danger to hand-fed babies, and forms one of our chief obstacles to the raising of infants. In older children it is of frequent occur- rence. It seriously affects their nutrition, and interferes with development and growth. Mothers term it biliousness. The little one loses its appetite,, mopes, lies about, has a dull, pasty or yellow complexion, and looks dark under the eyes. At night it sleeps badly, and is restless and irritable during the day. If the tongue is protruded there is a fur on it, with a coat in the centre; the breath is sour-smelling; there is a fullness about the stomach ; all indicating catarrh of the stomach, which, with its fungus, interferes with the digestion of the food. It may be vomited or pass by the bowels, but it leaves the stomach weak, and another is likely to follow, and nutrition is seriously im- paired. In addition to the above symptoms, affected children complain of pains in abdomen and sides, and are likely to suffer from vertigo, syncope from pressure upward of the distended stomach and against the diaphragm and heart. Bowels usually are constipated. Catarrhal conditions of the intestines, in which a dwarfed species of the sarcoinae is developed, yields readily to the per- sistent administration of ozonized extract of Collinsonia and Virginia stone crop. This dwarfed species of the sarcinae is to be found in all cases of chronic diarrhea and catarrh of the bowels in groups of four and eight. Catarrh of the Neck of Uterus. — Is the most common of all diseases that afflict modern women. Catarrh of the neck of the uterus, called by the physicians ulceration, so as to make it appear a formidable affair, and frighten their patients. It is true the disease is chronic, but erroneous statements regard- ing it are unnecessary. In this affection the mucous membrane is swollen, red, and bleeds easily, and exudes a mucopurulent fluid or pus. This can be readily seen. The mucous membrane has a punctate, granular appearance; its papilla? are often denuded, and only affects the neck, which is distinct from the body of the uterus, and constitutes a large, open gland, which is liable to catarrh. The disease is of the greatest importance, on account of its fre- quency, being the most common. Catarrh of the neck is caused by sexual excesses, wearing sponges, rubber tents, childless marriage, abortion, tedious full-time delivery, cold, rheumatism, gout, gonorrhea^ suppres- 1 66 Twentieth Century Practice. sion of the menses, sedentary occupations, masturbation and other forms of irritation. Symptoms. — The ordinary symptoms are pain in the back, about the base of the sacrum, which is the common seat of cervical pain ; pain down the thighs ; a feeling of weight about the rectum or lower part of the belly, and a variety of reflex symptoms, as headache, languor, and a train of indescribable sensations. What chiefly attracts the patient's attention is the extraordinary discharge, leukorrhea or whites being profuse, or otherwise of a thick, yellow, viscid color, imparting a dirty grayish-yellow stain, varying from the healthy crystalline mu- cus to yellowness or greenness, or thick, ropy, yellow pus. A white, milky discharge cannot be called morbid ; it is the vaginal mucus in excess, and occurs in weakly women, after a long walk. A glairy, albuminous crystalline discharge can scarcely be called morbid, as it comes from the neck, when the patient suffers from extreme debility ; but a yellowish, greenish discharge indicates disease. Here one speculum examination is necessary, and it should be made by the duck-bill speculum, in the presenece of some lady friend or the husband. The mirror- glass speculum shows the disease most beautifully, if there is any, and the attendant can see it. No other speculum examina- tion is necessary. The patient can now, in nearly all cases,, manage her treatment successfully; remove the cause, if pos- sible. She should be placed upon alteratives, as saxifraga and uterine tonics, wine of aletris farinosa alternated with comp. syrup of partridge berry. The vagina should be injected by means of a half gallon fountain syringe filled with a tepid solu- tion of boroglyceride thrice daily. After each injection patient should lie down for one hour at least on her back, and insert one nymphse odorata pastil well up against the neck, and on retiring to bed an ozonized pastil should be inserted. The bowels in all cases must be kept regular by either one kolatina tablet at bedtime or fruit, such as prunes, during the day. Nutrition should be attended to. If appetite is poor, comp. matricaria. Intra-Uterine Catarrh. — One of the most common mala- dies of the modern female, induced by such causes as gonor- rhea, sexual excesses, sexual incompatibility, metritis, miscar- riages, retention of the products of conception, the introduction of the uterine sound, metastasis of disease germs, and the like, which give rise to a partial death of the intra-uterine mucous membrane, leaving it weak, relaxed, pouring out its mucous Twentieth Century Practice. 167 secretion, in which an evolution of the amoeba, yeast plant and sarcinse takes place. The bacterial products of the growth of these germs — toxins — give rise to a feeling of goneness ; a so- called hysteria, headache, dyspepsia, bloating, with an inde- scribable burning in the hands and feet; a germ-laden leukor- rheal discharge, most copious after getting up, which is in- tensely acid. The sequelae are sterility, dysmenorrhea, and ultimately the cancer neoplasm puts in an appearance. At least two-thirds of American ladies are victims of intra- uterine catarrh. Most experienced physicians find this malady difficult to manage; nay, some pronounce it incurable, simply because they have failed to realize that the cavity of the uterus, with its entire mucous membrane, is but a colony of millions of microbes, factors of morbid action, the precursors of cancerous deposit. Never inject the uterine cavity in these cases; never insert bougies prepared of any drug. Simply wash out the vagina with a tepid solution of boroglyceride, and subsequently have the patient insert a pastil of white pond lily at 9 and 12 a. m., and one at 5 p. m., and on retiring for the night one prepared from the oil of thuja. These are sufficient to annihilate the yeast plant, amoeba, sarcinae, etc. These pastils are inserted well up against the os uteri ; the patient in the recumbent position for an hour; used for three weeks out of every four for three or four consecutive months. This is indispensable, as the uterus is considerably dilated, and its walls much thickened. At the initial period of treatment place the patient upon full doses of the wine of the aletris farinosa. This is a most effi- cacious remedy, as it induces contractility of the body of the uterus as well as its walls; it tones and vitalizes, being a re- storative of great power. With this treatment comes a change — a drying up of a morbid secretion, with no auto-infection ; a diminution of stric- ture, with every infective germ wiped out, an alkaline secretion re-established, and the once barren fertile and strong. The ozonized wine of aletris farinosa excels all remedies as- a uterine invigorator. Catarrh of the Reproductive Gland. — The ozonized extract of black willow is a medicament which has been much overlooked, nay neglected, in intra-uterine catarrh and in semi- nal leakages. The ozonized extract of black willow is a remedy 1 68 Twentieth Century Practice. of unquestionable efficacy and great merit. No better remedy has ever been presented to the profession for the cure of sper- matorrhea, catarrh of prostate, seminal vesicles and testes, for the weeping penis of our drained-out youth, or the devitalized reproductive glands of the libertine. It is a good remedy in itself, but its therapeutic action is enhanced by combining it in equal proportions with passiflora incarnata. The ozonized extract of black willow works well, adminis- tered orally ; better when prescribed by suppository and soluble bougie. There is only one objection to its use, and that is its astringent properties, which can be easily overcome by the kola nut lozenge. All catarrhs in North America owe their origin to a neurosis. Speaking therapeutically, simultaneously with the excessive secretion of mucus, measures and agents which prove to be efficient in the cure of nervous disease are most valuable, such as rest, massage, nutritious food, matricaria, thyroid extract and c. p. solution of spermin. In all catarrhs, for each one has its microbe, each infectious, a retention of each one's respective toxin, the products of in- complete oxidization giving rise to goneness, depression, gen- eral misery, are best overcome by the organic extracts, which are remarkable for their potency as oxidizing agents, and for their promptness in action. Catarrh of the Bladder. — Becoming daily more common in both sexes, but especially in the male. In early life, cold, exposure, uric acid in excess are common causes; later gonor- rhea, masturbation, sexual excesses, various morbid changes in the prostate, including degeneration. In all cases the mi- crococci urese are evolved. All the old treatment by buchu, uva ursi, Pareira bran a is discontinued ; even injecting the bladder with antiseptics is giving way to the administration of urotropin. A most efficient diuretic, urinary antiseptic, uric acid sol- vent, and remedy for calculous disease. Rapidly renders alka- line and putrid urine containing mucus, pus, uric acid, and amorphous urates normal in appearance and reaction. It ster- ilizes the urine, increases its quantity, and dissolves calculi and deposits. Very valuable in all suppurative diseases of the genito-urinary tract, pyelitis, cystitis with ammoniacal decom- position of the urine, phosphaturia, also in gouty and rheumatic affections where active elimination of uric acid and the urates is required. Twentieth Century Practice. 169 When prescribed in ten-grain doses, thrke daily, it promptly annihilates all disease germs in the urine, checks all decompo- sition, prevents the evolution of the micrococcus urea, so com- mon in either urinary retention, or cystitis. CAVITIES IN LUNG. (Micrococcus Tetragenus.) — Grave affections of the lungs frequently commence either with an ordinary cold in the head and chest, nasal catarrh, laryngitis and bronchitis — conditions which are decidedly common. Lungs weakened from or by any condition often become the abode, the receptacle of disease germs, provided they be in the blood or air breathed. By preference they penetrate the substance of the lung, and into this they aggregate in masses and form nests, technically termed vomica or caverns. The tubercular bacilli possess this faculty of aggregation in a most remarkable degree; the actinomycosis comes next, making- great havoc, immense cavities ; the venereal bacillus frequently gives no exceedingly large formations; the pueunwcoccus has little tendency to form isolated masses, but it migrates, forms infiltrations. Whatever be the microbe that makes up the vomica, and it has been once expectorated, on the walls of all such cavities, in the breath, in the sputum, the micrococcus tetragenus is ever found. Very generally this germ is found in groups of four (tetrade) surrounded by a hyaline capsule- Once this microbe finds an abode in the lung, it very soon fol- lows that groups of the characteristic tetrad are also present in the spleen, kidneys, liver. The micrococcus tetragenus is pathogenic of vomica or caverns in lung structure. Being hardy and vigorous it bears cultivation well in any nutrient liquid. Cultures injected into any mammalia give us the characteristic symptoms and precise pathological condition. The evolution of this microbe on the walls of a vomica — its extremely rapid growth, toxins most deadly, the product of bacterial growth thrown off in an unlimited degree — gives rise to putrescency, fetor of breath, diarrhea, hectic, profound pros- tration. It has been customary in clinical teaching to classify all vomicas as being due to tuberculosis ; the time has now arrived when very many cases can be diagnosed as either syphilitic or due to actinomycosis. 170 Twentieth Century Practice. CELERY COMPOUND.— This remedy is composed of celery seed, guarana, ambrosia orientalis. Properties. — A most extraordinary remedy to neutralize the poisonous properties of bacterial life in the blood and rein- vigorate the nervous system. Indications for its Use. — In all cases of auto-infection from the presence of the toxins of disease germs in the blood and nerves ; essentially a nerve restorative and vitalizer ; imparts to the aged youthful vigor and vivacity; very efficacious in all fevers and inflammation, shortens their duration, mitigates their severity; allays restlessness and irritability, promotes cardiac vigor; gives colossal brain strength. Indicated in all forms of albuminuria. The great value of the remedy as a vital restorative has been thoroughly verified. Celery comp. ozonized, then, is indicated in all conditions of debility, where the vital forces are below a normal standard, or in an asthenic condition from the presence of the toxins of disease germs. Impotency (functional and congenital), sper- matorrhea, sexual debility, weakness of the bladder, testes, mammae or ovaries, prostatorrhea — valuable as a diuretic. It neutralizes the poison; rapidly restores the vitality of all the tissues by stimulating the process of assimilation. Dose. — From one to two teaspoonfuls before meals. This is a true nerve tonic; indicated in restlessness, irrita- bility, insomnia, whether of infancy or senility, and of the utmost value in the excitability of hysteria, or the depression of neurasthenia. In alternation with the uric acid solvent it effects most wonderful results in the uric acid diathesis; in albuminuria of disease germs blocking up the kidneys; and in degenerative changes incidental to chronic nephritis. Take it all in all, the ozonized celery comp, has a wide range of action and seems upon the whole to be an effective drug in Bright's disease. Weakness, relaxation of the secreting structure of the kid- neys, with albuminuria, are much more common than is gen- erally supposed. Bright's disease does not account for half the number of cases met with in practice, although it accounts for more than any other individual disease. If you have a case of chronic interstitial nephritis, a condi- tion responsible for cardio-arterial, ocular and other remote phenomena, with urea in the blood, try the ozonized celery comp. If you have a case of renal sclerosis of inflammatory origin, Twentieth Century Practice. 171 diminution or loss of functional power in the kidneys — when- ever the protoplasm or master tissue of the kidneys fails to excrete, try the celery comp. If you have a case of intense frontal headache, puffiness of the face, drowsiness, ringing in the ears, dimness of vision, dizziness, difficulty of breathing, nausea, vomiting, involuntary twitching, prostration, urine scanty and containing albumin, try the ozonized celery comp. If you have a patient suffering from nervous or mental dis- turbances due to inability of the kidneys to secrete and excrete urea, try the ozonized celery comp. If you have a fatal form of anemia with albuminuria, for which no cause can either be assigned or detected, for the change the blood is undergoing, a steady and destructive im- poverishment, the structure of the spleen, lympathic glands, pink marrow of bones, not in any way altered, just try the ozonized celery comp. CEREBRAL CONGESTION.— Chronic inflammation of the auditory and nasal passages is a frequent factor in the pro- duction of cerebral hyperemia, irritation of the outer and inner ear is transmitted directly to the brain ; whereas in nasal irrita- tion the olfactory spread on the mucous membrane covering the anterior and posterior ethmoidal cavities, the sphenoidal cells, the frontal sinuses directly emanates from the brain. The vas- cular paresis in both cases commences in the periphery, grad- ually travels to the brain and vascular system. This disturbs the cerebral circulation, interferes with normal function, gives rise to symptoms of nervous prostration, gives rise to irritability of temper, headaches and inability to hold the mind continuously on a definite subject any length of time, vertigo, impaired memory, sleeplessness, extreme excitability on the least perturbation, instability, love of change, loss of am- bition. Associated with those, there are usually digestive dis- turbances, constipation, due to an unequal blood distribution, the brain getting more than its share. Independent of nasal, auditory, optic or rectal irritation, chronic cerebral hyperemia may be brought about by shock, fright, grief, worry, irritation in any part of the body. Irrespective of cause, the pathological condition in all cases crystallizes itself into a paresis of the brain, paralysis of the vasomotor nerves, causing continuous congestion of the brain capillaries. 17 2 Twentieth Century Practice. If recognized early, most amenable to treatment, if there be a nasal catarrh or any auditory derangement, they should re- ceive proper topical treatment. In the management of these cases, and they are numerous, the diet should be nutritious ; daily baths and massage ; secre- tions' activity stimulated and the patient placed upon large doses of passiflora, several times daily, and an active tonic, like matricaria administered. Make an energetic effort to cure before it merges itself into cerebral anemia. If it has progressed this far such remedies as kephalin, avena sativa, protonuclein, c. p. solution of spermin, thyroid, are invaluable and essential to a cure. If these cases are not attended to early and cured they are extremely prone to lead to sclerosis of the cerebral pulp, result- ing in dementia, progressive paralysis and death. CEREBRIN. — Dose : One to five grains at meals thrice daily. Cerebrin is a soft, light amorphous hygroscopic powder — isolated from the white substance of the brain. As it is liable to chemical change, it is best administered in the glycerite of kephalin or phosphated tincture of oats. CEREBRO-SPINAL MENINGITIS. (The Strepto- coccus.) — Or spotted fever, may be defined to be a fever due to the presence of a streptococcus and its ptomain in the blood. Its diagnostic points are the history of the case, epidemic and endemic, the stage of collapse, rigors, fever, with stupor, coma, opisthotonos, convulsions or spasms, delirium. A microscopical examination of the breath, tongue scrap- ings, blood, demonstrates the presence of a microbe in the blood, which appears in the form of cocci ; diplococci and chains - — these are most abundant in the cerebro-spinal fluid, base of brain, around the medulla oblongata, spinal cord ; zooglcea are found in the spleen, liver, kidneys. The alkaloid ptomain excreta is not only toxical but highly tetanizing — usually caus- ing death in less than seven days. The microbe is pathogenic — bears culture well in an infusion of wheaten grits or oatmeal. The general principles for a highly contagious and infectious fever should be inculcated — bathing, antisepsis, nutrition, with the most powerful stimulants to the cerebro-spinal axis, or else chloroform and peroxide. The microbe of this fever is difficult to sterilize or annihilate. Twentieth Century Practice. 173 Our best remedies are veratrum viride, skullcap, calabar bean, gelsemium in combination, alternated with either peroxide of hydrogen, resorcin, sulphur water. CEREBRUM. — When an anatomist removes the brain from its bony cavity it is so soft that is loses its form and flattens down on the platter which receives it into an almost shapeless mass. It bears then little resemblance in form to the beautiful pictures seen in our text-books on anatomy. But by putting it into alcohol or passing a current of alcohol through its vessels for a few days, it becomes sufficiently hardened, and then will retain its original shape much better. As it lies in the skull in health, it is surrounded by a fluid which keeps its surface moist and soft and prevents all injury from movements in running, walking, jumping, or falling, and to allow it to swell or decrease in size, as there is more or less blood in it. The brain is essentially composed of two kinds of tissue, and both differ from any other of the tissues of the body, and also from each other; one is gray in color and one is white. The gray matter of the brain is sometimes called the cortex. It is a thin external layer spread over all the surface of this organ, and it also dips down between the convolutions of the brain, thus greatly extending its surface and increasing the amount of gray beyond what it would be if it was simply stretched out evenly. This gray substance is said to be composed of cells, the so-called brain-cells; but the word cell is very misleading and does not give a good idea of what they are. They are, in fact, little nodules of protoplasm of various shapes and sizes bound together by delicate threads, so that each nodule or gang- lion is united to all the others, permitting them to act together, and allowing of impulses arising in one part to be conveyed to another part in brain activity so far as this is needful. The white substance consists of nerve fibres which come from or extend to the sense organs, as touch, taste, hearing, see- ing, and to the various organs of the body which cannot act without the stimulus of the brain. Each so-called cell prob- ably, or, perhaps, group of cells, connects with one of the white fibres, and thus a connection is made to the part to which it is related. The gray matter of the brain contains a far greater number of capillaries for the blood to circulate in than the white matter. It has been estimated that it receives five times as much blood, 174 Twentieth Century Practice. and we may, I think, infer from this that the activities going on in it are also very much greater. To this we may add that the whole brain is supplied with blood-vessels so as to nourish it abundantly. A glance at any well illustrated work on anatomy will show this. The brain in its embryological development arises from five bladder-like structures which are the same in all vertebrate animals, but in man the front bladder grows more rapidly and larger than in animals, covering and enclosing the whole central part, and this greater size is of the greatest im- portance, because this part is the organ for all the higher mental activities ; because in it, as Haeckel has said, "are accomplished those functions of the nerve cells the sum of which is generally designated mind." The highest activities of the animal body, the wonderful manifestations of consciousness, the complex phenomena of thought, all have their seat in the fore-brain. It is possible to remove the fore-brain in some animals little by little without killing them, when all the higher manifestations — thought, consciousness, volition, and sensation — are de- stroyed one by one, finally annihilated. If the animal thus treated is artificially fed, it may be kept alive for a long time, for digestion, respiration, circulation, secretion, etc., are not destroyed by removing the fore-brain. They have their cen- tres elsewhere. The same conclusions had, however, been reached before without vivisection. The average weight of the brain of an adult male is about 49 Yz ozs., or a trifle over 3 lbs. That of the female is about 44 ozs., the average difference being from 5 to 6 ozs. The brain of the male usually ranges from 46 to 53 ozs., that of the female from 41 to 47. In the male the maximum weight out of 278 cases was 65 ozs., the minimum 34 ozs. The maximum weight of the female brain out of 191 cases was 56 ozs., and the minimum 31 ozs. Different weights, however, have been given by different investigators. The weight of the brain increases rapidly from birth up to the seventh year, more slowly to between sixteen and twenty, and still more slowly between thirty and forty, when its greatest weight has been attained. After this its weight gradually diminishes about one ounce each ten years. The same is true in regard to both sexes. These observations given by Gray in his Anatomy are made from averages of people in the ordinary conditions of life, and may be taken with some allowance. They indicate that man reaches his best intellectuality between thirty and forty years Twentieth Century Practice. 175 of age, and from this time he gradually declines in brain vigor. The experience acquired before this period of decline, however, makes some amends for the loss of vigor after the brain begins to deteriorate. It has, however, been observed that those who have a well integrated brain, a robust body, and good habits, retain their "highest vigor long after this time, while many whose lives have Ibeen reckless decline much earlier. This fact alone ought to prove the value of hygienic knowledge so far as it relates to this organ, and, indeed, on account of the close relation of the l^rain to the other organs of the body, to all hygienic knowledge. An effort has been made to show that the size of the brain bears a general relation to the intellectual capacity of the in- dividual, but there are many difficulties in this way of demon- stration. Certainly, a well integrated, healthy brain, well nourished by good blood, would show greater power than a larger one poorly integrated and nourished. So a well dis- ciplined one may show more power than a poorly trained one of larger size. It is to the amount of gray matter in the brain probably that we are to look for superior intellectual power. And this is increased by the greater size and depth of the con- volutions and furrows. On this subject Haeckel says : "In all Tiuman individuals distinguished by peculiar ability and great intellect these swellings and furrows on the surface of the hemi- spheres exhibit a much greater development than in the com- mon average man, while in the latter again they are more de- veloped than in cretins and others with an unusually feeble intellect. There are also similar gradations in the internal structure of the fore-brain of mammals." It was formerly be- lieved that man's front-brain had some additional organs, not common to animals, but this seems not to be the case, though Tiis are far more highly developed. The complex nervous system found in man is the basis of his mental life. The latter cannot exist without the former; anything which injures this organ alters and lowers the mental life, may ruin it : anything that improves this organ, perfects the mental life, makes it better. CEDRON SEEDS. — This is used in the preparation of the simabicidia, which is so valuable in neuralgias, snake-bite, rabies. Dose : A teaspoonful, repeated at short intervals. 176 Twentieth Century Practice. CERII. — Liquor cerii ozonized. The cerii is presented in a form which produces the highest beneficial action which the remedy is capable of producing. It has been much used, and with marked advantage in chronic intestinal disturbance, and in nervous dyspepsia, at- tended with gastrodynia, pyrosis, and chronic vomiting. In obstinate vomiting, especially that incidental to pregnancy, it seldom fails. Dose : Fifteen drops added to three tablespoon- fuls of water. CHANCRES. — An aggregation or a colony of the venereal bacillus, either in the skin and* subcutaneous tissue or in the mucous membrane. They are generally met on the organs of generation of either sex, as the penis, vagina, uterus; also on the lips, arms, fingers. Two varieties, hard or infecting, soft or non-infecting. Recognized by the following landmarks : the hard infecting chancre is generally oval or round, scooped out ; on grasping it between the finger and thumb, it feels as if there was a piece of cartilage in its base ; if any, the discharge is scanty ; the soft non-infecting chancre is round, has a copious discharge, has no hardness or cartilaginous sensation ; the infecting gives rise to systemic syphilis ; the non-infecting, the microbe is incapable of affecting the blood. The old treatment of chancres is discarded since its microbial nature has been discovered. They are now treated with lotions of lime water and tincture of iodine, or sulphur water, or with powders iodol, aristol. CHAPS. — Cracks or fissures of the skin, usually on the lips and hands, caused by exposure to extremes of heat and cold, dry or moist. A feeble circulation predisposes to their form- ation. The repeated application of ozonized jelly of violets is usually sufficient to prevent and effect a speedy cure. CHAULMOOGRA OIL.— Oil prepared from the seeds of Gynocardia odorata, contains an active principle, gynocardic acid. The oil is obtained by cold or hot compression. Therapeutic Uses. — A powerful bactericide, completely anni- hilates the bacillus of leprosy, tubercle, syphilis, lupus, psoriasis,, rheumatism. Preparations and Doses. — The oil may be administered in- ternally in hot milk, or in capsules in from five to ten dror> Twentieth Century Practice. 177 -doses; applied externally in a pure state, or incorporated in an ointment in the proportion of one ounce of the oil to three of ointment. CAULOPHYLLUM.— The root of the blue cohosh, grows freely all over our country. Therapeutic Action. — Emmenagogue, diuretic, diaphoretic, antispasmodic ; an excellent uterine stimulant. Preparations and Doses. — As it freely yields its properties to boiling water, an infusion is most efficient, two ounces of the ground root to a pint of water. Dose : Wineglaasful every two or three hours in suppression of the menses. A 'fl. ext, also good. Dose : From ten to thirty drops, added to water. The glucoside caulophyllin. Dose : One to three grains. CHIONANTHUS VIRGINICA.— The root bark of this plant, known as the fringe-tree or snow-flower. Thepapeutical Uses. — The cholagogue properties of this plant have been thoroughly investigated, and are greater than any of the mercurial preparations, hence it is of great efficacy in all hepatic affections, torpidity of the liver, jaundice, enlarged liver, and dyspepsia. Preparations and Doses. — Fluid extract. Dose : Ten to thirty drops, three time a day. The glucoside chionshin does not seem to be active. CHIAN TURPENTINE MISTURA. (Highly Ozon- ized.) — By the introduction into this compound of the ethereal peroxide of hydrogen, we obtain it in a form less liable to irritate the stomach, more easily absorbed, and its germicidal properties increased at least 500 per cent. Chian turpentine, which we use, is specially collected for us in the island of Chio, from the Pistacea tercbmtha. This, as we have prepared it, is an energetic ozone producer, an agreeable aromatic, with an odor resembling the pinaceous turpentine. Its special action, when administered, passed into the blood- tissues, is to search out the cancer germ, which it surely finds, and slowly, silently kills it. Under its use pain ceases, the tumor, or aggregation of germs, with it also dies. If there is an open breeding, eating surface it becomes covered with a characteristic grayish slough, indicating a perfect annihilation 178 Twentieth Century Practice. of the cancerous microbe. Tumors also dwindle and atrophy- under its use. Dose: One teaspoonful of the Chian turpentine mistura, three times a day, which is to be gradually increased to nine tea- spoonfuls in the twenty-four hours. CHILBLAIN. — Intense cold applied to portions of the body in which the circulation is feeble may give rise to symptoms identical to that of burns, erythema, vesication, ulceration. The comp. tincture of myrrh stands unrivaled as a local remedy. Next best, a decoction of walnut leaves, to every pint add two ounces of ozonized borogylceride. The frozen parts should be enveloped in either one during the day, and the other during the night. When either is applied cover with an impermeable dressing. After the burning and tingling have subsided the anti-microbe powder or ozone oint- ment can be used with comfort. As a prophylactic those susceptible should avoid the wearing of damp stockings, or long exposure and violent changes in. temperature. CHINOSOL {A Powerful Germicide) . — A product belong- ing to the chinoline series. It occurs in the form of a yellow crystalline powder, possessing a slightly aromatic odor and an astringent taste. It is readily soluble in cold water and in- soluble in ether or concentrated alcohol. A solution of 1 in 40,000 is sufficient to prevent the development of the staphylo- coccus pyogenes aureus. As might be inferred from its chem- ical composition, chinosol, when brought into contact with the slightly alkaline fluids and secretions of the body, sets free oxychinoline, which, under these circumstances, exerts a pow- erful effect. It is to this loose condition of the oxychinolin that chinosol owes its powerful action as an antiseptic. Chinosol (C 9 H 6 N. KS0 4 ) finds its most important applica- tion in the treatment of fresh wounds, burns, etc. ; ulcers, sup- purative processes, etc. ; diseases of the throat, ear and nose ; also in obstetrics, and in dermatological and dental practice. Chinosol must not be brought into contact with steel and iron, because of its reaction of these metals, though the stains can be easily removed with the aid of chalk, etc. Other metals, as nickel, silver, zinc, tin, copper, are not affected by chinosol.. Twentieth Century Practice. 179 CHLOASMA. — Liver spots. Peroxide of hydrogen is our best remedy, and upon the whole is very satisfactory, but occa- sionally fails. To be effectual it should be very freely applied, and allowed to soak into the skin by means of cotton soaked in it and laid over the surface for five minutes morning and night. It will cause somewhat of a desquamation, but this can be easily remedied by the use of a little ozone ointment. CHLORAL HYDRATE.— Dose : Fifteen grains, added to syrup of orange peel, every hour, or every three hours. Ex- tremely efficacious in producing sleep in delirium tremens. Combined with bromide of potassa, it will control raving mania, puerperal convulsions. Its persistent use creates a habit, and exhausts the ophthalmic tract ; causes amaurosis. Applied locally to the breasts, during lactation, it will arrest the secretion of milk; it is also an invaluable counter-irritant; more penetrating than cantharides. CHINAPHILA UMBELLATA.— Pipsissewa, or winter- green, prince's pine. Therapeutical Indications. — Germicide, astringent, very use- ful in rheumatism and dropsy. When used for a great length of time it excites absorption of testes and mammae. Fluid extract. Dose : Twenty to thirty drops every three hours. CHLOROSIS. — A peculiar form of anemia occurring in young persons of both sexes, but most common in the female about the age of puberty. There is a defect in the normal evo- lution of the red corpuscles — the development of the corpuscles up to a certain point, but no further. The red corpuscles are small, pale, and besides being dwarfed in size are diminished in number. The cause in some nervous defect, as some demand upon the nerve forces; in males a common result of masturbation and deleterious trades ; in girls precocity due to modern education, and many of the causes that operate in the production of anemia. Symptoms. — General symptoms of anemia, with a wax-like hue of face, yellow pallor of skin, whence the name "green sickness." Deficient or depressed appetite, fetor of breath heavy coat on tongue, skin dry, constipation, abundant limpid 180 Twentieth Century Practice. urine, weak quick pulse, hysteria. If a woman, pale, scanty menstrual discharge; if a man, his semen entirely destitute of spermatozoa. CHLORALAMID. — Dose, 15 to 45 grains, triturated in sugar of milk, either in wafers or capsules. An efficacious hypnotic, but if administered to beer-drinkers, or tobacco-users, paralyzes the heart and vasomotor centres. CHLORIDE OF CHROMIUM {Ozonised; the Cancer An- tidote). — Dose: For external use only. The liquid chloride of chromium is added to pulverized blood root, or any other inert powder; is made into a paste of the consistency of tar, spread on leather the size desired, and applied over the cancer, the adjacent parts being carefully protected by plaster. Spread fresh every morning, and apply until the cancer drops out, then discontinue. Indicated in all external cancers, whether they be covered with cuticle or open, ulcerating. The moment it is applied, by endosmosis, it penetrates the cancer germ, unites with it and kills it. To this germ it has a chemical affinity, as the mass of cancer germs are, when destroyed, a perfect ozonoid. The destruction of the germ is effected without pain, but the surrounding tissues are so blended in and through it that they suffer oxidation, which gives rise to some pain in the separation of the germinal mass from the healthy tissue, but much less than what is caused by any other remedy, except the ozone paste. CHLOROFORM.— A volatile, colorless liquid, which will dissolve phosphorus, sulphur, iodine, gutta-percha. When given in the form of vapor, it is best to combine it thus : One part of alcohol, two of chloroform, three of sul- phuric ether. Mix. In this form it is our best general anes- thetic, and when administered by inhalation is practically with- out danger, if administered by a competent physician. Chloro- form, when thus combined and inhaled, stimulates, then depresses the nerve centres — the higher centres are first af- fected, during which operations are safe; delay or dally till it affects the lower centres, which control the heart, respiration, in the medulla and cord, dangerous. Respiratory failure usually precedes cardiac; if either is threatened, insert one or two nitroglycerin suppositories per rectum; if there be ap- parent failure, artificial respiration. All operative procedures Twentieth Century Practice. 181 should cease. Safest and best A. B. C. for all operations at- tended with pain, such as parturition, spasm, tetanus, hydro- phobia, and convulsi6n. Proper precaution should always be observed as regards heart, lungs. Applied to the surface of the body, depresses all the sensory nerves and relieves pain; added to an ointment or oil and rubbed in, it carries the medicament down to the bone. ' Dose, 3 to 10 drops as an anodyne, antispasmodic in syrup or mucilage. Thirty drops added to one pint of any vegetable infusion, will preserve it indefinitely. CHRYSOPHANIC ACID.— Dose, locally, once or twice daily. Of great efficacy in psoriasis. Dissolve gutta-percha in chloroform and the acid in the quantity desired, and paint over the eruption and a little beyond. The result is excellent. CHOLERA. — We anticipate a recrudescence of the cholera germ in the near future, and it is well to keep our ideas in that direction the coming years. I. Cholera Infantum. — Solar heat, insanitary conditions, overcrowding, deleterious food, reflex irritation and other causes favor the evolution of a dwarfed species of the comma bacillus in children under two years of age ; although infinitely minute, it excretes poisonous ptomains in the body in which it is developed. Treatment. — The first and the most important point in the treatment is to stop vomiting, for as long as this continues the patient cannot be nourished nor diarrhea arrested. I have found that one grain periodate aurum on the tongue, every half hour, the most effectual remedy, often acting like a charm. For a drink, a whey of dilute lactic acid, checks the diarrhea in a short space of time ; the intervals between the doses should be gradually prolonged. If the diarrhea be very frequent, first oil the abdomen, then apply concentrated ozone, which rarely fails. When the violence of the attack is over administer one siegesbeckie tablet, dissolved in water, every three hours. An enema of four ounces of a warm solution of boroglyceride, to which half a teaspoonful of ozonized passiflora is added. This soothes the irritable bowel; powerfully checks the diarrhea. Stop milk, give infusion of barley, and juice of raw beef. All artificial foods and other forms of starch are simply hurtful, as they pass through the alimentary canal undigested. 1 82 Twentieth Century Practice. The dwarf form of comma bacillus keeps up fermentation in the stomach and bowels, besides bacteria and various forms of sarcinae multiply enormously. The periodate aurum is a powerful germicide and alterative, a powerful sedative to the gastro-intestinal mucous membrane, relieving vomiting, sus- pending purging ; always give the passiflora in the form of an enema. The efficiency of this treatment, simple as it is, gives us diminished mortality from this, our summer scourge. All predisposing and exciting causes should be removed, and germicide remedies, which are essentially curative, pushed with all energy. A lemonade made of lactic acid should be drunk freely by the little patient — an excellent remedy, better than any other, as it aids digestion, whereas salicylate soda in- terferes with the peptic glands and pancreatic secretion; con- centrated ozone applied over the entire abdomen, at night, together with a germicide suppository, 15-grain size of per- iodate. If the case is seen even later on, it is still curable, even when the bacillus of tubercle is effused on the bowels, in the mesen- tery. Indeed, some of the most striking recoveries take place, where the patient appeared as if resurrected from the dead — where the patient was wasted to a shadow, with a large, painful and tumid abdomen, slowly recovers, becomes stout and ruddy under the use of the ozonized solution of spermin, with a guaia- col suppository at night, upon which the child appeared to re- gain health most marvelously. It is needless to repeat that nutritious diet, cold water bath- ing, abuandance of fresh cool air, are useful adjuncts. 2. Cholera Morbus. — Predisposed to by extreme solar heat, overcrowding, insanitary states, and debility. Induced by some irritating agent in the form of green fruit, or vegetables which give rise to the evolution of a germ of feeble vitality, and an acute catarrhal inflammation of the mucous membrane of both stomach and bowels, and is attended with nausea, retch- ing and vomiting, with painful spasms of the muscular coat of the bowels, severe watery diarrhea, consistng of profuse transu- dation of fluid containing little albumin, the whole system be- ing affected, as is seen by the prostration and fever. If there be some offending material on the stomach, an emetic might be valuable; ipecac is the best, as it exercises a special influence on the mucous membrane of the alimentary canal — a remedy not to be despised, if continued on in one- eighth of a grain dose ; appease thirst with a lemonade of lac- Twentieth Century Practice. 183 tic acid, concentrated ozone over abdomen. Last summer I had quite a number of these cases, in which I had the best suc- cess with the following: Bichloride of methylene, 1 dram; peroxide of hydrogen, 1 ounce; muriatic acid, 30 drops; dis- tilled water 4 ounces. One teaspoonful added to a glass of water every three hours. Its action is antiseptic, stimulant, antispasmodic, and ano- dyne. Its antiseptic properties are remarkable — forming one of the best intestinal bactericides ever introduced. Try it ; you can rely on its action every time, and for cholera morbus it is the remedy, sweeps out of existence every germ with which it comes in contact ; a perfect scavenger to the bowels. 3. Cholera, Epidemic. — Due to the presence of the comma bacillus, a pathogenic microbe which has a perennial area on the banks of the Ganges, but under certain electrical and me- teorological conditions is disseminated over the surface of the earth, by human intercourse. The seizure is a premonitory diarrhea, debility, muscular tremors, vertigo, nausea, vomiting, spasmodic griping pains in the bowels, depression of the func- tions of respiration and circulation, with great depression. The stools are like rice water, alkaline, and loaded with the bacillus. As the microbe grows rapidly, toxins and ptomains are liberated, vomiting becomes incessant, coldness, dampness, blueness, lividity of the lips, cold breath, unquenchable thirst, suppression of the urinary secretion and collapse. The comma bacillus is found only in the intestinal canal — - its ptomain, which is taken into the blood, is what paralyzes the nervous system and gives rise to the symptoms present. No definite line of treatment can be laid down; we merely enumerate a few remedies which are found to be of utility in every case. All authorities agree on the fact that the bacillus is promptly annihilated by an acid, hence copious enemata, re- peated several times in the twenty-four hours, of lactic and tannic acids, with peroxide of hydrogen in distilled water, in- ternally. A selection of remedies should be made from some of the following intestinal bactericides : Salol, naphthalin, sulphocarbolate of zinc, Warburg's tincture ; and all spasmodic action held in abeyance by administering small doses of the compound tincture of lobelia. Our readers will find as a prophylactic remedy, that none excels the ozonized coca wine, its acidity, its powerful bacteri- cide properties, being such that it wipes the comma bacillus out of existence. 184 Twentieth Century Practice. CHOREA. — Inco-ordinated movements, which prevent and interfere with voluntary motion, cease during sleep, are path- ognomonic of chorea. Choreic movements on one side of the body may precede and follow hemiplegia. An extreme form of this affection, with quick involuntary movements, is common in spermatorrhea due to masturbation, in which maniacal excitements, physical dis- turbance are common, associated with which are irritability of temper, emotional attacks and mental enfeeblement. The jar, the want of equilibrium between the gray and white matter of the brain and spinal cord, to which this affection is due, may be the result of shock, mental overwork, or emo- tional disturbance, the ptomain or toxins of disease germs, especially those of rheumatism and syphilis — the same poisons which give rise to endocarditis. In eighty per cent of all cases the toxins of rheumatism; in the other twenty per cent, a ptomain identical in toxicity is present. In the treatment of chorea, no definite rule can be laid down. All predisposing and exciting causes must, if possible, be re- moved, such as masturbation, worms, rheumatism, emotional shock, and every effort made to improve the general health and increase the nutrition of the body, by daily baths, massage, country air and best of diet. If the chorea can be traced to irritation of the reproductive organs, masturbation or sexual excesses, in either sex, they should at once be placed on large doses, as large as can be, of the tincture of the green root of gelsemium, as this is our best genital sedative and aphrodisiac, an allayer of all irritation in the sexual glands. The reproductive organs of both sexes are largely supplied with sympathetic nerves. No medicament equals gelsemium, it soothes or sedates the motor tracts of the cerebro-spinal sys- tem, and controls the sympathetic ganglia. The dose must be such as will control the involuntary movements. Try it. If it fails, combine it with passiflora incarnata, which aids its action immensely, both being active sedatives. If the heart be irritable, feeble, with capillary circulation languid, add to the gelsemium small doses of strophanthus. The action of this combination is soothing, strengthening to the heart muscle. Skullcap is another remedy from which marked benefit is derived in chorea. Administered in large doses, its action is restorative to the jarred gray and white matter of the cord. Twentieth Century Practice. 185 The ozonized fluid extract of musk root is another invalu- able remedy in chorea. Good results always follow its ex- hibition in one-half the cases. It completely controls the in- voluntary movements. In the other half its administration is a failure. The never-failing remedy in all cases and under all condi- tions of life is the ozonized solution of cacodylate of sodium. This remedy undoubtedly acts by its promoting nutrition of the nerve centres and heart. The success of this remedy depends entirely upon its mode of administration. It should be commenced in small doses and gradually increased dose by dose, until its physiological action is obtained. Then it should be diminished to drop doses, never left off altogether, but when all untoward symp- toms subside, then gradually increase, always added to a little water and given after meals. Thyroid extract and c. p. solution of spermin have effected some excellent cures. What percentage of cases of chorea and epilepsy are due to the germs of tubercle and syphilis, no one can correctly appre- ciate. A weakened patch in the brain or bulb, with either of those two disease germs in the blood, will give rise to epilepsy. An imperfect nutrition or weakened patch in brain and cord, with impaired nutrition of the nervous ganglia, or group of nerve cells, with the same or other germs present, will give rise to chorea. Besides, there are the ordinary reflex causes. The two affections demand an alterative and tonic course of reme- dies — all the time — with repeated small blisters of about the size of a silver dollar, to nape of neck, for six hours daily, twice a week, as there is always a coexistence of spinal tenderness, greater spinal impressibility and other hybrid ailments. In addition nothing should militate against the use of avena sativa day by day, as the tissues are starved. It increases the motor power of the heart, tones the nerves, increases the number of nerve cells, overcomes the want of equilibrium between the gray and white matter of the cord ; relieves insomnia, over- comes mental weakness, and inco-ordination of muscles. If, however, the motor phenomena are peculiarly violent, the pa- tient must have rest — rest from excitement, from noise, from harsh words, from taking any active part in the struggle of life. We do not endorse the use of bromides in either ; it is true they suspend the reflex impressibility of the medulla oblongata — the seat of reflex action — but it is also too true that they 1 86 Twentieth Century Practice. diminish nervous energy; true vital stamina is lowered; motor and sentient power diminishes under their use. They soothe, dispose to sleep, but they blunt the intellectual faculties, impair the memory, confuse the ideas, render the individual dull, stupid, apathetic, with a tendency to somnolence. They im- pede speech, weaken special senses, make the body infirm, feeble, unsteady. Its effects on the ovaries and testes are to de- stroy, or obliterate the secreting cell; being analogous to cas- tration, so that sexual power is abolished. The bromides de- vitalize the mucous membrane of the stomach, give rise to gastric catarrh (sarcina ventriculi), nausea, flatulence, etc. It also slows the heart, covers the skin with (bromine rash) acne. Now, none of these symptoms are produced by the ozonized fluid extract sumbul. It has precisely the same action upon suspending the fits or the choreic twitching, but never impairs, nor damages, nor atrophies the sexual apparatus. The bro- mide craze has had its day. Many brilliant minds have been wrecked by its indiscriminate use; it has caused impotency to be very general and sterility exists from its use to a very alarm- ing degree. The most eminent authority in this country says that chorea is want of equilibrium between the gray and white matter of the spinal cord. Predisposed to by inherent nervous debility, and brought into active existence by the toxins of disease germs, such as the bacillus amylobacta and others. Sometimes it comes on sud- denly after some emotional excitement, fright, fear, anxiety, worry, etc. Often the sequel of reflex irritation, such as worms, masturbation, constipation, burns. Most common between five and fifteen. Characterized by irregular movements, which increase under observation or excitement, and cease entirely during sleep. In this neurosis, the involuntary movements are very variable, from a mere restlessness or awkwardness of manner to gro- tesque expression, etc. The patient cannot keep still, constantly either raising shoulders, jerking his head, twisting fingers, shuf- fling feet. The symptoms present in each individual case depend upon what portion of the cord is implicated in the neurosis or jar. If from a fright, or some emotional condition, the •cervical portion of the cord involving the sympathetic is af- fected ; then the muscles of the face and larynx are involved. Stammering results, difficult mastication, swallowing, choking spells. Twentieth Century Practice. 187 Lower down the cord, hands, arms, side of the body, may be'eome seriously implicated. The general health in chorea is always impaired, and the case is of such a nature that it speedily causes mental deterioration, and might terminate fatally through some complication, as organic cardiac disease. If a child, it should be taken from school, placed under the most perfect hygienic conditions attainable; if of more ma- ture years, they should suspend all avocations, lay off till re- covery is assured. The general health should be built up, the system fortified by every possible means, nutritious food, bathing, massage, flannel clothing, rest, and healthful surroundings. Then the attending physician will select a remedy, probably some one of the following which he deems the most efficacious in curing the malady. It is not necessary for us to discuss whether the pathological condition be due to a toxin of the amylobacta or to a lesion or jar. Cocodylate of sodium has acquired a firm reputation as a bactericide, a promoter of nutrition, and if properly managed as to its dosage will cure every case of chorea. An ozonized solution is probably the best form, as the dose can be well regulated, added to water and given with the meals. In prescribing the cacodylate in chorea you are sure of suc- cess, so it is well not to rush it, beginning with 2-drop doses thrice daily, increasing the dose each day by one drop addi- tional, until its physiological action is obtained. As soon as this is visible decrease dose by dose, in the same manner as it was increased, continuing in this way between the minimum and maximum until a cure is effected. Passiflora incarnata is rapidly acquiring a reputation in the cure of chorea. An excellent remedy, a rejuvenator of the great sympathetic, a vitalizer, a reconstructive of our entire nervous system. As it is non-poisonous, it can be administered in large doses. If it fails in arresting the involuntary move- ments, add to each dose a few drops of the tincture of green root gelsemium. Chloral hydrate is another remedy from which excellent re- sults can often be obtained. It has a peculiar and marvelous action of its own, a powerful germicide, rectifies, fortifies the nerve centres, prolongs sleep indefinitely, gives nature a chance to recuperate. As an enema it is even more beneficial than when administered orally. 1 88 Twentieth Century Practice. Skullcap is a remedy in the form of a decoction that is well adapted for patients of mature years. Taken just as freely as the stomach of the patient can tolerate it, so as to induce a partial suspension of the nervous system, which is recognized by numbnes or anesthesia of sensation and partial paralysis of motion, it will do good, energizing work in chorea. Protonuclein, the active principle of life, is suppository form, will cure chorea. Although this remedy, chemically speaking, is a phosphorized proteid, its therapeutic effect is to induce leukocytosis, a vast increase of white corpuscles in the blood stream, augmenting vital force, cohesion of the chaotic cord. Take it all in all, it is a good curative agent in chorea, best in suppository, as it is active as a reconstructive without stimulating the heart. CIMICIFUGA RAC, FL. EXT.— Of special utility in acute rheumatism. Stimulates the nerves of nutrition, effi- cacious in whooping-cough and all spasmodic diseases. CINCHONA. — The bark of the cinchona tree, commonly known as the Peruvian bark. Therapeutical Cases. — Tonic, vitalizer, contains numerous alkaloids of immense value, and a vast number of preparations. Cinchona FL Ext. — Dose, 10 to 30 drops added to water, every three hours. The most valuable tonic in the materia medica, protects the red corpuscles of the blood from the ma- larial and other germs ; promotes an appetite, increases the as- similation of nutritive matter, the number of red discs in the blood, as a tannate, in the form of port wine and cinchona, with aromatic sulphuric acid, is one of the best of all tonics at the change of life. Port wine, one quart ; Peruvian bark, one ounce ; pulverized cloves, cinnamon, each one ounce; one dram of quinine and one ounce of aromatic sulphuric acid; dissolve these two together and add to the wine. Capsicum should be added. Half a teaspoonful to a teaspoonful is a dose. Prunia, four ounces; sulphate of quinine, two drams; aro- matic sulphuric acid, one ounce. Mix. S. One teaspoon- ful, So patient takes three prior to chill. 'Bisulphate quinine, sixty grains; syrup licorice, two ounces. 'Mrxi^ S: Doses sufficient. Twentieth Century Practice. 189 CIRSOCELE. — A term used ambiguously and synony- mously with varicocele ; a dilated condition of the veins of the testes and scrotum, feeling like a bag of worms. If not amenable to the usual treatment, by the application of the distillate of witch hazel, thrice daily, the wearing of a suspensory during the day, and persevering with tonics and nutritious food, ligature is resorted to with very poor success. CIRCUMCISION.— A sacrament of the Jewish Church, introduced by that great, far-seeing Law-Giver, Moses, con- > sists, as performed by the rabbi, of a mere slit of the superior aspect of the prepuce. The flaps or ears on each side of the slit are, in the course of a few months, entirely absorbed, leav- ing the corona glandis completely uncovered, consequently phimosis and paraphimosis never appear. In adult life it is usually performed for the relief of those two affections, and it is necessary to remove it entirely, uniting the cut surfaces, skin, and mucous membrane with lead-wire sutures and applying a dressing of peroxide of hydrogen. The performance of circumcision has many advantages, some few disadvantages. When removed, no secretion of smegma is possible, to excite balanitis ; no abiding place either for the micrococcus of gonorrhea, or microbe of syphilis, or rank secretions (microbic) of courtesans, or the germs of herpes preputialis, or chancres. There can be little doubt of its removal promoting the growth of the penis ; its disadvantages are few, blunting or deadening the nerves of the corona glandis the only one worthy of mention. CLITORIS. — In ballet or dancing girls, cyclists, the clitoris if often attacked with inflammation, effusion of lymph, and en- largement. In some cases the hypertrophy is great, and term- inates in abscess; in other cases, in cystic degeneration. The excessive development is in some cases congenital, being so large that some are in doubt but that they may be males. The clitoris is sometimes the seat of cancerous deposits. The en- tire organ may be diseased, or its prepuce. Induration or enlargement may be due to self-abuse. The treatment of inflammation, and its results, must be upon general principles, with alteratives and tonics. CIRRHOSIS. — A diseased condition of various organs of the body, embracing chiefly the liver and kidneys, and charac- 190 Twentieth Century Practice. terized by the formation of fibrous tissue in these organs. This hard tissue either contracts or enlarges, thus giving rise to either atrophy or hypertrophy. In the former it is hard, sur- face nodulated, with edema of the legs; in the latter usually jaundiced and no dropsy. Its great causative factors may be alcohol, syphilis, mercury, malaria, defective and perverted digestion, auto-intoxication, gastritis, intestinal obstruction, and whatever favors putrefac- tion of intestinal contents loads the liver with toxic substances which it is unable to destroy, and it becomes overworked, either atrophied or hypertrophied, and its normal structure usurped by fibrous tissue. Although the malady may be incurable, still by the removal of the cause, and the administration of periodate aurum at night, and the chionanthus virg. during the day, a stay on the morbid condition is induced. Many recoveries are noted. In my experience with the fringe tree bark in cirrhosis, I deem an infusion to be the most efficient agent in the materia medica. Although an incurable affection, much can be done to arrest its progress and prolong life. The removal of the invading agent which produced the fibrosis is a point ; whether it be alco- hol, malaria, carbonaceous substances ingested, solar heat, drugs, syphilis, it is immaterial, for no remedy can restore the cells of the injured machinery by which the crippled organism survives. It matters little whether the degenerative changes are either fatty or amylaceous, if the damage is done by an in- crease of fibrous tissue and the condition shows fat or starch, alcohol in all its forms must be rigidly forbidden, as well as all fat and starchy food — the physiological function of the liver must not be taxed with either. Diet must be nutritious, be re- stricted to white fish, eggs, milk, bread, fruit, and vegetables. Daily bathing, massage. The indigestion relieved with comp. tine, matricaria and phosphate of soda, which will arrest the fermentative changes on the stomach. If it be due to alcohol and syphilis, the kolatina tablets operate well, one every night at bedtime. They are of signal service, with a few grains of periodate aurum, and during the day, comp. saxifraga, effect marvelous results in the liver — ar- resting changes and gummatous formation. The action of syphilis and alcohol, together with malaria and solar heat, closely resemble each other in the production of cirrhosis of the liver. Kolatina, periodate aurum, saxifraga, effect very Twentieth Century Practice. 191 .-searching action in restoring some of the dilapidated cells, ef- fect combined a standstill of growth of morbid tissue. • Continuous stimulation over the liver by means of a large guaiacol plaster should never be overlooked, as it invariably does good, arresting degenerative changes, aiding absorption, thus clearing the gland of all debris, old broken-down cells. In the management of all cases of cirrhosed liver, there are two complications of great magnitude, and these are a weak, di- lated heart, and abdominal dropsy. For the former we need digitalis and creatinin ; for the latter, apocynum, a drug of un- excelled merit. Ascites is a sure sign that the tension in the portal vein and its tributaries in the peritoneum has been raised to the oozing point, or that inflammatory effusion has taken place, that the liver function is seriously impaired. The mere mechanical affection of the distention of the abdo- men is serious; all the viscera are compressed, their working faculty impeded; the diaphragm is pushed up, embarrassing Tx)th the organs of circulation and respiration, thus a variety of complications are set up. Apocynum, ozonized tincture, in from 5- to 30-drop doses, has a special action in all cases of ascites, although many phy- sicians prefer the decoction. COCA. — The leaves of the Erythroxylon coca, which grows abundantly in Bolivia and Peru. Physiological Action. — Its administration increases the heart's action, by stimulating the ganglia of the great sympa- thetic; energizes the pneumogastric and vagus; equalizes the motor cells of the gray matter of the brain, arrests normal metamorphosis ; appeases thirst. Therapeutical Action. — Chewing the leaves will appease hunger, thirst, fatigue. It is an excellent remedy for dipso- mania, the opium, chloral, and alcohol habit. It restrains tis- sue metamorphosis, diminishes the amount of urea excreted; valuable in wasting diseases and in the convalescing stages of fevers ; a tonic with wide range of action. Whenever you need the aid of a potent drug to sustain the vital power, under the condition of extraordinary fatigue and privation, prescribe coca. It promotes cohesion of nerve force ; ■especially useful in nerve tire, worry or exhaustion. It contains a valuable alkaloid, muriate of cocain, an anes- 192 Twentieth Century Practice. thetic to the mucous surface of intensely sensitive parts, as the ear, nose, mouth, urethra, vagina, rectum. Preparations and Doses. — A bolus of the leaves is used for chewing. A fluid extract in 30- to 60-drop doses. Coca et celerina, same dose, great utility in neurasthenia. The wine is a tonic especially adapted to public speakers, singers, actors. It is a tensor to the vocal cords, strengthens- and increases the volume of the voice. Coca wine, dose, a tablespoonful. Cocain suppositories, whose use as a genital sedative is in- valuable. For all neuralgic or painful conditions of the rec- tum, they are excellent. COFFEE. — Medicine is but a means to a desirable end; often it is very disagreeable. Patients cannot take it at times,, because it is nauseatingly objectionable. On this very account is the doctor so often the bugbear of children. On the other hand do we constantly find patients craving food indulgence. Perhaps one of the commonest foods is coffee, and it is one of the first things many recuperating patients call for. But it is one of the things that it is a routine practice to forbid sick peo- ple the use of. There is no reason why coffee should be cut off when nux vomica or other nerve stimulants are given, for one aids the other; they are, therapeutically, synergistic. Convalescence is often hastened by the use of a good brand of well-made cof- fee. It is a much better stomachic tonic in many cases than any of those having a regular place in the materia medica. We have known physicians to destroy what little appetites their patients still had left by the peremptory withdrawal of their coffee. The interdiction of coffee to all sick people is a routine practice that is indefensible. Cases of nerve exhaustion do better with it than they do without it. This is the rub. There are exceptions. One of these is when coffee sets up stomach trouble and so-called biliousness. But it seldom does this if the coffee is properly made. We have never seen anything but good results follow the use of coffee made as follows : Java and Mocha coffee should be blended to suit the taste. The roasted beans are to be finely ground, the finer the better. A tablespoonful of this coffee is to be used for each cup of water. It is wetted with enough cold milk to give the finished product a rich light brown color, say two tablespoonfuls of milk Twentieth Century Practice. 193 to each one of ground coffee. This is allowed to stand in a closed pot for at least five minutes. At the end of this time boiling water is poured over the milk and coffee mixture, a cup- ful to every tablespoonful of ground coffee, as already stated, after which the pot is again closed and set over a moderate fire to simmer for about ten minutes, or to boil for one or two minutes. It is then ready. If not used at once, it should be decanted so as to avoid the abstraction from the coffee grounds of those ingredients that spoil the taste of the coffee and injure the stomach. Coffee thus made is not bitter, and when bitter, it has abstracted objectionable material, it has boiled or sim- mered too long. Coffee thus made does no injury, but it is a nerve stimulant, or appetizer; it cheers, invigorates, and aids •digestion. Attention to its mode of preparation, provided the correct kinds of coffee are used, insures to a patient one of the best aids we have to hasten and perfect convalescence, or to sustain one under nervous strain, due to operation or other depressing in- fluences. The exceptions do not preclude its use where it does unquestionable good. When there in a community the germs of typhoid fever, cholera, erysipelas, scarlet fever, and the various types of ma- larial fever, which are transmitted almost entirely through the medium of food and drink, coffee is a valuable agent, and may he used as a drink instead of water. It is a valuable agent in assisting the digestion of food, and aids the blood in taking up more nourishment than it would without it. It quickens the circulation of the blood and respiration. It is also stimulating and refreshing (due to the caffein it contains). In tiding over nervousness in emergencies, it is a sovereign remedy. Taken in the morning before rising, minus cream and sugar, it acts in many cases as a superior laxative (probably from the riot water contained in it). As a stimulant and caloric generator in cold weather it is •one hundred per cent ahead of whisky and other liquors. As a disinfectant it is one of no small usefulness in the sick -chamber. The use of coffee as a disinfectant is generally known, but it is doubtful if the majority of people are aware of its true value in this direction. They probably know that it is handy and 194 Twentieth Century Practice. harmless ; but besides these qualities it is really one of the most powerful and effective agents known, as has been shown by re- peated experiments. In one case a quantity of meat was placed in a close room and allowed to decompose. A chafing dish was then introduced and 500 grams of coffee were thrown on the fire. In a few minutes the room had been entirely disin- fected. In another room, the fumes of sulphuretted hydro- gen and ammonia were developed, and the smell — which no- words can express — was destroyed in half a minute by the use of 90 grams of coffee. As a proof that the noxious smells are really decomposed and not merely overpowered by the fumes of coffee, it is stated that the first vapors of the coffee are not smelled at all, and are therefore chemically absorbed, while the other smells gradually diminish as the fumigation continues. The merest "pinch" of coffee is usually sufficient to cleanse a sick-room, even in aggravated cases. The best way to employ it is to freshly pound the coffee in a mortar, if no mill is at hand, and sprinkle it on a red-hot iron surface. Caffein citrate is the best form for medicinal use, and it is to this that the kola nut paste owes its marvelous power in habitual constipation. Invaluable also as a bracing tonic in chronic diseases. Dose, 1 to 2 grains every three hours, or more frequent. This remedy is indicated in all forms of headache or neuralgia ;. of the greatest efficacy in all organic affections of the heart, with imperfect compensation; regulates the heart's action; operates well in chronic interstitial nephritis, with edema and difficult breathing, as a diuretic and antidote to opium poison- ing, and appeases the appetite for stimulants. COLD. — Acts chiefly from without, freezing inwards, caus- ing serous congestion of the three great cavities; with giddi- ness, inability to see, weakness, and rigidity of limbs; almost imperceptible respiration and pulse ; tendency to profound sleep r or coma. Patient must be placed in a room without fire, and an attempt made at restoration of circulation and sensibility, by rubbing the body with snow, or ice, or cold water. Fric- tions with flannels, long continued; very gradual application of warmth; a stimulating enema, warm milk, with capsicum, coffee, beef-tea, or warm wine. COLIC. — Cramp, spasm, neuralgia of the nerves that sup- ply the circular muscular fibres of the intestines, is a most ex- Twentieth Century Practice. 195 cruciating, painful affection ; it may be produced by any toxin or poison, indigestible food, giving rise to fermentation and bacteria, acrid bile from a congested liver, worms, irritants, and poisons generally; it may be due either to cold or to a metastasis of gout or rheumatism or obstruction. The pain of colic comes and goes, rolling or twisting in char- acter, relieved by pressure. There may or may not be vomit- ing. In some cases the spasmodic action may be so acute, so intense and exciting that fecal contents are vomited. The pain is usually so severe, the reflex effects so disastrous, that immediate relief is imperatively demanded. Heat and moisture are always at hand, and they should be applied with a liberal hand, hot, moist application over the ab- domen, hot baths, hot drinks of warm water, with euphorbia pil. ; warm water enema, 102 degrees F., with a teaspoonful of the same remedy to the pint of water. In administering these enemata, place the patient on the right side, with the hips well raised. If these remedies fail, ad- minister chloroform orally, and chloral hydrate as an enema, with concentrated ozone to the entire abdomen. Once relieved, if the cause can be ascertained, then special remedies to meet the pathological condition as if due to fer- mentation of undigested food, administer siegesbeckie tablets; if due to acrid states of the bile, give periodate aurum; if due to rheumatism prescribe glycerite of wintergreen, in essence of menthol, with a cocain suppository. What is termed lead colic, is much more common than is generally understood ; drinking water from tin or leaden ves- sels, cider prepared in lead; claret wine, to which is added acetate of lead to taste more cooling. Its diagnosis is based upon the history of the case, a peculiar aspect of the skin, blue line on the gums, dyspepsia, constipa- tion, and depression of spirits. In the seizure severe pain ensues in the region of the navel, a feeling of indescribable wretch- edness, vomiting, constant change of posture, struggling or crying with pain; stools, if passed, are dark-colored and in knotty lumps ; tongue pale ; tremulous, if not relieved ; inflam- mation, delirium, convulsions, paralysis, apoplexy, asphyxia, gangrene of bowels. Lobelia and opium. Let the patient drink freely of warm water with these two remedies. They are valuable specifics; soon give relief. Iodide of potass in saxifraga unites with the lead and eliminates it from the body. Sulphate of alumfna, 196 Twentieth Century Practice. in 5-grain doses, thrice daily, prevents the ingress of lead into the body. Quinine, with capsicum, are the best remedies for the paralysis, with rest and massage. Warm bath with one pound of sulphuret of potassium unites with the metal and elim- inates it from the tissues. Canned fruit and vegetables in tins give rise to irritation of the intestinal nerves ; fine, delicate nerves supplying the muscles, the duodenum usually first affected. As a prophylactic, 15 drops of aromatic sulphuric in a glass of lemonade is good thrice daily; the iodide potass, in comp. saxifraga, when ad- ministered, unites with the tin and eliminates it from the body. Colic in hand-fed infants is due to swallowing air along with their food and to fermentation, which can be obviated by fen- nel seed tea, slightly acidulated with lactic acid. Failing in this, and the colic severe, the best immediate treatment con- sists in irrigating the lower bowel with a large quantity of warm water or administering a copious warm enema. The application of hot fomentations to the abdomen and of warmth to the feet are also serviceable and 20 drops of brandy and a dose of carminative may help to relieve the child. An aperient is usually indicated to clear away irritating matter, and if the bowels are habitually constipated this should be attended to. When there is obstinate recurring colic small doses of passi- flora are occasionally useful as a palliative while the diet is being gradually regulated. The alleviations thus produced en- courage the mother to persevere. Other children who have chronic indigestion accompanied by recurrent colic are often relieved by small doses of protonuclein, taken immediately be- fore meals. COLLAPSE. — A state of condition that signifies great de- pression of vital power, liable to follow any accident, injury, or concussion, or inhalation or absorption of any poison, or any depressing passion or excess. Symptoms are very variable. Most commonly, however, we find the patient lying on the back, with a cold skin, feeble pulse, sighing respiration, half unconscious. If the force of the shock or injury, or poison, has fallen upon the vascular system, there will be syncope or fainting, pulse and respiration im- perceptible ; if upon the nervous system, patient bewildered, in- coherent, vomiting, coma, convulsions, paralysis of sphincters. The duration of the stage of prostration is variable, depend- and Dictionary of Diseases. 197 ing on the power of vital resistance inherent in the patient and the amount of violence inflicted or poison absorbed or degra- dation of living matter, commonly from a few to forty-eight hours. The mode or manner of recovery from shock or collapse is termed reaction, everything depending on the nature, degree, or quality of that reaction. If, aided by proper means, it is perfect, we have recovery; if in spite of our best efforts it is altogether wanting, we have death: if it is imperfect, then it is followed by fever, a salutary effort of vital force for recovery. The indications in treatment are to stimulate vital forces to healthy reaction. If the patient is cold, shivering, respiration and pulse feeble, diffusible stimulants should be administered, such as brandy and water, or capsicum, or some preparation of ammonia; if incapable of swallowing, the same remedies should be administered by the rectum in an emulsion of slippery elm, and spirits of turpentine added. COLLIXSOXIA. — Stone root possesses most extraordi- nary properties, being astringent to the entire intestinal tract. In its action it resembles stone crop, the great bowel invigorator and antiseptic, hence it is of great value in diarrhea, dysentery, gout, catarrh of the bowels, bladder, uterus. Take it all in all, it is a most remarkable drug in all rectal affections. Preparations and Doses. — From 30 to 60 drops of the fluid extract every three hours. Xo other preparation of any value. COMA. — Deep sleep, one deeper than stupor, may be due to fracture of the skull, effusion of serum or blood, cerebral softening, with paralysis; to microbes or gases poisoning the brain ; urea in the blood ; the action of acronarcotics. The treatment must be according to the cause; administer- ing remedies 'either by the stomach, rectum, skin, generally to neutralize a poison, an offending material — then to rouse up vital force by friction, shampooing, flagellations, electricity, enemata of glycerin with peroxide of hydrogen; a drop of a one per cent of nitroglycerin on the tip of the tongue has a magical effect on the heart and brain. CONIUM MACULATUM. — Of all acronarcotic drugs, conium is the only one that perfectly inhibits the evolu- tion and growth of the cancer neoplasm, and all that group of germs which give rise to symptoms of malignancy ; it is there- 198 The Germicide 20th Century Practice fore a remedy which stands alone, useful and powerful for good. It can, under all conditions, be given with perfect safety, and can be relied upon when administered in allaying irritation, subduing pain, upholding the powers of the consti-' tution ; favorably influencing nutrition and secretion. Pain is an essential symptom of malignancy; of degenerate changes ; of nerve and arterial derangement, and conium abro- gates the pain of that formidable malady; affords comfort when life is intolerable. The conium extract, combined with elixir red, is the best form for general administration, efficacious and reliable, never fails to relieve pain, renders life comfortable. As regards the dose, limit it by its effect ; it need not be stinted by any rule. When commencing, half of a three grain pill every three hours will be sufficient, but after a week or two it can be in- creased to one and still larger doses. It can in all cases be depended on to relieve pain and render life tolerable indefinitely. CONTINENCE AND INCONTINENCE OF URINE.— Continence, or an inability to pass urine, may be due to exces- sive acidity of the urine; overirritability of the muscular coat either from the acidity or overdistention ; weakness of the sphincter; reflex irritation, as balanitis, adhesion between pre- puce and glans penis, smegma around the corona ; drinking ex- cessively causing too great a flow; calculi; malformation; con- traction of the bladder owing to hypertrophy of its walls; metastasis of the amylobacta of rheumatism, enlarged prostate. Acidity to be overcome by alkalies, acetate potassa, uric acid solvent, fruits containing vegetable acids are changed in the system to alkalies; spasmodic contraction, belladonna, gelse- mium ; lack of force in the sphincter, ergot, salix nigra, passi- flora incarnata. Try alkaline baths hot ; a stream of water from a height often starts bv acting on the sympathetic. All failing, draw urine off. Incontinence, an inability to hold the urine, is much more commonly met with than continence — extremely prevalent among children; neurasthenic ladies, and more rarely among adult males. The causes are mainly the same as continence, inherent de- bility lying at the root of nearly all cases. Try some of the following remedies: iron and belladonna;: and Dictionary of Diseases. 199 gelsemium and bromide of soda ; ergot ; nux ; damiana, can- tharides, muira puama, rhus aromatica, salix nigra, pichi, passi- flora incarnata, stone crop. CONVALLARIA MAJALIS.— The leaves and other parts of the lily of the valley. Therapeutic Action. — A valuable remedy in functional and organic disease of the heart. Its action is almost identical with digitalis in dropsy, not so definite as strophanthus, but a valuable remedy in heart mischief. Chemistry. — Two glucosides have been insolated, also an alkaloid named maralin. Preparations and Doses. — An infusion of 10 grains of the flowers to 6 ounces of water. Dose, tablespoonful at suitable intervals apart for dropsy. A tincture and fluid extract are best adapted for general exhibition ; small closes, watching its effects. CONCENTRATED OZONE.— An extremely valuable and powerful anodyne antiseptic, with the property of penetrating to deep-seated parts. Its principal action is on the nerves, blunting their sensibility and thus relieving pain. Rubbed over the entire abdomen and over the lumbar por- tion of the cord, it completely anesthetizes all the sensient uterine nerves, not in any way interfering with the motor, and thus relieves the pain of parturition. The insertion of a few obstetric cones renders labor painless (millions of ladies use them) with a certainty. It is a remedy for the relief of all human suffering — a perfect anodyne to pain. It is best to oil the part, then rub it in. Internally in one or two drop doses, in syrup, it is a sedative and anodyne; a safe hypnotic for children; relieves colicky pains of the intestinal tract and toothache. CONVULSIONS. — The common predisposing causes are an unstable and irritable nervous system; the exciting causes are rickets, laryngismus, stridulus, blows and concussions on the head, cerebral hemorrhages, birth palsy, meningitis, uremia, pneumonia, fevers, etc. Most causes are all forms of reflected irritation, as teething, worms, burns, injuries, indi- gestion, asphyxia, invariably associated with malnutrition of the nervous system, giving rise to coarse brain lesions. The immediate treatment of convulsions, from whatever cause, should be the immersion of the body in a warm mustard 200 The Germicide 20th Century Practice bath, drying, followed by friction over the entire body. If not prompt relief, follow with enemata of warm water into which one teaspoonful of euphorbia pil. is added. This is never-fail- ing, provided life is not extinct. The same remedy internally, 15 drops in warm water and repeat if necessary, is excellent to correct the disordered brain function, cerebral neurosis. Two-thirds of the convulsions in children are due to auto- intoxication from the decomposing products of digestion, no remedy is so effectual in antagonizing those products and in- testinal bacteria. Euphorbia pilulifera is a safe, reliable remedy in the cure of convulsions ; as a prophylactic one of the best. Convulsions occurring during the progress of parturition : Convulsive movements of the limbs, muscles of the face; di- lated pupils, red or livid countenance, fixed or convulsive eyes. foam at the mouth, involuntary escape of urine and feces. The ptomains are present in the blood in all cases and it is imperative to remove all sources of irritation. Empty the bladder and rectum, place a piece of rubber between the teeth. Give infusion of lobelia freely by mouth and rectum as soon as possible. If the urine is albuminous and scanty, give di- uretic teas, then administer bactericides, such as either peroxide of hydrogen, or resorcin, or salicylate soda in siegesbeckie, or bromide of ammonia with passiflora to neutralize the ptomains. CONSTIPATION has come to be a very common ail- ment, not only with sick people, but among those who call themselves well. It is one of the many symptoms of that very prevalent disease, dyspepsia. Its causes are numerous and varied. Anything that interferes with the digestive process may produce constipation, at least temporarily. With feeble people, a little overwork, mental or physical, will render diges- tion imperfect; and the food not being properly elaborated remains in the alimentary tract, undergoing partial decompo- sition. The gases that are given off distend the stomach and bowels, causing pressure on the nerves in the adjacent organs, which is sometimes followed by severe pain, perhaps cramping. The latter can generally be relieved by the application of hot compresses over the affected part; or if the trouble is in the stomach, a glass or two of hot water will send up the gases, relax the contracting muscles, and stop the cramping. A very common cause of constipation is the use of white flour bread; it should be banished from our tables. Another and Dictionary of Diseases. 201 cause of extreme torpor in the bowels is highly seasoned food. Those who like their foods well salted, hot with pepper and other condiments, will sooner or later have impaired digestion in some form. Persons who are inclined to be plethoric fre- quently have a sloughing condition of the bowels, a looseness ; in other words, diarrhea, which may in time become chronic, But those who are lean and muscular often suffer in a different way. The use of salt, pepper, spices, and other irritating sub- stances begets inflammation of the mucous membranes. This burns up the natural fluids which are intended to lubricate the parts, and they are rendered dry and harsh. After a time the bowels become shriveled, inactive, torpid ; they can only be evacuated by persistent straining, and finally they will not move at all without assistance. Much sugar clogs the liver with sac- charine matter, and it fails to do its work; the bile is retained in the blood ; and the feces, no longer softened by that natural lubricant, become impacted in the colon, as well as in the small intestine. The latter then loses its function, and cannot se- crete those intestinal juices which should aid in the digestive process. And so it is that the individual goes on from bad to worse; his food distresses him, or it fails to nourish. He suffers from nervousness, insomnia; he has periodic headaches, or a rush of blood to the head. In some instances there is twitching of the eyes, or the muscles of the face ; and there are symptoms of St. Vitus' dance — tetanus. The hands and feet are inclined to be cold, and the general circulation is sluggish. The odor from the body is offensive and the breath the same, owing to retained fecal matter which is poisoning the system. In fact, all the excretions have a foul odor; and the blood is so thick that it can scarcely circulate in its vessels, especially the capil- laries. The pulse at the wrist is heavy and indistinct, sometimes the beats intermittent. There is a sense of oppression about the heart; and the patient wonders if he has organic disease of that organ. He can settle the question, however, by finding out whether his pulse is normal at any time ; for if the beats are not regularly irregular, there is no organic affection. There is simply functional disturbance; though constant dosing with digitalis and other medicines that are often given to whip up the heart's action will very soon create trouble that may be serious. This suggests another cause of chronic constipation, and 202 The Germicide 20th Century Practice other dyspeptic symptoms. Those who take much medicines are frequent sufferers from stomach troubles. The contents of the apothecary's shop do not strengthen the digestive organs, but weaken them, though the victims are sometimes very slow in finding it out. Usually they wake up to that fact after the mischief is done. Patients who, from any cause, have been long ill usually attribute their bad feelings to the disease — ■ whatever that may mean. Very few understand that they are making their own diseases as they go along; they see little or no connection between incorrect habits and their physical ail- ments. Our people need to learn what is meant by good health; that it is. the product of right living; and if we disre- gard the known laws of physiology we destroy health. It is only as we learn to relate ourselves normally to those life- giving agents around us that diseases can be avoided and good health secured. Pure air, pure water, wholesome food, regular and correct habits — these are what constitute health; they en- able us to preserve it. We cannot continue to enjoy it if we lead reckless lives. Exercise, rest, sleep, fresh air, sunlight, plain food, all are needed to give us a sound mind in a sound body. But suppose we have already parted with that inestimable boon, good health, what is to be done? If we have eaten badly, lived in stuffy offices filled with tobacco smoke and other impurities, taken sleep at all hours or clone without it, worked from morning till night with little or no relaxation, and vio- lated generally the laws that govern human life, what then? We must take the road back, as nature points it out. We must cease to do evil and learn to do well. If there is such a thing as a correct dietary let us find it, and take only as much food as the system can appropriate. We must also partake of it under conditions that favor perfect digestion; not eat in a hurry, rush off to business, and divert the blood away from the stomach to other parts of the body. Neither should we put faith in any or all of the so-called aids of digestion. These are frauds, every one of them; and we shall make this discov- ery after having been victimized a few times. These are ways to cure that are natural, and that address themselves to our reason ; ways in which normal function can be restored to organs that are weak or debilitated. On examining a patient who suffers from chronic consti- pation, we shall probably find one of two conditions : either there is a hollowness or cavity below the ribs, down where the and Dictionary of Diseases. 203 stomach and bowels are supposed to be, or else a full and ple- thoric state — an abundance of fat with very little muscle, and the bowels more or less distended with gases. In either case there is a loss of muscular fibre in these parts, and the power to contract is feeble. The abdominal muscles have also wasted away, and the spaces that they formerly occupied are filled with loose areolar tissue, or with layers of adipose ; either that, or there is next to no covering over the intestines except a shriveled skin. But how are we going to bring back normal functions to organs that are torpid? The peristaltic action of the bowels has been reduced to a minimum, and the same causes have been at work to weaken the abdominal walls. These must be strengthened ; we must promote growth of muscular fibre, not only in the bowels themselves, but in the muscles around them. The contractile force must be increased. There are several methods which we may employ in order to do this. If the patient is a woman, the first thing generally (if we want the best and quickest results) is to throw away the corset; also loosen the skirts and other underwear, and suspend every- thing from the shoulders. Then the muscles must be called into exercise, either by thorough hand manipulation or in some other way. A quick sponge bath in the morning, a light but whole- some breakfast, and a brisk walk once or twice a day in the open air and sunshine, will do much towards bringing fresh color to faded cheeks. Many are dying daily for lack of oxy- gen; and if we stint ourselves of this life-giving agent we shall suffer for it. Among business men and women, the heaviest meal at night does much to ruin health. It generally leads to late hours ; or if we retire on a full stomach the sleep is disturbed. Whether, as business is at present arranged, the heartier meal can come earlier is an important question. There is no doubt that taking only a very simple repast, say theree hours before bedtime, is, as a rule, conducive to good, sound sleep. If we add to these exercises a simple and nutritious dietary, this consisting largely of fruits (raw ripe fruits especially), grain preparations well cooked, a few fresh nuts rather than so much meat, and some plainly-cooked vegetables for the heartier meal, the most obstinate constipation can be over- come. For a time you may have to move the bowels with 204 The Germicide 20th Century Practice enemas of tepid water, but the latter should be gradually re- duced in quantity (absorbed if need be), until none what- ever is required. An occasional meal of raw ripe apples ex- clusively will help to. produce normal evacuations. By methods apparently so simple and yet so effective, we strengthen tissues that have been weakened, give tone to dis- abled organs, and restore functional action after it is well-nigh lost. This is the natural way; but the one commonly pur- sued is to swallow a cathartic, provoke vital antagonism in the alimentary tract, and cause the bowels to forcibly expel their contents. Then in a day or two there is just as much torpidity as before, and the same need of a purgative. We weaken rather than strengthen the intestines, and finally they refuse to act altogether. Let us go back to Nature and learn her way of doing things ; she is the best physician. Kola-nut extract in the form of paste or lozenge is the remedy for constipation, when due to a deficiency of vital force and normal secretions in the alimentary canal; it is the remedy when due to deficient peristalsis from any cause, es- pecially atony due to over-stimulation, which exhausts the various coats of the bowel. Kola-nut is the remedy where constipation is due to brain exhaustion ; it is an unexcelled nervine, has an inhibitory influence on the wear and tear of the central nervous system. Kola-nut is the remedy when due to deficiency of bodily exercise or movement. It is the remedy above all others when constipation is due to dilatation of the colon; to debility of the intestinal wall when an accumulation of feces takes place. The evils of the administration of strong purgatives, sup- positories of glycerin, repeated enemata, are they exhaust, enervate, wear out the tone of the different coats of the bowel. Of all remedies now used for constipation, the glycerin sup- positories are the most disastrous, as they drain off all the serum from the bowel, and predispose the rectum to cancer. Provided there be no hernia, no manformation, no invagina- tion or intussusception, rendering defecation difficult or painful, kola-nut extract is the proper remedy, because it vitalizes the entire alimentary canal, excites activity in the liver, increases secretion, stimulates peristalsis and copious evacuation. So regulated as to afford one motion daily, continued indefinitely ; intestines all the time getting better and better. In health and disease constipation gives rise to auto-intoxi- cation, which is visible in the headache, fever, foul breath, and Dictionary of Diseases. 205 coated tongue, and backache from the distended colon, fecal accumulation in the large intestines. All disappear under the use of kola-nut. Kolatina, also an extract from this remarkable tree, is in- valuable. Made up in the form of 5-grain tablets. The chief sources of auto-infection are the effete matter of the wear and tear of the tissues, foods, putrefactive changes, the toxins of disease germs. All the secretions and excretions contain toxic products; in order, therefore, to enjoy health, elimination should be perfect; there should be no retention of morbid products. Septic absorption, which is seen in the lassitude, the fever, the headache, gone feeling, is often due to arrested peristalsis, defective skin, impaired kidney. The feces, from birth to death, are a living mass of germs and toxins, struggling for supremacy; so long as they are ex- creted, the individual is safe. Habitual constipation calls for a tonic and germicide, such as the kola-nut paste or lozenge; besides it increases peristalsis. The cascara tablet or lozenge is perfectly tasteless, mild. Generally speaking, however, for inertia, or inactivity of the bowels, administer comp. matricaria before meals, and on re- tiring for the night a small piece of kola-nut lozenge. A diminution of the peristaltic action of the bowels from either deficient secretion of bile or other intestinal fluids, or possibly obstruction, exceedingly common. Habitual constipation is a common ailment. Its causes are numerous and varied ; its effect auto-intoxication, with nervousness, insomnia, periodic headaches, cold feet, etc. Im- perfect digestion, the use of baker's bread, highly seasoned food, much saccharine matter, clogs the liver, bile is retained, the natural lubricant is deficient, intestinal juices absent. The eternal drugging, the contents of a drug store do not strengthen the digestive organs, but weaken them. We want health-giving agents around, that disease may be avoided. Pure air, pure water, wholesome food, correct habits, exercise, rest, sleep, fresh air, sunlight. All the so-called aids to diges- tion are simply frauds. Regulation of the diet is important, which should include oatmeal, bran bread and certain fruits. The habit of defecation after the morning meal is excellent. A sponge bath, a brisk walk in the morning sunshine, aids much, for all suffering from constipation are literally dying for want of oxygen. In all cases the grand remedy for 206 The Germicide 20th Century Practice habitual constipation is the kola-nut paste lozenge, a small piece before retiring. It is a tonic, a vitalizer to the centre intestinal tract. It supersedes all other remedies, enemata often do .good; glycerin suppositories never, but by draining off the serum of the lower bowel are most productive of cancer. Sphincter stretching for prolonged constipation and anal fis- sure was introduced into the practice of medicine by a no- torious charlatan. Forcible dilitation of the anal sphincter is incompatible with good common sense, when we have drug treatment that will at all times overcome the difficulty. The daily use of one, two or three krameria suppositories will, in the course of two or three weeks, heal up the most in- tractable of fissures. The introduction within the sphincter muscle of 20 grains of the jelly of violets once a day will cause a dissolution of all strictures, all effused lymph, and cause a •complete suspension of all reflex irritation. As for rectal ulcers, which are mostly tubercular, the use of the guaiacal suppositories, one, two, or three per day, never fails to promote perfect cicatrization. The sphincter can be completely paralyzed, if the seat of spasm from any cause, by the use of the boroglyceride supposi- tories. CORNEA. — That portion of the covering of the eyeball next to the conjunctiva is called the cornea, from its fancied resemblance to a horn; transparent and nearly circular, form- ing the anterior sixth of the globe. It is a structure of ex- tremely low organization; difficult to induce a condition of partial death in it, either by violence, contiguous inflammation, unless the vital forces are very low, shattered in the extreme, or some cachexia, as tubercle, syphilis, gout, etc., be present. Acute Corneitis. — May be the result of injuries, cold, wet, exposure in, depraved subjects, or inflammation from other parts. When it takes place, it renders the polished and trans- parent surface of the cornea hazy, dim, and rough, or to look like ground glass. Symptoms. — Dull, deep-seated pain in the eye; intolerance of light; abundant secretion of tears; no mucopurulent dis- charge of any moment; a concentric plexus of minute vessels can be seen passing from edge of cornea ; a zone of pink ves- sels in adjacent sclerotic; haziness of cornea, with opacity. Patient affected very tuberculous; disease runs a very chronic course, lasting for months, leaving cornea permanently cloudy. and Dictionary of Diseases. 207 Opacity of the Corxea. — Invariably the result of inflam- mation, and effusion of lymph into the cornea, or between it -and the conjunctiva. When the effused lymph is light and cloudy it is called nebula; a limited white patch, such as results from a cicatrix, is called albugo; and if it is very dense, of the consistency of ivory, leukoma. Absorption may take place under alteratives and tonics, with a local use of brushing on iodide of potass, in solution ; or aromatic sulphuric acid, or alum and white of egg emulsion to eye, in nebula and albugo ; but they are useless in eukoma. CORNS, BUNIONS. — The cause in all cases irritation. Soak the feet in warm water and soda for half an hour. Have the following paste made : Half pound potash ; four ounces of water ; half ounce of extract of belladonna ; a little gum arabic and wheat flower, enough to form a paste; apply this to the corn for a few minutes, then remove it, loosen the edges of the corn with a sharp knife, re-apply the paste and in a few minutes the corn can be taken out by the roots. After it is out apply a lotion of sulphate of copper and chloroform. An- other method is to rub the corn well. down with emery paper every night and touch it with acetic acid. Another excellent formula for corns is : Salicylic acid, 30 parts; extract cannabis indica, 5 parts; collodion, 240 parts. Mix. This mixture is applied by means of a camel's hair "brush. In four days use a foot bath ; rub off the collodion. If any portion of the corn remains, apply again and again. The collodion fixes the acid to the part and protects it from friction ; the cannabis indica, an anodyne, and the acid reduce and loosen the corn. With reference to bunions remove the pressure of the boot or shoe by some mechanical contrivance. Then apply corn plaster or tincture iodine and collodion, or salicylate soda plaster. Salicylate soda and siegesbeckie make an excellent application. CORONA CLANDIS. — The phenomenon of sexual pleas- ure to some extent in the male, originates in the sensory nerves of the glans penis, thence transmitted to the seat of reflex action and the sexual sense in the brain. In the delicate, pinkish, semimucous membrane covering the corona glandis there are imbedded thousands of minute 208 The Germicide 20th Century Practice nerves, each of which terminates in a little pea-shaped bulb not larger than the 1-1200 part of an inch in length. These microscopical nerve-bulbs or ganglia are very highly- organized, exquisitely sensitive, and are easily and readily damaged by masturbation, by sexual excesses, abnormal sexual methods, as withdrawal during ejaculation; congress with harlots; sexual incompatibility; all unnatural practices; se- dentary occupations, blows, chancres, balanitis, exhausting diseases. All these and many other conditions deaden, blunt, exhaust, change the characteristics of the periphery of these nerves, may irritate them, and this irritation is carried to the testicles, seminal ducts, spinal cord, and brain. Irritation of these nerves renders their sensitive function chaotic — unim- pressible. The best method of treatment to restore these glands to .their pristine condition is to bathe the glans penis nightly, dry it off well, then smear it over with pure testicular juice of the bull. Its application to the nerve ganglia completely renovates their character ; otherwise the local symptoms, that is, the ex- hausted, devitalized parts, are best re-invigorated, strength- ened, nourished by the administration of c. p. solution of sper- min, kephalin, oats, muira pauma, until the emission and penile erections cease. Although apparently local, the internal course of the proper remedies will bring about a perfect recuperation. Married or middle-aged men, or even those older, in apparent good health, but from unnatural practices, in early life have their sexual organs weak, are benefited by the same local treatment. It is the weakened nerve-tendrils or bulbs, which require the aid of a vitalizing tonic like spermin to restore its lost vitality. The remedy in this form is an inestimable boon to men sexually weak or diseased. An analogous condition is met with in women, who have been either guilty of masturbation or sexual excesses, or suf- fered sexual incompatibility, or even worse, promiscuous sexual intercourse, and have the nerves of the clitoris blunted, deadened, and have become entirely callous. CORPULENCY.— The overaccumulation of fat under the integuments and around the viscera constitutes obesity. Al- though it is essentially a non-vital condition, it is not to be confounded with fatty degeneration. Causes. — Hereditary tendency, with overfeeding, consump- tion of large quantities of fluid ; indolence, and too much sleep ; and Dictionary of Diseases. 209 •excessive use of fatty, farinaceous, vegetable and saccharine foods, malt liquors, no care or anxiety. Fat is formed in the body from food containing it, also from chemical trans- formation of starch and sugar. Symptoms. — Besides the increase of weight and bulk, there is an impeded play of various important organs, as lungs, and heart ; diminution of bodily and mental activity ; disturbance of organs of respiration, circulation and digestion; panting on the slightest exertion; blood is poor in fibrin, deficient in quantity as well as quality; weakness of muscles, countenance bloated and sallow ; liability to gouty and neuralgic affections. Obesity not conducive to longevity; sudden death not uncom- mon. Partial obesity, such as fatty tumors, fat around heart in beer drinkers ; fatty omentum or fat belly, in gormandizers. Treatment. — Bowels to be kept open twice a day; bathing daily in alkaline or acid water ; sleep to be restricted to six or seven hours; patient to walk first a mile, then two, or more, daily, until he is lathered over with free perspiration, then stripped in a warm room and rubbed down briskly with aqua ammonia and water, and dry clothes put on. This should be done before breakfast. If circumstances favor, horseback ex- ercise. Diet should consist of meat, white-fish, green vege- tables, biscuit or dry toast, tea without sugar. Avoid or pro- hibit as much as possible bread, butter, milk, sugar, beets, po- tatoes, beans, peas, and broths, with coffee. Appetite improved if faulty, with bitter tonics, as gentian, quassia. Our best remedy to get rid of fat is the ozonized phytolacca berry juice. CORYZA. — Inflammation of the nostrils, irritation, sneez- ing, catarrh, chills, fever ; discharge from nostrils, first watery, then mucous, mucopurulent ; pain in forehead ; when the frontal sinuses are involved, pain and swelling in cheek ; when inflam- mation extends to antrum it is liable to extend to larynx and bronchia. In young infants the nostrils become blocked up and they are unable to nurse. Thymol jelly is one of our best local restoratives, inserted up the nostrils, while a warm bath, rest in bed, warm room, a free administration of passiflora incarnata are of great efficacv. COTTON ROOT.— The inner bark of the green root is an emmenagogue, parturient and abortive; promotes uterine contractions with great efficiency. 210 The Germicide 20th Century Practice Preparations and Doses. — A fluid extract prepared from the- inner bark of the green root is the most reliable, in teaspoon- ful doses every three hours. COUGH. — A "cough" may be due to any of the following causes : 1. Enlarged tonsils. 2. Inflamed throat. ' 3. Enlarged uvula tickling the back of the throat by flapping about. 4. Dropsy of the entrance to the windpipe. 5. Bronchitis and inflammation of the lungs. 6. Asthma. 7. Stomach disorders. 8. All febrile disorders. 9. Consumption. 10. Pleurisy. 11. Growth about the air passages. And several other rarer causes too numerous to mention. It is therefore obvious that a "cough" cannot be treated with- out knowing the cause, and we shall endeavor to make plain the different varieties of cough, and how they may be recog- nized, taking them seriatim. Enlarged tonsils can be seen by telling the person to open the mouth and take a deep breath, or, if necessary, by pressing down the tongue with the handle of a tablespoon, and may further be known by a peculiar throaty voice. Inflamed Throat. — On examination in a good light, by the method indicated in last paragraph, the throat will be found reddened and swollen. Elongated Uvula. — By an examination in the same manner, and observing whether it touches the back of the tongue or tonsils. Dropsy of the Glottis. — By the sudden symptoms of choking and great difficulty in breathing, and almost always occurring in women, especially at the climacteric. Bronchitis. — By the violent paroxysms of coughing, accom- panied after a time by expectoration of thick, yellowish, viscid mucus. Pneumonia. — By the high state of fever and the short hack- ing cough, accompanied by the expectoration of rusty-colored mucus. Asthma. — By its "twangy" cough, which is periodical and and Dictionary of Diseases. 21 r severe, great difficulty in breathing, the arms generally being placed on some object to raise the shoulders in order to get a better leverage for the pectoral muscles. Stomach disorders usually give rise to a cough which is not severe, but which obviously starts in the diaphragm or muscle that divides the chest from the abdomen. Febrile complaints give rise to a short cough not charac- teristic. Consumption is accompanied by a hollow cough, and the ex- pectoration of mucus that looks like pledgets of wool soaked in water, and frequently there is coughed up mucus mixed with bright streaks of blood and air bubbles. Pleurisy gives occasion to a restrained cough, kept down be- cause of the great pain it causes in the region of the inflamma- tion. Watch a patient as he enters the room, and several things may be noticed which will aid the diagnosis. If the lips are parted, and there is a curious vacant look about the face, it is a throat cough, probably from enlarged tonsils. If the voice is husky, most likely it is due to inflammation of the pharynx. If the cheeks are hollow, and the person is thin, and has a flush over each cheek, look out for consumption. A big, burly man or woman, with a large chest, and bluish lips, and suffused eyes, generally denotes bronchitis — the bluish, livid appearance par- ticularly. If the hand be held to the side as the person coughs, pleurisy may be suspected, especially if there is an evident de- sire to repress it. A person with dropsy of the glottis will not be able to walk to the surgery. Children do not spit up the mucus; to distinguish throat from chest ailments in them, watch the nostrils and the rapidity of breathing. If you find the former moving rapidly, dilating and shutting, and the breathing quick, it is a chest ailment. Croupy coughs speak for themselves, and so does whooping- cough when the whoop comes on. In the earlier stages whoop- ing-cough has a simple cough, but croup early develops a "crowing cough." In the cough of commencing fevers, the other obvious signs are those of heat, thirst, and constipation, and the heightened flush on the cheeks and glistening eyes. A simple cough — that is, a cough due to inflamed throat — is best treated simply by glycerin being swallowed, or syrup of tolu, with a little pare- goric, and in adults by sucking ice, or a cold water bandage to the throat externally. 212 The Germicide 20th Century Practice Besides, there is what is denominated nervous cough. Common to some nervous persons, irritation of inhaling ■dust, or excitement in delicate males and neurasthenic females, also children of feeble organization are often troubled with an irritative cough analogous to that present in bronchial irrita- tion. Most likely due to some reflex cause. Such remedies as the ozonized tar syrup, aconite, belladonna, matricaria, Pulsatilla, musk-root, avena sativa, phosphates, and prunia, as follows : Prunia, four ounces ; aromatic sulphuric acid, one dram; sulphate of quinine, thirty-six grains. Mix. Dose, according to age of .patient. Passiflora incarnata, a splendid remedy if of nervous origin ; if due to the toxins of microbes, the comp. syrup of tolu is most efficacious. In pulmonary tuberculosis, much of the cough is due to the rapid growth of the bacillus and its presence in the bronchial tubes. In bronchitis there is a greater or less amount of mucus at all times exuding through the air vesicles and tubes, which keeps up an incessant coughing, and aggravates all bron- chial conditions. In both these states, preparations of the pine tree soothe or alleviate the cough. Inhalations of the pine tree distillate from the needles; pine tree syrup is excel- lent; as for the pine-tree tablets, simply keeping one in the mouth during waking hours is very effective. In pneumonia, sulphide calcium one grain, every hour until the hepatization breaks up; when this has been accomplished, the same expectorants might be used. CRAMP. — Cramp is a spasmodic, involuntary, and painful contraction of the muscular fibres. The term is generally ap- plied to the affection of the voluntary muscles, in contradistinc- tion to spasm, applied to that of the involuntary. Any muscles may become affected with cramp, but those of the legs and arms, of the former especially, are most liable to be so, doubtless from the greater liability of the nerves supplying the lower extremities to irritation and pressure, two great ex- citing causes of the disorder. The cramp may be confined to one or. two muscles, such as those of the calves of the legs, or may be more general, as happens in cholera. The affected fibres are drawn in hard knotty contractions, and maintain this condition for a longer or shorter time. The most frequent causes of cramp are the presence of indigestible food in the stomach, or of acid in the bowels, or the pressure exerted on and Dictionary of Diseases. 213 the nerves by overloaded bowels. A similar acting cause in pregnancy or labor, the weight and pressure of the child, also occasions painful and troublesome cramp. The disorder is often associated with the presence of worms. When cramp affects the arms and fingers, it may be connected with disease of the heart and great blood-vessels of the chest. The power of the application of sudden and prolonged cold in producing cramp is often sadly exemplified in the case of bathers. The best immediate remedy for cramp is friction with the hand ; or, better still, with concentrated ozone and olive oil, and thoroughly evacuate the bowels with'kolatina. CREOLIN. — A product of the dry distillation of coal. It is an oily dark-brown fluid, smelling of tar, but differing from carbolic acid in being easily and completely miscible with water, forming a milky solution which tends to become brown. We have tested its action on several varieties of organisms. A two per thousand mixture of creolin killed the cholera bacillus and the streptococcus of pus and of erysipelas in two minutes, the bacillus anthracis in five minutes; but the typhoid bacillus, the staphylococcus pyogenes, was not affected in an hour's treatment. A two per cent mixture, however, killed the staphylococcus and tetragenes in about fifteen minutes. Creo- lin is a more powerful germicide than carbolic acid. A three per cent mixture killed the spores of bacillus anthracis in two days, a six per cent in twenty-four hours, whereas a carbolic acid mixture up to eight per cent did not affect the spores in seven days. Many other experiments confirmed the superi- ority of creolin over carbolic acid. Given in large doses to animals, creolin is not found to be poisonous. It is eliminated by the kidneys, and the urine is not discolored, although tri- bromphenol may be separated from it by the addition of bro- mine water and of hydrochloric acid. Creolin has been used therapeutically both for external and internal administration. Externally, we have used a one per cent mixture in a severe case of puerperal joint affection, in ulcers of the leg, in old operation wounds, and also in recent wounds. Good results were obtained in all these cases; the growth of granulations was stimulated, and the excessive discharge was stopped. Ulcers may be treated with a gauze-compress soaked in a one to two per cent solution and bandaged up for about four days. We strongly recommend the employment of creolin in gauze or as an emulsion in surgical practice, in conditions similar to 214 The Germicide 20th Century Practice those indicated above. We have employed it with good results in otitis media. We use an injection of the strength of ten drops to one-half pint of warm water in acute otitis. It re- lieves the pain, and owing to its innocuousness, it may be used as an injection in leukorrhea. As regards its internal adminis- tration, it effects big results in gastric catarrh, in diseases of the stomach and intestines. It was found free from poisonous ef- fect and non-irritant. It may be given in doses of 3 to 15 grains, in gelatin capsules, three times daily, and relieves meteorism and catarrh, and is serviceable in the severe forms of local inflammation of the intestines, such as typhlitis. In simple dilatation of the stomach, in flatulence and in diarrhea, it is of great service. It is of great utility as an injection in cystitis. It is always well to be a little cautious of taking too rose-colored a view of the action and effects of a newly-intro- duced drug. If all that has been stated about creolin be cor- rect, we have in it a drug of great importance, a powerful anti- septic with no poisonous qualities. Experience will determine the extent of its utility. CREATININ. — The alkaloid of muscle is found to some extent in all muscles, but the heart muscle of man is most pro- ductive of it, besides it is quite abundant in the active muscles of all wild animals and fowls. The white meat of the quail of North Carolina contains more of this organic substance than the muscle of all animals or fowls. It is an invaluable remedy in weak heart, or what is termed heart failure; to the amount of three grains every four hours. It is worthy of the confidence of all. When the tubercular bacillus is either evolved in the blood, or enters the body by contagion and infection, it has a peculiar affinity to live upon the creatinin of the muscles, rather than upon the blood, hence some pathologists have endeavored to show that the wasting, or emaciation, is due to that cause. It should be administered alone after meals, never combined with any other medicament. CRETINISM. — This may be regarded as the utmost extent of deterioration that can be brought about in a human being by tubercular without death. It may be regarded as an imperfect formation or development of the body, accompanied by a dwarfish stature, malformation of the head, which is flat on top and Dictionary of Diseases. 215 and spread out laterally; mental imbecility, countenance va- cant, devoid of intelligence, physical deformity in various de- grees, mouth gaping, tongue protruding, saliva flowing, bron- chocele, brutalized habits, squinting, deaf-mutism, blindness. This disease is common in valleys or gorges in which there is an absence of sunlight, and the inhabitants are necessitated to drink ice and snow water. In addition to those, stagnant air, filthy abodes, the ice or snow water loaded with calcareous matter, with extreme poverty, bad food, sensuality, and other forms of mental and physical degradation. Consanguinity and incompatibility of temperament may also be a cause. When cretinism is developed it never can be transmitted; an impure sustained breed cannot be produced. Procreation ceases ; a cretin never produced a cretin, nor an albino an albino. There is no establishment of a morbid race. Myxedema, sporadic cretinism, feeble-mindedness, idiocy, nervous diseases, loss of memory, physical deformity, phrenal softening, which have received so much attention by the lead- ing physicians of the present age, point to the conclusion that profound changes in the whole body take place and are asso- ciated with either an absence or atrophy of the whole thyroid gland. Continued, never-failing success attends the exhibition of thyroid extract in the treatment of the above diseases, and of all others in which a failure of the vital forces is present, in all of which a renewal of life is indicated. Such success attends the use of the remedy that it will doubt- less extend the sphere of its usefulness. The administration of the thyroid extract prevents race de- terioration and decay. This is well illustrated in its admin- istration in cases of obesity. Nearlv all cases of feeble-mind- edness, mexedema, cretinism, idiocy, are characterized by stout- ness and hebetude of mind. After taking thyroid extract, they show a marked decrease of weight and intellectual brightening. It is an excellent remedy for obesity, as it acts on the neuro- trophic and vasomotor systems, increasing their force, regulat- ing the amount of blood sent to each glandular organ, power- fully affecting the secretion of the bile and pancreatic juice, and thus stimulating the metabolic functions of the body. In- creased activity of secretion means less adipose tissue. The first dose of the ozonized thyroid extract relieves the heaviness, the oppressed breathing, the clouded brain, the slow- ness of thought and action which are the characteristics of the stout. 216 The Germicide 20th Century Practice Thyroid extract has been thoroughly tested in insanity, and the value of this treatment has been demonstrated to be im- mense in the mental affections due to myxedema. The value of the thyroid extract in all forms of insanity associated with goitre is most striking. In mania, the thyroid operates as a rebuilder of vital tissue. To the raving mania of the masturbator it acts well, but its action must be strengthened by large doses of green root tinc- ture of gelsemium and c. p. solution of spermin. We see nothing of Alpine cretinism in North America. What we do see is usually the result of alcoholic conception, hence mostly congenital, occurring in infants, and identical with myxedema in adult life. In both the essential feature is either the absence, or perverted, or deficient action of the thy- roid gland, which gives rise either to dullness of conception, gaping idiocy, feeble-mindedness. In both the cerebral motor and trophic nervous system are profoundly affected. In the infantile form, with absent or defective thyroid, there is either an arrest of growth of some special or every tissue of the body, or some abnormal growth. The thyroid gland secretes some substance which is essential to the healthy and harmonious working of the central and peripheral nervous system. A want of this substance, the nervous mechanism is deprived of a something which regulates the formation of every cerebral and physical element in the body, and the disposition of mucin products, the production of some substance which counteracts the abnormal constituents of the blood. The thyroid gland, being ductless, points to a secretion of some active principle of life substance, something which im- plants a vitalizing element, at the same time neutralizes the toxic materials in the blood and system at large. Defects, mental and physical, are either mostly due to an imperfectly developed thyroid or to a failure in the perform- ance of function. Thus the secretion of the thyroid gland or its administration, especially of the lamb, has a powerful effect on the mental and physical system; and its administration promotes growth, overcomes feeble-mindedness, cures idiocy and two-thirds of all cases of mental aberration. Don't overlook the ozonized extract of the lamb's thyroid when the patient needs to be braced up and desires either his hair or his memory to grow — don't fail to give it on the slightest indications of imbecility or arrest of development. axd Dictionary of Diseases. 217 If there be one in your neighborhood, you will know him by the following characteristics : Stunted growth, large broad head, with scarcely any brow ; thick features, widely staring- eyes, flat nose, large gaping mouth, narrow chest, pot belly, crooked legs, coarse wrinkled skin, deficient mental capacity, approaching idiocy. If he is under twenty-one years of age, he can be cured by the administration of the ozonized thyroid extract. If there be a case of defective development, approximating; either idiocy or insanity, the same remedy will aid us to get rid of useless idiots and helping the insane. Defective develop- ment suggests some force which has influenced the thing we call life ; heredity, intermarriage, alcoholic conception being the chief causes. A liberal use'of the ozonized thyroid extract will speedily do away with all institutions for deaf-mutes and feeble-mind - edness. CREOSOTA. — Beechwood creosote, a bactericide of great efficacy, has a special affinity for the tubercular bacillus. The best form for administration is : Creosote, twenty grains ; alcohol and syrup, of each six drams ; water, three ounces. Mix. Dose, one teaspoonful thrice daily. The ozonized mistura creosote is an admirable form for in- ternal administration. The distillate of creosote is termed guaiacol, which has prodigious powers in annihilating the tubercular bacillus. Used by inhalation, orally in the ozonized mistura guaiacol ; by suppository, and added to olive oil by in- unction into the skin : in an ointment, wonderfully efficacious in enlargement of the testicle. CROTOX CHLORAL HYDRATE.— Dose : Five grains in syrup every half hour, or a three-grain pill as frequent. Indi- cated as an anesthetic for deep sleep and relief of pain. Croton chloral contains more hydrogen than chloral hydrate. It is, in fact, butyl chloral. Its practical value is the property of diminishing sensibility before producing narcosis. CRIME. — The reabsorption of the testicular secretion makes the man and the ovarian secretion the woman, that the failure of either predisposes to insanity. A perversion of this secretion brought about by irritation, originates morbid im- pulses in the pelvic nerves, producing a reflected neurosis, with incoherence and instability of all acts. Abnormal ovulation,. 218 The Germicide 20th Century Practice erotic impulses, lowers the psychical and physical inhibitory control of the entire nervous system, increases the suscepti- bility to irritation, weakened will control, which permits dis- torted mental visions, erratic moral acts. A woman at the climacteric period is helpless to evade or subdue her mental equilibrium to profound disturbance, as melancholia, dementia, insanity, if not depression of spirits, hallucination. Prevention being better than cure, it becomes the duty of every family physician, when his female patients reach the age of forty, to inculcate a prophylactic treatment, and select and place her upon the best, most efficient remedies in the materia medica to tide her over that crisis which is impending. Wine of aletris farinosa, which is not only a restorative, but a bracing tonic to the entire reproductive system, and a remedy that can be administered in every case with great advantage, never failing to afford relief and benefit, whenever the uterus undergoes organic change. Another very valuable remedy, of universal efficiency at this period, is the c. p. solution of spermin, a brain builder of immense power; add to this the ozonized tinct. of matricaria, and we have the three best reme- dies, which administered at that peculiar period of life will prevent that dreaded disease which every modern woman fears — cancer. CROUP. — An irritation, inflammation of the mucous mem- brane of the larynx and the effusion of plastic lymph in which a pathogenic microbe appears — an affection very common and fatal among young children of a sanguine temperament, plethoric habit, short necks, with plump embodiment. The microbic evolution is blended with a plastic state of the blood, and is usually ushered in as the electric forces become lowered toward the afternoon and evening by symptoms of catarrh, hoarseness, clanging cough, sore throat, slight febrile exacerbation. About midnight, when the electrical forces are at their low- est, the child awakes with a husky cough, great difficulty of breathing an impending sense of suffocation, face either flushed or dusky or livid, with a high temperature — becomes gradually and rapidly worse and dies from asphyxia. This may occur the first night, generally two or three nights, growing worse every succeeding day, or the vital forces of the child may rally, an improvement taking place towards morning, "but the attack is likely to recur towards evening. The recur- and Dictionary of Diseases. 219 rent attacks, each growing worse, become fatal, or they grow less and less, till recovery ensues. Shreds of false membrane, heavily loaded with cocci, are often expelled from the throat during an attack. Treatment. — This should be prompt, energetic — a hot mus- tard bath admits of no delay — smear the neck with warm salad oil, then apply concentrated ozone, and over that hot sponges or poultices. If breathing be impeded, administer small but oft repeated doses of the ozonized comp. syrup of blood root and lobelia ; if not speedy relief, larger doses ; carry it to emesis at once; rest in bed; warm room, 75 degrees F., with formalin exposed so as to vaporize. To completely annihilate the micrococci of croup, administer iodide of calcium : Iodide of lime, ten grains ; distilled water, four ounces. Mix half a teaspoonful every half hour; or tritu- rate a dram of iodide of lime in one ounce of sugar of milk, administer in suitable doses. It not only cures, but eradicates every germ, and prevents their re-evolution in the blood. Its use will not disappoint even the most unbelieving. The comp. syrup of blood root and lobelia should never be overlooked. The diet should be light and nutritious. CUTANEOUS MEDICATION {Jellies and Ointments). — In the present era of new methods of treatment and new remedies, none have met with such approval as the excellent procedure of aborting inflammatory action by means of power- ful germicides of an anesthetic character ; of instantaneously breaking all breaches of continuity and promptly curing all cutaneous diseases by means of medicated jellies. These have been extensively used by progressive physicians for the past twenty years, and their utility has exceeded the anticipations of the most sanguine. Ozonized Jelly of Violets is a local anesthetic, powerful bactericide, which presents strong and special claims for recog- nition — non-toxic, producing local insensibility wherever applied. For aborting various inflammations there is no remedy to be compared with it. In the various forms of ophthalmia, simply everting the lid and inserting one grain of the jelly twice or thrice daily completely wipes out inflamamtory action in a short space of time. In tonsillitis, acute, paint it over all the painful and congested parts, inflammatory action ceases. 220 The Germicide 20th Century Practice In acute and chronic nasal catarrh; in neurosis of the olfac- tory nerve, due to the inhalation of pollen, aromas, such as is present in hay fever, or asthma, epidemic influenza and kindred conditions, painting the interior of the nostril with it thrice daily completely eradicates the pathological conditions. In all cutaneous inflammations, such as erysipelas and burns, simply paint or spread on lint the jelly and apply on the in- flamed or denuded surface, when all redness, congestion, pain subsides at once. In cancerous and syphilitic ulceration of the tongue and larynx, thickening, infiltrations, large excavations, patient only able to take liquid food, apply the jelly of violets every three hours, the excruciating suffering is promptly relieved. In gastric ulceration, cancerous infiltration, enteritis, one grain in a capsule every three hours will do big work in main- taining a local anesthetic effect upon the nerve ending. It may in those doses be given with impunity on account of its non-toxicity. Very celebrated cancer specialists employ the jelly of violets in the cure of cancer of the tongue or stomach, intestines and rectum, combining it with papoid in all cases, which is a power- ful digestive and absorbent. Guard it exceedingly well, as it is a powerful anesthetic, operates well in all cancers, subdues reflex irritability, pain of coughing and swallowing, especially if the tongue, soft palate, larynx, be affected with epithelioma. If necessary the jelly can be dissolved in water and used as a spray in laryngeal cancer, infra-nasal ulcer, malignant tuber- cular ulceration. All pain, tenderness disappear, and a rapid diminution of all odors in the discharge. It excels all other dressings in phagedenic ulcers and venereal sores. The Ozonized Resorcin Jelly, a peculiar cutaneous germicide, which next to the jelly of violets occupies the foremost place in the armamentarium of the dermatologist. It is not exactly a new remedy, but by clinical observation and experience new fields have been opened up for its use. It has a most extensive sphere of usefulness, valuable results always attend its internal as well as its local application. It has the peculiar property when applied of exciting an exudative form of inflammation, thereby removing infiltrations, hypertrophies, causes abnormal or adventitious tissue to peel off. Its indications are numerous and its action effective in psoriasis, for acne rosacea, and even in epitheliomatous patches. and Dictionary of Diseases. 221 Ozonized Jelly Chlorate of Carbon is principally used as a tooth, gum and tongue preparation, being powerfully anti- septic ; it kills the oidium albicans, the leptothrix buccalis, and tooth, gum and tongue preparation, being powerfully anti- septic; it kills the oidium albicans, the leptothrix bucalis, and all the bacteria common in the oral cavity. The method of application is simply to dip the dry brush in the jelly and apply to the desired part, .or the jelly can be dissolved in water in sufficient quantity to suit. Its chief value is its germicide properties, its vitalizing in- fluence on the teeth and gums. It is a decidedly efficient prophylactic against all diseases of the mouth and throat, such a preparation that should be in very general use, as the early decay of the teeth is very general in all whose vitality is exhausted by overtaxing the nervous system. Jelly of Ichthyol is useful in pityriasis, ichthyosis, eczema, erysipelas, boils, as well as all vegetable and parasite skin affections, extremely effective in the different forms of tinea. Clinical observation teaches it to be very efficacious in local- ized rheumatic pains, both in muscles and joints. Smeared liberally over old muslin and applied. Many physicians use this jelly in burns and in gastric catarrh. Thymol Jelly, used with most benefit in genital eczema, pruritus, as a general antiparasite, it embodies even in weak dilutions strong bactericide properties, but is cooling, soothing, healing, absolutely non-irritating. It can be applied freely, as there is no toxicity, and it affords rapid relief of all pain. Jelly of Chrysarobin is of especial value in leprosy, psoriasis, rupia. Before applying this jelly, smear the parts well with ozone ointment, over which apply the jelly. Jelly Periodate Aurum, valuable in syphilis, applied freely, so as to saturate the system. In this way it is utilized in initial sclerosis, good and very effective in condylomata of rectum, scrotum, vulva. When applied, they disappear rapidly. Its application affords prompt relief in gouty and rheumatic pains. Indicated in all syphilitic cutaneous affections, abscesses, car- buncles, indurations. Jelly of Boroglyceride is an excellent, efficacious germicidal application. Used in cases of superficial injuries, burns, fever sores on lips, nose, angle of the mouth during the winter months. It completely annihilates the oidium albicans on mouth and nipple. Excellent application to old ulcers with indurated edges. One of the best applications in erysipelas. 222 The Germicide 20th Century Practice Jelly of Salicylic Acid is used for thickening of the skin, cal- losities, corns, keratoid eczema. Has a most decided action in lupus, ichthyosis, acne, sycosis, lichen, in rheumatic synovitis. All grades of strength of which the skin of the patient is tolerant are prescribed, with a decided effect. Jelly of Acetate of Aluminum has met with great success in burns and superficial inflammation of the skin; also in badly healing ulcers, lupus and malignant excrescences. Jelly of Carbolic Acid has been utilized as a local application to lumbar portion of the back in initial sclerosis. Jelly of Formalin, useful in infected wounds, indolent ulcers, chancres, lupus, eczema, boils, erysipelas, careinomatous excres- cences, bites of rabid animals. Ointments. — Quite a number of new ointments have been introduced, all having their base in petrolina jelly or vaselin. Some of these possess rare value and are entered in the pharma- copoeia. Ozone Ointment is a powerful bactericide. Indicated : In all skin diseases, as in erythema, eczema, lichen, psoriasis, prurigo, pityriasis, impetigo, all forms of tinea, blotches, pimples, burns, frost-bite, erysipelas, excoriation, ulcers, varicose veins, itch, scurvy, piles, as a dressing to all wounds or sores. Its energetic germicidal properties render it the finest, most penetrating emollient, healing product virtue, as no microbe can live under where it is applied. Hence it is valuable locally in phthisis, pneumonia, metria, balanitis, chancre. Chrysophanic Acid Ointment in variable strengths, ten, twenty and thirty per cent is of great therapeutic value in psori- asis, lepra, and cutaneous leprosy. Applied in its high potency, it causes a complete exfoliation of the malignant cutaneous affection, leaving a healthy tissue, and if the proper constitutional remedies are administered, seldom reappears again. A strength that will cause desquama- tion is desirable in all cases. Gaultheria O in t incut. — This ointment has a most remark- able affinity for the bacillus amylobacta, the pathogenic microbe of rheumatism. By endosmosis it passes into joints; over the pericardium of the heart it has an active sterilizing effect, as is visible from the prompt relief of pain. Besides killing off the bacillus, it neutralizes its toxins. As an agent to be employed in partially ankylosed joints due to gout and rheumatism, it has no equal. Best applied by gentle massage. and Dictionary of Diseases. 223 Guaiacol Ointment. — A much more active agent than the pine-tree ointment, being capable of completely annihilating the tubercle bacillus. In endosmosis it has remarkable powers of penetration; in the same potency as the pine, it will double it in real practical utility as a bactericide. It is also exceedingly valuable in cases in which the gonococcus has migrated to the testes and produced orchitis, with considerable pain and en- largement. Bathing the scrotum with water as hot as can be tolerated, drying off, then applying guaiacol ointment every three hours, speedily brings about resolution. Guaiacol ointment or jelly is inimical to the microbe of ery- sipelas ; its microbicide properties are great in destroying every vestige of the germ. Mexican Ointment. — The climate of Mexico is most relax- ing, hence hernia is very common among both old and young of both sexes. Some twenty years ago a celebrated surgeon in the city of Mexico introduced this ointment as an applica- tion over all hernial openings so as to induce contraction, and at the same time excite adhesive inflammation, with effusion of plastic lymph and obliteration or filling up of the hernial aperture. The method adopted in its application is to return the hernia, bathe over it, dry well, then apply the ointment over and above all the truss, pad or compress. The application is unattended with danger, and is more successful and rational than the injecting of irritants into the hernial aperture. In order to effect a radical cure, keep on with its application for a few weeks, until abundance of plastic lymph has been effused. Siegesbeckie Ointment. — Being a powerful germicide, has great healing properties in gangrenous ulcers. It is of utility in all vegetable parasite skin diseases. It contains an alkaloidal substance called darutyne, which is an active bactericide. Resorcin Ointment. — A valuable local application to all can- cerous cavities and ulcers. It operates well also in syphilitic sores. Resorcin ointment is the best known of all germicide cerates, and can be successfully prescribed in acne, eczema, pruritus, in all acute and chronic skin diseases; one of the best and most reliable of all cutaneous applications. Saw Palmetto Ointment. — This is prepared from the oleo- resin of the ripe, undried berries, and possesses all the medicinal properties in a very marked degree of this very celebrated agent. As a vitalizer, a promoter of nutritive growth and development of the organs of generation in both sexes, there 224 The Germicide 20th Century Practice is no remedy which can be compared with it. It is easy of application ; simply bathe the breast or scrotum, dry well, apply the ointment with gentle massage or friction for fifteen min- utes, morning and night. During the day and night a thin coating of the ointment should be kept in close approxima- tion without pressure. Storax Ointment. — This is prepared from the best Persian storax, and makes one of the most valuable of all microbicide ointments. It unquestionably forms one of the most valuable dressings for cancerous cavities after removal. An elegant application to syphilitic sores. , Pine-Tree Ointment. — The oil of the needles of the North Carolina pine incorporated into ozone ointment, potency ten^ twenty and thirty per cent. This ointment, containing all the ozonizing aroma of the pine, when applied over a tubercular solidified lung, over tubercular damaged joints, inhibits, steril- izes, and is actively inimical to the vitality and growth of the tubercle bacillus underneath. We do not claim that it will annihilate the bacillus: it is a scavenger, and puts the germ in a quiescent state ; valuable as an auxiliary agent. Microbes in the Skin. — In all deviations from a healthy standard in and on the cutaneous surface, we have either animal or vegetable germs present in the degraded living mat- ter. All applications, whatever they may be, should be germi- cidal and anodyne. At the head of all oleaginous preparations stand storax and resorcin ointments. Storax Ointment has acquired a well-earned reputation in the healing of open cancerous sores. It is an excellent dressing for any irritable condition of the skin, such as chapped hands, face, chilblains, excoriated nipples aphthae), destroys every microbe present in from twelve to twenty-four hours. When about to apply it on a raw or cracked surface, first wash it well with hot water and soap, thoroughly- dry it, and then spread it on lint and apply. Resorcin Ointment. — This elegant pharmaceutical prepara- tion is a chemical combination of resorcin and ozone ointment, forms an unalterable and absolutely non-irritating salve, which has proved itself of remarkable efficacy in eczema, relieving the intolerable itching the moment it is applied. Its action is rapid in ail chronic intractable, inflammatory skin affections; for the moment it is applied it disipates the capillary hyperemia, relieving the local congestion. and Dictionary of Diseases. 225 In the proportion of one ounce of resorcin to ten of ozone ointment it is soothing, healing in all inflamed eruptions. Its germicidal action is powerful, prompt in killing all germs in the eczematous patches or upon cracked, fissured excoria- tions, denuded or abraded surfaces; it even alleviates the in- tense burning of erysipelas. For itching and inflamed piles it is one of the best remedies known. Spread on lint and applied. it stops the nightly itching of pruritus. It is an ointment which is unaffected by age. Chryso phanic Acid Ointment has met with much success in eczema of the face. After a removal of the crusts, it is applied in the strength of five grains of the acid to one ounce of ozone ointment. Always used with the most gratifying results. Boroglyceride Ointment, made by incorporating boroglycer- ide in ozone ointment. It has a strong microbicidal action, and has now superseded all other remedies in burns, as it at once relieves pain, the shock is lessened, and one of its initial dangers avoided. It possesses merit in soothing the irritated periphery of sensient nerves. American practitioners seem to be more partial to medicated jellies than to ointment in cutaneous affections; their lubricant properties ; their ready miscibility with water ; their protective influence in guarding against infection; their rapid absorption gives them a distinct influence ; their powers of penetration are immense. The principal jellies in use are the thymol, menthol, resorcin, ichthyol, boroglyceride. In order to illustrate the power of penetration of those jellies, apply itchthyol in mumps, and witness the disappearance of the pain, the subsidence of the swelling, the abrogation of fever the moment it is applied ; the remedy by endosmosis enters the I)Ody of the gland, annihilating all microbes in its interstitial structure. There are no complications, no metastasis, but rapid absorption of effused lymph takes place. Applied warm over the lungs when they are riddled with the bacillus of tubercle, and the expectoration loaded with the germ, its penetrating power is most manifest in a great amelioration of every symptom and a disappearance of the bacillus from the sputum. Another excellent illustration of their absorbent action is seen in the application of resorcin jelly in cancer before any breach of continuity has been effected. Daily applied, it suffers 226 The Germicide 20th Century Practice a retrograde process, grows less and less, until pain finally" ceases, and if persevered with, disappears. Their germicidal power is best witnessed in diphtheria, painting freely the tonsils, uvula, fauces with menthol jelly every two hours. No false membrane can form ; if effused it will kill it. The action of thymol jelly is beyond all powers of descrip- tion ; applied to the mouth and throat, fetor, sordes, disappear. Applied over the entire abdomen fever ceases, cicatrization of the bowel glands is rapid. It is a good plan, whatever local remedies are used, no mat- ter what the character of the eruption may be, always admin- ister from two to six sulphur lozenges a day. They not only regulate the liver, increase peristalsis, kill all intestinal germs, and are of the greatest value in arresting the activity of all putrefactive changes in the contents of the bowels. A numer- ous group of dermatoses appear and disappear in direct relation with the decomposition of the chyme. The use of these lozenges have a very salutary action in preventing this, but invariably ameliorate the cutaneous affection. CYCLISTS' DISEASES.— There are a number of ills- new diseases — incidental to the use of new appliances, which have become recognized in medical practice; the victims have given them names, which have been adopted in scientific phraseology. The Bicycle Back is common and familiar to all — the doubled-up position, which assumes a relationship to miners' back — a stooped position for many hours at a time, producing a special form of spinal curvature, which is universally attract- ing the attention of philanthropists. This form of anterior curvature gives compression of vital organs, as the lungs, heart, liver, etc., and shortens greatly the mean duration of life. The Effects of the Bicycle. — Every man who rides a bicycle has either irritation, congestion, inflammation or en- largement of the prostate gland, due to pressure. The prostate is essentially a sexual gland. From its com- plete development at puberty it has no rest. At all times and occasions it is liable to lesion. Masturbation blights it. Ab- normal methods of coitus derange it. Gonorrhea demoralizes it. Cyclism is its death. The prostate is also acted upon by urination ; participates in each erection; suffers a partial death by every conceivable axd Dictionary of Diseases. 22j means of irritation ; once it suffers organic change, the morbid condition is reflected to the spinal cord and brain at the sexual centre, so there are both peripheral and central changes stamped upon the tissues. Brain and prostate reciprocate each other's morbid condition; a damaged prostate is synonymous with brain irritability, idiosyncrasies, suicidal tendencies. "Whenever the prostate is damaged the act of micturition is deranged ; it may at first be simply increased in frequency, but by and by it becomes lame, hesitating, and if excessive, por- tions or shreds of prostatic epithelium from the inflamed pros- tate urethra are abundant in the urine. Sexual activity becomes a very great aggravation. Besides the difficulty in the act of micturition, there is usually pain in the groin, aching in the testes, sharp-shooting sensations in the limbs, leakages of prostatic and seminal prod- ucts, greater disturbance of the mental poise. This partial death of the prostate involves nearly the entire urethra; its severity depends upon the amount of exercise taken. It differs from all other forms of irritation, being the direct result of pressure, shocks, jars, concussions. It differs from the enlarged prostate, the effect of withdrawal during coitus, from the swollen prostate of the masturbator from that acquired from connection with harlots, or gonorrhoea; from that incidental to marriage excesses or dalliance. The effects of prostatic enlargement from the use of the bicycle are deeper seated, more extensive, give rise to more rapid organic change, which begins in its glandular structure and extends to the stroma, all due to contusion and concussion from the see-saw movement. The diagnosis is easy; a distinct increase of size of the pros- tate can readily be detected by the finger in the rectum ; the tenderness is best appreciated by the introduction of a metallic bougie into the prostate urethra. The reflex effects are variable, from mere indigestion to pro- found mental chaos. The disease is very common, as every rider is affected from puberty to old age. It is a national calamity, as it induces spermatic crystals in the spermatozoa — in other words, it ren- ders the semen infertile. Such cases admit of cure, provided the patient can be induced to follow well-defined rules. These embrace removal of the cause, rest, and a course of medication calculated to promote a renewal of life in the prostate, the use of iodol bougie every 228 The Germicide 20th Century Practice other day inserted well up into the prostate urethra, permitted to dissolve, and excite its peculiar absorbent action, has an admirable effect. Washing out the rectum, morning and night, with a tepid solution of boroglyceride, and permitting it to escape, following the morning washout with a saw palmetto suppository; in the evening following the same with first a boroglyceride suppository, and later on with an ichthyol. Such a course of treatment has a decided effect in exciting anesthesia with absorption, and in obliterating all traces of enlargement. While this direct local treatment is being carried on, internal medication should not be neglected. Protonuclein is of the greatest possible utility. One three-grain tablet, thrice daily, answers well. At the same time, matricaria before meals is one of the best of tonics, bracing to every tissue of the body. After a case has progressed along for six weeks, we have found the fluid extract of celery comp. of rare value in sooth- ing the nerves of the pelvic viscera, checks metamorphosis in uric acid, vitalizes and astringes the kidneys, prevents albu- minuria. The ozonized fluid extract of celery comp. is a therapeutic agent of real merit, and is prophylactic to all morbid changes in the reproductive organs. Cyclists' Sore Throat. — After a spin on a more or less dusty road, the cyclist often experiences a dry, and subse- quently an inflamed condition of the throat, with headache, languor, debility, and a sense of nausea, general indisposition, and other symptoms resembling the inhalation of a poison of some kind. In the bacteriology of the streets and roads, traversed by those health-seekers, we find in the dust hundreds of millions of bacteria, according to the nature of the locality, and many pathogenic oganisms. The most common are the microbes of pus, malignant edema, tetanus, tubercle, syphilis. The mischief to all riders, as well as pedestrians, might be prevented, provided they kept their mouths shut and breathed through the nostrils. Confine respiration to the nasal passages, keep the mouth firmly shut, the microbes in the air would never reach the pharynx or bronchial surfaces. After a dusty run, douche the nasal cavity with a tepid solu- tion of boroglyceride. If the throat is sore, paint it with the jelly of violets, using gargles of chloride of carbon. Cyclists' Heart. — In bicycling, the heart is severely taxed, irritated so that it contracts at the rate of 120 beats per minute. and Dictionary of Diseases. 229 The organ cannot stand that without overstrain, and such a strain gives rise to dilatation of the ventricles and chronic heart disease. The commonest is palpitation and temporary dilata- tion; but even this is sometimes very difficult to cure. That temporary dilatation occurs is enough to show the great strain put upon the heart, and it is an added danger that the sense of fatigue in the limbs is so slight. The rider is thus robbed of the warning to which he is accustomed to attend, and repeats or continues the strain upon the heart. As in other similar cases, the effect is to render that dilatation permanent which was at first but temporary, and to cause an increase in the muscle of the heart by repeated exertion. The heart produced is of large dimensions and of thick walls — a condition which may, perhaps, give little uneasiness to its owner, but which a medical man will view with considerable distrust and apprehen- sion. Cyclists' Luxg. — Chiefly due to compression, great, rapid inspiration resulting in emphysema. The Bicycle as a Factor ix Sexual Debility. — All medical authorities are agreed that the use of the bicycle gives rise to chronic inflammation of the prostate, and induces infiltration, induration, and fibrous deposits, and a general chaotic condition of the reproductive glands: that it gives rise to induration oi the testes, sarocele, varicocele, hydrocele, spermatocele, and numerous other abnormal conditions, all leading to impotency or loss of sexual power. The effects of this mode of locomotion are very varied, and depends much on the constitutional powers of the individual, but speaking generally, all have spermatorrhea, all have semen oozing away, without erection or contact with the opposite sex. The practice oi cycling invariably induces leakages, which so weaken and deteriorate the seminal fluid that it becomes watery and infertile. The daily pressure upon the ejaculatory ducts in the prostate gives rise to weakness, relaxation, and renders the ducts loose, patulous, unable to hold their contents, and the semen dribbles away. A species of paralysis is also promoted whereby the ejaculatory ducts are unable to perform their proper function. Another condition among this class of individuals is. they may appear well, may have strong and vigorous erections, but during the act of coitus no evacuation of semen takes place, owing to a spasmodic contraction sufficient to close or oppose the ejaculatory forces, and thus prevent the flow of semen dur- 230 The Germicide 20th Century Practice ing the act of copulation. In old cyclists the secretion of the seminal fluid is either hindered or sexual intercourse may be difficult or painful ; or there may be spermatocele, the testicle distended with semen, an overaccumulation, and other portions of the testicles suffer through this retention, and is invariably followed by impotency. The physical and mental effects of cyclism are analogous to masturbation and spermatorrhea ; every symptom is iden- tical ; the same weak, relaxed and shattered condition in both ; the same leakages or oozing; the same involuntary losses in urine or at stool ; the same wasting and degenerative changes in the organs ; the same nervousness and general unbalanced state. In both the same dilated pupil, wild stare, unsteady gait, weak back, shaky knees ; in both the same physical and mental debility ; the same impaired vision, with dull headache and lost memory. Buoyancy of spirits is gone; mind depressed; the snap, the vim, the force, the vigor has departed; the great motor power is paralyzed — both become impotent. Other factors in the production of impotency, aside from masturbation and cyclism, are to be found in injuries and blood diseases. These causes of sexual debility are often overlooked, and are to be traced to the ptomains of disease germs, more especially to those of syphilis, tubercle, and gonorrhea. They induce neuralgia and a blight or withering of the reproductive glands. The entire sexual and urinary apparatus derive their nerve supply from the general reservoir, the great sympathetic, on which depend all vital functions. A lowered vitality gives rise to a sexual debility, imperfect erections and premature emis- sions. Masturbators and cyclists, and those who resort to venereal excesses, are the greatest sufferers. Associated, or caused by this debility, is varicocele, which plays a most important part in the blight. Cases of partial or complete impotency, due to the use of the bicycle, require a special treatment of their own. The practice must be discontinued, a general alterative and tonic course inculcated; baths, massage, electricity; a diet of the best, with a well-regulated condition of the bowels. Then a special treatment for at least three months or more should be adopted to repair the damaged prostate, and absorb the effused products which give rise to the enlargement. The experience of the best specialists in Europe and America em- and Dictionary of Diseases. 231 phatically declare that the best method is to produce perfect anesthesia of the gland by administering persistently the ozonized extract of black willow bark and tincture of the green root of gelsemium; salix nigra suppositories and bougies; alternate those with the ozonized extract of saw palmetto. Such a course, managed with tact and skill, will give the desired anesthetic action upon the entire reproductive glands. The enlarged prostate will wilt, recede or diminish in size; emissions, leakage, semen at stool and in urine will cease ; patient will begin to gain flesh and strength ; various auxiliary aids to absorption may be worked in, as the aristol and saw palmetto suppository, with daily enemata of a solution of boro- glyceride to one pint of which one or two drops of ichthyol is added. Nearly all this class of patients are under thirty-five years of age ; the fibrous deposit in the gland is not so firmly con- solidated in an older class of patients, hence absorption is more rapid — a renewal of life is more easily effected. Just as soon as the gland is reduced to its original size, a rebuilding or reconstructive plan of treatment should be inaugurated. In this the ozonized saw palmetto extract must still be persevered with; two doses per week of the thyroid extract should be given to aid the evolution of the organic cell. C. p. solution of spermin and glycerite of kephalin should now be commenced, and these remedies held on to until recovery is complete. Any failure in the erectile power can be rectified by the use of the muira puama, which is one of the best remedies in these cases. All Cyclists Wreck their Sexual Organs. — All have a weeping penis ; leakings, visible or invisible ; it is thin, con- sistino- first of a mucus, a mere moisture — later it becomes mucopurulent, and mixed with spermatozoa; the prostate suffers, a catarrhal exudation follows ; the testes are damaged ; either atrophy or hypertrophy takes place; their secreting faculty is destroyed ; he becomes sterile, impotent, a nonentity ; later on still, his brain, being deprived of the vitalizing action of the testicular secretion, becomes soft, its typical fissures of thought shallow; hence memory is poor, vision, hearing im- paired ; his expression is simple, idiotic. A Bicycle Malady. — When a bicyclist has a frequent, dull, aching, dragging or throbbing pain in the perineum, ag- gravated by standing, walking, jolting, and is relieved by hard 232 The Germicide 20th Century Practice pressure, or the recumbent position; when he has a pain in micturition, burning, smarting, twisting of the stream; when he has an oozing of a thin, glairy fluid which glues the lips of the urethra, with aching or soreness of both testicles ; when he has a pain or ache in the loins, vertigo, spells of exhaustion, pervading nervousness, seminal losses more or less constant, the wear and tear of which breaks him up — some by much irritability of the bladder, which may travel along the seminal ducts to the testes ; or it may extend to the ureters, settle in the prostate, and he has a disease which once exterminated a nation. The cause for producing such symptoms must be removed, a general tonic and alterative course prescribed, matricaria and saxif raga ; then direct treatment to the prostate by first cleans- ing the rectum, then introducing first a boroglyceride, and one hour later on an ichthyol suppository. In bad cases to be repeated as indicated for prompt relief. In such cases, when acute symptoms are present, administer c. p. solution of spermin for a tonic, and kephalin granules to restore the integrity of the damaged prostate. Cyclists' Ptomains. — There is danger in all athletic exercise by poisons produced by the forced combination of his tissues. Every cyclist's system is at all times, when exercising, poisoned by ptomains engendered by his continuous exer- tion. The blood of any man who runs a long distance is found to be full of these poisons, and every race he runs he adds a fresh dose of poison to his system; he renders himself liable to many other maladies, and if he runs his exercise into perspiration, it must ever be borne in mind that humafh sweat is toxical, especially that resulting from muscular exertion — nay, even fatigue causes a poisoned condition of the blood. Women Cyclists suffer precisely as men. To them it is immoral in its tendencies, injurious to their mental and physical welfare, destroys the graceful contour of their form. The unrestricted license is objectionable on moral grounds. To a woman, the bicycle, like roller-skating, is simply a masturbat- ing machine; it produces a chaotic state of her entire sexual system, gives rise to kidney and rectal trouble, and even de- formity of the bones. CYANOSIS, BLUE DISEASE, BACILLUS INDICAN. — The microbe indican appears in the blood in newly-born infants in malformation of the heart ; depending on imperfect closure of the foramen ovale; a communication between ven- and Dictionary of Diseases. 233 cricles; also, often due to imperfect expansion of lung air- cells ; blueness almost amounting to blackness ; coldness, faint- ness, intermitting pulse. It is also present in all diseases in which there is imperfect aeration of the blood, as pneumonia, tuberculosis, bronchitis, asphyxia, carbonic acid and sewer gas poisoning. Prepara- tions of ammonia, as the chloride alternated with creatin; small doses of strophanthus ; passiflora, peroxide of hydrogen, adonin; spartein, digitalis, pure air, very nourishing food, sea bathing, avoidance of fatigue and mental excitement. CYSTIC DISEASE. — Cysts, or closed sacs resembling hydatid cysts, are often developed in the substance of organs or beneath the internal mucous lining or under external serous covering. They are found in the mouth, bladder, but are specially common in the uterine walls, which are often invaded with cysts, or small bladders, while another part is infiltrated with fibrous tissue, or the ordinary fibroid tumor. These cysts give rise to trouble and inconvenience when they attain any size, such as leukorrhea and hemorrhage. If within reach, they may be punctured. They, like the others, are unac- companied with pain; not infrequently give rise to uneasiness. The best treatment is a general alterative and tonic course. In order to avoid those three common forms of uterine disease, there should be a rigid avoidance of irritation of the uterus, either by tight lacing, wearing sponges or pessaries, masturbation, abortions, irritating caustics of doctors, especially nitrate of silver; even certain occupations, as the sewing-machine, should be guarded against, or other forms that aid in the production of congestion. DAMIANA. — The leaves and stem of the Turnera micro- philla, which is indigenous to Mexico. Therapeutical Uses. — An invaluable and most efficacious aphrodisiac, well worthy of use in all forms of impotency, sex- ual lethargy ; also of utility as a tonic in nervous diseases. Preparation and Dose. — Ozonized extract from 10 to 30 drops every three hours. There is a compound damiana pill, which is composed of the solid extract and muira puama, an instantaneous sexual invigorator. A suppository made from the damiana leaves is much esteemed as a sexual excitant in profound impotency. As the prostatic urethra has most remarkable absorbent 234 The Germicide 20th Century Practice properties, the glucoside of the damiana has been made into a urethral bougie, and also used with great success. One of them inserted right up, or rather into the prostatic portion, and held there half an hour till it completely dissolves. DEAFNESS may be due to the same cause as blindness: anemia, congestion, poisons, reflex irritation, phrenal de- generation, and may often be rectified or cured by the same course of treatment. To the inflammatory form may be traced swelling of the mucous membrane, causing an obstruction of the outer ear and Eustachian tube, sore throat, morbid growths in the pharynx — inflammatory action may be so violent that it may cause an ulceration or rupture of the membrana tym- panum. In nasal catarrh, if not cured, its germs may migrate either downwards to the bronchi, or up the Eustachian tube. Under the class of poisons, the toxins of all disease germs, as fevers, syphilis, are the most common cause; under drugs, probably the administration of large doses of quinine, salicylate soda, affects the auditory nerve most disastrously. Long ex- posure to sudden undulations of waves of sound exhausts the auditory nerve, membrana tympanum, such as occurs in boiler- makers, artillery firing, and in the streets of cities. Diseases of the brain, or auditory nerve, usually associated with deaf- ness. The treatment of deafness, in all cases, must vary accord- ing to the cause ; if that is not visible, alteratives and tonics. In all aural affections it is safe, salutary practice, to fill the ear, head laying flat on the unaffected side, with peroxide of hydrogen ; retain this for five minutes ; empty and refill, subse- quently dropping two to five drops of ozonized mullein oil in the ear. This might be repeated morning and night. Mullein oil administered in this way will cure otalgia, otor- rhea and many diseases incidental to this organ. The practice of slapping children on the side of the head is highly reprehensible, very productive of ear disorders; so are exposures to wet or cold ; the toxins of the eruptive fevers have all a disorganizing action on the auditory apparatus. Perforation of the membrana tympanum, either by ulceration or mechanical violence, gives rise to an irreparable form of deafness, which, in some cases, is overcome by wearing an arti- ficial ear-drum. There is little doubt that the turmoil and din of all large cities are productive of deafness ; the general subsidence of all noises is one of the desiderata of the age. and Dictionary of Diseases. 235 In childhood there is probably no disease of the ear so com- mon as otorrhea, a mucopurulent discharge from the ear, often a sequel of fever, exposures, injuries, neglect. No treatment so effective as filling the affected ear morning and night with peroxide of hydrogen, permitting it to remain for a time, until it boils thoroughly; refilling, and when thor- oughly cleansed, drop in mullein oil. The germicidal treatment of ear diseases with mullein oil and peroxide of hydrogen completely wipes out all fungus or vegetable growths, like the aspergillus, which often gives rise to deafness. The loss of hearing is often caused by disease of the nose and throat, drinking ice water hastily, nasal catarrh. The nasal douche, with ozone et chlorine, permitting to flow easily, and, when so doing, close the nostrils, instructing the patient to hold his breath; the fluid penetrates the collapsed Eustachian tube or tubes, and hearing is restored. Aural vertigo is promptly relieved by the administration of a few drops of gelsemium. As it is the brain which hears, the ear being simply an acoustic instrument, it is better in ruminating over the subject to classify deafness as chiefly nervous, of which there are five different varieties. 1. All that class of cases due to anemia of brain, exhausted vital force by sexual excesses, masturbation, shock; want of nutrition in brain; action of sun; railroad jars, meagre brain food, isolation, monotony, sameness, obliterating the cerebral convolutions. Best treated by removal of cause ; nourishment, brain food, and remedies to give richer blood. 2. Congestion. — Plethora, determination of blood to brain. The deafness of fevers may be due either to this or anemia or toxins. Best treated with foot baths, free purgation, and stim- ulants to nape of neck.' 3. Reflex. — Chiefly teething, stomach or liver, or bowels, or uterine irritation, or masturbation. Get rid of cause. 4. Use of Drugs. — Quinine, chloral, opium, belladonna, to- bacco in large doses, carelessly, or indiscriminately adminis- tered, cause deafness. 5. Organic. — Due to some organic change in nerve or brain, as softening, or old age; involving the condition of senile atrophy. Very hopeless. In the first four varieties an effort should be made at cure by an alterative and tonic course of treatment, keeping in view 236 The Germicide 20th Century Practice that it is the brain that hears : that the auditory nerve, ear and appendages are simply the medium or instrument. Ear dis- eases are most amenable to constitutional treatment. In the organic form, treatment same as for chronic inflammation of the brain, blisters to nape of neck, brain food, change of air, especially to the mountains, where the atmosphere is highly rarefied and ozone abundant. DECAY, NATIONAL. — The present age is one of degen- eration and decay. The great men of our country have small minds with meagre ideas. The Caucasian brain is shrinking. The principal cause of all this is seminal incontinence. In its restricted sense, spermatorrhea means a constant escape of sem- inal fluid, without erection or pleasure sensation, but the term is used to designate all varieties of involuntary losses, which occur beyond the limits of health, and is synonymous with sem- inal incontinence. All cases dependent upon weakness or ex- haustion, with increased anemia of the genito-spinal centre have phenomena in common, induced and perpetuated by hyperesthesia of the nerves which supply the prostatic portion of the urethra. Seminal incontinence is met with in three forms, each of which may exist separately. Nocturnal emissions, which occur during sleep; accompanied with erections and erotic dreams; diurnal, while awake, without erection; and all the time, night or clay. There are no leakages or spermatorrhea in health. They are pathological, likely to be followed by languor and lassitude of mind and body, headache, backache, enfeeblement of the func- tional power of the brain, mental depression and impotence. Whence comes the unsteadiness of character, the tremor of speech, the drowsing, apathetic condition, the convulsive seiz- ures, the psychical changes and early paresis, with exaggera- tion of the reflexes? Extreme debility and muscle waste, incidental to some cases of spermatorrhea, is most remarkable; both the pink and white marrow, the lymph canals, even the blood-corpuscles shrink, atrophy, and the muscular waste is immense. In those cases the patient is little else but skin and bone. The active principle or alkaloid of muscle creatin is found in the urine. Creatin crystals are remarkable for their brilliant and mica- cious aspect, which causes them, when viewed under the micro- and Dictionary of Diseases. 237- scope, to stand out conspicuously among other crystals with which, in the evaporated and colored extract, they happened to be surrounded. This micacious aspect alone is sufficient to dis- tinguish them as crystals of creatin, as it is crystal of organic origin ; it is always brilliant and micacious. Creatin, the product of muscle waste, is a nutritious principle, as well as an excrementitious substance. Ozonized thyroid extract, protonuclein, comp. tincture of matricaria, have each a definite action in checking this remark- able waste; c. p. solution of spermin meets the case precisely. In such cases in which the patient is a living skeleton, look out for creatin. Decay, Premature. — Early decay, lost manhood, is becom- ing too common, and at a very early period of life. The reasons which may be assigned for this are masturbation, sexual excesses, coition with women of the town, withdrawal in the act of ejaculation, dalliance, gonorrhea, syphilis, sedentary habits, bicycle riding, etc. We meet with premature decay in all stages or degrees, sim- ply as a condition of partial death, in which the chief symptoms are excessive irritability, manifested by premature discharges, leakages, a moisture, imperfect erections, nocturnal emissions. If the abnormal practices are persisted in, then the highly organized nerves of the glans-penis become dulled, blunted, their exquisite sensibility are impaired, ejaculations take place at the mere thought of coitus, inability to procure an erection, delay in making water, and other symptoms of impotency. Every stage of premature decay has its own peculiar symp- toms ; all affect the brain and nerves, as well as the sexual ap- petite. It rs only within this last thirty or forty years that this par- tial death of the sexual organs has become extremely common, and at a very early period of life — from twenty-five to thirty, but more common from forty to fifty years of age. From some of these causes, and others not enumerated, there seems to be a blight upon the sexual organs ; the tone, the vigor, the sensibility, nay, the appetite itself is impaired. There is a partial or total loss of power, with no visible affection, but slight prostration during exertion or in hot weather. These are but incipient symptoms. They do not at first threaten either life or reason, but they become progressive from bad to worse, at the same time become more obstinate to cure. Middle-aged men, widowers, fast livers, are peculiarly liable 238 The Germicide 20th Century Practice to this form of sexual apathy, or impairment, or loss of power, more especially if they are troubled with varicocele. Perfect celibacy is not conducive to vigorous sexual power, for we see in widowers and men who have had sexual congress at proper intervals, that when they are deprived of it, they often have a secret draining away of the vital fluid in the urine, in the form of a few drops, but just enough week by week to weaken or undermine their health and strength, and render them liable to softening of the brain or paralysis. The causes which produce premature decay also give rise to sexual paralysis, by which is meant a loss or decay of erectile power, a blunting of sensibility, a diminution in size of the organ; true, blows and injuries to the spine, softening of the brain, effect the same result. Men of all ages who have abused their sexual organs are its victims. Enlargement of the pros- tate gland at the neck of the bladder is most productive of all forms of premature decay. An early symptom, a precognition of premature decay of the function of the testes, is a sensory numbness of the sexual ap- paratus, a sensitiveness of the testicle and spermatic cord; a dragging and stinging pain in the testicles that conies on in paroxysms. It may be accompanied by a painful sensation in one or both groins, or a stinging pain in the urethra during and after the ejaculation of semen. Introduce a salix nigra bougie into the urethra and it will be found sensitive throughout, but aggravated at the prostatic portion. To overcome all conditions of premature decay it is indispensable that there should be a perfect subsidence of all excitement of the sexual glands. Gelsemium and passiflora must be administered in large doses every evening ; during the day extract of black willow orally, by suppository and bougie, so as to dry up every vestige of seminal leakage. Then, and not till then, a constructive treatment should be commenced which should embrace the exhibition of matricaria for a tonic, twice a week thyroid extract, c. p. solution of spermin after meals, with the occasional use of the ozonized glycerite of kephalin, avena sativa and other agents to build up, best of diet, bathing and avoidance of all mental and physical excitement. Decay, Sexual. — The great annual increase of sexual im- potency demands the serious attention of our profession, and an enlargement of their views on this subject, which is sapping our vitals as a nation. The causes are apparent, visible in an atmosphere highly and Dictionary of Diseases. 239 oxygenized in diet, in the use of tobacco and alcohol, in all in- sanitary conditions, in our literature, in our amusements, in nervous strain, masturbation and sexual excesses, that these and many other causes, acting either directly or indirectly, pro- duce a central lesion in the brain or spinal cord or both. A broader view of the causes of the pathological condition present necessitates a much wider range of treatment, not only to afford relief but a lasting cure. Individuals suffering from sexual decay, whether twenty-five years of age or aged veterans of seventy, should place them- selves under the care of physicians of the highest integrity and scientific skill, and not become the victims of the miserable char- latans who invade the profession. The times call for reliable, honest, scientific physicians, who are thoroughly conversant with newer methods of treatment, by urethral bougies soluble, which readily melt, run over the mouths or orifices of the sem- inal ducts and sympathetic nerves, and thus vitalize and pre- vent leakage; by rectal suppositories, which rapidly dissolve and are quickly absorbed into the seminal vesicles, the real seat or source of the local trouble; plasters to the base of the brain over the spinal cord at the origin of the sexual nerves, from which vital energy can be acquired ; by the internal administra- tion of drugs, nerve builders. All. these methods can be brought to bear on a bad case, or one may do the work. The reason assigned for this is, the seat of the difficulty is not always in the urethra, neither is it always »in the seminal vesicles behind the bladder in front of the rec- tum, nor in the deadening or paralysis of the sensory nerves in the glans, or erectile nerves in the organ itself; neither may the brain and spinal cord be seriously involved at first. In sexual decay the entire organism is sapped, drained out, exhausted, nervous system bankrupt, blood full of toxins, acid ; appetite poor, digestion bad, vitality evaporated. This is the state of too many young, middle-aged and old men. There is now hope for such cases in our extended materia medica, our newer remedies ; our recent great improvements in pharmacology. Take for example the ozonized soluble, urethral bougies. We have the thallin, a never-failing cure for gonorrhea; the sulpho carbonate of zinc for gleet; the iodol for stricture; the salix nigra and oil of thuja bougie for leakages and seminal emissions; while arresting an oozing, soothe, calm irritability, allay excitement and all tendency to sexual excesses or self- 240 The Germicide 20th Century Practice abuse, while the ambrosia orientalis bougie restores strength, power, tone and equilibrium to the exhausted, deadened erectile fibres. Take suppositories, witness the magical effect of the ichthyol in reducing an enlarged prostate; the salix nigra and oil of thuja in putting a complete stop to seminal emissions; the mar- velous action of the saw palmetto in vitalizing the prostate gland; the marvelous action of the protonuclein suppository, the active principle of sexual life, being a nerve tonic, nerve food, a builder, vitalizer; and the ambrosia orientalis, stimu- lating brain, spinal cOrd and the several plexus of nerves, wip- ing out paralysis, wasting and atrophy. Others might be enumerated; but add to these and many others well-tried remedies for oral administration, such as keph- alin, avena sativa, protonuclein, thyroid extract, c. p. solution of spermin, ambrosia orientalis, muira puama, comp. matri- caria. The generative act on the part of the male implies the com- pletion of sexual congress with an ejaculation of fertile semen, and its deposition in the upper part of the vagina. The capacity for copulation depending upon a perfect erection of the penis, the failure of which renders a man sterile from impotence. Ster- ility does not include impotence, but is met with in men vig- orous in intercourse, but who ejaculate a fluid destitute in sper- matozoa. Both these conditions are radically cured by the use of the kephalin granules. Decay. Senile. — In nearly all individuals between sixt}r and seventy years of age, certain normal and abnormal symp- toms of degeneration begin to appear, among the former de- bility, atrophy, with induration of the brain, a general shrinkage of vital organs, which give rise to a variety of nervous peculi- arities, embracing with it the senile heart, with its slowed pulse, vertigo, epilepsy, high arterial tension. Degenerative changes are physiological, incidental to advanced age; but such symp- toms as apoplexy, plethora, increase of blood pressure, melan- cholia, vertigo, bewilderment, are abnormal, pathological, and have a significance of their own. Characteristics of the diseases of the aged : Pneumonia leads, 19 per cent; cancer, 15 per cent; bronchitis, 11 per cent; senile decay, 9 per cent ; pulmonary tuberculosis, 5 per cent. Senile decay can, to a certain extent, be retarded, never pre- vented. Daily massage, the pumping of the vitality of the young, the and Dictionary of Diseases. 241 vital into the old, the feeble, the degenerative, rejuvenates, be- sides the peripheral stimulation fills the capillaries, promotes the nutrition of all vital organs, relieving the labored heart, stimulating the sluggish brain. The bathing incidental to well performed and daily massage removes the toxins of all disease germs from the surface. The digestion and assimilation of food is promoted by the exhibition before each meal of that prince of all tonics, comp. tincture of matricaria ozonized. After each meal three grains of protonuclein to increase blood formation. This is the modern method of becoming young, or living to a very advanced age. To this menu much can be added of real sterling merit, such as the occasional exhibition of the glycerite of kephalin, ozon- ized tincture of oats, c. p. solution of spermin, and a weekly dose of the thyroid extract. DEFECATION. — The essential physical element in the act of defecation is peristalsis. A clear understanding of this function is of vital importance in this discussion. Peristalsis may be defined as a peculiar rhythmic contraction of successive muscular fibres of the intestine. This undulating movement extends through the length of the canal, thirty-two feet, and is called the peristaltic wave. f It is less active in the large than in the small intestine. Its function in the upper bowel is ( 1 ) to assist in mixing the food from the stomach with bile and the digestive ferments of the pancreas and intestinal glands ; (2) to bring nutrient matter in contact with large absorbing surfaces; and (3) to impel waste materials towards the lower bowel. In the large intestine and rectum its function is chiefly that of evacuating their contents. The rectum receives its in- nervation through the rectum plexus of the sympathetic sys- tem. Its communication with the cord and spinal ganglia lies through the sacral plexus. Its communication with cerebral centres lies through the hypogastric and the solar plexus, and reaches the brain through the pneumogastric nerve. Thus the muscular structure of the intestines is connected by two routes with the central nervous system, from which all primal im- pulses emanate. The act of defecation is accomplished by the increased peristalsis of the descending colon, sigmoid flexure, and rectum upon their fecal contents, assisted by the fixation of the dia- 242 The Germicide 20th Century Practice phragm and voluntary pressure of the abdominal muscles. We have said the essential physical element in the evacuation of the bowls is peristalsis. Let us bear in mind that normally it is a rhythmic, physical force ; that the mechanism, nervous and muscular, by which the phenomena of peristalsis and defecation are accomplished are necessarily dominated by an intelligent, regulating mentality, which sends out these impulses to rhythmic action. Any agent which promotes peristalsis will favor evacuation of the bowels. This stimulus may be: (i) Mechanical, acting on the peripheral termini of the sympathetic nerves, which con- vey their impressions to the central intelligence, which in turn sends out its motor peristaltic impulses. Such a stimulus is normally excited by the presence of feces in the lower bowel, by foreign substances like seeds, bran of wheat, oats, or corn, by ptomains from bacterial life or protozoa, by massage and physical exercise. (2) Thermic, as seen in excessive peristalsis of diarrhea, from extremes of atmospheric temperature. Brief applications of hot or cold compress or enema will arouse peristalsis. (3) Electric. (4) Chemical, by the physiologic action of drugs such as kolatina. DEGENERATION. — Retrograde metamorphosis, a change in the structure of an organ, in the solids and fluids, which are transformed into matter essentially morbid, such as fatty, amylaceous, fibroid, cystic, malignant, tubercular. Degenerations, whatever may be their form or character, are disorders of the declining periods of life, and at whatever age they may occur, are simply manifestations of local senile decay or its equivalent. In no other way can the anatomical and clinical features of their condition be accounted for. These primary perversions of growth and nutrition are to some extent heritable. In none of the forms of degeneration do they grow with regularity, but by successive impulses, al- ternating with periods of quiescence. Regarded as incurable, for healthy senile changes terminate either in complete ex-tinc- tion of function of an organ or in death. We by some drugs can stave it off, but not permanently arrest the progress of age. Degenerative changes often influence the rate of normal growth; they may even appear during fetal life, in early in- fancy, at puberty, or at the menopause; often originate in or are either aggravated or suspended by pregnancy or the and Dictionary of Diseases. 243 puerperal state; thus very many morbid conditions are im- plicated in the physical rise and fall of growth and nutrition. Degenerative changes, overgrowths and shrinkage are iden- tical in nature, if not in quality, with senile decay; granular and fatty degeneration of the liver cells of the kidneys and spleen assumes precisely the same quality and intensity as we have in old livers and osseous formation. Degenerative changes are factors that are most frequently visible in the liver, in granular kidneys, leukocythemia, acromegaly, pernicious, anemia, etc., essentially aging and depressing in their character. Add to those anxiety, grief, depressing emotions, a residence in low-lying, malarious dis- tricts, sunless valleys, sewer engulphed cities, struggle, in- sufficient food and clothing, disease, syphilis, use of alcoholic drinks, with its offspring, gout, prolific of degeneracy; every- thing which debilitates and depresses. The use of alcohol is far reaching in the production of de- generacy, not a food, but a stimulant, narcotizer ; elevates, but at the same time degrades the mind, whittles down vital force, lessens perception and sensation, impairs and disturbs func- tion, arrests normal metamorphosis. A stimulant narcotic whose action maintained for a reasonable period brings about mixed overgrowths, and accounts for the disastrous influence played by this remedy alone in the induration of brain ; cirrhosis of the liver; granular kidney and fibrous and cystic degenera- tion of other organs. Again look at the action of some drugs, such as opium ; its initial exhibition in early life gives rise later to cerebral and mental degeneration, fertilizes the crime in- stinct, perverts, damages, paralyzes the higher psychical cen- tres, lessens the vigor of intelligence, weakens volitional power. True, we have remedies that retard, delay these effects, such as coca et celerina, cacodylate of sodium, preparations of iodine and gold, saxifraga, thyroid ext. and c. p. solution of spermin, cinchona, with fresh air, sunshine, bracing sea or mountain breezes, electricity, massage, good food, bathing, congenial occupation, change, lively society. A most remarkable feature of all degenerative changes of a senile character is their proneness to affect organs becoming extinct. Myxedema generally first shows itself at the menopause; enlargement of the thyroid (goitre) at the middle period of life; osteomalacia, when the bone marrow is on the wane; osteitis deformans, when the shafts of the bone exhibit de- 244 The Germicide 20th Century Practice generacy; prostatic enlargement from fifty-five to sixty-five years of age, when the male sexual organs are becoming ex- tinct; weakened tissue, devitalized organs, afford a liability, a focus or seat for the entrance and a habitat for disease germs, so with structures which have suffered from mechanical vio- lence often become the seat of either innocent or malignant tumors. Degenerative hyperplasias of the stomach, pylorus, breast, tongue, thyroid gland, liver, bone marrow, shafts of bone, are not affected by age more than other organs, but from per- verted nutrition, a growth of cells of a low order, not de- generative, perhaps, but embroyonic cells, or of a low type of sporadic origin, dwarfed and pernicious, influenced by all adverse conditions, malformation, error in growth, defective development, premature decay. Speaking thus generally of degeneration, we might remark, that there can be no general deterioration of the human race, for the evil cures itself in non-procreation ; there can be no es- tablishment of a morbid race. DELETERIOUS TRADES. — Strange to say, you cannot frighten the workmen who know how dangerous is their trade, and not even higher wages will tempt them from such death traps. Lead, in the form of bullets and shot, is a deadly, dan- gerous thing, but it is also death-dealing to all who use it in their work, as house painters, gilders, calico printers, type founders, potters, and braziers. Mercury is a foe to life. Those who make mirrors, barome- ters, or thermometers, who etch, or color wood or felt, will soon feel the effect of the nitrate of mercury in teeth, gums, and the tissues of the body. Silver kills those who handle it, and photographers, makers of hair dyes, and ink, and other preparations, ere long turn gray, while a deadly weakness subdues them, and soon they succumb. Copper enters into the composition of many articles of every- day life, and too soon those who work in bronzing and similar decorative processes lose teeth and eyesight, and finally life. Makers of wall paper grow pale and sick from the arsenic in its coloring, and match makers lose strength and vitality from the excess of phosphorus used in their business. Nitric acid is used by engravers, by etchers in copper, by axd Dictionary of Diseases. 245 makers of gun-cotton, and those who supply our homes with lovely picture frames. Its fumes are poison to the human lungs, and soon destroy them completely. Ammonia kills the soap makers; workers in guano grow deaf; hydrocyanic acid deals death to gilders, photographers, and picture finishers ; while zinc is a fatal foe to calico printers, makers of optical glasses, and meerschaum pipes. Mankind is, by nature, brave, and very few are deterred from action because of supposed danger. If the great builders and engineers of the world would stop and ask, "How many lives will this undertaking cost?" it is probably that we would be without some of the greatest triumphs of modern thought. Everyday life and common occupations are full of silent courage, and all around us are workers who die in the harness, and are true heroes without knowing it. Statistics gives the ages about which these operatives die. Among the operatives who die on the average before the age of 40 are porcelain turners, stonecutters, and female mirror makers. Under 45, goldsmiths, lead and quicksilver miners. Under 50, cabinetmakers and operatives in cotton- mills. Under 55, needle-polishers, file-cutters, and engravers. Under 60, blacksmiths, butchers, carpenters, machinists, turners, watchmakers, and gravediggers. Under 65, tanners, dyers, gasmen, catgut makers, and bone-boilers. Above 6$ only three trades are mentioned. Physicians, surgeons, chem- ists and druggists, mercers and drapers, hairdressers, barbers, wigmakers, hatters, miners, and some others have a high but not an excessively high, rate of mortality. Carvers and gilders suffer less than they did ; and manufacturers of wool, silk, and cotton no longer experience an exceptionally high mortality. Among the healthy classes may be named carpenters, wheel- wrights, ^nd workers in wood generally, shoemakers, grocers, publishers, and booksellers. Among the healthiest and long- est-lived are the agricultural classes, gamekeepers, barristers, and the clerical profession. DELIRIUM TREMENS.— The congelation of both the gray and white matter of the brain by the use of alcohol is always accompanied by disturbance of the renal functions — a nephritis, accompanied with albuminuria. Delirium tremens varies much in different countries and races, and with the quality of the spirits consumed, but in all insomnia is the leading, distressing symptom of the drunkard. 246 The Germicide 20th Century Practice The malady, properly speaking, is an acute auto-intoxica- tion of the brain following the insufficient performance of the renal function — a failure at elimination of auto-toxic products as well as alcohol. The special forms which the disease assumes, namely, hal- lucinations, terrifying visions, tremors, wasting, are chiefly due to the part of the brain involved in the general break down, and the constitutional debility, embraced in cerebral anemia. In the interstitial atrophy, loss of cohesion in brain substance, it shrinks from its bone case and its specific gravity is ab- normal. The specific gravity of the cerebrum in a healthy man is 1050; cerebellum 1043, m delirium tremens falls to 1030, same as general paralysis. The terms softening and indura- tion are used in the most uncertain manner. In the use of alcohol, the function of the brain is impaired, interrupted ; its nutrition is disarranged ; its vessels, cells, tubules, are filled with an adipose albuminous material, which produces actual ramollissement, often giving rise to liquefaction, a decided change in limited portions before the entire brain becomes dis- organized. Whatever treatment be adopted in any individual case we say give kephalin granules, the great reconstructor of lost vital force. The passiflora incarnata should in all cases be administered to rectify molecular nutrition. Other forms of delirium consist in an acute disorder of the mind, due to irritation of the gray matter of the brain. It varies in degree from incoherent ideation to complete mental derangement. It may be quiet, garrulous and noisy, low and muttering, or quite maniacal. It may be due to inflammation of the brain, organic disease of the brain, poisonous substances circulating in the blood, reflex irritation (as when there is great pain elsewhere), or to great mental shock. The nervous constitution of the individual is also a factor which must be considered. Intemperate people are very liable to delirium from causes which would not produce it in an ordinary in- dividual. DENTITION. — In man and most mammals, there are two distinct sets of teeth ; one set which appears shortly after birth, and which are termed the milk or deciduous teeth; and a second set, which, after a few years, replaces these, and which are termed permanent teeth. In the human subject, the milk-teeth are twenty in number, each jaw containing (from before backwards) four incisors, and Dictionary of Diseases. 247 two canines, and four molars ; while the permanent teeth are thirty-two in number, each jaw containing four incisors, two canines, four bicuspids, and six molars. The following is the usual order and period of appearance of the milk-teeth : The four central incisors usually appear through the gums about the seventh month after birth, those of the lower jaw showing themselves first. The lateral in- cisors next appear between the seventh and tenth months; the anterior molars show themselves about the thirteenth month, and are soon followed by the canines, which usually appear be- tween the fourteenth and twenty-first months. The posterior molars are the last and most uncertain in their time of protru- sion, which may range from the eighteenth month to the end of the third year. About the middle or end of the seventh year, the jawbones have become sufficiently elongated to permit the appearance of the first true molar; and about the same time, the central in- cisors are replaced by the corresponding permanent teeth. The advance of the permanent teeth towards the surface of the gum causes the absorption of the roots of the temporary teeth, and thus facilitates their shedding : the crown falling off, and leaving room for the permanent tooth behind it to come for- ward and supply its place. In the replacement of the first by the second set of teeth, the following order is observed : The middle incisors are first shed and renewed (usually when the child is about eight years of age), and then the lateral incisors (perhaps a year later"). The anterior molars of the first set are then replaced by the anterior premolars (this usually happens about the eleventh year) ; and about a year afterwards the posterior deciduous molars are replaced by the second premolars. The permanent canines take the place of the deciduous ones in the twelfth year ; these being the last of the milk-teeth to be exchanged. The dangers of teething among children are chiefly due to a want of phosphates in the blood, hence there is not material for their nutrition — hence they grow slowly, dentition is re- tarded — the reflex effect is disastrous, as the whole organism is undergoing a revolution, most productive of bacteria in the mouth. Morbid Dentition. — Precocity, irritation of gums, due to want of phosphates in the food; tissue starved; cerebral dis- order; give rise to convulsions, spasms of glottis, cough, in- digestion. 248 The Germicide 20th Century Practice Irritation from non-advancing teeth occurs because the normally flinty teeth, to which the soft gums can offer no prac- tical resistance, are suffering from lack of nutrition. While the gum lancet gives temporary relief, yet it transforms normal into cicatricial tissue. In place thereof, the writer recommends correcting any faulty conditions in the infant's alimentary tract, and placing it upon a mixture of the calcic salts, ap- proximating the proportions as nearly as possible to those found in the teeth. For example : R. Calcium phosphate 2 parts. Calcium carbonate 3 parts. Sodium phosphate 1 part. M. Triturate to an impalpable powder. Sig. : Three to four grains, or more, with other food, three or four times a day for a week then once a day, pro re nata. In anemic children a trace of ferric phosphate is added. The decay of the teeth (caries) is exceedingly common, es- pecially so among civilized people. The lack of power to resist this disease may be due to the depression of vital vigor through overtaxing the nervous system or through sedentary habits and luxurious living. In this, as in other matters, there are in- herited tendencies, and the children of those whose teeth decay early themselves suffer the same evil. The solution is found in the germ theory, which has already settled the origin of so many infectious diseases. Dental decay is due to the microscopic germs which are called bacteria, the smallest of organized beings, so small that it takes 100,000 of them placed lengthwise to measure an inch, belong to the plant family. They multiply both by division and by the formation of spores. The spores, which correspond to seeds, have great vitality, and are unaffected by the temperature that would destroy the parent plant. The multiplication by division is exceedingly rapid. Thus the total eradication of the germs is almost out of the question, and in even a short time, if the pest be neglected, it becomes difficult to limit the harm they can do. That harm may be effected either by the growth of the bacteria at the ex- pense of the cells of the body, or more probably, perhaps, by developing a poison in their waste products. It must be remembered, however, that many kinds of bacteria are perfectly harmless, while it is possible that some aid in the vital processes of the organism. The mouth is infested bv several forms of innocent bacteria. and Dictionary of Diseases. 249 The saliva is never free from them. Therefore, in order to as- certain if dental caries is due to bacteria, most rigorous tests were necessary. The bacteria must be found in the decayed matter of the teeth; be isolated from every other kind; culti- vated outside of the body, and the pure cultivation must pro- duce a similar caries when introduced into healthy tooth, and this caries must show the same form of bacteria. Judging from the questions constantly asked the dentist, it is no exaggeration to say few people have a clear conception of the causes which lead to decay of the teeth. Chief among them is the fermentation of particles of food lodged between the teeth, or in their pits or depressions, during mastication. When, through carlessness or indifference, these deposits are not removed, under the influence of the warmth, moisture and the microbes present, fermentation, or chemical change, takes place and an acid is generated, and this dissolves the enamel and dentine, leaving a cavity to grow larger and deeper. The dentine is of a tubular structure, and in these tubules the microbes which constantly exist in the mouth penetrate, where they continue their destructive effect till the tooth is completely destroyed. Microbes are minute vegetable organisms, some of the many species of which are so small that they are only visible under the highest powers of the microscope. They are the cause of a large class of infectious or contagious diseases, and between them and the body there is a constant struggle. The process of fermentation is of itself but the growth and multiplication of these minute organisms, and in this process of their life-history they produce the acids and other poisonous materials which make them so fatal to mankind. Their num- ber is inconceivable. These are the direct causes of decay of the teeth. But there also exist indirect, or contributing, causes, and these may be anything which will lower the general tone of the system, and make it less able to resist the action of deleterious agents. Among these secondary causes producing decay may be men- tioned any protracted sickness, the lack of outdoor exercise, excessive study, anxiety, or worry, which undermine and weaken the system. When the body is ill, no one organ can be said to be perfectly sound. The teeth may be crowded or depressed, or there may be fissures which offer a ready means for lodgment of food. The 250 The Germicide 20th Century Practice walls of the teeth may not be dense, and their power of resist- ing decay may be very weak ; or the food may not contain the necessary elements for nourishing the teeth, and hence the work of repairing the wear and tear of daily use may be but poorly accomplished. Again, there may be an hereditary tendency to decay. That our ancestors suffered from any special ailment does not necessarily demonstrate that it will be reproduced in us, but it is probable that the same debilitating conditions will be in- herited. Their consequences can, however, be avoided by proper and unremitting care. These causes are constantly at Avork, producing decay of the teeth and forming minute cav- ities, through which the decay rapidly progresses till the living matter of the tooth is reached. Unless this is checked, the tooth will be totally wrecked ; even if it be not wholly destroyed, it will be so badly decayed that it will threaten the welfare of the entire dentition, and therefore it may become necessary to extract it. DETERIORATION OF RACES.— The human race never can suffer degeneracy. There is a limit which terminates in non-procreation. There is no establishment of a morbid race. The demand made upon the working capacity of man in the present age is excessive, enormously increased; the call is for rapid action, intense exertion, gigantic effort. Thirty years ago life was tranquil, leisure abundant, competition small. Now we have the inevitable struggle which adheres to the survival of the fittest. The results of this incessant brain activity create an insuf- ficient supply of vital energy — a functional neurosis, character- ized by deviations from the normal, with an inability to perform the usual amount of physical and mental work. A poverty of nerve force involves a weak brain, spinal cord and nerves, ner- vous exhaustion, neurasthenia, which may be either hereditary or acquired. Loss of sexual power is usally an early and constant symp- tom, gradual in its outset, and exists in proportion to the amount of depression present. For this condition there is no remedy so valuable as isolation, rest, massage, and comp. ma- tricaria, and ozonized glycerite of kephalin. The latter is the only known drug that will prevent a deterioration or degener- acy of the human race. Degeneracy is attacking the native American race. There is a failing birth-rate brought about by masturbation, corrupt and Dictionary of Diseases. 251 morals, dishonesty in all spheres of life, which induces system- atic decay, an increase in crime. Simultaneously with this di- minished birth-rate, infanticide, insanity and suicide increase. There is no room for doubt that masturbation, sexual excesses give rise to racial degeneracy and non-survival. Xo nation can withstand the constant drain on vitality, the cessation of mental and moral growth, the upsetting of principles, the upsetting of life's activities as seen in the daily life of America. Kephalin meets all the indications of creating a higher type •of manhood. At the very origin of this state of degeneracy lies neuras- thenia, a poverty of nerve force, a condition in which the nerve centres are exhausted, the store of energy drained off, not only weak but chronically and constitutionally without force or en- ergy every gland is sluggish, inertia, auto-intoxication, blood and tissues loaded with effete matter, with poisons generated in the alimentary canal, in such quantities that the liver is un- able to destroy them, neither can the kidneys eliminate them; tissues are literally saturated with these toxins; nerve centres not only weak but stupefied with alkaloidal poisons ; the whole body out of gear by the presence of ptomains and toxins. Enervating diseases bring about neurasthenia sooner or later ; sooner, for the intestinal tract is simply a hot-bed of disease germs, whose toxins are nerve irritating, brain stupefying, heart exciting, tissue paralyzing, deranging every vital function or process. Such condition kephalin will cure. Neurasthenia is hourly on the increase, for every new discovery or mechanism in every- day life multiplies the production of new diseases ; every new discovery in the hands of the degenerates develops new patho- logical conditions, new forms of crime. See what the bicycle is doing — giving us a doubled-up, hunch-backed race ; idiotic, an instrument of crime, disease, degeneracy ; it is the etiological factor of prostatic catarrh, spermatorrhea, impotency and ster- ility, a loss of reproduction which kephalin can only cure. We state again, to be more emphatic, that there is a marked tendency at the present time for the birth-rate to keep pace with the death-rate, even a slight excess of deaths in some States. Is this infertility of the pure colonial stock, native American, to be supplanted by the dregs of reeking brothels of European and Asiatic pauperism and crime? Most assuredly no. The cause of this decay is a loss of reproduction ; fecundity is the factor which maintains the survival. The fertility and sterility 252 The Germicide 20th Century Practice of our people is one of absorbing interest, and does not receive the attention it deserves. The decay is apparent in a loss of pristine vigor, which the daily use of kephalin can overcome, aided by good diet, a strict avoidance of all alcoholic bever- ages, prolong sleep, stamp out all excesses, enforce more rest, cut off all expenditure of energy, mental and moral peace, es- sential conditions for rapid recovery. The daily bath with massage has tonic properties equaled by no known drugs, a temperature borne without discomfort. Properly manipulated, it has strong and powerful effects. DENGUE, BREAK-BONE FEVER.— Along the entire seaboard of the Southern States every summer and fall there is quite an epidemic of this fever, characterized by well-marked symptoms of prostration, great pain and stiffness in the bones, so agonizing that he cannot move a limb. Most excruciating in the forehead and orbits, increasing in intensity and severity, with some delirium and sleeplessness. Usually a well-defined period of incubation of about forty- eight hours, followed by violent rigors and a very high fever., which, if not interfered with, continues for four days, when symptoms diminish and a very variable form of eruption makes its appearance ; some cases a mere erythema ; in others an urti- caria; while in another class of cases a papular rash, with burning and itching all over. The eruption usually continues a few days. The microbe, which is pathognomonic of the malady, is found in great abundance in the scrapings or scales of the erup- tion ; in the coating of the tongue, saliva, blood ; the liver, spleen and lymphatic glands suffer congestion, but not to such an ex- tent as in yellow fever. The victims of dengue are the poor, badly clad, ill fed, half- starved denizens of the rice swamps. If nursing is procurable, then emesis by the administration of comp. lobelia powder; free action of the liver; an alcoholic vapor bath, or bathing the skin all over twice or thrice daily- As to curative remedies, the concentrated tincture of kurchicin completely annihilates the microbe; and just as this remedy- effects that result, symptom by symptom yields, until it disap- pears. One teaspoonful of the kurchicin every three hours. No other remedy can effect what this performs. If the patient is and Dictionary of Diseases. 255 much prostrated it can be administered per rectum, either in the tincture form or as a suppository. In the absence of the kurchicin, the suppository of quinine is next best. This operates well, as it produces no cerebral dis- turbance whatever. DERMOLIA. — An emollient, healing cream for acne, ec- zema, and all abrasions and eruptions of the skin. Instantly relieves the intolerable itching and burning sensation of the skin in cutaneous diseases, prurigo, psoriasis, etc. An admir- able substitute for the old-fashioned zinc ointment, which it far excels, as it is beautifully smooth and of creamy consistence and delicately scented. In all roughness and irritation of the skin its healing and soothing properties are gratefully recog- nized. Dermolia is an ointment which possesses strong healing prop- erties, being thoroughly antiseptic, germicidal, non-poisonous, unirritating, and powerful promoter of a reparative process. It is of great efficacy in all contusions, incised and lacerated wounds, no matter how inflicted. Its application requires no safeguard. Simply apply it freely and at least renew twice daily. If the ordinary precautions be observed, such as the removal of foreign bodies, the arresting of hemorrhage, the approxi- mating of the edges, close by sutures, then this ointment ap- plied, wounds rarely if ever suppurate, but invariably heal by first intention. An ointment of superior efficacy in burns; splendid results follow its application in old indolent ulcers and in all vegetable parasite affections of the skin. DIABETES. — The increasing prevalence of glycosuria — its dependence upon some disturbance of the origin of the eighth pair of nerves in the base of the brain, giving rise to cerebro-spinal complications — the fact that it is very common among the neurotic and insane, is significant, unusually com- mon among the paralyzed, possibly an etiological factor, at all events associated with, or dependent upon, chronic brain dis- ease, shocks to the great sympathetic, concussions of the brain, involving the diabetic centre in the fourth ventricle. The enlargement of the liver, the smallness and softness of the spleen, the paleness of the heart-muscle, the atrophy of the pancreas, the saturation of the fluids and solids of the body with ^54 The Germicide 20th Century Practice saccharine elements, give rise to many complications, such as tuberculosis, which infiltrates the lungs; boils, opacity of the lens, giving rise to cataract; gangrene of the skin. Saccharine diabetes grows more prevalent annually, just as neurasthenia prevails. The loss of vigor is usually associated with increased appetite for food and drink ; the tongue changes to red and. dry with transverse fissures; skin dry and harsh, a partial or total absence of perspiration, with a flow of urine in- creased in quantity, loaded with sugar, and of a high specific gravity, ranging from 1035 to 1060. Albuminuria may be associated with glucose; polyuria is aggravated at night ; constipation an inevitable attendant. To give a favorable prognosis in any case in which the glu- cose is permanently present in large amount, is assuming too much in practically an incurable condition. All that can be claimed for the best scientific treatment is a stay of the progress. Daily baths, massage, and relieving the constipation are use- ful. The introduction of jambul in the treatment of every case of diabetes is most important. It has proved exceedingly bene- ficial in arresting the transformation of amylaceous substances into saccharine. It is a remedy never to be omitted. In addition to the very large amount of glucose in the blood, the fungus excretes a ptomain, an alkaloidal body; the product of chemical change, of bacterial life, which possesses great te- nacity, and materially aids in the general breakdown. It has been ascertained, by careful clinical observers,* that kephalin and avena sativa completely neutralize or antagonize this toxin. The active principle of these two remedies has been isolated and re-combined in the form of the kephalin granules, which, when prescribed in all cases of glycosuria, effect very wonderful curative results; repairs the central brain lesion; rectifies the errors of nutrition ; diminishes the amount of sugar secreted by the liver ; relieves the pain in the joints ; appeases the voracious appetite for food and drink. This remedy, the kephalin granules, is the only one that promises hope for the future. Whether paroxysmal or permanent, the presence of grape sugar in the urine is indicative of cerebral wreckage. An irritation of the brain, transmitted to the liver, causes grape sugar to be elaborated in great abundance; so much so, that the ozone-forming faculty of the lungs is incapable of and Dictionary of Diseases. 255 burning it up ; hence, the presence of this agent in the blood and tissues of the affected individual's body, in such abundance as to give rise to the presence of a fungus in the blood — a living breeding microbe, pathogenic of the disease, whose toxin is most inimical to brain vigor. There is no microbic affection so easy of recognition as this ■ — the intense sensation of goneness ; the excessive appetite for either food or drink ; the chloroform odor of the breath ; obsti- nate constipation; arrested function of the skin; visional trouble, occasionally cataract; urine loaded with grape-sugar. Usually a very high specific gravity, ranging from 1020 de- grees to 1060 degrees, later stages tuberculosis. Fungus easily isolated from the urine, and can be cultivated in any sac- charine or amylaceous fluid at a temperature between eighty de- grees and ninety degrees. The very great increase of diabetes all over our country is leading scientific minds to investigate the causes. One impor- tant conclusion has been reached, namely, that wherever coal tar derivatives are prescribed, that is, antipyrin, phenacetin and somatose, there diabetes is liable to follow; that is, there will be prostration, chloroform breath, dry husky skin, saccharine urine, of a high specific, with an increased appetite for either food or drink. Diabetes (Glycosuria. The Sugar Fungus). — A dan- gerous and fatal malady, the leading symptoms of which are profound prostration, voracious appetite for food and drink, with the discharge of an excessive quantity of pale urine of a high specific gravity, loaded with glucose, general derange- ment of health ; pains in the loins, cramps in the legs, insomnia and great restlessness, symptoms become gradually worse; emaciation, sugar increasing, appetite failing, and a breakdown in the brain terminates the difficulty. During the last century this morbid condition was peculiar to adults of both sexes, but in the twentieth century it is becoming quite common among children. With them it is usually acute, early and rapidly fatal, but as age advances its acuteness passes off, and symptoms diminish. Incontinence of urine arising suddenly in a child suggests the possibility of diabetes. It is not a neurosis, but is due to some form of cerebral irrita- tion, indigenous to modern civilization, such as modern travel. Habitues of both steam and electrical cars are subject to jolt and jar, which induces a disturbance of the cerebro-spinal fluid, which irritation is communicated to the cord, thence to the brain in the fourth ventricle. 256 The Germicide 20th Century Practice Certain it is that railroad employes are its victims, and cere- bral irritation is a constant factor. Glycosuria is a transitory condition brought about by some neurosis, such as some onerous and perplexing duties, lack of recreation, something that will produce some functional nervous disorder. The newer materia medica brings to the front some remark- able remedies of rare value in the treatment of this disease. Jambul is a remarkable medicament, when administered pre- vents the pytalin of the saliva from converting the amylaceous portion of the food into sugar. The remedy has achieved much success. The powdered seeds in five-grain capsules is the only of the food into sugar. The remedy has achieved much suc- cess. The powdered seeds in five-grain capsules is the only form that is admissible. By taking one or two after meals the evolution of the glucose fungus is completely cut off. The specific gravity of the urine becomes normal, quantity also is decreased, and the entire aspect of things is changed. The powdered drug in pearls or capsules only effects such important results. Another exceedingly valuable remedy in all cases of diabetes is the ozonized comp. tincture of matricaria. It is especially valuable when certain psychical symptoms, and such physical symptoms as immobility of countenance, diminished resisting power, heart failure, sleeplessness, cervico-occipital pain or dis- tress and dyspepsia are of most frequent occurrence. It is worthy of a trial. The ozonized giycerite of kephalin and tincture of avena sativa have effected wonderful results in this malady. In their administration the matricaria is best given before meals and the kephalin or oats immediately after — all well diluted in water. Protonuclein in diabetes is at present under observation. All cases so far in which it has been used apparently do well, are much improved, and manifest conditions of recovery. In health the pancreas yields a secretion which acts on all the principal organic constituents of the food and prevents any excessive production of sugar within the body, and profoundly modifies the metabolism of the tissues. If the pancreas becomes diseased, if this internal secretion be deficient or absent, glucose or grape sugar is to be found in all the secretions and excretions, in all the solids and fluids of the body, and an evolution of the microbe of diabetes makes its appearance in the bood and tissues. and Dictionary of Diseases. 257 The causation of either temporary or permanent glycosuria is of much interest, as depressed states of the brain and great sympathetic ; hard work, great mental anxiety, shocks ; the ac- tion of the sun, malaria, all react either directly or indirectly upon the pancreas. Essentially a disease of civilization; annually increasing in frequency among men who exercise their brain and nervous system inordinately. Excessive wear and tear of this life centre sooner or later brings about great exhaustion. Diabetes then originates in a want of nerve power, affecting the chemical centre in the brain and the pneumogastric nerve, branches of which supply the vital organs. In the recognition of this malady it is not well to depend upon the excessive appetite for either food or drink, neither upon symptoms of indigestion, nor upon frequency of urina- tion, nor upon abnormal sensitiveness to cold, nor wasting, nor cerebral depression, nor impoverished blood, but rather upon the persistent presence of sugar in the urine, with its imperfect combustion in the lungs, giving rise to the chloroform breath, paralytic condition, with impoverished blood laden with frag- ments of broken down corpuscles, which obstruct the current, plug up the capillaries, giving rise to boils, abscesses, car- buncles. The persistent presence of sugar in the urine is the leading- feature of diabetes; glycosuria, occurring in gouty subjects, signalized by occasional appearance, differs materially from that which is persistent — polyuria. In the latter excessive ap- petite, great weakness, inflammation of nerves, nutritive changes, degeneration of usual organs, diminution of vision are found. Whether it be simply glycosuria or true diabetes it is in- variably a good plan, tends to prolong life many years, to keep down the amount of sugar circulating in the blood. This can be effected best by the administration of from five to ten grains jambul seed pulverized, in a capsule, which prevents the conver- sion of amylaceous substances into sugar. Whatever the type of diabetes be, temporary or persistent, in every case give jambul ; only the fresh pulverized seeds, as it completely gets rid of the sugar in the urine. Don't let drug concerns saddle you with any other preparation, as they are completely worthless. Animal extracts are looming up as the only curative agents. Very many cases might be enumerated in which thyroid extract 258 The Germicide 20th Century Practice has arrested the morbid process; kephalin or cerebrin works admirably, both the glycerite and the granules. Our very best remedy, as it seems to retard the rapid metamorphosis of tissue and keeps the urine at a normal standard. Paroxysmal glycosuria is simply the first step. It eventually develops in diabetes. It is not supposed to be the sugar that causes the fatal explosion of diabetes. The toxins are held re- sponsible for the acetonuria. It is customary in this malady to restrict or forbid the use of all saccharine or amylaceous articles of diet, but this is not nec- | essary if five or ten grains of jambul in capsules be taken after eating. This remedy prevents a change in the starchy elements of the food, and prevents the sugar fungus from forming. The systematic administration of intestinal germicides has met with much success, such as siegesbeckie tablets, thymol, salts of uranium, resorcin, ozone water or peroxide of hy- drogen. In the present age opium is out of date. No more sheet anchor about it, but a means of soothing the patient to the grave. The up-to-date remedy is the ozonized tincture of passi- flora incarnata, administered in large doses every three hours. It has a most salutary action on any tissue of the body. It should be persistently administered. Nitrate of strychnine or comp. matricaria best tonics, either one before meals. Rhus aromatica has formed a valuable remedy in this disease. The tincture of the bark of the fresh root in from five- to thirty- drop doses. It is worthy of a trial. The administration of the glycerite of kephalin is esteemed by our best clinical teachers as the only curative remedy in dia- betes^ overcomes the extreme debility, the loss of sexual power, the progressive emaciation, the insomnia, repairs the cerebral lesion. In cases of diabetes where there is reason to suspect that the normal secretion of the pancreas is absent or in abeyance, tryp- sin should be made into pills and coated with keratin, so as to pass through the stomach unaltered. The alkaline bile or duo- denal secretion will dissolve the keratin and set free the fer- ment, and thus supplement the pancreatic secretion. The ordinary diabetic diet is meat, eggs, and milk, with vege- tables containing no starch. Almond flour and gluten are also- used. The patient soon tires of these ; and, moreover, the excess of nitrogen is almost sure to be followed by decomposition and auto-intoxication. If, as is generally supposed, derangement and Dictionary of Diseases. 259 of the liver is the cause of diabetes, the abnormal increase of the work of the liver on account of the auto-intoxication would naturally tend to increase the diabetic symptoms. Fruits can be used freely. They give variety to the diet, and furnish the much-needed carbonaceous elements without increasing the sugar. They tend to diminish gastro-intestinal decomposition, and hence take work off from the liver, so that it is better pre- pared to attend to its function of storing up the sugar until it is needed. Give the patient all the water he wants ; feed him freely on fruits ; they increase the alkalinity of the blood, and this favors oxidation of the sugar. Give him nitrogenous foods in the form of gluten gruel or mush, gluten biscuits and nut foods. If he is vigorous, have him exercise ; if feeble, keep him in bed. In Bright's disease the albumin is being passed off from the body, while some of the poisons are being retained. The kid- neys are crippled; the indication is to diminish the loss of al- bumin and to flush out the kidneys and then get rid of the accumulated matter which prevents their free action. With a fruit diet there are less ptomains from intestinal absorption, and less extractives from the meat, and hence less work for the liver and kidneys. The fruit also acts as a slight diuretic, caus- ing the passage of more fluid, and thus acting as a flush to the kidneys. DIAGNOSIS (To Learn Disease). — A physician, when consulted by a patient, is naturally enough expected to be an attentive listener to what, to his informed mind, is a strange medley and most confused account of those deviations from health or actual sufferings by which the patient has been driven to seek aid. The more serious symptoms are often lightly touched upon, the more trivial exaggerated, and the whole jum- bled together without logical sequence or the slightest attempt at orderly arrangement. This story, trying as it is to the physi- cian, and all the more trying the more his own mind is duly trained, he ought to listen to ; for this the patient expects, and perhaps has a right to expect. During the tedious narration it may give him patience to bear in mind two considerations : first, that from it he must obtain the right end of the clue which is to guide him in the difficult task of ascertaining the nature, ex- tent, and seat of the disease; and, second, that by this often most prolix narrative, taken along with his attitude, manner, and expression, the patient, absorbed in his own sufferings, is 260 The Germicide 20th Century Practice giving his physician, if he is careful and observant, the best opportunity of becoming acquainted with the ego with whom he has to deal. The most critical examination of symptoms, the most careful inquiry into the state of internal organs, the most logical de- ductions from these as to the morbid changes from which they have originated, will often be erroneous unless the physician is also a student of human nature, and is able to arrive almost in- tuitively at some knowledge of the mental characteristics and peculiarities of the patient. But sooner or later, and more often later than sooner, the pa- tient will have arrived at the end of his narration, and then the physician must unravel for himself this tangled web ; and, tak- ing the different threads, he must follow them up, and by means of close physical examination, ascertain the condition of the various organs of the body, particularly those which the train of symptoms detailed indicates to be implicated in the morbid process. It is only by a methodical examination of the different systems of the body that a satisfactory view of the condition of the patient can be obtained, and the very foundation of rational treatment laid. How to Recognize Disease. — In order to do this with cer- tainty the patient should be examined according to a well-de- fined plan or order. The name, age, occupation, residence, tem- perament, previous history, sex, should be carefully noted, and then inspection, palpation, measurement, percussion, ausculta- tion, pulse, tongue, skin, secretions, excretions, heart, respira- tions, etc., carefully noted. All interrogations should be put to the patient in plain language such as he can readily compre- hend, in systematic order, so as to arrive at a precise knowledge as to what kind or nature of deviation from health has taken place; and, above all, in our examinations and manipulations we should never forget that we are learning the disease of a fel- low-creature like ourselves, who possesses the same feelings and sensibilities. Prudence, delicacy and kindness should, therefore, guide our movements. The consulting room of a physician should be as sacred as the confessional, never de- graded into an engine of terror or extortion. There should be the strictest honesty of purpose, conduct pure and exalted, and everything called by its proper name, never overstated, never condescending to anything ignoble, never coining names for trifling maladies, or aggravating the type of a disease. Patients should not be maltreated by endless examinations, speculations, and Dictionary of Diseases. 261 applications, and by drugging for years when nothing is the matter. Disease is best studied between fifteen and forty-five. Diag- nosis during that period is much aided by stability, perfect ossification, pulse, respirations, heart being steady, and all the functions of the body up to a healthy standard. Inspection. — Inspection of the general position of the pa- tient in repose and in motion is often very suggestive. The po- sition and attitude in fever and inflammation, in paralysis, hy- drothorax, asthma, colic, and spasmodic diseases are highly characteristic. The recumbent posture on back indicates de- bility; quick forcible changes indicate excitement of the ner- vous system, while fixed or restrained movements are dependent on paralysis or inflammation. Inspection of the countenance is of great importance, observ- ing whether sadness, peevishness, despair, fear, joy, grief, or other emotional condition is evinced. The yellow color of the skin in jaundice, its uriniferous aspect in Bright's disease, speak volumes ; whereas its conformation tells us much, as the corrugation of the brows in pain of the head. Pain in the chest causes the nostrils to be drawn upward : in the abdomen the lips to be raised and stretched over the gums and teeth. Inspection of the chest refers to the form and configuration of the entire thorax and its various parts, and a careful com- parison of the two sides, whether in motion or at rest. The mo- tions of the chest are referable to inspiration and expiration, which pass imperceptibly into each other. In disease these mo- tions are altered in various ways. First, by excess or diminu- tion, as in asthma and laryngeal obstruction. Second, by par- tial immobility as in pleurisy, or by augmented expansion as in pneumonia and pleurisy. Third, by increased rapidity as in pericarditis, or unusual slowness as in coma. Inspection of the abdomen is no less important than that of the chest. In health it is slightly convex, marked by elevations and depressions corresponding to the muscles of its walls, the umbilicus, and prominences of the viscera below. It varies with age and sex; smooth and flat in the young; broader in- feriorly in females than in males, from the greater width of the pelvis. In disease it may be enlarged generally and sym- metrically, as in dropsies; partially or irregularly in ovarian, hepatic, splenic, and other diseases ; it may be retracted from emaciation or intestinal obstruction. The respiratory move- ments of the abdomen bear a certain relation to those of the 262 The Germicide 20th Century Practice chest, and are increased or arrested with them. In pleurisy the respiratory movements are mostly abdominal; in periton- itis altogether thoracic. Disturbed relations of the respiratory movements of both abdomen and thorax are useful points in diagnosis in hydrothorax, asthma, ascites, abdominal tumors, etc. Palpation. — This is a valuable mode of examination, and is best practiced by simply pressing the tips of the fingers against the various parts. In some cases the whole hand or both hands are used. The most favorable position for palpa- tion is the horizontal or erect. The information that palpation gives is : First, increased or diminished sensibility. Second, the altered form or shape, size, density, elasticity, etc., of the parts under examination. Third, the different kinds of move- ments to which they are subjected. Pain, if inflammatory, is increased on pressure ; if neuralgic, it is relieved. In paralysis, the diminution of sensibility can only be ascertained by feeling the part, and the limitation of the anesthesia is best arrived at by pricking the surface. Alterations in size, form, density are often made out by palpation; a change in elasticity, hy- pertrophy, or atrophy is also easily discoverable. Certain mo- tions, as expansion, contraction, vibrations, frictions, grating, crepitation, are also determined by palpation. The natural fremitus or thrill perceptible on placing the hand on the chest when a person speaks is increased or diminished in disease. Fluctuation is a sensation caused by tapping on or percussing parts in such a way as to cause an agitation or wave of their fluid contents. Mensuration. — This is another valuable mode of examina- tion, and consists in measuring the distance between any two points by a graduated tape. For measuring either side of the chest or abdomen, a spinous process of the vertebrae should be selected as a fixed point, and the middle of the sternum or um- bilicus for the other. The exact level of the measurement should be carefully noted and an allowance of from one and a half to two and a half inches made for the right side, or for the left if a left-handed individual, and in case of a blacksmith even a little more. The pressure of the corsets in ladies en- larges the thoracic but diminishes the abdominal movements. In ascertaining the circular measurement of the chest and ab- domen, the moment should be selected when the patient holds his breath at the time of an ordinary expiration, care being taken that the tape is carried evenly around the body. axd Dictionary of Diseases. 263 Mensuration is valuable in detecting emphysema when the ribs bulge out ; in hypertrophy of the heart ; when the lungs are eaten away in phthisis ; in enlargement of liver, spleen, and ovaries. Percussion. — Percussion is best performed by spreading the fingers of the left hand not too widely apart transversely across the ribs and tapping on them with the right — the bare hand on the naked chest or some very thin intervening body, the patient either sitting or in the recumbent posture. The ob- ject is to ascertain the resistance and size of organs. The sounds elicited by percussion or beating arise from the vibra- tions occasioned in the solid texture of the organs percussed. The different density and elasticity of organs modify the num- ber and continuance of the vibrations, and give rise to different sounds. For the sake of simplicity all the sound obtained by percussion may be embraced under three heads, and these three sounds are dependent on the organs containing air, or on their containing fluid, or on their being formed out of dense solid tissue. These sounds or tones may be termed the resonant, hu- moral, and parenchymatous; resonant over organs that contain air, humoral over organs that contain water, and a dull, flat sound over solid organs. To become thoroughly familiar with these three sounds takes a little time and close attention. The sense of resistance is an important consideration in percussion ; it bears a relation to the density of the object struck; thus firm and solid organs or textures suffer more resistance than the soft or elastic ones. The ribs and entire thorax of a child are very elastic; those of an adult, when ossification is complete, very unyielding. Before percussing a person affected with disease, the op- erator should have a clear and accurate knowledge of the limits and intensity of clearness or resonance, or of dullness of the entire thoracic and abdominal viscera. For example, the lungs from top to bottom on both sides are resonant on percussion in health, reserving four square inches of dullness on the left side below the nipple for the heart and a variation at the base of the right lung for an enlarged liver, and of the left for an enlarged spleen, of an inch or more from the verge of the ribs. Over a healthy lung, then, there is perfect resonance ; but suppose the lungs are invaded by tubercle, this disease germ like all others selects the weakest parts for its deposit and growth, which in ordinary cases is the apex of the left lung, or the apexes of both lungs, depositing itself at the uppermost point and grow- 264 The Germicide 20th Century Practice ing and being deposited from above downwards. In such a case there would be dullness more or less, and the intercostal movement of the ribs would be arrested. There is one excep- tion to the above : if the patient was suffering from irritation of the liver, the branches of the eighth pair of nerves that cover the upper lobe of the right lung might be so weakened as to permit passive congestion, and dullness on percussion would be found. This only happens when the integrity of that nerve is weakened and all the blood-vessels it supplies thereby relaxed. There is scarcely any stage of deposit of tubercle in the apexes of the lung that fails to be detected by percussion; whereas when inflammation takes place it almost invariably begins in the large aerating surface of the lower lobe of the right, which is abundantly supplied with the 'sympathetic nerve, and it may proceed up the same lung or pass over to the left. Perhaps the only exception to the rule of dullness at the base would be in the closing stage of melituria or diabetes, when tubercle is thrown out at the base. As a general rule, then, congestive consolidation, the result of inflammation, begins at base. In some cases of tuberculosis, right in the centre of a lobe weak- ened by some irritation there may be an encysted mass of tu- bercle as large or even larger than the closed fist, and both apex and base clear on percussion. This mass may remain, or it may die and be expectorated, leaving a chasm or cavity or cavern in the lung, in which an undue resonance can be detected and mapped out. An undue resonance or a tympanitic sound may then be due to a cavity left vacant by expectorated tubercle, or it may be due to a dilatation of the air cells into pouches, or to infiltration of air at the abrupt angles or corners of the lung which is present in emphysema. A lobe or an entire lung may ulcerate away in consumption, giving rise to this sound on percussion, in which case there would naturally be a collapse of the ribs, whereas in emphysema there would be more of a bulging. Water may be effused into the cavity of the chest, the result of pleurisy, an obstruction about the heart, and can be readily ascertained by first percussing the chest of the patient when lying down, in which position the water, if there is any, in the cavity of the chest will gravitate to the back and the lungs will float, when the chest will be found clear from the top to bottom ; then sitting up, the dullness, if there is water, can be detected and its height marked. . The diagnosis of affections of the heart constitutes the most and Dictionary of Diseases. 265 difficult in the art of medicine. Any increase or diminution in size can be readily appreciated and detected. Its size varies with the individual ; four square inches or the size of the closed fist is reckoned normal, but in effusions from the pericardium which are so common in chronic rheumatism, the area of dull- ness is increased to a greater or less extent. In hypertrophy there is often a vast increase, so much so that dullness is great; there is a bulging to a considerable ex- tent. In percussing the solid organs like the liver, great care is necessary to carefully map out its boundaries; the superior margin is generally found from one to two inches above the margin of the ribs, while its inferior boundaries extend to a considerable distance. Variations in the size of the liver are great in our climate, extending from simple congestion, inflam- mation, induration, enlargement, abscess, hydatids, tumors. down to wasting or atrophy, and all can often be detected by percussion. In aggravated jaundice, as a symptom of organic disease of the liver, the increase or diminution in size of the organ will bear a proportion to the disease. If the gall-bladder is distended by bile or gall-stones, it is easily detected by per- cussion, and the dullness under the inferior margin of the liver, anteriorly and somewhat laterally, may be marked out. The size of the spleen is four inches long and three inches wide. In diseased states it is either enlarged or atrophied. In per- cussing this organ the patient should be on the right side. The sounds elicited on percussion of the stomach, bowels, bladder, are of great value in determining the size and position of other organs, as liver and spleen, also in locating tumors, and effu- sion of fluids. In dropsy of the abdomen the swelling is equable. On percussing the abdomen with fingers of the right hand with the fingers spread of the left, their points rest- ing on the opposite side of the abdomen, patient standing, a wave, undulation or fluctuation, can be detected very easily, and if not satisfactory empty the bowels with oil, and put the patient in a recumbent posture; bowels being empty will float on the top of the water, as the water has gravitated to the back ; then the standing posture should be again tried. A correct ap- preciation of the state of the bladder is also obtained by per- cussion. In percussing the kidneys turn patient over flat on the abdomen, so as to get a clear appreciation of the renal organs. Auscultation. — This consists in applying the ear either directly or through a stethoscope to the chest, abdomen, or 266 The Germicide 20th Century Practice other parts of the body, to listen to sounds or murmurs. Its object is to ascertain and appreciate sounds and their nature, and its utility is limited to the pulmonary and circulatory organs. Before resorting to this method of diagnosis, it is well to refresh the memory with what exists in health. If we place the ear over the larynx and trachea of a healthy adult male, we hear two sounds or noises, one accompanying in- spiration, the other expiration : they are called the laryngeal and tracheal sounds or murmurs. Move the ear to the right or left of the sternum, and you will hear the same sounds, only diminished in intensity; these are now called the bronchial sounds or murmurs. Place the ear under the nipple of the right side and two fine murmurs will be detected, normal vesicular respiratory murmurs. Keep the ear at the same place and cause the patient to count one, two, three, and so on, and there will be a peculiar impetus or sound of the voice called pectoriloquy or bronchophony. With regard to these healthy sounds, it must be borne in mind that vocal resonance originates in the larynx and dimin- ishes or increases from the point or source of the sound, modified by the textures in transmitting it. In all morbid states of the lungs these natural sounds are altered and new or abnormal sounds are developed. The alterations of the natural sounds in diseased conditions may consist in their being in- creased, diminished, absent, or location changed ; the most com- mon change is in intensity, often stronger or weaker, indicat- ing increased or diminished action. They may be altered in character, the sounds becoming harsh as in pneumonia, cavern- ous when a cavern exists in the lung in consumption, amphoric pneumothorax. There may also be an alteration in position; that is, sounds which are natural to certain parts of the chest are heard distinctly at other places whereas in health they were never detected. For instance, in pneumonia, bronchial or tubular breathing may be evident when only a vesicular mur- mur ought to exist. The inspiration in health is three times as long as the expira- tion, but in certain diseased conditions this relation is altered or inverted. For all practical purposes all the abnormal sounds may be classed under three heads : First, rubbing or friction sounds. Second, moist rattles. Third, vibrating murmurs. Besides these there may be whistling, blowing, cooing, rasp- ing and other rales or rattles caused by different impediments, mechanical obstruction. and Dictionary of Diseases. 267 1. Rubbing or Friction Sound. — This is caused by an irritation, inflammation, an effusion of serum in serous mem- branes which elevates the membrane into little blebs or blisters the size of a pin-point or head of a pin. It is a condition that we find after death an irritation of the membranes of the brain, peritoneum, pericardium, and pleura. In acute pleurisy about four or five days from rigor it can be very distinctly heard im- mediately over the site or location of the stitch or catch. On putting the ear to the place, we hear a rubbing like two pieces of brown paper being rubbed against each other. In health the pleura of the lungs and the pleura of the ribs are smooth, silky, finely lubricated; but when a partial death takes place, this effusion occurs with other symptoms of inflammation; they become dry, rasping, grating, and we may hear any degree of friction noise. The sound may be altered in various ways ; the stage of inflammation modifies it greatly. Although most distinct in pleurisy, we also hear it very finely in all forms of pericarditis. 2. Moist Rattles. — y/hen serum, or mucus, or muco-pur- ulent matter, or liquor sanguinis, or blood is effused into the bronchi, the air in the act of inspiration and expiration is forced down and then up through them, which causes a bubbling or rattling or crepitating which can be distinctly heard by the ear and often felt by the hand. A large number of names are ap- plied to this, but in all cases there must be a fluid to the moist rattle, so fine in some cases as to be scarcely audible (crepita- ing) ; so coarse as to resemble a gurgling or splashing (cavern- ous) ; and between these two grades medical experts enumerate a large nuraer of rales or rattles, as mucous, submucous, sub- crepitating. For all practical purposes, just adhere to the term moist rattles. These are present in bronchitis, pneumonia, phthisis. 3. Dry, Vibrating Murmur. — The wheezing or vibrating murmur is chiefly brought about by an irritation of the nerves that supply the circular muscular fibres of the bronchi, causing a contraction. We have excellent examples in asthma, whoop- ing cough, and emphysema, and in some cardiac diseases. There is a true condition of spasm, obstruction, loss of tone and elasticity in the bronchi, whereby the vibrations into which they are thrown by the column of air produce tones of an ab- normal character. The murmur is usually dry, and the fine- ness or coarseness of the sound will depend on the calibre of the tube or tubes of cavity thrown into vibration. Murmurs may exist from a fine squeaking to a hoarse snoring. 268 The Germicide 20th Century Practice The Heart in Health and Disease. — In placing the ear to the heart, we should pay attention to the impulse, to the character and rhythm of the sounds, to the place they are heard loudest, and the direction in which they are propagated. First find the spot where the apex of the heart beats or strikes against the walls of the chest, then listen to the sounds ; place the ear two and one-half inches above, a little inward, and listen to the sounds there; in the first position, where the apex strikes the chest we have the systolic sound, and two and one-half inches above the diastolic sound. There are two sounds, then, heard over the region of the heart. The first is dull, deep, more prolonged than the second, coincides with the shock of the apex of the heart against the thorax and immediately precedes the radial pulse; it has its maximum intensity over the apex of the heart below and in- side of the left nipple. The second sound is sharper, shorter, more superficial, has its maximum of intensity two and one-half inches above the other, and there is a gurgle in it. These sounds have received the names, systolic (contraction), and diastolic (dilatation), the former when the apex strikes the ribs in contracting, the other in opening to receive the blood. The two sounds are repeated in couples. First, there is the long- dull sound, coinciding with the contraction of the heart. Second, there is a pause. Third, the short, sharp sound. Fourth, a longer pause; all of which correspond to one pulsa- tion. With the systolic (contraction) sound we have the striking of the apex against the chest-walls, then contraction of the ven- tricles, then rushing of the blood through the aortic orifices, followed by flapping of the auriculo-ventricular valves. With the diastolic (dilating) sound, we have the rushing of the blood through the auriculo-ventricular valves and flapping together of the aortic valves. In disease, there may be a modification of the sounds heard in health, or there may be new and abnormal sounds devel- oped. The modifications of healthy sounds are variations in their seat, intensity, extent, character, and rhythm. For example, the sounds may be heard at their maximum intensity lower than the natural point in cases of dilated hyper- trophy of the left ventricle, enlargement of the auricles, or tumors at the base depressing the organ. They may be higher, owing to some abnormal swelling, or more on one side than another by effusions of air or fluid into the pleural cavity, or tumors, aneurisms, deformity. and Dictionary of Diseases. 269. The intensity and extent of the sounds may be diminished in atrophy, in fatty heart, nervous insufficiency — when there is a pericardial effusion, concentric atrophy of left ventricle, or emphysema. The intensity and extent of the sounds are in- creased in cases of dilated hypertrophy, nervous palpitation, or when the adjacent parts of the lung are indurated by effu- sion in inflammation, or tubercular deposit in phthisis. The character of the sounds may be clearer or duller than in health, according as the walls of the heart are thinner or thicker. The sounds are muffled in cases where effusion has taken place into the pericardium. Sometimes they are rough when due to in- flammatory changes. The frequency of pulsations varies in different affections. In certain diseased conditions the beats may be intermittent, or there may be pauses, or they may be irregular. There may be a variation in sound, an insufficiency of action, in other cases it may be irregular. There may be a variation in sound : a want of harmony in the occurrence of the two sounds, one faint the other tumultuous. All the diseased sounds of the heart may be classed under two heads. First, friction murmurs. Second, blowing or vibrating murmurs. The friction-sounds are due to inflamma- tion. The vibrating murmurs depend on some organic change, generally the result of inflammation. These murmurs vary in character from a general blowing or puff as if from the nozzle of a bellows (bellows murmur) , while others are harsher, grat- ing, or sawing, but all caused by diseased condition of the valves. Sometimes the valves do not close, and as a result the blood regurgitates through them ; in some cases the valves are constricted, shriveled, indurated, roughened, calcareous. The diseased sounds may be single or double, and have their origin either in the auriculo-ventricular or arterial valves, or in both. These sounds often resemble musical notes ; more or less resem- bling the cooing of a dove, singing, whistling; all depending upon some excessive narrowing of the orifices, perforation of the valves, irregularities in their margins, or exudations or deposits on their surface. Not infrequently a soft systolic blowing is audible at the base of the heart, or over the carotids and deep jugular vein; sometimes it is continuous, resembling the humming of a top. These murmurs, which are so common in poor blood, are easily distinguished from valvular ones by being systolic, by their softness, and by their presence when the substance of the zjo The Germicide 20th Century Practice Tieart is imperfectly nourished. On listening over the arteries in the vicinity of the heart, the same sounds can be detected. In peritonitis, the friction sound is often heard, and some- times a grating. Various sounds are heard in the bowels, etc. Auscultation, percussion, and other means of diagnosis are not to be depended on alone; they are simply aids, modes, or means of reaching an end, and should be strengthened by ob- servation of the pulse, tongue, skin, heat, temperament, urine, and other means of a definite character. The Pulse. — The pulse at birth averages 130 per minute. There is a gradual decline till puberty, when it reaches its permanent standard, from seventy-five to eighty. From fifty- five years of age upwards there is a gradual decline, so that in old age it ranges about sixty. In persons of a sanguine temperament it is about five or six faster than the bilious. In females it averages ten beats more than in males. The re- cumbent posture causes a lowering of the pulse of about eight or more beats per minute. The pulse being the sign of this or that disease, is also the sign of non-existence of special activ- ities, of strength and weakness, of irritation and relaxation of certain tissues. The more frequent the pulse, the greater the heat; the more rapid the respiration, the greater microbial evolution (ptomains), excretion, the weaker the patient. Frequency is the characteristic of all fevers and inflamma- tions. In acute rheumatism, frequent but remarkably full. In all acute inflammatory diseases, firm. In all abdominal inflammations, small, wiry, and frequent. In fevers proper, large and soft, or small and feeble, but frequent. In aortic regurgitation, hammering. In hemorrhage, jerking. In old age and in all conditions of arterial degeneration, hard and incompressible. In excitement, rapidity and shortness of stroke. In all acute inflammations of the brain, remarkable for its great frequency. In cerebral disease, very unequal and depressed. If there is pressure on the brain, slow and labored. In disease of the heart, irregular. In aortic regurgitation, although hammering, it is remark- ably faint and feeble. In syncope and cholera, imperceptible. and Dictionary of Diseases. 271 In all conditions of prostration, more or less faint. Scarcely perceptible in great exhaustion. A full pulse may be due to one of three factors: powerful ventricular contractions, loss of elasticity of the arterial wall, and interference with the blood flow from the arteries into the capillaries. The pulse wave propagated from the heart, outwards towards the periphery, may not arrive at the two wrists syn- chronously, due to aneurisms of the aortic arch. The character of the pulse varies in different ways. It will be sufficient for ordinary purposes to notice the following points : The expansion of the pulse, a pulse which reaches its full expansion quickly, and as rapidly collapses again, giving to the finger a very quick stroke, aortic incompetence. The opposite condition, pulsus tardis, is distinguished by the slow manner in which the artery fills and empties, and this sluggish- ness may be due to slowness in the contractions of the heart, to a hindrance in the capillary and venous circulation, to a loss of elasticity in the arterial wall itself, generally met with in arterial sclerosis. When disease affects origin of subclavian, pulse only found on one side. In all conditions of depressed vital force, frequent, unless there exists some mechanical impediment like emphysema. Pauses in the pulse, or an intermittent pulse, depend either upon disease of the brain or heart. Pauses in the pulse, still not quite intermitting, are often present in the users of tobacco, the nicotene affecting base of the brain. The Tongue. — The tongue is an excellent index of the state of the stomach and bowels; it often indicates the state of blood and brain. A map of the empire of diseases, its form varies much in shape. Swollen in inflamation or from the germs of variola, scarlet-fever, abuse of mercury. The motor innervation of the tongue is through the hypo- glossal nerve ; spasms of the tongue present in chorea, eclamp- sia, epilepsia. A heavy white coat, with or without elevated papillae, gastric derangement. A brown coat in centre and white at sides, derangement of stomach and liver. A very dark brown, gingerbread, or even a liquorice aspect, malignant bilious fever, or typhus. 2J2, The Germicide 20th Century Practice A charcoal hue at root indicates blood-poisoning. A fur on tongue, catarrh of the stomach. Transverse fissures on the tongue, intestinal irritation. Longitudinal tracks, irritation of the kidneys. Sharp pointed tongue, nervous irritation. A large flabby tongue, glandular disease. A smooth, raw-beef tongue, acute inflammation of the stomach. Red tip and edges, sharp-pointed, with white coat, or fur or other coat in centre, chronic inflammation of the stomach. A large, flabby, tremulous, creamy tongue, delirium tremens. Tremulous, and patient thrusts or darts it out, in chorea. Buff coat, like new leather, very dry, sharp-pointed, or it may be patchy, or papillae elevated, typhoid fever. Peculiar buff leather appearance in enteritis. Thick coating, white or brown, malassimilation. Aphthae, or ulceration in patches, malnutrition very great, so as to cause degradation of healthy living matter into micro-organ- isms ; if very patchy the irritation may be deep. Strawberry tongue, perhaps surface slightly coated in streaks, papillae projecting greatly, is characteristic of scarla- tina. In hysteria, tongue often morbidly red, moist, with or with- out a coat. Extreme dryness, diabetes. The tongue is shining, glazed, or chapped in ulceration of the bowels. Warts on edges near root indicative of syphilis. Tongue thickly furred, dirty white or brownish white, with- out either unusual dryness, enlargement, or redness, indicates that the derangement involves rather the lining membrane than the nerves of the stomach, and that not to a serious extent The derangement is comparatively recent, and easily reme- diable. Tongue furred with shiny matter, with vivid red tip and margins, indicates also an affection of the lining membrane, but of a more serious and continuous character. Yellow tongue, qualified by one or more of the last-stated conditions, indicates the liver as implicated. Clean tongue, of bright redness, naturally moist, but with the papillae unnaturally prominent, indicates that the derange- ment affects the nerves of the stomach and is of recent date. Dry, red, glazed tongue represents a similar affection to the last, but more severe and of longer standing. Swollen, red and Dictionary of Diseases. 273 tongue, with white fur, represents such a degree of nervous derangement of the digestive organs as to react congestively upon the brain, and implicate that organ. Cracked, furrowed, fissured, swollen tongue indicates a severe derangement of the nerves of the stomach. Swollen tongue, thinly coated, white, but bright red at the tip and margins, indicates a complication of both varieties of indigestion — that of the lining membrane, and that of the nerves of the stomach, of old standing, and of an obstinate character. We may look for irregular operations of the brain, as associated with the symptom, as well as ex- treme despondency, nervous irritability, and depression of spirits. Tongue indented on either side is a modification of the swol- len tongue, already mentioned as associated with derangement of the nerves of the stomach. Tremulous tongue, or tongue- trembling when protruded, common among habitual drunk- ards, distinctly indicates a complex variety of the nervous form of indigestion, implicating the spinal marrow. Blackish, dry, furred, and tremulous tongue is a severe symptom in abdom- inal or putrid typhus. Tongue drawn to one side, effusion upon base of the brain of the opposite side. Red like a piece of raw beef, with a dark hue at the root, gastro-peritonitis. Microbes gather upon the tongue in all germ diseases, as in the incrustation of typhoid, the germs are matted together. The Skin. — Hot and cold alternately in the entire skin or a part of it indicates nervous depression. Peculiarly thin and easily raised from the subcutaneous tis- sue in consumption and wasting diseases. A feeling of fullness and tension in the eruptive fevers, amounting to even a sense of hardness in erysipelas, and a gritty feel in smallpox. The nails are clubbed and hair falls off, in tubercular disease. Loss of hair is common in the convalescing from fevers and in syphilis. The skin is dry, harsh, in children suffering from tubercular disease. Remarkably moist, soft, doughy, in delirium tremens. Pallor is due to defective filling of the capillaries, due to in- digestion, anemia. Perspiration is sour in rheumatism, also in diseases attendant on malassimilation ; and excessive perspiration of any kind may be accompanied with small blisters on the skin, sudamina. 274 The Germicide 20th Century Practice Profuse drenching or colliquative sweats indicate great de- bility or exhaustion, as in lung-consumption or profuse suppu- ration, A rigor or chill indicates nervous depression, and either fore- shadows a fever or formation of an abscess. Rigor, with the cutis anserina or plucked goose-skin, de- notes the presence of the malarial micro-organism irritating the microscopical nerves of the skin, causing the muscles to con- tract in two different directions, thus creating a puckering. Rigor occurring during the progress of inflammation indi- cates the formation of pus. Jaundice, or yellow discoloration, disease of the liver, ab- sorption of bile. The crackling feel of emphysema is very characteristic, as is also the doughy character and pitting under pressure of ana- sarca. Protuberant eyeballs, wasting disease. The Appetite. — Becomes excessive in diabetes. Craving in mesenteric disease. When intestinal worms are present, variable and capricious. In hysteria or anemia of spinal cord, morbid, craving chalk or other alkaline substances. In pregnancy, very fanciful, longing for articles of food usually abnormal. In dyspepsia, variously altered. Thirst. — A central origin in the brain or medulla must be assigned to thirst analogous to the sensation of want of breath, or air hunger. The sensation is peripheral, due to the excita- tion of nerves in mouth and throat, which pass from the centre. In diabetes it is remarkably increased. In cholera very urgent. In diarrhea urgent, but less so than in cholera. Diuresis with uncommon thirst, when there is no sugar in the urine, generally due to anemia of cord or hysteria ; not at- tended with hunger, urine of very low specific gravity. Generally increased in all fevers. The Saliva. — i. The quantity of saliva in mild febrile dis- eases is increased and its ferment action unchanged. 2. In severe febrile diseases the quantity of saliva is de- cidedly lowered and is amylolytic action increased, the ferment evidently being secreted in a saturated condition. The salivary quantity is lessened as the amylolytic action is increased, but there results quite an important lowering- of the total ferment. and Dictionary of Diseases. 275. 3. After the crisis the quantity as well as the ferment power of the saliva is reduced. 4. In acute, long-lasting febrile diseases the quantity of saliva is not infrequently normal, but its amylolytic action is subnormal. 5. In pulmonary tuberculosis, even in severe cases, the quantity of the saliva is not lowered, and its ferment action is normal. Not until a few days before death is the quantity lowered, but even then the ferment action remains unchanged. 6. In chronic nephritis the salivary quantity is diminished and its amylolytic action not seldom subnormal. 7. In ascites the quantity of saliva is lessened, while the fer- ment action suffers but little change. 8. In long-lasting, debilitating diseases, such as scurvy, Ad-* dison's disease, and diabetes, the total ferment power is often diminished. Mosler found the diastatic power of the acid saliva of dia- betes not decreased, but very strong. The results here given comprise the greater part of the work relating to the ferment value of the saliva in pathologic con- ditions. The observations of Jawein, that the diastatic power of the saliva is not infrequently diminished in long-lasting, debilitat- ing diseases, together with the fact that the various secretions of the body are altered, and that the glandular functions and tissues in general are changed, and the occurrence of sialorrhea and sialaporia in the various anemias, have led me to study the ferment power of the saliva in these conditions. Alterations of Color. — In anemia the skin is remarkable for its paleness ; in chlorosis, for its greenness. In dropsy, from albuminuria, the skin is not only pale but white. In nervous irritation, often of a marbly whiteness. In phlegmasia dolens, where there is inflammation of veins and coagulation of their contents, the skin is as white as snow. There is a dingy yellow hue in cancer which is easily distin- guished by the pearly lustre of the eyes. The yellowness of jaundice varies from a pale to a deep green yellow and saffron color. Redness of the skin, when local, indicates congestion ; when general it may be due to erythema, measles, scarlatina, heat, or erysipelas. Redness in gout or rheumatism is usually local. In diseases of the spleen and lymphatics, whiteness and pal- 2/6 The Germicide 20th Century Practice lor ; but when the blood is not greatly affected, it may be of a muddy hue. In cholera morbus and malignant cholera, blue ; in non-aera- tion of blood, in pneumonia, bronchitis, diseases of heart, cya- nosis, blue, especially the lips, neck, ears, nails, face, etc. Lividity might be applied to it instead of blueness, but this term is applied to incipient gangrene. Spots, patches of discoloration, valuable in the recognition of certain fevers, purpura, scurvy, lead-poisoning, syphilis, and cutaneous disease. In disease of the suprarenal capsule, bronzed. In a well-marked case of malarial fever blueness may be looked for. The skin is of a peculiar uriniferous color and odor in uremia. Purple spots or patches in purpura and scurvy. The pallor of anemia and the greenish waxy hue of chlorosis are never to be confounded with the pasty hue of kidney dis- ease. The puffy appearance about the eyelids with anemia is an indication of albuminuria. The sallow hue of malignant disease is but another form of anemia. In diseases of the heart and chronic bronchitis, the blue, livid, or slate color of the nose and lips is remarkable, and contrasts strikingly with the dusky hue of pneumonia or the hectic flush of phthisis. In measles and typhus fever, suffused eyes are exceedingly characteristic. Irregular habits of living, generally indicated by a bloated, blotched face. In erysipelas, mumps, facial paralysis, the face undergoes re- markable changes. The pallid face and lips, the anxious look, the restless eye, tell, even before the finger is put upon the pulse, of the loss of blood. The pinched nose, the sunken eyes, ashy-colored coun- tenance, with perhaps beads of sweat upon it, speak suffering or pronounced sepsis. The pale face of chlorosis; the puffy, waxy, countenance of Bright's disease ; the bloated, heavy look of myxedema are not less characteristic than the bronzed hue of Addison's disease, the prominence of the eyeballs of Graves' disease, or the yellow tint of jaundice. In nasopharyngeal adenoids there are a seeming prominence and puffiness of the cheeks and the nasal bones, which cause heavy, sunken eves. and Dictionary of Diseases. 2*]j Extreme pollor or paleness may signify anemia, syncope, leukocythemia, dropsy, nausea, etc. The size of the face is often very considerably altered in disease. As a result of gout we have the ruddy appearance of blooming health, which, when associated with high tension in the arteries, is highly sug- gestive of chronic nephritis. Inspection is even more import- ant in the case of children. Pain in the head is indicated by contraction of the eyebrows; in the chest, by sharpness of the nostrils ; in the belly, by drawing of the upper lip. In abdomi- nal colic, screaming is intermittent. Sensations. — Flashes of heat and coldness are peculiar to nervous derangement. An aura epileptica consists in a sensation of some kind ; it may be like a gust of air on the side of neck and head, or a creeping up the arm or leg, or cold water running down the back, a feeling of insects in the skin, etc. A sensation of pins and needles, or a pricking sensation, is peculiar to paralysis. There is a great contrast between the external coldness of the body and the sensation of internal heat by which the pa- tient is oppressed. In diarrhea there is often chilliness. The heat of fever is often remarkable. The sensations of a hypochondriac or hysterical patient are often opposed to the evidence of the senses and good reason. A patient's complaint of want of sleep is sure to be exagger- ated. The attendant's statement alone should be relied on. The sympathetic or reflex pains are important. Pain in the right shoulder is indicative of disease of the liver. Pain in the sacrum, of inflammation of the uterus. In the knee, of inflam- mation of the hip-joint, of the meatus, of stone in the bladder. At the orifice of the urethra, with aching in the thigh and re- traction of testicle or irritation of the ovary, irritation of the kidney. In the cerebellum, of exhaustion of the lumbar por- tion of the spinal cord. A feeling as if scalp was rising, in- dicates irritation of the pneumogastric nerve. Drowsy, sleep sensation, or coma, may be due to bile or urea in the blood. Pain anterior or posterior over either chest or abdomen de- notes carcinoma. Pain in the crown of the head, chronic inflammation of the womb. Emaciation seems to affect, in phthisis, the arms and thorax most, face least. In abdominal disease, the lower limbs and face. 278 The Germicide 20th Century Practice In disease of pancreas there is remarkable emaciation. Increase of bulk often becomes remarkable in dropsy, say of the abdomen, of a limb, or of the head. It may rise from an internal or an external tumor. A delicate appearance, with long fringed eyelashes, points out the tubercular diathesis. The thickened alse of the nose and upper lip of tubercular disease are most marked in childhood. Posture and Gait. — Inability to stand depends on weak- ness, vertigo, paralysis. In weakness and vertigo the patient reclines, in paralysis he sits. In curvature of the spine and diseases of the hip the body is bent to one side. In excitement the gait is quick. In debility, slow. In disease of the brain and paralysis, labored, staggering, uneven. In rheumatism and disease of joints, stiff, halting. In chorea, constant, involuntary moving. In nervousness, tremor, and more especially in delirium tremens, regular shaking like shaking palsy. Tonic spasm occurs in tetanus, disease of the spinal cord, poisoning with strychnine. Catalepsy is a peculiar form of tonic spasm; cramp is its mildest manifestation. Clonic spasm occurs in epilepsy, chorea, and hysteria; sub- sultus is also a form of clonic spasm allied to tremor. In mania and delirium tremens the muscular movements are exalted. The muscular movements are generally diminished in idiocy and imbecility and in paralysis. A certain restlessness belong to hypochondriacs and more rarely to hysteria, allying them with delirium in the external manifestation. Position. — Head chiefly elevated in disease connected with the heart, less frequently in disease connected with the lungs. Head bent forward when there is pressure on the trachea. Patient may be unable to lie down from pain of head or gid- diness. Lying on the back is the position of debility; also position for paralysis when combined with inability to alter it; also in acute rheumatism. Same position assumed in acute gastritis, peritonitis, metritis, cystitis, with head and shoulders elevated and knees drawn up toward the abdomen. axd Dictionary of Diseases. 279 A prone position is generally assumed in abdominal spasm or colic. A doubled-up position, with or without vomiting, is present in colic, the passage of gall-stone or calculi through the ureter. Expression. — In disease of the heart, and in urgent dysp- nea, acute laryngitis, the face is remarkably anxious and con- tracted. When there is much pain in a vital organ, the face is pinched and contracted. Immobility most remarkable in catalepsy, or in states of un- consciousness and under the influence of spasm and in tetanus. In nervous disease and' hysteria, the opposite state exists. By the swelling of erysipelas the face is materially altered. Facial Appearances. — A retreating chin shows lack of force, mentally, morally, and physically; usually of the sweet, yielding sort; soon discouraged; desires protection; small ex- ecutive force. The development of other faculties often makes up for this defect. A small, well-rounded chin, with mobile and red cushion of flesh upon, indicates a pleasure-loving owner. If dimpled, all the more so, for dimpled chins belong to coquets. People with dimples love to be petted and loved ; like admiration and praise. Generally fickle. Usually this chin is healthy, recuperative, and long-lived. Broad chins signify nobleness and large dignity, unless verti- cally thin, when, if with it there be thin lips of bloodless kind, you find cruelty. Square chins with little flesh denote firmness and executive ability. These make good haters. Drunkards usually have a circular line about their chins. Slovens have wrinkles about their chins. Long thin chins are poetical, unstable, and delicate in con- stitution. Such people are subject to bowel derangements. If thin through the angles of the mouth, too, they are prone to tuberculosis. Generally short-lived. Medium chins with a suggestive bifurcation in the centre, with small mounds of flesh on either side, characterize gene- rosity, impulsiveness, cheery natures. (The same sized chins, with a dab of flesh just under the centre of lower lip, indicate meanness, selfishness, brutality). As a matter of fact, however, no one feature can be taken in judging character. Often development of other faculties of mind or feature entirely governs. In each case take the "to- tality of indications" before judging. 280 The Germicide 20th Century Practice Character of the Stools. — Digestion during the day in stomach. During the eight hours of sleep is carried on in the bowels, and the peristaltic wave is started in the act of masticating breakfast. The entire ingesta is emptied into the rectum, so one defecation in the twenty-four hours. Any de- viation from the rule is disease; more frequent diarrhea, less frequent constipation. Watery, mucous diarrhea. Undigested food in stools show that stomach, liver, pancreas, are at fault; if fat is passed, the latter. Very solid and retained longer than twenty- four hours, con- stipation. In typhoid fever, like pea-soup. In cholera, like rice-water. In acute dysentery, blood, mucus, pus. In chronic dysentery, mucopurulent discharge. When an internal abscess bursts into intestinal canal, pure pus. When black, the stools are likely to contain blood. In piles or hemorrhage low down in bowel, blood of a na- tural color. In deficiency of bile they are clay-colored; in excess very dark brown. When fermentation supplants digestion, frothy, yeasty. Enlargement of prostate causes the stools to be flattened like a ribbon. In stricture of the rectum, cut or chopped into flattened pieces. In disease of the pancreas, there is fat or oil-globules in the stools. Green, resembling chopped spinach in color, irritation of brain. In intestinal catarrh, stools mixed with mucus. Stools imbedded in mucus, an affection of the colon. The evacuation of pure mucus from the bowel without any admixture of feces points to catarrh of the rectum. When firm feces are passed, completely enveloped in mucus, we may conclude that the morbid process affects the lower part of the colon and rectum. The admixture of mucus with the feces in abnormal quantity is not always apparent to the naked eye. It often happens that when the feculent matter is examined microscopically there are found scattered intimately through it small masses of mucus, which are whitish-gray, hyaline and and Dictionary of Diseases. 281 transparent. This peculiar admixture of mucus indicates that the catarrhal affection is limited to the upper portion of the large intestine (and possibly, the small intestine), while the rectum and descending colon are free from disease. When the stools contain small masses of mucus tinged yellow with bile pigment, we may conclude that the small intestine has become affected. In normal feces, the reaction which is characteristic of bile pigment cannot be obtained; but when, from whatever cause, the peristaltic action of the small intestine is increased, this characteristic play of colors will be seen on the addition of nitric acid. Character of the Nails. — Clubbed or filbert-shaped nails in phthisis pulmonalis. In gout, reedy, brittle ; rot, black in great nerve shock, Suppuration of the nail bed in children, due to inherited syphilis in the parents. In leprosy, broken up, fibrous, much thickened, lifted up by the formation of epidermis, scales in the nail bed, no smooth surface to be seen on any of them. The onyx of the nail copper-colored, syphilis. A distinct transverse ridge, acute disease, like typhoid. Respiration. — The normal pulse divided by four gives the number of respirations per minute, provided there is no disease of the brain, lungs, or heart. Number of respirations at va- rious ages per minute : First year, 35 ; second year, 25 ; at puberty, 20; adult age, 18; old age, 15 to 16. Most frequent in inflammations and fevers. Pauses in respiration, cerebral or cardiac disease. Stertorous, labored, with deep sleep, in inflammation of brain, apoplexy, congestive fevers, as typhus. Imperceptible in collapse, cholera. Very embarrassed in cardiac and bronchial disease. Hurried or excited respirations are common in nervous ex- citement, hysteria. The odor of the breath is often signficant. It has a chloro- form odor in melituria, diabetes, and chronic alcoholism, when there is sugar in the blood. Loud respiration under all conditions in which the air-cells are less permeable. Feeble respiration may be produced by pleuritic effusion, ad- hesion of the lungs to the chest-walls or obstruction of air- passages. Absence of respiration in catalepsy or great weakness, The: 282 The Germicide 20th Century Practice respiration is often grating, caused by thickening of the air- cells ; grating and short in acute bronchitis and pulmonary con- gestion. It is often tubular or blowing, which indicates induration or pulmonary condensation. It is often cavernous or hollow upon the breaking up of cavities in the lung. It is sometimes buzzing, which indicates a large cavity in the substance of the lung. The rhoncus and sibilant rales are dry, sonorous, whistling, cooing, snoring, in inflammation of the bronchi. The crepitating rale resembles the friction of the hair rubbed between the fingers; it is to be heard when resolution begins in pneumonia or bronchitis at the seat of congestion. The subcrepitating is the ordinary moist rattle caused by air going down and up through a fluid — the density of the fluid modifying the sound. Temperature. — The pulse at birth ranges from 130 to 140; respiration from 33 to 40; and animal heat from 102 to 103 F., from which period to puberty there is a gradual decline. From puberty to twenty-five the pulse reaches 70 or 80; res- pirations 18, and the temperature 98 F., at which they remain if in perfect health till between forty-five and fifty-five, when there is an appreciable decline. A rise is indicative of dimin- ished vitality and ptomain excreta from disease germs, and the greater the rise the more aggravated the loss of vitality ; and a continued depression, if persistent, is indicative of disease. Observations by the thermometer should be made morning and evening, and a due allowance made for the diminished electrical condition existing in the night, during which time the type of all diseases is much intensified, and labor, death, and other conditions are more likely to occur. In applying the thermometer the bulb should be placed under the tongue, mouth closer, or applied in the arm-pit, or to the groin or belly, and be retained in close contact with the skin and Well covered and allowed to remain several minutes. In all conditions of partial death, as in fever and inflam- mation, we have an elevation, whereas in collapse, emphysema, cholera, atrophy of the heart, etc., there is a remarkable de- cline. A rise to 103 to 105 is indicative of danger; above that almost invariably fatal. A lowering, if persistent, below 85 , unfavorable; a very sudden fall below that occurring in acute attack of peritonitis, etc., may indicate gangrene, or per- foration of bowel in typhoid. During convalescence, a sudden and Dictionary of Diseases. 283 rise in temperature, pulse, and respiration may indicate a re- lapse. We have no instrument superior to the index and adjoining finger for the pulse, and by the hand laid flat across the base of the chest the respirations can be easily counted. If there is no disease of the brain proper, heart or lungs, there will be a perfect harmony existing between heat, pulse, and respirations. Pulse 72, divided by four, gives respirations 18 and heat 98 in health, with the rise or fall of each in disease. Odors. — The diagnosing of disease germs and their ptomains is of great importance. Most physicians can name the microbe at work the moment he enters the sick chamber. The microbe and its ptomain have a diagnostic odor in spite of frequent bathing, ventilation, cleanliness, and all sanitary pre- cautions; the microbe in every case assails the nostrils of the medical attendant. Measles, scarlet fever, and smallpox are easily recognized by the odor of their respective microbes. The patient will often recognize the dreadful smell of smallpox, and compare the odor of his skin to that which he first experienced in taking the disease. The odors of typhoid fever and pneumonia are perceptible near the patient and in the room. There is also a peculiar emanation in tuberculosis, in cancer, and syphilis, with odor of each microbe respectively diagnostic of each. The odor of hydrosulphate of ammonia is always present in open cancer, and on that smell we place great reliance. In spite of great cleanliness, the odor of the gonococcus is perceived at some distance. The victim of masturbation has the odor of the ailanthus or dog-kennel — the microbe of this degraded bioplasm affects all weak persons in its proximity, hence its prevalence in prison- retreats. The mousy smell of the streptococcus of erysipelas, car- buncle, and typhus fever is indescribable. There are various odors from the lying-in chamber ema- nating from the patient — the usual odor of the lochia, that of the lacteal secretion, and that which indicates the approach of puerperal fever, the micrococcus active. Many women emit a peculiar odor while menstruating, which resembles a mixture of blood and chloroform; others have peculiar odors from parts of the body. A peculiar fecal smell is experienced from a lunatic or hypo- 284 The Germicide 20th Century Practice chondriac, very nearly the same as is experienced from patients who suffer from habitual constipation. The uriniferous odor of uremia emitted by persons suffering- from diseased kidneys is all-important. The comma-bacillus of malignant cholera can often be de- tected very early by the odor given out by the skin, breath, and stool. The odor of the sick-room and of the body of the patient generally, the smell of the breath, the sputa, urine, feces, sweat, ulcers, are utilized for diagnosis and treatment. The cadaverous odor is a peculiar earthy smell emitted from the body, sometimes as early as two weeks before death, in other cases a few days. The smell of the streptococcus of diphtheria is pungent, and is never forgotten. The chloroform odor of the glucose fungus in the breath in diabetes is most significant. The Weight of the Body. — The average weight of the body at birth is about seven and one-half pounds. We meet with cases frequently over twelve pounds and as low as two pounds in living - children. But when the average male com- pletes the twenty-fifth year of his age, growth has reached its maximum, but not weight. The general weight consistent with good health and stature should be as follows : Weight Increased Mean Weight. 7 per cent. Stature. Pounds. Pounds. 5 ft. I in 120 128 5 " 2 " 126 135 5 " 3 " 133 142 5 " 4 " 139 149 5 " 5 " 142 152 5 " 6 " 145 155 5 " 7 " 148 158 5 " 8 " 155 .. 166 5 " 9 " 162 173 5 "10 " 169 181 5 "11 " 174 186 6 " 178 190 If greater than the allowed seven per cent it affects the vital capacity, and respiration becomes diminished. Clothes av- erage about one-eighteenth of the weight of the body in autumn and early spring. Loss of weight is indicative of and Dictionary of Diseases. 285 phthisis, bronchitis, nervous dyspepsia, and other exhausting- diseases. Character of the Urine. — In hysteria, and anemia of the spinal cord, due to self-abuse, the urine is remarkably pale, limpid and abundant, with very low specific gravity — 1006 or 1010. In all fevers and inflammations it is scanty, high-colored, and loaded with uric acid, the result of excessive waste of tis- sue, which deposits on standing. If very scanty and much acid, there is a very copious brick- dust deposit. In disordered liver it gives a red stain to the vessel. In jaundice, the presence of bile gives it a dark porter-color. If blood is mixed with urine, it has a smoky color when acid ; a pinkish hue when alkaline; quite crimson when much blood is passed. The greatest amount of acid in urine is to be found in acute rheumatism or the uric acid diathesis. Urine, when it deposits a white, limy or calcareous matter, denotes nervous disease or the alkaline diathesis; if it contains pus there must be ulcer- ation either in urethra, bladder, or kidneys. In melituria or diabetes, urine very copious, increased be- yond the amount of fluids taken, loaded with grape sugar, and usually of a very high specific gravity ranging from 1035 to 1065, but in rare cases it is very low and still sweet. Healthy or unhealthy urine may have a peculiar aromatic smell, which may be affected by many articles of food or medi- cine, such as asparagus, garlic, cubebs, turpentine, copaiba. Urine voided in the twenty-four hours in a man of average height free from disease, averages about thirty ounces in the summer and forty in the winter. It should weigh about fif- teen per one thousand parts more than distilled water. If the kidneys are weak it may be highly albuminous, which can be detected by boiling, which coagulates the albumin. In disease of the brain it may be loaded with a white, floury substance, which can be precipitated by a solution of nitrate of silver. Albumin is found in the urine in conditions of weakness, ir- ritation, and collapse of the kidney, and also in diseases of the blood, as anemia, purpura, and is easily detected by boiling the urine in a tube, when, if albumin be present, it will become milky or cloudy; then add a few drops of nitric acid, which will clear the urine and coagulate the albumin into a mass. Its quantity can also be ascertained in the same manner. 286 The Germicide 20th Century Practice Phosphates and Chlorides represent waste of brain and bone, and are present to a certain extent in all urine, but are greatly in excess in all nervous diseases, as epilepsy, chorea, masturbation, paralysis, white softening of the brain, and other states. When very excessive they appear as a white cloud in urine, or in a copious white flour of gritty deposit in the bot- tom of the vessel. They are easily detected and their quantity estimated by boil- ing an ounce of urine, and adding a solution of nitrate of silver in the proportion of sixty grains to the ounce of water, which will precipitate the entire amount of phosphates in the urine, when the excess must be deducted from the normal amount, which will indicate the condition of nerve-waste or nerve-tire or exhaustion present. Pus is only present when there is suppuration in the kidney from a stone, or from ulceration of the bladder, or catarrh, or a gonorrhea, and is easily detected by boiling the urine and add- ing some liquor potassse, which will coagulate the pus into a gelatinous mass, or by the addition of the peroxide of hydrogen to the urine, if pus be present effervescence will take place. Sugar. — If the urine does not indicate disease of the kidney, but rather of the liver, pancreas, or more especially of the co- ordinating chemical centre in the brain — in some cases -to over- feeding, and for domestic purposes can be easily ascertained. if it exists, by placing the chamber with the newly evacuated urine in a warm place, keeping it at 8o° R, and adding a teaspoonful or more of yeast, effervescence will soon take place, a brisk discharge of gas ensues, and a yellowish liquid is formed, which has the odor of beer, and by distillation yields an alcoholic liquid. The quantity of sugar present can be esti- mated, since every cubic inch of carbonic acid gas given off by fermentation corresponds to one grain of sugar, so that the quantity can be readily approximated. Bile in the urine is likely to be present in disease of the liver, and it may be necessary to distinguish it from certain color principles as rhubarb and santonin. Dip a white rag into urine that contains bile ; it is at once colored yellow. Pour a little urine on a sheet of writing paper to form a very thin layer and let one or two drops of nitric acid drop on it. If bile be present, green and pink colors will show themselves around the drop. This can be confirmed by mixing a little muriatic acid with the urine and then adding a few drops of nitric, and a change of colors, of yellowish-green, blue, violet, red occurs. Uric acid in excess represents rapid waste of the nitroge- and Dictionary of Diseases. 287 nous elements, as in fever and inflammation, but a supply of nitrogenized food greater than what is required for the repair of the tissues, such as excessive indulgence in animal food, too little bodily exercise, isolation, monotony, sameness, deficient aeration of the blood; and also an insufficiency of gastric juice is easily detected by the blue litmus paper being turned red by the brick-dust sediment to the chamber vessel. Microscope. — A thorough knowledge of all the tissues of the body, its normal and abnormal secretions, is necessary for diagnosis with the microscope. An instrument of small power is the most useful, say from 250 to 300 diameters, one whose adjustment is easy, so that an object can be readily detected. It is of great utility to detect diseased germs in the secretions, especially in discharges or scrapings. For example, by scrap- ing the tongue in all cases of malassimilation, we can see the bacteria; in typhoid fever, the vibrios; in diphtheria, strepto- coccus; in the discharge from the nose in catarrh, the amoeba; in the urine, the germs of cancer, and in the sputum, those of tubercle. Most invaluable, and one which the unitiated in med- ical science can readily and at once appreciate. Vital Capacity of Lungs. — To test correctly it must be done by a spirometer, an instrument used to measure the vol- ume of air expired from the lungs. Quantity expired after the most complete inspiration is the total volume of vital capacity. The vital capacity increases with stature, and is considerably affected by weight. The capacity to breathe is affected most by phthisis. The following table shows the capacity in health and in the three stages of pulmonary consumption : Capacity in Health. Capacity in Consumption. Cubic First Second Third Height. Inches. Stage. Stage. Stage. in. 174 117 99 82 " 182 122 102 86 " 190 127 108 89 " 198 133 US 93 " 206 138 117 97 " 214 143 122 100 " 222 149 127 ...... 104 " 230 154 131 108 " 238 159 136 112 " 246 165 140 116 " 254 170 145 119 " 262 176 149 126 5 it, I 5 2 5 a 3 5 a 4 5 a 5 5 a 6 5 t( 7 5 a 8 5 a 9 S (( 10 5 (t 11 a 288 The Germicide 20th Century Practice To test the vital capacity, a man should stand in the erect posture, take as deep an inspiration as possible, at the termina- tion of which the tap should be turned off by the operator and the vital capacity can be traced off the scale. It is not for one moment to be supposed that the lungs are emptied of air, as there always remains a certain proportion called residual air. The vital capacity is greatly diminished in bronchitis, em- physema, pneumonia, as well as in consumption and in disease of heart and viscera of the abdomen. Spirometer. — An instrument for measuring the volume of air expired from the lungs. Females measure less than males, and in either sex the lung capacity decreases after fifty. The quantity of air expired after complete inspiration is termed the vital volume or capacity. This increases by stature. Obesity diminishes the breathing capacity; so also does any abnormal condition which interferes with the mobility of the thorax or the inflation of the lungs. Effusion into lung structure is the most prominent of all forms of obstruction. Every inch of con- solidated lung insures a decrease of forty cubic inches of air by measurement, and should have immediate attention. Electricity. — As a means of diagnosis is of rare value. The best mode of application is by or through wet sponges. The positive pole in all cases should be applied to the origin of the nerve, and the negative to the other end. By placing the positive at the nape of the neck, the centre of all nerve supply to the body, and the negative over the chest and abdomen, any weakness or tenderness can readily be detected ; or, running it down the spine, any loss of vitality in any special nerve can be recognized by a soreness, or burning, or tenderness over it, and the disease located in the cord and organ to which the nerve branches. It is particularly valuable in recognizing the diseases of muscles, especially any tendency to fatty degeneration. In placing the positive pole at the origin of a muscle and the nega- tive at the other end, the muscle if healthy will knot or con- tract in the centre. The battery must be of sufficient power. The points which it elucidates are the tenderness and soreness of weakened parts, and behavior of the muscles. Still it is capable of defining precisely obscure forms of paralysis. whether due to effusion or white softening. In diagnosing paralysis, it is well to test the sound side first. then the affected side, and compare the result. Keep the two poles on the muscles about four inches apart; the positive to and Dictionary of Diseases. 289 the origin, and the negative to other end, then the contractility -can be compared. In hemiplegia due to effusion, the paralyzed muscles lose their contractility at once; in that due to white softening, by degrees. In paraplegia, the condition of the paralyzed muscles is similar to hemiplegia. In lead and mercurial paralysis, the contractility remains after the power of voluntary motion is gone, or till atrophy has set in. In rheumatic paralysis the contractility is usually normal. In progressive muscular atrophy, diminished contractility follows the gradual destruction of the muscles. The sphygmograph is an instrument designed to give the curve of the radical pulse by tracing. It is strapped on the wrist, and is moved by the stroke of the pulse. It never can supersede the fingers, but as a curiosity or toy is well adapted to deceive the ignorant. Spinal Diagnoses. — The method of diagnosing disease of the chest and abdomen by mapping out a seat of irritation or anemia of the spinal cord is old and empirical. It consists in either applying a sponge pressed out of hot water, or the elec- trode of a battery, or pressure with the fingers in the inter- vertebral spaces. If a tenderness or weakness or irritation can l>e detected, then it is supposed that there is lost vitality in the nerve or nerves that emanate from that point, and the organ in chest or abdomen that the nerve supplies suffers from dimin- ished vitality or disease. The irritation or disease in an organ is carried to the cord, which is a reflex centre, sets up an irrita- tion there, and a tenderness or weakness can be detected. In hysteria, masturbation, and other anemic conditions of the cord, such points are said to exist. The method has no merit, neither is it reliable, but often subserves the ignorance of the charlatan. Longevity. — By this is meant the mean number of years which at any given age the members of a community, taken in- discriminately, may expect to live. An easy rule, and one very generally adopted by life insurance agents, has been established for determining this fact, and corresponds very closely with our best statistics. The criterion or rule for determining this is : The expectation of life is equal to two-thirds of the difference between the age of the individual and eighty. Thus, a man is twenty years old, sixty is the difference between this age and 290 The Germicide 20th Century Practice eighty; two-thirds of sixty is forty, and this is the sum of his expectation. By the same rule a man of sixty will have a lease on life for fourteen years, and a child of five for fifty years. Another method of testing the longevity is by drawing a piece of thread from the outer corner of the eye to the centre of the prominence at the back portion of the head (the occipital protuberance), taking the opening or meatus of the ear as the index. If the opening is below the line, and for every degree below, strong vital tenacity — a degree of vital force that will weather grave disease; if the opening is on the line with the cord, vital force is very weak, little power of resistance to ward off morbid action ; if the opening is above the cord, the slight- est, most trivial disorder will cause death. The natural atrophy or shrinkage of the brain in old age and in whisky drinking is often remarkable, and exhibits the veracity of this line or angle. Temperament, Constitution or Diathesis. — Many per- sons show in their general appearance that they have a consti- tution which is liable to certain forms of disease. The recogni- tion of such peculiarities of appearance may be of great im- portance in cases in which it is difficult or impossible to obtain a complete history of the case. The following are the more important varieties: The Sanguine Constitution. — Body well developed, head large, teeth massive and good, complexion ruddy, hair thick, digestion and nutrition good, pulse hard, blood pressure high. In later years the body becomes corpulent, and the signs of old age come on prematurely. Such persons are liable to arthritic affections of all kinds, and to diseases of the heart and blood vessels (angina, fatty heart, aneurism, atheroma, apoplexy, etc.). The Nervous Constitution. — Figure small and wiry, face mobile, features small and delicate, great activity of mind and body, dyspeptic, and with highly strung nervous system. Indi- viduals of this temperament are specially liable to nervous dis- eases of all kinds. Tubercular Constitution. — The whole osseous system badly developed, joints enlarged, mucous membranes irritable, upper lip and alae nasi thick, thorax contracted, skin pale and delicate, and hair thin. Such persons are liable to diseases of bones, lymphatic glands, and to tubercle in all its forms. Lymphatic Constitution. Body large and clumsy, mus- cles flaccid, face pale and expressionless, movements slow, and functions both of body and mind sluggish. and Dictionary of Diseases. 291 Bilious Constitution. — Face oval, long upper lip and chin, long nose, complexion dusky, digestion sluggish, liver in par- ticular being inactive, nervous system not highly strung. In its further developments this constitution passes into melancholic, where the patient takes gloomy views of things in general. Such persons are liable to melancholic insanity. Gouty Constitution. — Hair early gray, little tendency to baldness ; nose short, rounded, and red ; cheeks ruddy, eyes generally dark, teeth large and covered with thick enamel, di- gestion bad, suffers much from dyspepsia, heart tends to de- generative changes, arteries atheromatous, arcus senilis ap- pears early and is well marked. Persons of this constitution are liable to all the forms of gout, to the cirrhotic form of Bright's disease, to neuralgia, and to apoplexy. Rheumatic Constitution closely resembles the sanguine, as already described. There is, however, in it a greater ten- dency to fulness of body and less general vigor. The teeth are liable to early decay. The greatest difference that can be obtained between the re- spective sexes within the race between the vital temperaments is the most favorable for a large, long-lived, energetic, civilizing race; the difference is essential for a healthy offspring. All marriages in antagonism to this law will entail on the children some unfortunate result. Children born from parents partly incompatible possess a feeble organization, which is liable to yield to the simplest forms of diseased action, and it is here that a scientific practitioner is so frequently baffled; his best re- sources of no utility, for in its very birth, blood, tissue, organi- zation, disease and death are stamped, the product of incom- patible marriage. It is unnecessary to repeat that races are antagonistic and dis- tinct, that marriage should never be consummated outside of the race, for if it is, and there be offspring, that progeny will be tuberculous and will enevitably die out. It is simply a deteriora- tion to both races concerned in the effort, and should be pro- hibited by the most rigid legal enactments, and not counte- nanced by a set of pseudo-fanatics. Modern clinical pathology enjoins on every one treating dis- ease, the necessity of a careful examination of the patient. Often, indeed, correct diagnosis, and consequently treatment, depends on the performance of this duty. Exact elucidation of the case is always necessary, as neglect of the presence or absence of a single point may be of grave importance. 292 The Germicide 20th Century Practice DIARRHEA. — In all fermentative changes in the aliment- ary canal, an innumerable host of bacteria are evolved. These, in the progress of growth, excrete a variety of toxins, which, according to their character and predominance, give rise to various forms of diarrhea, serous, biliary, mucous, feculent, nervous. The best treatment consists in rest, dry heat to the abdomen, the avoidance of all food, all fluids, which are simply a pabulum to these germs, simply giving teaspoonful doses of Valentine's meat juice every two hours, then selecting a germicide from the following: One dose of periodate aurum to begin with, in every case, either siegesbeckie tablets or kaki, or lactic acid, or baptisia, or coto, or stone crop; and passiflora incarnata in every case. If the diarrhea does not yield promptly to some one of those reme- dies, try another, and oil the entire abdomen, then apply con- centrated ozone. In the most aggravated cases it is doubtful if we have a remedy that can supplant the siegesbeckie tablets. Summer Diarrhea. — Both children and adults during the summer months suffer from a variety of gastro-intestinal dis- turbances. These causes are very common, namely, irritation of the bowels, depressing action of heart, and toxins. The irritation of the intestines may be due to indiscretion in diet, such as eating green fruit; milk with its tyrotoxicon; canned meats and vegetables — agents productive of bacterial life and ptomains. During the heated term the vital resistance of the gastro-intestinal tract is much lowered by various causes independent of the heat, although it is true that all germs in both stomach and bowels are more active in hot weather. ' The best means of prevention are to tone up the stomach, get rid of indigestion, for such conditions diminish strength; im- pair health ; encroach on the function of life ; hinder perfect so- lution of food; disturb the process of digestion — indigestion means fermentation; great care in diet. Forbid the use of water ; plain water for drinking purposes should be boiled ; ice may be placed around the container, but never in it. The great- est possible care should be exercised with regard to milk, which in all cases should be boiled, and cared for like the water. Cheese, ice cream, all canned or tinned food should be looked upon with suspicion; cooked and uncooked food of certain kinds, if mixed with beer, ale and wine, frequently give rise to an attack. In the treatment few drugs should be administered. Cleanse and Dictionary of Diseases. 293 the alimentary canal by the administration of a few doses of the periodate aurum, followed by the aromatic syrup of rhubarb and potassa, which might be repeated. Then administer every three hours one or two tablets of siegesbeckie dissolved in water. This latter is the most available of all remedies. No other form of medication is required. All food except a little boiled water on toast should be interdicted for a day or two. The use of milk in case of infants must be discarded and infant food substituted. The use of salol as an intestinal antiseptic should be discour- aged. It is a cardiac paralyser, and has a tendency to form calculi, and we cannot afford to employ a remedy which pro- duces disastrous results to the patient, when the seigesbeckie tablets can be procured, which are much more efficient than the salol salts. The causative factor of the summer diarrhea of children is due to fermentation and the evolution of a dwarf species of the comma bacillus, whose toxins give rise to intestinal spasms and much paroxysmal pain. Usually teething children, whose intestinal glands are be- ginning to develop preparatory to the digestion of a different kind of food, are its first victims ; later to diet, solar heat and insanitary conditions. The process of glandular development gives rise to hyperemia, and a very slight irritation gives us the diarrhea. Distilled water, sweetened, rendered very slightly acid by the addition of lactic acid, is one of the best remedies to kill the germ and neutralize the toxins. Chronic Diarrhea. — Quite a number of cases of chronic diarrhea appear to have existed in all parts of the country and in all conditions of life. Nearly all resisted treatment con- tinued for six months, with five or six motions of the bowels per day. The motions were soft, semi-fluid, contained a notable amount of mucus, and very light colored, passed without pain or discomfort, invariably a loss of appetite, headache and bad taste in the mouth. The old treatment by bismuth, iron, tannin, opii, catechu, was a complete failure, aggravating all the symptoms. Progressive physicians, men of profound thought and intel- lectual culture, found the remedy in the fluid extract of Vir- ginia stone crop to stem the progress of this malady. One tea- spoonful, thrice daily, the diarrhea disappeared at once, and in every case the patient improved rapidly. Simple treatment, but efficacious. 294 The Germicide 20th Century Practice Many of the cases were bad, emaciated, steadily losing- strength, with aphthae pervading- lips, gums, tongue, pharynx ; ozonized stone crop saved every case*. Some cases occurring every summer for a period of years, in which the entire intestinal tract seemed ulcerated for its entire thirty-two feet — troublesome cases; in these enemata of stone crop. One teaspoonful to four ounces of tepid water, followed by a cassia suppository, brought the motions from six per day to one, with great gain of flesh and strength. It is apparent from the testimony of many thousand physicians that stone crop is one of the best bowel vitalizers that we possess ; every time *it is prescribed diarrhea disappears rapidly ; that after it is used for a few weeks it never recurs again ; that it makes no difference how wasted, or how greatly the strength has failed, Virginia stone crop promotes active intestinal assimilation. DIATHESIS OF TUBERCLE.— Medical science and ad- vancing civilization have practically stamped out the plague, kept cholera at bay, and robbed leprosy, typhus fever and small- pox of their terrors ; wiped out the belief that the civilized races of mankind will die out as the result of the ravages of the tubercular bacillus. Tubercle, what is it? The changed, altered, degraded bio- plasm of our own and other bodies, brought about by condi- tions inimical to vitality, and when once present give rise to a diathesis — which may be transmitted from husband to wife or from wife to husband — direct transmission by contact is other- wise rare, being chiefly disseminated by means of dust ren- dered infective by the drying and pulverization of tubercular sputum. The blood of man may be a mass of germs, his nervous sys- tem feeble, but unless some part has suffered devitalization, and effusion has taken place, there may be no growth of any ex- tent. High vital force, normal physiological activity retards growth. In all cases there must be a weak point, a locality, a zone in which germs can grow. The inhalation of infected dust irritates and weakens the lung; at the same time, is a method by which the germ may enter the bodies in addition to the use of tubercular meat and milk. The infectiveness of rooms that have been occupied by the infected, and the disposal of the sputum, teach us a most important lesson, namely, that all individuals suffering from tuberculosis should be placed in an invigorating locality, stir- axd Dictionary of Diseases. 295 rounded by an ozone-generating atmosphere, where no disease germ can live, for where ozone is, tubercle cannot exist ; a diet rich in blood-forming elements ; an avoidance of all insanitary conditions ; body protected with flannel, and daily invigorated with bathing and massage. In lung tuberculosis there is a great depreciation of vital force, of nerve power; the tone of the blood vessels is lowered, circulation feeble, the working ca- pacity of the lymphatics and pink marrow are impaired ; so, in limiting its propagation, we must proceed on a solid basis. The best prospect of arresting this scourge of humanity con- sists in an elevation of vital force and in the use of germicides. DIGITALIS PURPUREA.— The leaves of the foxglove is a powerful arterial sedative, reduces the action of the heart, lowers temperature, exercises an unlocking influence upon the absorbent system, hence its value in cardiac disease and drop- sies ; small doses stimulate, medicinal doses soothe. Like other acro-narcotics, its prolonged use is disastrous to sexual vigor, destroying the reproductive or fertilizing cells in the brain and spinal centres. Preparations and Doses. — For unlocking the absorbents in dropsy, an infusion of two or three grains of the leaves to a pint of water ; a wineglassful every hour. Tincture in three to four-drop doses as a cardiac stimulant; in eight to ten drops sedative ; being a permanent tonic, doses can be decreased in a few weeks. DIPSOMANIA. — Dipsomania is the term now generally used to indicate an insatiable craving for alcoholic stimulants, though there is nothing approaching madness connected with it. Patients can abstain from it if they so will ; such, however, is the enslaving and demoralizing nature of the habit that they need considerable aid from others, and sometimes absolute re- straint, to aid them in breaking through the infatuation. To such restraint they usually submit cheerfully, and sometimes they are the very parties to suggest it. There are several es- tablishments in different parts of the country for the reception of those addicted to intemperate habits ; the task of reclamation, however, can be safely undertaken anywhere under kind but firm and constant supervision. Ozonized passiflora is the best medicine for allaying the craving, which is often very trouble- some. Gelsemium, china, nux vomica, cocculus, coca et cele- 296 The Germicide 20th Century Practice rina, nux moschata, ignatia, aletris farinosa, and cacodylate of sodium are also adapted to the treatment. For beverage, toast and water, milk, lemonade, fruit-flavored syrup, and water. Change of scene, constant occupation and amusement, together with, for some time, untiring supervision. DIPHTHERIA.— It is a natural law that when the soil is impoverished, or exhausted, the rot or blight makes its ap- pearance, which, when the soil is properly fertilized, disappears. So, in animated nature, when the vital forces are exhausted, impaired, weakened by improper or imperfect nutrition, the •elementary molecules of the blood become blighted, altered, degraded into other living matter, a disease germ. This takes place in animals as well as man, and the outcome of degrada- tion in both is identical. This human blight or rot may take place at any time, in any season, but great cold and great heat hinders the evolution of the germ, whereas damp, chilly weather gives it an impetus, an increase and activity ; social changes in the population, large crowded schools, tenements not only favor the evolution, but afford opportunity for communication of the germ. This changed, altered, degraded, living matter of our own and other animals assumes the dignity of a pathogenic microbe, which is found chiefly upon mucous membrane, either singly or in groups, forming a kind of interlacing reticulum, often of considerable size. This organism is demonstrable in every case of diphtheria, upon the mucous membrane, especially of the throat, fauces, tonsils, uvula. We have been in the habit of treating all cases of diphtheria very successfully by improving the sanitary conditions of the surroundings, abundance of fresh air, and improved nutrition. Spraying, or gargling, or swabbing the throat every hour with a mixture of equal parts of peroxide of hydrogen and ozonized distillate of jequirity and administering the ozonized glycerite of sulphur, in oft-repeated doses, until it operates upon the bowels, at the same time administering a tonic : Elixir cinchona, four ounces; thyroid extract, half an ounce. Mix. Half a teaspoonful every three hours. The use of thy- roid in this is to prevent race decay. It acts admirably. Now this treatment is simple, effective, and according to the dictates of common sense. Improved nutrition is the great prophy- lactic. Diphtheria is a microbe disease, exhibiting itself in the for- and Dictionary of Diseases. 297 mation of a false membrane, with great constitutional depres- sion, due to the excretion of the toxins in the vascular lym- phatics, followed often by paralysis. Like all microbe diseases, it is both contagious and infectious, but it can only take root when the soil is favorable for its devel- opment. A favorable condition of soil may consist in the mode of life, insanitary surroundings, vital depression of the patient ; they have an influencing of the degree of susceptibility. The most intelligent conception of the serum treatment of diphtheria is that it is a humbug, a big fallacy of modern medi- cine, and does not in any way advance bacteriological investiga- tions. The germ, the factor of each disease, is the essential and active agent in the production of a ptomain or toxin, a chemi- cal product of bacterial life, which gives rise to the symptoms. The use of serum in the treatment of diphtheria is based en- tirely upon theoretical grounds : ( 1 ) that rapid immunization from an infective disease can be produced by the disease itself, and (2) this immunization is due to the formation of an anti- toxin, a chemical substance which destroys the toxic bacteria. This is not a fact ; it has never been produced. It is merely an hypothesis of visionary minds, not a chemical substance. Has it been demonstrated that this serum, when injected un- der the cuticle, produces immunity from diphtheria, or even cures it, or that its use is free from danger? Our experience has been that it neither protects nor cures, and always incor- porated with danger. There are no scientific, theoretical or experimental grounds for accepting the so-called antitoxin serum as a specific remedy for diphtheria, because it has no specific remedial power. The remedy often does harm, for it always exerts a decomposing or septic influence upon the blood and acts disastrously upon the kidneys. The reminiscences of the atrocious system of vaccination at our quarantines, of tuberculin, of the attenuated virus of canine madness, of serum, are simply the avaricious modes of charlatans. The National Bacteriological Society of the United States of North America is the largest membership of scientific men in the world, embracing twenty thousand of the most eminent in the medical profession. We give their opinion in corrobora- tion of our own : Diphtheria is recognized as an infectious and contagious disease, often endemic, characterized by great prostration of 298 The Germicide 20th Century Practice vital power, combined with great constitutional disturbance, and an exudation of plasma in which the spores of the strep- tococcus are distributed on the mucous membrane of the throat, mouth and nose, and other mucous membranes. This pathogenic microbe possesses prodigious tenacity of life, surviving long periods in clothes, especially if laid away in damp places. All domestic animals, cats, dogs, even rodents, as mice, rats, squirrels, become affected and are active carriers of the germ; parrots, doves, chickens, turkeys, etc., are also frequently victims of its ravages. The toxin of this microbe creates embolism of the blood, paralysis of the laryngeal, pharyngeal, facial and other nerves ; cardiac failure, and renal disorganization. The specific micro-organism in this disease, the strep- tococcus of diphtheria, has a double cycle of existence; one is passed in the soil and another in a devitalized body ; one is a saprophytic, the other a parasite. In order to account for the epidemic and even pandemic waves of diphtheria, there is a diminished electrical state of the atmosphere, a vitally de- teriorated body; then the germ becomes actively virulent and infective. Such an atmosphere as is engendered by a large public school, the greater the better, the aggregation or over- crowding, form a favorable site for the dissemination of the streptococcus of diphtheria. In this microbic disease two classes of remedies are required, germicides and fortifiers ; the former, like the glycerite of sul- phur, to kill the germ ; the latter, the glycerite of kephalin, to feed the brain, reinvigorate the system. Place the tissues in a condition to prevent the lodgment of germs; strengthen the blood, so as to render it a barren soil for their growth. The growth of the diphtheric germ in a feeble body is rapid, terminating in four or five days ; treatment must be prompt, decisive. Administer freely glycerite of sulphur until the sys- tem is saturated with it, which will be known by its action on the bowels; give a cinchona alkaloid to aid blood formation; spray throat every two hours with peroxide of hydrogen and papoid, or peroxide of hydrogen and jequirity. Spraying the apartment every two hours with formalin de- stroys all the germs in the apartment, unites with all sulphur- etted or nitrogenous products of decay or decomposition ; pre- vents auto-infection. Under states of greatly depressed vitality in man and do- mestic animals there appear certain microbic or fungoid dis- axd Dictionary of Diseases. 299 eases. These occur sporadically, endemically, epidemically, and are contagious and infectious, and capable of passing from animals to man, and vice versa. The microbe of diphtheria is the most common and best un- derstood of all those conditions. Vital force being low, the germ, if in close proximity, enters the blood, and in an indefinite period of time, depending upon the status of vital force, demonstrates its presence by a charac- teristic inflammation of the mucous membrane of the throat, which tends to exudation of plastic lymph, the formation of a false membrane, consisting by and by exclusively of microbic growth, which has prodigious powers of growth and repro- duction, and which, during the process of sporulation, excretes a most potent deadly poison or toxin, which kills the red cor- puscles of the blood and paralyzes the nervous system. Its true etiology is not fully known, but this blight falls upon the young, the feeble, the broken down, the defenceless, those whose vital forces are weak, whose tissues are soft, non-resist- ing. The very weakness or delicacy of structure enables this germ to penetrate. Place all or any of our domestic animals in conditions adverse to a high state of vitality, the same degenerative conditions of blight appear. Highly vitalized individuals, or structures, re- tard or prevent the ingress of this blight. In the treatment of diphtheria there are three things indis- pensable : kill the germ, neutralize its toxin, build up or re- construct vital force. The only known antidote to kill the germ, neutralize its toxin, is the ozonized glycerite of sulphur. The administration of this in every case completely annihilates this fungoid condi- tion in the blood, and roots out its toxin. Try it ; you can rely upon it; it will never disappoint. Give it in small doses, oft repeated, until the system is thoroughly saturated with it — every spore and germ obliterated. This is known by the sulphur acting upon the bowels. When this is the case don't discontinue, but administer every three or four hours. What can be done for the diphtheric exudation on the tonsils, uvula, fauces, trachea, which is encroaching on respiration? If the child is quite young, spray it with a mixture of equal parts of c. p. peroxide of hydrogen and ozonized distillation of jequirity ; if older, able to open his mouth, paint all the parts freely with the jelly of violets or some powerful germicide. Local remedies are of much value. Every physician has his 300 The Germicide 20th Century Practice favorite formulae. Peroxide of hydrogen and carbolate of sodium answer a good purpose, and more recently a solution of the hyposulphite of sodium. When this latter is used it is pre- pared as follows : Take a saturated solution of the hyposul- phite of sodium, four ounces; c. p. glycerin, four ounces; mix. Apply by a brush to the germ-swollen parts once or twice daily, or as often as the attending physician deems it necessary. It generally suffices to clear away the false mem- brane, kills all the germs, relieves the engorgement of the mucous membrane, which is so favorable to the evolution and growth of the streptococcus. This remedy has a decided ac- tion as a germicide-chemical destruction of the microbe. The profession must digest the subject of human and animal blight with an unbiassed mind. It has its origin in profound debility, exhausted vitality, so that the most constructive and vitalizing agent in the materia should be administered. Mould and rot in the vegetable, diphtheria in the animal kingdom are preventable maladies. The use of microbicides to retard, sterilize, is invariably followed by limitation of the disease. Both are the evolution of partial death, of decay. When either gets around some one is to blame. Danger of contagion and infection when the streptococcus of diphtheria has made an escape. All outgoings and incomings must be checked; all domestic animals, such as dogs, cats, parrots, etc., banished ; exterminate all sources of filth, whether of the earth, air or water. Don't be deceived. Diphtheria, the modern blight, does not come from afar, through the air; so do not shut up your houses tightly, for it cannot be shut out. Inhaling re-breathed air makes it easier for the microbe, if present, to seize the child. Abundance of fresh air at all times, sunshine, and the best of nutrition, are inimical to the germ. Crowded schools are the foci of contagion. We have many adults walking around with sore throat ; tech- nically, diphtheria ; vulgarly, but truthfully, the rot. Prudence dictates caution in using tumblers, drinking cups, towels used by others. Stern rectitude demands of us that no infected individual should kiss a child, as that very act may be the unconscious signature to the little one's death warrant. Drinking water and milk carefully scanned. It has been recently discovered that if there be any value whatever in antitoxin it is due to the carbolic acid in the serum ; that all the sudden deaths, heart failures, degenerative changes in the kidneys, which follow the use of antitoxin, have and Dictionary of Diseases. 301 led all progressive physicians to discard the serum for a one- eighth of one per cent aqueous solution of carbolic acid. Clinically, it has been found that the hypodermic use of this solution produces the same effects claimed for antitoxin, namely, a lowering of temperature and amelioration of the inflammation in the throat. When used early, before extensive blood changes occur, and in patients having a reasonable amount of vitality, it often aborts the disease. This is a valu- able item of knowledge which we have gleaned from our ex- perience with antitoxin. The carbolic acid treatment acts best in children who have strong hearts and considerable vital reserve force. Superfi- cially viewed, these cases seem the most serious because the system makes a strong fight against the disease. There will be high fever, great nervous excitement, and intense congestion of the tissues of the throat, so that the child presents a deplorable spectacle with its livid, swollen face, and anguished struggles for breath. In these cases the injection of carbolic acid solu- tion, one-eighth of one per cent early, produces an effect similar to pouring oil on troubled waters. The fever declines, the con- gestion subsides, and the excitement being over, the various organs return to their ordinary duties, and the system soon recovers its previous tone. But if the child is suffering from great nervous prostration, low fever, passive congestion of throat and nose, with sanious discharge, weak heart, profound anemia, no hypodermic injections should be used. DIRECT MEDICATION.— The efficacy of direct medica- tion is becoming daily more appreciated by the profession. The power of absorption by the glands and follicles of the mouth, vagina, rectum and urethra are immense, and form excellent channels for the exhibition of remedies. Sublingual medication is away ahead in real practical utility. A protonuclein tablet under the tongue, thrice daily, increases blood cells and plasma at a rapid rate, double in potency as when swallowed ; two grains periodate aurum under the tongue operate powerfully as a bactericide, and a glandular stimulant ; so with many other remedies. In all lethargic states of the female organism insert, and re- insert at proper intervals, a pastil of white pond lily well up against the uterine os; an affect of rejuvenation is promptly experienced, lost elasticity is restored. The insertion of a senecin tabloid in a case of a prolapsed uterus causes it to re- cede two inches. 302 The Germicide 20th Century Practice The passing into the rectum of a kurchicin suppository j thrice daily, kills the entire brood of malarial germs swarming in the blood; wipes out that indescribable tired feeling inci- dental to ague, and enriches the blood. The administration of cassia suppositories kills the bacillus of typhoid fever ; the use of guaiacol suppositories are so efficacious that they are super- seding stomach remedies in tuberculosis. Boroglyceride and ichthyol suppositories relieve the misery of an enlarged pros- tate, whether the result of age or early excesses; salix nigra suppositories arrest all the oozing, weeping, leakages inci- dental to spermatorrhea; the oil of thuja suppository inhibits the sprouting as well as the matured neoplasm of cancer. Urethral medication is chiefly carried on by means of medi- cated bougies, which are easily and painlessly inserted, and when once in melt, run over the irritated, inflamed, germ- smitten or structured parts. The iodol bougies, when inserted, absorb stricture; the thallin bougies kill the gonococci; the ambrosia, alternated with the damiana, cures impotency; the saw palmetto relieves a congested prostate gland, whereas the salix nigra bougie affords local and direct medication of the seminal ducts and vesicles, as well as the generative nerves. Their use relieves the irritation in the deep urethra, into which the seminal ducts open; in other words, they cure the trouble which always exists in spermatorrhea and impotence; their daily use subdues inflammation, congestion at the neck of the bladder, stops the loss from the seminal ducts, the drain of vital fluid which is continually oozing away and sapping their vital force. These bougies contract the mouths of vessels and prevent semen oozing away, thus relieving the distressing ner- vous symptoms. Take it all in all, direct medication is one of the necessities of the age ; all our young men need it. The growth, vigor, pros- perity of our nation depends upon our young men maintaining their strength and vitality ; if they are nervous, weakened, ef- feminated by masturbation or drained out by sexual excesses, the result is disastrous ; direct medication is indispensable. DISEASE. — Disease may be defined as a deviation from health, or a partial death either of a part or of the entire body. Some would define it as a want of equilibrium between the positive and negative forces of the body; others a difference between the solids and fluids. The aim or object of all treat- ment in disease is to aid nature to promote a renewal of life. and Dictionary of Diseases. 303 DISINFECTANTS.— The best of all is chloride of lime, and should always be kept in the house. Never forget that the sanitary state of the house requires attention all through the year, and not during the hot months only. A little chloride of lime should be put down sinks and drains every night and morning. The best plan is to mix a couple of tablespoonfuls in a pail of water and flush the drains with it. Some people object to the smell, but it is so wholesome that none need mind it, and it purines the air, rendering it very fresh where it has been close and oppressive before the introduction of the chlo- ride. Turpentine is a powerful disinfectant, and deserves to be better known than it is. It is of the greatest possible use in smallpox, as the use of it prevents its spreading, and it relieves the irritation and unpleasant effluvia always present when that terrible disease is at its height. It should be used thus : Mix four parts of pure olive oil with one part turpentine, and apply with a feather, using a fresh one for each application. Camphor is another good disinfectant, and will, if carried about and inhaled in a sick room, prevent infection. In scarlet fever it relieves the patient to place a piece on a red-hot iron spoon and carry it about the room until dissolved. Formalin, two drams to a quart of water, either sprinkled around a room or exposed in hollow vessels ; renewed daily. The fumes of burning sulphur are excellent, but unfitted for respiration. Disinfection. — The destruction of the microbe on which a particular disease depends. This may be done by means of a disinfectant. An antiseptic prevents the growth of micro-or- ganisms, but does not necessarily destroy them. These terms have been very loosely applied, and it as well they should be known to refer to perfectly distinct agents, such as can be in- haled without injurious effects. DISLOCATIONS. — The joints of the human body are sim- ply so many hinges upon which the bones move, all finely lined with a soft, velvety membrane, which, during sleep, secretes a bland fluid for lubrication. This lining tissue is called a syno- vial membrane, and the amount of synovia secreted during re- pose depends greatly on the health of the individual ; if of good vital stamina, it is so great as to increase the stature by nearly an inch in the mornings. In cases where the nervo-vital fluid is deficient, as in masturbators, the secretion is so deficient as to 304 The Germicide 20th Century Practice cause the joints to crack. If a joint is tied up, immovable for some time, and no demand made for this lubricating fluid, there is none secreted. In all cases it is expended by healthy exercise during waking hours. Joints are all encased in a strong capsular cover- ing, or ligament, which retains or holds them in position, and forms a cap, cup, or reservoir to hold its synovia. This capsular covering, or ligament, is often weak, relaxed, and in some cases it is torn or lacerated, so that the head of the bone escapes from its cavity into the surrounding parts. If the cov- ering of the joint is merely relaxed, the head of the bone may come out of its socket, but is easily thrown into its place by the individual himself; but when it escapes through a tear, it re- quires relaxation of muscles and manipulation to get it to re- cede back through the same opening by which it escaped. A dislocation, therefore, is the escape of the head of a bone from its natural cavity. Causes. — It may be caused by external violence, or muscular action, and in some cases of diseased joints, by ulceration of the ligament. Symptoms. — The symptoms are two : deformity being the alteration in the form of the joint, in unnatural prominence at one part, a depression at another, with lengthening or short- ening of the limb. Loss of the proper motion of the joint. There may be numbness, pain, ecchymosis, swelling, etc., but no* crepitus. Treatment. — If possible reduce the dislocation before the patient recovers from the- shock, while relaxed; if not, admin- ister lobelia, to nauseate him and relax, or else chloroform' and ether. Better, as a rule, to relax the muscular system in all cases, either completely or partially. Then the head of the bone should be manipulated or manoeuvred back into the socket through the same opening through which it made its escape. The shoulder and hip joint are the only two that re- quire nice manipulation or rotation; all others are brought into their place by simple extension, an assistant holding one part, and the other drawn gently into its place by the operator. After a dislocation has been reduced, the limbs should be ban- daged up for ten or fifteen days, giving the tear in the capsular time to heal up. If it is complicated with fracture it is likely to give rise to a stiff joint, or ankylosis, under the best of care. and Dictionary of Diseases. 305 DUMPING GROUND.— All the poverty, squalor, ignor- ance, ' crime, human depravity, helplessness, parasite and mi- •crobic diseases of the old world are dumped at our very doors by immigration. Just think of it, that among the best fed, housed and clothed people in the world, we have in our very midst quite a large proportion of lepers. Past years have witnessed the importation of typhus fever, dumped down in every nook and corner of our cities by the Commissioners of Emigration, but promptly stamped out by the efficient Boards of Health ; but they still persist in a recur- rence, a fresh importation of the deadly malady. Smallpox of a most malignant type has recently been im- ported in goodly numbers, dumped down on our shores, where it became endemic and epidemic, all remedies failing to wipe it out until oil of thuja eradicated the microbe. Through the same apathy, morbid indifference, criminal cal- lousness, we are likely to have a visitation of the microbe of cholera and plague. We see no reason why all our seaboard cities should become the dumping ground of Asiatic and Euro- pean cholera. The factor of the disease is a pathogenic microbe, of deadly power, which may be carried through air, either by ships or by clothing or by individuals. The stoppage of emigration for ten years would stamp out all leprosy, all typhus, much of the smallpox and scarlet fever, epidemic influenza, with its fatal sequel pneumonia, and prevent the approaching visitation of the comma bacillus and bubonic plague. DYSENTERY. — When isolated from the ordinary excre- mentitious matter of the lower bowels the microbe of dysentery appears in the field of the microscope as a germ, slightly elongated and oval, or short and cylindrical, with rounded ends. They divide by fission; like the micrococci, the in- dividual elongating and becoming constricted in the mid- dle, capable of spontaneous locomotion, having a flagellum at one or both ends, with which they perform active spin- ning or darting movements. They are capable of form- ing zooglcea, in which the interstitial gelatinous is more copious. The microbe is pathogenic of the disease, bears cultivation well in any broth; the culture when injected into animals give us all the virulence of the original dis- ease. The micro-organism is indigenous to the rectum and 306 The Germicide 20th Century Practice colon; breeds and multiplies there, excretes ptomains, which, give rise to the tenesmus, fever, furred tongue. Our ideas of the treatment of all cases should be to some extent guided by its etiology; whether it originates under the influence of solar heat, catarrh, malaria, carbonaceous food or drink, or whether it be sporadic, epidemic, sthenic or asthenic,. and general conditions. If the microbe has migrated to the colon with decided in- flammatory symptoms, give green root tincture of gelsemium and passiflora incarnata in as large a dose as the patient can bear. Maintaining this action subsequently with smaller doses, Take periodate aurum twelve grains, sugar of milk one dram. Mix thoroughly and give one morning and night. This cleans the tongue, sweetens the breath, appetite returns, languor dis- appears. In catarrhal cases, administer siegesbeckie tablets from three to six daily, dissolved in water ; in malarial cases the concentrated kurchicin should never be omitted. In all cases flush the colon morning, noon and night with a warm infusion of flaxseed and peroxide of hydrogen or Chian turpentine mistura; either will sweep out the entire germ colony. In the convalescing stage select some germicide like stone crop, resorcin, lactic or mineral acids, with cinchona to wipe out the debris of microbic growth, unload the intestinal follicles to eliminate waste products of the body. Never treat diarrhea with astringents, but always with germicides, as in all cases there are microbes of every descrip- tion in the intestinal tract. Diarrhea often attends the com- mencement of fevers, epidemic cholera, hepatitis, meningitis, etc., owing to microbic irritation of the bowels. It is often associated with gout, and is often a dangerous complication in remittent or continued fevers, scarlatina, measles, smallpox, in which cases it arises from a migration of the pathogenic mi- crobe of each respective malady to the abdominal viscera, and the pathological changes induced by the retrocession, the de- jecta being loaded with bacteria. It is also frequently due to the ptomain or toxins of disease germs, as we see in the dis- organizing effects of the tubercle bacillus; auto-infection of other germs and absorption of their toxical matter generated in their growth. All cases, whatever be the cause, the vital cohesion or tonicity of the mucous follicles have become im- paired, often ulcerated, and the germ-laden evacuations are either mucous or mucopuriform, or serous or grumous, or sero- purulent and partly feculent. axd Dictionary of Diseases O u / Aside from rest in the recumbent posture, nutritious liquid diet, concentrated ozone over the abdomen, with heat, a selec- tion should be made from one or other of the following anti- bacterial list : if a purely vegetable course be deemed advisable, kaki. wild indigo, or siegesbeckie are excellent; but more ef- ficient remedies might be selected, as either lactic acid or salol, or sulphocarbolate of zinc, or resorvin or salicylate soda. Still disinfection of the intestinal canal may be effected by either benzol or naphthalin, or even creosote in balsam of Peru, more efficiently than by salol or resorcin, or mistura guaiacol. The Pathogenic Microbe of Dysentery. — A most suc- cessful method of exterminating the micro-organism of acute dysentery is as follows : A copious enema of an eight volume solution of peroxide of hydrogen, rendered acid by the addi- tion of a few drops of lactic acid : as soon as this passes off, en- join perfect rest in bed in the* recumbent posture: relieve ab- dominal pain by rubbing concentrated ozone over the entire abdomen; administer often, every 'half hour in small doses, tincture of the green root gelsemium, which will diminish the irritability of the stomach, prevent nausea and vomiting, con- trol microbic evolution, thereby soothing restlessness and alle- viating tenesmus. The desire to go to stool passes away, fever departs, skin becomes moist, and great relief is experienced: even the motions become feculent and yellow in color. For drink, infusion of kaki, acidulated with lactic acid, is an ex- cellent drink. If any irritation should remain, apply the con- centrated ozone again over the abdomen, continue the gelse- mium, and insert a cocain suppository, which has a most bene- ficial effect, as it gives ease, sleep, aids recuperation. If there be much hepatic torpor or portal congestion, small doses of matricaria is a remedy of rare value. Liquid nourishment, beef tea, chicken broth is indispensable. To tone up. revitalize, the weakened bowel, no remedy is so efficacious as the ozonized Virginia stone crop, which should be persevered with for some months. The medical reports of all our hospitals afford evidence of the success of this remedy in all weakened states of the intes- tinal canal. It ameliorates every symptom of disease and pro- motes a renewal of life in the bowel. DROPSY. — An abnormal accumulation of serum in one or other of the three great cavities of the body or into the minute lymph spaces of the cellular tissues, constituting edema. It may 308 The Germicide 20th Century Practice either be the result of inflammatory action in serous mem- branes, or due to obstruction, degenerative changes, or to the toxins of disease germs, or an excessive exudation may take place from the walls of the capillaries, owing to a watery con- dition of the blood or a stasis in the capillaries. Edema may occur from loss of tone or contractility in the minute vessels. In anemia and chlorosis, watery blood, there is a tendency to exudation through their walls, more especially if vasomotor paralysis exists. Rarely does either venous or lymphatic obstruction give rise to dropsy; but it is often present in the uric acid diathesis, when there is an excess of this acid in the blood, renders the walls of the vessels permeable, favoring transudation. Disease germs and their toxins are often productive of drop- sical effusion. Anasarca. — An effusion of •serum into the cellular tissue, the result either of some degenerative or obstructive action in the kidneys or cardiac failure — one of the compromises of na- ture, which enables machinery to go on a little longer. This form of dropsy is due to a leakage from the congested capil- laries into the cellular tissue ; also, to a retarded removal of the fluids by the lymphatic vessels. General treatment, and in this form the hot air bath, which does not produce so much sweat- ing. The hot air relieves the kidneys and aids in the elimina- tion of the toxin which caused the obstruction. The hot air bath relieves the kidneys, and the abundant sweating gets rid of the effusion. We cannot speak too highly of an infusion of digitalis leaves in extreme cases of anasarca ; cases in which all remedies failed to relieve the dyspnea and edema ; a fresh infusion made daily, and while one pint of water is boiling briskly, one dram of fresh digitalis leaves is added. Permitted to cool and drunk freely, causes a copious secretion of urine. We get the full diuretic effect of the drug, in addition to its action on the heart muscle. It removes the dropsy and gives the heart another chance to recover itself. Ascites. — An accumulation of fluid in the peritoneal cavity often leads to enormous distention of the abdomen. Its eti- ology chiefly either an effect of peritonitis or cirrhosis of the liver, although it is often associated with morbid states of the kidneys and pancreas, cardiac failure. The fatty liver of the drunkard is its most common origin; once a slight distention, an unraveling of the peritoneal fibres adds greatly to the dif- ficulty, and hastens the effusion. and Dictionary of Diseases. 309 In this and the following forms of dropsy the ozonized tinc- ture of apocynum is the only remedy to depend upon ; treating the condition otherwise on general principles, with baths ; secre- tions well stimulated by alteratives and tonics. Use ozonized apocynum irrespective of the remedies you are using; add to your list ozonized tincture of apocynum. This is the remedy for dropsy, both prophylactic and curative, as when admin- istered it braces up the blood-vessels, prevents exudation. Don't fail to give it in every case and with a liberal hand; it will never disappoint when there exists an atonic state which permits free exudation. Whenever there exists relaxation of blood-vessels, even in the irritable, relaxed heart of the smoker, this remedy does splendid work. Hydrocephalus. — Under two years of age, effusion of serum from the membranes of the brain is very liable to occur in modern neurotic children, either from blows, falls, or from reflex irritation from the intestinal tract or other parts of the body. The very fact that in infancy, nay, up to puberty, there is but one skull table in the various bones, that the dip- loetic structure has not been elaborated, renders the brain of all children extremely susceptible to the slightest irritation. Especially is this true as regards boys, who are the weaker till puberty is reached, but subsequently become the strongest as the sympathetic and sexual organs are developed. All irritations under two years of age are liable to give rise to effusion of serum ; if not that, invariably depreciate the centre of vitality so much as to create a tubercular diathesis, in which the elementary molecules of the blood are degraded ; changed into a disease germ, the tubercular bacillus. In irritation of the cerebrum its membranes sympathize; it makes little difference whether it be mechanical or reflex; effusion may take place, child's head enlarges ; forehead over- hangs the face, which is wrinkled and aged looking, with eyes deeply sunken. As a rule, the inflammation which gives rise to it is insidious in its course, often almost devoid of fever ; but the characteristic headache is there, aggravated by noise, light, heat, motion; vomiting, loss of appetite ; convulsions, idiocy, and other forms of mental derangement are often present, and finally paralysis and death. Hydrothorax. — An effusion of serum into the cavity of the chest, either as an affection in pleurisy or some obstruction in the heart muscle ; occasionally present in anemia. 310 The Germicide 20th Century Practice General principles of treatment should be carried out. In- fusion of apocynum operates like a charm, eliminating material that blocks up the absorbents ; one of the very best remedies in hydrothorax, sulphate spartein, is highly extolled as a remedy for dropsy. Hydrops Pericardium. — Generally due to the toxin of the bacillus amylobacta, giving rise to inflafnmation of the sac into which the heart is suspended. When it does take place the area of dullness over the heart is increased ; sounds of the heart are muffled ; very probably edema at the ankle. The successful treatment of dropsy can only be obtained by carefully adapting the remedies to the pathological peculiari- ties of each individual case. And a disregard of this axiom ac- counts for the ill success in this disease. Where dropsy is con- nected with organic diseases of the heart, such remedies as collinsonia, digitalis, convallaria, adonis, and such other reme- dies as lessen the' exudation of lymph into the cavities and lymph spaces, and such as encourage the free exit of the lymph from the cavities and lymph spaces, tend to the cure of dropsy. Hydragogue cathartics aid this last result, but they are too debilitating to be long continued. Diuretics' can be used with much benefit, as they eliminate the lymph from the blood, thereby inviting the lymph back into the circulation, to be thrown off by the kidneys, and at the same time other remedies should be given to lessen exudation into the lymph spaces and the cavities, and remove it as rapidly as possible. Dropsy of the Scrotum. — An effusion from the internal lining membrane of the scrotum. May occur in scarlatina, the toxin of the micrococci, from defective elimination may irri- tate the serous coat, and give rise to considerable effusion. All sources of irritation are liable to give rise to it. Easily recognized by its transparency, smoothness, fluctua- tion. Usual internal treatment for dropsy may be tried, together with chloride of ammonium lotion locally, and it is usually a success in the young, but in elderly patients they may be tried ; but it must be borne in mind that tapping is certain and safe provided that when the fluid is drawn, the secreting faculty of the sac is destroyed by either injecting tincture of iodine or oil of thuja, or peroxide of hydrogen; and none of them being* handy, a seton. It must be borne in mind that in some cases the effusion is sacculated, like a honey-comb; hence, it is indispensable for a. positive cure that each be tapped. and Dictionary of Diseases. 311 DYSMENORRHEA (Difficult or Painful Menstruation). — There are three varieties met with in practice : I. Neuralgic Dysmenorrhea. — Nervous dysmenorrhea is very common among highly educated and refined ladies — those who have developed their nervous system at the expense of the physical, those who have insufficient exercise for body, who lounge and keep reading our fictitious, debasing, modern literature — that deadly poison which undermines their ner- vous systems. It may appear at puberty, but more generally it comes on from enervating causes after some years of painless menstruation, especially in the unmarried. In married life, it may come from the irritation of frequent abortions and the use of means to accomplish that act. It may be due to in- compatibility in the sexual act. Symptoms. — General languor, lassitude, debility, headache, withj pains in the back, sacrum and lower part of abdomen, coming on a few days prior to period ; an aching soreness of inner and upper part of the thighs ; bearing-down, with a sense of weight in the pelvis. As soon as the discharge comes on freely, relief is promptly experienced ; if the flow is scanty, and comes on in slight gushes, the suffering is often excruciating: it becomes paroxysmal, pain comes and goes; often consider- able pain in left ovary, sometimes in both : no swelling or heat, or increased sensibility in parts. There is flatulence, constipa- tion, hysterical symptoms or convulsions. Treatment. — During the attack, a warm hip-bath, teaspoon- ful doses of solution of morphia, every half hour, till relieved, or large doses of gelsemium and passiflora. Then discontinue. A better plan is to let her inhale thirty or forty drops of chloro- form, and give hypodermic injections of one-quarter of a grain of sulphate of morphia; that affords instantaneous relief. If aware of attacks coming on, they may be prevented by apply- ing a belladonna plaster across loins, four by nine inches long- ways across the back; the administration of tincture of bella- donna internally, till throat becomes slightly dry and pupil dilated; the introduction of a pastil up vagina, and supposi- tory up rectum, every three hours ; for the vagina a boroglycer- ide pastil ; for the rectum a cocain suppository. Begin five days before periods. From two to three weeks during the interval the following treatment should be carried out vigorously : The bowels to be regulated with cascara ; daily, tepid alkaline bathing, followed by shower-bath or friction: flannel next skin, especially over 312 The Germicide 20th Century Practice loins ; most nourishing food, easily digested ; avoid tea, coffee ; sleep on mattress, not over seven or eight hours ; abundance of exercise, games, moderate work, so locomotion is active ; horse- back exercise; sedentary habits and novel-reading to be for- bidden; if married, sexual intercourse to be avoided. Then place patient upon two of the following remedies each alternate week: Glycerite of kephalin, c. p. solution of spermin, wine of aletris farinosa, comp. syrup partridge berry. For the stom- ach, matricaria. 2. Congestive Dysmenorrhea. — Membranous or inflam- matory dysmenorrhea may occur at any period of life, and in the large percentage of cases it is associated with plethora and sanguine temperament. Its true origin is not well understood ; indeed, it is in uncertainty and doubt ; but one thing is very cer- tain, that there 'is congestion — a sort of inflammatory condi- tion of the internal lining membrane of the uterus. Whether this hyperemia is in the uterus, or in the ovaries, or in the pel- vis, generally it is immaterial. Causes. — Aside from the diathesis, gouty or rheumatic, and pelvic irritation, general plethora of the genito-urinary organs, from sedentary habits and occupations, it may be caused by local irritation, as abortion, exposure to cold and moisture; sluggishness of the liver, displacement of uterus, and metritis. Symptoms. — Suffering begins four or five days before each period, in a general sense of languor, or weariness, with head- ache, pains in the loins ; a feeling of weight in the pelvis ; gen- eral restlessness and irritability of the bladder ; there are heats and colds, with other evidences of nervous depression. The weight in the uterus becomes a pain of a throbbing character ; then dragging in the back, aching in the hips and thighs, and bearing-down, especially when pain is on. Discharge, after a few days' suffering, makes its appearance, usually slowly and gradually, scanty at first, but subsequently, after the system is relaxed by the condition of prostration, it comes freely. It may come in small clots, or shreds, or flakes of membranes, or sometimes in the form of a large pear-shaped clot, covered with a false membrane, an exact cast of the cavity of the uterus. This membrane looks like the epithelial membrane lining the cavity of the uterus, analogous to the decidua. In some cases there is no congestion of the uterus, while in others it is much engorged, often displaced; ovaries very tender, with swelling and tenderness of breasts. If the portal circulation is sluggish there will be piles. and Dictionary of Diseases. 313 Treatment. — During the period, warm hip-bath, free action of bowels, gelsemium and passifiora and boroglyceride pastils, cocain suppositories. During the rest of the month, or when the period is over, patient should have the best of food, bowels to be open twice daily, bathing daily, flannel clothing, general alteratives and tonics, embracing such as ozonized syrup of saxifraga, with iodide of potass, ozone-water, glycerite of ozone, iodide of lime or lime-water, and tincture of iodine; with such bitter tonics as gentian, collinsonia, kurchicin. With those remedies, in the course of three or four months, a cure is effected. The plan is to select two, a tonic and an alterative, administer for a few days, then change on to other two, and so invariably keeping patient on either iodide of potass, or iodide of lime. To inject the uterus once a month with four ounces of dis- tilled water (milk warm), with twenty grains of iodide of po- tass dissolved in it, has a most salutary effect; but American ladies, being so highly civilized, do not bear it well, it produc- ing reflex symptoms that are often alarming, such as nausea, vomiting, numbness in hands and feet, and prostration. To guard against such, the four ounces should be placed in a hard rubber syringe, just holding that amount, with a male catheter point, carefully introduced into the uterus, and thrown in very gently, allowed to remain a few minutes, then every drop drawn back into the syringe, and then withdraw it. If performed care- fully, and with nicety, there need be no trouble; it hastens a cure amazingly, by producing a healthy action in the walls of the uterus. If there are no very distressing effects, it might be permitted to remain a short time, but in all cases never leave a drop in uterus. The best period to do it is about the middle of the month, between the two periods. It is rarely necessary to repeat over three times in all. Moderate exercise ; recumbent posture better for rest than sitting; malt or alcoholic liquors, and sexual intercourse, to be avoided. Conception never takes place in a well-marked case. The shreds, clots, or coagula, are always loaded with in- numerable bacteria. 3. Mechanical Dysmenorrhea. — This term is applied to a thickening, induration, cartilaginous degeneration, or stricture of the external and internal os uteri, or neck, or a nar- rowing of the entire canal of the neck. It may also be due to some tumor, or uterine displacement, as anti- or retro-flexion ; 314 The Germicide 20th Century Practice these latter we do not include in the following remarks. What we speak of here is either a narrowing of the canal of the neck or its infiltration with lymph, or cartilage, or a true stricture of the external or internal mouths of the cervical canal — condi- tions that cause sterility as well as dysmenorrhea. Causes. — The causes that give rise to this induration, or mechanical obstruction, are inflammation, such as acute and chronic vaginitis, leukorrhea, self- abuse, excessive coition ; con- genital irritation common cause. Treatment. — Usual treatment during an attack, as already laid down, with the exception that tincture of green root of gelsemium, or lobelia, might be added to more effectually relax. There are several methods of treatment that can be tried dur- ing the intermenstrual period. In all it would be well to put patient under an alterative and tonic course of remedies, as ozonized saxifraga, phytolacca, glycerite of ozone, iodide po- tass, cinchona and mineral acids, attending to all minor symp- toms, as dyspepsia, constipation, anemia. Then try treatment with aristol alternated with boroglyceride pastils, one inserted every three hours alternating, lying down for one hour after each. Dilation, by means of sponge-tents, sea-tangle, and metallic and rubber dilators is worse than useless, setting up more irritation and additional obstruction. Those expanding instru- ments may produce no bleeding, but they are very destructive, and if often repeated are most harassing to the patient, and invariably after their use the canal returns to its former size, even a little narrower. There is no good in either slow or rapid dilation, and even the new method of dilating, lacerating, tear- ing, by divergent blades, is useless; there is danger of irrita- tion, if not of metritis, pelvic cellulitis, or peritonitis. Incision is the best plan, as it gives rise to no suffering, gives a sure result, and is free from danger, if properly performed, and rapid. This is best performed by a pair of scissors, made for the purpose, one blade terminating in a probe-pointed end, which enters the os; the other by a hook, which seizes and fixes the vaginal portion at the point desired. One stroke of the scissors divides the intervening tissue in a straight line. The proceeding is then repeated on the other side of the os, and the operation is then completed. There is a tendency to contract again even after that. To meet this, there should be a slight nick made of the internal os, just sufficient to divide the mucous membrane and some of the superficial circular fibres and Dictionary of Diseases. 315 of the muscular coat. This will allay spasmodic sphincteric action. The incision should be no greater, because it is super- fluous and even dangerous. At the mouth of the inner neck there are blood-vessels in profusion, and of considerable size. Large veins, without valves and small arteries, gap at the uterine level, and are apt to bleed very profusely if uterus is cut into. A piece of lint, saturated with the juice or extract of hemlock bark, is to be inserted between the cut edges, and pa- tient kept in bed under opium. If the patient and friends are willing, the best plan, if the suffering is great, is to perform the operation at once, as it is only a waste of valuable time to exhaust the usual list of reme- dies on her first. DYSPEPSIA. NERVOUS.— May be denned as a sensory neurosis differing from hyperesthesia in that the disturbances are intimately associated with digestive activity of the stomach and that symptoms are very similar to those of different forms of gastritis. In nervous dyspepsia both motory and sensory functions may be disturbed. There may be an acidity, sub- acidity, or hyperacidity. Diminution in the amount of the gastric juice, hypermotility and atony are often found. If the functional disturbance is marked and continues a long time, nervous dyspepsia may be easily confounded with other affec- tions, especially with one or other of the forms of gastritis. Nervous dyspepsia, thus defined, is not the frequent affection it is commonly supposed to be, and not all dyspeptic symptoms in a nervous individual point to nervous dyspepsia. In fifty such cases post-mortem examination revealed the fact that more than one-half of the patients had suffered from other diseases of the stomach, principally inflammatory processes, and only in eleven cases were the complex symptoms of nervous dyspep- sia found. Nervous dyspepsia usually brings with it other nervous symptoms, sometimes giving us a complete picture of neuras- thenia or, more seldom, of hysteria. That nervous dyspepsia is always a symptom of neurasthenia has been maintained, and it often happens that nervous symptoms depend on stomach disturbances and disappear when the latter are cured. Never- theless, in nervous dyspepsia the treatment of the stomach symptoms is very useful, especially when combined with the treatment of the general condition and the pathogenesis. In all- forms of partial death of the stomach there are a 316 The Germicide 20th Century Practice variety of bacteria that put in an appearance. In what is termed mucous dyspepsia or gastric catarrh, the sarcinae ventriculi are pre-eminent ; in chronic inflammation of the stomach there are quite a host of germs present; whereas in nervous dyspepsia there is a sensory neurosis, which differs from all others, even that of chronic gastritis. Nervous dyspepsia is but a symptom of neurasthenia, an out- come of a poverty of nerve force, a condition of debility oscil- lating between the brain and stomach. There may be an acid- ity, subacidity or hyperacidity. A diminution in the amount of the gastric juice, hypermotility and atony are invariably present, with a want of digestive activity. In the treatment of nervous dyspepsia the stomach merits close attention, as well as the general condition of neurasthenia. To meet the true pathological condition, the complex symp- toms of nervous dyspepsia, one of the most important factors is rest, so as to enable the vital powers to recuperate, to regain their lost vitality. To effect this, nothing is so efficacious as the administration of the ozonized glycerite of pepsin — the ex- pressed juice of the stomach of the calf, taken before its vital elements have escaped, and added to glycerin and ozone — an elegant and most efficacious preparation. A teaspoonful just as the patient commences his meal, effects digestion so per- fectly that there is literally no call, no demand for stomach and brain secretion. In other words, those organs have rest for repair. About one hour before eating, from six to ten drops of the comp. tincture of matricaria added to one ounce of water should be given. Of all tonics it is incomparably the best, the most active in the materia medica, when both the sensory and motor functions of the stomach are out of gear. Local, persistent stimulation over the region of the stomach promotes a renewal of life in that organ ; besides, it is beneficial for its reflex effect. The oil of capsicum is the remedy. The profession has too long been imposed upon by bastard prepara- tions of this oil, which are worthless. The attending physician must be the judge whether this oil be applied in the form of a plaster or by cotton medicated with it, or simply painted on and covered with rubber plaster, either pure or diluted. A form which can be comfortably worn by the patient is best. To build up vital force and overcome neurasthenia, one week, one teaspoonful of the c. p. solution spermin immediately after eating; second week, substitute one, and one only, kephalin granule immediatelv after each meal. and Dictionary of Diseases. 317 By alternating those two wonderful remedies, we bring to bear upon the nervous system of man remedies that fertilize the brain, deepen its typical fissures of thought and, together with bathing, massage, nutritious diet, freedom from care, will by proper management wipe out neurasthenia. The following are the views entertained by the leading members of our profession on dyspepsia : DYSPEPSIA. — Whatever diminishes strength impairs health — encroaches on the function of life — hinders perfect solution of food — disturbs the function of digestion. What- ever diminishes, either the secretion from the salivary glands, or the gastric juice, or perverts its quality, deteriorates its solvent properties. Food during digestion is quickened into life, a vital transformation, a nutritive process. Dead animal and vegetable protoplasm is magically endowed with the prop- erty of life, for the building up and regeneration of tissue. To effect this we must have a healthy stomach, normal diges- tion. There must be no altered condition of the mucous membrane (excessive secretion and evolution of the sarcinae ventriculi), no defect of either the mucous membrane or its nerve supply. Impaired gastric digestion renders a man feeble — often ex- tremely exhausted ; even adapting diet, mode of life to the con- dition not always curative. The gastric juice is merely a secretion from the brain, the function of the stomach to evolve it. The activity and in- tegrity of both organs depend upon the quality of blood sup- plied to them. The quality of blood is determined by the food eaten and assimilated. Rest by artificial digestion with papoid, comp. matricaria, stimulates both brain and stomach to a higher degree of ex- istence, and are the two best remedies in dyspepsia. Dyspepsia is a racial characteristic of the to-day American, induced by too hasty eating; the form denominated gastric catarrh is usually the outcome of excessive beer drinking, and when present gives rise to degeneration and atrophy of the gastric glands. Very many cases now arise from adulter- ated food and the use of chemical preservatives. Anemia is a very common sequel of imperfect digestion and assimilation ; then follows the inevitable nuerasthenia, poverty of nerve force, nervous exhaustion or prostration, a growing 3 1 8 The Germicide 20th Century Practice malady in which the vital forces are lowered and every func- tion of the body impaired. The general treatment is important ; cure hastened by the re- moval of cause, by attention to diet, by the administration of ozonized matricaria before meals and the c. p. solution of spermin after meals — those two remedies, in the physio- logical and therapeutic action, favor digestion, assimilation and metabolism — their action is immediate and direct — and the vital forces are favorably influenced by them, as they com- pletely overcome the gone feeling, as well as that of exhaus- tion. Eminent medical men infer from reliable statistics that indigestion is the most common of all maladies with which the human race is affected ; that neurasthenia lies at the origin of every case — once presented it favors the evolution of a large family of microbes, of which the sarcinse ventriculi is the most common ; that it is the toxin of that micro-organism which gives rise to the headache and indescribable feelings of misery. If the ozonized jelly of ichthyol is used in such cases, it inhibits their activity or destroys them. At all events, it is a good germicide, invariably gives a good result — but its effect or action in fermentations and acid crustations is quite marvelous. In addition, all of the mineral acids, together with ozone water and ozonized sulphur water, are invaluable in dyspepsia. Probably no malady is so common in our country as some form of gastric derangement, with all its collateral symptoms of pain, acidity, flatulence. The causes which give rise to gas- tric disturbance are legion, although for brevity they may be classed under one term, a want of nerve force — a deficiency of nervous power. Produced generally either by too much drain upon the nerve centres, by either mental application, general exhaustion from any cause, excessive use of tea or coffee, or abuse of tobacco, or too great a strain upon the sexual powers. Unstable con- ditions of the nervous system induce feeble digestion simply by want of power in the nervous system; with this condition of partial death, this deficient tonicity, evolution of pathogenic bacteria takes place. The lack of nervous energy gives rise to active bacterial existence with all the well-defined symptoms of dyspepsia ; the difficulty may not be gastric alone, it may extend to the in- testines. The division of dyspepsia under three distinct heads axd Dictionary of Diseases. 319 is to be commended : chronic gastritis, nervous dyspepsia proper, and gastric catarrh with its pathogenic microbe, sarcinae ventriculi. In the three forms there pervades each a deficiency of nerve supply ; so in each the first thing to do is to correct what is wrong in life and habits, ameliorate all dis- tressing symptoms, rest to the nervous system — rest in the recumbent position — a carefully restricted diet — all indigest- ible food excluded — any article that had been found by ex- perience to disagree. In the drug treatment the aim is to increase the nervous power of the stomach, annihilate the germs, so that nerve tonics are invaluable ; among these pre-eminently stands ozon- ized tincture of matricaria — if we were restricted to one rem- edy that would be the one — it imparts tone to the stomach, cleans the tongue, corrects the disordered state of the gastric mucous membrane, and braces up the muscular coat. Properly administered in a little water before meals, it never fails to afford prompt relief. As a rule, pain in the stomach is best relieved by the ad- ministration of green root tincture of gelsemium and passirlora incarnata. Liquor cerii after meals is much more efficient than any preparation of bismuth — it is a true gastric sedative. A decoction of kaki, given cold, to which a few drops of the peroxide of hydrogen are added, most effectually destroys the sarcinae in the stomach. In recommending a diet to our people, who nearly all are dyspeptic with weak hearts, we must forbid the use of the banana as an article of diet. It is simply a large mass of raw starch, containing some sugar and an appreciable dose of nitrite of amyl. Physiologically speaking, it is a vegetable, highly nutritious, but not digested till it enters the small intestine. In its chemical composition it is identical with the sweet potato, which also contains an even higher percentage of nitrite of amyl, which produces such havoc on weak hearts. Both are contra-indicated in feeble digestion, as they are productive of harm. Comp. tincture matricaria before and a few grains of papoid after meals are productive of much good, and afford relief in the most aggravated indigestion. For the constipation and general malaise, nothing can excel small closes of the kola-nut paste or kolatina. which vitalizes the enfeebled digestive organs. 320 The Germicide 20th Century Practice EAR, ITS DISEASES.— The auricle, or external ear, forms an important element in man, and serves a variety of purposes, such as the protection of the delicate organ which it. surrounds; preventing sensible perspiration, as it trickles over the head, from entering the ear; protecting it from wind and weather, dust and rain, the rays of the sun, and warding off various substances in active life. The mobility of the auricle causes wax to become dislodged and fall out. It also aids in maintaining an equable temperature and a proper degree of natural moisture within the ear, and assists in the catching of the undulations of sound, a sound conductor or condenser, an assistant in transmitting the vibrations to the inner ear. Its uses, then, may be briefly enumerated; to protect the ear and in catching sound, or sound waves, and of aiding in conducting them to the inner ear; it gives knowledge, also, of the di- rection of sound, and quickens the perception of musical notes. It is subject to all the various diseases of the skin, to various growths and tumors. The human ear is a perfect instrument of acoustics. Its mechanism is so arranged that the undulations of sound are transmitted or impressed upon the auditory nerve, or brain, in the most definite manner. The brain is the organ of hear- ing, the ear being simply the medium through which it re- ceives its impressions. This, of course, reduces all diseases of the ear to two classes — the ear and brain. The human ear is subject to the same fundamental laws of physiology and pathology as the rest of the body. This at once simplifies our investigations on ear diseases. Indeed, an overwhelming ma- jority of ear diseases are due to inflammation and its results, and in this process various parts of the organ may be affected;, all embraced under one general term — Otitis, or Inflammation of the Membrana Tympani and Middle Ear. — Beyond all question, the diseases of the auditory apparatus, which occur most frequently and possess the greatest interest, are the inflammatory affections of the tympanum and middle ear. The middle ear properly consists of the membrana tympani, the tympanitic cavity, the mastoid cells, the chain of ossicles, and certain muscles, vessels, and nerves. In a small, confined space, we have a most delicate, intricate structure, performing important functions ; easily dis- turbed by the standard of health, by a variety of causes, and attaining increased importance from their contiguity to such vital parts as the labyrinth, the internal jugular vein, the in- and Dictionary of Diseases. 321 ternal cartoid artery; the dura mater, and several venous sinuses of the brain; so when we look at the parts implicated, there should be no apathy in our treatment, no ignorant, officious meddling. Causes. — It may arise from cold, damp, exposure, rheu- matism, gout, boils, injuries, or accidents, injudicious tamper- ing with the ear with hair-pins. It may also be due to ex- tension of inflammation inwards, or upwards from the pharynx, carrying the germs of scarlet fever, quinsy, diphtheria, measles, smallpox, whooping cough, catarrh, pneumonia, bronchitis, influenza, syphilis, mercury, tuberculse, and the use of nasal douches. When the inflammatory action reaches the throat, it travels along the Eustachian. tube, which is the channel de- signed by nature for maintaining a due equilibrium between the atmospheric and tympanitic air, and for draining super- fluous mucus from the tympanum. When all is well it serves those purposes admirably, but when disease exists is serves as a channel for carrying disease germs up from the pharynx. The tube is short, being one and a half inches in the adult, but its continuity of mucous membrane permits an easy road for the germs to travel, and more so if it is a young child, in whom the tube is much shorter and more open than in the adult. Dentition, first and second periods, are productive of inflam- mation of the middle ear. The vasomotor impressions are readily conveyed from the inflamed gums to the correlated membrana tympani by the dental nerve, and the nervi vasorum of the tympanitic branch of the internal carotid artery. There can be little doubt that the difficult or retarded dentition due to a want of phosphates in the modern mother's milk is a com- mon cause of inflammation of the inner ear. It is impossible to doubt it when we look at the troubled little face, the resting of the head on the nurse, the thrill of agony that passes over its features, accompanied with piteous cries or shrieks when its position is moved, especially if done suddenly ; and, more than all, the constant raising of its little hand to the side. of the head ; all indicate the agonizing sufferings of earache. Of all living disease germs, those of scarlatina are most de- structive to the ear, give rise to hopeless chronic affections, or drift into deafness. The ear, in scarlet fever, is about as obnoxious to irritation as the kidneys, and when we bear in mind that every congestion of the lining membrane of the ear is a true periostitis, and every ulceration a caries of its osseous walls, so that with better care, a true appreciation of germ 322 The Germicide 20th Century Practice diseases, a more thorough antiseptic course, many lives might be saved, useful ears spared, and deaf-mutism become a rare exception. Symptoms. — General symptoms of inflammation, headache; pain in back, legs ; rigors, and a fever ; uneasiness in ear, fol- lowed by sharp, lancinating pain in the inner ear, increasing in severity; there are also impairment of hearing, giddiness, a sense of fullness in the head, and an increase of pain in moving jaws, mastication, or swallowing, moving the head, or blowing the nose. On examination of the membrana tympani, it is found red and congested. Beating noises in the ears; eyes be- come injected; countenance anxious; fever greater; function of skin, kidneys, and bowels -disordered. There may be de- lirium or convulsions. There is always great depression and despondency. If case is not seen to, there may be facial paralysis, from a spreading of the inflammation. Should the attack be a slight one, or the vital force vigorous, and treat- ment appropriate, perfect resolution may take place, but if powers of life are low, suppuration may take place, pent-up pus bursting on discharging itself, if in inner ear, by per- foration of membrana tympani ; or in more grave cases the in- flammatory process spreads into the mastoid cells internally, or by bony meatus to the periosteum, covering the mastoid process externally. In external otitis, perforation of the membrana tympani may take place, owing to the extension of inflammation from with- in outwards. The disease usually runs a very rapid course, suppuration often taking place in from twenty-four to forty-eight hours from its inception, a significant fact for rational and active treatment. Treatment. — The cause, if possible, should be promptly re- moved. Then patient should be put to bed in a warm room (yo° F.), moist atmosphere, well ventilated, comfortable, and free from all noise, no talking, the greatest quietness ; dry heat to the ear and side of head, such as hops, chamomile flowers, bran,. or salt, in bags or pillows, made hot in oven; and per- mit no food requiring mastication, for moving the jaws inter- feres with the rest of the organ. The fever, as well as the local inflammation, must be regulated by arterial sedatives. To do this effectually, administer a saline purge, or cascara, or both, and enemata, if not soon moved; heat to feet; aconite, belladonna, and veratrum viride. If the skin does not become and Dictionary of Diseases. 323 moist, compound tincture of serpentaria. so as to cause free diaphoresis ; hot drinks ; near night either chloral or Dover's powder, so as to get a long sleep. The dry heat is of primary importance and should be watched with care. Never poultice either an eye or an ear is an injunction to be obeyed. One or two grams of the jelly of violets dropped in the ear every three hours will completely alleviate pain. The idea of this line of treatment is, if possible, to prevent the formation of abscesses, or suppuration, as that is a result to be dreaded, as we never can know how, when, or where it may terminate, or to what it may lead. Case, otherwise, should be placed upon alteratives and tonics. If there is a manifestation of gout or rheumatism, colchicum, quinine, iodide of potass : if upon teething, lance the gums; as soon as fever, pain, etc., are re- lieved, alteratives and tonics. Earache, Otalgia. — Neuralgia of the auditory nerve is simply the cry of a nerve for better and purer blood. It may be brought about by cold, damp, rheumatism, gout, tubercle, syphilis. When an attendant upon some acute disease there may be fever, but more generally it is unaccompanied by any febrile disturbance. The intimate connection of the auditory nerve with the various nerves of the face, especially those supplying the upper and lower jaws, the stomach, liver, uterus, render ear-neuralgia common where those organs are out of gear. Earache is thus common, as its causes are numerous and varied. It is easily recognized by the sharp, lancinating pain in the ear, very severe ; frequently also shooting through the nervous filaments distributed over the side of the head and face, causing much suffering and great restlessness. Pain in this affection is intermittent in character — that is, ir comes and goes for no very apparent cause. It is a shooting, not a throbbing^ pain ; is frequently associated with toothache, but may also be due to rheumatic causes or to the presence of foreign bodies in the ear. Treatment. — If it is traced to imperfect performance of stomach or liver, an emetic of lobelia, and saline purge; any uterine derangement, compound betin pill ; a carious tooth, extraction ; or to any special disease germ, treat for its destruc- tion. In all cases, and at once, relieve pain by dropping into the ear either jelly of violets or mullein oil, or both; resting the head on very hot pillows of hops, or chamomile flowers, or brar or salt; or the roasted bulbs of onions; or, better still, gar 1 324 The Germicide 20th Century Practice In addition, if very severe, the aconite, belladonna and chloro- form liniment should be applied to the side of the face ; cotton- wool, saturated with concentrated ozone. During the day, aconite and belladonna in alterations with quinine are true stimulants to this nerve, and it is well to give pretty large doses ; at night either passiflora or gelsemin, or both, to procure a good night's rest. In the mean time treat the case according to the cause, with alteratives and tonics ; and bear in mind that in this painful nerve-cry nutrition is of vast importance. Otorrhea, or discharges from the ear, so frequent in young children, must always be regarded as a sign of constitutional debility. It is really a catarrhal or a purulent or muco-purulent discharge from the ear — a sequel or result of inflammation, or a symptom of polypus; granulations; thickening by lymph; se- baceous tumor in meatus; is a common and often stubborn disease. Causes.- — Irritation, inflammation, even if not appreciable, is the cause; so we have to recapitulate the causes of inflam- mation of the middle and inner ear : teething and scarlet fever in tubercular children; in adults it may depend on gout, rheu- matism, syphilis, and other depressed states of the system. The secretion is always contagious, being loaded with bacteria, if muco-purulent ; but if very offensive, the oidium albicans are present in it. It may be tinged with blood. Symptoms. — A mucous or muco-purulent discharge from the ear, either scanty or profuse, occurring all the time or ceas- ing at intervals. If the discharge is very purulent, that is, loaded with disease germs, it may be corrosive or eating in its character, and destroy the membrana tympani, the bones of the ear, or cause caries of the bony walls of the meatus and tympanum. Disease germs may penetrate to the mastoid pro- cess of the temporal bone, or into the petrous portion of the same bone, until the brain or its membranes become involved in the unhealthy action. This event is ushered in with rigors, fever, and marked cerebral symptoms, and ultimately con- vulsions, coma, and death. Inflammation or abscess of the l>rain may be induced by extension of disease to the cerebral sinuses and veins, as well as the dura mater. If there is any cancerous cachexia, it may also be developed at this point. Treatment. — The first point is to wash out ear with tepid water and castile soap, and examine to ascertain if no growths or polypi exist. There being none, the instructions must be to fill the ear thrice daily with peroxide of hydrogen and after and Dictionary of Diseases. 325 with one grain of jelly of violets. If weather is cold, ear-laps ; then place patient on the following alteratives week about in succession: ozonized compound phytolacca, idoide of potass in saxifraga compound. At the same time tonics, as sulphate of quinine and aromatic sulphuric acid, or compound tincture cinchona and mineral acids, or glycerite of ozone. Bowels and skin to be looked after ; clothing warm. The diet to be of the best, nourishing, and in abundance — animal food, milk, eggs, fruit. Parents must bear in mind the chronic, stubborn nature of complaint, and persevere. True, other alteratives might be used, and also other tonics, but, as a rule, these will suffice. Ear Microbes. — The fungi which affect the ear belong to the family of molds, and are as per gill us niger, Havus and fumigatus, the first named being the one most commonly found. To the naked eye they appear to consist of a felt-like structure composed of fine filaments, varying in color accord- ing to the species of fungus. Microscopically, the fungus consists of thin mycelia with hyphae, from which extend the fruit filaments. The latter terminate in a rounded capsule (the sporangium) , on the other surface of which are arranged radially the condia or fungous spores. These spores are always present in dwellings, but the meatus does not usually offer, a soil favorable to their development, and all attempts to inoculate healthy ears have failed. The presence of ceru- men and pus prevents their growth, but serum forms a favor- able soil. The fungus is, therefore, found only in eczema of the meatus or where a discharge loses its purulent character and becomes serous. Otomycosis is also favored by instilla- tions of glycerin, zinc, alum, tannin solutions and oil, and also by injuries causing a dermatitis. The part chiefly affected is the inner portion of the meatus and the membrana tympani ; but if prolific, the fungus may affect the whole meatus and lead to obstruction. Unless there is exudation, whitish or blackish (if aspergillus niger) spots appear on the membrane or meatal walls. If exudation be present, the meatus contains black-spotted membranous patches. These flakes may easily be mistaken for epidermis or cereum, and the microscope is necessary for certain diag- nosis. Otomycosis may give rise to no symptoms or merely to itch- ing, slight dullness of hearing, tinnitus, and pain of a dull, heavy character. A slight serous exudation may also be 326 The Germicide 20th Century Practice noted. Rarely, perforation of the drum-head and middle- ear inflammation have occurred. Treatment. — The removal and destruction of the fungus is indicated. The most certain method of destroying the mold is by repeated instillations of peroxide of hydrogen every other day, with the addition of one or two of violet jelly. The fungus, after a few applications, is killed, breaks up into pieces and is expelled. The installation of the peroxide may be con- tinued briskly for a few days, and subsequently at intervals of twice a week for some time. Foreign bodies in the ear and accumulations of wax are best removed by syringe with warm water. Insects, which give rise to alarm and pain, best treated by filling the ear with olive oil. Polypi, when they form in the ear, irrespective of variety, will yield promptly to the introduction of the ozonized oil of thuja. ECCHYAIOSIS. — An extravasation of blood beneath the skin giving rise to discoloration, and. usually due to injury. The commonest examples are bruises and a black eye. Ozon- ized tincture of marigold or oil of anilin and arnica are our best remedies. ECHINACEA AUGUSTIFOLIA.— Perhaps the most powerful of all vegetable antiseptics in the form of an ozonized concentrated tincture ; hence it is of great efficacy in all mala- dies in which a disease germ is the factor of morbid action. The ozonized concentrated tincture is a remedy that will cure snake-bites, and is a positive prophylactic for rabies, pro- vided it is administered before swallowing becomes difficult. Judiciously managed, locally and internally, it overcomes sep- ticemia. ECLAMPSIA. — Convulsions, with loss of consciousness, unconnected with any grave cerebral or spinal lesion, occurring in parturient women. The frequency of its occurrence is one in every 260 labors ; it may vary some among different women in peculiar grades and position in life. They may come on the day after impregnation, and at any intervening period during pregnancy; still they are most commonly met with just before labor commences, or during and after it, and the largest pro- portion, 93 per cent, synchronous with parturition. and Dictionary of Diseases. 327 Although there is no aura or warning there is likely to be languor, lassitude, debility, headaches, disturbance of vision, flashes of light before the eyes, amblyopia, amaurosis, ringing in the ears, difficulty of breathing, tingling, numbness in the limbs, epigastric pain, steady diminution of urea eliminated, in- variably associated with albuminuria, which is always present before, during and subsequent to the attack. Fifty per cent of all the fetuses die before delivery, usually poisoned by the same causes which produced the eclampsia in the mother, or are asphyxiated on account of deficient oxygena- tion of the blood, or a too early separation of the placenta. Complete recovery may take place, or death may occur in spite of the best treatment and most approved remedies. Super- saturated poisoned blood leads to heart failure, gradual as- phyxia, lung congestion, puerperal sepsis due to infection. Puerperal convulsions are nothing more nor less than toxe- mia, the retention of poisons in the blood, which are usually eliminated by the kidneys. The source of the toxic principle is elaborated in the kid- neys, the failure to eliminate is there — the toxicity in the blood is increased, supersaturated owing to renal incompetency — both the brain of the mother and fetus are poisoned by a physi- ological product. The pungency of this poison can barely be estimated by its action on the brain in the deep coma, constantly recurring convulsions, slowed labor combined with anemia. If puerperal eclampsia be suspected an effort at prevention should be made. This can best be effected by flannel clothing, most nutritious diet, keeping the skin active by sponge baths at least once daily; stimulating the excretory function of the kidneys by apiol, and the liberal administration of the comp. syrup partridge berry and the insertion and retention of two obstetric cones, one per vaginam and one per rectum, morning, noon and night. These cones vitalize the kidneys, stimulate secretion, aid free elimination; besides they produce absolute anesthesia of the uterine and sacral plexuses of nerves, thus subduing all reflex irritation. If convulsions have actually taken place, delivery should be effected as speedily as possible ; then aid nature in the elimina- tion of the poisonous product from the body through the usual avenues, skin, kidneys, bowels; either a hot or an alcoholic vapor bath is unexcelled ; dry cupping over the loins, followed by hot linseed-meal poultices made with glycerin; enemata of pint infusion of flaxseed, to which twenty grains of chloral 328 The Germicide 20th Century Practice hydrate, thirty grains of bromide potassa, half a teaspoonful of apiol solution is added ; if there be much congestion, a few drops of veratrum viride should be added, and repeat, if indi- cated. Never omit the obstetric cones, both vagina and rectum, and repeat often, as they are a powerful aid in controlling the convulsions. Once the patient can swallow, saline purgatives with per- oxide of hydrogen are excellent. The patient should be well guarded so as to prevent her doing violence either to herself or others. The albuminuria of pregnancy occurs independently of heart or kidney disease. Its occurrence in one pregnancy does not indicate its recurrence in another. The trouble is due to the toxin of a micro-organism, a planococcus, an evolution from the products of conception, which gives rise to a toxic condition of the blood, hence the eclampsia. The cause of the albuminuria in all those cases is the toxin in the blood, which relaxes the vessels of the kidneys, permitting the white portion of the blood to ooze through, a condition which is highly prejudicial to the nutrition of the fetus. In all such cases, the ozonized celery comp. effects splendid results; its administration vitalizes the kidneys, while impart- ing tonicity, it increases their action, favors elimination — at the same time is a perfect antidote to the poison. Albuminuria should be looked for in every case of preg- nancy, and if the merest trace of it exists, or can be detected, bear in mind that in the ozonized celery comp. administered, we have a never-failing remedy. ECZEMA. — The practice of medicine is not now, and from the very nature of the human mind never will become, an exact science. This characteristic it possesses in common with all the sciences and arts that have for their object the welfare and happiness of living creatures upon the earth. The fundamental principles of nature are fixed and certain ; those of the sciences likewise to a certain extent, but their development is apparently unlimited, unless it be so by the exhaustion of the ingenuity or the extinction of genius from the human race. Improvement on every side is unquestionably the order of the age in which we live. Man in his advanced state of civilization demands that the talent of the world be at his feet if it tends to make his wealth more abundant, his health more perfect, or his happiness and Dictionary of Diseases. 329 more complete. Medical men are frequently asked to explain why the advances in the domain of surgery have been so much more pronounced within later years than those in that of prac- tical medicine, not knowing that it is but the untrained eye, the unreasoning or ignorant class of persons, who first give rise to such assertions ; for the fact is, that the most pronounced and the most unhoped-for remedies for the cure of disease have been brought forth within the last decade, did the public but know it. Physicians have but rarely achieved great success by their perfection of medicinal or chemical preparations, nor is it their province to labor in that direction ; their work lies in the direc- tion of diagnosis, advice, and administration. The most promi- nent factor in the advancement and the discovery and perfec- tion of medicine is undoubtedly the chemist. He is continually seeking new remedies that will be adapted to the more rapid and certain alleviation of pain, and the elimination of disease and disease-products from the human system. To-day the medical profession is not bound down by any set or fixed rules of treatment, but all schools are one in that the honest and worthy unite in doing the greatest good to the greatest number, and in the shortest possible space of time. Speaking definitely eczema is simply catarrhal, vesicular in- flammation of the skin, which, in a typical case, shows a red, irritable, raw-looking surface, from which a fluid exudes which on drying forms scabs or crusts. In advanced forms of the disease the patches become dry and scaly. It is difficult to cure permanently, for, in those subject to it, it recurs readily when- ever the skin is exposed to irritation. It is usually due to local irritation, such as the exposure of a part to contact with irri- tating fluids, etc. Other causes are dyspepsia, gout, and rheu- matism. Treatment should be constitutional and local. The food should be plain and nutritious; stimulants, spices, and rich foods being avoided. Regular exercise should be taken. The medicinal remedies are : In children, thyroid ext. of c. p. solu- tion spermin; in the gouty, colchicum and ozonized uric acid solvent; in other cases, quinine and iron. In chronic cases, cacodylate of sodium is usually necessary. The local remedies are : In the acute stage, when the skin is red, hot, and moist, soothing lotions — such as solutions of ozonized boroglyceride, borax, bicarbonate of soda, or powders of boracic acid, camphor, etc. — should be applied. 330 The Germicide 20th Century Practice In chronic cases the crusts must be removed by means of a lye poultice. Dermolia ointment or zinc ointment should then be applied. When the inflammation is going down, mild mer- curial ointments may be used. When there is much itching and the part is dry and scaly, ointments of tar, creosote, or car- bolic acid are useful. Soap and washing in water must be avoided in all cases of eczema. Cleansing may be carried out by washing with milk or weak gruel. ELDER BARK. — Sambucus nigra is a bactericide of in- trinsic value. The ozonized extract of the inner bark is of most therapeutic power and may be administered successfully whenever there be a germ in the blood, such as spyhilis, rheu- matism, erysipelas. It is, in addition to its microbicide proper- ties, an active diuretic and heart tonic; hence it is valuable in all dropsies, but especially those dependent upon cardiac and nephritic failure. Alternated with either digitalis or caflein, or both, its in- fluence or action is greatly prolonged. A decoction of the flowers make an excellent eye lotion in the different varieties of ophthalmia and a splendid application in erysipelatous inflammation, for it is destructive to all mi- croscopic life, hence the inflammatory condition subsides. An ointment prepared by simmering either the leaves or flowers of the elder in lard, deprived of its salt, is a most effi- cient germicide in all bacterial cutaneous affections and in chronic microbic ulcers. Bacteria of the skin will persist in very many cases after the initial cause has ceased to act. Even a tonic prepared from the berries is such an active bac- tericide that, if taken thrice daily, it kills the sarcinse ventriculi on the stomach. ELECTRICITY. — When properly regulated, not indis- criminately used, and of an intensity not excessive, is a valuable nerve stimulant and vitalizer. The forms of electricity that have been found useful in medi- cine are static, or franklinic electricity, which has an enormous voltage and a very high amperage; faradic electricity, whose voltage is lower and amperage low; and galvanic electricity, whose voltage is low and amperage somewhat higher. The negative spark is always the more irritating, and it should be used only on cloudy days, when it is difficult to obtain proper and Dictionary of Diseases. 331 effects from the positive pole. When the patient is perfectly insulated and is given static electricity, nutrition is improved and pain relieved: It is especially soothing for those nervous, discomforting conditions which are so hard to reach by any ordinary medical means. If sparks are taken from the patient when in this condition, a wheal is often produced and also a lesion not unlike a flea-bite. The indirect spark, which is less irritating than the direct, should be used always except on damp days, when it is difficult to obtain the proper charge of electricity. The electric breeze, which is obtained from a charged machine by the use of a pointed electrode, is soothing for local irritation. In facial neu- ralgia, as well as other localized pains, it often gives excellent results, and often works well for such general conditions as insomnia. An interrupted electric current is of great service in electrical treatment. It causes contraction of the muscles, but the con- traction is painless as compared with the faradic current, and the effect is more diffuse. This current is very efficient in the treatment of such maladies as lumbago, sciatica and other neu- ralgias, as well as in chronic rheumatism. It has a specific analgesic effect, which makes it useful in most painful condi- tions. It has been used with marked success for ovarian pain, while stitches of pelvic pain of uncertain cause, and for which it has been difficult to obtain relief, are often completely over- come. It is far better than either the galvanic or the faradic current in such painful conditions of obscure origin. In general, electricity is good for most subacute or chronic conditions. Static electricity is not a cure-all, and should not be used indiscriminately; but, used with precision and judg- ment, it will relieve pain in a number of chronic affections. It must be used with judgment. The faradic apparatus produces excellent effect by the stimu- lation of atrophic muscles, and in general by its tonic effect on the surface of the body. Care should be taken, however, not to subject weakened muscles to prolonged tetanization by the faradic current. As a general rule, the best number of faradic impulses to allow to pass through a muscle per minute is about thirty. EMBOLISM; THROMBOSIS; BACILLUS INDICANS. — A thick, clotty condition of the blood, may be the result of malarial or other poisons, non-aeration of blood, defective ac- 332 The Germicide 20th Century Practice tion of the liver, skin, congestion of lungs, and disease of supra- renal capsules. Incidental to this state, cause or effect, the bacillus indicans appears in the blood. Its recognition is usually easy, if there be blueness of the ears, nose, lips, nails, peculiar sensations about heart, fainting fits, etc. In a drop of the patient's blood, the bacillus can be seen in the form of very short rods, with rounded ends. They are round, ovoid, or spindle-shaped, and have charac- teristic granular margins, having a strong resemblance to the microbes of pneumonia and rhinoscleroma, both of which are capable of giving rise to the formation of indigo blue, and to indigotic fermentation. This microbe plays an important part, and determines the formation of indigo in various diseases. Indigo is a fermentative product due to the action of this microbe. The indigo-bacillus is pathogenic of various diseases, which are chiefly due to a non-aeration of the blood, bears cultivation well in blood-serum. Cultures injected into any animal give rise to embolism, hepatization of lungs, cardiac apoplexy, vis- ceral congestion, fibrinous exudation. This microbe is completely sterilized in the presence of liquor ammonia acetatis, in alternation with tincture of belladonna; peroxide of hydrogen in alternation with sulph. quinine ; comp. oxygen, ozone water and other bactericides. EMERGENCIES— HEMORRHAGES.— External hem- orrhage must be arrested by pressure, by tying a bandage around limb, and using torsion till medical aid is reached. Hemorrhage from the Nose. — Raise both arms above the head, apply cold — ice, if possible, to the nape of neck and over nose, and if necessary plug the nostrils with cotton saturated with vinegar. Hemorrhage from the Stomach. — A solution of common salt ; small pieces of ice ; gallic acid ; digitalis ; gelsemium. Hemorrhage from the Lungs. — A solution of common salt ; tincture of iron ; digitalis ; gallic acid ; solution of alum ; ice. Hemorrhage from the Bowels. — Turpentine ; sulphuric acid ; digitalis ; bayberry. and Dictionary of Diseases. 333 Hemorrhage from the Kidneys. — Heat to loins; gelse- mium in infusion of uva ursi ; gallic acid ; ergot ; if bladder is full of clots, wash it out. Give urotropin. Hemorrhage from the Uterus. — If it occurs during un- married life, from fright, shocks: Rest; elevation of pelvis and foot of bed, head low ; digitalis ; gallic acid ; turpentine and sulphuric acid ; no hot drinks or food ; perfect quiet. Hemorrhage Before Delivery. Rest in incumbent pos- ture, hips elevated, foot of bed raised, head low ; opium in al- ternation with the aletris wine; nothing hot, no excitement. Hemorrhage After Delivery. — Patient well bandaged from middle of thighs to above the navel; compress over uterus ; elevation of hips and foot of bed ; no excitement, noth- ing heating. If the contents of uterus are removed, there is not much likelihood of hemorrhage. If uterus has contracted on after-birth, or a portion of it, plug vagina with a sponge or sponges saturated with vinegar, which will excite contraction, and violent pain, and expulsion. Give uterine stimulants, as capsicum in warm milk; quinine; but avoid ergot, if possible. If uterus dilates sufficiently, remove after-birth, or clots, with fingers. Don't give the turpentine mixture till all has been re- moved ; then it is very useful. Hemorrhage in which the After-Birth is Over the Mouth of the Uterus, or Placenta Previa. — Plug the vagina with sponges; if that fails, dilate the neck, detach enough of the placenta to admit the hand, rupture membranes, seize the feet, and bring down, and hurry up delivery by in- ternal and local stimulants. There must be no wait or hesita- tion. Contusion, or Ecchymosis. — Arnica, marigold, muriate of ammonia, leeches. EMERGENCIES — WOUNDS. — Wounds of the Throat. — Arrest the flow of blood by pressure of the ligature. Wounds of the Chest. — Hemorrhage should be controlled by internal remedies. In some cases the intercostal arteries can be ligated. Wounds of the heart are not always fatal. Wounds of the Abdomen. — Generally either punctured or incised. If bleeding is profuse, tie the vessels, if they admit of it. If the intestines protrude, return them; and if the wound is not large enough for the purpose, enlarge it. If they are wounded, stitch them carefully up and return, carefully spong- ing away any blood or escaped feces. Wounds of liver, kidneys, bladder, are very fatal. 334 The Germicide 20th Century Practice Wounds of the Perineum. — Hurried labor, want of sup- port, ignorant use of the forceps, ergot, and other causes, ren- der the perineum liable to be frequently torn or lacerated. As soon as the lochial discharge ceases, edges to be carefully pared and stitched up. Gunshot Wounds. — Must all be treated on general prin- ciples. The essential features are to rouse the patient from the state of collapse, control hemorrhage, and, when prostration is overcome, foreign bodies, particles of bone, pieces of clothing, bullets, splinters of wood, or other matter, are to be removed or extracted, and the wound treated on general principles, with antiseptic dressing. Patient kept well over on it to allow for- eign bodies, or morbid matter, to flow out by gravitation. Limbs Torn by Marching or Other Violence. — Tie strong handkerchief around sound part, and use torsion to pre- vent hemorrhage until surgeon arrives. In all accidents, arrest the hemorrhage before moving the patient. If unable to walk, some conveyance— a settee, or litter, or carriage, according to the nature of the case. The injured person should be taken to the nearest hospital, or house; clothes ripped up, so as to uncover them and ascer- tain the extent of the injury; all onlookers excluded. The great point is, if there is a wound, to arrest the flow of blood by compressing the limb above the injury sufficiently tight until a surgeon arrives. Foreign Bodies in the Air Passages. — Foreign bodies, as seeds, beans, fruit-stones, buttons, pins, coins, beads, marbles, pebbles, fish-bones, etc., may pass into the larnyx, trachea, and bronchi of children ; or vomited matter, pus from abscess, and other substances. The entrance of a foreign body from without usually takes place during a sudden, strong, deep inspiration. It at once causes violent spasmodic cough, difficulty of breathing, a sense of impending suffocation, or even immediate death. In a few minutes symptoms become less severe ; cough and difficulty of breathing return at intervals. If the body remains in the larynx, there will be harassing cough, of a suffocative char- acter ; loss of voice ; an inability to speak above a whisper ; pain in swallowing; tenderness; noisy, hissing respiration, with difficulty of breathing. If it descends into the trachea, it is seldom stationary, can sometimes be felt by the hand exter- nally to rise and fall ; the change in position gives rise to severe •spasmodic attacks of difficulty of breathing ; a flapping, valve- and Dictionary of Diseases. 335 like sound, owing to a foreign body being forced against the rima glottidis, in expiration. If the substance passes down the bronchial tubes, it fortunately takes to the right, directed "by the bronchial septum. Auscultation and percussion will reveal the point, whether the patient's lung is permeated by air. Bronchitis and pneumonia are now to be dreaded. Fluids may enter the larnyx, but they usually induce a sense -of choking, with convulsive cough, which causes their expul- sion; but if very abundant, as in drowning, they may cause death. Treatment. — If the body be at the entrance of the larnyx, or between the vocal cords, it may be seen, and seized with polypus forceps. This failing, place the child's head down- wards, and slap quickly and smartly on back. Emetics, lobelia, and snuffs should be tried. If the body remains in the larnyx, it should be at once opened, and the substance will probably be either ejected through the glottis or the artificial opening. If successful the opening should be stitched up, and strips of adhesive plaster applied between. Various other methods have been suggested, as the inhala- tion of chloroform, hanging patient up by feet, and slapping briskly on back. Foreign Bodies in Nose, such as peas, small shot, fre- quently occur in children. Excite sneezing, or use nasal douche, or, if possible, extract them with the forceps. Foreign Bodies in the Ear, such as grains of wheat, bar- ley; slate-pencil, seeds, insects, cause great irritation. Treatment. — In case of insects, fill the ear with olive oil, turning patient on sound side ; or with vinegar and salt in solu- tion, and plug with cotton-wool. Insects will be found usually on the plug. Other bodies must be removed by syringing out the ear twice daily with tepid water. Foreign Bodies in the Eyes, such as sand, cinders, broken eyelashes, which often lodge on one of the eyelids. In all cases they should be immediately removed, to prevent inflammation. Treatment. — Invert the eyelids, and remove the foreign body with a small camel's-hair brush, dipped in a solution of one •grain of chloride of gold to one ounce of water. Burns and Scalds. — Vinegar, lard, flour, and eggs are in every house. Put on flour, beat up in lard, thick, covering the burn half an inch. If vinegar is applied, kept constantly wet, white of eggs invaluable, and as soon as the carbolic acid mix- 336 The Germicide 20th Century Practice ture can be procured, let it have the preference for a permanent dressing. Shock, or Collapse. — Artificial heat to feet, inside of thighs and arms; perfect- rest, recumbent posture; diffusible stimulants. If there is no reaction, artificial respiration ; cloths, wrung out of boiling water, over heart ; enemata of linseed tea, with spirits of turpentine; friction to entire surface; electricity. Sun-Stroke, in whatever form, is best treated by placing patient in recumbent posture, in a cool room, near an open win- dow ; removing his clothes, and keeping tepid water constantly applied to the entire body; bromide of ammonium and tepid water internally, and also by the rectum. Place the greatest reliance upon tepid water and ammonia ; warmer water, if skin is cold. Retention of Urine. — Hot hip-bath, with lobelia ; tincture of gelsemium internally; a poultice of hot, bruised, roasted onions to perineum ; the running of a stream from a narrow orifice; all failing, catheter. Dog- or Snake-Bite. — Apply firmly a ligature above the bitten part ; bathe it freely with very hot water and echinacea, if procurable. While so doing, chop a few red onions very fine ; then mix in some common salt, and bind an inch thick over the wound. A solution of muriate of ammonia answers better for a dressing, if at hand; if so, keep it constantly wet, and the solution as strong as it can be made; keep either applied till the physician arrives. If a snake-bite, don't wait, but begin administering half a tumbler of the best brandy or whisky that can be got, every five minutes, till the patient is perfectly drunk. Lightning. — Usually causes instant death by paralysis; when not immediate, the tissues may be charred, or simply the loss of speech, sight, hearing; or hemorrhage from mucous membrane, from eyes, ears, mouth, rectum. General prin- ciples, according to the condition of the patient. Burns treated like other burns ; collapse, by stimulants. EMERGENCIES— INSENSIBILITY FROM MANY CAUSES. — When an individual has been picked up on the road or street insensible, irrational, or inarticulate, and his antecedents unknown, what is the matter? Is he ill, drunk, drugged, or suffering from some brain concussion, or from coma after an epileptic fit, or otherwise ? and Dictionary of Diseases. 337 Syncope, trance, catalepsy, coma, are names used by medical writers to designate states of insensibility, which the public call fits. Syncope is fainting, a condition of the body in which there is a death-like pallor, with loss of muscular power and con- sciousness; a faint is usually transitory, due to shock. In it the person collapses, rather than falls to the ground ; his knees are bent under him, he subsides into the sitting posture, his head drops forward, and by the time his head has thus sunk to the level of the heart, or below it, the circulation of the brain becomes sufficiently restored for consciousness to return. In a faint, a person seldom bruises his face. Upon waking, he may feel sick, giddy, or alarmed, but his brain resumes its thinking functions at once, and entirely. Recumbent posture on the right side, articles of dress loos- ened, dashing cold water on face and front of chest, cautious inhalation of ammonia, diffusible stimulants. Trance is a state of death-like faintness, in which some con- sciousness is retained, but inability to speak. In trance, the body appears inanimate, there is no power to move a muscle, the limbs are flexible ; he may hear, see, and remember all that goes on around him. There is no perceptible pulse or respira- tion; hence trance has been, and often is, mistaken for death, as the temperature is lowered ; muscles react to galvanic stim- ulus. There should be no hurried burial alive, or post-mortem, unless rigor mortis or signs of putrefaction be present. Treat same as collapse — artificial heat, enemata of turpen- tine, cups to both sides of entire spine, over abdomen ; and as soon as he can swallow, diffusible stimulants. Catalepsy, a rare inanimate condition ; insensible, stiff, un- able to move, or articulate ; pulse slow, respirations diminished ; extremities cold and flabby. He or she may be pinched, pricked, beat without flinching — statue-like, but perfect mute- ness. There is neither the lividity of asphyxia, nor the pallor and general flexibility of syncope, nor the stertor of coma, nor the paralysis of epilepsy, nor the movements and dreamy men- tal automatism of somnambulism. Treat same as Hysteria, or Anemia of Brain, Cord, and Gan- glionic Centre. Coma, or deep sleep, may be due to very many causes, as to pressure exercised upon the brain from effusion within the ventricles, and outside of the membranes; to alteration in the molecular state of brain from concussion, contusion, apoplec- 338 The Germicide 20th Century Practice tic extravasation to brain-poisoning by insufficiently oxodized blood ; to uremic blood, narcotics, anesthetics, inebriants. It is impossible to give accurately positive land-marks for diagnosing each kind of coma. Profound Coma is present in serous effusion into the ventri- cles of the brain, such as arises from extensive burns, or from tubercular meningitis in later stages. Patient is first sleepy, then drowsy, then stupor, slow of comprehension, difficult to wake, and finally, incapable of being roused at all. The breath- ing is stertorous ; at first he can swallow, then he fails to do so ;. pupils are not characteristic, most frequently contracted, and then dilated. Coma, due to fracture or effusion of blood, as in sanguineous apoplexy, is sudden in its advent. The breathing is stertorous, pupils contracted, heat may be normal, skin perspires freely. In fracture of the skull, there is oozing of blood or serum from ear and nose; or there may be blueness, humidity, ecchymosis of the eye, neck. In apoplectic cases, face often turgid with blood. Coma, due to molecular death of a portion of the brain, the face is pale, heat lowered, pupils unequal, evidence of hemi- plegia, or some form of paralysis. Coma, due to some brain-poisoning, as deficiency of oxygen in pneumonia ; nitrous oxide gas ; the nose, lips, neck, face, and other parts, are livid, often black. If patient has breathed carbonic acid gas, say, from a lime- kiln, or sulphuretted hydrogen from some source, those two gases arrest the oxygen-carrying properties of the blood, and this blood-change, or damage, is not recoverable from brain- poisoning; and coma by anesthetics and inebriants is usually detectable by the breath of the comatose person. Apoplexy and dead-drunkenness are often mixed. In Brain-Poisoning, try artificial respiration, abundance of fresh air, cloths out of boiling water over heart ; enemata, say, one and a quarter pints of cold or warm water, with a table- spoonful of salt; cups to nape of neck; mustard to feet and hands ; free purgation, if he can swallow ; suppositories of nitro- glycerin. Uremic Coma is recognized by edema of eyelids, or extrem- ities; wax-like pallor, uriniferous odor of breath and skin, furred tongue, pearly conjunctiva, dilated pupils. Try warm bath, free purgation with salines, and hypodermic injections of pilocarpin. and Dictionary of Diseases. 339 Coma of an epileptic fit is usually recognized by the bruises, torn or soiled clothes ; indications, as if the tongue was bitten. Patient to be placed on right side, clothes loosened or re- moved; enemata of lobelia, capsicum, and valerian; or hypo- dermic injection of one- fourth of a grain of sulphate of mor- phia, if over seventeen years of age ; dashing cold water on the patient, of little service. EMPHYSEMA. — A term applied to the introduction of air, either into the areolar tissue or the lungs. Pulmonary emphysema is met with in one or other of two forms, lobular and vesicular, the former mechanical, generally due to some violent concussion of the chest or the lung, which produces a laceration and infiltration of the damaged structure by air; the latter to forced inspirations, the distention of a vesicle into the air sac, such as occurs in racing, hoisting, play- ing wind instruments. In addition to the incidental debility, with dyspnea, slowed pulse beat, lowered temperature, the dis- tention or infiltration can invariably be mapped out by percus- sion. When the emphysema is progressive, depending upon bron- chitis, asthma, degeneration and atrophy of lung tissue, the necessity for forced inspirations is increased by defect of ex- piratory power in the lung and chest, insufficient to empty the lungs of residual air, then toxemia is present. Nature, in- creased vitality, may cure the lobular form, otherwise it is irre- parable ; whereas, the vesicular is amenable to treatment. Euphorbia pil. has a marvelous vitalizing action upon the lungs, increases their capacity, their tonicity, their power of ex- pansion; diminishes the calibre of the air sacs, thus relieves the dyspnea and strengthens the action of the heart. It is either administered in fifteen-drop doses of the extract, or in a fifteen grain tablet; whether drops or tablets, it should be given in warm water at stated intervals. There is invariably a condition of constipation in emphy- sema; hence enemata of either an infusion of slippery elm or flaxseed should be administered once or more frequently daily, according to indications. After the contents of the rectum have passed, insert a kurchicin suppository, which with the greatest benefit can be repeated thrice a day. With such a sim- ple remedy, that priceless element, human life, can be preserved and prolonged with comfort. As a tonic in emphysema, matricaria comp. is by far trie best. 34° The Germicide 20th Century Practice ENTERITIS (Inflammation of the Bozvels) — Causes. — Indigestible food (especially in children), irritant poisons, al- coholic excesses, impacted feces, peritonitis, and intestinal ob- struction. It may be confined to several parts of the intestines, when, according to the situation, it is indicated by such terms as duodenitis, ileitis, colitis, and proctitis. ■ In simple cases only the mucous membrance is inflamed ; in others, the whole thickness of the intestinal wall may be af- fected. Symptoms. — Vary according to part affected and the degree of inflammation present. In most cases, severe recurring at- tacks of colicky pains, tenderness on pressure, flatulent disten- tion of the abdomen, gurgling sounds, and diarrhea. The stools vary greatly, but blood is rarely present unless there be some ulceration. As a result of the intestinal conditions, the general health suffers, and there is fever, anemia, depression, loss of appetite, and progressive emaciation. When the duodenum is affected there may also be some jaundice. When the lower parts of the bowel are attacked there is usually much straining. When the disease becomes chronic, the chief symptoms are prolonged diarrhea and malnutrition. Treatment.— Light and unirritating diet; select Virginia stone crop, passiflora incarnata, gelsemium, for the acute symp- toms; then follow or alternate with the sulphocarbolates of zinc, soda, lime with concentrated ozone over the entire abdo- men, changed twice daily; mucilaginous drinks. Although this affection is regarded as a simple inflammation of the small intestine, nevertheless there is a microbe resem- bling the comma bacillus either elaborated in the bowels or gains access through the drink or air, for when the dejecta of all cases of enteritis are examined, with the most careful pre- cautions, there is always present a small but very active ba- cillus. In cultivation and inoculation experiments it behaves some- what differently from the micro-organism of diseased meat, and it is undoubtedly a species or a culture of the meat poison- ing; a culture of the bacterium coli commune of exceptional virulence and rapid growth; but much caution is needed in such conclusions, because the constant presence of this bac- terium, pathogenic to many diseases, makes it difficult to recog- nize other possible causes of disease in the intestinal contents. The presence of this germ accounts for the contagious and infectious nature of all cases of enteritis. During the summer and Dictionary of Diseases. 341 months this affection is exceedingly common; sudden in their seizures, ushered in with rigors, fever, diarrhea, delirium and prostration. The following remedies met the anticipations of all physi- cians: One dram of Virginia stone crop, ten drops of the tincture of green root of gelsemium, and ten grains of resorcin ; mix. Taken in divided doses, so as to take the entire dose in three hours. Repeat, every three hours, until every vestige of inflammatory action ceases. Then follow with ozone water to prevent auto-intoxication or poisoning. To weak small intestines, chronic enteritis, can be traced much of that terrible gone feeling, so unusually common among our people, that feeling of prostration or auto-intoxica- tion from poisons of ptomains within the body. The follow- ing conclusions have been arrived at : Slowed peristalsis, from debility, gives rise to retention of cadaveric alkaloids which should be eliminated, excreted from putrefactive bacteria in the bowels. Disorders of digestion, anemia and other causes of enfeebled nutrition may thus, as well as disorders of the excretory organs, be indirect causes of auto-intoxication. Fatigue, fasting ,etc, produce diminished intestinal toxins, which, by allowing undue fermentation of the retained dejecta, may produce similar effects. Pathogenic microbes may, by the products of their growth in the body, produce auto-intoxication in another sense. Membranous Enteritis. — Numerous cases of this singular malady have come under the cognizance of the author within the last decade, namely, the passage of shreds, mucous casts, passed either at intervals or continuously with every mo- tion of the bowels. Females about the middle period of life, whose nervous systems are deranged or seriously broken down, are sufferers from this malady; also those who are suf- ferers from genital or intestinal disorders. The passage of this exfoliation in the form of either shreds or casts is usually paroxysmal, accompanied by a good deal of nervous disturb- ance, abdominal pain, tenderness, and often tenesmus. What- ever amount of abdominal pain there may be is usually relieved by the passage of the membrane. Everything associated with these cases pointed to a marked want of nutrition. As there is little literature to consult, few clinical cases, we must depend almost entirely on the cases as they present themselves. Presuming there is a microbic evolution, that its toxins seriously invaded the brain cells and produced much of the 34 2 The Germicide 20th Century Practice trouble, it is advisable in all cases to pursue a germicidal course, under which favorable recoveries are made. Every morning, immediately after breakfast, an enema, con- sisting of a pint of flaxseed infusion, to which one tablespoon- ful of Chian turpentine mistura was added, and thirty grains of c. p. resorcin. This was repeated before retiring at night. Internally, one teaspoonful of ambrosia orientalis was given before meals, and two hours after eating one dram of Virginia stone crop. Very nourishing diet, all of a soft, non-irritating character, was given. Rest in recumbent position. ENURESIS. — Incontinence of urine may be either di- urnal or nocturnal or both. Very common malady among children with a feeble organization, disappearing with puberty or the acquirement of good health: In the large percentage of cases there is an extreme irrita- bility of the spinal centres, which in itself, without any exces- sive secretion of urine, may give rise to it. From maldigestion, errors in diet, we generally find the urine loaded with uric acid and urates, often depositing the former ; occasionally an excess of oxalate of lime. Such urine is usually scanty, concentrated rather than copious, which indi- cates an error in the metabolic process, which may depend on some morbid action, diathesis, or faulty diet. Depreciated health, the index of disordered digestion; then follows a dis- turbance of assimilation, which is never primary, but the result of an altered state of the blood, which has its cause in the presence of some toxical substance, the proceeds of microbial action. In some cases of nocturnal enuresis the cause lies in the di- rect excretion of pathogenic bacteria by the way of the urine — ■ urine thus charged with living bacteria and their derivatives naturally irritate the bladder walls ; the spinal centre responds vigorously to the irritation. The etiology of enuresis is somewhat varied, but there al- ways lurks in the affected child the inherent weakness of or- ganization, either bordering on anemia, tuberculosis, or some neurosis, or displacement of the neck of the bladder. Invari- ably lithiasis, or irritation of the rectum from worms. Whatever may be the cause, there is a perfect innervation of the bladder sphincter. Sex exerts no influence on the pathological condition. "A most nutritious diet, daily bathing, followed by massage, and Dictionary of Diseases. 343 flannel clothing, seaside or country more invigorating than the sewage atmosphere of our modern cities — bladder well emptied before retiring. Ozonized uric acid solvent always ; then select either passiflora and gelsemium, or Virginia stone crop, and occasionally tinct. belladonna to cause a slight enlargement of the pupils and dryness of the throat. EPIDIDYMITIS. — A common sequel or complication of gonorrhea, occurring at any time during an attack, being due to a migration of the gonococci — in other cases, sexual ex- cesses, masturbation, congress with harlots, bicycle exercise, inebriation, may give rise to it. As a rule, the testis is spared in nearly all cases of inflamma- tion of the epididymis, which is generally the part of the organ affected ; usually one is attacked first, later on the other. The first indication is a dull pain in the scrotal region, drag- ging of the cord and in the loin ; pain in the groin, radiating to the pelvic cavity. By-and-by the testicle may soon assume the same condition ; when the pain becomes very distressing, even the tunica vaginalis may be involved. In epididymitis, the tendency is to effusion of plastic lymph in the interior of the canals, which gives rise to persistent in- duration, but with good treatment may gradually disappear, but if tampered with may give rise to sterility of one testis, or complete infecundity of both if both are affected, the spermatic fluid being destitute of spermatozoa. If there be induration, the passage of semen is prevented. Under all conditions, resolution takes place slowly ; that con- dition is generally favored by rest in the recumbent posture — by the administration of equal parts of the ozonized tincture of passiflora and gelsemium (green rad. tinct.) until their physiological action is observed, and then maintained by per- severing repeated doses for at least one week; secretion kept active, nutrition never neglected ; to the scrotum, guaiacol oint- ment, spread on lint or cotton, large enough to entirely cover,- spread fresh every three hours. By endosmosis, the guaiacol reaches the vital part, annihilates the gonococcus lodged there, excites absorption, promotes renewal of life. This is an un- discovered property in guaiacol, true a germicide, but also an active agent as a cell producer. Strapping the scrotum is a miserable expedient, never attended with good results. Chronic Epididymitis. — May be a sequel of an acute at- tack, or it may originate itself, per urethra, or arise from a mild: 344 The Germicide 20th Century Practice form of urethral inflammation, from masturbation, from im- perfect or abnormal coitus ; or in having congress with prosti- tutes, or with women the calibre of whose vagina is immense, or from a stricture. In the chronic form the epididymis becomes enlarged, thick- ened, hard, knotty, from the formation of fibrous tissue in it; the result of inflammation. The testes are tender, swollen, the cord is enlarged, there is effusion of serum in the tunica vagi- nalis. In old chronic cases the recently-formed fibrous tissue causes obliteration of the seminal tubules. Atrophy or wasting of the gland is the result. Effusion of lymph is more rare, and when it does occur it is very prone to terminate in suppuration and abscess. When this takes place, adhesions take place between the skin of the scro- tum and the tunica, and the pus is discharged. Occasionally the abscess bursts in the testicle, and is extravasated through its structure. Extremely bad results are liable to follow, which shows the imperative necessity of such cases being managed by skilled physicians. In all states or conditions, in all forms of inflammation, acute or chronic, affecting either a portion or a whole of the testes, success attends the exhibition of two remedies, namely : the green root tincture of gelsemium and the ozonized fluid extract passiflora incarnata. First of all have the bowels opened, enjoin rest and the recumbent posture, and administer these two drugs every half hour in average doses, persevering with them, giving all he can bear ; the lethal action of the gelsemium in the green tinc- ture is very feeble, still it must be guarded with care, whereas the passiflora can be given freely ; just enough of each to obtain their full physiological effects, until resolution is complete. If energetically administered, a short time is necessary. The action of these two drugs promptly affords resolution. It is a rule of practice that whenever any part of the body has suffered a partial death it is always weak, less vital; but it is marvelous to state that in inflammation of the testes, cared for by these remedies, resolution is perfect. Guaiacol salve, ozonized, is a remedy of great efficacy, when applied to either an indurated or enlarged testicle. EPHEMERAL FEVER.— A slight depression of the ner- vous system, with fever, in which the vital forces react, some- times in a day, at other times having a variable duration of from a few to ten days. and Dictionary of Diseases. 345 The cause is usually cold, wet, exposure, overwork, mental depression. The usual symptoms are, the patient is seized with lassitude and debility, nausea, want of appetite, chilliness, pain in head, back, and limbs. After a few hours rigors and a fever, high heat, frequent pulse and respirations, headache, thirst, consti- pation, dry skin, scanty urine, perhaps slight delirium; symp- toms aggravated at night. After a few days a remission ; crit- ical sweating or diarrhea. Convalescence often somewhat slow. It usually terminates in recovery. It is easily recognized by its cause, mildness, short duration, by its comon occurrence in children, persons of feeble vital force, and nursing women. Simply requires rest and a tonic course of treatment. EPIDEMIC. — Diseases which attack a large number of people in a place at the same time and then disappear. The cause varies with the epidemic, and in many cases is not well known. Predisposing causes are peculiar states of the climate or atmosphere, defective ventilation, overcrowding, impure water, unwholesome diet, starvation, want of cleanliness, and lack of attention to hygiene generally. Most epidemic diseases are also contagious. EPIDEMIC INFLUENZA.— An epidemic as well as a con- tagious and infectious disease, one that spreads with more ra- pidity than any other disease, hundreds being attacked almost simultaneously. It is, without doubt, highly contagious, and the opinion is gaining ground that the germ of the disease mul- tiplies in the air and not in the human body. Symptoms. — During former outbreaks of influenza the chief characteristic has been a severe catarrh of the nasal and bron- chial tracts, with a marked tendency to the development of bronchitis and pneumonia ; but in the later epidemics the nasal catarrh has not been so marked a symptom. The disease begins with fits of shivering, pains in the eyes, frontal headache, and muscular pains in the back and limbs. Fever now ensues, and the temperature rapidlv rises to 103 ° or 104°, but falls as rapidly as it rises. The pains continue, and the patient becomes very weak and prostrated. Besides these common symptoms, there are others which are not so constant, s^me cases being marked by respiratory troubles, whilst in others nervous and abdominal symptoms predominate. Diar- 346 The Germicide 20th Century Practice rhea, jaundice, and abdominal pain are the chief digestive dis- turbances. Some cases get well in a few days, whilst others take a long time to get over the disease. Many cases are fol- lowed by pneumonia and pleurisy, and during the last epidemic pneumonia was the most frequent cause of death in the fatal cases. It has been noticed that mental impairment, suicide, and even insanity, is occasionally traceable to influenza. At the commencement of treatment rest in bed, diaphoretics, diuretics, open bowels — administer veratrum viride; if there "be great nasal irritation, paint repeatedly inside of the nostrils with jelly of violets. Much prostration, stimulants, nitro-glyc- «rin; bronchial complications, ammonia and passiflora. But the remedy to stand on from the beginning to the cure is the concentrated tincture of kurchicin. It is the only remedy cap- able of closing the career of this pathogenic microbe ; it is the only remedy to ward off complications and prolong life. The dose suitable to meet the inroads made by the germ should be sufficient to maintain gentle diaphoresis. Cardiac complications of influenza and cardiac influenza, there being a distinction between the two. Under the first heading are included peri-, endo-, and myo-carditis ; while the second includes a much more complicated series of alterations in the heart's action through its nervous apparatus. The car- diac rhythm is more or less altered, there being acceleration of the beats, equalization of both pauses, and both sounds come to resemble each other, a condition to which the term "embryo- cardia" has been given. Influenza would seem to be the dis- ease in which this is most frequently met with, and its prog- nosis is very grave. The pulse very often becomes irregular in every way; it is frequently intermittent. There may be an extreme degree of bradycardia, the pulsations having been found as low as fifteen to sixteen to the minute. On the other hand, a high degree of tachycardia has been noted by several observers. Extreme cardiac weakness, followed by syncope, is another frequent complication ; but the author more particu- larly draws attention to influenzal angina, which bears a marked resemblance to angina pectoris, with which, indeed, it is probably identical, being produced under the same condi- tions, and accompanied by the same symptoms. There may be the same pain preceded by a kind of aura and a feeling of constriction of the chest. The duration of these sensations is variable, for the most part lasting some time. The variability of these cardiac affections depends on whether the vagi, the and Dictionary of Diseases. . 347 sympathetic, or intracardiac ganglia are affected, or they may .even depend on a bulbar origin. The indispensable necessity of treating all cases of epidemic •influenza by the concentrated tincture of kurchicin and crea- tinin so as to give tone and vitality to the heart is apparent. Considerable speculation exists as to the habitat of the in- fluenza microbe during the summer months, when the disease is seldom manifest. Extensive research shows that this germ is capable of existence for a long time in a dormant condition ; that they may remain in the system for months, without giving rise to any special symptoms, when all on a sudden it may loom up in a violent outbreak of the disease, either in the individual or in his associates, or in an epidemic form. The bacillus of epidemic influenza is very variable in size, mode of growth, and the action of its toxin; consequently its mode of seizure is often different. The large majority of cases commence with nasal and bronchial disturbance; others with great nervous depression, headache, languor, debility; some with loss of appetite; scanty, high-colored urine; distressing palpitation, difficult breathing, prostration and extremely copi- ous sweats. The sweats are often intractable and a condition of most profound neurasthenia and goneness, which persists in spite of our best remedies. Sweats, goneness and bronchial disturbance often alternate, one diminishing as the other in- creases. The toxin affects the nervous system in a most de- plorable manner, an utter chaos. Once I had a case of this description diagnosed. The follow- ing has been my method of treatment : Unload the liver, clear out the alimentary canal, and act efficiently on the skin by means of an alcoholic vapor bath, rigidly confining the patient to bed in his apartment, the temperature of which should be kept about 75 degrees F. I have the patient commence at once with the concentrated tincture of kurchicin in doses of from thirty to sixty drops every two Or three hours, according to the indications. This is undoubtedly the best, most effectual of all germi- cides to annihilate the germ, neutralize its toxin. If, from any cause, the stomach does not tolerate the rem- edy in a liquid form, administer it in suppository, one every two hours. In sections visited by this microbe, it would be well to have a stock of kurchicin on hand for emergencies. Epidemic Influenza (La Grippe). — Deficient ozone areas. 348 The Germicide 20th Century Practice meteorological, atmospheric disturbances, have given rise to the evolution of a microbe within those areas, which seizes upon and lodges in the weakened respiratory mucous membrane, en- ters the blood, produces great constitutional disturbance and morbid changes in that fluid. As far as our microscopical examinations have gone, to- gether with the various culture tests, the germ is found to be pathogenic of the disease, it bears culture well in any gelatinous fluid, which, when fed to rabbits, produces the original disease in all its virulence and malignity. The microbe belongs to the pneumococcus family, but is a compound conglomerated germ consisting essentially of the croupous bacterium pneumococcus, numerous forms of spo- radic germs, cocci, diplococci, short rods, mostly encapsulated. Its presence in the United States has increased the usual weekly mortality of all sections of our country. The electrical disturbances between the oxygen and nitrogen of the atmosphere give rise to pneumo-paresis, which is the great source of danger. The treatment in all cases should be the same as for pneu- monia — energetic — and persistent use of concentrated tincture of kurchicin, ozonized passiflora and echinacea alternated with sulphide of lime. EPILEPSY. — Epilepsy seizures are of recent years becom- ing extremely common, violent and prolonged. They consist of attacks of unconsciousness, with or without convulsions, and in a large number of cases the seizures are preceded by some peculiar sensation or aura. Abrupt loss of consciousness fol- lowed by tonic or clonic spasm. The localization of the diseased brain patch is not always, easy, as sufficient attention has not been paid to this subject. The initial commencement of the epileptic wave and the group of muscles implicated aid us much, together with the careful applications of the induced electrical current, in singling out the spot. The etiology of epilepsy is traceable in all cases to some weakened brain patch, acting upon which there is either some central irritation, as an exostosis or clot; or the toxin or ptomain of some disease germ in the blood ; or to irritation re- flected from some distant part of the body. Whichever of these three causes exist, there is to be added to all the microbe of neurasthenia, whose ptomain gives rise in itself to auto-intoxi- and Dictionary of Diseases. 349 cation, toxicity of the urine, a condition present in all epileptics as well as in the insane. Nine cases out of every ten originate either directly or indi- rectly in irritation of the genito-urinary organs ; consanguinity, either by blood or temperaments ; alcoholism, syphilis, mastur- bation or sexual excesses in parents, give rise to an epileptic or idiotic offspring. The great source of acquired epilepsy is masturbation and sexual excesses in both sexes. This is the goal toward which all who practice self-abuse and libertines are hastening, and one which is reached in a short space of time, when the will power is weakened or destroyed, or inadequate to put a stop to the practice. In the treatment and possible cure of epilepsy, we must fol- low the rules of common sense. During the seizure or fit, with muscular system contracted, rigid, with every conceivable form of contortions, foaming at the mouth, unconscious, patient's clothing should be loosened, and the patient placed in such a position on the right side that he or she should be protected from injury, and immediate measures taken to arouse him from the fit; the most available means should be resorted to, such as a hypodermic injection of a quarter of a grain of the sulphate of morphia into the subcutaneous tissue of either the nape of the neck or over the deltoid. A few drops of a one per cent solution of nitroglycerin will answer the same pur- pose. If neither are procurable, enemata of brandy with a few drops of spirits of turpentine. Once the seizure or fit is broken up, some remedy must be selected, and persistently administered, to diminish their in- tensity, abbreviate their length, with longer intervals between, or ward them off altogether. Our preference for this purpose are the ozonized extract of sumbul the cenanthe crocata and the cocain suppository. Little, very little good results from the exhibition of the bromide of potass or the simulo or solanum. It must be clearly borne in mind, that the suspension of the seizures does much good in savtnsr the vital forces, preventing exhaustion, and has a good mental influence on the patient, but is never curative. Pathology tells us most emrV>at ; ca11v that there is a brain patch which needs reconstruct 1 '^ a state of auto-intox ; cation from the toxins of a disease-T^^^p- eerm. The remedies, then, from wVch curative results a^° ^Main- 350 The Germicide 20th Century Practice able are the organic extracts or brain builders, especially the thyroid extract and c. p. solution of spermin ; these two, when administered orally, increase the appetite, promote digestion, augment strength, exhilarate and vitalize mental activity. As their results are visible in wiping out old age, so here in epi- lepsy they promote a renewal of life in brain tissue ; during their prolonged use the brain patch is repaired, besides adding to muscular strength and endurance. Epilepsy occurring during pregnancy is presumptive evi- dence of a latent diseased patch of the nerve centres, evoked into activity under the excitement of gestation, and ranks as a peripheral source of irritation. The treatment would be the same. Interspersed throughout the treatment of a case, light nu- tritious food, freedom from excitement, woolen clothing, cold shower baths, rain-like in character, friction or massage to the entire body. The use of germicides aids the cure materially, such as bro- mide of gold and arsenic; ferratin and arsenic, borax, citric acid, carbonate of soda. If the case is of long standing, and de- generative changes have made a great inroad, bromide of gold and arsenic orally and the cocain suppository are of unexcelled value. The nerve storm of epilepsy is no doubt often due to alco- holic conception, consanguineous marriages, habits, etc., as 32 per cent of children the offspring of such being epileptic, so says vital statistics. First and second dentition, the evolution of puberty, are periods when it is most likely to put in an appearance. In the cure of the epileptoid groups of diseases, we have sev- eral remedies of rare value. The ozonized extract of sumbul administered persistently may arrest the seizures, but it requires the comp. kephalin gran- ules and protonuclein to effect a cure, to repair the brain lesion. CEnanthe crocata, a remedy of intrinsic value, but highly toxical, must be administered with great caution, beginning with one-drop doses added to water, every three hours, and in- creasing gradually to thirty or more until its physiological . action is obtained in an abrogation of the fits. Simulo tincture, prepared from the seeds oiCapparis coriacae, is quite extensively used in the treatment of chorea and epi- lepsy. Statistics of cases treated with simulo demonstrate it to be a much inferior drug to either sumbul or cenanthe crocata in warding off the fits. and Dictionary of Diseases. 351 Suppose we take up the entire range of vegetable remedies, ive can find none that equals passiflora in epilepsy — the ozonized preparation in a very large percentage of cases not only wards off the seizures, but in itself often becomes curative. In the present state of medical progress, we must in every case of epilepsy recognize a pathological condition seen only by the microscope, a patch of degeneration of the cerebral pulp, a central phrenal lesion, which may be either acted on by the toxin of some disease germ, or by some reflected irritation. It may be the toxin of either the bacillus of syphilis, or tu- bercle or amylobacta or typhoid or leprosy or some other — the appropriate antidote must be pushed. If there be some irrita- tion which can be reflected to the medulla oblongata, thence to the central lesion, as either a fistula, or masturbation or a para- site or any irritation whatever, it must be removed. There is, therefore, in epilepsy three things essential to com- plete recovery. The brain patch of molecular death must be repaired — all toxins must be neutralized — all sources of reflex irritation zviped out. Since the introduction of the antitoxin-serum craze, the in- jection of the ptomains of glandered horse serum, for a cure, forsooth, statistics state that epilepsy, cardiac and nephritic de- generation have been doubled. To repair the brain patch, there can be no doubt of the value of trepanning, if by some means it could be precisely located — of great efficacy independent of exostosis — very highly vital- ized remedies, such as protonuclein, ozonized thyroid extract, spermin, kephalin granules — assimilated under the influence of matricaria are excellent. To cleanse the blood of toxins, a special antidote to meet the peculiar bacterial poison, with ozone water, peroxide of hydro- gen, comp. oxygen. To suspend the impressibility of the medulla oblongata, the best combination is one of one part of the green root tincture of gelsemium and concentrated tincture of passiflora incarnata, which should in all cases be administered liberally in order to obtain a result. Our present method of treating all epileptic seizures must be enlarged, to meet the pathological condition of a disease much on the increase. Epilepsy and Paralysis Caused by tpIe Toxins of Dis- ease Germs. — All authorities admit that in epilepsy there is a 35 2 The Germicide 20th Century Practice molecular change or death in a patch of the brain, that the toxins of disease germs lodge there, blight for a time, nay, ob- literate the mental faculties, as is seen in the nerve storm or fit. with loss of sensibility, bereft of consciousness, volition, and for some time subsequently stupid, confused, exhausted. In all epileptics the brain invariably presents signs of degeneracy, want of tone as is visible in the pallor, atrophy, softening ; it is a malady, at once the slightest and direst, ranging from mere vertigo to apoplexy, paralysis, mania. Some very extraordinary results in the way of staving off the attacks or fits have attended the exhibition of the ozonized extract of sumbul in large doses, a teaspoonful every three hours. It relieves the gray matter of the brain of the irritation of the toxins, maintains an equilibrium, thus preventing the liability to sudden discharges of nerve force. Any toxin that irritates the nerve and brain structures, and provokes a nerve storm, followed by the stupor of exhaustion is damaging, and requires the constructive aid of passiflora and c. p. solution of spermin. To develop the nervous system, make it grow in the right direction; its physical structure must be protected from all violence, and so educated, that when its growth is completed the intellectual and moral faculties shall be the rulers, and the emotions and passions the servants of the higher faculties; there must be no strain, no friction — nerve food for brain and nerve action — no nerve storms nor tempests to waste and weaken mind and body and destroy the moral nature. To fill this gap administer ozonized thyroid extract, which, if used judiciously to individuals under twenty-one, prevents cerebral bankruptcy. Changes in the brain cortex are almost invariably present in epilepsy and in paralysis, and as a rule animal extracts, thyroid and spermin especially, do good work in epilepsy. An eminent physician in Indianapolis, Ind., has cured bad cases of epilepsy with cenanthe crocata, and administered the remedy in quite large doses. Use only the ozonized preparations in epilepsy and the result will be apparent. The majority of pathologists are of the opinion that general paralysis is due to degeneration of the brain and entire nervous system, brought about by the circulation of some toxical agent in its interstitial structure, the initial point of attack being in the nerve-cell bodies. To the toxins of some disease germ is at- and Dictionary of Diseases. 353 tribnted the grave changes found throughout the entire nervous system. in all cases of paralysis it is always of utility to maintain two points of irritation at the nape of the neck on each side of the spinal cord at base of the brain by means of the old can- tharidal plaster. Simply irritation, no vesication, its applica- tion for a few hours twice a week will be sufficient ; it will un- doubtedly excite leucocytosis, but it almost invariably attracts the toxin from the weakened brain patch; it must be kept up for months, nay, years. New remedies, germicides, will have an opportunity to do their work. If it be possible to ascertain the toxin present, it will be a valuable aid to the selection of the proper remedy. If it be the toxin of syphilis, periodate aurum and comp. saxifraga; if it be the toxin of the microbe of neurasthenia, kephalin, avena and ozonized Phytolacca ; if it be the toxin of the bacillus of tubercle, glycerite of ozone is indicated. Effusion on the base of the brain, due to a clot, an effusion of serum, a mechanical condition, requires iodide of potass and periodate aurum. There is little doubt that general paralysis as well as ataxia are mainly dependent upon the toxin of syphilis. There is no doubt that either the cure or prevention of syphilis would be followed by a very general disappearance of paralysis. Stamp out syphilis and it would cease to exist. In countries in which there is no syphilis there is no paralysis. The true etiology of paralysis, its predominating factor is the toxin of this germ. Every man or woman who contracts syphilis is liable to have degeneration of the brain or spinal cord, the initial point of deposit of the toxin is some weakened part of the nervous sys- tem. EPISTAXIS. — Hemorrhage from the nostrils is often due to mechanical violence ; very common in patients of a plethoric habit, sanguine temperament ; in girls about puberty. In the adult, epistaxis is often a grave affection, pointing to disease of a serious character. It may be an indication of one or two diametrically opposite conditions; either plethora with a tendency to cerebral congestion and apoplexy, or to anemia and cachectic conditions, in which the blood is poor, watery, destitute of fibrin, its coagulation imperfect. In nearly all cases, nasal hemorrhage is preceded by head- ache, fullness in the head, ringing in the ears, contracted pupil and disordered vision. 354 The Germicide 20th Century Practice Nasal hemorrhage, due to plethora or congestion, may to a limited extent be beneficial, relieving the volume o'f the blood from an excess. Even this must be guarded against by raising- the arms above the head ; by applying cold to the nape of the neck and root of nose. And if these do not quickly succeed a spray of peroxide of hydrogen or perchloride of iron, both by mouth and nostrils. If they fail, plug nostrils. Nasal hemorrhage in delicate, anemic or aged individuals, is a condition of much importance, often fatal, and requires such remedies as creatinin, thyroid extract and c. p. solution of spermin with rest, nutritious food, fresh air, sunlight. Nasal hemorrhages (vicarious) in young ladies at puberty and at all periods of life till forty-five years, uterine suppression from cold and mental shocks, etc., the comp. betin pill, thyroid extract, protonuclein, are unsurpassed in their action. Nasal hemorrhages due to the blood changes in scurvy, give chlorate of potassa in lime juice, and strophanthus. Due to the pathological condition in purpura, digitalis and ozone water. Nasal hemorrhages, a precursor of fevers, typhoid and typhus, toxins affecting the brain becoming rare as the treat- ment by intestinal microbicides is pushed, with abundance of fresh air. In organic cardiac, hepatic and nephritic affections, the nasal hemorrhages are always associated with a broken down condi- tion of the system. In these cases the application of ozonized turpentine over the region of the liver is usually effectual in arresting the hemorrhage ; a mixture of equal parts of alcohol, turpentine and nitric acid, mix carefully, a few drops in iced water occasionally, is an excellent hemostatic. Creatinin will do much for the heart; ozonized uric acid solvent is of great efficacy in kidney disease. Perhaps the most remarkable cases of epistaxis, which oc- curred in 1897, were those of a mohair factory in Connecticut, in which 500 female operatives had a daily attack from inhal- ing the dust together with the spores of anthrax from the im- ported wool. A spray of fifteen vol. sol. c. p. peroxide of hy- drogen relieved the condition. ERIGERON CANADENSE.— An annual, indigenous plant of North America. Common name, Fleabane. Therapeutical Uses. — A tonic, diuretic astringent. A vola- tile oil of the terebene species is distilled from the fresh, flow- and Dictionary of Diseases. 355 ering herb, which is an active hemostatic to the uterus and bronchial mucous membrane. Preparations and Doses. — Fluid extract, 30 to 60 drops ; of the oil, 5 to 8 drops on sugar, and repeat. The action of this oil resembles a mixture of equal parts of spirits of turpentine, alcohol and nitric acid, an instantaneous uterine astringent. ERUPTIVE FEVERS.— The principal diseases of this class have some features in common ; they are each due to the presence of a living germinal poison in the blood, which has a definite period of germination, called incubation; they are ac- companied with fever, which runs a precise course, are attended with an eruption, at which period the germ seeks the surface for oxygenation, where they either destroy the cuticle and peel off, or gather in colonies and form vesicles, pocks, or scabs; those changes are regular and definite — for the most part, the germ uses up in its own nutrition and growth certain ele- ments in the blood, which seldom if ever aggregate in that fluid again ; hence, as a general rule, the patient is subject through life to but one attack. They all arise from a special germ, whose progress can be in some measure arrested or cut short, their severity mitigated, modified and even abridged by proper remedies, thorough nurs- ing, and attention to certain rules. The diseases of this class are measles, rotheln, scarlatina, and smallpox. Disease, measles; germination, 10 to 14 days; eruption ap- pears, fourth day of fever ; eruption fades, seventh day of fever. Disease, scarlet fever ; germination, 4 to 8 days ; eruption ap- pears, second day of fever ; eruption fades, fifth day of fever. Disease, smallpox; germination, 12 days; eruption appears, third day of fever; eruption fades — scabs form on ninth day, fall off fourteenth to twenty-second da]/. If either of the above three forms of eruptive fevers is con- veyed from an opposite or antagonistic race of men, the germ takes on inordinate activity and malignancy. ERYSIPELAS. — A peculiar form of disease due to per- verted nutrition, malnutrition induced by deleterious food, sameness of diet, in which the evolution of a microbe takes place, which gives rise to both local and constitutional symp- 356 The Germicide 20th Century Practice toms. Usually one precedes the other, or they may appear simultaneously. The constitutional symptoms are rigors, derangement of the stomach and bowels ; pain in the head, back, calves of the legs ; lassitude, drowsiness, anorexia, nausea, vomiting, tongue heavily coated with a heavy brown coat ; constipation, motions, if any, are very offensive ; urine albuminous, turbid, or saffron colored ; pulse full, oppressed or irregular. As a rule the microbe seeks the skin for free oxygen, and in doing so its toxin excites inflammation of a peculiar character, tense, burning, stinging, redness diffused throughout with a tendency to spread itself widely. As a rule the redness is not intense, either pale or rose colored, of a pale yellowish hue. Redness disappears on pressure, but immediately returns. Edema to some extent is always present; delirium if about the head or face. The speedies way to eradicate this microbe is to administer an emetic, open the bowels with some remedy to rouse up the action of the liver, and a vapor bath. To the skin apply cloths saturated with a warm solution of boroglycerid, covering over with oiled skin or some imperme- able covering. Internally, select a good microbicide and ad- minister faithfully; select one or other of the following: ozo- nized glycerite of sulphur, matricaria. Creosote, both internally and locally, is inimical to the mi- crococci of erysipelas. The mistura creosote with negative ozone is unsurpassed internally, under it the tongue cleans, and all the symptoms subside ; locally, add one ounce of the mixture to one quart of water; saturate cloths with this solution and apply over the erysipelas blush. Keep it constantly covered and always wet. It can be added to slippery elm powdered, and made into a poultice and applied, and renewed every three hours, strength regulated according to the virulence of the at- tack. The germicidal properties of the remedy are immense, not only in the complete destruction of the germ, but in abro- gating all tendency to suppuration. As a sedative in erysipelas, give passfliora incarnata in large doses, and alternate with comp. tincture of matricaria. Rest, nutritious diet, avoidance of all insanitary conditions. ETHER. — Sulphuric ether. A colorless, volatile, inflam- mable liquid, with a characteristic odor, which is obtained by acting upon alcohol with sulphuric acid and then purifying. and Dictionary of Diseases. 357 Ether is used as a local anesthetic, particularly in carrying out small operations. It is applied by means of a spray, which is directed on the part. The rapid evaporation which ensues freezes the part, and makes it insensible to pain. Taken inter- nally, it is stimulant, antispasmodic, and relieves flatulency. It is useful in bronchitic asthma, particularly when given in the form of Hoffman's anodyne. When inhaled it acts as a general anesthetic, like chloroform. It is safer than chloroform, but is more unpleasant to take, causes great lividity of the face, often some bronchial irritation, and is more liable to be fol- lowed by vomiting. EUCALYPTUS. — A tree which grows luxuriantly in Aus- tralia. There are two varieties, the blue- and red-gum — the Eucalyptus globules and the Eucalyptus ro stratus. Therapeutical Uses. — In all its pharmaceutical forms it is a powerful bactericide, sterilizing and destroying disease germs. Its properties have not been so greatly valued, as a germicide, as they should be. Administered in large doses it paralyzes the medulla, lowers heat, and slows the pulse by its microbicide properties; in- creases the excretion of urea. The red gum has been found valuable as an astringent, especially in throat affections. Preparations and Doses. — Eucalyptus oil, a distillate of the fresh leaves, good for inhalation, in phthisis, scarlet fever, and diphtheria ; an ozonized distillation destroys the gonococcus of gonorrhea. Fluid extract, from 30 to 60 drops. Syrups, bougies, pessaries, lozenges, etc., are all prepared: the honey is also used. A distillation from the fresh leaves, ozonized. Dose : Add one fluidounce to four fluidounces of water. For external use only. In gonorrhea, used as an injection after urinating, or three times a day; for leukorrhea, use an injection by fountain syringe, morning and night ; for ophthalmia, keep a cloth con- stantly wet with it, loosely applied to the eye. An energetic agent, to destroy the germs of gonorrhea and leukorrhea. It not only destroys the germ, the factor of gonorrhea, but its use before a suspicious connection acts as a prophylactic. In the various forms of purulent or gonorrheal ophthalmia, it completely kills the bacteria or gonococcus present. EUPHORBIA PILULIFERA IN ASTHMA.— This is one of the safest and most efficacious remedies in the relief of 358 The Germicide 20th Century Practice asthma. Every physician who prescribes it finds it successful in relieving the paroxysm and in inducing sleep. No drug has given such satisfactory results, being a safe remedy the afflicted individual can use it with perfect freedom. It not only relieves the spasm of asthma, but it induces tranquil, re- freshing sleep without any objectionable after affects. Its pro- longed use never gives rise to a habit, and on this account it is a most desirable drug. The administration of euphorbia pil. in asthma is of vast im- portance ( I ) in breaking up the spasm, ( 2 ) in obtaining sleep, thus saving unimpaired the vitality of the affected. The drug occasionally causes sickness ; although disagreeable to the taste, it can be administered in simple elixir and its pungent flavor disguised. Easy breathing, diminished respiration, tranquil sleep are to be obtained from its use. No doubt a large amount of the drug is excreted by the lungs, and its vapor exercises a narcotic influence on the terminations of the sensory nerves in the lungs while it is being expired. One can readily understand that by its double action of in- ducing sleep and preventing pulmonary spasm euphorbia has such a powerful effect for good in asthma. EXTRA-UTERINE PREGNANCY.— Every pregnancy is the result of the impregnation of the ovum of the female by the spermatozoa of the male, and the normal place for the devel- opment of the impregnated ovum is the cavity of the uterus, while the channel through which the ovum must pass from the ovary in order to gain the uterine cavity is the Fallopian tube. The tube is specially fitted to be the cannel for the re- ception and transit of the ovum. The delicate plications of its mucous membranes are seen best when floated under water, forms one of the lightest and most ethereal of resting places, while the innumerable cilia of its epithelium, waving always towards the uterus, tend to sweep the ovum onwards and out- wards. These plications, with their waving cilia, are not con- fined to the tube itself, but are continued over their fimbriated extremity, into the peritoneal cavity to the ovary itself. Ovarian fimbria are remarkably full, broad — a complete ap- paratus for the direction of the ovum — marked and ceaseless from the ovary to the tube. No fixed place where impregnation occurs — anywhere during its descent, whether in tube or uterus it is possible for conception to take place. Normal impregna- and Dictionary of Diseases. 359 tion occurs only in the uterus — fertilization in the uterus. The ciliated lining of the Fallopian tube prevents the spermatozoa from entering. Fructification, the union of the ovum with the spermatozoa, may retard a movement. EXTRACTS (Animal). — The ozonized glycerated extract of the peptic glands of the stomach ; pancreatin the active prin- ciple from the sweetbreads. The former a good digestive agent, the latter the emulsifier of oleaginous products. The ozonized extract of the thyroid gland of the lamb, a promoter of growth of every tissue in the body, and the c. p. solution of spermin, the breat vitalizer of our race, are reliable remedies; but we must admit, after careful and extensive clinical tests, that all others are worthless. All animal extracts must be administered orally, never sub- cutaneously. Undoubtedly one of the greatest professional blunders of the present age is the hypodermic injection of these extracts into the cellular tissue of the body. Take spermin as an example, injected subcutaneously, it is a violent irritant, whereas if administered orally, with two doses of thyroid extract weekly, it is the great reconstructor of vital force — a stimulant and builder of all the tissues of the entire body — that which gives the snap, the push, the energy and ambition. The growth, vigor, even the prosperity of our nation depends entirely upon spermin, the most precious substance in animated nature ; if it be drained off, effeminacy, neurasthenia, cowardice are the result. Spermin in the male, ovarin in the female, identical chemi- cally, is produced and circulated in the body of every individual, and is a most important factor in the healthy performance of every organ ; neither life nor vitality without it. In speaking of the c. p. solution of spermin prepared from the testicle juice of the bull, as a vitalizing agent in both health and disease; in the former its use renders the vital forces of the body impregnable to all disease germs; they may find an in- gress, but there is no growth ; in the latter, its use is not limited to any special disease, being of utility in every deviation from health. It is a reconstructive in all diseases, indispensable and necessary to aid the vital forces to recovery. As a constructive agent, spermin is of the greatest efficacy as a remedy in all exhausted states; imparting strength, de- creasing nervousness. It is a most important medicament in all diseases, and espe- 360 The Germicide 20th Century Practice daily those in which the oxidizing power of the blood and nervous system is impaired. EYE, THE. — The eye has good defensive arrangements, a natural formidable barrier to the ingress and advance of the bacillus of tubercle and syphilis. The natural fluids of the eye are inimical to and hinder the growth of the micro-organism, the connective tissue cells are unfavorable to them, besides the phagocytic destruction of the bacilli by the leukocytes. True, in an intense tubercular diathesis the germ localizes itself upon the conjunctiva, but even there the nidus is unfav- orable for growth and reproduction, so multiplication is ar- rested. The eye, therefore, possesses an immunity to both of the leading microbes. Removing all insanitary states there would be little, if any, tubercular ophthalmia or syphilitic iritis, for both germs are incapable or reproducing themselves by aerial infection. Different, indeed, is the mouth in tuberculosis, syphilis and cancer. A perfect breeding pond, its secretions, if the microbes be present, expectorated on pavements or floors, sputum dries, germ liberates, gets freely blown about and comes in contact with other people's tissue. It cannot reach them in an active state. The infectious agent becomes harmless in the presence of nature's disinfectant, light and air, oxygen being the chief agent inimical to microbic growth. No medical agent has demonstrated itself of such boundless efficacy in the effectual cure of all eye and mouth diseases as comp. saxifraga, alternated with either quinine or comp. kur- chicin. As an eye lotion, chloride of sodium ; as a mouth wash, solution of chlorate of carbon. In hereditary tuberculosis, syphilis, cancer, where either germ is transmitted by either or both parents to the offspring, either at the date of conception by sperm or germ transmission, or through the placenta, the periodate aurum completely anni- hilates it. Eyes Damaged. — Masturbation is destructive to vision, al- cohol equally so, deteriorates the brain and mental capacity; nicotine as well as all acro-narcotic drugs are injurious to the eyes, also the indiscriminate use of quinine. The wearing: of tight neckwear injures the eyes from a slowed circulation. Excessive use of the eyes in study, in crowded school-rooms, and Dictionary of Diseases. 361 with an atmosphere reeking with bacteria, is productive of ophthalmia. Nets in windows and veils are destructive to* vision, most objectionable; the dotted texture plays a part, in embarrassing vision to an appreciable degree. The brain of man does not see well through the optical in- strument, the eye, when its finer mechanism is blunted by any of the coal-tar derivatives, such as antipyrin, phenacetin. Brown- and dark-colored eyes are most susceptible of injury, as they are much weaker than blue or gray eyes. The lighter the pupil blue and gray, the greater is the tension which the eyes will sustain. Bathe all damaged eyes with a hot solution of boroglycerid. This is a safe remedy, and can be entrusted to the nurse — it vitalizes, contracts the blood-vessels in and about the eye, strengthens the tissues, washes away all germ secretion, pro- motes a healthy reparative process, relieves the leading symp- toms, whatever they may be. In the entire materia medica no remedy in essential efficacy can compare with passiflora in- carnata in the improvement of vision — a prolonged course of a few months works wonders. Kephalin ranks next best as an eye tonic. FAINTING, OR SYNCOPE.— A sudden partial or complete loss of consciousness. The immediate cause is a diminution in the amount of blood going to the brain, and this naturally de- pends, in the majority of cases, on a diminished action of the heart. Nervous, circulatory, and respiratory functions either cease or are greatly lessened in strength. Fainting arises from sudden mental shock, severe pain, loss of blood — in fact, any- thing which lowers the vitality of the system. Just before the fit there is a sensation of tingling in the extremities, noises in the ears, a blurring of the sight, and a general deadening of the senses. There is loss of control over the muscles, and the pa- tient falls to the ground. When due to brain disease, cardiac disease, or in old and feeble people, death may occur from syncope, but in most cases the fainting soon passes off*. Treatment. — The patient should be placed on his back with his head lower than his feet, his dress opened at the neck, am- monia applied to the nostrils, cold water thrown over his face and neck, and, if possible, given him to drink in sips. Glonoin, either on the tongue or by suppository, is our best remedy to arouse the patient. 362 The Germicide 20th Century Practice FASHIONS IN MEDICINE.— Vaccination is a fashion to which the medical world tends. We naturally ask, Has it been a prophylactic in variola? Has it been productive of good? Has it rendered the action of the micrococcus less virulent ? or in any way mitigated its destructive action upon the blood and tissues? Can we demonstrate or even assert that it has eaten up the pabulum in the blood upon which the microbe subsists? Has the deadly, fearful scourge been lessened ? Most assuredly not. Variola is neither modified, mitigated, nor its fatality less, these 220 years. Pause, look at its inner workings, and we are led to say, that it is the greatest curse ever imposed upon the human race ; it has been productive of more disease, crime, sui- cidal mania, vital deterioration and premature death than any empiricism in medicine. Vaccination from cultures of the pathogenic microbe, the venereal bacillus, has been extensively tried, and in every case the most disastrous results have been engendered. Inoculation, for rabies, with minimized attenuations of the bacillus of hydrophobia, taken from the spinal juice in close proximity to the medulla oblongata of a victim of the microbe, is simply a delusion of a vitiated intellect of a man who loves to keep close by the public crib. The next proposal is inoculation with cultures of the tuber- cular bacilli, as a prophylactic against tuberculosis. Let us pause, hesitate before such a measure, or any proposed exten- sion of inoculation for a disease, — the product of neurasthenia or impaired vital force. Then comes the glandered horse serum for diphtheria — the serum of the ass and goats' blood-serum for mental lethargy, exceedingly fashionable. If you have an ache, a pain from in- testinal toxins, from eating canned food, it is very highly fash- ionable to have your appendix removed. We do not endorse inoculation methods ; there is something filthy in it ; something degrading ; nay, derogatory to the very essence of humanity. There is no resisting power in it; it affords no immunity against the disintegration of vital force, or the evolution or ingress of a microbe. We advocate the administration of bactericides in all dis- eases, either by the skin, bronchial mucous membrane, mouth or rectum. If we have a bactericide like the glycerite of ozone, guaiacol, etc., which will augment vital force, and at the same time sterilize or destroy the microbe, the factor of morbid ac- tion, then that is the remedy demanded. axd Dictionary of Diseases. 363 FATTY HEART. — General obesity, clue to excess of eat- ing and drinking, is usually associated with gout, in which the adipose tissue is deposited on the heart muscle, whereas when due to other chronic poisoning, or to the toxins of typhoid or puerperal fever, fatty degeneration of the muscle is the rule. The efficacy of the ozonized succus or juice of the ripe Phy- tolacca berry, slightly touched by frost to temper its asperity, is attested by all careful observers, in doses of from two to fif- teen drops, in all cases of fatty heart. A safe reliable remedy for the removal of fat. Bowels and kidneys must be kept ac- tive, the former with kola-nut paste, the latter with sulphate spartein : sulphate of spartein ten grains, water two ounces, mix. Three- or four-ounce drop doses at stated intervals. Caffein and creatinin are two of the best heart strengtheners ; brace it up ; promote its nutrition. They in all cases should be administered in alternation with phytolacca berry juice. There must be an avoidance of all amylaceous and saccha- rine substances in diet; alcohol, wines, beer, tea, tobacco are forbidden. If any other remedies are indicated, try comp. matricaria, a heart tonic of inestimable value, one that acts upon respiration, digestion and assimilation. FERRATIX. — Annualized iron, extracted from the liver of the calf, prepared under the most careful antiseptic precautions and only in tablet form, when administered exhibits in a most remarkable degree the antiseptic function of the liver, pos- sessing germicidal and neutralizing properties. It is an anti- toxin ; administered in chlorosis and pernicious anemia, it kills the poison by transforming it and eliminates it from the body. Animalized iron is a vitalizing remedy, absorbed promptly and most effective in aiding the reconstruction of the blood. Probably the best effects are visible in chlorosis, a morbid con- dition peculiar to woman, but its occurrence among neurotic males, with effeminate cachexia, is common. The blood in these cases indicates anemia in which hemoglobin is diminished ; the most brilliant results are obtained by the use of ferratin, which is promptly absorbed. Myopic vision, common in all our large schools and tene- ments, often due to sewer gas, eye-strain in gaslight and burn- ing lights in sleeping apartments, masturbation, auto-intoxica- tion from toxins in constipation give rise to myopic eyes ; often due to anemia, the outcome of overlactation or albuminuria. In 364 The Germicide 20th Century Practice all such cases for the removal of cause, administer kola-nut paste for defective peristalsis and give ferratin to vitalize blood and optic nerve. Animalized iron isolated from the liver of the calf — a food product, an article of nutrition. Ferratin is found in both the animal, vegetable and mineral kingdom, but that extracted from the calf's liver has immense bactericide properties, which neither the vegetable nor mineral ferratin possesses. Besides it completely antidotes the sul- phuretted hydrogen generated in the intestines. The essential property of animalized iron or ferratin is its remarkable faculty in increasing both the red and white cor- puscles of the blood ; in strengthening them so much as to repel the ingress of all disease germs. Animal ferratin agrees well with patients, no matter what may be the trouble, never a symptom of digestive trouble, that necessitates a suspension of the remedy; it is essentially a re- constructive and curative agent; increases the appetite, which is always precarious and capricious in anemic patients. It is a remedy of intrinsic value, indicated in all debilitated states of the body, but especially in anemia and chlorosis, in which the red corpuscles are diminished. It is well for the profession to understand, that the physio- logical properties of animalized ferratin cannot be replaced by any other preparations of iron, either mineral or vegetable, and they will be disappointed in its use, unless they prescribe the genuine. A very eminent practitioner says that his experience in the use of ferratin is : "That it increases the secretion of the di- gestive fluid, relieves congestion of the mucous membrane of the stomach and bowels, and restores the assimilative functions to a normal condition, being thus a remedy for indigestion and malnutrition.' ' One excellent feature of ferratin is that it agrees well with all patients, without exception. Its exhibition changes and reno- vates the blood and improves the general health. FETATION (Extrauterine) . — Pregnancy out side of the uterus. Withdrawal to prevent conception. The relation be- tween the unnatural pregnancy and the unnatural coitus is not a mere coincidence. The very frequent occurrence of extra- uterine fetation at the present time, is the definite result of the adoption of certain means to prevent conception. and Dictionary of Diseases. 365 There is a distinct relation of cause and effect between the unnatural coitus and unnatural pregnancy. Warn individuals of the serious risks they run when they seek to avoid parental responsibility. The practive involves most disastrous results to the male as well as the female. FETICIDE. — The moral atmosphere of the American fe- male is tainted by a variety of causes, habits, association, system of living; laziness, amusements, and literature. The latter especially is exercising a baneful influence on her ; our modern periodicals and dime novels, the press, that great engine of thought, progress and vitality, sways a corrupt, reckless, and unscrupulous influence, and aids her demoralization by adver- tisements, and otherwise ; nay, may be regarded as irreverent, offensive, and profane ; an eating ulcer in the female economy — fostering a state of things, that is sapping the very vitals of our country — one of the most serious and sinister symptoms of general national decadence. Married women trying to es- cape the cares and responsibilities of mothers, betokens a seri- ous derangement in the body politic, and more so when the entire force of female character is permeated with this one idea, and our clergy powerless to stem this current of national crime. The number of abortions committed in our large cities is enormous ; the uninitiated can have no conception of the im- mensity and gigantic proportions of the crime. Out of the eighty thousand so-called physicians in our country, one-half, at least, are either open or concealed abortionists. There is no crime so common as feticide; even some druggists and herb dealers could not maintain an existence but by selling drugs to procure abortion. The crime prevails largely, and enters like an eating worm into every condition of society and threatens our very existence as a nation. The abortionists are plying their fearful calling with frightful activity, and measures should be taken to arrest it. Our people should be instructed regarding the sanctity of ante-natal life, and the fact that there is no distinction in the turpitude of the crime of the destruction of ante-natal, or post-natal existence. The induction of crim- inal abortion should be made a capital crime, and any one who knows of its commission made accessory to it. The induction of abortion is only legitimate when the life of the mother is imperiled by a continuance of pregnancy; that the emptying of the uterus presents itself as the only alter- native to save her. 366 The Germicide 20th Century Practice Abortion is the most terrible calamity that can befall a preg- nant woman, and it is doubly worse when brought about by malpractice; the number of morbid conditions that follow it are beyond all calculation. The following may be enumerated as a few results that are likely to follow : It gives rise to a habit which nothing can overcome; it causes painful sitting, painful sexual connection, intrauterine catarrh, catarrh of the neck, falling of the womb, neuralgia of the ovaries, nerve-ex- haustion, aching kidney, irritable bladder, ulceration of the uterus, cancer. FEVER. — This term is applied to any diseased condition characterized by undue elevation of temperature. The normal temperature of the body is 98.4 degrees F., but even in health there is a daily variation of from 1 degree F. to 1,5 degrees F., the temperature being higher towards evening and lower in the morning. Very slight variations also occur, due to food, physical exercise, the surrounding temperature, etc. Heat is produced in the body by the oxidation of the tissues and food, which is concomitant with all forms of bodily ac- tivity. Heat is most largely produced in the muscles and the liver. Heat is lost constantly by the excretions, by the lungs in expired air, and largely by evaporation and radiation from the surface of the body. Both of these processes — those of heat production and heat loss — are under the control of the nervous system, and the state of equilibrium between them represents the normal body tem- perature. When this equilibrium is upset or disturbed, the temperature rises and fever is the result. If the temperature be below 101 degrees the fever is slight, above 104 degrees is severe, and above 106 degrees it is very •dangerous, and is known as hyperpyrexia. In all fevers cer- tain symptoms are always present. The skin is hot, dry, harsh, and pungent, but in some cases there may be profuse prespira- tion. Headache, giddiness, restlessness, want of sleep, and de- lirium are common nervous phenomena. The pulse and respirations are increased in quickness. The tongue is coated, the mouth dry, there is great thirst, loss of appetite, nausea, and constipation. The urine is scanty, and high-colored. General emaciation occurs in proportion to the fever. A rigor or chill usually ushers in the rise of tempera- ture. These usually begin with a precursory stage — lasting some and Dictionary of Diseases. 367 days of nerve depression, pain in the head, back, and limbs ; a coated tongue, loss of appetite; arrested secretions, with lan- guor; subsequently a chill, or rigor; then fever, lassitude, de- bility, headache ; quick, hard, full pulse ; increased respiration, nausea, vomiting, giddiness on attempting to sit up or get up, urine scanty, bowels constipated. The duration of the fever will depend on the poisonous char- acter of the ptomain and the skill of the physician in annihilat- ing the germ and neutralizing the ptomains. The entire nervous system is irritable from the presence of these bodies and must be soothed by the administration of either tincture of aconite, veratrum viride, belladonna or passiflora incarnata, alternated with bactericides to kill the germ and neu- tralize the ptomains. These remedies must be aided with rest, bathing, liquid diet, destruction of disease germs in the apart- ment by disinfectants, after which, by degrees, the heat, pulse, and respirations decline, the skin becomes moist, the tongue cleans, the appetite and strength improve, and the patient be- comes convalescent. The various types of fever are simply the outcome of various disease germs and their ptomains. When a fever continues for some time without change it is said to be continuous. When the fever drops almost to the normal temperature and then rises again, it is said to be remit- tent. When in the intervals the temperature drops to normal the fever is said to be intermittent, as in ague. Fever is said to he asthenic, or adynamic, when there is great weakness with a comparative slight increase of temperature. Inflammatory fever accompanies acute inflammations. A specific fever is due to the presence within the body of a specific poison, as in scarlet fever and other zymotic diseases. FISTULA. — A deep, long, and sinuous ulcer, which often forms a connection between the exterior of the body and some internal part, such as the lower bowel. Such fistulas are said to be complete. When they end in a cul de sac they are said to l>e blind or incomplete. The most common is that known as fistula in ano. It arises from the formation of an abscess in the neighborhood of the lower bowel, and the bursting of this abscess either externally, into the bowel, or both. There is usually great pain, which is greatly increased during defeca- tion. There is also discharge of purulent matter, and some- times blood. 368 The Germicide 20th Century Practice Fistula in Ano. — A fistulous tube, lined by a false mem- brane, which is loaded with microbes communicating with the bowel and parts external to the anus. Three varieties, blind internal within, opening in the rectum, but none external to the anus ; blind external, no opening outside on the nates, but one inside the bowel ; complete, when the fis- tula runs clear into the bowel. In the three forms bacteria are abundant. 1. In all cases, under all conditions, heal it up. Select some of the following methods of treatment : Ligation and gradual compression are used. Injection, favorite method as it meets the pathology as follows : First wash out the fistula with a 5. per cent solution of peroxide of hydrogen. Then inject a 95 per cent solution of carbolic acid and an equal quantity of a 10 per cent solution of cocain. Draw twenty to twenty-five minims in the syringe. Push the needle to the depth of the fistula, and then inject slowly as you withdraw the needle. Within two hours inject a solution of equal parts of oil of eucalyptus and glycerin, and the operation is finished. Keep patient quiet forty-eight hours. 2. Another very excellent method : Take of each, carbolic acid and glycerin, three drams ; sperm oil, half a dram. Mix. Heat to 300 degrees F., and evaporate to four drams. Use the same as thus directed. Open bowels with large dose of castor oil. After evacuation, wash out rectum with saturated solution of boroglycerid. Then place patient upon his arms and knees on a chair seat, clean out sinus, put one finger in the rectum over the opening in the bowel (if there is one), then fill the sinus with the solution as the instrument is withdrawn; press down the piston of syringes when removed that it will be full, put finger on external opening for a few minutes. Lock up bowels for over a week by administering one grain of opium every four hours. If there is the least doubt of this procedure, inject sinus the following morning in the same manner without finger being in the rectum. The rules of sound practice are, under all and every possible condition, to obliterate the fistula. The following methods are worthy of the attention of our readers, as both rectum and fis- tula are literally loaded with microbes of all descriptions. 3. Before retiring for the night, cleanse out the rectum, using a fountain syringe, with a warm solution of ozonized boroglycerid. When the entire contents of the bowel have passed, insert one or two jequirity crayons; repeat this every and Dictionary of Diseases. 369 night for one week. In 95 per cent of cases so treated, an effu- sion of plastic lymph will be thrown out sufficient to block up the fistulous opening. 4. If this method fails, then try : Wash out the bowels after the cathartic has acted ; still further cleanse the rectum as in No. 3 ; then take a small piece of ozone paste, thicken it with flour, roll it out in the shape of a pipe-stem, pass a linen thread lengthwise through it, make its size or calibre just sufficient to pass through the fistula; then fasten the end of the thread in the eye of a blunt probe, passing this through the fistula into the rectum, bending the probe, bringing it out at the anus. Then tie the two ends of the thread externally on the nates, leaving the thread coated with the ozone paste in the fistulous opening. Usually if this is permitted to remain twenty-four hours, sufficient plastic lymph will be effused to completely close the aperture. This can be aided by inserting a krameria suppository every two hours. 5. If these methods fail, cleanse out the bowels as above, also the fistula, and inject into it a mixture of 25 minims of carbolic acid and one grain of eucain. Push the needle of the hypo- dermic syringe to the depth of the fistula, and inject slowly as you withdraw the needle, placing finger on orifice. Keep patient quiet in bed for forty-eight hours, inserting a krameria suppository every three hours. If there be the least doubt as to its efficacy, it can be repeated in twenty-four hours. 6. The insertion of several guaiacol suppositories daily often cause effusion of plastic lymph sufficient to effect a cure. These methods merit the serious consideration of all con- scientious physicians, before cogitating upon either ligating or crushing or cutting the intervening tissue between the fistula and the sphincter muscle of the rectum. Fistula, Salivary. — This is usually the result of a wound opening into the salivary duct. The saliva escapes by the sinus. All these are curable by operation, but they require skillful treatment, and are often very tedious. They are not dangerous, out the worry, pain, and protracted discharges may produce a breakdown of the constitution. Fistula in Urethra. — If a stricture is not absorbed, it will give rise to irritation of the urethra and gleety discharge. The obstruction rebounds upon the prostate, and causes chronic en- largement of that gland ; besides, in bad cases, a drop of urine is liable to lodge behind the stricture, and excite irritation, in- 3/0 The Germicide 20th Century Practice flammation, ulceration, and ultimately an opening or fistula,, through which the urine flows or drops when the patient uri- nates. The best method of treatment, patient under an anesthetic,, is to carefully dissect out the fistulous tract ; then forcibly intro- duce through the stricture into the bladder a No. 12 silver catheter, and retain ; stitch up the wound, and by the time it has healed — eight or nine days — stricture will have entirely sup- purated. Fistula, Vesico- Vaginal. — A fistulous opening from the bladder into the vagina. Its common cause is the use of instruments during delivery, especially if the bladder has not been emptied. A full or dis- tended bladder, with hurried labor, or with a bad presentation, or a crooked or deformed pelvis, may also give rise to it; and various other like conditions. It is often caused by ladies attempting to commit abortion on themselves by knitting- needles, whalebones. The dribbling of the urine through the orifice, night and day, gives rise to irritation, rawness of the vagina, and renders the patient very miserable, and an object of great distress. It should be treated by getting her into as good health as possible, and then stitching it up; placing her upon her arms and knees, head down, parts well exposed by two crow-bill speculums, a catheter in the bladder. The edges of the fistula should be well pared, and then stitched up with lead-wire sutures; patient put to bed, and a catheter kept constantly in the bladder. All cases are successful. Fistula, Recto- Vaginal. — This may originate from a lac- eration of the perineum, which extends back through the sphincter muscle of the rectum, which has been stitched up, but left an opening between the vagina and rectum ; or it may have arisen from chancre in the vagina perforating through, or from stricture of the lower bowel, foreign bodies ; from the introduc- tion of knitting-needles, whalebones, to induce miscarriage; and like conditions. It is easily recognized by the passage of gas, liquid, or solid feces into the vagina. If very small, and in doubt, empty the bowels from above with castor oil; after it has operated, put patient on her back, knees drawn up, and a crow-bill speculum into the front part of the vagina; have a good light, and the index finger into the bowel, and examine it all over for an orifice. Thev are seldom high up, and by bulging the rectum and Dictionary of Diseases. 371 with the finger, can be easily seen. If very small, so that a pea would penetrate through, it can be closed up without an opera- tion if carefully managed. Every second or third day for five or six weeks it can be touched with nitric acid; that is, the edges of the fistula and a little beyond ; after it is raw, it will begin and throw out granulations that will effectually block up the orifice. It takes time and care, and while it is going on, the patient must keep bowels very soluble and free from gas, by eating a proper diet. If it fails, or if the opening is large, it should be stitched up. Patient's bowels having been well cleansed out, placed under chloroform on her back, a crow-bill speculum should be inserted, and the part exposed to a good light; its edges should be freely pared, so as to have a good raw surface. If the sore is round, like a three-cent silver piece, it has to be lengthened slightly, to prevent puckering when the stitches are introduced; then sewed up with lead sutures; and the sphincter muscle on both sides of the coccyx must be di- vided, so that the patient can have no control of the bowels, that gas and solid matter may pass without disturbing the fistula; bowels locked up for ten days with opium ; and kept perfectly quiet in bed for two weeks. If the patient is strong and vigor- ous, all may go well ; the cut sphincter may unite ; if it does not, the patient is a miserable object all her future life, not being able to hold or have control over her bowels. The original fistula, however, unites perfectly, unless there has been some bungling in the paring of the edges or application of the stitches. To obviate the cutting of the sphincter muscle of the rectum, tubes have been tried, with partial success. In all cases the best of nourishment should be given, so that a high standard of health be maintained. FORMALIN (Chemically Pure).— Formaldehyd(C.H 2 .0) a gaseous body, prepared by subjecting methyl alcohol to oxidization. It is readily absorbed by and mixes with water in all proportions. One part added to 40 of water makes what is termed a 40 per cent solution, one tablespoonful of which, added to a quart of water, makes a powerful germi- cide, disinfectant and deodorant, an efficient sterilizer of in- fected tissue. One ounce of formalin to four ounces of water is a grand formula for spraying the atmosphere of a room in which are domiciled patients suffering from microbic diseases (contagious 372 The Germicide 20th Century Practice and infectious), such as whooping-cough, eruptive fevers, ca- tarrh, ozena, chronic bronchitis, diphtheria, fevers, hay asthma, and it might be used slightly stronger in a steam atomizer for inhalation in pulmonary affections, sore throat and diphtheria. It has a most extraordinary microbicide power in keeping the atmosphere free from all germs. When pure, undiluted formalin is painted on a chancre, it gives considerable pain, but one application wipes it completely out, and it is healed. C. p. formalin applied to the skin exerts a kind of tanning or hardening effect, making the skin impermeable, and painting it twice daily for a few days brings about its necrosis — it pene- trates deeply if applied in cancerous tumors or infiltrations and effectively destroys them; no suppuration whatever following its use. The efficacy of the action of formalin in lupus, epithelium of the eyelids, lips, tongue, nipple, breast, uterus, etc., is simply marvelous. It is working wonders in the cure of cancer, com- pletely necroses the coccidial parasites; it has a most remark- able action on the development, relationship and intimate struc- ture of carcinoma — epithelial and glandular — it cuts clean, and in carcinoma of the neck of the uterus it is highly prized. Corns, moles, disease growths generally, all disappear when it is used. The mode of application in all cases is the gradual destruction of the growth by repeated applications. For cleans- ing and disinfecting instruments; injecting phagedenic cavi- ties, abscesses, gangrene, etc., it is unexcelled. The watery so- lution of formalin, one tablespoonful to the quart is sufficient. The same placed in deep plates or saucers, six or eight will keep an ordinary sized apartment sweet and free from microscopic life for a week, when it must be renewed. Its antibacterial properties are immense. For embalming and the preservation of anatomical specimens it is exceedingly valuable. Besides rendering them indestruc- tible, it hardens, maintains the normal color and translucency of the tissues. For the preservation of the dead, either for embalming or dissection purposes, maintaining a life-like color, such a formula as the following is unrivaled : Formalin, six parts ; chloride of sodium, one part ; sulphate of soda, sulphate of magnesium, of each, two parts. Mix. We would urge upon the profession a general use of forma- lin, and we would suggest that they keep it already prepared in and Dictionary of Diseases. 373 their offices. To those who are desirous of using it, we would suggest such a mixture as the following : Make a half gallon saturated solution of ozonized boroglycerid, add to that four ounces of the concentrated tincture of echinacea, a dram of thymol and the same quantity of menthol, with one ounce each of the essence of wintergreen and pine needles, adding one pound of formaldehyd ; our readers will find this of surpassing efficacy for adding to lotions in cutaneous diseases. As a prophylactic and cure of whooping-cough, croup, bron- chitis, simply spraying the room every three hours. For the immediate eradication and cure of all cutaneous dis- eases of animal and vegetable origin, as psoriasis, lepra, tinea, etc., it has no equal. Excellent to apply in bites and stings of insects. Another addition to every physician's office is formal-gelatin for dusting on all wounds, after the indications of treatment are fulfilled, on all sores, ulcers and abrasions. The moment this is applied, it yields its formaldehyd to the living tissues, and produces instantaneous cicatrization of the wound, hermetically sealing it by the formation of an eschar. Formalin must never be administered internally, not even in a diluted form. Although invaluable in disease on account of its antibac- terial, non-toxic, non-corrosive properties ; although it cannot be detected by either taste or smell, it should never be used as a food preservative, nor for preserving wines, beer, fruit juices, milk, cream, meat, fish, catsup, vinegar, pickles. The internal use of formalin causes atrophy of the optic nerve — irreparable blindness. FOUL OR FETID BREATH.— This arises from a variety of causes, disorders of the salivary glands, digestive disturb- ances, decaying teeth, nasal catarrh, torpid liver. In inertia of the salivary glands of the mouth with fetor, use a mouth wash of a solution of chlorate of carbon before and after meals, which kills the bacteria in the oral cavity. If it arises from gastric catarrh, the toxins of the sarcina ven- triculi, administer one siegesbeckie tablet dissolved in water after eating, which will clear the stomach of all germs and ren- der the breath sweet. If from the teeth, it usually comes from a cavity in which food lodges, decomposes and suffers microbic evolution, which 3/4 The Germicide 20th Century Practice is ruinous to health, deleterious to all in close proximity. Re- moval or filling at once should be resorted to. If from torpid liver, the emanations from the tonsils are most offensive. Administer three to five grains periodate aurum every evening for a few weeks. If from nasal catarrh, it is usually atrophic, considerable dry- ness and hawking, the ameba cling closely to the mucous mem- brane decomposing, evolving deadly toxins in the posterior nares, and giving rise to a bad species of auto-intoxication. A douche of ozone et chlorine, if properly applied, has a marvel- ous action in obliterating catarrh of the respiratory membranes. Apply it well and only once, follow every evening with a spray of peroxide of hydrogen, mix with an equal portion of water. Excellent to destroy odors, clear the parts of germs. Resorcin, jelly of violets will also be found of great service. FRACTURE. — By the term fracture is meant a break of bone. Causes. — There may be a predisposition in the bones to give way, owing to disease, as atrophy, softening or excessive brit- tleness of bone, due to an abscess or excess of certain constitu- ents. The exciting causes are either mechanical violence or muscular action. Mechanical violence may be direct or indi- rect ; direct when the bone gives way at the point to which the violence has been applied; indirect, when the bone gives way between two opposing forces. Muscular action is rarely a cause, unless the bones are either weak or diseased. Varieties. — Fractures are divided into simple and compound — simple when there is no laceration of the skin or soft parts ; compound when the bone has protruded through the skin. Sim- ple fractures are divided into classes as follows : transverse, when the bone is broken clean across ; oblique, when broke in an oblique direction ; longitudinal when slit up in its length ; com- minuted, when broke into small fragments. Compound frac- tures are more dangerous than the simple because the force or violence necessary to cause a bone to force its way through the skin gives rise to a greater shock ; because there is more danger of a laceration of nerves and blood-vessels ; and because, under the tedious process of healing of broken bone, with ulceration of soft parts, the patient's vital forces may give out. Symptoms. — The symptoms of fracture are essentially three : Deformity, such as bending, shortening and twisting of the in- jured limb ; preternatural mobility, one end moving indepen- and Dictionary of Diseases. 2>75 dently of the other; crepitus, a grating noise, heard and felt when the broken ends are rubbed against each other. In addi- tion to those three essential symptoms, there may be pain, heat, redness, swelling, ecchymosis, helplessness, twitching, spasm of the muscles. Treatment. — The treatment is very simple, and embraces four indications, which, if properly carried out, patient in good health, no blood taint, or disease, will insure a good union of broken bone. Before attending to those four points, the patient must be carried to his home, or hospital, on a stretcher, or ambulance, with both legs tied together at knee and ankle ; or, if an arm, tied to the body, so that there be no chance of the broken bone being thrust through the skin. When home, the bed on which he is to rest should be made as level as possible; the patient laid upon it, undressed and examined, and well washed. i. The limb must be placed in such a position as will relax the principal muscles that cause displacement. 2. The fracture must be set; that is, the broken parts must be adjusted in their natural position. For this purpose the upper end of the limb must be held firmly by an assistant ; the lower is extended, or firmly but gradually and gently drawn in such a direction as to restore the limb to its proper length and shape, carefully manipulating any fragments with the fingers into their proper position. If necessary to overcome pain or spasm, chloroform should be administered. 3. If it does not interfere with the dressing, the limb should be bandaged from extremity up, so as to confine muscles and prevent them from disturbing the fracture. 4. It is always necessary to use some mechanical contrivance to keep the limb its proper length and shape, to keep the two broken ends in perfect apposition, and prevent all motion or movement. There are various contrivances and appliances, embracing splints, pads, sandbags, starch and plaster of Paris rollers, par- affin molds, adhesive strips, for each respective fracture. If vitality is good, no syphilis, nor mercury, nor tubercle, nor cancer-germ in blood; if the bones are in perfect apposi- tion, no pain, and a very high standard of health maintained, the broken bones might become cemented together without any swelling, or lymph-callus being present — a perfect union by first intention ; but more frequently they unite in the following manner : 376 The Germicide 20th Century Practice Repair of Bone. — When the vital forces of the patient rally from the shock of the accident, nature begins to throw out lymph from the broken ends of the bone, the periosteum, and surrounding textures. She continues this process for a week or ten days. This lymph embraces the two ends of the bone and adjacent parts. When nature has completed the effu- sion, she begins next a process of absorption and consolidation of this lymph, which gradually grows less and less, firmer, and more substantial, so that in ordinary cases, at the end of six weeks, the patient may get about, with care; and at the end of four and a half months more this lymph is all absorbed, the two ends of the bone perfectly united, even as strong as the original bone. The technical term for that lymph, from its first effusion to its ultimate absorption, is a provisional callus. It is supposed that that lymph is first converted into fibrous tissue, and gradu- ally into bone. The time of absorption and consolidation varies with the age, vitality, and fitness of dressing, apposition, rest, good nourishment, freedom from worry, etc. There are some bones when broken that do not unite by bone except in rare cases, such as all flat bones, like the skull, the neck of the thigh- bone, the heads of bones in joints, or bones covered by the synovial membrane, or lining of joints. There are numerous reasons for these not uniting, as they cannot be kept in appo- sition, or contact, or at rest; there is no structure present to form a provisional callus. This is a wise provision of nature, for if bony matter was thrown out in joints, their mobility would be entirely destroyed. The shafts of the long bones are where perfect union can be best obtained and with exactness. Non-union and False Joint. — A perfect union of the broken ends of two bones may not take place by bone, but by ligament, or not at all ; the ends of the bones become smoothed off, and false joint forms. This is liable to occur from a defect in the dressing; from irritability and restlessness of the patient ; from age ; debility ; albuminuria; or from the presence of disease germs in the blood, as tuberculse, syphilis, cancer ; or to the poison of mer- cury; or if the patient is pregnant, or a fever comes on; or if there is disease in other parts; or if there is an inadequate nerve-supply, meagre diet, insanitary surroundings, stimulants that deprave the blood ; from pain in the fracture. No fracture can unite by bone if pain is present. Drugs are very liable to cause it, especiallv iodide of potass. Treatment. — Should union not occur in the regular period, and Dictionary of Diseases. 377 the best plan is to apply the paraffin dressing, which is soft, firm, and will keep the parts at perfect rest and perfect appo- sition, and in no way impede the circulation, like plaster of Paris or the starch roller. Should this not succeed, after six or eight weeks' trial, make an effort to remove the cause, if pos- sible, and get the health restored. Then there are various methods of procedure, which have the same object in view, namely, causing a determination of blood to the part, a mole- cular excitement, a true hyperemia. This may be done by the two poles of a battery, applied daily ; by the irritating plaster over the part ; by rubbing the ends of the bones against each other; or the fractured ends could be cut down upon, their ends sawed off, and treated as a compound fracture. In other cases holes are drilled in the bone; ivory pegs, setons, etc., everything calculated to cause a determination of blood to the part. The constitutional treatment is of the greatest importance- Debility must be overcome, with good food, tonics; and it is well to see to food that contains bone, as oatmeal porridge and cream, boiled fish, and even administer lime-water in milk. Compound Fracture. — A fracture with a wound, or lacera- tion, through which the bone has penetrated. The greater vio- lence necessary to cause this form of fracture gives rise to more danger from the shock, from the danger of tearing nerves and blood-vessels, fever, tetanus, and the long process of suppura- tion incidental to such injuries. If principal nerves or arteries are torn or bruised, or other grave injuries present that would render repair impossible, amputation may be required; and divers other conditions present that render this class of injuries at all times serious. Treatment. — If it is decided to save the limb, then the rough or splintered broken ends must be sawn off, and the fracture set like a simple one, and an effort made by plugging the wound with a piece of sponge saturated with carbolic acid and olive oil, to hermetically seal the wound up, and make it a simple one. The object in view is to destroy all micro-organism; coagulate the tissues. In 80 per cent of all cases this will be success- ful if wound is thoroughly cleansed of clots, dirt, by washing- it out with an antiseptic wash. FRANCISCA. — Manaca, or the plant, Francisca unfflora, native of Brazil. Therapeutical Action. — A powerful, energetic bactericide^. 3/8 The Germicide 20th Century Practice completely annihilates the bacillus amylobacta of rheumatism and of syphilis ; does good work in lepra and psoriasis. Preparations and Doses. — Ozonized fluid extract, in doses of from 10 to 20 drops. Great care is requisite to so manipulate it as to obtain splendid results. FRECKLES. — Small yellowish-brown spots which appear on the faces (and exposed parts) of fair-complexioned people or people exposed much to the weather. Very little can be done to remove them. A lotion of olive oil and lime-water in equal parts, to which a little ammonia has been added, has been recommended; and still more efficient remedies are lotion of either lemon juice or lactic acid, or the sixteen-vol. peroxide of hydrogen. FUCUS VESICULOSUS. — Sea-wrack, or sea-weed, algae. Therapeutical Uses. — Contains a large percentage of iodine combined with the salts of potassa and soda, its chemical con- stituents being chiefly iodine and ozone from nature's labora- tory — the one from the sea, the other from the atmosphere. The vitalizing properties of each render it a remedy of ines- timable value as an alterative. If the fluid extract is prepared from good, fresh sea-weed, dried under cover, it is one of the best alteratives, and has a re- markable affinity to strip off fatty tissue, and cause a reduction of the weight of the body. Dose : Ozonized fluid extract, 1 to 2 drams. GALACTAGOGUE. — Any remedy that increases or favors the secretion and flow of milk. From the earliest period the profession has had to depend chiefly upon malt extracts and the castor-oil plant, the leaves applied to the breast and the oil given orally. More recently the ozonized thyroid extract of the lamb has superseded all other remedies, and demonstrated itself to be the best and most efficient of all galactagogues. Its use starts the flow of milk ; if in any way deficient increases it immensely. The best method of administration is to add one ounce of the thyroid to four ounces of sherry wine, of which a few drops should be given daily. . For nursing mothers, independent of its prompt action in increasing the lacteal secretion, it is a remedy of priceless value not only to the mother but to the child; it prevents and cures myxedema in the mother ; it is a prophylac- tic against idiocy, feeble-mindedness ; all congenital defects and Dictionary of Diseases. 379 in the child and all deviations from the normal whether they be physical or mental. Protomtclein also is invaluable as well as all malt extracts. GALLIC ACID. — An important vegetable acid obtained from galls and which is also present in a large number of other astringent plants. It is the source from which pyrogallic acid — so largely used in photograph) 7 — is obtained. In medicine it is largely used as an astringent, in doses of from 2 to 20 grains, to check hemorrhages, discharges, etc. It is used ex- ternally as glycerin of gallic acid (1 to 4 of glycerin). In its properties it is practically identical with tannic acid. GALLS. — Excrescences of the oak tree (Quercus hisuanica) caused by the punctures and deposited ova of Cynips gallae tinc- torae. From galls a tincture and an ointment are obtained, as well as gallic acid. The ointment is largely used as an astrin- gent in the treatment of piles. GALLSTONES. — The chemical composition of the human bile : water, 850 parts ; bile salts, 91 ; fat, 9; cholesterin, 2 ; mu- cus and coloring matter, 29; salts, 7 in 1,000 parts. The se- cretion of bile is continually going on, but somewhat retarded during fasting and accelerated during the taking of food. The bile formed in the hepatic cells is discharged into the minute hepatic ducts, passes into the larger trunks, and from the main hepatic duct into the duodenum. The gall-bladder is a true reservoir for holding the bile for the wants of the economy. Under certain conditions, such as with an excess of amy- laceous, carbonaceous, saccharine food, malt and alcoholic drink, together with monotony, indoor life, imperfect ventilation, non- aeration of the blood takes place ; the bile becomes thick, crystal- lizes, forms an obstruction to its own escape; it is absorbed in great quantities, constituting the phenomena of jaundice. It is supposed that an ordinary sized man secretes from 20 to 40 ounces of bile in the twenty- four hours. A thick, clotty, or crystallized condition of bile may arise from a variety of other causes not so common in early life, un- less due to malaria, but after thirty-five very common among the sedentary, or in those who lead a physically inactive life; much more common among women than men. Pain, par- oxysmal over the region of the gall-duct, with vertigo, nausea, 380 The Germicide 20th Century Practice vomiting, biliary-coated tongue, injected conjunctiva, constipa- tion, favor the idea of the formation of biliary calculi. Gallstones, or biliary calculi, may be very numerous, but, if they remain in the gall-bladder, they give rise to little trouble. When, however, one of them passes into the common bile-duct, and its passage is impeded, it gives rise to most alarming symp- toms, which sometimes terminate fatally. The pain is par- oxysmal and most excruciating, vomiting comes on, and there is usually some shivering. When the stone passes on into the intestine the pain ceases. In some cases the stone does not pass on, and may cause ulceration and perforation of the gall-blad- der or its duct, and thus bring on fatal peritonitis. Gall-stones are said to be one of the causes of cancer of the liver. In all cases calculi are made up of either a deficiency or re- dundancy of certain elements of the bile, a scantiness of its watery elements, it may coagulate ; an excess of cholesterin, it may crystallize. When the symptoms of gallstone passing the duct are pres- ent, the curative indications are to facilitate its passage into the intestines, to relieve pain and prevent inflammation, which the presence of an extraneous body if large is calculated to produce in the duct. This is best effected with large doses of gelsemium. Dose after dose relaxes the duct and favors the expulsion of the calculus. Warm bath, hot fomentations, are of great benefit. Between the attacks solvents should be tried, to cause a chem- ical disintegration of the calculi, and for this purpose the ozon- ized uric acid solvent should be preferred above all other rem- edies. Under its influence the calculi breaks up, disappears, without any trace, in copious, bilious evacuations, which it pro- duces. I have used this remedy in several hundred cases, and found it an excellent solvent for those stones. It is well enough one or two days of each week to administer compound tincture of cinchona and nitromuriatic acid, with phosphate of soda, sufficient to keep the bowels free ; but in all cases, five days out of seven, the patient should be placed upon the uric acid solvent ozonized. There is little doubt in my mind but this remedy owes its powerful solvent properties to the combination in it of the chionanthus virg. and dioxide of hydrogen. The same preparation is efficient in nearly all dormant states of the liver. Diet has a marked influence upon the quality of the bile ; vege- tables and fruit have a marked influence upon the bile, with lean meats proportioned to the wants of the system. and Dictionary of Diseases. 381 Non-aeration of the blood in conditions of monotony,, in in- door life, malaria, toxins of disease germs, chronic alcoholism, carbonaceous diet, have a tendency to form biliary concretions, which are often numerous and give rise to much trouble and danger. Biliary concretions are common at all periods of existence from intra-uterine life and early infancy, due to a stagnation of bile in the gall-bladder; later on calculi arise from catarrh of the ducts, probably nothing present but simple jaundice; they are likely to be present in malaria, dengue, yellow fever, also in cancer of the liver, scirrhosis and pancreatic disease, in yellow atrophy of the liver or epidemic aundice, phosphorus poison- ing, much more common among women who lead an indoor life, or who once suffered from any congestion of the liver. The special treatment of biliary calculi consists in hot fo- mentations over the liver; just as large doses of the green root tincture of gelsemium as can be borne ; olive oil, slight inhala- tion of chloroform ; very light but extremely nourishing food. The passage of these stones takes from a few minutes to a few hours ; not only the paroxysm, but the pyrexia, rigors, sweat- ing, vomiting, are promptly relieved when the stone drops into the duodenum. Monotony, isolation, non-aeration of the blood, together with the toxins of disease germs, are the leading causes, and all aid in setting up inflammation of the gall-duct, which may form an abscess from which pyemic infection may follow. Every physician should see to it that an ample supply of green root tincture is always procurable. Periodate aurum is probably the most efficacious remedy to disgorge the liver and gall-duct ; but for continued use, curative and preventive, no remedy can excel the ozonized expressed juice of the Phytolacca berry in doses of from two to sixteen drops added to warm water. The ozonized fluid extract of chionanthus virg. is also of great utility. One of the commonest of the false statements enunciated is that gallstone affections are not generally dangerous. Exactly the contrary is the case ; the general ignorance of the fatality of gallstone cases being due to the unfortunate frequency with which patients succumb to them without the medical attendant's having had the remotest idea of the true pathology of the case he was treating. The reason of this is not far to seek, for it lies, I believe, in the fact of his having been falsely taught that all dangerous gallstone cases are associated with jaundice and 382 The Germicide 20th Century Practice paroxysmal pain; whereas it actually happens that the majority of fatal gallstone cases are unassociated with either one or the other of them. Incredible as this may appear, it is never- theless perfectly true. For there is no jaundice, and no paroxysmal pain (indeed, in the first instance very little pain of any kind whatever) when a gallstone ulcerates its way out of the gall-bladder. Should the stone in this case enter the peritoneum, a fatal peritonitis is the result. Sould it enter the intestines, if large it kills the patient by ileus ; if small, it passes safely down the intestines until it reaches the ileo-cecal valve, where it often sets up such an amount of irritation as speedily induces a fatal enteritis. When olive oil is ingested, a stimulating action on the secre- tion of bile is produced, causing it to flow in large quantities, it possesses a higher power of stimulating this secretion than either food or drugs with the single exception of ox-gall. Salicylate soda, in alternation with glucozone, increases bil- iary secretion immensely, besides it dissolves and disintegrates biliary concretions most effectively. The uric acid solvent also acts efficiently with, or in alterna- tion with, either of the above remedies. An ozonized extract of chionanthus virg. has a most re- markable action in liquefying the bile ; it increases its secretion, promotes gastric and intestinal activity, and has a most valuable action on the blood. Sulphate cinchonidine ; irisine, of each, twenty grains; hy- drastine white alkaloid, ten grains; extract nux vomica, five grains. Make twenty pills, one before meals. Very superior combination for gallstones. Phosphate of soda, chloride of ammonia, nitromuriatic acid still do good work where there is a tendency to form concre- tions. But olive oil and gelsemium are the great panaceas. When four to eight ounces of oil are poured into the stom- ach, that organ in the throes of animated contractions quickly sends a portion of it into the duodenum, where it exercises a most soothing influence on the irritated mucous membrance, and by reflex action causes the spasm to cease, which formed the principal element of the painful attacks. That the oil has any influence in dissolving the calculus is doubted. Repeated at intervals', the oil seems capable of hindering the return of the trouble by rendering active and fluidifying the biliary secretion. and Dictionary of Diseases. 383 GANGLION. — The bones at the joints rub on each other and in order to minimize the wearing away, which would re- sult from friction, nature has lined all joints with a synovial membrane, which secretes a lubricating fluid. Muscles all end in tendons, which are affixed to bone, passing round or over tuberosities, under which and around are synovial sacs, termed ganglia or bursse. Every structure in the body, if irritated, is liable to take on inflammation. Tendons, bursse and ganglia are no exception to this rule ; hence about the knee and wrists we often meet with those ganglia swollen size of peas or small eggs, rarely larger than an ordinary marble. When cut open, they resemble a little bag filled yith a clear transparent, yellowish fluid. On feeling, it is globular, elastic in connection with a tendon. Rest, with compression, is usually curative; pressure by means of the genuine old caoutchouc is effective. GANGRENE. — The process of dying; partial death, incipi- ent mortification. Usually ushered in by a sudden diminution of feeling or sensibility in the part ; livid discoloration ; detatch- ment of cuticle, under which a turbid serum is effused; with crepitation owing to the evolution of gases in the areolar tis- sue. When it has become quite black, cold, incapable of feel- ing, circulation and life, it constitutes mortification or complete death. To prevent gangrene, more active treatment, more vitalized remedies, more bactericides to arrest molecular change, de- structive metamorphosis and evolution of bacteria. Most powerful antiseptics orally and locally. For the former select either ozone, comp. oxygen, sulphide of lime echi- nacea, wild indigo, carbolic acid, or yeast; for the latter apply either a poultice of carbolic acid, yeast, capsicum, or charcoal ; echinacea alone, comp. tincture of myrrh, peroxide of hy- drogen, either arrest the process of dying or establish a line of demarkation between the living and dead parts. GASTRITIS.— One of the coming maladies of the twen- tieth century will be acute and chronic gastritis, the causes be- ing adulterated food, canned and embalmed meat in tins ; the bacteria, the evolution from these deadly products, produce disease. Deadly germs thus enter the stomach, live and grow in a toxical pabulum homogeneous to their character created l>y themselves. 384 The Germicide 20th Century Practice The principle of the coming age should be annihilation to such food products, maintain the vital force, sustain it, keep* in health, good food, and air ; thorough cleanliness, no excesses, labor in moderation, no mental worry. Watch what enters the stomach. The earliest signs of acute gastritis are the raw beef appear- ance of the tongue. Nausea, vomiting, with a coffee-ground vomit, which is blood changed by the acids of the stomach, to- gether with restlessness, feverishness, thirst, pain, offensive breath, loss of appetite and burning sensation at pit of stomach. When these symptoms are present there need be no doubt in regard to the lesion, though the primary cause may be obscure or unknown. For a time the stomach will digest nothing, hence no food may be swallowed. The constant call is for water ; and the colder it be so much the better it is relished. Ice will do, yet a constant supply must be at hand. As soon as the stomach is full of fluid, emesis takes place, often with retching. Then, more water ! To treat such a case successfully requires thought, skill, experience. Slippery elm water added to which gelsemin and passiflora. Possibly a few drops of camphor water, a sip of warm water, or a teaspoonful of ginger ale. Warm water will slake the cravings of thirst better than cold. A dilute solution of sulphate of magnesia operates favorably, even if not well received at first. As the nausea subsides rest will be obtained — possibly sleep. Repose is curative. Almost the starving point is reached before food will stay in the stomach. The juice of beef is to be offered in preference to starchy articles of diet. A hot plate placed on the epigas- trium generally affords relief from pain. A teaspoonful of orange juice is agreeable in the advanced stages of the disease, but will be rejected in the earlier stages of the morbid onset. The gastritis of drunkards is obstinate and often dangerous. Ulceration of the stomach is apt to be fatal ; and there is no way to tell when a gastritis may become ulcerative. Gastritis, Chronic— -Met with in all degrees or stages up- to the acute. Symptoms very variable, from a gastric neurosis, tenderness on pressure, headache, heartburn, sour eructations, vomiting, constipation, submucuous coat of tongue red or else red in patches, to gastralgia, all the symptoms of indigestion. Hydrastis, cinchona, mineral acids, collinsonia, gentian, mix. ozone water, gelsemin, hyoscyamus, passiflora, liquor cerii. Stimulating plasters over the stomach, warm flannel clothing. Cream, milk, eggs, arrowroot, rice, barley. All solid food and Dictionary of Diseases. 385 must be well masticated. A milk diet is often curative. Drink- ing warm water as hot as it can be taken relieves distress, over- comes nausea and vomiting. Forbid strictly the use of tea, coffee, tobacco, pudding, sauces, stimulants, fresh bread, corned beef, cabbage, pies and pork. In chronic gastritis, all the usual symptoms of indigestion are present; added to these, the coated tongue, with its red tip and edges, with pain aggravated by pressure over the region of the stomach. Symptoms are so clear, welldefmed, that it is impossible to confound it with cancer of the stomach, gastric ulcer, hepatic, renal or pulmonary affections. If a proper diet be pursued, rational medical treatment em- ployed, every case of chronic gastritis will recover promptly. In the first place, sufficient doses, at proper intervals, of the green root tincture of gelsemium, should be administered to efface pain, and a tepid infusion of kaki should be drunk when the stomach is empty, and at stated intervals. This exerts a powerful influence in arresting the excessive secretion of mucus, destroying the microbic elements of fermentation, and stimu- lating normal action — it even inhibits the growth of the sar- cinae. The very best results follow drinking an infusion of kaki, at any time with advantage. The unguentum capsicum of the dispensatory is one of the very best applications over the region of the stomach in chronic inflammation — strength just sufficient to be slightly rube- facient. Gastric Vertigo. — This is a disorder that attacks a number of persons, mostly those of sedentary habits, professional people and brain-workers. It is very often diagnosed as simply biliousness. It is a sub- ject that has given me much concern, and I was a long time arriving at a satisfactory diagnosis and the best plan of treat- ment. I conversed much with my fellow-practitioners about the symptoms of this malady, and read all the books and litera- ture that I could find relative to the symptoms of the affection for a number of years back, but I could only get a scrap here and there. Its main symptoms with most patients is a sudden quivering and twitching of the eyeballs, with gradual diminu- tion of vision and dizziness, followed by a sense of fullness at the forehead. The patient at first generally gets more or less frightened, and whatever they are working at must be aban- doned ; because, between the loss of vision and nervousness, the 386 The Germicide 20th Century Practice patient is unfitted for anything for the time being. If a remedy is not handy and the subject attempts to go on with whatever is occupying his mind, vomiting and severe headache will sooa supervene. If the patient should happen to be walking he becomes ap- prehensive lest he fall in the street, or feels that something is going to happen to him — a stroke of paralysis, apoplexy, epi- lepsy, etc., are the usual thoughts that flash through the mind. It is very distressing and annoying when one first has these attacks, and it is calculated to make almost any one lose his nerve. A disturbance of the circulation is noticed; a cold clammy sweat and a nervous tremor generally follow. Men generally stop and are quiet for a few minutes, and then seek a remedy. Women often lose control of themselves, fall or faint from fright, and frequently have convulsions and are pros- tracted for a while. In making out a proper diagnosis, hostero- epilepsy, paralysis, epilepsy, liver, kidney and brain diseases, and reflex disturbances are to be considered. In these cases there seems to be a sudden interruption of the cerebrospinal fluid. A slight constriction is often felt over the forehead and at the occiput. Some have sudden severe headache with sick stomach. If constipation exists the trouble is aggravated; but I have known the paroxysms to come on when the bowels were loose, but at that time most patients I noticed were suffering from liver tor- pidity or malaria. There is an intimate relationship between the brain arid the liver and digestive apparatus which is an interesting study. Disturbances in the liver disorder the brain directly, as well as by the abnormal products which reach it through the blood. Look at the disorders of toxemia. The liver has its representative area in the brain just as much as the arm or leg is represented in a distinct and localized area. Kolatin in tablets is an excellent remedy in these cases to rouse the liver into activity — at the same time comp. matri- caria energizes the molecular working power of the brain. Gastric Catarrh {Sarcinae Ventriculi). — Mucous dys- pepsia, catarrh of the mucous coat of the stomach, is the most common of all forms of indigestion, seventy-five out of every hundred being of this type. It may be defined to be a weak, relaxed condition of the lin- ing membrane of the stomach, with an excessive secretion of mucus, in which the fungus "Sarcinae" is evolved^ and breeds according to the amount of mucus secreted. and Dictionary of Diseases. 387 Its etiology is due to the habit of drinking excessively of fluids, especially malt liquors, to improper mastication of food, hurried eating, disease of the liver. Its diagnosis rests chiefly upon the fur on the tongue, and sarcinse in the mouth; pyrosis, heartburn, flatulence, sour eructations, distention of the stomach and abdomen, constipa- tion, with every two or three or more weeks sudden attacks of diarrhea, the maturing of the fungus, and its passage by the stools. A reformation, re-growth of the plant takes place and goes through the same process. The reflex symptoms to the medulla oblongata give rise to headache, vertigo, languor and debility. The train of nervous symptoms which accompany gastric catarrh are due to the ptomains excreted by the fungus. For a good microscopical examination it is best to administer an emetic, and procure the fungus free from admixture with food — place a piece of it in the field of the microscope, when cocci, cubes or packets, with rounded-ofT corners, are seen in groups of four, or multiples of four, united in families of eight, sixteen, thirty-two, sixty- four. Contents of the fungus, green- ish or yellowish red. The germ or fungus bears cultivation well on albumen or liquid gelatin. Pathogenic of catarrh of the stomach, communicated to water, through the sewers, thence to poultry and animals. Fungus starved out by either drinking freely of an infusion of bayberry or stone crop, or collinsonia, kaki; streilized, by mineral acids, peroxide of hydrogen ; sulphide of lime ; resorcin, saccharated sulphur; lactic acid; creolin; ozonized sulphur water ichthyol jelly. Gastric Fever. — Essentially a malady peculiar to children, and induced by some agent that is devitalizing to the stomach, as the digestion of pastry, cabbage, nuts, candies, alcohol, or other irritants. There is a period of prostration, during which the child suf- fers from languor, lassitude, debility, nausea, vomiting, fol- lowed by rigors and a fever, in which the predominating symp- toms are nausea, vomiting, pain over the region of the stomach ; acid or fetid breath, white-coated tongue are always present. Its duration is from seven to fourteen days, and if properly treated terminates in recovery. It is easily recognized by its history, derangement of stom- ach, nausea, vomiting, white coat on tongue, irritation of 388 The Germicide 20th Century Practice brain, and the entire absence of any other type of fever, and that it is peculiar to children. Just as soon as diagnosed, give the little sufferer an emetic of the wine of ipecac. The peculiar shape of a chilld's stomach enables it to vomit easily and effectively. If possible get the patient to precede the emetic with tepid water in which a little bicarbonate of coda is dissolved — free emesis if possible follow this with 2-gram doses of periodate aurum on the tongue, and the neutralizing cordial — continue till bowels move freely. A warm bath to commence with, followed by sponge bathing twice daily. If nausea and vomiting be a symptom, apply stimulants over the abdomen, either a mixture of spices or concentrated ozone over the stomach. Give the stomach rest, boiled water on toast or crackers, to which a few drops of glucozone are added. Neutralize the toxic elements, which have undergone a de- composition in the alimentary canal — the peroxide of hydro- gen and resorcin an excellent combination in these cases, safe, as salol is not admissible remedy to administer to children . Several days after the fever has entirely disappeared is the proper time for tonics, as the wine bitters, elixir cinchona, sul- phate cinchonine. Otherwise, the treatment should be the same as for fevers generally, especially insisting upon rest in the recumbent pos- ture, and sponging the body thrice daily. Gastric Tumors. — Every form of thickening, or infiltra- tion or tumor on or in the walls of the stomach, whether it be simply an effusion of lymph, fibrous tissues, or an aggregation of tubercular germs, in the near future will be capable of being removed or dissolved by those newly-introduced remedies, papoid, trypsin, lactic acid in different strengths, and the local application of ozonized clay. These remedies are remarkable for their solvent power over all adventitious tissues. The peroxide of hydrogen is best adapted to malignant growth. The fluid extract of Virginia stone crop is most bracing to the walls of the stomach. An almost infallible remedy for the absorption of gastric indurations and tumors consists in a mixture of equal parts of resorcin ointment and ozonized phytolacca berry juice — ap- plied all over the region of the stomach; by way of change, an occasional application of the ozonized clay. and Dictionary of Diseases. 389 Gastro-intestinal Infection. — In children of an early age, from a variety of conditions, chiefly from deleterious food, contaminated milk, an evolution of a dwarfed species of the sarcinse, giving rise to intestinal catarrh, dyspepsia and often a destruction of the epithelium, with intestinal atrophy, and accompanied with vomiting, diarrhea, colic — the function of both liver and pancreas being greatly impaired. Periodate aurum is invariably here, repairing the damaged liver and pancreas — heals the lesion in the follicles, arresting the morbid process due to infection or auto-intoxication which proceeds from within. Peroxide of hydrogen, resorcin, ozon- ized stone crop, echinacea are remedies of rare value. GAULTHERIA. — The preparation, oil of wintergreen re- duced to a glycerite by means of negative ozone, is an admir- able and exceedingly efficacious remedy in all cases of either acute or chronic rheumatism. When administered in doses of 10 of 15 drops very frequently, until its physiological effects are visible, in the ringing of the ears, a lowering of temperature, a reduction of the frequency of the pulse, a per- fect freedom from pain, when a normal condition is secured hold it by doses at intervals of three or four hours apart. Its action is that of a powerful microbicide, destroying the bacillus amylobacta in all the fluids and solids of the body, uniting with the lactic and butyric acids, rendering them inert, toning the organs of digestion and assimilation, has the won- derful capacity of preventing the evolution of the germs, and neutralizing its toxin in the synovial membrane of joints. It is a perfect substitute for salicylate acid and soda, better by far, as it has no depressing action upon the heart, no delete- rious effects, but rather a prophylactic to relapse. Advanced, higher-graded physicians prefer this preparation to any other derivatives of the true oil of wintergreen. GELSEMIN. — The bark of the root of the yellow jasmine, which grows freely in our Southern States. Physiological Action. — A cerebral sedative in small doses.; administered in large doses, it causes vertigo, double vision, paralysis of the sensory columns of the cord, heart's action slowed, temperature lowered. Chemistry. — It contains a glucoside, which is soluble in alco- hol or ether, but sparingly soluble in water; and an acid "gel- semic acid." 39° The Germicide 20th Century Practice Therapeutical Uses. — An excellent remedy in all forms of malarial fever, in neuralgia, and nervous affections generally. It has a most decided action upon the sexual appetite, and is a remarkable sexual sedative, cutting off erections as well as desire. Preparations and Doses. — A tincture prepared from the bark of the root, freshly dug out of the ground. When in full bloom is the best for general use, being administered in dose from 5 drops up. The powdered extract, or abstract, good. All other preparations are most unreliable, even the hydro- chlorate of the gelsemin is not a safe drug. In malarial fever it is administered as follows: Sulphate quinine; prussiate iron, aa gr. xxx; abstracta gelsemin, gr. iii; abstracta mandrake, gr. iii; oil black pepper, gr. q. s. To make thirty pills. Give one or two every hour, so that three doses are taken before the chill, or make into powders by adding capsicum in- stead. Another is green root tincture gelsemin, one ounce ; sulphate of quinine, two drams; aromatic sulphuric acid, half a dram. Dissolve the quinine with the aromatic sulphuric acid, then add the gelsemin. Dose: Half a teaspoonful added to water, so that three doses be taken before the chill. It never should be administered in infantile diseases. Ozonized green root tincture of gelsemium is a true sedative to the sexual glands, allays all irritation, and, together with passiflora, is a standard remedy in spermatorrhea. It is an American drug, peculiarly adapted to the infirmities of our people. It is good in a common cold, arrests profuse nasal secretion, subdues cough, relieves pain ; favors the re-establish- ment of normal secretions; it has a vitalizing action upon the skin, kidneys and intestinal tract; it lowers heat, slows the heart's action, creates a feeling of comfort over the entire body. Keeping a malaria-struck patient at perfect rest, administer- ing this remedy, so as to obtain its full physiological action, the germ will die in the body. Unlike antipyrin, it does not interfere with the oxygen-carry- ing capacity of the blood-corpuscles. The indistinctness of vision, dilation of the pupil, amblyopia, imperfect memory, feeble or squeaky voice, hebetude of mind, confusion of thought, point to seminal loses as the cause. Green root tincture of gelsemium and passiflora incarnata, full dose at bedtime and a salix nigra suppository. During the day, ad- and Dictionary of Diseases. 391 minister ozonized black willow extract in average doses. As the symptoms give way, give small doses of avena sativa. Take it altogether, gelsemium is one of our sheet-anchors, and has a very wide field of usefulness. Its indications are bright eyes, contracted pupils, flushed face, elevated tempera- ture and fast pulse. You can thus see that it is frequently called for in acute inflammatory affections of all kinds, and we do thus use it, and many times combine it with the indicated special sedative. It is of use in spasmodic affections. In re- flex spasms of childhood we would not exchange it for any other remedy we possess. It is also of great use in spasms of centric origin. In retention of urine from a spasmodic con- traction of the neck of the bladder, we know of no better rem- edy; but for this purpose it must be given in full-sized doses. In suppression of the menses from cold, combined with Pul- satilla, it has no equal. The dosage has a wide range — from the fraction of a drop to half a dram. It is seldom necessary to give the latter dose, though we have done so, in the retention of urine, as stated above, and in a few cases of puerperal eclampsia. GERMLESS WORLD NOT DESIRABLE.— Suppose that air, water, soil, animals and plants have all been thor- oughly sterilized in the bacteriological sense; suppose that by the universal application of an ideally perfect germicide every microbe has been killed, while higher living things remain un- harmed ; and suppose that no agents have been created to per- form the functions of the extinct families? What is the re- sult? First, we observe with gratitude that we have clone with a large number of diseases, acute and chronic, affecting beasts and men. Rinderpest and glanders have disappeared : anthrax no longer slays its thousands among sheep and cattle ; tuber- culosis in all its forms is unknown. The plague has vanished, never to reappear in the east or west. Leprosy, the mysterious scourge of many ages and many lands, at last dies out. In all probability we may expunge scarlatina, measles, and all the common infectious fevers from our text-books ; certainly no one need fear cholera, typhoid, diphtheria, or erysipelas Fn this changed world wounds and injuries are robbed of half their terrors, and surgeons take no precautions against sept ; c trouble. Food-poisoning by ptomains is never heard of. Sanitation becomes easy ; evil odors are almost banished from 392 The Germicide 20th Century Practice our streets. Various minor sources of annoyance have been abolished; milk does not turn sour, nor butter rancid; eggs keep always fresh; in the hottest summer our meat never be- comes "high." It would almost seem that everybody should be satisfied, except the bacteriologict, whose occupation is done. But very soon we begin to miss some things in our germless world. There is no beer, wine, or brandy, all the yeast-plants having perished by the germicide. No doubt chemists will sooner or later devise a substitute, but natural fermentation is at end. For the same reason artificial methods of aeration must be universally employed in making bread ; the leaven that has been used for so many ages has lost its potency. Our cheeses will not "ripen," owing to the absence of certain bacilli that used to effect the change ; and there is a distinct falling-off in the flavor of our best butter. The manufacture of vinegar is stopped, because there is no longer a bacillus aceticus to work upon weak alcoholic solutions. Along with these changes in our diet we seem to notice some impairment of our digestive powers, which may be explained by the absence of those in- numerable micro-organisms which used to inhabit our ali- mentary canals, and which assuredly had some influence upon the processes therein. Certainly the health of our herbivorous animals suffers on this account ; they lose the power of digest- ing the cellulose which enters so largely into their food. This, however, would not be the worst of it, for to the mi- crobes of the soil we owe the nitrification and other chemical processes that fertilize it and that enable plants to obtain their nutriment from it. If the soil were rendered "sterile" in the bacteriological sense — that is, if all the lower fungi in it were destroyed — it would soon be sterile in another sense also; our crops would perish, and agriculture would come utterly to an end. Neither grass nor herb yielding seed, nor fruit tree yielding fruit after his kind, could survive the deprivation of their natural nourishment ; and as animal life is ultimately dependent upon plant life, the fatal consequences would not be confined to the vegetable kingdom. But, indeed, when we consider the matter from another point of view, it becomes still more evident that the activity of these lowly forms is a condition essential to the continuance of higher life on the earth. For nothing is more certain than the fact that the processes by which organic bodies, animal and vegetable, are converted after death into simpler combinations and Dictionary of Diseases. 393 or into their ultimate elements — the processes known to us as putrefaction and decay — are absolutely dependent on micro- scopic organisms, especially bacteria. But if such processes did not take place, whence would be derived the materials for the construction of successive generations of animals and plants? The amount of carbon, hydrogen, nitrogen, oxygen, etc., available for the composition of living bodies in not an un- limited quantity, but is constantly utilized over and over again ; there are necessary economies in the working of the labora- tories of nature. At present all living things die and return to the earth from which they are derived, and their substances are again used to construct the substances of new living things. A part is at once assimilated by ''necrophagous" creatures, the scavengers of the soil ; but the important economy consists in the slow decompositions set up by bacteria, resolving dead organic matter into elements available for fresh life. If these decompositions were to cease, if animals and plants were to remain incorruptible after death, how can we escape the conclusion that sooner or later the supply of such available elements must be exhausted, and life itself must come to an end? Germs, Disease Producing. — The salivary glands of the mouth are the channels of ingress of nearly all disease germs ; hence the importance of keeping the mouth shut. The method of breathing makes a vast difference to a man's health and longevity, for if he be a mouth-breather his vital elements are low, as he is continually taking in disease germs. It therefore makes quite a difference whether you breathe by the mouth or the nose. You can enter with immunity a most deadly swamp, a smallpox hospital, if you keep your mouth shut; there is no infection. The mosquito as a carrier of the three-potency parasite of malaria is a mere humbug. Look to the salivary glands as the real inlet. Men who spit their salivary secretion by the use of either smoking or chewing tobacco are exempt from the en- trance of disease germs. Women who before and after meals wash out their mouths with a warm ozonized boroglycerid solution are never the victims of microbic disease. In gaping imbecility, the microbe of eipdemic influenza enters by the salivary glands and gives rise to its typical manifesta- tions — rigors, febricular pains, prostration and depression. Shut the mouth, suspend social intercourse, disinfect domiciles and administer concentrated tincture kurchicin orally to keep 394 The Germicide 20th Century Practice the blood streams pure — free from germs. This remedy kills the pathogenic microbe, increases the resisting power, mini- mizes the chance of infection by making the various tissues of our bodies unsuitable for the growth of the bacilli ; increases vital force. Don't mask the remedy ; give it diluted, so that it will come well in contact with the salivary glands. Mouth-breathers invariably suffer from tonsillitis, pharynigi- tis, laryngitis, bronchitis, with imperfect thoractic development, and a morbid predisposition to hypertrophy of the turbinated bones, together with the formation of adenoid growths in the naso-pharynx, which entail alterations in the voice and deaf- ness — often congestive engorgement of the mucous membrane, which leads to nasal stenosis, which interferes with the passage of lymph along the ducts which traverse the cribriform process of the ethmoid bone, and by preventing the drainage of the brain entail mental hebetude, paving the way for serious mis- chief. GLANDERS. — A disease peculiar to horses, an evolution under ; r^anitary conditions of the bacillus mallei, communi- cated both by contagion and infection to all individuals brought in contact with those animals, such as grooms, jockeys, stall keepers, farriers, harness rubbers. The 1es : ons classified under this head are of two types, glanders and pharcy — the former showing itself in a specific in- flammat ; on. ulceration in the nasal mucous membrane; the latter, th^ lymphatics are involved. In glanders proper, the septum nasi and adjacent parts, the mucous membrane exhibits an inflammation in which nod- ules form, gray, translucent, appearing with profuse, offensive, catarrhal discharge ; ulcers, round, scooped out ; often the entire respiratory passages, as well as the lungs, are involved; often associate^ 1 with enlarged lymphatics of the neck and chest. Nodules are often found in liver, spleen, bowels. In pharcy the lymphat ; cs are first affected; they become swollen : rregularly thickened, knotted like cords; suppurative softening- usually follows; pharcy buds form and secondary nodule? on the mucous membrane; scratches, abrasions on hands, arms, are the common mode of ingress in pharcy, local changes, followed by constitutional disturbance, and in both forms fever, and in many cases a specific eruption appears on the sV'ffaS well as On the mucous membrane of both nose "and mouth— a 'papular rash, which goes on to the formation and Dictionary of Diseases. 395 of unhealthy ulcerations; abscesses under the skin, joints and muscles are of frequent occurrence. Albuminuria; a low form of pneumonia often prevails; diarrhea, vomiting common in fatal cases. The glander bacilli cause a rapid metamorphosis of all the structures of the body, essentially destructive. This pathogenic microbe appears in very many localities in an endemic form and many valuable animals die, besides many grooms are infected through abrasions and scratches on arms and hands. Scientific physicians and eminent veterinary surgeons, cog- nizant of the habits, growth and toxins of the bacillus mallei, have little difficulty in staying the progress of the malady and in effecting a permanent cure in both man and horse. The remedies used with success are the iodide of lime every hour, alternated with chlorate and sulphate of quinine, and every three hours a dose of Chian turpentine mist. Echinacea also of utility. The iodide of lime seems to meet precisely the indications; excellent results follow its use. These remedies are followed by protonuclein, which is of great value in glanders by creating a leukocytosis. GLONOIN. — Nitroglycerin, is prepared by dissolving glycerin in nitric and sulphuric acids. For medicinal purposes it is dissolved and diluted in alcohol. Physiological Action. — It is a prompt, powerful excitor of vasomotor action; accelerates the action of the heart, relaxes dilated arteries, causes a general sense of fullness, and is a di- rect sedative to the medulla oblongata. Therapeutic Uses. — Of great utility in vertigo, headache, asthma, angina pectoris, neuralgia, chronic interstitial nephritis, seasickness, and disturbances of the intercranial circulation, asphyxia. Preparations and Doses. — A one per cent solution in one, two or more drop doses ; or a one per cent solution in pill form, as indicated. Better than all preparations is the nitroglycerin suppository ; acts silently but efficiently in all cases of suspended animation. GLYCERIN.— The sweet principle of oils and fatty bodies; soluble in water and alcohol ; insoluble in ether, chloroform and fixed oils. 396 The Germicide 20th Century Practice A germicide and valuable menstruum. Its dehydrating prop- erty causes it to be a laxative when administered internally : this same property renders it of intrinsic value in many skin affections, as by drawing off the serum inflammatory action is relieved, cicatrization promoted. Its general use must ever be most emphatically condemned, in the form of a suppository for habitual constipation. Such suppositories drain off the serum, exhaust the mucous and serous coat, render the bowel weak, liable to disease, especially carcinoma. GLYCOZONE. — This is a combination of dioxide of hyro- gen and c. p. glycerin, in variable proportions some use it as weak as 2 ounces of the peroxide to 14 ounces of glycerin; others 4 ounces to 12 according to the therapeutic effect desired. In any or all of its different strengths it is a powerful bac- tericide, destroys all disease germs. It is well adapted in this form for oral administration, good in dyspepsia, catarrh, ulcer, or induration of the stomach. Well adapted for spray in aphthae, enlarged tonsils, diph- theria, scarlet fever; also of great efficacy in ulcers; in this form it is of the greatest possible utility, for when it comes in contact with the tissues it liberates its ozone, vitalizes, purifies. The value of this remedy consists in its evolving nascent oxygen. It is perfecly stable, a strong, active germicide, in- nocuous, covering a large field of usefulness, being antipuru- lent as well as antiseptic. Administer orally in a little water, in typhoid fver, dysentery, desquamative enteritis, and mi- crobic affections of the alimentary canal. Administered per rectum, once or twice daily, its action is unrivaled in ulceration of the rectum, diabetes, and chronic urinary affections. As a mouth wash, gargle, and inhalant, it is exceedingly efficacious ; in pulmonary tuberculosis, in wiping out the tuber- cular germ whenever it reaches it. Spray a diphtheric throat with it, it promptly dissolves the membrane. Of immense utility in gynecological practice. Applied to all cancerous sores, to breaches of continuity produced by the removal of malignant growths, it corrects their malignancy, their tendency to gangrene. The dose internally, a few drops added to water and repeated several times a day. To open wounds, apply in full strength on cotton. and Dictionary of Diseases. 397 GOITRE. — At the root of the neck, just above the breast- bone, is situated the thyroid gland. In its healthy state this is an innocent-looking red body, consisting of two lobes joined together by a slender isthmus, and weighs a little over one ounce. Absolutely nothing was known about the use of this gland until recently, when it was discovered that its secretion possessed the vital elements of growth of every tissue of the body. It is now very generally recognized that certain organs in the body may be tissue-starved, anemic, and otherwise incapable of performing their proper function, and that by the introduction of the very same chemical constituents of the organs impaired, or the analogous organs, or their secretion from some one of our domestic animals, the mischief or disease will be repaired, provided the organs of digestion and assimilation be intact; that is to say, if the brain be exhausted by struggle, care, worry, study, enjoin rest and administer brain juice, glycerite of keph- alin; if the ever-moving heart muscle be exhausted, feed on creatinin; if the reproductive organs be weakened, lethargic, or altogether impotent, administer a solution of spermin; if the stomach fails through or by any cause to secrete, give its own juices as we have in the glycerite of pepsin; if there be a freak of nature, a chaotic construction, prescribe thyroid juice, so as to regain a perfect mechanism of body. The juice of the thyroid gland is one of the most important secretions of the whole body and plays the principal part in the elaboration, preparation and maintenance of the blood and nervous system. We have in it a material prepared which is rendered subservient to brain evolution, growth, nutrition and most perfect construction, and calculated to keep all parts of the body in most perfect development. The juice of the thyroid gland of many of our domestic animals is chemically identical with that of the human being. The fresh glands for administration are not always procurable, hence various pharmaceutical products of the fresh thyroid have been prepared. There has been great difficulty experi- enced in preserving its vital properties, for in either drying or desiccating them, it is lost. There is only one reliable method of preparation, and that possesses distinct and unique advantages over every other form of thyroid medication, and that is the ozonized glycerin ex- tract, prepared from c. p. ozone and glycerin, together with the fresh juice of the throid without heat or drying. In this 398 The Germicide 20th Century Practice form we have a splendid preparation, an unexcelled purified extract of the thyroid body, free from all extraneous sub- stances, uniform in strength, a permanent preparation which will keep in any climate, never decompose, well suited for in- ternal administration, mixes readily in water or cold beef-tea or soup, and can be taken by the most fastidious. The practical bearing of these facts amount to this : that in the administration of a remedy so potent, of an organic animal nature, having immense, inconceivable powers in constructing and reconstructing the human system; the energy of which is so far-reaching, as the very pillarizing of the human brain and increasing its capacity for intellectuality, great care and scien- tific skill must be observed. The pure ozonized extract of the thyroid gland positively cures myxedema, cretinism, idiocy, imbecility, insanity, feeble- mindedness, psoriasis and lowered state of the human body which calls for a renewal of life. The remedy is one of pro- digious power, and if given in the ordinary routine of life, its use will make the mind brilliant, ideas rapid, restores the memory, and retards or prevents the approach of age. It gives elasticity to the step, animation to the speech, quickens all the vital functions of the body ; renews mental as well as physical activity, reinvigorates, revitalizes. The dosage, generally speaking, and the one best adapted for cases generally, is from five to ten drops once a day, best admin- istered either in water, cold beef-tea, or any fluid food; and there must be no change made until there is a complete cure. Whatever the disease may be, it is thyroid juice all the time ; but all other animal extracts are compatible with it. For ex- ample, if there be a brain wreckage, kephalin, oats and thyroid juice can be given with success ; if there be heart failure, creat- min from the heart muscle can be given with small doses of thyroid; if the reproductive organs are blighted, impotency prevailing, thyroid juice and solution of spermin are admissible. GONORRHEA (The Gonococcus). — An irritation, inflam- mation of the mucous membrane of the urethra in the male, and vagina of the female, accompanied with a mucopurulent discharge, in which the gonococcus can be detected, is one of the most common affections of the present day, pervading some of the inmates of every dwelling. Therefore its etiological significance, its ravages and treat- ment, should be thoroughly familiar to every practitioner. and Dictionary of Diseases. 399 In making a diagnosis, we must not depend too much upon the pain in urinating, nor upon the mucopurulent discharge, nor upon other symptoms of inflammation, but rest upon a mi- croscopical examination of the discharge. The great danger of gonorrhea is that it does not remain localized, but migrates in men from the deep urethra to the epididymis, prostate gland, bladder, ureters, kidneys; in women, to the uterus, Fallopian tubes, ovaries, with their peri- toneal coverings, and to parts that would seem inaccessible. Early treatment, prompt, energetic, which should aim at the destruction of a germ in the urethra or vagina. After urinating, copious, antibacterial irrigation, with an ozonized distillation of eucalyptus, followed by the insertion of a thallin bougie; in women, vaginal injections of a solution of boroglycerid, to which peroxide of hydrogen is added, at least thrice daily. Internal medication should be promptly administered, and as the germ produces extensive devastation in the reproductive organs of both sexes, the best remedy the materia medica can afford should be given. For very many years the profession have depended upon bal- sam copaiba, sandal-wood oil, cubebs, kava kava, salol, petro- leum, and within the past year the balsam llaretta. This latter remedy is a high-graded germicide. A balsam derived from the Haplo pappus llaretta, which grows abundantly in the northern part of Chili. Indicated in gonorrhea and all dis- charges from either the male or female genital organs. Our readers are thoroughly conversant with the fact that in all maladies which owe their origin to a disease germ, mor- bid action is intensified on its passage from one race to another. The pathogenic microbe of gonorrhea is often the result of an evolution, the degradation of the elementary molecules of nutrition of the sexual organs. If we examine microscopically the mucus in the urethra of the masturbator we find it there ; also in the urethra of all men guilty of promiscous sexual inter- course; in the urethra of every man who has coition with a prostitute ; so in women who permit the embraces of numerous men. It is a germ that is very prevalent — 80 per cent of all the women who to-day are curetted, castrated, or mutiliated in some way, can be traced to the gonococcus. In the process of bacterial growth it evolves a toxin which has an affinity to all the white fibrous tissues of the body, the testes, thyroid, conjunctiva, synovial membranes, etc. In both 400 The Germicide 20th Century Practice sexes, the gravity of the affection is far-reaching; indeed, the destructive effects of the toxin of the gonococcus cannot be duly appreciated. Gonorrhea, then, is a grave affection, and merits prompt, energetic treatment. The first essential element is to kill the germ which is the factor of inflammatory action. For this purpose, after every act of micturition the urethra should be thoroughly injected or washed out with the following: Ozonized distillation of eucalyptus, one ounce ; water, three ounces ; mix. Use only as an injection. On or near retiring every night as long as symp- toms indicate, a thallin bougie should be inserted. Thallin is a deadly enemy to the gonococcus ; inserted into the urethra, per- mitted to dissolve, it penetrates into all the crypts and follicles of the mucous membrane, and kills the germ. The remedy for internal use must be one that is incapable of being used up therapeutically in digestion. Such a remedy we have in mistura llaretta, which should be administered in half teaspoonful doses every three hours. It is the best remedy we possess, being an active germicide, is passed in the urine in fine molecules, which, coming in contact with the gonococci, imme- diately kills them. This treatment is good, but it must be aided by the observ- ance of great cleanliness by frequent bathing of the affected organs in hot water, by rest, by keeping the bowels in a soluble condition with salines, and the urine alkaline. To aid in subduing inflammatory action, preventing erec- tions and chordee, it is well to give one or two doses of the green root tincture of gelsemium every evening until subdued. Gonorrhea in the Female. — A multiplicity of causes give rise to an evolution of various micro-organisms in the genital tract of the female, all giving rise to a mucopurulent discharge-, which in all cases is highly contagious and will produce the same discharge in the male if he happens to be a weakly subject. The old theory still holds good, promiscuous sexual inter- course, few women among many men, masturbation, immoder- ate sexual congress, vegetations, such as warts, eruptions due to errors in diet, ascarides in the rectum, and many other causes, as bicycle riding, all are productive of a degradation of the living matter of the parts and the evolution of the gono- coccus. Whether the pathogenic gonococcus be the outcome of a normal evolution, or due to direct contact, it is usually found in both the urethra and vagina, and too frequently it is permitted to migrate to the uterus and ovaries. and Dictionary of Diseases. 401 Gonorrhea may be taken from any woman, however virtuous she may be, provided the mucous membrane of her genital tract be altered or degraded by adverse states. The mucous mem- brane of the vagina of every woman who rides a bicycle is cap- able of communicating clap in sexual congress; it is a gono- cocci laboratory from which a weak man has no escape. The administration of the mistura llaretta is equally effective in the female as in the male. One teaspoonful thrice daily, vaginal injections of ozonized boroglycerid, warm and copious, are esteemed effective, followed by a pastil of either the boro- glycerid or nympha odorata. Either of these pastils stamps out of existence this disease disseminating microbe and pro- motes a renewal of life in the infected parts. GOUT. — Gout occurs with exceptional frequency in per- sons whose forefathers suffered from the disease, and it is thought that there is some hereditary defect in the cells of the progenitor, continued in the offspring through the ovule and spermatozoa. In gout there is an impairment of metabolism as regards nitrogenous matter — in an inability of the tissues to effect the complete destruction of albumin. Diabetes consists in the want of power of the tissues to ef- fect the combustion of sugar — to complete the transformation of the carbohydrates. The incomplete destruction of waste products loads the system with acids, which diminishes the solubility of uric acid and certain toxic agents, which give rise to albuminuria and nephritis. Whether gout be inherited or acquired, it is an inherent vice of nutrition, with demoralized liver and kidneys. This very inadequacy leads to the formation of uric acid. It is a diathesis with an abnormal state of the protoplasm, the outcome of a cerebral neurosis. Gout then is a nutritional disorder, associated with an ex- cessive formation of uric acid, and characterized by attacks of acute arthritis, in which the urate of soda is effused in and about the joints, and by the occurrence of irregular constitu- tional symptoms. Whenever this urate of soda is effused, symptoms of gout will be manifest. Sedentary occupations, curtailed physical exercise; cerebral depression ; digestive disturbance, a gnawing feeling in the stomach; lassitude, followed by a great increase of uric acid, and an accumulation of urates in the blood; all the white 402 The Germicide 20th Century Practice fibrous tissue of the body liable to have effused in or on them, especially in the small joints, urate of soda; ligaments, valves of the heart filled with the same deposit, also the membranes of the brain. Deposits of urate of soda are also found in the fine papillae of the kidneys, which give rise to interstitial nephritis, and al- buminuria. Among all men and women who eat largely of meat, drink freely of beer or wine, live sedentary lives, indoors, whose blood is insufficiently aerated, a gouty diathesis is created. The symptoms of this diathesis are protean in number, but may be briefly epitomized as follows : Occasional bilious attacks, with foul breath and tongue; constipation ; sallow skin, yellow conjunctiva, denoting a torpid liver; pain around the heart; darting pains in the joints and bones; a feeling of faintness and vertigo; heat, often itching in the skin, feet ; cramp in the legs ; periodical headache ; high-colored urine, strong acid reaction, albuminous. This may be all the time or periodically, or after an increase of symptoms. Sugar often found in the urine; great liability to the formation of calculi. In the treatment of gout, the patient must keep his skin ac- tive by daily sponging and prolonged massage ; warm flannel ; exercise in the open air; lead a quiet life; eat sparingly of plain but nutritious food ; avoiding all amylaceous substances, saccha- rine articles, salt meats, sweet fruits, hot bread and stuffing. Another but identical view of this disease is that it is a painful disease affecting principally the smaller joints, particu- larly those of the toes. It is usually hereditary, but is often acquired. As a rule, it is a disease of the latter half of life, but in hereditary cases may appear much earlier. The immedi- ate cause is an excessive accumulation of uric acid in the sys- tem, due to want of exercise, overindulgence in rich food and alcohol, and luxurious living generally. Gout, when it only affects the joints, is said to be regular; when it attacks the various organs it is said to be. retrocedent or irregular. Symptoms. — An acute attack is usually preceded by digestive disturbances, irritability, and scanty high-colored urine, but in many cases it comes on without warning, usually at night, by the sudden onset of intense pain in the great toe, which speedily becomes red, glazed, swollen, and smooth. At the same time there is some fever, constipation, and restlessness. and Dictionary of Diseases. 403 A disease in which uric acid is present in the blood and tis- sues in the form of sodium biurate. The formation of uric acid is in the liver, imperfect aeration of the blood; an excess of animal food and alcohol inflicts an injury upon the metabolic activity of the liver, equal to the toxin of malaria. The ozonized uric acid solvent, when ad- ministered, is a powerful stimulant to the liver and intestinal glands ; a cholagogue which diminishes the output of uric acid. The cause of gout is indigestion; the uratic deposits are re- sponsible for the symptoms, together with a failure of the kid- neys to eliminate toxins. Numerous are the morbid conditions due to the presence of uric acid in the blood, such as acute uritic arthritis, chronic uritic arthritis, uratic deposits, dysphagia from spasm of the esophagus ; dyspepsias, as cardialgia, gastrodynia, pyrosis, en- terodynia, palpitation of the heart and large vessels, irregular cardiac action, angina, chronic arteritis (aneurism) and phle- bitis ; laryngopharyngeal catarrh, bronchitis, asthma and dry pleuritis; chronic interstitial nephritis, primary renal gout, uratic gravel and calculi, cystitis and irritable bladder, prosta- titis; neuralgias, lumbago, sciatica, hemicrania, cramps of muscles, hysteria, hypochondriasis; ophthalmia, conjunctivitis, iritis, otitis, eczema, psoriasis, and vulvar prurigo and acne. GRAVEL. — There are three forms of gravel recognized : a hard, reddish-brown powder, or crystals of uric acid and urates ; a brown, hard, nodulated substance, oxalate of lime ; a white or gray powder, phosphate of lime. Red gravel consists of uric acid, sharp crystals, which cut, tear, lacerate tissues, give rise to hemorrhage. Uric Acid Diathesis. — Re'd gravel, due to degenerative changes in the tissues. It may be hereditary, peculiar type or conformation, monotony, isolation, sameness ; digestive trou- bles, excess of animal food, insufficient exercise, especiallv out of doors ; violent mental emotion, blows, wounds, disease with its destructive metamorphosis, favor its production. Much more prevalent among the inhabitants of cities and the rich than in the country; inactivity, excess of food, provoke its formation. It is a near relative to gout and diabetes. To an individual possessing this diathesis, a diet of beef, beans, tomatoes, a choice and unsparing cuisine, are most pro- ductive of it, besides wines, beer, ale, brandy, favor the ag- glomeration of uric acid in the kidneys. 404 The Germicide 20th Century Practice Irrespective of all causes, the want of sufficient exercise in the open air is the most worthy of notice, for if he does not oxi- dize the nourishment he takes, he must forever remain a suf- ferer. The formation of uric acid, its presence in the kidneys in excess of what the urine can carry off, leaves a deposit in the kidney which will give rise to pain of variable intensity in the kidney, bladder, urethra ; hence the danger of renal colic, hema- turia. Perverted nutrition invariably gives rise to uric acid, and if this is not excreted, gout or rheumatism is ushered in. The nitrites clear the blood of uric acid, dilate the blood-ves- sels, promote free elimination. The presence of a large percentage of uric acid in the blood will irritate any weakened tissue or gland, and give rise to an indefinite number of maladies. Gravel, Red or Uric Acid. — In health the urine is very slightly acid, but very nearly neutral; but when there is dis- ease, when the co-ordinating chemical centre is damaged or weakened, there is a perversion in nutrition, and the urine will be found acid. The acid diathesis, then, is a state in which the nerve-centres are impaired, and the starchy or saccharine ele- ments of the food are changed into uric acid instead of fulfilling the purposes of nutrition. Causes. — The causes that act upon the co-ordinating chemi- cal centre in producing this faulty condition of digestion and assimilation are numerous, as monotony of life, isolation, soli- tary confinement, sameness of diet and habits; mucous dys- pepsia, disease of the liver, and pancreas ; imperfect aeration of blood by skin and lungs; rapid oxidation of the fibrin of the blood, as we have in fever and inflammation; excessive mus- cular exercise ; the lactic acid of rheumatism is changed for the purpose of elimination into uric acid. Symptoms. — It is to be recognized by the persistent and more or less copious deposit in the urine of a brick-dust sedi- ment ; it may be only a few grains, and in some cases it is quite considerable. In mild cases it may not appear till urine has cooled ; in more severe forms, it is deposited at once. There is always associated with it depression of the nervous system, in some cases amounting to prostration; undefined sensations of irritation in the loins ; sometimes excruciating pain in the kid- neys ; nausea, vomiting, aching in the thighs ; retraction of the testicles ; irritation of ovary ; itching at the orifice of the and Dictionary of Diseases. 405 urethra; irritable bladder, with continence or incontinence of urine. The passage of the urine causes a burning or smarting sensation ; and when the uric acid crystals are large, a cutting, tearing sensation, as if particles of glass were being passed, with bearing-down and prostration. Treatment. — Special attention should be made to give the patient immediate relief, and this can only be done by the immediate administration of large doses of the green root tinc- ture of gelsemium and passiflora, following these with the uric acid solvent and the removal of causes. Gravel, White, or the Phosphatic Diathesis. — This is a cachexia in which the urine is persistently loaded with phosphates and chlorides, which are deposited in the form of a floury mass, or white, gritty substance, calcareous in its character, called white gravel. The urine may or may not be alkaline. When human urine becomes alkaline, it is due to one or other of the following conditions : To excess of the alkaline carbonates of potassa and soda, which is apt to occur after a meal, especially of fruit and vegetables; to excessive elimina- tion of the phosphates, as in brain and bone waste; to the formation of ammonia in the urine from decomposition of urea. The reaction of the healthy urine in the twenty-four hours is slightly acid; but if separate samples are taken at different intervals, great variation is observed; and these are constant. The acid reaction increases and diminishes, commonly, with the secretion of gastric juice, — acid before a meal, alkaline after and during digestion. This is called the alkaline tide, and may be caused by the entering of newly-digested products into the blood, or a preponderance of alkaline bases in articles of diet. There is another channel by which acid is withdrawn from the blood besides the gastric juice secretion, and that is by the lungs. The exhalation of carbonic acid gas by the lungs is increased by food and the conscious state, and diminished by fasting and sleep. The urine need not, however, be alkaline, in the phosphatic diathesis; it is sufficient, in order to constitute this condition, that there be an excessive elimination of brain elements, that it be loaded with phosphates, the metamorphosis of such tissue. Causes. — Cerebral exhaustion, shattered nervous system, nervous disease, nervous dyspepsia, chronic disease, irritation transmitted, study, worry, gout, sexual excesses, etc. Symptoms. — The general indications are those of an intense 406 The Germicide 20th Century Practice nervous temperament ; white skin ; sharp features ; emaciation ; some chronic or nervous disease. There is no pain or irritation whatever ; hence it is often unobserved by the patient ; so there are few symptoms but the amount of gravel present in the urine each twenty-four hours, which, grain for grain, represents so much waste of brain-tissue, just as the uric acid represents fibrin, muscle, etc. If the alkaline condition be present, it is due to two causes : either from the presence of the carbonate of a fixed alkali (potash or soda), or of the alkaline phosphate of sodium ; or from the presence of the carbonate of the volatile alkali, ammonia, which is due to the decomposition of urea. The white gravel that is deposited in the last, the decompo- sition of urea, is formed as follows : Healthy urine contains phosphate of magnesium in a state of solution; if the urine becomes alkaline from decomposition of urea, a portion of the ammonia combines with the phosphate of magnesium and forms a triple salt, which is insoluble in the urine. This triple phosphate is usually an admixture of phosphate of lime. Urine of this kind, being allowed to settle, a scum forms on its surface, which, under the microscope, resembles the salts we have de- scribed. But the urine may become alkaline from the presence of the carbonate of potassa or soda, and then, no ammonia being present, instead of the triple salt, there is a deposit of amorphous phosphate of lime. In these cases the urine is generally alkaline, pale, copious, slightly turbid, of a low spe- cific gravity, and of a peculiar odor. In these cases select ozone water alternated with kenhalin granules, then use in alternation nitromuriatic acid and cinchona. GRINDELIA. — The entire herb Grindelia robusta, which grows in California, is used. Therapeutic Uses. — Possesses strong bactericide proper- ties, which render it of great value in all microbial affections of mucous membranes, as whooping- cough, asthma, bronchitis, ophthalmia, leukorrhea, uterine catarrh. Preparations and Doses. — Fluid extract is the best form for general use. Doses, variable from 10 to 30 drops and upwards. GROWING PAINS.— Are supposed to exist when the osseous system grows more rapid than the muscular. This condition is common in our large cities, where bony nu- trition is defective owing to the phosphates in bread being de- stroyed by alum and ammonia. and Dictionary of Diseases. 407 Myalgia from fatigue : this is the commonest variety, usually about the knees and ankles after unusual exertion. They are probably due to auto-infection brought about by excessive pro- duction of effete materials in the blood and their inefficient elimination. Elevating the limbs and rubbing with the palm of the hand in a direction towards the heart, relieving venous stasis and facilitating a supply of healthy blood to the exhausted muscles promptly quiets the pain. Rheumatism : this is second, if not first, in frequency. There are slight pain in the joints, little or no swelling, and very mild fever, and hence the true cause is recognized; but rheumatic, endocarditis frequently develops in these cases. Diseases of joints and bones of the lower extremities : Cases of hip-joint disease and suppurative epiphysitis of the upper end of the fibula, diagnosed by the laity and allowed to go on untreated, are related under this heading. GUAIACOL. — A bactericide isolated from creosote, a strongly refractive, oily, colorless, limpid liquid, of an aromatic odor, soluble in 200 parts of water, especially destructive to the tubercular bacilli, and has the remarkable property while being taken of augmenting vital force. A most eligible method of administration is as follows : Guaiacol, 15 grains; alcohol, 8 ounces; fluid extract American columbo, 1 ounce. Mix. Dose: from 5 to 15 drops added to water after meals, which can be gradually increased; it kills the bacilli as an inevitable result, a disappearance of cough, hectic, sweats, emaciation with a remarkable increase of appe- tite. A splendid remedy with which to alternate the glycerite of ozone. The guaiacol mistura ozonized is the best form in which to administer it; this is composed of guaiacol, glycerin, Ameri- can columbo, and dioxide of hydrogen. This preparation is of inestimable value in every case of tu- berculosis. Its antagonism to that germ is well known, and its power in eradicating it from the blood and tissues duly appre- ciated. A germicide capable, when administered, of rendering the whole body unfit for microbic growth, soon becomes appre- ciated by the profession. My experience with mistura guaiacol in typhoid fever has been quite extensive, and in every case most salutary, for be- sides killing the bacillus in the intestinal glands, neutralizes the toxins, it exercises a remarkable influence over nutrition, di- gestion and assimilation. 408 The Germicide 20th Century Practice Mistura guaiacol has a remarkable influence on the vital forces of the body, enabling them to resist the evolution and growth of disease germs; it has a direct inhibitory action on all bacteria. Take it all in all, it is very doubtful whether in the entire materia medica we have a remedy equal in value to the guaiacol suppository in the treatment and cure of tuberculosis. First unload the rectum, thrice daily, with small enemata of some nutrient fluid, and as soon as passed insert and retain a guaiacol suppository. Its steady, persistent use soon, very soon, ren- ders all the solids and fluids of the body untenable for either the bacillus of tubercle or its toxin. It is a perfect annihilator of the germ; hence cough, hemoptysis, night sweating, diar- rhea, wasting, etc., rapidly disappear, followed by reconstruc- tion of vital force. Even inhalation in severe causes must not be overlooked. GUAIACUM. — Fluid extract prepared from the resin is of great efficacy in the destruction of the amylobacta of rheuma- tism. A decoction of the wood administered freely is also a germicide and diaphoretic, valuable in rheumatism. GUARANA. — The seeds of Paullinia sorbilis, growing in Brazil. Chemistry. — It contains an active principle called guaranin, which is identical with caffein, tannin, gum, extractive matter. Therapeutic Uses. — Being a powerful nerve stimulant, it is valuable in nervous or anemic headaches; its astringent prop- erties render it of efficacy in diarrhea and dysentery. The best preparation is a well-prepared fluid extract in doses of irom 10 to 30 drops as indicated. The elixirs have little medicinal property, but contain chiefly bad whisky. HABITS. — Man has both instinctive and moral faculties, and is in addition a creature of habit, with too often a perverted appetite to the use of alcohol, tobacco, opium, chloral, arsenic. In the eradication of these states of perversion, absolute control of patient is necessary to success; then diminish dose by dose without the knowledge of the patient, and substitute coca with tincture of oats or full doses of passiflora incarnata, alternated with cerebrin, with two hours' massage morning and night, followed by electricity. and Dictionary of Diseases. 409 Success is promoted by correcting abnormal condition of di- gestive functions by appropriate remedies. It is most im- portant to keep patient well nourished. Habits are becoming fearfully common throughout our en- tire country, the largest proportion of which are caused by a want of thought on the part of the attending physician. There is a numerous class of neurotic people for whom the physician cannot prescribe alcohol, morphine, chloral, cocain and similar drugs without the danger of starting a habit, which eventually terminates in a disease. Sensitive, weak people, full of pains and aches of a fugitive and erratic character, suscep- tible to the slightest fluctuations of temperature, atmospheric changes, etc., with minds always dwelling on their infirmities^ soon discover that such a prescription lends them artificial, un- real strength, a deceptive feeling of well-being. They are un- able to reckon the cost, and even if they were made to under- stand that the sense of strength and calmness, or exhilaration, is temporary, due to a physical illusion, produced at the ex- pense of vitality, are often so reckless or so helpless that they will not forego the habit. A physician thoroughly cognizant of man's instinctive and moral nature locates all the trouble in the great sympathetic. Clinically it has been very extensively tested that if a half or more of a teaspoonful of ozonized passiflora were administered with the habit- forming remedies no habit would be formed. No craving would exist, and even if formed would be blotted out. The coming remedy of the twentieth century is to be ozo- nized tincture of passiflora incarnata in every prescription ; for every disease to which the human body is susceptible it will be given. No matter what the malady may be, passiflora is indi- cated to vitalize the great sympathetic, the seat, to obliterate all neuroses. HAMAMELIS. — The bark and leaves of the Hamamelis Virginian a, which grows in Canada and the United States. Therapeutic Uses. — Possesses invaluable astringent, styptic properties, and is useful in hemorrhages from mucous mem- branes, as in epistaxis, hemoptysis, hematemesis, menorrhagia, hemorrhoids, hematin bruises, wounds. Preparations and Doses. — Fluid extract in doses of one or two drams. The ozonized distillation of the green leaves contains all the 410 The Germicide 20th Century Practice "hazelin" of the witch-hazel; the volatile principle, a clear, elegant and efficacious product, is unequaled for contusions, sprains, swellings; its properties are highly germicidal, ano- dyne, sedative, styptic, tonic, astringent- — also used internally. The ozonized distillation excels all other preparations. HARELIP. — Harelip is one of the commonest of congen- ital deformities, due to alcoholic conception, and takes its name from the resemblance to the cleft lip of the hare, with the differ- ence, however, that in the latter the cleft is always in the middle of the lip, whereas in the child the cleft is to one side or the other of the middle line. Harelip is frequently associated with the condition known as cleft palate, and probably the ori- gin of the deformity is the same in each case. The principles on which the success of the operation depends are simple. The edges of the cleft must be pared, so that when brought together the raw edges may unite. These edges must be brought together so that the red line of the lip is continuous. During healing the parts must be kept perfectly at rest. The raw edges are usually kept together by means of long pins which pass from one side to the other of the wound. The ends of these pins project out of the skin, and are kept in position by means of catgut, or other forms of suture, which is passed over each projecting end from one to the other in figure-of-8 fashion. Outside all, the parts are drawn together by means of a long strip of plaster passing from cheek, to cheek. After the operation the child is able to feed by suction, and it is advisable that the mouth should be opened as little as pos- sible. If the child be not an infant, care must be taken to pre- vent it from meddling with the pins, etc. In order to do this it is even found at times necessary to tie the child's hands in such a manner as to make it impossible for it to touch its mouth. The harelip pins should be removed on the second or third day after the operation ; if retained any longer they give rise to a furrow in the lip which is afterwards followed by a scar. The stitches may be left in a clay or two longer. When removing the pins the surgeon usually takes care not to disturb the figure- of-8 ligature, for this becomes encrusted with blood and ad- herent to the lips, and thus helps to hold the parts in position. The strap of sticking-plaster is kept on until complete healing has occurred— that is, for about a fortnight. HAY FEVER OR ASTHMA (Bacillus Subtilis).—So- -called hay fever, because the pollen of certain grasses, coming and Dictionary of Diseases. 411 in contact with the periphery of the olfactory nerve in the nose and sinuses of the head, Eustachian tube, lachrymal duct, give rise to altered nutrition, a degradation of primary elements into other living matter, a disease germ. In every case of hay fever there exists in the affected indi- vidual a predisposition, a neurasthenic condition which permits of the pollen exciting, evolving this peculiar bacillus. The recognition of hay fever is easy; there is an intense pov- erty of nerve force, a perfect state of neurasthenia; then the season and susceptibility, hay, roses, grapes, ragweed — general languor, "lassitude, debility, headache, sneezing, lachrymation, goneness, cough, wheezing, bronchial irritation, pyrexia, gen- eral disorder of the whole body. In microscopical examination of the nasal discharge the ba- cillus subtilis is seen in the form of cylindrical rods of variable lengths and breadths. Originally they appear as threads, which become developed into rods and cocci. They are motile and provided with a flagellum at each end. Precisely the same microbe can be obtained from an infusion of hay, or dog-grass, which can be isolated, and will grow pro- digiously in any nourishing medium, by spore formation and division by segments. The microbe is pathogenic of hay fever or asthma; bears cultivation well in any vegetable infusion. The inoculation of the cultures or their hypodermic injection into animals pro- duces the disease. . The germ in its growth in individuals greatly broken clown excretes a ptomain of a very toxical character, which gives rise to great constitutional disturbance. To sterilize and completely annihilate this bacillus there must be a union of different forms of bactericides, as it is often impossible to move patients from the sphere of contagion. An excellent plan is to sterilize the lining membrane of the nose by the introduction of jelly of violets, painting it on the interior of the nose or a few grains can be dissolved in tepid water as a douche, or by painting the parts with resorcin or thymol jelly, or ozonized iodine ; or inhalations of menthol, or thymol. Bactericides internally should be administered so as to ster- ilize the blood, thus prevent spore evolution; the best reme- dies for this purpose are the distillation of the pine needles : nitroglycerin ; nitrite of amy! ; comp. syr. tolu ; sulphate of spartein ; euphorbia pilulifera ; pyridin. Apply the jelly of vio- 412 The Germicide 20th Century Practice lets in all cases. Although the jelly of violets, which is incom- parable in its action, relieving and curing the worst cases, even when the eyes and nasal organ are badly affected, and in old chronic cases of ten or twelve years' standing, it is a specific. HAZELIN. — The actice principle distilled from the Hamamelis virginiana by the aid of ozone gas gives us a re- markable germicidal remedy, and a tonic, and hemostatic. This ozonized preparation is a pleasant, slightly acid, clear, fragrant liquid, and is soothing, cooling, bland, astringent, and kills all microbes with which it is brought in contact. One of the best, non-irritating germicides that can be used in any form of nasal catarrh. As a mouth wash and gargle for aphthae, nothing can excel it. It has a softening, healing influ- ence on the skin, and is excellent for bleaching all cutaneous discolorations. In all forms of ophthalmia, as a local antiseptic, its action is unexcelled. Under its use, diluted with an equal part of water, poured on absorbent cotton, kept constantly wet and applied to the eye, pain, intolerance of light, redness, mucopurulent dis- charge, cease ; it acts promptly, most admirably. It annihilates bacteria, whenever brought in contact with this microbe. If the erysipelas blush is kept moist with it, the germs as they appear on the skin are killed. It is well known that in embolism, thrombosis, phlegmasia dolens, membranous dysmenorrhea, the blood of the affected individual is germ-laden with bacteria, and that the old treat- ment with belladonna and preparations of potassa to keep up the fluidity of the blood is entirely superseded by the internal and local use of this never-failing germicide. It is this action which renders it so valuable in piles ; indeed, its utility in vari- cose veins, varicocele, if its use is persevered with, all varicosi- ties are permanently and effectually removed. Its astringent properties are much superior to ergot or digi- talis in hemorrhage, either from the lungs or uterus. As a dressing to wounds it is of very decided value, invari- ably promoting union by first intention. HEADACHE. — Headache depends on many causes : nerv- ous is the most common, dependent on a poverty of nerve force ; congestive, due to worry, overwork, exhaustion, stooping ; bil- ious, from impaired action of the liver; microbial, due to in- haling germ-laden air, as sewer-gas; reflex, as irritation in and Dictionary of Diseases. 413 stomach, bowels, liver ; anemia, exhaustion from loss of blood ; cerebro-spinal anemia, a sensation as if a nail was being driven into the head. Regulate all secretions; daily alkaline bathing; use the shower-bath; flannel clothing, nourishing food, avoidance of brain tension or worry. After cause has been removed, select special drugs to meet the different forms, as passiflora; nitroglycerin; nitrite amyl; coca wine ; cinchona ; gelsemium ; guarana or caffein ; aconite ; belladonna; sambul. The periodical recurrence of headache with many persons is a grievous affliction. Those who suffer from it should correct every habit and avoid all indiscretions which they know are likely to be followed by an attack. They should also overcome every derangement of the system which exists, if possible, and strengthen every part and function of the same. In fact, they should treat at first not the head and its aches, but endeavor to build up the general health. In the attempt to do so they must not indiscriminately dose themselves with drugs, but rather depend upon pure air, exercise, sufficient sleep, good, wholesome food, and other measures of like character. One of the greatest essentials in treatment will be a careful selection of diet and a rigid restriction to those articles of food which, in their experience, have proved the least burdensome to their digestive organs. There is no dietary which is alike suited to alL Each must learn what, and how much, is proper for him or her to eat, and what should be avoided, and those substances which are known to be difficult of digestion should never be indulged in. While careful not to tax the stomach, they must keep the bowels active. If constipation exists, head- aches are quite certain to occur. Under this simple treatment, if properly employed and per- sisted in, many who are victims of sick headaches will suffer less often, or escape entirely, those distressing visitations. Perpetual headache — a headache which can be readily con- founded with true migrain, as there are paroxysmal exacerba- tions, although there is no vomiting or nausea. The headache is generally localized in the frontal region, rarely in the temples, vertex or occiput. The trouble possesses none of the character- istics of syphilitic headache. It is more frequently found in women than in men, and is generally associated with neuras- thenia. Give in such cases periodate aurum on retiring and be- fore every meal a kephalin granule. 414 The Germicide 20th Century Practice HEART, THE. — The heart is the central organ of the cir- culation, is placed obliquely in the chest, the base upward, the point, or apex, being so situated as, in the liv- ing body, to strike the side of the chest, or beat, be- tween the fifth and sixth ribs, about two inches below the left nipple ; this point, however, and indeed the position of the heart generally, is liable to alteration according to the position of the body. The size of the heart is generally computed to be a little more than that of the closed fist of the individual; the organ is contained in its own proper bag, or pericardium, which in the healthy state is lined by an extremely smooth moistened membrane; this membrane is also reflected or carried over the surface of the heart itself; and thus during the constant mo- tion the two surfaces glide easily and without friction over each other, the heart lying sufficiently loose in its bag to permit of free movement. The heart is often described as a hollow muscle; it consists of four cavities, surrounded by muscular walls, and is, in fact, a double heart, this being requisite for the performance of the double circulation — through the body and through the lungs. Of these four cavities the left auricle and ventricile are devoted to the circulation of the blood through the body after its return in a purified state from the lungs ; the right ventricle and auricle being devoted to the lung circulation. The course of the circulation may be traced through the great veins, which ultimately terminate on the right side of the heart in the right auricle ; the blood then passes into the right ventricle, from which it is propelled through the pul- monary artery into the lungs, where, coming into contact with the air, it becomes arterialized or purified ; it is afterwards re- turned to the left side of the heart to be propelled by the left ventricle to all parts of the body, through the medium of the large blood-vessel, the aorta. The auricle and ventricle on the right side of the heart have not, when properly formed, any communication with the cor- responding cavities on the left side ; but the auricle and ventricle on each side are separated from each other, and from the blood- vessels with which they are connected, by means of valves — so arranged and governed in the motions of the heart that the hlood can only pass in the right direction when the valves are in a healthy state ; but should these valves become diseased in any way, the proper currents of the blood are interfered with, and disease is the result. Thus the passage from the great blood-vessel, the aorta, to the heart is closed by three "semi- and Dictionary of Diseases. 415 lunar" valves, which allow the blood to pass freely into the ves- sel, but should it attempt to return, these bag-like valves in- stantly close the passage — the blood itself acting as the closing agent — and this action takes place once for every beat of the heart. At every contraction of the ventricles the heart raises itself somewhat, its point presses forward and moves slightly from left to right, and also twists from left to right, owing to the spinal course of some of the heart fibres. Like any other mus- cle the heart becomes harder during contraction, and its length is diminished. When the heart is listened to two sounds are heard, which are called the first and second sounds of the heart. The heavy sound heard at the moment of the heart-beat is the first sound ; the sharp, clicking sound which immediately follows is the second. The first sound is caused by the closing of the mitral and tricuspid valves, by the contraction of the muscular sub- stance of the heart, and by the impact of the heart against the walls of the chest. The second sound is due to the closure of the aortic and pulmonary valves after the contraction of the ventricles. The average rapidity of the heart's beat is about seventy pulsations to the minute in the male, seventy-five to eighty in the female; but this is subject to considerable variation with age, etc., under various circumstances. In childhood the pulse is more rapid. Exercise, postures demanding exertion, such as standing, increase the rapidity of the heart's action. The nerves of the heart have been a subject of interest with pathologists. They are derived chiefly from the ganglia of the great sympathetic, a few only coming from the pneumogastric, but these latter seem rather to inosculate or communicate with the plexuses of the former than to directly supply the texture of the organ. The cardiac ganglion seems more particularly to preside over the actions of the heart, or to reinforce with ad- ditional energy whatever it may receive from other sources, especially from the centre of the ganglial system, and the other ganglia in the neck and chest. These nerves supply the sub- stance of the heart in two ways: 1. There are numerous branches which proceed from plexuses directly to the muscular texture, and which, dipping between the fibres, give off minute fibrillje to the muscular fibres next to them in their descent into the substance of the heart. 2. A large "portion of the cardiac nerves form a reticulum around the coronary arteries. A part of these follow the arteries to their distribution; but before 416 The Germicide 20th Century Practice these arteries are ramified minutely, a part of the nerves sur- rounding them is detached to adjoining tissues, so that all the nerves reticulated around the coronary arteries do not accom- pany them to their ultimate distributions. The actions of the heart may reasonably be referred chiefly to the influence which the ganglial nervous system bestows on the muscular structure of the organ. The principal organic diseases of the heart include pericar- ditis, endocarditis, valvular disease, dilatation, hypertrophy and degenerations. Pericarditis, or inflammation of the pericardium, is a very serious complaint. It arises in the course of acute rheumatism and Bright's disease, or from exposure to cold and damp, or, in rarer cases, it may be due to injury. Symptoms. — Great pain and tenderness over the heart, in- creased by pressure, so great that the patient is unable to lie upon his left side. The heart acts more frequently. Palpita- tion is common. There is great depression, and the counte- nance expresses alarm. The neighboring pleura also often be- comes inflamed, so that some symptoms of pleurisy — cough, acute pain at each inspiration, etc. — are present. Fluid, often in large quantity, collects in the pericardium around the heart, and may cause visible bulging over the cardiac area. Treatment. — Rest and quiet. Warm moist applications to the chest. For the pain, give passiflora in large doses with glycerite of wintergreen. The diet should be nourishing (with stimulants if necessary. ) No other medicines are of use in the acute stages. Later on tonics are needful. When a large amount of fluid is present, it may be necessary to tap the peri- cardium. Endocarditis {Micrococcus) . — In all forms of inflamma- tion of the internal lining membrane of the heart, whether the original cause be gout, rheumatism or some grave depressing passion, there is usually a disease germ present, which possesses great powers of reproduction. The presence of this germ in all cases of endocarditis is recognized by the following landmarks: irregular action of heart, great difficulty of breathing, palpitation, irregular pulse, pain and uneasiness about the heart. After death the streptococci are found upon the thickened valves of the heart — they are seen in the form of small chains, linked irregularly together; later on they assume the form of zooglea, and are found congregated together, and form plugs and Dictionary of Diseases. 417 in the muscular substance of the heart. In the detritus of the ulceration which follows they are found in chains. When the sympathetic system is greatly shattered this germ assumes great microbial growth, engorging the entire muscular structure, causing abscess and other grave changes. The micrococcus is most difficult to sterilize or annihilate; spartein, passiflora, adonidin, strophanthus cause the germ to wither and die. Endocarditis, or inflammation of the internal lining mem- brane of the heart, is most often a complication of acute rheu- matism and Bright's disease. Symptoms. — Palpitation, rapid pulse, some fever, and dif- ficulty in breathing. The valves of the heart are often attacked and the normal sounds of the heart are altered. Treatment. — Warm applications or even counter-irritants; rest ; quiet ; sedatives, passiflora. Atrophy of the Heart. — A condition in which there is a decrease, a diminution in the weight and size of the whole or- gan, easily recognized by vertigo, increasing debility, very fee- ble action ; sounds almost inaudible ; area of dullness much less than normal; pulse almost imperceptible; slowed respiration; lowered heat ; syncope ; heart failure. The principal nerve supply being from the great sympathetic and pneumogastric, the influence of toxins, great mental de- pression, shocks and concussions should be well guarded against. In either atrophy or hypertrophy of the heart-muscle, if not cured, the sequel is fatty degeneration. Before and during the efforts at cure, all cardiac depressants, such as tea, tobacco, beer, sexual congress, worry, fret, must be strictly forbidden, and the aim of all treatment should be increased nutrition, rest and thrice daily massage, which dilates the blood-vessels, imparts tonicity to the organ — rich diet; light, easily digested; so that it be readily assimilated. To stimulate the nutrition of the heart, locally keep a guaia- col plaster over the region of the heart twelve hours out of the twenty- four; internally, either nitroglycerin alternated with creatinin, the muscle alkaloid or kephalin granules. To increase muscular growth, thyroid extract of the lamb, protonuclein and c. p. solution of spermin are of undoubted ex- cellency ; but the dose must be small and guarded with an ex- perienced hand. Occasional doses of dioxide of hydrogen and pellets of cac- tus grandiflorus must not be overlooked. If a toxin or pto- 4-i8 The Germicide 20th Century Practice main be suspected, as lead, mercury, syphilis, auto-intoxication, the action of iodide potass is most salutary. Arsenic, Fowler's solution, cacodylate of sodium, small doses, bracing to the muscle-fibres ; spartein also good. Hypertrophy of the Heart. — A most common condition, due to overestimation, excessive nutrition; organic disease of the kidneys, and its entire substance is greatly increased in bulk and weight over the normal standard. Easily recognized by the frequent, audible and visible sounds; bulging of the pre- cordial region; numbness of left arm; area of dullness in- creased; plethora, florid face; action of heart accelerated; vertigo, apoplexy; increased respirations and temperature — a permanent increase in the force and activity of the organ. If the action of the heart be regular, fatty degeneration has not supervened, and a favorable prognosis may be entertained. To effect this abolish all cardiac depressants, as tobacco, tea, beer; avoid all excesses, especially sexual; all ebullitions of pas- sion, or any kind of mental excitement or strain. In inordinate growth, enlargement, a liberal diet and rest must be enjoined. As the nervous supply of the heart is largely from the sympathetic, passiflora should be administered with a liberal hand and combined with every remedy, on ac- count of its purely sympathetic action. If digitalis is adminis- tered to contract, diminish the force and frequency of the heart-beats, give it with passiflora; if strophanthus is given to repress its irritability and ascites, combine it with that remedy. The heart naturally increases in size with advancing years, but the increase is not considerable, and is not regarded as a dis- ease. Hypertrophy is simple when the muscular walls are in- creased in thickness, and there is no other change in the organ. When at the same time there is no expansion or enlargement of one or more of the cavities, whose walls are hypertrophied, it is eccentric hypertrophy, or hypertrophy with dilatation. Some recognize a concentric hypertrophy, or an increase in the thickness of the cardiac substance and a diminution of the cor- responding cavity or cavities. But the better opinion is that this diminution is not the result of disease, but announces that natural contraction, more or less complete, was the last act of cardiac life. The internal cause of hypertrophy is an increase in the number of muscular fibres in the cardiac walls, and not an increase in the size of the original fibres. Cardiac hyper- trophy is analogous to the enlargement of the blacksmith's and Dictionary of Diseases. 419 arm or turner's leg : new demands made on its strength produce a multiplication of its muscular fibres. The cause of this enlargement is generally some obstacle to the circulation, requiring increased strength of muscle to over- come it, as a diseased valve, or a tumor pressing upon a large artery, or a large organ so diseased that the circulation through it is seriously obstructed. It is produced by the mental emo- tions, which increase the force and frequency of heart-beats, as frequent anger and the anxieties that excite the heart (some depress its action), and, it may be added, by causes that have not yet been discovered. Its subjective manifestations are a strong impulse of the heart-beat, which, however, may be very strong and never be noticed by the affected person, and short- ness of breath on exertion, and very little else. The physician discovers it by many signs, chief of which is the extension of dullness on percussion to the left of the line already given as the left boundary of the healthy heart. The heart, once en- larged, never returns again to its original size, and alone it rarely causes death. This usually is the result of secondary disorders (apoplexy or kidney disease), or it may wait for the intercurrence of other entirely distinct diseases. Hypertrophy, increase in size, as well as in the multiplication and thickness of its muscular fibres, due to overestimation, must be carefully diagnosed from enlargement or expansion of its cavities, hypertrophy with dilatation. The great danger of an enlarged heart, induced either by ex- cessive exertion or beer drinking or such like causes, is degen- erative changes in the kindeys with albuminuria. The presence of uric acid in the blood and tissues gives rise to a group of disorders far-reaching and grave, for it invariably gives rise to atheromatous changes in the blood-vessels, contrac- tion of the arteriole, and is a prime factor in the production of enlarged heart. The contraction of the arteriole varies with the amount of uric acid in the blood. All beer drinkers have enlarged hearts. Discard digitalis and strophanthus, heart constrictors ; success in all cases is cer- tain with the following: Either five grains or five drops of a solution of nitrate of sodium three times daily, in alternation with a full half-teaspoonful of passiflora incarnata between each dose. Cases in which the uric acid diathesis predominates greatly, a teaspoonful of the solvent thrice daily in which either the nitrate of sodium or passiflora can be given. 420 The Germicide 20th Century Practice Dilatation of the Heart is an enlargement of its cavi- ties. The left ventricle may be so dilated that its capacity is considerably greater than would be sufficient to contain the whole of a healthy heart. The dilatation may be in all of the four cavities or may be confined to one. The ventricles are far more liable to dilatation than the auricles, and the left much more than the right. Dilatation and hypertrophy very com- monly go together, so that eccentric hypertrophy, or hyper- trophy with dilatation, already explained, associated with and caused by morbid changes in the shape and function of the valves, is the most common form of heart disease. The condition of the heart may be regarded as alternately ac- tive and passive — active in systole, passive in diastole. If in the passive state, while the blood is flowing naturally into a heart cavity, there is at the same time a reflux of blood into the same cavity in consequence of a defective valve, dilatation of that cavity will be sure to occur. The extended wall of such a cavity may not be thicker than it is in health, yet as it bounds a greater space it will require more material, and is hypertro- phied by multiplication of the muscular fibres. In this state the heart has been known to weigh sixty ounces, or six times its natural weight. They are almost always found in persons who have had rheumatism and heart disease in childhood, and have grown to manhood with a damaged heart. It is noticeable that children bear these cardiac affections better than adults. The body, as it grows, seems to accept and tolerate an amount of such disease that would overwhelm a grown-up person. When it begins thus early it is usually carried to manhood, and often to advanced manhood. It is the repetition of the attack which is fatal in childhood. Dilatation with hypertrophy is, after it reaches a certain stage of progress, attended by shortness of breath on exertion, sometimes palpitations, irregular heart-beating, and conse- quently irregular pulse. Its chief danger is, however, an in- duced or secondary Bright's disease, with dropsical swellings of the legs and body, without which the common forms of heart disease are not generally fatal. There is a form of dilatation of the heart in which there is not only no hypertrophy, but in which the walls of one or all the cavities gradually grow thinner and thinner by fatty degeneration and by absorption of the muscular tissue, till this tissue is almost wholly removed, and the walls are stretched and expanded in the effort to expel the blood from their cavities. and Dictionary of Diseases. 421 Valvular Heart Disease. — The cardiac valves may be at- tacked by inflammation and become thickened or ulcerated. The valvular opening may become narrowed, and the valve work imperfectly. As a result, the following symptoms may be present : Headache, digestive disturbances, congestion of liver, congestion of the kidneys, piles, fainting fits, apoplexy and dropsy. There is also oppression of breathing, either pallor or lividity of the face, and depression of spirits. On auscul- tation the heart's sounds are found to be altered in character, and these changed sounds or murmurs enable the physician to determine the valve affected. As a result of valvular disease extra work is thrown upon the heart, and it therefore enlarges or hypertrophies. When the extra work is too great the cavi- ties of the heart often dilate and their walls get thinner. Hence dilatation of the heart, which is characterized by a failing and feeble circulation and great exhaustion. Heart Failure. — The male and female sexual systems, the entire reproductive and urinary apparatus of both sexes, de- rive their principal nerve supply from the general reservoir of the great sympathetic, on which depends the performance of all vital functions. The heart, stomach, intestines, also larynx and lungs, in all civilized men, derive an abundant nerve supply from the same source. Drain oft this nerve supply by grief, worry, care. Exhaust this nerve supply by sexual excesses, masturbation, with its sequel spermatorrhea, and there is at once a want of nutrition from the sympathetic and a failure on the part of vital organs, especially the heart. The weakness of the heart-muscle is visible in the unsteady gait, in the bloodless brain, in the vertigo; the cold, clammy hands and feet : the cold, moist skin ; in the weakness of all the tissues; in the greater frequency of varicocele in all mastur- bators and libertines. Heart failure is becoming exceedingly common among both young and middle-aged men, and should in all cases receive prompt attention by checking off all seminal losses, which are productive of cardiac disease. In the adaptation of remedies for the cure of heart failure, nervous insufficiency, we must bear in mind that the special nerve force which presides over the circulation of the blood is furnished by the vasomotor system. This part of our ner- vous organism is formed by the intermingling of fibres from 422 The Germicide 20th Century Practice both the cerebrospinal and sympathetic system, so that the heart and circulation of the blood is subject to this influence. Every possible cause must be removed, and every effort made to brace up the cardiac nerves, physical and mental rest or re- pose enjoined; no care, no worry; nutrition increased; sexual congress, tea, tobacco, alcoholic drinks rigidly forbidden. Local stimulation over the region of the heart and cervical portion of the spinal cord persistently maintained. We will briefly enumerate a few of the newer remedies, which clinical experience has demonstrated to be of utility in heart failure, and which have a remarkable action for good upqn ; a weakened heart. The thyroid extract is of undoubted efficacy in heart failure. This secretion lies at the very origin of organic life, the vital element of all the tissues of the body. The more thyroid ex- tract that is carefully and cautiously administered and assimi- lated the greater the activity of life. It is this secretion which stimulates the heart, rouses up the pink marrow, to elaborate more red blood. Great care must be exercised in its exhibi- tion, small doses frequently repeated. A human heart, abundantly covered with a well-developed sympathetic nerve, subjected to chemical analysis, contains a very large amount of alkaloidal substance termed creatinin. In the heart of a sexually-exhausted man there is found little if any of this vitalizing body. Unassailable chemical evidence shows this. Besides, there is an atrophied condition of the sympathetic. In other words, he is soulless. Nerve and car- diac nutrition are demanded. The thyroid extract stimulates the evolution of the organic cell. The heart-muscle owes its intrinsic activity, its perfect growth to creatinin; its nerve supply to kephalin. The paucity of creatinin in all animal hearts has been well attested. The white meat of the quail and pheasant contains an immense supply of this substance, and should be freely eaten by every one suffering from heart failure, as it strengthens the heart in a remarkable degree. Kephalin should not be overlooked. Its exhibition reaches the immense ramifications of the great sympathetic in the chest and abdomen, and will always be. found a good remedy in car- diac neurasthenia. • Ferratin, animalized iron extracted from calves' liver, is one of the very best of remedies for building up the hemoglobin of the blooc}- .It is of great. value in cardiac failure, as it is assimi- and Dictionary of Diseases. 423 lated speedily, acts promptly. It is our best preparation in weak heart, and never fails to afford admirable results. Digitalis, belladonna, cactus grand., and all acro-narcotics have no place in heart failure. Heart failure directly or indirectly traceable to sexual ex- haustion is greatly benefited by the occasional administration of the green root tincture of gelsemium, either alone or combined with strophanthus. The best results are obtained when the heart is really feeble and the circulation languid. The combi- nation is excellent. One-quarter of a drop of strophanthus to three or five drops of the gelsemium every two or three hours. In this form it is remarkably soothing to the nerve centres, strengthening to the heart, and completely relieves the insomnia incidental to cardiac failure. The addition of passiflora in- creases its restorative action. The nitrites are invaluable — nitroglycerin and nitrite of sodium. The former in the form of a suppository, as the symp- athetic nerve can be best, most effectually reached through the rectum ; the latter in solution. One of the most widely prevailing maladies of the age and of our country is a weak heart, a product of neurasthenia. The condition of the heart is the index of the physical and mental status. The heart acts as a starting point of the circula- tion. If its action is strong, vigorous, the life-giving fluid flows freely through every tissue, vitalizing them. If the heart is feeble, all vital functions are slowed — the stomach does not re- ceive enough of blood from which to elaborate gastric juice, so there is indigestion : the bowels, skin, kidneys are sluggish, and there is deficient elimination ; the brain suffers anemia, as is visible in the rapid exhaustion of the mental powers ; there is an impairment of all the senses and imperfect nutrition of every structure ; the feeble impulse gives us a slowed circulation, with cold hands and feet ; a pale or livid surface with cyanotic mu- cous membrane. To treat anemia, due to cardiac debility, with ordinary tonics invariably proves ineffectual. The blood may be normal, but if imperfectly distributed there will be friction. The natural method of increasing the heart's vigor is exercise, which the patient is unable to take, so this must be supplied or supplanted by the highest vitalized massage procurable, administered morning and night for at least one hour each application. Fric- tion and electricity are poor adjuvants compared to massage. • Our o-reat reliance, however,. is placed in drugs to repair the 424 The Germicide 20th Century Practice structural weakness. We want a remedy, an energetic cardiac tonic, one that will improve digestion and supply the needed energy to the heart. This we have in the comp. matricaria, an incomparable tonic ; and as an element of nutrition of the most vitalizing and strengthening character, creatinin, the alkaloid of heart-muscle. No disease is so rapidly on the increase as failure of the cardiac muscle. This may be due to a variety of causes, the wear and tear of the brain incidental to our present state of civilization to wasting of the heart-muscle, but much more generally it can be traced to fatty deposits, the result of de- generative changes in the fibres of the muscle itself — a state in which its fibres waste, become pale, inelastic, and whose struc- ture is replaced by fatty nodules. Besides these degenerative changes, the heart itself may become loaded with fat without its fibres being implicated. Both of these conditions can be detected by the intermittent character of the pulse. It is true that intermittency of the pulse is a more common symptom than it formerly was, and the explanation is to be found in the increased emotional strain and excitement incident to our present mode of living, the affection being due to "nervous ex- haustion of the vital nervous system.' * When not present in an exaggerated degree, intermittency of the pulse is often less dangerous than it seems. It does not, as might be feared, carry with it the necessary idea of sudden dissolution from heart dis- ease, for the heart is the regulator, not the prime mover, of the circulation. The harmlessness of the symptom in its moderate development is shown by the fact of its common occurrence after middle age, and by the long duration of life in many of those who present it. At the same time, the symptom has its significance. Occurring in infancy, it is an important indica- tion of serious nervous derangement. Occurring in young adults, it has the same meaning, and tells the story of com- mencing failure of power. Occurring suddenly after any great event which has told upon the mind, it may be a sign of very serious import. By far the greater number of persons whose pulse exhibits intermittency are unaware of the fact that only in cases where the intermittent period extends over as many as five normal heart-beats and is irregular as to time and not pro- longed, no real organic change has taken place. But when it oc- curs with precision, regularity and is prolonged, with difficult breathing, neuralgic pains, vertigo, no doubt can exist. Heart failure due to degenerative changes has been, in the t and Dictionary of Diseases. 425 minds of all scientific physicians, deemed incurable, — no aid from any source, either from diet or drugs, or any line of treat- ment, being of any avail. But within these twelve months past these ideas have been changed. We have found in the ozonized juice of the Phytolacca berries a remedy, which when admin- istered will strip the cardiac muscle of fat and replace even adi- pose tissue by fleshy fibre. The remedy is simply the expressed succus or juice of the berries, combined with a definite proportion of negative ozone. Two articles should be avoided by all sufferers from alcoholic failure of the heart. These are tea and tobacco. The number of relapses which we have seen brought about by them are so many we almost despair of success so long as they are used. They both depress the circulation, and make the craving for alcohol extremely severe. Coffee is less objectionable, but it may produce flatulency and indigestion. Cocoa is, as a rule, very suitable, but milk and water, with, as a change, a little fresh lemonade, or a mixture of water and fruit lime juice, meet the question of drinks best. Very soon the abstainer from alcohol drinks less fluid of every kind. From fifty to eighty ounces a day under alcohol, he comes down to thirty or forty, is satisfied with soft water pure and simple, and is lighter and better for the change. It is absolutely necessary, in order to ensure a good recovery from alcoholic asthenia of the heart, for the sufferer to get plenty of sleep at night. Early to bed is the last prescription, and in some senses the best. To bed by nine at night and rest of heart in recumbency to seven the next morning is the best rule. Let it supplement other hygienic rules, and of the many who suffer from failure of the heart from alcoholic drinks, there are none that will not be benefited and few that will not be cured — assuming always that degeneration has not produced fatal changes of vital organic structures. Weak Heart. — All hearts are not equally strong, some are inherently weak, and an important question is how much can it stand without getting out of gear. Whether then there be such a thing as functional disease of the heart it is doubtful ; there may be reflex disturbance, and even that does not long ex- ist without organic lesion. There is a limitation to the capacity for work in every heart; it is well to know its extent and de- gree. Malnutrition, anemia in the physically and mentally overworked are prone to give rise to cardiac weakness, which terminates in dilatation. The toxins of all disease germs tell 426 The Germicide 20th Century Practice disastrously upon the heart when the great sympathetic is highly developed, as is visible in pneumonia and rheumatism. Tobacco and alcohol, violent muscular exertion, care, anxiety, worry, are the most productive of the malady. The most satisfactory remedy to prescribe in all cases of en- feebled heart is creatinin, the alkaloid of the heart-muscle, but chiefly isolated from the white meat of the quail. This remedy completely usurps arsenic, its effects are better, more perma- nent. Strophanthus is an excellent cardiac sedative, but if the arteries are contracted, elongated, its action must be guarded. Nitroglycerin is the best vascular dilator and stimulant. Strychnin and matricaria the best heart tonic as well as stimu- lant ; digitalis if dilatation has taken place. Local stimulation, with guaiacol plaster, invariably of great efficacy. Heart weak- ness means heart failure. No such thing as functional disease. An all-round remedy, a true cardiac vitalizer, administered in every case from its inception to its close, is passiflora incarnata. Protonuclein is only of advantage in atrophy. The only reme- dies to avoid are the coal-tar derivatives, which are cardiac depressors and paralyzers. Fatty Degeneration of the Heart. — In this disease the muscular fibres of the heart have degenerated and become re- placed more or less by fatty material. It is a result of mal- nutrition of the heart itself. Causes. — Senile decay, long-standing anemia, or other chronic disease, other forms of cardiac disease, gout, alcohol- ism, phosphorus poisoning, etc. Sedentary occupations and habits predispose to this disease. Symptoms. — This disease is by far the hardest of all heart diseases to diagnose. No symptoms are pathognomonic, but there are usually present the following : Pallor, debility, cold- ness of extremities, feeble and irregular pulse, perspiration, faintness, giddiness and dyspnea. A great number of sudden deaths are due to this disease. Treatment. — A quiet, regular, uneventful life ; gentle exer- cise ; a light, nutritious and stimulating diet, with tonics, par- ticularly mix vomica. In heart diseases digitalis and strophanthus in small doses very useful. General obesitv, due to excess of eating and drinking, is usuallv associated with gout, in which the adipose tissue is deposited on the heart-muscle, whereas when due to other chronic poisoning, or to the toxins of typhoid of puerperal fever, fatty degeneration of the muscle is the rule. and Dictionary of Diseases. 427 Usually exists either as a degeneration of its muscular struc- ture and its usurpation by adipose tissue, or an excess of adi- pose tissue on its surface, embarrassing its contractions, or com- plicated with atheroma of the coronary arteries. The efficacy of the ozonized succus or juice of the ripe Phytolacca berry, slightly touched by frost to temper its as- perity, is attested by all careful observers, in doses of from two to fifteen drops, in all cases of fatty heart; a safe, reliable remedy for the removal of fat. Bowels and kidneys must be kept active, the former with kola-nut paste, the latter with sul- phate spartein : sulphate of spartein ten grains, water two ounces, mix. Three- or four-drop doses at stated intervals. Caffein and creatinin are two of the best heart strengtheners ; brace it up ; promote its nutrition. They in all cases should be administered in alternation with Phytolacca berry juice. There must be an avoidance of all amylaceous and saccha- rine substances in diet: alcohol, wines, beer, tea, tobacco are forbidden. If any other remedies are indicated, try comp. matricaria, a heart tonic of inestimable value, one that acts upon respiration, digestion and assimilation. In all forms, danger of sudden death. In cases of simple fatty degeneration of the heart, fatal syncope is extremely li- able to occur from excitement, forcible movement, shocks, cold bath or very slight injuries. Even cerebral anemia, occasioned by a sudden change from the horizontal to the upright position, may be the cause of rupture. In all cardiac maladies there is an impending danger, and the treatment of such cases requires tact and skill. Inefficiency of the Heart in the Young. — A condition which is becoming very prevalent in the weak, the young, the present demands of school life, excessive exercise, climbing stairs are productive of it ; the rapid growth of children in our climate, a condition in which either the heart-'muscle does not keep pace with or participate in. An excessively common condition as the result of overwork, boat-rowing, base-ball, cyclism or any violent exercise. The result of an acute strain may be recovered from under rest ; but it is its frequent repetition that must be dreaded which gives permanency, with either dilatation or hypertrophy, with indescribable heart pangs. Associated with inefficiency there are usually a series of con- stitutional symptoms which crop up, such as loss of appetite for 428 The Germicide 20th Century Practice food, a loss of energy, palpitation,, headache, difficulty of breathing on slightest exertion. Rest, the administration of creatinin in one-, two,- even three-grain doses every three hours operates well in bringing about cardiac efficiency, slowing the pulse, increasing the power of the heart-muscles by promoting its growth. The best medi- cal authority in America says that creatinin is the best of all cardiac vitalizers. General Observations on Cardiac Trouble. — Heart dis- eases may be broadly classified as acute and chronic. Acute heart disease is usually inflammatory ; sometimes it consists in sudden degeneration of the heart-muscle, as in diphtheria and other infectious diseases. A severe strain or a terrible shock may also develop a sudden dilatation or paralysis of the heart. When the heart or its enveloping sac is in a state of inflam- mation, with hyperactivity and increased friction, the pri- mary indications are rest and sedation. The patient is kept flat on his back in bed. Mustard over the region of the heart, followed by sedative poultices of crushed linseed, saturated with an opiate, is an invaluable measure. These poultices must be warm, but not hot. The patient should be clothed in flannel, and guarded from con- tact with cold bed-clothing. Aconite is the best drug for this condition. It controls pain, irritability and slows the action of the heart. It must be given for its effect upon the pulse. In all cases of heart disease char- acterized by rapid, wiry pulse and cardiac pain, aconite, with or without ipecac, alternated with matricaria, will be of benefit. Where the pulse is full, rapid and throbbing, Norwood's tincture of veratrum viride is preferable to aconite. In the muscular degeneration of the heart present in infec- tious diseases, the indications are different. The patient is very pale, the pulse fast but small and irregular, and we don't want to give digitalis. Digitalis cannot tone a heart softened by ante-mortem decay. Heart-muscle must be reasonably firm to respond to the action of digitalis. Strychnin is the drug for a poison-rotted heart, and give it with a free hand in conjunc- tion with antiseptics. In treating cardiac disease it is important to know when to change from sedative to stimulant medication. A feeble car- diac impulse and cold feet call for stimulation. Hot bottles to feet and legs, a hot-water bag over heart are simple measures which have often saved life. and Dictionary of Diseases. 429 Adhesions frequently form as a result of inflammatory dis- ease of the heart, restraining its action and causing pain, trouble in breathing, valvular failure, dropsy, etc. Snug strapping of the left chest will partially relieve these annoying symptoms. Medicinally, give belladonna in alternation with aromatic spirits of ammonia. Chronic disease of the heart is, however, much more common and more insidious in its beginnings. Sedentary life, over- feeding and intense mental application, dissipation and excesses of all kinds are the factors which contribute to make heart dis- ease a fountain of many ills. There are the multitude of business men, who have always been healthy and energetic, but suddenly find themselves short of breath. Digestion is slow, constipation develops. They do not sleep well. Attention is dulled and memory impaired. Other symptoms of passive brain congestion and insufficient oxidation show themselves. The heart-muscle is undergoing- degenera- tive changes of a fibrous or fatty nature. If the patient is obese, of a lemon-yellow color, with sluggish skin reflexes, the portal system needs invigoration. Give him a mixture of the ozonized extract of chionanthus and matricaria. In defective cutaneous circulation the daily use of the flesh- brush morning and night tones the nerves, increases the area of circulation, lessens the heart's work. In fatty degeneration of the heart there is a flabbiness of muscles throughout the body, a low-tension pulse; a tendency to sweats, with fits or par- oxysms of palpitation, followed by prostration; here matri- caria and stimulants are valuable. In chronic heart disease, where dilatation and obstruction are just beginning, with dropsy, water-logged lungs, give periodate aurum and apo- cynum. The heart being a muscle, needs fresh-air, oxygen, which is its very life ; outdoor life, free ventilation, massage, baths, elec- tricity are all valuable in their sphere. HEARTBURN.— Symptoms.— Cardialgiai, or heartburn, presents itself in two forms, each of which assumes various grades of severity. It is generally attended by acid or acrid eructations, exciting irritation in the throat and fauces. The acidity of the eructated matters is often remarkable, occasioning the most unpleasant sensations in the mouth and pharynx, with a copious flow of fluid from those parts. The matters brought 43-0 The Germicide 20th Century Practice up from the stomach are sometimes rancid and alkaline, partic- ularly after a full meal of rich or fat animal food. In this case a feeling of disgust is excited on each eructation, and large quantities are thus thrown off or > regurgitated from the stom- ach without either nausea or retching. In either form unpleas- ant gnawing, burning pain and tenderness are felt at the epi- gastrium, with distention extending to the hypochondria, and with tightness or oppression in the chest. Cardialgia chiefly oc- curs during the period of digestion, but sometimes not until an advanced stage of the process. It may be mild, and consist simply of uneasy sensation, gnawing or burning at the cardia, sometimes with slight f aintness or flatulence ; or it may be se- vere, the uneasiness extending over the region of the stomach, attended by depression, anxiety of countenance, and faintness. This latter state has been denominated "sinking heartburn." It is only when cardialgia is severe that it is accompanied with frequent and copious rancid, alkaline, or septic annotations. Treatment. — Heartburn is best treated by medicines which act upon the secretions and move the bowels. Kolatina tablet to regulate the bowels and comp. tincture matricaria are most useful when this symptom is connected with acidity. But when heartburn is attended by rancid, septic or insipid eructations, the mineral acids, as the nitric, the hydrochloric, and the aro- matic sulphuric acids, given in simple camphor, or aromatic water, or in suitable tonic infusions, will be most serviceable. When there is a liability to heartburn, wine, spirits, and particu- larly malt liquors, should be avoided. Hock or old sherry may, however, be taken in great moderation in seltzer water. HECTIC FEVER. — Fever of a remittent or intermittent type, such as is met with in cases of phthisis and in connection with persistent purulent discharges. It comes on insidiously, and lasts a long time. Symptoms. — Wasting, a characteristic flushing of the cheek, profuse perspirations, and irregular action of the bowels. Treatment. — Depends upon the cause of the fever — grave debility, the toxin of the bacillus tubercle and typhoid. Mis- tura guaiacol is the best antidote, or, better still, guaiacol sup- positories. If symptoms of septicemia prevail, push large doses of echinacea with peroxide of hydrogen. HEMATOGEN. — Contains perfectly pure hemoglobin, all the salts that are found in fresh blood, together with its albu- and Dictionary of Diseases. 43 1 urinous constituents, in a highly concentrated and purified form, preserved by adding to each pint four ounces of glycerin, two ounces of white wine and an ounce of negative ozone ; a most efficacious remedy in general debility, anemia, chlorosis, neurasthenia, rickets, scrofula, weak heart, wasting diseases of children, chronic catarrh of the stomach and bowels, loss of appetite, convalescence after influenza, and fevers (includ- ing typhoid fever, etc.) and overrapid growth in young per- sons. HEMORRHAGE.— Loss of blood, or the escape of blood from the blood-vessels in which it is naturally contained, con- stitutes a hemorrhage. It is classified in different ways ; as, for example, it is called : Traumatic, when due to a wound, or injury, or incision ; usu- ally escaping in jets, corresponding to the contractions of heart ; symptomatic of disease, as the bleeding from the nose in ty- phoid, and from other parts in tubercle, cancer, etc. Sometimes the term idiopathic is appplied to it ; then it is said to be a dia- thesis. It may be active or passive. Active hemorrhage is pres- ent in injuries, inflammations ; passive, when it depends on pov- erty or depreciation of the blood. They may be periodical, as in cases of vicarious menstruation. The seat of hemorrhage will depend upon the location of par- tial death or weakness. The general principle of treatment of all hemorrhages are: the circulation kept below 70 ; recumbent posture ; freedom from excitement; simple, nourishing, but unstimulating diet; ele- vated position; and the application of stimulants, as heat, etc. Our best styptics are digitalis ; mineral acids, as cinchona and nitromuriatic acid; quinine and aromatic sulphuric acid; tur- pentine, sulphuric acid; gallic acid. As soon as it is arrested, a diet rich in fibrin, as broiled beefsteak, eggs, cream, etc., mineral acids, cinchona. Uterine Hemorrhage. — This means hemorrhage from the uterus at any other than the menstrual periods. This may arise from various states ; it may be a symptom of inflammation and congestion; of endometritis, of ovarian disease; of polypus in the uterus, or other tumors, or cancerous infiltration. It is often the precursor of miscarriage or labor. Occurring during pregnancy, it is suggestive of a partial detachment of the placenta, or of what is called placenta previa, that is lo- cated over the mouth of uterus. 43 2 The Germicide 20th Century Practice After labor it may be due to inertia of the uterus, the organ being tired out ; to the presence of shreds of membranes, pieces of placenta, or clots. Intra-uterine coagula, both in the menstrual and puerperal state, are common causes. Puerperal coagula differ from menstrual coagula essentially in the time of their occurrence. Menstrual coagula may occur at any time during the child- bearing period of life, remote from childbirth or abortion. Puerperal coagula occur only in the period called that of the puerperal state, which is limited to abortion, or childbirth, which is covered by a period of one month or six weeks after delivery. The retention of a coagulum, or portion of the pla- centa, is a common cause of hemorrhage, and there is a con- stant risk of bleeding so long as a particle remains ; laceration of the genital tract; relaxation or inertia is the common cause. Fibrinous polypi are very productive of it. Treatment. — In cases of pure relaxation and dilation of the uterus, sulphate of quinine in mineral acids, in alternation with tincture of black snake-root; and if these fail, wine of ergot should be cautiously administered; the washing out of the vagina, if there is fetor, with tepid water, peroxide of hydro- gen ; and if all fail, insert the sponge plug saturated with a so- lution of alumina. The use of hot Water, 117 degrees to 120 degrees F., for syringing the vagina has a much better action than cold in causing a renewal of life and a regaining of lost contractility. More recently, wine of aletris farinosa internally and per- oxide of hydrogen locally. The latter possesses immense hem- ostatic effects ; used either as an injection into the uterus, as a tampon, or douche, it is most effectual, better than ergot or iron. Hemorrhagic Diathesis. — Individuals possessing a san- guine temperament have a lack of cohesion in the fibrin and red corpuscles of the blood ; associated with this the micrococ- cus hemophilia appears in the blood, a cocus characteristic of hemorrhage, bleeding from the nose, bleeding on the slightest scratch or injury. It may occur from special locations, as from the nose, constituting epistaxis ; from the lungs, hemoptysis : from the stomach, hematemesis ; from the kidneys, hematuria : from the uterus, metrorrhagia. This diathesis can be overcome, the micrococcus destroyed by mineral acids and cinchona, ozone water, coca, digitalis, avena, kephalin and a diet rich in blood elements. and Dictionary of Diseases. 433 Hematemesis. — The vomiting of blood from the stom- ach. This may be a result of external injury; acute con- gestion of the stomach due to inflammation or suppression of the menses ; mechanical congestion due to cirrhosis of the liver, obstructing the portal vein, or chronic heart or lung disease ; ulceration of the stomach (either simple or cancerous) ; dis- eases of the blood, such as yellow fever and scurvy ; and, rarest of all, the bursting of an aneurism into the stomach. Symptoms. — Loss of appetite, indigestion, pain, and nausea may precede the appearance of hematemesis. When the bleed- ing is profuse, there is a feeling of faintness and sinking in the region of the stomach, a small pulse, pallor of countenance, and nausea followed by the ejection of partially clotted dark blood. For a day or two afterwards the stools are dark and tarry looking. In slight hemorrhages the vomited matter re- sembles coffee-grounds. After an attack the patient may be completely prostrated, but a single attack rarely terminates fatally. Treatment. — Depends upon the cause, but in all cases com- plete rest in bed, ice (either sucked or in the form of cold drinks), and abstention from food are necessary. Nutrition should be carried on by means of nutrient enemeta of beef-tea, etc. The drugs used to check the hemorrhage are gelsemium. gallic acid, oil of turpentine (in small doses), and resorcin, five grains to ounce of ice water. Hemoptysis. — The spitting of blood due to hemorrhage within the lung. The blood is usually bright red and frothy. This symptom in most cases points to phthisis, often being one of the first symptoms. It may be due to heart disease, cancer of the lung, aneurism, injury of the chest, etc. Treatment. — Rest in bed. Ice may be sucked. Hot foot- baths and a purgative are useful, particularly in full-blooded people. The drugs given are gallic acid, ergot, dilute sul- phuric acid and turpentine, passiflora, digitalis and strphan- thus. Hematuria. — (Bloody Urine). — It may be from the kidneys, bladder or urethra. Try infusion of digitalis ; gallic acid ; turpentine, uva ursi ; cleavers, Warburg's tincture, stro- phantus. General Measures. — Vapor bath, absolute rest, drink linseed tea; copious injections of warm water into the bladder. If bladder is filled with thick blood that cannot be passed or drawn through a catheter, inject into the bladder two ounces of warm 434 The Germicide 20th Century Practice water, five drops of hydrochloric acid and thirty grains of pepsin, and in a few hours the contents of the bladder will pass through; or papoid or trypsin as injection. The hematuria due to the presence of the malaria germ, with its toxin literally stuffed or imbedded in th tubules of the kidneys, is best cured by gelsemin orally ; with a suppository of quinine or kurchicin. Sulphate of quinine in suppository from 10 to 20 grains gives, excellent result — for it produces neither nausea, headache, nor any cerebral disturbance, and it is undoubtedly the best method of exhibition in all cases of hematuria, or where the remedy is indicated. Hematophilia. — A diathesis in which there is a tendency to bleed from nose and other parts. It is an hereditary con- dition, supposed to be chiefly transmitted by the mother. Boys- affected with it rarely live. It usually manifests itself in early life, at dentition or puberty; in females at first appearance of the menses and their cessation. All cuts, scratches bleed pro- fusely; some races are more liable to it than others; due to a defect in fibrin of blood. Nutritious diet, abundance of fresh air, use of digitalis with care, with mineral acids and prepara- tions of cinchona are supposed to overcome it, but it is very doubtful. It is identical with what is termed the hemorrhagic diathesis. Hematocele, Pelvic. — An effusion of blood into peritoneal pouch, between uterus and rectum; or, into subperitoneal tissue,, behind and around the uterus. Causes. — Abortions, lingering labor, violence of some kind ;. ovarian pregnancy, blows, kicks, falls. Symptoms. — These are very variable. If the loss is ex- cessive, there is the great nervous shock and exhaustion from profuse hemorrhage. Usually acute pain in the lower part of abdomen, shivering, coldness or extremities; vomiting; in- creasing feebleness of circulation; ghastly appearance of face, and death in a short time. If the loss of blood is not excessive there is nausea, rigors and a fever, with violent abdominal pain; countenance very anxious, white and pinched. A frequent desire to empty blad- der, but inability to do so; irritability of rectum; in some cases the. pelvic tumor may be felt through the vaginal walls. Treatment must be upon general principles. HEMORRHOIDS, OR PILES.— A varicose condition of the veins of the rectum. As a result of passive congestion of axd Dictionary of Diseases. 435 these parts (due to obstruction of the flow of blood in the veins) the veins become varicose, and project as little tumors. Some- times there is bleeding, particularly when the patient is at stool. They are classified as external or internal piles, according to their position just outside the bowel or within it. When they bleed they are said to be open ; when there is no bleeding they are said to be blind. The tumors vary in size from that of a pea to -that of a small bunch of grapes. There is often consider- able pain, so much so that in some cases the patient is unable to walk. In some cases the hemorrhage is so free as to be a cause of danger from the constant drain on the patient's con- stitution. They also predispose to the formation of ulcers, fissures, abscesses, and fistulae in their neighborhood. Causes. — Any condition which impedes the circulation in the veins of the part. Thus constipation, pregnancy, and liver disease are common causes. Sedentary occupations predis- pose to this disease. Treatment. — Regular habits and exercise. Avoidance of alcohol. Otherwise strengthen up the entire system, but es- pecially the veins, by general tonics and alteratives ; the bowels should be regulated by either the cascara sagrada lozenge or tincture of nux vomica and belladonna, or sulphur. Bowel should be injected daily with either distillation of witch-hazel or horse-chestnut, or water acidulated with aromatic sul- phuric acid ; the suppositories of the horse-chestnut of great value; same form of medication, with care, has proved of greater efficacy. All remedies failing, the hemorrhoid tumors should be in- jected. An excellent formula for injecting and subsequently causing the obliteration of hemorrhoids is the following : Two drams each of carbolic acid, glycerin and fluid extract ergot, added to one dram and a half of water. Mix. Inject from three to eight drops, according to the size of tumor. Or the following : Carbolic acid, olive oil, glycerin, of each, one ounce ; pure crosote, twenty drops; muriate of cocain, five grains. Mix. Inject from two to six drops. Coagulation, absorption and obliteration of piles can be effected without the use of carbolic acid, thus : Fluid extract arbor vitae, six drams; fluid extract hamamelis, one dram; fluid extract horse-chestnut, three drams. Mix. Change syringe with this ; insert nozzle to centre- of the hemorrhoid ; inject from six to ten drops. If it does not entirely disap- pear this can be repeated in two weeks. 436 The Germicide 20th Century Practice Piles can often be got rid of with horse-chestnut supposi- tories or an ointment made from the horse-chestnut, and also in the following manner: After the morning stool, throw a copious injection of warm water into the rectum; then insert a piece of the following, about the size of a hazel-nut, into the bowel, smearing all the internal and protruded parts with the same : Take one ounce of ozone ointment, the same quantity of butter of coca, then add two drams of subnitrate of bis- muth, one dram of muriate of hydrastin; and when all are melted together, add three grains of cocain, thirty drops of oil of eucalyptus : use when cool. Inculcate rest, as little exercise as possible. Inject into the rectum, afternoon and evening, one teaspoon- ful of the following mixture : Fluid extract of hamamelis and of hydrastis, three drams of each ; olive oil, two ounces. Mix. Internally, we have found the following unsurpassed : Tinc- ture of nux vomica and tincture of belladonna, of each half an ounce. Mix. Dose : two drops in a little water one hour be- fore meals and on retiring to bed. Remove all apparent or suspected causes. Rigidly forbid the use of beer, whisky; fatty, starchy, saccharine food. HEPATITIS, ACUTE AND CHRONIC— This occurs in connection with ague and other fevers, injury, new growths, and, most often, from alcoholic abuse and gluttony, particularly when to these are added the effects of a hot climate; irregular habits, alcoholism. It may also be a result of constipation — the same as those of congested liver, but in a more intense de- gree, together with a rise of temperature and pain on pressure over the liver. An abscess may form in the liver. When this occurs there is a stage of fever, with fits of shivering, and later on uneven enlargement of the liver, with "fluctuation" and perhaps bulging of the abdominal wall. Abscess of the liver is also a complication of acute dysentery. Symptoms. — Irritability, depression, headache, pain in the right shoulder and right side; the tongue is foul; there is a bitter taste in the mouth, impaired appetite, nausea and vomit- ing. Jaundice may be present. In long-standing cases there may be some ascites. The liver is uniformly enlarged. The acute form is rare in temperate climates. Veratrum vi- ride and gelsemium; phosphate of soda alternated with nitro- muriatic acid; kolatina alternated with ozone water; hot fomentations over the liver area to relieve pain, to promote vi- and Dictionary of Diseases. 437 tality; chloride of ammonia alternated with ozonized chio- nanthus. In dropsy, apocynum ; light, non-stimulating diet ; no alcohol. If case is stubborn, periodate aurum and concentrated tincture kurchicin are very useful. Guaiacol plaster over liver. Hepatism. — By the term hepatism is understood a group of diseases existing together — gout, obesity, biliary lithiasis, gravel, diabetes — the relationship of which is proved by the fact that they exist coincidently, or follow each other, appearing in one individual, or being transmitted by him, one or the other, to his descendants. A common morbid principle, which we call a diathesis, lies at the bottom of this condition. The lo- calization of this group of diseases of nutrition is in the liver. The characteristics of the diathesis are shown by regular peri- odical disturbances of the digestive apparatus, of which the liver is the preponderating organ, acting with the periodicity of the digestive functions, disturbances of sleep, and anomalies of excretion. The causes are disturbed function of the liver ; pri- marily, in the individual or his ancestors, disease of the liver, intoxications or auto-intoxications, infections, psychical shock or traumatism. The diathetic treatment consists of purgatives, alkalies, sometimes diuretics, dietetic regimen of the diseases of the liver. The diagnosis is easy, made by a regular system- atic palpitation of the liver in all nutritional diseases, by a mi- nute analysis of the patient's subjective symptoms, and by a careful comparison of the subjective and objective symptoms of these diseases with diseases of the liver, at the same time in- dicating that the satisfactory treatment of these conditions is that of hepatic disease. HEREDITARY DISEASE.— The problems of the heredi- tary transmission of qualities and tendencies to disease are some of the most wonderful in nature, and they are as yet by no means clearly elucidated. Many of them, as yet, cannot be brought under any law. In our present state of physiological knowledge it is. for instance, a quite inconceivable thing what takes place when we have two generations of perfectly healthy persons intervening between an insane great-grandmother and an insane great-grandchild. The grandparent and the parent carried something in their constitutions which was never ap- preciable to us at all. Yet it was there just as certainly as if it had broken out as a disease. It is one of the future problems of physiology and medicine to deduce the exact laws of heredity 438 The Germicide 20th Century Practice in living beings, and to counteract the evil hereditary tendencies through conditions of life. To do the latter we shall undoubt- edly have to begin early in life, and we shall have to control the education especially, and make it conformable to nature's indi- cations, laws, and conditions. HERNIA, OR RUPTURE.— This term is applied to any condition in which any internal organ of the body protrudes from its natural cavity. Thus we may have hernia of the brain, lung, testicle, etc., but in the majority of cases the term is ap- plied to the protrusion of a part of the intestine through some part of the abdominal wall. The abdominal wall is made up principally of layers of muscle. At certain parts this muscle wall is thinner than elsewhere, and it therefore sometimes hap- pens that when irregular pressure is exerted upon the ab- dominal contents they press upon the abdominal wall and pro- trude at the weaker parts. Hernia may occur at any part of the abdomen, but is most frequent at the weaker parts referred to above — namely, at the navel, groin, and upper part of the thigh. The part protruded may be the omentum or some part of the intestine, or both, and cases occur where other abdominal or- gans have been protruded. When omentum alone protrudes, the hernia is known as an epiplocele ; when intestine protrudes, it is an enterocele ; when both protrude, it is known as an en- tero-epiplocele. Other names are applied according to the po- sition of the hernia. Thus we may have umbilical, inguinal and crural, or femoral, herniae, according to their position at the navel (or umbilicus), groin, or upper part of the thigh respec- tively. Men are more liable to hernia than women, particularly to the inguinal form. The femoral form is more common in women. The tendency to hernia decreases with age. A hernia is said to be reducible when it can be got back into the abdomen, irreducible when this cannot be done. When the hernia is so firmly fixed that the circulation in it is arrested, it is said to be strangulated; and unless the strangulation be relieved at once by operation or reduction under chloroform, a fatal result from gangrene will probably ensue. The protrusion of either the intestine or omentum or both from their natural cavity, either through some of the natural openings or through some weak spot of the abdominal walls, constitutes usually a soft, compressible swelling, increasing in size when the patient stands up, dilating when he coughs, or makes exertion — when in the horizontal position, diminishes axd Dictionary of Diseases. 439 or disappears, or when well-directed pressure is applied. An individual with hernia is at all times in great danger, even if he wears a pad or truss to keep it within its natural cavity. There is always danger, and this very idea has led surgeons to resort to what they term a radical cure, namely, by injecting irritants into and around the neck of the sac or opening so as to excite adhesive inflammation, and effusion of plastic lymph to obliterate the opening, and form a solid barrier to prevent the descent of the bowel. Various agents are used, but tincture of cantharides has the lead as an injecting agent; others again to tucking the folds of the scrotum into the neck of the sac ; others to scarification; and introduction of needles — all very risky procedures. In the city of Mexico rupture in all its varied forms is exten- sively common; the surgeons there use an ointment of some merit. They have the external parts bathed morning and night, and have this ointment applied on a piece of lint, and over and above all either a compress, pad or truss. It takes a little time, from two to four weeks usually ; the cutaneous surface becomes quite red, but is never permitted to ulcerate. There is no danger in this procedure, no risk, and above all, it yields the largest amount of effusion of lymph — a quantity far in excess of what is necessary to block up the orifice through which the bowel escaped. There can be very little doubt regarding its efficiency and its value; it simply requires a little time, some patience, which is far better than running risk of peritonitis and death. The remedy is powerfully germicidal, and capable of exciting adhesive inflammation, with a profuse exudation of plastic lymph, and possesses the power of penetrating deeply. If the physician and patients manipulate it properly and per- severe with it, the Mexican ointment, so called, will cure all cases of reducible hernia. In semi-tropical as well as tropical countries hernia is very common, especially so in the United States, the largest per- centage being among men. Its importance is great, and a rad- ical cure, if it can be obtained without risk, is an imperative necessity. If a rupture is reducible, and can be maintained in its natural cavity by the aid of a pad or truss, it can very easily, and with- out either pain or inconvenience or suffering or risk, be got rid of by the twice-daily application of the Mexican ointment, placed underneath the pad or turss. No other medicinal agent 440 The Germicide 20th Century Practice yet discovered can effect what this ointment will do. When applied, its power of penetration is great — as soon as placed in position it causes a most abundant effusion of plastic lymph to flow all around the hernial ring, which speedily becomes ozon- ized and blocks any descent of either bowel or omentum. The secret of success is to maintain for two or three weeks an ery- thema all around and over the aperture, just long enough for complete organization to take place. We have used the remedy in several cases with much success, and find it much better, more efficient, never attended with danger, than any of the methods in vogue of exciting lymph effusion. Hernia in Children. — The inguinal is the sole form found in children. The diagnosis is always easy, as malposition of the testes or disease of the cord is rare in youth. When it does exist, regular bathing, proper diet, the avoid- ance of all intestinal irritation leading to abdominal disten- tion. Massage is useful after the twice-daily bath. In all cases in children in which the hernia is reducible, and can be prevented either by a pad or truss from descending, the Mexican ointment should be applied, and kept applied, until sufficient lymph is effused in the internal ring to block forever the descent of the bowel. If the hernia is strangulated, irrepressible, or where treat- ment is impossible owing to the incompetence of the mother, the Mexican ointment must not be used. The use of this ointment, when the case admits of it, gives in all cases a large amount of lymph, which rapidly organizes, and forms an excellent plug in the hernial sac. HERPES, OR TETTER.— An acute inflammatory disease of the skin, characterized by groups of vesicles on an inflamed base. The vesicles are filled with clear fluid, which in a few days becomes milky, after which they dry up, leaving small scabs. It runs its course in a couple of weeks, and is not con- tagious. The vesicles usually follow the distribution of one of the cutaneous nerves, and hence the disease is supposed to be of nervous origin. There is pain and some rise of temperature. It is oftenest seen about the lips and in a zone round one-half of the body. The latter is known as herpes zoster, zona, or shingles. Treatment. — The eruption should be dusted with powdered starch, with a little oxide of zinc and camphor, and protected from the air by means of a layer of cotton-wool. Small patches and Dictionary of Diseases. 441 may be painted over with dermolia. The general health should be seen to, tonics being of great service, especially matricaria, thyroid and kephalin. Herpes Preputialis. — A contagious affection of the pre- puce, consisting of clusters of vesicles, usually upon a non- inflamed base, in size from the head of a pin to that of a small pea, sometimes isolated, in other cases in patches. The con- tents of the vesicle are simply a mass of living disease germs. Although readily communicable from one to another, or from the serum or germs running on the skin or mucous membrane, and being originally the result of a degradation of normal bio- plasm, still it is doubtful if it can be regarded as a venereal affection. Treatment. — As soon as a vesicle forms or fills, puncture it with a needle and let its contents escape, and press a sponge saturated with lime-water and tincture of iodine lotion, or with a lotion of permanganate of potash ; then dry by gentle pressure, and apply ozone ointment. There is no use in caustics, as the disease will reappear after their application. In all cases, al- teratives and tonics for a few weeks. If a married man, same precautions as to wife, and abstinence from sexual congress till both are well. HICCOUGH. — Hiccough is a spasmodic affection of the diaphragm. Generally a trivial and transient inconvenience, its occurrence in the last stages of acute disease is a grave, often a fatal symptom, indicative of giving way of the nervous sys- tem generally. Continued and obstinate hiccough sometimes occurs in persons, more especially in young females of an hys- terical tendency, and may continue for a very long period with- out cessation, except during the hours of sleep, in spite of all kinds of treatment. The causes of ordinary hiccough are gen- erally fasting or some sudden stimulant taken into the stomach, such as highly-seasoned soup ; and the affection generally sub- sides of its own accord. When inconvenient nothing is so likely to remove it as some active emotion of the mind suddenly excited. The continued sipping and swallowing of cold water, or sucking of ice, either aromatic spirits of ammonia or chloro- form added to a glass of water, are good domestic remedies. All failing, administer periodate aurum. HOANG-NANG. — The bark of a creeper growing in China and Hindoostan. Therapeutie Uses. — A powerful and peculiar bactericide,. 44 2 The Germicide 20th Century Practice its use neutralizes snake-bites and the inoculation of rabies. Kills the bacillus of leprosy and hydrophobia. HORDEOLUM. — Chalazion or stye, a hard, round, trans- parent tumor, like a grain of seed developed on the eyelid. The cause malnutrition — the bacteriological outcome, dwarfed bac- teria, but identical with boils. Internally sulphide of calcium; locally, incision through the palpebral conjunctiva and a thor- ough curetting of the sac. If unrelieved, a succession of them is likely to follow. Being a retention cyst, it is likely to occlude the adjacent ducts, forming large sacs, giving rise to impaired mobility of the lid. Hot lotions of ozonized boroglycerid are of rare efficacy in stye. HOT-AIR TREATMENT.— No therapeutic agent has a greater range of utility than heat, both dry and moist. A much higher degree of heat can be tolerated if dry than if moist by the surface of the body. The physiological effects of dry heat to the surface of the body are : i. A diffuse hyperemia of the skin, caused by a dilatation of the capillaries. 2. A sensation of numbness over the heated surface, prob- ably caused by the effect of heat on the superficial sensory nerves. 3. A slightly-accelerated pulse and respiration. 4. An increase in body temperature of one-half to one de- gree. 5. Increase of arterial tension. 6. Increase in the elimination of nitrogen. The beneficial effects are purely local, and it therefore be- comes imperative to supplement these treatments by general medication. Furthermore, it is imperative that the heat bath should be followed by massage. This essential adjunct makes it advisable to take these treatments under the supervision of trained assistants and a professional masseur. From the foregoing it will be seen that we have in the dry hot-air treatment an ideal and thoroughly practical therapeutic agent for the treatment of articular rheumatism, muscular rheumatism, sciatica, neuritis, lumbago, pleurodynia, arthritis, sprains, intercostal neuralgia, torticollis, gouty joints, pleurisy and kindred diseases. and Dictionary of Diseases. 443 HYDATID. — A cystic tumor which forms within some organ of the body — most usually the liver or kidney — due to the presence of the embryo of a species of tapeworm, the Taenia echinococcus, which infests the intestinal tract of dogs and wolves. The ova of the tapeworm, being discharged by the dog, become introduced into the human body by way of the water supply or in food, and on reaching the stomach make their way to various organs of the body, most usually the liver. Here the embryo develops into the cystic form, becoming a large cystic tumor filled with clear fluid, floating in which are other cystic embryos. The latter attach themselves to the wall of the larger cyst by means of a head with four suckers and a row of little curved hooks. The disease, having reached this stage, may end in three ways — the tumor may inflame, suppu- rate, and become an abscess ; it may burst into the parts around ; or the parasite may die and the whole tumor shrivel up. Symptoms. — As a rule the disease is painless and presents few symptoms unless the enlargement presses upon and inter- feres with the functions of neighboring organs. There is a gradual, irregular enlargement of the organ attacked by hy- datids ; there may be a bulging of the surface over the organ, and the tumor may be felt to be elastic and fluctuating. Treatment. — Drugs are useless ; the only thing to be done is to tap the cyst and draw off the fluid ; whereupon the parasite dies. HYDRASTIS. — Hydrastis canadensis, commonly known as golden seal. Physiological Action. — All preparations of the hydrastis act as a vasomotor constrictor — average doses of it paralyze the vasomotor centres and diminishes blood pressure. It determines contraction of the uterine blood-vessels, so that considerable benefit accrues from its use in pelvic conges- tion, labor, hemorrhage. Therapeutic Uses. — Excellent in atonic dyspepsia and slug- gish liver ; a tonic and cholagogue ; a good remedy to chronic ulcers both internally and locally. It yields some energetic al- kaloids, as hydrastia, zanthopnceia, hydrastinin. Preparations and Doses. — Fluid extract. Alcoholic and non-alcoholic, 30 to 60 drops thrice daily; hydrastin 2 to 6 grains; hydrastinin, dose, 1 grain as a substitute for ergot. 444 The Germicide 20th Century Practice HYDROBROMIC ACID.— A pure, colorless liquid, with- out odor, with a strong, acid taste, prepared from either bro- mide of potassa or barium with sulphuric acid. Therapeutic Uses. — A heart sedative, lessens nervous excita- bility; checks the nerve storm of epilepsy; relieves insomnia and is an anodyne to the stomach. Preparations and Doses. — A 10 per cent solution, in doses of from 30 to 60 drops, thrice daily, added to water. The hydrobromate of quinine. Dose : One to 5 grains. HYDROCELE. — The collection of serous fluid within the walls of the scrotum from various sources of irritation. Cases are met with where the amount of fluid varies from a few ounces up to pints ; it flattens or compresses the testicle and depreciates the sexual function. It is well recognized that to attempt to cure hydrocele by external applications of absorbents is useless, that tapping, draining off the fluid, following this up with an injection of peroxide of hydrogen, fifteen-volume solu- tion, is absolutely safe, and invariably an infallible cure for this malady. The operation is simple enough. The scrotum being seized in the left hand and compressed tightly to force the fluid to the front, the testicle lies safely at the back; the trocar is forced in an upward direction at a dependent point to the ex- tent of about an inch. With the cannula held in situ, and upon the rapid withdrawal of the trocar, the serum flows out freely. Every drop ought to be permitted to ooze out. A rubber syr- inge, containing one or two or more ounces of dioxide of hy- drogen is injected into the scrotum. The skin of the scrotum is then pinched at the seat of punctures, the cannula withdrawn by a quick, steady pull, and the scrotum briskly shaken, so as to diffuse the peroxide of hydrogen through it. This done the patient is put to rest. No local application is necessary, and it is best ; the destruction of the secreting faculty of the sac pre- vents any further recurrence of hydrocele. Tapping is painless ; the subsequent injection of peroxide of hydrogen is not near so productive of pain as the old seton or tincture of iodine injected. With this treatment 90 per cent of all cases are radically and permanently cured. HYDROGEN, PEROXIDE OF (H 2 2 .).— Negative ozone is a colorless, transparent liquid of a syrupy consistency, as now prepared is a stable product, but if permitted to remain in a watery solution undergoes decomposition. In full strength and Dictionary of Diseases. 445 when applied to the skin it whitens it, but when diluted it is bland, unirritating. The use of this agent is merely another source to obtain oxygen in a different form from a gaseous state. It is a defi- nite compound of oxygen and hydrogen. A fifteen-volume solution, being equivalent to a two- or three-per-cent solution, yields 500 times its own volume of oxygen. Whether inhaled or applied to the tissues it evolves free oxygen, and is the most powerful of all bactericides ; none can excel in microbicide action. Administered internally from 5 to 30 drops in distilled water every four hours, it is the great scavenger to germ-laden blood. Kills the microbe of dyspepsia, the fungus of diabetes ; the streptococcus of diphtheria and ery- sipelas. Injected into boils and abscesses it promptly destroys the pus germ. Perfectly innocuous to healthy tissue, but when- ever a microbe exists it promptly annihilates it. In sprays, douches, lotions, gargle, however applied, it sweeps all mi- crobial life before it; hence its utility in ulcers of all kinds, carcinoma, venereal. Injected into a polypus it at once causes its death. Glucozone is simply a solution of the dioxide of hydrogen in c. p. glycerin, which is an excellent form for internal use. It has also been utilized in the form of baths for leprosy, syphilis, and other cutaneous diseases. Instantly promotes primary unions in wounds by destroying the bacteria. The internal administration of the peroxide of hydrogen prior to an operation fortifies the patient ag-ainst the shock by the superoxygenization of the blood. Peroxide of hydrogen H 2 O s , in the strong fifteen-volume solution, is almost as harmless as water, and yet it kills anthrax spores in a few minutes. For preventing suppuration we have bichloride of mercury, hydronaphthol, carbolic acid, formalin, and many other anti- septics, but for stopping it abruptly and for sterilizing a sup- purating wound we have only one antiseptic that is generally efficient, so far as I know, and that is the strong peroxide of hydrogen. Therefore I have qualified it not as "good/' not as "useful," but as "necessary." In abscess of the brain, where we could not thoroughly wash the pus out of tortuous canals without injuring the tissues, the HoO^, injected at a superficial point, will follow the pus, and throw it out, too, in a foaming mixture. It is best to inject a small quantity, wait until foaming ceases, and repeat injections 446 The Germicide 20th Century Practice until the last one fails to bubble. Then we know that the pus cavity is chemically clean, so far as live microbes are con- cerned. In appendicitis we can open the abscess, inject per- oxide of hydrogen, and so thoroughly sterilize the pus cavity that we need not fear infection of the general peritoneal cavity if we wish to separate intestinal adhesions and remove the ap- pendix vermiformis. Many a patient, who is now dead, could have been saved if peroxide of hydrogen had been thus used when he had appendicitis. This single means at our disposal allows us to open the most extensive psoas abscess without dread of septic infection following. In some cases of purulent conjunctivitis we can build a little wall of wax about the eye, destroy all pus with peroxide of hydrogen, and cut the suppuration short. Give the patient ether if the H 2 2 causes too much smarting. It is only in the eye, in the nose and in the urethra that peroxide of hydrogen will need to be preceded by cocain (or ether) for the purpose of quieting the smarting, for it is elsewhere as bland as water. It is possible to open a large abscess of the breast, wash it out with H 2 2 ,and have recovery ensue under one antiseptic dress- ing, without the formation of another drop of pus. Where cellular tissues are breaking down, and in old sinuses, we are obliged to make repeated applications of the H 2 2 for many days, and in such cases I usually follow it with balsam of Peru, for balsam of Peru, either in fluid form or used with sterilized oakum, is a most thorough encourager of granulation. If we apply H 2 2 on a probang to diphtheritic membranes at inter- vals of a few moments, they swell up like whipped cream and come away easily, leaving a clean surface. The fluid can be snuffed up into the nose, and will render a fetid ozena odorless. Peroxide of hydrogen H 2 2 . Warranted chemically pure. Specially prepared for medicinal use. Isolated in the prepara- tion of c. p. ozone, or prepared synthetically in the form of a fifteen- volume solution. The oxygen in it is in a positive state antozone, while the ozone from which it is separated is in a negative state — the two mixing produce neutral oxygen. Indications. — Used internally and locally in all states in which a disease germ is the factor of morbid action — as in all fevers, cancer, syphilis, tuberculosis, diphtheria, bronchitis, pulmonary phthisis, nasal catarrh, ozena, gout, rheumatism, diabetes, Bright's disease, etc. Directions. — From a few drops to half up to one teaspoon- and Dictionary of Diseases. 447 ful, which is a large dose, but in cases in which the blood is germ-laden, the dose may be cautiously increased to a table- spoonful added to a glass of water every four hours. For bathing purposes or packs, one to two tablespoonfuls to a quart of tepid water. Variable degrees of strength are used for inhalation and ulcers. HYDRONAPHTHOL.— This is a secondary compound of betanaphthol, has a slight aromatic taste, almost colorless, spar- ingly soluble in water, but dissolves freely in alcohol, ether, chloroform and glycerin; it is non-poisonous, non-irritant, non-corrosive, but causes congelation of protoplasmic masses, hence its germicidal action. In a recent analysis on the value of germicides it is only nec- essary for my purpose to cull those experiments immediately bearing on hydronaphthol and corrosive sublimate. And the first experiment I would quote is that made to test the relative action of each on the spores of the bacillus anthracis and ba- cillus subtilis. In each case the strength of the antiseptic solu- tion used was 1 in 1,000; and it was found that in the treat- ment of the spores of the bacillus subtilis the length of exposure necessary to dstroy them was in corrosive sublimate thirty minutes and in hydronaphthol only ten minutes ; in the bacillus anthracis a ten-minutes' exposure was necessary for hydro- naphthol, while corrosive sublimate required fifteen minutes to destroy the spores. From this we may fairly conclude that hydronaphthol as a germicide is superior to corrosive sublimate or formalin, and from being non-poisonous and non-irritant it affords an ideal medicament for tinea tonsurans. As to the best means of getting the remedy constantly applied, the plasters of hydronaphthol, 10 and 20 per cent, give excellent results, limiting the propagation of the disease and causing the more rapid penetration of the germicide than any other means we can employ. The plasters also help us in starving the fungus, and to perfect this we need to hermetically seal the plaster round in the way I am about to describe. The method of treatment I have found successful is as follows : Have the head completely shaved, leaving the usual fringe all around; then wash with a 5 per cent soap of hydronaphthol, using water as hot as can be borne. After drying the scalp, apply over the affected area a 10 per cent plaster of hydronaphthol in narrow strips, letting each strip overlap its fellow, taking care that the plaster. Repeat the process, this time applying the 10 per cent 448 The Germicide 20th Century Practice plaster for ten days, when on removal the disease will be found to be cured. During the plaster treatment apply a 5 per cent diseased patch. Outside the margin of the plaster paint a layer of 10 per cent hydronaphthol jelly (when melted) so as to ex- clude all air. At the end of four days remove the plaster, when the diseased stumps will be found adhering to it. Repeat all the previous process, applying for one week a 20 per cent plaster. Repeat process, this time applying the 10 per cent plaster for ten days, when on removal the disease will be found to be cured. During the plaster treatment apply a 5 per cent ointment to the unaffected portions of the head night and morning. Care should be taken that all articles brought in contact with head before treatment be destroyed, otherwise re- infection will take place, and the treatment be brought into discredit. HYDROPHOBIA. — An infectious disease, which in na- ture occurs epidemically, chiefly among dogs; but the cat, fox. wolf, horse and all mammalia may become affected. Infection usually carried by a bite of a rabid animal, less frequently through a wound or abrasion. All manifestations of the disease, as it originates in dogs, point to a grave affection of the nervous system, and shows itself in two forms : In the first, which is the most common, is known as furious rabies ; the first indication is he becomes shy. low-spirited, restless, tears up things generally, bites with a peculiar high-toned bark. He refuses his ordinary food, but eats earth, rags ; spasm of the muscles of deglutition and respi- ration ; there is an abundant salivary secretion. Paralysis en- sues ; the jaw drops, the limbs drag and latterly he dies. In the second form is dumb rabies, in which great nervous depres- sion and despondency, paralysis comes early, and the dog dies without any furious symptoms appearing. The dread of water is a myth. The incubation period in man, after a bite of a rabid animal, is from fifteen to forty days up to seven or eight months, or even longer, depending greatly on the status of vital force in the bitten individual. A very small percentage of those bitten take the disease, and when about to appear it generally shows itself with a pain radiating along the nerves from the scar of wound to the trunk, a feeling of depression, irritability, insomnia, restlessness, in which all the reflexes are exaggerated, victim starting at the and Dictionary of Diseases. 449 slightest noise or ruffle or external compression. Appetite fails ; there is a choking in the throat. Spasms of the muscles of deglutition and respiration, and cortical excitement as evidenced by the delirium — foams at the mouth, breathing becomes spasmodic and sighing ; and all the muscles of respiration strongfy contracted. Tetanic convul- sions follow ; face is full of terror ; maniacal if occasionally con- scious, delusions and hallucinations. Temperature rises, face intensely congested; rapid but progressive emaciation; great exhaustion, with paralysis and coma. The virus of hydrophobia is not to be found in the blood, but in the nerve centres, chiefly in the cervical portion of the spinal cord. The source of infection in all cases is supposed to be due to the bacillus, which produces irritation, effusion of serum, de- generation in the anterior cornua of the gray matter of the cervical portion of the spinal cord, and in the nuclei of the cranial nerves — these changes include pigmentation, atrophy, and vacuolation of the protoplasm. Precautionary Measures. — Immediately a bite of a rabid animal, ligate above and below the wounded part, then thor- oughly wash with warm water; cup it. Make free incisions into it; then hot water to encourage free bleeding; even excise it if the parts admit of it ; cauterization with dry permanganate of potassa is good, then wash off ; apply peroxide of hydrogen for twenty-four hours and dress with jelly of violets, cicatriza- tion takes place ; renew the application morning, noon, night. Rabies is a most remarkable microbic disease, different from all others, usually as seen in our country due to an evolution in the dog under insanitary conditions. The evolution takes place in the salivary glands ; there its toxin is liberated, which travels along the nerves peripheral to the centre, never impli- cating the blood. A common disease of dogs, communicated both by contagion and infection, most frequently through a scratch, abrasion, a bite. In some localities it is epidemic, difficult to eradicate. It is estimated that from 10 to 20 per cent of individuals bit- ten by rabid animals become affected by the disease, depending altogether upon the strength and integrity of the nervous system. A strong, vigorous nervous system will resist the entrance of the microbe; if so feeble as to permit or effect an entrance, a period of incubation, depending upon the integrity of the vital 450 The Germicide 20th Century Practice force of from 20 to 90 days, seldom less an interval than three weeks is required, before the central nerve is in a state of chaos. No antitoxin — no hypodermic injection of a solution of car- bolic acid has ever cured either the bites of snakes or of any rabid animals, neither has the attenuated virus been more suc- cessful. All will admit that in the most aggravated cases of snake-bite, with impending death threatening, if the patient can swallow quart after quart of either brandy or whisky, un- til profound intoxication is induced and maintained twenty- four or forty-eight hours, the microbe will die, patient recover. Although we are how in the twentieth century, this partial suspension treatment must not be let drop; it is needful in peri- tonitis, and above all in rabies, each requiring a different remedy, but obtaining a like result. Brandy for snake-bite; opium for puerperal metroperitonitis, and skullcap and echi- nacea combined for hydrophobia. It is only in -the stage of incubation that any treatment is available in rabies. The microbe of rabies consists of small globular cocci, single or united into characteristic colonies. They are not met with in the blood, but are found literally swarming in the cerebral secretion, in and around the medulla oblongata and spinal cord. One hundred and twenty drops of brain juice from above the medulla yields three- fourths of a grain of a distinct crystalliz- able (ptomain) alkaloid, one thirty-second of a grain of which injected into a mule gives rise to all the symptoms of hydro- phobia, and in a short time collapse, convulsions and death. The exceptional virulence of this microbe is due to its vital and reproductive energy, to the rapidity with which it multi- plies, and the excessive amount of ptomains excreted by the germ directly in the nerve centres. The microbe is pathogenic of the disease, bears culture well in a neutral menstruum. Inoculations of the cultures, or bet- ter still the ptomains, give rise to the disease. From these cultivations new ones can be made and carried on through successive generations, all cultures behaving in the same manner, showing exactly the same changes as in the parent culture. The most minute droplet of any of those cultivations pro- duces the disease in animals. So far no germicide has been discovered that will either ster- ilize or annihilate the microbe; ammonia, skullcap, black co- and Dictionary of Diseases. 451 hosh, elecampane, electricity, Turkish baths, are of no avail. In a case of snake-bite an honest physician will prescribe brandy, see it administered until profound narcotism is in- duced, even if it necessitates immense doses, for he knows that if he can induce a quasi suspension of the nervous system for ten or twelve hours the snake bacillus will die — the patient is saved. So in peritonitis deep narcotism saves the patient. Induced mainly by opium and gelsemium. From practical experience I might give you cases in which the same principle is supreme in hydrophobia, but induced by a copious, freshly-made decoc- tion of skullcap. This remarkable plant has the faculty in its crude form only of inducing partial paralysis of sentient nerves and nerve matter, and restricting molecular activity in the motor. The action of skullcap is much intensified by alternat- ing each dose with ammonia, either liquor ammonia acetatis or the chloride of ammonia. The stomach must be well guarded so as to be tolerant, of doses sufficient to induce a feeling of pins and needles over the entire body. No rule in either of the conditions mentioned can be laid down for doses and retention in the stomach. The doses in all cases must be effective to do the work, modified by other remedies. If the case is let alone, incubation carried out, spasmodic ac- tion commenced, no remedy is in any way available; but one thing I will sav, that if a course of skullcap be administered thoroughly there will be no rabies. It is effective here as brandy is in snake-bite. More recently practitioners of repute and trustworthiness in Asia have introduced hoang-nan (strychnos gaultheriana) as a germicide which will destroy the microbe. The effects and physiological action of this drug are general indisposition, with extreme fatigue, vertigo, tingling of the hands and feet, with involuntary movement of the jaws, and a partial suspension of nerve power. If these symptoms are not present, while the drug is being administered, it is a certain sign of the presence of a microbe imbibing the remedy. In such cases the treatment must be continued, the remedy in- creased every dose, until the microbe is destroyed, which is known when the above symptoms appear. If the remedy acts too violently, either because the microbe or its ptomain is absent, or to the administration of too large a dose, it is easily counteracted by administering fluid extract 452 The Germicide 20th Century Practice licorice. Energetic, repeated doses either in the stage of sprouting (incubation) or upon segmentation (violent rabid stage) should be the rule. HYPERICUM. — Hypericum perforatum, or St. John's- wort. Therapeutic Uses. — It is an astringent and antiseptic ; good for gravel, diarrhea, hemorrhage, worms, jaundice, wounds, bruises ; contains a volatile oil and resin. r Preparations and Doses. — The fresh leaves bruised and ap- plied to ulcers, or the flowers macerated in olive oil in the pro- portion of four ounces to the pint, or submitted, like the mul- lein oil, to polarized light. The fluid extract is most available for external use : Dose : Thirty to sixty drops, every three hours, in dysentery. HYPERTROPHY OF CLITORIS.— May be congenital, caused by reading novels, dancing, posing, roller-skating, bi- cycle exercise, masturbation. Ozonized extract sumbul, bro- mide; salix niger; very large doses of the green root tincture of gelsemium ; continued for months. HYPOCHONDRIASIS.— An obscure mental disease most commonly met with in persons of middle age. The hypochon : driac studies his own feelings and functions so much, and in- dulges so largely in introspection, that he is always ready to believe himself to be a subject of some disorder, real or imag- inary. In most of these cases there is some dyspepsia or consti- pation ; in other cases the only cause seems to be monotony in the daily routine of life. In Ireland many cases are traceable to monotony of diet and a diet consisting principally of starchy food, such as potatoes. The disease is closely allied to hysteria. HYPODERMIC MEDICATION.— This form of medica- tion has been found of great efficacy in a large class of cases. The patient should be an adult, the skin should be raised by grasping it with the index finger of the left hand, and the noz- zle of the syringe inserted by a rotatory and piercing movement into the cellular tissue for at least one-half or three-quarters of an inch; into this the remedy is deposited, and the syringe withdrawn in the same manner as inserted, and, as it is with- drawn, the index finger pressed firmly for a few minutes on the aperture. The best locations for use are those in which there are few veins, such as over the deltoid and nape of neck. The axd Dictionary of Diseases. 453 remedy used, if possible, should be an alkaloid, the dose put up in the form of a compressed tablet, which dissolves readily in a few drops of water. The advantage of this form of medi- cation is the greatest positive accuracy, compactness, and per- manency. The following maladies have been successfully treated by this method : Abscesses. — Injected with c. p. dioxide of hydrogen are per- fectly obliterated. Apoplexy. — After free cupping to nape of neck and shoul- ders, active purgation, mustard, with heat to lower extremities, is most successfully treated by subcutaneous injections of er- gotin. Boils. — At any stage, aborted by injections of c. p. peroxide of hydrogen. Bubo. — Aborted by the same procedure and remedy. Chloroform Poisoning. — One drop of a 1 per cent solution of nitroglycerin in 15 minims of distilled water, which can be repeated in half or one hour. Chorea. — The glucoside scutellarine, 2 grains in a solution, or from one-twentieth to one-fortieth of curare, has been suc- cessful hypodermically. Convulsions. — Hypodermically, one-eighth or one-fourth of a grain of solution of sulphate of morphia immediately breaks the attack. Convulsions, Puerperal. — Chloral subcutaneously is better than orally. Congestive Chills. — Injections of atropia, alternated with bisulphate or bromate of quinine. Croup, Membranous. — Dioxide of hydrogen, 3 to 6 drops, respectively of glycerin and water, injected into the cellular tissue over the thyroid gland, dissolves the membrane, enables its expectoration, and substitutes tracheotomy. Dysentery. — Morphia, hypodermically, in one-third-grain doses, has been found more rapid in relieving tenesmus than any other opiate. Eclampsia, Puerperal. — Veratrum viride. 2 to 4 drops of the tincture, subcutaneously, as required to keep the pulse down to about 60. Pilocarpin. 2-per-cent solution, is also recom- mended. Eczema. — Arseniate of soda, hypodermically, in solution of one-fifth, one-half, and 1 per cent, commencing with 10 minims of the weaker, and gradually increasing, is recommended. 454 The Germicide 20th Century Practice Enuresis, Nocturnal. — Two very small doses of the nitrate of strychnia, injected in the vicinity of the rectum at suitable intervals, have proved successful. Epilepsy. — Curare in solution, 2 grains in 25 minims of water, with 2 drops of hydrochloric acid. About once a week inject about 4 drops beneath the skin. It has cured cases of several years' standing within two months. Erectile Tumors. — Have been successfully treated by injec- tions of perchloride of iron and chloride of sodium in solution, the tumor to be surrounded by a ring. Erysipelas. — Carbolic acid, 3-per-cent solution, eight or ten injections at the same time, so as to surround and cover the inflamed regions; also salicylic acid in the same manner. Foreign Body in Esophagus. — Threatened strangulation from impaction of gullet has been promptly relieved by induc- ing vomiting. Apomorphia, one-tenth grain, hypodermically. Emetina is also suggested in the same way. Fractures, Ununited. — Glacial acetic acid, 5 to 10 minims. between ends of the bones with hypodermic syringe. Iodine has also succeeded, used in the same way. Goitre. — Has been successfully treated by subcutaneous in- jections of ergotin, one-third, gradually increased to 1 grain. Hemoptysis. — Sclerotome acid (substitute for ergotin), 5- per-cent solution injected in neck or arm. Hemorrhages. — Hemorrhages, hematemesis, and uterine hemorrhages have all been arrested by hypodermics of ergotin and ergotinin. If pain, add morphia. Hernia. — Is more easily reduced by giving an hypodermic of morphine, with or without atropia. Hiccough. — In an obstinate case, resisting all other means, three-eighths of a grain of chlorhydrate of pilocarpin, hypo- dermically, quickly proved successful. Hydrophobia. — Much amelioration of the symptoms has fol- lowed hypodermics of curare. Obstruction of the Bowels. — Aloin has been used with suc- cess, subcutaneously, to move the bowels. Opium Poisoning. — Quite rapid recovery is reported to have followed warm hypodermics of fluid extract coffee, in 30- minim doses Caffein citrate and sulphate atropine are also con- sidered antidotes to opium. Perspiration, Arrest of. — Pilocarpin, the alkaloid of jabo- randi, will cause more or less profuse sweating, according to amount injected beneath the skin. and Dictionary of Diseases. 455 Polypus, Nasal. — Carbolic acid, .1 part; glycerin, 4 parts; 20 drops sunk into tumor by means of hypodermic syringe effectually dissipated polypus in some cases reported. Retention of Urine. — From paralysis of the bladder, accom- panying typhus, variola, and hydrocephalus, has been promptly overcome by hypodermics of ergot in the fossa behind the great trochanter. Skin Diseases. — Caused by animalculse. Sulphuric, carbolic, salicylic, or sclerotinic acids, hypodermically, as in erysipelas. Snake-Bites. — Ammonia, brandy, carbolic or salicylic acids are all recommended, hypodermically, in case of snake poison, and have been injected with benefit directly into a vein. Strychnia Poisoning. — Caffein, 1 grain, hypodermically ; al- cohol in same way is also suggested ; chloral injections are also, mentioned. Surgical Shock. — Quinine, 6 grains, hypodermically, with one-third grain of morphia. Suspension of Salivary Secretion. — Pilocarpin excites sali- vation. Szveats, Night. — Atropin has given results. Syphilis Bacillus. — Completely annihilated by injections of albuminic solutions of the protiodide of mercury. Tetanus. — Nicotine, one three-hundredth of a grain, alter- nated with chloral hydrate : accompanied internally with pow- erful antispasmodics. Trichinosis. — Ergot, dioxide of hydrogen, hypodermically, have effected cures. Tumors. — Hypodermically, dioxide of hydrogen, followed by faradization, sponged, moistened with the same remedy. Urticaria. — Saturated solution of bisulphate of soda, perox- ide of hydrogen, and other bactericides. The hypodermic use of either glandered horse serum or the ass or goat preserved by carbolic acid produces degenerative changes in heart, liver, kidneys. HYSTERIA. — Anemia of brain and spinal cord, giving rise to morbid excitability of the nervous system, with convulsions, paroxysms and various disorders. The peculiar pathological condition gives rise to distress at the epigastrium — a feeling as of a ball working up from the abdomen into the throat: convulsions, and a perfect fac simile of all disease in which spinal accessory nerves are involved, as tonic spasms, coma, epilepsy, chorea, lockjaw, heart, liver, ab- dominal disease, all simulated. 456 The Germicide 20th Century Practice General alteratives and tonics,, avena sativa, kephalin, nux, glycerite ozone, coca, Pulsatilla. Seclusion and rest, perfect isolation from all friends. Massage for five hours daily by vitalized operator. Electricity by induction and faradization. Diet. — Most highly animalized possible, with oatmeal and boiled fish. Most perfect cures by this method in all cases. ICHTHYOL. — A distillate of bituminous substances. In appearance it resembles coal-tar ; it unites freely with petroleum ointment or oil, and is partly soluble in alcohol or ether. Therapeutic Uses. — A cutaneous bactericide. Its value consists in its high percentage of sulphur, its solubility in water, and its freedom from toxic properties. It is used both in- ternally and externally in various forms of rheumatism, gout, -etc. ; also in parasitic skin diseases, eczema, etc., variously di- luted with water, or in the form of an ointment. In the form of a jelly it is curative in gastric catarrh; kills the sarcinae ; in suppository, valuable in enlarged prostate. The administration of this suppository should in all cases be preceded by a boroglycerid suppository at seven p. m., and the ichthyol two hours later. The advantages to be derived from its use are complete absorption of all adventitious ma- terial, and a reduction in the size of the gland to its normal condition, provided it is persevered with. The shape and make of this suppository are unique, pre- senting many advantages for easy insertion, being largest about the middle, tapering to each end, the apex being pointed and the base truncated, with infinitesimal circular corruga- tions. When this suppository is introduced as far as its greatest diameter, the pressure of the rectal sphincter at once carries it forward into the rectum, and the inconvenience and dis- comfort to the patient of having to push it far in, against the pressure of the sphincter, is obviated. This is of special im- portance in prostatic hypertrophy. These suppositories are germicidal, their base the finest butter of coca, an inoxidizable hydrocarbon. Their use obviates all surgical procedure, which is so disastrous to mental integrity. The internal administration of the jelly of ichthyol is pre- eminently destructive to the sarcinae ventriculi, the factor of gastric catarrh ; hence a good remedy for that form of stomach trouble. axd Dictionary of Diseases. 457 ICHTHYOSIS. — A rare disease of the skin, associated with a dryness and scaliness of the cuticle, without heat, pain or itching. It is usually congenital. Treatment. — Frequent bathing and the free use of dermolia ointment is curative. IDIOCY. — Gaping idiocy, feeblemindedness, a condition in which there is a deficiency of the cineritious elements of the brain, and an obliteration of its typical fissures of thought. Its etiology is either alcoholic conception, incompatibility of temperament on the part of the parents, drugging of the mother during pregnancy with abortefacients, drudgery. Its treatment is quite elaborate and generally successful be- fore the patient reaches the age of twenty-one. The absurd cataclysmal stages of seven, fourteen and twenty-one must find no place in scientific treatment. Thyroid extract must be administered daily in such doses as the attending* physician deems prudent to start brain growth ; persevered with for months; c. p. solution spermin, avena sativa, kephalin, comp. hypophosphites, diet rich in phosphates, oatmeal, boiled fish, wheaten grits, etc., liberal to a fault. Frequent bathing or sponging to wipe away the peculiar exhalations. Massage to quicken the springs of life. Plant life in him by maintain- ing the highest possible state of health. Keep him from isola- tion, solitariness, as they increase intellectual torpor and are productive of deterioration. Surround him with influences of art and nature to make life joyous and quicken his power of thought. If under twenty-one years of age, thyroid extract of the lamb never fails ; push it during all seasons. Summer brings a remarkable immunity from disease; gym- nastics, massage, faradization, moral training: and instruction can be pushed. IMMUNITY. — The capability of our bodies in a state of health to resist the attacks or entrance of disease germs is wonderful; different, however, when we are unnerved, either by overwork or worry or depression, or exhaustion; then all or many bacteria can enter, as the vital forces are powerless to resist. No evolution of bacteria in health — even if an entrance be effected, they are harmless, as long as perfect health exists. Germicides will kill microbes, stop their propagation, but it is vital force that prevents their growth. Germs may pro- 458 The Germicide 20th Century Practice duce disease, but health never produces germs. Deadly germs can only live in a pabulum homogeneous to their character. If, with the microscope, we examine a capillary blood-vessel, we will observe, the red blood-corpuscles flowing rapidly along, compactly, close together, in the centre of the blood-stream. They appear to be hurrying on as though engaged on some im- portant business, and, being somewhat late, were impatient to reach their destination and begin work at once. They seem to have a definite purpose, and are eager to carry it out. The red blood-corpuscles have, indeed, a special function, that of carrying oxygen from the lungs to the tissues of the body. The oxygen, which is loosely combined with the hemoglobin of the red blood-corpuscles during their momentary exposure while passing through the lungs, is carried to those parts of the body to the welfare of which it is essential. In as far as we know, red blood-corpuscles do not convey carbonic acid in any con- siderable quantities from the tissues to the lungs ; that this gas does reach the organs of respiration from the tissues and is there expelled from the body is well known, but that it is car- ried by the red blood-corpuscles is not by any means assured ; i< is, in fact, probably carried by the plasma When we examine the white blood-corpuscles we find them moving slowly along the outer edge of the capillary blood- stream, clinging to the sides of the vessel, or lying in the still layer. We will also notice the leukocyte occasionally sending out pseudopodia as if feeling along the walls, and presently, into a small crevice between the cells, the process will in- sinuate itself, and the white corpuscle gradually passes from the capillary into the surrounding tissue. A white blood-corpuscle is composed of native undifferenti- ated protoplasm, not fitted for any special purpose, but possess- ing all the fundamental properties of protoplasm — irritability, contractility, metabolism, reproduction, etc. Therefore, when it escapes into a surrounding tissue, it has the faculty of be- coming a part of that tissue, whether nerve, muscle, connective, or other, but if not taken up, it enters a lymphatic vessel, and in time returns to the general circulation, to enter upon another round of adventure. As free protoplasm, the white corpuscle lias the fundamental properties mentioned ; as fixed, it is gov- erned by the organ or tissue of which it becomes a part, and we have then a manifestation of certain only of these properties, to the exclusion or complete subordination of all the rest. As has alreadv been stated, the leukocytes are in the still and Dictionary of Diseases. 459 layer of the capilllary blood-stream, having, apparently, very little to do, and abundant time in which to do it. These entities are, however, not so idle as they appear, but are, in fact, doing what we might call police duty. They are on the look- out for invaders, foreigners, such as bacteria, bacilli, and micro- organisms of every kind, for such are the natural prey of the leukocytes, or, as better designated, the phagocyte. Bacteria abound everywhere, on all external things. We absorb them constantly with our food, with our drink, and with the air we breathe ; they thus constantly reach the blood-stream in large numbers, but are there attacked and destroyed by the phagocytes, and whatever harm they might have done is pre- vented. When germs come in extraordinary numbers, the conflict be- tween the phagocytes and the invaders grows fiercer, and should the foreigners prove too strong, the phagocytes suffer defeat, the pathogenic bacteria triumph, and the body in which the conflict has occurred is damaged to such an extent as to destroy the organism as a living entity. But if, as is more frequently the case, the phagocytes have eventually conquered, the body then becomes immune to that special form of invasion against which battle was waged, and will not again suffer from an attack of the particular form of pathogenic germ which was conquered. And thus the individual is protected from a future attack of measles, smallpox, or whatever form of contagious disease is represented by the attacking pathogenic germs. The battle between the phagocytes and the assailing hosts gave rise to considerable friction, the temperature of the body was elevated, the circulation accelerated, and the patient be- came very uncomfortable during the conflict. The phagocytes at first, unaccustomed to the invaders, were taken by surprise, did not understand the methods of warfare employed by their opponents, and were almost defeated. But as the war con- tinued, new phagocytes were born, who, arriving on the field with inherited resistance, acquired more, until in time a race appeared which was able to expel the enemy. Perhaps several generations of phagocytes may have been necessary with the survival of the fittest before this was accomplished, but when once attained, immunity was permanent. Sometimes, rarely, a second attack of the same contagious disease may occur. This is due to the debilitating influences to which the body may liave been subject, and to an exhausted heredity, the opposing power of the phagocytes having been weakened. 460 The Germicide 20th Century Practice Acting upon the theory of natural immunity through phago- cytic action, artificial immunization has been attempted. The object has been to gradually render the phagocyte immune to the various microbes of infectious diseases by injecting into the blood a weak cultivation of the pathogenic organism. As the phagocytes learned to resist the weakened culture, the strength of the culture was gradually increased, and in propor- tion the resistant power of the phagocyte increased, until eventually, the strongest infection was repelled, and thus im- munity was conferred upon the body. In this manner hydrophobia was anticipated, smallpox pre- vented, and other infections, of which a weak and harmless germ culture could at first be made, were introduced into the healthy body to render it immune. It was for a time claimed that almost all diseases could thus be evaded, even syphilis, tuberculosis, and cancer; and enthusiasts were rejoicing that the millennium in preventive medicine was near at hand. This theory of immunity has terminated in one of the grossest frauds ever perpetrated upon the medical profession, fallacious in every essential point. The theory of the phagocyte action of the white blood-cor- puscles was also made to serve here. It was granted that there was a conflict between the invaders and the phagocytes. The theory was, then, to increase the number of phagocytes by the injection of white blood-corpuscles into the body, and thus to- re-enforce them, as it were, and in this way to overcome the pathogenic organisms by force of superior numbers. According to a very popular theory, a course of injections must be taken for the prevention of each contagious disease, as immunization from one did not prevent at attack from another, different in nature, and so it would require a long time to render the body safe from all. Seropathy does not endeavor to ren- der the body immune, but waits until infection occurs, and then by re-enforcing the natural protective forces of the body. the phagocytes, drives the disease from the body. Both of these theories are based upon well-known facts, and doubtless have some good points. That the results are, so far, not all which fervent adherents claim is well known. There seems to be a limit to the protective and combative power of phagocytes, however numerous, and when introduced into the blood in large numbers they consume each other or die, and are thrown off by the excretory organs. The normal proportion of white blood-corpuscles in the blood is at most but one of and Dictionary of Diseases. 461 two hundred of the red, and it does not appear that artificial leukocytosis increases the resistant power of the body. The theory is a beautiful one, but it fails in its ultimate realization. It is to be regretted that such is the case, but from foreign shores the rumblings of decay are already heard, and soon only those behind the times will be found upon this ground. In a high state of vital force — perfect health, free from lesions, free from auto-intoxication is a body immune — a body in which pathogenic microbes are powerless to cause disease; all disease germs require a soil ready for their reception. There must be no defect, no depression of vital force either temporary or permanent. True a rudimentary condition of the great sympathetic ren- ders its possessor immune to some maladies, such as yellow fever, acute laryngitis, carditis, pneumonia, etc. Immunity is lost either by neglect or ignorance of hygenic and sanitary precautions — it is lost by inertia, sloth, which gives rise to auto-intoxication, the indirect cause of licentious- ness and intemperance, potent factors in the production of disease. Remedies that vitalize the nervous system act efficiently by promoting molecular activity of the great sympathetic — favor the acquisition of immunity, such as change, abundance of fresh air; good wholesome, unadulterated food, bathing, massage, etc., together with the administration of passiflora, a nerve builder, aided by avena sativa, kephalin, alternated with thy- roid extract, c. p. solution of spermin, protonuclien. ' Immunity by nutrition increases the phagocytes that take up foreign bodies, poisons, into their own bodies and destroy them ; then certain substances appear in the blood, antagonistic to all toxins, and the vital activity of all disease germs ; then a process of immunization goes on and keeps ahead. IMPAIRED VISION. — One thing that strikes a stranger visiting our large cities is the vast number of cases of im- paired vision. Now;, gentle reader, you must not entertain the idea that all such cases in young men and women are due to masturbation, or that in adults it is due to sexual excesses. A certain proportion are due to those causes. A great excess of uric acid in the blood produces a hazy or foggy vision. To the presence of toxicity we must trace the largest pro- duction of impaired vision — that toxin of disease germs. I 462 The Germicide 20th Century Practice have met with numerous cases in the eruptive fevers of sudden loss of sight, which was restored by a warm bath and an emetic. The toxin of typhoid fever, under the old treatment, often gave rise to optical neuritis and cerebral degeneration. Under the germicidal system this is unknown. The toxin of diphtheria has a preference for the optic nerve, for certain branches of the musculo-spinal, the palate, while that of spyhilis affects the cranial nerves generally. The prolonged use of all acro-narcotic drugs is injurious to the optic nerve, the alkaloidal element leads to neuritis of the peripheral part of the nerve. Nicotin from pipe-smoking, tobacco, comes under this class. In impaired vision from tobacco-smoking there exists an in- terstitial inflammation of the axial portion of the optic nerve, a true neuritis. The defect occupies the centre of the field of vision and is usually the most marked for colors. The impaired vision in chronic alcoholism is due to atrophy of brain and optics, a true shrinkage. The impaired vision in diabetes is due to the toxins of glucose giving rise to inflammation and opacity of the lens. Very much of the impaired vision of the present age is due to the preservation of milk and other food products, especially meat and poultry by formalin — a process which causes ir- reparable atrophy of the optic nerve of every individual who consumes such articles. Impaired vision due to toxins affecting the optic nerve is best treated by a general alterative and tonic course, improving nu- trition in every possible manner, inculcating a change of scene, the withdrawal of the poison, stimulation to the root of the optic nerve in the medulla oblongata. As a real curative drug ozone water is undoubtedly the best. It is a scavenger to the blood, an excellent remedy to sweep alkaloidal poisons from the tissues. Although a powerful eliminator of tissues it is constructive. The dose not to exceed three teaspoonfuls daily — one morn- ing, noon and night. If there be anemia give protonuclien a trial. If the case is stubborn I have been most successful with the hypodermic injection of the nitrate of strychnine over the deltoid muscle, the solution being eight grains to the ounce of distilled water. Ten drops every day, or if twenty drops be injected the patient must be held under the physician's observa- tion for an hour after the injection. axd Dictionary of Diseases. 463 IMPETIGO. — A disease of the skin characterized by the appearance of pustules, which are most numerous on the face and limbs, but are generally few in number at one time. Each pustule is surrounded by some redness. After a few days the pustules burst, shrivel, and dry up, scabs being formed. It is most commonly met with amongst children, but one variety appears to be contagious. It is not a dangerous disease, al- though there is often some slight constitutional disturbance. Treatment. — Locally dermolia ointment is invaluable in- ternally sulphite of lime. IMPOTENCE. — An inability to copulate or perform the sexual act is one of the most common derangements of the male sexual organs, and this failure of the generative function is either due to debility or weakness ; to deficiency or absence of erection ; to abnormal conditions of the genital organs, which render intromission of the penis impracticable. Hence men who are impotent are usually sterile, the power of procreating depending upon depositing the semen well up into the vagina. There are four conditions, either of which may render a man impotent : 1. Debility or Atonic. — The most common of all forms, due to exhaustion of the nerve cells, a sequel of fevers; local inflammation of the prostrate urthra, the result of sexual ex- cesses, gonorrhea, injuries, masturbation, withdrawal. 2. Sympathetic or Psychic. — Due to some damage done to the great sympathetic, either by or through some depressed emotion, desire, affection, passion — the outcome of sexual neurosis, brought about by excessive mental strain, close literary brainwork, which is attended by a lack of confidence. 3. Paralytic. — Generally due to defective nutrition of the nerve cells or neurosis of the reproductive organs; often originates in masturbation, sexual excesses, perversion of the sexual act, dalliance, wearing condums, varicocele. 4. Organic. — May either depend upon malformation or some congenital defect ; or mutilation or deformity ; or obesity, inguinal hernia, hydrocele or undescended testes; or to the toxins of disease germs, drugs, coal-tar derivatives, alcohol, which give rise to softening of the brain or spinal cord. The first three forms of impotency thus enumerated are more common in America than any other country in the world. This is due to the widespread excesses, masturbation, overstimula- tion; to our highly oxygenized atmosphere, to an intense neu- 464 The Germicide 20th Century Practice rosis which pervades our entire population and infiltrates every cell and neuron of the body; to debasing, sensually-absorbing* literature. In higher altitudes impotency is alarmingly common. The treatment of these different forms of impotency re- quires great skill, finest discrimination, tact and extensive ex- perience. The confidence of the patient must be secured; he must be squarely and honestly dealt with ; all causes that can be removed should be got rid of. The general health should be seen to by proper clothing, daily bathing and a most nutritious diet. All cases are benefited by a general tonic and alterative course of treatment, and every organ in the body, especially the brain and spinal cord, put into good working order. All incidental maladies, as piles, varicocele, relaxed states of the ejaculatory ducts, seminal vesicles, stricture, irritable pros- tate, all must be got rid of. It must also be recognized that certain trades or professions blight, wither, exhaust the reproductive centres, such as opera- tors in photographic and electrical supplies, or workers in lead. 1. Debility or atonic impotency is the most common form. Through some weakness, the lumbar or reflex centre for erection fails, wholly or partially, to respond to the ordinary stimulus ; the centre is defective, lessened in vitality, deficient in activity, mobility, excitability, tonicity. Any cause or causes which would be productive of a partial death or inflam- mation of the prostatic portion of the urethra will give us this form of impotency, such as masturbation, sexual excesses, gonorrhea, bicycle riding, perversion of the sexual act, congress with harlots ; a constricted or elongated prepuce. Inflammation of the prostate urethra and genito-spinal centre gives rise to seminal incontinence and incapacity. It is a true neurosis, with the prostate urethra exquisitely tender, with a diminished sensibility ; lax, flabby condition of the skin of the penis and scrotum. Most common of all forms, usually caused by gonorrhea and masturbation, but many other latent causes are at work ; char- acterized in all cases by an inability to consummate the act of coition. All aphrodisiacs, such as mix vomica, muira puama, spermin, ambrosia, damiana, must be kept back until all congestion is removed, until the reflex excitability of the spinal cord is sus- axd Dictionary of Diseases. 465 pended. The diet in the four varieties should be abundant, generous to a fault, nutritious and digestible, but unstimulating — tea and all alcoholic beverages avoided. Sleep on right side on a hair mattress ; empty the bladder before retiring. Bicycle and horseback exercise must be avoided, even driving on the rough seats is injurious. Every condition in life that will cause congestion of the prostate urethra must be carefully avoided. To cure the genital centre in the cord, remove the congestion in the prostate urethra, wipe out irritability, the combination of the green root tincture gelsemium and ozonized passiflora excels all other remedies. 2. Sympathetic or Psychic Impotency. In this form we must recognize that the great sympathetic has suffered a shock, a partial death. There are numerous forms or varieties ; the most common are the sexual, those due to exhaustion of the great sympathetic which covers the anterior portion of the penis. The damaged state of this branch usually occurs in those who have been guilty of early indiscretion, masturbation, excesses, unnatural methods of intercourse, or in those who have had the gonococcus, or had congress with harlots. Catarrh of the prostate and bladder, or inflammation of the testes, or some depression of the nerve either in the heart, larynx, lung or stomach, because any weakness of this nerve in any part, even in organs so distinct, causes by sympathy genital failure, all organs supplied with branches of this nerve are in constant •communication with each other — they harmonize. In more than two-thirds of all cases of impotency the cause lies in a deranged state of the sympathetic, a lack of confidence in his power to accomplish the act ; a fear or dread which ren- ders them impotent. In consequence of this fear and dread, the inhibitor}* nerves become paralyzed in any one resorting to unnatural methods for the gratification of his sexual appetite. Even the prostate in highly civilized men contains in its cortical layers extensive nervous plexi interspersed with ganglia. This form of impotency not infrequently disappears spon- taneously when the mental condition is removed — pain, grief, misfortunes have a paralyzing effect on the centres of erection. Impotency from the restraining or inhibitory control of the brain over the genital spinal centre is much less common than the preceding form. The erection may cease or fail altogether under the influence of excitement, or under the influence of 466 The Germicide 20th Century Practice some depression, emotion or passion, or a mental preoccupa- tion, is a fact with which we are familiar. Masturbators who marry, or married men who resort to withdrawal, are at first victims of this form. All such are liable to have erections failing before the act is complete, or having erections so feeble that penetration is impossible. Disgust, fear, indifference, repugnance, suspicion of in- fidelity, lack of self-confidence, due to early vices and ex- cesses, has produced reflex excitability. The semen of young men of a nervous temperament who have been addicted to the secret vice, or been with courtesans, or who have read books with vivid colors, very soon become destitute of healthy spermatozoa ; that is, they become dwarfed, poverty struck, infertile, and lose their vitalizing effect upon the careworn sufferer, and the so-called seminal discharge is thin, watery and loaded with spermatic crystals, and the very- presence of these crystals denotes nervous bankruptcy, dimin- ished spermatozoa or their entire absence, degenerative changes with unproductive semen. Men with damaged sympathetic nerve or brain, with a chaotic or disarranged nervous system, often suffer from im- aginative impotency from the slightest exciting lesion. Some neurasthenic men will imagine their penis too small, others have occasional nocturnal emissions and they are afraid of failure; while another class imagine that they have either stricture or a tight foreskin, or varicocele, or a gleety dis- charge, or that their testes are wasting. All usch, when they make the attempt, not infrequently have erections failing- through sheer fear of inability to penetrate. The mind preys upon itself, constant thought that impotence is impending, that it is the natural outcome of early errors or excesses is sure to cause a failure. Young husbands on the first night of marriage often fail", simply through eagerness ; the sympathetic influence withdrawn from the heart all droop. Most men will fail once in a while; especially if they have masturbated: they are baffled because they cannot consummate the act; unfortunate attempts give rise to much distress and misery in regard to its re-occurrence. In psychical or nervous impotence everything is favorable for a cure if all the sexual organs are normal.^ The excited cerebral activity must be overcome by the ozonized passiflora extract, doses sufficient to control their abnormally excitable nervous patients, who enter upon coitus with powerful erec- and Dictionary of Diseases. 467 tions and extraordinary excitement, yet before the beginnings of the act the penis droops and its introduction an utter im- possibility. Such failures are discouraging, but in the ozonized passiflora, in black willow extract ozonized, in the salix nigra bougie and suppository we have a true panacea. Psychical impotency depends upon a damaged sympathetic, characterized in a large percentage of cases by weak erections of short duration, ejaculation too soon, aversion not an infre- quent condition. Complete loss of erections is soon followed by abolition of the sexual appetite altogether. As patients suffering from physical impotence have generally a normal genital apparatus, and very few of them suffer from azoospermia, the prognosis as a rule is favorable. This neu- rosis of the sympathetic is most variable in its manifestations. When alone in bed he may have powerful erections, yet as soon as he attempts coitus, he approaches it with fear and doubt, and there is no erection, or an imperfect one. Some men can go with one woman only; whereas, there are others who can go with any one, under all conditions. Brain workers, as a rule, play a lamentable role in sexual intercourse. The nervous system is particularly susceptible to the effects of sexual excesses, still more to masturbation; both induce a series of changes in the nerves — in the cells of the cerebral cor- tex — which is of the nature of a softening, with a swelling of the protoplasmic branches of the fibres of the nerve cell. These changes are followed by a gradual disintegration and breaking up of the cell protoplasm. 3. Paralytic. — May be denned as a loss or decay of erectile power, with diminished sensibility and size of the organ pres- ent in the advanced stage of impotency. It may be partial or complete. Most commonly met with in those who have abused their sexual powers with harlots, masturbation, excesses, or have received blows or injuries upon the head or spine. It is a sort of blight upon the reproductive organs. Most insidious in its commencement, appearing in men of thirty years of age, becoming more common as we ascend the scale of age, with apparently no effect upon the general health, unless it be an occasional slight dyspepsia or marked depression in the hot weather. In every case there can be detected a secret draining away of semen, a mere humidity, moisture, weeping, but just enough, week by week, to undermine the health, impair the strength, weaken the vitality of the individual, rendering him liable to- cerebral softening, apoplexy and paralysis. 468 The Germicide 20th Century Practice In other cases semen may pass in the urine-, or there may be intermittent priapisms, followed by exhaustion, prostration. , Such states of oozing or leakages are not less debilitating than an emission, for every drop that does escape is the abode of a living being, a particle of living seed, possibly deteriorated by disease, but the gradual loss of which is tantamount to the destruction of the body. For the cure of sexual apathy or paralysis I have found it of the utmost benefit to administer remedies both by the rectum and mouth. In the rectum remedies which will dissolve readily set free their potent properties and be quickly absorbed into the seminal vesicles, which lie directly in front of the rectum, affecting also the sympathetic and ganglionic nerves that surround the vesicles in a veritable network. Salix nigra suppository, for losses, drains, weakness, exhaus- tion, and in short all forms of spermatorrhea. The pink marrow suppository after every meal for lost vigor, degeneration >of the sexual ganglia, for obliterating reflex neuroses, and some forms of impotency and sterility ; for vital- izing and rejuvenating the deadened, dulled, paralytic and all forms of sexual decay. The pink marrow restores strength, imparts tone and equi- librium to deadened nerves; besides, it soothes irritability and excitement. Muira puama is a drug of intrinsic value, for if there be a spark of sexual vitality left, its careful administration will bring it to the surface. This remedy supersedes all sexual excitants, and is worthy of the serious consideration of the profession. 4. Organic Impotence. — The power of sexual intercourse may be altogether extinguished or permanently abolished in consequence of certain congenital or acquired defects, malfor- mation, injuries or disease of the external genital organs, through which penetration and erection is impossible ; an arrest of the secretory activity of the testes, malformation of the penis from a mere rudimentary condition to one of hypertrophy; a scrotal hernia, hydrocele, deformities of the scrotum unfit the organ for use. Congenital shortening of the corpus spongi- osum, which keeps the penis bent down toward the perineum. Distortion and vicious deviation, generally due to induration during erection externally to one side or the other, interfere with coition, rendering that act impracticable; calcification of and Dictionary of Diseases. .469 the spongiosum may give rise to impotence from upward or downward curvature of the penis. Absence of the testes is attended by an inability to copulate. If present, the microbes of syphilitic cancer completely destroy their structure, secre- tory and fertilizing power. The power of erection may, after it has been lost, be re- stored, if the cause can be removed. If it depends on syphilis, comp. saxifraga and chloride of gold ; if on arrest of develop- ment, ozonized thyroid extract, protonuclein, oats, kephalin. c. p. solution of spermin. If it arises from indiscreet use of saturating the system with medicinal agents, such as lead, arse- nic, opium, cocain and all the coal-tar derivatives, a general alterative and tonic course is best, with the comp. tincture of ambrosia orientalis orally and in suppository form. As the state of impotency is of such vast importance, we herewith append the views of the leading physicians in our country on the subject : Impotence is a morbid condition, physical or mental, in either sex that prevents the spermatozoa of the male from com- ing in contact with the female ovule : in other words, it is an inability to consummate the sexual act. Sterility is a condition in which neither spermatozoa nor ovules are secreted or elab- orated ; or if evolved, their vitality is immediately destroyed, or possess no fertilizing power whatever — a perfect want of power to fecundate. The act of copulation in man may be rendered inoperative by a variety of causes, such as by an absence of the penis, or a want of growth or development, or malformation, or mutilation of the organ. The dorsal or upper aspect of the penis is covered with branches of sympathetic nerve, and its erectile power may be influenced by moral influences, as emotions, desires, affec- tions, passions ; these may be simply overexcited, or violent, or dormant ; the man may have lost his confidence, through fear. or modesty, or anxiety, or great love, or even disgust, and find it impossible to get an erection, the organ remaining flabby, like an old rag. It is to be naturally expected that diseases, as in fevers, blood diseases, and general debility from any cause, would render the sexual organs feeble for some time. Injuries about the back of the head, blows, falls and jars of childhood, as well as the concussions, shocks of more mature life, as rail- road accidents — which are a great factor in its production ; heat of sun on back of head : those are the most stubborn, as sexual desire is located and semen secreted in the brain. Again, in- 4/0 The Germicide 20th Century Practice juries and diseases of the spinal cord will abrogate the power to copulate, though the desire remains and semen may be se- creted. Abuse of the sexual organs by masturbation, and by what is vulgarly known as tasting, destroys every vestige of erectile power. If persisted in, the function may be forever lost. Congress with loose, lax, very large women, or those affected with leukorrhea, or excessive sexual intercourse, will in time impair and remove the power of erection. Excessive obesity, large scrotal hernia, hydrocele, locomotor ataxia, and other diseases will also prevent coition. Drugs, and the reckless abuse of some remedies, have a most deleterious effect 'on the sexual function. The excessive use of tobacco, which impairs digestion, weakens the nervous system, relaxes and whittles down the muscular tissue, renders a man feeble in procreative power, and ultimately saps his very vitals. Opium eating, or smoking, or morphine and chloral using, dries up the very springs of life, prevents the elaboration of semen in the brain, and paralyzes the nerves that supply the erectile fibres. The long-continued use of digitalis in cardiac affections tells most disastrously on the penis, in causing impotency as well as ster- ility. The long use of bromide of potass on brain, spinal and testicle is equal to castration. The treatment of impotence and sterility must be influenced by the causes from which they spring; some are incurable, whilst others can be removed by appropriate remedies. Cases that depend upon congenital deficiency or malformation of the sexual organs are all more or less capable of removal in one way or other. The cases of impotence which depend upon functional or moral causes are the most numerous. It is met with in the following forms : slight deficiency of desire and capacity, or in deficiency of capacity with an increase of desire, as is met with in spinal irritation or blows on the head. In either of these forms the emission may come too early or even before introduction. Profound deficiency, both of desire and capacity, due to self- abuse, excess or perverted sexual function, in which varicocele, wasted testes; penis cold, shrunken, paralyzed, or anesthetic; power of erection weak or utterly wanting, is the most com- mon of all forms. Some have damaged their procreative powers so irreparably that erectile power is increased abnor- mally, and in the sexual act no discharge of seminal fluid takes place; while others have a mere debility or weakness of the generative organs from too early coition or abuse. and Dictionary of Diseases. 471 The sexual sense is in the brain, transmitted by nerve fibres to the glans penis, in which all sensations in the male sexual apparatus originate. The delicate pinkish or reddish mucous membrane of the head has in it thousands of microscopic nerve fibrils, each of which ends just under the mucous membrane in a delicate pear-shaped bulb, about one-twelve-thousandth of an inch in diameter. It is the overexcitement of those nerve bulbs by self-abuse, excesses, sedentary occupations, venereal disease, or by agents acting on the brain, as solitary confinement or blows ; these and like causes deaden the nerve bulbs, and give us the impotence so common in the present age. It is then the damaged glans penis and brain that we find to be the source of failing power, lost sensitiveness, lack of erectile power, wasting, shrinkage, impotency. Now the ordinary treatment for such cases is bathing, friction, massage, best of diet. The internal use of glycerite of kephalin ozonized, phosphated tincture of oats, damiana. etc., is often slow, unsatisfactory, or it may be inef- fectual. But the direct method of treatment seldom fails, that is to bring ozonized vitalized bougies into the urethra up to the semi- nal ducts in the prostate urethra, permitting them to melt and be absorbed, so that they will soothe the nerves of the glans and reinvigorate them with new life. The absorbents here are keen, active; they carry the remedy deep down to the ducts, vesicles and nerves, imparting tone, vigor to the parts. The most hopeless cases of impotency are those in which the brain and spinal cord have been damaged from shock, concus- sion, the toxin of disease germs, sclerosis of the cord (ataxia), some chronic organic disease of the cord, thickening, mutila- tion; these are not common, and, as a rule, cannot be rectified. As a rule there should be a general treatment in all cases, which should embrace daily bathing, with the use of the shower bath, friction, massage, hips daily; bowels to be kept regular; sleep on right side, and its duration extended to eight or nine hours out of the twenty- four; moderate exercise, no mental work, no care, worry or excitement. The use of tea, coffee, whisky, together with tobacco, must be rigidly forbidden. The use of brain food should be insisted on, such as oatmeal, broiled white fish, corn bread, eggs, oysters, beef, mutton, poultry, game ; aid digestion, if necessary, with pepsin or papoid and matricaria. An alterative and tonic course can always be followed with 4/2 The Germicide 20th Century Practice advantage, as it has a tendency to improve the general health ; besides stimulating applications to the spine are most beneficial in the form of plasters, friction, shampooing, electricity. Men with a largely developed or weak great sympathetic often suffer from passive or imaginative impotency, fear they have an inability; disgust with their partner; perfect incom- patibility in some cases, and it is in those very cases the admin- istration of passiflora and matricaria work magnificently. As to special remedies for the cure of real genuine impotency, a physician can select from the following list a feAv remedies of genuine, intrinsic value : Comp. tincture matricaria for all around tonic in every case of sexual impotency is unexcelled in its action. It stimu- lates a rousing appetite, braces up the reproductive centre, the brain and the cord. The ambrosia orientalis, either in tincture, pill, tablet or sup- pository, is a powerful sexual vitalizer, a cerebrospinal stimu- lant, prompt and powerful in its action. Muira puama and damiana, tincture, bougie and suppository, are often of much value, especially muira puama, administered in small doses for a length of time. Its sole property seems to be to augment the strength of the erectile fibres ; if its action is well supported by oats and kephalin, it has much merit as a vit- alizing remedy. As regards damiana, the article must be good ; even then it has a feeble action. It is a drug much depreciated by the manner in which ignorant charlatans have manipulated it. The animal extracts are of immense utility in aiding a cure of hopeless impotency. Either protonuclein or thyroid extract should be administered in every case, in alternation, week about ; they favor evolution and growth of spermatozoa by their producing leukocytosis ; in other words, they are the active principle of life. In alternation with one or other of these two, either c. p. solution of spermin or glycerite of kephalin, or tincture* of Scotch oats. These remedies are true builders of vital elements when once introduced into the alimentary canal; they are bound to gen- erate and augment sexual vigor. They produce a higher type of manhood, rejuvenate, revitalize the sexual centres in the brain and spinal cord. For the present age and its general char- acteristics these are the remedies for more power, more strength. and Dictionary of Diseases. 473 The kephalin granules are a most elegant form, suitable for those unable to take liquid preparations. The large mass of our population are victims of neuras- thenia, and especially so among professional men, clerks, mer- chants, bankers, brokers, ministers and theological students, who suffer from impaired sexual and vital power, and are un- der the care of some physician, losing time, and taking treat- ment for some imaginary disease, such as dyspepsia, consump- tion, constipation, etc., when really their very life and vitality is oozing away, either in the urine or otherwise. Some of them may have had a gonorrhea imperfectly treated, followed by gleet, stricture, damaged urethra, and the inflam- mation has been carried back to the seminal ducts, at the neck of the bladder, caused them to be relaxed, lose their tonicity, the semen oozes away, giving rise to impotency. Stricture of the urethra caused by masturbation, one of the most common of all causes. Varicocele, the weak, relaxed, dilated veins of the spermatic cord, in itself inherent debility, gives rise to imperfect nutrition and atrophy of the testes ; semen becomes thin, watery, infertile : sexual organs wasted, misshapen ; sterility ensues. In such cases the remarkable action of matricaria and keph- alin excites a renewal of life, a rapid and perfect restoration of the organs to a natural and healthy condition. Even cases deemed hopeless, who have gone from one physi- cian to another, without help, have been radically cured by a prolonged course of these two remedies. Children of masturbators are usually puny, sickly, dwarfed in all the attributes of health ; but let a man so circumstanced take matricaria and kephalin, all subsequent children will be healthy and fully developed. This fact alone speaks volumes for the efficacy of the remedies. The sexual decay of advancing age, blows on the head and back, concussions of modern travel, damage to the testes, the toxins of disease germs, use of tobacco, alcohol, chloral, opium, all dry up the springs of life. With regard to the failure of sexual power in old men; or past middle life, no man, if he is reasonably careful, should find his sexual power decaying before he is seventy or eighty vears of age. But what man has been even reasonably careful? Has there not been some time in life that he has been guilty of some indiscretion which he thought did not injure? But it did : he may have escaped an acute attack, but silently it weak- ened him. 474 The Germicide 20th Century Practice To those cases of hopeless impotency in the aged we would suggest a course of treatment somewhat different from that which is usually adopted. Instead of rushing to sexual ex- citants, begin with a course of remedies calculated to promote a growth of spermatozoa, such remedies as ozonized thyroid, protonuclein, the active principle of life, c. p. solution of spermin, kephalin, avena, aided with the best of brain food, freedom from worry or care, daily bathing and massage, to- gether with every possible means to promote a renewal of life, before such sexual excitants as damiana, ambrosia orientalis, muira puama be administered. Unless there be some grave lesion of the brain and spinal cord, success is likely to attend this change in treatment. A condition of the sexual organs in which a man is un- able to beget his species ; it may be because he has either lost his erectile power or his desire or both, or because the spermatozoa is so weakened and degenerated as to have lost its procreative power. Impotence is becoming common at an early age, either due to excesses, masturbation, spermatorrhea, gonorrhea, and is often accompanied by a train of symptoms incidental to ner- vous debility. These symptoms may be absent. If sperma- tozoa be oozing away, impotence may be due to the weakness thus caused. Spermatorrhea et Impotency. — The principal causes of these two conditions are masturbation, perversion of the sexual act, self -treatment of gonorrhea, etc. The effects in all cases are an involuntary loss of semen in the shape of diurnal and nocturnal losses, which naturally attract the attention of the affected individual, for which he seeks help, and if from a physician up to the times, he will prescribe ozo- nized extract of black willow internally, suppository and bougie. A great many men suffering from prostration, nerve exhaus- tion, do not realize that they have loss of semen, simply feeling an invisible trickling, a mere moisture at the orifice of the urethra, a kind of oozing almost of the character of perspira- tion, or there may be a dribbling and a slight mucous discharge, a mere drop that does escape, which nevertheless gives rise to vital -deterioration. The salix nigra bougie and suppository are the remedies, with matricaria for a tonic. There is a brain phase of spermatorrhea produced by the loss and Dictionary of Diseases. 475 of such a vitalizing secretion, and a reflex source of irritation by the act of masturbation — the brain deprived of this secretion becomes anemic, as is visible in the pallor of the face, indistinct- ness of vision, dilation of pupils, myopia or double vision, deaf- ness, feebleness of voice, mental preoccupation, hebetude of mind, confusion of ideas, aching or tingling sensations in hands, arms, legs, feet. In this cerebral phase of spermator- rhea and impotency all leakages must be completely arrested with the black willow internally and salix nigra for suppository and bougie. Then matricaria for an all-round tonic, ozonized thyroid ex- tract, and protonuclein daily, with c. p. solution of spermin three times a day. The best remedies to cure the impotency. A man suffering from seminal leakages, the product of mas- turbation, should not marry till perfectly cured; even if his semen be fertile, the offspring will be ever ailing, never healthy, never strong, a blight. . Impotence and spermatorrhea may coexist in the same indi- vidual — there may be no other symptoms, simply a failure of the sexual organs to respond when called upon. As to the sites of the morbid processes at work, it is impossible to speak with certainty. Changes in the tubes of the peripheral nerve struc- tures, which supply the erectile muscles, which induce weakness and paralysis, probably due to changes in the posterior spina] ganglia, resulting from exhaustion. In such cases all seminal leakages must be arrested, either by the administration, orally, of black willow extract, or by the salix nigra suppository or bougie. Then brain builders, reconstructive agents, should be tried and persevered with for a reasonable length of time. Proto- nuclein to induce leukocytosis and comp. kephalin granules, a true brain food.. These remedies are worthy of a trial in every case, as they have proved themselves successful in ninety-six cases out of one hundred. Excessive loss of semen in young men interferes seriously with the development of the brain and the evolution of the mental faculties. There is much variation in cases, in some mere .alienation, and in highly developed nervous organiza- tions delusional insanity. There is a brain .phase in every case. indistinctiveness of vision, impairment of hearing, feebleness of voice, mental preoccupation, confusion of idea£; melan- cholia. Spermatorrhea is invariably complicated by prostatic 476 The Germicide 20th Century Practice enlargement, which keeps the seminal ducts open and weeping. Arrest all seminal weeping with the black willow and its de- rivatives by prescribing them orally, rectum and urethra, and when thus effecting salutary results, ichthyol and boroglycericl suppository could be used to induce a renewal of life in the prostate. Follow this up with thyroid extract to repair and equalize the mental disorder, and give the never-failing kephalin gran- ules to repair the wreckage. This is no visionary treatment : it has been thoroughly tested in several insane asylums. When the world looks blue, nothing in the horizon but despair, kephalin granules are indicated. INCONTINENCE OF URINE IN THE YOUNG.— In- continence, or inability to hold the urine, so that it flows or dribbles away during the day or night, is the most common, and may depend on diseases of the kidneys, or gravel, or the uric acid diathesis, or to the presence of urates in the urine: cold ; wet ; seat-worms ; long, contracted foreskin ; falls or blows on the back ; nervous debility. In young children it is favored by excessive drinking of fluids during the day ; by being put to bed between cold sheets : by lying on the back, a position that causes passive congestion of the lower part of the cord, and very unfavorable for reten- tion of urine, especially when the natural sensibility of the mucous coat of the bladder is increased. It may also be caused by habit, fright, fear or passion. When clue to inherent weak- ness of organization, the difficulty seems to be entirely limited to the nerves of the sphincter muscle, impairing power of con- traction. Treatment. — The treatment is very simple; daily bathing: flannel clothing; to sleep between warm blankets; diet to be of the best and most nutritious kind ; bladder to be emptied before retiring to bed, and child instructed to retain it during- the day ; either the application of a strengthening plaster or, in some cases, a belladonna plaster, over loins or sacrum, and pre- cautions taken to keep the child, if possible, on right side, and have him waked up before the regular hour of retiring to have bladder emptied, and every means resorted to to restore tone and strength to the system. All causes, such as seat-worms, long prepuce, etc., should be removed. First of all, try tincture of iron in alternation with tincture of belladonna. Regulate dose to age; then try sulphate of cinchona in alternation with and Dictionary of Diseases. 477 wine of ergot ; or tincture cinchonia compound and collinsonia.. If due to acidity, the malnutrition to be corrected by tonics,, changes of diet, open-air exercise, etc. Incontinence in the aged is generally due to sexual excesses ; enlargement or degeneration of prostate; a breaking down of the nervous system ; nervous disease, especially affecting lower portion of the core}; to uric acid, or oxalate in urine; stone in the bladder; disease of the walls of the bladder; piles, falling of rectum, stricture of the urethra, vascular tumors of rectum, ovarian or uterine diseases or displacements, pregnancy, coi- tion, hysteria, etc. If the cause admits of removal get rid of it, and place patient upon alteratives and tonics ; inculcate daily shower-baths, good food, flannel clothing, stimulating plasters to loins; if due to sexual excesses and nervous debility, rich phosphatic diet, glyc- erin of kephalin, or ozone ; tincture damiana compound. Direct medication by means of suppositories has been the most effectual method. The cocain, boroglycerid, thuja, and ichthyol suppositories have effected a complete revolution in the cure of this malady. INDIGESTION. — Indigestion or dyspepsia is a general term applied to various morbid states of the stomach, in which the natural processes of digestion and assimilation of food are delayed and deranged. The structure of the stomach may be damaged by irritants, mechanical violence or blood poisons ; its mucous coat may be impaired, weakened, relaxed, and, as a result, an excessive se- cretion of mucus, in which the sarcinse ventriculi are developed and grow ; owing to some brain lesion, as worry, struggle, men- tal toil, there is an imperfect nerve supply to the organ. This very naturally divides dyspepsia into three forms : 1. Chronic inflammation of the stomach. 2. Gastric catarrh or mucous dyspepsia. 3. Nervous dyspepsia. Chronic gastritis is quite a common form of indigestion,, caused by irritants, protracted drinking of alcoholic drinks, ha- bitual excess in either eating or drinking, indigestible food, irri- tating medicines, etc. Gastric catarrh, with the sarcinae ventriculi, is usually the re- sult of beer drinking, tobacco chewing, such drugs as bromide potassium, hasty or hurried mastication, excessive use of fluids at meals, adulterated food, baking powders. 478 The Germicide 20th Century Practice The nervous is present in all forms of neurasthenia, wher- ever there is a poverty of nerve force. The three forms have certain symptoms in common. Appe- tite is either deficient, depraved, or ravenous; nausea, or un- easiness after eating; food vomited, acid eructations from fer- mentation or bitter from admixture with bile ; flatulence, eruc- tations of gas, distention of the stomach ; cardialgia, or heart- burn; pyrosis, or waterbrash; depraved and imperfect diges- tion, etc., and all forms have a tendency to terminate if not cured in ulceration. INFECTION. — The. spread of disease by the conveyance of deleterious matters (micro-organisms, etc.) by the air, by clothing or by personal contact. To avoid the risk of infection great attention must be paid to the personal health ; there should be temperance in all things, cleanliness and good ventilation should be seen to, and, in addition, disinfectants, such as chlo- rine, sulphur, chloride of lime, formalin, should be exposed to evaporation. INFLAMMATION. — A state of vital depression of some part of the body; usually caused either by the action of me- chanical violence or by some poison, heat or cold, or noxious gases. When a part is thus vitally depressed there are pain, heat, redness, swelling present — it may be acute, subacute, chronic. If the vital forces are properly stimulated internally and lo- cally it may terminate in resolution or recovery, but if there be a failure in treatment, not energetic, or not a proper remedy used, or the vital forces of part greatly shattered, then the in- flammation may terminate in one or other of the following effects: 1. Effusion of serum. 2. Effusion of blood. 3. Effusion of lymph. 4. The breaking down of lymph or formation of pus. 5. Gangrene, the process of dying. 6. Complete death, mortification. In every form, location, type of inflammation there is ever present some form of disease germ, the outcome of the de- graded tissue which is implicated. Whatever its type, wherever its location, an effort should be made to stimulate in it a moderate and healthy reaction. For and Dictionary of Diseases. 479 that purpose cerebral and local stimulation. Keep the action of the heart between sixty-five and seventy-five with either vera- trum viride, passiflora, aconite, digitalis, gelsemium. Locally in all cases a stimulating germicide, adapted chemically to the affected tissue, as ozonized turpentine to serous membranes, pleurisy and peritonitis ; concentrated ozone over joints, a lotion of echinacea. If unable to stimulate resolution, then the inflammation will terminate in either : 1. Effusion of Serum — which constitutes dropsy — the best remedies for which are digitalis, strophanthus, elaterin, vapor baths; or 2. Effusion of Blood. — Hemorrhage; rest, styptics, eleva- tion, stimulants, heat ; or 3. Effusion of Lymph. — Lotions of ammonia, peroxide of hydrogen, boroglyceride, belladonna ; or 4. Formation of Pus.— Hot poultices, free incisions, per- oxide of hydrogen ; or 5. Gangrene, Process of Dying. — Brandy, peroxide of hy- drogen ; poultices, charcoal, yeast, capsicum, echinacea ; or 6. Mortification. — Complete death. In every inflammation there are traumatic, thermic and chemical agencies — the evolution of micro-organisms, which give rise to toxins, that originate destructive influences on blood formation, producing an abnormal interaction between vessels and tissues, which is visible in the effusion or exudation of fluid and formed blood elements and in the retrogressive change of the tissues themselves — in the presence of a greater or less number of leukocytes. INFLUENZA. — Its pathogenic microbe, together with its toxin, the product of bacterial life, w T hen in the body spends its force, like other germs, upon weakened parts, selecting either the respiratory mucous membrane, the gastrointestinal tract, the heart, the nervous system. In all cases the nervous system, the centralization of life, is profoundly affected, as is visible in the. pain of the head, back, calves of the legs, delirium, prostra- tion. A Toxin on the Nervous System. — The incidence of the in- fluenza toxin on the medulla oblongata and great sympathetic, evidenced upon the dyspnea, with the presence of the pneumo- coccus together with tachy- and brady-cardia. As the poison affects cord or brain, aphasia, eye and auditory changes of in- 480 The Germicide 20th Century Practice fluenzal origin are common. The overcrowding and sewer gases of cities intensify the poison. In the psychical states of influenza the greatest changes in the nervous system are apparent. (For treatment with concen- trated tincture kurchicin see Epidemic Influenza. ) INSANITY. — Any deviation from sanity. It is divided or classified according to the most prominent symptoms, as gen- eral insanity, or raving madness; monomania, insane on one thing ; dementia, feebleness of mind ; moral insanity, continued perversion of certain feelings, affections or impulses, with power of correct reasoning; hypochondria and suicidal and homocidal monomania; insane impulse; irresistible impulse to do some insane and criminal act ; nymphomania, insane excite- ment of the erotic impulse in chlorotic females. The causes which induce insanity are functional or organic disease of brain, intestinal irritations, apoplexy, epilepsy, fevers, gastric or hepatic disease ; meningitis, delirium tremens, a microbe present. Alcoholic conception and masturbation are two factors of immense importance. Purely mental and moral causes play a comparatively small part in the production of insanity as compared with causes which are bodily and physical. In only n| per cent of the cases dealt with, trouble, worry and anxiety or mental shock produced the disease. The remainder of the great mass of the cases are due to causes acting on the brain through the body — drink, faulty development, gross brain disease, strong hereditary predisposition, child-bearing and suchlike causes : and as shown how mental troubles were caused by bodily dis- ease, the recent epidemic of influenza had caused more insanity than all the public and private anxiety in connection with wars. These remarks have a very definite bearing on preventive meas- ures. Without doubt the present generation is apt to coddle its nerves, and also to plume itself on the delicacy of its organiza- tion. It is widely held that so great is the influence of worry in the production of nerve disease that those prone to nervous breakdown should be in every way protected from irritating and disturbing influences. It would aid its prevention if our people could live according to physiological and moral law, arrange suitable marriages and avoid alcoholic conception. A Common Cause of Insanity. — The disastrous effects of all sexual excesses and masturbation are apparent in sperma- and Dictionary of Diseases. 481 torrhea, leakages and in an impaired state of the nervous sys- tem, as is visible in the neurasthenia, mental incapacity, various nerve disorders which are common among that class of sub- jects. In all seminal losses, when excessive, the hebetude of the mind is characterized by a blunting or dulling of the faculty of perception ; passing events come and go without being noticed or recorded on the mental tablets, while things of the past are in oblivion. Individuals suffering from seminal losses are am- bitionless, have no capacity for work or exercise; have no anxiety for either the present or the future, simple indifference, sublime in its degree, but painful and aggravating: or if they nave penetrated deeper, he is irritable and suspicious. The cause of the various nervous derangements is to be found in a damaged or altered state of the cortical nerve-corpuscles, due to defective nutrition. The specific gravity of the brain structure is much lowered by the nervo-vital fluid being drained off. Defective brain nutrition is present in all cases of masturba- tion, sexual excesses, or congress with courtesans ; brain sub- stance becomes anemic, soft, pultaceous, while the semen be- comes infertile, creamy or watery in substance. Old age, the use of alcohol gives rise to defective brain nutrition, which leads to atrophy, a shrinkage, an induration, congealing or shriveling up with anemia : different altogether is the brain of the masturbator, it is simply mushy. There is no other patho- logical condition in which we find the same softened, low spe- cific gravity of brain as we find in those in whom seminal losses are the result of abnormal practices, precisely the same condi- tion as is found in the insane. With our new and improved remedies this peculiar form of defective brain nutrition does not preclude success in treatment ; it is capable of cure by removing the cause and providing the brain with proper nutrient, physiological rest, isolation, a com- plete change of mode of life and habits. In studying these cases carefully, scanning them to their origin, there is always to be found a congenital nervous insta- bility which is much aggravated by sexual precocity. One essential point to begin with is the practice of mastur- bation must be got rid of; all abnormal methods forever sus- pended. For this purpose the green root tincture of gelsemium is a most valuable aid ; but when given it should be watched ; dose 482 The Germicide 20th Century Practice after dose should be administered, so that an erection would be an impossibility. Profound relaxation induced, should be maintained at all hazards. Then the weeping, oozing, leakages completely controlled ; for this purpose the ozonized black wil- low bark extract should be prescribed internally ; a suppository and bougie of the same. When these principal points are at- tended to, the condition of the deteriorated mental organs can be seen to. The first agent we must give is a rebuilder of brain tissue; a something to aid in the evolution of brain cells ; this we find in the thyroid extract a most efficacious remedy. Thyroid extract daily, if need be, once or twice a week, just as the medical attendant deems proper. The -thyroid is the evolver of cell growth in the brain, its action must be promptly aided by the best of diet and the c. p. solution of spermin, the great restorer of vital force. Occasionally cerebrin, kephalin,. or the tincture of oats may be added. This treatment is no theory, but easily demonstrated by liv- ing cases which could be enumerated. Let us take the statistics- of our insane asylums, 75 per cent of their inmates have been victims of masturbation and spermatorrhea ; take our deaf and dumb and feeble-minded homes, their inmates are made idiotic either from the effects of alcohol or masturbation in the par- ents. Such cases are amenable to thyroid and spermin; cases of epilepsy, chorea and all nervous affections, as well as raving lunacy, yield to the exhibition of those remedies. The secret of success is in a persistent use of the remedies. There is a widely prevalent idea that medicine is of very little value in the treatment of insanity. This is far from cor- rect, and is fraught with much harm. To be sure, there are no specifics for this affection. There are, in fact, very few dis- eases for which materia medica stands ready with a specific to be administered as soon as a diagnosis is made. Were ma- larial fever and syphilis excluded, there are no other diseases for which any remedy is considered a specific. The specific action even of quinine and saxifraga respectively in these dis- eases is disputed by some men whose opinions are worthy of attention. By means of careful and scientific research a flood of light has, within the last half century, been thrown upon mental diseases. We now know that insanity is the legitimate result of some pathological condition of the brain — some struc- tural changes have taken place. These changes are often so obscure, and affect the minute cells only, that they present no and Dictionary of Diseases. 483 microscopical divergence from the normal. In other cases even the most expert microscopist will fail to detect satisfactory conditions to account for the grave disturbances observed in the functions of the brain. The changes may not be in the minute or gross structure of the cells, but only in a disturbance of their normal arrangement. The battery may be in working order, but some of the wires are down. A fuse may be burned out somewhere, and the proper connection cannot be had, or an operator at some station may be out of sorts, and messages are not received or transmitted. An operator may be sick, and prevent messages both in receipt and transmission. There are so many places and ways in this complicated ap- paratus which we call the nervous system for abnormal changes to occur that we are amazed that it should ever all be in perfect working order at the same time. Just as in all other diseases and departures from the normal, nature, the, the great repairer, is ever on the alert to keep things in harmony. Sometimes the breakdowns come so fast and are of such a nature that the vis medicatrix naturae gets behind — in other words, gets more work on hand than can be done. It is in just such cases, and under just such circumstances, that the physician steps in, and with the proper medicines assists nature to turn the tide from utter ruin and dissolution to health, and once more puts this complex machine in smooth working order. Since the introduction of animal extracts, especially thyroid and spermin, there is a complete change in the mind of the medical profession as to the curability of very many of the cases of modern insanity. We see these two extracts effectually curing every case of idiocy and feeblemindedness in which they are prescribed. There are no diseases that respond more readily to the proper remedies than those of the nervous system. Time in these affections is, perhaps, more valuable than in almost any other class of diseases. They become quickly chronic and in- curable. Permanent structural changes take place rapidly, for the reason that the nervous system is more highly organized and more finely tempered than any other part of the human or- ganism. When the battery is exhausted it must be replenished with properly selected and administered nerve tonics. When the conduction is faulty the conducting wires must be looked after and obstructions removed. When too much nervous en- ergy is being produced, more than can be normally utilized, the battery must be weakened bv sedatives. When some locat 484 The Germicide 20th Century Practice transmitter is disarranged it must be repaired. Physicians are too prone to stand in awe in the contemplation of this complex apparatus when it has slipped a cog and become deranged. INSOMNIA. — In healthy sleep the person becomes uncon- scious of the external world ; voluntary action ceases, and even the automatic centres for circulation and respiration act less energetically, so that the breathing becomes slow, the pulse quiet, and the vessels tend to dilate. This condition of the ves- sels has been regarded by some as a cause of sleep rather than its consequence, for the two principles to explain sleep are : first, that it depends upon anemia of the brain, and, secondly, that it is due to an exhausted or inactive condition of the brain-cells. In all probability the truth is that it depends upon the condition of the brain-cells, but this is so much influenced by the circula- tion that frequently the condition of sleeping or waking will depend entirely upon the cerebral circulation. The gray substance of the brain is possessed of a great power of reduction, but during life the necessity for oxygen is so great that it retains within it a sufficient quantity of stored-up oxy- gen to prevent such reduction taking place under ordinary cir- cumstances ; but if its functional activity be augmented by stim- ulation, its store of oxygen is used up, and thus it becomes ready at once to reduce. Its very activity, however, gives rise to the formation of acid products which lessen its reducing power, so that the mere supply of fresh oxygen would not be sufficient to restore it to its previous condition unless the acid were neutralized. Arterial blood supplies both these requirements, neutralizing the acid and giving off oxygen to the brain-cells. Thus in some conditions of the brain, simple increase in the supply of arterial blood will restore functional activity and cause wakefulness, while diminished supply will produce sleep. Food induces sleep by dilatation of abdominal vessels. We cannot see the intes- tinal vessels, but we know that abdominal Avails are thin in front, and it is almost certain that external cold will act through the abdominal walls on the intestinal vessels and cause them to contract. Such contraction will also drive the blood to the "brain and tend to prevent sleep, but warmth to the abdomen will tend to relax them and induce sleep. In cases where blood tension is high, as in chronic Bright's disease, we often find troublesome insomnia; whereas in cases •of debility with low tension we often find troublesome drowsi- ness. One condition of the circulation is, therefore, a most im- and Dictionary of Diseases. 485 portant factor in the production of sleep, but it will, by itself, no more explain completely the insensibility of sleep than it will that of anesthesia. Sleeplessness, get rid of the cause if possible. Keep bowels regular, stimulate skin with baths and massage. These means failing, resort to medicaments. Give passiflora incarnata the first trial — it stimulates phrenal nutrition. If it fails try croton chloral, which contains more hydrogen than chloral hydrate — it is in fact butyl chloral. Its practical value is the property of diminishing sensibility before producing narcosis. Its action does not last so long as morphia; they, however, operate well combined. In croton chloral -we have an instant remedy, more effective in neuralgia than all others. An excellent formula is the following: Croton chloral, gr. ii; sulph. quinine, gr. i; glycerin, q. s. Make a pill. To be taken on the approach of an attack, and repeated every two hours, till relief is obtained. Another excellent formula : Croton chloral, 10 parts ; glycerin. 20 parts; distilled water, 130 parts. Shake before using. The dose is half an ounce every five or ten minutes. It is best to begin small so as to avoid producing hypnotism. To procure sleep, 10 to 15 grains. Syrup of croton chloral hydrate is a most reliable and efficacious preparation of the drug. Sul- phonal in 30-grain doses affords most refreshing sleep ; dissolve in hot water and administer as it cools. Sleeplessness is due to a variety of causes, such as disease of the brain and blood, the toxins of disease germs, obstructive pulmonary disease, latent gout and rheumatism, reflex irrita- tion, functional and intestinal derangement. Sleep is essential to health, for during that period intestinal digestion is perfected and the brain regains its vigor or to- nicity. Hypnotics are used for inducing this desideratum. Sleep to be sleep is accompanied by cerebral anemia and cutaneous vascular dilatation. Any remedy that will produce that is of value; a warm bath increases vascular dilatation, warm liquid food or drink : but beyond and above all massage is of the greatest efficacy, indicated in all possible conditions, invariably effectual when prolonged. Physicians are too careless, druggists too unscrupulous in prescribing hypnotics; the inexperienced physician prescribes for the symptoms, never looking the case over to ascertain whether there be cerebral degeneration, organic heart disease, urea in the blood. 486 The Germicide 20th Century Practice The ignorant physician prescribes opium or its alkaloids to club the patient into insensibility and calls it sleep, but it too fre- quently creates a deplorable habit. One still lower in the scale gives bromide, which often blights the testes or destroys the ovarian bed ; or it may be chloral hy- drate and bromide of potass, which gives rise to unrecognized heart trouble. He may be a therapeutic nihilist, his judgment perverted; finding some drugs which he has used have but a. slight beneficial effect, launches out with some conglomeration. Invariably danger in hypnotics. They interfere with nutri- tion and create disease. They should be carefully prescribed and never but under the sacred scrutinous eye of a physician. IODINE. — A bactericide with a special stimulating action on the glands of the body. It is never administered in its pure state, unless it be in starch or tincture in sweet milk. Its various compounds are of priceless value in the management of nficrobial affections, as syphilis, etc. IODIZED HYDROGEN WATER.— Uric acid accumula- tions. Dose : One ounce thrice daily. IODIZED IODINE.— Dose : From 5 to 15 drops added to water, of great efficacy in causing the complete annihilation of. the bacilli of tubercle and syphilis. IODOFORM. — The addition of four drops of oil of sassa- fras to the ounce entirely covers its odor. Dose : Sprinkling- on by powder or solution. IODOL. — As this salt contains 90 per cent of c. p. iodine it is an active germicide. Sprinkled on a chancre it at once- changes it to a simple ulcer — great utility in uterine and rectal ulcer, one application being often sufficient to effect a cure; a solution in alcohol and glycerin makes an invaluable lotion in phagedenic sores, carcinomatous ulcers, bed sores, etc., destroys the germs ; first application with that the offensive odors disap- pear. Dose : A powder resembling iodoform, free from its disagreeable odor and toxic property ; sprinkle on by powder or solution. A mixture of iodol and thymol gives us what is termed aris- tol — iodide of thymol. Iodol, combined with an equal quantity of boracic acid and Dictionary of Diseases. 487 and a percentage of negative ozone, makes a snuff, which is of much efficacy in nasal catarrh, being both prophylactic and curative. Iodol bougies, incorporated in soluble ozonized gelatin, are remarkable absorbents in urethral stricture. The only medica- ment that has ever been of merited utility in effacing them. ITCH (Scabies). — A disease of the skin associated with the formation of pustules and excoriations, and due to the pres- ence in the skin of a parasite belonging to the mite family called the Acarus scabici. The presence of this insect causes intoler- able itching, hence the name of "itch" given to the disease. The parasite burrows its way into the skin and deposits its ova in the burrows. It then dies and a pustule forms. If one of the burrows be opened up with a needle and the contents placed under the microscope, the insect is easily seen. The disease is communicable from man to man, and occurs chiefly at the bend of the wrists and between the fingers. From these places it may extend over the whole body, but it never attacks the face. Treatment. — Hot baths, with the use of soft soap, followed by the rubbing in of sulphur ointment twice daily. Liquor calcis sulphurata is also very useful. The insect may also be killed by means of other parasiticidal ointments, such as car- bolic ointment or staphisagria ointment or bathing the body with either oil of bergamot or benzin. The clothes of a sufferer from itch should be either boiled or exposed to dry heat up to 180 degrees F. Fumigation with sulphur is also recommended. IZAL. — A distillation of bituminous coal, consisting' of oxi- dized hydrocarbons containing a greater proportion of hydro- gen to carbon than the recorded member of the phenol series. and a less proportion than the members of the alcoholic series . It is a non-poisonous, non-corrosive bactericide ; one part, di- luted in 200 of water, promptly destroys the bacillus coli and the staphylococcus pyrogenes aureus. Excellent results have attended the use of this non-poisonous body when administered internally, in typhoid, dysentery and other specific diseases of the alimentary canal. In surgery., mineral izal has won unqualified praise from those who us? it. Proved to be exceedingly valuable in ozena, erysipe- las, old abscesses, old sinuses, and fetid bronchitis. Pulmonary Tuberculosis. — When vaporized in the pa- 4^8 The Germicide 20th Century Practice tient's room, izal quickly produces a marked improvement. The results are such as to warrant the highest hopes from its use in this fell disease. JABORANDI. — The dried leaves of the Pilocarpus pennati- folius yield an alkaloid, pilocarpin, which when administered produces copious perspiration, a slowing of the heart, a lower- ing oi temperature following its use. It is an antagonist to atropin supposed to be capable of re-establishing the secretion of milk. Preparations and Doses. — The fluid extract in 10 to 60 drops added to water, and repeated as indicated, is of value in asthma, diabetes, eye affections, or eruptive fevers; whereas pilocarpin operates best in albuminuria, dropsy. One-tenth of a grain to the dose triturated in sugar of milk. JAMBUL. — The tree, Syzygium jambolanum, has been highly praised as a remedy which will arrest the formation of glucose. Destroys the fungus of diabetes. The pulverized root, introduced into capsules, containing 5 grains or more each, is taken immediately after eating. Not curative, but of great efficacy in saccharine diabetes, a perverted state of the elaborative function in which certain ele- ments which go to make up nutrition — starch and sugar — fail to reach their normal destination in the economy. The direct cause of the disease is impaired functional capacity in the liver and pancreas, the former in its glycogenic relations, the latter a failure of secretion. The primary damage is in the brain near the seat of the eighth pair of nerves, the lack of nutrition and the damaging effects of the sugar upon the tissues, with nerve prostration, are the leading features of the case. Males chiefly affected, together with a few strong-minded women. Specific gravity of the urine is from .1036 to .1065, increased in quantity from six to twelve pints or more in the twenty- four hours. Jambul will not cure saccharine diabetes, but if five or ten grains be administered after each meal it will correct this per- version of starch into sugar ; its use will cause the sugar to dis- appear in the T urine, its specific gravity and quantity will become normal. Still the remedy won't cure, although it ameliorates greatly. A real curative drug in diabetic saccharine is to be found tokephalin or cerebrin. axd Dictionary of Diseases. 489 The microbe or fungus, the evolution of this saccharine con- dition, is literally extinguished under jambul. Our readers can rely upon its intrinsic value. JAUNDICE. — A yellowish discoloration of the skin and white of the eye, due to impregnation with the pigments of the bile. Bile pigment is at the same time found in the urine. It is, properly speaking, a symptom and not a disease. Bile is constantly being formed in the liver, and this bile, after per- forming its duties in the intestines, is continually being ab- sorbed into the blood in the liver, gall-bladder and intestines without causing jaundice. It therefore follows that bile under- goes change in the blood. If any morbid condition upsets the balance between secretion and absorption of bile, or if the bile is unchanged in the blood, the bile circulates with the blood and gives rise to jaundice. Jaundice is therefore due to two chief classes of causes : 1. Excess of bile in the blood. 2. Causes which prevent the bile being changed in the blood. In the first class are : a. Obstruction of the bile-ducts, due either to their being blocked by gall-stones or to changes in the walls of the bile-ducts, as in catarrhal inflammation, or to pres- sure by tumors, etc., outside the bile-ducts, b. Excessive for- mation of bile in the liver, as in congestion of that organ. c» Increased absorption of bile in the intestines, due to constipa- tion. In the second class — viz., causes which prevent the bile being changed in the blood — are included poisons (such as phosphorus, copper, snake-bite, yellow fever and ague), acute atrophy of the liver, brain injury, and strong mental emotion. Usually persons affected with jaundice are low-spirited and irritable, lose their appetite, and have a slower pulse than nat- ural. Troublesome itching of the skin, without any apparent cause, is also sometimes noticed. A feeling of exhaustion and inability to work exists pretty constantly. Unless the jaundice is caused by some incurable disease of the liver, or occurs in persons who are enfeebled by sickness or age, the prospects of recovery are favorable. An exception to this may be in cases where it follows mental shock. In addition to discoloration of the skin and conjunctiva, and bile in the urine, there is a bitter taste in the mouth, digestive disturbance, flatulence, constipation, itching of the skin, de- bility, emaciation, anemia, languor, depression, and even con- vulsions, delirium and coma. In addition there are the symp- toms which point to the cause of jaundice. 49° The Germicide 20th Century Practice Treatment. — Many cases of jaundice recover without any treatment whatever after an interval of two to fourteen days. Others continue for a longer time, especially when due to dis- ease of the liver. When the gall-duct is obstructed by a gall-stone or plug of thickened bile, the jaundice will disappear when the obstacle to the flow of bile is removed. A remedy occasionally resorted to at such times is chloride of ammonium, in doses of twenty grains in water every four hours. Nausea and vomiting may "be controlled by abstinence from food for a few hours ; the use of ice swallowed in small lumps ; mustard plasters or hot poul- ties applied over the stomach, or milk and lime-water in the proportion of one part of lime-water to two, three or four parts of milk. Daily one dose of periodate aurum with either ozonized chionanthus and phosphate of soda or kolatina every three liours operates well, on which a cure may be effected. Jaundice Due to Toxins of Disease Germs. — This is but an effect, a symptom, a something which either arrests the flow of bile from the liver or else gives rise to an excessive produc- tion of it and its absorption into the blood. The impediment to the flow of bile may arise from various causes; mechanical, such as pressure, tight lacing, wearing belts, thus pressing the gall-duct, slowing or stopping the passage of the bile, permitting its watery constituents to escape. Bile thus becomes thickened and frequently crystallizes into gall-stones. The toxins of all disease germs, especially those of syphilis and malaria, alcohol, mercury, together with all insanitary states, as overcrowding, seriously damage the liver, especially its protective function. The working and protective function of the liver is very seriously impaired by these poisons, so much so that its diminished function gives rise to either auto-intoxi- cation or jaundice. Many other causes might be enumerated, as carbonaceous food, violent mental emotion, exposure to the rays of the sun are capable of producing in the liver very grave changes. A partial death in the liver very soon gives bile in the blood, quickly manifest by headache, languor, lassitude, depression, disordered digestion; itching and yellowness of skin; yellow conjunctiva; disturbed seeing and hearing; perspiration leaves a yellow or brown stain ; urine orange or porter-colored ; stools clay-colored ; apoplectic symptoms. If due to gall-stones, spas- modic pain in the gall-duct may be looked for. and Dictionary of Diseases. 491 We now possess valuable remedies which exert a potent ef- fect upon the liver function. One dose of the Carlsbad salts first in the morning. The powder dissolved in warm water, to be followed by a few grains of the periodate aurum an hour later. During the day tea- spoonful doses of simabicidia. An efficient method of treat- ment. One or two doses of the phosphate of soda, alternated with either the tincture of lycopodium or sulphur, with matricaria before meals, form an excellent treatment. If clearly due to the action of the toxins of disease germs, peroxide of hydrogen operates admirably ; alternate with fringe tree bark extract. If there be pain, symptoms indicating gall-stones, push gelse- mium and passiflora,and alternate with either nitromuriatic acid or chloride of ammonium. If the nitromuriatic acid be used, give it in this form : Comp. tincture cinchona, simple syrup, of each two ounces ; nitromuriatic two drams. Mix. Dose : One teaspoonful every three hours added to a little water. If gall-stones be suspected, adhere closely to the olive-oil treat- ment for their disintegration. Many other liver stimulants might be enumerated, but we would caution the profession, both here and in Europe, never to be deceived nor swindled by a class of remedies termed con- centrations, for such do not exist. Podophyllin, leptandrin, euonymin, chionanthin, are simply solid extracts in a state of trituration — an American swindle much greater than the Ger- man fraud of the coal-tar derivatives. These remedies are most efficient in the form of a mother tincture, and are often serviceable when the liver function is paralyzed. JELLIES. — In the present era of new methods of treatment and new remedies none have met with such approval as the ex- cellent procedure of aborting inflammatory action by means of powerful germicides of an anesthetic character: of instanta- neously breaking all breaches of continuity and promptly cur- ing all cutaneous diseases by means of medicated jellies. These have been extensively used by progressive physicians for the past twenty years, and their utility has exceeded the anticipa- tions of the most sanguine. Ozonized Jelly of Violets is a local anesthetic, powerful "bactericide, which presents strong and special claims for recog- 49 2 The Germicide 20th Century Practice nition — non-toxic, producing local insensibility wherever ap- plied. For aborting various inflammations there is no remedy to be compared with it. In the various forms of ophthalmia simply everting the lid and inserting one grain of the jelly twice or thrice daily completely wipes out inflammatory action in a short space of time. In tonsillitis acute, paint it over all the painful and congested parts, inflammatory action ceases. In acute and chronic nasal catarrh, in neuroses of the olfac- tory nerve, due to the inhalation of pollen, aromas, such as is present in hay fever, or asthma, epidemic influenza and kindred conditions, painting the interior of the nostril with it thrice daily, completely eradicates the pathological conditions. In all cutaneous inflammations, such as erysipelas and burns, simply paint or spread on lint the jelly and apply on the in- flamed or denuded surface, when all redness, congestion, pain subside at once. In cancerous and syphilitic ulceration of the tongue and larynx, thickening, infiltrations, large excavations, patient only able to take liquid food, apply the jelly of violets every three hours, the excrutiating suffering is promptly relieved. In gastric ulceration, cancerous infiltration, enteritis, one grain in a capsule every three hours will do big work in main- taining a local anesthetic effect upon the nerve ending. It may in those doses be given with impunity on account of its non- toxity. Very celebrated cancer specialists employ the jelly of violets in the cure of cancer of the tongue or stomach, intestines and rectum, combining it with papoid in all cases, which is a power- ful digestive and absorbent. Guard it exceedingly well, as it is a powerful anesthetic, operates well in all cancers, subdues re- flex irritability, pain of coughing and swallowing, especially if the tongue, soft palate, larynx, be affected with epithelioma. If necessary the jelly can be dissolved in water and used as a spray in laryngeal cancer, infranasal ulcer, malignant, tuber- cular ulceration. All pain, tenderness disappear, and a rapid diminution of all odors in the discharge. It excels all other dressings in phagedenic ulcers and venereal' sores. .The Ozonized Resorcin Jelly, a peculiar cutaneous germ- icide, which next to the jelly of violets occupies the foremost: place in the armamentarium of the dermatologist. It is not ex- and Dictionary of Diseases. 493 actly a new remedy, but by clinical observation and experience new fields have been opened up for its use. It has a most ex- tensive sphere of usefulness, valuable results always attend its internal as well as its local application. It has the peculiar property when applied of exciting an exudative form of inflam- mation, thereby removing infiltrations, hypertrophies, causes abnormal or adventitious tissue to peel off. Its indications are numerous and its action effective in psoriasis, acne-rosacea, and even in epitheliomatous patches. Ozonized Jelly Chlorate of Carbon is principally used as a tooth, gum and tongue preparation ; being powerfully anti- septic, it kills the oidium albicans, the leptothrix buccalis, and all the bacteria common in the oral cavity. The method of ap- plication is simply to dip the dry brush in the jelly and apply to the desired part, or the jelly can be dissolved in water in sufficient quantity to suit. Its chief value is its germicide properties, its vitalizing in- fluence on the teeth and gums. It is a decidedly efficient prophylactic against all diseases of the mouth and throat, such a preparation that should be in very general use, as the early decay of the teeth is very general in all whose vitality is exhausted by overtaxing the nervous system. Jelly of Ichthyol is useful in pityriasis, ichthyosis, eczema, erysipelas, boils, as well as all vegetable and 'parasite skin affec- tions, extremely effective in the different forms of tinea. Clinical observation teaches it to be very efficacious in local- ized rheumatic pains, both in muscles and joints. Smeared lib- erally over old muslin and applied. Many physicians use this jelly in burns of the three different degrees. Thymol Jelly, used with most benefit in genital eczema, pruritus, as a general antiparasite, it embodies even in weak dilutions strong bactericide properties, but is cooling, soothing, healing, absolutely non-irritating. It can be applied freely, as there is no toxicity, and it affords rapid relief of all pain. Jelly of Chrysarobin is of especial value in leprosy, psor- iasis, rupia. Before applying this jelly, smear the parts well with ozone ointment, over which apply the jelly. Jelly Periodate Aurum, valuable in syphilis, applied freely, so as to saturate the system. In this way it is utilized in initial sclerosis; good and very effective in condylomata of rectum, scrotum, vulva. When applied they disappear rapidly. Its application affords prompt relief in gouty and rheumatic pains. -494 The Germicide 20th Century Practice Indicated in all syphilitic cutaneous affections, abscesses, car- buncles, indurations. Jelly of Boroglycerid is an excellent, efficacious germi- cidal application. Used in cases of superficial injuries, burns, fever sores on lips, nose, angle of the mouth during the winter months. It completely annihilates the oidium albicans on mouth and nipple. Excellent application to old ulcers with in- durated edges. One of the best applications in erysipelas. Jelly of Salicylic Acid is used for thickening of the skin, callosities, corns, keratoid eczema. Has a most decided action in lupus, ichthyosis, acne, sycosis, lichen, in rheumatic syno- vitis. All grades of strength of which the skin of the patient is tolerant are prescribed, with a decided effect. Jelly of Acetate of Aluminum has met with great suc- cess in burns and superficial inflammation of the skin; also in badly-healing ulcers, lupus and malignant excrescences. Jelly of Carbolic Acid has been utilized as a local appli- cation to lumbar portion of the back in initial sclerosis. Jelly of Formalin, useful in infected wounds, indolent ulcers, chancres, lupus, eczema, boils, erysipelas, carcinomatous excrescences, bites of rabid animals. KAKI. — Pulverized root of Japanese persimmon. Dose : One to two tablespoonfuls to a half pint of boiling water ; when cool, permit patient *to drink freely. It is indicated in gastric catarrh, chronic diarrhea, typhoid fever, dysentery, ulceration of the bowels, catarrh of the colon and rectum. Decidedly one of the best remedies ever introduced, as it excites a renewal of life in the various coats of the entire intestinal tract; a sove- reign remedy in the diseases enumerated. KAVA-KAVA. — A plant which grows in Tahiti. The root contains a crystalline principle "kavalin," an essential oil, with resin and starch. Therapeutic Uses. — It exercises a stimulant and tonic action, like cubebs. It is employed to sterilize the gonococcus and other germs on the mucous membranes. It is also of utility in all catarrhal states of the bladder. Preparations and Doses. — Fluid extract. Dose : Thirty to 60 drops, and a solid ozonized paste. Indicated as a remedy to destroy the gonococcus of gonorrhea, which it does most ef- fectually and promptly. A three-grain pill is most eligible. and Dictionary of Diseases. 495 KEPHALIN (OZONIZED), OR CEREBRIN.— Glyc- erite. Composition of a hundred parts of this brain fertilizer : Isolated nitrogenous hypophosphite of — Parts. Calcium 6 Sodium 5 Potassium 3 Ammonium 8 Magnesium 3 Iron 4 Tlypophosphorous acid with albumen 2 -Zoalin (an alkaloidal hypophosphite composed of three parts of blended nitrogen and glycerin with one of hy- pophosphorous acid) 9 Glycero-hypophosphorous acid 5 Hypophosphorous acid (liberated from its oleonitrogenous association) 5 Chemically pure glycerin 50 Total 100 Formula. — The oxidizable phosphorous element isolated irom animal brain and the hypophosphites from the germinal portion of oats, dissolved and isolated by hypophosphorous acid, held in suspension by c. p. glycerin, and then charged with ozone gas. Indication. — As this is a true brain essence, it is of the great- est efficiency in all nervous diseases, as mental and physical exhaustion, wasting diseases, loss of memory, vertigo, worry, struggle, nervous debility, decay of brain power, premature and otherwise, nervous prostration, neuralgia, loss of vital power, general vital deterioration, sleeplessness, paralysis, white softening, typhoid : effectual and permanent cure in all cases of nerve debility, builds up the brain, restores lost energy, refreshes the nerves, stimulates the sexual appetite and supplies it with nervovital fluid. It thus is a positive cure for seminal weakness, impotency. or loss of power in the generative organs. It is also of great efficacy in leukorrhea. female weakness and change of life. Gives intellectual vigor and vivacity. Dose : From 20 to 30 drops, added to a little water, thrice daily, either an hour before or immediately after meals. The compound kephalin granules are composed of the active vitalizing principle cerebrin of ox brain, the phosphates of 496 The Germicide 20th Century Practice cereals, wheat and barley: the avena from Scotch oats; proto- nuclein and thyroidin — remedies representing the active prin- ciple of life, universally celebrated as the best health restorers, brain builders ever introduced to the profession. They are pre-eminently active in the cure of what has hith- erto been termed chronic or incurable nerve disease, such as softening of the brain, paralysis, locomotor ataxia, impotence,, impairment of the mental faculties, chorea, etc. They are of great utility when the nervous system is ex- hausted, blood poor, appetite and digestion bad ; they are sim- ply a food to the brain and nerves ; very soothing and exceed- ingly strengthening; of great efficacy in seminal weakness, physical and mental decay and impotency. Men who are physically well, but sexually dead, use these granules and become vitalized and productive. Tired, exhausted nature finds a reliable recuperative in the life-giving, invigorating kephalin granules — a potent strength- ener. All diseases of the brain and nervous system, white soften- ing, paralysis, epilepsy, chorea, loss of memory, loss of appe- tite, loss of mental power, yield to this remedy, and a keen, highly vitalized condition of every function of the body is the result of their use. Dose : One only at meals. Eighty millions of people in these states suffer from a - pov- erty of nerve force. The rapid increase of brain deterioration- is inducing a manifold list of nervous maladies which are at- tracting the attention of scientific minds, who are in diligent search of a remedy by which the lost brain-power and mental energy can be restored. Brain growth is shrinking. Modern life, with its increased nervous maladies, is but the outcome of depletion of the brain of its most valuable constitu- ent — phosphorus. When this is drained off by masturbation, by sexual excesses, study, worry, struggle, there is no thought,, no energy, no ambition, no memory; and just in proportion as this remedy is deficient, the brain-power of the individual is. lowered. Exhausted nature finds a reliable specific, a recuperative, in these granules ; a potent strengthened a powerful tonic to the neuron, a food to the stationary cells of the nerve centres and ganglia, a brain vitalizer, a tissue builder. In speaking of these kephalin granules one of the greatest discoveries of modern times consists in the isolation of the and Dictionary of Diseases. 497 active, vitalizing principle cerebrin from ox-brain; the phos- phates from wheat and barley; the avena from Scotch oats; protonuclein and thyroidin from the life-forming glands of animals — remedies representing the active principle of life — and their formation into granules, accomplished by the great- est pharmaceutical skill, giving us one of the most celebrated remedies of modern times, a perfect health restorer and brain builder ever introduced to the medical profession. These granules are pre-eminently active when introduced into the stomach to raise the standard of vital force and to ef- fect a cure of what has hitherto been termed incurable nerve diseases, as softening of the brain, paralysis, locomotor ataxia, impotence ; impairment of the mental faculties and the senses. These granules are chiefly prescribed by highly-scientific physicians, gentlemen of great culture and skill, and sold only by the leading druggists of Europe and America. In order to give our readers an idea of the estimation in which these granules are held by the medical profession, we quote the following items from various leading journals : The glycerite of kephalin ozonized, being the natural phos- phate of ox-brain, barley, oats, wheat, is a true nervovital es- sence, and can be administered in all cases of impotency with the best success. Neurasthenia, poverty of nerve force, cerebral anemia, or softening, or paralysis, and other states of nervous shock, are too frequently the result of excesses, and thus by draining off the cerebral essence, leave that organ in a state termed starved. A brain in that state soon has its typical fissures of thought obliterated, and granular deposits appear on the arachnoid; adhesion of its membranes to the surface of the convolutions ; crystalline granulations in the lining membrane of the ventri- cles, with an unusual amount of fluid in the sac of the arach- noid. Besides, a tissue-starved brain gives rise to inflamma- tion of the cortical portion, terminating in degeneration of the nerve cells of the hemispheres, and these changes give rise to structural change in the organic cell. The brain of man, his brilliancy of thought, his energy, his force of character, are due to the quantity of phosphorus con- tained in the cerebrum. If this is economized it might sustain him to a good old age in full genital vigor, but let overwork or excess drain it off, health fails, the vital forces can supply no more; then unless kephalin or oats can be administered, de- 498 The Germicide 20th Century Practice generative changes will take place in the gray matter of the brain and spinal cord, simply because the phosphorus in the brain is exhausted. Brainworkers, mechanics, professional men, the libertine in his excesses, feel this in their languor, want of energy, vic- tims of excessive brain exhaustion. Nothing can invalidate the assertion that unless our present race obtain more phos- phorus, impotency will prevail. Kephalin is an excellent brain food, a reconstructor of shat- tered nerve force, refreshing to the nerves, repairs lost sexual power. Kephalin gives intellectual capacity, a higher stratum of life. It is a stimulant to the molecular growth of the brain, with a special action on the lymphatics and pink marrow and other blood-forming and blood-raising glands, and above all an ac- tive energizer of the seat of the sexual power in the brain, the results of which have astonished the civilized world. It is prepared as follows : A sufficient quantity of Scotch oats, very coarsely ground, is covered with distilled water and kept at a temperature over 80 degrees F. until it ferments. When this is perfect the mass is thoroughly macerated with alcohol and ozone, is transferred to glass percolators, and after permitting it to rest for seven days, percolation is commenced and continued until the last grain of avena has passed. Prepared in this manner and from the best quality of Scotch oats, it contains a very high percentage of avena, is highly acid and of a nutmeg-brown color. Of all cereals Scotch oats yield. the largest amount of phosphates. No other manufacturer claims this, the only true method of preparation, to isolate every particle of the brain pabulum; there are no imitators, all other preparations made by various firms are utterly worthless. Avenin, the active or alkaloidal principle of the ozonized tincture of Scotch oats, is a great brain builder, a nerve tonic. fertilizer and restorer of wasted nervous energy. Avenin is one of the best pabulums that can be introduced into the hu- man body for the proper nutrition of the nervous system and the creation of a higher type of manhood — a vitalizing agent to every organ in the body. It enters largely into the composition of the compound keph- alin granules which are of such wonderful efficacv in all de- rangements of the nervous system, such as softening of the- brain and paralysis, loss of sexual power, impaired memory , dyspepsia, epilepsy, chorea. and Dictionary of Diseases. 499 Very many, if not nearly all the maladies of the present age,, are caused by a depletion of the brain of its most vital con- stituent, phosphorus; when this is deficient, drained by mas- turbation, sexual excesses, struggle, study, worry, there is no thought, no ambition, no energy, no memory, and just in pro- portion as this element is lacking, so is the brain-power of the individual deficient. Certain it is that phosphorus enters into every tissue of the body, and its absence or presence in normal quantities regulates the standard of health. Its presence in due proportion excites thought, capacity and brilliancy of in- tellect, power of invention, the rise of human progress in mak- ing the very elements subservient to our use. Man, races, nations are modified, influenced by the character of their food. People who use starchy food are mere imbeciles, whereas those who consume largely of phosphatic food are re- markable for the possession of large brains and great intel- lectual development. Our present state of civilization, with its ceaseless activities and endless strain, cannot be maintained upon ordinary food, for it cannot keep up the nutrition of the brain of individuals whose labor is chiefly mental. Hence the nervous system of the great mass of our people is literally starved. Feed the brain with kephalin or kephalin granules, and a very large proportion of our present diseases would disappear. The initial step to cerebral starvation is a deficiency of phos- phates in our food. This paucity of primary elements impairs the springs of life, deteriorates all the senses and faculties; but none becomes so thoroughly bankrupt as the sexual sense — that which presides over the evolution of the spermatozoa. With a starved brain, cerebral anemia from any cause, the evolution of the spermatozoa goes on sluggishly, feebly; besides, they be- come infertile, few, dwarfed, misshapen. Let the brain be adequately nourished, vital force vigorous, whether by brain food or that great vital constructor, keph- alin, the spermatozoa become numerous, active, fertile and well developed and the fissures of thought deepened — the en- tire nervous system rejuvenated. KIDNEYS, DISEASES OF THE.— The kidneys are liable to a large number of diseases, all of which are more or less grave, and not infrequently fatal. There are two classes of diseases : 1. Those due to local causes, such as injury, calculus and diseases of the bladder, prostate, and urethra. Retention, ^oo The Germicide 20th Century Practice of urine after a time leads to dilatation of the ureter and kid- ney, and the latter becomes atrophied or inflamed. 2. Those due to constitutional diseases, such as cancer of the kidney, tubercle or scrofula of the kidney, Bright's disease, hydatids of the kidney, etc. Inflammation of the kidney is caused by damp, cold, alcohol, scarlet fever, etc. Symptoms of inflamed kidney are pain in the back, groin, and down into the testes, alterations in the secre- tion of urine, fever, vomiting, a hard pulse, and ultimately, if the disease becomes chronic, changes in the arteries, eye, brain, apoplexy, paralysis, etc., so that the whole system is affected. Treatment. — Locally, cupping, warm fomentations; purga- tives, warmth, etc. Ozonized tincture green root of gelsemium is of remarkable value in inflammation of the kidneys ; combine it with passiflora incarnata. The kidneys are the organs for the elimination of waste products and toxins of disease germs. So long as they are not organically diseased, many, very many maladies admit of cure. There is no affection so productive of kidney irritation as the uric acid diathesis, which is the prevailing malady of civilized man. Uric acid kidneys admit of easy recognition both by chemical tests and the microscope, and its persistent presence, together with the languor, inertia, headache, constipation. There are many remedies which, if judiciously administered, such as the ozonized uric acid solvent, which will flush the kidneys and free them from the ashes of tissue, the uric acid crystals, but the action of this remedy must be aided, strengthened by a dietary which will agree with and nourish the patient, yet put as little strain as possible on the kidneys. Meat should be eaten but once a day, and preferably at noon. If the system demands albuminous food, milk and eggs may be used in addi- tion. We cannot say too much in favor of fruit — especially the fruit breakfast — as a corrective and alterative to the blood and digestive juices. Eating to repletion is always injurious to those who have weak kidneys, and is usually followed by a run on those organs. Stop just short of satisfying appetite at each meal, and receive the reward of keen assimilative powers and unobstructed cir- culation. A slowing and weakening of the circulation precedes that -torpid condition of the kidneys which results in imperfect elimi- and Dictionary of Diseases. 501 nation, gradual atrophy of the renal epithelium and contraction of the organ. To keep up the circulation, regular, moderate, light exercise must be insisted on. Baths, massage, and skin friction are in- valuable, both as nerve tonics and measures to keep the glan- dular system in good condition. Fresh air and sunshine deserve more than passing notice. Sunshine softens up hard flesh and renews vitality, while fresh air tones sensitive nerves and purifies the stagnant blood. The become a curative agent the remedy must unite with those poisons and cause their elimination from the body. Iodide potassium fulfills the requisite conditions of a curative agent in all lead and mercurial diseases, being equally efficacious in both. To every teaspoonful of comp. saxifraga there is in it five grains of iodide potass. In lead and mercurial poisoning the comp. saxifraga stirs up the tissues, excites their molecular activity, so as to enable the iodate to unite with either, form an inert body, which is readily taken up by the blood and evacuated by the various emunctories of the body. To still further aid the action of the iodide potass in the comp. saxifraga a daily warm alkaline bath, in which is in- corporated the sulphuret of potassium ; with this treatment both these metals can be readily eliminated from the body. As a prophylactic agent to the lodgment of lead in the body no remedy has yet been found to supersede the aromatic sul- phuric acid in fifteen-drop doses thrice daily, added to water. LEPROSY, THE MICROBE.— A most highly infectious and extremely contagious form of skin disease, due to a hybrid microbe, the outcome of the bacillus tuberculosis and syphilis. Its diagnosis rests upon the general constitutional disturb- ance, debility, mental depression, loss of appetite, chilliness with slight recurrent febrile attacks, and then a development upon the skin of isolated or scattered blebs of a dull red-brown color, tender to the touch, slightly swollen, variable in size. These 520 The Germicide 20th Century Practice may disappear, and then return. But in most cases we notice ere long a slight but peculiar change in the face which is not easily mistaken ; the skin of the cheeks a little below the eyes looks rather swollen and puckered, the nose appears somewhat thickened, the patient at the same time complaining of not being able to breathe quite freely through it, and the tone of the voice is a little altered in consequence; he speaks, as we commonly say, "through the nose/ 5 As a further and later change, very characteristic tubercles develop in the skin, especially on the face and hands; these swellings are tender on pressure, and they produce much thickening of the tissues, and consequent alteration in the features. The skin of the forehead becomes thickened and tuberculated, its furrows deepened and its promi- nences exaggerated ; this is especially the case on and over the eyebrows, and gives a peculiar heavy, morose expression to the countenance; the hair of the eyebrows is quickly lost, the nose becomes tumid with nodules and tubercles ; the cheeks are irregularly thickened; the lips hard, swollen and sometimes everted; the chin is nodulated, and the ears, greatly enlarged, stand out stiffly from the side of the head. The whole appear- ance is hideous and revolting. One peculiar effect of these changes is to make young people look middle-aged. Coincidently with these changes in the face the dorsal aspect of the hands and feet may be similarly affected; the skin be- comes brown, and the fingers, greatly enlarged, stand stiffly apart; the nails become dull, dry and fissured; some of the tubercles shrink and are absorbed, while others ulcerate and leave open sores very difficult to heal. Sooner or later the mucous membrane of the mouth, tongue and larynx becomes altered and thickened, and the voice assumes a peculiar hoarse whisper which is very characteristic of the disease. The eyes also suffer; the cornea becomes opaque, and a partial or com- plete loss of sight is the consequence. Coincidently with these visible changes in the skin and mucous membrane we find alterations occurring in the nerves, and leading to the formation of patches of completely anesthetic skin; they vary much in size, and are met with chiefly on the forearms, hands and feet, rarely on the trunk. In fact, in ordinary cases, the new growth and structural changes of all kinds are confined to the face, ears, hands, feet, forearms, legs, and mucous membrane of the mouth and throat. Tue ulnar nerve is particularly liable to be af- fected, and a nodular swelling may be easily felt just above the point where it crosses the elbow joint. Gradually all these and Dictionary of Diseases. 521 symptoms increase, the constitution becomes greatly enfeebled, the temperature is commonly below normal, and the vital powers exhausted; sooner or later some internal complication arises, and the miserable sufferer is carried off by disease of the lungs or kidneys. In the blood and eruption, the microbe can be found in great abundance ; it consists of fine slender rods, occasionally pointed at both ends, some clearly motile, others not. In the secretions from the mouth and eyes they have a beaded appearance. They are best cultivated artificially on blood serum or meat juice. The microbe is pathogenic of the disease. Not a single sporadic case has ever occurred in this country, all are imported cases from parts of the world where it is common. Chian turpentine mistura, and chaulmoogra oil are the only two remedies which sterilize the germ. LEUKOCYTHEMIA.— White cell blood, a morbid condi- tion of the blood in which the white corpuscles are greatly in- creased in number while the red are much diminished, usually found connected with hypertrophy of the spleen. As to the cause of this white cell disease of the blood, we can lay down nothing definite. It has been assigned as a sequel of diseased or caked spleen in third stage of inter- mittent fever specially, and other malarial conditions. It is difficult to harmonize the alleged causes as atributable to that gland. We know that the spleen is a ductless gland, the great storehouse of red blood, that in cases of long fasting it plays an important part in the nutrition of the body. It acts also as a sort of safety valve to the heart in cases of chill or rigor, when there is a determination of the blood from the surface, and in the cold stage of ague it is greatly engorged. Whether this repeated congestion impairs its function if it does elevate or raise the white corpuscles to red we cannot say, or whether it is not really the poisonous action of the malarial, paludal and kindred germs on the blood factors that are the real source of the trouble. LEUKORRHEA (Whites). — All mucous or mucopuru- lent discharges from the vagina are termed leukorrhea, whether they be due to a damaged or relaxed condition of the mucous membrane of the vagina, to a catarrhal condition of the glands of the neck of the uterus or to intrauterine catarrh. 522 The Germicide 20th Century Practice All discharges from the vagina are loaded with germs, as the ameba, sarcinae, various streptococci. A mucous or mucopurulent discharge from the vulva, it may be either from the vagina or from the cervical neck or cavity of the uterus. It is generally of such a nature as to destroy the vitality of the spermatozoa before their ascent into the cavity of the uterus. In health the spermatozoa can remain active for a long period in the vagina, but if certain morbid conditions arise and there is leukorrhea, with either an acid or an alkaline reaction, the integrity of the spermatozoa is impaired by the vagina becoming unfit for their reception and transmission, and sterility is the necessary consequence. The relation of leukorrhea to sterility, the mode by which barrenness is produced and impregnation prevented are sub- jects of interest to every woman. Some women with leukor- rhea will conceive regularly, just as if they were free from all derangement of the generative organs, while many others do not conceive during the presence of this disorder, not sterile, but become fertile the moment the leukorrhea is cured. Ster- ility then is often the outcome of leukorrhea, which too fre- quently prevents the function of evolution in the ovary, and rendering the canal of the Fallopion tube and cavity of the uterus unfit for fructification of the germ. The administration of the ozonized wine of aletris farinosa will positively cure every case of leukorrhea in which it is ad- ministered ; it never fails. One of the best of all remedies. The glucoside of life-root, senecin, made into oval tablets and inserted into the vagina, well up, permitted to remain over night, is also an excellent curative agent. Pastils of nympha odorata, which are prescribed so extensively in Europe and America for prolapsus of the uterus, are of immense value in the cure of leukorrhea. Discharges from the genital organs, both simple and infec- tious, are very frequent in women. The notion of a neurosis of the plexus supplying the mucous membrane of the vagina is often too far-fetched, for in all cases of leukorrhea. with or without pruritus, there are micro-organisms present which give rise to local infection. These germs can be all isolated and classified. To keep the vagina healthy, free from all disease germs, should be the aim of every woman. For this purpose the senecin tablets have been placed at her disposal. By the in- troduction of one or two of these every evening she can keep axd Dictionary of Diseases. 523 the vagina aseptic, free from all forms of low organic life, even the most virulent. Factory life in the United States seems to be inimical to a healthy vagina, the semi-tropical climate, the insalubrious at- mosphere, the standing posture, all aid in relaxing and giving rise to an inveterate form of leukorrhea, so that every female operator is affected with the malady. Seven hundred mill hands were examined by the medical officer of a factory; •every one had leukorrhea, and all obtained a speedy cure by the introduction of the senecin tablets, and keep well by using the same. In the more aggravated forms, pruritus is a common ac- companiment. Some have it many years, and often all treat- ment seems hopeless. Many of these cases have the orifice of the urethra reddened and the external mucous membrane studded over with, pretty far back, minute soft warts which keep up the discharge. The application of the oil of thuja will remove these growths. With the arrest of microbe growth, cessation of the pruritus, a complete cure by the senecin tablets. Sene- cin as a vitalizer of the uterus and its appendages has an ex- tensive range of action, whether used internally or locally; even in cases of leukorrhea associated with vertical headaches it affords prompt relief. Remedies. — Vaginal pastils : when dependent on a consti- tutional defect, helonias. aletris, Pulsatilla, cinchona, hydras- tis, mineral acids, vaginal injections of boroglycerid daily. General Measures. — Improve the general health by every possible means, as the discharge is only evidence of debility, weakness of the vagina; injections with fountain syringe are very beneficial ; medicate with hydrastis. witch-hazel, white pond lily, potassium permanganate, boroglycerid ; use ozonized pastils. Leukorrhea, Infantile. — Discharge chiefly from external genitals ; sometimes extends up the vagina. There are often consideration and anxiety regarding these discharges in very young children. Ascarides, skin diseases, malnutrition, are usually the cause. Lotions of boroglycerid or sulphur water are usually suffi- cient with removal of cause. LICHEN. — A papular disease of the skin. There are sev- eral forms of lichen, all of which are characterized by the erup- tion, on the face, trunk, or limbs, of groups of red papules, which itch a good deal. A familiar form is "prickly heat.'' 524 The Germicide 20th Century Practice 1 Treatment. — Plain, light food, a saline aperient, and alkalies internally. To relieve itching, a lotion of borax and vinegar is useful. In chronic cases a course of cacodylate of sodium is invaluable, never failing. LIFE-ROOT. — The use of alkaloid remedies deserves the attention and patronage of all physicians as being definite in their action. The alkaloid of life is a valuable germicide capa- ble of annihilating all the disease germs in the urethra of the male and the vagina of the female. It is best adapted for local use, as in the form of a bougie for the male, and a tablet or wafer for the vagina. The vagina is the home of fourteen different varieties of disease germs, six of which are pathogenic, in all of which the microbe can be detected in the leukorrheal discharge. In twelve per cent of all cases, the bacillus of tubercle is found ; in forty per cent, the gonococcus ; in ten per cent, the microbe of syphilis ; in the balance, other disease germs are found. The germ-laden leukorrheal discharge gives rise to. auto-in- fection of the affected woman by penetrating the lymph canals of the mucous membrane of the vagina, which communicate with the internal lining membrane and body of the uterus, giving rise to inflammation of some degree. The examination of the vaginal discharge is the only reliable method of diagnosis. The great aim and object of all women should be to keep the vagina aseptic, so as to prevent inflammation of the uterus and its appendages, with the sequel, sterility and cancer. This is easily effected by the insertion of a senecin pastil on retiring, which penetrates the mucous membrane, the large lymph vessels which run alongside the uterus and in the folds of the broad ligaments. LIGHT. — A remarkable curative agent and germicide — its vitalizing and bactericide properties have never been properly- appreciated by the medical world. It is true, that our present knowledge of the chemical and physical action of the different rays of the spectrum, and the influence of light and darkness on life in its highest and lowest manifestations is meagre; still enough is known to render it valuable as a therapeutic agent. On the three eruptive fevers it is of signal efficacy. In measles a darkened room, with scarlet blinds, with a lamp ignited with an orange yellow globe, used for artificial lights and Dictionary of Diseases. 525, causes the rash to disappear ; ameliorates all the symptoms ; pro- motes rapid recovery; admit light all the severity of the disease returns. In smallpox, if the patient is kept under the influence of a yellow light, symptoms are mild; no pitting of the exposed parts take place ; maintain the yellow light the micrococcus will die. A blue light is inimical to the microbe of scarlatina. A violet light completely annihilates the microbe of neuras- thenia; hence this light is of the greatest utility in the treat- ment of nervous maladies, as headaches, epilepsy, chorea, paral- ysis, and above all in insanity, a malady over which it exercises a most mitigating action. Exposure to the sun's rays, sunlight, is death to many disease germs, causes the complete destruction of the bacillus of typhoid fever, the tubercular bacillus and many others. There is a big future in sunlight as a chemical agent in gener- ating ozone, either in plain, colored water or in the menstrum of plants ; mullein oil, oil of arbor vitae, and St. Johnswort owe their marvelous disease curing properties to the action of polarized sunlight, extracting their oils, intensifying their germicidal action. Water in different colored bottles, set in sunlight becomes chemically identical with ozone water, ac- quires wonderful germicidal properties, and when administered kills the germs of diarrhea, dysentery, bubonic plague, hydro- phobia and leprosy. Light is intensified by means of glass and colored fluids, focused on a part loaded or infiltrated with the neoplasms of cancer or lupus, is effectual in causing their complete destruc- tion without pain. The eminent accurate observers, the cancer specialists of our country, are an acknowledged authority on this subject, and are now treating cutaneous malignant disease by means of light. LIME WATER. — Lime water when applied to suppurating^ or mucous surfaces, checks or stops secretion, and produces dryness of the parts ; hence it is a desiccant, and is useful in sickness and irritability of the stomach during teething. The power of exciting and changing the mode of action of the ab- sorbent vessels and glands has been ascribed to lime water, and probably with some foundation, for under its use glandular enlargements have become softer and smaller — in other words, it is a resolvent. It often relieves the superficial but painless ulceration of the mucous membrane of the mouth, observed in 526 The Germicide 20th Century Practice dyspepsia. In these cases one part of lime water to two or three of milk is usually sufficient. Given in this form it will often stop the most violent sickness. In some tubercular ulcers its power of checking secretion is most marked. Lime and sugar form a compound considerably more soluble in water than pure lime — the colder the water, the greater its power of dis- solving lime. LIVER. — The old writers on physiology considered the liver as performing simply the function of separating the ele- ments of the bile from the blood. But later investigations con- vince us that the liver performs three distinct functions :■ ( 1 ) the storing up of glycogen; (2) the oxidation of albuminoids; (3) the formation of bile. The liver, then, is seen to be an im- portant organ. In order that the liver should perform its share in the digestive process, it is necessary that the mastication first be well performed, then the digestion in the stomach performed, then the liver if in a healthy state can perform its function well also. Bad teeth, causing imperfect mastication, and that bad di- gestion; so imperfect assimilation may cause hepatic disturb- ance. The liver converts the sugar, which is found in the por- tal vein after digestion, into glycogen, which is a substance much like dextrin in its composition. It is an insoluble form of sugar. But for the metamorphosing action of the liver, this sugar would accumulate until the blood would be surcharged with it. But being stored up by the liver after each meal in this insoluble form, it is then gradually given off as the or- ganism requires it. The liver, then, in one sense becomes a fuel depository in the first function it performs. And if the sugar accumulates more rapidly than the liver can rehydrate, or change into glycogen, then it passes out through the kidneys and constitutes one form of glycosuria. A great many liberal eaters of starchy food may pass sugar in the urine in small quantities. But if it is found in considerable quantities, it pro- duces the symptoms of diabetes. If there is more sugar in the blood than the liver can convert into glycogen, then diabetes will result, and the tissues soon waste away, unless such other food be provided in sufficient quantities to prevent it. There Tnay be glycosuria, and yet there may not be any great danger, -as it may appear as a species of waste, but in large quantities it is evidence of serious disturbance in this hepatic function, which, if not relieved, endangers life. Diabetes is actually a -disturbance of the first function of the liver — that is, it is the and Dictionary of Diseases. 527 failure of the liver to convert the sugar into glycogen, hence it accumulates in the blood until the vicarious action of the kid- neys removes it from the blood, with other waste materials. The second function of the liver is the oxidation of the al- buminoids of the food. These albuminoids of the diet are con- verted into peptones by the action of the gastric and pancreatic juices, and from these peptones the various tissues of the or- ganic structure are continuously replenished and the surplus is formed by the action of the liver into glycogen and nitrogenized waste, as into leucin and tyrosin, and these are, by more com- plete oxidation, converted into urea and uric acid. The liver, likewise, burns up the worn-out blood-corpuscles ■and the debris of the tissues more completely. The liver also destroys the waste albuminoids and is a great physiological pro- tector and preserver of the organism in three ways. ( 1 ) It prevents disease. It constitutes a barrier not only against poisons introduced with the foods, but against substances which result from perversion of the primary digestive processes in the alimentary canal, such as alkaloids of fermenta- tion and and putrefaction. (2) The liver combats and controls disease by perfecting the ultimate steps of diges- tion, thus furnishing nutrition and munition to the army of cells in their battle with microbes and toxins. (3) The liver pre- serves the health and hygiene of the body by directly eliminat- ing toxins and waste products of metabolism through the bile into the intestines and indirectly by furnishing the most pow- erful physiologic diuretic, urea, to stimulate the most important excretory organ, the kidney, thus aiding the complete elimina- tion of the waste products of normal dissimilation as well as the refuse resulting from the carnage in the combat of the cells against disease. And it is a noted fact, that when a portion of the liver is destroyed by cancer or abscess, the quantity of urea is diminished. We find the liver involved in the disorders which are associated with the deficient oxidation of the al- buminoids. If there is a large quantity of sediment in the urine, there is deficient oxidation, either from the fact that the liver is overburdened with albuminoids — that is, that there is an excessive quantity of food taken — or else there is deficient action in this organ, called biliousness, and often improperly drugged with the so-called cholagogucs to no purpose but to the increase of this condition. Excess of nitrogenized food may also produce lithiasis in persons whose liver is active. In many cases where the liver is inactive the kidneys will separate 528 The Germicide 20th Century Practice the lithates from the blood freely, and thus depurate it, and thereby ward off that condition called lithiasis. In cases of lithiasis the quantity of albuminoids should be diminished to the smallest amount that will actually supply the wants of the tis- sues. A diet consisting of hydrocarbons, without nitrogen, will not produce lithiasis ; but if the diet contain excess of hydro- carbons and albuminoids, then lithiasis may readily occur. Hydrocarbons oxidize very slowly when combined with nitro- gen. Hence the oxidizible hydrocarbons burn readily and con- sume the oxygen of the blood, and leave the albuminoids im- perfectly. In hot climates if the albuminoids are freely eaten the liver, sooner or later, is apt to become diseased. Tropical liver diseases, and functional disorder of it in all climates, are associated with the second function more than with the first function of that organ. Rich food, such as contains sugar or fat, causes liver disturbances by impaired oxidation of the nitrogenized elements of the food ; especially will this be the result where the meals are excessive and contain the albumin- oids in excess also. The bile which the liver produces is secreted under very low pressure, and a very slight obstruction indeed is sufficient to prevent its exit from the bile-duct into the intestine. Its ex- pulsion is usually aided by mechanical compression, because the liver lies directly under the diaphragm (or midriff), and dur- ing exercise it is compressed between this muscle on the one side and the abdominal organs on the other ; these are pressed up against it by the muscles of the body's walls. But this exercise, in order to be efficacious, requires to be brisk. When a person is sitting at rest, or even walking slowly along a level road, the abdominal muscles yield as the diaphragm descends, and so little or no compression is exerted on the liver. In running, in climbing, in jumping, in vigorous efforts of any kind, the con- ditions are different ; the abdominal muscles and diaphragm are frequently brought into action at the same time, and thus com- pression of the liver is effected ; thus a quarter of an hour's ex- ercise at lawn-tennis, at cricket, at boating, or, perhaps, even better in riding, is more efficacious in stirring up the liver than an hour and a half, or even more, of a languid constitutional walk. Such is the treatment that ought to be adopted, if possible : but where circumstances render exercise impracticable, the plan is to lessen the quantity of animal food and to increase the action of the liver by hepatic stimulants. The mere sipping of and Dictionary of Diseases. 529 water is a stimulant of this sort; not only has it the extra- ordinary action upon the circulation already mentioned, but it increases the quantity of bile, and causes it to be secreted under a greater pressure, so much so that it will overcome an ob- struction to its entrance to the intestine, such as would other- wise have stopped its flow. A glass of Carlsbad water sipped hot in the morning during dressing is very useful also, and if necessary, recourse may be had to the powerful liver stimulants. LOCAL ANESTHESIA.— Many medicaments are now in use for the production of local anesthesia, besides the evan- escent ether and rigolin. Very many of these have been in- troduced by the Germans from our own coal, and sent here to soothe the aches and pains of the Yankee, and at the same time paralyze his heart. In a very extensive clinical experience I have prescribed them all to their fullest extent, but none of them has served my purpose so well as the jelly of violets, a natural product without a rival as a means of allaying excruciating pain. Digesting all the advantages and disadvantages of the coal-tar derivatives, heart-paralysis, and recent synthetical com- pounds, jelly of violets excels all ; besides it is a germicide, non- toxic, prompt in action, penetrating deeply, arrests inflamma- tory action wherever it exists. It neither affects the heart nor disorders the nervous system. It is a typical local anesthetic, and so highly antiseptic that it prevents fermentation and even putrefaction. Permanent solu- tions can be formed with it, and can be combined with other remedies which render it of great efficacy in many diseases, such as ulcers, chancres, and especially in cancer. Painted on in its full strength, it will efface pain from twelve to twenty-four hours. Many successful cases of cancer of the stomach might be cited, in which the jelly in a papoid solution has effected brilliant results. LOCK-JAW. — The medulla oblongata, the seat of reflex ac- tion, having its vitality in some way impaired, any peripheral irritation may, if of sufficient intensity, give rise to spasmodic action, and to the evolution of a germ peculiar to the partial death of that tissue, which in the progress of growth excretes a most deadly toxin, which causes irritation of all weakened nerves, such as the nerves that supply the muscles of the jaws (constituting trismus) ; the nerves that supply the muscles of • the back (opisthotonos) : the nerves that supply the anterior 530 The Germicide 20th Century Practice muscle of the chest and abdomen (emprosthotonos) ; the nerves of one side (pleurothotonos), more or less violent according to the loss of vitality, Some claim that the microbe is to be found in garden earth, especially in spring and fall, that it finds an entrance into the bodies of men and domestic animals, through some abrasion or lacerated wound — coming directly under the class of infectious and contagious maladies. Lobelia orally, subutaneously and by enemata ; maintain pro- found relaxation for seventy-two hours, till the micorbe dies. LOCOMOTOR ATAXIA.— The so-called Christian world and would-be philanthropists are in trouble over the general increase of suicides. The cause is easily traceable to mastur- bation and sexual excesses, which produce high tension of the cerebral circulation, with consequent mental instability, leading' to self-destruction. But why overlook a more prolific source of self-destruction, where the effect is not so severe and rapid, but where the power of mental concentration is gone, memory feeble, diminished vision, impaired hearing, with pains in the head and heart, nervous system drained out. Lightning pains in the legs, ptosis where the pupil does not contract to light, but accommodation, optic atrophy, sensory- disturbance, in which hot articles appear cold, or vice versa; anesthesia of the soles of the feet, ;if he shuts his eyes, totters and falls, marked inco-ordination, ataxic gait, impotency, gastric- crisis and loss of motor power. Why overlook this malady, Locomotor Ataxia, which is rot- ting the very vitals of our nation — a pathological condition, in which the peripheral nerves and posterior roots of the spinal cord are degenerated — in which the posterior columns of the cord are sclerotic, in both the dorsal and lumbar regions, and its membranes in a state of active inflammation. Outside of sexual excesses and the ptomain of syphilis, locomotor ataxia is caused by the toxin of influenza, which in all cases has a disastrous effect upon the nervous system. This ptomain induces changes in the spinal cord of an inflamma- tory character. The toxins of measles, scarlatina, smallpox, and typhoid fever, penetrate the substance of the cord and in- duce pathological changes often overlooked. Up to date, the treatment of ataxia has merely been a pro- fessional blunder. Great hopes are entertained of the organic- and Dictionary of Diseases. 531 extracts, whether the thyroid extract which cures myxedema, idiocy, feeblemindedness, incurable cutaneous affections, cancer, all human defects is available here. Can it also rectify this abnormal condition? My experience, with it has been some- what meagre, only a few cases. I must state that it certainly retards the disease. These few cases were placed upon the thyroid ; to some it was administered daily, to others every other day. At the same time, all the cases were placed upon the comp. saxifraga ozonized, a wonderful remedy to change the sen- tient and motor cells of brain and cord, while the guaiacol plas- ter was applied and kept on as much as possible over the dorsal and lumbar portion of the spine. To my professional brothers who have cases of ataxia on hand, try the thyroid and saxifraga treatment. They have greatly benefited my patients, and so will they yours; and if not essentially curative, they retard its onward progress, and make a decided change for the better ; such a change as is worth living for. LONGEVITY. — Three score years and ten is the mean duration of life, but the average man is not satisfied with this, and engrosses his mind with ideas of prolongation. No doubt longevity is attainable by avoidance of all insanitary conditions; by the observance of hygienic rules ; by the avoidance of dele- terious or adulterated food. The principal causes of death are accidents ; disease ; old age. With our modern civilization, accidents are more common; disease less and less fatal ; excesses greater and more frequent, which give rise to a premature curtailment of human vigor. Old age, or physiological ossification, in which there is a deposit of calcareous matter on the walls of blood-vessels and the valves of the heart. These elements are found in food, chiefly, however, in the water consumed; and it may be accepted as a truism that if after puberty is reached, only distilled water were used, it would lengthen the mean duration of life at least twenty years. Auto-intoxication, due to imperfect elimination of the waste products. The body in health is the theatre of change, of metamorphosis of tissue, incessant destruction and rebuilding, and it is of vital importance that the debris should be promptly and thoroughly removed. Nature has provided several avenues by which the 532 The Germicide 20th Century Practice •waste may be removed from the body, the principal being the skin, the lungs, and the intestinal canal. The latter is infinitely more important than the others, since by it the waste products of digestion are expelled. t If it fails to promptly fulfill its office, every vital function is interfered with; and in addition, the fluid portion is absorbed into the circulation, re-depositing in the very fountain of life effete substances inimical to the econ- omy. Should the system, while in this condition, be exposed to a chill, a congestion of the surface excretory vessels takes place and practically the whole work of elimination is thrown upon the already hard-worked kidneys, frequently resulting in uremic poisoning and death. Besides eliminating the waste material, daily bathing, mas- sage, flannel clothing, and eight hours of repose — it is in these we have the secret of longevity. Statistics show that small meat-eaters, abstainers from stim- ulants — avoidance of all excitement and worry — are the long- est livers. But it is very doubtful if those who live a feverish, hurry- scurry life can, unless they have very excellent constitutions and not often then, ever live a hundred years. Seventy-five or eighty years ought to content the majority of mankind, until we are able to live rationally. Eight hours' sleep. Sleep on your right side. Keep your bedroom window open all night. Have a mat to your bedroom door. Do not have your bedstead against the wall. No cold tub in the morning, but a bath at the temperature of the body. Exercise before breakfast. Eat little meat and see that it is cooked. (For adults) drink no milk. Eat plenty of fat, to feed the cells which destroy disease germs. Avoid intoxicants, which destroy those cells. Daily exercise in open air. Allow no pet animals in your living rooms. They are apt to carry about disease germs. Live in the country, if you can. Watch the three Ds — drinking water, damp, and drains. Have change of occupation. Take frequent and short holidays. Limit vour ambition. and Dictionary of Diseases. 533 Early senility of the nervous system is due chiefly to cardiac and arterial degeneration, and is seen chiefly in the male sex. Its prophylaxis is to be sought in bodily and mental activity and moderation in living. It is very often hereditary, and in such cases treatment should be commenced early in life, about the twentieth year. Habitual moderation in eating and drink- ing should be enjoined, with a fair amount of athletic exercise in the open air, taken regularly and systematically. If pos- sible, one whole day weekly should be spent in the open air. but fatigue should be avoided. Great moderation in eating and in the use of alcohol is especially necessary. Excess in tobacco and in the sexual functions should be avoided. The hours spent in sleep should not exceed eight out of the twenty- four, and after fifty years of age five or six hours are enough. Early rising conserves the intellectual energy. It is especially important to maintain a good flow of spirits and to avoid habitual ennui, low spirits, or depressing emotions. The ab- sence of occupation, such as follows retiring from business, often precipitates the changes inevitable to old age. Hence, in every case, some "hobby" should be indulged. LUMBAGO. — An undefined malady, in which we have an excess of uric acid in the blood, the toxin of the bacillus amylobacta of rheumatism infiltrating the sheaths of the mus- cles of the back, blocking up the kidneys and permeating origin of the sciatic nerve. When the muscles of the back are the parts affected there is a dull, dragging pain and some soreness, at times, and efforts to move the spinal column in any direction cause sharp paroxysms of pain. The patient, on standing, is obliged to bend forward, and efforts to stand upright, or pick objects from the ground, are rendered almost impossible on account of the suffering which they cause. The remedies of most utility in lumbago are such as are most serviceable in chronic rheumatism : comp. saxifraga simabicidia, pric acid solvent, tinct. cimicifuga racemosa. Much amelioration follows the application of a large guai- acol plaster over the loins, and over this a large stout ban- dage of flannel. The relief following this plan of treatment is immediate and almost miraculous. LUNGS, DISEASES OF THE.— These diseases are only too common in this country, and are in most part due to the 534 The Germicide 20th Century Practice damp, cold climate, sudden vicissitudes and also in no small, degree to overcrowding. The lungs are liable to general constitutional diseases, such as cancer, hydatids, syphilis, etc. Tuberculosis in man almost always affects the lungs, giving rise to Phthisis Pulmonalis. The bronchial tubes may undergo catarrhal changes and in- flammation, and this is called Bronchitis, which is described elsewhere. The lung tissue itself is diseased in cases of in- flammation of lungs, or Pneumonia, and may become passively congested as a result of other diseases, as in heart disease. When the membrane (the pleura) lining the chest wall and cov- ering the lungs becomes inflamed, we have the disease known as Pleuritis, or Pleurisy. Lung Cavities. Micrococcus Tetragenus. — Vomica, or caverns in the substance of the lung are very common as the result of the massing of large numbers of the tubercular bacilli into one spot. The actinomyces make fearful havoc in the lung and leave large cavities. The venereal bacillus also does effective work ; the pneumococcus does not possess this faculty to a great degree. On the walls of all lungs diseased and cavities, in the sputum, the micrococcus tetragenus is ever present. The presence of this microbe in the lungs gives ries to grave symptoms ; its excretion of ptomains of the most toxical kind seems to be unlimited and of the most deadly character. Grave affections of the lungs frequently commence either with an ordinary cold in the head and chest, nasal catarrh, laryngitis and bronchitis — conditions which are decidedly com- mon. Lungs weakened from or by any condition often become the abode, the receptacle of disease germs, provided they be in the blood or air breathed. By preference they penetrate the sub- stance of the lung, and into this they aggregate in masses and form nests, technically termed vomica or caverns. The tubercular bacilli possess this faculty of aggregation in a most remarkable degree; the actinomycosis comes next, mak- ing great havoc, immense cavities ; the venereal bacillus fre- quently gives no exceedingly large formations; the pneumo- coccus has little tendency to form isolated masses, but it mi- grates, forms infiltrations. Whatever be the microbe that makes up the vomica, and it has been once expectorated, on the walls of all such cavities, in the breath, in the sputum, the mi- crococcus tetragenus is ever found. Cultures injected into any and Dictionary of Diseases. 535 mammalia give us the characteristic symptoms and precise pathological condition. The evolution of this microbe on the walls of the vomica — its extremely rapid growth, toxins most deadly, the product of bacterial growth, thrown off in an unlimited degree — give rise to putrescency, fetor of breath, diarrhea, hectic, profound prostration. It has been customary in clinical teaching to classify all vomicas as being due to tuberculosis ; the time has now arrived when very many cases can be diagnosed as either syphilitic or due to actinomycosis. LUPUS. — A very chronic skin disease, which, if left un- treated, causes disfigurement, the features being, as it were, eaten away. Hence the name lupus, eaten by a wolf, supposed to be a hybrid germ. There are two chief forms of lupus, in both of which the skin is infiltrated with new cells and the blood-vessels altered. They are Lupus Vulgaris and Lupus Erythematosus. The latter is a purely local affection. It attacks adults, and consists of several red, elevated patches on the face. These patches become slightly scaly, and the openings to the glands are seen to be dilated. On healing there is left a slight super- ficial scar. Lupus Vulgaris is a more serious complaint, for it is one of the terrible tubercular diseases. It appears first during child- hood, just before puberty. It generally begins at the corners of the nose with the formation of gelatinous-looking tubercles, red in color, with some scabbing. The disease gradually spreads, and the tubercles either disappear, leaving a scar (non- exedens variety), or else they ulcerate (exedens variety) and cause great destruction of tissue. The disease is very chronic. The eruption is nearly all made up of tubercular matter, swells, forms considerable thickening, devoid of moisture; in the more aggravated form, the tubercular patches ulcerate, causing deep excoriations and cicatrices, eating in all directions. Lupoid ulceration is sometimes met with in the labia of pros- titutes and the scrotum of males. Recent treatment consists in first brushing it over with pure formalin, poulticing a few days till the eschar separates, then dusting on formal gelatin, to form a scab, under which, if the constitutional treatment be pushed, it will heal. The treatment, which has been successful, is the same as 536 The Germicide 20th Century Practice tuberculosis : matricaria for appetite, protonuclein to cause leukocytosis; c. p. solution spernim, thyroid extract, glycerite of ozone. Most nutritious diet. Some cases successfully cured with jelly of violets. LYCOPODIUM. — The yellow spores of Lycopodium clo- valium, commonly called club-moss. Therapeutic Uses. — A microbicide of the highest order, of great efficacy in boils, skin affections, catarrh, dysentery, leukorrhea. Preparations and Doses. — Tincture, 10 to 15 drops every three hours. MALARIA, THE MICROBE.— In all countries where the atmospheric temperature exceeds 80 degrees F., there is an evolution of the microbe of malaria from all decaying vegetable matter, a germ which is liable to enter the blood of man and animals, chiefly through the salivary glands of the mouth, bronchi, mucous membrane and skin. These micro-organisms once in the blood, enter the interior of the red corpuscles, live in them, receive their nourishment from them, ultimately using them up in their own growth and nutrition. Once the microbe of malaria occupies a red disc, it gradually usurps the entire corpuscle, and enters upon a new era of ex- istence, during which segmentation commences, spores are formed, set free and forming a new germ — the activity of growth depending upon the degree of vitality in the germ-sat- tirated individual. The entrance of this micro-organism into the blood is char- acterized by a special type of fever, periodic in character, with three distinct stages — a cold, a hot and sweating. Each may last but a few minutes to several hours ; in many cases, one or more may be absent. Truly, the fever is periodic, that is, it may come on every day at a definite hour (quotidian) ; or every other day (tertian) ; or every third day (quartan) ; during the interval between, pa- tient comparatively well. The explanations offered by bacteriologists as to fre- quency of occurrence and periodicity are. : The degree of vital force of the individual and sprouting of the germ as to stages, that the chill, rigor or cold stage represents the segmentation, and Dictionary of Diseases. 537 the setting free of spores; the fever to their maturity and dis- semination of the products of growth, toxins. An examination of the blood during the interval or intermis- sion shows a quiescent stage of the germ, no segmentation; that during the rigor the sprouting or shedding process begins, because free spores are then found. The microbe of malaria is pathogenic of disease, isolated it will grow in any nutrient fluid, cultures injected into animals will reproduce the affection. The best prophylactic measures are a very high standard of health attained by massage, bathing, high-graded diet; avoid- ing all excesses ; sleep in upper stories ; open fire places ; remain in doors after sundown; keep bowels regular, and, above all, keep the mouth shut when exposed out of doors in all malarial zones. After a succession of very unhealthy years, due chiefly to ex- traordinary seasonel and meteorological conditions, the ma- larial germ has attained the power of being slowly communi- cable in an indirect manner from person to person, so much so that an intensified form* of malarial fever has been visible fol- lowing attacks of epidemic influenza. When convenient, seg'- regation of cases in infected sites is desirable to eradicate the germ and protect all new-comers and the unacclimatized. Dis- infection of houses should be performed in the winter months, when infection is at its minimum. A condition of neurasthenia is most favorable for the ingress of all disease germs, and in particular the malarial; and if a very decided and energetic treatment be not resorted to, it very speedily disorganizes the blood-discs often beyond the power of recuperation — induces structural changes in vital organs, as the brain. In North America, from Canada to Mexico, we have a hisfhlv oxygenized atmosphere, teeming with the malarial germ, and are in no ways dependent for its propagation upon the "mos- quito.'' Solar heat, acting upon decaying vegetable matter, gives us the evolution. Any individual who has the slightest poverty of nerve force is liable to become its victim, have it enter the blood-stream and grow according to the defective vitality of its host. Now the theory upon which eminent physicians act is that the microbe must be annihilated in the blood, eradicated be- fore embolism takes place in the brain and blood-vessels — be- fore leukocvthemia sets in. 538 The Germicide 20th Century Practice That body, the leading physicians of North America, cure malaria by the administration of the concentrated tincture of kurchicin ozonized. The type of fever is ascertained, stomach cleansed, bowels opened, skin bathed and stimulated, the patient placed in the recumbent position in bed; three hours before the rigor, one teaspoonful of tincture is then given, and subsequently another every hour, so that three be taken before the chill. Even if this be successful, it should be repeated seven consecutive days. Neither water nor any liquid pabulum upon which the microbe could subsist should be permitted while taking the kurchicin. It is essentially a curative drug. Upon this remedy we stand, for it rarely disappoints us, but when the microbe is either the evolution from the turning over of the virgin soil, or the rice swamps, or the upheaval of large rivers, paludal poison, tincture of green root of gelsemium and ozonized passiflora must be also administered and the kurchicin given steadily according to the directions of the physician in attendance. This is the usual method in dengue, remittent, bilious remittent and relapsing fevers, keeping liver active, to work off the toxins as they accumulate in the blood. If the kurchicin suppository be used instead of the tincture, first wash out the rectum four hours before the rigor, permit its contents to pass, then insert one every hour until six are utilized. The next most reliable remedy to cause annihilation of the germ is Warburg's tincture, a good germicide. Sulphate of quinine, always in solution by the addition of aromatic sulphuric acid, so as to form a bisulphate. Never administer either in pills or tablets, which are a miserable sub- terfuge ; a suppository is often efficacious. These are the most successful elements of a treatment, which meets with universal success in arresting the growth of the germ in the human blood, in staying the pathological conditions which entail so much misery on the human race. Following, the breaking up of this, the first stage of microbic existence, the patient, for a few months, should take some tonic strongly imbued with microbicide properties. Any of the fol- lowing would fulfill the indications : Good old port wine, one quart; pulverized Peruvian and wild cherry bark, of each one ounce; half an ounce of coarsely-ground cinnamon and cloves; one dram of nutmeg and one of capsicum; one tablespoonful of table salt and one of the milk of sulphur; mix. Shake well and Dictionary of Diseases. 539 every hour for half a dozen times. It is then ready for use. Dose, from one teaspoonful to a tablespoonful as indicated, at least every three hours. Another excellent formula which will bring the malarial mi- crobe to bay is : To one bottle of good old port wine add two drams of sulphate of quinine dissolved in one and a half ounces of aromatic sulphuric acid ; two ounces of Peruvian bark very coarsely ground; two drams of cloves, one teaspoonful of capsicum; mix. From one to two tablespoonfuls every three hours. Kephalin granules kill the malarial germ, first, by producing leukocytosis, and second, in raising the standard of the blood discs so greatly that the microbe is literally smothered out. In chronic malaria, when properly understood and appreci- ated, the alcoholic bath is invaluable in malarial poisoning. It accomplishes much, soothes the irritated nerves, aids in elimina- tion of toxins and waste material. It equalizes the circulation, relieves congestion of both brain and spleen. It vitalizes and purifies the blood-stream. It is a rebuilder of tissue, hastens metamorphosis. The primary action of the heat is to relax the tissues, invite a more even distribution of the blood. Every organ is quick- ened ; secretion and excretion become active, sluggish lungs re- gain energy, the cloudy brain clear, its pristine activity re- instated. An alcoholic vapor bath affords the most perfect system of sewerage of the human body. The secondary action resulting from sweating, is, the heart is relieved by lessening the volume of the blood, dilating the peripheral arterioles; water from the blood, containing waste toxical elements, is expelled. Torpidity gives place to activity. No vitality is extracted, but much gained by the reflex stimula- tion. The effect of the hot-air treatment is good to purify the blood, and places the patient on a higher plane to resist the in- gress of germs. The following are the leading opinions regarding this mi- crobe : The skin, the bronchial mucous membrane, but more espe- cially the salivary glands of the mouth and the absorbent of the stomach, are the mode of ingress by or through air and water that these microbes reach the blood ; not so often by the mos- quito. From the germ-laden air or water they will enter the blood, if vital force be low ; they will imbed themselves in the red corpuscles and cause crescentic pigmentation of the blood, 540 The Germicide 20th Century Practice with segmentation of the germ; if vital force be high, even nor- mal, they will be repelled. The blood of man and domestic animals in whom the micro- organisms of malaria have entered, have the disease germ en- ter the interior of the red discs, in which they undergo changes, sprout, develop, grow. In their first attack upon the red corpuscles, they are of an ameboid form and cause crescentic pigmentation. As they grow older they assume the flagellated form, which is the adult condition of the germ. Any one can readily verify the fact by drawing a drop of blood from any part of the body ; place it in the field of a microscope of 2500 diameters; take a drop in the cold stage, and the ameboid pigmentation will be seen ; take a drop in stage of decline, and the flagellate protozoa are present in millions in a case of ordinary quotidian. The germs crowd the capillary vessels of the brain and the blood-forming glands, as the spleen, suprarenal capsules, pink marrow of bones, lymphatics. These, in chronic cases, are filled with dark granules, flagellate organisms, with an undulat- ing fin-like membrane, highly polymorphic. In the tertian, quartan type, and in the comatose pernicious- forms, the germs are most numerous and most destructive to the red corpuscles. x\n interesting practical point is still unsolved, which is. whether the micro-organism from decaying vegetable matter, when it enters the blood, coalesces with and destroys the red discs, or whether the microbe produces a special degradation of living matter, changes it into the microbe, causing destructive metamorphosis of the red corpuscles. One thing is certain, that the micro-organism is pathogenic of the disease, that all attempts at the culture of the germ outside of the blood have so far failed. The influence of sulphate of quinine, or Warburg's tincture, or the concentrated tincture of kurchicin, are definite on the organisms. Either one of those remedies causes those pig- mented bodies to disappear, provided three or four full doses are administered before the paroxysm. The kurchicin acts as a positive specific. Many valuable germicides, as thallin, kairn, antifebrin, anti- pyrin, have no effect on the microbe whatever. The germ of malarial fevers is an organic germ floating in the air we breathe, and capable of introduction into our bodies through the food we eat or the water we drink. The patho- and Dictionary of Diseases. 54 r logical effects of the germ upon the human organism are pro- tean in their forms, varying from the intense saturation of the system to the slightest degree. No organ in the body escapes the influence of the germ. These remedies exercise a special curative action, killing the germ and rendering the blood unfit for its reception, growth and development. The parasite of malaria causes a diminution of the red cor- puscles of the blood. The time of sporulation corresponds to the rigor; its climax of development coincides with the maxi- mum temperature, at which period it breaks up into spores, which rapidly invade other corpuscles. The integrity or non- integrity of the vital force of the germ-smitten parent has much to do in the production of grade or type of case. Whatever remedy is prescribed for the annihilation of this parasite should always be given in three distinct doses, at proper intervals before the rigor. The rectal treatment with me is a grand success. Wash out the rectum with a copious injection of a warm solution of boro- glycerid two hours prior to the chill ; after it passes insert one suppository kurchicin, in half an hour another, then another. If properly performed usually never another chill. Repeat for three days. Of all disease germs to which man is liable, there is really none so great a breeder of disease and death as malaria. It shatters the brain, devitalizes the spleen, liver and kidneys, wrecks the finer nature of our existence. Good, strong, vital force, the essential elements of a hardy race, cannot prevent the entrance of this microbe in water, in air, and otherwise into our bodies, but such a state can retard its growth, maintain its latency; whereas, overwork, exhaus- tion, meagre food, exposure to solar heat, derangement of the hepatic function, or irritation of the hepatic vasomotor nerves, favor its growth if it once has found an ingress. The liver has a peculiar function with regard to the ptomains- of all disease germs, retaining, destroying, or utilizing them in its metabolism. The latency of the malarial germ depends much upon the retention of the germ in the liver, until some functional derangement permits their access to the circulation. For the complete annihilation of the malaria, either in a latent or active state, -our readers will find the following plan of treatment unexcelled for efficacy : Give six grains periodate aurum on the tongue. If germ is 542 The Germicide 20th Century Practice active, follow three hours before the rigor with one teaspoon- ful of concentrated tincture kurchicin; one hour later another teaspoonful, and a few minutes before, another. The very nature of the germ being algid, no water must be given. This not only kills the germ, but at the same time increases the phagocytic action of the blood. As a safeguard, this treatment should be repeated for a few successive occasions. The organism must be destroyed in the blood; if not, it will exhaust itself by other channels. As a rule it reacts favorably to this treatment. There has been lately much discussion regarding the types of malarial fever. As we find it in this country, there is only one germ, one parasite which enters the body in three different stages of devel- opment, giving rise to three distinctive types of fever — quo- tidian, tertian, quartan — the respective stage of germ growth can be detected in the blood of all malarial patients prior to the rigor; the relationship is clear between the amebic, the sporulating and crescentic varieties of the Plasmodium. One thing is certain, that if the concentrated tincture of kurchicin be properly administered to any one infected by this microbe, the germ in any or all its stages will die. Excellent results are obtained by prescribing three teaspoon- fuls of the con. tincture of kurchicin in three doses, during the hour prior to the chill. If the stomach is irritable, three or four drams per rectum has a decided action. There is only one species of the malarial parasite which is polymorphous, presenting slight differences in structural char- acter in the different types of this fever. In the quotidian form the parasite is of small size, even be- fore sporulation takes place in the centre of the red corpuscle, and passes through its cycle of development in twenty-four hours. In the tertian form the cycle of development is forty-eight hours, the parasite larger, occupies more of the red corpuscle. In the quartan form the cycle of development is seventy-two hours. In the three forms the microbe is the same structure, modified by conditions of growth and segmentation. The in- vasion of the red corpuscles of the blood takes place in every type. All have a malignant tendency, all penetrate the central capillaries, and the meshes of glandular organs are filled with them. There are many methods of treatment, of complete annihila- and Dictionary of Diseases. 543 tion of the parasite in the blood encapsulated in the red discs. These modes of cure it is unnecessary to describe, although suc- cessful, as they do not harmonize with modern ideas and facil- ities. The malarial parasite is too well known, its peculiarities and growth too clearly elucidated in the minds of all educated American physicians, for any charlatan to try either an ex- pectant or specific fraud upon it. The entire treatment is nar- rowed down to two remedies, either cinchona or its alkaloids, or kurchicin, administered either orally or per rectum. The dose to do the work is all important, the method of adminis- tration something. Pills, tablets, insoluble compounds must be discarded, and whichever remedy used should be in a liquid form and warm, and three distinct doses should be given before the rigor, beginning one or two or three hours ahead. Synthetical quinine is a fraud, never should be administered, the pure alkaloid from the Peruvian is the article ; a few grains dissolved by the acid of the juice of one lemon in a teacup filled with Mocha coffee answers well. If the concentrated kurchicin is used, teaspoonful doses in tepid water. If the rectal method is to be tried, the bowels must be thoroughly evacuated by some saline and enemata used to cleanse out the rectum and three distinct doses, suppositories inserted, at distinct intervals prior to the rigor. MALE FERN. — This invaluable anthelmintic consists of an ethereal extract of oleoresin extracted from the rhizome. This is the only preparation fit for medicinal use — it is a thick, dark-green liquid, has the odor of the fern — nauseous, bitterish, acrid to the taste. On standing, a granular, crystalline sub- stance appears on the surface, which is the active ingredient, and should not be separated. Dose from 30 to 60 grains is the proper quantity, adminis- tered in capsules. If capsules are not acceptable, it may be administered con- veniently in the following combination : Ethereal extract male fern 60 grains, rubbed up in mucilage of gum acacia one ounce. To be taken at a dose, followed by copious drinks of slippery elm. Castor oil to be taken two hours afterwards. MALIGNANT EDEMA.— A fatal disease of animals, communicated to man, by contagion and infection, closely re- sembles the anthrax bacilli, but differs a little by their greater breadth, habits, and peculiar segmentation. 544 The Germicide 20th Century Practice The edema bacilli are apparently extremely widely distri- buted in our surroundings. They appear to be present in al- most all decomposing substances in greater or less numbers, and they perhaps also take a definite though limited part in the- putrefactive process. As is shown by the behavior of the pure cultivations, the edema bacilli have the power of energetically peptonizing albumen, and possibly also of further breaking up the albuminous molecule. A more accurate analysis of the nature of the decomposition is as yet wanting, at all events the edema bacilli pass through their characteristic cycle of develop- ment as saprophytes. In accordance with this, we find them in the most putrid substances, in the bodies of animals which have died of suffocation and have then been kept at a high temperature, in the feces, and in the intestinal contents; their spores are present in every specimen of earth which has been impregnated with putrid fluids, etc. ; they are also found in the dust of rooms, in the dust of rags, of hay, etc. At the same time, also, the edema bacilli possess pathogenic properties, and by means of these their presence can be most easily demonstrated, and they can be most readily isolated from the mixture of other saprophytes. Many sudden and mysterious deaths take place from the con- sumption of putrid meat and fish, and microbial sausage- There is no degree of vital force so great that can afford im- munity against the ptomain alkaloids. MAMMARY GLANDS.— Mastitis.— Acute inflamma- tion of the breast is ushered in with swelling, tenderness, rigors and fever. Suppuration is indicated by additional rigors ; usually occurs during lactation. Remedies. — Aconite, belladonna, bryonia; passiflora, open the bowels freely; give comp. conium pill. General Measures. — As soon as hardness appears, poultice with linseed meal, and change every three hours ; while chang- ing rub the breast with ozone ointment and extract of bella- donna, from the circumference to the centre. Keep this up during the night; smear the breast with concentrated ozone. and apply poultice; keep the breast firmly pressed. If ab- scesses form, open in the most depending part. Chronic Inflammation. — Is generally limited to a few lobes, which swell and become hard ; not much pain; put bella- donna, rubbed up in ozone ointment, during the day, and con- centrated ozone over night ; cover with oiled silk. and Dictionary of Diseases. 545 Atrophy and Hypertrophy of the Mammary Glands. — Defective nutrition is the common cause of atrophy, which is best remedied by tonics, most nutritious diet and the applica- tion of the saw-palmetto ointment to the atrophied gland ; fric- tion and electricity being of little utility. Hypertrophy is an increase in volume of the organ from an excess of nutrition of its constituent parts, which in other re- spects retain their normal character and consistency — there is really no enlargement of all the normal constituents, but mor- bid products, adventitious tissue, are thrown out in its texture, such as fatty or lipomatous cells. To correct this condition of enlargement, from whatever cause, the ozonized pokeberry juice, rubbed up either in ozone or resorcin ointment, spread on cloths and kept applied to the entire gland, day and night, is much more effectual than all preparations of iodine or mercury. The application, bound firmly on, not in any way to interfere with respiration, spread fresh morning and night and persevered with for some months, never fails in effecting the result. Mastodynia. — Neuralgia, in a perfectly developed fe- male breast, is either predisposed to by a depression of the great sympathic nerve, by the toxins of disease germs, or directly from blows, shocks, jars, concussions; the irritation of some article of dress ; reflexly from some exhausted, irritable condi- tion of the uterus, ovaries, clitoris ; from excessive drain upon the lacteal secretion. An indelible neuralgic stamp upon the nerves of this gland is benefited by the administration of full doses of passiflora in- carnata, and locally by applying the jelly of violets, followed by either coca, kephalin, avena or simabicidia. If due to any uterine irritation, reflected, few cases can re- sist the action of the boroglycerid pastils and cocain suppos- itories, with the wine of aletris farinosa internally, with one ap- plication of the violet jelly. If due to local irritation, the violet of jelly is the best of all applications. If due to excessive lacteal secretion, belladonna locally. If due to sexual excesses, gelsemium and salix nigra. MAN. — The Caucasian man, on account of his great nerve sympathetic development, is liable to many maladies not in- digenous to other races and woman, such as cerebral disease, laryngitis, carditis, etc. 546 The Germicide 20th Century Practice The recent discovery of so many definite products for the restoration and maintenance of a high grade of vital force suggests the idea of a higher type of manhood and some of the means of acquiring it. Every man, let him be ever so healthy, ever so conscious of perfect health, should never enter the marriage state without due preparation. As the voice, skin, hair, mental and physical characteristics of youth change at the period of puberty, so does the system, men- tal and moral, change upon marriage. At puberty new diseases show themselves, some of the older disappear, so at marriage a like change takes place. Every man who, in early life, has injured his procreative powers by either abuse or excess, or exhausted his nervous sys- tem in any way or undermined it by the presence of the venereal microbe should, for a few months at least, undergo a special tonic, strengthening, cleansing course. If, in his youth, he has been guilty of masturbation, he should at least for four months take protonuclein thrice daily, alternat- ing weekly with cerebrin and spermin, to repair the lesion, if there be one, give tone and vigor to devitalized parts, fortifying the system, rendering it favorable for the production of vigor- ous offspring. If, perchance, by some early indiscretion the venereal germ has ever effected an entrance — if a solitary spore or toxin lingers in the blood — -it will damage, dwarf humanity in its very bud, deforming its very form or essence. It should be eradicated by a prolonged course of comp. saxifraga ; the spirit of humanity demands that much. Many other new remedies might be suggested, all bearing on the vitality of the mother cell. Most men between fifty and sixty years of age, apparently healthy, are often compelled to urinate during the night, once or more frequently, and may have a delay in starting the stream. Usually this meagre symptom is the first indication of an enlarged prostate, a very common condition in elderly gentlemen. Simultaneously with this he finds his sexual power declining, and he cannot understand that an enlarged prostate is the cause of it. As age progresses, the gland increases in size, it becomes infiltrated with fibrous tissue, quite hard, presses upon and deprives the sexual nerves of their circulation, produces paral- ysis of these nerves ; hence impotency. and Dictionary of Diseases. 547 Just at this point nature furnishes a remedy in the eleoresin of the saw palmetto made into a suppository. If the profession could be made to realize the potent influence of these suppositories upon the prostate ; that if prescribed for a patient and used steadily, year in and year out, the eleo- resin in this form will prevent the formation, as well as rob the prostate of its adventitious tissue or deposit, and thus keep modern men in ease and comfort to a ripe old age. Usually one suppository on retiring is sufficient. It must be retained, when it will melt, run all over the affected parts, re- ducing inflammatory action as it spreads, toning, strengthen- ing, revitalizing the sexual nerves. Later on, when marked hypertrophy takes place from such causes as withdrawal, immoderate coition, gonorrhea, gleet, stricture, masturbation, exposure to cold, wet; recipient of blows, injurious injections, introduction of instruments, ex- cessive use of stimulants, the saw palmetto is not of much efficacy, as we have indurated fibrous tissue to deal with. In confirmed enlargement, the sexual nerves are involved, weakened as in impotency, while the hard, infiltrated substance of the prostate keeps the mouths of the seminal ducts patulous, open, and the nervo- vital fluid runs away into the urethra, either to maintain a moisture, or a leakage, to be swept away in the urine, without any impediment. Soon this continual loss tells upon the brain, spinal cord, the entire nervous fabric, the general health and upon the testes, where it is stored. Vitality is blighted, no fertilizing fluid for the brain; semen is thin, watery, infertile, and the genital organs are weak, flabby, like an old dish-rag, owing to the great nervous tear and wear. It is here, in confirmed hypertrophy, where the ichthyol and boroglycerid suppositories do immense service. This is the plan of procedure : After the morning meal, the patient should wash out the rectum by means of a fountain syringe and a quart or two of warm infusion of flaxseed ; after all has been passed, insert a boroglycerid suppostiory, one hour later an ichthyol suppository. Repeat the same after the noon- day meal, and before retiring for the night. During the day insertions patient must maintain the recumbent position for an hour subsequently. It is the only cure, so far. To remove a man's testes as a cure for hypertrophy of the prostate is truly a mean affair. True, it will cure, but when thev are removed the brain is 548 The Germicide 20th Century Practice deprived of a secretion without which it withers, dies, and he becomes hopelessly insane. Such is science. With disintegration of those adventitious elements in the prostate, sexual power and vigor returns. Its restoration can be promoted by the administration of some of the following remedies, which the attending physician may select, namely, kephalin, avena sativa, c. p. solution of spermin, thyroid ex- tract, muria puama, ambrosia orientalis, comp. tincture mat- ricaria. MASSAGE. — Properly performed, of the entire body, in- creases the blood, energizes the nerves; the mere mechanical effect is good ; better the reflex effect on the vasomotor centres in raising the standard of vitality. Properly conducted massage flushes the blood-vessels, increases nutrition, for a larger amount of blood flows through the manipulated tissue than formerly. Accompanying this, increased blood pressure, strengthening of the pulse rate, a rapid removal of tissue waste ; an augmentation of the red corpuscles, which increases cu- tanous respiration and a greater avidity for oxygen. The lymph-stream is accelerated, and the heart participates in all the benefits which arise from it, a proceeding never to be neg- lected in cardiac debility. The mere emptying of the capillaries accelerates the return of blood through the veins, diminishes the resistance to the contraction of the left ventricle, consequently when the cardiac muscle is weakened or yielding to the strain of valvular lesions — heart failure — massage relieves, mitigates those distressing conditions, and at the same time husbands the vitality of the cardiac muscle; immensely aids recuperation. Associated with this treatment, administer five grains of creatinin thrice daily, and at meals one kephalin granule ; con- tinue for several months. This treatment will relieve dyspnea, maintain and promote healthy nutrition of the heart-muscle. In cerebral anemia our usual medical treatment is almost useless, and this very fact necessitates a com- plete change of procedure, a change that involves not only great expense but considerable inconvenience, as it involves the re- moval of the patients from the unwholesome moral atmosphere in which they have been living, away from sympathizing- friends and neighbors; by a renewal of the patient's vitality by baths, brain food, and other nutrition, and causing its as- similation by positive muscular exercise; by resorting to and Dictionary of Diseases. 549 peripheral stimulation, thus stimulating the reflex centres, ■causing an increased cutaneous circulation, and thus improving nutrition. The treatment is physiological, and up to the latest discoveries in medicine, and involves the following heads : Seclusion and Rest. — This is absolutely indispensable to carry out the entire treatment in its most minute detail; the entire seclusion of the patients under a competent nurse, and their removal from old scenes, associations, and the morbid atmosphere of invalid habits which encircles them. Unless the patient is entirely removed from the injudicious sympathy and constant waiting on of friends, it is impossible to obtain the necessary control over them which is requisite for a cure. This point is to be made absolute ; sever the connection between them even if it seems harsh and strange; no compromise on this point can be made, and if it is impossible to secure the removal, the isolation and perfect seclusion of the patient, better to have nothing to do with the case and its peculiar treatment, for even if they are isolated in a separate room in the same house under a competent nurse and visited by no one but the medical at- tendant, the case does not do so well as when apart. There should then be a perfect separation from all moral and physical surroundings; the change is beneficial, and aids immensely in the cure. Following this is rest in bed, absolute repose, no reading, talking, looking at pictures, no sewing or knitting, not even allowed to feed themselves for at least six or eight weeks. Under this condition of rest the whole system becomes regenerated, and new tissues begin to form ; it acts like a brain or nerve food; it restores lost energy, refreshes the nerves tired by worry, excitement or strain, and gives renewed vigor to the whole body. After this condition of absolute re- pose has existed for six or eight weeks, it may be broke or les- sened, and then the patient be permitted to sit up several hours daily, and gradually this is to be extended. The old diseased habits are to be discarded and a new life to be inaugurated while the above is being faithfully carried out; the essential part, of the treatment is also being fulfilled in the form of — Massage. — Simultaneously with the condition of seclusion and rest being commenced, this, the really indispensable part of the treatment, should also be inaugurated : the entire surface of the body of the patient morning and evening to be thor- oughly sponged off with castile soap and water, and well dried by the nurse, and thus made ready for massage. This is to be performed by a young, healthy, vigorous person, full of 550 The Germicide 20th Century Practice vital force, intelligent, and well posted in his or her work. Massage should be commenced the first day, half an hour in the morning, and same length of time in the afternoon, the duration of time increased daily, until two and a half hours are thus occupied morning and evening, making five 1 hours altogether daily, and after its performance each time, 1 one-half or three-quarters of an hour of electrical manipulation to fol- low. This massage is to consist in taking a leg and thigh, beginning at the toes, foot, leg up to groin, first rubbing from the extremity up ; then grasping the parts between both hands. from foot up, moving each joint as you go along; then a care- ful, pains-taking kneading from the sole of the foot up, manipu- lating the joints well; this is to be followed by beating or pat- ting with the fingers of both hands coming down on the part at the same time, and the whole to be followed by a rubbing* with the points of the fingers, always moving the joints. After one limb has been well done, then the other; then one arm. then the other; the back, and latterly the abdomen, spending- upon each a little over half an hour. If there is great sen- sitiveness, it is often best not to spend the entire time on one member at once, but to go from one to the other, going over each several times. The intensity of massage will depend al- together on the sensibility of the patient. In no cases is there any violence or roughness to be used ; neither is the skin to be irritated nor much redness induced. During this manip- ulation, the patient is to remain perfectly passive — not to make a single effort ; all to be done by the operator. This systematic shampooing, grasping, kneading, patting, beating and exercise of all the muscles and nerves of the body, extremities and trunk of all the muscles and nerves of the body, extremities and trunk, has a magical effect. Its advantages are, the peripheral nerve stimulation carried to brain, cord and other centres, rais- ing the standard of central vitality, the vital force or stamina of the operator is planted into the nervous system of the patient by reflex emanation; all his reserve vitality accumulated are thus given to the devitalized. Nerve action in all cases is- vibratile ; in anemia of brain an abnormal series of nerve vibra- tions are set up. This is at once changed by massage, which restores the healthy, mechanical vibrations to the nerve ; carry- ing- the same state of vitalitv to the centres, it thus relieves wan- dering, erratic pains and neuralgia, strengthens the nerve cen- tres, and gives renewed vigor in all diseases, of nervous ex- haustion or debility; it stimulates the cutaneous circulation^ and Dictionary of Diseases. 551 the muscles are exercised without the expenditure of nerve force; the reflex stimulus carried to the medulla oblongata gives greatly improved vitality, and the psychological condi- tion of the manipulator, as well as his vitality, is implanted in the patient. To do it effectually, requires a well-educated per- son, of line mind, strong will, solid determination, sound vigor, and of high vitality. The party who does the massage should have nothing else to do but walk around, eat well, and acquire all the vitality possible, so as to communciate it to the patient. The regular nurse, tired and wearied with his peculiar avoca- tion, should never be permitted to perform the massage. There is to be no oleaginous body used by the operator, as that destroys or breaks the vivifying current. After the first application the patient will feel sore and stiff, but this will soon wear off in a few days. Although we incul- cate gentleness, still it must be efficient ; this feeling of soreness will soon pass off. when the patient will enjoy the manipulation amazingly, and after it is performed will have a pleasant sense of exhaustion followed by refreshing sleep. Electricity. — This should follow the massage, and is to be used simply as a means of exercising the muscles. The inter- rupted current should be employed twice daily, from half an hour to three-quarters of an hour. The poles armed with wet sponges squeezed out of salt water, so as to carry the electricity away down into deep parts, are to be placed on the muscles to be operated on in turn, beginning at the leg and going up, taking each muscle in turn. The sponges with the poles should be placed four inches apart and moved slowly up and down the muscle until it contracts fully and freely. This is somewhat painful and annoying, but it is of unquestioned utility in long- standing cases of cerebral anemia, especially where there is wasting or muscular paralysis. It is not to be used about the neck or head, and it should never be rubbed about indiscrim- inately, but simply applied to the muscles. Regimen and Diet. — These form an important and es- sential part of the cure. All this class of patients are but living skeletons, skin and bone; white, anemic, wasted, emaciated, neither able to sleep nor walk ; suffering a living death, mocked at by ignorant physicians who are too superficial to understand their case. And it is perfectly astonishing to see how the treat- ment tends to recuperate and rejuvenate them. Once the pa- tient is secluded, it is well to cleanse out the bowels and begin with a milk diet exclusivelv for a few davs. This should be 552 The Germicide 20th Century Practice given every two hours in sufficient quantities, which they are able to consume and perfectly assimilate, usually from three to four ounces. After two days of the massage, the amount can be increased to eight or ten ounces, so that within the twenty- four hours from two to three quarts of milk will be con- sumed. There is no difficulty in getting rid of that quantity even if there is dyspeptic symptoms, for they disappear like magic, and flesh, strength and increased weight are visible to the eye from day to day. As soon as the manipulator reaches five hours of massage and an hour and a half electricity daily, one-half in the morning and the other half in the afternoon, then the diet is to be increased by the following additions, which are greedily taken, thoroughly digested and assimilated into brain, muscle and other tissues. The following schedule will give an imperfect idea of the diet list or something near it : Every evening during the treatment there should be made beef tea, say a pound and a half of fine lean meat, chopped line and water sufficient to obtain ten ounces ; this should stand over night so as to be ready for use at five a. m., when, after the patient is sponged off, a portion of it should be taken with a soda-cracker. This meat extract should be seasoned to suit the taste, and parsley, if in season, added to it. At five a. m., beef extract with cracker, to be followed with two and a half hours massage and half an hour electricity; to be followed with a bowl of oatmeal porridge and cream. At nine o'clock a. m., breakfast, consisting of toast and but- ter, soft boiled eggs, corn bread, broiled beefsteak and coffee. At eleven a. m., milk. At one p. m., dinner, consisting of boiled white-fish, chicken, mutton chop, broiled beefsteak, vegetables, fruit and cream. At three p. m., milk, to be followed with massage and elec- tricity for three hours ; to be followed with beef extract, fish, biscuit or milk. In other words, a system of feeding consisting of brain ele- ments, and that to excess. In this treatment, which is so successful, the massage is the dominant agent, and the question is, how does it work? The vital stimulus of the rubbing, patting, kneading, shampooing, is imparted to the superficial nerves. This passes along the nerve tubes by means of the pulp to the gray matter of the spinal cord, where, by the influence of the ganglion through which it runs, the supply of blood to the nerve cell is regulated. In the cell of the gray matter of the cord a vital electrical con- and Dictionary of Diseases. 553 dition is established which travels along the spinal cord to the brain, which is toned up and receives more blood. Every rub, every vibratory thrill gives a myriad of tonic phenomena, which causes the anemic capillaries to become filled with blood rich with brain elements, and a renewal of life in the weakened tissue promoted. This treatment, simple as it looks, needs the supervision of a medical attendant of great skill. The time necessary to accomplish a cure is usually about twelve weeks, unless in old cases of paralysis, which may require a longer period. Is this treatment reliable? Assuredly it is. Not only reli- able, but endorsed by the highest medical authorities, and thou- sands of hopeless cases of disease have been cured by it. It is no experiment. The nervous system is the controlling agency by which development is perfected, and the animal magnetism of the operator is the mysterious force that rouses it into action. No drug, no remedy but this can quicken the benumbed and paralyzed limb or faculty like the invigorating stimulus of intel- lectual animal magnetism. There is an affinity in all cases of debility to absorb or draw from the stronger around, to imbide their nerve vigor and thus rouse their own dormant activities. The system of cure as laid down above comes right in among a class of diseases in which all remedies fail. For there is no drug or mechanical contrivance that can induce a healthy vibra- tory action of the nerves with living, thinking matter, and bring a new power to the deadened nerve forces but this. MASTURBATION. — An excitement of the genital organs in either sex, by the hand, a habit which produces the most dis- astrous form of brain wreckage, as is seen in the widespread neurasthenia, chorea, epilepsy, paralysis, imbecility, insanity : a morbid state Of the sexual sense, which is either hereditary or acquired. It gives rise to intense cerebral and spinal anemia, with all their horrors of despair. The repeated draining off of the vital fluid gives rise to suicidal mania, and renders its victim ambitionless, a cipher in this sphere of existence. Best treated by general alteratives and tonics, keeping the secretions active, daily baths. Our best remedies are an aphro- disiac, of which tincture of the green root of gelsemium is the best. It should be adminstered in large doses, so as to cut off for the time being all erectile power and sexual desire. Ozon- ized extract of black willow bark ; very large doses of passiflora incarnata ; suppositories of salix nigra are excellent; urethral 554 The Germicide 20th Century Practice bougies of black willow, belladonna, digitalis, hyoscyamus are of utility. As soon as the abnormal appetite is appeased "avena or kephalin" should be administered in small doses to build up a more vigorous and healthy brain nutrition. The Effects of Masturbation. — The ulterior results of self-abuse are a complete, wreckage of the generative organs, infertile semen, impotency, cerebral failure, and other maladies. One effect which is becoming very common. at an early period of life, is sarcoma of the testis. This is usually neither noticed early, nor properly treated when diagnosed, made light of, at- tributed to injury, but the common cause is either masturbation or cyclism. The progress of these cases is usually as follows : The testis enlarges without pain at first, maintains its normal shape, and forms a highly elastic swelling, which gives a deceptive sense of fluctuation, with a loss of normal testicular sensation and pain. The skin is usually stretched in proportion to the size of the growth, although not always implicated, but when ad- hesions form, ulceration speedily, nay, inevitably takes place, and the tumor fungates, as a bleeding mass. Later on the spermatic cord is enlarged, and the lymphatic glands of the iliac and lumbar regions are infiltrated. Gradually the general health becomes impaired, much emaciation, debility, and the affected individual dies from implication of the viscera. An examination of the testis in an early stage shows that the growth commences to grow most commonly in the posterior portion of the gland, and that the testicular structure itself is often spread over the anterior surface of the tumor. The tunica albuginea at first stretches, but after a time gives way, and may thus allow hemorrhage to take place in the cavity of the tunica vaginalis. This is an occurrence of some clinical importance, and it is well to remember that hematocele may complicate a sarcomatous growth, for in cases in which the diagnosis is difficult the discovery of blood in the tunica vaginalis might otherwise lead to error. On section, a sarcomatous testicle is very soft and pulpy, either opaque-white, pinkish, mottled, or gelatinous and semi- transparent ; the spermatic cord may be infiltrated with similar growths. The iliac and lumbar glands often form a series of immense tumors, and the liver, kidneys, lungs, and other parts may be infiltrated with numerous secondary masses. A microscopical examination usually shows a large, round- celled growth ; but in some cases the cells are oval, or spindle- and Dictionary of Diseases. 555 shaped, in others mixed. As a rule sarcoma of the testis grows rapidly, and rapidly involves both testes. The direct effects of masturbation are to drain off the nervo- vital fluid, so necessary to make the man; the indirect effects, the production of neurasthenia ; the reflex effect, a damage to the spinal cord, a central brain lesion, a devitalized great sym- pathetic, especially that portion of it which covers the anterior portion of the heart. This in time gives rise to organic cardiac disease ; how soon this is effected depends upon the frequency, the intensity of the irritation and the greatness of the blood pressure. Slowly but progressively in such cases cardiac disturbance is variable, generally pain, anxiety ; frequent troublesome palpita- tions, shortness of breath, sinking. With variable heart's ac- tion, slow, often irregular and unequal. The remedy for heart failure in the masturbator or those guilty of sexual excesses is matricaria. A true vitalizing agent and restorer. In urgent cases, small doses, often repeated, are the rule ; keeping the patient as quiet as possible, so as to avoid all arterial excitement, emotional disturbance, shocks. Indi- viduals suffering from heart failure should be warmly clad, should take rest before meals. If there be fault} 7 nutrition, give matricaria ; if there be constipation the kola-nut paste. Weak-hearted people are benefited by a diffusible stimulant, carefully given ; it prevents degenerative processes. The one from which I have derived the greatest benefit is oil of cajuput in doses of six drops, rubbed up in mucilage. It can be combined with either the passiflora or the matricaria ; it is a quick, powerful, safe, arterial stimulant, much to be preferred to either the nitrate of sodium or nitroglycerin. More reliable than cactus. The act of masturbation depreciates all the vital attributes of manhood; even if the practice be abolished, its stamp of degen- eration is there, blind in name and morals, with a cataract cov- ered conscience. If he chances to have offspring they are really unfit to enter the arena of life, as they are unstable, viciously endowed, mentally crippled. All the mental and physical defects induced by alcoholic con- ception, all the degenerative changes stamped upon the organ- ism of a child whose father has committed masturbation, can now by the modern light of scientific medicine be rectified by the administration of the ozonized thyroid extract. Its administration has a powerful effect upon both the phys- 556 The Germicide 20th Century Practice ical and mental systems, especially it imperfectly developed or in any way suffering deterioration. Administer if possible early in life and continue its use for a reasonable time. Next in value, to rectify the chaotic cerebral condition of the masturbator's nervous system, are kephalin and avena, either in liquid or granular form; it operates invariably well in favoring the evolution of a rich crop of active spermatozoa ; c. p. solution of spermin is a most reliable preparation in such cases and never should be omitted in the cure of the damage done, and especially if there be atrophy of the testes and other parts. MEASLES (Rubeola). — An acute, specific, contagious dis- ease to which children are liable. It is not so contagious as scarlet fever. Incubation period, seven to ten days. This microbial fever originates by contagion and infection — - the microbe or contagion is given off from the skin and breath, and lungs, persistently to books, clothes, furniture ; hence it is spread more by one child to another and the clothing of indi- viduals who have access to such cases than by the air. Its diagnosis is easy, a stage of incubation of from seven to* fourteen days, with languor, lassitude, debility, and sprouting : proliferation and ptomain excretion take place during the three days of fever, after which the microbe emigrates to the skin, where it appears for four days. During the premonitory stage, coryza, that is watery discharge from the eyes, nose, sneezing, some cough; headache, tongue white coated. These symptoms become aggravated during the stage of fever. When the erup- tion appearance on the fourth day of fever is on the face, it feels tense, rough, irregular, elevated in patches. With the microscope round cocci and diplococci can be de- tected in the watery discharge, also in the sweat, saliva, and in the eruption of all patients who have measles. • The germ is pathogenic, bears culture well. Cultures either injected subcutaneously or fed to animals reproduce the dis- ease. A point in diagnosis much overlooked is the appearance on the buccal mucous membrane of small, irregular red spots, with a bluish-white centre. They are entirely different from the reddened mucous membrane of scarlet fever, the whitish specks of aphthae, or the ulcerated state of stomatitis. These spots on the buccal mucous membrane are seen early and lose their char- acteristics when the eruption appears. and Dictionary of Diseases. 557 In German measles the catarrhal and bronchial symptoms are slight, sore throat more decided, the rash appearing on the first and second day as a diffused red blush, or small red spots, which do not form crescent-shaped patches, desquamation be- ing scarcely visible. The absence of catarrh and bronchial irritation, the tempera- ture and pulse, the intense sore throat, strawberry tongue, the smooth, silky feel of the eruption, and the greater tendency to nephritis, are diagnostic marks of scarlatina; whereas the twelve days of incubation, three days of fever, with a papular eruption, pain in the loins, and the special odor, nausea and vomiting in the early stages are characteristic of variola. It is high time that the profession impressed upon the people that measles is by no means a trivial disease; in all its stages and under all conditions there is danger, and no child, no indi- vidual of feeble vital force should be exposed to its entrance into their bodies, for the microbe is a protozoa and, like all organisms of that class, depresses the tissues in such a way as to enable other pathogenic organisms to gain an entrance into the body, such as the implantation of otitis media, bronchitis, pneu- monia and others, which not infrequently follow measles, and from which the conferva, pneumococcus and other organisms of suppuration can be isolated. It is therefore no trivial disease ; every care should be used to prevent its dissemination. During recent epidemics a complete change of treatment has been effected, the old-fashioned diaphoretic teas, aconite and asclepias, are laid aside and ozonized passiflora incarnata and sulphide of calcium are administered in alternation in proper doses to influence or stay the process of bacterial life. A patient on proper doses of these two will have no complication, no bronchitis, pneumonia, inflammation of the eyes, ears, nose, neither will there be any tendency to gangrene. Our space pre- vents us giving the treatment of several thousand cases of measles with these two remedies. Passiflora incarnata, although not a narcotic, quiets and calms the nervous system in measles, it favors a restoration of vital force, uncouples the chain of neurosis, relaxes protoplas- mic tension or tone ; it improves the quality of sleep, aids in its prolongation, entirely controls fever, a therapeutic agent of rare value. Besides simple measles, there is a malignant or suppressed form, which is more severe, and in which the rash is less well marked. 558 The Germicide 20th Century Practice Measles may be complicated by bronchitis, pneumonia, in- flammation of the eyes, ear, or nose, and the gangrenous dis- eases of the mouth and genitals known as cancrum oris and noma. Measles, German. — Epidemic roseola. A distinct disease, which is more contagious and is less serious. It generally lasts only four or five days. There is no catarrh, the rash is not so crescentic, the temperature is lower, and it is altogether milder than measles. There is usually some sore throat. MENINGITIS. — Inflammation of the membranes of the brain is usually an affection of infancy and may originate from falls, blows, mechanical violence of all kinds, reflex irritation, teething, worms, burns, the presence of the germs and toxins of tubercle and syphilis, and it may be a sequel or complication of various diseases in more advanced life, such as otitis, typhoid fever, pneumonia, epidemic influenza. Characterized and ushered in with rigors, high fever, head- ache, stiffness of the neck, vomiting, rigidity of the muscles, opisthotonos. The absence of the diplcetic structure in the skull renders children more obnoxious to it. If death should occur, the whole surface of the brain will be found covered with a fibro- purulent exudation. A headache aggravated by noise, heat, light, motion, needs darkness, rest, seclusion, with cool temperature. Head shaved ; anodyne, evaporating lotion, consisting of ammonia, passiflora, iodine. Sponging entire body thrice daily; dry mustard in stockings to knees; aconite; veratrum; passiflora; periodate aurum, enough to give free biliary evacuations, several daily; iodide and bromide of potassium. MENOPAUSE (Change of Life). —According to the last census, there were three millions of women in the United States, between the ages of forty-five and fifty, undergoing the change of life; and this number is annually kept up by fresh recruits ; so that we have, at all times, about that number. The importance of the period, the history of suffering endured, can- not be approximated ; neither have its diseases been adequately investigated. The terms, change of life, turn of life, critical period, etc., are understood to mean a period of life beginning with those irregularities which precede, the last appearance of the men- and Dictionary of Diseases. 559 strual flow, and ending with the resettlement of health on a new basis. This is usually divided into a premonitory period, the actual stoppage or cessation of the flow, and the adapta- tion of the system to the change. The first indication of fail- ure of ovarian energy or ovulation is irregularity; when the failure is complete, perfect cessation. Although it is termed a critical period, it is not to be deemed fatal, if the patient's system is healthy. It is a gradual change, leading to better or worse; to complete recovery more fre- quently than to death. The streams of life, instead of flowing on in a smooth, tranquil current from the cradle to the grave, are marked by rapids, or milestones, which are critical, metamorphic, or de- veloping epochs. Seven, fourteen, twenty-one, are clearly and •distinctly written on the first part of life; forty-two, forty- nine, and sixty-three, are less deeply cut, but are distinctly visible in the later period of life. Those periods are charac- terized by important changes, which give a peculiar aspect to the physiognomy of the human body, and impart a family likeness to the diseases of epochs justly deemed critical, in which one or several organs of the body undergo changes. The object of each critical change in our bodies is to insure the greatest amount of health for each subsequent period of life. This object, if the vital forces are of average strength, is effected quickly; but if there be debility or disease, then there is more or less disturbance, according to the degree or intensity of that state. The critical changes of dentition and puberty are frequently brought about without any disturbance or ill health; nevertheless, they are often followed by debility. At critical periods, the activity of important apparatus may be too powerful, and disturb other organs, or too feeble to react on others. When the energy of the preponderance-seeking organ is above or below par, health may be impaired. With regard to the influence of critical periods of life, first and sec- ond dentition influences both sexes alike, and in the same way. Puberty is common to both; but the impulse given to the constitution of man, by the perfect development of the sexual apparatus, is, in general, fully effective, and all-suffi- cient to insure its permanent activity until extreme old age; whereas, in women the crisis is very liable to be delayed, or per- verted; and even when puberty has been fully and effectively established, the health of woman is dependent on those oscil- lations of vital force, which render it most uncertain. The 560 The Germicide 20th Century Practice chemical activities of a womon cause her to mature early ; the inertia of man's nature renders him slow., late in maturing. The same inherent qualities of sex give woman an early change ; whereas, man's change is delayed (if not too early precocious) till a good old age, he being capable of begetting children to seventy or eighty; whereas, the moment a woman changes,. fecundity ceases. It is true that children begot by very old men are of very feeble vitality. Although most women change at forty-five or forty-seven years of age, it does not follow that sexual appetite is extinct. Sexual congress may not be enjoyed by some, whereas others never have a warmth of feeling until the change of life takes place. The large proportion of women, on cessation taking place, become callous, indifferent, lose their sexual vivacity and vigor. Menstruation, healthy or morbid, marriage, pregnancy, par- turition, and lactation are critical eventualities in a woman's life, curing some complaints, giving greater activity to others ; and when, after having lasted thirty years, the action of the reproductive organs is being withdrawn from the system, then there arises a series of beautifully adapted critical movements, the object of which is to endow a healthy woman with a greater degree of strength than that which she had previously enjoyed. But this will not occur if there are disease germs lurking in her system, such as cancer, tuberculse, syphilis; then the seeds of those germs, when vital force is low, are liable to become active,, and destructive; because the very essential of the change, debility, brings them into active growth, and causes them to locate and grow in the very organs in which the change is pro- gressing. The change stimulates their growth ; imparts to them fresh activity. So, as a rule, it is at this period we meet with the greatest proportion of cases of cancer of the womb, and breast, adenoma, and other tumors. The change of life is only critical to the diseased. It is only them that need fear the crisis. To the healthy, to those who live according to natural laws, eat healthy food, avoid balls, avoid tight lacing, bad literature, and sedentary occupations, nothing is to be feared. It is well to make no haphazard prediction, but if there is no disease, the process will not be critical. True, the disease may be got rid of : if so, it will mitigate the condition. The change does not cause disease ; it detects it, brings it into active existence, and causes an aggravation of it. Thus, congestion of the womb, chronic inflammation of the ovary, etc., existing at the change, become excessive. Disease has little tendency to leave, or become in- active or quiescent during the change. and Dictionary of Diseases. 561 The critical nature of a period is shown by its effects on the health in ensuing years. Thus, puberty is not only a crisis of most of the complaints of the preceding years, but it determines the health of the subsequent thirty-two years, for good or evil. In like manner, the change of life, if it can be consummated in a salutary manner, will influence the succeed- ing period; nay, it will govern the whole subsequent period •of life. So we can prognosticate, from the manner of the cri- sis, whether the after-life shall be good or bad. Five years after a woman ceases it tells its own tale in the great additional strength of constitution. The greater sanative change, the greater longevity of woman after the period, her less liability to disease, and death, her very remarkable good health, and almost total immunity from the general run of ailments ren- der her last stage of existence a comfort and a blessing. From forty to forty-five is a general period of invigoration for both sexes — a period in which the daily work of nutrition is very actively carried on in our bodies, rendering them stronger, more vital, healthier, and thereby insuring a more perfect performance of all the functions. The change in man is carried on insensibly and worked out without disturbance. In woman the passage is often full of danger, if natural laws have been violated, but the very great improvement that fol- lows the change is so salutary as to compensate for all the suffering. Although the phenomena of change of life are principally due to withering of the ovaries and suspension of their func- tion, it is aided by and associated with other structural changes, which take place in both sexes, due to coming age, such as the ossification of the cranial bones; atrophy of spleen, and lym- phatics ; changes in bone, marrow ; degeneration of some form : a smoothing down of Peyer's patches in the bowels, and some shrinkage of the brain proper. But after cessation a woman's constitution is entirely remodeled ; she takes a new lease of life : decay and suffering has then less hold on her, and she begins anew. The importance of the change cannot be too highly rated, especially if easily passed ; for if it is accomplished with- out much disturbance, so will the future period be healthy ; but if gone through with great suffering, then we may expect the subsequent time to be one of long-continued misery. It is a final settlement for good or evil, and it may be reasonably enter- tained that if it does not excite the activity of some disease ;germ in the body which previously existed there in a quiescent 562 The Germicide 20th Century Practice state, and the violence of the change be not excessive, it is reasonable to conclude, from thousands of pre-existing cases, that the rest of life will be passed in uninterrupted good health, and unusual longevity attained. The invigoration of the health which follows is often accompanied with a great improve- ment in personal appearance — where the thin and emaciated become fat and comely, where the timid become bold and daring; while another class become masculine, and lose their feminine appearance; their cheek bones project, the skin loses its velvety feel, creases show themselves, and stray hairs start on the upper lip or face. The effects of a suspension of ovarian action has a marked- influence on all the emotions, desires, affections, passions, as- well as on the brain proper, giving rise to debility, prostration, nervous irritability and confusion. Puberty and change of life are caused by physiological and anatomical changes in the same organs; puberty is ovarian evolution ; the change of life involution or stoppage. The true seat of both is in the reproductive centre in the brain; the one growth, the other death to that special centre ; the ovaries beings merely the organs to perform the work. When, with proper age and perfect blood development, this co-ordinating reproductive centre in the brain matures (pu- berty) the seed or egg organs, the ovaries, increase in size, be- come very vascular, and begin to let fall ovula or eggs every twenty-eight days, and cause in modern civilized women men- struation. When the reproductive centre in the brain dries up, which it usually does after thirty-two years of activity, the change has come; the ovary or egg-bed, which during the ac- tive period was smooth and turgid, becomes dried up, shrunken into a knot like a peach-stone, and it becomes difficult to trace the cavities of the Graafian vesticles, for their walls are pressed together. A few years later they shrink ; wither still more ; be- come atrophied, so much as to be no larger than a bean, and latterly completely obliterated, being marked by fibrocellular tissue. This ovarian atrophy, or shrinkage, or wasting, or withering, comes from a want of germinal influence from the brain — there being no use for the organs, they wither and die. This change is accompanied with corresponding changes in the Fallopian tubes, determined by the same cause ; these tubes con- tract, wither, become impervious and perfectly obliterated. The same condition of non-use, want of stimulus, or enfeebling en- ergfv causes the womb to contract, become small, round like an. and Dictionary of Diseases. 563 orange ; its neck becomes thinner, and shorter, and obliterated, and in some cases an obliteration of its mouth takes place. The vagina becomes very narrow, short, and there is a shrivel- ing" up of the pampiniform plexus of vessels which previously supplied the organs with blood, which accounts for the remark- able coldness of the parts. Incidental to this general collapse, the broad ligaments that retain the womb in its position also shrink and disappear. The breasts, which are a part of the reproductive system, also become cold, small, and wasted. During the change they are often seriously affected, being- painful and congested, if not otherwise diseased. It would be a matter of infinite surprise how so many phenomena of health and symptoms of disease could be determined by two little bodies whose structure does not appear complicated, but the fact is unquestionable that not the bodies, but the bra'in, is the source or seat of change. The ovaries are energized by that nervous centre of sexual power located in the spinal cord, op- posite the fourth lumbar vertebra, and supplied from the cerebral centre ; but although a central act in the brain through the cord, there can be no perfect exercise of sexual power with- out well-formed and healthy ovaries. The ovaries influence all parts of the body (directly the cord and brain) through the medium of their nerves, for as they have both ganglionic and cerebrospinal nerves, they can react on both the ganglionic nerves and their centres, and the cerebrospinal and their central organs. Whether the ganglionic be an independent system of nerves, or an offshoot of the cerebrospinal nervous system, it is not necessary here to discuss. All are agreed that vasomotor nerves follow every capillary to their minutest ramification and govern the nutrition of every part of the body. All organs of nutritive life are supplied with ganglia and a plexus of ganglionic nerves; but they all communicate together, and with a larger plexus and more voluminous ganglia, situated in the viscera of the abdomen. And before those foci of nervous- matter were discovered, this region, that is the ganglia on the bowels, liver, spleen, bladder, kidney and reproductive organs, was called the lever of forces by which the body is moved. Sensation and motion are dependent on the cerebrospinal nerves, nutrition on the ganglionic ; but there is a concentration of ganglionic nervous power in the central ganglia which gives and receives from each viscus a variable impetus. The ganglionic is a centre of nerve force, capable of controlling- 564 The Germicide 20th Century Practice and disturbing the various parts of the body by its nervous fluid or soul. The human body is so constructed that the various compo- nent organs act upon each other in the way most conducive to health, until the age of puberty. At that time health may fail and the whole system languish, unless the reproductive organs come into full activity. From puberty to the change of life, the health of woman cannot be maintained without an energizing influence from the reproductive centre in brain and cord, so as to impart an appropriate amount of ovarian influ- ence. If the ovarian energy reacts under proper nerve stimu- lus in a healthy way, it will augment, vitalize, energize the visceral centre, or brain, and cause the function of nutrition to be performed with increased energy; give vigor, instinctive consciousness of strength. If the ovarian energy be inefficient, the abdominal brain, the visceral centre of ganglionic action, is half or partially paralyzed, and uneasy sensations are felt at the pit of the stomach, a feeling of sinking, of faintness, gone- ness, or even actual fainting is sometimes induced; defective nutrition follows, with anemia of the cord and brain, vulgarly termed hysteria, met with at puberty, during pregnancy, lacta- tion and change of life. If the brain does not furnish the necessary amount of ovarian stimulus, so that evolution is in- efficient, the menses will come on in an irregular way, off and on and likely scanty ; if it be too strong, as under emotion, pas- sion, it will react upon the adjacent viscera and cause violent disturbance. All the organs in the chest and abdomen are, on their front part, covered over with the cervical sympathetic, similarly en- dowed with ganglia or little brains. They are knit together by a mysterious network of nerves ; they sympathize with each other at puberty, menstrual period and change of life, and in this way any disturbance of the ovaries, irrespective of reflex states, will give rise to nausea, sickness, depraved appetite and deranged bowels and kidneys. If the ovarian stimulus be too great for the allied abdominal organs, there may be pain in the ovaries themselves; pain, disturbing sensations, irritation which may be transmitted to a weakened cord and bulb, then hysteria, tetanus, nervous irritability, restlessness, hysterical convulsions, or there may be a numbness in skin and other parts. The strength or relative weakness of the nervous system may be inferred from the condition of anemia of brain and cord and Dictionary of Diseases. ;6; O'-O that is present. The solar ganglia in both sexes form an im- portant centre of nerve force. Insufficient ovarian influence "having reached the solar plexus affects the brain chiefly by means of the pneumogastric nerve, so any disturbing influence at puberty, pregnancy, parturition, change of life, may be shown by the distressing headaches, fretfulness, peevishness, irritability, capriciousness. perversion of the moral nature, moral insanity. In other cases, excessive or disturbed ovarian action is manifest by high spirits, or depression, a cloud or a weight on the mental faculties, haziness of mind, brain mud- dled, memory faithless and an unquenchable desire to sleep during the day. remaining awake all night, almost amounting To coma or lethargy. From puberty to the change, healthy women, when not preg- nant or nursing, drop ovules every twenty-eight days,, and as a rule modern civilized women lose about four ounces of "blood. But there are women in perfect health, who live ac- cording to nature's laws, eat healthy food, avoid modern litera- ture as a destructive ovarian poison, that have perfect ovula- tion, are easily impregnated, and whose womb does not bleed on the shedding of the egg in the ovary and dropping within its cavity. Those women enjoy the highest possible standard of health. Indian women, in their aboriginal state, seldom lose blood at the monthly period, nothing but a white, glairy discharge. Sexual involution has an ill-defined beginning and end. and only one fixed date, cessation. The activity of the menstrual period is usually thirty-two years, between fourteen and forty- six; but there are cases, once in a while met with, where the ■menses stop as early as twenty-one. twenty-eight, thirty-five, and at all periods up to sixty-one. The average, however, is forty-six in healthy women, and more cease to menstruate at forty-five than any other period in life. It depends greatly on accidental conditions of life. Blows on the head or back, frights, and other nervous states may prevent its appearance, and arrest it at any time, either when the discharge is on or off. and, if the shock is grave, forever. Its continuance depends greatly on the state of the health, the richness and purity of the blood, the freedom from worry, struggle, shocks, jars, and xiterine and nervous disease ; but taking all these into account, the average among our ladies is forty-six. Races, being essen- tially distinct, have each their peculiarities in menstruation. It is said that Hindoo women run from twelve to sixty, when 566 The Germicide 20th Century Practice free from disease; and the Laplanders and other races have different peculiarities and eccentricities. Ovulation and menstruation stand together, very nearly as cause and effect. Periodicity is an element in a woman's nature. Vaginal blood, even if it occurs with periodicity, when late •in life, may not be menstrual, but may come from conges- tion, ulceration at the neck, polypi, and other morbid states. Still there are, as we know, rare cases of cessation at sixty-two or later, in strong constitutions, so it is well to be guarded. Cases at sixty and seventy menstruating are mostly due to- some disease. Out of one-half million women who became mothers from under twenty to above fifty, seven thousand bore children from forty-five to fifty years of age, and one hundred and sixty-seven were mothers after they passed their fiftieth vear. Cases of menstruation admit of great variation. Iso- lated cases are met with at six; more numerous at eight to eleven. Still there are a greater number late, from eighteen to twenty-two; while the general average does not vary from fourteen to forty-six. Ovarian activity, then, is commensurate with constitutional vigor. An unusual prolongation of ovarian life and longevity indicates a healthy condition of the functions of vegetative life, and when prolonged, it implies great vigor, strength, and endurance, and means a good old age. During the wear and tear, struggles, hopes, cares, sorrows, vicissitudes of life, the ovaries are often simply paralyzed, and their action suspended; when the difficulty is removed their function will be resumed. Visceral disease has the same effect ; when the disease is cured, and better health brought about, their activity is restored. There may be a stoppage for a long* time, and then a recurrence. A woman past the age of fifty-three may be regarded beyond the age of child-bearing, except in very rare and exceptional cases. Pregnancy late in life is often mistaken for other dis- eases; and late labor is dangerous to the mother; indeed, it may be regarded as an extraordinary risk. Cessation is often delayed by morbid blood and affections of the womb and nerves, ulceration of the os. We will again repeat that there may be uterine bleeding without menstruation. It should not be called menstrual unless it occurs between four- teen and forty-six ; comes periodically, or with periodical par- oxysms, and the blood has the characteristics subsequently de- scribed. On the approach of a fever, or pneumonia, or intense worn*, or excitement, the womb of an elderly lady may bleed. and Dictionary of Diseases. 567 Early cessation is very common, and consists in a premature paralysis of the ovaries; and this extinguishment of the re- productive force may be caused by hard work, worry, miscar- riage, or induced abortions, falls on back, cold, fright, wet, purging, cholera, fever, long trouble, drugs, occupations — all paralyzing influences. It is called early any time before forty- six, whether it be at twenty-one, twenty-eight, thirty-five, or forty-two. This condition runs in families ; mothers and daughters resemble each other in this special department only. Women of the same family usually begin to menstruate at the same date ; have the same kind of trouble, same eccentricities, same complications ; cease at the same time, with the same peculiarities; and even die under the same conditions. In this alone they resemble the mother; in their mental charac- teristics and conformation, they are specially the same as the father. Prostitution has a fearfully deteriorating influence on both brain and ovaries, and causes a loss of reproductive power. The vagina of a woman whose sexual act is loose and varied is cold ; it has lost its vital vigor and contractility; it has no vivify- ing influence on the male. Its mucous membrane is purple or livid ; it has none of the cherry redness of the virgin, and it is even in a more dilapidated condition than that of the woman after the change. As a consequence, if they live over the three years allotted to their abnormal existence, they change, irre- spective of age. Even the conditions of life have a modifying influence on menstruation and change ; the former comes on late in the poor and ceases early, whereas in the rich, it is early and holds on longer. Menstruation usually takes place about the period of full moon in about two-thirds of all cases ; the other one-third in the middle of the month. In spite of this disparity, there can be no doubt but that ovulation is regular, inevitable, uninter- rupted ; but the menstrual function shifts, owing to some special attribute of the nervous system, and this fact shows that it is governed by nervous influence, and explains how strong emo- tion may repel or alter the time of its appearance. Menstruation is the effect of ovarian action, the shedding of an ovule : but the menstrual flow, or a discharge of blood can occur without ovulation, just as ovulation may occur without menstruation. Nervous emotion, overexertion, reading sexu- ally exciting literature, passion, hearing disagreeable news, fatigue, quarrel, and jars will bring on menstruation in some 568 The Germicide 20th Century Practice ladies without an ovule being shed. That sudden passion should cause the uterine surface to perspire blood is a well- known effect. The average duration of the menstrual function is thirty-two years, which is the possible duration of female fecundity, and that of each successive generation. The mode of stoppage in the largest percentage of women is by a gradual diminution of the flow ; by a sudden stoppage of the usual flow, or by a flood- ing or successive floodings, or by alternate copious or scanty flow, or at irregular intervals longer or shorter than twenty- one days. The greatest number exhibit a diminution, a gradual decrease in quantity, and also in the time of its duration; the other class, where it is erratic and the duration irregular; the next class, where there is flooding, the flow growing less and less, and at long intervals apart, till it becomes a mere show. The discharge, at first like blood, becomes blacker and blacker, clotty, then like cinder-dust or dirty-green water; in other cases like a lochial discharge in smell. The menses, in health, are not to be regarded as pure blood, there are certain chemi- cal elements in them induced by the brain, ovarian act, the presence of the ovule, that renders this blood totally different from the blood circulating through the lady's body ; so much so if it is absorbed, owing to sudden suppression, it will not mix, but is thrown off at some weak point in the skin, lungs, nose, bowels ; it is sweet, not saltish like pure blood, but prior to and during the change it is still further altered in quality, whether it be scanty or profuse, at first paler in color, or later, brown or simply green water. As a rule ovarian influence begins to fail before menstruation becomes irregular, because when the sex- ual organs are healthy their loss of power is gradual, the ova- rian forces become feebler and feebler, until they can no longer determine any influence over the uterus and the discharge subsides. Many women, under false teaching and with modern thought, Entertain the idea of having their ovaries removed so as to escape the menopause. Such an operation is never justifiable, unless there be diseases of the oviducts sufficient to destroy its integrity, such as solid or malignant tumors, blood-cysts, ec- topic gestation, etc. In such cases there should be no pro- crastination, but every therapeutic measure must first be tried to exhaustion. We are strongly opposed to their removal in all cases, because it cuts off the internal secretion, alters a woman's whole nature, and is productive of insanity. An ovary and and Dictionary of Diseases. 569 Fallopian tube should never be removed unless the most tang- ible evidence exists of irreparable organic disease. The extreme frequency of gonorrhea and post-partum endometritis wrecks many women, but never justifies their re- moval. All women at the change should be placed upon a course of tonics and alteratives, in which thyroid extract and c. p. solution should be a chief agent ; and if any other malady exhibits itself, treat on general principles. Flushes of heat alternated with coldness, burning in the palms of hands and soles of the feet, stone bruises, abnormal sensations in the skin, headaches, fetor of breath, insomnia, gastric disturbance, gastralgia, hematemesis, diarrhea, hemor- rhoidal stools and many other conditions of neurasthenia, all of which she may suffer, or pay tribute, owing to the insuf- ficiency or want of ovarian secretion, which point to general nervous depression and absorption of useless products. In fifty years' practice my chief reliance for ameliorating those symptoms of nervous depression, of molding the entire system into new ruts or channels, has been cinchona, sometimes as an infusion, in other cases as a comp. tincture cinchona, as a wine, and, if need be, in the form of Warburg's tincture, to- gether with daily bathing, keeping the secretions active, and with good diet. For the unbalanced mental state, whatever form it assumes, the same remedies, but add to them thyroid extract and c. p. solution of spermin. Independent of either cancer or polypus, hemorrhages at the change are not infrequent. Best treated by rest ; every means possible to improve the general health ; bathing, diet and a free exhibition of the wine of aletris farinosa. There is no remedy so valuable as this, in promoting the vital integrity of the uterus, and even in such cases in which the germs of cancer and polypus exist. These hemorrhages are often associated with heart failure : if so creatinin, the alkaloid of the heart-muscle, must never be omitted. The secondary action of digitalis and strophanthus proves well as a cardiac bracer. Cyanosis often occurs ; spartein and digitalis often relieve it. Rheumatism and gout are often leading features of the change. The acute form is rare, and when it occurs glycerite of wintergreen is usually sufficient. The chronic form, what is termed nodular rheumatism and gout, is most common ; usu- ally it is relieved by either colchicum or the uric acid solvent, or by general tonics and alteratives. 5/0 The Germicide 20th Century Practice Nymphomania and pruritus are more rarely seen, and when present should be treated with large doses of the green root tincture gelsemium, and copious vaginal injections of a solution of boroglycerid, followed by pastils of life-root. Diabetes, the true glucose diathesis, at the cessation of the menses, is apparently on the increase. Strong-minded women are its victims. Usually all the leading symptoms are well de- fined : The abnormal appetite for food and drink ; the inde- scribable languor; constipation; urine of a very high specific gravity, averaging from 1035 to 1060; chloroform breath, and amaurosis. Usually most amenable to treatment. In all cases sumbul, 5 to 10 grains at meals, completely ar- rests the evolution of the glucose fungus, — a most important point, as all symptoms become much ameliorated ; even the spe- cific gravity of the urine often becomes normal — 1015. Vari- ous remedies will aid in carrying her over the crisis, such as comp. matricaria, kephalin, passiflora, thyroid extract and c. p. solution of spermin. It is rare for cataract to form in women. Pneumonia occurring at the change has been rather of grave significance. Still, it is well not to deviate from the line of successful treatment. Passiflora in sufficient doses to control all irritability; sulphide of calcium as an antiseptic and blood- liquefying agent, and concentrated tincture of kirchicin as a vitalizing tonic, with local stimulation over the damaged lung, sufficient to excite leukocytosis. According to my experience inflammation of the lungs at the change is most frequently double; hence the most gigantic efforts should be pushed to aid nature in her efforts. Veratrum in small doses should in all cases be combined with the passi- flora. All other maladies appearing at the change should be treated on general principles. MENSTRUATION, ITS DISEASES.— In the Caucasian female menstruation takes place between fifteen and forty-five years of age; in some cases a little sooner, in others later. The sanguineous exudation, in health, takes place every twenty-eight days, and in quantity varies from one to four ounces, and is un- accompanied by pain. Two-thirds of all ladies menstruate about the end of the month, the other one-third about the four- teenth. In a condition of health, this periodic evolution should be regular; no arrest, nor excess, nor difficulty, only during pregnancy and nursing, when it should cease. If it does not suspend during pregnancy, and for fifteen months after the and Dictionary of Diseases. 571 birth of the child, the proper duration of lactation, measures must be taken to cause its disappearance, as it is highly detri- mental to the health of the child. These measures should con- sist of an avoidance of coition, or reading of our modern liter- ature, in the daily use of hip-baths, and remedies like aletris wine and partridge berry to strengthen the system. There are three different morbid conditions of menstruation, — amen- orrhea, dysmenorrhea, and menorrhagia. Menorrhagia. — Too great a flow or loss of blood at the menstrual period, or otherwise, is traceable in numerous in- stances to the presence of microbes in the blood or their pto- mains ; even such constitutional causes as scurvy, hemorrhagic diathesis, cardiac and hepatic disease have their primary origin in disease germs; and even the local causes, such as pelvic congestion, endometritis, metritis, adenoma, polypus, fibroid tumors, carcinoma or sarcoma, retained products of concep- tion, hematocele, ovarian disease as cvstic defeneration. Constitutional causes vary with age. Prior to and subsequent to puberty — often due to a want of nerve force — the vasomotor nervous system in general is feeble, tissues lax, a characteristic of rapid growth ; and in woman ap- proaching the forties, malignant disease; after the change, atrophic degeneration. Among medicinal agents, none are so productory of hemor- rhage as the coal-tar derivatives, bearing the names of anti- pyrin, antifebrin, methylene blue, etc., because they tend to break down the red blood-cells, depress the motor and sensory nerves, paralyze the heart, and give rise to inertia of the uterus. It is a matter of regret that we have such remedies, as they give rise to so many morbid conditions. Our tropical climate, fast living, sedentary habits, sexual excesses, are productive of it. In all conditions of menorrhagia there are two remedies which stand forward as uterine tonics and reconstructive agents, and these are the ozonized comp. syrup of partridge berry and wine of aletris farinosa. With reference to the partridge berry, it is undoubtedly the most important therapeutic agent that has ever been presented to the medical profession for the treatment of diseases of the female reproductive organs. It possesses most extraordinary curative properties in all devitalized states of the uterus or its appendages, aids a renewal of life in all its weakened parts. It is a great uterine vitalizer and tonic, possesses the peculiar prop- 572 The Germicide 20th Century Practice erty of evolving organic elements in the complex uterine sys- tem, and proves eminently beneficial in all cases where the func- tions of the uterus or the ovaries are either dormant or de- ranged. In atrophy, its exhibition stimulates growth; in all cata- menial disorders it is the rectifier : in all chaotic states incidental to pregnancy it is the great equalizer, overcoming nausea, vom- iting, albuminuria, thereby wiping out all tendency to con- vulsions from toxalbumin, preventing miscarriage, imparting such strength to the uterus that parturition is almost painless. Unquestionably the best remedy we have when puberty is retarded or sterility is present. It is indicated in all states of uterine debility or weakness, such as chlorosis, dysmenorrhea, menorrhagia; all forms of displacements; metritis, endometritis, ovaritis; in induration and ulceration of the cervix : leukorrheal melancholia ; uremic eclampsia ; cancer. Dose : Best administered in doses of from one to two tea- spoonfuls three or four times a day for a week, then suspend for five days ; in the interval the patient should be placed upon the ozonized aletris farinosa, then the use of the ozonized par- tridge berry should be recommenced. As it is a remedy whose efficacy is best noted after a six months' course, this break is essential. As an appetizing tonic no remedy can excel the ozonized comp. matricaria, and if the nervous system requires the aid of a bracing constructive, the c. p. solution of spermin. Every case of uterine hemorrhage deserves immediate atten- tion, especially if there be pelvic pain and breaking down of the general health. MENTHOL (Mentha Arvensis). — Japanese peppermint, a camphoraceous body, is a bactericide of considerable power in influenza and catarrhal affections. Administered orally as follows : Menthol, i dram; fluid ex- tract licorice, water, brandy, of each 3 ounces; carbolic acid. 20 grains ; oil of origanum. 20 drops. Mix. Four drops every 3 hours. For inhaling either by atomizer, spray, or other methods. Incorporation of menthol with other methods in nasal ca- tarrh. Menthol cones, the crystals put up in cones, in closely-fitting boxes or bottles, on account of the exceedin^lv volatile nature and Dictionary of Diseases. 573 of the drug. In this form success has attended its use in head- ache, facial neuralgia, sciatica, by rubbing it over the affected part. MESENTERY. — Tabes mesenterica, a disease of infantile life. The mesentery belongs to that class of blood-raising- glands, as the lymphatics, pink marrow ; any damage to it, in- filtration of its proper structure with either the products of in- flammation or the bacillus of tubercle, renders it unfit to per- form its functions. The summer diarrhea of infants, with its green stools, or prolonged cholera infantum, creates a tubercular diathesis, and the local irritation of the comma bacillus in the bowels gives rise to eusion of tubercle throughout the entire gland; the abdomen enlarges, the blood becomes anemic, and the amount of the tubercular bacilli in the mesentery is so great that it quickly undergoes its usual metamorphosis, — milky, cheesy, calcareous. If possible get rid of the cause, which is usually summer diarrhea or cholera infantum, by a selection from such reme- dies as periodate aurum, lactic acid, resorcin, stone crop, guai- acol aided with proper diet, fresh, cool air, bathing. If the mesentery has become infiltrated largely or immensely with the tubercular bacillus, which is known by the white skin, dry hair, triangular features, profound emaciation (a living skeleton), with a greatly enlarged abdomen — when the tubercle has undergone degenerative changes, cheesy, calcareous, the abdomen can be felt lumpy, knobby, hard. The tubercle in both the blood and mesentery must be destroyed, the integrity of vital force not only maintained but elevated, for which a physi- cian will select two of the following remedies, administer al- ternately and change weekly, viz. : Glycerite of ozone, car- bonate of guaiacol, hypophosphite of potassium, glycero-iodine in sweet milk, glycerite or kephalin. Over abdomen, a roller flannel ; underneath it either guaiacol ointment or concentrated ozone, with menthol or without, jelly of violets and ichthyol. Bathing morning and night, followed by inunction of warm olive oil and guaiacol. Bathing in a solution of pine-tree nee- dles, iodine and sea salt. METRITIS (Acute). — The causes which give rise to acute inflammation of the uterus are very varied, such as injuries from instruments introduced, cold, rheumatism, suppression of the menses, retention of placental debris. 574 The Germicide 20th Century Practice The symptoms : Inflammation of the uterus, acute ; pain in the back, darting to the pubes and down the thighs; frequent chills ; fever ; pulse quick, wiry, feeble, or slow ; breasts tender, painful ; pain in sacrum in act of defecation, nausea, vomiting ; gives rise to hysteria, induration, softening, abscess, gangrene. A depression of the great sympathetic, exposure to cold or wet, hard labor, violence of any kind, a disregard of sanitary conditions, may give rise to a partial death of the uterine body. There is no condition of life, between 15 and 45, that can give immunity from acute inflammation of the uterus in mar- ried or single life. The uterus is abundantly supplied with blood-vessels and nerves, in constant excitement and activity, its anatomical structure perfect, and there is nothing to pre- vent metritis and the evolution of bacteria, provided uterine col- lapse has occurred. Toxins of the most deadly character are evolved. The question naturally arises, Has our newer remedies, mod- ern methods lessened its severity or diminished the mortality of acute metritis ? Most assuredly not. Our only safeguard in all cases is narcotism with opium; thorough uterine stimulation with the uterine cones, one every hour, and the local application of ozonized turpentine over the entire abdomen, until a blush is apparent, when it should be removed, covered with sweet oil, and after a little the turpentine should be reapplied again and again. Resolution, under these three remedies, will take place, pro- vided they are energetically and judiciously pushed to obtain perfect uterine stimulation. As a tonic vitalizer of the uterine body, follow with the wine of aletris farinosa, a never- failing remedy to brace up the fibres of a relaxed uterus. A prolonged course of the wine of aletris farinosa is always followed by the most gratifying results. Acute symptoms overcome, treat same as chronic inflamma- tion. Chronic metritis may be a sequel of an acute attack, but more generally it comes on of itself; it is very common, undermines the health of a large percentage of American women, but treated with rest, vaginal injections and pastils, recovery is fre- quent; the sovereign remedy in all cases is the wine of aletris farinosa. Acute and chronic inflammation of the neck of the uterus can exist for a long period of time, isolated without invading the body of the uterus. and Dictionary of Diseases. 575 Modern bacteriological researches have demonstrated that the external os uteri formed a boundary between the lower part of the genital tract containing micro-organisms and an upper containing none. The alkaline cervical mucus is destructive to micro-organisms introduced from without, and so forms a pro- tection to the uterus, tubes and ovaries. There are two mi- crobes which resist the destructive action of the cervical secre- tions, namely, the gonococcus and tubercular bacillus. For these the defensive means are unavailing. The bacillus of syphilis, tuberculosis, diphtheria and cancer give rise to erosions of the cervix and mucous membrane, but have not the power of migration. Internally gelsemium, locally pastils of life-root, alternated with boroglycerid, meet all the indications with cer- tainty. These cases, if not promptly cured, invariably merge into cancer of the uterus, for which extirpation is never efficacious, as the primary neoplasm is in the blood. The mysterious evo- lution of the cancer microbe, a sequel of metritis, is due'to some cellular anomaly in the blood. It is well in all cases of either acute or chronic metritis, after recovery, to institute a treatment calculated to prevent an evolu- tion of the cancer germ in the blood, such as comp. saxifraga alternated with the aletris cordial. MICROBES. — To the eye of the modern scientist there is a microscopical world in the atmosphere, water, earth ; as he rinds all swarming with germs, he sees them in the motes of the sunbeam; in the morning mist, in the dust which settles on the window and floor, and the question naturally suggests itself, what are they? They are the living elements of animals and plants, in a state of transition, which hold an intermediate place in nature. Their function, their place in the fabric of the world, is to pull down, destroy, reduce to elementary forms, by a process of disintegration, of eating up each respective tis- sue in detail, the more highly organized products of plants and animals, before their conversion into cadaveric alkaloids. To form some conception of this microscopical world, it is necessary to compare them with some known object. Place them in a row, it would take 1,500 of them to reach across the head of a pin. These bodies vary in shape and size, some in the form of spheres ; others, straight spinal rods, covered by a membrane or capsule, pale, translucent bodies, which in order to study correctly must be stained. 576 The Germicide 20th Century Practice Warmth, moisture, oxygen and some amount of organic matter are necessary for their growth, which if present, their growth is prodigious. A single one will divide and subdivide, until it has produced sixteen million five hundred thousand in twenty-four hours, and these will continue to multiply in like manner as long as they are favorably environed. There are numerous varieties; all have the faculty of self -movement, of nourishing themselves, and reproducing their kind. They make radical changes in organic matter, rendering it available for use and for the continuance of all life. Microbes, in the cycle of life, have a role to play which can- not be dispensed with. Plants cannot feed upon dead animals nor upon a fallen tree until they have undergone a rotting process. This process is the special business of the microbes. They lay hold of all dead matter by the million, pull apart, disintegrate, reduce to prim- ary elements the raw material on which plants may begin again - Were it not for the disintegrative work of microbes, plant and animal life would reach a deadlock ; if all microbes would sus- pend operations, the earth would be covered with dead plants and animals, in whose tissues would be locked up, out of reach of new life, the circulating medium of all living things ; as it is, they are ever busy aiding fermentation, putrefaction, decay — they are the ever-living scavengers, in transforming dead, de- caying matter into nutrition for plants, cereals, etc. In the study of microbes they are divided into two general divisions, one class which are peculiar to and subsist upon dead organic matter, and the other class which are pathogenic of some special disease — or as some authors put it, technically classed as schizomycetse, or splitting fungi, and then divided into two classes — the saprophytic and parasitic — the first being those which carry on decay and deal with the dead rather than the living, while the second find their abode in every living- thing. To the farmer, microbes are his ever-ready slaves; so in the cycle of crops, his soil needs replenishing with phosphates, sul- phates and nitrates ; the two first are abundant in earth depos- its ; but nitrates are the products of life ; therefore the supply is limited, although the nitrogen of our atmosphere can be gath- ered by certain plants if aided by a microbe that forms tubercles on their roots ; red clover, peas, beans are of this class. This microbe assists the plant to get its nitrogen supply from the atmosphere. Rejuvenation of soil takes place from such crops- and Dictionary of Diseases. 577 — it saves the life world from bankruptcy, as all the nitrates are lost in permitting sewage to run off into our lakes, rivers, seas. In the curing of milk ; heating, cooling, thawing and ref reez- ing of cream, microbes are evolved, which in their growth ex- crete a most deadly poison (tyrotoxicon) ; in butter-making, microbes do it. Active microbe workers produce beer, wine, vinegar, lactic, .acetic and citric acids — produce mold upon bread, the rot in vegetables ; some microbes cannot live alongside of others — the toxins excreted by one often kill the other, whereas others again cannot live separately, as the action of one liberates ma- terials upon which the other feeds and grows. In all conditions of partial death, in the human body, mi- crobes are ever ready to proceed to disintegrate the tissue, and reduce them to their primary elements ; whether the cause are as precursors or simply the attending evolution, it is here un- necessary to discuss. . Depreciate the nervous system of man, either by overwork, meagre, adulterated food, want of sunlight, deleterious trades, insanitary states, disease, or impair the vitality of any animal, — if so the microbe of tuberculosis will put in an appearance somewhere in the body that happens to be weakened. A very large percentage of the human race, and domestic animals, have this germ either latent or active in their blood and tissues. In an active state, tubercular disease in some form. To erad- icate this microbe there are two essential points to be attained : (1) it must be killed, its destructive metamorphosis arrested; toxins neutralized; (2) vitality must be raised. To effec!- the first, saturate the affected individual with guaiacol, administer the mixture orally, by inhalation, by sup- pository, inunction by the skin, plaster; administer glycerites of ozone, preparations of the pine and other germicides. To effect the second — that is, raise the standard of vital force by abundant nutrition, best of food, fresh air, sunlight, woolen clothing — administer matficaria, kephalin, c. p. solution •of spermin, avena sativa. protonuclein, baths, massage. Statistics corroborate the assertion of the National Bacteri- ological Society that 80 per cent of the heterogeneous population of North America suffer from the presence of this microbe in the blood stream. Next in order of frequency, in every-day life, are the vene- real microbes, gonococcus and syphilis. The gonococcus is a direct evolution of promiscuous sexual 578 The Germicide 20fH Century Practice intercourse, loose and varied, a few women among many men — masturbation, the damage, the partial death productive of the act, also gives it an origin. It is excessively common, ex- tremely infectious, and to some extent contagious- — its toxin is inimical to all sexual vitality — destructive to the testes and ovaries, blights the white fibrous tissues, and thus resembles the toxins of rheumatism. The best remedies to kill and wipe out this microbe are the mistura llaretta internally and the washing out of the urethra or vagina, after every act of mictu- rition, with distillation of eucalyptus. The microbe syphilitica is altogether a very different germ from the preceding, and modern science is not yet prepared to assert how or in what way its evolution is brought about ; it is a microbe whose toxin has a terribly destructive action on every tissue of the body, and gives origin to every grade, type, species of disease. The brain (the nerves) has a greater store of vi- tality than all the bodily systems put together ; it is the last to mature, the last to grow old, a texture even after death that is long shrinking ; even this highly vitalized structure the toxin of syphilis will degenerate most rapidly. Highly contagious and infectious. The up-to-date remedies for annihilating this microbe are compound saxifraga, periodate aurum and comp. tincture mat- ricaria. Incidental to the condition of modern neurasthenia, great nervous depression, the uric acid diathesis appears on the ho- rizon — fermentation of the amylaceous and saccharine ele- ments of food in maldigestion, the microbe amylobacta, patho- genic of rheumatism, appears — easily found, readily cultivated, anaerobic, found in the softening of cheese ; in the fermentation of sauerkraut and in the souring of gherkins, and other forms of microbic change. In the process of bacterial growth a toxin is evolved which produces much havoc on the blood, on all the weakened white fibrous tissues of the body and the heart with its appendages. The acute and subacute forms are most successfully treated by the administration of the ozonized glycerite of wintergreen, the uric acid solvent, and matricaria, together with bathing, massage and nutrition. The chronic form yields more readily to comp. saxifraga, uric acid solvent and tonics. An ointment- or liniment of the oil of wintergreen in which chloroform is incorporated is the best local application. A hale, heartv individual receives a fracture of the ribs, with and Dictionary of Diseases. 579 laceration of the lung substance, promptly giving us the pneu- mococcus in the rusty or prune sputum, and if the proper germ- icides are not administered pneumonia may set in. Let cold, wet, exposure, inhalation of irritants be brought to bear on the devitalized body, congestion, red and gray hepati- zation of the larger aerating surface of the lungs may take place and form a most aggravated case of acute pneumonia; toxins in prodigious abundance may be excreted, so great that they themselves will kill the pneumococci, produce a crisis, with recovery. Few patients can withstand the action of the coal-tar deriva- tives, antipyrin and phenacetin, in pneumonia, as they paralyze the heart. Let the remedies be stimulation and nutrition, prompt local stimulation over the damaged lung, with veratrum viride, passi- flora incarnata. sulphide of calcium and quinine internally. The indication for the latter remedy in all cases is, it dissipates pul- monary congestion, which is effected through an increase in the diastolic movement of both heart and arterioles. It also re-enforces the medullary nerve centres, enables them better to resist vagus irritation, limits the area of filtration, and arrests the tendency to death. Like all microbic maladies, contagious and infectious. There is no difference either in the rot or blight in the vege- table and animal kingdom, their etiology is the same — an im- poverished soil. Of late years diphtheria has been carefully studied the conclusion reached is that it is a blood disease, a true rot ; the exudation upon the throat or elsewhere is the re- sult, and common among all domestic animals — propagated by contagion and infection. If it be due to an exhausted system — all are agreed on this. Two classes of remedies are required to check its progress — germicides and fortifiers. Germicides internally and locally, to alter the character of the blood and build up vital force — the sulphates are natural antidotes to such a soil ; so we find in practice the ozonized glycerite of sul- phur a safe, sure, exceedingly valuable remedy, administered in small but frequent doses, until the system is saturated with the remedy, which will be known by its acting upon the bowels ; then diminish dose, give less frequently. Sulphide of lime and the chlorides are good remedies. No antitoxin can cure diphtheria. Glandered horse serum contains one-eighth of a 1 per cent solution of carbolic acid, will not do it, but it will produce degenerative changes in the 580 The Germicide 20th Century Practice heart, kidneys, brain, and probably kill the child. All hypo- dermic treatment is injurious. If any physician who believes in the tainted horse-serum craze would use hypodermically the one-eighth of a 1 per cent solution of carbolic acid in its stead he would obtain the same results without degenerative changes, and without feeding grasping corporations. Stimulants and nutrition to get the system strengthened by any possible way. Some bacteriologists assert that in neurasthenia a degrada- tion of the living matter concerned in the nutrition of the nerv- ous system takes place, which gives us the typhoid fever germ, as we find in all cases of nerve prostration the micrococci of this germ infiltrated in the follicular glands of the intestines; in the mesentery, liver, spleen, swarming, even multiplying in the human blood. Even in this stage of incubation, contagious and infectious, the full-fledged germ, the typhoid fever organ- ism, has great tenacity of life, can live for a long time in the soil, as there it gets fresh supplies of organic matter at in- tervals. From grass soil and river pollution the organisms spread by wind, land and water into our bodies through food products and otherwise. The essentials of sound treatment are to build up vital force hy nursing, bathing and nutrition, and to kill the germ in the intestinal glands. For this latter many remedies are recom- mended. We would suggest to our readers to try the great in- testinal germicide, siegesbeckie, in tablet form. The annihila- tion of the germ gives rise to diminished metabolism, in les- sened destructive metamorphosis ; the heart is relieved from its embarrassment, its action becomes improved, the liability to cardiac failure is mitigated, and the febrile process abates, and a natural performance of all organs takes place ; even the excre- tion of urea, phosphates and chlorides in the urine is dimin- ished, and a ready, rapid assimilation of the blood elements from the food taken is the result. A partial death of the mucous membrane of the lips, cheek, gums, tongue, nipples, from any cause, either toxins in the Mood, or cracks, abrasions, fissures, known as sore mouth, promptly gives us an evolution of the microbes oidium albicans and the leptothrix buccalis, germs which have a remarkable ten- dency to break down tissue, and are communicated by infection, and possibly contagion — germs which are easily annihilated, provided ordinary antiseptic precautions are observed with a tepid solution of ozonized boroglycerid — or simply touching the fissures or sores with oil of thuja. and Dictionary of Diseases. 581 When the Schneiderian membrane of the nose suffers a par- tial death, the living elements concerned in its nutrition are -changed, altered, degraded into a disease germ ameba, we have what is known as nasal catarrh, a contagious and infectious malady. Very common in all sections of the country and one which, by migration, causes a great havoc in the olfactory tract, sinuses of the head, Eustachian tubes, bronchi — and by its tox- ins impairs the integrity of the brain and blood. Chronic nasal catarrh gives rise to congestion, hypertrophy and other pathological changes in nose and blood. Douches or inhalation of ozone and chlorine will vitalize the lining membranes of the nose, will either kill or drive out every germ. This can be effected, but organic changes, brought about by this and other germs, require a course of careful medication with comp. saxifraga as an alterative and matricaria as a tonic. If nasal catarrh be not cured by local microbicides and a highly constructive constitutional course, the ameba will eat up all the tissue for which it has an affinity, and the microbe of ozena, with its pungent, gangrenous odor, will appear. Here push tonics, thyroid extract, protonuclein, matricaria, kephalin, most nutritious diet; cleanse the whole nasal cavity daily, with either a tepid solution of ozonized boroglycerid or ozone et chlorine or the formal lotion, thorough douching; later on a nasal spray of five drops of tincture of iodine to the ounce of water, twice daily, a mild but efficient antiseptic — it does away with all clap-traps, such as powders and iodoform, boracic acid, gelatin, nasal bougies, and the like. Let the mucous membrane of the stomach suffer a partial death from beer drinking, tobacco chewing, inordinate eating or drugging, a condition termed gastric catarrh or mucous dyspepsia, with all the horrors of fermentation, the yeast plant and the sarcinse ventriculi will suffer an evolution. To effect a cure these microbes must be annihilated, toxins neutralized, the integrity of the mucous coat of the stomach restored, revitalized. An infusion of kaki will do this, or siegesbeckie tablets, or ichthyol in capsules and the mucous coat of the stomach strengthened by the administration of matri- caria. The increasing prevalence of cancer, appearing in all ages, in all conditions of life, has led some eminent bacteriologists to the conclusion that this microbe will eventually cause the ex- termination of the human race. It is the germ of all germs. 582 The Germicide 20th Century Practice extremely contagious and infectious, its dissemination is with- out a parallel, its ravages prodigious; no organ, gland, struc- ture, tissue of the human body exempt from its evolution, when malnutrition and degenerative changes set in. The cream of the medical profession, the brightest, most in- tellectual physicians in America and Great Britain, are now using their best energies in placing a "stay" on its further progress by the use of germicides and reconstructive agents :. all have one idea, the betterment of our race, the blotting out of a dangerous microbe. Some physicians report great results from the administration of the ozonized thyroid extract; others from conium et phytolacca ; still another class from comp. saxi- f raga and protonuclein ; whereas some shrewd observers admin- ister Chian turpentine mistura and glycerite of sulphur to cure the malady ; but where does the prophylaxis come in ? Three of the leading pathogenic microbes "visible" among- the people of the United States are the bacillus of tubercle, syphilis, and cancer — three contagious and infectious maladies : the germ of each may invade any tissue of the body provided it- be weakened. The toxin of each of these microbes effects grave changes in the blood, diminishing the red, increasing the white corpuscles, and otherwise toxically affecting them. Another microbe, "invisible," which is affecting the entire nation, is the bacillus of neurasthenia, the outcome of over- exertion, strain, worry, sexual excesses. According to the light of modern science, we are compelled in the treatment of the grave changes produced by those germs to abandon the accumulated teachings and experience of ages, and adopt a newer materia medica. 1. We now find that the most efficacious drugs, to destroy and sterilize the tubercular bacillus, are the glycerite of ozone : guaiacol, orally, cutaneously, inhalation and by the rectum: preparations of the pine needles, either as ozonized tar syrup or pine-tree tablets, or by inhalation ; thyroid extract, protonuclein and c. p. solution of spermin. 2. For the annihilation of the bacillus of syphilis : ozonized saxifraga comp. and chloride of gold and platinum, periodate aurum are now more successfully used than the mercurial prep- arations. 3. To wipe out the cancer microbe, Chian turpentine mis- tura; comp. saxifraga and phytolacca, glycerite of sulphur, pro- tonuclein, thyroid, c. p. solution of spermin. and Dictionary of Diseases. 583 Matricaria is conceded to be the best tonic in the three varie- ties, together with abundance of good food and fresh air. All microbic diseases are both contagions and infections, and should be so classified. MICTURITION. — The act of urinating or passing water. Urine is an excrementitial fluid secreted from the cortical part of the kidney, filtered through the tubular portion, poured by drops from the apices of the tubular papillae into the pelves of the kidney and transmitted to the ureters, which convey it slowly, painlessly and continuously into the bladder, where it is deposited until its accumulation excites a desire to void it. The excretion of the fluid takes place through the urethra, which is caused by the action of the abdominal muscles and the diaphragm and the contraction of the fibrous coat of the blad- der. Of the varieties of pain to which our poor humanity is heir, none is more distressing or more insistent than pain on passing water. This must necessarily be the case, because of the ex- treme importance to the organism of the proper exercise of the urinary function. Through this exit pass away the nitro- genous elements of tissue metabolism, of the excess of albu- minous matter taken as food, and of the products of microbic activity; three classes of bodies which, if retained in the sys- tem, gravely clog the wheels of life, and ultimately establish degenerative changes in the tissues. It is not then to be won- dered at that the urinary passages should have evolved acute sensibilities, so that any serious abnormal state is vividly im- pressed on the consciousness, and the individual thereby driven to seek a remedy .for a condition threatening the integrity of a vital function. The causes of pain on passing water are to be sought from the side of the passages or from the side of the urine which flows along them. The passages may be inflamed and hyperes- thetic from the effect of congenital malformation, mechanical injury, or microbic invasion; the urine ma}' be irritating, from concentration of uric acid, from precipitation of its crystals, from the evolution of the micrococcus ureas, in fermentation, from the presence of microbes and their toxins. Pain may be due from many causes both in the urine and in the passages, strictures are common ; inflammation of the passages, urethra, bladder, kidneys. "Whatever be the cause, it must be either re- moved or rectified. It is true it is but a symptom, and usually 584 The Germicide 20th Century Practice the first thing we rush to is to administer alkalies. Alkaline urine is less irritating, less provocative of tenesmus when in contact with an inflamed surface. There are two remedies of intrinsic value in painful micturition well adapted to the ma- jority of cases, and they are the ozonized celery comp. alter- nated with the uric acid solvent. The administration of the celery compound in all cases of urinary pain or distress is of great utility, it promotes secretion, vitalizes the kidneys, and is very soothing to all the nerves of the urinary tract, and especially is this remedy indicated if there be any tendency to Bright's disease. Celery compound is curative in painful micturition. The ozonized uric acid solvent is one of our best antagonists to uric acid crystals ; it completely dissolves and eliminates them. The symptom of pain on passing water is, indeed, a very important one, and should never fail to meet with attention. It may be "nothing much," but it is more likely to be a danger signal of impending complications, which cannot remedy them- selves, but only tend to get worse if neglected. Slight pain may call attention to the gravest conditions of kidney disease, or diabetes, hitherto unsuspected ; while, with regard to other less dangerous states, it may be the first warning that anything is going wrong. MIDWIFERY, OR OBSTETRICS.— Pregnancy.— Con- ception consists in the fertilization of the ovum or egg of the female by the spermatozoa of the male in the ovaria; then fecundation takes place. There must be a union of the two materials furnished by both sexes; that is, the spermatozoa must unite with the egg in the ovary and fertilize it; and the embryo results from the union. The spermatozoa is ejaculated into the vagina ; the uterus, by inhibitory action and vermicular movements, takes it into its cavity and passes it along the Fal- lopian tubes to the ovaries. It may occur without the patient being conscious of its occurrence, or against her will. The most favorable period for conception to take place is either be- fore or after a menstruation. After the ovum is impregnated it increases in size, and becomes prominent on the ovarium; then absorption of its peritoneal coat takes place ; and when free is seized by the fimbriated extremities of the Fallopian tube and carried into the cavity of the uterus. The ovum as a general rule is found in the uterus twenty clays after impregnation, sooner or later. axd Dictionary of Diseases. 585 After the exfoliation of the ovum from the ovary, an effusion of blood takes place into the cavity in which the egg was im- bedded, and this is followed by a corpus luteum. The human impregnated egg is very small, about the size of a dwarf pea. When impregnation takes place, the internal os uteri becomes closed by a soft gelatinous substance, and the internal lining membrane of the uterus throws out a flocculentor downy substance, which fills the cavity entirely. This is called the membrana decidua. and into this downy bed the ovum drops when it makes its exit from the Fallopian tube, and if not dis- turbed will form its attachment near the point of ingress and cause a growth of that part with which it comes in contact, and is called the decidua reflexa. So that the decidua is now di- vided into that portion lining and in contact with the uterus, called the decidua vera, and the other portion called the decidua reflexa. The embryo then becomes covered with two membranes, the chorion and amnion. The amnion is an internal lining serous membrane, which furnishes a fluid for the protection of the embryo ; allows space, facilitates motion and development of the fetus, and wards oft shocks, jars, concussions. The chorion or outside covering furnishes a means of com- munication with the uterus. The ovum, after its establishment within the uterus, consists of the decidua, decidua reflexa. chorion, amnion, liquor amnii. fetus and umbilical cord, with one extremity attached to the child, the other to the membranes at the point of attachment in the after-birth. The after-birth or placenta is a plexus of vessels by which the circulation is main- tained between mother and child, and by which the latter is nourished. When of full size it is from six to eight inches in diameter, and its thickness varies from a line to one inch, or more, at its centre. It has two surfaces, one attached to the uterus, which is rough, spongy, traversed by ditches, and the fetal side, which is lined by the amnion, which is smooth. For the first three months of intra-uterine existence this twig of humanity is called an embryo ; the latter six a fetus. As soon as impregnation takes place, the walls of the uterus become greatly infiltrated with blood, which increases the size of the vessels from being very small and convoluted to that of large and straight, the muscular fibres grow with perfect regularity. This increase of growth and development for the first three months is very great, so much so that the specific gravity of the uterus is so much that its broad ligaments are unable to hold it 586 The Germicide 20th Century Practice up, and it descends very low into the cavity of the pelvis, often nearly protruding. * After the fourth or fifth month this diffi- culty is entirely obviated by the uterus floating above the pubes, and at six months it is still higher. After the fifth month there is a /gradual distention of the body of the uterus, which en- croaches upon the neck, distending it, merging it into the body, and causing it to become shorter and shorter, until from the eighth to the ninth month it is entirely obliterated, that is, merged into the body. The duration of human pregnancy is about 275 days. This is subject to some variation, and the longest period is still un- determined. As labor occurs in the larger proportion of cases between 270 and 290 days from the last menstruation, it is usual to reckon either from the first or last day of this period, taking as the mean 280 days, or a little over nine calendar months. Parturition. — A physician when called to a case of labor should take with him his pocket and obstetrical cases ; some chloroform, ether, concentrated ozone, obstetric cones, ergot. For all highly civilized women, with a curved sacrum, the left side in a doubled-up position near the foot of the bed, with a sheet or something to hold by, during the pains of labor, is the best. This must be from below, up. Women lowly civilized, with nearly a straight sacrum, do about as well on their back or in a kneeling position. Examination. — Place the patient on the left side, ascertain the condition of the bladder and rectum; if loaded both must be thoroughly emptied. During a pain insert the index finger of right hand, well oiled ; note caref ully the condition of the vagina, the state of the membranes, capacity of pelvis, and determine, if possible, the presentation and position. Allow the finger to remain during the interval, and when the next pain comes, if not too long, make out the presentation before the membranes rupture. Do not press on the membranes during a pain. Presentations. — Labor and conception occur usually at a monthly period — the normal period of parturition corresponds to a menstrual, so that pregnancy occurs 280 days, more or less, as impregnation takes place before or after menstruation. So true, so admirable, so energetic are the vital intelligences of the uterus, that it parts with its contents like ripe fruit from a tree. When the uterus is ready to drop the fruits of conception, a axd Dictionary of Diseases. 587 certain portion of the fetus (by specific gravity the head) pre- sents or appears at the os uteri. The head is the type of natural labor, and in this state it pre- sents itself as follows : Vertex Presentations. — The head, the occiput, presenting, may be placed in six different positions at the superior strait ; lience the six kinds of natural presentations of the head, namely : 1. The anterior part of the cranium pointing to left sacro- iliac synchondrosis, or left occipito-anterior. In this position the anterior fontanelle is found at the right sacroiliac sym- physis, the sagittal suture running obliquely across the pelvis, from left to right, posteriorly. 2. The anterior part of the cranium pointing to right sacro- iliac synchondrosis, or right occipito-anterior. In this position the forehead of the child and the anterior fontanelle will be toward the left sacroiliac symphysis, the sagittal suture running obliquely across the pelvis anteriorly, from the right to the left, posteriorly. 3. Anterior part of cranium pointing to the symphysis pubis, or occipito-tubal, in which the occiput faces the symphysis pubis of the mother, and the anterior fontanelle will be toward the sacrum. 4. The anterior part of cranium pointing to the left foramen ovale, or left occipito-posterior, in which the occiput looks toward the left sacroiliac symphysis of the mother, or posteri- orly to the left of the pelvis, the sagittal suture running obliquely across the pelvis from left to right. 5. Anterior part of cranium pointing to right foramen ovale, or right occipito-posterior. In this position the forehead of the child, or its anterior fontanelle, will be toward the left acetab- ulum, the sagittal sature running obliquely across the pelvis anteriorly, from the left to the right. 6. Anterior part of cranium pointing to the promontory of sacrum, or occipito-sacral, in which the occiput faces the sacrum of the mother. The anterior fontanelle will be found toward the symphysis pubis. Hand positions are diagnosed by the Tiardness of the bones, position of sutures and fontanelles. In order thoroughly to master these positions, let the student take an articulated pelvis and a fetal head, and he will easily gain a thorough knowledge of the various positions. Take the vertex or occiput for a guide, and place it, anteriorly or posteri- orly, in the maternal pelvis, then begin with its anterior posi- 588 The Germicide 20th Century Practice tions, as the vertex to the left anterior, to the right anterior, left posterior, right posterior, etc. In this way a more accurate knowledge of the presentation can be obtained in a shorter time than could be acquired for months otherwise. It is true that in the first, second, fourth and fifth positions, nature, if properly aided, will terminate the labor ; and it is also true that a physi- cian well skilled in the diagnosis of these positions, can easily recognize the third and sixth as being invariably attended with difficulty and delay, and can also rectify these by a slight rota- tion of the head, into either of the first four positions. A cor- rect appreciation of these positions is indispensable to every one practicing midwifery. Unnatural Presentations. — The most common is the face, which usually presents in two positions. The first is when the forehead is to the left ilium ; the second the reverse of this. The presentation of the breach or buttocks, easily diagnosed by the slow labor, softness, cleft between the buttocks, anus r meconium, os coccyx, scrotum or vulva. Presentation of the superior extremities occurs about once in 230 cases, shoulder, arm, elbow and hand. The back of the child, either looks toward the abdomen of mother or backward toward her spine ; here labor is impracticable, version or turning; should be resorted to ; no delay. Rigidity of the Neck of the Uterus. — Internally. Alternate belladonna with gelsemium. These two remedies act like magic in producing dilatation and producing uterine contractions. Locally apply belladonna cerate to os uteri and resort to hot hip baths, warm vaginal injections' with lobelia. The obstetric cones are the best of all remedies to effectually overcome a rigid os uteri, two inserted well up in the rectum, the same in the vagina. Tough Membranes. — If they are tough and served their pur- pose as a dilating body and retard labor, notch the finger nail like a saw and rub it to and fro over membranes and they will give way. Be sure that the bladder and rectum are empty. If the perineum is rigid, unyielding, apply hot fomentations, as hot as can be borne. These failing, steam the pelvis with hot water in which either tobacco or lobelia is steeped. If the vital force is feeble, stimulate, give sulphate quinine, capsicum in warm milk, hot milk-punch. Inertia of uterus during labor. Try injections into rectum. friction to abdomen. Capsicum, prnnia, with quinia, is the best and Dictionary of Diseases. 589 remedy. Beef tea, stimulating hot drinks, pulsatilla, passiflora. Ergot should not be given in labor to facilitate or hasten unless the parts are fully dilated, position normal and head presenting at outlet. The practice of administering ergot early in labor is most detrimental, giving us, as a result, still-born children and often sudden death of the mother from thrombosis. Freshly pulver- ized ergot in infusion is the best. Painless Parturition. — Ladies who take abundant exercise, eat wholesome food, live hygienically, keep the bowels regular, have remarkably easy labors. To render it almost painless take four ounces concentrated ozone, one ounce of chloroform. Mix. Repeatedly bathe the entire abdomen and back during the prog- ress of labor, at the same time insert two obstetric cones well up the rectum ; the same number up the vagina ; this can be re- peated at intervals of half an hour apart. Bandage after Delivery. — After delivery of the child and after-birth the patient should be bandaged with a roller, reach- ing from the middle of the thighs to the ensiform cartilage, pin firmly below and somewhat easier or looser as it ascends; pin closely at every three-quarters of an inch. It has advantages. It relieves after-pains and prevents hemorrhage, maintains the rotundity and natural shape of the abdominal walls, obviates the pendulous abdomen, so common. It ought to be worn at least two months. Antiseptic Precautions. — The washing out of the vagina with warm lotions of boroglycerid is of great efficacy. After-pains. — After the first confinement there is always more or less inertia of the uterus, with some irritability; hence after-pains, slow contraction of the uterine walls, retained pla- cental debris, coagula. The following mixture is most efficacious : Aqua cinnamon four ounces ; sulphate of morphia four grains ; bicarbonate of soda twenty grains. Mix. One tablespoonful every three hours is excellent for after-pains, as it relaxes the neck of the uterus, permits egress of clots or pieces of membranes. If it fails, loosen the bandage and apply hot fomentations, vaginal injec- tions, warm, to hasten expulsion of clots. Rubbing the abdo- men gently with concentrated ozone is of great utility. The insertion of one or more cones of great efficacy. Aid nature every way possible by hot diaphoretic teas, catnip, sweet mar- joram ; passiflora and pulsatilla are efficacious in mild cases. Hemorrhage after Delivery. — This may be due to retained 59° The Germicide 20th Century Practice placenta, to shreds of membranes, to clots, to profound relaxa- • tion from long, hard labor. The placenta must be removed, the uterus cleared of its con- tents, vagina and rectum both thoroughly washed out with hot injections of boroglycerid, and the roller with compression over the uterus applied. Keep patient very quiet in a recumbent posture, head low, elevate the foot of bed, give cold drinks, allow no excitement. If these means fail give the mixture of turpentine, alcohol and sulphuric acid,' or ergot, quinine, alum, iron, sulphate of alumina. Retained Placenta. — If due to inertia, use friction over the abdomen, inject the vagina and rectum. Give ergot, quinine, caulophyllin. If the placenta is adherent, wait some hours, evacuate the bowels, put dry heat over the uterus, give hot stimulants. Cause the patient to sneeze. Hot punch. All this failing, insert the hand, in form of a cone, back of it well oiled, into the cavity of the uterus, grasp the placenta. The pressure of the hand usually excites contractions ; if it does not, it must be detached. Leave no fragments. If there is an hour-glass contraction, withdraw hand, administer several teaspoonfuls of tincture of lobelia with a few drops of tincture of belladonna and gelsemium. As soon as the physiological effects of reme- dies and relaxation are complete reinsert the hand, when it will readily pass through the contraction, then seize the placenta and withdraw. The above effectually relaxes the circular uterine fibres. Prolapse of the Cord. — If there is no pulsation in cord it is unnecessary to interfere; if there is pulsation, return it if pos- sible. Place the patient in a kneeling posture, and, if possible, return it with the hand, or by means of a loop of tape, attached to the end of a gum catheter. If this is unsuccessful, terminate labor speedily by use of forceps or otherwise. Placenta Praevia. — Place the patient on the back, with hips elevated, shoulders low, and if the neck of uterus is not dilated sufficient to admit the hand, pack the vagina with the tampon. Do not leave this too long, about three or four hours. See to the bladder and rectum. As soon as the parts are dilatable and presentation of placenta complete, insert the hand, push it past that portion which is detached, and rupture the membranes if they are entire, and seize the feet, bring the toes down, pointing to either inner aspect of the mother's thighs, and deliver as rapidly as possible. axd Dictionary of Diseases. 591 T uiiiing. — Version or turning is necessary in placenta pre- via; prolapse of the cord; the shoulder, or arm, or transverse presentation, rupture of uterus, death of mother, convulsions, mania. Try first, if os uteri is not dilated, or but slightly so, to deter- mine the # position of the head, and by combined action of both hands, gradually work the head downward and up, until the "head is brought to present at os uteri, when the membranes should be ruptured, one finger into os uteri, the other hand use for manipulating the abdomen. If the above cannot be done then it is necessary to wait till the os is dilated or dilatable. Keep patient anesthetized with a mixture of alcohol. 1 ; chloroform, 2 ; and ether, 3. Mix. Bring the hips to edge of bed. Bare your arm and anoint the hack of hand and arm with sweet oil. Insert it up in form of a cone into the vagina ; pass it on between the membranes and uterine walls. Carefully search for the feet, rupture the mem- branes and seize them ; bring one or both down, the toes point- ing to thighs of the mother. Once over the breach, as in the pelvic basin, terminate labor in the natural way. Instrumental Delivery. — The use of the forceps. The parts must be dilated ; empty the bladder and bowels ; keep the pa- tient anesthetized. This is not. or may not be. necessary, if child's head is at the outlet. Immerse the blades in warm water. Place the patient across the bed, hips at the edge, sepa- rate the thighs and have some one to hold them. If the mem- branes are still intact, rupture them. Lard or oil on the convex surfaces of the blades ; stand between the limbs of the patient. Take male blade into left hand; hold it nearly upright; pass two fingers of the right hand a short distance into the cervix on the right side between the fetal head and uterine wall, then- in- troduce the point of the blade along inside of fingers, and pass it gradually, lowering the handle until the convexity of the child's head is grasped by the fenestrated portion of blade : de- press the handle near perineum. Here take the female blade in the right hand, and begin by holding the blade in an upright position ; in the same way, but by reversed movements, pass the handle down and lock the two. Operate with gentleness, don't apply force. Traction. — Make the traction only during a pain. If the head is high, the direction should be first downward, and, as the head gradually descends, move upward until just before the head escapes from the vulva, when traction is at almost right 592 The Germicide 20th Century Practice angles with the long axis of the patient's body. As a general rule, the direction in which the blades point denotes the line of traction. Craniotomy. — Place the patient in the same position as when the forceps are applied. See that the bladder and rectum are empty ; pass the fingers of the left hand up to the fetal bead and carefully pass the perforator along palmar surface until it reaches the head; take care that you do not injure any of the maternal soft spots. Perforate the cranium, break up and evac- uate its contents. Sometimes nature enforces the expulsion of the child. Twins. — As soon as the first child is born and separated from the mother apply a bandage about the abdomen, and wait for expulsion of the other. Do not attempt the removal of placenta of the first child until after the birth of the second one. If the two placentas remain in the vagina twist the cords to- gether and deliver in the ordinary manner. MOLES. — Moles are patches of variable sizes in the skin r colored by pigment, often raised above the surrounding skin, and frequently covered with hair. They never grow on the body after birth, but are always congenital. They can hardly be called tumors, for they show no tendency to increase in size. Tumors, however, such as sarcoma, or cancer, may, later on in life, begin at a mole and extend from it. The mole may grad- ually increase in size, become more and more prominent, until a tabulated, dark-colored tumor has arisen. Such an enlarged mole may be greatly irritated by the friction of the clothes, and may ultimately ulcerate and give a good deal of trouble. When such a condition is present, the surgeon's knife is the best and the simplest remedy. With regard to smaller moles, if on the body or limbs, they give no trouble, and it is unnecessary to interfere with them. A large mole on the face may be a disfigurement, and hence one may naturally desire to get rid of it. Ladies are often particu- larly anxious to get advice on the subject of the removal of a disfiguring mole. The leading pathologists of the present age- assert that moles are of epithelial origin, incomplete sarcoma derived from the epidermis, the cells of the tissue composing' the mole show this origin. The pigment of a mole is due to an adventitious deposit of iron, not essentially at first to melanotic sarcoma. This usually comes later on, if it suffers irritation and vitality be weakened. and Dictionary of Diseases. 593 Malignancy is not a positive characteristic, but in all those growths, the cells being epidermal, the slightest alteration in the protoplasm itself is liable to give rise to that condition; hence the rule of sound practice is to destroy moles, in whatever region they may be, by painting them (according to their size) several times with liquid chloride of chromium. One applica- tion only being necessary, pain subsides in a short time; no dressing is required. MOUTH, ITS DISEASES.— The tongue is exposed to many sources of disease and injury. It is a highly sensitive •organ; hence, slight affections of its mucous membrane or its muscular fibres are highly painful.. Glossitis. — Inflammation of the substance of the tongue is a rare affection, since mercury has been nearly discarded from practice; when it occurs it is usually dependent upon consti- tutional causes, or some irritation applied directly to the organ. In either case there is fever, great nervous depression, and debility. The local symptoms are those of pain, heat, redness, swelling. The tongue becomes of a very deep red color, and so swollen that it fills and protrudes out of the mouth. It usually comes on quickly, and is often attended with urgent symptoms, and requires prompt treatment, as active purga- tives, followed by hypodermic injections of one-third of a grain of pilocarpin, heat to feet, poultices of slippery elm to tongue, and suppositories of veratrum viride and gelseminum per rec- tum. If mercury is the cause, iodide of potassium, chlorate of potassium gargles, and sulphurated potassium baths, or both. Ulcers, Cracked, and Other Morbid States of the Tongue. — The tongue is not only an index of the condition of the stomach and alimentary canal, but often a valuable criterion as to the state of the nervous system and intensity of blood poisoning. The strawberry tongue of scarlet fever, the raw, fleshy- looking tongue of gastritis, the patchy, ulcerated tongue of typhoid fever, and other states of great exhaustion. The sore- ness in the organ is relieved by bland food, mucilaginous drinks, smearing it with vaselin ointment, or using mouth washes of chlorate of potassium and glycerin, or borax and honey in infusion of bayberry. Ulcers, the result of malnutrition, or of inflammation, or irritation from old stumps; the removal of the cause, the use of emetics and bitter tonics. As those ulcers are generally 594 The Germicide 20th Century Practice very small, superficial, without definite shape, very sensitive, most numerous at the tip or bridle ; in addition to internal tonics they are readily cured by infusions of golden seal and borax r or sage-tea and borax. Mercurial ulcers are common; not so much to internal ex- hibition of mercury as to the use of amalgam in filling teeth, especially large cavities. They are very easily recognized by the fetor of the breath, affection of gums, salivation. The removal of the cause; the use of chlorate of carbon as a mouth- wash, and iodide of potassium internally. Syphilitic ulcers are easily recognized by their copper-col- ored appearance. In mild attacks most common on front part of tongue and edges and superficial aspect ; in more aggravated cases they occupy the root, and they are deep and intractable. The general treatment for syphilis, with mouth-washes of infu- sions of sage and borax, hyssop and chlorate of potassium, echinacea. There are also tubercular, cancerous and other forms of ul- ceration; constitutional remedies, with local antiseptics. Cracked Tongue. — They may be fissures, transverse, if in- testinal irritation ; or longitudinal, of kidney irritation ; or, more generally, they are the clefts and fissures of malassimilation. forming a series of irregular grooves often quite deep, render- ing eating, speaking, or reading difficult and painful. Cured by sage-tea and borax, glycerin and chlorate of potassium, golden seal and alum. Surface of tongue often presents patches of baldness, one or more smooth oval patches; no ulceration or fissure, indica- tive of a syphilitic taint ; alteratives and tonics. Warts are usually met with at the edges of the root of the tongue, and are presumptive of syphilis. Condylomata are not uncommon in same disease. Papillary patches, thickening,, induration, give an unpleasant feeling to the organ in speaking., causing thickness of speech called psoriasis and ichthyosis: often precursor of cancer. Hypertrophy of tongue is rare; when it does exist, it is so large that the mouth is too small for it. In some instances it protrudes as far as the chin. Its removal by ecraseur is the only cure. Tongue-tie, when the frenum or bridle is shorter than usual, the movements of the tongue are interfered with, the bridle has simply to be cut. All kinds of tumors, fatty, fibroid, encysted, etc., are met with here; extirpation is the proper remedy. and Dictionary of Diseases. 595 Ranula (so called because the voice is said to be croaking* like a frog's) is a semitransparent, fluctuating swelling as large as a walnut, situated under the tongue. It consists of a dila- tion of Wharton's duct of submaxilary gland. Painting it with the perchloride of iron, or passing a setbn through it, is usually sufficient to effect its disappearance, using mouth- washes to heal and strengthen. Care of the Mouth. — Perhaps no part of the body is so often neglected as the mouth; especially is this noticeable in the case of children. A mother who will religiously bathe her child and keep its body sweet and clean will often fail to cleanse its mouth. A new-born infant should have its mouth washed after each feeding ; a soft cloth wet in a weak solution of boro- glycerid should be used for this purpose. If this were always done we would rarely find a case of infantile sore mouth. After the teeth come and the mouth is large enough, a small, soft brush should be used ; the teeth and mouth should be thor- oughly cleaned at least twice daily. In illness where sordes and mucus accumulate rapidly, and where the tongue and lips are parched and stiff, attention is needed every hour; the mouth should be kept moist and the same treatment carried out through the night as during the day. Boroglycerid solution, lemon juice, glycerin and distilled water are all refreshing, and soften the tissues; where the lips are chapped or fissures appear, a lubricant of cold cream or ozone ointment should be applied. Where the gums are spongy or soft, and bleed readily, a few drops of tincture of myrrh added to pure water will help to harden them. Small squares od" old linen or soft gauze should be used instead of a brush where one is ill or weak. These should be immediately burned after use. Every part of the mouth should be cleansed ; behind the wis- dom teeth, the roof of the mouth, and under the tongue ; lemon juice and water will remove the fur from a thickly coated tongue. Where the teeth are sensitive the water used should be slightly warm. MUCIN. — A compound substance composed of a proteid and carbohydrate, which are the chief constituents of mucus, a substance very widely distributed throughout the body, in the mucous membrane, gland cells. There are numerous varieties, but all are viscid, tenacious. Its functions are very varied — a protector of delicate mucous membrane, a lubricator ; poured 596 The Germicide 20th Century Practice over an abraded membrane, causes it to heal with marvelous ease and rapidity. When administered, its good effects are at once visible — immediate relief of all painful sensations in the stomach ; it regulates the bowels ; otherwise physiologically soothing. MUCOMEMBRANOUS COLITIS.— Bears a strong- relationship to desquamative enteritis in that both have the passage of shreds, skins, exfoliation of the mucous coat of the intestines. A catarrhal affection, due to a secretional irritation of the mucous membrane of the large intestine, and depends either upon some neuroses, or hyperesthesia of the walls of the bowel or its centre in the brain. Invariably associated with some neuropathic tendency, nervous disease, either of the genital organs, or brain or cord, or constipation, or auto- intoxication, or organic disease of the bowel. Its characteristics are the passage of large mucous masses, tenderness of the colon, coloptosis, interstitial atony with the colitis usually alternated with constipation and diarrhea and the evacuation of masses of mucus and shreds. In the cure of this condition, regulate the bowels with kola- tina, administer matricaria for a tonic, one week give kaki in infusion freely as a drink ; the following week Virginia stone crop; continue this treatment for a few months. Add nutri- tious, easily digested food. Occasionally either a few drops of peroxide of hydrogen or echinacea could be added, if stools be very feculent. MULLEIN OIL. — Otalgia when reflex calls for the removal of the cause; when not reflex, but is periodic, concentrated tincture of kurchicin; if due to syphilis, comp. saxifraga and periodate aurum ; when the pain is deep seated, agonizing, or even superficial in the cervical plexus, mullein oil is the remedy. Before dropping this in fill the ear with peroxide of hydro- gen, head horizontal on a pillow, affected ear uppermost ; let it remain five minutes, then evacuate it and drop in half a dozen drops of mullein oil; never failing for earache. Another excellent formula is to rub up five grains of hydro- chlorate of cocain in one dram of concentrated ozone; mix thoroughly; rather an empirical prescription, but it invariably affords instant relief. The following internally has been found useful in the otalgia of the gouty : Add to two tablespoonfuls of water, one tea- spoonful of aromatic spirit of ammonia, fifteen drops of green and Dictionary of Diseases. 597 root tincture of gelsemium, fifteen grains each of chloral hydrate, bromide of potass and bromide of sodium. Take at a dose ; instantaneous relief. MUMPS. — Just below the lobe of the ear, folded, as it were, round the angle of the lower jaw, is the largest of the salivary glands, the parotid. It is the favorite seat of many toxins, such as those of typhoid, typhus, scarlet fever and other contagious maladies, a location whence originates many tumors and abscesses. During several seasons in many states and localities, mumps or epidemic parotitis prevailed quite extensively. In- flammation, attended with pain, heat, swelling, considerable pyrexia, movements of the jaw difficult and painful. Ad- vanced physicians in scientific therapeutics have most suc- cessfully treated this condition thus : Jelly of violets over the entire gland ; passiflora and gelsemium, in alternation with the sulphide of calcium internally, this latter remedy frequent. With these remedies not a single case of metastasis, either to the breast, testicle or ovary, occurred. Febrile symptoms in all -cases subsided in twenty- four hours. Suppuration of this gland, due to the toxins of disease germs lodged in its interstices, an unfavorable complication of any disease, may be prevented by exhibition of the sulphide of lime. Epidemics of this malady have prevailed extensively of late in our public schools. The exact origin of the disease could not be traced. All cases were ushered in with a slight indisposition, fol- lowed by a rigor, rise of temperature and the characteristic swelling, which was well marked and in some cases extended over the neck. Temperature fell on third day, unless orchitis or ovaritis supervened, when it rose again. Antiseptic mouth washes of boroglycerid were used in all cases, with concentrated ozone over the parotid, which acted as an efficient microbe killer, promoting resolution and afford- ing relief of pain. In orchitis, the application of a fifteen-volume c. p. peroxide of hydrogen acted like magic. The commencement of the disease begins by the entrance of the germ into the mouth, spreading to the glands along the ducts, hence the value of germicidal mouth washes. In cases where they were used freely, orchitis seldom put in an appear- ance. Isolation and disinfection are indispensable as prophy- lactics. 598 The Germicide 20th Century Practice MUSCE VOLITANTES. Specks and spots floating before the eyes ; may be a symptom of either cerebral ex- haustion, or a failure of the liver (torpidity) to work off toxins, a slight auto-intoxication, effete' elements in the blood, penetrating- the aqueous humor; the image of the body, being imprinted on the retina, passes before the field of vision, interfering with it, hence specks, spots. Taking a more scientific view of it and the opthalmoscope for a guide, it would seem that the vessels of the aqueous humor are varicose, lost their contractility, and the brain, looking through the optical apparatus, sees objects which she compares to things in nature; this latter idea is confirmed by its presence in mas- turbators, excessive or prolonged lactation, hemorrhages, anemia. So that both ideas may be correct. If due to morbid products in the blood, administer periodate aurum for a short time, which promptly removes the often too great annoyance. If due to brain anemia, give tonics, comp. matricaria, c. p. solution of spermin. MUSCLES AND TENDONS.— The muscles of the body act like so many ropes or pulleys upon the bones, for the pur- pose of locomotion. They rarely suffer from disease, unless it be those peculiar to muscular structure, viz., atrophy and hyper- trophy with fatty degeneration. Myositis. — Inflammation of muscular structure is rare; in- deed, the heart is about the only muscle in which we see at times inflammation thoroughly established. Circumscribed in- flammation in other muscles may be the result of injury, strains, over-exertion, disease of bones or adjoining textures. Symptoms. — Pain, greatly aggravated by any movement of affected muscle. It becomes localized ; there is heat, swelling., the latter distinct, resembling a tumor: rigors and fever. It may terminate in effusion of lymph, thickening, induration, or in a breaking down of lymph, suppuration. Treatment. — Control fever with aconite and serpentaria : relieve pain with anodynes ; apply hot alkaline poultices during- the day, and linseed poultices, with tincture of opium, at night : nourishing food ; establish convalescence upon tonics. Myalgia. — Stiffness, soreness, cramp, or pain in the vol- untary muscles of the body, may be due to various causes ; for example, in young persons of rapid growth, persons in whom the bones grow faster than the muscles, the muscles and ten- dons become stretched, and the individual suffers from what is ASSB DlCTIOXARY OF DISEASES.- 59c/ termed growing pains. These are often quite severe, and in- volve both the tieshy part of the muscles as well as its tendons, •either the eentre, or where it is inserted into the bone, or both. It is often due to a strain, lift, over-exertion, and involves the muscles of back, chest, abdomen, arms, or legs. It is also a symptom of a shock from cold, great nervous prostration, and is thus prominent in certain diseases., as fevers, inflammation, parturition, rheumatism, scurvy, tuberculosis, cancer, chlorosis, leukocythemia. dysentery, diarrhea, prolonged lactation, ex- hausting maladies generally, and spermatorrhea. Symptoms. — Pain is the chief symptom; and this in its de- gree and intensity bears a direct ratio to the amount of debility that is present. Where it depends on too rapid growth of bone in young persons, they seldom complain of it in the morning after a good night's rest, but comes on after exertion, and gradually increases till night. In the case of the masturbator,. or those suffering from seminal losses, pains in the morning, and rather wear off during the day ; whereas in the case of dis- ease, mostly an aching all the time. The pain in all cases, how- ever, is aggravated by movement. General health in all cases is poor; skin cool, pulse natural or depressed; appetite good, clean tongue. In bad cases there may be night-sweats, loss of appetite, impaired digestion, constipation, no vigor or energy, inability for work, severe mental depression. Treatment. — The principles of treatment will be modified by the cause, but all cases require good nourishing diet, as animal food, boiled fish, oatmeal, porridge, cream, raw eggs, fruit, vege- tables in abundance ; tonics, as cinchona and mineral acids ; sul- phate quinine and aromatic sulphuric acid ; quinine, iron, hydrastin, mix pill. Rest for the affected muscles, by splints or otherwise. Massage to be performed twice daily; begin with half-an-hour treatment, and increase length to two hours, if patient has means to carry out treatment. In the massage treatment, bathe a limb with soap and water ; dry ; use dry hand until there is a glow of warmth; then shampoo, rub. knead, and otherwise manipulate with warm olive oil : then another limb in same manner until the entire body is massaged. Electricity can follow if case is bad. or in a hurry to get well. Muscular Atrophy. — Muscles may waste, their fibres be- come pale, small and inelastic. This may happen from want of use or exercise, or from injury to their nerves, as in fevers, injuries, disease, or from sxposure to cold. damp, or from some affection of the nerve centres ; the muscles of an arm or 600 The Germicide 20th Century Practice leg may be smaller, as it were, by a blight. The affected mem- ber may become chilly, skin numb; it becomes imperfectly nourished and decreases in bulk ; or if the patient be young, it fails to grow in proportion to the rest of the body. Some cases of atrophy may be attended with pain, especially if its nerves are irritated by blood poisons. If atrophy is not cured, it progresses on to fatty degeneration ; that is, the muscle or muscular fibres become usurped by fat, an inelastic body, and their power for movement is irreparably lost. This can be ascertained by placing the positive pole of a battery near its origin, and the other near its insertion, per- mitting current to run pretty strong, and bring the poles within four inches of each other. If muscular fibre is still good, muscle in a few minutes will bulge up or contract at its centre between the two poles of the battery ; if muscular fibre has be- come usurped by fat, it will lie quiescent, and exhibit no signs of contractility. Treatment. — If the muscle has undergone fatty degenera- tion, no known remedy will avail ; but if there is still evidence of contraction between the poles of the battery, a cure can be effected if the cause can be removed; so that the treatment embraces a general tonic course, as cinchona and mineral acids ; very nutritious food, stimulating frictions, shampooing, manipulation, passive exercise, electricity, baths, etc., so as to promote growth and keep the muscular fabrillse exercised. It may take months, but by constant perseverance with the massage twice a clay it is bound to come. If there is pain, stiffness, with spasmodic action, muscle rigid as well as wasted, the cause should be removed, and the case managed on general principles. Hypertrophy of Muscles. — Muscles may suffer enlarge- ment by excessive use. The muscles on the arm of a black- smith or prize-fighter are enormously developed. In the former it is quite common for the right side to measure four or five inches more than the left. This can only go on to a certain extent — to a degree of growth in which there is an adequate nerve supply; when that limit is reached, and exercise still con- tinued or persisted in, fatty tissue will begin to take the place of muscular fibre, and the muscle will lose its contractility and become useless, because it has undergone fatty degeneration. The treatment is rest and alteratives. Muscular Degeneration. — Over-exercise is bad for the individual. It wastes vitality, weakens the system, fills it with poisonous fatigue products, and, if persisted in, shortens life. and Dictionary of Diseases. 6oi But the other extreme is equally bad. Failure to develop the muscles, or their degeneration for want of systematic, moderate use, predisposes to a disturbance of nutrition and circulation, leading to accumulations of fat on one hand and imperfect elimination on the other. Obesity, constipation, torpid liver and kidneys, fatty heart and fibroid degeneration of the blood-vessels, are some of the results of muscular degeneration. The substitution of fat. for muscle in the abdominal walls and hips is responsible for pro- lapsed and congested viscera. Displaced and congested organs will not functionate normally, of course. Muscular degeneration affects the joints, leading to fibrous changes, drying up of synovial fluid and the deposit of urates. In their turn, these irritating products in the joints will cause sensory and motor neuroses, which pain and disable the in- dividual. Muscular degeneration also occasions anemia, because activity of the muscles is directly concerned in the production of hemoglobin, and hemoglobin carries the oxygen to burn tissue waste into soluble products easy of elimination. This burning also produces heat and energy, keeping us com- fortable and furnishing the power to work. Moreover, the normal development and moderate regular use of the muscular system overcomes such moral faults as timidity, indolence, procrastination, lack of perseverance. In a word, helps to discipline the moral powers, and gives the individual command of all his forces. Endurance is increased and courage fortified. MUSK ROOT. — Ozonized fluid extract of sumbul in doses of from 30 to 60 drops, every three hours, is our best remedy in epilepsy and chorea ; its action is chiefly upon the medulla and cord, a vitalizing sedative and astringent, wards off the attacks, and causes their disappearance. MYELITIS. — Inflammation of Substance of the Spinal Card. — Is recognized by spinal pain; formication; tingling, numbness and coldness of extremities : at first convulsions, afterward paralysis which extends gradually, often affecting the sphincters. In the chronic form, unusual fatigue : then par- alysis, tremors, tottering gait or inability to stand. Active treatment with cups. Organic Disease of the Spinal Cord. — Including Hyper- 6o2 • The Germicide 20th Century; Practice: ■trophy, Atrophy, Aneurism, Hydatids, Tubercles, Sclerosis,. S. : Pain of various degrees and character; disordered sensa- tions in limbs and surface; muscular weakness; paraplegia, paralysis of rectum and bladder. Spinal Irritation. — Various symptoms, one being a con- stant tenderness on pressure over some part of the spine;:symp- toms as if from severe gastric, or pulmonary, or cardiac dis- order ; neuralgic pains. General Measures. — In all obscure spinal diseases, alteratives and tonics; rest; constant applications of irritating plasters: on both sides of the spine, massage. Innumerable remedies act specially on the cord or its membranes, as ntix, rhus, cinchona, passiflora, cause an increase of blood to the part, whereas bella- donna, ergot and like remedies diminish, the flow.. NAPHTHALAN. — This remedy is acquiring- quite a reputa- tion as an antiseptic and disinfectant in certain diseased" condi- tions of the tissues. Administered internally, orally and per rectum, it is a most valuable remedy in all cases of typhoid fever., A rrricrobicicle which can be relied on every time it is given. In cutaneous diseases, especially eczema,, that often obstinate catarrhal inflammation of the skin, an ointirjent, strength: ten per cent, will promptly relieve burning; tangling, pain and pruritus. Even a two per cent solution is an antidote to the poison of vines and insects, invariably affords prompt relief. A similar solution acts well in burns, causing the rapid subsidence of the inflammation. I The remedy is cheap, but good. I NASx\L CATARRH, CHRONIC— An infectious and contagious disease, capable of spontaneous origin in the de- graded living matter concerned in the nutrition of the Schneiderian membrane (under adverse conditions) into the disease germ ameba. The very- great prevalence of this dis- ease in all parts of the country, the great havoc it causes in the olfactory tract, sinuses of the head, Eustachien tubes, throat, bronchial tubes, brain and blood, renders its correct treatment of vast importance. The vast amount of unsuccessful treat- ment results chiefly from its true etiology not being duly ap- preciated. The evolution of the ameba causes the mucous membrane to and Dictionary of Diseases. 603 become congested, thickened, and even the bone becomes hyper- trophied and a special diathesis is created. We claim that, ozone et chlorine will positively cure nasal catarrh; that is, if used by the douche it will drive every ameba from its nestling-place. This can be effected in one treatment, as has been demonstrated by numerous specialists; but if the case is very chronic ; if there has been organic changes brought about; if there is tubercular or syphilitic germs lurk- ing in the blood, a more varied course of medication is indis- pensable. In addition, therefore, to the destruction of the disease germ ameba in the air-passages, whether by one heroic treatment or several milder ones, there should be invariably a tonic and alterative course pursued for months. As tonics the best results are to be obtained from the glycerite of ozone. As an alterative, the ozonized saxifraga stands unrivaled. It is most potent in freeing the blood from disease germs. It should be given in large doses and perse- vered with. It acts according to the quantity given — cleanses the blood of all disease germs. NATIONAL DEBILITY.— The American nation is essen- tially neurasthenic — suffers a deterioration. A general national weakness pervades its most tiny village up to its metropolis. This state permeates all, as is indicated by the dudes of modern society, the general childishness and foolishness of the masses, the incipiency state of imbecility, the small heads with dwarf intellects, etc., etc. To what can this weakness or vital deterioration be due among the best-fed and best-clad nation in the world? Not to a highly oxygenized atmosphere, not to incompatibility of races, not to the germs of syphilis or tubercle, but rather to the hidden vice of masturbation, which dwarfs mental and physical growth and vigor. The constant drain of seminal fluid, the most highly vitalized substance in nature, entails upon the individual loss of flesh, digestive power, of mental energy and a despondency of the most deplorable kind, with brain disease of some special type, loss of memory, epilepsy, softening and insanity. In addition. there are local complications or diseases innumerable, as affec- tions of the bladder and kidneys, irritation and softening of spinal cord, diseases of the testicle, varicocele. Indirectly, seminal losses so weaken vital energv that the 604 The Germicide 20th Century Practice normal embryonic living matter becomes changed, altered, de- graded into other living matter, disease germs, the bacilli of tubercle, one of the most frequently developed under the in- fluence of sexual abuse or perversion. The mortality from tubercle is great; few realize the fact that its real cause is sexual indiscretion. The great increase of albuminuria, cardiac disease, asthma, are to be traced to the same source. Rheumatism and gout are often directly due to the genera! prostrating effect of masturbation on the nervous system. Physi- ologists have recently discovered that the composition and mode of production of the nervous substance and the seminal fluid are almost identical; that in fact they are essentially the same thing. It has also been ascertained that, in all cases of severe nervous or mental derangement, the actual substance of the brain and nerves either wastes away or undergoes a de- structive change. And in the same way, in all cases of con- firmed loss of sexual power, the seminal substance either wastes or becomes destructively changed in a similar manner. But. what is still more important, the destruction or injury of either one of these elements of our systems brings on inevitably a similar evil to the other. Every man, therefore, who becomes impotent is in immediate danger of becoming insane, or at least of weak intellect. The male and female sexual systems, the entire reproductive and urinary apparatus of both sexes, derive their principal nerve supply from the general reservoir of the great sympa- thetic, on which depends the performance of all vital functions. The heart, stomach, intestines, also larynx and lungs, in all civilized men, derive an abundant nerve supply from the same source. Drain off this nerve supply by grief, worry, care. Exhaust this nerve supply by sexual excesses, masturbation, with its sequel spermatorrhea, and there is at once a want of nutrition from the sympathetic, and a failure on the part of vital organs, especially the heart. The weakness of the heart muscle is visible in the unsteady gait, in the bloodless brain, in the vertigo; the cold, clammy hands and feet ; the cold, moist skin ; in the weakness of all the tissues; in the greater frequency of varicole in all mas- turbators and libertines. Heart failure is becoming exceedingly common among both young and middle-aged men, and should in all cases receive and Dictionary of Diseases. 605 prompt attention by checking of! all seminal losses, which are productive of cardiac disease. The condition now called irritable heart is analogous to irritable uterus, irritable ovary, irritable breast, irritable testes, irritable eye and ear, spinal irritation and cerebral irritation, and it is very often associated with the nervous dyspepsia of an irritable stomach ; indeed, nearly all, if not all, the organs of the body, and the whole body, may fall into a state of irritability with symptoms that simulate and suggest organic disease, and which are very often mistaken for such. In the irritable heart of the sexually exhausted there may be the extreme of slowness or the extreme of rapidity, from thirty or forty up to one hundred and ten and thirty. Slight exertion or trifling emotional influence suffice to put up the pulse all the way from twenty-five to seventy-five per cent ; climbing moun- tains, going up hills even, or but one or two flights of stairs, the sudden meeting of a friend, a start or shock of an exceed- ingly insignificant nature, are enough to produce this effect ; it is very hard to convince such persons that they have not organic disease of the heart, especially as precordial pain and uneasi- ness and distress and intermitting go with this high or low pulse. Functional disorders of micturition are to be diagnosticated from similar symptoms coming from stricture by their capriciousness, and demonstrable dependence on nervous ex- citation. Some of these cases have ordinarily no trouble in urinating, but if they chance to be at a public urinal, where a line of persons is behind them waiting for their turn, they can do nothing. This is a very good illustration of one of the phases that this function assumes in condition of debility. It is mainly subjective — mind acting on body. But if the parts were in. their full strength the mind would not produce this effect. Their very anxiety to urinate in order to make way for others, keeps them from doing it. Analogous illustrations in other functions are very abundant. Extreme exertion of the will defeats its objects; hysteria and hystero-epilepsy, and especially trance, exemplify this general law in ways innumer- able. It is, indeed, one of the diagnostic features of trance that the subject cannot do the very thing that he particularly wants to do. A sign that a mesmerized subject is under the influence and ready for experiment is the inability to open the eyes when commanded to do so, and when, with all his might, he tries to do so and fails. There are cases of hysterical paralysis that 606 The Germicide 20th Century Practice only recover when we succeed in calling off the patient's atten- tion from the paralyzed limb to some other portion of the body. The attempt to walk makes it impossible for them to walk. When the symptoms come from stricture or from contracted meatus or phimosis, they are more likely to be permanent until the source of the irritation is removed. The extreme stages of these morbid phenomena are so well known that it is not needful to more than refer to them for the sake of completeness. The milder, subtler and more evanescent degrees of these affections are, however, but rarely thought of or appreciated. Impotence is a symptom of very wide range and gradations, beginning with premature emission, or simply waning pleasure in the sexual act, and advancing through the stages of ejaculation before intromission, deficient desire and power, to absolute want both of desire and power. Similarly, involuntary emissions may be so rare, or may occur several times nightly, or even in the day. They may or may not be complicated with true spermatorrhea, that is with the flowing away of the semen in the urine, or at the stool, or on excitement. The existence of even quite frequent involuntary emissions by uight or day is not a proof of the existence of true sperma- torrhea. There may be very frequent emissions and yet no spermatozoa in the urine or any discharges at stool. On the other hand, emissions may be infrequent, as rarely as once or twice monthly, and yet spermatorrhea may be active all the time. Indeed, it would appear that the spermatorrhea acts as a relief for the accumulated seminal fluid, and saves the noc- turnal discharges. Thus it happens that patients are often deceived; they observe that their emissions are less frequent, and suppose that they are recovering, when really the fluid is but taking another mode of exit. Only the microscope can answer the question whether spermatorrhea does or does not exist. All conclusions formed from the various local or general symptoms may be swept away by careful and repeated mi- croscopic examinations by an expert with that instrument. True spermatorrhea is yet far more common than is admitted by the medical authorities. It is not found because it is not looked for, and usually not even suspected. In the majority of cases where trouble with the genital system is suspecetd by patients, some form of trouble does exist. It may not be what the patient suspects. It may not be so grave as he has fancied, but there is usually something abnormal that requires treat- ment or hygiene, and there is also need of sound instruction on axd Dictionary of Diseases. 607 rhe whole subject of the management of this function. The long-disputed question whether seminal discharges take place from the penis during or directly after stool, and. in some instances, during any form of sexual excitation, the microscope answers in the affirmative. In many instances — perhaps in the majority — certainly in the majority of those discharges that take place during erotic excitement, the fluid discharged comes from the prostate or from Cowper's glands, or from both; but in a certain proportion of cases it is just as de- preciating, perhaps even more so. By mere analogy we speak of nations as we do of persons, lor being a collection of individuals, they, act after the manner of persons, and have their period of youth, colonization and decay. A national disease may be defined a state in which it cannot direct its energies towards self-preservation. A diseased organ in a nation may destroy it ; that might be a bond-holding aristocracy : lack of a true religion ; a corrupt government; imperfect nutrition from adulterated food; poi- sons, alcohol and tobacco: epidemic diseases, as malaria, syphilis, tuberculosis, cancer, fevers and infectious maladies : mental shocks, panic or prostration of the national energies : sexual decay from masturbation, immoderate sexual inter- course ; subversion of the sexual powers ; the diminution of the population from many causes ; an avoidance of the state of motherhood are most insidious and dangerous causes of na- tional decay. Imbecility, criminality, delusions sap the life of nations. An inordinate mental exaltation, imaginary o-reatness in all o JO things, leads to a national disease of the emotions which may prove to-day, as in the past, "very fatal." NEPHRITIS (Acute and Chronic). — Acute and chronic inflammation of the kidneys may be caused by lifting, hoisting, mechanical violence, or by gout, rheumatism, uremia, calculi. Deep-seated pain over the kidneys, aggxavated by motion, pressure or jar. The urine very scanty, high colored or mixed with blood, nausea, vomiting. Fever, if it is the acute form. Try one or other of the following remedies : Aconite, thallin, passiflora. belladona, gelsemium. uva ursi, queen of the meadow, digitalis — infallible in renal congestion. In the acute form dry cups over the kidneys, followed by dry heat; hops or bran; mucilaginous drink like marshmallows : in the chronic form, locally, irritating plaster, concentrated ozone ; ■internally nitrites, cinchona, alteratives and tonics. 608 The Germicide 20th Century Practice Nephritis, Interstitial. — A gradual breaking down of the kidney; chiefly internal structure that gives way, with breaking down of its healthy substance ; persistent presence of albumin of the urine. In heavy drinkers, or in scarlet fever patients, it takes on an acute form; urine highly albuminous and very scanty. It is met with generally in a chronic form, when the symptoms are most obscure, until it merges inta dropsy. It has three stages : Congestion, degeneration,, atrophy, or breaking down. If the patient is tubercular and suffers from syphilis or a poverty of nerve force, the degeneration will be amyloid or starchy. If he indulges in alcoholic drinks, the degeneration will be fatty. . Prognosis. — First stage: If treatment is good, recovery; at stage of degeneration, recovery rare ; and atrophy or tumbling" in of kidneys is invariably fatal. Common cause of death is uremia. Remedies. — Alteratives and tonics ; gallic acid and port wine ;. digitalis, coca, cure numerous cases; phosphorus, glycerite of ozone; kephalin; avena sativa; nitric acid, aromatic sulphuric acid ; cinchona, nitroglycerin, apocynum. General Measures. — Adopt measures to keep the skin active and promote free diaphoresis, give vapor baths; salt water baths, sponging with salt and alcohol; flannel clothing; avoid changes of temperature ; open-air exercise, never to fatigue the body. Milk, eggs, fish and beef, for diet. Nephritis Malarial. — The malarial germ belongs to the vegetable kingdom, is a protozoon; certain varieties of the organism give rise to different types of fever. Once in the blood, it is invariably present in all the cycle of changes which it undergoes, corresponding to a type of fever (quotidian) which occurs either in twenty- four hours, or (tertian) in forty- eight hours, or (quartan) in seventy-two hours. Kidneys feeble from any cause, pathological changes are induced by the elimination of the toxic products of the germ which gives rise to malarial nephritis, which is present to a greater or less extent in every case of malarial fever; hence kidney lesions are extremely common, so much so that albumin in the urine is present in sixty per cent of all cases, hematuria to a limited extent. All practitioners rush to quinine in these cases, an erroneous method, for although it will kill the germ, it is too irritating tc- and Dictionary of Diseases. 609 the renal functions; to the kidneys themselves; its action, if administered at all, should be modified by green root tincture .gelsemium, or what is still better, either Warburg's tincture or concentrated tincture of kurchicin should be used. Sulphate of quinine itself, unmodified, creates too much congestion of the urinary organs to be of utility in malarial nephritis besides the quinine most dispensed in the United States is an abominable synthetical compound unfit to enter human blood It is well in all cases of malarial poisoning to look to the Iddneys, protect them as the toxin is being eliminated. Suppositories of quinine sulphide and concentrated kurchicin Tiave been introduced which act promptly in curing malaria and all its complications, provided the rectum be thoroughly cleansed before their insertion — one every three hours. Spring and fall the atmosphere of the United States is literally swarming with the malarial microbe. Strong vital force on the part of the eighty millions of people who occupy this area resists its entrance, or if it enters the vital elements of the blood, causes its destruction, hence immunity. Very different it is with the feeble, the devitalized, the neurasthenic. This microbe enters, and if quite exhausted it lives, grows, multiplies immensely and enters the red corpuscles of the blood and destroys them ; in this microbic growth toxins, the products of bacterial life are set free, and they are so abundant, even in mild cases, that neither the breath nor the skin nor liver is able to eliminate them, consequently: the kidneys are compelled to aid in this process of ousting a poison. In doing this they become overworked, exhausted, suffer irritation, relaxed, and an exosmosis of either blood or its albumin takes place ; so both conditions either favor hematuria or albuminuria. So nephralgia, nephritis and other affections pertaining to those emunctories are common. We have on our books an im- mense list of such cases, showing the efficacy of the green root tincture of gelsemium and passiflora in completely relieving this difficulty and aiding it still further by the exhibition of periodate aurum. These three remedies never fail to relieve the irritation, affording immediate and permanent benefit. Any of our readers having obstinate cases of chronic nephritis on hand, whether due to the toxin of malaria, syphilis, influenza, tubercle or alcohol, would do well to try such cases on the ozonized celery comp. — a remedy that neu- 6 io The Germicide 20th Century Practice tralizes a poison, one that aids its expulsion, and at the same time strengthens those important glands, and acts as a prophy- lactic to degenerative changes. Small doses, a steady persis- tence in its use does effectual work. NERVE TIRE. — The human body, roughly dissected... presents to the naked eye a brain, a spinal cord and great sympathetic. From these central points nerves pass to various parts of the body, which by the aid of the microscope can be traced to their most minute ramification. The brain, in addition to its being the soul-seat, the matured organ of thought, an organ of elaborate mechanism, has an important function to perform, namely, to elaborate and transmit neurine cells to every part of the body, so as to maintain its nutrition. Waste and repair are carried on, in the human body, during its existence ; the waste of the tissue of an organ is. in exact pro- portion to the demand made upon its working capacity. Re- pair, renewal is in proportion to the demand, provided the proper elements of nutrition exist in the blood ; if they do not exist there, the organ injured is incapable of perform- ing its ordinary function. Nerve tire, nerve exhaustion is es- sentially a disease of civilization, an excessive brain waste, an expenditure of vital force; if repair keeps pace with waste, all' is well ; if not, if there be a loss, disease. There is no station so exalted, no intellect so bright, no power so great, no influence that can adequately realize the suffering of nerve exhaustion. Nervous exhaustion may be congenital or acquired ; the lat- ter is usually due to an unusual amount of work done by the- nerve centres, increased without a proper supply of brain elements being present. The brain is subject to the same general law of waste and repair as other parts of the body. Every thought, every emo- tion, every exercise of volition is accompanied by waste: destruction of tissue and its excretion from the body are indis- pensable. Ther emoval of causes, if possible; seclusion and rest ; systematized massage for two hours, morning and night : inaugurate a plan of overfeeding, a diet of brain elements, to which faradization may be added. The patient should go and live in the open air in the country; if he cannot, he should occupy rooms well aired, ventilated, and with full exposure to the sun. Between each period of work, covering a few hours, and especially before and after meals, he should take mild physical exercise in accordance with his tastes, such as walking, and Dictionary of Diseases. 6ii rowing, gymnastics, open-air games, bowling, golf, croquet, lawn tennis, etc. If he cannot go out he can do gymnastics in his rooms, play billiards — in a word, seek distraction and move- ment. If he finds gymnastics too fatiguing he will derive benefit from carriage exercise. His meals ought to be regular and substantial, with avoidance of alcoholic drinks. Massage and douches are valuable adjuvants. These cases are much benefited by shampooing the head every day, and then rubbing it with alcohol before drying thoroughly. It is well, however, to begin the treatment with a complete absolute rest from mental labor for several weeks. XETTLE-RASH. — Urticaria cannot be better described than as an eruption which closely resembles nettle stings, both in appearance and the sensations it gives rise to. When acute. it is generally accompanied with more or less fever. The nettle-rash, in almost all cases, arises from disorder of the digestive organs, and evolution of bacteria, caused either by indigestible food, or in some persons by particular kinds of food. Kernels or seeds, such as almond, peach, etc., which contain prussic acid, seem especially apt to cause nettle-rash. and in some individuals even the pips of an apple have been known to produce this disorder. Fish, particularly shell-fish, also bring it on, or mushroom ; also certain medicines, such as turpentine; teething, hurry and agitation of mind in adults, and other irritations, also give rise to nettle-rash. The generally known causes of this affection indicate the remedy — ■ the removal from the alimentary canal of offending matters. If there is tendency to sickness, and if the eruption appearh soon after a meal, an emetic is the appropriate remedy, but whether this is given or not, there should be given an aperient, and as the toxins accumulate in the intestinal tract, administer siegesbeckie tablets to neutralize them. As an intestinal anti- septic, these tablets are unique and remarkably efficacious. NEURALGIA*. — A devitalized anemic condition of some special nerve or nerves. Its etiology embraces a large class of conditions that would either weaken or exhaust its vitality; all depressing agents, heat, cold, mechanical violence, toxins of disease germs, poisons. Its recognition is easy, pain of a sharp, lancinating, irregular, intermitting character, shooting along the course of the nerve. 612 The Germicide 20th Century Practice It receives different names, according to its location. If in the brain, cerebral; the face, facial; in the heart, angina pec- toris; in the stomach, gastralgia; in the bowels, colic; in the kidneys, nephralgia ; in the sciatic nerve, sciatica ; in the uterus, uterine; in the eye, ocular; in the ear, otalgia; in the coccyx, coccyodynia ; in the breast, mastodynia ; in the pleura, pleuro- dynia ; in the testes, testicular. The general principles of treatment in all cases are, first, to relieve pain as promptly as possible by both local and internal remedies, selecting from a large list either heat or concentrated ozone and menthol; a liniment of aconite, belladonna and chloroform ; oil of cloves, gaultheria and menthol ; oil capsicum and chloroform, jelly of violets. Whatever is applied, cover to prevent evaporation, and protect from cold, damp. Probably the two best sedatives for internal use are the passiflora and green root tincture of gelsemium. The second indication is to either kill the germ or neutralize it. Maintain the integrity of the blood. As an all-round altera- tive, simabicidia is the best, and adapted to every case, no matter what its origin may be ; a blood purifier and tonic. To increase blood formation and growth rapidly, acodylate of sodium; as a nerve vitalizer, kephalin and oats; wear warm clothing; rest, no worry, no care, no fret; avoid over- work ; daily bathing, regular secretions, and a rich, nutritious diet. Cerebral Neuralgia. — Removal of cause and the exhibi- tion of large doses of the solid extract of hyoscyamus ; if there be poor circulation and great nervous exhaustion, alternate with kephalin granules — not only gives relief, but is essentially curative. If the pain is paroxysmal, or clue to malarial toxins, concen- trated tincture of kurchicin may be added. Facial Neuralgia may be due to the toxines of disease- germs, to the poison of mercury, lead, brass. Relieve pain in all cases; follow with saxifraga, comp. simabicidia, according to cause. If it depends upon carious teeth, cleansing and inserting pledget of cotton saturated with jelly of violets, most effica- cious ; if reflex confined to the fifth pair of nerves, a five-grain pill of croton chloral, one every half hour, and relief is ob- tained. Neuralgia of the Coccyx {Coccyodynia). — Pain, tender- ness about coccyx; often sharp, tearing, lancinating; is a most and Dictionary of Diseases. 613 unpleasant form of neuralgia. Most common in women, on account of their great development of coccyx, and above all, in women of high civilization, who have as an index of that ■condition a sacrum at an angle well verging on to 45 degrees, and a coccyx most perfect. In women of low civilization the sacrum is nearly straight, and the coccyx almost as rudimentary as it is in man. Causes. — Hurried labor, or insufficient support to the perineum, whereby the nerves of the coccyx receive a shock ; blows, falls, fractures, and horseback exercise, etc. Symptoms. — Pain in sitting down or in rising, or in walking, or in defecating. Pain is even more than neuralgic, more than sharp and lancinating; there is a general soreness. In many cases patient can only sit on one hip. Any movement or pressure on the surrounding parts gives rise to pain. It is ag- gravated by menstruation, or sexual intercourse. One boro- glycerid pastil every three hours per vaginarn, with patient in recumbent posture; at the same time a cocain suppository as frequent until relief is assured. In coccyodynia, as a result of fracture of the hinge-joint, after ossification, in having a child after thirty-five years of age, there is apt to be a laceration of the nerves, and neuralgia established, which gives rise to painful sitting. This is also present in deep-seated inflammation of the genital organs, especially in the uterus and ovaries, so very slight, how- ever, that the patient does not experience uneasiness, only in the sitting posture. Relaxation of the great joints of the pelvis towards the end of pregnancy is very natural ; they become loose and juicy, and a considerable increase of motion is observed in them. If the labor is long, the presentation not a good one, or the head of the child large, or instrumental deliver)*, made with force or violence, there may be a low grade of irritation set up in them. So that there is a morbid loosening, which not only gives rise to pain in sitting, but hopeless lameness. Rest, general alter- ative and tonic treatment will, in time, effect a cure. Pain in all cases must be relieved by the introduction of the cocain sup- pository and the ozonized pastil. Neuralgia of the Stomach. — Gastralgia, a devitalized condition of the pneumogastric and vagus, and other peripheral branches of nerves that supply the stomach. The partial death may be in the nerves themselves, it may be reflected, it may be due to toxins of disease germs, poisons. Neuralgia never can 614 The Germicide 20th Century Practice be mistaken for gastritis, for the pain is paroxysmal, radiating' from the stomach to all parts of the thoracic cavity ; invariably relieved by pressure; diminished during and after eating, but returns again. Nausea, eructations, variable appetite; no special desire for fluids, and when not suffering from pain, apparently well. A characteristic of gastric neuralgia is the mental phe- nomena, despondency, disgust of living or a morbid fear of death. The pain of gastralgia, and the eradication of the patholog- ical condition, may be completely antidoted by one or other of the following remedies : Dissolve one dram of the jelly of violets in two ounces of comp. tincture of matricaria, then administer ten drops in three tablespoonfuls of water before meals. This affords instan- taneous and in many cases permanent relief. Another excellent prescription is sulphate of quinine twenty grains; prussiate of iron sixty grains; gelsemin (alkaloid) two grains. Mix, make into ten powders, administer one powder every three hours for a few days, until the pain is completely arrested, and a little longer for a cure. The pain of gastralgia is promptly allayed by the taking of a papoid et cocain lozenge either before or after eating. For temporary relief, if none of the above are convenient. add three drops of chloroform to one teaspoonful of glycerite of pepsin. Instant relief is experienced the moment it is swal- lowed. If the neuralgia be due to fermentative changes in the con- tents of the stomach, one or two siegesbeckie tablets every four hours is a capital remedy. If the attacks are accompanied by extreme weakness, pallor, vertigo, cold perspiration, tremor, exhaustion from either lack of food, combined with auto-intoxication from undigested food, frequent small meals, preceded by a kephalin granule, are ex- cellent. Poisonous food is probably more productive of gas- tralgia than all other causes. Many individuals, by reason of their impecuniosity, partake of articles unfit for food — articles in which alkaloidal poisons are abundant, and these are re- sponsible for much of the gastro-enteritis so prevalent. Brewers' yeast is a remedy never to be overlooked in gas- tralgia. It has the property of assimilating microbes, or inglobing them. Singular to say, all cases improve under its use. and Dictionary of Diseases. 615 Neuralgia of the Heart. — See Angina Pectoris. Neuralgia of the Breast (Mastodynia) . — Neuralgia of the breast, with extreme pain and tenderness, may be due to blows, contusions, the irritation of corsets, most commonly due to some irritation of the uterus, ovaries, or clitoris. The removal of cause, tonics, coca, avena, kephalin, sima- bicidia, passiflora. Locally belladonna, concentrated ozone and menthol, jelly of violets. These remedies failing, look to the uterus ; give aletris wine, alternated with nitroglycerin ; comp. syr. partridge berry, alternate with cimicifuga and Pulsatilla ; use pastils of boroglycerid alternated with nymphae odorata. Nephralgia. — Often due to gravel, or disease germs, like malaria; to drugs; to suppression of an eruption; in the left kidney to poisons of rheumatism ; gout, cold, wet. It is attended with most excruciating suffering; sharp lancinating pains, coming on suddenly, violent in intensity, relieved by pressure, never aggravated by it. If due to gravel, it may be continuous, beginning at the time it commenced to pass into the ureters, and continuing until it reached the blad- der. The pain is paroxysmal in its character, not only ex- perienced in the loins, but extends to the groin, thigh or abdomen, causing retraction of the testicle in the male, and irritation of ovary in the female. If the paroxysms are severe, they may be accompanied with nausea and vomiting; a small, wiry, feeble pulse ; profuse perspiration ; prostration, with a desire to pass urine, and an inability to do so. When concre- tion, if due to that, reaches the bladder, pain suddenly ceases : if due to other causes, it may continue till the cause is removed. Its location (relieved by pressure), character of pain being- paroxysmal, with other symptoms of kidney irritation, are always important landmarks. In the treatment, alcoholic vapor-bath ; external warmth over kidneys : if stomach is so irritable as to cause everything to be rejected, apply mustard over it, and give a large dose of tincture of green root of gelsemium; if vomiting still persists, hypo- dermic injection of morphia, preceded by the inhalation of a few drops of chloroform. Then apply belladonna plaster over kidneys, and depend on quinine and gelsemium internally. In some cases aconite and belladonna answer well, with dry cups and lobelia fomentations. If due to the retrocession of an erup- tion, compound tincture of serpentaria or jaborandi; if due to rheumatism, alkalies, as nitrate of potassa and cream of tartar. Each case managed as to its cause. 616 The Germicide 20th Century Practice Ocular Neuralgia is usually relieved at once by rubbing concentrated ozone over the forehead and temples, and dissolv- ing one grain of the jelly of violets and dropping it into the eye — most reliable method. The indiscriminate use of cocain and eucain is not to be com- mended in eye affections, as they give rise to impaired nutrition and are decidedly injurious. Even the pain of glaucoma and ophthalmia is alleviated by the violet jelly and concentrated ozone. The best internal remedy is simabicidia. Otalgia, recurrent neuralgia of the ear, should be treated constitutionally in all cases. Simabicidia, gelsemium, passi- flora. To relieve pain promptly dry heat, a hot hop-bag, bran- bag, hot salt, desirable methods. Mullein oil, a few drops. One grain of jelly of violets dissolved in a few drops of warm water and poured into the ear affords immediate relief. Of all local anodynes for earache, the jelly of violets is the best, for the instant it touches the membrana tympanum otalgia is relieved. If it be clear that the toxin of the aspergillus is the cause of the recurrent neuralgia, the ear might be occasionally filled with the peroxide of hydrogen, which promptly kills this fungus. The application should be repeated to obtain a good result. Pleurodynia, intercostal neuralgia, may be a complication of pleurisy or exist by itself, and is usually either of a rheu- matic or uremic origin, and must be actively treated on anti- dotal lines. Comp. conium pill relieves pain. Then select two remedies from the following group, and push with energy, ozonized, either grycerite of wintergreen and uric acid solvent; or col- chicum wine and gelsemium; or matricaria and simabicidia. If uremia be prominent, matricaria, gelsemium and uric acid sol- vent with asclepsias. solvent with asclepias. These remedies stimulate, revivify every function of organic life, and must be fully known to be appreciated. Locally, dry cups, then select either concentrated ozone and menthol; or mustard and albumen; or guaiacol plaster; or oil of wintergreen ointment. Sciatica, being the longest nerve in the body, with a cellular sheath of considerable thickness. Very common in the uric acid diathesis, in all disorders of metabolism in which rheuma- tism and gout are present. The pain in the back radiating along' the course of the nerve, well down to the popliteal, is usually most excruciating, especially on movement; demands impera- and Dictionary of Diseases. 617 tive relief. The compound conium pill must be given un- til the passiflora and gelsemium take hold. The remedies in- dicated in every case are the simabicidia, saxifraga, and uric acid solvent, to rid the blood of toxins, absorb effused lymph on the sheath of the nerve, cleanse its neurilemma. These are truly curative drugs, but slow in their action ; consequently, the comp. conium pill must not be neglected, as it not only affords immediate relief, but soothes the jaded brain. Locally, acu- puncture along the course of the nerve, followed with rubbing* in jelly of violets, is excellent. Concentrated ozone, with men- thol added, also efficacious. Guaiacol plaster along the course of the nerve fairly good ; even oil of capsicum diluted with chloroform not to be despised. Neuralgia of the Testes. — Generally caused by either the toxins of the gonococcus, rheumatism, gout, malaria. A legacy of congress with harlots, excessive sexual intercourse, abnormal methods, masturbation, or whether the sexual act is loose and varied. For immediate relief of pain try conium pill, followed with gelsemium and passiflora with cocain suppositories, with jelly of violets over scrotum. Simabicidia and matricaria always the remedies, according to the cause. C. p. solution of spermin and passiflora are good for recruit- ing. Uterine Neuralgia. — Becoming more common daily. Some rare cases may be traced to irritation, others to the gono- coccus, another numerous class to repeated abortions, followed by intrauterine catarrh. The causes that produce it are ex- tremely numerous. Independent of mechanical irritation, a most common cause is want of development. Modern educa- tion and civilization drain off the vital energies of the brain and nervous system, leaving the reproductive organs in a state of atony, defective nutrition, hence the modern woman at puberty makes an effort to perform an adult function with an •infantile organ. The effect is imperfect and painful. Microbes and other toxins, sexual incompatibility and other conditions give rise to it. In the treatment the reproductive organs must be given an opportunity to catch up with the system in development, which involves rest, massage, electricity, protonuclein, c. p. solution of spermin, altogether a different treatment from that pursued by the modern gynecologist. The pain in all cases must be re- ' lieved with the boroglycerid pastil and suppository. 618 The Germicide 20th Century Practice Remedies that favor uterine growth are comp. betin pill, cot- ton-root bark, thyroid extract. Medical treatment with c. p. solution of spermin and keph- alin, with that elegant, reliable uterine restorative wine of ale- tris farinosa, of great efficacy ; so also Pulsatilla, green root tincture gelsemium, passifiora are of benefit. Locally the boroglycerid pastil and the cocain suppository stamp out the neuroses. Every remedy failing, massage and rest. In all cases hygienic treatment is among the best of all cura- tive means. Nutrition, exercise, healthful mental and moral surroundings are of the utmost importance. Young ladies must receive special attention with regard to these matters, and all undue drains upon their vital forces, as to close confinement in school, at music or art lessons, late hours, and the dissipation of society must be discontinued. Local treatment. NEURASTHENIA.— Poverty of nerve force gives rise to the evolution of a striking pathogenic microbe, which admits of artificial culture. It can be easily isolated from the blood of every individual who suffers from any nervous malady, be- sides it is to be found on the tongue. In languor, debility, head- ache, neuralgia, epilepsy, spermatorrhea, impotency, suicidal mania, and in all forms of insanity, the blood literally swarms with the microbe. It is the presence of this microbe which ren- ders suicide, spermatorrhea, impotency, endemic, and mental aberration contagious. Men, on account of their great development of the sympa- thetic, are more obnoxious to the ingress of this microbe than females. Contagious and infectious in the true sense of the term, close contact being necessaiy. Like all other disease germs, this bacillus in its evolution and growth excretes toxins or ptomains. Four ptomains are found in all stages or degrees of nervous shock, from a simple head- ache up to tetanus; these are tetanin, tetanotoxin, spasmotoxin, and a toxalbumin. These poisons are found in the blood and tissues of the in- sane, the paralytic, the epileptic, the choreic, puerperal convul- sions, the tremulous. The influence or effects of toxins is upon weakened parts ; a devitalized patch of the brain, when they are present in the blood, gives rise to the nerve storm of epilepsy ; a feeble cervical and Dictionary of Diseases. 619 sympathetic, choreic movements; general nerve depreciation, convulsions, etc. A complete restoration of vitality (to secure immunity) can only be effected upon a most liberal diet and a persistent admin- istration of ozonized thyroid extract and c. p. solution of sper- rnin. During a quasi-suspension of vital force, or narcosis, there is a complete suspension of microbic evolution and growth, and their ptomains are also neutralized or become inert. We see this illustrated when pint after pint of whisky is administered to a snake-bitten-stricken patient, until complete narcosis takes place, on awakening from which recovery is perfect ; when the antitoxin lobelia or tobacco is poured in by every avenue in cases of tetanus, until the tetanin is neutralized, then the clonic spasm ceases ; when cenantha crocata is persistently given to an epileptic, the nerve storm, or seizur, ceases ; when the system becomes saturated with scutellarin and arsenic, all choreic move- ments are abolished; when narcotism is induced by opium in puerperal peritonitis, all symptoms disappear, human life is saved ; when puerperal eclampsia takes place, from the toxalbu- min generated from renal incapacity, for quieting the con- vulsive seizures (neutralizing the toxin) there are no remedies which give such perfect results as concentrated ozone and chlo- roform — the former by enemata, one dram to half -pint of de- coction of linseed, to which when cold one ounce of' peroxide of hydrogen is added ; the latter by slight inhalations — the rapidly recurring fits are controlled, followed with large doses of ozo- nized extract of passiflora incarnata, a remedy of great value. These facts inaugurate the beginning of medicine as an exact science. The presence of this microbe in man strikes at the origin of life, the reproductive organs, saps his sexual vigor ; causes the disappearance of spermatozoa in the prostatic secretion, and in their stead spermatic crystals appear, which are devoid of all vitalizing or fertilizing elements. Annihilate this microbe with bactericides; languor, debility, neuralgia, sucidal mania, sexual callousness will disappear: even the same remedies in epilepsy, chorea, insanity, will tend to cause a marvelous improvement, and bring the number of such cases to a cipher. The remedies to completely wipe out this microbe are pro- longed vitalized massage, electricity, cerebrin, glycerite of kephalin, avena sativa, passiflora. 620 The Germicide 20th Century Practice The diet should be rich in brain elements, phosphates, broiled animal food ; boiled fish, eggs, poultry, game, abundance of rest. A highly ozonized, salubrious atmosphere; perfect freedom from care, worry, anxiety ; daily bathing, gentle exercise. Sexual Neurasthenia. — Impotence, a difficulty or impos- sibility to perform the act of copulation, a state which either implies poverty of nerve force or impairment of the sexual ap- petite, or disease, or malformation of genital organs, or de- rangement of the brain and spinal cord, by reason of which there is either an absence of sexual desire, or power of erection, or of ejaculating the semen into the vagina, or any pleasurable sensation in the act of copulation or emission of semen. Im- potence relates to the act of intercourse and differs essentially from sterility or an ability to beget an offspring. Without venereal desire or an absence of the sexual appetite, the act of coition would be rarely performed. The essential parts of sexual congress are the emission of semen, the experi- encing of physical pleasure before, during, and for some time- after its ejaculation. This sensation originates in the seat of sexual appetite in the base of brain, reflexly in the glans penis, extends to the adjacent parts, and is experienced in the spine, head and entire body. • Absence of the sexual appetite is acquired by struggle, worry, strain, nerve tire, brainwork; sexual indifference is well marked in users of tobacco, alcohol and opium habits ; in such states the rendezvous of soul is withered, blighted, whittled down; the sexual appetite is extinguished by masturbation or perverted methods of congress. Venereal disease, balanitis, chancres on the glans penis, destroy its finer sensibility, depre- ciate vigor, virile power; masturbation weakens the power of erection; so does early excesses; so does gonorrhea, stricture, irritable and enlarged prostate; so does tightness or absence of the prepuce. The glans penis possesses the highest degree of sensibility — this faculty is paramount to all others. Masturbation is the cause of spermatorrhea, the loss, the ooz- ing away of the nervovital fluid, whether it be diurnal or noc- turnal; disease of prostate; damaged, irritable, inflamed, en- larged, weakened cord and brain; then failure of procreative power. All this may be oblivious to the patient ; semen passing in the urine unobserved, or at stool, or the prostatic secretion with spermatozoa may flow back into the bladder and be dis- charged during micturition and giving rise to impotence. In our modern state of civilization our condition of mental' and Dictionary of Diseases. 621 preoccupation operates adversely, and is most efficacious in pro- ducing impotency. There are numerous factors at work that impair or abolish sexual power, as plethora or obesity, ema- ciation ; the latent germs of cancer, syphilis, tubercle, which en- gender local atrophy, or wasting of glands or organs; or the want of nerve influence to the testes, injuries or blows on the back of the head, and all the habits. Nervous Impotency. — The sensory neuroses of the sexual apparatus may be confined to the testicle, spermatic cord ; it very often is of a painful, dragging or stinging sensation in one or both groins, or there may be a stinging in the prostate urethra daring and after ejaculation of semen. On making an examination by the metallic sound the urethra is sensitive, especially its prostatic portion — in other cases quite the reverse, a diminished sensitiveness exists, almost amounting to anesthesia. With such a state of hyperemia existing there is often an impossibility of consummating the normal act of coition, al- though this inability is frequently due to organic change, a mal- formation or defect. Many causes are often present, nervous or psychical, to wipe out a lasting and powerful erection, chronic ailments, some drugs ; unrecognized affections of the brain and cord ; all have their effect ; perhaps the most common is that form met with in young men addicted to masturbation, or who suffer from sper- matorrhea. Relative impotency, an inability to consummate the sexual act with certain individuals, while with others they succeed all right, a state of things which often exists among married men who have an aversion to their bed companion. Neurasthenic individuals, men who have exhaustive brain- work, business cares, worry, not infrequently have erections which are too weak, too short in duration, evanescent — ejacula- tion too soon; vagina large, penis flaccid — emission follows; coitus incomplete — unsatisfactory. The causes of this form of nervous impotency are to be found in a damaged brain and spinal cord, usually the product of un- natural sexual excesses; when the individual attempts normal coitus, he is unable to accomplish the act — a total failure. Recognizing the fact that the mechanism of erection is es- sentially under the control of the cerebrospinal system, the treatment and cure of such, to be successful, must be by reme- dies that act directly upon the disordered parts. 622 The Germicide 20th Century Practice Ozonized extract of passiflora incarnata in teaspoonful doses, thrice daily, is a nerve vitalizer and brain purifier. Quite in- dispensable in the correct treatment of a sexual neurosis — it does the work and its action is permanent. It seems to be the only drug that relieves every pain and inspires a man with per- fect confidence. Usually I prescribe a kephalin granule ; one at each meal to give the system more phosphates ; in other cases ambrosia orientalis in liquid or tablet form. Sexual Neurosis. — Among the highly civilized races of men we find an excessive development of the great sympathetic in both sexes, and as in this nerve the emotions, desires, affec- tions, passions are localized — that branches ramify in great abundance in the prostate and neck of the uterus — both rich in sympathetic branches, supplied from the hypogastric plexus of the sympathetic, re-enforced by filaments from the sacral gan- glia — so that any violent emotion, any depressing passion, any abnormal desire, by debasing affection enervates the uterus in women, and seminal vesicles and prostate in men. The peripheral termination in the cervix and in the cortical layer of the prostate are kept in a constant state of chronic in- flammatory excitement, and a reflected irritation to other nerves in the sexual area. Every violation of divine law meets with prompt retribution - — the perusal of dime novels are sexually depressing, give rise to involuntary emissions; masturbation is invariably followed by seminal leakages, diurnal and nocturnal losses — spermator- rhea with all its devitalizing effects. Long addicted to masturbation, or continuous association with harlots, ultimately gives rise to impotency or an inability to consummate the normal act of coition. This may be due to organic change, some morbid condition of the brain or spinal cord — the centre for the nerves that pre- side over creation in the lumbar portion of the cord, and if there be a decided breakdown, there may also be a failure of secre- tion of semen. Young men who enter this arena are the victims of unnatural sexual excesses, coupled often with mental and physical exhaus- tion, shocks and blows on the back and head. Inability to have a lasting and powerful erection is the termi- nation of all sexual neuroses. If there be either a leakage or a weeping, a moisture or an emission, visible or in the urine, it must be completely arrested. For this purpose salix nigra orally and by suppository and and Dictionary of Diseases, 623 "bougie or oil of thuja suppository are two excellent remedies. Diet, assimilation, bathing, massage, freedom from worry and care — every point well guarded, then remedial measures are in order to excite and maintain erections. It is well known that there is nothing so vitalizing as the se- cretion from the brain of semen rich in spermatozoa. This is the first point to be arrived at — nutrition, food, highly phosphatized, and in abundance. Give matricaria comp. be- fore meals, and while eating, kephalin or the c. p. solution of spermin, occasionally protonuclein or avena sativa. A course of brain-building remedies is indispensable in such dilapidated cases. Kephalin is the most highly vitalized remedy in the materia medica. If the case progresses favorably under the above, then stimu- late erections. Most physicians just here rush for spinal stimu- lants, such as mix vomica or strychnine, cantharides, rhus tox and electricity. This is a mistake. Better try the gradual ad- ministration of ambrosia orientalis in small doses for a few weeks. If the tincture fails add to it the suppository and bougie ; if the remedy fails altogether, then give muira puama, perhaps the only remedy of definite value as a sexual tonic, dif- fers from all other remedies in directly strengthening the erec- tile power. In this respect it is away ahead of all other reme- dies. It has a peculiar action on the brain cells, on the sympa- thetic, and when it does act it affords permanent relief. A Neurosis of the Sexual Geands. — This is undoubtedly one of the most common complaints which are incidental to the reproductive organs of the male, for with every sexual excite- ment, either before a partial or complete erection has taken place, or even an ejaculation of semen, a clear, transparent, vis- cid drop, like the white of an egg, oozes from the meatus. This drop represents the secretion of the accessory glands of the urinary and genital tract, and consists of the secretion from all the glands. The prostate being the largest, the mass of mole- cules of that one drop consists of prostatic secretion. The object of this secretion is to lubricate the urethra and thus facilitate the discharge of semen, which is a fluid of greater density than urine. If this clear, viscid fluid be secreted in greater amounts, at all times, and appears without sexual excitement as an oozing, it is prostatorrhea or catarrh of the prostate. Very variable in degree and intensitv from acute, subacute, chronic forms. 624 The Germicide 20th Century Practice Occurring in young men, commonly found as a sequel to gonorrhea, when yellowish drop gradually becomes whitish and flocculent and finally colorless, watery and slightly viscid. The gonorrhea has disappeared, but a moisture, an oozing, a leakage remains. This moisture is seen at the orifice of the urethra, if slight, by parting the lips ; if greater in degree a general leakage, often copious and profuse, wetting the cloth- ing. Aside from gonorrhea, masturbation is another extremely common cause. Congress with harlots may be enumerated as productive of it. Married men acquire prostatic catarrh from sexual excesses, and abnormal methods of intercourse, and incompatibility and relaxed vaginas. The uric acid diathesis, acid urine passing over the prostate urethra, vesical calculus, rectal irritation. The moisture, the oozing or leakage is greatest if there has been inflammation, and that complicated with cystitis and epididymitis; whereas, in chronic prostatitis, with thickening and enlargement of the lobes, or hypertrophy of the whole gland, this hypersecretion is no longer clear and transparent, but turbid from cell ele- ments. The diagnosis of all these cases must never rest on their history, but upon a microscopical examination of the se- cretion. If the moisture or leakage contain spermatozoa, then it is spermatorrhea; if it contains no spermatozoa, it is most likely prostatic catarrh. An examination by the sound shows extreme tenderness in the prostate urethra in all cases due to inflammation. Examination of the rectum by the finger reveals a want of symmetry of the lobes and irregularity of the body. The patient's urine shows phosphaturia. The prognosis of all cases of prostatorrhea is favorable, but as it is a genitourinary neurosis, the treatment is often quite tedious. There is, however, a general line to follow in the treatment of all cases ; the patient should be placed upon a general altera- tive and tonic course, administering comp. saxifraga and mat- ricaria ; the best of diet ; morning and evening, hip baths ; bow- els kept regular either by fruit or kola-nut lozenge. When rest- ing the recumbent posture is best. Sexual congress should be completely suspended. The special treatment which we have found of great efficacy embraces the abrogation for the time being of sexual desire and and Dictionary of Diseases. 625 erections, which is best effected by administering tincture of the green root of gelsemium in doses sufficient and in fre- quency to completely control all erections. The use of bromide of potassium to this class of patients is most disastrous, and should never be given. The internal administration of the ozonized black willow bark extract is our best remedy, provided it be faithfully given. A suppository and bougie of the glucoside of the black willow often are of much service; nay, are never-failing in checking the leakages and removing the latent irritation. Their ad- ministration requires tact, discretion and skill ; where they are properly handled there are few failures. Just as soon as you are satisfied that there be no moisture, no leakage, no drop, no gluing of the lips of the meatus, the remedies might be gradually changed to thyroid extract and c. p. solution of spermin. Neurasthenia, The Microbe. — This is an evolution due to a poverty of nerve force — a weakness and exhaustion of the nervous system. Man's reserve vital force is exhausted and there is either derangement of the entire system or some special organ, which influences the mental function to a great extent; often difficult to draw the line between actual insanity and its delusions and nervous prostration with its eccentricities and irritability. A poverty of nerve force gives rise to an evolution of this microbe, whose toxin implicates every weakened organ of the body ; this may be the brain, spinal cord, genitourinary organs, stomach, intestines, etc. ; a special neurosis. In all its degrees neurasthenia, a microbic malady, is con- tagious and infectious, from simple mental feebleness to the most violent form of raving madness. A healthy organism responds to the calls made upon it; this is not the case with the neurastheniac. Among the many exciting causes may be shocks, concus- sions, exposure to the sun's rays, but the brain may be weak- ened by care, worry, struggle, excessive mental work, business strain, losses, grief, fright, tjie toxins of disease germs, and much enfeebled by a solitary or monotonous mode of life; ex- hausted, starved from adulterated food, a want of phosphates; all reflex irritation, most prominently disease of the uterus and ovaries in women and the prostate gland in men. The microbe of neurasthenia respects neither age nor sex; is the great factor in the causation of the uric acid diathesis, -every case being identified with that condition. 626 The Germicide 20th Century Practice Neurasthenia frequently originates in diseases of the repro- ductive organs of both sexes, acting reflexly. The influence of a pathological condition of the sexual organs on the brain is remarkable, apparently insignificant, but gives rise to serious disturbance of the general health and morbid impulses in the central nervous system; such anomalies should be rectified promptly. Neurasthenia is the precursor of many mental disorders, one of the principal being hypochondria, which has always a sex- ual basis ; and melancholia, due to prolonged mental depression and actual laxity of the brain cells. It is caused in the neurasthenic by exhausting disease, per- nicious habits,, as masturbation; certain employments; emo- tional influences, as grief and anxiety. Of diseases, those of the stomach, liver, lungs, kidneys, and above all those of the geni- tal organs. Melancholia is the termination of neurasthenia, hypochon- dria — a state in which they lose all interest in life and business and cannot reason intelligently; they feel bad; have morbid feelings ; are troubled with insomnia ; lose strength, flesh, appe- tite ; suffer from constipation ; have occasional attacks of severe neuralgia; dull cerebellar and post-cervical pain; rapid, small pulse; sluggish capilary circulation, with mental instability. To overcome the extreme poverty of nerve, to supply the brain with its own pabulum, cause a cohesion of its cells, we have a most valuable remedy in kephalin, either in liquid form or granules ; besides it is an excellent remedy in all conditions of debility. As a brain builder its action is incomparable in gen- eral nervous weakness ; efficacious in neuralgia, headache, sleep- nessness; in anemia, influenza, indigestion, anorexia; in rheu- matism and gout. Its action as a tonic is most invigorating, and as a general pick-me-up to the worn-out sensualist and the ex- hausted inhabitants of our large cities nothing could be more efficacious. We strongly endorse its use in all cases of neuras- thenia. Another remedy of great value is spermin, C 2 H 5 N. A chemically pure solution of a sterilized, vitalized extract, or alkaloid, a basic substance obtained from the fresh testicle juice of the bull, brain, bone marrow and the glandular fabric of the reproductive organs, prepared under the most careful antiseptic precautions. The indications for the use of the remedy are when the ad- ministration of the most powerful vitalizing tonic and nerve and Dictionary of Diseases. 627 stimulant is required ; when a brain fertilizer and reconstructive are demanded, this remedy is of decided efficacy. Properties and Uses. — Its use has a decided influence on the health, activity and longevity of the blood-corpuscles; height- ens all the vital functions, physical as well as mental ; promotes a higher type of manhood ; blends with and is intimately con- nected with the origin, existence and prolongation of life; in- valuable and never failing in hopeless impotency, lethargy and deficient erectile power. Dose : For all ordinary cases, one teaspoonful every four hours is sufficient; for extraordinary cases two teaspoonfuls as often. This c. p. solution has an electric action upon the nutrition of the brain, so it is indicated in every case of neurasthenia whenever the nerves suffer from the want of nutrition, and fail in their activity because it accelerates metabolism, favors the assimilation and increase of vitality. Very striking results are obtained from it in all cases of great exhaustion of the nervous system, especially in impotency, phosphaturia and ataxia. In functional disturbance of spinal nerves, as in all neu- ralgias, impairment due to anemia, it is the remedy indicated. The occasional exhibition of avena sativa (Scotch oats) ozo- nized tincture; we have an excellent brain builder and nerve strengthener. One of the best of all known remedies to cre- ate a higher type of manhood, with a high grade of vital force. As a tonic in neurasthenia matricaria compound is at the head of the list. It is well to administer it occasionally, as it markedly increases assimilation, and gives the individual a keener relish for food, upon or from which all true vigor comes. NEUROSES. — The etiology of all forms of neuroses generally depends upon a disturbance of nutrition, either of the brain or some special nerve, which gives rise to some abnormal, reflex excitability, associated with anemia and a feeble constitu- tion. Persons in ordinary health may acquire, by various causes, an exalted reflex excitability which disposes to neuroses of the genito-urinary organs, especially if they weaken their nervous and physical system by overwork, cares and vicissitudes of life. Immoral reading may excite a neurosis of the urinary organs. Shocks to the sympathetic, as fright, grief, not infrequently give rise to disturbance of both the urinary and sexual func- tions. Long-continued excitement, loss of property, struggle, 628 The Germicide 20th Century Practice often give rise to the most varied nervous phenomena. Worry often gives rise to frequent micturition, polyuria, even slight glycosuria, and sexual impotence. A very large contingent of the general widespread nervous- ness is brought about by irritation of the urethra, prostate, blad- der and rectum. These four organs are in close alliance and sympathy; any irritation in either spreads with alacrity to the ejaculatory ducts, reflexly to the brain and great sympathetic, enervates and irritates the cortical layers. The peripheral termination of the entire genito-urinary plexus is kept in a state of constant tension. The urine in neuroses is excessive polyuria, pale straw-color, clear and of a low specific gravity; sugar is not infrequently found. This is common in all neurotic cases who suffer from chronic brain and spinal-cord lesions. In neuroses we have found the following formula most effi- cacious in all cases : Glycerite of kephalin, tincture passiflora incarnata, of each four ounces. Dose, half a teaspoonful thrice daily, with all the good diet, bathing, massage and electricity procurable. For neurosis of the organs of generation, with complete par- alysis, impotence. In addition to the kephalin and passiflora, muira puama, in from five- to ten-drop doses, thrice daily, is a most effectual remedy. An eminent authority says: "Nervous prostration, cerebral exhaustion, poverty of nerve force, is one of the all-common maladies of the present age. What can be done for it? The starting point of all treatment is rest; then bathing and mas- sage, morning and night, with regular carriage exercise, sub- stantial meals, with an avoidance of alcoholic drinks. The most valuable remedy that is to be found for the re-establish- ment of brain nutrition is the kephalin granules. Nothing bet- ter can be found. "The increasing tendency to nervous diseases is due to the overestimation of the young; it permeates our educational system, diet, recitations. Overstraining and stimulation of the mental and nervous organism of the young create a nervous temperament in later life. "A combination of these elements produces defective nutri- tion of the brain, which can only be effectually overcome by kephalin." Nervous Diseases. — A most important class of diseases, not always easy to diagnose, and not always well understood. There are two great groups of nervous diseases : and Dictionary of Diseases. 629 1. Those known to be due to injuries or disease of the nerves or nervous tissues. 2. Functional diseases, in which no morbid lesions can be demonstrated. The former includes the different forms of paralysis; the latter such diseases as chorea, hysteria, neuralgia, insanity, de- lirium tremens, etc. Symptoms. — More or less paroxysmal pain. Certain tender spots on pressure along the course of the nerve. Neuralgic pains have a tendency to shift from one place to another. Neuralgias of special nerves have distinctive names, thus : Tic douloureux (fifth cranial nerve), sciatica (sciatic nerve), gastralgia (the nerves of the stomach), and so on. Treatment. — Removal of the cause, if it be known. Light, nutritious diet. To relieve pain, internal and external remedies may be tried. Internally. — Quinine, passiflora, simabicidia, c. p. solution of spermin and ammonia. Externally. — Counter-irritation, belladonna, aconite, chloro- form liniments, concentrated ozone, jelly of violets. Nervous Temperament, in which the nervous sys- tem is developed at the expense of the physical. A common condition. This is a nervous age.- Rapid development has made the nervous system highly susceptible and unstable. The strain and pressure of modern life, acting upon this increasing sensibility, causes so much suffering, men instinctively look around for arti- ficial stimulants to benumb it. Alcohol, opium, cocain, coffee, tea, tobacco, sauces, condiments, and large quantities of stimu- lating food are used to relieve the very conditions for which they are largely responsible. All artificial stimulants and un- necessary food, in health, create excitement, uneasiness, and extra work in the system. If the individual feels better after indulging in stimulants, it is either due to temporary paralysis of the nerves of sensation, which, like sentinels asleep on duty, fail to report to the brain the damage done by the enemy, or else there is a reckless expenditure of vitality, which the indi- vidual can ill afford. The habitual and excessive use of artificial stimulants is liable to cause disease of the vasomotor system of nerves, chronic congestion of the brain and viscera generally, followed by inflammatory or degenerative structural changes in the blood-vessels and other organs, often terminating in apoplexy. 630 The Germicide 20th Century Practice All nervous energy generated in excess of that needed for the performance of function should be utilized in work. It should not be stupefied by narcotics, wasted in high and reck- less living, or turned in upon the brain to ravage the system with worry, according to the individual temperament. The unrest, the acute and painful consciousness of which neurotic persons complain, may be forgotten in light, suitable, and varied work. Habitual work has specialized all our organs, and, temperately performed, it will give stability to the higher nerve centres. The neurotic person's salvation lies in cultivat- ing his individuality by thinking and doing, and in the strictest observance of temperance and moderation. If he must have artificial help, give him some mild nervine, such as kephalin or a vena sativa, constructive agents by which we increase the tone of the nervous system. NEVUS. — An anastomosis of small blood-vessels, capilla- ries or veins, which become permanently dilated and their con- tents communicate freely with each other. They are usually congenital, appearing either at birth or puberty; sometimes the result of a contusion, a bruise or ecchymosis which never disappeared. Most common on the head, face, neck and chest ; located either in upper layers of the skin or beneath it ; they are also met with on the mucous mem- brane of the cheek, gums and under the tongue; more rarely on the scalp, lips, body, breast, intestine, liver. They are termed port-wine stains, or mother's marks ; their color and shape give rise to fancied resemblance to things in nature, as strawberries, raspberries ; very variable in thickness, some merely superficial, others thicker, with a well-defined margin; some are influenced by excitement, crying, laughing, coughing, straining. The large percentage of cases are congenital ; in some rare cases the atrophy and disappear. With regard to treatment, very many methods are resorted to with but poor success, as leaving a scar either on the exposed or covered parts; nevertheless they should in all cases be re- moved. Every surgeon has his favorite method ; if superficial, they paint them with liquid chloride of chromium ; if deep, excision ; in other cases, ligation and subcutaneous injection, with coagulating fluids, like carbolic acid and perchloride of iron, a dangerous method, saving us a clot in the circulation often and Dictionary of Diseases. 631 terminating in apoplexy and paralysis ; coagulation by needles and electricity no better. Even vaccination with croton oil, ethylate of sodium and a seton are unsatisfactory. Ozonized oil of thuja has come to the front as a remarkable remedy to cause all nevi to shrivel up, atrophy and disappear. If the dilated vessels are superficial, it may be applied on lint, simply saturating it every three hours and binding it on; if deep-seated, it can be injected into the mass. NEW DISEASES. — There are a number of ills incident to the use of new appliances, and these have already become so clearly recognized that they are a matter of course in medical practice. Indeed, the victims have given names to them which have been adopted in scientific phraseology. Bicycle back is a familiar ill, and comes of the doubling-up position about which so much has been written and said. It is akin to the disease known as miner's back, which comes upon men who work in mines and are in a stooped position for many hours at a time. Telephone ear is a not uncommon complaint. It is not an or- ganic disease, but purely a nervous condition, and arises from nervous strain. Almost without exception, the trouble ceases with the discontinuance of the use of the telephone. Teleg- rapher's and typewriter's cramp has many victims. This diffi- culty is not easily got over, as in many instances the muscles become almost or altogether useless, and the patient is unable to control them. It is curable only after a course of scientific treatment. One of the latest complaints is the trolley foot. Of all these new diseases, those due to cycling are the most disastrous. Every cyclist has an inherited weakness in their physical and mental constitution ; it is therefore for the interests of humanity that a check be placed upon all the participants in anything that would degenerate vitality, breed disease, or work out their own destruction. Every scientific physician can attest that all cyclists have urethral discharges at all times of prostatic and seminal secre- tions, as a result of this mode of exercise ; that this leakage drains away the nervo-vital fluid, atrophies and degenerates the penis, spermatic cord, testes, prostate, spinal cord and brain ; that it induces profound impotency. as the weeping from the penis being continuous, is exhaustive, devoid of sperma- tozoa, infertile. As a cure which can be effected, if no organic change has occurred, the mode of exercise which induced those urethral 632 The Germicide 20th Century Practice discharges must be forever discarded. Comp. matricaria should be given before meals to promote an appetite, aid nutri- tion. C. p. solution of spermin after meals; the ozonized ex- tract of black willow bark internally, and the salix nigra sup- pository will promptly check the discharge from the ever- weeping penis. For the defective, chaotic nervous system, under which may be classed defective brain organization, impotency, spinal irrita- tion, loss of sensation in feet, numbness in the penis and perineum, there must be rest, massage, together with matricaria and large doses of the ozonized extract of passiflora ; when the threatened symptoms of paresis are overcome, try kephalin and avena, prolonged course ; occasionally ozonized thyroid extract. Vascular and degenerative changes in the spinal cord and its membranes, so great in numerous instances as to destroy the embryonic cells. In the early stages ozonized extract passiflora incarnata and green root tincture gelsemium, large doses and frequent. Locally to the lumbar portion of the spinal cord; first anoint a surface with olive oil equal to nine inches trans- versely and five inches longitudinally, then rub in as much con- centrated ozone as can possibly be absorbed. Repeat this every evening before retiring, on any spot in which inflammation can be detected. Later on protonuclein and c. p. solution of spermin. Difficulty in the act of micturition. Absolute suspension of the exercise, large doses of the green root tincture gelsemium, followed by a course of Virginia stone crop to brace up the sphincter. All cyclists have albumin in their urine, for which proto- nuclein and matricaria are excellent; when arrested add ozonized passiflora to the other remedies. Cardiac failure. Probably the prevailing malady. The strain thrown upon the heart gives rise to dilatation of the left ventricle, which if the exercise be persisted in becomes per- manent, irreparable ; then follows a want of nutrition and fail- ure. The destructive exercise must be forever discarded. Comp. matricaria ozonized the best tonic ; to feed the weakened heart-muscle, give three grains of creatinin isolated from the white meat of quail, thrice daily; occasionally protonuclein or ozonized thyroid extract. Give passiflora and gelsemium for difficult breathing. Any edema, strophanthus. Increased all lung maladies; augmented their mortality, and Dictionary of Diseases. 633 aggravated, intensified, and complicated all respiratory affec- tions ; been extremely productive of emphysema, a dilatation of the air cells, which no remedy can either ameliorate or cure but euphorbia pilulifera. The reabsorption of human sweat, which possesses intense toxicity, spends its virulence upon the lungs, gives rise to pneumonia. Auto-intoxication. The character of the exercise dissipates all the reserve force of the individual ; incidental strain is ex- cessive ; the nerve prostration and excitability intense ; waste of all the structures extreme; toxical products are not eliminated, hence, auto-intoxication; the toxicity being visible in the headache, prostration, fever, general enervation. Baths, massage, unlock the secretions ; administer very large doses of ozonized extract of passiflora incarnata, periodate aurum. Women cyclists have analogous conditions, add to which a rigid, leathery perineum, a great barrier to easy parturition. Add to all, cycling is productive of gross immorality. NIPPLE. — The mammilla or nipple of the breast may be the seat of numerous morbid processes. Its peculiar anatomical character renders it liable to become the seat of disease germs, so that we frequently meet with the germs of eczema, lepra, lichen, psoriasis, the colonies forming crusts, scabs, and the like, irritated or aggravated by corset bones. During lacta- tion, especially at the commencement, nipple is very apt to become tender, from mother permitting it to lie in child's mouth. Young or inexperienced mothers are not aware of the fact that the child should be nursed at regular intervals of two hours apart; that the child should empty breast perfectly, no milk left in it ; because if there is, it will irritate the gland, dry up the secretion, so that the mother will become a poor or scanty nurse. When nipple is removed from the child's mouth it should be well dried, and care taken that no article of dress irritates it. Nursing mothers should wear flannel summer and winter, so that the breast be always covered with this vitalizing covering, so arranged as to permit breast to be easily uncovered. The practice of bathing the nipple the last two months of pregnancy, in order to harden it and prepare it for work, with port wine and bark, brandy, or astringents, is not to be recommended among our ladies, who are highly civilized, whose nervous systems are keen, liable to impres- sions. When we look at the intimate connection of the nerves of the nipple and the uterus, such practice is not likely to be fol- lowed by good results. 634 The Germicide 20th Century Practice NOSE. — The mouth is not more distinctly the gateway to the alimentary system than the nose is to the respiratory, nor is it more carefully designed for preparing food to enter the stomach, than is the nose for preparing air to enter the lungs. The nose has three highly necessary functions related to breathing, and for which it is delicately adapted, besides those of an opening for air and a detective of bad air, viz., to warm, to moisten, and to filter air which it admits; and that neither of these functions can be performed by the mouth. However cold or warm the atmospheric temperature, the air is brought almost, if not quite, to the temperature of the blood in passing through the nose alone, and even before reaching the pharynx, or cavity back of the nose; that however dry the external air may be, it is completely saturated with moisture by passing through the nose; that instead of the moisture of the breath being supplied by and carried from the pulmonary tissues, it is carried to them from the nose, and may be deposited as a dew upon the bronchial surfaces ; that gaseous exchanges take place in the nose, between the gases of the blood and those of the air, just as in the lungs; that nearly one-fiftieth of the exhaled carbonic acid is given off by the nasal mucous membrane, even when expiration is not performed through the nose. It is evident that if air of a low temperature be brought in contact with the lower respiratory passages, inflammatory processes would be likely to be induced ; and when at the same time the air is dry, if not duly moistened by being inhaled through the nose, this tendency would be greatly increased, and the coincidence must be the most efficient occasion of con- sumption, pneumonia, bronchitis, etc. Drying out thus the moisture of the air-passages provokes an exudation of the albuminous part of the blood, and so provides the best possible culture fluid for the bacillus tuberculosis, the pneumonia, typhoid, or other health-destroying germs to lodge and propa- £ ate - In the mouth there is no provision for supplying sufficient moisture. Deprived of its normal watery constituents, the normal mucus of the bronchi becomes thick and a source of irritation. By the abattis of hairs at its entrance, and by its narrow and tortuous mucous passages, the nose protects the parts below not only from the irritating qualities of particles of dust and smoke, but from the deadly invasion of microbes. With all parts of the current of inspired air coining in immediate con- axd Dictionary of Diseases. 635 tact with the nasal mucous membrane, it must follow that vast numbers of germs will adhere to this membrane. On the one hand is the narrow entrance, through which the air enters with all its invading hosts. On the other hand, nature has provided for the defence of this grand point of attack a tortuous defile, which the current of air cannot pass through without hugging its sides and its warm and moist lining. In this lining are ever-watchful defenders, congregated to devour the army of invading germs. Here, then, is con- tinuously waged one of the great battles of life. From what has been said the following conclusions can be drawn : 1. The nose should be kept clean. 2. All obstructions to nasal respiration should be removed. Especially should the mouth be kept firmly closed on emerging into the cold air; and while it should always be used as little as may be convenient for breathing, let such use be carefully avoided in the presence of foul, smoky, foggy, dusty, or extra dry and cold air. It is estimated that in good healthy sections of our country, with abundant ozone areas, each inhabitant, with an ordinary breathing capacity, inhales into the nose every hour 1 50 micro- organisms, whereas the denizens of all our large cities, with no ozone, inhale 1,500 per hour. The fate of those germs is of great importance, especially when we remember that expired air is practically free from all germs, clearly showing that they never reach the air-cells in the pulmonary tissue, but are destroyed in the nasal fossae. In the act of inspiration the air. containing the 1,500 germs which pass into the nasal cavity every hour and are arrested there, is freed from all microbes before it enters tht trachea. The interior of a nasal cavity is perfectly aseptic, and pos- sesses a potential bactericidal action — the vestibules of the nares, the vibrissas lining them, crypts and crusts are swarming with bacteria. The different structures of the nose not only arrest the in- gress, but annihilate the germs : the vibrissas act as a filter for the microbes, which penetrate the cavity before they meet their fate in the moist meshes of the hair which fringe the vestibules, and are subsequently ejected by the action of the ciliated epithelium; even the nasal mucus itself exerts a germicidal action on all pathogenic microbes. The nasal cavity and its secretion possess the important 636 The Germicide 20th Century Practice property of an inhibitory action on the growth of all microbes in the nose — even eliminating and killing many. In a healthy nose all microbes are thus arrested, many de- stroyed before they reach the nasopharynx; a majority stopped by the vibrissas at the entrance, and those that do penetrate the mucous membrane are rapidly eliminated. The nasal secretion is an unsuitable soil for the growth of all organisms, an impor- tant factor in preventing their growth and multiplication. The removal of the intruding germs from the Schneiderian mem- brane is due to the action of the ciliated epithelium, assisted by the trickling of mucus and lachrymal secretion. Phago- cytosis aids to some extent. A healthy nasal cavity is thus prophylactic against the en- trance or ingress of all contagious and infectious diseases. Such an organ should be nursed. To keep it in a still more healthy condition, increase its germicidal power, a tepid saturated solu- tion of ozonized boroglycerid should be used as a wash, douche and gargle morning and night. To mouth breathers, into whose lungs 1,500 microbes hourly enter, subjects who suffer from germ-growth, multiplication and excretion of ptomains, as is seen in the general lassitude and debility, try the ozonized boroglycerid in tepid solution as a mouth-wash. NUCLEIN. — Protonuclein, the active principle of life, chemically a phosphorized proteid, the principle of the defensive proteids of the organism. It is extracted from the active glands of the sheep, from plants, yeast, and vegetable life generally. It is indicated whenever we are desirous of stimulating nutri- tion — whenever we desire to bring into being successive broods of young cells or increase the number of leukocytes in the blood stream, augmenting their functional activity, and so stimulate cellular action to resist morbid changes produced by disease germs. It is upon the presence or absence of nuclein that the vitality and growth of all animal and vegetable life depends. Possessing all these qualities in a pre-eminent degree, it is a great tissue builder, of intrinsic value in disorganized states of the blood, of great efficacy where the toxins of disease-germs of tuberculosis, pneumonia, bronchitis, dysenterry, cholera, typhoid fever, laryngitis, diphtheria, sap the very essence of life. It has a potent action in rebuilding the wavering, tottering body when it needs support. and Dictionary of Diseases. 637 No matter what the malady may be or what plan or course of treatment may be pursued, add protonuclein to the bill in what- ever form is most eligible. It is usually administered either in powder, tablet, supposi- tory, or in solution hypodermically. The great value of protonuclein, in suppository form, has been thoroughly demonstrated in stimulating the germinal spot of the ovum in sterility; in causing the growth of broods of spermatozoa in impotency; it is the essential of life, nutrition, reproduction. In disease, its action is both curative and pro- phylactic in diphtheria, typhoid fever, pneumonia, tuberculosis, malaria, anemia. The protonuclein suppositories used by individuals in feeble health keep the blood-corpuscles and tissue cells in good fight- ing shape and exterminate any bacilli that may dare to enter. NUTMEG. — Many familiar culinary substances have been found to have valuable medicinal properties ; the nutmeg, so far as we are aware, has not been among the number. Its turn has now come, however, for it is efficacious in the treatment of summer diarrhea, many cases yielding readily to doses of half a dram administered in milk. Insomnia is said to be effectually relieved by it. In delirium tremens it can be em- ployed with safety and benefit, when any other sedative would be dangerous. For itching and irritable piles an ointment of two drams of powdered nutmeg, one dram of tannic acid, and one ounce of ozone ointment is an excellent application. Powdered nutmeg may be administered in doses of from two to ten grains for children, and from ten grains to two drams for adults. Larger doses have produced profound coma, lasting for hours. NYMPHOMANIA. — Constant and distressing desire for sexual intercourse, with an erectile condition of the clitoris, may arise from disease of the brain, spinal cord, inflammation of clitoris, from masturbation, or excessive venery, sedentary habits or occupations, bicycle exercise, and, above all, by the vascular excitement that is produced by our abominable, sensually exciting literature. Treatment. — Removal of cause, plenty of exercise, or hard work ; daily shower-bath, well-regulated bowels, sleep on straw or hair mattress, light covering; cold-water hip-baths, and vaginal injections of cold water, except during menstruation ; 638 The Germicide 20th Century Practice large doses of green root tincture of gelsemium and passiflora at bedtime, or camphor, belladonna, and conium, to cut off sex- ual desire; alteratives and tonics administered persistently; a strict avoidance of all light literature; a pure, moral atmos- phere; same treatment as for masturbation in male. The amputation or partial destruction of the organ with caustic potassa is of doubtful benefit. In cases of inflammation, rest, open bowels freely, hot poul- tices, and general treatment for fever. NYMPH^E ODORATA.— Various preparations of the white pond lily are in use, all possessing tonic and vitalizing properties to the generative organs of the female. A glucoside from the root is unquestionably the best, and applied directly to the parts, most efficacious, in the form of a pastil. They are extremely efficacious in all relaxed, debilitated, or devitalized states, morbid or callous states of the vagina. This preparations excels all uterine tonics in this, that it stimulates the lumbar portion of the spinal cord, which stimulus is im- parted to the ovaries, broad ligaments, and uterus, causing a general contraction or drawing up of the organs if displaced. Therefore, they are of efficacy in all loose, relaxed states of vagina, falling of the uterus, leukorrhea, catarrh, ulceration, etc. Never failing when the complex generative system of the female loses its tone, vigor, vivacity — where callousness has suspended enjoyment; where the sexual act is inoperative, where the vagina needs the aid of a great vitalizer and con- tractor. In addition to its great power over the broad liga- ments and ovaries, in this form it is an excellent germicide, and very valuable in all cases of gonorrhea, which are passed by so lightly. The gonococcus in the vagina is always dangerous. It does not localize itself in the urethra, but is liable to irritate the uterus and set up metritis or endometritis, giving rise to grave changes in the reproductive mechanism, fraught with danger. The washing out of the vagina thrice daily with a tepid solu- tion of boroglycerid, followed by the introduction of a white pond lily pastil, very soon clears the vagina of this disease germ. Besides, through the vagina a most decided impression canjbe made on the uterus, bladder, ovaries and adjacent parts, as absorption of the drug is rapid through its mucous mem- brane. and Dictionary of Diseases. 639 OBSTETRIC CONES.— These "cones" are prepared from the finest butter of coca, boroglycerid, hydrochlorate of cocain, and hydrogen peroxide. Their use is indicated in every case of parturition. Simultaneously with the first pain one should be inserted as far up the vagina as the finger can push it, and at the same time one up the rectum. These speedily melt, thoroughly lubri- cate the parts, and produce anesthesia of the uterine plexus of the nerves, rendering the parts soft, moist, easily dilated. In a short time two more should be inserted, and thus re- peated every half hour, in accordance with the judgment of the accoucheur. At the same time the abdomen over the uterus and lumbar portion of the back should be rubbed with a mixture of concentrated ozone and chloroform. By these procedures the pangs of parturition are either totally obliterated or reduced to a cipher, the vagina rendered aseptic. The use of these cones in all cases of parturition at full time, or miscarriage, is far-reaching. When thus used there is no tedious labor, no inertia of the uterus, no hour-glass contrac- tion, no retained placenta, no post-uterine hemorrhage, no metria, no puerperal convulsions, a speedy convalescence. Those cones have numerous other valuable properties; they cure the three forms of dysmenorrhea, specific inflammations, induration of the neck, leukorrhea, pruritus, pile, irritable and ulcerated rectum, ascarides. The chief physician of one of our largest midwifery hospitals says that the obstetric cones are the greatest desideratum of the age ; of the greatest possible value before and after delivery ; invaluable for procuring painless labor, and for an antiseptic protection for both vagina and uterus they are unexcelled. We have used them in several thousand cases of labor, and there has never been a single case of puerperal fever, or peritonitis, since we commenced to use them. The use of these cones clearly shows that puerperal fever is a preventable malady. The use of these obstetric cones in all cases of parturition has made it possible for the child to pass beneath the pelvic arch, through which every candidate for immortality has to pass, without causing much pain to the mother. Science has thus completely antagonized the idea of pain. OBSTRUCTION OF THE BOWELS.— Mechanical im- pediment to the evacuation of the bowels. The ordinary symp- 640 The Germicide 20th Century Practice toms are distention of the abdomen, colicky pains, nausea, vom- iting sometimes of mucous, greenish or bloody matter, hie* cough, tympanitis, feeble pulse, haggard looks, tetanus. The obstruction may be due to strangulated hernia, or to an accumulation of impacted feces; to solid concentrations of chalk, magnesia, indigestible matter; to spasmodic or perma- nent stricture; to inflammatory adhesions of bowel to walls of abdomen; or by adhesion of bowel, or by external violence or otherwise; to intussusception or invagination of the bowels, the introduction of one portion within the other, most common in loose, flabby persons. Remedies. — Very large doses of sweet-oil and opium, copious warm-water injections, lobelia and hyoscyamus. Peroxide of hydrogen in infusion of flaxseed is one of our best remedies, as it evolves large volumes of ozone gas in the bowels which relieves the obstruction; concentrated ozone over the abdomen. Prolonged anesthesia, massage. ODONTALGIA. — A pain in a tooth depends upon a variety of causes, such as the toxins of disease germs acting disas- trously on the nerve ; decay of the dentin carries its microbe : exposure of the nerve to the atmosphere and extraneous matter. Cleansing cavity thoroughly, inserting a piece of cotton satu- rated with jelly of violets, or if not sufficient destroy the nerve completely with arsenious acid or chloride of zinc. ODORS. — The liver being the organ to work off all toxins, when active few odors from the body are perceptible, but let there be inertia of that gland from any cause, the sebaceous glands of the tonsils, mouth, nose and feet are called upon to eliminate, and in this process there is a fetor, a germinal evolu- tion. In dealing with bacteria we must never lose sight of the idea that they only grow when vitality is low. Every debilitated in- dividual has a bad taste in the mouth and a foul breath, regard- less of how clean he keeps the mouth. The mouth is simply a breeding ground for all manner of germs ; a constant stream of those elements of disease is carried into the stomach, infect- ing the alimentary canal, irritating the liver, entering the blood. The most common cause of bad breath is the sluggish liver and decomposition of the coating of the tongue. To rectify the sluggish liver take a selection from remedies and Dictionary of Diseases. 641 that energize that gland, such as periodate aurum, chionanthus virg., comp. matricaria; mouth-wash of boroglycerid. Odors from the feet, with sweating, exhibit a state of re- markable toxicity, which, until the liver trouble is eradicated, is best got rid of by painting the soles of the feet with formalin, first bathing with soap and water, drying off, adding twenty drops of formalin to one tablespoonful of water, and brushing it on lively over the soles and other parts of the feet. Almost immediately the offensive odor disappears. The physician must be the guide as to the strength of the solution used. It must be sufficient to destroy the microbe of sweat, whose toxin is depressing. Thus we have the odors of disease well marked and defined, such as variola ; the odors of races, of menstruation, of vegeta- tion. Besides, some highly civilized beings have an idiosyncrasy to odors, which are productive of headache and nerve disturb- ance — intolerable odors which give rise to nasal, laryngeal and lung trouble. CENANTHE CROCATA (Water Hemlock, Cowbane).— This plant is conspicuous in the cure of epilepsy of the most intractable form, succeeding in warding off the spasms when all other remedies have failed. Our preparation is made from the plant, specially imported from Scotland by ourselves, and is most reliable. Properties extracted by percolation. Dose : Variable ; best to begin with small doses, 1 to 5 drops, and increase very gradually, every three hours, in water, until the spasms are warded off. CEDEMA. — A swelling produced by the accumulation of a serous fluid in the interstices of the areolar tissue. Recognized by its softness, by leaving an indentation for some time, which gradually disappearing is pale, and without pain. (See Dropsy. ) GEdema common in weakened parts, serous or sero- purulent infiltration of the submucous tissue of the glottis, with symptoms resembling croup, but attacks adults rather than the child ; is in all cases very fatal. CEdema, Pulmonary. — Serious apoplexy of the lung. The primary, pathogenic condition of pulmonary oedema is the stop- page of the capillary circulation in the alveoli from the increased Wood pressure in the left auricle: a too free supply of blood from the right side of the heart coming through the pulmonary 642 The Germicide 20th Century Practice arteries ; exudation taking place. Whether mechanical or pas- sive in its origin, it is invariably accompanied with persistent dyspnea, a great increase of carbonic acid in the blood and death of the heart from general asphyxia and pulmonary oedema, which had its origin in the left auricle. There are three forms recognized : congestive, inflammatory, toxic. Its etiology embraces infective conditions : toxic agents in the blood, the toxins of the bacillus amylobacta, epidemic influ- enza, diphtheria, typhoid fever, pneumonia, chronic alcoholism ; cardiac disease an important factor. Usually ushered in with profound prostration, tickling in the fauces; painful, most irritable thoracic tension; intense dyspnea ; continuous spasmodic cough, followed by frothy ex- pectoration; cyanosis, colliquative sweats. With regard to treatment, experience has shown the unde- niable value of the acetic tincture of lobelia, followed by di- oxide of hydrogen, with nitroglycerin suppositories. (ESOPHAGUS, STRICTURE OF.— Two varieties, spas- modic and organic stricture. Spasmodic Stricture. — Usually comes on suddenly during* a meal, and is followed by a rejection of food, a sense of con- striction and inability to swallow ; often depends upon swallow- ing some acrid substance ; reflex irritation from the gums, stom- ach, bowels ; reflected to medulla ; then transmitted by weak- ened nerves that supply the circular muscular fibres or rings of oesophagus. Remedies. — Apply stimulating remedies to the spine from the nape of the neck down ; administer extract sumbul and al- ternate with coca, lobelia comp. Organic Stricture. — Consists in a thickening of the cir- cular muscular rings, with lymph, excrescences, tumors. The difficulty of swallowing is always encountered and per- manent. The digestive action of either papoid or trypsin has been tried in digesting organic stricture. ; it is usually combined with boroglycerid paste and made into a bolus sufficiently large to swallow, but of such a size as to be arrested at point of obstruc- tion, at which point it operates well, for it will digest the ad- ventitious structure of a stricture more readily than a normal' tissue : it can also be inserted on the hollow point of a bougie. and Dictionary of Diseases. 643. OIL. — This is a collective name, under which two classes of fluids are included, very different from each other. Those belonging to one class are viscid, mawkish, almost insipid : those of the other class are devoid of viscidity, are caustic, anti- septic, volatile ; the former being known as fixed oils, the latter volatile or essential. All of utility in medicine. Olive Oil. — Pure olive oil is useful in infancy, adult life and old age, in health and in sickness. Its increasing demand would very decidedly indicate an increasing knowledge of the laws of health. Much is sold as olive oil which has nothing of the olive about it save the name. Much is of an inferior grade. A good, pure oil is valuable, all others worthless. Pure olive oil has been well known and freely used by the members of the medical profession in all forms of chest trouble. but it does not receive as much attention as its valuable proper- ties and its successful use would seem to merit. From the earliest moments of infantile life — and we might add, as early as its first bath — olive oil will be found a valuable application for the new-born infant, soothing and nourishing the delicate skin. One of the most important things to have always on hand in the nursery, therefore, is a bottle of the best olive oil. In a large proportion of the diseases of infancy and child- hood it will be found of the greatest value. It is especially use- ful in all forms of bronchial diseases, whether acute or chronic. It relieves the congestion of the mucous lining of the air pass- ages, maintains an equable temperature, affords a soothing warmth, and is, without doubt, highly nutritious. -It is safer and better than jackets of Indian meal or any of the common applications found in the nursery. The oil should be slightly warmed, then the patient's chest should be bathed profusely with it. Afterward a strip of clean, old, and soft shirting, large enough to completely envolop the whole chest, and thoroughly saturated with the oil, should be carefully applied. Over this a larger piece of dry cotton cloth must be firmly but not too tightly adjusted. Inunctions will be found excellent in all cases where artificial nutrition is sought for. In all eruptive diseases like measles, and especially in scarlet fever, chicken-pox, etc., nothing is better for an external appli- cation. Oleum Hyperici. — This oil is made by filling wide-stop- 644 The Germicide 20th Century Practice pered bottles with flowers of St. John's-wort; then fill them with olive oil ; the bottles so filled to be exposed to the action of the sun's rays for about six weeks, or until the oil becomes of a deep-red color. It is then fit for use. In its action, when applied to the human tissues, it is an anesthetic, and has the identical properties of arnica, marygold and mullein; hence, it is of efficacy in contusions accompanied with ecchymosis. In th otalgia of children, whether due to neuralgia or in- flammation or rheumatism, it does not produce the effect that is obtained from mullein oil; it does not relieve the pain so promptly. If a patient be suffering from violent earache, the ear filled with peroxide of hydrogen and retained until effervescence ceases; then emptied, and from three to five drops of warm mullein dropped into the external meatus, it promptly relieves pain. It is doubtful whether, in the near future, that all those vegetable agents be not entirely superseded by the jelly of vio- lets, introducing one or two grains into the ear. Oleum Verbascum. — Identical in proportion to» therapeutic effects. OINTMENTS. — Quite a number of new ointments have been introduced, all having their base in petrolina jelly or vase- lin. Some of these possess rare value, and are entered in the pharmacopeia. Ozone Ointment is a powerful bactericide. Indicated : In all skin diseases, as in erythema, eczema, lichen, psoriasis, prurigo, pityriasis, impetigo, all forms of tinea, blotches, pimples, burns, frost-bite, erysipelas, excoriation, .ul- cers, varicose veins, itch, scurvy, piles, as a dressing to all wounds or sores. Its energetic germicidal properties render it the finest, most penetrating emollient, healing product virtue, as no microbe can live under where it is applied. Hence it is valuable locally in phthisis, pneumonia, metria, balanitis, chancre. Chrysophanic Acid Ointment. — In variable strengths, 10, 20 and 30 per cent is of great therapeutic value in psoriasis, lepra, and cutaneous leprosy. Applied in its high potency, it causes a complete exfoliation of the malignant cutaneous affection, leaving a healthy tissue, and if the proper constitutional remedies are administered, sel- dom reappears again. A strength that will cause desquamation is desirable in all cases. and Dictionary of Diseases. 645 Gaultheria Ointment. — This ointment has a most re- markable affinity for the bacillus amylobacta, the pathogenic microbe of rheumatism. By endosmosis it passes into joints; over the pericardium of the heart it has an active sterilizing effect, as is visible from the prompt relief of pain. Besides kill- ing off the bacillus, it neutralizes its toxins. As an agent to be employed in partially ankylosed joints due to gout and rheumatism it has no equal. Best applied by gentle massage. Guaiacol Ointment. — A much more active agent than the pine-tree ointment, being capable of completely annihilating the tubercle bacillus. In endosmosis it has remarkable powers of penetration ; in the same potency as the pine it will double it in real practical utility as a bactericide. It is also exceedingly valuable in cases in which the gonococcus has migrated to the testes and produced orchitis, with considerable pain and en- largement. Bathing the scrotum with water as hot as can be tolerated, drying off, then applying guaiacol ointment every three hours, speedily brings about resolution. Guaiacol ointment or jelly is inimical to the microbe of ery- sipelas ; its microbicide properties are great in destroying every vestige of the germ. Mexican Ointment. — The climate of Mexico is most re- laxing, hence hernia is very common among both old and young of both sexes. Some twenty years ago a celebrated surgeon in the City of Mexico introduced this ointment as an application over all hernial openings so as to induce contraction, and at the same time excite adhesive inflammation, with effusion of plastic lymph and obliteration or filling up of the hernial aper- ture. The method adopted in its application is to return the hernia, bathe over it, dry well, then apply the ointment over and above all the truss, pad or compress. The application is unat- tended with danger, and is more successful and rational than the injecting of irritants into the hernial aperture. In order to effect a radical cure keep on with its application for a few weeks, until abundance of plastic lymph has been effused. Siegesbeckie Ointment. — Being a powerful germicide, has great healing properties in gangrenous ulcers. It is of utility in all vegetable parasite skin diseases. It contains an alkaloidal substance called daturin, which is an active bactericide. Resorcin Ointment.— A valuable local application to all cancerous cavities and ulcers. It operates well also in syphil- itic sores. 646 The Germicide 20th Century Practice Resorcin ointment is the best known of all the germicide cerates, and can be successfully prescribed in acne, eczema, pru- ritus, in all acute and chronic skin diseases. One of the best and most reliable of all cutaneous applications. Saw Palmetto Ointment. — This is prepared from the oleoresin of the ripe, undried berries, and possesses all the me- dicinal properties in a very marked degree of this very cele- brated agent. As a vitalizer, a promoter of nutritive growth and development of the organs of generation in both sexes, there is no remedy which can be compared with it. It is easy of application ; simply bathe the breast or scrotum, dry well, apply the ointment with gentle massage or friction for fifteen min- utes, morning and night. During the day and night a thin coating of the ointment should be kept in close approximation without pressure. Storax Ointment. — This is prepared from the best Persian storax, and makes one of the most valuable of all microbicide ointments. It unquestionably forms one of the most valuable dressings for cancerous cavities after removal. An elegant application to syphilitic sores. Pine Tree Ointment. — The oil of the needles of the North Carolina pine incorporated into ozone ointment, potency 10, 20 and 30 per cent. This ointment, containing all the ozonizing aroma of the pine, when applied over a tubercular solidified lung, over tubercular damaged joints, inhibits, sterilizes, and is actively inimical to the vitality and growth of the tubercle bacillus underneath. We do not claim that it will annihilate the bacillus ; it is a scavenger and puts the germ in a quiescent state ; valuable as an auxiliary agent. OLD AGE AND PREMATURE DEATH.— Pathology teaches us that the chief characteristics of old age are the de- posit of calcareous matter in the heart and blood-vessels. This results from a slowed action of the heart and defective elimina- tion. Ossification causes this condition, upon which nutrition depends. In youth digestion is perfectly performed, assimilation is rapid, repairs promptly made ; not so after the middle period of life. Three- fourths of the human body is water, which holds those earthy salts in solution ; but as time progresses, assimilation and elimination become defective, and the human blood, which contains lime, magnesia, iron, having done its work in the and Dictionary of Diseases. 647 body, in early life is thrown off; as age advances, it has not the power to do it. Blood is produced from food, and we must look for an early accumulation of earthy salts, if the diet is not well guarded. By a careful selection of diet, man can prolong life; by keep- ing those earthy salts at a minimum, and in a state of solubility. Bathing, pure air, warm clothing can do much, together with a proper selection of food. Living matter, as it deviates from the simpler protoplasmic cellular type and becomes more complex, loses its vitality. Cells in the course of their existence become differentiated — that is, they are changed from the primitive type; they attain a higher degree of perfection ; their functions are exalted ; they become specialized, and, in doing this, they lose some of their power of attraction ; their resistance is lessened ; in other words, what they give in quality they lose in quantity. But, for- tunately, all cells are not highly differentiated, and all do not reach their maturity at once. If they did, our lives might be shorter than they are. The nerve cell is probably the most highly differentiated, and is the first to wear out, other things being equal ; while the connective-tissue cell is the least differ- entiated, and as a result enjoys a long and happy existence. When the more highly organized cells cannot be reproduced rapidly enough to fill in the gaps, their place is taken by con- nective-tissue cells, the functions of the organs are interfered with, and old age commences. Degenerative changes in the nerve cell give rise to numerous and varied miseries, which are seldom relieved by active treat- ment or modern remedies, consequently new treatment and newer remedies are in demand by those who feel the trammels of senility closing around them — anything reliable is a welcome addition to our therapeutical resources. There are two forms of old age, the premature and the really aged. Premature old age, in which the individual is unable to at- tend to the ordinary demands of life, owing to debility, to con- stitutional defects, infectious diseases, depressing emotions, venereal excesses or losses. In genuine old age, senile involution, with a tendency to arteriosclerosis, the functions of the body are slow, inefficient, appetite poor, digestion feeble, defecation insufficient, heart's action feeble, respiration superficial, everything a burden; he is indifferent to surroundings ; has vertigo, indecision of char- acter, weariness, insomnia, impaired memory, sexual power at 648 The Germicide 20th Century Practice a low ebb, the expulsive power of the bladder feeble, walking bad, dull pain in the knees, temper testy, peevish, fretful, sel- fish. The mean duration of modern life is between 40 and 50 years; but the cycle of physiological life should be 100 years. Few reach that, owing chiefly to bad inheritance, neglect in the bringing up, bacterial poisons, improper or adulterated food, deleterious trades, insanitary states, impure air, overwork, use of alcohol, sexual excesses, draining off the nervo-vital, excessive brainwork with monotony, worry, grief, anxiety, accidents, concussions. OLFACTORY NERVE, in which the sense of smell is located, has its origin in the medulla oblongata, leaves the ~brain opposite the inner part of the fissure of Sylvius by three roots, or branches, which by their union form a triangular knot or expansion, reaching the ethmoid fossae, where it spreads itself, forming a triangular ganglion or a grayish soft bulb, which furnishes from its inferior surface the branches, which ;are distributed to the nasal fossae. These filaments are numer- ous, pass through the foramina in the cribriform plate and enter the nasal fossse. They are arranged into the internal, ex- ternal and middle. The former is distributed over the mucous membrane, covering the outer walls of the nasal fossse; the second descends upon the septum, and the third is lost on a portion of the pituitary membrane that lines the vault of the fossae. It is impossible to justly appreciate the marvelous function of this nerve, in either warding off, annihilating disease germs or rendering them innocuous ; how in inspiration a germ-laden atmosphere passing over it, and in expiration free of both them and toxic products of their growth ; susceptible in certain neu- roses of producing grave pathological conditions, as in hay fever so called. ONYCHIA. — A peculiar ulceration, usually commencing in the matrix of either the finger or toe nails. Common in chil- dren under ten years of age ; due to filth and breathing a dele- terious atmosphere of animal and vegetable matter in a process of decay; later in life, syphilis, lead and mercury are at its origin. The exciting cause is an injury or some form of irritation. It has a microbic evolution, identical with fungous foot, com- and Dictionary of Diseases. 649 mences with the end of the finger swelling, and an effusion of serum under the nail, which loses its natural color and becomes thin and flattened at the end and curled up laterally, divesting itself from its normal attachment, exposing a foul and painful ulcer, with characteristic fetor. If not promptly attended to ? the phalanx itself may become necrosed. The latest method of treatment is based entirely on the pres- ence of a disease germ, and consists first in washing the affected member with a lotion of formalin, one ounce to a quart of water, trimming the nail back to where it is attached to the matrix, dusting on iodol, bandaging, then immersing the finger every half hour in peroxide of hydrogen. , Repeat this daily; it is the most successful local treatment; free from the usual modifications of cutting, scraping, burning. The formalin wash is a valuable disinfectant and parasiticide brought into the presence of living organisms ; it is powerfully destructive to them and all microscopic life, and has a distinct influence in promoting a renewal of life. The peroxide, preceded by dusting on iodol and keeping it saturated, works well. In a few days, apply the rubber adhesive plaster, which fits better, is softer and easier applied, requiring neither heat nor moisture. OPACITIES OF THE CORNEA.— Sulphate of cadmium must never be overlooked as an active absorbent in corneal opacities, nebula, albugo, leukoma. Add two and one-half grains of this remedy to one ounce of mucilage. Shake well, then dip a camel's hair brush in it and apply it to the centre of the spot of haziness, and retain it in contact with it for a few seconds. At the commencement, the application is best made once a day, but after a while it can be repeated two or three times in twenty-four hours. As the pain decreases, after each application, the strength of the solution may be increased to five, even seven, grains to the ounce. When its opacity is of recent formation it readily disappears under this remedy, but when it has existed some time, the application may have to be continued longer. OPHTHALMIA (Conjunctivitis). — Inflammation of the mucous membrane of the eye and inner aspect of the lids is met with under the following different forms : Infantile, common acute, purulent, gonorrheal, tubercular, rheumatic, granular, 650 The Germicide 20th Century Practice All are contagious and infectious, because each one contains a pathogenic microbe, the living, breeding germs of disease. They have certain symptoms in common : pain, heat, redness, swelling, with intolerance to light, mucopurulent discharge and a sensation as if there was sand in the affected eye, with great constitutional disturbance, headache and fever. There are certain measures in treatment common to all, such as confinement to bed in a dark room with his surroundings hygienically perfect; passiflora incarnata for fever; as the ophthalmic nerve originates in the cervical portion of the cord, apply to the nape of the neck and under the eye a thin coating or plaster of the jelly of violets; dissolve one grain of atropia in one ounce of rose water, drop a few drops into the eyes every one or two hours. In all cases the affected eye must be washed out with, some antiseptic lotion ; cover the eye lightly with some cloths wet with the same solution. If one eye only is affected, guard the other with extreme care. Bowels must be kept open with periodate aurum ; bathing at least morning and night; nutritious diet, but no stimulants. 1. Infantile Ophthalmia. — It is customary by the pro- fession to attribute this form to either leukorrheal or gonorrheal discharges of the mother, or to the glare of light or currents of cold air. This, as a rule, is not correct, for on careful investi- gation we find that it is due to imperfect removal of the seba- ceous secretion with which the child at birth is covered — de- cided carelessness in the application of the oil to unite with that secretion, and permitting it to enter in either the inner or outer canthus of the eye. If this should occur, it will manifest itself inside of nine days after birth, ushered in with slight intolerance to light, dis- charge, and, if permitted to progress, all the symptoms become well defined. The general principles of treatment must be carried out : bathing, atropia, violet jelly, and usually a hot solution of boro- glycerid should be used for washing out the eyes, to which peroxide of hydrogen may be added, and cloths wet with the same lightly laid over the affected organ. The mucopurulent discharge, greater or less, must never be permitted to accumu- late, as it is liable to give rise to haziness or opaqueness of vision, or even penetrate the cornea. 2. Common Acute Ophthalmia. — Generally the result of irritation, dust, sand, foreign bodies, cold, exposure. Same treatment as for the purulent. and Dictionary of Diseases. 651 3. Purulent Ophthalmia. — Most aggravated of all the varieties, generally due to insanitary conditions, overcrowding. Often prevails in epidemic form. A low grade of this species exists in our public schools, disseminated by the use of towels used by the infected. Exceedingly contagious and infectious. Immense amount of mucopurulent discharge, which flows from the corners of the lids. The inflammation is intense, progresses with rapidity; conjunctiva enormously swollen, in- tensely red; blood-vessels much engorged, elevated above cornea (chemosis) ; often several small points of ulceration can be detected; great danger, liability of the cornea being de- stroyed. Constitutional symptoms are of great severity. The treatment must be of the most active description ; vera- trum viride, aconite, passiflora, vapor baths, atropia in eye every three hours, sulphate of quinine and protonuclein ; wash out affected eyes with a tepid solution of ozonized bo.roglycerid, with an excess of peroxide of hydrogen added ; place jelly of violets to nape of neck, and insert in the affected eye one grain of the jelly at bedtime. Its effects are marvelous in subduing inflammatory action and killing microbes. Enforce rigid antiseptic precautions and avoid all insanitary states. Destroy all cloths that have been applied. Under this rigid treatment, the microbes are completely an- nihilated, and recovery takes place. 4. Gonorrheal Ophthalmia. — This is either due to the direct application of the gonococcus to the edge of the lids in individuals who have the gonorrhea, to imperfect cleansing of the hands, or to towels used by the infected, etc., or to the toxin of the gonococcus irritating the sclerotic coat. As a rule, the inflammation progresses with great rapidity, most de- structive in its effects, and symptoms severe. The same treat- ment as inculcated under the purulent should be tried, washing ing out the eye every three hours with a solution of perman- ganate, strength of three grams to the ounce of distilled water, applying cloths lightly saturated with peroxide of hydrogen. Alteratives and tonics are indispensable for a cure. 5. Tubercular Ophthalmia. — Occurs only in individuals who possess an intense tubercular diathesis, and is characterized chiefly by the greatest possible intolerance of light, with no pain, no redness, no sensation of sand, no mucopurulent dis- charge, merely a little mucus. The atropia solution may be useful, but, as a rule, a lotion of chloride of sodium, three grains to the ounce of water, with a dram or two of per- 652 The Germicide 20th Century Practice oxide of hydrogen added, makes the best wash and local ap- plication to the eye. Enforce a rigid treatment for tuber- culosis, matricaria for a tonic, glycerite of ozone and mistura guaiacol to kill the tubercular bacilli in the blood, at the same time resorting to all obtainable methods of building up vital force. Protonuclein, c. p. solution spermin. 6. Rheumatic Ophthalmia. — In this form the bacillus amylobacta has invaded the white fibrous tissue, the sclerotic coat; toxins are excreted, which give rise to most agonizing pain; but little redness, but considerable intolerance of light. A serous discharge, often profuse, runs from the eye. Con- siderable constitutional symptoms, with pain in the head ; and the leading symptoms of rheumatism present themselves. To the affected eyes, dry heat, or baked chloride of sodium, as hot as can- be tolerated, renewed frequently; atropia always serviceable; dark room; otherwise the general treatment for rheumatism should be pushed energetically, selecting from the following : ozonized glycerite of wintergreen, manaca, matri- caria, ozonized uric acid solvent, tine, cimicifuga racemosa, protonuclein, comp. saxifraga and Phytolacca. 7. Granular Ophthalmia. — A result, an effect, or con- comitant of some of the other forms, especially if the affert " 1 individual is greatly debilitated in health, or the treatment poor. It consists in granulations, enlarged papillae projecting from the conjunctiva, apt to extend to the entire mucous membrane covering the globe of the eye; there is intolerance to light, a seropurulent discharge, ulceration and opacity. Atropia of utility; a lotion of resorcin, three grains to the ounce, as an eye-wash. A grain of jelly of violets in affected eye every night is of great efficacy. Internally, comp. saxifraga and matricaria, and every possible means to improve the general health by a highly nutritious diet. The next best remedy in granular ophthalmia is a good strong infusion of the pulverized decorticated jequirity bean. It is a safe remedy, rapid and efficacious in its results. 8. Ophthalmia Tarsi. — Inflammation of the Meibomian glands at the roots or matrix of the eyelashes. May be a sequel of some of the preceding forms ; often sympathetic from gonorrhea, but most generally dependent on the bacillus of tubercle and syphilis in the blood ; insanitary states and mal- nutrition are favorable for its evolution. The cause is a devitalized condition of the edge of the eyelids, and the evolution of a microbe in the Meibomian glands and alt and Dictionary of Diseases. 653 around the edge of the lids, which renders it essentially con- tagious and infectious. The micro-organism is extremely virulent, one case contaminating the atmosphere of a large school. Its characteristics are either in the acute or chronic form by some degree of irritation, lachrymation and intolerance of light, and on everting the lids the granulations are visible as elevations on the mucous membrane of the lids, never encroach on the globe. These granulations are variable in size and ar- rangement, and they do not all appear to mature at the same time; in color grayish or yellowish, often hidden by the sur- rounding papillae ; ulceration, incrustation of the lids, cicatrices form as the result of degenerative changes. The malady is becoming very common — so much so that formalin should be kept constantly exposed in all our school- houses, theatres, churches. In calling the attention of our readers to granular ophthal- mia, we have no reference whatever to the sympathetic redness of the lids in cases of gonorrhea or masturbation. The most successful treatment ever presented to our pro- fession consists in a rigid avoidance of all insanitary states, bathing, best of nutrition and a constant evaporation of forma- lin vapor in the apartment. To the edge of the lids, to the eyes, a highly ozonized solution of boroglycerid should be kept con- stantly applied, and the edge of the lids everted should be painted thrice during the twenty-four hours with jelly of violets. Vigorous treatment is indispensable for the relief of the pa- tient. Speaking pathologically of the different forms of ophthal- mia, every one has its own pathogenic microbe, which renders each contagious. In recent years, towns and cities on the banks of rivers, along" the line of the sea-coast, have the output of their sewers emptying into which bathers enter, which has caused another virulent form of ophthalmia to appear, known as pink eye. To prevent this, bathing must be restricted, so that it should not be performed within five miles of any sewer outlet; if within that restricted area, there is danger to all bathers' eyes, coming in contact with the microbes of typhoid fever, pneumococcus, diphtheria, etc., a conglomerate mass of germs, which gives rise to pink eye, a sewer-bred bacillus. Same treatment as the purulent; action so as to prevent granulation and corneitis.. In such cases boroglycerid lotion is invaluable. 654 The Germicide 20th Century Practice OSTEOARTHRITIS.— An acute and subacute inflamma- tion and enlargement of joints, differentiated from rheuma- tism by the character of the swelling being in the bones, chiefly involving the large joints; circumscribed, permanent, not moving from joint to joint; not usually affecting the smaller peripheral joints ; negatively by its obstinate character, absence of tonsillitis, cardiac lesions, and profuse acid sweats — from gout by the want of periodicity, length of the attack, involving chiefly large joints, like the knee; no disposition to metastasis, but in osteoarthritis, in addition to the bone-pain in the larger joints, stiffness of the neck and jaws, a stabbing pain in the wrist, ball of the thumb, numbness and tingling in the ex- tremities. Common among people in advanced life, due to degenerative changes in the epiphysis of bones. Alteratives and tonics internally; among the best are saxi- fraga and carbonate of guaiacol. The latter does interfere with digestion, but in the intestines splits up into carbonic acid and guaiacol; an excellent remedy in this distressing malady, free from all irritation, stimulating an appetite, facilitating assimilation. Begin with five grains thrice daily and increase to ten and twenty grains, relieving pain, reduces temperature, and diminishes swelling. Locally, either keep joints wrapped up in cotton or apply compresses of alcohol and salt or olive oil, followed immediately with concentrated ozone. Persevere on this line. OTORRHEA. — We naturally ask what causes the dis- charge ? Where is the initial starting point ? What is its ex- tent ? What tissues and structures does it involve ? The ear is a delicate organ, made up of very highly organized structures, a bony frame-work, with cartilages, muscles, nerves, blood-vessels, mucous membrane ; divided into external, middle and internal. The ear is shut out from the outside world by a drum or tympanum ; this membrane is attached to a series of bones, to hold it tense, and when so held receives the undulations or waves, or vibrations of sound, and plants them upon the auditory nerve. The cavity of the inner ear is connected with the throat by the Eustachian tube. In order to have good hearing, there must be an unobstructed passage for the air to go in and out, according as the cavity of the ear is made lesser or greater, by the movement or vibration of the tympanum. If the and Dictionary of Diseases. 655 "Eustachian tube be closed, air cannot enter the ear cavity, sound cannot cause the membrane to vibrate — deafness is the result. It is the brain that hears ; the reflection of the auditory nerve upon the tympanum is the medium of transmission. Variable pathological conditions are liable to take place, chiefly from inflammation induced by cold, injuries, toxins of disease germs, such as thickening of the mucous membrane; anky- losis of the small bones, that they cannot move. Very many constitutional conditions affect the ear, and give rise to conditions dangerous to health and life. Individuals suffering from inflammatory states of the ear, with otorrhea, have a less chance of long life — their brain is more exposed to the ravages of disease, more liable to have a penetration of morbid action with the mastoid cells. Some recent remedies are of intrinsic value in ear maladies, such as peroxide of hydrogen, jelly of violets, mullein oil. OVARINL — The absorption of the ovarian secretion makes the woman. When ovulation ceases, between 45 and 50, and there is a complete absence of this internal secretion, there is usually great constitutional disturbance, with a marked change in every organ of the body, and a variety of troublesome symp- toms, such as congestion of different organs, excessive hemor- rhages, dyspepsia, flatulency and vertigo, rheumatic and neuralgic pains, cutaneous eruptions, profuse sweats, ulcers of the legs, hysteria, pseudo-apoplectic seizures, diseases of the breasts, insanity, paralysis, are common. The constitutional disturbance attending this critical period, the want of the in- ternal ovarian secretion, is indicated by great turmoil of the cerebral circulation, with irregular action of other vital organs. The effects of the change locally are briefly as follows : 1. Atrophy of the uterus, together with atrophy of fibroid tumors, should they exist. 2. In cases of polypoid growths, the hemorrhage, as a rule, is less, due to the diminished blood supply to the uterus and its appendages. 3. The change has no beneficial effects whatever upon malignant disease of the pelvic organs. The treatment, to be effective, must be direct ; we must sup- ply the system, at least for a few years, with ovariin, for which the brain and other vital organs are literally starving, and gradually and comfortably merge her into the new life into -which she is entering. 656 The Germicide 20th Century Practice She needs a bracing tonic, which is to be found in tlie comp.. tincture of matricaria, which should be always administered before meals ; she needs a vitalizer, a restorative, a remedy that will brace up her tissues, and make her feel young again, which she has in the wine of the aletris farinosa and comp. syr. par- tridge ber-ry. A course of treatment like the above has been found most useful in tiding the patient over this crisis. OVARITIS. — Usually caused by some uterine irritation, as abortions, absorption of lochial products. It is met with acute and chronic. Deep-seated pain over the region of the ovary, aggravated by pressure, numbness in the limbs, extending down to the thigh, sharp, darting; stinging pains in the ovary. Our best remedies are rest, recumbent posture, local stimula- tion over affected ovaries; try first a combination of aconite, belladonna and gelsemium, with pure cocain suppositories in both vagina and rectum — if these do not afford good result, bromide and iodide potass in fluid extract sumbul. Run it into a chronic form, then administer fluid extract of salix nigra. General course of tonics and alteratives. Pulsatilla in alterna- tion with passiflora is of great efficacy. OVULATION. — No organ in the body exerts so great an influence over physical and mental development as the ovaries. At birth they are very small, smooth and flat, but as age ad- vances they enlarge and become oval and tense. When about puberty, they so greatly increase in size that they are matured and throw off or exfoliate or discharge the ova. Puberty among the Caucasian race and in our own country is usually about fifteen years. When this event takes place, the ovaries assume a nodular appearance, due to cicatrization which takes place after the discharge of the ova, and this condition remains till late in life, when they shrink, atrophy, and present the appearance of short and thickened bands. Menstruation usually accompanies ovulation, through the child-bearing period of life. This consists of a discharge of blood and detritus, which comes from the uterus, and ought not to exceed four ounces, and in health passed without pain. Puberty ushers in complete ovarian development ; simultane- ously with this the breasts enlarge ; nipples become prominent ; and Dictionary of Diseases. 657 vagina more roomy; mons veneris covered with hair, pelvis broadens, hips and thighs increase in size, and become rounder ; even the voice and the whole tone and aspect of the body change when these characteristic landmarks appear. Unless some shock, disease or pregnancy take place, men- struation will continue from 15 to 45 years of age, at which latter period they cease, when ovarian atrophy sets in. The cessation of the menses or change of life, menopause generally, therefore takes place about 45 years, at which time we see something of a return to the muscular type ; the voice becomes coarse, breasts atrophy, more or less hair appears on the lips and chin — there is a general shrinkage and coldness of the sexual organs. There has been much discussion regarding ovulation and menstruation, the relationship between the two. Ladies enjoy- ing the highest possible state of health are frequently met with who never had the slightest discharge, and conceived. Con- ception often takes place in young ladies before the menses have appeared ; in married women while suppressed during lactation. The age at which conception is possible varies greatly in races and in individuals. In tropical countries and other races than the Coucasian, often as early as 10 years; in cold climates 17 to 21. The ovaries mature early in hot climates, late in cold countries. The general well-being of a people ; rich or meagre diet, con- dition of life, the city or country, all influence growth and maturity. Conception is very rare in women who suffer from organic disease, such as diabetes, or from deficiency of blood and nerve elements, as anemia, or chlorosis — states in which the ovaries are incapable or do not possess sufficient energy to evolve healthy ova. The ova are discharged periodically, once a month or every 28 days, and it is near that period that impregnation is most likely to take place, for about 10 days before or after. The season of the year has a most remarkable effect on con- ception — being much more common in the spring, and summer than in the autumn and winter months. The quantity and quality of food used by a given race affects conception. More children are born where there is plenty and comfort than in abject poverty. Again, women in moderate circumstances are more prolific than those living in luxury. Isolation, sameness, indoor life induce sterility. Stability of our political institution is favorable for fecundity. 658 The Germicide 20th Century Practice Menstruation is a mere symptom of evolution. When it does not make its appearance until the 20th year it is a sign of non-development or atrophy of some essential part of the generative organs. From 46 to 50 years of age, it becomes permanently suppressed and indicates senile sterility. The menses may be arrested by fright, cold, great physical and men- tal excitement, and indicates a condition unfavorable for con- ception. Many women claim to be able to tell the precise date of their impregnation, due probably to the perfect orgasm which takes place. In most of the lower animals the relative position during^ copulation of the two participants is back to belly, the part played by the female being merely passive throughout; but in man she is more of an active agent, this being rendered pos- sible by the belly to belly position. This position also brings the most sensitive parts of the geni- tal organs of each sex in contact. The engorged and sensitive clitoris during coitus is drawn down by muscular action, so as to make it come in contact with the superior aspect of the penis, while the corona glandis of that organ causes friction against the roughened folds of the anterior vaginal wall. In many married and young women, the anterior wall of the vagina, situated behind the symphysis pubes, is even more sen- sitive than the clitoris, so that if friction be continued for some time, all the female organs of generation become engorged with blood and roused into a state of great excitement. Mus- cular action is excited. The uterus enlarges, becomes cylin- drical, straightens out in the axis of the canal. Its external os becomes dilated and round, while the plug of mucus, normally closing that opening, is expelled. With these changes, there is a slight descent of the uterus towards the mouth of the vagina, while its fundus is tilted back to the sacrum, so as to bring the uterovaginal axis down to a right angle. When orgasm ap- proaches, the contents of the vulvovaginal glands are dis- charged in jets and the vagina and uterus take on a rhythmical, contractile action, which assists the entrance of the seminal fluid, as it is ejaculated over the cervix into the uterine cavity. By these same contractions the uterine terminations of the Fallopian tubes are also opened. OXALIC ACID DIATHESIS— OXALURIA.— When the co-ordinating chemical centre is further enfeebled by some ner- and Dictionary of Diseases. 659 vous disease, alloxan is formed in sufficient quantity to combine with glycogen and prevent the formation of other substances ; oxalic acid is formed, and appears in the urine. Now, this di- athesis is dependent upon very great nervous prostration, es- pecially in the nerve-centre and nerves that supply the lungs, stomach, pancreas, and liver. Generally found in old cases of chronic bronchitis or nervous dyspepsia, and is characterized by the persistent appearance of crystals of oxalate of lime in the urine. Rhubarb may cause a temporary appearance of oxalic acid, which disappears as this vegetable is discarded or discontinued. The crystals appear in the form of minute, transparent octa- hedra, or like dumb-bells. The persistent presence of oxalic acid in the urine indicates the very low state of vital power, and is very liable to give rise to two distinct and dangerous complications : 1. A concretion of oxalate of lime (mulberry calculus) may form, either in the kidney, bladder or prostate. 2. The poisonous action of oxalic acid in the blood is liable to produce irreparable lesions in the brain, heart, stomach, etc. Treatment. — Great attention should be paid to diet. It should be generous, consisting of animal food, eggs, fish, milk, etc. ; all articles that contain oxalic acid, as rhubarb, sorrel, tomatoes, sugar, etc., be forbidden; daily shower-baths, fol- lowed by friction; flannel clothing. Vegetable alteratives and tonics should be administered. Our best tonics are iron, cin- chona, hydrastis ; muriatic acid in compound tincture cinchona is invaluable. The above three states are what is understood when we use the term "gravel," being the passage of one or the other of those three bodies in the form of a gritty powder, or sand-like bodies, or small calculi, occasioning pain, irritation of kidneys, ureters, bladder, and urethra. Of those three principal forms, the uric acid is present in about eighty per cent of all cases, and gives rise to more irrita- tion than either of the other two forms. All ages and both sexes are liable to be affected. They often give rise to neph- ralgia or neuralgia of the kidneys. In order to relieve this condition promptly, hot baths, hip- baths, hot fomentations to loins ; open bowels with salines, and enemata. 660 The Germicide 20th Century Practice OXYGEN COMR— Dose: Internally. One teaspoonful, three or four times daily, in a glass of cold water, is sufficient to supply the blood with oxygen, — at least with all that it will imbibe, or in any form of blood disease, as chlorosis, anemia, etc. As a gargle, in scarlet fever, syphilitic, tubercular, malignant sore throat, one teaspoonful in half a tumbler of tepid water, every three hours. For inhalation, use in full strength in a hot or steam atomizer. Compound oxygen, or oxygenized water, is a germicide, of immense power, destructive to all micro-organisms, completely annihilating the bacilli of tubercle, syphilis, cancer, fungus of diabetes, germs of scarlatina, etc. Vitalizes the blood, pro- motes the activity of the pink marrow and entire lymphatic system. Very efficacious in general nervous debility, nerve tire, and in debility of the respiratory organs, as in asthma, bronchitis, consumption, pneumonia, whooping-cough. An invaluable remedy for impure, impoverished, germ-laden blood, or where the blood is literally swarming with myriads of disease germs from overcrowding, sewer gas; in embolism, bacteria- laden blood from imperfect action of the heart, lungs, liver, spleen, or skin. OZENA. — A degeneration of the pituitary membrane, which gives rise to a disagreeable odor resembling crushed bed- bugs ; rather different in odor, intensely offensive and pungent when due to either ulceration in chronic nasal catarrh or mer- cury, or syphilis. Best treatment, nourishing food, change of scene, saxifraga and tonics. Locally, douche of boroglycerid, resorcin, inhalation of ozone et chlorine, iodol snuff. OZONE THE GREAT SCAVENGER OF NATURE.— Ozone, allotropic oxygen, has a peculiar penetrating odor, and is the most powerful energetic oxidizing agent known; indif- ferent in its affinities, converting all into the highest forms of oxidation; most destructive to all forms of microscopic life. Ozone is produced artificially in the same manner as in nature, by electric discharges in the atmosphere. It is more abundant on sea billows, on the cliffs of mountains, cloud masses, higher and more rarefied strata. Through the agency of rain, and particularly snow, as well as by the descent of con- densed moisture, it is conveyed to the lower regions of the and Dictionary of Diseases. 66i atmosphere. It is then rapidly decomposed by coming in con- tact with oxidizable substances of either vegetable or animal origin, on which it can exert its effects. Such bodies as car- bonic oxide gas, sulphureted and phosphoreted hydrogen are at once attacked, deprived of their gaseous forms and trans- formed into other combinations which are then transferred to the earth. Air loaded with putrid or miasmatic exhalations is therefore immediately purified by contact with ozonized air, and again a development of such exhalations cannot well take place in the presence of ozone. The action of ozone on such impure air is extremely pow- erful. According to Schoenbein, an atmosphere containing only 1-3,240,000 of ozone is capable of destroying all noxious matter contained in an equal volume of miasmatic air. Ozonized remedies possess the property of imparting or giv- ing off ozone when taken into the body ; of destroying all dis- ease germs in the various tissues. Its penetrating power is im- mense, annihilating disease germs, the factor of morbid action, cleansing and revitalizing all vital organs. The inhibition or taking of ozonized remedies, which have an affinity for the blood and other tissues, gives a higher degree of life, and if there is a partial death restores the lost vitality. It has a special affinity to the dark, germ-laden blood, and restores its natural condition by its germicide property. All diseases are more easily cured ; affections deemed incur- able are now brought into a healthy state. The effect of all those remedies is to promote the formation of arterial blood throughout the entire body and to maintain it at a high grade of purity. Now that it is universally admitted that in all lower states of vitality or conditions of partial death the embryonic living matter of the patient's own body is degraded, altered or changed under the adverse condition into other living matter, a disease germ which is capable, in or out of the body, if the surroundings are favorable, of independent existence and pro- digious powers of multiplication or growth — besides it is well known that disease germs floating in the air, water, in our food, find an abiding place in our bodies and become the factors of special microbic disease. This only happens when vital force is depressd, or if vital force be normal such germs are expelled. The elucidation of the germ theory of disease has completely revolutionized the treatment of all diseases. The most enthusi- astic bacteriologists are well aware that one germicide will not 662 The Germicide 20th Century Practice wipe out all disease germs, for example the glycerite of ozone, guaiacol, pine preparations are most inimical to the bacillus of tuberculosis. Remedies when properly administered and persevered with will destroy every spore and germ in the body, diffuse and penetrate to the most minute gland. The remarkable ozoniferous properties of the succus of the Phytolacca berries in annihilating the parasite of cancer and the pathogenic microbe of rheumatism is too well known to our readers to be recapitulated. The great prevalence of the bacillus of syphilis throughout our country enables those with enfeebled vital force to quaff poison at every breath, is thoroughly wiped out by the adminis- tration of the chloride of gold and saxifraga. The bacillus of typhoid, the outcome of nervous debility, so thoroughly diffused by our system of sewerage as to penetrate all our creeks and rivers, can be easily annihilated by nearly any germicide. Concentrated Ozone. — As a therapeutic agent is a pain- relieving agent of unequaled value in conditions in which its application is indicated and possible, because of its constant effectiveness, rapidity of action, its power of penetration to deep-seated parts, its perfect innocuousness, its freedom from deleterious results. In rheumatism its action is so profound in connection with glycerid of wintergreen that it possesses positive curative power in annihilating the bacillus, and it is a powerful con- tributing agent to the prolonging of life. Many, very many cases of pleuropneumonia could not be cured without it, and the patient maintained in comfort during the attack. It must ever be regarded as an excellent drug to relieve pain and aid a cure. It stimulates tissue repair in a most remarkable manner, as is demonstrated by its action in angina pectoris, upon sprains and intractable neuralgia. It is capable of antidoting septic inflammation of serous membranes, as is seen in pleurisy and peritonitis. It gives us the power of economizing nervous energy by relieving pain, thereby enabling us to refrain from sedatives and cardiac stimulants; it is a remedy which saves, stores the reserve vital forces and tides the patient over a crisis by which he would otherwise be overwhelmed. In some affections its effects are marvelous. Concentrated ozone, three ounces ; oil of horse-peppermint, one ounce. Mix, applied over an hepatized lung, a most dangerous condition in pneumonia; it most effectually disseminates the clot; gives the patient breathing capacity. and Dictionary of Diseases. 66 o As an aid to the induction of painless parturition, it seems to possess a transcendental action upon the sentient nerves of the uterus, and with the aid of the obstetric cones, gives pain- less parturition. In its application to induce painless parturition, first smear the abdomen and loins with warm, sweet olive oil, then smear on the concentrated ozone. One good application is usually sufficient ; still, if not perfectly complete, it can be reapplied. The cones must always be used in conjunction with the ozone. Ozonized Distillation of the Pine. — From the earliest dawn of creative existence the ozonized aroma of the pine tree has been utilized as a curative agent in destroying disease germs, the factors of tissue metamorphosis and death. Re- cently discovered papyrographs show the exhalation from the foliage of this ozone-generating tree, and a decoction made from selected leaves, young shoots and needles, were used by the Egyptians during the captivity of the Hebrews, and also that it was a standard remedy among other ancient nations. Lately eminent chemists have untiringly devoted themselves to a thorough elucidation of the best methods of obtaining, isolating and holding in suspension the germicidal or ozonized principle in the form of an oil, balsam, extract, and a pure distillation by the action of ozone gas, from the young and tender shoots or needles of the ozoniferous tree. From the most careful investigation and rigid chemical analysis, it has been ascertained that the pine trees of Maine and North Carolina, in this country, and the Braemer pine in Scotland, yield or generate the largest amount of ozone. The ozonized distillation of the pine needles is decidedly the only one suitable for internal administration ; it is an elegant preparation, a product of the first rank in chemistry, prepared with the greatest care, so that the ozoniferous principle be specially preserved. It is a pleasant, palatable, easy form of administering nature's ozone. When it once reaches the stomach, it speedily enters the blood, is carried to the blood- forming glands, as the spleen, pink marrow, suprarenal cap- sules, lymphatic and respiratory mucous membrane; wherever it goes it kills the microbes of disease, heals ulcerations and erosions, and restores the parts to a healthy condition ; it stimu- lates a renewal of life in any organ of the body by its germi- cidal properties and keeps the blood free from all germs. This remedy is specially indicated as a great prophylactic to the en- trance or evolution of disease germs in the body. 664 The Germicide 20th Century Practice The great prevalence of asthma, bronchitis, catarrh, con- sumption and kindred affections in this country, due to a want of acclimatization, too much brainwork too rapid atmospheric transitions to the vices of inheritance and a gross civilization, gives us microbes of rare gravity. Such affections demand a ponderous ozone microbe destroyer, such as we here find. Be- sides its germicide action, it is a nutritive tonic of the highest order, promotes an appetite, increases assimilation, brings strength and flesh. Its effect on the lungs, on the mucous membrane of the bronchi, air vesicles, -nose and throat are simply marvelous; it strengthens and heals; changes the area of germ destruction to health. When administered it rapidly diffuses itself into every air vesicle. Ozone et Chlorine. — Chlorozone, a union of the two most powerful microbicides held in solution by permanganate of potassa, readily yields its ozone, chlorine and oxygen to all disease germs, and effectually destroys them. It has been found of great efficacy in chronic nasal catarrh, for the complete annihilation of the ameba which is patho- genic of that malady. Usually used by or in the form of a douche, minimum dose being from 30 drops to a maximum dose of 2 to 3 drams to a pint of tepid water ; use by each nostril alternately. One application, if well performed, eradicates the entire brood of amebas present, followed by some mild antiseptic, a cure follows. Ozone Water. — The great scavenger of diseased blood. Dose: From a half to one teaspoonful in half a tumbler of water, every three or four hours. It is invaluable in destroy- ing all micro-organisms or disease-producing germs in the human blood, annihilates the germs of typhoid fever, of ery- sipelas, of diphtheria, scarlet fever, smallpox, and other con- tagium virum. It is of great value in all nervous diseases, cleansing, purifying, vivifying, vitalizing, and increasing re- newed molecular growth of the entire nervous system. It is true brain or nerve food, vitalizing and feeding, by promoting good blood for healthy brain. It is of great utility in all derangements of the stomach; it annihilates the sarcinse of gastric catarrh, corrects faulty nutrition, the outcome of indi- gestion and malassimilation of food, promotes gestation and lactation, and is a true physical restorer in all cases of sexual debility. It is a remedy of rare value in mental depression or despondency. When uric acid is present in excess, depression of mind and and Dictionary of Diseases. 665 irritability of temper are marked, but give place to a feeling of mental buoyancy when the excess is. got rid of. Many suffer from mental lassitude, and from depression in the morning between breakfast and lunch. It is at this time that the acidity of the urine is the least, and that the excretion of uric acid is normally at its greatest. Alkalies will produce artificially this condition of things by washing an excess of uric acid into the blood. By administering ozone water in sufficient quantity to neutralize the excessive alkalinity of the blood, the mind clears, and a feeling of well-being replaces despondency and heaviness. A strongly alkaline state of blood permits solution of uric acid. in excess, which, in its turn, brings about mental depression. Coincident with increased alkalinity of the blood, excretion of uric acid by the kidneys is proportionately in excess of the average. A dose of ozone water will drive the uric acid out of the blood and diminish its excretion in the urine. Shooting pains in the joints very commonly accompany the disappearance of the uric acid from the blood. The. occasional administra- tion of ozone water will not always cure headache produced by excess of uric acid. It is important that flesh food be eaten sparingly. Stimulants must be avoided. In severe cases the diet must be restricted, and occasional doses of the ozonized uric acid solvent given. Ozone et Formalin. — A union of two powerful microbi- cides is invaluable as a caustic for cancerous growths; as a powerful disinfectant; air sterilizer — the usual quantity used being a tablespoonful to one quart of water placed around a room in flat saucers. The evaporation of it in this form and quantity, gasified in a room of ordinary capacity, is harmless to the respiratory organs, but very vitalizing to the higher principles of animal and cerebral life. In a powdered form, formalin-gelatin, it is the ideal anti- septic of the age; dusted on fresh or infected wounds, it forms a firm scab in a short space of time, and requires no other anti- septic treatment nor any other dressing. Ozone et formalin as a wash or lotion is thus prepared : Take two-thirds of a quart of water, one-third peroxide of hydrogen, two drams each of thymol, formalin, and menthol; mix, Strongest antibacterial lotion known — when applied it kills all germs — saturates the tissues — prevents their decay. Its success has been phenomenal ; it is practically without a rival. Try it, in lupus; simply saturate compresses and apply; its phagedenic ravages cease. 666 The Germicide 20th Century Practice Try it, in eczema, a cutaneous affection, that often taxes the skill of the practitioner, as he often finds that all the various remedies proposed are powerless, until this one is reached. Try it, in cases of bleeding cancer, with offensive discharge ; it is the most effectual lotion to remove the fetor, and checks the hemorrhage, after all the other means fail. Try it, in all parasitical skin affections, which are contagious for adults as well as children, and all those affected with this should be segregated ; they are spread by infection in shaving, hair-cutting, sleeping on railway cushions, towels, drinking- vessels — no matter how or when it comes, apply ozone et formalin; its use is consonant with clinical facts. Ozonized Syrup of Tar. — Dose : From a half to one tea- spoonful, every three hours, or more frequently, so as to relieve -cough. Indicated wherever there are bacilli, or microbes, or micrococci irritating the periphery of nerves imbedded in the "highly sensitive and exquisitely organized mucous membrane of the larynx; thus it promptly relieves the cough of phthisis, by 2 The Germicide 20th Century Practice In all cases there is a fungous organism present, and requires the use of a parasiticide. Boracic acid is the best and safest remedy. It is well not to use it with glycerin, as the glycerin has such a strong affinity for water, and often aggravates. A strong decoction of poppies or elder-flower water can be used with advantage, and they form excellent vehicles for the boracic acid. The boracic acid is excellent, but not so soluble in water as the plain borax. No internal treatment of any use. The diffi- culty disappears as soon as confinement is over, the sugar dis- appearing from the urine. Eruptions and Excoriations about the Pudendi are usually of the character of eczema, and it is also due to the saccharine urine dribbling down, and acting as a local irritant ;. and when the eruption is once caused, this renders it intoler- able and intractable, and excessively irritating in this region, and often incurable as long as the pregnancy exists. The changing of the diet, forbidding sugar, and using light animal food, with eggs, milk, fish, etc., does not do much good. Vase- lin or ozone ointment can be smeared over the part three or four times a day. It will palliate the irritability at least, which is about all that can be done. The difficulty disappears promptly as soon as labor is completed. Any cracks or abrasions should be treated by an infusion of poppies, followed with ozone ointment, which should be used freely. Piles are usually the result of liver trouble, and must, never be treated by sulphur, nux, mandrake, or other liver stim- ulants, because those drugs are active abortive remedies. Keep- ing the bowels regular with fruit, diet, or senna and prunes,, and local cold-water baths, is all that should be attempted. A watery or other discharge from the vagina may be re- lieved with port wine and cinchona. Swelling of the labia is to be relieved with rest. Varicose veins of the limbs to be relieved by a bandage or elastic stocking during the day, and the limb bathed morning- and night, well dried, and then rubbed with extract of ham- amelis. Cramps in the limbs are to be relieved by rubbing. Inability to hold the urine, or retention of urine, is usually- due to pressure and debility. Rest and the use of the mother's cordial, or the viburnum compound, relieve this difficulty. Although we thus deprecate drugging during pregnancy,. and Dictionary of Diseases. 733 and recommend palliation and rest, yet it is not good to the health of a pregnant mother that she house-up too much. She needs gentle, moderate exercise and change, as conducive to a high state of mental and physical vigor. She should not ex- haust her body by work, nor her brain by worry or study. She should cultivate the higher and holier attributes of her nature; avoid as much as possible sameness or monotony. Avoid literary pursuits above all things, as it wearies the mind and arrests brain development in her offspring. Undue tightness of the abdomen is best relieved by rubbing it with warm olive oil once or twice daily. Spurious Pregnancy. — This is a peculiar condition, which sometimes gives rise to all the symptoms of true pregnancy, even the morning sickness, the suppression of the menses and the progressive enlargement of the uterus having a perfect resemblance to a genuine gravid uterus. It will even commu- nicate the sensation of movement, or tenderness on pressure, and dullness on percussion; the breasts may increase in size, and even secrete milk, and the progressive enlargement of the abdomen may continue for nine months, and the phenomena of labor supervene. The pains may even come on and suc- ceed each other, becoming stronger and stronger, and latterly ceasing by a return of the abdomen to its natural state, and perhaps a slight fever. On an inspection of the tumor, it is most generally in the centre of the abdomen. The navel is more protruded ; there are no striae over the abdomen. On feel- ing it with the points of the fingers, the tumor is elastic, and its boundaries can be traced easily. It has no connection with the liver, spleen, ovaries, or uterus ; no sign of fetal heart or rum- bling noises. The cause of this phantom tumor is some exhaustion of the cord, bulb, and base of brain — a true condition of anemia, ex- haustion, and irritation which is transmitted to the diaphragm and other abdominal muscles, which causes contraction and gives rise to an appearance exactly resembling a body, or gravid uterus, or tumor. If there is any doubt about it, place the patient under chloroform, when the contraction will entirely disappear. In such cases, when carefully examined, it will be found that the general health is feeble ; there is great exhaus- tion of the nerve-centres, or strong hysteria. We use the term because we have no other by which we can describe the morbid condition of the cord that is present. There is likely to be associated with it irregular uterine functions, dyspepsia, ovarian 734 The Germicide 20th Century Practice irritation, or some form of chronic disease. Same treatment as for hysteria. Deformities and Mutilations. — It may be laid down as a general rule that all deformities, such as harelip, club-foot, imperfect arms, etc., are due to incompatibility of temperament or close consanguinity ; whereas mutilations, monstrosities, are due to shocks, frights, impressions, sights made upon the mother during the embryonic period, the first three or four months of intrauterine life. Probably amputations of the arms or limbs may occur later. The prevention of deformities is in the hands of the parties entering the matrimonial field, and should be regulated by stringent laws ; whereas the prevention of mutilations is in the hands of the mother alone; she should avoid reading all dime-novels, fictitious literature, going to theatres, witnessing the killing of fowls or animals, or of seeing, hearing, or feeling, any strange or abnormal thing that would be likely to vividly impress her. The question is often asked, Is there a microbe in pregnancy ? No doubt there is a toxin generated in all cases, either by a germ or by changes incidental to that condition. No microbe has been as yet found ; nevertheless there is a toxin formed in the blood, which gives rise to headache, toothache, perversion of appetite, vomiting often severe, uncontrollable albumin ex- hibiting damage from a poison upon the kidneys, which ir- ritates, lowers nutrition, causes spasmodic constriction of the arterioles, either by direct irritation or through the vaso- motor centres ; as it passes off gives rise to uremia. The poison has defied detection, yet its presence can be demonstrated be- yond question. It may be absorbed from the bowels ; the liver may be at fault, which, besides its glycogenic function — urea- forming function, is charged with neutralizing toxins, which find their way into the circulation. Uremia is a retention of toxic bodies in the system. Every pregnant woman should take daily wine of aletris farinosa ozonized. It is of definite and immediate advantage. It relieves every symptom, even gastro-intestinal catarrh, the mother of intestinal toxins ; it protect the system, imparts tone and vivacity to the nervous system, strengthens the heart muscles. Pregnancy, or its toxin, bears heavily upon the heart ; it is not the strain of labor; there is something else in that state prejudicial to a weak heart, depreciating cardiac vigor, and that something is completely overcome by a liberal use of the ozonized wine of aletris farinosa. and Dictionary of Diseases. 735 PRIAPISM. — Erection of the penis, not transitory, but permanent. 1. Priapism observed in infants and children, induced by reflex action, in cases of long, light, adherent prepuce, of stone in the bladder, or prostatic urethra, and of worms in the rectum. 2. Priapism in adults symptomatic of stone in the bladder, stone in the prostatic urethra, stricture, cystitis, and observed during retention. In these cases the uneasy or painful sensa- tion is felt in the glans penis, while the body of the organ usually is only moderately congested, and sometimes curved downward or laterally. This condition disappears upon the removal of the cause. 3. Priapism symptomatic of gonorrhea, with perhaps in- volvement of the corpus spongiosum and downward curvature. This condition is painful and transitory, and may occur several times during the night. In cases of downward curvature of the penis, clue to inflammatory engorgment of the corpus spon- giosum and spasm of the musculature of the urethra, the term chordee is applied. 4. Priapism due to the ingestion of cantharides is a form that is seldom or never seen now, since this drug is so rarely used in medicine. 5. Essential priapism may be divided into four varieties : (a) Priapism caused by injury to the spinal cord (either high or low down), and by blows or violence inflicted upon the per- ineum; (b) priapism which is a symptom of the cerebral or descending spinal cord disease ; (c) priapism which occurs after alcoholic and sexual excesses; (d) priapism which comes on a person in ill health, in whom it is difficult to obtain data as to local injury and causation, and in which cases there is now a tendency to look upon leukemia as the etiological factor. In all cases, irrespective of cause, administer equal parts of tincture passiflora incarnata and green root tincture gelsemium ; small doses, but very frequently administered until this dis- turbing symptom is relieved. PROLAPSUS. — The falling or displacement of organs from their natural position is not uncommon, in parts that are either weakened or devitalized, subject to pressure. Prolapsus or Falling of the Rectum is quite common. Protrusion of either the mucous or muscular coat of the bow T el is due to debility; and produced by straining at stool, due to constipation, or the tenesmus of dysentery ; irritation of asca- rides, piles, or enlarged prostate. 736 The Germicide 20th Century Practice In all cases, the bowel should be immediately returned, if pos- sible ; for if not returned it becomes swollen, greatly tumefied, and covered with an epidermis. If unable to return it the sphincter should be placed under the influence of belladonna in the form of a cerate, and if it does not act speedily cocain also should be used; once returned, it should be kept in position by a pad or compress and a T bandage. Then the contents of the bowel should be rendered soft by the internal use of the fluid extract of juglandis, and injections of some astringent, as either decoctions of the witch-hazel or oak- bark, or hydrastis, or perchloride of iron, or the following" rectal tonic : Take one ounce of aromatic sulphuric acid, one dram of sulphate of quinine, dissolve the quinine in the acid,, then add sixteen ounces of water. Inject three teaspoonfuls twice daily. If after a proper course of treatment with these and like rem- edies, all fail, the contents of the bowel should be removed with castor oil, after which an anal speculum should be inserted and through its window seven vertical streaks made at equable distances by fuming nitric acid, bowels locked up for a week with opium. If perfectly performed this usually effects a radical cure. Prolapsus of the Womb. — There are three principal forms : ( 1 ) simple prolapsus ; ( 2 ) anteversion ; ( 3 ) retro- version. In simple prolapsus the womb, situated in the upper and middle part of the pelvis, is but imperfectly secured in its natural position; hence it sometimes descends, so as to pass more or less downwards in the vagina, or even protrude beyond the vulva. Protrusion of the uterus gives rise to distress in both bladder and rectum ; bearing down ; dragging in the loins, aching in the thighs, aggravated by the erect position. In the successful management of such cases, two points are essentially necessary to be observed to return the organ into its natural position and maintain it there. For this purpose strengthen the walls of the vagina, brace up the broad liga- ments, improve the general health. In all relaxed, devitalized states of the vagina the mucous coat is literally swarming with the germs of disease, which give rise to an endless variety of leuckorrheal discharges, which, if not eradicated, go on weakening this structure ; hence, to a scientific and Dictionary of Diseases. j^~ -mind, mechanical support is inoperative and injurious, and should be dispensed with except in rare instances. To strengthen, tone up, promote a renewal of life in the vaginal walls and contract the broad ligaments, the remedy is the use of the nymphae odorata pastils. By their use all germs and leuckorrheal discharges disappear, and there is no use for womb supporters. To still more effectually vitalize, matricaria comp. before meals and the wine of alteris farinosa after meals. Practitioners will find it of utility in all weakened states of the reproductive organs to produce leukocytosis by the nightly introduction by the protonuclien suppository and follow up the cure with thyroid extract and c. p. solution of spermin, which is the ultimatum of gynecological science. Anteversion of the Uterus. — The fundus falling for- ward. Rare. Those of pressure of urethra or rectum ; tumor in anterior wall of vagina; with retention of urine, and con- stipation. Vesical calculus; retroversion; pelvic tumors; ovarian tumors. Retroversion. — The fundus falling backward, the cervix impigning against the urethra ; in less degree, the fundus being only tilted back, termed retroflexion. Derangement of men- struation; aching pains in loins and back; tumor in posterior wall of vagina. Dyspepsia ; hysteria ;• retention of urine ; con- stipation. Diagnosis. — Tumor in pelvis; ovarian disease; anteversion; ascites. Both conditions must be rectified by mechanical support. Inversion of the Uterus. — The organ descending, and turned inside out; (i) partial; (2) complete. May occur im- mediately on delivery ; a few days after parturition ; or grad- ually, from weight of a uterine tumor; sudden and alarming- exhaustion ; paleness; pulse rapid, small and fluttering; vomit- ing; often violent uterine contraction, as if to expel a second child ; globular, elastic tumor in the vagina, or protruding from the vulva ; in the gradual form, symptoms less marked. Seq ; Exhaustion; fatal hemorrhage; cystitis; gangrene of the in- verted portion ; sloughing. Polypus ; uterine and vaginal pro- lapses. Fatal, unless speedily reduced. This must be done by gradually returning the superior part, by grasping it with the hand, and making the rest follow. PROSTATE GLAND. — In inflammation of the substance 738 The Germicide 20th Century Practice of the prostate, besides the symptoms of granular prostatitis, there are aching or stabbing pains in the anus, sacrum, or per- ineum ; pain at the suprapubic region is a common sign. There are also radiating lumbar or femoral pains after exercise or long journeys, languor, malaise, or depressed spirits. Increased frequency of micturition is often absent ; when present, it is felt by day, not by night. The flow of the urine is altered by delay at the beginning, which may amount to retention. Dull pain after micturition, sometimes spasm at the end of the flow, with a sense of more to come, are complained of. In cases of long standing, micturition during sleep is a symptom, — constipation is almost invariable. When the congestion is great, there is pain during defecation and between the acts a sense of weight at the anus or in the perineum. Pain in the testes when it oc- curs is simply a neuralgia. There is constantly hypersecretion of mucus. In some patients, the organ recovers its natural condition in a few weeks ; but usually the disease drags on a course more or less wearisome; thus the termination is very uncertain. Re- lapses are almost sure to follow if the patient exceed in his diet or regime. In relapses small abscesses often collect in ob- structed ducts, which usually empty themselves through a duct before accumulating much. Sometimes the inflammation spreads to the parenchyma, and the prostate then becomes un- yielding to the touch, hard and sensitive. The enlargement of the organ may last long. The increase in size may be sym- metrical, or only affect one part, giving the sensation of ir- regularity or lobular form when felt by the finger. In course of time, the nodules may disappear, and the organ regain its natural size, or even shrink below it, and feel quite firm and smooth. The treatment of all forms of prostatitis is always obstinate and tedious — of the many remedies in use, few are trustworthy. General treatment assists the local remedies. General altera- tive and tonic course. If the cause of the inflammation be due to sexual excesses, the introduction of bougies, cyclism, gonorrhea, insist upon rest and the general treatment of inflam- mation. The prostate is a purely sexual gland, coining into activity at puberty, liable to damage from many causes, hence a diseased prostate is the most common of all maladies incidental to the male. Irritation, effusion of lymph into its structure, its organiza- tion into fibrous tissue, excessive growth, hypertrophy. and Dictionary of Diseases. 739 It is superfluous for us to state that masturbation, imperfect coition, withdrawal in the act of ejaculation, congress with women of the town, sexual incompatibility, gonorrhea, with its common sequel inflammation of the seminal vesicles; bicycle riding, sedentary habits, horseback exercise, are most pro- ductive of an enlarged prostate; age, with its degenerative changes, has now little to do with its approach, for we find it common in young and middle-aged men. An enlarged prostate gland is a source of much tribulation to its possessor ; reflexly the brain suffers ; also all the genito- urinary organs — irritable bladder, the evolution of the micro- coccus urese, frequent nocturnal micturition, obstruction, etc. The relief or cure of an enlarged prostate by oral medica- tion is a failure, even with the most efficient remedies ; hence its removal by a surgical procedure has been attempted, but few survive, as it is an operation of great danger. It has been known for many centuries that if the testes were removed the prostate gland would atrophy, and all the dis- tressing symptoms of hypertrophy would gradually disappear. Castration has been tried, as it is an operation comparatively devoid of danger to life ; it is thought well by some, although it completely wrecks the cerebrum. Once the spermatic cord is cut, there is a mental death, the brain fissures of thought suffer obliteration; the pulse rate is lowered, never again to be re- gained, for intense mental depression, melancholia, mania, follow rapidly for want of the internal testicular secretion ; so that neither removal of the gland itself nor the testes can be of any real benefit to suffering humanity. To some extent the intrinsic value and efficacy of the internal secretion of spermin can be compensated for by the administra- tion of the protonuclein and c. p. solution of spermin and a course of direct medication to the prostate per rectum. Internally tonics and the best of nutrition, locally enemas twice daily of either a decoction of slippery elm or linseed, medicated with either boroglycerid or dioxide of hydrogen or both ; following these insert a boroglycerid suppository, and in one or two hours later insert an ichthyol suppository. The action of the boroglycerid on the rectum is sedative, anesthetic r the action of the ichthyol is that of a powerful absorbent. In two or three weeks there is a great change for the better, for there is usually a rapid absorption of organized lymph, a sub- sidence of congestion ; cystitis disappears, the phosphatic blad- der deposits disintegrate. 74-Q The Germicide 20th Century Practice PROSTATIC HYPERTROPHY AND ATROPHY.— This occurs in 85 per cent of all civilized men, and is usually either the result of prostatitis, cystitis, calculi, excess of uric acid or phosphatic deposit, congestion of the kidneys, badly cured gonorrhea, strong injections, careless introduction of bougies or sounds, stricture, masturbation, wearing condums, withdrawal in the act of ejaculation, excess and incompatibility or sexual connection with prostitutes, or with women with large vaginas, inebriety, licentiousness, dalliance in coition, constipa- tion, rectal disease, sitting on the cold earth or stone, or, in other words, whatever increases the circulation in those parts beyond a healthy standard ; besides, blood-vessels lose their tone in the decline of life and under mental strain or worry of a high grade of civilization. Besides, in all men of a lymphatic or gouty diathesis, in middle-aged or old men there is a natural tendency to enlargement from the presence of uric acid and lithate of soda in the blood. From whatever cause the enlargement may arise, it is pro- gressive, and may involve the whole gland, the middle or one or both lateral lobes. As a general rule, whatever the cause may be which gives rise to it, the middle lobe does not appear to suffer so frequently, and is tardy at taking on enlargement even when the two lateral lobes are considerably engorged. When the middle lobe begins to enlarge it closes up the en- trance into the bladder, and presses inward toward the cavity of the bladder, putting the internal lining membrane on the stretch, and carries with it, by immediate continuity, the in- flammation which causes its own enlargement. Whatever may have been the original cause, masturbation, excesses, gonorrhea, etc., there is an irritation, inflammation of the entire mucous membrane from the orifice of the urethra to the kidney ; the inflamed state of the lining membrane of the bladder and prostate gives rise to irritable micturition, par- ticularly as the last few drops are voided and a desire and straining to make more, although the bladder is empty or there may be but a dribbling, with constitutional disturbance. In the majority of cases the difficulty lies with the middle lobe, and as this increases in size it projects into the cavity of the bladder in the form of a nipple, pushing the membranous covering and that in close proximity before it, so as to put it on the stretch in the direction from the ureters to the verumon- tanum. In its gradual enlargement it loses its nipple-like ap- pearance, becoming broader from side to side, and ultimately involving the lateral lobes. and Dictionary of Disease?. 741 As the enlarged prostate is located immediately behind the orifice of the urethra, every time micturition is performed the anterior portion of the bladder is pushed forward, bladder con- tracted, retention of urine, never completely emptied, great pain; straining efforts at micturition accelerate the progress of the hypertrophy. As the enlargement progresses, rectum and bladder grow more irritable, dribbling, retention ; cavity of bladder distended. Revert to the bladder, the trigone or floor of which is highly sensitive, contains very few muscular fibres in its composition, so that just above the prostate muscular contraction can hardly be said to exist. Assuming then that the prostate is irritated, that a partial retention of urine occurs from some cause, habit, position of the body, loaded rectum, or weakness connected with advancing years, the trigone or non-contractile part of the bladder becomes prematurely depressed or altered in form, so that the person finds himself unable to get rid of the last half ounce of urine — the effect will be frequent repeated efforts to throw it off; these devitalize the muscles adjacent and render them destitute of contractility. This condition leads to hypertrophy or thickening of the pros- tate and all the tissues around, with an irresistible desire to empty the bladder as a constant and annoying symptom. The quantity of urine which is retained varies greatly, but let it be small or large, a micrococcus urae is generated, a patho- genic microbe which breeds freely, acts as an additional irritant, tending to greatly aggravate the disease. The patient is in constant pain and distress, great constitu- tional disturbance, progressive enlargement continues. As the seminal ducts open into the urethra in its prostatic part, and as these ducts traverse this gland, seminal weakness and irritation are invariably present ; so irritation of the pros- tate leads to the production of spermatorrhea, impotency, and complete retention of urine. The secretion from the whole gland is abundant, viscid, ropy. Its quantity depends upon the amount of irritation, the act in straining ; its tenacity varies ; often has an offensive odor. The effects produced on the coats of the bladder by an en- larged and still enlarging prostate are thickening of the walls, contraction, with its internal lining membrane throwing off shreds of the thick, coagulated pus. Enlarged prostate with obstruction to the act of micturition predisposes to numerous grave affections, as formation of cal- 74 2 The Germicide 20th Century Practice culi when the bladder is unable to empty itself, especially if the middle lobe is enlarged and the orifice is blocked up, so that it is impossible for urine heavily charged with uric acid, triple phosphates to make an exit. As a general rule less urea is excreted, hence there is a state of uremia existing at all times. The reflex effect upon the nervous system is most disastrous, as is exhibited in the mental disquietude, irritability and reslessness. The facts in connection with uric acid in enlarged prostate may be summarized as follows : It is manifest that the uremic condition is dependent upon a failure in the proper perform- ance of the functions of the kidneys. That, in consequence of this failure, certain matters accumulate in the blood and the tissues, the most important being uric acid. That the amount of the retained uric acid, all things being equal, is propor- tionate to the uremic poisoning. That when urea is introduced into the blood, under conditions which preclude its elimination, it is followed by uremic poisoning. Lastly, that the intro- duction of no other excrementitious matter, as far as is known. is succeeded by like symptoms. The affection is of easy recognition : the frequent and urgent desire to urinate and thus relieve the bladder: a scalding in urinating; a sense of fullness, weight in the perineum, rectum. and at stool, a feeling as if there were some body to pass. Pains radiating through the hips and thighs, a constant sense of un- easiness about the loins. Besides, the enlarged prostate can be felt per rectum. An examination of the urine, and also of the residual urine which is retained in the bladder, will exhibit the microbes of micrococcus ureae, and an intense uriniferous odor. The mi- crobe of ammonia in fermentation of urine is ever present. The presence of this fungus in the urine indicates an alkaline state of that fluid, and is almost invariably present in hyper- trophy of the prostate. The presence of this fungus gives rise to an increased sensation of fullness or discomfort in the per- ineum, increased during defecation, aggravated by standing, walking and sexual intercourse. Usually a loss of power of seminal emission. It is clear that the influence of the testes upon the growth and maintenance of the characteristics of the male sex is a property independent of their power in producing spermatozoa, and the very remarkable fact is established that the spermatozoa-pro- ducine facultv of the testes is not necessarv for the vital- and Dictionary of Diseases. 743 izing influence which those organs exert upon the rest of the body. The natural involution of the testes in the aged is unaccom- panied by any corresponding change in the system, but if the testes in an elderly man be removed, the prostate and accessory glands wither, atrophy, disappear, and the mind weakens. This idea has been taken advantage of by the introduction into surgical practice of the removal of the testes as a radical cure for enlarged prostate. As far as it goes the operation is a success so far as it atrophies the prostate, but it removes the seminal cells which secrete a substance which is reabsorbed, has a most remarkable influence upon the nerve-centres, controlling growth, nutrition, sex. Since the inauguration of the germ theory of disease, there has been an immense impetus given to scientific medicine, so much so that a complete revolution has taken place, and the materia medica has been searched for a remedy to diminish the size of the prostate, one capable of completely annihilating its growth, of absorbing its adventitious matter. To a certain extent success has attended in the production of the ichthyol suppository, which if properly managed will do the work. Patients are naturally impatient; medical men are doubtful, often hesitating, but if they could only be induced to enter the field with the same positive assurance of success as the surgeon, the prestige of ichthyol in enlarged prostate would be a success. For the exhibition of this suppository the bowels should be flushed, then a cocain or boroglycerid suppository should be inserted, preceding two hours the insertion of the ichthyol. The cocain or boroglycerid used in that manner produces a complete anesthesia of the rectal nerves. Then the ichthyol should be inserted. Usually in four or five days of its use the patient can urinate without the catheter. Once commenced, the entire procedure should be carried out daily until the prostate has been reduced to its normal size. We are opposed to the castration of all our old men and many young ones, because the mutilation deprives them of all the characteristics of manhood and gives rise to insanity, but we are in favor of castration of every epileptic or insane in- dividual who is so afflicted as the result of masturbation. Use with care, all the necessary precautions, and give ichthyol a trial, for it will reduce the size of the prostate, induce 744 The Germicide 20th Century Practice atrophic changes which terminate in permanent reduction. It effects this by causing the cessation of congestion, by diminish- ing the blood through the gland, causing contraction of the walls of the vessels, exciting reflex muscular spasm, which operates like the black willow bark. The present state of our knowledge does not justify us in re- moving the testes at the risk of precipitating dotage or mania. Hypertrophy of the prostate is associated or caused by stric- ture of the urethra, an obstruction to micturition, in which con- siderable force is necessary to expel the urine. This causes ?the muscular coat of the bladder to become thickened, hyper- trophied; in which bands of lymph are thrown out, sacs form which retain urine. This sacculated condition may extend over the entire inner wall of the bladder. These sacculi vary much in size, some become capacious, others quite small. Whatever ~l>e their size, they retain residual urine, which undergoes de- composition ; an evolution of the micrococcus urese takes place, the toxins of which produce cystitis and other grave symptoms. Suppositories of boroglycerid, urethral bougies of iodol; inject bladder once daily with ozonized witch-hazel, one ounce to four of tepid water, with uric acid solvent internally. This is rather a gloomy view in a national point of view, because a damaged prostate is the inevitable precursor of a diminution of sexual vigor and impotency. A normal prostate is composed of fibrous tissue, gland struc- ture and involuntary muscular fibres, but in the hypertrophied organ the normal proportions of the several constituents are seldom preserved. In most cases the fibrous tissue is increased more than the glandular and muscular structures, and the organ is thus more dense and firm than normal. The enlargement may take place in the entire gland ; all its three lobes may be equally affected, although it is much more common to affect the left side first, and subsequently involving the entire three lobes. The extent or size of the enlargement varies much, but even a slight degree of enlargement not in- frequently causes as much trouble as a more decided hyper- trophy. The most eminent authority says that when the hair becomes ^ray and scanty . . . the prostate gland becomes in- creased in size, and this irrespective of age. Nine men out of :eneficial action upon the whole body, inimical to all pathogenic microbes. Very eminent authority shows that, independent of morbid conditions, uric acid is a derivative of animal food, beer drink- ing, monotony, isolation, besides being responsible for very many pathological states. "To dispose thoroughly of a meat diet, requires active, vig- orous digestion, fresh air;" change, active growth and devel- opment ; in adults who have attained the maximum of growth, body completely built up, all that is necessary is food, fuel, to run the machine, repair waste, keeping at the same time secre- tions active. The trouble with our people is eating too much animal food, carbonaceous drink, which is imperfectly di- gested, neither oxidized nor eliminated, but lingers in the body in the form of nitrogenized mast or uric acid ; true restricting the diet to two full meals daily, well eaten, proper quantity and quality is sufficient for brain and muscle, with daily baths and massage. The symptoms of the uric acid diathesis depends greatly upon the degree of saturation, whether these be simply enough to circulate in the blood, or to form a precipitation in the urin- ary organs, or merely periodic attacks, spring, fall and damp weather, with a varying susceptibility, but always irritating weakened tissue. One man may have it in an overtaxed brain, another in his exhausted back, another in his devitalized blad- der and prostate, another in his head from excessive worry or fret. In every ache and pain, indigenous to civilized man, uric acid, perverted nutrition is the origin of the trouble, and it must be eliminated or neutralized, its excessive formation checked. Uric acid, being simply the ashes of muscular structure, a product of destructive metamorphosis in malnutrition, it must be eliminated by the administration of the ozonized uric acid solvent — its formation must be prevented, by all possible means calculated to improve the general health and a perfect dietetic reform. In this very general form of human suffering there is little 982 The Germicide 20th Century Practice use in placing reliance upon fraudulent preparations of the lith- ium salts, when we have in this preparation one much more efficacious. Uric acid, head and heart ache, due to its presence in the blood, disturbs the vasomotor system of nerves, giving rise to spasm of the arterioles, damming the blood in the great arteries and heart — in this condition the blood needs the action of the uric acid solvent, which cleanses the blood, completely over- coming the condition of lithiasis. A condition in which we have uric acid in excess in the blood and secretions, the result of destructive nitrogenous metabol- ism, with lack of elimination. Uric acid is formed in the liver and spleen and excreted by the kidneys in the form of urates, In gout and anemia it accumulates largely in the blood, as a re- sult of defective oxidization. Monotony, isolation, sorrows, want of exercise in the open air, indoor life or occupation, mental strain, worry. The symptoms -of the uric acid diathesis, excepting gout and rheumatism, are protean in number and variety and are ex- ceedingly hard to classify. Among those affecting the diges- tive system are anorexia, discomfort after eating, flatulence, pyrosis and persistent constipation ; of the urinary organs, a sense of heat and burning after micturition, frequent micturi- tion and pain over the region of the kidneys ; the pulse may be irregular and intermittent, there is increased arterial tension and sometimes attacks of palpitation, and there is generally present great depression of spirits and a general sense of weari- ness and inaptitude for effort of any kind. The sleep is rest- less, and on awakening in the morning the patient feels as tired or even more so than on retiring. When this acid irritates the nervous system there is vertigo, amaurosis, tinnitus aurium, muscular pains and cramps, head- ache, neuralgia, affecting various parts of the body, spinal irri- tation, vasomotor disturbances, insomnia, nervous prostration : heat and burning in the skin, itching, pruritus, choreic and epi- leptiform seizures, mental hallucinations, are not uncommon. The urine of individuals suffering from the uric acid diathe- sis is highly acid, of a dark golden color, and contains a sedi- ment of uric acid crystals, seldom deposited pure, but in combi- nation with other salts, forming urates. As to the treatment of the uric acid diathesis, much has been written, many remedies advocated, and extensive clinical ex- perience tested their utility. and Dictionary of Diseases. 983 No remedy in the materia medica so highly esteemed and ap- preciated by the profession as the ozonized uric acid solvent. In this remedy we have a combination of the most valuable de- scription with the salts of lithia and potassa. a powerful solv- ent and efficient eliminator. Its use is always followed by the most beneficial results. At the time this chemical solvent is being administered, it is found extremely advantageous to prescribe before eating a full dose of the comp. tincture of matricaria in a glass of water. Always best to aid it with daily bathing, half an hour or more massage, flannel clothing, considerable outdoor exercise, some occupation that will absorb attention, wipe out melancholia, and regulation of diet. Ozonized Uric Acid Solvent. — This remedy is one of great value, being composed of vegetable agents that have a direct solvent action on uric acid and negative ozone ; it is of value and great efficacy in all derangements and diseases of the kidneys, which have their origin in an excess of uric acid in the blood, particularly in incipient Bright's disease, diabetes, cystitis, dropsy, calculi, hematuria, rheumatism, neuralgia, an- gina pectoris, and functional disorders of the heart. In the neurasthenic condition of our people, anemia of the brain is decidedly common, and uremic amaurosis, caused by edema of the structures of the optic nerve, from irritation of the urea in the blood, is not only prevalent but persistent. In the treatment of ocular affections occurring in renal dis- ease, the pushing of this remedy is often the best that can be done for the eyes. The part that the uric acid plays in the production of morbid conditions is now fully recognized. It is accountable for a long train of symptoms — many obscure, many not easy to formulate. There is reason to believe that nearly all cases of periodic, or paroxysmal headache, melancholia, neurasthenia can be traced to this cause. Then rheumatic affections, tonsillitis, cutaneous irritation, as in the various forms of eczema, anemia and men- strual disorders. Uric acid in the blood must be recognized as a powerful fac- tor in the causation of diseases. Normally, uric acid is simply the ashes of the fibrin of the blood and muscles; abnormally, it may be due to many other causes: certain foods and drink are most productive of it, in- 984 The Germicide 20th Century Practice dependent of dietetic indiscretion ; nervous shock and prostra- tion, monotony; gout, including certain hereditary traits; vis- ceral sluggishness, growing old, and the inability of the organ- ism to accommodate itself to the change of environment; cli- mate, and probably the prime mover in the production of uric acid is the distinction between healthy youth and maturity. Every one of our readers realizes that the only solvent for this acid in the blood, in the renal organs, is the ozonized uric acid solvent. This remedy is not in itself curative, but dis- solves and aids its elimination. To render this remedy pala- table administer it in some light wine. To cure the uric acid diathesis banish care, worry, regulate the diet, overcome the sluggish liver with periodate aurum, matricaria, or a prolonged use of concentrated kurchicin, with daily baths and massage. Uric acid in the blood, circulating through the kidneys, acts as an irritant and excites a growth of connective tissue, which blocks up and destroys the secreting faculty of those glands; the lodgment of this acid in the kidneys cripples their func- tion ; they become inadequate as depurators of the blood ; inter- stitial nephritis is the outcome of the uric acid formation, which in such cases is liberated freely from the liver. Alcohol, carbonaceous food and drink, malaria, insanitary states cripple the liver by too much work, and an excess of uric acid is the result. The use of the ozonized uric acid solvent has a most salutary effect upon both liver and kidneys. It is a remedy that flushes the tubules and relieves the congestion — the renal inadequacy. The physiological 'action of this remedy is based on the rec- ognition that the uric acid in the body can only be got rid of by a process of oxygenation, and it must pass off by the kid- neys, never by the bowels. Purgatives do no good, simply de- plete and leave the renal secretion concentrated, so that the uric acid requires a very large proportion of fluid for its solution, blocks the tubes of the kidneys in the form of crystals. Very generally administered in lithiasis, in chronic cystitis, irritability of the bladder, chronic rheumatism, neuralgia. In cases where it is necessary to bring about a solution of the urates, the following formula proves invaluable : Ozonized uric acid solvent, one ounce ; simple elixir, three ounces ; mix. A teaspoonful once in three hours. In typical cystitis, with vesical tenesmus, irritability of the bladder so great that retention of urine is impossible; in the and Dictionary of Diseases. 985 above doses symptoms rapidly decline, mucus, pus, micrococ- cus urese disappear and retention of urine becomes possible. In suppression of urine, from uric acid irritating the kidneys, the action of this preparation is simply marvelous, diuresis appearing, the urine becoming abundant and free from all abnormal substances. URIC ACID SOLVENT (Ozonised).— Most efficacious in dissolving uric acid concretions or formations in both liver and kidneys. No remedy so effectually relieves a crippled kidney as this; it dissolves and washes the debris away, and renders the kidneys able to act as depurators of the blood. It relieves renal inadequacy by its solvent action, flushes the tubules and obviates the state of interstitial obstruction. Dose. — From a half to one teaspoonful added to water every two or three hours. URINALYSIS. — In the examination of urine the specimen should be taken from the whole quantity (well mixed) passed in twenty-four hours — that passed, say, from 7 o'clock one morning to the same hour the following morning, and should be tested before decomposition sets in. The principal points of note are enumerated in the following: Quantity. — The amount voided in twenty-four hours varies, normally, within wide limits. The normal amount is usually- stated as fifty fluidounces. Increased. — By excessive ingestion of liquids, as water, beer, milk, etc. ; by cold and damp weather and other conditions in- terrupting cutaneous transpiration; in diabetes, hysteria, in contracted kidney and waxy disease of the kidney. Decreased. — By ingestion of small quantity of liquids; in hot, dry weather (excessive perspiration) ; in diarrhea; in feb- rile conditions; in the earlier stages of dropsies; in certain forms of Bright's disease. Color.— The color of normal urine is that of amber or slightly reddish-yellow. The color of urine is much affected by food and medicine, as well as by many morbid conditions. Santonin colors it a bright yellow ; pyoktanin, a blue ; madder,, logwood, rhubard, a red or brownish-red ; strong coffee, tur- pentine, creosote, carbolic acid, etc., render it dark. A red or smoky color may indicate blood; greenish-yellow or brown„ bile; whitish or turbid, earthy phosphates (excess), pus, or mucus. 986 The Germicide 20th Century Practice Decreased quantity of urine is usually accompanied by in- crease in color, as in febrile conditions, etc., and vice versa, as in diabetes, hysteria, etc. Reaction. — Determined by the use of litmus-paper — acid turns the blue, red; and alkaline, the red, blue. The normal reaction of the urine is slightly acid, though at times it may be neutral. Nitrogenous food increases acidity; vegetable food decreases it. Some drugs influence the reaction of the urine, e. g.j organic acids (citric, tartaric, etc.), and their salts with the alkali bases render the urine less acid. Mineral acids ren- der the acidity greater. Alkalinity is generally due to decom- position of urea into anmonium carbonate, seen in retention, cystitis, etc. In this case, gentle heat will restore the red color of the litmus-paper used. Odor. — Normally, characteristic, urinous. Concentration increases odor. Many foods, as asparagus, and drugs, as cubeb, turpentine, etc., greatly influence the odor. Turpentine gives the odor of violets. In diabetes mellitus, it is fragrant; in cystitis, retention, etc., with decompositon, it is fetid. Specific Gravity. — Most conveniently ascertained by means of a urinometer. The urine should be at or very near the tem- perature at which the urinometer was graduated (generally 60 degrees F.), and in a vessel sufficiently large to permit the instrument floating free of the sides. Read the sp. gr. from the top of the meniscus, on a level with the eye. The sp. gr. of normal urine is 1,015 t0 I ?° 2 5- ^ n infants it is Ioav — 1,007 to 1,012. By multiplying the last two figures of the sp. gr. by 2.33 (Haser's coefficient) a close approximation to the number of parts, per 1,000, of solids contained may be ob- tained, and from this the total amount of solids passed in twenty-four hours may be easily calculated, which is normally fifty-three to sixty-seven grains (800 to 1,025 grains). Increased. — In diabetes mellitus ; in cyanotic induration of the kidney; in acute diffuse nephritis; in concentrated urine, etc. Decreased. — In diabetes insipidus; in Bright's disease; by fasting ; in copious quantity of urine, etc. Average Composition of Normal Adult Urine (Leh- man). — Water, 932.019; solid matter, 67.981; urea, 32.909; uric acid, 1.098; lactic acid, 1.5 13; lactates, 1.732; water ex- tract, 0.632 ; spirit and alcohol extract, 10,872 ; sodium chloride, ammonium chloride, 3.712; alkaline sulphates, 7.321; sodium phosphate, 3.989; calcium and magnesium phosphates, 1.108; mucus, o. no. axd Dictionary of Diseases. 987 Variation in Quantity of Normal Constituents. — Uric Acid — Tests. — A roughly approximate test of the dimi- nution or increase of uric acid in urine may be applied as fol- lows : Place in a test-tube two fluidrams of the urine to be ex- amined and the same quantity of normal urine in another test- tube. Now acidulate each with hydrochloric acid and set aside for twenty-four hours. A comparison of the two sediments (uric acid) will show the relative amounts. Increased. — Excess nitrogenous food; excessive tissue waste; diminished oxidation; gout; rheumatism; general mal- assimilation ; diseases of the liver. Decreased. — By vegetable diet: exercise: in chronic Bright's disease, etc. Urea — Tests. — Place two fluidrams of urine in a test-tube, add one-half fluidram of colorless nitric acid and set the tube in ice- water. If urea is in excess, the characteristic crystals of urea nitrate will be precipitated. Increase of urea raises the sp. gr. of the urine. If the sp. gr. of the urine is lower than normal and no precipitate is obtained by the above test, evaporate two fluidrams of the urine to one-half its bulk, then apply the test as before. If no precipitate, the urea is below normal. If there be no abnormal ingredients present, e. g. f glucose, albumin, etc., the urea present may be approximately estimated by calculating the amount of solids present, as given under specific gravity (vide) and dividing the result by two. Increased. — In febrile conditions; by excess of nitrogenous foods; in diabetes; epileptic attacks; during administration of phosphorus, arsenic and alcohol. Decreased. — In diseases of the liver, acute yellow atrophy, carcinoma, etc. ; in faulty excretion due to renal disorders, bil- iary colic, etc. Chlorides. — Place in a test-tube two fluidrams of the urine to be examined, and in a companion tube the same quantity of normal urine. Acidulate each with nitric acid, add a solution of silver nitrate (1-50), enough to precipitate the chlorides, set aside and let settle. A comparison of the two precipitates will show variation from normal. Increased. — By abundant drinking of water: increased in- gestion of common salt; immediately following the crisis of acute febrile diseases, pneumonia, etc., if favorable termination is indicated. Decreased. — In diarrhea ; in rapid formation of The Germicide 20th Century Practice udations; acute febrile conditions, especially just prior to the crisis ; acute and chronic diseases of the kidneys with albumin- uria ; chronic diseases. Phosphates. — Put into a test-tube two fluidrams of the urine ; make decidedly alkaline with a few drops of solution of caustic potash, boil and set aside for precipitate to settle. At the end of twenty to twenty-five minutes the precipitate should be about one-eighth the bulk of the urine, if the quantity is normal. Increased. — By excess of nitrogenous food; in inflammatory^ diseases ; mental strain ; traumatic meningitis ; acute rheuma- tism ; rickets ; extensive bone disease. Decreased. — In epilepsy; maniacal paroxysm; melancholia; general or sexual exhaustion. Note. — The above simple tests are not given as yielding sci- entifically accurate results, but are only intended for rough approximation, which frequently will be of service to the phy- sician in his clinical work. More elaborate and accurate tests will be found in any of the reliable works on urine analysis. Tests for Abnormal Constituents. — Albumin. — Place in a test-tube two fluidrams of urine and heat to boiling. Add ten or twelve drops of nitric acid. A small amount of albumin is shown by a slight diffuse cloudiness, a larger amount by a more or less flaky deposit ; if considerable quantity, a firm mass will be formed. Heat Test. — Filter the urine if necessary. The urine must be slightly acid ; if not already so, add a drop or two of acetic acid. Now boil some in a test-tube. The presence of albumin will be indicated by an opalescence, a cloudiness, or a precipi- tate. Note. — Urine containing pus or blood always contains al- bumin. Picric Acid Test. — Picric acid has the advantage of being a test both for albumin and glucose (sugar), and its application in both is here given. In a test-tube add equal volumes of the urine to be tested and a saturated aqueous solution of picric acid. The albumin, if present, is coagulated and is shown as a turbidity or a flaky precipitate or a heavy mass owing to its quantity. If there is no albumin, ann sufficient solution of caustic pot- ash to make the mixture alkaline and boil. If sugar is present, the mixture will be colored a dark red or brown, or black, the color dependent on the amount of sugar present. Glucose (Sugar) — Picric Acid Test. — See under Albumin. and Dictionary of Diseases. 989 Trommer 's Test. — To a small quantity of urine in a test-tube add a small amount of solution of copper sulphate, being care- ful not to get an excess of the latter; make strongly alkaline with solution of caustic potash and boil. A yellow or red pre- cipitate indicates sugar. Moore's Test. — Add to the urine about one-fourth its vol- ume of caustic potash solution and apply heat. If glucose be present, the color of the mixture will become dark yellow or brown, and an odor of molasses will be evolved. Nitric acid added will more or less completely destroy the color. Biliary Matters. — Biliary coloring matters occur in the urine in different forms of icterus, and color the urine yellowish- brown, deep brown, greenish yellow, or nearly pure green. The foam produced by shaking the urine possesses a yellow or greenish tint. Gmelin's Test — Rosenbach 's Modification. — Filter the urine through a very fine filter. Apply to the filter, after the urine has all passed through, a drop of yellow nitric acid. A pale yellow spot will be formed, surrounded by a play of colors — red, violet, blue and green. Pus. — The best means of detecting pus is the microscope, but Donne's pus test may be applied. Let the urine stand in a test-tube, or, better, a conical glass, until- the sediment is well settled ; then carefully pour off the supernatant liquid ; now add to the sediment a few drops of a strong solution of caustic pot- ash and stir. A thick, slimy, tough mass will be formed. Blood — Guaiacum Test. — Place in a test-tube equal vol- umes of tinct. guaiacum and old turpentine which has been ex- posed to the action of the air under the influence of light for some time, and hence has absorbed oxygen. This mixture should not have the slightest blue color. Now cautiously add the urine to be tested. If blood be present, a ring will be formed at the union of the two liquids — changing from a bluish green to a blue color. Pus in the urine gives the same reac- tion, but can be differentiated from blood in that the former does not require the ozonized turpentine to obtain the reaction. The blue produced by pus is dissipated by heat ; that by blood not. URTICARIA (Nettle-rash). — A skin disease characterized by the appearance of stinging, itching, red wheals. There is very slight constitutional disturbance. It is usually due to some error of diet, giving rise to bacteria. 990 The Germicide 20th Century Practice Treatment. — Cooling lotions of lead and borax. Powdered starch with some oxide of zinc dusted on the part. Purgation, and a light nutritious diet. Give concentrated tincture echi- nacea ozonized. UTERINE CATARRH.— Intrauterine catarrh, one of the most common maladies of the modern female. Catarrhal, or croupy inflammation of the mucous mem- brane lining the internal cavity of the uterus. Causes. — Ovarian disease ; frequent abortions ; the irritation of instruments; drugs, as bromide of potassa, sabina, aloes; sudden suppression of menses from cold or damp; masturba- tion, mental excitement, torpid liver, tight lacing, gout, rheu- matism ; incompatibility in married life. Gonorrhea, sexual excesses, sexual incompatibility, metritis, miscarriages, retention of the products of conception, the in- troduction of the uterine sound, metastasis of disease germs, and the like, which give rise to a partial death of the intrauter- ine mucous membrane, leaving it weak, relaxed, pouring out its mucous secretion, in which an evolution of the ameba, yeast plant, and sarcinse takes place. The bacterial products of the growth of these germs — toxins — give rise to a feeling of gone- ness ; a so-called hysteria, headache, dyspepsia, bloating, with an indescribable burning in the hands and feet ; a germ-laden leukorrheal discharge, most copious after getting up, which is intensely acid. The sequelae are sterility, dysmenorrhea, and ultimately the cancer neoplasm puts in an appearance. Symptoms. — It may be met with in either an acute or chronic form. In the acute variety, the skin is dry, hot ; general irrita- bility, some fever, sallow complexion, loss of appetite, consid- erable headache, pain in loins and lower part of abdomen, sac- rum, groin, and inside of the thighs. A sense of great heat and fullness about the pelvis, and bearing down. Bladder very irritable; a desire to pass water every few minutes, which is loaded with uric acid. Diarrhea and tenesmus, and subse- quently constipation. Tenderness on pressure over ovaries and uterus. After a day or two, thick, ropy, tenacious dis- charge, which, after awhile, becomes mucopurulent, and is tinged with blood, and imparts a greenish-yellow, or greenish- red stain to the chemise, or other body linen. There is often piles. and Dictionary of Diseases. 991 The chronic form is the most common, and runs a tedious course, with headache, languor, lassitude, debility; great men- tal depression, obstinate dyspepsia, flatulence, and constipation. A sense of weariness, if not pain, about loins, sacrum, groin, inside of the thighs, and bearing down. The discharge now is thick, ropy, tenacious ; very abundant, glairy, like white of egg. Often, under the microscope, the sarcinae and yeast-plant germs can be detected in it. The discharge is most abundant in the mornings, accumulating in uterus overnight, or after lying down awhile ; indeed, in bad cases, after being in the re- cumbent posture for some time, it will flow right out. The de- bility increases, and a train of other symptoms set in, as hys- teria, convulsive affections, nausea, vomiting, tympanitis, ten- derness of breasts, and menorrhagia, if the lining covering the fundus is involved. At least two-thirds of American ladies are victims of intra- uterine catarrh. Most experienced physicians find this malady difficult to manage; nay, some pronounce it incurable, simply because they have failed to realize that the cavity of the uterus, with its entire mucous membrane, is but a colony of millions of microbes, factors of morbid action, the precursors of cancerous deposit. Success in these cases is to be obtained by common-sense treatment. Never inject the uterine cavity in these cases, never insert bougies prepared of any drug. Simply wash out the vagina with a tepid solution of boroglycerid. or peroxide of hydrogen ; and subsequently have the patient insert a pastil of white pond lily at 9 and 12 a. m., and one at 5 p. m., and on retiring for the night one prepared from the oil of thuja. These, in my hands, have been of sufficient power to annihi- late the yeast plant, ameba. sarcinoe, etc. These pastils must be inserted well up against the os uteri ; the patient in the recumbent position for an hour: used for three weeks out of every four for three or four consecutive months. This is indispensable, as the uterus is considerably dilated and its walls much thickened. At the initial period of treatment invariably place the patient upon full doses of the wine of the aletris farinosa. This is a most efficacious remedy, as it induces contractility of the body of the uterus as well as its walls ; it tones and vitalizes ; being a restorative of great power. With this treatment comes a change — a drying up of a mor- bid secretion, with no auto-infection ; a diminution of stricture. 992 The Germicide 20th Century Practice with every infectiye germ wiped out, an alkaline secretion re- established, and the once barren fertile and strong. The ozonized wine of aletris farinosa excels all remedies as a uterine invigorator. UTERINE TUMORS.— Of all organic diseases of the uterus that manifest themselves during the period of sexual vigor, non-malignant tumors are the most common ; and there can be little doubt but that the causes that tend to produce chronic inflammation are the same as cause those growths. They may manifest themselves in various ways. There may- be a general hypertrophy of the muscular fibres, with a deposit of fibrin, causing a general increase of size ; and the condition may progress on and on until fatty degeneration is reached — - a condition of non-contractility which gives rise to hemorrhage Fibroid Tumors. — A condition in which we have an excess of fibrous tissue. It may be simply an outgrowth of the or- dinary fibrous tissue of the uterus ; if not an outcropping, a de- posit. It may be in the form of a nodule, or tumor, developed in any part of the uterus ; or it may be effused just on the sur- face, below the peritoneal coat; or it may be interstitial, or intramural, that is, imbedded in the uterine walls; or it may be submucous or intrauterine, when in the cavity of the womb. An excess of fibrous tissue elements in the blood, and local irritation are the causes. Symptoms. — Very frequently neither important nor well marked, as there is neither cachexia nor pain, in front or back, or shooting through. When of sufficient size, it encroaches on the pelvic viscera, and can be detected over abdomen, or per vaginam, or rectum, or by sound. Even if small, it is likely to give rise to frequent hemorrhages, difficulty in passing urine, or in retaining it; obstruction of the bowels, or constipation, hemorrhoids. If it is interuterine, the hemorrhage is likely to be severe, and to be accompanied with bearing-down pains. The sharp lancinating pain of cancer is entirely absent, but there is, nevertheless, a sort of dull, aching, or throbbing pain, with a sense of weight and bearing down, corresponding to the size of the deposit, or growth. Enlargement and tenderness of breasts, and they often exude serurr from the nipple. If un- able to detect, evacuate bowels thoroughly with oil, and make a careful abdominal manipulation and vaginal examination. . Adventitious fibrous tissue on and in any part of the body is indicative of degenerative changes on or in the uterus ; there is and Dictionary of Diseases. 993 no affection so varied in its manifestatoins as fibroma of the ^uterus, whch is most common between thirty and forty years of life. This is regarded as the typical age, single or married. Sterile if married has not had children for some years. In some cases the infiltration is so small that it gives rise to no appreciable symptoms ; whereas in other cases it totally in- capacitates the individual for work. When it is any appreciable size it gives rise, to pain and hem- orrhage. The latter most common, a slight metrorrhagia, which, together with its presence, gives rise to exhaustion and discomfort. The size and position of the tumor give rise to nemorrhage and pain, besides, if of any size, produces pressure on important viscera; irritable bladder; retention of urine; dif- ficulty of defection from pressure on the rectum ; edema of the lower extremities from pressure on the iliac vein ; loss of power in the lower extremities from pressure upon the sacral plexus ; sub-acute pelvic peritonitis not rare; uterus always enlarged, often an enormous size ; glandular endometritis always present, give rise to various irregularities in shape. Of all the various drugs used in treatment none are so valu- able locally as washing out both rectum and vagina with a warm boroglycerid solution and subsequently inserting a boro- glycerid pastil and ichthyol suppository, using one of each morning, noon and night. They have a definite action in every case. Whilst using these the bowels must be kept regular. The use of ozonized clay, every other day, over the pubes, for a period of time to cause a mere blush, affords a slow, but decisive, permanent result in aiding the absorption of the tumor. Of all the various drugs prescribed internally ergot and mat- ricaria lead; nux vomica and quinine alternated with wine of aletris farinosa follow next in efficacy. Protonuclein and thyroid extract must never be omitted. A three months' course of these remedies, properly adminis- tered, invariably shows distinct diminution in size and hard- ness, often a complete eradication of the growth, and lastly, but not least, the cacodylate of sodium, with which most mar- velous results are often effected. Quite a large number of practitioners think well of hydrastis canadensis, but as an all-round remedy in fibroma its action is decidedly inferior to the remedies enumerated. The oil of thuja is often a most available remedy, both in- ternally and locally, good for hemorrhage; unsurpassed for 994 The Germicide 20th Century Practice the removal of any polypoid excrescence — it invariably gives permanent results, without risk and mutilation of the sexual organs. Two of the above remedies should be given the same week : one before, and other two hours after eating. To hasten the process of absorption, pastils and suppositories of iodide of potassa should be used every night. All remedies but clay to- be discontinued during menstruation. Hemorrhage and other symptoms to be treated on general principles. Polypus of Uterus. — A pear-shaped excrescence attached and growing from the mucous membrane of the uterus. It may be in the cavitv, on the neck, os, or in the vagina, or otrier part, by a pedicle, or root, or stem. There are three varieties: (i) Gelatinous, or mucous. (2)' Fibroid, pale white, covered with mucous membrane. (3) Fi- broid, fleshy, or placental. The predisposing cause is tuber- cular; the exciting cause, irritations, as abortions, masturba- tions. Symptoms. — Either profuse menstruation, or irregular at- tacks of uterine hemorrhage, or a dribbling all the time, or even excessive flooding; leukorrhea very profuse. If polypus is large, there may be irritation of the bladder and rectum by pressure. The same condition is likely to give rise to bearing- down or expulsive pains, coming on by spells, or worse after exercise. The continual loss of blood is a heavy drain, and gives rise to debility, loss of flesh in proportion to the amount of loss. The polypus can easily be detected in the uterus by the sound, or, if on neck, os, or vagina, by finger and speculum. Treatment. — If the polypus is in vagina, or on the neck, or os, any of the following methods of treatment can be resorted to : It can be excised, and bleeding arrested with a sponge, proper size, saturated with perchloride of iron; it can be le- gated and allowed to slough off"; torsion can be used, that is, it can be turned a little every day, thus impeding its circulation, strangulating it, and allowing it to slough off; or the chain of the ecraseur can be applied round it, and crushed ; or, if it can be brought into a speculum handy, the ozonized chloride of chromium can be applied, and cause its instant death without a particle of pain. Now all these methods of procedure can be dispensed with, and the polypus caused to die and exfoliate simply by placing patient upon the internal and local adminis- tration of the oil of thuja. It must be given in sensible doses. from ten to thirty drops thrice daily, and it can be inserted and Dictionary of Diseases. 995 in the vagina either in the form of a suppository or tampon. Cysts of Uterus. — Cysts, or closed sacs, resembling hy- datid cysts, are often developed in the substance of the uterus or beneath internal mucous lining, or under external serous covering. Sometimes one part of the uterine walls is invaded with cysts, or small bladders, while another part is infiltrated with fibrous tissue, or the ordinary fibroid tumor. These cysts give rise to trouble and inconvenience when they attain any size, such as leukorrhea and hemorrhage. If within reach, they may be punctured. They, like the others, are unaccom- panied with pain ; not infrequent give rise to uneasiness. The best treatment is a general alterative and tonic course, with a prolonged course of cacodylate of sodium. In order to avoid those three common forms of uterine dis- ease, there should be a rigid avoidance of irritation of the uterus, either by tight lacing, wearing sponges or pessaries, masturbation, abortions, irritating caustics of doctors, espe- cially nitrate of silver; even certain occupations, as the sewing machine, should be guarded against, or other forms that aid in the production of congestion. Warts on the mucous membrane of the vagina are com- monly met with among women of easy virtue, or among those the possessors of unfaithful husbands. These give rise to a dense microbic leukorrhea discharge, which is exceedingly in- fectious. It must never be blended with a neurosis of the sex- ual plexus, but rather of a specific micro-organism. These cases are cured by boroglycerid, injection oil of thuj either in suppository or on a tampon, and oil of thuja inter- nally. In the female, aside from warts, there is often met with vas- cular tumors at or near the orifice of the urethra. These excrescences vary in size from a pea to a walnut. Usually they are highly sensitive, exquisitely painful, giving rise to most excruciating pain and irritability in making water, which continues for some time. They also give rise to irritable bladder, pain in back, and considerable constitutional disturb- ance. The only treatment is either excision, or ligation, or destruction with caustics, as chromic acid, supersulphate of zinc, salicylate. If preferred they yield slowly, but "never re- turn, by applying oil of thuja locally and internally, with the addition of the cacodylate of sodium. Keep urine alkaline during the process of healing, and in- culcate a o-eneral tonic and alterative course of remedies. 996 The Germicide 20th Century Practice UROTROPIN. — This chemical compound is formed by the action of formalin on ammonia, and is a urinary disinfectant and germicide — a drug of marvelous power, a specific for all urinary infections, rapidly causes all bacilli to disappear from the urine after its use. When prescribed in ten-grain doses, thrice daily, it promptly annihilates all disease germs in the urine, checks all decompo- sition, prevents the evolution of the micrococcus urese, so com- mon in either urinary retention, or cystitis. Physicians who are curing enlarged prostate by cocain, saw palmetto and boroglycerid suppositories, would do well to try urotropin as a distinct antiseptic to the contents of the bladder. It is a most efficient diuretic, urinary antiseptic, uric acid solvent, and remedy for calculous disease. Rapidly renders alkaline and putrid urine containing mucus, pus, uric acid, and amorphous urates normal in appearance and reaction. It sterilizes the urine, increases its quantity, and dissolves calculi and deposits. Very valuable in all suppurative diseases of the genitourinary tract, pyelitis, cystitis with ammoniacal decom- position of the urine, phosphaturia, also in gouty and rheu- matic affections where active elimination of uric acid and the urates is required. The introduction of this remedy marks a new era in the suc- cessful treatment of all diseases of the genitourinary tract, especially when disease germs or their toxins are present, either in the kidneys and bladder — completely wipes them out, and at the same time exercises a healing and soothing action upon the inflamed mucosa of the entire passage. It operates also well in cancer of both bladder and kidneys. Its great thera- peutic value is a perfect solvent to uric acid in the urine, whether in the form of sand, brick dust, gravel, stone, or cal- culi. UVULA. — A fleshy appendix or prolongation, which hangs from the middle or free edge of the velum palati ; of a conical shape, of a greater or less size in individuals. Its use, evidently so designed to regulate the swallowing of food and liquids; covered with mucous membrane; all diseases of mouth and throat are liable to be effected; subjected often to paralysis in diphtheria. Diseases of the uvula have not received attention commen- surate with their importance. Inflammation simply causes relaxation, whereas repeated at- and Dictionary of Diseases. 997 tacks gives rise to infiltration, thickening and elongation, its specific gravity being increased it falls upon the root of the tongue, even extends to the opening of the trachea, giving rise to constant irritable cough, which is often mistaken for bron- chitis or tuberculosis. The old treatment was the use of astringent washes, garg- ling or painting, such remedies as either a solution of sulpho- carbolate of aluminum, zinc, or infusion of golden seal, or ap- propriate inhalations of the same remedies. These failing, simply cutting it off. It is indispensable to get rid of it to wipe out irritation, espe- cially if the microbes of syphilis, tuberculosis, cancer be in the blood. Painting or brushing over the elongated formalin causes it to shrink, to diminish not only in weight, but in length. This the present century practice and is decidedly good, instanta- neous, getting rid of the constant irritating cough, a source of annoyance, even danger ; besides this new treatment completely annihilates the microbes of syphilis, tubercle, cancer, when lodged in the uvula. VACCINIA. — A disease peculiar to the cow ; arising spon- taneously under certain insanitary conditions, being transmit- ted to man by inoculation, either through ignorance or super- stition. An idea has permeated some minds that if the serum of the cowpox vesicle were injected into the true skin of a hu- man being a microcosm of Deity, it would prevent him from taking variola — an imaginary prevention, that is, they suppose that this cowpox microbe uses up, when it enters the blood, all the elements in the body upon which the genuine microbe of smallpox subsists, thus either sterilizing the indi- vidual or rendering him immune, both to the entrance and growth of that germ in the blood. This idea, in recent years, has been found to be erroneous, as it has been demonstrated that it has no protective power whatever, neither in preventing nor even modifying the disease, the whole affair being simply ignorance and superstition operating upon minds destitute of cineritious matter. Physicians of culture, men of advanced ideas, look upon vaccination (bovine) as being most productive of degenerative changes, and favoring the evolution of the cancer neoplasm in the human body. There is no doubt that the introduction of animal matter, either into the true skin, a secretins: membrane, 998 The Germicide 20th Century Practice or into the cellular tissue, is attended with degenerative changes in vital organs; it makes no difference whether it be the cells of cowpox or the serum of a glandered horse, or a vicious goat, or stubborn ass, the result is the same, degenera- tion, Alkaloidal substances are the proper agents for subcu- taneous administration. VAGINISMUS is perhaps the most common of all forms of neuroses — a hyperesthetical condition of the nerves which supply the sphincter muscles of the vagina — giving rise to a spasmodic contraction of the muscles of both perineum and vagina. It is brought into action by a variety of causes — the predisposing being spinal neurasthenia, the exciting cause some irritation, small size of the vagina, ulcers, fissures, irri- table hymen, organic uterine disease, cold, congestion often due to masturbation, sexual excesses, childbirth; every attempt at coition is attended with violent spasmodic pains. It is not at all uncommon to find numerous married ladies who never had been able to have connection with their husband owing to this difficulty. The hymen elastic and normal in appearance, but where any attempt is made to introduce the finger there arises the most intense excruciating pain, accompanied with spas- modic closure of the vaginal sphincter muscle. Cases have occurred in our own observation where an entrance has been effected, a violent spasm seizing the muscle, contracting upon the penis, causing fatal results. The etiology of these cases lies in an exhausted condition of the lumbar portion of the spinal cord, which is speedily re- lieved by administering green root tincture of gelsemium com- bined with passiflora incarnata; locally insert per vaginam one boroglycerid suppository every three hours. The use of these afford instantaneous and permanent relief. VALDIVINE. — A glucoside from pomegranate root bark, pumpkin seed, male fern, koussa, kamula, and other tenicides. See directions. This preparation is identical with the alkaloid" pelletierin; put in extract of gentian and capsules, ready for administration. Directions for Use. — The patient should take very little food for two days, and that should be of a fluid nature. On the evening of the second day he should take a purgative (castor oil is best) of sufficient strength to cause an evacuation of the bowels ; in the morning, after the castor oil given the previous and Dictionary of Diseases. 999 evening has operated, and while fasting, the patient should take seven or eight capsules along with another dose of castor oil or other purgative, follow that with another eight capsules to another dose of castor oil. The worm generally comes away within two hours after the second dose of capsules. VARICOCELE. — A weak, relaxed condition of the veins of the spermatic cord is extremely common. It may be the result of inherent debility, aided by a hot, relaxing climate, but generally it is caused by masturbation and spermatorrhea — possibly in some few cases the effects of blows, falls, strains, bicycle and horseback riding. Neglected or overlooked it may become quite large, and as it enlarges, it destroys the delicate glandular structure of the testes, and gives rise to complete impotency ; reflexly its irrita- tion gives rise to seminal losses, that cannot be relieved until the varicocele is cured. The recognition of varicocele is easy: the history of the case — the left side; a swelling, dilating when he coughs, dis- appearing some or altogether when he lies down; reappearing when in the upright position; feeling like a bag of worms; atrophy of the testicle, and complete impotency ; imperfect cir- culation and seminal disease with aching and peculiar itching on the skin of the scrotum are a few of the landmarks. Its constant irritation, the dragging in the back, and general progressive debility, with complete loss of sexual power soon attract the attention of the sufferer. The inability for coition is a physical disability, a loss of erectile power. The sympathetic soon becomes involved and a feeling of disgust toward his partner, and a lack of self-confi- dence soon takes place. In such cases there is a combined ooz- ing of semen without the slightest erection. Impotence be- comes so complete that even the closest contact with the oppo- site sex fails to revive the faintest scintillation of an erection. If by chance the slightest erection should occur, a premature discharge of thin, watery, infertile semen follows ; besides, the ejaculatory ducts are relaxed, patulous, unable to hold the semen and it dribbles away, and the muscular fibres of the pros- tate are paralyzed and unable to promote the ejaculation of seminal fluid. In the cure of varicocele, not a ray of hope is to be obtained from any surgical procedding which consists in the ligation of the veins of the cord, an operation not only dangerous but futile. iooo The Germicide 20th Century Practice General tonics and alteratives are always of great service; the internal exhibition of matricaria is attended with the best results, while, locally, bathing with ozonized witch-hazel and wearing a suspensory do some good in the way of ameliora- tion or palliation of the urgent symptoms. Cases have occurred to me in which the thyroid extract administered internally and the use of thyroid cream locally have effected relief and cure. The success resulting from this remedy has been immense. Cases pronounced incurable have been obliterated, and the spermatorrhea and impotency com- pletely cured. A very popular and most successful method is the periodate aurum varnish cure ; it is thus prepared : Make a solution of gutta-percha in chloroform; add to every four ounces of this four drams of the periodate aurum. Mix thoroughly. Let the patient take a bath, and when well dried off let him apply to the hairy parts surrounding the varicocele a paste made of equal parts of the sulphuret of barium and starch. In a few minutes remove, and all the hair with it. This must be carefully wiped off and over the smooth surface this gold varnish painted on so as to obtain an impermeable coating. The repeti- tion of this application has effected some most wonderful cures. Inherent weakness of organization is the predisposing cause, whereas the exciting conditions are habitual constipation, sedentary habits, venereal excesses, masturbation, sexual per- version, spermatorrhea, congress with courtesans, bicycle exer- cise, etc. Its recognition is easy, can readily be detected by feeling the cord or testes between the forefinger and thumb ; if it is present a knotty feeling can be detected, feeling precisely like a bag of worms, which dilates when the patient coughs, diminishes or disappears when he lies down — spermatic cord is usually thickened, often considerable aching or dragging in the back. When this devitalized state of the testicle or cord exists, it gives rise to either spermatorrhea or impotency, and when these exist form a barrier to a rapid cure. If varicocele be neglected and not attended to early it has a most damaging effect upon the nerve centres, on the nervo- vital fluid from which the semen is evolved — even if the brain be vigorous, it will dwarf the spermatozoa, render them weak, watery, infertile. The true principles of cure consists in resorting to. every known means to strengthen the vital forces, improve the gen- eral health and vitalize the veins. and Dictionary of Diseases. iooi Bathing the genital organs morning and night with tepid water and witch-hazel soap is to be commended, the retraction of the prepuce, the removal of the smegma should be attended to, then well dried, and the ozonized extract of witch-hazel used with liberal hand over the affected part. This, during the day, should be followed by mechanical support, which is of infinite value — an elastic, compressible suspensory bandage, so as to keep all excess of blood from the parts, and thus, to a certain extent, prevent dilatation of the veins. The internal remedies, from which good results are obtained, are comp. tincture matricaria, protonuclein, ambrosia orien- talis, aletris wine, and keep the bowels in a soluble condition wih the kola-nut lozenge. Usually the result of masturbation and sexual excesses, more recently a sequel of bicycle exercise; a loose, lax, dilated condition of the veins of the spermatic cord; a state existing in which the secreting faculty of the testes is impaired and partial or complete atrophy of those glands induced. The brain imperfectly nourished, the mental condition is peculiar; mind depressed, attention distracted. The constant weight in the scrotum, the perpetual aching pain up the cord, into the groin and down the thighs, keep his attention riveted on his ailment ; his life is miserable. It seems to make little difference whether the mass of veins be large or small. Tincture ambrosia orientalis, thrice daily in thirty- and sixty-drop doses ; bougie and suppository of ambrosia on retiring are the best of all medicaments for varicocele. It is well to aid their action with every known palliative measure of any value, especially such as bathing the parts well, then applying ozonized extract of witch-hazel morning and night; a faithful, persevering trial and wearing a well-fitting suspensory bandage. Ambrosia orientalis, pill, tablet or tincture, is an excellent sexual tonic and invigorator, and its use as a restorative in varicocele will be watched with much interest. Some cases admit of a cure, before complete wasting and organic change has taken place. A cure can only be effected by strict observance of every possible means of improving the general health and strengthening the veins of the cord. As a special remedy to vitalize the spermatic cord, its veins, the testes, general sexual invigorator, ambrosia orientalis leads ; it stands alone above all others. Its action is still greater by adding c. p. solution of spermin and thyroid extract. Am- 1002 The Germicide 20th Century Practice brosia in the form of tincture, pill, tablet, suppository, bougie, and ointment for inunction. Bathing scrotum, groin with ozonized distillation of witch-hazel, and during the day wearing a silk suspensory, bandages, are excellent. Unprincipled parties, either through ignorance or avarice, are endeavoring to foist upon the profession a rubber or vul- canized rubber suspensory, which if ever used will produce grave pathological results, namely, absorption, complete disap- pearance of the testes, make the wearer in six months a eunuch, and in twelve months more a maniac. There is something in rubber, when applied to the nude skin, antagonistic to life, to vitality, for all underneath it withers and dies. Too true, it reduces by compression, absorption and by inducing degenerative changes. A rubber bandage applied to any part of the body induces atrophy of all the various tissues underneath it. Fatty degeneration takes place. Things are still worse if it is a vulcanized rubber suspensory, for, in addi- tion to the blighting action of rubber, we have absorption of the poisons of lead and mercury to contend with. Therefore discard all rubber goods, as highly prejudicial. VARICOSE VEINS.— Incidental to the great increase of neurasthenia, varicose veins are an essential element of debility or weakness, become more and more prevalent. A tortuosity, engorgement, or enlargement of the veins, is attributed to an inherent weakness, from organic changes in their walls, or to the relaxing effects of a hot climate. The veins most usually affected are those of the leg, the long saphenous vein, which runs down the inner aspect of the side of the leg to the ankle ; the veins of the spermatic cord, testes, scrotum, rectum, eye. The exciting causes are any obstruction to the return of the venous blood, such as pressure in pregnancy; the effect of gravity, such as standing all day ; congestion of the liver gives rise to varicosity of the veins of the rectum, piles; scrotum and spermatic cord, varicocele, masturbation, sexual excesses; the eye, cold. In the treatment of varicose veins, rest, elevation, pressure over the part, by means of bandages, or elastic stockings. Operations are either dangerous or inefficient. The only true method of cure is to impart increased vitality to the whole body, but especially to the veins. For this purpose the internal axd Dictionary of Diseases. 1003 administration of ambrosia orientalis, comp. tincture matri- caria, protonuclein, thyroid extract, and locally in all cases ozonized witch-hazel extract. In varicocele, the same remedies, wearing a suspensory, and inserting either an ambrosia orientalis or salix nigra supposi- tory three times daily ; excellent results are to be obtained with a free use of witch-hazel as a wash. Bowels must be kept in a soluble condition by kola-nut pill. Rubber bandages cause atrophy, and should never be used as a support to varicose veins. If a varicose vein bursts, there is usually profuse hemor- rhage, often dangerous, which is to be promptly arrested by recumbent posture, compression with a pad over the bleeding orifice, and subsequently by the hypodermic injection of a solu- tion of tannic acid and iodine all around the bleeding aperture to close it by plastic lymph. Hemorrhoids, piles, varicose veins of the rectum must be cured by rousing up the liver with either periodate aurum, or mix vomica and belladonna, and by inserting at stated intervals suppositories of either horse-chestnut or krameria. The coagulation of the contents of the varicose vein (pile) by injecting it with carbolic acid and glycerin may in some •cases be commendable. (See large Encyclopedia of Practical Medicine, based on bacteriology.) Varicose ulcers are chiefly met with on the leg. The skin •over some angle in which the blood clots becomes imperfectly nourished, much irritation follows, pain, heat, burning redness and latterly ulcer forms. All operations, all procedures having in view the obliteration of the vein, are futile. Apparent success may be realized, but the deeper-seated veins take on the same pathological condi- tion, and are even worse to manage than the superficial. So a highly constructive treatment, rest, massage of the limb to the body, elevation, mechanical support, bandages steeped in solution of oak-bark or witch-hazel, sprinkling over the ulcer formal-gelatin, then boracic acid pulv., are all of some efficacy. VARIX. — Varicose veins. Debility is the predisposing •cause; sedentary habits, pregnancy, certain occupations are exciting causes. They are relaxed, dilatable, purple ; knotty and become filled np with blood, which often coagulates. 1004 The Germicide 20th Century Practice VARIOLA. — (Micrococcus) . — Smallpox is the best defined of all fevers due to the presence of a microbe in the blood. Once the germ enters the body either by the mouth, bronchial mucous membrane, or skin, it takes precisely twelve days to sprout, during which time the patient suffers from languor, lassitude, debility, nausea and vomiting, pain in the loins, and a gritty feeling in the skin. At the end of this stage of devel- opment, rigors and a fever, active germ proliferation and ptomain excretion commence, which last three days, then a papular rash makes its appearance over the chest, abdomen, face, limbs, and sometimes on the mucous membrane of the eyes, nose, mouth; papulae fill or mature in eight days, cica- trization taking place in from seventeen to twenty- four days. The state of vital force, the amount of germs present in the blood, will give the type of fever, whether the papulae be few and small, constituting chicken-pox, or papulae large, numer- ous, constituting what is known as varioloid; or larger still, even more numerous, smallpox (discrete) ; or still more nu- merous, running into each other (confluent). In any of its stages, its diagnosis is easy. The nausea, vomiting, pain in the loins, with gritty feeling of the skin, during the twelve days when germ is sprouting; the rigors, fever, subsidence of the vomiting and loin pain, lasting three days, and the papular eruption appearing, first as papules, then as pustules, regular pocks, peculiar odor. By the microscope, in the early stage, the micrococcus can be detected in the breath and urine, later on in the pustules, micrococci, either isolated or united, same microbe in the mucous membrane of the mouth and larynx. The micrococcus found in the pustules is chemically, mor- phologically, and microscopically identical with the cowpox. The micrococci are pathogenic of the disease, bear cultiva- tion well in any warm, nutrient broth; cultures, either injected or fed to animals or man, give rise to the disease. The microbe in the blood appears as cocci, singly, in pairs, and in long or short chains or colonies. They are found in the fresh lymph of human and cowpox and in the pustules of true smallpox. They are found most numerous in and around the pustules. Successful vaccinations result from artificial cellu- lations. The micrococci of varicella, variola and confluent smallpox are identical, thus establishing most conclusively that these are but one morbid state, that the microbe is patho- genic of the disease. and Dictionary of Diseases. 1005 Living as we do among distinct races of men, in which every microbial disease is intensified, variola is the great pathogenic and therapeutic question of the day. The microbe variola can be detected in the atmosphere for fifty feet around an infected person ; all within that radius are exposed to it and it enters their bodies, but, in order to take hold and multiply, there must be particular conditions of tem- perature and chemical media constituting what is termed recep- tivity. Just as some seeds will germinate only in presence of certain meteorological conditions and in certain soils, so organic receptivity is requisite, that disease germs be followed by their effects. Once the microbe of variola enters our bodies and produces smallpox, the solids and fluids of our bodies are so altered or modified, that all the essential elements for their further nutrition are used up and never appear again. If the germ of variola enters the human body and finds a medium suitable for its existence, it quickly multiplies, with the celerity peculiar to minute bodies, their marvelous facility of reproduction compensating for their microscopic size. During the twelve days of incubation millions of ova or spores are evolved, so that when the rigors come with the three days of fever, the microphytes having used up all the oxygenizable material in the body, eager, greedy for more, with air and light, accumulate near the surface; scattered in groups, in the skin and mucous membrane the microbe excites suppurative inflam- mation, which constitutes "pustulation." The microbe variola is sterilized and utterly annihilated in the presence of the ozonized glycerite of sulphur, oil of thuja occ, sulphide of lime, bichloride of mercury ; and these agents freely elaborated in the blood render the soil unfit for their growth. The glycerite of sulphur with the hydrogen peroxide has excellent germicidal properties, diffuses itself well through the blood, sterilizes that fluid, combats the invasion of the bac- terium of variola. It is the dominant germicide in diphtheria, aphthous stomatitis, also in variola. Lowers heat, pulse, res- pirations. Sulphide of lime can be used instead, as it also destroys the germ and renders the blood (soil) unfit for their growth: so with thuja, etc. Are these remedies efficacious? Do they sterilize the blood,, render it unfit for microscopic life; do they kill the germ? In its etiology, in some cases, it would appear to originate in all insanitary conditions, and even to be an evolution of filthy ioo6 The Germicide 20th Century Practice and human degradation, essentially infectious and contagious, and, when transmitted from one race to another, most malig- nant — black smallpox, skin and mucous membrane both in- volved. From the moment of inception, that is, from the entrance of the microbe into the salivary glands of the mouth, until the rigor and fever appear is twelve days — that is, the germ in the blood-stream takes twelve days to mature, during which time the germ-saturated subject suffers from headache, pain in the small of the back, calves of the legs; languor; lassitude; de- bility; nausea, often retching and vomiting; constipation. Usually about the ninth day a gritty feel can be detected in the skin or subcutaneous tissue, like rice, or shot, or barley- grains. At the termination of the twelve days of incubation rigors and a continued type of fever set in, which last three days, and are followed by a papular rash, which is either scattering or joined together — discrete or confluent. Simul- taneously the same eruption may appear on the mucous mem- brane of the mouth and fauces. At the termination of the third day of fever there is a gen- eral lowering of temperature, a slowing of pulse, a keenness of appetite sets in, and the papular rash rapidly fills up into vesi- cles, which mature about the eighth day, ultimately drying up into scabs, which exfoliate or drop off from the seventeenth to the twenty-fifth day. Dangers. — The greatest danger arises from the secondary fever about the ninth or twelfth day, when the pustules are ripening, and vital strength has already been much exhausted. In a confluent case, fatal chest symptoms or laryngitis, may arise; or the pocks may be followed by abscesses in various parts of the body ; or there may be ulceration and opacity of the cornea and loss of sight. The recognition of variola is easy : history of the case, severe pain in the loins, gritty feel in the subcutaneous tissue about the ninth day; the odor most significant; the definite duration of fever. Prophylaxis, a tight-shut mouth, either the vapor of chlorine or formalin at all times in the room and throughout the dwell- ing; take some antiseptic at stated intervals. In the treatment select two good germicides, and adminis- ter them alternately one every two hours. Chlorine and bi- chloride of mercury have stood the test for ioo years. If not satisfied with these, try lime-water and tincture of iodine in and Dictionary of Diseases. 1007 milk; alternate with sulphocarbolate of sodium. If these are not approved try ozonized oil of thuja, alternated with a decoc- tion of sarracentia purpurea, with a few grains of chlorate of carbon, so that the total amount in twenty- four hours does not exceed fifteen to twenty grains. If no other remedies are at hand, give brewers' yeast ; otherwise general principles of treat- ment of fevers, even to bathing, which can be carried out till the eruption appears. If the above remedies are given properly, there will be no cicatrization or pitting of exposed parts. You may lack confi- dence in the action of drugs; if so keep the apartment either dark or a yellow light. If you lack faith in that completely cover the eruption with a piece of fine linen on which storax ointment is thickly spread. This never fails. Enjoin perfect isolation. Give a most generous diet, as the disease is an ex- hausting one, but it must be given in such a form as to be readily digested and absorbed. Liberal allowance of milk, diluted with about one-third soda-water, raw eggs beaten up with milk (cold), beef-tea, arrowroot, sago, etc. Tea or coffee is often grateful and useful; but to quench thirst nothing is more pleasant than cold water. Lemonade, soda-water, and •other effervescing drinks may also be allowed. VENEREAL DISEASE.— In order thoroughly to under- stand the venereal disease, it will be necessary very briefly to make a few remarks. Under this pathological state, we find two distinct disease germs, one of them of very low power, capable of either pro- ducing inflammation of the mucous membrane of the urethra or other mucous membranes ; or, if applied to an abraded, cracked or fissured surface, a specific, soft, non-infecting sore, but inca- pable of entering or damaging the blood. This microbe has been named the gonococcus. The other germ is the true venereal bacillus, which, if it by any means can enter the urethra, forms a nest and gives rise to a chancroid in which it breeds by sporulation ; or if it reaches some weakened point on the glans or prepuce, inoculates it and gives rise to a hard, infecting, Hunterian chancre or sore from which the microbe emigrates to the lymphatics of the groin, and from thence to the blood and weakened parts of the body, where it has prodigious growth. Gonorrhea. — In order to wipe out various absurdities which have crept into the medical literature of the subject, it ioo8 The Germicide 20th Century Practice will be necessary to consider each disease germ seperately, and in so dong we will briefly mention the leading features of each. The gonococcus, which gives rise to a gonorrhea, and a soft, non-infecting chancre, is supposed to be the evolution of pro- miscuous sexual intercourse, and when once originated, propa- gated by contagion and infection. There seems to be some truth in this, for after the degrading practice of self-abuse is committed by either sex the gonococcus is found in either the urethra or vagina. The gonorrhea (the gonococcus) is a term applied to a specific inflammation of the urethra of the male or vagina of the female, usually the result of impure sexual congress, and accompanied with a profuse mucopurulent discharge. After an exposure to the "germ," an uncertain period of time elapses, depending upon the vital stamina of the individual, before the symptoms make their appearance, generally from twenty- four to seventy-two hours. The Symptoms in the Male. — It usually begins with a slight redness, itching and irritation of the orifice of the urethra. The glans becomes congested, of a bright-red color; the lin- ing membrane of the urethra becomes swollen, and painful ; a thin, white, watery discharge appears; urine is passed with difficulty, stream is diminished in calibre, often twisted, forked,, with a dull aching pain in the back, loins and testicles. As the gonococcus grows, becomes mature, sporulation begins, symptoms become aggravated, and in addition to the gonorrhea germ there is the pyogenes aureus in the canal, with lymph in the discharge, which becomes thick and puriform, with a greenish or reddish tinge. There are in a large percent- age of cases prolonged and painful erections at night, during which some of the erectile fibres give way, and the penis be- comes bent or curved (chordee), a state which is extremely painful. In some cases the glans becomes excoriated, smooth and glassy (balanitis). In other cases the prepuce or fore- skin becomes elongated, edematous, contracted over the glans — cannot be pushed back (phimosis) ; or retracted and con- tracted behind the glans (paraphimosis). The lymphatics in the groin always sympathize, become less or more irritated, inflamed, often suppurate (buboe). Either testicle may be- come acutely inflamed, giving rise to orchitis. If the micrococcus is not killed in the urethra it will gradu- ally die out and degenerate into a gleet, which is often intract- able, or it mav terminate in a stricture. axd Dictionary of Diseases. 1009 The evolution of the gonococcus in the urethra of a man who commits self-abuse, or has suffered external violence, or from the use of instruments or in having connection with women who have leukorrhea, or who are loose and flabby, should on moral grounds be made a distinction, but there is no wiping out the fact that if the germ is there, contagion and infection exist. Treatment. — In all stages of the life of the gonococcus, the bowels should be kept open daily by some mild saline purge, as cream of tartar lemonade, or sulphate magnesia; diet, plain, unstimulating diet; as much rest as possible; the penis should be bathed frequently with Castile soap and water as hot as can be borne. The greatest cleanliness observed. The remedies used must be both local and internal, and to be of utility must be bactericides of some power. There is quite a diversity of opinion as to the mode of proce- dure, and even in the antimicrobe used. Some are partial to copious injections after urinating of distillation of eucalyptus; others to the insertion of soluble gelatinized bougies of either thallin or iodol; some use both. The internal remedy must be one incapable of digestion — one which will pass in the form of fine molecules in the urine, and coming in contact with the germ in the urethra kill it. Such remedies as the balsam of llaretta, oil of sandal-wood, kava- kava. Gleet, a thin, glairing discharge from the urethra is either due to weakness or relaxation of the lining membrane of the urethra, or to stricture, or to papillary hypertrophy of the canal. In such cases, a general course of tonics, sea bathing and other means to improve the general health. Injections of sul- phate of quinine in port wine; bougies of aristol or iodole are very efficacious. The soluble gelatinized bougies are the best for. the treatment of gleet. Origin of the Venereal Germs. — As to the origin of the genuine syphilitic germ we know nothing; it is very different, however, with the gonococcus which gives rise to the soft chan- cre and a gonorrhea. Here we can clearly demonstrate that this micrococcus is simply an evolution from the elementary molecules of nutrition, which has been changed, altered, de- graded into other living matter under the lowering effects of promiscuous sexual intercourse, where that act has been loose, or varied, few women among many men. We find this same ioio The Germicide 20th Century Practice evolution in the urethra of masturbators for at least twelve hours after the act, and also in the vulva of females who are addicted to the same pernicious practice. This evolution becomes a pathogenic microbe, the gonococcus, bears culture in almost any albuminoid fluid, and when it comes in contact with weakened tissues excites violent inflammation and de- struction of tissue; but although this germ can do much local damage, it is incapable of ever entering the blood. How very different in all morphological characteristics from the vene- real bacillus ! It may either be localized in the urethra in the form of a chancroid or on some other parts as an indurated sore ; or simply contact with the fresh secretions, or by kissing or nursing — that point it finds a habitat and enters the blood, in which it finds a true pasture field. Soft Non-infecting Chancres. — A soft chancre is sim- ply a contagious ulcer produced by the micro-organism, the gonococcus, during actual contact with an unclean or impure vagina or otherwise; the germ lodges in a follicle and gives rise to a small irritable pimple, which gradually enlarges as the microbe grows. The power of growth is great, and begins the moment it reaches the true skin. The period of growth and maturation depends a great deal upon the vital integrity of the individual inoculated. Very generally the pimple shows itself within forty-eight hours after contact. It runs along rapidly to suppuration, forming a pustule. The top of this is either rubbed off by the clothes or else it bursts and gives rise to superficial ulceration. The sore is generally seated in the sulcus between the prepuce and the glans, sometimes on the foreskin, more rarely at the bridle. The base of the ulcer is always soft (unless it has been cauterized by the nitrate of silver), it can be easily compressed between the index finger and thumb, and the discharge from the ulcer contains an abundance of the specific germ with the pus microbe, with the debris of the tissue broke down in the process of ulceration. In the soft chancres, there is usually quite a good deal of sup- puration and there are frequently more sores than one present. The lymphatic glands in the groin usually sympathize, become swollen, inflamed and often suppurate. Although the gonococcus is so feeble that it cannot enter the blood, still its local ravages are often quite great. For example, if the health of the affected individual be poor, or if he happens to reside under insanitary influences, the micrococcus will become very active, eat deeply, which causes the sore to spread and Dictionary of Diseases. ioii widely, and it assumes a phagedenic form or type. Again, if the individual happens to have the tubercular bacilli in his blood, the ulceration may creep over the head of the penis like a horseshoe (serpiginous). Above all kinds of ulcers, if they are neglected or ill-treated, they are the most liable to slough and even destroy the organ. Although this germ never enters the blood it often, when treated by empirics or charlatans, creates dreadful ravages. The microbe through all its vicissitudes is found in the secre- tions of the ulcer, which can be inoculated into any part of the patient's body, and the identical sore will be reproduced, simi- lar in all respects to the original. True, the action of the germ is local, but extremely contagious. In the treatment of a non-infecting chancre, the greatest care and nicest discrimination exercised. If a case presents itself with a suspicious-looking pimple, which has appeared within a day or two after an impure connection, it should at once be dressed with some bactericide lotion, which should be changed every few hours, never permitting it to become dry — an antimicrobe lotion is the best application because if pene- trates deep and kills the germs which have probably buried themselves into deep parts. When the epidermis exfoliates we probably have seen the last of the germ ; but better to keep this dressing on for ten or twelve days. If the sore or pock is more advanced, or if it is irritated or inflamed, the same plan of treatment is applicable. A good rule of practice is, that all irritation must be allayed, and no irritation of any kind produced. If ulceration spreads rapidly and deeply, if it becomes phag- edenic its surface might be brushed over with a solution of the chloride of gold, followed by sprays of the peroxide of hydrogen, then poultices of yeast and charcoal kept constantly applied till a healthy surface is established, and then dressed with boroglycerid ointment. Sloughing phagedena is managed pretty much the same way. Powdered aristol sprinkled on the eating surface is most effectual in arresting microbe evolution. Aristol is also a good remedy when lotions cannot be applied. If the inguinal glands become inflamed, they should be treated by rest and hot fomentations ; if suppuration is inevit- able, they should be injected with peroxide of hydrogen, which promptly and at once changes the contents of the lymph-sac to innocuous matter. ioi2 The Germicide 20th Century Practice The Hard Chancre or Infecting Ulcer. 1 — The true Hunterian chancre, the sore in which the pathogenic microbe, the venereal bacillus, creates and takes up his abode differs in every respect from a soft chancre — an essentially different microbe which gives rise to it. This may begin as a pimple on some crack or fissure, in and around this the bacillus forms a nest, breeds by spores, during which induration takes place; the pimple may burst, may be rubbed off, and an open sore with a hardened base may be the result. But ulceration, suppuration are not essentials of this microbe, and the abraded surface may be skinned over, and nothing but the induration felt. When the venereal bacillus, in any way, either from an impure connection or otherwise, reaches a crack, fissure or some weak part of the skin, through which it may find ingress, it lodges there and grows ; if the vital forces of the individual are strong, it may remain latent for many years, or if the vital forces be simply average it may incubate in from ten to thirty days, before even a sore or hardness is developed, and even longer before induration be complete. The hard-chancre sore is generally single, but a woman might give a man both varieties, a hard and soft, or the man might have congress with different women with all varieties of ulcers, and both varieties be the result of the indiscretion. As a rule, it is rare for infecting sores to make their appear- ance earlier than ten days after exposure to contagion, and in rare cases several weeks may elapse. Or it may assume or pre- sent itself in one of the following forms, the difference being due to some accidental condition : as irritation, friction, inflam- matory changes in the tissues affected by the bacillus. The epidermis may appear abraded, or excoriated and peel off in flakes, exposes a circumscribed circular patch of a livid hue or purple color, with very little ulceration or induration; or An indurated tubercle may form beneath the epidermis, the latter remaining intact, the surface of the sore not excoriated, no moisture or discharge ; or A coin-shaped nodule may develop in the substance of the skin, flattened on the surface, with circular margins and a definite shape, elevated edges ; it is very hard, feeling as if car- tilage were set in the skin, the surface raw, red, excoriated, which discharges a thin, watery fluid, which contains much epithelial scales. Inoculation may take place in any part of the body, as on and Dictionary of Diseases. 1013 the lips in kissing; from pipe of a smoker; contact by sleeping, drinking vessels, towels, sitting on seats, and handling articles used by the infected, without a sore, induration, or any mark by which the microbe could be detected. If there be a sore, or an induration, or crack by which this microbe does enter the blood, the lymphatics in close proximity, the veins leading from the point of ingress are usually con- gested. True, the microbe may enter the blood through every crack or fissure in the body, if applied there, without a sore or indu- ration, although the genital organs are decidedly the most com- mon seat of inoculation. Once the venereal bacillus enters the blood, it may remain latent there if vital force be high, as vital blood-plasma prevents all microbial evolution. Vital force somewhat depressed, admits of germ growth and certain constitutional symptoms invariably come to the surface, and the intensity, violence and destructive action of the germ depends altogether upon the degree of vital force present. It should be clearly understood, then, that with low vital force, symptoms of a destructive microbe in the blood will be prominent at once, or nearly so after the inoculation; if they are very vigorous they may never appear, but pass to the wife of his bosom and the innocent child of his love. All the old discoveries in syphilis are wiped out by the dis- covery of it being a microbe, no sore, no induration is neces- sary, as it can enter the blood without. Whenever microbial evolution begins in the blood, there are symptoms of languor, lassitude, debility, rigors, febrile attacks, pain in the sternum, enlargement of the post cervical glands of the neck, nocturnal pains in the bones ; eruption of some kind on the body, which is copper-colored and insensible. Here the microbe rests; growth and sporulation; no secondary or ter- tiary states — the microbe's presence is destructive to the blood and tissues. It has been a grave medical error to endeavor to divide it into stages. The very real bacillus, like all other dis- ease germs when in the blood, migrates to the weakest part, and there give rise to most active sporulation and destructive meta- morphosis in the form of plastic inflammation and ulceration of tissue — an exudation of inflammatory products, a tendency to the formation of young fibrous tissue. Prophylaxis of Syphilis. — Annually there seems to be an increase, a wider distribution of this germ, which is apparently due to (1) an increase of the social evil, (2) to the degraded ioi4 The Germicide 20th Century Practice character of emigrants who are permitted to land, and (3) to its very infectious and contagious nature. So extremely bad is this becoming that Congress will be compelled to pass, at an early date, a contagious disease act, before the entire country is riddled or eaten up with the germ. Licensed prostitution, weekly inspection by irreproachable physicians would do much to stunt its growth. There is no reason why our entire country should become contaminated by the foulest of all microbic diseases, which is now under- mining the life and health of our nation. There should be no mawkish sentimentality about protecting the dignity and modesty of fallen women. There is no reason why every town in the United States should become con- verted into a pest-house. Keener minds are needed in our pro- fession to grapple with this subject. We hear much of our water supply being poor, our drain- age imperfect, food adulterated, overcrowding and malaria, accounting for the indescribable languor of our people, as the cause of nocturnal headaches and septic sore throats, when such symptoms exhibit the activity of the germ in the weakened tissue. Fifty millions of our people should be placed upon comp. saxifraga, which has a specific tendency to kill it, and exerts such a powerful influence upon the lymphatic 'system, improving nutrition and building up deteriorated blood, wiping the bacillus out. It is the duty of the state not only to limit prostitution, but to exercise a constant supervision over it. When the venereal disease is of such a nature as to justify the fear that it is prejudicial to public health, being both con- tagious and infectious, essentially destructive to human life, moralizing is of no service in inducing women to leave the ranks of prostitution. As a contagious and infectious disease, syphilis, having the same etiology as smallpox and the plague, needs the same medicament and prophylaxis ; the infected must be isolated and treated. Open wide prostitution, licensed under state inspection of its inmates twice weekly, is preferable to hidden dens or brothels. Secret, unwatched prostitution is far more active in the propagation of the syphilitic bacillus than prostitution which is under control or license. A woman who spreads the venereal disease as her daily avo- cation should not be allowed to go free, while a butcher who and Dictionary of Diseases. 1015 sells diseased meat is prosecuted. The woman and the meat are both offered to the public for sale ; both should be inspected. Health officers, sanitary police condemn bad meat, carefully guard the people from variola, plague and kindred living con- tagions ; but the venereal disease is at the door of every house- hold, nothing being done to prevent its dissemination. It can be prevented; its cause, its etiological factor, unre- stricted, promiscuous sexual intercourse, by which it properly originates, and spreads or transfers itself from one individual to another by contact — a human malady, a pathogenic organ- ism entering the body by surface inoculation, and produces physical as well as pathological changes. Its presence in our midst is simply a disgrace to our present civilization. Just at the present time we have a governor com- petent for the work of obliterating this microbe from our midst. He has all the moral and religious elements in his grasp, the strength and power to give an impetus to public opinion on the subject, to bring out the higher elements of human nature. Solicitation, the selling of the body for prostitution as a means of living certainly can be prevented. At the same time better housing, means whereby the growth of modesty and chastity should be fostered — rational health amusements for mind and body provided ; curtail all influences that materialize precocity and animalism. One thing is sure, the syphilitic virus has been, is, extensively dispensed in this community*. Prostitutes, as persons carrying on a pernicious, unwhole- some, disease-breeding trade, should have the benefit of license and biweekly examination. Propagation of Syphilis. — Etiology. — Syphilis is a monstrous disease, terrible in its effects, and probably never more widely spread than at present. The bacillus of syphilis is not an aerobic germ, possessing more weight than many others, not volatile, but most active in some secretions. Once the germ enters the blood-corpuscles, and if vital force be kept high, it may never show itself; never sporulate. Since the discovery of this germ, its mode of propagation and culture, and also the important discovery that all the secre- tions of the body of a syphilitic patient are contagious, a com- plete change has taken place in the minds of all physicians on the nature of this disease. All the secretions, all the serum or matter of an ulcer, or skin eruption are most contagious. Inoculation from the blood of ioi6 The Germicide 20th Century Practice one affected will cause it in the healthy. One secretion or juice of an eruption may be more heavily loaded with the germ, and thus more contagious than another. Thus, for example, the saliva, the mucous tubercles, or the serum of a pemphigus are agencies through which the germ is most easily communi- cated. A nursing mother who has syphilis is bound to im- part to every child who nurses with her. It seems to be very active when derived from the fresh saliva, tears, sweat. Inocu- lations made with these fluids afford every time positive results. Kissing is a most prolific source of the disease ; next comes mucous tubercles; sleeping with persons next — the fresh secretions from an eruption; washing the clothes of the affected ; close contact of any kind. Babes often have the germ from their parents — any mother nursing or kissing these germ- laden specimens of humanity. Cupping, tattooing, dental forceps, catheterism of the ure- thra or Eustachean tube, speculum, syringes, drinking-vessels convey the bacillus. Glass-blowers are often infected; wind-instrument players from the tubes of some infected person. Sleeping in a bed recently tenanted by a syphilitic individual is by no means safe. The diagnosis of the presence of the venereal bacillus must never rest upon the presence of an indurated chancre, for the disease may be caught in a hundred other ways, from fresh secretions ; neither must it rest upon nocturnal pains in the bones ; nor upon a copper-colored rash, caused by the microbe whose ptomain poisons and blunts the sensory nerves of the skin; nor upon an ulcerated mouth and throat; nor upon enlarged lymphatics ; nor upon bone tenderness ; nor upon peri- osteal swellings, with nodes; but one recognition of all such cases should be made by themicroscope alone, either from the fresh secretions of a sore on genitals, mouth or skin or from a thin slice of the enlarged lymphatic, or, better still, from a drop of blood or rupial patch. The germ must be recognized as the special infective agent ; in syphilis its ptomain, as a poison which blunts and paralyzes sensory nerves. It is the microbe which excites plastic inflam- mation in brain, bone, skin and mucous membrane, and other parts, and creates a definite arrangement in the weakened tissue. The syphilitic bacilli do not occur free in the tissues, nor in the blood, but are for the most part present only in large oval, or polygonal, cells, in the interior of which they lie in groups and Dictionary of Diseases. 1017 of two to eight, often crossed or twisted round one another. As a rule, they congregate in nests, seldom isolated. Some- times several sections have to be examined before a well- formed nest can be detected or found. The venereal bacillus as found in all syphilitic new forma- tions, as in the chancre, or lymphatics, or ulcers on the mouth, tongue, or from a rupial patch, or gummata, or any fresh secre- tion is usually bent, slightly S-shaped. They show little knob- like swellings at their ends; their contour is not quite uniform, but is more or less wavy, or indented at several parts. When the finest possible section is highly magnified we can see the bacillus most distinctly in clear, oval refracting spots, two to four in number, placed at equal distances. These spots are; spores. Take the bacillus or a nest, plant them in beef juice, keep at a temperature of 98 degrees F. and in twenty-four hours per- fect cultures are formed, which, when injected into animals or man, produce the original, typical disease in all its malig- nancy. This microbe is visible in every case where there is a coppery ulcerated throat, or a coppery eruption on the skin. They are most abundant in the rupial rash, with the hair falling out. In the demonstration of these bacilli we employ a solution of chloride of iron to decolorize either the section or cover-glass preparations. In this method, the sections are stained for twenty-four hours in fuchsin, then washed in water and sub- sequently placed for a few seconds in either pure or a diluted solution of chloride of iron, washed in alcohol, and then trans- planted to the oil of cloves. The syphilitic bacilli remain red, or reddish violet ; the tissue remains unchanged. Double staining does not alter the result, nor anything to the distinct- ness of the illustration. This is the best method for the stain- ing of the syphilitic germ. Occasionally we have found this bacillus in the smegma of the prepuce, and in the vulva, which presented the same appar- ent morphological appearance; we have been unable to obtain cultures from them. YVe present the views of eminent members of the profession on the venereal disease : When the venereal bacillus enters the body, it has the power of multiplying in and acting upon the living tissues, at the same time elaborating deadly toxins, which give rise to a variety of constitutional symptoms, w r hich vary according' to the status of vital force. ioi8 The Germicide 20th Century Practice Each one of the pathogenic microbes has its own mode of growth, and selects a gland or tissue for which it has an affinity, but the syphilitic microbe grows luxuriously in every gland, organ or structure, if it be only weakened. Like all other disease germs, the presence of syphilis in the body renders that individual capable of propagating it by contagion and infection, for this pathogenic microbe can enter the blood through the mucous membrane, without an abrasion or sore or breach of continuity — close contact being sufficient, inhalation of the breath, absorption of sweat, or from bed- clothing and bathing garments. Non-infected become infected in workshops, handling tools of the infected ; towels, smoking pipes and sleeping with the infected are prolific sources of con- tamination. There is no use of such senseless prattle to the embryonic doctor, as primary, secondary and tertiary stages, for there are none, the microbe invariably selecting the weakest part ; neither is there any use in asserting its incurability, for there is now no disease germ able to withstand the array of bactericides in the laboratory of the chemist. Diet of the best, clothing, bathing, change of scene — all means capable of improving the general health — are good. Medicated baths of iodine and sulphur are of efficacy, inunc- tion into the lymphatics of the axilla and groin with an oitment of chrysophanic acid has merit in it. Protonuclein may be persistently administered, so as to crowd the bacillus of syphilis out. Affected individuals of this class expect a radical course of treatment to destroy the germ and insure their speedy recovery, and they should have it.. The question is, What is our best remedy? Is it mercury, iodide potassa, periodate aurum or chloride of gold? or is it Phytolacca, sulphur or comp. saxifraga? Judging the merits of a remedy by its sale, we would say the ozonized comp. saxifraga is many thousand gallons ahead of all other remedies; its formula embraces every drug of known efficacy, except mercury, which can be added if the physician so desires. All the leading physicians of the world use it for the radical cure of syphilis, and were it not for saxifraga our country would be depopulated by this bacillus. Take another view of it: j Syphilis is the outcome of a prolonged struggle for life and Dictionary of Diseases. 1019 between the invading microbe and the phagocytes. All we see of syphilis is the action of a toxin which the bacilli produce. This toxin acts locally and generally — locally by inducing inflammatory action, cell-infiltration in the areas occupied by the colonies of microbes; generally by diffusion through the blood, causing toxemia, with degenerations, anemia, muscu- lar wasting, nervous lesions, such as optic atrophy, ataxia, dementia, paralysis, etc. Rational treatment to kill the germ, or reduce its activity, or break up the toxin which is the cause of the lesions. Ozonized comp. saxifraga and periodate aurum check, con- trol, kill the growth of the germ of syphilis. The same ger- micides permeate the phagocytes, aid their vital energy in destroying the microbe. We have in these two remedies the means of eradicating the disease. Natural cure means total destruction of the bacillus by the phagocytes, which is effected by good diet, clothing, comfort- able housing and baths; complete means going into the spore state of any surviving microbes. Then, the toxin ceases to be formed and complete health is restored, till some local or gen- eral depression of vitality causes the resting or quiescent to develop. The general health must be kept up in every possible way, since any enfeeblement means weak phagocytes, a lowered power of the vital forces, which favor microbic activity. There is no better remedy for syphilis than saxifraga, as it wipes out the toxin rapidly and its removal enables the cells to assume the spore state, and the typical symptoms disappear with the toxin formation. The remedy should be given in water, as it is more effective, and never in larger doses than one teaspoonful three or four times daily. The toxin is quite soluble and its excretion by the kidneys will be promoted, if the supply of fluids is increased. Once the bacillus of syphilis finds an entrance, its future course, either generally or locally, depends on vitality. Good, strong, vigorous vitality, well maintained, it may never show itself; remains latent. Lowered vitality, germ activity. If an organ be depressed, such as the brain or stomach, or spinal cord, or lungs — then syphilis of that organ. Take an example in gastric ulcer, a simple erosion of the mucous membrane, either acute or chronic. The acute is usu- ally small, round, looks as if it was punched out of the stomach 1020 The Germicide 20th Century Practice walls; the chronic, large, irregular in shape, very common in middle or advanced life; more than twice as frequent in men as in women, and if that individual be syphilitic, so will the ulcer be, and must be so diagnosed. If there be no sternal pain, no nocturnal headache, no enlargement of the post-cer- vical glands, no copper-stained tissue, there will be the copper- colored mucous membrane of the hard and soft palate, pain after eating, local tenderness not great, irregular vomiting, considerable grumous or coffee grounds; often fetid, and if dilatation of the stomach exists, fermentation and the sarcinse. which is yellow, with great wasting of the entire body. Such cases tolerate the periodate aurum well, but they are not only benefited by that on the tongue, but one or two or more grains of jelly of violets, a powerful local anesthetic, mixed with thirty grains of ichthyol jelly, administered thrice daily, rapidly heals the ulcer, removes all the irregular, indurated edges, everted or inverted, hematemesis and melena disappear- ing. This treatment is a success. With Regard to the Bacillus of Syphilis. — For a cor- rect and efficient treatment all old ideas as to its pathology, of a pock, primary, secondary and tertiary stages, must be obliter- ated, for the germ may find an ingress in numerous ways into the blood, and when once there strike for tissues that are weak- ened for its habitat — there It will grow. Many millions of both sexes have the latent germs of syphilis in their blood which never appear, simply because the individual who has received the germ, either by contagion or infection or inoculation or by vaccination, maintains a high standard of health ; but let there be the slightest possible depres- sion, there will probably be lassitude, headache, osseous pain, liver trouble, bronchial irritation, some indisposition, for the toxin of syphilis is a subtle and rancorous poison, insinuating itself into the bone-marrow and cerebral arteries. To annihilate this germ in the blood, in every solid and fluid in the body, is the aim of all sound treatment. Various reme- dies have been placed before the profession for this purpose, none precisely specific, for such do not exist. From the vegetable kingdom, the comp. saxifraga ozonized is the most reliable of all alteratives; each teaspoonful of this valuable remedy contains five grains of the iodide of potassa. Old, reliable practitioners, well grounded in orthodox meth- ods, believe in the efficacy of mercury as a potent germicide, and' they add one-twtlfth of a grain of the bichloride of mer- and Dictionary of Diseases. 102 1 cury to each teaspoon ful of the saxifraga, which makes the preparation the protiodide of mercury — supposed to be elimi- nated after it has performed its work of inhibiting the growth and killing the syphilitic germ in the body. As saxifraga is dispensed it contains no mercurial prep- aration whatever; if desired it must be added. Preparations of gold have some little efficacy on the annihi- lation of the germ; the chloride of gold and platinum in pill form and the periodate aurum are considered the best. In the process of transmission typical types of the disease are delineated, the original pock on the skin and mucous mem- brane, stomatitis, interstitial corneitis, which have no parallel ; deafness is common in inherited cases. The pegged, notched teeth are also significant. All germicides, if administered properly, bear upon the death and extermination of germs, upon wiping out the microbe of syphilis from the blood and tissues. As an antisyphilitic ger- micide, never failing in its action, comp. syrup of saxifraga stands unrivaled. Its action upon the syphilitic germ is utter annihilation. Its action is greatly aided by administration of a few grains of the periodate aurum every other day, and a good tonic, either sulphate of quinine or comp. tincture matri- caria. Syphilis. — It is a good rule in practice to destroy all chancres with formalin, whether they be infecting or otherwise, as it is most effective, penetrates deeply through the induration, the focus of the germ dissemination through the blood. Ex- cision, if it can be effected without mutilation, is justifiable, to get rid of this fountain of microbic growth. Treatment in all cases should be commenced at once with ozonized comp. saxifraga and periodate aurum, and persevered with for some months. They are most reliable remedies to kill and eradicate this germ. A dressing of ozone ointment, morning and night, is usually sufficient, unless some compli- cations such as phagedena should take place, when the perox- ide of hydrogen should be applied in full strength, and changed every few hours, and reapplied again and again. Syphilis is a curable affection when those remedies are used, but they should be pushed thoroughly and systematically. Regularity of living, avoidance of all insanitary conditions and of alcohol are indispensable auxiliaries, together with good food, warm clothing. The syphilitic germ, like all other pathogenic microbes, when 1022 The Germicide ,20th Century Practice once it finds an entrance into the blood, no matter whether by a sore, or simply contact, usually manifests its activity and growth in weakened parts of the body, hence we have such states as brain and bone syphilis, syphilis of the eye, mucous membrane, lungs, liver, spleen; such states are usually easily diagnosed without a history of the case, by the toxin of the microbe paralyzing the sentient nerves of the part, lack of sen- sibility; the toxin stains the tissues copper colored, invariably in this state of partial death, gives rise to nocturnal pain. Whenever this germ is recognized as being present, begin constitutional treatment at once. The worst subjects to cure are the tubercular, who in addition to the regular antisyphilitic treatment should be placed upon glycerite of ozone and guai- acol ; comp. saxifraga ozonized and periodate aurum annihilate the microbe of syphilis. The vices, the defects of civilization, the keen struggle for existence, weaken the central nervous system, and if the patho- genic microbe of syphilis be present in the blood, it will find its way to weakened parts, exciting meningitis, thickening, gumma. The recognition of such cases may be obscure, but if the evening headache, giddiness, mental excitement, insomnia be noted, together with convulsions, commencing in a limb, with consciousness retained, a strong case is made out. Very much of the present paresis, locomotor ataxia and paralysis are due to the toxin of the syphilitic bacillus, which the attending phy- sician recognizes, but fails to pronounce. Phrenal syphilis is simply brain anemia, and with such remedies as thyroid extract, spermin, cerebrin, oats, we enter- tain a most hopeful view of the case, more than when those symptoms are due to degenerative changes, induced by sexual excesses and seminal losses. The treatment by increased cerebral nutrition, by pushing internally comp. saxifraga and phytolacca, and brushing the entire length of the spine from top to bottom, a few inches wide with the periodate aurum. The Microbe of Syphilis on the Skin. — Once the vene- real bacillus finds an ingress into the blood in man, woman or child, it is liable at any moment to appear on the skin, and the behavior of the germ here is somewhat different from other germs. In its growth on the skin the microbe excretes a toxin which paralyzes the sensory nerves : so whatever the character of the and Dictionary of Diseases. 1023 rash may be, there is neither pain nor itching, nor burning of any sort. Wherever the microbe may be it has a most extraordinary tendency to form nests in the skin, mucous membrane, hair, nails, brain, lung, lymphatics, periosteum. Therefore the type of all syphilitic skin lesion is generally papular. Wherever the syphilitic bacillus localizes its presence gives rise to fever and inflammation. It invariably causes discoloration of the skin; in the Cau- casian, copper colored; in other races of men, black. No portion of the body is free from the germ. Once it has invaded the body it may involve the whole or a part of the skin ; it may form a labial condylomata ; it may exist on the nipple, as a crack or fissure; or form rhagades between the toes; or a fisure on the tongue; or aquamous syphiloderma on the hands or feet. As the vitality of the skin is often impaired, weakened from some cause, it is on this gland that the microbe most generally appears. The irritative effects of the pathogenic baciHus upon the cutaneous surface give rise to every form and variety of eruption, in all of which the microbe can be detected, isolated, and even cultivated ; the more coppery and insensible the rash the many more millions of germs are in it. One of the most common types of skin affections caused by this microbe is roseola, on the chest and abdomen chiefly, although other parts of the body are often implicated. Inter- mixed with this roseola rash there are often found rose-colored circular spots, so closely set that they are very little apart, while in some cases they are very scarce. These spots under high microscopic power have been found to be simply nests of the germ ; they are seldom raised. Mingled with this form of skin eruption, there is often seen a lichenous rash, small papillae, copper colored, which termi- nate desquamation, the microbe peeling off in shreds. Again, if vital force be terribly shattered, the tubercular bacillus may appear with the pathogenic microbe, and both migrate to the surface together in the papillary layer of the skin. The epithelium covering these tubercles also desquamates and comes away in fine powdered scales. After this peeling of! takes place it assumes a dull red or copper color. In very debilitated cases the tubercles die and give rise to ulceration; in others they do not, while in others permanent pigmented scars are left. The forehead, nose and cheeks are 1024 The Germicide 20th Century Practice the favorite location of tubercular-syphiloid germs, the result- ing pigment scars being unsightly. Still lower vital force, more wreckage of the nervous system, the venereal bacillus may appear in the form of another erup- tion on the chest and abdomen, then on the arms and legs; it is a scaly or squamous eruption termed psoriasis. The rash consists of circular spots, slightly raised above the surface of the skin. Sometimes they appear white from the havoc and debris of the syphilitic germ ; rub this off, a dark reddish hue appears. The palms of the hands and the soles of the feet often suffer with this form of rash, which is invariably persistent and intractable. These cases are recognized by their history; their coppery color. Vesicular and pustular eruptions are also common; in the former, in the effused serum of the vesicle or pemphigus, the syphilitic germ is found; in the latter, effusion of lymph (eothyma), the germ is also present. In the latter abscesses are common, which produce cicatrices which are difficult to oblit- erate. With the microbe of syphilis in the blood an eruption of almost any kind may appear — all assume the copper color and a remarkable loss of sensibility. The cutaneous appendages, the hair and nails, often suffer from the ravages of the microbe; the matrix of the hair is often eaten out, the hair becomes loose and shed themselves in great numbers; frequently the head becomes bald, and the hair of the face and other hairy parts may share in the same destruction. In most cases the baldness so caused is not per- manent, the hair growing again when the microbe has been killed in the blood. The nails may suffer, become brittle, reedy r break off and, in some rare cases, the germ excites inflamma- tion in the matrix, which gives rise to intractable inflamma- tory changes. To recapitulate then, the microbe in the form of a roseola is its most common form on the skin ; it may occur on a portion or over the entire body. Vascular changes in the capillaries, occasioned by heat, cold, rapid cardiac contraction, influence the progress of the germ to the surface; any excitement or stimulant may throw it on the surface. So also with the lichen or papular rashes. The vesicular only occur among the most dilapidated or axd Dictionary of Diseases. 1025 "broken down, with meagre food and insanitary surroundings ; they are not so common. When they do occurthey may be from the size of a pinhead to a pea, conical, globoid or umbilicated ; isolated or grouped, and crusting elevations of the epidermis, with lucid or cloudy contents; situated on any part of the iDody. When the bacilli are very numerous in the blood ; when the powers of life are very low, and everything of the most degraded and filthy character, the vesicles become very large, like half marbles or hens' eggs on the surface of the skin of the foody and mucous membrane of the mouth. These vesicles, small or large, become pustular, or, in other words, rupia. Rupia is a form of ulceration of the skin, a sequel of the vesicle eruption, pemphigus, or it may take place without any effusion of serum. It is met with only in syphilis and consists entirely of a mass of syphilitic bacilli — brood after brood, in all stages of growth, from the spore to the mature microbe. It is estimated that in each vesicle or ulcer, or pustule or scab, there are millions in it — not dead but capable of inoculating others. The young brood below the scab throw the mature swarm off and produce a fresh crop, increasing every time the circum- ference of the ulcer. In this way there is a constant increase ; the recent scabs are larger than the earlier ones. There may be a few or a vast number of these rupial sores over the patient's body — all of a dark-brown color. They may be discrete, confluent, disseminated or in groups, effecting the curve of a circle. To the ordinary practitioner these germ nests are difficult to treat, but with bactericides, and physicians who believe in that theory, with our specific treatment check their growth and consummate their death by complete annihilation. When an individual, possessing the tubercular diathesis, receives the syphilitic bacillus either by an impure connection or by contact, the two distinct disease germs in his blood give a peculiar aspect to all eruptions or sores, causing them to become serpiginous, or a horseshoe shape. The presence of two of the most destructive bacilli in the blood produces fearful ravages, and exhibit themselves as mucous tubercles around the various orifices of the body, and in a most intractable form of skin eruption, all of a round or horseshoe shape. The areas of those syphilitic-tubercular are most variable and peculiar for the atrophic changes which take 1026 The Germicide 20th Century Practice place. Even the scars following the typical lesions retain their color, shape and pigmentation. The best plan in those dual cases is to place the patient upon both the treatment for syphilis and tuberculosis, such as cornp. saxifraga, alternated with cacodylate of sodium thrice daily, with periodate aurum at bedtime. The next alternate week mistura guaiacol, alternated with phytolacca, and so on. Syphilis Malignant is usually caused by meagre diet, insanitary surroundings, mercurial drugging, its association with the germs of tubercle and cancer in the same affected individual. When it assumes this malignant type it takes on either im- petigo, ecthyma or rupia. This embraces the rupial division of syphilitic eruptions. At the commencement or at the first appearance of either of those three forms, a red spot is first seen, on which pustules arise. These burst and a greenish crust forms over an irregular ulcer, with small-sized granulations, and surrounded by a red circle. Rupia is most common on the lower extremities, but may extend to the whole body. Pem- phigus is often the precursor of this condition. In such cases the nerve centres are dreadfully shattered, and the whole body literally saturated to overflowing with the microbe. Among this class of cases small tumors of a dusky red color often appear; occupy the entire thickness of the skin. These gradually soften and give rise to phagedenic ulcers. Some of these tumors contain millions of syphilitic bacilli. Fortunately at the present time malignant syphilis in our country is very rare. When malignancy stamps its impress upon an individual saturated with the germs of syphilis he must have best of food, sulphur baths, hygienic surroundings, in addition to saxifraga and periodate aurum; should likewise be put upon echinacea, cacodylate of sodium, , c. p. solution of spermin, matricaria : most energetic treatment. Squamous or scaly affections, as syphilitic psoriasis, are common and are not infrequently mistaken by very many physicians for lepra. Syphilitic psoriasis is found in the form of round copper-colored elevations, with white scales on the chest and arms; on the feet and hands purely copper colored, with hard scales. The best plan to distinguish this from the common forms is by a microscopical examination of the scales for spores of the germ, for if the protoplasm operated by the germ be young and Dictionary of Diseases. 1027 the toxin coloring (copper) may not be present. In old pro- toplasm the character of the projecting patches, of copper hue,, covered with hard and grayish scales, there is no difficulty in its recognition, even by the eye. The pigmentary eruption (toxin) is hard to wipe out, but the three remedies, compound saxifraga, periodate aurum and sulphate of quinine, for a few months effect a complete change from disease to perfect health. Vesicular eruptions, small or large blebs filled with ordinary bacteria and the pathogenic bacillus of syphilis, are not so very numerous — that is, do not occur so frequently as one would suppose. Sometimes we meet with a few in groups which may form a crust and thus resemble eczema; at other times they may be as large as small marbles or eggs ; a few or they may cover the entire body and even the mucous membrane of the mouth. If their protoplasm be young they may not be stained, but in old cases they are invariably stained around their base, surrounded by a coppery areola. In several weeks, if not rup- tured, these vesicles become pustules, their contents changed form a serous to a yellowish pus mixed with blood ; by and by the crusts become brown, with the microbe imbedded in it. When they dry up in this form, they form what is termed "rupia," a rather formidable form of eruption which, in the hands of some inexperienced physicians, often prove fatal, from the fact that the blood is litedally saturated with the germ. The onyx of the nails is frequently a favorite location for the localization of the germ ; in that case the onyx is tinged yellow or copper colored by the action of the toxin. The presence of the bacillus in this vicinity is most disastrous to the nutrition of the matrix. In its imbedding itself at this point it excites irritation, inflammation, ulceration. This usu- ally begins at some part of the lunula or root of the nail, and the toe becomes swollen and of a deep, black red. The nail generally drops off, and if neglected the phalanx may suffer necrosis and gangrene and require removal. The most power- ful constitutional treatment should be pushed, together with germicide treatment for the destruction of the germ; locally keep it packed with peroxide of hydrogen in which a percentage of sulphocarbolate of sodium is dissolved. The Syphilitic Microbe on the Mucous Membrane. — In what we deem healthy states of the mouth and throat there are some germs present but, when malnutrition or some other depressing influences act upon the mucous membrane, its pri- 1028 The Germicide 20th Century Practice mary elements or molecules of nutrition are changed, altered, degraded into other living matter which has special and inde- pendent powers of existence, and is named a disease germ. The degraded primary element of nutrition of the mouth, under adverse states, constitute what is known as the oidium albicans and leptothrix mingling together in vesicles or nests, small blisters followed by ulcers, which is described under the name of aphthae. This may occur in any one liable to malnutrition and weakness of the mucous membrane. Suppose an individual with a devitalized mucous membrane, with aphthae, with its two microbes, has the pathogenic venereal bacillus in his blood, it will migrate at once to this weak point, where it will grow alongside of the odium albicans and the leptothrix, shed its spores with such wonderful rapidity as to become the predominant microbe of the three in the mouth. It is the leading germ, as is seen by the copper-colored ap- pearance of the sores or ulcers ; by the prodigious number seen in the secretions of the ulcer ; by its great potency of seeking other mouths in kissing, and instantly communicating the disease. The entire mouth may be but an immense pasture field for the germ, or only a portion may be affected. The lips, gums, cheek, often cracked, fissured, ulcerated, all teeming with the microbe in various stages of growth and sporulation. The mucous covering of the tongue ; in the central area we often see a prolongation, or perpetuation of the same rashes as on the skin, vesicles, psoriasis or squamous syphiloids, are often seen here. Warts, or papilloma, due to the syphilitic germ are not also uncommon on the edges and at the root or base. Both on the dorsum and tip are often found gummatous growths. These often vary in size from a pea to a walnut — typical, positive evidence of the disease. But the common leading affection is syphilitic aphthae, vesi- cles or blebs, ulcers, superficial or deep ; excavations on its sur- face or edge — in bad cases deep ulcerations may affect its whole surface — or there may be cracks and fissures, resembling epi- thelioma, usually somewhat persistent, intractable, liable to dangerous changes unless bactericide treatment is rigidly carried out. The larynx suffers with the tongue, congested, inflamed, either superficial or deep ulceration. It is to this germ-eaten state of the larynx, more than anything else, that we owe the sore throat, the huskiness, hoarseness and loss of voice. and Dictionary of Diseases. 1029 There seems to be no tissue in the body so rich in pabulum for the syphilitic germ as those in and about the larynx. So it is here, if there be a weakness to attract it, that it makes such ■dreadful ravages — frequently commencing in the epiglottis, which it often completely destroys; it penetrates to the vocal cords and eats them out. The cartilages of the larynx are often attacked, and either ulcerate or necrose. In consequence of the very considerable formation of fibrous tissues which fol- low the ulceration, the glottis is sometimes stenosed and dysp- nea results. The tonsils sympathize in all cases; even when the microbe but slightly infiltrates the tongue, with greater microbial growth or evolution, they swell greatly; ulcers of a circular shape, intensely copper colored, with sharp-cut edges penetrate deeply into their substance; the base of those ulcers often slough. The lining membrane of the nose being in such close prox- imity to the mouth and throat, often becomes attacked by the microbe; destructive metamorphosis is not nearly so common, since the use of mercury has been discarded in treatment. Of all the structures in the body none seem to have such an affinity or attraction for the venereal germ as the mucous membranes of the body. In the throat we find, in all cases of syphilis, a uniform redness on the velum palati; tonsils and pillars of the fauces ; later on, on the posterior wall of the phar- ynx and the interior of the larynx, which appears to proceed down. The mucous membrane of the nostrils also shows symptoms of the presence of the microbe. In snipping off the top of some of the raised tops of the patches on the larynx you can readily isolate the bacillus, but they are more numerous in the ulcers on the edges and surface of the tongue, on the fauces, in the nostrils and sides of the lips, and on the inter- nal aspect of the lips. They are usually superficial, return again and again for years with annoying precision until the treatment by comp. saxifraga, ozonized echinacea, periodate aurum and alkaloids of cinchona are brought to bear on the case for many months. There are also certain appearances which are only seen when this great pathogenic microbe is in the blood. These are char- acterized by elevated patches in the skin or mucous mem- brane, circumscribed and more or less whitish, in color, or rose white. These are developed sometimes on the healthy surface. On the skin these germ nests are covered with a transparent 1030 The Germicide 20th Century Practice crust, and surrounded by a swelling. On the mucous mem- brane these germ nests are a little prominent. The vulva, the anus, the upper part of the thighs, the tonsils, mouth, lips and spaces between the fingers and toes, the nipples, groin and ears are most frequently affected. On the scrotum the merest patches are often met with. In the mouth they are at first of a violet hue, and then fissures of the tongue often ensue. They are whitish on the velum palati, and are also found on the vocal cord, and one out of every six cases of hoarseness are due to the presence of the syphilitic germ. Such appearances are seen at the edge of the nostrils and mouth for years, and are cases essentially of great danger ; they often disappear and recur, but remain a focus of contagion until inhalation, several times daily, of either peroxide of hydrogen or chlorine, or chlorate of carbon, and internally saxifraga, periodate aurum, quinine, ozonized echinacea. Syphilitic Ulcers. — Cutaneous ulcers are breaches of con- tinuity of surface either caused by inflammation or some unre- paired injury. They are usually divided into simple, inflamed, irritable, chronic. Such ulcers are liable, when any special microbe is in the blood, to have its appearance in the ulcer, which modifies, changes or alters it completely into a nest of breeding germs. There is no form of ulcer without some special germ, but when the bacillus tubercle, or syphilis or can- cer is present the microbe can be isolated from the ulcer and cultivations made. Probably the syphilitic germ is present in the blood and tis- sues of seventy-five per cent of our entire population. The native-born American, as a rule, is comparatively free from the venereal bacillus; whereas if we take the foreigners who annually emigrate here, all are tainted, and if there hap- pen to be a few free from all blood-germ taint they are inocu- lated at quarantine with vaccine charged with syphilitic germ- laden lymph. No escape, for the health physician must have his fee. This is a procedure, an indignity to our race, but it is a definite measure for the propagation of syphilis among those who seek our shores. The recognition of a syphilitic ulcer is easy; its copper-col- ored appearance and the presence of the germ in the discharge. The great trouble with all syphilitic ulcers is, if they are treated erroneously by physicians ignorant of their nature they are extremely liable' to assume a phagedenic form — a state of things in which the ulceration spreads rapidly, the tissues and Dictionary of Diseases. 103 i breaking down and becoming disintegrated. When sloughs form around the margin of the sore and it becomes painful, spreads widely, syphilitic phagedena is present. Sloughing, eating, painful ulcers with constitutional dis- turbance indicate great depression and vitiation of the blood. It is impossible for any one now to suffer from ulcerative phagedena, mercury seldom used. Sanitary science thoroughly understood and germicide remedies, peroxide of hydrogen, chlorine, saxifraga, periodate aurum, echinacea and tonics to improve the general health and restore a healthy condition; our local antiseptic dressing at once arrests the ravages of the disease. In patients who have been mercurialized, or happen to be surrounded by insanitary conditions, any syphilitic ulcer may assume a state of either dry or moist gangrene. When this occurs, the edges of the sore becomes painful, swollen and livid ; a grayish slough covers the surface ; the dis- charge becomes thin, watery and scanty. If the progress of this local death be not arrested the destruc- tive action spreads with fearful rapidity. Vessels may be opened, bones laid bare ; profuse hemorrhage may set in. These local symptoms are usually accompanied with great constitu- tional disturbance. In these cases the strength must be upheld by ( a generous diet and stimulants; pain must be alleviated at all hazards. The sore must be treated by powerful germicides, and the same class of remedies given internally. Patients getting into such abject states can readily trace the cause to its proper source. Under bactericides, benign and efficacious treatment, we never have complications like this. Alopecia is most common in the asthenia form; that is where great debility and general feebleness of the powers of life exist. Alopecia is due to the activity of the bacillus in the blood penetrating to the hair-bulbs ; to a want of nutrition ; to the ex- creting of toxins, poisoning the hair-bulbs or root, causing the hair to fall out without redness of the scalp. There is often a general tendency to free thinning of the hair in patches — the beard and eyebrows often suffer. The alopecia may last many months, but the hair soon reap- pears when the germ is killed and the health restored. Internal bactericide remedies should be pushed with great energy in those cases, especially chlorine and cacodylate of sodium. 1032 The Germicide 20th Century Practice The resorcin ointment is an excellent remedy to apply to the scalp in all cases of alopecia. It softens and smoothes the hair, promotes its nutrition by neutralizing the poison in the hair- bulbs. The ozone hair restorer also excellent. The thyroid extract has done much in alopecia in starting a new and healthy growth of hair. The Bacillus of Syphilis in the Brain (Phrenal Syphilis). — Nerve tissue, being intrinsically the most valu- able structure in animated nature, is the most highly vitalized, the most effective in resisting depression, the most difficult to weaken, and above all it has a most remarkable faculty in resist- ing the ingress of the syphilitic germ — even when the blood is germ laden the brain will resist their localization of those cop- per-colored micro-organisms. We need no history of a case, as the germ often gains access to our bodies by some slight indiscretion, some impure connec- tion without a visible pock. What of those mysterious headaches, — aches, pains; that unaccountable languor is clue to. the syphilitic germ feeding upon brain-tissue, — insomnia, vertigo, nerve storms, as epi- lepsy and chorea, paralysis, aphasia — neuroses of all descrip- tions occurring in middle life, when the diploetic structure of the skull has become obliterated; when ossification is com- pleted — all are significant, especially of these : numbness, formication at night, with heats and colds during day. If such symptoms radiate from an individual, even were he a deacon or a priest, look for phrenal syphilis, because, as a rule, tumors, abscesses, organic lesions, white softening are rare at the early period of life. Our readers must bear in mind that in every town and city of our country the germs of syphilis are widely spread, mi- nutely diffused, in various forms. No man or woman can say that the germs of that terrible bacillus are not lying latent in their blood. No one can deny that the germ is not an eating ulcer in our land. We all know that it enters our bodies from the breath, sweat, contact of the affected ; by handling articles in ordinary use; by drinking vessels in our parks and public places ; towels ; sponges ; sleeping cars. We receive the bacilli unconsciously, and if we maintain good health it will not sprout. We must accept the inevitable; if we cannot elucidate the symptoms on a good basis, we are justified, at least, in placing the patient upon special remedies to destroy the venereal bacilli, and Dictionary of Diseases. io 33 and aid in increasing vital force by every possible means. True syphilis is the saddest affection of the human race, espe- cially when it invades the brain. The pathogenic microbe of syphilis, the very moment it enters the blood, will, if the brain be weak, exhibit its ravages upon that organ. This is also true of brain workers, who have overworked that organ. We have seen many cases in which the microbe went for the brain alone without any manifestation on either the skin or mucous membrane. These cases of cere- bral syphilis occurred among clergymen, school-teachers, attorneys, merchants — all individuals who suffered from brain wreckage. The germ in the brain produces either nests, gummata or sclerous arteritis, which is followed later on by brain-soften- ing. The germ produces in the brain the same lesions as it does in other parts of the body. The lesions of the meninges are sclerous meningitis and gummy meningitis, of which the first is the most common. These are the most important of all the lesions which syphilis produces within the cranium, because most frequent and severe in their effects. Their action may extend to the nerves, the vessels or the brain substance. When the germs act on the nerves they produce palsy of the cranial nerves ; when on the vessels, they compress, narrow or occlude those, and when they act on the brain thev may do so by their ptomain poisoning it, or by the obliteration of vessels which nourish it. Sclerous arteritis takes place in this way : first there is more or less abundant proliferation of the young germs in the vascular sheath, or in the coats of the vessel ; then comes progressive organization of these germinal elements, with formation of rigid and fibroid lamellae, with deformity or obliteration of arteries. Stenosis, thrombosis, and complete obturation of the vessel may result. Cerebral gummata have been seen as lar.ee as a walnut or hen's Qgg. They may occupy any part of the brain, but are generally located on or in the cortical substance in the peri- phery and most frequently in the front part of the brain and middle portion of its base. Syphilitic nests or gummy tumors in the cranium have been mistaken for cancer and tubercle. Tubercle is found only in the tubercular and has a predilection for the cerebellum. Gummata are followed by softening, which is not common in tuberculosis. The common lesions resulting from the presence of the germ in the cranium are inflammation and softening. The leading 1034 The Germicide 20th Century Practice symptoms produced are headache, epilepsy, paralysis, aphasia and the mental malady of imbecility, mania. Once the bacillus of syphilis enters the brain it produces a condition of chaos. The commonest form of phrenal syphilis is that of progres- sive dementia; but delirium and mania are not at all uncom- mon. Syphilitic insanity is a common malady, much more so than is generally supposed. Persons with cerebral syphilis are often remarkable for want of memory and intellectual debility. Such persons become nonchalant and forgetful, and commit many gross errors and faults in business. The patient becomes quite unlike himself and neglects his family and rela- tions, or maltreats them. The law takes no cognizance of such states; the individual is really not accountable for his actions. Undoubtedly want of memory is one of the most characterise tic of the disease. It may be sudden and complete — intel- lectual depression with incoherence, followed by complete dementia. In rare cases of cerebral syphilis there are seen bad cases of melancholia and hypochondriasis, and the patient ■may have ideas of being persecuted and desire to commit suicide. In other instances the lesions of cerebral syphilis may cause excitement, delirium or exaltation. Patients of this kind may have attacks of furious mania. Others, again, become eccentric and excitable, and are considered by their friends as rather out of sorts. They waste their means, fail in business, or talk incessantly. Some are. perfect maniacs. They are excessively irascible, often violent or abusive and even dangerous to their friends. They suffer from insomnia, but are often capable of great muscular exertion. In short, the incoherence, delirium, mania, melancholy and all other mental perturbations seen in syphilis are identical with those in other forms of cerebral lesions. The Germ Syphilitica in Bone. — When the electrical forces of the atmosphere are lowered toward and during night, and the bones and their coverings weak, the microbe, if in the blood, will migrate there and excite periostitis and ostitis, and give rise to great pain, which subsides toward morning. By and by organic changes take place, lymph is effused, round or oval swellings form, called "nodes," when the nocturnal pains become excruciating. The superficial bones, as the tibia and the ulna, not infre- quently become notched like the teeth of a saw, and in young and Dictionary of Diseases. 1035 men or women the joints and head of the bones suffer almost an exfoliation. The syphilitic germ, when, improperly treated, may enter some of the bones and produce dry caries, giving the bone a worm-eaten appearance. Injudicious treatment, the improper use of soluble mercury by empirics, inexperienced practitioners, in a most remarkable degree influences this form of caries, and they will hold on to it until the external table of the skull becomes eaten like a sieve by the microbe. This form of dry caries also attacks the bones of the nostrils, although periostitis is almost always the cause of the con- comitant ozena. Whilst one part of the bone may be eaten away by the germ, the opposite side may be undergoing a thickening by a deposit of the germ imbedded in the lymph in its interstices. The pain in all cases in which the microbe enters the bone and there grows is nocturnal for the reasons already stated and causes sleeplessness. When in the bones of the head it may result from a node on the internal table of the skull. In such cases there is often great giddiness, with epi- leptiform seizures and a feeling of tearing and excruciating twisting of the parts is complained of. Dry caries of the skull is characterized by persistent headache, and by slight promi- nences which have depressions. Acute Inflammation of the Prostate. — A partial death of the prostate gland at the neck of the bladder may be either acute or chronic. Acute inflammation of the prostate is generally the result of either a gonorrhea, the erroneous exhibition of remedies; "blows ; irritation of the genital organs by masturbation, or per- version of the sexual act ; irritation of the rectum ; exposure to wet or cold ; passage of instruments. The ordinary symptoms are pain, heat in the perineum, fre- quent calls to make water, with difficulty in doing so. In some cases the swollen gland interferes with micturition, and there is retention of urine. Evacuation of the rectum is at- tended with pain. Prostatis causes much swelling of the whole gland, with great pain in the gland, and also in the limbs; fever, prostra- tion. In the treatment of such cases the patient should be confined to bed; hot anodyne fomentations kept constantly applied. Large doses of the green root tincture of gelsemium ad- 1036 The Germicide 20th Century Practice ministered, with cocain suppository into the rectum. If there be retention of urine it must be drawn off from time to- time as occasion requires. As soon as the acute symptoms sub- side he should be placed upon the black-willow bark. Enlargement of the Prostate Gland. — There is no- gland in the entire body which so frequently suffers irritation. If weakened or damaged and the bacillus of tubercle or syphilis be in the blood they are often thrown out into the structure of the gland, which gives rise to rapid enlargement. In simple irritation fibrous tissue is effused ; whether microbial or simple there is a natural tendency in the gland after the age of fifty to enlarge from its natural size of a chestnut to that of an orange. When an enlarged prostate is cut into after death it exhibits a very firm, whitish-brown substance, fibrous bands and calcareous deposits; ulcerations and fistulous openings, anterior and posterior. Invariably impotency, urinary trouble, continence or incontinence of urine, with the micrococcus urese in the bladder, which gives rise to straining efforts at micturi- tion which tell disastrously on the bladder, giving rise to organic changes, catarrh, thickening, ulceration. Catarrh of the Prostate Gland. — Gonorrhea, mastur- bation, sexual excesses, perversion of sexual congress, immoral reading, an impure mode of life, bicycle riding weaken the nor- mal vitality of the prostate gland, and give rise to a catarrhal condition — a state in which the natural secretion of the gland is white, shiny, glairy or milky ; in which its chemical secretion is changed or altered ; in which no spermatozoa can be detected, but in their stead prostatic crystals, and hopeless, irreparable impotency takes place. Prostatorrhea is essentially a malady of our neurasthenic young men — a most common affection, one that is sapping the growth, vigor and future prosperity of our country, draining its strength and energy. If the place of the robust and healthy are to be filled by these effeminate, weakened, nervous, and physically drained youths it will be most disastrous indeed. Every man who has a leakage, even a moisture, should con- sult us either personally or by letter, as all urethral discharges tend but one way. Syphilitic Affections of the Cornea. — Keratitis is generally associated with much photophobia and lachryma- tion. Patients of a tubercular and syphilitic constitution are its victims. There is usually some fever, haziness of the cornea. and Dictionary of Diseases. 1Q 37 The syphilitic germ usually enters the cornea at the centre. From the remarkable rapidity of microbe growth the cornea soon becomes hazy and covered with white specks of opacity between the laminae. There is usually increased vascularity of the corneal vessels. In a few weeks' time the other cornea becomes similarly invaded, unless very active measures are taken to arrest the destructive progress of the bacillus. Asso- ciated with this there are other evidences of the venereal bacil- lus — the pegged, defective teeth, broad and flat nose, thick upper lip, fissured margins of the lops, peculiar muddy com- plexion, etc., all indicative of the presence of the microbe. Nourishing food, iron, tonics, comp. saxifraga and the aurum and platinum tablet. Iritis — Eye Affection of Systemic Syphilis. — S^bhi- litic iritis is one of the most frequent forms of syphilitic affec- tions observed in the eruptive period of the disease. In a large array of syphilitic cases the author has seen much of this dis- ease, and it is much more prevalent than is generally supposed ; even that myopia of school-children so much talked about, nine cases out of ten are due to the syphilitic germ in their parents, and are cured by us by antibacillary remedies which we use for the cure of syphilis. Authors speak of iritis as superficial and deep-seated. In ordinary cases the eye is red from congestion, the iris dull, then of a dusky hue, with occasional small elevations on its surface. The pupil is uneven and more or less altered in form — triangu- lar shaped ; the iris sometimes assumes a yellowish, rusty hue. In some cases there is adhesion of the posterior part of the iris to the lens. Physicians ignorant of its microbial origin will treat it and it apparently gets well, but it will recur again and again, year after year, and in this way give rise to irremediable damage to vision. The pain is slight at first, afterwards severe round the orbit. Intolerance of light is uncommon. It is rare for both eyes to be attacked at once ; still, they both later on are affected. It is a most obstinate form — stubborn to reach, and unless the patient is placed upon the remedies laid down in this work, with locally atropia (gr. iv to one ounce of vaselin). I have met much of this form of iritis among syphilitic children which is easily recognized by the irregularity of the pupil, the presence of dimness of the cornea. In some cases of syphilitic iritis the germ migrates to the choroid and retina, and causes destruction of the eye. Besides which the cornea becomes also involved, giving rise to great 1038 The Germicide 20th Century Practice imperfection of vision. There is muscse volitantes, some pho- tophobia and considerable night pain. In my examination of these cases with the ophthalmoscope, we can see sinuous veins packed with the germs, with hazy, vitreous humor showing the optic nerve in a fog. Patches of exudation are seen on the choroid. In spyhilitic retinitis the optic nerve has an ill-defined out- line, and is surrounded by a dirty, greenish zone. Mydriasis is rare ; still, it occurs. It is well that physicians should be aware that the microbe of syphilis is the cause of both hereditary and acquired blind- ness; the statistics of all our institutions for the blind will verify this assertion. Loss of vision may be occasioned by exostoses and caries of the sphenoid bone, or by syphilitic humors pressing upon the optic nerve. There may be complete loss of vision also by syphilitic tumors pressing upon the optic nerve. The same may take place from changes in the interior of the orbit and seen by the ophthalmoscope, such as contraction in the size of the ar- teries and atrophy of the papillae. Blindness or amaurosis is not, by any means, rare ; neither is atrophy of the disc. Syphilitic iritis is not uncommonly a loss of vision. Iritis. — When the nervous system of the patient has been shattered or broke down either by overwork or excesses or meagre food, or insanitary states, or mercurial drugging, or any depleting cause, the venereal bacillus seeks that delicate, sensitive structure of the iris. The presence of the germ in this part of the eye is invariably accompanied by pain, aching, head- ache, with more or less photophobia and lachrymation. The conjunctiva and other structures sympathize, and the iris itself becomes surrounded by a deep zone of congested vessels in which the microbe is at work. The aqueous humor is also infiltrated by the microbe, becomes turbid from their presence, and the effused products of inflammation. This causes a change in the color of the iris as well as a blurred or ragged edge appearance. The pupil is sluggish, different in size from its fellow. In the anterior chamber, on the margin of the pupil, and in the substance of the iris, beads of lymph may be seen. If iritis be erroneously treated, or neglected, or permitted to run its course the plastic lymph and the ptomain of the germ become organ- ized into a degenerative form of fibrous tissue, which causes a complete adhesion between the germ-laden iris and the lens capsule — even lymph bands extend to the cornea. and Dictionary of Diseases. io 39 The formation of such adhesions, the degenerative changes induced by the bacillus, often give rise to the most persistent form of chronic iritis that can be imagined, with an exten- sion of the inflammation to the ciliary processes and choroid. The essential elements of sound treatment must be observed, the bacillus must be destroyed with our great specific, the comp. saxifraga and the gold and platinum pill. In addition, rest in bed in a dark room, freedom from care or worry; the best of diet. The pupil should be kept well dilated by dropping into both eyes a solution of atropia; large doses of sulphate of quinine should be administered, and active stimulation at the nape of the neck, over the origin of the optic nerve, in the medulla ob- longata, resorted to. The affections of the auditory nerve caused by the germ syphilitica are buzzing, whistling, ticking sounds, or deafness of various degrees. The affections of the optic nerve are by no means rare and occur in one out of ten of all cases of cerebral syphilis. They are generally progressive in their evolution. They are of all degrees, from slight amblyopia to complete blindness. Amaurosis and ptosis often exist together. The lesions seen in these cases are known as optic neuritis, and atrophy of the disc. These states testify to the presence of a lesion seated behind the optic nerve, within the cranium. Ptosis, a dropping of the eyelid, is not infrequently the sole lesion observed in cerebral syphilis — the germ attacking the centre of innervation of the upper eyelid. A palsy of the eyeball is more rare. Rhinitis. — A very gloomy and foreboding condition, dan- gerous, is when the germ attacks the lining membrane of the nostrils, and gives rise to ozena. One nostril is generally first invaded and the patient complains of obstruction and sometimes of pain at one point. The external integument be- comes red and inflamed. Serosanguineous fluid, loaded with genus, begins to exude, and is often very fetid. When the inflammation is confined to the anterior part of the fossa, crusts are seen covering ulcers. If the germ is not annihilated it will attack the cartilages and bones of the nose and may cause the nose to waste — atrophy. This is a serious lesion and requires energetic treatment, vigorous medication with our best remedies. Topical applications are of little avail when the germs have penetrated deeply. Ozsena syphilitica and numerous cases of nasal catarrh ex- 1 040 The Germicide 20th Century Practice hibit in a marvelous manner, the opedations of the germ hx the nose. The nasal canal invariably exhibits irritation in sys- temic syphilis, and the bones not infrequently become necrosed by the germ. The nasal canal has long been known to become inflamed in syphilis ; especially in old, neglected cases the canal is badly damaged, being literally germ-eaten. General Treatment for Syphilis. — Peroxide of hydrogen, to which either resorcin' or sulphocarbolate of zinc is added, snuffed up or brushed over the parts thrice daily, is very effica- cious, with the occasional use of iodol snuff. The Microbe of Syphilis Attacking the Spinal Cord- and its Membranes. — The usual effects of the bacillus of syphilis upon the spinal cord or its membranes is to excite a chronic form of myelitus, with effusion of plastic lymph, a type of disease which is remarkable for its chronicity and termi- nates either in chorea, locomotor ataxia or paralysis. Locomotor ataxia has increased with . precisely the same ratio as the syphilitic germ. About 90 per cent of all cases can be traced to the presence of that microbe. That ataxia should be caused by this germ is due to the power which that germ possesses of deteriorating nutrition and thereby the power of resistance of this part of the central nervous system is weakened, and also to the peculiar form of fibroplastic in- flammation which is set up. When this kind of inflammation attacks the posterior zones of the spinal cord, it gives rise to fibrous effusion, a true scle- rosis, which branches out in all directions, and literally de- stroys the function of the cord. The bacillus of syphilis, when in the blood, often invades the spinal cord if it be weak. The presence of the germ in this structure very much resembles that of the brain. The germ is usually found in the dura mater; but the cord itself may be turned into a substance like fibrous tissue; the nerve-cells being obliterated ; or it may be softened, just as we have in the meninges and arteries of the brain. Syphilitic nests, or gummy tumors, are found in the cord, resembling those in the liver. Locomotor ataxia is caused by the germ syphilitica, a sclerosis of the cord which causes a destruction of the nerve- cells. Why the germ should select the posterior columns of the cord is not quite clear. Still it is the cause of ataxia. Paraplegia is very frequently syphilitic in its origin, and all physicians are agreed that the large number and great increase and Dictionary of Diseases. 1041 in all nervous diseases is due to syphilis. There is sometimes a. difficulty in deciding whether the paralysis of the extremities be due to the cord or brain; that is, when all four extremities are involved ; when the brain is effected, some cranial nerve is implicated. A sense of constriction around the body is a symp- tom of spinal disease, and this may be felt at all levels, from the axilla to the pelvis. This symptom is not seen in cerebral, but only in spinal affections. The purely syphilitic tongue is characterized by its wrinkled and shriveled appearance; the whole organ is more or less de- nuded of epithelium; presents a mottled, whitish appearance, and often looks small and pointed. Generally we find a few shallow ulcers scattered about its dorsum, with intervening ridges of tissue; comparatively elevated, and more or less de- nuded of epithelium. There may be sessile, whitish, warty growths of irregular shape, with fringed and ragged edges; usually multiple. Warts along the edge and root of the tongue are very generally met with on males and are most excellent landmarks as to the presence of the bacillus in the blood. The adjoining mucous membrane of the lips and cheek presents numerous patches of faintly-white discoloration, alternating •irregularly with tracts of healthy epithelium; the former ap- pearance being due to shallow ulceration and subsequent cica- trization. Ichthyosis of the tongue is frequently met with. If a gummata is formed and breaks down, there will be no appreciable induration around the ulcer, and the rest of the tongue does not put on a glassy edema. The lymphatic glands under the gum will be slightly enlarged. They usually remain small, hard and permanently hypertrophied, but do not pro- gress to suppuration. Syphilitic ulcers are painless; the breath never has the fetor which is present in cancer. Tumors, consisting of millions of the bacilli of syphilis, are found on the tongue, in many cases, near the base, like hazel-nuts. If not treated, these soften, and, bursting, leave abscesses in the organ, and cicatrices. They are not infre- quently mistaken for cancer, when in the ulcerative stage ; but the chronic progress of the syphilitic ulceration, the odor of the breath, the non-implication of the lymphatic glands, and a microscopical examination of the discharge from the ulcer will clear up the diagnosis at once. Germ-nests, or gummy tumors, rapidly perforate the velum and hard palate. Such cases should be treated vigorously by our valuable bac- 1042 The Germicide 20th Century Practice tericides; by the application of the dioxide of hydrogen thrice daily; saxifraga; periodate aurum; echinacea. If large ulcerations fill the mouth, or pharynx, nitric acid should be fearlessly applied, followed with the dioxide of hy- drogen as a wash. Adhesions of the uvula to the posterior esophagus opposite the larynx has been found. Mouth and Pharynx. — The mucous membrane of the mouth very early exhibits the presence of the syphilitic germ in the blood by its ptomain coloring the lining membrane of the oral cavity. Irritation, inflammation, ulceration, or, in other words, a partial death of the tissue from the presence of the germ; thus we find ulcers on the tonsils, edge of the tongue, gums, pharynx. The various parts are reduced to a mass of pulpy consistence. ' The bones of the hard palate often become exposed, and necrosed by ■ such ulceration. The palate is commonly attacked, but the pharynx and larynx are very fre- quently involved in the destructive process, which is often de- plorable. Sloughing of the throat is common where the pa- tient has been maltreated. Larynx, Bronchial Tubes, Lungs. — The bacillus of syphilis has a strong affinity for the fine, delicate, highly or- ganized mucous membrane and cartilages of the larynx. The slightest hoarseness or change in the voice is one of great dan- ger, as the germ eats rapidly and is liable to produce necrosis of the cartilages, complete destruction of the epiglottis. The loss of voice so common among all syphilitic patients results from the germ gnawing the vocal cords; the aphonia of per- manent their destruction, with probably either necrosis of the cartilages of the trachea and larynx. The germ of syphilis evades the joints, but strikes for the spongy tissues of the head of the bones, together with the pink marrow. The syphilitic germ in any portion of the throat, fauces, larynx, or trachea, is of grave importance. Ulceration of the epiglottis, with perforation, is by no means rare ; ulceration of the mucous membrane of the vocal cords often has a fatal term- ination in spite of our best efforts. When such ulcers are got to heal, they often leave behind them a dangerous narrowing^ of the chink of the glottis. Venereal nests of the germ, or gummy tumors, form in the mucous membrane of the epiglottis, or vocal cords, soften and ulcerate. Edema of the glottis is often caused by the syphilitic germ, and the cartilages are often necrosed or carious. These cases are generally complicated and Dictionary of Diseases. 1043 with the tubercular germ. It is not, however, difficult to diag- nose those ulcers ; the presence of the germ in the moist secre- tions from the ulcers and their appearance to the eye and laryn- goscope are sufficient — copper or yellow colored, "syphilis;" cheesy mottled in "tuberculosis" Loss of voice and difficulty of breathing in most cases. There is a short cough, scanty expectoration; in other cases purulent, tinged with blood. Asphyxia may take place from the edema. Deglutition is sometimes very difficult, especially when the glottis is attacked. Syphilitic laryngitis is quite common, and unless tenderly guarded with great skill often fatal. The trachea is often invaded by the germ ; all parts are liable to ulceration and thickening of the submucous tissue, causing narrowing of the trachea along its circular muscular fibres, gives rise to what is termed syphilitic asthma. Syphilitic bronchitis is quite common and is easily recog- nized by the usual landmarks. The microbe can be detected in the sputum without any tubercle being present. Nodules are often detected on the tubes loaded. The bronchi are often ex- tensively ulcerated, and rilled with pus. Whistling sounds are heard in inspiration, indicates clearly lesion of the trachea ; per- cussion and auscultation revealing nothing abnormal in the lungs. The exhibition of the same remedies as in bronchitis, by in- halation and otherwise, and push energetically the same reme- dies as in syphilis. Aphasia. — The loss of the cerebral faculty of speech with cerebral syphilis is quite common. There are few medical men of any experience at all who have not seen cases of this causation of aphasia. The conjunction of right hemiplegia with aphasia is almost habit. Aphasia often exists alone, without any other form of paralysis, or it may occur with left hemiplegia, amaurosis, paraplegia, epilepsy, or glossoplegia. There is a motory centre for the lips and tongue in the third frontal convolution. Aphasia syphilitica may come on slowly and insidiously; in other cases it may come on suddenly. The sudden form is the most common, slight or complete ; slight, a mere forgetfulness of words ; complete loss of speech. Sometimes a mere passing symptom; at others, it is permanent and quite unamenable to treatment. Complete and permanent aphasia may either be an early or late condition — as early as a few days after inocu- lation; as late as twenty years after initial lesion. I044 The Germicide 20th Century Practice Under the use of modern remedies, aphasia must never be regarded as incurable, unless of many years' standing. Many years ago we drew the attention of the medical pro- fession to syphilitic infiltration of the lungs by the pathogenic microbe of syphilis. That the presence of this germ in the lungs occurs in one-third of all cases of what is termed phthisis pulmonalis ; that the symptoms produced by the germ syphilitica are almost identical with that which the tubercle bacilli causes; the same emaciation, loss of hair, clubbing of the nails, thinness of the skin, night-sweats, hemoptysis, cough, expectoration, dullness on percussion, moist rales or rattles, large and small crepitation ; ulcers or collections of pus in the lungs without a tubercle being present. Generally speaking, the germ in the lungs is met with in a variety of forms; as interstitial infiltration, occupying any part of the lungs; gummy tumors are found in all parts of^the lung, in the form of grayish or yellowish- white tumors the size of a pea or nut. These soften and leave cavities, just like tubercles do, but are not infrequently cured, and leave the cicaltrices so often seen in the lungs of persons who have died of syphilis. Thousands upon thousands of cases of pulmonary consump- tion are treated annually by eminent physicians for tubercle in the lung, when no tubercle can be detected in any part. It is not tubercular consumption that is so greatly on the increase, as syphilitic destruction of lung structure. In a very large number of cases, which have come under the author's care and observation, there was little to guide its rec- ognition, save the occurrence of cicatrices in the pharynx, or depression on the skull or syphilitic sarocele. Such cases are most amenable to bactricides. There cannot be the shadow of a doubt that in many cases of so-called pulmonary consumption, if a more careful examina- tion were made, a very large portion, at least one-third, were solely due to the syphilitic germ ; and this very fact should make us more hopeful and willing to try bactricide remedies on this terrible microbe which carries off one-tenth of the entire popu- lation of this country annually. The Bacillus of Syphilis in the Liver. — The venereal microbe localizes in the liver in all ages from the cradle to the grave ; and when it does so, it is found in the form of nodules. The aggregation of germs is usually either in small masses the size of a pin's head up to even the size of an orange, pre- axd Dictionary of Diseases. 1045 senting different appearances according to their age. All are surrounded by a capsule, which is merely the colored outer margin of the mass. When examined with the microscope, the germ can be seen and isolated with great ease, even though mixed up with other debris. The most common symptoms of the presence of the syph- ilitic germ in the liver are the yellow or sallow complexion, the brown-coated tongue, pain in the right shoulder, fetid breath and a general feeling of great languor; but when the microbe invades or attacks the hepatic and common ducts there is jaundice. Syphilitic livers are seldom increased in size, for as the microbe grows in that gland atrophic changes take place ; the absence of enlargement does not matter much in the recognition of the case, for whenever an ill-conditioned, an- emic, dark, bilious, sallow-complexioned, cachetic-looking syphilitic-tainted individual complains of hepatic discomfort, with disordered biliary symptoms, for which no direct cause can be assigned, the case in all probability is one of microbial liver syphilis. Something may be detected in other parts of the body, as a node, a neurosis, an induration, some ache or pain, for it is impossible in this modern age of intermingling of races and sexes to escape syphilitic contamination. He- patic stimulants, such as periodate aurum, chianthusi, chloride of ammonim should be persistently given in alternation with comp. saxifraga, peroxide of hydrogen and ozonized echinacea. Among a people with weak livers we find a large amount of syphilitic hepatitis, accompanied with jaundice. Mercurial drugging; malaria: the general use of alcoholic drinks, especially malt liquors ; solar heat ; neurasthenia, nat- urally cause our people to have weak, sluggish livers ; and when they accidentally receive the syphilitic microbe into their blood, it almost simultaneously finds its way to the liver, and forms its usual microscopic nests. The presence of the pathogenic venereal germ in the liver is productive of inflammation or a partial death. Many cases of unsuspected liver disease, jaundice, etc., are due to syphilis. In the liver, we find the occurrence of interstitial hepatitis; gummata; cicatrices. No doubt cirrhosis of the liver is due to syphilis. A syphilitic liver looks like the kidney of a young calf. This is due to the formation of new elements in the con- nective tissue of the organ and wasting of the liver cells. The edges of the liver become irregular and the capsule thickened. There are whitish patches seen in places, and on a section of it 1046 The Germicide 20th Century Practice being made, bands of white fibrous tissue extend across the organ in all directions, producing the puckering observed on the surface. Germ-nests or gummy tumors of the liver are the most com- mon. These cause induration and enlargement. In these cases the liver substance is filled with small round grains, dis- tinct from one another; in these the germ is imbedded. The liver is very yellow; hard, almost cartilaginous. If the patient happen to be tubercular, the presence of this germ modifies the pathological condition ; tubercles, large and small; nodosities are now found in the liver, of a yellowish white color, dry and surrounded by a yellowish, callous, or tendinous tissue. These tumors are generally deep-seated and generally the size of a pea, but grow up to egg-size, when they begin to soften and their contents absorbed. Syphilitic cicatrices in the liver are common. Fatty degeneration is the outcome of liver syphilitica in the majority of cases; occasion- ally an amyloid case is met with. The recognition of a syphilitic liver is based upon the -fol- lowing landmarks: A sensation of projection on the surface of the liver is experienced; ascites is present if degeneration has commenced ; diarrhea is common ; is serous and sometimes blackish in color ; the urine is highly albuminous ; extreme want of nutrition. The skin is discolored and looks extremely cachectic. Syphilitic Carditis and Pericarditis. — In individuals, whose blood and tissues are swarming with the bacillus of syphilis, we often find germ-nests in the substance of the heart, the valves being usually intact. Such tumors in the cardia muscle are usually of the size of a pea or even larger. Aneur- ism of the ascending aorta is frequently caused by syphilis. Other pathologists have seen the aorta corroded and ulcerated in the bodies of those who have died with the disease. The cerebral arteries have been found completely obliterated in some cases. Oftentimes, the pericardium is found affected. Lymphatic Glands. — The lymphatic glands of the entire body as well as the pink marrow of the bones, whose function is to raise or elevate the blood-corpuscles from the white to red, are early infiltrated, enlarged, with the microbe of syphi- lis, when that germ is present in the blood. The glands which first swell are the inguinal, posterior cervical, the mastoid, sub- maxillary and popliteal. Unless the patient be under such a course of treatment as we prescribe they may remain enlarged for years. and Dictionary of Diseases. !047 In very old chronic cases, the lymphatic glands are exten- sively affected ; the thyroid is sometimes increased ; the supra- renal capsules enlarged and degenerated in visceral syphilis; the spleen is affected just like the liver with gummata, in the form of rounded nodosities. The glands of the abdomen are often implicated in syphilis and become indurated; enlarged. The peculiar cachexia and odor of the germ is due, to a cer- tain extent, to the disease of the blood-forming glands. Bubo, inflammation of the lymphatic glands of the groin, is a common complication, if the gonorrhea is permitted to run along for several weeks, and is exceedingly liable to terminate in suppuration or abscess. The pus found in the glands con- tain the same, or identical, micro-organism which exists in the urethra; the pus, the resulting ulcer which follows, must be treated with germicides. The treatment in all cases must consist in rest ; hot fomenta- tion or poultices ; large doses of anodynes to relieve pain when suppuration is inevitable ; there are several modes of procedure which can be adopted with success, but in all of them a free outlet must be given to pus. Wreckage of the Male Sexual Organs by the Germs of Gonorrhea and Syphilis. — Disease, degeneration, and death of the sexual organs of both sexes are marvelously on the increase, owing chiefly to the alarming, widespread dis- semination of both germs of gonorrhea and syphilis, together with masturbation and perversion of the sexual act. These and other causes do immense damage, and are the principal causes of sexual incompetency and structural change. Mor- bid states of the testicle, induced by these conditions, are pro- ductive of cystic degeneration, atrophy, variocele and hydro- cele. Cystic degeneration and impotency go hand in hand. Adenoma follows next in frequency. The victims of sexual impotency and wreckage of vital parts of the generative or- gans are our drained-out youth and middle-aged libertines. - The Gummata. — The gummata is a lesion peculiar to syphilis ; no other microbial disease has anything at all like it. The bacillus of syphilis has, in all its different modes, the great- est tendency and affinity to form in nests or groups. When the vital forces are literally paralyzed, a complete wreck either by the bacillus, or most erroneous treatment, the germ will congregate in the subcutaneous tissue in strictly circumscribed, well-rounded, painless, indolent sacs, or nodules ; at first scarcely larger than a pea, in a sac, with an unalterable cov- 1048 The Germicide 20th Century Practice ering and movable. If the case is not being treated correctly, the bacilli grow by millions till they assume the dimensions of an egg, or even of a larger size. Sooner or later, if the treat- ment is not correct, they attach themselves to the skin, which becomes of a livid purple hue, and the microbes break through to the surface, and discharge a gummy substance, full of germs. Ulcers result of every kind ; round, oval in character ; with edges clean cut and floor germ-laden, purulent, and ex- tending to the subcutaneous tissue, cartilage and bone. Thin and unyielding bands or bridges of undermined skin often ex- tend and give way before this destructive process of germ growth. Ulceration is the alternate result of all gummatous conditions, and when this takes place, it may even exhibit the appearance of a simple ulcer, save in the thinned, purplish, pig- mented appearance of the outlying integument. The scars are typical bleaching from the centre, often attached to the peri- osteum, or bone, though this is rare. Considering the activity of the bacilli in these gumma and the depth of the ulcers, there is comparatively little waste of structure. About the neck the cicatrices may be linear in shape and slightly puckered; whereas on the lower extremities they are circular or oval. The number of gummata upon a badly-smitten syphilitic microbal patient varies from one to half a dozen, or a large number. They may appear on any part of the body. Same treatment as syphilis generally. Locally, thrice daily, apply an ointment of oil of thuja; strength about twenty per cent, or simply add the oil to ozone ointment and apply as frequent. Condylomata, or warts, due to the microbe of gonorrhea, being permitted to lie at rest upon the foreskin or glans, which acts as an irritant, and excites an evolution of the germ. They are generally situated either along the corona glandis, or on the edge of the prepuce in males, and any part of the vaginal walls in women. Great cleanliness ; bathing the parts thrice daily with Castile soap and warm water, then applying the oil of thuja is most effectual. The same remedy should be administered internally. It most effectually kills the germ in the blood and causes it to wilt, wither and disappear; at the same time administer antisyphilitic remedies. Granulating Syphilis. — Excrescences, or warts, are made up of two microbes ; that of syphilis, and of warts ; they are most commonly met with around the carona glandis, on the edge of the prepuce ; in the female they form the granulat- ing excrescences of the urethra ; warts on the walls of the va- gina and neck of the uterus. and Dictionary of Diseases. ic>49 In this dual condition of the two mixed germs, a union of the microbes of warts and syphilis, it is extremely active; highly contagious. The author has been remarkably successful in the thorough eradication and extermination of the germ in this form by the use of our newly-prepared oil of thuja, both locally and inter- nally, and by specially-prepared remedies. Plain, simple vegetations, or warts, it must be remembered, are met with on the genital organs on persons who never had any syphilitic germ, and they, benig of a germinal nature, are essentially contagious. Stomach and Bowels. — Infiltration of the walls of the stomach, near the pyloric region, is often due to the presence of the syphilitic microbe and the evolution from the gastric secretion of the carcinse ventriculi. Syphilitic ulceration of the large intestine often gives rise to persistent diarrhea. In a very large number of cases of chronic diarrhea, seen by the author, there has been a syphi- litic history, and the microbe was isolated from the dejecta. The rectum also suffers. They yield readily to our specific treatment, with small doses of lactic acid. Stricture of the rectum from the same cause is extremely common in women. These masses of germ-laden lymph are met with from one to two inches above the anus. There we find a hard ring, scarcely admitting the finger, of thickened mucous membrane, with transformed cellular tissue. Below the stricture the mucous membrane is turgid and covered over with pus; above it, eroded. This affection is accompanied with obstinate constipation, varied with diarrhea, and causes wasting and emaciation. Dilatation with bougies, together with our invaluable remedies, never fail to give an excellent cure. The Anus. — If the anus be weakened either by dysentery or by piles, or by irritating drugs, and the individual has the pathogenic microbe in his blood it may appear here, ether alone or simultaneously with its appearance on the skin or mucous membrane of the mouth; generally it is first observed at the junction of the cutaneous surface with the mucous membrane in the form of nests, which are termed mucous tubercles. These are really warty growths or excrescences, but in them can be found the microbe of warts and the bacillus of syphilis. The presence of those two germs gives rise to a watery discharge, which keeps constantly exuding from them. They are rarely 1050 The Germicide 20th Century Practice single; usually several, and when irritated or excoriated give rise to considerable pain and discharge. The structure of those tubercles, condylomata, or warts, is made up entirely of the two germs and young connective tissue. Treatment most successful by internal bactericides, and locally by suppositories of oil of thuja. Syphilis in Muscle. — The microbe, we have seen, invades muscular structure, and none more frequent than the sphincter ani; even more than the biceps. It occurs very frequently, and manifests itself by severe pain and tenesmus during and after defecation. In severe cases the pain may last for hours. It occurs much more frequently in women than in men. Gummy tumors sometimes occur in muscles, and often de- stroy a portion of the muscular tissue, thus causing shorten- ing and deformity of the limb. It is chiefly in the muscles of the forearm that these germ-nests are formed. They may occur on any muscle weakened by a strain or blow. Brigut's Disease — Syphilis in the Kidney. — We have found that the germ frequently invades the kidneys, blocks up its tubules; gives rise to effusion of lymph and interstitial de- feneration. From careful collection of cases extending over a very long period, it appears that out of every three cases of Bright's dis- ease, one is caused by the syphilitic germ. Next to the brain and liver the kidneys, of all internal, are most frequently at- tacked by syphilis. Post-mortem appearances confirm this. Chronic interstitial nephritis is caused by syphilis, as well as by alcohol. Nests, or gummata, have been detected in the cortical substance, and the toxin of the germ stains the kidney all over with its peculiar copper color. The course of syphilitic Bright's disease is slow, and most commonly fatal, although in numerous cases a cure may take place under ordinary antibacillary remedies. Malposition of the Testes and Their Infiltration with Syphilitic Germ. — The testis may be arrested in any part of its passage from the lumbar region to the scrotum. For example, they may never leave this region, but may re- main permanently in close proximity to the kidney. They anay pass as far as the internal abdominal ring, but fail to enter the inguinal canal. They may pass into the inguinal canal, "but fail to traverse the internal ring. It may pass through the ring, but fail to descend into the scrotum. The conditions which produce retention are very numerous ; and Dictionary of Diseases. 1051 such as intrauterine peritonitis, which produces adhesions be- tween the folds of the peritoneum in the neighborhood of the gland ; another, cause is an unusually small external ring, and a want of power in the gubernaculum testes brings about an incomplete descent. Shortness of the vas deferens, and an unusually large epididymis, are also undoubtedly causes of re- tention. A retained or undescended testis is prone to suffer either a withering, or blight, or become undeveloped, and the patient is sterile, but this is not always the case, for we find in a large number of the cases the glands normal, full size, active, and secrete semen freely. The testes are much less likely to be- come undeveloped or blighted, if retained in the abdomen, than they are when arrested by some mechanical condition in their descent, and subjected to pressure by the surrounding muscles. When the testes are either blighted, withered, atrophied, par- tially or completely undescended, or otherwise, from a gonor- rhea, or a blow, sterility is inevitable, and associated with loss of virile power, and change in the aspect of the individual. In all cases of undescended testes, the corresponding half of the scrotum, as well as the tunica vaginalis, is imperfectly de- veloped. Instead of the above-described conditions, a retained testis may pass into the peritoneum, or through the femoral ring into the femoral canal, and other unnatural positions. A retained or misplaced testis usually gives rise to heaps of trouble, such as constantly to irritation ; to orchitis ; from very slight muscular exertion. Even in the abdomen it may be at- tacked by the micrococci of gonorrhea or mumps. Besides in its abnormal position constantly suffering irrita- tion, weak, imperfectly developed, it is extremely liable to be- come the seat of either the bacillus of cancer or syphilis. It is also extremely liable to give rise to inguinal hernia, from imperfect closure of the funicular portion of the tunica vaginalis. Syphilitic infiltration of the testicles is of frequent occur- rence, and often followed by absence of spermatozoa in the semen. The germ, effused with lymph, forms an interstitial deposit in the testes, which is characterized by lymph nodules and bands, radiating from the tunica albuginea and insinuat- ing themselves between the semeniferous tubes, thus com- pressing and separating them. The tubules become atrophied ; the testicle, hard at first, degenerates and wastes. Almost 1052 The Germicide 20th Century Practice every case of chronic orchitis is syphilitic. It is not at all un- common in these cases to find tumors the size of a walnut de- posited in the body of the testicle, which, when removed and examined, consist almost exclusively of a mass of pathogenic bacilli. There need be no difficulty in its recognition. Tubercle goes' for the epididymis; the germ syphilitica for the testes proper. Tubercle rapidly softens, and forms abscesses ; syphi- lis rarely does that. Concer never can be mistaken for it ; the pain and vascularity are sufficient guides. There is rarely any pain at the onset of syphilitic sarcocele; nor much tenderness on pressure, as the ptomain of syphilis poisons and blunts the sentient nerves. We remark a pear-shaped tumor, either smooth on the surface or with irregularity, little hydrocele in general, and both testes usually become affected. In every case examined by the author, there is perfect sterility as a re- sult of this condition of the testes, and this in some cases has supervened very early. As a rule it is slow, and affords a most ample opportunity for treatment, to which it is most amenable when our remedies are properly used. Treatment should be carried on for several months. Still to the Testes Do the Germs Migrate. — Let the testes be once weakened by either a gonorrhea or by masturba- tion, by perversion of the sexual act, or by having intercourse with impure or common women, any disease germ which may be in the body will likely migrate there. For example, if a tubercular individual happens to, by any chance, let the bacillus of syphilis into his blood, the two germs may migrate to the testes, and each give rise to its peculiar characteristic symp- toms. In such cases both testes are usually affected, and the pecu- liarity of this is this : that the syphilitic microbe goes for the testicle proper, while the tubercular bacilli go for the epididy- mis. The bacillus of tubercle in the epididymis is usually effused in great abundance ; becomes hard and knotty ; and as it increases in size, forms a semicircle, or crescentic mass behind the testes ; while the testicle proper, being invaded with syphilitic germ, wilts ; withers ; atrophies. Unless vital force is rapidly restored, the tubercular germ goes for the tunica vaginalis, the result of which is signalized by the formation of hydrocele. If this state progresses, the germ-laden epididymis may sup- and Dictionary of Diseases. 1053 purate; adhesions may form and pus be evacuated by nature. The syphilitic germ in the testicle proper either completely withers or enlarges and becomes nodulated, and it may sup- purate, and a protrusion of the testicular substance ensues. Generally the spermatic cord is thickened, and the vas deferens hard and swollen. Both germs may migrate, either to the vesicular seminales, or to the prostate, or other parts of the genitourinary tract, but in and among all our patients our treatment has been such that we never have any serious exten- sion of the germ ; never any suppuration or complications. Our treatment differs from all others; it is constructive; while at the same time it soothes and eradicates the disease. We control the irritation, the inflammatory condition, before the germs have time to cause degeneration of tissue. We guard those important organs. The tubercular bacillus selects the epididymis; whereas the venereal germ selects the testes proper. In the testicle, this holy ground, the germ thrives well ; excites interstitial orchitis, and gives rise to a painless swelling of the whole gland, which becomes firm, heavy and of an oval shape, flattened from side to side; smooth on the surface and not tender. The epididy- mis is not perceptibly affected, spermatic cord swollen, often slightly thickened. The tunica vaginalis usually contains some effused serum. On making a section of such a testicle, the tunica albuginea is usually found to be thickened; fibrous masses can be seen all through the substance of the testicle, forming loops from which the venereal bacillus can be isolated. The fibrous tissue, with the germ, necessarily diminishes the proper structure of the testes, brings on atrophy with impotency. Under our treatment seldom do we have such complications arise. The Venereal Bacillus in the Testes.— Men who, in their early days, have either been guilty of masturbation, or other indiscretion, or later in life sexual excesses, are very apt to have weakened testicles. If, by any chance, they should be so unfortunate as to have the syphilitic microbe enter their blood, it is very apt to migrate into the devitalized testes and excite plastic inflammation : one or both glands may be invaded. When the true syphilitic germ enters the testes, it is altogether different from the orchitis produced by the gonococcus. With the syphilitic microbe there is general enlargement from effu- sion of lymph, and germ growth, which becomes organized 1054 The Germicide 20th Century Practice into hardened masses, interspersed with fibrous tissue. The syphilitic microbe goes for the entire gland. The enlargement of it necessarily causes a stretching of the serous covering, which excites effusion of serum into the tunica vaginalis. Usu- ally the microbe avoids the epididymis, so, except in some iso- lated cases, it and the spermatic cord are also free. A true germ-loaded syphilitic testis is painless, and gives no trouble except by its size. It is often as large as a hen's egg', more rarely the size of a goose-egg ; smooth, heavy, oval, not tender, but with a marked absence of testicular sensation, when sub- jected to pressure and firm to the touch. In a chronic case the secreting granules are entirely destroyed by the germ, and the presence of fibrous tissue obliterates the last vestige of man- hood. Later on a species of atrophy sets in, with cirrhosis. Such cases, allured into the net of some notorious charlatan, are forever afflicted with incurable impotency ; whereas, if they are treated on correct principles are mostly all cured. Orchitis and epididymitis are very common complications of gonorrhea, occurring generally about the third or fourth week, if the disease is permitted to run along so long. They are caused by a migration of the gonococcus from the pros- tatic urethra to the ejaculatory ducts, and vas deferens, down to the testicle ; when this migration takes place the discharge in the urethra diminishes or disappears ; when their inhibitory ac- tion ceases, the discharge returns. Morbid States of the Seminal Vesicles. — The vesicu- lar seminales are two membranous receptacles, situated one on each side, beneath the base of the bladder, between it and the rectum. Their length is usually about two inches, and their greatest breadth from four to six lines ; but they vary both in size and shape in different individuals. Their posterior ex- tremities are separated widely from each other; but anteriorly they converge so as to approach the two vas deferentia, which run forward to the prostate between them. With the vas def- erentia thus interposed they occupy the two diverging sides of the triangular portion of the base of the bladder, which lies upon the rectum. The seminal vesicles themselves rest upon the rectum, but are separated from it by a layer of the recto- vesical fascia, which attaches them to the base of the bladder. The posterior ends lie beneath the openings of the ureters. The common seminal, or ejaculatory ducts, two in number, are formed on each side by the junction of the narrowed ex- tremities of the corresponding vas deferens and vesicula sem- and Dictionary of Diseases. io oo inalis, close to the base of the prostate. From this point they pass, side by side, through the prostate, between its middle and lateral lobes. After a course of nearly an inch, they end in the iloor of the prostatic portion of the urethra by two valve-like slits placed in the verumontanum, one on each prominent mar- gin of the opening of the prostatic sinus. Inflammation of the seminal vesicles is usually the result of some irritation in the urethra, as gonorrhea, masturbation, perversion of the sexual act. In these the gonococcus is pres- ent, so that if the treatment be carried out by some one inex- perienced or devoid of a proper knowledge of the micro-organ- ism, it will migrate backwards, along the common ejaculatory duct to its termination in the vesicle, thence to the testicle. Besides these causes, the passage of a bougie, the presence of a stricture, coitus with a leukorrheal woman, or by the elongated front of bicycle saddle. When inflammation takes place here, there is swelling at the base of the bladder, due to effusion into the perivesicular connective tissue. This gives rise to great irritability of the bladder ; ether pain or uneasiness in the perineum; painful defecation; frequent and painful micturition, or retention ; nocturnal emissions ; persistent mois- ture, or weeping penis, with priapism. Extravasation of Urine. — May proceed from the blad- der, or from the urethra. The bladder may give way from ulceration, or lacerated by violence. When the urethra gives way it is generally from retention as a result of stricture. It is very easily recognized, as the affected individual feels that something has given way; if the bladder, the rupture is usually in front of the posterior layer of the triangular liga- ment. The immediate feeling is one of relief. Soon, how- ever, the lower part of the abdomen and scrotum becomes in- filtrated with the germ-laden urine ; the evolution of the micro- coccus urea is so prodigious that the swelling of the parts is immense; rapid; sloughs form; great prostration from the germs entering the blood causing a smothering sensation; "brown-coated tongue; fever; muttering delirium. The treatment must be prompt and vigorous. Free inci- sions should be made wherever the tissues are infiltrated, so as to give vent to the extravasated urine. Peroxide of hydrogen should be sprayed around the parts ; poultices of charcoal, yeast 1056 The Germicide 20th Century Practice and wild indigo applied; alternated with a solution of boro- glycerid. In all cases a catheter should be passed into the bladder. The diet should be liberal, including beef tea, eggs, wine, brandy. Our medical treatment of these cases has been such that in a most extensive practice of fifty years we have never lost a case. Urinary Abscess. — This is generally the result of stricture,. a drop of urine or pus remaining behind it, exciting irritation, inflammation and the formation of abscess. Such abscesses, may occur at any part of the urethra, but are most common in the bulbous or membranous portion of the canal. The usual symptoms of abscess are present : pain, swelling, induration, rigors, pain changing to a throbbing; sense of fluctuation. As soon as matter forms the abscess should be freely opened. As there is usually a stricture, it should be dilated, and a No. 12 catheter inserted into the bladder and retained there twenty- four days, during which time the abscess should be well stimu- lated and healed. Urinary Fistula. — A fistula, a tube communicating with a cavity, lined by a false membrane, the result of an organic stricture, or urinary abscess. The fistulous tract between the urethra and skin, through which the urine dribbles, is the seat of microbes lined with a false membrane, which is often car- tilaginous. As we have had great success in the management of these cases, patients flocking to us from all parts of the globe, we will briefly give our method of treatment for the benefit of the profession. The first thing is to dilate the stricture with our dilator, and once dilated the fistulous tract should be thor- oughly dissected out; then a No. 12 catheter inserted into the bladder, and the fistulous opening carefully stitched up with lead sutures. Boroglycerid ointment should be kept con- stantly applied until it is healed up. Headache. — The clinical study of the operations of the pathogenic microbe of syphilis on the nervous system has for quite a number of years attracted attention. It is found that a great deal of the headache which is so very prevalent in every family is due to the microbe making an inroad into the brain, and this discovery of the bacillus has thrown a flood of light on many obscure points in the pathology of the dis- ease. Syphilitic headache is markedly internal and deep in character, aggravated by noise, light and motion. It is ter- and Dictionary of Diseases. io 57 ribly severe, especially when it is nocturnal, and most ten- acious. The pain often causes delirium. It may last for many years before its cause is suspected. It is often an early symptom of the presence of the germ; too much overlooked. There may be associated with it vertigo, failure of the mental faculties, with impaired vision, or buzzing in the ears. Low spirits and impotence are generally associated with it. There may also exist with it paresis of the cranial nerves, with slight ptosis ; strabismus ; mydriasis, or facial or lingual paresis. In some rare cases headache has been followed by blindness and coma. Syphilitic Fever. — Febrile exacerbations occur off and on at all periods, when the syphilitic microbe sporulates. Fever occurs in whatever location the germ is domiciled, skin, mucous membrane, muscles, brain, bone, eye, liver, lungs, in- testines. Syphilitic fever usually commences by headache, or sensation of cold; shivering. The pulse more frequent; gen- eral malaise ; disorders of the digestive organs. The reoccur- rence of chilliness, with sweats, are frequent. The fever as- sumes a variety of forms. Among women the symptoms are often very high, especially the pulse and temperature, accompanied with cerebral. There is usually great debility ; inability to read, work or make an in- tellectual effort. Germ Nests, Infection. — The status of vital force regu- lates the sporulation of the bacilli ; the want of vitality in any special part or organ constitutes a point of paramount impor- tance in the evolution and growth of a microbe which is doing so much to embitter the existence of our race. It has only been of late years that the localizing of the germ in the brain, liver, kidneys, or nervous system has been understood. It is only in states of extreme prostration that we see -the great lesions produced by the germ. No rules can be laid down as to when this microbe will form gummy tumors, or when it will invade the testes, or some other vital part. Paralysis. — The bacillus of syphilis often infiltrates the brain and spinal cord, giving rise to organic changes and par- alytic seizures, as aphasia, hemiplegia, paraplegia, etc. ; in such cases the microbe infiltrates the convexity of the brain with the diagnostic yellow ptomain exudation. Paralysis of the insane is caused by this germ ; even general paralysis occurs in syphilitic individuals. Syphilitic disease 1058 The Germicide 20th Century Practice of the brain produces all forms of paralysis. In general pa- ralysis we notice intellectual and motor disturbances first of all, and with those, in many instances, vertigo, epilepsy, maniacal attacks. This holds true in cerebral syphilis. There are certain features in ordinary general paralysis of the insane which make it distinguishable usually from cerebral syphilis. The patients who suffer from it are remarkable for the perfect satisfaction which they feel with their own position. These are the insane who, in asylums, are wont to consider themselves as the illustrious characters of some sort. Such a condition of mind is rare among the syphilitic insane. Trembling of the tongue and lips, so common in general paralysis, is wanting in cerebral syphilis. Paralysis with or want of co-ordination of movements is essentially syphilitic. In general paralysis the gray matter of the convolutions is far more extensively affected than it is in cerebral syphilis, where the predominating feature is induration of the convolutions. General paralysis of the insane is always fatal; whilst the syphilitic lesion, which resembles it, is curable under proper treatment. If cerebral syphilis is not treated properly hope- less paralysis will occur. This microbial disease never re- mains stationary; progressively worse, if not properly treated; invariably disappears under bactericidal remedies. Hemiplegia is one of the most common forms of syphilitic paralysis. Headache is the precursor of an attack, with noc- turnal aggravations. Syphilitic hemiplegia resembles apoplexy in its mode of seizure. Epilepsy. — Syphilitic epilepsy is now a well-recognized form of epileptic seizure. It occurs generally in males be- tween the ages of thirty and forty ; nine cases out of ten occur- ring in men of that age for the first time. It is one of the most common symptoms of cerebral syphilis. This is no doubt due to the germ affecting the cortical substance of the brain, or the gray matter of the convolutions ; the meninges being first at- tacked in many cases. The epileptic fit in syphilitic cases is not to be distinguished from that of essential epilepsy merely by the aspect, neither in the phenomena ; but by a careful analy- sis of all the symptoms. In some cases it is the first and only symptom of syphilis ever present. The occurrence of such seizures is often preceded by pallor, emaciation, languor and nocturnal headache. Once an epileptic seizure takes place, it is sure to be followed by another after a long interval of time, but they come on more and Dictionary of Diseases. 1059 frequently as the microbe grows, the interval between each growing less and less. Generally they are preceded by head- ache; usually in the temporal region. They may or may not be preceded by an aura, or warning, or this may not occur. The aura may feel like a waft of wind or a flash of light, or some strange sensation in the upper or lower extremities. The fit at first is very light, being purely convulsive; but by and by there is loss of consciousness, power of voluntary mo- tion, a fit or spasm of long or short duration. After a time these seizures become of great intensity and violence and paraly- sis of the upper and lower extremities or dementia take place. Patients with syphilitic epilepsy become in a short time quite unfit for business; indifferent; morose; taciturn. The mem- ory gives way first ; becomes greatly enfeebled, and he is very forgetful. His moral nature, emotions, desires, affections, passions, become impaired, and he becomes a mere wreck of his former self. A correct diagnosis of these fits, syphilitic epileptic, was ex- tremely difficult before the discovery of the microbe. The presence of that in the blood is the initial step to a positive diagnosis; the consecutive paralysis after those nerve storms. The spasms are often limited to one side of the face, an arm or a leg. Patients often suffer pain in a part of the body. Par- tial or reflex fits are not seen in purely nervous epilepsy; whereas they are common in syphilis. Partial epilepsy, as we often have in syphilis, shows alteration in the gray matter at the level of the cortical motory zone. As a rule the fits of epi- lepsy are mostly nocturnal. One peculiar feature of the syphi- litic fits is that in the intervals between the fits the patient is truly a sick man ; this is not the case in the other form. Head- ache, vertigo, or some form of paresis, occurs in many cases, and the fact that it occurs in an adult, and not in a child, is at least suggestive of syphilis; but none of these but the micro- scopical examination are pathognomonic. Indeed the only other landmark is the result of our specific treatment. If there are any diagnostic marks, as a gumma in any part of the body, it will be of great value. If, again, we can find no evident cause for the fits, such as alcoholism, uremia, tubercle, lead- poisoning, tumors in the brain, it would be well to try our anti- syphilitic treatment. We might again repeat that all cases of epilepsy coming on in adults who have had syphilis should at once be placed under an energetic treatment for syphilis. 1060 The Germicide 20th Century Practice Inherited Syphilis. — Most reliable statistics exhibit in 1,000 cases the following characteristics, with their propor- tions : Papules of the skin or mucous membranes, 74 per cent ; rhagades of the lips and anus, 70 per cent ; rhinitis, 58 per cent ; ulcers of the hard palate, 52 per cent; macules, 45 per cent; chronic lymphadenitis, 29 per cent; ulcers of the tongue, 27 per cent; pemphigus, 25 per cent; onychia and paronychia, 23 per cent; excoriations, 20 per cent; laryngitis, 17 per cent; pseudoparalysis of the extremeties, 7 per cent; ulcers of the skin, 4 per cent ; gingivitis ulcerosa, 4 per cent. Most of the children were extraordinarily thin and atrophic. The disease makes its appearance in the first month in 64 per cent of the cases, and in the second month in 22 per cent; most often in the third week, then in the second and fourth week. The earliest symptoms of hereditary syphilis are rhinitis and pem- phigus. Syphilis is a germ full of variety and irregularity, depending greatly upon the soil in which it is planted; in the young the tissues are succulent, microbe very active, whereas in the ma- tured it is sluggish. The heredity syphilis in the young best and most success- fully managed by administering periodate aurum, in one grain doses every two or three hours. Infantile Syphilis. — This term is generally limited to an infant born from parents who have the syphilitic microbe in their blood and tissues. For example, if the father's blood and tissues are saturated with the germ, he may transmit the microbe to the wife of his bosom ; she to the child of his love. This may occur at the period of conception, or subsequently, the mother herself may, if she have the germ in her blood, impart it to husband and child. There are many ways aside from an impure coitus in which a woman may be contaminated with this microbe, as in the practice of kissing; in the extrac- tion of teeth; the use of drinking vessels; clothing, and close contact. The mother may in this manner infect the child through her own blood. When the father engrafts the syphilitic bacillus upon his offspring, and the mother's vital force be strong, there is an inherent element in a healthy uterus to repel the presence of a germ-laden fetus in its cavity; so she very frequently mis- carries about the fourth month. Repeated miscarriages are most suggestive of the presence of the venereal bacillus. When both parents are affected the mother is more likely to complete and Dictionary of Diseases. 1061 her pregnancy, and give birth to a child ; likely born alive, but distorted in its very form and features; probably thin and shriveled, with a prematurely old expression; a hoarse voice: a snuffling breathing; a discharge from the nostrils, and an eruption about the anus and genital, or it may appear on skin in the form of copper-colored vesicles. Or, again, the child may be born apparently healthy, and the germ latent ; but assume activity within six weeks after birth. Or it may be later in life before the germ exhibits itself, either in malnutrition ; irregularities of the teeth ; a non-union of the epiphyses of bone and various other malformations, and bronzing of the skin. Our treatment of such cases has been most remarkably successful with our new remedies and iodine baths. The child must be artificially fed, so that it may neither reinfect the mother, nor the latter the child. The common manifestations of the microbe of syphilis in in- fants are of a superficial character ; nasal obstruction with dis- charge; cutaneous eruptions; mucous tubercles, and the like. It sometimes happens that the lungs, the liver and the brain are implicated; may be affected by the germ; other internal organs are also often affected by the same. In these cases the child gradually withers, wastes, or else it is attacked by convulsions and dies after a sort illness. When such cases come under our observation, we push a plan of treatment which has been most successful in eradicat- ing the germ from its blood, and at the same time place both parents on our specific course, in doses according to the state of their health, and the special symptoms that may be present. It is of the utmost importance that in medical teaching a more thorough course should be given to students ; a wider ob- servation and experience regarding a germ which pervades the blood of nearly every family in our land, so as to recognize all the. characters and migrations of this great pathogenic microbe — so that they may be better able to root it out by the recogni- tion of its most obscure symptoms, and a higher graded treat- ment. Many honorable men, and women, too, are often unaware that the microbe is in their blood ; they may be ignorant of the fact, even how they got it. In such cases the greatest care should be exercised to elicit all the information possible with- out exciting suspicion or creating social discord. A physician is often asked how soon it is safe for a person io6z The Germicide 20th Century Practice who has had the pathogenic microbe in his blood to contract marriage. We would most emphatically answer, not until he or she has taken a six months' course of specific treatment ; for it is doubtful if ever the germ can be annihilated and com- pletely eradicated by any other remedies than by those laid down in this article. An individual who once has had the disease and been treated and bamboozled by ignorant charlatans and seems apparently well, still has the bacillus lurking in his blood, ready, nay. keenly alive to sprout into active existence the very moment his vital powers are depressed, or the slightest ill health or des- titute circumstances prevail. This may occur after the lapse of many years. The germ may lie dormant one entire life, pro- vided a high standard of health be maintained. It is therefore impossible to lay down any rule when a patient is safe; free from the germ. The question often suggests itself, Who has not the venereal bacillus in his blood? Echo answers, Who? No man or woman is safe who even drinks out of the same vessel, even the sacramental cup, which has been known to infect or in- oculate many, one by one, who drank from the sacred vessel. ■ Syphilitic Germ Causes Tubercle; Syphilis Engen- ders Tuberculosis. — The prodigious power of the bacillus of syphilis upon the nervous system so weakens, so depresses it that it creates in the individual lowered vitality, depressed vital force, a neurasthenia, which is termed tuberculosis, because in that state the elementary molecules of the blood are so de- graded, changed, altered into other living matter which has in- dependent powers of existence, a germ named the tubercular bacillus. When these two microbes exist in the blood, the tubercular germ changes many of the characteristics of the syphilitic; for example, it causes the eruption to occur in round groups; ser- piginous ; form circles, or segment of circles. They may be moist, with secretions; dry; scaly; scabby. They may occur - over the entire body, but their common seat is on the face, fore- head, around the nose, or on the lips, upper and lower extrem- ities. At first their color is red, but subsequently coppery. Although they are very indolent, rarely ulcerate, they fre- quently leave ugly-looking marks on the skin. Among the class of skin affections induced by the two 'germs, tubercle and syphilis, is a peculiar form of tuberculo-ulcerative syphilitic- ulcerative affections, which commence with a crop of red, hard,. axd Dictionary of Diseases. !o63 smooth, indolent tubercles, which soften after a time and ulcer- ate, the ulcer being covered by a thick uneven crust, blackish green in color. The ulcer tends to extend its surface rather in depth, and leaves dead white scars with ridges and depres- sions. In some cases the ulcer extends deeply, and destroys the nose and adjacent parts very rapidly. There is some re- semblance to canGer and lupus ; but the microscope reveals that it is due to the syphilitic germ intermingled with the tu- bercular germ. The author has over and over again seen such cases cured readily by the administration of his specific reme- dies. Syphilitic Ptomain. — In numerous cultures with the path- ogenic microbe the venereal bacillus, the important discovery has been made that it is the toxin of the germ, that is, its chem- ical excreta, which gives rise to all the principal symptoms of the disease — that it is the toxin which produces iritis, and that terrible pain in the brain in phrenal syphilis ; that it is the toxin which gives rise to the nocturnal pain in the bones when the electrical forces of the atmosphere are lowered ; that it is toxin which gives to the cutaneous eruption and the ulcers in mouth that peculiar copper color, and it is the toxin which blunts the sensibility of sentient nerves, and produces profound intoxica- tion of the cineritious pulp. The extreme contagiousness of syphilis renders it very doubtful whether it is not very largely disseminated among all classes of society. There are in our midst a very large number of syphilitic patients the germs from whose bodies are everywhere present, in workshops, street cars, linen, clothes, furniture, in carpets and floors, even in the dust of our streets. Gonorrheal Ophthalmia. — This is caused by the gono- coccus being brought in direct contact with the conjunctiva. This is usually done either by the fingers after dressing the affected penis, or by a towel or napkin used on the parts. This micro-organism, once on the mucous membrane of the eye, has a very rapid growth ; excites great local irritation. The micro- bic discharge is profuse, thick, abundant, alongside the gono- coccus. There is generally some chemosis of the ocular con- junctiva, and the disease may spread to both eyes by the germ being carried there. To save the eye, it is always necessary to resort to most active measures of treatment, as the cornea may slough within a few hours, unless the microbe be killed. The affected membrane must be touched all over with a mixture of 1064 The Germicide 20th Century Practice dioxide of hydrogen and glycerin. This to be followed with either lotions of resorcin or creolin, with belladonna; hot fo- mentation frequently renewed. Large doses of opium to re- lieve pain, and blunt the sensorium. Tonics, especially qui- nine; stimulation to nape of neck. Syphilis on the Uterus and Ovaries. — The effects of the syphilitic germ upon the uterus is damaging in the ex- treme; it causes amenorrhea,, which is very persistent. It blights the ovaries; causes sterility. If impregnation be pos- sible, it causes abortion at the fourth month; or dead and pre- mature births. I saw a case very recently of a woman w T ho was syphilitic, aborted seven times in succession ; another who had nine children at different periods, all syphilitic. The analogue of the testicle, the ovary, often suffers greatly from the germ; giving rise to syphilitic ovaritis, which is the cause of sterility. The bacillus attacking the neck of the uterus produces those never-ending discharges which are so common and obstinate in women who have once been infected with the germ, and which so often infect men with the malady. Ovaries, Disease Germs. — When the bacillus of tubercle, syphilis, and cancer exist in the blood, and the ovaries happen to be weakened by any cause, these microbes find their abode in those glands, and give rise to various ptahological changes, in all of which sterility exists. These three leading microbes in the ovary are usually at- tended with anemia, chlorosis, and should be treated on general principles. The most common of all diseases in 1 the production of or- ganic changes in the ovary is the gonococcus. This germ is the most potent factor in producing sterility ; withers ; whittles down the evolving faculty of the testes as well as the ovaries. Injections of creolin have a most remarkable action in caus- ing a complete destruction of all the spores o£ the gonococcus, at the same time most vivifying to the ovaries. Stricture of the Urethra may be defined to be a nar- rowing of the canal, due either to congestion,, as in inflamma- tion ; a spasmodic contraction of some of the circular muscular fibres, which surround the membranous portion of the urethra; and organic stricture, which is due to effusion of lymph, gen- erally upon the lower aspect of the canal, more rarely circular, which may become organized and fibrous, or even cartil- aginous. and Dictionary of Diseases. 1065 1 Strictures are generally the result either of acute or chronic inflammation of the urethra, or of injuries, mechanical vio- lence, or by the use of strong injections, masturbations, etc., all irritations which would cause effusion of lymph into its lining membrane. Inflammatory, congestive, spasmodic strictures, so called, are simply due to swelling and contraction of the muscular fibres which form part of the walls of the canal. In the management of such cases we must look at the cause from whence they arise ; the nature of the irritation ; excesses, drink, etc. Rest in bed; warmth; an active saline purge; sedatives to re- lieve pain. In spasmodic cases, hot fomentations of conium and belladonna, with a cocain suppository, are most effectual in affording relief; subsequently the case should be treated on general principles, according to cause. Organic stricture is always invariably the result of inflam- mation ; the plastic lymph which is thrown out and forms the stricture is effused from the submucous areolar tissue, or it may be the effects of an ulcer or chancre in the urethra, or near its orifice. The character of stricture varies much; sometimes and most generally the effused lymph is on the lower aspect of the canal ; in other cases round the entire urethra, or situated on one side ; sometimes it is rough, fibrous and cartilaginous; sometimes it is like a fold thrown across the canal. The most common seat of stricture is at the junction of the membranous with the spongy portion of the urethra, or a little in front. There may be one, two, three, or more. When a stricture is once formed, it never tends to get well, but gradually becomes worse ; the contraction goes on increas- ing; as it grows larger, firmer, the urethra behind it becomes dilated; the prostate becomes irritated; the muscular coat of the bladder thickened and hypertrophied, and its lining mem- brane disordered. Even the ureters become distended and tortuous; the kidneys congested. The stricture extends its pernicious influence in a direction backwards to the seminal ducts ; this, with the constant irritation, makes the patient ner* vous and depressed. The general health suffers, and he be- comes a wreck. If, however, the patient takes timely advice and puts himself under our care, these evils may be avoided. The general symptoms are more frequent calls to make water. The effort to do so is attended with pain and difficulty. 1066 The Germicide 20th Century Practice The stream is diminished, and is either forked, twisted or scat- tered. In very bad cases passed drop by drop, and with much straining. The act of micturition often followed by rigors, prostration and a febrile exacerbation. Usually a continuous gleety discharge from the urethra, often intercurrent attacks of orchitis and other local inflammation. The patient at all times is liable to fits of complete retention. When some of these symptoms exist, there is reason to sus- 2)ect a stricture; a silver catheter. No. 6, should be passed, if possible, to ascertain the state of matters ; it should be cautiously passed, feeling its way carefully, and the character and amount of the obstruction estimated. If that size cannot pass, a smaller one should be used. The silver catheter is better than any sound. Before being used it should be well warmed and oiled. In the introduction of the catheter, either to ascertain the size or nature of a stricture, the patient should be placed in the recumbent posture, and an instrument that will pass put through the stricture and permitted to remain half an hour, followed by an iodol. This should be repeated every other day, a larger instrument being used every time until a No. 12 passes easily. Various ointments are in use for the purpose, as resorcin, iodol, aristol. By this simple method of the in- troduction of these silver sounds and cerates the stricture will gradually disappear, and never return; whereas if it is burned out by electricity, or slit up with a stiletto, they will invari- ably return again and again. There are cases met with in which the stricture is dense, has become cartilaginous, due to the microbe of syphilis, that are benefited by antisyphilitic remedies, and in which the instru- ment has to be forcibly pushed through and retained, and a process of gradual dilatation carried out; or suppose it to be impermeable a full-sized catheter should be pushed through into the bladder and retained there fourteen days, during which period it will be wiped out by a process of suppuration. But suppose, again, a very small instrument can be inserted, even with great difficulty, our dilator should be inserted, which rapidly restores the urethra to its natural calibre. We might again repeat that there is no plan of treatment so safe, so successful, as gradual dilation, and when properly car- ried out under our directions they never will return. The Effects of Stricture. — The effects of a stricture on the urinary organs are very many and often serious, being dis- and Dictionary of Diseases. 1067 astrous in proportion to the amount of obstruction to the pass- age of urine, and may all be prevented by our method of treat- ment. The urethra behind the stricture is always irritated, thick- ened, hypertrophied ; gives rise to a persistent gleety dis- charge ; in other cases it may be dilated by the backward pres- sure of the urine into a pouch or sac. In all cases the mucous membrane is inflamed, often ulcer- ated, ragged; the lacuna enlarged, forming little pockets, in which microbes, the urine, and products of inflammation accu- mulate. The progress of these cases is onward; ulceration penetrates the urethral walls, and urinary fistula follows. There is liability to extravasation of urine, and great damage to the prostate and bladder. In cases of urinary fistula, it is usually immediately behind the stricture and is the result of the damming back of the urine giving rise to ulceration, or gradual thinning of the urethral walls, until it eats through. The urethra is more liable to per- forate in the bulbous portion. In bad cases a large amount of tissue may slough off. Complete retention of urine from an organic stricture is gen- erally brought about by some complication, as anything which excites active congestion, as a highly acid state of the urine, spasm of the muscles at the neck of the bladder. When urine is retained in the bladder the micrococcus urea is evolved, which often gives rise to dreadful results, pam, in- flammation, thickening, involuntary contractions, and hyper- trophy, with sacculated bladder. Retention of urine may be due either to a congested or swol- len state of the mucous membrane of the urethra, or stricture, or paralysis of the neck of the bladder from the gonococcus migrating back to the ejaculatory ducts and bladder. The first indication in the management of this is to render the urine alkaline by repeated doses of the uric acid solvent ; hot hip baths; the application of a solution of belladonna to the pubes, penis and perineum, just as hot as can be borne; cocain suppositories introduced into the rectum. These and other means failing, a catheter should be introduced and drawn off. The Gonococcus in the Kidneys. — Gonorrhea is a fre- quent causative factor in disease of the kidneys, even active inflammation. This is produced by a migration of the micro-organism along the bladder and ureters 1068 The Germicide, 20th Century Practice This is the result of excessive stimulation by copaiba and cubebs, causing partial retention. The bladder being filled causes the urine to collect in the pelvis, calyces and tubules of the kidney, a sort of damming back; in this retained urine the gonococcus is present. Besides the two remedies mentioned often induce disease of the kidneys. Gonorrhea in the Female, — The multiplicity of causes discharges in the female, render the use of the microscope in- dispensable for the diagnosis of every case that comes under our observation. The presence of the micrococcus of gon- orrhea is far more common in the vagina and even of, the neck of the uterus than in the male urethra. The presence of the gonococcus in any discharge renders it contagious, but there are discharges due to the presence of other germs, as the pyor genes, or pus germ; the sarcinse of uterine catarrh, which, if they be present in the vagina when coitus takes place, give rise to quite a discharge in the male, which cannot properly be termed a gonorrhea. To be more explicit, a woman may be capable of communi- cating any discharge she may have, for all of them contain germinal matter of some kind, and are all contagious, but the genital discharge, which communicates gonorrhea, must have the gonococcus in it, and she must have received it from an in- fecting source. The thousands of male patients who have consulted the author with regard to their gonorrhea have all, with but few exceptions, obtained it from the fresh secretions. Still there is no doubt that certain discharges from the vagina, when no gonococcus is present, are also communicable. When a gonorrhea exists there must be present the patho- genic microbe as its cause, usually in forming nests in the crypts or follicles of the mucous membrane; a high grade of inflammation is present, and the vulva, urethra and vagina are bathed with thick greenish pus. The urethra is usually in- vaded with the germ, and many maintain that the persistence of urethritis is good for diagnosis. This will not do, for urethritis is often caused by vascular excrescences and other states, and we must depend upon the microscope for a correct recognition of the case. It is important in practice to be able to say positively that such is the case; and we have only one positive landmark to guide us, and that is the presence of the germ in the field of the and Dictionary of Diseases. 1069 microscope. Unless this is used there is great incertitude re- garding it. Very true, nearly all cases of gonorrhea in the male are derived from the fresh secretions of the vagina. Inflammation of the urethra is present in all females who have gonorrhea ; a very rare symptom of all other affections of the genital tract. The gonococcus often gives rise to vulvitis, the mucous membrane covering the labia, the follicles of which in some cases pour out a thick purulent secretion, often extremely of- fensive, and the pain is excruciating. The microbe, once in the vagina, is very apt to migrate into the neck of the uterus, unless our specific treatment be adopted ; there it gives rise to ulceration or erosions of the cervix; still further the germ may find its way into the uterus, although in the large proportion of cases it is confined to the cavity of the cervix. The two great causes of intrauterine catarrh are either re- peated abortions or the microbe of gonorrhea. From the uterus the ovaries are often attacked, and no doubt this is the chief cause of the sterility of many women. There is no doubt that the presence of the gonococcus in the vagina, uterine appendages, is the chief cause of the notorious infer- tility of prostitutes. Leukorrhea of a contagious character may arise from nu- merous causes, as immoderate sexual intercourse, violent mas- turbation, the presence of vegetations, errors in diet, ascarides in the rectum, and the external influences of cold ; moisture. Vaginitis may be caused by scarlatina, and in young chil- dren from malnutrition; teething; ascarides. Complications of Gonorrhea. — There are several acci- dents which may happen to a patient suffering from the pres- ence of the gonococcus, such as enlargement of the glands of the groin, balanitis and inflammation of the prepuce, prosta- titis, retention of urine, abscess of the periurethral tissues, etc. ; gonorrheal rheumatism and ophthalmia. In inflamma- tion of the urethra, the glands of the groin become engorged through reflex irritation, or by migration of the gonococcus into the gland through the lymphatics. Sometimes the skin of the organ becomes of a rosy hue and more or less considerably swollen, while the lymphatics are in- flamed and enlarged. The penis sometimes becomes greatly enlarged, twisted, and so painful as to cause sleeplessness and feverishness ; when but a few simple remedies will subdue this 1070 The Germicide 20th Century Practice apparently serious condition. Sometimes, however, diffuse suppuration of the prepuce takes place, followed by gangrene. At other times there is induration of the prepuce. Balanitis, that is, inflammation of the covering of the glans and inner aspect of the prepuce, is often a complication when the dis- charges are not neutralized or washed away. There is a very peculiar, chronic form of balanitis, not caused by either of the venereal germs. It consists in areas or patches of a deep-red color, with a slight exudation or moisture; the patches are neither raised nor ulcerated; they are not round, but have abruptly margined edges. They are generally met with in men over the middle period of life. They often remain for years, with no change unless it be a slight extension. The surfaces affected look slimy and glazy, and easily crinkle like tissue paper. Phimosis results either from serous infiltration of the pre- puce or from inflammation. Paraphimosis sometimes takes place when the retraction is behind the glans. When phi- mosis coexists with balanitis injections of solution of aristol under the foreskin speedily effects a cure by killing off the germs. In obstinate cases circumcision is often required. This, of course, exposes the glans penis, which in no way lessens the sensibility of the gland, as some suppose. The sacrament of circumcision, as practiced by the Jews, is no prophylactic against gonorrhea, but a most effectual check on inoculation by the syphilitic germ, hence the wisdom of the act. Bleeding from the urethra is common in gonorrhea when a stimulating plan of treatment is carried out, and should be checked by cold ; rest ; gelsemium. In cases of retention of urine the patient must be placed in a warm bath (102 degrees F.) and warm relaxing injections of lobelia into the rectum. The seminal vesicles often suffer, so does the prostate become congested, especially if there be con- nection, masturbation, or nocturnal emissions, or alcoholic drinks as an element in the case. The symptoms of conges- tion of the prostate are weight and pain in the perineum, pain- ful and frequent micturition, tenesmus and great anguish. The prostate can be felt to be enlarged and sensitive by the in- troduction of the finger into the rectum, and when a catheter is introduced into the urethra it is suddenly arrested ; there may be rigors; fever; insomnia. Either resolution or suppuration may take place, but if the former all goes well ; if the latter, the and Dictionary of Diseases. 1071 abscess may burst into the rectum, or urethra, leaving a cavity and giving rise to extreme danger. Prostatitis produces chronic hypertrophy in old men; in the young, tubercular en- largement. In rare cases, in the hands of the inexperienced, or badly managed, it may prove fatal. Chronic prostatitis may also be caused by the gonococcus entering the prostate, also by excessive sexual intercourse, or masturbation. In such an affection a leakage, or moisture, is frequent, consisting of mucous corpuscles, epithelium cells with or without pus, much resembling an involuntary seminal emis- sion. The use of the microscope readily clears up what its nature is. Acute inflammation of the bladder is common, as the germ passes back at any time during the period of its growth. Fre- quent desire to micturate, with tenesmus, sometimes leading to incontinence of urine, pain with least drop of blood in the urine. Generally subsides rapidly under our remedies. Epididymitis is also a common occurrence in gonorrhea, when it is treated empirically either by excessive stimulation, or irri- tating injections. The gonococcus goes for the epididymis, so does masturbation, excess, drinking, but the syphilitic mi- crobe selects the testes proper. In the testicular covering, when the micro-organism of gonorrhea is present, plastic lymph is effused into the little canals, or the cellular tissue sur- rounding them, most marked at the tail of the epididymis, and long after the inflammation ceases the induration persists, which usually gradually disappears ; but they may remain, and be little thought of until sterility of one testicle, or complete in- fecundity if both are inflamed. In either case there is either a poverty or a total absence of spermatozoa in the seminal discharge. Unless epididymis is managed upon our correct princples of treatment, no spermatozoa are to be found in the semen, but if managed with our remedies they will ultimately reappear. If there be induration of both testicles sterility ensues, but this under good treatment may disappear. In the immense ma- jority of cases, epididymitis is not a grave affection; and it is in cases where it is double and under the care of ignorant em- pirics, followed bv hard points in the tail, that it produces ster- ility. Gonorrhea does not directly cause rheumatism, but the oc- currence of articular rheumatism along with a gonorrhea is common. This consequence of gonorrhea is rarely met with 1072 The Germicide 20th Century Practice before the third week, and it is usually confined to a few joints ; rarely implicates the heart. , There are two affections of the eye common during an em- pirically treated gonorrhea; the one is ophthalmia produced by the direct application of the gonococcus to the eye; in the other the sclerotic coat of the eye is affected as in rheumatism. Fortunately the presence of the gonococcus in the eye is not very common, but when it does happen, there is. a sudden in- vasion of very acute symptoms ; lachrymation, abundant muco- purulent discharge from the conjunctiva; edema of the eye- lids, with spasm of the orbicularis; chemosis; periorbital pain amounting to anguish, with effusion into the layers of the cor- nea with a tendency to ulceration. The prognosis of such cases is bad, and demands the nicest tact, care, experience and judg- ment. Gonorrhea in women is altogether a less formidable mal- ady than it is in men; the lymph spaces in which the germ lives and multiplies are wide apart, renders the symptoms milder, less acute, more apt to degenerate into a chronic gleet. The principal complications that may arise are bubo and ulcer- ation of the neck of the uterus. When a woman is affected with gonorrhea she has pain in micturition, considerable scalding, backache, pains in the thighs. The extent or area of the gonococcus may be either the ex- ternal parts, the labia, nymphae, meatus urinarius, or vagina, and neck of the uterus ; a discharge of germ-laden mucopuru- lent matter from one or all; when it involves the uterine neck' ulceration is inevitable. The disease in woman must be carefully diagnosed from other discharges to which they are liable. From leukorrhea, a thick white discharge ; from catarrh of the neck of the uterus, or that termed intrauterine ; from vulvitis, inflammation of the external parts of genitals, dependent on a want of cleanliness, or a form from intestinal irritation, very common among chil- dren. The treatment is very similar to that recommended for men, general principles must guide. During the acute stage, rest in bed; hot fomentations; hip baths. Three times a day, at least, the vagina should be syringed out with either a solution of boroglycerid, or ozonized witch-hazel, or resorcin, or creolin, and boroglycerid pastils kept constantly inserted after each injection. The insertions of these latter make short all attacks of gonorrhea in the female. and Dictionary of Diseases. 1073 The Syphilitic Germ in Women. — All microbial affec- tions, in which the blood, tissues and organs of the body are im- plicated, present precisely the same conditions in the female as in the male. The syphilitic germ is no exception ; but it must be admitted, that the predominance of certain forms of tem- perament, and particularly the nervous, with the conditions inherent in the manner of living, diet, habits, as well as the special conformation of the genital organs, either exaggerate or lessen certain manifestations of the germ in women. With regard to the extraordinary immunity of the vagina from syphilitic chancres, its anatomical construction forbids it unless there be a crack or fissure. There is the same distinc- tion to be observed between the hard and soft sores in the female as in the male. The extraordinary number of cases occurring on the nipple must either be due to carrying the germ on the fingers or by the mouth, in the saliva. As a rule the latter secretion is heavily loaded, as we see the germ carried in tattooing, when the saliva is used. Mammary infection is perfect, sore or no sore, if a sore is seen, coppery red, elevated, slightly eroded, or a crack or fissure; when matured an eroded papule, a pustule of ec- thyma, about the size of a ten-cent piece. The chancre of the cervix uteri is situated either centrally, or excentrically. When central it often passes up to the cavity of the cervix. Papular in form ; rarely very large ; not painful ; sores on both nipple and uterus are liable to have engorgement of the lymph glands in close proximity. Herpes on the female organs, as in the male, is often mistaken for the initial lesion of syphilis. The bacillus of syphilis is the same in either sex; has the same histological elements; the same structure; the same pro- gress. And why not ? Have not the tissues, the blood, all the elements of both the same chemical composition ; the same ar- rangement in the one as in the other ? The pathognomonic value of induration in chancres and sores has been much exaggerated. The germ may thus enter in many hidden ways. As a rule, however, women are much more seriously affected from the presence of the germ than men. The bacillus in women may rouse up in their system other germs which are lying dormant, as those of tubercle and psora. The toxin of the germ stains the skin, often permanently ; this is rarely the case in men. The alopecia in women is more severe than in men; some 1074 The Germicide 20th Century Practice women lose the hair on the mons, on the eyebrows, axilla, head, which is neither so severe or extensive in men. Mucous tubercles, condylomata, are merely an efflorescence of the germ, the moisture or secretion from which is pre-emi- nently contagious. These are often the chief landmarks by which the presence of the germ is recognized in the female. Of course, the worst cases of mucous tubercles are seen among' the most depraved elements of womankind. In women, as in men, the germ gives rise to periostitis, ostitis, ostalgia. Peri- ostitis is more common ; pains in the joints belong to this. The muscular structure in ladies is more frequently affected, and pain, contraction, weakness and atrophy of the tissue take place. Trembling is the consequence of these affections of the muscles. Some women become greatly emaciated and seem to- be twenty years older than they really are. These symptoms are entirely got rid of by the remedies already enumerated, which remove the pains in both joints and bones. In addition to the headache, insomnia, nervous weakness,, and neuralgic affections, commonly witnessed, all of which are amenable to the same remedies. There is a curious fact in the progress of the germ in some women, that they have occasionally lost sensation in the skin. This syphilitic analgesia is peculiar to women, partial and con- firmed, chiefly about the back -of the hands, the skin over the mammary gland and the cheeks. This analgesia is mostly su- perficial and symmetrical. It sometimes extends to the mucous membrane. Paralysis of special nerves is common, but never difficult to overcome, as in men. The generative system in women is seriously damaged by the bacillus; they suffer often from leukorrheal discharges, which are contagious. In a great many women the germ, for a long time at least, has little influence on the menstrual func- tion; in some cases it produces total suppression. The cause of these menstrual troubles resides doubtless in an impairment of the general health by the germ. There is little doubt but that the germ produces sterility, and it is a rare fact that many syphilitic women never become pregnant. Pregnancy produces changes in important glands, which tend to anemia, and this added to the syphilitic germ produces great weakness. Very frequently does not run its full term, and the patient suffers an abortion or premature labor. How Long Does the Discharge Incidental to Gon- orrhea or Gleet Remain Contagious? — This is difficult. and Dictionary of Diseases. 1075 nay, even impossible in all cases to answer. As the best means of deciding the question, it has been laid down that the absence of the gonococcus in the discharge, from day to day, renders the discharge non-contagious, bereft of its inoculating power This faith in the presence of the gonococcus is justified by our present knowledge of the germ. But it is difficult to say when the urethra is free from this micro-organism, as they lodge in the granular patches, the crypts and ducts of glands, having ceased to furnish pus. True, we can say with certainty when the discharge is no longer spe- cific; no longer capable of communicating the disease; that it is not contagious. This is important, for the gynecologist has made out a for- midable list of affections attacking newly married women, whose husbands are suffering from slight urethral discharge ; which, giving no pain or inconvenience to the patient, has ceased to attract attention until the unfortunate wife is afflicted by some serious illness of undoubtedly gonorrheal character. All men, before marriage, should have their urethra ex- amined, especially if they ever have had gonorrhea, to ascertain if there are any warts, granulations, nodules, ridges, bridles, ulcers in the urethra, as we have instruments of great power, and the most scientific methods of discovery, not in possession of the ordinary, everyday physician. VERTIGO. — A swimming in the head ; muscae volitantes, specks or spots before the eyes ; and tinnitus aurium, noises or ringing in the ears, are respectively due to exhaustion of the cerebral pulp associated either with congestion or anemia. Ver- tigo, a transitory state of giddiness, a whirling or falling, sur- rounding objects appearing to be in motion, is often followed by headache, nausea. It is a symptom of a devitalized state of the brain, weakness or general disease of the blood, or it may be due to a poison, as opium or tobacco, or alcohol ; or of some auditory, cardiac, gastric, intestinal or hepatic affection. Any want of equlibrium will give rise to it. It is often a precursor of apoplexy and paralysis. In aged persons it is often due to disease of the cerebral arteries. Vertigo is the most common of all morbid states of the brain, and its great frequency must be accounted for irrespective of disease or poisons. It has long been known that the nervo-vital fluid within the skull forms a bed-plate upon which the brain rests ; that this watery fluid within the ventricles finds entry and exit from the 1076 The Germicide 20th Century Practice brain into the spinal column, so that it comes and goes from spine to brain according as the pressure of blood is less or more, Themechanism by which the human frame is adapted to go upright is unnecessary to discuss. It will not do to say that it was the size of the brain and ambition that gave him this nervous energy to brace up or take the trouble to be upright. True, the increased size of man's brain and its peculiar richness in gray matter necessitate an increased supply of rich blood. The erect posture placed in the brain aloft, so that blood supply is difficult, but this is guarded against and regulated by the cerebrospinal ..fluid. Three ounces of fluid is a small quantity ; still, the circulation of blood in the cranium is subject to small changes. In extravasation in apoplexy the amount of blood seldom exceeds three ounces; there is no room for more; for that corresponds with the amount of cerebrospinal fluid. In the recumbent posture, the entire spinal fluid is within the skull, which slows the heart ten to fourteen beats per minute. When the body is raised and the venous blood flows away readily from the brain, the cerebrospinal fluid may outstrip the arterial blood in the race to supply its place, and thus the ven- tricles of the brain may fill up with water more quickly than its substance with blood, and so the brain blanches and the person feels giddy. In the anemia of exhaustion the ventricles have an increased capacity, and many persons, with feeble circulation, experience giddiness, a sense of insecurity. Besides these there are numerous other conditions that render vertigo more com- mon than the other two symptoms. The immense size of the human brain, and its extreme rich- ness in gray matter (weighing from forty-five to sixty-five ounces), necessitates a great demand for phosphates, which, if not very abundant in human food, gives rise to a condition of starved brain, of which vertigo is the only symptom. This is common in brain-workers who neglect a phosphatic diet. Vertigo is a peculiar sensation of giddiness with a fear of tailing; a feeling of instability, which indicates a disordered action of the brain, or that portion of it concerned in co-ordi- nation of muscular movements and the maintenance of the equilibrium of the body. Giddiness has a cause. If due to an anemic state of the brain, an insufficient blood supply, there will be pallor of the face, dilated pupil, weak pulse, signing respiration. Then the indications will be stimulants and nutrition, nitroglycerin, protonuclein, cinchona and min- eral acids. and Dictionary of Diseases. 1077 If due to congestion of the brain, or plethora, the face is flushed, arteries distended, pupils contracted. Giddiness of this sort is always dangerous, and should be treated actively by free purgation, dry cups to nape of neck and shoulders, mustard to the feet and limbs, with veratrum viride internally and iodide potassa. Congestive form, common among women at the two critical periods of life, when it is of less importance as a symp- tom than when it occurs in men past the middle period of life. Passiflora incarnata, apiol solution, in liberal doses, if at pu- berty or change of life. If due to reflex irritation, to the toxins of the bacteria, and the sarcinae ventriculi of indigestion or dyspepsia, there is dis- tress after eating, eructation of gases, buzzing noises in the ears, dizziness, which lasts a few minutes, during which he may lose his balance and fall. Specks or cloudiness may occur during the giddiness. In this form comp. tincture matricaria or nitrate strychnia before meals, papoid or glycerite of pepsin, siegesbeckie tablets, immediately after eating. Individuals with lowered vitality, the aged, those fatigued by overwork, intellectual or physical, are often the sufferers from vertigo. The principal reflex causes are worms, either the taeniae, tape- worms, or the nematodes, or round worms — the former re- moved by decoction of pomegranate root bark; the latter by santonized obstinate constipation; exercise immediately after eating may provoke vertigo. Aural and visual vertigo is generally dependent upon the action of toxins on the auditory and optic nerves ; such as all the alkaloidal poisons, the toxicity of the products of growth of all disease germs, as malaria, typhoid fever, pneumonia, etc., giving rise to disturbance, altered nutrition of the brain. General Principles. — Select from two of the following either thyroid extract or protonuclein. or matricaria, or c. p. solution spermin, or kephalin granules, or avena. If from weak, dilated heart, with albuminuria, matricaria, protonuclein, creatinin, nitroglycerin, kephalin, celery comp. Hepatic inertia and formation of gall-stones, a prolific cause of vertigo ; relieved by phosphate of soda, chionanthus ; cured by olive oil and dioxide of hydrogen. VERBASCUM.— Either the fresh or dried leaves of the mullein plant. IO/8 The Germicide 20th Century Practice Therapeutic Uses. — Of some value as a germicide in pul- monary tuberculosis, asthma, bronchitis. It increases assimila- tion, and allays cough. Preparations and Doses. — Fluid extract doses thirty to sixty drops water. Mullein oil, prepared by steeping the fresh mullein leaves in olive oil, submitting it to polarized sunlight, and before perco- lating adding peroxide of hydrogen. Of immense utility in earache and deafness. Instantly, as if by magic, gets rid of all purulent discharges which are so unpleasant and dangerous, Cures deafness, polypus, and neuralgia. VIBURNUM. — Black haw, a nervine tonic, antispasmodic, exceedingly valuable as a uterine restorative, and an excellent remedy for habitual abortion. Preparation and Doses. — Fluid extract thirty to sixty drops. In addition to these new remedies, there is a class of so-called concentrations which must never be confounded with the alka- loids and glucosides, the true active principles of drugs. These concentrated medicines or resinoids are prepared, for the most part, by evaporating, or distilling off, the alcohol of a saturated alcoholic tincture of the drug, until reduced nearly to the con- sistency of honey, and then gradually poured into about ioo parts of cold water (below 50 degrees F.). When the pre- cipitate has settled, the water is poured off, and the precipitate (resinoid) is washed twice with fresh portions of cold water, by decantation. The resinoid is then spread out in thin layers , and dried in a cool place free from dust. They are thus really not much stronger than a solid extract in trituration, or an abstracta. VITAL FLUID. — There are thousands of weak, nerveless, men, who do not know what ails them; thousands of invalids whom the attending physicians cannot account for their rapid waste of strength, energy, vitality; much less check it. Some are treated for malaria ; others for neurasthenia ; while another class are managed for an exhausted brain ; others sicken and die in hopeless despair. Masturbation, sexual excesses, congress with harlots, per- version of the sexual act, even immoral literature, not only- drain off the internal secretion of spermin, so essential for am- bition, so necessary for mental vigor and growth, but such weaken, relax, srive rise to varicocele and a steady, invisible ooz- and Dictionary of Diseases. 10 79 ing of the vitalizing elements — the incessant loss lowers vitality , gives rise to mental disease, hebetude of mind, confusion of ideas, imperfect memory. The loss of both the internal and external secretions of sper- min gives rise to wasting of the reproductive glands — the organ with all its appendages atrophies, becomes small, puny, and wastes away, terminating in impotency. To-day, a physician who has kept up with the times can cure these cases of seminal leakages, which twenty years ago was deemed impossible. This department of medical science has reached perfection. In illustration of this we could cite case after case sent us by the most eminent physicians — cases deemed chronic and in- curable, which under the germicidal remedies for a few months were restored to sexual strength and vigor. Twenty years ago the action of the green root tincture of gelsemium and passiflora incarnata with negative ozone were unknown. With their proper use to-day, all nocturnal emis- sions are completely arrested ; and for those invisible losses going on at all times, the salix nigra suppository and bougies act with promptitude ; besides, the use of the black willow inter- nally rarely fails. Twenty years ago, we had neither kephalin, nor avena sativa, nor c. p. solution of spermin, to furnish the system with vital elements to restore enfeebled vitality. Masturbation, at any age, is a blight — retards growth and development ; the brain is imperfectly nourished, a nervous or- ganization is acquired, delusional insanity sets in; the depriv- ing the brain of its internal secretion gives rise to suicidal mania. For this condition, the tincture of ambrosia orientalis meets the leading indications. VITAL FORCE.— The capability of the vital forces in a condition of health to resist either the evolution or entrance of disease germs is remarkable; but if they are exhausted, enervated, both the evolution, growth and entrance of disease germs is certain. Sustain the vital forces by every possible means is the key to health, and the primary principle in the treatment of all dis- eases. Strong vital force renders all bacteria powerless — the destructive germ can only enter when its defences are de- stroyed. The administration of germicides may kill germs, or stop their growth, but the aim of all treatment is to construct 1080 The Germicide 20th Century Practice or build up. The slightest element of devitalization, the de- fensive mechanism is weakened; microbes become active; but as long as vital force is maintained they are insignificant. Sus- tain the vital forces, keep in health, which means, have abun- dance of fresh air, thorough cleanliness, good food, no ex- cesses, moderate exercise, no worry. In sickness this means more; the break down must be repaired, flagging energies re- vived, stimulated, toned. Special selection of food, of bathing ; massage and remedies to eliminate morbid matter and restore the function of organs ; constructive remedies always; tissue-builders to sustain the vital forces. We drive out bacteria ; render them harmless by so doing. VITALITY OF THE SEXES.— There is a prevailing im- pression that men are not only less subject to ailments and ill- nesses and are longer lived than women, but an examination of life-insurance companies' tables will show that the term of life of women is slightly longer than that of men. The dif- ference in the mortality rates during the first few years of life is striking. During the first year the mortality among males is decidedly greater than among females. Though more boys are born than girls the proportions are reduced to almost even terms at the end of the first year by the excessive male mor- tality. Even during the first four years the mortality among males exceeds that among females, notwithstanding the fact that there are practically no distinctions made in the manage- ment of the two sexes. Both are subject to the same condi- tions, are dressed virtually alike, and receive the same food. At about five years the comparative death rate among girls begins to increase. This has been attributed to the fact that boys of this age are more in the open air. The mortality in both sexes diminishes from this time to the twelfth year, when it attains its lowest point. It then steadily rises, being larger in each successive year. Between the twelfth and sixteenth years the death-rate among girls increases more rapidly than among boys, but after the sixteenth year, for several years the rate of increase is more rapid on the male side. The explana- tions that have been offered for these peculiarities are not wholly satisfactory, but one fact is clear that during early years females possess a greater tenacity of life than do males. VOMITING AND RETCHING.— Vomiting is due to forcible and repeated contraction of abdominal muscles, the and Dictionary of Diseases. 1081 diaphragm being pressed by closure of the glottis ; the stomach is thus compressed against the diaphragm, and by this force, together with its own contraction, the pylorus being closed, and the cardiac sphincter relaxed, the gastric contents are ex- pelled upwards. In retching there are fruitless attempts to empty the stomach, the cardiac sphincter being contracted, or the stomach empty. Nausea, vomiting, and retching, are present as symptoms in many diseases, as in cerebral, spinal, pulmonary, biliary, gas- tric, pancreatic, intestinal, uterine, ovarian disorders. They are often reflex, as in pregnancy, irritation of pneumogastric nerve, as in poisons and irritating substances. To disease germs in blood, as smallpox, scarlatina, yellow fever, icho- remia, etc. To acute or chronic gastritis or peritonitis. To ab- dominal aneurisms, tumors, ascites, to invagination of bowels, strangulated hernia, or some latent, morbid state. When the vomiting is due to some derangement of the stom- ach, liver, and intestines, it is likely to be preceded by nausea, dicharge of contents of stomach, biliary matters, offensive se- cretions, acid matter, pus, blood ; tongue usually coated, breath foul, white of eye tinged, abdominal griping pain, fetid eruc- tations, diarrhea, unhealthy stools, and the headache is frontah When due to some brain difficulty or reflex condition acting on a weakened bulb, there is no nausea, no food, tongue clean, breath sweet or pure, and if there is headache, is mostly behind ; no belching of foul gases. If vomiting and retching is due to disordered stomach, liver, pancreas, bowels. Lobelia emetic, cleanse out bowels, saline purge, or com- pound licorice powder, and follow with cinchona and nitromu- riatic acid ; a bland, simple diet, rest. If due to disease germs in fevers, give antiseptics, as echina- cea, ozone-water, carbolic acid, and tincture of iodine, yeast and milk. If due to inflammation, as in acute gastritis, peritonitis, yel- low fever, green root tincture gelsemium and passiflora, mus- tard over stomach, toast-water in half teaspoonful dose, lime- water and milk, ice in mouth, but spit out fluid as it melts. If due to cholera germs, ozone-water, camphor, menthol, echinacea, carbolic acid and iodine, with external warmth. Vinegar, always at hand, the comma bacillus present in either epidemic or cholera morbus cannot exist in the presence of di- lute acetic acid. Give this and the microbe perishes; patient promptly relieved. ; 1082 The Germicide 20th Century Practice If due to alcohol, aromatic spirits of ammonia, with infusion of calumba, or kurchicin. If due to reflex irritation, in pregnancy, try strong cup of coffee before getting out of bed in the morning; oxalate of cerium in five-grain doses thrice daily; infusion of cloves, lemon- juice. Drop doses of wine of ipecac, laurel- water, sul- phurous acid, spirits of chloroform, or, better still, chloroform and menthol. If due to hysteria, musk-root, wine of aletris, valerian, shower baths, cups to loins. If it does not yield, uterine alteratives; food and liquids in small quantity. Seasickness. — A flannel roller around abdomen; a few drops of chloroform in sweetened water; inhalation of from five to eight drops of nitrate of amyl. A one per cent solution of nitroglycerin in minim doses, repeated; bromhydric acid, car- bonic acid gas, as in champagne, effervescing salt; recumbent posture, head to bow of ship. In some cases a cup of tea and soda biscuit, early rising, keep- ing centre of vessel, and avoid wine, alcohol. WARBURG'S TINCTURE.— The following is the for- mula for this preparation : Aloes soc. one pound ; rhubarb, angelica fruit, confection of democratis, of each four ounces; elecampane, saffron, fennel, prepared chalk, of each two ounces ; gentian, zedoary, cubebs, myrrh, camphor, agaric, of each one ounce. Digest the whole in 500 ounces of alcohol for fourteen days, then percolate, after which ten ounces of quinine are added and dissolved. Indicated in malaria. WARTS. — Warts, or papillomata of the skin, consist of enlarged, elongated papillae covered by horny epidermis— that is to say, a little patch of the papillary layer of the skin has hyper trophied, and the horny layers over it have also increased in thickness. There are several kinds of warts. The common wart, verruca vulgaris, is dry and horny, and its surface is mapped out by minute cracks. They are usually multiple, and vary in size from a pin's head to that of a pea. They occur most frequently on the hands and face of young people, and come and go without apparent cause. They sometimes appear rapidly in crops, and vanish quite as rapidly. At times they occur symmetrically — that is, if a wart is on one side of the face or on one hand, another wart will be found at an exactly and Dictionary of Diseases. 1083 similar spot on the other side. This fact may point to some nervous cause, but is supposed to depend upon microbic origin. Owing to some adverse state or condition in which the pro- toplasmic elements are either changed, altered or degraded into a disease germ, the bacterium porri, which is pathogenic of warts. The microbe bears culture well in any warm nutrient fluid ; if cultures are injected into any animal it invariably causes an abundant crop of warts to appear over the entire body. Conta- gious and infectious on close contact. The microbe is at first sterilized, then completely annihi- lated by the internal and local administration of thuja occiden- talis. Lactic or acetic acid also of efficacy ; peroxide of hydro- gen, bichloride of mercury excellent as follows : Fifteen grains of corrosive sublimate added to one ounce of collodion ; painted on the wart once daily until it entirely disappears, is efficacious. Venereal Warts. — Warts, wherever they exist, are both contagious and infectious. Regarded as simple when they grow upon the fingers. When associated with syphilis, oc- curring on the male or female genitals, they are denominated venereal. Chancres are, by mere coincidence, often implanted upon the existing warts. On the genitals of both sexes rapid multiplication and bulk is the rule. A never failing remedy for all warts is the ozonized oil of thuja, administered both orally and applied locally. To be completely successful, to eradicate the spores of the microbe from the blood, it must be administered internally in five- to ten- drop doses in a glass of water thrice daily; locally, parts thoroughly cleansed, well dried and applied several times daily. It is a certain, slow, painless method, never fails. WEN. — A name given to a circumscribed indolent tumor; without inflammation or change of color of the skin ; met with in all parts of the body; their size and nature very variable. They come properly under the head of sebaceous cysts, filled either with a serous fluid or fatty or cheesy substance. Extirpation is the only treatment available. WHITLOW. — Properly speaking, whitlow, or felon, is sim- ply periostitis, inflammation of the periosteum of the phalanges of the fingers, and often proceeding to suppuration. The part attacked, however, is confined to the fingers ; the same disease may also appear in the toes. Paronychia and onychia are 1084 The Germicide 20th Century Practice terms which are used to express the same disease. Surgical authors describe several forms of whitlow or paronychia, ac- cording to the textures which the inflammation attacks. Thus it may be situated in the skin, the tendons or theca of the finger or toes, in the periosteum, or it may be seated in the cel- lular tissue under the nail. When the inflammation is con- fined to the skin, vesicles appear, which quickly advance to suppuration, and the case requires little attention. When the subcutaneous cellular tissue is affected, the case is more serious, though it seldom extends ; there is throbbing pain of the part, and there may be severe constitutional disturbance, and sup- puration is a less greater length of time in taking place. The whitlow under the nail differs from this form only in situation. In these cases only the cellular tissue under the cutis is affected, and no great danger or mischief is to be apprehended from the whitlow. W'hen, however, the inflammation extends to the tendons, periosteum, and bone, then the symptoms are very severe ; and by extending from the finger affected, up the arm, and involving a large extent of surface, fatal consequences have sometimes been the result. The commencement of this form of whitlow is indicated by a burning, shooting, throbbing pain of the finger, with a vary- ing degree of constitutional disturbance. Sometimes the fe- brile symptoms are very violent ; and when the arm is involved, delirium and other alarming symptoms come on. At first there is no perceptible change in the part affected; at length, however, slight swelling comes on, which may extend up the arm even to the axilla. In these cases a small quantity of matter is collected under the flexor tendon of the finger or under the periosteum, in which latter case the bone is mostly affected with caries. Whitlows may be caused by some external injury, such as a prick from a needle, pin, thorn, or other pointed object, or they may arise spontaneously. The latter not infrequently occurs in young persons who are appar- ently in a good state of health. The treatment consists in applying the most powerful form of local stimulation over the affected part; powerful but not destructive oil or saturated tincture of lobelia constantly ap- plied; but if there be evidence of suppuration, rigors, pains changed to a throbbing, swelling; free incisions down to the affected periosteum are indispensable. At the same time ad- ministering antiseptics, such as ozonized concentrated tine, of echinacea, or peroxide of hydrogen. and Dictionary of Diseases. 1085 WIND DYSPEPSIA.— Flatulence, wind, spasms, or belch- ing — for this affection is known by all these names — is one of the commonest symptoms of dyspepsia, and is often the one of which the sufferer is most anxious to be cured. Dyspeptics nearly always complain loudly of the "wind in their stomach," and frequently enough regard it as being at once the essence and cause of all their discomforts. The gas that produces all this trouble is usually derived from undigested food, detained in the stomach and undergoing a process of fermentation or simple putrefactive change. It is thought that sometimes it is formed by the stomach itself, for the flatulency may come on when that organ is quite empty. Many people always suffer from this disorder if a meal happens to be delayed beyond the accustomed hour. Sometimes the flatus is quite tasteless, while at others it is attended with both the flavor and odor of rotten eggs. Flatulent dyspepsia occurs far more frequently in women than in men. Nervous and hypochondriacal women, who par- take of tea, are very liable to suffer from it, especially when there is a general relaxed condition, and want of tone of the system. Frequently the gas accumulates so quickly in the stomach and intestines, and leads to such an amount of disten- tion of the abdomen, that patients have to loosen their clothes from inability to bear their tightness. In many people flatu- lence is always produced by the use of any food which is liable to undergo rapid fermentation. The formation of gases in the stomach indicates neuras- thenia of that organ. It is, therefore, best to arrange treatment into palliative and curative. Palliate the formation of wind by the use of one or other of the following remedies: Either willow charcoal, pulverized, in five- to ten-grain tablets before meals, is of great value ; men- thol alone — better still in chloroform; a few drops added to water rapidly dispels gases; sulphocarbolates or siegesbeckie tablets ; sulphur water, or remedies of the aromatic series — gin- ger, oil of cajuput, comp. tr. horseradish ; in other words, all antiseptics. Curative remedies are to be selected from the following group : One given before meals, another two hours after eating ; both to be changed weekly: Ozonized glycerite of pepsin; comp. tincture matricaria, collinsonia, American calumba, keph- alin granules, a most excellent stomach invigorator. Tonics that will dissolve readily in the stomach should have a prefer- ence. io86 The Germicide 20th Century Practice At the same time, when those remedies are being used, observe the following rules: The first rule is to eat slowly, masticate thoroughly, and insalivate completely, three things which are by no means always the same. The next rule is to take solids and liquids separately, the latter in the shape of hot water on rising in the morning, between eleven and twelve in the forenoon, about four or five in the afternoon, and at night before going to bed. When these rules do not suffice to remove the dyspepsia, the patient must take his farinaceous and proteid foods at different meals alternately, a farinaceous meal at breakfast time, and again at five o'clock, and meat or fish meals at midday and at eight o'clock. In some cases it will be found advantageous to supplement the gastric juice with a little acid and pepsin. WORRY. — Man possesses three brains proper, the cerebrum, the cerebellum and spinal cord, and great sympathetic — worry, fret, struggle belong to the third. Nevertheless their very exis- tence injures the brain cells proper, and as the cerebrum presides over all organs — all suffer. Worry acts as an irritant which, if long continued and persistent, makes grave inroads into the ce- rebral pulp. Occasional worry, fret, struggle, the brain can cope with; it is the iteration and reiteration which the brain cells cannot endure — the persistent blows never ceasing; the same week in and week out, that irretrievably diminishes the vigor of that delicate organism. The brain wears out more rapidly under worry than under work ; the former tires out the brain cells, the great sympathetic, the cortex of the frontal lobes ; degenerative changes set in. The brain can stand much irritation, but it is the perpetual wear in one isolated, monotonous groove that causes meta- morphosis. The effect on the nerve cells is chemical as well as mechani- cal ; fatigue products are found in the cells during the period of repose and relaxation — these products are toxical and produce pathological and microscopical changes in the cells. The entire nutrition of the body is dependent on normal con- dition of the brain; if it be unable to eliminate waste toxical substances it loses its vitality; appetite fails; a state of mal- nutrition sets in. In either sex worry is bad ; to a man, with a full-developed great sympathetic, it stamps an impress of de- terioration upon his brain ; to a woman, with her rudimentary '■sympathetic," it is evanescent. and Dictionary of Diseases. 1087 In either case it must be avoided, abolished; the emotion must be dropped. Passiflora incarnata in very large doses, alternated with kephalin, are our best remedies for a damaged great sympa- thetic by worry. That mental strain and kindred affections may and do have an effect on the genitourinary system, aside from that superin- duced by masturbation and sexual excess, we have had occa- sion to observe in a large practice devoted exclusively to the diagnosis and treatment of nervous disease. Thus through close application to business or literary pursuits, lawyers, bank- ers, ministers and students are very subject to a form of im- paired vital and sexual power, which is commonly termed ner- vous exhaustion; and such cases are usually very difficult to treat, because the system is so run down that there is very little stamina or vitality to rely upon, and many not having any idea what their real trouble is, lose much valuable time in treating for dyspepsia, consumption, neurasthenia, and the like, when really their very life and vitality are oozing away from them in their urine or otherwise. The results of overwork and mental strain are becoming alarmingly prevalent, and coupled with ex- cesses give rise to loss of nerve power and a predisposition to disease. For all such cases I have derived the utmost benefit in my practice from the use of ozonized glycerite of kephalin in alternation with coca. WOUNDS. — Wounds are denned to be the separation of parts by external violence that ought to be together or united. Varieties. — The incised wounds are those made with clean- cutting, sharp instruments; the punctured, or those made by instruments whose length greatly exceeds their breadth, includ- ing stabs or pricks; the lacerated, in which parts are torn ; and the contused, or those effected by bruising. The incised are the least dangerous, as they are produced by little violence, and admit easily of repair. The punctured are dangerous, from their depth, and from the possibility that either deep vessels or viscera may be injured, or that deep- seated extravasation of blood or abscess may follow. The lac- crated, or contused wounds, are produced with greater violence, less likely to heal, and more prone to slough or suppurate. They do not bleed so readily as incised wounds. Treatment. — The treatment of all wounds comprise four indications: (1) to check bleeding; (2) to remove foreign 1088 The Germicide 20th Century Practice bodies; (3) to bring the divided parts into apposition and keep them in union, and (4) to promote adhesion. Bleeding should be arrested by a raised position; the appli- cation of a sponge and pressure, and if a vessel is torn it must be tied. Foreign bodies should be removed by fingers, forceps, sponge, water. The edges are to be brought together by stitches, one in the centre and the requisite number on each side : and they are to be supported by adhesive strips and bandage : and to promote healing, antiseptic dressing should be applied . as solution of ozonized boroglycerid, diluted tincture echina- cea, tincture of benzoin, balsam of fir; so as to destroy the micro-organism in the wound. Wounds of the Ear, Nose. — Wash the parts well by drop- ping cold water on them from a squeezed sponge; then press sponge on the part; when thoroughly cleansed, introduce as many stitches as are necessary to keep the edges together. Even if parts are completely separated they should be cleansed and placed accurately in their place, and stitched there, as they often adhere. Over and above the stitches, dress with some antiseptic, as balsam of fir, or compound tincture of benzoin, or pulverized borax ; or if parts have been completely severed, compound tincture of myrrh. Keep wet all the time. Over all some bandage. Wounds of the Scalp. — Cleanse thoroughly; remove all foreign bodies, as dirt, sand; shave the parts all around the wound, for one or more inches back; then with lead-wire the edges may be stitched together. If there is no lead-wire handy use adhesive plaster; over it a compress, and then a bandage. Stitches in scalp-wounds should never be made with linen or silk thread. Whatever is resorted to should latterly be fol- lowed by some antiseptic dressing, as balsam of fir, pulverized borax, or compound tincture of benzoin, or echinacea. Wounds of the Throat. — Seize and tie every bleeding- vessel that can be secured. If the windpipe is only partially cut through, secure it with strips of adhesive plaster. If it is completely divided, bring its edges together by stitches through the skin and the covering of the windpipe on both sides, drawing them closely together. Don't put any stitches through the windpipe itself. Adhesive plaster to be applied, dressed with some antiseptic, and the head kept well bent forward, to aid in the approximation of the wound. Wounds of the Back of Neck. — The skin and muscles of axd Dictionary of Diseases. ' 1089 the back of the neck are often cut deep to the bone, by razors ; head drops forwards. Stitches of strong saddlers' silk to be inserted at close intervals; adhesive strips, antiseptics, and head kept well back to favor approximation and union. Wounds of the Chest. — In simple, incised wounds of the chest their edges should be drawn together by adhesive plaster, and compresses of antiseptics applied, and kept wet, and the chest bandaged so as to confine the ribs; bowels opened, and treatment for pleurisy resorted to. If the wound has been oc- casioned by a bullet, remove it if possible, or any clothing that may have been carried into the wound. Dress with lotions of permanganate of potassa, and keep patient over on the wounded side, so as to drain it effectually. If a portion of lung protrudes, return it into its place gently. Bayonets, crowbars, etc., penetrating the chest, to be removed, treated antiseptically, and on general principles. Wounds of the Belly. — In wounds of the abdomen, use stitches through the skin only, about half an inch from the edge of the wound; put them close, every one-quarter or one- half inch; apply between strips of plaster, and over all com- press, kept wet with compound tincture of benzoin, with band- ages over entire abdomen, followed with grain doses of opium every two or three hours. Treat for peritonitis ; anticipate it ; don't wait till it comes. Should any portion of the intestines protrude, wipe them clean and return, if they are uninjured; but if wounded, care- fully remove all foreign bodies, clots of blood, and then stitch them up with an over and over stitch, and return, closing the wound in the walls as in the simple wound. Treat at once for peritonitis. Wounds of the liver, spleen, bladder, kidneys, are very serious, but not necessarily fatal. Wounds of Joints. — In all wounds of joints, the opening must be at once closed by stitches in skin, adhesive plaster, paraffin splint applied to secure rest ; opium and veratrum viride given freely. Begin passive motion as soon as inflam- matory action ceases, say in two or three weeks. WRYNECK. — A deformity caused by a rigid contraction of the sternocleido muscle on one side of the neck. It may be either congenital or acquired ; if the former, it may be cured by a subcutaneous division of the muscle and wearing an ap- paratus to maintain extension, until the muscle resumes its "natural condition; if due to acquired causes, chiefly those due 1090 The Germicide 20th Century Practice to some reflex irritation, such as teething, worms, masturba- tion, removal of the cause is indispensable. YEAST FUNGI, THE.— In catarrh of all the hollow organs of the body, as the stomach, bowels, bladder, uterus, the yeast fungi grow side by side with the sarcinse. Yeast torula consists of spherical or oval cells, very much larger than the largest micrococci,; each cell consists of a membrane and con- tents. The contents are either homogeneous, or finely granu- lar protoplasm; in the latter case there are generally present one, two or more vacuoles. There are a great many species of torula, varying from one another morphologically, chiefly in their size, and physiologi- cally by their action on different fluids. The cells of all of them multiply in suitable media by gem- mation, a minute knob-like projection appearing on one side of the cell and keeps enlarging till it reaches nearly the size of the original mother-cell. It finally becomes constricted or exfoli- ated off from this latter, or having reached its full size remains fixed to the mother-cell, and each cell again producing by gem- mation a new cell. In this way, aggregations of four, six. eight, or more cells are formed, which may be arranged either as a chain, when the production proceeds in a linear manner, or otherwise, or as a group if the gemmation takes place laterally. Under varying conditions of nutrition or growth, yeast cells are productive of organic change, such as the evolution of the malignant neoplasm in some of its varied forms. YELLOW FEVER (a Streptococcus, or Fungus). — The microbe or fungus of yellow fever has been found difficult to isolate and cultivate. It is a paludal germ, originating in or on the banks of rivers, spread by maritime commerce over the entire intertropical zone of the globe. The mouths of which give rise to mucous, profuse mucous, or mucopurulent great rivers and. along the seaboards are the sources of the germ, which, when inhaled, modifies, changes, alters, the pri- mary bioplasm into a diseased fundus, giving rise to yellow fever. The diagnosis rests chiefly upon the location, season of the year; all the symptoms of bilious malignant fever, yellow skin and conjunctiva; heavy dark-brown coated tongue, which subsequently becomes red; nausea, vomiting, first of greenish matter, then coffee-ground appearance, later black vomit ; symp- and Dictionary of Diseases. 1091 toms of inflammation of stomach and liver, spleen, kidneys, with intense prostration, acute fatty degeneration of glandu- lar organs. The symptoms are divided into three stages : 1. Prominent in this are chills, prostration, fever; hard, rapid pulse ; violent thirst, red face, restless ; nausea, vomiting slimy, greenish, coffee-ground matter ; cerebral congestion, with pain, eyes red. 2. Add to the above, gastric disturbance much worse; the tongue heavily coated, dry, cracked; irritability, much vomit- ing, persistent, of brown mass, coffee-ground flakes, indicate approaching hemorrhage. 3. Face very yellow and livid; eyes dull, sunken; nose pinched, or lips, tongue brown or black, intense burning pain in stomach and liver, spleen; suppression of urine, oppression of chest, difficult breathing, pulse small and tremulous ; skin cold, clammy ; great prostration ; vomit, brown turbid matter, mixed with dark clotty blood. The most successful remedies ever used, and under which the mortality of this fever is reduced to a cipher, are germi- cides. A microscopical examination of the blood shows minute cocci, which occur in chains, distend the capillaries and lym- phatics of all organs enumerated. There can be no doubt that the microbe is pathogenic of the fever, as it is pre-eminently contagious and infectious. In the treatment the most rigid sanitary measures must be enforced for fever. The bactericides which have been found of utility are Warburg's tincture and ozone-water : con. tinct. kur- chicin and hydrocyanic; sulphate quinine and gelsemium. General Measures. — Isolate the patient in upper story room. Keep him quiet, free from light and noise, and in a horizontal position. Abundance of fresh, pure air ; sponge the body thrice daily with water acidulated with nitromuriatic acid. Packs or thick compresses, same water to head, over the stomach, liver, spleen and entire body. All authorities are agreed that the evolution of this germ depends upon solar heat, malarial and paludal miasmata, together with intense insanitary conditions, which act as a fos- ter-mother to the microbic growth; either by inhalation, or orally or cutaneously, it enters the body, finds access to the blood, passing its stage of incubation, lodges in the blood-form- ing glands, especially the spleen, and then develops its peculiar toxin or poison. 1092 The Germicide 20th Century Practice This pathogenic microbe is remarkably tenacious of life, re- taining its vitality for many years, in heat, in water, even after it has been dried. The following treatment is generally successful: Nursing of special importance, the best ventilated apartment for the pa- tient, bathing thrice daily with hot water acidulated with hy- drochloric acid, ice-water with c. p. peroxide of hydrogen for vomiting, very large doses green root tincture of gelsemium and passiflora administered, repeated doses of periodate aurum, one suppository of kurchicin every three hours ; beef juice ex- tracted by water acidulated with hydrochloric acid and press- ure the only source of nutrition for a few days. Formalin, one tablespoonful to a quart of water, divided up into four saucers and exposed in the apartment is the best dis- infectant ; it has been thoroughly tested and has merit in it. INDEX. PAGE Abdomen 5 Ablution 5 Abortion 6 Abrasion 7 Abrus Precatorius 7 Abscess 7 of the Antrum 55 Absinthium ... 8 Absorbents 8 Acetic Acid 9 Aceto-Tartrate Aluminum 30 Acholia 10 Acid, Boracic ' 117 Benzoic 10 Carbolic 10, 142 Chromic 10 Chrysophanic 181 Lactic 10 Nitric 10 Acids 9 Acne 10 Aconite 11 Acromegaly 13 Actinomycosis 1 1 Acupressure 12 Acupuncture 12 Adenitis 14 Adenoma 15 Adhesion 14 Adipose Tissue 15 Air 16 69 (1093) 1094 Index. PAGE Albinos 17 Albumin , 285 Albuminuria 17 Alcohol & Alcohola Poison 20 Alcoholism 18 Aletris Farinosa 29 Alkali 22 Alkaloids 23 Alimentary Canal 25 Alimentation 23 Alopecia * 28 Alopecia, Senile 28 Structural 28 Pigmentary 28 Parasite 28 Alumen 30 Aluminum 30 Amaurosis 30 Ambrosia Orientalis • . 33 Amenorrhea 34 American Hemp 63 Amido-Benzine 36 Ammoniemia 36 Ammonium, Picric 695 Amyl Nitrite 25 Anal Fissure • 38 Anasarca 308 Anesthetics • 39 Anesthesia 40 Anemia 41 Aneurism 42 Angina Pectoris 43 Aniline 46 Animal Extracts 26 Anise 46 Ankylosis 46 Antagonism 46 Anthelmintics 50 Anthemis 51 Anthrax • Si Antidotes 27 Antidotes for Acetanilid • • • 706 Aconite 708 Alcohol • 708 Anilin 708 Index. 1095 PAGE Antidotes for Antimony 708 Arsenic 709 Belladonna 709 Benzene 709 Bromides 709 Camphor 710 Cantharides 710 Carbolic Acid 706 Carbon Disulphide 710 Castor Beans ■ 710 Caustic Potassa 707 Chloral 710 Chloroform 710 Chlorates 711 Chromic Acid 707 Cocain : . . . . 711 Colchicum 711 Conium 711 Croton Oil 712 Curarin 712 Cytisin 712 Digitalis 712 Dog Bites 713 Ergot 713 Gelseminum • 713 Hydrocyanic Acid 707 Iodine 713 Lead Compounds 713 Lobelia 714 Mercury 714 Mezereum 714 Mushrooms 714 Nitric, Muriatic 707 Nitrobenzin 714 Opium 715 Oxalic Acid 707 Phosphorus 715 Physostigma 716 Phytolacca 716 Pilocarpus 716 Savin 7 I( > Silver Compounds 716 Snake Bites 716 Staphisagria 716 Stings 717 Strychnin .-•••. 717 1096 Index. PAGE Antidotes for Tobacco 717 Tin Compounds 717 Turpentine • • • • 717 Veratrum Viride 718 Zinx Compounds 718 Antifat 53 Antif ebrin 53 Antikamnia 54 Anti-Microbe Powder 57 Antipyrin • • 54 Antitoxin 58 Antrum 55 Aphonia 59 Aphthae 59 Apiol 61 Apis Melliflca 62 Apocynum 63 Apoplexy 63 Apoplexy, Serous 65 Nervous 65 Sanguineous 65 Appendicitis • 62 Appetite 274 Arbor Vitse 56 Araroba 67 Aristol 67 Asthma 77 Ascites *• 308 Aseptol 66 Ash, American 68 Aspergillus, Varieties • 325 Aspermia 61 Asphyxia 68 Aspidium, Filix Mas 68 Asthma, Hay 410, 800 Ataxia 7* Athletics 57 Atmospheric Disinfection • 72 Atrophy 73 Atrophy of Bone 113 Atrophy of Brain 73 Breast 545 Heart 74, 417 Heart • 74 Mammary Gland 74 Muscles 75 Index. 1097 PAGE Atrophy of Prostate 740 Spinal Cord 75 Testes 76 Uterus yy Aurum , 79 Auscultation yg y 265 Auto-intoxication yg Avena Sativa 80 B Bacillus Indicans 331 Bacteria 81 Bactericides 82 Bacteriuria 83 Balanitis 84 Baldness 85 Balsams 86 Bandages 86 Baptisia Tinctoria 87 Barium 88 Baths 88 Bed Sores 92 Benzoic Acid 10 Bile 92 Bituminous Coal 93 Black Willow 94 Bladder 96 Blindness 30, 104 Anemia 31 Congestion 31 Poisons 32 Reflex Causes 31 Uremia 33 Blisters 105 Blood 105 Blood Poisoning 106 Body, Human 107 Boils 108 Bones 109 Boroglycerid 115 Boracic Acid 117 Bougies 1 18 Brain 119 Brain Degeneration 125 1098 Index. PAGE Brain Exhaustion 121 Brain Fissures 122 Brain Growth - 125 Brain Softening 32 Brain, Starved 124 Brain Workers 126 Break-bone Fever • 252 Bright's Disease 129 Bronchitis 130 Acute and Chronic 131 Bronchocele 130 Bronchopneumonia 134 Bruises 134 Bunions 207, 859 . . Burns 135 Burns 335 Bursas 136 Cachexia • 136 Cactus Grandiflorus 137 Cadmium 137 Caesarian Section 137 Calculi, Urinary 139 Callosity 138 Canal, Alimentary • 25 Cancer of Arm 147 Bladder 151 Breast 147 Eye 147 Esophagus 148 Face and Lip 148 Penis 148 Rectum 148 Stomach 149 Tongue 149 Uterus • 149 Cancrum Oris I4 1 Cannabis Indica 14 1 Cantharides l 4i Capacity, Vital 287 Capsicum . , 141 Carbolic Acid 10 Carbolic Acid 142 Index. 1099 PAGE Carbolates 143 Carbon Chlorate 143 Carbuncle 143 Carcinoma 144 Cardiac Disease 428 Cardiac Insufficiency 427 Caries 15, in, 151 Carriers' Contagion 142 Caruncle 152 Caryophyllus , 152 Cascara Sagrada .' 152 Castration 153, 768 Catalepsy 154, 337 Cataract 153 Catarrh, Nasal 155, 602 Epidemic 159 Gastric 162 Uterine 165 Caulophyllum 177 Cavities in Lung 169 Cedron Seeds 175 Celery 170 Cerebral Congestion 171 Cerebrin 172, 495 Cerebrospinal 172 Cerebrum 173 Cerium 176 Chaffing 57 Chancres 176 Change of Life 558 Changes in Testes 778 Chaps 176 Character of Nails 281 Stools 280 Urine 285 Chaulmoogra Oil 176 Chian Turpentine 177 Chionanthus Virg 177 Chilblain 178 Chimaphila 179 Chinosol . 178 Chloasma 179 Chloralamid , 180 Chloral Hydrate 179 Chloride of Chromium 180 Chlorides 286 * iioo Index. PAGE Chloroform 180- Chlorosis 179 Cholera 181 Epidemic 183 Infantum 181 Morbus 182 Chorea 184 Chromic Acid 10 Chrysophanic Acid 181 Cimicifuga 188 Cinchona 188 Circumcision 189 Cirrhosis 189 Cirsocele 189 Clitoris • ■ • ■ • 189 Cloves 152 Coal, Bituminous 93 Coca 191 Coffee 192 Cold 194 Colic 195 Collapse 196 Collapse 336 Collinsonia 197 Color Blindness 104 Coma • 197 Coma 337 Compound Fracture 377 Concentrated Ozone 199 Conium • 197 Constipation • • 200 Continence Urine 198 Convallaria 199 Convulsions 199 Cornea 206 Corns • 207, 858 Corona Glandis 207 Corpulency • 208 Coryza 209 Cotton Root - 209 Cough 216 Cracked Tongue ; • 594 Cramp 212 Creatinin 214 Creolin • • • 213 Creosote 217 Index. iioi PAGE Cretinism 214 Crime 217 Croton Chloral 217 Croup 218 Cutaneous Medication ,. . . . 219 Cyanosis • • • 232 Cyclists' Diseases 226 Cystic Disease 233 Cystitis 97 Damiana 233 Dandruff 697 Deafness 234 Deafness due to Anemia 235 Congestion 235 Organic 235 Poisons 235. Reflex 235 Decay, National 236 Decay, Premature 237 Sexual 238 Senile 240 Defecation 241 Degeneration 242 Degeneration of the Heart 426 Degeneration of Testes 783 Deleterious Trades 244 Delirium Tremens 245 Dengue 252 Dentition 246 Dermolia 253 Deterioration 250 Diabetes 253 Diagnosis 259 Diathesis 136, 294 Diathesis, Uric Acid 403 Hemorrhagic 432 Oxaluria 658 Phosphatic 405 Digitalis 295 Dilatation of Heart 420 Diphtheria 296 Dipsomania 295: no2 Index. PAGE Direct Medication 301 Disease . . , 302 Disease-producing Germs 393 Disinfectants 303 Disinfection 72 Dislocations 303 Dog Bite 336 Dogwood, Jamaica 696 Dropsy 307 Dropsy of the Antrum 55 Dry Murmurs 267 Dumping Ground . ■ 305 Dysentery 305 Dyspepsia 315 Inflammatory 312 Mechanical 313 Dysmenorrhea 311 Dysmenorrhea, Neuralgic 311 Earache 323 Ear, Its Diseases 320 Ear Microbes 325 Ecchymosis 134, 326, 333 Echinacea, Aug. 326 Eclampsia 326 Eczema 328, 853 Elder 817 Elder Bark 330 Electricity 288, 330 Elephantiasis . . 857 Emaciation 277 Embolism 331 Emergencies 332, 336 Emphysema 339 Endocarditis '. 416 Enteritis 340 Membranous 341 Enuresis 342 Ephemeral Fever . • * 344 Ephelis 858 Epidemic 345 Influenza 345> 799 Epididymitis 343, 77& Index. 1103 PAGE Epilepsy 34 8 E P istaxis 353 Erigeron 354 Eruptive Fevers 355 Erysipelas 355 Erythema 852 Ether 356 Eucalyptus 357 Euphorbia 357 Exostosis '. 113 Expression 279 Extracts, Animal 26, 359 Extrauterine Pregnancy 358 Eye 360 Facial Appearance 279 Fainting 361 Fashions in Medicine 362 Fatty Degeneration of Heart 426 Fatty Heart ; 363 Ferratin 363 Feticide 365 Fetid Breath 373 Fever 366 Fever, Breakbone 252 Ephemeral 334 Eruptive 355 Gastric 387 Puerperal 756 Relapsing 762 Remittent 763 Scarlet 821 Typhoid 954 Typhus 959 Fetation, Extrauterine 364 Fissure, Anal 38 Fistula 367 Fistula, Anal 368 Salivary 369 Ulcer 963 Urethral , 369, 1056 Vesico- Vaginal , 370 Foreign Bodies in Bronchi 334 1 1 04 Index. PAGE Foreign Bodies in Ears 334: E y es 334 Larynx 335 Formalin 371 Fracture 374 Frambesia 857 Francisca 377 Freckles 378, 858 Friction Sound 267 Fringe Tree 177 Fucus Visiculosus 378 G Gait 278 Galactagogue 378 Gallic Acid 379 Galls 379 Gallstones 138, 379 Ganglion . 383 Gangrene 383 Gastritis 383 Chronic 384 Gastric Catarrh 16, 386 Fever 387 Tumors 388 Vertigo 385 Gastro-Intestinal Infection 389 Gaultheria 389 Gelsemin 389 Germless World 390 Glanders 394 Glonoin •• 395 Glycerin 395 Glycosuria 255 Glycozone 396 Goa Powder 67 Goitre 397 Gonorrhea 398, 1007 Gout 401 Gravel 403 Grindelia 406 Growing Pains 406 Guaiacol 407 Guaiacum 408 Guarana 408 Index. iioj H PAGE Habits 408 Hamamelis 409 Haplopoppus Llaretta 399 Hare-Lip 410 Hay Fever 410 Hazelin 412 Headache 412 Healthy Ulcer 960 Heartburn 420 Heart, Fatty 363 Heart Failure 420 Hectic Fever • • • 430 Hematocele 434 Hematogen 430 Hematophilia 434 Hematospermia yyy Hemorrhages 332, 43 1 After Delivery 332 Bowels * 332 Kidney 333, 433 Lungs 332, 433 Stomach 332 Uterus 333, 431 Hemorrhagic Diathesis .' 432 Hemorrhoids 434 Hepatitis 436 Hepatism 437 Hereditary Disease 437 Hernia 438 Herpes 440 Labialis 852 Prseputialis 852 Zoster 853 Hiccough 441 Hoang-Nang 441 Honey 62 Hordeolum • 442 Hospital Gangrene •_• 965 Hot- Air Treatment 442 Hunterian Chancre 1007 Hydrastis 443 Hydrobromic 444 Hydrocele 444 Hydrocephalus 309 no6 Index. PAGET- Hydrogen Peroxide 444 Hydronaphthol 447 Hydrophobia 448 Hydrops Pericardium 310 Hydrothorax 309 Hypertrophy of Bones 1 13 Breast 545 Clitoris 452 Heart 268, 414 Prostate 740 Hypericum 452 Hypochondriasis 452 Hypodermic Medication 452 Hysteria '. 455 Ichthyol 456 Ichthyosis 457, 857 Idiocy * 457 Immunity 457 Impaired Vision • 461 Impetigo 854 Impotence .. 463, 474 Incontinence, Urine 198, 476 Indigestion • • 477 Indolent 961 Infection 478 Inflammation 47$ of Bone : no Membrana Tympanum 320 Bowels 340 Breast 544 Urethra 977 Lungs 699 Pleura 698 Pericardium 681 Periosteum • 682 Peritoneum 682 Veins 689 Uterus 573 Inflammatory Dysmenorrhea 312 Influenza 159, 345, 479 Insanity 480 Insomnia 484 Index. 1107 PAGE Inspection 261 Iodine 486 Water .., 486 Iodoform 486 Iodol 486 Irritable Bladder 103 Irritable Ulcer 961 Itch 487, 856 Izal 487 J Jaborandi 488 Jambul 488 Jaundice 489 Jelly of Violets 219, 491 Resorcin 220, 492, 797 Carbon 221, 493 Ichthyol 221, 493 Chrysarobin 221, 493 Periodate Aurum 221, 493 Boroglycerid 221, 494 Salicylic Acid et Soda 222, 494 Acetate of Aluminum 222, 494 Carbolic Acid 222, 494 Formalin 222, 494 Thymol 221 Jellies 219, 491 Jequirity 7 K Kaki 494 Kava Kava 494 Kephalin 495 Kleptomania 501 Kola 502 ' Krameria 503 Kurchicin 503 L Labor 504 Lactic Acid I0 Lactucarium 5*5 no8 Index. PAGE Lanolin 515 Laryngismus 515 Laryngitis 802 Acute 515 Chronic 516 Lead Poisoning 517 Lepra 857 Leprosy 519 Leukocythemia 521 Leukorrhea 521 Lichen 523 Lichen, Simplex 854 Agrius 854 Life Root 524, 839 Light 524 Lightning 336 Lily of the Valley 199 Lime Water 525 Liver , 526 Liver Spots 179 Local Anesthesia 40, 529 Lock Jaw 5 2 9 Locomotor Ataxia 7i> 53° Longevity 289, 531 Lumbago 533 Lung Cavities 169 Lungs 533 Lupus 535 Lycopodium 536 M Malaria 536 Male Fern 68, 543 Male Sexual Organs 7§9 Malignant Edema 543 Mammary Glands • • 544 Man 545 Manaca 377 Massage 54& Mastitis - 544 Mastodynia 545 Masturbation 553 Membranous Enteritis 341 Measles 556 Index. 1109 PAGE Measles, German 558 Mechanical Dysmenorrhea 313 Meningitis 172, 558 Menopause 558 Menorrhagia 570 Menses, Retention 34 Suppression 34 Vicarious 35 Menstruation 570 Mensuration 262 Menthol 572 Mesentery 573 Metritis 573 Microbe of Dysentery 3°7 Leprosy 5 10 - Tetanus 922 Whooping Cough 683 Microbes • 46, 325, 575 Micrococcus Tetragenus 169, 534 Micrococcus Ureas 804 Microscope 287 Micturition 583 Midwifery 584 Moist Rales 267 Mollities Ossium 114 Moles 592, 858 Mouth 593 Mucin 595 Muco-membranous Colitis 596 Mullein Oil 596 Mumps 597 Muscae Volitantes 59& Musk Root 601, 901 Muscles 598 Myelitis 601 Myositis • 598 N Nails, Character of 281 Naphthalin 602 Nasal Catarrh 602, 798 National Decay 236, 603 Necrosis in, 151 Nephritis 607 70 i no Index. Nerve Tire g I0 Nervous Dyspepsia 3^ Impotency 621 Temperament 629 Nettle Rash 611, 852 Neuralgia 61 1 Neuralgia of Brain 6 I2 Coccyx 612 Ear • 323, 616 Eye 616 Heart 615 Kidneys 615 Pleura 616 Sciatic 616 Sexual 620 Stomach 613 Testes 617, 777 Uterus 617 Neuralgic Dysmenorrhea 311 Neurasthenia 618, 625 Neurosis 627, 622 Nevus 630 New Diseases 631 Night Blooming Cereus 137 Nipple 633 Nitric Acid 10 Nitrite, Amyl 25 Nuclein, 636 Nutmeg 637 Nympha Odorata 638 Nymphomania 637 Oats 80 Obstetric Cones 639 Obstruction of Bowels 639 Odontalgia 640 Odors 283, 640 (Edema 641 CEnathe Crocata 641 GEsophagus 642 Oil, Arbor Vitse 56, 99 Chaulmoogra T 76 St. John's-wort 644 Index. i i i i PAGE Oils . . : 643 Ointments 219, 644 Guaiacol 223 Gaultheria 222 Mexican 223 Ozone 222 Saw-Palmetto 223 Resorcin 223 Siegesbeckie 223 Storax 224 Old Age 646 Oleum Verbascum 644 Concentrated 199, 662 Clay 666 et Chlorine 664 et Formalin 665 Ointment 667 Paste 666 Tar Syrup 666 Water 664 Wines 668 Olive Oil : 643 Olfactory Nerve 648 Onychia 648 Opacities 649 Opacity, Cornea 207 Ophthalmia 649 Common 650 Gonorrheal 651 Granular ., 652 Infantile 650 Pink Eye 653 Purulent 651 Rheumatic 652 Tarsi * 652 Tubercular 651 Osteoarthritis 654 Ostitis 1 10 Otalgia 323 Otitis • • 320 Otomycosis 325 Otorrhea 324, 654 Ovarian Syphilis 1064 Ovarin 655 Ovaritis 656 Ovulation 656 1 1 12 Index. PAGE Oxaluria 658 Oxygen 660 Ozena 660, 799 Ozone 660 Ozonized Boroglycerid 115 Ozonized Distillation of Pine 663 Painless Parturition 588 Palpation 262 Palpitation 668 Pancreas 669 Papilloma 101, 670 Papoid 670 Papulae 854 Paralysis 671 Paraphimosis 67s Parasite Alopecia . . . . 28 Parasites 674, 855 Paresis 677 Parsley 61 Partridge Berry 678 Passiflora 679 Pastils 680 Pemphigus 853 Pepsin 681 Percussion ■ • 263 Pericarditis 416, 681 Periostitis 109, 682 Peritonitis 682 Pertussis 683 Perityphlitis 63 Permanganate Potassa .' 682 Peroxide, Hydrogen 444 Phenacetin 689 Phimosis • • • 689 Phlebitis 689 Phlegmasia Dolens • • • • 689 Phloridzin 690 Phosphates • • 286 Phosphaturia 69° Phosphorus 112, 694 Phytolacca 6 94 Picric Acid 6 95 Index. 1113 PAGE Pigmentary Alopecia 28 Pile s 434 Pimples 695 Pink Eye 653 Pinus Needles 695 Piscidia 696- Pityriasis 867 Plague 697 Plethora 698 Pleurisy 698 Plumbism 698 Pneumonia • • 699 Podophyllum 703. Poisons 704 Poison, Alcohol 20 Polypi 719, Polypus 994 Polypus, Nasal 720 Rectum 722 Uterine 720 Position 278 Posture 278 Powder Marks 722 Pregnancy 723 Premature Death 646 Premature Decay 237 Priapism 735 Prolapsus 735 Rectum J2>$ Propagation of Syphilis 1015 Prostate Gland yyj Prostatitis • • 791 Prostatorrhea 795 Prunia 751 Prurigo 854 Pruritus 751 Psoas Abscess 752 Psoriasis 697, 856 Pterygion 752 Ptomains 753 Puerperal Convulsions 754 Eclampsia 754 Fever • • 75& Mania 759 Peritonitis 760 Pulse 270 1 1 14 Index. _ PAGH Purpura 7 6 Pus 2 86 Pyoktanin . . 760 Pyorrhea 7 6 Rabies 448 Radiography 760 Railway Shocks 761 Ray Fungus n Recognition of Disease 260 Rej uvenescence 761 Relapsing Fever 762 Remittent Fever j(S$ Reproductive Organs 765 Requisites for Poisons 705 Resorcin 797 Resorcin Jelly 797 Respiration 281 Respiratory Diseases 797 Retention of Urine 336, 804 Retention of Placenta 590 Rheumatism • • 805 Rickets 114, 811 Rigidity of Neck of Uterus • • 812 Rigor Mortis 813 Ringworm 813 Rosacea 855 Roseola 852 Rubeola 556 Rupia 815, 853 Rupture 438 Salicin . 815 Saliva 274 Salix Nigra 815 Salicylic Acid and Soda 815 Salicylate, Phenol 816 Salol 816 Salophene 816 Salt 816 Index. 1115 PAGE Sambucus 817 Sanguinaria 817 Sanitary Science ! 818 Santonin 818 Sarcinse 818 Gastric 818 Intestinalis 818 Urinse 819 Uteri , 819 Ventriculi 386 Saw-Palmetto 819 Saxifraga 821 Scabies 821, 856 Scalds . 135, 335 Scarlet Fever 821 Sciatica 823 Sclerosis 824 Scrofula 826 Scrotal Dropsy 310 Scrotal Hypertrophy 826 Scurvy 827 Scutellaria 827 Seasickness 829 Sea Air 828 Secretion 830 Bile • • 831 Gastric 831 Pancreatic 831 Milk 830 Saliva 831 Tears • • 830 Semen 770 Urine • • 831 Seminal Fluid 773 Seminal Infertility 832 Vesicles • • 834 Seminal Weakness 838 Senecio Gracilis ....•• 839 Senile Alopecia 28 Senile Decay 240 Senility 775, 839 Sensations 277 Sexual Debility • • 840, 842 Impotency 843 Paralysis ....•• 848 Sexual Neurasthenia 620 iii6 Index. PAGE Sexual Decay 238 Shock 336 Siegesbeckie ' 850 Sight 851 Simabicidia 851 Skin 273 Skin Bactericides 82 Skin Diseases 852 Sleep 859 Smegma ... . 861 Snake Bite 336 Sodium Sulphocarbolate • 861 Sore Throat 927 Spartein Sulphate 862 Spasm of Bladder 102 Spaying 153 Spermatogenesis 772 Spermatorrhea 474, 862 Spermin 876 Sphygmograph 289 Spices 878 Spina Bifida 878 Spinal Cord 641 Spinal Curvature 879 Spinal Diagnosis 289, 880 Spirillum Plicatile 881 Spirometer 288 Squamous Skin Diseases 856 Squinting 882 Stammering 883 Sterility in Female 883 in Male 887 and Impotency 891 Still-birth 894 Stillingia 895 Stomach • 895 Stone Crop 896 Stools , 280 Strains ' 896 Streptococcus Pyogenes 7 Stricture 896 Stricture of Esophagus • 642, 898 Rectum 897 Urethra 897 Structural Alopecia 28 Structural Changes in Testes 778 Index. 1117 PAGE Stye 442 Sudamina 853 Sugar 286 Sugar Fungus .• 255 Suicide 898 Sulphonal 899 Sulphur 900 Sumbul 901 Summer Diarrhea 292 Sunstroke 336, 902 Suppository, Saw-Palmetto 821 Suprarenal Capsules 903 Surgical Fever 905 Surgical Procedures 906 Suspended Animation 68 Syphilis 915, 1021 Syphilis in Skin 1022 Malignant 1026 in Mucous Membranes 1026 in Ulcers 1030 in Alopecia 103 1 in Brain 1032 in Bone 1034 in Prostate 1035 in Eye, Iritis 1037 in Nose, Rhinitis 1037 in Spinal Cord 1040 in Lungs and Larynx 1042 in Aphasia 1043 in Liver 1044 in Carditis 1046 in Stomach and Bowels 1049 in Anus 1049 Syphilitic Paralysis 1057 Fever 1057 Epilepsy 1058 in Infants io5o Syncope 337, 361 Synovia 9 : 4 T Temperament 290 Bilious 291 Gouty 291 Lympathic 290 ni8 Index. Temperament, Nervous 290 Rheumatic 291 Sanguine 290 Tubercular 290 Temperature 282 Testes yj 0} g 20 Tetanus 922 Tetter 440 Thallin 923 Thirst 274 Throat 924 Thrombosis . . . ' 331 Thuja 56 Thymol 927 Thyroid 928 Extract 929 Tin Oleate 933 Tinea Capitis 855 Tired Eyes 933 Tobacco 934 Tolu 937 Tongo 937 Tongue 271, 937 Tonsils 938 Tonsillitis 939 Toothache 940 Toxins 94 1 Trance 337 Trichinosis • 942 Tubercular Diathesis 294 Decalvans 856 Favosa 856 Sycosis 856 Tonsurans 855 Tuberculosis 803, 943 Joints 946 Mesentery 945 Peritonitis • 948 Skin 857 Turpentine, Chian 953 Tumors • 388, 949 of the Antrum 55 Cartilaginous 951 Cystic 951 Fatty 950 Fibroid 950 Index. 1119 PAGE Tumors, Gelatinous 951 Glandular 951 Melanotic 952 Osseous 951 Ovarian 953 Sebaceous 951 Typhoid Fever 954 Typhus Fever 959 Typical Fissures 122 U Ulceration 960 Fistulous 963 Healthy 960 Irritable 961 Indolent 961 Lichen 854 Malignant 965 Neck of Uterus 966 Stomach 965 Rodent 969 Tubercular 962 Varicose 963 Ulcers of the Mouth 593 Undeveloped Sexual Organs 971 Uremia 97 1 Urethra 972 Uric Acid Crystals 979 Diathesis 403, 9§o Solvent 9S5 Urinalysis 9§5 Urinary Calculi 140 Urotropin 996 Urticaria 852, 989 Uterine Catarrh 990 Tumors 992 Uvula 996 V Vaccinia 997 Vaginismus 99° Valdivine 998 Varicocele 999 Varicose Veins 1002 U20 Index. PAGE Variola 1004 Varix 1003 Vegetations 858 Venereal Disease 1007 Verbascum 1077 Vertigo 385, 1075 Vesicants 105 Vesicles 852 Viburnum 1078 Vision 461 Vital Capacity of Lungs 287 Fluid 1078 Force 1079 Vitality of Sexes 1080 Vomiting 1080 W Warburg's Tincture 1082 Warts 858, 1082 Weak Heart 425 Weight of Body 284 Wen 1083 Whitlow 1083 Whooping Cough 683 Wind Dyspepsia 1083 Worry 1036 Wounds 333, 1087 Yeast 1090 Yellow Fever 1090 LIBRARY OF CONGRESS 022 216 088 1