Glass Book COPYRIGHT DEPOSIT THE STANDARD Household Physician. A PLAIN AYD PRACTICAL GUIDE DESCRIBING SIMPLE DISEASES, THEIR CAUSES, PREVENTION, AND SAFE HOME TREATMENT. ANATOMY, EMERGENCIES, AND DOMESTIC PRACTICE. / By WILLIAM PEABODY DEFRIEZ, A.M., M.D., SURGEON TO THE BOOTHBY HOSPITAL, BOSTON ; ATTENDING PHYSICIAN AT THE HAHNEMANNIAN DISPENSARY ; FORMERLY INTERNE AT THE CHILDREN'S HOSPITAL, MUNICH, BAVARIA; MEMBER OF MASS. HOMOEOPATHIC MEDICAL SOCIETY : FORMERLY VISITING PHY- SICIAN AT THE OLD LADIES* HOME, BOSTON: ME3IBER OF BOSTON MEDICAL SOCIETY; MEMBER OF THE " HUGHES MEDICAL CLUB,"' OF THE INTERNA- TIONAL HAHNEMANNIAN SOCIETY. AND OF THE BOSTON HAHNEMANNIAN SOCIETY. ILLUSTRATED. BOSTOX : THE HYGIEXIC PUBLISHING CO. 1S92. ^=> tx COPYRIGHTED, 1892, BY THE HYGIENIC PUBLISHING CO BOSTON, MASS. PREFACE. In spite of all detraction and crying out by the allopathic school of medicine, the practice of the science of homoeopathy, as created by Hahnemann its founder, has come to take a permanent place among the recog- nized methods of cure. Homoeopathy, as now standing, has made the greatest advance possible. It has grown, from the very few scattered disciples practising its principles and doctrines, to have schools of medicine of its own, hospitals and dispensaries, and is recognized not only by the public generally, but by State govern- ments. It has been found beneficial to place the insane, in many States, under its law of cure, with the most beneficial results. It commends itself to the thinking mind: first, by its simplicity and the lack of danger to the patient in the administration of its remedies, as well as by the avoidance of such nauseous drugs as senna, castor oil, etc. , to which every mother administering to her children can abundantly testify; but principally it is its law of cure that tends to impress it upon the mind. The administration of the remedy as called for by the symptoms of a disease cures that disease simply because we have gained the knowledge that these same symptoms are produced in the healthy body by the VI PREFACE. taking of the remedy. This is done by men and women, who, in the cause of science and for the benefit of Buffering humanity, are willing to bear the discomforts which necessarily attend such provings. In issuing this work, the writer is guided by a desire to introduce a more judicious and rational system of domestic practice, and to put the community on their guard against the absurdities of the allopathic system of medicine as at present practised. The very fact of prescribing for a disease by its name, instead of by the symptoms it develops, is an absurdity, and an allopath without a diagnosis of the disease before him — that is, a name for it — is as helplessly afloat as a ship in a gale of wind without compass or rudder. This is abundantly proved by the utterances of the champions of the old school. Such is the dictum of Dr. 0. W. Holmes, that if all the medicines in the world were thrown into the sea, it would be infinitely better for mankind and worse for the fishes. Another prominent allopathic physician made a reply, when asked what the science of medicine consisted of, in the following terse sentence : ' ' The science of medicine consists in putting a remedy of which we know nothing, into a body of which we know less." Let every person possessed of intelligence, judge. The Drs. Bleedum and Purgeum have passed away, and their place has been filled by men who, at the pres- ent date, would hesitate to do what was considered a necessity in a time but recently passed, as the majority of us can recall. The denial of a mouthful of water to a suffering patient with a parched tongue and a pulse at its height, can readily be recalled by many still in the prime of life. That homoeopathy has had a distinct PREFACE. Vll and ruling influence, provoking these changes and opening the eyes of the people to their absurdity, is proven by the fact that no physician would, at the present time, attempt such measures. In dietetics the changes have been momentous. Tea and coffee, as well as tobacco, have been denied to those suffering from disease, and with justice to them. How many, partic- ularly among the female portion of our people, have had as irresistible a desire for those beverages as for any more potent stimulant ; and how many of us recall when it was common practice to have the teapot, espe- cially, ever ready for immediate use ! We are not here at liberty to enumerate more concisely, as these matters will be treated more elaborately under their proper headings. Suffice it to say that this little volume makes its entrance into the world with the distinct hope of its author that it may do the greatest good to its readers in the simplest and most rational way. It shall be our endeavor to bring the very latest remedies and medical truths so plainly before our readers, that he who runs may read and understand. There are many virulent diseases, of serious nature, which affect the human body, that will, of necessity, have but a brief mention, as in such cases the presence of a physician is imperative. For the sake of comfort to herself, and the well-being of her children, we advise every mother to become acquainted with homoeopathy, and follow its precepts. The remedies act specifically, that is, touch the disease where it ravages, and conquer and subdue it where it is, without undermining health, as we see, but alas, too often occurring through the use of such remedies as opium, mercury, quinine, and many others. But if viii PREFACE. many of the minor ails can be placed, through its con- tents, in such a way before the mother that she may be spared the dread and fear that attend disease, and feel confident of giving relief and making cures, the volume will meet with an abundant reward. W. P. DEFRIEZ. CONTEXTS Preface CHAPTER I. Anatomy Animal Anatomy . The Trunk The Subdivisions of the Body Number of the Bones Structures of our Bodies . The Skeleton Form of Bones The Spine General Characters of a Vertebra, The Sacrum The Coccyx Peculiar Vertebrae Atlas Axis The Skull The Cranium The Thorax The Sternum The Collar Bone The Bibs Upper Extremities The Clavicle or Collar Bone The Scapula . The Humerus The Radius . The Ulna The Wrist . The Palm The Fingers The Lower Extremity The Acetabulum The Tibia . The Fibula . THE ARTICULATIONS AXD MUSCLES. Structures Composing the Joints . 29 Cartilage 30 Synovial Membrane .... 30 General Description of Muscle . 31 CHAPTER II. The Blood and Vascular System, The Blood . The Heart . The Currents of Blood The Arteries The Veins Capillaries The Larynx The Trachea Epiglottis CHAPTER III. The Respiratory System. The Bronchial Tube; The Lung . 40 CHAPTER IV. The Xervous System. The Brain . The Cerebrum Cerebellum . Pons Varolii Medulla Oblongata The Spinal Cord . Spinal Nerves SYMPATHETIC SYSTEM. Sympathetic Nerves Gansrlia i'3 CONTEXTS. CHAPTEB v. The Digestive Organs Alimentary Tube Salivary Glands 4i * Gullet Stomacb Duodenum Jejunum 49 Ileum 50 49 Small Intestine , 51 50 Large Intestine . , 51 50 The "Pocket" , 52 50 Liver . 53 50 Pancreas , 54 CHAPTEB VI. The Kidneys, . Bladder, Skix, and Peritoneum. 56 The Sweat Glands , , , 59 The Kidneys The Bladder The Skiu The Sweat Glands Peritoneum . CHAPTER VII. External Injuries. Contusions Vomiting Resulting from Bruises Sprains Wounds Incised Wounds .... 61 Punctural Wounds 64 62 Poisoned Wounds 64 63 Gunshot Wounds 64 63 Treatment of Wounds 04 64 SnakeJjites . 66 CHAPTER VIII. Burns, Scalds, and Frostbites. Burns TO Frostbites 72 CHAPTER IX. Hemorrhage. Venous Hemorrhage ... 73 Location of Important Arteries . Arterial Hemorrhage ... 73 CHAPTER X. Fractures and Dislocations. Fractures 77 Dislocations Splints 77 CHAPTER XL Apparent Death. Shock SO Asphyxia ...... CHAPTER XII. Concussion and Compression of the Brain. Concussion of the Brain 84 Compression of the Brain CHAPTER XIII. Poisons and Poisoning. General Character of Poisons . 86 Mineral Poisons 81 84 CHAPTER XIV Instructions to Patients Instructions to Patients. CHAPTER XV. The Investigation of Disease. The Causes of Disease The Character of Disease The Symptoms of Disease The Pulse . The Tongue . 93 Sensations in Sickness 93 Temperature of the Body 93 The Breathing , 95 Skin 96 The Appetite 97 l the Inner Lining of the Bowels Appendicitis inflammation of the "Pocket" Prolapsus of the Rectum Hemorrhoids, Piles . Pruritus Ani 167 Abscess of the Abdominal Walls 174 170 Invagination of the Bowels 174 170 Worms . 175 Seatworms 178 Itching of the Anus . 178 171 Constipation .... . 179 Diarrhoea . 184 174 Cholera Morbus, Summer Complaint 186 Diseases of the Rectum. 197 Eczema . 201 197 Abscess in or near the Anu- . 203 201 Fistula in Ano .... . 203 CHAPTER XXVI. Diseases of the Liver. Inflammation of the Liver . . 206 Jaundice .... 207 (HATTER XXVII. Diseases of the Urinary Organs. The Urine . Involuntary Urination 208 209 Painful Urination The Passing of Blood Urine 209 210 CHAPTER XXVIII. Diseases of the Skin Skin Diseases in General . Urticaria (Nettle Rash), Hives Boil Carbuncle Abscess Felon, Whitlow, Runround, Panari- tium Ingrowing Toe Nails . . . . Chilblains, Frostbite . . . . 211 Corns .... 212 Sore Feet 214 Warts .... 215 Bedsores 215 Poisoning by Ivy Eczema, Milk Crust, Salt Rheum 216 Ringworm . 218 Itching of the Skin . 219 220 220 221 222 223 224 226 226 CHAPTER XXIX. Eruptive Diseases. General Consideration of Eruptive Scarlet Rash Diseases 22S Chicken Pox Measles 228 Smallpox Scarlet Fever 231 Varioloid 234 234 235 237 CHAPTER XXX. Fevers. Fevers in General . . . .238 Catarrhal Fever 239 Typhoid Fever 241 Intermittent Fever, Chills and Fever, Malaria .... 244 Causes of Intermittent Fever . . 245 CHAPTER XXXI. Rheumatism and Gout. Rheumatism . Wry Neck . 250 251 Intercostal Rheumatism (Neuralgia) Sciatica 251 257 CHAPTER XXXII. Some General Diseases. 259 Lockjaw, Trismus Bursas, Housemaid ing Sinew Bunion .... Chorea, St. Virus's Dance Knee, Weep 261 5M». Diabetes Mellitus Diabetes Insipidus Cramp in the Limbs . Insomnia, Sleeplessness 262 263 264 CONTEXTS. Xlll CHAPTER XXXIII. Children and their Diseases. Management of Children The Pulse The Respiration . 277 277 Infant Feeding 278 Weaning 287 CHAPTER XXXIV. Features of Sickness, and General Rules for Nursing of Sick Children. General Remarks Temperature of the Body Care of Infants . General Hygienic Rules . The Nursery 290 Toilet Powders .... 291 General Nursing of Sick Children 291 Bathing 294 The Features in Sickness . 295 The Cries of Children 296 297 299 300 CHAPTER XXXV. Hygienic Care of Children, Diseases. Some General Dentition The Care of the Teeth, Nails, and Hair Sore Eyes Colic * Coryza and Snuffles .... Sore Mouth Sore Throat ...... Constipation .... Diarrhoea .<,... 300 Inflammation of the Foreskin . 315 The Navel 315 303 Hemorrhage from the Navel . 315 304 Chafing, Excoriation . 316 305 Crying 316 306 Hiccough 317 307 Crusts on the Head . 317 308 Spasms or Convulsions 318 309 Retention of Urine or Feces . 319 310 Observation and Suggestions . 320 THE STANDARD HOUSEHOLD PHYSICIAN CHAPTER I. ANATOMY. Anatomy in its literal sense means the dissection or separation of parts by cutting, but it is generally accepted as referring to the construction, form, and structure of bodies that are or have been living. We divide the subject into two classes, Animal Anatomy, which relates to the structure of animals; and Vege- table Anatomy or Phytology, which relates to the structure of plants. It is with reference to the general formation of our bodies that we have to do in the present article. Man belongs to the class of vertebrates, that is, he possesses a spine or vertebral column and a skull, in which are contained the brain and spinal marrow; in front of the spine are situated the respiratory, circu- latory, and alimentary organs. But man differs from all the others of his class, inasmuch as he is able to walk and stand erect. 18 ANATOMY The body may be considered as divided into two lateral halves, a right and left; and as every muscle in the body has its mate, this division is especially correct in speaking of the muscular system. We also divide the body into regions or sections. First comes the stem or stock of the body, and consists of the head, the neck, and the trunk. The trunk is again sub- divided into the chest or thorax and the belly or abdomen. The abdomen is again subdivided into the abdomen proper and the pelvis. In the head is situated the brain, and from it is prolonged the spinal marrow, extending down the spinal canal. In the neck we find the gullet, behind the windpipe in front, con- nected with the organs of speech. Within the chest or thorax lie the lungs, heart, and the continued pro- longation of the gullet ; the thorax or chest organs are partitioned off from the abdomen by a muscular structure called the diaphragm. The abdomen contains the stomach, intestines, liver, spleen, pancreas, kidneys, bladder, and generative organs. The body as a whole is made up of liquids and solids, varying in proportions according to the age. In infancy the liquids are in excess, and gradually the solids pre- ponderate, so that in adult fife the proportion is exactly reversed.. It is estimated that the liquids are thirty- rig. 1. ANATOMY. 19 three and one third per cent, solids sixty-seven and two thirds per cent in adults. It is when there is a continued disproportion of the two substances, as an excess of liquids, that constitutes the disease called rickets. The human skeleton consists of two hundred bones. They are distributed as follows : — The spine or vertebral column . . . . 26 The head or cranium . k 8 The face 14 The ribs 21 Upper extremities 61 Lower extremities 62 Breast bone and os hyoides 2 200 The structures of our bodies possess many peculi- arities in form and structure, and have a variety of functions or uses: the bones forming the osseous sys- tem ; the joints the articulator} 7 " system ; the muscles which make movement of the joints possible, the muscular system. The blood and lymph vessels form the vascular system ; the brain, the spine, and the nerves, the nervous system ; the throat and lungs, the respiratory system. The alimentary canal, or perhaps better understood if called a "tube," begins at the mouth and consists of the pharynx and gullet which convey the food into the stomach, then by its continuation through the intestines to the anus, thus forming a canal about thirty feet long; this, together with glands opening into the alimentary tract, con- stitutes the digestive system; the kidneys, bladder, and urethra, the urinary system. The uterus, ovaries, and 20 ANATOMY. clitoris in the female, the penis, spermatic cords, and testicles in the male, the generative or reproductive system. The tegumentary system consists of the skin, hair, nails, and teeth. The osseous system con- sists of the bones, which form a structure upon which the other systems rest. They are composed of two substances, one of which is an ivory - like material called compact tissue, and a fine fibrous structure which, from its resemblance to lattice- work, is called cancellous tissue. The relative pro- portions of these two kinds of tissue vary in different zones. If we carefully examine a bone or make a section, we find the compact tissue outside Fig 2 is perforated or porous, The human skeleton 1 The head. as fg the Cancellous, Only 2. The neck. 3. The chest. 4. The trunk. ' J 5. The abdomen. 6. The pelvis. the gpaces are much smaller in the former, thus containing a large amount of solid material; thus we call one the solid or earthy material, the other the animal. Bones are permeated by vessels and enclosed by a membrane called the periosteum, which is a firm, resist- ing membrane covering it on nearly every part except ANATOMY. 21 where cartilage is present. The periosteum is the nutrient membrane of bone, endowing its exterior with vitality. When the periosteum is injured or becomes de- tached, death of the bone ensues, which is termed necrosis, and is well exemplified in a felon. The interior of all the long bones presents a cylindrical cavity filled with a sub- stance called marrow, and lined by an internal periosteum or medullary mem- brane ; these two structures, the ex- ternal and internal periosteum, serve as a medium through which the blood- vessels reach the compact and cancel- lous tissues of which bones are com- posed. Bones are supplied with nerves and lymphatics or absorbents. The spine or vertebral column is composed of twenty- six bones called vertebrae, and supports the skull and its con- tents; each bone is so formed that when joined together a bony canal is Fi s- 3. formed through its entire length, thus furnishing a firm protection for the spinal cord. The base of the column rests on the sacrum or wedge bone between the "haunch bones" or hips. A vertebra consists of several important parts, a body, a solid The arch is formed of two prO- Fig. 4. A vertebra. 1. The body. 2. The spinal canal. 3. The spinous process. piece, and an arch. 22 ANATOMY. jections. The bodies of the vertebrae are arranged one above another, and separated by a pad or inter- vertebra] substance which furnishes a soft cushion for each vertebra to rest upon. Its structure prevents jarring, and through this elasticity aids in assum- ing the erect position. At night we are about half an inch shorter than in the morning, from the continued pressure on the inter- vertebral substance. Eest and the incumbent position of the night restore it to its previous condition. The irregular projections on the sides and back of the ver- tebra? furnish attachments for muscles and ligaments, ■which make the several pieces composing the column as one. The average length of the spine is twenty-eight inches. In its general outline two series of curves are seen, convex and concave. Looking from the front, a slight deviation to the right is also seen, due no doubt in the majority of cases to greater development of the muscles on the right side. These curves are called "compensating," as they are so related that the in- cumbent weight is properly balanced. It is estimated that these curves greatly increase the strength of the column. The bones of the vertebral column are thus divided, viz. : — Cervical or neck 7 Dorsal or back 12 Lumbar or loins 5 The sacrum, which (in foetal life) represents five vertebrae joined into a single bone .... 1 The coccyx, also four bones fused in one as the sacrum 1 26 ANATOMY. 23 The peculiar vertebras are the first and second. The first is called the atlas (so named from supporting the head). It has two canals or openings: one for the passage of the spinal cord or marrow; the other for the projecting process of the second vertebra or axis (so named from forming the pivot upon which the head rotates). The atlas, from its formation, allows of the rocking or nodding movements of the head, while the axis makes the rotatory movements possible. The skull or skeleton of the head is composed of twenty- two bones. The cranium or helmet is made up of eight bones; viz., occipital 1, parietal 2, frontal 1, temporal 2, sphe- noid 1, ethmoid 1. The face comprises fourteen bones; viz., nasal 2, superior maxillary 2, lachrymal 2, malar 2, palate 2, inferior turbinated 2, vomer 1, inferior maxillary 1. The differ- ent bones which together form the skull are united by sutures or " seams." These sutures act similarly as dovetailing, though in the earlier months of infancy the bones are not closely united, thus permitting at birth of some com- pression, and also allow for future growth in the size of the head; Fig. 5. A view of the outside of the cranium, showing the sutures, numbered 1, 2. 3. Fijr. 6. A view of the foetal head, showing the fontanels. 1. Back fontanel. 2. Line of separation of the parietal bones. 3. Front fontanel. 24 ANATOMY. they also prevent the dispersion of blows or jars re- ceived upon the skull. Before birth there are several spaces between the hones of the cranium called fontanels or ••soft spot-." in which hone substance is wanting; these intervals gradually close as development goes on, although the fontanel on the top of the cranium often remains open beyond tw< > years. The thorax or chest is an enclosure or cavity -which contains the lungs, heart, and large blood-vessels. It is formed by the ster- num or "breast bone" in front, the twelve ribs on each side, and by the dorsal vertebrae behind. The sternum is a flat, narrow bone, larger at the top and gradually tapers to the bottom. It is about six inches long, and from its shape has been likened to an ancient sword. It af- fords an attachment for the collar bones at the top and the ribs, with the exception of the last two, they being attached only to the vertebra^ behind. The ribs are pliable arches of bone, twenty-four in number, twelve on each side, which form the greater part of the chest walls. The first seven are connected to the spine behind and to the sternum in front. The remain- ing five are false ribs, three of which are connected by cartilages to the sternum, the last two being Fig. 7. A front view of the thorax. 1. Sternum. 2. First dorsal vertebra. 3. First rib. 4. Falain in the temples, delirium, follow with Hepar sulphur. As soon as the abscesses break, con- tinue the heat, and give Nux vomica, if there are sharp darting pains. Earache differs only from the above- mentioned disease in its origin. The pain is more in- termittent and seldom associated with chills or fever. The attacks may occur at stated times, with long remis- sions. Pulsatilla is the remedy oftenest given; the pain is worse at night, is tearing, boring, and humming in character ; absence of thirst, tearful, chilly. AFFECTIONS OF THE EARS. 121 Chamomilla. — Pains like a knife or single stab, patient very cross and impatient ; can't stand the pain. Mercurius viv. — Patient sweats much without re- lief ; tearing pains extending to the cheeks. Hepar sulphur. — Pain felt in the ear whenever he Wows the nose, with throbbing and roaring in the ears. Dulcamara. — Pains in ears after taking cold ; pains worse when patient is at rest, especially at night, and attended with nausea. If the remedies above mentioned avail nothing, or are not at hand, place the patient's head on one side, cover the neck and shoulders with towels, and pour from a pitcher, held two or three inches above the ear, water as hot as can be borne, slowly and continuously into the cavity of the ear affected. This will be found to be very efficacious in mitigating the pain. Discharges from the Ears. Punning of the ears is always a disease that needs intelligent treatment and that by a physician, for the inflammation, which is the cause of the discharge, is often disastrous to the integrity of the function of hear- ing, if not quickly checked. The cause of the trouble may be due to inflammation in the middle ear or from disease in the deeper structures ; when the latter, there exists an element of danger not to be trifled with, inas- much as the brain lies in such close proximity, only separated by a thin wall of bone tissues, that an abscess or inflammatory action may be set up in the brain tissue and lead to a fatal termination. Acute inflam- mation may arise from various causes, as mentioned under heading of "Pain in the Ear," or as a result of 122 AFFECTIONS OF THE EARS. measles, scarlet fever, or deep constitutional taints, as scrofula, tuberculosis, syphilis, or suppressed eruptions. The treatment of this disease should be constitutional, with absolute cleanliness of the canal as far as is pos- sible with a constant discharge. This can be done best by washing the ear externally, and then rolling pieces of absorbent cotton into the shape of cones and patiently removing all the accumulated discharge with the bits of cotton ; then leave a small piece of cotton in the ear. This should be done in preference to syringing often as a means of cleanliness. Avoid all washes or powders intended to " dry up" the discharge quickly; for if this is done too soon, serious symptoms of brain involvement may ensue, a complication that is not imminent as long as the discharge is free. The remedies most often used are Pulsatilla, Hepar sulphur, Mercurius viv., and Sulphur. Ringing and Buzzing in the Ear. This symptom is usually attendant upon inflamma- tory diseases of the ear, or may be due to nervous troubles produced by overwork or debility, or from spasmodic closure and opening of the Eustachian tube ; hardened ear wax may likewise produce crackling sounds. It is impossible to suggest medicinal treat- ment unless the cause be known, and a physician should be consulted. Hardness of Hearing. This affection arises from several causes, due in some cases to hardened ear wax or foreign body in the ear, catarrh, obstruction of the Eustachian tube, as the result of improper drugging, and as a consequence of AFFECTIONS OF THE EARS. 123 diseases of the brain and nervous system, likewise from chronic suppuration of the ear destroying the drum- head. It is obvious that treatment can avail but little when the deafness is due to destruction of tissue or serious disease of the brain. If the cause lies in catarrhal diseases of the nose and throat, then they should be treated, thereby relieving the deafness. Hardened ear wax is often a cause of deafness, and can be removed safely by syringing the ear with warm water as before mentioned ; never pick the ears to try and remove it. As a rule, all these troubles should be treated by a physician. CHAPTER XX. THE NOSE. Catarrh, Coryza, or Cold in the Read. The symptoms of a cold in the head are too well known to need a description. The affection may follow exposure or become epidemic. Aconite. — In the first stages with feverishness, hot head, backache. Cepa. — For sneezing, watery eyes with burning and itching, discharge from nose thin, causing the sides of the nostrils to become sore. Patient better out of doors and in the cold, but always worse again when returning to the warm room. Arsenicum. — Thin watery discharge from nose, the upper lip is red and inflamed from the nasal discharge. Eyes burn and are watery. The nose feels stopped up, yet discharge is profuse. Nux vomica. — Similar symptoms to Arsenicum or when the catarrh is fluent by day and dry at night ; pain between the eyes with sensation of fulness. Euphrasia is also serviceable in catarrhs accompanied by a thin discharge from the nose and scalding tears from the eyes ; throat feels rough and irritated. Mercurius vivus. — Catarrhal colds, chilliness, dread of air, perspiration, septum of the nose sore. Silicea. — For catarrh which lasts a long time, or returns again and again. THE NOSE. 125 Catching cold is the result of various conditions of the system. We see those who seldom have colds, while others are susceptible to the slightest changes. If people were perfectly well, or could so live that the digestion would be normal at all times, and would keep the surface of the body neither too warm nor too cold, then would taking cold be rare ; but so long as persons eat improperly, are irregular in their habits of sleeping, wear very heavy underclothes, and do not take proper care of the skin, will they be liable to frequent colds. ' ' Nobody takes cold who has no impurities in his sys- tem." Children will not throw off a cold as long as they indulge in too much sugar, syrups, and other sweets. Certain articles of food, as green goose, will produce cold in the head in some people. Nosebleed. Nosebleed is most frequently caused by mechanical injuries, congestion accompanying a cold in the head, predisposition, as in those who seem to be easy bleeders ; suppressed hemorrhages, as the menses, or radical cure of bleeding piles, or from disease of the blood which leads to hemorrhage. The bleeding is seldom from both nostrils. Sometimes nosebleed becomes alarming and requires the assistance of a surgeon to control it ; usu- ally, however, simple means are sufficient. Treatment. — If the hemorrhage is at all severe, com- press the nose with the fingers at the angle of the nose. Never insert plugs into the nostrils from the front, as they are worse than useless. Cold applications to the spine will generally help to stop the flow ; a bunch of keys answers very well if the person is dressed at the time of the nosebleed. 126 THE NOSE. Aconite. — For nosebleed occurring during affections of chest. Carbo veg. — Nosebleed profuse, occurring in con- valescence from fever. Mercurius viv. — For nosebleed when the blood co- agulates and forms clots that hang from the nostrils like icicles. Nux vom. — Nosebleed after suppression of bleed- ing piles. Pulsatilla. — Nosebleed instead of menses, or nose- bleed that occurs during catarrh. CHAPTEE XXI. AFFECTIONS OF THE MOUTH. The lips are often the seat of inflammation, result- ing from other diseases or from exposure to the sun ; fever blisters occur during the course of intermittent fever and pneumonia, and as an accompaniment of acute cold in the head. China, if taken as soon as the presence of a "cold sore " is felt, will often dispel it. The mouth, including the gums, teeth, tongue, ton- sils, and upper portion of the throat and their diseases, will be considered under this heading. When a person is obliged to keep the mouth open to breathe, at once suspect some obstruction to breathing, and examine the nose and throat for the cause. In exhausting diseases the lower jaw hangs down, and indicates a critical con- dition. Gumboil. It usually takes its origin in a diseased tooth, but may arise from some cause unknown. If it arises from a dis- eased tooth, the swelling spreads to the cheek of the same side, and usually results in an abscess, or, as it is gen- erally termed, an ulcerated tooth. Mercurius viv. will oftenest give relief of all remedies. If a discharge of pus occurs and repeatedly refills' and discharges, try Silicea. Fistulae of the Teeth. Small spots of pus often appear on the gums, which if pricked discharge a few drops of pus, and for a short time disappear. These small spots are the exter- 128 AFFECTIONS OF THE MOUTH. nal openings of little channels which connect with the roots of the teeth, where there exists some unhealthy condition. Causticum, Calc. carb., Sepia, Silicea, or Sulphur will he found curative, unless the disease is of a surgical nature, when it should he treated hy a surgeon. Toothache. The causes of this painful affection are many, and numerous instances have been known of teeth being ex- tracted without relieving the pain. The use of opium or laudanum is to be deprecated, as the pain will return with increased severity, even if relieved at first by opium. For toothache caused by eating warm things: Bry., Cham., Puis. " " " drinking warm things ; Bry., Puis., Merc. viv. " " worse from cold air : Bell., Hyosc., Xux vom., Silic, Staph., Sulph. " " " breathing : Puis. " " " " drawing air into the mouth : Ant. crud., Phos. " " " " eating cold things: Bry.. Cham., Xux vom.. Puis., Staph., Sulph. " " " in the morning: Hyosc, Xux vom., Rhus., Staph. " " " in the evening: Puis. " " "in the night: Bell., Carbo. veg., Cham., Puis., Rhus, Staph. " " " every other day : China, Nat. mur. " " u at night, not during the day /Phos. " " " external warmth : Cham., Puis., Sulph. AFFECTIONS OF THE MOUTH. 129 Menstruation, before : Arsen. 16 during : Cham. " after : Calc. carb. Pregnancy, during : Hyosc. , Puis. , Staph. Nursing, ivhile : Staph. , Phos. , China. Getting better from : — Cold air : Nux vom., Puis. Lying clown : Merc. viv. , Bry. , Nux vom. When lying clown in bed : Merc, Puis. Warmth, from : Rhus, Staph. Drawing air into the mouth : Puis. Cold hand : Rhus. Cold water held in the mouth : Bry. , Coffea, Cepa. Smoking tobacco : Merc. viv. When chewing : Bry., China, Coffea. Lying down on the painful side : Bry. , Ign. phos. Lying down on the painless side : Nux vomica. In selecting a remedy for toothache, carefully find out the conditions which tend to make the pain worse, and those which relieve ; also the time when the pain is better or worse. Note the influence of heat or cold, and whether lying clown or walking, or position in gen- eral, has any influence ; then compare the symptoms in the list, and the remedy having the greatest number of the symptoms will be the one indicated. There may appear a paradox when the same remedy is recommended for opposite symptoms, but this is really often the case. Inflammation of the Tongue. The symptoms are heat and rapid swelling of the tongue, which may continue increasing for two or three 130 AFFECTIONS OF THE MOUTH. days, and render the life of the patient in danger of death from suffocation. There are varying degrees of the disease, fortunately. The swelling may go down rapidly or an abscess may form. The causes are said to be due to stings of a wasp, bee, or hornet ; it may be epidemic or produced by overdoses of mercury, or from biting the tongue, or wounding of the tongue from any cause. Treatment. — Anthracinum. — Severe forms of the disease with gi T eat burning and disposition to gangrene. Arsenicum. — Swelling about root of tongue, exter- nally and internally, gangrene of the tongue ■ spots on tongue burn like fire. Apis. — Tongue looks red at the tip, dry and glossy. Inability to talk or put the tongue out. Arnica. — For inflammation of the tongue following wounds. Aconite should first be given, then Arnica. Lachesis. — Dangerous cases with gangrene ; tongue looks dark and green. Phos. etc. — In inflammation produced by biting the tongue during sleep. Canker in the Mouth. (See chapter on ' ' Sore Mouth " in diseases of chil- dren.) Ranula. It is a disease of the floor of the mouth under the tongue, showing itself by a swelling of varying size and resembling a blister or bag. This disease must not be confounded with cysts or abscesses, which sometimes form in this cavity. Treatment. — Belladonna, Calc. carb., Merc, Nit. ac, Thuya. AFFECTIONS OF THE MOUTH. 131 The Tonsils. They are two round or oval bodies situated on either side of the throat. When of normal size, they do not protrude but little. In appearance they are slightly roughened or pitted. The diseases which affect the ton- sils are quinsy, tonsillitis, chronic enlargement, and diphtheria. QUINSY is an acute inflammation of the tonsils resulting in the formation of an abscess ; the disease usually is confined to one tonsil. There is at first the general sensation of sore throat, which soon becomes more severe, with a feel- ing of constriction and inability to move the jaws ; the voice is thick and talking is painful. Upon examination one tonsil is seen to be enlarged, of bluish red color ; the throat. is full of mucus. As soon as pus has formed, there are chills, headache, and prostration. One attack is liable to render the person more liable to a return. The duration of the disease is from one to three weeks. Treatment. — Aconite to be given first, followed by Hepar sul. , until abscess has broken, then give Silicea. If this treatment is begun as soon as the first symptoms of the trouble are perceived, the course of the disease will be shortened. TONSILLITIS begins with soreness of the throat, and, in some cases, preceding the sensations of pain in the throat, there is the- general feeling of having taken cold, headache, backache, and fever, or the disease may be ushered in with a chill and sudden prostration of strength, which does not seem commensurate with the disease. Upon 132 AFFECTIONS OF THE MOUTH. examination of the throat, one tonsil or both will be found to be studded with round, white spots quite clearly defined at first, these gradually increase in num- ber and run together, giving the appearance of a mem- brane, and leading to a mistake that the case is one of diphtheria ; usually at the height of the disease, which is of rapid development and the tonsils are quite covered, the patient experiences less soreness on swallowing. The ' ' spots " may appear on only one tonsil, and then appear later on the other. The fever is usually high and pulse very quick. Eecovery is almost always cer- tain. The disease is often epidemic, but not considered contagious. The causes are usually from taking cold, or due to improper diet, debility, loss of sleep, or from epidemic causes. As it has been stated, fatal cases are exceedingly rare, though the tendency to frequent recurrence is apt to follow, or chronic enlargement of the tonsils remain. Treatment. — Rest in bed and light diet are of signal advantage. Aconite, earliest symptoms and for the fever, face red, skin hot and dry, great restlessness. Belladonna, tonsillitis, especially right side ; parts bright red, skin moist, throbbing headache ; children may awaken from sleep slightly bewildered ; pain when swal- lowing extends to the ear. Lachesis, tonsillitis, espe- cially left side, or may go from left to right tonsil ; great sensitiveness of the throat externally to the lightest touch. Patient always worse after sleeping. Lycopo- dium, tonsillitis, especially of the right side, disordered stomach, feeling of fulness after eating very little, rumbling in the bowels. Merc, viv., throat dark red, in- crease of saliva, thickly coated tongue, offensive breath. AFFECTIONS OF THE MOUTH. 133 ENLARGED TONSILS. This condition may result from repeated attacks of acute inflammation, or indicate a scrofulous constitution, or as a result of obstructed breathing through the nose, requiring the patient to keep the mouth open constantly to obtain air, which is then carried into the throat and lungs much colder than is intended naturally, as it should become warmed by its passage through the nose. When, hoAvever, the nose is obstructed and ' ' mouth breathing" becomes necessary, it causes catarrh and leads to inflammation of the tonsils and the entire mucous membrane of the throat. Many cases of deaf- ness are caused by enlarged tonsils. Treatment. — The nose should be examined first, that any disease there may be cured if it exists ; usually the general health is affected and some constitutional remedies are required. Baryta carb., Calc. carb., Calc. phos., Psorinum; and Sulphur are the remedies gener- ally required, and should be given in minute doses, and seldom repeated. Catarrhal Sore Throat, as the name implies, is a catarrh of the throat, and is the result of atmospheric influences or constitutional predisposition ; it is an accompaniment of other acute diseases, such as scarlet fever, small-pox, or measles. It may at times prevail epidemically. The symptoms are redness and swelling of the mucous membrane of the back of the throat, tonsils, and sides of the palate arches extending to the false palate, or uvula ; swallow- ing is painful, the tongue is coated, and the mouth tastes badly. There is much mucus in the throat, or sensation of extreme dryness. 134 AFFECTIONS OF THE MOUTH. Treatment. — Cool compresses, with dry coverings externally, are very soothing. Aconite. — Early stages, fever, restlessness ; sore throat caused by cold west or northwest winds. Apis. — Burning, stinging pains, or heavy aching pain ; false palate looks as if filled with water ; thirst - lessness. Belladonna. — Scarlet redness of the throat, stitches extending into the ear ; great thirst, constant desire to swallow, fever, throbbing headache. Lachesis. — Throat feels as if constricted ; lump in the throat, sense of suffocation, neck sore to pressure externally, left side worse. Sleeping aggravates the symptoms. Mercurius viv. — Sore throat with dark redness, tongue thickly coated, whitish, shows imprint of the teeth ; increased secretion of saliva ; chilliness and dread of air, worse at night ; sweating gives no relief. Nux vomica. — Catarrh in the head and throat, with a feeling of scraping and soreness. Sanguinaria. — Throat feels sore and as if scalded by hot drinks ; dryness of the throat which water does not relieve ; sensation as if the membrane of the throat would crack. Chronic Sore Throat. Following a neglected case of catarrh or from long- continued speaking when the throat is not in a normal state, there may ensue a chronic soreness. Clergymen and public speakers are especially prone to this disease. The most annoying symptom is the sensation of dryness or desire to clear the throat, and induces the habit, which is in itself a bad one, of constantly hemming or AFFECTIONS OF THE MOUTH. 135 trying to clear the throat. Upon inspection, the throat looks red, and on the back of the throat are to be seen little round red spots raised above the surface ; these may extend all over the throat, or show themselves only in isolated patches. Bands of swelling also are apparent, and shreds of white mucus extending from above down- wards on the mucous membrane. Swallowing is rarely painful ; sometimes the efforts to clear the throat are so violent as to cause slight hemorrhages, which create great alarm on the part of the patient. The disease is not alone confined to public speakers, for in point of fact, the hoarseness and dryness, or giving out of the voice during prolonged use, is usually due to straining of the vocal cords or muscles of the palate. Treatment. — The patient should control, as far as possible, the excessive attempts to clear the throat, for he thereby adds to the inflammation. Alumina. — Soreness, rawness, hoarseness, or secre- tion of tough phlegm ; worse in the afternoon and evening ; better from eating and drinking warm things. Arum tripli. — Constant hawking, dropping of mucus into the throat ; hoarseness, worse from talking. Arg. nit. — Collection of tough, thick mucus caus- ing gagging ; feeling as of a splinter in the throat when swallowing. Singing causes hoarseness and increases the secretion of mucus. Causticnm. — Hoarseness from singing and talking ; burning in the throat, worse on stooping ; must swal- low continually. Sips of cold water relieve the cough temporarily. Elaps. — Sore throat ; offensive discharge from the nose, occasional nosebleed ; back of the throat is studded 136 AFFECTIONS OF THE MOUTH. with round, red, raised spots, or it is wrinkled and cracked. Smell gone. Kali hi. — Mucus in throat ropy or stringy ; difficult to expectorate, and can be drawn out in long strings. Lachesis. — Inclination to swallow, though it causes pain ; worse on the left side of the throat ; the throat is sensitive externally to pressure ; hoarseness. Phosphorus. — Throat dry and glistening; hard, dry cough, worse from talking. Phytolacca. — Throat burns like fire; can't eat hot things, choking sensation. Ulcers in the Mouth. The inside of the cheeks, the tongue, and the throat even are subject to catarrhal inflammation. The spots, or canker, as it is generally called, are irregular-shaped ulcerations of a yellowish color. There is usually in- creased flow of saliva, pain, and almost total inability to swallow. This affection is usually brought about by some enfeebled state of the system, poor or improper food, or unsanitary surroundings. The tongue is usually heavily coated, and the breath offensive. The glands about the jaws are usually affected. Baptised. — Ulceration, salivation, low state of the system ; after abuse of mercury. Calc. curb. — Sore mouth during teething. Lachesis. — Canker sores on the tip of the tongue. Mercurius viv. — Ulcerated gums, tongue, and cheeks ; teeth loose ; this remedy is almost a specific, but care should be taken that it is not the cause of the sore mouth, in which case another remedy would be required. Nit. ac. — After abuse of mercury. AFFECTIONS OF THE MOUTH. 137 Diphtheria. This disease is of so serious a nature it never should be treated by laymen. In fact, the most skilful physi- cians undertake such cases with feelings of reluctance, knowing, as they do, how fatal a malady it is, and so insidious in its nature. Perhaps no other disease has been so often incorrectly diagnosed ; severe cases of ton- sillitis have been pronounced diphtheria, and reported as cured. We often hear physicians pronounce a case to be only a diphtheritic sore throat, but not diphtheria, w'hich is incorrect ; diphtheria is always diphtheria, and the same precautions should be taken in slight cases as in the more malignant forms, for a mild case may prop- agate a very severe one in another person. Therefore, a positive stand should always be taken in a case of sore throat. Diphtheria is often confounded with tonsillitis, but careful examination will usually make apparent the real nature of the disease. Diphtheria produces greater prostration, the fever is not so severe as in tonsillitis ; then the appearance of round, white spots on the ton- sils in tonsillitis differs from the irregular appearance of the membrane which appears on the tonsils, arches of the palate, or back part of the throat. Then again, the glands of the neck are usually swollen in diphtheria. Pharyngitis may be confounded with diphtheria from the appearance of white shreds of mucus in the throat, but it is easily dislodged, or swallowing will change its location. Membrauous croup and diphtheria are by some con- sidered identical. Be this as it may, suffice it to say they are both very serious diseases. Whenever there is a case of diphtheria in a family, the patient should be 138 AFFECTIONS OF THE MOUTH. isolated and no one allowed in the room but the attendr ants and physician ; if there are other children, they should be sent away and not allowed to return until the case is ended and fumigation has been properly attended to. The ceilings should be whitened and walls washed and freshly papered. The floors washed thor- oughly, and if a carpet was on the floor, it should be cleansed and not relaid for some time ; bed and bed linen if not destroyed should be subjected to naphtha cleansing. All handkerchiefs or cloths used about the patient should be burned as soon as soiled. Should the disease prove fatal, no public funeral is allowed by law. Members of the family residing in the house during the patient's sickness should not mingle with persons out- side of the house. The causes of this dreaded disease are many, and in some cases wellnigh unfathomable, for cases appear in all locations, both high and low, among rich and poor. Defective drainage of course is a powerful cause. The disease also appears sporadically and in epidemics. Some cases apparently arise from disorders of the digestion. Xo mention will be made of medicines for this disease, as it should be treated only by a competent physician. CHAPTER XXII. AFFECTIONS OF THE .CHEST. Hoarseness. This affection is due to inflammation of the larynx, either acute or chronic, or may be due to disease of the nervous system. The loss of voice in the last-named affection is usually sudden, and may occur without pre- vious warning ; there is usually absence of cough or expectoration, and of all trouble in breathing. Catarrhal hoarseness has the usual attendant symptoms of a cold with altered voice. Causticum. — In obstinate cases, and when the pa- tient has no other symptom ; small sips of water relieve the throat for the time. Chamomilla. — Hoarseness, especially in children with catarrh ; tickling cough ; child cross and fretful ; wants to be carried. Hepar sulphur. — Catarrhal hoarseness; voice is uncertain, sounds as if the throat was full of mucus ; much sweating without relief ; cough sounds coarse and croaking. Mercurius viv. — Catarrhal hoarseness ; patient very sensitive to any change in temperature ; sweating with- out relief ; worse at night. Phosphorus. — Hoarseness with dry cough, worse from talking ; pain in the throat ; suitable for tall, slender people more especially. 140 AFFECTIONS OF THE CHEST. Sambucus. — Hoarseness, with deep, hollow, dry cough, which occasions catching of the breath. Carbo veg. — Chronic hoarseness, worse mornings and evenings, and after talking ; indicated in hoarseness following measles. Spongia. — Hoarseness, with croupy cough. Cough. Every cough has a language of its own, and to properly prescribe, a number of symptoms should be obtained. It may arise from a variety of causes, com- bined as it may be with a cold in the head, or it may arise from acute or chronic disease of the lungs. If the cough is attended with pains in the chest when breath- ing, expectoration, chill, and fever, one should think of pneumonia or bronchitis. Many coughs, however, are due to cold or irritation of the throat. Belladonna. — For a dry, tickling, incessant cough, without expectoration ; constant tickling in the throat, and sensation of dryness. . Bryonia. — Dry cough with vomiting ; cough worse after eating ; great thirst ; cough worse going from out- door air into a warm room. Causticum. — Dry cough with involuntary urination with each coughing spell ; sips of cold water momen- tarily relieve the tickling. Drosera. — Loose or dry cough, causing retching or vomiting. Hyosciamus. — Dry, incessant, tickling cough, espe- cially at night ; better sitting up, and for cough caused by elongated uvula. Nervous coughs. Hepar sulphur. — Croupy coughs, excited by cold AFFECTIONS OF THE CHEST. 141 w^est winds ; cough excited when any part of the body gets cool, particularly at night. Must sit up to cough. Ipecacuanha. — Cough dry and hard, which sounds as if the lungs were full of mucus. Especially for children, the cough affects them so much, that they can scarcely breathe, and they become purple in the face, and the limbs get stiff. Sweat of the forehead ; walking in the cold air excites the cough afresh. Kali carb. — Hard, dry cough; pains in the chest sharp and shooting. Cough worse in the afternoons and three a. m. Must sit up and lean forward to cough. Mercurius viv. — Cough dry, with tearing sensation in the chest ; worse at night after lying down ; much sweating. Expectoration streaked with blood. Opium. — Dry cough when swallowing or breathing ; worse after lying down. Pulsatilla. — For cough which increases in the open air and becomes very violent in a warm room. Cough- ing is so hard and violent, that it causes the urine to escape. Thirstlessness. Easy expectoration part of the day, then none at all, and cough causes retching. Rumex crisp. — Incessant, dry cough, excited by the slightest cold air ; patient must cover the head com- pletely, the cold air is so noticeable. Sanguinaria. — Tickling, dry cough; irritation to cough felt in the hollow of the neck. Coughing spell ends by passing flatus, either upwards or downwards. Sulphur. — For chronic, dry cough coming on in the afternoon and continuing till towards midnight, or when well-selected remedies fail to complete a cure, give a dose of Sulphur and then repeat the indicated remedy if necessary. Coughing produces a bursting 142 AFFECTIONS OF THE CHEST. pain in the head ; blackness before the eyes, heat in the head and face, but cold hands. Tartar emetic. — Cough sounds loose, but yields no expectoration ; for coughs of children and old people especially ; the chest seems full and cough produces rattling, yet no expectoration. Much sweat on the head and chest. In recent coughs, with cold in the head, it is advis- able to keep warm and in an equal temperature for a few days. Persons subject to repeated attacks of cough and catarrhal cold should be particularly careful not to wear too heavy underclothing, thereby creating perspiration and greater liability to take cold. They should take a cool sponge bath every morning, rubbing briskly after- wards with a coarse towel. Such persons should wear cotton next the skin, but not all-wool garments,, which are only suitable for laborers and sailors, who are liable to be drenched to the skin. Whooping-Cough. This affection is epidemic, and characterized by three stages. The first is the stage of fever, and resembles an ordinary attack of catarrh, lasting for a few days only, or may continue a week or two. It is therefore difficult to diagnose the affection at this stage. The second stage introduces the characteristic convulsive cough, strangling, retching, and whooping. This stage of the disease is liable to be complicated with pneumonia or bronchitis. The duration of the second stage is uncer- tain, varying from three or four weeks to as many months. The third stage is called the stage of decline, and is made known by the paroxysms growing shorter AFFECTIONS OF THE CHEST. 143 and lighter, the whoop gradually disappears, and the cough does not differ from that of an ordinary catarrh. If any cold be taken at this stage or immediately after the cessation of the cough, there may be a return of the paroxysmal cough for a short time. The disease is most contagious during the second stage. Whooping-cough is almost entirely a disease of childhood. For the first stage, Aconite and Belladonna. For the second stage, Carbo veg., Drosera, Ipecac, and Yeratrum. A change of climate is sometimes advantageous, especially if a sea voyage be included, or a stay of a few weeks at the sea- shore. Mental emotions should be avoided as much as possible, inasmuch as they tend to provoke the cough. Particularly so is it the case with fits of anger. The use of medicaments in the form of candles or lamps are not advised, they often do more harm than good. False Croup. This affection, so dreaded by parents, is seldom fatal, though the symptoms are apparently alarming. An attack is usually sudden in its outbreak ; in the majority of cases the patient awakens about midnight with the croup ; the cough is metallic sounding or crowing, of deep tone with hoarseness, and great difficulty in breathing ; they often clutch the throat and evince great distress. At this stage, the administration of Aconite every fifteen minutes for one hour is serviceable. Apply, also, a cool, wet compress to the throat. After administering the Aconite for an hour, give Hepar sulph. for the same length of time and at similar inter- vals. Should these two remedies fail to bring relief at the end of the second hour, give Spongea in the same 144 AFFECTIONS OF THE CHEST. way for one hour ; then alternate the Hepar sulph. and Spongea every hour until relieved. This treatment will suffice in most cases, though other remedies may be needed, but should be prescribed by a competent homoeo- pathic physician. The patient during the attack should be kept warm, and see that the feet especially are not allowed to become cold. For a day or two after, if the attack has passed off, keep the child quiet and warm, free from draughts and off the floor. The diet should be simple, and no fruit allowed. Sometimes the attack will pass off during the day and return again the following night, but in such cases there usually will be observed a slight hoarseness continuing through the day. If such is the case, continue giving Hepar sulph. every three hours throughout the day. The treat- ment here recommended is intended to apply to cases of croup uncomplicated with other diseases, as membranous croup and diphtheria. False croup, as above described, presents several points of difference from membranous croup, inasmuch as the symptoms do not show themselves all at once in the latter disease. Usually in membranous croup the child begins with a slight fever, catarrh and some hoarseness ; these symptoms may continue a few days, when the symptoms peculiar to croup manifest themselves. So, too, is it in diphtheria ; the first symptoms are attendant for a few days, then occur the croupy symptoms, if the disease has extended farther down. Inflammation of the Lungs (Pneumonia). Pneumonia is an acute inflammation of the lung substance, and its symptoms are quite characteristic. AFFECTIONS OF THE CHEST. 1^5 The affection is ushered in by a long, hard chill followed by a hot, dry skin and flushed face The breathing is rapid and attended with sharp pains in the chest at- tended with cough. The disease progresses with well- marked symptoms, unless perchance the disease is arrested in this stage ; if not, the expectoration which soon appears is characteristic ; at first consisting of a glairy mucus, it soon becomes tougher, and from the admixture of blood with the mucus, resembles iron-rust stains in color, or as dark as prune juice, although some cases of pneumonia run their course without it. The breathing becomes still more rapid as the disease continues, and the pulse increases in frequency. There is usually headache, occasionally delirium ; the cheeks are usually flushed. The duration of the disease varies from one week to four. The course of the disease may be complicated by the supervention of typhoid symp- toms, inflammation of the heart sac, or result in tuber- culosis. When convalescence is approaching, the fever abates, the skin becomes moist, the expectoration becomes freer and white, and breathing is easier and less frequent. The treatment of so dangerous a disease ought to be intrusted to a skilful physician only. In the inception benefit will follow the administration of Aconite for a short time. Phosphorus, Bryonia, Tar- tar emetic, and Sulphur are most often indicated. Cool wet compresses at first afford great relief, and are bene- ficial. The diet throughout should be nourishing and easily digested, and administered in small quantities, often repeated. Cold water and chopped ice are agree- able and should never be withheld. 146 AFFECTIONS OF THE CHEST. Pleurisy. Pleurisy is an inflammation of the membrane enclos- ing the lungs. In the beginning there is usually a number of short chills, then a hot stage, and again a chill, though it is not always noticed. The most char- acteristic symptom, however, in the early stage of the disease, is the sharp, acute pain, the ' ' stitch in the side." The fever continues and a dry cough without expectoration. The patient favors the painful side in every way, dreading to breathe, cough, or move, know- ing that it produces great pain. The breathing is short and quick. Pleurisy may be the result of exposure, sup- pressed perspiration, catching cold, or it may be attendant upon other diseases, such as affections of the lungs, measles, scarlatina, and typhoid fever. In the first stage of pleurisy, the pain may be confounded with neuralgia of the chest, called intercostal neuralgia, but in this affec- tion there is absence of fever, and the pain shifts, like- wise there is great tenderness of the chest walls. Pleu- risy may be of short duration, or become chronic in its nature. The fluid which is secreted by the inflamed pleura in simple acute cases is like water, but if the disease is improperly treated, and the fluid is not ab- sorbed, it is liable to take on the nature of pus. Such cases are often overlooked, and yet the patient is short- breathed, every exertion is an effort ; the reason is, the fluid occupies the space that the lung should, and hence the lung is compressed and therefore almost useless. Pleurisy usually leaves behind it adhesions which cause much hindrance to full inspiration. The treatment, like that in pneumonia, should be applied by a physician. Many cases, apparently slight, become dangerous to life AFFECTIONS OF THE CHEST. 14:7 through neglect. The pleuritic or stitch-like pains in the sides will often be relieved by cool, wet compresses, and internally Bryonia, Kali carb., Merc, Squilla. Bryonia. — Stitching pains in the chest ; worse from the slightest motion ; better when lying on the affected side ; great thirst ; better lying on the painful side. Kali carb. — Stitching pains in the chest, especially on the left side ; the cough is worse towards three o'clock A. M. ; violent palpitation of the heart ; better lying on the unpainful side. Mercarius viv. — Pains in the chest ; worse in the right side ; chilliness ; then heat, with copious sweats. Squilla. — Stitching pains in left side ; short cough, inability to lie on the left side ; profuse perspiration. False Pleurisy (Pleurodynia) . False pleurisy resembles true pleurisy very much, yet the origin, location, and termination are entirely unlike it. This disease is of a rheumatic or neuralgic nature, and occurs in persons subject to these affections, or follows from taking cold. With the pains in the chest there will usually be associated pains in the neck and shoulders. The pain in false pleurisy is felt during exhalation, while in true pleurisy the pain is during inspiration. Hard pressure aggravates the pain in false pleurisy, while slight pressure is felt keenly in true pleurisy. Treatment. — Apply a cool, wet compress and ad- minister internally a carefully selected remedy. Aconite. — If the attack follows from catching cold ; the patient is restless, skin hot and dry, face red, mov- ing in bed causes a chill. 148 AFFECTIONS OF THE CHEST. Bryonia. — Sharp, stitching pains ; great thirst ; patient irritable and cross ; better lying perfectly quiet ; every motion is painful. Ranunculus. — Pains in the sides of the chest sharp and cutting ; the painful spot is not larger than a sil- ver quarter of a dollar, but extends through the chest. Pulsatilla. — Pain severe, but feels better by chang- ing his position ; feels worse toward evening and at night. Sulphur. — This remedy may be indicated in cases of subacute nature and when other remedies fail to en- tirely remove the symptoms. Bronchitis. Bronchitis may be acute or chronic, and is always attended with a cough. Acute bronchitis may follow a neglected cold, or as a result of other diseases occurring in the course of fevers, of rheumatism, and of heart disorders. The lungs are traversed by tubes called bron- chial tubes ; some are large and some are very minute. Bronchitis varies a good deal according to the size of the tubes involved. When the smaller tubes are affected, the disease is termed capillary bronchitis, or suffocative catarrh, and is considered a grave disease. The aged and young children are most liable to have the form of disease known as capillary bronchitis. Bronchitis of the large tubes is very common, and may be acute or last for a number of years. The symptoms of bronchitis are, a tickling sensation in the throat, pain under the breast bone, slight obstruction in breathing, some fever, aching of the limbs ; the cough at first is dry and har- assing, or a slight expectoration of clear mucus ; as the attack wears on, the expectoration becomes thicker AFFECTIONS OF THE CHEST. 149 and greenish or yellowish in color ; occasionally, streaks of blood will be observed mixed with the sputa. The fever and general languor soon pass away, but the cough and expectoration may continue. Capillary bronchitis may succeed an attack of bronchitis of the large tubes, or may from the first be located in the small tubes. Whenever capillary bronchitis exists, the disease may be recognized by the dusky hue of the face, and its lividity ; the lips are blue or purple, and countenance pinched ; the finger-nails look dark ; the breathing is rapid, the skin is usually clammy, though the fever may run quite high. The expectoration is thin and ropy, or foamy in appearance. As the disease continues the patient be- comes more depressed ; the cough continuing, but the expectoration fails with the strength. In old people, delirium and stupor, in young children convulsions, characterize the approach of death. From this de- scription of capillary bronchitis, the distinctions will be easily seen between this form of bronchitis and that affecting the larger tubes. Tartar emetic. — Bronchitis when the cough sounds loose and the rattling in the chest would seem to in- dicate that the chest was full of mucus, yet there is little or no expectoration. Patient is drowsy, inclined to slumber much, with the eyes half open. Children want to be carried about constantly. Face bluish or pale, and puffy. Belladonna. — Severe throbbing headache, worse from coughing ; oppression of the chest ; feeling as if bound, with rattling in the chest. Cough dry and spasmodic, worse at night ; patient starts in his sleep ; child cries when he is coughing. 150 AFFECTIONS OF THE CHEST. Bryonia. — Dry cough with pains in the head and chest ; stitches in the chest ; thirsty for large quantities of water ; lips dry and cracked ; cough worse going from the cold air into a warm room. Phosphorus. — Cough hard and dry ; chest feels op- pressed ; talking makes the cough worse ; every breath of cold air aggravates the cough ; suitable for tall, slender persons. Mercurius viv. — Bronchitis with catarrh of throat and nose ; chilliness, dread of a draught, profuse per- spiration, cough sounds as if it would tear the inside of the chest ; cough is always worse at night. Pulsatilla. — Cough loose, with yellow or greenish expectoration ; cough loose by day ; dry after every sleep ; remaining after measles ; stitching pain in the side of the chest, particularly at night, when lying ; better from lying on the painful side ; obstinate bron- chial catarrh. Ipecacuanha. — Dry, teasing cough, with much rat- tling in the chest ; coughing almost suffocates the patient ; perspiration on the head after each fit of coughing. Hepar sulphur. — Loose cough; rattling, anxious breathing ; must sit up with the head bent back ; cough worse in the morning ; sweat without relief ; cough excited if any portion of the body gets cold ; after cough, sneezing and crying ; better from wrap- ping up and keeping warm. Sulphur. — Much rattling of mucus in the chest; expectoration greenish, lumpy, of sweetish taste ; cough excited by tickling in the throat, as if caused by dust ; burning of the soles of the feet. AFFECTIONS OF THE CHEST. 151 Sanguinaria. — Cough dry, caused by tickling in the throat pit ; tickling in the stomach ; dry cough, awakening the patient and not ceasing until he sits up in bed and passes flatus, upward and downward. Asthma. This disease, so ancient, and so well known by its marked characteristics, is nevertheless puzzling to the physician, as so many conditions of the system may promote asthmatic attacks. It has been said that asthmatic subjects are chronic dyspeptics, and this is really true in some cases, while the exciting causes in others may be due to suppressed eruptions, menstrual derangement, mental emotions, heredity, atmospheric changes, occupations which subject the patient to fumes of chemicals or inhalation of dust, as frequently occurs with stone-cutters and millers. The symptoms are well known. The patient experiences little difficulty in inhaling, but great distress when trying to exhale ; . the sense of suffocation is hard to bear ; faintness is often an accompaniment. Eelief may sometimes be found in change of abode, even if not a great distance. Ipecacuanha. — Will be indicated when there is a sense of constriction about the chest ; the patient fears suffocation and gasps for breath ; face pale, worse from least motion. Arsenicum. — Asthma following suppressed catarrh, when worse about midnight ; worse lying down ; must incline the chest forward ; loss of breath immediately on lying down in the evening, or walking quickly, ascending, and from changes of warmth and cold. Lachesis. — Asthma worse from covering the mouth 152 AFFECTIONS OF THE CHEST. or nose, or touching the throat, or moving the arms ; worse, just after sleeping ; better sitting up, bent for- ward. (Nux vom. also. ) Pulsatilla. — Asthma, especially of children, after suppression of a rash, in hysteria, or with suppressed menses ; dizziness, drowsiness, palpitation of the heart ; worse from heat. Veratrum alb. — Asthma in damp, cold weather ; in early morning, better throwing the head back ; inclina- tion for motion ; cold sweat of upper part of body. Coffea. — Asthma in consequence of mental emo- tions ; breathing is jerking, with uneasiness ; heat and sweat. CHAPTER XXIII. AFFECTIONS OF THE STOMACH AND BOWELS, Loss of Appetite. The disorders of the stomach and bowels are very common, and the majority of people, if at all unwell, attribute the cause of their trouble to an improper state of the digestion. Loss of appetite is one of the most common signs of a disordered stomach. It may amount to absolute repugnance to taking any kind of food, or merely an inability to partake of certain articles. Again, the dislike for eating is gradually more and more pro- nounced, and the general strength of the patient suffers. It is not an easy matter to decide what the loss of appe- tite depends upon. We know, from experience, that there are various causes which produce this condition. That nervous influence has something to do with the loss of appetite is shown by the sudden loss of all desire to eat, when any strong impression is made on the ner- vous system, as unpleasant news or anxiety. Loss of appetite is also dependent upon diseased condition of the stomach or other organs. What the loss of appetite really depends on cannot easily be determined, and very often the cause is not specific, but the result of many little abuses. Want of exercise, improper bath- ing, excessive use of tea, coffee, and tobacco, irregu- larity in eating, loss of sleep, too close application to business, or the monotonous routine of daily duties, — 154 AFFECTIONS OF THE STOMACH AND BOWELS. any or all of these may be factors in producing the above-named disorder. The common practice is to try and arouse the appetite by tonics, roots, barks, herbs, spices, alcoholic stimulants, etc., but they oftener do more harm than good. They may awaken the appetite for a day or two, or possibly longer, but in a com- paratively short time they produce an undesirable effect. By degrees these crude drugs accumulate in the system, thereby causing incurable diseases, not in the intestines or the blood, whence they might be ex- tracted by purgatives and blood letting. For every one should know that nothing can remain in the blood any more than in the intestines, as the former is under- going changes every day. It is the solid parts of the body which undergo a change as well as the fluids. Sometimes a craving for salt fish, or acids, or some- thing bitter may do good, if the desire is satisfied and ceases ; if, however, the same craving returns very soon, it should not be indulged, and is a sign that their use is injurious. The best treatment for this condition of loss of appetite is to carefully regard every known law of health and obey it, not for a month, but until it becomes second nature. If there is any habit which is known to be injurious, correct it. In addition to these rules, the regular use of hot water is recom- mended. In the morning particularly, an hour before and a couple of hours after each meal, drink slowly a glass of hot water. At meals, drink moderately. Cold water is also of benefit in many cases, if drank between meals. People drink too little water, although fleshy persons should avoid drinking water excessively, as liquids help to produce fat. The medicines recom- AFFECTIONS OF THE STOMACH AND BOWELS. 155 mended for this affection will be found under the head- ing ''Dyspepsia." Morbid or Capricious Appetite. A morbid appetite may manifest itself in conse- quence of some constitutional disease, or the result of worm affections, dyspepsia, or associated with neuralgia of the stomach. It is often the case that persons may have a capricious appetite, eating enormous amounts for a time, followed by entire loss of appetite. For excess- ively increased appetite or voracious appetite, if not dependent upon stimulants or condiments, one of the following remedies will be found efficacious : — Natrmn muriaticum. — Longing for bitter food and drink ; excessive appetite, loss of taste, continuous thirst. Sulphur. — Sour taste in the mouth all day ; excess- ive appetite ; food tastes too salt ; aversion to meat ; empty, weak feeling in the stomach about eleven a. m. Berberis. — Mouth tastes bitter ; sour, voracious appetite ; great thirst, alternating with aversion to drink ; tongue smarts when touched ; slimy, furred tongue ; heartburn. Dyspepsia, Indigestion. Dyspepsia and indigestion are synonymous terms, and if we consider all the causes by which indigestion may be brought about, we will at once see what a multi- tude of sins these names stand for. Dyspepsia may be caused by changes in the digestive apparatus, such as catarrh, inflammation, thickening, ulceration, eruptions on the membranes of the stomach ; or the gastric juices, 156 AFFECTIONS OF THE STOMACH AND BOWELS. pancreatic juices, or the secretions of the liver and the intestines may be increased or diminished in quantity, bringing about diseased or altered conditions denoted by indigestion. Again, the nervous system being diseased reacts upon the organs of digestion, and it is like a piece of machinery, which cannot properly do its work unless all parts are in perfect order. Dyspepsia may be caused by the use of irritating or stimulating food or drink. We find a whiskey dyspepsia, a pepper and mustard dyspepsia, coffee dyspepsia, tea dyspepsia, ice- cream dyspepsia, hot -bread dyspepsia, candy or sugar dyspepsia, and all sorts of other dyspepsias. Then there are cases of dyspepsia arising from overeating or sur- feiting, indulging in too rich foods, too much greasy food. Dyspepsia is characterized by irregular appetite or mor- bid appetite, accumulation of wind in the stomach, caus- ing distress with desire to belch ; palpitation of the heart, mental depression, sour, bitter, or rancid eructations, burning in the stomach, water brash, nausea, vomiting. The region of the stomach is sore to touch, sensitive to the pressure of clothes ; bloating of the bowels. Sleep may be disturbed or wanting. The face expresses suffering and fatigue ; the eyes are dull. As the disease continues, the patient's strength diminishes, and there is a gradual loss of flesh. Before mentioning the treatment of dys- pepsia, the various diseases which may produce dyspep- tic symptoms will first be mentioned. Catarrh of the Stomach. Catarrh of the stomach is similar to catarrhal in- flammation of any other mucous membrane. Catarrh of the stomach may be produced by taking cold or AFFECTIONS OF THE STOMACH AND BOWELS. 157 getting wet, but principally it is caused by either too cold or too hot food or drink, or indigestible kinds of food, like too fat or old meats, also fish, pork, sausage, cheese, alcoholic drinks, ice cream, ice water ; iced milk is still worse than ice water. Starvation will cause catarrh of the stomach. Mental exertions and excite- ment, fright, grief, worriment, may cause it. One form of catarrh of the stomach is what is so popularly known as biliousness, or "bilious attacks." The symptoms of catarrh of the stomach are in the main those of dys- pepsia, loss of appetite, nausea, and frequently bilious vomiting ; a feeling of uneasiness in the region of the stomach, and soreness to touch. The bowels are con- stipated in the beginning, and the urine scanty and dark colored. Cold sores often ajDpear toward the close of an attack. Fever is not usually marked, unless the grade of inflammation becomes severe ; then the disease is known as gastric fever. Bronchial catarrh is often noticed. Obstinate cases of catarrh of the stomach are likewise accompanied with catarrh of the bronchial tubes. In the treatment of all the disorders of the digestive organs, it is first necessary to correct the abuses and regulate the amount of food taken and its quality. Then eat regularly and at proper hours. Avoid exercise immediately after a meal, or mental work requiring much thinking. These rules apply especially to the treatment of dyspepsia. The diet has to be prescribed for each individual case in a measure ; the diet, how- ever, should be simple, and during an acute attack of catarrh only very little food should be taken at a time, but quite often, every three hours perhaps. 158 AFFECTIONS OF THE STOMACH AND BOWELS. Antimony crudum. — Catarrh of the stomach, after bad, sour wine ; overeating, pork, or acid drinks ; long- lasting loss of appetite, with disgust for all food ; tongue thickly coated, milky white ; stomach weak,_ easily dis- turbed digestion ; stomach is sore to pressure, with a painful sense of fulness ; nausea and vomiting, bowels loose or stools in lumps. Nursing children throw up a little sour milk as soon as they take the breast or bottle; worse in warm weather ; cannot bear the heat of the sun. Arsenicum. — Catarrh of the stomach produced by ice cream, ice water, vinegar, sour beer, tobacco, alco- holic drinks, bad sausages, cheese, fruits ; nausea and complete loss of appetite ; fruitless retching, vomiting, with apprehension of death ; intense heat and burning in the stomach and pit of the stomach ; drinks often, but little at a time. Bryonia. — Nausea increased or brought on by the slightest motion ; must be quiet ; vomiting immediately after eating ; tongue tastes bitter, which water relieves ; great thirst for large quantities of water ; great desire for oysters and sweets ; pressure in the stomach, after eating, like a stone ; makes him fretful ; stomach and pit of the stomach sensitive to the pressure of clothes, to touch, or when coughing. Carbo vegetabilis. — Catarrh, great now of water from the mouth ; sour or rancid eructations ; vomiting in the evening of food, of sour, bilious, or bloody masses ; great debility, and sensitiveness to warm and cold or damp weather ; gastric symptoms from wine, too much milk, excessive use of butter, from fats in general, or from abuse of salt or salt meats ; stomach feels heavy, as if hanging down ; want of appetite. AFFECTIONS OF THE STOMACH AND BOWELS. 159 China. — Loathing of food, as if he had overeaten; voracious appetite, or aversion to all food ; loss of appe- tite in foggy weather ; averse to bread, to butter, to meat, to warm food ; desires sweets, spirits, sour, cool- ing things ; gastric symptoms from eating fish ; exces- sive use of tea ; impure water ; worse from smoking ; heartburn after milk ; frequent vomiting, especially at night ; slow digestion ; bloating after eating ; catarrh of the stomach after severe illness or loss of blood, or in persons debilitated and "broken down." Hepar sulphur. — The stomach is easily disordered, notwithstanding a regular mode of living is followed. Heaviness and pressure in the stomach, after moderate eating ; unusual hunger in the forenoon ; craving for acids, sour and strong-tasting things ; much thirst ; aversion to fats ; heartburn ; frequent but momentary attacks of nausea ; particularly useful for weak stomach produced by taking blue pills or other preparations of mercury ; inclination to vomit, with flow of saliva from the mouth ; burning in the stomach ; distention of the stomach, with desire to loosen the clothing. Ipecacuanha. — Catarrh of the stomach ; no appe- tite, nausea and vomiting ; indigestion, caused by eat- ing raisins, lemon-peel, cake, salads, pastry, pork ; for spasms produced by such indigestible articles ; for nausea with almost all complaints ; indescribable sick feeling in the stomach ; nausea 'and retching from smoking ; vomiting of food, bile, jelly-like mucus, or of a pitch-like substance ; after vomiting, sleepy ; dys- pepsia every other day at the same hour. Nux vomica. — For stomach troubles following the use of allopathic drugs and mixtures, tonics, liver pills, 160 AFFECTIONS OF THE STOMACH AND BOWELS. coffee, wine ; after mental overexertion ; bad effects of a sedentary life ; bitter or sour taste ; sour belching ; dizziness, headache, irritable, cross ; always worse in the morning ; feels as if he had been pounded after sleep ; sleepy in the early evening, but wakens early in the morning and cannot go to sleep again ; bowels constipated, with frequent unsuccessful desire for stool. Pulsatilla. — Disordered digestion, caused by fruits, fats, pastry. Vomiting, with pale face and chilliness ; nausea with colic ; eructations tasting sour, rancid, bitter, and smelling of food ; hunger, but knows not for what ; eats greedily, followed by vomiting ; thirst- less ; weight like a stone in the stomach, worse early in the morning on waking ; pain in the pit of the stomach. The patient is cross, morose, and easily moved to tears. A particular aversion to warm food; sleepless after late suppers, or eating too much ; sleep- less first part of the night. Sleeps late in the morning. Sulphur. — Tedious cases of dyspepsia. The remedy should be taken at very long intervals. When improv- ing, the patient should wait until the symptoms remain stationary, or are worse again, before repeating it. If this remedy fails to effect a cure, try Calcarea carb., or Mercurius, and then Sulphur again should be tried. Veratrum album. — Hunger between paroxysms of vomiting ; nausea, with sensation of fainting, generally with violent thirst ; vomiting violent, with great cold- ness of the body ; cold perspiration and great prostration; vertigo ; pale face ; indicated in cases of chronic weak- ness of the stomach from dampness of climate and want of fresh air, from abuse of quinine. ' AFFECTIONS OF THE STOMACH AND BOWELS. 161 Nausea and Vomiting. Nausea and vomiting are often combined, but some- times there is a persistent nausea without vomiting ; sometimes vomiting occurs without any or with but slight nausea. Nausea or vomiting alone conveys but little idea of the real disease which causes the symptom, for it must be considered only as a symptom. Nausea and vomiting accompany disease of the stomach, or from the introduction of indigestible substances into the stomach, which are thrown off because they are irri- tants. Likewise nausea and vomiting may result from mental emotions in those persons peculiarly sus- ceptible to all impressions. Diseases of the brain also are accompanied by nausea and vomiting. The vomiting of pregnancy is an example of reflex irritation ; also the nausea and vomiting following wounds of the extremi- ties, in inflammation of the peritoneum, or from a fall ; all of these conditions give rise to sympathetic vomiting at times. The character and the quantity of the vomit are varied of course, and convey some idea of the causes which produce the vomiting. Food or liquid mixed with saliva and some mucus is expelled when the stomach is very irritable, or if an obstruction exists which prevents the free entrance into it. Half-digested food, tasting strongly sour or acid, is cast out when the gastric juice is interfered with or the food has been retained for a long time in the stomach. This kind of vomiting accompanies chronic inflammation of the stomach, and in cancer of that organ. Mucus is often ejected in large quantities, both mixed with food or clear mucus. When this is the character of the vomit, it generally indicates a catarrhal inflammation of 162 AFFECTIONS OF THE STOMACH AND BOWELS. the stomach, which may extend to the bowels, in that case mucus will also be evacuated. Bile may find its way into the stomach, and if vomited imparts a greenish or yellowish color to the vomit, and has a very bitter taste. The occurrence of bilious vomiting is generally held by the laity as indicating a disease of the liver, or that the patient is extremely "bilious." It is not a proof of either. The effort of vomiting, if repeated, will always be accompanied by bitter fluid, from the irritation set up by the convulsive action of the stomach in the act of ejecting its contents. Blood is not infrequently vomited, and the quantity varies of course greatly. It may arise from an injury to the stomach, or from inflammatory processes, which eat into the smaller blood- vessels of the stomach, or it may arise from suppressed menstrual flow, and known as ' ' vicarious. " Usually the stools contain blood when there is hemorrhage in the stomach. Vomiting, therefore, is only a symptom, and in the great majority of cases is easily controlled, or it is the means by which relief is obtained when the stomach contains improper substances. Ipecacuanha is the first remedy to be thought of in nausea or vomiting, and will cure a large majority of cases. The tongue is usually clear or only slightly coated when Ipecacuanha is the remedy to be given. If the tongue is thickly coated white or yellowish, try Antimony crudum. When nausea and vomiting follow a fall on the head or spine, always give Arnica. Nausea caused by riding, give Cocculus. Nausea and vomiting from disordered digestion calls AFFECTIONS OF THE STOMACH AND BOWELS. 163 for some one of the remedies mentioned under the heading of ' ' Catarrh of the Stomach. " Pain or Cramp of the Stomach. Pain occurs in many of the gastric disturbances, and is of every conceivable description. If the pain is more severe soon after meals, or when the stomach is full, and more severe after eating a heavy meal of animal food than after a light one of cereal food and milk, it probably indicates a change in the membranes lining the stomach ; it indicates that the trouble lies in the improper secretion of the gastric juice. This rule is a general one, but not absolute, and therefore should not be considered an infallible one. The pains may only amount to a sense of fulness, or reach a point when they become excruciating. The stomach is often the seat of violent paroxysms of pain. These are often associated with a chronic affection of the organ, and not infrequently they occur when there exists no abnor- mal change in the organ, but are purely of a neuralgic character, coexisting with a tendency to neuralgic pains all over the body, or the pain is brought about by some article of food which the stomach does not tolerate or is unable to digest. The pains which occur in the form of neuralgia are described under the name of gastrodynia or gastralgia, or as stomach colic. This affection may be brought on by exposure to cold or damp weather, a draught of cold water drank when heated, sudden and violent emotions, or a collection of wind in the alimentary canal. The persons most likely to have this painful affection are of a gouty or rheu- matic tendency, or persons who are much debilitated, 16-t AFFECTIONS OF THE STOMACH AND BOWELS. although apparently healthy persons may be attacked. The pain is usually at the pit of the stomach, and radiates from thence to the back, into the chest, bowels, or sides of the chest and abdomen. It is not an easy matter to decide whether the pain is due entirely to simple neuralgia or to disease of the stomach, yet we often find in cases of gastralgia that the pain is worse in the morning, and is almost immediately relieved by a hearty breakfast. When the gastralgia is produced by some article of food that disagrees with the individ- ual, it is recognized that it is of short duration, and the offending article will soon be found out by careful observation. When gastralgia is dependent upon disease of the stomach, there are other symptoms which point to the condition, such as sluggishness of the bowels, palpitation of the heart, and shortness of breath after meals. After having eaten, the face is apt to flush and the palms of the hands grow hot. Persons suffering from these symptoms usually attribute them to heart disease, and seek aid for that malady, or they think the lungs are affected, because associated with the above-men- tioned symptoms. Nux vomica. — For pains in the stomach, in brandy or coffee drinkers, when they abstain from taking these drinks ; pain in the bowels two or three hours after meals ; bloated feeling, and as if a stone lay in the stomach ; clawing, cramping pains in the stomach, and pain between the shoulder blades ; pain extends to the chest or down the back ; gastralgia worse from food, better from hot drinks ; worse in the morning before breakfast ; colic from suppression of bleeding piles. Chamomilla. — Pressive pain in stomach and be- AFFECTIONS OF THE STOMACH AND BOWELS. 165 neath the short ribs, which prevents easy breathing ; pains drive the patient almost frantic ; they cannot answer questions, cross and irritable ; gastralgia from anger ; the symptoms are worse at night, and profuse sweat accompanies the pain, with restless tossing. Coffea may relieve, if Chamomilla seems indicated but does not relieve. Cocculus. — Is indicated when Nux vomica gives partial relief only, and the pain returns. The bowels are constipated ; the Cocculus patient is not cross or ugly, but rather sullen and averse to talking ; nausea and vomiting with contractive pains in the stomach, relieved by passing wind. Bryonia. — Similar to Chamomilla, particularly when the cramps begin during meals, or immediately after- wards, and the pit and region of the stomach feel as if swollen. The pain may be pinching or cutting, which is relieved by pressure upon the stomach or by raising wind ; the pains are worse from motion (China better from motion) ; there is constipation, headache, with pressure in the temples, the forehead, or back part of the head, as if the bones were being forced asunder, which is better when pressed hard or tied tight with a handkerchief. Pulsatilla. — When the pains are sharp and cutting; for flatulent colic in the evening after eating or at night ; wind moves about, creating distress ; colic from ices, fruits, pastry ; from getting the feet wet ; colic obliges the patient to bend forward ; relief from cool things, made worse by heat ; chilly with the pains. China. — Spasm of the stomach in debilitated per- sons ; cold feeling in the stomach after small quantity 166 AFFECTIONS OF THE STOMACH AND BOWELS. of food ; pressure in the stomach, which is not relieved by raising wind ; stomach feels sore, cannot bear the slightest touch ; pain relieved by motion. China is of prime importance in the colic of nursing women. Carbo veg. — Flatulent colic ; pain is burning, or constant, painful, anxious pressure, worse when touched; pain forces the patient to bend, takes away his breath, and worse by lying down ; burning pain extends from the stomach to back, spreading up to the shoulders from the small of the back. Cramps in the stomach, occurring periodically, re- lieved by vomiting, Hyosciamus. Cramps in the stomach in coffee drinkers, Chamo- milla and Nux vomica. Cramps in the stomach, worse by drinking cold water, Calcarea carbonica. Cramps in the stomach with nausea, Graphites, Natrum mur., Nux vomica. Cramps in the stomach with vomiting, Calc. carb., Pulsatilla. Cramps in the pit of the stomach, Ant. crud. and Chelidonium. CHAPTER XXIV. DISEASES OF THE ABDOMEN. Colic. This affection is attended with paroxysms of pain, referred chiefly to the middle or lower part of the abdo- men, and is unattended with much fever or tenderness. The pain is usually griping or pinching, and par- oxysmal in character. The causes of simple colic are usually due to acid fruits, to indigestible food, ' ' catching cold,'' to accumulation of wind ("wind colic"), to drinking cold water when overheated. Colic is also caused by metallic poison, and is met with in painters and plumbers. The presence of bile gives rise to ' ' bilious colic." This form of colic is preceded by nausea, loss of appetite, and a coated tongue ; vomiting soon sets in, and is followed by a yellow tinge of the eyes and sore- ness over the region of the liver. The passage of gall- stones and stones from the kidneys alike resemble ordi- nary colic; they can be recognized only when found in the stool or urine. There are two signs when present which point out the passage of a kidney stone from simple colic, and that is the numbness of the thigh and retraction of the testicle, but they are not always present in this affection even. Treatment. — Hot compresses applied to the bowels afford relief in some cases ; they require to be changed often, and applied as hot as can be endured. A general 168 DISEASES OF THE ABDOMEN. hot bath is also efficacious. One of the following named remedies may be administered : — Nux vomica. — Is indicated when the patient has been given strong tonics or " mixtures " after the abuse of liquors ; if there is constipation or frequent desire for a stool, with inability to evacuate. Colocynth. — When the colic pains are very violent, causing the patient to cry out or shriek aloud ; he writhes and twists about like a worm ; the patient is covered with perspiration ; seeks relief from bending over double, or presses the corner of a table against the bowels. When the patient has taken opium for the pains, and still finds no relief, give coffee first, a tea- spoonful without milk or sugar, then administer Colo- cynth. If this remedy does not suffice, try Staphysagria. Belladonna. — Is indicated in colic, when during the pain a thick cord-like swelling protrudes across the abdomen ; when the pain is relieved by bending over and from pressure. The characteristic pain of Bella- donna comes quickly, and is griping, with it a bearing down, as if the intestines were about falling out. The face is generally very red, and the veins full. Cepa. — Violent colic pains either after catching cold, particularly from wet feet, or from eating cucum- bers, salads, or from eating too much. The pain begins in the region of the liver, and extending through the whole abdomen ; better from moving about. The pain is always worse on the left side ; there is urging to pass water, and to go to stool, when Cepa is indicated. Cocculus. — The indications for this remedy resemble Nux vomica ; there is distention of the abdomen, with pressing under the short ribs. Flatulent colic about DISEASES OF THE ABDOMEN. 169 midnight, raising the wind gives no relief. Sensation in the abdomen, as if sharp stones rubbed together on every movement. Ignatia. — Colic which awakens the patient out of sleep ; colic after grief or fright. Pulsatilla. — Colic worse at night ; no thirst ; tear- ful disposition ; from eating fat and greasy food. Gelsemium. — Colic with diarrhoea. Alumina and Opium. — For lead colic or painters' colic. China. — Flatulent colic, worse at night ; brought on by eating fruits or drinking beer ; profuse perspira- tion. Arsenicum. — Colic after ice cream and ice water. Dulcamara. — Colic from taking cold ; nausea and diarrhoea. Sepia. — Colic pains in pregnant or lying-in women. In the preceding pages the affections of the abdomen have been spoken of which have no tenderness of the abdomen, or fever. We will now consider those condi- tions which give rise to marked tenderness and pain in bowels, confined to small areas or diffused over the abdomen. When a. patient complains of tenderness of the abdomen, attended with pain, the following diseases should be thought of as indicated, by those symptoms, viz. : — Acute enteritis, or inflammation of the small intes- tines. Acute peritonitis, confined to certain spots or all over the surface of the bowels. Inflammation of the womb or bladder. Eheumatism of the abdominal walls. 170 DISEASES OF THE ABDOMEN. The symptoms of enteritis are those of colic, attended with fever, and tenderness to touch. The fever may run high. There is nausea and vomiting. The tongue is clean and of natural appearance, or it is coated white, or again it may he red and dry. There may be diarrhoea or constipation. A mild form of this disease is recognized, attended with the above symptoms, except the fever is not high, and diarrhoea is always present. This last-mentioned form of enteritis is com- mon in children, especially during dentition. The disease may pass off in a week or two, or the symptoms abate somewhat, leaving a chronic catarrhal inflammation, which may continue for months. Peritonitis, as well as enteritis, is attended with pain and tenderness of the bowels. In peritonitis the nausea and vomiting are more marked, the bowels more dis- turbed. There is constant desire to urinate ; fever is very high. This disease is very dangerous, and requires the services of the most competent physicians to suc- cessfully treat it. It is considered a good sign when the pain gradually subsides, and the pulse grows stronger. The methods of treatment followed by allopathic physicians in this malady are productive of lasting injury", even should the patient recover. They rely almost entirely on morphine, thinking that to conquer the pain is the most rational thing to do. Inflammation of the womb would be recognized by the location of the tenderness, and there being no swell- ing of the bowels. Inflammation of the bladder presents many similar symptoms to the above-mentioned diseases, and from them it may be distinguished by the character of the DISEASES OF THE ABDOMEN. 171 urine, which is scanty and painful, is cloudy instead of clear as in peritonitis. Kheumatism of the abdominal walls is not infrequent, and might be mistaken for peritonitis, but the pain is not so constant, nor is it so suddenly produced. It is also less affected by movements or by pressure. Not that these diminish it, on the contrary, they aggravate it ; but deep pressure causes little or no more pain than slight pressure, and it is only during certain motions, when the abdominal muscles are placed on a stretch, that the pain is severe, or sometimes, indeed, at all produced. The pain is often one-sided, or more marked on one side. There is generally slight fever. Treatment of Catarrhal Inflammation of the Inner Lining of the Bowels. It has been explained how these varying abdominal diseases differ in symptoms, and the remedies may be properly applied to them all, if the indications which arise in each individual case are carefully noted, with- out distinction to the names applied to the different conditions. Aconite will, in most cases, be required at the com- mencement. It may be given quite often for a short time if the dose is not too strong, and then wait for a while, after which some other remedy may be re- quired. Aloes. — Pain and rumbling in the bowels before stool ; escape of large quantities of wind with the stool. Antimony crudum. — Tongue coated white ; nausea and vomiting ; watery diarrhoea ; thirst at night. Arsenicum. — Colicky pain, and diarrhoea like water, 172 DISEASES OF THE ABDOMEN. nausea, retching, and vomiting ; diarrhoea may be accom- panied by pain or without pain, worse about midnight ; sudden prostration and thirst for small sips of water frequently ; great restlessness ; prostration and fear of death ; cutting pains in the abdomen ; abdomen dis- tended and painful. Bryonia. — Griping pains about the navel ; sudden painful cuttings in the intestines, with a feeling as though one were digging him with the fingers, com- pelling him to bend double ; relieved by profuse pasty evacuations ; great sensitiveness of the abdomen ; stitch- ing pains in the abdomen flying upwards ; hard, black, and dry stools, as if burnt, and rather scanty ; great thirst for large quantities of water ; better from rest, worse from least movement. Belladonna. — Abdomen distended like a drum ; during the pain, protrusion extending across the abdo- men like a pad ; colic-like pains, as if a spot in the abdomen were squeezed by the finger nails. Abdomen very sensitive to pressure ; cannot bear the slightest touch, not even the bedclothes ; great pain in the right side low down, towards the groin ; great thirst ; desires lemonade. Vomiting of mucus, of bile and mucus, of undigested food ; can keep nothing down. Sleepy, yet cannot sleep ; starts when on the point of falling asleep. Violent, throbbing headache. • Chamomilla. — Diarrhoea of teething children ; stools look like chopped eggs, smelling like spoiled eggs. Pain in the bowels from side to side, just above the navel, commencing in the right side, going over to the left. Pain in the bowels is excruciating, with pain also in the back, and extends down to the thighs. Children DISEASES OF THE ABDOMEN. 173 are cross and fretful ; want to be carried all the time. One cheek pale, the other red. The patient is cross and impatient, nothing pleases. China. — Abdomen distended, feels full, wants to belch, but it does not give relief ; painless diarrhoea ; stools brownish, frothy, worse at night. Dulcamara. — Diarrhoea from sudden change in the weather from warm to cold, especially cold, damp weather ; chilly feeling in the small of the back ; nausea, loss of appetite ; great chilliness during the vomiting. Ipecacuanha. — Diarrhoea and vomiting during den- tition ; griping pains in the bowels ; cutting pains, extending from left to right side : vomiting makes him feel worse, instead of relieving. Mercurius viv. — Abdomen tense, hard, swollen, and sensitive. Pain in the bowels, which does not allow the patient to lie on the right side. Bitter taste in the mouth ; more thirst than hunger ; constant chilliness and dread of air. Diarrhoea, stools slimy, green, or bloody; great straining, "never get done feeling." Worse at night. Mercurius follows Belladonna well, also indicated after Lachesis. Nux vomica. — After previous use of quack medi- cines, teas, opium, brandy. Pulsatilla. — Painful sensitiveness of the abdomen to touch ; pressure in the abdomen and small of the back, as from a stone ; desire to loosen the clothing ; diarrhoea worse at night ; chilliness ; absence of thirst ; easily moved to tears ; bitter taste in the mouth ; coated tongue ; disordered stomach ; nausea. Sulphur. — When well-chosen remedies fail to pro- 174 DISEASES OF THE ABDOMEN. duce permanent good, a dose of Sulphur tends to arouse the system, when the indicated remedy will bring about a cure. Intestines feel as if strung in knots ; worse from bending forward. Painful sensitiveness of ab- domen to touch, as if internally raw and sore. Early morning diarrhoea, driving the patient out of bed. Veratrum album. — Burning in the abdomen, as from hot coals ; peritonitis, with vomiting and diar- rhoea ; skin cold and bathed in cold perspiration ; features sunken, pulse small. Patient seems very low ; complains of feeling icy cold ; cold feeling in the abdomen ; diarrhoea coming on suddenly at night ; vomiting and purging ; faintness ; cramps in the ex- tremities, beginning in the feet and hands ; profuse watery diarrhoea. Besides the above-mentioned diseases of the abdom- inal organs, there are many others of serious nature which might be mentioned, but they require great skill to diagnose correctly, and would not therefore properly belong in a work of this kind ; they come under this same heading of diseases attended with pain and marked tenderness to pressure over the abdomen, but with this distinction, that the tenderness is in the right side of the bowels, opposite the hip. They will merely be referred to by name. Affections of caecum or appendix (known as the pocket). Inflammation of the right ovary. Abscess, deep, in the right side of pelvis. Abscess of the abdominal walls. Invagination of the bowels ("a slipping of a tuck of intestine into the cavity of the portion of intestinal DISEASES OF THE ABDOMEN. 175 tube immediately below it, with which it is contin- uous"). It is intended that by stating the diseases so often mistaken for each other that may have their locality in this part of body, and all of them of so serious a nature, to impress upon the laity the importance of employing skilful physicians, instead of trying in any way to tamper with themselves by home medication. Never give aperients, although there is usually ob- stinate constipation in all the above referred to diseases ; the less this symptom is interfered with, the sooner will the patient be restored to health. Cathartics and emetics may not always prove fatal if administered, though they certainly have when given in this class of diseases ; certain it is, however, they may produce a chronic malady which is difficult to cure. Constipation is looked upon as a favorable sign in these complaints. Typhoid fever, which will be spoken of under the head- ing of "Fevers," likewise has marked tenderness over the right side of the abdomen opposite the hip, with dis- tention of the bowels. Worms. There are many physicians who doubt the existence of worms in the human being, but it seems somewhat singular that all of them have not had visible proof of their existence. Too much importance has been attrib- uted to the presence of worms, and by the laity are looked upon as the cause of disease, rather than the result of some dietetic error. The late Dr. Hering has so well expressed these ideas, that it will be well to quote his views: "Many complaints are ascribed to 176 DISEASES OF THE ABDOMEN. worms which arise from very different causes. When children have been fed upon pap, cakes, and similar articles of a hurtful nature, or when the mother, whilst nursing, overloads her stomach with meat, fish, salted and fat things, particularly with pies, the children must necessarily become sick in consequence, or a predisposi- tion to sickness be induced. If the children are kept too warm, get little outdoor air, and besides this, are dosed with vermifuges, injections, purgatives, etc., the worms cannot fail to prosper and increase. When chil- dren are supposed to have worms, the first thing to be looked to is a rational mode of living, by which means the worms will soon diminish, and if symptoms of the complaint remain, the remedies will afterwards prove the more effective. Most persons are by far too much afraid of these little creatures, which are not nearly so noxious as the remedies usually prescribed for them, and particularly as the nostrums advertised in the newspapers. Simple persons believe in these things, and pay for the trash, when, if they knew what they or their children were swallowing, they would rather pay twice as much to keep it out of the house, to say nothing of their bodies. It is true these things sometimes kill the worms, but too frequently they kill the children also, or affect the abdomen in such a manner that the con- sequences appear many years after. " First, it is to be considered that almost all children have worms, sometimes before they are born, and that it is frequently a sign of a dangerous disease when these worms pass off spontaneously ; secondly, that what these worms subsist upon in the body is more hurtful than the worms themselves. Almost all symptoms DISEASES OF THE ABDOMEN. 177 attributed to worms may arise from some general disease in the system, which has a tendency to increase them, especially if aided by an unwise mode of living. When the worms are expelled, the symptoms which they gave rise to, of course, disappear, but the real disease may increase. Sometimes diseases subsequently make their appearance which are worse than the first, although slower in their operation, and perhaps not manifesting themselves until the tenth or twelfth year. Expelling the worms is of no essential use. The remedies here prescribed will frequently cure the disease itself, and if there are really too many worms, which is but rarely the case, will remove them also. Children who have worms should have enough to eat, but not too much bread, very little salt, and few or no cakes or pies, but in preference a good deal of ripe cooked or dried fruits, and in particular carrots. ' ' When you are not certain of the existence of worms, and the child becomes emaciated, and vomits frequently, give first Ipecacuanha ; but when the tongue is coated, Carbo vegetabilis ; if this has no effect, Pulsa- tilla ; if the child has been much troubled with diar- rhoea, or has taken much aperient medicine, give Cinchona ; when the bowels are constipated, Nux vomica; when the child passes worms occasionally, picks its nose much, and the belly is distended, give Cina, which is one of the chief remedies for all com- plaints really arising from worms. ' ' For colic caused by worms, with frequent inclina- tion to vomit, when much water collects in the mouth, and the parts around the navel are hard, also when the whole abdomen is hard and distended, with frequent 178 DISEASES OF THE ABDOMEN. ineffectual straining to evacuate, or secretion of noth- ing but slime, give first Aconitum ; some hours later, Cina ; and if this is not sufficient, Mercurius. In all complaints caused by worms, Aconitum is of great use in the beginning, and if this and the other remedies mentioned above do not remove them, Sulphur should be given, and will be found to be of great value, partic- ularly after Mercurius. These remedies will generally effect a cure. In rare cases, attended with much thirst, sudden starting and fright, Belladonna may be required. ' ' In very bad cases it may also be necessary to give Lachesis. ''Persons troubled with tapeworms discharge joints of this worm from time to time. These pieces are nearly square, quite flat, about as broad as the little finger. There is no sure sign of the existence of tape- worms, except the discharge of pieces of this descrip- tion, which generally pass away about the new and full moon. Tapeworms may frequently be destroyed by taking, when the moon is waning, two mornings suc- cessively, a dose of Sulphur, and at the next full moon, Mercurius, in the same way, and eight days after, Sul- phur again twice. Eepeat these remedies in the same order several times. Sometimes the tapeworm is dis- charged after taking a few doses of Calcarea. If this treatment does not effect a cure, apply to a homoeo- pathic physician." Itching- of the Anus, Seatworms. Seatworms, or pinworms, are very minute, thread- like creatures, which infest the rectum only, and cause most distressing itching. These little worms sometimes DISEASES OF THE ABDOMEN. 179 crawl from the back passage to the genital organs, and cause even greater trouble, as the person often is obliged to rub the parts excessively ; in some cases this leads to masturbation. The other diseases which cause itching of the anus are piles, pruritus ani, and eczema. These will be found under the heading, ' ; Diseases of the Eec- tum." Treatment. — Injections of cold water every evening will be found serviceable, or the introduction of a small piece of fat bacon within the passage, a small piece attached to a string, allowing it to remain fifteen min- utes to half an hour, and then removing it. Lemon juice, salt and water, vinegar and water, have also proved efficacious. Teucrium is said to be specific for this trouble. Nux vom., Ignatia, Ferrum, Calc. carb., Silicea, or Sulphur should be prescribed, according to the symp- toms in each case. Constipation. The average mind often elevates the function of defecation from the lowest to the highest position in the wonderful mechanism of our bodies. A purgative is considered as the essential remedy in the vast majority of sicknesses. If constipation is one of the conditions present, and even if it is not, great good is expected to follow the free "clearing out " of the bowels. Dr. Epps aptly says : ' ' The practice of giving purgatives for -the cure of diseases is founded upon an assumption that the constipation is the keystone that binds all other symptoms of the disease together, whereas it is merely one of the many stones that go to form the diseased 180 DISEASES OF THE ABDOMEN. structure. No doubt its presence arrests the attention, and vulgar minds are apt to notice that which is most apparent. Cultivated minds penetrate deeper, and dis- cover that that which is less obtrusive is often the more important." Constipation as a disease in itself should not for a moment be considered. If one would stop to consider the endless processes involved in feeding, distribut- ing, and of elimination to preserve life, we would hesi- tate for a time and ask the question, Where lies the trouble that has for its expression constipation as a symp- tom alone ? Constipation does not exist without more important and more reliable symptoms. It is one of the insignificant ones, and should not be considered a disease. Watch carefully all the workings of the human system ; note all its departures from a state of health ; and when they are corrected, then will the process of elimination of the waste be natural. Constipation depends upon a constitutionally deranged state. Cathartics never cure constipation ; they increase the trouble, and tempora- rily cause another disease ; either diarrhoea or far too frequently death has followed the use of purgatives. The strong dose of medicine does relax the bowels, and for a time gives a sense of relief, but the next day or after their continued use they are inert, and the con- stipation is never more stubborn. To attempt to restore the secreting powers of the bowels or of the liver by thus artificially spurring them to unnatural actions is like attempting to recruit the exhausted powers of the horse by spurring his sides till they bleed. You may urge him on from time to time, but it is only at an increased expense of energy, and only tends ulti- DISEASES OF THE ABDOMEN. 181 mately to a more rapid exhaustion of his powers. One evacuation daily is proper for a person in robust health, but in the thin, pale, delicate, and weakly, especially if they are small eaters, they are better with four or five stools a week than with seven or eight. The stools are but excretions, and should be in proportion to the activity of the system. The great error is in regarding constipation as the want of discharges from the bowels, rather than the want being created through too little substances being sent into them. Hence, cathartic medicines tend to drain the system, already too dry, instead of the rational method of increasing the secre- tions. Many and varied are the arguments used to justify the use of purgative medicines. People fear an accumulation in the bowels. What of that ? Were not the bowels made for just such a purpose ? We know that the length of the intestinal tube is about five times our height : hence there is room enough for quite an accumulation. The stomach, with the intestines, is made for the purpose of receiving food, to digest it when received, to carry it forward, when digested, through the tube; and nature has, in the arrangements for so digesting the food, and for carrying it forward, acted quite efficiently to prevent accumulations ; for the churning motion of the stomach is but the begin- ning of an action throughout the whole tube. Such a tube is not a dead machine, a mere sewer. If this function is impaired, then constipation may be one of the many symptoms produced which indicate a diseased state. To attempt to cure this, or any condition of the intestinal tube by administering purgatives, is proved to be incorrect ; because it is a well-known fact that 182 DISEASES OF THE ABDOMEN. diseased states proceed in their injurious course, not- withstanding the bowels are forced to act daily. An- other argument is embodied in the expression, "I always feel better when my bowels act regularly." No doubt such is the case. Why not add, ' ' I always feel better when I am well." There is no doubt that a forced action of sluggish bowels may relieve, but it is only temporary. Persons argue that when the bowels act, relief follows ; therefore the action brought relief ; then they reason, " When I am not well, my bowels do not act. I will force them by purgatives, and I shall be well." This part of the argument does not hold true. From the above -stated views it is desired that this much should be remembered : that constipation is the result of something wrong in the system, and not that the system is wrong from the constipation. Do not force the bowels by powerful doses of medicines. Select a remedy that covers all the symptoms. At the same time, attention should be paid to the manner of living ; moderation in the use of meat, which had better be taken only once a day ; a free use of salted food is to be avoided, mastication attended to, or the food be well cut up, if the teeth are poor or absent; vegetables, fruit, and coarse bread to be taken freely ; strong or green tea and all spirituous liquors to be avoided. Buttermilk is one of the best of beverages in this condition. Avoid cheese, smoking before meals, better still not at all. Drink freely of cold water. Take plenty of exercise, walking particularly up hill. Persons who are costive should be regular in soliciting the bowels to move. Strictures of the bowels, tumors, displaced uterus, pa- ralysis, etc., are attended with constipation, but belong DISEASES OF THE ABDOMEN. 183 to mechanical causes in the main, and should be treated accordingly. Treatment. — Antimony crudum. — Headache, dull, stupefying ; worse walking in the open air ; aversion to food ; deranged stomach, after suppressed eruptions ; alternate diarrhoea and constipation with old people ; difficult hard stool ; feces too large ; sensation as if large stool passed, but only wind escapes, with finally very hard stool. Alumina. — Inactivity of the rectum ; even the soft stool requires great straining ; stools hard and knotty, like sheep dung, with cutting in the anus, fol- lowed by blood. Constipation of nursing children. Bryonia. — Constipation, stools hard and black ; look as if burned ; particularly useful in constipation occurring in warm weather or if worse then, and in persons who suffer from rheumatism ; irritability of temper. Nux vom. — Constipation occurring in persons of sedentary habits, and those accustomed to drinking ardent spirits ; also for constipation occasioned by eat- ing too great a variety of food at once ; after surfeiting, or when constipation is preceded by diarrhoea, or for suppressed diarrhoea, with want of appetite ; disagree- able taste ; the tongue slimy, coated, loathing ; sick- ness of the stomach ; frequent ineffectual efforts for stool. Platina. — When, after much straining, the pieces are evacuated in small quantities ; straining and itching at the anus ; shuddering over the whole body after every evacuation, accompanied by a weak feeling in abdomen, with contraction, bearing down ; oppression 184 DISEASES OF THE ABDOMEN. of the stomach, and ineffectual efforts to belch wind. Suitable for constipation after or while travelling. Lachesis. — For protracted costiveness, ineffectual urgings ; anus feels closed ; beating in the anus as from hammers ; rectum comes down. Nat rum muriaticum. — In tedious cases, where there is no inclination whatever to evacute ; stools, if any, are scanty, hard and insufficient ; anus feels contracted ; emaciation even while living well. Sepia. — For unsuccessful urging to stool ; only wind and mucus passed ; sensation of a lump in the back passage ; stools insufficient ; patient feels better in the open air ; can't tolerate a warm room. Silicea. — Constipation ; stools large or composed of hard lumps, light colored ; expulsion difficult ; when partly expelled, it slips back again. Sulphur. — Frequent unsuccessful desire for stool. Constipation and diarrhoea alternately. Diarrhoea. Much that has been said under the heading of ' ' Con- stipation " is equally applicable to diarrhoea. Both states occur as an accompaniment in a vast number of diseases, but other symptoms more characteristic than these are to be noted. There are several varieties of diarrhoea. The length of time the diarrhoea has con- tinued is distinguished by the terms "acute" or "chronic" form. Acute diarrhoea may arise from more than one cause ; it may be excited by improper food, excessive heat, getting wet, impure air, cutting teeth, sudden fright, fear or anticipation of some important event. Diarrhoea likewise may be the precursor of some other DISEASES OF THE ABDOMEN. 1S5 disease. Chronic diarrhoea is usually the result of a neglected or badly treated acute attack, or as the result of injudicious treatment of a previous sickness, the abuse of purgatives, or a symptom of some consti- tutional disease. One form of looseness of the bowels is called membranous enteritis. Here the discharges show shreds of membrane or skin- like substances in connection with the loose stool, or the evacuation from the bowels may be entirely of membranes. This disease may be intermittent in character, varying in severity, and likewise very obstinate to cure. Hysterical symp- toms are very often associated with this trouble. Dysentery is perhaps most likely to be confounded with ordinary diarrhoea. The character of the stools is different. In dysentery the stools are small, consisting of bloody mucus, highly offensive, but no real feces are discharged, while diarrhoea is attended with liquid fecal stools ; the latter disease may terminate in dysentery. Dysentery, instead of being diarrhoea as commonly be- lieved, is just the reverse ; it is constipation, and the seat of the disease is in some portion of the large intes- tines. If children while teething have diarrhoea of moderate degree, do not at once try to check it; if there are no other symptoms, wait a day. At the beginning of any attack of looseness of the bowels, immediately regulate the diet, avoiding all acids, coffee, tea, and everything salt should be denied ; fruit, eggs, chicken, veal, and vegetables should likewise be withheld. Arrowroot, imperial granum, flour gruel, barley water, crust coffee, mutton broth thickened with rice flour or sago, and scalded milk are articles of diet that can be recommended in acute diarrhoea or dysentery. 186 DISEASES OF THE ABDOMEN. Chronic diarrhoea requires a greater variety of and more nutritious food ; mutton, beef, poultry, soft eggs, game if not old, meat broths, rice and milk, milk as a beverage ; avoid vegetables in the main, unless certain varieties are known not to disagree. In cholera morbus the diet is somewhat different. During the attack no food whatever is required ; after the attack no solid food should be taken until the stools are consistent or fecal. Cholera Morbus, Summer Complaint. Like cholera infantum of infants, cholera morbus, or summer complaint, is a disease of the hot season, yet it is also observed at other seasons of the year. Although heat is generally the exciting cause which develops this disorder, there probably are some other conditions which occasion it ; such as exposure, checked perspiration, drinking large quantities of ice water, or imprudence in eating unripe fruits, cucumbers, etc. This disease is characterized by violent purging and vomiting with the attending symptoms of griping, great thirst, and sometimes by cramps and coldness of the extremi- ties. In some cases the disease seems to overcome the patient very early, and we find coldness of the skin, cold perspiration, faintness, pinched features, sunken eyes, and collapse even. Death from this disease some- times occurs after a very short illness, but this is in rare and exceptional cases. The attacks usually come on suddenly, and especially at night, or the disease is some- times preceded by colicky pains, nausea, and rumbling in the intestines. Cholera morbus can hardly be mis- taken for any other disease except true cholera, and from DISEASES OF THE ABDOMEN. 1ST it we distinguish by the greater severity of the symp- toms in the latter disease, the rice-water evacuations, the early appearance of collapse or sinking, and from the epidemic character of cholera. During an epidemic of cholera never go out without first taking some light nourishment, eat no fresh bread nor sour food, and leave alcoholic drinks alone. This is not only a pre- ventative in cholera, but also in many other epidemic diseases. Cholera morbus is recognized as differing from simple looseness of the bowels by the occurrence of purging and vomiting. Treatment. — The remedies here mentioned will be applicable to diarrhoea, acute and chronic, cholera mor bus, cholera, and dysentery. Before prescribing, note carefully all the symptoms, the character of the stool, the kind of pain, and when it occurs, whether before, during, or after stool, or all, the time of day or night when the symptoms are worse, the influence of eating, of heat or cold, and the causes which produced the attack. Prescribe only one remedy at a time, and ad- minister a dose immediately after a stool or attack of vomiting, and stop the remedy as soon as improvement begins. Acute Diarrhoea. — Antimony crud., Arnica, Arseni- cum, China, Croton tig. , Colocynth, Dulcamara, Ipecac- uanha, Gambogia, Iris v., Magnesium carb., Merc, v., Podophyllum, Pulsatilla, Kheum. Chronic Diarrhoea. — Arsenicum, Calc. carb., China, Ferrum, Graph., Hepar sulph., Iodine, Kali bich., Lachesis, Lycopodium, Natrum sulph., Phosphorus, Sulphur, Thuya. Cholera Morbus. — Antimonium carb., Arsenicum, 188 DISEASES OF THE ABDOMEN. Camphor, Croton tig., Dioscorea, Ipecacuanha, Iris versicolor, Podophyllum, Veratrum alb. Dysentery. — Aconite, Aloes, Apis mel., Arsenicum, Baptisia, Belladonna, Cantharis, Capsicum, China, Col- chicum, Colocynthis, Mercurius cor., Mercurius v., ^sux vom., Rhus tox., Sulphur, Tartar emet., Veratrum alb. CHARACTER OF THE STOOLS. Color black. — Aeon., Apis, Biy., Camph., Capsic, China, Iris v., Merc, v., Pod., Sulph. " bluish. — Phos. " broivn. — Aeon., Aloe, Apis, Ars., Arn., Bapt., Camph., China, Graph., Iris v., Merc, v., Nux v., Sulph., Tartar emetic. Verat. alb. " chalk-like. — Cede, c, Hepar sulph., Lach., Pod. " chocolate-like. — Ars., China, Lach. " clay -color eel. — Hep. snip. " green. — Aeon., Aloe, Apis, Ars., Bry., Calc. c, Cham., China, Croton tig., Bute, Gamb., Hep, snip., Iris v., Mag. carb., Merc, c, Merc, v., Natr. s., Nuxv., Podo., Puis., Rheum, Sulph., Tart, emet., Yerat. a. grass green. — Ipecac. green, like chopped spinach. — Aeon. greenish yellow. — Apis. white, with masses like tedlow. — Magn. c. whitish gray, streaked with blood. — Calc. c. yellow. — Aloes, Ant. c, Apis, Ars., Bapt., Bell., China, Coloc, Croton tig.. Diosc, Dulc, Gamb., Hepar snip., Ipec, Iris v., Lach., Lycop., Magn. c, Merc, c, Merc, v., Natr. s., Phos., Podo., Puis., Rhus, Sulphur. Tart. emet. yellow, like stirred eggs. — Cham. DISEASES OF THE ABDOMEN. 189 Color yelloic, turning green on standing. — Eheum. Bloody. — Aeon., Aloe, Apis, Am., Ars., Bapt., Bell., Bry., Calc. c., Canth., Capsicum, Cham., China, Coloc, Dulc, Ferr., Hep. sulp., Iod., Ipec., Iris, Laeh., Lye., Merc, cor., Merc, v., Nuxvom., Natr. s., Phos., Podo., Puis., Sulph., Tart, emet., Yerat. alb. Blood, great quantity of. — Merc. c. " in streaks. — Calc. carb., Sulph., Podo. Stools painless. — Apis, Am., Bapt., Borax, Bry., Camph., Cham., China, Croton tig., Ferr., Hep. sidp., Lye, Natr. s., Phos., Podop., Sulph., Yerat. a. pouring out. — Aloe, Croton tig., Podop., Sulph. copious. — Croton tig., Yerat. a., Podop. membranous. — Canth. , Colch. shooting out. — Crot. tig. small. — Aloe, Ars., Caps., Cham., Croton tig., Merc, v., Merc, c, Nux vom. odor of stools. Odor coppery. — Iris v. " eggs, rotten-like. — Cham. " putrid. — Ars., Bapt., China, Ipec, Podop. " soar. — Eheum, Sulph. TIME WHEN STOOLS ARE WORSE. Drinking, after. — Ars., Crot. tig., Ferr., Lach., Podo., Sulph., Yerat. a. Drinks, alcoholic, after. — Lach. Eating, while.- — Ferr. Fright and fear, after. — Gels. Grief. — Coloc, Gels., Ign., Phos. ac. 190 DISEASES OF THE ABDOMEN. Morning, 6 A. M. — Arg. n. Morning, before rising. — Sulph. Morning, after rising and moving about. — Bry., Nat. s. Overheating, after. — Aeon., Aloes, Ant. c. Smell of broth, eggs, fish, or meat cooking. — Colch. Veal, after eating. — Kali nit. Vexation, after. — Coloc. SYMPTOMS BEFORE STOOLS. Colic. — Aloes, Bapt., Canth., Cham., Coloc., Diosc, Dulc., Gamb., Ipec, Lye, Rheum, Verat. a. Difficulty of retaining stool. — Aloe, Sulph. Fainting. — Ars., Dig. Flatus, desire for, but knows not whether wind or feces will escape. — Nat. mur. Nausea. — Aeon., Bry., Calc. c., Dulc., Ipec, Merc. v. Urging, sudden. — Phos., Podo., Sulph. Vomiting. — Ars. , Dig. , Ipec. SYMPTOMS DURING STOOLS. Colic. — Cham., Coloc, Crot. tig., Podo., Iris y. Worms, discharge of. — Calc. c, Cina. Back, pain. — JEscul. Bladder, urging and bearing down. — Canth., Merc. c. Faintness. — Crot. tig. , Verat. a. Hunger. — Aloe. Nausea. — Ipec, Merc, v., Verat. a. Paleness. — Verat. a, Never get done feeling. — Merc y. , Merc cor. Vomiting. — Ipec, Verat. a. SYMPTOMS AFTER STOOLS. Colic. — Diosc, Puis., Kheum, Coloc, Merc, c, Merc y., Podo., G-ambog\ DISEASES OF THE ABDOMEN. 191 Empty feeling in abdomen. — Verat. Anus prolapsus. — Ars., Merc. Poclo., Sulph. Anus, smarting. — Canth., Gamb., Sulph. Anus, weight, sense of. — Aloe. Exhaustion. — Yerat. a. Fainting. — Aloe. Faintness. — Verat. Piles. — Aloe. Relief of colic. — Gamb. Strain, desire to. — Merc, v., Merc, c, Caps., Canth., Ipec. Vertigo. — Croton tig. Vomiting. — Arg. n. SYMPTOMS OF REMEDIES. Aconite. — Especially useful in the beginning of acute diseases of the bowels, and often cuts short dysentery and even cholera morbus. It resembles Dulc. The stools are watery, green, or bloody. Small, painful, very frequent stools. Indicated iu diarrhoea or dysentery after getting wet or taking cold ; skin hot and dry, great thirst ; intense restlessness ; full, hard, very quick pulse. Aloes. — Is especially indicated when the stools are yellow, fecal, or bloody ; jelly-like mucus, or small dysenteric stool. Stools occur most often in the early morning, in hot damp weather. There is also a great sense of weakness in the back passage, as if he could not restrain the movement or dare to pass wind. Loud gurgling in the abdomen, as of water running out of a bottle. Hunger with an attack of diarrhoea is a strong indication, especially when this symptom is met with in children. Aloes resembles Sulphur. Antimony crudum. — Diarrhoea from disordered 192 DISEASES OF THE ABDOMEN. stomach ; nausea, vomiting, and heavily coated tongue. Indicated in diarrhoea from overheating ; in aged per- sons. Absence of thirst is a distinguishing symptom of this remedy. Apis met. — In infantile diarrhoea and cholera infan- tum, Apis is a good remedy. The absence of thirst, with a dry tongue, and dry hot skin, a bruised soreness of the abdominal walls, are guiding symptoms ; when the stools are greenish, yellowish, watery, involuntary, stupor with shrieks occasionally. Arsenicum. — This remedy is often prescribed when it should not be for diarrhoea, and requires the follow- ing symptoms to be present : violent, unquenchable, burning thirst, with frequent drinking of small quanti- ties of water ; great restlessness ; constantly changing place ; vomiting, immediately after eating or drinking; stool is composed of thick dark green mucus ; brown mucus ; bloody, dark, watery, offensive stool, smelling like carrion. Pain may be present or it may not ; more often great pain. Borax. — Diarrhoea in nursing infants ; stools light yellow, slimy mucus ; green mucus, painless ; constant vomiting, with painless diarrhoea ; frequent urination, preceded by cries ; dread of downward motion, as swinging, riding in an elevator, or rocking. Camphor. — Is principally useful in the very com- mencement of diseases of the bowels. Eice- water discharges, generally painless. Attack very sudden. Sudden and great sinking of strength. Icy coldness of the whole body. No thirst. Camphor is most promi- nent in collapse, when stools and vomiting stop, and the end seems near at hand. DISEASES OF THE ABDOMEN. 193 Cantharis. — Stools white or reddish mucus, like scrapings of the intestines. Burning after urination. Chamomilla. — Diarrhoea during dentition when children cry very much, and are only stilled by being carried about. Eedness of one cheek. Stools green, slimy mucus ; mixed white and green mucus, smelling like bad eggs ; compare Cina. After Cham., give Merc, v. or Sulphur. China. — Nightly diarrhoea; absent during the day or occurring after meals. Eesembles Arsenicum in its thirst. Abdomen full of wind. Emission of large quan- tities of flatulence ; yellow water. Stools undigested, putrid. Colic before stool. Colchicum. — Painless cholera morbus, small stools. The smell of fish, eggs, fat meats, or broth causes nausea. Autumn diarrhoea or dysentery ; exhaustion after stool- ; child falls asleep on the vessel, as soon as the straining ceases ; great thirst. Colocynth. — Saffron, yellow, frothy liquid stools; first watery and mucus, then bilious, and lastly bloody ; odor like brown paper burning ; great pain in the bowels ; must bend double ; great urging ; nausea when the griping comes on. Mercurius is needed afterwards. Croton tig. — The three symptoms most character- istic of this remedy are, the yellow watery stool, sudden expulsions, and the necessity to go to stool after drinking or eating. Infants while nursing pass stool. Besides the yellow stool, brownish green sometimes. Stool undigested, excessive nausea and vomiting. Dioscorea. — In cholera morbus this remedy has often been very efficacious. It resembles Colocynth in 194 DISEASES OF THE ABDOMEN. the griping pains, which are excruciating, but the pain differs from those of Colocynth in this, that the pains shift suddenly and appear in distant localities, as the fingers and toes. Dulcamara. — Is indicated in cases directly traceable to taking cold or to a change in the weather from warm to cold. In such cases the remedy becomes all suffi- cient, whether the attack is diarrhoea or dysentery. Pains must be present, as a rule. Ferrum met. — For chronic diarrhoea in adults or children. Stools painless, undigested, sudden, gush- ing, odorless ; worse while eating or drinking, at night, during pregnancy. For patients whose face flushes easily on the least excitement or exertion. Gambogia. — Stools thin, yellow, fecal, coming out all at once with a single somewhat prolonged effort. Eyes itch ; child rubs them often. This is one of the most important remedies in the treatment of acute or chronic diarrhoea. Gelsemium. — Diarrhoea after fright, fear, grief, bad news, or excitement. The anticipation of any unsual ordeal, as appearing in public, or submitting to a surgi- cal operation, is sufficient to excite diarrhoea. This rem- edy removes the mental agitation, and diarrhoea as well. Hepar sulph. — Chronic diarrhoea from abuse of mercury or quinine, cinchona bark, and after suppression of the itch. Craving for condiments. Empty, sinking feeling of the stomach ; strong and comfortable feeling after a meal. Frequent desire to loosen the clothing about the waist, particularly a few hours after a meal. Stools are light yellow, fecal, green, watery, undigested, smelling like old cheese. DISEASES OF THE ABDOMEN. 195 Iodine. — Chronic diarrhoea. ' ' The more the patient eats, the thinner he grows." Digestion being rapid and the appetite good, yet in spite of this, the emaciation goes on. The stools are watery, foamy, whitish mucus, whey-like ; worse in the morning. Ipecacuanha. — Diarrhoea, cholera morbus, or cholera infantum when the continuous nausea is the guiding symptom to its use. The stools are green as grass. Ipecacuanha should be followed by some other remedy, probably Arsenicum. Iris v. — For watery, yellow diarrhoea ; burning from the mouth to the anus ; violent vomiting of an extremely sour fluid, which scalds the throat. The burning at the anus as though on fire, and the vomiting, lead to the selection of this remedy. Lycopodium. — For chronic diarrhoea and cholera infantum. The symptoms which lead to the selection of this remedy in chronic diarrhoea are those of the stomach. A little food seems to fill the stomach full, and causes fulness and distress of the abdomen. Faintishness during the day. Bumbling and rolling of wind in the abdomen, especially in the left side. Child screams before urinating. Child springs up from sleep, terrified and screaming ; is angry and cross, striking, kicking, and scratching every one who ap- proaches. Magnesia carb. — In diarrhoea when the stools are green, watery, frothy, with green scum like that on a frog pond. White lumps, like masses of tallow, float- ing in the green, watery stool. Merc. cor. — Dysentery, with intense burning in the urethra . 196 DISEASES OF THE ABDOMEN. Merc. viv. — Diarrhoea, dark, greenish stools, bilious, like stirred eggs. "Never get done feeling." Sweats on the least exertion. Nux vom. — Thin, brownish mucus ; thin, bloody mucus ; back ache as if broken ; constant urging. Nux is often of first importance in dysentery ; and because more often used in constipation, it must not be forgotten in diarrhoea. Podophyllum. — Profuse gushing stools, each seeming to drain the patient dry, but soon he is full again. In painless cholera morbus, Podophyllum is very frequently indicated. There may be violent cramps of the feet, and yet the remedy is indicated if the stools are as mentioned. Pulsatilla. — Diarrhoea without thirst ; loss of taste ; chilliness. Nightly diarrhoea is very characteristic of Pulsatilla. Rheum. — Diarrhoea during dentition ; sour- smelling stool ; in fact, the whole child smells sour. Sulphur. — Early morning diarrhoea ; sleepy as soon as the stool is passed ; averse to washing. Stomach feels empty and weak every day at eleven a. m. Veratrum alb. — Profuse watery, bilious stools; worse at night ; cold sweat on the head ; vomiting ; after stool, weak and faint, has to lie down ; cramps of the extremities. CHAPTER XXV. DISEASES OF THE RECTUM. Prolapsus of the Rectum. Prolapsus of the rectum is a protruding or turning out of the intestine at its lowest part ; if it occurs it is when the bowels move, or when much straining is necessary, or it takes place in sitting or walking. To replace the protrusion, put the patient on his knees, and apply cold cloths to the parts protruding. If the cold application gives pain, or the bunch does not dis- appear, try hot water ; failing in these, anoint with sweet oil, then slowly and gently press with the fingers backwards and upwards. Podophyllum will generally relieve either children or adults, if administered internally. Sepia for adults when prolapsus occurs when walking. Obstinate cases sometimes require surgical interference. Hemorrhoids, or Piles. This disease consists principally of little bunches situated outside the anus (external piles), or within the rectum (internal piles), caused by over- distention of the veins situated in this part of the body, and the forma- tion of little clots of blood, which causes inflammation and swelling. If the hemorrhage or distention is at all extensive, the disease is very painful. Piles may occur with diarrhoea or constipation, and they may be eithe^ 198 DISEASES OF THE RECTUM. constant or intermittent. The symptoms of this affec- tion are as follows : Preceding the appearance of any local trouble in the rectum, there is often noticed some disturbance of digestion ; the bowels are most generally costive, though there may be diarrhoea, dull pain in the head and back ; gradually there is noticed a soreness on defecation, or perhaps some slight hemorrhage. Upon examination one or more little, small bunches are felt about the anus ; there is itching, burning, and great sensitiveness to pressure. These symptoms may continue for months, or they may soon pass off. The treatment of this affection should be most careful, and by homoeopathic remedies. The common method among the old-school doctors is to cut them out, inject them, or suppress them with ointment. Not unfre- quently, after a sudden suppression of piles, a disease of more dangerous character appears in their stead. Piles are only one of the symptoms of some general disorder, and therefore should be treated as such, and not simply suppressed. Medicines will stop this affec- tion, and at the same time remove the cause ; but the patient should regulate his habits, if faulty. If he sits a great deal, try and take more exercise. Avoid stimu- lants, alcohol, beer, and coffee ; drink plenty of water, and eat little meat. Active exercise should not be taken during the threatening symptoms of an attack of piles, or during their early manifestation. Smoking often causes a sympathetic irritation of the anus, and this habit should be restrained. Wash the anus night and morning with warm water, and apply after this a little sweet oil to the parts. Other diseases of the rectum besides piles give rise to bleeding and DISEASES OF THE RECTUM. 199 soreness. Fissure of the rectum is very often mistaken for piles by patients because of the discharge of blood. As a rule, when there is great pain on defecation (not after), it is not piles, but a fissure that is the cause. A fissure is a small tear in the lining of the rectum which sometimes becomes very large and angry, amounting to an ulcer. The pain while defecating is excruciating, ceasing entirely a short time afterwards, and not returning at all until another stool ; but it often continues very severe and of a burning character. The causes of this affection are straining, or the passage of a very hard, dry stool, causing a tearing of the lining of the rectum. Uterine displacements are often the cause, and is frequently the result of confinement. The treatment consists in regulating the diet, so that the stools will be soft and easily defecated, and the internal administration of some homoeopathic remedy selected from those mentioned under the heading of "Piles." Aconitum. — For piles when blood is discharged, and there are shooting pains and pressure in the anus. The small of the back feels as if broken or bruised. Indicated more especially when the piles are inflamed and there seems to be fever. JEsculus hep. — External piles, bleeding slightly, at- tended with constipation, and a sensation as of sticks in the rectum. Aching pain and lame feeling in the back. Aloes. — External piles, protruding like a bunch of grapes ; hot and sore, relieved by cold water. When urinating, he has a feeling as though some liquid dis- charge from the bowels would take place at the same time ; much flatus with stool ; fissure or painful ulcer 200 DISEASES OF THE RECTUM. Arsenicum. — Piles, with sensation as if hot needles were sticking into them ; great burning ; back feels as if broken ; impossibility of stooping ; feverish ; fissures of the rectum, relief from heat ; restlessness. Cede. carb. — Profuse, bleeding piles ; protruding, painful when walking, better when sitting ; too early and too profuse menses; cold feet, as if one had on damp stockings ; after suppressed flow from piles, constant giddiness ; heaviness and fulness of the head. Causticum. — Piles large, painful, stinging ; burning when touched, hindering stool. Chamomilla. — Bleeding piles ; hemorrhoidal colic ; angry, peevish, and ill-humored. Collinsonia. — Bleeding piles, incessant, though not profusely, or protruding piles without bleeding ; sen- sation in the rectum as if sticks, sand, or gravel had lodged there ; growing worse as evening approaches till late at night ; better in the morning ; constipation or diarrhoea ; pain in the stomach, with loss of appetite. Hydrastis. — Piles ; constipation ; fissure of the anus. Hamamelis. — Profusely bleeding piles, characterized by soreness, burning, weight, and fulness ; at times rawness of the anus. . Ignatia. — Piles after confinement; violent stitches which penetrate deeply, with itching and crawling in. the anus, when much blood is discharged, or the rectum protrudes considerably after each stool. Lachesis. — Piles ; very painful ; a stitching pain is felt to go through them, especially when coughing or sneezing ; beating like little hammers in the rectum ; indicated especially when piles occur at the critical age. DISEASES OF THE RECTUM. 201 Muriatic acid. — Large, protruding piles, exquisitely sensitive to touch or pressure ; even the sheet is in- supportable. Nitric acid. — Very painful fissures, especially after stool. Nux vom. — All sorts of piles following the use of purgatives, and following the use of external and inter- nal allopathic treatment ; m persons of sedentary habits, or overindulgence in stimulants ; ineffectual urging ; constipation, headache. Podophyllum. — Piles and falling of the rectum, with diarrhoea or constipation, with flatulence and headache. Sulphur. — Suppressed flow from piles causing head- ache, dizziness, palpitation of the heart, pain in the pit of the stomach, with difficulty of breathing ; loss of appetite ; faintness at eleven a. m. ; sleepy by day, sleepless at night. Pruritus Ani and Eczema. Pruritus ani, or, as it may be w^ell called, painful itching of the anus, is a most distressing malady. It may be caused by various general or constitutional disorders and derangement, hereditary predisposition, or in debili- tated conditions of health. The disorder is frequently induced or kept up by habits of too free eating and drink- ing. It is however met with in very abstemious persons. Particular articles of diet or drink affect some persons in a remarkable manner. Lobster, crabs, salmon, bring on the affection, likewise drinking of stimulants, as cham- pagne, ale, and coffee ; smoking also may be a cause. In women it may result from uterine disorders, or an accompaniment of pregnancy. Doubtless there are 202 DISEASES OF THE RECTUM. many cases of pruritus for which we are unable to assign any ordinary cause, and it then may be con- sidered a purely nervous disorder, being aggravated or occasioned by mental worry or overwork. The disease in the majority of cases is worse at night, especially when the patient gets warm in bed. The more the patient yields to the inclination to scratch or rub the parts, the worse he makes himself. Eczema is an inflammation of the skin causing an eruption around the anus, and is recognized by an increased redness extending outside the back passage, which may secrete a thin fluid. It is like pruritus in its intense itching, but the latter disorder shows almost no change in the skin around the anus. Eczema may be caused by piles, or the result of violent scratching induced at first by pruritus. The treatment should be by internal medication in both disorders. Dr. Allingham, of London, in his work on rectal diseases, speaks of the following device for the relief of pruritus : ' ' When the irritation of pruritus is so great that the patient is quite worn out for want of rest, I have for years recommended the introduction of a bone plug, shaped like the nipple of an infant's feed- ing bottle, with a circular shield to prevent it from slipping into the bowel ; the nipple should be about an inch and a half in length, and as thick as the end of the forefinger. This is most effectual in preventing the nightly itching ; a good night's rest is almost sure to result from its use, but I advise it to be worn only every other night." If these disorders, pruritus or eczema, are due to any of the known causes mentioned, a cure cannot be expected unless it is removed. DISEASES OF THE RECTUM. 203 Remedies. — Arsenicum, Calc. carb., Lycop., Petro- leum, Merc, v., Eumex (if the itching is better from warmth and worse by cold), Sepia, Sulphur. Abscess in or near the Anus. An abscess is, in the majority of cases, the beginning of a fistula, or false passage, so called ; it usually forms just outside the anus, but it may form in the rectum and open into the bowels. An abscess in this locality is like a gathering or boil in any other part of the body. They may come quickly or be months in forming. Persons having an abscess in this locality usually do not consult a surgeon, as they should, but considering it unimportant and only needing to be poulticed to hasten it to break, and then think that is the end of the trouble. No greater mistake could be made, for, as stated above, it is usually the beginning of a fistula. Ninety-nine cases out of a hundred will result in this. Perhaps the abscess will discharge quickly, giving little discomfort, and then fill again and break ; an abscess near the rectum seldom closes entirely. So the case goes on until, tired of this, the patient seeks the advice of a surgeon or physician, only to be told he has a fistula. Fistula in Ano. A fistula is a permanent, abnormal opening into the soft parts, with a constant discharge ; it is a deep, nar- row, chronic abscess. Wherever such an opening exists, and they may form in any part of the body, it is known as a fistula. Fistula in ano refers to false openings into or about the back passage. There may be one or more openings. When one opening exists, it is known as a 204 DISEASES OF THE RECTUM. blind external or internal fistula, or incomplete fistula; when there are two openings, complete fistula. The blind external fistula is one that has only an opening on the outside. A blind internal fistula has one or more openings situated anywhere in the rectum ; it is the most painful, though fortunately the rarer form. A complete fistula is one that opens into the rectum and has another opening on the skin. Fistula is the most common rectal disease. Men are more subject to this affection than women. The causes of fistula, or abscess ending in fistula, may be specified as resulting from injury to the anus, sitting on damp seats after exercise, when the parts are hot and perspiring ; con- stipation ; foreign bodies, such as fish bones or rabbit bones, which have been swallowed and have reached the anus in an undigested state. Abscess and fistula may occur after fevers or debilitated conditions of the system, or they may proceed from a tubercular or scrofulous tendency, inherited or acquired. As it has been stated, fistula most frequently commences by the formation of an abscess immediately beneath the skin, just outside the anus. Treatment. — Whenever an abscess forms, as stated above, do not neglect it at all, or pass it over as a mere trifle. Immediately consult a good homoeopathic phy- sician. Internal medication will result in a cure in these troubles, as well as in many other so-called sur- gical cases, and without the use of the knife. All cases of fistula are not operated upon even by the allopathic physician, knowing, as he does, that they are the expression of some deep constitutional disease, and to try to close this escape would hasten the DISEASES OF THE RECTUM. 205 progress of the disease. Almost all surgeons and phy- sicians have witnessed the ill effects of surgical inter- ference. Therefore, while advising the absolute impor- tance of attending to the earliest symptoms of trouble in or about the anus, it cannot be too forcibly urged that these affections should receive proper homoeopathic treatment. CHAPTEE XXVI. DISEASES OF THE LIVER. Infi animation of the Liver. Inflammation of the liver is characterized by more or less painful fulness of the region of the liver, the pain extending towards the right shoulder blade, and more especially pain under the right shoulder blade ; by headache, nausea, and vomiting in some cases ; by constipation or diarrhoea. One of the following reme- * dies will be found beneficial : — Belladonna. — High fever; throbbing headache; moist skin ; region of the liver painful and sore to touch ; worse lying on the right side ; pains go to the shoulder and neck. Bryonia. — Stitches in the right side, with painful sensitiveness of this region to hard pressure or deep breathing ; great thirst for large quantities of water ; constipation ; bilious vomiting ; dizziness and nausea when rising from a recumbent position. Laches is. — Liver complaints at the change of life ; after ague ; cannot bear any pressure about the waist. Acute pain in the liver extending towards the stomach. China. — Pain in the region of the liver ; cannot bear the slightest touch ; food tastes bitter or too salt ; thick, dirty coating on the tongue. DISEASES OF THE LIVER. 207 Jaundice. Jaundice is not a disease, but only a symptom, and consists of a yellow discoloration of the skin. The so- called liver spots have no relation to the diseases of the liver. Jaundice is one of the symptoms of liver disorder, or some general disturbance of the system, which causes the bile to escape into the blood. As a rule, this affection is not serious, although when ac- companying peritonitis or pneumonia, or the hue of the skin becomes very dark, as in black or green jaundice, it is an unfavorable sign. Jaundice may make its appearance during pregnancy. Infants very often become very yellow a few days after birth ; it should not be mistaken for the slight yellowish discoloration of the skin which in most children is seen a few days after birth, and is of no importance as a symptom. In this latter condition the whites of the eyes are entirely clear. • Merc. v. — Is usually sufficient if the patient has not already abused this drug ; in that event, China will be preferable, which may be followed in obstinate cases by Hepar s., Sulphur, or Lachesis. Chamomilla. — Jaundice following a fit of passion. Nux v. afterwards or abuse of Ehubarb. Belladonna. — Jaundice after abuse of Cinchona bark or Mercury. CHAPTER XXVII. DISEASES OF THE URINARY ORGANS. The urine is not only an index of the condition of the kidneys, but it also is a valuable indication of the condition of many other organs, and to some extent it throws light on the workings of the nervous system. Physicians depend upon the chemical and microscopical examination of the urine, together with a knowledge of the quantity passed each day. The quantity is diminished in acute diseases, in fevers, in cholera, and in the early stages of dropsies. In some forms of Bright' s disease the quantity is lessened ' throughout, and for the most part in the last stage of all forms. On the other hand, the urine is increased in hysteria, and other forms of kidney diseases, except Bright's. In bladder troubles, urination is very frequent, and is a marked symptom, although the quantity is not always increased. The color is often a guide to the condition of the system. Food and medicine as well as disease affect it. A red aspect is apt to be associated with an admixture of blood ; very pale urine denotes an increase of the watery constituents. In fevers the urine is very dark ; a dark yellowish hue of the discharge is indicative of bile, but a similar tinge may be present when rhubarb has been taken. Strong coffee darkens the urine. In digestive disturbances the urine on standing shows the presence of sediments, either whit- ish or like brick dust. It is always advisable to have DISEASES OF THE URINARY ORGANS. 209 the urine examined occasionally, for by so doing the earliest stages of a disease may be recognized, that may not assert itself until it becomes incurable Involuntary Emission of Urine, "Wetting the Bed. Children and adults are sometimes affected by this disorder. It more often occurs in the very young and the aged. Involuntary urination when coughing requires Caust. or Puis. Involuntary urination while passing wind, Puis. Involuntary urination during the day, Ferrum. Involuntary urination at night, Caust., Sep. Children who wet the bed at night, if it is not from carelessness, can be benefited by treatment. Do not put children to bed immediately after eating. Painful Urination. Painful urination may arise from inflammation of the urinary passages, the bladder, or unclean diseases. Many persons are careless regarding urination. It is very harmful to neglect this function by not urinating when the desire is present. Many people have suffered intensely, and sowed the seeds of long-lasting and incuable disease from this neglect. It is important to drink freely of water, particularly when the urine becomes scanty ; there is no better diuretic. Aconite. — For the most common cases, when there is painful urging ; for children if they put their hands to the parts and scream ; when no urine or very little passes ; for women and children. Cantharis. — Pain in the region of the kidneys, and urging to urinate ; fruitless efforts to urinate with great 210 DISEASES OF THE URINARY ORGANS. urging ; heaviness in the bladder ; feels sore on slight- est motion. Cannabis sat. — Soreness and inflammation of the kidneys and bladder ; great difficulty in passing even a few drops, with smarting, burning, and desire to pass more ; burning while passing water, but especially just after ; desire to urinate continues after having passed water. Apis met. — Desire to urinate, only a few drops voided or not any ; inflamed bladder ; after abuse of Cantharides ; difficult urination with children. Merc. v. — Region of the bladder sore to touch ; urine passes only in drops, or a thin stream ; sudden, irresistible desire ; urine involuntary. Lycopodium. — Child screams with pain before pass- ing water ; red sand on the diaper ; bearing down over the bladder ; frequent desire to urinate ; pains worse lying down, especially at night ; urging to urinate ; must wait long before it will pass. Cepa. — Frequent urging ; the urine passes by starts, or only in drops, is bright red and burning ; for chil- dren when they scream, particularly when you press on the region of the bladder with your hands ; after a cold, or exposure of the abdomen to cold air ; getting the feet wet. The Passing of Bloody Urine. Bloody urine follows external injuries, abuse of liquors, sexual excesses, inflammation of the kidneys. Give Arnica if produced by injuries ; Kux vom., for abuse of liquors ; China, from excesses ; Hepar sulph. , if the complaint keeps recurring ; Terebinthina, for bloody urine caused by hemmorhage from the kidneys. CHAPTEK XXVIII. DISEASES OF THE SKIN. Diseases of the skin, or most of them, should be treated by a physician. It is a nearly universal opinion of the allopathic physicians that skin diseases require external applications, and in some cases of a very pow- erful description. Eczema (salt rheum), itch etc., are looked upon as being purely external local diseases, requiring only external washes to dispel them. Homoeo- pathic physicians, with few exceptions, do not so believe ; they hold that no disease or symptom should be suppressed by local measures alone. Because an eruption is something visible and tangible, should it be driven away ? This would be all well enough, if a cure were made ; but in the vast majority of cases of skin diseases that are so treated, they only disappear for a longer or shorter time, or the causes which produce the eruption, being interfered with, assert themselves in other forms of disease, perhaps more dangerous and exceedingly difficult to cure. "When the system is affected with some chronic disease which threatens to destroy life itself, nature often tries to avert this danger by substi- tuting and maintaining a local disease, on some exter- nal part of the body ; the presence of the local disease for a time arrests the internal evil, without, however, being able to cure it or lessen it essentially. When an old-school physician, acting under the impression that he 212 DISEASES OF THE SKIX. is curing the whole disease, destroys the local symptom by external remedies, nature will offset it by awakening and extending the inner disease. This is popularly defined by saying that the external treatment had driven the whole disease back into the system. It becomes apparent, upon reflection, that no external disease (not caused by external injuries) can be origi- nated, hold its place, or, least of all, become worse, without some internal cause. An external disease could never make its appearance without involving the entire state of health, and without the participation of the living whole. Our bodies are an indivisible whole in feelings and functions, that not even an eruption on the lips or a case of felon can be accounted for, without assuming a previous or simultaneous diseased state of the body. In order to combine both safety and thor- oughness in the medical treatment of external diseases not dependent upon external injuries, all curative measures should be planned with reference to the state of the ivhole system, in order to effect the obliteration and cure of the general disease. This is unequivocally verified by experience." From the statements above given, it is apparent that it would be useless to give any specific indications of treatment for skin diseases, other than the few varieties mentioned. Urticaria (Nettle Rash), Hives. As the name indicates, this eruption resembles the patches or "wmeals" caused by the stings of nettles. The wheals are solid bunches or elevations of the skin, of a perfectly white or pinkish hue with an abrupt margin, and surrounded by a red margin or halo. DISEASES OF THE SKIN. 213 They are either circular or oval in shape, and vary- greatly in size. There is always a burning and stinging sensation with extreme itching, which causes fierce scratching, which increases the trouble, as the skin of the whole body may first itch, and after scratch- ing these wheals appear. Nausea and vomiting, loss of appetite, and furred tongue usually precede the eruption. The causes may be either external or inter- nal. Among the external causes may be mentioned the contact of the skin with nettles ; the bites of mosqui- toes, bedbugs, lice, and fleas often induce urticaria. The internal causes comprise such articles of food as fish, clams, oysters, lobsters, crabs, pork, eggs, honey, mushrooms, cucumbers, berries, fruits. Urticaria may result from mental emotion. The disease sometimes alternates with asthma. Aconite. — If the eruption is preceded by much fever, with hot, dry skin, thirst, hard, quick pulse, extreme restlessness. Pulsatilla. — Urticaria produced by eating fruits, pastry, or pork ; diarrhoea in the morning ; chilliness ; especially suitable for women and children. Bryonia. — When the eruption " strikes in" and is followed by difficult breathing ; pain in the breast ; net- tle rash, when the stinging is made worse by touch. Hepar sulphur. — Urticaria with ' ' cold in the head" and croupy cough ; eruption begins on the arms and chest ; worse in the open air ; also chronic cases. Cepa. — Urticaria with catarrhal symptoms ; erup- tion begins on the thighs ; is better in the open air ; sleepiness. Arsenicum. — If caused by eating unripe fruit ; 214: DISEASES OF THE SKIX. worse at night ; also for suppressed eruption ; thirst for small sips of water often. Cede. carb. — When the eruption always appears more after cold or washing, or has been suddenly repelled. Lycopodium and Bovista. — Will be found service- able for chronic forms of this disease. Boil, Furuncle. A boil is too well known to be explained. Some persons seem to have a peculiar predisposition to boils ; they also frequently follow acute fevers and other dis- eases. Never use a knife or allow one to be used, because it never does any good, but always harm, as it increases the inflammation and protracts the healing process. Keep the surface of the skin over the boil lightly covered, in order that the clothing may not irritate it, and take one of the following remedies internally : — Arnica. — For boils that occur from injuries or over- heating and bruising of the skin, as in horseback riding ; for many small and painful boils, one after an- other ; extremely sore. Crotalus. — Parts are bluish and discharge scanty ; diarrhoea. Anthracinum. — Bluish 'boils, mostly on the face, arms, hands, and fingers, or uncovered parts in general. Lachesis. — Boils having a bluish hue, and sur- rounded by small pimples ; better from warmth, Hepar follows Lachesis well, if, after breaking, the dis- charge is scanty and pus does not seem sufficient to relieve the trouble. DISEASES OF THE SKIN. 215 Sulphur and Calc. carb. — If there is a frequent return of boils. Carbuncle. Carbuncle is larger and harder than a boil. It ap- pears more like a number of boils in one spot, several small white spots, or "heads," being present in a group ; the extent of inflammation is greater, and the color of the diseased skin looks bluish or purple. Carbuncle is more apt to occur in the debilitated. Its favorite situa- tion is on the neck or back, near the spine. A carbun- cle should never be cut ; an incision is always injurious, and often the cause of death. Anthracinum. — Carbuncle with horrible, burning pains, or discharge of watery, offensive pus ; hard spots, like knots, under the skin ; the most important remedy for carbuncle. Arsenicum. — For the intense, burning pain in car- buncle ; thirst ; restlessness. Carbuncle feels better from warmth. Secale. — Carbuncle worse from external warmth. Abscess. An abscess differs from a boil in appearance, there being no white head or point containing a little pus, as we see in boils, but the skin is swollen, red, and shiny. The pain is usually severe, and as the abscess "ripens" there are marked chills. If proper remedies are given from the beginning, it is seldom necessary to open an abscess. Belladonna. — At first, for the throbbing pains, and then Merc. v. if the abscess shows no sign of going away ; give Hepar sulph. to hasten the formation of 216 DISEASES OF THE SKIX. pus ; after it has broken give Silicea. Hard and swelled glands on the neck and under the chin or ears, Merc, v., Dulc., and Calc. carb. are principal remedies. Felon, Whitlow, Runround, Panaritium. These are terms for an inflammation which attacks the fingers or thumbs, which terminates in the forma- tion of pus. There are two varieties of felons, a super- ficial and a deep-seated one. The superficial form, called whitlow or runround, is the most common perhaps, and is an inflammation of the skin around and beneath the nail, commencing either at the side of the finger or at the end. A runround begins with a slight sense of soreness felt whenever the finger is touched ; after a short time there is noticed a slight redness about the sore spot, but not much swelling ; the pain soon is throbbing in character, and the patient may feel generally miserable ; after two or three days of pain a small accumulation of pus will be visible just under the skin, and if pricked a slight discharge of matter will follow. Instead of the trouble stopping here, the redness spreads and gradually more of the finger is involved in this process, until the skin of the entire end of finger is seen to be filled with matter, and underneath the finger nail also. The dis- ease may affect all the fingers or be confined to one. The cause of this affection is probably a " run-down" state of the health. The deep-seated form is called a felon, and the inflammation involves the deeper struc- tures of the finger ; . even the bone itself is often attacked and may be destroyed, followed in such cases sometimes by the loss of one or more joints of the fin- ger. Even when the inflammation does not attack the DISEASES OF THE SKIN. 217 bone, and is confined to the muscles and tendons only, the finger is left stiff and deformed. The pain of a felon is much severer than in the whitlow, and is often ex- traordinary in severity, depriving the patient of sleep for days and nights together. At first the pain is like that caused by a small splinter or little thorn, gradually growing worse until it is an intense, throbbing, tensive pain, extending often as high as the elbow or shoulder, greatly aggravated by a depending position, of course. There is great swelling, sometimes enormous, involving the finger, hand, and wrist. As the inflammatory action is deep, the pus is liable to burrow along the fin- ger and hand, and unless timely surgical interference is made by deeply incising the tissues down to the bone itself, the consequences may be as stated above, loss of the finger. The causes of felons are unknown, but probably due to constitutional defects. Eest is of great importance in both these affections ; keeping the hand elevated relieves the severity of the pain somewhat ; poultices are sometimes useful. Avoid putting the hands in hot and cold water alternately. Amm. carb. — "I have seen the nightly pain, which had deprived the patient of sleep for several nights, relieved in a few hours, and the disease arrested at the same time, by one or two doses of Amm. carb., 500th dilution." (Raue.) Arsenicum. — For intense burning like a fire, with restlessness ; worse about midnight. Anthracinum, after Arsenicum, if it does not relieve the burning. Lachesis. — When the parts look bluish. Ledum. — Eunround, in consequence of the prick of a thorn, splinter, or needle. 218 DISEASES OF THE SKIN. Natr. sulpli. — Inflammation at the root of the nail ; pus forms ; very painful ; relieved out of doors ; the patient looks pale and sickly ; head feels weary and dull, especially mornings. Graphites. — Eunround which discharges, but does not heal ; proud flesh follows. Patient inclined to humor, especially behind the ears. Hepar. — To hasten formation of pus. Silicea. — Bone affected ; proud flesh; terrible pain; very important after Hepar. Dioscorea. — Disposition to felons, with a tendency to colic. Whether met with this combination or alone, Dioscorea will usually cure a whitlow if taken early when the pains are sharp or the pricking sensations, so com- mon in the beginning, are" felt in the finger ; it will greatly relieve and hasten the termination if taken soon enough. Ingrowing- Toe Nails. Ingrowing toe nails cause great pain, and sometimes the skin becomes so inflamed that an ulcer is formed. In other cases walking is so painful that they incapaci- tate the patient, making an invalid of him in a certain sense. Ingrowing toe nails are usually caused by cut- ting the corners of the nails, making them round like the finger nails ; no greater mistake is made than by doing so, for toe nails should as a rule be shorter in the middle than at the sides, and instead of cutting them in a convex fashion they should be concave. If the cor- ners of the toe nails are cut shortest, the tendency is for the points to grow in, as this part of the nail grows fastest, and then the nail acts as any foreign body in the flesh ; it sets up inflammation, and consequently DISEASES OF THE SKIN. 219 pain and soreness must follow, even ulceration. To obviate all this, those afflicted should not cut the nails until they have grown out sufficiently to allow a little lint, absorbent cotton, tin-foil, or tape to be introduced underneath the corners of the nails, and between them and the flesh; also cut a V-shaped piece from the centre of the nail. The linen threads or tape need not be introduced at once, but gradually ; bathe the feet two or three times weekly in hot water, and whenever the nails need cutting, remember that they should be longer on the sides. The nail will in consequence grow faster in the centre than on the sides now. After a few months the irritation of the flesh having been removed, all soreness is gone ; then the nail need only be cut slightly concave in the middle. The soreness arising from the growing in of the nails into the flesh will soon disappear after the patient can tolerate a small piece of lint under the corners of the nails, thereby lifting the sharp points of them out of the flesh. Sweet oil, tinc- ture of arnica externally are often of benefit in redu- cing the inflammation. Sometimes ingrowing nails ulcerate, when the person is debilitated, and then an internal remedy should be given covering all the symp- toms. The remedies most frequently called for are SiL, Sulph., Ant. crud. Chilblain, Frostbite. Chilblain is a chronic inflammation of the skin, occurring chiefly in winter, and most liable to affect children and adults whose health is not good and cir- culation is poor. Its most common site is upon the toes, although other parts may be affected. In the DISEASES OF THE SKIN. treatment of this common and annoying affection, carefnl attention mnst be paid to the general health of the patient. The feet must be warmly clad and pro- tected from exposure to cold and dampness as much as possible. Nux vom. — For chilblains that burn and the skin looks blue, or when the skin cracks. Puis. — When the skin looks blue or livid, and the chilblains itch and burn. Nitric ac. — Chilblains from slight cold ; itching, with cracking of the skin ; painful chilblains. Sulph. — Chilblains itch worse from . warmth ; feel better when the feet are exposed to the cool air. Rhus tox. — Chilblains that tickle. Corns. Corns are the result of pressure from too tight boots or shoes, also from a certain disposition with some per- sons to callous spots or corns which may be lessened by Antimony crud., Lycopodium, and Sulphur, according to temperament, constitution, and other symptoms. Eelief may be obtained by bathing the feet in hot water, and paring the corns closely, but not to make them bleed, and apply arnicated oil. The shape and size of the boots and shoes worn should be properly attended to. Sore Feet. The feet are liable to blister from long- continued walking, or from slipping of the boot at the heel, if the counters are too stiff or narrow. The heel sometimes is the seat of painful sores, which gather and break. Ordinary blisters should be treated with nothing but DISEASES OF THE SKIN. 221 water externally. If there is continuous pain, soreness, and throbbing, an abscess is probably forming, and a poultice may be of relief . Cepa. — Sore and raw spots on the feet, from friction. Lamium alb. — Blister on the heel, from rubbing of shoes ; then a smarting ulcer. Lachesis. — For abscess on the heel. Warts. An ordinary wart is a small, dry, and horny tumor, varying in size from a pinhead to a pea. They usually develop quickly, persist for a longer or shorter time, and likewise they suddenly disappear in some cases, and are entirely gone before the fact of their going is perceived. The hands, and especially the fingers, are their favorite location, but they may occur elsewhere. The cause of warts is obscure. There is no doubt respecting the contagiousness of warts. Children proba- bly often contract them from the hands of playmates who are affected. The ordinary treatment of warts varies from the mildest charm to the harshest caustic ; the latter method is to be deprecated in the strongest terms. One of the following remedies will usually dispel the trouble, if taken internally : — Warts, bleeding. — Nit. ac, Thuya. homy. — Sulphur, Thuya. flat. — Dulc, Lach. finger tips. — Caust. small. — Calc. carb.. Sepia. palm, on. — Natr. mur. fingers. — Lach., Lycop., Sulp. 222 DISEASES OF THE SKIX. Bedsores. This affection often gives a great deal of trouble to both surgeons and attendants, as well as to patients, whenever they appear. There are recognized two varieties of bedsores. The common bedsore is liable to occur in all injuries or diseases which are attended with inability on the part of patients to move them- selves or change their position in bed. The continued pressure occasioned by this enforced quiet interferes with the circulation of the skin. An additional evil is the almost impossible prevention, with even the great- est care, of some urine, perhaps but very little, from trickling into the bedclothes or down the private parts. Likewise the fecal discharge lodges about the parts, and becomes mixed with the urine, and forms a com- pound that in its results resembles the use of some blistering mixture. The second variety arises from some disease of the spinal cord or spinal nerves. The existence of this variety is proved by the fact that a person having either of these affections may be afflicted with bedsores after being confined to the bed only a very short time, while persons not confined to bed through spinal troubles do not develop bedsores for some length of time. The treatment of ordinary bedsores consists in removing the causes, as far as that is possible. Frequent change of position, so as to relieve the inflamed parts for a portion of the time, is of course beneficial. Kings of cotton cloth stuffed with hair, cotton, or wool, of such a size as to bring the pressure outside of the sore, should be carefully ad- justed. These pads are more efficacious than the rings DISEASES OF THE SKIN. 223 of India rubber and air cushions. When the presence of the urine cannot be prevented, benefit will be derived from the constant use of sweet oil or simple cerate. Bathing the surfaces of the sores with water, made acid by the addition of lemon juice, will do much to prevent the formation of an ulcer. The preventive treatment consists in never aUowing a bedridden patient to lie long in one position, and to. bathe the dependent parts with cool water and alcohol, and if only a slight redness of the skin in spots is present, apply a cool compress wet with alcohol and water, changing it every two hours. Poisoning' by Ivy. Poisoning by ivy or Ehus tox., sumac, and the dogwood shows itself by a fine, elevated eruption, generally appearing on the hands at first, but usually in a few hours the forearms, face, and other por- tions of the body become similarly affected. Before the eruption makes its appearance there is a smarting or tingling sensation in the skin ; soon after there will be noticed numerous small, thickly crowded pim- ples. The skin often becomes swoUen, and itching intolerable. The eruption usually lasts about a week, and then gradually subsides ; the surface of the skin peels off, leaving a slight redness. A fresh outbreak may now take place, even without renewed expos- ure, and in this way the eruption is sometimes pro- longed for many weeks. There is a marked differ- ence in the susceptibility of persons to this peculiar eruption. While some can handle the plant with impunity, there are others who become affected by 224 DISEASES OF THE SKIN. merely passing to the leeward of a field where farmers are burning the brush. The poisonous influence is oftentimes carried in gloves, and in knives used for cutting the branches, thereby affecting susceptible individuals. Treatment. — Croton tig. has been of great service in a number of cases, followed by Ehus tox., two hundredth dilution, a dose every other night, for one week. No local application is advisable ; simply protect the parts from the air. Eczema, Milk Crust, Salt Rheum. Eczema is the most common disease of the skin which the physician is called upon to treat. It occurs at all ages, in both sexes, and among all classes. The appearance of the skin in eczema resembles the erup- tion resulting from ivy poisoning. The eruption may not cause more than a scaling of the skin, and it may go on to the formation of pustules. The tendency of the disease is to a moisture of the surface, which is the most common form. The surface of the skin upon which the eczema appears gradually increases in thick- ness, by the drying of the moisture as it oozes out, and forms crusts, except when the eruption appears in deep folds of skin or under the arms, where the appearance is more like an unhealthy sore. The form known as ' ' milk crust " of infancy is distinguished by the for- mation of small pustules (pus points), and if situated on the face, pits the cheek, which in after years might be mistaken for the effect of variola. Another variety is known as the scaly variety ; it is the first-mentioned variety in a chronic form. Eczema is not contagious. DISEASES OF THE SKIN. 225 Allopaths believe all forms of eczema purely local, and see no possible harm in trying to drive the eruption away by strong local washes ; fortunately for the patient, they do not always succeed. Milk crust is mostly an affection of young infants. The eruption begins by numerous small white pimples, appearing in clusters, situated on the scalp and cheeks ; gradually the white spots run together and form yel- lowish crusts. The itching is usually very intense, as it is in all forms of eczema, and the child's hands have to be protected by mittens in order that they cannot scratch the skin and forcibly remove the scabs, which aggravates the disease. Usually the diet is at fault in all forms of eczema, and should be carefully regulated. Treatment of Eczema. — The disease is one so difficult to completely cure, and the symptoms upon which a prescription is prescribed are of so wide a range, it seems next to impossible to mention in a work of this kind any adequate indications for the remedies. Arsenicum, Natr. mur. , Rhus tox. — For eruptions that look very red and angry, and the surfaces involved are raw in appearance. Clematis. — For moist eczema ; worse from wash- ing in cold water, from warmth of the bed ; eruption mostly on the neck and back part of the head. Graphites. — Eczema, especially when appearing behind the ears, in the bends of the elbows, and bends of the knees. Lycop. — When the crusts have a foul smell and cause lice. 226 DISEASES OF THE SKIN. Cole. carb. — Eczema or milk crusts during teeth- ing ; scrofulous habit, swollen glands of the neck ; pot- bellied children with small necks. Ring-worm. Eingworm is a contagious affection of the skin, re- sulting from the growth of a microscopic plant. The disease begins either in the form of a group of little pimples or one large pimple, which, increasing in size, presents a circular outline. This disease resembles an eczema, from which it is told by the round appearance of the eruption in ringworm. •Treatment. — Graphites, Phos., Ars., Tellur., and Sepia are usually the remedies prescribed. Alcohol is said to destroy the parasite, if applied externally. Itching- of the Skin. Occasionally there are cases of itching of the skin without any visible eruption whatsoever. This affection may be constant or intermittent, acute or chronic. The causes are various, arising, as the disease does, in some cases from some obstruction in the circulation of the blood through the liver, or from the presence of bile in the blood. Again, it may follow vaccination, or from a general disturbance of the nervous system. The itching, which is very intense, is usually worse at night, especially after becoming warm in bed. Dolichos. — Has been very serviceable in curing a violent itching all over the body without any visible eruption. The skin may be slightly yellow, the eyes also yellow. Stools almost white. DISEASES OF THE SKIN. 227 Cantharis. — Itching as from vermin, changing place, great burning of the skin. Mezereum. — Itching of the skin, especially in old people. Sulphur. — Voluptuous itching and tingling, with burning or soreness after scratching ; worse at night when warm in bed. CHAPTER XXIX. ERUPTIVE DISEASES. Eruptive diseases, or eruptive fevers as they are called, form a group having numerous features in common. They all have a period of incubation, during which the poison lies dormant in the system, followed by a fever which is more or less severe and an eruption which is distinctly different in each disease, and which has a series of progressive stages, well defined and dif- fering in them all. They are all contagious, and rarely attack the same person twice. Measles. Measles is a highly contagious affection, sometimes prevailing as a widespread epidemic. The disease usually begins with a slight fever, the eyes look weak, slightly reddened and watery, and are sensitive to light ; frequent sneezing, with a thin watery discharge from the nose, and a dry cough ; nausea, vomiting, and some- times nosebleed ; in fact, the beginning of an attack of measles resembles a cold in the head. On the fourth day after the commencement of these symptoms a rash is perceived, appearing first on the face and neck ; thence it continues to extend until, in the course of two or three days, the whole body is covered. The rash and fever continue two or three days, then the eruption begins to fade and the fever to lessen ; and by ERUPTIVE DISEASES. 229 the ninth clay both the fever and rash have left. Fre- quently the skin comes off in fine scales, and is attended with very annoying itching. The patient, now that he is convalescent, shows his sickness ; he is pale, and shows a loss of flesh. He stiU coughs, and his eyes are slightly inflamed. The eruption consists of irregular dusky red blotches, slightly elevated, and as they increase in number run together, with natural-colored skin showing between them. If the skin is touched, it feels rough where the eruption is present. The eruption disappears from the face first. Measles is usually met with in children, but adults may have it, though usually attended with more serious symptoms. The greatest danger consists in a sudden suppression or "striking in " of the eruption, and of pneumonia or bronchitis occur- ring ; we may suspect the latter complication if the breathing becomes very rapid and the fever increases. Measles frequently leave behind diseases, sometimes of a serious character and difficult to cure. These sequelae are swelling and inflammation of the glands, especially those of the neck ; chronic inflammation of the eyes and running from the ears, and chronic bronchitis. Scarlet fever is the only disease most liable to be mis- taken for measles, but in scarlet fever there is usually greater fever, the catarrhal symptoms are not liable to occur ; the tongue is very red, and delirium is common ; the eruption in scarlet fever appears on the second day, first on the neck and chest, and is of a bright red and shiny appearance. The eruption in measles appears on the fourth day, first on the face and neck ; it is rougher, and the rash or blotches arrange themselves in cres- centic patches, with intervening portions of healthy skin . ^30 ERUPTIVE DISEASES. Treatment. — Keep the patient comfortably warm, and guard against exposure to cold air. Do not exclude light from the room, but avoid a strong light. The diet wants to be simple and light ; give the patient cold water to drink if thirsty. The room should be aired frequently with care, and a temperature of sixty-eight degrees maintained. Aconite. — Is the remedy at the beginning, when the pulse is f ull and quick ; dry, hot, burning skin ; extreme restlessness ; nosebleed ; dry, hacking cough. (See " Belladonna.") Pulsatilla. — Is almost a specific for measles, and is the remedy most frequently given. It suffices for all stages. Belladonna. — Should be given in the beginning if, with the catarrhal symptoms and the fever, the skin is moist, constant drowsiness, with inability to sleep ; head aches and throbs ; throat sore ; jerkings of the limbs ; convulsions. Bryonia. — Slowly developed rash or sudden receding of rash, with difficulty in breathing; shooting, stitching pains when taking a long breath. Ipecacuanha. — Is most serviceable in arresting the vomiting ; also good when the eruption is tardy in ap- pearing. Arsenicum will be required if Ipecacuanha does not relieve the vomiting and sickness. Carbo. veg. — Persistent hoarseness after measles. Drosera. — Paroxysms of cough after measles. Pulsatilla. — For loose cough after measles; also chronic discharges from the ears thereafter. Sulphur. — Chronic cough, chronic diarrhoea, dis- charges from the ears after measles. ERUPTIVE DISEASES. 231 Scarlet Fever, Scarlatina. Scarlet fever, known also as scarlatina, is one of the most dreaded diseases of childhood, and indeed it well may be dreaded, especially when the patients are sub- jected to old- school treatment ; no doubt many of the after effects attributed to this disease are more likely to be due to the treatment. Children and adults are both liable to be affected by the disease : it is very con- tagious, and unless the most thorough disinfection of the clothing, bedding, and room follows, the germs may prove infectious, even years afterwards. Infants less than six months of age are mostly exempt from the disease, but children between the ages of one and fifteen years are most liable to contract it. One attack usually precludes the possibility of another. The disease mani- fests itself in the beginning by repeated chills, followed by heat, nausea, vomiting, violent headache, and a feel- ing of great prostration. The temperature often reaches on the evening of the first day the height of 101° to 105°. This is quite characteristic of the disease, as no other disease shows such a rapid increase of temperature. Besides these symptoms, the patient complains of sore throat, dryness and burning, with pain on swallowing. The rash appears on the second day of the disease. It comes out almost simultaneously all over the body, although, on close scrutiny, it may be first seen on the neck and breast. At first the surface exhibits an almost uniform red blush. If the skin is pressed with the finger, it leaves a white spot on the skin, which quickly reddens from the outside to the centre; in measles the color will return from the centre to the periphery. The 232 ERUPTIVE DISEASES. eruption becomes more scarlet in the flexures of the joints, and a few rough pimples may appear on different portions of the body, which will be in strong contrast to the general smoothness of the surface. The skin is very hot and itchy, and especially on the hands and feet. On the fourth or fifth day of the eruption it begins to fade, and at the end of a week or ten days the skin begins to come away in fine bran-like flakes, which last from eight to fourteen days. There are various degrees of the intensity of the eruption, and of all the symptoms in fact, in the different cases of scarlet fever. Cases of scarlet fever occur without any rash. The sore throat of scarlet fever is very characteristic of the disease, and may be a dangerous complication. Swelling of the joints also is liable to occur during the progress of this disease, a form of rheumatism probably. The tongue too is characteristic and peculiar. At first it is thickly coated, and its borders only are red ; but soon the coating disappears, leaving the whole tongue very red. From its color and roughness it is known as the ' ' straw- berry tongue" of scarlet fever. Like many other diseases, there often follow disorders quite as threaten- ing to life as the original one. After scarlet fever, dropsies, passage of blood from the kidneys, pleurisy, diphtheria, running from the ears, etc. , may be observed either during or after the fever. Of all these the kidney disorder is the most common ; it is most likely to show itself between the tenth and twentieth day. Sudden suppression of eruption is always to be looked upon with anxiety ; every precaution should be taken to guard against taking cold. Treatment. — Keep the temperature of the room ERUPTIVE DISEASES. 233 about 68°. Provide for a sufficient supply of fresh air constantly. Isolate the patient, and if possible select a room in the top of the house, away from every one ; do not allow any one in the room except the attendants. Eemove all heavy draperies, if there are any in the room ; give milk freely, also fruits. Frequent sponging of the skin without exposure is very gratifying and beneficial. When the skin begins to scale, the itch- ing, which is then very annoying, may be relieved by rubbing the body all over with fat bacon, olive oil, or cocoa-butter, once or twice a day. The normal course of an ordinary case of scarlet fever is from three to four weeks, but the patient should not be allowed to go out for some time longer, especially if the attack occurs in cool weather. Too much care is not possible in pre- venting the spread of the disease-bearing germs. The scales are considered very contagious; and as they are abundant, every precaution should be taken to prevent them being carried in the clothing or lodging in the furnishings of the room. As soon as the patient is able to leave his apartment, the clothing should be fumigated and washed, the bedding likewise ,' if the walls are papered, it should be removed, and the ceiling washed and whitened. Carpets or rugs that were allowed to remain in the room are to be fumigated, and the floor washed and the cracks cleaned and filled with plaster of Paris. Never pack away any clothing worn by the patient without it has been thoroughly aired and fumigated. During the course of the disease it is well to fasten a sheet over the outside of the door leading to the room, and keep it saturated with a solution of Piatt's chlorides or some other reliable disinfectant. As a preventive, 23i ERUPTIVE DISEASES. Belladonna is quite universally considered of value ; even if it does not prevent an attack always, it has seemed at least to mitigate its severity. Give one dose every night of the thirtieth potency of Belladonna. This disease sould be treated by a physician only, and therefore only a slight mention of the remedies most often used will be made : — Belladonna, Bryonia, Apis mel. , Hepar sulp. , Lache- sis, Merc, viv., Merc, bin., Ehus tox., Zincum. Scarlet Rash. Scarlet rash is a name given to the lighter forms of scarlet fever. It is, however, equally contagious, and followed by dangerous sequelae. The same precautions should be taken as in scarlet fever. Chicken Pox. Some authorities consider chicken pox as the slight- est form of smallpox. This does not seem possible, for an attack of chicken pox does not prevent the lia- bility to smallpox or varioloid. Chicken pox is usually preceded for a day or two by a slight degree of prostra- tion and feverishness ; then the eruption appears, looking at first like neabites, which in a few hours changes to little blisters or vesicles filled with a yellowish fluid. These little vesicles appear scattered widely over the body, and continue to appear in crops for several days, the whole course of the disease lasting from two. to three weeks. The patient does not appear to have any annoyance from the disease, and is a mild, harmless disease, requiring little or no medicine. Per- haps if there is some fever in the beginning, a dose or ERUPTIVE DISEASES. 235 two of Aconite might be given ; or if much headache, Belladonna. If the eruption is at all abundant, a dose of Tart. emet. had better be given". Smallpox. Smallpox is one of the most dreaded of the erup- tive diseases, not only from the danger to life, which in late years has been less, owing to a better understand- ing of the disease, but from the repulsive nature of such cases, and the necessity which the law rightly imposes of isolation of the patient. The disease is epidemic and contagious in its nature. It is not known what the nature of the contagious virus is, except by its effects upon the system. After exposure to this influ- ence, if contagion has taken place, it requires from ten to thirteen days before it is apparent ; during this time slight languor, with pain in the head and back, may be noticed. The real symptoms of an outbreak of the disease are known by a violent chill or chills ; the head- ache is severe; there is great fever, temperature reaching 10i° at this time, but the backache is one of the most constant and never to be forgotten symptoms if once experienced. Vomiting, and very soon a red rash appears on portions of the body, and continues for a day or two, only to give place to the real smallpox eruption, which begins on the scalp and forehead in the form of red, slightly elevated spots ; they soon spread to the face and thence over the body. In about two days these spots develop into hard shot- like pimples, which become more pointed in the next few days, and on the top of each point will be noticed a minute blister with a little peculiar dent in the centre of 236 ERUPTIVE DISEASES. each. This dent is very characteristic of the disease. The spots increase in size somewhat, and at the end of the ninth day they appear like small boils or pustules, having a red circle or halo around them. If the erup- tion is at all abundant, these spots or pustules run together. When the eruption has reached the stage of pustular formation, the fever is generally higher, and delirium is apt to occur. The pustules remain as they are for two or three days, when they break, and the fluid dries on the surface, forming crusts. The fever now begins to abate, unless the number of pustules is great, when there occur chills and fever from the blood poisoning occasioned by the presence of pus. The course of the disease is from four to six weeks in normal cases. In malignant cases, death ensues or the convalescence is protracted. It has been observed that when there are few pustules the case is lighter in severity. When the pustules run together, the case is always more severe. The younger the individual the greater the danger. Vaccination is lauded and equally condemned as a preventative of this disease. Certain it is that diseases have been communicated by use of humanized virus, and should never be used. The laws of -some States require vaccination ; it is even com- pulsory. Treatment. — Good nursing is most essential, and attention to the minute details which give comfort to the patient will often turn the scale between life and death. Keep the patient' in a cool, well- ventilated room, from which bright light should be excluded ; give cold water as a beverage freely, and resort to cool baths or sponging. The diet should consist of the most ERUPTIVE DISEASES. 237 nutritious liquid foods. The patient should, of course, be isolated, and all unnecessary furnishings discarded from the room. All articles of clothing should be carefully fumigated or sterilized ; everything that can- not be cleansed and sterilized should be burned. In a work of this kind it would appear unnecessary to recommend the use of drugs, which should be prescribed only by the skilful physician. Varioloid. Varioloid runs a similar course to smallpox, and is a similar disease, but not so severe ; all its stages are milder and shorter. Varioloid is hi fact a modified smallpox. The same care in preventing its spread should be observed as in the severer forms of the disease. CHAPTEE XXX. FEVERS. Fever is the term applied in ordinary parlance to any increase of the temperature of the body which lasts for a time ; without an increase in the natural heat of the body, there is no fever. Almost all complaints at some period or other are attended with a rise in tem- perature; we therefore classify fevers into two classes, symptomatic and essential fevers. Thus typhoid and scarlet fever are essential fevers, while the fever noticed after an injury or neglected wound is of the symptom- atic variety. Fever is an applied term to a condition of the system denoting a wasting or increased tissue change, and more or less disturbance of the functions of the body. The essential fevers run a definite course, and are preceded by lassitude and undefinable sensations of discomfort. They have well-marked stages, run a typical course, and end within fairly well-defined periods. We speak of essential fevers also as continued fevers, in contradistinction to the eruptive fevers. The following classification may be instructive as showing the varieties of fevers according to groups. This table is taken from Da Costa's "Medical Diagnosis " : — Simple continued fever. Catarrhal fever, or influenza. Typhoid fever. Typhus fever. Cerebro-spinal fever. Relapsing fever. Continued Fevers. FEVERS. 239 Periodical Fevers. Eruptive Fevers. Intermittent fever. E emit tent fever . Congestive fever. Yellow fever. Scarlet fever. Measles. -{ Smallpox. Dengue. Erysipelas. Catarrhal Fever. The name of catarrhal fever is seldom applied to the condition about to be described ; it is oftener character- ized as a mere variety of bronchitis, because the symp- toms point prominently to an inflammation of the bronchial mucous membrane. This is not exactly true, for the disease maintains its peculiarities, and has appeared as an epidemic from time immemorial. The disease usually sets in suddenly and attacks the mucous membrane of the nose, eyes, and bronchial tubes. There is sneezing, irritation of the throat, cough, great lassitude and impairment of strength, more than could be attributed to the severity of the case or its present duration ; loss of appetite, nausea, and vomiting may be present. The disease lasts three or four days, and then the symptoms begin to subside. Treatment. — The patient should keep in the house and in an even temperature ; the diet should consist of soups and gruels ; cold water, if drank freely, will be beneficial. Aconite. — For the initial symptoms of dry, hot skin, flushed face, restlessness. 240 FEVERS. Belladonna. — Congestion; great heat of the skin, which is moist ; frequent sneezing ; dryness of the nose, with dull, frontal headache ; nosebleed ; constant urging and desire to swallow, throat feels constricted ; thirst, craves lemonade ; vomiting of mucus ; child be- gins to cry immediately before the cough comes on ; dry cough. Chamomilla. — Irritation to sneeze, with crawling, dry heat and stopped-up sensation ; feeling as if coryza would appear ; nosebleed, relieving the head ; constant irritation to cough beneath the upper part of the breast bone ; especially worse at night ; child wants to be carried. Cepa. — Smarting in the eyes, like from smoke ; constant sneezing with profuse, burning, watery dis- charge when coming into a warm room ; the discharge from the nose poisons the upper lip ; hacking cough from inhaling cold air ; constant inclination to hack ; catarrhal hoarseness ; coldness alternates with heat. Dulcamara. — Influenza, dry, hoarse, rough cough, or loose cough and copious expectoration of mucus ; dull hearing ; catarrhal fever ; cough worse lying down, from warmth of the room, or from deep inspiration ; better in the open air. Hepar sulph. — Scraping sore throat ; dryness of the throat ; sensation as if a splinter or fish bone were sticking in the throat ; croupy, hoarse cough ; after coughing, sneezing, crying ; great chilliness in the open air ; sweats a great deal, or first don't sweat at all and then sweats profusely. Merc. viv. — Cold in the head, fluent discharge, fre- quent sneezing, not relieved by sweat ; violent, racking FEVERS. 24:1 cough, as if the head and chest would burst, sometimes with vomiting ; always worse at night ; great chilliness, even in a warm room. Nux vom. — Cold in the head, when the discharge from the nose is profuse in the daytime and nose stops up at night ; sneezing early in the morning ; better in the cold air, worse in a warm room ; scraping in the nose and throat ; worse in dry, generally better in wet weather. Pulsatilla. — Loss of smell; cold in the head; loss of taste, nostrils sore ; later the discharge becomes yel- low and greenish; worse indoors ; chilliness, face pale, head confused, frontal headache ; cough from irritation in the pit of the stomach. Typhoid Fever. Typhoid or enteric fever is essentially a disease of youth ; the very young and the very old seldom contract it, although exceptional cases have been known. It is now regarded as settled that the cause of typhoid fever is a specific or organized germ, and that this germ always arises from a previous case ; neither the extreme of heat or cold affects the power of growth and repro- duction of this germ. These germs find entrance into the bowels through the nose and mouth, either from their floating in the air or from drinking water or milk containing them. That typhoid fever is contagious in an ordiuary sense may well be doubted, although cases do occur that are difficult to explain in any other way. The germs, having gained admission to the body, and the conditions being favorable, grow and multiply, and in so doing manufacture a poison which produces the 242 FEVERS. characteristic symptoms of typhoid fever. The same may be said of many other species of germs, and they too produce their own train of symptoms. Several days previous to an attack of typhoid fever the patient complains of debility, tiredness with headache, dizziness, and soreness of the limbs ; sometimes nosebleed, or chilliness even in warm weather ; his appetite is poor ; his sleep is disturbed, and he dreams of his work ; he feels miserable, and knows not why ; finally a decided chill followed by fever. Diarrhoea usually accompanies, though constipation may be an attendant symptom ; the abdomen seems bloated or distended, and tender to the touch ; an eruption will often be observed on the chest or abdomen, consisting of small red spots resembling fleabites. These symptoms appear during the first week ; the second week finds the patient still feverish, the tenderness of the bowels more marked, and an especially sore spot in the lower part of the bowels opposite the hip. The tongiie is drier and of a brownish color, the appetite lost ; delirium, either mild or violent, now appears ; he may be only drowsy, and fall asleep while answering a question if one is asked, or he be- comes violent, attempting to destroy himself or his attendants. The course of the disease is variable, from three weeks to as many months. Under any circum- stances the convalescence is long and tedious. Of all the symptoms mentioned, the fever is most characteris- tic ; the rise and fall are so regular and follow so uni- form a course that they offer a guide to the recognition of the malady in most cases ; exceptionally, in light attacks, the thermometer shows no definite rise or fall. For example, in typical cases of typhoid fever, if the FEVERS. 213 temperature on the first day in the morning we will say is 98.5°, in the evening we will find it 100.5° ; on the second day, in the morning, it is about 99.5°, in the evening, 101.5°; and so on until the evening tempera- ture reaches 104:°. From that time on the temperature ranges between 103° and 104°. About the middle of the second week in mild cases the fever diminishes, and the range in the morning will be one or two degrees lower. Diarrhoea is a prominent symptom, except in mild cases, when constipation occurs. Should the stools contain blood, it is a grave symptom. Treatment. — The patient should have a large, well- ventilated room, if possible, and one away from noise. Give the patient very little food the first week, and gradually increase the amount as the fever subsides. Cool sponging is very grateful, and, if the temperature is very high, the cool, wet pack is of great value. All dis- charges from the bowels should be thoroughly disin- fected, that the disease may not be allowed to spread from this source of infection. Care should be taken that all windows are kept guarded, for patients have been known to jump from an open window during their delirium. The sad case of a delirious typhoid patient deliberately shooting his nurse forcibly points the need of great caution and watchfulness of ail delirious typhoid patients. During convalescence the greatest care should be taken in regard to the diet of the patient, especially just after the temperature becomes normal ; the least deviation from the strict dietetic rules may cost the patient his iife. The use of stimulants should be avoided, unless ordered by a physician, although the writer considers them harmful, 244 FEVERS. and sadly remembers the case of a relative who was con- fined in a hospital in Italy by typhoid fever, who was given beer to drink as soon as the fever left him. Diarrhoea followed in a few hours, followed by hem- orrhage and death. It is not possible to say the beer was the only cause of the relapse, but it is more than probable. Typhoid fever, like smallpox, scarlet fever, etc. , is a disease of so varied a nature, and requires the most skilful attention, that no indications for remedies will be given. Homoeopathy has proved itself to be wonderfully efficacious in this as in all other diseases, even cutting short the attacks, and, by its application of remedies, saved many lives even after they were despaired of under the old-school methods of treatment. Intermittent Fever, Chills and Fever, Malaria. No disease in recent years has been more prevalent, apparently, than some form of malaria. It has become one of the fashionable diseases of the day. Every household fortifies itself with quinine pills. They are given to young and old, weak and strong. In fact, quinine is as much abused to-day as ever calomel or blue pill used to be, and quite as hurtful and lasting in its effects upon the system. Physicians, too, are to blame for popularizing the term "malaria " ; it is so sat- isfying to the masses to tell them that they have a light attack of malaria, and the term covers a mul- titude of sins, from simple headache, dyspepsia, etc., to those fatal typhoid conditions. It is, nevertheless, true that malaria visits different belts of country, caus- ing epidemics in places which have been non-malarial ; in fact, few sections are now entirely free from it. FEVERS. 245 The causes of this disease are not wholly understood as yet. All observers agree that the soil is the natural seat of the poison, and that moisture is absolutely necessary. The opening of ground that has long been covered with grass exposes to the air the malarial poison which has lain dormant for years. Malaria, or intermittent fever, consists of three divisions, — chill, fever, sweat. The attacks may be once daily, every other day, every fourth day, and known as quotidian, tertian, or quartan. The attack usually comes on be- tween ten o'clock in the morning and one in the after- noon. The chilly stage may last from a few minutes to full three hours. During this stage the patient seems to present a shrunken appearance ; his face ap- pears drawn, his nose pinched ; headache, thirst, colic, nausea, cough, backache, etc., may occur at this time. The stage of heat creeps on gradually, until the whole body is in a perfect blaze, and lasts for some time, until sweating comes on and greatly relieves the sufferings of the patient. All these stages may not occur ; some- times only the chill and heat, or the sweat may come first. Chronic malaria, or suppressed intermittent fever, frequently terminates in dropsy, inflammation of the kidneys, or general debility. Under strict homoeo- pathic treatment the course of the disease should be limited, and few of the secondary troubles occur. Before administering a remedy be careful in obtaining all the symptoms ; those occurring before and during the chill, heat, siveat, and between the attacks ; the time of day when the paroxysm occurs ; the parts of the body in which the chill first makes its appearance ; the regularity of its stages ; the degree or absence of 2±G FEVERS. thirst. Of importance is the proper way to administer the medicine. It has been observed that the following method is most efficacious : The medicine should be given a short time after the cessation of a paroxysm. and not repeated until after another paroxysm has pre- sented, if the remedy was not sufficient to dispel the attack or change its character. If. after the adminis- tration of the medicine, the next paroxysm be earlier and more severe or later and milder than the preceding one. the action of the remedy should not be interfered with. Capsicum. — Thirst some time before the chill, and great thirst with the chill : paroxysm 5 to 6 P. M. . 10.30 a. iff. : -every chill is attended with thirst, and every drink with shuddering": during the chill, cold- ness of chest, with a sensation of water dropping down the back : heat without thirst, sweat without thirst ; for fevers from abuse of quinine : during the chill must have something hot to the back. Carbo. veg. — Best adapted to persons, young or old, who have suffered from exhausting diseases ; ailments from quinine, especially for intermittents that have been suppressed : awakens often from cold limbs : no regular form of paroxysm : headache, backache, tooth- ache, before a chill : thirst with chills ; begins in left hand and arm : sometimes sweat first, foUowed by chill : heat without thirst, with headache, flushed face. vertigo, and nausea : during the fever wishes . to be fanned constantly. Canst icurn. — "One of the few remedies where sweat follows chill without intervening heat ; left -sided chill, most pronounced of any remedy " ; averse to FEVERS. 247 sweet things, which disagree ; chill without thirst, lessened in bed and by drinking ; shivering, beginning in the face, thence extending over the body ; patient is either chilly or in a sweat always ; cold feet, chill passes downward ; heat without thirst. China. — Adapted to stout, "swathy" persons; "broken-down " systems ; chill preceded by palpitation, anxiety, and hunger ; chill over the whole body, increased by drinking ; thirst before or after, but not during the chill ; stinging or fierce, needle-like stitches in skin, with heat of one part and coldness of another. Eupatorium perf. — Tertian fever, 7 A. M. to 9 A. M. ; before the paroxysm insatiable thirst, but drink- ing causes nausea and vomiting and hastens the chill ; bones pain as if broken, especially those of the extremi- ties ; painful soreness of the eyeballs ; intense thirst with chill ; drinking during the hot stage will make him shiver. Igaatia. — Violent yawning and stretching before the paroxysm ; chill begins in the back, extends to the arms, with thirst, followed by heat (without thirst) over the whole body, with cold feet ; accompanied with internal shuddering, not disappearing until the sweat has broken out ; during the time between the parox- ysms great weariness and bending of the knees. Ipecacuanha. — If paroxysm has been suppressed by quinine, this remedy is all the more indicated. Nausea and vomiting predominate ; slight chilliness without thirst, afterwards violent heat with thirst ; nausea and vomiting ; patient is always worse when in a warm place ; external coldness with internal heat, great lassi- tude and weariness during chill. Natrum muriaticum. — Great emaciation ; hang- 248 FEVERS. nails ; skin around the nails dry and cracked ; dreams of robbers in the house, and on waking will not believe to the contrary till search is made ; chill generally observed to occur from 10 to 11 a. m., though other times have been noted ; patient dreads the chill ; knows the paroxysm is coming because of headache and thirst ; chill with thirst, violent chill till noon, then heat till evening ; sensation as if the head would fly into frag- ments, is stupefied, knows not where he is ; chill begins in the feet, fingers, and toes, or small of the back, with blue lips and nails ; the thirst continues through all the stages ; the headache is violent, with the heat relieved by perspiration ; the heart's pulsations shake the body. Nux vom. — Always to be thought of when under- taking cases that have been drugged by mixtures, bitters, vegetable pills ; patient very sleepy in the evening while sitting hours before bedtime, and wakes at 3 or 4 A. M. ; feels tired and weak in the morning ; constipation, frequent unsuccessful desire, passing small quantities of feces, sensation as if not finished ; parox- ysm at night or early morning, 6 to 7 a. m., 12 m. ; before paroxysm a drawing sensation through the thighs and legs that obliges him to draw them up and stretch them out ; chill without thirst, with bluish cold face and hands ; long-lasting heat with thirst ; cannot move or uncover in the least without feeling chilly. Pulsatilla. — Wide awake in the evening, does not want to go to bed ; first sleeplessness, sound sleep when it is time to get up ; paroxysm usually at 4 p. M., preceded by diarrhoea . without thirst ; chilliness over the abdomen extending around the sacrum and back ; can't bear a close room, although he is cold in a warm FEVERS. 249 room even ; heat, with red face or one cheek red and one pale ; thirst only during heat ; paroxysm of increas- ing severity and ever-changing symptoms ; no two attacks alike. Rhus tox. — Paroxysm preceded by burning in the eyes, pains in the limbs and dry, teasing, fatiguing cough ; rheumatic symptoms from exposure, especially by cold bathing, swimming ; chill is irregular ; severe chill, as if ice water were dashed over him ; begins in the fingers and toes, feeling as if something cold were running through the blood-vessels ; heat with thirst ; nausea and vomiting ; all kinds of pains ; tongue heavily coated, salt taste ; aversion to bread ; cold sores around the mouth, like string of pearls. Sulphur. — Adapted to persons in whom diseases are continually recurring, patient seems to get almost well, when disease returns again and again. Constant heat on top of the head ; cold feet with burning of the soles, puts them out of bed to cool them off ; paroxysm begins with thirst ; chill without thirst ; frequent internal chilliness ; there may be no subsequent heat or thirst ; great prostration after every paroxysm, with thirst for something bitter. Veratrum album. — For "pernicious" forms of intermittent fever. ' ' The patient thinks he will die, and the physician shares his fears." The patient in the cold stage resembles the condition of collapse ; shaking chill, "with sweat, at first warm, but soon passes off into general coldness ; icy coldness, with profuse cold sweat ; pulse almost imperceptible. Veratum album should be given when stimulants are often given without lasting benefit. CHAPTEE XXXI. RHEUMATISM AND GOUT. Eheumatism is a term that has been used very loosely to indicate any affection accompanied by pain and tenderness of the joints and muscles. Eheumatism may be classified as either acute or chronic, and accord- ing to the structures involved. We speak of acute or chronic articular rheumatism when the joints are affected ; acute or chronic muscular rheumatism when the seat of inflammation is in the muscles. The principal causes are exposure to wet or dampness, and sudden suppression of perspiration after great exertion. Eheu- matism is most certainly hereditary. The symptoms are pain, soreness, inability to move without causing suffering ; swelling, and fever. The pains are very liable to shift locality, and joint after joint will become involved ; and when it is thought the pain has gone from one place for good, it will as suddenly reappear in its last location and return to its first seat of attack. The tongue is usually coated and the ap- petite diminished. Perspiration is usually common and of an offensive, sour odor. As a compli- cation of rheumatism, we are liable to meet with inflammation of the heart sac (pericarditis), result- ing in trouble with the valves of the heart. Acute rheumatism may continue for a few days or weeks, and then the pain gradually subsides and the swelling RHEUMATISM AND GOUT. 251 too, but the stiffness and tenderness of the parts continue some time longer ; or the attack may run weeks, and even pass into a chronic form which continues for months or years. In chronic rheumatism the joints usually are the seat of pain, not of an acute nature, but sensitive and painful to motion and contact, and are periodically worse either before or during a storm. Swelling may be present, and generally the joints become permanently enlarged, caused by a chalky deposit in them. Chronic rheumatism may show itself in another way, which consists of frequently repeated attacks of acute articular rheumatism ; such patients feel every approach of wet weather. Muscular rheu- matism, as it has been stated, is a term applied to rheumatic inflammation of the muscles, sheaths of muscles, and tendons. There is little or no swell- ing in this form, and is characterized more by the pain, which may be shooting, stitching, burning, or only a lameness and soreness as if bruised. Accord- ing to the location of the attack, it has received different names, as, for example, stiff neck, or, when the muscles of the neck are involved, movement of the head is painful and frequently draws the neck to one side. This condition may become chronic and known as "wryneck." Pleurodynia, or intercostal rheumatism, has been described. (See index.) Lumbago, or kink in the back. The peculiarity of the latter form is that its appearance is instantaneous ; usually while bending, stooping, or reaching, the patient is suddenly seized with a stabbing pain which prevents him from assuming an erect position. The attack usually lasts from eight to ten days. 252 RHEUMATISM AND GOUT. Gout differs from rheumatism in the form of its attacks, by its never attacking children. Men oftener than women are subject to the disease, especially those who are accustomed to a rich table and the habitual use of beer or wine, and who take very little exercise. Its principal cause is hereditary predisposition, which is generally aroused into activity by the mode of living, which causes an excess of uric acid in the blood. Gout is said to be a rich man's disease, while rheumatism is the poor man's gout. An attack of gout gives no fore- warning. The person feels perfectly well and usually says "he never felt better in his life," until he was awakened all at once in the night by a burning, screw- ing pain in one of his big toes, which steadily grows worse from hour to hour. The toes soon begin to swell and redden ; there is great thirst, high fever, dry skin, great mental irritability. This condition of things continues until morning, when a sense of relief begins to come, and the day is passed in comparative comfort, until the next night, when he again experiences another paroxysm. In this way it may go on for about a week, and finally the pain, redness, and swelling grad- ually disappear, and the skin at last peels off the affected toe. This is the course of a first attack ; in later attacks, however, other joints may become involved. The finger joints, the knee joints, each or all may be attacked. These joints usually become enlarged by a firm deposit which is observed around them resembling bone. In the beginning, it is as though plaster of Paris had been injected into the joints and as gradually hardens. Treatment. — As homoeopathic physicians do not RHEUMATISM AND GOUT. 253 prescribe for diseases by their names or forms, but for the peculiarities of each individual case, I have preferred to annex the necessary indications for some of the remedies applicable to all forms of rheumatism and gout. It will be observed, if attention be paid to the subject, that almost every attack of rheumatism is preceded by some digestive disturbance ; it is therefore important that chronic rheumatic patients should be careful in their dietary, and partake sparingly of acid fruits, excepting during the hottest weather, when per- spiration is usually profuse. This is in contradistinc- tion to the prevailing opinion, that acids are beneficial in rheumatism ; but it is a matter of conviction with me, that patients suffering from chronic rheumatism cannot take acids as a rule, excepting under the condi- tions mentioned. Gout, as has been stated, arises from excessive eating, especially of rich foods and the habit- ual use of wines, and from want of a proper amount of exercise. It therefore follows that such persons should deny themselves of the pleasures of the table, and institute a regular habit of exercise. Turkish and Roman baths are sometimes beneficial. Arnica. — Rheumatism and gout ; pains are tearing and drawing ; change quickly from place to place ; feels as if beaten or bruised ; feet feel heavy, as if a weight was on each instep ; pains are worse toward evening ; fears to have persons come near, lest they strike the foot; big toe joint red, feels sprained ; everything on which he lies feels too hard ; sensation as if the joints of the arms and wrists were sprained ; thumbs feel bruised. Apis mel. — Violent rheumatism in the right, later in the left shoulder ; shoulder blades feel lame ; muscles 254 RHEUMATISM AND GOUT. stiff; tender on pressure, somewhat swollen. Never give Khus tox. immediately after Apis. Actcea racem. — General bruised feeling as if sore ; cramp in the muscles of the neck on moving the head ; stiff neck from cold air, pains from moving the hands even. Rheumatism of the muscles, cramping, stitching pains ; limbs feel uneasy, causing restlessness. The patient goes out feeling tolerably comfortable, but as he walks the joints ache and even swell. Antimony crud. — Grout commencing in the right great toe, going to the left ; drawing, tearing pains. Bryonia. — Rheumatism when the joints are pink and swollen ; the grand characteristic symptom for Bryonia is the aggravation from slightest motion, while Rhus tox. is indicated when the pains are worse from keeping still and better from motion. The pains are either drawing, tearing, or shooting in character when Bryonia is called for ; but the aggravation from slight- est motion, the great thirst and irritability, are peculiar and trustworthy guides in selecting the remedy. Berber is. — Lumbago ; bruised pain, with stiffness in the small of the back ; rises from a seat with diffi- culty; gurgling sensation or as of something alive in the joint ; burning while passing water; aching in the bladder before, during, and after urination. Calc. carb. — Rheumatism caused by working in water ; gouty deposits about the fingers ; very great sensitiveness to the open air ; takes cold easily. Causticum. — Rheumatism from exposure to cold ; when the joints are stiff and the tendons shortened. Custicum resembles Rhus tox. in that both have rheu- matism from exposure to cold, but Rhus tox. has rest- RHEUMATISM AND GOUT. 255 lessness and relief from motion, while Causticum has restlessness only occurring at night. Guajac follows Causticum well, especially in gout. Causticum and Rhus are indicated in rheumatism of the jaw, recog- nized by pain when moving the lower jaw as in chew- ing. Chamomilla. — Rheumatic pains almost drive the patient mad ; he must jump out of bed and move about ; he is thirsty, hot, and almost beside himself with an- guish. Colchicum. — Gout and rheumatism ; pain begins in one joint and travels to another ; the joint is very sensitive to the slightest motion ; the urine is dark red and scanty ; patient is very irritable ; little things annoy him. Colchicum is given in massive doses by the old-school doctors; and if that has been the case, give Spigelia as an antidote. The joints are swollen and dark red. It is especially useful for weak, debilitated persons. Chronic rheumatic or gouty patients requir- ing Colchicum feel uncomfortable while lying on the left side, compelling them to turn over. Dulcamara. — Rheumatism made worse by sudden changes in the weather, twitching of the muscles of the eyelids or mouth whenever the weather becomes damp. Stiff neck. Rheumatism after suppressed, eruptions or when chronic forms alternate with attacks of diarrhoea. Ferrum met. — Irresistible desire to bend the arm, which causes great agony ; especially for rheumatism of the left shoulder. Sanguinaria has rheumatism of the right shoulder. Ferrum has rheumatism better from moving about slowly at night ; lumbago all night, ceas- ing on rising. 256 RHEUMATISM AND GOUT. Gnaiaciim. — Tearing pains with contractions of tendons, making the limb stiff and immovable ; gouty inflammation and abscess of the knee ; worse from touch, better when sitting ; gouty deposits in the joints. Chronic rheumatism when the joints have become de- formed. Pains after abuse of Mercury are relieved by Guaiacum. Ledum pal. — Eheumatic pains, which start from below and extend upwards ; with stinging, drawing pains ; worse from warmth of bed and bed covering, from motion, and in the evening before twelve at night. Gout worse in the feet ; gouty deposits ; ball of the great toe painful, swollen, soles very sensitive, tendons stiff. Merc. viv. — Eheumatic pains, tearing, stinging ; worse at night in the warm bed ; with profuse sweat, which gives no relief, but makes the patient feel worse ; joints swollen, pale or slightly red. Nux vom. — Is called for in rheumatism of the back, when the patient is unable to turn over in bed without first sitting up. Pulsatilla. — Gout or rheumatism, pains shift about, now here, now there. The pains are better from slow motion and from pressure ; worse from warmth and relieved by cold ; worse in the evening. Eheumatism caused by getting wet, especially the feet, from pro- tracted wet weather ; pains appear suddenly, leave gradually. Rhus tox. — The best indication for this remedy is this, the patient has relief of his symptoms by contin- ued motion, while he experiences aggravation on begin- ning to move ; in other words, he grows limber as he RHEUMATISM AND GOUT. 257 continues to move, although it is painful at first. Lyco- podium and Pulsatilla have relief from slow motion. Ferrum has relief at night from slow motion. Eheu- matism occurring from wet, damp weather or from living in such places ; grows stiff from keeping still, and pains are worse. Khus patient cannot tolerate cold, fresh air. Sulphur. — Acute or chronic rheumatism and gout, with burning of the soles of the feet; has to put them out of bed to relieve the burning ; jerking of the limbs on falling to sleep. Sciatica. The pain begins in the fleshy part of the buttock, ex- tending from thence down the back part of the thigh to the bend of the knee, and in rare cases to the ankle and heel. Usually the disease attacks only one side, though in rare cases both sides are affected at the same time. The pain generally commences mildly, and gradually grows worse. The causes are somewhat obscure. At- mospheric influences, such as damp, cold weather, sit- ting on damp ground, or sleeping on the ground ; taking cold ; suppressed perspiration will cause this affection. Eemedies. — Colocyntli. — One of the best remedies when there is crampy pain in the affected hip, as though the parts were screwed in a vise, lies on the affected side with knee drawn up. Conium. — Sciatica of the right hip, worse from going down stairs, better going up. Sensation of weakness, even to trembling, in the right thigh, while walking. From slight exposure of the feet he catches cold. 258 RHEUMATISM AND GOUT. Arsenicum. — Pain relieved by bending the knee, better going up stairs. Constant desire to change the position of the feet at night, can't lie still. Warmth almost always relieves the pain. Lachesis. — Left-sided sciatica ; pain as from a hot iron ; pain better from lying down quietly in bed, worse from sitting up or rising to one's feet ; always worse after sleep. Nux vom. — Darting pains from toes to the hip or from the hip to the hollow of the knee ; worse at stool, or from motion or lifting and at night. Sepia. — Sciatica, with cutting pains ; must get out of bed for relief ; pains worse from rising, but better from slow walking. Podophyllum pelt. — Pain and weakness in the left hip, worse from going up stairs. CHAPTEE XXXII. SOME GENERAL DISEASES. Trismus, Lockjaw. Trismus, or lockjaw, consists of involuntary contrac- tions of the muscles, with convulsive movements. This disease occurs during the course of external injuries, as of the hands, feet, and face, or from injuries of the w r omb, etc. ; from poisoning by strychnine or brucine ; in new-born children, from disease of the cord resulting from improper care, as filth or urine on the cord. It never occurs in cases well kept, clean, and in sanitary houses. Lockjaw is more prevalent in warm countries than in the middle climates. The symptoms are slowly developed, and usually the first manifestation in an adult is a feeling of stiffness about the head and neck, usually attributed to catching cold. The pain and contractions increase until periodic spells of rigidity show themselves, coming suddenly like a jerk, and may be so violent that the patient is thrown backwards 01 forwards, while in some they resemble electric shocks. In this way the disease progresses, alternating with rigidity, partial relaxation, and convulsive jerks. There is great pain in the muscles during their contractions. Thirst is usually distressing, and in some cases actual hunger. The brain seems clear throughout the course of the disease. Sleep is entirely absent, and if patient loses himself for a moment, he is at once aroused 260 SOME GENERAL DISEASES. by violent jerkings. .Death results generally from asphyxia, or suffocation, during a spasm. Lockjaw is most often thought of after any injury to the feet or hands caused by a blunt instrument, or when the wound inflicted is deep and has a very small external opening, or when any foreign substance, as iron rust, is carried into the wound by the instrument. For example, a rusty nail may enter the foot, and although it is at once removed, unless proper treatment is given, small particles of iron may remain, and, together with the injury to the nerves, may give rise to tetanus, trismus, or lockjaw. Or again, suppose a person was thrown from a carriage and the skin on the hands was laid over in folds ; sand and small stones were packed into the flesh exposed, • and unless every particle of the foreign substances were removed, not even allowing a small pebble to remain, there might be danger of lockjaw. I once was called to a case where the person had been injured as I have last described, and a local surgeon had partially cleansed the wound and sewed it up ; when I saw the case twenty -four hours after, I removed all stitches, and long and patiently cleansed the wound, removing large numbers of pebbles, and then dressed the wound without sewing it. In four days symptoms of lockjaw appeared, and I again and again examined the wound to see if any particles still remained, and, to my surprise, I found a stone as large as a bean deeply imbedded in the tissues between the knuckles. Needles and pins often produce lockjaw when run into the flesh of the hands or feet. The only treatment here offered is in the way of a suggestion, that whenever an injury to the feet or hands occurs SOME GENERAL DISEASES. 261 producing a small punctured wound, encourage bleeding as much as possible, and then wash most thoroughly and apply a solution of Hypericum, one part of the tinc- ture to five parts water. A competent physician should always be called, that proper treatment be applied. Bursa, Housemaid's Knee, "Weeping Sinew. Bursa, or housemaid's knee, as it is commonly called, is a firm, tense, round swelling which projects from the front surface of the kneepan. It may reach the size of an infant's head, but more commonly is not larger than a small orange. Slight stiffness of the joint is usually complained of, and a sense of soreness after prolonged exercise. These tumors usually result from the pressure from working in prolonged kneeling position, hence the name "housemaid's knee." Tailors and cobblers develop a similar swelling ; in the former it is situated on the ankles, and in the latter above the kneepan. Treatment. — Kest, and avoidance of the causes, will often bring about absorption. Arnica, Silicea, and Sticta pulm. are serviceable as internal remedies. Weeping sinew is another form of bursae, and is technically called a ganglion. It is a small, round, movable tumor, rarely larger than a filbert, most generally observed on the back of the wrist ; it is seldom painful, but the patient usually complains of a sense of weakness in the joint. It is sometimes connected with the joints. These tumors do not usually arise from pressure ; they sometimes follow a sprain, but usually appear without evident cause ; they are of slow growth, but now and then appear quite suddenly. 262 SOME GENERAL DISEASES. Treatment. — When large and painful, removal is advisable. Cole. carb. — Bursa on the back of the right hand. Silicea. — Ganglion on the back of the left wrist. Bunion. A bunion is an inflammation and enlargement of the great toe joint, caused by undue pressure of boots or shoes. Treatment. — Eemove the cause. Give Arnica or Antimony crudum for the acute symptoms, and Calc. carb. for chronic cases. Chorea, St. Vitus's Dance. This affection is characterized by incessant twitch- ings and jerkings of groups of muscles. The causes are various. The disease occurs during pregnancy, in consequence of disturbances of menstruation, from too close application to study, from mental emotions, such as fright or fear. The disease, if protracted, may affect the mental functions. The patient shows a loss of memory, weakness of the mental capacity, and in some extreme cases even foolishness. Under good homoeo- pathic treatment the disease is, in most cases, easily cured. Diabetes Mellitus. This disease is characterized by the presence of sugar in the urine. The exciting causes of this disease are mechanical injuries, especially severe concussions of the brain and spinal cord, and diseases of the nerve centres; violent mental emotions, such as fright, SOME GENERAL DISEASES. 263 anxiety, fear, grief, immoderate mental strain ; errors in diet; exposure to cold and moisture; and follow- ing severe illness, especially after intermittent fever. The symptoms are obscure in the early stages of the disease. Usually the increased thirst and excessive urination are noticed ; gradually the strength becomes impaired. Sometimes the excessive irritation of the private organs, especially in women, is noticed, causing heat, dryness, and terrible itching. The disease may be very brief in its duration, usually it lasts for years. No doubt a number of cases have been cured by the different methods of treatment. Diabetes Insipidus. This affection is characterized by profuse urination and great thirst. The urine is free from sugar. There is no structural disease of the kidneys. The causes are violent and sudden emotions ; chronic diseases of the brain and spinal cord ; injuries of the skull ; excessive drinking or very cold beverages. The patient very rarely dies of this complaint, although it is only a symptom to speak correctly, unless the causes which give rise to the above condition are necessarily fatal in their results. Diabetes insipidus can be cured by ,medicines, or it may disappear of itself. Cramps in the Limbs. Cramp in the calves of the legs, in the feet, and in other parts of the body causes great suffering and often disturbs sleep ; this affection may occur often in some persons, while others only experience a slight contraction now and then. Those subject to cramp 264 SOME GENERAL DISEASES. habitually at night will find some relief if the head of the bed is elevated slightly. The usual procedure dur- ing an attack is well known, consisting either in press- ing very hard against something firm or very cold. Treatment. — Veratrumalb., taken at night on retir- ing, will sometimes bring relief to chronic sufferers. Sulphur or Colocynthis should be tried after Ve- ratrum alb., if it fails. Colocynthis is also good for the stiffness and soreness sometimes remaining after an attack. Rhus tox., for day cramps, especially while sitting, or for cramps occurring while pulling off the boots. Hyosciamus also for cramps while pulling off the boots. Lycopodium. — For cramps occurring principally when walking. Cuprum. — For cramps at night in bed, principally of the soles of the feet, and when the toes are drawn in different directions. Sleeplessness, Insomnia. Among the many ills to which humanity is subject, there is probably no condition more annoying than sleeplessness. With the changing modes of living, the hasty methods of business, and prevailing social customs, it is small wonder that our people suffer so almost uni- versally from this disorder. To restore the nervous forces expended during the day in the business pursuits, further depleted by the demands of social life, it is necessary that a certain amount of sound, unbroken sleep be obtained, it is even imperative. The amount of sleep required for the preservation of health varies in different people ; a very few hours of sleep in some SOME GENERAL DISEASES. 265 cases, and a great number of hours in others, being sufficient for good health. Frederick the Great, Sir Walter Ealeigh, and John Hunter are stated to have required only four or Ave hours' sleep out of the twenty- four. The Duke of Wellington was another person requiring only a few hours of slumber, and is said to have made it his rule that ' ' when it was time to turn over, it was time to turn out." The average amount of sleep required by a healthy person has been set down at from six to eight hours. In the present age we do not observe those habits of regularity and method in our daily life which were wont to be the guides of our fore- fathers. In the olden times, the habit of men in sleep- ing was more like that of the birds, and soon after sun- down they retired to rest and rose in the morning at the "peep o' day." They lived in slow-moving times, they went about their work in the peace and fulness of mind which the absence of keen competition and over- crowding would assure them. Sleeplessness is, in its prominence, essentially a modern affliction, and like one form of nervousness which has been dignified by the name of "American nervousness," so too might Ave speak of American sleeplessness. Americans as a class suffer more from insomnia than any other nation. The causes are quite the same wherever the affliction is found, yet with us our climate, our habits of diet, which includes more meat than that of any other people, and our lack of outdoor exercise, all tend to bring us to that condition which ultimately checks the progress of so many brilliant careers by not heeding the premonition which the symptom of sleeplessness gives ; and though this condition may go on for some time unheeded, and 266 SOME GENERAL DISEASES. in some rare instances does not constitute a disease, yet in that large majority of cases it should be taken as a warning that incorrect conditions are present that call for a radical change. Habit has much to do with the obtaining of a proper amount of sleep, for, as irregularity is one great source of wakefulness, so, on the contrary, is regularity of habit an inducer of sound and refreshing sleep. Sailors, and those who have to be on duty at certain stated hours, can, from mere custom, fall asleep immediately they "turn in," and wake at the proper time, so sub- servient is our nature to the force of habit. We know that moderate physical and mental fatigue is healthy and predisposes us to sleep. Every one knows too that extreme fatigue, on the other hand, will prevent sleep. "I could not sleep because I was too tired," is a well- known expression. When we are "overtired," sleep usually deserts us. The causes of sleeplessness are many and varied. It may be stated that loss of sleep occurs as a symptom in many diseases, and in such instances the original affection must be the object of treatment ; but it often exists as the chief symptom or condition to be counteracted. It is universally known, I think, that excitement is a fruitful source of wakefulness at night. Any such stimulation, particularly if prolonged or derived from an unaccustomed source, will almost surely dispel sleep. Hence entertainments, as balls, parties, theatres, etc., involving as they do excitement of the brain and nervous system, and irregularity of hours, occasion loss of sleep. The emotions, likewise so liable to shocks, caused by sudden joy or sorrow, good news and bad, and the incidental anxieties and cares of SOME GENERAL DISEASES. 267 life, when pressing heavily, are all instrumental in pre- venting sleep. No more potent influence than care can be imagined which robs us of sleep, and too often it is a useless worriment, a crossing of bridges before they are reached, so many persons* never learn to lay aside their cares for even a brief period ; instead of seeking diversion by some pleasant occupation for a few hours before retiring, they persist in the routine of thoughts of the day, and finally try to find repose, when, instead of sleep, the quiet and lonely hours are perhaps more opportune times for planning, and sleep is dispeUed until the habit has become settled, and the path which would lead to quiet repose is lost in an endless rushing, crowd- ing of ideas. Wakefulness is a common accompaniment of the convalescent stage of long and exhausting ill- nesses. Sleeplessness is most commonly caused by the condition known as brain-fag, or mental over-taxation. Sufferers from this malady are to be found amongst all classes of people, from the school boy and girl to the statesman. It is a sign of the times in which we live. Our school system is responsible for far too many cases of brain-fag ; the required studies are too numerous ; very young children are compelled to devote more time and energy than they can well afford to give, and at the same time maintain their health. The same hurrying and desire to attain a certain standard within the short- est period are observable in our school system as well as in the pursuits of adult life. Young children should not be forced ; their physical growth is rapid, and to crowd their little brains is harmful in the extreme, and by so doing the extra demand which must be made to keep up, robs the nutritive supplies, and often results in 268 SOME GENERAL DISEASES. a general breaking down of health, or they grow up mentally strong, but without physique to enjoy their attainments. Students, literary, professional, and busi- ness men are by their vocations also the subjects of brain exhaustion. The requirements of the present day are such that to lead, or even keep up, we feel that we must work early and late, but it is not necessary that every hour and every day should be devoted to ceaseless endeavor ; it, however, becomes a habit, a monomania almost. We see men so thoroughly engrossed in busi- ness that they feel they cannot relax their efforts even for a short time ; now this is all wrong, the necessity of the times does not call for so entire a concentration of the energies of a man in order to succeed, and to surrender all other possibilities. There is a golden medium, even though we must recognize that we live in this age of rushing. The old saying that "it is better to wear out than rust out" is true, and there would be fewer ' ' mental breakdowns " if men would work and play, but not work all day and night too. Similar results are incurred by prolonged night- watching and all over- anxieties of mind. Dys- pepsia is very often the cause of wakefulness, acting as it does through disturbance of the sympathetic nervous system. Any disturbance set up in the stomach, such as may result from overloading or indigestible food, causes irritation there, which is reflected thence to the brain. This, then, explains why the taking of heavy suppers late at night produces that state of unrest or, still worse, that condition which we term nightmare. Alcoholism. — The immoderate use of alcoholic stim- ulants is only too frequently the cause of sleeplessness. SOME GENERAL DISEASES. 269 The chronic inebriate always suffers, more or less, from want of sleep ; and when, by continuous irritation of the brain and nervous system, the condition known as delirium tremens is set up, sleep vanishes entirely, until the attack of delirium ceases. Kepeatedly do these attacks recur, promising each time shall be the last, but the confirmed drinker's system is a shattered one ; his mental, moral, and physical forces are impaired ; his strength of will is a thing of the past ; and in spite of warnings, advice, and treatment, he lapses again and again into the old habit, and finally succumbs entirely to its influence. It is popularly believed that the sudden stoppage of the accustomed stimulus will be followed by harmful results, but evidence derived from hospital practice, and from the reports of convict prisons, seems directly to negative it ; in fact, it is highly probable that a person accustomed to the very free use of stimulants may at once give them up without any danger whatever. In fact, as with other poisons, the only risk to be feared is from continuing their employment. The apparent harm, whenever it occurs from such a course, is simply due to the refusal of proper nourishment by the patient. When the desire for drink comes, he should take some liquid food, such as beef tea, milk, or milk and egg. This will stay the craving for stimulants for the time, and check that empty sinking at the stomach which always induces the yearning for alcoholic drink. Tea and Coffee. — The excessive use of either induces a whole train of nervous symptoms, with dyspepsia and sleeplessness as prominent ailments. The frequent indulgence in tea, so common among 270 SOME GENERAL DISEASES. students and ladies, acting as a stimulant, enables them to work harder, but it is sure to end in some disorder, for action and reaction are equal. A cup of tea or coffee drank a short time before retiring will often dispel sleep. Coldness of the feet is another frequent cause of wakefulness at night, and may arise from sluggish circulation or want of proper exercise. To " toast " the feet at the fire is unwise and unscientific, and only produces temporary effect. The same may be said of the use of the hot-water bottle for cold feet. The only permanent benefit is to be derived from the cold foot bath ; the water should only cover the ankles, and should have a tablespoonful of mustard added to it. The feet, being placed in the water, are then to be well rubbed by an attendant for a period of six or eight minutes, after which brisk dry friction with rough towels should be employed until a thorough reaction has taken place. Although this bath may be taken at night by those who are wakeful from coldness of the feet, it may also be employed with advantage in the daytime, when it is well to follow up the process by walking exercise to further the reaction of blood to the feet. The association between cold feet and sleep- lessness is much closer than is commonly imagined. Persons with cold feet rarely sleep well, especially women ; yet the number of persons so troubled is very considerable. Cold feet are the bane of many women. Tight boots keep up a bloodless condition of the feet in the day, and want of proper exercise, either or both of which prevent the proper circulation of the blood ; the usual custom among such people is to toast the feet SOME GENERAL DISEASES. 271 before retiring, or have a hot-water bag in bed. But it is all of no avail ; their feet still remain cold. How to prevent this troublesome condition has been men- tioned ; and while it is not a very attractive plan at first sight, it is nevertheless efficacious. All are familiar with the snowballer's hands. The first contact of the snow makes the hands terribly cold, but, as the snow- baller perseveres, his hands commence to glow. This is the plan to adopt with cold feet. They should be dipped in cold water for a brief period ; often just immersing them, and no more, is sufficient ; and then they should be rubbed with a pair of hair flesh- gloves or a rough Turkish towel till they glow, imme- diately before getting into bed. Pills, potions, lozenges, " nightcaps," all narcotics, fail to enable the sufferer to woo sleep successfully ; # get rid of the cold feet, and then sleep will come of itself. Sleeplessness as a concomitant symptom of disease is well known ; many persons of nervous, hysterical disposition from the least excitement will be sleepless. Pain of all kinds banishes sleep, and of a necessity the only way to produce sleep is to cure the causes if possible which produce the sufferings. Treatment . — In all cases where sleeplessness is the only apparent symptom, oftentimes there will be found to exist a cause other than mental worry, overtaxa- tion, etc. I have previously referred to the ill effects of taking heavy and late suppers, to the loss of sleep or labored sleep and nightmare which they often occasion ; but in conditions of mental or nervous exhaustion, a moderately substantial supper of wholesome quality is often needed to aid in bringing about sleep. It is gener- 272 SOME GENERAL DISEASES. ally a safe rule not to go to bed hungry, or to try to sleep if the stomach feels empty or ' ' all gone. " The increased supply of blood determined to the stomach by the pro- cess of digestion relieves the congested blood-vessels of the brain, and sleep is thereby encouraged. It fre- quently happens that patients will complain of waking at an unusually early hour in the morning, or of wak- ing often, and find it difficult to sleep again. On awak- ing let such persons take some light food, such as a plain cracker or warm milk, and further sleep will often ensue. The usual ways and means of inducing sleep by monotony of thought or sound, continuous counting, the reiteration of the alphabet forward and backwards, the recital of some favorite poem over and over again, the imagining of some place far distant perhaps, that tend to bring back pleasant memories, these and many others succeed in inducing sleep, and are familiar to all. Exercise is a matter of importance to the sleepless, particularly to those of feeble and languid circulation, and who habitually complain of cold feet. There is much wisdom in the ancient piece of advice, " after supper walk a mile." Those who, from their vocations, are unable to obtain sufficient exercise, or who suffer from a feeble circulation, will derive considerable benefit from the operation of mas- sage. Dr. Talcot says of it : " Not only is the process entitled massage of singular value in the rebuilding of worn and depleted systems, but we find in our experi- ence that it is a remarkable promoter of sound and healthful sleep. When persons cannot afford time during the day to take a sufficient amount of outdoor exercise, the services of a masseur may be called in for SOME GENERAL DISEASES. 273 an hour during the evening, and the benefits of a five- mile walk be thus obtained, not the least of those benefits being a subsequent night's rest of the most grateful and refreshing character." Those who suffer from sleeplessness should avoid being too warmly cov- ered at night ; an excess of clothes induces an over- heated condition of the body, with restlessness and insomnia as consequences. It is likewise wellnigh im- possible to sleep if too lightly covered ; cold and exces- sive heat are enemies to sleep. There should be a free circulation of air through the bedchamber, and it is a happy and healthful practice to become accustomed to sleep with the window open the whole year round. In these days of " Pullman cars" and rapid railway trav- elling, Dr. Tuthill Massy recommends that persons go headforemost in sleeping cars, otherwise the blood will rush to the brain and the feet become cold. A word of warning must here find a place for the benefit of those who, to obtain sleep, depend upon opiates or other nar- cotics. The apology for sleep which all these agents produce must necessarily be followed by a reaction ; the dose has to be repeated, until, by constant use, the system becomes so inured to the influence of the fa- vored soporific, that larger and increasing quantities have to be taken to produce the desired effect. The sufferer, weakened in body and mind and driven to despair, seeks refuge in another drug, which for a time, perhaps, produces the desired result, until at last, in sheer despair and from the urgent want of sleep, an overdose is swallowed, and there comes i ' the sleep that knows not waking." Instances of profound dosing with narcotics by allopathic and, I am sorry to say it, 27i SOME GENERAL DISEASES. by so-called homoeopathic physicians are numerous. I think I do not exaggerate when I say that a great many patients are killed yearly by their use. Certain it is that the use of narcotics during sickness has pro- duced a confirmed habit of their use. Homoeopaths, if true to their law of cure, never will make use of sedatives or narcotics in any form. Every case can be met, if the physician has the requisite patience and knowledge of his drugs. By the use of only the indicated remedy, which includes sleeplessness as one of the symptoms, it will bring about a change by curing the cause, and not simply overcoming it for a short time, as is the case when sedatives or narcotics are used. When pain is the cause of the loss of sleep, then too will the curative drug, which is the one that is homoeopathic to the case, stop the pain, and then will sleep follow. The allopathic physician and some wrongly called homoeopathic physicians believe that to stop pain by morphine or other narcotic is the only thing to be done ; but alas, how many times massive doses are required, and although the pain is deadened, the heart and brain are so profoundly overcome by the narcotic, that a long and tedious illness often ensues that would not have followed from the original cause which produced the pain ! In incurable cases, narcotics are not called for ; greater comfort and full possession of the faculties will be obtained by the use of homoeo- pathic remedies carefully selected. CHAPTEK XXXIII. CHILDREN AND THEIR DISEASES. The proper rearing of children necessitates patience, intelligence, constant watchfulness, and knowledge of the laws of health. The future well-being of the child depends upon the early treatment it receives. Its food must be correctly furnished and prepared, if it is to be brought up by artificial feeding. Its hygienic sur- roundings must be carefully considered, and above all watchfulness on the part of parents that the first symp- toms of trouble may be recognized. In order, there- fore, that this care may be competent, let us consider in a general way the normal type of development. The average weight of the new-born child varies between six and nine pounds. The length varies from sixteen to twenty-two inches. From the first day the growth in length and weight go on progressively and according to fairly defined rules. The child increases in length most rapidly during the first week ; after that time the weight and length progress uniformly until the sixth month, after which time it is not as rapid. Children fed from the breast grow more steadily, and always exceed those fed artificially. It has been stated that the child grows in weight and length uniformly until the sixth month ; this holds true in a measure, and although there are no definite proportions, there is a certain relation between them. A healthy child after the 276 CHILDREN AND THEIR DISEASES. first week usually gains about four pounds in weight in three months ; during teething period, weight and length apparently stand still. It may be stated approxi- mately that a healthy child should weigh twenty-five pounds, and measure ten inches in height, when two years old ; the third year about four pounds are added to the weight, and four and one half inches to the stature ; from the first to the tenth year a child should show a yearly gain of four or five pounds ; after ten years of age to seventeen the yearly increase should be at the rate of eight pounds a year. There are other measurements which furnish evidence of the normal development of children, — the measurement of the head and thorax. The circumference of the head of the new-born is stated to be about twelve inches, and, gradually increasing until at the twenty-first month, it measures nineteen inches ; the thorax has a circum- ference of twelve and one half inches at birth, and at the twenty-first month the measurement of the chest increases to sixteen and one half inches. Up to this period it will be perceived that the head has increased in growth faster than the chest ; but from this time on the relative proportions are reversed, and at the end of the third year the circumference of the thorax exceeds that of the head ; if this does not take place, it is a sign of constitutional disease possibly. The measurements here given must be considered in the light of approxi- mations, for climate, food, nationality, and heredity have a marked influence on the process of growth ; it is also to be remembered that the growth of children is not always constant ; some continue in regular pro- gression, others remain, for a longer or shorter period, CHILDREN AND THEIR DISEASES. 277 almost stationary, and then for a time grow rapidly. The infant is unable to maintain the head in an upright position until the fourth month, and if poorly nourished this may be postponed indefinitely ; the first attempt to sit up is usually noticed about a month later, although a really firm seat does not obtain usually until the tenth or twelfth month. Some children never creep on the floor, but the majority begin to show signs of creeping about the ninth month, although some children have been known to walk even at this early date ; as a rule, however, walking is not possible before the fifteenth month, or until two years old ; there is no absolute rule in these matters. It may be remarked that girls de- velop faster than boys, and that the second or succeed- ing children learn, by imitation of their elders in the nursery, to talk and walk earlier. The Pulse. The pulse of infants is very variable, the normal frequency in the first few weeks fluctuates between 120 and 150 ; at the end of the first year, the pulse rate is varied from 100 to 120 ; from this period the fre- quency diminishes, until at the fifth year the normal rate of 90 is reached. The Respiration. The number of respirations per minute varies in the new-born from 30 to 50, the frequency gradually dimin- ishing to 25 or 30. It is stated that a child produces, in proportion to its size, nearly twice as much carbonic acid as an adult. 278 CHILDREN AND THEIR DISEASES. Infant Feeding. It is universally admitted by physicians of all schools of practice that breast-feeding is superior to any other method. On the one hand, we must consider those circumstances which arise when breast-milk does not agree with the child, as sometimes happens ; and when nursing becomes impossible, from a want of milk, or the quality or quantity, from either or all of these conditions nursing is impossible. On the other hand, we must consider the relative values of artificial foods, and which one offers the most reliable results from its use. Human milk, it has been stated, is admitted the only natural food for an infant, and therefore is the best, but many infants do not thrive on the food nature has provided, and we are forced to provide some com- pound that will agree. The fact that so many artificial foods are manufactured and used, too, shows that physi- cians themselves are not agreed as to the best one, and the fact that new foods are being introduced is evidence that a perfect substitute has not been found as yet. Within the last few years a new field of work and investigation has been opened to the profession by dis- covering the presence of germs or bacteria, to which has been attributed the power of producing diseases, and, from elaborate scientific investigations applied to their influence in infant-feeding, has led to a conclusion which seems as though it should have always been known, that, as human milk is always sterile, that is, it contains no bacteria, that therefore cow's milk ought to be sterilized ; by so doing, we approach nearer the standard of nature, and from the undoubted truth of the discovery of disease-bearing germs found in milk CHILDREN AND THEIR DISEASES. 279 and many other substances as well, we have in the process of sterilization a means of destroying these germs ; but this is only one of the many steps to be taken in producing an artificial food for infants. It is especially important that we endeavor to copy, each in its turn, the various ingredients and devices which Nature makes use of in her production of human milk, for we cannot, if we try, improve it. We have not yet acquired sufficient knowledge to enable us to follow nature exactly, and we therefore have not yet obtained a perfect substitute for breast- milk, but that may yet be discovered, and until it is, we must consider well the imitations which are offered. We constantly hear of one food that gives brilliant results, and equally encour- aging reports from others, and yet infant mortality still remains far above that from human breast-milk. It is a significant fact, that breast-fed infants gain flesh faster, and their development is likewise more rapid. If from any cause the mother is unable to nurse her child, it would be for the child's good if a healthy, clean wet nurse could be obtained ; but this suggestion carries many obstacles with it. It is difficult to obtain a wet nurse when wanted, then, too, to obtain the services of a well, strong woman, who has not had any constitutional troubles in the past, whose milk is of proper age ; in fact, to procure a proper nurse requires the services of a careful physician. If it is found better to use artificial foods, attention should be paid to every detail. The nursing bottle should be simple, easily cleaned, and provided with a plain nipple drawn over the mouth of the bottle. All complicated arrange- ments are dangerous to the health of the child, as they 280 CHILDREN AND THEIR DISEASES. are more difficult to cleanse, and offer larger surface for fermentation to take place, from which disease germs spring. During the first week, infants artificially fed should be given nourishment every two hours and about one ounce each time, and in the course of twenty-four hours should be fed ten times ; from the end of the first week to the time the child is eight weeks old, the amount given should be a little more each day, until two ounces are taken at each feeding, with an interval of two and one half hours between. When the child is three months old it should be fed every three hours, and requires from three to four ounces each time. Judgment should be used in this matter, as no actual rule can be made. If the child increases in weight from week to week and appears well, the amount of food is to be as gradually increased. Many points must be considered in this matter of feeding ; a food may be sufficiently nutritious, yet improperly digested, or again insufficiently nutritious, and properly digested. It is always a good plan to make weekly weighings of children, and while not an absolute test, much may be learned therefrom. Before considering the subject of artificial foods, there are several points which demand a passing word. We have stated that the mother's milk is the only scientific food for a child ; such is the case, but there are many children deprived of it from some supposed irritant conveyed by the milk to the child. There are many difficulties which beset the nursing mother : mental emotions react upon the child, producing much suffer- ing, and in some cases death of the child ; then, too, drugs, if administered to the mother, affect the child CHILDREN AND THEIR DISEASES. 281 seriously. There is another danger in too frequent nursing. How often do mothers nurse their children to keep them quiet ! Irregularity in nursing, too frequent nursing, and too prolonged intervals often so disturb the quality of the mother's milk as to render it unfit for the child. Many children are nursed for three or four months, and, from some supposed irritant in the mother's milk, the child is put on artificial foods ; whereas, had proper investigations been made as to all the habits of the mother, and a carefuL examination of the milk been made, a wiser course might have been decided upon. I am convinced that were greater care used in this matter, the infant mortality would be less, and there would be fewer artificially fed babies. It must be admitted that there are valid reasons for not allowing a mother to nurse her child : if her general health is impaired from some constitutional cause, as consumption or syphilis. But because the mother looks too delicate, she should not be denied the privilege of nursing her child, without first examining the milk critically. Eecognizing the fact that human milk is the best food for an infant, we are forced to admit that with our methods of living, the proportion of bottle-fed babies will continue increasing. The better to under- stand how to imitate the composition of human milk demands great attention. To-day the great hue and cry is for sterilized milk ; and while this process undoubtedly is a step in the right direction, there remain other points equally important to be considered. Babies that are breast fed usually have a more uni- formly developed stomach than the artificially fed. It is therefore necessary that the quantity of food given 282 CHILDREN AND THEIR DISEASES. by bottle be accurately measured, and in proportion to the weight of the child ; in this way the rule is wider in its application than to follow a plan of feeding according to the child's age or apparent hunger. Many children become weaker and thinner, though they take large quantities of food, owing to improper quality and quantity of the food in the great majority of cases. There is greater danger of overfeeding children than that they will have too little. As soon as it becomes apparent from very careful investigation that the baby must be fed on artificially prepared food, either in conjunction with the limited supply which the mother may have, which is, I think, generally considered the better plan, rather than entirely discard it, or that it shall be wholly fed artificially, — I say, as soon as this is decided upon, then comes the all-important question, what food shall we use to take the place of that which nature has provided ? We are told of this one's baby that did so splendidly on this food, of another on that kind, and so the names almost become legion. The weight of evidence goes to prove that unmodified cow's milk does not agree with infants in the early months, of their life. From comparisons made of human milk and cow's milk, it is perfectly certain that marked chemical differences exist ; and therefore since it is admitted that of course no better food can be found than human milk, it is practically settled that it is possible to modify cow's milk until a compound is obtained that approaches human milk as closely as possible. Regarding the modification of cow's milk by mixing with any of the prepared foods now on the market, it can only be said in argument against them CHILDREN AND THEIR DISEASES. 2S3 that they all contain an element foreign to the ingre- dients of human milk ; and as we cannot improve on nature's methods, they should be regarded with suspicion. That there are many children who have thrived on Horlick's, Mellen's, and other food prepara- tions, is not to be denied, and they will continue to be used. There are, however, infants that do not do well on any of these ; and while not wishing to be understood to undervalue their merits in certain cases, still I believe modified cow's milk sterilized will be found to be more suitable for a larger number of infants than any other preparation. I do not intend to emphasize the need of sterilizing milk as enhancing its value ; it is an old and correct theory that boiled milk is more digestible ; it is likewise true that milk which has been sterilized keeps longer ; if added to these benefits, we know that disease-producing germs are destroyed also by steriliz- ing, it seems as though it is an important factor. It has been stated that cow's milk is the best to be used, but mention has not been made of condensed milk, which should be classed with the patent foods, a prep- aration varying in its proportions and containing little nutritive value, although in some cases of feeble diges- tion, from whatever cause, it certainly is very service- able ; but I can see no benefit derived from its use that could not be obtained from ordinary milk modified to the conditions of the infant. The preparation which approaches the nearest the chemical composition of human milk, and which has in my hands produced most gratifying results, is a compound or mixture first fomulated by Dr. Meigs, of Philadelphia, and since modified by Dr. Rotch, of Boston, and is as follows : — 284 CHILDREN AND THEIR DISEASES. Cream 11-2 ounces. Milk 1 " Water 5 " Milk Sugar 3 3-8 drams. The above formula has to be changed somewhat to meet the varying conditions of children. Sometimes the amount of cream must be lessened when the digestion seems unable to care for so much fat, though as a rule it is not the cream which is the cause of the indigestion, but the milk may not be suitable. The main points to be carefully noted in any food mixture for babies are, to obtain a slightly alkaline compound, and one in which there is sufficient fat and not too great a quantity of albuminoids, which is the fault in cow's milk unmodified, and that no starch is present in the food. There are various thicknesses of cream to be obtained, and it is necessary that a thin cream, register- ing twenty per cent, be used. I have said the milk is to be sterilized ; that is nothing more nor less than boiling or steaming it. Boiled milk, however, has a peculiar taste, and when cool has a scum on the surface. There is also a general belief that it is constipating, but it may be that raw milk is less digestible, and, therefore, more liable to cause diarrhoea. Steamed milk, while it also has some odor, and taste, and a scum, these are so much less than in boiled milk that the scum will readily disappear on shaking ; it there- fore seems better to steam the milk than to boil it. Dr. Jeffries very aptly says ' ' that it is a curious fact that, while older people are chiefly fed on sterilized food, that is, cooked food, infants are fed on food peculiarly adapted, by its composition and fluid state, to offer a home for bacteria." Boiled milk does not CHILDREN AND THEIR DISEASES. 285 become sour as quickly as raw milk, due, of course, largely to the fact of its sterilization. This is admitted by all, I think, and so I would advise that infants artificially fed should receive their food sterilized, thereby lessening the danger of indigestion and con- tagion by impurities in the milk. The following plan has been the one usually recommended by me, and found, I think, quite simple : Having obtained a daily supply of thin cream (twenty per cent), mix the whole quantity of food which is to be used by the infant in twenty-four hours, by mixing as soon as the milk and cream come in in the morning, and according to the formula given. For example, if it is desired to prepare one pint of food, first pour into a measuring glass two ounces of milk ; then add three ounces of cream and ten ounces of water ; then add six and three fourths drams of milk-sugar ; now pour this mixture, as soon as the sugar is dissolved, into the feeding bottles, each to contain as many ounces as will be required for one feeding, using as many bottles as is necessary ; it is ready now to be steamed or sterilized. There are many sterilizers offered for sale, and, of course, they differ somewhat in construction, but the principle is the same in all ; the requisite article being a tin pail eight or ten inches in diameter, and twenty or twenty- four inches deep, with legs sufficiently high to allow a gas burner to stand under it ; this, however, is not essential, as the pail can be placed on the stove ; then a perforated tin sheet, on which the bottles can stand while being sterilized, which is to be held four inches from the bottom of the pail ; a cover with a small vent in it for the escape of steam fits on the pail. Water is placed 286 CHILDREN AND THEIR DISEASES. in the bottom of the steamer to the depth of about an inch, which is allowed to boil, and then place the tin sheet or diaphragm in place, on which the bottles are to be stood ; the mouths of the feeding bottles are loosely packed with clean, absorbent cotton, the cover is now adjusted, and the steaming continued for thirty or forty minutes. The bottles are now removed and allowed to cool. When the food is required subse- quently, a bottle is simply immersed in hot water to bring the milk to a required temperature ; the cotton should always remain in the neck of the bottle until just before the nipple is put on at the time of feeding. Food sterilized in this way can be kept for a number of days, and can be utilized when the infant is to be taken a journey. When a steamer cannot be obtained, made especially for the purpose, a simple colander with a lid, placed on the teakettle or over a pot of boiling water, will answer quite as well. GENERAL RULES FOR FEEDING. Age. Intervals of Feeding. Average Amount at Each Feeding. Average Amount in 24 Hours. First week. 2 hours. 1 ounce. 10 ounces. One to eight weeks. 2>o hours. \%_ to 2 ounces. 12 to 16 ounces. Eight to fourteen weeks and possibly to fifth or sixth month. 3 hours. 3 to 4 ounces. 18 to 24 ounces. At six months. 3 hours. 6 ounces. 36 ounces. At ten months. 3 hours. 8 ounces. 40 ounces. Certain abuses should be referred to common with artificially fed children. Never allow a child to feed CHILDREN AND THEIR DISEASES. 287 from a bottle while lying down ; imitate, as near as possible, the position of a breast-fed child. Avoid complicated nursing bottles ; use only a nipple, on a smooth, wide -mouth bottle ; cleanse all bottles with soap and hot water, and when not in use fill with a solution of soda and water. The nipples should be turned inside out and thoroughly washed ; they, too, should be kept in clean water when not in use; Do not use a nipple too long, but procure new ones often. Examine the openings in every nipple to see if the flow of milk through them is neither too free nor restricted. Feed the child at regular intervals, and regulate the frequency according to the age of the child ; the quantity should also be accurately regulated according to the weight of the child ; bear in mind the mistake .is oftenest made of giving too much food rather than too little. If the child does not take the whole of its milk at one feeding, throw it away. Never reheat the milk, or use it after it has been standing. Better waste a little food than jeopardize the health of the child. The milk from a herd is better than one cow's milk, for obvious reasons. "Weaning". The time of weaning cannot be positively stated for all children ; dentition is usually a determining process, and as soon as the lower incisor teeth appear it may be considered time to think of a change of food or supplemental feeding. With the eruption of the teeth occurs a change in the digestive organs of the child, — a change which makes possible the digestion of ad- ditional elements, and a necessity for the continued 288 CHILDREN AND THEIR DISEASES. growth of the tissues. It is too commonly believed that when the teeth appear the child requires a greatly changed diet ; nothing could be further from the truth ; milk should continue to be the chief article of the child's diet even up to the fifth year, and perhaps longer, but not modified ; as above mentioned, cow's milk ster- ilized ought now to be used. Certain additions may properly be made ; some farinaceous substance can be added to the milk, — barley water, bread crumbs, bread jelly. Beef tea is often a good intercurrent food ; also mutton and veal broths are nutritious. Mutton broth is excellent if the child has diarrhoea ; veal broth sometimes produces looseness of the bowels. As soon as the child has its full complement of teeth (sixteen in number), a more varied diet may be given. At this period potatoes may be given sparingly, either baked or mashed, stale bread and butter, and soft boiled eggs. The child should be fed five or six times daily ; it is, however, generally better to continue with a milk diet in the main, adding thereto barley water or well- cooked oatmeal. If this plan is carried out, the terrors of the second summer are overcome. Then comes a period when children are walking alone, and have passed the second summer safely, when parents often relax their efforts to select proper food for their children. They now sit at table and are allowed to taste of many things which are improperly given either by the parents themselves or some other imprudent person. Such liberties often make children dissatisfied with their simple diet, where- as, had they never known the taste of other food, they would continue satisfied with their simple diet. Children CHILDREN AND THEIR DISEASES. 289 at the age of three to five should be allowed well-cooked oatmeal, rex wheat, wheat germ, wheaten grits, white and Graham bread and butter, with plenty of milk, boiled eggs, plain soups, oyster broth, roast beef, mutton and broiled beefsteak, in very small quantities, fresh fish ; if unusually hearty, allowed to have milk be- tween meals. Fresh ripe fruit may be given in moder- ation ; potatoes may be given as before mentioned, also peas, macaroni, and tomatoes. Avoid all spices and salted meats, made gravies, and highly seasoned food. Allow no tea, coffee, wine, or beer. The articles men- tioned are not all that may in some cases be allowable ; it is impossible to lay down arbitrary rules for the feed- ing of children ; it must be borne in mind that the old saying, u one man's meat is another man's poison," is applicable to children as well. CHAPTEE XXXIV. FEATURES OP SICKNESS, AND GENERAL RULES FOR NURSING OF SICK CHILDREN. It is as important to keep a child in health as to know how to restore it when sick. A mother carefully watches her child during its waking and sleeping, and if the attention is intelligent, every abnormal symptom is noted. Too many mothers worry and fret over trifling ills, while others fail to recognize sickness when present. In some families the use of a clinical ther- mometer is of benefit, providing the knowledge that there is a rise in temperature does not cause too great alarm, and if the persons using the thermometer will inform themselves of the true significance of thermom- etry, then will the instrument be a valuable aid in the management of children's ailments. The normal tem- perature of a child is about 98 2.-5° to 99° F. Thermom- eters now in use are provided with what is known as an indestructible index, there being a broken column of mercury ; when heat is applied the columns rise to their registering point, and when the thermometer is removed, the upper piece of mercury is left in position and remains in the exact place to which it was elevated. To test the temperature of a person, always look at the register and see that the upper column of mercury is opposite the 96° marking ; if it is higher, by holding the end which contains the mercury down, and hitting one hand against the other, the column or register will RULES FOR NURSING OF SICK CHILDREN. 291 be shaken down ; this should be done carefully, and when the above-named point is reached, place the lower end or bulb of the thermometer in the armpit, and see that the flesh completely surrounds the bulb ; it is to be kept in this position five minutes, and upon removal the temperature is noted ; then carefully wash the instrument in cold water. In young infants it is much easier to take the temperature by inserting the bulb, properly oiled, about one inch into the rectum. Children often submit much easier to this procedure than under the arm. The child should be laid on the bed upon its left side, and covered with a light blanket ; the observer should hold the thermometer and place the other hand on the body to prevent sudden movement of the child and displacement of the instrument. The mercury rises rapidly, and therefore need be retained in position only one or two minutes. In estimating the significance of temperature elevation or depression, great care must be shown. Bear in mind that a normal temperature may vary from 97° to 100° F., being influ- enced by the time of day. The temperature taken at the rectum is usually one degree higher normally than that under the arms. The temperature is likely to go below the normal about midnight, and a degree above in the afternoon. A child's temperature is more easily dis- turbed than an adult's : a slight digestive trouble may cause the temperature to rise quickly to a great height. To rightly interpret the results of thermometry, an accurate record should be kept on paper. State time of day, then the registering of the thermometer ; repeat the observation in two hours, and again make a note of it. Taking the temperature at stated inter- 292 RULES FOR NURSING OF SICK CHILDREN. vals, and making a record of it, enables one to follow the nature of the causes which produce the fever. From continued elevation of temperature to spasmodic rise and fall much can be learned ; a continued rise of temperature is more to be dreaded than a high temper- ature followed by long remission. If the temperature daily grows higher, much anxiety is to be felt, or a high temperature followed by a subnormal of two degrees or more is a greater cause for anxiety. Rapid rise in tem- perature continuing only a few hours, followed by nor- mal heat, occurs during slight catarrhal troubles and simple digestive irregularities. Continued rise of tem- perature indicates inflammation of some internal organ, as the lungs or pleura, or some continued fever, as typhoid, scarlet fever, or measles. Subnormal temper- ature is caused either by hemorrhage or loss of fluids, as in cholera infantum ; in wasting diseases, as anaemia, mal- nutrition, or occurring during the course of any inflammatory trouble when the vital forces are becom- ing depressed. Subnormal temperature should always be considered dangerous. The degrees of temperature should be carefully understood, that their significance may be given a proper interpretation. Unless such knowledge is obtained, many a mother will be caused unnecessary alarm, or even distrust her physician be- cause he does not do more for her sick baby, or if per- chance she calls another one, not to over-rate the latter because his coming was at the stage of decline of fever due to natural causes. The temperature of adults is quite uniform, though extremes of age have their in- fluence. In very aged persons a temperature of 97° F. may still be normal, and we must remember that in RULES FOR NURSING OF SICK CHILDREN. 293 children the temperature is somewhat higher than adults, and the daily range greater. From Finlayson's "Clinical Manual" I copy the following table as a guide : — 95° Fahr. ^) Very low or collapse tem- 96.8° " ) peratures. 97.7° " Subnormal temperatures. 9S.6° " Normal temperatures. 1 SHghtly above normal, or Below About normal. About About About Above 99.5° 100.4° U01.3° ('102.2° (103.1° f 104° (108.8° 105° slight fever tempera- tures. Moderate fever tempera- tures. Highly febrile tempera- tures. Excessive fever tempera- tures. General Hygienic Rules. Every family cannot set aside a separate room for a nursery, but every one can observe certain rules which, if carried out, will redound to the health of the children and adults as well. Sunlight and pure dry air should be the essential features of every home, but more par- ticularly should attention be paid to obtain both of these for children who spend so much time indoors. During the fall, spring, and winter seasons the proper tempera- ture of the house is difficult to obtain, and at the same time have proper ventilation. Those who can have open fires are supplied with means for both ends, though they cause floor draughts which are felt by young chil- dren who spend much time on the floor. In winter, 294 RULES FOR NURSING OF SICK CHILDREN. when rooms are heated by stoves, great care must be taken that some form of window ventilation be obtained, and there is no excuse for not having it, since the ex- pense is trifling. The temperature of the nursery should be from 65° to 68° F. This may seem too low a standard of heat for many, but if it were the general custom to maintain as low a temperature, there would be fewer i 'colds" taken. The arrangement of the windows in the nursery should require special thought ; not only does the radiation of cold from the glass deduct from the heat of the room, but children are subjected to this difference of heat if they stand near the win- dows, therefore it is necessary that some ingenuity be shown to prevent them from standing near them. The furnishings of a nursery should be simple in character, the floor of hard wood or covered with rugs that can be easily removed for cleaning. Children should never sleep in the same bed with their nurse, or with old people, nor in the same room occupied by any person known to be suffering from consumption. There should be no set bowls in any sleeping-room, and better that the bath-room should be as far re- moved as possible from sleeping-rooms. Toilet pow- ders are often of more harm than good; in fact, they are wellnigh unnecessary if care be taken to dry the skin by pressure with soft cloths ; powder may be of some use to prevent chafing around the seat and groins. The toilet powders usually sold in the shops are mainly composed of lycopodium, and should never be employed; powdered starch or talc is best. The infant's clothing should be light in weight, yet warm, and all parts uni- formly protected ; avoid tight clothing or bands. There RULES FOR NURSING OF SICK CHILDREN. 295 is no greater abomination than the practice of pinning children's skirts ; all garments should hang from the shoulders ; abdominal bands are unnecessary after the first few months. Opportunity must be given for free movements of arms and legs, and that it may breathe naturally. How often do infants cry and worry from too tight clothing ! Children's nightgowns should always be of cotton and wool, for the bodily heat falls markedly during the sleeping hours. Then, too, a child should be uniformly protected by night as by day. Children must be kept out of doors as much as possible ; they can be taken out at the first month, for a very short time, well protected ; the eyes should be shielded from the bright light ; as they grow older keep them out in the air as much as possible. General Nursing of Sick Children. Good nursing is better than doctoring, is an old say- ing, and one is dependent upon the other for good re- sults. It is of first importance that the person who is to take care of the children when sick should be firm though gentle, and when the confidence of the child is won, then will the rules so important for the welfare of the child be of utmost good. Never deceive a child in the slightest degree ; for though the deception may avail your purpose once, you are prejudicing your future use- fulness. Children are too often coddled and fondled too much when sick. It may seem unsympathetic to lay a child in its bed; but if the experience of physicians and hospital nurses could be every mother's, they would never forget the restful expressions, even of sick chil- dren, when allowed to lie quietly in their beds. It is this 296 RULES FOR XURSIXG OF SICK CHILDREN. apparent letting alone which is so important in nurs- ing sick children. It may be said in rebuttal of this teaching that children cry to be taken up, but they know not what is for their physical good. It is true, nevertheless, that children will rest and recuperate better if let alone. Pure, fresh air is of necessity, and that the supply is constant, care being taken that the tem- perature never falls below 60° F. In lung troubles it is of great importance that the child who is breathing so rapidly, and consuming the oxygen of the air so quickly, be given a renewal at frequent periods. Never allow the gas or a lamp to burn low in a sick-room ; it vitiates the air quickly ; candles are far better to use. The majority of children are warmly dressed during the day, but when put to bed they are too often thinly clothed. The nightgown, or combination garments, should be of cotton and wool, loose and easily changed-; in sickness they should be changed at least twice daily. As it is difficult to keep children covered while lying in bed. a light-weight woollen sack should be put on that will offer protection for the chest and arms. The feed- ing of sick children is often a matter of great difficulty, and requires patience in its proper fulfilment. If the child is fed artificially, the utensils should be scrupu- lously clean, and the food, which must be given often, must be freshly prepared each time. In general, when children are sick, diminish the quantity of food and its strength, and give in small quantities oftener, according to the apparent need of the patient. Bathing or sponging the child with alcohol and water is necessary, and should be repeated twice daily unless otherwise or- dered. Hot baths should be of a temperature of 95 c F. i RULES FOR NURSING OF SICK CHILDREN. 297 A thermometer should be used to determine the requi- site heat, and not the hand. For children in health, a hot bath had better be given daily for the first year, but always sponge the child with cool water after taking him from the hot bath ; then thoroughly but gently dry the skin. The cool sponging is a good prophylactic against taking cold. Very sick children should be care- fully watched to recognize the first appearance of a bed- sore, that it may be detected, and means at once taken to protect it. Children so rapidly grow ill that the attendant should be on the alert for every change. Mothers should never wait for a child's illness to define itself, but check the early manifestations of trouble ; it is better to call the doctor once unnecessarily than an hour too late. Quiet is another essential for the sick, whether adult or child. Many a child has been forced into a fatal relapse by over joyous parents or friends trying to entertain the little one, or the course of a disease been made more tedious for want of quiet and rest. The Features in Sickness. There are certain general evidences in diseases of chronic and acute nature which aid in locating the seat of trouble. We notice the enlargement of glands in the neck or groins, or films over the sight of the eye, and the peculiar pink and white color of the complexion, all indicating a scrofulous tendency. Then, too, we see children of delicate build, bright, shining eyes, quick and eager, of handsome feature, w T ith a delicate blush on their cheeks, and surrounding skin almost waxy it is so delicate. These features we often fear may suggest the tendency to tuberculosis. Coarse features, thick 298 RUJ.ES FOR NURSING OP SICK CHILDREN. lips, and reddish hair may also be indicatory of the same disease. Pallor of the skin is significant of anaemia, and may arise from want of proper food, exercise, or inherited weakness. Sometimes there is a bronzed skin which is associated with the same diseases. Dark-complexioned children we perhaps wrongly con- sider will suffer from digestive and liver troubles, while with a blond complexion we are on the alert to recog- nize the incipient brain symptoms, and expect such children to show delirium from trivial ailments. Flushed cheeks are common in feverishness of all illnesses. In cerebral troubles we often have one or both cheeks of circumscribed redness. Flushing of the face, alternating with duskiness, is often seen in acute lung troubles. If there is more decided duskiness, even approaching blueness of the face and under the finger nails, we think of bronchitis and threatening collapse. We also see this latter manifestation in whooping cough during a paroxysm of coughing, but it passes off with the subsidence of the ' ' spell. " .Continued blue skin, as seen in "blue babies," indicates malformation of the heart. Sweating is common in many feverish states, and if warm is not a symptom causing the anxiety that cold, clammy perspiration does that is an attendant upon collapse or occurring during exhausting diseases. Scrofulous and rickety children usually perspire pro- fusely about the head and neck, especially during sleep. The Cries of Children. In sickness we can often interpret the meaning of the- cry, for by this method a child expresses a great RULES FOR NURSING OF SICK CHILDREN. 299 deal ; it even seems to be their only language. To deduce a meaning from the crying of children requires close observation. With thoracic troubles in children, as pneumonia and pleurisy, they cry after any effort to cough. If expiration and inspiration are equal, we, as a rule, think there can exist no lung complication. However, this is not always true ; children cry pas- sionately when the pain is connected with digestive ail- ments, drawing up their knees and making all sorts of movements vainly trying to find ease. Children some- times cry after urination, due to passage of gravel or sand. We also notice that children having spinal disease cry when being lifted by the feet, as in the act of "changing. 55 In brain troubles we most generally hear a shrill, loud shriek, called the ' ' hydrocephalic cry," but the writer has known children to give just such shrieks when the brain was in normal condition, but there existed an inflammation of the ear. In croup the hoarse, metallic sound is pretty generally understood. The absence of crying is of graver import sometimes, for when a child is exhausted it becomes too feeble to utter a sound ; it only wrinkles its little face, but its lips utter no sound. CHAPTER XXXV. HYGIENIC CARE OP CHILDREN. Some Common Diseases. The human subject is provided with two sets of teeth in the course of life. The first set, consisting of twenty teeth, appear during the first two years after birth, and are known as the temporary, milk, or de- ciduous teeth. The second set, thirty-two in number, appear after the fifth year, and are called the permanent teeth. The teeth are generally cut in groups, each effort being followed by a short pause or period of rest. There is no absolute certainty as to the order of erup- tion of the teeth, although generally the following averages are the rule : — First, the two lower incisors appear between the fourth and eighth months after birth. Between the eighth and tenth months, the two upper central incisors, followed shortly by the two lateral incisors. Between the twelfth and fourteenth months, the two upper anterior molars, the two inferior lateral incisors, and the two lower anterior molars appear in the order mentioned. Between sixteenth and twenty-fourth months, the canine teeth (eye and stomach teeth) appear. Between the twentieth month and the end of the third year the four posterior molars appear. HYGIENIC CARE OF CHILDREN. 301 Diagram showing the order of the Eruption of the Temporary Teeth. The temporary teeth drop out in about the same order as they appear. The roots begin to absorb first, and gradually the teeth are loosened and their places filled by the presence of the permanent teeth. The process of eruption of the teeth is usually in the order mentioned, but there are many variations from this rule. We see children who were born with one or more teeth ; they usually fall out, to be replaced at the proper age by well-formed milk teeth. Natal teeth are usually incisors. Some children cut their first teeth much younger than has been stated above as the rule. Girls are more apt to cut their teeth early than boys. Dentition may be delayed. Artificially fed babies, as a class, are more tardy in cutting their teeth than those reared at the breast. With such, though healthy in every respect, a delay of one or two months is a common and not at all serious event. On the contrary, whatever the method of feeding, if no teeth appear by the end of the first year, it may be assumed that the child's general nutrition is at fault, or that some disease of the bones is threatening, like rachitis. The teeth may appear out of their regu- lar order ; this may be the case especially in bottle-fed infants, which is of some importance as an evidence of general weakness, or it may be due entirely to a family peculiarity, and, as such, bears no special significance. Dentition has been looked upon as a time to be dreaded, 302 HYGIENIC CARE OF CHILDREN. being held accountable, directly or indirectly, for nearly all the ills of infancy. At the present day, however, due to a better understanding of children's diseases, the symptoms occurring during the periods of dentition are traceable to other causes. It is a purely physiological process, and as such should not be a cause of sickness. Fever, restlessness, fretfulness, and disturbed sleep are the commonest manifestations of infantile derange- ments. Not unfrequently they are coincident with the eruption of a tooth or a group of teeth. Under such circumstances the general practitioner might connect the symptoms mentioned with the eruption of the teeth. If, however, this was the cause, one would expect these symptoms to continue throughout the process or occur at each teething time. Diarrhoea, so common during teething, is looked upon by some as beneficial to teething children, thereby relieving the brain from possible in- flammation. This is wrong. Many children are sacrificed, and usually through a belief in this erroneous doctrine. A perfectly well child should go through the teething process, as he does through any other period of develop- ment, without symptoms. The modern use of soothing syrups, rubbing the gums with laudanum or cocaine, and the unlimited and unwarrantable use of the lancet, are disastrous in the extreme. Healthy, vigorous, and nor- mally developed parents beget healthy children. Proper hygienic surroundings and care as to the diet will insure the child against most of the ills of the period of teeth- ing. Too much care cannot be bestowed on the nourish- ment of the child. Too often does the attributing of the symptoms coincident with teething lead to a fatal mistake, and the cause would be found if properly HYGIENIC CARE OF CHILDREN. 303 sought for, and found to arise from pneumonia, pleurisy, diphtheria, or some other serious malady. The perma- nent teeth erupt at the following periods, the teeth of the lower jaw preceding those of the upper, quite the same condition as with the temporary teeth. To accom- modate the increased number of teeth, the jaw increases in length. Sixth year Seventh year Eighth year Tenth year Eleventh year Twelfth to thirteenth year Twelfth to fifteenth year Seventeenth to twenty-first year, first molars, central incisors, lateral incisors, first bicuspids, second bicuspids, canines, second molars, wisdom teeth. The Care of the Teeth, Nails, and Hair. The cleansing of the teeth should begin with the appearance of the first tooth. Ordinarily, a soft cloth folded over the finger, dipped in cool water and thor- oughly rubbing the teeth, is sufficient to keep the first teeth clean. If, however, a thin green scum forms at the junction of the teeth and gum, a little chalk, charcoal, or pumice may be required. For this purpose a piece of wood may be employed to rub them with, first clipping in water, then allowing a little of the powder to adhere to the moistened end, care being taken not to injure the gums and cause them to bleed. Take good care of the milk teeth, for upon their integ- rity depends the regularity of shape of the permanent teeth. Never allow the first teeth to be extracted, for it may result in deformity of the jaw. A tooth- 304 HYGIENIC CARE OF CHILDREN. brush can be used after a number of the milk teeth have been erupted. The brush, of course, should be small, and its bristles soft and fine, and it must be used with gentleness. No powder need be used, except under conditions mentioned above. The child should early learn to clean his own teeth. The hair should be well brushed, and the scalp thereby stimulated ; this will be enough to keep the hair moist and make unnecessary the use of oils, pomades, etc. Avoid the use of a fine-tooth comb. Occasionally washing the hair with soap and water, and drying thoroughly, is necessary. The toe nails should be carefully cut ; there is a right and a wrong way ; cut the nails straight across, without rounding the corners. Should the latter be done, the nail is liable to grow into the flesh, and cause the child years of suffering. The finger nails should not be allowed to grow too long, but care must be taken that they are not cut too close. Sore Byes, At a very early age, perhaps on the second or third day after birth, children are liable to have conjuncti- vitis, or sore eyes, an affection that may be of a mild type or a destructive inflammation. In either case it begins with a slight white discharge, which may grow more abundant in a very few hours. If the attack is mild, the discharge continues white and scanty in amount. Very frequently it does not remain so simple a trouble, and then the disease assumes a severe aspect, requiring prompt attention and the treatment of a skil- ful physician. Neglect has been followed by deplorable HYGIENIC CARE OF CHILDREN. 305 results. It is estimated that a large majority of the inmates of our asylums for the blind are examples of the results of negligence or bad treatment of infants' sore eyes. This disease is very contagious, and there- fore great care should be taken that the cloths used to wipe away the secretions be burned immediately. The causes are infection from the discharges of the mother, exposure to too strong light, etc. Preventive measures should always be taken when the child is born. The eyes should be kept clean by removal of the discharge with a soft cloth or sponge. As the disease requires special medical care, no remedies will be here recom- mended. At the very outset call the attention of a physician to it, and insist that a very careful exami- nation be made of the condition of the eye structures. Many cases become hopeless through the carelessness of physicians as well as mothers. Colic. Nearly the first of the lighter ailments of infants is colic. It may be caused by errors of diet on the part of the mother, or the result of some mental or physical trouble of the mother. In artificially fed infants the food may be too rich, or it is otherwise unsuitable either in quantity or composition. Following an attack of colic, the bowels are likely to be relaxed, and the dis- charge " greenish" in color. Treatment. — Chamomilla. — Child wants to be carried ; face flushed ; one cheek white, the other pale ; draws up its legs when in pain, feet cold. Colocynthis. — Draws up its legs in pain, feet cold. Pulsatilla. — Shivering with rumbling of wind; 306 HYGIENIC CARE OF CHILDREN. child is easier lying on its stomach ; face pale ; abdo- men sensitive to pressure. Light-haired children with blue eyes. Nux vomica. — Constipation, attendant colic. China. — Great distention of bowels, abdomen dis- tended and hard, more liable to occur towards even- ing. Crying at one time, then laughing. Ipecac. — Vomiting and diarrhoea, perspiration, face pale, pain severe. Coryza and Snuffles. Children sometimes refuse to nurse from their inability to breathe, because of obstructions in the nose due to a catarrhal secretion. Cleanse the nose care- fully, and if the mucus becomes encrusted, remove with the blunt end of a hairpin. Aconite. — If skin is hot, face flushed, extreme restlessness. Nux vomica. — If the discharge is free by day, and ceases at night, beginning again in the morning. Mercurius vivus. — Discharge thin at first, great sneezing, nose sore, or if the secretion becomes thick and yellowish. Euphrasia. — For sneezing, thin white discharge, eyes water a great deal. Tartar emetic. — Battling of mucus in the chest, worse at night, with running from the nose. Sore Mouth. This condition may be due to a simple disturbance of the stomach, from improper food, want of cleanliness. The mouth is at first dry, but soon there is an increase HYGIENIC CARE OF CHILDREN. 30T of saliva, and the child is unable to nurse, as the contact gives pain. There may be a white deposit or separated white spots on the inside of the cheeks resembling milk curds, or on the margins of the gums, and tongue. The child will be restless, irritable, and sleepless ; diar- rhoea. There are several forms of sore mouth besides the above. The aphthous sore mouth differs in the appearance of the mouth, and is recognized by the clean-cut ulcers which appear under the tongue and upon the edges of it, also on the under lip ; they are round, slightly raised, and have a yellow centre sur- rounded by a bright red ring. The latter affection is more likely to occur in children between the age of two and six years, while the former is often met with soon after its birth. Either condition may occur dur- ing the course of severe constitutional disease, or may result from easily removed causes. Treatment con- sists in perfect cleanliness of the mouth with water several times daily. Washing of the mouth should be a part of the first cleansing at birth. Correct any dietetic errors, if known to exist. Some one of the following remedies will be fouod useful : — Baptisia. — Sore mouth, aphthous variety, salivation. Mercurius vivas. — Increased secretion of saliva, diarrhoea, perspiration increased. Arsenicum. — Thirst for small quantities of water, restlessness, diarrhoea, ulcers look bluish in appearance. Prostration marked. Sore Throat. Infants occasionally are prevented from nursing by soreness of the throat. The disease may be produced 308 HYGIENIC CARE OF CHILDREN. by exposure and changes of temperature, or the result of predisposition. The disease is recognized by inability to swallow. Children begin to nurse, and then, when swallowing, finding it gives pain, desist ; their cry is hoarse ; in the beginning, feverishness ; in some cases the disease is a precursor of scarlet fever or measles. The throat should always be examined whenever a child complains of sore throat or shows signs of painful swallowing. Two forms of sore throat only will here be consid- ered, namely, tonsillitis and pharyngitis. The former is recognized by the presence of round white spots on the tonsils ; these spots may be seen only on one, or both, or disappear from one only to appear on the other tonsil. Diphtheria is easily confounded with tonsillitis, but the spots in the former disease are larger, irregular, and look more like patches of wash-leather; then, too, the odor of diphtheria is characteristic. Pharyngitis is an inflammation of the membrane on the back surface of the throat. When inflammation attacks this place, the surface looks irregular, studded with elevated small bunches like a split pea, or a streak of redness with swelling like a whipcord. There may be fever as in all the throat affections, and increased mucous discharge. Prostration is common to all these affections. Aconite. — Is indicated for the feverish state with dry, hot skin, flushed face, extreme restlessness. Belladonna. — Flushed face, moist skin, skin hot, throat looks bright red. Lycopodium. — Right side worse ; appetite easily satisfied. HYGIENIC CARE OF CHILDREN. 309 Lachesis. — Left side worse ; throat of a dusky hue ; always worse after sleeping. Throat sensitive to pres- sure on the outside. Constipation. Constipation in children is usually not a disease in itself, but a result of various causes. The normal number of discharges from the bowels each day varies with children ; for some, one is normal, others -having four or ^.ve movements daily. It is difficult, therefore, to estimate what constitutes constipation. It may be the cause of some serious abdominal troubles, but very rarely, however, and likewise it may be an accompani- ment of other diseases. Constipation may be recurrent, with regular remissions. Artificial foods are very liable to be the cause of constipation ; or neglect in establish- ing regularity. If the new-born infant has no passage very soon after its birth, examine carefully to see that no mechanical obstruction exists. If the child has painful evacuations, it will often resist the desire, and so aggravate the existing difficulty. If the child suffering from constipation is nursed, attention should be paid to the diet of the mother or wet nurse. If the infant is artificially fed, and its development is satisfactory, do not change the food, but administer one of the follow- ing remedies. Sometimes several injections of luke- warm water may be given, but not to be used too often or continuously day after day. Gentle kneading of the bowels is often beneficial. Bryonia. — If stools are hard, dry, and look burnt. Nux vomica. — Frequent desire, without accomplish- ing anything ; useful after allopathic remedies have been given. 310 HYGIENIC CARE OF CHILDREN. Opium. — Stools are like sheep dung; great strain- ing. Antimony cruclum. — Tongue coated white; opera- tion very painful. These are only a few of the remedies that may be useful. Bear in mind always that all the symptoms are to be taken, and not to prescribe for one condition alone. Diarrhoea. Diarrhoea is the result of predisposition, improper food, or improper habits of feeding, unhealthy sur- roundings, excessive heat, fatigue, or dentition. The symptoms are well known, but it may be advisable to consider the difference between simple diarrhoea and the disease known as cholera infantum. Both have diarrhoea and vomiting, but with the former the disease is of shorter duration. In cholera infantum the child is more restless and overpowered by the disease, and chiefly by the character of the stools. In simple diar- rhoea the stools often contain undigested food, much gas, and the odor is very foul. In cholera infantum the first stools are pale green, yellow, or brownish, but soon become very frequent and lose all color, and look like thickened water. In acute dyspeptic diarrhoea the stools are not so frequent ; there is less fever and prostration. There may be vomiting in dyspeptic diar- rhoea, but always in cholera infantum. A dyspeptic diarrhoea may run in to cholera infantum if neglected. Treatment. — It is both general and medicinal. There are some points in the manner of feeding children in diarrhoea to which special attention should be paid. HYGIENIC CARE OF CHILDREN. 311 If the stomach is very irritable, withhold food for some time, and then diminish the quantity and frequency. Always attend to every case of simple diarrhoea, and never allow it to become serious through negligence. If a diarrhoea becomes chronic, or cholera infantum does not readily yield to combined treatment, remove the patient to seashore or mountains. The change of air and motion of the cars or carriage are very beneficial. It is an admitted fact that the motion in riding is most salutary in cholera infantum. Many apparently hope- less cases have begun to improve during a journey in the cars. A very common error in the feeding of infants is the frequent changes of foods before suffi- cient time has elapsed to prove the wisdom of the change. During an attack of diarrhoea, whether in the simple form or the nature of cholera infantum, an attempt should be made to arrest all nervous excite- ment ; quiet and pure air are all essential. Medicinal Treatment. — One must recognize the characteristics in every case if possible. Recognize if there be pain or absence of pain before, during, or after stool ; character of the discharge ; color, odor, whether fecal or mucus. Try also to discover the exciting cause. Arsenic. — Brown or dark green stools, gradually becoming thin and watery ; exhausted after each stool ; thirst for small quantities of water, but wants a sip often ; burning sensation in the rectum after stool ; painless ; worse at night, especially after midnight ; diarrhoea caused by ice water or ice cream, cold milk ; vomiting, especially before stool ; great restlessness ; vomiting more after eating or drinking. The thirst and 312 HYGIENIC CARE OF CHILDREN. marked restlessness are marked characteristics for Arsenicum. Antimony crudum. — Stool profuse, watery ; diar- rhoea alternates with constipation ; diarrhoea may be pro- duced by being overheated, and after bathing ; pains sharp and cutting ; rectum protrudes during stool ; children dislike being touched or even looked at ; tongue thickly coated white ; violent vomiting ; urine profuse. There is not the severe thirst as in Arseni- cum, but with the heavily coated tongue it is also a good guide. Aloes. — Stool yellow fecal ; bloody mucus, some- times greenish ; involuntary, especially when passing flatus or urine ; hunger with diarrhoea ; great pain, much flatus ; hemorrhoids, large and tender ; loud rumbling in abdomen. The character of the stools, the good appetite, and rumbling in the abdomen form a trio of symptoms indicatory of the remedy. Borax. — Stool light yellow or green ; slimy mucus or watery'; children dislike downward movement or rocking ; nursing sore mouth ; loss of appetite ; start- ing during sleep with screams, acting as if frightened ; skin pale. Chamomilla. — Stools look like chopped spinach, or green watery stool ; smell like bad eggs ; diarrhoea, especially during dentition ; child cross, and wants to be carried ; one cheek pale, the other flushed ; colic, retching ; child is peevish ; wants many things which are rejected when offered ; convulsions. This remedy is not indicated in long-standing cases, and often fails to complete the cure alone. China. — Stools yellow, watery ; blackish or dark, HYGIENIC CARE OF CHILDREN. 313 watery, painless stools ; involuntary, worse after meals ; at night ; after severe illness ; worse every other day ; stools may be painful, but more often painless, with emission of large quantities of fetid flatus ; great de- bility ; sweats at night, and stools more frequent at night. Croton tig. — Stools yellow, watery, dark green, or tenacious mucus forcibly expelled ; coming out like a shot ; worse after eating, drinking, or nursing ; perspi- ration on the forehead ; nausea, with fainting ; nausea during sleep. The yellow stool, its forcible expulsion, and aggravation from drinking, eating, or nursing, are symptoms plainly calling for Croton tig. Gamboge. — -Stools thin, yellow, fecal, mixed with mucus ; offensive ; frequent ; quickly expelled with effort, however, straining may continue after expul- sion ; cutting pains ; nausea ; aphthous sore mouth : urine smells like onions ; exhaustion. Ipecac. — Stools green as grass ; bloody mucus, fermented ; worse at night, during dentition ; continued nausea and vomiting of green mucus in large quantity ; colic ; skin cold, clammy, and pale. Magnesium carb. — Stools green, watery, frothy, with green scum resembling that seen on a frog pond : bloody mucus ; pain pinching and cutting in character before stool ; thirsty. Mercurius viv. — Stools dark green, frothy ; mucus, streaked with blood ; stools are frequent, often scanty in amount, sour smelling ; diarrhoea worse at night ; during dentition ; violent urging before stool, and ' ' a never get done feeling" after stool ; much perspiration ; increased amount of saliva ; restless sleep. 314 HYGIENIC CARE OF CHILDREN. Nux vomica. — Stools thin, brownish, small, offen- sive, and frequent ; suitable after children have had many strong drugs given ; acute pain and frequent urging. ' Podophyllum. — Stools thin, yellow, watery, pro- fuse ; rectum protrudes after stool ; gagging or empty retching ; the stools are very profuse, and, though fre- quent, there seems to be no limit to the supply. Pulsatilla. — Stools greenish, yellowish, mixed with blood ; involuntary (during sleep at night) ; indicated in diarrhoea caused by eating ice cream, fruit, and cold drinks ; constant spitting of cotton-like mucus ; vomit- ing, chilliness ; especially indicated in nightly diar- rhoea. Sulphur. — Stools watery, changeable, sudden ex- pulsion, and sometimes involuntary ; worse in early morning, during dentition ; desire sudden and violent ; children averse to washing. Veratrum album. — Stools greenish, watery, brown- ish, blackish, watery, frequent ; profuse ; violent thirst for very cold water and iced drinks ; violent vomiting, followed by extreme weakness, fainting ; pain is a marked characteristic of the remedy, and is colicky ; cold sweat on the forehead during stool. In administering a remedy for diarrhoea, it is best to give it immediately after each stool, or after vomit- ing, and to discontinue its administration as soon as improvement appears. The diet, as above stated, should be regulated. For children who are upwards of three years, mutton broth, juice of a rare roast, are excellent. It may be added, also, that for nursing infants, barley water and rennet are likewise beneficial. HYGIENIC CARE OF CHILDREN. 315 Inflammation of the Foreskin. Both infants and children are liable to inflammation of the foreskin, which begins with swelling and redness of these tissues, attended with pain and soreness, espe- cially sore when passing water or from pressure. The cause is usually from want of cleanliness. The natural secretions become mixed with a few drops of the urine, and, becoming foul, poison the skin. Other causes are improper handling of the parts by the child's attendant, or pressure of clothing. In older children the irritation caused by this inflammation induces mastur- bation, or masturbation may be the cause of the inflam- mation. To relieve this affection the cause must be removed. If scrupulous cleanliness does not a^ail, a physician should be consulted, that more active meas- ures may be instituted. The Umbilicus, or Navel. After the cord has become detached and the depres- sion healed, care should be taken that light pressure be exerted by means of a small pad of linen for a few days. From prolonged crying, sometimes a hernia (rupture) forms, characterized by a swelling which fluc- tuates with the breathing or during a crying spell. A simple truss will retain the protrusion, if worn con- stantly. Hemorrhage sometimes occurs after separation of the cord, and may prove fatal if profuse ; slight bleeding is easily controlled, but should be watched. When it is profuse, pinch up the navel between the fingers, and by this pressure you control the bleeding. Send for a physician at once. 316 HYGIENIC CARE OF CHILDREN. Unhealthy Growths. — A few weeks after the navel is apparently healed, unhealthy growths may show themselves, usually a soft rounded mass, and unless removed will continue growing in size, emitting a hloocly discharge which causes the surrounding tissues to inflame, and may affect the entire navel. Consult a physician that he may advise what ought to be done. Excoriation, or Chafing. The folds of skin about the neck, under the arms, and in the groins often become sore, due in some cases to want of care. Avoid using too much soap at all times, and where the child is chafed use none ; lukewarm water alone for bathing the parts, and dry without rubbing. It will be observed that this trouble will be most likely to show itself when the child is not quite well, and should be treated as a symptom to be relieved by internal medication. Attention has been called to the use of toilet powders in another chapter. Chamomilla, Mercurius, and Sulphur are the usual remedies, one of which will usually suffice. Crying. Prolonged crying of infants usually indicates pain, and the cause should be discovered, if possible ; it may arise from too tight abdominal bands or other clothing ; see that no pins are sticking into the flesh, or that there is no intestinal irritation. Sometimes the cause is not apparent. Under no circumstances should the child be given any preparation of opium ; soothing syrups contain opium, and have been the cause of many deaths by being administered. Irresponsible nurses HYGIENIC CARE OF CHILDREN. 317 often give infants some of these preparations on the sly. Infants cry when hungry or need changing, or from lying too long in one position ; therefore all these - things should be taken into account before considering the necessity of medicinal treatment. Learn to inter- pret the cries of children. A little observation will soon teach one to distinguish, fairly accurately, the meaning of the different cries of infants. If, how- ever, no apparent cause is found for continued crying, Belladonna may bring rest, if the child starts suddenly out of sleep and screams, or child seems sleepy yet cannot sleep. Coffea. — For restlessness, with crying. Nux vomica. — Will prove efficacious for earache, which often is the cause of sleeplessness and crying. Hiccough. Hiccough is a very common trouble in childhood, and if prolonged' causes great uneasiness, both to mother and child. Exposure of the body in part or whole to the air, even in a warm room or undressing the child, may cause it. Generally, wrapping up the child and a few teaspoonfuls of hot water are sufficient to stop the trouble ; if not, and it is prolonged, a few doses of Nux vomica or Pulsatilla will suffice. Crusts on the Head. A scurf or yellowish crust may form on the head of infants, and if it continues emits a foul smell ; it usually arises from want of cleanliness, or too much irritation of the scalp by combing, or from keeping the head too warm. If the head is washed regularly every morning 318 HYGIENIC CARE OF CHILDREN. and properly dried, then brushed with a soft hair brush, these crusts will seldom form, unless there be some digestive trouble due to improper feeding, or an hered- itary humor is in the child's system. Never remove the scales or crusts forcibly ; wash the scalp . thoroughly with warm water, then dry with a towel, and anoint the spot or spots with sweet oil, which will soften them, and then they can be removed ; this will have to be repeated probably from time to time. If the attention to bathing or diet does not improve the condition, give Sulphur, Mercurius viv., or Calcarea carbonica inter- nally. If the child shows that there is itching of the scalp, and any eruption appears on the forehead or face, it is better to consult a physician, that proper medicinal treatment may be instituted. Under no circumstances use medicinal preparations externally. The favorite remedy with old-school physicians is lead ointment, which dries the skin and repels the humor, but it never cures, and may cause other diseases ' more to be feared than the annoyance and disfigurement of the eruption on the skin, which can be cured forever by the use of the homoeopathic remedy indicated in each case. Spasms or Convulsions. Spasms in children are generally due to some irrita- tion in the stomach or intestines, or to teething or re- pelled eruptions ; they may be due to brain or kidney disease. The eyes are fixed or quiet ; portions or the whole of the body only may be convulsed at once ; apply cold to the head, and benefit is derived from put- ting the feet and legs in hot water, or the whole body may be immersed in a warm bath until the spasm has HYGIENIC CARE OF CHILDREN. 319 partially subsided, then removed and wrapped warmly in blankets. At once send for a physician, but if not at hand, or before he arrives, the above treatment should be followed. . Retention of Urine or Feces. Infants frequently do not pass urine for several hours after birth ; sometimes not for days. This should always receive attention, and if no urine is passed after several hours, place a hot cloth or sponge, wrung out of hot water, on the bladder, or put the child in a hot bath. If these measures are not effective, the attention of the physician should be called to the matter. Sometimes some physical malformation is the cause, and therefore calls for different treatment. The same condition may also prevail in the bowels, and unless there is an evacu- ation after the lapse of twenty-four hours an examination should be made. If there is known to be some irritat- ing substance in bowels, or constipation is the probable cause, give an injection of tepid water. Chamomilla. — Is indicated in convulsions, with jerk- ing of the limbs and twitching of the muscles of the face and eyelids, and rolling of the head from side to side; one cheek red, the other pale. Ipecacuanha. — Convulsions accompanied by nausea, retching, and vomiting or diarrhoea. Cina. — Delicate children, when troubled with worms, itching of the nose and anus. Merc, vivus. — Convulsions caused by worms ; abdo- men distended, increase of saliva in the mouth. Opium, Hyosciamus, and Stramonium. — For con- vulsions caused by fright. 320 HYGIENIC CARE OF CHILDREN. Sulphur, Bryonia, and Cuprum. — For convulsions caused by repelled eruptions. Observations and Suggestions. From infancy to puberty, parents should be ever watchful of their children's movements arid postures. Many progressive diseases might be checked if the ini- tial symptoms were recognized. Hip joint disease, for example, is often months in developing, yet how many parents remember, when their attention is called to the fact by questioning, that their child has shown a slight limping when walking, not perceptible at all times, or the child was clumsy in stepping, or tripped easily if any slight obstruction was in the way, or the child does not put both feet on the ground evenly, and when standing elevates the heel. Watch carefully a child that complains of pain either in the hip or thigh, especially if the pain occurs more often at night. One hand may show signs of contraction. The spine also should be watched that any deviation from side to side may be early recognized. It is not the place here to point out what these deviations signify if they exist, but merely to put parents on their guard that they may intelligently watch the progress of their children, that any departure from a state of normal growth may be attended. to early. CHAPTER XXXVI. MATERIA MEDICA. 1, Aconite. Acute local inflammations ; active, sanguineous congestions ; evil consequences of a chill in a dry, cold air ; affections in consequence of fright or of anger ; measles ; erysipelatous inflammations ; inflam- matory fevers, even with bilious or nervous symp- toms ; mental alienations, with fixed ideas of ap- proaching death ; cerebral congestion, with dizziness ; croup, first period ; whooping cough, first period. General Symptoms. — Shooting pains, or rheu- matic, which are renewed by wine, or other heating articles ; sufferings which, particularly at night, seem insupportable ; attacks of pain, with thirst and red- ness of the cheeks ; uneasiness, as if in consequence of suppressed perspiration, or in consequence of a chill ; great restlessness. Skin. Skin dry and burning ; scarlet rash ; measles ; nettle rash. Sleep. Sleeplessness, from anxiety, with constant agitation and tossing ; starting in sleep. Fever. Dry, burning heat with extreme thirst, sometimes, especially at the beginning of the disease, preceded by shiverings with trembling ; heat, chiefly of the head and face, with redness of the cheeks, shuddering over the entire body ; shivering for the 322 MATERIA MEDIC A. short time that they may be uncovered during the heat ; pulse hard, frequent, and accelerated. Moral Symptoms. Great agitation and boasting, with anguish, discouragement that cannot be con- soled ; cries, tears, groans, complaints, and reproaches ; apprehensions and fear of approaching death ; a great disposition to be angry, to be frightened ; alternate paroxysms of laughter and tears ; inquietude under disease, and despair respecting a cure ; delirium, chiefly at night. Head. Weight and fulness in the forehead and temples, with pressing outward, as if everything was going to issue through them ; congestion of blood to the head ; aggravation of the pains in the head by movement, by speaking, by rising from a recumbent position, and by drinking ; amendment in the open air. Eyes. Eyes red and inflamed, with deep redness of the vessels and intolerable pain. Nose. Bleeding from the nose. Face. Eed spots on both cheeks. Throat. Pain in the throat, with deep redness of the parts affected, and difficult deglutition ; burning and pricking in the throat, chiefly when swallowing. Stomach. Sensation of swelling, tension, and pres- sure, as from a weight in the precordial region and in the stomach. Abdomen. Tension and pressure in the hypochon- driac region ; pressure in the hepatic region ; painful sensitiveness of the abdomen to the touch, and to the least movement. Stool. Loose, watery stools ; white stools, with red urine. MATERIA MEDIC A. 323 Urine. Urine scanty, burning, dark red, and with a brick-colored sediment. Larynx. A constant desire to cough, produced by an irritation or a tickling in the larynx ; short and dry cough, principally at night ; spitting of blood, with the cough ; shootings and pains in the chest when coughing. Chest. Short breathing, chiefly during sleep, and on getting up ; breathing difficult, anxious, and attended with groans and painful stitches in the chest, chiefly when breathing, coughing, and moving ; stitches in the side ; palpitation of the heart, with great anxiety. Trunk. Painful stiffness in the nape of the neck. 2. ^3sculus Hippocastanum. The following is an extract from Dr. E. M. Hale's " Materia Medica of the New Eemedies'' : — General Symptoms. — Feeling of extreme illness ; fatigued feeling ; sleeps sound, but too heavily. Head. Confusion in the head, with throbbing ; heaviness and pain all over the head. Stomach and Abdomen. Burning distress in stomach ; retching, nausea ; constant urging to stool, with itching and raw feeling in anus ; appearance of hemorrhoids, like groundnuts, of a purple color, very painful, and with a sensation of burning. 3. Apis Mellifica. General Symptoms. — General feeling of lassitude, with trembling ; sudden prostration of the vital force, vomiting, diarrhoea, cold extremities, paleness of face, and feebleness of pulse. 324 MATERIA MEDICA. Skin. Eruption like nettle rash, with burning and itching ; blotches on the body and back of the hands ; large, hard elevations, like mosquito bites, upon the back and legs, with stinging, itching, and burning ; furuncles and large swellings, with stinging pains ; oedematous swelling of the extremities. Pains like bee stings. Moral Symptoms. Irritable disposition ; unfitness for mental exertion ; dread of death ; feels as if he should not be able to breathe again. Head. Oppressive headache when in warm room and reading. Eyes. Burning, stinging, itching in the eye, eye- lids, with swelling and pricking sensation as if from a foreign body ; smoky opacity of the cornea, with al- most entire loss of sight. Face. Burning, biting, stinging heat, with a purplish hue ; erysipelas on cheek and nose ; swelling under the eye. Mouth and Throat. Scalding of the mouth and throat ; feeling of contraction in the throat, with diffi- cult deglutition ; tongue feels as if burnt (glossitis). Stomach. Violent eructations ; nausea and inclina- tion to vomit, with rumbling in the abdomen, and threatening diarrhoea. Abdominal Region. Sickly feeling ; dull pain and soreness of the bowels when sneezing or pressing upon them ; enlargement of the abdomen, with swell- ing of the feet, and scanty urine. Fceces. Frequent yellow, watery evacuations ; painful diarrhoea. Anus. Hemorrhoids, with constipation ; biting, boring, stinging pain ; urging to stool. MATERIA MEDIC A. 325 Urine. Scanty, with burning pain ; highly col- ored. Menstruation. Profuse, with faintness ; ovaritis (ovarian dropsy?). 4. Arnica. Affections in consequence of mechanical injuries (falls, commotion, blows, etc.) ; wounds, principally those inflicted by blunt instruments ; bites ; exco- riation of bedridden patients ; bruises, dislocations, sprains, and fractures ; accidents resulting from a sprain ; stings of insects ; corns, by an external appli- cation of it, after having pared them. General Symptoms. — Pains, as from dislocation ; fainting fit, with loss of consciousness, in consequence of mechanical injuries ; paralytic state on left side, in consequence of apoplexy. Shin. Eed, bluish, and yellowish spots, as if from contusions. Head. Whirling giddiness, with obscuration of the eyes, chiefly when getting up, moving the head, or walking. Eyes. Pain like excoriation in the eyes and eye- lids, with difficulty of moving them. Stomach. Vomiting of dark, coagulated blood. Abdomen. Pain, as from contusion in the sides. Urinary Passages. Involuntary emission of urine ; urine of a brownish red, with brick- colored sediment. Respiratory Organs. Cough, with expectoration of blood ; even without cough, expectoration of black, coagulated blood after every corporeal effort. Chest. Respiration short, panting, difficult, and 326 MATERIA MEDIC A. anxious ; shootings in the chest and sides, with diffi- culty of respiration, aggravated by coughing, breathing deeply, and by movement ; pain as of a bruise, and of compression of the chest. Trunk. Pains, as from a bruise, and dislocation in the back, in the chest, and in the loins. Arms. Pain, as of dislocation in the joints of the arms and hands ; want of strength in the hands on seizing anything. Legs. Pains, as if from fatigue or from disloca- tion ; tension in the knee, as if from contraction of the tendons ; inflammatory, erysipelatous swelling of the feet, with pain, and aggravation of the pain by move- ment ; hot, painful, hard, and shining swelling of the great toes. Generalities. Grive Arnica after falls or bruises. 5. Argentum Nitricum. Head. Vertigo, with headache on waking, and pains in the back part of neck and head. Spine. Back of occiput to lower vertebrae, rheu- matic, drawing, and acute pain ; forces one to lie down. 6. Arsenic?. General Symptoms. — Burning, chiefly in the in- terior of the parts affected, or sharp and drawing pains ; nocturnal pains, so unbearable that they excite despair and fury ; aggravation of suffering in the even- ing in bed, on lying on the part affected, or during repose ; mitigation by external heat and ^movement of the body ; want of strength, excessive weakness, and complete asthenia, even to prostration. MATERIA MEDICA. 327 Skin. Skin dry as parchment, or cold and bluish ; ulcers with raised and hard edges ; fetid smell, ichorous suppuration, ready bleeding, putridity, and bluish or greenish color of the ulcers. Sleep. Nocturnal sleeplessness, with agitation and constant tossing. Fever. Coldness over the whole body, sometimes with cold and clammy sweat ; pulse irregular, or quick, weak, small, and frequent, or suppressed and trembling. Moral Symptoms. Anxiety, inquietude, and exces- sive anguish, principally in the evening in bed. Face. Face pale, hollow, and cadaverous ; lips bluish or black, dry and chapped. Mouth. Offensive smell from the mouth ; tongue brownish or blackish, dry, cracked, and trembling ; ulceration of the tongue on the anterior edge ; thrush of *the mouth. Throat. Inflammation and gangrene of the throat. Appetite. Violent burning, choking, and unquench- able thirst, with inclination to drink constantly, but little at a time ; want of appetite. Stomach. Vomitings after drinking and eating ; vomiting of mucous, bilious, or serous matter of a yellowish, greenish, brownish, or blackish color ; burn- ing internal heat, diarrhoea, and fear of death ; exces- sive pain in the epigastrium, chiefly when touched ; insupportable heat and burning in the precordial region, and in the stomach. Abdominal Region. Swelling of the abdomen, as in ascites ; violent cutting pains, cramp-like pains in the abdomen ; colic, chiefly after eating and drinking, 328 MATERIA MEDIC A. or in the night, and often accompanied with vomiting or diarrhoea, with coldness, internal heat, or cold sweat. Fceces. Violent diarrhoea, of greenish, yellowish, whitish color, or brownish and blackish ; burning in the rectum and in the anus. Larynx. Dry cough, in the evening after lying down, with a wish to rise ; also, after drinking, with difficulty of respiration. Chest. Breathing short ; difficult, stifling dyspnoea, and attacks of suffocation, sometimes with cold sweat ; spasmodic constriction of the chest or of the larynx, anguish, great weakness, coldness of the body, pain in the pit of the stomach, and paroxysms of cough ; oppression of the chest when coughing, when walk- ing, and when going upstairs ; violent and insup- portable throbbings of the heart, chiefly when lying on the back, and especially at night. 7. Baptisia Tinctoria. General Symptoms. — Great prostration of the whole system, with frightful, uneasy dreams ; con- fused feeling in the head ; does not know where he is, does not know how he is. Ears. Does not hear well ; dull roaring in the ears. Mouth, Tongue, and Throat. Ulcerated sore throat, tonsils, and pharynx; assuming a putrid character, with a fetid breath and clouded sensorium. 8. Belladonna. General Symptoms. — The least contact, and some- times, also, the slightest movement, aggravates the MATERIA MEDICA. 329 sufferings ; dread of every movement, and of all exertion ; over-excitement, and too great sensibility of all the organs. Skin. Swelling, with heat and scarlet redness of the whole body, or of several parts, chiefly the face, the neck, the abdomen, and the hands ; red, hot, and shining swelling of the diseased parts. Sleep. Constant desire to sleep ; nocturnal sleep- lessness in consequence of excessive anguish or great agitation ; when sleeping, frequent starts, with fright, groans, cries ; on waking, headache, and aggravation of sufferings. Fever. Dry, burning heat ; pulse strong and quick, or full and slow, or small and slow, or small and quick, or hard and tense ; sweat of the parts that are covered only. Head. Fulness, heaviness, and violent pressure on the head as if going to burst, with desire to lie down ; dartings into the head as if from knives ; strong- pulsation of the arteries of the head ; bending the head backward ; boring with the head into the pillow while sleeping. Eyes. Aching pains in the eyes and the sockets, extending into the head ; inflammation of the eyes, with injection of the vessels ; dread of light. Ears. Piercing pressure, sharp pain, pinching, squeezing, and shooting in the ears ; swelling of the parotids. Face. Face pale, sometimes suddenly alternating with red ; burning heat of the face ; dark, or scarlet, or bluish redness of the face ; swelling of the sub- maxillary glands, and those of the neck. 330 MATERIA MEDICA. Mouth. Sensation of great dryness, or actual and excessive dryness and choking in the mouth ; tongue red, hot, shining, dry, and cracked, or loaded with whitish mucous ; redness of the edges of the tongue ; paralytic weakness of the tongue, with diffi- cult and stammering speech. Throat. Excoriating, scraping, and shooting pains in the throat and in the tonsils, principally when swallowing ; inflammation and swelling of the throat, of the velum palati, of the uvula, and of the tonsils ; suppuration of the tonsils ; complete inability to swallow, even the least liquid, which frequently is forced out through the nostrils ; sensation of choking, and spasmodic constriction in the throat. Abdominal Region. Cramp-like, contractive, and constrictive pains in the abdomen, and especially around the navel, with a sensation as if the parts were squeezed or seized with the nails ; the pains force one to bend himself, and are accompanied by vomiting, or by inflation and protrusion of the trans- verse colon in the form of a pad ; soreness of the whole abdomen, as if everything in it were ex- coriated. Urine. Frequent discharges of urine, copious, pale, and watery ; difficulty of retention and involuntary emission of urine. Genital Organs. Violent pressure toward the gen- ital parts, as if all were going to fall downward, princi- pally when walking or sitting upright ; menses too copious and too early. Larynx. Loss of voice ; cough chiefly at night, or in the afternoon, in the evening in bed. mostly dry, MATERIA MEDIC A. 331 short, and sometimes convulsive ; when coughing, cut- ting in the abdomen ; the least movement, when in bed at night, renews the cough. Chest. Oppression of the chest, difficult respiration, dyspnoea, and short breath, sometimes with anxiety ; respiration short, anxious, and rapid ; pressure on the chest. Trunk. Painful swelling, and stiffness of the neck and the nape. 9- Bryonia. Rheumatic and arthritic affections, even with in- flammatory fever and swelling ; local inflammations ; inflammatory fevers, with nervous, gastric, or bilious affection, and strong excitement of the sanguineous and nervous system. General Symptoms. — Tension, drawing pains, acute drawings, and stinging, especially in the limbs, and chiefly daring movement, with insupportable pains on being touched ; red, shining swelling of some parts of the body ; aggravation of the pains and sufferings at night, and from movement ; amelioration during re- pose ; desire to remain in a recumbent posture. Sleep. Restlessness, especially before midnight, caused by heat, agitation of blood, and anxiety ; sleep disturbed by thirst, with bitter taste in the mouth when waking ; inability to remain lying on the right side. Fever. Cold and shivering of the body, even in bed, accompanied by pains in all the limbs ; shiverings ; with trembling, often with heat in the head, redness of the face, and thirst ; before the shiverings, vertigo and headache ; universal dry heat, external and inter- nal, almost always with a great desire for cold drinks. 332 MATERIA MEDICA. Head. Great fulness and heaviness of the head, with raking pressure toward the forehead, and, when stooping, a sensation as if everything were going to fall out through the forehead ; headache aggravated by movement. Nose. Swelling of the nose ; frequent bleeding of the nose, sometimes in the morning, or when the menses are suppressed, or even when sleeping. Teeth. Toothache, with desire to lie down ; miti- gated by lying on the parts affected ; jerking, drawing toothache, with a sensation as if the teeth were too long, or loose. Mouth. Dryness of the mouth, with burning thirst ; tongue dry, loaded with a white, dirty, or yellow coating. Appetite. Bitter taste in the morning ; repugnance and disgust for food. Stomach. Nausea and desire to vomit, especially after eating ; vomiting as soon as one has drank and especially on drinking after a meal ; shootings in the stomach during movement ; burning in the pit of the stomach. Abdominal Region. Pains in the liver, when touched, on breathing or coughing ; cramp-like pains, or cuttings and shootings in the abdomen. Faeces. Constipation ; diarrhoea in the summer. Urine. Urine scanty, reddish, brownish, and hot. Genital Organs. Menses suppressed ; metrorrhagia of a deep-red blood, with pain in the loins and in the head ; swelling of the labium, with a black and hard pustule. Larynx. Cough, mostly dry, excited by a tickling MATERIA MEDICA. 333 in the throat : cramp-like, suffocating cough, after having eaten or drank, and often with vomiting of food : cough, with stinging in the sides of the chest, or with aching j)ains in the head, as if it were going to split : cough, with expectoration of mucus of a dirty. reddish color. Chest. Bespiration impeded by stinging in the chest, stingings in the chest and in the sides, es- pecially when coughing or breathing deeply, allowing one to lie only on the back, and aggravated by any movement whatever ; heat and burning pain in the chest, with anxiety and tightness : beatings of the heart, frequently very violent, with oppression. Trunk. Pains in the loins, like a painful weight ; shootings in the loins and in the back, aggravated by cough and respiration ; rheumatic heaviness aud ten- sion in the nape of the neck and in the neck. * Arms. Tractive pains in the joints of the shoulders and the arms, with tension, stinging, and shining, red swelling ; pain of dislocation in the joints of the hands on moving them. Legs. Drawing pains in the thighs : swelling of the legs, extending to the feet : pain, as of dislocation, in the foot, when walking. 10. Cactus Grandiflorus. Head. Vertigo, with congestion, from overaction of the heart : Eyes. With dimness of sight : Ears. Humming and pulsating ; Nose. Bleeding of the nose : Throat. Constriction of the throat : and 334 MATERIA MEDIC A. Chest. Impeding respiration ; stitches in the region of the heart, with feeling of compressions ; region of the heart feels too large, and as though it were grasped by a hand of iron ; feels worse lying on left side. 11. Calcarea Carbonica. Muscular weakness, difficulty of learning to walk, atrophy and other sufferings of scrofulous children ; rickety affections ; difficult dentition in children. General Symptoms. — Agitation of blood, mostly in plethoric individuals, often in the head and in the chest ; epileptic convulsions, with cries ; the symptoms are aggravated after washing and laboring in the water, in the evening, after a meal, and every second day. Skin. Nettle rash, chiefly disappearing in the fresh air ; swelling and induration of the glands, with or without pain. Fever. Excessive internal coldness ; frequent attacks of transient heat, with anguish and beating of the heart. Moral Symptoms. Melancholy, and disposition to weep and to be frightened. Head. Piercing in the forehead as if the head were going to burst, hammering pains in the head after a walk in the open air ; icy coldness in and on the head ; falling off of the hair ; tumors in the hairy scalp. Eyes. Ulcers, spots, and opacity of cornea ; red and thick swelling of the eyelids. Ears. Purulent discharge from the ears ; polypus MATERIA MEDIC A. 335 in the ears ; cracking in the ears, when swallowing and chewing ; hardness of hearing : inflammatory swelling of the parotids. Face. Swelling of the upper lip ; painful swelling of the submaxillary glands. Stomach. Kegurgitation of sour substances ; sour vomitings. Abdominal Region. Swelling and induration of the mesenteric glands ; enlargement and hardness of the abdomen. Faeces. Evacuations like clay ; diarrhoea during dentition, of a sour smell, fetid, or yellowish, in infants. Genital Organs. Menses premature and too copious. Larynx. Cough at night, violent and dry, some- times even spasmodic. Chest. Pain as from excoriation in the chest, especially on breathing and being touched ; palpitation of the heart. Trunk. Hard and painful swelling of the glands of the neck. 12. Carbo Vegetabilis. Evil effects from the abuse of mercury, or of cin- chona ; sufferings caused by warm and damp weather ; sensibility to changes of weather ; intermittent fevers, even those which the abuse of cinchona has rendered obstinate ; Asiatic cholera, with total absence of pulse, etc. General Symptoms. — Burning pains in the limbs and in the back ; the majority of symptoms appear 336 MATERIA MEDICA. while walking in the open air; soreness of all the limbs, especially in the morning, when one has just risen ; sudden prostration of the physical powers ; liability to take cold. Fever. Shivering and coldness in the body ; cold sweat on the limbs and face. Moral Symptoms. Inquietude and anxiety, es- pecially in the evening. Throat. Scraping and burning pain in the throat, the palate, and the gullet. Stomach. Rising of fat food ; sour risings after a meal. Fceces. Evacuations liquid, pale, or mucous ; invol- untary evacuation. Urine. Diminution of the secretion of urine. Larynx. In the morning and in the evening, hoarseness, aggravated by prolonged conversation, and chiefly in cold and damp weather. Chest. Dyspnoea on walking ; pain as from excori- ation of the chest. Trunk. Eheumatic, drawing pains, acute pulling and shootings in the back, the nape of the neck, and the muscles of the neck. Arms. Pullings, and acute drawing pains in the forearms, the wrists, and the fingers ; paralytic weak- ness of the wrists and of the fingers. Legs. Drawing, and paralytic pains in the legs : cramps in the legs, and in the soles of the feet. 13. Chamomile. Bad effects from the abuse of coffee and of narcotic palliatives ; suffering in consequence of a chill ; affec- MATERIA MEDICA. 337 tions arising from sudden grief, or a fit of passion ; convulsive and spasmodic attacks ; excoriation of the skin ; disposition for every wound to ulcerate ; bilious and gastric affections ; excoriation of the nipples ; erysipelas on the breasts ; catarrhal cough, with hoarseness, chiefly in children. General Symptoms. — Rheumatic, drawing pains, chiefly at night in bed ; pains with thirst, heat, and redness of one of the cheeks ; over-excitement, and excessive sensibility of the nervous system, with great sensibility to pain. Sleep. Nocturnal sleeplessness ; when sleeping, starts with fright, cries, tossing, tears, talking. Fever. Burning heat and redness (often only in one) of the cheeks, chiefly at night, with groaning, tossing. Moral Symptoms. Disposition to weep and to be angry, with great sensibility to offence ; quarrelsome and choleric humor. Head. Headache on waking in the morning, or while asleep. Eyes. Eyes inflamed and red, with pressive pains, chiefly on moving the eyes and on shaking the head ; blearedness in the eyes, and nocturnal agglutination. Ears. Shootings extending into the ears, with dis- position to be angry at trifles ; buzzing in the ears ; inflammatory swelling of the parotids, as well as of the submaxillary glands and those of the neck. Face. Face hot, red, burning, or redness and heat of one cheek, with coldness and paleness of the other. Teeth. Toothache, mostly of one side, and chiefly 338 MATERIA MEDICA. at night, in the heat of the bed, with insupportable pains, which almost drive one to despair, frequently after eating anything hot (or cold), and chiefly after having taken coffee. Throat. Sore throat ; deep redness of the parts affected. Appetite. Bitter taste in the mouth, and of food ; excessive thirst for cold drinks. Stomach. Bitter, bilious vomiting. Abdominal Region. Flatulent colic, with inflation of the abdomen ; excessively painful colic, pullirigs and cuttings in the abdomen. Anus and Rectum. Diarrhoea at night, with slimy or greenish faeces, or mucus. Larynx. Dry cough, produced by constant titil- lation in the larynx ; anger excites cough (in children). Chest. Attacks of flatulent asthma, with anxiety and fulness in the precordial region. Legs. Cramps in the calves of the legs, chiefly at night. 14. China. — Cinchona. General Symptoms. — Pains or sufferings, excited or aggravated by touch, at night, or after a meal ; great general weakness, with trembling ; great ten- dency to perspiration when moving and sleeping. Skin. Yellow color of the skin. Sleep. Painful, frightful dreams, which continue to produce agitation after waking. Fever. Shivermgs, with shuddering, or feverish trembling, commonly without thirst ; the thirst gener- ally takes place only before or after the shivermgs ; MATERIA MEDIC A. 339 easy perspiration during sleep ; nocturnal debilitating sweats. Head. Headache as if from suppressed coryza ; pain as from a bruise in the brain ; pressive head- ache ; acute jerking or pressive pains in the head ; headache as if the head were going to burst ; con- gestion to the head ; sensibility of the exterior of the head, and even of the roots of the hair, when touched. Nose. Bleeding of the nose and of the mouth. Face. Complexion pale, earth-like, sometimes of a blackish yellow. Mouth. Tongue with a yellow or white coating. Appetite. Bitter taste of food and drink ; desire for a variety of food and for dainties, without know- ing exactly which ; great weakness of digestion. Stomach. Eructations, with taste of food ; pressure in the stomach, with cramp -like pains, especially after having eaten. Abdominal Region. Hardness and swelling of the liver ; swelling and hardness of the spleen ; piercing in the spleen ; dropsical swelling of the abdomen, with asthmatic sufferings and fatiguing cough. Faeces. Slimy, watery, yellowish, diarrhoea ; loose evacuations, with excretion of undigested food ; loose evacuations, chiefly after a meal or at night ; crawl- ing in the anus, as if from worms. Urine. Urine deep colored, with sediment like brickdust. Genital Organs. Congestion to the uterus ; leucor- rhcea, with cramp -like contractions. 340 MATERIA MEDICA. 15. Cimicifuga Racemosa. (Synonymes : Actsea racemos ; Macrotys racemos.) Rheumatic and neuralgic affections in various parts of the system, especially in the muscles, voluntary and involuntary ; thus its great effect in heart and uterine diseases. General Symptoms. — Weak, trembling, exhausted feeling ; must lie down. Sleep. Very restless at night, also early in the morning. Chest. Stitches in the region of the heart, with a feeling of ebullition and fluttering of the heart. Genital Organs. Leucorrhcea ; pains in abdomen before menstruation ; pains in uterine region before menses ; the pains run down in the groins with chilliness. 16. Cina. Scrofulous affections ; acute hydrocephalus of chil- dren ; wetting the bed ; whooping cough ; chiefly in scrofulous children or in those suffering from worms. General Symptoms. — Convulsions and distortion of the limbs ; epileptic convulsions, with cries, turn- ing on the back, and violent movements of the hands and feet ; external pressure aggravates or renews the sufferings. Sleep. Nocturnal sleeplessness, with agitation, tears, cries, heat, and anguish. Moral Symptoms. Child cries when it is touched. Eyes. Pupils dilated. Nose. Desire to put the fingers into the nose ; stoppage of the nose. MATERIA MEDIC A. 341 Teeth. Grinding of the teeth. Appetite. Hunger a short time after a meal. Fceces. Loose evacuations, of the consistence of pap ; discharge of ascarides and of worms by the anus ; loose, involuntary, whitish evacuations. Urine. Wetting the bed ; urine soon becomes turbid. Larynx. Cough, with sudden starts and loss of consciousness. 17. Coffea. Excessive nervous excitability ; excessively pain- ful neuralgia ; sleeplessness from nervous excitement ; evil consequences of unexpected or excessive joy. General Symptoms. — Painful susceptibility of parts affected ; mental and physical excitability ; sleeplessness from excitement of the imagination, flow of ideas, and fantastic visions ; desire to lie down and to shut the eyes, without being able to sleep. Head and Throat. Pains in the head, as if the brain were bruised ; sore throat, with great and pain- ful sensibility. Stomach and Faeces. Cramps in the stomach ; abdominal pains, which even drive one to despair, especially in women ; diarrhoea, also, during teething. 18. Colocynthis. Evil effects from mental emotions, with indignation and mortification. General Symptoms. — Painful cramps and cramp- like contractions in the internal or external parts. Skin. Troublesome itching, with great restlessness 342 MATERIA MEDICA. in the whole body, especially in the evening in bed, followed by perspiration. Head. Attacks of semi-lateral headache. Stomach. Colic and diarrhoea, however little is eaten. Abdominal Region. Inflammation of the abdomen, as if from tympanitis ; cramp -like pain and constriction in the intestines, especially after a fit of passion ; ex- cessively violent colic, with cutting, cramp -like, or contractive pains, which compel one to bend double, with restlessness in the whole body, and with a sensa- tion of shuddering in the face, which seems to proceed from the abdomen ; coffee and tobacco smoke diminish the colic. Fceces. Loose evacuations of a greenish yellow ; dysenterical evacuations, with colic. Urine. Diminished secretion of urine. 19. Cuprum. Spasmodic affections and convulsions ; encephalitis ; Asiatic cholera ; whooping cough ; spasmodic asthma . General Symptoms. — Tonic spasms, with loss of consciousness, throwing of the head backward ; the convulsions generally begin in the fingers and in the toes ; convulsive startings at night when sleeping ; violent convulsions, with great display of strength ; symptoms which appear periodically, and in groups. Head. Whirling vertigo, as if the head were going to fall forward ; stupefying depression in the head, with crawling in the vertex ; pains in the occiput and nape of the neck, on moving the head. Eyes. Convulsions and restless movements of the eyes. MATERIA MEDICA. 343 Face. Spasmodic distortion of the face ; lips bluish. Teeth and Mouth. Foam in the mouth. Stomach. Violent vomitings, with cramps in the abdomen, aggravated by touch and by movement. Abdominal Region. Spasmodic colic. Fceces. Violent diarrhoea. Chest. Eespiration accelerated ; short, difficult respiration, with spasmodic cough and rattling in the chest ; suffocating fits ; cramps in the chest which interrupt the respiration and the voice. Trunk and Arms. Cramps of the fingers and of tlje toes. 20. Drosera. Catarrh and hoarseness ; whooping cough ; affec- tions of the respiratory organs in consequence of croup. Larynx. Crawling in the larynx, which excites a short cough and shootings as far as the throat ; sensation of dryness or roughness, and of scraping in the bottom of the gullet, with inclination to cough ; hoarseness, and very low voice ; dry, spas- modic cough, with inclination to vomit ; fatiguing cough, like whooping cough, with bluish face, wheez- ing respiration, attacks of suffocation, bleeding from the nose and mouth, and anxiety ; vomiting of food during the cough and afterward. Chest. Difficulty of respiration when coughing or speaking. 21. Dulcamara. General Symptoms. — Aggravation of sufferings, chiefly in the evening or at night, and during repose. 34± MATERIA MEDIC A. mitigated by movement ; swelling and induration of the glands ; dropsical swelling of the whole body, limbs, and face. Skin: Dry, furfuraceous, humid, scaling, or sup- purating tetters ; reddish tetters, bleeding after being scratched, with painful sensibility to the touch, and to cold water. Fceces. Diarrhoea, as if after a chill, of greenish or brownish mucus ; nocturnal, watery diarrhoea, with colic. Larynx. Catarrh and hoarseness, as if from hav- ing taken cold ; moist cough. Arms. Tettery eruption on the hands. 22. Gelseminum. Head. Vertigo, like intoxication, with loss of sight and double vision ; feeling of a tape or band around the head ; bruised feeling of the brain. Eyes. Dim sight, blindness, photophobia. Chest. Weak voice ; stitches in the right side, and also in the heart. Genital Organs. Stoppage of uterine flow, with convulsions. Extremities. Pain, as of a sprain, with loss of voluntary motion ; threatened paralysis. 23. Graphites. General Symptoms. — Great disposition to take cold, and fear of the open air and currents of air. Skin. Tetters, and other humid or scabby erup- tions, sometimes with secretion of corrosive serum, or with itching in the evening and at night ;" un- MATERIA MEDIC A. 3 ±5 healthy skin, every injury tends to ulceration ; de- formity and thickness of the nails. Eyes. Inflammation of the eyes, injection of the veins, swelling and abundant mucous secretion from the eyelids. Ears. Dryness of the internal ear ; scabs, tetters, running, and excoriation behind the ears ; hardness of hearing mitigated by the motion of a carriage. Nose. Dry scabs on the nose ; nostrils excoriated, cracked, and ulcerated ; fetid smell from the nose. Face. Flushes of heat in the face ; erysipelatous inflammation and swelling of the face, with eruption of vesicles ; one-sided paralysis and distortion of the muscles of the face, with difficult articulation ; ulcers on the internal surface of the lips ; scabby eruption on the chin and around the mouth. Tliroat. Sore throat, even at night, as if there were a plug within it. Appetite. Weakness of digestion ; inflation of the abdomen after a meal. Abdominal Region. Immoderate expulsion of fetid wind, preceded by pinchings. Fceces. Obstinate constipation, with hard faeces ; large hemorrhoidal excrescences in the anus. Urine. Wetting the bed. Menses. Suppression of menses : in place of menses, flow of blood from the anus. Arms. Arthritic nodosities on the fingers ; tettery excoriation between the fingers ; thickness of the nails of the fingers. Legs. Tetters on the thighs, hams, and tibia ; cold feet, even in the evening in bed ; tettery exco- 346 MATERIA MEDICA. riation between the toes ; thickness and deformity of the toe nails. 24. Hamamelis Virgin. (Witch Hazel.) Head. Fulness, with dull, frontal headache. Nose. Bleeding of nose, with a feeling of tight- ness at the root of nose. Abdomen. Pains in the umbilical region ; hem- orrhage from the bowels — bleeding piles ; dysentery, with profuse hemorrhage. Urinary Organs. Hematuria, with scanty, high- colored urine ; stranguria. Extremities. Varicose veins on lower limbs ; sprains and feelings of dislocations on upper and lower limbs ; externally and internally to be used. 25. Helleborus. Dropsical affections, especially some kinds of ana- sarca, and chiefly those which proceed from the re- percussion of eruptions, such as measles ; scald-head, with obstruction of the glands of the neck ; acute hydrocephalus. General Symptoms. — Convulsions. Sleep. Sleepiness, with eyes half open and pupils turned upward. Moral Symptoms. Dulness of the internal senses. Head. Stupefying pain and sensation of a bruise in the head ; painful heaviness of the head ; disposition to bury the head in the pillow when sleeping. Fceces. Watery and frequent evacuations. Chest. Difficult respiration, as if from hydro- thorax ; constriction of the chest. MATERIA MEDICA. 347 26. Hepar Sulphuris. Evil consequences of the abuse of mercury ; scrof- ulous affections, icterus ; scald-head ; eruptions and tetters on the face ; scrofulous catarrhal ophthalmia ; ulcers on the cornea. General Symptoms. — Pains, as if from excoria- tion or a bruise on different parts when touched ; swelling, inflammation, and ulceration of the glands ; aggravation of the pains at night. Skin. Eruption of pimples and tubercles, painful when touched ; unhealthy skin, every injury tends to ulceration ; suppurations. Sleep. Jerking at night, as if from want of air. Fever. Dry heat at night ; great disposition to perspire in the daytime. Head. Pain in the head as if a nail were driven into it ; pain, as if from ulceration in the head, directly above the eyes ; tuberosities on the head, with pain, as if from excoriation when touched. Eyes. Stinging in the eyes ; inflammation of the eyes and eyelids, with pain as from a bruise and excoriation when touched ; specks and ulcers on the cornea ; spasmodic closing of the eyelids. Ears. Heat, redness, and itching in the ears ; scabs behind and on the ears. Nose. Pain, as from a bruise and excoriation in the nose when touched. Face. Face burning and of a deep red ; erysipe- latous inflammation and swelling of the face ; pains in the bones of the face when touched. Teeth. Toothache, with jerking and drawing pains, 348 MATERIA MEDICA. aggravated by closing the teeth, by eating, and in a hot room ; swelling and inflammation of the gums, which are painful to the touch. Mouth. Salivation ; sore throat, as if there were a plug in it. Appetite. Desire only for acid or pungent things. Stomach. Eructations, with burning sensation in the throat. Fceces. Whitish diarrhoea, of an acid color, es- pecially in children ; dysenteric evacuations, greenish or of a clay color, with evacuation of sanguineous mucus. Urine. Wetting the bed ; discharge of mucus from the urethra. Genital Organs. Flow of prostatic fluid, especially after making water, and during a difficult evacuation ; excoriation between the thighs ; leucorrhcea, with smarting. • Larynx. Hoarseness ; dry cough in the evening, from any part of the body becoming cold, or when lying on the bed ; attacks of dry, rough, and hollow cough, with anguish and suffocation, often causing one to weep. Chest. Anxious, hoarse, wheezing respiration, with danger of suffocation when lying down. Arms. Pain, as from a bruise", in the bones of the arm ; arthritic swelling of the hand, fingers, and joints of the fingers, with heat, redness, and pain, as from dislocation, during movement ; skin of the hands cracked, rough, and dry ; panaris. Legs. Swelling of the knees ; cracks in the feet. MATERIA MEDICA. 349 27. Hydrastis Canad. General Symptoms. — Great emmi and lassitude ; sinking at the stomach, with violent and long-con- tinued palpitations. Skin. Erysipelatous rash over most parts of the skin, with intense burning heat ; given early in small- pox or varioloid will cause the prevention of these diseases to full maturity. Nose. Catarrhal affection, with profuse secretion of tears ; principal constitutional remedy for catarrhs. Urinary Organs. Incipient stricture, spermator- rhoea and inflammation, and ulceration of the whole internal coat of the bladder. 28. Hyoscyamus. General Symptoms. — Convulsions, with cries, great anguish. Fever. Burning heat of the body, especially of the head. Moral Symptoms. Desire to run away ; loss of consciousness, with eyes closed, and raving about business ; delirium ; perversion of all actions. Head. Headache, as if from concussion of the brain ; oppressive and benumbing pain in the fore- head. Eyes. Eyes red, fixed, convulsed ; spasmodic closing of the eyelids ; nocturnal blindness, weakness of sight, as if from incipient amaurosis. Mouth and Throat. Eedness of the tongue ; con- striction in the throat, and inability to swallow liquids. 350 MATERIA MEDIC A. Appetite and Stomach. Vomiting of food and drink immediately after a meal. Fceces. Involuntary evacuations. Genital Organs. Metrorrhagia of a bright-colored blood. Larynx. Cramp-like cough at night, especially when lying down ; sometimes with redness of the face and vomiting of mucus. Chest. Pressure on the right side of the chest, with great anxiety, and shortness of breath when ascending stairs ; spasms in the chest, with short breathing. Arms. Hands clinched, with retraction of the thumbs (in the convulsive fits). Legs. Painful cramps in the thighs and calves of the legs. 29. Ignatia. Spasmodic affections, especially in consequence of fright or contradiction, and chiefly in hysterical women, or in children ; melancholy, and other mental affections caused by affliction ; difficult teething of children, with convulsions ; prolapsus recti also, in children. General Symptoms. — Violent pain, merely on be- ing touched, in different parts ; attacks of cramp and of convulsions ; hysterical debility and fainting fits ; the pains are removed always by change of position. • Sleep. Violent spasmodic yawnings,, especially in the morning. Fever. Absence of thirst during the heat and perspiration. MATERIA MEDIC A. 351 Moral Symptoms. Tenderness of character, and delicacy of conscience ; love of solitude. Head. Pressive headache, especially above the root of the nose ; aggravated or relieved by stooping ; the headaches are aggravated by coffee, brandy, tobacco smoke, noise, and strong smell ; headache, as if a nail were driven into the brain. Eyes. Convulsive movements of the eyes and eye- lids. Face. Convulsive jerkings, and distortion of the •muscles of the face ; convulsive twitchings of the corners of the mouth. Throat. Sore throat, as if there were a plug in it ; shootings in the throat, extending sometimes to the ear, chiefly when not swallowing ; inflammation, swell- ing, and induration of the tonsils, with small ulcers ; impeded deglutition (of drinks). Appetite. Dislike to milk and tobacco smoke ; painful inflation of the abdomen after a meal. Stomach. Hiccough every time after eating and drinking ; periodical attacks of cramp in the stomach, aggravated by pressing on the part affected. Abdomen. Shootings and pinchings in the abdo- men, especially in the sides ; flatulent colic, especially at night. Faeces. Hard evacuations, with frequent ineffectual efforts ; prolapsus of the rectum during evacuation ; itching and *crawling in the anus. Catamema. Cramp-like and compressive pains in the region of the uterus, with attacks of choking. Larynx. Short cough, as if from a feather in the throat, becoming more violent the more one coughs. 352 MATERIA MEDIC A. Chest. Difficult respiration, as if hindered by a weight upon the chest ; choking with running ; pal- pitation of the heart at night. Arms. Insupportable pains in the bones and joints of the arms, as if the flesh were being loosened ; convulsive jerkings in the arms and in the fingers. Legs. Convulsive jerkings of the legs. 30. Ipecacuanha. Gastric and bilious fevers ; intermittent fevers ; gastric uneasiness, especially when caused by indiges- tion ; Asiatic and sporadic cholera ; gastric affections, with vomiting and diarrhoea ; asthmatic affections. General Symptoms. — Attacks of uneasiness, with dislike to all food, and excessive and sudden debility. Fever. Coldness, especially of the hands and feet ; thirst only during the shivering or chill. Head. Attacks of headache, with nausea and vom- iting. Appetite. Great repugnance and dislike to all food. . Stomach. Nausea ; vomiting of drink and undigested food, of bilious, greenish, or acrid matter, and some- times immediately after a meal ; vomiting with diar- rhoea. Fceces. Loose evacuations, like matter in a state of fermentation ; diarrhoea, with nausea, colic, and vom- iting ; dysenteric evacuations, with white flocks, and followed by tenesmus. Genital Organs. Metrorrhagia, with discharge of bright red and coagulated blood. Larynx. Cough, especially at night, with painful shocks in the head and stomach, with disgust, and MATERIA MEDIC A. 353 inclination to vomit, and vomiting ; or with fits of suffocation, stiffness of the body, and bluish face. Chest. Spasmodic asthma, Avith contraction of the larynx. 31. Lachesis. General Symptoms. — Great weakness of body and mind. Skin. Skin yellow, green, lead colored, or bluish, or blackish, chiefly around the wounds and ulcers. Head. Vertigo, chiefly on waking in the morning ; apoplectic fits, with blue face, convulsive movements of the limbs ; headache, with congestion of blood, sparkling before the eyes ; headache every morning on waking, or after dinner, or else from every change of weather. Mouth. Tongue shining, red, and cracked ; painful excoriation and inflammatory swelling of the throat ; constant desire to swallow, and a sensation on swallow- ing as if there were a tumor, some foreign body, or a plug in the throat, ulcers on the palate, back of the mouth, and throat. Appetite. Desire for wine. Stomach. Excessive sensibility of the precordial region to the slightest touch. Abdominal Region. Inflammation and softening of the liver ; pain and stitches in the region of the spleen ; abdomen hard and distended, with flatulent colic. Fceces. Obstinate constipation, with hard and diffi- cult evacuation ; loose evacuations, principally at night, or after a meal, or in warm (and damp) weather, or from having taken fruits and acids. 354 MATERIA MEDICA. 32. Lycopodium. General Symptoms. — Excessive sensibility to fresh air ; great tendency to take cold. Skin. Excoriation of the skin of children. Moral Symptoms. Melancholy and disposition to weep ; aversion to speaking. Face. Frequent flushes of transient heat in the face ; swelling of the submaxillary glands. Mouth. Dryness of the mouth without thirst. Throat. Dryness of the throat ; inflammation of the throat and palate, with shooting pain. Stomach. Pressure in the stomach after every meal ; swelling of the epigastrium, with painful sensi- bility to the touch. Abdominal Region. Tension around the hypochon- dria, as if caused by a hoop ; induration of the liver ; fulness and distention of the stomach and abdomen ; obstructed flatulency. Fceces. Obstruction of the abdomen. Genital Organs. Leucorrhcea, milky, yellowish, reddish, and corrosive ; excoriation and running sores of the nipples. Larynx. Nocturnal cough, which affects the head, diaphragm, and stomach. Chest. Short respiration during almost every exer- tion ; palpitation of the heart, especially during diges- tion ; painful eruption and liver spots on the chest. Trunk. Swelling of the glands of the neck and shoulder with shooting pain. Arms. Nocturnal aching pains in the arms ; dry- ness of the skin of the hands. MATERIA MEDIC A. 355 Legs. Swelling of the knees ; ulcers on the legs ; pain in the soles of the feet when walking. 33. Mercurius Vivus. Swelling and inflammation of the glands ; inflam- matory fevers, with disposition to perspire profusely ; rheumatic or catarrhal headache ; scrofulous, rheu- matic, catarrhal (and arthritic) ophthalmia ; syphilitic ophthalmia ; rheumatic and catarrhal otalgia ; rheu- matic prosopalgia and toothache ; dysentery ; mucous or bilious diarrhoea ; influenza. General Symptoms. — Bending, or drawing, or stinging pains in the limbs, principally at night, in the heat of the bed, which renders the pain insup- portable ; nocturnal aching pains ; rheumatic pains, with profuse sweat, which affords no relief ; the whole body feels as if it had been bruised, with soreness in all the bones ; emaciation and atrophy of the whole body ; excitability and sensibility of all the organs. Skin. Enlargement, inflammation, and ulceration of the glands, with pulsative and shooting pains, hard, red, and shining swelling ; violent and volup- tuous itching over the whole body, principally in the evening, or at night, augmented by the heat of the bed, and sometimes with burning after being scratched. Fever. Copious, excessive, and colliquative sweats both day and night ; in the morning, sweat, with nausea and desire to vomit ; great fatigue. Head. Vertigo, principally on getting up or on raising up the head ; fulness and pressure in the 356 MATERIA MEDIC A. head, as if the forehead were squeezed by a band, or that the cranium would split ; heat and burning, or tearing and drawing pains, or stinging in the head, often only one-sided and extending to the ears, teeth, and neck. Eyes. Itching, tickling, and burning in the eyes ; eyes red and inflamed ; eyelids red, inflamed, swollen, ulcerated on the margins, and covered with scabs. Ears. Tearing, stinging, and drawing pains in the ears, increased by the heat of the bed ; puru- lent otorrhoea, with tearing in the affected side of the head and in the face. Face. Bloatedness and swelling of the face ; tear- ing in the bones and muscles (of one side) of the face ; obstruction and inflammatory swelling of the submaxillary glands, with stinging or pulsative pains. Teeth. Tearing, stinging, or pulsative pains in the carious teeth, or in the roots of the teeth, often spreading as far as the ears, and in the entire cheek of the side affected, sometimes, also, with painful swelling of the cheek or of the submaxillary glands, with salivation and shivering ; appearance or aggravation of toothache, principally in the evening or at night, in the heat of the bed, where it is insupportable ; renewed by the fresh air, as well as by eating, and taking anything hot or cold into the mouth ; retraction and swelling of the gums, prin- cipally at night, with burning pain and sensation of excoriation on touching them and on eating ; gums livid, discolored, and very sensitive ; ulceration of the gums. Mouth. Putrid smell from the mouth ; inflam- MATERIA MEDICA. 357 matory swelling of the inside of the month ; burning pain, vesicles, blisters, aphthae, and ulcers in the mouth ; accumulation of tenacious mucus ; profuse dis- charge of excessively fetid saliva ; tongue moist, with white and thick coating ; inflammatory swelling and ulceration of the tongue, with stinging pains ; entire loss of speech. Throat. Stinging pains in the throat and ton- sils, principally when swallowing ; inflammatory swelling and redness of all the back parts of the mouth and throat ; constant desire to swallow ; in- ability to swallow the least liquid, which escapes through the nostrils ; the pains in the throat com- monly extend as far as the ears, the parotids, the submaxillary glands, and those of the neck ; they are aggravated, for the most part, by empty deglutition, as well as at night, in the fresh air and when speaking, and they are accompanied with salivation. Appetite. Acid and mucous taste ; dislike to all food, principally solid nutriment, meat. Stomach. Violent, empty eructations ; excessive tenderness of the stomach and precordial region ; pressure as if from a stone in the pit of the stomach. Abdominal Region. Painful sensibility of the hepatic region, with stinging, burning pain ; complete icterus ; obstruction and inflammatory swelling of the -inguinal glands. Fceces. Loose and dysenteric evacuations, prin- cipally at night, with colic and cuttings ; tenesmus and burning in the anus ; nausea and eructations ; shivering and shuddering, exhaustion and tremor of all the limbs ; scanty evacuations of sanguinolent 358 MATERIA MEDIC A. mucus ; evacuations, which are mucous, or bilious, or putrid, or acid, or of a greenish or brownish color ; evacuation of acrid and burning fecal matter ; dis- charge of blood or of mucus from the rectum ; dis- charge of ascarides and lumbrici. Urine. Frequent, copious emission of urine, like diabetes ; corrosive and burning urine. Larynx. Catarrh, with febrile shivering ; con- tinued hoarseness and loss of voice ; pains in the head and chest when coughing, as if these parts were about to burst. Chest. Difficulty of respiration, with attacks of suffocation at night, or in bed, in the evening when lying (on the left side) ; shootings in the chest and side, or extending as far as the back, principally when breathing, sneezing, and coughing ; pain as from excoriation and of ulceration in the chest. Trunk. Obstructions and inflammatory swelling of the glands of the neck. .Arms. Sharp pains in the shoulders and arms, principally at night, and when moving these parts. Legs. Sharp and piercing pains in the hip joints, as well as the thighs, principally at night, and when moving ; cedematous, transparent sweUing of the thighs and legs. 34. Mercur. Subl. Corros. Abdomen. Sensitive to touch ; cutting below navel. Stool. Bloody, green mucus, with straining and colic ; very severe pains, with the smallest quantity of bloody mucus/ MATERIA MEDIC A. 359 35. Nux Vomica. Sufferings from the abuse of coffee, wine, or other spirituous or narcotic drugs ; bad effects from passion or excessive study, prolonged watching, or a sedentary life ; periodical and intermittent affections ; gastralgia ; gastritis ; gastrico- mucous or bilious affections ; dys- pepsia, also with vomiting of food ; vomiting of drunkards, of pregnant women ; incarcerated hernia ; obstinate constipation ; blind and bleeding hemor- rhoids. General Symptoms. — Eepugnance to the open air ; great desire to remain lying down or sitting. Sleep. Too short sleep, with difficulty in going to sleep again after midnight, and inability to remain in bed after three o'clock in the morning ; on wak- ing in the morning, pain in the limbs as if they were bruised, great lassitude, with desire to remain lying down, and fits of stretching and of convulsive yawning. Fever. During the shivering, skin, hands and feet, face or nails, are cold and bluish ; during the heat, vertigo, headache, shivering when moving in the least, or when uncovered in the slightest degree, thirst. Moral Symptoms. Hypochondriacal, sorrowful, and sad humor ; ill-humor, vexation, and anger ; dislike to, and unfitness for, bodily and mental labor. Head. Vertigo, with sensation of turning and of wavering of the brain ; heaviness, pressure, and sensa- tion of expansion in the head, as if the forehead were about to burst, especially above the eyes. Eyes. Eyes inflamed, with redness and swelling, also the evelids. 360 . MATERIA MEDIC A. Nose. Obstruction of the nose, sometimes on one side only, and often with itching in the nostrils and discharge of mucus ; obstruction in the head, princi- pally in the morning, or at night, and dry coryza with heat and heaviness in the forehead, and obstruction of the nostrils. Teeth. Putrid and painful swelling of the gums. Mouth. Fetid, putrid, and cadaverous smell from the mouth ; tongue loaded with a white coating, or dry, cracked, brownish or blackish. Throat. Swelling of the uvula ; bitter taste of the mouth ; desire for brandy. Stomach. Frequent, bitter, and acid eructations ; violent hiccough ; vomiturition and violent vomit- ing of mucous and sour matter, after drinking or eat- ing, or in the morning ; pressure in the stomach as if by a stone ; tension and fulness in the epigastrium ; tight clothes are insupportable. Abdominal Region. Flatulent colic, sometimes in the morning, after eating or drinking, with pressing pains, as if by stones. Fceces. Frequent but ineffectual and anxious desire to evacuate ; obstinate constipation, as if from inactivity of the intestines ; incomplete evacuations ; small, loose, aqueous or mucous and sanguinolent evacuations ; hemorrhoids, with excoriating, stinging, burning pain, and pressure in the anus and rectum. Urine. Ineffectual desire to urinate ; frequent emission of watery and pale urine ; burning pain in the neck of the bladder when making water. Larynx. Catarrhal hoarseness and painful rough- ness of the larynx and chest ; accumulation of tenacious MATERIA MEDIC A. 361 mucus, which it is impossible to detach ; pains, as from excoriation in the larynx, when coughing. Chest. Asthmatic constriction of the chest at night, in bed, when going upstairs, choking, anxiety. Trunk. Pains, like those caused by a bruise in the back and loins ; rheumatic, drawing, and burning pains in the back. 36. Opium. Eecent affections rather than those of long stand- ing ; nervous torpor, and want of vital reaction against the medicines that have been administered ; sufferings of drunkards ; affections of old men ; bad effects of fright, with continued fear, or of sudden joy ; typhus ; delirium tremens ; ileus ; constipation, principally that caused by torpor of the intestinal canal, a£ter frequent diarrhoea, or from want of exercise, and especially in the case of vigorous persons, or those who are plethoric, or well fed, as well as in the case of children and pregnant women ; tympanitis ; suppressed or false and spasmodic labor pains. General Symptoms. — General insensibility of the whole nervous system. Sleep. Lethargy, with snoring and mouth open ; excessive desire to sleep, with absolute inability to go to sleep. Fever. Pulse generally full, slow ; fever with lethargic sleep, snoring. Face. Face dark red, sometimes brownish, hot, and bloated. Stomach. Vomiting of fecal matter and of urine. Abdominal Region. Abdomen hard and distended, as in tympanitis. 362 MATERIA MEDICA. Fceces. Constipation, long continued ; involuntary evacuations. Chest. Noisy, stertorous, and rattling respiration ; attacks of suffocation on making an effort to cough. 37. Phosphorus. Physical and nervous weakness caused by pro- tracted influences injurious to the vital economy ; hemorrhage and congestion of blood ; cholerine ; chronic and colliquative diarrhoea ; chronic laryngitis ; disposition to croup. General Symptoms. — The majority of the symp- toms manifest themselves morning and evening, in bed, as well as after dinner, while several others appear at the beginning of a meal and disappear after it. Skin. Lymphatic abscesses, with fistulous ulcers, which have callous margins, and secrete a fetid and colorless pus, with hectic fever ; copious bleeding from small wounds. Sleep. Unref reshmg sleep ; in the morning it appears as if one had not slept enough ; nocturnal heat ; hectic fever, with dry heat toward evening, espe- cially in the palms of the hands ; sweat and colliqua- tive diarrhoea ; circumscribed redness of the cheeks, etc. Moral Symptoms. Anguish and uneasiness, espe- cially when alone. Head. Vertigo, with nausea and pressing pains in the head ; congestion to the head, with beating ; falling off of the hair. Eyes. Inflammation of the eyes ; nocturnal agglu- tination of the eyes ; black spots before the sight. MATERIA MEDIC A. 363 Xose. Unpleasant dryness of the nose ; continual discharge of yellow mucus from the nose. Face. Face pale, wan, dirty, earthy, with hollow eyes surrounded by a blue circle. Stomach. Sour regurgitations of food ; nausea of various kinds, especially in the morning ; spasmodic pain and contraction in the stomach. Abdominal Region. Spasmodic colic ; sensation of coldness, with heat and burning in the abdomen ; flatulent colic, with grumbling. Faeces. Prolonged looseness of the bowels. Larynx. Aphonia ; cough excited by a tickling and itching in the chest, or with hoarseness, and sensation as if the chest were raw ; cough, with puru- lent and saltish expectoration, or of blood. Chest. Obstructed respiration of various kinds ; congestion to the chest ; palpitation of the heart. Arms. Trembling in the arms and hands. Legs. Drawing and tearing in the knees ; swell- ing of the feet. 38. Podophyllum. Head. Vertigo ; morning headache. Abdomen. Pain and fulness in right side (liver). Stool. Constipated, with headache ; fulness of bowels ; prolapsus ani ; icterus, with induration of liver. 39. Pulsatilla. Affections of persons of mild character, inclined to pleasantry, and to laughter or weeping, with a mild countenance, and of phlegmatic temperament, 364 MATERIA MEDIC A. inclining to melancholy, lymphatic constitution, with pale complexion, blue eyes, and light hair, freckles, disposition to take a cold in the head, or to other mucous discharges, etc. ; bad consequences from the abuse of sulphur waters, of mercury, cinchona, cham- omilla, or from the fat of pork ; rheumatic and arthritic aff ections, with swellings ; inflammatory otal- gia ; dyspepsia, with vomiting of food ; mucous or bilious diarrhoea ; inflammatory swelling of the testes ; organic affections of the heart ; inflammatory swelling of the legs and feet. General Symptoms. — Sharp, drawing, and jerking pains in the muscles, aggravated at night, or in bed in the evening, as well as by the heat of the room, mitigated in the open air, and often accompanied by torpor, with paralytic weakness or hard swelling of the parts affected ; shifting pains, which pass rapidly from one part to the other, often with swell- ing and redness of the joints. Skin. Eed spots, like measles or nettle rash ; chilblains, with bluish red swellings ; heat and burn- ing, or pulsative pains. Head. Vertigo, as during intoxication ; headaches in the evening after lying down, or at night ; com- pression sometimes mitigates them. Eyes. Pressive or sharp, shooting pain in the eyes, with inflammation ; sties on the eyelids. Ears. Shootings, with itching, or sharp, jerking pains and contraction in and around the ears ; the pains sometimes come on by fits, attack the whole head, appear almost insupportable, and almost cause the loss of reason ; inflammatory swelling, heat, and MATERIA MEDIC A. 365 erysipelatous redness of the ear and auditory duct, as well as the surrounding external parts ; tingling, roar- ing, and humming in the ears ; hardness of hearing. Nose. Obstruction of the nose, and dry coryza, principally in the evening and in the heat of a room. Face. Face pale, and sometimes with an expres- sion of suffering Teeth. Sharp, shooting pains in the teeth, or drawing, jerking pains, as if the nerve were tightened, then suddenly relaxed ; or pulsative, digging, and gnawing pains, often with pricking in the gums, and shivering ; worse in the evening, or afternoon, in the heat of the bed, or of a room ; mitigated by cold water or fresh air. Mouth. Tongue loaded with a thick coating, of a whitish or yellowish color. Throat. Pain, as if from excoriation in the throat, as if it were all raw, with sensation as if these parts were swollen, principally when swallowing, or accumu- lation of tenacious mucus, which covers the parts affected. Appetite. Bitter or sour taste in the mouth, immediately after having eaten ; sensation of derange- ment in the stomach, similar to that caused by fat pork or rich pastry ; after eating, nausea, and pressure in the pit of the stomach, and many other sufferings. Stomach. Nausea and vomitings take place in the evening or at night, and after eating or drinking, with shivering, paleness of face, colic ; pressive, spasmodic, contractive, and compressive pains in the stomach and precordial region, after a meal, or in the evening ; pulsations in the pit of the stomach. 366 MATERIA MEDICA. Fceces. Loose evacuations, with colic and cuttings, of greenish, bilious, or watery matter ; blind and bleeding hemorrhoids, with itching, smarting, and pain, as if from excoriation. Genital Organs. Inflammatory swelling of the testes, and of the spermatic cord (sometimes only on one side), with pressive and drawing pains extending into the abdomen ; metrorrhagia ; black menstrual blood, with clots of mucus, or " discharge of pale and serous blood ; menses irregular, too tardy, or entirely suppressed, with colic, hysterical spasms in the abdo- men ; % nausea, and vomitings, shiverings, and paleness of face ; leucorrhcea thick, like cream. Larynx. Shaking cough in the evening, at night, aggravated when lying down, accompanied with a desire to vomit, or by a choking, as if caused by the vapor of sulphur ; moist cough, with expectoration of white, tenacious mucus, or of thick, yellowish mat- ter. . Chest. Spasmodic constriction of the chest, or larynx, in the evening, or at night when lying horizontally ; frequent and violent palpitation of the heart. Trunk. Kheumatic, tensive, and drawing pain in the nape of the neck. Arms. Sharp, jerking, and drawing pains in the shoulder joint, as well as in the arms, hands, and fingers. Legs. Pain, as from subcutaneous ulceration in the legs and soles of the feet ; swelling of the knees, with sharp, drawing, and shooting pains ; great fatigue in the legs and in the knees, with trembling. MATERIA MEDICA. 367 40. Rhus Toxicodendron. Rheumatic affections, with swelling ; vesicular ery- sipelas ; bad effects from a strain, dislocation, concus- sion, and other mechanical injuries, especially when attended with sufferings in the joints and synovial membranes ; gastric affections ; diarrhoea and dys- entery ; coxalgia and spontaneous dislocation. General Symptoms. — Rheumatic and arthritic draw- ings, tension, and tearing in the limbs, increased to the highest degree during repose, in bad weather at night, and in the heat of the bed ; red and shining swellings. Sleep. Disturbed sleep, with anxious and frightful dreams. Fever. Malignant fever, with loquacious delirium, violent pains in all the limbs, excessive weakness, dry or black tongue, dry, brownish, or blackish lips, heat and redness of the cheeks. Head. Heaviness and pressive fulness in the head ; beating and pulsations in the head, especially in the occiput ; balancing and sensation of fluctuation in the head at every step, as if the brain were loose. Eyes. Inflammation of the eyes and lids ; swelling of the whole eye and surrounding parts. Ears. Swelling and inflammation of the parotids, with fever. Face. Erysipelatous inflammation and swelling of the face, with pressive and tensive shootings, and burn- ing, crawling ; vesicular erysipelas, with yellow serum in the vesicles ; humid eruption and thick scabs on the face. Month. A yellow, and sometimes, also, a sanguin- eous saliva flows from the mouth at night. 368 MATERIA MEDICA. Appetite. Thirst from a sensation of dryness in the mouth. Fceces. Loose, sanguineous, serous, or slimy evac- uations ; obstinate diarrhoea. Larynx. Cough, excited by a tickling in the ramifi- cations of the bronchi, short and dry. Chest. Shootings and lancinations in the chest and its sides. Trunk. Pains in the loins, as if beaten ; stiffness of the nape and neck. Arms. Warts on the hands and fingers. 41. Secale. Gastric and bilious affection ; Asiatic and sporadic cholera ; diarrhoea, especially in old men ; metrorrhagia of weak women. Sleep. Great desire to sleep, and deep, lethargic sleep. • Eyes. Eyeballs sunk deep in the sockets. Face and Teeth. Face pale, discolored, yellow, wan, with the eyes hollow and surrounded by a blue circle. Fceces. Loose, frequent evacuations, with serous or slimy faeces, and sudden prostration of strength ; involuntary evacuations. 42, Sepia. General Symptoms. — The symptoms disappear during every violent exercise, except on horseback, and are aggravated during repose, as also in the evening ; uneasiness and throbbing in all the limbs, violent ebullition of blood during the night, with MATERIA MEDICA. 369 pulsation in the whole body ; great tendency to take cold, and sensitiveness to cold air. Skin. Itching in different parts, which changes to a burning sensation ; brown, reddish, and livid spots on the skin ; deformity of the nails. Fever. Profuse perspiration from the slightest movement ; sadness and dejection, with tears ; suscep- tibility and peevishness. Head. Attacks of headache, with nausea and vomiting when shaking or moving the head, and also at every step ; semi-lateral headache ; violent congestion of blood to the head. Eyes. Pressure on the eyeballs ; inflammation, redness, and swelling of the eyelids, with sties. Ears. Shooting in the ears. Nose. Scabby and ulcerated nostrils. Face. Yellow color of the face ; yellow streak on the nose, and cheeks in the form of a saddle ; yellow color and herpetic eruption around the mouth. Teeth. Toothache when compressing the teeth, when touching them, and when speaking, as also from the slightest current of cold air. Throat. Hawking up of mucus, especially in the morning. Appetite. Putrid or sour taste ; repugnance and dislike to food. Stomach. Throbbing in the pit of the stomach. Abdominal Region. Enlargement of the abdomen (in women who have had children). Fceces. . Ineffectual desire to evacuate ; greenish diarrhoea, often with putrid or sour smell, or especially in children ; prolapsus recti ; protrusion of hemorrhoids. 370 MATERIA MEDICA. Urine. Wetting the bed during the first sleep. Genital Organs. Bearing down in the uterus ; prolapsus uteri ; leucorrhcea of a yellowish or greenish red water. Larynx. Dry cough, which seems to arise from the stomach, especially when in bed in the evening, and often with nausea and bitter vomiting ; cough ex- cited by a tickling, and accompanied with constipation, detached with difficulty. Chest. Dyspnoea, oppression of the chest, and short breath when walking and ascending^ as well as when lying in bed, in the evening, and at night ; ebulli- tion of blood in the chest, and violent palpitation of the heart. 43. Silicea. Obstruction, inflammation, induration, and ulcera- tion of the glands ; inflammation, softening, ulceration, and other diseases of the bones ; ulcers, almost of all kinds ; ulceration of the mammae ; chronic coryza and obstinate disposition to take cold in the head ; panari- tium. Skin. Mild and malignant suppurations, especially in membranous parts ; carbuncles. Head. Vertigo, with nausea, which mounts from the back to the nape of the neck and head ; tearing pains in the head, often semi-lateral ; moist scald-head. Eyes. Redness of the eyes ; swelling of the lachry- mal gland ; black spots before the sight. Ears. Hardness of hearing ; swelling and indura- tion of the parotids. Nose. Scabs, pimples, and ulcers in the nose. MATERIA MEDICA. 371 Face. Ulcers on the reel part of the lip ; herpes on the chin ; swelling of the submaxillary glands. Appetite. After a meal, sour taste in the mouth ; pressure in the stomach ; water-brash ; vomiting. Stomach. Nausea every morning. Fceces. Constipation, and slow, hard faeces. Trunk. Inflammatory abscesses in the lumbar region ; swelling and deviation of the spine ; swelling of the glands of the nape of the neck, on and under the axillae, sometimes with induration ; suppuration of the axillary glands. Arms. Burning sensation in the ends of the fingers ; panaritium. Legs. Inflammatory swelling of the knee : caries in the tibia ; offensive smell from the feet. 44. Sulphur. General Symptoms. — Great sensitiveness to the open air and to the wind ; the majority of the suffer- ings are aggravated, or appear at night, or in the evening, and also during repose ; when standing for a long time, and by exposure to cold air ; they dis- appear when walking or moving the parts affected, and also in the warmth of a room ; but the heat of the bed renders the nocturnal pains insupportable. Skin. Itching in the skin, at night in bed ; sca- bious eruptions, with burning itching ; desquamation and excoriation of the skin in several places ; ulcers, with elevated margins, surrounded by itchy pimples ; inflammation, swelling, and induration, or suppuration of the glands. ' Fever. Frequent and profuse perspiration day and 372 MATERIA MEDICA. night ; aptness to perspire when working, partial per- spiration, principally on the head. Head. Fulness, pressure, and heaviness in the head, principally in the forehead ; congestion of blood to the head, with pulsative, clucking, hammering sensations, and feeling of heat in the brain ; quo- tidian, periodical, and intermittent headaches, appear- ing principally at night, or in the evening in bed, or in the morning ; movement, walking, the open air, and meditation often excite or aggravate the head- aches. Eyes. Itching, tickling, and burning sensation in the eyes and eyelids ; inflammation, swelling, and redness of the sclerotica, conjunctiva, and eyelids ; pustules and ulcers round the orbits, as far as the cheeks ; great sensitiveness of the eyes to the light. Ears. Obstruction and sensation of stoppage in the ears, on one side only : humming and roaring in the ears. Nose. Inflammation, ulceration, and scabs in the nostrils. Face. Heat, and burning sensation in the face, with dark redness of the whole face ; circumscribed redness of the cheeks. Teeth. Appearance or aggravation of toothache, principally in the evening,- at night, or in the open air, and also from a current of air ; from cold water, eating, and masticating. Mouth. Aphthae in the mouth and on the tongue. Throat. Pressure, as if from a plug, or from a tumor in the throat. Appetite. Dislike to sweet and acid things. MATERIA MEDICA. 373 Abdominal Region. Shootings in the abdomen, principally in the left side when walking ; pains in the abdomen, principally at night, or after eating and drinking, mitigated by bending forward. Fceces. Constipation, and hard, knotty, and in- sufficient evacuations ; hemorrhoids. Genital Organs. Excoriation between the thighs and groins. Larynx. Moist cough, with profuse expectoration of thick, whitish, or yellowish mucus ; when cough- ing, pain as if from excoriation, or shootings, in the chest. Chest. Obstructed respiration, dyspnoea and attacks of suffocation, principally when lying down at night, and also during sleep ; periodical spasms in the chest ; shootings in the chest or sternum, or extending as far as the back, or into the left side. 45, Veratrum. Sporadic or Asiatic cholera ; diarrhoea, of different kinds, also those produced by cold drinks, when one is overheated. General Symptoms — Pains in the limbs, which are rendered insupportable by the heat of the bed, and disappear completely when walking ; sudden, general, and paralytic prostration of strength. Fever. General coldness of the whole body, and cold, clammy perspiration ; fever, with external cold- ness ; pulse slow, and almost extinct. Head. Attack of headache, with paleness of the face, nausea and vomiting ; cold perspiration of the forehead. 374 MATERIA MEDICA. Nose. Icy coldness of the nose. Face. Face pale, cold, hippocratic, wan, with the nose pointed, and a blue circle round the eyes ; cold perspiration on the face ; lips dry, blackish, and cracked. Teeth. Grinding of the teeth. Mouth. Sensation of coldness on the tongue; tongue dry, blackish, cracked. Appetite. Immediate vomiting and diarrhoea, how- ever little is eaten. Stomach. Violent nausea, with desire to vomit, with excessive thirst ; violent vomiting, with con- tinued nausea, great exhaustion and desire to lie down ; vomiting of black bile and blood ; vomiting, with diarrhoea ; the least drop of liquid and the slightest movement excite the vomitings ;" burning sensation in the pit of the stomach. Abdominal Region. Excessively painful sensitive- ness of the abdomen when touched ; cramps in the abdomen, and cuttings, as if from knives ; burning sensation through the whole extent of the abdomen, as if from hot coals. Faeces. Loose, blackish, greenish, brownish evac- uations ; unnoticed evacuation of liquid faeces. Urine. Eetention of urine ; urine diminished. Genital Organs. Menses suppressed, with delirium. Chest. Chest very much oppressed ; cramp in the chest, with painful constriction ; violent palpitation of the heart, which causes heaving of the chest. Arms. Icy coldness in the hands ; cramps in the fingers. Legs. Violent cramps in the calves of the legs and feet ; icy coldness of the feet. GLOSSARY OF MEDICAL TERMS. Abortus. Miscarriage; abortion. Abscess. A collection of pus seated in any particular organ or tissue. Adhesion. In surgery, the direct union of parts that have been divided. This union is often attended by inflamma- tion, which is thence called Adhesive Inflammation, which at- tends the union of surfaces, separated by a wound; it is synonymous with union by the first intention. Adypsia. The absence of natural thirst. Alkali. A substance which unites with acids in definite proportions, so as to neutralize their properties more or less perfectly, and to form salts. It changes vegetable blues to green. Allopathy. A term used by homoeo- pathic writers to designate the old practice of medicine in contradistinc- tion to their own, now generally em- ployed by both parties; literally im- plies, curing a disease with a medicine which produces a dissimilar one. Amenorrhea. Absence or stoppage of the menstrual flux. Anasarca. Dropsy of the cellular tis- sue, or membrane, immediately under the skin. Angina. Sore throat. The term is also applied to diseases with difficult res- piration. Angina Membranacea. Croup. Angina Parotidea. Mumps. Angina Pharyngea. Inflammation of the membrane which lines the pharynx. Anorexia. Want of appetite. Anthrax. Carbuncle. Antiphlogistic. Applied to remedies employed in the old system against inflammation; literally, against heat. Antrum Highmori. The maxillary sinus. A hollow or cavity above the teeth of the upper jaw, in the middle of the superior maxillary bone. Anls. The inferior opening of the rectum. Apoplexia. Apoplexy ^ a loss of vol- untary motion and consciousness. (See Diagnosis under this head.) Apyrexia. The intervals between fe- brile paroxysms. Arthritis. Gout. ASCARIS, plur. Ascarides. Pinworms. Asphyxia. Absence of pulsation. Asthenic. Low; applied to disease; literally, want of strength. Astringents. Medicaments used in the old practice to contract the animal fibre. Atony. A want of tone or energy in the muscular power. Atrophy. A morbid state of the di- gestive system, in which the food taken into the stomach fails to afford sufficient nourishment. A wasting of the whole or of individual parts of the body. Auscultation. The detection of symp- toms by the ear in disease. Bilious. Connected with the secretion of bile. Blepharitis. Inflammation of the eye- lids. Borborygmus. Rumbling in the in- testines, caused by flatus or wind. Bronchia; Bronchi. The tubes into which the trachea or windpipe divides. Bronchitis. Inflammation of the rami- fications of the windpipe. Bulimy; Bulimia. Canine, or excess- ive hunger. Cadaverous. Resembling a corpse. Caecum. The blind gut; so called from its being perforated at one end only. Carcinoma. Cancer, adj. Carcinoma- tous. Cardialgia. Pain in the stomach. Carditis. Inflammation of the heart. Caries. Ulceration of the bones. Carotids. The name of two large ar- teries of the neck. Carpologia. Picking at the bedclothes. Cartilage. Gristle. Catamenia. The menstrual flux. 376 GLOSSARY OF MEDICAL TERMS. Catarrh. Cold; used, also, to express inflammation of the mucous membrane. Catarrhal Ophthalmia. Simple in- flammation of the conjunctiva. Cathartic. Purgative. Cellular Tissue. The fine, netlike membrane enveloping or connecting most of the structures of the human body. Cephalalgia. Headache. Cerebral. Appertaining to the brain. Cervical. Belonging to the neck. Cessatio Mensium. Discontinuance of the menstrual flux. Chlorosis. Green sickness. Chronic. Long continued, in contra- distinction to acute. Cicatrix. A scar left after the healing of a wound. Clavi Pedis. Corns. Clonic Spasm. A spasm which is not of long duration. It is opposed to ionic spasm, which see. Coagula. Clots of blood. Coagulable Lymph. The term given to the fluid which is slowly effused into wounds, and afterward forms the uniting medium or cicatrice. Colic. Griping in the intestines. Collapse. Failing of vitality. Colliquative. Excessive discharge of any secretion . Coma. Drowsiness. Coma Somnolentum. Drowsiness, with relapse thereunto on being roused. Comatose. Drowsy. Compress. Soft lint, linen, etc., folded together so as to form a pad, for the purpose of being placed, and secured by means of a bandage, on parts which require pressure. Congestio ad Caput. Determination of blood to the head. Congestio ad Pectus. Determination of blood to the chest. Congestion. Over-fulness of blood- vessels of some particular organ. Conjunctiva. The membrane lining the eyelids, and extending over the fore part of the eyeballs. Contagion. Propagation cf a disease by contact. Cornea. The anterior transparent por- tion of the eye. It is of a horny con- sistence. CORYZA. Cold in the head. Coxagra. Inflammation of the hip joint. Literally, seizure or pain in the hip. Coxalgia. Literally, pain in the hip; inflammation of the hip joint. Cranium. The skull. Crepitation. Grating sensation, or noi9e, such as is caused by pressing the finger upon a part affected with emphysema; by the ends of a frac- tured bone when moved; or by certain salts during calcination. Crepitant Rhonchus or Rale. The fine crackling noise heard in conse- quence of the passage of air through a viscid fluid. It is heard in the first stage of inflammation of the lungs. Crepitus. Crackling or grating. Cutaneous. Appertaining to the skin. Cuticle. The outer or scarf skin. Cystitis. Inflammation of the bladder. Deglutition. The act of swallowing. Delirium. Derangement of the brain, raving. Depletion. Abstraction of the fluids; generally applied to venesection. Desiccation. A drying up. Desquamation. Falling off of the epi- dermis in form of scales. Diaphragmitis. Inflammation of the diaphragm (muscular partition be- tween the thorax and abdomen). Diagnosis. Distinction of maladies. Diarrhcea. Looseness of the bowels. Diathesis. Constitutional tendency. Diatetic. Relating to diet. Diplopia. Affection of the eyes, in which objects appear double or in- creased in number. Diuretic Medicines which increase the secretion of urine. Dorsal. Appertaining to the back. Drastic. Powerful purgatives. Duodenum. The first intestine after the stomach, so called from its length; the twelve-inch gut. Dyscrasia. A morbid condition of the system; adj. Dyscrastic. Dysecoia. Deafness. Dysmenorrhcea. Painful menstrua- tion. Dyspepsia. Indigestion; literally, diffi- culty of appetite. Dyspncea. Difficulty of respiration; shortness of breath. Dysuria. Difficulty in passing urine. Effusion. A pouring out or escape of lymph or other secretion. Emaciation. A falling off in the flesh. Emetic. Provoking vomiting. Encephalitis. Inflammation of the brain and membranes. GLOSSARY OF MEDICAL TERMS. 377 Endemic. Peculiar to a particular lo- cality. Endocarditis. Inflammation of the internal parts of the heart. Enteralgia. Colic. Enteritis. Inflammation of the intes- tines. Ephemeral. Of a day's duration. Ephialtes. Nightmare. Epidemic. Diseases arising from gen- eral causes. Epigastrium. The region of the stomach. Epilepsy, Epilepsia. Falling sick- ness. Epistaxis. Bleeding from the nose. Epithelium. The cuticle. Erysipelas. St. Anthony's fire. Kose. A disease of the skin. Erysipelas Phlegmonodes. Phleg- monous erysipelas. Erysipelas CEdematodes. (Edematous erysipelas. Erysipelas Erraticum. Wandering erysipelas. Erysipelas Gangrenosum. Gangre- nous erysipelas. Erysipelas Neonatorum. Induration of the cellular tissue in infants. Exacerbation. Aggravation of fever, etc. Exanthema. Eruption terminating in exfoliation. Expectoration. Discharge of any matter: phlegm; pus from the chest. Exudation. Discharge of fluid from the skin, etc. Faeces. Alvine excrement. Fascle. In anatomy, dense fibrous expansions, which either attack or invest muscles. Fauces. The throat. Febris. Fever. Febris Nervosa. Nervous fever, or typhus. Femur. The bone of the thigh. First Intention. (See Union by the.) Fistula. An obstinate, tube-like sore, with a narrow orifice ; adj. Fistuloxis. Fistula Lachrymalis. An ulcerated opening in the lachrymal sac. Flatus. Wind in the intestines. Flat- ulency. Fcetus. The infant in the womb. Fomentation. The application of flan- nel wet with warm water. Functional Diseases. Those in which there is supposed to be only derange- ment of action. Furunculus. A boil. Furunculus Malignans. Carbuncle. Gangrene. Incipient mortification; adj. Gangrenous. Gastralgia. Pain in the stomach. Gastric. Belonging to the stomach. Gastritis. Inflammation of the stomach. Gastrodynia. (See Cardialgia.) Gland. A small body met with in many parts of the body, and consisting of various tissues, blood-vessels, nerves, etc. Glossitis. Inflammation of the tongue. Glottis. Opening of the windpipe. The superior opening of the larynx. Granulation. (See Incarnation.) Hematemesis. A'omiting of blood. Hemoptysis. Discharge of blood from the lungs. Spitting of blood. Hemorrhage. Discharge of blood. Hemorrhoids. Piles. Hectic Fever. Habitual or protracted fever. Helminthiasis. Worm disease. Hemiplegia. Paralysis of one side of the body, longitudinally. Hepatitis. Inflammation of the liver. Hepatization. Structural derange- ment of the lungs, the result of in- flammation, changing them into a substance resembling the liver; hence its name. Hernia. Kupture. Hernia Congenital. Congenital her- nia. Literally, hernia from birth. Herpes Circinnatus. Ringworm. Hordeolum. Sty. Hydrocephalus. Water in the head. Hydrophobia Symptomatica. Symp- toms resembling those arising from hydrophobic virus, appearing during the course of other diseases. Hypertrophy. A morbid increase of any organ, arising from excessive nu- trition. Hippocratic. Sunken and corpse-like. Hypochondrium. Region of the ab- domen, contained under the cartilage of the false ribs. Hypochondriasis. Spleen disease; great depression of spirits, with gen- eral derangement; adj. Hypochondri- acal. Hypogastrium. The lower anterior portion of the abdomen. Hysteria. Nervous affection; almost peculiar to females. Ichor. A thin, watery discharge se- creted from wounds, ulcers, etc.; adj. Ichorous. 378 GLOSSARY OF MEDICAL TERMS. Icterus. Jaundice. Icterus Neonatorum. Jaundice of infants. Idiopathic Original or primary dis- ease. Idiosyncrasy. Individual peculiarity. Ilium. The haunch bone; it, together with the pubis, sacrum, and ischium, contributes to form the pelvis. Ileus Miserere. A form of colic; a twisting pain in the region of the navel. Incarcerated. Strangulated or con- stricted; a term applied to rupture. Incarnation. The process by which abscesses or ulcers are healed; this takes place by means of little grain- like, fleshy bodies, denominated gran- ulations, which form on the surface of ulcers or suppurating wounds, etc., and serve the double purpose of filling up the cavities and bringing closely together, and uniting, their sides. Incubus. The nightmare. Infection. Propagation of disease by effluvia. Infiltration. Diffusion of fluids into the cellular tissue. Integuments. The coverings of any part of the body. The skin, with tbe adherent fat and cellular membrane, form the common integuments. Intention. (See Union by the first.) Ischias. Pain in the hip. Ischuria. Suppression of urine. Lachrymation. Tear-shedding. Lactation. Suckling; also the process of the secretion of milk. Lacteal. Appertaining to the process of the secretion of milk. Lactiferous. Conducting or convey- ing the milk. Laryngeal. Belonging to the larynx. Laryngitis. Inflammation of the lar- ynx. Larynx. Upper part of the windpipe. Lesions. Injuries inflicted by violence, etc. Lesion, Organic. Structural derange- ment or injury. Leuco-phlegmatic. Torpid or slug- gish; mostly applied to a temperament characterized by want of tension of fibre; with light hair, and general inertness of the physical and mental powers. Leucorrhcea. Female sexual weak- ness; vulg. whites. Lochia. Discharge from the womb after delivery. Lumbago. Rheumatism in the loins. Lumbar. Appertaining to the loins. Lumbricus. The round or long worm. Luxation. Dislocation. Lymph. A colorless liquid, circulating in the lymphatics. Lymphatic. As applied to tempera- ment; same as leuco-phlegmatic. Lymphatics. Absorbent vessels with glands and valves distributed over the body. Lymphatic Glands, Conglobate Glands. These are composed of a texture of absorbents, or lymphatic vessels, connected together by a cel- lular membrane. Mamma. The breast in the female; adj. Mammillary. Mania. Insanity; madness. Marasmus. A wastiug away of the body. Materia Medica Pura. The title of that splendid work of the immortal Hahnemann, in which the true prop- erties of medicaments are given, as determined by experiment upon the healthy body. Maxillary. Appertaining to the jaws. The superior and inferior maxillary bones from the upper and lower jaws. Megrim. A pain affecting only one side of the head. Meibomean Glands. Small glands within the inner membrane of the eye- lids. Menorrhagia. Excessive discharge of blood from the uterus. Menses and Menstrual Flux. The monthly period. Meningitis Spinalis. Inflammation of the spinal membranes. Metastasis. The passing of a disease from one part to another. Meteorismus. Extreme inflation of the intestines. Metrorrhagia. Discharge of blood from the womb. Miasm, or Miasma (Marsh). Peculiar effluvia or emanations from swampy grounds. Micturition. Urination. Miliaria. Eruption of minute trans- parent vesicles of the size of millet seeds; miliary eruption. Miliaria Purpura. Scarlet rash. Morbus Coxarius. Disease of the hip; hip disease. GLOSSARY OF MEDICAL TERMS. 379 Mucous Membrane. The membrane •which lines the sides of cavities which communicate with the external air, such as that -which lines the mouth, stomach, etc. Mucus. One of the primary animal fluids; secretion from the nostrils. Myelitis. Inflammation of the spinal marrow. Miopia. Short sight; near-sighted- ness. Narcotic. Having the property of in- ducing sleep. Nasal. Belonging to the nose. Nasal Cartilages. The cartilages of the nose. Nephritis. Inflammation of kidneys. Neuralgia Facialis. Face-ache. Nodosities. Swellings; nodes, a swell- ing of the bone or thickening of the periosteum. Notalgia. Pains in the loins. Occiput. The posterior part of the head. Odontalgia. Toothache. OZdema. Swelling; dropsical swelling; adj. (Edematous. Olfaction. The act of smelling. Omentum. The caul. The viscus con- sists of folds of the peritoneum con- nected by cellular tissue; it is attached to the stomach, lying on the anterior surface of the bowels. Ophthalmia. By this term is now usually understood simple inflamma- tion of the Conjunctiva. Catarrhal ophthalmia. Ophthalmic Nerve. The first branch given off from the Gasserian ganglion of the fifth pair of nerves; it divides into the lachrymal, frontal, and nasal nerves. Ophthalmitis. Inflammation of the entire ball of the eye. Organic Disease. In pathology, dis- eases in which there is derangement or alteration of structure are termed organic. OS Uteri. The mouth or opening of the womb. Ossicula Auditoria. The small bones of the ear. They are situated in the cavity of the tympanum, and are four in number; termed the malleus, incus, stapes, and os orbiculare. Otalgia. Earache. Otitis. Inflammation of the ear. Otorrhoea. A discharge, or running, from the ear. Ozena. An ulcer situated in the nose. Palate Bones. These are placed at the back part of the roof of the mouth, between the superior maxillary and sphenoid bones, and extend from thence to the floor of the orbit. Palpitatio Cordis. Palpitation of the heart. Panaris. Whitlow; panaritium; pa- ronychia. Pancreas. A gland situated trans- versely behind the stomach. Paralysis. Palsy. Paralysis Paraplegica. Paralysis affecting one half of the body trans- versely. Parenchyma. The connecting medium of the substance of the lungs. Parotitis. Inflammation of the paro- tid gland; the mumps. Paroxysm. A periodical fit of a disease. Parturition. The act of bringing forth. Pathogenetic. The producing or cre- ating of abnormal phenomena. Pathognomic. Characteristic of, and peculiar to, any disease. Pathology. The investigation of the nature of disease. Pectoral. Appertaining to the chest. Pectus. The chest. Pelvis. The basin-shaped cavity below the abdomen, containing the bladder and rectum, and womb in woman. Percussion. The act of striking upon the chest, etc., in order to elicit sounds, to ascertain the state of the subjacent parts. Pericarditis. Inflammation of the pericardium (sac containing the heart). Perineum. The space between the anus and the external sexual organs. Periosteum. The membrane which envelops the bones. Peritoneum. The serous membrane which lines the cavity of the abdo- men, and envelops the viscera con- tained therein. Peritonitis. Inflammation of the peri- toneum. Petechle. Spots of a red or purple hue, resembling a fleabite. Phagedenic. A term applied to any sore which eats away the parts, as it were. Pharynx. The throat, or upper part of the gullet. Phase. Appearance, or change exhibited by any body, or by disease. Phlebitis. Inflammation of the veins. 380 GLOSSARY OF MEDICAL TERMS. Phlegmatic. (See Leuco- Phlegmatic.) Phlegmon. An inflammation of that nature which is otherwise termed healthi/ inflammation. Phrenitis. Inflammation of the brain. Phthisis (Pulmonalis). Consumption, abscess of the lungs. Physiology. The branch of medicine which treats of the functions of the human body. Plethora. An excessive fulness of the blood-vessels. Pleura. The serous membrane which lines the cavity of the thorax or chest. Pleuritis or Pleurisy. Inflammation of the pleura. Pleurodynia. Pain or stitch in the side. Pneumonia, Pneumonitis, Peri- pneumonia. Inflammation of the parenchyma of the lung. Polypus. A tumor most frequently met with in the nose, uterus, or vagina. Porrigo Scutulata. Ringworm of the scalp. Precordial Region. The fore part of the chest. Prognosis. The act of predicting of what will take place in diseases. Prolapsus Ani. Protrusion of the in- testines. Prosopalgia. Face-ache. Prurigo. Itching of the skin. Psoas Muscles. The name of two muscles situated in the loins. Psoitis. Inflammation of the psoas muscles. Pubis. The pubic or share bone. Puerperal Fever. Appertaining to childbed. Puriform. Pus-like, resembling pus. Purulent. Of the character of pus. Pus. Matter. A whitish, bland, cream- like fluid, found in abscesses or on the surface of sores. Pustule. An elevation of the scarf- skin, containing pus or lymph, and having an inflamed base. Pyrosis. Heartburn ; water brash. Quinsy. Inflammatory sore throat. Quotidian. Intermittent, about twen- ty-four hours intervening between the attacks. Rabies. Madness arising from the bite of a rabid animal ; generally applied to the disease showing itself in the brute creation. Rachitis. The rickets. Raucitas. Hoarseness. Rectum. The last of the large intes- tines, terminating in the anus. Remittent. A term applied to fevers with marked remissions, and, gen- erally subsequent exacerbation. Repercussed. Driven in. Resolution. A termination of inflam- matory affections without abscess, mortification, etc. The term is also applied to the dispersion of swellings, indurations, etc. Rheumatic Ophthalmia. Inflamma- tion of the tunica albuginea, and of the sclerotica. Rose. A term applied to erysipelas, from its color. Rubeola. Measles. Sacrum. The bone which forms the base of the vertebral column. Saliva. The fluid secreted by the sali- vary glands into the cavity of the mouth. Sanguineous. Consisting of blood. Sanies. A thin, greenish discharge of fetid matter, from sores, fistula, etc.; adj. Sanious. Scabies. Psora, itch. Scapula. The shoulder blade. Sciatica. A rheumatic affection of the hip-joint. Sciatic Nerve. A branch of a nerve of the lower extremity. Scirrhus. Indolent, glandular tumor, generally preceding cancer in an ul- cerated form. Sclerotica. The hard membrane of the eye; it is situated immediately under the conjunctiva. Scorbiculus. Pit of the stomach. Scorbutus. Scurvy. Scrofulous Ophthalmia. Inflamma- tion of the conjunctiva, with slight red- ness, Out great intolerance of light, and the formation of pimples, or small pustules. Secretory Vessels or Organs. Parts of the animal economy, which separate or secrete the various fluids of the body. Semi-lateral. Limited to one side. Sinus. A cavity or depression. Solidification. (See Hepatization.) Somnolence. Disposition to sleep. Specific. A remedy possessing a pe- culiar curative action in certain dis- eases. Spleen. A spongy, viscous organ, of a livid color, placed on the posterior part of the left hypochondrium. GLOSSARY OF MEDICAL TERMS. 381 Splenitis. Inflammation of spleen. Splints. Long, thin pieces of wood, tin, or strong pasteboard, used for preventing the extremities of frac- tured bones from moving so as to interrupt the process by which they are united. Sputa. Expectoration of different kinds. St. Anthony's Fire. Erysipelas. Stertorous. Snoring. Stomacace. Canker or scurvy of the mouth. Strabismus. Squinting. Strangury. Painful discharge of urine. Sternum. The breast bone. Stethoscope. An instrument to assist the ear in examining the morbid sounds of the chest. Stricture. A constriction of a tuhe or duct of some part of the body. Struma, Scrofula. The king's evil; adj. Strumous. Sty. An inflammatory small tumor on the eyelid. Submaxillary. Under the jaw. Submaxillary Glands. Glands on the inner side of the lower jaw. Sub-mucous Tis-sue. Placed under the mucous membrane. Sudorifics. Medicines which produce sweating. Sugillation. A bruise, or extrava- sated blood. Suppuration. The morbid action by which pus is deposited in inflammatory tumor, etc. Syncope. Fainting or swooning. Synocha. Continued. inflammatory fe- ver. Synovia. A peculiar, unctuous fluid secreted within the joints, which it lubricates, and thereby serves to facili- tate their motions. Synovial Membrane. The membrane which lines the cavities of the joints, and secretes the synovia. Taenia. Tapeworm. Tartar. A concretion incrusting the teeth. Temporal. Appertaining to temples. Tendon. The white and shining ex- tremity of a muscle. Tenesmus. Painful and constant urg- ing to alvine evacuations, without a discharge. Tetanus, adj. Tetanic. A spasmodic rigidity of the parts affected. Therapeutics. That branch of medi- cine describing the action of the dif- ferent means employed for the curing of diseases, and of the application of those means. Thorax. The chest, or that part of the body situated between the neck and the abdomen. Thrush. Numerous small, white vesi- cles in the mouth. Tic-Douloureux. Face-ache. Tinea Annularis, Tinea Capitis. Ringworm of the scalp. Tinea Faciei. Milk-crust; milk-scab. Titillation. Tickling. Tonic. Medicines which are said to increase the tone of the muscular fibre when debilitated and relaxed. Tonsils. The oblong, suboval glands placed between the arches of the pal- ate. Tonsilitis. Inflammation of the tonsils. Trachea. The windpipe. Tracheotomy. An operation by open- ing the windpipe. Traumatic. Appertaining to wounds; arising from wounds. Tremor. Trembling. Trismus. Lockjaw. Trituration. The reduction of a sub- stance to minute division by means of long-continued rubbing. Tubercle. A small, round, eruptive swelling, anatomically speaking. In pathology, the name is applied to a peculiar morbid product occurring in various organs or textures, in the form of small, round, isolated masses of a dull whitish yellow, or yellowish gray color, opaque, unorganized, and vary- ing in shape and consistence according to their stage of development and the texture of the part in which the}* are engendered. Typhoid. Applied to diseases of a low character. Umbilical Cord. The navel-string. Umbilicus. The navel. Union by the First Intention. The healing of wounds by adhesion; the growing together of the opposite sur- faces of a wound, when brought into close approximation, without suppu- ration or granulation. The latter process of healing is sometimes des- ignated the second intention. Urethra. The urinary canal. Urticaria. Nettle rash. Uterus. The womb. Varicella. Pimples, quickly forming pustules, seldom passing into suppu- 382 GLOSSARY OF MEDICAL TERMS. ration, but bursting at the point and drying into scabs. Chicken-pox. Variola. Smallpox. Variola Spuria. {Varicella). Chicken- pox. Varix, plur. Varices. Swelling or en- largement of the veins. Venesection. The abstraction of blood by opening a vein. Vertigo. Giddiness, with a sensation as if falling. Vesicle. A small, bladder-like erup- tion; an elevation of the cuticle con- taining a transparent, watery fluid. Vicarious. Acting as a substitute. Virus. Contagion or poison. Viscid. Glutinous and gelatinous. VlSCUS, plur. Viscera. Any organ of the system. A bowl. Vomica. An abscess of the lungs. Zygomatic Process. A thin, narrow projection of bone, defining the squa- mous portion of the temporal bone at its base. INDEX PAGE Abdominal Walls, Rheumatism of, 171 Abscess 215 Alimentary Tube . .... 49 Anatomy, Animal .... 17 " Vegetable .... 17 Ano, Fistula in 203 Anus, Abscess in or near . . . 203 Aorta 35 Appetite . . . " . . . 99 " Capricious .... 155 " Loss of 153 " Morbid 155 Arms, Bones of 26 Articulators and Muscular System, 29 Artificial Foods 279 Asphyxia ...... 81 Asthma 151 Atlas ....... 23 Auricles 34 Babies, Blue 299 Bathing, Cool 297 Biliousness 157 Bladder 57 " Inflammation of . 170 Blood, The 33 Body, Temperature of ... 98 Boils 214 Bowels, Catarrhal Inflammation of, 171 " Condition of . . . . 99 " Inner Lining of . . . 171 Brain 43 " Compression .... 84 Breathing 98 Bronchi 39 Bronchitis . . . . . . 148 Bunion 262 Burns 70 Bursa? . 261 Canker ....... 139 Capillaries ...... 36 Carbuncle ...... 215 Cardiac Opening 50 Cartilage 30 Cerebellum 44 Cerebrum .44 Chafing . Chilblains Children, Cries of " Diseases of " Weight of Cholera Infantum " Morbus . Chorea . Chyle . " Receptaculum Circulation . Arteiial " Venous Clavicle Coffee, Abuse of Cold Feet Colic Collar Bone . Column, Anterior " Lateral " Posterior Composition of the Body and Liquids . Composition of the Bones Concussion . Conjunctivitis Constipation " Treatment of Contusions . Convulsions . Cornea .... Corns .... Coryza .... Cough . Cramps in the Limbs Croup, False Crying of Infants Cutis Dentition Diabetes Insipidus " Mellitus Diaphragm . Diarrhoea " Acute . " Chronic " Teething PAGE . 316 . 219 . 299 . 275 . 280 310, 311, 312 Solids 16: 262 54 55 35 35 35 25 269 270 305 25 18 20 84 117 309 309 61 318 118 220 306 140 263 143 316 58 300 . 262 41 99, 1S4, 310 . 187 . 187 . 302 384 INDEX. PAGE Diarrhoea, Treatment of . . 310-314 Diet 101 Digestion, Disturbances of . . 253 Digits 28,29 Diphtheria 137 Disease, Causes 93 " Investigation ... 93 Dislocations 78 Distribution of Bones ... 19 Divisions of the Body ... 18 " " " Vertebral Column. 22 Dropsy, Kesulting from Malaria . 245 Dysentery 188 Dyspepsia 155 Earache 120 Ear, Ringing and Buzzing in . . 122 Ears 119 " Discharge from . . . . 121 Eczema 201, 211 Enteritis 170 Epidermis . 58 Epiglottis 39 Eyelids, Abscess of . . . . 115 " Inflammation of . . . 114 " " " Margins 115 " Tumors of . . . .115 Eyes 114 " Inflammation of . . . .117 " Sore 304 Feeding, General Rules for . . 286 Felon 216 Femur 28 Fibula 29 Finger Nails 303 Fluid, Pancreatic .... 54 Fluids 52 Follicle 60 Food, Inorganic 106 " Requisite Quantity . . .107 Foods 103 " Nitrogenized .... 103 " Non-nitrogenized . . .105 Foot 29 Foreskin, Inflammation of the. . 315 Fractures 77 Frostbites 72, 219 Furuncle 214 Gall -Bladder ..... 54 Ganglion 261 Gas, Nitrogen 41 " Oxygen 41 Gastric Juice 50 Gland, Parotid 49 " Sublingual .... 49 " Submaxillary .... 49 Glands, Lacteals 54 Glands, Salivary . " Sebaceous " Sudoriferous Gout " Causes of " Diet in . " Remedies for " Treatment of Gumboil Hair, Care of the . Hairs Hand . Hardness of Heaiing Headache Head Cold . Heart . Hemorrhage " Arterial " Capillary " Vein " Venous " Scalp Wound Hemorrhoids Hiccough Hives Hoarseness . Housemaid's Knee Humerus Hygienic Rules . Indigestion . Infant Feeding . Inferior Vena Cava Innominata . Insomnia Internal Organs . Iutestine Duodenum " Ileum . " Jejunum " Large . " Small . Iritis Jaundice Joints " movable . Kidneys Larynx Ligaments Limbs . Lips Liver . " Inflammation of Lockjaw " Treatment of Lower Extremities PAGE 49 58 58 252 252 253 253 253 127 303 60 27 122 110 306 34 73 74 73 73 75 76 197 317 212 139 261 26 294 155 78-280 35 28 264 18 50 50 50 51 50 118 207 29 30 56 39 30 25 127 53 206 259 260 28 INDEX. 385 2-4 Lumbago " Duration of Lungs " Inflammation of Lymphatics Malaria, Causes of " Chronic " Diseases following " Method of Administering Remedies in " Quotidian . " Remedies for " Tertian or Quartan " Three Divisions of " To prescribe for . Mediastinum .... Medulla Oblongata Metacarpus .... Metatarsus . . . . Milk, Cow's, Modified " Crust " Modified, Benefits of " Main Points of . " " Rules for Preparing " Sterilized .... Mouth " Sore " Ulcers in . Mumps Muscles, Involuntary . " Voluntary Nausea and Vomiting Navel, The " Hemorrhage of Neck, Wry Serves " Auditory .... " Cranial .... " Motor .... " Olfactory . . . Optic .... " Sensory .... " Spinal . . . • . " Sympathetic . Nosebleed Number of Bones in human Skeleton Nursery, The .... 294, Nursing Bottle, Best Kind of . Nursing, Abuses of . " General Rules for " Mothers . . " Effect of Drugs on " of Sick Children . " Reasons for not . Observations OZsophagus . 'AGE 251 251 40 144 55 245 245 245 245 245 245 245 245 245 40 45 28 29 282 317 283 284 ,285 281 127 307 136 119 31 31 161 315 315 251 43 47 47 46 47 47 46 46 47 125 19 295 279 281 290 280 280 296 281 320 39, 50 Olecranon Organs, Circulatory and Alimentar Panaritium . Pancreas Papilla3 . Patella . Pericarditis . Peritoneum . Peritonitis . Pharyngitis . Pharynx Piles" . Pleura . Pleurisy False . Pleurodynia . Pneumonia . Pocket . Poison, Mineral . " Vegetable Pons Varolii Pruritus Ani Pulmonary Artery Pulse . Pyloric Opening . Pylorus Quinsy Radius . Ranula . Rectum, Fissure of " Prolapsus of Remedies, Symptoms of Retention of Feces Rheumatism, Acute . " Chronic Diet in . " Symptoms o Ribs, Number and their Positio Rotation Run round Rupture, Umbilical Scald Head . Scalds . Scalp, Eczema of Sciatica . Scleritis Screaming Seatworms Sensations Shock . Sickness, Features in . of Skin .... Skull and Composition Sleeplessness, Causes of the PAGE 27 17 216 54 57 29 250 60 170 308 50 197 40 146 147 174 144 52 87 87 44 201 36 95 50 50 131 26 130 199 197 191 319 250 251 253 250 24 31 216 315 117 300 178 97 80 290 r, 98 266 386 Snake-bites ..!... Snuffles Soothing Syrups Sore Feet Spasms Sprains Sterilizers Stiff Neck Stomach Catarrh of ... " Pain or Cramp in Stoppage St. Vitus's Dance . Stye Subdivision of the Body . Summer Complaint . Superior Vena Cava . . . . Synovial Membrane . Systems and their Uses Tarsus Tea, Abuse of Teeth, Care of Teeth, Fistulae of . Teething Temperature, Method of Obtaining " Normal, of the Body " Significance of Thermometers Thoracic Cavity . Thorax and Formation Throat, Sore Throat, Sore, Catarrhal " " Chronic " " Treatment of Tibia Toe Nails, Ingrowing Tongue m INDEX. £> PAGE 66 306 302 220 318 65 283 251 50 156 163 319 262 115 18 186 35 30 19 29 269 303 127 300 290 290 41 24 308 133 134 309 29 218 96 Tongue, Inflammation of . Tonsilitis Tonsils . " Enlarged . Toothache . Trachea Trismus (see Lockjaw) Ulna Umbilicus, The . Urinary Organs, Diseases of Urine ..... Urine, Passing of Bloody . " Retention of . Urticaria .... Ventricles Vertebx-ae Column Vertebrae, First and Second Vertebrates .... Vesicles .... Warts Weaning .... " Articles of Food when Weeping Sinew . Wet Nurse .... Whitlow .... Whooping-Cough Womb, Inflammation of . Worms Wounds .... " Gunshot " Incised . " Lacerated " Poisoned " Punctured . Wrist PAGE 129 131 131 133 128 39 259 315 20S , 100 210 319 212 34 21 23 17 39 221 288 261 279 216 142 170 175 63 64 64 66 64 64 27 ^-^TV-PTH? ^