Class Mji «nd. .Mas ropYRiorr deposit THE NEW MEDICAL WORLD. A BOOK FOR REFERENGE AND CONSULTATION CONTAINING A THOROUGH DESCRIPTION OF DISEASE WITH THE LATEST AND BEST METHODS FOR ITS TREATMENT. ALSO POPULAR AND PRACTICAL DISCUSSIONS ON MEDICAL PROGRESS, HEALTH, MARRIAGE, MATERNITY, THE CARE OF CHILDREN, NURSING OF THE SICK AND MANY OTHER TOPICS OF WORLD-WIDE INTEREST. BY E. EDGAR MARYOTT, A.M., M.D. ILLUSTRATED. 1897. The Hampden Publishing Co., Publishers, springfield, mass. ?. ^ Copyright, 1897 BY HAMPDEN PUBLISHING CO., Springfield, Mass. " I have often said, what profession is there equal in true nobleness to medicine r He that can abolish pain and relieve his fellow mortal from sickness, he is indisputably the usefulest of men. Him savage and civilized will honor ; he is in the right, be in the- wrong who may." — Carlyle. CL\KK W. I.RYAN CO.. fKIMKHS AM) 1IINDEK8, BprtnftfieM, v AUTHOR'S PREFACE, THE title of this book, "The New Medical World," does not imply that a new system of medicine has been discovered; for this is no announcement of novel, or untried methods. There have been, however, so many recent advances in the practice of medicine and surgery, as the result of bacteriological study, that it seems fitting to recognize them in a popular work. It is therefore believed that a book which delineates the latest and best in Medicine will be appreciated and accorded a favorable reception. It has been the author's purpose to prepare a practical, modern and reliable work upon domestic medicine, which shall comprise the best known in medical literature suitable for the convenient use of the masses as a book of reference in health or sickness. It contains a large amount of practical information, and will prove an earnest instructor and counselor to every one who possesses a thirst for medical knowledge ; and when an emergency occurs it will enable one to act promptly, and to determine what course to pursue for the best interest of all. It is not the purpose of the book to so instruct the masses that they will become experts in the healing art, for that would be impos- sible. It aims rather to be helpful by bringing into prominence many interesting and important facts ; and hence it is essentially a book of instruction and reference. It tells what to avoid and how to live in order to maintain good health. Directions for nursing the sick, advanced ideas upon the care and education of children are included ; so that in this regard it is believed that it will be especially helpful to a large number of persons. The methods of treatment proposed are, for the most part, simple and efficient, such as can be understood by a mother, a nurse or any persons of ordinary intelligence. The prescriptions have been iv. PREFACE. prepared with care, and are the result of experience and successful practice, and are of unusual value. The treatment of all the more dangerous diseases could have been withheld, but this would have greatly marred the completeness and worth of the work. It is hardly to be expected that any person, without a suitable degree of medical knowledge, will desire to treat any except the more simple forms of disease, and yet it has seemed necessary to enter somewhat into details for the sake of information. The work includes a brief discussion of many interesting and practical topics, closely allied to medicine, as healthy homes, food, clothing, climate, exercise, drainage, the water supply, the preven- tion of disease, necessary disinfection after contagious diseases, surgical hints upon fractures, hemorrhage and other emergencies. It attempts in this way to show the bearing of many topics not strictly medical to the conditions of health and disease, in order that correct living may be more easily attained. Attention is also called to that part of the work which gives advice to those who co)demi)late marriage. The Chapter upon Marriage and Maternity contains many useful suggestions and directions. It is designed to be a safe book for perusal or study, by young or old and with this end in view it has been examined and received the sanction of eminent clergymen and physicians. In so far as it has been deemed necessary to consider or discuss delicate topics, it conforms to good taste and will give satisfaction to the culti- vated and those morally sensitive. Technical language has been avoided so far as possible, with the belief that a medical work requiring constant reference to a dic- tionary would be of doubtful utility. The classification adopted is natural rather than scientific as a simple arrangement is more in accord with the general plan and purpose of the work. The author has performed his task with scrupulous care, and believes that he has prepared a Medical book adapted to the every day need and use of the people. E. E. MAKYOTT. Springfield, M vss., July 1, L897. CONTENTS CHAPTER I. Page Introductory Articles, .... 1 I. Medical Progress and X Kays, - - 1—1 II. Medical Study Fascinating, ... 6 III. Medicine a Popular Science, - 7 IV. Medical Common Sense, ... 8 V. General Causes of Disease, - 9 VI. Special Causes of Disease, ... 11 VII. Bacteria, or Germs in Disease, - - 12 CHAPTER II. Sanitary Subjects, - - - - - 17 I. The Choice of a Home, - - - 17 II. The House Furnishings, - 20 III. Drainage and Sewerage, - 21 IV. The Air and Ventilation, - - - 24-26 V. The Water Supply, - 29 VI. Food, 32 VII. Clothing, - - - - 36 VIII. Climate, - - - - - 40 IX. Exercise, ----- 43 X. Longevity, - - - - - 47 CHAPTER III. General Topics of Interest in Medicine, - 52 I. Home Prescribing, - 52 II. Strange Delusions, - 53 III. Patent Medicines, - 55 IV. Medicines, - - - - - 57 V. Doses, ------ 75 VI. Household Remedies, - 80 CHAPTER IV. Poisons and their Antidotes, - 88 I. Poisons in General, - 88 II. The Mineral Acids, - 91 VI, I oXTENTS, Pagk III. Oxalic Acid, ----- 92 IV. Carbolic Acid and Creosote, - 92 V. Acetic Acid, ----- 93 VI. Ammonia, ----- 93 VII. Prosaic or Hydrocyanic Acid, - 93 VIII. Arsenic and its Preparations, - - - 94 IX. Copper, Mercury and Zinc Compounds, - 95 X. Tartar Emetic, : 95 XI. Lead Compounds, ... - 96 XII. Nitrate of Silver, - 96 XIII. Phosphorus, ----- 96 XIV. Opium and Morphine, - 97 XV. Chloral Hydrate, ... - 97 XVI. Strychnia, ----- 98 XVII. Aconite and Vegetable Poisons, - 98 XVIII. Poison Iw, ----- 98 XIX. Poison Gases, - 100 CHAPTER V. The Use <>k Alcohol axd other Dangerous or Narcotic Drugs, ----- 102 I. Alcohol, its Use and Abuse, - - - 10*2 II. Chronic Alcoholism, - 104 III. The Morphine, Cocaine and Chloral Habits, - 107 IV. The Effects of Tobacco, 109 CHAPTER VI. Ac< iii\ rs, - - - - - - 111 I. Drowning, - - - - - m II. Painting, - - - - - 112 III. Burns and Scalds, .... 113 IV. Lightning Stroke, .... iig V. Sprains and Bruises, - 11(5 VI. Frost Bite, ... . . . 119 VII. Bites of Serpents, - - - - 120 VIII. Stings of In-ects, - - - - 121 IX. Poisoned Wounds, .... 122 X. Hemorrhage from Wounds and the Treatment of Wounds in General, - - - 1*24 XI. [noised Wounds, - 126 XI !. Scalp Wounds. .... 127 CHAPTER VII. Gknkrai - trrs Prelimixabi ro the Stud? 0* Disease, - - - . . [28 I. [leal tli iii.l I useaso, - - - [28 CONTENTS. Vll. Pagk. II. The Two Great Types of Disease, - - 131 III. Temperature in Disease, ... 133 IV. Kissing in its Relation to Disease, - - 135 V. Bathing in its Relation to Disease, - - 136 VI. Symptoms of Disease, How to Read and In- terpret Them, - - - - 137 CHAPTER VIII. Anatomy and Physiology, Including the Bones, Joints and Muscles, - 149 I. Anatomy and Physiology, - - - 149 II. The Relation of Physiology to Anatomy, - 151 III. The Anatomy of the Bones, - - - 153 IV. The Bones of the Skull, - - 153 V. The Bones of the Face, - - - 155 VI. The Spinal Column, - - - - 157 VII. Injuries of the Spine, - 159 VIII. The Bones of the Upper Extremities, Chest and Pelvis, - - - - - 160 IX. The Bones of the Lower Extremities, - 168 X. The Joints, - - - - 166 XL The Muscles, ----- 166 XII. Nature's Effort to Prevent Injury, - - 168 XIII. The Fracture of Bones, - - 171 XIV. Dislocations. - - - - - 176 CHAPTER IX. The Blood and its Diseases, - 179 I. Anaemia, - 180 II. Chlorosis, ------- 182 III. Leukaemia, - - - - - 183 IV. Septicaemia — Pyaemia. Blood Poisoning, - 183 CHAPTER X. The Lymphatic System and Glandular Diseases, - 187 I. The Lymphatic System, - - - 187 II. Scrofula, - - - - - 189 III. The Pancreas, 191 IV. Diseases of the Pancreas, - - - 19*2 CHAPTER XL The Skin — its Anatomy, Functions and Diseases, 194 I. The Skin, ' - - - - - 194 II. Management of the Skin, - 200 Vlll. CONTENTS. III. IV. V. VI. VII. VIII. IX. X. XI. XII. XIII. XIV. XV. XVT. XVII. XVIII. XIX. XX. XXI. XXII. XXIII. XXIV. Cosmetics, General Observations on Diseases of the Skin, Disorders of the Sweat Glands, Disorders of the Sebaceous Glands. 1. Sebor- rhea or Dandruff. 2. Wens or Tumors of the Scalp. 3. Baldness or Alopecia. Acne and Comedo, T Milium, - Prurigo, Itching or Pruritus - Shingles or Herpes Zoster, Eczema, Tetter, Milk Crust or Salt Rheum, - Urticaria, Hives or Nettle Rash, Psoriasis, - Leprosy, - Lice or Pediculosis, - Itch or Scabies, - Ringworm or Tinea, - Favus, - Freckles or Lentigo, - Moles, - Warts, - Corns or Clavus, - Bunions, - - - - Scurvv. - Page. 202 202 205 207 212 215 215 216 218 220 221 222 223 224 226 227 227 228 229 229 231 231 CHAPTER XII. The Brain, Cranial Nerves, Spinal Cord, Nerves, Sympathetic Nerves and Their Diseases, - 233 I. The Brain and Cranial Nerves, II. The Nerves and Spinal Cord, III. Hydrocephalus or Dropsy of the Brain, IV. Meningitis or Inflammation of the Brain, V. Neuralgia, - VI. Headache, - - - VII. Vertigo or Dizziness, - VIII. Insomnia, - IX. Insanitv, - X. Apoplexy. XI. Various Other Diseases of the Brain. 1. seess of the Brain. 2. Tumors of Brain. .'>. Aphasia. 4. Amnesia. Numbness. <*>. Hemiplegia. 7. Paraplegia. s Locomotor Ataxia. 5*. Facial Paralysis. K>. Congenita] Defects. - - - 258 - 233 - 238 - 240 - 241 . 242 - 24o . 247 • 24S ■ 249 - 251 Vb- the 5. CONTENTS. IX. CHAPTER XIII. Page. The Eye, its Appendages and Diseases, - - 256 I. Description of the Eye. 1. The Orbits. 2. The Optic Nerves. 3. The Sclerotic. 4. The Choroid. 5. The Iris. 6. The Cil- iary Muscle or Ligament. 7. The Ciliary Processes. 8. The Retina. 9. The Interior of the Eye. 10. The Appendages of the Eye. ----- 257-262 II. Examination of the Eyes. 1. Errors of Re- fraction. 2. Myopia or Near Sight. 3. Hypermetropia or Far Sight. 4. Pres- byopia or Old Sight. 5. Astigmatism, - 262-264 III. The Use of Glasses, and Directions for Testing the Eyesight, - 264-268 IV. Care of the Eyes, - - - 268-270 V. Diseases of the Eye. I. Ulcers. 2. Paralysis. 3. Twitching of the Lids. 4. Inflamma- tion of the Eye. 5. Stye. 6. Blepharitis. 7. Wounds of the Eyelids. 8. Conjunct- ivitis or Ophthalmia. 9. Purulent Oph- thalmia. 10. Granular Ophthalmia or Gran- ular Lids, - 270-273 VI. Foreign Bodies in the Eye, - - - 273 VII. Inflammations of the Cornea (Corneitis). 1. Ulcers of the Cornea. 2. Corneal Opacities. 3. Staphyloma, - 273 VIII. Inflammation of the Iris or Iritis, - - 275 IX. Inflammation of the Choroid, - 276 X. Sympathetic Inflammation, - 276 XL Glaucoma, - 276 XII. Inflammation of the Retina, - 277 XIII. Inflammation of the Optic Nerve, - - 277 • XIV. Cataract, ----- 277 XV. Cross Eye, Squint or Strabismus, - - 279 XVI. Various Other Affections. 1. Growths. 2. In- flammation of the Tear Duct. 3. Ab- scesses of the Lachrymal Sac - - 279-280 CHAPTER XIV. The Ear and its Diseases, - 281 I. Description of the Ear. 1. The External Ear. 2. The Auditory Canal. 3. The Middle Ear or Tympanum. 4. The Eustachian Tube arid the Ossicles. 5. The Internal Ear or Labyrinth, - - - 281-282 A. CONTENTS. Page. II. Diseases of the Ear. 1. Deafness. 2. Im- pacted Wax or Cerumen. 3. Foreign Bodies in the Ear. 4. Inflammation of the Ear. 5. Polypi. 282 III. Diseases of the Middle Ear. 1. Rapture of the Drum. 2. Acute and Chronic Catarrh of the Middle Ear or Otitis Media. 3. Inflation of the Middle Ear. 4-. Con- genital Defects of the Ear, - - 285 IV. Mastoid Disease. .... 287 CHAPTER XV. The Nose and its Diseases, - 289 I. Description of the Xose, - 289 II. Acute Coryza or Cold in the Head, - - 290 III. Ulcers in the Nasal Cavity. - - - 291 IV. Other Affections. 1. Warts. 2. Polypi. 3. Tumors, etc., 292 V. Hemorrhage from the Nose, - 292 VI. Chronic Nasal Catarrh, - - - 293 VII. Hay Fever, Rose Cold or Summer Catarrh, - 295 CHAPTER XVI. The Mouth and its Appendages, ... 298 I. Description of the Mouth and its Appendages. 1. The Mouth. *2. The Upper and Lower Jaw. 3. The Mucous Membrane. 4. The Lips. 5. The Cheeks. 6. The Glands. 7. The Toncrue. 8. The Gums. 9. The Antrum. 10. The Palate. 11. The Teeth, 298-301 II. Diseases of the Mouth, Tongue and Vicinity. 1. Alveolar Abscess or Gum Boil. 2. Catarrhal Stomatitis. 3. Canker or Aph- thous Sore Mouth. 4. Gangrenous Stom- atitis or Can crum Oris. 5. Toxic Stoma- titis. (I. Other Minor or Rare Affections, a. Calculus of the Ducts, b. Salivary Fistula. c. Growths, d. Hare Lip. e, Hypertrophy of the laps. 7. Diseases of the Tongue, a. Tongue Tie. b. Enlarge- ment of the Tongue or Hypertrophy, c. Inflammation of the Tongue or Glossitis, 801-305 CONTEXTS. XI. CHAPTER XVII. Page The Throat, Larynx and their Diseases, - - 306 I. Description of the Throat and Larynx. 1. The Throat. 2. The Larynx, - - 306 II. Affections of the Throat. 1. Getting Choked. 2. Taking Cold, - 306 III. Acute Sore Throat or Laryngitis, 307 IV. Chronic Sore Throat or Clergyman's Sore Throat, - - - 308 V. Loss of Voice or Aphonia, - 309 VI. Quinsy Sore Throat or Tonsilitis, CHAPTER XVIII. 309 The Trachea or Windpipe, Lungs and their Dis- eases > 312 I. The Trachea, ----- 312 II. The Lungs, ----- 313 III. Asthma, - 314 IV. Bronchitis, ----- 315 V. Capillary Bronchitis, - 317 VI. Pleurisy, - 318 VII. Pneumonia, - 320 VIII. Consumption, - 322 IX. The Prevention of Consumption, 325 CHAPTER XIX. The (Esophagus and Stomach, - 328 I. The (Esophagus and its Affections, - - 328 II. Description of the Stomach and Digestion, - 329 III. Dyspepsia or Indigestion, - 331 IV. Gastritis, Gastric Fever or Inflammation of the Stomach, ----- 334 V. Gastric Ulcer or L^lcer of the Stomach, - 335 VI. Nausea and Vomiting, - 336 VII. Gastralgia, Stomach Ache or Xeuralgia of the Stomach, - - - - 337 VIII. Cancer of the Stomach, - - - 338 IX. Loss of Appetite, - 33* X. Unnatural Appetite, - 339 XL Hiccough. ----- 340 CHAPTER XX. The Liver, Spleen and Gall Bladder, - - 341 I. Description of the Liver and its Functions, - 341 II. The Gall Bladder, - 344 Xll. CONTEXTS. III. Diseases ot* the Liver in General, IV. Congestion of the Liver, - V Jaundice or Icterus, - VI. Cirrhosis or Hardening of the Liver, - .VII. Gall Stones and Bilious Colic, VIII. Other Affections of the Liver. 1. Abscess of the Liver. 2. Cancer of the Liver. 3. Fatty Degeneration of the Liver. 4. Amy- loid Degeneration of the Liver. 5. Acute Yellow Atrophy. 6. Hydatid Disease of the Liver. - IX. The Spleen and its Diseases. 1. Inflamma- tion. 2. Enlargement. ... Page. 344 345 346 348 349 350 352 CHAPTER XXI. The Heart, Circulation, Pericardium, Blood Ves- sels AND THEIR DISEASES, - - 354 I. Description of the Heart and its Valves, - 354 II. The Circulation, - 357 III. Overwork of the Heart or Heart Strain, - 359 IV. The Pericardium or Heart Sac, - - 359 V. Inflammation of the Heart Sac or Pericarditis, 360 VI. Valvular Disease of the Heart or Endocarditis, 361 VII. Angina Pectoris or Neuralgia of the Heart, - 363 VIII. Palpitation. ----- 364 IX. Various other Diseases of the Heart. 1. Hypertrophy or Enlargement of the Heart. 2. Fatty Degeneration, - - - 365 X. The Blood Vessels and their Diseases. 1. Aneurism. 2. Varicose Veins, - - 366-367 CHAPTER XXII. The Intestines, Rectum and their Diseases, - 368 I. The Small Intestine, - :;i VII. Measles, German or Roseola, - 458 VIII. Mumps or Parotiditis, - - - l;">4 IX. Scarlet Fever or Scarlatina, - - - !.">•'> \. Whooping Cough <>r Pertussis, - - 459 XI. Disinfection During and after Diphtheria and Scarlet Fever, - 4<>l CONTENTS. CHAPTER XXVIII. Fevers, ------ I. Bilious or Remittent Fever, II. Malarial or Intermittent Fever, III. Catarrhal Fever, Influenza or La Grippe, IV. Neuralgic Fever or Dengue, - V. Typhoid Fever, VI. Typhus Fever, VII. Yellow Fever, VIII. Puerperal Fever, xv. Pagk 464 464 465 468 470 471 474 476 477 CHAPTER XXIX. Nervous Diseases, I. Epilepsy. IT. Hysteria, III. Catalepsy, IV. Ecstacy, V. Chorea or St. Vitus Dance, VI. Convulsions, Fits or Spasms, 479 479 480 482 483 484 486 CHAPTER XXX. General or Unclassified Diseases, - I. Rickets or Rachitis, - II. Erysipelas, - III. Rheumatism, - IV. Gout, V. Obesity, - VI. Small Pox or Variola, - VII. Varioloid, - VIII. The Prevention of Small Pox or Vaccination, 488 490 491 494 496 497 499 500 CHAPTER XXXI. Various Inflammatory Affections, - I. Inflammations, - II. Abscesses, - III. Felon or Whitlow, IV. Onychia or Suppuration of the Matrix, V. Ingrowing Nail or Onyxis, VI. Chilblains, * - VII. Boils and Furuncles, -• VIII. Carbuncles, - 502 502 504 505 506 507 508. 509 511 Xvi. CONTENTS. Page. IX. Malignant Pustule or Anthrax, - - 512 X. Glanders, _ - - - - 513 XI. Hydrophobia or Rabies, - - - 514 XII. Tumors. 516 CHAPTER XXXII. 519 519 523 525 526 529 530 Marriage and Maternity, I. Marriage, - - II. Reproduction, III. Symptoms of Pregnancy, IV. Diseases of Pregnancy, - V. Advice to the Pregnant, VI. Miscarriage, VII. Labor, Stages and Management, 531 fill. Management of Infants, ... 530 IX. Care and Education of Children, - - 542 CHAPTER XXXIII. Nursing. Diet for the Sick and how to Prepare it, 546 I. Nursing, - 546 II. Diet for the Sick and its Preparation, - 549 Gall-bladder Bight supra-renal capsule Descending duodenum Mesentery Ileum Ccecum Greater curvature of stomach Left kidney Trans, mesocolon Transverse colon Jejunum Sigmoid flexure %-UracJius 1 Relations of internal organs. Anterior view Left lobe of liver- 5 Lobus Spigelii— Capsule of left's kidney Splenic vein - Inferior mesenteric vein Sigmoid. flexure Yas deferens Seminal vesicle— 4 Vena cava inferior Non peritoneal surface Bight lobe of liver Impressio renal Gallbladder Impressio colic Capsule of right kidney Vena porta Common bile-duct Sup. mesen. vessels Mesocolon Back of peritoneum — Caecum Bladder Head of femur Brostate Glands Relations of internal organs. Posterior view CHAPTER I. INTRODUCTORY ARTICLES. I. Medical Progress. X Rats. — II. Medical Study Fasci- nating. — III. Medicine a Popular Science. — IV. Medi- cal Common Sense. — V. General Causes oe Disease. — VI. Special Causes of Disease. — VII. Bacteria, or Germs in Disease. I.— MEDICAL PROGRESS. MEDICINES must have been used at quite an early period in human history, the conditions of life being such that disease is inevitable. Only in jest can one habitually cast out the doctor and "throw physic to the dogs." To trace the history of medicine for a thousand, or even a hundred years, however interesting the process, becomes too tedious. In the past, many strange agents have been employed medicinally, which seem to us ridiculous, as for instance the hag-stone, which was sup- posed to keep the troublesome witches from sitting upon the sleeper's stomach, and thus prevent the nightmare The history of medicine has been associated to no little extent, with charlatans and pretenders; notwithstanding, we flatter our- selves that medical science has been making remarkable progress during the last half century. The medical men of to-day are trying faithfully to answer these questions : What ails the sick? What is the best method of treating dis- ease ? How can disease be prevented ? Notice what recent medical science has done to answer this question : What ails the sick ? It produces the microscope, to examine diseased tissues, and announce with certainty, the difference between a cancer and a harmless growth. THE NEW MEDICAL WOULD. It is able to disclose disease germs when they exist in the saliva, the sputa, the urine and other excretions, as well as in the food and water which we consume. It brings forward the fever thermometer, to record the accurate temperature <>f the body, and is capable of revealing whether pus is forming, or other danger signals. It lias invented the stethoscope, to exaggerate the abnormal sounds in the lungs and heart, so that diseased conditions are readily recognized. It provides many other delicate instruments to assist in the examination of the eye, the throat and other obscure organs. By the aid of these modern inventions, we are far better able to obtain a correct answer to the question: What ails the sick? Great progress has been made in modern times toward answering our second question : What is the best method of treating disease? Physiologists have made Important discoveries with living animals causing them to suffer for the good of man. There is no question but what much definite knowledge concerning the action of medi- cines upon the blood, the nerve centers, and other important tissues, has been obtained by these experiments upon the lower animals. In this, and in various other ways, medical science has been constantly ad- vancing and the sufferings of mankind correspondingly alleviated. The discovery of Ether and Chlo- roform for the relief of pain, marked an important advance in the science of medicine, while words almost fail to portray the benefits which attend their use in surgery. There are many surgical operations made successful by their use, which could not be attempted without them. Dr. William T. G. Morton, the Boston, Mass., dentist, who dis- covered anaesthesia, and opened up the way for painless operations in Surgery was born in L819, and died in l v «'»s. His claim was satisfactorily demonstrated on the 16th of October, L846, at the Massachusetts General Hospital. Before that time whenever misfortune rendered the surgeon's knife a UK. WILLIAM T. O. MORTON. THE NEW MEDICAL WORLD. 8 necessity, the patient experienced an extreme sense of suffering and untold agony. Since then and for all future time the agony of the operating room has been and will forever be " steeped in the waters of forgetfulness." The injection of medicine under the skin, a comparatively recent method, antidotes and relieves the most agonizing pain. The hypo- dermic use of medicine, while it should be employed exclusively by physicians, has much in its favor. The medicine enters the cir- culation immediately, and is not altered and changed by the slow process of digestion, as it is when administered by the mouth, and it is able to relieve the severest pain in a very brief space of time, and thus beginning inflammations are conquered at the very threshold. There are many medicines which could be admin- istered in this way to great advantage, and are likely to be so employed more frequently in time to come. Electricity is an agent that has come somewhat to the front in medical practice, and is sometimes curative when other remedies have failed. It is used to improve the nutrition of wasting muscles, by stimulating and strengthening their nerve control ; hence it arrests atrophy or wasting, and restores power to limbs that are partially paralyzed. It is also used to remove superfluous hairs from fan faces, to destroy moles, birthmarks, and for various other purposes. Anyone can observe that great progress has been made in the management of acute diseases, in recent times ; instead of depletion, blisters, blood-letting, setons, issues, heroic doses of mercury and other powerful drugs, we present a method which we are certain yields better results. We sustain the strength of the patient and make use of good nursing and hygienic measures with increased success. The working of nature is at present more fully recognized in treating the sick ; it is found that with timely and simple assistance, she is often able to work the miracle of healing, with the aid of but very little medicine. Still more important than the questions already answered is this last one : How can disease be prevented ? Anxiety to answer this, has led to the vigorous study of hygiene and sanitary science. Such study is comparatively recent. Much attention is now being properly given to our water, ice, milk and other food supplies. The infectious germs, only recently recognized, 4 i in, m;v. MEDICAL \voi:i.i>. producing typhoid and scarlet fever, diphtheria, consumption, and an exceedingly large list of other diseases, have been investigated irith untiring diligence, and with the avowed aim of preventing the spread of these undesirable, and often fatal infectious or con- tagious diseases. The habitat of these genus is sought <>nt to find where they originate and multiply, and what are the conditions favorable to their spread and multiplication. To this end, defective sewerage is inspected and remedied, well water suspected of con- tamination is analyzed, and a thousand matters are awakening gen- eral attention which relate to the prevention of disease, and hence the germs of disease are often destroyed and its spread prevented. We have learned that it is easier, safer, and less expensive to prevent disease, than to restore health after weeks of prostra- tion and suffering. There were never more agencies at work to prevent the spread of disease than at present, and as for medical men, they were never more intelligent, or better able to cope with it and baffle its ravages. In respect to these matters, the day which has dawned upon us knows no sunset. Eminent men may die, but progress in the healing art is destined to a perpetuity as lasting as the race. Facts are constantly accumulating, discoveries are being multiplied for curtailing human maladies, relieving human suffering, and check- ing the spread of infectious and contagious diseases. The present is often spoken of as the age of invention, the age of rapid transit, rapid transmission of speech, wonderful machinery and a thousand inventions, which, in the light of the past are marvel- ous ; but at the same time thoughtless persons are prone to intimate that medicine is now and lias forever been at a standstill, that so far as the medical profession is concerned, there has been no prog- ress. Such imputations are utterly without foundation. There is n<> body of men more keenly alive to every scientific improvement in the sphere of their labors than the large and educated body of physicians practicing medicine throughout our broad land. THE X RAYS. The discovery <'t" the X rays by Professor Rontgen of Wurtsburg w&6 announced during the preparation of this work. It has proved t<» be of an usual interest to the scientitic world, and has stimulated experimentation in the field of electrical research enormously. 1.— Photographs of scissors, needles, pins, etc., enclosed in a leather case with metal cor- nerpieces. 2.— Dr. William Konrad Rontgen, discoverer of the X Rays, Professor of Physics at the Royal University of Wiirzburg. He had only a local reputation before the announcement of the discovery of the X Rays but on account of this he has suddenly be- come famous 3 — Photograph of a lady's hand, showing the bones, and a ring on the third finger, with faint outlines of the flesh. THE NEW MEDICAL WORLD. The previous employment of electricity for the larger develop- ment of light and force is phenomenal, for during the past ten years our methods of street travel and lighting have been revolutionized. Thus the world had been prepared by the rapid progress of the recent past to give this new discovery fitting attention and wide- spread notoriety. It was at once perceived that the Rontgen discovery would be of extraordinary interest to medical men, as its practical side has a special bearing upon the further and more complete examination of the living tissues of the human body. It has been known for many (40) years, that the negative or cathode current, when passed through a glass vacuum tube, produces a vivid fluorescence. Professor Rontgen discovered that when pass- ing a rapidly interrupted current of these cathode rays through a glass vacuum tube, some of the rays penetrate more or less certain substances and cast a shadow picture upon a photographic plate, the distinctness of which depends upon the character of the substance exposed. In brief the whole process is carried on by means of a Ruhmkorph coil connected with a Crookes tube. The portion of the body to be examined is placed between an opening in a disk of the tube and a sensitive photographic plate. The rays which pene- trate and cause the shadow on the plate may be cathode rays, ultra- violet rays, or others associated with them. Just what rays produce the picture is as yet not definitely known, and hence the discoverer called them X rays, because X is used to denote an unknown quan- tity or factor. The picture made by the employment of the X rays has received a variety of names, but as yet no scientific term suggested seems more appropriate than Skiagraph, which literally means a shadow writing. The X rays, though imperceptible, readily pass through flesh, leather, clothing and other similar substances. They pass less readily through bone or metal, except aluminum. Glass through which ordinary rays of light pass with much readiness almost com- pletely obstructs the passage of the X rays. When the human hand or foot is exposed in the manner already indicated, a shadow picture is formed upon the photographic plate which reveals the outline of the hand, foot or other ]3art exposed. In this shadow picture the muscles and soft tissues show only a little in their outline, the bones themselves show much plainer, so that it is possible by this process for one to see a picture of his 6 I. IK NEW MEDICAL WORLD. own Framework; as though a living person could look upon his own skeleton. Any foreign body, as a piece of glass, needle, bullet, or other piece of metal, is readily detected and located, also any deformity such as results from a fracture or dislocation, or an abnormal growth or bone enlargement may be discovered so that it may be remedied. rp to the present time the hands, feet, forearm, and such portions of the body, are more successfully penetrated by the X rays than the head, which is surrounded by thick plates of bone on all sides. The trunk and pelvis for similar reasons are as yet difficult to penetrate, and thus reproduction upon a sensitive plate by this inter- esting process awaits other discoveries to perfect the methods employed. Many improvements for producing these shadow pictures have been suggested and attempted with more or less success in nearly every electrical laboratory. As the matter now stands the discovery of the X rays is a great aid in certain diagnoses and promises to render the surgeon espe- cially valuable assistance in the performance of his delicate and often difficult work. II.— MEDICAL STUDY FASCINATING. Medical study possesses a peculiar and remarkable fascination! Who does not wish to know more about the mechanism of the human body, and the laws which govern it, whose keeping bring health and delight, and whose violation entails sickness, distress and death ? What can be of more practical service than to know how to keep well and strong, and perpetually young ? The owner of a valuable horse is particular about his care, his f 1, grooming, shoeing, the tit of the harness, in fact, whatever conduces to the good looks and lofty bearing of this noble animal. Inasmuch as man is better than the horse, ought he not to receive greater attention? It is a pari of our mission to devote such care to ourselves ami the race as will conduce to the health, happiness and longevity of all. In order to do this, we must devote an intelligent Interest t«» a large variety of subjects. Attention must be given to leanliness, for frequent baths are necessary to keep the skin in a healthy condition. The eyes, the ears, the teeth, tin- hands, the THE NEW MEDICAL WORLD. / feet, all require especial care. Exercise, rest, clothing, proper food for the body and mind, are important. How fascinating ought to be the consideration of all these subjects, so intimately are they related to the important question of our health ! We do not exaggerate when we say that there are no more inter- esting subjects than these which relate to medical study, in its bear- ing upon healthy men, women and children ; subjects which are thoroughly treated in this household work. III.— MEDICINE A POPULAR SCIENCE. Formerly the physician appeared to have a monopoly of medical knowledge, and was regarded with profound veneration. He was considered the wisest among men, whether he spoke or remained silent. Even the movement of his head in the sick room was ominous. This old time veneration for professional men belongs to the past. Medical subjects are no longer shrouded in mystery, which only the physician cares to penetrate. The human body is not, as formerly, but little understood and studied by the masses. Even the school children -are now taught the rudiments of anatomy and physiology, and many besides profes- sional persons know considerable about one or more of the several branches of medicine. Intelligent people are everywhere discussing hygienic measures, the prevention of sickness, the quarantine of contagious diseases, the causes of disease, the latest theories, especially the germ theory and other kindred topics. Nearly every household magazine, at the present time, has its medical department for answering the many questions proposed by its readers, and various medical subjects are studied and written up, so that medicine to-day, may be especially regarded as a popular science. This increased interest in medical subjects is to be hailed with delight, for the more intelligent the people are concerning these matters, the more satisfaction can be derived, and' the greater the success which will attend treating their ailments. A smattering of medical knowledge is likely to make people fussy, superstitious, and the easy victims of prejudice or incompetency. A general and cultivated understanding of these subjects renders a per- son sensible, self-reliant, and better fitted to act deliberately and s THE NEW MEDICAL WORLD. wisely in times of emergency and danger. Such persons, instead of being frightened, and ready to faint at the sight of a dron of blood, render timely and valuable assistance to the injured. The more generally medical knowledge can be disseminated, the better it will be for the physician, for he is liable to have his best suggestions hindered, and his anxious hopes blighted, by the want of intelligent co-operation. The physician is sure to experience far greater pleasure in his earnest and difficult work, when his sugges- tions are helped to the utmost, by intelligent co-operation, and his patient is correspondingly benefited. Medical subjects, too, of all others, broaden the mind, enlighten the understanding, and fit men and women everywhere to better fill their places in a world of suffering and misfortune. IV.— MEDICAL COMMON SENSE. There are usually thought to be several schools of medicine. In reality there ought to be only one, and that one broad and liberal enough to embrace every method and remedy of positive value. Prejudice has done much in the past to prevent the best results of medical science. It has been fostered by selfishness, and encouraged by ignorance. The age of prejudice fortunately is slowly passing away, and yet how few, even at the present time, know that apart from pretensions, there is but one field of medical science. The field, i< must be remembered, is a very broad one, for there is no patent upon medical books, or medical knowledge, and no monopoly of these can be created. The first requisite of a medical student, as of every other, should be a teachable spirit, and he should resolve to receive the truth, from whatever source it originates. The untaught mind is like a dark room, and we must throw open the shutters and let in the light un- hindered. It is fortunate indeed that many a mind is broader than its professed creed, and it is to be hoped that every one who prac- tices the healing art, is progressive enough to lay aside prejudice, ami make use of the very best known remedies, in the very best manner possible. "here is n<> question but what medicines have sometimes hindered the process of recovery, and in such cases better results would have been obtained without them. It is as important to know when to withhold, as when to prescribe. When medicinal agents are neces- THE NEW MEDICAL WORLD. 9 saiy they should be used in such doses as will assist nature to reach the desired result. The law of cause and effect should not be ignored ; for it should operate constantly when we attempt to work any preceptible changes upon diseased conditions. We must apply the same good judgment to medicine which is successfully applied to farming or shop-keeping. For the reasons given above this book contains no sections upon homeopathic, eclectic nor other special methods of treatment. It proposes to recognize truth from all reliable sources and any remedy sufficiently important to be embodied into this work has not been intentionally withheld nor obscured on account of its origin or advocates ; the same is true with respect to the medical doses recom- mended ; for in all cases where admissible the medium dose rather than the maximum has been given the preference. The design has been toward a broad, liberal and modern system of medical belief and practice. There has been no intention of narrow- ing the broad circle of medical knowledge nor of fostering prejudice. V.— GENERAL CAUSES OF DISEASE. Medical study trenches upon a much wider field than the curing of disease. It embraces a large variety of subjects of vital importance to the health and well being of the family and community. A consid- eration of these topics, so closely allied to medicine proper, cannot be omitted without failure to understand the obscure causes of many important affections. In order to treat the sick intelligently, one must consider the question of diet, exercise, ventilation, clothing, climate, proper nursing, and many other subjects related to the wel- fare of those suffering from acute or chronic affections. It is necessary to study the causes of diseases, in order to learn how to bring about their removal. We must understand how con- tagious diseases spread, in order to check, successfully, their onward march. It is usually necessary to know the cause of a patient's suf- fering, in order to administer the proper remedy. When sickness invades a family or breaks out suddenly in some particular locality, the foremost question is, — What caused the out- break ? The physician is not the only person interested in the origin of disease. It is a matter of vital interest to the general public. Hence, at the present time, others beside the family doctor, are ask- ing the following questions : Is the location of this house a healthy 10 THE NEW MEDICAL WORLD. one? Is the cellar clean, dry, light and well ventilated? Is the plumb- ing modern and worthy? Is there anything about the house or its location that can favor the introduction or assist in developing disease? If there is any defect about the sanitary condition of this dwelling, can it be successfully remedied? Has it been thoroughly disinfected since it gave shelter to contagious disease? As population multiplies and becomes more crowded in the large cities a knowledge of the causes and the methods of prevention, especially of the infectious and contagious diseases, becomes more essential to all classes, the rich and the poor alike. Questions of no less importance about the water supply, concern us all. When we consider that the many outbreaks of typhoid fever, entailing upon communities vast cost and large mortality, are, or can be traced in nearly ever instance to water polluted b}' infec- tious germs, an abundant supply of pure water cannot be regarded witli indifference. Many diseases are also caused by unhealthy occupations. It is essential that those inheriting a debilitated condition of the system or who are otherwise unfitted for the dangers and hardships of cer- tain callings or occupations should avoid them. Mental worry and anxiety exert a depressing influence upon all the processes of life. So well is this recognized, that the saying has passed into a proverb, that "worry kills more people than hard work." It is probable that this well-known fact accounts for the many frequent deaths among public men, in the prime of life. Men of business, men at the head of great enterprises, politicians and statesmen are no doubt often heavily laded with vexatious care and exposed to a fatiguing mental strain, which weakens digestion, induces insomnia, and causes the prostration of the whole nervous system. Many sensitive men, who occupy positions of great responsibility, are fearfully fretted and annoyed by needlessly harsh and cruel criticisms. Is it a matter of wonder, when they envy the health of the daily toiler, whose food, though coarse, LS sweet, and whose Bleep LB refreshing? We shall never know how large the list is, of this \;i-t number, cut off in the prime of life, in the midst of their activ- ities, disappointed, grieved, wounded and broken-hearted. Only physicians are able to perceive how widespread are the nervous troubles which grow out of our intense activities, our struggles to get ahead in the world, the constant worry and perplexity which in the heat of the strife is so exhausting. THE NEW' MEDICAL WORLD. II Our variable and ever changing climate often exerts a deleterious effect upon infants, old people and those otherwise debilitated. A large number of acute and chronic affections are supposed to have their origin in that almost indescribable process which is denominated taking cold. Intemperance, and other reprehensible habits, should not be lost sight of in this enumeration. From the intimations of this brief article you will observe that the causes of disease form a very complex and exhaustive subject, which must receive detailed attention elsewhere, for here we have only touched upon them in the most general manner. ' VI.— SPECIAL CAUSES OF DISEASE. The number of denned diseases is put down as two hundred and fifty. Of these, about one hundred are more or less fatal, and add to the death rate. In a comparatively few instances, accidents and unavoidable calamities, such as storms, floods, earthquakes and light- ning, increase slightly, the rate of fatalities. But for the fatal diseases, man would, with the few exceptions noticed, live a natural life, and die a natural death. In old age, death is a natural process, for it is simply conformity to nature. With but few exceptions, disease comes from without, and like a foreign foe attacks the system. This is readily seen in contagious diseases, while hereditary diseases, like scrofula and syphilis, appear to be exceptions. It has been discovered quite recently that contagious diseases are due to organic poisons, which enter the system in the form of microscopical disease germs from the air or water consumed by the individual. These germs find in the human body favorable soil for their development, and begin to multiply and so affect the blood and other tissues as to cause sickness, prostration, and often death. Atmospheric conditions are prominent factors in the causation of such diseases as bronchitis, croup and catarrh, and the heat of sum- mer and autumn is prominent in causing diarrhceal diseases. Some diseases extend .everywhere, while others are found only in certain sections. Yellow fever requires a high temperature, while consumption is limited by excessive cold. 12 THE NEW MEDICAL WOKLD. A very large number of the well-known diseases are preventable, tluir progress can be checked, and their spread limited. In other words they can be controlled. Diseases resulting from over work can be prevented, because they are self induced. Other diseases which result from the habitual use of debilitating agents, as alcohol, tobacco, narcotics and poisons are preventable. Contact with those dreadful diseases which work through human passions, as syphilis, can be prevented. This is a foul and dreadful disease, for it pollutes all life which it touches and travels down to blight the innocent ones of future generations. Among the old medical writers the predisposing and exciting i-auses of disease were much dwelt upon. When insanity appeared in a family through several generations, they said such a family was predisposed to mental disease. Other families were predisposed to scrofula, others to gout or rheumatism, to epilepsy, to cancer and other diseases. The second term, exciting causes, was much in vogue. Sedentary habits are regarded as the exciting cause of constipa- tion. Want of cleanliness is considered to be the exciting cause of certain affections of the skin. Poor ventilation causes diseases of the blood and respiratory organs, loss of sleep, mental disturbances, and improper food taken into the stomach, dyspepsia. Colds are generally considered as an exciting cause of many diseases, as croup, bronchitis, catarrh, etc. The diseases which result from old age should be regarded as natural. They are especially heart failure and stomach failure. The digestive apparatus is worn out and is no longer able to perform it- task. In old age congestion of the lungs is common, owing to a weak condition of the circulation. Heat produces burns, and excessive heat of the sun, sunstroke. Cold causes frostbite, lack of food, starvation. Intemperance pro- luces a long train of bodily disturbances. Tobacco and opium produce typical diseases, and you are referred to the articles upon those topics. VII.— BACTERIA OR GERMS IX DISEASE. Reference has been made so frequently to the influence of germs <>r bacteria in causing disease, that a brief review of a few things THE NEW MEDICAL WORLD. 13 known about them will help us to a more intelligent understanding of this interesting subject. The microscope has revealed a vast army of life which is invisible to the naked eye, and because the bacteria are visible only by means of its power, they are often called micro- organisms. So minute are these germs that it has been difficult to decide Avhether they belong to the realm of animals or plants. They are so small that several hundred of them would scarcely stretch across the head of a pin. It is only within the last half century that these germs have been recognized and studied. In fact such recognition and studv was im- possible previous to the perfection of a microscope which would magnify three or four thousand diameters. One of these micro- scopes reveals a drop of water as an animated skating rink, contain- ing many millions of these micro-organisms. They vary in shape. Some are spherical or egg-shaped, and these are known as micrococci; others are rod-shaped, like a match or pencil, these are bacilli ; still others are spiral, like a corkscrew, these are spirilla. The rod- shaped are the most common variety. They are composed of a cell and enveloping material. It is usual to stain them red, blue or violet, in order to trace their outlines more perfectly. Their movements are accomplished by means of hair-like pro- jections or cilia, which have been successfully photographed. When the conditions are favorable for these germs they multiply rapidly; these conditions are warmth, moisture, oxygen and organic matter. The estimate of their multiplying ability is marvelous if they encounter no obstructions. Fortunately the struggle for life is especially severe among these lower orders of microbes, and the weak go continually to the wall. One variety may feed upon and destroy another, or one variety may become extinct for lack of material to provide nourishment. Some are poisonous, and poison each other. Some species are enemies and cannot thrive together ; some cannot live without other varie- ties, and if separated, die. Many of these germs are harmless, so far as the human race is concerned, while others are beneficial, and absolutely essential. The latter are our invisible friends, and indispensable to human existence. Only a few are capable of producing disease, and find favorable con- ditions for their development in the human body. They may be cultivated like plants and flowers. Some thrive 14 THE NEW MEDICAL W0BL1). in this, others in that medium ; some kinds will grow on a piece of cooked potato; some in beef broth; some thrive by means of heal ; others can endure a great amount of cold and survive freezing. Genus are the agents of putrefaction; they reduce all animal mat- ter after death, to dust, and set free all kinds of odors, good and bad, sweet and sour. They are found everywhere, but are more abundant where putrefaction is going on. They exist in the water, in the soil and on all plants, vegetables and fruits. It may be remarked that the canning of fruit is simply a process to keep out the germs which produce fermentation ; boiling destroys them and sealing the can keeps out those that pervade the atmos- phere. In this connection, it will help our understanding of this Avhole subject to define what is meant by a spore. A bacterium that is unable, for the time being, to reproduce itself, becomes a spore. Spores become dry and lie dormant, like the seeds of a plant, till they are brought into favorable conditions for their development. These spores aj'e carried about in the air, and float about our rooms like particles of dust, as if searching for moisture and a foothold. When such opportunity is found, they develop like the seeds of plants, and produce a progeny. The dried yeast germs are examples of these spores ; they lie dormant until they are introduced into the moistened Hour, when they begin to multiply with marvelous rapidity. We have already hinted that there are certain varieties of germs which, in the human body, produce disease. Their activity liberates poisons called ptomaines, which produce fever, sickness and a train of systemic disturbances. We shall endeavor to give, in condensed form, a few of the leading facts which have been learned about these disease producing germs or bacteria. The causes of disease have baffled all former ages. When the germ theory was first proposed to account for the mysterious origin of certain diseases, it had only a few believers, but the more care- fully and thoughtfully intelligent persons investigated the subject, the more converts to this teaching were multiplied, till at the present time all scientists have adopted the germ origin of infectious diseases. The revelations of the microscope have banished ancient supersti- tions, and brought to light millions of agents which swarm in the air and water about us, most of which are not only harmless to tin human body, but are absolutely essential to its well being. Some ot these germs, however, are found to be always present in certain forms THE NEW MEDICAL WORLD. 15 of disease, and it is believed that they cause its outbreak. There are certain diseases which when introduced into a family or community, spread more or less rapidly. A small quantity of the disease poison, no matter whether introduced into the system in the act of respiration or with the food and drink, reaches the circulation, and creates a marked disturbance, especially rise of temperature, due to the rapid multiplication of this poison, or septic material. The multiplica- tion of this septic material resembles the action of yeast, a little of which soon permeates the whole mass. It multiplies with marvelous rapidity, and produces fermentative changes. One sort of germs produces measles ; another, typhoid fever ; another, consumption ; still another, small pox ; another, chicken pox ; and so on through the large list of contagious diseases. These varieties of germs always reproduce themselves, and are always true to their kind. The yeast germ always produces the same kind of fermentation, the measles germ always produces measles, and never small pox. The small pox germ never begets cholera, and so on, to the end of the chapter. Each variety of germ works under its own special law, but in all some general methods are observed. Upon exposure to the disease contagia or germs, a certain time is necessary for their development, this period is known as the incubation ; during which time the dis- ease lies dormant in the body. The period of incubation varies from a few hours, as in scarlet fever, to several weeks or months, as in hydrophobia. Having had a germ disease once, we are not likely to have that same disease again. The yeast germ will not work the second time upon the same mass. It consumes all the material favorable to its growth and development the first time, so that there is nothing left for it to feed itself upon in the future. Introduced the second time, the germ is most likely to die of starvation, unless new material has been elaborated upon which it can subsist. In some of these germ diseases the poison or infectious germ, can be approached nearer than others, without danger of contagion. In small pox or measles it is either necessary to come near the infected person, or else in contact with some object, as clothing, that has been about or near the sick person, or the dried spores which are capable of communicating the contagion. In diseases like cholera and yel- low fever, the poison is wafted through the air for some distance. It is perfectly safe to pass by a house where small pox exists, and there 16 THE NKW MEDICAL WORLD. is little danger of contracting the disease, but the district even, where cholera or yellow fever exists cannot be visited without peril. In some diseases, the poison is introduced by means of infected drinking water, or the emanations of infected water carried into the house by means of sewer gas. Other disease germs must be brought into actual contact with the mucous membrane, of which gonorrhoea and syphilis are examples. Bach year the character of these disease germs is becoming better understood. The enthusiastic labor of Louis Pasteur has done much to bring about an understanding of the character of bacteria. Such infinite painstaking as he has manifested has not been too highly rewarded by the eminence he has attained, and the unusual honor he has received. Sir Joseph Lister applied the principle enunciated by Louis Pasteur to the dressing of wounds. By keep- ing disease germs out of wounds, they heal without the develop- ment of erysipelas, or the formation, in many instances, of a single drop of pus. A knowledge of the character of these disease producing germs helps us to know what course to pursue in each -case, in order to prevent the spread of the contagion. Some are readily destroyed by one agent, and others by another. In general, the sick should be isolated from the well, and when the disease is over, disinfection and thorough destruction of the germs should take place. The fumes of burning sulphur destroy the germs of diphtheria and scarlet fever; boiling destroys the typhoid germ in drinking water, and renders it harmless. Cold destroys the yellow fever germ, and heat the small pox germ. When proper disinfection is neglected, or when the work is imper- fectly done, cases of contagious disease multiply. Disease germs are easily destroyed outside of the human body if we only know how. They are destroyed with great difficulty after they have entered the circulation. It is not wise to imitate the man who swallowed a potato bug and then Paris green to kill it. All germ- icides are poisons, and can be used to much better advantage outside than within the human body. CHAPTER II. SANITARY SUBJECTS. I. The Choice of a Home. — II. The House Furnishings. — III. Drainage and Sewerage. — IV. The Air axd Vex- tilation. — V. The Water Supply. — VI. Food. — VII. Clothing. — VIII. Climate. — IX. Exercise. — X. Lon- gevity. I.— THE CHOICE OF A HOME. u He who has health has hope; and he who has hope, has everything '." THOSE who have abundant means experience but little trouble in the choice of a home. They can select an elevated position^ on dry, porous soil, where the surroundings are attractive, and the sunlight makes cheerful and healthful the rooms of the house. They can have the best drainage and sewerage possible, for there is no commodity which money will not buy. They can employ compe- tent and skillful architects, to supervise the work of building, and carry into effect the most advanced knowledge in respect to ventila- tion, plumbing and other hygienic requisites which conduce to the health and happiness of the family. There is a large and respectable class, however, who cannot select the situation and build the house they would like ; they are com- pelled to make the best selection possible for a quite limited sum of money. If laboring men could choose their homes in accord with their intelligence and taste, they would undoubtedly prefer elevated and healthy situations, dry soil, pure air and water, abundance of sun- light, and thorough drainage. Abundant means add greatly to the ability of building homes after the most approved patterns ; in fact, it is the indispensable requisite for carrying out advanced health measures to any marked degree. ]^ THE NEW MEDICAL WOBLD- The truth i-, thai a Laboring man, with a family to support, is obliged to provide such a home as his limited earnings will command. This is the reason he is so often forced into unhealthy and filthy quarters, where the rooms are small and receive but little sunlight, where the alleys and streets are foul and odorous. He has not pre- ferred for his family, mouldy walls, damp cellars, filthy alleys, defective drainage, and a polluted atmosphere, but lie has become the creature of necessity, and he lias been unable to escape his en- vironment. Between the wealthy and the unfortunate poor alluded to, every grade of necessity intervenes. Only a portion of the income can be expended for rent; in addi- tion f 1. fuel, and clothing must be procured, and a margin allowed for incidentals. No family, at the present time, will be satisfied with the bare necessities of life. Clothing must not only be warm and durable, but it must also be tasty in appearance. The wife feels compelled to dress herself and children so as to avoid ridicule, and be admitted, at least, to the privileges of common society. A man who retains his self-respect cannot permit his family to be regarded nor treated as outcasts; it then becomes necessary to conform some- what to the customs of the times so far as they are harmless, and to be in touch with the people among whom one lives. The laboring man who has a family to support, unless he receives more than the average wages, must practice a rigid economy. The expenses and wages must be in proportion ; for the income must equal or exceed the outgo. In addition to the ordinary expenses the unexpected is always likely to occur, so that where five dollars were planned, ten are often required. Sickness, though undesired and unprepared for, is liable to come, and who can deny a sick child the luxuries which a fevered or abnormal condition demands. If the wife i» sick, expenses multiply rapidly, hired service must do the work she so cheerfully performs, and so reluctantly "puts aside. These are seme of the odds against which the laboring classes are often compelled to struggle in our large cities. The first, most diffi- cult, and most important lesson for them to learn i- economy, if they would ever become the independent possessors of a dwelling place. The problem at first is a hard one. It is not merely t<» live on the income, but t«> lay by something each year for the purchase of a home. It is easy for a family of average Bice to dispose of a large income, when the desires are not restrained, and extravagance pre- vented. Everv man ought to look forward, for many reasons, to the THE NEW MEDICAL WORLD. 19 possession of a home. Landlords are often petty tyrants, doing only what they are compelled for the health and convenience of the tenant. The laboring man, aided by his wife, ought to make a heroic effort to escape such tyranny, and become the independent possessor of a home, which will conduce greatly to the health and happiness of his family. The author of this work, a few years ago, attended three cases of diphtheria in a tenement house, where an examination of the san- itary condition of the premises revealed a desperate condition of affairs. The sink drains were conducted, about twenty feet from the back door to a surface privy vault, which was overflowing from heavy rains and surface water, and the overflow found its way back into the cellar, and stood there, a pool of filth about two feet deep. From such places, unworthy the name of home, the laboring man ought to pray earnestly to be delivered, and so strive to improve his condition by rigid and enforced economy, that he can become the owner of a more suitable and homelike dwelling. Co-operative banks and building loan associations have accom- plished much in helping these worthy and scantily paid laborers out of then difficulties. In making choice of a home avoid damp, unhealthy locations ; do not be tempted into a swamp or peat bog by a cheap lot. An elevated position is always preferable for a house ; sandy soil or gravel is desirable, sunlight is free, and enters wherever permitted, carrying cheerfulness and good health. It is a destroyer of disease germs, and contributes more than we are aware to cheerfulness, happiness and longevity. Sleeping rooms ought to be large, well ventilated and admit abundant sunlight. Nearly one- third, of our time is spent in sleep, and to occupy rooms which are small, damp, and otherwise unsuitable for such a large proportion of time, is to invite rheumatism, malaria and other unde- sirable diseases. In buying a home already constructed, examine the woodwork in the cellar, this will give you a clue to the desirability of the place or the reverse. If you find dampness, mould and decay- ing timber, do not negotiate for the premises, no matter how low the figures. A house is not desirable covered in and about with dense shade. Shade trees are delightful a proper distance away, but if too near, they render a house damp and unhealthy. "ZO THE ITEW MEDICAL WORLD. n.— THE HOUSE FURNISHINGS. Dust accumulates and abounds in human habitations; it always contains undesirable properties, and whatever harbors it and pre- vents its thorough and constant removal is, from the standpoint of health, undesirable in the furnishings of a home. Managers of hospitals have at length learned the best way to keep out infectious disease germs. You do not find carets upon the floors, paper upon the walls, draperies, pictures and upholstered furniture as formerly, because it has been learned at last that all these beautiful products of a modern civilization are liable to become a menace to the health of the inmates. What is true of hospitals would be as forcibly true of all our homes, if they were constantly crowded with the sick. The objection to woolen carpets, upholstered furniture, draperies and such like, is not their convenience, elegance or cost, but it is that they become the receptacles of dust, and when stirred or moved by a footstep, they send into the surrounding atmosphere a cloud of dust and lint which, if destitute of disease germs is; to say the least, irritating to the air passages, and unfavorable to the enjoyment of perfect health. A hard floor, with mats or movable rugs, which are daily shaken, is free from the objections which arise against a carpet fastened to the floor and removed for purposes of cleaning only once or twice a year. All furniture should be plain, chairs cane-seated and without upholstery. The less furniture put into sleeping rooms the better for health purposes. A matting carpet is cool, is easily cleaned and preferable to tapestry or brussels. Draperies and portieres are undesirable, for they harbor dust, which, upon the slightest agitation, is precipitated into the air, and gives to a person whose air passages are especially sensitive, a stuffy, unpleasant sensation, and in other instances produces such difficulty of breathing, as to render the victim unable to sleep or rest. It is the over-furnishing of the homes of the wealthy which makes their apartments often more unhealthy than those of the poor, includ- ing polluted air and lack of ventilation. When contagious diseases gain a foothold in these costly furnishings they are dislodged with difficulty, and for this reason, consumption, diphtheria and scarlet fever, are often more obstinate and malignant in homes of gorgeous interior, than in the humble abodes of the poor. Many die but- THE NEW MEDICAL WORLD. 21 rounded by all the elegances and conveniences of civilization, the victims of myriads of disease germs, floating in the respired air, who would have recovered in tents by the seashore, or in the pine woods, with only nature's soft carpet beneath them, and the sweet, pure air and blue sky around and above them. It is quite possible to sacrifice too much for elegance, convenience, and the gratification of our taste for beautiful and costly furnishings. The health of the wife and her vigorous and rosy children, a thousand times more than compensate for attention to all these details of furniture, whose principal ends ought to be utility and cleanliness. In the homes expensively furnished we often find the husband the only party whose countenance bears upon it the evi- dence of health, and for the reason that he spends a large part of his time away from home. The wife appears faded and sickly, and the few children, or often lone child, still spared by disease and death, are slender, pallid, irritable and unhappy. There is no deficiency in what money can buy, but a sad deficiency, perhaps, in the best gifts of nature, rosy cheeks, sparkling eyes, smiling lips and healthy bloom. III.— DRAINAGE AND SEWERAGE. These hygienic articles only contemplate the consideration of sub- jects closely related to health, with a view to the prevention of disease. It is therefore unnecessary, for practical purposes, to follow the usual course, and consider drainage and sewerage as two separate subjects, the former referring to surplus water about a house from rain and damp soils, and the latter to excrementitious matter includ- ing the refuse of the kitchen and sink. We will agree at the outset, to understand by drainage, all the surplus of water, and the waste material capable of fermentation and decomposition, which it is nec- essary to remove beyond the reach of human habitation, in order to prevent dampness and the pollution of the soil and atmosphere. Most of the waste products of human habitations in cities, are conducted away in drain pipes aided by the inflow of water. These conveying pipes ought to be of sound material, with perfect joints. Defects in drainage are due to a great variety of causes, among which may be mentioned the hasty construction of houses ; the soil about them settles, and often disarranges and strains the pipes, and 22 THE NEW MEDICAL WORLD. opens their joints. Drains placed in new or made soils, should have the earth packed solidly about them by tamping, in order to prevent the dangers which result from injury to the pipes and the escape of sewer gas into the cellar or surrounding soil. Cheap plumbing is always dear in the end, and that which is costly may he spoiled by bad workmanship and prove unsatisfactory and unsafe. When doing a job so important as the house plumbing, use only good materials, and employ only reliable workmen. It is poor economy to scrimp here and get a poor job. Have the best plumbing which experience has sanctioned, and have it adequate for the demands made upon it. Plan for a dry cellar ; if necessary, have it cemented, and place tiles below the cellar bottom to drain away moisture, and conduct it outside the Avails. Avoid surface sink-drains if possible. When there is a system of adequate sewerage, the refuse from the sink empties into the sewer. Look diligently to see that these pipes do not become loaded inside with grease, and be sure of good trapping to keep gases and odor out of the house. Perfect plumbing is such a rarity that sewer pipes should never be carried into sleeping rooms, nor into the closets which open out of sleeping rooms, for the pur- pose of having handy washbowls. The water-closet and bath-room should have an abundant supply of water, the former should have the overhead flush. The elevated cistern should contain several gallons and deliver it with such force as to secure thorough cleansing. The "pan"" closet is unsatisfactory, filthy, and ought not to be tolerated. It is flushed by a valve in the supply pipe, which delivers an inadequate amount of water for Hushing purposes and often leaks, wetting the woodwork about the Mat bowl. In the modern appliances, the cistern or reservoir is elevated and the space about the bowl is left open, which secures cleanliness and ventilation; this is a great improvement on the pan closet with leaky pipes and a space boarded up about the bowl which cannot be easily reached and cleaned. Whatever the system of sewerage, make sure that the soil about your dwelling does not become polluted with refuse liquids, and be- come the breeding place of germs; also make sure that sewer gas and unhealthy odors do not gain admittance to your house. A few things are absolutely essential for the maintenance of health; these are pure aii 1 , pure food, ami pure water. Pure air is impossible without pure soil. Water must not be contaminated by THE NEW MEDICAL AV0RLD. 23 proximity of the supply to vaults and cesspools, nor must it be per- mitted to absorb sewer gas. Proper drainage is of paramount importance to the health of a family. It is not always easy to state the precise relation between ill-health and improper drainage. It has been proved, however, that diphtheria is much more prevalent in damp localities. Damp- ness and iilth, while they do not of themselves cause diphtheria, seem to furnish the essential conditions by which this disease thrives and becomes malignant. Human beings naturally pollute their sur- roundings, both the atmosphere and soil ; as population becomes more dense the danger multiplies. The unpolluted country with its pure air and water possesses the ideal requisites for perfect health, while the crowded city where poverty and filth abound, offers all the favoring conditions for the development and spread of disease. Hence the saying that " God made the country and man the town " has long since passed into a proverb. It is well known that typhoid fever germs may gain an entrance into houses and prostrate the inmates with tedious and expensive disease by means of imperfectly trapped sewer connections. The nations of the old world have been slow in learning*- that cleanliness is an inrportant factor in staying the march of devasta- ting diseases ; they have manifested great carelessness in polluting with filth the soil and atmosphere about their habitations, and hence the plague and other frightful epidemics have swept over Europe re- peatedly, leaving in some rare cases not more than one-tenth of the population alive, and in other still rarer cases whole districts were abandoned to the wild beasts, the entire population dying leaving only a desert and desolation behind. During four years in the fourth century we learn that the plague or black death, resulting from the filthy conditions of life, destroyed forty millions of people. The cholera of India is attributed by modern writers to the filthy habits of the pilgrims. These diseases together with scurvy and typhus fever, are now almost unknown among civilized nations, abolished by better health measures and attention to the removal of filth and decomposing vegetable and animal substances. It is only quite recently that people are beginning to comprehend the causes of disease and manifest an interest in those conditions which render the existence and spread of disease possible, and it is still more recently that they are earnestly trying to master the knowledge which will altogether banish many of the contagious and infectious diseases. •24 THE NEW MEDICAL "WORLD. A few practical thoughts should be thoroughly impressed upon the minds of everyone. The removal of all filth from the habita- tions of man to some place where it cannot vitiate the atmosphere, pollute the water, nor breed disease should be speedily accomplished. The drain pipes which carry off the kitchen slops should be securely trapped, and in hot weather proper disinfectants should be dissolved in hot water and poured into the sink ; copperas is excellent for this purpose. Garbage should be removed before decomposition takes place and foul odors arise therefrom. "Where there are no sewers in the country the slops from the sink should be carried away from the house where they may be used for fertilizing fruit trees and the garden. In the country all drains should be carried far away from the well if it is used to supply water, neither should surface water, the result of heavy rains, be permitted to reach it. The water-closet in the country should be abundantly supplied with dry earth, charcoal or ashes, and these should be freely used so as to absorb the liquids and prevent odors. A solution of copperas should be used occasionally and no neglect in emptying the contents of the receiving box should be permitted. People living in the country should remember that typhoid fever is more prevalent in small places than in the city, and the conta- gious germs usually enter the system by means of polluted water. Wherever odors are noticed they should be regarded as signals of danger, and receive prompt and efficient attention. It is likely that the best methods of drainage have not yet been devised. Some method, unprejudicial to health, is needed which will prevent the pollution of our rivers and streams and which will enrich our soil by using it for fertilizing purposes. IV.— THE AIR AND VEXTILATIOX. The air performs a very important service in the animal economy. It is a mixture composed of nitrogen, oxygen, carbonic acid, moisture and small amounts of organic matter. Nearly four-fifths of this mixture is nitrogen, which has only the one known office of diluting the oxygen sufficiently to render it suitable for the requirements of respiration. The most important constituent of the air is oxygen, and without tliis vital element no animal life could be maintained. Neither could animal life exist in an atmosphere of pure oxygen, for it is too stimulating and it has to be diluted very much to adapt it t<> the requirements of respiration. THE NEW MEDICAL WORLD. 25 Combustible substances burn with a greatly increased brilliancy in an atmosphere of pure oxygen, and many which are not combustible under ordinary circumstances will burn freely in such an atmosphere. The oxygen which we breathe is the great source of animal heat. It gives health and bright, red color to the blood. It acts as a stimulant to the brain, the muscles and all the functions of organ- ized life. Air contains a small quantity of carbonic acid, a varying amount of moisture which renders the act of respiration more easy and some other substances in small amounts which are quite unimportant. Air like water is a solvent of other substances, and for this reason is often very impure. The act of respiration adds to the impurity of the air about us and soon renders it unfit for use, unless there is constant renewal and ventilation. In the act of breathing oxygen is taken from the air and carbonic acid is added. A person breathes about twenty times a minute, using on an average sixteen cubic inches of air each respiration, or nineteen thousand cubic inches each hour. Every person may therefore be said to vitiate about one cubic foot of air each minute. The combustion of every pound of coal consumes the oxygen out of one hundred and twenty cubic feet of air. A single candle consumes the oxygen of ten cubic feet of air each hour and an oil lamp about twenty cubic feet. A person's sleep- ing room ought to contain one thousand cubic feet of air to provide sufficient amount for respiration during a single night. It is the oxygen of the air which sustains life, and by maintaining a condition of slow combustion in the body maintains the animal heat. It also comes in contact with the carbon in our stoves and furnaces, and thus the process of combustion is carried on and heat is evolved. For breathing purposes the purity of the air is of no little consequence. Some of the diseases which result from breathing impure air are those of the respiratory organs, as catarrh, bronchitis, asthma, broncho-pneumonia, etc. Wall paper colored by arsenical pigments may give rise to poison vapors sufficient to produce symptoms of that particular poison upon the occupants of a room. In paint shops the vapors and particles of lead may escape into the air in sufficient quantity to produce after a long time symptoms of lead poisoning. Those working in quick- silver mines often absorb mercurial vapors sufficient to produce the symptoms of poisoning. The impurities of the air also produce dis- orders of the digestive functions. The air may contain* and trans- 26 THE NEW MEDICAL WOBLD. port disease germs, it maybe loaded with impurities arising from the soil or from decaying vegetable and putrefying animal matter, or pollution arising from human habitations. It is on account of this tendency of the air to absorb impurities and transport them, and to carry disease germs, that we cannot be indifferent to the squalor and disease of the slums of a city. The health and cleanliness of one home concerns every other home in the vicinity, and from a Hygienic standpoint every man becomes his " brother's keeper." VENTILATIOX. As human beings rapidly pollute the air about them, the subject of ventilation is of prime importance. The act of respiration removes oxygen from the air and in its place is found carbonic acid, ammonia, sulphureted hydrogen and. decomposing organic matter. It is main- tained that from the moisture in the expired air a very poisonous liquid can be distilled capable of producing almost instant death. The process of ventilation is to let out the polluted air, and admit pure air in its place. In a work of this kind we must consider ven- tilation in a practical manner; for we cannot enter into the theoret- ical, scientific or chemical study of the subject. This must be left to the domain of special works. The dangers from polluted air de- mand our notice because they come under the head of the prevention of disease. Some of the more immediate and noticeable result- of impure air are headache, languor, loss of appetite, faintness, vomiting and diarrhoea. It is well known that some persons are more sus- ceptible to the effects of impure air than others, usually the weak, the debilitated, infants and children showing the first and clearest signs of suffering, while the middle aged, the vigorous and strong are affected the least. Where the blood is thin and deficient and the lung capacity is small the results are most marked and disastrous. A skilled person can judge much concerning the efficiency of ventilation from the appearance of the inmates of the house. Those habitually subjected to the influences of impure air reveal a pallid, amende condition, a want of color in the face, a peculiar lack of vitality. Special attention ought to be given to the ventilation of public balls, theatres, churches, and above all in the order of importance, schoolrooms. The crowded condition especially of city school- rooms and the tendencies and lack of vitality on the part of the THE NEW MEDICAL WORLD. 27 younger children, make them the easy victims of a vitiated atmos- phere. It would be better for children to remain partially unedu- cated, than to be poisoned, dwarfed and ruined by the pollution of schoolroom atmosphere. An item which interferes with ventilation in cold climates is the expense. The changing of the air means the loss of heated air and the incoming of cooler currents to take its place. Heat is expensive, school boards and other authorities usually vote cautiously and too exclusively on the side of economy, rather than on the side of pure air, health and incidental expenses. With the poor who live in small, overcrowded rooms heated by the cook stove, the question of ventilation is often entirely overlooked in the efforts put forth to keep from freezing. Floating dust is the housekeeper's nuisance. In order to remove it from a house spread a line of damp sawdust across the room and sweep it before you, or if woolen carpets are to be cleaned, dampen the sawdust with a carbolic acid solution. In this way cleanliness and disinfection can be combined. After sweepings damp cloths should be used to remove the remaining dust from furniture and woodwork. It aids very much in removing the dust to open the outside doors and windows while sweeping, as the air loaded with dust and lint, is driven out by the incoming currents. The dust of rooms is composed of a great variety of pulverized substances in- cluding filth and lint, and is to say the least, irritating to the air passages. It may become quite an important factor in chronic dis- eases of the nose, throat, bronchial tubes and lungs. It is important to drive it out of the house. In considering the dangers which threaten human abodes, almost a monopoly of attention and interest have been given to sewers and the drinking of polluted water,. Contagious diseases, however, are not transmitted by odors nor by air contaminated by the decomposi- tion of vegetable or animal matter in sewers or elsewhere, unless the specific germs of contagion are present. Decaying cabbages or potatoes are unhealthy and render the air unsuitable for respiration, but they cannot convey diphtheria nor other infectious and conta- gious diseases, unless in addition the germs are present which pro- duce the infection or contagion ; as, however, they furnish an excellent hiding-place for disease germs, ventilation demands the removal of all decavino- substances from the cellar and all the filth. and mouldy articles which are so prone to accumulate even in the 28 THE NEW MEDICAL WORLD. best regulated homes, in cellars, pantries, dark passages and out of sight places. The air of the cellar constantly penetrates the other rooms of the house and it should be made sweet and wholesome at all times by ventilation. It is unkind to charge Providence with the results of our filth, impure air and laziness. Mould and mustiness in the cellar are danger signals and should be driven out by persistent ventilation and an abundant use of whitewash. Anything which vitiates the atmosphere rendering it unfit for respiration, must be considered as an indirect cause of disease, and hence there are many apparently insignificant matters often over- looked in the sanitary inspection of health boards, which are of vital importance practically. There are many people who possess a bad breath, the result of decayed teeth or an untreated catarrh. All these causes of polluted atmosphere are easily remedied, but require attention to additional matters aside from thorough ventilation. Some one has properly said that "the price of a healthy, clean breath is eternal vigilance and a toothbrush." Five minutes de- voted to cleaning the mouth and teeth after eating would add much to the sweetness and cleanness of many a home, and those who can- not spend that amount of time in the interest of sweetness must be sadly overworked. A few pennies spent for one of the remedies recommended for nasal catarrh will remove the disagreeable odor from that filthy disorder, and those who cannot afford the amount of money required in the interest of a sweet breath must be poor indeed. If a person's teeth, mouth, nose and skin are in such a condition as to perceptibly scent the air, the effect must be injurious to the per- son himself. As the odor does not come from the lungs, the foul- mouthed not only breathe out but also breathe in polluted air into their own lungs; hence they poison themselves and become a nui- sance to others. .Many workingmen smoke old, filthy pipes. Wherever they <_ro they taint the air with sickening odors. If thev enter your home for only a tew minutes you are obliged to open the doors and windows to drive out the intolerable and indescribable stench left behind them. They pollute the cramped apartments of their own home and render it unlit for a human being. In the winter when fuel is expensive and pure air is shut out as much as possible, and ventilation is disre- garded, think of crowding a family of four or live persons into such a stilling place to live and obtain the oxygen needed from THE NEW MEDICAL "WORLD. 29 such an atmosphere. Add to these quarters the smoke and odors of cooking and you have a condition of affairs that is truly loathsome. Just think what a struggle an infant must have, introduced into such an atmosphere at the sensitive period of birth. No wonder the inmates look yellow as if cured by the smoking process. Imagine the germs of contagious diseases introduced into such polluted quar- ters, and fancy if you can, what the doctor has to contend with. Is it any wonder that the disease is often superior to his drugs ? It is fortunate if he has positive views in regard to sanitary conditions, and smashes out a pane of glass or opens a window and drives out the vile air by the incoming of some that is lit for respiration. This will be of nearly as much service as any medicine he can prescribe, and will probably aid the working of his prescription so as to give a fighting chance for victory. Some of these matters affect more intimately the welfare of the homes of the laboring classes than anything ever touched upon by health boards. There are no subjects of more vital importance to the homes of the poor than cleanliness and ventilation. In Iceland where the houses are destitute of all devices for ventilation, we are told that the odor which arises from the herding together of human beings and animals, the refuse of fish and the filthy habits, is beyond description, and the infant mortality terrible. Births equal the aver- ages in other places, yet population is decreasing, for the majority of children born die within twelve days of an endemic disease gen- erated in the foul atmosphere. It is said that a similar condition of affairs exists in the Hebrides Islands. The remedy for foul cellars, house odors and musty parlors is ven- tilation. Bedrooms and bedding should be exposed to the sunlight and air. Faded carpets are more desirable than faded children. Fresh air and sunlight are not only the best disinfectants known, but are the cheapest; for they will save the doctor's call and may pre- vent the Angel of Death from spreading his dark wings over the household. V.— THE WATER SUPPLY. The estimated amount of water required for the use of each per- son daily, including the bath and closet, averages twenty-five gallons. This estimate is, as it should be, abundant. In all large cities the water from wells except artesian should be avoided ; for it is usually polluted by surface drainage and in very deep wells the 30 THE NEW MEDICAL WORLD. water is warm and dissolves impurities. In small communities even, the water is liable to become contaminated and produce sickness. Wells should be removed away from all dangers of pollution by barn-yards, privies, cesspools and sink drains. Water absorbs am- monia gas, pliosphureted gas, sulphureted hydrogen, and other impurities. Chemically considered all water is impure, but not suf- ficiently so to prevent its healthful use for drinking purposes. Great care must be taken in cities to prevent water from absorbing sewer gas. Water which contains decomposing nitrogenous matter is polluted by sewerage and unsuitable for use. Lead pipes are unhealthy conductors of water, especially if it con- tains as an impurity lime in solution. Rain water dissolves lead to some extent. A larger amount than one one-hundred and fortieth of a grain of lead in a gallon of water renders it unsuitable for drinking purposes, and if the use of such water is continued for a long time, symptoms of lead poisoning are liable to intervene. The analysis of water is not as usually supposed a very simple process. There are a variety of methods of purifying water. When mixed with clay and vegetable matter it may be allowed to stand till the foreign matters settle, when the upper portion can be re- moved. A lump of alum dissolved in a bowd of water curdles the vegetable substances and carries the impurities to the bottom. The amount of alum must be so small as not to be tasted. This method on a small scale is made use of in purifying the water supplies of many cities and large towns at the present time. It is claimed that when water to which the proper amount of alum, one-third of a grain to each gallon has been added, has passed through a filter every trace of it disappears, the alum uniting accord- ing to this theory, with the organic matters in solution forming a coagulum which the process of filtering removes. A small amount of permanganate of potash may be added to water just sufficient to give it a pink tinge. If the water does not change the color of this addition there is no organic impurity contained in it to occasion fear, and it may be safely used for drinking pur- poses. I 'nrc water may be obtained by the process of distillation, and this method is employed by the druggist. Freezing water into ice purifies it only in theory, and hence ice taken from rivers polluted by sewerage is unfit for household purposes. Water is sterilized by boiling, as there are no germs that can sur- THE NEW MEDICAL WORLD. 31 vive the process of boiling water for ten minutes. This is the most important of all methods for domestic use. Water raised to the boiling point for a short time and then cooled is safe for sick or well persons to drink as freely as needed. The filtering of water through charcoal and sand removes the solid matters. This is a valuable method and much employed. It will not, however, remove everv element of danger in waters con- taminated by sewerage, and for this reason the boiling of water is a means of great safety. Rain water collected in cisterns and filtered through charcoal and sand is in many sections abounding in minerals the most healthy water that can be obtained. A good filter can be extemporized by a little ingenuity which will serve an admirable purpose. Take a barrel, fix in a faucet near the bottom ; a few inches above the bot- tom put in a false bottom full of holes and over this stretch a layer of flannel. Then put in a two-inch layer of clean gravel, and above this a layer of pounded charcoal. Repeat this process, adding a layer of clean, small gravel and then a layer of charcoal, till within one foot of the top of the barrel. The last layer should be gravel covered with another layer of flannel held in position by half a dozen clean stones, so as to hold all in place when a bucket of water is turned in. Draw off the filtered water from the faucet. Spring water, which is not too heavily charged with minerals, and coming from elevated regions above and beyond human habitations, is healthful. TVater is decomposed into hydrogen and oxygen by means of electricity, for the purposes of experimentation ; there being just twice as much hydrogen as oxygen by measure. Pure water is destitute of smell and taste and is colorless except in large quantities, when it has a bluish tinge. Water is constantly evaporating from the surface of the earth and passing into the air as an invisible vapor, so that the air is always more or less charged with moisture. This vapor is condensed in the higher and cooler currents of the atmosphere, and descends to the earth again in the form of rain. TTater unlike most other substances is expanded by cold, and this fact is of very great consequence, as otherwise ice would settle to the bottom of rivers and lakes where the rays of the sun could never melt it. Impure water, especially that contaminated by sewerage, causes no little disturbance to health, such as loss of appetite, dyspepsia, gas- ?i'l THE NEW MEDICAL WORLD. tritifi and diarrhoeal diseases. The breaking out of diarrhoeal affec- tions in any community ought at once to direct attention to the water supply. It lias already been noted that the germs of typhoid fever and cholera may be introduced into the system through the pollution of our water supply with human dejections. Stomach worms also gain an entrance into the system through unsuitable drinking water. How important then to the health and well being of every family is the consideration of this subject. VI.— POOD. Waste and repair are the phenomena which characterize all animal life. Every process of thought or motion, whether voluntary or in- voluntary, involves destruction of tissue. The more vigorous the thought or muscular activity, the more rapid the process of waste. The activities of the student's brain, the anxieties of the man of busi- ness, the sedentary occupations of the professional man, consume force and produce bodily waste as well as the muscular efforts put forth by laborers in swinging the scythe, lifting the sledge or follow- ing the plow. The involuntary movements of the lungs in breath- ing or the heart in maintaining*; the circulation consume a certain measure of force, and this force is produced by the combustion and destruction of tissue. Nature is constantly demanding fuel for her fire. The lungs bring fresh oxygen to the blood nearh T twenty times each minute ; for oxy- gen being essential to combustion, a constant and never-failing supply must be provided. It would be inconvenient, however, to eat food as constantly as we breathe, and so a stomach or receptacle for food is provided, and by eating at intervals, usually about three times a day, enough for nutrition is stored up to meet the require- ments of the body in repairing its wastes, and hence an equilibrium is maintained both of nutrition and animal heat. When the store of food in the stomach is exhausted, nature admonishes us by a feeling of hunger and thirst, a desire for food and a relish for it, which makes the gratification of the appetite in health one of the most com- mon pleasures of living. When we consider what a complex piece of machinery the human body is ami that whatever enters into its composition must be sup- plied from our food, it seems as though it would be essential to employ a chemist to preside over the culinary department of the household, and instruct the cook in order that our food may contain THE NEW MEDICAL WORLD. 33 lime, sulphur, magnesia, soda and potash for the muscles and bones, phosphorous for the brain, iron for the blood, together with other mineral salts and acids which unite to build up a human body. The chemist, however, can be dispensed with because nature has antici- pated all the requirements of the body, in the great variety of foods placed at our disposal and if the appetite is normal and the food supply is not too scanty and too limited in variety, she can develop and maintain a healthy body, but if some abnormal development of the appetite exists so that the food demanded by nature is loathed,, or there is poverty in the amount and variety of food, then diseases; of nutrition may develop, as rickets, a crooked spine, ansemia, gout and scurvy, while under such conditions the course of scrofula and consumption is greatly accelerated. Where the food supply is abundant, very little attention has to be given by the individual to the consideration of its constituents or as to whether it contains the essential elements required by the body. For the appetite will be a safe guide, unless it has been pam- pered and spoiled like some only child by too much indulgence. The appetite is not an infallible guide, since it must be controlled, especially in children, by persons of reason, good judgment and experience. It is safe to gratify the appetite to a reasonable extent by good wholesome food of which persons rarely over eat. The danger of over eating is not from the appetite, but from the arts of the cook by which foods are made too rich, too highly seasoned or too concentrated for the stomach. As a rule the plainer and more simple the preparation of food, the more wholesome it is, and the less danger there will be of overfeeding. We can already see why suitable, nutritious and wholesome food is such an impor- tant factor in preserving the health of individuals and families. A thorough study of nutritious and wholesome food involves a con- sideration of the chemical composition of the various articles of diet; but this cannot be entered upon in a work like this, which cov- ers so great a variety of subjects in a single volume. It will be suf- ficient to give a few practical hints, and direct those who wish to study the subject further to special works on physiology. As to the disputed question in regard to animal foods, the vegeta- rian contends that vegetable foods only are intended for use, that the slaughter of animals is cruel, repulsive and wicked. He does not, however, hesitate to partake freely of milk, eggs, cheese and butter. As these belong to the list of animal foods, even those who profess 34 THE NEW MEDICAL WORLD* to be vegetarians are so only in name. Experience teaches that a mixed diet of meat and vegetables is the most natural and wholesome. Too large an amount of animal food causes congestion of the liver, and probably enlargement of that organ. Sedentary persons and the aged, who use too much meat, develop a tendency to gout, disor- ders of the blood, degeneration of the arteries and apoplexy. An excess of foods containing fat, produces bilious troubles and obesity; while a diet of rice and starchy foods requires the consumption of too large an amount in quantity to satisfy the bodily requirements; and the development of body and mind in nations too exclusively con- fined to their use, is notably inferior. Good milk contains all the ele- ments of nutrition and is an excellent and nutritious article of food. Of all foods it is the most suitable for infants prior to dentition. The two great classes of foods required by nature are the nitrog- enous foods, so called because nitrogen enters largely into their com- position, and the carbo-hydrates or non-nitrogenous. A human beinof could not thrive on an exclusive diet of either. The nitroge- nous foods are represented by muscle or lean meat, fish, the caseine of milk, the gluten in bread, the albumen of the egg, beans, peas and other vegetables. These also contribute to the formation of muscle or flesh, while the carbo-hydrates are represented by starch, sugar, oils and fats. These latter are the heat ami fat producing articles of food. They unite with oxygen in the body and produce a slow com- bustion, by which heat is evolved. The heat of the body is main- tained t" details that only interest th >se making a special THE NEW MEDICAL WOELD. 41 study of the subject. There are also many articles in all the ency- clopedias on this and kindred topics. Climate is of interest to us from a medical standpoint and we shall briefly consider it in its rela- tion to health and disease. Man has the faculty of adapting himself to a great variety of cli- mates. He is able to live in the frozen north amid snow and ice, where his clothing must be the skins of animals and such material as will prevent as much as possible the radiation of heat. He is on the other hand able to live in tropical regions where the heat makes clothing almost intolerable. The two extremes of heat and cold are not as favorable for the best race developments as the temperate climates. In the northern or arctic regions the struggle for life is too severe, the products of the earth are scanty, the races are stunted, dwarfed not only physi- cally but also intellectually. In the tropical regions vegetation is luxuriant, nutritious fruits are produced in abundance with the mini- mum of labor, man has to put forth but little effort to secure a liv- ing and he does not have to store up fuel and provisions and so the tendency is toward indolence and laziness. The two extremes, distressing poverty or abundant luxury, are also inimical to the best interests of a race. Climate has its bearing on these conditions and is a very significant factor in the welfare and happiness of the human family. Man is effected physically, mentally and morally by his environ- ment. This he cannot escape except by change of habitation. It determines largely the diseases from which he must suffer. High altitudes have a well-known immunity from consumption and malarial diseases. Climate is the most important factor in dis- eases of the air passages. Catarrh, so troublesome in the Xew Eng- land states, especially in winter, is almost unknown in a climate such as Southern California. Sudden and extreme changes in the temperature work injuriously upon many constitutions. The debilitated are the greatest sufferers from a variable climate. The northern portion of the United States is subject to these try- ing variations in a marked degree against which no foresight can always provide. There are periods when the climate is that of a region far to the south; the air is mild, the sky soft and southern, while south winds blow ; in an hour the wind changes and cold currents come sweeping down upon our habitations "from Greenland's icy A'2 THE NEW MEDICAL WORLD. mountain s." The robust brave these sudden variations without injury, but persons suffering from diseases of the air passages or lungs are greatly depressed, and sometimes the decision between life and death is made by such climatic changes. The best climate for consumptives, or those suffering from chronic bronchitis, and other kindred diseases is in those regions where the greater portion of time can be spent daily in the open air the whole year around. This requisite demands pure sky, pure air, dry atmos- phere, warm, even temperature and freedom from sudden and vio- lent changes. Some who are not too far advanced in sickness and who possess a Large amount of vigor and endurance improve in cold, salubrious cli- mates like that of Minnesota, while others have better chances for im- provement in Florida, Arizona or Southern California. Colorado enjoys considerable reputation at the present time for consumptive patients. It must not be forgotten that change of scene, better health regula- tioiis and other minor matters often combine to bring about the improvement which follows a change of climate. A change of climate often aids indirectly in producing the desired improvement; for it may help to increase the appetite, improve the digestion, increase muscular exercise, which means increased respira- tion and circulation and consequent gain in bodily weight. It i< impossible to give rules in regard to change of climate or to specify the places suitable for different diseases and persons. No one cli- mate is adapted to the requirements of all. Some are benefited by the sea aii% while Others are made worse. The best method to pursue in regard to change of climate is for each case to seek advice from com- petent authority. Our own country contains almost every variety of climate modified by altitude, heat, moisture, the ocean currents and many other factors. Some people prefer other lands and for such there are suitable places in Switzerland, France, Italy ami the islands of the sea. N:iv sau, <>n one of the Bahama Islands, has the reputation of a mild and even climate throughout the entire year. Having decided that a change of climate is essential, one should give the new locality a thorough trial and not leave before notice- able improvement can have time to take place. Winter in a south- ern clime and summer in the Adirondacks would afford variety and diversion for those who are fond of changes ami can afford the expense. * THE NEW MEDICAL WORLD. 43 IX.— EXERCISE. There is close relation between exercise and good health. It is not merely important but it is essential to the functions of all the organs and to a normal ami healthy condition of the Serves and mus- cles. The beneficial effects of exercise upon the nerves will be seen from their relation to all functional activity and every bodily and muscular movement. There are two sets of nerves, known as nerves of sensation and nerves of motion ; the former receive the outward impressions and carry th'em to the brain, the latter transmit the impressions to the place where motion or action is essential. The brain is the capital center of all nerve force and the numerous nerves running to every portion of the body and from every portion back to the brain are like telegraph wires carrying messages to and from the central office. Back of every movement whether voluntary or involuntary is the controlling nerve influence ; when this is disarranged there is a cor- responding disarrangement of this or that organ or function, as the heart, stomach or muscular system. Such disarrangement produces dyspepsia, lack of nutrition, constipation, irregular heart action, weakness, prostration and a host of diseases depending upon the character and degree of nerve trouble. This is sometimes so pro- nounced that the whole mental or physical system is shattered and not infrequently the whole man becomes a mental wreck. We can do little more than suggest here how the nerve force acts and reacts upon every tissue and fiber of the body. It is well known that motion is produced by the action of the nerves upon the muscular libers, causing them to relax or contract as necessary. Exercise could not improve the muscular force if it did not equally increase and develop the ability of the nerve force. It is always the trained nerve which controls the action of the muscle fiber. This training of the nerves is the most important result of physical exercise. Men of powerful muscular development cannot write out their thoughts upon paper unless they have learned the process of writing, unless the nerves and muscles of the hand have been trained to do this work conjointly. Any common handicraft is easy to the trained nerve and muscle, but otherwise difficult or impossible no matter how great the muscular power. 44 THE NEW MEDICAL WORLD. Exercise is just as much a tonic- for the nervous system as it is for the muscular system and just as essential, but this fact is usually lost sight of. Exercise is usually considered as having reference simply to muscular development, hut let us remember that its relations are a- dose to the mind as to matter; for no process of the mind or body, no tissue, nothing, can he separated from the nervous system. It is omnipresent in the human organism. Hence all exercise affects primarily the nervous system and through it secondarily the tissues and functions under its control. Exercise affects the process of respiration favorably; but think for a moment how far reaching such a proposition is. Increased and improved respiration means that more oxygen is taken into the lungs, that the carbonic acid and other waste and poisonous products of the system are more successfully eliminated. This implies purer blood and the remotest tissue and fiber of the body feels the exhilaration almost immediately. It is not essential for your well being to follow up the newspaper advertisements of the dispensers of oxygen for there is oxygen all about you, oceans of it, abundant and to spare, and you may breathe it in freely and become more vigorous and healthy. The Creator who made man and who knows what is neces- sary for his well being has put as much oxygen in the air as the human body requires, if you will only use it and inflate your lungs with it daily to their utmost capacity. Exercise increases and improves the heart's action. This, if not excessive, sends the improved blood with greater energy and force to the extremities, and relieves cold feet and hands far more satisfac- torily than sitting over a register to get the hot air from a furnace. It is better than medicine in most instances to aid the circulation. There is no more satisfactory tonic for a weak heart, purple veins, cold extremities and pale cheeks than exercise judiciously taken. There is no unfavorable reaction from such a stimulus. It is in keep- ing with nature's great remedies and her methods of healing are the best yet known, though often the least appreciated. Many who resort t<> medicines would derive more benefit from pure air, nutritious diet and duly regulated exercise. But how difficult it is to analyze the health- ful results which follow nature's processes; they are so complex and so Lap on to each other at every point. N<>t only the lungs and heart do their work better, but the results of exercise are to be traced in that important organ, the skin, spread <>ut over the whole surface of the body. It becomes more active, THE NEW MEDICAL WORLD. 45 the pores are opened, copious moisture is eliminated together with other waste products which tend to embarrass the system. Every organ of the bod}^ is stimulated to a more healthy performance of its- functions. It is not easy to enumerate in detail what exercise can do in the way of maintaining or restoring the health. It increases the demand for nutrition, hastens digestion, aids absorption, promotes sleep and increases the energy of mind and body. It acts like a balance wheel to regulate, equalize and preserve the health. The many ailments of the sedentary which render life a kind of prolonged misery can be largely prevented, or if in more advanced stages can be cured by means of exercise intelligently prescribed and conscientiously admin- istered in appropriate and regular doses. Many sedentary persons are subject to headache, nervousness, sleeplessness, neuralgia, disor- dered stomach, biliousness, constipation, piles and a long list of such allied miseries which could be alleviated, if not wholly cured by systematic exercise. It is a powerful factor not only in the preserva- tion of the health and the prevention of disease, but also in diminish- ing the bodilv weight when such result is desirable, in reducing deformities and overcoming the weakness of nerves, muscles, parts or organs. The use of physical culture in all the public schools should be encouraged. While the practice is a splendid discipline it also serves to relieve the weariness of close application or prolonged study and restraint in one position. School children thoroughly enjoy such drill and student life is rendered far less tedious than under the old methods. Feeble persons must omit out door exercise in bad weather and be contented with home gymnastics, which can readily be devised with a little ingenuity. Of two medicines possessing equal virtue that is to be selected which is the more pleasant. On the same principle that exercise is preferable which will be relished, which possesses the element of diver- sion and combines the cheerful employment of the mind and body. That exercise which is not enjoyed, like bad-tasting medicine, is more likely to be omitted than taken. It is quite essential in order to obtain the best results that exercise should be agreeable and much enjoyed. Public gymnasiums are preferable to private because the feeling of compulsion and restraint experienced causes a more regular and sys- tematic pursuit of their benefits. 46 THE NEW MEDICAL WORLD. The danger of carrying exercise to excess must be guarded against. It is well known that professional athletes suffer unpleasant conse- quences from their occupation. Even the bones suffer injury, the joints after a time lose their mobility, the muscles are over-taxed, the heart valves are strained and often permanently injured. Exercise should be regulated in order to stimulate the bocjy and brain in the right proportion. The energy must not be wholly consumed in mus- cular exertions. Exhaustive exercise may affect unfavorably not only the muscles, joints and heart, but also the brain and nervous system. School boys and college students are especially liable to carry physical exercise to excess. The vying with each other and the powerful stimulus to excel often result disastrously. Football is an exercise of such severe nature as to be dreaded by the friends of those who participate in the game, and it is doubtful if such immoderate exertion is ever beneficial, while it often results in minor accidents and sprained ankles if nothing more serious. Prize contests on the part of athletes should not be' encouraged; for the nervous strain is injurious even though the muscles appear to endure it unharmed. Out-door games when there is no especial ele- ment of rivalry are healthful and invigorating and should be encour- aged. Walking is good exercise though not vigorous enough to develop the chest and upper extremities. It may be carried to excess by beginners. Horseback riding has much to commend it as healthful exercise. It should alternate with walking as it does not sufficiently exercise the muscles of the legs. Walking makes up the deficiency. Rowing should be added when practicable, to develop the chest and its mus- cles. No one kind of exercise serves for complete development. In winter skating is admirable exercise for boys and girls ; it should not be too long continued. Bicycle riding is an ideal exercise in which all the members of a household can join. From the bicycle, women learn the important Lesson of controlling the nerves. "It is a tine Bight," says a recent writer, "to see in L896 a woman weaving her wheel in ami out among the loaded teams who in 1894 would hardly have dared to cross the same street without a policeman's arm. When the mother of a family can strap a lunch box to her handle bar and convey a brood of young cyclists for a day at the seashore or in the woods there is a decided gain in the average health of women. The girls, not a few but nearly all of them, are getting OUt-of-doors THE NEW MEDICAL WORLD. ±i which is precisely what has been wanted for the last two generations to give the American race a lighting chance to survive." After exercising, the pores of the skin become relaxed and care must be taken not to cool off too suddenly. Draughts of air should be avoided and friction of the skin with a coarse dry towel is advan- tageous. The following health code by an unknown writer contains a prac- tical summing up of the whole subject, "Take the open air, the more you take the better, Follow nature's laws to the very letter; Throw the drastic pills in the Bay of Biscay, Let alone the gin, the brandy and the whiskey. "Freely exercise, keep your spirits cheerful, Let no dread of sickness make you ever fearful, Eat the simplest food, drink the pure, cold water, Then you will be well, or at least you ought to.'" X.— LONGEVITY. " Years steal fire from the mind as vigor from the limb ; And life's enchanted cup but sparkles near the brim."' — Byron. It is the duty of all mankind to apply their knowledge so far as possible to right living. Longevity is promoted by a proper observ- ance of health laws, but the strictest observance of these laws cannot guarantee health or long life to every one. In attempting to dis- cover the secrets of longevity, if secrets there are, our research must be extensive enough to include certain exceptions, found in the foot notes, under all rules. For those who inherit a debilitated constitution, a deficit in phys- ical force, the problem of longevity appears to be a very difficult one and its working out seems to promise only uncertain results. It is well known by medical men and actuaries that there is no factor so prominent in the subject under consideration as heredity, and yet it would be useless to pause and discuss it so far as the present gen- eration is concerned, since no one can rectify the mistakes of his progenitors. It is everywhere admitted that those who have descended from hardy stock, who are by nature strong and vigorous, have the advantage, and it would seem as though predictions could be made in their favor with great certainty, but we have all noticed that 4# THE NSW MEDICAL WORLD. the strong are often rash and fail to conserve their health, while those naturally trail may be 80 cautious and temperate as to outlive them and reach a ripe old age. There can be no system of living which everyone can adopt to insure longevity, but there are many aids which if brought into con- stant service offer the best prospect for reaching up to and beyond the average expectancy. There are certain general principles that experience has taught the thoughtful in every age, which it is advan- tageous to learn early and practice persistently. These have almost become proverbial and can be stated in a few brief sentences thus: take plenty of exercise; bathe often; keep the head cool, the feet warm and dry; avoid unwholesome food, impure water, unventilated rooms, foul air, damp dwellings, etc. Any discussion of health sub- jects can be but little more than the elaboration of these hackneyed expressions made interesting and impressive simply by the earnest- ness with which they are enforced. We announce no new discovery, only an open secret, when we say that the body and mind are in the most favorable condition for the maintenance of health when occupied by some congenial employ- ment. Work is not unhealthy. Many of the hardest workers the world has ever known have lived beyond their allotted threescore years and ten; and it would be a great misfortune for the masses to be relieved of the necessity of toil. The diligent live longer and enjoy more than the indolent whose time is a burden and who squan- der it in nursing imaginary evils and complaints. Idleness is destruc- tive of human happiness and the welfare of both individuals and nations. It tends to effeminacy and immorality. There is not so much danger of over work as is popularly sup- posed; but there is far greater danger of violating those general health principles to which reference has already been made. The (Treat danger is not from hard work but from worrv, anxiety and constant vexation, which are largely the outcome of our present methods of business in which competition is often so selfish, fierce and heartless. It is no wonder that in this desperate struggle many are crowded to the edge of the precipice and that occasionally some poor disheartened victim, prodded till his brain whirls and reason gives way, is tempted to leap off. These unnatural burdens of anxi- ety make the heaviest draft upon the reserve, exhaust the brain ami ire detrimental to health and bloom. Self regulation la one of those fundamental principles which if THE NEW MEDICAL WORLD. 49 learned by experience may come too late. It is necessary to avoid that stress of business which interferes with digestion and refreshing sleep. There are many who do not allow sufficient time for eating ; "five minutes for refreshments," then the rush and scramble are renewed. We must not permit ourselves to get into a chronic state of hurry and fty around as if there was only another moment to live. Take time to eat, masticate your, food thoroughly; for this is the only process by which it can be prepared for digestion and otherwise you will pay the penalty, which is dyspepsia. Take time to sleep. It has been learned that eight or nine hours out of the twenty-four are essential for this purpose. Sleep is a period of recuperation during which repairs are in progress. Unless com- pensation is made during sleep for the wastes of the body an equilib- rium of its forces cannot be maintained. History appears to coincide with experience and proves that man needs, in addition to sleep, an occasional day of rest from his labors and there is probably no better arrangement than the one which already exists, of one day out of every seven. It is important to cultivate a cheerful disposition and not allow despondency to obtain control of the spirits. Cheerfulness quickens the circulation, adds warmth and vitality to the blood, sends a thrill of health to every fiber of the body and stimulates all the functions of animal life. Whatever banishes cheerfulness upsets the digestion, obstructs nutrition, makes the liver sluggish, renders the blood impure and riles up all the foundations of life. Cheerfulness purchases contentment, that perpetual feast for the mind, while its violation breeds discontent and may eventually end in suicide or insanity. There is no doubt but what great emotions overtax the nerve force, disturb the stomach, the brain, the heart, and should be avoided. There can be no emotion that does not reach the heart and brain. You cannot even run or hurry without compelling the heart to beat faster in order to provide the necessary force. There is nothing in the line of emotion or effort which does not affect the heart and consequently no organ is so liable to overwork. When the heart is overburdened and begins to fail the stomach becomes feeble, digestion is disturbed; the brain suffers from want of nutrition, the memory falters and unmistakable signs of age or exhaustion quickly follow. It has been observed that strong emotions affect unfavorably the .",!) THE NEW MEDICAL WoKLD. secretion of the mother's milk and it is a matter of record that adults have sometimes fallen dead in a fit of anger. How important it is then to regulate the emotions, to control the feelings and pracl Belf-management. Excesses of all kinds squander the vital forces, hence are debilitat- ing. They destroy the natural and normal equilibrium of the body and ought to be strenuously avoided. The control of self demands thai reason have sway even if it makes you a tyrant over your pas- sions. When reason presides there will be contentment, order, so- briety and happiness ; where reason is violated discontent, misery, intemperance and anxiety reign. Be on the outlook in regard to oxer-indulgence at the table and late suppers. In some things absti- nence, in others moderation and in all things a life pure and constant, is consistent with longevity. Temperance and sobriety are among the open secrets of a long life. The most natural drink for mankind is water and there is no more healthy beverage when all other things are considered. The prolonged use of alcoholic stimulants inflames the stomach, congests the brain, excites and overworks the heart, produces vascular excite- ment of all the organs and at length leads to alteration of their structure. All powerful or narcotic drugs should be avoided except under skilled direction for the amelioration or cure of disease. Those who resort on every trifling pretext to the use of such agents, unless restrained, will shorten life and till its brief remnant with untold bit- terness. All fatigue should be counteracted by rest or sleep and not by a resort to stimulants. When temporarily wearied a warm bath will be found refreshing; to the bath may be added with bene- fit a tablespoonful of aqua ammonia or a little common salt. Friction of the skin with a coarse towel should follow the bath; if this is thoroughly done it will draw away surplus blood from the overtaxed brain, equalize the circulation, invigorate the system and promote test. Harmless recreation, without making pleasure the aim in life, should be sought, for it is exhilarating. Change of place and rest from the drudgery of a continued and harassing occupation is refreshing. It is beneficial to body and mind to breathe the sefl air, to look upon the vast ocean, for the sight is both grand and inspiring. THE NEW MEDICAL WORLD. 51 Travel is beneficial in many ways. It enables one to mingle with diverse classes of people, observe their habits, their hardships, their undesirable methods of living and teaches lessons of gratitude and contentment. Such experiences broaden and quicken the mind, increase its capacity for enjoyment and bring us into touch with all the world outside ourselves; they help us to avoid excessive thirst for wealth and assist us in the cultivation of charity, liberality, magnanim- ity. They illustrate the folly of the miser's stinginess, the unfriend- liness of the selfish, the emptiness of pride and enforce more just and correct views of life. Finally it should be borne in mind that there are more desirable attainments than old age with its infirmities, its waning strength and weakened intellect. Many have succeeded in crowding a short life full of glorious achievements. " We should count time by heart throbs. He most lives Who thinks most, feels the noblest, acts the best." CHAPTER III. GENERAL TOPICS OF INTEREST IN MEDICINE. I. Home Prescribing. — IT. Strange Delusions. — III. Patkxt Medicines. — IV. Medicines. — V. Doses. — VI. House- hold Remedies. I.— HOME PRESCRIBING. IF you can diagnose disease and determine from the symptoms what particular disease you have to treat and not confuse one disease with another, then the matter of prescribing for the members of your family will be quite a simple matter in ordinary cases. But if on the other hand you are unable to distinguish between things that differ and cannot recognize even the simpler forms of disease, you will be able safely to do but very little home prescribing. You cannot prescribe unless you will learn to read and interpret svmp- toms. This book will help you in this matter if you will give to its pages your earnest attention. The trouble with home prescribing is apt to be that you consider the patient dangerously ill when the ailment is simple, almost trifling: and then your imagination helps to exaggerate the ease, you allow your good judgment to be dethroned by fear, you first get nervous, then frightened and the whole household becomes demoralized. The reverse is still more unfortunate; for perhaps the disease is really serious, but being unable to interpret the symptoms you consider it slight and unimportant; time is lost and evil consequences are averted with difficulty. Every physician encounters cases where the household is misled in these different ways. The author has often been called to attend children sick with lung fever (pneumonia), some of them in great danger. It is quite usual to find some neigh- bor present whose reputation i^ extensive for experience ir sickness THE NEW MEDICAL WORLD. 53 perhaps some old lady, wise in her own estimation, who with a know- ing look and j^ositive utterance hastens to display her cunning by remarking that "nothing but worms ails that child," and she usually feels quite humiliated when the doctor fails to confirm her diagnosis. There is no disease among children which deceives the household more often than pneumonia ; in another place you will find a full description of the symptoms. These can be easily learned if you will give heed, but if you cannot or will not learn these positive symp- toms then you will be obliged to depend upon some one whose knowledge is not guesswork. Above all, do not trust to some wise- acre who will declare every ill of childhood due to worms. There are many mild diseases which can be intelligently treated if you will only give heed to their symptoms and learn their simple management; there are other diseases you could not treat after a thorough medical education unless you had supplemented it with years of observation and experience. Diseases too difficult for home treatment will be outlined and the hint properly given, so that having recognized a serious malady you will see the need of experienced counsel and direction. It is far bet- ter to employ a skillful physician and pay him cheerfully than to run a serious risk and imperil the life of yourself or others for lack of knowledge. It is expensive to employ skillful counsel, but that is little com- pared with the heartache which would fill your life with a never- ending regret, if a dear friend or child were the victim of your igno- rance or prejudice. II.— STRANGE DELUSIONS. Many persons otherwise intelligent adopt a strange course when sick- ness overtakes them. As drowning men catch at straws so sick people are often the victims of lying pretenders. The belief that the gift of healing is a natural one is a relic of the past. In olden times disease was a demon, to be cast out by those who were espe- cially gifted in prayer and in other mysteries which the common peo- ple did not understand. Superstition and pretence come nowhere to the front at the present day, so much as in attempts to deceive and work the miracles of healing. Some people seem to be ever courting deception, ready for the silvery words of flattery and pretence. A good and competent man must live a long time in a community and .".4 THE NEW MEDICAL WdlM.H. win the confidence of the people little by little, but let Borne brazen-faced deceiver come to town with flowing locks and advertise himself as the most wonderful healer of modern times, and it is astonishing how credulous the people are and how cheerfully they will bring forth their hidden shekels and how enthusiastic they will become over the Greasy locks and swarthy complexion of such an ignorant fraud. Men of honor and attainment stand a poor show in comparison with the boasting seventh son of a seventh son, a natural healer or perchance a natural bone-setter. Does a person know any too much about the practice of medicine who has made it a thorough and conscientious study, and who has pursued a complete course of medical study in a college of recognized merit ? Ask the opinion, if in doubt, of men of good judgment and experience who are leaders in their profession, if it is possible for a man to be a natural healer of diseases or a natural bone-setter or Burgeon. You would not employ a man to build a house because his only qualification was that he professed to be a natural carpenter. Y*ou would not think of employing a man to shoe a valuable horse because he pretended to be a born blacksmith. No man would pre- tend to be a natural carpenter or blacksmith because his works would condemn him and prove him a humbug. But there is something mysterious about the art of healing, nature is so prompt and efficient in her work, that a humbug or fraud can point to her incomparable art and shout, "Behold my skill, I can work miracles." People often employ these frauds who have almost no qualifications to treat them, because they boast unceasingly of some special and peculiar or inher- ited power oxer disease, without making any effort to ascertain whether they can perform a tithe of what they pretend. The fol- lowing code is a good one to remember: True wisdom is always quiet, modest and unassuming, makes no boast, is cautious about promising a cure for disease and free from pretence. Those who know nothing fear nothing, [gnorance i- loud- mouthed, shouting to attract attention, full of boa-ting and pretence and rushes into print to make impossible statement-. The pretender in medicine always heralds his coming with no little splurge, ljc hes- itates not to boast of marvelous ami impossible achievements. He can always cure consumption or Blight's disease in their last Btaj anything, no matter what. The truth probably is that his medical knowledge is bo scanty, that he knows almost nothing except a THE NEW MEDICAL WORLD. 55 little smattering gleaned from the medical almanacs; his medicines are receipts that he has copied or stolen or obtained in questionable ways, yet what miracles they will perform, warranted to cure every disease flesh is heir to. What a shame it is that in some of the states the tramp, the jail-bird, the cowboy, any ignorant pretender, male or female, can enter a community and announce himself as Doctor Blank without fulfilling a single requirement as to medical study or graduation . The pharmacist must be registered, else he cannot put up your medi- cines; the dentist must be licensed, else he can neither fill nor extract your teeth ; the peddler who sells tin must have a license and even the man who picks rags from the gutter. But in some of the states no restriction is deemed necessary to protect citizens from self-styled doctors. A diamond in his shirt front, a dashing manner and a loud mouth are all some people demand as evidence of ability. III.— PATENT MEDICINES. "Canst thou not minister to a mind diseased?" Patent medicines like advertising doctors should be avoided. If you are in health you do not need them and if you are sick you need something better. A few of these shop remedies may possess a small amount of virtue, and even when taken at random may occasionally benefit, especially if the taker has a large degree of faith in their potency. It is usually the mysterious make-up of these compounds, coupled with the wondrous stories of the advertisement which ex- cites the curiosity of the credulous. If they could only see the form- ula written out in full upon the bottle and know how small the grain of truth the advertisement contains the spell would be broken and their faith shattered. The inspiration of all this vast business is not, as pretended, to alleviate human suffering and cure the ills of mankind ; for it is a money-making scheme. Vast fortunes have been made out of the sell- ing of mixtures for one dollar which cost about ten cents. Patent medicines are usually concocted out of inexpensive drugs and many of them contain an objectionable amount of alcohol and vile whiskey. Their great item of cost is not in the making of them but in adver- tising them. It is easy to see why the press rarely criticises with severity this nefarious business of selling nothing for something, inasmuch as about fifty per cent, of the income of advertising doc- 56 THE NEW MEDICAL WORLD. tors and their remedies is paid to the newspapers. It is a matter simply of millions to the income of the press, and hence, no pub- lic sentiment is awakened and no attempt is made to instruct the people in regard to these important health matter-. The field for this patent medicine business is an extensive one, for the American people are largely overworked and nervous. In this condition they easily fancy themselves ill, and if they can be in- duced to read and ponder the worthless literature of the medical advertising page, this fancy will soon take a deep root and become an actual growing reality. More than half the dosing of the people is for fancied illness. If the mixtures they buy and prescribe for themselves were only as harmless as they are worthless little would need to be said. Even when you are really sick it is not much medicine you need. but a little, and that of the right kind. Do not pervert your stom- ach with base and uncertain mixtures; for it was never intended to be converted into an apothecary's shop. There are strong reasons for believing that patent medicines do a great amount of harm in the aggregate. They are often the cause of dyspepsia, constipation and a host of other functional disorders. Many people exercise about the same grade of intelligence in regard to medicine, as a certain family who called one doctor to see their sick child, and after his departure called still another doctor. Acting on the theory that if one doctor knows a little, two know more, they alternated one's medicine with the other's. Acting also on the the- ory that if one spoonful of medicine is good, two are better, they doubled each dose. As a result the child died. The following recent incident illustrates the danger of the patent medicine business: A hard-working butcher who inherited a taste for alcoholic liquors moved from the city to a small town to avoid temptation. In this village to which he had come was a certain gro- ceryman who had decided to sell out his stock of goods, and in order to do so offered them at reduced prices. The butcher bought a list of necessary goods and at the suggestion of the grocer, added to his purchase one of the compound sarsaparillas. He took his go. ids borne and soon commenced taking a dose of his Barsaparilla each morning, as he was obliged to go to work early and work a long time before breakfast. He soon noticed QOW6V6I that if he failed to take the medicine for a single morning he felt depressed and unequal t<> the work to which he had been accustomed. His next Btep was to THE NEW MEDICAL WOULD. n< resort to whiskey drinking for which the medicine had prepared the way. There is no question but what patent medicines under the names of bitters, tonics, etc., have often led the way to the dramshop, hence on this ground, if no other, they should be avoided. IV.— MEDICINES. Medicines are substances used to accomplish certain objects, as the prevention or cure of disease. They also help to produce changes in the body or in some tissue or part and bring about results more or less definite. Medicines possess certain properties which aid in their identifica- tion as color, taste, odor and weight. They also possess chemical properties some of which are similar and some are antagonistic or incompatible. Advantage is taken of the various properties of medicines by the prescriber. He sometimes unites remedies which aid each other and gets much better results than could be obtained by a single remedy. In order to do this suc- cessfully he must have an acquaintance with their chemical proper- ties, otherwise medicines might be placed in combination which would render the mixture worthless or even dangerous. Acids are neutralized by alkalies, and a knowledge of this fact enables one sometimes to relieve suffering or save life. A single medicine sometimes contains several active principles or medical proper- ties. The action of medicine often depends upon the size of the dose. Ipecac, in large doses, excites the mucous and muscular coats of the stomach and causes vomiting ; while in very small doses it may be successfully used to allay vomiting. It has other properties which render it valuable as an expectorant, an astringent and to check hemorrhage. Rhubarb has a double action, in the first place as a cathartic, in the second as an astringent. Opium is made more effi- cient for relieving pain by combining it with belladonna, while the action of the two remedies upon the pupil of the eye is antagonistic, the one contracting and the other dilating it. A great number of sim- ilar illustrations might be brought forward to prove that medicines are capable of accomplishing a great variety of results, if their prop- erties are familiar, and when they are administered in the correct dose and proper combination. . THE NEW MEDICAL WORLD. The insolubility of certain remedies must not be overlooked. Many are freely soluble in water, others in glycerine, others in acids, others in alcohol, still others in ether and some are not soluble in any of the substances mentioned. In order to prepare suitable com- binations it is necessary to know about the chemical properties and solubility of medicines, as this cannot be learned except by extensive study of chemistry and other branches, it has been deemed essential to include under the treatment of diseases, suitable prescriptions with complete directions for their use, in addition to the list and doses of household remedies in this chapter. Such an arrangement renders this work as complete as possible for the household purposes for which it is designed. Some medicines enter the blood and assist in removing from it morbid material, or add to it some property of which it is deficient; thus the quality of the vital fluid is improved, purified or enriched and made efficient to work a renovation of the system. In this way disease is cast out, normal processes are invigorated and health is restored. Such medicines are known as hcematics. Another class act upon the nervous system and exert their influ- ence upon some special nerve or nerve center, or upon all the nerve centers and the numerous nerve fibers by which they are connected. Medicines which work changes in the blood accomplish their mission in a deliberate and permanent manner, but those which influence the nervous system work quickly and the effect is often temporary and fleeting, requiring a repetition at stated intervals to continue the result. Such medicines are known as neurotics. Another class act upon the muscular system and cause contraction of the muscular fibres and are often used for allaying hemorrhage, or for toning up the system weakened by debilitating discharges: and they also diminish the secretions of the glandular system. These are known as astringi tits. Another class excite the secretions by stimulating the action of the glandular system. They aid in removing those morbid products which OUght to be cast out of the body. They are known as often unsuitable for another stage. There are many individual peculiarities which must be regarded. Some persons are always harmed by certain medicines which prove tor other people ordinarily beneflcial. Some conditions increase while other conditions diminish the action of medicines. To appre- ciate ;ill these modifying influences if will be necessary to give ear- nest attention to this part n\' the work. THE NEW MEDICAL WORLD. 61 EMETICS. Emetics. — There are many medicines which excite nausea and vom- iting. They are often indicated to rid the stomach of poisons, to re- move some obstruction in the trachea or oesophagus, to expel secretions from the air passages, to relieve convulsions in children or headache and hysteria in adults. When an active poison has been swallowed death may result before a physician could arrive, or so much poison may have been absorbed into the system that his efforts would be unavailing. It is well to have some efficient remedies at hand to produce vomiting. A tea- spoonful of ground mustard and the same amount of common salt mixed up in a cup of lukewarm water, will usually act promptly and is harmless Ipecac is a harmless emetic but is rather slow in action. It is a good remedy, especially for children, when vomiting is indicated in bronchial diseases, to relieve the air passages. It is useful in croup and whooping cough. It is much used in small doses in colds and coughs, in bronchitis and other diseases of the air passages, for its expectorant effect. The emetic dose for a child is one teaspoonful or more of the syrup. The compound syrup of squill (Hive Syrup) may be used to pro- duce vomiting. It owes its chief action to the small amount of tar- tar emetic which it contains, each teaspoonful containing one-eighth of a grain. The dose for a child is from eight drops to a teaspoonful. It produces considerable nausea and is consequently quite depressing. It should be administered to a feeble infant, if at all, with considerable care, in small and repeated doses. Alum in powder is an excellent remedy in croup to promote vom- iting. It has considerable reputation for dislodging the false mem- brane which is characteristic of this disease and in preventing it from reforming. It is prompt, thorough and without depressing effects. A teasjjoonful of the powder may be administered in syrup and repeated every half hour till it causes free vomiting. The action of emetics is favored by a free use of lukewarm water. Cathartics. — These are medicines which cause the bowels to act, usually by irritating their muscular fibers, thus stimulating the nor- mal peristaltic action. Cathartics are often serviceable but no rem- edies are more abused in domestic practice. The custom of buying cheap pills composed of aloes, gamboge and such like drugs cannot f)li THE NEW MEDICAL WORLD. bo too severely condemned. They cause an evacuation of the bow- els in consequence of their irritant action; but constant repetition renders their action less satisfactory and the bowels finally lose their normal vigor or tone and will not respond to the natural stimulus. In this way the habit of constipation is often induced and becomes chronic. It is always detrimental to the comfort and health of the individual. Constipation and its attendant evils and Bufferings are largely the result of the cheap and drastic pills bought in the shops ; for they produce an over stimulation of the bowels and reaction is sure to follow. They are called mandrake pills and liver pills to give them popularity and increase their sale. They often bring a large fortune to the proprietor,, Avho has little regard for the injury they cause. Sim- ple remedies to produce daily and normal evacuation of the bowels are preferable to harsh and irritating medicines. Regulation of the diet, the eating of fruits or the occasional injec- tion of water or soap water or a small dose of nux vomica daily, to improve the action of the muscular coat of the bowels, are simple remedies but much more satisfactory in the long run than harsh cathartics. Among medicines the granular effervescent citrate of magnesia is a mild though excellent cathartic. From a teaspoonful to a dessert- spoonful in a half glass of water can be taken each morning or of tener, as needed. The sulphate of magnesia (Epsom Salts) is an old and cheap rem- edy and in certain cases where there is a tendency to dropsical effu- sions it is especially valuable. It has been recently prepared in the granular effervescent form which adds not only to its cost but to its elegance. The dose of this is one or more tablespoonfuls in water. The infusion of senna is a safe ami valuable physic. It is liable to produce griping pains and hence should be combined with such car- minatives as ginger, peppermint or camphor. Its taste is rather un- pleasant. It is prepared like a cup of tea by pouring :i little boiling water upon a generous pinch of the leaves. Castor oil is a well-known domestic remedy, somewhat difficult to take but an excellent physic for many conditions. It is soothing in its nature, it does not produce nor aggravate inflammation and is Mire to act if given in sufficient doseand allowed a proper time. It may be given <>n the top of a cup of milk, coffee, chocolate or soda water or with lemon juice and be scarcely tasted. There is no better phvMc THE NEW MEDICAL WORLD. 63 for children in summer nor for women after confinement. The dose for children is one to two teaspoonfuls ; adults can take one or two tablespoonfuls as needed. Of the many remedies used as cathartics reference will be made here to only one other, namely, podophyllin. This is a remedy of o-reat potency in curing constipation. It stimulates the liver to a healthy action, increases the now of bile and in small doses is one of our most valuable remedies. Its efficiency will be improved by com- bining it with mix vomica. It is usually taken in too large doses. It can be obtained in little sugar-coated parvules containing one- twentieth of a grain. From one to two of these may be given to a child as needed. If the parvules cannot be obtained it may be used in the following prescription: i * ]^ Podophyllin six grains Alcohol one ounce Mix. Dose, six drops in sweetened water for a child one year old and for other children in proportion each day as needed. The following makes an excellent pill for general cathartic use : fy Podophyllin one grain Hydrastin ten grains Leptandrin five grains Ex. ^ux Vomica three grains Ex. Hyoscyamus five grains Mix. Make twenty pills. Dose, one each night or one each night and morning as needed. The dose in the above pills is small, the design is not to over- stimulate the action of the bowels but to bring about a natural and healthy condition when their use is to be diminished or discontinued. Diuretics. — Diuretics are medicines which increase the action of the kidneys and consequently augment the flow of urine. A very intimate relation exists between the skin and kidneys. In hot weather large quantities of fluid escape from the body through the pores of the skin, while in cold weather the kidneys are more active and secrete a larger quantity of urine. Diuretics are made use of not only to increase the flow of urine but also the solid constituents 04 THE NEW MEDICAL WORLD. which it holds in solution. It is for this reason that diuretics are administered in gout; for they assist in carrying off the uric acid and the other waste products which clog uj> the system and produce dis- ease. They are much used to cany away the excess of fluids in drop- sical effusions. They are prescribed in rheumatism for the purpose of eliminating the lactic acid, which if retained in the blood in excess is thought by some to be a common cause of this disease. Diuretics are numerous and it will not be difficult to select a few suitable for domestic use. Some mineral waters, as the Bethesda, are given with excellent results as diuretics. An infusion of buchu or uva ursi leaves are serviceable diuretics and easily prepared as needed. The dose of the infusion is two or three tablespoonfuls. The following combination is much more efficient than one rem- edy alone : I£ Acetate of potash one ounce Ext. Buchu ff. one ounce Sweet spirits of nitre one-half ounce Syr. Tolu. two ounces Wintergreen water sufficient to make eight ounces. Mix. Dose, one or two dessertspoonfuls three times a day taken in water. The following is an efficient diuretic: Ijt Juniper berries two drams Cream of Tartar two drams Boiling water one-half pint Mix. Flavor with wintergreen and use as needed to increase the flow of urine. The granular effervescent citrate of potash is an excellent diuretic drink. Dose, a dessertspoonful in a glass of water and drink while effen esoing. In dropsical conditions, digitalis combined with caffeine are very efficient, but such remedies are not suitable for any but physicians to administer. Sudorifics. — These are medicines which stimulate the sweat glands and produce copious perspiration. The action ot sudorific THE NEW MEDICAL WORLD. 65 remedies is retarded by cold and favored by warmth ; and when such remedies are administered they will be assisted to produce their best results by bathing the feet or body in hot water, drinking hot drinks, covering the patient with blankets and by the application of hot poultices and artificial heat. Sweating medicines are made use of in domestic practice to break up colds. They are beneficial in the early stage of fevers, measles, scarlatina, pneumonia, pleurisy and other affections of the lungs and throat; also in dropsical affections. Hot sage or catnip tea, hot drops, pepper or composition tea will often promote profuse sweating without resort to more positive rem- edies. Opium is a valuable remedy to produce perspiration. The dose is one grain. Still better than opium alone is its combination with ipecac in the familiar and widely-used Dover's powder, the adult dose of which is from five to ten grains. Aconite is much used in the early stage of fevers and is especially valuable to produce sweating in children. Ten drops of the tincture of aconite can be added to two-thirds of a tumbler of water, one tea- spoonful of which can be given every half hour or hour till it thor- oughly 'moistens the skin, when it may be continued at longer inter- vals as needed to allay fever. Jaborandi is a popular remedy with physicians but is hardly a household medicine. The tincture of lobelia may be given in doses to adults of from ten to sixty drops every hour or two and will be found efficient if not too depressing for the patient. The following is a good prescription in the early stage of pneu- monia or other acute diseases, to favor sweating : 3 Tiq. ammonia acetate one ounce Tincture of aconite fifteen drops Syrup of ipecac two ounces Water sufficient to make four ounces Mix. Dose, one teaspoonful every two or four hours. The sweet spirits of nitre in doses of from one-half to one tea- spoonful is a valuable domestic remedy. Quinine in five to ten-grain doses lowers the temperature and pro- duces perspiration. If threatened with some acute disease, as pneu- monia or pleurisy, I should have more faith in this remedy to abort Ob THE NEW MEDICAL WORLD. it than in all the others. It would be necessary to make the dose large enough to produce a decided impression upon the system, and to take it in the first stage of the disease. Astringents. — These are medicinal substances which cause con- traction of the muscular fibers and soft tissues of the body. They have a puckering taste and coagulate albumen. They are used both internally and externally. There are two varieties of astringents, vegetable and mineral. The vegetable astringents owe their virtue to tannic or gallic acid. The mineral astringents as alum, sulphate of zinc and the sub-sulphate of iron are more styptic in their nature and the last is so powerful in its action that it not only contracts the tissues, but instantly coagulates the blood and can be used to arrest hemorrhages from the vessels of small caliber with considerable success. Astringent remedies are applied to the mucous membrane of the nose, throat, the eye, the bowels, the urethra, vagina and wherever there is inflammation, congestion and a relaxed or swollen condition of the mucous surfaces. Tea and coffee are somewhat astringent owing to the tannin that they contain. Persons not accustomed to their action will find the first use, especially of strong tea, attended with marked constipation. Ergot powerfully contracts unstriped muscular fibers and hence its ability to control hemorrhage by diminishing the caliber of the blood vessel. It will contract the uterus when it is in a relaxed eon iition. It has considerable power to relieve diarrhoea and hemorrhage of the bowels or lungs and also congestion of the brain. The sulphate of zinc is much used as an astringent in conjunctivi- tis, gonorrhoea and vaginitis. The subnitrate of bismuth is regarded as of great value in Bummer diarrhoea, especially in cholera infantum. Blackberry root is also a vegetable astringent which enjoys con- siderable reputation in diarrhoea. The infusion, fluid extract, syrup or wine, are all efficient. It may be prepared domestically and enough brandy added to the infusion to keep it. The brandy improves its medical action in weakened and relaxed conditions. Witch-hazel owes its popularity to its astringent action. It has some virtue iii the treatment of pile*, mild hemorrhages, varicose veins and ulcers and chronic throat atliections. Gallic acid is administered for internal hemorrhages. THE NEW MEDICAL WORLD. hi Nitrate of silver in suitable solutions is an astringent of great effi- ciency. In some eases of persistent diarrhoea, combined with opium, it has cured cases in the author's practice that have resisted every other method of treatment. It is not a domestic remedy. Tannin in some cases of painful hemorrhoids (piles) has been used in combination with cocaine and other remedies (in suppositories) with almost magical results. The list of astringents has only been touched upon here. They form a very large class of remedies; but those suggested are in common use and represent the whole class sufficiently for these pages. Astringents when taken internally should not be brought in con- tact with the stomach or food, just before eating or during the proc- ess of digestion, they should be taken in a pill or else well diluted. It may be noticed that some of the remedies mentioned, as the sul- phate of zinc and the sulphate of copper, act as emetics as well as astringents. Many other remedies possess properties which belong to two or more classes. Tonics. — Tonics are medicines which impart strength and energy to the system. They quicken the appetite, aid digestion, stimulate the various functions of the bodily organs, improve the quality and quantity of the blood and thus increase the strength and build up the general health. Tonics like other remedies have a wide range of action, some exerting their influence upon the blood, as iron, others upon the nerv- ous system as phosphorus and strychnia and others as the simple bit- ters upon the stomach. Tonics can be used but little in acute dis- eases or inflammatory conditions ; but for the most part they are appropriate in the debility which follows prolonged sickness and in chronic disorders. Tonics must be selected with reference to the particular condition :t is essential to reach and improve, but the dose must not be too laro-e as there is dangler of disarranging the digestion instead of strengthening it. Tonics designed to improve the apj)etite should be taken betore meals. Medicines designed to aid digestion, like pepsin, or to stimu- late the flow of gastric juice should be taken at meal time or directly after. The simple vegetable bitters which have the reputation of stimulating the appetite and improving digestion are represented by gentian, colombo, mix vomica, motherwort and boneset. 68 THE NEW MEDICAL WORLD. There is no single tonic equal to iron in a large number of cases especially where anaemia is marked. It improves the blood, adds to its richness and renders it able to carry to the cells which are elab- orating the tissues, the materials which are essential to growth or health. The slow recovery which is liable to follow fevers, pneu- monia and other severe sicknesses is often hastened by iron in some suitable form or combination. Salicin is of marked benefit in cases suffering from chronic rheu- matism. Cod liver oil is sometimes indicated in wasting diseases and in scrofula. It enriches the blood and aids in the reproduction of tis- sues ; hence the body shows that it is better nourished during its use. It combines the virtues of a food and medicine. It contains bro- mine, iodine, phosphorous and iron in small quantities in addition to a large amount of nutrition. Its use has been so extensive that it has often been prescribed where it was neither indicated nor tolerated and in this way it has sometimes been brought into disrepute. Not- withstanding all this there are cases, especially of wasting diseases, where it serves an admirable purpose. The following is an elegant emulsion : I£ Gum Tragacanth two drams Cold water one pint Oil sweet almond sixteen minims Cod live oil one pint The directions for combination must be observed. Place the trag- acanth in the water and let it remain for twenty-four hours, stir occa- sionally, then place it on the back of the stove, warm it a little and sweeten to taste with sugar, then add one pint of pure cod liver oil and mix thoroughly, adding the oil of sweet almond. If preferred the oil of peppermint, wintergreen or lemon may be used instead to flavor. Wild cherry bark is a good tonic. It possesses sedative proper- ties making it popular in coughs. Quinine enjoys the distinction of being a tonic- almost specific in malarial troubles, it is also indicated in enlarged spleen of malarial origin. Other tonics possess proper- tics of a stimulating character and will be noticed under the head of stimulants. Antispasmodics. — These are remedies which allay the excited condition of the nervous system as seen when the muscles are thrown THE NEW MEDICAL WORLD. 69 into a state of spasm or convulsion. They are very similar in their action to nervines. They quiet and soothe the nerves which are un- duly excited, relax the muscular condition and secure rest which is often the prelude to recovery. They are necessary in treating the convulsions of children, hys- teria, chorea, tetanus (lockjaw), and diseases of this class. Among the vegetable antispasmodics may be mentioned lobelia, camphor, valerian and assafoetida. Other remedies are ether, chloroform and chloral-hydrate. The latter remedy is elsewhere recommended for the convulsions of children and its method of use and administration will be found under that head. Assafoetida is an efficient remedy for hysteria. It is a safe medi- cine with disagreeable odor and taste and is usually prescribed in pills containing two or four grains. Stimulants. — Stimulants increase the heart force and are indi- cated in the condition known as shock. When a severe injury has produced a powerful and depressing effect upon the nervous system or where disease has been so prostrating as to cause a marked decline in the heart force and threaten failure in that vital organ, the condi- tion is similar to that known as shock and usually requires stimulants. Ammonia acts quickly in emergencies and in cases of fainting is often serviceable. Its inhalation is beneficial. It may be given inter- nally and in weak conditions it has been injected hypodermically. The carbonate of ammonia is a reliable stimulant of the lungs in pneumonia and other diseases where the lung capacity is greatly diminished. Alcoholic liquors are much used for their stimulating effect in cases of emergency and in some diseases which depress the vitality by the action of poison upon the nerve centers. Turpentine has considerable reputation as a diffusible stimulant, a carminative, a diuretic and anthelmintic. Digitalis stimulates the heart's action and in suitable cases is a rem- edy of decided value but it is in no sense a household remedy. Nitro-glycerine in doses of one one-hundredth of a grain exerts a powerful and almost instantaneous exhilaration of the heart's action. It can be obtained in tablets of the above dose. Sedatives.— These are medicines which lessen the heart's action as aconite, gelsemium, veratrum, tartar emetic and prussic acid. 70 THE NEW MEDICAL WOULD. They arc dangerous remedies except in small and suitable doses, and poisons winch cannot be trilled with. In fevers and acute inflam- mations they afford the prescriber some of his most valuable weapons for combating disease. When the pulse is rapid, strong, full or bounding, no remedies are administered with greater satisfaction and with more certain results. In the early fever stages, in pleurisy and pneumonia, aconite and veratrum are remedies of efficiency. Aconite has come to be so widely known and so generally recog- nized and employed as a domestic remedy that it is necessary to know when and how to administer it. It produces the best results in small doses. It lessens the frequency of the pulse, calms the excitement of the heart, relieves the circulation, relaxes the skin and produces moisture in febrile conditions. Veratrum is given in the same dose as aconite and by some is con- sidered preferable in the early stages of pneumonia and other inflam- matory conditions. It should not be used if the heart is weak or if the condition shows signs of depression and exhaustion. It may be as successfully used as aconite or any other powerful remedy. Put ten drops of the fluid extract or fifteen of the tincture in half a glass of water and give one teaspoonful every hour till the pulse rate declines near the normal. The leaves and bark of the peach tree contain a trace of prussic acid and are consequently sedative. One or two tablespoonfuls of the infusion are said to be serviceable in irritable stomach, with nau- sea and vomiting. Dilute prussic acid in small doses is often added to cough mixtures for its sedative effect. Gelsemium is a valuable sedative to the nervous system. It allays congestion of the brain and is especially serviceable in meningitis and is reported to have cured cases of lockjaw. It is a valuable remedy in neuralgia of the face, the pains of menstruation, also the after pains following labor. It is serviceable in inflammation of the Lungs and has been highly recommended in bilious and malarial fevers. Expectorants. — Expectorants are remedies which act on the mucous membrane lining the throat and bronchi and modify the character and quantity of the secretions. They are sometimes use- ful in acute and chronic bronchitis, but they should DOt be t<»<» long continued. Some of the more common ami efficient expectorants are the syrup of tolu, syrup of ipecac, syrup of squill, sanguinaria. chloral hydrate and miniate of ammonia. THE NEW MEDICAL WORLD. 71 Antipyretics. — Antipyretics are remedies which antagonize feb- rile conditions and lower the temperature. Acetanilide and phen- acetine are members of this class. The}^ may be safely given in five- grain doses if there are no signs of heart weakening. Alteratives. — Alteratives are medicines which affect the bodily nutrition, stimulate the secretions, aid elimination of waste products and cause improvement in the health. They are closely allied to tonics, stimulants and laxatives. An alterative remedy often pos- sesses the property of several other classes. Podophyllin acts favorably upon morbid conditions of the system, removing the effete materials and stimulating the secretions ; hence it is not only a cathartic but a powerful alterative. Yellow dock, burdock and bloodroot are among the most useful and efficient vegetable alteratives. The iodide of potash, lime and iron are often used with the most happy effect. The administration of such remedies cannot be recom- mended for domestic use except in some combination. The fol- lowing prescription is a reliable blood purifier and an efficient alter- ative. ]J Iodide of potash two drams Ext. sanguinaria, fl. one dram Ext. yellow dock, fl. one ounce Syr. sarsaparilla comp. one ounce Spirits gaultheria two drams Elix. cinchona q. s. to make four ounces Mix. Dose, one teaspoonful three times a day after meals. This may be given where the condition of the system requires thorough renovation. Antiseptics. — Antiseptics are remedies which prevent putrefaction. Some of the more commonly used are chlorine, creosote, carbolic acid, salicylic acid, boracic acid and corrosive sublimate. Escharotics. — Escharotics are applied locally to destroy some growth or unhealthy tissue. They are the strong acids, especially nitric, nitrate of silver, caustic potash, chromic acid and carbolic acid. 72 THE NBW MEDICAL WORLD. Anodynes. — These are used to relieve pain. At the head of the list stands opium and some of its alkaloids as morphia and codeina. Belladonna and its alkaloid atropia, especially where associated with opium or morphine, assist in relieving pain. Henbane and its alka- loid hyoscine are also included in this list. The alkaloid is given in d<»scs of one one-hundredth of a grain. Opium and its helpers ought not to be prescribed on every pretext of pain. Prescriptions con- taining them ought not to be repeated except by the advice and con- sent of the physician who first ordered them. Too little attention is given to the danger of the morphia habit. A resort to opium or morphine on every occasion is reprehensible; and yet at times their use is demanded and to withold such agents is unwise, but their use should be discontinued as soon as the condition of the patient will admit of it. In peritonitis there is no remedy which can take its place. It should be given in this fearful disease boldly and unspar- ingly till the danger is over. It has saved many lives. Properly used opium is one of the most valuable remedies known but it is not a remedy for domestic use, except perhaps in the form of paregoric, Dover's powder and Tully's powder. It requires much experience and skill to know when and how to use an agent so potent for good or for evil. Anodynes should be sparingly administered to children and only in minute doses as their nervous systems are powerfully impressed by this class of remedies. When a very sensitive stomach will not tolerate morphine from an eighth to a fourth of a grain inserted under the skin will produce speedy relief. Anaesthetics belong to this class. They are taken by inhalation and produce such a condition of unconsciousness that a tooth can be ex- tracted or a limb amputated without any feeling of pain whatever. Their discovery has accomplished much for the progress of surgery as well as for the amelioration of human suffering. Other minor classes of medicine as carminatives allay pain in the stomach and bowels from flatulency; anthelmintics destroy worms. These require mention merely as the remedies referred to are suffi- ciently mentioned in connection with the treatment of the various diseases in ..thcr sections of this work. Emmenagogues are remedies which favor the appearance of the monthly flow. THE NEAV MEDICAL WORLD. 73 Aphrodisiacs are remedies which stimulate the sexual organs and their functions. Infusions are generally made by pouring boiling water upon medici- nal substances, whether bark, leaves, roots or seeds and allowing it to cool. Then it is strained. An infusion should be made in small quantity and fresh as wanted as it does not keep well. Tinctures are prepared by soaking the medicinal substances in officinal or dilute alcohol. The dilute alcohol dissolves medicinal principles, which water will not, and its preservative Qualities are a great advantage. Syrups are simply medicated fluids added to a sugar solution. Many of the medicated syrups are useful in the preparation of pre- scriptions, some adding more to their flavor than to their virtue. Some medicines are best given in powder form but when they are very bitter or bad tasting they are better in the form of a pill, tablet or capsule, so that they can be swallowed without tasting. The preparation of medicines has become an extensive business and requires an acquaintance with a great variety of processes. Anyone wishing to give the subject thorough study should consult the United States Dispensatory or other books on the subject of phar- macy. Many medicinal substances like opium, contain several distinct alkaloids or active principles. The separation of these active prin- ciples from drugs as strychnia from mix vomica, atropia from bella- donna, quinia from cinchona and morphia from opium provides the physician with a list of efficient medicines in concentrated form always reliable in dose and action. This is a great benefit both to the patient and physician. It does away with the administration of large draughts of nauseating mixtures as well as with the doctor's saddle-bags. In the ordinary pocketcase containing only one or two dozen little bottles, can be stored more medicinal virtue at the pres- ent day than could be placed in the oldtime attic filled with herbs, roots, plants and barks from meadow and woodland. The following abbreviations commonly used will be found com venient : aq. stands for the Latin aqua and means water carb. " " " • " carbonas " " carbonate co. or comp. " " " " compositus " " compound cort. " " " " cortex " " bark 74 THE NEW MEDICAL WORLD. (HI. stands for the Lati n dilutus : and means dilute (list. u u LL LL distillatus a LL distilled emp. LL u LL LL emplastrum LL LL plaster ext. u ll LL LL extractum LL LL extract fort. a ll LL LL fortior LL LL stronger inf. a ll LL LL infnsum ((• LL infusion lin. u ll LL LL linimentum LL LL liniment lot. a ll LL LL lotio LL LL wash mist. a ll LL LL mistura LL LL mixture mur. a LL LL LL mnrias LL LL muriate nit. a LL LL LL nitras LL LL nitrate ol. a LL LL LL oleum LL LL oil pul. u LL LL LL pnlvis LL LL powder rad. ll LL LL LL radix LL LL root sol. a LL LL LL solutio LL LL solution spts. a LL LL LL spiritus LL LL spirits snlph. a LL LL LL sulphas LL LL sulphate snppos. a LL LL LL suppositorium LL LL suppository SVT. a LL LL LL syrapus LL LL syrup tr. or tine. « LL LL LL tinctura LL LL tincture ungt. (( LL LL LL unguentum LL LL ointment vin. u LL LL LL vinum LL LL wine The following are the more common abbreviations used in pre- scriptions : stands for the Greek ana and means of each a a ad LL LL LL Latin adde LL LL add chart LL LL LL LL chartula LL LL a small paper collyr. LL LL LL LL collyrium LL LL eve water 1). ' LL LL LL Greek dosis LL LL dose div. LL LL LL Latin divide LL LL divide fl. LL LL LL LL fluidum LL LL fluid ft LL LL LL LL fiat LL LL make M. LL LL LL LL misce LL LL mix pil. LL LL LL LL pilula LL LL pill q. s. LL It u LL quantum suth( •it u sufficient quantity Big. LL LL LL It signa and LL write ss LL LL It u semis LL LL one-half t. i. d. LL (( u l< ter in diem" LL three times a day gr. LL hi (( " granum LL (( a grain minimum " cc a minim scrupulum " cc a scruple drachma " cc a dram uncia " cc an ounce octarius " a a pint THE NEW MEDICAL WORLD. 75 gtt. stands for the Latin gutta and means a drop jq cc cc cc c< -p. a a cc (i T cc cc a (i Z « « " ' Q a u cc c< P} This sign is placed at the head and left hand of each prescrip- tion and means recipe or take, the remedies to be taken or used usually follow in Latin, taking the genitive termination, while the quantity if written out would take the accusative case. In practice a prescription is never fully written out; it is abbreviated and the directions are written in plain English. For the sake of ease in reading it has seemed best to discard in this work the use of Latin and symbols for the most part and use English words. one minim is equivalent to about two drops one dram " cc one teaspoonful two drams " cc one dessertspoonful four drams " cc one tablespoonful sixty minims make one ) dram wi •itten thus : 3f eight fluid drams a cc ounce cc cc oT sixteen fluid ounces cc a pint cc cc Or twenty grains cc cc scruple cc cc 3r three scruples cc cc dram cc cc 3i- eight drams cc cc ounce cc cc 3i~ sixty grains cc cc dram cc cc 3r four hundred and ei ghty grains cc cc ounce cc cc 3t A little time and study devoted to the above symbols will render them plain and well repay one interested in medical literature for the labor. Y. DOSES. The dose of any medicine is the average quantit} 7 , ascertained by experience as necessary to produce a desired result. No more of any medicine should be administered than the necessity of the case re- quires, nor should its use be needlessly prolonged. A powerful, dangerous remedy should not be chosen when a mild and harmless one will answer* just as well. Any remedy should be avoided which is liable to produce results more desperate than the condition for which it is to be administered. 70 THE NEW MEDICAL WORLD. Age is an important factor in regulating the dose of medicines. The chief difficulty in household prescribing is to determine the proper dose for the different ages. How much ought to be given to an infant or a child one or two years old ? In administering medicines, the dose for an adult is taken as the standard, and when a dose m recommended, unless otherwise specified, an adult dose is always to l»e understood: The following will he helpful in ascertaining the dose for different ages : An infant from one to three months old requires about ^ the adult dose, six months old -fa. Give a child one year old ^ of the adult dose. " " two years " 1 " " " " three " " i " " t< u four " u V u " '* t( t< ayv U U 1 U t( U u u twelve " " l " a person fourteen " " | " " M u " from eighteen to twenty nearly the full dose. After fifty reduce the dose J " seventy " " i " ninety " " \ There arc sonic exceptions to the above rules which should be borne in mind. Persons under size require a smaller dose than those over weight; those in a debilitated or feeble condition require a smaller dose than the robust and strong. Persons engaged in in- door work, or those of sedentary habits require a smaller dose than those engaged in manual Labor, ami who are exposed to the weather at all seasons. .Medicines should he prescribed tor feeble infants ami very old peo- ple with especial care. The nervous system of an infant is easily impressed, therefore opium or morphine, if given to very young children, should be in smaller doses than those indicated by the fore- going rules, ami such remedies ought not to he prescribed by inex- perienced persons. < >\\ ing to the sensitive condition of the mucous membrane in young children, emetics and cathartics act with proportionably greater energy than in tin- case of adults, so that the administration of such remedies should be cautious and guarded ; and the harsh and more irritating remedies should consequently he avoided. For domestic THE NEW MEDICAL "WOULD. 77 use choose those remedies which are simple and whose effects are well known. Many harmless medicines are the most efficient, and it is not necessary to be as particular in their administration. They can be given in much larger doses to children than indicated by the above rule. It is not necessary that a remedy should be expensive in order to be efficient. In using a remedy with which you are but little acquainted, choose the minimum dose ; this rule is imperative in the case of energetic and powerful drugs. Small doses, frequently repeated generally give better results than laro-e doses at longer intervals, except where vomiting is the object aimed at. A dose table for the more common remedies, and the diseases for which they are chiefly used, is here appended, while valuable medical combinations with full directions for their use, is to be found under the treatment of each disease. In addition to the following doses those remedies advised for household practice will each receive still further notice to render their use intelligent and successful. REMEDY. INDICATED FOR WHAT. DOSE. acid, carbolic vomiting 1 drop well diluted with water " " solution disinfectant wash q. s. " " ointment sores, burns, itching, etc. q. s. " hydriodic syrup asthma, hay fever 1 teaspoonf ul in water " phosphoric dil. exhaustion of brain 10 to 30 drops in water " salicylic rheumatism 5 to 10 grains " tannic piles in suppositories 2 to 3 grains acetanilid rheumatism to re- duce temperature 2 to 5 grains aconite tinct. fevers 1 to 2 drops in water " fl. ex. a £ to 1 drop in water alum pulverized croup, (emetic) 10 to 60 grains in water ammonia — carbonate pneumonia 5 to 10 grains " aromatic spir- its fainting | to 1 dram ammonia valerianate elixir hysteria 1 dram anise water colic 1 to 4 drams 78 THE NEW MEDICAL WORLD. REMEDY. anise oil arnica tinct. arsenic INDICATED FOR WHAT. colic bruises concussion of brain, cancers " sulphide skin affections atropia catarrh " with morphine severe pain belladonna tinct. bismuth subnitrate " subgallate blackberry root, tinct. wine or syrup buchu fluid extract burdock root — fl. ext. caffeine calcium sulphide camphor castor oil chalk mixture charcoal of wood pul- verize* 1 chloral hydrate chloroform scarlet fever and many other dis- eases diarrhoea stomach distress diarrhoea irritable bladder or gravel chronic skin diseases weak heart or dropsy abcesses, carbuncles and acnae chordee, after pains, cholera laxative and cathartic antacid, summer complaint flatulence convulsions, . sleep- lessness convulsions Dover's powder cold, to ease pain elaterium dropsy Epsom salts or sulphate of magnesia cathartic DOSE. 1 to 4 drops externally 5 to 20 drops inter- nally A to iro g rain li o g rain t£t> g rain tablets internally or hypodermically, y-^ gr. atropia and J- gr. morphia 1 to 3 drops 3 to 60 grains 5 to 10 grains one teaspoonful | to 1 dram L to 1 dram 1 to 5 grains i to 1 grain 1 to 5 grains 1 to 8 drams 1 to 8 drains 10 to 20 grains 5 to '20 grains 3 to 10 drops cau- tiously inhale- 1 5 to 10 grains j to J grain in pill 1 to 4 drains in water THE NEW MEDICAL WOULD. 79 REMEDY. ergot fl. ext. gentian tr. comp. grino-er tr. gold thread grindelia robusta fl. ext. henbane tr. " fl. ext. iodine ipecac, wine of " syrup of iron tr. chloride iron reduced lavender spts. comp. lactucarium syrup laudanum or opium tincture of lime water lobelia tinct. magnesia cit. granular effervescent menthol morphia niter, sweet spirits of nux vomica, tinct. " " ext. opium pepsin pure paregoric peppermint spts. phenacetin pink root, and senna fl. ext. podophyllin quinine rhubarb, syr. aromatic INDICATED FOR WHAT. DOSE. hemorrhage dyspepsia colic, dysentery sore mouth, wash asthma diseases of bladder mania enlarged glands cough, bronchitis expectorant, emetic anasmia, erysipelas blood tonic — in pill flatulence cough pain, enemeta antacid expectorant, antispas- modic laxative and cathartic neuralgia, burns pain diuretic, in fevers anaemia, dyspepsia and constipation u a cholera, peritonitis dyspepsia cough nausea, colic pain and rheumatism worms biliousness, constipa- tion malaria, fevers 1 to 20 grains laxative for children 1 to 4 drams 10 to 30 drops 1 to 2 drams 10 to 30 drops ^ to 20 grains £ to 1 dram 10 to 60 drops 2 to 10 drops externally 1 dram \ to 4 drams 5 to 20 drops \ to 2 grains \ to 2 drams 1 to 2 drams 10 to 30 drops 1 to 4 drams 10 to 60 drops 1 to 4 teaspoonfuls externally tV t0 I g rain \ to 1 dram 3 to 10 drops (pills) \ to | grain 1 grain 1 to 3 grains \ to 1 teaspoonful 20 to 30 drops 5 to 10 grains \ to 2 drams iV to \ gram 80 THE NEW MEDICAL WORLD. REMEDY. salol santonin soda bicarb, soda, bromide of squill, syrup of squill syrup comp. strychnia sulphonal Tally's powder wild cherry syr. INDICATED FOR WHAT. rheumatism worms antacid nervousness expectorant croup paralysis, alcoholism sleeplessness after pains, stomach ache or pain in bowels cough DOSE. 5 grains. 1 to 3 grains 5 to 60 grains 5 to 20 grains ^ to 1 dram 8 to 30 drops t* o t0 *V grain 5 grains 5 to 10 grains VI. 1 to '2 teaspoonfuls -HOUSEHOLD REMEDIES. It is unnecessary to have constantly on hand all the remedies mentioned in this book, some of them are rarely required and it is better to obtain them fresh as needed. There are a few remedies, however, which should be kept in every family to meet cases of emergency, especially if beyond the easy reach of a competent physician. This article follows the general description of medicines, and pro- poses to select from them a small list of those efficient remedies which arc appropriate for domestic use, tell you when they are indi- cated, and give all necessary instruction in regard to their action, so thai you can practically have the doctor with you to consult on all occasions. Household medicines should be kept together in some secure place, away from the reach of children, distinctly labeled with the name and dose. They should be kept tightly corked and excluded from the atmosphere as much as possible. It is a good plan to have the powerful remedies and poisions like aconite in round, two dram vials, and conspicuously labeled poison or caution. Liniments and external remedies, being used more freely, can be placed in square bottles, holding six ounces. A cough and diarrhiea mixture can be put in four ounce bottles. Some such plan, modified to meet the tastes and requirements of each family, will prove con- venient and satisfactory. This list might be easily extended, the chief difficulty being tO keep it within reasonable limits. These remedies arc not expensive, THE NEW MEDICAL WORLD. 81 yet often worth a hundred times more than they cost, if at hand as needed. They can be used by an intelligent adult person who will give attention to simple details and make use of good judgment. This list does not contain anything like all the good remedies, but what it contains are efficient to accomplish the purposes for which they are directed, in so far as it is possible with a list of domestic remedies. Experience and careful attention to the other portions of this work will enable you to add other remedies to the list, or in some cases to substitute, for those suggested, others better adapted to special cases. Tincture of Aconite Root. — This is an excellent and powerful remedy, to be used in the early febrile disturbances of children or adults. It moderates the heart's excitement, relieves the congestion of the blood-vessels, checks the process of inflammation, and can be used with the best results by any intelligent person. Its effects should be watched, for it should be given less often when the pulse has declined to its normal condition and when free perspiration has been produced. The dose is from one to five drops of the tincture in water. One drop every hour is usually sufficient to produce the characteristic results. For a child one year old, put five drops into one half glass of water, and of this mixture give one teaspoonful each hour or half hour, depending upon the urgency of the case, till sweating is pro- duced and the fever symptoms abate, when it may be continued at less frequent intervals or discontinued as indicated by the symptoms. Tincture of Belladonna. — This is a remedy much used and popu- lar among the people who prescribe somewhat for their own family. The tincture can be used in the same dose and manner as aconite. Belladonna renders good service in the collapse of cholera infantum. It increases the capillary circulation, and relieves congestion of the internal organs. It improves the depth and character of the respira- tion and hence is much emplo} T ed in inflammations of the lungs and air passages. It is used in asthma, whooping cough, catarrh with profuse secretions of mucous, in headache, in neuralgia, and noctur- nal incontinence of the urine in children. It flushes the face in full doses, dilates the pupils, causes dryness of the mouth and throat, and excites the nervous system.- Atropia is the best form of using this powerful remedy. It can be obtained in soluble tablets containing v - THE NEW MEDICAL WORLD. one one-hundredth of a grain, one of which is an adult dose. For a child one year old, one of these tablets can be dissolved in ten or twenty teaspoonfuls of water, of which one teaspoonful is a suffi- cient dose, given every one or two hours. It may also be alternated with aconite, with good results, in fevers and inflammations of the lungs and air passages, or pleurisy. It is made use of extensively in eye practice, also in connection with morphia' hypodermic-ally, to relieve sciatica and other severe neuralgias and cramps ; also colic, either bilious, intestinal, uterine or renal. Atropia is an efficient remedy for night sweats. Belladonna oint- ment is a valuable application to an inflamed breast. It is also used locally to check the secretion of milk. Alum. — Pulverized alum is a serviceable and safe emetic in case of croup. It would be well to keep it on hand if there are children in the family liable to attacks of this urgent disease. The dose is one teaspoonful in water, to be followed by free drinking of warm water. Ammonia. — It is known also as hartshorn, or smelling salts, and is a convenient stimulant for inhalation in cases of fainting. A small glass- stoppered bottle of strong aqua ammonia will answer as well. If used internally it must be well diluted. A teaspoonful in a half u'lass of water and given in teaspoonful doses every half hour would be appropriate in an emergency, requiring the use of a stimulant. A teaspoonful dose of the aromatic spirits, if at hand, would be prefer- able. Some care must be exercised in the inhalation of ammonia, otherwise it might injure the mouth and produce inflammation of the glottis. Tincture of Arnica. — This is much employed domestically as m remedy for bruises. In case of much soreness or pain equal parts of thi' tincture of arnica and the tincture of opium form a valuable external application. It maybe applied freely, as needed, on a piece of clean muslin. Spirits of Camphor. — There are but few households probably where camphor is not included among the domestic remedies. It is a sort of habit to have a camphor bottle, even when no attempt is made to keep any medical supplies. A few drops will often relieve hysterical vomiting; it is also serviceable in flatulence. The dose is eight t«» twenty drops, well diluted with water. Camphor is service- THE NEW MEDICAL WORLD. 83 able in summer diarrhoea, but as it enters into the composition of Tully's powder, which is given later, it requires no further mention here. Camphor Liniment. — (Camphorated oil.) — This is camphor gum, dissolved in sweet oil. It is an excellent emollient for many purposes. In pleurisy or inflammation of the lungs it can be used externally on flannel, or added to a flaxseed poultice just before applying it. It is somewhat warming and stimulating, it keeps the poultice warm and soft, and is a reliable and safe remedy. It is excellent to apply ex- ternally to all glandular swellings, such as appear in the neck in diphtheria and scarlet fever. It may be applied to bubo swellings in the groins and any acute glandular enlargements. It penetrates such indurations, softens them, relieves the congestion and inflamma- tion and often prevents suppuration. Camphor Liniment Compound. — This is composed of camphor liniment three parts and chloroform one part. This mixture has been prescribed and used for years by the author with the most happy effects. It makes a clear mixture and does not, like most liniments, separate. It is a liniment of great efliciency to apply to painful joints in gout and rheumatism, to painful swellings, sprains or wmerever a soothing application is needed. Castor Oil. — This isa valuable laxative for children, and it can be used with safety in the early stages of all diseases when there is inaction of the bowels. A small teaspoonful for a child is the proper dose. It is used in cholera infantum, combined with the tincture of opium or paregoric with happy results. (See cholera infantum.) The following elegant and palatable prescription may be used for giving castor oil : $ Castor oil two ounces Saccharin two grains Syr. acaciae half an ounce Syr. of liquorice half an ounce Wintergreen water one ounce Mix. Shake before using. Dose, one to four teaspoonfuls as needed. Tincture or Essence of Jamaica Ginger. — This is a good domestic remedy for colic in the bowels, or cramps in the stomach ; *4 I Hi: NEW MEDICAL WORLD. also diarrhoea with griping pains. The dose is ten to thirty drops or more in hot water. A teaspoonful of paregoric may be added for an adult and Increases its efficiency in all the range of its employment. Tincture of Iodine. — This is an excellent remedy for application to corns, bunions and chronic swellings of the glands or joints. It may be painted over such enlargements once or twice a day. It favors the absorption of chronic swellings. , Ipecac. The Syrup of. — This is a convenient emetic and expec- torant. It is given in colds, croup, coughs, or bronchitis in minute ilnscs and for vomiting. The dose is from one half to two teaspoon- fuls, repeated as necessary. The larger dose is for emetic purposes. It is a perfectly safe remedy. Menthol Liniment. — This is a very efficient remedy for head- ache, neuralgia, and superficial pains. The formula is as follow- : 1£ Menthol one dram Alcohol two ounce- Oil of clove twenty minims Oil of cinnamon twenty minims Mix. This is to be applied externally as needed. Pills. For a safe and efficient pill see formula under constipation. Podophyllin. — This remedy in little granules or parvules. contain- ing one-twentieth of a grain, is an excellent cathartic for children ; one or more can be given at night, or night and morning, as required. Quinine. — This is a remedy that ought to be kept on hand* in malarial regions. The dose is from one to five grains in pills or powders. It is often given in much larger doses. It should be taken in connection with the podophyllin parvules, if the liver is inactive. (For formula see Malaria.) Syrup of Squill Compound. — (Hive Syrup.) — There is no better household remedy for sudden attacks of croup. It should be used with caution, as it is somewhat depressing in its action. It may be given with excellent results in acute colds, bronchitis and croup. It may be given in small and often repeated doses, or it" it is desired to hasten vomiting, increase the dose till such result is obtained. As THE NEW MEDICAL WORLD. 85 soon as it has caused vomiting the dose, if continued, should be con- siderably reduced. The dose is eight to twenty droj>s. It should be given to feeble infants cautiously. A few other remedies are handy in case of emergency. The Oil of Clove. — A dram of oil of clove is a convenient remedy to have on hand in case toothache should occur suddenly at night. A piece of cotton saturated with the oil and placed in the cavity of a tooth affords temporary relief. Creosote is more efficient, but is a less safe remedv to use, and if handled carelesslv burns the lining: of the mouth and the skin. The two remedies may be combined. A prescription for toothache is found under that head. Lime Water and Sweet Oil. — Have a four ounce bottle of equal parts of lime water and sweet oil on hand to apply to burns and scalds. It is an efficient remedy and affords marked relief from pain. The old name for this remedy is Carron oil. Carbolized Ointment. — Prepare this useful ointment by adding ten drops of strong, pure carbolic acid to an ounce of vaseline ; if you wish a stronger ointment twenty drops may be added to an ounce of the vaseline. This makes an inexpensive domestic oint- ment which may be applied to burns, chapped hands, cracked lips, cold sores, itching of the skin and to other abrasions and sores as they occur. Ground Mustard. — This is an excellent domestic remedy. Do not allow yourself to be without it in the family. A teaspoonful, mixed with lukewarm water and taken, will produce speedy vomiting arid often perhaps relieve a person choked with a chunk of meat or piece of bone or other substance. Ground mustard is excellent to add to a foot-bath in case a person has been much exposed and has had wet feet during the day. Cloths wrung out of hot mustard water are excellent to apply to the surface in case of pain, vomiting or to stimulate the skin and bring out the rash of scarlet fever. It is useful in convulsions. A mustard poultice is a well-known and much-used counter-irritant. It is used to allay vomiting, applied over the stomach. It is serviceable in the first stages of pneumonia, pleurisy and to relieve many conditions of internal congestion and deep-seated pain. It will often relieve lumbago. The strength of a mustard poultice 86 THE NEW MEDICAL WORLD. can be reduced by mixing it in any desired proportion with flour; and it can be prevented from blistering bv mixing with the white of an egg. A mustard poultice is much improved by adding to it a tea- spoonful or more of sweet oil. For small children the strength of a mustard poultice should be considerably reduced as the skin is very sensitive. Hot Water. — This has many uses both externally and internally. It has a large range of uses in the household. Taken internally it often relieves pain in the stomach, vomiting and dyspepsia. It can be safely used in fevers if it has been previously boiled, and in the chill stage of many diseases. It is useful for injections to allay hem- orrhages ; it must be used as hot as it can be borne for that. It relieves congestions and inflammations. A hot foot-bath often re- lieves slight congestion of the brain by drawing the blood away from the upper extremities to the general circulation. It is an ex- cellent dressing for slight wounds, sprains, bruises and the attendant pain. It should be used in the form of a hot pack, wrapped outside with flannel or oiled silk. Xotwithstanding the numerous valuable prescriptions contained in this work, the following for cough and another for diarrhoea will not bo out of place to complete this list of domestic medicines. COUGH MIXTURE. 3 Muriate of ammonia two drams Muriate of morphia or codeina two grains Spts. of chloroform two drams Syr. of wild cherry two ounces Anise water enough to make four ounces Mix. Dose, one teaspoontul, and repeat in four hours as needed: DIARRHOEA MIXTURE. $ Tincture deodorized opium sixteen drops Subnitrate of bismuth two drams Syrup of blackberry root one ounce Cinnamon water two ounces Mix. Dose, a teaspoonful every two or four hours. THE NEW MEDICAL WORLD. v , This list of remedies, recommended for household use. contains about twenty medicines and ought not with the prescriptions 1 cough and diarrhoea to cost more than two or three dollar-. Tully's Powder or Paregoric. — For stomach ache so common amonor small children it might he well to add Tully's powder. The adult dose is ten grains, for an infant under a year old one-half a grain is a sufficient dose. If preferred a few drops of paregoric can be used instead but the common and constant use of paregoric or soothing syrup to quiet cross children and keep them sleeping to avoid a racket is reprehensible. In sickness attended by pain it is admissible but in health it is injurious. CHAPTER IV. POISONS AND THEIR ANTIDOTES. 1. Poisons in General. — II. The Mineral Acids. — III. Ox- alic Acid. — IV. Carbolic Acid and Creosote. — V. Acet- ic Acid. — VI. Ammonia. — VII. Prussic or Hydrocyanic Acid. — VIII. Arsenic and its Preparations. — IX. Cop- per, Mercury and Zinc Compounds. — X. Tartar Emetk . XI. Lead Compounds. — XII. Xitrate of Silver. — XIII. Phosphorus. — XIV. Opium and Morphine. — XV. Chlo- ral Hydrate. — XVI. Strychnia. — XVII. Aconite and Vegetable Poisons. — XVIII. Poison Ivy. — XIX. Poison Gases. I.—POISONS IN GENERAL. IT is somewhat difficult to give a satisfactory definition of poisons because there are so many vegetable, mineral and animal suii- Stances which come under this head and because there are so many substances, like the chloride of sodium, (common salt,) which are poisonous in large doses and yet harmless or essential to life in small quantities. There are some substances which are poisonous only when sepa- rated from the inert material by which they are diluted. Oxygen, which is always essential to the maintenance of life is poisonous when separated from the nitrogen which dilutes it sufficiently for breathing purposes. A person inhales enough carbonic acid dur- ing twenty-four hours to destroy life if breathed alone by itself. Some of the properties of plants are harmless in their natural com- binations but when their medicinal virtues are concentrated or their active principles separated they may act as violent poison-.. The common sorrel and pieplant contain oxalic acid; and the leaf and bark of the cherry and peach trees, also the pit of the latter, contain prussic acid, a most deadly poison. The active principle of aconite, known as the alkaloid aconitia i> •i fatal poison in the dose of one-twentieth of a grain, the medicinal THE NEW MEDICAL WORLD. 89 dose being from one two-hundredth to one four-hundredth of a grain. Some substances are poisonous simply because their strength is concentrated but when sufficiently diluted are harmless. Muriatic acid is a powerful common poison, burning and destroying the tissues, yet in diluted form it is a useful medicine and it is also a constituent of the normal gastric juice. Phosphorus is an energetic poison but its compounds exist in many articles of our daily food and it is essential to the growth of the bod- ily tissues, the bones containing it in large quantities. We shall simply regard poisons as those substances which destroy life, without attempting a comprehensive definition. There are three classes of poisons, mineral, vegetable and animal. Some of the most active as prussic acid, strychnia, aconite, hyoscine and many others are obtained from the vegetable kingdom. Poisons usually act upon the system in one of two ways ; chemically or physiologically. By the first method they unite with the fluids of the body with which they come in contact and corrode a layer of the tissue leaving it as if charred; the vitality is destroyed as deeply as the corrosive substance can penetrate and there is superficial death of the corroded layer. By the second method the poison is absorbed, enters the circulation and produces some definite condition or physi- ological result. The strong mineral acids are poisonous by means of their corrosive action. They produce death of the soft tissues to which they are applied. Opium illustrates the action of the second method. It does not act chemically. It has no power to destroy the life of a tissue but it is absorbed into the system and in poisonous doses stupefies the brain and certain nerves whose action is essential to the process of respiration and the continuation of life. The processes of life become fainter and fainter, the breathing takes place at unusually long intervals until it ceases altogether and the whole machinery stops. There are several ways by which poisons may enter the system, the most common method is by being taken into the mouth and stomach. Some poisons exist in the form of vapor and gas and enter the sys- tem by being inhaled. The vapor of prussic acid cannot be safely inhaled ; even the smallest amount is not without great danger. It produces fatal results almost instantly and where a case of poisoning occurs from this powerful agent the physician rarely has an oppor- tunity to reach the victim before death has occurred. 90 THE NEW MEDICAL WORLD. Some poisons are occasionally introduced into the system through an abrasion in the skin, or a wound, or it may be injected into the cellular tissue beneath the skin. The poisons of rabid animals and serpents are introduced by means of a wound or bite. Some poisons reach the system simply by contact with the skin. Poison ivy acts in this way. Lead is absorbed into the system from hair-dyes and mercury from cosmetics. Cases of belladonna poisoning have occurred from its extensive application externally in the form of plasters. ANTIDOTES. Antidotes are substances which antagonize the action of poisons and render them more or less harmless. Some of the antidotes for the mineral acids are alkalies which neutralize their action by con- tact. Other poisons are antagonized by physiological antidotes. These set up an action in the system which is opposed to the action of the poison and thus its effect is counteracted until nature can eliminate it. There are some general principles to be observed in treating those who have taken poisons. It is necessary in the first place to get rid of the poison as soon as possible. Nature often accomplishes this end by means of vomiting and thus irritating poisons are often expelled. The process of vom- iting is favored by the abundant administration of lukewarm water. [f the poisonous substance does not itself produce vomiting, admin- ister an emetic. The sulphate of zinc is an excellent emetic in doses of from five to twenty grains. It is rapid in its action and it does not produce depressing effects like many other emetics. Ipecac, either the syrup or teaspoonful doses of the fluid extract, stands sec- ond on the list, or from fifteen to thirty grains of the powder may be Stirred into warm water and drank freely. Ipecac can be taken in considerable quantity as it does no injury and the dose can be fre- quently repeated till it acts. When these cannot be obtained do not wait tor their arrival but use ground mustard, a teaspoonful or more in warm water and repeat frequently. Common salt may be used in uarin water. Vomiting is hastened by tickling the throat or fames with the finger or a feather, also by the copious administration of lukewarm water. In the hands of a physician apomorphinc may be used tO cause vomiting. It is a certain emetic. The dose \s from one-tenth t<> one-twentieth of a grain injected under the skin. THE NEW MEDICAL WORLD. 91 Poison introduced by the bite of a rabid dog requires energetic treatment (see hydrophobia) ; the wound should be speedily and thoroughly cauterized. It is customary to recommend sucking a poison wound immediately. This can be done without danger if there is no abrasion about the mouth to favor the absorption of the poison and if the wound is not extensive. It is seldom that all the poison taken can be expelled by vomiting hence other measures are made use of, as the administration of an antidote. There is no universal antidote for all poisons, but the special antidote to be used in each case will be mentioned in connec- tion with each particular poison or group of poisons. Antidotes should be such remedies as can be freely administered without further danger. They should act quickly and be able to counteract the danger which arises from the use of the poison. It often happens that too much time has elapsed between the taking of a poison and the administration of an emetic or an antidote. The poison which has been absorbed and sent all over the system cannot be expelled by vomiting, and antidotes in these cases will not always avail. In many instances it is necessary to combat the unfavorable symp- toms which arise by stimulants, or remedies which produce upon the system the opposite effects of the poison. When poisons suspend the act of respiration artificial respiration performed for a certain time as indicated is sometimes sufficient to avert death. Life some- times trembles in the balance and a little prompt action is often the means of changing the result from death to life. II.— THE MINERAL ACIDS. Bicarbonate of soda Sulphuric acid Muriatic acid , TV . . , > Antidotes .Nitric acid f Chalk Magnesia Nitromuriatic acid J [ and other alkalies In poisoning from the mineral acids vomiting will not avail. It is necessary to neutralize the acids with alkalies ; prompt action is es- sential. In case cooking soda is not at hand make a solution of soap by shaving it up, mixing it with warm water and administer quickly. After the copious use of the. antidotes give milk, olive oil, mucilage or whites of eggs. These substances can be mixed with the anti- dotes and given together. 9*J THE NEW MEDICAL WORLD. For acid in the eye use a wash of common baking soda (bicarbon- ate of soda) and then use oil to allay the irritation. These acids taken into the stomach are corrosive and produce inflammatory conditions of the alimentary canal of a severe type. (Treat pain in the mouth and distress in the stomach are experienced. It is difficult to administer the antidotes quickly enough to prevent serious results. III.—OXALIC ACID. Chalk Antidotes { T . , Lime Magnesia Occasional poisoning from oxalic acid has occurred on account of its great resemblance to Epsom salts. Druggists have in occasional instances sold oxalic acid by mistake for Epsom salts. The tastes of the two drugs are different. Oxalic acid has a sour taste and the well-known saline purge is extremely bitter ; but many times a dose of salts is mixed with water and swallowed too quickly to recognize the difference even when a mistake has been made. It is a violent poison and produces the following symptoms : Great anxiety, ex- treme pain, great thirst, swollen tongue, violent efforts to vomit, marked debility and prostration. The mouth and throat appear as if scalded, and the mucous lining of the stomach is more or less in- jured or destroyed by a fatal dose. The antidote must be used with haste. Chalk or magnesia mixed with milk or water, should be drank freely. Vomiting may be encouraged by drinking a teaspoonful of mustard mixed with warm water. Also tickle the throat with the finger or a feather. In case no other remedy is at hand, take lime from the walls of the house, crumble it into water and drink it. Stimulants are necessary to combat the depression of the vital forces. The much used pie plant contains oxalic acid, and children are sometimes made sick by its extensive use in the spring when it grows abundantly. [V.— CARBOLIC ACID AXD CREOSOTE. . . , ( Olive oil or whites of eixurs. Antidotes. \ Be ( Sacoharate or lime (lime and sugar). [f strong carbolic acid or creosote is taken internally, it acts as an irritant and corrosive poison. A teaspoonful has been known to THE NEW MEDICAL AV0RLD. 93 produce fatal results. Olive oil should be freely used. The saccha- rate of lime is the best antidote, but not likely to be at hand. Mus- tard and warm water should also be given to provoke vomiting. Obtain the saccharate of lime, if possible, and give it in solution. A dose of Epsom salts should be given, and hot applications and stimu- lants as demanded. The symptoms are violent vomiting and purg- ing, burning pain in the stomach and bowels, a pinched look, weak pulse, difficult breathing and collapse. V.— ACETIC ACID, OR STRONG VINEGAR. Antidotes. " Baking soda Lime water Carbonate of magnesia. Soap water. After neutralizing the acid, administer olive oil, flaxseed tea or mucilaginous drinks. VL_AMMONIA. QUICK LIME. Lye of wood ashes. Caustic potash or soda. . _, ( Vinegar Antidotes, u . . ( Lemon juice. When ammonia has been taken by mistake it produces irritation and caustic action upon the mucous membrane. Give diluted vinegar, olive oil, and milk. VIL— PRUSSIC ACID, OR HYDROCYANIC ACID. CYANIDE OF POTASH. Antidote. — There is no chemical antidote. Ammonia or chlorine are recommended. This is the most potent and speedily fatal of all the poisons, acting almost instantly in many cases. The symptoms of poisoning by prussic acid are loss of sense, diffi- cult breathing, coldness of the extremities, weak pulse and convul- 9-4 THE NEW MEDICAL WORLD. sions. The poison is absorbed with great rapidity and the victim often drops dead with a gasp. If life continues for twenty or thirty minutes it is to be regarded as a favorable sign. Peach pits, bitter almond oil, cherry laurel water and some other .table substances, as peach tree leaves and wild cherry, contain prassic acid. Twenty peach pits have been known to fatally poison a child, eaten upon an empty stomach. The treatment indicated i> the best that can be used for this class of poisons. Throw cold water on the face, use inhalations of ammonia, also give ammonia internally; see that it is properly diluted : use friction over the chest and abdomen ; keep up the respiration by artificial means ; apply warmth. Moisten chloride of lime to liberate the chlorine, and cause the gas to be inhaled. Atropia, hvpodermically, would no doubt prove beneficial, as it increases the respiration. A physician rarely has the opportunity to treat a case of poisoning by this assent, so speedily fatal is its action. Other remedies could be suucrested by a medical man, as the sulphate of iron, but those sug- gested above are the most practical, and the easiest to obtain in haste, which is a good point in the treatment. VIII.— ARSEXIC AND ITS PREPARATIONS. Antidote. — The hydrated sesqui-oxide of iron with magnesia. Arsenic in large doses usually excites vomiting. This action is to be favored by the administration of ground mustard mixed with warm water. Also tickle the throat with the finger. The stom- ach should be washed out by the stomach pump. Dialvzed iron, a fluid and somewhat feeble preparation, may be used as an an- tidote t<» arsenic in doses of from fifteen to thirty minims. The usual antidote to arsenic is the hydrated sesqui-oxide of iron, and it is pre- pared thus : Take a pint of the muriate tincture of iron, add to it ammonia or magnesia to precipitate the iron ; strain off the liquid through a mus- lin and wash out all the ammonia; this leaves a sediment like iron rust, which is harmless and can be administered freely. This antidote may be administered with magnesia, which is also an anti- dote. The symptoms of arsenical poisoning are violent gastritis, with vomiting and purging, cramps, great pain in the stomach and abdo- men. The bowels art' denuded of the nnicous membrane, which THE NEW MEDICAL WORLD. 95 passes off in shreds. To meet these conditions, opium should be given to alia}' pain and vomiting, or still better, morphia, hypoder- mically. Milk, olive oil and the whites of eggs should be taken in- ternally. Fluids should be freely used to enable the kidneys to eliminate the remaining poison. Death may occur from arsenic several days or even weeks after the poison has been taken and when there appears to be promise of complete recovery. IX.— COPPER, MERCURY AND ZINC COMPOUNDS. The more common of these poisons and their names are : Blue vitriol, verdigris, corrosive sublimate, vermilion, the white and red precipitate, and white vitriol. These poisons coagulate albumen and enter into combination with it. Therefore give the whites of eggs freely, then warm mustard water to excite vomiting. After free vomiting, give the whites of eggs and milk, also olive oil, and apply mustard poultice over the stomach to relieve the gastic symptoms. Copj>er salts in poisonous quantity cause violent, burning pain in the stomach, and metallic taste in the mouth, the vomiting of glairy mucous, great exhaustion, and also convulsions. Corrosive sublimate in overdoses causes violent pain, vomiting of mucous and blood, metallic taste in the mouth, and an eroded condition of the mucous lining of the mouth, purging of mucous and blood, collapse and death. X.— TARTAR EMETIC. ALSO KNOWN AS TARTAEIZED ANTIMONY. Antidote. — Tannin in large doses. As tea and coffee contain tannin, strong infusions of either may be used instead, unless the symptoms are severe. Warm water freely taken will render the process of vomiting more tolerable, also extreme heat should be applied, stimulants, and perhaps morphine, hypoder- mically. The symptoms of antimony poisoning are violent vomiting of mucous, fluids, bile and blood, also violent purging. Later the rice water stools appear, very similar to those in Asiatic cholera. The pulse is rapid, feeble and flickering. The respirations are faint, 96 THE NEW MEDICAL WORLD. fluttering and shallow. The temperature falls if death approaches, and cramps in the legs attack the patient on account of the removal of liquids from the tissues. XI.— LEAD COMPOUNDS. SUGAR OF LEAD, WHITE LEAD, LITHARGE. Antidote. — Epsom salts (sulphate of magnesia.) Give an ounce of Epsom salts dissolved in water. But first pro- mote vomiting by giving ten to fifteen grains of sulphate of zinc dis- solved in water, or mustard water. Hot applications should be applied to the feet and hands, and the pain and irritation relieved by doses of opium. Milk and eggs are serviceable and soothing. The symptoms of lead poisoning are obstinate constipation, pain in the stomach, vomiting, rapid pulse, anxious face, thirst, cramps and muscular twitching. XII.— XITRATE OF SILVER. Antidote. — Common Salt (Chloride of Sodium). Common salt solution neutralizes the action of this poison. The whites of eggs and mucilaginous drinks or olive oil should be given, after vomiting has been provoked by warm mustard water. The symptoms are pain in the abdomen with vomiting and purging. The face is anxious and covered with perspiration. The lips are stained brown or black and convulsions may occur. xiii.— phosphorus. There is no certain antidote for this poison. It should first of all be removed from the stomach by vomiting and other available means. Kinetics of mustard and warm water or ipecac should be adminis- tered. Vomiting should be followed by giving calcined or carbonate of magnesia or cooking soda, .Mix a teaspoonful of either with water or gruel and give as soon as vomiting has taken place. Nothing containing oil or fat is admissible in phosphorous poisoning. It is to be remembered that oils are serviceable in every other kind of poi- soning, especially when the tissues are corroded, but as oil favors the absorption of phosphorus it should never be given after ac- cidental poisoning by this agent, Turpentine formerly regarded as an antidote is no longer used. THE NEW MEDICAL WORLD. 97 The symptoms of poisoning by phorpkorus are so violent that it is never taken intentionally for suicidal purposes but only by acci- dent. The symptoms are violent pain in the stomach, vomiting, di- arrhoea, great distress in the stomach and bowels, and convulsions with the approach of death. Care should be taken in every family to keep matches out of the way of children. A phosphorous paste is used for the destruc- tion of rats. Such active agents should be used if at all with espe- cial caution. XIV.— OPIUM AND MORPHINE. The first indication is the removal of the poison from the stom- ach. Give twenty grains of the sulphate of zinc or strong mustard water to provoke free vomiting. Prevent the patient from going to sleep. Give ammonia by inhalation and keep the patient aroused by dashing cold water on the face or making the patient walk to and fro. Flagellations are sometimes employed. Administer tannin or strong coffee and in extreme cases resort to artificial respiration. One one-hundredth of a grain of atropia should be given hypoder- mically. Stimulants may be necessary. Efforts should not be re- laxed until the patient is out of danger or so long as life continues. The symptoms are drowsiness, deep sleep, slow pulse and con- tracted pupil. In the worst cases the face becomes pale, the respira- tions decrease sometimes to four or five a minute, the breathing becomes very shallow and in fatal cases the patient becomes so deeply narcotized that no effort can arouse him from this condition. Death results from the failure of respiration. The tincture of opium (laudanum) is often used with suicidal intent. Soothing syrups have sometimes destroyed the lives of chil- dren by means of the large amount of opium or morphine which they contain. Carelessness in constantly repeating prescriptions contain- ing opium is to be observed by watching the drug business and is censurable. XV.— CHLORAL HYDRATE. Promote vomiting by the administration of warm mustard water or fifteen to twenty grains of the sulphate of zinc dissolved in water. Give strong tea and coffee. Artificial respiration must be employed if necessary. Stimulants with the exception of ammonia are indi- cated. '» v THE NEW MEDICAL WORLD. Strychnine should be given to stimulate the respiration ; one-for- tieth to one-twentieth of a grain will be needed in these cases, or atropia may be used for the same purpose in doses of one-ninetieth of a grain. The symptoms of poisoning which develop from a fatal dose are sleep followed by coma, the respiration becoming slow and labored and gradually getting shallow and feeble. The pulse becomes thready, Hiekering and at length ceases at the wrist. The face is pale, the body is covered with a cold sweat and the pupils are widely dilated. The whole muscular system is in a state of marked relaxation and sometimes no effort succeeds in arousing the patient. XVI.— STRYCHNIA. (The alkaloid of mix vomica.) In treating strychnia poisoning nitrite of amyl is an excellent rem- edy to control convulsions. Three or four drops as needed may be placed upon a handkerchief and inhaled. Excite vomiting by means of strong mustard water and tickling the throat. Give tannin in water. This is a chemical antidote. After the stomach has been emptied by vomiting give bromide of potash, thirty grains and chloral hydrate, fifteen grains, in water sweetened to taste. Chloroform may be inhaled to relax muscular spasms. If relaxation does not occur the injection of nitrite of amyl hypodermically should be tried. The symptoms of strychnia poisoning are convulsions. The contractions of the muscles are attended by pain and the patient dies from spasm of the chest muscles which prevents respiration. XVII.— ACONITE AND VEGETABLE POISONS. There is still a large list of vegetable poisons, but as they are rarely used with suicidal intent, and not as likely to be used acci- dentally as those already mentioned, it will be unnecessary to describe each one by itself. Aconite well represents this class. When any vegetable poison has been taken, exeite vomiting as quickly as possible, then give milk, or strong coffee, also stimulants, if necessary. XVIII.— POISON IVY. Poisoning by this agent needs to be noticed because of its preva- lence. Ivy is a climbing plant, very common in hay Melds, and about THE NEW MEDICAL WORLD. 99 old walls and fences. Some are more severely affected by coming in contact with it than others. It produces a fiery inflammation of the skin, characterized by itching, redness and the formation of vesicles. It should be treated with soothing lotions, as equal parts of lime water and sweet oil, or a solution of bicarbonate of soda, or either of the following : I£ Hyposulphite of soda one ounce Carbolic acid one and a half dram& Glycerine two ounces Water enough to make eight ounces Mix. Apply upon cloths and repeat frequently. 3 Benzoinal four ounces Carbolic acid one dram Cocaine thirty grains Mix. Apply as needed. There are a number of occupations which, if long continued, result in a chronic condition of poisoning ; the most common among which are those occupations which require the use of phosphorus, lead and mercury. Those who work in match factories, thermometer manufactories, paint shops and similar places, should exercise all the more generally known precautions, and abandon the occupation for one more health- ful if symptoms of poisoning appear. Poisoning of chronic form has occurred from the use of cosmetics^ hair dyes and fabrics colored by the arsenical pigments. Lead, mercury and arsenic are the three poisons which are most used in a great variety of ways, and concerning which it is necessary to be on guard. Most of the hair dyes contain lead and are danger- ous to apply to the scalp ; and much ill health and some cases of lead palsy have resulted from their use. The best way to escape the dangers that lie concealed in prepara- tions for the hair and complexion is to avoid them. In the long run, cosmetics injure and destroy the complexion more than they beautify it. There is really no sufficient excuse for the use of such prepara- tions as involve the risk of poisoning. 100 THE .NEW MEDICAL WOULD. XIX.— POISON GASES, Gases with few exceptions have a poisonous action when breathed into the lungs or inhaled. The severity of the condition manifested usually depends upon the concentration of the gas and the length of time it has been inhaled. If sufficiently mixed with atmospheric air no evil consequences except headache, vertigo, pallor and nausea may be experienced. Danger attends the burning of coal and charcoal when used foi fuel in rooms unventilated and having no chimney exit ; for death lias frequently resulted from the gas escaping from these substances under these circumstances. Sewer gas has caused death when its inhalation has been pro- longed as in the case of workmen engaged in the construction of the Thames tunnel. Illuminating gas being made from coal is quickly poisonous when inhaled in concentrated form. If well mixed with atmospheric air its action is less speedy and fatal. The gas fixtures in houses should be so constructed as to preclude any possible danger from escaping gas. Gas has a peculiar and offensive odor, easily recognized when a person first enters a room, going from the outside air ; but the gradual escape of gas into a room may be unperceived by the occupant, and more especially if sleeping. Persons, unaccustomed to the use of gas, visiting a large city for the first time have sometimes lost their lives by blowing out the flame instead of turning it off. When gas escapes into the atmosphere of a room it forms with the aii- an explosive mixture ; hence when a strong smell of gas is perceived in any room no lighted flame should be introduced until the main supply has been turned off and the room ventilated. TREATMENT. When a person has been overcome by gases, whether illuminating, coal, or charcoal the in- creased amount of friction developed. Alcohol increases the speed of that human machine, the heart caus- ing strain and overwork of that organ, also congestion of the blood vessels of the various organs of the body and hence is detrimental •>nd dangerous to the healthy man. THE NEW MEDICAL WOK LI). 103 Alcohol itself like many other things used medicinally, may be re- garded as an active poison, for fatal cases sometimes occur among children who accidentally find and drink it. It may produce such severe inflammation of the stomach or such violent congestion of the brain or such abnormal disturbances of natural processes as to cause death on the part of those unaccustomed to its use. The proper use of alcohol as a stimulant is seen in depressing sick- ness and in emergencies. In these cases it can be used to antag- onize the tendency to heart failure and maintain life till nature is able to assert itself. The action of poison upon the system may seem to paralyze the life forces. The heart strike becomes feeble and threatens to fail altogether. Then this ao-ent is the most reliable antidote known. There are a few diseases or stages in certain diseases when it is sometimes strongly indicated and its use becomes a necessity, but it is ever to be remembered that its administration must be carefully guarded and cease as soon as it can be safely omitted. In the late stages of typhoid fever and pneumonia, after the excite- ment of the inflammatory stage has subsided, it may be needed to prevent heart failure and its wise administration may sometimes save life. In the acute stages of most diseases it is uncalled for and is capable of producing harm ; for it quickens the jmlse too much, in- creases congestion of the internal organs, augments inflammatory action and aggravates many of the early symptoms. Its use must be reserved for strengthening the waning life forces as manifested by the flagging of the heart. In some conditions, however, when used medicinally, it exerts another important and almost contrary action to what it does in health. In these cases, when its use is demanded, it prevents the rapid waste of muscular tissue, thus conserving the strength. It may so strengthen and steady the pulse which has become excited, rapid and thready from exhaustion and weakness, that it declines in frequency and manifests greater energy. The flickering, weak action of the heart is changed to a nearly normal condition. Alcohol used medicinally in appropriate cases may be said to have an effect directly opposite from what it has when used in health or injudiciously and inappropriately. It has its true j^lace in medicine as well as arsenic, strychnia, aconite and other powerful remedies. It is no wonder that some persons have acquired such a prejudice from its destructive and demoralizing action upon the human family, 104 THE NEW MEDICAL WORLD. through its misuse, that they deny that it has a legitimate place even when judiciously prescribed. The successful practitioner cannot fail to recognize this fact, and he must only make use of this powerful agent in such a way as commends itself to his conscience, reason and experience. Ordinarily, alcohol as a stimulant or nutrient is rarely required in the diseases of children. It is more often appropriate and service- able in the diseases of the aged, the infirm, and those greatly debilitated, where the circulation is sluggish, and all the processes of life are verging towards the minimum. From the standpoint of the moralist alcoliol is appropriately re- garded as a great evil. Its wrecks lie thi place the patient upon the back with the head low. The dress or clothing about the neck or waist should be loos- ened. Ammonia of suitable strength may be applied t<> the nose or THE >."EAY MEDICAL WORLD. 113 a few drops of nitrite of amyl may be inhaled from a handkerchief. Cold water may be sprinkled upon the face to incite reaction and fresh air should be admitted. Brandy or other stimulants may be ad- ministered by the mouth or hypodermically. These means usually avail to restore a person who has fainted, but when the swoon is profound and threatens to destroy life the electric battery may be applied or artificial respiration may be resorted to, and brandy with warm milk may be thrown into the bowels by the aid of a sj^ringe. The patient must be kept in a reclining posture tilL recovery has taken place. When the fainting; is due to hemorrhage lift the bleeding limb higher than the head and proceed to stop the now of blood as by direction given for such an emergency. The head should be placed lower than the heart so that what blood remains in the body may be used by the brain. If the hemorrhage is uterine lift the foot of the bed six or eight inches. III.— BURNS AND SCALDS. " What wound did ever heal, but by degrees." Burns are caused by dry and scalds by moist or liquid heat. The amount of injury produced depends upon two factors ; the first is the degree or intensity of the heat and the second is the extent of surface involved. A slight superficial burn or scald involving only a small area of surface is a very common injury and one that is comparatively void of danger. There is usually only slight redness of the surface of the skin with a somewhat persistent, smarting sensation. The appli- cation of a soothing lotion gives relief and the injury is soon for- gotten. Then again the injury may be so deep and extensive as to produce death in a short time, and between these two extremes there may be every grade of injury. In instances of mild injury, only a superficial layer of the skin is destroyed, beneath which blisters which fill with serum form, or the whole thickness of the true skin may be burned owing to the inten- sity of the heat applied. In addition to the external injury there may be internal injuries from the inhalation of steain, hot smoke or flames. A superficial burn which involves a large surface is often far more serious than a 114 THE NEW MEDICAL WORLD. deep burn of only small area. Even a superficial burn or scald dis- ables the functions of the skin which are essential to the continuance of animal life. It is a common rule that when from one-third to one-half of the surface of the body is burned or involved in the injury the ease is fatal, even though the degree of injury may not be severe. The skin is very liberally supplied with nerves' ami for this reason a burn or scald of wide area produces that condition of the system well-known and recognized by medical men as shock. This is a de- pressed condition of the system in which a person may die without rallying. Severe burns are sometimes followed by ulceration and other serious disturbances of the bowels and other internal organs. Burns and scalds result from a great variety of causes among which are the accidental contact with molten metals, explosions of steam, gas and gunpowder, the accidental ignition of cotton garments about a stove or range, the falling of children or workmen into tubs. tanks or vats of boiling water, hot fat and other liquids too numer- ous to mention. TREATMENT. When the clothes are on fire a person instead of fanning the flames by running into the street should lie down and smother the flames with a rug, blanket or whatever is within reach. If a second party is present he should dash water upon the flaming victim or extinguish the flames by means of a shawl or blanket. Success depends upon instantaneous action governed by good judgment ami courageous methods. In removing partially burned clothing from a person exercise much care not to remove the injured skin. Blisters should be carefully pricked at the lowest point ami their contents allowed to escape with- out the removal of the superficial layer of the skin which forms the besl covering for the injured surface. If the person is suffering from shock a little stimulant may be ap- propriately administered ; if from severe pain and anguish morphia should be administered hypodermically, for this will relieve the pain and al><> stimulate the action of the heart. If the injury i> extensive it maybe dressed in sections, one part at a time. Tlie dressing should be put on in a warm room or near the life and the parts not necessary THE NEW MEDICAL WORLD. 115 to expose covered by warm blankets. The dressing should seek to exclude the air from the injured surface, hence oleaginous dressings have been extensively employed. A very soothing application for a burn is the following old but efficient remedy. It is composed of equal parts of lime water and linseed or sweet oil. This may be applied upon lint and covered over with a layer of absorbent cotton, carbolized cotton or iodoform gauze. For superficial burns this dressing will answer every purpose. Another good remedy is carbolized vaseline or oil. One-half a dram of carbolic acid to an ounce of vaseline or oil is the proper propor- tion to use, but where a very large extent of surface is involved other remedies are more suitable, or a less proportion of carbolic acid should be used. Iodoform and vaseline make a good dressing. If a large extent of surface is involved use less iodoform, as there would be danger of too free absorption of this remedy. Other valuable formulae for burns are as follows : 5, Muriate of cocaine five grains Oxide of zinc ointment one ounce Mix and apply as needed to a burned surface. fy Carbolic acid fifteen grains Fl. ext. calendula half an ounce Olive oil one half pint Mix and apply as needed. ^ Menthol twenty grains Muriate of cocaine five grains Vaseline one ounce Mix and apply as needed. All of the above prescriptions are of a high order. Deep burns about the neck and joints require much care in the healing process to prevent contraction of the skin. The modern method of skin grafting is a very flattering method of preventing unsightly contractions. This delicate operation requires the experience of the surgeon, to render its performance successful, and hence it is unnecessary to attempt a description of the process. 110 THE NEW MKDK AL WORLD. By this simple operation large surfaces can be healed in a brief time, and unsightly contractions prevented. No discovery of modern times yields more uniform and successful results. Burns produced by contact with strong acids or other chemicals should be treated on the same general principles mentioned. It is well t«> bear in mind that the skin of infants ami young persons is more easily impressed by the action of heat than that of adults, and hence extensive burns or scalds are more liable to prove fatal to such patients. In very serious injury from burns the nerves are para- lyzed, and ordinarily the degree of pain experienced is less than would otherwise be supposed. IV.— LIGHTXIXG STROKE. A person receiving an accidental electric shock may be rendered unconscious temporarily, or if the current is a strong one, instantane- ous death may ensue. The shock maybe largely the result of fright. When this is the case recovery usually soon takes place. Insensi- bility may last for some time, and then be followed by recovery. There is often some paralysis of the motor nerves, usually those of the lower extremities. There may be loss of some of the special >enses, as sight, hearing, taste or smell. If a person is not killed on the spot, there is a chance of recovery. Sometimes the body is wounded or burned, and such injuries are to be treated the same as similar ones from other causes. When death results instantly, it is caused by the shock which paralyzes the brain. In some cases the blood is found to be coagulated by the electrical cm-rent. The treatment for those not killed outright is rest and stimulants, as ammonia, brandy and other efficient heart tonics. V._ SPRAINS AND BRUISES. Sprains are often associated with bruises, and hence we shall con- sider both subjects under one head. A sprain is the over-stretching <>f the muscular and ligamentous tissues. It may be a Blight or severe injury, or any grade of injury between the two. In some ca^es the ligaments which bind the bones in place may be partially or completely ruptured ami the neighboring parts more or leas injured and torn. the new medical world. 117 Sometimes, in stepping down from a carriage or step, the whole weight is accidentally thrown on to one side of the foot, and the foot is turned under. This occasionally occurs in walking over rough walks, or from stepping into a hole or upon a stone. The injury caused from such a misstep may be so severe as to require several weeks for recovery. In this injury the out or inside ligaments of the ankle joint are overstrained, and in the worst cases more or less ruptured. Many sprains are more serious and require a longer time for recov- ery than a fractured bone ; hence a bad sprain should not be treated as a trivial affair for no one would so regard a broken bone. Some- times the sprain or injury of a joint which at first appears to be slight will develop) later serious consequences. Cases of hip joint disease in children have resulted from an injury which at first was regarded as trivial. Sometimes a fracture has been regarded only as a bad sprain and then again a si^rain has been treated with splints as a fracture. It sometimes requires a large amount of experience to de- termine which condition exists. The treatment is so important that a correct diagnosis should be made. In a sprain, while there is considerable swelling, the parts are not misplaced, and motion of the bone can occur without crepitus. Crepitus is the name given to the sound, when one piece of bone grates upon another, and is a certain indication of fracture. More or less weight can be borne upon a sprained joint, although movement is painful while upon a fractured limb, as a rule, no weight can be borne upon the injured part, neither can its own weight be supported without assistance. TREATMENT. This is all important. Rest must be enjoined for a reasonable time, depending upon the degree of injury. Cold applications such as alcohol, witch-hazel or ice are preferred by some to check the inflammation. Hot fomentations are, however, the best agents for reducing the swelling and relieving the pain. These should be applied at once and changed and re-applied for the first day with persistency to avert the inflammation. Holding the injured joint in a hot bath is beneficial. A little aqua ammonia or bicarbonate of soda added will increase the elheiencv of this agent. lift THE NEW MEDICAL WORLD. Hot applications are recommended because they are preferable to cold and afford a greater sense of relief. They aid the capillary circulation in the tissues and favor the rapid absorption of the extrav- asated blood and lymph and consequently reduce the swelling. If the lameness and swelling continue for several days the following stimulating liniment will assist the process of recovery: ^, Camphor liniment three ounces ( hloroform one ounce Mix and apply three or four times a day. If the parts are much swollen a snug bandage carefully wound about the limb will give a comfortable feeling of support, and will favor the tedious process of absorption. If the swelling continues and becomes chronic in spite of such well directed efforts as have been recommended, absorption and recovery will be further aided by painting over the injury with the tincture of iodine. It is good economy to commit the care of a severe sprain to a competent med- ical man, as there may be earnest indications for treatment which it is impossible to anticipate, and which, if unobserved and neglected, might lead to serious mischief. Bruises are the result of an injury, as a blow with some blunt agent, as a stick of wood, an axe, or from a fall. At the same time other injuries often accompany bruises, as lacerations of the flesh, dislocations and fractures. This is often the case in carriage and railroad accidents. The effusion of blood which follows a bruise or contusion is due to the injury either of the capillary blood vessels or, [i — often, to the rupture of a vein or artery. In the Latter case a large amount of blood will penetrate the surrounding tissue-. In some parts of the body, as about the eye, where the cellular tissue is abundant, a bruise is BUCCeeded by a large amount of extrav- asated blood. The technical term for a black eye or other extrav- asation of blood is ecchymosis. TREATMENT. The treatment <>t' bruises IS quite Bimple, nature being able in most instances to accomplish the cure with but little aid. Whatever the treatment, nature must absorb the extravasated blood, which always requires time; the discoloration changing in the process from black THE NEW MEDICAL WORLD. 119 or dark purple to green, and finally yellow, gradually fading till it reaches the normal color. The process requires about two weeks. Simple water dressings, to which alcohol has been added, are service- able, so also are hot fomentations. When soreness and symptoms of inflammation follow a bruise, equal parts of tincture of arnica and tincture of opium will usually afford relief. Slight bruises require no treatment, but sometimes the effused blood, when the injury is extensive, instead of being absorbed is changed into pus, and sup- purations follow the injury. In such cases it is necessary to lance the abscess and allow the pus to drain away, and then wash out the cavity with carbolic acid water. One dram of the former to a pint of the latter, or a solution of corrosive sublimate of suitable strength. For ecchymosis about the eye, there is no better application than the following : ty Muriate of ammonia one dram Water one pint Mix and apply to a bruised surface on a cloth. VI.— FROST BITE. This is an injury where the cold has taken a deeper hold than in chilblains and is sufficient to arrest the circulation. Frost bite is preceded by tingling and numbness. If frost bite of an extremity as a toe is prolonged and severe, the death of the part will result. Any part which has been frosted or somewhat frozen should not be ex- posed to the heat suddenly as there will be an excessive reaction. The nerves in their paralyzed condition are unable to control the blood supply, the parts will suffer congestion and gangrene or death of the frozen portion will ensue. Persons who are exposed to severe cold should not give way to a desire to sleep or fall into a state of stupor for death will certainly follow. TREATMENT. This must be careful and cautious. Frosted members must be re- stored to the normal condition very gradually, neither warm air nor warm water nor the heat of a fire should be allowed but the frosted parts should be rubbed with a piece of flannel to aid in establishing the circulation, previous to which, rubbing with snow or ice water is more suitable if the freezing is severe. 120 THE .NEW MEDICAL WORLD. It may be necessary to administer stimulants. Especial care must be exercised to see that the return of the temperature is gradual* Re- member never to apply heat to a frosted limb. After the circulation hag been established warmth may he gradually added and the frosted parts should he wrapped in flannel. Portions which slough should he treated in the same way as ulcers, burns and other open sores. Sometimes the feet are so frozen as to require amputation. In these cases a line forms between the living and the dead tissue and shows the Burgeon where to draw the knife. In severe climates per- sons are sometimes frozen to death. Persons under the influence of liquor are often so bereft of judgment as to lie down in the snow or upon the frozen earth and if not rescued are found frozen. VH.1-BITES OF SEKPEXTS. The red viper or copperhead, cobra and rattlesnake are venomous and their bites cause convulsions and death. The poison is intro- duced into the system in the act of biting'. The bite of the rattle- snake is succeeded by pain of a pricking, burning character, which becomes more and more intensified. The tissues surrounding the bite or injury show the usual symptoms of inflammation, viz : red- ness, heat, pain and swelling, ami there is hemorrhage into the sur- rounding tissues which causes their discoloration. After the system has been inoculated by these poisons, glandular enlargements, suppuration and gangrene take place in succession. If the amount of poison introduced by the fang of the serpent is large great prostration follows, the circulation is checked or stopped in the wounded extremity in consequence of the changes which take place in the blood and death results with great rapidity. Snake bites produce blood poUoning and the action of this poison on the nerve centers produces Irritation, prostration and convulsions. TREATMENT. The treatment needs to be as energetic as possible in order to have a chance of success. A few seconds are sufficient for the absorption of the poison into the blood ami general system. A Ligature is ad- vised to prevent the poison from reaching the circulation and nerve '•enters. This ligature must be placed about the injured extremity between the Injury and the heart. It must be tight enough to stop THE NEW MEDICAL WORLD. 121 both the arterial and venous circulation ; the venous blood must be prevented from returning to the heart from the injured member. Then the tissues about' the wound must" be cut away and the whole wound thoroughly cauterized by means of strong carbolic acid or a stick of nitrate of silver. Then the blood in the wounded extremity is withdrawn by puncturing and cupping and in this way the poison with the blood is removed before the circulation is again estab- lished. In some cases it has been necessary to amputate the limb in which the poison is deposited. As the j:>oison is harmless when introduced into the stomach it is recommended to immediately suck the bite. Stimulants are given internally to counteract the depression and the effects of the poison, those most used being ammonia, digitalis, whiskey and strychnia. The nitrate of strychnia is reported to be an almost infallible remedy, failing in only one case out of a hundred. It is used hypodermically and repeated every few minutes as the condition of the patient re- quires. The hypodermic tablets are made in doses of one-fortieth, one-sixtieth and one-eightieth of a grain which are suitable doses- One of these is to be dissolved in a teaspoonful or syringe full of warm water and injected beneath the skin, watching the effect and repeating the dose as often as the patient's condition demands a re- newal of the stimulant. Cases of such importance demand all the skill of a competent physician as soon as his services can be pro- cured. YIIL_STI1\ T GS OF INSECTS. In temperate regions the stings of insects, unless in large numbers, are rarely severe. They sometimes cause in children fever and other constitutional disturbances of a mild character. Sometimes a wasp or bee stings the tongue, in consequence of being accidentally taken into the mouth with fruit. Should this happen there may result a rapid and extensive swelling of this organ. It has sometimes been necessary to open into the windpipe (tracheotomy) after such an accident to prevent suffocation. The stings of insects are relieved by the application of an alkali as aqua ammonia. The sting or bite of some of the tropical insects is more serious and is sometimes followed by pain, vomiting, nervous depression and other nervous symptoms. 122 THE NEW MEDICAX World. The bite of the mosquito in South America is more poisonous than in North America and is sometimes followed by local inflammation and ulceration. In Africa and Asia the bite of the scorpion is so ven- omous as sometimes to cause death. Large spiders are the means of many harrowing stories. They are said to have poisoned infants and small children. It is to be observed that such occurrences are usually so far away as to render verification impossible. The sad story of the death of a child from the bite of a poison spider can generally be seen- in the columns of a sensational newspaper about once a year or once in six months, and if other news items are scarce, as often as every three months. The bite of a spider is to some extent poisonous but it is hardly to be be- lieved that a spider is venomous enough to destroy even the life of an infant. TREATMENT. The treatment is the same for a spider bite as for that of the scor- pion* Aqua ammonia is the best external application. It may be combined with olive oil as the latter is also a useful application. Menthol liniment is cooling and would be appropriate. The principal remedies relied upon for internal treatment are am- monia and brandy if there be symptoms of prostration sufficiently well marked to require stimulants. IX.— POISONED WOUNDS. Many of the bites of insects, reptiles, dogs, eats, weasels, squirrel*. rats, and other animals are poisonous to a greater or less degree. For the most part these wounds heal readily and occasion no special inconvenience; there are numerous exceptions, however, to this statement. Medical students are exposed to the risk of introducing into the system poison material from dead bodies. There is especial danger of introducing dangerous poison into the body from handling or dissecting those persons who have died from puerperal and scarlet fevers, diphtheria, glanders, malignant pustule and such like diseases of a poisonous character. Kven inhaling the odors from dead bodies may Introduce more or less poison into the system, but this is rarely followed by anything more serious than nausea, slight malaise, ami THE NEW MEDICAL WORLD. 123 perhaps boils subsequently. Care must be exercised to prevent the inoculation of the system with the fluids of horses, cattle and other animals that have died from certain malignant diseases. It requires but a very slight abrasion for the introduction of poison into the system, and it may be so slight as to be imperceptible. Those who have been bitten by a dog or other animal are liable to become the victims of fear, and to experience in their imagination all the horrors depicted in sensational literature. Dog bites, unless severe or by rabid dogs, usually heal kindly and are without especial danger. TREATMENT. Wounds made upon the hands in the dissection of dead animals should be first cleansed in the following manner : Suck the blood from the wound immediately, and then cleanse it by means of an antiseptic fluid, as the peroxide of hydrogen or a carbolic acid solu- tion. If the introduction of dangerous poison is suspected, cauterize the wound with the nitrate of silver pencil, or with chloride of zinc. Should inflammation follow, apply poultices, and should pus form open the abscess early to jjrevent its absorption into the sys- tem. After the pus has been thoroughly removed by poultices, apply carbolic salve, iodoform ointment or aristol in powder. Indu- rated glands may be painted over with the tincture of iodine ; mean- time keep the bowels free and the system in a vigorous condition. The wounds caused by a dog's bite are to receive the same treat- ment as w r ounds from other causes, unless the animal is suffering from rabies. (See hemorrhage from wounds in the article upon hydrophobia.) A wound caused by the bite of a healthy dog should be carefully cleansed. For this purpose use a pint of warm water to which has been added a teaspoonful of carbolic acid. The carbolized water should be prepared in a clean earthern dish. The wound may then be cauterized with nitrate of silver if any suspicion exists as to the condition of the animal inflicting the wound, but this process will somewhat retard the healing process. The wound may then be dusted with aristol powder. Gaping wounds should be brought together with plasters or stitches, as the nature and extent of the wound may require. 124 THE NEW MKDK'AI. WulM.I). X.— HEMORRHAGE FROM WOUNDS, AND THE TREATMENT OP WOUNDS IN 6ENERAX. Blood flows from a wound however Blight, and the amount of blood does not depend upon the size of the wound but upon the size of the vessels injured. The slightest wounds injure some of the capillary vessels, but bleeding from the capillaries is not usually attended with danger. The blood from a vein is not of a bright scarlet color a^ La blood from an artery. When a large vein has been cut blood flows from it in a steady stream. Pressure usually controls hemorrhage from capillary vessels and veins. If it does not dust upon it some of Monsel's salt (ferri subsulphate) which is a powerful styptic. When an artery is cut or wounded bloods flows from it with every beat of the heart in a spurt or jet. The danger from arterial hem- orrhage depends upon the size of the vessel wounded. From the This figure shows the arrangement of the handkenhief-tourniquet to arrest bleeding from a wound below the knee A large pad made by folding a towel, or napkin, or roll- This figure shows the manner of employ* tag up a woolen stocking, must first be put tag the knotted handkerchief to srresJ Into the hollow behind the knee and the blooding from ■ wound of an artery in the handkerchief applied over it. left upper extremity. large artery of the leg, the femoral, one would lose blood enough to produce death in a very short time. A Btrip of stout cloth wing to the hardness of tin- bone beneath, blunt instruments often divide the scalp and produce wounds which resemble incised wounds. The sealp is very vascular, being abundantly supplied witli blood vessels, hence hemorrhage from these wounds is often profuse. It can be stopped usually by pressure and the application of cold water. Make a compress, dip it in cold water and hold it (irmly over the bleeding wound with the hand. In treating a wound of the scalp the first thing is to cleanse the wound, remove the hair or dirt and wash away the blood clots, for no foreign substance must be allowed to remain. After cleansing the wound bring the parts into apposition and hold them there. Nothing serves this purpose so well as stitches from one fourth to one half an inch apart made with good coarse -ilk. Water dressings, tint, of arnica and opium, or powdered aristol can be applied. Remove the stitches in four or five day-. CHAPTER VII. GENERAL SUBJECTS PRELIMINARY TO THE STUDY OF DISEASE. I. — Health axd Disease. II. — The Two Great Types op Dis- ease. III. — Temperature ix Disease. IV. — Kissing nsr Its Relation to Disease. V. — Bathixo ix Its Relation to Disease. VI. — Symptoms of Disease. How to Read am) Ixterpret Them. I.— HEALTH AND DISEASE. THESE are relative terms since they refer to no definite con- dition. It is not easy to determine where health ends and dis- ease begins because there is no well-defined border line. Health and disease are conditions which overlap each other. In order to understand disea.se it is necessary first to know what is involved in the conditions which we designate health. Health may be regarded as that condition in which the various tissues of the body are maintained and all the various bodily functions are per- formed in a normal manner. Disease is some departure from these normal conditions; it may be only slight and temporary or severe, pro- gressive and chronic So long as all the tissues of the body are maintained unimpaired and the numerous functions of all the organs and parts are performed in a regular manner, health is preserved. This leads to an inquiry concerning the process by which the tissues and functions oi the body are maintained. We immediately perceive that the material for maintaining every organ ami every function must be derived from the blood supply; hence this must be sufficient in quantity and quality in order to maintain health. If the blood supply should be deficient in quantity nutrition must fail to a greater or less degree and either the whole body suffers a diminished nutrition, or if only parts then these parts suffer in a more intense manner. This would mean THE NEW MEDICAL WORLD. 129 either a departure from health, with respect to the whole body or the parts which feel the force of the reduced blood supply and deficient nutrition. The quantity of the blood may be sufficient and still be imperfect or below the natural standard in its composition. The blood must be maintained both in quantity and quality, and constantly reinforced from the food by means of the process of digestion and absorption. It is easy to see how food, unsuitable in quantity and quality, can disorder the digestive apparatus, effect the blood unfavorably and produce disease. There may be some imperfection also in the process of elaborating the blood, some disorder of the blood making functions, even though the food supply is adequate. Thus we perceive how easy it is for this delicate bodily machinery to fail in some fine adjustment, so that the composition of the blood may be changed sufficiently to allow departure from health and become the starting point of disease. To preserve health, an abun- dant supply of nutritious food is absolutely required. There must be, in addition, the inherent ability to convert the food, taken into the alimentary canal, into rich, healthy, normal blood. The complex process of absorbing out of the food material all the fluids and salts required for the maintenance and growth of the vari- ous parts of the body must be carried on with precision and success. There must not only be digestion, but assimilation, in order to con- stantly manufacture within the body a perfect blood supply. Con- sider for a moment that over all these complex processes the nervous system must preside. Now when you remember that occupations, climate, emotions, and a thousand little things may disturb the nervous forces, is it any wonder that sickness or departure from health is common ? It is by the power, not of the will, but of nerve force, largely independent of the will, that the food we eat becomes bone and muscle, nerve and brain. So complex is the machinery of the human body, which we so little consider, and so often misuse and abuse, that the striking wonder is, not that it so often fails in its delicate and mvsterious work, but that it succeeds so well and with so little of failure. There is still another important and interesting thought in connec- tion with the function of the blood, which thus far has escaped our notice. Xot only must the blood current carry to the reach of every part the nourishment sufficient for its growth and maintenance, but it must also carry away the waste products, no longer needed. The 180 THE NEW MEDICAL WORLD. blood supply must come to every part richly laded with nutrition, all elaborated and ready to be appropriated, and m its place must receive debris, which must be transported to some other organ for change or excretion. If these waste products were not carried by the blood to the lungs and other organs to be changed, or to the kidneys ami other organs for elimination, the whole body would soon be, overloaded and over- whelmed by poisons, and the blood itself would speedily become poisoned and unfit to support life. In certain diseases this failure of change or elimination becomes a serious complication and threatens death. The carbonic acid, the uric acid, and many other poisons, the results of the wear and tear of the human machine, must be cast out. If they remain, even in small amount, they soon disorder the functions of the body and enkindle disease. How close then are the relations between many things which seem at first separate and distinct. Healthy blood and an abundant supply, depends upon healthy food and a proper supply, also upon exercise, which stimulates muscular action and assists the process of circula- tion ; also upon an abundant supply of oxygen to change the impure venous into pure arterial blood. This last change takes place in the lumrs, every heart-stroke sending the impure venous blood to the loners and every breath bringing the oxygen to carrv on the wonder- fill change. Can we fail when we trace out these complex methods to recog- nize the intimate relation which always exists between health, pure food, pure air, pure water and exercise; and to observe that a corre- spondingly intimate relation must exist between disease, impure food, impure air or water and a lack of exercise. It took the medical profession ages to learn what now is so simple and apparent, that disease is most successfully treated and most effec- tually cured by preventing it altogether. The best medical practice is the one coming everywhere to the front in the light of hygienic revelation. The physician's greatest work is not in administering pills but in disseminating such knowledge in regard to food, water, an-, exercise, stimulants and various hygienic topics as will keep not Only the individual, but the whole human race, in a constant and vig- orous state of health. The food which we eat may introduce poison and death, or at least sickness and functional disturbance; the water which we drink mav THE NEW MEDICAL WORLD. 131 contain germs that will work untold mischief in the human economy; the air which we breathe may be contaminated with poisonous gases or convey dangerous disease germs into the system. He is our friend who helps to eliminate the dangers to health which lurk in our path- way, and who assists in providing for the absolute needs of the race, healthy foods at a reasonable price, healthy water uncontaminated by foul pollutions, and all the requisites of health, contentment and happiness. II._ THE TWO GREAT TYPES OF DISEASE. There are two kinds of disease — -functional and organic. Disease is always some departure from the condition of health. It is gener- ally caused by some change in the working of nature's great labora- tory, or by the alteration of the structure of some organ or organs. We will endeavor to explain these two great general classes of disease, known as functional and organic. When there is simply a temporary disturbance of an organ, causing a departure from health, and no alteration has taken place in its structural make up, the disease is simply functional. When perma- nent change has taken place in the structure of an organ, so that it has become contracted, or enlarged, and its tissues are pressed upon, causing pain and disease, this is recognized as organic. The distinction is a very clear one, if we will only master the phraseology which describes it. A headache is often due to inaction of the liver ; there is some functional trouble, the liver is not doing its customary work. This may be due to the fact that certain elements, which are ordinarily eliminated from the system, when its functions are normal, failing to be removed, are absorbed into the general circulation, and irritate the brain and nerve centers. The waste products of the system, which cannot be transformed and reused, must be cast out, or eliminated. When this process is inter- fered with, and these irritating substances are too long retained, they act as poisons, and give rise to a great variety of symptoms, which are known under the somewhat indefinite term biliousness. These symptoms, sallow complexion, dizziness or vertigo, headache, want of ambition, sleepiness, etc., are departures from the condition of health, but they are due to no chang'e in the structure of the liver, and hence the disease is termed functional. Again, a headache may be due to an entirely different cause, some VS'2 THE NEW MEDICAL WORLD. growth or tumor, may press upon a nerve ; the disturbance in this latter case is not functional, but due to some change of structure, and hence organic. Tubercles of the lungs, cirrhosis of the liver, fatty degeneration of the heart, Bright's disease of the kidneys, these are due to organic change in the structure of various organs, and are illustrations of what is known as organic disease. ' Functional disease, it will be perceived, is much more 'satisfactory to treat than organic. The former usually responds quickly to rem- edies, while the latter often advances to an unfavorable issue, in spite of all remedies. A disturbance of the working or functions of the liver can be easily remedied, often without medicine, if the patient will abstain from unsuitable foods, and provide rest and favorable conditions for recovery, nature herself being able in a little time to regulate the disordered functions. Cancer of the liver is a severe departure from the health condition ; organic changes have taken place in the liver which neither nature nor medicine can cure. The latter can only alleviate suffering, prolong life, and render existence tolerable. People often get a wrong idea about disease conditions. They think the medical practitioner should be able to cope with every kind of disease. They do not see the distinctions which are apparent to the practiced eye. If they are not at once benefited by medicine, they are prone to think the doctor at fault ; and they fail to realize that the trouble is not from without, but from within, and hence they rly from one to another, catching at this and that straw, hoping for health and finding none. People seem to think that death is to be avoided at all hazards, in some way or other, that it is foreign to human conditions, and always accidental rather than natural. There is another and more rational view of this subject. Death is a natural process, a part of tbe great plan. To be born means to die, and the only question i*» when. Every beginning, or birth, points to an end, or death. This is true in the whole realm of the animal kingdom. It is as much a pro of nature to die as to live ; to cease to exist as to begin to exist. Scarcely has the new born babe entered upon its life career before it musl run the gauntlet of one disease after another; BO that in a Very few years half of the whole number are missing. One by one the weak and puny fall out by the way, and sometimes tin- most vig- orous, too, are CUt Off by disease. The great problem before u^ i> to strengthen the w>'ak, to increase their power of resistance, and then THE NEW MEDICAL WORLD. 133 to diminish the diseases that invade our pathway, to prevent disease and thus add to longevity. Hence, whatever tends to improve the health condition of the parent contributes to the living prospects of the child, and whatever weakens and reduces the vitality of the parent reduces the health prospects of the progeny. Do we not then see how intricate and far- reaching are the subjects which we discuss with regard to health and disease ? Do we not see how even our most tenable theories must be modified to account for a thousand exceptions which may occur in a field of work where all is uncertain, owing to a thousand impor- tant factors which may not only be obscure, but entirely hidden ? To-day a child is born, even from healthy parents, so far as can be discovered. It may seem to have every advantage, and its prospects of a long life be excellent ; to-morrow it may begin to decline, by reason of some undiscovered organic defect. The heart, perhaps, is faulty in its structure and proves unable to maintain the circulation and the infant dies. We must not possess the confidence, that in all cases, death can be avoided, but on the other hand, the ratio of deaths can be materi- ally diminished. How many little ones are sacrificed every summer to artificial feeding? Instead of the healthy and abundant supply nature intended, there is the improperly cleansed bottle and the unhealthy milk full of poisonous disease germs by the time it reaches the child's stomach. Thousands of children die of cholera diseases every summer that, under better conditions, might live and perhaps run the average course of human existence. This disturbance or disease is only functional, and not organic. Its cause is improper food and poisoned air during the heated term, and a lack of knowl- edge as to the proper care of these little patients. Its ravages are to a great extent preventable. III.— TEMPERATURE IX DISEASE. The temperature of the body in health and sickness did not receive very close attention and study until about thirty years ago. The recent observations concerning the temperature of the body are due to the invention of a little instrument called the fever ther- mometer. This is a very convenient, but rather frail, little instru- ment, which consists of a graduated glass tube, in which the mercury ascends when the bottom part or bulb is exposed to heat. It is very useful in the diagnosis of disease, and discloses a lar^e amount of 134 THE NEW MEDICAL WOULD. information concerning fevers, the breaking down of tubercular nodules, and the formation of pus in the body, which can be obtained in no other way. The temperature of the natural body is called the normal tempera- ture. It is very nearly the same in all healthy persons, at all seasons of the year. The best way to obtain the temperature is by placing the bulb containing the mercury under the tongue, where it should remain four or live minutes, if accuracy is desired. It is sometimes placed in the armpit, or elsewhere, when the patient is unable, from any cause, to hold it in the mouth. In some high fever stages, it reaches one hundred and five <>r six degrees ; but such a temperature indicates severe sickness, and immi- nent danger. In acute rheumatism, a temperature of one hundred and four is quite alarming, because it indicates some complication, especially of the heart valves. In consumption, a temperature of one hundred and four degrees indicates rapid waste of tissue and a galloping progress of the disease. In typhoid fever the temperature rises slowly, and it takes a week or more for it to reach one hundred and three or four degrees, or the highest point. When the evening temperature in typhoid does not reach above one hundred and three degrees it is a mild case, if it reaches a hundred and five degrees it is a severe case, and danger threatens ; a hundred and five degrees is very high temperature, it rarely goes above this except in fatal cases. There is considerable difference between the morning and evening temperature. The case is not as favorable when the temperature is high in the morning. In fevers which pursue the ordinary course the temperature goes higher in the evening and falls toward mid- night, a process which goes on until morning. When the morning temperature is as high or higher than it was in the evening it is a sign of some complication, and indicates a severe case. In malaria and malarial fevers the temperature reaches its highest point i?i a few hours. A person who was well yesterday and who has a temperature of one hundred and four to-day has malarial or ephemeral fever. It is not typhoid. In pneumonia the temperature rises rapidly from one hundred and two on the first day, to one hundred and four or five on the second and third days. In pneumonia a temperature below one hundred and two indicates a very mild case, with but little exudation into the air cells, while one hundred ami four Of five indicates a severe attack THE NEW MEDICAL AVORLD. 135 and a large amount of exudation, and in such a case delirium is quite likely to be present. The temperature rises rather higher in children when sick than in adults, owing to the more active processes of the body. Each mother ought to be acquainted with the significance of temperature in disease. If a child complains of feeling ill and the temperature is under one hundred degrees the sickness is slight, while if above a hundred the case is important, and becomes more grave as the tem- perature ascends. The higher then the temperature goes the sicker the child, except in fever which follows malarial chills, when the temperature may ascend very rapidly and reach, for a brief time, a very high point without much significance. A rise of one degree in temperature corresponds to about ten beats of the pulse. The temperature is high in scarlet, yellow, typhus and typhoid fevers. When the temperature rises above one hundred and five degrees the patient is usually in danger, especially if it continues elevated to that degree for any considerable period of time. When the temperature remains high after the appearance of the rash in measles some complication is indicated. After an attack of pleurisy a high temperature generally indicates the formation of pus in the pleural cavity. After many acute diseases, if the temperature continues at one hundred and three or four degrees, it either shows that the disease is still active or that some complication exists. In the condition of collapse, prior to death, the temperature falls below the normal. When the temperature falls below ninety degrees recovery seldom takes place. A person is sick so long as the tem- perature fluctuates or continues above the normal. When, after sickness, the temperature falls to the natural point and continues there during the entire twenty-four hours it indicates that the disease has abated, and complete recovery to health may be anticipated. When, during a course of sickness, the temperature rises higher in the morning than at night the patient is getting worse, but if the decline is in the morning, it should be regarded as significant of improvement. IV.— KISSING m ITS RELATION TO DISEASE. There is no especial objection hygienically to kissing on the part of equals, or friends and relatives, nor as the expression of affection and love ; but for strangers to force kisses upon infants and small 130 THE NEW MEDICAL WORLD. children, simply because the babies are sweet and the little ones cute and attractive, should be condemned as needless, and liable to convey to the child, whose ability to resist disease is especially limited, certain contagia which may prove fatal. It is also dangerous to kiss persons who are sick with certain ailments, and the practice should bo restricted as much as possible. Many persons are led by a sincere affection to kiss loved ones after death ; it should be universally known that no little danger attends this practice. A dead body cannot be regarded as a whole- some object, for already the process of decomposition has com- menced. We need not regard the dead with horror, nor with heathenish superstition, for the body is simply the tenement, vacated by its occupant, and it is useless to consume our emotions upon a dead and decaying body, which is not only destitute of life, but which may be capable of conveying to ourselves and others con- tagious diseases. Many cases of sickness and death have been traced to this revolting custom. Outbreaks of diphtheria have resulted from such a cause, and where death has resulted from diphtheria it has been found, in one instance at least, necessary to issue orders pro- hibiting the practice of kissing the dead. V.— BATHING IX ITS RELATION TO DISEASE. The frequent bathing of the body is essential to health, but in order to get the most decided benefits from the bath good sense is essential. In addition, a few common rules may not come amiss to the inexperienced. A person should not bathe too soon after a hearty meal, but an interval of two hours should occur between it and the dinner. A bath may be very injurious to a person who is very much fatigued or exhausted. Wait till a reaction has taken place. Be careful about taking a bath when the pores of the body are open and the vitality has been lowered by free perspiration. In such a condition the bath should be quite warm. Do not stay in the water after you experience a sense of chilliness. This applies more especially to open air bathing. Only the vigorous and strong should bathe in the morning before breakfast. Two or three hours after a meal is the preferable time. A towel bath followed by brisk rubbing of the skin is very refresh- ing before retiring iii hot weather. Bathing in the salt sea water is apt to be too prolonged and exhausting, if in the company of a Large THE NEW MEDICAL WORLD. 187 number of persons. Bathing in salt water is invigorating and enjoy- able if judiciously performed at the proper season, at suitable hours, and is not indulged in too extensively. Persons who are indisposed may be injured rather than benefited by this vigorous tumble in the waves. Young people who bathe in the surf are inclined to remain too long in the water. Fifteen or twenty minutes is long enough for the most robust, except the water is delightfully warm, when a pro- longed stay may be unattended by harm. Rubbing the body after the bath is essential, and completes the act with the best results, quickening the circulation of the external surfaces. Systematic bathing, or the daily sponging over of the body, followed by friction with a coarse towel is healthful and exhil- arating. The best time to do this is in the morning before dressing. VI.— SYMPTOMS OF DISEASE. HOW TO READ AND INTERPRET THEM. In cases of sickness, one difficulty which confronts the ordinary individual is the inability to read and interpret the symptoms of disease correctly. No positive diagnosis can be reached except in trivial cases without giving considerable attention to this important subject. Disease symptoms must be considered collectively, as well as singly. Scarlet fever is often ushered in by vomiting, but from this symptom alone you cannot infer that you have a case, for it is very common in many other affections. It only indicates the begin- ning of scarlet fever, where a group of other symptoms point in the same direction, otherwise it may suggest an over-loaded stomach, the condition of pregnancy or many other varied conditions. By going over some of the common and important symptoms of disease carefully you will be better able henceforth to determine what is the matter with the sick members of your family. The Countenance. — The first thing we naturally notice about a person is the countenance, and by a sort of intuition we recognize the difference between that of health and sickness. The pupils of the eyes are dilated in most diseases, but contracted in opium poison- ing and in certain affections of the brain. The countenance is pallid in anaemia or from loss o,f blood, from fright or after a fall, or other severe injury, especially if there exists the condition known as shock. The face is pale in cholera morbus, and both pale and anxious in the 13^ THE NEW MEDICAL WORLD. collapse which soon comes on, when timely relief is not obtained. There is an anxious look in diseases of the abdomen, and also in certain diseases of the heart. The face is pallid and careworn during the progress of many chronic diseases. Mania and imbecility make their impression upon the countenance. Emaciation appears in addi- tion to pallor if the sickness is severe and of long duration. In cholera infantum emaciation comes on early. In some diseases of the lungs or air passages, when oxygen is not obtained in sufficient amount to aerate the blood the face is pallid, with a bluish hue (cyanosis), the lips are blue, and there is a pinched look about the nose and face. The countenance bears a purple aspect in some of the low forms of fever, as typhus. In some affections of the liver the face is sallow. This is the case in malaria which always involves the liver, and also in dyspepsia. In some of the severer affections of the liver the skin is yellow ; this yellow hue, known as jaundice, is especially noticeable in the whites of the eyes. In cancer there is a peculiar waxy, sallow countenance, which is characteristic of this malignant disorder. The face is flushed in con- gestions, in the early stage of pneumonia and fevers, in apoplexy, in poisoning from belladonna, and in the hectic fever which accom- panies the progress of consumption. The symptoms which appear in the countenance may mislead one who is unaccustomed to the peculiarities of an individual. Some persons in health have a flushed countenance, while others are pallid or sallow, so that these things must have due consideration. A single glance often suffices for grasping the symptoms which appear in the countenance. With these a close observer has little or no trouble. The Tongue. — The next thing is a look at the tongue, which presents a great variety of appearances and reveals much about the condition of the individual. The natural appearance of the tongue is familiar. It is red, moist and slightly coated in the back part of the mouth, even in the condition of health. This natural appearance docs not continue long after some departure from health. In slight ailments the tongue is usually more or less furred over with a whitish or yellowish coat. This condition often indicates biliousness, indigestion or some temporary disorder i^i the stomach and alimentary canal. In typhoid conditions the tongue is brown and sometimes so lissured as to bleed. In scarlet fever the tongue THE NEW MEDICAL WORLD. 139 presents a peculiar appearance, known as the strawberry tongue, because the little papillae are swollen and look like the seeds on the outside of a strawberry. In anaemia and malaria the tongue has a peculiar indistinct appear- ance and looks as though it was partially bloodless ; this pale appear- ance of the tongue is rarely wanting in malaria. After typhoid fever the coating peels off and leaves the tongue somewhat raw and very red. This condition is known as the beefsteak tongue. In the collapse of cholera the tongue is cold and in conditions of great weakness or extreme debility the protrusion of the tongue is ac- companied by trembling. In apoplexy the tongue when protruded is inclined to either the right or left side of the face, the side opposite that half of the brain where the pressure exists which causes the paralysis. The tongue is coated in all acute diseases as pleurisy, pneumonia and the various kinds of fever. The degree and extent of this coat- ing, its color and the want of moisture make up a variety of sugges- tions which practice teaches one to interpret without mistake. The Teeth and Gums. — While glancing at the tongue the phy- sician also notices the condition of the teeth and gums. These parts often require special attention. Decayed teeth are unhealthy and they should be cleaned and filled or else removed except in the case of the shedding teeth, which should be allowed to remain as long as possible to prevent contraction of the jaw. Rapid decay of the teeth is often indicative of some constitutional impairment. Certain medicines as iron injure the teeth, and when administered should be given in such a way as to prevent this unfortunate occur- rence. In typhoid fever the teeth and gums are covered with a black collection of matter called sordes. This should be washed off and vaseline applied to the lips to prevent their cracking and scaling. A blue line along the gums indicates lead poisoning. An exces- sive flow of saliva sometimes indicates mercurial poisoning though there are other conditions which also produce this symptom. The Saliva and Mouth. — Some medicines, like jaborandi, in- crease the flow of saliva, and others, like belladonna, check the secretion, rendering the mouth and throat uncomfortably dry. An excessive flow of saliva is sometimes troublesome during the period of teething, also in pregnancy and other conditions. 140 THE NEW MEDICAL WORLD. The saliva is thick and viscid in catarrhal inflammations and in fevers. It is sometimes mixed with purulent matter in protracted bronchitis, and rust colored sputa in pneumonia. An eroded condition of the mouth sometimes reveals the fact that poison has been taken, and the peculiar appearance of the eroded membrane indicates to the experienced eye, just what particular poison has wrought the mischief. Appetite and Taste. — A bitter taste in the mouth usually indi- cates dyspepsia or biliousness, and a sour taste indicates an acid condition of the stomach, very common in indigestion. A saltish taste is noticed in hemorrhage, and a very disagreeable putrid taste from the discharge of a quinsy sore throat, when the abscess ruptures, or from gangrene of the lungs. In most acute diseases the appetite is lost, and it is perverted in hysteria, chlorosis, and frequently in pregnancy. It is often exces- sive in diabetes, in certain nervous affections, and when worms infest the stomach. Thirst is a noticeable symptom in fevers, cholera morbus and cholera infantum, and in diabetes. Dysphagia. — In certain diseases difficulty in swallowing appears as a marked symptom. This is the case in inflammation of the ton- sils, pharynx or larynx. It is usual in diphtheria, mumps, scarlet fever, abscess of the throat or neck, and many other affections which attack or infringe upon the tissues in the vicinity of the throat. The Odor of the Breath — The odor of the breath will be no- ticed in many cases. It is usually offensive in fevers, quinsy and diphtheria, sour in indigestion and it has a peculiar sweetish and sickish odor in uremia. This is so marked as to be readily observed by one who has ever encountered a previous case. The odor of small pox, typhus, gout and some other affections is characteristic. In gangrene of the lungs it is so offensive as to be almost unbearable, but fortu- nately this putrid condition is quite uncommon. The Pulse. — You have noticed that when a physician has been called to look you over and see what special departure from health is giving you trouble about the first thing he appears to do is to place his finger upon your wrist, over the radial artery, thus feeling the pulse. This is not the result of habit, but because the pulse reveals the action of the heart, and at the same time much concerning the THE NEW MEDICAL WORLD. 141 condition of the patient. There are some facts about the heart beat and pulse which it is well to know. It is more rapid standing than sitting, still more rapid walking than standing, and still more rapid running than walking. All exercise increases the action and force of the heart. The pulse is more rapid after a meal than before, owing to the energy which the digestion of food requires. Every thought or emotion of the mind correspondingly quickens the action of the heart. All excite- ment disturbs more or less the nervous system, and whatever disturbs the nerves disturbs the heart's action in a corresponding degree. Exercise and thought are healthy and invigorating within certain limits, but if too prolonged and carried to excess may lead to depart- ure from health. The relation of the mind to the bodily organs is intimate almost beyond our comprehension. Age reveals great variation in the frequency of the pulse. In infancy the pulse is more rapid than in adult life, and this tendency is still more marked in old age. There are many individual excep- tions to any general rule which could be formulated with reference to this subject. It is, however, sufficient for practical purposes to know that the pulse rate per minute in infancy is about 120, in child- hood from 90 to 100, and in adult age from 70 to 80, the average being about 72. In old age the pulse declines from 70 to 60, and in some cases to 50, and even 40. It is owing to the vigor of their circulation that children enjoy the rigors of winter, and the sports of coasting and skating, while old people cling to the warm rooms, and complain of the cold, because circulation is feeble in proportion as the heart force has declined. The average pulse rate in females is greater than in males. This increase does not appear to indicate less vigor, but it is nature's method of compensation, for as the stroke is less vigorous a greater number are probably required to accomplish the same work. The more rapid the pulse, usually the less force in each heart beat. In the early stages of fevers the pulse is full and bounding, the face often Hushed and the eyes congested. The pulse is rapid in the acute diseases of childhood, in scarlet fever, pleurisy, pneumonia and in typhoid fever. There are, however, exceptions to this rule. In diphtheria the poison acting upon the nerve force somewhat para- lyzes and retards its activity, and similar conditions exist in malaria, bilious fever and other conditions of disease poisoning. The pulse is slow in apoplexy or in allied conditions where com- 142 THE NEW MEDICAL WORLD. pression of the brain exists. The pulse is slow in cases of opium or lead poisoning. Some persons in health have a slow pulse rate with- out other evidence of debility or prostration, hence a slow pulse does not of necessity indicate sickness. Irregular pulse is often due to the excessive use of tobacco by smokers. Irregularity of the pulse ap- pears to be natural to some persons and may exist, without any other indication that health is impaired. In these cases some beats are more rapid or more energetic than others, a few" rapid beats may occur followed by a few which are slower or more full, or a beat may be occasionally omitted. A person of ordinary skill is unable to judge whether irregular heart action is natural or the result of disease* of the brain or the heart itself. Such symptoms are of but little practical importance to the individual and to be unconscious of their existence prevents anxiety of the mind and is often favorable to the continuance of health. In nervous diseases the pulse is usually quick or jerky showing an excited and disturbed condition of the system. In the last stages of fevers and other diseases which are approaching a fatal termination the pulse is small and thready and before death it becomes irregular and flickering. We see then how important are the suggestions which may be gained by placing the fingers upon the wrist. Practice and experience render this procedure almost prophetic. Respiration. — The character of the breathing and the number of respirations each minute are s3miptoms of great importance. Normal respiration admits of quite a wide range. The new-born infant breathes about forty times a minute, a child five years old breathes about twenty-five times a minute while an adult ordinarily breathes from fifteen to twenty times each minute ; the average is about eighteen for a healthy adult there being about four pulsations of the heart during each act of respiration. In fevers the breathing is more rapid than normal except in cer- tain typhoid conditions when it may be slower, and in profound opium poisoning it also becomes very slow or ceases altogether. The breath- ing is rapid and shallow in hysteria, it is short and attended with severe pain in pleurisy, it is shallow, rapid and painful in pneumonia, running up to forty and sometimes sixty a minute. It is obstructed and difficult in croup, Labored in asthma, stertorous (snoring) in pro- found anaBsthesia, in apoplexy and in the deep Bleep oi inebrity. In certain diseases <>t" the heart the respiration is labored and difficult. THE NEW MEDICAL WORLD. 143 Cough. — The act of coughing is common to many diseases of the lungs and air passages. It is sometimes of little at other times of serious import. The character of the cough often indicates its im- portance as a symptom of disease. A dry, hollow or hacking cough may be sympathetic or only of nervous origin and without any very special significance. In the early stage of bronchitis the cough is tight and dry and affords no relief. This is due to the inflammation and dry condition of the bronchi ; later however it becomes soft, deep, loose and brings up accumulations of thick mucous. In the incipient stage of consumption the cough may be merely of a hacking, bronchial type, but with the advanced stages of the disease it becomes deep and often distressing. In spasmodic croup the cough is hoarse and barking, or in ad- vanced croup it may have a whistling sound ; favorable symptoms are the softening of the cough and the secretions of mucous. In pneumonia the cough is shallow and owing to the pain a strenuous effort is made to suppress it. In whooping cough the paroxysms are characteristic and so familiar as to need no description. The peculiar symptom known as hiccough is caused by a spas- modic action of the muscular wall which separates the abdomen from the thorax known as the diaphragm. It may be the result of exhaus- tion or due to indigestion or some nervous disorder. It is very com- mon with infants but of little significance. It sometimes indicates the approach of death in serious cases and seems to be due to that final exhaustion which is relieved only by the calm and stillness which ensues. Nausea and Vomiting. — These are symptoms of considerable importance when weighed in connection with others. They may result from many diverse causes as will be seen from the following statements. They often occur from indigestible food in the stomach especially in children who devour unripe fruits in the summer. They occur in inflammation of the muscular lining of the stomach (gastri- tis) whether caused by alcoholic drinks or otherwise. They are familiar as occurring from sea-sickness, bilious disorders, pregnancy, cholera, cholera morbus and cholera infantum. They also occur in ulcers and cancers of the stomach, in diseases of the brain, in yellow fever, in Bright's disease, in strangulated hernia and from medicinal substances and various poisons. The character of the vomited matter is often of some value in diagnosis. In bilious attack the vomited matter is composed of mucous and bile, in cholera 144 TIIK NEW MEDICAL WORLD. the characteristic ripe- water vomit occurs, in yellow fever the black vomit appears, in ulcers of the stomach mucous, lymph and blood are vomited; in cancer of the stomach the microscope reveals cancer cells in the vomited matter, in strangulated hernia and obstruction of the bowels the vomited matter is characteristic and consists of the con- tents of the bowels. Vertigo is rarely due to brain disease but often to disordered stomach and liver affections of a temporary character. Pain. — This symptom is often urgent. It must then be inter- preted promptly and correctly, and in infants from their only lan- guage which is a cry. In general, pain which is relieved by pressure is not attended by inflammation. Colic causes pain of this kind and affords infants previous to three months of age most of their distress. One of the difficulties in interpreting this common symptom is dis- closed in the fact that pain is not always experienced at the seat of the trouble from whence it proceeds. In hip joint disease the pain is felt at the knee, in affections of the liver the pain is felt under the shoulder blade, in dyspepsia at the place usually described as the pit of the stomach, just under or below the sternum. In affections of the bladder and ovaries the pain is felt in the limbs and other mem- bers and parts, while uterine diseases produce headaches and pain in the top of the head. Where pain is the product of inflammation there is usually much tenderness on pressure. Pain may be constant or intermittent; it may be fixed at one point or wander about from place to place. The character of the pain aids in the act of diagnosis. In pleurisy the pain is located in the side of the chest, and is acute, sharp and cutting. In pneumonia it is dull, heavy and aching. In dysentery it is twisting and griping in char- acter, while in cholera morbus it is attended by cramping. In rheumatism the pain is tearing or gnawing, while in neuralgia it is shooting and darting in character, now here and now there. In an abscess the pain is pulsating, in erysipelas it is smarting and burning, in urticaria (nettle rash) it is stinging, in labor it is rhyth- mical and tends to bearing down. The pain which attends the passage of gall stones extends from the right side under the short ribs t»> the center of the abdomen. It is a very m-\ ere, cutting pain ; a similar pain, but in a different locality, attends the passage of a calculus from the kidneys through the ureter into the bladder. It is THE NEW MEDICAL WORLD. 145 an agonizing, tearing, cutting pain, which requires energetic measures to secure relief. The position assumed by the patient often throws some light upon the diagnosis. Patients suffering from peritonitis lie upon the back with the limbs drawn up. This is the position which permits of the largest amount of relief from the tenderness and severe pain in the abdomen. In asthma and in some forms of heart disease the patient is unable to lie down, and finds existence more tolerable by sleeping in a sitting posture. In the early stages of pleurisy the patient lies on the unaffected side, but later, after the effusion of water into the chest cavity takes place, changes and lies on the affected side with a greater degree of comfort. In some cases of heart enlargement and other affections of this important organ, the patient can lie only upon the right side. In the pain of colic the patient often finds a measure of relief by lying upon the abdomen. Hemorrhage. — This is a symptom which requires deliberate judg- ment, unless from an injury, where its source is easily recognized, and demands prompt action. Hemorrhage from injuries is treated elsewhere. In early life hemorrhage from the nose is frequent and usually insignificant. For the treatment of serious cases, which require plugging, see Chap. XV., Art. V. The amount of hemorrhage and the place from which it proceeds are alike important. Hemorrhage from the lungs may result from congestion caused by defect in the heart's action, or otherwise, or from tubercular disease. Hemorrhage from the lungs is frothy and bright red, and is brought up into the mouth by the act of coughing; if the quantity is large it is followed by corresponding prostration. Hemorrhage from the lips or gums is usually unimportant. It may come from the throat as the result of an abscess or ulceration. That which comes from an ulcer in the stomach is usually dark colored and brought up by vomiting. It is never frothy nor bright colored. Blood from the nose often escapes into the stomach during the sleep of a young person, and is raised on the following morning. Hemorrhage from the ear may occur as the result of a fractured skull. Hemorrhage from the bowels may indicate dysentery or piles, or it may result from ulceration of the bowels in typhoid fever. In these cases it is not necessarily fatal unless the amount is larg-e or the patient very weak. 14<5 THE NEW MEDICAL WOULD. Such hemorrhage is sometimes concealed and revealed only by a post mortem examination. Hemorrhage may result from abortion or after natural labor. This may be s<> sudden or so copious as to endanger life. The progress of a cancer in the stomach, rectum, womb or bladder may produce alarming hemorrhage owing to the erosion of- an artery. Blood sometimes appears mixed with the urine and may come from the kid- iirvs the bladder or the adjacent tissues. Blood may appear in the urine from congestion or inflammation of the kidneys or from a stone or cyst in the bladder. It has been known to appear in the urine in malaria and other diseases. It is sometimes of quite serious import in this connection. Blood in the urine as a symptom would be likely to mislead per- sons who have not had the advantage of professional training and experience. It should be borne in mind that some persons manifest a peculiar disposition to excessive hemorrhage from the slightest causes. Delirium. — This symptom is often observed in diseases of chil- dren associated with high temperature and does not necessarily im- ply an unfavorable condition. It is common in typhoid fever, mala- rial fever, meningitis and some other acute affections. Coma. — This is a symptom of serious import in the later stages of acute diseases. The coma produced by alcohol is recognized by smelling the breath and is not generally fatal ; that of opium poison- ing is recognized by the contracted condition of the pupils of the eye and if profound requires vigorous efforts to prevent a fatal culmina- tion. It is of serious import in typhoid and typhus fevers and other diseases which are attended by extreme prostration or disintegration of the blood corpuscles. The coma of apoplexy or from any injury or compression of the brain is generally the certain forerunner of death. Paralysis. — This may result from a local injury or inflammation of a nerve <»r nerves, or from disease of or pressure upon the spina] cord or the brain itself. Paralysis of either the right or left side is known a> hemiplegia, while paralysis of both lower extremities is called paraplegia. The Skin. — The skin is usually hot and dry in fevers. In debility, prostration and consumption there is a tendency to excessive >we;it- THE NEW MEDICAL WORLD. 147 ing. It is caused by the debilitated condition which it continually increases. In many diseases a moist condition of the skin is to be regarded as a favorable symptom. The various eruptions of the skin and their significance will be found in the chapter on the skin and its diseases. Constipation. — This usually indicates a torpid condition of the muscular coat of the bowels. It is often associated with indigestion and sedentary habits. It indicates a deficiency in the secretions of the liver and intestinal glands. The Eye Symptoms. — The eye symptoms which should be noticed in relation to disease are quite numerous. The pupils are dilated in many of the common diseases of childhood, also in hydrocephalus, apoplexy and from the use of belladonna and other drugs. The pu- pils are contracted in inflammation of the retina or brain, in profound narcotism by opium and other drugs of its class. In consumption the eyes are remarkably bright and lustrous, while in old age and in many diseases the eyes are dim and lose their lustre. The arcus senilis is a mark of physical degeneracy and of the ravages of age. It indicates that the vessels and tissues of the body are losing their elasticity and toughness. Rolling the eyes from side to side suggests irritation of the brain. Inequality of the pupils also indicates disease of the brain. In conjunctivitis the membrane about the eye is congested, in iritis the light is dreaded, in cataract the lens becomes opaque and the center of the eye looks milky. Many other symptoms, such as flashes of light, moving spots, double vision, etc., are of special inter- est to the expert, but could not be easily explained to those who have not made a special study of the eye and its diseases. Ear Symptoms. — Ear symptoms are not so numerous. Rino-ino; in the ears may occur from large doses of quinine, from congestion of the brain, from nervous debility, from twitching of the muscles, or from disease of the ear. Deafness may result from cold in the head, wax in the ear. from typhus or typhoid fevers, also from disease of the ear, throat or brain. (Abnormal Products.) — The Urine as a Symptom. — As the waste products of the system are extensively eliminated in the urine, this secretion becomes prominent in establishing the existence of many otherwise obscure and serious disorders. The normal urine is 148 THE NEW MEDICAL WORLD. acid, and when it is found to be alkaline, dyspepsia or some disorder of the digestive apparatus may be inferred. The color of ordinary urine is amber or straw, marked departure from which suggests malaria, jaundice or other disease according as if is colored more or less highly with urates, phosphates, bile pigments or blood. The specific gravity of the normal urine ranges between 1018 and 1025; marked departure from this suggests that it contains either sugar, which may appear in large quantities in diabetes, or albumen and tube casts, which, if persistent, indicate Bright's disease. There are many reliable tests for the various abnormal products which are occasionally found in the urine. These are contained in special works upon the subject. Inability to pass the urine is called strangury, and may be caused by a fly blister, a calculus or stone in the bladder, or by paralysis or loss of nervous control. This condi- tion is easily relieved by the introduction of a catheter. Suppression or failure of the kidneys to secrete urine is a serious condition, and if continued for only a few hours leads to uremic poisoning, coma, convulsions and death. Unless the uric acid is con- stantly eliminated from the system the blood soon becomes poisoned by it, the brain is stupefied and life continues but a brief season. There are many other symptoms of disease which are discovered by the means employed by the skillful physician or expert who calls to his aid appliances such as the opthalmoscope, the laryngoscope, various specula and the sphygmograph. Such means, however, are not of sufficient general interest to warrant their extensive introduc- tion in a domestic work. Lower lung limit Lower pleural limit Diaphragm Liver- — "T Gall-bladder-" Umbilicus J— Cazcum Peritoneum - Heart-cont Stomach Small intestine Sigmoid flexure -Bladder Relations of the abdominal viscera. Anterior view. Lung \~j--jt~ Spleen Pleural limit Descending . colon Quadrants-—- — /- Lumborvm / muscle I' F ■~ Diaphragm ■Liver . Kidney m -\ Ascending |f| I colon m--\~--~ Small •'ib- ' intestine Bit i \! / rS{ Relations of abdominal viscera. Posterior view. CHAPTER VIII. ANATOMY AND PHYSIOLOGY, INCLUDING THE BONES, JOINTS AND MUSCLES. I. — Anatomy and Physiology. II. — The Relation of Physi- ology to Anatomy. III. — The Anatomy of the Bones. IV. — The Bones of the Skull. V. — The Bones of the Face. VI. — The Spinal Column. VII. — Injuries of the Spine. VIII. — The Bones of the Upper Extremities, Chest and Pelvis. IX. — The Bones of the Lower Extremities. X. — The Joints. XI. — The Muscles. XII. — Nature's Effort to Prevent Injury. XIII. — Frac- ture of Bones. XIV. — Dislocations. L—ANATOMY AND PHYSIOLOGY. AN effort has been made to present the subject of anatomy so briefly and interestingly, and so associated with practical lessons, that it will be appreciated by every one. The skeleton, or framework of this wonderful human machine, known as the body, consists of a large variety of connected bones, which support it and give it form. The human skeleton itself, when brought from the closet, awakens unjneasant associations, and is usualty regarded as frightful and hideous, yet when covered and draped with the various tissues, as the muscles, and rounded out with the adipose deposits, embellished with the supple and yielding skin, and filled with animal life, easily ranks as the most beautiful work of art, or as the most intricate piece of mechanism. The bones are developed in cartilaginous tissue, beginning at points called the centers of ossification. Bone is one of the hardest tissues in the human body, and is composed principally of lime phos- phates, various salts and fat. The microscope shows that bone A The Human Skeleton— Fuont View. a, cranial bones ; b, cervical vertebra* ; c, clavicle ; rf, humerus ; e, sacrum ; /, ulna; g, carpus ; h, metacarpus ; i, phalanges ; j, femur ; k, tibia ; /, fibula; rn, tarsus ; n, meta- tarsus ; o, phalanges ; p, pelvis containing ilium, ischium :m