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WBA D133h 1898
63570010R
NLM D51bM3Sfl  7

    NATIONAL LIBRARY OF MEDICINE




    ^O-ofCong^V
SURGEON GENERAL'S OFFICE

    LIBRARY.
Section.
  No. 113,
W.D.S.6.0.
     ' 1 li O
No..—.:-•-____
3—613
NLM051643587 
 
THE  AUTHOR.
   He is a benefactor to posterity who adds by his own  toil
and discoveries to the acquisition of those who have preceded
him, and for every valuable  principle  he  unfolds  he starts
a wave of light that  vibrates forever. 
IE  HOME
:E  OF MEDICINE
Mr Lies and everybody
 /> THE ENGLISH
  'i /■■
V VVMA. ::)\:G COMPAN
V96 Tremo  :■•'. uti i.
  BOSTON', MASS.
    1898
 
 
THE   HOME
PRACTICE  OF  MEDICINE
FOR THE USE OF FAMLLIES AND EVERYBODY
       WHO CAN READ THE ENGLLSH

                LANGUAGE
BY
   JOHN WESLEY DAILY, A.B., M.D.

Formerly Field Surgeon with the Fifteenth Regiment of the United
 States Infantry ; Surgeon of the General Field Hospital, At-
  lanta, Georgia ; Surgeon of the General Hospital at Chatta-
   nooga; Surgeon of the General Clay Hospital, Louisville;
    Surgeon of Camp Douglas Hospital at Chicago; Visiting'
     Surgeon for a Year in the Hospitals of Europe ;
      and for  Years a Physician and Surgeon of a
       Private Hospital of Boston, Massachusetts
      THE DAILY  PUBLISHING  COMPANY
                 596 Tremont Street
                    BOSTON,  MASS.
tf$'-1,;,;'u  ■■■>>..     1898
>
V  v
* 916-9/
 
\NBA


   1898
         Copyright, 1898,

By THE DAILY PUBLISHING COMPANY.
     Norfoocrti $reB8
J. S. dishing & Co. — Berwick & Smith
    Norwood Mass. U.S.A.
TWO COPIES KECEIVED. 
Ea
         MY  BROTHER,  DR. S.  J. DAILY

To whom I am indebted for the able  article on "Heredity";
who  has also rendered me other valuable  assistance in prepar-
ing this work for  publication ;  who was  a surgeon in various
hospitals during the  Civil War; who was with  me, as surgeon,
in the General  Clay Hospital,  Louisville;  the General  Field
Hospital, Atlanta;  the General  Hospital, Chattanooga;  and who
has  been  my  companion in  sickness,  danger,  and distress,

             9Tfjts 13ook  is &fiecttonatelg  Uctotcatett
                      BY THE AUTHOR 
 
PREFACE.
   This book has been written mainly to save the lives of
people, to lessen heartaches and bereavements, and relieve
human suffering.
   Its greatest value to the world consists in the unfailing
methods of treatment it gives for about one-third of the
usual diseases  that afflict mankind.
   The names of all such diseases appear in  the index in
italics, and are also marked by a star.
   Any person, on turning to the  index, and finding a star
before the  name of a  disease, may know that the chapter
devoted to that affection gives a treatment that is practically
sure to cure it.
   By giving one drug  at a time, and experimenting in this
way during a period of thirty years in general and hospital
practice, the author found sure  remedies  for about  forty
diseases.
   The treatment of these diseases is as sure in favorable
results as anything can be in medicine, is almost wholly
original, and is given to the world for the first time in this
volume.
   If the book  only contained sure methods of treatment
for ten  diseases, — cholera  infantum, membranous croup,
diphtheria, dysentery,  acute rheumatism, pneumonia, dys-
                           5 
6
PREFACE.
pepsia, sick headache, cramp colic, and catarrh, — its worth
could never be estimated in dollars, because no one can
place a moneyed value upon life, health, and human love.
  The work is intended to separate the known and reliable
from the unknown and experimental, and to give facts and
advice that will bring joy to  the hearts of millions in times
of sickness and danger.
  The prescriptions have all been written in plain English,
and  everything that is  mind-confusing and time-wasting
has been left out.
  The habit of giving mixtures containing many drugs has
always been confusing to physicians, has prevented valu-
able discoveries in  medicine, and just as long as it lasts
will be a clog upon the wheels of progress.
  The use of one remedy to cure many diseases is far more
reliable  than the use of many remedies to cure one disease.
  A portion of the work is devoted exclusively to "female
diseases," including  the  signs of pregnancy, the manage-
ment of the pregnant state, and the effects  of the mother's
mind upon her unborn child.
  Another part  is exclusively upon "skin  diseases," and
gives sure  methods  of treatment  for over half  the affec-
tions of the skin, including  eczema in all its many forms,
such as  salt-rheum, tetter, scall-head, and scrofulous disease
of the scalp.  It also gives a never-failing treatment for acne,
a disease through which  so  many young  people  of both
sexes are ruined in personal appearance by unsightly pim-
ples upon the face.
  The treatment leaves the skin sound, by  entirely remov-
ing the pimples; the red color soon fades, and the face
becomes smooth, fair, and natural. 
IMPORTANT  EXPLANATIONS.
  As this  book is intended for the general public, every
chapter, including all the prescriptions, has been written
in plain English.
  The work has not been brought out to save the money
that is usually paid to doctors, but to save life and suffering.
  When a star  is found before the  name of a disease in
the index,  it means that the chapter devoted to that affec-
tion gives a method of treatment that is practically sure to
cure it.
  In discovering modes of  treatment that are sure to cure
over forty diseases, the  author wishes every one to know
that success frequently depends more upon the proper use
of food and drink than upon drugs.
  In  some diseases there is nothing capable of doing so
much harm as water, while in others, there is nothing can
do so  much good.
  The writer's success in cholera infantum, and almost all
diseases attended with sickness of the stomach and diar-
rhoea, depends  largely upon measuring and  limiting the
amount of fluid taken  by the patient.
  In cholera infantum there is nothing kills so many chil-
dren as the reckless use of water, and strange as it may
seem, the  quickest way  to reduce the thirst is to limit the
                           7 
8
IMPORTANT EXPLANATIONS.
water to a teaspoonful every half hour, and  this should
always be measured, as guesswork will not answer in such
cases.
  In almost all diarrhoeas there is constant thirst, which the
patient tries to control by drinking from a half to a pint of
water at a time, and this increases  the diarrhoea and the
thirst also.
  There are no drugs that will control diarrhoea under such
management, and the quickest and surest plan of treatment
is to limit  the amount of liquid to  a tablespoonful every
half hour for adults, and a teaspoonful for children.
  When this plan  is conjoined with  the drug treatment as
advised in the book, the sickness and diarrhoea will subside
in fifteen hours and the desire for water will gradually cease.
  Ice, for the purpose of allaying thirst, is one of the worst
things that ever went into the mouth  of a sick person, as the
reaction following its use is so great as to cause a burning
thirst that nothing but more ice will satisfy, and in a few
hours the stomach is full of water, and sickness and diarrhoea
follow.
  In the treatment of fevers, provided  there is no sickness
and diarrhoea, water, both internally and externally, is fre-
quently of the utmost importance; but in all diseases com-
plicated with sickness and diarrhoea,  water and other liquids
should be  limited to teaspoonful doses for children, and
tablespoonfuls for adults until  the trouble subsides.
  In inflammatory rheumatism the patient should drink all
the water  he can.  In all  acute inflammations of joints,
muscles, membranes, or  organs of the body, the inflamed
structures  should  be kept in a state  of  perfect rest, if pos-
sible, until the inflammatory condition  is overcome.
  Dyspepsia is found to exist  more or less in connection 
IMPORTANT EXPLANATIONS.
9
with a great many diseases, and  should  always be'treated
in accordance with the advice given in the chapter upon
" atonic dyspepsia."
   There are a great many maladies due to a common cause,
and yet are very unlike  in  their symptoms; for example:
neuralgia, sick headache, common headache, cramp colic,
common colic, insomnia, dyspepsia, melancholy, palpitation
of the heart,  and, usually, constipation  of the bowels, are
all due to a partial nervous  exhaustion, and are all treated
upon one general principle, and  mainly with  one drug —
the extract of ignatia.
   As some  of the above  diseases are found to exist with a
vast number of human ailments, and as ignatia always cures
them,  that drug is prescribed in  a great many chapters in
the book.
   It surely seems more  logical  to give one remedy for a
multiplicity of diseases, provided it cures them all, than  it
is to give a multiplicity  of remedies for  one  disease  and
guess  at  results.
   The reason that ignatia cures so many affections is, that
they are all due to a common cause — nervous debility.
   In almost all inflammatory affections of  an acute charac-
ter, an arterial sedative,  such as tincture of  veratrum or
aconite, should be given  as  early as possible in the disease.
   There are three diseases — cholera infantum, diphtheria,
and membranous croup — in either one  of  which a delay of
one hour may prove fatal to a little patient.
   Every family with children liable to these diseases should
always keep a  box of powders for cholera infantum, a bottle
of medicine to apply to the throat in diphtheria, and a bottle
of the syrup for membranous croup.
  hi cholera infa7itum, if the powders are given as directed, 
10
IMPORTANT  EXPLANATIONS.
and the amount of liquid  is limited to a teaspoonful every
half hour, every child can be saved.
   In membranous croup, if the remedy advised in the book
is given as soon as the attack  sets  in, and the sickness is
kept up for several hours, every case  will recover, as  the
sickness will  arrest the formation  of the membrane.
   In diphtheria, if the throat  is properly treated as soon
as the  white patches are seen, the disease  will be overcome
in twenty-four hours.
   In the treatment of over forty diseases for which this work
gives methods of treatment that are reasonably sure to cure,
but very few disappointments will occur if all the directions
are carefully followed. 
THE
     HOME  PRACTICE  OF  MEDICINE.



                     HYGIENE.

  It  seems that one  of  the most important chapters of
any medical book intended for the general public, is one
devoted to those principles and habits of life that relate to
health and longevity.   To  know  how  to keep  well  and
carry the health-tinted cheeks and youthful vigor across
and beyond the meridian of life's journey, is one of the
most interesting problems that concerns mankind.
  It is  not necessarily  the frosts of  many winters that
make us old, nor is  it  altogether the  weight  of  years
through which we are  depressed and bowed down.  Those
who recklessly abandon themselves to  all  manner of ex-
cesses, are soon bereft of  health and forced to join the
silent majority  before  reaching the natural noon time of
life.   Others, wisely  aware that  only  a certain amount
of enjoyment can  be crowded into the brief span of indi-
vidual existence, live model  lives,  and keenly enjoy health
and happiness at the age  of eighty.
  If the sporting  class that lead intemperate lives by in-
dulging in  all kinds of  dissipation, are truly the wicked
people of the world, then that old and sometimes abused
book uttered an approximate truth in saying, "The wicked
                          ii 
12
HYGIENE.
do not live out half their days."  But the maxim, " Ephraim
is joined  to  idols, let him alone," applies as well to the
sporting class of our time as it did to a similar class two
thousand  years ago; and therefore this article will not be
turned into  a temperance lecture  in order to reform those
who have hopelessly abandoned themselves to the allure-
ments of  vice.   Saint Paul struck  the  keynote of hygiene
when he  said in his letter to Timothy,  " Be temperate in
all things," as there is not a solitary pleasure that mankind
enjoys that may not  become a blighting bane to happiness
when its indulgence  is carried to excess.
  The main question under consideration is, what to do
and  what not to do in  order to  escape disease.  There
is nothing surer than this:  If every organ of the body is
kept in a natural, healthy condition,  and stimulants  and
excesses of  every kind are avoided, the individual is in the
finest possible state to resist disease.
  As one of  the most important factors connected with
the maintenance of a healthy organism is the avoidance of
stimulants, the subject of alcohol  in its many forms  and
of tea and coffee, all of which act  as a spur to the nervous
system, deserves special attention.
  There is nothing  in the universe superior  to nature —
nothing that can rise above it.  When a man is in a state
of health,  he is in the enjoyment of everything, so far as a
healthy, vigorous body is concerned, that any power  can
give.   To give  him a stimulant, is  to lash his entire
organism into exerting, for a limited time, undue energies.
There  are only three conditions, as regards the natural, in
which  a man can exist:  First, the normal, or  natural;
second, the  subnormal, which is below the natural; and,
third, the  supernormal, which is for a limited time above 
TEA AND COFFEE.
13
the natural.  There is only one way by which to force the
human  system into a  supernormal condition, and that  is
by a stimulant.  What follows ?   Let us see.   One of the
eternal  principles in the economy of nature is, that a cor-
responding degree  of depression always follows the exhil-
arating  effect of a stimulant.  For example : If a stimulant
raises the  energy of the organism twenty-five per cent
above  the normal, it will  certainly  fall twenty-five per
cent below the  normal when the effect of the stimulant
ceases;  and, what is more, the stage of depression will be
fully as  long as that of the exaltation.  The above being the
effect of a stimulant, what good can  it accomplish under
such  circumstances?   None  whatever.   Does it do  any
harm ?  It certainly does.  Anything that interferes with
nature and changes the functions of the physical body from
the natural to the unnatural, can do nothing but harm.

                TEA AND COFFEE.

  These two drugs are intensely stimulating to the nervous
system,  and  the harm they are capable of   doing when
used as  beverages, depends, first, upon the quantity taken,
and second, upon the temperament of the individual.  The
following  is an  exact  quotation  from  the  United States
Dispensatory, a standard work  on the preparation and
action of  drugs:  " Coffee,  if  taken  in large quantities,
leaves, after its  first effect, a degree of nervous derange-
ment or depression equivalent to the previous excitement;
and its  habitual employment is well known to injure the
tone of  the stomach, and frequently  to  occasion trouble-
some  dyspeptic and  nervous affections.   This effect  is
peculiarly apt to take place in persons of susceptible ner- 
14
TEA AND COFFEE.
vous systems and in those of sedentary habits.  We have
repeatedly known patients who have suffered with headache
and vertigo to get rid of them by abstaining from coffee."
  The action of tea upon the  nervous  system is very
similar to that of coffee, and like the latter, is liable to
cause wakefulness when taken at night; but owing to  the
delicious taste and fascinating odor of  coffee,  it is used
twenty times as much as  tea and therefore capable of  do-
ing that much more harm to mankind.
  The author, in  devoting a great deal of time and study
to a large number of diseases associated with dyspepsia and
largely depending upon  it, had occasion to  study closely
the causes of chronic indigestion,  a disease known to  doc-
tors by the familiar name of "atonic dyspepsia."  There
is scarcely anything more obvious to  the  intelligent reader
than this: that any drug having the  power, when taken in
moderate quantity for a limited time,  to favorably stimulate
digestion, also has the power  to ruin  digestion when taken
in large quantities, or during a long period of  time in less
quantities.   A knowledge of these facts caused the author
twenty-five  years ago to put a close  watch  upon coffee
as a leading factor in causing dyspepsia and its great train
of associated diseases.
  The manner in which coffee  enfeebles  digestion  and
develops those obstinate  dyspeptic conditions, such as sick
headache, painful colics, constipation, hypochondria, insom-
nia, and  many other maladies, seems to be as clear as a
cloudless noonday, and it is hoped it will be equally clear
to the reader.  The  eternal principle  that should govern
and limit the use  of all stimulants is  this :  A correspond-
ing period  of depression always follows the exhilarating
effect of a stimulant. 
TEA AND COFFEE.
15
  If a strong cup of coffee is taken at breakfast, a feeling
of moderate and rather  pleasant excitement lasts almost
until the next meal.   For this reason dyspeptics who limit
their coffee drinking to the morning meal, have but little
trouble, comparatively, in digesting that meal, because the
nervous system that presides over the digestive functions,
is under a constant spur for hours.  By noon, however,
the stimulant  has died out and a  state of depression in
which the nervous energy drops as far  below the  natural
as the coffee raised it above, is established.
  Before taking the coffee, the man is in a normal or nat-
ural condition.   For hours after taking it, he is in a super-
normal  or unnaturally excited state, and by dinner time,
when the stimulant has given out, he is in a subnormal or
depressed state. From the foregoing it seems evident that
any stimulant that forces the digestive system to the exer-
cise of  undue  energies,  in order to digest  the morning
meal, impairs the power of the  stomach and bowels to
digest the subsequent meals of the day.  Unfortunately
for mankind, coffee drinkers do  not limit themselves to
one or  two  cups  at  breakfast, but drink it at the other
meals as well.  Let us see what results from the constant
use of  a nervous  stimulant of any kind.  The muscular
system  when forced  to work too  hard  or too long, gets
tired  and sooner or later becomes  exhausted.  The same
is true, exactly the  same, of the nervous system, and a
stimulant like coffee bears about  the same relation to the
nerves that the lash of the task master  of the South did
to the muscles of the slaves in the cotton fields, and there-
fore, if coffee is taken three times  a day or even once per
day in  large quantity, a state of partial nervous  exhaus-
tion is almost sure to follow, and with it one  of the  worst
forms of dyspepsia imaginable. 
i6
EFFECT OF STIMULANTS.
  In such cases the disease  is called  " atonic  dyspepsia,"
as atony means debility, and is caused by nei'vous debility.
A better term would be coffee  dyspepsia, as  it is essen-
tially different in many respects from dyspepsia from other
causes.  One of  the most  distressing  characteristics  of
coffee  dyspepsia  is the frequent and terrible headaches
that accompany it, especially the " sick headache."
  It is well to state in this connection that most all coffee
drinkers suffer  from headache more  or  less,  and usually
the trouble is moderate or severe, according to the amount
of coffee taken.

EFFECT  OF   STIMULANTS  UPON THE  DIF-
       FERENT ORGANS  OF  THE  BODY.

  Under the influence of an excitant, the brain and nerves
work  harder, the stomach secretes more juices, digestion
is more complete, the liver secretes more bile, the pancreas
more  pancreatic juice, the kidneys more urine, the peri-
staltic  or worm-like action of  the bowels is increased, the
heart  beats faster, the lungs fill  and empty themselves
quicker, the  state of general vitality is  higher, and the
individual actually lives faster and wears out quicker than
he otherwise would;  but the most unhappy effect  of a gen-
eral stimulant is,  that after  its action ceases,  every organ
of the body drops down to a sluggish or subnormal state
and waits  to  be aroused by another stimulant.  A physic
is  usually a local  stimulant or  irritant, and  when  used for
constipation, is  as irrational as it is  harmful.   The  bowels
become accustomed to its use and simply wait  for it.
  Before the horse cars were taken from Tremont Street, in
the city of Boston, it was  found  hard  for the teams to pull 
TOBACCO.
17
a car filled with passengers up one of the steepest grades.
In all such cases the car had to wait until  an electric car
came up behind and boosted it over the hill.   The horses
soon learned that the electric car would do the work for
them, and therefore  they would wait  at the  foot of the
grade until they could  hear the buzzing of  the electric
wheels,  before  they would offer to pull.  This illustrates
a principle that runs  through the entire animal economy,,
namely: That  every physical organ when stimulated for
any  length of  time, becomes blunted in its susceptibility
to the natural nerve forces and waits for an artificial exci-
tant.  As constipation  is  treated at length in a chapter
devoted especially to  that  subject, it cannot be considered
further  in this connection than to  say this:  Never take
physic for constipation.   If  you do, the bowels will drop
into  the habit of waiting for it, and  in that way  your
trouble will gradually increase.
  There is a natural diminution of nervous intensity as
shown in its effect upon most of the organs as one passes
from  childhood to adult life, and therefore a general ten-
dency to constipation as we  grow older.  For this reason
anything that has an intrinsic tendency to dull or lessen
the susceptibility of the bowels to a  nerve force that is
gradually diminishing as the frosts of  other winters come
upon us, should be carefully avoided.

                     TOBACCO.

  This " weed " is used by millions and millions of people,
and is condemned by almost every one, including  those
who use it.  Its active principle consists mainly of nicotin
and a volatile oil — empyreumatic oil.  Strong tobacco con-
        c 
i8
SMOKING.
tains from five to eight per cent of nicotin, which  is a
deadly poison.  Tobacco, like alcohol, is an  active stimu-
lant in its primary effect, while its secondary action is that
of a prostrating sedative, especially if carried to the point
of producing sickness of the stomach.  The most harmful
way  in which tobacco  is  ever used  is by chewing.  In
addition  to the fact  that tobacco chewing is  disgustingly
filthy,  that the chewer  is compelled to be  spitting  con-
stantly,  that his breath is  extremely offensive, and the
spittoon is a foul, odor-breeding thing that is  not fit to be
in any parlor, the drug often has a terrible effect upon the
nervous  system  and organs of digestion.  Almost all of
the so-called heartburn from which tobacco chewers suffer,
is from tobacco.   The tendency of tobacco chewing,  even
when it does not seriously impair the general health, is to
reduce the flesh from ten to fifteen per cent.  For exam-
ple : A person whose normal weight is one  hundred and
fifty pounds before using tobacco in this way, will drop off
from fifteen to twenty pounds from its continued use.  A
forced reduction  of  flesh from  tobacco,  anti-fat,  or any
other drug, is almost always at the sacrifice of health and
vitality.
                     SMOKING.

   The first effect of a cigar or a pipe is to quicken the
heart's action and maintain, during the smoking hour and
for some little time after, a supernormal condition of the
nervous  system.  Since the nerve forces are  spurred by
the " weed " to an unnatural intensity, it is often claimed
by the friends of the pipe and cigar that smoking  after
meals  favorably  affects digestion.   But it must  ever  be
remembered that the nervous system is capable  of  exer- 
SMOKING.
19
cising a certain definite force, and that any artificial means
employed to develop a physical force that does not actu-
ally exist, is at the sacrifice of enduring energy.   There is
nothing in man superior to himself, nothing that can rise
above his natural organic forces.  If he could be hastened
in his  speed like a locomotive, only using a drug instead
of steam, he would  at once  cease to be a physical being
and  become a  machine.  Tobacco,  in  all the forms  in
which  it is used, belongs to the catalogue of stimulants,
and, like alcohol, tea,  and  coffee,  quickens the  heart's
action  and forces the entire body into a  condition that is
supernormally energetic for a limited time, to be followed
by a corresponding period of depression.  It is not possible
for an unnatural stimulant — and all drug stimulants are
unnatural — to raise the  average energy  of  the  nervous
system the thousandth part of a unit.  The only effect of
stimulants is to make the human organism run irregularly,
somewhat like a Kansas windmill,  that  only runs when
the wind blows.
   While tobacco is  a depressing  and  devitalizing agent,
and while smoking,  chewing, and  snuff rubbing are  all
debilitating,  it  must be admitted that some persons estab-
lish a perfect tolerance for  the drug and use it  during a
long life with impunity.
   A discharging ulcer upon the body is  a constant drain
upon the system, and yet nature arouses her energies, in
many cases, so as to supply an extra amount of recupera-
tive power to support the ulcer and a healthy and vigorous
organism.    It  is  probable that  through the elastic and
conservative principles of nature the otherwise disastrous
effects of the tobacco habit .are occasionally overcome and
health and longevity maintained. 
20                       DIET.
   A  century  ago, a  pseudo-philosopher, ignorant of the
principle that  action and reaction are equal, placed a great
bellows in the stern  of  his sailing-boat, in order to  blow
against the sails and make fair headway during a dead calm.
As part of the  artificial breeze went wide of the mark
and was wasted, the action was less than the reaction, and
the craft moved in the wrong direction, that is, backwards.
And  so it  will ever be with every man who attempts to
force himself  into an unnatural gait  by using stimulants.
He will go in the wrong direction.
   The recoil of a gun is always equal to the force of the
discharge in the  other direction, and whenever a man can
escape the recoil of a stimulant, that  eternal principle of
nature, that action and reaction are equal, will be destroyed,
and men will be able to lift themselves over the fence by
their own bootstraps.

                        DIET.

   There seems to be some excuse for  the maxim: " One
man's meat is  another man's poison,"  as some persons are
distressed by almost everything they  eat, while others eat
with impunity anything they can swallow, and for this reason
no absolute rule can be given for the guidance of  persons
in a state of  health except this:  Every man should use
those articles of food that he has found  by long and care-
ful experience best suited to his particular  case as regards
comfortable digestion, regularity of the bowels, and the
maintenance of a vigorous body.
   The treatment of constipation by coarse bread and other
articles of rough food is to  a great extent a failure,  as it
is a physic in disguise and acts by irritating the lining
membranes of the stomach and bowels. 
DIET.
21
  As the health and comfort of almost every individual
depend upon the regular movement  of the  bowels, the
subject of constipation has to be considered to some extent
in connection with diet, as the dietetic treatment  of the
trouble in connection with other hygienic measures is the
one upon which every person must mainly depend.
  The best treatment that the author has ever known for
constipation is  a fruit diet.  It consists in the abandon-
ment to a great extent of meat, and eating fish, bread and
butter, and an abundance of fruits and vegetables.
  The reason that fruits often fail to overcome constipa-
tion  is, that  the  fruit regime is not  rigidly  carried out.
Eating an apple now and  then when one happens  to feel
apple-hungry, or taking an  orange at bedtime,  does no
good.   If three  or  four  fair-sized  apples are eaten raw
during the day and suitable fruits and  vegetables taken  at
meals, the bowels will soon begin to move easily and will
gradually, except in the very worst cases, get to moving
every day.   Fruits containing seeds like raspberries and
blackberries are bad and  should not be eaten by persons
subject to constipation.   The same is true of  grapes if the
seeds are swallowed.  A great many cases of  fatal  appen-
dicitis are caused by swallowing such seeds.  The use  of
powdered magnesia as a physic is equally dangerous, as it
is liable to cause  obstinate obstruction if not appendicitis.
  Apples, peaches,  oranges, plums, and lemons are the
best  fruits to be eaten.  When the peach season is over,
the best  dried  peaches, when properly stewed, are  calcu-
lated to favor a natural action of  the bowels.  Prunes are
simply half-dried plums,  and are also  good,  but inclined
to act like a physic and  cause griping pains when eaten
in excessive  quantities.   They  are fine, however,  to eat 
22
CLOTHING.
in connection  with  other fruits.   While the fruit diet is
being followed, such articles as cheese and eggs and such
others as are known to be constipating, should be avoided.


                     CLOTHING.
  When the writer of a medical book brings forward ideas
in regard to clothing or  anything else that are in open
conflict with the established customs of the people, he is
called a  crank or fanatic.   The  author  has  not sought
to popularize this work by catering to the pet notions of
any  one, but,  on the other hand, has tried to  point  out
many of  the  customs  of  living  that are  radically and
deplorably wrong.  One of the greatest mistakes of this
generation,  especially among  the rich, is the  habit  of
clothing  children so warmly that  proper exercise in  the
open air during the  winter season is almost impossible.
  When a boy is fettered with overshoes, and then wrapped
up from his throat to  his feet, almost, with an overcoat, he
doesn't run to school as is natural with children, but walks
and  acts like  a  man.  In  many cases such boys are  ad-
monished never to go out of  the schoolroom without over-
shoes and overcoat.   He cannot indulge in any games or
romps with boys that are properly  clad, because he cannot
run.   He suffers for want of the vigorous thrill of  the
heart and arteries that childhood  ever demands, and  for
want of which physical development is impeded.
  Such boys are usually slender, with soft, flabby muscles,
are decidedly effeminate when fully matured, and not very
strong intellectually.   They  correspond  to the "feather-
bed  soldiers" of the late war.  In  childhood  the  heart
beats a third  faster than  in  adult  life,  the breathing is 
; THE SKIN.
23
faster, the vitality naturally greater,  much  more physical
heat is  generated, and the power to resist  cold  much
greater, and therefore they do not need the clothing that
men and women do.  The muscular  and  organic  systems
must be developed during adolescence, — during the main
period of physical and  mental growth, — and anything
that seriously impedes the motion of the body seriously in-
terferes with proper development.


                     THE SKIN.

  This is one of the most extensive  and  also  one of  the
most important organs of the body.  It  covers  and pro-
tects the veins and capillaries and also various glands.   It
is intensely endowed with nerve fibres, and is  therefore  a
highly sensitive organ.  This seems to be a wise provision
of nature, as the  skin, being an immense  envelope enclos-
ing the human body and  exquisitely  sensitive in  every
part, is practically a force of sentinels  guarding the indi-
vidual while he sleeps.
  Any one who  has ever  been aroused  from sweet  and
pleasing dreams  by a bedbug meandering  over  his body
at midnight, can realize how wonderfully sensitive the skin
is.   The membranes lining the  cavities of the body are a
continuation of the skin, and, like the latter, are depurating
organs,  or, in plainer terms, organs  through which innu-
merable poisonous elements are eliminated from the body.
The skin is endowed with a multiplicity of  glands of  two
kinds, — sweat glands and oil glands.  The latter are at the
roots of the hair  and contribute to hair nourishment  and
growth.  The sweat glands exist in some parts of  the skin
to the number of two thousand  or  more  to  the square 
24
THE SKIN.
inch, and  rising from them like church  spires,  are  little
tubes or ducts that conduct the water from the  secreting
glands to the surface of the skin.   These tubes are known
by the common name of " pores," and the water that they
bring to the surface under the name of " sweat," or " insen-
sible perspiration," gradually evaporates,  and in  doing so,
lowers the temperature of the body.
  In this  way persons are protected  from the otherwise
insufferable heat of summer.  The amount of water given
off  by the skin reaches,  in rare cases,  a  half  gallon in
twenty-four hours.  That is called " sweating"  or " per-
spiring," but when the amount of water exhaled  by the
skin is only a pint or a little more, it is called  " insensible
perspiration."
  It is said — and the statement seems reasonable — that
if a coat of varnish be applied to the entire  skin, that a
person would  almost perish from ordinary summer  heat,
as in that  case no water  could come out of the  " pores "
and lower the heat of the body by evaporation.  All these
things teach the importance of keeping the skin in a clean,
healthy condition so the  sweat ducts will  not be  closed.
This leads us up to the subject of bathing.
  As to how often a person of ordinary vigor and strength
of body should bathe, is  a question not easily answered,
as a great  deal depends  upon occupation.  Coal diggers
bathe every night, year  in and  year  out when  working.
With them it is  a  necessity, and they are  exceedingly
healthy.   The question, How often should a person bathe ?
can only  be  answered one way, and  that is  this: Often
enough to keep clean. 
EXERCISE.
25
                     EXERCISE.

  It  is one of the  immutable principles of nature that
every physical  organ that is not used, gradually becomes
atrophied or shrunken greatly in size so as to be worthless.
If a leg or arm is tied up for years and not used, muscular
atrophy or shrinking away of the muscles takes place, and
that member of the body becomes forever'useless;  and if
some  physical organ in a certain animal species becomes
useless for a great many generations on account of the
changed conditions of that species, the organ will entirely
disappear.  There  is a deep  and  rapid stream in  Mam-
moth  Cave, Kentucky,  that contains a  great many fish.
The light of day never enters the cave, and for that reason
the fish  never have an opportunity to see, even if they
had eyes.   Nature is  ever conservative, and  therefore
never creates  and maintains organs that are not needed.
For this reason the fish of the cave are " stone  blind."
When man, in the infancy  of the human race,  was  an
arboreal  animal or "cave dweller," he had muscles in his
ears like those of a horse, so that he could turn his ear in
any direction and gather and intensify the rustling  sound
of a leaf  and be warned of approaching danger.  In civil-
ized life  he is not exposed to such dangers, and  therefore
has no use for such muscles, and they have almost ceased
to exist.   Nature never  makes any half hinges, because
they would be useless.   She never maintains organs that
serve  no  purpose in the natural economy, and  therefore
all the organs of physical beings must be used or they will
perish.
  That style of exercise that is used solely for the  promo- 
26
EXERCISE.
tion of health, is called "calisthenics," and may consist of
exercising  with  Indian  clubs  or  dumb-bells, or  going
through the extensive routine of an  ordinary gymnasium
every day,  or of walking  or  running.   There is one very
important principle that should govern every  one in the
matter of taking exercise, and that  is this :  The condition
of the mind when exercising must always be  considered.
If the character of the exercise  is distasteful to a person,
there are two reasons why it will fail to be of much if any
benefit to him.  In the first place, he will probably abandon
it before it amounts to anything.  In  the second place, the
dissatisfied state of his mind is liable to do him more harm,
especially if he is sick, than the exercise would do good.
All exercise should either be pleasant  in itself or carry with
it some ultimate object or hope that is pleasant to contem-
plate.   If a person feels that some  good or pecuniary gain
will be accomplished  aside from the promotion of health,
the exercise naturally becomes pleasant and satisfying to
the mind, and in that way favors digestion and does much
good.   It is a  notable fact that persons who suffer from
dyspepsia, lung disease,  and other depressing affections,
are in a subnormal state so far as vitality is concerned and
very little inclined to exercise at all.    It is best for such
patients to place  themselves under  conditions that compel
them to exercise in  the  open air.  If they have a long
walk to and from their place of business, it is all the better
for them.   Walking calls into use  almost  all the muscles
of the body, more or less, and in  that way is capable  of
much good. 
EFFECTS OF THE MIND UPON THE BODY.
V
 EFFECTS OF  THE MIND  UPON  THE BODY.

  The influences  of  the mind  upon  the body manifest
themselves in a multiplicity of ways.  When a person with
a usually sunny and pleasant face  takes  on  a corrugated
brow, with wrinkles about the eyes, and has a " far away "
or vacant look, such  phenomena are to be hailed as the
outward  expression of  a deeply  seated grief,  anxiety, or
dissatisfied state of mind.  In such cases there is a con-
stant mental effort  to overcome the  trouble, whether
domestic or otherwise, and this gives rise, in  many cases,
to a state of mental abstraction that renders the individual
somewhat  oblivious to  his  surroundings.  An unhappy
state of  the  mind or an unduly  anxious  condition cannot
exist for a considerable length of  time without seriously
affecting the general health.
  When  a person  is suffering from  pain or infirmities that
are wholly physical, a haggard and wrinkled appearance of
the face  may exist, but  that total  abstraction  that shows
the mind to be struggling with  intricate and distressing
questions is absent.  All these  things have  to  be  con-
sidered in dealing with disease and also in our efforts to
prevent it.
  This may be assumed as a principle that is immutable:
A reciprocal  relation  between the mind and body always
exists ; that is, the condition of the body always affects the
mind, and  the condition of  the  mind always affects the
body.  Trouble is a  mental affliction, and sooner or later
develops a physical  one.  The  gravity  of  the physical
derangement is very liable to be in direct proportion to
the extent and severity of the mental perturbation.  Busi- 
28       EFFECTS OF THE MIND UPON THE BODY.

ness difficulties and embarrassments are health-destroying,
nerve-exhausting,  peace-disturbing,  and  sleep-preventing
afflictions that are familiar to almost every business man
who has passed the meridian of life.  They are also dis-
tressingly familiar to the physician in general  practice, as
he is usually confronted with the business  complications
of others, as well as his own.  The friction with customers,
the constant attention and  mental strain that business life
requires in order to succeed,  are all wearing and depress-
ing upon the nervous system, and  yet are of minor im-
portance compared with the distressing anxiety that arises
from inability to meet financial obligations.
  Following all these, and closely related  to them, comes
the grim and terrible nightmare of the closing century —
a dread of financial failure and bankruptcy.
  Happily for us all,  nature has  provided  the  human
family with  a redundance of nerve energy, so  as to afford
a supply for ordinary contingencies; but under  long  and
severe mental strains,  the supply gives out and nervous
prostration  follows.  In such cases the nerve forces are
inadequate to properly stimulate  any of the organs of the
body, digestion is  greatly impaired, the blood  is impover-
ished, color  fades from the cheeks, and the general trend
of the patient is to a  lower  state of vitality, because the
blood,  diminished in  quantity and  defective  in quality,
cannot nourish and properly excite the brain and nervous
system.  This further illustrates the correlation between
the mind and body.
  In cases  as above outlined, the sphere of  medicine is
very limited, as the primary and principal trouble is men-
tal, and an effort to restore  the patient to  health  and
vigor without removing the  exciting  cause of  diseased 
        EFFECTS OF THE MIND  UPON THE BODY.      29

conditions is like giving pills and powders in order to get
rid of a thorn in the flesh.
  There are two principal sources of mental  affliction that
concern mankind,  and  the  physical derangements  they
entail are as widely different as the origin of the mental
disorders.    One  is  business  trouble,  and develops  that
wide range of diseases  known  as dyspeptic  and nervous.
The other is the sorrow of all sorrows  and trouble of all
troubles, — domestic  discords  and wrangles that  finally
separate husband and wife, — and also disappointment in
love affairs.
  In the mental  afflictions  incident to  business complica-
tions  and overwork, the  expenditure  of nerve force is
greater than the daily income, and physical bankruptcy
must  necessarily follow sooner or later.   But the rapidity
with which  business  men  recover from financial disaster
and  regain  their physical  and  mental  equilibrium, is
wonderful.  Dear as  money is to us all, the cases are rare
in which  men  fail  to recover from the  state of nervous
exhaustion that bankruptcy usually brings.
  But the tenderest and most sacred chords that ever  thrill
the human  heart are those of love and affection between
husband and wife  or between  lovers.   When these are
permanently severed, a feeling of  heartrending disappoint-
ment  and  mortal anguish from which there is no recovery
often  takes possession of the mind.
  Any influences that permanently reduce  the  flesh and
vitality of a person have an intrinsic tendency to establish
in that person  a liability to  disease, especially to  consump-
tion.   When a young lady in whom there is but little,  if
any, predisposition  to consumption, is disappointed in her
affections to the extent of being heartbroken,  the  color 
30      EFFECTS  OF THE  MIND UPON THE BODY.

usually fades from  her  cheeks, she loses  flesh, her diges-
tion suffers, and in a few months she is liable to pass into
a state of  decline,—another name for consumption ; and
when she has passed away her friends truthfully say : " She
died  of a broken heart."
  Almost every one is familiar with such cases.  Unfortu-
nately the millions of eyes that are steeped in tears wrung
out by the pangs of blighted hopes in love matters, are
not limited to the state of celibacy, as many young people
of both sexes are  ruined by following  the  heroes  and
heroines of plays  and love stories, and in that way led  to
indulge hopes with reference to married life that can never
be realized.   When a young lady who has lived an ideal
life and pictured in her  morbid imagination an ideal hus-
band and an ideal home, is confronted with the cares and
privations of a poor man's home, to which  are  usually
added the responsibilities and anxieties of  motherhood, the
realities of her young  life seem  so strangely unreal and
disappointing to her that she is heartbroken.   In this way
the seeds of disappointment are sown, and domestic inhar-
mony and  grief with all  their  painful  complications are
the fruits. 
GENERAL  DISEASES.
                    DYSPEPSIA.
  Other  names :  Indigestion;  atonic dyspepsia ; heart-
burn ; pyrosis.
  As the digestive organs  are really the blood factory of
the human body, from which the entire organism  is nour-
ished, from which the system is repleted  and sustained
during the multiplicity of  diseases to which humanity is
liable, it has been thought proper to deal with this disease
extensively in the opening chapter of the book, as there is
scarcely a disease of any gravity, acute or chronic, in which
the digestive functions are  not more or less impaired.
  Dyspepsia is known by several names as follows:  Indi-
gestion, heartburn, pyrosis.  The term employed by physi-
cians,  is  atonic dyspepsia, the  word "atonic" meaning
debility, as almost all cases of chronic indigestion  are due
to a debilitated state of the nervous system.   .
  Symptoms. —Appetite irregular or lost, digestion painful
and difficult, a heavy, disagreeable feeling in the  stomach
after meals, sour stomach from the decomposition of  food,
heartburn, flatulence, and sometimes vomiting of  partially
digested food, frequent belching  of burning fluid, usually
called "waterbrash," the tongue broad and flat and gener-
ally pale.  The bowels are constipated as a general thing.
There is drowsiness after  meals, and sometimes patients
have great difficulty in keeping awake, while at night they
                           31 
32
DYSPEPSIA.
 are  afflicted with wakefulness, usually called " insomnia."
 The memory is often defective, there is more or less head-
 ache, and in many  cases  that  distressing complication
 known  as " sick headache."  This  is very common with
 dyspeptics, the  attacks often occurring every week, while
 in others every two  weeks or at wider  intervals.   The
 regularity with  which these paroxysms occur is hard to
 account for, as  they are  seldom if ever due  to  malarial
 influences.  Many  cases have been known  to the author
 in which sick headache occurred on a certain day of every
 week without an exception for several years.
   There  are  several  varieties of  dyspepsia.   First, we
 have the  nervous  dyspepsia that affects  business men of
 the nervous-sanguine temperament.
   Such men eat rapidly, do not properly masticate their
 food, and use too much liquid to wash it down.   Second, we
 have the flatulent dyspepsia afflicting hysterical women, and
 attended with great accumulation of gas in the intestines.
  The third variety is acid dyspepsia, and  is caused by
 eating coarse, greasy food.  The fourth is called irritative
 dyspepsia, and is characterized by sickness of the stomach,
 and more or less vomiting, the tongue being small and red.
  Termination. — With reasonable care  in  reference  to
 diet  and other habits  of living, including the  avoidance
 of stimulants, the worst forms of dyspepsia are curable.
  Treatment. — One of the  most important things in con-
 nection  with the treatment is to use such articles of  food
 as the patient, by long experience, has found best adapted
 to his particular case, so far as easy and painless digestion,
regularity of the bowels, and  maintenance of a vigorous,
healthy body are concerned.  It  is best to be regular in
eating  both as regards time and quantity of food taken. 
DYSPEPSIA.
33
Many  dyspeptics  have  irregular appetites.   Sometimes
they have scarcely any, and therefore eat but  little.  This
condition may continue for several meals, during which the
system  becomes  run down, and finally calls loudly  for
nourishment, the appetite being morbidly increased.   The
patient is then liable to eat enough  at one time for three
or four meals.  As he  cannot  digest that much,  he is
seized with colic pains of the stomach and  bowels, severe
sickness of the stomach, and other disorders  associated
with acute indigestion, the condition lasting for several
days.  It  is obvious from the foregoing that the life of
the chronic dyspeptic is a series of  ups and downs due in
a great measure  to  irregularity in  eating.  Hence,  the
following general advice is given to all dyspeptics : —
  First, use the kind  of  food that is nourishing and most
easily digested.
  Second,  take plenty  of time for chewing, and  use  but
little fluid with meals.
  Third, for  reasons to be hereafter mentioned  at length,
avoid the use of stimulants.  Use a due amount of exer-
cise, and for this  reason it may be advantageous  to  live
some distance from your place of business, so as to com-
pel a regular amount of walking every day.
  Fourth, all  exercise for the  purposes of health  should
either be pleasant in itself or have  associated with it some
ultimate purpose that is pleasant to contemplate.
  At the  close  of the treatment of this disease a  single
drug will be given,  which,  conjoined  with  good hygienic
measures, will cure  almost all cases  of  dyspepsia.   But
before entering upon the  drug treatment it is desirable
that all readers, and  especially all  dyspeptics, have a cor-
rect understanding of the unfavorable manner in  which
        D 
34
DYSPEPSIA.
stimulants of all kinds, including tea and coffee, affect the
organs of digestion.
  Under the influence of an excitant, the brain and nerves
work harder, the stomach secretes more juices, digestion is
more complete, the liver secretes  more bile, the  pancreas
more pancreatic juice, the kidneys more  urine, the peris-
taltic or worm-like action of the  bowels is increased, the
heart beats faster, the lungs fill and  empty themselves
quicker,  the state  of general vitality is  higher, and the
individual  actually  lives faster and  wears  out quicker
than he otherwise would; but the most unhappy effect of
a general stimulant is, that after its action ceases every
organ of the body drops down to  a sluggish or subnormal
state and waits to be aroused by another stimulant.
  There is scarcely anything more obvious  to the intelli-
gent reader than  this : That any drug having the power,
when taken in moderate quantity for a limited time, to
favorably stimulate digestion, also has the power to ruin the
digestive functions when taken in large quantities,  or dur-
ing a long period of time in less quantities.   A knowledge
of these facts caused the author twenty-five years  ago to
put a close watch upon coffee as a leading factor in  caus-
ing dyspepsia and its great train of associated diseases.
  The  manner in which coffee enfeebles  digestion and
develops those obstinate dyspeptic conditions, such as sick
headache,  painful colics,  constipation of  bowels, hypo-
chondria, insomnia, and  many  other  maladies,  seems as
clear as a cloudless noonday, and it is hoped will be  equally
clear to the reader.   The  eternal principle that  should
govern and limit the use  of  all  stimulants is this:  A cor-
responding period of depression always follows  the  exhil-
arating effect of a stimulant. 
DYSPEPSIA.
35
  If a strong cup of coffee is taken at breakfast, a feeling
of moderate and rather  pleasant excitement lasts almost
until  the  next  meal.  For this  reason dyspeptics  who
limit their coffee drinking to  the  morning meal have but
little trouble, comparatively,  in digesting their breakfast,
because the nervous system that  presides over the diges-
tive functions is under  a constant spur for hours.   By
noon, however, the  stimulant has  died  out and a state  of
depression, in which the nervous energy drops as far below
the natural as the coffee  raised it above, is established.
  Before taking the coffee the patient is in a normal  con-
dition.  For hours after taking it, he is in a supernormal or
unnaturally excited  state, and by dinner time, when the stim-
ulant has given out, he is in a subnormal or depressed state.
  From the foregoing it  seems evident that any stimulant
that forces the digestive  system to  the exercise of undue
energies in order to digest the morning meal, impairs the
power of the stomach and bowels to digest the subsequent
meals  of  the day.    Unfortunately for  mankind,  coffee
drinkers do not limit themselves to  one or two cups  at
breakfast, but drink it at the other meals as  well.  Let  us
see what results from the constant use of a nervous stimu-
lant of any kind.   The  muscular system, when forced  to
work too hard or too long, gets tired and, sooner or later,
becomes exhausted.   The  same is  true — exactly  the
same — of  the nervous system, and a stimulant like coffee
bears about the same relation to the nerves  that the  lash
of the taskmaster of the South did to  the muscles of the
slaves in the cotton  fields, and therefore, if coffee is taken
three times a day, or even once a day in large quantities,
a state of partial nervous exhaustion is almost sure to follow,
and with it one of the worst forms of dyspepsia imaginable. 
36
DYSPEPSIA.
  In such cases the disease is called " atonic dyspepsia,"
as atony means debility, and is due to debility or more or
less exhaustion of  the nervous system.
  A better term for this form of dyspepsia would be "coffee
dyspepsia,"  as  it is essentially different  in many respects
from dyspepsia due to other causes, one of its most distress-
ing characteristics being the frequent and terrible headaches
that often accompany it, especially the "sick headache."
  Almost all coffee drinkers suffer from headaches more
or less, and  usually the trouble is moderate or severe ac-
cording to the amount of coffee taken.
  The drug treatment of dyspepsia is exceedingly simple,
consisting of a single remedy, and is probably worth more
in curative results  than any or all  other drugs that have
ever been given in this disease.   If  the proper  hygienic
measures are followed as  heretofore  advised,  the extract
of ignatia, given before each meal in  doses ranging from
one-half  to  a full  grain,  according  to  the size  of  the
patient, will cure almost every case of dyspepsia.
  The remedy  is  to  be  given  in pill  form, and if  the
patient  weighs  from one  hundred to one hundred and
sixty pounds, a half-grain  pill before each meal  will  be
sufficient.  Those  weighing from one hundred and sixty
to two hundred will take  three-quarters of  a grain, and
all persons weighing over two  hundred are to have a  full
grain.  In all cases a pill is to be taken before each meal.
  The length of time necessary to give the drug depends
mainly upon the length  of time  the  disease  has  existed.
In the worst cases it is better to continue it for many
months without a solitary break.   No remedy can have a
fair trial  in any disease unless  it is given  regularly and for
a sufficient length of time.  One  of the pills must be given 
CONSTIPATION.
37
before each meal, and  should  be continued a month for
every year the dyspeptic condition has existed.   Even in
bad and very chronic cases, they may begin to afford relief
within two weeks.  One great difficulty in  the  treatment
with this  drug is that patients often feel so  well by the
end of the first month that they think they are cured, and
either drop the medicine or forget many times to  take it.
This is very wrong, as it should be taken for months after
the patient is  seemingly well.   The principle upon which
the remedy acts  is this:   During the time it is given it
stimulates  the nerves that preside over the functions of
digestion, rendering the digestive process practically per-
fect, and filling the veins and  arteries with  an abundance
of good, red,  healthy blood.   This blood  nourishes and
stimulates  the brain and  nervous system, which, in turn,
properly stimulate the organs  of  digestion, rendering the
further use of medicine  unnecessary.


                  CONSTIPATION.

  Other terms for same : intestinal torpor,  costiveness.
  This is a disease or habit of  the system  in which there
is general inactivity of  the bowels, either due to nervous
debility  of  the muscular structure, causing  diminished
worm-like action, or to  a deficiency of the secretions of
the liver and  bowels.   It is marked by a change in the
appearance, frequency, and quantity of the stools.
  Causes. — Dyspepsia, irregular habits of the patient, im-
proper food, organic diseases  of  the  stomach  and liver,
and lead poisoning.
  Symptoms. —When a person has one stool  per  day, he
is supposed to be in a normal condition, so far as action of 
38
CONSTIPATION.
the bowels is concerned, but is not necessarily in an abnor-
mal state if more or less than that number occur.
  Some cases of constipation are so moderate  as to cause
but little inconvenience; others are  somewhat distressing,
in which the bowels move only once in two or three days,
with stools dry and lumpy; while others in which the bowels
move only once or twice per week are attended with great
straining and distress, the face being flushed, and the blood
vessels about the head and face filled to a point threatening
apoplexy.
  There are other cases in which the  stools are frequent,
but small and hard,  and act as an irritant to the intestinal
tract,  especially to  the rectum.  In  such cases there is
generally more  or less mucus attending each movement of
the bowels.   When  constipation sets in, there is a gradual
change in the character of the stools, followed by dyspep-
sia, more or less headache, mental derangement  or stupor,
dizziness, fluttering of the heart, and often great distention
of the abdomen.
  Termination. — Never fatal.
  Treatment. — The successful treatment depends upon a
change of diet, regular habits, and hearty cooperation of
the patient.
  Every person who  can  possibly have  one operation of
the bowels per day should have  a regular  hour for going
to stool and  should not allow  business engagements  nor
anything  else to  interfere with his habits  in this respect.
  This is a disease in which physic should never be given,
and yet every one so afflicted  is disposed to  take it  and
thinks it is impossible to do without it.  This is emphati-
cally true with  reference to constipation: The physicking
treatment never cures a single case, nor will a drug treat- 
CONSTIPATION.
39
ment of any kind, except when conjoined with hygienic
measures, ever succeed.   It must be remembered that all
cases of constipation, except the hereditary form, are asso-
ciated with atonic dyspepsia,  both gastric and intestinal,
the atony, or  nervous debility, which  is the  same  thing,
being due in most  cases to  the excessive use of tea or
coffee, alcohol or other stimulants, or to exhaustion of the
nervous forces in dealing  with the annoying affairs of  life,
whatever  they may be.   All  these things must  be con-
sidered in formulating  a rational treatment for constipa-
tion.  As the underlying cause of the disease, aside from
heredity, is dyspepsia, the treatment is practically the same
as that given for dyspepsia, as far as drugs are concerned.
  Therefore, to overcome the atony,  or nervous  debility,
give the solid extract of  ignatia in pill form  before each
meal, the dose  ranging  from one-half to a full grain  ac-
cording to the size of the patient.  Adults weighing from
one hundred to  one hundred and sixty pounds are to take
one-half grain pills, those weighing from  a hundred  and
sixty to two hundred, three-quarters of  a grain, and all  per-
sons weighing over  two hundred are to take a  full  grain.
The remedy must always  be taken before meals and in no
case  more than one  pill taken at a time.   The treatment
should  be continued without  any interruption for eight
weeks,  even in  ordinary  cases.  In  the  most  obstinate
and distressing cases, it should be followed without a break
for four months.  This is all  the drug treatment that is
worth a trial in such cases, as the author has used the igna-
tia treatment for nearly  thirty years,  and has found it so
uniformly favorable in  dyspepsia that he considers it as
justly entitled to be  ranked as a specific  in that, disease
as quinine is in ague. 
40
CONSTIPATION.
  The great difficulty experienced in dealing with obstinate
physical  derangements  is that the  treatment is  not  suffi-
ciently radical, and therefore the use of fruits as they are
usually taken to overcome  constipation is  like trying to
drive  a railroad  spike with a tack hammer, as not enough
fruit is taken to do any good.  There are  but few, if  any,
persons who follow the  fruit-diet plan with any regularity,
taking but little, if any, between meals and using it at the
table just as it happens  to suit their  taste.   In order to be
successful, the meat diet should be abandoned, to a great
extent, and the  fruit  diet substituted.  An abundance of
fruit  should  be  taken every day, the green fruits being
most  desired when obtainable.  Of these the  best of  all
are apples.  Three or four apples every day can be eaten
with advantage between meals.  In addition to this, they
should be eaten either fried, stewed, or baked at two meals
during the  day.   Peaches, plums, and other fruits, except-
ing blackberries, raspberries, and other fruits  with small
seeds, are beneficial in all cases.  There is one  important
thing  for all patients  to remember, and that is this: The
improvement from the fruit diet  will not be  observed
immediately, nor will  a  seemingly favorable impression on
any chronic disease that manifests itself suddenly be either
lasting or beneficial.
  Recovery from  any chronic ailments must be slow, as
the human organism cannot be lifted  at once out of the
old ruts in which it has long been travelling.  If,  however,
the fruits are eaten  lavishly as recommended, to the  ex-
clusion, mainly, of meats, improvement will be  observed
within a week, and if continued, a regular and  easy move-
ment  of  the bowels  will be  the result,  sooner or later.
Fruits are said  to be  nature's cathartic, and it seems  to be 
ACUTE DIARRHOEA.
41
really so; for the acid of the fruit in promoting movement
of the bowels is not irritating  and not in the nature of a
physic,  for  anything acting naturally upon the bowels is
not a physic.  For this  reason  and  this alone, perhaps,
after  regularity of the bowels has been established by the
use of fruits, it does not become necessary to increase the
quantity,  but, on the  other  hand, a less  quantity may
suffice.

               ACUTE  DIARRHCEA.

  This is a disease characterized by frequent and loose move-
ments of the bowels, with or without pain, due to functional
irregularity  of the small intestines or to organic disease.
  Diarrhoea is caused by any irritating agents that  enter
the intestinal tract, or by indigestible food, or by food of
any kind that fails  to undergo  the  proper changes by the
digestive  process.    Impure  water, or  food that  is ill
adapted to the purposes of nutrition and carries with it a
large amount of inert matter, acts as a physic  and keeps
up a  diarrhoea.
  A severe  mental shock or  an unduly excited condition
of the mind, from any cause, or  grief, or great anxiety, is
liable to precipitate an attack of  diarrhoea  by arresting
digestion.   In such cases the food acts as a physic by pass-
ing through the bowels almost unchanged.
  There are two forms of this disease, — acute and chronic.
  Symptoms. — Acute diarrhoea varies in  accordance with
the causes that produce it.  When a patient within  a few
hours after  meals  is seized with pain and more  or less
flatulence, and has an anxious desire to  go to stool, it  is
safe to presume that at that particular time he ate some-
thing that did not agree  with him.  The food failed to 
42                 ACUTE DIARRHCEA.
agree with him because, for some reason, it was not digested.
The prostrating effects of hot weather with the great amount
of water usually taken, have a  great tendency to arrest
digestion and  bring on acute attacks of  diarrhoea.  As
almost all acute forms of this disease are due to a  common
cause, indigestion, one  general treatment is applicable to
all, however numerous the  names by which the  different
forms are designated.   As the presence of undigested food
along and through the entire canal is calculated  to keep
the bowels in a constant state of  irritation, and in that way
keep up an exhaustive  discharge of water and mucus, the
indications  for a successful treatment are  very clear, and
are as follows :  Rid the entire intestinal tract of all irritat-
ing matter whatever and at the same time exercise a cura-
tive  and healing  influence  upon  the  irritated  mucous
lining of the bowels.  The following is the  proper remedy
in such cases, because it always succeeds : For adults, give
eight powders of  five grains each  of  the first  decimal
trituration of  mercurius dulcis,  giving one powder every
hour.  They must not be given in water,  as that  dissolves
the sugar and destroys the effect of the  trituration.  The
powder may be mixed with a little common  sugar  and
placed upon the tongue in a dry condition.   Then  give a
tablespoonful of water.  A  patient should  not take more
than one tablespoonful of water  every half  hour when suf-
fering from this disease.   This amount should  be care-
fully measured, for it is just as important to  measure and
limit the water as it is  to weigh  or measure the  medicine
given.  By the time the powders are all given, if not  be-
fore,  they  will  commence to work  off.   The stools will
gradually become darker until they are almost black, then
they will fade in color at each  movement until  they  are 
CHOLERA INFANTUM.
43
natural.  Then the trouble is over, provided the patient
does not  foolishly  drink  too much  water.   It  is rarely
necessary,  after these powders  are given in  this way, to
give anything to check the bowels, and 7iever necessary if
the directions are carefully followed regarding the use of
water.   If, however,  it should even  become  necessary, a
teaspoonful of paregoric  two or three times  per day for
two or three  days will answer.

              CHOLERA  INFANTUM.
                  SUMMER  COMPLAINT.
  This is an  acute inflammation of the mucous lining of
the  stomach  and  bowels with  irritation of the  nervous
system, due  in  most cases  to the heat  of  summer  and
teething.   It  is attended with very severe pains, vomiting,
purging, intense thirst, and great prostration, sometimes
resulting fatally during the first day or night of the attack.
  Causes. —  Infancy, bad management, teething,  excessive
heat, improper or too much food,  and the greatest of all,
too much water.
  Symptoms. — The attack is usually very sudden and may
occur in a child of  perfect health or one  suffering from a
bowel disease.
  It begins  with  vomiting, is  soon  followed by severe
purging, attended with intense pain  and  straining,  the
child having a  determined disposition  to  stay on  the
vessel.  The thirst  is intense and  is foolishly indulged by
the mother or attendant to the great aggravation of the
trouble, as  the water,  even in small quantities,  excites  both
vomiting and purging, and is often the cause, and  perhaps
the main cause, of a fatal termination. 
44
CHOLERA INFANTUM.
   The thirst is one of the  most prominent symptoms, and
vain attempts  are  made by the  mother to allay it by the
use of ice or small  quantities of ice water.   The  water is
generally rejected as soon as it reaches the stomach, except
perhaps small  portions  which pass into the  bowels  to
aggravate the purging, and in  this way frequent and  pro-
fuse evacuations are kept up until the blood is relieved  of
its watery elements; while the child, often within  a  few
hours, is in a wrinkled, shrunken condition  as if from old
age.  In such  cases there  is  a rapid tendency to a fatal
termination.  The irritable and restless condition gradually
subsides, to be  followed by  one of stupor in which there is
clammy coldness, with pupil of the eye contracted, when the
child is almost  hopeless, death  occurring from exhaustion.
  Termination.—As cholera infantum is usually treated, but
little care being observed  regarding the  use of  water, the
disease is very grave, and  the result is at best doubtful;
but under proper drug treatment in which, practically, no
water is allowed, the vomiting and purging can be arrested,
and  every  child, if taken in hand  immediately after the
attack, ought to be  saved.
  Treatment. — The  first thing to  be done  is to stop as
quickly as possible  the  sickness and vomiting,  both of
which are very  prostrating.
  If the following directions are carefully followed, this can
be easily and promptly done and the child restored to com-
parative health  within twenty-four hours.  The great mis-
take of mothers and doctors in dealing with this disease
consists in the reckless use of water or some other form of
fluid to control  the thirst.   Water, cold tea, coffee, milk, or
any  other  form of  fluid whatever is simply death  to a
child in this condition as commonly given. 
CHOLERA INFANTUM.
45
  The physician properly understanding the terrible effects
of water in such cases has a constant trouble to keep the
mother  or attendant from killing the patient by giving ten
times as much fluid as should be given, as it is  a thousand
times better to give none at all than too much.  The doctor
who has a loose and careless way in dealing with sick people,
will lose half  his patients in cholera infantum by failing to
give proper emphasis to the dangers arising from the use of
fluids.  If he simply tells the mother to give a teaspoonful
of water occasionally, he will find on returning in a few hours,
if he inquires into the case, that she  has been guessing at
the amount of water instead of measuring it, and has given
a half-dozen  teaspoonfuls instead  of one,  and " occasion-
ally " has been construed to mean this :  to give the  child
water whenever it asks for  it.   Such management  gets
twenty  times as much water into the child's stomach  as it
ought to have,  and simply  kills it.  No  such indefinite
terms as " occasionally " should ever be  used in medicine,
and  no  mother or nurse should have charge of an infant
with  this disease  who  does  not measure every drop  of
water and limit the amount  to  a teaspoonful  every  half
hour.   The drug treatment is as follows: To a child from
one to two years old, give  mercurius dulcis, the first  deci-
mal  trituration,  in four-grain  doses,  one  powder being
given every  hour  until  six  are  taken.  Each  powder is
to be placed  upon a very little white sugar in  the bottom
of a teaspoon and  then covered with a little more and put
in the child's mouth  in  a dry condition.  The  medicine is
tasteless, the sugar is  pleasant and does not excite  sick-
ness.  One teaspoonful of water is sufficient to wash it
down, and if there is  no water  in the  stomach at the
time  the powder is  given, the child cannot throw it up, 
46
CHOLERA INFANTUM.
as it would  require more than a teaspoonful of  water to
bring the powder back.   There may be, and often is, an
attempt  at  vomiting, but owing to the  total absence  of
fluid in the stomach it is impossible to reject the medicine.
It soon commences to act favorably upon the mucous tissue
of the stomach and to allay the irritation, so by  the time
the second powder is given the sickness is entirely gone.
As  the medicine  is given every hour and with each dose
a teaspoonful of water, there is only one teaspoonful to be
given between  the times of giving the medicine.  These
powders are strewn along and through the entire intestinal
canal, exercising the  effect of a local and healing balm to
every part that they touch.  Within six hours the medicine
begins to work off, the  stools  become darker and darker
until they are almost black, then gradually fading off into
brown and, finally,  into  yellow  or natural.  While  the
powders are working off, the child will be somewhat more
distressed, and there  will be considerable straining at each
movement, the pain and straining gradually ceasing as the
stools change in color from black or dark green to natural.
Another important turn is this: As the favorable change
in the color  of the stools proceeds,  the movements become
much less frequent and, finally, instead of  occurring every
fifteen minutes, occur once in  four or five hours, and the
child is, practically, well.   To guard against the possibility
of  relapse,  great care must be  observed  in reference  to
food and water, especially the latter.
  One of the happiest things in connection with the treat-
ment is this  : After the powders begin to work off and the
stools become  gradually less  frequent, the thirst almost
wholly subsides, and  hence, irrational as  it may seem, the
quickest  and best way to overcome the  thirst is to give, 
INTESTINAL INDIGESTION.
47
practically, no liquids.  When the management of a case
is conducted in this way, it is rarely necessary to give  any
other drug to restrain the action  of the bowels.  As the
trouble  is usually associated with teething there  is a ten-
dency to looseness of the bowels, and it  is best for such
children to  have  four or five evacuations in twenty-four
hours.  If, however, the bowels should be too  loose  and
the stools inclined to green, it is obvious that digestion  is
imperfect and a pill  of  the  solid extract of ignatia, one-
eighth of a grain each, should be given at morning, noon,
and at night.  The best way to give  such pills, and they
are very small and coated with sugar, is to cover each pill
with some kind of fruit or jelly and wash it down quickly
with water before the patient chews it and gets the bitter
taste.   It is best for the child to take the pills in this way
for two or three weeks,  or until it is  in a healthy, natural
condition.  There must be no carelessness in the use  of
these pills,  for, while there is no danger in  giving  one
three times  a day,  there would  be  serious trouble  if a
double dose were given at any time.
   One-eighth of a grain is  intended for a child fifteen
months  old.   If younger, one-sixteenth will be large
enough.

           INTESTINAL  INDIGESTION.

                  INTESTINAL  DYSPEPSIA.

   This disease is a derangement in the functions  of in-
testinal  digestion in which there is  usually considerable
decomposition  of food that has  failed to digest, due  to
defects in the pancreatic, biliary, or intestinal  secretions,
or  from  deficient worm-like  action of the intestines.   A 
48
INTESTINAL  INDIGESTION.
defect in  the  secretions of  either  one of these  organs,
namely, pancreas, liver, or intestines, is sufficient to cause
distressing intestinal dyspepsia, and yet the cases are  rare
in which the defect in secretions is not  more or less in all
three of these organs.  The disease is characterized by ab-
dominal pain, distention of the bowels,  coming  on  several
hours after meals, with nervous disturbance and more or
less emaciation.
  Causes. — Bad diet, rapid and irregular or over eating, de-
ficient exercise, overwork mentally, the immoderate use of
stimulants, including tea, coffee, and tobacco.   It may also
be due to organic disease affecting the  intestinal tract,
liver, or pancreas.  It is frequently hereditary.
  Symptoms. — The  disease  may  be either  acute or
chronic, usually chronic.   The acute variety is generally
the  result of  an  irritant in the small intestines,  pain is
rapidly developed,  great   flatulence,  sometimes   severe
cramp  attending  the  pain,  slight  feverishness,  coated
tongue, appetite  morbid  or lost,  pains in the  limbs, and
often a mild attack of diarrhoea.
  If the attack develops rapidly, there is usually  a paroxysm
of colic, caused by distention of the bowels with gases.
  Severe  attacks are most frequently caused by derange-
ment of the liver, the stools  are light colored, often slight
jaundice and high-colored urine.
  Chronic Variety. — This form  is generally  caused by
decomposition  of partly  altered food  from the stomach.
It is attended with pain more or less severe in character,
coming on from two to four  hours after meals. There is
often tenderness and fulness in the right side and also in
the umbilical region.  There is considerable gaseous disten-
tion of the abdomen, and shortness of breath is often expe- 
INTESTINAL  INDIGESTION.
49
rienced from pressure of  the inflated bowels and stomach
against the diaphragm.  There is great disturbance of the
nervous system due to a limited and impoverished condition
of the blood from impairment of  the  digestive functions.
Spirits are depressed, with  sleeplessness,  or imperfect
sleep attended with disturbing dreams,  headache, dizziness,
deficient mental  application,  palpitation of  the heart,
numbness of the extremities, and sometimes pains through-
out the body.
  Termination. — Favorable  under  proper  and  timely
treatment.
  Treatment. — In the acute variety the pain is often so
severe as  to require a remedy for immediate  relief.   In
such cases it is best to give a one-fourth grain morphine
pill every two hours until perfect relief is secured.  After
relief is obtained, an effort should be  made to arouse the
liver and intestinal secretions.  This is best done by giving
five  grains mercurius dulcis, the  first decimal trituration,
every  hour  until  six powders are given.  The  remedy
must not  be given  in  water, but is to  be placed on the
tongue dry  and washed  down  with a  tablespoonful of
water.  The six powders  thus given are calculated to act
on  the bowels, but  under the restraining  effect of  the
morphine  may fail to do  so,  and may require a  dose of
castor oil or sweet oil, preferably the latter.  This treat-
ment will stimulate  the liver  and intestinal  tract, and the
stools will  be changed  from a light color to a dark brown.
In almost all cases of this disease there is an atonic condi-
tion  or debilitated state of the nervous  system.   For this
reason the  nerves fail to properly excite the pancreas, liver.
and  muscular action of the bowels.  This enfeebled condi-
tion  of the  nerve forces is often caused by excessive mental
        E 
50
INTESTINAL  INDIGESTION.
application or the  burdens and  perplexities  of  business.
In addition to this the impoverished condition of  the blood
fails to  properly  nourish and  stimulate  the brain  and
nervous system.   This increases  the nervous debility and
greatly adds to the  trouble of  intestinal dyspepsia.   From
the foregoing the indications for  a rational treatment are
very obvious and  consist in stimulating, temporarily, the
brain and nerve energies.   When  this is done they stimu-
late  the  digestive  organs and the latter digest  the  food
and  fill  the veins  and arteries with  pure blood.  This,
however, may require weeks of time, when an abundance
of good, healthy blood is created by the digestive forces,
the brain and nerves are properly nourished and excited so
as to render the use of an artificial stimulant unnecessary.
Therefore  the  curative  treatment  consists  in eating at
regular  hours,  taking  food  that  is easy to  digest  and
properly adapted to the  purposes of nutrition, never eat-
ing too much at any one time, and conserving  as far as
possible  the vital forces by avoiding the mental strain and
labors  that are the chief factors  in causing  both  gastric
and  intestinal dyspepsia.
  The same drug is to be given  in intestinal  dyspepsia as
that given in atonic dyspepsia of the  stomach, therefore
give the  extract  of  ignatia amara in pill form, ranging in
doses from one-half to a full grain, according to the size of
the patient.  One pill is to be given before each  meal, and
if the  patient weighs  from one  hundred  to  one hundred
and sixty pounds, a half-grain pill is the  proper dose; if
from one sixty to two hundred, three-quarters of  a  grain
is the proper sized pill.   All persons  weighing over two
hundred are to take a full grain.  The dose  for children
from eight years to twelve is one-quarter of a  grain.  Chil- 
ACUTE DYSENTERY.
51
dren from two to eight that are subject to colic pains and
other symptoms of disturbed digestion are to have one-
eighth of a  grain before each  meal.  Infants from three
months old  to  two years one-3ixteenth of a  grain three
times a day.  In the  chronic and obstinate form of intes-
tinal indigestion, the drug should be given for at least ten
weeks.  In  the treatment  and  management  of  intestinal
dyspepsia, alcoholic stimulants, and also  tea  and coffee,
except in a very moderate way, are to be avoided.


               ACUTE  DYSENTERY.
  Other names : colitis ; ulcerative colitis ; bloody flux.
  This is an acute inflammation of the mucous membrane
of the lower bowels, mainly the colon, followed sometimes
by fever, terrible pain, almost constant desire to  stool, dis-
charges from the bowels being small and bloody.
  Causes. — The disease prevails most extensively in the
summer and early autumn months.  The depressing effect
of hot weather is probably an exciting cause and, conjoined
with this, may be included a reckless use  of unripe fruits,
and  the use of impure  drinking water, especially the
latter.
  Symptoms. — The catarrhal and most common form of
dysentery begins gradually with diarrhoea, more or less
sickness  of  the stomach, increased temperature,  and loss
of appetite.  These symptoms  may continue for two or
three days,  when the real  dysentery sets  in,  with pain on
pressure along the transverse and descending colon, colicky
pains in the navel region, burning pain in  the  rectum, and
a feeling as if  something  offensive was there and a con-
stant desire  to go to stool.  Stools gradually change from 
52                ACUTE DYSENTERY.
a fecal character to that of mucus,  pus, and blood,  the
latter largely predominating.   In some  cases  there is  ob-
stinate vomiting.  The stools vary in number from ten to
thirty in twenty-four hours.  The duration  of  the  real
dysentery, unless very successfully treated, is from a week
to ten days,  and leaves the patient greatly reduced in flesh
and very weak.
  Termination. — Favorable, except in persons debilitated
or suffering  from other affections or intemperance.
  Treatment. — It is proper to regard dysentery under all
circumstances as a grave  disease, and in  the late war, when
it prevailed epidemically, it was said to be more destructive
to life than  all the weapons  of warfare.   In one regiment
it seemed to affect,  in one way or another, so many of  the
men that the colonel of  the regiment offered a reward of
ten  dollars for a healthy stool.
  Dysenteric  patients  should  be confined to the bed from
the  first,  and the  stools removed from the room as soon as
passed.   The vessels should be disinfected with a solution
of carbolic acid of the strength of one tablespoonful to the
pint.  The diet should be of  a kind  most easily digested
and void of irritating properties.
  As regards the drug treatment of this disease, the golden
opportunity  is during the premonitory  or  warning symp-
toms.  Whenever dysentery exists in a family, or even in
a town or neighborhood, extensively, it is safest to regard
all  cases of diarrhoea as the first stage of dysentery  and
treat them accordingly.   If this is done and a proper treat-
ment adopted, every case can  be broken  up before the
bloody discharges set in.   Suppose, for  example,  that  in a
family of a dozen children there are  three cases of dysen-
tery.   Each  one of these cases has commenced  with a 
ACUTE DYSENTERY.
53
diarrhoea, lasting about three days before the beginning of
the bloody flux.   Should a diarrhoea attack another one of
the children, there  is every reason to believe that it will
develop,  as the other cases have, dysentery.
  The proper treatment, however, is employed  to break
up the diarrhoea, and in doing so the dysentery is com-
pletely aborted, and so on with every other case that occurs
in the family.  Experiences of this kind have been so ex-
tensive in the practice of the author that he feels warranted
in giving the following as a specific treatment in dysentery,
provided it is adopted before the bloody discharges set in:
To  every patient with the supposed  dysenteric  diarrhoea,
give a five-grain powder of the first decimal trituration of
mercurius dulcis every hour until six powders are given.
The powder is to be placed in the mouth or on the tongue
in a dry  condition, and then washed down with a table-
spoonful of water.  The powder  must never be  dissolved
nor  given in water,  as that destroys the  effect  of  the
trituration.   In  this stage  of  the disease there is some
fever and liable to be considerable thirst, but water must
not be given except in tablespoonful doses, once every
half hour.
  As a tablespoonful of water is given every hour with a
powder, there is only one tablespoonful to be given between
powders.   The medicine will work itself off in eight or ten
hours, the stools becoming dark as soon as the physic com-
mences to operate, and the color will deepen until they are
almost black, and then gradually shade off into brown and
finally yellow, or natural. As the stools change from black
to the natural color, they become less frequent, the griping
subsides, and the trouble is over.   In all such cases as the
above, if the patient limits the water drinking to  one swal- 
54
ACUTE DYSENTERY.
low at a time every hour for a day or two, the diarrhoea will
not return and he will surely have no  dysentery.
  If for any reason this abortive treatment should be neg-
lected  until the  dysentery is fully established, it  will not
break it up, and  we are compelled to do the  best we can
with a  fully developed case of the disease.  The treatment,
however, as given above is the best way in which to rid the
intestinal tract of all irritating  matter, even after the flux
has set in.   When  this is done the action of the bowels
may be properly restrained by giving one-half  grain  of
opium  and  one grain of acetate of lead every  two or three
hours,  so as to limit the stools to ten or twelve in twenty-
four hours.  If the patient should be  a child five years old,
give Dover's powder instead of the opium, giving one grain
of the Dover to  a half grain of the acetate of lead.  For
adults, one grain of opium to two grains of acetate of lead
is the proper dose in ordinary cases.
  To overcome  the terrible burning  and annoying  desire
to go to stool, laudanum and sweet oil may be  injected into
the rectum with  a small, black rubber syringe, the quantity
being for an adult, a teaspoonful of the laudanum to a table-
spoonful of the  oil.  After it  has been held  from five to
ten minutes the  patient must discharge it  into a vessel to
avoid the constitutional effect  of the  laudanum.   If, from
the exhaustive evacuations and  deranged nutrition, symp-
toms of great debility supervene,  brandy is indicated and
may be given every half hour in teaspoonful doses, and
even in larger quantities.  But that which is most  vitally
important in dealing with dysentery, is to take  it during
its  developing stage and treat it as outlined above and
break  it up,  so  as to  avoid the pain,  complications, and
dangers that must always  accompany the disease  when
once fully established. 
EPIDEMIC CHOLERA.
55
               EPIDEMIC  CHOLERA.
  Other names:  cholera;  Asiatic  cholera;  spasmodic
cholera;  malignant cholera.  This  is  an acute,  specific
disease, both epidemic and infectious, and is attended with
the most violent purging and the discharge of  rice-water
stools, constant vomiting, muscular spasm, or cramp, often
followed by fatal collapse.
  Cause.—The cause of the disease is a bacillus, or spe-
cific poison, or a life germ that is seen only by the micro-
scope.  It is supposed that the main power of infection is
in the cholera stools, and that emanations from these  stools
poison the air and in that way extend  the epidemic from
one locality to another.  One attack of it does not afford
protection from the second.
  Symptoms. — It may set in abruptly, attacking a person
previously  in excellent health, or it may commence with
premonitory symptoms, consisting  of  a severe  diarrhoea,
sickness  of  the stomach, griping pains, and  more or less
prostration.  The first stage of cholera begins with a chilly
feeling, great thirst, coated tongue, pain in the bowels, and
several watery stools during the day, all these symptoms
being attended with weakness.
  In the second stage the stools become very frequent, or
immense in quantity,  consisting of a  whitish,  rice-water
fluid,  there  is  terrible vomiting,  the matter  thrown from
the stomach being mixed at first with  bilious matter and
finally becoming like  rice water.  As the water of  the
blood is being  discharged rapidly from the body  through
vomiting and purging, the thirst is constantly increasing.
Muscular cramps finally come on,  affecting most of  the
muscles of the  body, but especially severe in the legs. 
56
EPIDEMIC CHOLERA.
  In the third stage, the rapid stools, excessive vomiting,
and spasm of  the  muscles continue, the eyes are sunken,
the cheeks hollow, lips blue,  the skin  of the  hands and
fingers is wrinkled as in old  age, the  heat of the body
rapidly fails, the pulse is small, the voice weak, and all the
symptoms point to a fatal termination.  Death sometimes
occurs in three hours and is at other times delayed for two
days,  even in the fatal forms of the disease.
  In the stage of reaction  the heat of the body gradually
rises,  the pulse gets  stronger,  the face  takes  on  a more
natural appearance, the stools are less painful and not  so
frequent, sickness of the stomach subsides, and the patient
commences a  slow recovery, or the case may drift into a
condition of cholera typhoid from which recovery is slow.
  Termination. — This is very  unfavorable, as the death-
rate ranges from twenty-five to seventy-five per cent.
  Treatment. — In the treatment of this terrible  disease
there  are two exceedingly important things to be done.
The first is to take the case during the premonitory symp-
toms,  or  those of diarrhoea, and treat it so as to  prevent
the occurrence of cholera, for in almost  every  case  in
which the diarrhoea is cured the cholera fails to develop.
Experience has shown that it is bad policy merely to check
this diarrhoea with opiates and astringents, as it only delays
the trouble that must sooner  or later come on, the  diar-
rhoea  in such cases breaking out as soon as the opiate is
withdrawn.  It is  therefore best to remove all irritating
matter from the bowels  by giving calomel in divided doses
as follows for an adult:  Mercurius dulcis, the first  decimal
trituration,  thirty grains.   Divide into  five  powders and
give  one powder  every  hour by placing it  in  a dry state
upon  the tongue  and allowing it to be washed down with 
EPIDEMIC CHOLERA.
57
a tablespoonful of water.   It will act on every part of the
intestinal tract,  producing first an irritant  effect, and
second a healing and soothing effect.  During its primary
action the bowels are thoroughly emptied, the  stools be-
coming almost black and gradually fading  into the natural
color.  When this is done it is rarely necessary to give
any other remedy.  During the whole  treatment  of  the
diarrhoea, water must be given in teaspoonful  doses every
half hour, as larger amounts tend to keep up the diarrhoea
and endanger life by final development  of cholera.  The
second important thing to be done  is to commence a
vigorous  treatment with the first appearance of the dis-
ease, and prevent the stage of collapse  that  is  almost
always fatal.  A  great  many cholera mixtures are used
in this stage, but the basis of all such mixtures is opium
in some  form, and upon this drug we must  rely  almost
absolutely in order  to control the  terrible symptoms.
Just after a severe  vomiting, when the stomach  is sup-
posed to  be empty, a full  half grain of morphine  should
be given.  If thrown up, another dose of equal size should
be given, and so on until the  drug is retained.  Within a
half hour the pain  and spasm  of the muscles may be
slightly relieved, but if great relief  is not apparent within
forty-five minutes another half  grain should be given, as
there is  scarcely any  danger of fatal poisoning by mor-
phine in  half-grain doses in cholera.
  During all the  time the morphine is  being given,  hot
poultices should be applied to the abdomen to overcome
the cramp.  Morphine given in this way or by hypodermic
injection  is the sovereign remedy in cholera, just as it is in
cholera morbus.   There is scarcely anything  that goes
down the throat calculated to do as much harm as water 
58
CHOLERA MORBUS.
in such affections of the stomach and  bowels.  Instead of
water checking the thirst, it provokes it by causing both
vomiting and  purging.  In this way a half pint  of water
given to allay the thirst is liable to  cause  a  loss to the
system of two or  three times that amount by  vomiting
and liquid stools.  This gives rise  to greater thirst,  and
more  water is given  with  the  same results.   It  is  all
wrong, and the thirst  may be controlled  much quicker by
limiting the amount to a teaspoonful every half hour.


               CHOLERA  MORBUS.
  Other names: bilious cholera; sporadic cholera; Eng-
lish cholera.
  This is an acute inflammation of the mucous membrane
of the stomach and bowels attended  with great pain in the
abdomen,  continual vomiting  and purging, cramp colic,
the cramp  affecting the abdominal  muscles and those of
the extremities.   The pulse  is rapid  and weak, the face
anxious  and covered with cold perspiration.
  Causes. — The most important of  all causes are the  irri-
tating effects  of  hot  weather.  As the  heat of summer
is  very  depressing to  the nervous  system, the power to
digest food is diminished while at the same time the copious
draughts of cold water further reduce the digestive  energy
of the stomach, causing a fit of acute indigestion, and that
is what  cholera morbus practically is,  acute  or temporary
indigestion.
  Symptoms. — The disease commences with but little if
any warning and almost always in the latter part of the
night.  The first  symptoms are those of deathly sickness,
soon followed by vomiting and purging, accompanied with 
CHOLERA  MORBUS.                 59
terrible griping pains.    During the sickness and vomiting
there are painful cramps  of the abdominal muscles  and
those of the extremities.  To commence with, the vomited
matter  is generally undigested food, showing, although  it
has been in the stomach for  hours, that  it has undergone
but little change.  The  part of the undigested food that
is not vomited passes into the bowels, arouses the secre-
tions by acting  as an irritant, and brings on  a profuse
liquid diarrhoea.  The stools are usually a yellowish green.
If the attack  is unusually severe, approaching  in gravity
epidemic cholera, the stools will  take on the "rice-water"
character.  The patient is rapidly reduced in strength  and
seemingly  in  flesh also, the features are  shrunken  and
wrinkled, the  surface cold  and covered with perspiration,
pulse frequent and feeble.   The thirst is great  and water
excites  vomiting.
   Termination. — This  is very favorable under the right
treatment  if  the  patient is in a healthy condition at  the
time of the attack.   In those suffering from the infirmities
of old  age the mortality is great.   Drunkards, in this as
in all other violent and prostrating diseases, are most liable
to perish,  as  they are shorn of half their  strength  and
power of endurance at the  commencement of the attack.
   Treatment. — Happily there is  a rational and almost
unfailing remedy for this  distressing disease.   It is best
not  to  give any medicine  to restrain  the action of  the
stomach in its efforts to get rid  of the offending contents
until it has pretty thoroughly emptied itself.   If it were
possible for the stomach to retain and absorb enough opium
to stop the vomiting and  leave  the organ distended with
undigested food,  it would be very unfortunate if not dan-
gerous.   Therefore, the stomach  must  be  emptied  and 
6o
CHOLERA MORBUS.
a pint of warm water will be a material assistance in rid-
ding it of all offending matter.   The rest of the treatment
is easy and simple and consists in giving from one-fourth
to one-half  grain of  sulphate of  morphine   as  follows:
Give it in pill form so as  to avoid the  disagreeable taste,
put the pill well back on the tongue and give  a teaspoon-
ful of water to wash it down.  The point is this :  In order
to avoid having the pill thrown up, give as little  water as
possible, and if this amount can be limited to a teaspoonful
to wash it down, it will not be sufficient  to  wash it up.
If the  stomach is  entirely empty, the pill will be absorbed
in one-tenth the time that it would  be if  it were full of
food.   After about three-eighths of a  grain  of morphine
is given on an  empty stomach, the  sickness and pain will
begin to subside in twenty minutes, and within three-quar-
ters of an hour, if the dose has been sufficiently large, the
patient  will  be perfectly relieved and will not likely need
any more medicine of any kind.  Morphine is  the best
of all remedies  in these cases and should be given in a dose
sufficiently large to render perfect relief in three-quarters
of an hour.
  It is not always  possible to tell how  large a dose a par-
ticular  case will require, and it may be best to give a quar-
ter  of  a grain  and wait  about  forty minutes, and then  if
necessary give another  quarter.   It usually  takes about
a half grain  to  secure perfect relief. 
INTESTINAL  COLIC.
6l
                INTESTINAL  COLIC.
  This disease is a spasmodic contraction of the muscular
structure of the bowels.   It is attended with acute parox-
ysmal pain near the  umbilical region, and  is relieved by
pressure or the application of heat.
  Causes. — Obstruction  or  constipation of  the  bowels,
impaired digestion or the presence  of  indigestible food,
collection of  gases, an  excessive  amount  of bile  in  the
intestines, or lead poisoning.
  Symptoms. — There are frequent pains  spreading over
the abdomen, attended with intervals of  more or less com-
fort; the pain is  often very severe and accompanied by
cramps of  the most excruciating  character.   The  patient
is restless, with  an anxious, distressed  countenance, and
tries to relieve the pain by lying on  his stomach.  There
are often nausea and vomiting and a desire to go to stool.
The bowels are usually bound but sometimes are loose.
  Termination. — Most favorable.   It  rarely  terminates
fatally.
  Treatment. — In all cases of severe pain the attention
must be directed to  immediate relief.   For this  purpose
there is  nothing better than a morphine  pill,  one-fourth
grain, given every hour until the  pain is relieved.  After
relief is obtained an effort must be made for a radical cure.
For this purpose eight or ten powders, five grains each, of
mercurius dulcis,  the first decimal trituration,  should  be
given,  one powder being given every hour and followed
by a physic of sweet oil, two tablespoonfuls.  In this way
the patient will get from four to five grains of  calomel,
which will act on  the liver and intestinal tract.  After  it
works off the stools will change from a very dark brown 
62
CATARRHAL ENTERITIS.
or black, caused by the mercury, to a normal color, and the
trouble will be over.


            CATARRHAL  ENTERITIS.
  Other names:  inflammation of the bowels; intestinal
catarrh;  acute diarrhoea.  This is an inflammation of the
mucous membrane of the  smaller bowels, attended  with
pain, soreness on pressure, and diarrhoea.
  Symptoms. — It usually commences with a chill or chilly
feeling, followed by a fever which is sometimes considera-
ble.  The pain that accompanies  the fever is  severe, but
comes  and goes.  The  pain  is  just below the stomach.
There  is more  or  less sickness, with occasional vomiting.
The diarrhoea setting in soon after the attack  is obstinate
and severe.   The stools are a greenish yellow, mixed  with
undigested food.
  The duration of  the disease is from four or  five days to
two weeks.'
  Termination. — Favorable if  properly treated.
  Treatment. — The main thing in these cases is to keep
the bowels as near a condition of  absolute rest as possible.
With this  idea  in view  the diet   should be restricted  to
chicken broth, milk, and  articles of food that  do not irri-
tate inflamed  bowels.
  Rest in bed is very important, as any movement  of the
body is painful to  the patient  and has a tendency to ag-
gravate the inflammatory condition.   Where  the disease
exists in children it is exceedingly troublesome to manage,
the most  difficult  thing being  to control  the  pain.  The
way to accomplish  this deserves very careful consideration.
As  a rule children do not bear opiates well, and for this 
CATARRHAL ENTERITIS.
63
reason they should be given as little as possible.  But they
cannot  bear the pain and something very decided  in its
action must be given to relieve it.   In  the great majority
of cases there are green stools, and these never exist either
in children or adults except in connection with severe pain,
and it is almost out of the question to  control such pain
until the  stools  are  changed  from green to natural.  In
this affection  there  is often  vomiting, and  this and the
green stools call for  the administration  of' mercury, but it
must be given in very small doses to avoid the irritating
effects  of the  physic.   Calomel in doses of three-tenths
of  a grain may be given to children every hour, until five
or  six powders are given.   They will act gently on the
stomach and bowels,  will change the stools from green to
natural, after which the griping pains will cease.  When-
ever the stools are natural in  color, the diarrhoea will sub-
side and the little patient will pass into a quiet  sleep that
may last for hours.   The best way to give the drug  is as
follows: Mercurius dulcis, the first  decimal trituration,
grains fifteen, divide into five powders and give one every
hour until all are given.   The powders must  be  placed in
the mouth dry and washed down with a swallow of water.
Children should not be allowed to drink over a teaspoonful
of water every half hour until the diarrhoea is entirely con-
trolled.   After the powders have worked off, should it be
necessary to give anything to control the pain and  move-
ment of the bowels, paregoric  in doses ranging from  three
to six drops, according to the age of  the child, may be
given every three or four hours.
  Should the green stools  and griping pains affect  adult
patients, the same treatment must be followed, doubling the
quantity of  the drug and  giving it  every hour whether 
64
DRUNKARD'S DYSPEPSIA.
there is sickness of the stomach or not.  Long experience
has shown that the pain  is a great deal easier  controlled
after the stools are changed from  green to the natural
color, and recovery is much more rapid and less subject to
relapses.   In all adult cases after the  stools  have become
natural in  color, opium, to keep the bowels  in  a state of
perfect rest, should be given.  One  grain every three or
four hours will be  sufficient.
  Beef, mutton, or chicken broth may  be given several
times per day in  small quantities, or milk with  a limited
amount  of stale  bread  when  desirable.  As  there is  a
tendency to diarrhoea, water should not be used except in
teaspoonfuls  every half  hour.   It is  much better to use
milk or something that is nourishing.


            DRUNKARD'S DYSPEPSIA.

  In this  form  of dyspepsia, to the  baneful effects of  a
stimulant to the  nervous system is added the terrible irri-
tation of alcohol to the mucous membrane of the stomach.
Like other stimulants, alcohol quickens the heart's action
and arouses every organ  of the body to undue activity, and
except for the chemical effect of the drug upon the food in
the stomach, has an intrinsic tendency to promote  diges-
tion  by increasing, temporarily, the  nervous forces.   But
unfortunately alcohol has been  found in all cases of arti-
ficial digestion in which tests have  been  made to retard
the digestive process.  If this were  the  only objection to
the use of alcohol before or during  meals, it  would be
enough to  condemn it; but the stimulating and irritating
effect is a hundred times more deplorable than the local
chemical effect upon the food.   It  will therefore be ob- 
DRUNKARD'S DYSPEPSIA.
65
served that alcohol interferes with the  functions of diges-
tion in  three different  ways.  First,  by stimulating the
entire organism.   As  a  corresponding degree of depres-
sion always follows  the  exhilarating effect of a stimulant,
a state of the digestive functions that is more or less enfee-
bled must always follow the effects of alcohol.  Second, the
irritating effect of  the drug upon the stomach  causes that
organ to secrete for a limited  time an abnormal amount of
gastric juice.  This, of course, favors digestion for a little
while, but the  stomach  is unduly irritated and gradually
drifts into a state of  chronic inflammation in which the
functions  of digestion  are seriously  disturbed.  Third, the
chemical  action of the alcohol upon the  food renders  it
difficult to digest and almost  doubles the time required for
the completion of  the  digestive process.   This, of course,
draws heavily upon the nervous and vital forces, and has a
tendency, sooner or later, to produce nervous exhaustion.
  Under  the continuous use of alcohol the mucous mem-
brane of the stomach, which  is usually thickened, is in a
chronic state of irritation, and in time the organ  begins to
reject food.  The  vomiting established in this way gradu-
ally grows worse, until it has a serious effect  upon nutri-
tion.
  This impoverishes the blood, which fails to nourish and
properly stimulate the brain  and  nerve  fibres,  and thus
greatly increases the alcoholic indigestion.   It may reach
a stage, if the patient survives long enough, in which the
mucous membrane of the stomach is  to a great  extent
destroyed.  However this may be, when an alcoholic dys-
peptic  gets so far on the downward road as habitually to
throw up part of his food, his  days are  numbered, as ceas-
ing the use of the poisonous drug will rarely save him.
        F 
66
PERITYPHLITIS — APPENDICITIS.
There  is no available treatment of this disease  except
leaving off the stimulant before the habitual vomiting  is
established and resorting to the treatment given for atonic
dyspepsia, which please see.   All such cases, however, are
exceedingly obstinate, and  the organic changes  render
recovery under the best possible treatment doubtful.


        PERITYPHLITIS — APPENDICITIS.
  Other names:  perityphlitic abscess;  suppurative appen-
dicitis.
  Perityphlitis is an acute inflammation, involving  a small
portion of the colon called the caecum, usually resulting  in
an abscess.  Appendicitis is an acute or subacute  inflam-
mation of a little worm-like appendage of the bowel, called
" appendix vermiformis."  It usually leads to perforation  of
the appendix and the formation of an abscess.
  (Without a  knowledge of anatomy the nature of these
two affections is  very hard to understand; but so many
deaths have occurred in the last few years from appendi-
citis, and so many surgical operations have been performed
and the diseased appendix removed in  order to save  life,
that the public have become deeply interested in the  sub-
ject of appendicitis.   It is therefore thought best  to give
a careful and plain description of the  two diseases with
which this  chapter is headed, and which are  anatomically
connected with each other.)
  Perityphlitis is usually caused by  appendicitis,  but not
always.  Appendicitis is  caused by the lodgment of  a
foreign body in the appendix.  The small  seeds of fruits
may get switched off into this useless pocket of  the bowels
and cause inflammation, leading to perforation of the appen- 
             PERITYPHLITIS — APPENDICITIS.           6f

dix by an abscess.   It seems to be more common in males
than in females, and is most frequent  between childhood
and the age of thirty.
  Symptoms. — The two diseases, perityphlitis and appen-
dicitis, have symptoms very much alike.  The symptoms
of appendicitis commence with soreness on the right side
of the abdomen, low down, and are attended  with  severe
pain, sickness, and  vomiting.  The  right leg is generally
drawn up so as to relax the muscles  of  the  right side  and
relieve the pressure upon the inflamed portion of the bowel.
At the seat of the  pain and soreness  is found, sooner or
later,  a  hard lump  or  swelling.   The  affection may com-
mence with a chill.   Whether it does or not there is fever
from the beginning, and the pulse is full and  strong as in
other inflammations.
   The bowels  are  costive, tongue coated, and  colic pains
frequent and  severe.    The dangerous tendency  of the
disease is to the formation of an abscess,  and during its
development there are  chilly feelings, with greatly  in-
creased temperature, throbbing of the  tumor, and  general
increased gravity, all characteristic  symptoms of the sup-
purative process, or the formation of  an  abscess  that is
liable to lead to a fatal termination.
   Treatment. — An effort should  be  made  to allay the
inflammation as soon as possible.   For this purpose it is
best to give the tincture of  veratrum veride in two-drop
doses every hour, commencing as soon as the pulse reaches
one hundred beats per minute.   Continue the  drug for six
hours, then leave it off for two hours, and then give it six
hours  longer.   In the mean time  the swelling  must be
painted every five  or  six hours with a  strong  tincture  of
iodine. 
68
INTESTINAL PARASITES.
  (This is a disease that requires the attention of a skilful
physician from  the  commencement, or as soon as  it is
recognized.)
  When  it becomes evident that  an abscess  is forming,
the suppurative process should be  hastened  by flaxseed
poultices, and as soon as the matter  is located by fluctua-
tion  of the tumor, it should be freely lanced.  Morphine
should be given to quiet the pain and keep the bowels in
a state of rest.


            INTESTINAL  PARASITES.

                     TAPEWORMS.

  Causes. —The "armed tapeworm " is the most frequent
in this country,  the  germ or embryo entering the  bowels
by the patients eating raw pork.
  The " unarmed "  tapeworm  enters the  stomach by pa-
tients eating raw  beef infected with the tapeworm germs.
  Another " unarmed " tapeworm is the largest ever found
in the human body, and the embryo is supposed to  come
from some kind of a fish.
  The egg of the worm is simply  swallowed with  food,
hatches in the intestine, and grows to maturity.  Why the
worm egg is  not  destroyed by the gastric juices that eat
up and dissolve all kinds of meat,  hard-boiled  eggs, and
other solids, no  one can tell.   It is well to remember that
but few people  have perfect digestion, and when it is not
perfect some of  the food passes into the bowels undigested,
and along with this food may pass unharmed the eggs from
which various worms  are  hatched.  Some parasites are
exceedingly hard  to kill,  as worms seemingly as long and 
INTESTINAL PARASITES.
69
large as a darning needle are found in the strongest cider
vinegar, but of course are infinitely small and can be seen
only with a microscope.
  The "unarmed" tapeworm is  from  ten  to thirty feet
long, has a round head and  slender neck, somewhat like a
snake.  The  most unfortunate thing  connected  with a
tapeworm is that  it is divided up into a  multiplicity of
joints,  the longest worm having at least a thousand joints,
each and every joint containing the sexual organs  of both
male and female.   When a long  worm gets broken into
pieces, as frequently happens, the rapid propagation of
new worms  is readily  imaginable.   It is  said  that  the
ordinary tapeworm contains millions of eggs.  The worm
lives in the upper part of the small intestines, to the walls
of which it secures itself by  suckers.
  Symptoms.—In many cases where tapeworms  have
been found  by accident to exist,  their presence  was  at-
tended by no symptoms whatever; but  as a general thing
the symptoms are essentially those of dyspepsia, such as
a painful hunger, severe colic in the  stomach and  bowels,
loss of flesh, constipation, fluttering of  the heart, and some-
times itching about the anus and nose.
  As in dyspepsia, all the  symptoms  are usually relieved
by the patient eating a full meal.   There is no  symptom
nor group of symptoms to afford infallible evidence that a
tapeworm exists in the bowels of any  patient until  a worm
or part of a worm  is passed.
  Treatment. — In dealing with this trouble it is proposed
to give one remedy, and only one, for the destruction of all
the varieties of tapeworm;  and the drug is a positive spe-
cific, provided all the directions are carefully followed, and
if they are not followed the chances  are more than even 
;o
INTESTINAL PARASITES.
that the whole  of the worm will not be expelled, and as
each joint contains the reproductive  organs of both sexes,
any part of the worm remaining in the bowels will breed
other worms.   The  idea that the expulsion of the head
of the worm ends the trouble is exceedingly delusive, as
the power of reproduction belongs  to every  part  of the
worm.
  The treatment and full directions  are as follows: First
go to a drug store and get one ounce of powdered Kousso.
The drug should be as fresh as  possible.   Twenty-four
hours before giving the medicine, a thorough  physic must
be taken,  and this should be in the morning before break-
fast and sufficient to thoroughly empty the bowels.  But
very little food  should  be taken  during the day, so on the
following  morning the stomach  and bowels will be practi-
cally empty.   Put a half ounce of the Kousso in a half
pint of hot water, let it sit till  it cools, then stir it well,
have the  patient swallow half of it, and in  a half hour
swallow the other half.  This must be taken as  soon as
the patient arises from bed and no food eaten until the
Kousso works  off, which  is usually within  four or five
hours.
   Should it not pass off in  that  time, a full dose of castor
oil should be given.  To avoid  sickness from the use of
this remedy it is sometimes found best to give a half cup
of  hot coffee  after each portion of the drug.   Given in
this way it is rarely necessary to repeat the dose, but the
author has found a few  cases in which he was compelled
to give the remedy in  ounce doses,  owing, most likely, to
impurities of  the drug or to its having been kept too
long. 
INTESTINAL PARASITES.
71
                    ROUNDWORMS.
  Of these there are two varieties: the long roundworms,
ranging in length from eight to fifteen inches, are the most
common; the eggs of these worms are introduced with food
or drink, and hatch and  establish their dwelling-place in
the small intestines, though they  meander through the
entire bowels, more or less.  The other  variety is com-
monly called " pinworms ";  they are  also  called  " seat-
worms" and "threadworms."  They develop in the lower
and larger bowels, mainly the rectum.   Their eggs or larvae
gain entrance with food and drink.  These little annoying
things are from a quarter to a half inch in  length, and look
like  a piece of white sewing thread.   They conceal them-
selves in the folds of the rectum or anus, and in wriggling
about cause the greatest itching imaginable.
  Symptoms. — There  are  no  symptoms that positively
indicate  the presence of  the roundworms  except  the pas-
sage of one or more from  the  bowels.  Many symptoms
are given in the medical books suggesting  that worms exist
in the bowels, but such  symptoms are liable to  occur in
other affections, and therefore there is but little reliance
upon any signs except the actual passage of worms.
  The symptoms of pinworms  are intense  itching and a
frequent desire to go to stool.  As anything that irritates
the mucous membrane excites a flow of  mucus, the frequent
stools caused by pinworms consist mainly of such mucus.
These small worms  sometimes get into the  sexual organs
of children and cause terrible suffering.
  Treatment. — There is an infallible remedy for the long
roundworm, and it is as follows:
                 Santonine, grains ten, 
72
GASTRALGIA.
            Calomel, grains three,
            Mix and divide into five powders.
  Give  one every three hours during the day, and at bed-
time give a couple of teaspoonfuls of castor oil.
  If there is any difficulty in getting the child to take the
castor oil some other gentle physic will answer.
  The same remedy may be given for pinworms,  and in
addition  an injection of  the following into the rectum may
be given: Carbolic acid, one teaspoonful; water, one pint.
After shaking well,  inject about one ounce into the rectum
of a child, and have it sit on the vessel and pass it  away
immediately.  This may be repeated every  day for several
days until the worms are all destroyed.
  In adults a half  pint of the solution  may be injected.
After it is held four or five minutes, it must be passed into
a vessel,  and the  rectum washed out  with  a half pint of
pure water.  In  all cases,  when  pinworms cause  great
itching by their presence in the anus, an injection of cold
water, to the amount of half a pint, should be given, and
will  almost  always  afford  complete relief by dislodging
them.

                   GASTRALGIA.

  Other names: stomachic  colic;  cardialgia;  gastro-
dynia; neuralgia of the  stomach; spasm of the stomach.
  This disease is commonly known as  neuralgia of the
stomach, and, as in neuralgia of other organs, the  pain is
intense, coming in paroxysms, and there is the severest and
most painful cramp  involving the muscles of the stomach,
usually called "cramp colic."  The pain is so terrible as to
develop symptoms of fatal collapse, the countenance show-
ing great anxiety and the face covered with cold perspiration. 
GASTRALGIA.
73
   Causes. — It may be due to  a great  many  causes, but
 the most important are those influences that  exercise an
 exhaustive  effect  upon  the  nervous system.   Business
 troubles, family cares  and anxieties, and indeed any and
 all things that use up nervous  energy, favor the develop-
 ment of gastralgia, and  with  it  acute  indigestion.  The
 disease may be  caused by overeating  or  by the use of
 articles of food that are very hard to digest.
   Symptoms. — Almost all neuralgic affections are  char-
 acterized by paroxysms, and  this  is especially  true of
 neuralgia of the  stomach.   There  is violent pain in the
 stomach, frequently severe cramp, the extremities are cold,
 stomach distended, patients often screaming from intense
 agony.   These severe  attacks may last only a few minutes
 at a time, but in  some cases they may not  subside for an
 hour  or more.   Even  where no  opiate is given, vomiting
 may  occur,  in  which the stomach is entirely  emptied of
 everything,  including the gas that was the source of the
 most  pain, and in  that  way immediate relief is obtained.
   Termination. — This is  almost always favorable in refer-
 ence both to life and health.  It is not a dangerous disease
 so far as life is concerned, but the treatment that is usually
 adopted by  doctors, with a view of curing the affection,
 almost  always  fails, and  persons in whom gastralgia is
 once  fairly established seem to  be doomed  to  suffer from
 it  as  long as they live.  The author has always adopted
 in this extremely aggravating affection a treatment  never
 given in any of the text-books,  and that  is essentially his
 own.   He considers it strictly a neuralgic trouble, just as
 sciatica and  other local disturbances are, and  directs his
treatment absolutely to the nervous system.  So far as cure
is concerned, nothing whatever can be accomplished during 
74
GASTRALGIA.
the paroxysm.   This must  be controlled with an opiate,
and nothing is better than morphine.  A quarter-grain pill
of the sulphate of morphine  may be given every half hour
until the spasm and pain are overcome.  In a day or two,
when the patient  has in a  measure  recovered from the
prostrating effects of  the attack,  the  proper treatment
should be commenced to prevent  the  recurrence  of at-
tacks.  This  is strictly the curative treatment.  The par-
oxysms are periodic, in some cases coming on every month,
and in others occurring  only two or three times per year.
In cases that have existed for years, the treatment to be
given hereafter should be followed for six months.  It con-
sists in giving the solid extract  of ignatia three times per
day, in doses as large as the  patient will bear without caus-
ing headache or twitching of the muscles.   For persons
weighing from  one  hundred to one  hundred and  fifty
pounds, a half-grain  pill will probably be strong enough.
In those weighing from  a hundred and fifty  to two hun-
dred pounds, a three-quarter-grain pill may be given before
breakfast and before dinner, and a half-grain pill  before
supper,  as a large dose of the drug taken at night is liable
to interfere  with sleeping.  It must be remembered in all
cases, however, if the size of the pill selected causes head-
ache, a smaller one must be taken in its place ; for example :
If headache occurs  every day  from the use of a three-
quarter-grain pill before each  meal,  these  pills  must be
discontinued and half-grain pills used  instead.
   One of the  very  happy  features  of the treatment is
this :  The patient  does not  feel the  effects of the drug
at all, when the proper dose  is given.   The only  effect
that is  observed is  that the paroxysms cease to occur.
Where the treatment is commenced immediately after one 
GASTRIC CANCER.
75
paroxysm with a view of preventing the next one, which
may be due in six weeks, it will almost always prevent it.
The drug must not be  left off  for five or  six months.
After this,  if no paroxysms have occurred, the patient is
usually safe.  Sometimes,  however, after  four  or five
years,  the  disease  sets  in  again  and must be treated in
exactly the same manner.


                GASTRIC  CANCER.
  Other  names:  gastric  carcinoma;  cancer  of  the
stomach.
  This is a malignant tumor  or growth involving part of
the  stomach, with  a  tendency to  constant development
and gradual destruction of  that organ.  The  functions of
digestion are always interrupted  more or less, giving rise
to pain, vomiting, and other symptoms of acute dyspepsia,
death sooner or later in all cases  ending the  suffering of
the patient.
  Symptoms. — The first symptoms may be those of indi-
gestion,  gradually becoming more marked in character.
In  most cases  there  is vomiting soon after  eating.   In
such cases the cancer is located at the upper part of the
stomach, but if  the vomiting should occur two or three
hours  after  eating, it  is at the lower part where  the
stomach  connects with  the bowels.  The matter vomited
may be imperfectly digested food or it may be food  mixed
with  blood.  Hemorrhage,  which  is  very moderate  in
quantity, is liable to occur at any time, and  the quantity
being  small,  is not liable to excite vomiting for several
hours, and therefore, when food is thrown up it is  mixed
with broken-up blood  clots that look like coffee-grounds; 
76
ASCITES.
hence  the  "coffee-ground" vomit  is considered a  char-
acteristic symptom of cancer of the stomach.
  Termination. — This is  always unfavorable.   Medicine
affords no hope whatever as far as recovery is concerned.
  Treatment. —This consists in doing whatever is possible
to relieve the sufferings of the patient.   A  sour stomach
may be controlled as well with the bicarbonate of  soda
(common baking soda) as with  any other  drug.  Put a
heaping teaspoonful in a  half glass of water  and  let a
swallow of  it be taken as often as is necessary.   The pain
must be controlled, and for this purpose morphine may be
given in one-fourth-grain  doses,  repeated  as  often  as  is
needed.  For convenience it is best  to give the drug  in
pill form, as morphine  pills in  desirable doses  are obtain-
able at all drug stores.


                      ASCITES.
  Other names : abdominal dropsy;  peritoneal dropsy.
  This is a collection  of  water in  the  abdominal cavity,
causing great  enlargement,  usually  stretching the skin
covering the abdomen so as to give it a glossy appearance.
The upward pressure is often so great as to seriously em-
barrass respiration.
  Causes. —The disease may exist in  connection with gen-
eral dropsy or it may arise from  obstruction in the  liver,
causing a delay in the backward flow of blood from the
lower part of the body to the heart.   Such  a condition of
the liver is almost always  malignant  and  therefore  incur-
able, and so is the attending dropsy.   The affection is also
due to diseases of the heart and kidneys.
  Symptoms. — The dropsy comes on gradually.   The first 
ASCITES.
77
important and most  noticeable symptom is the  abdomi-
nal enlargement, and this causes most of the other symp-
toms by mechanical pressure.   For example : Pressure of
the fluid on  the lower part of the colon causes constipation
of the bowels, and pressure upon the vessels of the kid-
neys causes  the urine to be scanty, upward pressure against
the  diaphragm crowds the lungs and heart together and
interferes with respiration and circulation.
  Termination. — This depends largely upon the cause of
the  dropsy, but when all the  different  causes  are  con-
sidered, it is not very favorable.
  Treatment. — If  the accumulation  of water  is great,
threatening suffocation,  the patient  should  be  relieved
immediately by tapping with a trochar.   The operation is
exceedingly simple and  easy.   It  consists in making  a
little cut in the skin,  an inch and a  half  below the navel,
and then  pushing the trochar, which is about two and  a
half inches long, into the cavity containing the water.
The patient should be in a sitting posture, and the instru-
ment should be pointed a little  upwards and pushed as far
as it will go,  and then the trochar, which is the cutting
part, is drawn out of  the  tube,  or canula, the latter being
left in.  The water, which is usually a straw color, will con-
tinue to flow until several gallons are  drawn off.   As the
canula is only about the size of a small goose-quill, it will
take some little time for the water to run off.  The habit
of giving exhausting cathartics and  producing copious
watery stools to get rid  of the dropsy, is very  bad,  as  a
person cannot survive very long who has to be relieved in
this  way.   If  the kidneys can  be stimulated so  as to do
double or triple duty for  a short time, the water  can be
carried  off rapidly and the resort to tapping avoided;  but 
78
CHRONIC GASTRIC CATARRH.
ordinary remedies to act on the kidneys have never seemed
to do much good in such  cases.  There  is one  remedy,
however, that the author has used a great many times with
most happy results.   The preparation is as peculiar as it
is wonderful in its effects, and is as follows : Common nails,
one pound; cider vinegar, one quart.   After twelve or fif-
teen hours, pour the-vinegar off of the nails  that  are  yet
undissolved, and give the patient  a half tablespoonful of
this vinegar, holding the iron in solution, and  repeat  the
dose every three hours if it does not offend the stomach,
which it does not usually do, but it  must be given largely
diluted.  After a few  hours  it will commence acting on
the kidneys, and will carry off the water  in  twenty-four
hours so that the skin of the abdomen will hang in loose
folds.  There  is nothing like this  in  such cases.  Some
cases are entirely cured  in this way,  while in  others  the
remedy finally loses  its effect,  as all medicines do in
chronic cases where  they fail  to  cure  in a  reasonable
time.


         CHRONIC  GASTRIC  CATARRH.
  Other names: chronic dyspepsia;  drunkard's  dyspep-
sia ;  chronic gastritis.
  This is a chronic inflammation of the mucous membrane
of the stomach,  attended with thickening of the coats and
shrinking away  of  the glands  that  furnish  the gastric
juice.  There  is  pain  at the pit of the stomach, more or
less loss of appetite, difficult digestion, and depression of
spirits.
  Causes. — It is often caused by frequent attacks of acute
gastritis, but much more frequently, perhaps, by the exces- 
CHRONIC GASTRIC CATARRH.
79
sive use  of  intoxicating liquors.  Tea and coffee may be
used so recklessly as to cause the worst forms  of  dyspep-
sia, and  develop  chronic  gastritis.   Irregular meals, indi-
gestible food, or too much of any kind of food may lead,
first, to indigestion, and second, to chronic  inflammation
of the membranes of the stomach, due to the scalding and
irritating effects of sour food.  Tobacco chewing is another
frequent cause.
   Symptoms. — The symptoms of this affection are mainly
those of  a chronic and aggravated case of dyspepsia.  As
dyspepsia always accompanies chronic gastritis and chronic
gastritis  accompanies,  to some extent, the worst forms of
dyspepsia, the two diseases  are  very hard to separate.
The disease under consideration is attended with loss of
appetite  at times, at others with a gnawing feeling of the
stomach, or painful hunger, a feeling of oppression at the
pit of the stomach, and also tenderness.  There is  liable
to  be  swelling due  to  gases  from  decomposing  food.
There is usually more or less  vomiting, especially  after
meals.   Drunkards afflicted with this disease are very apt
to vomit as  soon as they  rise from  bed.  Burning at the
stomach, usually called " heartburn," is almost  a constant
symptom.   There is almost  always depression of spirits,
with a drowsy, sleepy feeling during the day  and an in-
ability to sleep  at night.   These distressing symptoms are
largely due  to a deficiency in the digestive juices secreted
by the stomach, or a defect in the quality of these juices,
causing the  food to sour instead of undergoing  the natural
changes  from the digestive process.
   The sour  and scalding  fluid that is frequently belched
up, sooner or later may cause inflammation of  the throat,
adding to the misery of the patient. 
80            CHRONIC GASTRIC CATARRH.
  Termination. — So far as life is concerned this is favor-
able, but as regards complete recovery, it is not.
  Treatment. — The first thing to be done is to cure the
accompanying dyspepsia if possible,  and as soon as  possi-
ble, as the great acidity of the stomach, due to indigestion,
acts as  a constant  irritant to every part  of  the mucous
membrane.   Meals should be taken regularly, the patient
should be  in a quiet,  cheerful state of mind, if  possible
take plenty of time for meals, eat  only those  articles of
food that are found by long experience best  suited to his
case,  take  no stimulants  of any  kind,  but little sugar or
starchy  food, drink but little at meals, and eat no fat meat.
To  overcome the constipation  that is one of the aggravat-
ing features of this disease, it is  best to resort to a fruit
and vegetable diet, and eat but little if any meat, provided
the fruit does not cause too much pain from an  increase
of the gases.  The constipation  cannot be improved, but
can only be aggravated and made more distressing by the
use of a physic of any kind.  It dulls the  sensibility of
the intestinal canal,  requiring the  use of stronger  and
stronger irritants to arouse the muscular, worm-like action
of the bowels.  For this reason it is  obvious that whatever
is done  in overcoming the constipation must  be accom-
plished  through dieting, to the utter exclusion  of physic.
When a radical change is made in the diet,  as when  a
patient  is taken from a heavy meat diet  and put almost
exclusively upon fruits and vegetables, it may require some
little time for the stomach to  acquire a tolerance for the
new diet, but after  a number of days, provided a  great
deal of  fruit is taken, the fruit  acid will  begin to act as
nature's physic, the bowels will begin to move, the  stools
will become soft and easy instead of hard  and knotty, the 
CHRONIC GASTRIC  CATARRH.
8l
 colic pains will  gradually subside, and a  greatly improved
 condition of the stomach can be hoped for.
   It seems there is nothing more rational, more sensible,
 than the substitution of a fruit diet, which should be un-
 irritating, for a  drug treatment that  is always distressingly
 so in the inflammatory conditions of the stomach and bow-
 els.   In this  affection we are dealing with inflammation of
 the  mucous lining of the stomach.   A physic is an irritant
 that arouses  the secretion of the bowels,  and at the  same
 time increases their muscular action so  as  to  empty the
 entire tract.   This  irritant cannot get into the bowels with-
 out  passing through the poor, inflamed, and crippled stom-
 ach, and of course  must cause great  distress to that organ;
 therefore, what can be  more irrational  than the  use of
 physic in this complaint ?
   This is a disease in which the inflamed  condition of the
 stomach tends constantly to  increase the dyspeptic diffi-
 culty, while the dyspepsia is just as constantly aggravating
 the  inflammatory affection.   Therefore anything that will
 reduce the inflammation will act favorably upon the indi-
 gestion,  or dyspepsia, and any remedy  that will  reduce
 the dyspepsia will favorably affect the  inflammation.  To
 save repetition  the reader is referred to  the  treatment
 given  for "acute gastric catarrh," in which  the use  and
 value of calomel in  divided doses to heal and soothe the in-
 flamed membranes  of the stomach are carefully explained.
  The use of ignatia in  promoting digestion is also ex-
plained in connection with that  disease, and  the whole
treatment is applicable to the treatment of chronic  gastric
catarrh, the disease now under consideration.
        G 
82
PROCTITIS.
                    PROCTITIS.
  Other  names:  inflammation  of  the rectum;  rectitis;
catarrh of the rectum ;  dysentery.
  This is a catarrhal inflammation of the mucous membrane
of the rectum attended with pain, frequent stools, often of
a mucous or bloody character and sometimes mixed with
pus.  The stools are often hard and lumpy.
  Causes. — The principal causes are constipation, the ha-
bitual use of physic, hemorrhoids, and diseases of the liver;
but the most frequent cause is piles.
  Symptoms. — There  is a burning or aching sensation in
the rectum, with a desire to go to stool.   When on the ves-
sel  or seat there is  an  inclination to bear down or strain,
hoping in that way to be relieved from  the distress.  This
sometimes causes falling of the mucous membrane of the
rectum, but if  it does not,  it is liable to cause enlargement
of the blood-vessels of  the anus and bring  on hemorrhoids,
or what is the  same thing, piles.  The  stools may be hard
and lumpy or  consist of a  bloody mucus.  There is gener-
ally more or less sickness of the stomach,  fever, and head-
ache.  In the  most aggravated form of the disease there is
great difficulty to  pass water, especially in  male  patients.
If  the case  be protracted, much of the tissue round the
rectum  is liable to become involved, developing an abscess
and leading to  fistula in ano, or fistula of the rectum.
  Termination. — The disease when uncomplicated is favor-
able.
  Treatment. —The rectum should be thoroughly emptied
with a pint injection of warm water.   After this has passed,
inject another pint and perhaps still another, until the rec-
tum is  thoroughly cleansed.  The following suppository 
ACUTE GASTRIC CATARRH.
83
will probably do a great deal of good in overcoming the in-
flammatory condition by keeping the lower bowels in a state
of perfect rest: —
            Opium, six grains,
            Sugar of lead, eighteen grains.
            Mix and divide into six powders.
   Put each powder into a large capsule and when ready to
insert, cover it all over with vaseline and push  it in with
the point of the index finger, pushing it up into the rectum
the whole length of the finger.  One of these may be used
in this way two or three times in twenty-four hours, but as
soon as any of the  lumpy, irritating stools come into the
rectum  they must be removed by warm water injections,
after which the lead and opium capsule maybe again inserted.
   The tormenting desire to go to stool may be relieved by
injecting four  ounces of cold water, that is, a half a table-
glassful.  This may be repeated a dozen times  in twenty-
four hours, as cold water often works wonders in reducing
inflammation.

          ACUTE GASTRIC  CATARRH.
   Other  names:  gastric fever;  acute  indigestion; suba-
cute gastritis ;  bilious fever.  This is an acute inflammation
of the  lining  membrane of  the  stomach, attended with
fever, loss of appetite, sickness of the stomach,  and more
or less vomiting, pain, and difficult digestion.
   Causes. — The disease may be caused by defects in the
juices of the stomach that digest  the food; for example,
the gastric juice may be  either deficient in quantity or de-
fective in quality, or both.  In addition to this, the food may
be improperly masticated, owing to bad teeth, or eating too
fast.  Then, again, indigestible food may be  eaten, the 
84
ACUTE GASTRIC CATARRH.
stomach may be abused with hot drinks, and the worst of
all, by intoxicating liquors.  To sum  it up, and  get  the
causes into a condensed  form,  it is mainly due  to indi-
gestion.
  It is an affection that often arises from eruptive fevers,
such as small-pox, measles, and scarlet fever.  It is well to
remember that  the skin covering the outside of the body
is  closely analogous  to the  mucous membrane lining  the
inside, and  any eruptive  fever  that breaks  through and
inflames the outer covering is very liable to break through
and inflame the inner lining.
  Symptoms. — Loss  of appetite, tongue heavily coated, a
loathing  for  food,  disagreeable  taste  in the mouth, con-
stant sickness of the stomach,  and occasional  vomiting.
The vomited matter is, to commence with, undigested food,
but may finally be mucous and bilious matter.   The inflam-
matory fever attending this disease is  mild, though thirst
may be considerable.   In most fevers there is a craving for
acids, and that is especially  the case in  subacute gastritis.
There are frequent  sour  eructations attended with pain,
tenderness, and heaviness at the  pit of  the  stomach.  The
bowels are usually loose.   There is, many times,  a  great
deal of nervous derangement, anxiety, and melancholy.  As
the affection is largely due to acute indigestion, it is obvi-
ous that errors in diet must surely aggravate it.
  Termination. — This is almost always favorable but re-
covery is slow.
  Treatment. — As  the stomach is not in a condition to
digest food, diet should be almost absolutely withheld for
twenty-four hours  or more.   The  vomiting can  be best
allayed by the use of calomel in small doses as follows :
Mercurius dulcis, the first decimal  trituration, twenty-five 
ACUTE GASTRIC CATARRH.
85
grains;  divide into five powders and give one every hour
until all are given.
  This trituration must always be placed in the mouth  in
a dry state, and swallowed with  a small quantity of water
or some other suitable liquid.  The manner in which the
drug acts in overcoming inflammation of the mucous mem-
brane, both of the stomach and bowels, is very interesting,
and is as follows: If calomel is sprinkled upon an ulcer of
the skin or  mucous  membrane it greatly stimulates the
healing process, but should  the surface  involved be very
extensive, the crude drug could not  be  applied to every
part of it  without the  risk of  salivation.   In subacute
gastritis the whole mucous lining of the stomach is usually
involved, and it is  desirable to bring  the drug in  contact
with every part of it.   The system will not tolerate enough
of the crude drug  to allow this to be done; therefore it is
mixed with nine parts of sugar of  milk, so as to spread it
over ten times as much  surface.  The advantages of the
trituration  over the crude  drug  are  twofold : first, ten
times more surface can be reached by the trituration than
by an equal amount of calomel not diluted with the sugar;
second, in  the highly irritable condition  of  the stomach
that exists in gastritis, the  calomel is too severe, and  to
have the happiest effect  must be reduced in  strength by
mixing it with the  sugar of  milk.   As a  healing stimulant
it has only  one-tenth  of  the irritating properties of pure
calomel, and therefore it stops the sickness of the stomach
by healing and soothing the inflamed  membrane, and soon
subdues the inflammation.  After it passes out of the stom-
ach it stimulates the secretions of the whole intestinal tract,
and, acting as a physic, removes all irritating matter, such
as imperfectly digested food, and in that way further  con- 
86
GASTRIC ULCER.
tributes to relief  of the stomach.   After the  sickness of
the stomach and other acute symptoms have subsided, the
following is by far the best remedy with which  to  stimu-
late the digestive  process:  Extract of ignatia, from one-
half to three-quarters of a grain, according to the size of
the patient, three  times a day before meals.
  It is always given in pill form, and if the patient only
weighs from one hundred pounds to a hundred and seventy-
five, a half-grain  pill  is sufficient, but if more  than  one
hundred  and seventy-five, three-quarters of a grain must
be given.

                  GASTRIC  ULCER.
  Other names : perforating ulcer ; peptic ulcer; chronic
gastric ulcer.   This is a solution  of  continuity affecting
the mucous membrane and some of the other coats  of the
stomach.   In plainer language, it  is a hole in the mucous
membrane and other coats,  caused by  ulceration.   It is
attended with pain and deranged digestion and sometimes
vomiting of blood.
  Causes. — It  is probably due to self-digestion of  the
stomach at the seat of the ulcer.
  Symptoms. — The symptoms of  indigestion  are very
prominent in this affection.  There is constant pain in the
stomach, which is increased by taking food.   Vomiting is
almost a constant  symptom and may be greatly aggravated
by eating.   As the ulcerative process sooner or later  de-
stroys a  blood-vessel,  vomiting of fresh  blood in large
quantities  is liable to occur and  is very characteristic  of
gastric ulcer.  If it is not vomited for some time after the
hemorrhage occurs, it will  of course be dark instead  of
bright red.  The  ulcer is slow in forming, and it may be a 
ACUTE GASTRITIS.                 87
year before it is fully matured.   Sometimes, however, it
develops rapidly, perforates all the coats of the stomach,
and ends  in death  by perforation and inflammation in a
few weeks.
  Termination. — This is more or less unfavorable.   Many
cases die and many recover.
  Treatment. — The stomach should be kept in a state of
absolute rest if possible.  In order to do this, beef, chicken,
or mutton broth may be given several times a day by the
rectum, but if for any reason this cannot be done, a milk
diet by the mouth may be necessary.  A quart of milk, or
even more, may be given in twenty-four hours, by giving
only a few ounces  at a time, as it will be better  borne
when given in this way.
  For hemorrhage  that may occur any time, it  is best to
give fluid extract of ergot in teaspoonful doses every hour
until it is arrested.
  In order to hasten the healing process in the  ulcer, give
subnitrate of bismuth in twenty-grain doses, three or four
times per  day.   It may be mixed with a little sugar, placed
in the  mouth, and then  washed down with a swallow of
water.

                ACUTE GASTRITIS.
  Another name :  toxic gastritis.
  This is an acute and severe inflammation affecting the
entire  stomach,  including  the mucous  membranes  and
muscular coats, and is attended with violent pain, incessant
vomiting, the vomited matter being usually  bloody mucus.
To these distressing symptoms are added those of a fatal
collapse.
  Causes. — It is due to swallowing corrosive poisons, such 
88
ACUTE GASTRITIS.
as corrosive  sublimate, carbolic acid, or any other drug
that burns and inflames the stomach.
  Symptoms. — Soon after the  poison is swallowed there
is  deathly  sickness  and  constant vomiting.  After the
stomach  is emptied  of  all food, portions of the mucous
membrane  that have been destroyed by the irritant are
thrown up, and with  them clots of blood, or bloody mucus.
There is a great depression of spirits, weak pulse,  and
skin covered  with a cold sweat, and yet there is a terrible
heat at the pit of the  stomach and a burning thirst that
nothing will satisfy.   There is frequently a burning pain
in the mouth and throat, as well as the stomach, and terrible
purging,  all from swallowing the corrosive poison.
  Termination. — Recovery is very doubtful, death being
due to a  great shock upon the nervous system and chemi-
cal destruction of the stomach.
  Treatment. — So far as the  treatment is concerned in
this affection, almost everything depends on the nature of
the drug causing the mischief.
  If  it be a  strong acid of any kind,  excepting carbolic
acid, bicarbonate of soda (common  baking soda) should be
given immediately in water, using  a heaping teaspoonful
to a  half a glass of  water and giving a  swallow every
minute until the gas  ceases to rise  from the stomach.  As
long as the gas rises the soda,  however strong it may be,
will not injure the stomach, as it is  in a chemical fight with
the acid.   Should the poisonous drug be an alkali such as
caustic potash, caustic  soda  or lye, used in  washing, the
best  remedy  is vinegar,  and should be given diluted in
water as  long as gas rises from  the stomach.
  Poisoning from drinking a solution of concentrated lye,
or lye of any kind,  is  an accident that very frequently 
FEVERS.
89
occurs among young children, who are disposed to drink
everything they can get  hold  of.  The treatment in all
such  cases is vinegar, given as above directed, and fol-
lowed, after  the  gas ceases to rise,  by a tablespoonful
of sweet  oil.  Should lye be swallowed  by a child  and
no vinegar at hand, a couple of tablespoonfuls of sweet
oil should be  given immediately, which will unite with the
lye, forming  a crude, imperfect soap.    Melted butter or
lard, or grease of any kind, can be used in the place of the
oil and will  have the same effect  on the lye.   After the
action of the poison is destroyed in one of the above ways,
the stomach  may be left  in an inflamed and irritable con-
dition  with  constant  tendency to vomit.  In such  cases
solid food will not be borne by the stomach, and the diet
should be milk, gruel,  or  animal broths.  If carbolic acid
should be swallowed, an  alkali, such as  baking soda, will
do no good, as the drug is not really an acid.   Oil is the
best antidote for  carbolic  acid, and one or two tablespoon-
fuls of sweet oil should be given  immediately.   Melted
butter or lard will also answer, but if much of the terrible
poison is swallowed the  nervous system  will be  over-
whelmed by the shock, and death cannot be  long delayed.
   See chapter on poisons.

                       FEVERS.
   Fever is a condition characterized by a rise in tempera-
ture of the body,  the heart's action being quickened, tongue
usually dry  or less moist than normal, and  a general de-
ranged condition of  the secretions.
  The one symptom that  belongs to all fevers and without
which there can be no fever, is a rise in temperature above 
90
FEVERS.
the natural, which is said to be ninety-eight and a half de-
grees F.   It is impossible for any one to determine, accu-
rately, the degree of fever that a patient has, without using
a thermometer.   When the temperature is only about one
degree above  the natural,  it is proper to  say that such
patients are a little feverish.   If  the temperature rises to
a hundred and one, or a hundred and two,  the patient is
said to have " slight fever";  if a hundred and three to a
hundred and four, high fever, and when it reaches a hun-
dred  and  five, a burning fever.   There are but  few con-
ditions, either in inflammatory or  common fevers,  in which
the temperature rises above one hundred and six.
   The height  of the fever as witnessed by the thermometer,
the experienced touch of the physician, nurse, or mother,
affords  some  information  regarding the severity of  the
attack and always  deserves  proper  consideration; but in
the sick brashes  and  gastric  disturbances of children, the
intense fever  that accompanies them is not necessarily a
dangerous symptom, as the organism of childhood is in a
vigorous,  active,  and  keenly  sensitive state, and  responds
so readily and violently to disorders of digestion and other
minor ailments  as  to create  unnecessary alarm.   For ex-
ample :  A child after eating a very hearty supper may go
to sleep apparently in a state of perfect health, and before
morning may awake with a burning  fever  and  intense
thirst, and seem to be suffering from some terribly danger-
ous disease.   Sooner or later vomiting occurs, and perhaps
purging also, the offending matter in the form of undigested
food is gotten rid of, and by morning the child is  compara-
tively well.  Such cases are  constantly coming under the
observation of practicing physicians. 
GENERAL MANAGEMENT OF FEVERS.        91
    GENERAL MANAGEMENT  OF FEVERS.
  Before considering special fevers, it is thought best to
give some plain and important facts regarding the general
management of  fevers.  The most distressing feature  of
all fevers is the  high temperature of  the body, as its ten-
dency is  to  dry  up the secretions of every organ.  This
leads  to  constipation  of the bowels,  derangement  of the
liver  and pancreas, and, consequently, to  a diminished
power to digest the food.  The system, as if aware  of this
condition, does not call for food, and naturally enough there
is no appetite.  The urine is scanty and high colored, for
the same reason that all the other secretions are limited in
quantity, and  in almost all  cases of  high fever  attended
with delirium, the latter is mainly due to a retention of the
salts of the  urine in the blood, known as uremic poisoning.
  From  the foregoing, the  obvious indications in dealing
with fevers  of all kinds are  to reduce the temperature and
hold it as near the degree of natural heat as possible.  The
manner in which  this  is to be effected depends greatly
upon  the character of  the fever, whether due to malaria,
the typhus,  or typhoid  germs, the specific poison of erup-
tive fevers,  or inflammation, the latter being called  inflam-
matory fever.   In the great majority of general fevers it is
impossible to reduce the temperature, to any material extent,
by any drug treatment.  In other words, the remedies given
in the treatment of fever, except in the inflammatory type,
affect  the temperature but little, if  any.  This suggests
other remedies besides drugs, in  reducing the burning tem-
perature  of  typhoid and other fevers that dry up  all the
secretions and tend to a fatal termination.   Just in propor-
tion as the fever can be lowered, all the secretions  can be 
92         GENERAL MANAGEMENT OF FEVERS.

conserved.   For example :   Should there be six degrees
of extra temperature, the organic secretions would be con-
sumed twice as fast, and the tendency to  a fatal termina-
tion twice as great as would be the case if the extra  heat
were but three degrees.  Therefore every degree of fever
that can be  dispensed with, saves materially the natural
secretions and the vitality of the patient.
  One of the eternal principles of nature is this: That the
evaporation of water reduces temperature by absorbing the
heat.  Therefore if water is spread over the surface of any
body, animate or inanimate, the temperature  of that body
is immediately lowered.  If the body should  be a physical
one, that is, a human being, and such being should  have a
high fever, would not the  evaporation upon the surface
of the body  have a direct  tendency  to lower the  fever ?
It certainly would.  This leads us up  to a  consideration of
the power and efficacy of water in the treatment of fevers
generally.
  There are five ways in which water can  be  used to great
advantage in lowering the temperature : —
  First, Bathing in a bath-tub.
  Second, By using the wet pack, consisting of a dripping
wet sheet or towels.
  Third,  The shower, or spray bath.
  Fourth, The sponge bath.
  Fifth, By drinking large and frequent draughts of  cold
water.
  The use of the bath-tub, even where such a convenience
is obtainable, is limited.  The patients are frequently too
weak to be bathed in this way, and even if not very weak,
they are liable to become so by too long and  too frequent
ablutions.   In the early stages of severe fevers, while the 
INTERMITTENT FEVER.               93
patients are yet comparatively strong, the bath-tub can be
used to great advantage when followed by the proper use
of the  spray or  wet sponge.  Where  proper facilities are
provided for taking care of the extra water and saving the
bed clothing from getting wet, the spray bath, such  as is
used by ladies in watering house-plants, may be used several
times a day with the happiest results.  As all fevers are
attended with evening exacerbations, that is, an increase of
temperature of one or two degrees in the  evening, this is
the proper time  for the  water  treatment, in whatever form
is best  suitable to the case.  If used at all, it is best to use
it freely during the three or four hours of the day in which
the fever is highest.
             INTERMITTENT  FEVER.

  Other names:  ague;  chills  and fever;  swamp fever;
malarial fever.
  This  is a paroxysmal fever consisting of three stages,
namely,  a cold,  a  hot, and a sweating stage.  The sweat-
ing stage is followed by a complete  intermission, varying
in length according to the  character of the attack.  Until
this is established  by the recurrence  of another chill, it is
impossible to tell whether the type is quotidian, in which
the chill occurs every day, the  tertian, in which  it occurs
every other  day, or the quartan, in which it occurs on the
first and fourth  days.
  Causes. — Malarial bacillus.  These malarial-fever germs
are true parasites, but how their effects manifest themselves
periodically, and that, too, with such wonderful regularity,
it is  impossible  to tell.   There  may possibly be several 
94
INTERMITTENT FEVER.
species of the parasites, each one capable of developing
a special  type of the disease, as tertian, quartan, etc.
  Varieties. — There are many distinct types  of  this dis-
ease.  First, the quotidian, with  a paroxysm  every day;
second, the tertian, with one every other day; third, the
quartan,  with  a  paroxysm  on the first and fourth days;
fourth, octan,  when the paroxysm occurs weekly ; fifth,
the double quotidian, in which two paroxysms occur daily;
sixth, the double tertian, with two paroxysms every second
day.  The dumb ague  is an irregular form of the disease
in which  one of the stages, either hot, cold, or  sweating, is
absent.   This  is usually the  cold stage.  Sometimes two
stages are absent, the sweating stage alone showing itself.
   Symptoms. — Each paroxysm has three stages,  the cold,
hot, and  sweating.
   The cold stage begins with  premonitory symptoms such
as headache, yawning, sickness of the stomach,  followed
by a  chill.   The teeth rattle, the nails and lips become
blue, the skin  pale and rough like goose flesh, while there
is great thirst and internal fever.  The thermometer dur-
ing a severe chill often ranges from one hundred and two
to one hundred and four F.  The duration of a chill is
from fifteen minutes to an hour.
   The patient gradually passes out of the cold stage into
the hot by the  shivering  ceasing, the surface becoming
first warm, and then  hot and  flushed, the temperature
sometimes  reaching  a hundred  and  six or  even more.
The  pulse  is full and strong,  there is headache  with
nausea and  great thirst, the  skin being perfectly dry and
swollen.  The urine is always scanty and  high colored,
and the hot stage lasts from one to eight hours or more,
according to the length and severity of the  cold stage. 
INTERMITTENT FEVER.
95
 For example:  if the  cold  stage is long and severe,  the
 hot stage will be correspondingly so.
   The sweating stage comes on gradually, its first appear-
 ance being on  the face and forehead, and then spreading
 over the entire body.   The  temperature rapidly returns to
 the normal standard, the patient is  restored to a condition
 of comfort, and drops into  a refreshing sleep.   The dura-
 tion of the sweating stage is from one to four or five hours.
 From the time  the sweating stage ceases  until the chill of
 the next paroxysm begins, is called the  intermission.
 During this time, the patient  is seemingly  in  a state of
 usual health.
   Termination. — Almost always favorable.
   Treatment. — The treatment  consists, first, in  the use of
 remedies during the premonitory, or warning, symptoms of
 the chill, either to postpone or modify it.  This may  be
 effected by giving a full dose of morphine as soon as the
 warning symptoms appear.  Just in proportion as the cold
 stage is modified as regards duration and severity, the hot
 and sweating stages will be.  During  the hot  stage, cool
 drinks and frequent sponging with cold water will afford
 the greatest comfort.   The  sweating stage seldom, if ever,
 requires any treatment.
   All efforts to  break up  this disease  and restore  the
 patient  to a condition of perfect   health should be com-
 menced immediately after  the  cessation  of  the sweating
 stage, or, in  other words,  during  the intermission.   As
before remarked, until  the  second chill occurs, the type
of the disease  cannot  be determined,  and,  therefore,  the
length of time in which to give  quinine or other remedies,
to prevent another chill, is entirely unknown.  For this
reason the  time is precious.  The best remedy in  the 
96
INTERMITTENT FEVER.
acute form of the disease  is sulphate of  quinine, which
may be given in three-grain doses every three hours until
fifteen grains are  given.  If  the  next  day the dreaded
chill fails to  occur, it is reasonably fair to presume that
the quinine has prevented it, but at least twelve or fifteen
grains of the drug must be  given  on the second  day to
guard against the tertian form  of the disease.  If by the
third or fourth day there is no  chill, it is evident that the
attack is  broken up.   The  quinine, however, should be
continued in three-grain doses three times  per day for
about  a  week.   Regarding the amount of quinine neces-
sary to give in order to  break up and permanently  subdue
an  attack of ague, almost everything depends upon the
amount  of  malaria affecting  the  district  in which  the
patient lives.  If this is slight, as shown by the  limited
number  of  cases,  the  amount of quinine  necessary to
break  up and  permanently  cure  an attack of  ague is
correspondingly  small.    In  such  cases nine  grains of
quinine per day  will arrest  the  disease in three or four
days, and by giving about six  grains per  day for  four or
five days longer, the chills  will  not return.
  Unhappily, if a case of ague is trifled with by giving too
little medicine  until it is allowed to  return several times,
the  disease  becomes chronic and obstinate, the skin more
or  less yellow,  and, sooner  or later, the  patient  has an
enlarged spleen.  Under such poor management patients
gradually drift  into conditions  that are incurable by ordi-
nary means, and start out on a  health-hunting journey, but
the ague stubbornly continues, regardless  of the usual
remedies.  In such cases, whether the patient  abandons
the malarial district or not, the following prescription will
effect a permanent cure : — 
REMITTENT FEVER.
97
         Sulphate of quinine, one drachm,
         Arsenious acid, one grain,
         Sulphate of strychnine, one grain,
         Aromatic sulphuric acid, ten drops,
         Extract of gentian, a sufficient quantity.
         Mix and divide into twenty pills.
   For an adult, give one pill before each meal.   The cases
 are  exceedingly  rare  in which this prescription fails to
 cure, however  chronic and obstinate  they  may be.   No
 one  except  an  accomplished  druggist  should ever  be
 trusted to put up this prescription.


               REMITTENT FEVER.

   Other  names:  typho-malarial  fever;  bilious  fever;
 bilious remittent; marsh  fever.  This  is  a paroxysmal
 fever that  may come  on exactly like  ague, that is, by a
 chill followed by a hot and a sweating stage, but usually
 the chill  is not  so long and pronounced as in ague, and the
 sweating stage  is sometimes absent.
   It is characterized by an exacerbation or aggravation
 every day, usually in the evening, after which  there is a
 remission or falling  of the fever, generally in  the  latter
 part of the  night and forenoon, and it is during these re-
 missions  that patients must get their  sleep.  During the
 intense hot stage, there is severe headache and  irritability
 of the stomach.  In many cases there  are sharp pains in
the chest like  pleurisy, always occurring, if at all, during
the hot stage.
  Cause.  — The presence in the blood  of  a parasite  or
malarial bacillus.
  Symptoms. — There is a moderate  chill  to commence
        H 
98
REMITTENT FEVER.
with, the temperature rising one or two degrees above the
normal, tongue dry and coated,  the coating  usually of a
lightish brown color, oppression at the pit of the stomach,
headache, and pains more or less over the entire body, but
mainly about the chest.
  Hot stage. — During this stage there is often vomiting,
the coating  of  the tongue  heavier and  somewhat darker
than in the  cold  stage, pulse full and  often rising to a
hundred and twenty, injected eyes, flushed  face, severe
headache, pains over the body, hurried  respiration, and a
temperature ranging from a hundred and four to a hun-
dred and six.  The bowels are usually costive, stools dark,
urine scanty and high colored, the skin frequently yellowish.
During the highest part of the fever there is often delirium.
  Sweating  stage. — Sometime within twenty-four hours
all the  above  symptoms  mainly subside, and moderate
sweating commences.  The pulse drops ten or fifteen per
minute, the  headache and  vomiting cease, and the fever
falls about two degrees.  This is called the remission, but it
must be remembered that this stage is never free from fever.
  After  several hours, the symptoms of the  hot stage
return, usually  without the chill, this stage  always being
known as the exacerbation, which is followed again by the
remission, the entire  course of the disease being simply a
series of exacerbations and remissions.
  Authorities differ regarding the duration  of this fever,
probably owing to the different localities in which they
have practised, but  the fever  rarely gives way under four-
teen days.  Just in proportion to the darkness of the
tongue, with red  edges, is  the tendency to  typhoid,  and
sometimes at the end of  about two weeks, when there is
reason to hope for  convalescence, the tongue takes on a 
REMITTENT FEVER.
99
dark brown coating, lips become parched with a tendency
to bleed, and a black, gum-like deposit appears upon  the
teeth, showing  that the case has  drifted into a malignant
form of typhoid.
  Termination. — Usually favorable.
  Treatment. — The preponderance of authority favors the
administration  of quinine during the  remissions, in order
to break the force of the paroxysm  and shorten the dura-
tion of the disease.  The author, during a very  wide ex-
perience with this disease in malarial  districts of the west,
followed the quinine  treatment for a long  time,  giving
about ten grains during each remission, and failed to note
any decided  improvement from  such a course.   On  the
other hand, quinine given in this way seemed  to increase
the headache and nervousness  that usually attend the hot
stage.   In  this way he was led to try the expectant plan of
treatment, which simply means nothing, so far as medicine
is concerned.   It consists in waiting for the disease to run
its course, while sweetened water, or something else equally
valueless as a medicine, is given  to satisfy the patient  and
friends.  He found that most of the cases treated  in  this
way  ran a milder course,  and were  not a day longer in
duration than those treated with quinine.  In all cases, due
attention was paid to the condition of the bowels, kidneys,
and other organs of the body.   There is really but little to
do in the treatment of  a case of bilious fever except to keep
the bowels, skin, and kidneys in a healthy state.   If there is
irritability of the stomach it is best  allayed by small doses
of calomel, given in the following form:  Mercurius dulcis,
the first decimal trituration, twenty grains, to be divided
into five powders, and one powder given every hour.  The
powders are to be placed in the mouth dry, and swallowed 
100
REMITTENT FEVER.
with a tablespoonful of water.  After they work off, which
they usually do in ten or twelve hours, the  irritability of
the stomach  and intestinal tract  ceases.   The urine is
always scanty and high colored, with a tendency to blood-
poisoning by  retention of the salts that should be excreted
by  the  kidneys.   There are  two ways  to  facilitate  the
action of the  kidneys and get rid of  the poisonous effects
of the salts, that are one of  the greatest sources of delirium
in the severest types of fever.  One  is to give a diuretic to
act directly upon the kidneys, and the other is to allow the
patient  to have  all  the water  he can drink, in order to
wash the .salts  out  of  the body through  the kidneys.
Hence the following: —
   Sweet spirits  of  nitre, two  ounces,
   Acetate of potash, one-half ounce,
   Water, two ounces.
   Mix, and give a  teaspoonful  every two or three hours
when awake.
   During the hot  stage there  is usually a  great  deal of
thirst and, unless there  is  irritation of the stomach  and
bowels with a tendency to diarrhoea and vomiting, the patient
ought to drink as much water as he  desires.    The use of
the sponge bath  during the hot stage  has a tendency to
lower the fever by  the direct application of cold to the
surface, and  also by maintaining  a  healthy  action of the
skin and favoring perspiration.   When  delirium occurs in
the hot stage, it is best controlled by the constant applica-
tion of cold water to the head.   The  practice of putting a
wet towel on the forehead is bad, as it keeps the head hot,
and does more  harm than good.   The water should be
applied with a sponge very freely all over the head, satu-
rating the hair thoroughly, and causing its rapid evapora-
tion by the vigorous use of a fan. 
TYPHOID FEVER.
IOI
                 TYPHOID FEVER.
  Other  names:  enteric  fever;  gastric fever; nervous
fever ;  abdominal typhus ; autumnal fever.
  This is an acute infectious  fever that is self-limited.
  Causes. — It seems that the predisposing causes are age
and heredity.  It most frequently occurs between the ages
of fifteen  and thirty, and  is rarely seen  in  those over
fifty.
  Some families are  especially liable to the disease, and
this fact establishes heredity  as a predisposing cause.
  A special germ or bacillus, known as the typhoid  germ,
is the exciting cause.
  The poison  of typhoid fever, through which it is mainly
propagated, is in the stools  and  expectorations.  The at-
mosphere is not impregnated with these germs, but  the
poison enters  the system through food and water.   The
stools and expectorations should be disinfected with a solu-
tion of carbolic acid, using  about four tablespoonfuls of
the acid to a quart of water.
  Symptoms. — The fever comes on gradually, preceded by
several premonitory symptoms, such as dizziness, headache,
especially in the back of the head, nervousness, with in-
ability to sleep, deranged digestion, low spirits, and general
weakness, followed by a chill or chilly feeling.   When the
patient comes  under treatment he is wholly unable  to tell
when  the attack began.   In malarial districts, however, the
disease occasionally sets in suddenly with  a chill, followed
by high fever.
  What is known as the premonitory or warning symptoms
may last ten or twelve days, but usually this stage is much
shorter. 
102
TYPHOID FEVER.
  During the first week  of  the  fever, the temperature
gradually increases, the pulse  becomes more frequent, the
coating of the tongue heavier, more headache, the abdomen
enlarges, and  there is  tenderness  in  the  right side and
frequent gurgling  of the bowels in that locality.   About
the end of  the first week in the well-marked cases, a few
reddish  spots appear upon  the chest, back, and abdomen.
  During the seco7id week, all these symptoms increase in
severity, the fever becoming higher, pulse  more frequent,
abdomen more distended, and frequently delirium at night.
There is headache, more or less stupor, some cough,  jerk-
ing of the muscles, and dark accumulations upon the teeth,
and there may or may not be diarrhoea.  The coating often
disappears from the tongue and the mouth becomes so dry
that it is difficult for the patient to speak.  Deafness fre-
quently exists.
  During the  third week,  the  fever  becomes  remittent.
It continues quite as high in the evening but is decidedly
lower in the morning, while all the other symptoms remain
about the same.   By the end  of the third  week, however,
there is a general improvement.
  Unfortunately, in quite a number of cases, all the symp-
toms grow  worse during the  third week, the tongue and
lips becoming dry and  cracked, both  teeth  and  gums
covered with a black deposit, called " sordes," the pulse and
respiration quicker, the urine and stools are passed  uncon-
sciously, and the case ends fatally.
  In the great majority of cases, patients that  survive
until the fourth week without  any  of  the desperate symp-
toms referred to above, recover.  Generally the  symptoms
of improvement  set in  during the  third week,  so by the
fourth the fever is greatly reduced, being almost absent in 
TYPHOID FEVER.
103
the morning, the pulse  is less frequent and  stronger, the
tongue  clean  and moist, and a  general  but slow conva-
lescence is established.   Diarrhoea  is usually supposed to
be one of the most dangerous symptoms, but the author
has found constipation to exist in many malignant types
of the disease.
  Termination. — The favorable indications are, moderate
fever, slight diarrhoea or constipation, and delirium, if at
all, of moderate character.  The most fatal  period of the
disease  is during the third week.
  Treatment. — There are two great sources  of danger in
this disease.   One is from ulceration of the  bowels and a
discharge of their contents into the cavity of  the abdomen,
causing fatal inflammation, death usually occurring within
twenty-four hours.   In order to  prevent  this termination
it is best to keep the bowels in a state of perfect rest,  if
possible, so as to allow the ulcers, if present,  to heal.   For
this reason the diarrhoea, if any, must be controlled,  and it
is much better in such cases if the bowels  don't move for
two or three days.  To arrest the diarrhoea and keep the
bowels in condition to favor the healing of ulcers, give the
following: —
  Powdered opium, ten grains,
  Sugar of lead, twenty grains,
  Mix and divide into ten powders, and give  one every five
or six hours if needed.
  The second source of  danger  is exhaustion, caused by
the intense fever and all the  prostrating influences of the
poison producing it; and just in proportion as the fever
can be  reduced in  severity,  the  tongue and mouth kept
moist, the accumulations upon the gums and teeth les-
sened, the delirium prevented, and good  refreshing sleep 
104
TYPHOID FEVER.
procured, the danger will be diminished.   A great deal of
the delirium  in typhoid fever is caused by a retention in
the blood of certain salts that should be discharged by the
kidneys.  On this account it is best to keep up a  gentle,
stimulating  action  upon  the  kidneys during the entire
fever,  care being taken to avoid offending the stomach
with too much medicine.   To act on the  kidneys give the
following: —
  Sweet spirits of nitre, two ounces,
  Acetate of potash, a half ounce,
  Water, simple syrup, of each two ounces.
  Mix; give  a teaspoonful every three hours when  awake.
  There is nothing so effectual in reducing the  fever and
controlling the distressing symptoms associated  with it,
as the  direct  application of cold to the body, and water
is the  best possible form  in which  it can  be  applied.  If
the water treatment is commenced in the early stage of
the fever, while the patient is comparatively strong, the
bath-tub is by far the best means of applying it.  Experi-
ence has proved that  when the temperature in typhoid
first reaches  a  hundred and two,  it is  best to put  the
patient in a bath-tub with the water at  a  temperature of
about seventy, allowing the water to come  up to his chin,
while gallons and  gallons may be poured  upon  his head.
Meanwhile he is rubbed all over with a coarse towel, so
as to excite the circulation  of the skin.   If not very weak,
the  bathing should be kept up for  twenty minutes.   This
generally reduces the temperature from one to two degrees,
and the  most of  the bathing  should be done during the
part of the day at which the temperature is highest.  The
injurious and prostrating effects of the  fever are  mainly
due to  the evening exacerbations, in which the temperature 
TYPHOID FEVER.
105
is about two  degrees higher than the  rest of  the  day.
This is when the secretions are dried up, when the tongue
and lips become dry and parched, and  the dark accumula-
tions appear on the teeth and gums.
   If in every case of typhoid fever the temperature can be
held down during three, four, or five hours of the evening
aggravation, thousands of cases that would otherwise end
fatally can be saved.  There is nothing of any value in low-
ering the temperature in such cases, but water.   After the
patient is taken from the bath-tub, should the fever soon rise
again, water should  be applied freely all over the body by
a spray such as would flow from a small watering-pot.  In
order to apply water in this way, the patient should lie
upon  an oil-cloth or rubber sheet, and  the waste water be
lifted by  a sponge.   If, in spite of the frequent use of
water in this  way, the fever is not held  down, a sheet
dripping wet with cold water should  be spread over him,
and changed as often as necessary by dipping it again in
cold water.  The idea that must be kept in view is this:
Whenever the temperature reaches  a hundred  and  four
or five for  a few hours during  every day, the  tendency is
very dangerous, and every possible effort must be made to
reduce the fever and hold it down to  one hundred and one
if  possible.  Water  must be used in  the various ways
mentioned  above, and will often succeed when everything
else fails.
  To prevent the chilly feeling and bluish color of the  skin
that sometimes occur during  bathing, vigorous rubbing of
the body with a moderately coarse towel is often necessary.
After the  temperature  is reduced by  water, the patient
frequently falls into a refreshing sleep.
  If delirium of an active character exists, it is during the 
io6
CEREBRO-SPINAL MENINGITIS.
part of the day or night in which the fever is highest; and
it is best to have a wash-tub close to the side of the bed,
hold his head over it with his face inclined downwards, and
slowly pour several pitchers of water upon it, thoroughly
bathing his hair and every part of the scalp.   If not too
exhausting,  this should  be kept  up  for  ten  or  twelve
minutes at a time.
  To secure refreshing sleep, the following may be  given
when necessary, and acts like a charm : —
          Fluid extract of valerian, a half ounce,
          Bromide of potassium, half an ounce,
          Water three ounces.
  Mix and give a teaspoonful, then turn  down the lights,
keep  the  room  perfectly quiet, and he will  usually fall
asleep within  an hour and may  sleep all  night.


        CEREBRO-SPINAL MENINGITIS.

  Other  names :    cerebro-spinal fever;  spotted  fever;
cerebro-spinal typhus.   This is  a malignant fever,  often
prevailing epidemically,  attended  with terrible  headache,
vomiting,  severe contractions of the  muscles of the neck,
extreme sensitive condition of the skin  and muscles, caus-
ing the  patient to scream  when handled;  frequent delir-
ium, stupor, and more or  less  coma, with frequently an
eruption  of the skin  in the form  of  dark red  spots.
Excepting the epidemic cases, the eruption  that  has  given
rise to the term " spotted fever," is not often found.   The
disease is due to  microbes,  resembling those  found in
pneumonia and erysipelas.  Bad sanitary conditions seem
to  favor  the development  of  the malady, which  occurs
most frequently in the winter, usually attacking children. 
CEREBRO-SPINAL MENINGITIS.          107
  Symptoms. — The common  form begins suddenly with
a chill,  severe  headache, nausea, vomiting, dizziness,  and
extreme weakness.   In a short time, sometimes within a
few  hours, the muscles  of  the neck become rigid, with
great pain upon  moving  the  head,  the  rigidity or spas-
modic action soon extending to the back, when the  patient
is curved in the back somewhat like a bow, and, like cases
from strychnine poisoning, disposed to rest upon the  but-
tocks and top of the head.   There are liable  to be severe
cramps  in all the  muscles of the body, especially the legs,
and  spasmodic twitching of the lips and eyelids.   Con-
vulsions frequently occur.   Patients cannot bear the light;
deafness, with loss of smell and taste, are  liable to follow.
The eruption generally  develops  between the  first  and
fifth day.  The disease reaches its meridian in point of
severity within  eight days, gradually passes into a comatose
state that is fatal, or improved symptoms  show themselves,
to be followed by a slow and tedious recovery.
  Termination. — Not  very  favorable, as  more than  half
the cases die in a severe epidemic.
  Treatment. — The medical profession has always seemed
to be at sea in the treatment of this disease and has never
settled on  any well-defined  plan.   The  disease germ of
spotted  fever is similar to that of pneumonia,  and like the
pneumonic germ, develops  a  violent  inflammatory fever,
the  pulse  being,  in the  early stages, like  the  pulse of
pneumonia.  The experience of the author has shown  that
most cases of pneumonia, if treated  early in the  disease
with veratrum veride, can be broken up within twenty-four
hours;  that the  fever, having been  brought down,  and
with it  the pulse  to  the  normal   standard,  does  not
reappear,  and  the  patient is  actually restored to  health. 
io8
CEREBRO-SPINAL MENINGITIS.
Therefore, as  cerebro-spinal  meningitis  develops  sud-
denly like pneumonia,  it has,  like the  latter,  a proper
period in which to give the same sedative, veratrum, which
may be  given in doses of the tincture as follows: From
one-half to one drop every hour for five or  six hours, com-
mencing immediately after the initial  chill.   If,  by this
means, great sickness of the stomach with efforts to vomit
occurs,  the fever will  very  probably  fall and the pulse
also.  The skin will become  cold and clammy, drops of
perspiration will stand upon  the  face  and forehead, and
the patient will seemingly be  in a state of fatal collapse.
In such  cases a half tablespoonful  of  whiskey in a little
sweetened water will  hasten  the reaction  which  always
follows  the use of  veratrum  in  this  way,  whether the
stimulant is given  or not.  Sometimes an attack  of this
disease  is  broken up  by the  timely  employment of the
sedative.  In the great majority of cases, however, it does
not  succeed  in aborting the affection,  but it certainly
breaks the force of the inflammatory  action and  lessens
the organic changes that would otherwise follow.   To put
it  in plainer  language,  it  is calculated  to  modify the
disease  and  cause it  to  run  a more favorable  course.
After a reaction from  the  first effects of  the drug, the
veratrum  should be resumed  and given for a few hours,
every hour as before,  and  then every  two  hours.  By
keeping the patient under the influence of  this  sedative
more or less  for  forty-eight  hours,  which  is  really the
formative  stage  of  the  disease,  great  good  can  be
accomplished.
  It is believed that a great many cases that would other-
wise result fatally can be saved in this way, that it  renders
the distressing effects of the blistering  treatment unneces- 
SIMPLE CONTINUED  FEVER.
109
sary, and prevents, to a considerable extent, deafness and
permanent  mental derangement.   In such  a malignant
disease, however, it is not claimed that any treatment will
save all  the cases, but the  sedative treatment as above
given  affords the greatest  hope.  The time  may come,
later in the disease, as it does where the  sedative is never
used, for a supporting treatment, such as tonics and stimu-
lants.  They are to be given as in weakened conditions
from other diseases.


          SIMPLE CONTINUED FEVER.
   Other  names: irritative fever;  ephemeral  fever;
synocha; f ebricula.
   This is a fever lasting from  twenty-four to forty-eight
hours,  without any decided remissions, not  the result of a
specific  poison,  seldom fatal;  but when death occurs it
shows  no anatomical changes characteristic of the disease.
   Causes. — Anxiety, grief, overwork, mental  or physical,
mental perturbation, from whatever cause, but the most
probable of all,  excesses in eating and drinking, resulting
in a distressing attack  of  indigestion.  It belongs mainly
to childhood.
   Symptoms. — The  attack is  sudden,  often  coming  on
with a  chill, followed by a strong  reaction  and rapid rise
of  temperature,  high  pulse, dry  skin,  great  thirst, foul
tongue, bowels  costive,  urine  scanty and high  colored,
usually headache and  sometimes  nausea  and vomiting.
The temperature is liable  to  rise to a hundred and three
or more,  and to be attended with delirium.
  Termination. — Almost  always  favorable,   the  disease
running its course, as a general thing, in  from  twenty-four 
no
HAY FEVER.
to forty-eight hours, but in some cases lasting six or seven
days.
  Treatment. — If the symptoms of indigestion are promi-
nent, and especially if there is diarrhoea or colicky pains in
the  bowels,  give a five-grain powder of  the first decimal
trituration of mercurius dulcis, every  hour, until five  are
given.   Place the powder  upon the tongue in a dry  state,
and wash it down with  a  tablespoonful of water.  The
powders will work off in eight or ten hours, and the gas-
tric and intestinal disturbance will usually cease.
  Where there are severe  nervous symptoms, with inability
to sleep, the following can be  given with  the  happiest
results: —
         Fluid extract valerian, two drachms,
         Bromide potassium, two drachms,
         Water, three ounces.
  Mix and  give from  a half to a  teaspoonful,  according
to the age of the child, at  bedtime.


                    HAY  FEVER.

  Other  names: hay  asthma;  autumnal  catarrh; rose
fever.
  This is a  specific  inflammation  of a catarrhal character
affecting the  large air passages,  including those of  the
nose, throat, and tubes of the lungs, with spasmodic con-
traction of the muscular walls of the latter.   The affection
occurs in the  latter part of summer or early autumn, and
is attended with a flow of mucus from the nostrils, cough,
and more or less difficulty of breathing.
  Causes. — The most common cause is  an inherited pre-
disposition   to be  morbidly sensitive  to  the perfume of 
HAY FEVER.
Ill
flowers or whatever it is that causes the affection.  Persons
in whom this tendency exists have paroxysms of hay fever
that are supposed to be due to the inhalation of the pollen
dust of various grasses, roses, or other flowers.
   Symptoms. — The first appearance of the trouble is fre-
quently a flow of a  watery mucus from the nose, the smart-
ing of the eyes, sneezing, and  sore throat.  A little  later
the larynx and tubes of the lungs are affected, the voice
becomes husky, and there  is a wheezing cough with  diffi-
culty  of  breathing,  the  latter occurring  in paroxysms like
attacks of asthma.   The affection is a series of paroxysms
and remissions for a month or more, during  which there is
almost constantly an irritating bronchitis.  After it is  once
developed it is liable to  continue till cold weather destroys
the pollen dust.  It  is impossible to  tell what plant  or
flower exercises the most influence in exciting the disease,
and it may be the combined effect of many flowers.
   Termination. —The affection in itself never proves fatal,
but may develop incurable  asthma and chronic bronchitis.
   Treatment. — The most satisfactory treatment is a change
of climate each season before the hay fever sets in, and
going to  a high mountain climate where the fever-producing
plants do not exist.   Almost  any part of the Rocky  Moun-
tains  seems  to afford  a  complete immunity from hay
asthma.
   It is claimed that  Dover's powder, given  in six-grain
doses three or four times in  twenty-four hours, has often
broken up an  attack of hay fever.   It  is claimed  that
quinine  in five-grain  doses, given three times a day for
several days and commenced two or three days before the
expected attack, will prevent it.  The  paroxysms are al-
ways  relieved by the application of a four per cent solution 
112
RELAPSING  FEVER.
of cocaine to the  nostrils by means of an  atomizer.  The
application may be repeated every three  or  four  hours
during the day.  If the effects of the  drug wear  off to
some extent, the strength may  be increased to a six per
cent solution.

               RELAPSING  FEVER.
  Other names : febris recurrens ; famine fever ; bilious
typhoid.
  This is  an acute, infectious disease, is  contagious, epi-
demic, and self-limited.   The fever paroxysm  lasts about
six days, and then there is a complete intermission to be
followed by a relapse, the second paroxysm being about
the same as the first, both in duration and  gravity.
  Cause. — A specific poison.   It seems to flourish most
extensively in the crowded, filthy, and unhealthy districts of
cities.
  Symptoms. — It has no premonitory or warning  symp-
toms.   The attack is  sudden, the  fever running up from
one hundred and two  to one hundred  and four, pulse fre-
quent and  rather weak,  headache, nausea, and vomiting,
with sharp pains in the limbs and muscles, especially the
legs.  On the second  day there  is a feeling of  fulness and
pressure  in the  right and  left sides,  caused  by swollen
liver and  spleen.  The  deranged function of  the liver
manifests  itself by the appearance of jaundice.  The first
paroxysm  ends on the  seventh  day in  profuse  perspira-
tion ; the second ends about the  thirteenth or fourteenth
day, the symptoms being somewhat milder.   There may
be several relapses.
  Termination. — Generally favorable.
  Treatment. — The disease  cannot be  aborted by any 
TYPHUS FEVER.
H3
known treatment.  Quinine has been used extensively to
prevent relapses, but never succeeds.  For the nausea and
vomiting, and also to arouse the secretions, five-grain doses
of mercurius dulcis, in the first decimal trituration, may be
given every hour until four are taken.   They are to be put
in the mouth dry, and washed down with a tablespoonful
of water.    They will produce a slight action  upon the
bowels, and almost always allay the sickness.  If there  is
great weakness during the last days of the affection  and
after the fever has subsided, quinine may be given in one-
grain doses, and  with  each dose a tablespoonful of port
wine.

                 TYPHUS FEVER.
   This fever is known by a half-dozen different names,
as follows :  ship fever; contagious fever;  jail fever ;  pe-
techial fever; exanthematic typhus; spotted fever.
   It is an acute, epidemic  disease, very contagious, devel-
ops suddenly, characterized by extreme depression of the
vital powers, disagreeable odor, an eruption of rose-colored
spots, sometimes being but few in number, while in other
cases they cover the entire body so thickly that they al-
most touch each other.  The favorable  cases terminate in
about fourteen  days in profuse sweating.  The disease is
due to a germ regarding the nature of which but little  is
known, and yet it is unfavorably influenced by bad sanitary
conditions.
   It is  rarely  seen in  the United  States, except among
recently arrived emigrants, and soldiers in the army.  The
author,  who was an army surgeon, saw a great many cases
in the General Field Hospital, Atlanta, Georgia.
  Symptoms. — Commences with a chill, followed  by in- 
ii4
YELLOW FEVER.
tense fever, the temperature frequently reaching a hun-
dred and five F. within a few days, pulse rapid and bound-
ing, soon becoming small and weak ;  severe  headache and
usually delirium.   From the fifth to the seventh day, red
spots appear on the skin that do not disappear on pressure;
there is great prostration, dizziness, trembling of the hands,
also  tremor of  the muscles, and generally constipation of
the bowels.   Within  about two  weeks the temperature
subsides suddenly, followed by a speedy recovery.
  Termination. — In many cases unfavorable, except when
the disease occurs in  youth under  somewhat  favorable
sanitary conditions.  The best authorities agree that the
mortality ranges from five to thirty-five per cent.
  Treatment. — As the disease  is emphatically contagious,
each patient should be isolated  to prevent contagion.
  The high fever is best controlled by cold  sponging, the
cold wet pack, or by putting the patient  in the bath-tub.
When placed in the tub a gentle shower of water upon the
patient, the temperature being that  of  summer heat, will
give the  happiest results.   The  bath may be  continued
for ten or  fifteen  minutes at a time, if  the  patient is not
too weak.   For the great debility, brandy or whiskey may
be given  every half hour in doses of  one or  two teaspoon-
fuls.

                 YELLOW  FEVER.
  Other names: bilious malignant fever; Mediterranean
fever; yellow jack; sailor's fever; black vomit.
  This is an acute disease, characterized by paroxysms, and
having three stages, the fever, the remission, and the col-
lapse.  It is an infectious disease, attended with violent
fever, yellowness of  the  skin, and black  vomit.  The af- 
YELLOW FEVER.
115
fection is not  contagious, but  prevails as other  disorders,
the infection through which it is propagated being due to
a vitiated atmosphere.   It is said that one  attack of this
disease affords an immunity from a second.
  Symptoms.—The first stage, which is the fever,  may
have a premonitory or warning stage in  which there is a
dull, stupid condition and  more or less headache, or it
may commence abruptly with a chill, followed in two or
three hours by a fever ranging from a hundred and two to a
hundred and six F.   The pulse may rise to one hundred
beats per minute, the eyes becoming glossy, the countenance
flushed, tongue coated, and  the stomach irritable.  There
are often severe  neuralgic  pains over most of  the  body,
especially in the large joints and  region of the  stomach.
In the severest cases there  is  delirium.   As in all fevers,
the urine is scanty and high colored.  The duration of the
first stage is from thirty-six hours to three or four days.
  The second stage is that of  the remission, in which  the
temperature falls almost to the normal point, and there is a
relief of all the distressing symptoms, convalescence  being
established; or, in more unfavorable cases, the third stage,
that of collapse,  or the period of  secondary fever, com-
mences within three days, and is marked by all the symp-
toms of the first  stage  in an aggravated form;  the skin
becomes yellow and finally changes to a dark brown, cof-
fee-ground vomit,  pulse  feeble,  surface cold,  breathing
irregular, death occurring from exhaustion.
  Termination. — The mortality is about  one in four.
  Treatment. — The disease is self-limited. Patients should
be made as comfortable as possible in a good bed, the sick-
room being provided with an abundance  of  fresh air; and
to guard against the irritable stomach that usually follows, 
n6
YELLOW FEVER.
the bowels should be moved  gently  with small doses of
mercury, and what is the best form  and most  efficient in
allaying  gastric and intestinal irritation, calomel, tritu-
rated in  sugar of  milk, one grain of the calomel to nine
grains of the sugar of  milk.   The  trituration  should be
very thorough, or,  in plainer terms, they should be ground
together  for  about  fifteen  minutes in a mortar.  Of  this
trituration give a five-grain powder  every hour until  five
are given.   Each  powder  must be  placed in  the mouth
dry, and  washed down by a tablespoonful of water.  Calo-
mel thus subdivided by being mixed with the sugar of
milk  acts as a physic by  arousing  the secretions of the
whole intestinal tract, while its secondary effect is healing,
soothing, and quieting.   In dealing with a disease  that is
always attended with an  irritable stomach, it is  best to
anticipate it and use such treatment as is necessary to  pre-
vent its occurrence.  In  all such cases, in addition to the
mercurial treatment to prevent vomiting, the use of water
should be limited in quantity  to a teaspoonful  every  half
hour.
  The practice of giving patients small  quantities  of ice
to slowly dissolve in the mouth, and  in that way allay the
thirst,  is "dead wrong," for  two reasons:  In the  first
place, after  it is once fairly commenced it must  be  con-
tinued through the fever, to avoid the terrible reaction and
thirst that would follow  if it were left off.  In  the  second
place, the ice, by  constantly  melting in the mouth, soon
gets entirely  too  much water in the  stomach, which is
liable to  excite both vomiting and purging.  Should mer-
cury given in this way fail to arrest the vomiting, morphine
may be given in one-fourth-grain doses, or, in the severest
cases, three-eighths of a grain may be given.   In order to 
PERNICIOUS FEVER.
117
succeed with this,  a  great  deal  depends on  the  way in
which it is given.  If  swallowed during a  fit of vomiting,
or when there is water in the stomach, it will probably be
rejected.
  Immediately  after a spell  of vomiting,  the  stomach is
supposed to be  entirely empty, and this is the proper time
in which to give the morphine pill.  If it is placed on the
tongue, well back,  and a teaspoonful of  water given to
wash it down, it will be difficult for the patient to throw it
up, and in  twenty minutes  it will be absorbed  by the
stomach and the sickness will be over.  The great objec-
tion to morphine as compared with mercury in these cases
is that in ten or fifteen hours, if not  sooner, the sickness
comes  on again and is  often attended with  nausea and
vomiting,  solely due  to  the effects  of the drug,  and is
known to doctors  as  "morphine sickness," and there is
nothing that will  allay it.  The only remedy is to wait
until the effects of the drug die out, which is sometimes
forty-eight hours.


               PERNICIOUS  FEVER.

   Other  names:  congestive fever;  malignant remittent
fever;  malignant intermittent fever.
   This is an exceedingly malignant  malarial fever, and
may be either of the remittent or intermittent  form.  It is
attended with great congestion  of one or more  internal
organs, with violent nervous action,  followed by nervous
debility.
  Cause. — An excessive amount of malarial poison.
  Symptoms. — The disease  may commence in any of its
forms,  either as a remittent or an intermittent  fever.  The 
u8
PERNICIOUS FEVER.
first  paroxysm  usually  appears as an  ordinary malarial
attack.
  The gastro-enteric variety of the disease is the one  in
which the stomach and bowels are greatly affected, and  is,
consequently, attended with intense nausea, vomiting, and
purging, the discharges  being thin and  mixed w;th blood.
There is a painful desire to go to stool, burning heat in the
stomach, great  thirst, pulse frequent and  weak, feet and
hands cold and  shrunken, and great vital depression.  This
condition may continue for several hours, followed by either
an intermission or a remission.
  The thoracic form may have most  of the above symp-
toms, and,  in addition, there is  great  congestion of the
lungs, in which suffocation is threatened, the patient  gasp-
ing for breath,  and breathing fifty times  per minute,  or
more.   There is a  desperate  effort to cough, and the ex-
pectoration  is often streaked with blood.   The pulse is
weak and rapid, and surface cold.  The chill may last for
several  hours.
  The  cerebral or brain form  is  caused by great conges-
tion  of  the  brain, sometimes by accumulation of water in
the cavities, or by rupture of small  blood-vessels of  the
brain.   This form is attended by terrible delirium  with
stupor  and coma,  the pulse  full and  slow, the surface
flushed. As the hemorrhage  of  the brain is  truly apo-
plexy, there is a great  tendency to fatal coma.   Duration
of chill, from one to four hours.
  The hemorrhagic variety begins as a  common remittent
or intermittent fever, and is soon  succeeded by  symptoms
of internal congestion.   Nausea,  vomiting, threatened suf-
focation, intense pain over liver and  kidneys, continue  for
two  or  three hours, when  the  skin suddenly turns yellow 
PERNICIOUS FEVER.
119
and the urine bloody.   The bloody urine has given rise to
the name "hemorrhagic form."   After the yellow skin and
bloody urine appear there is a remission or intermission, to
be followed sooner or later by another and severer paroxysm.
  The algid form is so named because  the word " algid "
signifies cold.   It is characterized by extreme  coldness of
the surface, while the internal temperature of  the  body
may  reach one  hundred  and  seven  F.   The attack,
which begins with a  chill, is soon followed  by a fever of
uncertain duration, and when it subsides, the temperature
of  the body  falls  to ninety,  and  sometimes  even to
eighty-five F.;  there is a  cold   sweat, the  tongue is
white, the breath is icy  cold, voice weak, pulse slow and
feeble, sometimes imperceptible, and notwithstanding all
these  symptoms of extreme cold  the  patient complains
of a  burning thirst.  The mind is clear,  but  the counte-
nance is ghastly.
   Termination. — In all its forms it is unfavorable, unless
it is controlled prior to the second paroxysm.   Those cases
in which a complete intermission occurs are more favorable
than  where there is  only a remission.   Under the best
treatment and best management it is calculated that from
twelve to fifteen cases in a hundred end fatally.
   Treatment. — In all the forms of this  disease the first
and most  important  thing to be  done is to establish a
reaction as soon as possible.  Stimulants are to be used
internally and heat applied to the  surface with a view of
modifying or shortening the cold stage.   In the hot stage,
cold water is to be applied freely to the surface by means
of a sponge, and using a fan to hasten the evaporation and
cause the absorption of the heat.
  The terribly  distressing symptoms of the hot stage  are 
120
PERNICIOUS  FEVER.
best controlled by a  full dose of morphine,  and of this,
most patients will bear three-eighths, if not a half grain at a
single dose.  As soon as an intermission or  remission of
the fever occurs, sulphate of quinine should be  given, and
as the time may be limited in which it is possible to give
it, at least twenty grains should be given at a single dose,
to be followed in two  hours by another dose of  equal size.
There is a difference  of opinion among  authors regarding
the proper time in which  to commence the quinine treat-
ment.   Some  wait for an intermission or   a  remission,
while others favor giving it  as soon as the reaction is
established.  The latter plan is doubtless the  safer course,
as it is not known how  soon  the  second chill, which is
usually fatal, may occur.
   Like  all other terrible diseases, a multiplicity of remedies
are suggested for congestive  fever, and formulas contain-
ing a dozen, and  sometimes even  twenty different  drugs,
are found  in  the text-books.   The curative  value  of  all
such prescriptions depends  almost  absolutely upon one
drug, and that is quinine.  Such large  combinations are
liable to offend the already irritable stomach,  and  for that
reason it is decidedly  better to limit every prescription to
such remedies as have beyond  question  the greatest cura-
tive action.
   When a many-drug  prescription is made to stop vomiting,
it  almost always contains mercury in some  form, as that
drug is known to cover a wider range of such affections
than any other drug.   In such cases the curative action of
the only valuable remedy in the  prescription  is  often
ruined  by  irritating  and  useless drugs,  and  the  stomach
rejects them all.
   Therefore, in the gastro-enteric variety of  this disease, 
SCARLET FEVER.
121
it is better to  allay the vomiting with small doses of calo-
mel as follows: —
  The first decimal trituration of mercurius dulcis, twenty
grains.   Divide into five powders, and give one every hour
until the  sickness is relieved.   Give each powder dry, and
as soon as it is in the mouth, give a tablespoonful of water.
  If the mercury fails to allay the vomiting, a one-fourth-
grain morphine pill may be given, using the smallest amount
of water necessary for swallowing.   If vomiting is the only
distressing symptom, a quarter-grain pill may be sufficient;
but there is usually a great deal of pain and irritation in the
bowels, and the dose  may have to  be repeated in a half
hour.  Therefore it is better  in most cases to give three-
eighths of a grain to commence with.


                  SCARLET  FEVER.

  Other names : scarlatina;  scarlatto.
  This is an  acute, contagious, infectious disease, essen-
tially belonging to childhood, attended with high tempera-
ture,  rapid pulse, and  a scarlet  eruption  covering the
entire  body.  There  is  inflammation  of the mouth and
throat, and also of the glands of the throat and jaw.  It
has  what  is called a  desquamation stage following the
fever, and during which  the  entire  cuticle separates  from
the underlying skin.   In other words it peels  off.   One
attack  affords an immunity from others.
  Cause. — A  specific  poison.  At present the informa-
tion regarding the character of the specific  germ is con-
flicting, but it seems to be a parasite, the nature of which
has not been satisfactorily determined.
  Scarlet fever ranges in point of severity from cases that 
122                SCARLET FEVER.
are so mild as to attract but  little, if any, attention to
those of the severest and most fatal type.
  The development is usually sudden, and  commences
with a marked chill and vomiting.  There  is pain in the
throat followed by a high fever, the pulse being very rapid.
Within twenty-four hours the eruption appears, which is
a bright  scarlet,  giving  rise to the name of the disease,
"scarlet  fever."  The rash, which  appears first on the
neck  and chest, spreads over  the entire body in a  short
time.   At  this time  there  is burning  heat of the skin,
pain in the throat, and difficulty in swallowing.   On exami-
nation the  throat is  found red and inflamed.   The  head-
ache  and restlessness are  great, and  there is frequently
delirium.   Diarrhoea is a frequent complication.
  Within four or five days  the fever  declines and with it
the eruption fades,  when the  cuticle  begins  to  separate
from the skin.  This process may cover a period of two or
three weeks.   The patients are thin and pale, and recovery
very slow.
  Termination. — Always more or less unfavorable, as the
disease  is  a grave  affection, the mortality  ranging from
fifteen to twenty-five children in a hundred.
  Treatment. — The medical profession knows no remedy
that will abort the disease;  in  other words it is impossible
to break it up until it  runs  its  course.   The treatment
consists,  mainly, in treating  the symptoms as they occur.
  As it is highly  contagious, each  patient should be sepa-
rated from other members  of  the family, with room well
ventilated  and disinfected.  The fever and inflammatory
condition of the skin are best controlled by cooling drinks
and frequent sponging with water at a temperature of about
eighty F.  The wet  pack is often used as a substitute for 
SCARLET FEVER.
123
the sponging, and a great deal is claimed for it in keeping
down the fever and carrying the patient along to a favor-
able termination.   Water, if not actually a sovereign balm
in scarlet  fever, is  certainly one  of  the best remedies.
During the high fever great benefit may be obtained from
the use of aconite, as follows: Tincture aconite, ten drops,
water, forty teaspoonfuls.   For children  from two to six
years old, give a teaspoonful every hour.  In cases attended
with great  fever, throbbing of the arteries of the neck, and
wild delirium, very small doses of  the tincture of  bella-
donna may be given with benefit.   A convenient way to
give the drug is as follows :  Put four drops of the tincture
in a glass  of  water,  and give  a teaspoonful every hour.
Aconite, as above recommended, may be given at the same
time, so as to bring  one dose of the latter between  the
doses of the belladonna.  As soon as the eruption appears,
rub the patient's entire body, except the  scalp, with vase-
line, night and morning.  The most happy effect of the
ointment is quieting the irritation of the  skin, and in pro-
portion as  this is effected, the inflammatory action and the
fever  are  reduced.   Later  in  the  disease, usually  during
the  " peeling-off" process,  there may be  a  great deal of
itching.  If the  simple ointment does not allay this itch-
ing, it is best to add ten drops  of pure carbolic acid to two
ounces of the vaseline, and thoroughly mix.  In some cases
the  venice turpentine acts  better  than the  carbolic  acid.
When  it  is  used,  one drachm may be  mixed with  two
ounces of  the vaseline.  It is  hard to  tell when a patient
is out of danger with scarlet fever, as  it is  attended with
many complications, some of them commencing after the
patient seems to be almost  well.  One of the  serious
phases of  the affection is the inflammatory and enlarged 
124
SCARLET FEVER.
condition of the glands about the throat.  This, conjoined
with the accumulations of mucus in the mouth and  air
passages,  greatly embarrasses  respiration, causing blood
poison,  and in  that way hastening  a fatal ending of  the
case.  The swelling of the  glands, as a general thing, is
best reduced  by the use  of hot cloths, changed every two
minutes, and  applied for about fifteen minutes at a time,
and  repeated every two hours.   The  cloths  are to be
dipped in  water as hot as the patient can bear.   Instead
of this, hot  flaxseed  poultices, changed every  half hour
and continued eight or ten  hours at a  time, may rapidly
reduce  the  swelling.   Sometimes these enlarged glands
cannot be reduced to any great extent  by any treatment,
but obstinately continue through the entire acute stage, and
suppurate.   In other words, they "break," or have to be
lanced.    These  abscesses  developing  in the  advanced
stage of the disease, may lead to  a fatal termination from
exhaustion and blood poisoning.   In such cases the follow-
ing tonic may be of great benefit: —
    Fluid extract of cherry-tree bark,
    Fluid extract of peruvian bark, of each a half ounce,
    Sulphate of iron, thirty  grains,
    Port wine,  fourteen ounces,
    Simple syrup, one ounce.
  Mix, and give a half tablespoonful three times per day.
  The irritation of the bowels attended with diarrhoea, with
or without sickness of the stomach, is best controlled by
the first decimal trituration of mercurius  dulcis in five-grain
powders, one powder being given every  hour until five are
given.   These powders are always to be put in the mouth
in a dry state, and washed down with a  little water.  This
is the best treatment for the irritation of the stomach and 
MEASLES.
125
bowels, at whatever time it may occur during the course
of the disease.
  There  is always a tendency to disease  of  the  kidneys
in scarlet fever.  This is probably due to an extra amount
of work they have  to perform in order to  compensate for
the suppressed action of the skin.   In this way they may
become "tired,"  as it were, and need stimulating.
  For this purpose give the following as directed: —
       Sweet spirits of nitre, one ounce,
       Acetate of potash, two drachms,
       Simple syrup, water, each an ounce and a half.
   Mix, and give a teaspoonful every three  hours.
                     MEASLES.

  Another name: rubeola.
  This is  an acute disease,  communicated by contagion.
It commences with the symptoms of a very severe "cold."
There is usually a cough  and a flow of mucus from the
nose, considerable fever, loss  of appetite, and a miserably
bad taste in the mouth, so that food of every kind is dis-
agreeable.
  Cause.—A  specific poison, or a poison  that is  sure  to
produce in all cases the same  kind of disease.   The attack
almost always protects a person from another.
  Symptoms. — The disease comes on gradually, and from
the time of the first premonitory symptoms until the rash
appears on  the body, is  sometimes  four days.  Where
persons are exposed to cold, or get wet during the warning
symptoms of the  affection, the eruption is  liable  to  be
delayed, which greatly aggravates  the distress.  During 
126
MEASLES.
this prodrome there may be a decided chill, but  as a gen-
eral thing it is only a chilly feeling, followed by fever, the
temperature sometimes rising to one hundred and two, or
more.   There is soreness over most of - the  body, with
headache  and all the  symptoms of acute catarrh.  The
eyes are deeply reddened and watery.  On the second day
the fever subsides to a great extent, but the catarrh con-
tinues.  Usually on the fourth  day a deeply red eruption
occurs on  the  face and chest,  soon  spreading  over the
whole body.  The fever always returns with the appear-
ance of the eruption, and as the latter affects the mucous
membrane as well as the skin, the catarrh is aggravated,
the discharge from the  nose changing from the watery
form to a  thick and heavy mucus  that may be a  cream
color.   The catarrh also extends to the mucous membrane
of the air passages.  On the ninth or tenth day, the erup-
tion fades. The cuticle curls up and separates  from the
true  skin,  but  not  to  the extent that it does in scarlet
fever.
  The disease is frequently attended with  pneumonia, and
when it proves fatal in  children, death is mostly due to
pneumonia.
  Termination. — Generally favorable, but sometimes re-
covery  is  slow  and attended for weeks with a distressing
cough.  The disease is one of  the exciting causes  of  con-
sumption, and when this complication occurs it  is almost
always  unfavorable.
  Treatment.—The mild cases  require no medicine what-
ever.  In the winter season, patients should be  protected
from draughts of cold air and in that way avoid  taking
cold.  If  the fever is very high, give the following every
hour:— 
VACCINATION.
127
             Tincture of aconite, ten drops,
             Water, four ounces.
  Mix.  Dose, a teaspoonful to be given every hour until
the fever is properly controlled.
  Should pneumonia occur, it should be treated in the way
laid down for the management of that disease.   The  itch-
ing of the skin that is sometimes very annoying may be con-
trolled by the free application of vaseline, but if the  simple
ointment fails to stop the itching, five drops of carbolic acid,
added to each ounce of vaseline, will stop it almost instantly.
After the fever has all subsided, the eruption faded from
the skin, and the  peeling-off process  is under way, there is
yet great danger  from exposure to cold, and fatal  lung
complications may arise from getting caught out in  a  rain.


                   VACCINATION.

  When the teat of  a cow is scratched  in the proper way
so as to bleed slightly, and matter  and lymph are taken
from  a case of  smallpox and  applied  to  the cow's teat
about  as  vaccine matter is to  a person's  arm, the cow
takes smallpox.    As the animal is  much less susceptible
to  the  poison  than a human  being is, the virulence  or
severity of the disease  is greatly reduced, so that  a  scab
taken from the cow and used in vaccinating children affects
them in a  greatly modified form, manifesting itself  in a
group of symptoms familiar to every person who has seen
a case  of vaccination.  The cow vaccine is very properly
called  the nonhumanized vaccine matter.  When a  person
is vaccinated for  the first time with the cowpox matter,
fresh from the cow, such  person is liable to  encounter  all
the severe symptoms, and enjoy all the protection  obtain- 
128
VACCINATION.
able from any vaccination.   As syphilis and other consti-
tutional diseases cannot be communicated  to man through
a cow, it is evident that the horrible dread of contracting
the  bad disorder from cowpox is  not warranted.   It is
true that a  great  many complications  arise from  the  use
of the cowpox matter, and sometimes  there are extensive
sloughings of  the  arm, attended with unsightly scars.   In
all  such cases  the patients are themselves  scrofulous, or
tainted  with some constitutional  disease that  is  simply
excited  by  the vaccination.   These  cases, even  though
they rarely occur,  have given rise to a foolish and  absurd
opposition to vaccination.
  After a person  is once effectively vaccinated, whether in
childhood or not, it is a matter of  some doubt whether it is
ever necessary to repeat it, but in order to be  on the safe
side it is thought  better where persons are vaccinated in
childhood to have  them vaccinated again after maturity.
The author was vaccinated in boyhood, and when he was
twenty-four  had the varioloid.  The fever was considera-
ble, the headache and backache were terrible, the eruption
very slight, and the whole  trouble subsided in forty-eight
hours.  The best  way to perform the  operation in  vacci-
nating is  as follows: First, take the scab and put it  on
the bottom of  a plate and  add a  drop of  water to it, then
break it up with a table knife so as  to get it into a watery
paste.   Next, take a common lance, dip it quickly in boil-
ing water, wipe it  dry,  and make  four or five  light cuts
through  the skin  of the arm, about the  sixteenth  of  an
inch apart.  These cuts should be deep enough to cause
a very little bleeding, then  cross  them  at  right  angles
by  an equal  number of cuts made  in  the same way.
After this is done, scrape off the blood, and rub the check- 
SMALLPOX.
I29
ered surface over thoroughly with the pasty matter, using
the lance for this purpose.
   In this operation a great deal depends on  the  extent of
the surface to which the matter is applied.   If it is large,
more matter will naturally be absorbed, a larger  surface
affected,  and a larger  and deeper scab, with more fever
and greater protection, will be the result.  If done as
above  directed with  fresh cowpox matter, the protection
in the large majority  of cases will be perfect.
   Symptoms. — In successful cases of vaccination a papule
or pimple appears about the third day.  By the  sixth day
it is matured into a vesicle containing a pasty lymph, and
becomes depressed at the centre.  On the eighth or ninth
day it becomes a fully formed  pustule, the surface  sur-
rounding it for an  inch or more in every direction being
deeply red and inflamed.  The color begins to fade by the
tenth day, the  pustule dries, and in four or five days more
is a dark brown scab.   In from twenty to twenty-five  days
it drops  off.   The color of the  scar fades from red to the
natural  color of the  skin, finally becoming  white,  with a
number  of those indentations  characteristic of  smallpox.


                     SMALLPOX.

   Another name:  variola.
   This is an acute disease, and intensely contagious.  It
commences with the  severest  aching pains imaginable, in
the lower part of the back.   There is no possible position
in which the patient  can sit, stand, or lie, that affords any
relief.  The fever that  marks the beginning of the attack
lasts from three to  four days.   As this fever and  terrible
distress  in the back  begin to subside, the eruption char-
         K 
130
SMALLPOX.
acteristic of the disease gradually  makes  its appearance,
and has  three distinct  stages.   First, papular or pimple-
like.   Second,  vesicular,  in  which they contain  fluid.
Third, pustular, in which  they are full of white  matter.
From first to last they are called " pustules."  During their
development another fever comes  on which is called the
" secondary fever."
  Cause. — A specific  poison, the nature of which is un-
known, that retains its  specific contagious  energy for
months.  The poison  is the  most  contagious known in
medicine.   An  infected  sheet  of  writing-paper  would
breed a case of smallpox after going round the world.  Its
period of contagion lasts from the earliest appearance of
the fever  until it has  passed  through  all of  its stages,
until the scabs have all fallen from the skin and the latter
is entirely  sound and  free from  irritation.   The  stage of
suppuration is  the  one in which contagion  is greatest.
One attack usually protects a person from another.  Vac-
cination  in the great  majority of  cases affords  absolute
protection, the  cases being few, where it is properly per-
formed, that will  have it at all.   The period of incubation
is from fourteen to sixteen days.
  Symptoms. — It  commences with  a  terrible chill, sick-
ness of the stomach, and intense aching pains  in the back,
especially in the lower part.   The fever rises rapidly; the
pulse is full, bounding, and frequent, like the inflammatory
pulse.  The face  is red,  eyes red  and suffused,  severe
headache, extreme restlessness, and great debility.   Active
delirium is a frequent symptom in this stage of the dis-
ease.   The characteristic eruption  appears on the third or
fourth day, commencing first on the face.
  The eruption consists of plump, red spots about the size 
SMALLPOX.
131
of bird shot, rising about half  the diameter of such shot,
above the level of the skin; they feel hard under the finger
until they pass into their second stage.  All the prominent
and distressing symptoms either subside or become greatly
modified on the appearance  of the eruption,  and the pa-
tient is somewhat comfortable.  About  the fifth day the
spots are papular, or pimple-like.   By the sixth  day they
are vesicular and filled  with fluid  and  soon  become de-
pressed in the centre, as  is the case with  a vaccine pustule.
By the eighth  day the vesicles are changed  to  pustules,
that is, they are  filled with  pus instead  of watery lymph.
By the  ninth or tenth day the  pustules are fully matured,
and  the features are terribly swollen and distorted.  By
the eleventh or twelfth day, pus, more or less mixed with
pasty lymph, runs out of the pustule  and dries into a firm
crust, giving a crustaceous character to all scabs.   During
the suppurative stage of the  disease there  is  a terrible
fever, called the " fever of suppuration."   This is the most
distressing and critical  period  of the disease,  the delirium
being of the wild  and violent  type.  The fever begins to
subside in three or four days,  if  the case is inclined to a
favorable termination, and recovery commences.
  The confluent form of smallpox is the one in which the
pustules are so close • together that they run  into  each
other, and the malignancy of the disease is almost  always
in direct  proportion to the  amount of surface that is  in-
volved in the pustules;  therefore  the confluent form  is
exceedingly grave,  and should a patient recover he  is so
horribly disfigured as to  make life undesirable.
  In the most malignant form of the disease, death results
before the  characteristic eruption  makes  its  appearance.
It seems  that this is a much  more desirable termination 
132
SMALLPOX.
than recovery from the confluent form with the features
terribly distorted.
  Termination. — Much depends upon the character of the
epidemic, the variety of the  attack,  and the age  of the
patient.
  The discrete variety, or that form in which the pustules
do not run together, is comparatively mild, the deaths  num-
bering about five in a hundred.   In  the  confluent form at
least one-half  die.   It is claimed  that in cases of smallpox
under  five years old and over fifty, one-half die.  In the
malignant form not one survives.
  Treatment. — As the period of incubation of smallpox is
from fourteen to sixteen days, that is, it takes from fourteen
to sixteen days after exposure until the attack commences,
and the period  of incubation from  vaccination is  only a
little over half that, if the patient is vaccinated immediately
after the exposure, the vaccination will have time to run its
full course before the real smallpox sets in, and for this rea-
son an opportunity is afforded for a great deal of protection.
  Experience has  abundantly proven that smallpox is ma-
terially modified by vaccination performed  in  this  way.
During an  epidemic in the west in which the  author
treated nearly a hundred cases of smallpox in the various
forms, he saw that vaccination performed immediately after
exposure, modified the real disease at least fifty per  cent.
In other words, the cases  in which vaccination was per-
formed were  not more than half as severe as  those not
vaccinated at  all.  If,  however, the vaccination  is not per-
formed until several days after  the exposure, the chances
of its affording much if any protection are very small.  In
the epidemic  above referred to,  the  author was called to
visit a lady, five miles out of town, with an eruption somewhat 
SMALLPOX.
133
suspicious.  At  that time no cases  except varioloid had
shown up in that part of the country, and those had been
mistaken for chicken-pox.  On arriving at the house of the
lady, a party of about thirty young people were present and
arranging for a ball.   Sitting close to a wood fire was the
patient, with a heavy shawl around her, broken out all over
the face,  neck, and  hands,  with smallpox.  The dancing
party were arranging the large dining-room for an all-night
dance.  When it was positively announced that the lady had
smallpox, the crowd of young folks actually fell over each
other trying to get out of the house, and were terribly panic-
stricken and demoralized.   On examination it was found
that about one-half of them had good vaccine marks, and
that something like one-third of them had not been vacci-
nated at all.  The whole crowd went to  town that  night
and the next morning, and were vaccinated.  Those having
a good vaccine mark upon the arm did not take the small-
pox at all, while with the others, the disease, though more
or less  severe,  was greatly  reduced  in  severity by vacci-
nation.   There was  not a solitary case of the confluent
form from this exposure.   None  of  the cases were disfig-
ured to any extent by pitting, due, perhaps, to the careful
use of a mask to be hereafter described.
  During the first stage of the disease, the distress from the
fever  and intense  aching  of  the back  and head,  anti-
pyrine may be given in doses ranging from twelve to fifteen
grains, repeated every two hours until  patient is relieved.
For sleeplessness give the following: —
          Bromide potassium, one-half ounce,
          Fluid extract valerian, one-half ounce,
          Water, three ounces.
  Mix, and give a teaspoonful at bedtime and repeat it in five 
134
SMALLPOX.
or six hours if necessary.   The above is for an adult.   For
children over two years old, the dose  is from  one-eighth
to one-half of that for adults, according to the size and age
of the patient.   The most critical period of the disease is
during the secondary fever and is caused, largely, by blood
poison, and of  course  is pyaemic in character, that is, it is
due to absorption of pus  from the hundreds of pustules
covering the body.  This  stage is attended with extreme
depression, and liable to fatal exhaustion.   It calls loudly
for tonics and  stimulants, especially iron  and brandy.  A
convenient tonic containing iron may also contain the best
alcoholic stimulant, and hence the following: —
     Fluid extract Peruvian bark,
     Fluid extract wild cherry bark, of each an ounce,
     Sulphate of iron, forty-five grains,
     Brandy, one pint.
   Mix, and give a tablespoonful four times in twenty-four
hours.
   During high fevers of any kind, patients have a craving
for liquid food; and it is  fortunate they do, for the dry,
solid  foods, like  meat,  could not be  properly digested.
The appetite in such cases is an important guide in the
selection of diet, and patients usually crave chicken broth,
milk,  soft-boiled eggs,  and  such other articles as are easily
digested.


             TO PREVENT PITTING.
   The following  is the description of a mask that should
be applied to  the face of  every person with smallpox as
soon  as the eruption commences.   Make it of  two thick-
nesses of  heavy, black muslin, and large enough to cover 
SMALLPOX                   135
every part of the face, from the edge of the hair on the
forehead to beneath the chin.  It  must be secured to the
face by elastic bands passing round and over the head, so
as to make it bear as firmly as possible upon every part of
the skin it covers.
   It must have  four openings:  one for each eye, one for
the nostrils, and  one for the mouth.  When ready to apply,
it is to be covered with a paste or salve made as follows:
   Carbonate  of zinc, three ounces,
   Oxide of zinc, one ounce,
   Olive oil,  a sufficient -quantity to make  a  salve  soft
enough to spread nicely.
   After the salve is spread over every part of the mask, it
is then to be firmly secured  to  the  face.  It  must  be
obvious to every one that the mask cannot touch the sides
of the  nose nor  the parts of  the cheek close to the nose.
In order to overcome this  defect, a considerable amount of
cotton  batting must  be crowded in between the  two sheets
of muslin  on  each side of the nose  so as to force the paste
down upon every part of the  skin.  The mask  should not
be removed until all the scabs are ready to drop off.  Any
scabs that are pulled off before they are ready to drop off
themselves, increase the pitting and deformity of the features.
   The author has  used this form of mask through  two
great epidemics  of  smallpox, in which it was probably
applied to forty patients, knows what it accomplishes when
properly used, and  has this to say: If made, applied,  and
worn as  directed, it will  almost entirely  prevent pitting
except in  the worst forms of the  disease known as con-
fluent smallpox.   In this form  the scabs are  so thick that
they touch each other, and every  one that has it is to be
pitted. 
136
ERYSIPELAS.
  A separate mask should be kept on the neck from first
to last, and the ears must be kept covered with the paste.


                   ERYSIPELAS.

  This disease has a number of  other names, some pretty
large and rarely used.   They are as follows : erysipelatous
dermatitis ; the rose;  Saint Anthony's fire.
  It is an  acute, specific  disease, strongly  infectious,
attended with a fever  of low type and scarlet inflammation
of the skin,  usually  affecting the  head and  face.  The
inflammation is inclined to spread, sometimes rapidly, the
skin becoming swollen and greatly congested.   The glands
of the neck  and  jaw  are  often greatly  enlarged, so as to
endanger life from suffocation.
  Cause.— A specific poison.  Instead of one attack afford-
ing an immunity  from other attacks,  one  attack actually
predisposes to another.
  Symptoms.— The disease usually has an abrupt  com-
mencement, and, like  most fevers, is attended with a chill
followed by a fever that is either high or low, according to
the severity of the chill, but in the  well-marked cases the
temperature reaches a hundred and five, pulse rapid, tongue
heavily coated.  There is often nausea and vomiting, and
sometimes  diarrhoea.  Bleeding  from the nose  is not an
unusual symptom.  There are few diseases more prone to
delirium than erysipelas, especially when it affects the head
and  face.   During the fever that follows the chill, the
eruption appears, usually at the commencement of the
fever, but this is not always the case, and until the eruption
appears it  is impossible to  tell  what the  disease is.   A
doctor may visit a case in the evening and think he is deal- 
ERYSIPELAS.
137
ing with a case of bilious fever, and give a diagnosis to that
effect.  By morning almost any person can name the dis-
ease, because  it has  the characteristic  eruption.   The
author, who had charge of two erysipelatous wards in Camp
Douglas Hospital, Chicago, in 1865, treated several hundred
cases.   In almost all, the inflammation commenced about
the head and face, there was great  and rapid swelling  of
the skin, with burning, tingling pain, the swelling in almost
all the cases being so great as to close the eyes.   During
an attack which would last a week or more, the eyes were
probably  closed, on  the average, for  forty-eight  hours.
There was more or less delirium, of a violent character,  in
most of the cases.   It was controlled by the free use  of
water  and  bags of ice to the scalp.  The ice-bags were
applied for ten minutes at a time and then left off for twice
that period, and so on until the delirium was subdued.  In
the milder form the water was used instead of ice-bags, a
nurse sitting by the patient and fanning his head and face
to hasten the evaporation of the  water and reduce the tem-
perature.   The swelling of the skin, and also the extension
of the inflammation, were combated  with the tincture  of
iodine.  Every part of the inflammation was painted two
or three times in twenty-four hours by the strong tincture,
the painting always reaching a  little beyond the  diseased
skin.   Great care was taken to  prevent getting the drug
in the eyes, and consequently the eyelids were not touched.
The drug treatment consisted further of salts and cream  of
tartar in laxative doses, the aim being to get a good evacua-
tion every day.  With a view of  overcoming  the condition
of the blood that was supposed to give rise to the  disease,
muriated tincture of iron in twenty-drop doses was given
every three hours, so as  to give  a hundred drops or more 
138
ERYSIPELAS.
during the day.  No sedatives, no stimulants, and no tonics,
except the iron, were given.  Every case recovered.
  Termination. — Where  the disease  occurs  in  healthy
subjects it is usually favorable.  It  may cause death from
suffocation by closing the air passage of the larynx.  As
in all other grave affections, intemperate patients are most
liable to succumb.
  Treatment. — In  the  mild  cases  of this  disease,  unat-
tended by glandular enlargement  and swelling  of the
skin,  but  little treatment of any kind is  required.  In
such cases it is not necessary to  paint the  inflamed skin
with iodine, as that drug is  used  mainly to stimulate ab-
sorption and reduce the  swelling.   In the mild forms, or
those in which the  inflamed  skin  rises but little above the
surrounding  healthy skin, a solution of sugar  of  lead ap-
plied to the surface with  a small  sponge will have a very
soothing  and  cooling effect.  Under  its  use the redness
usually fades in a  short time.  The proper strength is a
heaping teaspoonful to  a  pint of water.  Great care must
be taken to avoid getting it into  the eyes.  In the more
severe cases, in which  swelling of  the skin and  enlarge-
ment of the  glands about the throat are great, the strong
tincture of iodine should  be  used upon every part of the
affected skin, except the eyelids.    It is best  to  apply  it
about every twelve  hours.  Should the swelling about the
throat be of a character to threaten suffocation, hot poul-
tices, changed  every ten or fifteen  minutes,  should  be
applied.
  The disease can  be  greatly modified by the use of  a
sedative to the heart's action  if commenced early.   If the
pulse is decidedly  strong  and full, tincture of veratrum
veride in two-drop doses every hour, for five or six hours, 
ERYSIPELAS.
139
will do a great deal of good.   There is often violent delir-
ium during the first twenty-four hours, and as this is caused
by the burning fever and brain congestion, any  remedy
reducing the force and frequency of the pulse must natu-
rally reduce  the fever, the congestion of  the brain, and
in doing  so lessen the delirium.
  After the veratrum has been given for five or six hours
in this way,  it  may  cause sickness  and vomiting.  The
nausea  from veratrum  is distressing, countenance pale,
bedewed with  a cold perspiration, pulse weak and  flut-
tering, the patient having all the symptoms  of  a fatal
collapse.  In such cases  a tablespoonful  of  brandy will
hasten a reaction, after which the  disease runs an exceed-
ingly mild course if  it is  not wholly  aborted.  It is  not
desirable to give the veratrum in such doses as to  get  the
prostrating effects of the drug as above mentioned, but to
watch the effect of it upon the pulse; and when it com-
mences to fall,  stop the remedy  at once.  In two or three
hours it may be commenced again, and sometimes  it  may
be best  to limit the  dose  to  a  drop every  hour.   Should
the pulse not  be  full and bounding, with delirium and
other symptoms less violent,  it is better to use a milder
sedative  than the veratrum.  Therefore, the tincture  of
aconite root may be given in  drop doses for  eight hours,
and  then left  off two or three hours, to be resumed as
before.   The sooner the sedative treatment is begun after
the fever is fairly established, and the nature of the disease
recognized, the greater effect it will  have in limiting the
gravity of the affection.   The same is true when veratrum
is given instead of aconite.  It is truthfully said that there
is a time for  all things, and there is certainly a time and a
proper time, too, in which to  give sedatives in inflamma- 
140
ERYSIPELAS.
tory diseases, and that is as near  the  commencement of
the attack as possible.   The object is to  arrest inflamma-
tory development,  and  if the  inflammation  is  allowed
unlimited sway  for forty-eight  hours,  a  sedative  of  any
kind can do but little,  if any, good.   In all forms  of  ery-
sipelas, what is known as the iron treatment is  the most
efficacious.  The muriated tincture of  iron is the most
popular  form in which  to give it, the dose  being from
twenty to thirty drops every three hours  during the day-
time.   It should be largely diluted  with water, and if the
patient is rational, it is better to  have it sucked through a
straw or glass tube to avoid its effects upon the  teeth.  The
treatment of erysipelas with this remedy has been so won-
derfully favorable as to suggest the idea that its effects are
not due wholly to the  iron.   It  is very probable that the
muriatic  acid  used  in  preparing the  tincture has a favor-
able effect in overcoming the condition  of the  blood to
which  erysipelas is mainly due.  If the intense fever  and
delirium  are not controlled by the sedative treatment, con-
joined  with the laxative  effects of  salts and cream of
tartar,  water may be applied freely to the  head and face;
but the  head must never be covered  by a cloth  of  any
kind.   If the hair is kept  thoroughly wet and the evapora-
tion of the water hastened by the gentle but constant use
of a fan, it  will probably do  more good  in arresting the
fever and delirium than bags  of ice applied to the head.
There  are many unpleasant things connected with the use
of ice  in this way, and one of  them is, that  the scalp  is
liable to be frozen, causing the hair to  fall off and never
return.   In  order to   avoid this  deplorable  result,  it  is
necessary to remove  the bags  of ice  every  five  or ten
minutes,  and keep them off  until  heat returns  to the 
GERMAN  MEASLES.
141
scalp.   As reaction from the  use  of  ice is very intense,
the trouble is liable to be aggravated by leaving it off too
long.  It is therefore apparent that the use  of ice in sub-
duing inflammation affords an opportunity for two serious
mistakes.   For  this  reason  water,  as above  advised, is
much  safer  and  better.  The  most  violent  forms  of
delirium are  sometimes  entirely  subdued  within  ten
minutes by holding  the patient's  head over a  wash-tub
with his face  down, and pouring a dozen dippers of cold
water all over it,  keeping up a slow but  constant stream
for ten or fifteen minutes.


                GERMAN  MEASLES.
   Other names: epidemic roseola;  French  measles; false
measles.
   This  affection is  a self-limited  disease,  attended with
slight fever, congested and watering eyes, sore throat and
cough, while the glands about the neck are enlarged.   The
eruption, which is red and generally exists  in patches of
irregular size,  appears on the first day.
   Cause. — It  is due to infection, the exposure to the  infec-
tion before it breaks out covering a period of from one to
three weeks.  The length of time elapsing  after a person
is  exposed to  a disease until  the attack  commences is
called  the  period of incubation.  It  literally means  the
hatching period.
   Symptoms. — It is  an acute  disease, and  the  attack is
abrupt in its  development, but  the  fever  is mild, eyes
suffused with  tears, enlargement of the glands about  the
neck, attended with an  inflamed condition  of the throat,
and pain on swallowing.   The  eruption generally appears 
142                   VARICELLA.
early in the disease, but  sometimes it is delayed  till the
fourth day.  The spots constituting the eruption are about
the size of  bird shot, rising a little above  the level of the
skin.  Some of  these spots  run together,  forming thick
clusters of  irregular size.  The  eruption appears  on the
upper part of  the body first, and commences fading there
about the time it begins to appear on the lower extremities.
  Termination.—Always  favorable, as the disease runs its
course in a week, leaving no  after effects  of any conse-
quence.
  Treatment. — There is scarcely anything  to be done in
this affection.   If there is severe itching of  the skin, vase-
line ointment, as recommended in scarlet fever and measles,
will allay it.

                    VARICELLA.
  Common name:  chicken-pox.
  This  is a mild, contagious, eruptive fever, the vesicles
drying up and falling off within four or five days.
  Cause. — A specific poison, the disease being limited to
childhood,  because but  few  persons  pass  through  that
period without having it.
  Symptoms. — It commences with a  moderate fever, fol-
lowed by the eruption of  vesicles that dry  up rapidly and
fall off within a week, leaving little dints or pits, very much
like varioloid.
  Termination. — This is always  favorable, as the affection
is so trifling in its nature  as to attract but  little attention
if it were  not for the eruption.  In  some  cases there is
serious  pitting,  and it is very probable that persons dis-
figured in  this way are scrofulous subjects,  and  that the
disease simply arouses an affection that had not previously 
APHTHOUS  STOMATITIS.
M3
manifested itself, just as vaccination does  under similar
conditions.  To avoid the pitting, use zinc ointment to the
pimples, and cover the face, neck, and forehead with a black
cloth, leaving holes for the eyes, mouth, and nostrils.


            APHTHOUS STOMATITIS.
  Other  names:  croupous stomatitis;  follicular stomati-
tis; vesicular stomatitis.
  This is an inflammation  of  the mucous lining of the
mouth, including the covering of the entire tongue.   It is
characterized  by vesicles appearing in small  clusters  in
different parts of the mouth, these clusters multiplying in
number and gradually  spreading  until they  meet  each
other, thus involving the whole of the mouth and tongue.
These vesicles finally rupture, leaving an ulcer correspond-
ing to the size of the vesicle, and slowly heal.
  Causes. — It is a  disease almost exclusively of childhood.
It is due to deranged digestion, delay in teething, neglect
to properly wash the child's mouth after nursing, and some
of the eruptive fevers, especially measles.  One  of the  most
frequent and provoking causes is sour stomach, caused by a
failure of the milk to  digest.
  Symptoms. — It  commences with a  reddened  and in-
flamed condition of the  mucous membrane of  the mouth,
soon to be followed by the appearance of whitish vesicles
on the mucous covering of the lips and point of  the tongue.
As  the disease develops, the vesicles, which  exist in  little
clusters or patches, increase in number until  every part of
the mouth and tongue is covered with  them.   The mouth
is so sore  that  the child  cannot nurse.   As  soon  as  it
catches the nipple and tries to nurse, it will let go with an 
144
APHTHOUS  STOMATITIS.
angry scream from pain.  There  is  a constant  flow  of
saliva from the  mouth.  In children two or  three  years
old the  mouth is so sore they cannot chew, and are com-
pelled to live on liquid food.
  Termination. — Always favorable.
  Treatment. — As in all other cases  the  cause of  the
disease  must be  found  and  removed.  The  affection is
usually  attended  with sour stomach, which can  be  con-
trolled with bicarbonate of soda, given as  follows: —
           Soda, a heaping teaspoonful,
           Water, a half pint.
           Mix; dose a teaspoonful every hour.
  Where these vesicles run together so as  to form, after
rupturing,  an ulcer of  some  size,  it is best cured with
carbolic acid, full  strength, as  follows: Clean the floor of
the ulcer with a bit of  absorbing cotton, then touch it with
a drop  of  the acid so as to make the ulcer  as white as
milk.   Several  of them  can  be treated at  one  time, and
they heal  in  a  day or two.  It will not do to treat very
many of them at once, as there would be danger of poison-
ing from the drug; but carbolic acid  has no equal in such
cases, first, because it  is painless,  and, second, because it
always  cures.  Nitrate  of silver  is  cruelly painful, and
should never be used  as a  caustic when carbolic acid will
answer.   If  there is  derangement  of  the bowels,  small
doses of calomel may be  given as  directed in  the  treat-
ment of catarrhal stomatitis. 
THRUSH.
145
                      THRUSH.
   Other names : white mouth ;  parasitic stomatitis.
   This is an inflammation of the mucous membrane of the
mouth, attended with the growth of a fungus or parasitic
plant.  There  is usually derangement of  the digestive
organs.
   Causes. — The disease is largely due to carelessness and
uncleanliness, and occurs in debilitated children.  It is sel-
dom seen after two  years of age.
   Symptoms.—Great pain and tenderness, aggravated by
chewing  or nursing.   There is great drooling, the lips are
sore and swollen, and the breath has a fetid odor.   There
is generally diarrhoea attended with  griping pains, the
stools  being green.
   Termination. — This is almost always favorable.
   Treatment. — Thorough  cleanliness of the mouth is of
the utmost importance, and  the nipple must be thoroughly
cleansed  after  nursing, and the mouth carefully rinsed.
In this affection  the  stools  are  green, due to indigestion,
and there is a great deal of griping pain which adds to the
restless condition of  the  child.  In this, as  in all other
affections of the mouth, in infancy and in childhood, when
green stools are found, the following must be given : —
   Mercurius dulcis, the first decimal  trituration, fifteen
grains; divide into  five powders, and give one every hour
until all are  taken.   A  powder must always  be placed in
the mouth, dry, and  then  washed  down with a swallow of
water or  milk.  As the powders work off, the stools change
from green to almost black, then gradually fade into brown,
finally  becoming yellow or natural, when the stomach and
bowel derangement is conquered.   As the mouth trouble
         L 
146
GANGRENOUS STOMATITIS.
is largely due to disorders of digestion, the powders given
in this way favor a rapid recovery.
  The following is  a very desirable wash for the mouth :
             Common borax, three drachms,
             Water, three ounces.
             Mix, and apply with a swab.


           GANGRENOUS  STOMATITIS.
  Other names : water-cancer;  cancrum oris; noma.
  This is a destructive, gangrenous ulceration of the mouth,
in which most of the affected tissues are destroyed.
  Cause. — It is  usually  a  disease  of childhood, seldom
appearing in adults,  and is due to a parasite.
  Symptoms. — The  disease may develop  in  connection
with  ulcerative stomatitis, or  it  may start as  a sloughing
ulcer upon the gum or mucous  membrane  of the mouth,
when all the other mucous tissue is seemingly in a healthy
condition.   There is great swelling of the cheek, the skin
becoming glossy,  the inflammation spreading, usually so
as to  involve entirely one side  of the face.
  The pulse is rapid but weak, fever high, debility great,
and the case is characterized by a terribly disagreeable
odor.  Death usually occurs  in  a week  or ten days.
  Termination. — This is almost  always unfavorable, as it
is one of the most malignant diseases that afflict children.
  Treatment. — There is practically nothing to be done in
these cases, except to make the  patients as comfortable as
possible until death ends the suffering. 
ULCERATIVE STOMATITIS.            147
           ULCERATIVE  STOMATITIS.
  Another name :  diphtheritic stomatitis.
  This is an inflammation of the mucous membrane of the
mouth, diphtheritic in character, attended with extensive
ulcerations.   It generally begins on the edges of the lower
gum,  and soon affects  the lips and whole interior of the
mouth.  It is almost wholly a disease of childhood, and
is closely connected with poverty, indolence, and unclean-
liness.
  Symptoms. — It commences with an inflamed and swol-
len condition of the gums, both chewing and  swallowing
causing great pain,  and the patient is compelled to live on
liquid food.   The  mouth is intensely feverish, and hot
saliva, often mixed  with blood, drips from the mouth; the
glands below the jaw are enlarged and very sore.
  Termination. — This  is quite  favorable so far as life is
concerned, but the destruction of the gums is considerable,
and sometimes part of the teeth are lost.
  Treatment. — The cause of the disease should be found
and removed.   Absolute  cleanliness must be observed
from  first to last.
  Chlorate of potash, given in three-grain doses every two
hours, has  a positive curative  value, its prompt action
often winning for it the reputation of a specific.  In this
affection there is a very low state of vitality  with a dis-
position  of the ulcers  to  spread, and to touch them
with carbolic acid,  which lowers the vitality of the  part
for many  hours, might do a great deal more  harm  than
good  by increasing the disposition to  spread; therefore,
a very stimulating application, such as nitrate of silver, ten
grains to the ounce of  water, may be  necessary.   Should 
148                   GLOSSITIS.
irritation of the stomach and bowels exist in this affection,
it may be treated in the same way as in catarrhal stomatitis,
which please  see.

                     GLOSSITIS.
  This  is an inflammation of the entire structure of the
tongue,  in which swelling is great, mastication and swallow-
ing painful, and speaking difficult or  impossible.  It may
be either acute or chronic.  The acute  form is  generally
caused by an injury,  such  as hot water, an irritating  drug,
or the sting of an insect.
  In the chronic form the  inflammation is generally limited
in extent, may  be caused by constant irritation  from the
teeth, and also from  the use of a tobacco pipe.  Smoking
is by far the most frequent cause of chronic inflammation
of the  tongue, the  inflamed  and reddened part usually
appearing at or near the  point.  When once, established,
it is almost impossible to cure  it until  the smoking is left
off.  While  the nicotin of the tobacco  has much  to do
in causing the  inflammation,  it is not the only source of
the trouble, as the  heat  of the smoke, especially  when
a cigarette is used,  is very irritating.  To  overcome the
trouble from heat, it is often found necessary to use a pipe-
stem two feet long.
  Symptoms.—Acute inflammation of the tongue develops
suddenly, is attended with fever, pain, anxiety, and great
swelling of that  important organ.  There  is always an
unusual flow of saliva, and a burning sensation in the mouth.
Chewing and  swallowing are difficult. The power of speech
is almost lost, and there is threatened suffocation.   There is
usually enlargement of the glands at the angles of the jaw.
  Termination. — This is  not always favorable, as there is 
GLOSSITIS.
149
 more or less danger  of  death from suffocation.   Chronic
 inflammation of the tongue, after it has existed for many
 months, is very difficult  to  cure, and  in the majority of
 cases is not favorably affected by any treatment, except
 when due  to smoking, recovery may occur when the habit
 is abandoned.
   Treatment. — This should  commence as soon as possible
 after the disease is developed and recognized, and the best
 possible remedy to break the force of the  inflammatory
 action and lessen  the dangers that are  liable to arise from
 suffocation, is the  tincture of veratrum veride in three-drop
 doses every hour for six or eight hours.  It should be given
 in a tablespoonful of water.  By the time five or  six doses
 are taken in this way the pulse may fall rapidly, attended
 with extreme nausea and vomiting, the countenance very
 pale and wet with a profusion of cold perspiration.   In
 a  case  with such  marked drug action as the above, the
 pulse is liable to be feeble and fluttering, and this, conjoined
 with the other symptoms, suggests the  idea of a fatal  col-
 lapse.   When reaction occurs, which may be hastened with
 a  tablespoonful of brandy, the pulse  gradually increases
 in volume, heat and color are restored to the features, the
 nausea  and vomiting stopped, and the patient is  better in
 every way, the  inflammatory  action being almost subdued.
 Where this treatment has been followed so as to get such
 decided drug action as this, the case  rarely needs further
 treatment.   The prostrating  effects of the drug, however,
 are frightful to those who have had no experience with
 it, but  the  cases of death  are a hundred times  more  nu-
 merous  from the less violent sedative,  aconite, than from
veratrum, as the latter gives warning of its  own  specific
action through vomiting.   Aconite does not. 
ISO
CATARRHAL  STOMATITIS.
           CATARRHAL STOMATITIS.
  Other names :  simple stomatitis ; catarrh of the mouth.
  This is an  acute  inflammation  affecting the mucous
membrane of the mouth and  tongue  and sometimes  the
throat.  It may be limited to a part of the mouth, but in bad
cases it involves the whole mucous surface.  Infants at the
breast are most liable to the affection.
  Causes. — It most frequently arises from inflammation of
the mouth caused by teething  and disorders of the  stom-
ach.  All the eruptive fevers, such as measles, scarlet fever,
and smallpox, have a tendency to produce the affection.
   Symptoms. — Stomatitis   commences with  the   usual
signs of inflammation, such  as  heat, pain, and redness, and
may affect  the entire  mouth  or only a  part of it.   The
mouth is usually so sore that infants cannot nurse, render-
ing it necessary to feed them with  a spoon.   They are
intensely fretful and hard to take care of.
  Termination. — Patients almost always recover from the
acute form of the disease.  In chronic cases they are gen-
erally adults in whom the disease has been developed  by
alcohol or tobacco,  and no treatment is available in such
cases until the tobacco habit or the whiskey is  abandoned.
  Treatment. — That which is most important in this, as in
all other affections, is to remove the exciting cause.   If it
is due to derangement of the stomach, this may be  some-
what easily effected; but if from difficulty and delay in
teething, it may require weeks of time to remove the cause,
as  the  teething  process  cannot be  hastened,  and  any
attempt to do so by lancing the gums is injurious.  When
a tooth  is almost ready to  come through the  gum, so its
sharp edges can be felt by the finger, mothers sometimes 
CHRONIC BRONCHITIS.
151
bring it through by rubbing the gum with the  edge of a
thimble or the finger nail.   This is all right; but when the
tooth is covered by enough tissue  to require the use of a
lance, the incision in  the gum will close by healing, the
scar will be harder than the natural  gum, and it will be
that much  harder  for the tooth to get through when the
proper time comes.
  The following mouth wash will  probably give the best
results in allaying the irritation:
                 Borax, two drachms,
                 Water, three  ounces.
  Mix, and use as a mouth wash three times per day.
             CHRONIC BRONCHITIS.
  Other names: winter cough; secondary bronchitis.
  This is a chronic inflammation of the  membranes lining
the large and middle-sized  tubes of the  lungs.  It is
attended with cough and copious expectorations.
  Causes. — The main causes are exposures to cold, or liv-
ing in a wet,  disagreeable locality or climate.  It is also
caused by the  inhalation of irritants, such  as marble dust,
and often afflicts  stone-cutters.  The secondary form is
mostly due to inflammatory affections  of the lungs.
  Symptoms. — The principal symptoms of the disease are
cough and expectoration.  The cough is more or less peri-
odic, disappearing at times and then reappearing, and thus
continuing more or less  through life.  It is more severe at
night, the expectoration being greatest  in  the  morning.
As the lungs and stomach are supplied by the same nerves,
a sympathetic  action  between  the  two organs manifests 
152
CHRONIC BRONCHITIS.
itself by a loss of  appetite,  impaired  digestion, and the
general symptoms of dyspepsia.
  Termination. — Chronic bronchitis when not complicated
by other diseases is rarely a fatal affection.
  Treatment. — Patients  suffering with this affection may
find great relief by adopting and  carefully following proper
hygienic measures.   The most important  of these, except-
ing a change of climate,  is to wear woollen underclothing,
year in and year out, always keeping the feet warm and
dry.   There  is  no one  factor  in the  treatment of the
disease so important as a change from a low, cold, wet cli-
mate to one that is  high, dry, and moderately warm.   Per-
sons going from the low altitudes of New England, where
the air is damp and cold, to live  on the dry plains of New
Mexico, or to the best of all climates, Southern California,
are not only relieved of their sufferings from chronic bron-
chitis,  but in almost all cases get entirely  well.   Complete
recovery often  occurs when  the changes of climate are
much  less  radical, as when patients go from the eastern
coast to central Kansas where the  altitude is  only about
twelve hundred  feet above the sea level.   So far as a per-
manent cure is concerned there  is nothing but a decided
change of climate that affords much, if any, hope, but there
is one drug, if properly given and for a sufficient length  of
time, that  favorably affects most cases of  chronic bronchi-
tis.   It is  iodide of  potassium and should  be  given as fol-
lows : —
       Iodide of potassium, two and a half drachms,
       Compound syrup of stillingia,  one pint.
       Mix ; dose a half tablespoonful three times a day.
  This  mixture may  aggravate  the  symptoms for a few
days by causing a flow  of mucus from the nose, but the 
INFLUENZA.                   153
system  soon  gets  used to  the drug,  when  a gradual
improvement  follows,  the  cough  becoming  much  less
troublesome.  The  treatment  should  be  followed  for
several months.   Where it is given in  chronic bronchitis
attended with asthma, the  paroxysms of  the latter  are
usually much less frequent and less severe.  The  syrup of
stillingia in this  prescription  is not used merely as a con-
venient vehicle for iodide of potassium, but it has a curative
effect, scarcely second  to the iodide itself; and  those who
have  always given iodide of potassium  in simple  syrup or
some  other form instead of being combined with stillingia,
have failed to  appreciate one of the most valuable  altera-
tives we have.

                    INFLUENZA.

  Other names : La Grippe; " grip ; " contagious catarrh.
This  is  an acute, infectious fever, somewhat contagious.
There is almost always bronchitis, derangement of  the
digestive functions, and marked disturbance of the nervous
system.   There  is  usually great debility with a tendency
to melancholy.
  Cause. — The disease is  due to  bacillus, another term
for  a  disease  germ that floats in  the atmosphere.   It is
said that one attack of  the disease predisposes to  another.
  Symptoms. — The disease  ranges in  severity from  the
mildest possible  form to one of the gravest character.  In
those  cases that are well  marked, the disease generally
commences  with a chill or a chilly  feeling, followed  by
fever.  The pulse is quick, shooting pains about the eyes,
pains  in the muscles and also  about the joints,  suggesting
the idea of rheumatism.   There  is chilliness  along  the 
154
INFLUENZA.
spine, pain in the throat, hoarseness, as if from  a severe
cold, deafness, discharge from the nose, frequent sneezing,
as in hay fever, eyes red and watery, and  usually a severe
cough.  The attacks are sometimes attended  with distress
in the stomach,  nausea, vomiting, and  diarrhoea.   The
fever generally begins  to subside in from four  to seven
days, and a slow  convalescence  is  established.   Relapses
often occur.  The most frequent and  fatal complications
are those  of pneumonia.  The mild attacks are  liable to
be mistaken for a "bad  cold."
  Termination. — Almost always favorable,  as  the fatal
cases are less than one in a hundred.
  Treatment. — The medical profession knows no remedy
that can be  ranked as a  specific  in  this disease.   The
most rational course to pursue is to meet the symptoms
with the best known remedy as they  occur.   Everything
that has a tendency to exhaust the vitality, or depress  the
nervous system, or unduly excite the respiratory functions
and heart's action, should be carefully avoided.
  Patients  should be kept  comfortably warm, and as a
general thing it is safest for them  to  keep  their bed.
  For the guidance of every one who may be  afflicted with
this disease, it is well to state this:  The great majority of
fatal cases are rendered so by exposure  to cold  and  the
hardships of  labor or business after the disease has set in.
One peculiarity of this  affection  is, that  violent  physical
exertion during the attack, even though it may be mild, is
very apt to develop pneumonia, the most  dangerous com-
plication.
  The most annoying symptoms of this  trouble, such as
pains in the  muscles and joints, cough, and acute nasal
catarrh, are relieved  by  Dover's powder in ten-grain doses 
INFLUENZA.
155
four or five times in twenty-four hours;  in mild cases, two
or three powders will be sufficient.
  It is a  self-limited disease, running its course in from
five to twelve days, and there  is but little to be done  except
keeping the patient either in bed or in a warm, comfortable
room, and giving such remedies as  are  best calculated to
secure rest and comfort.
  If there is sickness of the stomach with a tendency to
vomiting,  it can  be  promptly controlled by giving  a half
grain of  the extract of  ignatia before each meal.   The
headache  complications are  also controlled by the same
remedy.

                 AFTER  EFFECTS.

  One of  the most terribly unfortunate terminations of this
disease is  the state of mental aberration, or deranged mind
that often follows it.  Such patients are liable to be greatly
depressed and to live in a chronic state of melancholy with
great tendency to suicide.  They are also in a somewhat
childish condition, with an inclination to weep on the slight-
est provocation.  Whether  these  symptoms are  due to
indigestion or not, the best remedy is the extract of igna-
tia, ranging in dose from one-half to a  full  grain, accord-
ing to  the size of the patient, persons weighing over two
hundred pounds requiring a full grain.
  One pill is to be given before each meal and should be
continued for several weeks;  meanwhile the patient  should
not be left alone, as many have been known to slip off to
the barn  and hang  themselves, or  suicide in some other
way. 
156
PLEURISY.
                     PLEURISY
   Other names : stitch in the side ; pleuritis.
   This is an inflammation of the pleura, which is a mem-
brane covering the lungs or lining the cavity of the thorax.
The membrane  covering the lungs is called  the pleura
pulmonalis.   The  membrane  lining the  chest  is called
pleura costalis.  They are both sleek,  glossy membranes,
and come in contact with each other in breathing.   Dur-
ing inflammation of the lungs there may be more  or less
pleurisy, and in that case it is usually inflammation of the
membrane covering the lungs.  Where the disease comes
on independently of inflammation of the adjacent organs,
it is very liable to affect both membranes.
  Causes. — It is usually due  to  exposures to cold or to
injuries of the chest.  Consumption frequently causes pleu-
risy, but in such  cases it is limited to a small part of the
membrane covering the lungs, and is never what is termed
general pleurisy.
  Symptoms. — The disease in its acute form commences
as most inflammatory affections do, with a chill, followed
by a sharp pain  in  the side or near the nipple, which is
always increased by breathing or  coughing.  The breath-
ing is  rapid, running from thirty to  forty per  minute,
attended with a dry cough,  fever, and frequent pulse.
Soon water is poured  out on the  surface of the inflamed
membrane, the fluid accumulating between the two mem-
branes, the one covering the lung  and  the other lining the
walls of the chest.   This fluid presses upon the lungs and
interferes with breathing, the difficulty being in proportion
to the amount of the existing fluid.  It often causes a feel-
ing of threatened suffocation, and the patient almost always 
PLEURISY.
157
 lies on the affected side.  There are two reasons for doing
 so.  The first is to keep the muscles of that side that are
 concerned in breathing, in a state of  perfect rest so as to
 prevent pain by the inflamed  membranes rubbing against
 each other.  The second is to give the sound lung every
 opportunity to carry on the functions of respiration, instead
 of being compressed by the weight of the body and dimin-
 ished in its breathing capacity.
   Cases of pleurisy that are more or  less chronic come on
 slowly, after exposure to cold or other exciting causes.
 Such cases are affected by shortness of breath, aggravated
 on slight exertion, have fever and night-sweats, a dry cough,
 the pulse being small, frequent, and  rather weak.  There
 may be but little, if any, pain  in the side.
  Termination.— Pleurisy  that comes on independent of
 any other affection is generally favorable, running its course
 and ending in recovery within a few weeks.   If it exists as
 a result of pneumonia or consumption, it ceases to be a
 simple disease, and the danger to life is largely due to the
 cause producing it.
  When it occurs on both sides at the same time it is called
 double pleurisy, and is exceedingly unfavorable.
  Treatment.— In all cases of acute pleurisy in which the
 inflammatory symptoms, such  as severe pain, full, frequent,
 and bounding pulse are present, a sedative to the heart's
 action should be given every hour as follows : —
          Tincture veratrum veride, one drachm,
          Water, four ounces.
  Mix, and give a teaspoonful every hour for eight hours,
then leave it off for three hours, after which give it every
two hours for twelve hours longer.  If at any time  while
this drug is being given sickness and vomiting should occur, 
i58
PLEURISY.
it must be left off at once, and a tablespoonful of whiskey in
an equal amount of sweetened water given.  When vomit-
ing occurs from the remedy given in this way, it almost
always reduces the force and frequency of the pulse, brings
the temperature  down greatly, and relieves pain and other
distressing symptoms.   When this occurs, the pleurisy or
inflammatory process, whatever it may be, is  completely
aborted, and rapid recovery follows.   Unfortunately, how-
ever, the cases of pleurisy  that are  sufficiently acute and
violent to call for this powerful sedative, are comparatively
few.
  For  this reason, milder .forms  of  treatment  have  to be
employed in most cases.  While  there is  nothing so com-
pletely abortive as the veratrum veride when it is perfectly
adapted to the case, there are other remedies calculated to
modify the disease and  greatly shorten its course, and one
of the very best  is salicylate of soda, given as follows: —
            Salicylate  of soda, two drachms,
            Water, four ounces.
  Mix, and give a teaspoonful every hour for eight or ten
hours,  after which give  it every two hours.  If this is com-
menced in the early stage of pleurisy, and the  patient cov-
ered up warmly in bed, profuse perspiration will soon follow,
and with it a subsidence of the pain, fever, and other dis-
agreeable symptoms.   It is claimed by the best authorities
that pleurisy is often broken up by this drug, if timely and
properly given, and that it  is also valuable  in the stage of
affusion, or during the  collection of  water in the cavity of
the chest.  After water  has  accumulated in  the thoracic
cavity  it greatly embarrasses the  breathing  process, and
should be gotten rid of  as soon as possible ;  and the follow-
ing treatment  hastens its absorption: Give, about an hour 
ACUTE TONSILITIS.
159
before breakfast, two heaping tablespoonfuls of Epsom salts
dissolved in two or three ounces of water.  Continue this
for two or three mornings and there will  be  four  or five
stools each day, consisting almost entirely of water, and in
that way the system is in a great measure drained of the
watery portion of the blood, and the fluid  in the cavity of
the chest  naturally passes back into the circulation.  But
little  water should be  given  to the patient during this
treatment.
   In  the chronic form of pleurisy, absorption of the fluid
should be stimulated by iodide potassium in ten-grain doses,
three times per day, in  a  gill of water.   In all cases of
pleurisy it is best to control the pain  with the sulphate of
morphine, given in quarter-grain doses every three  or four
hours, as the case seems to require.


                ACUTE TONSILITIS.
   The common name is quinsy.
   This is an acute  inflammation  involving the structure or
substance of one or both tonsils, and is attended with fever
and pain in the throat which is greatly increased by  swal-
lowing.   In the majority of cases one or both tonsils sup-
purate, and either break or have to be lanced.
   Symptoms. — The disease commences  suddenly  with a
chill,  followed by a fever, the  pulse being full and  strong,
characteristic  of  inflammation.   There  is  headache, great
thirst, with  swelling at  the angle of the jaw, severe pain
which is  always  increased  by  swallowing.  There  is  a
feeling of suffocation caused by the general swelling about
the throat, but more especially from enlarged tonsils.  When
suppuration of one of the tonsils is  taking place, all the 
160                ACUTE TONSILITIS.
distressing symptoms are increased, and to these are added
a new one, that of painful throbbing in the affected tonsil.
This gets worse  and worse, the pain  and throbbing in-
creases, the breathing becomes more and more embarrassed,
and the countenance takes on an anxious expression.  Fi-
nally in a violent effort to cough or get rid of offending mucus
in the throat the abscess of the tonsil breaks, the matter is
discharged by the mouth, and immediate relief follows.
  Termination. — This is  almost always favorable, except
in children.  In  the little patients  it  sometimes  proves
fatal by obstructing the air  passage in the throat.
  Treatment. — In  all  inflammatory affections  commen-
cing suddenly with a chill and followed by a high fever
and a strong, full, and frequent pulse, tincture of veratrum
veride  in  two-drop  doses  every hour,  should be given to
an adult for about six hours.   Acute tonsilitis is  of this
character, and the system should be brought under the in-
fluence  of the drug as  soon as possible without running
the risk  of  over-dosing.   Where the  veratrum is given
every hour in this way the pulse must be watched, and as
soon as it  commences to fall, the remedy should be  left off
for a couple of hours.   The  object of the veratrum is to
so control the heart's  action as to lessen the amount of
blood sent to the  affected part, and in doing this to  reduce
the swelling, the fever, the  inflammation, greatly  relieve
the pain,  and prevent  abscess  of  the tonsils.   There is
nothing so capable of  bringing about these favorable re-
sults as this drug.  Unlike the tincture of  aconite,  if it is
given in too large doses, or continued for too long  a time,
or in small doses too often repeated, it causes vomiting, in
which the drug is thrown up.   The sickness in such cases
warrants the doctor or nurse to discontinue the remedy for 
WHOOPING COUGH.
161
 a few hours.  A tablespoonful of whiskey will check  the
 sickness and hasten  a  reaction.   Aconite gives no warn-
 ing of its dangerous effects upon the system, and for that
 reason is a dangerous remedy.
   During the whole course of this disease the bowels may
 be kept open by a mixture of Epsom salts and cream of
 tartar, equal parts, given in heaping teaspoonful doses two
 or three times per day in a half glass of  water.  It is well
 to stimulate the kidneys by a teaspoonful of sweet spirits
 of nitre in a gill of water every three hours.

                WHOOPING COUGH.
   Other names : pertussis; hooping cough.
   This  is a catarrhal affection of the bronchial tubes of
 the lungs, manifesting itself by convulsive coughs coming
 on  in  paroxysms, and  characterized by a loud, familiar
 whoop as the air is drawn into  the lungs.
   It is  a disease of childhood, because  a person  seldom
 fails to contract the  affection in early life.  One attack
 usually prevents another.   It  is due to a poison, the  char-
 acter of  which is unknown,  that  acts upon the nervous
 system.
  Symptoms. — It has three stages.  The first is  the  ca-
 tarrhal  stage in which  the membranes  of  the nose, the
 larynx and bronchial tubes are affected,  and this stage is
 attended with a loose cough, lasting from one to two weeks.
  The second stage is  the whooping or  spasmodic stage,
 in  which the cough comes on in paroxysms, and is exceed-
ingly rapid  so as to almost exhaust the child, and when
the breath is about given out, the  effort of the child to get
another full breath is accompanied with a crowing whoop.
        M 
162
WHOOPING  COUGH.
There are usually about three spells of coughing in each
paroxysm, the last one generally ending with a discharge
of mucus and sometimes vomiting.  Bleeding of the nose
sometimes occurs during  this stage.
  The third or closing stage: During this stage  the  par-
oxysms  become less frequent or milder in character and
shorter  in  duration, the expectoration is easier,  and the
patient  much more  comfortable.   The duration of  this
stage is from one to two weeks, ending in recovery.
  Termination. — This is almost always favorable, except
in very young infants or when associated with other dis-
eases.
  Treatment. — It is a self-limited disease, and it is doubt-
ful if its course can be shortened by remedies.  As a gen-
eral  thing, simple whooping  cough does not require  any
drug treatment.  The little patient  should be  kept in
rooms that  are comfortably warm  and not exposed to
draughts of cold air, and the clothing should  be warm.
When the cough is severe, the spells may be modified in
severity  and  lessened  in  frequency  by the following:
Brown mixture, six  ounces.   Shake, and give from a half
to a  teaspoonful and a half, according  to the age of the
child.  The  dose may be  repeated  every four  hours if
necessary.   When  this is  given at bedtime and another
dose after midnight, the paroxysms after midnight will be
less frequent and less severe. 
ASTHMA.                    163
                      ASTHMA.
   Other names : spasmodic asthma; bronchial asthma.
   This is a spasmodic contraction of the muscles surround-
ing the smaller  tubes of the lungs, and is paroxysmal in
character.  It is  almost always  attended with  chronic
bronchitis, and  in  the  majority of cases the frequency
and severity of  the asthmatic  attacks are in  proportion
to the existing bronchitis.
   The spasmodic  attacks of asthma  may last  for only a
few hours, or  they may last for weeks.   In some patients
they are always  short, in others always long.
   Causes. — Asthma is  undoubtedly a  nervous affection,
and is due  to a  condition of  the nervous system  that
affects the  breathing functions.    It is essentially a  he-
reditary  disease, that is,  the  tendency to the disease is
inherited.
   Attacks of asthma  are frequently brought  on  by dis-
agreeable odors, such  as  musty feathers or mattresses.
Dust of  any kind, but  more especially that of irritating
drugs, often causes a violent attack.
   The most distressing paroxysms  often  arise from  a re-
flex or sympathetic condition in which the stomach is the
seat of the  trouble, as when that organ is gorged with a
heavy, meat supper, or food that is difficult to digest.
   In such cases  the attack may be cut short by vomiting.
   Symptoms. — When asthma first sets in, the seizure may
be sudden, but after the disease has once  fixed itself upon
an individual, the attacks are preceded  by warning symp-
toms which  are  usually those of a  common cold.  Acute
indigestion is often one of the premonitory symptoms.
  The paroxysms may come on at any time, but like other 
164
ASTHMA.
nervous disorders frequently break out in the night.   The
first symptom of the attack is an intense and anxious de-
sire for air.   The breathing is attended with loud wheezing,
the face is either flushed or takes on a  dusky appearance
due to a want of breath.   The labored breathing sometimes
brings on profuse perspiration, and  the symptoms  for a
time are so distressing as to threaten  life from suffocation.
  Sooner or later the respiration becomes easier, the  tubes
of the lungs  ceasing their  spasmodic contraction, and the
dusky appearance of the face  changes to normal, and the
.paroxysm is over.  Sometimes asthma consists of a series
of attacks and remissions,  lasting  for many days or even
weeks, during which the patient is unable to attend to busi-
ness of any kind.
  Termination. — Simple asthma is never fatal.
  Treatment. — The  first and most important thing  to be
done is to relieve the distressing paroxysm, and the second
to commence such a  course of treatment as to prevent, if
possible, its recurrence.   If the treatment fails in prevent-
ing other paroxysms it  may reduce them in  number and
severity.   To relieve the paroxysm a full dose of opium in
some  form is the most effective.  A quarter of a grain of
morphine, if  given to a patient not long  accustomed to its
use, may give prompt relief, but if  the drug has been used
a great many times  it may take twice  that amount or a
full half-grain.  There are  two serious  objections to mor-
phine, or opium in any form.   The first is, that the dose
must be gradually increased until it becomes enormous in
order to be effective.   This necessarily develops the opium
habit.  The second  objection is, that  it  suppresses the se-
cretion of all the organs, and causes disorders of digestion.
Therefore, it is a poor  remedy in  a never-ending  disease 
ASTHMA.                     165
 like asthma.  It is much better  to rely upon inhaling the
 smoke from burning stramonium leaves, or nitre-paper, or
 both.
   The disease  is one of the most  distressing that afflict
 mankind,  and the effects of any drug  used  to  overcome
 the paroxysm will wear out sooner or  later, and for this
 reason a great deal of time is spent by asthmatic patients in
 hunting for a new remedy to relieve their sufferings.  The
 disease is usually considered incurable, and this is true^
 if the patient is compelled to live in a climate and locality
 where it developed.  As a  great  many cases  are attended
 with chronic  bronchitis  upon which the severe attacks of
 asthma mainly depend, a systematic treatment should be
 adopted with a view of curing this affection.  The follow-
 ing is the best :
    Iodide potassium, three drachms,
    Compound syrup of stillingia, one pint.
    Mix; dose a half tablespoonful three times per day.
   This remedy soon  produces a flow of mucus  from the
 nose with other symptoms of  a  severe cold.  It  affects in
 the same way the mucous  membranes  of the bronchial
 tubes of the  lungs, and gradually cures or greatly relieves
 the bronchitis, and just  in proportion as it  is relieved the
 asthma is  modified.   The pleasantest thing  that can be
 said of asthma, obstinate and stubborn as it  always is, is
 this :  Proper climatic  changes will almost always cure it, or
 so wonderfully modify it, that the attacks scarcely amount
 to anything.   The author can speak from abundant expe-
 rience  on  this  subject,  and knows  that the altitude of
 Denver, Col., affords  in most patients an immunity from
asthmatic attacks.  There are others, however,  who  are
not greatly benefited  by living in Denver.  They need a 
166
SPITTING OF BLOOD.
drier  atmosphere than that locality, and may find  com-
plete relief in Los Angeles, and other parts of Southern
California.   Others may fail to get relief in California, and
get permanent freedom from it on the high and dry moun-
tain ranges of the West.
  It  sometimes happens that  climatic  influences, though
almost absolutely curative  to  commence with, lose  their
effect in time, but this rarely occurs except after the lapse
of many years.

              SPITTING  OF BLOOD.
  Other names:  haemoptysis ;  pulmonary hemorrhage.
  This consists of  an expectoration of blood  following  or
accompanying the act of coughing, the blood usually being
bright red.
  Causes. — It is  almost  always due to pulmonary con-
sumption in  which small arteries have been severed  by
the destructive process of  tubercular softening.   It may
also be caused by violent muscular action in which small
blood-vessels of the bronchial tubes are ruptured.
  Symptoms. — It occurs  suddenly  as a general thing.
Sometimes it has no warning symptom whatever, while at
others it is  preceded  by a slight pain in the throat.  The
quantity of blood may be small or it may be  a pint or more.
Sometimes it is so great as  to end fatally in  an hour.  As
a general thing the attacks are much less severe and sub-
side for several hours at a time, to come on  the following
night or day.
  Termination. — Spitting of blood in itself is not neces-
sarily dangerous, although it weakens the patient and has
a discouraging effect upon  his  mind, as it is usually hailed
as an unmistakable sign of  consumption. 
MUMPS.
167
  Treatment. — The patient should be  kept in  a state of
perfect rest in bed, as the least movement of the body ag-
gravates the hemorrhage.
  The author has always been able to stop  the spitting of
blood by giving a teaspoonful of the fluid extract of  ergot,
repeating the dose in twenty minutes if necessary.  The
second or third dose  always  stops the  hemorrhage  if the
first does not.

                       MUMPS.
  Another name: parotiditis.
  This is an inflammatory disease  involving the parotid
glands at the angles of  both jaws, and  also other salivary
glands, and adjacent parts.  The affection is much inclined
to move to other parts of the body, affecting the mammary
glands or breasts of females and the testicles of males.  It
is characterized by swelling, pain, and functional disorder
of  the parts  affected,  and  is infectious,  that is,  it is
" catching."
  Cause. — It is due  to  a specific poison, and one attack
almost always affords an immunity from other attacks.
  Symptoms. — It  comes  on quite  suddenly, often with
a  slight chill,  followed  by  considerable fever, frequent
pulse, headache, and dry skin. Within twenty-four  hours
it is difficult for the patient to open  his mouth, owing to
the swelling and soreness at the angle of the jaw or at the
affected  side, if only one side is involved.  The disease
runs its  course, as a general thing, within eight or nine
days, and where both sides are involved simultaneously it
will run its course in about a week.
  The affection is  liable to be set up in the breasts, ovaries,
or testicles, any time during its usual course.  If the fever 
168
MUMPS.
 continues after the glandular swelling subsides, the disease
 is very liable to migrate to the other parts.
   Termination. — Uncomplicated  mumps almost  always
 end favorably.   But while the affection does not endanger
 life it is liable to impair, or even destroy, the functions of
 the ovaries and testicles.
   Treatment. — The  disease  is self-limited,  running  its
 course in about a  week,  and with proper care, recovery
 ought to be perfect.
   The author has  treated hundreds of cases, has  always
 kept the boys in bed until the subsidence  of the glandular
 swelling, and kept them in their room for some time after-
 wards.  Children of either sex  should not be exposed to
 draughts of cold air, nor be allowed to sit in cold rooms
 during the disease.   A state of  perfect  quiet  for each and
 every patient should be maintained, as any exercise, such
 as romping and playing,  increases the  heart's action and
 tends to the development of  the  disease in the  sexual
 organs.  If the glands about  the jaw continue to be en-
 larged after the disease  has had proper time  to  run  its
 course, they should be painted with the tincture of iodine,
 twice in  twenty-four hours.  In addition  to  this give the
 following: —
           Iodide of potassium, two drachms,
           Simple syrup,  a half pint.
   Dose, teaspoonful three times a day.  If  the  child is
 very young, half of the above dose will be sufficient.  If
the testicles are inflamed  and swollen,  hot  flaxseed poul-
tices, changed every fifteen minutes, should be used.  It is
twenty times easier to keep children quiet in bed, and in
that way avoid  inflammation of the testicles, than it is to
 control it after it is established. 
MEMBRANOUS CROUP.
169
              MEMBRANOUS CROUP.
  Other names: true croup ;  croupous laryngitis.
  This is an acute inflammation of the mucous membrane
of the larnyx in which a false membrane  is gradually de-
posited upon the true membranes.
  Cause. — It is a disease of childhood and  most common
in strong and vigorous boys.
  Symptoms. — Membranous croup may develop  suddenly,
being ushered in by an attack of spasmodic croup, or it may
come on as an acute inflammation of the larnyx, attended
with fever, thirst,  dry cough, and  hoarseness or  loss of
voice.   Difficulty of breathing soon  follows in which the
child is unable to lie down.  As this increases, each inspi-
ration is  attended with a shrill or almost whistling sound.
As  the  disease continues to  develop, the air passage is
narrowed by encroachments of  the membrane from all sides,
and fatal suffocation is threatened. The skin gradually takes
on a bluish appearance caused by a deficiency of  air in the
lungs, and  death seems imminent; but sometimes when all
hopes appear desperate the spasm is suddenly  relaxed, the
air  rushes  into the chest, the  breathing is easier, and the
child drops into a short sleep.
  But these  attacks of  suffocation continue to  return at
short intervals, or there may be portions of the false mem-
brane discharged by coughing, affording  longer intervals
of quiet repose.
  In favorable cases the  paroxysms gradually become less
severe and  less frequent,  the bluish cast of the skin fades,
the difficulty of breathing is less, the cough gets looser, the
voice becomes more  natural, and the fever  diminishes or
ceases altogether. 
170
MEMBRANOUS CROUP.
  If the case is destined to end fatally, all the violent and
distressing symptoms are aggravated, the paroxysms are
more frequent, expectoration ceases, the voice is  lost, diffi-
culty of breathing increases, and the blue condition of the
skin takes on a deeper  hue.  The child becomes drowsy
and stupid from blood  poisoning, a cold, clammy  sweat
comes on, and the patient dies for want of breath.
  Treatment. — The indications are first, to commence treat-
ment as soon as the character of the disease is suspected,
with a view of arresting the inflammation and preventing
the formation of the false membrane, as it is a great deal
easier and safer to stop the development of the croup mem-
brane, than to secure its detachment and expulsion after it
is fully formed.   As the disease is essentially an inflamma-
tion of the natural membrane of  the larnyx, and the false
membrane is simply a product, and often a fatal one too,
there is nothing more obvious than this: Any remedy that
will stop the inflammation will prevent the false membrane
from forming.  The author is positive, from years and years
of experience, that tartar emetic given in small  doses, after
vomiting is once established, so as to keep the  child under
the influence of the drug for eight or ten hours, will so re-
duce the inflammation as to prevent the  false membrane.
The extent to which it is proposed to  keep  the patient
under the  influence of the drug  is this : It  is to be given
every fifteen minutes until  vomiting occurs.  After this
the sickness of  the  stomach, followed by vomiting, will
occur every half hour for two or  three hours, and  mean-
while there will be watery discharges from the bowels, prob-
ably.  As  soon as the sickness of the stomach  subsides,
about half of the first dose of the drug should be given, and
in this way sickness of the stomach, attended with more or 
MEMBRANOUS CROUP.
171
less vomiting every hour, should be maintained for eight or
ten hours.  As soon  as the child vomits, it drops back into
a refreshing sleep and so continues until the sickness and
vomiting come on again.   In such cases the hot skin and
flushed or bluish countenance are absent, the child is rather
pale,  and the  skin  covered with  moderate  perspiration.
There are  two ways in which the  antimony given in this
manner exercises its  curative effect.  In the first place, as
soon as the nausea and vomiting are commenced, the  heart
is brought under the control of the nauseating sedative, in
which its power to pump  blood to the affected parts and
develop the inflammatory exudation, that is, the false mem-
brane, is reduced one-half or more.   In the second place,
the relaxation of  the system by the constant sickness pre-
vents  the  spasmodic paroxysm, and as these  paroxysms
have  an intrinsic tendency to increase the congestion of the
parts involved in  the inflammation, anything that prevents
their occurrence exercises a curative effect upon the disease.
As it is proposed to  break up and abort all cases of mem-
branous  croup in which the treatment as herein given  is
commenced at the beginning of the attack, it is a waste of
time to mention other  remedies for this disease.  The fol-
lowing is the formula for the tartar emetic: —
               Tartar emetic, eight grains,
               Simple syrup, five ounces.
  Mix, and give a teaspoonful  every fifteen minutes until
vomiting commences.  If the  symptoms are exceedingly
violent and the vomiting does not occur within fifteen min-
utes,  two teaspoonfuls may be given.  This remedy will
cure every case of croup if commenced early in the attack. 
172         ACUTE CATARRHAL LARYNGITIS.
       ACUTE CATARRHAL  LARYNGITIS.
  Other  names : sore throat; catarrhal  laryngitis.   This
is an acute inflammation of the mucous membrane of the
larynx,  and is  attended  with a  slight fever,  hoarseness,
pain on swallowing, and often difficulty in breathing.
  Causes. — The most important of  these include atmos-
pheric  changes,  draughts  of  cold  air, and  all  other
conditions  causing  persons  to  contract a severe  cold.
The affection is also due  to  irritating drug powders or
vapors.  It is also caused by public speaking and  singing.
  Symptoms. — It  comes on abruptly, the throat feeling
raw and dry, with a tickling pain in the windpipe.  There
is pain  on swallowing and also  at any attempt to speak.
In the early stage of this affection the voice is  hoarse  and
soon ceases altogether.  In children the fever  develops
suddenly,  the  tongue is  coated,  pulse rapid and strong,
skin hot, the face  red, and the child has a croupy cough
with threatened suffocation.
  Termination. — This is  always favorable.
  Treatment. — Patients should be kept in rooms uniformly
heated  and  the air kept  moist  by steam.  This can be
done  in a  great many ways.  If there is a stove in the
room, water can be  evaporated  in a large flat dish; but
if there is  not, large hot rocks  may be  placed in a  pan
and water poured slowly upon them so as to keep the air
almost saturated with vapor.
  Cloths wrung out of hot  water and wrapped around the
neck are capable of doing a great deal of good.  It is  best
to  have them very large so as to hold the heat for a long
time.  The bowels  should be thoroughly  moved  in  the
commencement by  a suitable physic. 
ACUTE CATARRHAL  LARYNGITIS.         173
   In order to procure rest and at the same time get a free
action  of the skin, the following may be given at  bedtime
to adults: Dover's powder and nitrate  of potash, of each
twelve grains.  Give this at one dose, and keep the patient
warmly covered in the bed or with clothing  if not  in bed.
If there is  much fever and the pulse strong and rapid,
give tincture veratrum  veride  in  two-drop  doses every
hour for five hours, and then  continue  it for  eight or  ten
hours in one-drop doses.   The treatment given here is for
adults, as the doses are far too large  for children.  When
the disease occurs in  children, the bowels may  be kept
open by teaspoonful doses  cream of tartar, three or four
times  a  day in  water.  In almost all  fevers there is  a
craving for  acid,  and for this reason the cream of tartar
water will be eagerly taken.  To  control the heart's action
and lessen the fever and  inflammatory development,  the
following may  be given to children from three  to eight
years old: —
          Tincture veratrum veride, ten drops,
          Water, twenty teaspoonfuls.
   Mix; teaspoonful every hour  for  ten hours and then
leave it off for two or three hours, after  which continue  it
every  hour  till it is all given.
   To  procure  rest for little  patients from  one  to eight
years old, paregoric may be given in doses ranging from
four to twenty drops every four or  five hours, but care
must be taken to avoid  giving too large doses of opium
to children, especially to  those suffering  from throat
affections, as profound sleep  favors  the accumulation  of
mucus  in the  air passages and leads to danger from
suffocation. 
174
THROAT CONSUMPTION.
            THROAT  CONSUMPTION.

  Other names: tuberculous inflammation of the larynx;
laryngeal phthisis.
  This is an ulcerative inflammation of the larynx caused
by tubercles, practically  the same kind of tubercles that
exist in pulmonic or  lung consumption.   The throat con-
sumption is attended with cough, pain on swallowing, more
or less loss of voice, great loss of flesh, and fever, in which
there are usually red spots on the cheeks.
  Causes. — The exciting cause is the action of tuberculous
parasites upon  the larynx.  The  predisposing causes are
hereditary.
  Symptoms. — The  affection is almost always a complica-
tion  of  pulmonary  consumption.  When it  occurs as a
primary disease lung consumption  soon follows.   About
the first symptom noticed is hoarseness or a feeble state of
the voice.   The husky voice may gradually increase until
only a faint  whisper  is heard; at the same time there  is
generally a distressing cough with but little expectoration.
The  act of swallowing is difficult and painful.   In addition
to these symptoms those of pulmonary  consumption are
added, such  as  loss of  appetite, loss of flesh,  night-sweats,
and extreme restlessness.
  Termination. — Always unfavorable.
  Treatment. — This  disease is  essentially consumption,
although it  may appear, primarily,  in the throat instead
of the lungs.  As it  is purely a constitutional disease, the
application of  local remedies afford no hope so  far as  a
cure is concerned. There is nothing but a change of cli-
mate, from  a  low  altitude, low  temperature, and moist 
THROAT CONSUMPTION.              175
atmosphere to a high, dry, and warm climate, that is calcu-
lated to afford any hope of recovery.
  There is one general principle that should be observed
in dealing with consumption either of the larynx or lungs,
and that  is  this: Any locality or climate in which  the
disease develops, should be abandoned as soon as possible,
as a person who  passes from  a state of perfect health to
one of constitutional disease  under climatic influence,  can
scarcely hope to be restored  to normal health  under the
same influences.  The climate best suited to consumptives is
the warm, dry, semi-tropical region of Southern California,
where the high  mountain  ranges exclude the  northern
winds and prevent precipitation of moisture in the form of
rain.   For this reason  the so-called rain season only lasts
about five or six weeks in the  year, during which there are
a few light showers.  The climate is  so mild  and uniform
that patients can live in tents  and exercise in the open air
with impunity.  A  great  many patients who have gone to
Los Angeles within the last ten years, suffering from lung
and throat affection, have entirely recovered.  But a great
many people are too poor to go, while others have business
affairs they cannot  readily leave, and in the meanwhile
something must  be  done to  stay as  far as  possible  the
ravages of the fell destroyer.  It has  been fashionable for
decades to give  all  consumptive patients cod-liver oil with
a view of  stopping the wasting of flesh.  The cases in
which it  succeeds, even though when mixed with whiskey,
are comparatively few, as consumptives generally have an
intolerance for oil of any kind and especially this.   The
author, many years ago, substituted  cream  for the cod-
liver oil with the most satisfactory results.   It is given as
follows:  Put two tablespoonfuls of good cream into a glass, 
176
PNEUMONIA.
and then pour into it one tablespoonful of  pure whiskey.
Stir it, adding a little sugar if desirable, and  give it  at
once.   If the whiskey and cream are given in this way, the
latter will not curdle, but  if the cream  is poured into the
whiskey, coagulation immediately follows.  The mixture
should be given  just before meals, and  under its use the
cough frequently grows less, the throat symptoms improve,
and the patient either ceases to lose flesh or gains a few
pounds.  Sometimes, however, the cream is not well borne,
and in such cases it is worse than useless to give it.


                    PNEUMONIA.

  Other   names:   lung  fever; winter fever;  pleuro-
pneumonia ; pneumonitis.
  This is  an acute inflammation involving  the  substance
of the lungs, the congestion being of such character as to
render the  affected parts of the lung impervious  to air.  It
commences with a severe chill, headache,  fever,  pain  in
the chest, cough and difficulty  of breathing, expectoration
being of a rusty  color.
  Cause. — It is said to be an infectious disease,  caused
by parasites.
  Symptoms. — A well-marked case of  pneumonia  com-
mences with  a  protracted chill followed by a high fever;
the pulse  is  full,  strong,  and  rapid, there  is sharp  pain
in the chest, caused  by each act of breathing or coughing,
the breathing often  being  so  rapid as  to  reach forty  or
fifty respirations  per minute.   The  cough is at  first harsh
and dry, but  gradually becomes moist, with a discharge of
frothy mucus that changes by  the second day into a rusty
colored expectoration, characteristic of the disease.  There 
PNEUMONIA.
177
 are all the symptoms of a violent fever, the face being
 flushed, sometimes of a bluish red color due to  carbonic
 acid poison in the blood, for want of breath.  The above
 symptoms, more or less  severe, continue for  eight or nine
 days, when a crisis sets  in attended with profuse perspira-
 tion and symptoms of great prostration ; the fever almost
 entirely subsides, and if the case is destined to end favor-
 ably, recovery speedily follows.
   Unfortunately, a great many cases of pneumonia, after
 having passed through the various stages in a reasonably
 favorable manner, seemingly sink rapidly as soon as the
 crisis is reached and  die within a day or two.  Such cases
 are exceedingly  common in  those who  have passed the
 meridian of life's journey or gone a little beyond it.
   Termination. — The highest  medical authorities claim
 that less than  twenty per cent of  all cases of pneumonia
 end fatally, but there is something exceedingly deceptive
 in this claim.
   Between the ages  of  childhood and forty, deaths from
 pneumonia are  exceedingly rare,  while above forty the
 fatality gradually increases, and  after the age of fifty is
 passed, more than half  die.  A man's  intrinsic worth to
 the world  is  far greater after he has  passed fifty  than
 during the early part of  his life, and it is the province of
 medical art to save him if possible.   How can it be  done
 in pneumonia ?   The expectant plan  of  treatment, that is,
 waiting for the disease to run its course, is generally fatal,
 as the natural crisis is so long delayed that fatal exhaus-
tion soon follows.
  Treatment. — Other things being equal, the longer the
crisis is  delayed the greater  is the  tendency to a fatal
ending by exhaustion.
        N 
i78
PNEUMONIA.
  The extent and violence of  the inflammation and its
continued interference  with  the functions  of  respiration
and  nutrition cause the  exhaustion mainly.  The ques-
tion arises:  Is there any way to cut short the  destructive
and  strength-consuming stage  of  inflammation so as to
save enough of  the vital  forces to carry a bad case of
pneumonia  to  a favorable termination,  even  when  the
patient has passed the fiftieth or sixtieth mile-post of life ?
Let us see.   Suppose the natural crisis is destined to  end
on  the  seventh, ninth, or  eleventh day of the disease.
This gives at least a whole week for  all the  distressing
and  exhausting stages  of the inflammation to  run their
course.   Now if any drug can  be given  during the first
twenty-four or thirty-six  hours that will break up the inflam-
mation  and  bring  on  an artificial crisis  attended with
sweating  and a subsidence of all  the  violent  symptoms,
and  yet exercise  but  little  prostrating  effect upon  the
patient, what could be more rational than the use of such
a drug ?   Exactly such  a drug is known to the author  and
has been used by him for  thirty years.  It is true that  it is
very depressing, that it reduces  the force and  frequency
of the pulse to the natural  standard if  not lower, changes
the face from red  to a peculiar pallor, bedews the skin
with cold perspiration, often causes sickness and vomiting,
and  may alarm nervous  and  timid attendants; but  the
whole period, from  the earliest development  of the artificial
crisis until reaction occurs, is  less  than  one-twentieth of
the time  required  to  establish  the natural crisis.  The
artificial crisis arrests  the disease during  the stage of
engorgement or congestion,  and absolutely prevents  the
various inflammatory stages that always attend the disease
when it is permitted to run its full and natural course. 
PNEUMONIA.                   179
  As it takes the morbid condition twenty times as long
to bring on the natural crisis as it does the drug to estab-
lish an artificial one, the  logical  inference is  that  twenty
times more physical  force is used up  by the disease than
by the drug, and  a  very  extensive experience in dealing
with pneumonia affecting  persons of all ages, confirms the
theory.
  Based upon an experience of thirty years during which
the abortive treatment of pneumonia has  been employed
in all well-marked  cases, the  following treatment is given :
In all cases of pneumonia attended with a full, strong, and
bounding pulse, high temperature, flushed face, and other
symptoms  indicative  of the  disease, the following  should
be given as directed, as soon as the reaction from the chill
occurs:—
         Tincture  veratrum veride, a teaspoonful,
         Water, twenty teaspoonfuls.
  Mix, shake, and give a teaspoonful every hour until the
pulse and fever begin to fall.  About this time sickness of
the stomach will come on, the face will become pale, the
skin will be  covered with cold  sweat, the pain, hurried
respiration, and other violent symptoms will subside, and
the whole  group of symptoms, excepting the  sickness of
the stomach,  will be practically the same as those of the
natural crisis.
  The similarity of the drug effect to  the natural crisis is
further  observed  in  the  fact that  all the inflammatory
symptoms permanently subside after the specific effect of
the drug is obtained.   In  other words, the crisis, whether
artificial  or  natural,  practically  ends  the inflammatory
process.
  When the  artificial crisis  is reached within twenty-four 
180                   PNEUMONIA.
hours, — and it ought to be reached within ten or twelve
hours, — the disease is broken up  before  it has time to
exercise much,  if any, prostrating effects, and  also before
it has time to produce permanent organic  changes in the
lungs.  The depressing effects of the remedy are transient,
wholly disappearing  in a  few hours, and  the patient  is
practically well in three days.
  When the disease is permitted to run its  course, the
crisis is liable to be followed by fatal prostration, and this
liability is greatly increased if the patient is advanced in
years.  If, however, enough strength is  conserved through
it all to prevent a fatal ending,  the patient, even if  young,
is liable to be left with a crippled respiratory apparatus, —
a partially consolidated lung that is worthless.   Under the
system  of practice in vogue  fifty years ago, certain symp-
toms were given  calling  for  blood-letting.  The principal
ones  were a strong,  full,  frequent, and  bounding  pulse.
These were few  and easy to  remember, and  afforded a
general guide  to doctors in  treating inflammatory affec-
tions  in those days.   Exactly the same  symptoms call for
the use of an arterial sedative,  such as veratrum veride, in
all acute and violent inflammations, especially pneumonia.
  The time in which to give this  sedative is of  the  utmost
importance.  It should be given as soon as possible after
the chill subsides, but at this early stage of  the disease its
character can only be suspected.   It cannot be positively
known, but if  the  full, frequent, and  bounding pulse  is
present the sedative should be given on general principles,
as an inflammatory  seizure  of  some kind is  imminent.
Should  it not  be given until twenty-four hours after the
initial  chill, the  chances  of  wholly aborting  the  inflam-
mation, that is  of  breaking it  up during the stage of 
SPASMODIC LARYNGITIS.
181
 congestion, are much less than if given at the commence-
 ment; but  it should be  commenced just  the same, and
 followed  for fifteen hours with the hope of terminating
 the disease in its first stage or greatly modify  its subse-
 quent force.
   After the disease is developed,  and the  lung  is fully
 involved in the inflammatory process, the arterial sedative
 can  do nothing  but harm.   During this  and subsequent
 stages of the disease, what  is known as the supporting
 treatment, such  as quinine, iron, alcoholic stimulants, and
 animal broths, is  the best.  But this idea cannot be urged
 too strongly:  The golden opportunity is  during the first
 twenty-four hours when the disease ought to be broken up
 by the sedative.


            SPASMODIC  LARYNGITIS.
   Other names:  false  croup ; spasmodic  croup; child-
 crowing.
   This is an inflammation of the mucous membrane of the
 larynx, attended with a spasmodic contraction of that part
 of the air passage known as the glottis.
   Causes.— The  principal cause is the sudden contraction
 of a violent cold.
   Symptoms.— The paroxysm comes on chiefly in the night,
 and may affect a child that a few hours previous seemed to
 be in a perfect state of health.   The little patient is aroused
 from sleep in an agonizing state of suffocation, has a sharp,
 dry cough, hot fever, face flushed, and general symptoms
 of distress.  Within an hour or so the breathing becomes
easier, the cough moist, and  the child falls to sleep.  On
the following day  the cough is loose and easy, the breathing 
182
SPASMODIC LARYNGITIS.
natural, and the patient seems practically well; but if the
proper treatment is not followed during the day, the par-
oxysm comes  on the second night about the same time,
but usually less  violent.  The child is well  during the fol-
lowing day, and  on  the third night  another very slight
paroxysm occurs, and this is usually the end of the trouble.
  If the first paroxysm does not abate during the day, but
is accompanied  with inflammatory symptoms for two or
three days, there is danger that the true croup may set in.
  Termination.— False croup is almost always favorable in
its termination.
  Treatment.— The  best  thing to break  the paroxysm,
which is always nervous in false croup, is to put the child
in a tub of warm water.   If the paroxysm  does not yield
to the use of the warm bath in fifteen minutes, an emetic
should be given, and at this point arises a question of the
greatest importance in dealing with croup, whether true or
false.  The  false croup always terminates favorably.  The
true croup is always dangerous and should  receive prompt
and radical  treatment from  the first.  Should the false
croup be mistaken for the true, and  treated accordingly,
such treatment might be  unnecessarily severe, but would
not injure the  child.  On the other hand, if the true croup
is mistaken  for  the false, and  so treated, the disease will
get so fully developed before  its  true character is deter-
mined as to greatly endanger the life of the child.  Doctors
frequently make mistakes  by failing to recognize the form
of disease they are dealing with, and of course mothers and
fathers are much more liable  to commit the same error;
therefore it is  always safer to treat every case of croup as
if it were the  worst form of the disease, and  in that way
arrest the inflammatory development,  should it be the true 
SPASMODIC LARYNGITIS.
183
 membranous croup, and save the child.  This can probably
 be done in almost all cases.   Therefore get the following
 mixture put up, keep it  in  the house, and when croup
 shows itself in any child, give a teaspoonful every fifteen
 minutes until vomiting begins: —
               Tartar emetic, eight grains,
               Simple syrup, five ounces,
               Alcohol, one ounce.
   Mix;  dose, a  teaspoonful  every fifteen   minutes  until
 vomiting commences.   After  it once  commences the child
 will  be sick more or less for several hours,  probably most
 of the night, and will vomit every  hour or so.   This is all
 very desirable, as it acts as a  sedative to the heart's action
 and  arrests the croup.  There is usually more or less spas-
 modic croup in connection with the true croup, and this is
 always relieved by the relaxing effect of emetics.
   The folly of  trying to distinguish between the mild and
 grave forms of croup, and  thus taking chances of making
 a  fatal mistake,  ought to be readily apparent to  every
 father and mother, and the treatment herein  given will save
 every child if the directions are carefully followed.  It is
 not claimed that it will save every patient unless it is com-
 menced soon after  the attack.  In croup, as in all other
 inflammatory affections, the  golden opportunity in which
 to arrest the disease is  during the first two  or three hours
 after its commencement.
  Unfortunately,  this time is  often wasted  in hunting for
some particular physician, and by the time he is found, the
opportunity to save the child is past. 
184
DIPHTHERIA.
                   DIPHTHERIA.
  Other names :  malignant quinsy; putrid sore throat.
  This  is an  acute, specific  disease, both epidemic  and
contagious, commencing in the throat, and characterized
by the appearance  of small white patches upon the  ton-
sils which run together, forming  a white membrane  that
gradually  extends to other  parts.  The glands  of  the
throat and corners of the jaw are swollen and sore, there
is  usually a burning fever,  the  temperature sometimes
rising to a  hundred and five  or more.   It is  generally
understood that the grave  character of the disease is in
direct proportion to the height of the fever.
  Causes. — A specific germ that exists in the atmosphere.
  Symptoms. — It may  be  mild and slow in its develop-
ment, the chills or  chilly feeling  being followed by mod-
erate fever, headache, loss of  appetite, soreness about the
angles of the jaw, and slight tenderness of  the throat caused
by swallowing.
  In other cases the disease may come on suddenly with
a severe chill,  followed by intense fever, rapid  swelling of
the glands at the angles of the jaw, great  pain on swallow-
ing, aching of  the limbs, loss of strength,  loss of appetite,
and bowels relaxed.  On examination the throat is found
to be red, the tonsils enlarged and partly  covered with the
white exudation or membrane that always determines the
true  nature  of the disease, as such a membrane is  not
found in other affections.
  Termination. —As the disease is usually treated it is one
of the most dangerous maladies  that afflict children.   It is
an unfortunate thing that the medical profession has never
settled upon a  definite treatment, but, from time  immemo- 
DIPHTHERIA.
I85
rial, has  pursued a  course purely experimental,  always
totally unreliable, and always, in grave cases, void of satis-
factory results.
   Many years ago, the author, who had  had a sad  experi-
ence with diphtheria, set out to  find a remedy that would
break  up the  disease  at  once by killing the  parasites
secreted in the mucous tissues of  the throat, as the throat
has always been the focus of infection.
   As he regarded the disease mainly as a  local affection
in its  commencement, he  naturally thought  any remedy
that would destroy the infecting germs, would prevent the
deplorable and prostrating effects of blood-poison that are
so often fatal.  His first and only selection of a remedy
was carbolic acid, as follows : —
   Pure carbolic acid crystals, melted by heat, one ounce,
   Pure olive oil, three ounces.
   Mix.
   There  must be no water whatever used in dissolving
the acid,  for if there is, the  mixture will be muddy.  It
should be almost exactly the color of olive oil.
   If this remedy is timely and thoroughly used, it will cure
every case of diphtheria, and  as much depends upon the
thorough  way  in which  the work  is done, the following
full and explicit directions are given: Take a stick of the
proper length and about as large as a common lead pencil.
Around this stick, cut a  notch close to  the end.   A half
inch from this, cut another.  Then wrap a piece of white
muslin several  times round the stick, allowing it to  project
three-eighths of an inch beyond the end.  Tie it securely
by two strong threads, one at each  notch.  Pour a little of
the remedy in the bottom of a teacup, dip the  swab into it
until it is well soaked, then rub it carefully on the edge of 
186
DIPHTHERIA.
the cup so it will not be dripping wet.  Next take a  large
tablespoon, holding it right side up, and with the handle
press down the tongue.  The spoon should be pushed well
back, and will almost always make the child "gag."   This
is the golden opportunity for applying the remedy to every
part of the throat, and the work  should  be done in a very
few seconds, turning the mucous membrane of  the throat
as white as  milk.  Even   if these membranes are  only
partially affected at the time, the parasites are there and
must be destroyed.
  The disease never extends to the parts  thus treated,
and  where  the cases  are  taken  in hand during  the first
twenty-four  hours and  treated  in this way, it is rarely
necessary to  repeat the operation or to give other treat-
ment.
  That diphtheria is, practically,  a  local disease  in its com-
mencement, that a local treatment is an absolute necessity,
and  that the  plan of treatment herein given  is the cor-
rect one, the following  is  submitted as  a proof: In  such
epidemics as  were attended with  great mortality under
other methods of treatment, there were absolutely  no
deaths when  this drug was used.  When called to see
cases during the  second day of the attack, it was often
found difficult to save them, but where other cases occurred
in the same  family and the carbolic acid treatment was
used, the child would be about well on the following day.
  From  the  unfailing  success of  this quick,  easy,  and
simple treatment, the author has long since  ceased  to
regard diphtheria as  a dangerous disease, and it  does not
seem that one case  in  a  hundred should be  lost if the
carbolic acid and  sweet oil plan is skilfully carried out.
  In using the swab, care must be taken not  to have it 
DIPHTHERIA.
187
dripping wet with the drug so it will run  down the throat
or spread extensively to the parts not touched.  It is only
necessary to touch the parts affected with the wet swab
in order -to turn them white, and  every parasite secreted
in the membranes thus whitened  is instantly killed.   It
is not possible for any one to see the parts that are being
touched by the swab, as children always struggle, but after
the treatment is over, a glance into the throat will show
exactly what has been done, as the membranes  touched
will be milk-white.   In  a large  number of cases operated
on in  this way  no symptoms of poisoning from  the car-
bolic acid were ever  observed, and yet it is best not to use
too much of the medicine to commence with, knowing that
if the parts  are not sufficiently whitened  at first,  another
application can  be made in two or  three hours.  The best
caution that can be given to prevent the remedy from run-
ning  down the  throat is  this: Get  the swab thoroughly
wet in the solution, then press it against  the  sides of the
teacup until it  ceases to run.  If  it will not  run down
the sides of the teacup when thus pressed it will  not run
down the throat.
  The terribly poisonous  character of this remedy has no
doubt  prevented its  successful employment in diphtheria.
A watery solution would probably be  very dangerous, as
it would be liable  to run  down the gullet, but an  oil mix-
ture, with anything like reasonable care, is  not.   When it
is a well known fact that the focus of infection, or starting
point of the disease, is in the throat, and in ninety-nine
per cent of  the cases within easy reach  of an unfailing
local application, the folly of using antitoxine or any other
blood-poisoning injection, is readily apparent.   As anti-
toxine has been used  quite extensively by hypodermic 
 188          HEMORRHAGE OF THE BRAIN.

 injection to cure diphtheria, and  in  many cases with fatal
 results, it  deserves a passing notice.   With  reference to
 that remedy, if it can  be called a remedy, there is one
 puzzling question  that  confronts us:  Will  the  system of
 any patient tolerate enough poison, when injected into the
 blood, to  destroy  the  parasites  that  caused diphtheria ?
 The attempts that have been made to get a satisfactory
 answer to  this question by injecting antitoxine, have cost
 many children  their lives.  The  injection  of  any remedy
 into the blood is  radically wrong,  because the  parasites
 are located in the throat and can  be easily killed by a drug
 applied locally, that is a thousand times stronger than the
 system would bear if  injected into the blood,  and there is
 no guessing at  results, as every parasite is  destroyed, and
 the disease arrested.  If all cases of diphtheria are treated
 locally  as  recommended above,   and   the  application is
 made as soon as the white patches make their appearance
 in the throat, the use of tonics, such as quinine and  iron,
 with  alcoholic  stimulants to overcome  the  prostrating
 effects of blood-poisoning, will seldom if ever be necessary.
 The early  and thorough employment of  this  treatment
 will prevent its extending to the larynx, or windpipe, and
 causing death from diphtheritic croup.


        HEMORRHAGE OF  THE BRAIN.
  Other names : apoplexy; " a stroke."
  This disease comes  on suddenly from bursting a blood-
vessel in the  brain, and  the escape of blood into the brain
substance,  causing undue pressure upon that part of the
brain at which the hemorrhage occurs, and ultimately more
or  less destruction of  brain tissue.   It is characterized  by 
HEMORRHAGE  OF THE BRAIN.           189
complete  and sudden unconsciousness, irregular and ster-
torous breathing, with absolute relaxation of the muscles.
   Causes. —The disease is almost always confined to those
who have passed the meridian of life, the main cause being
disease of the blood-vessels.   It may also be due to intem-
perance in the use of alcoholic stimulants and also in eating.
Enlargement of the heart, in which the muscular structure
is greatly increased in volume and strength, is not an infre-
quent cause, as the blood is thrown with such force as to
greatly endanger the vessels.  Fright,  intense grief, and
mental anxiety are all important factors in causing a stroke
of apoplexy.
   Symptoms. — Apoplexy usually comes on suddenly, but
not always.   The vessels ruptured are sometimes so very
small that it takes considerable time for enough blood  to
accumulate  to cause the " stroke."  The usual premonitory
symptoms are headache, dizziness, the patient  being more
or less blind,  with numbness  of  the  limbs, and  often a
powerless condition of  some of the muscles.   Vomiting
frequently precedes the "stroke," the breathing immedi-
ately becoming slow and irregular, with a puffing sound.
The cheeks are usually  blown outward at each expiration.
The pulse is slow and full, and the eyes are insensible  to
light.  The  face is flushed, and yet there is  no fever until
several hours after the attack.  The muscular system  is
thoroughly relaxed.
   Sooner  or later  reaction  occurs  as  a  general  thing.
Sometimes  it commences within  an hour, at  others it  is
delayed for  several  hours.  A return of the senses brings
headache, the mind is wandering  and confused, and  one
side of the body is usually paralyzed.
  During  reaction  inflammatory symptoms  may  set  in, 
190          HEMORRHAGE OF THE BRAIN.
attended with a high fever, and the paralyzed muscles may
become rigid.   In such cases there is  frequently severe
shooting pains.
  Termination. — The great gravity in  apoplexy consists
in the fact that one attack predisposes to another, and  if
the first is not fatal a subsequent one is almost sure to be.
  Treatment. — If a stroke is  preceded by premonitory
symptoms, it shows that slow hemorrhage is probably tak-
ing place in the brain, and the best thing  to  be done in
order to relieve the pressure upon the arteries and stop
the hemorrhage is blood-letting.  This should be done in
the old-fashioned way, by  opening a vein in the arm and
drawing off a pint or more of blood.
  During  the  attack the  tendency to hemorrhage of the
brain may be  lessened by  elevating the head, and this
should be done immediately.  The patient  should be  on
his  side with the face inclined a little downward to prevent
the choking effect of the mucus  and saliva,  that might
otherwise accumulate in the throat.   If  when reaction  is
established the pulse should be full and bounding, a seda-
tive to the heart's action should be  given, and the best  is
the tincture veratrum veride as follows : —
         Tincture veratrum veride, one drachm,
         Water, three ounces.
  Mix, and give a teaspoonful every hour until the strong
and bounding  character of the pulse is  lessened or  until
sickness of the stomach occurs.
  If an attack is marked by pallor  of the countenance and
feeble  and irregular pulse, a tablespoonful  of whiskey in
an equal amount of sweetened water may be given every
hour until the  condition commences to improve.  After all
the acute symptoms of an  apoplectic seizure have subsided, 
SICK HEADACHE.
191
iodide  potassium may be given in ten-grain doses three
times a day to cause absorption of the blood clot in the
brain.
  The following is a convenient form for giving it: —
       Iodide potassium, three drachms,
       Simple syrup, nine ounces.
       Mix, and give a tablespoonful three times a day.
  After a month or two  the paralyzed condition may be
favorably affected by giving the solid extract of ignatia
three times a day before meals, the dose ranging from one-
half to a full grain according to the  size of the  patient, a
full grain being intended only for the largest and strongest
men.

                 SICK  HEADACHE.
  Other names;  bilious headache;  blind headache; mi-
graine; hemicrania.
  This is a paroxysmal pain or aching in the head, usually
periodical,  attended  with sickness and vomiting  and a
morbid sensibility of the nervous  system.   The  affection
is aggravated  by sound, disturbed by  strong light  and  ob-
noxious odors.  The smell of  tobacco smoke greatly in-
tensifies the sickness and headache.
  The causes  are largely hereditary, that is, patients inherit
an irritable, nervous disposition that favors the develop-
ment of atonic dyspepsia, and the dyspepsia in  a large
majority of cases causes the  sick headache.  There are a
great many cases of the disease, however, that  are not
traceable to any known cause,  and yet permanently yield
to such a  course of  treatment as cures dyspepsia, even
though the latter does not seem to exist.   There is noth-
ing in the way of diet or habits of living that is so great 
192
SICK HEADACHE.
a factor in causing sick headache as the use of tea  and
coffee, but more especially the latter.  In a large per cent
of the obstinate cases of  sick headache the patients are
excessive coffee drinkers, some of them taking one or two
strong cups three times per day.  Others drink  two cups
at each meal, and the number of persons who can drink
coffee thus intemperately and not be afflicted with frequent
and severe paroxysms of headache, are certainly  very few.
  Symptoms. — The attacks of  this  disease come  on in
irregular paroxysms, each attack seemingly ending in  per-
fect recovery.   The paroxysms usually have warning symp-
toms which are mainly disorders  of digestion.
  The headache may commence with  a feeling of chilliness
followed by nausea and vomiting, or the  chilly feeling may
be entirely absent.  There is often soreness of the muscles
somewhat like  muscular rheumatism, and the patient is
disturbed by strong light, by unusual sounds, or anything
calculated to disturb  in the  least  the  nervous system.
About this time pain of a severe character sets in.  It may
be darting like  neuralgia .or it may be an intense aching
pain over the eyes, in one or both temples, or in the back
of the head.  The pain is usually felt on the left side and
very rarely felt on both sides at once.
  The sickness of the stomach, instead  of preceding the
pain,  as it sometimes does, more frequently commences
with it and accompanies it, the greatest nausea and vomit-
ing being apparent during  the greatest intensity  of the
headache.
  Motion, light, sound, disagreeable odors, and everything
that perturbs the  nervous system, aggravates the suffering.
These attacks, if not cut short by drug treatment, may last
for two or three days. 
SICK HEADACHE.
193
  Termination. — The disease is not only free from danger
to life, but almost all cases, under the  right treatment, can
be permanently cured.
  Treatment. — The first thing to be done is to break up
the paroxysm, which can be  done with  either one of two
remedies.  Sulphate of  morphine given in pill form, sugar
coated, in one-fourth-grain doses every half-hour until the
patient is entirely relieved, is, perhaps, the best, unless that
intense sickness of the stomach, characteristic of morphine,
should make its use undesirable.  If it  is given, however,
as directed, the third pill will rarely if ever  have to be
given.   The  other remedy  is antipyrine, and in severe
cases may be given in twenty-grain doses.  The first dose
will afford within one hour partial relief, but it is usually
necessary to give  the second dose within an  hour and a
half from the first.   This  almost always breaks up  the
paroxysm.


          THE  CURATIVE TREATMENT.

   There is a permanent and almost infallible cure for this
terrible affliction, if the proper remedy is taken for a suf-
ficient length of time, and the advices regarding eating and
drinking carefully followed.  In the first place  coffee, if
used  at all, must be abandoned.  It is better to avoid the
use of stimulants  of every kind; but if something in that
line must be taken, a cup of tea at breakfast may be used
instead of coffee.  Granting that this wonderfully pleasant
beverage, coffee, is to be permanently abandoned, the next
thing is  to select a remedy that will so act upon the nervous
system, and so change it, as to break up the headache habit.
The  remedy is well  known to the author, and  has been
         o 
194
SICK HEADACHE.
successfully employed by  him in these cases for thirty
years.
  It is the solid extract of ignatia amara, given in doses rang-
ing from one-half to a full grain three times per day before
meals.    If a person weighs from a hundred to a hundred
and sixty pounds, a one-half-grain pill is sufficient; if from
one hundred and sixty to two hundred, a three-quarter of
a grain pill must be given.  All persons weighing over two
hundred should take a  one-grain pill.   All  adults, even
though they may weigh less than a  hundred pounds, will
bear a half-grain pill.  Children from eight to fifteen years
old may take a quarter-grain pill, and in those below eight
sick headache rarely if ever occurs.
  It seems that the merits of this remedy are almost wholly
unknown to the medical profession, as the impression gen-
erally prevails that ignatia is about the same as nux vomica,
or its more active principle, strychnine.   The facts are, that
ignatia,  though chemically very similar to nux vomica, has
medical  properties wonderfully superior,  and also vastly
superior to strychnine, and covers a wider range of  nervous
and dyspeptic disorders than any other remedy  known in
medicine.
  When it is given  to cure  sick headache or any other
affection that has existed for many  years, it  must be re-
membered that the primary cause of  the disease has to be
removed, and the habit of its occurrence broken up.  For
this reason, when sick headache has existed for fifteen or
twenty  years it is foolish to suppose that any  treatment
will cure it in a  month  or two.   Therefore  the  remedy
should be given three times a day without a miss for six
months or more,  where it has existed for  many years.
If it is  much more  recent in its origin, that  is, if it has 
CONGESTION OF THE BRAIN.
195
only existed for two or three years, three months will prob-
ably be long enough to continue the drug.


          CONGESTION  OF THE  BRAIN.

   Other names: cerebral congestion; cerebral hyperaemia.
   This is an unnatural fulness of the vessels of the brain.
When the congestion involves the arteries, it is called active
congestion.   When the veins are  mainly involved, it  is
called passive congestion.   The affection is attended with
headache, dizziness, and sometimes convulsions.
   Causes. — In the active form it may result from enlarge-
ment of  the  heart,  causing a flow of too much blood to the
brain, and unduly distending the vessels.
   Excesses in eating lead  to  a fulness of all the  blood-
vessels by creating too  much blood, and in  this way are
liable  to  cause brain congestion.   Alcoholic stimulants,
sunstroke, great anxiety, or severe mental labor, all have a
tendency to cause cerebral congestion.
   Symptoms. — Congestion  of the brain  may  come  on
suddenly or may develop gradually, and the symptoms are
liable  to  be  aggravated by the horizontal or recumbent
position.  It  is characterized by headache,  neuralgic pains,
and derangement in the senses of vision and hearing, ring-
ing in the ears, dizziness, contracted pupils, a  "rattled" or
stupid condition of  the intellect, and weird hallucinations ;
the face is congested, eyes suffused with tears, or there  is
more  or less twitching of the muscles.
  Termination. — This is more or less  unfavorable so far
as perfect recovery is concerned, but the cases that end
fatally are comparatively few.
  Treatment. — In  the active form of the disease the appli- 
196
DYSPEPTIC MELANCHOLY.
cation of cold water to the head in immense quantities, so
as to completely overwhelm the morbid action, is the best
treatment that  can  be adopted, but in the meantime the
head should be  sufficiently elevated to allow the force of
gravity to assist in carrying the blood away from the brain.
In using water  a great deal depends  on  the amount  and
the temperature, and a wash-tub full is not too much as a
general  thing.  A physic of Epsom salts,  to the amount of
two tablespoonfuls, may be given in half  a glass  of water
if the patient can swallow.
  In all cases where the symptoms are  violent and attended
with a strong, full, and frequent pulse,  the following should
be given as directed : —
         Tincture veratrum veride, one drachm,
         Water, two and a half ounces.
  Mix;  dose, a teaspoonful every hour.  Within eight or
ten hours the fever and pulse will probably be greatly re-
duced, preceded by sickness of the stomach and  vomiting.
These changes are  the characteristic  effects of  the drug,
and when the distressing symptoms subside in this way re-
covery is usually rapid; but should the nausea and depres-
sion from the drug be great, a tablespoonful of whiskey in
an equal amount of water may be given to hasten reaction.


           DYSPEPTIC  MELANCHOLY.
  This is one of the  forms in which dyspepsia  manifests
itself.  In such cases the  patient is  called a hypochon-
driac, or a subject of hypochrondia.  He is very much
depressed in spirits, and imagines he has an incurable mal-
ady of some  kind.  The tendency of such  patients is to
brood over their physical infirmities, and  allow themselves 
ANGINA PECTORIS.
197
to be haunted with ideas of cancer of the stomach or some
terrible affection from which there is no escape.  It is hard
to convince them that dyspepsia,  originating in nervous
debility, is the cause of all their misery and painful abstrac-
tions.  Many cases  of insanity are traceable to stomach
derangements, and  in  all such  affections  attended with
profound melancholy, there is a tendency to  suicide.  Mel-
ancholy itself  is a mental derangement, and when it reaches   >
a condition in which  it is incurable,  it is called insanity.
  Termination. —Under prompt and proper treatment this
is almost always  favorable.   It consists  in  giving from  a
half to a full  grain  of the solid  extract of ignatia before
each meal.   If a person weighs from 100 to  160 pounds,
he should take a half-grain pill; if  from  160 to 200, three-
quarters  of a grain  will be the proper dose.  All persons
weighing over 200 pounds, should take a full grain.   In all
cases  the  drug  should be continued  for  three or four
months.  In cases of very long standing  it may be best to
keep up the treatment for six months.
  Under the use of the remedy there is rapid improvement,
which  usually sets in during the first week.   It is unneces-
sary to prescribe  anything else, as the ignatia is worth
more in  such cases than all other drugs in the materia
medica.


                ANGINA  PECTORIS.

  This is a disease in which  there  are sharp pains in the
region of the heart, usually reaching the left shoulder and
arm.
  Causes. — It is often  due  to a hereditary tendency.   It
may also be  associated with  fatty degeneration of  the 
198
ANGINA PECTORIS.
heart and disease of the valves, but its true place is among
nervous disorders.
  It has for its exciting causes in many cases, the exces-
sive use of tobacco and alcoholic stimulants.
  Symptoms. — The attacks occur in paroxysms, are irreg-
ular in character, commence with but little, if any, warning,
and when the patient is seemingly in a state  of  perfect
health.
  A person attacked with it screams out suddenly as one
in a fit of epilepsy; the pain is terrible, with a feeling of
cramp  in the chest, especially in the region of the heart.
  Termination. — It is considered a very grave disease, and
in bad  cases any paroxysm is liable to prove fatal.
  Treatment. — Neuralgia of the heart has heretofore been
thought incurable, but in the last  few years a remedy has
been found that has proven a specific in some of its forms.
This remedy is  the cactus grandiflorus,  or night-bloom-
ing cereus.   It is given  as follows: —
         Tincture cactus grandiflorus, twenty drops,
         Water, twenty  teaspoonfuls.
  Mix, and give a teaspoonful every ten minutes until the
patient is relieved.
  In using this remedy it is best to buy the green tincture.
When  in the course of an inflammatory rheumatic attack,
there is  the  sudden setting  in of a constriction in the
region  of the heart, as  if the  heart were  grasped with a
band of  iron, this remedy is of the greatest  importance,
and almost always acts like a charm.
  As a  preventive of the paroxysms, one drop in a tea-
spoonful of water three  times a  day may be taken for a
week,  and then  suspended if no symptoms  are noted.
The sulphate of morphine in  pills from one-fourth  to  a 
SNAKE-BITE.
199
half  grain, according  to  the  severity of the symptoms,
should be resorted to in case the treatment  directed does
not relieve promptly.


                   SNAKE-BITE.
  It is scarcely necessary to burden the reader with the
symptoms arising from the bite of a rattlesnake or copper-
head, as the man that is bitten by such snakes will know
it; and if he lives very long, will become thoroughly famil-
iar with the symptoms until he passes into a state of un-
consciousness.
  Fortunately, a rattlesnake is never looking for an oppor-
tunity to bite any one, and if unmolested, never " strikes."
Before striking, he gathers himself  into a coil and is then
prepared  to  jump about one-third of his entire  length.
When ready to make the jump and inflict the wound that
is often fatal to the one he bites, he shakes his tail, and the
sound of his " rattles " gives warning of the deadly stroke
he is liable to make;  and even  then, if not  further en-
croached upon,  he may not bite.  He is utterly helpless
when stretched to  his full length, and  for this  reason, it is
hard to get him to strike at a dog.   He seems to know
that the dog will get hold of him before he  can get  back
into his coil so as to defy  the  canine.  The  dog under-
stands the snake just as well as the  snake  does the dog,
and will  never try to get  hold  of him as long as he keeps
in his coil, but will bark, jump toward him in a threatening
way, and  do  everything to tempt the snake to strike  at
him.   Finally the snake gets desperate, jumps at the dog,
but the  latter  always  dodges him,  and before the poor
snake can get himself back in a coil ready to strike again, 
200
SNAKE-BITE.
the dog catches him in the middle and shakes the life out
of him.   Dogs rarely if ever get bitten by a snake.
  The effects of a snake-bite upon a man, depend upon
the location of the bite with reference to blood-vessels.   If
one of the  fangs  enter a vein, the poison passes at once
into the circulation, and death ensues  before there is any
time for remedies.  If the part  bitten is not covered by
clothing, a  great deal  more poison enters the  body than
would if the flesh were  covered by a thin stocking, and
the treatment should be very prompt and thorough.
  Treatment. — The best thing  to be done after a person
is bitten is to touch the wound as soon as possible with the
strongest solution of carbolic acid, as that kills every par-
ticle of the poison that is not already taken into the circu-
lation.  Nitrate of silver, sulphuric acid, or nitric acid may
be used if  the carbolic acid is not  to be had, or the part
bitten may  be touched with a hot iron.
  A great many remedies are popular among people living
in countries infested  with rattlesnakes and copperheads,
and among them may be mentioned the habit of binding a
large piece of warm and bleeding chicken upon the wound.
Another favorite treatment is to put the foot, if that is the
part bitten, into a bucket full of blue mud obtained from the
bottom of a foul and sluggish stream.  They usually keep
the foot in  such mud for hours.  It is scarcely possible for
any  such treatment to be of benefit.  The best remedy
known to antidote the poison of such snakes, is whiskey
or some form of alcohol.   The tendency of persons  bitten
is to pass into a state of fatal stupor, and whiskey is given
with a view of counteracting it.
  It is  foolish  to give it  in  tablespoonful doses, as such
quantities can have but little  effect upon  the poison or the 
COMMON  HEADACHE.
201
 patient.   The writer  remembers one particular case that
 occurred in his practice that will afford some reliable infor-
 mation to the reader.   He was called to see a boy sixteen
 years old that had been bitten by a rattlesnake a half hour
 before his arrival.  The foot was considerably swollen and
 the  patient was in a  condition somewhat alarming,  as the
 symptoms were similar to those of poison from morphine.
 He was  given  a half pint of whiskey immediately.  This
 soon began to  act favorably in overcoming the stupor, and
 was followed in an hour by smaller doses amounting to a
 pint in all, and the boy was practically well by the following
 morning.

               COMMON HEADACHE.
   This is one  of the  most common ailments of humanity,
 as nine out of  ten of the adult population of the civilized
 world have it more or less.
   The predisposing cause is heredity, as the inclination  to
 headaches runs in families.  The exciting causes are dys-
 pepsia, the immoderate use  of tea, coffee, and alcoholic
 stimulants.   Among the exciting causes, coffee, though one
 of the most pleasant drinks known to mortals, holds a front
 rank.
   There  are but few persons who drink coffee  to any
 extent that  are  not  subject  to headache.  Some  of the
 attacks are moderate,  consisting of a dull headache lasting
 for a day or two, while others are so severe that the patient
 is compelled to go to bed.  There are other cases in which
 the headache lasts for a week at  a time but is not severe.
 There  are others in which the  paroxysms occur once per
month, or at wider intervals.  When not accompanied with
sickness of  the stomach, they  are not called " sick  head- 
202
PALPITATION OF THE HEART.
ache," but are known as "common headache," but are all
cured by the treatment  given  in  the  chapter devoted to
"sick headache."
  It is unnecessary to repeat the treatment here, as the
reader can easily turn to " sick headache " and find the
treatment for " common headache."


        PALPITATION  OF  THE  HEART.
  Other names :  irritable heart; fluttering of the heart.
  This is a functional disease of the  heart in which its
beats are so fast that the pulse at the wrist can scarcely be
counted.
  Causes. — A great many causes of  this  affection are
enumerated by authors, but the principal one is undoubt-
edly dyspepsia, as palpitation of the heart always accom-
panies that disease, more or less.
  Symptoms. — As nine-tenths of  all the cases of palpita-.
tion of the heart, and  probably a great  deal  larger per
cent than this, are due to dyspepsia, the  symptoms of the
affection arising from that cause are given, and  are about
as follows :  After eating a very hearty meal or  partaking
of indigestible food, a feeling  of  distress in the stomach
occurs, with more or less difficulty of breathing and general
feeling of discomfort.  About  this time a rapid fluttering
of the heart may set in, the heart beating violently against
the walls of the chest, its pulsations being apparent through
the  patient's clothing;  there  is  frequently shortness  of
breath, dizziness, and an expression  of general anxiety.
These symptoms are not all present in any one case, as the
disorder is greatly modified in its symptoms by the tempera-
ment of the  patient.  Some are unable to lie down, owing 
PALPITATION  OF THE  HEART.
203
 to a  feeling of suffocation that follows.   Others become
 feeble and  tottering  soon after the seizure, and are com-
 pelled to lie down.
   Termination. — So far as life is concerned this is almost
 always favorable, as palpitation of the heart is a functional
 disease as a general thing;  but there are few patients in
 whom habitual palpitation is once fully  established, that
 ever entirely recover from it.
   Treatment. — In this as in all other diseases the most
 important thing to be  done is  to remove, if possible, the
 cause.   Next  to this in  importance is to find a remedy
 that will break up at once the  paroxysms when they oc-
 cur.  As most cases are associated with chronic indiges-
 tion and depending upon it, the treatment must be directed
 to the stomach and  bowels  through the action  of  drugs
 upon the nervous  system.  As  this is essentially a treat-
 ment of atonic dyspepsia, the  reader is referred to the
 chapter on that disease and assured that when the stomach
 and intestinal indigestion are overcome, the  paroxysms of
 palpitation will occur much  less frequently, if  at all.  It
 is well to remember, however,  that in all disorders of  a
 nervous  character,  certain organs acquire certain habits,
 and  when these habits have long continued, they are hard
 to break up.   For  example, epileptic convulsions may
 commence early in life from a certain or specific cause.
 After a great many " fits " have occurred they will probably
 continue, even  though the cause that  originally produced
them has long since ceased to exist.
  The frequent recurrence of palpitation seizures ceases
to be distressing to a patient, provided he has learned some
easy and simple remedy  to  break up the attack.   Such
a remedy was discovered by  the author over thirty years 
204
PALPITATION  OF THE  HEART.
ago, has  been used by him ever since, and rarely fails to
stop the  palpitation in a few minutes.   The manner in
which it was  discovered is as follows: Hiccough, which is
a spasmodic affection, is almost  always controlled by  a
patient taking a full inspiration and holding his breath as
long as possible.  As  the author considered palpitation of
the heart a nervous disorder, he tried the same treatment
with all patients as that used for hiccough.   If the palpita-
tion is of the character that permits patients to lie down,
they should stretch themselves upon a lounge or bed imme-
diately, and after a few minutes quiet  repose, be directed
to fill the lungs as full as possible with air and  hold it for
a half  minute  or  more.  The palpitation usually ceases
within  a  few seconds  after  the lungs  are  completely dis-
tended, and  when  it once  stops it seldom if ever com-
mences again that day or night.  So far as that paroxysm
is concerned, it is completely broken up.  This is a remedy
that never wears out, as the effects  of drugs  do sooner or
later, but is valuable and usually unfailing  during the life
of  the patient.   Should the first effort  at  holding the
breath fail to stop the palpitation, another effort of exactly
the same kind should be made after the lapse of five or
ten minutes.   There is one important point always to be
observed and that is this:  In obstinate cases the shoul-
ders should be thrown back and  every cubic inch of air
sucked into the lungs that they will hold.   Where a fail-
ure occurs in the first effort it is almost always  owing to
a trifling effort at inflating the lungs,  and  next time  a
stronger, deeper, and  fuller  breath  must be taken. 
INFANTILE  COLIC.
205
                INFANTILE COLIC.
  This is one of the most frequent and annoying troubles
of  the human race.    Many babes, although growing
rapidly and seemingly healthy, have green stools more or
less, showing imperfect digestion.   In all cases attended
with green stools there is colic, and this may be so distress-
ing as to keep the infant  crying most of  the  night.  The
parents give it hot teas, peppermint, and  various remedies
to stop the  pain, and, unfortunately, sometimes  give it
paregoric or something of that kind which further inter-
feres with the functions of digestion, binds the bowels, and
increases  the liability to colic.
  Treatment. — This consists in the  first place in giving a
remedy to act on the whole intestinal tract so  as to get rid
of curdled and irritating food, including  the  green stools.
Therefore give the following: —
  Mercurius,  the  first  decimal  trituration,  ten  grains.
Divide  into  five powders and give  one every hour, by
mixing  it  with a little  white sugar  and putting it in the
mouth  in  a dry condition, and washing it down with a
teaspoonful of milk or water.  By the time all  the powders
are given, the stools will be dark and will gradually change
to brown.   After this,  give  the  babe one-twentieth  of a
grain of the solid extract  of  ignatia  three times per  day,
allowing about  six hours between  each dose.  The ex-
tract should be given  in pill  form and continued for two
weeks.   This  treatment prevents further  trouble from
colic, as a general thing. 
206  BLEEDING  FROM THE EXTRACTION OF A TOOTH.

            BLEEDING FROM  A  CUT.
  When an artery is cut that lies close to a bone, it is
unnecessary to tie it, as the bleeding can  be  stopped in  a
minute by pressure, so as to compress the artery against
the bone.  If on the foot,  a half dozen folds of muslin,
making a little firm compress an inch square  or a little
more, should be  placed over  the cut, and of  course  it
must be large enough  to cover it. Then  a bandage  is
passed round the foot, commencing at the toes.   It should
extend to the ankle and bear  firmly upon  the  compress
covering the bleeding vessel.  The bleeding can be stopped
instantly in this way if the  bandage  and  compress are
properly applied.
  If the wounded blood-vessel is  not close to a bone, cot-
ton batting should be dipped in a solution of subsulphate
of iron until it is soaking  wet, and then forced into the
wound and firmly held there with the fingers,  until the
bleeding is stopped or until a doctor arrives to take charge
of the case.

BLEEDING  FROM  THE  EXTRACTION  OF  A
                       TOOTH.
   Many cases  of fatal hemorrhage have  been  reported
within the last quarter  of a century from the extraction  of
teeth.  Many other persons have  experienced  great an-
noyance  from  bleeding that  could  not be arrested for
twenty-four hours or more after parting with a  distressing
toothache through the application of " cold steel."   Either
of the following methods will stop such bleeding in a few
minutes,  if properly used:  If  convenient, examine the 
BLEEDING OF THE NOSE.
207
tooth that has been extracted so as to see the size of the
opening in the jaw.  Then select a vial cork large enough
to fit into this opening, and if  necessary cut off the top of
it, so when it is forced into the jaw it will not project above
the gum quite as much as the teeth do.  Next soak it in a
solution of subsulphate of iron, and crowd it  down  firmly
into the cavity  left  by  removing the tooth.  The hemor-
rhage will  be  arrested in a few minutes, if not instantly,
and the cork may be allowed to remain for several hours.
The other method is equally successful and is as follows :
Take an ordinary hypodermic syringe with a  point almost
at right angles.  Draw into  the syringe  three drops of
solution of subsulphate  of  iron, then  screw the point on.
Wipe the bleeding gum perfectly dry with a small sponge,
and as soon as a fresh drop of blood springs up, push the
hypodermic needle  into the  exact spot from which the
blood started  and inject two  or three drops of the solu-
tion.  It will curdle the blood  instantly and stop the
bleeding.
   The cork, if properly applied, will stop  the bleeding in
almost every case, even if not dipped in the iron solution
at all.   If  no cork of suitable size can be  found, a larger
one may be dressed down with a sharp knife.   A plug of
soft wood, if whittled down  to the  right  size to  fit the
opening in the jaw, will answer.


           BLEEDING  OF  THE  NOSE.

   Another name:  epistaxis.
   There are many persons in whom there is  a peculiar
tendency to hemorrhage,  and in all  such  patients  slight
wounds upon  the body, the  extraction of a  tooth, or  a 
208
BLEEDING OF THE NOSE.
" bump"  on the  nose may cause  an alarming  flow  of
blood.
   Bleeding of the nose may be due to congestion of the
brain, a  condition in which there is  usually a fulness  of
the blood-vessels about the head;  it may arise from en-
largement of the heart, causing blood to  be thrown with
such force as to rupture the small arteries of the nose and
its membranes, or it  may result from disease of the blood-
vessels.
  Termination. — Although many cases of bleeding from
the nose  have ended fatally, all such hemorrhages, if the
proper treatment is employed, can be easily and promptly
arrested.
  Treatment. — When due to  congestion  or  inflammation
of the brain, cold water should be applied  to the head very
freely for fifteen or twenty minutes.   If this does not
succeed in stopping  the bleeding  within  a  half hour, the
following plan must be substituted for the cold water: In
the first place, turn two ounces of  solution of subsulphate
of iron into a teacup.   Then get a half-dozen slender chicken
feathers about three inches long, from  the inner side of a
chicken's wing.  They are not to be  the  quill-feathers  of
the wing, but the small straight ones  that cover the roots
of the main wing-feathers.   The straightest and best ones
should be selected  whether found on the inside or outside
of the wing.
  They should  be tolerably stiff  and firm.   Dip one  of
them  into the solution in  the teacup so as to get all of its
feathers  soaking wet.   Then quickly pass it  into the
nostril that is bleeding, and let an inch of the quill end
stick out.  Dip another into the solution in the same way,
and push it into the nostril as far as it will go, and do it 
SORE LIPS.
209
quickly, or a clot will form so you  cannot pass  it at all.
These feathers are to be pushed in until there is no more
room in the nostril for another feather.  If there  is bleed-
ing from  both  nostrils  at the  same time, both  must be
treated in the same way.  It will arrest the hemorrhage in
a few minutes,  as the writer has been using the treatment
for a quarter of a century and has never known it to fail
in a single case.  After the  feathers are all in and the
bleeding stopped, the ends may be clipped off with scissors
to within a half inch of the nose.
   In a day or two the formation of mucus in the nose will
loosen all the feathers so they can  be easily pulled out.
   This treatment is to be employed  in all cases of bleed-
ing  from the  nose  that fail to  yield  to the  ordinary
remedies.

                     SORE  LIPS.
   This is an affection of the lips with which almost every
one is to some  extent familiar.  Such  sores are generally
known by the very familiar term of  " cold  sores," as they
are supposed to arise  from common " colds."
   In most cases they  do not arise from " colds " at all, but
are due to errors in diet,  or to eating too much rich  food,
such as fat turkey.  The sores as a general thing are first
seen in the morning, and are beneath the mucous mem-
brane of the lip in little lumps sometimes as large as a
pea or soup bean.  If allowed to break out, they  become
sore and distressing,  disfiguring  the mouth for  about a
week.  Some very pretty ladies  are  frequently ruined for
a week or two at  a  time by such  unsightly sores  upon
their lips.
  Treatment. — The  free application  of alcohol to the
        p 
2IO
CRAMP COLIC.
inflamed  lips as soon  as  the  sores begin to make their
appearance,  and repeated four or five times during the
day and twice during the night, will  always dry up the
inflamed part and prevent breaking  out.  This  treatment
seems to be absolutely sure if carefully  carried out, and
therefore it is not necessary for any  one, understanding
the treatment, to  suffer from raw, inflamed,  and bleeding
lips.   When the swelling is  first observed, the alcohol
must be freely applied, and it ought to be repeated about
every two hours during the day.  If  no alcohol is in the
house,  spirits of camphor may be used instead.


                  CRAMP COLIC.
  This is an  affection that comes  on periodically, as a
general thing, and yet the paroxysms are not always regu-
lar in returning.  Some persons may have the attacks a
dozen times per  year, while others may not have more
than half that many in the same length of time.
  Symptoms. — Sometimes the violent paroxysms of cramp
colic are preceded by warning symptoms,  such as tran-
sient pains  in  the bowels, or  a distressed  feeling after
meals,  attended frequently with headache.  Such symp-
toms often precede the regular attack a few days. Fre-
quently, however, cramp  colic breaks out  in  the  night
without any warning whatever, and is usually brought on
in such cases by eating too much or partaking of some-
thing very hard to digest.
  The pain  is severe to commence  with, and rapidly in-
creases until the cramp or spasm of the abdominal mus-
cles sets in.   Then there is a terrible feeling of constriction
as if the stomach and bowels were being squeezed by some 
CRAMP COLIC.
211
powerful force, the patient screams  and groans and great
drops of perspiration  stand upon the face.   As  a  rule,
there is  no amount of heat in the form  of  poultices or
towels dipped in hot water, that will assuage the terrible
pain, and it is always  best to resort to other  and quicker
means for relief.
  Treatment. — The  treatment consists,  first,  in  giving
something  for  immediate  relief, and  second, to put the
patient upon a regular course of  treatment that will pre-
vent the return of the paroxysms.  For immediate relief
there is nothing  so good as a full dose of morphine, and
in almost all cases it is better to  give from a quarter to a
half grain  at a single  dose.  If the patient  is large and
strong, whether male or female, a half-grain dose of  mor-
phine  will  not be too  much.  There  is nothing counter-
acts the effect of morphine so thoroughly as pain, — the
terribly excruciating pain of cramp  colic, — and the cases
that do not require a half-grain of the drug  are few.  It
is frequently necessary, even when a half-grain is given,
to follow it with  another dose within  an hour.
  After  complete relief is afforded by  the  remedy, the
paroxysm may be considered  broken  up.  The  next and
most important thing  to  do,  is to give such  remedies as
will  prevent the return of the disease.   Happily for all
sufferers from  this terrible affliction, there is a treatment
given in another  part of this  book that seems to be  abso-
lutely sure to cure it, as the author  has never known it to
fail.   The  remedy is the extract  of ignatia, and must be
given just as directed in the treatment of " atonic dyspep-
sia," to which the reader is referred.
  The drug should be  taken for several months. 
212
GOITRE.
                      GOITRE.
  Other names:  " thick neck " ;  bronchocele.
  The name by  which  this disease is most  frequently
known, is "thick neck," and consists of an enlargement
of the thyroid gland.  The tumor appears upon the throat
just below the prominence known as "Adam's apple," and
may be moderate  in  size so as to attract but little if any
attention, or may  be very large so as to cause  serious de-
formity.  It is usually slow in its development, and is much
more common in females than males.
  Treatment. — This consists in the  prompt and  regular
application of the tincture of iodine to  every part of the
enlarged gland.  The  drug thus applied has a powerful
effect upon the tumor, and will  almost always cause its
absorption within  a few weeks if commenced soon after it
makes its appearance.
  If the enlarged gland is neglected  for  several years,
during which it is allowed to develop  into an unsightly
tumor, it is liable to become hardened or cartilaginous,
and  consequently  incurable.  After it has  passed into a
cartilaginous state, iodine will not affect it, and it can be
removed only by  the surgeon's knife.  All glandular en-
largements,  this one included,  can be  favorably affected
with the tincture of iodine, if not entirely  overcome, pro-
vided they  are treated when they are comparatively small.
Then they  are soft and easily  removed  by absorption.
  As soon as a goitre makes its appearance,  it must be
painted  twice per day with  tincture of iodine, covering
every part  of the enlargement  and extending  a little be-
yond it in every direction.  After it is applied  for two or
three days in this way, the cuticle will peel  off.   Then the 
ULCERATIVE SORE THROAT.
213
application  should be discontinued  for four or five  days
and  commenced  again.   Meanwhile, iodide  potassium
should be given every day as follows: —
             Iodide potassium, one-half ounce,
             Simple syrup, one pint.
  Mix, and  take a tablespoonful three times per day be-
fore meals.


          ULCERATIVE SORE  THROAT.
  This is an affection  characterized by an  ulcer, usually
upon one of the tonsils  or the soft  palate, and  unless due
to syphilis or consumption, is generally acute, and does not
extend to the air passages so as to seriously affect the voice.
  Treatment. — All such ulcers occurring in strong, healthy
persons can be  cured in forty-eight hours or less time, as
follows:   Place in the  bottom of a teacup  the strongest
possible solution of carbolic acid.   Such a solution will only
contain five per cent of water.   Then  take a soft  swab
and  carefully clean  the  ulcer,  but do not make  it bleed.
After this is done, dip the rounded  end of a common lead
pencil into  the  solution  of carbolic  acid, and with it touch
every part of the ulcer so as to turn it perfectly white.   The
solution  should  only wet the  end  of  the pencil that  is
rounded  off with a knife  especially for the purpose, and
then there will be but little danger of  burning the tongue
or any other part of  the mouth.   If this is properly done
the ulcer will heal in a day or  two.  The  second applica-
tion  of the  remedy is rarely necessary.   Ulcers occurring
on other parts of the body, if not due to syphilis, can be
healed in the same way,  as a general thing.   In  cases of
scrofula there is a low state of vitality as a rule, with  a dis- 
214
CHRONIC NASAL  CATARRH.
position of all ulcers to spread; in such cases the carbolic
acid does  more harm than  good.   All ulcers found about
the eyes must be let "beautifully  alone"  until an oculist
or experienced physician can attend to them.


              ENLARGED  TONSILS.
   This  disease usually commences in childhood, and is
mainly due to a succession of "colds" and a chronic sore
throat.  In such cases the tonsils sometimes become so large
as to make breathing more or less  difficult.   For many
years the writer adopted the popular plan of removing a por-
tion of such tonsils with the tonsilotome or a suitable knife.
   Treatment. — In almost  all cases the  absorption of en-
larged tonsils  can  be effected by rubbing them once per
day with  a crystal of sulphate of  copper, which is usually
known by the name of "blue vitriol."  The crystal can  be
dressed, notched  like the flint of  an  Indian's  arrow, and
tied in the end of a split stick, so there is no danger of  its
falling out in the throat while being used.   The treatment
in this way should be kept  up for three months, as it only
takes a minute every morning.   Sometimes a crystal  of
alum acts equally well.


           CHRONIC NASAL  CATARRH.
   Other names: catarrh;  chronic coryza.
   This  is a  chronic  inflammation affecting the mucous
membrane of all the passages of the nose, usually causing
chronic swelling of these membranes and an increased flow
of mucus.  It may be attended with an  impaired  sense of
smell and partial  loss of hearing. 
CHRONIC NASAL CATARRH.
215
   Causes. — It is mostly due to frequent attacks  of  the
 acute variety.  It is also caused by irritating drug powders
 and vapors.   Syphilis is among the frequent  and persis-
 tent causes of the affection.
   Symptoms.—The most marked symptom is  an increase
 in the amount of mucus discharged from the nostrils.  As
 the  disease  develops, the mucus gradually increases in
 quantity, and running down into the  throat causes frequent
 paroxysms of "hawking," especially in the morning.
   The senses of smell and hearing are liable to  be both im-
 paired, the former by an inflamed condition  of the mem-
 brane in which the sense of smell resides, and the latter by
 closing tubes connected with the internal ear.
   Any changes calculated to cause a common cold, precipi-
 tates an acute attack.  The inflammation often involves the
 tear duct, so as to close it  in one or both  eyes.  In such
 case  the lachrymal secretion,  commonly  called " tears,"
 overflows, and the patient seems to be in a state  of constant
 weeping.  This is  greatly aggravated by the chilly winds
 of winter.
   Termination. — If properly treated and the treatment
 continued for a sufficient length of time, the great majority
 of cases  ought to be permanently cured.
   Treatment. — The author  takes the  position, and  his
 opinion is based on extensive experience, that nasal catarrh
 is almost always a constitutional disease,  and cannot be
 cured  nor permanently  benefited  by  a local remedy.
 Therefore the rational course to pursue is to find out what
 the disease is, as the trouble in the nose passages is not the
 disease at all, but simply the  local expression of a constitu-
tional affection.   It is doubtful if the irritating influences
that develop  common catarrh would  ever bring on that so- 
2l6
CHRONIC NASAL CATARRH.
 called disease if  it were  not  for  coexisting scrofula  or
 some other form  of  blood contamination;  therefore, the
 treatment must be from the first, general and constitutional
 instead of local, as the latter at  best is only palliative.  If a
 sore or ulcer exist on any part of the body and will not heal
 of itself, or by proper treatment locally, it is evident that
 the trouble is constitutional.  The  same theory applies to
 catarrh, as it is rarely cured by sprays, douches, and snuffs.
  The following, if given  for a sufficient length  of time,
 will cure almost all cases: —
         Iodide of potassium, two drachms,
         Compound syrup  of stillingia, one pint.
  Mix, and give  a dessert-spoonful three  times a  day.
 When this  remedy is given for  four or five days, all the
 catarrhal  symptoms  are aggravated, the flow  from  the
 nostrils is increased, the tenderness of  the  membranes is
 greater, and there is usually sneezing, as if the patient had
 taken cold.  In such  cases, it is best to leave the remedy
 off for a couple  of days and then give it  in teaspoonful
 doses.   It will probably increase the difficulty, even in the
 reduced dose, but not to any great extent.  The fact that
 it does aggravate  the symptoms proves that it is the proper
 remedy, and  affords  strong hope  that it will ultimately
 cure.   After it is given for a number of  weeks in tea-
 spoonful doses, it will cease to aggravate the affection by
the system becoming accustomed to the drug.  Then it may
be gradually increased to a  half tablespoonful, or a dessert-
spoonful, which is the same thing, and continued for six
months.   This remedy  sometimes causes   a little  sore
throat  when taken for a long time or in  too  large doses.
When it does this, it should be left off for four or five days.
When  it is given  for a long time in small doses,  as above 
             ACUTE  ARTICULAR RHEUMATISM.         217

 recommended, it is a sovereign balm for chronic catarrh;
 but, unfortunately, the great majority of patients will leave
 it off after a few weeks,  saying  " It made me worse."
 Special attention  is called  to  this feature of the remedy :
 It always aggravates the case, and this is  the greatest proof
 that it will finally cure.  As local treatments of every kind,
 given with a hope  of  cure, are a  useless waste of time,
 none are recommended except the following, which seems
 to be the simplest and one of the  very  best:  Snuff rich
 milk up the nose a half-dozen times a day.   It accomplishes
 a great deal in relieving  the irritated membranes, as  the
 milk on  evaporating leaves  a thin, protecting film  that
 shields the inflamed surfaces from the air.  It is important
 to remember that  deafness, resulting from existing catarrh,
 is greatly relieved, if not entirely cured, when the catarrhal
 inflammation permanently subsides  under this treatment.
 As the deafness is usually caused by swelling of tubes in
 the throat that connect with each ear, the iodide potassium
 is strongly indicated to stimulate absorption and get rid of
 the swelling.


      ACUTE  ARTICULAR  RHEUMATISM.

  Other names :  inflammatory rheumatism ;  rheumatic
 fever.
  This is an acute constitutional disease, attended by inflam-
 mation around the joints, and commences with fever,  the
 latter being high or moderate, according to the character
and extent of the inflammation.
  Causes. — The predisposing causes are largely hereditary.
The exciting causes are exposures to wet and cold.
  Symptoms. — The disease  usually begins abruptly with 
218
ACUTE ARTICULAR RHEUMATISM.
a chill, or chilliness, swelling and stiffness of the  joints,
intense pain, loss of appetite, and a hot fever, the tempera-
ture reaching sometimes the extreme limit of inflammatory
affections, or  one  hundred  and  ten.   The  pulse  is not
correspondingly rapid,  seldom reaching one  hundred per
minute in adults.  The urine has a sour smell, character-
istic of rheumatism, and the bowels are constipated.  The
fever  continues  throughout  the attack, subject  to  remis-
sions.  As there is no possible chance for mistake in recog-
nizing this disease after a person has once seen a case of
rheumatism, it is unnecessary to give all the symptoms.
  Termination.— The mortality  is very low,  as there are
only three or  four deaths in a hundred cases, and those
are usually due to heart affections.
  Treatment.— Twenty years ago this was considered an
incurable  disease, so far as remedies  were  concerned, but
was regarded self-limited, running its course in six or eight
weeks.  A knowledge of these facts caused an  eminent
physician to give an amusing but painfully unsatisfactory
answer to one  of his patients.  The patient said, " Doctor,
what  is the  surest  cure  for  rheumatism ?"   The  doctor
answered, " Six weeks."   The  idea became so thoroughly
engrafted in the minds of physicians that the term of six
weeks was necessary for the cure of rheumatism, that years
and years went by, during which but little effort was made
to find a new remedy for the most distressing affection that
afflicts mankind, and to-day there are  thousands of doctors
who believe that the " do-nothing " treatment is as good as
any.
  The author has had  an extensive experience with acute
inflammatory rheumatism, and radically dissents from this
view of the case, believing that there is a drug treatment, 
ACUTE ARTICULAR RHEUMATISM.         219
when properly conjoined with hygienic measures, that is
almost infallible  in  the severest  and  most acute cases.
The drug treatment to be hereafter given depends for its
success upon other things that  are  almost as necessary
as the drug itself.   If the patient has all the symptoms of
the most violent  form of rheumatism, he must be put in
bed, between heavy blankets, whether it is winter or sum-
mer, and made uncomfortably hot by  a  superabundance of
bedclothing.   The object of this is to  encourage copious
perspiration,  and this should  be further promoted by all
the cold water the patient can drink.  If he can drink a
pint every hour it  is all the better.  In addition to  this,
give the following  as directed: —
              Salicylate of soda, two  drachms,
              Water, four ounces.
   Mix, and give a teaspoonful  every half hour for twelve
hours, after which give  it every hour  until it is all given.
This is for adults, and if required for children must be re-
duced accordingly.  In the great majority of cases the
pain,  fever,  and swelling  will rapidly decline, and  the
disease is often brought under absolute subjection within
twenty-four  hours.  To  assist this  treatment,  however,
remedies must he given to act on the  kidneys, and carry
out of the blood  those  salts that  are supposed to be the
main cause of rheumatism.
   For this purpose the  following  is  probably the  best
remedy that can be given : —
             Sweet spirits of nitre, two  ounces,
             Acetate of potash, one-half ounce,
             Water,
             Simple syrup, of  each, one ounce.
   Mix, and give a teaspoonful every three hours. 
220
ACUTE ARTICULAR RHEUMATISM.
  If the bowels are bound, they should be moved freely
with the following: —
              Epsom salts, two ounces,
              Cream of tartar, two ounces.
  Mix thoroughly, and give a heaping tablespoonful in a
glass of water.   This  dose may be  repeated in ten  or
twelve  hours, the object  being to  get watery discharges
from the bowels.
  In the  practice of medicine  total  failures  often  occur
from the  neglect of little things, of things seemingly un-
important, and this is why salicylate of soda, as it is usually
given, often does but little good.  Instead of  giving it in
divided  doses every half hour, it is  usually given in heroic
doses every three or four hours.  In this way  an unneces-
sary drug effect is obtained when only a drug effect upon
the  blood is desirable.   When given  every  four hours,
fifteen grains is the usual dose.  When given every half
hour as herein directed, the dose  is  about four grains,
which means thirty-two  grains in four hours, or about twice
as much per hour as would be given by large doses.   The
remedy is not  given to act on any special organ, but to
sweeten and change the  character of  the blood that  is
always  sour in rheumatism.   While this is being done with
a chemical, the poison  in  the  blood  is largely diluted  by
copious draughts of cold water.  The patient is covered
up with blankets, and is practically in the hot room of a
Turkish bath-house.   In this way,  every one of the sweat
glands — and there are  millions of them — is stimulated to
its utmost, and  water pours out through every inch of skin.
Meanwhile  the kidneys are  carrying off water, and  in
twenty-four hours the watery portion of the blood is almost
entirely changed.  Salicylate  of soda is frequently given 
MUSCULAR  RHEUMATISM.
221
to patients  that are out in the  open  air and trying to
attend to business.   It is practically worthless when given
in this way.
   When patients have had one attack of rheumatism, they
are liable to another, and should always keep their bodies
warm with heavy flannels from head to foot.


            MUSCULAR  RHEUMATISM.
   This disease has a number of other names, according
to the part of the body in which it is located.
   Torticollis is a form of the disease affecting the muscles
of the neck, and signifies a wry neck, or stiff neck.   It is
usually  on  one side, and  the head is  always  inclined
towards  the  affected side.  In such  cases an attempt to
turn the head or straighten the neck is attended with great
pain.
   Cephalodynia is a name given  to a form of the disease
affecting the frontal muscles and back muscles of the head.
In this form  the muscles of the  eyes may be affected so
that movements of those organs will excite great pain.
   Pleurodynia is the form of muscular rheumatism involv-
ing the thoracic muscles, or the muscles of the chest,  and
is often mistaken for pleurisy, or  neuralgia of that region.
   Lumbago, which is also called  lumbodynia, is a form of
the disease attacking the muscles of the lower part of the
back.  This is by far the most common form of muscular
rheumatism, and probably the most distressing.
  Termination. — This is always  favorable so far as life is
concerned, as it is unattended with  heart  affection  and
never results fatally.
  Treatment. — In all inflammatory affections, rest is  one 
222
MUSCULAR RHEUMATISM.
of the most important features of the treatment, as motion
causes pain,  and whatever  causes pain  increases the in-
flammatory condition.
   Muscular rheumatism is one of the most obstinate diffi-
culties that ever confronts  a physician.   As in all  other
diseases that  are incurable by a drug treatment, a multipli-
city of remedies are given in the text books for this.
   The author has gone  through the  entire list time and
again, and is compelled to acknowledge he has never found
a  remedy  that  exercised any  curative  effect upon the
disease.  It is considered unnecessary to give a list of the
drugs usually employed in the various forms of muscular
rheumatism, as  they all seem to be worthless.   Within
recent years, however, the bromide of  lithium has come to
the front as a sovereign balm in the affection.  It is claimed
on very  high authority  to  be a specific.  It is  given in
twenty-grain doses, four or five times in twenty-four hours,
and in extreme cases, the dose may be increased to thirty
grains.   Each  dose  should be  given in a half  glass of
water.
   So  far as the old remedies are concerned, the  hygienic
treatment is  twenty times better than  all of them. As
lumbago is the worst and most frequent form, the  treat-
ment  aside from the use of drugs is carefully given, and
consists in  wearing a heavy  flannel pad around the entire
body, extending from  the  middle of  the  back to the
lower part of the spine.  This excludes  the air from the
surface and favors rapid  recovery.  As persons who  have
had this trouble once are very liable to have it again, it  is
best to wear the flannel  all the  time in  cold weather.  If
woollen irritates the skin too much, canton flannel may be
used in its place. 
JAUNDICE.
223
                     JAUNDICE.
   Other names: catarrh of  the  bile  ducts;  catarrhal
jaundice.
   This is an acute inflammation of the mucous membrane
of  the  bile  ducts,  and  also of  that  part  of the small
intestines called the  duodenum.  It is  attended  with
derangement of  the stomach  and bowels,  the  skin  is
yellow, itches terribly, and there is mild fever.
   Causes. — Excessive eating is the most frequent cause.
Malarial influences also develop the affection, but in such
cases  it is  very chronic, or  much  less  abrupt in  its
commencement.
   Symptoms. — It begins with distress at the pit of the
stomach,  the  tongue  is coated, appetite  usually  lost,
sickness of the stomach, and  sometimes vomiting.  The
bowels are  generally loose, and  there is mild fever.   In
four or five  days the eyes become yellow, and a jaundiced
condition spreads over the whole body. The skin becomes
dry and itches continually; the bowels are bound, stools
usually very light in color, showing the  absence of bile,
there are pains in  the bowels as if  from colic, and the
urine is unusually dark.
  Termination. — This is almost always favorable.
  Treatment. — The patient should  rest quietly in bed or
in an easy-chair, and be put upon a generous and unirri-
tating diet.    The inflammatory condition  of the small
intestine is best met by small doses of mercury, given as
follows: Mercurius  dulcis,  the first  decimal trituration,
twenty-five  grains.   Divide into five  powders, and  give
one powder every  hour, placing each  powder  on  the
tongue  in a  dry state,  and giving a swallow of water to 
224
ACUTE NASAL CATARRH.
wash it down.  As the powders work off, the  stools will
change from a light clay color  to a  dark brown, finally
becoming natural.   The drug acts both on the bowels and
the liver, and usually  places the patient  on the road to
recovery; but the kidneys must be stimulated in order to
get rid of the bile with  which the blood is heavily loaded,
and  which  is causing  the  intense  itching, and  which,
sooner or later,  must  give  rise  to bilious sores over the
body.  The best remedy for this purpose is  the fol-
lowing : —-
            Sweet spirits of nitre, two ounces,
            Acetate of potash, a half ounce,
            Water, two ounces.
  Mix,  and  give  a teaspoonful  every  three  hours in
sweetened water.
  Under this treatment, the  urine will become very highly
colored,  and the yellow will fade rapidly from the eyes
and skin.

            ACUTE  NASAL  CATARRH.
  Other names : " cold in the head ; " acute coryza.
  This is an acute inflammation of all the membranes of
the nose and those directly connected with the  cavities of
that organ, and is attended with fever, more or less distress
in the  head, and a discharge of watery mucus from the
nostrils.
  Causes. — Changes in the direction and temperature of
the air are the most common causes.   Sitting in a draught
of air,  whether it is particularly cold  or not, is a frequent
cause.   Exposing the feet to cold and wet, or a changing
from warm  apartments to cold ones, often brings on an
attack  of "cold  in the head."  Irritating vapors and the 
ACUTE NASAL CATARRH.
225
 dust of certain drugs  produce all the symptoms of com-
 mon cold.    The most noted one of these is turpentine.
 Where it is  used  in inside  painting, its vapor affects the
 membranes lining the cavities of the nose in such a way
 as to produce all the  symptoms  of  a violent  cold.   Pow-
 dered  ipecac acts  as an irritant to these membranes, and
 affects some druggists  so they cannot handle it at all.
  The pollen, or fecundating dust of certain flowers acts
 as an irritant upon those who are peculiarly susceptible to
 it, affecting the membranes of the nose and eyes, produ-
 cing all the head symptoms belonging to a common cold;
 but  the attack is  much more protracted,  and is usually
 called  "hay fever."
  Symptoms.—A "cold in the head"  is  often preceded
 by  a dull,  heavy feeling, with headache  over the  eyes,
 chilly sensations, and a tendency to sneeze.   This  is speed-
 ily followed by a flow  of watery  mucus from the nostrils,
 dripping in such a way as to render the constant use of
 the handkerchief necessary.  The membranes of  the nose
 are red and  inflamed,  and  sooner or later the discharge
 changes from a watery mucus to  a mixture of mucus and
 pus.  In five or six days, however,  recovery  sets in, and
 the patient is well within eight or ten days.
  Termination. — This is favorable if properly treated from
 the commencement, but if neglected may drift into chronic
 catarrh.
  Treatment. — When  this trouble arises from atmospheric
 changes, it may be broken up by eight  grains of  quinine,
 combined with  twelve  grains of Dover's powder,  given at
 one dose.   This is for an adult and not for  a child.
  When the attack is fully developed, great relief may be
obtained by giving the  following: —
        Q 
226
GIN LIVER.
           Tincture of belladonna, ten drops,
           Water, twenty teaspoonfuls.
  Mix, and give  a teaspoonful every hour for six hours,
then give the same dose every two hours  for six hours.
If there  is considerable  fever, give  the following at  the
same  time, allowing  the doses to fall between  those of
the belladonna: —
           Tincture of aconite, twelve drops,
           Water, twelve teaspoonfuls.
  Mix, and give a teaspoonful every hour until six  doses
are given, then leave it off for three hours, and if the fever
is not overcome give  a teaspoonful every hour until all is
given.  This dose is for adults.


                     GIN LIVER.

  This is a chronic inflammation of  the liver, with  hard-
ening of  its substance and shrinking away of its secreting
cells.  There is a catarrhal  irritation of the stomach and
bowels, great loss of flesh, and finally abdominal dropsy.
  Causes. — It is almost wholly due  to  the prolonged use
of alcohol in some form, or,  in other  words, to intoxicating
liquors.
  Symptoms. — In the  early stage  of the disease,  the
symptoms  are  not strongly  defined,  but when a constant
irritation of the stomach and  bowels is attended with fre-
quent attacks of jaundice, and the patient  is an intemper-
ate man,  it is safe to infer that he has a " gin liver."  As
hardening of the  liver offers an obstruction to the circula-
tion in the organ, the blood is checked in returning from
the lower part of  the  body to  the right side of the  heart,
giving rise to abdominal  dropsy, and causing enlargement 
GOUT.
227
of all the veins below the heart, and especially those about
the anus, and when  these latter are very large the condi-
tion is known as piles.  The affection is further character-
ized by dyspepsia, pain  in the bowels, hemorrhages from
the stomach or bowels, due to engorgement of the veins.
   Termination. — This is always unfavorable, and a man
generally  dies within a  year from the  time  the dropsy
makes its appearance.
   Treatment. — As the disease is always due to a perma-
nently hardened  condition of the  liver,  attended with a
withered or shrunken state of the secreting cells, there is
no remedy that can  exercise  any curative power whatever
upon the malady, and to attempt to accomplish anything
except temporary relief  of  the  patient's sufferings,  is a
useless waste of time.


                        GOUT.
   This is  a constitutional affection, the tendency to  the
disease usually being inherited, and is attended with  par-
oxysms of severe pain and swelling of one of the smaller
joints, frequently that of the "big toe."  There are often
deposits of the urate of soda  in the joints of the fingers.
   Causes. — The  predisposing causes are inherited.
   The exciting causes  are  intemperance  in  eating  and
drinking.   Cold weather may also be an exciting cause.
   Symptoms. — The disease occurs in paroxysms, a period
of one year  usually intervening between the first  and sec-
ond attacks.   The second and third attacks are liable to be
within six months of each other.   After this they may come
very close together.
   Each attack is preceded two or three days with symptoms 
228
GOUT.
of indigestion.   The  paroxysm  almost always  begins  in
the night with severe pain in the big toe  which rapidly
becomes inflamed and tender.
  The foot, ankle, and  leg become greatly swollen.   The
attack may be preceded by a chill, fever, rapid pulse, thirst,
and  all other symptoms attending an acute inflammation.
By morning the severe symptoms subside to come on again
about sundown, the disease gradually falling off in inten-
sity until the fifth or sixth day when recovery is established.
  In  the chronic form of the disease the symptoms are all
less  severe than in the acute, and the  deposits  of chalk-
stones are seen about  the joints.
  Termination. — This is almost always favorable as far as
life is concerned, but  the malady is liable  to return unless
the greatest care in reference to diet and the use  of liquors
is observed.
  Treatment. — The best remedy for the acute form is the
following: —
             Salicylate  of soda, two drachms,
             Water, four ounces.
  Mix,  and  give  a  teaspoonful every  hour, meanwhile
keeping the patient covered up with blankets.
  This should be continued for twenty-four hours and  may
be expected  to relieve greatly the  inflammation.   The
pain may be controlled by the use of morphine in quarter-
grain doses every hour until the patient is reasonably com-
fortable.   A rich meat diet should be avoided and milk and
soups used instead.
  In  the chronic form of the disease, iodide of potassium
is the best remedy  and may be given as follows: —
             Iodide potassium, three drachms,
             Water, eight ounces,
             Simple syrup, four ounces. 
HEREDITY AND HEREDITARY  INFLUENCES.
   Mix; dose, a dessert-spoonful four times a day.
   In chronic gout the diet is of the utmost importance and
 should  consist, mainly, of fruits and  vegetables.   Stimu-
 lants of every kind, including  tea and coffee, should  be
 dropped; pastry of  every kind  and eggs in every form  do
 harm.  Heavy flannel underclothing in cold weather is of
 the utmost importance.

 HEREDITY AND HEREDITARY INFLUENCES.
   This is  a  subject that  every  one  knows  something
 about, but  that  very few  know  much of.  It has been
 a current quotation for many generations  that the sins  of
 the fathers were visited upon the children to the third and
 fourth generations, but  the book out of which the quota-
 tion is  taken does not say  much  if anything about the
 effect of the sins of the mothers on  the  offspring.   In
 fact, the mothers did not amount to much  in the literature,
 nor in the religion,  of the day  in which  the language is
 supposed to  have been written.   The discussion of hered-
 ity belongs to social science, and should have  a  place  in
 the schools beside arithmetic, geography, history, philoso-
 phy, and physiology. The exclusion  of it from the com-
 mon  schools and  colleges, literary, medical, and religious,
 necessarily impresses the  educated and the cultivated,  as
 well as the ignorant, that  it is of no great importance and
 is not a factor  in human education.   Authorities  pretty
 well agree, now,  that physical  derangements and mental
 alienations are more commonly inherited from the mother
 than from the male  parent.  Especially is this so in the
diseases of  the mind.  Insanity and the suicidal impulse
are oftener communicated from the mother to the child,
and oftener to the daughter than to the son.   We notice 
230     HEREDITY  AND HEREDITARY INFLUENCES.

the following distinction  is observable between  man and
the other animals in the matter of the transmission  of
physical qualities.   In the former,  the  general  structure
of the body, the height, the degree of development of the
bones and  the muscles, the tendency to obesity,  leanness,
etc., seem to depend as frequently on one parent  as on the
other;  but in the dog, horse, and many other animals, the
male  ancestor more  frequently determines  the general
form,  size,  and strength  of  the  body.  It requires  but
small effort of the mind to determine why the more ancient
tribes of man placed so great estimate on, and gave  such
precedence to, the  position of the man in the business of
life over that of  the female.   In the near  approach to
crude and  animal  conditions  of the race, the size, form,
bony  and muscular  strength, were  far  more frequently
communicated to the child by the father.   These were the
most  important and dominant features of the individual
when  bodily strength was at  a great premium, and when
war with the  wild beasts, with the elements,  and  with
savage man constituted most of the exciting scenes of the
times.   It is a sad  reflection that so  many mothers become
mentally alienated.  They are compelled, with their refined
and delicate nervous systems, to bear the strain of nursing
and the care of the house affairs, often under poverty and
privation, of which the world in its pomp and learning
knows nothing.
   A French report,  and  they are an average  nation,
perhaps, says, that out of 467 cases of insanity, 279 were
traceable to the mothers.  It is still more lamentable that,
where  there is a taint of alienation in  the  mind of the
mother, the daughters are much more liable  to  affections
of the kind than the sons. 
        HEREDITY AND HEREDITARY INFLUENCES.    231

  Whilst the father in the more primitive races imparted,
quite uniformly, the  physical qualities, so did the mother
give to the child  the  refining  influences of  the  delicate
temperament, with the spiritual and the love of the beauti-
ful  more and more unfolded, as the race of  man spread
over the earth.   Thus  did  man become the  subduer, and
woman the educator, of the world.  Woman's refined and
delicate temperament  predisposes to insanity.  This will
not be the case when the race is more advanced, and when
better  and more suitable modes and conditions of life are
provided for her.   It  is truly distressing  that mothers
are so liable to transfer insanity to their daughters, who
are the prospective  mothers of what it is hoped will be a
better  society than  the present.  But the  disposition to
disease of  the nervous matter is manifested in  various
forms  and in different  members of the family.   It may be
insanity in  one member of the family, and  epilepsy in
another, and mere eccentricity in another, and they may
all be traceable to nervous affections in the mother.
  It is the  usual  custom of all the civilized  countries for
persons who come  to  maturity to take upon themselves
the burdens of  married life without any thorough investi-
gation of the family history in reference to  physical and
mental affections  of the  person of their  choice, and  in
case there  appears insanity, epilepsy, or idiocy, as a rule
they pay little, if any,  attention to it.   It is admitted to be
true that, in the new  family thus started, there may be a
number of children  born, and  no serious  deviation from
health ever crop out to call the attention of the parents
to the  carelessness of  their youth.   But then, again, from
physical inharmony in the father and mother, or from
some local  situations or misfortunes, aggravating or excit- 
232     HEREDITY AND  HEREDITARY INFLUENCES.

ing an inherited tendency, there may be a number of the
offsprings of  the union hopelessly diseased  in mind or
body, or in both.  All diseased tendencies  are inherited.
If one man lives in a swamp and does not contract ague,
whilst another beside him does, and  shakes himself to
death, it is not because the unfortunate one inherited the
ague from his  father or  his mother, but it was on account
of his not inheriting the same amount of vitality that his
neighbor did, other things being equal.  Should one man
take a cold and cough a week or two,  and then get well,
and another contract a catarrh  at the same time of, seem-
ingly, no greater severity, and in the same house and under
all the conditions and circumstances, and  yet, should he
continue to cough for months, and at last the doctor should
decide that he had bronchitis or consumption, what would
you say of such a case ?  You would  say that there was,
presumably, greater  hereditary tendency in the latter than
in the former case, to lung disease.
  We make  this general proposition: All diseases may
and can be shunned and avoided  in offspring by proper
precautions in  marriage, and in the  habits of life.
  If the rule will hold good  in  one  case it will hold in all.
Some persons  are so fraught in their  lives with harmoni-
ously distributed vitality,  that  they will  not contract the
contagious diseases.   If we should resort to the law of the
survival of the fittest, in marriage,  it might be decried as
cruel, yet it would not seem more  heartless than to  per-
petuate, for thousands  of generations, the diseases  that
have  crept into the  veins, arteries,  bones, nerves, and  the
brain of the present fabric  of society,  and  threaten  to
shake the human temple to  its  foundations.  There is
nothing more relentless than  perverted  nature,  nothing 
        HEREDITY AND HEREDITARY INFLUENCES.     233

in the shape of an enemy to happiness, more uncompro-
mising and awful, than the arrested processes of the pure
springs and currents of the life and  soul.  There is no
happiness greater than that of the  healthy and temperate
father, clasping his son or daughter in  his arms, and bless-
ing each with a father's love.  There is no  person on earth
more happy than he, unless it should be the  mother with
the warm and the rose-tinted cheek, surrounded by comfort
and possessing a true  and a loving husband, bestowing a
mother's love upon her sons and her  daughters to whom
she has given the pure  currents of life, and  the thrill of
an electric brain.  It was once said that there was  silence
in heaven on a certain occasion, for a  brief space of time.
Might not the angels in the cloisters of  the skies have
laid down  their  implements  of  praise,  and  ceased their
songs to gaze on a sight like this ?

       THE INFLUENCE OF HEREDITY ON LONGEVITY.
   It is not disputed that long life  is  inheritable.  On the
other hand, all seem to admit, with one accord, that great
age in  ancestors is  a  guarantee, more or  less, to the de-
scendants, of a long life.  In this  matter, however, many
would-be students of nature have  only the  most general
idea of how to proceed to gain information in any particu-
lar case, as to his lease of life, his  power to resist disease.
A keen discretion in  prognosis, an  ability  to weigh the
vital powers at the time  of  a crucial test, at the climax of
a term of illness, or at  other times, is no mean qualification
in a nurse or a physician.   In writing a  book to  be the
close companion of the fireside, the home, and the nursery,
one should not withhold the key that  unlocks the  door to
the chamber of the secret forces, and  reveals the natal 
234     HEREDITY AND  HEREDITARY INFLUENCES.

and ante-natal sworded angel, to use a metaphor, standing
guard to  perpetuate  the life of  the  patient.   The life
faculty  is  plainly shown in  a certain  location  on the
cranium, or the skull, one inch above and  perpendicular
to the  large  prominence immediately back of the  ear.
The degree  of prominence  in  this  locality  invariably
marks the power of  endurance, the ability to resist dis-
ease, and the strength, of tendency to longevity, or length
of the life.   Children who recover from long  and severe
illness will, in almost  all cases and instances, be found to
measure wide between these two points described as being
one inch above the prominence immediately back of the
ears.  If the head is narrow instead of wide here,  there is
less probability of  long life and of recovery from  disease,
and this will be in proportion to the depression and lack
of development.  A person with a small head, say a man
with a  six and a  half  hat,  might appear  narrow, but  if
discrimination were used it  might be  easily determined
whether or not there  was fulness or  depression.  If you
examine the  heads of persons  of from sixty  to  seventy
years of   age, and,  especially  if they  are strong  and
sprightly,   you will  find this  department  of  the  brain
rounded out, full,  and,  sometimes, projecting into almost
a sharp protuberance.   In running back in the ancestry
of such persons you  will always  find that a  number of
the family have lived  to  a great age, but it is  not always
the case that it is the  immediate ancestors, but may be the
grandfather or the grandmother, on one side; where the
grandparents  on both sides are long-lived  there  will be
a greater  number of  the descendants  having this faculty
well outgrown. 
        HEREDITY AND  HEREDITARY INFLUENCES.     235

          MENTAL CHARACTERISTICS.
  If this pronounced tendency to the inheritance of traits
in the physical character is an absolute and incontroverti-
ble  fact, which is easy of proof and  demonstration, the
same may be looked for  in mental  characteristics.  And
when we consider that this wonderful truth is established,
beyond the  possibility of a reasonable doubt, it then be-
comes a duty to study the details of its operation upon the
present and the  future generations, and to diligently in-
quire into the uses that we, as individuals,  might make of
the  knowledge of it in hastening the answering of the
petition of the prophet:  " Lord, I  beseech thee, show me
thy glory."  Our race has come  up from crude conditions,
through great tribulation.   They have sought for the lamp
of Aladdin, and in their sleep they have dreamed of Pan-
doras, yet in their visions they have  too seldom  sighted
" the true and the living way "  that is to  guide mankind
in struggling up the  steeps of time, that the gates of the
ineffable may be  opened to him, and that he may be able
to help this old world ever grow  brighter.
  There is this difference between the vitative faculty, and
what is termed the vital temperament: The vital tempera-
ment gives bounding of the blood  and vigorous digestion,
roundness of the limbs, and fulness  of the cheeks; whilst
the vitative  faculty may or may not be marked by these,
yet is always connected with  tenacity of life.   In the vital
temperament, the powers of  the mind and the body may
be  vivacious until middle life,  or some later,  and then
rapidly fail, whereas, in the case of the  high prominence
of the head in the location of the  organ, there is likely to
be a gradual growing and strengthening of the body and 
236     HEREDITY AND HEREDITARY INFLUENCES.

of the mind, also,  until a late period in the individual's
years.

 INTELLECT  AND   SPIRITUALITY  INHERI-
                       TABLE.

  Spirituality and intellect are inherited.  They are gifts
that  descend from parents to child,  and when liberally
bestowed, and   practically  outgrown, are  conducive  to
health, long life, and  happiness.
  Spirituality, as marked in the physical  organ,  is located
on the top of the head, but toward the sides, and  separated
by another organ, and is half-way between the edge of the
hair  in front and the  crown in  the back, and, when well
developed, gives broadness to the head in that region, from
side  to side.   The intellectual embraces all that part  of
the head that is called the forehead.
  Man and other animals find  their  associates, employ-
ments, activities, and pleasures, in their respective spheres
of existence.   It is hardly conceivable to one who is not
endowed with literary tastes and abilities, how another can
find pleasure in such gifts and pursuits.   It is mortifying
to read a splendid poem to a friend or a neighbor, and have
him  ask  you for a chew of tobacco instead of offering
a compliment on your manner of reading it, or of noticing
some remarkable beauty in the verse.   It is likewise very
difficult, if  not impossible, for  one who  is narrow in the
region of the head designated as occupied by the spiritual
sphere of the mind, to  understand the uses and  pleasures
of this higher and acuter sense of the  soul of man.   It is
well  known that there are those who complain that divine
providence has neglected to dispense  to them the favored 
        HEREDITY AND HEREDITARY INFLUENCES.    237

gifts,  and  they  have been  heard to  remark  that  it was
strange that they could not be the possessors of such grand
and noble talents.   Parental love weeps over a  child that is
a monstrosity in form, or a failure in brain development, or
diseased in a hopeless manner.  So does a true humanitarian
grieve to behold so many of our race deprived of the gifts
that make life sublime, and thrill the hearts of  men with
song and music, and cause the canvas to  speak to the living
eyes,  and the stone to utter words of praise to the infinite.
  There is no manner  of use to state facts and print them
in books, if they  are  not practised.  If  you  look  in  the
mirror and go your way and forget what manner of man
you are, you have not profited by the performance.  When
we make the declaration, — the clear and positive statement,
—that the spiritual function of the mind, the faculty that
determines the probable length of life on the  earth, by its
greater or less development, the intellectual powers, and,
indeed, all the  instincts, appetites, and inclinations,  are
inherited, even the disposition to burn, murder, and  poison,
the generality of the people of the age  may be poorly pre-
pared to receive it.
  In  view of this state of things existing among a large
class  of the population  of  the  earth, many of  the most
delightful, and the most practical truths  find  their way to
the understanding of men in much the same fashion as the
light  of the day reaches the inhabitants of the deep valley
by  struggling over the mountain peaks.   Therefore,  we
are not  writing for those who cannot  or will not  reason,
except in the sense of trying to entice them into the path
of unprejudiced  thoughtfulness.   We only mention these
Godlike proclivities of the human creature,  the intellectual
and the spiritual, as qualities of descent from an  earthly 
238    HEREDITY AND HEREDITARY INFLUENCES.

parentage, to show  their connection with  the  health and
the physical life in their  broader stages, and not to refer
to them in a religious sense.


EFFECTS  OF  EMOTIONS  OF  THE MIND OF
        THE  MOTHER ON  THE CHILD.
  Argument is not necessary to establish  the  fact that
violent and  excessive excitement  of the  mother's mind
sometimes proves disastrous to the unborn infant in pro-
ducing "marks," deformities, idiocy, epilepsy, etc.  We
remember once being acquainted with a family  in which
there were four idiots of different ages, some two years,
running down from the first to the second, etc.  None of
them could articulate, and all walked backwards on the
hands and the heels.  It was all  caused by  the mother
witnessing the  fall of a  man who was stunned to uncon-
sciousness and afterwards crazed,  by a  fall.   Another
case which seemed certain  of this kind  of origin in an
otherwise healthy family, was that  of a  young man  of
rather fine business  talent and good mind, generally, who
had epilepsy from the effect of the mother seeing a rat die
with convulsions from strychnine poisoning. Many slight
marks which point back to some taste or fancy of the mother
before the birth of her child are somewhat amusing, but are
no less confirmatory of the principle in question.
  These  and many  other instances that  might be cited
prove that through the  soul and  the life  of  the mother
pass the  influences which are to become  as the  brush  of
the artist and paint  the character of the  individual.  But
whilst the fact is easily discoverable when it takes a physi-
cal turn,  it requires more thought and attentive reasoning 
        HEREDITY  AND HEREDITARY INFLUENCES.    239

from cause to effect when it comes to matters of the mind.
It has been sufficiently demonstrated  to  clear away all
doubt, that the mother, if favorably situated and so desires,
may incubate her child to be a poet or a mathematician, or
both.   If  she exercises  her mind on these  or any  other
subjects in a systematic way in the time of her pregnancy,
she  may  safely calculate  on  results.   A  certain  lady
decided in her mind that she would like to have her  child,
who she imagined  would be a son, a poet.
  The child  was born in  due time  and  the mother was
disappointed  in it  not being a  male child, but she was  a
rhymer all the same, and attained distinction in her  writ-
ings.   The mother had read the standard poets, and had
made some efforts  herself  in the direction of verse during
the time of her term.  We well know a family in the West
who illustrates this feature of descent in a rather  remark-
able way.   The young mother was  absent from her hus-
band and was lonely; she would go  out in the wild,  deep
woods and gaze on nature in her  crude but bright and
grand glories, and  would draw pictures  and designs in the
sand  on the shores of a stream, and would make sketches
on the rocks.   And often in these haunts of hers she would
sing  the rural ballads  she had learned.  The  daughter
early in her life took to  landscape painting and trying to
write verse, and went wild, almost, over music.  We knew
a family in which there were two sons,  all the children of
the marriage.   The mother  informed us  that  in the time
of the uterine life of the first she loved and worshipped the
husband, but with  the younger she  did not  love  him but
hated him because she had  found that  he was false to her
and was not worthy of her love.  When the younger son
was born he was diseased and hated  his father as soon as 
 24O    HEREDITY AND HEREDITARY INFLUENCES.

 he was old enough to do so.   The mother of the Pomeroy
 boy hated her husband and used to want to kill him when
 he was butchering the animals.  The boy was a  murderer
 at  eight years old, and is in prison at the age of thirty or
 more on one of the islands near Boston.   Napoleon Bona-
. parte was the greatest expression  of military genius that
 ever lived.  His mother accompanied her husband  out  on
 to the field, and witnessed the progress of battles previous
 to his birth.   Among his first boyish performances was the
 arranging of  mock men in lines of battle, and  deploying
 them so as to take military advantages.   Beethoven was a
 great musical composer.  It is said  of him that he received
 his wonderful talent from parental and maternal emotions.
 He composed sonatas at the  age of thirteen, and in his
 last years, though deaf, he gave to the world specimens of
 musical art that can  never die.
   But it is not so much to have produced the prodigies of
 genius nor the muscular marvels, that we urge attention to
 these great and living and practical truths, but more to fix
 upon the mind that the best  inheritance one can leave is
 an ennobled and purified posterity.   It is to urge the plea
 of abstinence from the use of  stimulants and all  excesses,
 even that intoxication  of the mind  that is often connected
 with business, going on from  one degree of strain to an-
 other until the life is sapped and all  source of happiness is
 crushed out.
   We urge attention to these matters, again, because the
 men and the women of the present  are the  custodians of
 the happiness of  their successors  in the oncoming ages
 of the world.   Though your forms may sleep in the dust,
 blest in memory or not, according as you have lived, they
 will think through your brains and act through the physi- 
CONGESTION OF THE KIDNEYS.          241
cal machinery of your  lives.   Do not  be sick.  Do not
hand down to your sons and daughters shattered constitu-
tions  and  poor  vitality.  Seek the  best and  the  surest
means of restoring health and preserving it, and remember
that " common sense " is a splendid hygienic guide.
        CONGESTION OF THE  KIDNEYS.

  Other names :  catarrhal nephritis ; renal hyperaemia.
  Congestion  of any organ always signifies an increased
amount of blood  in the blood-vessels of that organ.   If
the arteries are distended, as they sometimes are in con-
gestion of the kidneys, the affection is  termed an active
congestion of  the  kidneys.   If  the  veins  only are dis-
tended, it is called a passive congestion.   Congestion  of
the kidneys,  whether active or  passive,  is  attended with
pain and a frequent desire to  urinate, the  urine  being
scanty, high colored, and sometimes bloody.
  Causes. — The active form may arise from exposure  to
cold, or from  taking irritating drugs,  either  by the mouth
or by  inhalation.  One of the worst of  all drugs in this
respect is turpentine, and for this reason  many  persons
cannot sit in  a newly painted room  in  which turpentine
has been used without experiencing great irritation of the
kidneys.
  Passive congestion  of the kidneys  may be due  to dis-
eases of the  heart, lungs, or liver, or to the condition  of
pregnancy.
  Symptoms. — In the active form there is  pain over the
kidneys,  the bladder is irritable,  with a continued desire  to
pass water, while the quantity is small and of course high
        R 
242
DIABETES  INSIPIDUS.
colored.  There is a slight fever, headache, more or less
sickness of the stomach, and sometimes vomiting.
  Termination. — Usually favorable if properly treated.
  Treatment. — In  dealing  with all  diseases, the  most
important thing to  be done is to remove the cause.   If
the cause  of this disease  is  irritating drugs, the  urine
should be diluted by drinking large  quantities  of water  so
as to weaken the effects of the drug and stop its irritation.
  The remedy that seems most applicable to both forms
of the affection  is digitalis, which  may be  given in ten-
drop  doses of the tincture, four or five times in twenty-
four hours.
  The pain is best controlled by sulphate of morphine  in
one-fourth  grain doses, two or three times in twenty-four
hours.

              DIABETES  INSIPIDUS.
  Other names: polyuria;  polydipsia.
  This is a disease characterized by the  passage of large
quantities of urine, without sugar or albumen.
  Causes. — More or less hereditary.  A disease of  child-
hood or  young persons, chiefly, and more liable to  occur
in men  than  in women.  May be caused by  drinking
freely of cold water, or from chronic debility.
  Symptoms. — There are two  principal symptoms that
characterize this disease, and when  always present  are
sufficient, in the  absence of sugar  in the urine, to  deter-
mine its  character.  The first  is  great and  continued
thirst.  The second  is  the  habitual  discharge  of  an
immense amount of  urine, in which no  sugar is found.
Either attending the large flow of urine or  preceding it,
is a general derangement of the nervous system, attended 
DIABETES  MELLITUS.
243
with  headache,  irritability   of   temper,   and  loss   of
memory.
  Termination. — In reference to a radical cure, the result
is not very favorable.   If, however, the disease is due  to
syphilis or some other affection that  is curable, the dia-
betes will disappear on removal of the  cause producing  it.
  Treatment. — If syphilis is  the  cause, iodide potassium
should be given  in small doses for a long time, as follows:
        Iodide potassium, two drachms,
        Water and simple syrup, each a half pint.
        Mix; dose, a teaspoonful three times a day.
  After  it is  given  for a few months, the dose may be
gradually reduced to a teaspoonful.   At the  same time
the following  may be given : —
        Corrosive sublimate, six grains,
        Water, one pint.
        Mix; dose, a teaspoonful night and morning.
  This may be given during the whole  time that the iodide
of potassium is being taken.

              DIABETES  MELLITUS.

  This is a chronic disease in which grape sugar is present
in the urine, with a profuse urinary discharge, and a con-
stant tendency to fall away in flesh and strength.
  Causes.—The tendency to  the  disease is often heredi-
tary, it is most frequent in males, and  occurs at all  times
of life,  but  mostly between thirty and fifty years.  It is
also due to diseases of the nervous system, involving the
liver and kidneys.   Starchy  food  and liquors are also
exciting causes.
  Symptoms. — Urination is much oftener than in health, 
244
DIABETES  MELLITUS.
and the amount of water passed  is increased, while there
is pain in the region of the kidneys.
   The amount of urine passed in twenty-four  hours may
range from a half  gallon  to three or four gallons.  The
amount of sugar in the  urine is very great, and if  a little
of it is spread on a piece of paper in the summer time, it
will attract the  flies as readily as if it were table syrup.
Another easy way to get an idea  of  the amount of sugar
contained in a sample of urine is  to  pour some  of  it in a
broad, flat dish, cover it over with netting to keep the flies
out, and allow it to evaporate in  the sun  and air.  When
the water is all  gone a thick  syrup or dry sugar will be
found on the bottom of the dish.
   Sugar in the urine causes itching and burning along the
urethra  and at  the  neck  of the  bladder.   In females it
causes itching of the external sexual  organs.
   One of the most notable  symptoms of diabetes is a thirst
that nothing will allay.   The most frequent group of symp-
toms are  those  of dyspepsia.   The  bowels are generally
constipated, and the stools are light colored.   The pro-
gressive  loss of flesh is the most frequent and alarming
symptom.
   Termination. — This is  decidedly unfavorable so far as
a cure is concerned,  and in the great majority of  cases a
fatal termination is reached within a  few years.
   Treatment. — In the line of drugs nothing has ever been
found to  exercise a curative influence  upon the disease.
In  other words, no  drugs  are  known that will cure dia-
betes, and therefore the treatment is  almost wholly  one of
diet.  As the morbid conditions consist of an  abundance
of sugar in the urine, all articles of food calculated  to pro-
duce sugar must be left off, and these include sugar itself, 
GALL STONES.                  245
 and all fruits and other  articles of food containing sugar,
 and all starchy articles,  such as bread, potatoes, peas, rice,
 beans, oatmeal, cracked wheat, and corn.   The diet must
 be almost wholly animal food.
   Tea, coffee, and milk may be used  at the table without
 sugar.
   A drug treatment  of  any kind  can do but little if any
 good,  except to  relieve symptoms.   Where the  nervous
 disorder is of a character to prevent sleep,  and  this is fre-
 quently the  case, sulphonal is probably the best remedy,
 and ten  grains,  either  in tablet  or  powder, given every
 night  at  bedtime, may be sufficient for months to secure
 for  the  patient  refreshing sleep.  In time, however, the
 dose will have to be increased  to fifteen grains, and finally,
 thirty  or forty grains may  have to be given, but such cases
 are rare.

                   GALL STONES.
   Other names:  hepatic  colic;  hepatic  calculi;  biliary
 calculi.
   This affection  consists of biliary deposits, either in the
 gall-bladder  or  bile-ducts.   Whenever  one of these de-
 posits  or gall stones passes into  the  duct leading to the
 bowels, the walls of that duct are stretched and sometimes
 lacerated, causing in  either case great pain, which  is com-
 monly called bilious colic.
   Symptoms. — Hepatic colic commences with  the  first
 attempt  of a gall stone to pass along the bile-duct, and
 therefore as soon as the stone leaves  the gall-bladder the
 colic, with all its  agonizing pain, begins, the seat of the
gall-bladder being the focus of distress.  The muscles  of
the abdomen are  sore, there is sickness of the stomach and 
246
ACUTE BRIGHT'S  DISEASE.
vomiting, pulse feeble, skin pale.  The paroxysm may con-
tinue  for several  days, remissions of the distress  usually
occurring, the pain finally ceasing when the stone reaches
the bowel.  When the stone reaches the intestines, all the
distressing symptoms suddenly subside and the jaundice
begins to fade.
  Termination. — This is usually favorable, but if the stone
is too large to pass  through the bile-duct and enter the
bowel, an abscess must be  formed in the duct, allowing
the stone  to  escape  into the abdominal  cavity outside of
the bowel, causing fatal inflammation.
  Treatment.—As the  pain attending  the passage of a
gall stone is one of the very severest that afflict mankind,
the dose of any remedy calculated  to relieve  such pain
must be very large, and therefore a half  grain of the sul-
phate of morphine may be given at one dose, and repeated
when necessary.
  The application of heat by the use of  cloths dipped in
hot water, if placed  over the liver,  may  do a great deal
of good in relaxing the gall-duct and allowing the stone to
pass.


           ACUTE  BRIGHT'S  DISEASE.
  Another  name:  inflammation of the tubes  of the
kidneys.
  This  is an acute  inflammatory affection of  the lining
membrane of  the tubes of the kidneys, and is attended by
fever, high-colored urine, more  or less  turbid or  muddy,
and nervous  derangement  due to uremic  poison, or to
retention  in the blood of uric acid  and other salts that
should be carried off by the urine. 
ACUTE BRIGHT'S DISEASE.
247
  Causes.—The disease is most common in young persons
and is frequently caused  by scarlet fever, diphtheria, and
other diseases peculiar to childhood.   It is also  caused by
the continued use of irritating drugs, especially turpentine.
  Symptoms. — Dropsical conditions coming on  slowly, at-
tended with general pallor, shortness of breath,  and weak-
ness, are the symptoms characterizing a mild case of this
affection, but it generally commences more abruptly and of
course with symptoms more severe, such as fever,  sickness
of the stomach and vomiting, and  pain over the region of
the kidneys.  There is usually diarrhoea, and also an urging
desire to urinate; pulse quick, strong, and full.   Sooner or
later dropsy  develops, when all the features are  swollen,
the dropsical condition soon being apparent over the en-
tire body.   Blood  poisoning  frequently occurs from  the
suppression of the urine.
  Termination. — This is usually favorable, and under
prompt and effective treatment recovery may be expected
in from  two  to four weeks.  A  retention of the salts of
the urine to  the  extent of producing  that stupor or coma
characteristic of  blood poisoning  from this  cause,  adds
greatly to the gravity in all  cases.
   Treatment. — The  patient should be kept as  quiet  as
possible; everything calculated to irritate  or disturb the
nervous  system should be  avoided.   As the affection  is
really an inflammatory one, the force and frequency of the
heart's action should be modified by the use of  a sedative
as early  in the disease as possible.   The best is probably
the tincture of veratrum  veride, and  may be given in two-
drop  doses to an adult, every hour for eight hours, unless
it causes sickness and vomiting.   In  that case it must be
stopped, and a little whiskey or brandy given to  stop the 
248                   THE URINE.
 sickness.   Whether  sickness  occurs or not  after  eight
 doses  are given, it is best to leave it off for a few hours
 and then give it in one-drop doses every hour.
   To avoid the irritating effects of the natural salts of the
 urine,  these salts should  be largely diluted with water so
 as to make the amount of water sufficient to take the irri-
 tating  edge off of the salts and at the same  time assist in
 washing them  out  of the body and  preventing blood
 poison.  If symptoms of  such poison manifest themselves
 by the appearance of stupor, the  remedies must be given
 at once to act on the kidneys, and the following is one of
 the best: —
       Sweet spirits of nitre, two ounces,
       Acetate of potash,  a half an ounce,
       Water and simple syrup,  of each an ounce.
       Mix, and  give a teaspoonful every three hours.
  The bowels may be kept in an  easy, open condition by
 giving  the following: —
              Epsom salts, two ounces,
              Cream of tartar, two ounces.
  Mix  thoroughly, and give a heaping teaspoonful at bed-
 time.
  The  diet should be nutritious  and  unirritating, milk and
 animal broths being the best.   Stimulants of  every  kind
 should  be avoided, including tea and  coffee.


                    THE URINE.
  As the urine is always affected as regards color, quan-
tity,  and other properties by diseases of any  kind  that
materially affect a person, the  appearance of the urine as
well  as its weight and  quantity often becomes an index, 
THE URINE.                  249
pointing to some well-known disease.  Aware  of  the in-
formation that the various changes of the urine afford re-
garding  diseases of the body, it becomes very important
to know the  characteristics of the urine in a state  of  per-
fect health.  The color of healthy urine  is a light  amber,
or about the color of very weak tea.   This color is due to
the various  salts that  the urine  holds in solution,  most
of them contributing, more  or less,  to deepen the color.
Now  if  a tablespoonful of coffee is steeped in a gill of
water the color will be nearly black and  the coffee very
strong.   If  the same amount be steeped in a quart of
water the color will  be very light and the coffee corre-
spondingly weak.  The same conditions regulate and gov-
ern, in a great  measure, the color and weight of the urine.
For example:  If the urine is scanty or small in quantity,
it  is  practically sure  to  be high colored, as  a  certain
amount of coloring matter must pass from the body every
day.  If the quantity of the urine is very large the color
must  be light  and the  weight  but  little  above  water.
Therefore any disease  that reduces the quantity of urine
passed in a  day will correspondingly increase the color.
In all fevers  the urine is scanty and of course high colored,
and these two symptoms, "scanty and high colored," al-
ways  go together in giving the symptoms of fever, when
as a matter  of  fact the quantity  of  urine passed  almost
always regulates the color.  Of  course there are  certain
drugs or certain articles of food that increase the color of
the urine and impart to it an odor  characteristic  of the
drug or food taken. 
250
EPILEPSY.
                     EPILEPSY.
  This is a disease of a chronic, periodic  character, at-
tended with violent spasmodic contraction of the muscles
and a sudden and total loss of consciousness.
  Causes. —The most frequent of all causes in epilepsy is
heredity, as more  than  half the cases are traceable to
hereditary influence.  Excepting in those cases depending
upon heredity, it is almost impossible to determine with any
degree of accuracy the cause of epileptic convulsions.
  Symptoms. — In  almost all cases  of epilepsy the attack
is preceded by warning or premonitory symptoms.  These
sometimes commence a day or so before the epileptic seiz-
ure, and consist mainly of melancholy or a distressed state
of mind.  In other cases the warning is very short,  not
being sufficiently long for the  patient to find  a  place of
safety.
  As  the attack commences  the patient falls, giving utter-
ance to  a scream  that is characteristic of the affection.
There is absolute loss of consciousness, the face is pale, and
the muscles of the body intensely  rigid.  Soon this rigidity
gives way to a convulsive action of the  muscles that may
last for five or ten minutes and sometimes longer.  As  the
convulsion ceases a profound sleep sets in, which often lasts
two or  three hours.  For some  time  after awaking,  the
patient is in a thoroughly bewildered state of mind.   After
the soreness caused by the violent action of the muscles
subsides, and  the  nervous system drops  into  its normal
channel, the patient  is much more comfortable, is in a
quieter  and  happier mood, and intellectually brighter than
for some time before the attack.
  Treatment. — It  is  probable that the  most important 
EPILEPSY.
251
factor in the treatment  of  epilepsy is the selection and
maintenance of  a suitable  diet.   It  is the opinion of the
author — and his experience warrants the opinion—that
meats of every  kind should be abandoned, and the diet
with the exception of milk and butter,  should consist of
fruits and vegetables.  This theory has been  extensively
advocated, and patients have been told to use as little meats
as possible.   They usually interpret  such advice to mean,
that when they are real meat hungry they can have a good-
sized  piece  of  steak, chicken, or turkey, and with such
interpretation they generally get about as much meat as
other persons.  If meat is allowed at all it is scarcely worth
while to try  to limit its use,  and the only rational plan is to
prohibit  it  absolutely.   Extensive  experience with vege-
tarians who have lived for years  and years without any
animal food at all, enduring in the meanwhile the severest
physical labor, has shown that a meat diet for the purpose
of sustaining a  strong and vigorous body is unnecessary,
and that people are just as strong, physically and mentally,
who live on  fruits and vegetables as  those who eat meats.
For this reason there is nothing to be  lost to the epileptic
by forever giving up a meat diet, except the mere pleasure
of eating animal food.
  Under a fruit and vegetable regime  the blood-vessels of
the body are not quite so full, the brain and nervous energy
are less intense perhaps, and all the  conditions  favoring an
outbreak of  epilepsy are modified in  their force.  There is
no doubt but such a dietetic course,  if adopted sufficiently
early in life, will cure a great  many  cases of epilepsy, but
however efficient such a course  may be,  it should be con-
joined  with  a proper drug  treatment in order to break  up
the epileptic habit. 
252
EPILEPSY.
   A  multiplicity  of  remedies  have been suggested  to
either modify or postpone the attack, and  bromide potas-
sium  has been given for years at a time for this purpose,
the amount being from thirty to fifty grains per  day for
weeks.   The drug simply acts as a check-rein  to the  ner-
vous system and exercises no favorable influence upon the
disease, except while it is being given, and yet when  it is
used in connection with a fruit and vegetable diet, it  may
exercise a curative effect by postponing  the paroxysm suf-
ficiently long to break up the epileptic habit.  A far better
remedy,  however,  and one that covers a wider range of
cases, is valerianate of zinc.
   The best way to give it is in pill form commencing  with
one-grain doses.   As to how often it should be given and
when, much depends upon the violence and frequency of
the attacks, and what time during the  twenty-four hours
they generally occur.  If they are frequent and severe it
should be given in grain  doses three  times per day, and in
extreme cases the dose may be increased to a grain and a
half.  If the convulsions only occur about once per month
a one-grain pill night and morning, conjoined with a fruit
and vegetable diet, may postpone them for  a long time, or
entirely prevent their occurrence.
   In a great many cases  the spasms come  on in the night
and never occur  in  the  daytime.   In  dealing  with  this
form of  disease  a one-grain pill given  at  bedtime some-
times postpones an attack for a year or two, even though
no attention is given to the patient's diet.
  Where the convulsions always occur at night, where the
patient is under twenty years of age, and where the whole
number of spasms  do not exceed one or two hundred, the
fruit and vegetable diet and valerianate  of zinc at bedtime 
NEURALGIA.
253
will often  effect a cure.  The highest authorities agree
that where any patient has had five hundred  spasms, the
epileptic habit is so thoroughly fixed upon him  as to render
any treatment, so  far as effecting  a cure is concerned,
hopeless.

                    NEURALGIA.
   This is  a  disease affecting the nervous system and  is
attended with sharp,  darting pains  along the course  of
sensory nerves.
   Causes. — It may arise from heredity, malarial affections,
exposures  to  wet and cold, from  mental exertion, fright,
intense anxiety, or from an injury to an important nerve.
It is customary to name the disease according  to the  parts
affected, as for example: When the neuralgic affection is
confined to the face with sharp, darting pains either above
or  below the  eyes, it is  called  tic-douloureux or facial
neuralgia.
   When similar pains  of a paroxysmal character affect the
back of the head and extend down the neck, it  is called
cervico-occipital neuralgia, and signifies neuralgia affecting
the back of the head and neck.
   Paroxysmal  pains of a  darting character, involving the
neck, shoulder, arm, and hand, are  called  cervico-brachial
neuralgia, which  means neuralgia  of the neck and arm.
   When similar pains  of a paroxysmal type dart along the
fifth and sixth ribs  or  the  intervening spaces on one  side,
the disease is  called  dorso-intercostal neuralgia, or,  more
commonly,  intercostal neuralgia,  which  simply  means,
neuralgia between the ribs.   This  form  of neuralgia  is
nearly always attended with a bright red eruption of the
skin known as " shingles." 
254
NEURALGIA.
  When neuralgic  pains  shoot along the course of  the
sciatic nerve, causing severe pain in the muscles of the hip,
it is called sciatica.  This form is generally associated with
or depending  upon an attack of  lumbago, or muscular
rheumatism of the back.
  The pain in sciatica  is more intense and involves more
important muscles  than that of neuralgia of other parts
of the body, and extends from the hip to the heel.   The
muscles of  the hip,  the inner part of the thigh, and ball of
the leg are  frequently all involved in a terrible paroxysm
of pain at the same time.
  Termination. — Neuralgia, including all the  different
forms, should end in  complete and perfect recovery if
properly treated.
  Treatment. — Many  years ago the author abandoned the
plan of treatment given in  the medical text-books which
consisted, as it does now, of giving an opiate to relieve the
violent pain of the  paroxysm,  and afterwards giving  the
necessary remedies to prevent recurrence of  such  par-
oxysms.
  The best time to break  up an attack of neuralgia, and
to break it  up so radically that it will never return, is dur-
ing the paroxysm.
  Why this is so is not so  easy  to tell, but the  fact is
established by treating a large  number of  cases both ways,
that  is by  giving remedies  when  patients are practically
in a state of perfect health, and giving the same remedies
during the  attack, in both cases with a view of curing  the
disease.  As long as the author followed  the old plan of
treating cases between the  paroxysms, he failed to prevent
their  recurrence.  Since substituting a curative  treatment
during  the paroxysm  for one of  temporary  relief,  his 
NEURALGIA.
255
efforts, with but few exceptions, have been crowned with
perfect success.   Instead of giving morphine or some form
of opium to blunt the sensibility to pain, the proper thing
is to give a remedy that increases the  sensibility  of the
affected nerves and intensifies the pain for a limited  time,
knowing by experience that  complete and  permanent  re-
lief will  follow.   Such a remedy is the  exact opposite of
morphine in its action, and is strychnine, given in the con-
venient form of ignatia pills.
   Before going into details regarding  the treatment, it
must be understood that  all forms of neuralgia, excepting
neuralgia of the heart,  are  treated  the same way.   As
most people are familiar  with sciatica and know something
of the intense and  prolonged suffering  that  it occasions,
the treatment here given is for that disease.   Suppose the
pain is of the usual, sharp, lancinating kind, affecting the
muscles of the hip and darting down the thigh and leg to
the ankle, the pains being so great that the  patient thinks
only of something for immediate relief.  In such a case, it
seems cruel to give  medicine to make him  worse, and yet
that is exactly the right  thing to do.   If he weighs 150
pounds,  or from that to 175,  give  him a three-quarter-
grain pill of the solid extract of ignatia and  in six hours
repeat the dose,  only giving  three  pills  in twenty-four
hours.  This dose  is calculated not  only to  increase the
pain, but to cause cramps of the affected muscles.   Should
it  fail to do  so by the time  the third pill is given, a one-
grain pill of  the  same drug  must be substituted for the
three-quarter-grain  pill, and one given before each meal.
The contractions of the muscles of the hip, thigh, and leg,
and also  the attending pain,  may be very severe.   Should
the pain  be too  great to bear, a half grain of morphine 
256                   NEURALGIA.
may be given at a single dose, as its effects will be neutral-
ized to a great extent by the ignatia.   After the spasm or
cramp of the muscles subsides, a sore  feeling of the flesh
for a few  days  is about  all that is left, and  the sciatica
rarely returns.   The success  of the  treatment  depends
mainly  upon  the extent to which the  drug is carried in
producing  intense  pain  and muscular spasm.  If only
slight cramp with but  little increase of  pain is excited, the
treatment will do but little if any good.  There is no dan-
ger whatever in  the use of the drug as herein advised, and
it  is very probable that a three-quarter-grain  pill will be
sufficient, and that it will not be necessary to  give  more
than three.
   If a one-grain pill is given, the second  dose if not the
first, will most likely bring on the desired cramp and inten-
sified pain.
   The principle  upon which the curative action of the
remedy depends, can  only be partially explained,  and is
probably as follows :  During  an attack the nerves con-
cerned are congested or inflamed, and  therefore intensely
sensitive to  the  action of strychnine, which increases the
congestion.
   A state of numbness or  partial insensibility of the
muscles  follows, during  which blood  ceases  to be  at-
tracted to diseased parts, and recovery commences.
   Why  the attacks never return, it is hard to tell.
   It is  thought best  to report a few of  the very many
cases in which ignatia has  been permanently curative in
sciatica  and other forms  of neuralgia  when given during
the paroxysms.
   Case I. — Mr.  Hersey,  aged 60, had  suffered for many
years with violent  attacks  of sciatica,  and in 1872, I was 
NEURALGIA.
257
 called and found him in  great agony.   It was found that
 the  attacks  came  on a dozen  times  per  year, and were
 always fearfully distressing.   I  decided then and there to
 break them  up forever, if possible, and gave  him a one-
 grain ignatia pill before  breakfast, and another before the
 noon meal.  At one o'clock the  violent contractions of the
 muscles began, the pain was terrible, and he was screaming
 as if he  was being  murdered.  I gave him a half grain of
 morphine by the mouth, as I had no hypodermic  with  me.
 In a half hour the  cramp in  the muscles of the hip, thigh,
 and leg  had almost ceased,  and the pain  was practically
 gone.  Within two  hours he was perfectly easy, and during
 the  next twenty years  of his life he never  had another
 attack.
  Case II. — Mrs. G.  W. Willis, of Mankato, Minn., ad-
 dressed  a letter to me in  Boston, in 1893, describing a
 neuralgic  affection  of the  shoulder,  arm, and hand,  the
 form technically known  as the  cervico-brachial neuralgia.
 It had resisted all efforts to subdue it or even  to favorably
 affect it,  and had been torturing her for many weeks.
  The ignatia pills  in three-quarter grain doses three times
 per day increased the  pain considerably and caused mus-
 cular contractions in the arm, shoulder, and hand, and, as
 directed, she left off the remedy at  once.   Complete and
 permanent recovery followed.  In this case, the cramp or
 spasm of  the  muscles  was not  very severe.  She  has
 never had an attack since.
  Case III. — William  Whitehead, aged 35, had suffered
with  neuralgia of the back of the  head and neck,  the
paroxysms occurring about twice per month and confining
him to his room for a couple  of  days.  He was put upon
ignatia pills  in doses  of three-quarters of  a grain  before
        s 
258
HYSTERIA.
each meal, and the treatment was begun during the earli-
est  and  severest part  of the paroxysm.   The  first  pill
given caused some muscular spasm, and in an hour and  a
half  after taking the second, violent cramps affecting the
muscles  of the  back of the head  and neck ensued, at-
tended with terrible pain.  The pain accompanying the
cramps was finally so severe as to require a hypodermic
injection  of morphine, which gave complete relief within
a half hour.  In this case the paroxysmal attack which had
usually lasted two days, was completely broken up in eight
hours, and the habitual attacks that had been coming on
every two weeks for years, never returned.
  Comment. — There was some very unpleasant experience
in this case, owing to the terrific pain occasioned by the
drug  which was probably given in doses unnecessarily
large.  It may be  that a half-grain pill instead  of three-
quarters  would  have answered, but  there were no bad
effects from the use of large doses except during a few
hours, and the final result was so completely  satisfactory
that there was but little  reason  for  complaint  on account
of severe treatment.

                    HYSTERIA.
  Common  name:  hysterics.
  This is a functional derangement of the nervous system,
characterized by more  or  less spasmodic  action of the
muscles,  and seems to be associated with a morbid desire
for sympathy, as the attacks almost always occur in the
presence of other persons.
  Causes. — The affection  is confined almost entirely to
females,  and is frequent among old maids, girls, and women
without children.  It is  often associated with the monthly 
HYSTERIA.
259
sickness, and also frequently occurs about the turn of life.
It is probably always  associated with functional derange-
ment of the sexual organs, although those  organs  may
seem to be in a state of health.  It is doubtless aggravated
by dyspepsia or anything calculated to disturb the nervous
system.
  Symptoms. —The symptoms of hysteria are so numerous
and varied that those of a typical case are exceedingly hard
to catalogue.  The fact that the paroxysms, attended with
sighing, crying, or boisterous laughter, almost always occur
in the presence of other persons and usually those of dear
friends, relatives,  or lovers,  suggests  the idea that the
underlying cause of the seizure may be a  morbid craving
for sympathy; and yet hysteria is truly a disease affecting
the nervous system in such a way, that the absurd and
meaningless demonstrations can neither be suppressed nor
modified by the patient.  There is laughter without mirth,
moaning  without  distress,  crying  without grief, talking
without saying anything, gestures  that  indicate nothing,
threatened suffocation  when there is no obstruction in the
throat  that is apparent.   All these  symptoms and some-
times a great many others  generally precede the hysteri-
cal fit  that is characterized by  seeming unconsciousness,
the patient usually being keenly aware of  what is  taking
place.   The paroxysm may be attended with violent strug-
gles  in which the patient has  to be  restrained to prevent
injuring herself or  others.   There may be  spasmodic con-
traction of the muscles affecting the  features and extremi-
ties as  if it were really an attack of epilepsy.
  Finally  after the  family and friends have been terribly
frightened, fearing that death  was imminent, the paroxysm
may  end abruptly in a sweet,  placid, bewitching smile, the 
260
HYSTERIA.
patient dropping into a quiet sleep.  After all these violent
symptoms have ended in quiet repose, a careful examination
usually shows that the pulse and temperature are but little
if any above natural.
  Termination. — As far  as  life is concerned, hysteria  is
always  favorable.   In regard  to perfect recovery  it  is
much less so, as persons who have had  one attack  are lia-
ble to have others, regardless of treatment.
  Treatment. — In the great  majority of cases  it is impos-
sible to tell the cause of hysteria, and  for  this reason the
treatment is to a  great  extent experimental.  A great
many cases are undoubtedly due to the  immoderate use of
tea or coffee,  by which the nervous system  is unduly ex-
cited, and sooner or later ends in a condition  of partial ex-
haustion, which  favors an outbreak of hysteria.  Nervous
exhaustion also  causes dyspepsia, to which  many of the
hysterical symptoms are often due.  Therefore in all hys-
terical cases  attended with the excessive  use  of  tea and
coffee, these stimulants should be absolutely  abandoned,
as they are nerve exhausting, causing those who use them
excessively to  be intensely nervous.  It is  well to remem-
ber that hysteria is simply an exaggerated  or extreme con-
dition of nervousness, and, aside from  that,  is no  disease
at all.  And further, that  any habits of eating and drink-
ing or living that have a tendency to use up and exhaust
nervous energy, have an equal tendency to carry'every
female patient in the direction of hysteria, as the nervous-
ness  from drinking  strong tea  and coffee is " hysterics "
on a small scale.
  From the foregoing it is evident that the rational treat-
ment of hysteria, with a view of preventing the paroxysms,
is almost entirely hygienic, as there are no drugs that will 
SUNSTROKE.
26l
 prevent hysterical paroxysms as  long as their exciting
 causes exist.  If the affection is associated with dyspepsia,
 that trouble must be met by giving a half-grain ignatia pill
 before each meal and continued for several months, but to
 permanently cure or greatly benefit any hysterical patient
 that persists in the immoderate use of tea, coffee, or other
 stimulants is a hopeless task.  They should not use tea
 and coffee at all.
   One of the most efficient remedies in quieting the nerves
 and subduing an  obstinate case  of  hysteria  is the fol-
 lowing : —
         Fluid extract of valerian, a half ounce,
         Bromide potassium, a half ounce,
         Water,  three ounces.
   Mix,  shake, and give a teaspoonful, repeating the dose in
 six or eight hours if necessary.  Patients usually drop into
 a quiet, restful sleep within an hour after  taking the first
 dose.
   When hysteria depends upon disease of  the womb, as it
 sometimes does, that organ must receive proper attention
 so as to remove the exciting cause of the disease.


                     SUNSTROKE.

   Other names:  thermic  fever;  heat stroke;  coup de
 soleil; heat exhaustion ;  insolation.
   This is a condition in which the vital powers are  over-
 whelmed with  heat.  It  is not necessarily sunstroke, al-
 though  this is the most common form of the affection, but
 may arise from heat of any kind.
  Causes. — The causes  are exposure to the effects of high
temperature, whether it be from the direct rays of the sun 
262
SUNSTROKE.
or from artificial heat such as workmen encounter  in roll-
ing mills, furnaces, and foundries.
  Symptoms. — A heat stroke comes on rapidly  with a
feeling of great prostration, the face becomes pale, voice
weak, pulse frequent and feeble, the patient sooner  or later
becoming unconscious.   Occasionally the prostration  is
sudden, and  without  any warning symptoms the  patient
falls and is  completely unconscious.  In sunstroke  the
symptoms come on rapidly, sometimes preceded  by a pro-
drome and at other times without  any warning symptoms
whatever.  The patient becomes irrational and may have
a violent  fit of delirium or convulsions,  or instead of the
latter,  the exact  opposite may  occur — paralysis.   The
surface is flushed with heat, the  eyes are red, the  breath-
ing usually labored and puffing as in apoplexy.  The pulse
is quick and may be either full and strong or  the opposite,
small and weak.  The fever  often  reaches  the extreme
limit.  In such cases death usually occurs from suffocation
or failure of the heart's action, or both.
  Termination. — Regarding  the  danger of  this  disease
everything depends on the violence of  the attack.   In
sunstroke most patients  die within a few hours.
  Treatment. — In heat  exhaustion it is best to  put  the
patient in a horizontal position, and give good whiskey in
half-tablespoonful doses in  an  equal  amount  of water
every half hour.  If unable to swallow, two or three times
this amount  may be thrown  into  the rectum, but in that
case should be  mixed with at least two parts of water.
  In sunstroke the fever is  intense, often  reaching  the
extreme limit, and the speedy reduction of the temperature
is of the utmost importance.   Cold water applied  without
limit to the surface of the body and especially the  head is, 
NERVOUS EXHAUSTION;
263
perhaps, the best  means by which to get rid of the bodily
heat.   The face should be inclined a little  downwards so
the water will not enter the  nostrils nor  the mouth,  and a
constant stream of  water flowing all over  the head and
neck  should  be poured from a pitcher.  Meanwhile  the
body  should be thoroughly wet with a  spray or shower
bath,  and evaporation favored by the use of fans or having
the patient in a draught of  air.    Everything  depends  on
getting rid of the heat as soon as possible.


             NERVOUS  EXHAUSTION.
  Other names:  nervous  prostration ; spinal irritation ;
neurasthenia.
  This is an enfeebled state  of the nervous  system that
reduces  the  physical and mental energy of  an individual,
rendering him less capable of dealing  successfully with
the affairs of life.
  Causes. — The  principal causes are  excessive mental
labor,  financial embarrassments,  extreme  and  long-con-
tinued anxiety from any  cause, disappointments in love,
excessive sexual indulgence, and the use of alcoholic stim-
ulants and tea and coffee.
  Symptoms. — When  nervous prostration affects  every
organ of the body, it is properly  termed general nervous
debility.   When it affects but one organ it is local or par-
tial nervous  debility.   This is the  case in dyspepsia, when
the nerves presiding over the functions of digestion  are
exhausted by excessive eating  or the use of improper food.
  In nervous exhaustion there is an irritability of temper,
the memory is more or less defective, the patient  is unable
to keep  his mind fixed upon his occupation, forgets  or 
264
NERVOUS EXHAUSTION.
neglects  business   engagements,  is  a  chronic  " day
dreamer," and usually afflicted with insomnia at night.   In
females, nervous prostration  is  generally  attended  with
functional derangement of the sexual organs.
  Termination. — This is usually favorable under proper
management.
  Treatment. — In  dealing  with  nervous exhaustion, hy-
gienic measures are of the utmost importance.   To free
the mind from the annoying  cares of life and  make the
individual as cheerful and happy as possible, transcends
any and all efforts that can be made with a drug treat-
ment.   In almost all cases of nervous debility, disorders of
digestion seriously complicate the situation.   The  nervous
exhaustion causes the dyspepsia, and the latter constantly
tends to increase the nervous exhaustion.  For this reason
an effort must be made at once to improve  the  digestion,
fill  the veins and  arteries with healthy blood,  properly
nourish, tone up, and stimulate the nerves, and in that way
maintain a healthy and vigorous nutrition.   The best rem-
edy in such cases is the solid extract of ignatia in pill form,
the dose ranging from a half to  a full grain according to
the size of the patient.  Persons weighing  from one  hun-
dred to one hundred and seventy-five pounds, should take
a half-grain pill before each meal.  Those weighing from
one  hundred and seventy-five  to two hundred  will need
three-quarters of a  grain, while  all persons  weighing over
two hundred must take a full  grain.  In all cases one pill
is  taken before  each meal, and  never more than  one.
They do not act as a physic, but spend their entire force
upon  the  nervous system.   They should be continued as
a general  thing for several months.  After  the  dyspepsia
is overcome and  a healthy color has returned to the cheeks, 
ST.  VITUS'S DANCE.
265
the blood will properly stimulate  the brain and  nervous
system,'the latter will excite the organs of digestion to the
proper performance of their functions, and further use of
the ignatia will be unnecessary.

                ST. VITUS'S DANCE.
  Other names : chorea; insanity of the muscles.
  This is a derangement of the nervous system, attended
with irregular, jerking movements of the  muscles.
  Causes. — It is a  disease of childhood and youth,  and
may be due to heredity, masturbation, or fright.
  Symptoms. — The  disease is gradual in its commence-
ment, the muscles of the face and hands commencing to
twitch about the same time.  These  symptoms may occur
more or less every day, and then cease for a day  or two,
but finally becoming more pronounced  so as to  involve
the muscles of the eyelids, the eyes, and those of the upper
extremities.   Last  of  all,  the  muscles  of  the lower
extremities are affected.
  Termination. — In most cases this is favorable.
  Treatment.— As the disease is attended with a weakened
condition of the nervous system, and consequent disorders
of digestion,  and an impoverished state of the blood, a
general nervous  tonic is called for with a view of giving
general tone to  nerve  tissue, improving  the  powers of
digestion, and filling the veins and  arteries with  healthy
blood.  Therefore,  in children from two  to  eight years
old, the  eighth of a grain  of the  solid  extract of ignatia
should be given  in pill form three  times  per day before
the meals.  At the same time the following may be given
three times per day after meals : — 
266
SHINGLES.
             Fowler's solution, one drachm,
             Water, four ounces.
  Mix, and give a teaspoonful after each meal.
  In children under  two years, this  remedy  may cause
swelling  or puffing of  the  eyelids within  six  or eight
weeks, or sooner.   When this condition is observed, the
drug  should be  discontinued  for  two  weeks  and  then
given as before.  If the child is from eight to fifteen years
old, it  should have a quarter of a  grain pill of  the  solid
extract of  ignatia before each meal,  and  three or  four
drops of Fowler's solution after each meal.  Meanwhile,
the diet should be nutritious and the child should be  kept
quiet.

                     SHINGLES.
  Other  names:  intercostal  neuralgia; herpes  zoster;
a girdle; zono.
  This is an acute  inflammation of the skin, upon which
there is a cluster of  pimples or vesicles, and is attended
with severe  neuralgic pains.
  Causes. — The neuralgia  and  eruption are  caused  by
inflammation of a nerve or nerves.
  Symptoms. — It begins with neuralgia, the pains being
sharp  and  darting, characteristic  of  that  disease,  and
usually situated on one side of the chest.  Soon  after the
neuralgic seizure, the  eruption, which is of a bright red
color, commences.
  Termination. — In  almost every  part of the  civilized
world, the idea prevails that shingles, should the infection
ever encircle the entire body, would prove fatal.  There is
nothing more  foolish  and groundless than this notion, as
the termination is always favorable. 
MENSTRUATION.
267
  Treatment. — It  is a  self-limited disease,  running its
course in about two weeks, but  is often attended  with
distressing pain, and  should be  broken up  as soon as
possible.  For this  purpose there is no  better  remedy
than the following:  Extract of ignatia in pill form, given
three times a day, the dose ranging from  one-half to a
full  grain.   The  pills  should  be  sufficiently large to
intensify  the  neuralgic  pains,  and  should  it also cause
twitching of  the muscles without severe cramp or mus-
cular spasm, it is all the better.   After  the characteristic
effects of the drug are obtained in this way, it is unneces-
sary to give it any longer, as the neuralgia almost always
subsides as soon as the drug symptoms die  out.  In such
cases the shingles  dry up,  and  the  patient is practically
well in forty-eight hours.  Give a three-quarter-grain pill to
adults.

                FEMALE  DISEASES.
                    Menstruation.
  Menstruation consists of a discharge of blood, once per
month, from the sexual organs of  the human  female, dur-
ing that period of her life in which she is capable of bear-
ing children.
  The discharge is  commonly called the menses because it
occurs once per month, as  the  word " mensis" means a
month, and when a girl has her first  menstrual sickness,
it is hailed as an unmistakable sign that she has arrived at
the period of life called puberty,  or, in other words, woman-
hood.  About this  time  her mammary glands, commonly
called her breasts, show  increased growth, she is widened
and enlarged in the development of her hips, is somewhat
more womanly in her  manners, being unusually dignified 
268
FEMALE DISEASES.
and  reserved in the presence of boys.  In this country,
menstruation usually commences between the fourteenth
and  sixteenth  years, and  terminates  between the  forty-
eighth and fifty-second years.
  The time which  most commonly elapses between the
successive appearances of the so-called monthly discharge
is about four weeks, although it is frequently shorter;  and
the duration of the flow is usually three or four days, but
is liable to greater variations.   The first appearance of the
discharge, as a general thing, is preceded and accompanied
by pain in the loins and general disturbance of the system,
and in many women these symptoms invariably accompany
the discharge.
  As menstruation rarely occurs  during pregnancy  and
lactation, the cessation of the menses is hailed as the  first
symptom that conception has taken place.
  In the natural or primitive condition of the human race
preceding the dawn of  civilization, it is supposed that the
menstrual function was unattended by pain.  In that period
of human  development,  there  was much less  difference
between the size and physical strength of the male  and
female than at present;  her limbs were untrammelled by
skirts, her body was  not dwarfed nor distorted by tight
garments, her muscular system was strong and vigorous in
development, the cavities of her body containing the vari-
ous organs  were not diminished in size, and she was a
natural, and not an artificial, woman.   Being entirely unre-
strained by garments,  she had the same opportunities  for
exercise and physical growth that the  male enjoyed.   She
was  much  larger in her waist, her hips and pelvis were
larger, affording greater  room  for  the  internal  sexual
organs, and these were correspondingly strong and  large. 
MENSTRUATION.
269
The general trend of civilization has been to a higher intel-
lectual development, to the neglect of her physical growth
and strength, and conjoined with this, there has existed for
centuries a morbid and gradually increasing desire to beau-
tify her person by deforming it.   School-girls are hampered
by  clothing, cannot play at games requiring the free and
perfect use of all their limbs and muscles, and in this way
the mothers of our race are restrained and enfeebled, physi-
cally, so that the  various  functions of womanhood and
motherhood are attended with more or less pain and incon-
venience.   Therefore  menstruation, which is a  natural
physiological function and should  be free from pain,  is
usually attended with suffering.   That the restraining effect
of modern styles in dress and their constant encroachments
upon female  anatomy, change  the form  from the  natural
to  the  unnatural, and are a  continued  menace to the
happiness, comfort, and usefulness of woman, there can be
no  doubt.  This  question  has  been under discussion for
many, many decades, and yet the evil continues.  Reforms
in dress are a thousand times more important to the women
of this age and through them to humanity, generally, than
the ballot, and yet they are justly entitled to the latter.
  But the general condition of humanity is improving; the
world is better this year than it was last; the relics of bar-
barism are becoming less conspicuous ; superstition is dying
out; women can speak in meeting with their heads uncov-
ered ; the once enthroned monster of the skies is becoming
an indulgent and loving father ; the superstition regarding
the sacred form of females has disappeared; women have
ceased to be the property  of  men ; are  no longer the
cherished  tools of kings and monarchs, with their  faces
veiled  from the  eyes  of other  men; are  now, more than 
270
FEMALE DISEASES.
formerly, the guardians of their own persons; have unlim-
ited sway in establishing and maintaining the various styles
with reference to dress, and if they do not cast off that pet
garment of ancient and  jealous kings, that leg-hampering,
speed-preventing, wage-reducing, exercise-restraining thing,
— the skirt,— and don, instead, the bifurcated garment, it is
their own  fault.   The  idea  of  women adopting a  male
costume to the extent of getting  rid of skirts, even though
it gives them all the freedom of muscles and  limbs that
men enjoy, is at first horrible to think of, as  we cannot
endure the idea of seeing our wives or sweethearts thus
clad.   We have learned to  love and admire women and
girls in skirt garments, and for this reason it does not seem
they can  ever look  so  pretty in  anything  else ; but  all
prejudice,  dislike,  and opposition  to male attire for the
lower extremities of  women would disappear in  a  year;
they would enjoy the same admiration of men that they do
at present; they could perform  all the duties  of life with
much less inconvenience, could earn more money with less
work,  enjoy  better  health,  gradually  become stronger;
girls could  romp,  run, jump, and  play without restraint;
physical growth would be favored instead of retarded ; we
would have larger,  stronger,  and more perfectly developed
women ; the pains and frailties of womanhood and maternity
would be greatly diminished, and in a few generations the
mothers would enjoy the strength and immunity from suf-
fering that those of the savage races now enjoy, while their
capacity for  intellectual development would  be commen-
surate with their increased physical strength.   The multi-
plicity of skirts that are belted around the waists of women
and girls, that impinge uncomfortably upon the abdominal
organs, forcing them  downward upon those  of the pelvis, 
MENORRHAGIA.
27I
that hamper the  limbs, limit physical exercise, cause dis-
orders of digestion and permanent derangement of the
sexual organs, must sooner or later give place to sensible
garments suspended from the shoulders, similar  to those
worn by  the male sex.

                    Menorrhagia.
               excessive menstruation.
  This is an  affection  in  which the  menstrual flow  is
changed  into  an  absolute hemorrhage from the womb,
and yet  in some women  it  occurs as regularly as the
monthly  periods themselves, is attended with a discharge
of large  clots  of blood,  the expulsion  of which  requires
bearing down efforts and pains similar to a miscarriage.
  The hemorrhage in such cases may be due to many dif-
ferent causes, such as polypus of  the  womb,  cancer, or
malignant growth of some kind, but in the great  majority
of cases  it is due to  an idiosyncrasy, or personal peculi-
arity of the patient and is, in itself, unattended with dan-
ger.  It is, however, to be greatly deplored for two reasons,
namely:   It is  distressingly  painful and annoying while it
lasts.  In the second place it drains the patient of  so much
blood that she  is left  in a weakened condition,  her face
being characterized by the pallor of childbirth.
  Treatment. — If the patient  is of  a  florid complexion,
the veins and  arteries seemingly full  of healthy blood,
and there is for this reason a natural tendency to hemor-
rhage, a  meat diet should be almost abandoned for one of
fruits  and vegetables.   This is  especially  necessary  if
she is habitually  constipated.  Whatever derangement of
digestion and other functions of the  body exist, should be 
272
FEMALE DISEASES.
corrected by the proper treatment.   If she is a subject of
dyspepsia she should adopt the treatment advised in the
chapter on  atonic  dyspepsia.   If  habitually  constipated
let her follow, in  a thorough  and radical  manner, the
treatment advised  in the chapter  on constipation.   In
order to arrest the hemorrhage when it occurs, and, there-
fore, prevent the formation of blood clots and the accom-
panying pains of  such profuse menstruation, the following
should be given as soon as the hemorrhage sets in: —
          Fluid extract of black haw, one ounce,
          Port wine, a half pint.
   Mix, and give a tablespoonful every hour until the hemor-
rhage is arrested, then give the same dose  every  three or
four hours until the time for the excessive flow has past.
   This remedy is one of  the  very best in such cases and
affords the  most prompt and  satisfactory relief  without
leaving an unfavorable drug  effect  upon the patient, and
yet it is not always easy to  tell the proper dose for any
particular case nor how often it may be necessary to repeat
such doses.  This information must be gained by experi-
ence, as one lady may  require much larger  doses than
another.   As a general  thing,  however, if given as  ad-
vised, every  hour, two or  three doses will arrest the hemor-
rhage.   Every lady who  is subject to profuse menstruation,
characterized by  great pain  and the discharge of blood
clots, should keep a bottle of  this mixture in the house and
commence taking it as soon as the hemorrhage begins.
   In more desperate cases, where  the hemorrhage  is so
great as to give but little time for the action of medicine,
a full teaspoonful of the fluid   extract  of ergot  may be
given every  fifteen or twenty minutes, until the hemorrhage
ceases, or until three doses  are given.   In  most cases, 
AMENORRHCEA.
273
 however, the fluid extract of black haw is much to be pre-
 ferred, as the use of ergot  every month is liable  to cause
 permanent injury to the blood-vessels.

                     Amenorrhcea.
              suppression of the menses.
   This is a condition due to one of many causes, or several
 combined, in which  the regular monthly sickness fails to
 occur, or which, having commenced, is suddenly suppressed.
 It is frequently caused by a severe cold, or being caught
 in a rain-storm about the time the flow should commence
 or soon afterwards.  In such cases great pain in the pel-
 vic region,  headache, thirst, fever, a full and  rapid pulse
 may follow.
   Treatment. — To treat amenorrhoea  rationally  with the
 hope of obtaining favorable and permanent results, every-
 thing depends upon the cause producing it and  the way in
 which it affects the individual.  If the  menses  are  sup-
 pressed by cold or by getting wet, the prompt and thorough
 application  of heat will afford the surest and  quickest
 relief, and for this purpose there is nothing better than
 hot water as advised in the treatment of dysmenorrhcea.
 This  should be followed up for several hours,  keeping
 patient, meanwhile, somewhat uncomfortably warm in bed.
 If there is much  fever, the following  should  be  given as
 directed : —
           Tincture of aconite root, one drachm,
           Water, four ounces.
  Mix, and  give a teaspoonful every hour for four hours,
after which give a dose every two hours.   The menses are
frequently suppressed or delayed by grief, fright,  or undue
        T 
274
FEMALE DISEASES.
mental excitement.   In such cases the trouble  is tempo-
rary so far as the menses are concerned, and will  disappear
as soon as the equilibrium of  the  nervous system is re-
stored.  The treatment,  if any, consists  in  quieting  the
mind.  The failure  of the menses to occur on time affords
no occasion for alarm unless the health of the individual is
unfavorably affected.   One of the greatest misconceptions
of parents and frequently of doctors also, is that physical
derangements of young  ladies are solely due to the  sup-
pression of menses, when actually the suppression in most
cases  is caused by  the  physical  infirmities. There  are
certain diseases in  which the menses are almost always
suppressed,  and one of the most serious and  important of
these  is consumption.  This is  usually slow and insidious
in its development, and attracts but little attention until it
is discovered that the color has faded from the cheeks and
the menses have failed to appear.  The misguided doctor
or parent is led  to think the trouble is all in the  sexual
organs, and gives remedies to restore the menses.  These
are wasted efforts, as it is just as natural for the  menses to
be suppressed with consumption as it is for them to occur
on  time in health.    Other debilitating  diseases  affect
females in  the same way, and the treatment  should be
directed to  such diseases instead  of  the sexual organs.
Suppression of the menses  by disappointments in love is
very serious, as in  many cases it  is the beginning  of a
fatal  decline, but the trouble is in  no way connected  with
the sexual organs, as it is wholly a mental condition.  The
derangement is primarily emotional and mental, leading to
derangements of nutrition, vital  depression, and  consump-
tion.  The morbid condition of the  mind must be over-
come  before the menses can be restored. 
DYSMENORRHCEA.
275
                   Dysmenorrhcea.
                painful menstruation.
  Dysmenorrhcea is the technical term applied to the pain
that precedes or accompanies  the  menstrual discharge.
Most women are more  or  less uncomfortable during the
first day of their monthly sickness, the pain frequently
preceding the flow.  Where  this discomfort  is moderate
it is not called  dysmenorrhoea,  or  painful menstruation,
but is considered natural.  But in many cases the pain is
severe, covering a period of two or three days, and confin-
ing the patient to her bed.
  The causes of painful menstruation  are numerous, the
remote causes being almost wholly errors in dress, produ-
cing more or less physical deformity, including a meagre
development of the sexual organs.   It is obvious from the
foregoing that the remote causes are, to some extent, hered-
itary, that mothers for many generations  have suffered
from the same kind of mistakes in dress that are diminish-
ing the comfort and happiness of the present generation
of women.  When an anxious father wrote to Horace
Greeley asking him the best time at which to commence the
education of  his  boy, the  old  philosopher  answered:
"About one hundred years before he is born."   The same
kind of advice applies to dysmenorrhcea, and  the  treat-
ment should be commenced several generations before the
birth of the patient.
  The exciting causes of painful menstruation are many,
among which may be included inflammation of the ovaries,
or the membranous  lining of the  womb, or mechanical
obstruction preventing or retarding  the flow of the  men-
strual fluid from  the womb. 
276
FEMALE DISEASES.
  Symptoms. — Where inflammation of the ovaries exists
there is a heavy, aching  pain  in  the pelvis before and
during the  menstrual  discharge,  with  soreness of  the
breasts and  sometimes  swelling also.  The time at which
the pain  sets in, with reference to the commencement of
the discharge, affords information that is somewhat reliable
regarding the cause.   For example : where there is inflam-
mation of the ovaries, the pain precedes  the  flow and is
not relieved  when the latter is established.
  When  the suffering  is due  to an  obstruction in the
mouth of the womb, the  pain  precedes the flow and is
greatly if not wholly relieved by it.  Where inflammation
of the mucous  lining of the womb causes the suffering,
the pain  commences with  the  flow and is gradually in-
creased as the  accumulated  fluid  with more or less  clots
impinges upon the  inflamed membrane.  In such cases,
however,  the freer the discharge the less will be the suffer-
ing from  pressure upon the inflamed surfaces.  This  form
is  sometimes called  membranous  dysmenorrhoea, as the
discharge is  frequently accompanied with  the  passage of
detached fragments of membrane.
  Treatment. — Where there is heavy, aching pain in the
pelvis before and during the discharge, and attended with
soreness  of  the breasts, it indicates an inflammatory con-
dition of  the ovaries, and the application of heat in the
form of a rubber bag filled with hot water and placed over
the lower part of the abdomen, keeping  a thick, dry towel
between  the bag  and  the   skin to prevent burning the
patient, will usually  afford  great  relief.  The  heat thus
applied is valuable  in relieving the  inflammation of the
ovaries and effecting a relaxed  condition of the  mouth of
the womb to facilitate the  flow.   If, however, a case of 
DYSMENORRHCEA.
277
 this kind is so  severe that this treatment does not afford
 the  desired relief, from  twelve  to  fifteen grains of anti-
 pyrine may be  given, and the dose repeated in two hours
 if necessary.  Alcoholic  stimulants of  all kinds should be
 avoided in dysmenorrhoea, and especially so in the ovarian
 form.  The treatment of the patient between  the men-
 strual  periods  is of  great  importance when the painful
 menstruation depends upon an inflammatory condition of
 the  ovaries.  The use of hot water as a vaginal douche
 three or  four times per week, if properly managed, ought
 to accomplish a great deal in unloading the engorged ves-
 sels of the ovaries and rendering the succeeding monthly
 flow much less  painful.
   The best way to administer the treatment is by means
 of a fountain syringe.  It is best for the patient to be in a
 bath-tub  with her hips  resting upon  some  soft cushion
 several inches  high.  The water should  be as  hot as  it
 can be borne without pain, and the flow continued for ten
 minutes,  the waste water being  allowed to escape from
 the bottom of the tub.
   When  the pain precedes the flow and is always relieved
 by it, it is evident that the suffering is caused by a rigid
 condition of  the  mouth of  the womb that prevents or
 retards the flow.  Heat  in some form is the best means to
 secure  a  prompt relaxation of the womb, and get rid of the
 accumulated fluid and the pains also by a free discharge.
 The application of hot water by the rubber bag, as men-
 tioned above, will afford prompt relief.
  When  pain  commences with the  flow and gradually
 increases, it indicates inflammation of the mucous lining
 of the womb, and every effort should be made to facilitate
the flow  and prevent undue  pressure  upon the inflamed 
278
FEMALE DISEASES.
surfaces.  Heat is usually the best  means  to secure this
end also, and the rubber bag filled with hot water can be
used to advantage.   Bags of hot salt, or a  jug filled with
hot water  and  securely  corked, will  afford  convenient
means of supplying  the  heat.   This form also may  be
greatly relieved by irrigating the vagina with  hot water
three  or four times per week between the monthly periods.
  In dysmenorrhoea, of whatever form, disorders of diges-
tion should  be corrected as soon as possible,  and where
constipation exists, a meat and mixed diet should be aban-
doned for one of fruits and vegetables.   An abundance of
fruits, of which apples, oranges,  lemons, and peaches are
the best, should be eaten every day until the bowels move
about once per day.   The stools should be soft and easy
so as to avoid the necessity  of straining, as such efforts
do great harm by causing congestion of the  internal sexual
organs and  causing   or increasing  painful  menstruation.
Where the  affection  is due to constipation, and it very
often is, the fruit diet, followed for all it is  worth, will
effect a cure.
  In  such cases  everything  depends  on the amount of
fruit  eaten,  and  the regularity with which the fruit-diet
treatment is followed up.  Some patients will eat an apple
once  or  twice per day, or  an orange at bedtime, and if
their  constipation is  not  promptly relieved will become
discouraged and give up the use  of  fruit.   Eating fruit in
such limited quantities will  do no good,  but  if  four or five
raw apples  are eaten in twenty-four hours, and fried or
stewed apples are eaten at  one or two meals per day, or,
in place of  apples any other fruits  that may  be desired,
excepting raspberries and blackberries, the fruit acid will
soon have a favorable effect upon the bowels, and a free and 
LEUCORRHCEA.
279
easy movement once per day may be hoped  for.   Fruits
do not act upon the bowels as a physic, and therefore it
does not become necessary to increase the amount.  There
is one matter of caution regarding the treatment of dys-
menorrhoea, that is of the  utmost importance.  It is this :
Never take a physic of any kind,  as  physicking in any
way has an absolute tendency  to cause congestion of the
pelvic organs.  Wherever  patients have dyspepsia, they
should carefully follow the treatment given in the chapter
of this book devoted to atonic dyspepsia.

                     Leucorrhcea.
                    " the whites."
   This  is a disease attended with more or less profuse dis-
charge  of white, yellowish, or greenish mucus from the
vagina,  resulting from acute  or chronic inflammation of
the vaginal mucous membrane.
   As inflammation or irritation of the mucous lining of the
vagina  is the cause of leucorrhoea, it is very evident that
the exciting causes of the disease consist of any influence,
mechanical, sexual, or otherwise, that is calculated to excite,
irritate  or inflame the vaginal wall.  Therefore, leucorrhoea
is caused by displacement of  the  womb downwards, in
which the tendency is to  turn the  vagina wrong side out
and chafe and irritate the two  opposing surfaces.   As all
mucous membranes when irritated, secrete mucus, a flow
of watery mucus necessarily  follows  such  displacements
of the  womb.  Then again,  if the womb is tipped back
against the rectum, called retroversion, the mouth of the
organ is directed toward the bladder, and impinges uncom-
fortably upon the front wall of the vagina, producing irri- 
280
FEMALE DISEASES.
tation and  consequently leucorrhoea.  When  the womb  is
tipped forward, the mouth is directed backward toward the
rectum and irritates the back part of the vagina, causing a
flow of watery mucus.  The most frequent and serious of
all the causes of leucorrhoea are probably those of womb
displacement, and any attempt to cure the affection  until
these  mal positions are corrected, can  do but  little, if any,
good.
  One of the most frequent and provoking causes of leu-
corrhoea, is excessive sexual indulgence.   The excitement
of sexual intercourse necessarily, naturally, and properly
causes temporary congestion of the internal sexual organs,
including the mucous membrane of  the vagina.  This is a
physiological action and harmless if not carried to excess,
but too  frequent sexual indulgence gradually produces  a
chronic  inflammatory condition called vaginitis, in which
every part  of the inflamed mucous membrane becomes
active in the secretion  of  a watery mucus and sometimes
of pus also.   Another cause of leucorrhoea is the retention
within the vaginal cavity of blood clots after profuse  men-
struation.
  Treatment. — As the form of womb displacement  most
conducive to leucorrhoea is downward, the remedy is easy
and simple if commenced  in time, and consists in  the in-
sertion of a soft rubber ring, the opening in the centre
being large enough for the mouth of the womb.  This ring
is hollow, and integral with it  is attached a  rubber tube
about eighteen inches long, for inflating the  ring when  it
is properly introduced.  To place it in the vagina in the
correct  position, it is covered with vaseline  and pushed
as far as possible with the index  finger.  Then the small
point  of a common bulb syringe is forced  into the end of 
LEUCORRHCEA.
28l
the rubber tube.  When the bulb is thoroughly compressed
twice,  the  ring will  be considerably inflated.  The index
finger, properly oiled,  may now be used to  further adjust
the ring so that the mouth of  the womb strikes the open
centre.   By compressing the  bulb once more the  ring is
fully inflated,  extending itself in every direction and for-
cing the womb upwards.   Sometimes it is  not necessary,
and this is especially true in women who have not borne
children, to compress  the  bulb more  than  twice, as that
amount of inflation  is often sufficient to correct the dis-
placement.  If when the patient gets  up and commences
to walk round, the distended ring causes pain, it is  an evi-
dence that  the inflation is too great.  If, on the other hand,
there is no pain at all,  and a constant tendency of the ring
to be discharged from the vagina, the inflation is not suffi-
cient, and  the bulb  should be compressed three times
instead of  twice.  After  the ring  is  properly blown up,
the rubber  tube is to be firmly tied with a piece of  cotton
twine of considerable size.   It should  be  tied  in three
knots.   When necessary  to remove the ring, the knots
may be untied, or the tube clipped with scissors just above
the cord.   This form of uterine support is  almost  wholly
free from irritation, and almost any woman can  properly
introduce it.
  In leucorrhoea  depending upon excessive sexual indul-
gence,  intercourse should  be wholly abandoned until the
vaginal canal recovers  from  the irritable or  inflamed  con-
dition causing the discharge.   Meanwhile,  irrigating the
vagina two or  three times per day with warm  water and
using an injection of sulphate of zinc after each cleansing,
will hasten recovery.  A  teaspoonful  of the zinc will be
enough for a  quart of water.  It should be injected with a 
282
FEMALE DISEASES.
hard rubber female syringe holding about one ounce.  An-
other very valuable remedy, and in many  cases  much
better than  the zinc,  is the non  alcoholic extract of  hy-
drastis canadensis mixed  with ten parts of  water.  This
should be injected night and morning.  Any preparation
injected for the cure  of  leucorrhoea should not be suffi-
ciently strong  to  cause much if  any pain, and  when sul-
phate of zinc  is  used, if  it  causes  much smarting, more
water must  be added to  the solution.


            Displacements of  the Womb.

  There are five displacements of the womb.  First, ante-
version, in which  the fundus or top of the womb is thrown
forward against the bladder, greatly diminishing its capac-
ity to hold urine, in consequence of which the patient has to
pass her water much oftener than usual,  and  in  bad cases
every fifteen or twenty minutes.   At the same time the
mouth of the womb presses against the rectum, often caus-
ing constipation.  Second, retroversion, in which the fundus
or top of the womb is thrown backwards against the rec-
tum, causing, if during pregnancy, terrible obstruction  of
the bowels.  Meanwhile the mouth of the womb  is pointed
towards the front of the pelvis, impinging so  firmly upon
the neck of  the bladder that the  patient is frequently un-
able to pass her water. In such cases the direction of the
urethra is very much changed, and a catheter  that is con-
siderably curved must  be substituted for the one commonly
used.   Third, anteflexion, in which the womb is bent for-
ward so the fundus or top  presses upon the bladder, while
the mouth is in its normal  position or  nearly  so.   The
symptoms of this  form of displacement are much the same 
DISPLACEMENTS OF THE WOMB.         283
as those of anteversion, so far as the effect upon the blad-
der is concerned, as it is compressed and diminished in its
capacity to hold water, frequent urination being necessary.
It does not, however, obstruct the bowels.   Fourth, retro-
flexion, in which the fundus or top of  the womb is bent
backward against  the  rectum, frequently causing obstruc-
tion of  the bowels, while the mouth of the organ remains
in  its  natural  position or practically so.   Fifth,  falling
of the womb, in which the  organ is  forced downward  in
the pelvis.  This  may be slight, causing  but  little incon-
venience, or it may be  great, in which there is  almost com-
plete prolapse or protuding of the womb.   The symptoms
of this  form of displacement are backache,  pains in the
lower part of the abdomen, frequently extending down the
thighs, a sense of heaviness  or bearing down in the pelvis,
and usually a frequent desire to pass water.
  Treatment. — In all these displacements it is much better,
if possible, for  the patient to lie in bed until the womb is
returned to its  natural position.  In retroversion that  oc-
curs mostly during pregnancy, obstructing the bowels and
also frequently  causing abortion, a good physician should
be called at once to  correct  the position of the  womb by
putting patient on  her  knees and breast, and inserting one
or two well oiled fingers in the rectum and pushing firmly
against the womb.   The other mal positions of the womb
will generally correct themselves by  the patient lying  in
bed a couple of  weeks, but in case of prolapse, where the
displacement is altogether downward, the soft rubber ring,
as advised for such displacements  in  the treatment  of
leucorrhoea, may be used, in which  case it is usually un-
necessary for the patient to  lie in bed.  The reader is re-
quested to turn to  the chapter on leucorrhoea, and carefully 
284
FEMALE DISEASES.
study the soft rubber ring and the manner of introducing
and inflating it.
  Whenever a woman is seized with a very frequent de-
sire to pass her water, and this condition continues for any
length of time, it is very safe for her to conclude that she
has womb displacement of some  kind.  In the large ma-
jority of cases the position of the womb can be corrected
by the patient taking to her bed for a few days, pro-
vided she does so as soon as the troublesome symptoms
make their appearance.   If this is not convenient the soft
rubber ring or pessary, if properly inserted and sufficiently
inflated, will raise the womb off of the bladder so as to cause,
in most cases, immediate relief.   In cases of anteflexion,
where the top of the womb  is bent forward against the
bladder, there is frequently more  or  less  displacement
downward, and the use of the soft rubber  ring will correct
the trouble.   It is well to remember  that all these displace-
ments have a natural tendency to irritate the  vaginal canal
and cause leucorrhoea, and whenever this flow commences,
whether associated with bladder  troubles or not,  displace-
ment of the womb should be suspected.


                   PREGNANCY.
  Pregnancy in the human family, when of the normal or
natural character, signifies a state of the  female  in whose
womb there is a  germ, or egg that has been fertilized by
the male germ,  and which  gradually  becomes developed
within the cavity of the womb.   When the ovum  is im-
pregnated or fertilized by the male  semen in the  uterus, a
local, vital action is set  up by which  it attaches itself to
the surface of the mucous membrane lining the womb, and 
PREGNANCY.
285
obtains from it indirectly the nourishment necessary for its
gradual growth during the  ordinary term of pregnancy.
The duration of pregnancy, however, may be protracted to
three hundred days or upwards, and ends with the birth
of one or  more children.   Pregnancy is commonly limited
to one child, but sometimes there are two or three, and in
rare instances four or five.

                 Signs of  Pregnancy.
  The first symptom of pregnancy, and the one  hailed by
almost all  married women as the most important, is sup-
pression of  the  menses.  The function  of  menstruation
rarely exists during the period of pregnancy.  Sometimes,
however, the menstrual flow occurs  once  after conception
takes  place, but in such cases it is generally slight and
limited in duration.   When it thus occurs it is only a short
time after  conception has taken place.  The suppression
of the menses, however, as a  sign of pregnancy, is  so
reliable that  the date fixed for the probable  birth of the
child is two hundred and seventy-five days after the  last
day of the last menstruation.  When a menstruation in  a
married woman  is limited both  in quantity and duration,
and this too in one who has always been regular as to time,
amount, and  duration of  the flow, it is a very strong  evi-
dence that conception has taken place.  As  it  may have
occurred several days previous to the flow, the duration of
pregnancy  when  reckoned from the last  menstrual flow,
must necessarily be shortened.
  The menses are  not  always suppressed during preg-
nancy, but the cases in which they are not, are exceedingly
rare.
  The value of menstrual suppression  as  a sign of preg- 
286
FEMALE DISEASES.
nancy is modified by many conditions.   If the individual is
very irregular in this respect, occasionally running over her
time from a few days to several weeks, it is almost valueless
as a symptom.  If on the other hand she has always been
prompt and regular, sudden suppression is almost a posi-
tive sign of pregnancy.   The state of the mind sometimes
exercises a demoralizing  effect upon the nervous system,
and in  that way delays  the commencement of the flow.
This may  occur with young married women who are very
averse to raising children, and consequently in mortal dread
of becoming pregnant.   It may exercise a  still greater in-
fluence upon  unmarried women who have rendered them-
selves liable to  become pregnant.   In either case  the
influence is equivalent to  a severe fright and  may  delay
the menstrual flow for several days.
  Another symptom of pregnancy which is of great impor-
tance, is  nausea  and vomiting, which is commonly called
"morning sickness."  This symptom is familiar  to most
married women.   The  sickness usually comes  on soon
after rising from bed in  the  morning.  Like the sickness
from taking morphine, it is provoked by the erect posture.
It sometimes commences  within a day or two after con-
ception, but more commonly is  deferred to the third or
fourth  week.   It usually ends during the fourth month.
It is sometimes mild, causing but very little inconvenience,
and at other times  so severe as to threaten the life of  the
patient.  In extreme cases it is necessary to bring  about
premature delivery to save the life of the mother.   Asso-
ciated with the morning sickness or existing independently
of it, are frequently other disorders of  the stomach, such
as acidity, heartburn, flatulence, and sour eructations.
  Salivation often accompanies the sickness of the stomach 
PREGNANCY.
287
in severe cases.  It may also occur in the form of drivelling
saliva when there is no morning sickness at all.
   Facial neuralgia and toothache are liable to characterize
the state of pregnancy during the early weeks.   This ten-
dency seems to run in families.  Sometimes all the girls in
a family are affected in this way as soon as they get married
and commence  raising children.   Where  heredity is a
strong predisposing cause  to toothache and neuralgia dur-
ing pregnancy, the occurrence of  those affections  may be
regarded as almost positive evidence of the pregnant  con-
dition.
   The mammary  glands or breasts commence a gradual
enlargement soon  after conception  occurs, and about the
same time there are often darting  pains in the region of
the nipple.  Sometimes, however, it is only an itching or a
burning.  The nipples are also enlarged  and surrounded
by a dark ring called the  areola, which is especially dark
in brunettes.
   The bladder  affords  another  important  symptom of
pregnancy during  the  first month on account of pressure
it receives from the womb, being diminished in its capacity
to hold urine, and  rendering frequent urination  necessary.
This in connection with other signs  of pregnancy is a very
convincing symptom.   During the second month there is a
natural anteversion or  tipping of  the womb forward upon
the bladder, further lessening its capacity to hold water,
and increasing the frequency of urination.  Early in the
fourth  month the pressure upon the bladder is relieved by
the womb rising out of the pelvis  into the cavity  of the
abdomen.
  Quickening  is the symptom occasioned by decided move-
ments  of the  child, and commences about the  middle of 
23S
FEMALE DISEASES.
pregnancy.  Where  conception  takes  place during lacta-
tion, and before menstruation is established after the pre-
vious pregnancy, there is no reliable means for determining
the commencement of pregnancy.   In  such cases quicken-
ing, which commences about the middle of utero-gestation,
affords the only information regarding the time at which
the child will probably be born.  Therefore, if the time of
birth is set four and  a half months after the first appear-
ance of  quickening, the calculation is liable to be correct
within one or two weeks.

              Management of  Pregnancy.
  Unfortunately for  mankind in general and especially for
the mothers of our race, the first  pregnancies occur at a
time when the ignorance of both  husband and wife, re-
garding the care and necessities of the pregnant state, is
most  profound.    For  this reason  the young husband,
utterly  unaware  of  an  abnormal  or  nervous condition
that may exist,  thoughtlessly neglects his wife, or fails
to be responsive  to her  cravings for love and tenderness.
This may lead to desperate despondency, or to the devel-
opment  of an excitable and intensely irritable  state of the
mind.   When to  her  morbidly  sensitive, nervous, and
mental state, are added disorders  of  digestion, morning
sickness,  constipation of the bowels, sour stomach, and
an uncontrollable desire for articles  of diet least suited to
her condition, it  is apparent that pregnancy, the most im-
portant period in the life of a woman, requires the exercise
of all the intelligence, care, patience, love, and forbearance
possessed by both husband and wife.   Granting that the
foregoing is true, this question  naturally arises: In what
does the 
PREGNANCY.
289
               Hygiene of  Pregnancy

mainly consist, or, in other words, what is  the best man-
agement of pregnancy ?  For  her own sake and that of her
offspring as well, every pregnant woman should be made
as comfortable, cheerful, and  happy as the circumstances
of her husband, and her general environments will permit.
The unfavorable business  and pecuniary  affairs  of  the
family should  never  reach  her  mind.   She  should be
carefully shielded  from everything that is mentally de-
pressing  or annoying.  If inclined to melancholy,  she
should not be left alone.   Correcting disorders  of diges-
tion, and providing her with the companionship of pleasant,
congenial people, may overcome all despondencies.
  She should be encouraged to indulge freely in the walks,
talks, and  general  pleasantries  of  life,  including  social
games.  If inclined to  literature  in  any form, her taste in
that direction should be encouraged, as whatever is men-
tally satisfying and pleasing is, on general  principles, cal-
culated to benefit her and her  unborn child.   If she wishes
to do housework, it is  much  better for  her to be  so  em-
ployed than to sit with folded hands, and muse pensively
upon her prospects of motherhood.
  EFFECTS OF THE MOTHER'S  MIND  UPON
              HER UNBORN  CHILD.
  It is well known that disgusting or frightful scenes that
violently affect the mind of the pregnant female are liable
to exert a morbid influence upon the unborn child, so as to
dwarf and deform its physical and mental growth.
        u 
290
FEMALE DISEASES.
  Thousands of cases are upon record showing that idiocy,
deformities, and human monstrosities have been  traced  to
impressions made upon the minds of mothers before giv-
ing birth to children.  How emotional impressions can
affect the mind,  the facial expression,  and  physical  con-
tour of  a child that has never  seen  the light of day,  is
hard to tell.  Interspersed with the matter of this mate-
rial world is a realm of mysterious, unknown, and perhaps
unknowable, forces.   The matter is objective and tangible,
while the forces are, for the  most part, but  dimly sensed.
  There are millions of sights that we cannot see ; millions
of sounds that we cannot hear ;  millions of  forces  that we
cannot feel; millions of tastes to which our natural organs
are insensible;  millions of perfumes reaching us upon the
wings of the viewless air, that we cannot smell;  there are
millions of life germs spreading diseases from ocean  to
ocean, that only the most powerful microscope can reveal;
and  there are  millions of  maternal influences — weird,
mysterious, and inconceivably delicate — connected  with
the impregnation of the  human germ and  its lodgement
and growth in the womb, that we cannot understand.
  The writer knows  that he  once lived in a dark, narrow
chamber,  the womb, where he  was  peculiarly nourished
and  slightly conscious, and  believes  that  the mind and
emotions of a loving mother moulded his plastic, prenatal
brain  and organism  so as to endow him at birth with the
capacity for physical and intellectual development that has
mainly determined his destiny in life.  How this was done,
is at best a matter of conjecture.
  When a wound is made in  the flesh, there is a  rush  of
blood to that locality,  carrying fibrinous lymph, the neces-
sary material for healing  the wound, and an active, adhe- 
PREGNANCY.
291
 sive inflammation is set up.   If the injury is extensive, the
 inflammation will be  correspondingly so, and  the demand
 for fibrine is liable to be greater than the normal blood can
 supply.   Nature,  as  if fully aware of the deficiency of
 healing material in the blood, creates an extra amount of
 fibrine with which  every  ounce  of blood is enriched, and
 in that way the wound is reenforced with fibrinous  lymph
 or repairing material,  and the healing process hastened.
   When a woman in the early months of pregnancy takes
 up a difficult line of study,  such  as  mathematics,  for ex-
 ample, and pursues it every day  for months, there is an
 increased flow of blood to the brain to supply the waste
 caused  by such long-continued mental taxation.  As the
 mental  labor has a tendency to use  up certain chemical
 constituents of the blood, is  it not logical to suppose that
 nature will recognize the draught made upon the blood in
 this way, and  enrich it with  an abundance of  suitable ma-
 terial to supply the waste in the brain ?
   It is obvious, if the  blood  is made excessively nutritious
 to  supply  the  waste  in  the brain tissue  occasioned by
 severe mental exercise, that it is in the best possible con-
 dition to contribute  to brain growth.
  As the mother and  her  unborn infant are nourished by
 the same  blood, it  seems that the brain  growth of  the
 child  in the womb must be  to a  great extent commensu-
 rate with the mental exercise  of the mother.
  If she should apply herself vigorously to the study of
 music, there would be an increased flow of blood  to  her
 head  to  supply the waste of brain substance,  but such
waste would not be the same as that caused by mathe-
matical  studies, and  conservative nature would add to
the nutritive qualities of the blood an  abundance of ele- 
292
FEMALE DISEASES.
ments  needed to meet  the  draught made upon it by the
study of  music, only.
  This blood would nourish the unborn  child,  and there-
fore contribute to the  development of  the  same organs
that had  been exercised  by the mother.
  If true that certain mental pursuits cause  the brain  to
draw from the blood certain chemical properties, it is also
true that nature  must meet the  demand made upon the
blood by increasing the amount of the much-needed ele-
ments, and  therefore it seems possible  for  a  mother  to
bestow upon her  child a  superior mental capacity by the
manner in which  she employs her mind  and body during
the nine  months preceding its birth.
  Evolution is the ruling principle,  and highest natural
power of the universe.   In all the countless worlds  that
are teeming with living beings, the order of development
is doubtless  from the lower  to higher forms of  life.   This
is  natural.   Man is the  dominating  intelligence of this
planet, as there is no other  being that approaches him in
intellectual capacity.  He has conquered everything that
breathes  or  inhabits the deep, and made the whole moving
world of  life subservient to his imperious will.  After fight-
ing ferocious beasts for thousands of centuries, and thread-
ing his way  through the bewildering mazes of the past,  he
has finally made  our little world a  suitable dwelling-place
for refined,  intelligent people.
  But in the  realm of the unseen, unheard, unfelt, and
unknown, he has a thousand worlds, as it were, yet to con-
quer.  As he has but  recently attained  a state of mental
development, rendering him capable of unfolding and util-
izing a few  of the possible millions of natural forces, it is
reasonable  to  infer that he  is yet in the childhood of his
intellectual  growth. 
PREGNANCY.
293
   If this  is true, the most important question of coming
centuries  is the  evolution of mankind.   From the infancy
of the human race, man has been groping his way upward
in search  of intellectual light, and it is  believed that his
greatest blunder is, and ever has been, his failure to under-
stand the  main laws and conditions that affect, for good or
ill, his mental growth.
   Experience has taught  that the kindergarten method of
teaching young  children — a method in which the mental
unfoldment of pupils depends mainly upon object lessons —
strengthens both body and mind, renders children exceed-
ingly precocious, and early in life lays a broad  and solid
foundation for the more difficult studies of schools and col-
leges.  The reasons are obvious.  The  little ones are put
under suitable training when the brain is as soft and pliable
as putty, the best of lessons are taught,  and every child is
carefully shielded from bad influences.
   A child is probably a thousand times more susceptible
to good or bad impressions during its earliest development
in the womb than it is after becoming a kindergarten pupil,
and  experience  and statistics almost warrant the opinion
that the womb of every pregnant woman is practically a
miniature  kindergarten in which the mother's object les-
sons are impressed upon the mind of the unborn.
   Granting that  this is true, we are compelled to admit the
existence of a multiplicity of conditions connected with the
subtle  forces and  functions  of maternity that we can
neither explain nor fully understand.  Oh, what a  library we
should need  in which to  record the things of this world
that no one  knows!  For every mystery that  science has
solved, she has discovered a hundred new ones.   She has
found a few precious and glittering gems along the surf- 
294
FEMALE DISEASES.
beaten shore, but the great ocean of truth that she surveys
with her tireless and wistful eyes, is unexplored.
  The objective  and  tangible  forces of nature, such  as
steam, fire, wind, and wave, we understand and can usually
avoid,  but unfortunately the  subjective, intangible, and
inconceivably  fine forces  are the  most powerful in their
effects, for weal or woe, upon humanity.
  It is  now  generally  admitted  by the highest  medical
authorities that structural alterations of the  growing child
in the womb  may be caused by unfavorable mental influ-
ences upon the  mother, and  that  human  monstrosities
generally  occur  in this  way.   Physiologists agree, and
observations abundantly prove,  that the emotions of the
mother  affect  the physical development, bodily  form, and
facial expression of her child.   They also agree that men-
tal growth may be arrested or  retarded  in  a similar way,
causing idiocy or an  enfeebled mental condition.  For
these reasons the best authors, in considering the manage-
ment of pregnancy, advise every patient to be carefully
protected  from  frights, physical shocks, and  all sudden
news of an unpleasant nature.
  It is pleasant to know that these ideas that were instilled
into the minds of young people by the intelligent mothers
of thirty or forty years  ago — ideas that were stigmatized
by  the  doctors  of those  days  as "old women's whims"
— have been recognized during the closing years  of this
most progressive and eventful century as an  important part
of the scientific literature of medicine.
  The sprout of an acorn  in coming up through a soft
and yielding soil, is not swerved from a direct course, and
therefore  appears above the surface as a straight and per-
fect scion. If not injured by accident, it will become  the 
PREGNANCY.
295
monarch of the forest, and after withstanding  the  storms
of a thousand winters will be as straight as an arrow.  But
if, in coming out of the ground, it is bent in its tender and
delicate fibres by a  stone or unyielding clod  of earth, it
appears above ground more or less crooked and deformed,
and can never make  a perfect tree.
  The acorn is an impregnated vegetable germ.  The earth
in which it is planted and to which it firmly attaches itself,
is the womb.   The length of time that it is planted before
making its appearance, is its period of gestation or  growth
in the womb.  This  may be from two to  four weeks, ac-
cording to the amount of moisture, character  of the soil,
and other conditions, and yet in this short  time the fate of
the majestic  oak, as regards shape  and beauty, is deter-
mined.   If two or three weeks of unfavorable conditions
will  dwarf,  deform,  and  ruin  a  tree  that might other-
wise live and grow  for a thousand years or more, the
importance  of the  period from  conception to the  birth
of a  child in determining  its destiny, is hard to  over-
estimate.
  If a woman is kept in a state of mental irritation by a
drunken or otherwise obnoxious  and  worthless husband
during pregnancy,  or if  vexed  and tormented in  other
ways, her poor child is no more to blame for being bad
than a tree is to blame for being crooked.
  Oh, what a sacred temple is the maternal womb in which
are nourished and developed the mind, body, and spirit of
a human being!  What infinite possibilities await  the pli-
able, receptive mind of the infant whose mother is  favored
with suitable environments during the nine months previ-
ous to its birth!
  Every industry, every enterprise, every school and col- 
296
FEMALE DISEASES.
lege, and everything else in this world that approaches the
goal of perfect success, must be established and conducted
upon settled and definite principles.  These  are facts that
the leaders of industry, science, literature,  and  art fully
recognize.  The telescope thrills us with the grandeur of
a hundred million suns; the artist's pencil gives body and
soul to color, light,  and shade; the magnet conducts  us
safely across the bosom of the deep to  the islands  of  joy
and rest; and that subtle, imponderable force — electricity
— brings  us  news  from every country  under  the  sun.
Why ?   Simply because the  principle and  power  of  the
telescope  have been studied and practically mastered;
painting is taught in well established schools of art where
all the colors, delicate lines, shades, and expressions of the
subject are carefully worked  out;  navigation  has become
a fixed and definite science; and electricity is governed by
laws that are thoroughly understood.   But unfortunately
for man—the dominating intelligence of the globe — the
laws relating to human  reproduction, to the natural, crea-
tive forces through which the world has been peopled, are
yet shrouded in mystery.
  When the effects of the  mother's mind and body upon
the unborn are properly studied,  the world will begin to
realize that the  best time to commence the education of
a child is nine months before it is born.  Then its intel-
lectual growth — the growth  upon which  its taste,  mental
capacity, and success in life largely depend — will begin
to receive the attention that the cause of human happiness
and  progress demands.  Then the management of preg-
nancy will be reduced to a thorough system, as everything
that is successful  must be.   Under this  regime, parents
will  have some  idea of the  inclinations  and capabilities 
PREGNANCY.                   297
of their children, and will not compel them to take up lines
of study for which they have no taste.
  Then the question of blooded people will receive quite
as much attention as that of blooded horses, blooded cattle,
or blooded dogs.
  When  a  boy  keenly  enjoys  mathematics or  anything
else, it is because he  has a  natural ability to succeed and
be equal, if not superior, to those of his class.  A solitary
half hinge is one of the most worthless things on earth, and
therefore conservative nature never makes one half with-
out  making the other.  For the same reason she does not
create  in any boy a  taste  for a certain line of study or
work without endowing him  with  a capacity to succeed,
and in almost all cases success depends upon his fondness
for  his work, whatever it may be.
  The best things of this world have  been slow in their
development, because man has been slow in his own mental
unfoldment.  A few  centuries ago, muscle was considered
the  Archimedes screw through which  to move the world.
Then a man never was considered a  hero  until he had
measured his strength with some mortal  foe and conquered.
It was then  that women — even  pregnant  women — en-
joyed feasts of  blood, and exultingly clapped their hands,
like Mrs. Fitzsimmons, when  their favorite vanquished his
enemy in the arena of mortal strife.
  Then, naturally enough, the world was filled with bullies,
thugs, and face-beaters.   Then physical  conflict was  an
essential  part of the pabulum upon which the mothers of
humanity lived and  flourished, and men took to fighting
naturally because the minds of their mothers dwelt upon
that subject previous to their birth.
  That was a fighting age.   Men, women, and children 
298
FEMALE DISEASES.
were in constant danger of being destroyed by wild beasts,
and the necessities of the times  made  fighters of every
one.   Husbands and  wives  fought  each other, their sons
and  daughters  fought  among themselves,  and young
men  frequently courted their  sweethearts  with a  club.
Then it was only the strong in bones and muscles that were
considered fit to survive.  Men like Corbett and  John L.
Sullivan were the idols of those days and fairly represented
the ideas of the people regarding the " survival of the fit-
test."  But over fifty years ago  the calcium light of genius
entered the dark places of earth with  a Yankee inven-
tion  that  thoroughly  discouraged the big-fisted manglers
of human anatomy.
  This established a physical equality among men, so far
as fighting was concerned, and  since  that  time,  brain,
instead of muscle, has been at a premium.
  The  inventor's  name  was  Colt,  and although  never
praised  as a benefactor to posterity,  his death-dealing
revolver was a world-civilizer,  and  did what  the  schools,
courts,  and churches could not  do — broke  up  fighting
among men.
  This showed  the superiority of  mind to brute force, and
turned  the admiration of  the world from physical  strength
to genius.
  When it was  found that a man, however strong he might
be, could not become famous with his fists in the face of
a six-shooter, parents ceased in their efforts to raise bullies,
because the world had no use for them.
  Women became less inclined, gradually, to  admire men
in consequence of  their great physical achievements, and
turned  their thoughts, tastes, and affections  in the direc-
tion of  mental refinement and superiority. 
PREGNANCY.
299
  The invention  of  the revolver was  the unfoldment of
a thought that has placed the world upon a favorable basis
for an intellectual development that will go on forever.
  The correct principles of evolution—of human develop-
ment— consist in  producing good  people with brilliant
minds, by a logical system  of breeding, just as fine, high-
bred animals are produced.
  However refining and beneficent religious teachings may
be,  they cannot make honest, reliable people out of persons
who are naturally thieves.  To be "born again" may im-
prove those who are brought  into the world  under condi-
tions that  compel them to be impure in their thoughts and
more or less depraved and dishonest in their dealings and
conduct with  the world,  but it is a thousand times better to
have them born right the first time,  and then the second
birth, about  which so much has been said, will be  un-
necessary.

               MORNING  SICKNESS.
  One of the most obstinate and annoying complications
of pregnancy is the sickness  that often comes on every
morning, immediately after rising from bed,  or sometimes
just after  breakfast.   Sometimes the  sickness is mild  in
character, only occurring once  in twenty-four hours, and that
soon after getting out of bed in the morning.   In  other
cases the vomiting occurs only after the morning meal, the
breakfast usually being thrown up.  Occasionally the sick-
ness of pregnancy comes on within a few days after concep-
tion, but as a general thing it  does not commence until the
third or  fourth week.
  There is every degree of morning sickness as regards
severity.   In  some cases all food, of whatever character, 
300
FEMALE DISEASES.
is  thrown up as  soon as swallowed.   In such cases the
smell of food may cause deathly sickness.  The nausea of
pregnancy is very much like seasickness, and  is also like
the sickness caused by taking a full dose of morphine, the
vomiting in the three conditions being  hastened by the
erect posture, and due mainly to similar causes, that is, to
complete arrest or derangement of digestion.
   Morning sickness has been considered from  time imme-
morial  a sympathetic disorder, in which the stomach sym-
pathizes  with the congested womb.  The writer  is very
much inclined to  the opinion  that this theory  is only par-
tially true,  as he  has  found that  the  sickness  yields
promptly to a remedy that he  has found to be  a specific in
atonic  dyspepsia.  As the treatment that almost always
cures atonic  dyspepsia breaks up the sickness from preg-
nancy so promptly and permanently that  it proves to be
a specific in  such cases,  it affords strong grounds for the
opinion that the  " morning  sickness"  is  mainly,  if not
wholly, due to a form of dyspepsia peculiar to the pregnant
state.  In pregnancy there is a foolish and morbid craving
for articles of food that are exceedingly hard to digest and
therefore  injurious.  The same  tendency manifests itself
in many dyspeptics, showing that the unnatural appetites
in both  cases are probably due to similar causes, and in-
stead of  catering  to such diseased tastes, it is far better to
correct the  conditions of the stomach,  bowels,  and the
nervous system upon which they depend.
   Treatment. — There are three very important things to
consider with reference to treatment.  First. Give her the
kind of food that  is nourishing and most easily digested.
Second.  Until  her  sickness is overcome she  should take
her meals and medicine while  lying in bed with her head 
PREGNANCY.
301
and shoulders slightly elevated.   Third.  The drug that is
calculated  to  stimulate  digestion and in that way stop
sickness, should be given a half hour before eating, and
but little fluid of any  kind  taken until meal-time.  The
following is the remedy for  a lady weighing  from one
hundred to one hundred and seventy-five pounds :  Give
a  half-grain pill of extract of  ignatia before each regu-
lar meal.   If she eats four times in twenty-four hours, and
the meals  are at least four hours apart,  she may take a
pill at  each  meal until the  nausea  and  vomiting are
stopped, but,  as a rule, three pills  in twenty-four hours
are sufficient,  even if  more  than three meals are taken.
This drug  does  not stupefy the brain and nerves as mor-
phine does, and therefore does  not relieve the sickness
like an opiate, but gradually corrects the morbid condition,
which is indigestion, and stops the sickness  permanently.
It is not a palliative remedy at all.   It  has no direct ten-
dency to relieve the sickness.   It  does  not quiet and
stupefy  the nerves, but arouses them to greater  activity,
so they stimulate the organs of digestion and cure  the dys-
pepsia of pregnancy  upon  which the  sickness generally
depends.
   Under this  course the  sickness generally ceases in two
or three days, and often within twenty-four hours, but in
rare cases it may have  to be given for a week before the
sickness is  entirely overcome.
   One pill  should be given three times a day for a month
after the sickness has ceased.   Persons weighing over one
hundred and  seventy-five pounds should  take the  three-
quarters  of a  grain pill,  and they must in all cases  be
coated with sugar or gelatine.  Those weighing over two
hundred  should  take a one-grain  pill.  The use of opium 
302
FEMALE DISEASES.
in any form, or  any other remedies that  quiet the irrita-
bility of the  stomach by  putting  the  nervous system  to
sleep, should not be tolerated in sickness from pregnancy,
as such remedies arrest digestion and increase the trouble.
For the sour stomach there is  nothing better than bicar-
bonate of soda, and that is nothing more than the common
baking soda.   Put a heaping teaspoonful in a half glass of
water,  and give her a  swallow of it  whenever she has
heartburn.   As  long as there is acid in the  stomach, the
soda can do her  no harm, as the fight is entirely between
the  soda  and acid.  The soda destroys  the acid in the
stomach and the acid destroys the irritating effect of the
soda.

       CONSTIPATION OF  THE   BOWELS.
  With many women constipation during pregnancy ap-
pears to be natural.  In such cases it is not a disease, but
a physiological condition depending upon  pregnancy, and
limited in its duration to the pregnant  state.  It is a con-
dition, however,  that requires considerable attention, and
yet it is best to avoid if possible the use of physic of every
kind;  not  that  a  moderate physic is  liable  to  cause  an
abortion or to do any harm to the unborn; but the terrible
sluggish state of the bowels lasts for many months, and is
more aggravated than benefited by physic, as the tendency
of every cathartic is to lessen  the vigor  and deaden the
sensibility  of  the  entire intestinal tract.   Therefore the
treatment of  constipation  should be in almost  all  cases
hygienic.
  A profusion of  fruits of every kind, excepting berries
with small  seeds, should be eaten every day.  In addition
to apples either  baked, fried, or stewed at meals, several 
PREGNANCY.
303    *
may be eaten raw during the day, while oranges, peaches,
and bananas may also be used  freely.  By  leaving off
meat in a great measure, and adopting a fruit diet thus
lavishly, the constipation of pregnancy grows beautifully
less and often disappears entirely.


             PILES  IN  PREGNANCY.

  One of  the most provoking complications arising from
costive bowels  and consequent  straining at stool during
pregnancy, is the development of piles.  The  best way to
avoid them is to use a syringe before  each  movement of
the bowels, and inject into the rectum about a pint of warm
water.   This will soften the stool so it will pass easily, and
in that way the necessity of straining will be avoided. Of
course, when the constipation is  overcome by a fruit diet,
injections  are not needed.


                ENLARGED  VEINS.

  Enlarged and knotty veins of the thighs and legs occur
in almost  all pregnancies, but usually  disappear after the
birth of the  child.  They are due in  a great measure to
obstruction  of the  veins by pressure, preventing  a free
flow of the blood upward to the  heart, but  the trouble  is
also increased by constipation.  The same obstruction that
causes the veins of the lower extremities to enlarge also
enlarges the veins  of  the  anus, causing piles, which are
simply enlarged and multiplied blood-vessels.  The obstruc-
tion, the tendency to piles, and enlargement of the veins of
the thighs and legs, are all increased by constipation. 
304
FEMALE DISEASES.
  Treatment. — If the knotty veins become large so as  to
be in danger of rupturing, it is best for the patient to wear
elastic  stockings, so as to firmly support the veins and pre-
vent further expansion of  the walls.   After the rupture  of
a vein  has occurred the situation is more complicated,  as
there is an open wound that needs attention.   It may soon
become an ulcer, soiling the elastic stocking, and rendering
its frequent  removal necessary.   Therefore it is far better
to properly  support enlarged and  knotty veins, so as  to
avoid all risks of bursting a vein.   If the expanded veins
are almost wholly below the knee, a short stocking, reach-
ing a little above the knee, will be sufficient, but if the veins
of the  thighs are also enlarged, the stockings should ex-
tend clear to the body.   They can be bought  of  almost
any house  dealing  in surgical  instruments.   The  cotton-
elastic  stockings will cost  about five dollars per pair, pos-
sibly a little more.   The  silks will cost  nearly twice  as
much.   In many cases only one stocking is needed.


                       SLEEP.

  Every pregnant  woman should  be permitted to enjoy
an abundance of quiet, restful, health-restoring sleep, and
for this reason she should not be burdened at night with
the care of  children.
                     CLOTHING.
  All garments should be suspended from the shoulders,
so as to absolutely avoid pressure  upon the chest and
abdomen. 
PREGNANCY.
305
                     COITION.
  If this is enjoyed by the pregnant  woman, moderate
sexual indulgence will do her no harm.  If distasteful  to
her it ought not to  be tolerated.   She should  be the sole
arbiter upon the question of intercourse during the entire
term of pregnancy.
            NURSING SORE  MOUTH.
  This is one of the most distressing diseases from which
a woman is liable to  suffer during pregnancy,  or  while
nursing her child, and as usually treated is as obstinate  as
it is painfully annoying.   It  may  commence soon after
conception, or it  may not  set in until after the child is
born.  It often affects the lower side  of  the tongue, the
mucous membrane becoming red and inflamed.   The first
symptom is usually a  smarting pain from  swallowing  hot
tea  or coffee.   The tendency of the  inflammation is to
increase and also  to spread and involve other parts of the
mouth.  Sometimes it causes the worst form of sore throat
and ends fatally.
  Causes.—The  predisposing  cause  is heredity,  as it
"runs in  families,"  and  is  mainly due  to a blood taint of
some kind.   Women of  scrofulous parents are especially
liable to it.  It also occurs  frequently among women sub-
ject to rheumic disorders such as eczema.  The exciting
causes are pregnancy and nursing.
  Treatment. — The disease should never be allowed to
kill a patient, because  there are three ways to get rid of it,
one of which is always sure.
        x 
306
FEMALE DISEASES.
  The first is to give the following as  soon as the disease
commences: —
             Iodide potassium, two drachms,
             Syrup stillingia co., one pint.
  Mix, and give a tablespoonful three times a day.  This
will  usually  cure a case  in  a week or  ten  days.  If,
however, the case is neglected  or badly  treated, until the
patient is approaching  a  dangerous  condition,  the ques-
tion of premature delivery must be considered if it is due
to pregnancy.  If due  to nursing, the  child  should be
taken from the breast and the  milk  dried  up as  soon as
possible.   This will be followed by prompt recovery.  In
a very extensive  experience with  this disease, the writer
has  only found  one  case in  which  the drug  treatment
failed to effect a cure.  In this case, the  patient was in
the sixth month of pregnancy, and died before the remedy
had time to be of any benefit to her.
  A local  treatment, such as ordinary mouth washes, is
almost entirely useless,  but it is very important to avoid
hot drinks, liquors, or any irritating drinks  whatever.


           DURATION  OF PREGNANCY.

  Pregnancy ends with  the  birth of the child, and its
duration is about  two hundred  and seventy-five  days,
dating from the  last occurring menstruation.  For many
reasons it  is exceedingly  important  to know about what
time the birth of a child  is liable to occur; and in  the
absence  of positive information as  to  when  conception
takes place, there is nothing so  reliable as the rule that
fixes the time  at two hundred and seventy-five days after
the last day of the last menstruation. 
PREGNANCY.
307
  Unfortunately, however, conception  frequently  occurs
while the mother is  nursing, and before the menstrual
flow suppressed by the previous  pregnancy has returned.
In such cases, the best way to get an approximate  idea  as
to when the birth is liable to occur, is  to place the time
at a  hundred  and thirty-five days after "quickening."
This will  usually be  within  two  or three weeks  of the
correct  time.   During a long and extensive  practice  in
midwifery, the  writer kept  a record  of  many cases  in
which the date of conception was positively  known, and
in all such cases the  duration was within a few hours  of
two hundred and seventy days.


            SEX  OF THE  OFFSPRING.
  The opinion prevails somewhat extensively among the
laity of this country, that where conception  occurs soon
after the cessation of  the menses, the child will be a girl,
and that if it occurs a week or more later,  it will be a boy.
In this calculation, it is supposed  that if conception occurs
in about four days after the cessation of the flow, the child
is about as liable to be of one sex  as the other.   As far  as
the observation of the writer  extends, the rule  holds good,
but unfortunately his experience is limited to  less  than a
dozen cases.

                SIGNS  OF LABOR.
  As this  is not a work on midwifery, it is not necessary
to describe the phenomena of labor, nor  to allude to its
various stages; but in order that every prospective mother
may be on her guard and avoid being left  alone and help- 
308                FEMALE  DISEASES.
 less at a critical time,  it is thought best to give the pre-
 monitory or warning symptoms of labor.
   In the first place, every pregnant woman should  know
 the  date  of her last  monthly  period, and by  counting
 forward two  hundred and seventy-five days from the last
 day of the  flow, she will usually be  within two or  three
 days of her time to be sick; and this, if nothing  more,
 should be a  warning to her and her husband.
   In addition to this, the precursory signs of  labor, con-
 sisting of a discharge of mucus streaked with blood,  set in
 within from one to three days before  true  labor.  This is
 called the " show,"  and is accompanied by trifling pains in
 the  back  and  abdomen.   Sometimes real labor follows
 these warning  symptoms within a few  hours, and this is
 especially liable  to occur with  women who have borne
 children, and therefore the physician who has been  en-
 gaged  to attend the case should be called.


    CHLOROFORM  AND  ETHER  IN LABOR.

   Millions  of  intelligent women bear testimony to the
fact, that among all the  agonizing,  torturing  pains  that
have ever afflicted  mankind,  the suffering  of  childbirth
holds a front rank.   Regarding the truth of  their  state-
ments on this subject,  there is no question.  It should be
the object of every physician, not only to save the lives of
men, women, and children, but to prevent, as far as possible,
human suffering, to accomplish the  greatest   amount of
good in the world with the least possible pain.   There is
no more excuse for  allowing women — the best part of the
human family — to  writhe in the agonies of childbirth for
hours, than there would be for strapping a man to a  table 
PREGNANCY.
309
 and amputating a limb without ether or chloroform.   Many
 objections to the  use of chloroform in labor have been
 brought forward.  They are all too absurd and groundless
 to be mentioned.  It is a fortunate  thing for the present
 generation,  that the great  physicians  of  thirty or forty
 years  ago,  who foolishly opposed the use of  ether and
 chloroform in labor,  are dead, and that a higher, wiser, and
 better civilization  has in a great measure  adopted what
 they condemned.  The writer has given chloroform hun-
 dreds of times in labor and never had any bad effects from
 it.  In all cases labor seemed to proceed as regularly and
 rapidly as if it had not been given, while at the same time
 the patient  was almost free from pain.  In recent years
 he has used ether instead of  chloroform, and it is hard  to
 imagine a case in which a physician with any intelligence
 would be  liable to do any harm  with it.  The  short and
 sharp pains  in  the early stages of labor should be  borne
 without ether,  but by the  time  the  mouth of the womb
 opens to the size of  a silver dollar,  it may be given and
 kept up until the birth of the child.   The hard and forcing
 pains come on an hour or two before the "waters break,"
 and are especially severe from the time the water escapes
 until delivery, and during this time the patient should have
 an abundance of ether so as to be almost  free from pain.
 Where she  is in her first confinement, and the  pains are
 violent and rapid, giving but little time  for the soft parts
 to dilate, it is best to  give enough ether to modify the bear-
ing down effort, and prolong the labor a half hour or more,
 so as to lessen the  danger of rupturing the soft parts.  At
this stage of labor the  patient will bear a great deal  of
ether before the voluntary, expelling  effort is checked  to
any extent, 
3io
FEMALE DISEASES.
  It is hard to think of a case in which ether is capable of
preventing the mortal anguish  that it does  in childbirth,
especially if labor is severe, and every woman should have
it, after the hard, forcing pains come on.   She should see
her doctor personally before  her sickness  and get his
promise to give her ether.  It  is  a  very poor  town that
does not have  more than  one good physician, and if one
will not give her ether another one will.   The drug does
no harm either to the  mother or the child.


    CONCEPTION,  AND WHEN  IT  IS MOST
               LIABLE  TO  OCCUR.

  Conception  takes  place when the living seed  of the
male is implanted in  the female germ.  The germ  thus
impregnated or fertilized is called an ovum, and  as to
where it is at the time of impregnation, is still a matter of
some doubt, and is of  little interest except from a scientific
standpoint.  The  time at which conception is most liable
to occur, is usually a matter of the greatest importance to
young  married people, and they are entitled to all the in-
formation that can be  given them on that subject.
  An ovum, which is the Latin word for egg, is matured in
one of the ovaries at the time of menstruation, and at the
cessation of the menstrual flow is in suitable condition to
be impregnated, but the length of time that  it remains in
the  organs of  generation after menstruation ceases, is lim-
ited, and in many cases is only a few days.  Therefore con-
ception  is most  liable  to occur  immediately  after the
flow ceases, and  the  liability  gradually diminishes  from
that time on.
  In a  report of thirty-five thousand conceptions  that 
PREGNANCY.
3H
appeared in a medical work a few years ago, the greatest
number were  about the fourth day after  menstruation
ceased.   The number of conceptions decreased rapidly
from the fourth to the tenth day, there being less than one
hundred on the latter date.   Five cases occurred on the
twelfth  day, two  on the thirteenth, and none  after that
date.    From the foregoing it seems that  less  than one
in a hundred occurred  after the tenth day and none after
the thirteenth.   Therefore it  appears that the cases  in
which conception  occurs after the twelfth day dating from
the cessation of the monthly flow, are  exceedingly  rare,
being only  one in thirty-five thousand.


    CAKED BREASTS AND SORE  NIPPLES.
   One of the most frequent and painful annoyances affect-
ing  mothers while  nursing their first infant, is,  first,
inflamed nipple, second, " caked breast," third,  abscess of
the breast.  The trouble usually  develops  in  the  order
named,  and the inflamed and cracked nipple is responsible
for the  coagulated milk, inflammation of the breast gland,
and the abscess.  It occurs in this way: the babe irritates
the tender nipple by nursing.   As it becomes inflamed the
milk-duct is more or less obstructed  by lymph, requiring
greater  suction  by the babe or  a breast pump  to get the
milk out.   The mother  cannot endure the torture neces-
sary to  empty the breast.   The coagulated milk  causes
inflammation of the breast, and abscess follows.
  Treatment. — It  is  best  to  commence  the  treatment
before the  child is born.  The main  point in preventing
trouble consists in elongating or  drawing out the nipples
every day with the thumb and finger.  This can be done 
312
FEMALE DISEASES.
by the  patient's  mother, sister, husband, or herself.  In
addition to drawing  them out with the thumb and finger,
they should be bathed every day and rubbed with a cloth
dipped  in cold water.  This treatment will almost always
prevent sore nipples, and in so doing will prevent abscess
of the breast if reasonable  care is exercised.  The  treat-
ment acts favorably in  three ways.   First.  By drawing
out the nipple so the babe can  easily hold it in its mouth.
Second.  By making the nipple harder, tougher, and less
liable to irritation.  Third.   By getting  the young mother
accustomed   to having  her  nipples  somewhat  roughly
handled, she is better prepared for the  suction necessary
to empty the breasts and prevent " caking " of the  milk.
If, however,  the  nipples become  the least inflamed, they
should be treated immediately by applying the following,
two or three times per day: —
         Tannin, one drachm,
         Glycerine, water, of each a half ounce.
         Mix.
  Should the nipples be inflamed and cracked, the follow-
ing is better: —
           Zinc ointment, one ounce,
           Carbolic acid, one-half drachm.
           Mix, and apply night and morning.
  The nipples must be carefully cleaned with soap  and
warm water  in either case  before  allowing  the babe to
nurse. 
DANDRUFF.
313
             DISEASES  OF THE  SKIN.

                       Dandruff.

   Other names :  seborrhoea; pityriasis;  acne sebacea.
   This is  a  functional derangement of the  fat glands of
 the  skin in which there is an unnatural  amount of fatty
 matter secreted that discharges itself upon the skin in the
 form of  a  greasy  coating, and sooner or later forms itself
 into crusts and scales.
   Causes. — There are various theories regarding the ori-
 gin of this affection, but  there is no positive information
 on the subject, the cause of the disease being unknown.
   Symptoms. — The disease  may occur upon any and
 every portion of the body, but it is most frequently found
 on the face and scalp.  Seborrhoea  oleosa is that form of
 the disease that appears  on the face as  a greasy coating.
 It is unattended with any congested condition of the skin
 and  does not  itch  as in  the  scaly variety, but gives a
 greasy, untidy appearance  to the features that is very an-
 noying.  In bad cases the oil stands in drops on the fore-
 head and cheeks.   This form is called seborrhoea of  the
 face and nose.
   Seborrhoea sicca is a form of the affection in which  the
 greasy coating dries up, more or  less, leaving scales upon
 the skin, and is attended  with intense itching.  When it
 occurs upon the scalp it is  called  seborrhoea capitis, which
 means grease of  the  head or a greasy condition of  the
 scalp.  When these scales or crusts have become some-
what dry, they separate from the scalp and are combed out
in the form of dandruff, and the  patient is constantly try-
ing to comb  them all  out; but the  diseased condition is 
314
DISEASES OF THE SKIN.
constant, a new crop of scales is always forming, and the
dandruff remains unchanged.
  Termination. — The trouble is very obstinate and a per-
fect cure not often possible, but under the right treatment
the condition  of the patient can be  so modified that he
will suffer but little inconvenience from the affection.
  Treatment. — The first thing of importance  is to act
upon  the glandular system, and for this purpose take the
following: —
             Iodide potassium, two drachms,
             Simple syrup, one pint.
  Mix;  dose, a tablespoonful three times a day.   It would
be well to follow this treatment for three months. When
the scales upon the scalp are dry, and they usually become
so, the hair should be cut short, and the head rubbed hard
and long with vaseline or sweet oil  so as to soften the
scales and cause them  to  separate from the scalp.  The
head should be covered with a cap of  oiled silk at night so
as to protect the pillow.   In forty-eight hours  after the oil
is applied in this way, wash the head with the  following
mixture: —
             Strong soapsuds, twelve ounces,
             Alcohol, four ounces.
  Mix.   The long and  gentle application of this by rub-
bing will remove all the grease and detach all the scales,
after which the  head should be combed with  a dull  comb
so as to avoid  wounding the scalp.
  After this, the following stimulating and healing applica-
tion will  be of great importance and may effect a cure: —
             Corrosive sublimate, eight grains,
             Pure brandy, one-half pint.
  Mix, and apply to every part of the scalp, once per day, 
DANDRUFF.
315
with a small sponge.   The  application should be  made
gently,  as  rubbing is  unnecessary, wetting the affected
parts being all  that is needed.  If with  this treatment,
conjoined with  the iodide of potassium, the case is  not
greatly improved in two months, the iodide  of potassium
should be left off and Fowler's solution given as follows:
       Fowler's  solution, two drachms,
      Water, four ounces.
       Mix, and give a teaspoonful three times a day.
  If, after everything is done that can be, the dandruff still
continues to be  very  annoying, falling out  in dry  white
scales on the clothing, the following, used  two or three
times a week as occasion requires, will almost entirely stop
the dandruff from falling out: —
                 Glycerine, four ounces,
                 Alcohol, twelve ounces.
                 Mix, and shake.
  This can be  rubbed into the scalp  and hair with  the
hands, and the way in which it prevents the dandruff from
falling out upon the  clothing is easily understood.   The
alcohol thins the glycerine  so as to make its  application
easy, and allow it to spread over the entire scalp and also
coat every hair in the head.  Within a  few hours  after it
is used, the alcohol  evaporates, leaving the thin  film  of
glycerine upon each hair, and also upon the scales that are
commonly called dandruff.   Now when  these scales sepa-
rate from the scalp, they stick to the hair instead of shower-
ing down upon the clothing.  When  a  fine comb  is used
they stick to the teeth, and in this way can all  be combed
out.   The use of this  preparation  three times per week,
with reasonable  care in the use of a comb, will keep almost
any head of hair practically free from dandruff. 
3i6
DISEASES OF THE SKIN.
                        ACNE.
   Other names: varus; acne vulgarus.
   This is a chronic inflammation of the fat  glands  of  the
skin, attended with pimples or pustules, and confined mainly
to the  face and neck.
   Causes. — The  affection   usually commences  at  the
period of manhood or womanhood and may continue in-
definitely.   The predisposing  cause  is  heredity,  as it
frequently runs  through an entire  family of children.
Disorders of  digestion is one of the most frequent of all
the exciting causes.
   Symptoms. — To put it in the  plainest possible language,
acne is a disease in which the face, forehead, and neck  are
more or  less covered  with  pimples, some of them being
small and flat, others pointed and containing fluid,  while
some others may  contain  pus.   The  flat form of  the
pimple is called a  papule,  the  one containing fluid a
vesicle, while the one with pus is called a pustule.
   This is an affection of the skin that absolutely ruins  the
appearance  of thousands and  thousands of both  sexes.
In many  cases the eruption  is very red, is attended with
more or less  suppuration, rendering the skin disgustingly
uncleanly, and almost every  one so afflicted has exhausted
the medical  skill  and patience of the  neighborhood in
which he lives in order to get cured, and yet in nineteen
cases out of  twenty has neither been cured nor materially
benefited.  With young ladies the case is simply desperate,
as that upon which the  hopes and happiness of  every
woman largely depends is her  beauty, and this is totally
destroyed by the eruption.  It appears that but few things
can bring joy to the hearts of more  people  than  the dis- 
ACNE.
317
 covery of a remedy or certain form of treatment that will
 always cure this affection.  Such a remedy has been dis-
 covered, has been used by the author for a great many
 years, and is published  for  the first  time in  this book.
 It is  applicable not only  to this disease,  but many other
 chronic affections of the skin, and is as follows: —
             Corrosive sublimate, six grains,
             Brandy, one pint.
   Mix, and take a teaspoonful before each meal.  The fol-
 lowing is to be used  as  a face wash once per day, and
 applied with a small sponge : —
            Corrosive sublimate, eight grains,
            Brandy, a half pint.
   Mix, and apply with a small sponge to every part of the
 face upon which there is any eruption, using great  care to
 avoid getting it in the eyes.  It will take many  months to
 entirely cure a bad case, but improvement will commence
 within a few weeks.   In  the worst case ever treated by
 the author, both remedies  were used for  ten consecutive
 months.   In  this case a young lady who was so disfigured
 by the eruption that she had to wear two veils, was  com-
 pletely cured, and became one of the prettiest  women of
 the city.   In much milder cases a  cure can be effected in
 a couple  of months.   But the  one general advice to all is
to follow the treatment  until the patient is cured, as it
always succeeds  finally.   In  extreme cases that  have
lasted for years, it sometimes requires three months to
make  a decided impression upon  the  eruption. 
3i8
DISEASES OF THE SKIN.
                       WENS.

  Other names:  sebaceous tumors;  encysted tumors.
  A wen consists  of a  morbid condition of a fat gland of
the skin, and its  accompanying duct  in which  the walls,
both of the gland  and duct, are greatly expanded and con-
verted into a sack that  is filled with a brown colored fluid,
somewhat thick, sometimes jelly-like, and  in other cases
consisting of doughy matter.
  Causes. — Entirely unknown.
  Symptoms.—Wens  come on slowly, and are  generally
found on the scalp, but frequently occur on the  shoulders
and  back,  and  sometimes upon  other parts of the body.
They are  generally round or nearly so, and range in  size
from a  buck-shot to  a small  orange, the  largest  usually
being on  the  back.   They are  painless  tumors  unless
irritated by pressure or friction.
  Treatment. — This is easy and  simple,  and consists in
opening the sack freely with  a  sharp knife or lance, and
emptying  it of  its  contents.  The  next thing is to remove
the sack, and the  best way to do it is  to get hold  of it with
the finger and  thumb,  carefully work it loose, and extract
it whole if possible.  When this is done the wen  is forever
destroyed.  In  the small wens affecting the scalp they can
be opened with a lance, the  fluid  pressed out, and the
little sack filled with two  or three drops of the strongest
solution of  chromic acid.   This will entirely destroy the
sack so it will never refill. 
EXCESSIVE SWEATING.
319
              EXCESSIVE SWEATING.

   Other names :  hydrosis ; hyperidrosis.
   This is a derangement  of  the sweat  glands attended
with an increased flow of  perspiration.  It may be either
local or general.
   Causes. —In the majority of cases the cause of the affec-
tion cannot be determined.
   Symptoms. — When this disease occurs during an acute
disease such as rheumatism, pneumonia, in the advanced
stage of consumption, etc., it has no reference whatever to
the disease  under consideration, for in such cases  it is
merely one of the  symptoms of an acute affection.
   When the perspiration has the odor and chemical char-
acteristics of urine, to some extent, it is called uridrosis.
When the drops  of  respiration appear  luminous in the
dark it is called phosphoridrosis. When profuse sweating
occurs locally it generally affects the  palms of the hands,
the feet,  armpits, the  anus, and external sexual organs.
Excessive perspiration of the feet is the most  disagreeable
feature of the disease, as the socks become bathed in per-
spiration, acting as a constant poultice upon the  foot, caus-
ing the outside skin to  peal off, leaving the  inner skin so
tender as to interfere with walking.   In addition to  this,
the feet give off a sickening odor that is almost unendur-
able.   When the  affection attacks  the genital  organs of
the male,  as it sometimes  does, it imparts a  disagreeable
odor, to get rid of  which frequent bathing is necessary.
  There are a great many cases that do  not  yield to any
treatment.
  The parts should be thoroughly washed and  dried with 
320
DISEASES OF THE SKIN.
a good towel.  Then  one of the best preparations as a
dusting powder is the following: —
               Salicylic acid, two drachms,
               Tannin, one drachm,
               Prepared chalk, four ounces.
  Mix, and make into the  finest possible  powder, and ap-
ply it with a puff.
  For the profuse sweating of the feet they can be bathed
every morning in the following: —
                 Tannin, two drachms,
                 Alcohol, two ounces,
                 Water, six ounces.
  Mix, and  rub the feet freely,  and especially the soles
and between the toes with a sponge  dipped in this solu-
tion.  The feet should be thoroughly cleansed with soap
and  warm water before  using  the  tannin in this way.
After this has been  used  for a few mornings, use the fol-
lowing dusting powder in the socks : —
             Tannin, one-half ounce,
             Powdered starch, four ounces,
             Powdered soapstone, eight ounces.
  Mix thoroughly, and apply to  the soles of the  feet and
between  the  toes with  the  puff,  and dust  freely  into
the  socks.  It is  claimed that a  saturated  solution  of
boracic acid, applied once a day to the parts affected, will
cause an absolute cure.
  To make a  saturated solution,  put  all the boracic acid
in water that it will dissolve, and a little more, then shake
it well before using it. 
CONGESTION OF THE SKIN.
321
          CONGESTION  OF THE  SKIN.
   Another name is erythema simplex.
   This is an acute disease in which the vessels of the skin
 are more or less engorged with blood, assuming a  swollen
 and reddened  appearance, the color  being  removed by
 pressure.  As it is a step in the direction of inflammation
 the temperature is generally increased.
   Causes. — It may be produced by anything acting as an
 irritant, for example, sunshine in burning the skin  causes
 acute  congestion.  The  application of  irritating  drugs,
 severe friction, or pressure will have a  similar effect.
   Symptoms.—The skin  turns  red, the color gradually
 increasing until it may become almost purple, and in all
 cases as  the color deepens the  engorgement of the blood-
 vessels increases.  When the irritant  producing the con-
 gestion is local, the affection  is local also, as  a  general
 thing.
   Treatment. — Remove  the irritating cause as soon  as
 possible.  To overcome the congested and irritable state
 of the skin, the treatment is easy and  simple unless it has
 been  caused by  a  poison.  If  due to friction, pressure,
 mustard, Spanish flies, the application of heat, or  similar
 causes, the congestion will  speedily  subside when  the
 exciting cause is removed.
   One of the best remedies for acute congestion  of  the
 skin is the following: —
           Sugar of lead, a heaping teaspoonful,
           Water, a pint.
   Mix, and bathe the skin,  using a  soft  cloth, once or
twice a day.
        Y 
322
DISEASES OF THE SKIN.
           RINGWORM  OF THE  BODY.
   Other names : tinea circinata ;  herpes circinatus.
   This is a contagious disease of  the  skin  caused by the
presence  of a  parasite, and appears in  irregular, slightly
inflamed patches upon the body.
   Symptoms. — The  affection generally commences  by
the appearance of pimples in patches or clusters which
sooner or later arrange themselves  into  circular  form,
giving rise to  the familiar  name, " ringworm."  The com-
mon  size of a  ringworm  is  about an inch in diameter.
When the disease becomes very chronic  it is  hard to  dis-
tinguish  from salt-rheum.  This  is  especially the  case
when it affects the thighs, and should be treated as  the
chronic form of eczema.
   Termination. — This is always favorable  under the  cor-
rect treatment.
   Treatment.—As it is a local affection the  application
•to the affected  parts of a suitable remedy to destroy the
parasites  is all that  is necessary.  For this  purpose  the
following should be  applied to every part of  the diseased
skin: —
         Crystals of chromic acid,  two  drachms,
         Water, one and a half drachms.
   Mix, and apply with a camel's hair  brush.   If the part
of  the body affected by the ringworms is covered with
hair it must be closely clipped.  If a great deal of surface
is involved, it  is not well to treat it all  at  one sitting, or
even  during the same day; but as  a  general thing it is
proper to apply the solution to all the diseased surface at
the same time.  In  the  very  chronic  form, in  which  the
circular  or ringworm characteristics  have disappeared, 
RINGWORM.
323
the corrosive sublimate treatment, as advised for chronic
eczema, may be substituted for the chromic  acid.   The
formula is as follows : —
             Corrosive sublimate, eight grains,
             Brandy, a half pint.
  Mix, and apply once per day with a camel's hair brush.
Before using this the  skin must be washed thoroughly
clean, as it will do no  good if  grease  or ointment of any
kind covers the surface.   It should  be  applied at  least
once per day, and as the affection is  liable to be compli-
cated with eczema, the internal remedies for that disease
must be given also, and are as follows: —
            Corrosive sublimate, six grains,
            Brandy, one pint.
  Mix, and give  a  teaspoonful three  times a day.  The
treatment, both local and constitutional, should be followed
until the patient is  entirely well, even  if  it takes months,
which it may require if complicated with eczema.
                    RINGWORM.
  Other  names :   tinea favosa;  porrigo favosa; favus;
crusted ringworm.
  This is a chronic, inflamed condition of the skin, caused
by a parasite.   It is always due to this cause, and is liable
to affect persons of any age, as it is decidedly contagious.
It is found mostly among  people  who are careless  and
uncleanly  in their habits.
  Symptoms.— Its commencement is characterized by the
appearance, usually about the scalp, of small, yellow crusts.
In a few weeks the crusts increase  in size and sink in the 
324
DISEASES OF THE  SKIN.
centre, somewhat like a vaccine scab.  They may be few
in number or very numerous, and about as large as a pea.
  In the early stages of this disease, the yellow color of the
scabs and their sunken appearance are so very character-
istic that it is easily recognized.
  Termination. — This is always favorable, and yields read-
ily to local treatment.
  Treatment.— There is  nothing more  rational than  this :
If a bug or insect of any  kind secretes itself  in the skin so
as to form an inflammatory affection, the first thing  to be
done  is to kill it.  If there are  thousands of them, they
must all be killed.   There  is no occasion for constitutional
treatment in this disease;  it is essentially  local in every
respect, and to attempt to cure it with internal remedies is
as unscientific as to try  to remove a thorn  or a splinter
from  the flesh by giving a physic.  The following  local
remedy, if properly applied, will cure every case : —
          Chromic acid  crystals, two drachms,
          Water, a drachm and a half.
          Mix.
  This  is a saturated solution of  the chromic acid, and
should be applied to every crust or  scab by means of a
glass  rod or stick dipped  in the solution.    It is best to
touch every part of the inflamed skin in this way, and it
will kill every parasite.  When these are killed,  recovery
follows  rapidly, and the patient is well within a week.   Its
use is attended with but little pain or  smarting.
  If a great deal of the scalp is involved it may not be best
to treat every part of it at one time; but cases of this kind
are rare.  Before making  the application the hair should
be cut very short, and great care  must be taken to see that
every part of the diseased skin, whether on  the face or 
SALT-RHEUM.
325
scalp, is painted with the solution.  If thoroughly done,
one application is usually sufficient; but the diseased parts
should be  carefully examined at the end of a week to see
if  there is any appearance of living parasites, and if so,
touch the suspicious spots again with the solution.


                   SALT-RHEUM.

   Other names : tetter;  eczema ;  scall.
   This  is  an  inflammation of the  skin, either acute or
chronic, and may have during its different stages, papules,
vesicles, and pustules.  In  the  acute stage it is attended
with burning and tenderness, and, sooner or later, a watery
discharge from the skin resulting in the formation of crusts,
and attended with itching.  The disease is not contagious.
A great many different varieties are named in the text-
books, but they are merely different stages of the malady,
and  to  catalogue them  here  would simply confuse  the
reader.
   Causes. — It is liable to attack persons in all the  differ-
ent walks of life and of any age.  There are a great many
exciting causes that are liable to develop the affection, but
it  is  doubtful if  any or all of them will produce  a well-
marked case of salt-rheum, in one in whom no  hereditary
predisposition to  the disease exists.   Among all the affec-
tions that are directly traceable to heredity, salt-rheum takes
the lead.   Where it is found in one member of a family
of any size, it is  almost sure to crop out in several others,
sooner or later.   Where a train of symptoms attending an
acute inflammation of the skin is rheumic in character,  that
is, having the characteristics of salt-rheum, they are exceed-
ingly easy to overcome by treatment if  no  hereditary  ten- 
326
DISEASES OF THE SKIN.
dency  to  that  affection  exists, and therefore it  is  very
doubtful if  such cases as recover with but little  if  any
treatment are salt-rheum at all.
  Symptoms. — Salt-rheum is so varied and profuse in its
forms,  stages, and symptoms  as to assume the character,
during the different periods of its development, of  several
other skin  diseases,  but when it  is watched through  a
number of  its  stages, it  is not liable  to  be confounded
with other affections.
  It is the most common of all eruptions, and it is proba-
ble that  something near one-half of  all the chronic ail-
ments  of  the skin are eczema, in some of its many forms
and stages.   Therefore, if a skin  disease commences with
heat, redness, and  swelling, attended with a watery  dis-
charge  that leaves a crust on drying up, and is further
characterized by intense itching  or burning,  it is safe to
call it eczema or salt-rheum.
  The  simplest form  is attended with  redness of the skin
in patches, and  as a  general  thing there is  no discharge
from the surface.
  The papular form is that occurring in bright-red or dark-
red pimples.  It is more or less associated with the vesicu-
lar form to be hereafter described, and is characterized by
terrible itching.
  The  vesicular variety commences with the four principal
signs of inflammation,  namely:  heat, pain,  redness,  and
swelling, soon followed by the appearance of small vesicles
containing fluid.  When these vesicles or pimples rupture,
the escaped fluid spreads over the surface and dries up,
leaving crusts or scales.  Itching  is the terribly distress-
ing symptom of this form also.
  The  pustular form usually affects the face and head but 
SALT-RHEUM.
327
mostly the latter, and is characterized by large, thick crusts
from between which there is frequently an oozing of mat-
ter.  This  variety is  commonly known by the  name of
scall-head.
  Eczema rubrum is a form  characterized  by red skin, as
the word "rubrum" means red.  But  this variety has no
symptoms essentially different from other forms.
  The fissured variety is one in which  the  skin is fissured
or cracked.   Sometimes these fissures are  extensive, deep,
and very painful.  They frequently affect  the hands, and
are known by the familiar term, " chapped  hands."
  In order that eczema  may never  be mistaken for any
other  disease, the following condensed symptoms charac-
teristic of the affection, are  given, namely: Inflammation
of the skin, swelling, redness,  a discharge of moisture which
is followed by crusting, and itching and burning.   If all of
these  symptoms  are found in any case, it is eczema, as
they are practically  its autograph.
  Termination. — If  properly treated, this is always favor-
able, as every case ought to be cured,  unless it is compli-
cated with  disease of  the stomach or other infirmities, by
which  the  patient is  rendered incapable of taking the
necessary medicine.
  Treatment. — As eczema is a constitutional disease, and
undoubtedly of ancestral origin, so far as  a predisposing
cause is concerned, the main  treatment should be  constitu-
tional.   On whatever part of the body it appears, it writes
its full name  and  character by a half-dozen distinguishing
symptoms that point unmistakably to a blood disease  that
may be centuries  older than the patient.
  To suppose that such a condition  can be eradicated or
torn out by the roots  in  a few weeks, is  utter folly.  It 
328
DISEASES OF THE SKIN.
 takes months, and sometimes many months, too, to cure a
 bad case; but the author has had an extensive  experience
 with the disease in all its many forms, and has never failed
 to cure any case where he has been permitted to carry out
 the treatment as desired.  The two plans of treatment to be
 hereafter given — one for the  acute, and the other for the
 chronic — are not experimental.   They have been tried in
 a great many cases, and always  succeed.   The object in
 speaking in such positive terms  of  the treatment, is to in-
 spire every patient with a degree of confidence necessary
 to follow it long enough to effect a permanent cure.  The
 length of time required to cure a case depends, to some ex-
 tent, upon the time the disease has been running.  Where
 it  has  recently broken out, it can be conquered in a  few
 weeks  with but little if any local  treatment.
  If the disease has only existed a few weeks, or  even a
 few months,  the  following should be given immediately,
 and followed until the patient is well: —
  Iodide potassium, three drachms,
  Compound syrup of stillingia, one pint.
  Mix, and give a dessert-spoonful three times per day.
  There are a few, and only a few, rules of caution to be
observed regarding this remedy.   First. Be sure to get it
put up  by a good, reliable druggist.  Second.  If the patient
is a child, the dose must  be  reduced to suit the size and
age, and in all children under ten years old a teaspoonful
three times per day will be sufficient.  Third. By the time
the syrup is given a few days, all the symptoms may be-
come aggravated, the skin being  redder, the inflammation
greater, and  the  burning and itching more  intense.   In
such cases  the remedy must be left off for three or four
days, and then given in a little smaller doses.  After it is 
SALT-RHEUM.
329
given for a  few weeks, if no further aggravation  follows,
the dose may be gradually increased to the amount first
given.   It sometimes causes an unpleasant feeling in  the
throat, and also a watery discharge from  the  nose, as if
one had a cold;  but these annoyances can be easily borne
when every patient is assured that a permanent cure will
result in a short time.  In the acute form, that  is, in cases
of recent origin, no local treatment is used with a view of
having a curative effect.  A little vaseline  gently applied
to the affected skin will prevent a great deal of  the itching
and burning, and will also keep the crusts or scabs soft.
   In the form of the disease affecting the scalp, the crusts
are usually large, sometimes more or less  loose, and pus,
or white matter, will frequently make its appearance from
beneath one when it is pressed.  The  pus  and  watery  dis-
charge stick the hair down firmly upon the large scabs or
crusts, and the whole surface is often of a  dirty, yellowish
green.  Such cases frequently  resist the  ordinary treat-
ment for several years, first being  treated by one physi-
cian,  and  then by  another, and all to no  purpose.  But
although a case may have been running for a  few years,
the disease may be more acute than  chronic in  its nature,
and the iodide potassium and syrup of stillingia, as advised
for the acute form,  is the best treatment; but  it will take
six months,  and  sometimes longer, to cure cases  of this
kind.   Success probably depends more upon the alterative
and curative effect  of the stillingia  than upon the iodide
potassium.    Whether this  is  true or not, the form  of
eczema that affects the scalp as above described, is always
cured by the mixture if properly given.  This variety of the
disease is commonly termed " scall-head," and is never too
chronic to be cured with the  one general treatment given 
330
DISEASES OF THE SKIN.
for all acute cases.  During the constitutional treatment
of ." scall-head " no local  treatment is needed except for
the purpose of making the patient as comfortable as possi-
ble.   No effort should be made to remove the crusts until
they are loose enough to drop off, as they afford great pro-
tection to the inflamed skin beneath.   The hair should be
kept short, and the frequent use of vaseline will prevent
matting together.


                CHRONIC ECZEMA.
   The generic or original meaning of the word " chronic,"
signifies " of long duration," but in medicine it does not
necessarily mean  "of  long standing," as a disease  affect-
ing one person may be acute at the end of a year, while
the same disease attacking another may be chronic  within
a week or two.  Some forms of eczema are more chronic
than  acute in character  from  the beginning.   When  it
comes on gradually, with no active, inflammatory symptoms,
but is mild and sluggish  in  its  development, it is chronic
in form, although of  recent origin, and must be treated as
chronic.
   If any  local treatment is used in  the acute form,  it
should be  something to reduce  the inflammatory  action
and modify the intensity of the disease.  Whatever local
application is used in the chronic form is to make the dis-
eased action more violent, and develop in that way a healing
and, ultimately, a curative effect.  Therefore, a local treat-
ment is always conjoined with the constitutional in chronic
eczema, the internal remedy being as follows : —
             Corrosive sublimate, six grains,
             Brandy, one pint. 
CHRONIC ECZEMA.
331
  Mix, and give a teaspoonful before each meal.
  This mixture  must be taken  for months, or until the
patient is entirely well.
  The local treatment to be applied at least once per day
is as follows: —
             Corrosive sublimate, eight grains,
             Brandy, one-half pint.
  Mix, and apply once per  day with a soft brush, a camel's
hair brush being preferred.  It is rarely if  ever needed in
"scall-head," or in the  suppurative form,  the variety  in
which matter is discharged from beneath the scabs.  Such
cases are cured with the idodide potassium and stillingia,
and where the syrup mixture is  used,  the  corrosive subli-
mate and brandy should neither be given nor used locally.
  There are many forms of eczema in which the skin is
very red and tender, and  the affected  parts have to  be
covered constantly to avoid the chafing effects of the air.
This  is especially the case when one or both hands are
diseased.
  Sometimes a hand is wrapped up for years in this way
with  salt-rheum, and is  red, painfully tender, more acute
in character than  chronic,  and stubbornly resists  all ordi-
nary  efforts in the  way  of treatment.   The corrosive
sublimate remedies, as  herein advised, will cure all  such
cases within six or eight weeks.  Improvement will  be
apparent within a week or  so, and the cure will be perma-
nent ; but it  may take months for the skin to  lose the
unnatural color.  In almost all forms of  eczema, except
" scall-head," the corrosive  sublimate mixtures are preferred
to the iodide potassium and stillingia whenever the patient
can comfortably bear the application of  the local  remedy,
as  the  cure is  much more rapid from  the two mixtures 
332
DISEASES OF THE SKIN.
of mercury and  brandy than from the syrup  and iodide,
the cures being permanent in both cases.
  Sometimes two or more diseases  of  the skin affect a
person at the same time, the symptoms being so confusing
that it is impossible for a specialist  in skin affections to
know what particular form of skin disease  he  is treating,
and  he is, therefore, compelled  to  proceed  on general
principles, and cure his patient if he can.
  The remedies  prescribed in this chapter will cure other
forms of skin disease besides eczema, provided the symp-
toms  are somewhat similar.  Then, again,  about one-half
of all the chronic affections of the skin are eczema in some
form, so that a non-professional, should he call  every erup-
tion of the skin he sees, eczema, would be right about half
the time.  Therefore : —
        To fathers, mothers, sisters,  and brothers,
        Uncles, aunts, cousins, and others,
the following advice is given : When  you encounter a skin
disease that you cannot possibly name, carefully read the
chapter on  eczema, including the treatment,  and if  you
find symptoms somewhat similar to those of eczema in any
of its  stages, treat  the affection  accordingly,  and if  you
cure a disease and do not  know its name nor  much of its
peculiar character,  you simply do what we  doctors are
compelled to do  many,  many times every year we practise
medicine. 
THE ITCH.
333
                     THE ITCH.
  Another name is scabies.
  This is a highly contagious disease  caused by the loca-
tion of little animals in the skin, and  is attended with an
eruption that usually involves most of  the body except the
head, neck, and face.  The eruption has three stages:  First,
the papule or pimple, when it first  begins to make its ap-
pearance ;  second, the vesicle, when the pimples are filled
with fluid; third, pustules, when pus or matter  is present
in the pimples.   The little parasites burrow into the skin,
causing inflammation and intense itching, to relieve which
the patient is seized with an irresistible desire to scratch;
this tears the top off the vesicle or pustule, causing more
or less bleeding, and greatly changes the appearance of the
affection.
  Termination.—This  is always  favorable  if  properly
treated.
  Treatment. — No  internal remedies are  needed in the
treatment of itch, as it  is purely a local affection.   The
following ointment will  cure every case if the  directions
are carefully followed: —
           Venice turpentine, three drachms,
           Powdered sulphur, one ounce,
           Vaseline, three ounces,
           Carbolic acid, one drachm and a half,
           Oil citronella, one drachm.
  Mix, and rub thoroughly over every  part of the body ex-
cept the face and  head, applying  it at bedtime.  On the
following night apply it again in the  same way, and the
next  night  wash thoroughly with  very warm water and
castile soap so as to remove  every part of the ointment, 
334
DISEASES OF THE SKIN.
and  then put on clean underclothes.   Common lard  may
be used instead of the vaseline if desirable, and is quite as
good in every way.


                  BARBER'S  ITCH.

  This is a contagious  affection  of the skin  due to a para-
site,  and involves  the roots of the whiskers.  It is a very
contagious disease, and  is  said to  be communicated  to
gentlemen by the barber while they are being shaved, the
infecting parasite being transferred to the skin by a brush
or sponge.
  Symptoms.—This form of itch begins as  scaly patches,
the affected  skin being reddish and gradually becoming
more inflamed and thickened.   As  the  inflammatory ac-
tion  increases, the skin becomes thicker and lumpy with
points  of suppuration.  The pain, itching, and burning are
very severe in some cases.
  Treatment. — The first thing  to be done  is to clip the
beard as short as  possible,  and put a poultice of flaxseed
meal on the face and allow it to remain all night.   In the
morning remove the poultice, and wash the  face with cas-
tile soap and warm water, carefully removing all crusts or
scabs if  it can be done  without making the face  bleed.
Then touch all the diseased portions of the skin  with a
solution of chromic acid, made as follows: —
             Chromic acid, two  drachms,
             Water, one drachm and a half.
  Mix, and apply with a  camel's hair brush, using it spar-
ingly so  it will not spread to parts not  touched with the
brush.   If this is properly  done one application  will be
sufficient  to  effect a  cure.  If  it attacks a person with 
FRECKLES.
335
heavy whiskers, and there are serious objections to having
them clipped close so as to allow the chromic acid solution
to be properly applied, the following can be used instead,
and will usually effect a cure: —
             Corrosive sublimate, ten grains,
             Brandy, one-half pint.
   Mix, and rub it into  the  skin thoroughly wherever the
disease exists.   If thoroughly applied it will kill the para-
sites, and recovery will soon follow.


                     FRECKLES.

   Another name is lentigo.
   This is a dark or yellowish deposit in the skin, showing
itself in the form of yellow  specks  that  are sometimes as
large as a pea.  It is most observed on the face, neck, and
hands, because those parts of the skin are most exposed to
the sun and air.
   Causes. — The predisposing cause is hereditary and the
main exciting cause is sunshine.
   Termination. — So far as permanent cure is concerned,
this  is not very favorable unless the patient is protected
from the sun.
   Treatment. — This affection becomes very serious when
the blotches are large  and deeply colored upon the faces
of young ladies, and efforts  are  constantly made  to bleach
out the  spots by the use  of various drugs  recommended
for such purposes.  It seems the best remedies  that  have
ever been found are only successful to a limited extent.
   In all diseases the most important thing to be done is to
get rid of the exciting cause,  and this  is especially true
with freckles.   Therefore the  only  rational  plan that can 
336
DISEASES OF  THE SKIN.
yield anything like satisfactory results is for every person
who is  constitutionally  inclined to have freckles, to veil
their faces from the sun.  The following local application
enjoys the reputation of being  one of the very best to re-
move freckles:—
             Corrosive sublimate,  six grains,
             Diluted muriatic acid, two  drachms,
             Alcohol, two ounces,
             Glycerine, one ounce,
             Water, a half pint.
  Mix, and apply at bedtime, taking great care to avoid
getting it in the eyes.   It should be washed off next morn-
ing with soap and warm water.


    CHALK-LIKE  DEPOSITS IN  THE SKIN.
  This  affection has a great many other names that are
decidedly technical and  unnecessary to mention  here, and
consists of a deposit of cheesy matter in the  duct of a fat
gland of the skin, the mouth of such duct, for some reason,
being permanently closed.   The  white deposit is there-
fore imprisoned, and shows  through the thin,  overlying
skin as a small piece of  chalk.  These  little lumps range
in size from small bird-shot to a large grain of wheat, and
are usually seen about the eyes, upon the eyelids, and just
below the  eyes.
  Termination. — This is always favorable.
  Treatment. — This consists in opening the sack, holding
the substance with the point of a sharp knife, or picking
it open with a  needle  and  squeezing  its contents  out.
After this if the sack  should refill, it should be emptied in
exactly the same way, and then touched with a saturated 
HIVES.
337
 solution  of chromic  acid.   This  should be  used very
 sparingly,  as  the  head of a pin will hold enough when
 crowded into the opening to destroy  the  sack.  Opening
 the sack with  a needle or lance is almost entirely free from
 pain.

                        HIVES.
   Other names:  nettle-rash; urticaria.
   This is an inflammation of the skin  accompanied with
 numerous round elevations of the surface, being somewhat
 deeper in color than the surrounding skin.  For example :
 The skin may be a light pink while the circular elevations,
 known as hives, are a deeper red, and attended with burn-
 ing,  itching, and stinging.
   Causes. — Hives prevail more extensively in hot weather,
 scarcely  causing any trouble during the fall, winter, and
 early spring.  It can therefore be accepted as a rule that
 the heat  of summer is the principal exciting cause.  As all
 affections of the skin are influenced, more or less, by dis-
 orders of digestion, the condition of the stomach must be
 considered  in dealing  with hives.
   Symptoms. — Hives are known by the  sudden appear-
 ance of rounded elevations upon the  surface of the skin,
 called wheals, which  are frequently whitish to commence
 with, and later becoming pinkish  or a deeper  red.  The
 color, no doubt, is  frequently  deepened by rubbing or
 scratching to allay the itching.
   The most distressing feature of this  affection  is the
terrible itching.  The wheals are usually  small, not much
larger than a half  pea, but sometimes are as large as an
egg.   They may be very few in number, while in other
cases they cover the entire body.
        z 
338
DISEASES OF THE SKIN.
  Treatment. — To relieve the distressing itching, the hives
should be  bathed in a strong  solution of baking soda.
About two  heaping teaspoonfuls of the soda to a glass of
water will probably answer, but should it  fail  to allay the
itching, it must be  made strong enough to cause  a little
smarting of the skin, when the itching will cease.
  Another  very efficient local application to stop the itch-
ing is the following: —
             Carbolic acid, a tablespoonful,
             Water, one pint.
  Mix and shake.  Dip  your finger  in the solution, and
wet every  itching wheal by  touching one at a time.   If
they are  numerous, the surface involved may  be wet by a
sponge or soft cotton cloth dipped in  the  solution.  They
must  neither be scratched nor rubbed, as anything  that
irritates the skin  greatly increases the trouble, especially
the itching.
  Stimulants of every kind, including tea and coffee, should
be left off.   The following is one of the best  remedies to
break up an attack of hives : —
            Salicylate of soda, two drachms,
            Water, four ounces.
  Mix, and take a teaspoonful every two hours for twenty-
four hours.  Then  give the following mixture until there
are free watery discharges from the bowels: —
           Epsom salts,
           Cream of tartar, of each an ounce.
  Mix thoroughly,  and take a heaping teaspoonful  in a
half glass of water every three hours until it commences
to act on the bowels.  During an attack of hives  it  is
best to  use every  possible means to avoid  heating  the
blood, and, therefore, the  clothing should be very light, 
BLACK-HEADED WORMS.
339
and  exercise in the  heat  of  the  day should be  avoided.
Should the patient resort to bathing  to quiet the burning
and  itching, the water should be a little warm, as the
reaction from a cold  bath greatly aggravates the affection.


            BLACK-HEADED  WORMS.
  Other names : acne punctata nigra; comedo.
  This is a disordered  condition of the fat glands of the
skin, in which there is retained in the duct of each gland
a resinous,  cheese-like  secretion,  having in  its  centre a
black point.  When  this obstructed  duct is squeezed be-
tween  the  thumb  and finger nails, the cheesy substance,
crowned  with  a black  head, comes out and  turns over
upon the  skin, presenting the  appearance of a worm the
eighth of  an inch long or more, and for this  reason the
affection is usually known as  black-headed worms.
  Causes. —The only thing sure in reference to the cause,
is  that it runs in families,  and  is  therefore  due to  an
inherited predisposition.
  Symptoms. — This is  a chronic derangement of the skin
unattended  by irritation, itching, or  any  other  unpleasant
symptom except disfiguring the features of the patient, as
the mouth of each excretory duct of the skin may be a
black  speck, giving a  person  the appearance of having
been burnt  with powder.
  Termination---Under proper treatment this is usually
favorable,  but many cases are tedious and troublesome.
  Treatment. — To begin  with, the disorders  of the stom-
ach  and bowels, if any exist, should be corrected.  The
local treatment consists in  poulticing the face  over night
with bread and milk  or  flaxseed, and washing  thoroughly 
340
DISEASES OF  THE SKIN.
in the morning with soap and water,  and  rubbing the
so-called  worms out of the skin with a  Turkish towel.
Those that cannot be rubbed out can be pressed out  with
the thumb nail.  After this, the application of zinc  oint-
ment  once per day will be of great service to prevent  their
return.   It may be continued for a week.

                    CARBUNCLE.

  Another name is anthrax.
  This  is  a  circumscribed  inflammation,  the  skin   and
tissues involved being thickened, hardened, of a dark red
color, and very painful.
  Causes.— It most frequently occurs after the meridian of
life, but its real cause is unknown.
  Symptoms. — To  commence with, it is usually a circular
inflammation  rising  somewhat above the surrounding  parts
like a boil, and taking  on a dark red  or purple  color.
Sometimes the inflammation is deep and extensive in all
directions.  The pressure from congestion and deposits of
lymph partially arrest  the circulation,  causing more or
less destruction of  the central part of the carbuncle by
gangrene.  There may be several of these points in which
death of the tissue has occurred.  These form openings
through  which matter  is permitted to  escape.  As the
disease progresses,  these numerous openings may honey-
comb the whole central part, leaving but  little living flesh
between  the  openings.  The  affection is attended  with
severe throbbing pain, loss of appetite, coated tongue, and
the usual symptoms of inflammation.  Its duration is from
two weeks to two months, and its favorite location seems
to be the back of the neck. 
CARBUNCLE.                   341
   Termination.—This  is not always  favorable,  as blood
 poisoning is frequently a fatal  complication.
   Treatment. — The diet should be nutritious, consisting
 of beef, chicken, or mutton broth, and  all the good  animal
 food that the patient may desire.   As a tonic, the  follow-
 ing  is probably as good as can be given: —
        Fluid extract of Peruvian bark,
        Fluid extract of wild-cherry bark,
        Of each, six drachms,
        Sulphate of iron, thirty-two grains,
        Port wine,  one pint.
        Mix; dose, a tablespoonful before each meal.
   After the flesh of the carbuncle is mostly destroyed by
 a number of pipes that are  connected only by thin walls,
 there  is no quicker, better, and safer plan  of treatment
 than to cut the whole honeycombed portion  out, leaving
 on all sides a wall of  inflamed  flesh.  The operation is
 easy, simple, and  almost painless.  For this purpose the:
 writer has always  used  curved scissors similar  to those
 used by an  oculist in taking out an eye.  In order to do
 this  without giving ether, the walls of the pipes embracing
 the central and main part of the carbuncle are wet with a
 strong solution of carbolic acid  so  as  to turn them white.
 By this means, clipping the tissues that separate the open-
 ings from each other is practically painless, and the opera-
 tion  is attended with  no hemorrhage to speak of.   When
 it is  all removed, leaving the walls  of the carbuncle sound
 and  free from  any dead tissue, the  cavity may be packed
 with absorbent  cotton wet with  a five per  cent solution of
carbolic  acid.   This  course  greatly lessens the  danger
from blood  poison, and recovery sets in immediately.
  The cavity gradually fills  up with granulations,  and the 
342
DISEASES OF THE SKIN.
scar does  net seem to be increased much, if any, by the
operation.

            FLESH-WORM  DISEASE.
  Other names :  trichinae ; trichina spiralis ;  pork worm.
  This is  a  condition of  fever caused by the pork worm
entering the  stomach and bowels, and meandering, sooner
or later, into other parts  of the body, especially the mus-
cular structure.   It  is attended with severe irritation of
the  stomach and  bowels,  soreness  of the muscles,  and a
typhoid type of  fever.
  These worms  gain entrance to the human body by the
use  of hog's  flesh  in the  raw or imperfectly  cooked state
as food.  The intestinal pork worm, which is fully matured
in its sexual  organs, is from one eighteenth  to one eighth
of an inch long, the longer ones being the female.   Seen
under the microscope they appear about as large and long
as a fine cambric needle.  As the author remembers them,
after the lapse of  several  years, they look like a miniature
snake, the head being enlarged, and the  neck somewhat
slender.  They  propagate by eggs.
  Symptoms. — These are greatly modified by the number
of worms  in  the  affected food.   It  is claimed  by good
authority that a cubic inch of pork may contain  eighty
thousand of the parasites.
  The  intestinal stage of  the disease is that  during which
the  worms are in the stomach and bowels, and is  attended
with nausea, vomiting, and liquid diarrhoea.  The symptoms
are  grave or mild, according as the number of worms  are
many or few.
  The  second stage is the one during which the  worms
travel to other parts of the body, and invade the muscular 
CHAFING.
343
tissue.  This stage is attended with fever,  somewhat  ty-
phoid in character, thirst being great, tongue and lips dry,
face red and swollen, with great soreness of the muscles.
  Encysted stage. — This is the stage  of the affection in
which the parasite locates  himself, and ceases to migrate,
a cyst or small  sack  forming around each one of  them.
In this way the  ravages of the worms  upon  the flesh are
stopped.  If the number that have invaded the muscular
structure are comparatively few, recovery may occur during
this stage.
  The mortality depends almost  solely upon the number
of worms in the pork, but, on the  average, from twenty-
five to fifty in a hundred die.
  Treatment. — The prevention consists in eating no pork
that has not been thoroughly cooked.  If the infected meat
has been recently eaten, a thorough emetic should be given
so as to have it expelled from the stomach. A large physic
of castor oil should also be given to carry them out of the
bowels.   After they leave the stomach  and  bowels  their
prostrating effects  on  the system is readily apparent, and
stimulants and tonics should be resorted to.


                     CHAFING.

  The technical name of  this very common affection is
erythema intertrigo.
  It is a congested  or inflamed condition of the skin, caused
usually  by friction of the opposite parts of the body, and is
specially troublesome in hot weather among fleshy people.
  Causes.— It is an annoying affliction confined mainly to
fat  people, and  caused by chafing  of  the opposing skin
surfaces in walking.   In such cases it  is usually between 
344
DISEASES OF THE SKIN.
the thighs or buttocks.   It also occurs under the arms, and
is  then due, in a measure, to perspiration and rubbing of
clothing.
  Symptoms.— Redness and soreness of the opposing sur-
faces  of  the skin, caused by the movements of the body,
the parts affected  being the  groins, armpits, beneath the
breasts of females, or any other parts of the body where
undue friction  occurs from the folds of  the skin coming in
contact with each other.
  Treatment.— The affected parts should be washed  thor-
oughly with soap and warm water and carefully dried, then
dusted with powdered starch, soapstone, or prepared chalk.
There is scarcely anything better  than powdered starch,
which can  be  applied with the fingers or a puff.  In ad-
dition to  this it is important to keep the opposite  surfaces
separated by the use of lint or absorbing cotton.   The latter
is of great service in separating the buttocks, where persons
are exceedingly fleshy.  Where the chafing has  developed
an inflammatory condition, it is better to wash it thoroughly
clean  in soap and warm water, and use the following lotion
at  bedtime: —
          Sugar of lead, a heaping teaspoonful,
          Water, a pint.
          Mix.
  The parts should be thoroughly washed in the morning,
and gently dried with a soft towel, and  then  some one of
the favorite dusting powders applied freely.  Common flour
is a good substitute. 
WARTS.
345
                       WARTS.
   The technical name is verruca.
   A wart consists of a morbid or unnatural excrescence upon
the skin, and may be as small  as a pin head or as large as
the end of a finger.   They are due to an unknown cause.
   Symptoms.— The  common  wart  is familiar to  almost
every person, their favorite location being upon the hands
and fingers.   There are many strange things in connection
with this form  and the manner of getting rid  of them.
There  are two drug treatments known  to the author, one
of which will remove a great many warts without causing
any inflammatory action  whatever.  The remedy is  sal
ammoniac, and is applied by wetting it with saliva and rub-
bing it on the wart once per day, causing it to disappear in a
couple of weeks.  It may be that  this treatment would
remove all of the common form of warts, if kept up long
enough.  A gentleman who undertook this treatment upon
a large wart on his finger,  applied it once just before start-
ing on  a long journey.  He forgot his remedy and deferred
further treatment till his return, several  weeks later.  On
getting home he got the crystal  of sal ammoniac to com-
mence  the treatment  again, but could not find the wart.
This treatment is painless, and should have  a thorough
trial before using severer remedies.   A treatment that never
fails to destroy any wart, if applied for a sufficient number
of times, is  chromic acid, as strong as  it can be made.
The solution is prepared by putting a drachm of the crys-
tals in  the least amount of water that will dissolve them,
which is  probably about the weight of the crystals.  The
application of the drug turns the wart black, hard, and dry,
and it finally falls off, leaving an inflamed surface that soon 
346
DISEASES OF THE SKIN.
heals.   There are a great many curious remedies for warts
that nobody can explain nor have any idea of the manner
in which they operate.  For example:  Some persons are
especially gifted as wart doctors, and by wetting their finger
with saliva and touching the wart, always cause it to dis-
appear.  When the author was a boy, he knew a man who
had this peculiar faculty, and  gratuitously  removed warts
from the hands of all the boys and girls in the neighborhood
by  simply wetting  the wart with  saliva,  and repeating
some meaningless  rigmarole  of  words.    Another  plan
very popular in the  country  is to go to  an old hollow
stump  partially  filled  with  stagnant water, and wash the
hands covered with warts every morning for a week, walk-
ing round the stump three times each  morning.  It seems
this is usually  successful.  It is probable that the curative
value of all  such methods, including wetting the warts
with saliva, depends upon the influence that the treatment
has upon the mind of the patient.
  Verruca filiformis is the long, slender character of warts
found on the face, eyelids, neck, and inside of the thighs.
These warts are from the eighth  to a quarter of an inch
long, and are  easily removed by  tying a  thread  around
them, making the knot double so  it  will not slip.  The
wart turns black and drops off in forty-eight hours, the
treatment being almost wholly  unattended with pain.

                       CORNS.
  Another name is clavus.
  Unfortunately, almost every one who has worn shoes is
keenly aware  of the character and sensitive nature of a
corn, and therefore a description of the horny and  painful
thing that afflicts so many people is unnecessary. 
CORNS.
347
   Causes. — Corns are always caused either by pressure or
friction,  and in almost all cases  by pressure from tight
shoes or boots.
   Treatment. — As the  principal cause  is a tight-fitting
boot it must be  changed for  one that  is soft  and easy.
Something depends upon the character  of the  leather as
well as the fitting.  If this is coarse, heavy, and more or
less unyielding it may cause a corn, even if the shoe is
abundantly large.  In  order  to remove a corn it is best to
soak it for half an hour in hot water to  which has been
added a few ounces of hartshorn.  After  this most of the
corn may be scraped off easily with  a dull knife.   If this
is followed up about  twice a  week for a couple of months
the corn will almost entirely disappear.   And during all
the time of treatment it is well to wear a corn-plaster ring
to avoid pressure from the shoe.  Where a corn is very
large and troublesome  it is best to have a shoe made with
the special object of protecting it from pressure.  In such
a case a shoemaker who understands his business will put
a bunch upon his last, considerably  larger than the corn,
and exactly  corresponding to  the location of  the latter
upon the foot.   In this way the  leather never contracts
sufficiently to bear much if any upon  the  corn, which
gradually grows less.
   Soft  Corns. — These occur between the toes, and  the
best way  to get rid  of them is to soak  them for a long
time in warm water in which a  little caustic potash  has
been dissolved.   It should be as strong as can be borne
without smarting  of the skin.   After this the foot must be
thoroughly washed in  soap and water, wiped dry, and the
corn picked out with the point of  a dull knife.
   All such corns, as well as hard corns that are painful 
348
DISEASES OF THE SKIN.
and tender, should be treated night and morning with the
following liniment until the soreness disappears : —
        Strong spirits of ammonia,
        Olive oil,
        Spirits of turpentine, of each, one ounce.
  Mix.  Previous to applying this, every corn should be
dressed down as thin as possible with a sharp knife, care
being taken to avoid making it bleed.


              INGROWN  TOE-NAILS.
  This  is  a condition of the toe-nail in which the  edges
have grown down into  the  flesh.   There are  two main
causes of the trouble: One is narrow-toed or badly  fitting
shoes that press upon the outside of the nail of  the great
toe, so as to change its direction and drive it down into the
flesh.  The other cause, and a very frequent one too, arises
from the bad way in which the nail is trimmed.  If  this
is done with a knife, and part of the nail  cut off of the
edge instead of the end, it destroys the shape  of the nail,
and causes it to send its sharp and unnatural edge into the
flesh, causing great pain and soreness.  This bad manage-
ment in the  matter of trimming increases the nail de-
formity until the person cannot get round without great
inconvenience.
  Treatment. — This is  easy and simple, and  yet it may
take a few months of proper management to get the  toe-
nail back to an easy, natural condition.   In the first place,
in order to avoid running the knife too  far  up the edges
of the toe  and in that way removing some of the nail from
each side,  it is best not to use a knife at all in  cutting the
nail.  The main thing is to cut the nail square  across or 
INGROWN  TOE-NAILS.
349
nearly so, and if it is done with scissors it is almost impos-
sible to do it any other way, and if they are so trimmed
for a number of months, the nails will become much  less
inclined to turn down as the corners project, so as to  rise
above the flesh instead  of going  into it.  Another impor-
tant  treatment, however,  must be conjoined with  correct
trimming in order to get the deformed nail in a  natural
condition.  This consists in carefully scraping the horny
edge until it is quite thin so it will easily bend, then lifting
it with the point of  a dull knife and pressing a small  tuft
of cotton under it.   This raises the  edge of the nail  and
changes its direction so it grows over the flesh instead of
into it.  In such cases it is best  to wear a tuft of cotton
under the  nail for  several  months,  scraping the  edge of
the nail now and  then if necessary.  When the  foot is
washed the old tuft can be taken  out, and a clean  one in-
serted in its place.    It is hard to imagine an ingrown  toe-
nail  so terribly distorted,  horny, and  refractory as to
require removal by the  surgeon's  knife, and yet the oper-
ation  is  frequently  performed,  and,  unhappily,  without
overcoming the  difficulty.   A ten-year old boy or girl, if
properly instructed, can do all the surgery necessary to
cure an ingrown toe-nail, and all the instrument needed is
a common pocket-knife to scrape the edges until they are
thin, so they can be raised sufficiently to admit a tuft of
cotton.  The scraping  should be commenced at   least a
quarter of an inch from the side  of  the  toe-nail, the point
of the knife being  directed  toward the  flesh, the scraping
being deeper as the edge is approached.   Meanwhile, the
nails must be trimmed with scissors instead of a knife. 
350
POISONS.
                      POISONS.
  For the sake  of convenience it is best to divide poisons
into three principal classes, as follows : —
  First.   Corrosive poisons, or those that cause  death by
their violent and destructive action upon the stomach.
  This class includes all the powerful acids, both mineral
and vegetable, and also strong alkaline salts such  as caustic
soda and caustic potash.
  Second.   Poisons  that act upon the  brain and nervous
system.  This class includes morphine, and opium in every
form, antipyrine and similar painkillers, the most  deadly of
all being prussic acid.
  Third.   In  this class  are included drugs that  have a
tendency to destroy life both by their corrosive action upon
the stomach and their effects  upon the  nervous system.
The well-known drug, carbolic acid, belongs to this class.
  Treatment. — For  all poisons that are truly acid, such as
nitric acid, sulphuric  acid, muriatic acid, and strong vinegar,
common baking soda must be given about as follows:  Put
a heaping tablespoonful of the soda in a pint of water, and
give a swallow of  it  every few minutes until gas ceases to
come from the stomach, and then give three or four table-
spoonfuls of sweet oil.
  When caustic soda or caustic potash or lye of  any kind is
swallowed, give  the following immediately: —
                  Vinegar, one ounce,
                  Water, three ounces.
  Mix, and give a swallow every few minutes  until gas
ceases to rise from the stomach, then give three tablespoon-
fuls of sweet oil.
  If morphitie, opium, or  any other poison,  except an  acid 
POISONS.
351
or an alkali, is swallowed, its fatal effects may often be pre-
vented by giving three or four ounces of sweet oil or sev-
eral raw eggs.   The oil or the eggs get mixed up with the
poison so its absorption by the  stomach is greatly delayed,
and the effects of the poison being much more gradual in
coming on are much less dangerous.  An immense quan-
tity of milk or melted butter is also good in such cases.
   The best antidote for morphine after its poisonous effects
have set in, is the sulphate of strychnine to counteract the
tendency to profound and fatal slumber, and if the drug is
given until it causes jerking of the muscles, it will probably
arouse the  action of the brain so as gradually to restore the
natural action of the heart, lungs, and  other organs, and
save the patient.
   The dose of the strychnine may be  from the tenth to the
fourth of a grain,  according to the  extent of the poison
from morphine.   It should be given until its characteristic
effects, which are jerking of the muscles, show themselves.
   The best remedy for  strychnine poisoning is morphine,
and the dose may be a half grain to commence with.
   In addition to this, chloroform should be given by inhala-
tion until the muscles are perfectly relaxed, and the patient
should be kept under the influence of chloroform or ether
sufficiently to prevent spasm of the muscles, until the effects
of the strychnine have worn away.
   In poisoning  from arsenic, several  raw eggs should be
given as soon as possible.  The following drug is the best
antidote:
   Hydrated oxide of iron, in the soft,  pulpy form, the dose
being a  tablespoonful as soon  as possible and  repeated
every ten minutes until the dangerous symptoms are over.
The dose for a child is a teaspoonful  to a dessert-spoonful,
according to age. 
 
INDEX.
Appendicitis, suppurative, 66.
Ascites, 76.
*Ague, 93.
Asthma,  163.
    bronchial, 163.
    spasmodic, 163.
    hay, no.
Apoplexy, 188.
"A stroke," 188.
* Angina pectoris, 197.
Acute coryza,  224.
*A girdle, 266.
Amenorrhcea, 273.
*Acne, 316.
    sebacea, 313.
    * vulgar is, 316.
    punctata Nigra, 339.
Anthrax, 340.

Black vomit, 114.
Bronchitis, chronic,  151.
    secondary, 151.
Brain, hemorrhage of, 188.
    congestion of, 195.
Bleeding from a cut, 206.
    *from pulling a tooth, 206.
    *from nose, 207.
    from lungs, 166.
* Bloody flux,  51.
*Bronchocele,  212.
Bright's disease, acute, 246.
Biliary calculi, 245.
Black-headed worms, 339.
       2A
  Clothing, 22.
  * Constipation, 37.
  Cholera, 55.
      epidemic, 55.
      autumnal, no.
      Asiatic, 55.
      spasmodic, 55.
      malignant, 55.
      * infantum, 43.
      *morbus, 58.
      *bilious, 58.
      * English, 58.
      *sporadic, 58.
  Colitis,  51.
      ulcerative, 51.
  * Catarrh, 214.
      *chronic nasal, 214.
      of bile ducts, 223.
      acute nasal, 224.
      of the mouth, 150.
      contagious, 153.
      acute gastric, 83.
      intestinal, 62.
      chronic gastric, 78.
  Catarrhal enteritis, 62.
      nephritis, 241.
      stomatitis, 150.
  *Cardialgia, 72.
  * Chills  and fever, 93,
  Cerebro-spinal meningitis, 106.
      fever, 106.
      typhus, 106.
  Chicken-pox, 142.
353 
354
INDEX.
Cancer, gastric, 75.
    of the stomach, 75.
    water, 146.
Cancrum oris, 146.
* Croup, membranous,  169.
    *true, 169.
    "spasmodic, 181.
    * false, 181.
* Croupous Laryngitis, 169.
* Child-croiving, 181.
Cerebral congestion, 195.
    hyperaemia, 195.
"Colic, intestinal, 61.
    "infantile, 205.
    "cramp, 210.
    hepatic, 245.
Coryza, chronic, 214.
    acute, 224.
Cephalodynia, 221.
Cold in the head, 224.
Coup de soleil, 261.
Chorea, 265.
Conception, when  most liable, 310.
Caked breasts and sore nipples, 311.
Congestion of the skin, 321.
"Chalk-like deposits of the skin, 336.
Comedo, 339.
Carbuncle, 340.
Cancrum oris, 146.
Chafing, 343.
Clavus, 346.
Consumption, of throat, 174.
    of lungs, 174.
Corns, 346.

Diet, 20.
"Dyspepsia, 31.
     "atonic, 31.
     "intestinal, 47.
     drunkard's, 64.
     "chronic, 78.
"Diarrhoea, acute, 62.
"Dysentery, acute, 51.
Dropsy, abdominal, 76.
Dropsy, peritoneal, 76.
"Diphtheria, 184.
Diabetes insipidus, 242.
    mellitus, 243.
Dysmenorrhcea, 275.
Dandruff, 313.

Exercise, 25.
Erysipelas, 136.
Erysipelatous dermatitis, 136.
*Epistaxis, 207.
Epilepsy, 250.
"Encysted tumors, 318.
Excessive sweating, 319.
Erythema simplex, 321.
"Eczema, 325.
    chronic, 330.
Erythema intertrigo, 343.

Fevers, 89.
    general management of, 91.
    "intermittent, 93.
    swamp, 93.
    malarial, 93.
    remittent, 97.
    typho-malarial, 97.
    bilious, 97.
    bilious remittent, 97.
    marsh, 97.
    typhoid, 101.
    enteric, 101.
    gastric, 83,  101.
    nervous, 101.
    abdominal typhus, 101.
    autumnal, 101.
    simple, continued, 109.
    irritative, 109.
    ephemeral,  109.
    bilious typhoid, 112.
    relapsing, 112.
    famine, 112.
    ship, 113.
    contagious, 113.
    jail, 113. 
INDEX.
355
 Fevers, petechial, 113.
     typhus, 113.
     spotted, 113.
     exanthematic typhus, 113.
     lung, 176.
     hay, no.
     rose, no.
     yellow, 114.
     bilious malignant, 114.
     Mediterranean, 114.
     cerebro-spinal, 106.
     cerebro-spinal typhus, 106.
     sailor's, 114.
     pernicious, 117.
     congestive, 117.
     malignant remittent,  117.
     malignant intermittent, 117.
     scarlet, 121.
     rheumatic, 217.
     thermic, 261.
     winter, 176.
Febris recurrens, 112.
Febricula, 109.
Favus, 323.
Freckles, 335.
Flesh-worm disease, 342.

Gastric carcinoma, 75.
"Gastralgia, 72.
* Gastrodynia, 72.
Gastritis, acute, 86.
     chronic, 78.
     toxic, 87.
Glossitis, 148.
"Grip," 153.
"Goitre,  212.
Gin liver, 226.
Gout, 227.
Gall stones, 245.

Hygiene, 11.
Haemoptysis, 166.
Hemorrhage, pulmonary, 166.
"Hemicrania, 191.
"Headache, sick, 191.
     "blind, 191.
     "bilious, 191.
     "common,  201.
"Heart, palpitation of, 202.
     "irritable, 202.
     "fluttering, 202.
"Heartburn, 31.
Heredity, 229.
Hereditary influences, 229.
Hepatic calculi, 245.
Hysteria, 258.
Hysterics, 258.
Heat stroke, 261.
Heat exhaustion, 261.
"Herpes, Zoster, 266.
Hooping cough, 161.
Hydrosis, 319.
Hyperidrosis, 319.
"Herpes circinatus, 322.
Hives, 337.

*Indigestion, 31.
     "acute,  83.
     "intestinal, 47.
Influenza, 153.
Intellect, inheritable, 236.
"Lntestinal parasites, 68.
Insolation, 261.
Insanity of muscles, 265.
"Llch, 333.
     "barber's, 344.
"Ingrown toenails, 348.

Jaundice, 223.
     catarrhal, 223.

Kidneys, congestion of, 241.
     inflammation of tubes of, 246.

La Grippe,  153.
Laryngitis, acute catarrhal, 172.
     catarrhal,  172.
     "spasmodic, 181. 
356
INDEX.
Larynx, tuberculous inflammation of,
Laryngeal phthisis, 174.         [J74-
Lumbago, 221.
Lumbodynia, 221.
Leucorrhoea, 279.
Labor, chloroform  and ether in, 308.
Lentigo, 335.

Mind, effects of on body, 27.
Measles, 125.
    German, 141.
    French, 141.
    false,  141.
"Migraine,  191.
Mumps, 167.
"Melancholy, dyspeptic, 196.
Mental characteristics, 235.
Menstruation, 267.
    suppression of, 273.
    excessive, 271.
    painful, 275.
Menorrhagia, 271.
Mother's mind, effects on unborn, 289.
"Morning sickness, 299.

"Neuralgia, 253.
    "of the face, 253.
    "of the head and neck, 253.
    "of the neck and arm, 253.
    "between the ribs, 253.
    "intercostal, 253.
    "of stomach, 72.
    "of hip  (sciatica), 254.
Noma, 146.
"Nervous  exhaustion, 263.
"Neurasthenia, 263.
* Nervous prostration, 263.
Nettle-rash, 337.

Proctitis, 82.
Pleurisy, 156.
Pleuritis, 156.
Pertussis,  161.
Parotiditis, 167.
"Pneumonia, 176.
*Pneumonia, pleuro,  176.
"Pneumonitis, 176.
"Putrid sore throat, 184.
Pulmonary hemorrhage, 166.
Pleurodynia, 221.
Polyuria, 242.
Perityphlitis, 66.
Polydipsia, 242.
Pregnancy, 284.
    signs of, 285.
    management of, 288.
    hygiene of, 289.
    constipation in, 302.
    piles in, 303.
    enlarged veins, 303.
    duration of, 306.
    sleep in, 304.
    clothing in,  304.
    coition in, 305.
    "morning sickness,  299.
    "nursing, sore mouth in, 305.
    sex of offspring, 307.
    signs of labor  in, 307.
Pityriasis, 313.
"Pyrosis, 31.
Porrigo favosa, 323.
Pork worm, 342.
Poisons, 350.

Quinsy, 159.
    "malignant, 184.
"Roundworms, 71.
Rectum, inflammation of,  82.
Rectitis, 82.
Rectum, catarrh of, 82.
Rubeola, 125.
Roseola, epidemic, 141.
"Rheumatism, acute articular, 217.
    "inflammatory, 217.
    muscular, 221.
Renal  hyperemia, 241.
"Ringworm, 323.
    "of the body, 322.
    "crusted, 323. 
INDEX.
357
"Summer complaint, 42.
Stimulants, effects of, 16.
Smoking, 18.
Stomach colic, 72.
"Stomach, cramp or spasm of, 72.
Spotted fever, 106.
Synocha,  109.
Scarlatina, 121.
Scarlatto, 121.
Small-pox, 129.
Saint Anthony's fire, 136.
Stomatitis, aphthous, 143.
     croupous, 143.
     follicular, 143.
     vesicular, 143.
     diphtheritic, 147.
     ulcerative, 147.
     parasitic, 145.
     gangrenous, 146.
     catarrhal,  150.
     simple, 150.
Stitch in the side, 156.
Snake-bite, 199.
Skin, congestion of, 321.
,     "chalk-like deposits in, 336.
Spitting of blood, 166.
Sore throat, 172.
"Sore lips, 209.
Sunstroke, 261.
Spinal irritation, 263.
"Shingles, 266.
Saint Vitus's dance, 265.
Suppression of menses, 273.
Seborrhoea, 313.
Sebaceous tumors, 318.
"Salt  Rheum, 325.
Spirituality inheritable, 236.
Sex of offspring, 307.
"Scald-head, 325.
 "Scabies, 333.

The skin, 23.
 Tea and  coffee, 13.
 Tobacco, 17.
* Tapeworm, 68.
To prevent pitting in small-pox, 134.
Tuberculous  inflammation of  larynx,
The rose, 136.                  [174-
Thrush, 145.
Tonsilitis, acute, 159.
* Tonsils, enlarged, 214.
"Thick neck, 212.
* Throat, ulceration in, 213.
Torticollis, 221.
The " whites," 279.
Throat, consumption of, 174.
* Tic-douloureux, 253.
* Tinea circinata, 322.
    "favosa, 323.
"Tetter, 325.
Trichinae, 342.
    spiralis,  342.
Tongue, inflammation of, 148.

Ulcer, gastric, 86.
    perforating, 86.
    peptic, 86.
    chronic gastric, 86.
Urine, 248.
Urticaria, 337.

Vaccination, 127.
Variola, 129.
Varicella, 142.
Varus, 316.
* Verruca, 345.

White mouth, 145.
Whooping cough, 161.
Water cancer,  146.
Winter cough, 151.
Wry neck, 221.
Womb, displacements of, 282.
* Wens, 318.
 * Warts, 345.

 Yellow Jack, 114.

  "Zono, 266. 
 
 
 
/ 
JUL
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NLM051643587