La' m •rU'. ||. wiwfflw^n* rvn ■I . ft 1 * A " s ' Sek-utiflc and Medical Books, and Minerals. A. E. FOOTE, M. D. Philadelphia, Pa. m i | SURGEON GENERAL'S OFFICE | ANNEX - 3 I #o..JZ~t+-0.0* , % HOKEOPATHIC DOMESTIC PRACTICE. This is the most complete work on Domestic Practice ever published. In addition to the portion the Treatment of Dis- eases ; it contains chapters on Anatomy and Physiology, illus- trated with elegant plates; also, a chapter on Hygiene, an abridged Materia Medica, and a Dissertation on the True Theory of Cure. Dr. Guernsey's book of Domestic Practice is a reliable and useful work. It is especially adapted to the service of well educated heads of families John F. Gray, M.D HOMEOPATHIC DOMESTIC PRACTICE, CONTAINING ALSO CHAPTERS ON PHYSIOLOGY, HYGIENE, ANATOMY, AND AN ABRIDGED MATERIA MEDICA. Ko, .', *«S EGBERT dT^RNSEY, M.D H^RV> FIFTH ENLARGED, REVISED AND IMPROVED EDITION. NEW-YORi: WILLIAM RADDE, 300 BROADWAY. Philadelphia: Rademacher & Sheek.— Boston: Otis Clapp.— Cleveland, 0.: John Hall.— Cincinnati, 0.: J. M. Parks, M.D.—«. Z/ouw, Mo.: D. R.Luytieb, M.D.— Mar)cAes/er, Eng.: Turneh, 41 Picadilly. 18 6 2. Av>Y\«X Entered according to Act of Congress, in the year 185*>, By William Radde, In the Clerk's Office cf the District Court of the Southern District of New-York PREFACE. The more intimately we are acquainted with our own orga- nization, and the laws of our being, the more readily may we guard against the numerous causes of disease to which we are constantly exposed, and preserve a healthy equilibrium in the system. There are cases, also, where disease presents certain symptoms so distinctly marked, that almost any one possessed of an ordinary knowledge of the human system and of remedial agents, may by the careful administration of medicines, check in the commencement, a difficulty, which if allowed to progress for a few hours, might have gained such headway as to place the patient almost beyond the reach of aid. There are other cases where there is but slight derangement of the system, and the symptoms are so well marked, that the patient will have no difficulty in selecting the remedy, a few doses of which will produce speedy relief. Thus, with a proper understanding of the laws of nature, and a certain knowledge of remedial agents, all possess the power, to a certain extent, of warding off disease, of relieving a vast amount of suffering, and prolonging their own lives. I have endeavored in the introductory chapter before pro- ceeding to the treatment of disease to make clear a few points : 1. I have spoken of the anatomical structure of the system, and the beautiful adaptation of the various parts to the duties of life. iii TlvEFACE. 2. The physiology of the system, the production from food of bone, and blood, and tissue, and the combustion and chemical changes, which are constantly going on within us. 3, The laws of health and the causes of disease, in which I have glanced at the transmission of disease from parent to child, and the necessity of a correct moral, physical and intellectual training. In the introduction I have given some general rules for the proper selection and administration of remedies, for the diagno- sis of disease, and the choice of a proper diet. In the part on the treatment of disease I have aimed to be as full as is necessary in a work on domestic practice. I have also endeavored to avoid where it could be done, technicalities, and to make the subject as plain and simple as possible. In most cases the quantity of the dose has been given, and the frequency of its repetition, but as this must depend in a mea- sure on circumstances I would urge a careful perusal of the ar- ticle in the introduction on the administration of remedies. In part third I have introduced a carefully abridged materia medica, in which the leading indications for a remedy are group- ed together under the appropriate head. This will often aid materially in an appropriate selection. While it has been my aim to prepare as clear and practical a guide as possible for the sick-room and domestic practice, I have had no wish to produce a work to supersede the labor of the physician. No one who has not devoted years to the investigation of the human system, the causes of sickness, the power of remedial agents, and who is not able to look beneath the surface and trace from apparent unimportant symptoms the true seat and cause of PREFACE. "V the difficulty, is capable of grappling with all forms of disease and of fulfilling the high and holy duties of the physician. The responsibility which rests on him is a fearful, an awful one. It is no light thing to stand, as it were, between life and death, to rekindle the flickering lamp, almost extinct, to call back the fleeting breath, to arrest the downward course, and drive back that cold shadowy form, whose awful presence is already blanch- ing the cheek and chilling the blood. In the preparation of this work I have advanced no new, strange and unheard of theory of disease and its treatment, but have aimed to make a plain and practical family guide, in which may be found a description of the human system, hints for the prevention of disease, and its treatment after its seeds have be- come implanted in the human system. Happy will I be, if any effort of mine shall be the means of diffusing a correct know- ledge of the human system " so fearfully and wonderfully made," and of alleviating in the slightest degree the vast amount of hu man suffering. PREFACE TO THE SECOND EDITION. The rapid sale of the first edition, of three thousand copies, in but a little over two years, is a gratifying assurance, that the plan and general scope of the work have been well adapted to the wants of the community. It is believed the present edition will be still more worthy the patronage of the public. In the description of disease the author has aimed to be as clear as possible, and in the treatment all the new remedies of importance have been introduced, the dose has been carefully given, and great pains taken to make the whole clear and in- telligent. It is confidently believed that the work will prove a valuable aid to the student, and a convenient and trustworthy family me- dical companion. The author takes this opportunity of acknowledging his in- debtedness to numerous eminent physicians in different parts of the country who have kindly offered suggestions and contri- buted important medical facts. These suggestions and medical facts, it is believed have ma- terially increased the value of the work. New-York. 1856, 10 West 2Sd-st vi TABLE OF CONTENTS. Pagb Introduction....................................... 1 Administration of Remedies......................... 12 Dietetic Rules..................................... 15 List of Medicines.................................. 18 Description of Plates.............................. 488 PART I. DESCRIPTION AND TREATMENT OF DISEASE. CHAPTER I. FEVERS. Fever. Simp e Fever. Inflammatory Fever. Nervous or Typhoid Fe^er. Yellow Fever. Bilious Remittent or Bi- lious Fever Intermittent Fever........................ 25 CHAPTER II. CUTANEOUS DISEASES. Eruptive Fevers. 1. Nettle-Rash. Scarlet-Rash. Scarlet- Fever. Measles. Erysipelas. Chicken-Pox. Small-Pox. Varioloid. 2. General Cutaneous Diseases. Itch. Itching of the skin. Scald-Head. Milk-Crust. Ringworm. Herpes. Tetter. Acne. Chilblains. Excoriation. Felon. Ulcers. Boils. Abscess. Swelling of the glands. Warts. Corns....... 55 CHAPTER III. AFFECTIONS OF THE STOMACH AND BOWELS. Dyspepsy. Loss of appetite. Morbid appetite. Nausea. Vo- miting. Sea-Sickness. Spasms and pain in the stomach. vii viii TABLE OF CONTENTS. Colic. Inflammation of the liver. Jaundice. Inflamma- tion of the Spleen. Inflammation of the Stomach. In- flammation of the Bowels. Diarrhoea. Dysentery. Cho- lera Morbus. Asiatic Cholera. Constipation. Piles...... 93 CHAPTER IV. AFFECTIONS of the windpipe and chest. 1. The Windpipe and Lungs. Hoarseness. Loss of voice. Influenza in the head; general; typhoid. Cough. Pleurisy. False Pleurisy. Pneumonia. False Pneumonia. Laryn- gitis. Bronchitis. Haemoptysis. Congestion of the Chest. Pulmonary Consumption. Asthma. 2 The Heart. Acute Disease of the Heart; Chronic Pal- pitation of the Heart................................... 15? CHAPTER V. AFFECTIONS of the mind. Insanity; moral; intellectual and incoherent. Monomania. Various affections of the Mind. Hysteria.................205 CHAPTER VI. affections of the head. Headache. Nervous Headache. Sick-Headache. Dizziness. Apoplexy. Inflammation of the brain. Sun-Stroke. Fall- ing off of the Hair...................................... 218 CHAPTER VII. affections of the eyes, ears and nose. 1. The Eyes. Weakness of sight. Inflammation of the eyes ; catarrhal, rheumatic, syphilitic, and scrofulous- Inflamma- tion of the eyelids. Stye on the eyelids. Watery Eyes. Nearsightedness. Foreign Substances in the eyes. Falling of the lid. 2. The Ears. Mumps. Inflammation of the ears. Earache Deafness. Noises in the ears. Running of the ears. Fo- reign substances in the ears 3. The Nose. Inflammation of the Nose. Bleeding of the Nose. Ulceration of the Nose..........................233 TABLE OF CONTENTS. 1A Page CHAPTER VIII affections of the teeth, mouth and throat. Treatment of ihe teeth. Toothache. Offensive breath. Gum boil. Scurvy. Canker of the Mouth. Salivation. Inflam- mation of the tongue. Swelling under the tongue. Defects of speech. Sore throat................................. 256 CHAPTER IX. affections of the urinary and genital organs. Inflammation of the kidneys. Inflammation of the bladder. Suppression and Retention of Urine. Urinary Calculi. Dia- betes. Incontinence of Urine. Seminal emissions. Go- norrhoea. Syphilis...........-........................274 CHAPTER X. eneral affections. Rheumatism. Gout. Lumbago. Neuralgia. Prosopalgia. Tic-Doloureux. Neuralgia of the Face, of the Heart, of the Spinal-Marrow. Pain in the Hip. Paralysis. Epilepsy. St. Vitus's Dance. Lock-jaw. Tetanus. Hydrophobia. Delirium Tremens. Tuberculosis. Scrofula. Cancer. Dropsy, Cellular, of the bowels, of the chest............291 CHAPTER XI. diseases of women. Retention or Suppression of the Menses. Painful Menstruation. Profuse Menstruation. Irregular Menstruation. Cessation of Menses. Change of Life. Green-Sickness. Leucor- rhcea. Falling of the womb. Pregnancy. Derangements during pregnancy. Morning-Sickness. Constipation. Diarrhoea. Dizziness and headache. Fainting hysteric fits. Toothache. Itching of the privates. Varicose Veins. Piles. Pains in the back and side. Cramps Derangements of the Urinary organs. Miscarriage. Parturition. False pains. Labor, cramps, convulsions, during labor. X TABLE OF CONTEXTS- Paos Treatment after delivery. After Pains. Duration of con- finement. The Breasts. Milk-Fevi-r. Suppressed secre- tion of Milk. Sore Nipples. Gathered Breasts. The Lochia Childbed-Fever............................... 3'28 CHAPTER. XH. treatment of children. 1. The Infant. Its clothing and food. Artificial feeding. Weaning. Cleanliness, air and exercise. Wet nurse. 2. Disease of Children. Apparent death of new-born infant. Swelling of the head. Cold in the head. Colic, crying and wakefulness. Swelling of the breasts. Inflammation of the eyes. Excoriation. Heat-spots. Jaundice. Retention of Urine. Constipation. Convulsions. Diarrhcua. Teeth- ing. Dropsy of the brain. Infantile remittent fever. Worms. Summer-Complaint. Cholera Infantum. Croup. Ilooping- Cough. Asthma. Vaccination.......................... 371 CHAPTER XIII. External Injuries. Burns and Scalds. Frozen limbs. Sprains. Concussions. Dislocations. Fractures. Wounds. Poisoned Wounds..................................... 430 CHAPTER XIV Po \i »X3 AND THEIR ANTIDOTES............................ 437 CHAPTER XV. REAL AND APPARENT DEATH. I. Actual death. Causes of death. Signs indicating the approach of death. 2. Apparent death. Apparent death from drowning, hanging, smothering, noxious gases, hunger, freezing, lightning, from a fall................................................. 443 TABLE OF CONTENTS. XI Paob PART II. CHAPTER I. A.NATOMY. Anatomy of the bones ; the muscles ; the brain and nervous system; organs of digestion; Urinary organs , respiration and circulation ; the skin; the teeth ; the eye___ 439 CHAPTER II. Physiology. The structure of the system ; perspiration ; nu- trition ; digestion; circulation of the blood...............493 CHAPTER III. Hygiene and the Causes of Disease. Climate; changes of temperature. Cleanliness. Diet. Exercise. Bathing, its varieties and uses ; Shower-bath ; Sitting-bath. Drop-bath- The Douche. Wet Bandages. Wet Sheet. Tepid and Vapor baths. Influence of the mind on disease. Hereditary taint. Moral, intellectual, and physical education.........514 CHAPTER IV. True Theory of Cure. Allopathy. Homoeopathy. Infini- tesimal doses______...............-.......--........— 556 CHAPTER V Materia Medica........................................ 574 Glossary...........-................................... 635 INTK0DTJCTI01N. Some general directions as it regards the importance of various symptoms, the varieties of constitution and temperament, the detection of the peculiar nature of disease, may appropriately be introduced in this place. In prescribing homceopathically, it is of high importance that the nature and cause of the disease should be un- derstood. In loosing sight of the great landmarks, in seizing hold of an isolated symptom and prescribing carelessly or at random very little good is effected, and sometimes, much positive harm done. Let us make plain then a few prominent points, the correct knowledge of which may enable the patient to understand more readily the character and progress of the disease and the presence of danger. VARIETIES OF CONSTITUTION AND TEMPERAMENT. A plethoric constitution, is characterized by a florid complexion, frame full and robust, activity and strength of body, and a strong and full pulse. There is an acti- vity in the circulative system, and a predisposition to local or general congestion. A feeble constitution, is directly the opposite of the foregoing. There is a deficiency in the generation of natural heat, and a tendency to become fatigued from slight exertions. The pulse is feeble and soft. The per- son is peculiarly subject to diseases characterized by in- activity in certain functions, or great relaxation. A bilious constitution, is recognized by a dark, or yel- low skin, by a predisposition to a derangement and irre- gularities of the digestive functions, and a tendency to constipation, piles, &c. v 2 INTRODUCTION'. An apoplectic constitution may be known by the large head almost buried between the shoulders, short, thick neck, thick set frame, slow full pulse, and tendency of blood to the brain. A nervous constitution, is characterized by extreme sensitiveness and excitability of body and mind. The pulse is variable, quickly changing from rapid to slow. The patient is liable to nervous disorders, and those spas- modic affections, which are not readily referable to any direct cause. A lymphatic, or mucous contitution, may be recognized by the light complexion, the frame full and rounded, but the flesh soft and flaccid, and the muscular fibre yielding and relaxed. The circulation is sluggish, the pulse slow, the generation of heat deficient, and there is also a sen- sitiveness to cold. The patient is subject to slow and sluggish affections, to catarrhal diseases, abscesses, accu- mulations of water about various organs. Acute dis- eases are also liable to assume a chronic form and run a slow and tedious course. The catarrhal or rheumatic constitution, is similar to the last, and is particularly characterized by want of vi- tality in the skin, which is easily affected by external circumstances. The consumptive constitution may be known by the clear transparent skin, often with a bright spot on the cheek, flatness of the chest, slender and fragile form, long and spare neck, rapid growth, quick and small pulse, long slender fingers with large joints. The patient is peculiarly liable to affections of the lungs. There is only one more variety of constitution to which it will be necessary to refer. It is characterized by a tendency to ulcerative sores, particularly of the glands, unhealthy secretions from the skin, and various forms of eruption. Both this and the preceding variety VARIETIES OF CONSTITUTION. 3 may be considered as modifications of the tuberculous habit. In the sanguine temperament—generally found in a plethoric constitution—there is great animation and buoyancy of spirits, the bodily health is generally good, but when disease does attack the system it runs a rapid and severe course. Choleric temperament is generally found in the bilious constitution. The increased and altered secretion of bile reacting on the moral and mental faculties has a tendency to engender ill-humor, outbursts of rage, and even a revengeful and malignant temper whenever ex- cited. The complexion is generally of a yellowish tinge, the muscular fibre hard, wiry, and tightly strung. The patient is subject to bilious derangements, which are sometimes even provoked by violent fits of excitement. The phlegmatic temperament, generally associated with the feeble or lymphatic constitution, is characte- rized by slow operations of both the mental and bodily functions, and tardiness and weakness of the reactionary power. A melancholic temperament is readily known by the meditative, gloomy, or retiring disposition. Impressions are deep and lasting, and there is a tendency to look on the dark side and brood often in secret over things, which in the mind of others would be speedily forgotten. The patient is seldom subject to violent impulses or sud- den impressions, and is liable to diseases of the stomach and bowels, which often assume a chronic character. THE PULSE. Not only the frequency, but the peculiar beat of the pulse is of vast importance to the correct diagnosis and proper treatment of disease. In feeling the pulse, it should be done as gently as possible, as unnecessary parade may needlessly alarm 4 INTRODUCTION. the patient. Three fingers may be placed on the wrist directly back of the root of the thumb and the joint of the wrist, and just within the external bone of the arm. Slightly compressing the wrist with the fingers, and holding there for a moment you will be able to notice not only the frequency but the peculiar character of the pulse. Its rapidity may be easily measured by the second hand of a watch. Notice whether it beats with regularity, full and soft, whether by compression it may be rendered so indistinct as scarcely to be felt, whether it is strong and bounding, almost forcing the fingers from the arm, or hard, or small and wiry like the vibration of a string, or intermittent, striking a few beats and then apparently stopping for one beat, or the pulsations flow- ing into each other small, and almost imperceptible. It will of course be necessary to understand the beat of the healthy pulse, and what its different varieties may indicate in disease. Healthy pulse. The beat of the healthy pulse depends much upon age, sex, constitution and temperament. In the adult male, of medium size, it generally num- bers from 70 to 75 beats in a minute. In the adult female, it is not generally so strong and full as in the male, and usually numbers from 76 to 84 beats in the minute. In a person between the ages of seven and fourteen it should number from 80 to 85 beats in the minute. After teething and until the age of about seven there are generally from 85 to 96 beats in the minute. In infancy, previous to teething, the pulse varies fron 100 to 120 beats in the minute. After man has reached the prime of life, and enters on the descending scale, which generally takes place in our climate between the ages of forty-five and sixty years, the pulse becomes still slower, numbering in the male about 70 and in the female 75 beats in the minute. THE PULSE. 5 As the person advances to old age, the frequency of the pulse is still further diminished, until in the male there may be only from 55 to 60, and in the female from 65 to 70 beats in the minute. I have given the usual standard of the pulse in health in the various stages of life, although cases are by no means rare, when in perfect health it may be much lower or higher than I have stated. If, however, the skin is moist and at a natural heat, this would be no in- dication of disease. The pulse also may vary before or after a meal, and be excited or depressed from exercise or influence of mental emotion. We should of course be cautious in attributing this temporary change to the in- fluence of disease. VARIETIES OF PULSE IN DISEASE. The rapid or accelerated pulse is indicative of inflam- mation or fever, especially if strong, full and hard, it small and very rapid, it indicates a low state of debility, such as is often present in the latter stage of typhoid fever. The slow pulse, if not habitual, may indicate debility or tendency of blood to the head, or especially, if full and strong, pressure on the brain. It is also generally found in old age. The hard or wiry pulse is generally indicative of a high state of inflammation, although in old age it may be occasioned by a hardening or ossification of the ar- teries. The changeable or unequal pulse indicates a derange- ment of the nervous system, and not unfrequently organic disease of the heart. The intermittent pulse generally shows an organic dis- ease or spasmodic condition of the heart. It is some- times occasioned by intestinal affections. The full strong pulse indicates a full habit, while the 6 INTRODUCTION. weak pulse denotes impoverished blood and a feeble state of the system. THE URINE. The appearance of the urine in health is slightly varied by age, sex, occupation, food and the season of the year. It should be of a brightish yellow or straw color, pos- sessed of a slight ammoniacal smell, devoid of unpleasant odor, and precipitating no sediment on standing. In old age, however, the urine may be slightly offensive, and darker in color than in early life, and in females a slight sediment is not always an unhealthy sign. In persons leading an active life, the urine is of a darker color than in those of sedentary habits. Different varieties of food may also produce a sensible effect upon the color and smell of the urine. The urine should not be examined, until five or six hours after a meal have elapsed, when it should be set aside in a moderate and even temperature for an hour or two. VARIETIES OF URINE AND THEIR INDICATIONS. In various forms of disease the appearance, quantity and smell of the urine, are important diagnostic signs of the state and progress of the disease, and should be care- fully observed. In cases of fever, as the disease approaches a crisis, the previously clear urine becomes thick, and forms a half floating cloud. If this cloud sink, a favorable crisis may be expected, while on the contrary if it remain buoyant near the top, a somewhat unfavorable issue may be anti- cipated. As the crisis of the disease declares itself, when the urine has been perfectly clear before, a sediment is now perceptible, and in those cases where the urine has been thick and turbid, the same sediment is perceptible, but VARIETIES OF URINE. 7 the urine above it is clear and transparent. If the sedi- ment is of a smooth, light or greyish color, and is deposit- ed shortly after emission, it is a favorable indication, but if it should be dark or black, it denotes a putrid state, if bilious or red, it indicates a rheumatic or intermittent type of the disease, and if it is disturbed, heavy, muddy or of a purple color, forming half of the whole quantity discharged, it is an unfavorable sign. The red or high colored urine, if the pulse be accele- rated, indicates the presence of fever. Urine of a saffron color marks the presence of bile in the blood, and shows derangement of the liver. If matter is found in the urine, it shows that suppu- ration is going on internally. In children, a milky appearance of the urine is looked upon as an indication of worms in the intestines. A very light or watery appearance of the urine may denote some disturbance of the nervous system Copious perspiration or watery diarrhoea may cause a decrease in the secretion of urine. The appearance of the urine may indicate the presence of Diabetes, or tendency to various forms of calculi in the bladder and kidneys. The voiding of a large quantity of straw colored urine of a disagreeable odor and of a sweetish taste, may de- note the presence of Diabetes. The lithio or uric acid calculus is shown by the red brick dust sediment. The calculi formed by the combination of phosphoric acid, magnesia and ammonia, is indicated by fetid urine and a whitish mortar-like sediment. For a description of the above, together with other forms of calculi, see that subject in the chapter on urinary affections. THE STOOLS, FLATULENCE, 4.C. Light colored or whitish stools indicate a deficiency of bile and a torpid condition of the liver; when the stools 8 INTRODUCTION. are very dark a profuse quantity of bile is present When the bowels are very much constipated a febrile or torpid condition of the bowels is indicated. Relaxed stools indicate much nervous irritability of the system or the presence of inflammation ; when they are purely involuntary they indicate a paralysis of the intestines and not unfrequently occur in the last stage of sinking fevers. Dysenteric stools are painful, accompanied with strain- ing and usually consist of blood, or blood and mucus. Accumulation of wind in the stomach and intestines is generally the result of indigestion and in children sometimes indicates worms NAUSEA AND VOMITING. If nausea is accompanied by severe pain in the right side there may be inflammation of the liver; if preceded by severe pain in the head it may be sympathetic. If the nausea is habitual we may fear organic derange- ment of the stomach; if food and drink are vomited as . soon as swallowed we may apprehend inflammation. Habitual vomiting in the morning accompanied with cramps sometimes indicates gravel. The stomach sympathises with almost every organ in the body and nausea not unfrequently exists in connec- tion with derangement of the stomach, kidneys, brain or chest. * INDICATIONS OF COUGH. A short dry cough and sneezing may mark the first stage of influenza or be the precurser of measles and other eruptive diseases. Cough is sometimes produced by indigestion and in this case it can only be cured by overcoming that diffi- culty. A loud barking cough indicates bronchial difficulty INDICATIONS OF COUGH. 9 and in children may indicate croup. A hacking cough with pain and fever points to inflammation of the lungs, In Asthma the cough is accompanied with a wheezing or whistling respiration and difficulty of breathing. GENERAL DIAGNOSIS. In the investigation of disease, to form a correct idea of its character and the treatment necessary to produce relief, there are several important points to be taken into consideration, aside from the symptoms as they casually present themselves to the eye. The age and sex of the patient should be borne in mind, and the diseases most likely to occur in the suc- cessive stages of life should not be forgotten. When man lives his appointed time, dying not of dis- ease but of old age, there is a regular ascending scale up to a certain point, which turned, he commences the de- scending path of life. Each of these several stages or steps is characterized by certain peculiarities. In the first period of childhood, extending to the time of teething, the little being is extremely susceptible to external influences, and liable to disease from the slight- est causes. The whole nervous system is exceedingly sensitive and the little patient peculiarly liable to affec- tions of the brain and spasmodic attacks. This period should be closely watched (see chapter on diseases of children.) In the second and third stages, extending from teeth- ing to about the seventh and fourteenth year, there is a want of firmness in the fibre of the system, a suscepti- bility to fatigue and the consequent necessity of a larger amount of rest than in later years. There is a liability to affections of the brain and respiratory organs. The next stage, extending to the twenty or twenty-fifth year, during which the system is approaching maturity, is one of the most important periods of cur existence. 10 INTRODUCTION. It is during this period that the seeds of constitutional disease are most liable to ripen into a fatal harvest, and now when the passions are strongest, there is danger by their abuse of being thrown from a proper balance, into a too powerful exertion of the mind and body, thus sowing the seeds of diseases, which may be a torment in after life and end in early death. After a person has reached the age of fifty-five or sixty years, he^enerally begins to feel that he is growing old; the functions of the body may become less active, and the mind, notwithstanding it may be equally strong, less active in its movements. As year after year rolls away, he is made aware in the stiffness of the joints, in the gradual blunting of the faculties of perception and sen- sation, that he is rapidly treading the downhill of life. During this stage, he is peculiarly subject to paralysis of various organs, deafness, blindness, apoplexy, asthma, &c. Constitution and temperament, are also important points of inquiry, a proper understanding of which will aid ma- terially in the correct selection and administration of remedies. The cause of the disease should by no means be overlooked ; the previous habits of the patient should be ascertained, and in cases of long standing, or when there is reason to suspect hereditary taint, the health of the parents, and even grand-parents, should be known, also whether at any time during the previous life of the patient he has been afflicted with either eruptions, or other diseases, which might not have been entirely era- dicated from the system, or whether the medicines given might not have engendered other diseases more painful and lasting than the former. An understanding of the cause of the disease will often be a sure guide to the selection of the remedy. Thus diseases resulting from contusions, sprains, &c. would indicate Arnic. In a rheumatic affection pro- duced by dampness, or getting wet, we should think of INTRODUCTION. 11 Rhus. Affections produced by grief or chagrin would require Ignatia, while those occasioned by fear would in- dicate Opium. Diarrhoea occasioned by cold requires Dulcamara. Derangement of the stomach with nausea under certain circumstances would yield to Ipecac, but if the disturbance was occasioned by eating fatty food, the Ipecac, would be ineffectual and Pulsatilla be re- quired. The mind should also be directed to exposures to heat or cold, dampness, unhealthy air, food and clothing, miasmata, contagions, errors of diet, abuse of spirituous liquors, and the various causes which would have a ten- dency to produce disease. Finally, the patient should be permitted to explain in his own words, his general sufferings, and the character and location of the pain. It should be ascertained whe- ther the pain comes on at intervals, or is uninterrupted, how long it continues and whether it is worse during the day, or at night, what peculiar symptoms it is associated with; and such other questions, as will guide to an accurate knowledge of the disease. For directions as to the administration of remedies, see the following chapter. ADMINISTRATION OF REMEDIES. Too much care cannot be taken in selecting the reme- dy. The symptoms should be closely compared with those delineated under the heads of that class of remedies most likely to be indicated. The cause of the disease has also an important bearing in the selection of the me- dicine. The mind should be directed to the leading symptoms, the pecularities of the disease, and notwith- standing it is not necessary that all the symptoms noted should be present, yet the utmost care should be taken, that there are no symptoms present not covered by the medicine, or at least more strongly indicating another. The totality of the symptoms or the symptoms taken as a whole, should be the guide. THE DOSE AND ITS REPETITION. No definite rule can be given as to the amount of the dose in all cases. Difference in age, sex, temperament and constitution renders variation both in the quantity of the dose and the frequency with which is repeated absolutely essential. The idea would be preposterous to give the infant, with its highly excitable nervous or- ganization, the same quantity of medicine and at the same intervals as at a much later period of life, or who who would think of giving the highly excitable and ner- vous temperament or those possessed of acute and ex- ceedingly sensitive feeling the same strength of medi- cine as would be required by the cold and phlegmatic constitution and temperament ? During the few years of infancy and early childhood the patient is usually quite susceptible to medicinal in- 12 ADMINISTRATION OF REMEDIES. 13 fluenee and generally requires the higher potencies. Females are for the most part much more susceptible to medicines than males, therefore the higher potencies may as a general thing be used with them in preference to the lower. The sanguine and nervous temperaments are usually quite susceptible to remedies, and may therefore require the higher potencies, while the bilious, where there is less susceptibility, requires the lower potencies, given at longer intervals. The lymphatic also, being but slightly, in comparison with other temperaments, susceptible to medicines, requires the low potencies given at short in- tervals. Some persons are much more susceptible to one class of remedies than another, rendering it absolutely essen- tial that those particular remedies should be given in the high potencies. As a general thing in acute diseases, excepting perhaps in young children, tinctures, and the low potencies should be used, while in chronic cases more benefit may be derived from the higher attenua- tions. In my own practice I have generally confined myself to the tinctures, and the potencies ranging from the first to the twelfth, more frequently giving the tinctures or the first, third, sixth, or twelfth attenuation. I am satisfied that in domestic practice the lower attenuations may be used with much greater safety than the higher. In the preparation of the medicines, if tinctures are used, one drop may be placed in a tumbler full of cold water, if intended for a child or a person quite susceptible to medicine, and a teaspoonful given at a dose. If intended for an adult or one not as susceptible to medicine two drops may be prepared in the same way. If the remedy is stronger than is necessary, producing an aggravation of symptoms, a teaspoonful of the mixture, prepared as above, may be mixed with a tumbler full of cold water, 14 ADMINISTRATION < >F REMEDIES. a teaspoonful of which may be given at a dose. In the preparation erf the remedy, pure water should be used, such as rain, or spring water, and great care taken that the tumbler and spoon are perfectly clean. Both should be thoroughly rinsed several times in pure water, and then left to dry. The medicine should be dropped into the tumbler first, and then the water poured in, turning it from one tumbler into an other several times, or stirring it with a spoon until is thoroughly mixed. The same spoon ought not to be used for more than one remedy until it has been cleanly washed. If the triturations are used, the size of the dose should be about as much as could be placed on a three cent piece, or taken up by the point of a knife. The remedy should be placed dry on the tongue, and left there until dissolved. If the globules or pellets are used, unless more spe- cific directions are given in the body of the work in con- nection with the disease, six of them may be dissolved in a tumbler of water, and a tablespoonful for the adult, and a teaspoonful for the child, given at a dose. The same directions as it regards the tumblers and mixing the medicines may be observed as given in connection with tinctures. The globules may in some cases act more promptly when given dry on the tongue, hence it is often advisable to give them in that way. By the adult, in these cases, three globules may be taken dry on the tongue. To the child one or two globules may be administered in the same manner. In acute cases especially, the symptoms should be watched with the utmost care, and the remedy be con- tinued as long, as benefit results from its employment The medicine, if carefully selected, should receive a fair ADMINISTRATION OF REMEDIES. 15 trial, and not be changed frequently, unless there are positive indications that it is doing harm. Often a medicinal aggravation may be seen and it is important that the aggravation produced by medicine be readily distinguished from that occasioned by disease. The medicinal aggravation comes on suddenly and with- out previous amelioration, while that occasioned by dis- ease is more gradual in its progress and generally follows an amelioration. In mild cases one dose will often be sufficient to remove the disease. In the chronic case a long continued admi- nistration of a certain remedy may, notwithstanding its clear indication, render the system less susceptible to its influence. In these cases, a few doses of sulphur, or some other remedy closely resembling the one previously ad- ministered may be given, and in a short time, if it be necessary, the patient may again return to the old remedy. If, either in acute or chronic cases an amelioration fol- lows each administration, the intervals may be gradually increased, and if, as is sometimes the case, susceptibility to its influence should also increase, a higher potency may be given. The medicines should not be taken within a half hour or an hour of eating, either before or after a meal. The medicines should be kept in a clean dark place, free from odors. Camphor and perfumery of all kinds should be avoided in the sick-room, as they have a tendency to an- tidote the remedy given, or complicate the symptoms of the disease. RULES FOR DIET In the successful treatment of disease, much depends on the proper diet adopted by the patient during the period he is under the influence of the remedy. It is of the utmost importance that the food be of that variety, which will neither stimulate the system too 16 ADMINISTRATION OF REMEDIES. much, nor clog it in its operations, and excite serious disturbances by throwing labor on diseased and weakened organs, which they are unable to perform. Not only should indigestible substances be avoided, but also those articles of food, which are more or less medicinal in their character. By indulging in either, the remedy may be antidoted, or at least new symptoms developed, not at the time distinguishable from those produced by the disease, thus complicating the symptoms, rendering the diagnosis imperfect, and frequently causing the loss of much valuable time. We can only give here some ge- neral directions as it regards diet when under treatment, as different articles may be required in different persons, and in the numerous varieties of disease. ALIMENTS ALLOWED. Lemonade and other mild acid drinks, water, pure or mixed with currant jelly, raspberry or strawberry syrup, and sometimes milk, or milk and water, cocoa, unspiced chocolate, arrow-root, farina, barley-water, rice-water. Beef and mutton-soup, mutton, beef, venison and most kinds of game, soft boiled eggs and fresh butter. Occasionally fish such as trout, cod, haddock, and fresh scale fish, boiled, or if fried only the white part eaten. Also oysters, unless, as along some parts of the sea-shore they are impregnated with copper. Among vegetables, potatoes, green peas, cauliflower, spinach, mild turnips, parsnips, carrots, rice, hominy, pearl-barley. Fruit*, such as peaches, raspberries,, strawberries, oranges, stewed or roasted apples and pears, also prunes, grapes, &c. They should be perfectly ripe and fresh. Bread, light and not newly baked, and biscuit free from soda or potash. Puddings such as rice, arrow-root, sago, tapioca, ma< ADMINISTRATION OF REMEDIES. 17 caroni, vermicelli, &c. Salt and sugar should be used sparingly. ALIMENTS PROHIBITED. Rich and highly seasoned soups, such as, turtle or mock turtle; pork, veal, bacon, duck, goose, liver, and all varieties of salt meats and salt fish, also smoked meats, smoked, potted, or pickled fish, eels, lobsters, crabs, and fish not having scales. Cucumber, celery, onions, garlic, radishes, parsley, horse-radish, and asparagus, also all kinds of pickles, salads, and raw vegetables. Pastry of all kinds, spices, aromatics, and artificial sauces, mustard, vinegar, cheese, confectionary, and al- most the whole variety of nuts. Thus, we perceive, the homoeopathic patient is not starved, nor his appetite pampered, or his stomach crowded with articles of food more or less indigestible and capable of creating serious disturbance in the system. But. diet plain, healthy, easy of digestion is adapted in all cases, though as I have before stated, different persons require, in the varied forms of disease and constitutions, different varieties of food. Thus, in cases of diarrhoea, fruits and vegetables should be avoid- ed, while a constipated state of the bowels requires a free use of these articles, also when symptoms of fever are present, meats, butter, eggs, and other stimulating articles of food, should be avoided, confining the diet more particularly to fruits and farinaceous articles. During treatment, the patient should carefully avoid the use of purgative medicine, salves, perfumery of all kinds, or even aromatic tooth-powder. More specific directions as to diet, will be found in the chapter on Hygiene, and in the body of the work in connection with the various diseases. LIST OF MEDICINES. THEIR ABBREVIATIONS, SYNONYMES AND ANTIDOTES. 1. Acon.—Aconitum-napellus. Monk's Hood. Anti- dotes. Wine, Vinegar, Camphor, Nux-vom. 2. Agar.—Agaricus. Bug-agaric. Antidotes. Vege table acids. 3. Alo.—Aloes. Antidote. Vinegar. 4. Alum.—Alumina. Oxide of aluminum. Antidotes. Bryonia, Cham., Ipecac. 5. Am.-c—Ammonium-carbonicum. Carbonate of ammo- nia. Antidotes. Arnica, Camphor. 6. Am.-m.—Ammonium-muriaticum. Muriate of ammo- nia. Antidotes. Camphor, Coffea, Hepar-sulph. 7. Ant.—Antimonium-crudum. Crude antimony. An- tidotes. Hep.-s., Mercury, Pulsatilla. 8. Arn.—Arnica Montana. Leopard's bane. Antidotes. Camphor, Capsicum, Veratrum, and Vinegar. 9. Ars.—Arsenicum-album. Arsenic. Antidotes. For its poisonous effects, rust of iron. For medicinal aggravation, Camphor, Ipecac, Nux-vom., Tabac. 10. Aur.—Aurum. Gold. Antidotes. Belladonna, China. Mercury. 11. Bell.—Belladonna. Deadly Nightshade. Anti- dotes. Coffee, Hyos., Hepar-sulph., Pulsatilla. 12. Brom.—Bromine. Antidotes. Coffee, Opium, Cam- phor. 13. Bry.—Bryonia. White Bryony. Antidotes. Acon. Cham., Nux-vom., Ignatia. 14. Calc-c—Calcarea-carbonica. Carbonate of lime. Antidotes. Camphor, Nitric-acid., Sulphur. 15. Camph.—Camphor. Antidotes. Opium, Vinegar. 16. Can.—Cannabis-sativa. Hemp. Antidote. Camphor. 17. Canth.—Cantharis. Spanish Fly. Antidote. Cam- phor. 18 LIST of medicines. 19 18. Caps.—Capsicum. Cayenne Pepper. Antidote. Camph. 19. Carb.-v.—Carbo-vegetabilis. Charcoal. Antidotes. Camphor, Arsenic, and Coffea. 20. Caust.—Causticum. Caustic. Antidotes. Coffea, Nux-vom. 21. Cham.—Chamomilla. Chamomile. Antidotes. Aconite, Cocculus, Coffea, Ignatia, Nux-vom., Pulsatilla. 22. Chin.—China. Peruvian Bark. Antidotes. Arnica, Arsenic, Belladonna, Calcarea, Carb.-veg., Ipecac, Sulphur. 23. Cina. Wormseed. Antidote. Ipecac. 24. Coc.—Cocculus. Indian Berries. Antidotes. Cam- phor, Nux-vom. 25. Coff.—Coffea. Coffee. Antidotes. Acon., Cham., Nux-vom. 26. Colch.—Colchicum. Meadow Saffron. Antidotes. Nux-vom., Cocculus, Pulsatilla. 27. Coloc—Colocynth. Bitter cucumber. Antidotes. Camphor, Coffea, Causticum. 28. Con.—Conium. Hemlock. Antidotes. Coffea, Spi- ritus-nitri. 29. Croc—Crocus-sativus. Saffron. Antidote. Opium. 30. Cupr.—Cuprum. Copper. Antidotes. Belladonna, China, Ipecac, Mercury, Nux-vom. 31. Dig.—Digitalis. Foxglove. Antidotes. Nux-v., Opium. 32. Dros.—Drosera. Round-leaved Sun-Dew. Antidote. Camphor. 33. Dulc—Dulcamara. Bitter-Sweet. Woody Night- shade. Antidotes. Camphor, Ipecac, Mercury. 34, Euphr.—Euphrasia. Eye-bright. Antidote. Pulsatilla. 35. Fer.—Ferrum. Iron. Antidotes. Arnica, Arsenic, Ipecac, Mercury, Belladonna, Pulsatilla. 36. Fer.-acet.—Ferrum-aceticum. Acetate of Iron. An- tidotes. Arsenic, Belladonna, Nux-vom. 37. Graph.—Graphites. Black Lead. Antidotes. Nux vom., Wine. 20 LIST OF MEDICINES. 38. Hell.—Helleborus-niger. Black Hellebore. Anti- dotes. Camphor, China. 39. Hep.-s.—Hepak-sulphukis. Sulphuret of Lime. An- tidotes. Vinegar, Belladonna. 40. Hyos.—Hyosciamus. Henbane. Antidotes. Bella- donna, Camphor, China. 41. Ign.—Ignatia. St. Ignatius' Bean. Antidotes. Pul- satilla, Chamomilla, Camphor, Vinegar, Cocculus. 42. Iod.—Iodine. Antidotes. Arsenic, Camphor, Coffea, Sulph., Phos. 43* Ipec—Ipecacuanha. Antidotes. Arnica, Arsenic, China. 44. Kali.-b.—Kali-bichromatum. Bichromate of Potash. 45. Kal.-hyd.—Kali-hydriodicum. Hydriodate of Potash. 46. Kal.-carb.—Kali-carbonicum. Carbonate of Potash. 47. Lach.—Lachesis. Poison of the Lance-Headed Ser- pent. Antidotes. Arsenic, Belladonna, Nux-vom.. Rhus. 48. Lyc—Lycopodium. Wolf's Claw. Antidotes. Cam- phor, Pulsatilla. 49. Merc-iod. Mercury Proto-iodid. 50. * Merc—Mercury. Antidotes. Arnica, Belladonna, Camphor, Hepar, Iodine, Sulphur, Lachesis. 51. Mez.—Mezereum. Antidotes. Camphor, Mercury. 52. Mur. ac—Muriatic acid. Antidotes. Large doses of Soap. Small doses of Bryonia, Camphor. 53. Nat.-mur.—Natrum-muriaticu.m. Muriate of Soda. Antidotts. Arsenic, Camphor, Nitri-spiritus. 54. Nitr.-ac—Nitri-acidum. Antidotes. Calcarea, Conium, Camphor, Hepar-sulph., Sulphur, Soap, in large doses. 55. Nux-vom.—Nux-vomica. Antidotes. Aconite, Cam- phor, Coffea, Pulsatilla. * The varieties of Mercury generally used are the Mercurius-solubilis, Mercurius-vivus, and Mercurius-corrosivus. For the antidotes, see Mei* cury. list of medicines. 21 56. Op.—Opium. White Poppy. Antidotes. Camphor, Calcarea, Hepar-sulph., Sulphur. 57. Petrol.—Petroleum. Naphtha, Stone Oil. Antidotes. Aconite, Nux-vom. 58. Phos.—Phosphorus. Antidotes. Camphor, Coffea, Nux-vom. 59. Phos.-ac—Phosphoric-acid. Antidotes. Camphor, Coffea. 60. Plat.—Platina. Antidote. Pulsatilla. 61. Plumb.—Plumbum. Lead. Antidotes. Belladonna, Opium. 62. Puls.—Pulsatilla. Pasque Flower. Antidotes. Cha- momilla, Coffea, Ignatia, Nux-vom. 63. Rheum. Rhubarb. Antidotes. Camphor, Chamo- milla, Nux-vom. 64. Rhus-t.—Rhus-toxicodendron. Sumach, Poison Oak. Antidotes. Belladonna, Bryonia, Camphor, Coffea, Sulphur. 65. Samb.—Sambucus. Elder. Antidotes. Arsenic, Camph. 66. Sab.—Sabina. Savine. Antidote. Camphor. 67. Sang.—Sanguinaria-canadensis. Common Blood-root. 68. Sep.—Sepia. Inky juice of the Cuttle Fish. Anti- dotes. Vinegar, Aconite. 69. Sec-corn.—Secale-cornutum. Ergot of Rye.. Anti- dotes. Camphor, Opium. 70. Sil.—Silicea. Silex. Antidotes. Camphor, Hep.-s. 71. Spig.—Spigelia. Indian Pink. Antidotes. Camph. Aurum. 72. Spong.—Spongia. Burnt Sponge. Antidote. Camph. 73. Stan.—Stannum. Pure Tin. Antidotes. Coffea, Puis. 74. Staph.—Staphysagria. Stavesacre. Antidote. Camph. 75. Stib.—Stibium. Tartar Emetic. Antidotes. Coc cuius, Ipecac, Pulsatilla, Green Tea. 76. Stram.—Strammonium. Thorn apple. Antidotes, Belladonna, Nux-vom. 22 list of medicines. 77. Sulph.— Sulphur. Antidotes. Aconite, Camphor, Mercury, Pulsatilla, Nux-vom. 78. Sulph.-ac—Sulphuric-acid. Oil of Vitriol. Antidote. Pulsatilla. 79. Tabac- Tabacum. Tobacco. Antidotes. Camph., Ipec, Nux-vom. 80. Tereb.—Terebinth. Turpentine. Antidote. Camph. 81. Thuja. Tree of Life. Antidotes. Camphor, Pulsatilla. 82. Verat.—Veratrum-album. White Hellebore. An- tidotes. Aconite, Ipecac, Arsenic, Camphor, Coffea, China. 83. Kalm.-l.—Kalmia-latifolia. Laurel. For a more particular description of the medicines. see Materia Medica at the close of the book. PART FIKS1 . TREATMENT OF DISEASE 23 FEVER. 20 CHAPTER 1. FEVER. In another chapter we have shown, that the human system is like a perfect, beautiful and harmonious instru- ment, each particle of matter having its own proper duty to perform, and when that duty is performed correctly, when each organ does its proper work, then the perfect machinery of the body quietly, silently fulfills its duty. There is no aching head, no throbbing pain, no burning fever, but the eye sparkles with health, the cheek is flushed with its rosy hue, the pulse bounds with vigor- ous life and with strong and elastic step man treads life's pathway, until this glorious temple crumbles away by the slow and undermining influence of age, and, liberating its ethereal spiritual form, returns to the dust from whence it came. When, from various causes, any part of the system is clogged in its operation, and is thus prevented from performing its functions aright, the struggle which takes place between the vital, living principle within us, be- tween nature in its effort to throw off this clog, to remove this friction, to restore the organ to its proper tone and strength, produces fever and its accompanying train of symptoms. Therefore fever, instead of being the di*< ase its>-lf, is merely occasioned by vital reaction against the disease, by the struggle of nature to throw off those clogs which prevent its free action. This struggle, as a matter of course, causes an increased combustion, an in- crease of heat is therefore the natural consequence, as well as an increased rapidity in the circulation of the blood. You have seen the important part that the skin per- forms in the economy of nature, how every part of it is perforated with minute tubes which throw off into the 2 26 fever. external world in the form of perspiration, not however always perceptible, worn out particles of matter which have performed their part in the economy of life. Close up these minute tubes, either by the sudden action of cold, by being exposed to a draft of air, or by any of the various causes of disease, and you at once disturb the whole economy of nature. Combustion is still going on, chemical changes are constantly taking place, but those particles which should be thrown of kept within. Now commences or should commence a contest between the vital principle, nature, or whatever you please to call it, against those causes which prevent its free action, and the result of this struggle is fever, the torturing pain, the rapid pulse and those various phenomena of disease to which different names have been assigned. . You know the absolute necessity of keeping the or- gans of respiration in a free and healthy state. Through them we receive oxygen, the life-giving principle of air in exchange for the carbonic-acid of the blood, the result of the chemical changes going on in me system. Re- strict the action of these organs either by cold, heat, sudden change of temperature, compression of the chest, or any of the varied Causes which produce disturbance there, and you cause inflammation, sometimes of a violent form, producing the most agonizing pain, or it may be of a more passive character, ending in suppura- tion and consumption. Take if you please the digestive organs. Fill the stomach with food it cannot assimilate, pay no attention to its powers of digestion, when it flags goad it on by stimulants, and you break down its strength, you render the liver torpid, you paralyze the intestinal canal, or deprive it of proper action, you force into the system more fuel than is required for the production of animal heat and the sustenance of life. And now the whole machinery of the body is out of order. Nature has FEVER. 27 been hampered in her movements, abused, trampled on, and yet she rises in all her strength and struggles man- fully to vindicate her rights. But the disturbing cause may be too great for her unassisted strength, and she sink paralyzed, or, roused into too violent action, a highly inflammatory state is the result. In the former case, the disease is of a low, sinking character, in the latter, highly inflammatory. In both cases, the progress is full of danger and the end may be, death. Now is the time for human skill to step in and aid nature in her efforts for relief. How is this to be done ? l>y binding her hand and foot, "by opening a vein and drawing away her life, by producing violent action on the bowels, by depleting and paralyzing her every effort at relief, by dragging her down, shorn of her strength until she is perfectly helpless ? No! common sense, outraged nature cries no, a thousand times, no. If you cannot aid nature, do not, in the name of heaven, throw obstacles in the way, and thus deprive the poor victim of the last chance of life. If you must meddle with something, meddle with inanimate matter, but oh! trifle not, tamper not with human life. In disease, nature has an important part to perform. Unassisted, its efforts are to bring about a crisis sufficient for the extermination of the disease. Failing in this, death is the inevitable consequence. Do we aid nature, if we take away her vital power to wrestle with disease ? How is it that in violent acute diseases, Pleurisy or Pneumonia, for instance, in which the patient has been bled, perhaps to fainting, where the depleting system has been carried on heroically ? The patient gains, it may be, present relief, but in a short time the fever returns with almost, if not quite its former violence. Nature has been prostrated for the moment, the disease remains un- touched, and the blow, which should have been aimed at the cause of the disturbance, is directed against na- 28 FEVER. ture. Instead of putting out the robber, who seeks to steal your life, the watchful sentinel, who warns of danger and struggles to repel the intruder, is stricken down at his post. For a moment it is paralyzed, but then rouses and renews, but with diminished strength, the contest How much more philosophical and in accordance with nature, to assist her efforts in removing gently, yet surely, the causes of disease. Homoeopathic remedies act upon the disease oftentimes in such a specific way, as to remove the trouble without giving rise to any perceptible crisis. A crisis may however take place, in perspiration, diar- rhoea, increased flow of urine, or eruption, the particulars of which will be given in their appropriate place. In the simple or irritative form of fever the efforts of nature are generally adequate to the removal of disease. In the inflammatory form the efforts of nature are more powerful, than is necessary, and the termination of the disease, unless human aid steps in, may be fatal. In the torpid form, nature requires aid, but from a different cause. In this case nature is prostrated and has not sufficient power to wrestle with disease. Before treating directly of the various forms of fever, some remarks are necessary as to general treatment, which is alike advisable in all varieties. Absolute rest both of the mind and body are very es- sential. The food should be light in its character, easy of digestion, the patient abstaining carefully from the more solid and stimulating articles of diet. It is for- tunate, that in most cases the stomach craves but little food, while there is a constant desire for drink, generally craving cold water, than which there can be nothing better. Ice-water, or even ice held in the mouth, when desired, can be given in small quantities with perfect safety. Toast water, or even lemonade, can also be given, save in looseness of the bowels, or while under the in- fluence of Aconite, when acids should be avoided. Should SIMPLE FEVER. 29 the fever be high, frequent ablutions in cold water are highly refreshing to the patient. The room should be well ventilated, the temperature kept as nearly as pos- sible at an even rate, say from sixty to seventy degrees, according to comfort. The patient should be placed on a mattress, lightly covered with blankets, and kept at as comfortable a temperature as possible. The covering should of course be regulated by the feelings of the pa- tient. Cleanliness should be carefully observed, and to this purpose the linen should be frequently changed. In nearly all cases, save where the bowels are disordered, fruits, but little if any tart, such as roast apples, oranges, strawberries, raspberries, and peaches, are, in moderate quantities, allowable. We now proceed to treat more directly of the different varieties of fever. SIMPLE FEVER. Causes.—This fever, unless the forerunner of some other disease, is exceeding simple in its character, generally terminating in the course of two or three days and often running its. entire course in twenty-four hours. It is generally occasioned by sudden change of temperature, or undue exposure to heat or cold. Diagnosis.—A sensation of shivering, followed by heat; thirst, quick pulse, and often an aching sensation in the head and limbs. Treatment.— Aconite. Two drops may be mixed in a tumbler of water, and a tablespoonful administered every two hours, the patient remaining quiet, and covered up in bed; perspiration will as a general thing be pro- duced in a few hours, and the patient be entirely 're- lieved in twenty-four hours, unless some other disease should be developed, such as scarlatina, measles, &c. Should there be soreness of the throat, aching of the head and limbs, Belladonna may be given in alternation 30 FEVER. with the Aconite, and prejmred in the same manner, a dose of each every four hours. INFLAMMATORY FEVER. Causes.—This fever may arise from suppressed per- spiration, sudden changes of temperature, external or in- ternal injuries, exposure to heat, damp, or cold. We may generally expect a favorable termination, unless, as is often the case, when treated allopathically, it runs into some other disease, or the patient sinks from exhaustion. Diagnosis.—Violent chill, preceded by lassitude and followed by great heat, hard, full, quick pulse, dry skin, dry and slightly coated tongue; heaviness of the head, soon passing into an aching pulsative pain particularly in the forehead; red face, sparkling eyes, great thirst, dry hot breath, sometimes hurried and anxious breathing; red and scanty urine, restlessness and anxiety. The symptoms are worse in the evening, generally abating after midnight. Treatment.—The great remedy in controlling the fever is undoubtedly Aconite. It acts more directly and power- fully and certainly with far less future harm to the pa- tient, than leeches, blood-letting and cathartics. Dose.—Put two drops or six globules in a glass half full of water and give a teaspoonful every two hours. Should there be fullness and heat in the head, vertigo, pain in the forehead, flushed face, and sensitiveness to noise or light, red shining eyes, Belladonna should be given in alternation with the Aconite and prepared in the same manner, a dose of the first one hour, and of the other the next. Bryonia, is particularly indicated, where there is tear- ing, shooting, or aching in the limbs, violent pain in the head with vertigo on rising or moving; delirium, pres- sure at the pit of the stomach, constipation; violent thirst and burning dry heat mingled with chills. We should TYPHOID FEVER. 31 look to it as the prominent remedy, where there is op- pression, shooting pain in the chest, short cough and difficult breathing. It should be given prepared like the Aconite, every two hours, or if there be much fever, as would most likely be the case, alternate with Aconite a dose of each every two hours. NERVOUS OR TYPHOID FEVER. (typhus.) This disease is of a low sinking character, the nervous system being particularly involved. Under this head we may include the dreaded, and so often fatal, ship and hospital fevers They are in reality a violent form of Typhus. This fever may assume from the commencement the form of Typhus, or, as is very often the case, especially under the prostrating treatment of the Allopathic school, other varieties of fever may run into this low sinking and more dangerous malady. Besides the two forms already mentioned, there are three forms of Typhus, more or less distinct, notwithstanding the general symptoms may be the same. These are : 1. Cerebred Typhus, or Typhus cerebralis, affecting principally the brain and the nervous system 2. Typhus Ahdominedis or abdominal Typhus, where some part of the abdomen is the principal seat of the disease. 3. Pneumo Typhus, or Typhus of the lungs. Typhoid lung fever, or Typhoid Pneumonia, affecting the organs of the chest. Typhus in its progress may indicate a high state of nervous action (Tyjhu* vesatalis), or the patient may be constantly inclined to stupor {Typhus stiqndus), or it may be of a putrid character (Typhus Putridus), where there is a strong tendency to disorganization and decay. This is the most alarming form of the disease. 32 FEVER. Causes.—The causes are numerous, and some of them remote. It may arise from hunger, bad food, ill-venti- lated apartments, where numbers are crowded into a small space and the air rendered highly impure, exposure, want of cleanliness and those hundred causes, to which the poor are exposed. It may arise also from chagrin, sadness, grief, care, disappointed love, disappointment in business, violent exertions of the mind and body, venereal excess, depressing emotions, excessive heat, prostration from disease, or from medical treatment, which may be worse than the disease; dampness, cold, and a peculiar state of the atmosphere, which may fail to give sufficient sustenance to the vital forces, and thus develop epidemic Typhus. The progress of the disease is often slow, sometimes lasting twenty-one or twenty-eight days, and even longer. The convalescence is also slow, and the patient, unless great care is used, very liable to a relapse. The pre- cursory symptoms, headache, lassitude and a general derangement of the system, unless controlled by appro- priate remedies, not unfrequently last for days and even weeks. Perfect quiet, great cleanliness, a room well ven- tilated and not too dark, are absolutely essential. There are several indications which every good nurse can watch, and which will indicate to a certain extent the danger, or immediate prospect of convalescence. 1. Th>, Pulse. Should this gradually become quiet and even, hope would naturally and justly brighten, but the more accelerated it becomes, the more the danger to the patient increases. A constant variation in the pulse is a worse indication even than its frequency. 2. The Urine. Should it be clear, thick, brown, bloody, or with a cloud floating or rising towards the surface, or with a sediment, with the urine turbid above it, the danger is great, but should there be a gradual clearing TYPHOID FEVER. 33 up of urine previously thick, or previously clear urine become turbid, improvement is indicated. 3. Haemorrhages, especially by urine and stool, diar- rhoea, putrid, fetid smell, are indicative of putrid disso- lution. Deafness, though naturally exciting alarm in the friends, is by no means an unfavorable symptom. Diagnosis.—This disease, notwithstanding it steals on, as a general thing, slowly, yet it firmly and surely gains a footing, unless arrested by appropriate remedies, and may in a short time so prostrate the system as to render the prospect of recovery very extremely hazardous. During the premonitory stage, the patient is languid, easily tired; he loses his appetite, the tongue becomes white, and in- clined to tremble. There are wandering pains in the head, chest, back, abdomen or extremities, fullness and giddiness of the head, drowsiness, and unsound and un- refreshing sleep at night. These precursory symptoms may last for days or weeks. The commencement of the fever is marked, not by a violent chill, but by slow chills alternating with heat, and sometimes violent headache. The expression of the face is dull and heavy, and there is no desire for exertion either of the mind or body. On pressing heavily on the abdomen near the right hip, a sensation of pain is distinctly felt. As the disease pro- gresses, the skin becomes dry and hot, the appearance of the tongue is exceedingly variable. At times it may be clean, smooth and red, then again slightly furred, the tip and edges red, with a dark brown almost black streak in the centre, or the whole tongue become dark and ex- cessively dry. Sordes form about the teeth. Delirium, generally of a low muttering kind, although sometimes more violent in its character, a vacant or indifferent look, perfect indifference to every thing, stupor, gradually sinking down in the bed, diarrhoea, &c, are among the symptoms which may be developed during the progress of the disease. 2* 31 FEVER. Treatment.—Perfect quiet, cleanliness, a room well ventilated and not too dark, cold water, or toast waler, whenever desired, are of course essential. If during the precursory symptoms there should be chilliness, lassitude, with alternate heat, headache, giddiness, rheumatic pains, pain in the back, furred tongue and restlessness at night, Bryonia and Rhus, two drops or twelve globules in a tumbler of water may be U3ed in alternation a tablespoon- ful at a dose two hours apart. These will often be sufficient to arrest the disease, but should inflammatory symptoms set in, such as a dry and burning skin, hard full pulse, restlessness, thirst, congestion of blood to the head, Aco- nite should be administered. Dose.—Mix two drops or twelve globules in a glass half full of water, and give a teaspoonful every two hours. Belladonna is indicated in the commencement of the disease, where it is occasioned by fright or chagrin, where convulsive twitching of the limbs, and a general feeling of restlessness is present, especially in the limbs; or where it commences with fainting turns which are follow- ed by extreme sensitiveness of all the organs; or where there is a continual drowsiness increasing to lethargy, with snoring, during which the countenance changes from cold and pale to red and hot, disturbed sleep, anxious and restless when awake, with internal heat and head- ache. Where also the inflammatory symptoms indicating Aconite are present, the two remedies should be given in alternation, a dose of each every two hours. Belladonna, is also particularly indicated where in the progress of the disease the delirium becomes more furious; there are visions while awake, starts as from affright, internal burning heat, without thirst, distension of the veins and throbbing of the arteries of the head, pressing pain in the temples, intolerance to noise ; the eyes may be congested; the tongue is red, burning hot and parched, the mouth and throat dry, deglutition diffi- TYPHOID FEVER. 35 cult, abdomen distended and sensitive to the touch, and frequent diarrhceic stools. Where these symptoms ap- pear Belladonna should be given, prepared in the same manner as the Aconite, every two hours. Bryonia is a most valuable remedy in Typhus, and is frequently indicated. It is often appropriate in alter- nation with Rhus. Its indications are a bruised, aching sensation throughout the whole body. The most downy bed would feel hard. Beating, pressing pain in the fore- head from within outward, particularly painful when looking up or moving the eyes, burning sensation of the head, notwithstanding the forehead may be covered with a cold sweat, moaning during sleep, heat and frightful dreams. In the commencement of the disease where heat alternates with chilliness, the former in the morn- ino-, the latter in the afternoon, and where there is mo- derate thirst, vertigo, increase of headache and excessive erethism of the nervous system, and where gastric symp- toms are present, such as bitter taste, yellow coating of the tongue, nausea, vomiting, and difficult stool, Bryonia is strongly indicated. This remedy is also indicated where in the progress of the disease the heat becomes permanent, and is accompanied with delirium, but little complaint of pain, yet grasping at the head, delirious talk of business, face red and bloated, lips dry and crack- ed, white miliary eruption and constipation. Dose—Mix two drops or twelve globules in a glass half full of water and give a teaspoonful once in two or three hours. Rhus tox. is a very important remedy, particularly in the "vwztile" and stupid forms of Typhus, especially the latter, and also where the convalescence is slow, the pulse continuing feverish, and the diarrhoea and oppres- sion of the chest not entirely removed. In the precursory stage there is chilliness even . iear the fire, colic and diarrhoea, bruised sensation in various parts, white-coated tongue, nausea, vomiting of mucus 36 FEVER. and vertigo; a stiff and lame sensation when at rest, numbness of the parts on which the patient lies, and a stinging, drawing and rigidity in the nape of the neck and back. %As the disease advances there is great weak- ness and prostration, sleeplessness, great restlessness at night with anguish or heavy sleep, with murmurs, snoring, dry heat, sleep disturbed by troublesome dreams, frequent starting and throwing off the clothes. Talkative delirium, frequent desire to run away, stupefying headache, vertigo on rising up. As abdominal typhus gradually develops itself, the heat and violent delirium become continuous, the cutting in the abdomen and diarrhoea are followed by pain in the limbs, great weakness, tongue and lips blackish, cheeks burning red, sopor, with muttering, snor- ing, and small accelerated pulse. The eyes are red and uninfluenced by outward impression, the odor from the mouth is fetid, the stools involuntary, and the urine whitish and turbid. Oppression of the chest strongly indicates Rhus. Dose.—Give it prepared as Bryonia, a dose every two hours, unless in alteration with Bryonia or some other remedy, when it should be taken every four hours. Opium.—Is indicated where there is a constant desire to sleep, or a lethargic sleep with labored respiration and snoring, hard full pulse. Dose.—It should be given, prepared as Bryonia, a dose every two or three hours. Hyosciamus—Excessive wildness, great nervous ex- citability, furious delirium with visions, or apathy and stupidity, fixed and dull eyes, surrounded by a livid circle, or red and sparkling eyes with pupils either dilat- ed or contracted. Dose. — Same as Bryonia. Strammonium.—Violent pain in the head, with faint- ing, delirium, violent tossing, illusions of sight, loss of consciousness, dilated and insensible pupils, lethargic sleep and snoring. TYPHOID FEVER. 37 Dose.—Same as Bryonia. These three remedies, it is often ad visable to alternate with Aconite, Arsenicum or Muriatic-acid. Phosphorus, is principally indicated when the disease arises from cold or onanism. In the precursory stage there are rheumatic pain in the limbs, worse morning and evening, and aggravated by cold air or the touch, and sometimes accompanied with a general sensation of sickness, a weary bruised feeling, tightness of the head, palpitation of the heart, and pain in the stomach and bowels. As the disease progresses, there is a small, hard, quick pulse, profuse sweat; sleep interrupted by shrieks, moaning, stitches, and rattling in the chest, oppressive cough and bloody expectoration, painfullness of every part of the body. The above group of symp- toms occurring in Typhoid Pneumonia are very ac- curately covered by this remedy. There may also be painful sensitiveness in the abdomen near the right hip, sometimes accompanied by half liquid bloody stools, beating pain in the head, and discharge of blood from the nose. Dose.—A powder or three globules every three hours. Phosphoric-acid.— Great prostration, flighty, even when awake, aversion to conversation, always on the back, in a drowsy state, replying to questions incoherently, or not answering at all, low muttering delirium, dryness of the tongue, dry and burning skin, loose evacuations generally passed involuntarily and sometimes bloody; frequent, weak, and sometimes intermitting pulse. The remedy should be alternated with Rhus, a powder or three glo- bules every three hours. Arsenic —If in connection with the above symptoms there is a rapid sinking of the vital powers, great pros- tration of strength, countenance deathly, eyes dull and glassy, pulse scarcely perceptible, burning thirst and diarrhoea, give Ars>nir, a powder or three globules every hour. Should the evacuations be fetid, cold perspiration 3S FEVER. on the face and extremities, rattling respiration, C 'a; ho- ve-/, should be given in alternation with the Arsenic, £ dose of each every hour. As the urgent symptoms abate the intervals should be lengthened to three or four hours. Muriatic-acid is an important remedy in Typhus- stupidus, where there is sliding down in the bed, with moaning and groaning during sleep, and constant mutter- ing when awake, with inability to collect the senses, paralytic condition of the tongue, with dryness of the mouth and fauces. Where these symptoms occur it is generally best to give the acid in alternation with Opium, a dose of each every four hours. Where the acid is given alone, it should be given once in three hours. Sufficient may be dissolved in a tumbler of water to make it slightly tart, and a tablespoonful given at a dose. Besides the remedies already enumerated, we will mention a list which may at times be found highly ser- viceable. For particular indications, see Materia Medica at the close of the book. Arnica, Camphor, China, Coffea, Cantharid s, Cocculus, Ipecac, Tgnatia, Leichesis, Zycopodium, Nux-vom, Pulsatilla, Mercurius, Vera- trum, Sulphur. Diet.—During the early part of the disease the diet should be of a farinaceous character, as the disease pro- gresses however, if symptoms of rapid prostration are present, such as weak or flickering pulse, feeble voice, and great general weakness, we should endeavor to sup- port the strength by means of broth, beef-tea, wine-whey or brandy. The nourishment should be given a few spoonfuls at a time and repeated once in two or three hours. The stimulants should be given a little at a time and repeated as the strength of the patient requires them. For the manner of preparing beef-tea, wine- whey, &c, see Index. During convalescence be careful YELLOW FEVER. 39 and not overload the stomach, for if the patient is al- lowed to indulge to the full extent the cravings of hungei a relapse may take place. For Cerebral Typhus or brain fever the principal remedies are Acon., Bell., Bry., Ilyos., Op., Rhus. For typhoid lung fever. Ip., Bry. and Rhus, or Ars, Chin , Ilyos., Phosphor, Phos.ac, Sulph., Laurocerasus. For Abdominal Typhus, Rhus or Bry. or Ars., Chin. and Merc, or Am., Carb.v., Nux-vom., Puis, and Sulph., Canth. and Phos. YELLOW FEVER. This disease prevails principally in warm climates and is peculiarly fatal where is attacks persons who are not acclimated, and who, coming from a colder region, seem to forget, that a change of climate would naturally indicate a change in habit, dress and diet. In a previous chapter we have spoken of the different amouut of oxygen contained in a warm and moist climate, wl.ce the heat continues for months, and in the colder regions of the temperate and frigid zones, where the intense heat is of but few days or weeks' duration. The amount of food, both in kind and quantity, should be materially different in warm climates from that in regions at greater distance from the equator. In the rarefied air of the former, a less amount of oxygen is taken into the system, and therefore less solid nourishing food is required than in colder regions, where the air is more condensed, thus necessarily containing more oxygen. Food introduced into the system and not consumed, remains as a clog and irritant, encumbering the organs, cramping their opera- tion, and sowing in the body the seeds of decay. Hence, in these warm climates great caution is necessary not only as it regards diet, but also clothing and exposure to the heat of the midday sun and the dampness of the night. 40 FEVER. Causes.—Animal and vegetable substances exposed to continued heat in a moist atmosphere soon decay, and fill the air with a poisonous miasmata. This miasm, may give rise to yellow fever, especially where it is pro- duced by the decaying animal and vegetable substances found in close streets, the crowded and ill-ventilated rooms and cellars, and the necessarily confined air of the populous city or village. The chemist, perhaps, would hardly undertake to detect the subtile poison in the atmosphere, by which the life-springs of thousands are tainted, and yet he can laugh right merrily at the folly and absurdity of infinitesimal doses. Other prominent causes, are exjwsure to the heat of the sun, mental anxiety, want of cleanliness, dissipation, a fondness for stimulants, both in food and drink, in reality a greater love for the palate and stomach, than for life and health. This is one great cause, why the disease is more fre- quent and much more fatal among that class of resi- dents who foolishly persist in indulging in the same variety of food, the same style of living, the same habits they were accustomed to in their colder home. Diagnosis.—This fearful pestilence is looked upon as almost as fatal as that terrific scourge, the Cholera. Sometimes the patient is taken down when at his daily avocations, without warning, and in a few hours is a corpse. In other cases the disease approaches more slowly, the premonitory symptoms being well marked. The severity of the disease, as we have before stated, depends much upon the constitution, habits and tem- perament of the patient. The first symptoms are generally want of appetite, constipation, oppression of the stomach, giddiness and debility. Where the attack comes on with violence, there is cold, shuddering, headache, nausea and vomiting. This is followed by severe pain in the back, shivering along the spine, although the setting in of the attack is YELLOW FEVER. 41 often preceded by great exhilaration of spirits, and tearing pain in the limbs, sometimes amounting to cramps. These sensations last for a few hours, and are followed by violent reaction. The breathing becomes difficult, the breath burning, the pulse hard, full and quick, the cheeks red and turgid, the conjunctiva in- jected, violent pain in the head and throughout the body, skin dry and hot, burning thirst, nausea and vomiting. The abdomen becomes hard and painful, and a sensation of great suffering is felt in the stomach. This period, lasting in severe cases from twelve to twenty-four hours, although sometimes it continues three or four days, is followed by what seems to the patient almost an entire remission. For a few hours the patient is comparatively comfortable, notwithstanding there may be some nausea and distress about the stomach, but this rest is speedily followed by a return of many of the old symptoms with increased violence. The skin and eyes acquire a yellow tinge. The tongue is parched and covered with a dark fur, the skin clammy, the head confused, the pulse sinks, delirium may set in, the retching increase in violence, the matter vomited pre- sents a darker and thicker appearance, and the stomach is painful and sensitive. This stage may last from twelve to forty-eight hours, sometimes with slight remissions towards the termina- tion, when it is followed by the third stage, when the symptoms increase at a fearful rate. The strength fails rapidly, there is extreme prostration, the tongue and lips are parched and cracked, the gums soft and livid, exuding black blood; there is intense suffering in the stomach, great anxiety, hiccough, the dreaded Hack vomit, getting darker and dancer, and more and more frequent, until death closes the painful scene. On the setting in of the third stage, the patient is generally be- yond the power of earthly aid. 42 FEVER. Treatment.—The most important remedies are,—in the first stage, and sometimes in the second, Aconite, Ipecac, Belladonna, Bryonia, Pulsatilla and JS'ux-vorn. In the second and third stage, Nux-vom., Mercurius-so7., Arsenicum, Argent.-nit., Digitalis, Phos.-ac, Rhus-tox., Verat., Canth., Carb.-veg. and when there are black de- jections, Hellebore. Ipecac.—Is generally indicated in the first stage, where slight chills, general pains, uneasiness in the stomach, nausea and vomiting, together with a sensation of faint- ness are present. Dose.—A powder, or three globules drv on the tongue every two hours. Aconite.—Should the symptoms after a short time re- main unabated, or change for the worse, other remedies are indicated, and the treatment should be of the most prompt and decided character. Aconite is indicated where there is violent febrile reaction; dry and hot skin, great thirst, full and rapid pulse, short and anxious respiration, restlessness and anguish; eyes red and sen- sitive, mouth dry, great internal heat; pain in the fore- head and head, also in the back and limbs, heat and sensitiveness of the stomach; nausea, vomiting, and a general sense of prostration. Dose —This remedy is particularly indicated in the first and some- times in the second stage of the disease. It is often indicated in al- ternation with Belladonna, when it shr.uld be given two drops of the tincture, or six globules, dissolved in a tumbler of water, a table- spoonful every two hours. When given alone, it should be taken every two or three hours, according to the violence of symptoms. Belladonna.—Indicated mostly in the first stage of the disease, where there are sharp shooting pains or violent throbbing in the head; face bloated and red, eyes sparkling and red, or fixed, glistening and promi- nent, pulse variable, burning thirst and heat, tongue loaded with whitish yellow or brown coating; nausea YELLOW FEVER. 43 or vomiting; aching and cramplike pains in the loins, back and legs; during the fever, great restlessness and anguish. Dose.—The same as Aconite. Bryonia.—Headache increased by movement, pains in the back, loins, and limbs ; pulse rapid, full or weak; great thirst, tongue dry with white or yellow coating; yellow skin; eyes painful on motion, red, or dull and glassy, or sparkling and filled with tears. Pain and burning in the stomach, or fullness and oppression; vomiting or nausea, particularly after drinking; rest- lessness, anxiety and delirium. Dose.—The same as Aconite. Give every two or three hours Sometimes the remedy can be alternated with Rhus. Rhus.—Dull, glazed, and sunken eyes; dry and black tongue, pulse quick and small; talkative delirium, or partial stupor; moaning and great restlessness, particu- larly at night. Violent pain and burning in the stomach; spasms in the abdomen; numbness or partial paralysis of the lower extremities r nausea and vomiting, colic, diarrhoea, and difficult deglutition. Dose.—Same as Bryonia. Nux-vom.—Eyes yellow or inflamed; yellow skin; pulse variable ; tongue dry, cracked and brown, or coat- ed with a white or yellow fur; vertigo ; pains in the head; pressure, cramp-like or burning pain in the stomach; hiccough; bilious or acid vomiting ; tremors of the limbs ; great desire for stimulants; frequent move- ments of slimy, bloody, or bilious matter; coldness, cramps, and numbness in the lower extremities. Dose.—A powder or three globules every two hours. Mercurius.—Tongue moist and white, or dry and brown, pulse very changeable, now quick, strong and intermittent, and again weak and trembling; loss of strength and feeling of fatigue ; vertigo or pain in the head; convulsive vomiting of bilious matter; extreme 44 FEVER. tenderness of the stomach; coldness and cramps in the arms and legs; constipation or loose mucous, bloody or bilious discharges. Dose.—Same as Nux. Arsenic—Changeable expression of countenance, ge- nerally a yellowish, bluish, or deathly cast; sunken eyes, surrounded by a dark circle; lips and tongue brown or black; nose pointed; cold clammy sweat, pulse irregular, generally quick, weak, and small, or trembling, indicating great prostration; burning pains, especially in the region of the stomach and liver, sometimes with oppression of the stomach, and vomiting, particularly after drinking; diarrhoea sometimes with pain and tenesmus, though often involuntary; pain in the ab- domen as from a weight; oppression of the chest, with rapid and anxious respiration. Delirium, low muttering, or talkative ; loss of consciousness. This remedy is peculiarly applicable in the second and third stage, where there is a rapid sinking of the vital power. Dose.—Give a powder, or dissolve six globules in a tumbler of water, and give a tablespoonful every half hour or hour, as the symptoms may indicate. Vera t rum.—This remedy is principally indicated in the second and third stage, where there is a general coldness, particularly of the hands and feet, which may be covered with a cold perspiration ; cramps in the upper and lower extremities, and in the stomach and abdomen; frequent loose evacuations; pain in the abdomen and stomach: vertigo; great thirst; severe vomiting, some- times of bile and mucus, and again of black bile and blood. Loss of sense, stupor or violent delirium. Dose.—One drop or six globules in a tumbler of water, a table- spoonful every half hour, hour, or two hours, according to symptoms Phos.-ac—Stupidity; aversion to conversation; great prostration, stupid expression, with glassy hollow eyes; sleeplessness, restless, or sleepiness, or delirium, with bilious remittent fever. 4c picking the clothes. Cold perspiration, with anxiety and oppression of the chest. Dose.—Six globules in a glass of water, a tablespoonful every hour. Besides the remedies we have already enumerated. Canth., Carb.-veg., Bach, and Sulph. may also be service- able. For particular indications, see Materia Medica, at the close of the book. Diet and Regimen.—When the attack first comes on let the feet be placed in warm mustard water for a few moments, then put the patient in bed, cover him warmly, to induce perspiration and apply cold water to the head. If the patient is very thirsty, small lumps of ice may be held in the mouth, or a little cold water or toast- water given. During convalescence particular care should be taken not to over-fatigue the system, to take nourishment in small quantities at a time, and to avoid mental excite- ment. BILIOUS REMITTENT, REMITTENT or BILIOUS FEVER. Causes.—In this country, this form of fever is most violent, and prevails to a greater extent in the southern and western states. It is the endemial fever of warm climates, particularly where the soil is marshy, the country new, and the vegetation rich. It is by no means rare however in more temperate climates, particularly in the autumn or during a summer of great heat; it sometimes develops itself in the winter and spring. In addition to causes already named, we may mention dis- sipation, either in eating or drinking, exposure to changes of temperature, anger, fear, or grief, and in fact, any of the numerous causes by which the digestive organs are disturbed. Diagnosis.—This fever holds perhaps an intermediate place between the intermittent, and the Typhoid, into 46 FEVER. which, either from bad treatment or the weakness and temperament of the patient, it often runs. There are generally premonitory symptoms, such as headache, un- pleasant sensation of the stomach, and general uneasi- ness. A chill, more or less severe, is followed by flushes of heat; mouth clammy and dry; thirst, nausea, and occasionally vomiting; pain in the head, back, and limbs, with hurried respiration and frequent, small, and sometimes irregular pulse. These symptoms are speedily followed by great febrile heat. There is a dry skin, violent and throbbing pain in the head, flushed face, full and rapid pulse, and sometimes delirium. The tongue is white, there is a tenderness of the epigastrium, with occasional vomiting ; the urine is high-colored, and the bowels generally constipated. In twelve or four- teen hours a remission of the symptoms generally takes place, although the fever does not entirely subside. After a calm of two or three hours the exacerbation again takes place, becoming shorter in duration, and less violent as the disease abates. In the more severe forms of fever the remission may be scarcely perceptible, yet there are certain indications always present,—viz., gastric irritability, a sense of oppression, and distress of the epigastrium, pain in the head, back, and limbs, and prostration of the strength early in the disease. Con- valescence is indicated by the remissions becoming more distinct, the pulse full, soft, and less frequent, and thebowels and stomach more regular and healthy in their action. The disease may continue fourteen days or even longer, although under the judicious use of homoeopathic remedies, it not unfrequently disappears in a very few days. Treatment.—As we have before stated, there are gene- rally premonitory symptoms, before the fever sets in, in- dicating a derangement of the stomach and bowels, sometimes lasting several days. Taken in hand now, a bilious remittent fever. 47 few doses of medicine will often remove every symptom of disease, and thus prevent a sometimes long and tedious fever. In cases of indigestion, where there is fullness and weight of the stomach, nausea and vomiting, Ipecac, and Pulsatilla are the prominent remedies. Pulsatilla is particularly indicated where these symptoms arise from the use of fatty food. The latter remedy, if nausea still continues after a short time, can be followed by Ant.- erud. Where the disease is occasioned by changes of tem- perature, Bryonia, Rhus and Stibium are indicated. Chamomilla when occasioned by anger, and Ignatia if by vexation, grief, or shame. Aconite—Is strongly indicated on the setting in of febrile symptoms, where there is high fever, rapid pulse, great thirst, yellow coating on the tongue; bitter taste ; bitter, greenish or slimy vomiting, painfulness in the re- gion of the stomach and the liver, and severe headache. Either Bryonia, Belladonna or Pulsatilla may be indi- cated in alternation with Aconite. DOSE,—Mix two drops or twelve globules in a tumbler of water, and give a tablespoonful every two hours, until the fever is relieved or the symptoms indicate other remedies. Bryonia.—Where there is aching or tired sensation in the head, back, and limbs; constipation; bilious vo- miting, especially after drinking; great heat, or shiver- ing with heat in the face ; 'great desire for acids, and aversion to food, bitter or insipid taste ; dry, brownish- yellow tongue. Dose.—Same as Aconite, with which if fever is present it may be alternated one hour apart. Bd'adonna.—Violent pain in the head, particularly the forehead; dry mouth; yellow or white tongue; heat about the head, with thirst, alternating with chills ; vo- miting of sour or bitter substances; sopor in the day- time, and sleepless nights. 48 fever. Dose.—Same as Aconite, with which it may be alternated. Pulsatilla.—Whitish tongue ; flat, pappy, or bittei taste; bitter and offensive belching; aversion to food, and desire for acids; nausea; vomiting of food, mucous or sour or bitter substances; pressure in the stomach, and difficult breathing ; inclination to diarrhoea, and fre- quent shivering. Dose.—Same as Aconite, with which, if fever is present, it maybe alternated, two hours apart. More generally indicated in females Chamomilla.—Bitter taste, fetid smell from the mouth; loss of appetite; nausea, and sour or bitter vomiting; anguish, tightness, and pressure in the stomach ; flatu- lent colic ; constipation; diarrhoea with greenish or sour stools; restlessness, and ill-humor; heat of the face and eyes, with red cheeks, or heat with shivering. Dose.—Two drops or twelve globules in a glass half full of water, a teaspoonful every two or three hours. Veratrum.—Great debility after a stool; bilious vo- miting and diarrhoea; pain in the abdomen, and cold- ness of the extremities. Dose.—Dissolve three drops or twelve globules in a glass half full of water and give a teaspoonful every hour or two hours, accord- ing to symptoms. Ipecac.—More particularly in the first part of the dis- ease, where there is loathing of food, nausea, ineffectual efforts to vomit, or vomiting; pressure and painful full- ness in the pit of the stomach; diarrhoea; aching in the forehead; heat with thirst or shiverings. Dose.—A powder or twelve globules in a glass full of water, a table- spoonful every hour or two hours until relieved, or another remedy is indicated. Nux.-vom.—Dry and white or yellowish tongue; bit- ter taste ; nausea, and vomiting, particularly when in the air; tightness, and pressure in the region of the sto- mach ; spasmodic colic; constipation with frequent and ineffectual urging to stool, or with slimy or watery stools; aching in the forehead with vertigo; ill-humor; heat with shivering; bruised sensation in the limbs intermittent fever. 49 Dose.—A powder or three globules every three hours. Mercurius.—Moist, white, or yellowish tongue; pain- fulness of the stomach and abdomen, particularly at night, with anguish and restlessness; sleepy in the day, and wakeful at night; ill-humor. Dose.—Same as Nux. Arsenicum.—Great debility; burning sensation and sensitiveness of the stomach, often with nausea and vo- miting. Dose.—A powder or three globules every two hours. Colocynth.—Violent colic, particularly after eating, sometimes with diarrhoea; cramp in the calves. Dose.—Same as Arsenicum. Stibium.—A prominent remedy in bilious fever, gene- rally in alternation with Bryonia. Nausea, gagging and vomiting, aching pain in the forehead, bruised sensation in the limbs; oppression of breathing, dry heat and ra- pid pulse. Dose.—A powder in alternation with Bryonia, one or two hours apart. Rhus is often indicated in alternation with Bryonia; for its particular indications as well as for those of Sul- phur, see Materia Medica. Diet and Regimen.—See general remarks further on. If constipation of three or four days' standing it may be necessary to give an injection. For the manner of pre- paring which, see Index. INTERMITTENT FEVERS. Chills and Fever. Fever and Ague. FEBRES INTERMITTENS. The symptoms of this fever are so marked, that there is no difficulty in distinguishing it from all other forms. In remittent fever, the fever is never entirely absent during the remission, while in intermittent the paroxysm comes on, and in a few hours, passes entirely off, leaving the patient without any perceptible trace of the fever. 3 50 FEVER. It prevails more extensively in marshy countries, par- ticularly at the south and west, where the land is being drained, forests leveled, and the rich soil turned up by the plow. The air is poisoned with a miasm so subtile in its character as to defy detection, and yet so power- ful as to prostrate the strongest man. It may also be developed after other diseases. Diagnosis.—The paroxysm is generally marked by three distinct stages, viz. 1st, cold; 2d, fever; and 3d, sweating stage • although these stages sometimes seen commingled together. The symptoms in this disease are exceedingly variable. In some cases, the paroxysms ap- pear every day, in others, every other day, and again, once in three or four days or even one or two weeks apart. The cold stage is preceded by headache, languor, and a stretching sensation; blueness of the nails, and numb- ness of the toes and fingers. The coldness and shivering of the limbs and back gradually increase and pervade the whole body, the teeth chatter, the shivering is so violent as to shake the bed ; the application of external warmth produces no immediate effect. There is oppres- sion of the chest, pain in the head or stupor and deli- rium. The pulse is weak and oppressed. This stage varies in violence and duration, lasting from half an hour to three hours, when it is followed by the hot stage. This stage is characterized by violent fever, quick, wiry, and rapid pulse, great thirst, dry skin, flushed face, pain in the head, and sometimes delirium, hurried breathing, and oppression of the chest. lasts from three to twelve hours, when it terminates in the sweating stage, or, as is sometimes the case in warm climates, runs into remittent, or continued fever. Sweating stage. The violence of the fever begins to abate and is succeeded by profuse perspiration: the pulse becomes less frequent, soft and full, and the aches and INTERMITTENT FEVER. 51 pains rapidly disappear, until all traces of the former violent paroxysm have entirely subsided. Treatment.—The remedies indicated are numerous, and should be selected with great care. No disease re- quires more care in the selection of remedies than this. A prominent remedy in distinctly marked intermittent, where all three of the stages are clearly and distinctly defined, is undoubtedly— Quinine.—Those of our Allopathic friends, who cure intermittent, without leaving after unpleasant conse- quences, would be somewhat surprised, if told the action of that drug is purely homoeopathic, and their patient is cured strictly on the homoeopathic principle. Dose.—Ten grains may be thoroughly triturated with twice the amount of white sugar, or sugar of milk, and made into ten powders, one of which can be taken every three hours, during the intermission of the paroxysm, or five grains may be dissolved in ten tablespoon- fuls of water, and a tablespoonful taken in the same way. During the paroxysm, the remedy must be discontinued. Even if it should not return, a powder should still be given every day for five or six days. In addition to the above remedy, one or more of the following well selected, are frequently sufficient to produce a speedy cure. Acon., Ars., Ant.-crud., Ipecac, Nux-vom., Puis., Bry., Vcrat, Sab., Ig- natia, Cham., Lack., Rhus., Caps., Sulph., Op., Carbo-veg., Cocc, Bell. Ipecac, is often highly beneficial in connection with Nux, particularly in the commencement of the disease. Dose.—A powder, or three globules, should be given every three hours between the paroxysms, and a powder or three globules of Nux, immediately after the attack. If the next attack should be equally violent, of course another remedy should be selected. If the tincture is given, one drop may be dissolved in a tumbler half full 01 water, and a tablespoonful taken at a dose. The particular indica- tions for Ipecac, are—much shivering with but little heat, or the contrary; shivering increased by external warmth ; oppression of the precordial region : nausea, vomiting. It is also particularly indicated in that variety, where the third or sweating stage is scarcely per- ceptible. Nux-vom.—This remedy as well as Verat., Bry., Bell., Coc, Pu7s. and Ip^cc will be found useful, where the bowels are constipated, and when errors in diet give rise 52 FEVER. to bilious symptoms. It is more particularly indicated in those fevers, where the paroxysm comes on every day or every other day, generally in the afternoon, evening, or night, and where there is aching pain in the forehead, vertigo, nausea, and bitter taste; spasms of the stomach, and great weakness. We shall also find it useful, where there are, particularly at the commencement of the dis- ease, paralytic weakness of the limbs, giddiness and pros- tration; difficult breathing, palpitation of the heart, shivering, followed by anxiety and warmth; violent head- ache, increased by walking and the open air; burning, itching, and sometimes delirium. Dose.—Same as Ipecac, with which it may be compared. Belladonna.—Violent headache with dizziness; shiver- ing, with moderate heat, or the contrary. Heat with red- ness of the face and pulsation of the arteries. Dose.—Two drops or six globules, dissolved in a tumbler of water, a tablespoonful every two hours, during the paroxysm; where the fever has been of long-standing, every six hours during the inter- mission. Arsenic—Is a prominent remedy in this disease, par- ticularly where the stages are not distinctly marked, but are in a measure commingled; or where there is burning heat, with anguish, restlessness, and great thirst; great prostration of strength; nausea, retching and vomiting; severe pains in the stomach and throughout the body. Preceding the chilly stage, there is often stretching, yawning, headache, vertigo, with stupefaction; between the chilly and hot stage, debility and sleep, vertigo, thirst, nausea and vomiting. Dose.—Same as Ipecac, given during the intermission of the fever every three hours. (Compare Chin. Ipecac, and Verat. Veratiurn—Is indicated in those fevers which consist simply of external coldness, or internal heat, with dark urine, or when a warm sweat is present, soon becoming cold, accompanied with vertigo, nausea, and great pain in the back. INTERMITTENT fever. 53 Dose.—Same as Belladonna. Give every two hours during the continuation of the symptoms. Pulsatilla.—Will be found beneficial, where there is vomiting of mucus; moderate thirst, pain in the head, and oppression of the chest, during the cold stage, and shivering when uncovered, during the hot and sweating stage ; aggravation in the afternoon or evening ; gastric or bilious affections with their accompanying symptoms between the paroxysms. Dose—Same as Belladonna. Give during the intermission of fever every two or three hours. Ant.-cr.—Has a close resemblance to Pulsatilla. The perspiration is simultaneous with the heat, and suddenly disappears leaving dry heat, thirst, want of appetite, nausea, vomiting, pressure in the stomach, and pain in the chest. Dose.—Same as Ipecac. Give same as Belladonna. Bryonia.—Where the paroxysms occur daily or every other day, particularly in the morning, preceded by ver- tigo, pain in the forehead; coldness and shivering more prominent than heat. During the chilly and hot stage, dry cough, stinging in the chest, asthma, nausea. Dose.—Same as Belladonna. Opium.—Particularly in young and old persons, where there is great drowsiness, snoring sleep, flushed face. Give a tablespoonful every two hours, during fever. Dose.—One drop or six globules in a tumbler of water. Rhus.—Is nearly related to Bryonia, with which it can often be given in alternation. The chilliness is some- times attended with pain in the limbs, headache, vertigo, and nausea. There is generally great restlessness and thirst; gastric symptoms, nettle rash; convulsions and hardness of hearing. Dose —Same as Belladonna. Capsicum..—Prevalence of the chilly stage, during which alone there is thirst, heat and sweat simultaneous; restlessness, headache or confusion of the head, sensitive 54 fever. to noise, vomiting of mucus, pain in the chest anbl back, tearing in the limbs, diarrhoea with slime and burning faeces. (Compare with Carb.-v.) Dose.—Three drops in a glass half full of water a tablespoonful during the paroxysm every hour Aconite.—When the paroxysms of fever are violent, Aconite should be given, two drops in a tumbler of water, a tablespoonful every hour, in alternation if necessary with the Capsicum, Belladonna, or Opium. For general directions as to the administration of re- medies, see page 12. CUTANEOUS diseases. 55 CHAPTER II. CUTANEOUS DISEASES. The skin is liable to an almost innumerable class of diseases, some affecting also other organs, and even the whole system, accompanied with severe pain, violent fever and often delirium, ending unless speedily reliev- ed, in death. Others are of a more chronic character, attended with but little, if any fever, oftentimes tedious in their cure, and generally far more annoying than dangerous. Among the former class we may mention, Scarlet Fever, Erysipelas, Measles, and Small-Pox. Scarlet Fever, Measles, Chicken-Pox, and Small-Pox, are infectious, and generally prevail as epidemics. Very seldom is a person attacked with either of the above diseases more than once. The danger of infection is greatest after death. Infection seldom if ever takes place before the eruption appears, but from that time until the pustules have fairly dried up, or the eruption has in a great measure subsided, the infectious matter is being constantly thrown from the system. For the sake of convenience, we shall divide eruptive diseases into two classes. 1. Eruptive Fever. 2. General Cutaneous Diseases. 1. ERUPTIVE FEVERS. NETTLE RASH. URTICARIA. This rash is seldom dangerous, although excessively tormenting. The eruption resembles very much that produced by the sting of the nettle, hence its name. It consists of an irregular pale red, or whitish eminence, surrounded by a rosy hue. Its appearance is preceded 56 CUTANEOUS DISEASES. by restlessness, and accompanied with heat, burning and tingling in the spots, itching and irritation. The blotches are constantly changing their position, disappearing in a few hours in one part of the body, and reappearing in another. They are generally brought out by cold, and disappear in warmth. It is occasioned by cold, changes of the temperature, excessive eating and drinking, and in many persons produced by the use of shell-fish, oatmeal, almonds, strawberries, and other kinds of food. Treatment.—External applications should be avoided. If the rash is produced by a cold, is preceded by a stinging sensation, Dulcam.ira is the proper remedy, a dose every six or twelve hours. If the rash is accom- panied by a little fever, is of burning stinging character. Rhus should be given. Bryonia is indicated, when the rash is occasioned by damp weather, and is accompanied with shivering. Dose.—Dissolve one drop or twelve globules in a glass half full of water, and give a teaspoonful every three hours. Pulsatilla and Nux-vom. are the prominent remedies, when the disease is occasioned by indigestion, Pulsatilla being particularly indicated, when it arises from the use of fatty food, and Nux from the use of shell-fish and fruits. Dose.—Of the first, a drop or three globules may be dissolved in a tumbler half full of water, and a teaspoonful taken every three or six hours. Of the last, if in tincture or globules, give as above ; if in powder, give dry on the tongue, at the same intervals. Ipecac is also useful, when the rash is accompanied with nausea. Should it assume a chronic character, Calcarea, Sulphur, Mercurius, or Nitr.-acid may be given. Dose.—A powder or three globules of the Ipecac, may be given every two or three hours. Of the latter remedies a powder or three globules may be taken morning and night. Should unpleasant symptoms arise from the rash striking in, a dose of Ipecac, may be given, followed in SCARLET RASH. 57 two hours by Bryonia, a dose every two hours until it has been taken three or four times. Diet and Regimen.—The diet should be plain and simple, abstaining from every thing of a heating or sti- mulating character. The above remedies will also ge- nerally be successful in the treatment of other simple forms of rash unconnected with any other disease, with the addition, perhaps of Aconite, where there is much increase of the circulation, and Chamomilla, when oc- curring in children. For more particular directions as it regards the admin- istration of remedies, see page 12. SCARLET RASH. PURPLE RASH. MILIARIA PURPUREA. Scarlet Rash is frequently developed in connection with Variola, Measles, and Scarlet Fever. It is not un- frequently mistaken for the latter disease, to which it has a considerable resemblance, and from which it is important, that it should be distinguished as the treat- ment is entirely different. Happily this can very readily be done; the small granular elevations easily felt on passing the hand over the skin, the dark redness of the efflorescence, and no white imprint being left after pres- sure with the finger are sufficient marks of distinction. Precursory symptoms are chilliness alternating with heat, heaviness and fullness in the head, vertigo and aching pain in the forehead. These symptoms generally last but a short time. The eruption shows itself in no particular place, but is more frequently seen on the covered parts, and about the bend of the joints. Sore throat may be felt previous to the eruption, but entirely subsides while the eruption is out. Should, however, the eruption recede, the throat becomes highly inflamed, and the disease may immediately assume a dangerous type. There is great danger of this disease striking in, thus producing derangement of the brain, or some other 58 CUTANEOUS diseases. vital organ, causing death. The disease is contagious, and those who have had it once, are still liable to have it many times again. Treatment —When this disease exists alone, Aconite is almost a specific remedy. Dose.—One drop or six globules dissolved in a tumbler of water. A tablespoonful given once in two or three hours according to the severity of the symptoms, until five or six doses have been taken, will often be sufficient. Should, however, there be a whining mood, great restlessness, pain in the head, back, and extremities, Coffea will be indicated and may be given, generally in alternation with Aconite, and prepared in the same manner, two hours apart. Should the eruption be slow in making its appearance or suddenly disappear, Ipecac, and Bryonia may be given in alternation, in the former case, every two hours, and in the latter, every half hour, until relief is obtained. Dose.—Same as Aconite. Belladonna will be required, should symptoms of head disturbance occur, with starting on closing the eyes, fullness of the head, and blood-shot eyes. Dose.—One drop, or eight globules in a tumbler of water, a table- spoonful every hour. Should there be stupor, Opium would be required, administered in the same way as Belladonna. When the disease is of a malignant character, or complicated with Scarlet Fever, the treatment should be similar to that indicated in Scarlet Fever. Diet and Regimen.—The diet should be of a light farinaceous character, and great care observed to prevent taking cold. SCARLATINA. Scarlet Fever. Scarlatina, is generally a contagious epidemic, seldom attacking persons but once, and more frequently seizing its victims from the ranks of childhood. The cheek of many a mother has grown pale with terror as she heard the news of its approach, and gathering her children scarlatina. 59 around her, she has fled from the neighborhood tainted by its presence, as from the breath of a pestilence. In severe cases the rapidity of its progress, often running its course in two or three days, and where the termina- tion is not fatal, the danger of its leaving behind some chronic difficulty, are enough to cause it to be dreaded in every community. The treatment of this disease with a success hitherto unknown, and in many cases its prevention did much towards turning the attention of the public to Hahnemann, and that great law of cure, which is now pervading every land. Diagnosis.—The genuine Scarlatina seldom attacks persons beyond the age of twelve, and is now generally met with in complication with scarlet rash or some other disease. The eruption is like the redness of erysepelas, of a fiery bright, scarlet red, or resembling the color of a boiled lobster, turning white under pressure of the finger, but speedily, on the finger being removed, re- suming its original color. The boundaries of this red- ness are not distinctly defined, but are imperceptibly lost in the surrounding white parts. The red skin is perfectly smooth and glossy, the redness from time to time increasing or diminishing in extent and intensity. The eruption commences on the uncovered parts, or those slightly covered, as the face, neck, hands, arms, chest and feet, is accompanied with swelling, and gradu- ally spreads over the body. Simultaneous with the red- ness, the heat and fever appear, continuing, in simple cases, three or four days, and in malignant ones, about seven, when the eruption gradually becomes paler and paler until it entirely disappears. The more extensive and intense the redness, the more violent the fever. With the disappearance of the redness and the abate- ment of the fever commences the stage of desquamation when the epidermis peals off in large patches. In con- nection with the fever, dryness of the mouth, severe 60 CUTANEOUS DISEASES. soreness and often ulceration of the throat exist. A severe form of the fever is often preceded by vomiting. If the disease is combined with sea*Jttrash, instead of the skin presenting a smooth shining appearance, the roughness of the eruption is distinctly felt on passing the hand over the surface. This disease was formerly, frequently mistaken for measles, but to the careful observer the distinctive marks are sufficiently plain. Independent of the eruption, the soreness of the throat present in scar- latina, is absent in measles, and the catarrhal symptoms, which are present at the outset of measles are not ob- served in the commencement of scarlet fever. Treatment.—Bella-donna is the specific in the true form of this disease, a few doses of which will often afford decided and permanent relief. There is fever, quickness of the pulse, dryness of the mouth and thirst, throat highly inflamed and swollen; spasmodic contraction of the throat, danger of suffocation, and inability to swal- low the least liquid; thirst,red and dry tongue,inflamed and painful eyes; pressure over the eyes or shooting in the head ; starts and jerks on closing the eyes, sleep- lessness with great nervous excitement. The external redness does not always appear, but in these cases the throat is swollen and painful, and the tongue presents a bright red appearance. Dose.—Two drops, or six globules, of the remedy should be dis- solved in a tumbler of water and a tablespoonful given every two or three hours, according to the severity of the symptoms. Should the symptoms be accompanied with fever, dry heat, bilious vomiting, &c, especially in the commencement of the disease, Aconite may be alter- nated with the Belladonna, one or two hours apart Stibium may also be indicated in the same manner, a powder given in alternation with Belladonna., when the Aconite proves unavailing, and when there is a stupid condition, great heat, nausea, vomiting, convulsions or spas- modic jerks and imperfect development of the eruption. If the symptoms should become worse shortly after the administration of the Belladonna, it may be suspended, and the article in the Intro- duction, on the administration of remedies, be consulted. If the in- crease of symptoms are an aggravation of the remedy, the system SCARLATINA. 61 will soon react, if however they are aggravations of the disease, other remedies will be necessary. Mercurius—Is a prominent remedy in the malignant form of the disease, where there is great inflammation about the throat, swelling and ulceration of the glands, accompanied by an offensive smell, salivation and ulce- ration of the mouth. It may be given after or in alter- nation with Belladonna, two hours apart. Dose.—A powder, or three globules, dry on the tongue. If after the expiration of twelve or fourteen hours no improvement is mani- fest, but the restlessness increases and the saliva becomes more offensive, Lachesis and Arsenic may be given in alternation, in the same manner as the Mercurius, one or two hours apart, until five or six doses of each have been taken or until a change is indicated. Arsenic—Will be indicated, where there is great prostration of strength, distorted features, nightly burn- ing fever, gangrene of the throat, as well as in the va- rious forms of dropsy caused by this disease. Dose.—A powder, or three globules, may be given every three hours. Capsicum—is also a useful remedy, when there is red- ness of the face, alternating with paleness ; violent sore throat, painful swallowing, and contraction and spasm in the throat, pains in the neck, sneezing, hoarseness, hacking cough and accumulation of tough mucus in the throat. Dose.__One drop, or six globules, may be dissolved in a tumbler of water, and a spoonful given every two or three hours. Coffea__Is often indicated in alternation with Bella- donna, when there is great restlessness, irritability and whining mood, particularly at night. They may be alternated one or two hours apart. Dose —One drop, or six globules, in a glass half full of water a teaspoon at a dose. jtfm8__Will be found useful, when the disease assumes a vesicular form, and is accompanied with restlessness, staits, thirst, and dry tongue. Dose.—Same as Belladonna. Give every one or two hours. 62 CUTANEOUS DISEASES. Muria'if-add is another prominent remedy in the malignant form of this disease, as well as in certain varieties of Typhoid Fever. It is indicated, where there is severe ulceration of the throat, fetid breath, acrid dis- charge from the nose, soreness and blisters about the nose and lips, efflorescence of an irregular and faint color, changing to a dark red, frequently intermixed with petechias; flushing of the check, and dull redness of the eyes. It is more frequently indicated after Mer- curius and Lachesis, particularly if those remedies have in a measure failed of producing good results. Dose.—Sufficient of Muriatic-acid may be put in a tumbler ol water, to make it very slightly tart, and a teaspoonful gifen every two or three hours. Nitric-acid,—May also be thought of, when the swell- ing and ulceration are severe. Opium.—This remedy will be found useful where there is snoring sleep, great restlessness, sometimes with vomit- ing or constipation, burning heat, and stupefaction. Dose.—Same as Belladonna. Give once in two or three hours. Sulphur—Will prove beneficial where there is le- thargic sleep, starts or constant delirium, puffed red face; red, dry and cracked tongue, great thirst; cerebral affec- tions, which do not yield readily to Belladonna. Dose.—A powder, or three globules, may be given every two or three hours until three doses have been taken, then select some other remedy. Secondary Diseases succeeding Scarlatina.—Severe pain in the ear will generally be relieved by Pulsatilla, one drop, or four globules, dissolved in a glass of water, and a tablespoonful taken every two or three hours, until foui or five doses have been taken. If this not does produce relief, alternate Bdladonna, prepared in the same man- ner, and Hepar-sulph., a powder, or three globules, one hour apart. The running at the ear will generally be controlled by Calcarea, a powder, or three globules, every six hours. scarlatina. 63 Fetid discharge at the nose, and pain in the nasal bones will be relieved by a few doses of Aurum, a pow- der, or three globules, at intervals of four or six hours. Mercurius will be found beneficial, where there is ulceration of the face or throat; a powder, or three glo- bules, three times a day to be followed, if necessary, after three or four days, SH. Cede, Ilep.-s., Sulph, or Iod. Digitalis is of benefit when there an indications of dropsy of the chest, such as oppressed breathing, thin and weak pulse. Give same as Hellebore. Should there be symptoms of dropsy of the brain, such as, great heat about the head, cold extremities, vomiting on moving, Bella danna and Hellebore may be given, one drop, or six globules, dissolved in a glass half full of water, and a teaspoonful administered in alternation every two hours. In cases of dropsical swelling of the body, or the ex- tremities, I have found great benefit from an alkaline bath. The water, comfortably tepid, is made sufficiently alkaline, to be perceptible to the taste, by dissolving in it Pearlash or Saleratus. In this bath the patient may be placed once or twice a day, being permitted to remain four or five minutes. Hellebore and Belladonna, as directed above, may be given in alternation four hours apart. Should the diffi- culty still continue, after three or four days, Arsenic or Phos-ac given at intervals of six hours, will generally complete the cure. Croupy cough will be relieved by a few doses of Hepar-s. given every four hours. During the administra- tion of these remedies, the patient should be very careful to avoid taking cold. Prevention.—During the prevalence of the scarlet fever, the attack may frequently by warded off entirely, or the disease rendered comparatively harmless, by ad- . ministering every evening three globules of Belladonna, 64 cutaneous diseases. for one or two weeks. I have always found as a pre- ventive the higher attenuations of this remedy far more beneficial, than the lower. Diet and Regimen.—Diet should be simple, such as gruels, toast, &c, returning gradually and carefully to more nourishing food. The room, of course, should be well ventilated, and yet the patient strictly guarded against taking cold. A particular caution is also neces- sary about going out too early as often serious secondary disturbances are occasioned by a want of proper prudence. MEASLES. Morbilli. This is generally an infectious epidemic, occurring, more particularly among children, where it is seldom fatal, unless badly treated, or it becomes complicated with other difficulties. In persons, more advanced in years, it may assume a severe and even dangerous charac- ter, from its power of arousing and developing into full and fatal action germs of disease which may have been slumbering in the system for years. Diagnosis.—The progress of the disease may be divided into three stages. At first the symptoms of an ordinary catarrh are perceived, such as slight inflammation of the eyes, sneezing, discharge of water from the nose, dry, short cough, difficult breathing, pain in the forehead, back, and perhaps diarrhoea, accompanied with fever of a remittent character, gradually increasing until the eruption appears on the skin. This is the first or febrile stage. The second or eruptive stage, commences on the third or fourth day. The eruption first appears on the face and arms in the form of small, red spots, and for three or four days gradually increases and extends over the body. On the fourth day the eruption grows paler, and measles. 65 the symptoms abate. On the sixth or seventh day the third stage, or stage of desquamation, commences. If the eruption is slight, the scaling may be scarcely perceptible, and all morbid phenomena terminate in the critical sweat, diarrhoea, or urine. During this stage, the cartarrh may increase to pneumonia, and perhaps, in scrofulous subjects, be followed by consumption. A long train of unpleasant difficulties may follow measles, such as, severe inflammation of the eyes, swell- ing of the glands, consumption of the bowels, pain in the ear, deafness, and tormenting chronic eruption. Treatment.—The two great remedies in the treatment of this disease are Aconite and Pulsatilla. Very often a few doses of either one or both of these remedies will be all the patient requires. One drop, or six globules, may be dissolved in a tumbler of water, and a table- spoonful taken in alternation every two, three, or four hours. The febrile symptoms, inflammation of the eyes, giddiness and confusion of the head, strongly indicate Aconite, while Pulsatilla is particularly useful, where gastric symptoms are present, when the cough is worse toward evening or in the night, is accompanied by yellow- ish or whitish expectoration, sometimes followed by vomiting, or there is a yellowish or greenish nasal dis- charge, and is almost a specific, where the eruption delays in making its appearance. When given alone, it may be taken every three hours. Should there be great restlessness, an occasional dose of Coffea may be given. Should the eruption strike in, or sickness at the stomach and oppression of the chest be present, a few doses of Ipecac, alone, or in alternation with Bryonia, prepared in the same manner as the Aconite, given one or two hours apart, will produce relief. < Bryonia—-Will also be found of great value, when ' the cough is* dry and attended with shooting pain in the chest, difficult breathing, &c, when it may be alternated 66 cutaneous diseases. with Aconite as directed for Aconite and Pulsatilla. Rheumatic pains in the limbs, and constipation also in- dicate this remedy. Dose.—Of the above remedies put one drop, or six globules, in a glass half full of water, and take a teaspoonful at a dose. Belladonna—Will prove beneficial, where there is severe pain in the head, sore throat, dry cough, twitching of the limbs, and great restlessness. Dose.—Two drops, or six globules, in a tumbler of water a table- spoonful every two hours. If much fever is present, it may be given in alternation with Aconite, two or three hours apart. Should the eruption be slight, and severe inflammation of the eyes be developed, or violent pain in the ear, with purulent discharge be present, Sulphur, in alternation with Pulsatilla given at intervals of two, three, or four hours, will generally produce speedy relief. Ilepar is of benefit in the hoarse cough which some- times follows measles. A powder or three globules may be given every three hours. Diseases occasioned by Measles.—Typhoid symptoms not unfrequently set in after measles, in which case, if there are dry, dark tongue and lips, burning heat, vomit- ing, or diarrhoea, Arsenic, a powder, or six globules, in a tumbler of water, may be given, a teaspoonful at a dose, once in two or three hours. If there should be loss of consciousness, watery diarrhoea, great weakness, cough, inclination to vomit, Phosphorus may be given in the same manner. Severe pain in the ear will generally be relieved by a few doses of Pulsatilla, given as heretofore directed, at intervals of one or two hours, and if much purulent dis- charge be present, it may be followed by four or five doses of Sulphur, one every four hours, and this, if necessary, by three or four doses of Carb.-v. at the same intervals. Croupy symptoms will be relieved by Hepar- sulph. or Spongia, and the remaining cough bv Puis.. erysipelas. 67 Sulph., Dro*., Ilyos., Bry., Phos. Should the measles be followed by disturbance about the head, irritation of the eyes, with intolerance of light, Belladonna or Strammo- nium, as directed heretofore, may be given at intervals of three or four hours. Swelling of the glands below the ear (Mumps), will be relieved by Rhus, and Arnica, prepared in the same manner as Aconite, and alternated every three or four hours. Constipation should create no alarm, as it generally passes off in a short time without medicine. Should a mucous diarrhoea set in, Puis., Merc, Chin., or Sulph. will speedily remove it. (See Materia Medica.) Diet and Regimen.—Same as in Scarlet Fever. The same care also should be taken to prevent unpleasant consequences from cold. During convalescence the patient should use the eyes but little, for fear of in- flammation. During the prevalence of measles, Aconite and Pulsa- tilla may be taken in alternation, three globules at a dose, two days apart. ERYSIPELAS. St. Anthony's Fire. Rose. Diagnosis.—Previous to the attack, gastric symptoms may be present, as well as a general sensation of languor and dullness. The actual attack very frequently com- mences with distinct shivering. The erysipelatous red- ness suddenly makes its appearance on different parts of the body, accompanied with swelling, heat and tingling, In severe cases, the parts become very much swollen, the skin presenting a deep red, shining appearance, the patient suffering intensely from a burning heat, tingling, and a painful sensation of tension. The redness and swelling gradually, and sometimes 68 CUTANEOUS DISEASES. very rapidly extends, and when it appears on the face, as is most frequently the case, unless checked in its pro- gress, covers the entire head. In these cases delirium is frequently present. Sometimes the inflamed surface becomes covered with vesicles or blisters, resembling those occasioned by a scald. In these severe cases, which are often attended with much danger, particularly tvhen it attacks the head, there is a high fever, thirst, pain throughout the body, gastric derangement, some- times vomiting, severe headache, sleeplessness, great nervous excitability, and a sensitiveness to the slightest noise. The erysipelatous inflammation often wanders, changing from one ear to the other, or from on side of the face to the other, or perhaps confining itself to the nose and eyes. Perhaps there is no disease which pro- duces such a complete change, for the time being, in the appearance of the face as erysipelas. Those who pride themselves on their beauty, would shudder could they see in the closed lids, the swollen cheeks, the inflamed nose, the fearful change which a few hours has wrought in their appearance. Causes.—It may be occasioned by gastric derangement, or, as is most frequently the case, by sudden suppression of perspiration. It is also very frequently found in fe- males during menstruation. It may also be produced by certain kinds of food at particular seasons of the year, as the different varieties of shell-fish, and also from the abuse of spirituous liquors. We also see it developed in mechanical injuries, and not unfrequently setting in after the operation of the surgeon, with such violence as speedily to destroy life. It sometims seems to pre- vail as an epidemic to such an extent, that the surgeon hesitates to perform even the most necessary operations. The physician, at these times, is often exceedingly an- noyed at finding it set in with great severity in the arm of the child after vaccination. erysipelas. 69 Treatment.—The prominent remedies are, Aconite, Belladonna, and Rhus, also Pulsatilla, Bryonia, Ar- senic, Lachesis, Sulphur. Aconite is indicated by the presence of considerable fever, with dry, hot skin. Dose —Two drops, or six globules, in a tumbler of water, a table- spoonful every two hours. Belladonna will be indicated if the redness expands in rays, and severe shooting pains with great heat are felt, aggravated by movement; particularly if the in- flammation is in the face, and is accompanied with se- vere swelling, burning heat, violent headache, delirium, restlessness, thirst, dry and hot skin. It is frequently alternated, with great benefit, with Aconite or Rhus. Dose.—Two drops, or six globules, in a tumbler of water, a table- spoonful once in two hours. Rhus is particularly indicated, when vesicles or blis- ters are perceived, or where there is great swelling, a tendency to spread or extend to the brain, and where there is great restlessness and delirium. This remedy is frequently given in alternation with Belladonna or Aconite. The combination of symptoms mentioned under those remedies will be a sufficient guide. Dose.—Two drops, or six globules, in a tumbler of water and a tablespoonful given every one, two, or three hours, according to the severity of the symptoms. In severe cases, particularly if there is a dryness or pain in the throat, or the swelling or vesicles show a suppurating tendency, a powder, or three globules of Lachesis may be given at intervals of three hours, until four or five doses have been taken, after which the Bel- ladonna and Rhus may be again administered. If at night there should be great restlessness, and no disposi- tion to sleep, two or three doses of Coffea may be alter- nated with Belladonna, one hour apart. A constant desire to sleep will be controlled by one or two doses of Opium, prepared the same as Rhus. 70 CUTANEOUS diseases. Pulsatilla may be given, where the disease affects the ear, where the skin is of bluish red, or the spots wander from one place to another, and also in those cases, which arise from injurious articles of food. Dose.—Dissolve two drops, or six globules, in a glass half full of water. Give a teaspoonful every two or three hours. Bryonia, will be found useful where the inflamma- tion occurs about the joints. Dose.—Same as Pulsatilla. Rh us, Sulphur, Arsenic and Lachesis are important remedies, where the disease has terminated in ulceration ; the two former or the two latter in alternation, twelve hours apart. Arsenic is also indicated, where the disease affects the scrotum, or where the vesicles are of a blackish cha- racter, and show a tendency to pass into gangrene, where there is great prostration of strength or black diarrhoea sets in. It may be alternated with Carb.-v. or Lachesis, a powder, or three globules every three or four hours. Where the disease assumes a chronic form, Graphites, Sulphur or Nit.-ac may be consulted. Diet and Regimen.—The diet should be of a simple character, similar to that in fevers. Great pains also should be taken to prevent cold during convalescence, as it often occasions troublesome dropsies. CHICKEN-POX. Varicella. This is a disease, confined almost entirely to child- hood, running its course rapidly, and is attended with but little, if any danger. It is somewhat similar to Small-Pox, but is distinguished from it by its mild cha- racter, and rapid course. In Small-Pox the face never escapes, while in Chicken-Pox it is but slightly affected, the eruption appearing more on the scalp, shoulders, neck, and breast. The fever, before the eruption, is alsc CHICKEN-POX. 71 of short duration, seldom lasting more than twenty-foui hours, and notwithstanding there may be headache, the swimming in the head and back-ache, which are charac- teristic symptoms in Small-Pox, do not appear. The eruption is composed from the first, of transparent vescicles or blisters, having but one cavity, the liquid seldom becoming turbid, but shrivels upon a spongy crust, while in Small-Pox the pustule has a dent on the top of it, contains cells like an orange, and in the com- mencement, presents the appearance of a little point like the head of a pin. Treatment.—Often no medical treatment is required, but if considerable fever is present, Aconite may be given every two hours. Should there be great heat and pain in the head, Belladonna may be given in alterna- tion with the Aronite, two hours apart, until better. Great nervous excitement, restlessness, anxious and disturbed sleep with dreams and moaning, will be reliev- ed by three or four doses of Cofft a, given at intervals of two or three hours. Should there be spasms, as is often the case during dentition, Belladonna and Ignatia may be given in alternation, one hour apart, until two doses of each have been taken. (See also convulsions.) The tenesmus, which is sometimes present, will be relieved by a few doses of Mercurius, given at intervals of two or three hours. The stranguary will be relieved by Cantharides. The disease in its mild form may be very much shortened by Pulsatilla, administered three or four times a day. Dose.—A powder may be taken dry on the tongue, or if tinctures or globules are used, two drops of the former, or six of the latter, may be dissolved in a tumbler of water, and a tablespoonful given at a dose. 72 CUTANOUS diseasfs. S M ALL-P OX Variola. This loathsome and highly dangerous disease has ever been looked upon with the utmost horror. The ear- liest accounts we have of it, we find it making its ap- pearance in Egypt and Arabia, about the middle of the sixth century. From these nations it gradually spread throughout the old world, in the thronged cities and villages, numbering its victims by thousands, and every where reaping a rich harvest. Wherever it appeared, the air seemed to bear on its wings its poisonous breath, and whole neighborhoods were desolated. In 1517, twenty-five years after the discovery of this western world by Columbus, it was introduced on this continent. So fatal did it prove, that in a very short time after in reached Mexico, three millions and a half of people were destroyed in that nation alone. One of the most sad and melancholy scenes in its fearful, desolating march was the death of the emperor, the brother and successor of the brave but unfortunate Montezuma. After a time it was found, that where the disease was communicated by inoculation, it was far less violent in its character, being attended with but little danger. Many persons in every community were therefore inoculated, so that instead of the disease decreasing, hundreds, even in country places, exposed to the contagion and not having guarded against it by inoculation, took it in its most violent form. In England the deaths by Small-Pox amounted to about 45,000 annually. At length in 1798, Dr. Tenner, an English physician, announced to the world a discovery, which has been the means of saving thousands of lives, and has checked in a great measure the ravages, of what was then consider- ed, one of the most loathsome scourges which had ever desolated the earth. That discovery was, that Cow-Pox small-pox. 73 is almost a sure preventive to the Small-Pox. This doc- trine at first was received with ridicule, contempt and the most violent opposition; but what are ridicule and opposition to the stubborn array of facts, and the ultimate triumph of truth ? But few years elapsed before the doctrines of Jenner, became universally popular, and vaccination for Cow-Pox was introduced into almost every nation. Careful observation has shown, however, that it is well to renew the vaccination every ten or fif- teen years. With this precaution, there is but little danger of exposure to the Small-Pox. Diagnosis.—This disease has four distinct stages, each of which generally requires different remedies. 1. The febrile stage.—This stage usually commences from eight to fourteen days after exposure to the con- tagion, and continues from two to four days. It sets in with shivering followed by fever, heat, and dryness of the skin, hard and frequent pulse, pain in the stomach and back, nausea and vomiting, aching in the bones, and bruised sensation of the flesh, swimming and severe pain in the head, and sometimes wild delirium and convul- sions. Cough and sensitiveness of the eyes to light are also usually present. Vomiting and pain in the back are characteristic symptoms of Small-Pox, and when these are very severe, the pain in the small of the back ex- ceedingly acute, and the vomiting extends into the erup- tive stage, a severe attack may be apprehended. 2. The eruptive stage.—From the second to the fourth day the eruption makes its appearance in the face, in the form of small red points, increasing in extent and elevation from hour to hour, and distinguished from other eruptions by a small pimple about the size of a millet seed in each point. On the second day it appears on the hands, and on the third on the feet and the rest of the body. o. The suppurative stage.—In this stage the pustule 4 74 CUTANEOUS DISEASES. completes its development, becomes as large as a split pea, and is filled with a yellowish fluid, which gradually changes its color, until it assumes a turbid appearance. It is surrounded by a red circle, and has on the top a blackish depression or dent. As the pustules first appear on the face, and lastly on the extremities, they may have reached maturity in one part of the body, while they are still filling in another. During this stage, which lasts three or four days, fever, more or less swelling, and saliva- tion are present. 4. The stage of Desiccation.—The pustules present on the top a brown appearance, and some of them burst, forming scabs. The fever and swelling gradually sub- side, the scales peel off, leaving at first a deep red .stain. All danger is over, when the process of desiccation has ceased in the face. The more violent, or confluent form of the disease, where the pustules are so numerous as to run into each other, forming an immence scab, is longer in duration, and attended with more violent symptoms and danger. Treatment.—During the sixteenth century and even later, in the treatment of this disease the great object was to expel the humor by means of perspiration. To accomplish this, the patient was confined in a hot room, dosed with hot drinks, and warmly covered in bed; not- withstanding under this treatment a majority of the pa- tients died, when Sydenham introduced, what is now called the cooling regimen, throwing away the hot drinks, using light covering, keeping the patient cool, and hav- ing the room freely ventilated, he was attacked on all sides by the learning and bigotry of the age, but without avail, for reason and common-sense in the end are sure to triumph. Febrile Stage.—Aconite may be given every two or three hours; in alternation with Belladonna, if there is severe pain in the head, intolerance of light or delirium, small-pox. 75 Should there be considerable stupor, two or three doses of Opium given at intervals of hours will produce re- lief. Dose.—Two drops, or eight globules in a tumbler full of water, a tablespoonful at a dose. Bryonia and Rhus may be alternated two or three hours apart, if after four or five doses of the Aconite have been taken, there should be aching and bruised sensation in the bones and flesh, and severe pain in the back. Sometimes, where the fever is high, and the above symptoms exist, either Bry. or Rhus may be al ternated with Aconite. Dose.—Same as Aconite, and continue until the eruption is fairly developed. Stibium should be given, if nausea or vomiting is present. Dose.—A powder every hour until the nausea is relieved, or until three or four doses have been taken. If there is great restlessness and inability to sleep, a few doses of Coffea may be required, given at intervals of an hour, and prepared in the same manner as Aconite. 2. The Eruptive Stage—During this stage I have found the most benefit from Strammomum, two or three drops in a tumbler of water, a tablespoonful every two, three, or four hours, according to the severity of the symptoms. It is particularly useful where the eruption is slow in its appearance and progress. Should there be cough and indication of considerable trouble about the lungs, Stibium, may be alternated with the Strammonium two hours apart. Sometimes, where the pustules are filling well, and the disease is progressing rapidly, the Strammonium may be omitted, and Stibium and Thuja, (the latter pre- pared as directed for Aconite), given in alternation, three hours apart. 3. Suppurative Stage.—If there should be but little fever, a simple regimen alone will be required. ^ If, how- ever, an ulcerative fever is present, attended with abun- 76 CUTANEOUS diseases. dant salivation, affection of the eyes, nose, and throat, Mercurius will be required. Dose —A powder, or three globules, every three hours. If the Pox become black, and typhoid symptoms set in, J/uriat'c acid may be given every two hours, or if considerable stupor is present, it may be alternated with Opium, two hours apart. Dose.—Three drops in a glass half full of water, a teaspoonful at a dose. Rhus or Arsenic will be indicated, when the skin around the pustules is of a livid color, and burning thirst and great exhaustion are present. If diarrhoea should set in, China will be required. Dose.—Rhus and China, same as Aconite. Arsenic, same as Mer- curius. 4. Stage of Desiccation.—Simple ablution with tepid water will generally be all that is required. A powder, or three globules of Sulphur, given morning and even- ing for three or four days, will frequently be serviceable. If as is sometimes the case, other diseases set in, see diseases under their separate heads. Diet and Regimen.—The room should be thoroughly ventilated, and kept at a moderate temperature. The patient should be placed on a mattress or straw-bed, be lightly covered and the room considerably darkened. The diet should be cooling, such as, water, lemonade, oranges, roasted apples, stewed prunes, strawberries, gruels, toast, &c, avoiding the lemonade and fruit, if diarrhoea should be present. Animal food should not be used in any form until the disease is pretty thoroughly over. VARIOLOID. By this term is generally understood a modified form of Variola or Small-Pox, occurring sometimes even after Cow-Pox. The pustules are few in number and the treatment, if any is required, is similar to Small-Pox. ITCH. 77 2. GENERAL CUTANEOUS DISEASES. Under this head might be arranged a large variety of cutaneous difficulties, more or less troublesome. The limits of a work like this, however, preclude the possi- bility of detailing the treatment of all these various classes, and indeed it would be in a measure unprofitable to the general reader. We shall therefore only speak of those less complicated difficulties, most frequently met with in family practice. ITCH. Scabies. King George 4th once remarked, in the peculiarly chaste and elegant language which characterized that monarch, " that none but kings ought to have the itch, it was such a luxury to scratch." A wish with which the community in general would very gladly concur. Diagnosis.—It appears, in the form of small vesicles, filled with a clear fluid, and surrounded by a red border, between the fingers, on the wrists, and in the bend of the joints. Sometimes, if the disease continues some length of time, it extends over the body, with the ex- ception of the face, which is entirely free. The itching is aggravated in the evening by the warmth of the bed, or on coming from cold into warm air. As the vesicles • become broken up by scratching, they may form thick scurfs. Cause.—The disease, the cause of which is a small animalcule burrowing in the skin, is generally commu- nicated by contact, either from individuals, or handling filthy articles, such as, dirty wool, cloth, &c. Treatment.—First, ascertain that the disease is really the itch. Second, remember that if suppressed or not thoroughly cured, it may lead to chronic difficulties oi an exceedingly troublesome or painful character, and that salves and greasy ointments are not the best to 78 CUTANEOUS DISEASES. thoroughly eradicate the affection, but may often drive it in, and should therefore as a general thing be avoided. Su'phur.—This is the most important remedy, and will often be alone sufficient to produce a cure. A powder of the first, or one drop of the tincture, may be taken morning and night for a week, when it will be well to discontinue the remedy, and give a sulphur-bath* at intervals of two or three days, until three or four have been taken, when, if necessary, the Sulph. may be recommenced, given in alternation with Mercurius. In connection with the internal use of Sulphur, five or ten drops of the tincture, may be dissolved in a tumbler half full of water, and the worst parts bathed with it, morn- ing and night. Carb.-v. or Hepar-s. may be required, if, after one week the Sulphur and Mercury should not be followed by decided relief. Dose.—A powder or three globules, night and morning. In the humid variety, characterized by yellow pustules, which are met with not only on the hands and feet, but about the body, Sulphur and lycopodium may be al- ternated, one in the morning, and the other at night for one week, when, if not materially better, Mercurius may be substituted for Lycopodium, and the remedies given as before. Dose.—Same as Carb.-v. Besides the remedies already mentioned, Causticum or Graphites will sometimes be required. ITCHING OR IRRITATION OF THE SKIN. Prurigo. This consists of a fine colorless, almost imperceptible eruption under the cuticle, itching excessively, particu- larly when warm in bed. It may be occasioned by the * See Sulphur-bath in the Index. ITCHING OR IRRITATION OF THE SKIN. 79 abuse of fatty food, extremes of heat and cold, and also be developed in connection with other diseases, when it must be treated accordingly. Treatment.—Bathing the parts with Alcohol, diluted one-half, will often produce decided relief. Sulphur may be given,if the itching is severe or worse in the evening, or in bed. Dose —A powder, or three globules, morning and night. Ignatia, where the eruption resembles flea-bites, and is relieved by scratching. Dose.—Two drops, or six globules, in a tumbler of water, a table- spoonful morning, noon, and night. Pulsatilla, when it comes on in bed, and is aggravat- ed by scratching. Dose—Same as Ignatia. Mercurius, where Pulsatilla seems to be indicated, and yet does not produce relief, and also where the parts bleed easily after scratching. Dose.—Same as Sulphur. Rhus, where the itching is attended by a burning sen- sation. If after three or four doses no relief is obtained, it may be followed by IIepar-'<. If the itching appear on undressing Nux may be alternated with Arsenic, one in the morning, the other at night. Dose.—Rhus, same as Ignatia. Hepar-s., Nux, Arsenic, same as Sulphur. In obstinate cases Sulphur in alternation with Carb.-v., or Lycopodium, Graphites, Silicea may be indicated. In old persons Opium will be serviceable, a dose every night. If the eruption shows itself around the anus or pri- vate parts, Sulph., Nit.-ac, Sep., Calc, Dulc, or Thuj. may be required. See Materia Medica. 80 CUTANEOUS DISEASES. SCALD-HEAD. Tinea Capitis. Favus. This disease, frequently called " Ringworm of the Sea7p," occurring principally among children, is highly contagious and excessively obstinate. It is often com- municated, by means of the comb and brush, or the towel. Pustular ringworm is not alone confined to the scalp, but frequently appears on other parts of the body. There are several varieties, but a general description will only be necessary here. The affected parts become red, hot, painful, and elevated, accompanied with swell- ing of the glands of the neck and head. After a few days, small round pustules start up, gradually filling with a yellowish white, thick fluid, smelling badly on being discharged. As the pustules break, the hairs be- come glued together, and in a short time, scaly, thick and hard crusts are formed. Frequently the roots of the hair are entirely destroyed. Violent external treat- ment may, by driving the disease in, occasion serious disorders, which not unfrequently terminate in death. Causes.—Want of cleanliness, keeping the head too warm, scrofulous disposition, coarse and indigestible food, close and filthy dwellings, and contagion, are among the numerous causes. Treatment.—Avoid of course, as much as possible the causes which produce the disease. Rhus is the prominent remedy during the inflamma- tory stage, especially where there is secretion of greenish pus and nightly itching. Dose.—One drop, or eight globules, in a tumbler of water, a table- spoonful morning and night. At the same time apply the solution externally. Sulphur may be given, should dry scabs be formed. Dose.—A powder, or three globules, morning and night. Should the pus assume a corrosive character, thus causing new ulcers, and therefore an extension of the MILK CRUST. 81 disorder, Arsenic may be given in the same manner as the Sulphur, again returning to Rhus, after five or six doses have been taken. The lighter form of the eruption may be controlled by Hepar-s. especially when it is not confined to the head, but is found on the neck and face, also when it is ac- companied by affection of the eyes. Dose.—Same as Sulphur. Staphysagria, will be very beneficial, where the dis- ease is of a humid, fetid character, with itching, and swelling of the glands of the neck. Dose.—Same as Rhus. Dulcamara, will prove of benefit where the glands of the neck as well as other parts of the body are swollen, or Bryonia, if they are highly sensitive. Dose.—One drop or twelve globules in a glass of water, a table- spoonful morning and night. Besides the remedies enumerated above, Calc, Graph., Lye, Acid-mur., or Phos. may be indicated. In connec- tion with these internal remedies, if the eruption prove obstinate, bathe the head with Tar-water, or apply a weak preparation of Citrino-ointment, obtained at the druggists. Diet and Regimen.—Strict attention should be paid to diet and cleanliness. It would be advisable to re- move the hair in the commencement of the disease. MILK CRUST. Crusta Lactea. This disease principally attacks infants between the seventh,and eighth month after birth, and during the first period of dentition. Where the child is naturally healthy, often no treatment is required, except perhaps a change of air. Diagnosis.—The eruption consists of yellowish white pustules on a red surface, breaking in three or four days, and forming whitish yellow crusts. As the secretion 4# 82 cutaneous diseases. continues these crusts become darker and thicker. Th6 eruption first appears on the forehead and cheek, and gradually extends over the face, covering it like a mask, sometimes also covering the entire scalp and ears. The prominent remedies are Rhus, Sulph., Hep.-'., Staph., Sep. and Ars. For their separate indications, as well as for external applications, see Tinea Capitis. The inflammation of the eyes, which not unfrequently accom- panies this disease, yield to Euphrasia, Hepar-s. or Bel- ladonna. See Materia Medica. CRUSTA SERPIGNOSA. This may be considered as a variety of the Itch, although it was formerly looked upon as identical with Crusta Lactea. Like, that, it is confined to children, but differs from it, in appearing first on the ear, break- ing out in small pustules, filled with some kind of fluid, and attended with violent itching, particularly at night, while the Crusta Lactea appears first on the forehead in irregular large pustules, and is attended with but slight itching. Treatment.—This form of eruption is much more ob- stinate than the other variety, and should generally be treated by a skilful physician. Sepia, Calct Sulph., Merc, Staph., Graph, are among the prominent remedies. Dose.—One drop, or eight globules, in a tumbler of water, a table- spoonful morning and night; or a powder, or three globules, dry on the tongue. RINGWORM. Herpes Circennatus. In this disease there is an eruption on a slightly in- flamed basis, in the form of small rings or circular bands, the vesicles occupying the circumference. Within, the skin at first looks healthy, but gradually becomes rough and scales off, as the eruption dies away. It generally occurs in summer and in warm climates. It frequently herpes. 83 disappears in the course of a week, or it may last all summer. Treatment.—A few doses of Sulphur, given morning and night, may be sufficient. If after a week no im- provement is perceptible, Sepia may be given, followed if necessary, by Causticum in the same manner. Dose.—One drop or twelve globules in a glass of water, a table- spoonful at a dose. In this form of Herpes, Dr. Metcalf has given Tellu- rium with the most happy results. A powder may be taken morning and night. The ashes of a cigar applied to the sore, or bathing it with a decoction of tobacco will be of benefit. HERPES. Tetter. This is a non-contagious affection of the skin, charac- terized by the eruption of clusters of globular vesicles on inflamed patches, of irregular or rounded form and of small extent. After a few days, the vesicles may sub- side or burst, formiifg a thin brownish scab. Of the numerous varieties of this disease it will only be necessary to mention three. 1. Herpes Phyletenodes. 2. Herpes circennatus, or Ringworm. 3. Herpes Zoster, or Shingles. 1. Herpes Phyletenodes. This variety is characterized by clusters of globular and transparent vesicles, appear- in^ in variable numbers upon red patches over different parts of the body. The appearance of the eruption is generally attended with considerable itching and smart- ing. We not unfrequently see varieties of this group appearing on the face, hands, body, extremities, and pri- vate parts. Herpes Zoster, Zona, or Shingles. This variety usual- ly attacks one side of the body in the shape of a semi- 84 CUTANEOUS DISEASES. circular belt or band, formed by several clusters of agglomerated vesicles. It is more commonly seen on the abdomen, where it begins in some part of a line, extending down the centre of the abdomen, and proceeds outwardly around the body, until it about reaches the vertebras, thus forming a sort of half girdle. It is generally attended with considerable itching, and some times with more or less fever. Treatment.*—Rhus, should there be much restlessness and fever, may be given morning, noon, and night. The ordinary forms of the disease will generally be controlled by Sulphur, Sepia or Causticum, given in the same manner as directed in Herpes circennatus. Should the eruption assume a dry character, Sepia, Sulphur, or Silicea may be given. Where there is a tendency to ulceration, it may be controlled by Merc, Rhus, Sulph. or Sep. If violent itching is present, Nit.-a : or Graphites or Staphysagria will produce relief, or if warmth increases the difficulty, Clematis may be given. Besides the remedies already enumerated,Dulc, Ars., Caib.-v„ Pho*., J\lez., Canth., Hep. may be indicated. (See Materia Medica) Dose.—One drop, or eight globules, in a tumbler of water, a tablespoonful morning and night, or a powder, or three globules, dry on the tongue at the same intervals. ACNE. A peculiar eruption consisting of hard, inflamed tu- bercles, is frequently seen, in persons of a sanguine tem- perament, on the forehead, temples, face, and chin, and sometimes on the neck, shoulders, and upper parts of the chest. They frequently suppurate, but sometimes scale off without perceptible suppuration, leaving a purple spot. For general directions as to the administration of remedies, seepage 12. CHILBLAINS. 85 To effect a cure, particular attention should be paid to diet. Among the remedies, Staphysagria will be found useful for stinging itching pimples, with pain when touched, and Sulphur when the round blotches are cover- ed with white yellowish scurfs. Dose.—A powder, or three globules, every other night. Another variety of this disease consists of a number of black points, which when pressed, discharge worm-shaped, indurated mucus. This variety also requires particular care, as it regards diet. A powder, or three globules, of Sulphur, Sepia or Nit.-acid. may be taken every other day. CHILBLAINS. Perniones. This inflammation generally appears on feet and hands, which have been frost-bitten. It is attended with more or less burning and itching, and sometimes ulceration takes place, when the parts are exceedingly troublesome and painful. Treatment.—Arnica Court Plaster, covering the in- flamed surface, often produces prompt relief, and is par- ticularly useful, where the difficulty is caused by pres- sure or friction ; or five or six drops of the tincture may be put in a tablespoonful of water, and the parts bathed with the mixture. If the inflammation be superficial with slight red swelling, burning and itching in the warmth, a few doses of Nux, taken morning and night, will produce relief. If however the chilblains should be very painful, Nit,- a", or Phosphorus may be given in the same manner. Should the parts present a blue-red and swollen appear- ance, accompanied with severe throbbing pains, Pusa- tilla will be indicated, morning, noon, and night, follow- ed, if relief is not obtained after five or six doses, by Belladonna, taken in the same manner. 86 cutaneous diseases. When the chilblains are blue-red and accompanied with violent itching, Kali cai b., maybe given morning and night, and if the itching should be more violent in warmth, Sulphur given in the same manner. Should blisters form on the inflamed part or ulcera- tion set in, Arsenic or China may be taken morning and night. The ulceration may be dressed with some mild and soothing application, as, simple cerate or a poultice. In severe cases Petrol., Agar and Carb.-v. may be con- sulted. Dose.—One drop, or eight globules, in a tumbler, a tablespoonful at a dose, or a powder or three globules may be given dry on the tongue. In recent cases bathing the feet with brandy into which has been dropped a few drops of melted tallow, will produce relief. EXCORIATION. Tntertrigo. This is often the result of a want of cleanliness, although it not unfrequently originates from some in- ternal cause. To produce a cure, often nothing more is required than a tepid bath every day. If, however, the difficulty still continues, Arnica, Nux, Lycopodium or Sulphur may be given, a dose every night, especially where it occurs during summer. The chfing of bed-ridden patients maybe bathed with Arnica, ten drops of which may be dissolved in four tablespoonfuls of water, and applied two or three times a day with a soft cloth. Where there is a disposition to fester, as is often the case after the slightest injury. A dose of Hepar-y., Silicea, Lachesis, or Sulphur may be given every night. Chapped hands, (Rhagades) which so often occur on the hands of those who work in water, may be relieved in such cases by Ctlcirea, Hepar-s., Sulphur or Sepia, taken in the manner indicated above. ULCERS. 87 When the difficulty manifests itself in the winter, a few closes of Sulphur or Petroleum, given in the same manner will produce relief. Dose.—One drop, or twelve globules, in a glass of water, a table- spoonful at a dose. Very great relief is often obtained by bathing the hands with honey-soap, or urine. WHITLOW. Felon. Panaris. We understand, by this term, an abscess, more or less deeply seated, forming about the end of the finger. The pain, when the disease is fairly developed, is agonizing, often depriving the patient of rest. The difficulty may frequently be removed, when it is first noticed, by dipping the finger in water as warm as can be borne. If this should fail to produce relief, give Mercury every four hours, applying at the same time a bread and milk, corn or flaxseed poultice. If no relief is obtained after four or five doses, Hepar-s. and Silicea may be alternated four hours apart. Should the pain become severe and there be pretty plain indications of the presence of matter, the abscess may be freely opened with a sharp knife. The parts should be frequently washed with warm water. Dose. A powder, or three globules, dry on the tongue. ULCERS. The presence of ulcers indicate a diseased state of the system, being in reality the outlets formed by nature to carry off matter, which, unless removed, might produce serious disturbance of some internal organ. The treat- ment should be directed to remove the disturbing cause, and where this is done, the ulcer will generally heal of itself. 1. Simple Ulcer.—The simple, purulent, or healthy ulcer, is characterized by pus of thick consistency and 88 CUTANEOUS DISEASES. white color, readily separating from the surface of the sore. Healthy granulations, small, florid and pointed at the top, speedily follow, and the sore is soon covered by a new skin. But little treatment is necessary, excepting to bathe the parts frequently with tepid water and cover with soft linen lint to absorb the matter 2. Irritable Ulcer.—The surrounding skin is jagged, terminating in a sharp edge. The ulcer generally pre- sents quite a cavity, undermining the skin and discharg- ing a fluid more or less thin and ichorous. The slightest touch may produce pain or cause the ulcer to bleed. The pain may be either constant, slight, or severe, or coming on in paroxysms. 3. The gangrenous or sloughing Ulcer is generally only a stage of the irritable one. In this the edges of the sore have a livid appearance, with small vesicles on them. The surface is dry, and more or less fever is present. Treatment.—The irritable ulcer should be bathed' freely with tepid water. Dry soft linen lint may be placed in the cavity, or the ulcer may be covered with a (ompress dipped in either cold or warm water, as is most agr.eable to the patient. If the ulcer presents a livid aspect, or bleeds readily, secreting an ichorous fluid, mixed with blood, and espe- ically if there is burning pain, Arsenic may be given in alternation with Carb-v., a dose of one in the morning, and the other at night. Lachesis may be substituted for the Carlo in case the surrounding parts present a mottled appearance. In ordinary cases, the external soothing treatment and internal use of Sulphur and Silicea, or Sepia in alterna- tion, a dose of one every night, will be sufficient to effect a cure. 4. Indolent ulcer.—The irritable ulcer frequently runs into this variety, or may, in some degree be complicated with it. Fomentations, such as bread and milk poultice, BOILS. CARBUNCLES. 89 applied for two or three days, will often so stimulate the ulcer as to cause it to put on a healthy appearance. Sulphur and S licea may be alternated in the same manner as indicated above, for one week, when, if im- provement is not perceptible, Calcarea and Sepia may be substituted. Should an ulcer proceed from a diseased state of the bone, Mercury and Sulphur may be given in the same manner, followed if necessary by Calcarea and Lycopodium. A very obstinate ulcer not unfrequently forms on the lower limbs, occasioned by swelling of the veins. This is called a v.iricose ulcer. Su7phur is here a prominent remedy, given as above, or Lycopodium and Lachesis may be alternated. The limb should also be tightly bandaged from below upward. Syphilitic ulcers, cancerous difficulties, &c. will be treated in their appropriate place. Dose.—A powder, or three globules, taken as directed above. BOILS. CARBUNCLES Boils are characterized by a hard elevation of a round or cone-like form, having an inflamed appearance, at- tended with pain more or less severe. They are slow in suppurating and discharge, on breaking, pus mixed with blood, and after a little while a core. There is sometimes a constitutional tendency to this difficulty, but very frequently they appear as critical dis- charges, particularly after fevers and eruptive diseases, and not unfrequently form the termination of chronic eruption, such as, itch, &c. Derangement of the system from abuse of food and torpidity of the circulation often causes them. Treatment.—The external application of a bread and milk, flaxseed, or slippery-elm poultice, is not only very soothing but hastens the cure. 90 cutaneous diseases. Arsenic may be given, a dose morning and evening, but should there be much swelling, and the boil present an inflamed and fiery red appearance, attended with con- siderable pain, B is an invaluable remedy and should * For general directions as to the administration of remedies, see page 12. 120 AFFECTIONS OF STOMACH AND BOWELS. be given alone every one or two hours, or if in alterna- tion, with some other remedy indicated, such as, Bryonia, Belladonna or China, every two or three hours. If the pain still continues after the fever has in a measure sub- sided, the appropriate remedies should be given. Dose.—Two drops, or twelve globules, in a tumbler of water, or three globules, dry on the tongue, given as above directed. Nux-vom. is indicated, where there is a sensation of swelling, and increase of the stinging pain to contact or motion; nausea, aversion to food, fainting spells, vomit- ing of blood, pains in the stomach, retention of stool, dyspeptic symptoms, &c. It is particularly useful after China or Arnica, where these remedies have only pro- duced a temporary amelioration, the constipation and pressing gastralgia continuing nearly the same. China is a very important remedy and may often be given at the very commencement of the disease alone, or in alternation with Aconite,' It is generally however given after the fever has been in a measure subdued by Aconite, and where the frequent vomiting of blood has produced great weakness, and also when there are lancinating, tearing pains, with hardness and painful swelling of the spleen, the patient being unable to lie on the affected side. The fever is frequently of an intermittent cha- racter, and characterized, by dry, burning heat, aversion to food, nausea and bitter taste, thirst, and restlessness. Arnica.—Generally after China, when that is not quite sufficient; and when there are pressive shooting pains, typhoid symptoms, apathy and stupor. Arsenicum—may be useful after China; or where there are diarrhoeic stools with discharge of dark coagu- lated blood, burning.pain in the spleen with anguish and pulsation in the pit of the stomach. Bryonia—particularly, if the constipation and stick- ing pains continue after the use of China, Arnica, and Nux. Pulsatilla may with advantage be alternated INFLAMMATION OF THE STOMACH. 121 with Bryonia, where there are sticking pains, increased by motion, and the part is visibly swollen. In the chronic form of the disease. Nux, Mercury, Bryonia, Sulphur, Calcarea, Carb.-v. or Iodine may be given. Dose.—Two drops of the tincture, or twelve globules, in a tum- bler of water, a tablespoonful at a dose, or three globules or a powder, dry on the tongue. In acute cases give every two or three hours, gradually increasing the intervals as the symptoms abate. In the chronic form of the disease a dose may be taken morning and night. Diet.— Same as in Inflammation of the liver. INFLAMMATION OF THE STOMACH. Gastritis. * This disease is exceedingly painful and violent, run- ning its course with great rapidity. It is astonishing, when we consider the ill-treatment the stomach receives at our hands, that it is not much oftener affected with violent inflammation. Diagnosis.—In the more violent forms of Gastritis there is a constant burning, gnawing, sticking, constric- tive pain in the stomach, occasioning shortness of breath, and aggravated by breathing, contact or pressure; the desire for cold drink is excessive, notwithstanding, if taken even in the smallest quantity, it is immediately vomited. The pulse is small, wiry, suppressed, frequent- ly intermitting ; the stool and urine scanty or suppressed. In the milder forms, the abovp symptoms are present in a less violent degree. Tuo vomiting is less frequent, and the pain less severe. The position which the stomach occupies in relation to other parts of the system renders inflammation of that organ exceedingly dan- gerous. It requires prompt and vigorous treatment to arrest the rapidity of its progress. There is also in con- nection with other symptoms great anxiety, prostration, * For a description of the stomach, see plat* 4, and Anatomy and Physiology. 6 122 AFFECTIONS of stomach and bowels. small, thread-like pulse, cool extremities and often faint- ing fits and convulsions. Death may taken place either by gangrene or nervous paralysis. In the former case, the sudden cessation of pain, one of the heralds of death, is often looked on by surrounding friends with joy, as an indication of returning health, but the accompanying symptoms, the small, scarcely perceptible, remittent pulse, and coldness of the extremities, dashes the cup of joy to tire earth, and chills them with the shadow of approaching dissolution. The latter termination, or " nervous paralysis,'' is generally accompanied with spasms, fits of fainting, and the utmost debility. The acute form not unfrequently passes into chronic inflam- mation, spasm and ulceration of the stomach. Causes.—This disease may be occasioned by mecha- nical injuries, the introduction into the stomach of acid or corrosive poisons, the use of cold drinks, when the stomach is heated, stoppage of bilious diarrhoea, and suppression of eruptions; inflammation of adjoining organs and metastasis of inflammation of other organs to the stomach. Treatment.*—In Gastritis, occasioned by poisons— see Poisons. Aconite is indicated at the commencement of the disease, where there is violent inflammatory fever and great pain, and particularly when occasioned by chills or cold drinks. Ipecac.—When vomiting predominates and when oc- casioned by indigestion or chill, and when Aconite is insufficient. The tongue is clear. Stibium.—Indications similar to Ipecac, with the ex- ception of a white or yellow coated tongue. Bryonia.—More particularly after Aconite or Ipecac. Pulsatilla.—When caused by indigestion, or chill in * For general directions as the administration of remedies, see page 12. INFLAMMATION OF THE BOWELS. 123 the stomach from ice, particularly after Ipecac, or Bry- onia. Arsenic is perhaps the most important remedy in the treatment of the disease. It may often be given in alternation with Veratrum. There is a burning pain, vomiting, rapid prostration of strength, paleness of the face and coldness of the extremities. Veratrum.—There is also vomiting, severe pain in the stomach, sometimes cramps, or spasms, prostration of strength, and coldness of extremities. Ilyosciamus.—When there are dropsical sufferings, or cerebral symptoms, with talkative delirium, loss of con- sciousness or stupor. Belladonna.—When Hyosciamus does not produce the desired relief. Opium and Camphor in alternation where there is prostration of strength, drowsiness and stupor. Nux is of benefit in those cases, where Aconite, Tpeca>:, Bryonia, or Arsenic may be indicated and prove insufficient, particularly in persons accustomed to ardent spirits. Dose.—A powder, or three globules, dry on the tongue ; or two drops of the tincture, or twelve globules, in a tumbler of water, a tablespoonful at a dose, In the more violent cases give every fifteen or thirty minutes until relief is obtained, when the time can gra- dually be increased to one, two, or three hours, or, if after eight or ten doses, there is no change of symptoms, another remedy should be selected. Fomentations of hops over the stomach, or the application of cloths wrung out in hop-water, will often produce a soothing effect. Diet.—As almost every thing taken into the stomach is vomited, but very little, at first should be taken, and that should be of the lightest and simplest character; cold water or toast water, in small quantities, not more 124 AFFECTIONS OF STOMACH AND BOWELS. than a tablespoonful at a time may be given, and gruels, as the symptoms gradually abate. INFLAMMATION OF THE BOWELS Enteritis. * This disease like gastritis is exceedingly painful and rapid in its progress. In its idiopathic form or setting in from the commencement as an inflammation of the bowels, it is by no means of frequent occurrence, yet as a symptomatic affection, setting in during the progress, or the sequele of some other disease, such as the various forms of fever, it is of very frequent occurrence. We are apt to find the symptomatic form existing to a greater or less degree in almost every variety of acute inflam- mation. Diagnosis.—Where the peritoneal coat is the principal seat of the disease, it is called " Peritonitis]' and is ac- companied in a greater degree, in addition to the usual symptoms of enteritis, with high fever, violent pain and an extreme sensitiveness of the abdomen to the touch. One variety of this disease we shall refer to under puer- peral fever. In the acute form of enteritis, involving the sub-mucous tissue and peritoneal coat, as well as the mucous membrane, we have violent burning, cutting pain, generally in one spot, especially in the region of the navel, and gradually extending over the abdomen, increased by the slightest pressure with tightness, heat and distension of the abdomen. The patient lies on the back, with the knees drawn up, and using only the muscles of the chest in breathing, avoiding, on account of the intense pain, every motion of the body. There is obstinate constipation ; nausea and vomiting, so violent that not only every thing taken into the stomach is thrown up, but even faaces; constant desire for cold * For a description of the intestines, see plate 4, and Anatomy. INFLAMMATION OF THE BOWELS. 125 water, which, however, produces aggravation of pain. The pulse, as in all acute abdominal inflammations is small and wiry, or weak and like a thread. As the dis- ease advances, there is hiccough, the pulse beats irregu- larly, the extremities grow cold, the features are sharp- ened and ghastly, and cold sweat breaks out. Delirium may occur toward the last, but generally the intellect remains clear. When the disease ends in death, similar symptoms tp those mentioned in gastritis occur, termi- nating in gangrene. The pain ceases, the pulse becomes weak and scarcely perceptible, the extremities cold, and the impress of death is seen stamped in visible charac- ters on the face, in the sharpening features, the glazing eye and the cold breath. The less acute form of this disease, or that developed by other diseases, is not cha- racterized by the same violent symptoms, but may end in obstinate constipation, perforation of the intestines and gangrene. In this variety, the pain is more diffuse, and diarrhoea of a slimy or bloody character may also be present. Causes.—It may arise from mechanical injuries, errors in diet, abuse of ardent spirits, the pernicious practice of eating chalk, magnesia, &c.; from cold, suppressed eruption, drastic cathartics, worms, parturition, and in connection with other diseases such as the malignant fevers. Treatment.—The utmost quiet is of course essential, and in those cases where the patient can not bear the lightest pressure on the abdomen, it may be protected from the weight of the bed-clothes by a light frame- work not allowing the clothes to touch the skin. A warm bath, if the patient is able to bear it, or sponging the abdomen with hop-water, will be found advantageous. The obstinate constipation being occasioned by inflam- mation, will not be relieved by the most violent cathar- 126 AFFECTIONS OF STOMACH AND BOWELS. tics, and when that inflammation subsides, the consti- pation ceases or is readily controlled. Aconite should commence the treatment as directed in gastritis, and be continued so long as the fever is in- tense, the skin hot and parched. Arsenicum is a prominent remedy in the severe forms of this disease ; there is prostration of strength, intense burning pain. It may be given either alone or in alter- nation with Veratrum. For particular indications, see Gastritis. It is also a prominent remedy in the less acute forms of the disease, where there is burning heat thirst, increase of pain after cold drink, nausea, fetid diarrhoea, and extreme debility. Belladonna.—Red and smooth tongue, or coated in the centre with red tip and margin; dry and hot skin, thirst, delirium, particularly at night; sensation of sore- ness in the abdomen, with tenderness on pressure. Belladonna is a prominent remedy in the severe forms of this disease, and is very often indicated in alternation with Mercurius. Dose.—Two drops, or twelve globules, of the above remedies in a tumbler of water, a tablespoonful at a dose ; or six globules dry on the tongue. Give every one or two hours. Mercurius.—The tongue is foul, coated white or brown; dry or covered with thick mucus ; great thirst, abdomen tender to the touch, hard and distended; watery, bilious, and offensive stools ; urging to stool, followed by severe straining and the passage of blood. There may be prostration of strength, chilliness, and disposition to perspire during the night. Dose.—A powder, or six globules, every two or three hours. Nitric acid is serviceable where Mercury has proved insufficient, particularly in chronic cases, where there is tenderness and tenesmus, especially where the disease occurs in those persons who have taken large quantities of calomel. INFLAMMATION OF THE BOWELS. 127 Dose.—Two drops of the first dilution, in a tumbler of water, a tablespoonful once in six or twelve hours. Opium and Plumbum are the prominent remedies where there is vomiting of faeces, spasmodic pain about the stomach or abdomen. Dose.—Of the former one drop, or twelve globules, in a tumbler of water : of the latter a.powder, or three globules dry on the tongue. Give every three or four hours. Nux-v.—There is soreness with burning heat in the abdomen, loss of appetite, vomiting of food, pain on drinking, constipation, flatulence, or watery or bloody stools with straining. Sulphur is frequently indicated in alternation. Dose.—A powder, or six globules, every four,six or twelve hours. Cantharides.—In severe cases where there is a dis- charge of pure blood and an inability to pass urine, also in the advanced state of this disease. See also Dysentery. Dose.—One drop, or six globules, in a tablespoonful of water, every three hours, until the severity of the symptoms have subsided. Veratrum—may follow Arsenicum, especially when there is coldness of the extremities; great prostration, severe burning about the navel, nausea and vomiting. Dose.—Two drops, or twelve globules, in a glass half full of water, a teaspoonful every hour, unless in alternation with Arsenicum and then every two hours. Besides the remedies already enumerated, Bryonia, Colocynth, Chamomilla, Pulsatilla, China, Rhus, Phos- phorus may also be consulted. As the more common forms of inflammation of the bowels occur in connection with other diseases, the particular indications of many of the remedies will be given when speaking of those diseases. Consult Worms, Gastritis, Hepatitis, Diarrhea*, Dysentery, Colic. Diet.—Same as in Gastritis. 128 AFFECTIONS OF STOMACH AND BOWELS. DIARRHCEA. Diarrhoea is generally a symptom of, or is developed in connection with, some other disease. It may at times be looked upon as a dangerous and even alarming symptom, and again as the precursor of returning health, the welcome indication that the crisis is favorable, and that the disease is leaving the system. The favorable crisis of a disease not unfrequently shows itself in a diarrhoea. This diarrhoea is an indication that nature is reacting, bursting the fetters of disease, which have hitherto bound it, preventing its free action, and is re- turning to a healthy equilibrium. In these cases no particular treatment is necessary. Another form of diarrhoea mentioned above, and by far the most common, is that which is developed in con- nection with some other disease. In these cases it is generally an unpleasant, and not unfrequently an alarm- ing symptom, as in consumption, typhoid fever, &c, where the powers of nature are rapidly prostrated. There is no difficulty in distinguishing between the favorable diarrhoea of the crisis, and the unfavorable one of disease. In the former case, there is a percep- tible amelioration of severe symptoms, the fever is sen- sibly diminished, and the pulse becomes more slow, soft and full, while in the latter case the pulse becomes weaker, the system more prostrated, or at any rate there are no ameliorating symptoms. It will be unnecessary to refer to the treatment of this variety here, as it forms only one of a group of symptoms in other diseases, and will be treated in con- nection with those diseases, under their appropriate heads. It remains then in this place only for us to speak of diarrhma, when it occurs as a primary affection. In DIARRHC3A. 129 its duration, it may vary from a day to several days or even weeks, often running into a chronic form lasting for months or years. The peculiar symptoms are familiar to all. The attack is sometimes preceded by precursory symptoms of a gastric affection, and is ushered in by an increased and more frequent discharge from the bowels, the color varying more or less from the natural. There are often nausea, flatulence, griping pain in the bowels, succeeded by stools of a fluid, watery, bilious, mucous, or bloody consistency. The tongue may also be furred and the breath foul, but in simple diarrhoea, there is generally but little, if any fever. Diarrhoea sometimes, as in bilious difficulties, and where it arises from indigestion or dissipation, may be highly beneficial, being the effort of nature to throw off those indigestible and irritating substances, which un- less expelled in this manner, might create violent fever and serious disturbances. It may again be the result of cold, occasioned by dampness or changes of temperature, impurities of the air and impure food, or the effect of the mind on the body, the prostration of fear, or the violent excitement of anger. The bowels, as well as the stomach, sympathize with almost every organ in the body, and give indications of uneasiness, when those organs are deranged. Diarrhoea is of itself indicative of some disturbed action about the bowels, and when this disturbance is of such a character, as to need medicine to relieve it, the remedy should be directed so as to remove irritation, restore the proper tone to the bowels and cause them to act in obedience with nature. Much harm is often done by suddenly suppressing a diarrhoea, by means of brandy, opium, and the general class of astringents. The disease is not removed any more, than is a putrid sore, which is covered with a plaster; it may be con- 6* 130 AFFECTIONS OF STOMACH AND BOWELS. cealed from sight, but the irritating cause is still un« touched. Treatment.—Diarrhoea is sometimes occasioned by the presence of undigested food in the intestinal canal In these cases a light cathartic, such as a dose of castor- oil will be of essential service in removing the irritating cause and prepare the way for other remedies. In the bilious diarrhoeas of summer and autumn when the stools are dark or frothy, a little sweet bottled cider of claret and water, sipped a few spoonfuls at a time, at in- tervals of two or three hours, will be of great service. Dulcamara—is the prominent remedy in diarrhoea occasioned by cold, particularly in the summer and fall, and where the evacuations are of a green, yellow slimy or sour character, occurring particularly at night, pre- ceded by colic and followed by debility; there may also be nausea, retching, restlessness, thirst and griping or lancinating pain in the bowels. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose ; or six globules dry on the tongue. Give every three, four or six hours. t Idna—if the diarrhoea is of a debilitating kind, oc- curring particularly after eating or in the night, and containing undigested food. Dose.—Same as Dulcamara. Give morning, noon and night. Bryonia.—When occasioned by the heat of summer, or when caused by cold, as drinking cold water, or when occasioned by vexation or passion, particularly if rheu- matic symptoms are present. The evacuations may be almost involuntary, have a fetid smell, and be accom- panied with flatulence or fermentation. Dose.—Same as Dulcamara. Give every four or six hours. Chamomilla.—Slimy, bilious, or watery diarrhoea of a yellowish or greenish color, resembling chopped eggs; there is thirst, tearing colic, griping and fullness in the pit of the stomach ; the abdomen is hard and distended, DIARRHCEA. 131 the evacuations frequent and sometimes attended with nausea or bilious vomiting. It is a prominent remedy in diarrhoea during dentition, and is often accompanied with cries, restlessness, and anguish. (See diseases of children.) Dose.—Same as Dulcamara. Give every three or four hours. Ipecac—Watery diarrhoea, of a slimy, yellowish, or greenish character, with nausea, or vomiting of watery or green mucus; or putrid, bloody or slimy, with white flakes and tenesmus (see dysentery) ; tearing colic, with restlessness, cries and tossing. Particularly useful in children. (See Cholera Infantum.) Dose.—A powder, or three globules, every two, three, or four hours, according to the severity of the symptoms. Pulsatilla.—Particularly in diarrhoea from disordered stomach, or indigestion, and when there are watery, bi- lious or slimy evacuations ; tongue coated white, nausea, or slimy, bitter vomiting, colic and cuttings, especially at night; sometimes the evacuations are mixed with blood or change their color to yellow, white or green. Dose.—Two drops in a tumbler of water, a tablespoonful at a dose ; orthree globules on the tongue. Give every three or four houis. Rheum.—A prominent remedy when the evacuations have a sour smell, are of a liquid, slimy, fermented or greenish character, accompanied with colic, frequent in- effectual efforts to evacuate, and tenesmus, or profuse evacuation with vomiting; restlessness, anguish, and cries. A prominent remedy in children (see diseases of children). Chamomilla is often suitable after it. Dose.—Some as Pulsatilla. Mercury.—Particularly when there is danger of its assuming a dysenteric form, and where the stools are watery, slimy, or bilious, or of a bloody or greenish cha- racter, preceded by colic and griping, and followed by 132 AFFECTIONS OF STOMACH AND BOWELS. tenesmus and straining ; there may also be nausea, shi- vering and shuddering. Dose.—A powder, or six globules, every three hours. Colocynth.—Watery or bilious diarrhoea with violent griping colic, particularly when caused by vexation or passion; where Chamomilla has not produced relief. Arsenic—Burning evacuations of a watery, slimy, putrid or brownish character, with burning, griping or tearing pains in the abdomen, especially after midnight; thirst, nausea, or vomiting; emaciation and weakness ; hollow eyes, pale cheeks. Coldness of the extremities, colic pains, distension of the abdomen, in alternation with Veratrum. Dose.—A powder or three globules every hour until a change. Ferrum.—Painless evacuations, especially at night, or after eating or drinking; thirst, emaciation, pain in the stomach, back and anus. Dose.—A" powder, or six globules, morning, noon and night. Sulphur.—In those obstinate cases, where other reme- dies seem to have failed, and particularly where the evacuations occur at night,—with colic, tenesmus, short- ness of breath,—of a slimy, watery, frothy, putrid, bloody or sour character ; easily renewed on taking cold. Dose.—A powder, or six globules, every four or six hours. Secale.—Where the evacuations are painless and are expelled with great violence, often involuntarily and without premonitory symptoms, and followed by weak- ness. Dose.—Three globules, once in four or six hours. Carbo-veg.—Diarrhoea of a putrid, fetid smell, or in wet weather, after taking cold. (See also Cholera.) Dose.—A powder, or six globules, every four hours. Ignatia.—Diarrhoea with rumbling in the bowels, oc- casioned by grief. Dose.—One drop in a tumbler of water, a tablespoonful once in two hours; or three globules dry on the tongue at the same inter- vals. DIARRHC3A. 133 Nux-vom.—Scanty evacuations with griping pain, colic and tenesmus. Phosphorus.—I have found this a highly valuable re medy in chronic diarrhoea with painless evacuations, debility and emaciation. Dose.—A powder, or six globules, once in six hours. Belladonna.—Small stools with bearing down pain, flushed face, and congested feeling in the head. Veratrum.—Diarrhoea with symptoms resembling cho- lera (which see), or where there are cutting, griping pains, and debility. These symptoms we frequently see during the diarrhoea, developed in fevers. In classifying some of the various remedies, we find where Diarrhoea occurs without pain, Fer., Chin., Phos., Secale are particularly indicated. Diarrhoea with Colic: Coloc, Merc, Nux-v., Cham., Bry., Ars., Sulph., Puis., Rheum. With Tenesmus: Ars., Ipecac, Merc, Nux-v., Bell., Sulph. With vomiting: Ars., Ipecac, Verat., Puis. With prostration of strength: Ars., Chin., Verat., Phos., Sec. Chronic diarrhoea: Calc, Fer., Phos., Chin., Nit.-ac^ Sulph, In consequence of an eruption: Ars., Chin., Sulph., Merc, Pulsatilla. In aged persons: Secale, Phos., Bryonia. In tuberculous persons: Iodine, Calc, Sep., Sil., Sulph* Phosphorus. From taking cold: Dulc, Chamomilla. From cold drinks: Ars., Carb.-v., Puis. From sudden emotion—joy; Coff., Acon., Pulsatilla' —Fright: Cham., Veratrum.—Grief: Phos.-ac, Ignatia —Disappointment or anger: Cham., Coloc, Nux-vom. The result of indigestion: Ant., Coff., Ipecac, Nux, or Pulsatilla. 134 AFFECTIONS OF STOMACH AND BOWELS. The result of a debauch : Carb.-v., Nux-v. Of milk: Bryonia, Sulphur. Of fruit: Ars., Chin., Pulsatilla. Abuse of medicinal substances: Mercury, Hep.-s., Carb.-v., Chin,, Nit.-ac. Of magnesia: Puis., Rheum. Of tobacco: Cham., Pulsatilla. For more minute classification and special indications, see Materia Medica and symptomatic index. In chronic cases a dose of the remedy morning and evening will be sufficient. Diet.—Rest is advisable, particularly in severe cases. Fruits and acidulated drinks should be avoided, and the diet consist of light unirritating food, such as salep, farina, gruel, arrow-root, &c. In chronic cases the food may be nourishing, yet easy of digestion. DYSENTERY. Bloody Flux. This disease is intensely painful and requires prompt and vigorous treatment to prevent its assuming a highly dangerous form. The suffering has often been repre- sented as similar to that endured by the mother in child- birth. It is generally attended with fever, sometimes accompanied with thirst, headache, nausea and vomiting. The dysenteric attack may be preceded by diarrhoea or rheumatic symptoms, or from the commencement assume the form of a decided dysentery. It cannot be looked upon as a diarrhoea, from which it may readily be dis- tinguished, but it is essentially an inflammation of the mucous membrane of a certain portion of the intestine. No fasces are discharged, but mucous or bloody stools, accompanied with straining and tenesmus, and generally preceded by severe griping pain in the bowels. The ap- pearance of fasces, though they may be mixed with blood, indicates that the inflammation is subsiding, reaction taking place, and that the patient is decidedly advancing towards convalescence. The discharges at first, may be DYSENTERY. 135 of a whitish or jelly-like mucus, resembling the scraping of the intestines, (called Dysenteria alba or white dysen- tery) speedily followed by the bloody flue or red dysen- tery of a mucous and bloody character, from the inflamed surface of the intestines, mixed with membranous shreds, and morsels that resemble flesh. The evacuations may vary in color, green, black, and reddish, like the washings of meat and very fetid. During this state there is of course a continuance of febrile symptoms, great restless- ness and intense anguish. The disease may terminate in mortification and ex- haustion, in a chronic dysentery, or in health. Dysenteries are particularly violent in warm climates, sometimes developed in severe epidemics, not only there> but generally in a less violent degree, in our more tem- perate regions. It is the pest and scourge of the army, exposed as the soldiers are to every variety of hardship, to-day engaged in the fierce strife of battle, and to-night sleeping perhaps on the cold damp ground, with the rain pouring in torrents upon them. In two years and a half the British army lost in Spain nearly 5000 men by this disease. Hundreds of our own army, during the cam- paign in Mexico, died with it. or returned home only to lay their bones among their kindred. It may be caused by indigestible food, errors in diet, and tainted or impure food, abuse of spirituous liquors, and by taking cold, par- ticularly when the perspiration is suddenly suppressed. Unripe or decayed fruit is also injurious, but fruit per- fectly ripe and fresh may be eaten with safety. The disease is more liable to occur in the latter part of the summer, autumn, and fall, and is particularly severe in damp miasmatic and marshy districts. Treatment.—To those of us, who have formerly been Allopathic physicians, it is refreshing to contrast our present treatment of this disease with our old practice; and if it is pleasant to us, it is much more so to the pa- 136 AFFECTIONS OF STOMACH AND BOWELS. tient. Under the homoeopathic treatment a death by dysentery when taken in time is exceedingly rare, while in other treatments it is an every-day occurrence. We have seen in this disease, that the mucous membrane of the intestines is highly inflamed, often coming away in shreds, while from the highly inflamed and irritated sur- face blood is freely discharged. The great object is of course to relieve this irritation and re-establish a natural and healthy action. How is this to be done ? An Allo- path would pour into those irritated, inflamed and bleed- ing bowels, cathartics, mercury, castor-oil, opium, astrin- gents, such as sugar of lead, &c. And as they pride them- selves on appreciable doses, the dose would consist of a considerable amount of the drug. A Homoeopath, by remedies acting gently, in obedience to a fixed law, would remove the febrile irritation, control the spasms and severe distress, as we shall hereafter show, gently, yet quickly and effectually. The prominent remedies are; Aconite, Bryonia, Bella- donna, R/ius, Mercurius, Colocynth, Ipecac, Nux., Sul- phur, Carb.-v., Nit.-ac, Plumbum, Pulsatilla As a general thing when we have any reason to sup- pose undigested food may have passed into the intestinal sanal, it is best to commence the treatment with a small dose of Castor-oil and then proceed with the appropriate remedies. Aconite* is indicated particularly in the commence- ment, where there is fever, shivering, heat and thirst, and in dysentery, during warm weather with cold nights; attended with rheumatic pains in the head, neck and shoulder. In the early stage of the disease, Aconite will often be sufficient to break up the attack. Dose.—Two drops, or six globules, in a tumbler of water, a table- spoonful every two or three hours. * For general directions as to the administration of remedies, see page 12. dysentery. 137 Aloes.—Violent evacuations with bloody stool, colic, heat in the rectum, tenesmus, and faintness, when at stool. Dose.—A powder, or three globules, once in three hours. Belladonna.—After, or in alternation with Aconite, where, in addition to the febrile symptoms, the exacerba tion comes on in the afternoon, the patient is restless, the face red, the head hot; colicky, or cutting burning pain, constant urging to stool, and discharge of bloody mucus. Dose.—Same as Aconite. Mercury is one of the most important remedies in the treatment of this disease. Violent tenesmus, straining before and after the evacuation, as if the intestines would be jerked out, which only produces a passage of blood, or of blood mixed with a substance resembling chopped eggs. During the evacuation, colic, nausea, and shiver- ing. Colocynth is second only to Mercurius in the treatment of most forms of dysentery. The prominent symptoms are bloody stools, fullness and pressure in the abdomen, and particularly, severe griping colic, so violent as to cause the patient to bend double. In most forms of dysentery, where Mercury is required, I have found the griping colic also present indicating Colocynth. In these cases I have generally given them in alternation, two or three hours apart, or even at shorter intervals, if the symptoms are very violent. Dose.—A powder, or six globules of the Mercury may be given, and one drop, or twelve globules of Colocynth, mixed in a tumbler of water, a tablespoonful at a dose, given as directed above. These re- medies, if their good effect seem to cease, may be followed by two or three doses of Colchicum with advantage. Ip°cac.—A very important remedy, particularly in the dysenteries of autumn and after Aconite', or when there is nausea, violent tenesmus and colic, stools, first of a slimy, then a bloody mucus. It may sometimes be indi« 138 AFFECTIONS OF STOMACH AND BOWELS. cated in alternation with or followed by Colocynth or Mercury. Dose.—One drop in a tumbler of water, a tablespoonful at a dose; or a powder, or six globules, dry on the tongue. Give every two or three hours. Arsenic—The indications for this remedy are similar to those of Carb.-veg, with which it is generally best to alternate. There is burning pain in evacuating the bowels, rapid prostration, coldness of the extremities, cold breath, putrid and offensive discharge of urine and fasces, often involuntary. Dose.—A powder, or six globules, every two hours. China is useful where the disease occurs in marshy countries, and where the sinking putrid symptoms still continue after the use of Arsenic and Carb.-v. Dose.—Three drops in a tumbler of water, a tablespoonful every four hours. Nux.-v.—Small, frequent evacuations, of bloody slime, with tenesmus, violent cutting about the umbilical region, heat and thirst. Particularly useful when brought on by the heat of summer, or when Arsenic only aggravates the putrid smell of the evacuations. Dose.—Same as Arsenic. Pulsatilla.—Mucus streaked with blood, nausea, vomit- ing of mucus, shivering and cutting in the bowels. Dose.—Two drops, or eight globules, in a tumbler of water, a tablespoonful once in three or four hours. Nitric-acid.—Constant pressing in the rectum without evacuation, or evacuation of mucus after which tenesmus continues, followed by tensive pressure in the head, heat, thirst, and intermittent pulse. Dose.—Same as Pulsatilla. Plumbum.—I have found this a valuable remedy in those very violent cases not relieved by Mercury and Colocynth. Nothing but blood is passed, the pain is in- tense, and the tenesmus continues even after the stool. Dose.—A powder, or three globules, every three hours. Bryonia and Rhus deserve attention when the disease CHOLERA MORBUS. 139 occurs during the heat of summer, and is occasioned by a chill, or accompanied with rheumatic pain. (See Diar- rhoea.) Sulphur.—After other remedies have failed, Sulphur often removes the disease, or arouses the system, so that it is more susceptible to the action of other remedies. Dose—A powder, or six globules, may be given every three hours until three doses have been taken. Diet.—The patient should keep in a reclining posture in the bed, and when the disease is violent use the bed- pan instead of getting up. The drink should consist of cold water, toast-water, rice, coffee, black tea; and the food, of toast softened in tea, or water, salep, arrow-root, farina, &c. All kinds of animal food and wines should of course be avoided even during the early period of convalescence. CHOLERA MORBUS. The sporadic or bilious cholera, known as Cholera Mor- bus, differs materially from that fearful pestilence Epi- demic or Asiatic Cholera, notwithstanding there is some- thing of a resemblance in appearance. It occurs princi- pally in the summer and autumn, and is common in all parts of the country. Diagnosis.—The attack may be preceded by the ordi- nary symptoms of bilious derangement, such as, languor, nausea, oppression about the stomach, colicky pains, &c. More frequently, and as a general rule, it comes on sud- denly, without any precursory symptoms. There is nau- sea, sudden and repeated vomiting, with a violent diar- rhoea, first of faeces, then of a watery, bilious fermenting liquid, accompanied with tenesmus, violent burning, cut- ting, griping colic, particularly about the navel. The vomiting consists at first of the contents of the stomach, but at length a watery, slimy, or bilious fluid is dis- charged in larger or smaller quantities. Even after the 140 AFFECTIONS OF STOMACH AND BOWELS. vomiting has ceased, painful retching and gagging may continue. In violent cases, if the disease is not promptly checked, there may be a rapid prostration of strength, cold sweat, pale and haggard face, spasmodic and scarcely perceptible pulse and convulsions. Causes.—Taking cold suddenly in hot weather, intense heat long continued, violent emotions, unripe fruit, acrid, non-fermenting drinks, fat, rancid food, powerful cathar- tics, suppressed menstruation, gout or cutaneous erup- tions. Treatment.*—The principal remedies in the treatment of this disease are: Ipecac, Chamomilla, Arsenic, Colo- cynth, Veratrum, China, Dulcamara, Pulsatilla. The precursory symptoms, if there are any, will generally yield to one or two doses of Chamomilla. Should how- ever nausea and vomiting with diarrhoea exist, a dose of Ipecac, repeated every hour or two, will be indicated. If these do not relieve in four or five hours, or the attack becomes fully developed, other remedies should be con- sulted, as Veratrum, Colocynth, &c. Particular Indication. Chamomilla.—When the attack is occasioned by a chill or fit of passion, and where there is yellow-coated tongue, bilious diarrhoea, cramps in the calves of the legs, colic pains, or pressure about the navel. Ipecac is an important remedy, particularly in the commencement of the disease, when the vomiting seems to predominate. Veratrum.—If, notwithstanding the use of the pre- ceding remedies the disease becomes fully developed, this is a most important remedy. The vomiting and diarrhoea are very violent, the countenance is pale and expressive of deep suffering, the abdomen is tender to the touch; excruciating pains in the region of the navel, * For general directions as to the administration of remedies, see page 12. CHOLERA MORBUS. 141 cramps in the calves of the legs and fingers, coldness of the breath and extremities, and rapid prostration of strength. It alternates well with Ipecac. Colocynth is also an important remedy and is indi- cated by violent griping colic, bilious vomiting, green, bilious or watery diarrhoea. Arsenic—Rapid prostration of strength, violent and painful vomiting, diarrhoea almost constant, small, weak, intermittent pulse, spasms in the fingers and toes, clammy perspiration, burning sensation in the region of the sto- mach, &c. Dulcamara.—Caused by changes of the temperature, iced drinks, &c.; griping or cutting pain in the bowels, greenish diarrhoea and bilious vomiting. Pulsatilla.—In mild cases, where there is mucous diarrhoea, and where the attack was caused by indigest- ible food. China.—When the disease was occasioned by indigest- ible substances, unripe fruit, and where it occurs in marshy districts. There is prostration, vomiting, pres- sure about the abdomen, and brownish evacuations, con- taining indigestible food. Dose—Three drops may be mixed in a tumbler of water, and a tablespoonful taken at a dose; or a powder or six globules may be taken on the tongue. In violent cases, a dose may be given every twenty or thirty minutes, until three or four doses have been taken, when, if indicated, other remedies may be selected, or those given in longer intervals, varying from one to three hours. Diet and Regimen.—The patient should be kept warm by means of blankets, bottles filled with warm water should also be applied to the feet, and in violent cases dry hot cloths,- or a mustard poultice, may be applied over the stomach. The drink should consist of cold water, and the food of gruels. 142 AFFECTIONS OF STOMACH AND BOWELS. ASIATIC CHOLERA Epidemic Cholera. We proceed now to the investigation of one of the most fearful diseases which has ever ravaged the earth. Confined to no nation and no clime, the breath of this pestilence has sped on its mission of death from land to land and from nation to nation, numbering its victims by thousands. In the East Indies, and the southern por- tions of Asia, along the banks of their mighty rivers, in their crowded cities, and valleys teeming with the rich luxuriance of tropical vegetation, it has reaped a rich harvest for many years. In Madras from 1818 to 1822 23£ per-cent. of the army were attacked, and of these 22f per-cent. died. In 1821, one-sixth part of the inhabitants of a province on the Persian Gulf perished, and in the same year in another province, in a few weeks' time 18,000 fell victims. In September, 1830, in Moscow, 54 per-cent. of all attacked died. In Paris, in 1832, 18,000 perished, and in Palermo in a population of 120,000, 25,000 perished. In the United States, in 1832, it filled the land with terror and carried consternation and mourning to thou- sands of family circles. In New-York city alone there were 5,547 cases, and of these 2,782 died, being one-half of all that were attacked. In 1821-2, twenty-five of the the Allopathic hospitals in Italy and France give a ratio of 63 deaths out of every one hundred patients, and in this country, in 1832-4, their success was but a little better. The success of Homoeopathy in the treatment of Cho- lera and other violent diseases, has contributed more than aught else to its rapid advancement all over the world. In 1832, there were treated allopathically in Vienna, 4,500 Cholera patients, and of these 1,360 or ASIATIC CHOLERA. 143 31 per-cent. died. There were treated homoeopathically 581 patients, of whom 49 died ; being only 8 per-cent. Dr. Quin, of London, gives the result of the treatment of ten Homoeopathic physicians. The patients treated were 1,093, and of these only 95 died, thus twenty-one out of every twenty-three were saved. Dr. Rath, sent by the King of Bavaria to ascertain the results of the Homoeopathic treatment of Cholera, re- ports the treatment of 14 physicians in Prague, in Hun- gary and Vienna. The number of cases treated was 1,269, the number of deaths only 85. In Austria, Berlin, Russia and Paris there were treated homoeopathically 3,017, of which ten out of every eleven were cured. Hon. Alex. Eustaphieve, the Russian Con- sul-General, makes a similar statement, as it regards the success of the Homoeopathic treatment in various parts of the Russian Empire, and the venerable Admiral Mord- venow, President of the Imperial Council, says, "not a single death has occurred, when Homoeopathic treatment was resorted to in the incipient stages of Cholera." But we need not go beyond our own country, for here we have ample proofs of the splendid triumphs won by Homoeopathy, particularly in the Cholera of 1849. Un- der Homoeopathic treatment the loss did not exceed from two and a half to three and a half per-cent. And the cases reported by Homoeopathic physicians as Cholera, were in reality such, decided and well marked cases. The mortality under the Allopathic system was similar to that already mentioned in Europe. Diagnosis.—There may be precursory symptoms, such as inclination to diarrhoea, rumbling in the bowels, de- bility, general feeling of uneasiness, but as a general thing, the attack comes on suddenly, and runs its course with great rapidity, not unfrequently terminating in death in ten or twelve hours. There is sudden prostration of strength, diarrhoea and 144 AFFECTIONS of stomach and bowels. vomiting, gushing forth in large quantities. The dis- charges follow each other in rapid succession becoming more and more watery and fluid, until after three or four discharges, they present the appearance of rice- water, and are without smell. These are the rice-water discharges of Cholera. There is also a painful burning in the stomach, sometimes extending behind the sternum, frequently connected with a sighing, and with it an in- satiable thirst, anxious breathing, accompanied with a constant desire for cold water, which however produces but slight relief, and it is almost immediately, particu- larly when taken in large quantities, thrown up in vo- miting. The prostration rapidly increases, the patient becomes restless and anxious, and in a short time the fearful and agonizing cramps are developed in the limbs and frequently the bowels and breasts. They generally commence in the calves, toes, and fingers. There is also an increasing oppression of the chest, and an excessive smallness of the pulse. The movements become painless aud may be either very frequent or few in number. If the stools diminish in number while there is also a decrease in the strength and pulse, a speedy dissolution is indicated. No trace of bile can be found in the evacuations, but they are accompanied by a great sense of exhaustion, which soon amounts to utter prostration. As the disease progresses, the last stage or that of collapse sets in. Besides the above symptoms which may be present, particularly the cramps, a coldness commencing at the lower limbs gradually spreads over the body, resisting all external means of warmth; the face and lips become pale, blue, and cold, the body and tongue present a shriveled appearance, the breath be- comes cold, a clammy perspiration bedews the skin, the circulation apparently ceases, as often no pulse can be felt for hours before death. The voice is peculiar, being feeble, fine, somewhat hoarse, hollow or without reso- ASIATIC CHOLERA.' 145 nance. The patient at length sinks into a stupor, the face presents a frightful ghostlike appearance, the eyes may be blood-shot, and turned up in the head, and death speedily closes the scene. Causes.—The medical world is still to a certain extent in obscurity, as it regards the cause of this fearful pesti- lence. It attacks people of all ages and of every condition in life, but is more frequent and fatal among those who are pent up in ill-ventilated rooms, exposed to the efflu- via of decaying vegetable matter, uncleanly in their per- sons, and imprudent in their diet, or among that class, whose chief delight is in the luxuries of the table and the exhilaration of the wine-cup. We cannot look upon this disease as a diarrhoea, for no foecal matter is seen in the discharges. It is rather a decomposition of the blood, occasioned by some un- known cause, aided by a variety of circumstances, such as fear, debility, as well as the causes mentioned above', in which the watery part or serum of the blood, separat- ing from the coagulum, escapes from the blood vessels into the stomach and bowels from whence it gushes in torrents. This decomposition may be the work of days or hours, or as in the cases of dry cholera, which are the most violent, and are unattended with discharges, be the work of a few moments, accompanied from the commence- ment with violent and continued cramps. These cramps are occasioned by a cessation of arterial action on the muscles and of course cease when that action is reestab. lished. Need we wonder then at the rapid prostration of the cholera patient, when we remember, that these rice-water discharges, which gush forth in such torrents, consist in reality of the white part of the blood ? Prevention.—Cholera prevails as an epidemic, often desolating a town or city, while villages within the dis- tance of a few miles entirely escape. Bv some it is con- 7 146 AFFECTIONS OF STOMACH AND BOWELS. sidered contagious, but this view I think is entirely er- roneous. In a somewhat extended observation of Cholera I have never seen or read any adequate proof of its con- tagion. Cleanliness, pure air, a healthy diet, and above all, a calm and even mind, are of course essential in warding off the attack. Giving way to fear, in this, as in every other disease, debilitates the system, and thus renders a person far more liable to its fatal effects. The gates are opened by the trembling victim, and all the disease has to do, is to enter and take possession. Any thing which would have a tendency to weaken the system, should be avoided, and yet a healthy vigorous action of the mind and body are of the utmost importance. A sudden breaking up of habits, injurious in them- selves, yet long persisted in, may cause too violent a shock of the system at a period, when violent shocks are dan- gerous. Thus, persons accustomed for a long time to the use of liquors or tobacco, may continue to use them, but in diminished quantity. The diet should be plain and simple, yet nourishing. Beef, potatoes, and bread, also ripe and fresh vegetables and fruit should constitute the principal part of the diet—the latter in moderate quantities.—Melons and green fruit and vegetables are not to be used. The best beverage as a general thing is cold water. It may be advisable to wear a flannel bandage over the bowels. The utmost regularity should be observed in all things, eating, sleeping, or exercise, and mental or physical excesses should be carefully guarded against. Tkeatment.—There is often previous, or after the at- tack, a diarrhoea with rumbling in the bowels, and a general feeling of prostration or uneasiness. This is called Choi rine, and is generally easily relieved. Where it has been occasioned by cold, and is accompanied with pain in the limbs, headache, shivering, &c, a few doses ASIATIC CHOLERA. 147 of Bryonia and Rhus, given in alternation every two or three hours, will produce relief. If occasioned by debi- litating causes either mental or physical a few doses of Phos-ac. or China, given at intervals of three or four hours, may be taken. If occasioned by fear, Chamo- milla would be indicated, and if there should be present much nausea, Ipecac, may be given. A dose every two or three hours. When the attack fairly commences, the rice-water discharges being present, Camphor is the all-important remedy, and should be immediately given. The patient should be covered up in bed, and three drops of the tincture of Camphor given on a lump of sugar every three, four, or five minutes. As soon as reaction takes place, and the patient becomes warm, the doses may be given less frequently, and when full perspiration com- mences, cease entirely. A little brandy and water may now be given. If after the use of Camphor headache should come on, a few doses of Belladonna will relieve it. Should however cramps commence, which are not removed, or are only modified by the Camphor, we must turn our attention to other remedies; these are Cuprum and Vtrairum, which are the most important, and can frequently be given in alternation. The cramps, cold- ness of the body or extremities, prostration, and dis- charges, clearly indicate these remedies. Veratrum, particularly when the cramps are exceedingly violent in the calves and bowels, and Cuprum when the vomiting is preceded by spasmodic constriction of the chest. Vera- trum, two drops of the tincture may be dissolved in a tumbler of water, and a teaspoonful given in alternation with a powder of Cuprum, ten, fifteen, or twenty minutes apart, gradually increasing the intervals as the symptoms are relieved. If after five or six hours the vomiting has nearly or quite ceased, there are cramps in the extrenii- 148 AFFECTIONS OF STOMACH AND BOWELS. ties, particularly the calves, and the evacuations still show no trace of bile, the prostration and coldness still continuing, Secale, a drop dissolved in a glass half full of water, a teaspoonful of which may be given at intervals of half an hour, until three or four doses have been taken. In this stage Phos.-ic. is often a valuable remedy, particularly where chest symptoms are prominent, op- pression of breathing, pain in the chest and side, anguish and restlessness. Two drops of the first dilution may be mixed in a glass half full of water, and a teaspoonful given every fifteen or twenty minutes. During this stage, the covering may be governed by the feelings of the patient, who generally prefers to be well covered. Small lumps of ice may be taken, the drinks may be either cold or warm, according to the feelings of the patient, and injections of cold water may be thrown into the bowels, when they are severely cramped. Eriction also should be made with the warm, dry hand, particularly over those parts violently cramped. Should the disease pass into the last stage, or that of collapse, Arsenic, or Carb.-veg. are the pro- minent remedies. Veratrum and Secale may also be indicated, and Camphor, if that remedy has not before been given. This stage may last from a few hours to two or three days with but slight alteration, and termi- nate inconvalescence, death or some other disease, par- ticularly Typhoid Fever. Carb.-veg. should be given every three hours, par- ticularly if stupor is present, or there is oppression of the chest or head, and should there be a sensation of intense burning in the stomach, with frequent desire for water, it may be alternated with Arsenic every two hours, gradually increasing the intervals to six hours, as the returning pulse shows signs of reaction. Should the burning sensation be the prominent symptom, Arse- nic may be given alone at intervals of an hour. Arsenic CONSTIPATION. 149 is also indicated when the disease sets in with great violence, and when there is violent burning in the stomach, bowels, and throat, with great thirst and debility. The covering should be governed by the feel- ings of the patient, who generally prefers but little if any. The application of external warmth' in this stage is entirely useless. I have thus endeavored to delineate the development and progress of Asiatic Cholera, as well as the treatment I found most successful in my own practice during the prevalence of this disease in 1849. As has already been seen Camphor, Cuprum and Veratrum are the prominent remedies, one or the other of which may be indicated in every stage of the disease, as well also as preventives. Phos.-ac, Ipecac, Arsenic, Carbo-v. Secale, Hellebore, are also important remedies and deserving of particular attention. During the prevalence of this epidemic, every family should be provided with a small case, containing a vial of the tincture of Camphor, one of Veratrum, one of the powder of Cuprum, and another of Ipecac. The pre- monitory symptoms should be promptly checked. At the commencement of the attack, until the physician arrives, the friends should not hesitate in their course, but administer the remedies with promptness and decision. CONSTIPATION. COSTIVENESS. This most troublesome and obstinate difficulty more frequently exists as a symptom of some other derange- ment. When however it seems to be the principal symptom, it requires patience and care in the use of remedies to effect its removal. It may arise from inaction of the liver, a general derangement of the digestive organs, causing weakness of the bowels, from mental difficulty, and an almost infinite variety of causes. Thus 150 AFFECTIONS OF STOMACH AND BOWELS. we frequently see it in persons of sedentary habits, as a result of dissipation, or mental anxiety, in pregnant females, and in various forms of disease. It can frequently be removed by means of a change of diet, fresh air, judicious exercise, perfect regularity in eating and the time of stool. Looking at this trouble in its true light, we very readily perceive the injurious effects produced by cathartics. The bowels, inactive and debilitated, are roused to violent action only to settle back into a state of greater weakness and inactivity than before. The experience of all accustomed to cathartics shows, that their secondary effect is almost always con- sti)>aticn. Hence they should be avoided entirely or only resorted to in extreme cases. Where mechanical means are necessary, injections of cold or tepid water may be used, or if the case is urgent, or these should fail, a tablespoonful of sweet-oil and a teaspoonful of salt may be added. Water is also an exceedingly valuable remedy both as a drink and as an external application. The sitz-bath, or a shower-bath, the water falling obliquely over the abdomen, and perhaps stomach and liver, are not un- frequently highly advantageous. (See Wet Sheet) The diet also should be simple, easy of digestion and of an open- ing kind. Hence, bread made of unbolted flour, fruits and vegetables perfectly fresh and ripe, may be eaten freely, together with a moderate amount of meat simply cooked. Late suppers, highly seasoned food, &c. should of course be strictly prohibited. The general directions given in treating of dyspepsy may also be observed here. How much more consistent with common sense is the doctrine, which teaches us that when the bowels or digestive organs are weakened, or in a measure paralyzed so as to be unable to perform their functions aright, that we should by gently stimulating nature, rouse it from its torpor to its natural and healthy action, rather than by CONSTIPATION. 151 strong mechanical means weaken it for a moment, only to render it by the violence of its action more helpless than before ? If we only reflect, that constipation is generally the result of a torpor, or want of action in the intestinal canal and digestive organs, we should hardly think of removing the difficulty by those means, the unavoidable tendency of which would by to weaken those organs. The prominent remedies in the treatment of this disease are: Nux.-v., Sulphur, Bryonia and Opium. Besides these Sep., Lach., Lye, Plat., Calc, Phos., Ant., SH., Coc, Alumina, Veratrum, Puis., Carb.-v., dec, are also frequently indicated. For persons of sedentary habits: Bry., Nux.-v., Sulph., Lye, Op., Plat, are generally indicated. That of drunkards, Nux-v., Opium, Sulphur. Following diarrhoea or purging: Nux-v., Opium, Ant., Lachesis. In old persons, often alternating' with diarrhoea: Ant., Op., Phos., Bry , Lachesis. In pregnant women: Nux-v., Op., Sep., Alum., Bry., Lye. In Lying-in-women: Ant., Bry., Nux-v., Plat. In Infants : see diseases of children. When traveling in a carriage : Plat., Alum., Opium. During a sea-voyage : Cocc, Silic, Tab. For other varieties, see Symptomatic Index. Particular Indications.* Alumina.—I have found great benefit from this remedy in cases of obstinate constipation, when the fasces were dry and hard, great inactivity of the large intestines, and the movements were accompanied with considerable straining, and also when attended with hasmorrhoidal tumors. It may frequently be given in alternation with Bryonia. * For general directions as to the administration of remedies, see page 12. 152 AFFECTIONS OF STOMACH AND BOWELS. Dose.—A powder, or three globules, every night. Bryonia.—Particularly indicated in those of an irri- table, passionate character, and also in rheumatic per- sons ; in warm weather, or when occasioned by a dis- ordered stomach with chilliness and headache. It alternates well with Nux-vomica or Alumina. Dose.—One drop, or six globules, in a tumbler of water, a table- spoonful every night. Nux-vom. is an important remedy in constipation, especially in chronic cases, occasioned by coffee, dissipa- tion, or from sedentary habits, also in persons subject to hemorrhoids, or in consequence of indigestible food, or a too hearty meal; and especially when there is nausea, distension, pressure and heaviness about the abdomen, headache, ill-humor, and fullness about the head, disturb- ed sleep, and general sensation of dullness, frequent and ineffectual effort to evacuate, with a sensation as if the anus were contracted. It is frequently advisable to alternate it with SulpJiur; Sulphur in the morning, and the Nux at night. A powder, or one globule, may be given at a dose. Sulphur.—In cases of habitual constipation, particu- larly if there is a tendency to haamorrhoids, or uneasiness about the abdomen, with ineffectual efforts to evacuate. Dose.—Same as Nux, with which it may often be alternated. Opium.—More particular in recent cases, or in old per- sons, and frequently in chronic cases occasioned by seden- tary habits. There is headache, determination of blood to the head, redness of the face, want of appetite, weight in the abdomen, sensation as if the anus were closed, and the intestinal canal paralyzed. Dose.—One drop, or six globules, in a tumbler of water, a table- spoonful morning and night. Pulsatilla.—Similar indications to those of Nux; espe- cially useful in persons of a mild, cold, phlegmatic tern- CONSTIPATION. 153 perament, or when occasioned by derangement of the stomach from fatty food. Dose.—Same as Opium. Sepia.—Particularly suitable to females, where there is irregularity of the menses, and also where there is a derangement of the circulation of the liver, accompanied with languor, heaviness, and pain in the head; hard, bullet-shaped fasces; also indicated in rheumatic persons. It is frequently suitable in chronic cases after Nux and Sulphur. Dose.—A powder, or three globules, morning and night. Platina.—Obstinate constipation and ineffectual desire to evacuate, accompanied with pain in the abdomen and stomach; excessively difficult evacuations, with tenesmus and tingling in the anus. Dose.—A powder, or three globules, morning and night. Plumbum.—Very obstinate constipation, either pain- less, as if the bowels were paralyzed, or accompanied with severe colic, particularly about the navel, or when there is ineffectual effort to evacuate with painful sensa- tion of constriction about the anus. Particularly use- ful in persons affected with palsy, epilepsy, dropsy or emaciation. Dose.—A powder, or three globules, morning and night. Silicea.—Especially in scrofulous constitutions, in ver- minous difficulties, and where dyspeptic symptoms are present. There may be ineffectual effort to evacuate, and colic. Dose.—Same as Platina. Veratrum.—Severe constipation, headache, flushed face; nausea, tenderness of the abdomen to the touch and especially in bilious, gastric and hypocondriacal individuals. Dose.—Two drops, or six globules, in a tumbler of water, a table- spoonful morning and night. lycopodium.—Particularly where there is a scrofulous 7# 154 AFFECTIONS OF STOMACH AND BOWELS. constitution, and also from long-continued dyspepsy, or abuse of medicines. Dose.—A powder, or six globules at night. Con iinn,—In old people or females, and where there is ineffectual effort to evacuate. Dose.—Same as Opium. In obstinate constipation the application of the Gal- vanic Battery to the region of the liver and abdomen will often produce relief. In recent cases of constipation, the remedy should be given more frequently than in the chronic form. In the former, where the accompanying symptoms are violent, it may be necessary to give it every three or six hours. HAEMORRHOIDS. PILES. An obstruction in the circulation of the hasmorrhoidal artery, thus producing a congested state of the rectum, particularly about the anus, gives rise to small tumors or lumps, called piles. These lumps may be external, or so far within the rectum as to be imperceptible to sight, and they may or may not bleed, and are therefore spoken of as either external, internal, bleeding, or blind piles. They may be occasioned by a constitutional taint, in which case, if partially removed, they are liable to return at any time. They may give rise to, or be combined with various forms of chronic disease, when close and careful observation is necessary to produce permanent relief. The exciting causes are, use of stimulants, such as, spirits, coffee, spices, &c, or frequent use of cathartics; constipation or the contrary; depressing emotion, great mental exertion, sedentary life, riding on horseback. They frequently occur during pregnancy, from wearing tight clothes, or from worms. They are generally attend- ed with considerable heat, burning, tearing, or cutting pain, and weakness and pain about the small of the back. HJEM0RRH IDS. PILES. 155 The food should be such as to keep the bowels mode- rately open; heating or stimulating drinks should be avoided, cathartics consigned to oblivion, and the sur- geons's knife allowed to rest quietly in its case. The habit of cutting off these tumors, is not only revolting treatment, but generally productive of far more evil than good. Treatment.*—I have found in these cases great ad- vantage in the use of the sitz-bath. It has a tendency to reduce the inflammation, and remove in a great degree the sufferings of the patient. Nux-v. is a prominent remedy in almost every form of this disease, and particularly useful when occasioned by constipation, abuse of stimulating drinks, sedentary life with mental exertion, worms, compression of the abdomen, swelling of the abdominal organs, and in pregnancy. Dose.—A powder, or six globules, may be taken every six or twelve hours according to the symptoms. Sulphur is also a prominent remedy, particularly in blind or flowing piles of a chronic nature. It is also strongly indicated for hasmorrhoidal colic with contrac- tive pains about the umbilicus. Dose.—Same as Nux, with which it may often be alternated, the Sulphur, in the morning, and the Nux at night. Belladonna is an excellent remedy in bleeding piles, especially where there is severe pain in the small of the back. It may be followed with advantage by Hepar-s. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful every six hours. Sabina is also a valuable remedy, especially in bleed- ing piles, with discharge of bright, red blood, or blood mixed with mucus. * For general directions as to the administration of remedies, see page 12. 156 AFFECTIONS OF STOMACH AND BOWELS. Dose. —Same as Belladonna. Arnica—when the tumors are swollen and painful to the touch, and also where there is pain in the back. Dose.—Three drops in a glass half full of water and give a table- spoonful every four hours. Bathe the parts three times a day with a mixture of ten drops of Arnica to two tablespoonfuls of water. Hamamelis—Is a very valuable remedy especially in bleeding piles attended with pain. Dose.—Same as Arnica both in its external and internal adminis- tration. Pulsatilla—is of benefit where there is blood and mucus discharged with the fasces, with painful pressure on the tumors. Dose.—Give the same as Nux. Much relief may frequently be obtained by throwing up with a syringe from time to time a small quantity of cold water. Capsicum, Carb.-v., and Arsenic, are also useful in flowing piles. In old and distressing tumors, Nit.-ac, Mur-ac, Calcarea, lycopodium are frequently indicated. The various forms of this disease, and its combination with other difficulties, render it advisable, particularly in chronic cases, to employ the skill and experience of the physician, rather than trust to home treatment. AFFECTIONS OF THE WINDPIPE AND CHEST. 157 CHAPTER IV. AFFECTIONS OF THE WINDPIPE AND CHEST.* We now proceed to the investigation of a class of dis- eases exceedingly common in our variable and ever- changing climate, and which, neglected, often lead to serious consequences. In the chapters on Anatomy and Physiology I have shown the important part which the organs connected with respiration perform in the eco- nomy of life, the beauty and regularity with which they perform their functions in health, and the necessity of their being well developed, vigorous and active, unclog- ged in their movements, to secure beauty of form and maintain a healthy and harmonious equilibrium in the system. A slight irritation of a certain portion of the wind- pipe may destroy the music of the sweetest voice, and the seeds of that wasting consumption, which has sadden- ed so many a hearth and blighted so many sweet buds of promise, may be sown by a slight cold, at the time easily removed, but neglected, planting its roots so deep and strong as to sap the fountains of life, and lay its victim in the grave. Serious disturbances of the chest of course require the aid of the careful and skilful physician, but many of the incipient symptoms are so plain, that not unfre- quently a few doses of medicine, properly selected by the patient, may remove the whole difficulty, and pre- vent the development of what might have been a serious disease. For the sake of convenience, we shall divide the dis- eases treated in this chapter into two classes. * For a description of the organs included under this head, see plate 2, fig. 4, and plate 5. Also Anatomy. 158 AFFECTIONS OF THE WINDPIPE AND CHEST. 1. Affections of the Windpipe and Lungs. 2. Affections of the Heart. 1. AFFECTION OF THE WINDPIPE AND LUNGS. HOARSENESS. Aphonia. Raucitas. When this difficulty, which is an affection of the mu- cous membrane of the larynx exists, as it often does in connection with other diseases, such as, measles, in- fluenza, and severe distarbances about the chest and windpipe, its treatment will be given in connection with those diseases under their appropriate heads. When however it exists alone or combined with cough, or, it runs into a chronic form, thus paving the way for more serious disturbance, of course, specific treatment is required. Treatment.* Pulsatilla.—Where there is almost complete extinc- tion of the voice (Aphonia), loose cough, and discharge from the nose of thick yellow mucus. It is frequently necessary to follow it by Sulphur. x Nux-vom. is a prominent remedy, and particularly in- dicated where the hoarseness is worse in the morning and is accompanied with dry, rough, fatiguing cough. (See Influenza.) Mercurius is particularly useful after Nux, or Pulsa- tilla, and where there is profuse perspiration, especially at night, a hoarse, rough voice, and a burning, tickling sensation in the larynx. (See also Influenza.) Capsicum.—Obstruction with sensation of tickling in the nose; violent cough, worse towards evening, and pain in the head or abdomen; smarting in the throat. Rhus.—Where there is a sensation of rawness in the * For general directions as to the administration of remedies, see page 12. HOARSENESS. 159 throat and chest, chilliness, pain in the limbs, hoarse- ness, worse after talking, difficult breathing, with sneez- ing, and watery discharge from the nose. It alternates well with Bryonia, a dose three or four hours apart. Drosera,— Hoarseness with low, hollow voice. Chamomilla.—Particularly in children, with accumu- lation of mucus in the throat; cough, worse at night, and often toward evening; slight fever and restlessness. Sambucus.—Deep, hollow cough; oppression of the chest, &c. Sulphur.—Particularly in cold, damp weather; rough- ness, and scraping in the throat; watery discharge from the nose in obstinate or chronic cases, where the voice is almost extinct. It will be frequently indicated after Pulsatilla or Mercury. Hepar-sulph. is particularly indicated where mercurial preparations have been used; where the cough is worse at night and accompanied by a sensation of soreness in the throat and chest. Causticum, which is also indicat- ed by the above symptoms, may be given, if, after four or five doses of Ilepar s. no relief is obtained. Carb. v.—In chronic hoarseness, aggravated by talk- ing, and worse in the morning and evening, also in wet weather. Phosphorus is a valuable remedy, particularly in chro- nic hoarseness, where there is a dryness in the throat and chest, sometimes with sensation of soreness, and voice almost extinct. It is not unfrequently indicated in alternation with Carbo-v. or Hepar-s. Administration.—In acute cases the remedy should be taken every four or five hours, until five or six doses have been taken, when if no relief is obtained, another remedy should be selected. In chronic cases, a dose every six or twelve hours, may be given, changing the remedy in three or four days, if no improvement is perceptible. 160 AFFECTIONS OF THE WINDPIPE AND CHEST. Two drops, or eight globules, in a tumbler of water, a tablespoonful at a dose ; or a powder, or six globules, dry on the tongue. Diet and Regimen.—The wet bandage, (See Index) around the throat at night will materially aid the cure. The food should be plain and simple, abstaining from spices and wines. INFLUENZA. There are but few persons in our ever-changing cli- mate, who have not had practical experience of the sen- sations produced by this disease. It very commonly, though not always, exists as an epidemic, frequently prevading a whole community. For the sake of clearness and convenience, we divide it into two varieties. 1. Coryza* or cold in the head. 2. General Influenza. 1. COLD IN THE HEAD. CORYZA. Diagnosis.—The difficulty may commence with shiver- ing, and feverish sensation, and is accompanied with pain in the head, particularly over the eyes and about the root of the nose, obstruction of, or running at the nose, watering of the eyes, sometimes with pain and redness. If these symptoms are not checked, the irri- tation may travel downward to the larynx and lungs, giving rise to other varieties of influenzas and colds, most of which commence in this way. Treatment.—If taken promptly, a few doses of Cam- phor will generally alone be sufficient to produce a cure. Two drops may be mixed with four tablespoonfuls of water, and one spoonful taken every hour. Next to Camplwr, Arsenic is the prominent remedy. It is indi- cated by obstruction of the nose, accompanied by, or » For general directions as to the administration of remedies, see page 12. COLD IN THE HEAD. C0RYZA. 161 in alternation with, profuse watery discharge, some- times with burning in the nose and excoriation of the adjacent parts. Dose.—A powder, or six globules, every two or four hours, ac- cording to the severity of the symptoms. Mercury is of great value, where is frequent sneezing, profuse watery discharge, swelling, redness, and exco- riation of the nose, itching or aching pain, on pressing the nose; pain in the limbs, restlessness, shivering, or feverish heat and thirst. Frequently indicated in alter- nation with Nux. Dose.—Same as Arsenic. Nux-v. is indicated, where there is dryness with ob- struction of the nose, headache with heaviness in the forehead, or shooting, tearing pains; running of the nose in the morning, with dryness in the evening or night; constipation and sensation of weariness. Dose.—Same as Arsenic. Ilep.-s.—Particularly if Mercury has not produced re- lief, or the patient has before been drugged with calo- mel ; also where cold air renews the difficulty, causing headache ; or the cold only attacks one nostril, and the headache is made worse by movement. Dose.—Same as Arsenic. Pulsatilla.—Loss of appetite, taste and smell; secre- tion of thick and offensive mucus; sneezing; heaviness and confusion, of the head, particularly in the evening, in the warmth of the room, with obstruction of the nose; better in the open air. Dose.—Two drops, or twelve globules, in a tumbler of water a tablespoonful once in four or six hours. Chamomilla.—Particularly useful in children, either alone or in alternation with Belladonna or Pulsa- till i. After suppressed perspiration ; heaviness of the head with stupor; shivering with heat; acrid and smart- ing mucus in the nose. Dose.—Same as Pulsatilla. 162 AFFECTIONS OF THE WINDPIPE AND CHEST. Sulphur.—Obstruction and dryness of the nose, or pro- fuse secretion of thick, yellowish and puriform mucus; sneezing, loss of smell, &c. Dose.—A powder, or six globules, every six hours. Euphrasia is useful where the eyes are red and wa- tery. Dose. -Same as Pulsatilla. Belladonna.—Redness and burning in the nose; pain in the head, aggravated by movement; give same as Pulsatilla, Administration.—Where persons are constantly liable to this affection on the slightest exposure, it can often be prevented by bathing the head and neck every day in cold water. If the discharge from the nose should suddenly stop and be attended with headache, Aconite, three or four doses, given at intervals of three hours, followed, if ne- cessary, by Pulsatilla, will produce relief. Should difficulty of breathing be developed, Bryonia and Ipecac in alternation, three hours apart, may be given, followed by Arsenic, if no relief is obtained after two doses of each have been taken. 2. GENERAL INFLUENZA. In addition to the symptoms mentioned under Coryza, there is more or less shivering, alternating with flashes of heat, violent headache, drowsiness, rheumatic pains, difficult breathing, generally cough, more or less severe, painful and red eyes, and general debility. Treatment.—In the commencement of the disease Camphor is the prominent remedy, a drop of which may be given every hour, until three or four doses have been taken. Arsenic is also strongly indicated in the first stage of the disease, three or four doses of which may be given at intervals of two or three hours. GENERAL INFLUENZA. 163 Mercury is particularly useful, where head symptoms preponderate.- There is sneezing, running at the nose, rheumatic pains, or red, watery eyes, sore throat, loose cough, slimy diarrhoea, with straining. Dose.—A powder, or six globules, once in two or four hours. Stibium.—Dry and hard cough, sometimes with rat- tling in the chest, alternation of shivering and flashes of heat, frequently with pain in the forehead, tightness about the nose, and pressing pain over the eyes. Should there be considerable pain about the chest, hoarseness and difficulty in drawing a long breath, Phosphorus may be alternated with the Stibium, two hours apart. Dose.— Same as Mercury. Belladonna may be alternated with Mercury, where there is soreness of the throat, pain in the head, rheu- matic pains, &c, given two or three hours apart. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose. Nux-vom.—Hoarse, hollow cough, excited by tickling in the throat, accompanied with headache, pain in the lower part of the back, constipation, obstruction of the nose, and sensation in the chest of excoriation. Dose.—^ powder, or six globules, morning, noon and night. Causticum.—Particularly where Nux seems indicated, yet does not produce relief, and where the cough is worse at night, with severe excoriating pain in the chest, and the aching pains in the limbs are aggravated by movement. Dose.—One drop in a tumbler of water a tablespoonful, or six globules on the tongue, at a dose. Pulsatilla.—Cough worse on lying down; discharge from the nose of thick offensive mucus, loss of appetite and insipid taste. Frequently required in alternation with Mercury. Dose..—Same as Causticum. Stannum.—In protracted cases with easy expectoration, 164 AFFECTIONS OF WINDPIPE AND CHEST. Dose.—A powder, or six globules, morning and night. Ipecac, when the cough is accompanied with vomit- ing, or where the attack is followed by difficulty of breathing. A powder, or six globules, every two hours until-better. (See also "Coughs") COUGH. Cough may be occasioned by a slight irritation of the air-passages and be simply catarrhal, or it may exist only as one of a group of symptoms, indicating a deep-seated disease of the lungs and throat, or it may be sympathetic, produced by a derangement of some other important viscera. Thus, we not only have coughs produced by the various diseases of the chest, but occasioned by teething, dys- pepsy, worms, growing too fast in children, and various other causes. The character of the cough, and the group of symp- toms connected with it, are to be our guide in detecting the seat and severity of the disease, and consequently the appropriate remedy. The treatment of cough, when it is developed in con- nection with derangement of important viscera, will be given in connection with those diseases in their appro- priate place. We shall here give the indications for several of the prominent remedies, where cough is the principal symptom. Aconite*—Violent short cough, witnfeverish heat and sometimes pain in the chest and difficult breathing. Stibium.—Deep, hollow cough or loose cough with rattling in the chest, rapid and difficult breathing, fever- ish sensation; cough with nausea or vomiting. In alter- nation with Phosphorus where there is much pain about the chest. (See Pneumonia. See also Influenza and Croup.) For general directions as to the administration of remedies, see page 12. COUGH. 165 Ipecac—Spasmodic coughs, frequently accompanied with nausea and vomiting, worse at night, or in cold air; oppression of breathing, as if the lungs were filled with mucus; and in children violent coughing until the face becomes livid and the body stiff. (See Hooping Cough.) Hepar-s —Dry, hoarse, or deep cough, frequently ex- cited by talking, stooping, or much exertion; worse at night and aggravated by exposure of any part of the body to the cold. Generally in alternation with Phos- phorus. Phosphorus.—Cough excited by lying on the left side; dry cough from tickling in the throat; hoarseness and pain in the chest as from excoriation. (See Pneumonia.) Carb.-v.—Dry, spasmodic cough, sometimes producing vomiting, aggravated by damp, cold weather, and worse in the morning or towards evening, accompanied with a burning excoriating pain in the chest. (Alternate with Phosphorus.) Nux-vom.—Dry, hoarse, fatiguing or spasmodic cough, worse in the morning and during the day. Oppression of the chest in the night, and on lying down, with a feel- ing of heat and dryness in the mouth. Cough excited by tickling, scraping sensation with feeling of rough- ness or rawness in the throat, accompanied with hoarse- ness, severe pain in the head, and bruised sensation about the stomach. Sometimes aggravated by eating, or meditation, and not unfrequently producing vomiting. Particularly beneficial in persons of an energetic, san- guine temperament. Sulphur.—Particularly in obstinate cases, where the cough is dry, frequently excited by food or a deep in- spiration, worse during the night. Cough with expec- toration of thick, or fetid mucus, or pus, of a salt or sweetish taste; headache, pain in the chest, abdomen, and loins. Chamomilla.—Dry cough, particularly in children, ex- 166 AFFECTIONS OF WINDPIPE AND CHEST. cited by constant tickling in the throat and chest, worse at night, or in the morning and evening, and aggravated by talking; cough during sleep, sometimes with fever, and so violent as to threaten suffocation. Fretfulness, cough after crying, or a fit of passion; fever towards evening. Bryonia.—Dry catarrhal cough, particularly in winter, and on coming into a warm room, excited by irritation in the throat, and frequently accompanied with shiver- ing, followed by fever, and rheumatic or aching pains in the head and limbs. Dry, nervous cough, or loose cough with yellowish expectoration. Rhus.—Short, dry cough, excited by tickling in the chest, worse in the evening before midnight, and attend- ed with restlessness and shortness of breath ; cough with shooting pains in the side and chest, sometimes with ex- pectoration of blood. Belladonna.—Violent spasmodic cough; dry, short, and hacking cough at night, renewed by the slightest movement; dry cough, almost without intermission, day and night, with redness of the face, and sensation as if something were in the windpipe ; pains in the abdomen, neck, and head; frequently an attack of coughing, followed by sneezing. Hyosciamus.—The symptoms indicating this remedy are similar to Bdladonna, which it can follow, if that fails to produce relief. I have found more benefit, how- ever, from Ilyoscietmus, where the cough is incessant, worse on lying down, and seems to be excited by a tick- ling in the throat, sometimes with rattling. Capsicum.—Cough, worse towards evening and in the night, severe pain in the head, as if it would burst, ach- ing throughout the body, and an aching, smarting sensa- tion in the throat, as from eating pepper. Ignatia.—Particularly in persons of a mild or variable temperament. Short hacking or shaking cough as from COUGH. 167 the tickling of a feather. Cough, worse after eating, on lying down at night, or rising in the morning. Dry cough, with running at the nose. Mercury.—Hoarse, catarrhal cough, with watery dis- charge from the nose, or diarrhoea, and frequently bleed- ing at the nose. Dry cough, worse towards evening or in the night, increased by talking, and sometimes at- tended with retching and expectoration of blood. Drosera.—Deep, hollow, hoarse cough. Dry, spas- modic cough, worse on lying down and at night, aggra- vated by laughing, and sometimes followed by retching and vomiting. (See Hooping Cough.) Stannum,—Cough with expectoration of a sweetish or saltish taste, attended with debility and perspiration. Dry, shaking cough, worse at night, and increased by speaking or laughing. (See Consumption) Dulcamara.—Loose cough after taking cold; cough excited by drawing a deep breath, worse when at rest. Sometimes expectoration of blood. Amm.-carb —Rough voice ; dry, tickling, suffocating cough, worse in the morning and in damp, cold weather, accompanied with sensation of burning behind the breast-bone. Pulsatilla.—Severe shaking cough, worse at night, and frequently attended with retching and vomiting. Loose cough with aching in the chest, hoarseness, cold in the head, and expectoration of bitter mucus. (See Influenza.) C/iina.—Asthmatic cough at night, with pain in the chest, or cough from ulceration of the lungs, or loss of blood. (See Consumption.) Arsenic —Asthmatic cough and breathing; dry cough worse at night, and sometimes with bloody expectora- tion, and a burning sensation over the body. (See Asthma.) Sipia.—Dry, spasmodic cough, worse at night, or on 168 AFFECTIONS OF WINDPIPE AND CHEST. lying down, and sometimes attended with nausea and vomiting. It is particularly useful in persons of a scro- fulus constitution, and in chronic cough with thick or puriform expectoration. Cina.—Principally in children. Dry, spasmodic cough. pale face, moaning, restlessness, and crying. (See Worms.) Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose : or a powder, or six globules, on the tongue. In recent cases the remedy may be given once in from two to four hours, until five or six doses have been taken, then wait four or five hours, and if no relief has been pro- duced, select another remedy. In cases which have assumed a chronic character, a dose once in six or twelve hours will be sufficient. Diet and Regimen.—-The same as in chronic diseases, unless considerable fever is present, when abstain from meats and fatty food. The predisposition to cold can often be overcome by bathing freely every day with cold water. Cough should be taken in hand at once, as cases are by no means rare, where neglected, it has laid the foundation of disease, which has mocked the efforts of human skill to eradicate. For Croup and Iloojnng-Cough, see Diseases of Children. PLEURITIS. Pleurisy. By consulting the chapter on Anatomy, (See Anatomy and also plate 5) an idea will be obtained of the position of the lungs and their investing membrane, which will aid materially in a correct understanding of the charac- ter of this disease. Diagnosis.—Pleurisy consists of an inflammation of the serous membrane covering the lungs, which is also re- flected over the inner wall of the chest, forming as we have already explained a shut sack. Thus it will per- pleuritis. 169 ceived, one part of the membrane covers the soft and compressible lung, which is suspended in the chest, the firm walls of which are lined with the other part of the membrane. These opposed surfaces freely moving upon each other, of course when inflamed produce a train of symptoms not only exceedingly painful, but unless promptly and carefully treated often highly dangerous. This inflamed membrane may pour out from its dis- eased surface a large amount of serum, or a watery fluid, or coagulable lymph, pus or blood." Thus the pulmonary pleura, or the membrane which invests the lungs, may by this coagulable lymph be firmly glued to the costal pleura or the membrane which covers the walls of the chest, thus attaching the lungs to the chest, preventing all lateral movement between them and obliterating the pleural cavity. Or the lung may be compressed to a very small compass, and the chest distended by the large amount of serous fluid, sometimes amounting to several pints, which has been poured out by the inflamed mem- brane into the pleural cavity, or one portion of the pleura may be united by coagulable lymph in some places, and separated by the effused fluid in others. Diagnosis.—The pain, which is frequently preceded by chill and fever, generally commences in a spot just below one or other of the breasts, from whence it radiates to other parts, but is sometimes felt in other places, as along the sternum, beneath the collar bone, and not unfrequently extends over the whole side of the thorax. The pain is sharp and stabbing, as if at each inspiration a sharp instrument were thrust into the chest at a par- ticular point, the patient is unable to take a long breath, being able to fill the lungs only to a small extent, the breath is quick and hurried, the face flushed, the skin hot, the pulse feverish. Pressure on the side increases the pain; the patient is at first unable to lie on the side affected, and as the disease advances, if much serous ef- AFFECTIONS OF THE WINDPIPE AND CHEST. 170 fusion has taken place, he is also unable to lie on the other side, from the fluid passing round to the side, compressing the healthy lung, so as to produce suffoca- tion. The urine, at this stage, is generally offensive, and has a sediment. Cough is also present, small, dry, half-suppressed and ineffectual; the expectoration, if any, is very slight. Should much frothy mucus be ex- pectorated, the disease is complicated with bronchitis, and if rust colored sputa be brought up, it is compli- cated with pneumonia. Causes.—The most common cause of pleurisy is exposure to cold and dampness. It is, however often occasioned by mechanical violence or by the acciden- tal extension of disease from other parts. Thus it may be excited by the splintered ends of a broken rib, by a wound penetrating into the chest, or by a perforating ulcer of the pulmonary pleura, the extension of a tuber- cular excavation. Of course the cause should be taken into consideration in the treatment of the disease. Treatment.*—Aconite and Bryonia are the two great remedies in this disease. If the attack is violent, they may be given two or three doses of each in alternation, twenty or thirty minutes apart, afterwards one hour apart, gradually increasing the intervals to two or three hours, as the symptoms become better. Two drops of the tinc- ture, or twelve globules, may by mixed in a tumbler of water, and a tablespoonful given at a dose. After the pain has been removed by Bryonia, or the fever still continues, notwithstanding the use of Ac-mite, a few do- ses of Sulphur will generally complete the cure. Sulphur may also follow the above remedies, if after twenty-four hours, no relief has been obtained by them, or if the disease is complicated with pneumonia, and there is dan- ger of solidification of the lung taking place. A powder or three globules may be given once in two or three hours * For general directions as to the administi ation of remedies, see page 12. 171 PLEURITIS. Mercurius is of great benefit, where the fever has been subdued, but the pain and shortness of breath still continue, and the patient is becoming exhausted by co- pious night-sweats. Dose—Give a powder, or six globules once in two or three hours. If during the night the patient should by very restless and sleepless, a few doses of Coffea or Belladonna- given at intervals of one hour will generally produce relief. Arsenicum is of use if considerable effusion has taken place, and there is prostration of strength, impeded and asthmatic respiration. Dose.—A powder or three globules, once in two or three hours. Pleurisy, as we have already said, may be complicated with pneumonia (pleuro-pneumonia), or with bronchitis, in which cases Ilepar-s., Phosphorus, Carb.-v., Belladonna, Rhus, laLiesis, Sulphur, Lycopodium, China, or Sepia may be indicated. Consult also those diseases. The external application of the wet bandage over the painful spot will also be of benefit. Diet and Regimen.—As in fevers. PLEURODYNIA. False Pleurisy. Diagnosis.—Notwithstanding this disease is often mis- taken for pleurisy, with a little care it can be very readily distinguished. It is a rheumatic affection of the inter- costal muscles, generally preceded .by pains in the neck and shoulders, and accompanied with but little if any fever or thirst. The pain is often severe in the side, but the cough is slight, only hard pressure between the ribs increases it, while in pleurisy the side is exceedingly sen- sitive to a slight touch, and the cough is dry and painful. Treatment.—Arnica, two or three doses, given at in- tervals of three hours, will often be sufficient to produce a cure. If then, relief is not obtained, the Arnica may be alternated with Pulsatilla, two hours apart, until three or four doses of each .have been taken. AFFECTIONS OF THE WINDPIPE AND CHEST. 172 Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose. Bryonia.—Where the pains are sharp and cutting, exceedingly violent during inspiration. Dose.—Same as Arnica, give every two or three hours. Nux.-v.—Shooting pain, with great sensibility of the external parts of the chest to the touch, aggravated by movement and by deep inspiration. Dose.—One drop, in a tumbler of water, a tablespoonful given ; or a powder or three globules on the tongue. Panunculus-b.—I have frequently found this remedy very efficacious, where the pains were sharp and cutting, increased by movement, and where other remedies had failed to produce a beneficial result. Dose.—Same as Bryonia. External application of warmth, in the form of hot cloths, or even a cloth wrung out in Alcohol, and slightly sprinkled with Cayenne pepper, will frequently produce relief. PNEUMONIA. Inflammation of the Lungs. This disease generally commences with chilliness, fol- lowed by heat. The breath is frequent, difficult, pain- ful and anxious, and where both lungs are inflamed, per- formed through the action of the abdominal muscles and the diaphragm. Pain in the chest on taking a long breath. Cough dry and deep, or quick and spontaneous, or excited by deep breathing, talking or swallowing. Expectoration tough, sticky, at first partially transparent and slimy, afterwards bloody, saffron or rust colored. The patient dislikes to talk, does not wish to be disturb- ed, and generally prefers lying on the back. Sometimes the face of the patient becomes very red, the head pain- ful, the tongue parched, the skin dry and hot, accom- panied with excessive thirst. The fever after a time may assume an intermittent type, disappearing in the morn- PNEUMONIA. 173 ing and coming on in the afternoon with renewed vio- lence. Or it may assume a typhoid form, accompanied with prostration, low muttering delirium, &c. (See Typhoid fever.) When the breathing becomes easy, the skin moist, the expectoration natural, the patient may be looked upon as in a fair way to recovery. Causes.—Sudden changes of temperature, exposure to cold, north or northeast wind, sudden cooling after vio- lent exertion, mechanical injury, or inhalation of acrid or noxious gases. Treatment.*—The prominent remedies are Aconite, Stibium, Bryonia and Phosphorus. Aconite is the prominent remedy, during the chilliness and fever, especially if the pulse is quick, the pain in the chest violent and the respiration oppressed. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in one or two hours. Bryonia.—Particularly where the difficulty has been occasioned by exposure to cold or violent muscular ex- ertion. There is oppression and pain in the chest, ag- gravated by movement, with constant desire to cough. The cough is generally loose, and the expectoration white, slimy and streaked with blood, or of a brick-dust color. There is often rheumatic pain about the extre- mities, thirst and constipation. It is frequently indicat- ed in alternation with Aconite. Dose.—Same as Aconite. Belladonna will be a valuable remedy, where there is congestion of blood to the brain, delirium and danger of typhoid symptoms. Generally in alternation with Aco- nite, one hour apart. Rhus.—Great restlessness, anxiety and palpitation of the heart. If no relief follows the administration of Aconite and Bryonia, and the disease passes into the second stage, * For general directions as to the administration of remedies, seepage 12. 174 AFFECTIONS OF WINDPIPE AND CHEST. Stibium, and Phosphorus should be administered, gene- rally in alternation, one or two hours apart. The Stibium is indicated by great oppression of breathing, cough, with much mucous rattling, profuse expectoration, dry, hard cough, and sometimes nausea. Phosphorus symptoms are severe sticking pains in the chest, excited or aggra- vated by breathing or coughing, shortness of breath, dry cough and rust-colored expectoration. Where the attack is severe, Pliosphorus is frequently required at the com- mencement of the disease, either alone or in alternation with Aconite or Belladonna. Dose.—A powder, or six globules, may be given every two or three hours. Should typhoid symptoms set in, which are character- ized by extreme restlessness, delirium and stupor, quick and irregular breathing, thread-like pulse, rattling of mucus and prostration of strength, the disease is assuming an alarming character. Phosphorus is here also an invaluable remedy; should there be indications of solidification of the lungs, de- tected by the greater difficulty of breathing, depression of the mental faculties, bland delirium, grasping at flocks, rapid prostration, feeble pulse, difficult cough, short and difficult breathing, with oppression and an- guish. Dose.—A powder, or three globules, once in two or three hours. China.—Where the patient has been weakened by a loss of blood, or when there is palpitation of the heart on breathing, or coughing, stitches in the sides and chest, and great weakness. Dose.—Three drops in a tumbler of water, a tablespoonful every three or four hours. Sulphur is beneficial in rendering the system more susceptible to the action of remedies. Where the appro- priate remedies fail to produce an effect, a few doses of Sulphur may be given, returning afterward to the pre- vious remedies. PNEUMONIA. 175 Dose.—A powder, or six globules, once in three or four hours. Veratrum.—Small, weak pulse, cold extremities; vo- miting, diarrhoea, rapid prostration of strength and de- lirium. Mercurius may be given if there are copious night- sweats, given every four hours. Bry., Rhus, Ilyos., Op., Bill., Phos.-ac, Loch., and Lye. are also sometimes indicated in this stage of the disease. For particular indications, see Typhus Fever. Pneumonia unless properly relieved, may become chronic or terminate in consumption. Mercury, Sulphur or Stannum will generally be sufficient to break up this chronic tendency. See also consumption. Diet and Regimen as in fevers. PNEUMONIA NOTHA. This variety of Pneumonia, sometimes called false pneumonia, more generally affects old people, and not unfrequently terminates in complete paralysis of the lungs. The symptoms at first are those of an ordinary cold. The cough is generally moist, the expectoration white, yellow and slimy, sometimes streaked with blood; pressure, stinging and burning sensation in the chest, in- creased on going up-stairs, or turning to either side. The fever, if present at all, is generally slight. Treatment.—Arnica is a valuable remedy, where there is a bruised sensation in the chest, slight cough, with blood-streaked, slimy expectoration. Dose.—Three drops in a tumbler of water, a tablespoonful every three or four hours. Bryonia.—Increase of symptoms at night, great heat in the chest, violent racking cough and expectoration of dingy-redclish mucus. Veratrum and Ars.—If there are cold extremities and rapid prostration. 176 AFFECTIONS OF WINDPIPE AND CHEST. Belladonna.—Flushed face, short, dry cough and diffi- cult breathing. Stibium.—If there be a great accumulation of mucus in the bronchial tubes. Dose.—If the symptoms are urgent, give the above remedies, pre- pared like the Arnica, every half an hour increasing the intervals to three or four hours. Phosphorus and Stibium may also be indicated. See Pneumonia. For other symptoms see also pneumonia. Diet and Regimen.—If much fever is present, the same as in Pneumonia, otherwise articles of a more nourishing character, such as, broth, &c. LARYNGITIS. Cynanche Laryngia. This disease in its acute form requires prompt and energetic treatment, as it is frequently exceedingly dangerous, running its course with alarming rapidity. It has numbered among its victims many distinguished men, among the rest Washington. Taken at its com- mencement, it is generally easily relieved by skilful ho- moeopathic treatment. It is occasioned by inflammation of the parts composing the larynx, and particularly of the mucous membrane covering the laryngeal cartilage, including the epiglottis. Diagnosis.—There is a sore throat, and on looking into it a redness of the fauces and uvula is perceptible, not enough however to account for the excessive restlessness and anxiety, and the great difficulty of deglutition. To the difficulty of deglution is shortly added great difficulty of breathing. The respiration is attended with a throt- tling noise, and the act of inspiration is protracted and wheezing, as if the air were drawn through a narrow tube. The distress seems to be situated in the vicinity of the Pomum Adami or Adam's apple. If there is cough, it is with a harsh, husky and abortive sound. The LARYNGITIS. 177 voice is hoarse or sinks to a scarcely perceptible whisper. The face is flushed, the skin hot and dry, the pulse hard. As the disease advances, the distress increases, the coun- tenance becomes pale, or livid, anxious and ghastly; the eyes protrude, the restlessness is extreme, the diffi- culty of breathing becomes greater, there is a constant desire for air, and unless relieved, death by strangulation speedily ensues. This disease occurs in both sexes, and at all ages. Causes.—It is generally occasioned by exposure to cold, or to cold and dampness. It is sometimes produced by mechanical violence or chemical injury done to the la- rynx, and not unfrequently by children attempting to swallow boiling water from the spout of a tea-kettle. Treatment.—The external application of the wet ban- dage is often advisable. The severity of this disease, and the rapidity with which it runs its progress, renders it highly important that, if possible, it should be treated by a skilful physician. Aconite is indicated, when the symptoms of inflamma- tory fever first declare themselves. It may be given, until the febrile symptoms abate, or until other symp- toms set in. Dose.—Two drops or twelve globules, in a tumbler of water., a tablespoonful every hour or two hours. Spongia follows well after Aconite, and is indicated as soon as the breathing becomes shrill, and the pain and sensibility in the upper part of the windpipe becomes more decided. There is also an increase of hoarseness and difficulty of articulation. Dose—Same as Aconite. Ilepar-s. may follow Spongia, when that remedy ceases to produce a good effect; or it may follow Aconite, when, notwithstanding the administration of that remedy, the febrile symptoms remain unabated. I have often found 8* 178 AFFECTIONS OF WINDPIPE AND CHEST. it advisable to alternate Spongia and Hpu/'-s., one or two hours apart. Dose.—A powder, or six globules, every one or two hours. Merc-Proto-Iod., or Mercurius may be given, when the throat is highly inflamed and the glands swollen; should there be a secretion of viscid or ropy mucus, the Mercurius may be alternated with Kali-bichrovn., a powder or six globules one hour apart. Bromine will prove beneficial, where there is hoarse- ness, extreme sensitiveness of the throat, dry and harsh cough, sometimes almost suffocative. It may be given once in two or three hours. Stibium is also a prominent remedy, where the symp- toms commence with severity; hoarseness, dry, harsh, and ringing cough, sometimes almost suffocative. A powder may be given every hour. Belladonna will likewise prove beneficial, where there are spasms in the throat, causing an inability to swallow liquids; the throat on looking into it presents a swollen and highly inflamed appearance. Dose.—Same as Aconite. Diet and Regimen.—Same as in fevers. BRONCHITIS This is an inflammation of the mucous lining of the Bronchia, or air-tubes of the lungs. It presents itself under two forms: the acute and chro- nic ; both of which will be treated separately. 1. Acute Bronchitis.*—This form of disease very often succeeds Coryza, or cold in the head, although in those whose lungs are highly susceptible, it may commence at once in the bronchia. At first a feeling of roughness is felt in the trachea, which soon amounts to such a degree * For a description of the windpipe, see plate 5. For general directions as to the administration of remedies, see page 12 BRONCHITIS. 179 of titillation, as to excite frequent cough, which is at first dry and hard. Hoarseness is also present as well as uneasiness of breathing, tight feeling across the chest} frequently amounting to pain, particularly on coughing. There is generally fever, pain in the limbs, shivering and rapidity of the pulse. The cough increases in se- verity and is accompanied with expectoration of froth or viscid mucus, which after a time may become streaked with blood. When the disease terminates favorably, the first symp- toms of improvement are, greater freedom of breath- ing, remission of fever, and expectoration diminished in quantity, and becoming thicker. Where it terminates unfavorably, the breathing becomes more and more dif- ficult, rapid prostration and collapse takes place. Treatment.*—As a preventive the free, daily external use of cold water is highly beneficial. Aconite.—During the inflammatory stage of the dis- ease, and where there is obstructed respiration, dry and frequent cough, excited by a tickling sensation in the throat and chest, hoarseness, hot and dry skin, with rapid pulse. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful may be taken every three or four hours. Sometimes Stibium is preferable, a powder given at the same intervals. Spongia and Ilepar-s., generally in alternation after the use of Aconite, when there is hoarseness, burning, tickling in the larynx, anxious, laborious respiration, hollow dry cough, worse towards evening; or cough with scanty expectoration viscid, and ropy. Dose.—Of the former one drop, or twelve globules, in a tumbler of water, a table-spoonful at a dose; of the latter a powder, or three globules, on the tongue Give three or four hours apart. Phosphorus.—This is a very prominent remedy, par- * For a description of the windpipe, see plate 5. For general directions as to the administration of remedies, see page 12. 180 AFFECTIONS OF THE WINDPIPE AND CHEST. ticularly after the inflammatory symptoms have sub- sided, and also where the disease assumes a chronic cha- racter, or where there is danger of the lungs being in- volved. There may by oppression of breathing, hoarse- ness, dry cough, pain in the throat and chest. Aggravat- ed by talking. Dose.—A powder, or three globules, every in three or four hours. Belladonna is frequently useful, where there is violent pain in the head, soreness of the throat, short and rapid respiration, dry and fatiguing cough, worse at night, and oppression of the chest. Dose.—Two drops, or twelve globules, in a tumbler of water; a tablespoonful once in two or three hours. Among the other remedies useful in this disease, we may enumerate Lack., Bry., Puis., Ipecac, Ars., Sulph. and Mercury. See Materia Medica. 2. Chronic Bronchitis.—This variety of the disease may follow the acute form, or it may steal on gradually, until, before the patient is really aware of his situation, he is fully under its influence. In its advanced stage it is nearly as serious a disease as phthisis, to which it not unfrequently leads, and with which its symptoms cor- respond so closely, that there is sometimes difficulty in distinguishing between them. As this disease is some- what long in duration, and generally requires the treat- ment of a judicious physician, it will be only necessary to mention here some of the prominent remedies; among them we may enumerate : Phos., Caust., Ilepar-s., Stan., Sep., Lye, Bar.-c, Lath,, Ars., Sil., Con,, Prot.-iod-hyd., Nit-ac, Sulph. and Calcarea. See also Cough. HAEMOPTYSIS. Haemorrhage from the Lungs. The hawking or coughing considerable quantities of blood, or the welling up of the crimson current, as from a fountain, often produces such consternation in there minds of the patient and surrounding friends, as to ren- HJEM0PTYS1S. 181 der them entirely unfit for those prompt and decided steps so essential to safety, and upon which, in fact, the life of the patient may hang. The haemorrhage arising from the nose, mouth, or throat may create unnecessary alarm, and tend to the supposition, that it is really from the lungs. A very slight inquiry into the attending cir- cumstances will be sufficient to detect the difference. Diagnosis.—It will only be necessary for us here to speak of two kinds of haemorrhage. First, That which depends on congestion to the lungs, and Second, that occasioned by consumption, where ulcera- tion gradually consumes the lung, and in its progress causes the rupture of some of the larger blood vessels. This latter variety not unfrequently dashes to earth de- lusive hopes, and startles the patient with the alarming fact, that a disease, the very name of which excites a thrill of terror, is weaving its meshes around the foun- tain of life, and drawing its victim swiftly into the arms of death. It arouses him to the necessity of either doing something, if it be nothing more than a change of air, or be content to die. The first variety mentioned, or that which depends on congestion of blood to the lungs, may be occasioned by lifting, violent exertion, mechanical injury, or the inhal- ing of poisonous gases or breathing an air filled with injurious dust, as metal filings, or the dust from lime, tobacco, &c, or it may be constitutional, or produced by rapid changes of temperature, or the abuse of spirituous drinks. It is frequently occasioned by suppression of blood from other organs. Thus we find it caused by the sudden disappearance of the piles, in ladies by the stop- page of the menses, and during pregnancy, by the pres- sure upward produced by the enlarging womb. Hemor- rhage more frequently occurs between the ages of 16 and 40. 182 AFFECTIONS OF STOMACH AND BOWELS, The haemorrhage therefore arising from simple con- gestion of the chest need excite but little alarm. The most dangerous of this variety of haemorrhage is the apoplectic ; when the symptoms of an apoplectic fit are present, the patient looses his consciousness and bloody froth is seen issuing from the mouth. Treatment.*—In severe cases, perfect repose in a half sitting, half lying position is essential, the patient should not be permitted to speak, and no unnecessary noise or confusion allowed in the room. In the absence of other remedies a teaspoonful of ordinary table-salt may be carefully given, so as not to produce choking, in water every ten minutes, or five or ten drops of Sulphuric-acid, mixed with a tumbler of water, and a tablespoonful given in the same manner, until relieved. Aconite is an important remedy in the commencement of the difficulty. There is generally a fullness and burn- ing pain in the chest, palpitation of the heart, feeble wiry pulse, pale face, restlessness and anxiety. The blood is discharged in large quantities, at short intervals. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful may be given every ten or twenty minutes, but if after two or three hours no relief is produced, another remedy should be chosen. Ipecac—If after the administration of the Aconite a taste of blood should remain in the mouth, or there should be present a slight hacking cough, with expecto- ration, streaked with blood. Dose.—Same as Aconite. A rsen icum.—Anxiety, palpitation of the heart, seething of blood in the chest, worse about midnight, and spread- ing a burning heat over the body; after Hyosciamus, in drunkards. Dose.—A powder, dry on the tongue, or one drop or twelve globules insixteaspoonsful of water, a teaspoonful every hour until relieved. * For general directions as to the administration of remedies, see page 12. HAEMOPTYSIS. 183 Arnica—particularly in those cases occasioned by mechanical injuries or violent exertion, and where with but slight exertion, blackish, coagulated blood is dis- charged, accompanied with stitches, burning, contracting pain in the chest, seething of blood, palpitation of the heart and debility, or where with a cough excited by irritation under the sternum, there is a discharge of bright red, frothy blood, sometimes mixed with lump,0 of mucus. Dose.—Same as Aconite. Millefolium is a prominent remedy, particularly where there is a discharge of blood, with but slight, if any cough, fermenting sensation in the chest, with sen- sation as of warm blood rising in the throat. Often after Aconite, a dose every half hour. Hamamelis is another prominent remedy in severe haemorrhage. Dose.—Six drops in a glass half full of water and in severe cases a teaspoonful every ten minutes, increasing the intervals to two or three hours, as the haemorrhage and pain subside. Belladonna.—Slight cough produced by tickling in the throat, with aggravation of the haemorrhage, sensation as if the chest were full of blood with shooting pains; worse by movement. Dose.—One drop or six globules, in ten spoonsful of water, a spoon- ful every half hour. China.—Where the patient is debilitated from the loss of blood, or where there is violent dry and painful cough, with taste of blood in the mouth, shivering with flushes of heat, cloudiness of sight and bewilderment of the head. Dose.—Same as Belladonna. Hyosciamus.—Where it is preceded by a dry cough, particularly at night, or in drunkards after Opium or Nux-vom. Opium.—Particularly in intemperate persons, or where there are expectorations of thick and frothy blood, 184 AFFECTIONS OF STOMACH AND BOWELS. stifling or shortness of the breath and anguish, trembling of the arms, sleepiness and anxious starts. Dulcamara.—Especially when occasioned by cold. Rhus.—Restlessness, tingling in the chest, discharge of bright, red blood, increased by the least moral emotion. Pulsatilla.—In obstinate cases, with expectoration of black coagulated blood, anxiety and shivering, parti- cularly at night; also when the difficulty is produced by suppression of the catamenia. Nux-v.—Frequently after Ipecac, or Arsenicum and in drunkards after Opium, or where there is tickling in the chest with cough, worse towards morning; also when occasioned by cold, anger, or a sudden suppression of haemorrhoidal discharge. Carb.-v.—Particularly in persons who have taken Mercury, and where there is burning pain in the chest, and where the patient is very susceptible to changes of weather. Sulphur, Ignatia, Sabina, Stannum, also deserve attention. Dose.—In violent cases same as Aconite, where the discharge is slight every six or twelve hours. In apoplectic cases Aconite should be given immediately, either in alternation with, or followed by Opium, in half an hour's time, if no relief is obtained. Diet and Regimen.—The patient should be kept cool. Stimulating food and drink should be avoided, and both food and drink given invariably cold. If the feet should become cold, they may be put in warm water. CONGESTION OF THE CHEST. Determination of blood to the chest is not an un- frequent difficulty with young people when the form is being rapidly developed, and also in persons of a phthisical habit. Diagnosis.—Palpitation of the heart with short and oppressive breathing, fullness and weight in the chest, congestion of the chest. 18o coldness of the extremities. Slight cough is sometimes present. Treatment.*—Nux-v. is a prominent remedy when pro- duced by a sedentary mode of life, abuse of spirits, or continued mental exertion, and where there is palpita- tion of the heart, short, panting breath, oppression, anxiety, asthmatic distress, heat and burning in the chest, particularly at night, with great restlessness and agitation; also sensation around the chest, as if the clothes where too tight. Dose.—Dissolve one drop, a powder or twelve globules in a glass half full of water, and give a teaspoonful every half hour until four doses have been taken, and then every two hours until a change or another remedy is indicated. Belladonna.—Palpitation of the heart and strong pul- sations in the chest affecting the head; shortness of breath, short cough, internal heat and thirst, and some- times slight spasms in the chest. Dose.—Same as Nux. China.—Especially where there have been debilitating losses, with palpitation of the heart, dyspnoea and op- pression, with great anguish. Dose.—Same as Nux. Aconite.—Great heat and thirst, shortness of breath, with violent oppression, and palpitation of the heart. Phosphorus.—Oppression with heaviness, fullness, and tightness in the chest; palpitation of the heart, and sensation of heat ascending to the throat. Dose.—Same as Nux. Mercury.—Anxious oppression, with desire to take a long breath, burning in the chest, palpitation of the heart, cough with expectoration of blood. Dose.—Same as Nux. Spongia,—Where the difficulty is produced by fatiguing exercise, is accompanied with prostration and nausea, * For general directions os to the administration of remedies, see page 12. 186 affections of windpipe and chest. or where it is brought on by the slightest movement 01 exertion. Pulsatilla.—When it occurs before menstruation, or when that has suddenly stopped. Dose.—Same as Nux. Bryonia.—When there is constrpation or piles, which have been suddenly suppressed. It may frequently be alternated with Pulsatilla. Dose.—Same as Nux. PULMONARY CONSUMPTION. Phthisis Pulmonalis. We come now to speak of a disease which in our ever- changing climate is constantly scattering its seeds over the land, gathering its victims alike among the poor and lowly, the sons and daughters of toil, and the gay votaries of fashion, the lovers of luxurious ease, and the mighty throng which ever crowd the various paths of dissi]^ation. Consumption, ghastly messenger of death, how many cheeks have paled as thou with stealthy footsteps and almost noiseless tread hast glided into the sanctuary of their home; how many young mothers hast thou laid in an early tomb; how many bright golden links, uniting hearts in fond affection, severed with thy corroding touch; how many barks freighted with the wealth of genius, of beauty, of deep and holy love, have gone down into the dark ocean of death at thy bidding ! To move on, day after day, week after week, and perhaps month after month, your friends feeling that with each revolving sun the hectic flush is growing brighter, the step more feeble, the form more attenuated, and the stern and perhaps unwelcome truth at length forcing itself upon your own mind, for the victim is too often buoyed up with a delusive hope, and the last to awake to his real situation, that the sands in your hour- glass are fast running out, that death is drawing you % PULMONARY CONSUMPTION. 187 on, slowly it may be, yet with a strength, you cannot resist, to his cold embrace, into that dim and shadowy spirit world, where his power ends, and the roar of time's waves is never heard — this is consumption. In another chapter it has been necessary for me to refer to the causes of this disease, and to urge the im- portance of watching for its first stealthy footsteps, and thus guarding against its entrance, or eradicating it before it has become so deeply planted as to defy control. I have spoken of it in the chapter on the causes and prevention of disease, as the result of hereditary taint, slow perhaps in its progress, as the sequele of other diseases, as produced by dissipation, exposure to sudden changes of temperature, imprudence in living and dress, and various other causes. Diagnosis.—The incipient stage of consumption can be cured, and even where it is hereditary, I am strongly inclined to believe, that by means of proper physical, moral, and mental training, a proper education of the whole system in childhood, in very many cases at least, the children may escape the doom of the parents. I say that consumption in its incipient stage may be cured, but beware how you allow it to fasten its fangs deep in the system, how you disregard the slight hacking cough, the growing sensation of languor, the weakness of -the chest, the increasing flush on the check, and those other symptoms which perhaps at first may be easily removed, but which, disregarded, are like the easy gentle motion of the boat gliding along the outer circle of the mael- strom, the victim unconscious of danger, until, rushing on with increased rapidity he is startled, when, alas, too late, by the roaring vortex below. The general symptoms of phthisis are, cough, dyspnoea, expectoration, haemoptysis, night-sweats and wasting, hectic fever, hoarseness, or loss of voice, diarrhoea, and 188 AFFECTIONS of windpipe and chest. various other symptoms, marking the different stages of the disease. Cough is one of the earliest symptoms. It is at first generally slight and dry, occurring particularly on get- ting into the bed at night, on getting up in the morning, or after any unusual exertion. It soon becomes more troublesome, and is attended with more or less expecto- ration. Haemoptysis, another symptom is a kind of expectoration; the expectoration of blood. This is a common symptom, but I have already spoken of it under a separate head. As the disease progresses, the patient is troubled with shortness of breath after but very little exertion, and particularly on going up-stairs or ascending even a slight eminence. Hectic fever gradually steals on. The patient may in the evening feel chilly, and at night flushed and hot, the skin, particularly the hands and feet, dry and burn- ing, followed during sleep and towards morning by profuse and exhausting perspiration. This perspiration is generally more copious on the upper part of the body, the chest and head, and almost invariably comes on during sleep, the patient on awakening often finding himself drenched. Diarrhoea is another very common symptom, more frequently, however occurring during the latter part of the disease, and rapidly prostrating the strength of the patient. The voice sometimes for months is almost entirely extinct, the patient grows weaker and weaker, until at length he glides almost without a struggle into the arms of death. Or perhaps for a time the unpleasant symptoms may abate, the strength begin to return, and brightening hope whisper to the soul promises of return- ing health, when the blow falls and all is over. In tubercular consumption, the tubercles may exist for years without disturbing the health, when by proper treatment they can be removed, but at length they soften PULMONARY CONSUMPTION. 189 and produce ulceration. The rapid form of consumption, which is frequently seen among the young, and after debilitating diseases, is rightly called galloping con- sumption, for its course is short. In tuberculous persons, syphilitic, and eruptive dis- eases, there is often a transfer of the disease from external organs to the lungs, developing a consumption, which speedily carries off the patient. Treatment.—The treatment of this disease in all its stages covers so broad a field as to render it not only impossible but unnecessary to go into the particulars here, as the skill and care of a judicious physician are necessary in its treatment. For the appropriate reme- dies in the incipient stage, consult ucough," ""inflamma- tion of the lungs;'' Ac. In the more advanced stages, among the prominent remedies are, Arsenic, Stan., Merc, Phos., Calc, Carb.-v., Hepar-s., Kal.-curb., Nit.-ac, and Iodine. Aconite and Belladonna are more particularly indi- cated in the congestive variety or when there is sore throat, glandular swelling with heat and fever. Dose.—One drop, or twelve globules, in a glass half full of water, a teaspoonful every two hours until a change. See also congestion of the chest. Calcarea-cctrb. Cough as if produced constant cough, dry and exhausting, with pain in the chest. Offensive brown expectoration mixed with pus; cough with lumpy purulent greenish or yellow expectoration; stitches in the side of the chest on coughing, breathing or moving about; chill with thirst; diarrhoea alternating with con- stipation, perspiration on the chest at night; chill with thirst. Dose.—Six globules morning and night, until a change. Phosphorus. A valuable remedy; for the indications see Cough and Pneumonia. Stannum. Constant tendency to cough with sensation of mucus in the chest. Violent fatiguing cough, at times 190 affections of windpipe and chest. dry, at others moist; cough with greenish or yellowish ex- pectoration of a sweetish or saltish taste. Pains all over the chest; oppression and difficulty in speaking; sense of suffocation. Dose.—Same as Aconite. Diet and Regimen.—Cleanliness, fresh air, and as even a temperature as possible, are of course essential. Often simply a change of air, going from a cold to a warmer or more temperate climate will be sufficient to arrest a disease which seemed almost hopeless. In selecting the food, the wishes and feelings of the patient should be consulted, taking care, however, that while the food is as nourishing as may be, it is as little stimulating as possible. ASTHMA. This is a spasmodic disease, producing a constriction of the bronchial tubes, often hereditary, incident to both sexes, but more common in men than in women. The air tubes of the lungs are encircled by minute bands of muscular structure, which like other muscular fibres may be affected by spasms. These spasms of course contract the air tubes, and the difficulty of breathing and the wheezing respiration is occasioned by the air being forced through the narrowed channels for respiration. Diagnosis.—There is great difficulty of breathing; coming on in paroxysms and accompanied with loud wheezing respiration, passing off in a few hours with more or less expectoration. If the patient has ever suffered from an attack, there are generally premonitory symptoms sufficiently pro- minent to indicate its approach, such as loss of appetite, languor, drowsiness, oppression, and chilliness. The dys- pnoea more generally comes on after midnight, but not unfrequently occurs during the afternoon and evening. There is a sense of constriction about the chest, and urgent desire for fresh air, often causing the patient to asthma. 191 rush to the open window, however cold may be the night, and a loud wheezing respiration. These symptoms often last for several hours, when remission gradually takes place. The attacks may return at longer or shorter in- tervals, and when they cease with little or no expectora- tion, the case is said to be one of dry asthma, but when expectoration is copious; it is called humid or humored adhma. Asthma is often connected with organic dis- ease of the heart and large blood-vessels. Causes.—This disease, as we have already said, may be hereditary, or it may be occasioned by certain states of the atmosphere irritating the surface of the air-pas- sages, or by certain influences, which affect in a peculiar way the nervous system; thus nearly all the exciting causes of catarrh may produce asthma. Some breathe with the most freedom in the keen air of the mountain top, others in moist, low places; not unfrequently the breathing will be exceedingly difficult in one street and perfectly easy in another not half a mile distant. A per- son at a hotel in Paris could sleep perfectly well in a room in the front of the house, but found it impossible to sleep in the back part, from the asthma. Treatment.—Before giving the symptomatic indica- tion for the different remedies it may present the treat- ment in a clearer light, to classify the remedies according to the exciting causes of the disease. When occasioned by a congestion of blood in the chest, Acon., Bell., Nux-v., Phosn Cup/r. or Puis, may be con- sulted. By a derangement of the menses: Bell., Cocc, Nux-v., Puis., Sep., Cuprum. By flatulence : Cham., Chin,, Nux-v., Sulph,, Verat. When it simply presents the form of cramps in the chest: Bell., Coc, Cupr., Moschus, Nux-v., Sir am., Stib. and Bryonia. 192 affections of windpipe and chest. When occasioned by inspiration of dust: Calc, Siln Sulph., Ipecac When the result of a chill: Dulc, Acon., Bell., Brym Ipecac, Arsenic In consequence of moral emotions: Ignatia., Coff., Cham,., Nux-vom. From suppressed catarrh: Ars., Ipecac, Nux-vom., Samb., Stibium. In hysterical women : Coff., Ignatia, Moschus, Stram., Asa,, Ipecac, Ars., Pulsatilla. In aged persons : Con., Op., Camph., Carb.-v., Arsenic. When moist with accumulation of mucus in the bronchia : Ipecac, Ars., Bay., Puis., Sulph., Stan., Phos., Stibium. Symptomatic Indications.—Ipecac^ Arsenic and Bryo- nia are the most prominent remedies, and perhaps more frequently indicated, than any other. If the attack should come on suddenly, it would be safe to give a dose of Ipecac, until the remedy most indicated could be ascertained. Ipecac,—Nocturnal paroxysms of suffocation, spas- modic constriction of the larynx, rattling in the chest from mucus; great anguish; short dry cough, redness and heat, or paleness and coldness of the face alter- nately ; nausea with cold perspiration on the forehead, anxious, rapid and moaning respiration, or respiration short and obstructed, as from dust It may be followed or alternated with Arsenic, Bryonia or Nux. Bryonia,—Obstructed respiration, increased by talk- ing or movement, particularly at night or toward morn ing, frequent cough with pressure or shooting pain in the chest aggravated by movement; palpitation of the heart; difficult,moaning anxious respiration, intermixed with deep inspirations. Arsenicum—Obstructed respiration, cough, and ac- cumulation of thick mucus in the chest; oppression at asthma. 193 the chest and want of breath at every movement; con- striction in the chest and larynx with painful pressure on the lungs, worse in a warm room. Suffocative fits, particularly at night or in the evening in bed, with pant- ing or wheezing respiration, great anguish and cold perspiration. Remission of the attack on the appear- ance of cough, and renewal during rough weather and changes of temperature. The attacks are often accom- panied with great weakness and burning pain in the chest, Arsenic is frequently required after Ipecac, and is indicated in most cases of chronic as well as acute asthma. Nux-vom.—Where Arsenic fails to produce relief, and where the constriction is in the lower part of the chest, even the clothes producing a sensation of tightness and oppression; short cough with difficult expectoration; sputa tinged with blood ; congestion toward the chest, with heat, burning, palpitation of the heart, and general uneasiness; asthma relieved by lying on the back, turn- ing and sitting up. Belladonna.—Particularly in children, and women subject to spasms, with congestion and pulsation in the head and chest; oppressed breathing and want of breath; dry cough at night; anxious and moaning respiration, at times deep, at others short and rapid; constriction of the larynx with danger of suffocation, and sometimes loss of consciousness. Pulsatilla—especially in children after the sup- pression of a miliary eruption; and in hysterical persons after the cessation of the catamenia or from taking cold: rapid, short and rattling respiration; choking as from the vapor of sulphur; paroxysms of suffocation, with anguish, palpitation of the heart, spasmodic constriction of the larynx and chest, particularly at night or on lying in a horizontal position; short, panting cough, expectora- tion of sanguineous mucus, tension, fullness, pressure 9 194 affections of windpipe and chest. and shooting in the chest. Asthma aggravated by movement. Phosphorus.—Dyspnoea, obstructed respiration and oppression of the chest, especially in the evening and during movement; great anguish or spasmodic constric- tion in the chest; nocturnal attacks of suffocation as from paralysis of the lungs; palpitation of the heart, short cough, shooting pain, heaviness, fullness, and con- gestion of blood to the chest. Alternate with Bella- donna, and where there is" danger of paralysis of the lungs, with Stibium. Stibium.—Especially in children and aged persons, and where there is anxious oppression, dyspnoea; chok- ing and paroxysms of suffocation in the evening or morning, with rattling of mucus in the chest, violent cough, palpitation of the heart, and congestion of blood to the chest. Sulphur.—Particularly in chronic cases, where there are nocturnal paroxysms of suffocation, and obstructed respiration, fullness, painful weariness, burning, and con- gestion in the chest; expectoration of mucus, detached with difficulty and sometimes of a bloody appearance; spasms in the chest, constriction and pain in the sternum short respiration and inability to speak. Veratrum.—In spasmodic asthma where there is pros- tration and coldness of the extremities. Sambucus.— Principally in children, and where there are choking when lying down; wheezing and rapid respiration, nocturnal paroxysm of suffocation with spas- modic constriction ; great anguish rattling of mucus in the chest and paroxysms of suffocating cough. Aconite.—Principally in sensitive persons and young girls of plethoric habit, especially if occasioned by moral emotion, and where there is dyspnoea, suffocative cough at night, anxious, short, and difficult respiration, conges- tion in the head with vertigo. asthma. L9o Cuprum.—In children and hysterial persons, after a fright, anger, a chill, and before the catamenia; spas- modic constriction of the chest; obstructed respiration on walking; short, spasmodic cough with paroxysms of suffocation, and whistling on trying to tane a deep in- spiration. China.—Dyspnoea and oppression with inability to breathe on lying with the head low; wheezing in the chest when drawing breath; spasmodic cough and noc- tural paroxysms of suffocation; sanguineous sputa; pal- pitation of the heart, and prostration of strength. Cocculuc—Especially in hysterical persons, where there is dyspnoea, constriction in the throat and chest, with oppression, particularly at night. Chamomilla.—In children after a cold or a fit of passion, and when there are paroxysms of suffocation, swelling about the pit of the stomach, agitation and cries. Moschus.—For hysterical persons and children, and where there is oppression and spasmodic constriction of the chest and larynx, particularly after a cold. Opium.—Deep stertorous and rattling respiration; obstructed breathing, choking, suffocating cough, and paroxysms of suffocation during sleep, like nightmare. Calcarea,—In chronic cases, and where there is ob- structed respiration, and frequent dry cough, as from dust, particularly at night. Ignatia.—Especially when occasioned by fright, grief or indignation. Dose.—Two drops, or twelve globules, of the selected remedy, in a tumbler of water, a tablespoonful at a dose; or a powder, or six globules on the tongue. In severe cases give every half hour, in- creasing the intervals to four hours. In chronic cases give morning and night. Diet and Regimen.—Persons subject to the asthma should bathe the chest morning and night, at first with tepid water, gradually lowering the temperature until it 196 affections of windpipe and chest. reaches the natural coldness. Coffee and greasy sub- stances should be avoided. Often when the paroxysm is excessively severe, it may be relieved by strong coffee, tobacco, or strammonium smoke. 2. AFFECTIONS OF THE HEART. These affections we shall divide into two classes: a. Acute, h. Chronic. a. Acute Disease of the Heart. Acute inflammation of the heart seldom exists alone, but is nearly always connected with rheumatism. So generally is this the case that it is sometimes called " rheumatic inflammation of the hearth Diagnosis.—The patient suffering perhaps from rheu- matism, becomes anxious, peevish and flighty. There is an oppression and hurried beating of the heart, pal- pitation, and perhaps a dry cough. Pain is felt on press- ing over the region of the heart, and is increased by a deep inspiration. The pulse is very irregular, generally weak, small and contracted. The head is of course considerably affected, and not unfrequently is mistaken for the seat of the disease. The patient may become very obstinate, cunning, or taciturn, or excessively stupid, and at length perhaps maniacal, exceedingly restless, or shaken with convulsions. Causes.—Besides being frequently the result of the transition of rheumatism to the heart, this disease may arise from cold, violent blows, injuries, &c. Treatment.—The prominent remedy is Aconite, a dose every half hour, in alternation with, or followed by Bryonia, Nux-vom., Cocc, Ars., Cannabis, Dig., Bell., Phos., Spigelia, a dose once in from one to three hours. See palpitation of the heart. affections of the heart. 197 b. Chronic Affections. Diagnosis.—Difficulty of breathing, and palpitation of the heart, particularly on ascending an eminence. Short- ness of breath, violent beating of the heart like the blows of a hammer; the beating extends over a larger space than usual; occasional pain, although neither this nor palpitation are always present. Pulse sometimes in- termittent, at others excessively irregular; slow, weak, and faltering, or quick and fluttering. There are gene- rally headache, irritability of temper, sometimes cough, spitting of blood, and dropsical swelling of the legs. Causes.—We have already described, in the chapter on anatomy, the formation and functions of the heart, but to impress the matter still more strongly on the mind of the reader, we will recapitulate some facts here. The heart, the great central point, the balance-wheel of the circulation, contains four chambers; into these the blood passes from every part of the body, and by their contraction is forced out, and conveyed through the appropriate channels, arterialized and charged with life, to tte most remote parts of the system. 198 affections of windpipe and chest. To make the matter still more plain, let the foregoing diagram represent the passage of blood through the heart. For the sake of convenience I have represented the heart in the form of a square. This, however as the reader is well aware is not the case. The arrows repre- sent the current of blood. A and b represent the right heart, divided into two chambers by the valve or folding- door which is seen partly open, the blood passing through, as represented by the arrows. 1 indicates the vein through which venous or defiled blood enters the heart from the head, and 2 represents the vein through which the venous blood from all the rest of the system, ascending, mingles with the descend- ing blood from the head at e and enter together. Into the first chamber, or auricle, of the right heart, a, we have then entering the blackened and impure blood from every part of the system. Passing through the valve or folding-door, it enters the lower chamber or ventricle b, and from thence at/ passes into the lungs g, and there undergoing a chemical change, in which its impurities are exchanged for oxygen, the life-giving pro- perty of air, it quits the lungs at h, ascends behind the great artery i and enters the first chamber of the left heart c, descends through the folding-door or valve into the lower chamber d, and now, having passed through the entire suit of rooms, thrown off its impurities and become again charged with life, it passes from the heart into the great aorta i, and is conveyed on its mission of life to every part of the system. We have seen that the blood is forced from one cham- ber to the other by the contraction of these chambers or pouches, how is it then, for instance, that on the contrac- tion of the lower chamber of the right heart, the blood is not forced upward into the upper chamber as well as downward into the lungs ? This is obviated by the valve AFFECTIONS CF THE HEART. 199 which is seen opening downward. The contraction of the chamber closes this valve, and prevents the blood ascending. The same arrangement also exists at/ and i, thus pre- venting the blood returning to the heart. It will very readily be perceived that the heart has a most important function to perform, and that any derangement of its machinery is speedily felt throughout the system. These valves must play with the utmost nicety, these chambers must contain the requisite amount of strength, and where this mechanism is prevented from the full per- formance of its duty, serious results are the consequence. We are now prepared to look at the cause of some of the diseases of the heart. The valves it has been seen, to perform their functions aright, transmitting the blood from one chamber to the other, and preventing its return, must open and close with the utmost freedom, and fit with the greatest nicety. They, however, sometimes lose their soft and flexible character and become stiff, bony and immoveable. The valve or door between the upper and lower (a and b) chamber of the right heart, remaining perhaps half open, and fixed in its potition, prevents the blood from passing with the freedom, it would have clone if the valve had remained wide open, into the lower chamber, and on the contraction of that chamber, is no obstacle to its being forced into the upper chamber as well as into the lungs. The consequence therefore is, that a deficient amount of blood is forced into the lungs, a portion being driven back into the upper chamber. Thus it will readily be seen, that the upper chamber is constantly gorged and distended with blood, and this partial stoppage or stagna- tion of course produces a like stagnation of the blood flowing into this chamber. It will very easily be per- ceived then that there can I e no free transmission of venous blood from the brain through the stagnant vein 200 AFFECTIONS OF WINDPIPE AND CHEST. opening into the upper chamber, and the choked up and congested state of that chamber must, as a matter of course, produce congestion and engorgement of the brain The vessels of the brain are engorged, because they can- not empty themselves into the already engorged vein (1), which is gorged because it cannot empty itself into the distended chamber a, distended, because the blood not only cannot pass freely into the lower chamber, but a portion of what does pass, is driven back. A large portion of the blood from the lower parts of the body in returning to the heart passes through the liver. The vein (2) not being able, for the reasons ex- pressed above, to empty its contents into the upper chamber of the heart as rapidly as necessary, a similar state of engorgement of the liver and the lower organs may take place, from the same cause as in the brain. When the valve of the left heart is affected in the way just described with the right heart, the same con- sequences result to the lungs, as we have just seen are produced on the brain, liver, and other organs. The chamber c becomes gorged in the same way as the chamber a, just described, so that it will admit but spar- ingly the blood flowing through the lungs (h.) The vessels of the lungs therefore, being unable to empty themselves, congestion is the result. These valves are subject to various other difficulties besides ossification, alike serious in their results, and pro- ductive of many of the same symptoms. Thus, the valves may be prevented closing, from warts or fleshy excrescences growing on their edges, or they may be too small, or perhaps holes may be ulcerated through them. Similar valves or doors to those already mentioned are situated at/and i, where the blood passes out of the heart into the lungs and out of the other chamber into the great aorta. Supposing the valve where the blood flows out of the chamber d into the great artery i be diseased AFFECTIONS OF THE HEART. 201 either by ossification or otherwise, so that the current of blood out of the heart into this vessels be obstructed, the chamber d of course becomes gorged and distended with blood, the heart contracts more strongly, and from the increased muscular exertion, the sides become harden- ed and swollen; thus constituting hypertrophy or enlarge- ment of the heart. Congestion of the lungs is also the almost inevitable result. In the same manner by derangement of the valve/ hypertrophy of the chamber d is produced, together with congestion of the brain, liver, &c. Surrounding the heart, which as we have before said, is lined both inside and outside by a smooth polished membrane, is a bag, applied loosely and allowing the heart to dilate and contract without the slightest im- pediment. This membrane may become inflamed, and in this state become firmly glued to the sides of the heart. The free movement of the heart is thus prevent- ed, its action is hampered, and it vainly struggles, and throbs to escape its imprisonment. The heart, thus cramped in its movements, the effect on the circulation will readily be perceived. Treatment.—See symptomatic indication. Palpitation of the Heart.* Perhaps this is as proper a place as any to introduce this unpleasant and very common variety of heart diffi- culty. It is frequently, as we have seen, a symptom of some severe form of heart-disease, and yet it is not un- commonly a very slight trouble easily relieved. The young, during the growing period, are often troubled with it, and the old from ossification of the valves. It may also arise from derangement of the nervous * The treatment of heart-disease should be entrusted to the physician; under the above head, however, I have indicated some of the prominent remedios of service in heat-affections. 9* 202 AFFECTIONS OF THE WINDPIPE AND CHEST. system, produced by violent mental emotion, the abuse of ardent spirits, coffee, &c. It is of very common oc- currence in persons of plethoric habit; during pregnancy, also by overloading the stomach, or eating at improper times. Treatment.—If occasioned by congestion of the blood, or plethora: Acon., Bell., Coff.., Op., Nux.-v., Lach., Phos. In nervous persons : Asa., Cham., Coff., Nux-v., Puis. After moral emotions: Cham., Coff., Ign., Op., Nux- vom. After a fright: Op., or Coff. From disappointment: Cham. Ign., Nux-vom. From joy: Coff. Fear, or anguish: Verat. After loss of blood: Phos.-ac, Chin. After the suppression of an eruption: Ars., Caust., Lach., Sulph. Symptomatic Indication.—I have chosen, for the sake of easy reference by the patient, to note under the above head the symptomatic indication of some of the different remedies for the various diseases of the heart which I have described, both acute and chronic. Spigdia.—An all important remedy in most forms of heart disease. Inflammation of the heart, with and without articular rheumatism. Tumultuous pulsation with suffocative sensation and spasms in the chest, par- ticularly when lying or sitting, aggravated by motion. Chronic affection of the heart, after inflammation, or with articular arthritis. Audible palpitation, increased on sitting down, bending the chest forward, and frequently accompanied with pain and oppression of the chest. Val- vular disease, hypertrophy, dilation of the heart with their accompanying symptoms. Tremulous motion of the heart. Aconite.—Palpitation of the heart with great anguish. affections of the heart., 203 general heat, great soreness and debility of the limbs Palpitation in young plethoric persons. Quick and rapid pulsations of the heart; notwithstanding the pulse is slow and intermittent. Oppressive aching in the region of the heart, sometimes as if a heavy load were pressing upon it. Difficult respiration in the erect position from snooting pain. Inflammation and chronic affections of the heart with fullness in the chest and sensation of con- gestion in the head. A urum.—Violent palpitation of the heart, coming on in paroxysms, and attended with oppression. Shaking sensation of the heart on motion. Arthritic metastasis and organic affections of the heart. Arsenic—Palpitation of the heart, irregular, with an- guish, excessively violent, particularly at night, and when lying on the back. Inflammation and organic dis- ease. Belladonna.—Great anguish about the heart, oppress- ed sensation, tremor with anguish and pain and a kind of bubbling sensation, in going up-stairs. Palpitation with intermittent pulse, also when at rest, increased by motion. Lachesis.—Palpitation with anxiety or weakness; felt in the back, debilitating with nausea; chronic; particu- larly in girls, also accompanying other affections, and frequently followed by oppressive pain in the chest. Ir- regularity of the pulsations. Great anguish about the heart with heaviness in the chest in rheumatism; con- strictive sensation. Arnica.—Quivering pulsations, oppression or stitches in the heart with fainting fit. Pain as if the heart were squeezed together. Natrum-mur.—Pains in the heart, particularly at night. Palpitation from the slightest motion, sometimes accompanied with anguish. Fluttering motions in the heart, irregularity or intermittent pulsations. 204 AFFECTIONS OF THE WINDPIPE AND CHEST. Digitalis —Intermittent and slow pulse with violent palpitation and shuddering. PhospJiorus.—Coldness of the extremities, great op- sion about the chest and fluttering of the heart. Administration.—Two drops, or twelve globules, of the selected remedy, in a tumbler of water, a tablespoonful at a dose ; or three globules, or a powder, on the tongue. In acute cases, a dose once in from a half hour to three hours. In chronic cases, once in from four to twelve hours. Diet.—Violent mental excitement and strong physical exertion, should of course be avoided. The nervous system should be kept as quiet as possible, and all strongly stimulating articles either of food or drink should be strictly prohibited. Pure air and a moderate amount of exercise are essential. insanity. 205 CHAPTER V. AFFECTIONS OF THE MIND. Insanity. Allowing the term insanity its strict signification, we should find hundreds with whom we mingle every day, yea, thousands in all grades of society, in every depart- ment of life, statesmen, clergymen, business-men, labor- ing under some form of mental derangement, and the world itself somewhat of a crazy world. A lunatic, who had been for some time confined in one of our asylums, was one day asked by a visitor, why he was sent there. He very shrewdly replied, it was all owing to a difference of opinion. The world insisted, that he was crazy, while he as strenuously maintained, the shoe was on the other foot, and the world was crazy ; the world being in the majority and having the power in their own hands, carried the day and shut him up. Perhaps both were partially correct. We can hardly believe, that a perfectly sane man will violate with impunity every law of nature, that he will sacrifice reputation, the esteem of the good, health, an easy conscience, and a home pervaded with an atmos- phere of love for the gratification of selfish or sensual passions. We can hardly look upon either the spendthrift, foolishly squandering his wealth, or the miser, hoarding up his gains and denying himself even the necessaries of life, as perfectly sane; and we certainly must look upon the mother, who trains her daughter in that cold and selfish school, where the warm feelings of the heart are frozen, and nature compelled to give place to art, in which, alas, too many of our daughters are educated, as possessing, to say the least, an extremely ill-balanced mind. 206 AFFECTIONS OF THE MIND. But our object here is to look upon insanity in a medi- cal light, only so far as it assumes the perceptible character of a disease. However interesting the subject may be, we shall only have room to glance at it here. We may look at it under three divisions: 1. Moral insanity, consisting in a morbid perversion of the natural feelings, affections, temper, habits, &c, but without any maniacal hallucination, or any particular lesion of the intellect or reasoning faculties. 2. Intellectual insanity, attended with hallucination, when the patient believes in some unreal event, repugnant to his former experience and common-sense, and acts under the influence of this erroneous conviction. 3. There is another form, which might with propriety be called incoherent madness, in which the ideas follow each other with astonishing rapidity, but in a state of the most complete incoherence and confusion. 1. Moral Insanity.—There are thousands of persons at large throughout community, who are affected more or less with this modifiation of insanity. They are gene- rally persons of singular, wayward, and eccentric character. On inquiry it will frequently be found, that habit, temper, and disposition seem gradually to have undergone a change. This may first be noticed after some severe shock, or a violent attack of sickness, or it may have been coming on for years, and is merely an increase of peculiarities always more or less natural or habitual. Certain forms of this variety of insanity are exceedingly difficult to detect, and sometimes, nothwith- standing friends might be perfectly satisfied themselves, that the patient was really of unsound mind, they would still find it almost impossible to bring forward sufficient proof to satisfy a jury. The patient might be capable of reasoning with the greatest clearness on almost any topic, and accounting with great ingenuity and even plausibility for his eccentricities of conduct. He often thinks and acts INSANITY. 207 under the influence of strongly-excited feelings, during which time we may obtain a ci^e to his mental derange- ment. I well recollect a case which occurred during my child- hood in my native town and created considerable excite- ment. A Portuguese, by the name of Rabello, murdered a boy about ten years of age, the son of his employer, in a most horrid and savage manner. With an axe the head was severed from the trunk, the chest laid open and the boy literally chopped to pieces. Rabello had been looked upon as possessed of a morose and irritable disposition, but had by no means been considered insane. The indignation of the community was so strongly excited by this brutal and cold-blooded murder, that law-abiding and law-loving as they were, they could hardly be prevented from hanging the victim without judge or jury. The proof of the murder was positive, and there seemed to be not the slightest chance for the prisoner of escape from the gallows. Hon. Truman Smith, since a member of the U. S. Senate, from Connecticut, believing the man deranged, undertook his defence, and on the trial so indefatigable was he in his exertions, that he succeeded in obtaining a verdict of insanity. Perhaps the indignation of the community was now about equally divided between Mr. Smith and the prisoner; both were denounced in the strongest terms, and the wise-acres shook their heads, mourned that justice had departed from the land, and the basest crime could now go unpunished. The prisoner was properly confined, and scarcely six weeks had pass- sed away, before he might have been seen chained to his cell, a raving madman. Had it not been for the enlighten- ed efforts of his council on his trial, notwithstanding his insanity, he would have been condemned to death. In this variety of insanity there are often violent out- bursts of passion breaking out without cause, and leading 208 AFFECTIONS OF THE MIND. oftentimes to the commission of crime. Cases are also exceedingly frequent where persons allow their feelings to become strongly and bitterly excited against others without proper cause or provocation; constantly brood- ing over fancied wrongs, misconstruing even acts of kindness, looking upon those who are really friends, as foes, ever finding fault with others, but seeing none in themselves, these feelings of malevolence and hatred may grow deeper and stronger, until the most ridiculous and absurd ideas obtain full possession of the mind, or perhaps the darker thoughts of murder creep in, at first scarcely whispered, but growing stronger and stronger, ever haunting them, and hurrying them on by an in- visible force until the bloody deed is consummated. This is one form of moral insanity. There is another class of cases in which there is a disposition to melancholy and dejection of the mind without any illusion of the understanding connected with it. Surrounded by every comfort, a feeling of gloom and sadness shrouds all their prospects. Their darkened sky is illumined by no golden ray of hope, nature has no cheering word for them, but crushing, dark despair and melancholy weighs them down. Sometimes the chilling thought of suicide, steals in upon them, or there arises in their mind a fear that they shall be led to the commission of some great crime. This thought continually gains strength, haunting them when- ever alone, hurrying them on with an almost irresistible power, until at length, too often, alas, the fearful deed is consummated. A propensity to theft is often a distinctive feature of moral insanity, and not unfrequently the sole characte- ristic of the disease. Cases are on record where persons possessed of wealth, surrounded by every comfort, would steal every thing they could lay their hands on, even articles they could never use, and the use of which they INSANITY. 209 were entirely ignorant. A case is on record where a lady, beautiful, amiable, highly educated and accomplish- ed, surrounded by every luxury, wealth and taste could furnish, the mother of two beautiful children, a devoted husband ready to supply every want, yet would pilfer whenever she had an opportunity, articles too, she could never put to any use. Her husband, devotedly attached to her, reasoned with her upon the guilt of her conduct. With bitter tears she would confess the fault and solemnly promise never to be guilty of the like offence again, and yet the very next hour, if opportunity offered, commit the same offence. She became known throughout the community, and in the stores she was watched on making her appearance, and if after leaving, any little article was missed, a bill was made out, sent to her husband, and immediately paid. Another form of moral insanity displays itself in an entire want of self-government, in constant excitement, and thoughtless and extravagant conduct. These persons frequently become drunkards, their drunken attacks being followed by periods of raving madness. After the attack has passed off, they will again in a short time indulge in intoxicating drinks, notwithstanding they know the inevitable consequence. 2. Intellectual insanity, or madness attended with hal- lucinations. When a morbid delusion is impressed on the mind, but little doubt can be entertained of the existence of insanity. There are two entirely different states of disease attended with this symptom. In the one case the understanding, when exercised on most subjects, is comparatively clear, and the morbid impres- sions only partial; in the other, the disturbance of the intellectual faculties involves all the other operations of the mind. The former is called monomania, the latter, mania. Monomania.—It is very common to see persons per- 210 AFFECTIONS OF THE MIND. fectly sane on every subject but one, but touch that and you open wide the floodgates of insanity. Some persons are deranged on the subject of religion, and display the utmost bitterness, and indulge in the harshest invective against all who dare to differ from them. Others are deranged on some particular science, or upon some of the great moral and philanthropic questions of the day. It is denounced by some as wild fanaticism, and is in reality a species of insanity, properly classed under the head of monomania. The patient laboring under this affection, is often gloomy, morose, and excessively melancholy. Mania.—The characteristics of this variety of insanity are too well known to require much description. They may either be highly excitable, raving in violent deli- rium, or perhaps the insanity may be of a milder kind ; they are generally firmly convinced that they have either performed some mighty deeds, that they are some il- lustrious characters, or troubled with other illusions equally devoid of truth. Thus, one believes he is Jesus Christ, another that he is Jehovah, and another perhaps, that he is Mahomet, or a king. 3. Incoherent madness.—In this form of madness the disease commences with great excitement; the patient is restless, active, and generally sleeps but little. Ideas follow each other in the most astonishing rapidity, but without the slightest connection. Words and sentences are half uttered, and this unmeaning jargon is kept up almost constantly, the patient scarcely allowing himself to eat or sleep. This state of excitement, after having continued for some time, frequently gradually decreases ; the patient becomes more quiet, obtains sleep, and may in time become perfectly rational. Causes —The causes of the various forms of insanity are exceedingly numerous. One fruitful cause is an er- roneous and unsuitable method of education. The bad INSANITY. 211 qualities are nurtured and allowed to grow without re- straint, until they choke the good, or the good feelings of the heart are warped and bittered, by an iron will and the cold harsh control of narrow and prejudiced minds. But I have already referred to this matter in the chap- ter on the "Causes of Disease" Among the other causes of insanity we may enume- rate abuse of ardent spirits, blows on the head, and ex- posure to the heat of the sun; intestinal irritation; ir- regularity of the uterine functions, not unfrequently produces temporary derangement, especially where the catamenia are suppressed, irregular, or attended with agonizing pain. Insanity of a violent form is sometimes developed in connection with child-bearing. Of the moral causes of insanity it will be unnecessary for me to speak here. Cases are familiar to all, where disappointments in business, or love, the workings of a troubled conscience, ill-judged religious advice, tending alone to excite fear, have sent the poor victim to the madhouse for life. All experience shows that civilized man is far more subject to insanity than the savage, and the inhabitants of large cities, as a general thing, than those of the country. Treatment.—The condition of the violently insane now, and half a century ago, is entirely different, then they were treated more like brutes, loaded with chains, scourged, abused in every way, and seldom met with kindness. Now they are treated like human beings, unfortunate it is true, but yet deserving care and kind- ness. It will be impossible to detail fully in a work like this, the treatment required in the various forms of insanity, and indeed, it would not be necessary as this disease is one that requires the skill of the physician, of 212 AFFECTIONS OF THE MIND. one too who is versed in human nature, and knows how to administer to a mind diseased. The patient should be surrounded by a proper moral influence, blending firmness with the utmost kindness, and watching the leading traits of character developed, acting accordingly. Mental alienation occasioned by oppressing emotions, such as anger, fear, mortification, or vexation, usually requires: Bell., Hyos., Ign., Phos.- ac, Nux-v., Plat. When the result of excessive study: Lach., Plat., Stram., or Nux-v., Op., Sulph., Bell, Hyos. From religious notions attended with melancholy; Lach., Sulph., Verat., Ars., Aur., Bell. For the delirium of drunkards : Nux-vom., or Op,, or Hell., Hyos., Stram., and Puis. (See also Delirium Tre- mens). In Females, from a derangement of the sexual func- tions: Acon., Bell., Plat., Puis., Stram, and Verat., or Cup., Sec (See also Diseases of Females.) Melancholy, of an excessively gloomy character, may require : Ars., Aur., Lach., or Nux.-v. Melancholy, of a more gentle and placid character, may require: Cocc, Bell., Ign., Hell., Con., Phos..ac, Puis., Sil. Symptomatic Indications.—Belladonna.—Great distress with agitation and inquietude. Frightful visions, fear of death, repugnance to conversation and society; hag- gard eyes, fixed and furious look, burning thirst, trem- bling of the limbs, sleeplessness with agitation; or gloomy, tearful humor, with apathy and indifference. Hyosciamus.—Paroxysms of violent delirium, alter- nating with epileptic fits; sleeplessness with constant talking, great anguish and fear, visions of the dead; jealousy; fury with impulse to kill. Lachesis.—Talkative delirium with rapid change of ideas; suspicion, jealousy or pride, and fear of death; INSANITY. 213 or despondency and great disposition to give way to grief. Nux-vom.—Anguish and inquietude, with disposition to wander abroad; congestion, bewilderment and heavi- ness of the head; pressure or fullness in the abdomen and stomach ; constipation or watery diarrhoea; sleepless- ness with starts. Opium—Great drowsiness ; visions of mice and scor- pions, convulsive movements; inability to sleep, notwith- standing there is sleepiness, constipation, congestion of the head, epileptic fits. Platina —Ravings of past events, with singing, dan- cing, or weeping ; quarrelsomeness; contempt for others, with great self-esteem; increased sexual desire ; dread of death and frightful visions. Stramonium.—Dizziness or loss of consciousness, be- lief that the body is divided into two parts; delirium with frightful visions ; religious movements ; lascivious ideas, or affected manners ; conversation with spirits, ri- diculous antics, or wild and ungovernable fury; bloated- ness of the face, with silly expression. Veratrum.—Great anguish and despondency; taciturn with violent oaths on the slightest provocation; loss of consciousness with singing, whistling, and religious mania, lascivious ideas, proud and haughty. Arsenic.—Great anguish; fear of spectres, robbers, solitude, &c. Aversion to conversation; inclination to commit suicide, or dread of death, tearfulness and fear offending. Cantharis.—Violent rage; renewal of paroxysms at the sight of water : excitement of the sexual organs. Pulsatilla.—Stupor, nocturnal delirium, sleeplessness with anguish, or agitated sleep with anxious dreams; great melancholy with weeping; despair of eternal hap- piness, with constant prayers. Tendency to fear and dis- position to hide. 214 AFFECTIONS OF THE MIND. Sulphur.—Confusion of the intellect, indifference, apathy, or uneasy about domestic or religious affairs. Cup-inn.—Went of moral energy ; imaginary occupa- tions ; wildness and redness of the eyes, during the paroxysm, tears, anxiety and disposition to hide. Administration.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose ; or a pow- der, or three globules on the tongue. In violent cases give once in from one to three hours. In cases less vio- lent, or where the symptoms are comparatively mild, or the affection only partial every twelve or twenty-four hours. VARIOUS AFFECTIONS OF THE MIND. Consequences of fright and fear: Op., Bell., Ignm Puis., may be consulted. Excessive joy: Coff., Op., Pulsatilla. Grief: Ign. Home sickness: Phos-ac, Staphysagria. Jealousy. Hyos, Nux-v. Violent anger: Nux v., Chamomilla. Chagrin: Cham., Nux.v., Ign., Platina. Insult and mortification: Bell, Ign., Plat., PuUa* tilla. Unhappy love: Phos-ac, Ignatia. For symptomatic indications and administration, con- sult Insanity. HYSTERIA. Ilypoch ondria. The two names above, indicate the same disease, the former being applied to the affection when found in the female, the latter in the male. Hysteria has characters peculiar to itself, but is also apt to assume the form and mimic the symptoms of dis- eases of a much graver nature. hysteria. 215 The hysterical paroxysm resembles somewhat an epi- lectic fit, yet is very easily distinguished from it. There are strong convulsive movements of the limbs and trunk; the head thrown backward, the face flushed, the eyelids closed and tremulous, and the jaws firmly shut. If the hands are left at liberty, she will often strike her breasts, tear her hair, and rend her clothes. After a short time a calm may take place, which, however, is generally followed by another spasm, and the whole attack not unfrequently terminates in an explosion of tears, sobs, and convulsive laughter. Another variety of this form of paroxysm, is when the patient suddenly sinks insensible, and without con- vulsions; there is a slow, interrupted breathing and flushed cheeks; she recovers, fatigued and in tears. In another form of hysteria, there is a sensation of a ball rolling about the abdomen and stomach, and some- times ascending the throat, so as to impede deglutition. The hysterical seizures are confined almost entirely to women, generally between the ages of fifteen and forty, and are as a general thing, connected with some derange- ment of the sexual functions. The variety of serious diseases which may be so ac- curately mimicked by hysteria as to defy detection, ex- cept by the practiced eye of the physician, is truly as- tonishing. Among the rest we find palsy—perfect hemi- plegia or panplegia—entire loss of voice, laryngitis, and pain in the breasts, resembling that of cancer. We also find a peculiar kind of cough, loud, harsh and dry, resembling croup, hiccough, violent vomiting, sometimes of blood. Hysterical affections of the bones, joints, and back, are exceedingly common, in which the pain is ex- tremely severe, and the symptom such as to lead friends and sometimes physicians to believe that a serious diffi- culty is present. The limbs are often drawn up and im- moveable, and the system so filled with pain on the 216 AFFECTIONS OF THE MIND. slightest movement, as to lead the patient to suppose that death would be the result of any attempt to walk, and yet, let the house take fire, or some violent shock take place, they would run for their life and be surpris- ed to find themselves when the excitement wore off, per- fectly recovered. I was once called to see a patient who had never moved from her bed for nine months. She ate well most of the time, yet insisted every morning she should not live till night, and every night persisted in taking a weeping farewell of her friends. I ordered a small pistol to be placed at night at the foot of the bed, so arranged that it could be discharged from another room by a slow match, and when discharged would set on fire a quantity of cotton, upon which had been poured some turpentine. When all was quiet, the pistol was discharged, the cotton blazed up, and the poor girl, screaming with terror, jumped from her bed and rushed from her room. I need not say, the next day on calling I found my patient entirely well. She has since married, and is the mother of two children, but ascertaining by some means or other the hand I had in the trick, she has never forgiven me. Treatment.—The application of cold water in the form of a shower-bath, or during the paroxysm, cold water dashed into the face or poured on to the head from a pitcher, will be found serviceable. The patient also may be allowed to smell from time to time of Camphor. Cocculus or Cuprum when there is clenching of the jaws and foaming at the mouth. If relief be not ob- tained after three or four doses give Veratrum. Dose.—One drop, a powder, or six globules in a glass half full of water, a teaspoonful every ten minutes during the spasm, when the spasm has subsided, give every two or three hours until entirely re- lieved. Ignatia.—Where there is intolerance of light and noise; shrieking for help ; suffocative constriction of the throat HYSTERIA. 217 and difficulty of swallowing. Also where the hysteria is attended with nausea and fainting. Dose.—Same as Cocculus. Pulsatilla.—Especially where there is a suppression of the menstrual flow, also where there is chilliness, or in- clination to tears, or tears and laughter: silent melan- choly ; sensitive with nervous paroxysms. Dose—Two drops, or twelve globules, in a glass half full of water, a teaspoonful every half hour until there is an improvement and then every four hours. Aurum.—Alternate tears and laughter; morbid sensibi- lity; religious melancholy, despair, oppression at the chest. Dose.—Same as Pulsatilla. Belladonna,—If during the fit the face is red and swollen, and there are evidences of a determination of blood to the head. Dose.—Same as Pulsatilla. Veratrum.—Spasms from fear, rage, or fright; clench- ing of the jaws; coldness of the extremities and cold perspiration on the forehead; convulsive jerking with numbness; fainting from the least movement. Dose —Same as Cocculus. See also Chlorosis, Amenorrhea, Menorrhagia and Insanity. If there is violent hiccough, give Nux, Coffea or Bel- ladonna every ten minutes. Nux-vom.—Aversion to life, ill-humor, aching and dull- ness in the head, exhaustion from walking, unrefreshing sleep, pain in the stomach and bowels, constipation and piles. Sulphur.—Great bodily and mental indolence, depres- sion of spirits, constipation and restlessness. Nat.-mur.—Depression of spirits, weeping and dis- position to be alone; ill-humor, aversion to life, head- ache with want of appetite. Dose.—Six globules or three drops should be placed in a glass half full of water, and if the symptoms are violent, a teaspoonful given every half hour. If the symptoms are not violent, a dose two or three times a day will be sufficient. 10 218 AFFECTIONS OF THE HEAD. CHAPTER VI. AFFECTIONS OF THE HEAD. HEADACHE. Cephalgia. The head sympathises with the derangements of nearly all the other parts of the system. The causes of head- ache are exceedingly varied, rendering it necessary, to ensure success in its treatment, that the symptoms shall be carefully noted, and the cause of the difficulty as- certained as nearly as possible. With a little care in selecting the appropriate remedy, persons can frequently relieve themselves of this troublesome affection, so com- mon to all, without the aid of a physician. We shall speak of some of the prominent causes, and mention the appropriate treatment under their several hands. 1. Headache from congestion to the head. 2. From catarrh or cold in the head. 3. From constipation, and gastric derangement. 4. From rheumatism. 5. From external causes. 6. Sick headache. 7. Nervous headache. 1. Headache from congestion to the head. Some of the prominent symptoms are, violent throb- bing of the arteries of the head; fullness and heaviness of the head, accompanied by giddiness, particularly on stooping or walking in the sun; also fullness and pain above the eyes, increased by stooping; heat about the head. Treatment.—Abstain from highly stimulating food and drinks, such as ardent spirits, tea, coffee, &c. Bathe the head freely in cold water, placing if necessary, a cloth wet with cold water on the temples. HEADACHE. 219 Congestion caused by chagrin requires: Chamomilla. By suppressed grief or mortified feelings: Ignatia. By anger : Nux-v., Chamomilla, or Bryonia. By fright; Opium. By constipation: Aloes, Nux-v„ Opium. From gastric derangements: Sepia, Nux-v., Ipecac, Bryonia, Sulphur. From the use of intoxicating liquors: Nux-v., Opium. From a blow : Arnica. From joy: Coff. From a cold : (See Influenzal) From suppressed menstruation: Bell., Puis., Acon., Verat., Bry., Sepia. From sedentary habits : Aloes, Nux-v., Sulphur. Symptomatic Indication.—Nux-vom., is an invaluable remedy, when the difficulty is caused by abuse of ardent spirits, sedentary mode of life, and severe mental labor, also when the following symptoms are present. Heat and redness of the face, throbbing of the arteries of the head, paroxysms of vertigo, violent headache, particularly in the forehead over the eyes, increased by stooping or coughing. Heartburn; insipid taste ; nausea and vomiting. Dose.—One drop, or twelve globules in a glass half full of water, a teaspoonful, every two hours, or if the trouble is chronic give morning and night. Belladonna.—In the more severe forms, when the veins about the head are distended, accompanied with paroxysms of stitching pain on one side, aggravated by motion, noise or light; not unfrequently scintillations before the eyes, and obscuration of sight; buzzing in the ears, and stupor. Violent aching pain, bloodshot eyes, delirium, worse on moving the eyes and head, and great sensitiveness to light or noise. The symptoms are generally developed by disturbance or derangement of some other organ, as during dentition, from cold or derangement of the menses. 220 AFFECTIONS of the head. Aconite.—When the symptoms are violent, accompani- ed by heat and considerable pain, violent throbbing, heaviness and fullness in the head, delirium, sensitiveness to light or noise, and aggravated by motion. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or six globules dry on the tongue, Give once in two or three hours, or every hour if the pain is violent. Alternate with Belladonna. These remedies, if the symptoms commence with considerable violence, should be given at the beginning of the attack. Bryonia.— Compressive pains in the head, or sensitive on stooping, as if every thing would protrude through the forehead. Bleeding at the nose, burning and watery eyes, constipation. Chilliness; thirst day and night. Especially indicated in warm and damp weather. Dose—Same as Aconite. Give once in three or four hours. Rhur.—Burning pulsative pains, with fullness in the head, fluctuation of the brain as from a fluid rolling in- side, weight in the back part of the head; particularly if pains occur after a meal. Nervous headache. Fre- quently in alternation with Belladonna, or Bryonia. Dose.—Same as Bryonia. Opium.—Severe tearing pains, heaviness and beating in the head. Muddy sensation of the brain, with stupor. Wandering look, constipation. Dose.—Same as Aconite Give once in four or six hours. Pulsatilla.—Pressive and distressing pain in the side of the head, commencing in the back of the head and extending into the root of the nose, or vice-versa. Re- lieved by binding something tight around the head, or walking, and aggravated by sitting or looking upward ; heaviness of the head; paleness of the face vertigo; tearful humor, particularly in females, shivering anxiety. Derangement of the stomach from fat food, flatulency; acidity of the stomach. It suits those of a cold or lym- phatic temperament. Dose.—Same as Aconite HEADACHE. 221 Gloeninc has been found highly beneficial when there is fullness and severe pain, almost causing delirium. Three globules may be given once in three or four hours. Mercury.—Fullness in the head as if it would split, or as if it were compressed with a band. Worse at night, with burning, tearing, boring pains, easy and profuse perspiration. Dose.—A powder, or six globules, once in four or six hours. Veratrum.—Pressive throbbing pain; sensation as if the brain were bruised; or constrictive pain, rigidity of the nape of the neck, nausea and vomiting; neuralgic pain almost insupportable. Dose.—Same as Bryonia. 2. HEADACHE FROM CATARRH, OR COLD IN THE HEAD. Aconite.—Where the fever is intermixed with chills, running at the nose and eyes, and pressing, dull feeling over the eyes. Frequently followed by Stibium: Dose.—Two drops or twelve globules, in a tumbler of water, a tablespoonful once in three hours. Nux-vom.—Constipation with chilliness, or feverish heat in the head, heaviness in the forehead. Dose.—A powder, or three globules, once in four or six hours. Mercury.—Pressing pain over the root of the nose, frequent sneezing and running at the nose, chilliness and pains in the limbs. (See also Coryza, or cold in the head.) Dose.—Same as Nux-v. 3. HEADACHE FROM CONSTIPATION AND GASTRIC DERANGEMENT. Headache occasioned by constipation will generally be relieved by Nux-v., Bry., Op., Sulph., or Aloes, (see Nux-v., Bry., and Opium, under headache from con- gestion to the head.) Besides these I have found great benefit from Sepia, where there is constipation occasioned by derangement of the liver, and where there are shooting and boring 222 AFFECTIONS OF THE HEAD. pains in the head, with nausea and vomiting; headache, worse in the morning ; intolerance of light, with inability to open the eyes; congestion of blood, with heaviness and confusion of the head. Particularly in females and where there is a derangement of the menstrual functions. Dose.—A powder, or six globules, once in six hours. Silicea.—Throbbing pain, with heat and congestion in the head, worse in the morning or afternoon, aggravated by intellectual labor, speaking or stooping ; sensation as if the head would split; pain on one side, shooting, tear- ing, and extending over the face; tubercles on the head, tenderness of the scalp, and falling off of the hair. Dose.—Same as Sepia. Sulphur.—Pressure and heaviness in the head, shooting pains, particularly in one side; severe pain over the eyes; throbbing, bubbling pain with heat in the head, worse in the morning, at night, or in bed, also increased by thinking or in the open air. Dose.—Same as Sepia. Where occasioned by gastric derangement, Bry., Puls^ Nux-v., and Ipecac, are the prominent remedies. Pulsa- tilla will be found beneficial where the headache has been occasioned by eating too freely, particularly of greasy food, and where there is considerable nausea. Ipec ic is also frequently beneficial where there is con- siderable nausea, and violent headache. (See gastric derangement.) HEADACHE FROM RHEUMATISM. The prominent remedies in this variety of headache are Be7!., Puis., Bry., Rhu*, Nit.-ac, Spig., Nux-v. For the symptomatic indications of Bell, Puis., Bry., Rhus, and Nux-v. (See Headache from congestion.) Nit.-ac is indicated where there is sharp shooting, or sore and aching pain about the head, particularly where it occurs after, or in connection with, a rheumatic attack in some other part of the body. (See Rheumatism.) HEADACHE. 223 5. HEADACHE FROM EXTERNAL CAUSES. The external causes, which may produce headache, are exceedingly numerous. It will only be necessary to enumerate a few, with the prominent remedies, under their respective heads. When produced by a fall, or blow: Arnica. From abuse of spirituous liquors: Carb.-v., Nux-v* Coff., Pulsatilla. From a chill: Bell., Bry., Dulc, Nux-vom. When produced by bathing: Ant., or Pulsatilla. From cold drinks: Bell., Ars., or Pulsatilla. From changeable weather: Bry., Rhus, Carb.-v., Nux- v., Rhododendron. From Tobacco: Ant., Ign., Aconite. From prolonged watching: Cocc, Nux-v., Pulsatilla. From heat: Acon., Bell., Bry., Carb.-v. Dose.—In sudden and violent attacks of headache it may be ne- cessary to give the remedy once in from half an hour to two hours. Where it is long-continued or habitual, a dose may be given every night, changing the remedy, if after five cr six doses but little benefit has been derived. 6. NERVOUS HEADACHE. This variety of headache is generally confined to one side of the head, or the pain is developed above the root of the nose. The pains are of a neuralgic character, vio- lent, throbbing, darting and stinging, worse at night, and attended with thirst, flushed cheeks, and great sensitive- ness to light, noise, or touch. Belludonna is a prominent remedy, where the pains are of a violent burning, shooting, or rending character, commencing sometimes gently, but increasing to a fear- ful intensity. There is often a roaring and buzzing in the ear, and sensation as if water were fluctuating in the head. Rhus, Bryonia, Ign., Nux-v., Puis., Coff., Cham, are also prominent remedies in this affection. (See Head ache from congestion.) 224 AFFECTIONS OF THE HEAD.. 7. SICK HEADACHE. This troublesome difficulty is generally dependent on gastric derangement, and in some persons it seems to be periodical, returning at stated times, at intervals either more or less frequent. There is generally sickness at the stomach, swimming in the head, or violent aching pain, not unfrequently coming on in the morning, and continuing until relieved at night by sleep. The prominent remedies are, Ipecac, Bell., Bry., Nux-v., Spig., Acon., Sep. Where the symptoms commence with nausea and vo- miting and are accompanied with bruised sensation about the head, Ipecac, is the appropriate remedy and should be given immediately at intervals of half an hour. Nux-v. is also a prominent remedy for the indications of which as well as the other remedies. (See Headache from Congestion. Also Sea Sickness.) The tendency to sick headache is often removed by taking a dose of Nux, when the first symptoms are no- ticed. A dose of Nux, Sepia, or Silicea taken every other night for a week or two, will often entirely eradicate the tendency to this extremely painful complaint. Dose.—A powder, or six globules, may be given on the tongue as directed above. In the different forms of headache I have found great benefit from the use of the Battery. Place the negative pole to the foot. Hold the positive pole in one hand and pass the other hand over the forehead and down the spine. VERTIGO. This is generally symptomatic, disappear'ng when the cause is removed, yet it is sometimes the prominent symptom. When occasioned by a derangement of the stomach, VERTIGO. 225 Ant,, Bell, Nux-v., Cham., Merc. Puis., and Rhus may be consulted. , By nervous affections: Am., Bell, Chin., Hep.-s., Nux- v., Pids., Mosch., Rhus. When occasioned by congestion of blood: Acon., Bell^ Chiln., Con., Op., Puis., Nux-v., Sulphur. Suppressed ulcers and eruptions: Calc, or Sulphur. The motion of a carriage: Hep.-s. and Sil., or Cocc and Pet re7. Aconite.—Vertigo on rising from a recumbent posture or stooping, nausea or cloudiness of the eyes, loss of con- sciousness and whirling in the head. Antimonium- Disordered stomach with nausea and vomiting. Arnica.—When occasioned by too full a meal, and at- tended by nausea, cloudiness of the eyes, and whirling in the head. Belladonna—Vertigo, with anguish, dizziness, cloudi- ness, or sparks before the eyes, or with staggering, nau- sea, trembling and recurrence of the attacks on stooping or rising up. Conium.—Whirling vertigo, causing the patient to fall sideways, heaviness and fullness of the head, weakness of memory. Hepar-s.—Produced by the motion of a carriage or moving the head, with nausea, fainting, and dizziness. If not sufficient, follow by Cocc, Petrol, or S'licea. lachesis.—With paleness of the face, fainting and bleeding at the nose, particularly in the morning. Nux-v.—During and after a meal, when walking in the open air, in the morning, or in the evening in bed, or when lying on the back, with whirling or wavering in the head, buzzing in the ears, cloudiness of the eyes or fainting. Opium.—Coming on when rising up in bed, or caused 10* 226 AFFECTIONS OF THE HEAD. by fright, and attended with trembling, dizziness, and humming in the ears. Pulsatilla.—Vertigo on raising the eyes, or when seated, or stooping, or in the evening in bed, or after a meal, with nausea, heaviness in the head, humming in in the ears, paleness of the face. Silicea.—Vertigo in the morning, on elevating the eyes; from the motion of a carriage, or mental emotion, with nausea and retching. Sulphur.—Vertigo when sitting; in the act of ascend- ing ; after a meal; in the morning; at night with nau- sea; fainting and bleeding at the nose. Administration. —Two drops, or twelve globules, in a tumbler of water ; or a powder, or three globules, on the tongue. Give once in from one to four hours, according to circumstances. APOPLEXY. Diagnosis.—The attack is generally preceded by pre- cursory symptoms, which if promptly met by the appro- priate remedies, often readily yield, and thus the attack itself, for the time is warded off. There is dullness and heaviness of the head, obscuration of sight, buzzing in the ears, hardness of hearing, great disposition to sleep, which however is unrefreshing and disturbed by dreams; derangement of the memory, heat and throbbing of the arteries of the head, and sometimes severe shoot- ing pain; cold hands and feet, pulse slow, full, and in- termittent, and not unfrequently torpor of the abdominal organs. When total apoplexy of the brain takes place, the pa- tient falls down without consciousness, totally, or par- tially paralyzed; the breathing is stertorous and slow, the pulse hard, full and slow, the eyes are staring and protruded, speech difficult, or entirely lost, the face is livid, and vomiting frequently takes place. APOPLEXY. 227 In some cases the patient complains of a sudden and violent headache, vomiting sets in, the pulse is at first soft, the face pale, and the patient in a kind of stupor; gradually the stupor increases, the face becomes red, the patient answers with difficulty, coma sets in, from which every effort to rouse the patient is unsuccessful. Causes.—Apoplexy is more frequent among males than females, and generally occurs after persons have passed the prime of life. A predisposition to apoplexy is indi- cated by a stout short body, large and short neck, corpu- lence, dark, red countenance. The predisposition is in- creased by rich living, piles, and sedentary habits. It is also frequently induced by sudden changes of temperature, strong mental emotion, abuse of spirituous drinks, or narcotic substances, tight cravats, and organic affections of the heart. Treatment.*—In the treatment of this disease the homoeopathic plan is much more successful than any other. If taken during the premonitory symptoms, as I have already stated, the attack can generally be warded off. The first step should of course be to remove the ex- citing causes. Tight dresses should be loosened, the pa- tient placed in a cold place, where there is plenty of fresh air, and the head and trunk raised. Should the attack have been produced by poison, this should at once be antidoted. (See chapter on Poisons and their Anti- dotes.) The premonitory symptoms require principally, Acon., Bdl, Opium, Nux-v., Ipecac, Coff., and Mercury. Belladonna is an important remedy, where there is severe pain in the forehead, and heat in the head, draw- ing, tearing, or heaviness and dullness of the head, vertigo, illusions of the senses, great restlessness, sopor, stertorous breathing, dilated pupils. * For general directions as to the administration of remedies, see page 12. 228 AFFECTIONS OF THE HEAD. Coffee.—When produced by mental emotion; sad and whining mood, great nervousness and sleeplessness, heavi- ness and tightness of the head, with pain as if bruised. Opium.—Particularly in old persons, and when oc- casioned by ardent spirits. Stupor, coma, stertorous breathing, red, bloated face, moaning, motion of the lips as if to talk, full and slow pulse, with throbbing of the arteries of the head. Hyosciamus.—Sudden attack, accompanied by con- vulsive motions and followed by snoring breathing. The precursory symptoms are characterized by languor, oc- casional loss of consciousness, disposition to sleep, from which he starts in affright, small and feeble pulse, violent vertigo, illusions of the senses, sad and peevish mood. Nux.-vom.—In the precursory stage, in persons of seden- tary habits, or addicted to the use of ardent spirits, par- ticularly when there is vertigo and dull heavy pain on the right side. Arnica.—Particularly when occasioned by mechanical injuries and where it appears after a meal. Mercury.—Distensive pain in the head as if it would burst, throbbing of the arteries, uneasiness and heavi- ness of the limbs, languor and lassitude from the least exertion, blackness of sight, with vertigo. Frequently in alternation with Belladonna. Administration.—In violent cases where the attack has actually commenced, do not trust too much to your own resources, but send immediately for a physician, giving in the mean time a dose of the appropiate remedy every fifteen, twenty, or thirty minutes. For the precursory symptoms a dose may be given three or four times a day. Mix two drops, or twelve globules of the remedy in a tumbler of water, giving a tablespoonful at a dose; or place three globules, or a powder on the tongue. Diet and Regimen.—The diet where premonitory symp- toms are present, is all-important. It should be light INFLAMMATION OF THE BRAIN. 229 and spare, and consist entirely of bread, fruit and vege- tables, and in very moderate quantities. INFLAMMATION OF THE BRAIN. Encephalitis. Meningitis. Arachnoiditis. The position of the brain and the membranes which invest it, has already been explained in the chapter on Anatomy. Inflammation of the brain itself, is called Encephalitis, of the Dura Mater or membrane next the skull, Meningitis, of the covering next the brain, Arach- noiditis. As it would be difficult to discriminate between these varieties of inflammation, and not essential to the treatment, it will be only necessary to give some of the prominent symptoms which characterize inflammation of the brain and its investing membranes. Diagnosis.—The attack may come on suddenly, with but little pain, but characterized by a drowsy sensation and great stupor, sensitiveness to light, dizziness, and contract- ed pupil. This is more frequently the form of attack in old persons. More commonly however, there is severe pain, heat and fullness in the head; throbbing of the arteries, irritability, vertigo, sleeplessness, or restless sleep, with disturbed dreams, or starting as in affright, stupor, un- steady gait. The pulse is full, sometimes suppressed, but generally rapid. As the disease increases and as- sumes a distinct character, the pain in the head may be- come dull and heavy, and be aggravated by the slightest movement, the head hot and burning, the countenance flushed and wild, the eyes shining and red, the pupils contracted; great sensitiveness to light, grating of the teeth, great stupor and stertorous breathing, delirium, mild, or wild and raving. The deeper the interior of the brain is affected, the more the senses become stupified, until the patient may become entirely unconscious. The thirst is intense, the skin dry and hot, and the pulse generally small, frequent, and tremulous. 230 AFFECTIONS OF THE HEAD. Treatment.*—External application should be made to the head of cold water, taking care to remove the cloths frequently before they become warm, or what is still better, the application of a bladder, filled with pounded ice. The latter is much the best as the cold is continuous. Aconite.—Particularly at the commencement of the disease, and when there is violent inflammatory fever, burning pains in the head, redness of the face and de- lirium. It is often indicated before or in alternation with Belladonna, Belladonna is a very important and in fact the prin- cipal remedy in this disease. Where there are violent burning and shooting pains in the head, together with great heat and violent pulsations in the head, and red- ness of the face. Red, sparkling eyes, with furious look, loss of consciousness, sometimes low mutterings, at others furious delirium, convulsions, spasmodic constriction of the throat, vomiting, &c. The patient buries the head in the pillow and is exceedingly sensitive to light or noise. In alternation with Aconite, or perhaps Hyoscia- mus, or Stramonium. Hyosciamus.—Drowsiness, loss of consciousness, wild and talkative, or muttering delirium, talking about his own affairs, dilation of the pupils; picking the bed clothes, redness of face ; inarticulate speech. Stramonium.—Constant jerks of the limbs, moans, and tossing during sleep, and frequently absence of mind on walking; timidity and fear. Bryonia.—Prolonged shiverings, with heat in the head, thirst; constant inclination to sleep, with delirium, starts, cries, pressive burning or shooting pain in the head. Opium.—Lethargic sleep, with snoring, half open eyes, dizziness on waking, frequent vomiting, entire apathy and indifference to every thing. Administration.—Two drops, or six globules, in a turn- • For general directions as to the administration of remedies, see page 12. SUN-STROKE.--FALLING OFF OF THE HAIR. 231 blerof water, a tablespoonful every one or two hours, and sometimes in exceedingly severe cases every half hour, until the severity of the symptoms abates. Diet and Regimen.—The same as in fevers. SUN-STR OKE. Coup-de Soleil. This is a kind of inflammation of the brain produced by exposure to the strong heat of the sun. It is quite common in India, and other warm climates. The head may be bathed with brandy, and a small quantity given internally occasionally, until the prominent symptoms are relieved. Camphor may be given, one drop at a dose, at intervals of five or ten minutes, to be followed after four or five doses have been taken, by Bdladonna, alone or in alter- nation with Carb.-v., or Lachesis, half an hour apart. FALLING OFF OF THE HAIR. Alopecia. Consult a physician if possible, if not, avoid the cause if you can discover it, and examine some of the following remedies. Where it is occasioned by severe acute disease: Hepar- s., Calcarea, and Silicea may be consulted. In Lying-in-Women: Calcarea, Sulphur. From Debilitating losses: CJiina, Ferrum, or Mercury. From Grief: Phos-ac, or Ignatia. From frequent attacks of headache: Hepar-s., Nit.-ac^ Pho^phoru*, Sepia.. From abuse of Mercury: Ilejjar-s., or Carb.-v. When there is a strong tendency of the hair to turn grey: Phos.-ac, Sulph.-ac or GrapJiitis. When there is much scurf on the head: Calcarea, Graphitis. The head should be bathed frequently with cold water, 232 AFFECTIONS OF THE HEAD. but oily applications should as a general thing be avoided. The great object is, to keep the scalp clean and gently stimulate the hair bulbs, which may be done in the manner described above, but which oily applications seldom accomplish. It is sometimes advisable to put five or six drops of Cantharidis into a tumbler half full of water, and wash the head once or twice a day. A dose of the medicine may be taken every night, or night and morning. AFFECTIONS OF THE EYES, EARS, AND NOSE. 233 CHAPTER VII. AFFECTIONS OF THE EYES, EARS, AND NOSE. 1. AFFECTIONS OF THE EYES.* The eyes are subject to various disorders, but the ex- treme delicacy of the organ renders it highly important that as a general thing they should be treated by a care- ful and scientific physician or occulist. The step from sight to blindness is so short, that often the utmost care and caution are neccessary to ward off serious conse- quences. Examine particularly the article on the eye in the chapter on Anatomy. Lotions should as a general thing be avoided, confin- ing externa] applications to puie soft water, milk and water, or a mixture made from pouring water upon quince seeds. These applications may be made either cold or tepid, according to the feeling of the patient. If the redness is occasioned by external injury, or is slight and the result of a simple cold, six drops of Arnica may be placed in a cup half full of water, and the eye washed with it three or four times a day. WEAKNESS OF SIGHT. Amblyopia, Under this head we shall include Amaurosis, and the various forms of weakness of sight, most frequently met in practice. The causes are exceedingly numerous, and sometimes difficult to detect. It may arise, as in amaurosis, from a weakened, paralyzed, or diseased state of the retina or optic nerve. It may be occasioned by inaction or derange- * For a description of the eye, see plate 1, and Anatomy. 234 AFFECTIONS OF THE EYES. ment of some of the various branches of nerves, which pass to different parts of the eye, and not unfrequently by gastric, nervous, or catarrhal derangement, or general weakness of the entire system, occasioned by disease too frequent sexual indulgence, and self-pollution, long. continued watching, great mental anxiety or trouble. It may also be occasioned by too great labor of the eyes, exposure to strong light, constant reading, especially in the twilight, and that variety of employment which re- quires close application. Amaurosis, sometimes coming on gradually, at others running its course with great rapidity, may end in partial or entire blindness. If neglected too long there is but little hope of relief, }ret if taken in time, it can speedily be removed by a judicious homoeopathic treatment. There may be more or less pain about the eyes and the head, a dimness of sight, every thing looking thick and muggy, or appearing as if seen through a net- work, black specks before the eyes like moats or cin- ders, multiplying in number until the whole becomes dark, or the first symptoms may be a remarkable dimi- nution of the apparent size of objects ; thus a horse may not appear larger than a dog. Treatment.*—In all forms of weakness of sight parti- cular attention should be directed to the general health the causes of the trouble should be carefully avoided' and the utmost care taken to live in accordance with the laws of nature. Pure and bracing air, out-door exercise, healthy nourishing food, frequent bathing, and a cheerful disposition, are of vast importance. As it regards some of the various causes, where the disease has been pro- duced by employment in fine work, Bell, Ruta, Calc, or Spig. may be consulted. Where the result of debilitating causes: Natr.-m.t Chin., Plios.-uc Nux-v., Sulphur. * For general directions as to the administration of remedies, see page 12 WEAKNESS OF SIGHT. 235 From abuse of spirituous liquors: Chin.,Lach., Nux.-v^ Opium. The result of a cold : Bell, Dale, Eupli., Pulsatilla. In aged persons: Aur., Con,, Op., Secale. In scrofulous persons : Bell, Calc, Me re, Sulph., Aur., Ilep-s, Iodine. The result of rheumatism: Cham. Euph, Merc, Puis., Rus., Hll, Spig., Causticum. Of suppressed eruption: Calc, Caust., Sil, Merc, Sulphur. Abuse of mercury: Aur., Nit.-ac, Bell., Hyos., Nux-v. Connected with congestion to the head: Op., Bell., Ilyos., Nux vom. With disease of the ear: Nit.-ac, Petrol, Pulsatilla. With gastric or abdominal affections: Caps., Cocc, Nux-vom., Puis., Staphysagria. With uterine derangement: Plat., Sep., Con., Cic.% Sidph. With pulmonary affections: Calc, Hep.-s., lod., Sil., Phosphorus. Symptomatic Indications.—Aurum.—Flames and sparks or black points before the eyes; appearance of objects as if they were divided horizontally. Bel'adonna.—Dilated or insensible pupils; great into- lerance of light; flames, black points or colored or sil- very spots before the eyes; nocturnal blindness com- mencing at sunset; pressive and shooting pain, extend- ing to the orbit and forehead. Calcarea.—Confusion of sight as if looking through a mist, especially when reading; intolerance of light; di- lated pupils. Cicuta.—Frequent suspension of vision, vertigo, wa- vering of objects before the sight, and apparent move- ment of letters when reading. Il/osciamu*.—Nocturnal blindness, dilated pupils, strabismus, and illusions of sight. 236 AFFECTIONS OF THE EYES. Mercury.—Cloudiness of sight; black points, sparks and dancing motes before the eyes; sudden attacks of blindness; great sensibility of the eyes; shooting or pulsative pain. Nux-v.—Sparks or spots before the eyes; sensibility to the brightness of day; heaviness and contraction oi the eyelids. Phosphorus.—Sudden attacks of blindness; objects appear as if covered with a grey veil; sensibility to the brightness of day, and black spots before the eyes. Pulsatilla.—Confused sight as if looking through a fog, or something which might be removed by rubbing; intolerance of light with shooting in, or flaming circles before the eyes; contraction of the pupils, and profuse discharge of tears. Ruta.—Confusion of sight as if looking through a mist; dancing black points before the sight, and press- ing, burning pains in the eyes, especially when fa- tigued. Silicea,—Momentary attacks of blindness, confusion and pale appearance of, letters when reading; black spots before the eyes, intolerance of light, and discharge of tears. Sulphur.—Confusion of sight as if looking through a mist, or a black veil were before the eyes ; intolerance of light; sudden attacks of blindness by day; sparks, dancing moats and black spots before the eyes; profuse discharge of tears or excessive dryness of the eyes. Agaricus.—Incipient amaurosis; indistinct sight; every thing appears obscured as from muddy water, or surrounded with mist, or as if covered with cobweb; double sight, black motes hovering before the sight Consult also Ophthalmia. Administrate.—Two drops, or twelve globules, in a tumbler, a tablespoonful at a dose; or a powder, or six OPHTHALMIA. 237 globules, dry on the tongue. A dose may be admin- istered from once to three times a day. OPHTHALMIA. Inflammation of the Eyes. In inflammation of the eye, the irritation generally extends also to the lids, as the conjunctiva or external membrane of the eyeball is, as we have already shown, reflected over the inner surface of the eyelids. External applications may consist of either cold or tepid water, or milk and water, or a mucilage made by pouring water on quince seeds. The room should be darkened, and the patient kept as quiet as possible. Care also should be taken that matter from the diseased eye should not be transmitted to those of the attendant, as a similar inflammation would be the result. In simple inflammation of the eye, a lotion may be used, two or three times a day, composed of one grain Sulph.-zinc to a tablespoonful of water. The prominent remedies in Ophthalmia are Bell, Am., Euphrasia, Acon., and Merc. These remedies may be indicated in almost every variety of the disease. In treating this disease, we shall for the sake of clearness, speak of it under the following heads. a. Catarrhal Ophthalmia. b. Rheumatic and Arthritic Ophthalmia. c. Scrofulous Ophthalmia. d. Syphilitic Ophthalmia. a. Catarrhal Ophthalmia. This is generally the result of a cold, frequently affects both eyes, and may be attended with cough and fever. The redness gradually extends over the whole conjunc- tiva, at first there is profuse discharge of tears, then more or less secretion of mucus. The eye is sensitive to the light; pressure in the eyes with burning, shooting 238 AFFECTIONS OF THE EYES. pains, and sensation as if sand were lodged between the lids, are also present. Aconite is an important remedy in the commencement of the treatment, either alone or in alternation with Belladonna or Cliamomilla. Chamomilla is servicable when there is slight catarrhal fever, sensation of pain on opening and closing the lids, which are often closed with mucus. Belladonna is an invaluable remedy, where there is congestion to the head, great redness and dryness of the eyes, and sensitiveness to light. It is particularly indi- cated where there is a profuse watery discharge from the nose, accompanied with the usual catarrhal symp- toms. The indications of Euphrasia are similar to those of Belladonna, with the exception that with the former there may be a profuse discharge of tears and mucus, which is not characteristic of Belladonna. The Eu- phrasia is also more particularly indicated where the inflammation is violent and extensive, or where little ulcers may have formed around the cornea. Ignatia will be of service where there is but little ap- parent inflammation, but severe aching pain in the balls, accompanied with great sensitiveness to light, and pro- fuse lachrymation and coryza. Dose.—Dissolve two drops, or twelve globules, in a glass half full of water, and give a teaspoonful every two hours, increasing the in- tervals as the symptoms improve. A disposition to catarrhal ophthalmia on every change of the weather, can frequently be relieved by a few doses of Suljjh., Calc, or Nux-v. In the first stage of the disease, four drops of Arnica may be placed in a cup of water, with which the eye may be bathed. OPHTHALMIA. 239 b. Rheumatic and Arthritic Ophthalmia. This variety of ophthalmia is generally connected with rheumatic and gouty difficulties, and is attended with severe pain. There are sticking, tearing or boring pains in the eyeballs, orbits, and not unfrequently in the temples, aggravated by change of weather. Great red- ness of the eye, sensitiveness to light, and sometimes profuse lachrymation are also present. This is a highly dangerous variety of ophthalmia, as the inflammation is liable to extend to the internal membranes, and create ulceration of the cornea, and frequently loss of sight. The prominent remedies, are Acon., Bell, Spig., Col., Enphn also Put*., Bry., Rhus. Sulphur, Calc, Ilep^ Cuu^t., Merc, may also be consulted. Treatment.—In the commencement of the difficulty, if the inflammation should be slight, and the disease evidently of a rheumatic character, Bryonia and Pu7- satilla may be given in alternation, and if there should be considerable fever present, and the pain be more severe, Rhus and Aconite may be alternated in the same way. As a general thing, where the usual inflammatory phenomena are present, Aconite should commence the treatment, either in alternation, or followed by Bella- donna, if there should be indications of congestion to the brain, violent pain about the eyes and profuse lachrymation. Be'lctdonna is particularly useful, when beside the symptoms already mentioned, there are severe aching pains over the eyes, with pain in the balls as if they would be torn out or pressed into the head; sparks and flashes before the eyes; intolerance of light, confusion of sight, &c. Euphrasia is a valuable remedy where the pain is severe, the inflammation extending to the cornea, or if 240 AFFECTIONS OF THE EYES. ulcers ha\ e formed there, and the pupil become con- tracted. Spigelia is suitable when the eyeballs feel swollen and exhibit a number of enlarged vessels; the pain is violent, sticking, boring, and digging, and proceeds from the in- terior of the eye; on opening the eyes objects seem to float in fire. Cob cyntli is an invaluable remedy where the pains are seated in the eyeballs, and are of a burning, cutting character, and where there is congestion of the head, intolerance of light, lachrymation, pressing and tearing pain in the whole brain, most violent in the forehead on moving the eyes. Veratrum. Tearing pain interrupting sleep at night; intolerable headache. Dose.—Two drops, or twelve globules, in a glass half full of water, a teaspoonful every hour or two hours until the pain is relieved ; then every four hours. Sulphur is also of importance near the close of the disease, or to quicken the action of the other remedies. See also, Inflammation of the eyelids and weakness of sight. Scrofulous Ophthalmia. This is a common form of ophthalmia, but generally is confined to children. The eyeball is very red and bundles of enlarged vessels run towards the cornea; there is intolerance of light, profuse discharge of corrosive tears, increased secretion of mucus, and an aggravation of symp- toms towards morning; the eyelids are generally redden- ed, and if the cornea is affected, it becomes dim and sometimes ulcerates. Arsenicum may be given when the pains are of a burning character. Dose.—A powder, or six globules three times a day. Bella lonna. Sensation of pressure in the eyes, worse on turning them up; sensitive to light. Dose.—Same as Arsenicum. OPHTHALMIA. 241 Hepar. Particularly useful in children who have taken calomel and when the lids are red, sore, and pain- ful to the touch, as if bruised. Dose.—A powder, or six globules, morning and night. China. Pain in the eyes in the evening, with sensation as if there were sand in them. Dose.—Same as China. Dulcamara. Will be of benefit when cold is the exciting cause. Dose.—Same as Arsenicum. Mercurius. When the pains are cutting, worse in the evening and in a warm bed; the eyes fill with tears and are sensitive to the light; sight clouded and small pustules on the ball. Dose.—Same as Arsenicum. Calcarea and Sulp/iur are both prominent remedies, in chronic cases, when they may be given, a dose of one in the morning, and of the other at night. See also Tu- berculosis. d. Syphilitic Ophthalmia. This variety of ophthalmia may arise from suppressed gonorrhoea or syphilis, and from a transmission of the matter to the eye. The treatment should commence with Aconite, followed after the fever is somewhat sub- dued, by Mercury, and this after eight or ten doses have been taken, if decided relief is not obtained, by Nit-ac, Sulph., or Thuja. A physician should be consulted immediately, as prompt and skilful treatment is necessary to avoid serious consequences. Administration.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or a powder, or three globules, dry on the tongue. In severe cases a dose in one or two hours, but as the symptoms gradually abate, the intervals may be extended to four or six hours. 11 242 AFFECTIONS OF THE EYES. In the milder forms of the disease, a dose once in four or six hours will be sufficient. See also page 12. Diet and Regimen.—The patient should be kept per- fectly quiet, and the room more or less darkened, to suit the feelings of the patient. The diet should be simple, as in fevers. Inflammation of the Eyelids. Aconite.—Where the eyelids are swollen, hard and red, with heat, burning, and dryness; or where there are burning and tensive pain, pale and shining swelling, in- tolerance of light, fever, &c. Bell, Hep., or Sulph., are often suitable after this remedy. Belladonna.—Eyelids swollen and red, burning and itching, bleeding on opening them, or with the margins everted, or paralytic heaviness of the lids. Calcarea.—Incisive, burning or smarting pain, espe- cially when reading, with red, hard and large swelling, copious secretion of humor, and nocturnal agglutination. Euphrasia.—Ulceration and itching of the margin of the eyelids, redness and swelling and agglutination by night; coryza and pain in the head. Hepar-s.—Redness of the eyelids, with pain as from ulceration, or as from a bruise when touched; nocturnal agglutination. Often after Aconite or Mercury. Mercury.—Eyelids hard, with swelling, difficulty in opening them, ulcers on the margin, pustules on the con- junctiva, scabs round the eyes, pain and itching, or absence of pain. Pulsatilla,—Inflammatory redness of the conjunctiva, secretion of mucus, appearance of styes, nocturnal agglu- tination. Sulphur.—Redness of the eyelid, with burning pains, discharge of humor; ulceration of the margin, pustules and ulcers around the orbits. It may be followed or alternated with benefit by Calcarea. Administration.—In acute cases the remedy may be STYE ON THE EYELID. 243 taken once in from three to six hours; in chronic cases once or twice a day. One drop or six globules may be mixed with a tumbler of water, and a tablespoonful taken at a dose; or a powder, or six globules, may be taken dry on the tongue. See also page 12. STYE ON THE EYELID. A swelling or ulceration of the meibomian glands, situated in the margin of the eyelid, is called a stye. This difficulty is exceedingly annoying, but of short duration. On the first appearance of the swelling, Pulsatilla is the prominent remedy, a dose three times a day. Should however ulceration take place, a powder, or three globules of Mercury may be alternated with the same amount of Hepar-s., one dose of each during the day. In these cases I have found great benefit in slightly touching the stye, twice a day, with a very little mild Citrine ointment, obtained at the druggists. Be careful not to let it get into the eye. For a predisposition to these swellings, or where they present a hardened appearance, Staph., Calc, or Sulph. may be given one dose, or six globules, each day. WATERY EYES, OR WEEPING. As we have already explained, in speaking of the ana- tomy of the eye, ducts or little tubes, called the lachrymal ducts, pass from the inner canthus of the eye into the nose, carrying off the water secreted by the tear-glands. When these little ducts are either partially or entirely closed by some obstruction, the tears, unable to pass off by the usua, channel, must of necessity flow over the lids upon the cheek. This difficulty, to say the least, is exceedingly annoying, rendering an almost constant wiping of the eye necessary. The prominent remedies are, Calc, Iod,, Puis., Bell, Sil, Petrol, and Sulphur. The two first may be given 244 AFFECTIONS OF THE EYES. in alternation, a dose of Calcarea one day, and of the Iodine the next. If the attack is recent and accom- panied with swelling, &c. Belladonna and Pulsatilla may be alternated in the same way. Dose.—A powder, or six globules, dry on the tongue; if the tincture is used, one drop may be prepared and administered aa heretolt/re directed. NEAR-SIGHTEDNESS. Myopia. This, when of long continuance is often occasioned by a too great prominence of the eye-ball, and may frequently be entirely removed by gently pressing it with the finger daily, so that it gradually assumes the more flat or natural form. In aged persons and even in others, debilitated by disease, where the sight is weakened, the eye may be too flat, and with the finger gently compressing the ball not unfrequently the original prominence is given to the eye, and the natural sight restored. The prominent remedies in short-sightedness are, Puis., Sulph., Phos.-ac, Nit.-ac. and Carb.-v. When occasioned by ophthalmia, Pulsatilla or Sulphur may be given every other night; when caused by abuse of Mercury: Carb.-ac, or Nit.-ac, and from debilitating losses, Pbm.-ac, in the manner indicated above. Dose.—Same as in "Watery eyes, or weeping." FOREIGN SUESTANCES IN THE EYE. If particles of dust enter the eye, they can generally be removed by bathing it in cold water, or turning the head on one side, gently opening the lids and dropping three or four drops of water into the outer canthus. The watsr flows inward over the eyes and washes out the particles. If the matter is not removed in this way, raise the lid, gently bringing it forward over the other, at the same ti me looking towards the nose. If a hard particle should become imbedded in the membranes of the eye. AFFECTIONS OF THE EYES AND EARS. 245 a silk handkerchief or the point of a needle may be used to remove it. The inflammation caused by the irritation may be removed by washing the eye in cold water or with a mixture, composed of six drops of Arnica to a cup of water. FALLING OF THE LID Frequently bathing the eye with cold water and using as much as possible the muscles on that side of the face where the affection exists will be found advantageous. The prominent remedies are, Veratrum, Zinc, Nit.-ac, Belladonna, Nux, Pulsatilla, and Sepia. A powder, or three globules, of the selected remedy may be giver every third day. 2. AFFECTIONS OF THE EARS. MUMPS. Parotitis. Perhaps this is as appropriate a place as any to intro- duce this oftentimes troublesome and painful, though sel- dom dangerous disease. It consists in an inflammation of the large gland lying under and in front of the ears. It more frequently occurs in children and seldom attacks a person but once. Treatment.*—In its simple form it requires but little treatment, except placing a handkerchief around the neck, and keeping the patient in the house. Mercury in most cases will be found a specific. A powder, or three globules, may be taken two or three times a day. If the tumor should suddenly disappear, and sharp pain be felt in the brain, with lethargy and delirium, Belladonna should be given every hour, followed after three or four doses, if necessary, by Hyosciamus. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose ; given as directed above. * For goneral directions as to the administration of remedies, see page 12. 246 AFFECTIONS OF THE EAR. Should the swelling assume an erysipelatous charac- ter, attended with considerable restlessness and fever Belladonna and Rhus may be alternated two or three hours apart. If there should be a metastasis to the sto- mach, or if the voice should become hoarse, Ca>b.-4)og. may be given, in the same manner as Belladonna, also if there is slow fever and the tumor begins to harden, Mercury having proved insufficient. If there is a me- tastasis to the testicles, as is often the case, the testicles swelling and becoming excessively painful, Pulsatilla, Nux-v., or Mercury are the appropriate remedies, given at intervals of from two to four hours, according to the severity of the symptoms. Diet and Regimen.—The patient should be confined to fruit and light farinaceous articles of diet, avoiding all animal food and stimulating drinks. INFLAMMATION OF THE EAR. Otitis. This is an exceedingly painful disease, attended with heat, redness and swelling, burning, stinging, lacerating and throbbing pain, aggravated by motion, frequently extending over the whole head, and often affecting the brain, accompanied with the usual symptoms of cerebral inflammation. There is generally considerable fever, often delirium, and not unfrequently in children, vomit- ing, coldness of the extremities, and convulsions. This affection is generally the result of cold, but some- times occasioned by the inflammation of an adjoining organ, or the suppression of some cutaneous eruption. Pulsatilla is the most important, and in fact almost specific remedy in inflammation of the ear, a dose of which at first may be given every hour, gradually in- creasing the intervals as the pain subsides. Belladonna, however will be required should symp- toms of inflammation of the brain set in, either with or EAR-ACHE. 247 without convulsions; if violent fever is present, it may be alternated with Aconite, one or two hours apart. Should there be confused noise or sensation as of water rolling in the head with throbbing pain, or if there is yellowish discharge from the ear, Mercury may be re- quired, at intervals of three or four hours, until better. Diet and Regimen.—Same as in fever. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose ; or a powder on the tongue. See also page 12. EAR-ACHE. Otalgia. There is often pain more or less severe in the ears, even when but little if any perceptible inflammation is present. When of a rheumatic character, Belladonna, Mercury, or Pulsatilla are the prominent remedies. When the result of a chill or suppressed perspiration, Chamomilla, Dulcamara, Pulsatilla, Clvina or Sulphur may be consulted. Belladonna.—Digging and boring pains, tearing and shooting, sometimes extending into the throat, with roar- ing and humming in the ears; great sensibility to noise; severe pain in the head and eyes, together with fullness and heat in the head and face. Pulsatilla.—Jerking and lacerating pains as if some- thing were endeavoring to pass out through the ears; redness, swelling, and heat of the external ear, or shoot- ing and lacerating pains, excessively violent, extending over the whole side of the head; particularly in females of a chilly disposition or easily moved to tears. Chamomilla.— Cutting, as from knives; sensation of stoppage about the ear; great sensibility to noise, and extreme sensitiveness to pain. Mercury.—Shooting pains, extending into the cheeks and teeth; sensation of coldness in the ear, and aggra- 248 AFFECTIONS OF THE EARS. vation of pain in bed ; spasmodic pain with inflamma- tory redness of the ear. Nux-v.—Lacerating or shooting pain extending into the forehead and temples, with lacerating in the bones of the face, worse in the morning or evening. Platina.—Spasmodic pains; rolling and thundering in the ears; coldness of the ears and tingling, extending over the face. Spigelia.—Pressive pain as if caused by a plug, with aching and tearing in the bones of the face. Administration.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful every one or two hours until relieved. If, notwithstanding the administration of the appropriate remedy, the pain is not entirely re- moved, a few doses of Sulphur, given at intervals of four or six hours, will generally complete the cure. See also page 12. DEAFNESS. Difficulty in hearing. Hardness of hearing may be produced by cold, mecha- nical injury, various diseases, and in many cases, as where it occurs in the aged, be developed without pain, and give to the patient no clue to its cause. Sometimes from birth, the ears are impervious to all sound, and consequently the child, having no guide in the sound of others' voices for the modulation of his own, is not only deaf but dumb. This condition at first thought so dreadful, is now through the interposition of science and our various excellent asylums, deprived of half its terrors. We shall only have space to give some of the leading indications for the treatment of the various forms of deafness, yet sufficiently full however for domestic prac- tice, as it is often complicated with other difficulties rendering the skill of the physician essential. Derange- DEAFNESS. 249 ment of hearing, the result of catarrhal or rheumatic affections, produced by a chill, generally requires Arsenic, Belladonna, Mercury, Pulsatilla, Calcarea, Causticum, Hepar-s., Nit.-ac, or Sulphur. Occasioned by suppressed eruption: Sulphur or An- timony. The result of measles: Pulsatilla or Carb.-v. Of Scarlatina : Belladonna or Hepar. Of Small Pox: Mercury or Sulphur. Of abuse of Cinchona in Intermittent Fever: Carb.-v^ Calcarea, Pulsatilla. Of abuse of Mercury, Nit.-ac. Aurum, Carb.-v., Sul- phur. Of Fevers, Nervous Affections, &c.: Arnica, Phos- phorus, Veratrum. When produced by by a suppressed discharge from the ears or nose : Hepar-s., Lachesis, Belladonna. Symptomatic Indications.—Calcarea.—Deafness as if the ears were obstructed ; humming, rolling or tinkling, singing, and noise, or throbbing and heat in the ears. Dryness of the ears or purulent discharge; pressive headache in the forehead. Causticum.—Vibration of sound, even the patient's voice in the ear ; sensation of obstruction, with rumbling, humming, and roaring in the ears; discharge from the ears ; rheumatic pain and great sensitiveness to cold. Graphites.—Dryness in the ears or purulent discharge; singing, whistling, tinkling or humming, and thunder- ing in the ears, particularly at night, eruption around the ears. Lachesis.—Often after Causticum, and where there is dryness in the ears, painful pulsations or cracking, roll- ing, drumming and reverberation of sound in the ears; excoriation around the ears. Mercurius.—Sensation of obstruction, ceasing when swallowing or blowing the nose; reverberation of sound 11* 250 affections of ears. in the ears ; tinkling, roaring and humming, particularly in the evening; discharge from the ear, sometimes with ulceration; rheumatic pain in the ears and head, and great tendency to perspiration. Nitric-acid.—Dryness or discharge from the ears; sen- sation of obstruction, with grumbling, throbbing, or cracking; frequent toothache, with affections of the gums. Phosphorus.—Greet difficulty in hearing sounds, and yet excessive reverberation of sounds in the ears, with resonance in the head; throbbing and pulsations in the ears. Pulsatilla,—Tinkling or chirping in the ears, or sen- sation as if they were stopped, with roaring and hum- ming ; shooting pains in the ears ; hard, black or liquid wax, and sometimes discharge of pus or blood. Sulphur.—Difficulty of hearing, especially the human voice ; closing up of the ears, particularly when eating, and blowing the nose ; gurgling, as if caused by water, or humming and roaring; discharge from the ears, and disposition to colds in the head. Consult also Inflammation and Running of the ear. Administration.—Deafness is sometimes caused by a collection of hardened ear-wax, in which case, have it carefully removed. A powder, or six globules, may be given morning and night, every night, or every other night, according to circumstances. See also page 12. noises in the ears. This difficulty seldom exists alone, but is generally connected with some other affection, as deafness, inflam- mation of the ears, or running at the ears. See those diseases. RUNNING OF THE EARS. 251 RUNNING OF THE EARS. Otorrhcea. Running of the ears, is frequently found in scrofulous persons, and is often the result of a cold, and of other diseases, particularly affections of the ear. If the result of acute inflammation of the ear, Pulsa- tilla, Mercury, Sulphur, are the prominent remedies. If occasioned by cold, Belladonna, Mercury or Pulsa- tilla will be required. Occurring after Measles or Scarlatina: Belladonna, Hepar-s., Mercury, Pulsatilla, After Small Pox: Mercury, Sulphur, Carb.-v. From abuse of Mercury: Aurum., Nit.-ac, Silicea. In Scrofulous persons : Hepar-s., Mercury, Sulphur, Iodine. When the discharge is of a purulent character : He- par-s., Mercury, Pulsatilla, Silicea, Calcarea, Nit-ac, or Aurum may be required. Bloody: Mercury, Pulsatilla, Lachesis, Silicea, Sul- phur. Offensive: Carb.-v., Hepar-s., Mercury, Pulsatilla. A sudden suppression of the running may be followed by exceedingly unpleasant symptoms, such as swelling of the glands in the throat, neck, or testicles, and vio- lent headache and fever. If swelling of the glands of the neck commences, Belladonna, Mercury, or Pulsatilla should be given. If there is violent headache, Belladonna, or Bryonia; if the suppression is occasioned by cold, Dulcamara, or Mer- cury ; and if the testicles should commence swelling, Mercury, Pulsatilla, or Aurum will be required. The remedy selected, should be given every three or four hours, until better. Belladonna and Mercurius are particularly useful in discharge after scarlet fever, or small Pox, alternate six 252 AFFECTIONS CF THE EARS. hours apart. Sulphur and Calcarea will be required in tedious diseases. Administration.—Give the remedy once, or twice a day, if the symptoms are urgent, for six or eight days, when, if no improvement is perceptible, another remedy should be selected. Two drops, or eight globules, should be mixed with a tumbler of water, a tablespoon- ful given at a dose; or a powder, or six globules, on the tongue. FOREIGN SUBSTANCES IN THE EAR. In every part of our body, we perceive the most won- derful evidence of design and wisdom. Were it not for the excessive bitterness of the wax in our ears, they would be constantly liable to be invaded by insects; as it is, so far as the ears are concerned, they seldom give us any trouble. When, however, insects do get into the ear, with a little care they can be removed. If the sub- stance should be of a hard nature, as a bean, pea, or seed, care should be taken not to crowd it farther in, but, bending the point of a pin or needle in the form of a hook, it can generally be inserted, and the offend- ing substance drawn out, after which, if the ear should be inflamed, it may be washed by a mixture, composed of two drops of Arnica, to one tablespoonful of water. 3. AFFECTIONS OF THE NOSE. The nose is liable to numerous affections, but as they are mostly connected with other troubles, the treatment as a general thing, is given in connection with those dis- eases. The symptoms and treatment of Coryza, or cold in the head, which frequently involves the nose, has already been given in connection with Influenza and catarrhal difficulties. BLEEDING OF THE NOSE. 253 INFLAMMATION OF THE NOSE. This may arise from a bruise, when it can be relieved by Arnica, or cold water. It is often produced by cold, abuse of ardent spirits, scrofulous and syphilitic affec- tions, and a variety of other causes. If there is swelling, soreness, heat or erysipelatous redness about the nose, a few doses of Belladonna will generally produce relief. For the indication of other remedies, see Coryza, or cold in the head. Where there are ulcerations or scabs in the nostrils: Alum., Aurum, Borax, Mercury, Nit.-ac, or Sulphur, may be given. A discharge of pus generally indicates, Aurum, Mer- cury, Sulphur. Syphilitic inflammation requires Mercury, or if that remedy has already been used to excess, Nit.-ac, Aurum, or Thuja. If arising from abuse of spirituous liquors; let liquor alone, and take, Arsenic, Culcarea, Belladonna, Phos- phorus. In Scrofulous persons: Aurum, Calcarea, Mercury, Phosphorus, Sulphur. Warts on the nose : Causticum. Administration —The remedy may be taken one, two, or three times a day, according to the severity of the symptoms. Two drops, or eight globules, should be mixed with a tumbler of water, a tablespoonful given at a dose; or three globules, or a powder, taken dry on the tongue. BLEEDING OF THE NOSE. Epistaxis. Bleeding at the nose is not unfrequently an accom- panying symptom of various diseases, particularly in fevers, where there is a strong tendency of blood to the 254 affections of the nose. head. When it occurs on what is called the critical days, it is looked upon as favorable. It is sometimes con- stitutional and is very often produced by the disturbance of some other organ. When it arises from congestion to the head: Aconite, Belladonna or Rhus, will be required. See congestion to the head. Occurring during Coryza: Arsenic, or Pulsatilla. See that affection. In children subject to verminous difficulties: Cina, Spigelia, Mercury. Preceding Catamenia: Lachesis, Pulsatilla. In women when the Catamenia are too feeble: Pul- satilla, S/pia, Secale. In women where they are too profuse: Aconite, Cro- cus, Sabina, In women, absence of Catamenia: Bryonia, Pulsatilla, Sepia. From great weakness : China, Secale, Ferrum. From being over-heated: Aconite, Bell, or Carb.-veg. From abuse of spirituous liquors: Nux-vom., Bell, Carb.-veg. From great exertion : Am. or Rhus. Tendency to bleed from the slightest cause: Calc^ Carb.-veg., Silicea, Sepia. Cold water, or ice water, should be applied to the root of the nose, and the head be kept elevated as much as possible. Administration.—One drop, or eight globules, in a tum- bler of water, a tablespoonful at a dose; or a powder, or six globules, on the tongue. In severe cases, the remedy should be administered every fifteen or twenty minutes. Heating or stimulating food, until the tendency to the attack has subsided, should of course be avoided. See also page 12. ULCERATION OF THE NOSE. °55 ULCERATION OF THE NOSE. Catarrh. In this disease, an ulcer is formed in the upper part of the nose, and sometimes in the cavity of the cheek-bone, discharging a pus-like substance, or pus mixed with blood. As the ulceration spreads, a sensation of tight- ness and obstruction is felt about the nose, severe aching pain is also felt about the root of the nose, and over the eyes ; as the disease increases, unless arrested, the car- tilage and even the bones of the nose may become in- volved, and frightful deformity ensue. The discharge is sometimes exceedingly fetid, and seems to drop into the throat, causing nausea, and sometimes vomiting. This disease requires the attention of a careful physician. The treatment may, however, commence with Bella- donna, at intervals of six hours, followed after three or four doses by Mercury, morning and night, and that in like manner by Sulphur or Aurum. If the pain is ex- ceedingly severe in the evening, and there is reason to expect syphilitic combination, the treatment may com- mence with Mercury, a dose two or three times a day, or if that remedy has been taken in excess, Aurum, Nit.-ac, or Sulphur, may be given in the same manner. Seals in the lower part of the nostrils generally re- quire, Lachesis, Calcarea, Carb.-veg., Graphites. Silicea A dose every night. 256 AFFECTIONS of the teeth, mouth and THROAT. CHAPTER VIII. AFFECTIONS OF THE TEETH, MOUTH AND THROAT. Sound and healthy teeth depend in a great measure upon bodily health. Persons who have always been healthy, who are never troubled with derangements of the stomach or bowels seldom have aching or decayed teeth. Derangement of the stomach and bowels, from whatever cause it may be produced, is exceedingly liable to affect the teeth, producing slow or rapid de- cay, and those torturing pains, the most agonizing to be borne, and yet for which the patient receives the least sympathy. Some teeth even in apparently healthy persons seem to be extremely brittle, and far more liable to decay or crumble away than others. We have already explained the formation of teeth, their connection with the nerve, and the cause of some of the torturing pains, to which they give rise when diseased. As the teeth, strictly speaking, come under the province of the dentist rather than the physician, it will be only necessary to give some general directions how to preserve them, and how to alleviate the sufferings they produce when in a dis- eased state. Pay strict attention to the general health, keep the stomach and bowels in a natural state, and above all, even if you are still wandering in the boggy and cloudy regions of allopathy, avoid taking large quantities of various nostrums, cathartics, mineral acids, &c. Keep the mouth sweet and clean by rinsing it with pure cold water, and brushing the teeth in the morning, and after each meal, avoid also exposing the teeth to sudden changes of heat and cold, as drinking cold water, when the mouth is filled with hot food. If tartar forms on the affections of the teeth. 257 teeth, have it carefully removed. If the teeth become diseased, consult a judicious and skilful dentist, and do not because they ache a little have them extracted forth- with. Your own teeth, however poor they may be, if they do not affect your general health, and can be pre- vented from paining you, are generally far better, than any artificial teeth, however beautiful, or skilfully pre- pared. Teeth are often extracted because the patient is vexed with long-continued pain, and the dentist is willing to indulge the whim, partly because it saves him future trouble, because it gives him a fine opportunity to display his skill, and pocket a good fee, in preparing an artificial set, when even a greater amount of skill might be displayed in patching up the tooth and saving it, if only for two or three years. Dentistry has reached a state of perfection in this country far superior to that of any other in the world, and in point of beauty almost rivals in its work nature itself. The thought is very consoling, when we see our teeth making their exit one after the other, that art has given us the means of replacing them by others equal in beauty, though not quite as serviceable. Treatment.—Bell, Cham, or Merc may be given in most cases of toothache, until the more specific remedy is ascertained. Pains affecting several teeth at once usually require, Cham., Merc, Rhus or Staphysagria. Affecting also the bones of the face: Hyos., Merc^ Sulphur. Extending to the eyes : Pulsatilla. To the ears: Cham., Merc, Pulsatilla. To the head : Cham., Nux-v^ Merc, Rhus, Pulsatilla, Belladonna. With swelled face or gums: Am., Cham^ Merc.,Pul3^ Sep., Sulph., Aur^ Belln Bryonia. 258 affections of the teeth, mouth and throat. For rheumatic toothache: Acon., Bell, Bry., Puls^ Rhus, Cham., Staph,, Sabina, Of a nervous character • Bell. Cham,, Coff., Ilyos., Ign., Plat, Spig. Occasioned by abuse of Mercury: Carbo-v. or Nit.-ac. From a cold/ Bell, Bry., Rhus, Puis., Merc, Dulc. Occurring at the period of Catamenia : Calc, Carb.-v., Chamomilla. During Pregnancy: Bell., Calc, Nux-v., Puis., Sep., Staph. In hysterical persons: Ign. or Sepia. In children : Cede, Bell, Cham., Coff., Ignatia. Symptomatic Indication.—Aconite.—If there is consi- derable fever, congestion, heat and swelling of the gums and face, with great restlessness. Frequently in alterna- tion with Belladonna. BeVadonna.—Drawing, lacerating or shooting pain in the teeth, face, and ears, worse at night, in the even- ing, and on lying down. Swelling of the gums and cheek; heat and redness of the face ; salivation or dry- ness of the mouth and throat with great thirst. Pains worse in the open air, from contact with food, or mental exertion. After this remedy Hepar-s., Mercury, Chamo- milla or Pulsatilla may be indicated. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in from half an hour to two hours. Chamomilla.—Violent, drawing, jerking, pulsative or shooting pains, almost insupportable, particularly at night, when warm in bed, with heat and swelling of the face ; violent semi-lateral pains, sometimes affecting the whole side of the face, aggravated by eating or drink- ing ; great restlessness and weakness. Dose.—Same as Belladonna. Mercury.—Lacerating, pulsative or throbbing pain, shooting in decayed teeth or in the roots, sometimes affecting the entire side of the face and extending into affections of the teeth. 259 the glands and ears, aggravated at night, by cool damp air, or eating and drinking, especially anything cold, and almost insupportable in the warmth of the bed. Salivation and swelling of the cheek, gums or glands. Sensation as if the teeth were too long; ulceration, bleeding, and discoloration of the gums. Frequently indicated after, or in alternation with Belladonna or Dulcamara. Dose.—A powder, or three globules, once in two or three hours. Pulsatilla.—Particularly in persons of a mild and timid character, with disposition to shed tears. Tooth- ache with earache and semi-lateral headache, drawing, shooting or jerking pain, or pulsative and gnawing pains with pricking in the gums, pains extending to the face and head, to the eye and ear of the side affected, with shivering and shortness of breath, aggravation in the evening, after midnight, when warm in bed, and from hot food, mitigated sometimes by cold water or cool air. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in one or two hours. Nux-vom.—Particularly in persons of a lively choleric temperament, with florid complexion, and in those who freely indulge in coffee and spirituous liquors, or who lead a sedentary life. Pains extending over the head, jerking, drawing as from excoriation, in the teeth and jaws; gums swollen and painful, with pulsation ; pain- ful enlargement of the glands, pain worse at night, in the morning on waking, or when engaged in intellectual labor; irritable and peevish temper. Dose.—Same as Mercury. Calcarea.—Toothache especially during pregnancy or at the period of catamenia; congestion in the head, par- ticularly at night; pulsative pains and feeling of ex- coriation; swelling and bleeding of the gums; pains increased by a current of cold air, or by drinking any- thing cold or hot. Bryonia.—Jerking, drawing pain, with looseness of 260 AFFECTIONS OF THE TEETH. the teeth, and sensation as if they were too long, par- ticularly on eating; pain rendering it necessary to lie down, worse at night or on taking anything hot into the mouth, or when lying on the side affected. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful every one or two hours. China.—Debility, occasioned by nursing or loss of fluids, and when the pain is increased by the slightest contact, or after eating, or at night; sometimes relieved by clenching the teeth. Dose.—Same as Bryonia. Give every two or three hours. Ignatia,—Especially where there is a tendency to in- dulge in grief, and when the pains are aggravated by coffee or tobacco-smoke, in the evening after lying down, or in the morning on waking. Often indicated after Cham., Nux-vom. or Pulsatilla. Dose.—Same as Bryonia. Mezerium.—Particularly where there are drawing, shooting pains, extending to the bones of the face and temple; pains in carious teeth, aggravated by touch or movement; shivering and congestion to the head. Rhus.—Especially in persons disposed to melancholy, and where there are tearing, jerking, shooting or tingling pains, worse in the open air or at night, and relieved by the external application of heat. Dose.—Same as Bryonia. Spigelia.—Jerking, pulsative or tearing pain, especially in carious teeth, coming on after a meal or at night, aggravated by cold water or exposure to cold air; fre- quently existing in connection with heart-symptoms. Dose.—Same as Bryonia. Staphysagria.—Where there is a disposition of the teeth to decay and break, with paleness, whiteness, ulcera- tion and swelling, and tenderness of the gums, swelling of the cheek and glands; tearing, drawing pain even in the healthy teeth, and in the gums; aggravated during AFFECTIONS OF THE TEETH. 261 or immediately after eating, or drinking anything cold, and from contact or exposure to the cold. Dose.—Same as Bryonia. Sulphur.—Tearing, jerking and pulsative pain, espe- cially in carious teeth; congestion to the head and pulsa- tive headache; constipation; pain worse at night, or on exposure to cold air; swelling and bleeding of the teeth and gums. Frequently serviceable after Coffea or Aconite. Dose.—A powder, or three globules, once in three or four hours. Coffea.—Violent pain with tears, trembling and ex- cessive anguish; worse at night, or after a meal. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful every hour or two hours. Arsenicum.—Painful looseness and elongation of the teeth. Insupportable pain, aggravated by lying on the side affected, and relieved by the warmth of the fire. Dose.—A powder, or six globules, every two hours. Carbo-v.—Frequently after Ars. or Merc, and where there is bleeding and ulceration of the gums, exceeding- ly sensitive to the touch and looseness of the teeth. Dose.—Same as Sulphur. Silicea.—Violent pain in the jaw, pain worse at night; ulcerative tendency of the skin. Dose.—Same as Sulphur. Nit.-ac—Pulsative and drawing or shooting pain, mostly in the evening, or when in bed. Dose.—Three drops of the 1st dilution, in a tumbler of water a tablespoonful once in two or three hours. Platina.—Pulsative and digging pains in the teeth; sensation of cramp and torpor on the side affected. D0SE —& powder, or six globules, once in three hours. Sabina.—Particularly when connected with menstrual functions; sensation as if the tooth where splitting; ag- gravated by the warmth of bed. Besides the above Hep'ir-*., Hyosciamus, Sepia, Veratrum, Aconite, it may also be consulted. 262 AFFECTIONS < F THE TEETH. If no relief, is obtained after five or six doses, another remedy should be carefully selected. OFFENSIVE BREATH. Offensive breath and bad taste in the mouth are al- most invariably only symptomatic of some other diffi- culty. When they arise from decayed teeth, the teeth should be cleansed, and the cavities properly filled by a dentist. If no dentist can be consulted conveniently, clean out the cavity yourself, and fill it with wax. If it should arise from derangement of the stomach, consult the disease under which it occurs. See also Symptoma- tic Index. GUM-BOIL. Abscess in the Gums. Should there be considerable heat, pain, and swelling, Aconite and Belladonna may be alternated three or four hours apart. If there is considerable throbbing, pulsa- tive pain, Mercury and Hepar-s. may be alternated in the same way. After matter has formed, Mercury or Silicea may be given once in four or five hours. Dose.—The Aconite and Belladonna may be given two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose. The Mercury, Hepar-s. and Silicea, a powder, or three globules on the tongue. SCURVY. Scorbutus. This is a very common disease among sailors, and those who have been a long time at sea, deprived of fresh provisions, particularly vegetables, and also among those, where the air is damp and impure, the food scanty, and the small amount of vegetables used, stale and unhealthy. There is evidently a great impoverishment of the blood and an absence of some of its most important consti- tuents. Notwithstanding we have introduced it in this place, scurvy. 263 it is not solely a disease of the mouth, but pervades the whole frame. It is characterized by great fetor of the breath, sponginess, turgidity, haemorrhage and ulceration of the gums and mouth; the gums recede, and the teeth become so loose as to fall out. There are livid subcu- taneous spots and haemorrhages in different parts of the body, particularly at the roots of the hairs, and frequent- ly contraction of the limbs. As the disease progresses, the limbs swell, and ulcers appear on various parts of the body. Scorbutic ulcers differ materially from others. In- stead of pus they excrete a thin, fetid, sanious fluid, mixed with blood; their edges are generally of a livid color, spongy and puffed up. Treatment.—A change of diet is of vast importance, and with this alone a cure may generally be effected. Fruits, vegetables, lemon-juice and other acid drinks should be used. Potatoes are particularly beneficial as an article of diet, and where a person can be well sup- plied with them, of a good quality, there is generally but little fear of the scurvy. Mercury is a highly useful remedy, if it has not been previously used to excess. It is particularly indicated where the gums are red, fungous, detached, ulcerated and readily bleeding, with burning pains at night; in- flammation and ulceration of the tongue and mouth; fetid smell and discharge of offensive or sanguineous sa- liva ; swelling of the tongue and loose scalding evacua- tions. Nit.-ac.—Particularly where much Mercury has been taken, and where there is bleeding, whiteness and swell- ing of the gums; salivation, looseness of the teeth, and and putrid odor in the mouth. Nux.-v.—Especially in lean persons, who lead a seden- tary life, and are of a lively temperament, and where there are putrid and painful swelling of the gums, with burn 264 AFFECTIONS OF THE TEETH. ing and pulsative pains ; fetid ulcers in the mouth, noc- turnal salivation, bloody saliva, putrid smell of the mouth, discolored face, emaciation and constipation. Generally in alternation with Arsenic ■ Arsenic.—Swelling and bleeding of the gums, loose- ness of the teeth; ulceration on the margin of the tongue, apthas, with violent burning pains; great debility. Carb.-v.—Especially where considerable Mercury has been taken, and where there are retraction, pain and ulceration of the gums, with profuse bleeding, looseness of the teeth, and fetid ulcers in the mouth. Sulphur.—Swelling and bleeding of the gums with pulsative pain; vesicles and apthae in the mouth and on the tongue; offensive and sour smell of the mouth. Sulphur-ac—Apthaa in the mouth, swelling, ulcera- tion, bleeding of the gums, and profuse salivation. Administration.—Two drops in a tumbler, a tablespoon- ful at a dose; or a powder, or six globules on the tongue. Give every four or six hours, increasing the intervals as the symptoms change for the better. CANKER OF THE MOUTH. This is a very common disease, particularly among children. White ulcerated spots are seen on the inside of the mouth and throat, and also on the tongue, gums, lips, &c. The gums swell, are spongy and recede from the teeth. These symptoms are generally preceded by feverishness, and more or less derangement of the sto- mach and bowels. There is often swelling of the glands of the throat and mouth, and a profuse secretion of acrid, putrid saliva. Treatment.—Mercury is the most prominent remedy, unless the disease has been caused by an abuse of that drug, when Nit.-ac, or Carlo.-v. should be taken. For the symptomatic indications of these remedies, also Ars., Nux-v., Sulph., Carbo-v., Nit.-ac. See Scurvy. salivation. 265 Borax.—Ulceration of the gums, mouth, and tongue; acrid, fetid, urine. Particularly useful in children. Capsicum.—Principally in plethoric persons who lead a sedentary life, and where there are burning vesicles in the mouth and on the tongue, and swelling of the gums. Administration.—Same as in Scurvy. SALIVATION. Ptyalism. This disease is almost always connected in our mind either with an abuse, or a free administration of Merc. yet it frequently owes its origin to other causes, as colds and the various forms of fever, particularly the cutaneous variety. The mucous membrane of the mouth, and the salivary glands connected with it, which in health se- crete only the necessary amount of saliva, when irritated, swollen and inflamed by disease, may discharge it in large quantities. To effect a permanent cure then, the glands and mucous membrane of the mouth must be brought back to a healthy state. Mercury produces the most frightful ulceration of the mouth and surrounding parts, as well as profuse saliva- tion. The appropriate remedies in these cases are, Nit.- ac, Sulphur, Hepjar-s., Iodine and Belladonna. When occasioned by cold, fevers, &c, Mercury is the prominent remedy, a powder, or three globules, once in four or six hours. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose ; or a powder, or three globules on the tongue. Give once in four or six hours. See also Scurvy, and Materia Medica. INFLAMMATION OF THE TONGUE Glossitis. This disease is exceedingly painful, and, as might naturally be supposed, attended with great anguish. Fortunately, however, it is of rare occurrence. It mav 12 266 AFFECTIONS OF THE TEETH. be occasioned by cold, derangement of adjoining organs, abuse of Mercury, ulcers, poisons, mechanical injuries, the sting of a bee, &c. The tongue swells to an enormous size, so as to fill the whole cavity of the mouth, and even protrude beyond the teeth, and unlesss peedily relieved, suppuration, gangrene, or hardening of the tongue may take place. Treatment.—When occasioned by mechanical injuries or by the sting of a bee, eight or ten drops of Arnica may be put in four tablespoonfuls of water, and the mouth rinsed with it three or four times a day. Should there be considerable inflammation and fever, Aconite should be given, a dose every hour, followed, if there is much pain, swelling, and tendency to suppura- tion, by Mercury and Belladonna in alternation one or two hours apart. Arsenic and Lachesis may be alternated in the same manner, should there be danger of gangrene. When the difficulty arises from the abuse of Mercury, JVit-ac, or Ilepar-s. may be administered two or three hours apart. If produced by a burn, Urtica-urens is the appro- priate remedy, administered in the manner indicated for Arnica. Dose.—Two drops, or twelve globules in a tumbler of water, a tablespoonful at a dose ; or a powder, or six globules on the tongue. Give as above directed. R A N U L A . Swelling under the Tongue. This is occasioned by an obstruction of the ducts, through which a portion of the saliva passes from the salivary glands into the mouth. It presents the ap- pearance of a bluish eminence, and is generally without pain. The prominent remedies are Calcarea, Mercury, Thuja, commencing with the first, and giving a powder or three DEFECTS OF SPEECH. 267 globules every night for one week, when, if not better, administer the next remedy, and so on in the same man- ner. Externally it may be washed by a solution of ten diops of Arnica in a tea-cup of water, once a day. DEFECTS OF SPEECH. Stammering, dec This may be the result of disease, such as paralysis, congestion to the head, or fever; in which case, see the respective diseases. It however very often exists with- out any apparent cause, and in these cases a certain men- tal training, particularly in childhood will prove far more beneficial than any medical treatment, and will as a general thing be entirely successful. The patient should be advised to read aloud, slowly and distinctly, enunciating clearly each word and sylla- ble, at the same time, beating time with the finger or foot. When talking, he should avoid excitement, keep the mind perfectly clear, and pronounce every word clearly, slowly, and distinctly. A course of mental train- ing like this, will, if taken in time, be sufficient to break up the habit. Should however there be great sensitiveness of the nervous system. A dose of Belladonna, Hyosciamus, Strammonium,, or Lachesis may be taken twice a week, until five or six doses have been taken. See page 12. SORE THROAT. Angina, Cynanche. There are numerous varieties of this disease, such as quinsy, simple, ulcerated, and chronic sore-throat. It may consist of a slight inflammation of the fauces and palate, attended with but little pain, or the swelling may be so great as almost to choke up the passage, accom- panied with fever and severe pain, and if not relieved terminate in extensive ulceration. 268 AFFECTIONS OF THE TEETH, MOUTH AND THROAT. Treatment.—In the commencement of the disease the wet bandage, or a cloth wrung out in cold water, bound around the throat, covered with a dry flannel, is an in- valuable remedy, and in simple cases with the addition of a few doses of Belladonna, will be the only treatment required. It should be applied at night or during the day, if the patient remain in the house. In persons subject to throat-difficulties, the chest and throat should be freely sponged with cold water morn- ing and evening, taking care, however to rub the parts perfectly dry. The treatment can generally be commenced with Bel- ladonna, or if considerable inflammation and pain are present, Mercury may be alternated with the Belladonna, from two to four hours apart, gradually increasing the intervals as the symptoms are relieved. Symptomatic Indications.—Aconite.—Violent fever, dry heat, great thirst, restlessness, deep redness of the parts affected, pain and difficulty in swallowing or speaking, burning and pricking sensation. Frequently in alterna- tion with Belladonna or Mercury. Dose.—Two drops, or twelve globules, in a tumbler of water, e tablespoonful every two hours. Belladonna.—In almost every variety of sore throat, especially where there are excoriating pains, scraping, dryness, burning or shooting in the throat, particularly when swallowing; pains shooting to the ears; spasmodic constriction of the throat, with great difficulty in swal- lowing; inability to drink, the fluid escaping through the nostrils, or violent thirst with dread of drinking ; bright or yellowish redness of the parts affected, without swelling, or severe swelling and redness of all the parts with suppuration, and rapidly spreading ulcers; accu- mulation of mucus in the throat; swelling of the muscles and glands of the neck; fever, hot, red and swollen face, SORE THROAT. 269 and aching in the forehead. Mercury is generally suit- able either after or in alternation with this remedy. Dose.—Same as Aconite. When alternated with Aconite or Mer- cury, they may be given either one or two hours apart, according to the severity of the symptoms. Mercury.—Violent shooting pain in the throat, espe- cially when swallowing, extending to the ears and glands of the neck; excoriating pain, swelling and great inflam- matory redness of the parts affected; difficult swallow- ing, especially drinks, which escape through the nostrils, yet a constant desire to swallow. Ulcers and tendency to suppuration in the throat; elongation of the palate; rheumatic symptoms in the head and nape of the neck; sometimes with shivering. In the commencement of the disease it may be indicated in alternation with Bella- donna, if however there are strong symptoms of suppu- ration or ulcerations, it should be alternated with Hepar- s., or Lachesis, and after the abscess is broken, with He- par-s. or Silica. Dose.—A powder, or six globules, every-two hours. Lachesis.—Particularly where Belladonna or Mercury seem indicated and yet prove insufficient, and especially if there are excoriating pains, burning and dryness in the throat in circumscribed places, extending to the ears, larynx and tongue, with shortness of breath and danger of suffocation; swelling and redness of the throat; sen- sation of a tumor or lump in the throat, inducing a con- stant disposition to swallow, which however is painful and difficult; symptoms aggravated in the afternoon and morning, and by the slightest touch of the neck. Com- pare with Belladonna and Mercury. Dose.—A powder or six globules, once in two or three hours. C/iamomilla.—Particularly in children, where the dis- ease is caused by checked perspiration, and where there are swelling of the glands of the throat, burning pain and sensation of enlargement in the throat; difficulty of swallowing solid food: tickling in the larynx, producing 270 AFFECTIONS OF THE TEETH. coughing and hoarseness, fever in the evening, with flushes of heat, alternating with shivering. Dose.—Two drops, or twelve globules, in a tumbler of water; a tablespoonful once in two or three hours. Nux-v.—Particularly after Chamomilla, or in persons lean and bilious, or of a sanguine temperament; pain in the throat as from excoriation, especially when swallow- ing ; sometimes with a sensation as of a plug, or a sense of constriction in the throat; swelling of the throat, dry cough, headache; small ulcers with a putrid smell. Dose.—Same as Lachesis. Pulsatilla,—In females or persons of a mild character, and where there is a redness of the throat, with a sen- sation as if the parts were swollen; scraping pain and dryness in the throat, without thirst; shooting in the throat, towards the ear, particularly when swallowing, accumulation of tenacious mucus; shivering toward evening. Dose.—Same as Chamomilla. Bryonia.—Hoarseness, cold in the head, dry cough and oppressed respiration; constipation ; pricking and pain- ful sensibility of the throat, when touched, on turning the head or swallowing; shootings and sensation of dry- ness in the throat; fever or shivering and coldness. After or in alternation with Aconite. Dose.—Same as Chamomilla. Hepar-s.—Frequently after or in alternation with Bel- ladonna or Mercury, and where there are lancinating pains in the throat, especially when swallowing or cough* ing; difficult swallowing; swelling and violent pressure in the throat with danger of suffocation, in alternation with Mercury. Capsicum.—Tingling sensation in the throat, as if pro- duced by pepper. Inflammatory pain with painful pres- sure or contraction, particularly during swallowing; vio- lent pain in the glands of the neck in paroxysms; ulce- SORE THROAT. 271 ration in the mouth and throat, dry hacking cough, hoarseness, &c. Often ci" decided benefit in epidemic maladies, and where the difficulty is complicated with gastric or rheumatic ailments, also in those cases where Cham., Bry., Ign,, Nux-v. and Puis, seem indicated, yet prove insufficient. Dose.—Same as Chamomilla. Ignatia.—Red and inflammatory swelling of the throat with severe pain and great difficulty in swallowing; sen- sation of a plug in the throat, or shooting to the ears; ulceration of the throat. Compare with Cham., Nux-v., Puis., Bell, Merc. Dose.—Same as Chamomilla. Sulphur.—Swelling, dryness, excoriating or lancinating pain in the throat; swelling of the glands of the neck; painful sensation of constriction with difficulty in swal- lowing. Dose.—A powder, or six globules, once in four or six hours. Cocculus.—Sensation of roughness and burning in the throat, extending into the chest, sensitiveness of the neck, inability to swallow, excessively violent cough at night, gastric derangement. Dose.—Same as Chamomilla. Nit.-acid is a valuable remedy, where the throat is filled with superficial ulcers, or where the throat-difficulty is occasioned by abuse of Mercury, or is the result of Syphilis. Dose.—Three drops of the first dilution in a tumbler of water, a tablespoonful once in four or six hours. Merc-proto-lod. is an exceedingly valuable remedy in certain varieties of throat-disease. There may be swell- ing of the glands of the throat, ulcers scattered over the gums and along the margin of the tongue, with red edges, and an ashy grey centre; severe inflammation of the throat, assuming as it advances, a deep scarlet or even purple color, or as it passes into the chronic form, show- ing itself in patches, covered with a secretion of yellowish 272 AFFECTIONS OF THE TEETH. mucus, inducing constant coughing. Sometimes where the inflammation is intense, as in malignant scarlatina, the parts present a smooth, shining glazed appearance, the voice sinks into a whisper, or is entirely extinct, an aching sensation is felt in the throat, particularly on pressing the larynx, also under the sternum and clavicles, with weariness and oppression. Dose.—A powder, once in three hours. In malignant or putrid sore-throat, where the disease sets in with great violence and often runs its course with frightful rapidity, in addition to the remedies already enumerated, the following deserve attention; consult also Scarlatina. Sulphuric-Acid.—Sudden and rapid prostration of strength, frequent chills, pain in the throat, with sensation of swelling, deep bluish red spots or patches re-covered by a membrane, beneath which is seen more or less sup- puration. Dose.—Two drops in a tumbler of water, a tablespoonful once in three or four hours. Arsenic—Particularly where the inflammation is of an erysipelatous character, or where it assumes a typhoid form; great prostration of strength, burning heat, cold hands, great restlessness and anguish, ulceration, dis- charging fetid matter and strong tendency to gangrene. Dose.—A powder, once in three hours. Conium is also a valuable remedy, where the parts have assumed an ash grey color and a blackish aspect, whitish eruption on the skin, swollen tongue, bloody and involuntary stools, together with the presence of symp- toms indicating Arsenic Dose.—Two drops in a tumbler of water, a tablespoonful once in two or three hours. In the treatment of this variety should the ulcers as- sume a more healthy character, it may be well for a time to cease the remedies previously given, and substi- SWELLING OF THE TONSILS—OF THE PALATE. 273 tute Sulph., a powder, or three globules, once in four or six hours. Where the disease is of a chronic or constitutional character, sometimes combined with bronchial and chest- difficulties, the remedies deserving particular attention are, Alum, Arg.-nit., Bar.-c, Calc, Hep., lach., Sulph., Nitr.-ac, Natr.-m., Nux-v., Sabad., Sen., Staph. Where the disease is caused by an abuse of Merc, Bell, Carb.-v., Hep., Lach., Sulph., Nit.-ac From a syphilitic cause: Merc, Nit.-ac, Thuj., Sulph. As it regards external application, where the glands are much swollen, and suppuration is apparent, poultices of flaxseed or slippery elm may be applied. The mouth and gums may be washed or swabbed with cold water or tepid milk and water. In certain varieties of throat- disease great benefit has been derived from swabbing the throat with a solution of Nitrate of Silver, but this should not be applied, unless by the hands of a careful physician. In chronic cases the remedy may be given once in six or twelve hours. Diet and Regimen.—Same as in fever. SWELLING OF THE TONSILS—OF THE PALATE. We have included the treatment of these diseases in the preceding article. In some there is a tendency to enlargement of the tonsils on taking even a slight cold, also to swelling and elongation of the palate. The treat- ment indicated above, together with gargling the throat with cold water, and the wet-bandage, will generally be sufficient to remove the difficulty. The prominent re- medies are, Nux-v., Bell., Merc, Calc, Arg.-nit. 12* 274 AFFECTION OF THE URINARY AND GENITAL ORGANS. CHAPTER IX. AFFECTION OF THE URINARY AND GENITAL ORGANS. The difficulties we shall enumerate under this head will be more readily understood by carefully reading that part of the chapter on anatomy, which refers to these organs, and thus gaining a correct idea of the ana- tomical relation of the parts. INFLAMMATION OF THE KIDNEYS. Nep/iritis. Diagnosis.—A dull or acute pain is felt in the loins, on one or both sides of the spine, between the hips and short-ribs, and frequently extending over the whole of the lumbar region. The pain extends along the ureter to the bladder, and is sometimes attended with nausea, vomiting, and colic. The region of the kidney is hot and painful, the pain is aggravated by motion and even deep breathing, and the patient is unable to lie on the affected side. The urine is generally of a fiery-red ap- pearance, and may be either diminished or suppressed, or be mixed with pus or blood, and its emission attended with burning pain. In the male, the testicle is drawn up, and in most cases the thigh of the affected side is numb. The fever is more or less severe, and sometimes assumes the typhoid form. The urine may be entirely suppressed and violent vomiting, delirium, or stupor set in. If the inflammation is not arrested, ulceration may set in, the pus being discharged with the urine. Treatment.*—The prominent remedies are, Aconite, Canth., Cann., Nux-v., Bell., Hepar-s., Pulsatilla, Mer- cury, and Cocculus. For general directions as to the administration of remedies, see page 12. INFLAMMATION OF THE KIDNEYS. 275 Aconite is indicated, where there is considerable fever present, generally in alternation with Cantharides and Cannabis. The most important remedies are, Cantharides and Cannabis, which are often given with advantage in al- ternation. Canliarides is indicated by the presence of sticking, tearing and cutting pains in the region of the kidneys, aggravated by motion, and coming on in paroxysms. Painful emission of urine, sometimes almost impassible, passed drop by drop, attended with violent burning pains, and mixed with blood. There is considerable fever, vio- lent thirst, and constant urging to urinate. Cannabis.—The indications for this remedy are similar to those of Cantharides, with the addition of a drawing, ulcerative pain from the kidneys to the groins. If the disease should be caused by suppressed haemor- rhage or abuse of spirituous liquors, Nux.-v. is a pro- minent remedy. Belladonna will be found of benefit, where there is burning, stinging pain in the region of the kidneys, ex- tending along the ureter to the bladder, and recurring in paroxysms, extending to the abdomen, aggravated by contact, colic, heat in the region of the kidneys, restless- ness, constipation, &c. Hepar-*. is often of advantage after Belladonna, espe- cially in chronic cases. Mercury will be of service, where there are throbbing, pulsative pains, or the emission of pus. See Gravel. Pulsatilla—'Will be of benefit in females of a lym- phatic temperament, where the disease is produced by a derangement of the menses. Administration.—Three drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or a powder, or six giobules on the tongue Give every hour or two hours, according to the severity of the symptoms. Where 276 AFFECTION of the urinary and genital organs. the paroxysms of agony are excessively severe, the re- medy may be given until three or four doses have been taken, every half hour. Diet and Regimen.—Same as in fevers. INFLAMMATION OF THE BLADDER. Cystitis. Like Nephritis, inflammation of the bladder com- mences with chills, hot and dry skin, nausea, and vomit- ing, scanty and highly colored urine and constipation. As the inflammation progresses, the pain becomes deep- seated, burning and cutting, sometimes extending over the whole abdomen, and into the penis or rectum. The urine is discharged drop by drop, or entirely suppressed, is thick, dark-red, and turbid, mixed with blood or mucus. The pain in the region of the bladder is intense, aggra- vated by the slightest motion, on attempting to pass water, or alvine evacuations. There is violent thirst, hot and dry skin, great rest- lessness, and anguish, and frequently, cerebral and typhoid symptoms. Convulsions and fainting may also be present. Causes.—This inflammation may exist in connection with derangement of the kidneys, or be produced by stone in the bladder. It may also be produced by cold, stimulating drinks, gonorrhoea, mechanical injuries, or derangement of the womb. Treatment.*—The selection of the remedy must be guided by the cause of the disease. When occasioned by abuse of spirituous liquors, Nux-v. is the appropriate remedy. When produced by the use of Cantharides, one drop doses of Camphor, given at intervals of two hours, will speedily produce relief. Aconite is indicated during the presence of fever, either For general directions as to the administration of remedies, see page 12. inflammation of the bladder. 277 alone, or in alternation with some other remedy, espe- cially Cannabis, or Cantharides. Cannabis.—Complete retention of urine, or a desire to urinate, principally at night, with burning pain; or emis- sion drop by drop of bloody urine. Cantharides.—Emission of urine, drop by drop, with shooting, burning pains, or violent and ineffectual desire to urinate; extreme sensitiveness of the region of the bladder to the touch. In alternation with Aconite or Cannabis. Digitalis.—When the neck of the bladder is prin- cipally affected, and where there is constrictive pain and retention, or painful desire to urinate, with emission of only a few drops. Dulcamara.—Particularly in chronic cases, aggravated or brought on by slight cold, or where the urine deposits a slimy sediment. Nux-vom,—Is of decided benefit when the trouble has been occasioned by a free use of spirituous liquors ; also where it can be traced to suppressed haemorrhoids or dyspepsy. Hyosciamus may be given, where there are spasms of the bladder, three drops in a tumbler half full of water, a tablespoonful every half hour until relieved. Sulphur, Thuja, Terebinth, and Copaiba may also be consulted. See Nephritis, also Symptomatic Index. Pulsatilla—Is of benefit in lymphatic temperaments, where it arises from suppressed menstruation, and also when there is scanty emission of bloody and slimy urine, burning and cutting in the lower part of the bowels, with external heat. The application over the painful part of the wet ban- dage will also prove decided benefit. Adminitration.—Where the inflammation is intense, and the sufferings severe, the remedy prepared as directed in Nephritis may be given every hour, gradually increas- 278 affection of the urinary and genital organs. ing the intervals as the symptoms abate, to two or threo hours. Diet and Regimen.—As in fevers. Avoiding particu- larly wines, liquors, and all kind of stimulating and heating drinks. SUPPRESSION, AND RETENTION OF URINE. Suppression and retention of urine although frequently producing similar symptoms are entirely unlike. In suppression of urine there is no secretion of urine, the secreting function of the kidneys being for the time either partially, or entirely destroyed. This variety is attended with considerable danger, the brain being ex- ceedingly liable to become diseased, and if the suppres- sion be total, serious cerebral difficulty generally sets in, in the form of delirium, succeeded by coma and effusion. In these cases the saliva, sweat, and water effused on the brain, have a urinous smell and taste. The suppression may arise from inflammation of the kidneys, when it is attended with febrile symptoms, nausea, vomiting pain in the region of the kidneys, ten- derness of the abdomen to the touch, frequent desire to urinate, but if any is secreted, it passes in small quanti- ties, and is accompanied with severe pain; or it may be occasioned by the presence of gravel or calculi in the kidneys, giving rise by their irritation to inflammation, when the symptoms are similar to those described above. Sometimes it may depend on paralysis of the kidneys, when there may be no desire to urinate, an absence of pain and febrile symptoms, but the unpleasant cerebral symptoms set in none the less rapidly. In retention of urine, the urine is secreted as usual, but from some cause, such as the presence of stone in the bladder, inflammation or stricture of the urethra, paralysis of the bladder, enlargement of the prostrate gland or the presence of tumors, it is prevented from SUPPRESSION, AND RETENTION OF URINE. 279 passing out. The symptoms of course are exceedingly varied according to the cause of the disease. There is distension of the bladder, which can be distinctly felt, elevated above the pubis,—and by this symptom alone the difficulty may be distinguished from suppression of urine,—pain in the region of the bladder, and constant but ineffectual desire to urinate, attended with severe pain, except in cases of paralysis, where there is an absence of febrile symptoms and pain. This difficulty seldom exists alone, but generally in connection with some other disease. If not relieved, the bladder may become so distended as to be ruptured, discharging the urine into the bowels, causing gangrene, and resulting in death. Treatment.—The use of the catheter may be fre- quently required, but as this should be used by the practiced hand of the physician, it will be unnecessary to speak of it here. The cause of the disease should be ascertained as nearly as possible; whether the result of stricture, of inflammation, of mechanical injury, of paralysis or gravel. External application, such as, warm baths, poultices, warm cloths, or if much heat is present, cold water will be found not only in this complaint, but in Cystitis and Nephritis, valuable auxiliaries. See also wet-bandage. The prominent remedies are: CantJi., Cann., Acon., Bell, Rhus, Nux-v., Terebinth, Ars., Asparagus, Arnica. Where in inflammation of the kidneys or bladder there is considerable fever: Aconite is indicated and may be followed after the fever abates, by Cantliarides and Cannabis, one or two hours apart. Where it is occasioned by mecJianical injury, or the irritation of calculi, Arnica is the proper remedy. When produced by metastases of gout or rheumatism, Rhus or Bellad >nna may be given, if accompanied with much fever, in alternation with Aconite. 280 AFFECTION OF THE URINARY AND GENITAL ORGANS. When the result of paralysis, Nux-v., Arsenic, Tere* binth. Spasmodic retention may be relieved by Camphor, Belladonna, or Aconite. See also Urinary Calculi. The treatment as a general thing should commence with Camphor or Aconite. These remedies will often produce entire relief. If however after four or five doses have been given no relief has been obtained select another remedy. Opium is of great benefit in the aged. Camphor two or three drops given every half hour will be of great benefit, especially in children. Administration.—Three drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or a powder, or six globules on the tongue. In severe cases a dose may be given every half hour, increasing the intervals as relief is obtained, to two or three hours. URINARY CALCULI. In the investigation of this disease particular attention should be directed to the urine, as its color, smell and sediment will afford a pretty correct guide to the character of the calculi. The lithic urine lays the foundation for a large pro- portion of the calculi which are formed in the bladder or other parts of the urinary organs. It is characterized by the spontaneous deposition of lithic acid, constituting the principal part of what is generally termed the sand, or brick-dust sediment of urine. Next in frequency to the variety just mentioned, are those composed of a combination of Phosphoric-acid, Magnesia and Ammonia. The urine is fetid and the sediment deposited of a white color, resembling mortar. Another variety, less frequent, however, than either of the above, is the mulberry calculus. It is of a dark brown color and is very heavy and hard. There are URINARY CALCULI. 281 several other varieties of calculi, varying in appearance and in chemical combination, but it will be unnecessary to particularize here. It is worthy of remark that this disease is more gene- rally found in the male than in the female sex, and is principally confined to youth and old age, and is seldom if ever seen either in the frigid or the torrid zones. It is especially liable to attack those in whom there is any hereditary tendency to gout. Diagnosis.—The urine, as a general thing, shows some kind of sediment, and there may also be frequent desire to urinate. Often no pain is felt for some time, unless after severe physical exertion. An attack may come on suddenly, in which the stone, if situated in the kidneys may pass into the bladder. The pain is of the most intense and violent character, the urine high colored, or mixed with blood. Where the stone is already in the dladder, the symptoms are varied. There may be stoppage of water, great heaviness about the region of the bladder and general uneasiness. Treatment.—One great object must be to prevent if possible, the formation of Calculi, by correcting those secretions on which the morbid sediments depend. After the stone is already formed, the physician must either dissolve it by means of medicines administered internally, or remove it by an operation. Among some of the pro- minent causes of this disease, we may mention derange- ment of the digestive organs, from errors in diet, abuse of spirituous liquors, &c., lime water, mental and bodily fatigue, and tendency to gout and rheumatism. A sea voyage to either a hot or cold climate, will often produce entire relief. In all cases, a plain and simple diet, and a cheerful temperament, are of the utmost importance. In the lithic acid diathesis, baths and friction should oe freely used, every thing of an acid nature avoided, and animal food form a principle article of diet. 282 AFFECTION OF THE URINARY AND GENITAL ORGANS. The pliosphatic diathesis requires, on the contrary, a vegetable diet, and the free use of acids and fruits. The prominent remedies are, Cannabis, Cantharis, Nux-vomica, Lycopodium, Sarsaparilla, Calcarea, Phos- phorus and Asparagus. Cannabis and Cant/iaris, during a paroxysm of pain from the gravel, are prominent remedies. There is a burning, scalding, and painful sensation when making water, as well as after; the urine is sometimes slimy or bloody, and violent pain may also be felt in the region of the kidneys and bladder. Dose.—Three drops of the remedy, may be dissolved in a tumbler half full of water, and a tablespoonful given in alternation, during the paroxysm, half an hour apart. The external application of warmth, during the severe paroxysm, will frequently aid in pro- ducing relief. « Nux-vomica will be found highly advantageous, when the disease originates in errors of diet, abuse of sti- mulants, and chronic derangement of the digestive organs, also where are acute and spasmodic pains. Dose.—If the paroxysm is severe, a powder, or six globules, may be taken once an hour, but as a general thing, once every twelve or twenty-four hours, will be all that is necessary. Lycopodium is especially useful in persons of a lymphatic temperament, and those who have been troubled with affections of the mucous membrane. The pain is principally in the urethra, and is of a burning smarting character, during the passage of water. The urine is fetid, is of a dark red color, and deposits a red or yellowish sediment. Dose —Same as Nux. Calcarea is useful where the affection is developed in scrofulous children. The pain in the urinary organs, and the desire to pass water, are worse during the night; the urine is fetid, and deposites a white sediment. Dose.—Until four powders have been taken, a powder, or sis globules, every twelve hours, after this, onre in twenty-four hours. Phosphorus.—This remedy will be found highly DIABETES. 283 advantageous in old and debilitated subjects, and where there is great prostration of strength, also where the patient has no control over the urinary organs, and where the urine has a strong smell of ammonia, and deposits a whitish, or brick-dust sediment. Dose.—A powder, or six globules, may be taken every twenty-four hours. Asparagus is a valuable remedy where there is a fetid smell to the urine, depositing a whitish sediment; fre- quent desire to urinate, pain on passing water, and cut- ting pain in the urethra and kidneys. Dose.—Three drops, or twelve globules, may be mixed in a tumbler of water, and a teaspoonful given once in twelve hours. DIABETES. In this disease, there is an increased flow of straw- colored urine, of a sweetish taste; or not an unusual secretion of urine, but what there is, strongly charged with saccharine matter. The disease may continue for months, or years, and in many cases, terminate at length in death. As the disease progresses, derangement of the digestive organs is perceptible, and the memory becomes impaired; there is great emaciation, coldness of the extremities, and dropsical effusion. Treatment.—Vegetables should be carefully avoided, and a nutritious diet enjoined of animal food. The external application of water, in the form of the sponge- bath, or wet-sheet, is highly advantageous. Kali-carl.—Will be found of benefit when there are jerking pains in the region of the kidneys, especially on sitting down; frequent and violent desire to urinate; pale greenish urine; cold feeling in the bowels; burning heat in the stomach; ulcerated gums, and great thirst. Dose.—Give a powder, or three globules, morning, noon and night until a change. Muriatic-acid—Is an important remedy where there 284 AFFECTION OF THE URINARY AND GENITAL ORGANS. is an absence of thirst and also when the urine has a milky appearance. Dose.—Mix three drops in a glass half full of water and give a tablespoonful four times a day. Mercurius. Constant desire to urinate; swollen, moist and painful prepuce; pain in the testicles; swelling of the gums and fetid breath; acid eructations and burning in the stomach. Dose.—Give a powder every two hours. The patient should place himself under the care of a judicious physician without delay. The prominent internal remedies are Phos.-acid, Carb.-veg., Muriatic- acid, Conium, and Nux-vom. ENURESIS. Incontinence of Urine. This may be occasioned by a weakness of the muscles concerned, or a partial or entire paralysis. In the latter case, the bladder is unable to retain for a moment the urine secreted, which constantly dribbles away, drop by drop, very much to the annoyance of the patient. Where there is merely a weakness, or partial paralysis, it gives rise to that difficulty so common among children, wetting the bed. Treatment.—Where enuresis is occasioned by either partial or entire paralysis of the muscles, the application of electricity along the lower portion of the spine, and over the neck of the bladder, will be found beneficial. The prominent internal remedies are, Hyosciamus, Causticum, and Conium. The sitz-bath will also be of service. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful morning and night. Enuresis in children, in the form of wetting the bed, may arise from some other difficulty, such as worms. The cause should be ascertained as nearly as possible. before any treatment is adopted. GONORRHOEA. 285 When there is a peculiarly strong and horse-like smell about the urine, a powder of Benzoic-acid may be taken every night. Cantharides may be found of benefit, one drop, or six globules, given every evening for three nights, stopping it immediately should there be pain in passing water. Ii after a week nc change is apparent, a powder, or six globules of Silicea, may be given every second night, until six doses have been taken, when if no improvement is perceptible, Sepia and Carb-veg., may be given in the same manner. SEMINAL EMISSIONS. These frequently occur in the young, just after reach- ing the age of puberty, and are generally occasioned by a morbid imagination, combined perhaps, with irre- gularity of habits, and errors of diet. The patient should strive to live more in obedience to nature, and cultivate a healthy frame of mind. The external application of the sponge-bath will be found beneficial. Three globules of Phos.-acid may be given every other night. GONORRHOEA. By gonorrhoea is understand an inflammation of the lining membrane of the urethra, with a discharge of purulent mucus. In from two to four days after an impure connection, a tingling or itching sensation is felt at the orifice of the urethra, especially when urinating. Soon the lips of the urethra become red and swollen, the inflammation extending an inch or two up the urethra; the emission of urine is attended with a scald- ing, burning pain, more or less severe. A discharge takes place at first of a mucous character, but if the inflammation increases, changes to a yellow or greenish color, and if exceedingly violent, may assume a bloody character. Erections, or cordee, of an exceedingly painful character, frequently come on at night. 286 AFFECTION OF THE URINARY AND GENITAL ORGANS. After a longer or shorter time, as the symptoms are more or less severe, the inflammation subsides, leaving a troublesome discharge. A gonorrhoeal discharge may not necessarily be the result of an impure connection- New wine, unfermented beer, stimulating spices, a cold, frequent exposure of the organs to the wind while urinat- ing, cause a gonorrhoeal discharge which runs the same course, and is similar to genuine gonorrhoea. Persons with large penis, wide urethra, long and nar- row prepuce are much the most easily affected. Exces- sive sexual indulgence long continued, or connection when the female is troubled with an acrid leucorrhea may produce gonorrheal discharge. In all cases where danger is apprehended, the penis should be thoroughly washed with cold water, and the urine voided immediately after connection. In this way the matter is washed from the penis be- fore it can be absorbed, and if any has passed into the urethra, it is washed out by the discharge of urine. Treatment.—Quiet, a plain and non-stimulating diet, and an absence of ardent spirits of very kind, are of great importance. During the inflammatory period, characterized by burning, scalding pain, on the emission of urine, copious discharge, &c. Cannabis and Cantharides are the proper remedies. One drop of each may be given in alternation, four hours apart, until the inflammatory symptoms have in a measure subsided, when Mercury and Sulphur may be substituted and administered, a powder on the tongue, at the same intervals. Mercury is more particularly indicated, when the discharge is of a greenish character, and SulpJiur where it presents a whitish or serous appearance. Before the inflammatory stage has fairly commenced, and where there is tingling and itching about the ure- thra, with slight discharge, Copaiva is the best remedy with which we are acquainted. Also after the inflam- SYPHILIS. 287 matory symptoms have subsided, the water being voided with but little pain, Copaiva is still a valuable remedy. It may be given, a powder of the one- tenth, four times a day, or what is still better, one of the Copaiva Capsules, obtained at the druggists, may be taken morning, noon, and night. This drug some- times produces a change of the disease to the testicles which become swollen and painful. In this case the Copaiva should be discontinued, Arnica and water applied to the testicle and Aconite and Pulsatilla taken internally two hours apart. If, notwithstanding the use of the Copaiva for several days, the discharge still continues unabated, give internally Mercurius or Sulphur, and use an injection, composed of one grain Sulphate-Zinc to one tablespoonful of water, or one part of Beds.-Copaiva to three parts of Mucilage Gum Arabic. In using the injection, the finger should be pressed on the urethra, about one inch and a half from the orifice so that merely the end of the urethra, which is the part affected, may be touched by the injection. In gonorrhoea in females, the treatment is the same ae described above. See also leucorrhcea. When the disease is allowed to run on for several weeks, it becomes chronic, and is called "Gleet." There is no pain, but a slight discharge. The prominent reme- dies axe, Sulphur, Mercury, Capsicum, Nit.-ac, or Thuja. Dose.—A powder, or six globules, may be taken on the tongue ; or twjo drops mixed with a tumbler half full of water, a tablespoonful at a dose. Give every night for a week, when if not better, another remedy may be selected. SYPHILIS. This disease may remain lurking in the system for years, be transmitted from parent to child, and lay the foundation for diseases ending in deformity, misery and death. It will only be necessary here to give some of 288 AFFECTION OF THE URINARY AND GENITAL ORGANS. the prominent indications, as after it has passed the pri- mary stage, it frequently becomes complicated with a variety of diseases, and requires all the skill of the prac- ticed physician to detect the cause and apply the appro- priate remedy. Diagnosis.—All sores on the penis are not by any means syphilitic, but the primary chancre or syphilitic sore usually presents itself on some part of the end of the penis, in from three to eight days after infection, in the form of a red and slightly itching pimple. In a short time matter forms in the centre of the pimple, and a deep ulcer with ragged edges, and yellowish surface is gradually formed. This ulcer may be slight and super- ficial, or perhaps deep and rapidly spreading, attended with severe pain, and rapidly destroying the adjacent parts. The most simple form, by bad treatment, such as the administration of Mercury in large and repeated doses, may be changed into sores of the most violent character, and the poison scattered over the system, pro- ducing the most fearful consequences. In connection with the chancre, swelling in the groin or bubo may set in, sometimes ending in ulceration. Where the disease is nofc checked in the primary stage, the poison may become diffused through the system, giv- ing rise to secondary and tertiary symptoms. The throat may become deeply ulcerated, the voice and nose de- stroyed, and deep and loathsome sores form in different parts of the body. A copper-colored eruption also may be developed on the skin, generally commencing on the face and hands. Another terrible result of neglected syphilis is an affection of the bones and their periosteal covering. The covering of the bones become swollen, and if the disease is allowed to run on, osseous deposits form beneath it, producing the venereal node. These generally exist on the head and the bones of the leg. The pain where the bones and their covering are affect- SYPHILIS. 289 ed, is often agonizing, generally coming on in the latter part of the afternoon, and continuing until midnight. Treatment.—It is highly important in this disease that a careful physician be consulted as soon as possible, as neglect or injudicious treatment may be attended with the most unpleasant symptoms. Syphilitic taint may, as we have before remarked, lurk in the system for years, laying the foundation of various diseases, which require the closest scrutiny on the part of the physician to detect the real cause. It may also be transmitted from parent to child, developing in the young frame diseases which fill the body with pain and end in deformity and death. Hence the vast importance of eradicating the disease thoroughly from the system. The almost specific remedy for primary chancre is Mercury-s l. This should be given a powder of the first or third trituration, morning and night for eight or ten days, when, if improvement is perceptible, the intervals may be gradually increased. Should however but little improvement take place, and other remedies be required, it may be followed by Nit-ac, two drops in a tumbler of water, a tablespoonful •et a dose. The ulcer should be kept clean by lint moistened in cold water, and where nitric-acid is used internally, the lint may be kept moistened with the same preparation. Where ulcers are developed in the throat, Mercury is still the appropriate remedy, given as before mentioned, but if after five or six doses no improvement is perceptible, it should be followed by Nit.-ac, one drop in a tumbler of water, and a tablespoonful given three times a day. The eruption, pain in the bones, ulceration of the throat and nose, and other secondary symptoms can generally be controlled by Mercury, Nit.-ac, Thuja, nurum^ given as above directed 13 290 AFFECTION OF THE URINARY AND GENITAL ORGANS. INFLAMMATION OF THE TESTES. We not unfrequently see in mumps and in gonorrhoea a metastasis of the disease to the testes. The swelling comes on suddenly and is attended with severe pain. When the swelling arises from an external injury Arnica will produce relief. Aconite is indicated where there is heat and pain, in alternation with either Mer- curius, Nux-v., or Pulsatilla. Dose.—A powder, or three drops, in a glass half full of water, a tablespoonful every three hours. Apply a compress wet with cold water, or Arnica and water. INFLAMMATION OF THE GLANS PENIS. The glans penis sometimes becomes inflamed where there is no trouble about the urethra. It may be pro- duced by handling poisonous plants, from mechanical injuries, and from a variety of causes. Where there is a burning heat and redness, Aconite may be alternated with RIius. Arnica will prove of benefit in case of mechanical injury. Where there is superficial ulceration Nitric-acid may be given internally, and the same mixture applied externally on lint. Dose.—Two drops, or twelve globules, in a glass half full of water, a tablespoonful every four hours. GENERAL AFFECTIONS. 291 CHAPTER X. GENERAL AFFECTIONS RHEUMATISM. This exceedingly painful disease is quite common in our ever-changing climate, and is alike the dread of the physician and patient, especially when developed in those in whom there is a hereditary predisposition to this kind of affection. Its constant liability to change from one part of the system to another, and even to attack some vital organ, renders it not only excessively painful, but highly annoying under any form of treatment. Not- withstanding Homoeopathy has shorn it of half its ter- rors, and abolished from the sick-room the painful and disgusting treatment so much in vogue in the allopathic school, yet under any treatment it is a disease to be dreaded, and one in which in violent cases we cannot always with certainty predict a speedy recovery. Rheumatism is essentially an inflammation of the fibrous tissue,—sometimes however involving, as the dis- ease extends, other tissues,—and most commonly seizes the fibrous parts, which lie around the joints, particularly the larger joints, although the inflammation frequently commences in the head, neck, chest, or arms, and extends to other parts of the body. So long as it is confined to the extremities, the pain may be excessive, deformity may ensue, but notwithstanding the severity of the symptoms but little danger to life is apprehended. Should however the disease strike some vital organ the danger is imminent. Diagnosis.—In acute rheumatism, languor, slight chills and general uneasiness are followed by swelling of some part of the system, accompanied with pain, heat, and ge- nerally more or less redness. The pains are exceedingly 292 general affections. variable in character, sharp, lancinating, dull and throb- bing, or numb aching, gnawing, or boring, aggravated by the slightest movement. The weight of the bed clothes is sometimes oppressive, and it is impossible to move the joints. The fever is high, pulse bounding and full, face flushed, the head aches, the urine is high- colored, turbid, acid, and sedimentious, and the patient is frequently drenched in sour-smelling perspiration. The tongue is red at the tip and edges, but the centre of it is covered with a whitish fur. Acute rheumatism generally occurs between the age of fifteen and forty, although it is sometimes seen in children as early as three or four. Chronic rheumatism differs materially from the acute form in the absence of fever, in the little or no con- stitutional disturbance, and in the pain being far less severe. In one from there is some heat and pain, and sometimes swelling of the joints. The pain is increased by pressure, motion, or warmth, but the appetite is good. In the other form there is a sense of coldness and stiff- ness in the painful joints. Causes.—Exposure to wet, cold, damp or changeable temperature, and sudden suppression of perspiration are the prominent causes. Treatment.—In the acute form where there is con- siderable swelling, heat and pain, frequently bathe the part affected with tepid water or with a mixture compos- ed of ten drops of Arnica to six tablespoonfuls of water. If cold water is applied, see uwet bandage? Aconite will be of advantage, where there is a dry skin, violent fever, thirst, redness of the cheeks, shooting, tearing pains, worse at night. Dose.—Put two drops, or twelve globules, in a glass half full of water, and give a teaspoonful every hour or two hours, according to the severity of the symptoms. It is frequently indicated in alternation with Bell-, Rhus or Bry. when the remedies may be given either one or two hours apart. rheumatism. 293 Belladonna.—Violent fever, congestion in the head, redness of the face and eyes; swelling with shining red- ness, shooting, burning pains, aggravated at night or by movement. Particularly indicated when the difficulty is felt in the upper extremities. It is often especially useful either after or in alternation with Acon. or Puis. Dose.—Same as Aconite. Bryonia.—Tearing, shooting pains on moving the parts, or pain flying about from one part to another; red and shining swelling; pains worse at night, or increased by the least movement; coldness and shivering or febrile heat, headache, bilious or gastric sufferings, stitching pain in the region of the liver, and pulsative headache. Frequently indicated after or in alternation with Acon. or Rhus. Dose.—Same as Aconite. Rhus.—Drawing, tensive and dragging, or wrenching, gnawing and boring pain; paralytic weakness and ting- ling in the affected parts; red and shining swelling; pains worse at night, during rest or in changeable weather. Frequently indicated after or in alternation with Am. or Bry. Dose.—Same as Aconite. Pulsatilla.—Pains passing rapidly from one part to another; drawing, tearing, or jerking pains, worse at night, in a warm room or on altering a position, sen- sation of paralysis in the parts affected, feeling of cold- ness on a change of weather; pain relieved by uncover- ing the limb to the open air. Dose.—Same as Aconite. Colchicum.—An important remedy both in acute and chronic rheumatism. There are lancinating, jerking or tearing pains, worse at night, and aggravated by motion or anxiety; or there may be only stiffness in the joints when attempting to walk, with swelling of the parts in the vicinity of the inflammation. 294 GENERAL AFFECTIONS. Dose.—Two drops, or twelve globules, in a tumbler half full of water ; in acute cases a teaspoonful every two or three hours, but in chronic cases, once in six or twelve hours. Chamomilla.—Dragging, tearing pains with a sensa- tion of numbness or paralysis in the parts affected ; pains worse at night; fever with burning or partial heat, pre- ceded by shuddering; great agitation and tossing, with shivering and a desire to remain lying down. Dragging and rheumatic pains in the extremities, worse at night; aching pains on waking. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in three or four hours. Mercurius.—Pains of a shooting, tearing or burning character, aggravated by the warmth of the bed and by cold or damp air, and worse towards morning; swelling and sometimes a sensation of coldness in the parts affect- ed ; profuse perspiration, but without producing relief. The pains principally affected the joints and bones. Dose.—A powder, or six globules on the tongue, once in three or four hours. Nux-v.—Sensation of torpor and numbness in the parts affected, with cramps and palpitation in the mus- cles, sensitiveness to cold, constipation and gastric suffer- ings. The pains also may be of a tensive or drawing character, and be particularly confined to the chest, loins, and back. Dose.—A powder, or six globules, once in three or four hours. Arnica—will be of benefit given internally and also as an external application, when the joints feel as if bruised; hard, red and shining swelling; a crawling sensation and feeling as if paralysed; pains increased by motion. It is frequently advisable to alternate in with Cham. Dose.—Three drops, or twelve globules, in a glass half full 01 water, a tablespoonful every three hours. Rhododendron.—Pains worse during repose,and aggra- vated by rough or damp weather. rheumatism. 295 Dulcamara,—Rheumatism following a severe attack of cold, and manifesting itself at night or during repose, and unattended with fever. Causticum.—Insupportable pains in the open air, re- lieved in bed or in the warmth of a room; or paralytic weakness or rigidity of the part affected. Arsenicum—Burning, tearing pains, worse at night, aggravated by cold air, and relieved by heat. China.—Pains increased by the slightest touch, with perspiration and paralytic weakness of the part affected. Ignatia.—Contused or wrenching pains as if the flesh were torn from the bones, worse at night, and relieved by a change of posture. Pliosphorus.—Pains excited by the slightest chill, and accompanied with headache and oppression of the chest. Sulphur.—An exceedingly valuable remedy in nearly all forms of chronic rheumatism, and particularly useful to rouse the system when it has in a measure lost its susceptibility to the appropriate remedy. Dose.—Of the above remedies two drops, or twelve globules, may be mixed with a tumbler of water, and a tablespoonful given at a dose; or a powder, or six globules, may be taken on the tongue. Give once in three, four, or six hours. Nitric-acid has been a very successful remedy in my own practice, both in the acute and chronic forms of rheumatism. The prominent indications are, severe drawing and lacerating pains all over the body; or pains particularly affecting the joints, bones, and the upper and lower limbs. The joints feel weak and bruised, and are exceedingly sensitive, especially after exertion. Pains aggravated by cold or damp air; trembling or numb sen- sation in the limbs. Dose.—Three drops of the first dilution in four tablespoonsful of water, a tablespoonful once in four or six hours. Where there is much heat in the affected part, the 296 GENERAL AFFECTIONS. application of a napkin wrung out in cold water will often produce relief. In the chronic forms of rheumatism lemon juice or lemonade may by given, often with the most happy re- sults. Great benefit may also be derived, especially in chronic cases, where there is a tendency to paralysis, or rigidity of the joints, by the proper application of the u magnetic battery? The poles of the battery should be so applied that a continuous current will pass through the limb or joint and also through the muscles affected from one end to the other. Thuja, Veratrum, Carb.v., Lach., or Colocynth, may also be indicated in certain varieties of rheumatism. Diet and Regimen.—When fever is present, the diet should be similar to that in fevers. Those who are liable to attacks of rheumatism will often find it advantageous to wear next the skin, silk undershirts and drawers GOUT. Arthritis. A gentlemen who had suffered intensely, both from rheumatism and gout, made quite an appropriate com- parison between the two. "Apply," he says, a "thumb- screw to the thumb, and turn it until the pain is as severe as can possibly be endured, and that is rheumatism. Now give it one more turn, and you have gout? The nature of the inflammatory action, both in gout and rheumatism, is undoubtedly the same. An attack of gout is almost always preceded, or accompanied by gastric derangement, and sometimes diarrhoea. The in- flammation may attack any of the small joints, although it is generally situated in the ball of the great toe. The integuments are swollen, the pains severe, of a darting, throbbing, burning or aching character, increased by contact and movement. The pains are aggravated at night; the urine is passed in small quantities, is high- PAIN IN THE SMALL OF THE THE BACK AND LOINS. 297 colored, and becomes turbid on standing, the patient is exceedingly restless and irritable. When the parox- ysms of gout are of frequent occurrence, a thickening of the articular membrane is produced, calcareous de- posits are formed about the joints, and the disease is liable to assume a chronic form. The disease, as a general thing, though not in all cases, may be looked upon as hereditary. The exciting causes are, high living, abuse of stimulants, particularly wines, want of sufficient exercise, loss of rest and irregularities in eating. It is generally confined to middle age, or more advanced life. Treatment.—Those in whom there is a strong predis- position to the disease, should be careful to avoid the causes which are liable to produce it. The treatment in all its stages, is similar to that indicated in rJieuma- tism. Consult that disease. PAIN IN THE SMALL OF THE BACK AND LOINS. Lumbago. Diagnosis.—Violent pain of a rheumatic character in the small of the back and loins, either periodical or per- manent, and sometimes accompanied with fever. It is frequently produced by cold or strain, and may come on suddenly, without a moment's warning, on suddenly ris- ing from a stooping posture, and cause the most ex- cruciating pain at every attempt to turn, or on the slightest motion. This kind of rheumatic pain often affects the neck, producing what is called kink or crick in the neck. Treatment.—Aconite is the prominent remedy in the commencement of the disease where considerable fever is present. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in two or three hours, or three globules on the tongue at the same intervals. 13* 298 general affections. Bryonia.—Severe aching or darting pain in the back, causing the patient to walk in a stooping posture, aggra- vated by the slightest motion, or a draught of cold air, and sometimes attended with a sensation of chilliness. Dose.—Same as Aconite. Rhus.—Pains of a shooting or dragging character; severe aching, as from a sprain or bruise; sensation of stiffness or tension in the affected part on movement; pain aggravated by rest. A prominent remedy in cases of long standing, and frequently indicated after, or in alternation with Bryonia. Dose.—Same as Aconite. Belladonna.—Deep-seated pains, producing a sensa- tion of heaviness, gnawing or stiffness. Dose.—Same as Aconite, and frequently in alternation with that remedy. Nux-vomica.—A valuable remedy in obstinate cases. Pains increased by motion and turning in bed at night, and attended with weakness; pains resembling those produced by a bruise or fatigue; irritable temper and constipation. Dose.—A powder, or three globules, once in four or six hours. Pulsatilla.—Particularly useful in females, or indivi- duals of mild, sensitive, or phlegmatic temperament. Pains resembling those mentioned under the head of Nux, but producing a sensation of constriction in the affected parts. Dose.—Same as Aconite. Give once in four or six hours. Mercurius.—Pains resembling those indicating Nux, but aggravated at night. Dose.—Same as Nux. Where the affection is of long duration, the above remedies may be given at longer intervals. NEURALGIA. PROSOPALGIA. TIC-DOLOUREUX. This disease may attack every system of nerves, and be developed in every part of the body. Being purely an affection of the nerves, the pain may become most NEURALGIA. PROSOPALGIA. TIC-DOLOUREUX. 299 intense and agonizing, sometimes producing delirium. It assumes different names, when developed in different parts of the body. Thus, we have Prosopalgia, Tic- doloureur, Nervous headache, Angina pectoris, c&c, all of which are only varieties of neuralgia. For Neuralgia of the Stomach, see Gastralgia. Neural- gia of the Abdominal nerves, see Colic. For Nervous headache, see headache. Of the other forms of neuralgia we shall treat of 1. Facial Neuralgia, sometimes called Prosopalgia or Tic-Doloureux. 2. Angina Pectoris, or neuralgia of the heart. 3. Neuralgia of the spinal marrow. 4. Sciatica. 1. Neuralgia of the Face. Diagnosis.—The pain is not continuous, but comes on in paroxysms at irregular intervals. At first it may be slight, like the commencement of a common toothache, but it gradually increases in severity, until the patient may become almost wild with the pain. The pain is of a lancinating, tearing, beating or boring character, and follows the course of the nerve. After the pain has continued a certain length of time, it gradually subsides. The more severe the paroxysm, the shorter its duration. Where the pain commences at a point in the eyebrow directly over the middle of the eye, it generally extends to the eyebrow, forehead, eyelids, and frequently deep in the orbit of the eye. If it commences at a point about the middle of the cheek bone, it may extend over the cheek, lower eyelid, upper lip, and radiate to the teeth, palate, and tongue. Where the pain commences about the middle of the chin, it may extend to the lips, teeth, sides of the tongue, and the soft parts under the chin. Thus, whatever nerve is affected, the pain may be traced along its branches. There may also be a reflex action 300 GENERAL AFFECTIONS. of the nerves of motion, producing an involuntary twitch- ing of the muscles of the affected part. The intervals between the paroxysms may be of hours, days, or even weeks' duration, but the longer they con- tinue the more frequent they become, until at length the nerves may become so sensitive that the paroxysm is excited by the slightest emotion, or by the least touch, or exposure to cold air. Causes.—It may be complicated with rheumatism, or be the result of cold, wounds, contusions, affections of the teeth and abdominal organs, suppressed chronic eruptions, carcinomatous, psoric, or syphilitic dyscrasia. Treatment.—Aconite.—In inflammatory or rheumatic prosopalgia, where there is considerable heat and swell- ing. The pain is throbbing, burning, shooting or stitch- ing, worse at night, appearing in paroxysms and accom- panied with great sensibility of the whole nervous system. Belladonna.—Paroxysm commencing with an itching in the affected part, and changing to a violent lancinating, aching, crampy or drawing pain in the check and nasal bones; the pain is on one side, and is frequently accom- panied with an increased secretion of saliva or tears. Agravationg of pain from the slightest movement, noise, warmth of a bed, or a current of air. Twitching of the muscles of the face. Dose.—Two drops, or twelves globules, in a tumbler half full of water, a tablespoonful during the violence of the paroxysm every half hour or hour, gradually increasing the intervals as the pain abates. Bryonia.—Particularly in rheumatic persons, and where the pains are of a pressing, drawing, lacerating or piercing character; mitigated by moving the part affect- ed; pains in the limbs, and sometimes chilliness fol- lowed by fever. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful every hour or two hours. NEURALGIA. PROSOPALGIA. TIC-DOLOUREUX. 301 Chamomilla.—Great sensibility and extreme restless- ness; swelling of the face; redness of one cheek and paleness of the other; drawing, tearing or pulsative pain, with sensation of torpor in the part affected. Dose —Same as Bryonia. China.—Stitching, pressive, or beating pains, par- ticularly in the cheek bones, aggravated by the slightest contact; sensation of torpor, and paralytic weakness in the parts affected. Dose.—Same as Bryonia. Colocynth.—Violent rending, or darting pains, princi- pally on the left side of the face, and extending to the ears, temples, nose, and teeth, and all parts of the head, aggravated by the slightest touch. Dose.—One drop, or twelve globules, in a tumbler half full of water, a tablespoonful once in one or two hours. Coffea.—Insupportable pain, and great excitability of the nervous system. Arsenicum.—Violent burning, or tearing pain, worse at night, or during repose, and relieved by the application of external heat. Great prostration, and sometimes a sensation of coldness in the affected parts. Tendency to periodicity in the attacks. Dose.—A powder, or six globules, once in two or three hours. Hepar-s.—Pains in the bones of the face, aggravated by the slightest touch; aggravation in the evening. Platina.—Sensation of coldness, or torpor in the affect- ed part, with severe spasmodic pain; or tensive pressure in the bones adjoining the ear, with a sensation of creeping or crawling; worse in the evening, or at rest. Dose.—A powder, or six globules, once in two or three hours. Spigelia.—Violent tearing or jerking pain, aggravated by the slightest touch, or by movement of the parts, or pains appearing to shoot from the centre of the brain to the sides of the head; pains of an aching, pressive 302 GENERAL AFFECTIONS. character, sometimes with glossy swelling of the affected part. Dose.—Same as Belladonna. Rhus.—Stinging, burning, or drawing pain, or pain as from subcutaneous ulceration; worse during repose and in the open air, and relieved by movement or warmth. D0Se.—Same as Bryonia, with which it may sometimes be al- ternated. Mercurius.—In rheumatic persons, with aggravation ol pain at night, and nightly perspiration; sensation of coldness in the parts affected, and great debility. Dose.—A powder, or three globules, once in two or three hours. Nux-v.—Especially in persons addicted to spirituous liquors, and those of a lively and choleric temperament, or those who lead a sedentary life. Drawing and jerking pain, aggravated in bed, in the cold air, and during meditation. Dose.—A powder, or three globules, once in three or four hours. Pu7satilla.—Lacerating or pulsative pain on one side, worse on lying down and during repose; relieved in the open air. Particularly useful in women and persons of a mild or timid character. Dose.—Same as Bryonia. SaHna.—Pains of a violent lacerating and throbbing character, occurring during menstruation. Dose.—One drop, in a tumbler of water, or three globules on the tongue. Give every hour or two hours. Kalmia.- This remedy has been given with marked success in the more violent forms of Prosopalgia, where the pains are of a violent lacerating or throbbing char- acter. Dose.—Three drops, in six tablespoonfuls of water, a tablespoon- ful every hour. Where the attacks are intermittent in their character, coming on at stated intervals, it may be necessary to give Quinine. From a half to one grain may be given NEURALGIA OF THE HEART. 303 during the interval between the attacks, once in four hours. Where the pain is excessively violent, it may be ad- visable to bathe the parts with a mixture, composed of six drops of Aconite, to four table spoonsful of water, Staphysagria may also be applied in the same manner. The external application may be wari^ or cold, accord- ing to the feelings of the patient. 2. ANGINA PECTORIS. Neuralgia of the Heart. Diagnosis. —Intense and terrible pain in the region of the heart, coming on in paroxysms, and extending over the chest, neck, and arms, and accompanied with sensa- tion of fainting. The pain varies in intensity, the breathing may be apparently arrested, or be exceedingly difficult and attended with moaning; the pulse is gene- rally small and feeble, and during the paroxysm, the face and extremities may be covered with a cold sweat. Causes.—It may arise from abuse of spirituous drinks, errors in diet, dyspepsy, rheumatism or gout, and is not unfrequently connected with organic disease of the heart. Treatment.—During the paroxysm the patient should remain perfectly quiet, in an erect position, and be re- lieved from all external pressure. Arsenicum.—This is a valuable remedy, where the patient is unable to breathe, except with his chest bent forward; oppressive stitching in the region of the heart, with fainting and anguish; the attack is renewed or aggravated by the least motion. Digitalis is indicated where the action of the heart is violent, or where the disease sets in suddenly, and there are present, drawing or spasmodic pains in the left chest and sternum, the ne'ck and arms, and sometimes a deathly anguish. Belladonna.—Difficult and hurried respirations with GENERAL AFFECTIONS. moaning; tensive shooting or pressive pain in the vicinity of the heart; tremor of the heart, with anguish and an aching pain. Rhus.—Violent pulsative stitches, in the region of the heart, sometimes with painful lameness and numb- ness of the left arm; palpitation of the heart; difficulty of breathing. Spigelia.—Great difficulty of breathing. Dull or op- pressive stitches in the region of the heart; cutting, lacerating, or tensive and drawing pain; violent palpita- tion of the heart. If other remedies are required, Iodine, Mercury, PhospJiorus, and Veratrum. See also "Facial Neuralgia," and "Materia Medica." Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose ; or six globules, or a powder on the tongue. In violent paroxysms, give every half hour or hour, gradually in- creasing the intervals as the pain abates. 3. Neuralgia of the Spinal Marrow. Diagnosis.—Pain in the back, with convulsive paroxysms in the internal body, or in the organ in relation with the affected portion of the spinal marrow. When the dis- ease is in the upper portion of the marrow, it may affect the head, causing severe pain there, dizziness, amaurosis, buzzing in the ears, deafness, delirium, and stiffness of the neck. If the affection is in the lower cervical portion, its effects are felt in the chest, arms, and throat, produc- ing serious pain and paralysis, spasms of the throat, hic- cough and oppression, or palpitation of the heart. If the upper dorsal portion be affected, we have spasmodic cough, palpitation of the heart, fainting fits, moaning and pains below the false ribs. If the lower dorsal por- tion is diseased, there may be pain in the stomach, de- rangement of the digestive functions, and difficulty in urinating. If the lumbar portion is affected, we may SCIATICA. 305 have colic, almost paralysis of the limbs, and drawing in the testicles. As this disease may be somewhat complicated in its character, it will always be best to consult a physician. Among the prominent remedies, we may enumerate Belladonna, Rhus, Staphysagria, Conium, Veratrum, Sabina Colocynth, Aurum, and Nux-v. See Neuralgia of the face, also Materia Medica. 4. SCIATICA. Pain in the Hip. Diagnosis.—Pain in the region of the hip, frequently extending to the knee and foot, and following the course of the sciatic nerve. By its severity it may not only produce violent pain, but stiffness and contraction of the limb. The pain manifests itself not only during motion, but also during repose. This, as well as other diseases jf the hip, and also of the knee-joint, should not be leglected, but the advice of a physician immediately )btained. Treatment.—When the attack is accompanied with ;onsiderable fever, Aconite may be given, if the pain is violent, in alternation with Belladonna, or Bryonia. Bellidoina.—Where the slightest motion increases the-pain; the skin of the part affected is red and shin- ing, and burning fever may be present. Bryonia.—The symptoms are similar to those indicat- ing Bellalonna, with the exception that the parts affect- ed are not as red, but quite as painful; constipation may also be present. Rhus.—The pains are darting, tearing or dragging, attended with tension and stiffness in the muscles, and aggravated during rest; painful sensibility of the joint when rising from a sitting posture. Ignatia.—Pains of an incisive nature, particularly on moving the limb. It is highly useful where the disease 306 GENERAL AFFECTIONS. occurs in persons of a mild or melancholic temperament Colocynth.—Sensation as if a tight band where around the hips and back, the pains running down from the regions of the kidneys into the legs; pain excited or aggravated by anger or indignation. Pulsatilla.—Pains worse toward evening, during the night, and when seated, but relieved in the open air. Nux-v.—Pains aggravated towards morning, and attend- ed with a sensation of stiffness and contraction, also of paralysis, torpor and chilliness, in the parts affected. Ars< nicum.—Burning pains or sensation of coldness in the affected parts; acute dragging pain, with great rest- lessness, occasional intermission of pain, with periodical returns; pain relieved by external warmth; weakness and disposition to lie down. Among the other remedies sometimes indicated, we may mention: Veratrum, Chamomilla, Conium, Staphy- sagria, Ilep.-s., Phosphorus, and Sepia, Sulphur, Mercury, and lachesis. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or a powder, or three globules on the tongue. In severe cases give a dose every two or three hours. If the disease assumes a chronic character, a dose once in six or twelve hours will be sufficient. In all forms of neuralgia the galvanic lattery will often produce the most beautiful results. PARALYSIS. Palsy. Diagnosis.—There is a partial or total loss of voluntary motion and sometimes of sensation. Certain portions of the body may be in a state of paralysis and other parts as active and vigorous as ever. Thus the arm may be para- lyzed, and also certain muscles of the face. Where it follows apoplexy there is generally paralysis of the whole of one side of the body from the head to the feet. This is called Hemiplegia. EPILEPSY. 307 When there is a loss of voluntary motion only, the affected parts become soft from want of action and wither away. Treatment.—Consult a physician without delay, for if taken in time a cure may often be affected, while, if the disease is allowed to run on, it may soon be out of the reach of aid. Rhus.—An important remedy where there is great sensitiveness to cold air, general debility and languor. tingling or itching in the paralyzed parts. Lameness in the extremities and joints, with stiffness, worse on rising, after having been seated for some time. Paralysis of one side or of the lower extremities, with dragging, slow, difficult walking. Particularly useful when caused oy nervous fevers. Nux-v.—Paralysis, particularly of the lower extremi- ties ; trembling of the limbs; cramps and spasmodic twitching of the parts; heaviness and stiffness of the dmbs, sensitiveness to cold air. Especially when brought on by the use of stimulants, narcotics, or from a too se- dentary life. Among the other important remedies, we may enume- rate: Belladonna, Bryonia, Cuprum, Secale, Plumbum, Cocculus, Stannum, Kali-carl., Natrum-mur., and Sulph. Cuprum, is a prominent remedy where the attack sets in after Asiatic cholera, nervous or typhoid fever, or apoplexy. Secale where the paroxysms are of frequent recurrence. Natrum-mur. is a valuable remedy where the paralysis is caused by sexual debauchery, onanism, vio- lent passion, anger or chagrin. The electro-magnetic bat tery will often establish a cure when all other means fail D0SB.—The remedy may be given once or twice a day. EPILEPSY. There are convulsive motions, with entire loss of con- sciousness ; falling down, with cries and foam at the | 808 GENERAL AFFECTIONS. mouth; the thumbs are flexed into the palm of the hand. The attacks occur in paroxysms, each paroxysm having two stages. The first or convulsive stage may last from a few minutes up two or three hours, when it passes into the second or the soporous or apoplectic stage. Sometimes the attack comes on without any premonition, when the patient, no matter where he may be, falls senseless to the earth, as if struck by lightning. Some- times, however, there are premonitory symptoms, such as, headache and nausea. The attacks may come on at certain periods, but more frequently at indefinite times. The disease is difficult to cure and the attacks may con- tinue through life, ending in weakness of the mental faculties, and sometimes almost idiocy. It must be borne in mind that in epilepsy, the convulsions, however weak they may be, are attended with entire loss of conscious- ness, while convulsions, even of the most violent charac- ter, if the patient still retain a certain amount of con- sciousness, are not epileptic. Treatment.—In the treatment of this disease almost every thing depends in getting at the correct cause, hence the case should be submitted to a careful physician. During the paroxysm particular pains should be taken to prevent the patient hurting himself from his violent motions. A snaall piece of pine wood or a piece of cork may also be placed between his teeth. Two drops of Belladonna may be mixed in a tumbler half full of wa- ter, and a teaspoonful given as soon as he can swallow, every fifteen or twenty minutes. During the second or soporous stage, Opium may be given in the same way, a dose once in a half hour or hour. CHOREA. St. Vitus''s Dance. This disease may occur as an epidemic, particularly when large crowds meet, some of whom are laboring TETANUS. 309 under some violent excitement. It most frequently, however, occurs in females at the time of development of puberty, from the seventh to the sixteenth year. There are involuntary motions of single members, or of the whole body, wandering from one part to the other. These motions are exceedingly variable in their charac- ter. Sometimes there are violent jerks of different parts of the body; if of the arm, whatever is in the hand at the time is thrown down with violence; sometimes there are violent contortions of the muscles of the face, again the patient may, against his will, dance for hours, or run for miles, until completely exhausted. It differs from epilepsy in one important particular, the convulsions are never attended with loss of consciousness. It would be impossible, in a work like this, to detail the treatment of this disease, as the practiced judgment of the physician is necessary to conduct the cure. The galvanic battery will be found an important remedy. The system should be strengthened, and to this end, the body should be bathed with cold water, out-door exercise taken, and violent excitement avoided. TETANUS. Trismus, or Lockjaw. By tetanus we understand sudden contractions 01 cramps, long-continued and violent twitching of the vo luntary muscles of various parts of the body. Generally the muscles most easily affected are those of the neck jaws, and throat. The patient feels an uneasiness in bending or turning the head, at length there is difficulty in opening the mouth, and this is shortly followed by closing of the jaws, either gradually, but with great firmness, or suddenly, and Math a snap. Soon the muscles connected with swallowing become affected, and this is shortly followed by a severe acute pain in the lower part of the sternum, piercing through to the back. The pain 810 GENERAL AFFECTIONS. is subject to aggravation in paroxysms, the spasms ex- tending to the muscles of the trunk; to the large muscles of the extremities', the muscles of the face, and so on until all the voluntary muscles of the body may become fixed. As the disease advances, the spasms increase in frequency and violence, and are attended with intense pain. Where the contractions or spasms are confined to the lower jaw, the disease is generally called " trismus or lockjaw? Causes.—The most common causes are punctured and lacerated wounds, which injure one or more of the nerves. It is more liable to follow punctured wounds in the ex- tremities than in the trunk. Taking cold in wounds, the irritating effects of splintered bones and foreign sub- stance, such as, dirt, rust, &c, also blows upon the back may lead to tetanus. It sometimes, although much more rarely, follows suppressed menstruation, low fevers and violent exertion of the mind and body. Treatment.— The exciting cause should by ascertained and removed if possible. Nux-v.—This is a highly important remedy in almost every variety of tetanus. It is especially indicated where the spasms are frequent and short, and there are cramp- like pains in the region of the stomach, constipation and loss of appetite. If the patient has been addicted to the use of spirituous liquors, the indications for the re- medy will be still more apparent. Dose.—A powder, or six globules on the tongue every hour. Arnica.—This remedy may be used with advantage as an external application in those injuries which threaten to lead to tetanus. Six drops may be mixed with three tablespoonfuls of water, and the wound washed with the mixture three or four times a day. Two drops also may be mixed in a tumbler half full of water, and a table spoonful given at the same intervals. Belladonna may be given where the disease affecia HYDROPHOBIA. 311 principally the extremities, and where it is occasioned by deranged menstruation and difficulties connected with the utero-genital system ; also where delirium is present. Dose.—Two drcps, or twelve globules, in a tumbler of water, a tablespoonful every two, three, or four hours. Pulsatilla may be given with advantage after Belladonna, at the same intervals. Should there be great rigidity of the extremities, wild and fixed look, and difficult respiration and deglution, Stramonium will be indicated in alternation with Hy- osciamus. Give every hour or two hours, prepared same as Belladonna. Warm bathing and the external application of hot fomentations are often productive of decided relief. Among the other remedies which may be indicated, we may enumerate, Veratrum, Hydrocianic-acid, Phospho- rus, and Camphor. HYDROPHOBIA. This is one of the most fearful and agonizing diseases on record, and what adds still more to the terror inspired by its name, but very little success has as yet been met with, in its treatment. Diagnosis—The disease follows the bite of a rabid ani- mal, not however immediately. The wound may seem perfectly healthy, and heal as kindly as if no poison had been infused into it by the bite of the animal. In the course however of a period, varying from three weeks to eighteen months,—and some say years may elapse,—the premonitory symptoms set in. The bitten parts present a livid and slightly swollen appearance, which is accom- panied by burning heat and sharp pain, extending toward the central part of the body. Very soon after this local irritation commences, sometimes even in a few hours, the specific constitutional symptoms begin. The patient is hurried and irritable; there is pain and stiffness about the neck and throat, and every attempt to swallow fluids brings on a paroxysm of choking and sobbing. As the 812 GEN RAL AFFECTIONS. disease advances, the eyes become red and brilliant, and highly sensitive to light, the cramps about the throat, neck, and chest, more and more violent, until the sight of liquid or any shining substance, or even the passing of a gust of wind over the face, produce the most pain- ful paroxysm. A viscid saliva is constantly secreted, and notwithstanding the most intense thirst is present, the patient cannot drink for fear of bringing on the fearful spasm. As the disease advances, the old wound opens and discharges an offensive substance, respiration be- comes more difficult, the countenance is haggard, the eyes sunken, but still brilliant; there is delirium of a wandering or violent character, constant inclination to bite, loss of voice, sinking of the pulse, until at length, death comes, as a welcome messenger to relieve the poor victim of his tortures. Treatment.—Where a person has been bitten by an animal supposed to be rabid, the bitten part should be immediately cut out or cauterized with caustic potash or some other burning substance. Belladonna may be used as a preventive and also during the disease. As a preventive, six globules, may be taken every other night for two weeks. During the disease two drops, or twelve globules, may be mixed with a tumbler of water, and a tablespoonful given every hour or two hours. Nux-v., Stramonium, Hyosciamus, Lachesis and Vera- trum may be of service given as in tetanus. DELIRIUM TREMENS. Mania a, Potu. This disease is so well known as to require but slight description here. It is met with in every grade of so- ciety, from the high to the low, among the rich and the poor. Among the so-called higher classes of society, it very often receives the name of nervous fever, or inflam- DELIRIUM TREMENS. 313 mation of the brain, while among the poor it is called by its blunt and appropriate name, "delirium tremens? This disease, as a general thing, is produced by a long- continued use of spirituous liquors. We sometimes find it, however, in those who are not in the least addicted to this detestable vice, but whose nervous system has been overstrained by other modes of strong excitement. Thus, the long-continued mental anxiety in which gam- blers and great speculators are accustomed to live, may cause it. Diagnosis.—This disease is sometimes mistaken for in- flammation of the brain, yet when observed even with but litle care, the difference is very apparent. The face may be red and the eyes blood-shot. There is a rapid pulse, wildness of look and constant fidgeting with the hands, and sometimes tremor of the limbs. The delirium is generally a busy delirium; whatever he does is done in a hurried manner, and with a sort of anxiety to perform it properly. There is great sleep- lessness, frequently an entire absence of sleep for several days and nights; constant chattering. The tongue is moist and creamy, the pulse though frequent, is soft, and the skin moist. Ask the patient a question, and he may answer it properly, but immediately his thoughts are wandering to things which exist only in his imagination. His thoughts are generally distressing and anxious; he is giving orders about his business to persons who are absent, or devising plans of escape from some imaginary enemy, or starting in terror at the hideous reptiles which he thinks he distinctly sees all around him. He seldom meditates harm, the delirium more frequently being com- bined with a mixture of cowardice and fear. Treatment.— Opium.—This is one of the most promi- nent remedies in the treatment of this disease. There are rapid and constant motions; wild and staring ex- pression; tremor of the hands and limbs; frightful or 14 314 GENERAL AFFECTIONS. fantastic visions, confusion of ideas, and sometimes stupe- faction and inclination to commit suicide. Nux-v.—Trembling of the limbs; spasmodic twitching in different parts of the body; vomiting or pressure and burning in the stomach; constipation, headache, cold- ness of the extremities; depression of spirits; constant uneasiness, anguish, and desire to run away; troublesome visions. Belladonna.—Congestion of blood to the head, flushed face, injected eyes, boisterous delirium; great nervous excitement; trembling of the limbs, and visions. Stramonium and Hyosciamus are also valuable reme- dies, especially where there are convulsive movements, great excitability, rapid motions, picking at imaginary objects and muttering delirium. Dose.—Two drops of the remedy, in a tumbler of water, a table- spoonful every hour, until relief is obtained TUBERCULOSIS. SCROPHULOSIS. Scrofula. We have already referred to some of the varieties of this disease, and the causes which contribute the most to its development. It might with propriety be called " Parent of diseases,''^ as it is the fruitful source of al- most an innumerable variety. It is, as a general thing hereditary, taints the whole system, and may be deve- loped in any organ of the body; even the bones furnish frightful evidences of its ravages. It may remain latent in the system for years, but be developed in all its viru- lence in some weakened organ, or in a system prostrated by disease, anxiety, or dissipation. A tuberculous constitution may be indicated by the following appearances; large head, short, thick neck, light hair, fair skin and rosy cheeks, generally blue eyes and large pupils; the form may be full and rounded, but the flesh is soft and flabby; frequent bleeding at the SCROFULA. 315 nose, and accumulation of mucus in the lungs, trachea, nose, and intestinal canal. The prominent symptoms are, glandular swellings and indurations on the neck, below the jaw, the nape of the neck, axilla, groins, and finally in almost every part of the body. The swellings are at first soft, painless and moveable, but afterward become larger, harder, painful, inflamed, and finally suppurate and form scrofulous ulcers. As we have said before, almost every tissue and organ of the body may be attacked by this disease. It may attack the mucous membrane of the nose, com- mencing with a swelling and redness about the wings of the nose, and attended with a thin offensive discharge which frequently blocks up the nostril. The stomach and liver may also be the seat of tuber- culosis, as well as the spleen, intestines, throat, lungs, brain, spinal marrow, eyes, ears, bones, joints, &c. A frequent form in which scrofula is developed is Scrofu- lous Ophthalmia; in this variety there is an extreme sensitiveness to light, even the slightest ray producing intense pain. An eruption generally appears during the inflammation on the cheeks near the eyes, into which they frequently extend, producing ulcers which may destroy sight. White swelling and Hip-disease, are other forms of scrofula in which the joints and the membrane which surrounds them are diseased. These diseases are gene- rally slow in their progress, at first pain only being felt after exercise. As the disease advances, the cartilages and other substances which compose the joint, become so thickened that the joint becomes immoveable. If the disease is still allowed to progress, suppuration takes place, accompanied with emaciation, hectic fever, great prostration, and night-sweats soon terminating in death. Racliitis or Rickets, is another variety of scrofula af- fecting principally the bones, and usually making its 316 general affections. appearance between the ninth month and the second year. This is a morbid alteration of the bones, characte- rized by swelling, softening and deformity. The head is large and heavy, and sinks on the shoulders. The softened bones are unable to retain their shape; hence the shoulders stand out, the spinal column is curved, and lasting deformity of different parts of the system may be the result, as well as serious diseases occasioned by the contraction of internal organs. I have already spoken of the tubercles of the lungs, in the article on Pulmonary Consumption. It will be im- possible in our limited space, to go into the minutiae of the almost innumerable variety of diseases produced either in part, or entirely by a tuberculous taint. It will be only necessary to refer the reader to the diseases under their respective heads. Causes.—The prominent causes of hereditary tuber- culosis have been given in the chapter on the causes of disease. But the disease as we there remarked is not always hereditary. It may be produced in childhood by nursing from a scrofulous or syphilitic nurse, or even be introduced into the child by vaccination, the pus having been taken from one in whom there was a constitutional taint. It may also be produced by living in impure, damp, or moist cold air; in a general neglect of clean- liness, and eating heavy indigestible food in the first years of infancy. Violent astringent medicines which impede and stop the salutary motions of nature, and measles, small pox, scarlet fever, and those other dis- eases which tend to weaken the lymphatic system, may also produce it. Treatment.—The treatment should be in a great mea- sure constitutional. The food should be healthy, and easy of digestion, but highly nutritious. Vegetables combined with animal food may be used,.but rich gravies and highly oily substances should be avoided. A mode- SCROFULA. 317 rate use also of porter, ale, and light wines may be ad- visable. Cleanliness, bathing the entire body daily, and a daily change of linen are essential, as well as pure air, and active muscular exercise. The most prominent remedies in the treatment of the various forms of Scrofula are, Suljdmr, Calcarea, Iodine, Ferrum, Mercury, Aurum, China, Belladonna, Conium, Hepar-s., Sepia, Barita, Dulcamara, and Rhus Sulphur.—Its prominent indications are, ulcers on various parts of the body; humid eruptions on the head, behind the ears, and discharge from the ears; eruption about the eyes, and inflammation of the eyes, sometimes with ulcers on the cornea, great intolerance of light and swelling and inflammation of the lids; swelling and sometimes suppuration of the glands; white swelling of the knee and pain in the knee and hip-joints; pulmonary cough, with sticking pains in the chest and purulent ex- pectoration; swelling of the nose with offensive discharge. Dose.—In acute cases, a powder, once in six hours, in chronic cases, every night. Rhus.—Eruptions and soft tubercles on the scalp; inflammation of the eyes, with eruption around them, and great sensitivess to light; eyelids itch, are swollen and inflamed; scurfy eruptions on different parts of the body; swelling of the glands about the neck and throat; enlargement of the bones and inflammation in the hip and knee-joints; stiffness and lameness of the limbs, and sensitiveness to the air; stitches in the chest, and short painful cough; crusty eruption in the nose and about the mouth. Dose.—Six globules, once in twelve or twenty-four hours. Iodine.—Enlargement and induration of the glands; rough and dry skin and emaciation; inflammation of the knee, with swelling, catarrhal affections of the mucous membrane; inflammation and swelling in the liver; abdomen tumid, with pain on pressure; cough and pain 318 GENERAL AFFECTIONS. in the chest; swelling and pain in the bronchial glands, and hectic fever. Dose.—Same as Rhus. Calcarea.—This is an exceedingly valuable remedy in almost every stage of tuberculosis, particularly in glan- dular swellings and softening of the bones. It is also highly indicated in the scrofulous ophthalmia of children, especially where there are ulcers on the cornea; also scrofulous eruption and ulcers in children. It follows well after Sulphur, Mercurius, and Hepar-s., and may be followed with advantage by Silicea. or Iodine. Dose.—A powder, or six globules, morning and night. Hepar-s.—Particularly where the tumors and enlarged glands are in a state of suppuration, and where the ulcers discharge a thin and offensive matter; also in Ophthal- mia where there is a profuse secretion of tears, and a considerable mucous discharge. Dose.—Same as Calcarea. Mercury will be found of great advantage where there is inflammation of the eyes, with danger of ulceration ; inflammation, pain, and swelling of the glands; eruptions and ulcers on the body, and affections of the bones and joints. Dose.—Same as Calcarea. Belladonna.—Glandular swelling, with inflammation and suppuration. Inflammation of the eyes, with heat, redness, and great sensitiveness to light, severe pain in the ball of the eye; swelling of the bones, of the lips, nose and tonsils, bleeding of the gums; roaring in the ears, soreness of the throat, &c. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful in acute cases, every three or four hours; in chronic cases every night. Baryta.—Scrofulous affections of the ears, with dis- charge of purulent matter; pain in the joints and bones; sore throat, especially after a cold ; chronic inflammation of the eyelids; scrofulous emotions and ulcerations. CANCER. 319 Dose.—A powder, or six globules, at night. Sepia is particularly useful in females affected with derangement of the menstrual functions, and Aurum, Ferrum, and Phosphorus will be found of great advan- tage in obstinate cases, especially where the strength is running down. Dose.—Same as Baryta. Bryonia will be found a most valuable remedy in tu- berculous affections of the chest, characterized by rheu- matic or aching pain in the chest and cough. Dose.—Same as Belladonna. Great benefit may also be obtained by visiting some of the Sulphur or Iron springs which abound in this country. CANCER. Carcinoma. This malignant disease may be correctly classed under the head of Dyscrasia. Like tuberculosis, taken in its incipient stage it can be in a measure held back if not entirely eradicated, but permit it once to fasten firmly in the system, and its progress is as a general thing steadily onward, notwithstanding the utmost effort of human skill to arrest its march, until its victims, are re- lieved from pain by the welcome summons of death. Cancer may properly be divided into three species, viz., scirrhus; encephaloid or brain-like cancer; and colloid or gum-like cancer. Scirrhus is characterized by great hardness. It is as firm as a cartilage, and creaks when divided by a knife. The surfaces exposed by its division, present a glisten ing, satiny appearance and a white, or grey, or bluish- white color. The encephaloid cancer is composed in a great measure of a soft white, opaque pulpy substance, very closely resembling, both in color and consistency, that of the healthy brain. This pulp is traversed and circumscribed 320 GENERAL AFFECTIONS. by fibrous septa. In the colloid or gum-like cancer, there is exhibited an appearance of small portions of a green- ish-yellow transparent gum, or jelly, arranged in regular cells. Hence it is sometimes called alveolar cancer. These three varieties may, notwithstanding the dissi- milarity of their appearance, coexist in different organs of the same individual. If a tumor of one growth be amputated, and, as is often the case, a fresh growth springs from the same place, this secondary growth may be of another species. Occurring in any one part of the body, they are exceedingly prone to multiply in other parts, so that if one is removed by the surgeon's knife, the probability is that the disease will soon be developed in some other part of the body, if not in the same spot. Cancerous growths are attended during some portion of their progress with severe pain; they enlarge in bulk sometimes slowly, at others with great rapidity, changing tissues and eating away contiguous parts, breaking out when near the surface into repulsive ulceration and ulti- mately destroying life. Vital parts are slowly disorga- nized by the corroding extension of these tumors and sometimes large blood-vessels are laid open, producing death by haemorrhage. This disease is liable to attack every organ and tissue of the body: the brain, the eye, the lip and face, the lungs, the stomach, the intestines, the liver, the kidneys, the breast, the womb, the testicles, the bones, all may suffer from its frightful ravages. Among the parts, however, which are more frequently attacked than others, we may mention, the female mammae, the uterus, the stomach, liver and testicle. The edges of a cancerous ulcer are generally hard, ragged, unequal and very painful. The whole surface of the sore is also unequal. The discharge is a thin, dark-colored, and fetid ichor, and in the advanced stages considerable blood is lost. A burning heat is felt over CANCER. 321 the ulcerated surface, and shooting or lancinating pains. When it occurs in the female breast, it is more liable to commence at that period, when the uterine functions are about to cease. In cancer of the stomach, there is but little perceptible difference between its earliest features and those of com- mon nervous dyspepsy. In both, flatus, acid eructations, and weight in the stomach are present. At length, in cancer, decided pain is felt, in a little time becoming oppressive and shooting from the stomach into the back and loins, down the thighs. Nausea sets in, and the food is rejected, mixed with quantities of ropy mucus, by which the pain and oppression are relieved. The appe- tite cannot be indulged in to satisfaction from the ag- gravation of symptoms, which full meals and certain kinds of food induce. The bowels are generally costive. In this first stage of the disease under the influence of some cause, evident or undiscovered, all, or nearly all the symptoms may rapidly vanish and continue suspended for weeks or months, but a length a time arrives, when the disease takes firm possession. A visible wasting now sets in, increasing as the mala- dy advances to a frightful emaciation. The pain in the stomach may become constant, but aggravated after a meal. If the appetite still remain, the wretched patient fears to satisfy the craving, from the violent pain pro- duced by the entrance of food, and the vomiting he knows will ensue. The vomiting no longer produces re- lief, but increases the distress, and may be brought on by the smallest quantity of food. Suffering now be- comes habitual, and unmistakeable signs of anguish are plainly stamped on every feature. Beside the food vo- mited, various other matters are thrown from the sto- mach. Of these, the most eommon are fluids, containing a dark substance like coffee-grounds, uncoagulated blood, a thick poraceous matter, or finally a dark green serum, 14* 322 GENERAL AFFECTIONS. Debility gradually seizes on all the functions, until at length the patient, wasted almost to skin and bones, the pain and vomiting cease, and death comes without a struggle, a welcome messenger to free the poor victim from the agony he has so long endured. Treatment.—Very much depends on the proper treat- ment during the percursory stage. Then, the disease may be held in check or perhaps entirely eradicated, while, if allowed to go on, it becomes so firmly seated, as in the majority of cases to terminate fatally. Arsenic is undoubtedly the prominent remedy in all forms of cancer. Where the cancer attacks the face, lips, cheeks, nose, or tongue, its indications may be seen in the burning swelling in the nose, painful to the touch; ulceration of the nostrils with discharge of fetid ichor; ulcers in the "whole face; wart-shaped ulcer on the check; ulcerated eruption around the lips, with burning pain, particularly when the parts become cold; spread- ing ulcer on the lip, tearing and smarting during motion. When the disease is in the stomach, its indications are equally apparent, There is a burning, corrosive and gnawing pain in the pit and region of the stomach, op- pressive anguish, cutting and tearing pain, alternating with the corrosive and burning pain. Great prostration, vomiting of food and mucus, and aggravation of symp- toms after a meal. Nux-vom. is indicated in cancer of the stomach, where there are pressive griping or crampy sensations; oppres- sion and sensation of constriction of the chest; nausea, belching up of sour or bitter fluid, constipation, palpita- tion of the heart and flatulence. Mezerium will also be of benefit in this variety of cancer, where there are burning, corrosive pains in the stomach; sensation as if the food remained a long time undigested, and sometimes vomiting of blood. Plumbum may produce relief, where there is obstinate DROPSY. 323 constipation; vomiting without relief, consisting of greenish, blackish, or bitter substances, and paroxysms of burning, constrictive pains in the stomach. Dose.—A powder, or three globules, of the above remedies dry on the tongue," morning and night. Aurum may be indicated in most forms of cancer, especially when not only the soft parts, but the bones are affected. Calcarea.—Polypi in the nose, which may degenerate into cancer; also pimples, scurfs, and ulcers high up in the nostrils and around the lips, accompanied with swell- ing, which by their long duration may end in cancer. Silicea has been found of great benefit, when there are suppurating glandular swellings, scirrhous indura- tions, putrid spreading ulcers, scurfs and ulcers in the nose, on the lips, and face. Dose.—A powder, or three globules, dry on the tongue, every night. Besides the remedies already enumerated, we may mention as deserving attention: Conium, Sepia, Sulph., Hepar-s., Thuja, Nit/ic-ac. Mercury, Staphysagria and Lachesis. Diet and Regimen.—The diet should be nourishing and easy of digestion. Meats and the more solid articles of food should be preferred to watery vegetables. The character of the food also must be guided in a great measure by the feelings of the patient, carefully avoid- ing those varieties, experience has proved injurious. DROPSY. Dropsy is a common term, signifying effusion into the cellular tissue, or into any of the natural cavities of the body. To enter into an explanation of the causes of this effusion wuuld lead us into a broader field, than the design of this work would admit, a field, which would be in a measure uninteresting to the general reader. It will only be necessary for us then to briefly describe some 324 general affections- of the varieties of this disease and the treatment. We shall here speak of three varieties: 1. Anasarca, or cellular Dropsy. 2. Ascites, or Abdominal Dropsy. 3. Hydrothorax, or Dropsy of the chest. 1. ANASARCA, OR CELLULAR DROPSY This variety generally first manifests itself in the lower extremities, especially after standing or walking, gra- dually extending upwards, until the cellular tissue of the whole system becomes involved. The swelling is gene- rally soft and doughy, leaving a dent on pressure, and the skin white and shining. When confined to the lower extremities, it may exist for years with but little danger, but it seldom pervades the whole system, unless the system has become seriously impaired. Causes.—It is frequently produced by abuse of Arsenic and Mercury. Loss of blood, abuse of stimulants, de- rangement of the womb, scarlatina, measles, pulmonary consumption, &c. 2. ASCITES, OR ABDOMINAL DROPSY. Dropsy of the belly is often the result of inflamma- tion of the bowels, or peritoneal inflammation, or it may come on almost imperceptibly from some constitutional disturbance. There is a gradual enlargement of the ab- domen, generally commencing in the vicinity of the sto- mach, and afterwards extending over the entire abdo- men. There is difficulty of breathing on taking exer- cise, sallow complexion, dry skin, and scanty secretion of high-colored urine. Also a general feeling of languor and debility, and stiffness, particularly when attempting to bend the body. 3. HYDROTHORAX, OR DROPSY IN THE CHEST. The most common causes of this affection are, organic disease of the heart, and protracted pleuritic inflamma- HYDROTHORAX. 325 tion. The symptoms are the most urgent when the patient has remained for some time in a recumbent posture. The breathing is rapid and labored, and the countenance distressed, pallid and wax-like. Shortness of breath occurs from the slightest exercise, and the pulsations of the heart are irregular. Dropsy of the heart is a frequent attendant on hydrothorax. Treatment.—The prominent remedies in the cure of dropsy are ApU-mel, Apocynum-'annabium, Arsenicum, Digitalis, Cliina, Hellebore, Colchicum, Asparagus, Can- tharides, Hyd.potassa, Mercurius, Crotalus and Dulca- mara. Aspis-mel—This is a most important remedy in gene- ral dropsy, but particularly in ascites and hydrothorax. The prominent symptoms are anxious respiration and sensation of fullness and constriction in the chest; full- ness and tenderness of the abdomen, harsh, dry skin, diminished secretion and sometimes painful emission of urine, impaired appetite and debility. Dose.—A powder every six or twelve hours, according to the severity of the symptoms. Apoci/num-can, is a very valuable remedy, particular- ly in abdominal dropsy, after the use of Quinine, in in- termittent fevers, in general dropsy, succeeding scarlet fever, and also in other varieties of the disease. Dose.—Three drops may be given at a dose, once in six or twelve hours. In acute cases once in three or four hours. Arsenicum.—In the different varieties of dropsy, espe- cially when they are accompanied by an earthy or pale and greenish color of the skin; great weakness and general prostration ; dryness and redness of the tongue; asthmatic sufferings, with suffocating sensation when lying on the back, coldness of extremities; great thirst; loss of appetite, tenderness of the abdomen, small se- cretion of urine, with frequent desire to urinate; diffi- cult respiration; blisters or dark colored spots on different parts of the body. 326 GENERAL AFFECTIONS. Dose.—A powder, or six globules; in acute cases, once in three or four hours ; in the chronic form every twelve hours. Digitalis.—Scanty secretion of high-colored urine, strong pulsations of the heart, irregularity of the pulse, pale face and blue lips; vertigo, distension of the ab- domen, frequent desire to urinate, stitches in the region of the heart. This remedy is strongly indicated in hy- drothorax, occasioned by disease of the heart. Hellebore.—Swelling of the face and lips ; fluctuating swelling in the abdomen ; great debility, nausea, pier- cing pains in the extremities; throbbing or compressive pain in the head; frequent desire to urinate with an al- most entire suppression of the secretions. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in from four to twelve hours. Dulcamara.—Particularly for dropsy, occasioned by suppressed perspiration, and where the skin is dry and hot, the whole body bloated, the urine small in quantity, turbid and fetid; great thirst, constipation and aggra- vation of symptoms at night. Dose.—Same as Hellebore. Crotalus.—General dropsy, swelling of the whole body; oppression of the chest, not permitting a recumbent po- sition, and hydrothorax in old people. China.—Pale, sallow or sickly countenance ; debility, derangement of the liver and stomach, with pain and tenderness in those organs; coldness of the surface of the body; great sensitiveness to cold, weariness of the limbs, restless nights, difficult and suffocative respira- tion, scanty urine. This remedy is particularly useful where the disease has been occasioned by loss of animal fluids and prostrating diseases. Dose.—Three drops in a tumbler of water, a tablespoonful once in six or twelve hours. Diet and Regimen.—These are of the utmost impor- tance. A warm, dry and pure air is necessary. In acute dropsy the diet should be the same as in other acute dis- HYDROTHORAX. 327 eases; in the chronic form the food should be light and nourishing, not much at a time, but taken frequently. In ascites particular attention should be paid to the di- gestive organs. The excessive thirst of which the patient complains may be gratified, provided the beverage does not interfere with the medicine. Cold water, milk, and buttermilk may be used, also diuretic drinks sometimes, such as, decoctions of parsley, asparagus, Sac. 328 DISEASES OF WOMEN. CHAPTER XI. DISEASES OF WOMEN. The female sex, from their physical organization, are subject to a large class of affections peculiar to them- selves. When the female is in a state of health and all the organs fulfil their duty correctly, the successive steps of nature are attended with but little if any pain, and but slight functional disturbance. But let the system become deranged, from almost any cause, and a distur- bance is very liable to be created in the generative or- gans. Diseases of these organs, more or less severe, are exceedingly common, and are attended with prostration and sometimes severe pain. At the age of fourteen or fifteen menstruation should commence, and continue at intervals of about twenty- eight days until the age of forty-five or forty-six, lasting from three to five days at each time, and throwing off from four to six ounces of fluid. During gestation and lactation, these monthly periods, as a general thing, cease. Menstruation commences earlier in warm climates than in cold, and the time may vary even in health, in all climates, and also the intervals between the periods may be a week shorter in some than in others. In a perfectly healthy female these periods should re- turn with the utmost regularity, and be attended with but little if any pain, but owing to a variety of causes, the menstrual functions are liable to serious derange- ments. These derangements are often brought on either through the carelessness or ignorance of the patient. In certain circles of society, obeying the arbitary dictates of foolish and absurd fashion, does much to undermine health, and scatter, broad cast, in the young frame, those seeds with soon ripen in a harvest of disease and suffer- ing, terminating often, after years of suffering in death. AMENORRHEA. 329 We pity the poor, who poorly fed and badly clothed, living in damp and unhealthy air, sink into an early grave But what shall we say of those who with the luxuries of life at their command, clothe themselves in garments which cannot afford sufficient warmth, walk the streets with shoes impossible to protect their feet from the dampness of the ground, and with the absurd idea of adding beauty to their form and complexion, compress the chest with corsets, and smear their face with cosmetics. The more comfortably a person is clad, and the more closely she obeys the laws of health in every respect, the less liable will she be to this variety of dis- ease. See also the chapter on Hygiene and the causes of disease. AMENORRHCE A. Retention, or Suppression of the Menses. There are two distinct classes of Amenorrhcea; one where the catamenia have never appeared, and the other where they have continued regular for some time, and then ceased. In retention of the menses, where their appearance is delayed beyond the proper age, the countenance general- ly presents a sickly appearance ; the appetite is variable, and there is often nausea, great debility and lassitude, and sensation of fatigue even after the slightest exertion. Palpitation of the heart, headache, consumption, de- rangement of the stomach, pains in the small of the back, head, limbs and side, and hysteric symptoms may also be present; haemorrhages may also take place in different organs. Not unfrequently the mind sympa- thises with the disturbance ; the temper may be irritable, or there may be a sad, weeping, or desponding mood. Suppression ef the menses, may be of two kinds, acute and chronic. The acute form may arise from cold caught by wet feet during the time of menstruating; from a bodily or mental shock received, either just previous to, 330 DISEASES OF WOMEN. or during the menstrual flow; from mental distress, or the depressing passions; from fever, or any serious dis- ease setting in at that time. In some cases no ill effects follow for some time this sudden suppression, but more generally a degree of fever arises, with headache, hot skin, quick pulse, thirst, nau- sea, &c.; or the patient may be attacked by local inflam- mations either of the brain, lungs, intestinal canal, or of the womb itself. Chronic suppression may be the issue of an acute at- tack, or it may arise from the gradual supervention of delicate health from disease of the ovaries, uterus, or other parts. The time may become irregular, and the quantity gradually diminish until it ceases entirely. More frequently, however, the menses are gradually sup- planted by a white discharge, until in time, the leucor- rhcea becomes permanently established. Some of the prominent causes of amenorrhcea we have already enumerated. It may arise, however, from con- genital deformity, but here the skill of the surgeon will be required. Treatment.—Pulsatilla is especially adapted to fe- males of a mild and easy disposition, and particularly when it arises from taking cold, from violent passions and emotions, and in partial obstruction, accompanied with hysteric and dyspeptic symptoms. The prominent symptoms are languor; pain across the small of the back and in the lower part of the abdomen; palpitation of the heart, loss of appetite, nausea and vomiting; sensa- tion of fullness in the head and eyes, and disposition to general coldness; alternate crying and laughter, or sad- ness and melancholy. The symptoms are generally worse in the afternoon, and may change from one place to another. Dose.—Dissolve two drops, or twelve globules in a glass half ful) of water and take a tablespoonful every six hours. AMENORRHOEA. 331 Co'cuius.—Great derangement of the nervous system, pinching and contracting pain in the lower part of the abdomen; also a scanty discharge of black blood, or when the patient is very weak, with agitation, sighing, groaning, &c. Dose.—Same as Pulsatilla. Cnpjrum.—A valuable remedy, in cases of spasms, with nausea and vomiting, or where cramps in the ex- tremities are present. Dose.—Same as Pulsatilla. Phosphorus.—In persons of delicate constitutions and weak chest, and where, in place of menstruation, ex- pectoration of blood occurs in small quantities, with hacking cough, and pain in the chest. Dose.—A powder, or six globules every second day. Arsenicum.—Great prostration ; swelling of the feet, ankles or face, especially around the eyes, with paleness of the face. Dose.—A powder, or six globules, once in twelve or twenty-four hours. Sulphur.—After Pulsatilla, and also after other of the above remedies, when they seem indicated yet prove in- sufficient. Dose.—A powder, or six globules, every night. Bryonia will prove of benefit, where the suppression is attended with swimming or heaviness, or pressure in the head; pains in the chest, or in the small of the back, dry cough, bleeding at the nose, and constipation. Dose.—Two drops, or eight globules, in a tumbler of water, a tablespoonful once in six or twelve hours ; or three globules on the tongue at the same intervals. Sepia.—Sallow complexion: nervous headache and debility ; giddiness, toothache, melancholy and sadness; pain in the limbs, as if they were bruised; frequent colic and pain in the loins. Dose.—A powder, or six globules, once in six or twelve hours. Ferrum and China are the prominent remedies Avhere there is constitutional debility, seen in the sickly com- 332 DISEASES OF WOMEN. plexion, emaciation, pain in the chest, back, limbs, and loins, palpitation of the heart, debility, languor, derange- ment of digestion, and often leucorrhcea. The remedy may be given every night or every other night. Aconite may be alternated with Bryonia where there has been a sudden suppression of the menses, producing congestion to the head or chest, with throbbing and acute pains. Dose.—Two drops, or eight globules, may be mixed with a tum- bler of water, and a tablespoonful given once in one or two hours. Besides the above remedies, we may enumerate Bella- donna, Veratrum, Calcare-a, GrapJiitis, Conium. Diet and Regimen.—Exercise in the open air is of im- portance. The diet should be simple yet nourishing. Warm foot-baths may be used, or a tepid sitz-bath. Great care should be taken to avoid the causes which might produce the disease. D Y S M E N O R R H CE A. Painful Menstruation. Menstrual Colic. This painful affection may occur at any menstrual period, and in some cases it may be traced back to the commencement of menstruation. The amount of pain varies; in some cases it may be moderate, lasting only a few hours, in others so excessively severe, as to cause fainting or delirium. Causes.—This painful affection may be of a neuralgic character, or be produced by the smallness of the mouth of the womb, or as is mostly the case with plethoric per- sons, be occasioned by a congested state of the secretory vessels of the womb. A fruitful cause of the deranged state of the womb may be traced to those almost in- numerable instances, where the patient has violated some of nature's laws. The digestive organs are impaired by an unnatural state of living, and this, together with DYSMENORRHGEA. 333 the buckram and whalebone used to compress certain portions of the body, impedes the natural circulation. Treatment.—The most prominent remedies in this affection are, Aconite, Pulsatilla, Secale, Belladonna, Nux-v., Platina, Cocculus, Sabina, Ferrum, Conium, and Veratrum. Aconite will be required if there are febrile symptoms present, quick pulse, thirst, rapid respiration, headache, and restlessness. It may frequently be alternated with Pulsatilla or Belladonna. Dose.—One drop, or twelve globules, in a tumbler of water, a tablespoonful every half hour. Pulsatilla.—Menses retarded, with discharge of black and coagulated, or pale and serous blood. Also when there are colic, abdominal spasms, severe pains in the small of the back, sometimess passing down the thighs, nausea, vomiting and shivering sensation. It is particu- larly indicated, when attended with sadness or melan- choly, or when caused by exposure to wet or cold, grief, mortification, or fright. Dose—Same as Aconite. Belladonna.—Violent pain in the back, and sensation in the lower part of the abdomen, as if the organs would be forced out, accompanied with congestion of blood to the head or chest, pulsative pain in the head, and heat and redness of the face. Particularly suitable in persons of plethoric habit. Dose.—Same as Aconite. Cocculus.—Early appearance of the menses, with ab- dominal spasms, or discharge of small quantities of dark coagulated blood, with pressive colic and nausea; para- lytic weakness and spasms in the chest, or convulsive movements of the limbs. Dose.—Same as Aconite. Secale.—.Menses profuse and of long duration, with tearing and incisive pain, coldness of the extremities, and great weakness. 334 DISEASES OF WOMEN. Dose.—One drop, or six globules, in a tumbler of water, a table- spoonful once in three or four hours. Ftrruui and Platina are indicated where there is pro- fuse menstruation, but severe pain in the back and loins, cramps in the abdomen, discharge of dark blood, mixed with membraneous shreds. Dose.—A powder, or three globules, once in two or three hours. Nux-''-— Where there is gastric derangement; writh- ing pains in the back, with nausea; pains of a spasmo- dic character, felt in the abdomen and neck of the bladder. Dose.—Same as Ferrum. Graphitis.—Menses feeble and of short duration. Griping and abdominal spasms; violent headache, nau- sea, pain in the chest and rheumatic pain in the limbs. Dose.—A powder, or six globules, once in three or four hours. It would be well to give a dose of the appropriate remedy, every third night, during the interval between the monthly period. When the pain is severe, use warm applications over the lower portion of the abdomen. MENORRHAGIA. Profuse Menstruation. If the menstrual discharge is excessive, and continues longer than usual, it will be necessary to check it by means of the appropriate remedies. Ipecac is the appropriate remedy, where there is a profuse discharge of bright red blood, sometimes attended with dullness or nausea. Dose.—One drop in a tumbler of water, a tablespoonful at a dose ; or a powder, or three globules on the tongue. Give at first every hour gradually increasing the intervals as the symptoms abate to two or three hours. Crocus is a highly important remedy, particularly where the menses have returned too soon, and the dis- charge is dark colored, clotted and too copious. Dose.—One drop, or twelve globules, in a tumbler of water, a tablespoonful at first every hour, increasing the intervals as the symp toms abate. MENORRHAGIA. 335 Sabina.—Menorrhagia during and after miscarriage, or at the menstrual period; profuse discharge of bright red, or dark coagulated blood, accompanied with rheu- matic pains in the head and limbs; also pains like labor- pains. Dose.—Same as Crocus. China.—Great debility from copious or long-continued discharges; also when the discharge has been checked, but weakness still remains. Dose.—Three drops in four tablespoonfuls of water, a tablespoon- ful once in three or four hours. g, Cf,i.—Where the haemorrhage arises from want of tone in the uterus, and from passi\ e congestion and de- bility of that organ; there may be pale face and cold- ness of the extremities; tenesmus in the rectum and bladder ; discharge of dark and offensive blood, increased by motion, sneezing, or coughing. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in two or three hours. Pulsatilla.—Discharge of blood at intervals; black and mixed with clots, with pains like labor-pains; parti- cularly during pregnancy, at the critical age and also in confinement. Dose.—Same as Crocus. Belladonna.— In persons of a plethoric habit; deter- mination of blood to the head; dizziness and pain in the head; pressing pain in the small of the back and abdomen; flushed cheeks, brilliant and congested eyes. Platina.—Profuse and too frequent menstrual dis- charge, consisting chiefly of thick, dark-colored blood, and attended with bearing-down pain like labor-pain. Besides the remedies already enumerated, Arnica, Chamomilla, Ignatia, Nux-v., Ferrum, Sepia, and Sul- phur. In connection with the internal administration of reme- dies it will be necessary that the hips be elevated, and the head lowered, and the patient kept cool and quiet 336 DISEASES OF WOMEN. Where the haemorrhage is profuse, the external applica- tion of cloths wet in cold water, or even a bladder filled with pounded ice, over the region of the womb, will be advisable. IRREGULAR MENSTRUATION. The treatment necessary in the various forms of men- strual irregularities has already been given. For menses too frequent or too early, see mcnorrliagia. For menses too late or insufficient, Amenorrhoea. For menses mixed with leucorrhoea, see leuccrrhwa. CESSATION OF MENSES. CHANGE OF LIFE. This change generally takes place about the forty-fifth or forty-sixth year, although it may occur several years earlier, or even later. In a very few cases it has been delayed until the age of sixty, and in a few instances even till seventy. Persons of delicate constitution, or those accustomed to sedentary habits or a high style of living, generally experience the change earlier than those of robust constitution, or accustomed to much ex- ercise. The change of life is one of the most important eras in a woman's existence, second only to the first appear- ance of the menses. This period, safely passed, and continued health and a long life are generally before her, but now her path is surrounded with danger, and she must tread it with careful footsteps. It is at this period that the seeds of much future suffering may be sown in the system, and those old predispositions to dis- ease, perhaps long forgotten, spring up in luxuriant growth. The menses become irregular both as to time and quantity, returning once in two or three weeks, or delaying three or four months, at times the discharge scarcely perceptible, at others so profuse as to amount to a haemorrhage. Sometimes the menstrual fluid is mixed with mucus. CHLOROSIS. 337 In most females during the progress of this change, there as more or less general disturbance of the system. There may be great nervousness, severe attacks of headache, dizziness, flushes of heat, or paleness and de- bility; there may also be derangement of the urinary organs, the urine at times scanty and high-colored, at others frequent and in large quantities; the patient may also experience pain in the back, loins, and abdomen, swelling of the abdomen or extremities, piles, and vio- lent itching of the privates, palpitation of the heart, and hysteric spasms. Sometimes the menses gradually cease without any unpleasant symptoms, and in almost all cases, where the female safely passes through this period and no after difficulties are developed, her health is more firmly established than before. The prominent remedies are Pulsatilla and Lachesis, given in alternation three days apart. Should the dis- charge be frequent and very profuse, consult menor- rhagia. If attended with much pain, see dysmenorrhicea, and for the other affections which may arise, consult the respective chapters in which these diseases may be found. Particular attention should be given to diet, exercise, clothing, &c. The room should be well ventilated, and if possible, daily exercise in the open air taken; daily bathing should also be practiced. The food should be nourishing, but easy of digestion, and articles of a highly stimulating character carefully avoided. The clothing should be warm and comfortable. Strong mental or physical excitement should be avoided and a cheerful state of mind cultivated. CHLOROSIS. Green Sickness. This disease is confined principally to female youth, but noA unfrequently occurs in married women, and 15 338 DISEASES OE WOMEN. occasionally in the young and delicate of the male sex. Diagnosis.—Chlorosis has generally three distinct stages ; the incipient, the confirmed and the inveterate. The first stage steals on the patient insidiously, and is usually but little observed by parents or friends. There is slight paleness and languor, fatigue more easily pro- duced by the ordinary occupations, restless, nights and heavy mornings. With these changes there is a confined state of the bowels, morbid appetite, deranged condition of the bowels, fetid breath and a white and pasty tongue; there is recurrent headache, pain in the left side, and palpitation. The menses are also, when present, of a lighter character. In the second or confirmed stage all the symptoms are aggravated. The whole system, especially the face and fingers, seem absolutely without blood, sometimes pre- senting a pearly, at others a yellow hue. The eyelids are sometimes slightly swollen, the tongue apparently without blood, the teeth liable to decay, the nails brittle, the hair dry and harsh, and the ankles swollen. As the dis- ease progresses, the menses grow scanty and pale, until they entirely cease, the stomach is oppressed after eating, and a pecular morbid appetite is present. The friends may be deceived, as it regards the character of the dis- ease, from the occasional appearance of severe headache, pain in the side or breast, and the various symptoms found in hysteria. The second stage gradually passes into the third, when dropsical symptoms set in, and the disease assumes a more dangerous form. There may also be in each stage of this affection a peculiar tendency to haemorrhage from different organs in the body. Causes.—The most usual exciting causes are, delicate and sedentary habits, especially in persons of a lympha- tic constitution, impure air and unhealthy food. Ser- vants, and especially cooks, are particularly liable to this CHLOROSIS. 339 disease, but the delicate and inert habits of the rich not less frequently lead to this affection. In all, there is the same torpor of the bowels, the same defective digestion, assimilation and formation of blood. Treatment.—Pure air, frequent bathing,moderate out- door exercise, and digestible and nutritious diet, are of the utmost importance in this disease. Daily bathing should be practiced, commencing with tepid baths, gra- dually increasing the temperature of the water, as the strength of the patient will permit. (See bathing.) Bath- ing in sea-water and a sea-voyage to some warm climate will also prove of benefit. The blood is impoverished and needs enriching, and this must be done by nutritious articles of diet, easy of digestion. The use of wine, porter, and Scotch ale, at the meals, may also be ad- visable. , It may also be advisable to drink the water of some mineral spring impregnated with iron. The most prominent remedies in the treatment of this affection are, China, Sulphur, Sepia, Ferrum,, Arsenicum, Calcarea, Pulsatilla, Platina, and Nux-v. Pulsatilla.— Especially adapted to persons of a mild, timid or sad disposition, who have been irregular in menstruation, or where there is total suppression of menses, with pain in the small of the back, chilliness, &c.; also if the disease was produced by cold or damp- ness. There may be beating and cutting pain in the stomach and abdomen; severe pain in one side of the head or in the forehead, pale face; green, slimy or bloody stools; suppression of the menses or scanty menstrual discharge ; acrid, thin leucorrhcea; nausea, loss of ap- petite ; pain and weakness in the small of the back; weight in the abdomen; general sensation of fatigue, palpitation of the heart, and periodic expectoration of dark coagulated blood. Sepia.—When Pulsatilla has proved insufficient, and 340 DISEASES OF WOMEN. where there are painful beatings in the head, swollen and puffy face, pain in the region of the liver, and dif- ficulty of breathing; colic, pain in the limbs as if bruised. and weakness and pain in the small of the back; sensi- tiveness to cold air, and restlessness during the night. This remedy is particularly indicated in females of a nervous temperament, and thin aad delicate skin, and in those in whom there is a great tendency to irregularity of the menses. Sulphur.—Pressive fullness and heaviness in the stomach and bowels; emaciation, violent appetite, and burning or sour eructations ; irregularity of the bowels, pain in the loins, and difficulty of breathing, congestion to the head, with throbbing pain; pain in the back of the head, or humming in the head ; eruption around the mouth and on the forehead; general nervous irritation; acrid or burning leucorrhcea; swelling of the feet and ankles ; glandular swellings about the neck. Symptoms aggravated by motion. China.—Pale or livid countenance: swelling of the limbs ; leucorrhceal discharge ; yellowish skin; scanty menses, or suppression of them; sensitiveness of the whole nervous system, and dread of cold air: unnatural appetite; lassitude and debility. It is particularly in- dicated where the disease is accompanied or produced by haemorrhage, leucorrhcea, or masturbation, and where there is great weakness of the whole system, fetid breath, pale or yellowish skin, and derangement of the stomach and bowels. There may be headache, vertigo, ringing in the ears, nausea, bitter or sour taste, flatulence, hae- morrhoids, asthmatic respiration, trembling of the limbs, and sensitiveness of the skin. It is particularly indicated in persons of sedentary habits, or in those who have in- dulged freely in wines or coffee. Bryonia.—Congestion to the head, chilliness, some* LEUCORRHC3A. 341 times alternating with heat; dry cough, colic, constipa- tion, and sometimes bleeding at the nose. Ferrum and Calcarea may be important remedies, where there are emaciation, swelling of the extremities, and great debility. Dose.—Six globules, or a powder, may be given morning and night; or if the liquid is given, two drops may be mixed in a tumbler of water, and a tablespoonful taken at the same intervals. LEUCORRHCEA. Fluor Albus. Whites. Leucorrhcea is one of the most troublesome and obsti- nate, as well as the most common of the whole class of female diseases. The causes are various. It may be pro- duced by cold, by a sudden suppression of the menses ; by severe labor, where the vagina has been kept for a long time on the stretch, by constipation, free use of tea and coffee, ascarides in the rectum, excessive sexual in- dulgence, exertion soon after delivery, violent exercise, or not sufficient exercise, frequent child-bearing, and also as a symptom of various affections of the womb. The most frequent causes of leucorrhcea, however, may be traced to errors in living, imprudence in dress, and that artificial life so common in certain classes of society. How often do we see the simple teachings of nature re- jected, and mind and body warped and compelled to bend to the dictates of fashion, or follow the lead of an absurd and diseased imagination ? Need we wonder that where the passions are stimulated, and the mind excited by the luxuries and stimulants of the table, the excitements of the ball-room or theatre, and the glowing and some- times impure pages of a certain class of fiction, a reaction should be produced both on the mind and the body. Diagnosis.—Leucorrhcea may be of two kinds. It may either be an affection of the mucous membrane of the vagina, in which case it is called vaginal leucorrhcea, or 342 DISEASES OF WOMEN. it may be a morbid action of the lining membrane oi the uterus, when it receives the name of uterine leucor- rhau. Both of these varieties may have an acute or chronic stage. It will not be necessary in this place to draw the precise line of demarcation between the varie- ties of the disease, and we shall therefore include all under the one head of, leucorrhcea. The milder forms are frequently allowed to run on for a long time before any medical advice is taken. The character of the discharge depends upon the seat and se- verity of the disease. When the discharge is consider- able, and of some standing, decided effect is produced on the system. The countenance becomes pale and sallow, the frame weak, the appetite impaired or capricious, the spirits languid, and exertion is attended with fatigue ; the bowels are irregular, and digestion disordered; pain in the back is also felt when fatigued, and a peculiar dragging, bearing-down and weary sensation. The dis- charge in these cases is of a mucous character, and may not be very abundant. The most acute form of leucorrhcea, generally the ef- fects of a cold, or some irritating cause, consists of a profuse watery or purulent discharge, attended with local soreness and pain. The vagina is hot and tender to the touch; fever is also present. When the discharge is more scanty and glairy, or creamy and opaque, it is an indication that the neck of the womb is affected. All the varieties of leucorrhcea may end in the chronic form, when the discharge is more or less profuse and constant, mucous or purulent, or a mixture of both; it may also become green and purulent. The quantity may also be abundant, amounting in some cases to a pint in twenty-four hours, and expelled in gushes on every change of posture. In these cases there is great emaciation and debility. There may be dragging pain LEUCORRHCEA. 343 in the back, palpitation of the heart, night-sweats, diffi- cult respiration, and swelling of the feet. Treatment.—In the successful treatment of this dis- ease, very much depends on the physical and mental condition of the patient. The food may be nourishing, but taken at the proper time, and be as little stimulat- ing as possible. Late suppers, wines and all kinds of dissipation should be avoided. Moderate exercise in the open air will be productive of good, but care should be taken to avoid much fatigue. Particular attention also should be given to the dress. The feet should be well protected from the damp ground, the clothing warm and comfortable, fitting loosely to the body, and the skirts instead of being permitted to hang upon the hips, held up by the shoulders by means of shoulder-straps or braces. Above all, cultivate a healthy tone of mind. Cast aside the exciting romance, and mingle only in those amusements which will have a tendency to pro- duce a healthy action on the mind and body. Water is a most important remedial agent in this af- fection. A daily hip-bath should be taken, and the en- tire body throughly bathed. Cold water thrown up the vagina by a syringe prepared for that purpose, may also be highly advantageous. The use of vaginal-injections in Leucorrhcea are of great importance. Often the simple use of cold water thrown into the vagina four or five minutes at a time with an ordinary female syringe, will be all that is necessary. Should however there be considerable irritation, a de- coction of green-tea should be used. I have also found great benefit from the use of Sulphate-zinc or Nitrate- silver, from fifteen to thirty grains dissolved in a pint of water, and one or two syringe-full thrown into the vagina morning and night. China, is a valuable remedy in the commencement of the treatment, and in those cases where the disease has 344 DISEASES OF WOMEN. been produced by debilitating causes, and is of long standing. Pulsatilla.—Especially when the affection occurs dur- ing pregnancy, and when the discharge is thick like cream, or milky, or thin, acrid and burning, and when it is associated with indigestion. Particularly useful in persons of a lymphatic temperament, in whom the monthly flow is irregular. Calcarea.—When Pulsatilla seems indicated, but yet has not produced the desired effect; and also in females in whom the monthly turn is excessive, and when the affection occurs at the turn of life, and is attended with severe itching; particularly suitable in chronic leucor- rhcea, affecting weak and scrofulous females. Sepia,—Particularly indicated in sensitive and deli- cate persons ; the discharge is yellow or greenish, more or less acrid or corrosive, generally watery, and most abundant just before or just after the menses, and at- tended with itching in the parts. Alumina.—Where the menstrual flux is scanty, and the discharge profuse, corrosive, and attended with itch- ing and burning. Nux-v.—Where the affection is induced by abuse of stimulants, or indigestible food, and the discharge is pro- fuse, and of a bloody, yellowish or fetid mucous charac ter, and is attended with constipation and cramp-like pains in the abdomen. Sulphur.—In obstinate cases, and where it results from repelled eruptions; also where the discharge is of a yellowish, burning and corrosive character, and pre- ceded by colic. Agaricus.—Particularly when occasioned by a torpid state of the liver, and where there is pain in the small of the back, weariness of the limbs and sensation as of a pressing weight in the lower part of the body, intense itching and burning in the genital organs. INFLAMMATION OF THE OVARIES.--PROLAPSUS UTERI. 345 Kreosote.—In most forms of chronic leucorrhcea. Dose.—A dose of the selected remedy may be taken morning and night, until five doses have been taken, when if necessary it may be changed. Besides the remedies above enumerated, Cocculus, Causticum, Graphitis, Iodine, Ipecac, Nitr.-ac, Natr.- mur. may also be of benefit. INFLAMMATION OF THE OVARIES. In this disease there is pain more or less acute, in front of the hips or along the groins. The pains are usually of a burning, aching, or throbbing character. There may also be itching or burning in the private parts, gastric affections, headache, constipation and de- rangement of the whole nervous system. Apis-mel,—Is indicated especially in dropsy of the ovaries, and where the pains are of a stinging and burning character, the urine being scanty. Dose.—One drop of the dilution, a powder or six globules in six spoonsful of water. Give a spoonful every four hours. Arsenicum.—Especially in ovariar dropsy, and when there is burning pain and great weakness. Dose.—Same as Apis-mel. Cantharis. — Severe burning pains extending into the thighs, with cutting pains when passing water. Dose.—Same as Apis-mel. Hepar.—When with the ovariar-pains there is profuse menstruation and tendency to eruptions. Dose.—Same as Apis-mel. PROLAPSUS UTERI. Falling of the Womb. Falling of the womb is a very common affection, especially among females, who have borne children, although it is occasionally met with in unmarried fe- males, and those who have never given birth to children. It is occasioned by a weakness of the ligaments, which give support to the womb, and also by a weakness of the 14* 346 DISEASES OF WOMEN. walls of the vagina. We frequently find it the result of sitting up too soon after delivery, and also occasioned by violent vomiting, coughing, or sneezing, by lifting heavy weights, and a general weakness of the system. The patient complains of a sensation of fullness in the pelvis, of weight and bearing-down and dragging from the loins and umbilicus. There is more or less pain in the back, extending round the groins. The patient is worse in the evening than in the morning, and the symp- toms are aggravated by much exertion. Leucorrhcea is generally an attending symptom, although the discharge may vary, occasionally very profuse, sometimes slight, but in all cases diminishing the strength of the consti- tution. Treatment.—The sitz-bath will be highly beneficial, also general bathing. Rest in the recumbent position will be advisable, or at least, the patient should avoid being on the feet, as much as possible. In the commencement of the difficulty, a powder, or six globules of Nux-v. may be alone sufficient to produce a cure. If this remedy fails of producing the desired ef- fect, it may be followed by Belladonna, Spia, Calcarea, or Aurum in the same manner, changing the remedy for another, if in a week's time no effect is produced. In severe cases the patient will of course perceive the propriety of consulting her physician It will be unnecessary to speak here of various other affections of the womb, such as cancer, and a variety of ulcerations and tumors, as the experience and skill of the physician or surgeon will be necessary to produce relief. PREGNANCY. The birth of a child, is at once the most wonderful, and sublime act of existence. Existence itself assumes a mightier import to the mother as she gazes on the PREGNANCY. 347 little being, whose pure eyes are turned to her's, whose form, clasped to her bosom, thrills through all her being, and unseals the fountains of a deathless love. Springing from herself, a part of herself, for two hundred and seventy days nourished in her womb, commencing from an almost imperceptible germ, and growing on day by clay, drawing life itself from her, until at length a minia- ture human being, it is folded in her arms, with a body, a part of herself, and a soul a part of God, deathless, et-rnal. Another ripple is started in the great ocean of life, whose widening circles are lost from mortal gaze in the ocean of eternity. Parturition is a crisis in a woman's existence. It is no disease, no chance of life, but the healthy action of nature, and one great end of her being. Safely carried through this crisis, the equilibrium of the system be- comes more perfect, and the health more firmly esta- blished. It is one of the strange things of nature that this crisis so complete, producing such a tremendous re- volution in the whole system, should, in such a vast ma- jority of cases, terminate favorably. The danger in the majority of cases, is in proportion to the previous health of the mother, and her obedience of the laws of nature Those who daily violate nature's laws, who forget the mighty responsibility which rests upon them, and the fearful crisis through which they are about to pass, need not wonder at being the victims of a train of evils, which may end in death. To one class the period of gestation seems like a dark and thorny path; others, less sensitive, or more philo- sophical, or enthusiastic in their nature, forget the pre- sent, in the bright anticipations for the future, or look upon it as something over which they can have no con- trol, and therefore give way to indolence, or freely in- dulge in all the luxuries and extravagances a morbid appetite can induce. 348 DISEASES OF WOMEN. The mother should never forget that her own health, and thoughts, and feelings, during the period of gestation must produce a marked influence on the child.* Her condition, mental as well physical, when carrying the child is all important to its future welfare. Cases are by no means rare, where the excessive anxiety or sad- ness of the mother during the period of gestation is shown in the after life of her child. It has been ob- served that in a large proportion of cases, where children are born out of wedlock, the delivery is premature, or if the mother reaches her full time, she gives birth to a still-born child. The agony of the mother, the thought of the brand of shame which will ever after cling to her, the withering of life's brightest flowers, the hissing tongue of the world's scorn, marking her out as an object fit only to be trampled in the dust, all this is enough not only to destroy the child, but the mother also. There is no period of life when a woman stands in such need of sympathy as at this time. It is now, when sensitive in the extreme, she needs the watchful and soothing care of affection. Let her at other times con- tend, and wrestle, if it must be so, with the stern, harsh and cruel exactions of a cold and selfish world, and there are times when a woman's spirit and nerve are stronger than man's, but now surround her with an atmosphere where the tumultuous heavings of the world, with its passions and troubles, are as little felt as possible. Make the path as smooth and easy as unwearied kindness, patience and affection can accomplish. The extreme sensitiveness at these times, often ren- ders the utmost tact and forbearance on the part of friends, absolutely essential. She should be surrounded with every comfort, and every means taken to secure cheerfulness and an easy, happy mind. To secure this * I have alluded to this subject in the chapter on the causes of disease pregnancy. 349 it is not necessary she should be surrounded by useless luxuries, and every ridiculous whim, the result of a morbid imagination gratified. This would produce the thing you wish to avoid. Gloomy and harrassing thoughts and impressions should be guarded against, and every means taken to preserve a healthy and vigorous tone to the mind and body. The mother should by no means yield to indo- lence or indulge in dissipation. Cheerful conservation, pleasant friends, agreeable books, and the soothing charm of music, as well as daily out-door exercise and household duties, all should contribute their share to promote comfort and enjoyment. The cases are very rare, where it is essential for the mother to give up her household duties entirely. She will be much happier by continuing to be mistress of her own household. Large ventilated rooms, and pure air are of the utmost importance. Great cleanliness should also be strictly practiced. It is essential that the pores in the skin should be kept constantly open, a healthy and even circulation induced, and an equilibrium kept up as much as possible through- out the system. The body should be washed from head to foot once every day in moderately cold water, taking particular pains afterwards to rub it quite dry, or a tepid bath can be taken every two or three days. Another important point which should by no means be overlooked is dress. We occasionally see mothers who attempt to conceal the rotundity of their form either from shame or some other reason, with tight dresses and corsets tightly laced. For a married woman in this situation, to be ashamed of her form, bespeaks a weakness of which I trust but very few of my coun- try-women are guilty. What situation in life is there more holy, and in the name of heaven, what is there in her situation for which a pure and virtuous woman 350 diseases of women. should be ashamed. The dress should be made perfectl) easy, either warm or cool as the weather may indicate, fitting lightly to the body. The slightest compression of the abdomen and chest should be avoided, so that the utmost freedom may be given to the organs and muscles of respiration. Dr. Eberle in speaking of this subject, makes use of the following excellent remarks. " The custom of wearing tightly laced corsets during gesta- tion cannot be too severely censured. It must be evi- dent to the plainest understanding, that serious injury to the health of both mother and child must often result from a continual and forcible compression of the abdomen, whilst nature is at work in gradually enlarging it for the accommodation and development of the foetus. By this unnatural practice, the circulation of the blood through- out the abdomen is impeded, a circumstance which, to- gether with the mechanical compression of the abdominal organs, is peculiarly calculated to give rise to functional disorders of the stomach and liver, as well as to haemor- rhoids, uterine haemorrhage, and abortion. The regular nourishment of the foetus also is generally impeded in this way ; a fact which is frequently verified in the re- markably delicate* and emaciated conditions of infants born of mothers who have practiced this fashionable folly during gestation. It may be observed, that since the custom of wearing tightly laced corsets has become general among females, certain forms of uterine disease are much more frequent than they were sixteen or eigh- teen years ago." Lycurgus, whose laws were sometimes a little arbi- trary, although generally characterized by sterling sense, ordained a law, that pregnant women should wear wide, loose clothing, and a similar law prevailed among the Romans. By attending particularly to dress, mothers would not only escape much of the pain of child-birth, but find themselves after the crisis had passed, more pregnancy. 351 quickly convalescent, and without those lingering and prostrating complaints, which do so much to undermine the constitution. Diet.—A proper diet is all-important. Food should be plain, simple and nourishing, easy of digestion, and free from exciting and highly stimulating compounds. The idea generally prevails that as the growth of another being depends on the food taken by the mother, the amount of food should be greatly increased, and to satisfy this double demand of nature, a very generous diet should be substituted for the ordinary manner of living Hence mothers are often urged to drink porter, and par- take freely of stimulating food, spurring on the appetite when it lags, by some new delicacy. They forget that notwithstanding there is an increased expenditure of substance necessary for the development of the child in the mother's womb, yet nature which understands its duty perfectly well, has in a measure provided for it, by suppressing the usual periodical discharge, which ceases at the close of the period of child-bearing. Nature we have said understands her duty, but we must be careful not to confound her voice with the whisperings of a morbid appetite and imagination, indicative of disease. When during gestation the general health, the appetite and digestion improves, an increase of food would not only be advantageous but highly necessary. As a general thing, where the diet has been plain, simple and suffi- ciently nourishing, no increase or change is necessary. There may be a morbid appetite, but unless the health and digestive powers improve, if the appetite is indulged in to its full extent, and even stimulated, as is often the case, exactly contrary to the object aimed at will be gained, the stomach will be overloaded with food it can- not digest, and the appetite will either give way, or a long train of painful symptoms follow, such as, nausea, heart-burn, colic, constipation, and piles, disagreeable 352 DISEASES OF WOMEN. breath and perspiration, difficulties which the mother is accustomed to bear in righteous resignation as a part of her lot. Even if the digestion should remain unimpair- ed, and larger amount of nourishment is taken into the system than is necessary, a sense of fullness will follow, producing difficulties about the head or some other organ, and not unfrequently miscarriage. There is less danger of running to the opposite extreme und taking too little food in this country, than among some of the thickly populated districts of the old world. There, where life is a continual struggle for bread, and where hundreds die from a want of the proper nourish- ment, the babe is often born weak and puny, and the mother from lack of nourishment herself is unable to furnish it to her child, and the poor child dies of what the world is pleased to call some infantile disease, but which in reality is neither more nor less than starvation. In our own happy country there are but very few who cannot obtain the necessaries of life. It makes but little difference whether the system lacks nourishment either from a want of food, or from too great abundance of it, so as to impair the organs of digestion and render them unable to perform their functions aright. Longings, which are so often observed in pregnant females for strange and even ridiculous things, by many are watched with a great deal of interest, and the ab- solute necessity of indulging them for fear of producing an effect on the child, is considered an important duty. Sometimes an urgent desire is felt to eat earth, or feast on a tallow candle, and a hundred such unnatural whims. I need not say that these longings are peculiar to deli- cate, irritable, and nervous women, whose minds are un- employed / we should hardly expect to find them in the healthy woman, whose mind is employed and made cheerful by reading, conversation, or any healthy exer- cise. The proper remedy is, not to gratify the whim— MORNING SICKNESS 353 unless it be for some harmless thing; for longings of this kind are common to all—that would only tend to in- crease the disease; but to make use of plain and simple food, such as the stomach can easily digest, and above all, give pleasant employment to the mind, take moderate exercise, and be as cheerful as possible. DERANGEMENTS DURING PREGNANCY. In about nine months, or two hundred and seventy days from the time of conception, labor commences, ter- minating in the birth of the child. The child may be born, however, as early as the seventh month, and yet live, and in some cases nine months and a half may elapse before the birth of the child. In the latter case, labor is more difficult on account of the increased size of the child. But delivery earlier or later than two hundred and seventy days, is an exception to the general rule, and is attended with more or less danger to the mother or child. During pregnancy, the female is liable to numerous troublesome affections, some of which we shall now enu- merate. MORNING SICKNESS. In most females, nausea, vomiting, and heart-burn are present, some portion of the time during their preg- nancy. They generally come on about the fourth or fifth week after conception, and continue for ten or twelve weeks, when they make their exit to return again during the last month. In some few cases they do not appear at all, and in others continue through the whole period. They generally come on in the morning shortly after getting out of bed. last two or three hours, and perhaps re-appear in the evening for the same length of time. Treatment.—In the acid stomach, and nausea during 354 diseases of women. pregnancy, I have found great benefit from the use of weak lemon-acid or sweet cider taken a little at a time. Ipecac, will produce relief, where there is bilious vomiting, or vomiting of drink and undigested food, or nausea and vomiting, with uneasiness in the stomach. Nux-v—Nausea or vomiting in the morning; acid and bitter eructations, hiccough, heartburn ; sensation of weight in the pit of the stomach ; depraved appetite or craving for chalk, earth, &c. Constipation and irri- table temper. Pu7saiilla.—Nausea after a meal; vomiting of food, heartburn, eructations bitter or acid ; depraved appetite, a longing for acids, beer, wine, &c. Arsenicum,—Excessive vomiting after eating or drink- ing, with attacks of fainting; prostration and emacia- tion. Natrum-mur.—In obstinate cases where there is loss of appetite, waterbrash, acid stomach, &c. Particularly after Nux. Dose.—A powder, or six globules of the selected remedy may be given morning and night. If the liquid is administered, two drops may be mixed with a tumbler of water, and a tablespoonful given at the same intervals. When the symptoms are exceedingly violent and long-continued, the remedy may be given once in three hours until relieved. CONSTIPATION. During pregnancy, the bowels are very liable to be- come constipated. As a general thing, the difficulty may be controlled by taking moderate exercise in the open air, and eating freely of brown bread and ripe fruits. Should the constipation still continue, a few doses of the appropriate remedy will produce relief, unless it is occasioned by mechanical obstruction. Nux-v.—Particularly where there are symptoms of de- rangement of the stomach, headache, and sometimes fre- quent inclination for stool, without result. Bryonia or Ignatia may follow Nux, or be taken in DIARRHC3A.--VERTIGO AND HEADACHE. 35L' alternation with it, one in the morning, and the other at night. Opium, Sulphur, and Lycopodiuui are also valuable remedies. For particular indications, see Constipation. DIARRHCEA. Diarrhoea occasionally occurs during pregnancy, when it should be speedily checked, or the strength may be- come prostrated, Lycopodium, Sulphur, Nux-v., Dulca- mara, and Ipecac are prominent remedies. For particular indications, see Diarrhoea. VERTIGO AND HEADACHE. There are frequently giddiness, fullness or pain in the head during pregnancy. There is sometimes sensa- tion of weight on the top of the head, or in the back of the neck; palpitation of the heart, and great nervous excitability. The symptoms are generally worse in the morning. The prominent remedies are, Aconite, Nux-v., Belladonna, Opium, Platina, Pulsatile, and Sulp>liur. Aconite is indicated in persons of plethoric habit, and nervous temperament, especially if there is giddiness on rising from a seat as if intoxicated, determination of blood to the head, stupefying pain, redness of the eyes, and intolerance of light. Belladonna- Congestion to the head; pain in the forehead, over the eyes, and in the top of the head; throbbing in the temples, redness of the eyes, and in- tolerance of light and noise. Nux-v.—Particularly in persons of a sedentary habit, worse in the morning, and relieved in the open air; giddiness and feeling of confusion in the head, or jerking, tearing, or periodical pains; constipation; acid or bitter taste. For particular indications of other remedies, ccnsull Headache. 356 DISEASES OF WOMEN. Dose.—A powder, or three globules, may be taken once in three or four hours ; or two drops, or twelve globules, may be mixed with a tumbler of water, and a tablespoonful taken at the same intervals. FAINTING AND HYSTERIC FITS. These are very common in persons of nervous tem- perament and delicate constitution. They are generally unattended with danger, and pass over in a short time- The causes which produce them should be carefully avoided. During the attack, the face should be sprink- led with cold water, and fresh air freely admitted. Belladonna and Aconite, may be given in alternation, six or twelve hours apart, in plethoric individuals, or where there is congestion of blood to the head. Chamomilla, when the attack is produced by a fit of anger. Dose.—Two drops, or twelve globules, in a tumbler of water, a tablespoonful once in six or twelve hours ; or three globules, at the same intervals. During the severity of the attack the remedy may be given every half hour. Nux-vom,.—When produced by derangement of the digestive organs. Dose.—Same as Chamomilla. Coffea.—Great nervous excitability; spasmodic pain in the bowels, oppressed respiration, cold perspiration. Dose.—Same as Chamomilla. Give once in three or four hours. Pulsatilla.—Disposition to hysteria; depression of spirits, &c. Dose.—Same as Chamomilla Lgnatia,—Severe headache as if a nail were driven into the head ; sadness, concealed melancholy and sighing. Dose.—Same as Chamomilla- Give at first once in three hours. Consult also Hysteria. TOOTHACHE. This is of very common occurrence during pregnancy, frequently commencing in a sound tooth, extending to the whole set, and the pain sometimes shooting to the VARICOSE VEINS. 357 face and head. The pain is exceedingly severe, some- times making the patient almost delirious. The prominent remedies are, Calcarea, Sepia, Bella- donna, Mercurius. Staphysagria, Nux-vom., Chamomilla, and Pulsatilla. For particular indications, see Toothache. PRURITIS. During pregnancy, the female is occasionally annoyed with excessive itching in the privates, sometimes so violent as to bring on miscarriage. It is generally oc- casioned by an acrid or vitiated secretion of the walls of the vagina. Sometimes the parts are covered with a white substance, resembling the thrush of infants, and is easily rubbed off; or the parts may assume a dark red hue, accompanied by a thin watery secretion, and the most intolerable itching. The parts should by frequently bathed with cold water. A weak solution of borax in water, applied three or four times a day, will generally remove the itching, without the aid of other remedies. Sepia, Silicea, Sul- phur, and Rhus, may also be consulted. See Materia Medica. Injections of green tea are also benefit. VARICOSE VEINS. ■ This disease is not confined to the period of pregnancy, although it most commonly occurs at that time. It seldom occurs in first pregnancy, but in subsequent pregnancies it is liable to come on the first months. It consists of a distension and dilation of the super- ficial veins, which at first assume a reddish hue, but afterwards a bluish or leaden color. They become larger from standing on the feet or allowing the limb to hang. They generally commence in the ankle, and are usually confined to one both of the lower limbs. After delivery, the pressure of the pregnant uterus on the large veins 358 DISEASES OF WOMEN. of the abdomen being removed, the swelling disappears and the veins regain their natural size. When the dis- tension is slight, it is not painful, but if it should con- tinue to increase, it may not only become painful, but the veins may burst. If the limb should be painful, the patient must remain in a recumbent position a few days. It may be neces- sary also to apply the laced stocking, or bandage the limb. If this is done, it should be applied in the morning when the veins are the least distended, commencing at the toes and progressing upwards with a gentle and equal pressure. If medicines are required, Arnica^ Nux-v., or Pulsa- tilla may be given, commencing with the first, and giving six globules every other night for a week, and then, unless relieved, following with the next in the same manner. HEMORRHOIDS. PILES. This troublesome affection is not confined to pregnancy, although it frequently occurs then and after delivery, in those who are never troubled with it any other time. It is occasioned by the pressure of the impregnated uterus on the haemorrhoidal artery and the veins of the abdomen. For treatment, see Haemorrhoids. PAINS IN THE BACK AND SIDE. An aching pain or a dull heavy pressure in the small of the back or in the side, just under the short ribs, is often experienced during pregnancy, particularly between the fifth and the eighth month. The pain in the back will generally be relieved by a few powders of Kali-carl., taken at intervals of twelve hours. Should other remedies be required, Bryonia, Rhus, Belladonna, Pulsatilla, or Nux may be selected, giving a dose every night, and changing it, if after the MISCARRIAGE. 359 expiration of four or five doses no relief has been ob- tained. For pain in the side, Aconite, Chamomilla, Pulsatilla, Bryonia, or Phosphor will produce relief, given as directed above. CRAMPS. We frequently find this painful affection coming on about the fourth or fifth month, and again towards the end of pregnancy; they may attack the muscles of the abdomen, hips, back, and the lower extremities. When they attack the muscles of the abdomen, Bella- donna, Pulsatilla, or Nux-v., will produce relief. The back: Ignatia, Op>ium, or Rhus. The hips : Colocynth, or Stramonium. The thighs: Hyosciamus. The legs: Calcarea, Chamomilla, Nux-v., or Sulphur. The remedy may be taken, when there is predisposi- tion to cramps, every night, and also on the first in- dications of their approach. For particular indications, see Materia Medica. DERANGEMENTS OF THE URINARY ORGANS. There is often, during pregnancy incontinence of urine, frequent desire to pass water, sometimes attended with pain. For the more general treatment of the various affec- tions of the urinary organs, see affections of those organs. For other affections of pregnancy, see their respective headings in their appropriate place. Inability to retain the water will generally be relieved by Pulsatilla given every four hours. MISCARRIAGE. Miscarriage may occur at any period during gestation but is more frequent about the third or fourth month. If it occurs after the sixth month, it is called premature 360 DISEASES OF WOMEN. labor. Miscarriage coming on at a late period, is often attended with considerable danger, and where a female has miscarried once, there is a great liability of its re- currence. The causes are numerous, but the most common are, dissipation, such as a free use of stimulating food and drinks, and late hours; a too sedentary mode of life, neglecting to take exercise or fresh air; great physical exertion; purgative drugs; violent and sudden mental excitement; and mechanical injuries, such as a fall or a blow. The attack is generally preceded by certain symptoms, which if taken in time, may sometimes be controlled, and the miscarriage prevented. The precursory symp- toms are usually chilliness followed by fever, and bear- ing-down pains; pains in the abdomen or loins, and pains resembling labor-pains ; discharge of mucus and blood, sometimes followed by emission of a watery fluid. At the first symptom of an approach of the attack the patient should be placed in a recumbent position, and remain there as quiet as possible until all danger is over. A physician of course should be obtained as speedily as possible. Treatment.—Arnica should be given when the symp- toms arise from a fall or blow or from great physical exertion, S cole.—Constant expulsive efforts with profuse dis- charge of dark liquid blood, followed by debility; and also where miscarriage has occurred before, and in de- bilitated persons. Sabina.—Dragging and forcing pains extending to the back and loins, with profuse discharge of bright red blood. Chamomilla, particularly when occasioned by a fit of passion; also were the pains are periodical, and are followed by a discharge of dark colored or coagulated parturition. 361 blood, or blood mixed mith mucus; violent pain in the bowels; coldness and shivering. Crocus, particularly in protracted cases and where there is a discharge of dark clotted blood brought on by the slightest motion. Hyosciamus should be given where there are spasms and convulsions of the whole body, with loss of con- sciousness. China.—In weak and exhausted persons, and where there are spasmodic pains in the uterus, or bearing-down pain with discharge of blood at intervals; giddiness, fainting, coldness of the extremities and prostration. Ipecac.—Spasms but without loss of consciousness; continuous discharge of bright red blood with pressing downward ; nausea or vomiting, pain in the abdomen and sometimes faintness. Belladonna.—Particularly in the commencement and where there are violent bearing-down pains; severe pain in the abdomen, loins, »md small of the back; flushed face and profuse discharge of blood. Platina.—If Ipecac, fails to relieve and where there are pressing bearing down pains; pain in the back pass- ing into the groins, and discharge of dark, thick or clotted blood. Dose.—Two drops of the selected remedy, or twelve globules, in a. tumbler of water, a tablespoonful, where the attack is urgent, every half hour or hour; or six globules may be taken on the tongue at the same intervals. For further directions as it regards flooding, see Menor- rhagia. PARTURITION. In about 270 days after impregnation, labor generally commences. There are certain signs by which the female is able to calculate with tolerable certainty about the time she may expect to be confined. Perhaps the most 16 362 DISEASES OF WOMEN. correct mode of calculating is, 280 * days from the last menstrual period till confinement; another calculation is, from the period of quickening, or the first sensation of fetal life, which is usually perceived about four months and a half after conception. During the last month also the child sinks lower down in the abdomen, and the waist becomes smaller. As the time approaches when a woman expects to be confined she of course sees that every thing necessary for the occasion is prepared, and placed convenient and in order, so that at the time every- thing may be in readiness, and all confusion avoided. Previous to the setting in of labor she frequently suffers from what are called. FALSE PAINS. These do not always exist, and when they do, they usually precede labor but a few hours; sometimes how- ever they come on days and even weeks before delivery' They differ from labor-pains in being unconnected with uterine contractions, not increasing in intensity as they return, and are principally confined to the abdomen. If medicines are required, a few doses of Bryonia, Nux-v., Pulsatilla, or Dulcamara, will generally be sufficient. Bryonia may be given if the pains in the abdomen are followed by dragging pain in the back and loins, with constipation and irritable temper. Nux-v. where there are similar symptoms to those indicated by Bryonia, also a bruised sensation in the region of the pubis. Pulsatilla where there are pains in the abdomen or loins, * The reason for calculating 280 days from the last menstrual period is, that conception usually takes place within ten days after the monthly period. About the time of the monthly period the ovaries throw off the ripened and perfected ovum which is seized by the fimbriated extremity of the fallopian tubes and pass ed into the womb. If the healthy semen of the male comes in contact with the ovum before it is discharged from the womb, which usually takes place in eight or ten days after the monthly period, impregnation takes place. This is the ge- neral rule, although sometimes impregnation may take place at any time. CRAMPS, CONVULSIONS, AND SPASMODIC PAINS. 363 with stiffness and painful dragging and aching in the thighs. Dulcamara where the pains are seated in the small of the back, and are the result of a cold or damp- ness ; and Belladonna where the pains are of a spasmodic character. Dose.—Two drops, or six globules, of the selected remedy may be mixed in a tumbler of water, and a tablespoonsful taken once in three or four hours. LABOR. Preceding labor there are often premonitory symptoms, such as, nervous trembling, sadness, looseness of the bowels, flying pains through the abdomen, frequent in- clination to pass water, followed by a slight discharge of reddish mucus. But at length pains, bearing down, come on at regular intervals, gradually increasing in in- tensity and frequency until the little being is ushered into the world. During the progress of the labor, cold water may be taken if desired. As the labor progresses there may be CRAMPS, CONVULSIONS, AND SPASMODIC PAINS. Chamomilla may be given, where the pains are acute, and are attended with spasms. Belladonna, if there are violent bearing-down pains, with convulsive movements of the limbs, congestion to the head, red and bloated face. Hyosciamus, where there are severe convulsions, with loss of consciousness, anguish, cries, and oppression of the chest. Stramonium.—Trembling of the limbs and convul- sions without loss of consciousness. Cocculus.—Cramps and convulsions in the limbs and the whole body; cramps in the lower part of the abdo- men. 364. DISEASES OF WOMEN. TREATMENT AFTER DELIVERY. After delivery the patient should remain perfectly quiet, and be made as comfortable as possible, without disturbing her. At the expiration of one hour or two, if every thing goes on well, she may be changed, and put to bed. If flooding sets in after delivery, see Menor- rhagia. AFTER PAINS. These pains come on after delivery and are more and more severe after each successive labor, seldom occur- ring with first children. They are occasioned by the efforts of nature to expel the clots of blood which may remain in the womb, and where they are not very violent nor of long duration, no treatment is necessary. Should, however, they be very severe and long-continued, one of the following remedies will produce relief. Arnica should be first given, followed after three or four doses, if necessary, by Pulsatilla. If relief is not soon obtained, and the pains are severe, accompanied with great restlessness, Nux-v. and Chamomilla may be taken in alternation, Secale and Cuprum may be alter- nated, where the pains are very violent, especially in those who have borne many children. Dose.—Two drops, in a tumbler of water, a tablespoonful once in one or two hours; or six globules on the tongue in the same inter- vals. DURATION OF CONFINEMENT. The first five or six days should be spent in bed, dur- ing which time the mother should remain perfectly quiet, her food of a light farinaceous character, consisting of toast, black tea, panada, farina, roasted apples, &c. At the expiration of this time she may be permitted to set up a little while, if every thing goes on well, increasing the period each dav. If the secretion of milk has become THE BREASTS. 365 fairly established, and all febrile symptoms subsided, her diet may gradually assume a more nourishing and sub- stantial character. There is generally a torpidity of the bowels for several days, but this should create no alarm, as for a few days, on account of the great change going on in the system, no evacuation is necessary. The constipation can as a general thing be controlled by the food, which should consist in part of fruit, such as roasted apples. If there should be no movement after four or five days, three or four doses of Bryonia, at intervals of four hours, fol- lowed if necessary by Nux, or Sulphur, will usually produce relief. If however after two or three days no relief is obtained, a tepid water injection may be given. The diarrhoea which sets in sometimes after delivery, will be relieved by a few doses of Rheum, Phos.-ac, or Pulsatilla, and if occasioned by a cold, Dulcamara, given at intervals of four hours. THE BREASTS. If, for several weeks previous to the birth of the child, particular attention is given to the breasts, much future suffering and trouble may by avoided. The breasts should be bathed with cold water daily, and afterwards rubbed dry. Should there be tenderness or slight ex- coriation, they may be bathed with weak brandy and water twice a day. Should there be aching pain in the nipples, a few doses of Aconite may be given. If there are cracks or excoriations, a powder of Silicea may be taken in the morning, and Hepar at night. A very excellent application for sore nipples is Calen- dula, six drops in two tablespoonful of water, in which a cloth may be wet and placed on the parts. MILK FEVER. About the third day after delivery, the breasts become filled with milk. The fever which usually attends this 366 DISEASES OF WOMEN. profuse secretion, generally lasts but two or three days, and is called the "milk fever? As a general thing, it passes off without serious injury, requiring no other treat- ment than good and careful nursing. Should, however, there be much soreness and hardness of the breasts, they may be bathed two or three times a day, with a lotion composed of six drops of Arnica, to a tablespoonful of water. If considerable fever is present, attended with restless- ness, and also if the breasts are knotted and hard, a few doses of Aconite may be given, at intervals of two or three hours. Bryonia may follow Aconite, if that is insufficient, and should there be oppression of the chest, and pain in the head. Pulsatilla or Rhus may be giv- en, should there be heat and hardness of the breasts, with rheumatic pains in the chest and limbs. If the breasts are very much distended and painful, they may be relieved by the breast-pump. For a week or two after confinement the breasts should be closely watched. If there is hardness of the breasts or lumps form in them in addition to the remedies in- dicated above, they should be freely rubbed with the dry hand. Dose.—Six globules on the tongue or two drops, in a tumbler of water, a tablespoonful at a dose. SUPPRESSED SECRETION OF MILK. In some cases there is a deficiency of milk. This dif- ficulty may generally be obviated by taking nourishing food, and those drinks which have a tendency to in- crease the secretion of milk, such as, milk, milk-punch, or beer. Again, owing to some mental or physisal disturbance, there may be a suppressed secretion of milk, followed by local congestion, determination of blood to the head, &c. In these cases, Pulsatilla should be immediately SORE NIPPLES. 367 given, two drops, or twelve globules, in a tumbler half full of water, a teaspoonful once in two or three hours. This may be followed after three or four doses, if neces- sary, by Bryonia and Belladonna, in alternation two hours apart. Should there be in connection with the above symptoms, considerable fever, together with great nervous excitement,Aconite and Coffea maybe alternated as above. SORE NIPPLES. The mother is frequently tormented with sore nipples, which are so painful as to render it almost impossible to nurse her child. They may be bathed two or three times a day with weak brandy and water, or alum- water, or with a lotion composed of six drops of Arnica or Calendula, to a tablespoonful of water, taking care however, after either of these applications, to bathe them with tepid milk and water before nursing. If there is a constant pain, Chamomilla may be given once in three or four hours, until relieved. Should suppuration or ulceration commence, a powder of Silicea may be taken morning and night, followed in four or five days if neces- sary, by Mercury, Calcarea, or Hepar. GATHERED BREAST. AGUE IN THE BREAST. The mother sometimes suffers severely from these troubles, which if not controlled, may produce serious derangement and severe suffering. Taken in the commencement, a few doses of Bryonia, two drops, or twelve globules, in a tumbler half full of water, a spoonful every two hours, will generally be sufficient. Should, however, considerable fever set in, and the breasts be swollen, painful, and very tender, Aconite and Belladonna may be alternated, two hours apart; warm cloths also may be applied, or Stramonium leaves be placed over the breasts. Should gathering 368 DISEASES OF WOMEN. or suppuration commence, indicated by hard swelling and throbbing pain, Hepar and Silicea, may be given in alternation, a powder, six hours apart, followed if necessary after two days, by Mercury and Lachesis, at the same intervals, until the abscess breaks. When the suppuration has pretty well advanced, poultices of bread and milk, slippery elm, or flax-seed may be applied. If the pain is very severe, the poultice may be dusted over with powdered Opium. After the abscess has opened, give a powder of Sulphur every night. THE LOCHIA. This discharge, which follows confinement, resembles at first menstruation, but gradually grows lighter colored, becoming before it ceases, yellowish or whitish. It is sometimes thin and scanty, ceasing in a few days, at others profuse, lasting for weeks, but its general dura- tion is about ten days. If long-continued and very profuse, it weakens the system, and should be checked. If it ceases too soon, and at the same time there is a suppression of milk, serious disturbances may be ap- prehended. If it is long-continued and very profuse, see Menor- rhagia, When it is suppressed: Bryonia, Pulsatilla, Dulca- mara, Opium, Platina, or Belladonna, will be required. Bryonia is indicated, where the suppression is accom- panied by severe headache, fullness and throbbing in the head, and aching in the back. Pu'satilla, where there is sudden suppression from mental emotion, or dampness, followed by fever, head- ache, &c. Dulcamara, when occasioned by cold or dampness, in alternation with Pulsatilla. Platina.—From violent mental emotion, with great sensitiveness of the sexual organs. PEURPERAL FEVER. 369 Dose.—Two drops, or six globules, in a tumbler half full of water, a tablespoonful once in four hours. PUERPERAL FEVER. This fever, sometimes called "Child-Bed Fever? is the dread of mothers, and is often attended with serious danger. A physician should be consulted without delay, for if allowed to go on, it may gain a fearful ascen- dency. Diagnosis.—The attack may commence even before de- livery, though these cases are rare, but they generally are developed in from twenty-four hours to three days after. The attack generally comes on with rigors or shivering, followed by thirst, quickened pulse, and flushed face. The pulse during the disease is rapid, small and wiry, varying from 110 to 140 in a minute. To these symptoms succeed, pain in the head, coming on gradually; nausea, vomiting, and increased sensibility about the uterus. Pain in the abdomen soon attracts notice, generally commencing in the lower part, on either side, and radiating over the abdomen. The pain at first is attended with considerable tenderness of a portion of the abdomen, which becomes very great as the in- flammation extends, until at length the patient may not be able to bear the slightest pressure. There is generally a suppression of the lochia, and the urine is usually diminished in quantity, turbid or high-colored. During the disease, ther« may be present at times, great excitement of the nervous system, attend- ed with spasms. This fever frequently prevails as an epidemic. Treatment.—It will be impossible, and in fact it would be unnecessary, to go into the details of treatment here, as the watchful care of the physician will be required to arrest its progress. Aconite should commence the treatment, in alternation with Bryonia or Belladonna. The specific indication 16* 870 DISEASES OF WOMEN. for Aconite are, fever with dry burning heat, thirst for cold drinks, redness of the face, short and oppressed breathing; tenderness of the abdomen to the touch, and scanty, bloody, and fetid lochia. Belladonna.— Distention or excessive tenderness of the abdomen, sometimes with shooting and digging pains; spasmodic colic; painful pressure on the genital organs; shivering in some part with heat in others, or burning heat with redness of face; pressive headache; great sleeplessness with agitation, or constant inclination to sleep, or delirium and other cerebral symptoms; scanty lochia, or profuse discharge of coagulated and fetid blood. Bryonia.—Sensitiveness of the abdomen to the touch on the slightest movement; constipation, with shooting pain in the abdomen; high fever with great thirst for cold drinks, and burning heat over the body. Chamomilla.—Particularly where the fever is brought on by a fit of passion, or a chill, and where the lochia is profuse, abdomen sensitive to the touch, colic-like labor-pains, great agitation and nervous excitability. Nux.-v.—Sudden disappearance of lochia, with heavi- ness and burning in the genital organs; or profuse dis- charge with severe pain in the small of the back, and difficulty in urinating. Constipation; nausea; pain in the thighs and legs with numbness; confusion of the head, or pressive headache with vertigo. Rhus, is a valuable remedy where there is great rest- lessness, particularly at night, and where the white lochia becomes bloody, with discharge of clotted blood. Dose.—One drop, or six globules, in a tumbler half full of water, a tablespoonful at a dose or a powder, or three globules on the tongue. Give once in one, two, or three hours. Diet and Regimen.—The patient should be kept as quiet as possible, and everything which might produce excitement, be strictly prohibited. The diet should be similar to other varieties of fever treatment OF CHILDREN. 371 CHAPTER XII. TREATMENT OF CHILDREN. THE INFANT. The child, while in the womb, is in reality a part of the mother, receiving its nourishment from her and ex- isting in a kind of passive state. The various organs of the body are in a state of complete repose, becoming prepared however for the duties they will have to per- form when this passive state is over. The muscles, the bones, the kidneys, liver, lungs, bowels, and the whole nervous system having no duties to perform, remain in a state of almost complete repose. But when the child is ushered into the world, it imme- diately commences a new existence. Now every organ is aroused and called into action. The lungs move, the bowels act, the kidneys perform their duty, the nervous system begins to show signs of action, and the whole machinery of life moves on in harmony. Before, surrounded by a fluid of unvarying warmth, and nourished by the mother's blood; now, introduced into a colder and ever-changing atmosphere and wrap- ped in clothing, however soft it may be, still subjecting it to much harder pressure than it ever before sustained, and compelled to digest its own food and throw out its own waste, the change is speedy, and the effect on the system necessarily great. The very suddenness of the change is necessary to call into action the organs of the body, and thus secure the life of the child. If respira- tion is not established before the maternal circulation ceases, the child dies as if from suffocation. The child is of course exceedingly sensitive, and the shock produced by the sudden transition of temperature from 98° to 1003 in the mother's womb, to 65° or 75° in 372 TREATMENT OF CHILDREN. the atmosphere, calls into activity respiration. The effect produced is similar to the panting and sighing, which al- most every one has noticed on plunging into a cold bath. The sensation to the child of this sudden change of temperature is so disagreeable, that generally the first intimation the mother has that her child is living, is a lusty cry, and none but the mother can tell the gushing love which that cry awakens in her heart, or its quick pulsations of joy. The extreme sensitiveness of the child to external in- fluences is its greatest safeguard. Changes of tempera- ture, hard or harsh clothing, want of cleanliness, and errors in food, may be the means, however trifling they might appear to the more hardy frame, of producing local disease. Hence the child gives utterance to its complaint in a warning cry of distress, the only way in which it can make its complaints known. We have seen in a preceding chapter, that aside from a venous and arterial circulation, by which the blood is conveyed, charged with nutrition to every part of the system and returned back to the heart charged with im- purities, there is a pulmonary circulation, by which the dark impure venous blood is thrown into the lungs from the heart, and there, changed by the action of the air in the air-cells, having received the elements of nutrition in the chyle, conveyed through the thoracic duct, be- comes arterialized, and is thrown into the right side of the heart, and from thence conveyed to every part of the system. In the unborn child the pulmonary circulation does not exist. The arterial blood is received direct from the mother, and as respiration does not exist, there is no necessity of the blood passing through the lungs. It therefore passes directly through, from the right to the left auricle of the heart, by what is called the foramen ovale, or oval hole. With the first gasp of the child on THE INFANT. 373 emerging into the air, the muscles of respiration begin to act, the blood passes into the lungs, and a new cir- culation commences. The foramen ovale, no longer of any use, gradually closes up, and the whole volume of blood passes through the lungs. Heretofore the child has lived through the mother, its arterial and venous circulation carried on through the umbilical cord, but now it must breathe and eat for itself. The lungs and heart are at first small, but they continue to expand and increase in size from year to year. Partly on account of the small size of the chest, and partly from the extreme nervous sensibility, the circu- lation of the blood in infancy is much more rapid than later in life. While in an adult the heart contracts and the pulse beats from 60 to 80 in a minute, during the first months of life it is nearly double that number, and varies from 120 to 130. Hence we should be on our guard about mistaking a perfectly natural for a feverish pulse. It is very obvious that the rapid circulation of the in- fant and its quick respiration, render it more liable, by increasing the nervous excitability, to various forms of acute diseases, than at a more advanced age, where the circulation and respiration are less rapid. Therefore an even temperature and a pure atmosphere are absolutely essential to the health of the child. Another condition indispensable to the life of the child is the supply of animal heat. This, before birth has been obtained through the mother, but now the child occupies a comparatively independent position, and the preparation of animal heat must be carried on in its own body and by its own organs. The evolution of animal heat we have fully explained in a preceding chapter. It is the same in the child as in the adult. It depends upon respiration, digestion, and nervous excite- ment. The power of generating animal heat, contrary 874 DISEASES OF CHILDREN. to what is supposed by many, is far less in the young than in the adult. The reasons are very obvious. The lungs are small, therefore respiration is less full and ac- tive ; the diet consists of watery and unstimulating milk, and the infant is of course prevented by weakness from making use of much exertion; and lastly the nervous system is not fully aroused, the child, during the first months of its life, sleeping a large portion of the time. A temperature of abour 98 is essential to man, and this we find he has, if in a state of health, whether he in- habits a land where the thermometer is 100° above zero or 20° below. This uniform temperature of the body is much warmer as a general thing than the surrounding atmosphere, and unless the internal fires were kept burning, the body would soon cool down to the same temperature as the medium by which it is surrounded. The power of generating animal heat is smaller in early life, than at any other period of existence, and there- fore the power of resisting external cold is far less at that period. The pernicious effects of highly heated and impure air, and allowing the limbs of the child, both in the house and out of doors, to be destitute in a great measure of clothing, will very readily be perceived by all. CLOTHING. We will suppose the little stranger fairly introduced into the world, and ready for its first bath. The room should be of a moderate temperature, and the possibi- lity of currents of air from doors, windows or cracks carefully guarded against. Drafts of air would be highly injurious, as well as tihe near vicinity of a large fire where the rays fall directly on the child. The tem- perature of the water should be about blood heat. Warmer than this would produce relaxation and conse- quent debility, colder, the animal heat would be rapidto CLOTHING. 375 withdrawn from the child at a time when its power of generating heat would be very limited. In washing the child, all that is generally necessary, is a soft sponge, by which the warm water can be thoroughly applied in a manner not to injure the delicate skin and the mucous or oily covering of the child effectually removed. Some- times the peculiar substance with which the child is covered cannot be removed merely by soap-water; in these cases the parts may be smeared with fresh lard, butter or the yolk of an egg, and then washed off. The face should be washed first, and with a different sponge from the rest of the body, and great care taken to prevent any of the soap from getting into the eyes. By failing to observe these simple directions, an ophthalmia of an exceedingly painful character is often induced. While particular pains should be taken to have the child perfectly clean, it should not be forgotten that you are handling a delicate being, who is taking its first les- son in life. I have often seen nurses in the lower walks of life, and even where there was no excuse for their not knowing better, grasp the head firmly in one hand, with the other, armed with a rag, not of the softest quality, and plentifully covered with soap, scrub the little face with an energy and good will, which expended on pots and kettles would be highly meritorious, but which is not exactly the thing with the tender flesh of the young infant. If the child is very weak, it should not be still further fatigued by a long washing. In these cases, let the nurse make the child as clean as possible in a reason- able time, and leave the rest till the next washing. After the child has been washed and dried, the cord may be wrapped in a soft linen rag; over this a thin flannel bandage must be applied five or six inches in breadth, and long enough to go once or twice around the body. The object is partly warmth, and partly to prevent the bowels pressing out at the opening of the navel. Id 376 DISEASES OF CHILDREN. warm weather, or where the skin is very sensitive, a linen or cotton bandage can be substituted. The ban- dage should not, as is often the case, be drawn too tightly, for this would prevent the proper action of the abdomen in respiration, and thereby produce much evil. The cord generally suppurates, and drops off in five or six days, and it is not necessary previous to that to change its dressing more than once or twice, if at all. As it regards the dress, the mother can consult the prevailing fashion, or her own taste, providing she also consults common-sense, and while she uses light, soft, and warm clothing, such as will afford ample protection to the child, is careful to have it fit so as not to com- press the body or prevent the utmost freedom of move- ment. The dress will of course vary somewhat according to the climate and season of the year. In the winter, or where the child is delicate, thin, soft flannel next the skin is generally preferable. The plan of rolling the child up in bandages like a mummy, thus preventing the expansion of the chest and abdomen, and the free motion of the limbs, has fortunately gone out of fashion. If flannel produces much perspiration and soreness, linen should be substituted. Whatever the clothing may be, it should be very frequently changed, and never put on until after it has been thoroughly aired and made comfortably warm. While the mother bears in mind the fact, that the supply of animal heat is the smallest in infancy, and therefore perceives the necessity of keeping her child sufficiently warm, she should not forget that too warm clothing, and too high a tempera- ture in the room, are equally injurious as the other ex- treme. As dressing is generally tiresome and irksome to the child, the garments should be made so as to be easily taken off or put on. Pins should be avoided wherever it is possible, and soft tapes, loops, or something of the CLOTHING. 377 kind substituted in their place. Unless great care is exercised, pins stick into the flesh, worry the child, and occasion paroxysms of crying, often attributed to dis- ease. The practice of leaving the upper portion of the chest and arms naked for the first five or six years can- not be too strongly condemned. The chest must be protected, or you will stand a pretty good chance of being called to watch with agonized emotions by the side of your child, suffering from croup, inflammation of the lungs, fevers, and those varied diseases which prevail to such an alarming extent at this period of life. Children who have their bosoms, arms, and legs covered for the first two years, are far less liable to colds, coughs, croups, inflammation of the lungs, and that long list of diseases which annually sweep off so many of the bright and beautiful little prattlers. Formerly it was the pride of the mother, to see her child with a beautiful cap on its head, now, mothers generally prefer to see the little head without any covering, except what nature gradually provides it in the form of hair. And this is much the wisest plan. Caps after all, make them as beautiful as you choose, are a great nuisance, and often productive of much harm. By them the head is kept too warm, inducing alarming diseases of the brain; and the tender scalp, constantly irritated, rendered much more liable to pain- ful and fetid eruptions. The string also passing under the chin, often gives the poor thing the first sensation of hanging. Where the head is kept too warm, diseases of the brain, as a matter of course, are much more fre- quent. Pains should be taken to keep the temperature of the child as nearly alike at all times as possible. During the day the clothing may be very judicious, while at night the child is often almost buried in feathers and made to swelter under warm blankets. Considering, that two-thirds of the infant's life is spent in sleep, the 378 DISEASES OF CHILDREN. danger of these sudden transitions from a high to a low temperature is very apparent. In the course of a few months as the strength in- creases, a change of clothing becomes necessary, and the long dresses give place to those more suitable to in- creasing activity. The feet should now be protected by stockings, and whatever form of dress is adopted, the ridiculous fashion of leaving the legs, arms, and the up- per portion of the chest naked, should never be indulged. FOOD. As we have before remarked, while the child is in the mother's womb, it has no need of appetite, as all its nutriment is imparted without any exertion on its part through the circulation of the mother. When the con- necting link, which for nine months has bound the child so closely to its mother, is severed, and the little being is ushered into the world, the various organs com- mence their proper functions, developing as a matter of course, appetite, and the first few days of a child is divided almost entirely between sleeping and gratifying its appetite. At this period it often is only aroused by hunger, and when this is appeased, drops to sleep. Several years since, when engaged in the practice of my profession in a beautiful Country village, I was called out late one evening by a Frenchman to see his little child, then about three days old The father had called at my office several times during the evening before my return, and was then so much excited, that he could not give me any rational account of the difficulty until I reached the house, where I found the mother in tears, sobbing as if her heart would break, and insisting, in broken English, that "mine child shall die." Her tears however were quickly changed to smiles, when I told her, that six months hence she would be delighted, if her child slept as quietly. There was nothing the matter. food. 879 The child was merely obeying the first demands of its being. In the course of a few hours, as soon as the mother has obtained a little rest, it is always best to place the child by her side, and let it receive its first nourishment from her breast. The milk at this time, if there is any, is thin and watery, of a whey-like con- sistency, and does not gain its rich and creamy char- acter, until the lapse of several days. In this we see another beautiful arrangement of nature. The milk is precisely of the character best adapted to the wants of the child. It acts gently on the bowels, causing the removal of the dark and slimy meconium, with which they are loaded at birth, and gradually, as it becomes richer in its properties, prepares the stomach for its re- ception. The mother's milk is of itself a laxative, and generally all the laxative the child requires. The habit of dosing the little being with castor-oil, catnip- tea, rhubarb and even calomel, cannot be too strongly condemned. Bear in mind the delicate organization, and remember that the organs are all new and unused, requiring the most delicate stimulus. However much the robust system may be abused, infancy will not be trifled with without showing the effects of it in cries, fretfulness, convulsions, colic, diarrhoea and often death. The bills of mortality show, that an enormous per-cent- age of death, nearly one-third, occurs before the age of three years. We are to look, as one frightful cause of this mortality, to the trifling with nature, and the kind- ly meant, though unwise intermeddling of friends and relatives. If, after the lapse of four or five hours there should be no movement from the bowels, and the child is evidently suffering from this cause, a small amount of tepid sugar and water, or molasses and water, will generally be all that is necessary to relieve the diffi- culty. If those having the care of an infant would bear in 880 DISEASES OF CHILDREN. mind the fact, that up to the moment of birth it has been nourished by the rich blood of the mother, they would be less anxious to crowd its delicate stomach with food of their own contriving, often to its injury. The cramps, colics, and cries of pain, which are so often heard in the nursery, are frequently the result of this forcing system. The cry of pain, which tortures the ear, is too often the voice of nature, protesting in the strongest terms against this abuse of her laws. An ordinary flow of milk is generally established in three or four days, and this gradually becoming rich and nourishing, as the wants of the child demand it, is with but few ex- ceptions, all that it requires. If however during the first few days there is not a sufficient secretion of milk its want may be supplied by a little tepid sugar and water, or weak milk and water. System and order are necessary in all things, and in nothing more than in the care of the infant. The practice is very common, when- ever the child cries, to stop its mouth with the breast. This is often done fifty or a hundred times a day, and at night, the mother's sleep is broken every half hour by the cries of her child ; thus both are deprived of their natural rest, the mother becomes a slave to her child, and the child develops as a reward a peevish and rest- less temper. This habit strongly reminds us of an anec- dote of an old lady, who in the fullness of her kindness begged her guest to " eat, eat, eat till you split. I really wish you would." The stomach of an infant, when a few days old, is very small, holding not much more than a tablespoonful; as the child increases in age, of course the stomach be- comes larger, but this repeated filling it with food in too large quantities, leaves it no time for digestion, and pro- duces flatulence, colic, diarrhoea, indigestion, and some- times entails on the young being a lasting disease. Crying is not always an indication of hunger. The babe FOOD. 381 can tell its sufferings in no other way, and it just as often cries from repletion, as from lack of food It cries when too warm or too cold, or whenever anything affects its delicate organization unpleasantly. Crying, however unpleasant it may be, is not unfrequently highly bene- ficial. The organs of respiration are developed and strengthened by the exercise. As we have already stated in speaking of the adult, the amount of food should be proportioned to the waste in the system. Crowding the stomach with food more than it can di- gest, whether in the adult or infant, leads to the most serious difficulties. During the first few weeks of in- fancy the child requires food oftener than when a few months old, but even then every three hours will as a general thing be all-sufficient, unless it should be de- manded more frequently by those evident signs of hun- ger which no mother need mistake. If the breast is not offered on every occasion and for every cry, it will only be demanded at stated intervals. As the child advances in age, the length of time between the period of taking nourishment will of course be proportionally increased. At first the child will require nourishment three or four times in the course of the night, but after a short time once late in the evening and again early in the morning will be all that is necessary. The child may, in a warm room, be suffering from thirst, and a drink of water be all that is necessary to still its crying. It is a curious fact, that great fatigue, strong mental emotion, fear, passion, or wild and excessive grief often produce a strong effect on the mother's milk. Hence she should by no means give the breast when suffering from great fatigue, or violent mental emotion. The case recorded of the German woman, is probably familiar to all. A soldier attacked her husband with a drawn sword. At first she was paralyzed with terror, but in a moment she sprang forward with fury, wrenched the 882 DISEASES OF CHILDREN. sword from the soldier's hand, and parted the com batants. While in this strong state of excitement she took her child from the cradle and placed it to her breast. The doom of the little being, at the time per- fectly healthy, was sealed, for in a few moments it was dead. Will those who will believe in nothing but tan- gible doses, tell us how much poison was contained in the mother's milk, and how the chemical change was produced, instantaneously, by the action of the mind ? " There are more things in heaven and earth, Than are dreamed of in your philosophy." ARTIFICIAL FEEDING. In all cases where the mother can nurse her child with safety, she should certainly do so, as the mortality among infants thus nourished is far less than among those who are " brought up by hand," as it is termed. At times, however, from a variety of causes, such as the non-secretion of the mother's milk, disease or death, it is necessary to administer food. In these cases a healthy wet-nurse should be obtained if possible, if not, the food should resemble that of the mother's milk as nearly as possible. The following analysis of several kinds of milk may guide us in a proper selection. CONSTITUENTS. cow. ASS. WOMAN. GOAT. EWE. Caseine 4.48 1.82 1.52 4.02 4.50 Butter 3.13 0.11 3.35 3.32 4.20 Sugar of milk 4.77 6.08 6.50 5.25 5.00 Various salts 0.60 0.34 0.45 0.58 0.68 Water 87.02 91.65 87.98 86.80 85.82 Total 100.00 100.00 100.00 100.00 100.00 Solid Substances 12.98 8.35 12.02 13.20 14.38 We perceive from this analysis, that woman's milk is the poorest of all, but that it contains most saccharine ARTIFICIAL FEEDING. 383 matter; next to this comes ass's milk. In choosing our substitute we should either prefer the one, which ap- proaches nearest the natural food of the child or en- deavor to modify the difference, in what we do take. Thus, a large proportion of water and sugar should be added to cow's milk, a less amount of each to goat's milk, &c. Cow's milk is generally used on account of its being more readily obtained than most of the varieties. It should be obtained perfectly fresh, from one cow if pos- sible, sweetened, diluted at first with two-thirds water, reducing the quantity of water after a week, or two, to one-half, and again in a short time to one-third, at which strength the child can be fed for four or five months, after which, if it is active, the milk can be given un- diluted. The utmost attention should be paid not only to the temperature of the milk, but to cleanliness. The food should be as nearly as possible the temperature of the mother's milk, at 96° or 98°. The water should be heat- ed and poured on the milk, and in no case should the food thus prepared be heated for use a second time. A variety of sucking-bottles are used, fitted with an artificial nipple, pierced with small holes. The nipple can be made of sponge, covered with a rag, chamois leather, folds of linen and a variety of materials. The sucking-bottle should never be put aside without, to- gether with the nipple, being thoroughly washed with hot water. This may seem an excess of care, but there is far less trouble in doing things properly than in lis- tening to the cries of the child or in watching by its sick-bed. After taking its food, the child naturally in the ear- lier periods of its life feels an inclination to sleep. In this it should be indulged, f r if tossed about and pur- posely kept awake, it will almost surely suffer from in- 384 DISEASES OF CHILDREN. digestion. I have often seen the nurse, after having fed the child place it on her knees and trot it with an energy as if its life depended on having the contents of its stomach well churned, and have heartily wished, that immediately after dinner she could be placed on some machine, where she might receive a practical lesson in the beauties of trotting. Sometimes after the first month or two, milk seems to disagree with the child. In this case it may be mixed with well boiled arrow root, sago, farina, or well baked and toasted bread. A very excellent food is "bread jelly." A quantity of the soft part of a loaf is broken up, and boiling water being poured on it, it is covered and allowed to steep for some time ; the water is then strained off completely, and fresh water added, and the whole placed on the fire and allowed to boil slowly for some time, until it becomes smooth ; the water is then pressed out, and the bread on cooling forms a thick jelly, a portion of which is to be mixed with milk, or water and sugar, for use as it is wanted. The steeping in hot water, and the subsequent boiling, removes all the noxious matters used in making the bread. Arrow-root made with water alone, or with milk and sugar is very good food; but as it is somewhat astrin- gent, it is more particularly suited to cases where the bowels are relaxed, in such cases also, boiled milk, or boiled rice and milk, may be given. Pap or panada, and gruels made in the usual way, also form a very good variety of food. Not unfrequently a change from Us usual food to some of the above articles, produces a Speedy change in the movements of the bowels. In poor and weak children, weak chicken tea, or beef tea, may be required. WEANING. 385 WEANING. The time of weaning, anticipated with so much dread by anxious mothers, must be governed by circumstances. Some women are not able to suckle but a few months, while others continue it for two or three years. I know a lady, now a venerable grand-mother, who nursed a child, now a strong athletic man, until he was so large that he was able to stand by her side and nurse. When visitors were present, a little ashamed to indulge in his favorite practice before them, he would call his mother out of the room, as if he had something of importance to tell, when he would commence nursing. As a general thing, the child should not be weaned earlier than nine months, or later than twelve months. By this time it will generally be provided with teeth, although sometimes they are not developed until the child is eighteen or twenty months of age. Should, however, there be a non-sufficiency of milk, or the health of the mother suffer, weaning can take place at any time. It should in no case be continued, when it is ap- parent that it is injurious to the mother. Weaning should not take place, if it can be avoided, when the in- fant is unwell, or when suffering severely from teething, or during the warm weather of summer. It is best, generally, that the weaning shall be gradual, accustom- ing the child, before it is entirely deprived of the breast, to be fed with the spoon. After the> child is weaned, its diet should still be of a fluid or soft character, gradually changing as the system requires. Milk, thickened with arrow-root, sago, farina, bread, gruel, crackers pulverized in warm water and slightly sweetened, will at first constitute its principal diet. Regularity now in administering its food, is of equal importance, as in the earlier or later periods of life, and the child should not be accustomed to be fed 17 386 DISEASES OF CHILDREN. whenever it cries, or is uneasy, unless there are signs that the uneasiness or crying is caused by hunger. If the child is really hungry, it should be fed, but in those cases a piece of bread will not be rejected, as it pro- bably will in case the appetite is artificial, and only for nice things. CLEANLINESS, AIR, AND EXERCISE. Every mother will perceive the necessity of perfect cleanliness. The clothes should be frequently changed, and the child be accustomed to a daily bath. The water should be during the first few days after birth about blood heat, gradually lowering the temperature as the child becomes stronger, until in the course of a few months, the water may be used nearly if not quite cold. A bath should be used in which the whole body may be immersed. After bathing, the body should be thoroughly dried, followed by gentle friction with the hand or a soft towel. Particular attention should be paid to the hair and scalp. At first it is of course washed all over every day, but after the child is a year old, once a week or fortnight will be sufficient, if it be well brushed night and morning. The Nursery.—There is one important subject in the training of the child, of which I have not spoken, I mean, thie nursery. A healthy location, pure air, and cleanliness are of course essential. A situation away from contamination, with a dry and pure air, should be selected. It is very common in New-York, and in fact in all populous cities, to see in certain localities, a dozen families occupying one house. Each family sometimes composed of six or eight children, besides the parents, has at most but two rooms, and often only one. Here within these dark, damp walls, sometimes in basements, and sometimes in attics, where the cold wind and rain CLEANLINESS, AIR, AND EXERCISE. 387 penetrates through every crack, they cook, and eat, and sleep, huddled together like swine. No wonder that disease and crime revel here. No wonder that these localities swell that dark and filthy stream of licentiousness, whose turbid waters cast their stench over society; morally and physically poisoned, what could we expect. And here they live in the midst of filth, pinched with poverty, seeing their children growing up around them candidates for crime, when at a less expense than they are now under, they could have pleasant homes in some of the many quiet villages clustering around, and within a few moments' ride of our great cities. Even among those who are possessed of wealth the most unpleasant and worst ventilated part of the house is not unfrequently taken as a nursery. The upper rooms, being more airy and dry than the lower, should as a general thing be selected. Those having a southern exposure would of course be preferable. A want of pure air and healthy food, is one of the principle causes of various diseases, as well as the development in infancy of that scourge of our race, Scrofula or Tuberculosis. Nothing should be permitted in the nursery which would have a tendency to vitiate the air, or interfere with a proper ventilation. While we take particular pains not to have the nursery at too high a temperature, we should be equally cautious to have an even and comfortable warmth at all times. Drafts of cold air should be avoided, and the so-called hot air stoves, standing like a mass of heated metal, exhausting the life of the air, and creating no current should never find their way into the nursery. The temperature must be regulated according to the season, and should range somewhere between 60° and 70° During winter, and a portion of spring and autumn, fire will be required during the day, but it is not necessary 388 DISEASES OF CHILDREN. at night, unless in case of sickness. After dressing in the morning, the children should leave the room for an hour or two, during which time it should be thoroughly ventilated. Children must, as a matter of course, spend hours and days alone with their nursery attendants, at a time when first impressions are stronger than at any other period of their lives. Great care then should be taken in the selection of the nurse. She should be orderly, cleanly, addicted to no vulgar habit, and of a mild and cheerful temper. I have already referred to this subject, in speaking of the moral training of children. Exercise,—This is essential to the proper develop- ment of the muscles, and the various organs of the body, but we should bear in mind the softness of the bones and the weakness of the body in the early months of infancy. Exercise at this period should be mostly of the passive kind, as violent exercise, or carrying the child in an erect or sitting position would have a ten- dency to produce curvature of the spine and limbs. Respiration, crying, tossing about the limbs, produce at first nearly all the exercise required. In summer weather the child can hardly be too much in the open air, and should be accustomed to it at longer or shorter intervals daily. In winter, more caution is necessary, but even then it may be taken out after the first or second month, in pleasant weather, for a short time. The indiscriminate exposure of children for the purpose of hardening them, is a barbarous practice. They should be warmly clothed, and not exposed to the weather when there is danger of being chilled. During the first four or five months, in taking exercise, the child should not be carried in a sitting position. The head is large and heavy, and for want of sufficient strength in the neck to keep it in an erect position, it falls from one side to the other, impeding respiration. SELECTION OF A WET NURSE. 389 The best way to carry young infants, is in an oblong basket, or on the arm of the nurse in a reclining position, so as to protect the body and head. It should never be lifted by the arms or guided by them, when it makes its first effort to walk, but one hand should be placed on each side of the chest, just below the arm-pits. The cradle in which the child is rocked to sleep, or its cries stilled, is rapidly losing favor, and should be entirely banished from every household. Rocking, with the rapidity often practiced, undoubtedly induces sleep, but it is an apoplectic sleep, endangering the brain and the nervous system. When a child is able to walk he will show his ability in a way which cannot be misunderstood, and then a little help, rather to enable him to balance than to sup- port himself will be sufficient. Walking requires not merely physical strength, but the power of balancing, and we should be cautious about forcing the child to step alone, until the latter as well as the former has been m a measure acquired. The child itself decides on the different steps of its progress, and a little watchfulness on the part of the mother or nurse, will easily discover the indications. As the child increases in strength, air and exercise are even more indispensable ; in fact, from two to ten, or twelve years of age, it cannot have too much fresh air, provided there is not an undue expo- sure. I have already referred to this part of the sub- ject in speaking of the moral, physical, and intellectual training of children. SELECTION OF A WET NURSE. In the selection of a nurse, the physician should of course be consulted. She should be cheerful, amiable, orderly and cleanly; there should be no traces of here- ditary or other disease; the skin should be sound, with- out eruption or trace of scrofulous disease; the mouth 390 DISEASES OF CHILDREN. and teeth healthy; the breasts of moderate size and firm It is desirable to choose a nurse whose child is about the age of the one she is about to suckle, although this is not always necessary. The milk should be thin, clear, of a bluish-white color, limpid and sweet. The food should be plain but nourishing, with the addition some- times at dinner of a moderate allowance of ale or porter. She should exercise daily in the open air; her digestion should be good, and her bowels regular. 2. DISEASES OF CHILDREN. As we have glanced at the general treatment of the child during the first few years of its existence, we will now speak of some of the affections with which it is most liable to be troubled. APPARENT DEATH OF A NEW-BORN INFANT. Where a new-born infant does not breathe for some minutes after delivery, steps should be promptly taken to resuscitate it. The back should be rubbed along the spinal processes, the limbs and chest should also be rub- bed, gently but firmly, and the abdomen around the cord rubbed with brandy and water. If after the lapse of five or ten minutes there are no signs of life, the cord should be cut, and the child placed in a warm bath, at the same time squeezing the limbs and chest gently. Put about as much Tartar Emetic as will lie on a three cent piece into a tumbler half full of water, and put two or three drops of this mixture into the mouth. Sometimes it is possible to inflate the lungs by placing the mouth over the child's mouth, and gently breathing, at the same time closing the nostrils with the thumb and finger to prevent the air passing out. After the lungs are filled, the chest should be gently compressed so as to imitate as nearly as possible respiration. In- fants have sometimes been restored after two or three hours of apparent death, therefore efforts at resuscitation COLD IN THE HEAD. SNUFFLES. CORYZA. 391 should not be given up too soon. Where there are un- mistakable signs of the death of the child previous to delivery, it would of course be useless to make efforts at resuscitation. SWELLING OR ELONGATION OF THE HEAD. At birth, the bones of the cranium, where they unito which each other are more or less soft, so that there is frequently an elongation or swelling of the head, espe- cially after difficult labor. The difficulty will usually disappear in two or three days. If the swelling should be extensive, however, the head should be washed with cold water or bathed with a mixture composed of six drops of Arnica, to a tumbler half full of water. COLD IN THE HEAD. SNUFFLES. CORYZA. This is a very common affection among infants. The nose becomes obstructed, so as to render it necessary for them to breathe in a measure through the mouth, hence they are obliged, when nursing, to relinquish the nipple frequently, in order to get breath. Nux-v. will frequently be all that is required, espe- cially where there is obstruction of the nose with dryness. Dose.—Three globules, or a powder may be placed on the tongue, morning, noon and night. Sambucus may be given, if after two doses of Nux no relief is obtained. Dose.—Three globules, or one drop in a glass of water, ateaspoon- ful at a dose may be taken once in four or six hours, until better, un- less one of the following remedies is indicated. Chamomilla, where the obstruction is attended with watery discharge from the nose. Calcarea, where Cha- momilla has been ineffectual. Stibium will be required, where together with the running at the nose, there is'cough, rattling of mucus in the chest, &c. Dose.—Same as Sambucus. 392 DISEASES OF CHILDREN. A little tallow applied with the finger to the bridge of the nose will often produce relief. COLIC. CRYING, AND WAKEFULNESS OF INFANTS. Where it is evident that the cries of a child proceed from pain, as they generally do, the cause should be as- certained. The dress should be carefully examined, to see that the flesh is not irritated by pins. If it is evi- dent, that the pain proceeds from colic, a few doses of Chamomilla will generally be all that is necessary to produce relief, especially if there are griping pains, in- dicated by writhing of the body, and drawing up the legs, together with diarrhoea. Belladonna or Coffea will be indicated where there is apparently no exciting cause, but the infant is peevish, wakeful and has prolonged fits of crying. Ipecac, where the colic is attended with sickness of the stomach. Dose.—Of the above remedies six globules, a powder, or one drop may be placed in a glass half-full of water and a teaspoonful given every half hour or hour until relieved. Rheum. — Screaming, restlessness, violent griping pains, and sour-smelling diarrhoeic stools. Nux-v. will be required, where the bowels are consti- pated, and where there is flatulent colic, accompanied by sudden fits of crying. Dose.—Same as Belladonna. SWELLING OF THE BREASTS. Shortly after birth the breasts of the infant are fre- quently found to be swollen. This swelling is not oc- casioned, as is sometimes supposed, by the presence of milk, and therefore squeezing the breast will not only be productive of no good, but a vast amount of harm. The swollen parts may be covered with a linen cloth dipped in sweet-oil. If this produces no relief, the parts may be bathed in warm brandy and water, giving Cha- ommilla and Belladonna in alternation, three globules, INFLAMMATION OF THE EYES. PURULENT OPHTHALMIA. 398 or one drop in a glass half-full of water a teaspoonful at a dose, six hours apart. If, notwithstanding this treatment, the swelling still continues to increase, apply a bread and milk poultice, and if the gathering has opened, give three globules, or a powder of Mercury one evening, and the same of Hepar-s. the next. INFLAMMATION OF THE EYES. PURULENT OPH- THALMIA. This affection is very common among infants, setting in sometimes when only a few days old. It generally commences in the lids, but if neglected, soon extends to the eyeballs. It may be occasioned by allowing soap or some of the substance which covers the child to get into the eye, at the first washing; also by exposure to a strong light, a draft of air or the glare of a fire. A little of the mother's milk should be dropped in the eye four or five times a dry. Give also two globules of Aconite, or one drop in a glass half-full of water a teaspoonful at a dose, in alternation with the same amount of Belladonna, three or four hours apart. If in the course of two or three days -no improvement is perceptible, and there is great intolerance of light, redness, swelling and agglutination of the lids, give Chamomilla, prepared like the Aconite once in four hours. Mercury and Pulsatilla may be given in alternation, prepared like the Aconite three hours apart, if there be redness of the eyes and eyelids, small yellowish ulcers along the margin of the lid, with purulent discharge. Euphrasia and Rhus may be alternated, three hours apart, if there should still remain accumulation of mat- ter in the eyes, and great intolerance of light. Sulphur and Calcarea may be alternated a powder oi 17* 394 DISEASES OF CHILDREN. three globules, twenty-four hours apart, where the dis- ease occurs in scrofulous children. Continue to bathe the eyes with the mother's milk, or tepid milk and water. Where the lids continue swollen, a little bread made soft with cold milk, may be applied. EXCORIATION. The utmost cleanliness is of course essential, to guard against this difficulty. Bathe the parts frequently with cold water; wipe dry with a soft cloth, and dust on a little fine wheaten starch, or apply a lotion composed of six drops of Arnica to a tea-cup of water. If there is considerable redness and inflammation, give two globules, or one drop in a glass half-full of water, a teaspoonful at a dose, of Belladonna, every night. If the child is very restless, and in fact, in most forms of excoriation, where it is not occasioned by abuse of C/iamomile-tea, Chamomilla prepared like the Belladon- na, every night, will usually produce relief. Mercury will be required, where the excoriation is extensive and severe, two globules, or a powder, every night. If after several days the difficulty still continues, one of the following remedies may be given, Sulphur, Sepia, Calcarea, or Carb.-v. JAUNDICE. This trouble is frequently occasioned by the adminis- tration of cathartics shortly after birth, and also from cold. There is yellowness of the whites of the eyes, skin, and urine. The bowels are sometimes costive, at; others loose. Chamomilla and Mercury may be given in alternation, two globules of one, a powder or three drops in a glass half-full of water, a teaspoonful at a dose, in the morning, and the same of the other at night. If after four or five days there is no improvement, Nux may be given THRUSH. SORE MOUTH. APHTILE. 395 in the same way, or it may precede the others, where there is restlessness and constipation. China will be required, if the symptoms still continue after the administration of the other remedies. THRUSH. SORE MOUTH. APHTHA. This very common affection in infancy, is characterized by the appearance of small, round, white vesicles on the interior of the mouth and over the tongue, which, if not checked, run together, forming patches, producing a su- perficial ulceration of the mucous membrane of the mouth and throat. There is of course difficulty of nurs- ing and swallowing, and generally, a deranged state of the stomach and bowels. Where the attack is severe, and the ulceration extensive, there is more or less fever, pain, restlessness, &c. There is another variety of aphthge, sometimes mis- taken for thrush.—It consists at first of small points or patches of curdy matter on the surface of the membrane, and generally easily wiped away with a cloth. In severe cases, blood may exude from the mucous membrane at these points. Causes.—The prominent cause is a constitutional taint. It is also frequently produced by improper food in those who are fed with the bottle or spoon. Treatment.—If the inflammation is not very severe, equal parts of borax and loaf sugar may be mixed dis- solved in water and applied to the mouth three or four times a day; or borax and honey may be mixed and ap- plied in the same way, or the mouth may be washed with a mixture made by dissolving a few grains of borax in a tea-cupful of water. Mercury should be given two globules or a powder twice a day, when the disease first makes its appearance, especially if there is salivation and ulceration. Sulphur should follow Mercury at the same intervals, if the latter fails to effect a cure in three or four days. 396 DISEASES OF CHILDREN. HEAT SPOTS. PRICKLY HEAT. During the heat of summer and occasionally at othei times, children are subject to an eruption of small vesi- cles about the size of a pin's head, filled with watery fluid. These sometimes break and form into thin scabs. They are attended with an itching burning heat and some fever. It is generally occasioned by warm rooms and too warm clothing. Daily bathing and proper attention to dress are es- sential to a cure. If much fever and restlessness are present, Aconite may be given in alternation with Cha- momilla, four hours apart. If the eruption is extensive and attended with a burning itching, Rhus may be given, morning and night, followed, if relief is not obtained in a few days, by Arsenic or Sulphur, at night. There is another form of eruption, called the " Red Gum? which consists of small red pimples, chiefly con- fined to the neck and arms, although sometimes extend- ing over the body. The treatment is similar to that indicated above. Dose.—Six globules or three drops of the remedy may be mixed in a glass half-full of water and a teaspoonful given at a dose. RETENTION OF URINE. Retention of the urine frequently occurs in young in- fants, especially shortly after birth. A warm cloth may be placed over the region of the bladder, and two glo- bules of Aconite given once in two hours; if after two or three doses no relief is obtained, Pulsatilla may be administered in the same manner. For other urinary difficulties, see affections of urinary organs, chapter IX. CONSTIPATION. Constipation in infants generally arises from an im- proper manner of living, either of the nurse or child. The bowels should be evacuated at least once a day, and if they are delayed longer than this, it will be necessary DIARRHOEA. 397 to assist nature. Frequently entire relief may be ob- tained by changing the food of the mother or nurse, but if remedies are necessary for the child, Nux-v., Bryonia, Opium or Sulphur may be given morning and night, changing the remedy if it seems to have pro- duced no effect in two or three days. Cathartics should never be used but when it is necessary to obtain a speedy movement from the bowels, it may be done by means of an injection, consisting of a small piece of soap, dis- solved in a little tepid water. Dose.—A powder, six globules, or one drop, dissolved in a glass half-full of water; a teaspoonful given at a dose. DIARRHCEA. Healthy infants usually have three or four, and some- times five or six movements in a day; should the dis- charges become more frequent than this, be unnatural in color, and attended with more or less pain, one of the following remedies may be given: Chamomilla, where the diarrhoea is of a greenish, watery, bilious, yellowish or frothy character, sometimes looking like beaten up eggs, and having an offensive smell; and where it is attended with colic, crying, and restlessness. Rheum.—Sour-smelling discharges; colic and straining before and after the discharges. Ipecac—If it arises from overloading the stomach, or is accompanied with nausea and vomiting. Belladonna.—- Small and frequent evacuations ; great restlessness, disposition to sleep, and frequent starts. Dulcamara.—When the result of a cold. When accompanied with considerable flatulence: Nux-v. or Pulsatilla. When it occurs in the heat of the summer: Ipecac, Nux-v. or Bryonia. D0SE.—Six globules or one drop of the selected remedy in a glas half-full of water, a teaspoonful once in two or three hours. 398 DISEASES OF CHILDREN. CONVULSIONS. Convulsions may attack infants and children of all ages, and are almost always attended with more or less danger. The causes are numerous. They may be the result of feebleness on the part of parents; marrying at too early or too advanced an age. Where the mother has been subject to a great shock, or fright, or strong men- tal emotion before the birth of her child, the child will be very liable to have convulsions soon after its birth. Protracted and difficult labor may also cause convulsions in the child. They may also be occasioned by shame, anger, or fright; by tight bandaging, excessive mental emotion, a loud noise, sudden exposure to a bright light, hot, im- pure air, or severe cold. Want of proper ventilation is a fruitful cause of convulsions. During the first year of life they may be traced to the milk of the mother dis- agreeing with the infant. Cases are by no means rare where fright, passion, or suffering on the part of the mother gives rise to such a change in her milk as to pro- duce convulsions, if the child is permitted to nurse, while the mother is under the influence of these causes. As the child grows older, they may be occasioned by dentition, suppressed eruption, a bruise on the head, &c. They also frequently set in, in connection with some serious disease, as inflammation of the brain, or tubercles on the brain, and in fact with nearly all the serious dis- eases to which a child is subject. Treatment.—The appearance of the child during the spasm or convulsion is often so frightful as to alarm the friends to such a degree that they are, entirely unfit for action. This is wrong, for we certainly can do no good by giving way to excitement, while if we control our own feelings, and are prompt and decided in our treat- CONVULSIONS. 399 ment, we may frequently be the means of saving the life of the child. The child should immediately be placed in a warm bath and left there five or ten minutes, or until the severity of the paroxysm is broken. It should then be taken out and wrapped in a warm dry flannel. If the spasms still continue, or are only partially relieved, im- merse the feet and legs in water as warm as it can be borne, at the same time pouring a stream of cold water on the head, from a distance of two or three feet. This process should be frequently repeated, if necessary. The first inquiry should be, the cause of the convul- sion. If the gums are red and swollen, and the attack evidently arises from dentition, with a sharp pen-knife they should be cut, applying the knife to the top of the gum and cutting down, until the teeth are reached. If occasioned by costiveness or irritating substance in the stomach or bowels, give immediately an injection of tepid water, sweetened with molasses. Chamomilla is indicated particularly when the con- vulsions have been excited by teething, a chill or a fit of passion or vexation ; there is restlessness, disposition to drowsiness when awake, moaning, loss of conscious- ness, twitches of the eyelids and muscles of the face, jerks and convulsions of the limbs, with clenched thumbs, rolling of the head from side to side. Belladoana.— Particularly where connected with dis- turbance in the brain and derangement of the nervous system; there are sudden starts, dilated pupils, rigidity of differents parts of the body, clenching of the hands, forehead and hands dry and burning. Ignatia.—Especially during teething, and in pale and delicate infants, where the fit returns at regular hours, and is followed by fever and perspiration; convulsive starts, tremor of the whole body, attended with violent 400 DISEASES OF CHILDREN. crying and agonizing shrieks; muscles of single limbs are convulsed.. Ipecac—When occasioned by undigested food or an overloaded stomach; there is nausea, vomiting and diarrhoea; constant inclination to remain in a recum- bent posture; convulsions are preceded or accompanied by spasmodic twitchings. Nux-v.—When occasioned by a fit of anger, indiges- tion or constipation ; there are convulsive jerkings of the limbs and tossings backward of the head. Cina.—When the attacks are produced by worms. Opium.—Where the fits are the result of a fright, and are accompanied with flushed face, snoring breath- ing, and at length entire insensibility. Stramonium,—Where the attack is produced by sud- den fright; the convulsions are sudden and violent; the attacks are renewed by luminous objects, such as a mirror or candle, and are sometimes accompanied with involuntary discharges of fasces and urine. Hyosciamus.—Convulsions from fright. Twitching of the muscles of the face, foaming at the mouth, and great wildness. Administration.—One drop of the tincture, or ten glo- bules, may be mixed with a tumbler half-full of water, and a teasponful, or a few drops, given at a dose; or three globules may be placed on the tongue. The re- medy may be given during the paroxysm, every ten or twelve minutes, gradually increasing the intervals to one hour. DENTITION. TEETHING. The period of the first dentition is subject to many variations, but as a general thing it occurs between the seventh and the twentieth or the thirtieth month, al- though sometimes it is delayed much longer. The teeth* * See plate 5. DENTITION. TEETHING. 401 usually appear in each jaw in couples; thus, about the seventh month the two central incisors of the lower jaw appear; then in a short time those of the upper jaw, followed after a short interval by the lower lateral incisors, and then by the upper lateral incisors. From the twelfth to the fourteenth month the first four molar teeth appear, and from the sixteenth to the twen- tieth, the lower and upper canine teeth ; last of all the last four molars. Notwithstanding the above sketch describes the usual process of teething, yet in very many cases there are deviations. Sometimes children are born with teeth, or they make their appearance shortly after birth. Thus Louis XIV. of France, Mirabeau, and Richard III. were born with teeth. Often the order of succession men- tioned above is violated, the upper incisors making their appearance before the lower, the molars before the canine teeth, and so on; frequently also they do not appear in pairs, there being a difference of some months between the appearance of the first teeth. But the first set of teeth are only temporary, being supplanted after a certain length of time by a perma- nent set. Up to the age of five, six, or seven years, the jaws of a child may be said to contain two sets of sockets, which are kept distinct by a bony lamina. But at length, while the process of growth and development of the jaw and the second set of teeth are going on, another commences, having reference to the first set. The root is gradually absorbed, so that after a time the tooth itself may easily be removed with the fingers. In its place the second or permanent tooth shortly makes its appearance. The first two central incisors of the lower jaw usually fall away about the age of seven years, and are speedily followed by the permanent teeth. About a year is occu- pied in shedding the four central incisors, and another 402 DISEASES OF CHILDREN. year in that of the four lateral incisors. The anterior bicuspid teeth of the lower, then those of the upper jaw are next shed, usually occupying about a year. The posterior bicuspids go next, then the canine teeth. At length, usually before the age of twelve or thirteen, the second set of twenty-eight teeth is completed. A few years now elapse, when, usually between the age of sev- enteen and twenty-one, four new molar teeth are put forth, called the wisdom teeth, completing the full num- ber of thirty-two teeth in the mouth. Deviations from the ordinary rule, are as common with the second den- tition as with the first. Appearance of first teeth.—If the child is healthy, and the process of dentition favorable, the suffering is slight. For some time the gums are swollen ; the child dribbles incessantly and thrusts its finger or any thing it can seize into its mouth. As the teeth advance, the gums swell, and become tender, but with a feeling of tension and itching, which causes the child to wish to bite some hard substance. The gums are inflamed, and are hot to the finger; the child is fretful and uneasy. Dentition is usually more severe in winter than in summer. In severe cases of dentition, the symptoms are much more violent; the mouth is hot, the gums swollen and so exceedingly sensitive, that the child does not wish them touched. There is fever, thirst, and sometimes convul- sions. Connected with teething there are many sympathetic affections. There may be either constipation, or diar- rhoea, swelling and suppuration of the glands, eruptions on the head and other parts of the body, cough, and great irritability of the nervous system. Treatment.—It is important that the bowels should be kept open and the head cool, as there is more or less determination of blood to the head. The child should be permitted to bite on some hard or elastic substance. DENTITION. 403 such as a crust of bread, a piece of silver, ivory, or in- dia-rubber. If the gums are hot, swollen, and painful, they may be bathed with cold water, and if they are evidently near the surface, and there is danger of con- vulsions, they may be cut with a knife, being careful to cut through the gums until the teeth are reached. This operation however is very seldom necessary. Aconite*—Should there much fever and restlessness. Aconite may be given once in three or four hours. Belladonna will be indicated, if there is derange- ment of the nervous system, swollen and inflamed gums, flushed face, and indications that the brain is becoming involved. Also where there are convulsions generally followed by sleep: the child starts from sleep as if frightened ; the pupils of the eyes are dilated; the body becomes stiff, and there is burning heat in the temples and hands. Dose.—The remedy is often required in alternation with Aconite Twelve globules, or two drops, may be mixed with a glass half-full of water, and a teaspoonful given one, two, or three hours apart, according to the symptoms. When given alone, it may be taken once in three or four hours, except in cases of convulsions, when it should be given once in ten or fifteen minutes. See Convulsions. Chamomilla is a prominent remedy in many of the difficulties connected with teething. It is particularly useful where the child is restless and uneasy at night, has spasmodic jerking and twitching of the limbs during sleep, starts from the slightest noise; hacking cough and oppression of the chest; also where there is diar- rhoea with watery, slimy and greenish evacuations, worse at night. See also Diarrhoea. Dose.—Same as Belladonna. Cina.—Dry cough, and disposition to rub the nose, and also to grate the teeth during sleep, together with other symptoms of worms. Dose.—Prepare same as Belladonna, and give morning and night. * For further directions as to the administration of remedies, see page 12. 404 DISEASES OF CHILDREN. Coffea.—When the child is restless, nervous, and can- not sleep. Give the same as Cina. Ipecac, where there is nausea, vomiting and diarrhoea. Prepare same as Bell. Give once in two or three hours. Ignatia.—Convulsive jerkings of single limbs ; heat followed by perspiration. Starting from sleep, with piercing cries. Give same as Ipecac Consult Convul sions. Calcarea should be given where the teeth are slow in making their appearance. Two globules or a powder may be taken every night. Mercurius.—Diarrhoea with straining; profuse saliva- tion and redness and soreness of the gums. Give two globules or a powder three times a day. Nux-v. and Bryonia should be given, where there is obstinate constipation; three globules or a powder of one, one night, and the same quantity of the other the next. Follow in a week's time if necessary, by Sulphur in alternation with Nux-v, in the same manner. Diet and Regimen.—If the child is nursing, the mother or nurse should pay particular attention to her own diet; if it has already been weaned, its diet should be simple, and unstimulating, avoiding those articles which have a tendency to derange the system. Cleanliness is of course essential as well as pure air. Daily bathing should be practiced, and the rooms kept thoroughly ven- tilated. DROPSY OF THE BRAIN. Hydrocephalus. This disease, so full of danger to the child, has an acute and chronic form. We shall first notice the acute variety. ACUTE HYDROCEPHALUS. In one variety of the disease the child may exhibit for some time symptoms of deranged health such as DROPSY OF THE BRAIN. 405 loss of appetite, wandering pains, deranged state of the bowels, headache, crick in the neck, and a growing weakness. Accompanying these symptoms there may be occasional chills, pale countenance, and disturbed temper. At length the child complains of headache, or if an infant, gives signs of it by putting its hands to its head, rolling it uneasily about. To this succeeds vomiting, the child becomes dull and heavy, complaining of weari- ness, and is sensitive to light and noise. Thus the dis- ease may continue for several days, but by degrees fe- brile paroxysms are observed, the vomiting continues, the bowels are generally torpid, the urine scanty and frequently voided. The child gradually becomes dull and stupid. He becomes greatly emaciated, the pulse increases, decided symptoms of pressure on the brain are seen, in starting, screaming, and partial or complete convulsions, with insensibility, squinting, glazed eye, &c. This state may continue for two or three days, until at length it is terminated by a convulsion or coma. Again, the disease may be sudden in its development, and marked by high fever. The child complains of se- vere pain in its head, or pressing it with its hands, and rolling it from side to side, indicates the locality of the suffering; or it may lie still, heavy, and dull, with an occasional cry of pain. The eyes are sometimes heavy, and have a muddy expression, but they are more fre- quently bright and restless, having a peculiar stare and moving quickly from one object to another. The child is generally wakeful, or sleeping restlessly, drowsy, but waking up suddenly, crying or screaming, as from fright. There is an entire loss of appetite, nausea, and vomiting Thus far the disease may have advanced with more or less rapidity, but at length the fever rapidly becomes intense, with occasional intermissions; there is great heat in the head, severe headache, delirium, and often loud outcries. The eyes are bright but sunken, the pu- 406 DISEASES OF CHILDREN. pils contracted, and painfully sensitive to light, as the ears are to sound. The pulse varied, sometimes quick, at others irregular or intermitting. The vomiting usual- ly continues, and the constipation increases. As the disease advances, the symptoms gradually change from those of excitement to those consequent on effusion or pressure. The headache is less complained of, although the head is still rolled about uneasily; the delirium subsides or occurs occasionally ; the sensibility of the eye is gradually lost, the pupil is generally di- lated, and it is evident the patient can no longer see ; the eye is rolled about, turned upward, or squinting takes place; the hearing, which may for a time have been acute, at length diminishes, until the infant seems un- conscious of sound. The convulsions, which may have occurred at intervals from the commencement of the disease, now increase in frequency and sometimes in strength, or perhaps there may be convulsions of one side of the body and paralysis of the other. About this time a new symptom is developed, the sharp piercing scream, which the child utters from time to time, which adds so much to the distress of the mother, but which is not in reality the result of pain. During the intervals of the convulsions, consciousness and sensibility diminish until they are finally lost. The child now lies quiet, occasionally moving the head of throwing about an arm or leg; the eyes are open or only half closed, and acquire a glazed appearance; the face is pallid, sometimes wax-like, without expression ; some- times sunken and anxious, as representing the last con- scious feeling; the vomiting rarely continues; the bowels are sometimes evacuated unconsciously, but ge- nerally confined. The attack terminates by a convul- sion or in coma. The duration of this form of the disease varies from thirty-six hours to ten or twelve days. DROPSY DF THE BRAIN. 407 Another variety of this disease has been called the (iwater-stroke." It consists of a sudden almost instan- taneous effusion of fluid within the brain, and may occur either idiopathically, or as the result of obstructed se- cretion from some other organ, or as a secondary af- fection in the course of some other disease, as small- pox, measles, or other febrile eruptions, or on the sud- den stoppage of diarrhoea, dysentery, or profuse per- spiration. The child may go to bed apparently well, or suffering from some other disease, and in the morn- ing it may be found dead. Or it may be attacked by a convulsion, followed by paralysis, or apparent apo- plexy, with insensibility, stertorous breathing, dilated or contracted pupils, terminating in death after a few hours. Treatment.—Medical aid should be obtained as soon as possible. The external application of cold is highly beneficial. The best way of applying it is by filling a bladder with pounded ice, and placing it on the head. Aconite should be given in the commencement of the disease if the skin is hot and the pulse quick. Dose.—One drop, or six globules in a tumbler half-full of water, a tablespoonful once in two hours; or two globules on the tongue at the same intervals. Belladonna —Great heat and severe pain in the head; burying the head in the pillow or moving it from side to side; sensitiveness to light or noise; shooting or burning pains in the head, eyes red and sparkling, or with a wild expression; contraction or dilation of the pupils; violent delirium; drowsiness and stupor; loss of consciousness; frantic screams ; low muttering; nau- sea, vomiting, and convulsions. Dose.—One drop, or six globules, in a tumbler half-full of water, a teaspoonful at a dose. If in alternation with Hyosciamus or Hel- lebore, give one or two hours apart; if alone, give every one or two hours, according to severity of symptoms. Hyosciamus.—Especially where there are violent con- 408 DISEASES OF CHILDREN. vulsions; loss of consciousness; delirium; redness of the face with wild or fixed look; picking at the bed- clothes. Dose.—Same as Belladonna- Strammonium,—The symptoms resemble those indi- cating Belladonna or Hyosciamus; the spasmodic or convulsive symptoms are more prominent. Hellebore.—A highly important remedy in all well marked and severe cases. There is total loss of nervous control; the senses are generally obtuse, and the head feels stupefied; the look is fixed and vacant; the eyes turned upward and remain half open during sleep. Dose.—Same as Belladonna. Opium. Lethargic sleep, with snoring respiration: confusion or giddiness after waking. Give once in two or three hours. Bryonia.—Constipation, yellow-coated tongue ; hurri- ed, laborious, and anxious respiration; great thirst, de- lirium, sudden starts with cries. Rhus.—In the low protracted form of the disease, and also where there is headache, giddiness, and heaviness of the head; aching, pressing pain in the back of the head, with creeping sensation; drowsiness, convulsive movement of the limbs, and great restlessness at night. Dose.—Same as Belladonna. Give once in two or three hours. Arsenic—Particularly in the chronic variety, where there is debility, weak and irregular pulse, and marked intermission in the disease. Sulphur.—Particularly towards the termination of the disease; also where the appropriate remedy seems to have lost effect, in which case two or three doses may be given, and then return again to the original remedy. 2. CHRONIC HYDROCEPHALUS. This variety of the disease may be symptomatic of other diseases of the brain, as tubercles, &c. It is some- INFANTILE REMITTENT FEVER. 409 times the sequel of the acute form, in which case the symptoms subside in a great degree, but do not entirely disappear. It frequently sets in without any acute form. There is headache, drowsiness, and unequal temper. The intellect is generally clouded, and all the organs of sense more or less affected. There is a peculiar look to the eyes, sometimes squinting, and the pupils sometimes dilated. After effusion takes place, the intelligence is more or less affected, except in those cases, where the head rapidly enlarges, when for a time the intellect may be even brighter than usual. After a time the child retro- grades until it has the look of an idiot, forgetful, babbling words without meaning, until at last it sinks into indifference, stupor or coma. A striking feature of the disease is the enlargement of the head, which some- times reaches an enormous size. The face after a time seems to shrink, presenting an old and withered look. The limbs are feeble and the walk uncertain. Very often the child is attacked by general or partial con- vulsions, followed by paralysis, which may effect nearly all the organs of the body. The pulse gradually becomes weak, the respiration after a time fails, and the appetite at length diminishes. This disease may be developed during the progress of scarlatina, measles, small-pox, hooping cough, difficult dentition, &c. Treatment.—We can only mention here some of the prominent remedies. Among them we may notice Arse- nic, Hellebore, Mercury, Sulphur. For particular indi- cations, see acute Hydrocephalus. The appropriate remedy should be administered two or three times a day. INFANTILE REMITTENT FEVER. This is a variety of fever, to which children from one to ten or twelve years of age are liable to be affected. 18 410 DISEASES OF CHILDREN. It is characterized by one or more daily exacerbations and remissions, by pain in the belly and sometimes in the head, loss of appetite and by an unnatural state of the alvine discharges. It is very often, although erro- neously, attributed to worms, and sometimes called * worm f ever? The affection usually comes on gradually, manifesting itself generally by irregularities in the bowels, which are usually costive. In the course of the day there are several slight accessions of fever, marked by drowsiness, in the intervals appearing well, though peevish. The appetite is variable, and the pulse ranges from 100 to 130. These symptoms may continue for 8 or 10 days, when a violent paroxysm sets in, preceded by chilliness and attended with vomiting, the pulse rises in frequency, the drowsiness is increased, and the cheeks are flushed. There is picking of the nose, lips, and angles of the eyes. Cough may also be present, also grinding of the teeth, and startings in sleep. Digestion is deranged, and food taken into the stomach is brought up some time after, or is evacuated from the bowels apparently undigested, and resembling a mass of putrid animal and vegetable matter subjected to heat and moisture; sometimes worms appear in the discharges. The breath is sickly, appetite is gone, and delirium sometimes occurs for two or three days together. The causes of the disease may be traced in part to the use of improper food, neglect of the bowels, want of pure air, and cleanliness. Treatment.—Ipecac should commence the treatment, particularly if the attack has been occasioned by in- digestible food or eating too fast. There is heat, thirst; extreme restlessness; perspiration at night, foul tongue, quick breathing, nausea and vomiting. Dose.—A powder, or three globules; on the tongue once in three hours. Pulsatilla.—If Ipecac fail to produce relief after five INFANTILE REMITTENT FEVER. 411 or six doses, or there is fetid whitish or bilious diar- rhoea, accompanied with griping and distention of the bowels. Dose.—One drop or six globules, in a tumbler half full of water, a teaspoonful once in three or four hours. Nux-v.—Constipated bowels with frequent inclination to stool, or straining followed by watery motions, mixed with mucus or blood; peevish temper, loss of appetite, nausea, disgust at food, restlessness. Dose.—Same as Ipecac. Chamomilla.—Lethargic sleep, or restless and agitated with frequent jerks and starts of the limbs; head hot and heavy, skin hot, pulse quick, thirst, nausea and bilious vomiting; constipation or diarrhoea with greenish evacuations. Dose.—Same as Pulsatilla. Belladonna.—In alternation with Chamomilla, where there is considerable disturbance about the head; ten- derness of the bowels to the slightest pressure. Dose.—Same as Pulsatilla. Bryonia.—Constipation, sometimes alternating with diarrhoea, derangement of the stomach and painful state of the bowels; headache, thirst, and laborious respiration. Dose.—One drop, or six globules, in a tumbler half full of water, a teaspoonful once in four hours. Mercury.—Tenderness of the bowels, cloudy or milk- like urine; diarrhoea, with straining stools, mixed with slime or blood. Dose.—Same as Ipecac. Cina.—Picking at the nose and lips, starting and screaming during sleep, colic and diarrhoea. Dose.—Same as Bryonia. Sulphur.—After the employment of other remedies, to complete the cure. Dose.—A powder morning and night. Diet and Regimen.—Particular attention should be paid to the diet, which should be of a light farinaceous 412 DISEASES OF CHILDREN. character, such as toast, gruels, &c, carefully avoiding the more solid articles of food, such as meat and fish. INTESTINAL WORMS. It is very common to refer those little ailments which children are so liable to have, and for which no cause can readily be found, to worms, when in reality worms have nothing to do with difficulty. The presence of worms, is often looked upon as the cause of all the suffering. This is a mistake, for notwithstanding certain symptoms are coincident with their presence, yet these symptoms are usually a coincidence merely, or the result of an irritation, which gives rise to worms, or which disturbs them in their usual quiet. Worms often exist in the system, when no unpleasant symptoms are present. Worms may be developed in every part of the system, but they are more frequently found in the intestinal canal. Some of the prominent varieties we shall briefly notice. a. Ascaris lumbricoid.es, unusually occupy the small intestines, sometimes in great numbers, and occasionally accumulating in the form of a ball. They are usually from three to twelve inches long, occasionally find their way into the stomach, and may be discharged through the mouth or nostrils. b. Taenia, or tapeworm, is white, flat und very long, often twenty feet, and sometimes it is said even sixty or seventy feet in length. It is usually found in the small intestines, and is one of the worst variety of worms. c The long thread-worm is usually found in the upper portion of the large intestines. It is from an inch to two inches in length, the anterior portion of the body being slender like a hair, and the rest much thicker. d. Ascarides, or pin -worms, are very small, white, and slender, and are found in large numbers in the large INTESTINAL worms. 413 intestines, and especially in the rectum, from whence they may often be wiped away with a cloth. Diagnosis..—Preceding and accompanying the appear- ance of worms, are derangements of the stomach and bowels. There may be disgust of food; appetite some- times nearly gone, at others voracious, or each alternate- ly; hiccough; fetid breath, nausea and mucus or acid vomiting; belching of wind, umbilical colic, sometimes constipation, at others glairy or mucus diarrhoea. To these symptoms are added puffiness of the face, emaciation and weakness, tickling cough, headache, agitation, sleeplessness, dilated pupils, itching and picking of the nose, grinding of the teeth, creeping of the skin, and some fever. There may be more or less pain about the bowels, and swelling of the abdomen, and the urine is generally yellowish, or whitish, like milk and water. There is also, sometimes, bleeding at the nose, and convulsions. Some of the signs indicating the presence of tape- worm, are, sensation as if something were rising in the throat and falling back, or as if there were a lump in the side, making an undulatory motion. The signs indicating pin-worms are, violent itching in the anus, difficulty in making water, and if in the female, often leucorrhcea. Treatment.—This variety of disease occurs principally in infancy, and may give rise to an almost innumerable variety of symptoms. Particular attention should be directed to the general health. The food should be simple and easy of digestion, the whole body bathed every day, either with cold or tepid water, moderate exercise should be taken; and unventilated rooms and impure air carefully avoided. Aconite is particularly indicated in the commencement, where febrile symptoms are present, with restlessness at 414 DISEASES OF CHILDREN. night, and irritability of temper; and also where there is continued burning and itching at the anus. Dose.—One drop, or six globules in a tumbler half full of water, a teaspoonful during the presence of fever, once in two hours. Ignatia may follow Aconite after the febrile symptoms have subsided, especially if there are spasmodic twitch- ings in the muscles of the anus, or intense itching in the anus, indicating the presence of pin-worms. Dose.—Same as Aconite. Cina.—Boring at the nose, irritable temper, fits of crying when touched, restlessness, a desire for things which are rejected when offered; paleness of the face, with livid circle around the eyes; constant craving for food; colic pains and hardness of the bowels, constipation or diarrhoeic evacuations, great restlessness at night, tossing about, starting, talking or calling out suddenly during sleep; weakness of the limbs; occasional delirium; face at times pale and cold, at others red and hot; nausea and vomiting, prostration and occasionally convulsive movements in the limbs; itching in the anus, and crawl- ing out of pin-worms; urine white and turbid, sometimes passing involuntarily. Dose.—Prepare same as Aconite- Give once in six hours. Spigelia.—Especially where the symptoms recur at about the same time of the day; there may be colic, diarrhoea and craving for food, also fever. Dose.—Where the symptoms are violent, the same as Aconite. In chronic cases every night. Belladonna.—Great nervous excitement; delirium at night with starting during sleep, severe colic, headache and fever. Dose.—Same as Aconite, with which, if much fever be present, it may by alternated. Silicea may follow Belladonna, if the patient is of tuberculous habit, and that remedy fails to produce effect. It may also be given where the disease assumes a slow chronic form. DIARRHC3A. 415 Dose.—A powder, or dry globules, morning and night. Mercury.—Diarrhoea, distension of the bowels, and increased secretion of saliva. Dose.—A powder, or three globules, morning and night. Nux v.—Derangement of the stomach, with constipa- tion, nausea, and painful sensibility of the stomach and bowels. Dose.—Same as Mercury. Ch ina.—Long-continued diarrhoea, distension and pain- ful sensation of the abdomen and stomach; debility, great nervous excitability with spasmodic twitching of the muscles. Dose.—The drops, in a tumbler half full of water, a teaspoonful morning and night. Sulphur.—After the prominent symptoms have sub- sided, to complete the cure. Dose.—A powder, or three globules, every night. Diet and Regimen.—Fruits and vegetables should be prohibited, as well as pastry and sweetmeats. The diet should consist principally of meat broths, except in acute cases, when it should be the same as in fevers. DIA RRHCEA. Summer Complaint, Children are very liable to derangement of the sto- mach and bowels, especially during teething, and the warm weather of summer. Particular attention should be given to the food. Vegetables and uncooked fruit should be prohibited. Daily bathing, fresh air, and if residing in the city, a trip into the country are advisable. Ipecac, should be given where there is nausea, vomit- ing, no appetite ; fermented stools, mixed with mucus, sometimes tinged with blood; cutting pain in the bowels and sometimes straining. Bryonia.—Especially during hot weather, and where there is thirst, putrid smell of the stools, and nausea after eating. 416 DISEASES OF CHILDREN. Chamomilla.—Where there is great restlessness, green- ish diarrhoea, and more or less rumbling or cutting pain in the bowels. Veratrum will generally arrest diarrhoea of a watery character. Stibium.—Nausea, offensive stools, gagging and great prostration. Dulcamara.—Diarrhoea, the result of cold. Mercury.—Straining, like dysentery, with colic, and bloody or slimy discharges. Sulphur. —In obstinate cases. Give a powder morning and evening. For indications of other remedies, see Cholera infan- tum. Dose.—One drop, or six globules, in a tumbler half full of water , in severe cases, a teaspoonful once in two or three hours; when the symptoms are less violent every four or six hours. CHOLERA INFANTUM. This disease is confined to infants, generally between the age of four and twenty months, and occurs mostly during the summer months. The attack is sometimes preceded by diarrhoea, but in most cases the vomiting and purging commence together, and are attended with great prostration; sometimes there are premonitory symptoms, such as languor, fretfulness, loss of appetite, or craving for food. At first the dis- charge from the bowels usually consists of a turbid frothy fluid, mixed with portions of green bile, or of a nearly colorless water containing small flocculi of mucus, but after the disease is fully developed, it loses all trace of bilious matter. In some cases the disease proceeds with such violence as to terminate in death in a single day, but usually the vomiting and purging, though vio- lent are not so rapid as to prostrate the system imme- diately. Sometimes the vomiting after four or five hours, gradually ceases, while the diarrhoea goes on untiJ CHOLERA INFANTUM. 417 it assumes a chronic character. In the early stage of the disease, there is a peculiarly distressing sensation in the stomach and bowels, and where the discharges are violent and frequent, there may be cramps or spasms in the muscles of the abdomen and extremities. If the disease continues even for a few days, rapid emaciation ensues, the countenance becomes pale and contracted, the eyes sunk, the nose sharp, and the lip>s thin, dry, and wrinkled. The thirst is great, but the cold water so much desired, is thrown up almost as soon as swallowed. At length, if the disease is not checked, the patient becomes somnolent, sleeps with its eyes half open, rolls its head about when awake, and at last sinks into insensibility and coma, and dies in convulsions, or under symptoms resembling acute hydrocephalus. If the disease is of long duration, the discharges at length become offensive and acrid, and food passes undigested through the bowels. Aphthaa appears on the tongue, and inside of the cheeks, and the face has a bloated ap- pearance. Treatment.—The treatment should be prompt and ac- tive, as the delay of a few hours will often allow the disease to gain such headway as to bid defiance to all efforts at control. Ipecac, should be given at the commencement of the disease in alternation with Veratrum. Its indications are nausea, vomiting; diarrhoea of fermented stools, or watery diarrhoea with white flocks; great thirst. Veratrum is indicated by the great exhaustion, violent vomiting and diarrhoea; vomiting produced by the slightest movement, or even taking cold water, for which there is great desire; sensitiveness over the pit of the stomach and sometimes cramps. Dose.—Veratrum, in alternation with Ipecac, or following thai remedy, will usually be sufficient to arrest the violent symptoms. Mix two drops, or twelve globules, in a tumbler half full of water, 18* 418 DISEASES OF CHILDREN. and give a teaspoonful in alternation, ten or fifteen minutes apart, in- creasing the intervals and as the symptoms abate. Arsenic.—If there are cold extremities; nausea and vomiting; great prostration, thirst and offensive diar- rhoea. Dose —A powder, or three globules, once in two hours. For other remedies indicated during the progress of the disease, see Hydrocephalus, page 387, also Diarrhoea, page 229 and 394. Diet and Regime x.—The food should consist mostly of gruels. Cold water may be given a little at a time. CROUP. The approach of this terrible disease fills the mother's heart with alarm, for she has learned to dread its fearful ravages, and to rightly look upon it as the scourge of infancy. The ringing, brassy cough, which characterizes the disease, is so peculiar, that once heard it is never forgotten. It generally attacks children between the age of one and five years, although it sometimes occurs at a later period, or even when the child is not more than four or five months old. It consists of an inflammation of the mucous membrane of the larynx or windpipe, the inflamed surface secreting a kind of thick lymph, which narrows the passage for the admission of air, and at length a false membrane may he formed, which al- most or entirely chokes up the passage, causing the child to die from suffocation. Our object in the treatment, is of course to remove this secretion, which is filling the windpipe and choking the child, by dissolving it, or causing it to be thrown up, at the same time breaking up the inflamed state of the organ, thereby checking its diseased secretions. Diagnosis.—Preceding an attack of croup, there is gene- rally more or less fever, cough, huskiness of voice, and other catarrhal symptoms. These symptoms may only croup. 419 last a few hours, and do not usually continue longer than twenty-four hours. These symptoms increase towards evening, or the attack may come on without any pre- monitory symptoms, the child suddenly awakes out of a sound sleep by a sensation of suffocation, with a hoarse, ringing cough, hurried respiration and great distress. The cough resembles slightly the crowing of a cock, or the bark of a dog; it has a peculiar ringing or brassy sound, like air passing through a brazen instrument. The paroxysms of coughing become more frequent and spasmodic, until breathing is almost suspended. It is with great difficulty the child can breathe, and its flushed face, sometimes bedewed with sweat, its clenched hands, arms tossing about, removing all covering from the chest, and its look of intense agony, show the violence of its struggles for breath. The pulse is quick, the skin hot, the face livid and swollen, the eyes injected and almost seeming to start from their sockets, the child restless, and tossing from side to side, in the vain hope of obtaining relief by a change of position. There may be a partial remission of symptoms during the day, returning again at night with renewed violence. All the symptoms are now fearfully aggravated. The voice is whispering and almost suppressed, the respira- tion extremely difficult and accompanied with a hissing noise. The convulsive struggles for breath are fearful, the head is thrown back, the face livid, cold sweat-drops stand on the forehead, respiration becomes more and more difficult, until at length with signs of convulsive suffocation, or falling into a state of stupor, it dies. The mother who has watched with bitter agony the fearful struggles of her child, breathes a sigh of relief as the last breath is drawn, and as the look of anguish changes to the sweet calm of death, she knows that suffering is over, and her little one is at rest. The above is a description of the more severe attacks 420 DISEASES OF CHILDREN. of croup, but they are often of a lighter character, There is a kind of croupy cough, which is sometimes mistaken for croup, and unnecessarily alarms the friends, as it is unattended with immediate danger, but if not cured may end in inflammation of the lungs. In real croup, as we have before said, the child is almost always attacked at night, is aroused from its sleep by violent spasmodic cough, is restless, and shows unmistakable signs of suffering; in a few moments however, it may again drop to sleep. In croupy cough the breathing may be labored, and the voice husky, but the child shows no indication of suffering, and the cough seldom fairly arouses it from sleep. As we have before said, there may be a slight remission of symptoms during the day, but even in the milder forms of croup, care should be taken not to expose the patient for three or four days, as the attacks are liable to return. Treatment.—If premonitory symptoms are present, such as slight fever, hoarse cough, &c, Aconite and Spongia should be alternated one hour apart. If how- ever in the evening the symptoms assume the distinct form of croup, or the attack commences suddenly with the barking, ringing, or suffocative cough, about as much crude Tartar Em-tic (Stibium) as can be placed on a five cent piece should be mixed with a tumbler of water, and a teaspoonful given in alternation with Spongia ten or fifteen minutes apart until relieved. A warm bath at the same time would be beneficial, or the appli- cation of cloths to the neck, wrung out in cold water and covered with dry flannel. After the violence of the paroxysm has subsided, and the cough is less ringing but of a more moist or loose character, Spongia and Hpar-s. may be alternated one hour apart. If at night the violent paroxysm should return, the same treatment should be repeated. Iodine is a valuable remedy in almost all stages of croup. 421 croup, and will often produce a decided effect, when other remedies fail. When the remedies enumerated above seem still indicated, but fail to produce the de- sired effect, one drop of the first dilution of Iodine may be given every half hour, until four or five doses have been taken. At length the disease, if unchecked, becomes very violent, and there are plain indications of the formation of the false membrane. The countenance wears a look of intense agony, and the breathing and cough are almost suffocative. It is evident, that unless speedy relief is obtained, death will soon close the scene. Bi-chromate of Potash and Bromine are here the prominent remedies. Caustic Ammonia.—When the voice is deep and weak, speech fatiguing and interrupted, great secretion of mucus in the bronchia, violent cough, with copious ex- pectoration, especially after drinking; rattling, labored, or stertorous breathing; suffocative fits and spasms in the chest. Bromine.—Hoarse, wheezing and fatiguing cough, sometimes with sneezing and suffocative fits; respiration accompanied with mucous rattling; wheezing; breathing slow and suffocative, or hurried and superficial, labored, painful, oppressed; gasping for air, and strong indica- tions of suffocation. Bi-chromate ef Potash.—This is an invaluable remedy in cases of membranous croup. Hoarse, dry and crowing or whistling cough; respiration accompanied with a whistling sound; the nose filled with mucus; evident signs of pain about the throat; great restlessness of the child; cough gradually subsides, breathing becomes more and more difficult, and the spasmodic efforts for breath, the tossing about from side to side, the look of intense agony, the flushed face and starting eyes, the nose and sometimes the mouth filled with mucus, all give clear indication of the rapid formation of the false 422 DISEASES OF CHILDREN. membrane, and unless relief be obtained, the certainty of speedy death. Hepar-s. and Spongia will generally complete the cure, with the addition, perhaps, if much soreness is pre- sent, of Phosphorus. Dose.—Bi-chromate should be given a powder of the first tritura- tion once in fifteen or twenty minutes. If Bromine is given, a drop should be put in a tumbler filled with water, and if the mixture seems too strong, a portion of it may be thrown away. The tumbler may be then filled up and a teaspoonful given once in twenty minutes or half an hour. With the other remedies where the amount of the dose has not already been given, two drops of the tinc- ture should be mixed with a tumbler half full of water and a teaspoonful given at a dose; or a powder taken dry on the tongue. Diet and Regimen.—During the attack, the diet should consist of arrow-root, or gruels, or perhaps milk and water. Cold water may also be taken, if much thirst is present. HOOPING COUGH. PERTUSSIS. This is an epidemic and contagious disease, mostly confined to early childhood, and seldom occurs but once in the same person. It is probably most easily commu- nicated in the second stage. There are two distinct stages, the catarrhal and spasmodic stage. The first stage commences with the symptoms of an ordinary catarrh or cold. There is watery discharge from the nose and eyes, sneezing, coughing, languor restlessness, and febrile symptoms. Sometimes however the fever is severe and the cough very painful, at first dry,but afterwards with profuse expectoration; and some- times, but very rarely, the catarrhal symptoms are en- tirely wanting. HOOPING COUGH. PERTUSSIS. 423 This stage may last only a few days, and rarely con- tinues more than two weeks. As the catarrhal symptoms subside, the second or the nervous, spasmodic, or convulsive stage commences, in which the characteristic symptoms of the disease pre- sent themselves. The cough occurs in paroxysms, is very violent, and consists of a series of forced and quick expirations in such quick successions, that the patient seems almost in danger of suffocation. The face and neck are swollen and livid, the eyes protruded and full of tears; at length one or two inspirations are made with similar violence, which produce that peculiar sound, compared to a wlioop, from which the disease takes its name. The paroxysms, or a rapid succession of them, usually last from one to fifteen minutes, and generally terminate in a profuse expectoration of ropy mucus or vomiting. The child is conscious when the attack is about to commence, and flies to some object for support, until it has subsided. The paroxysms may occur in rapid succession, not more than ten or fifteen minutes apart, or there may not be more than five or six during the twenty-four hours. As the disease declines, the paroxysms gradually decrease in frequency and violence, until they entirely cease. This second stage may last only two or three weeks, or it may continue five or six months. The first stage of hooping cough is, as we have al- ready seen, characterized by symptoms of an ordinary catarrh, and appearance and duration of the peculiar cough and whoop mark the period of the second stage. Simple hooping cough is seldom attended with danger, but when it becomes complicated with some other dif- ficulty, the danger may be imminent. Let us briefly glance at some of these complications. 1. Complicated with. Br one!litis and Pneumonia.— The presence of bronchitis or pneumonia may be indi- \ £24 DISEASES OF CHILDREN. cated in the first stage by an incessant cough, painful and difficult breathing and high fever. In the second stage there will be a return of fever, which will con- tinue during the intervals of the paroxysms of coughing and be accompanied with hurried and difficult respi- ration. The prominent symptoms indicating a compli- cation of these affections, are a greater amount of fever than usual, and the respiration quick, hurried and diffi- cult. The expectoration is also more difficult, the sputa being less profuse and of a puriform appearance. In violent cases the cough may lose entirely its spasmodic character, and exhibit only the cough of bronchitis or pneumonia. 2. Complicated with Infantile Remittent.—A disorder- ed condition of the bowels may occur, marked by un- healthy discharges, loss of appetite and foul tongue. If these symptoms are allowed to continue for some time, the infantile remittent may make its appearance, some- times commencing with a rigor, but usually conaing on gradually. The paroxysms of coughing are more fre- quent, and the breathing quick, hurried and unequal. Fever has distinct remissions in the morning and in- creases toward evening. 3. Complicated with congestion of the Brain, Convul- sions or Hydrocephalus.—These complications occur chiefly in infancy about the period of the first dentition, and may generally be anticipated before they are fully developed. We should fear their occurrence, where the cough is of great severity, and the face remains livid for a considerable length of time. The first symptoms may be sleepiness and heaviness after the fits of coughing, or spasmodic twitchings of the face or extremities, or perhaps the first indications that the brain is affected, may be coma or a fit of convulsions. These complica- tions occurring at any time, are exceedingly dangerous, HOOPING COUGH. PERTUSSIS. 425 but more especially so during the period of the first dentition. Treatment.—The treatment of the first stage should be the same as that indicated by an ordinary catarrh or cold. Aconite may be given on the first appearance of the febrile symptoms. Belladonna may be given, if the cough is worse at night, and if there is headache and sore throat. It is particularly useful both in the first and second stage, where symptoms of congestion to the head are present. Dose.—One drop, or ten globules, in a tumbler half full of water, a teaspoonful once in two or three hours. Stibium or Ipecac, will be indicated, particularly in the commencement of the disease, where there is sneez- ing, watery discharge from the eyes and nose, pain on the forehead over the eyes, dry, hard or suffocative cough. Dose.—A powder once in two or three hours. If there is severe pain about the head, soreness of the throat, Belladonna may be given in alternation. Dulcamara, where the attack has been brought on by cold, and is attended with hoarseness, the cough is loose, and the expectoration copious. Dose. —One drop, or twelve globules, in a tumbler half full of water, a teaspoonful once in two or three hours. Nux-v.—Dry cough accompanied with vomiting, agi- tation and sometimes bleeding at the nose; especially where it is more violent after midnight. Dose.—A powder, or three globules, once in three hours. Mercurius.—Hoarseness, watery discharge from the nose, with soreness of the nostrils: dry, fatiguing cough. generally occurring in two successive fits, bleeding from the nose, and vomiting. Dose.—A powder, or three globules, once in two hours. Pulsatilla,—Loose cough with watery discharge from the eyes, thick discharge from the nose, hoarseness and 426 DISEASES OF CHILDREN. inclination to vomit after coughing, occasional diarrhoea, Dose.—Same as Dulcamara. Chamomilla.—Paroxysms of coughing, excited by an irritation in the windpipe and upper part of the chest. Dose.—Same as Dulcamara. Bryonia or Phosphorus.—Either separately or in al- ternation, and sometimes also with Ipceic or Stibium will be indicated, where there are symptoms of a com- plication of bronchitis or pneumonia. Dose.—They may be given once in two hours. After the disease passes into the second or spasmodic stage, the prominent remedies are Hydrocianic-acid, Veratrum, Drosera, and Cuprum. Hydrocianic-acid.—Violent concussive cough, with rattling of mucus, suffocating respiration, and sometimes ejection of blood from the nose and mouth. Dose.—Two drops of the first dilution, in eight tablespoonsful of water, a teaspoonful once in three hours. Veratrum may be given if the violence of the par- oxysms continues unabated, and especially if there is great weakness, fever, and cold perspiration, and also when during the paroxysms there are pains in the chest and abdomen, involuntary emission of urine, and vomiting. Dose.—Same as Hyd.-acid. Drosera.—Especially in violent cases, with loud and hoarse cough, and where there is no fever, or the febrile symptoms are strongly marked, with shuddering and heat, aggravation of symptoms during repose ; and also where there is vomiting of food or slimy water. Dose.—One drop, or six globules, in a tumbler half full of water, a teaspoonful once in two or three hours. It may also be followed by Veratrum. Cuprum.—When during the paroxysm there is rigidity of the body, with suspended respiration, and loss of consciousness; vomiting after the paroxysm, and rattling of mucus in the chest, when not coughing. Dose.—A powder, or three globules, once in one or two hours. Ca 1-v.—Particularly where the attack threatens to proceed into the second stage, or where from the first ASTHMA OF CHILDREN. 427 the cough is of a convulsive kind, appearing especially in the evening, attended with sore throat and shooting pain in the head and chest. Cina is especially indicated, when, in addition to the usual characteristics of the disease, worm symptoms are present. Iodine will be of benefit, where the cough is excited by a constant tickling in the bronchia, with excessive anguish before the fits, and undulating respiration during the attack. Where there is danger of convulsions, or congestion to the brain, Hellebore, Belladonna, and Hyosciamus are the prominent remedies. Consult Convulsions and Hy- drocephalus. Where there are symptoms of Remittent fever, consult Infantile Remittent. And should the dis- ease become complicated with bronchitis or pneumonia. Consult Cough and also Bronchitis and Pneumonia. General Directions.—The frequency of the repetition of the medicines must be guided in a measure by the severity of the symptoms. Where they are violent, the remedy may be given as heretofore directed, but in the decline of the disease, and where the attack is light, a dose morning, noon, and night will be sufficient. Diet and Regimen.—The rooms should be freely ven- tilated, taking care, however, that the child does not take cold. After the severity of the symptoms are over, but the disease still continues for a long time, a change of air will often prove highly benefic al. If no fever is present, there need be no change of diet, but if more or less fever attends the disease, the diet should consist of arrow-root, gruels, &c. ASTHMA OF CHILDREN. Asthma of Millar. This disease is sometimes called Spasmodic Croup or False Croup. It consist of spasms of the glottis and 128 DISEASES OF CHILDREN. windpipe, and occurs during the night. It commences with a spasmodic inspiration, accompanied with a crow- ing noise ; if the fit continues, the face and extremities become purple, and there may be also spasmodic con- striction of the muscles of the extremities. Ipecac should be given immediately, especially if the attack has been occasioned by indigestible food, and where there are spasmodic constriction and symptoms of suffocation, and rattling in the chest, with anxious respiration, cramps, or rigidity of the frame. Dose.—One drop in a tumbler half full of water, a teaspoonful at a dose ; or a powder, or three globules on the tongue, given every ten or fifteen minutes. Sambucus should follow, or be alternated with Ipecac^ if there is ineffectual inclination to sleep, with oppressed respiration, and wheezing, convulsive efforts for breath, livid hue of the face and agonizing tossings. Dose.—Same as Ipecac. Arsenic may be given where there is great prostration of strength, anguish, and cold perspiration. If these remedies fail, Cuprum or Belladonna may be indicated, VACCINATION. This homcepathic preventive to small-pox has been the means of saving thousands from the ravages of one of the most loathsome plagues which ever desolated the earth. Formerly whole neighborhoods were depopulated by the small-pox, and its presence was sufficient to cause friends and neighbors to fly in terror from its poisonous breath. But now, protected by the homoeopathic pre- ventive of cow-pox, its presence creates but little terror, as we know that we possess a power to prevent its further progress. The best time to vaccinate is between the third month and the twelfth, although where the small- pox is present in the neighborhood, vaccination may take place at an earlier period. The best time is in the VACCINATION. 429 fall, spring or winter, as in the heat of summer the arm is liable to become very sore. Usually no treatment is required, as the pustule pursues a regular course, and at a certain time the scab drops off. It is of vast importance, that the pus used in vaccina- tion should be taken from the cow, or from a perfectly healthy child. Unless this precaution is adopted, disease may be transmitted through vaccination from one child to another. 430 EXTERNAL INJURIES. CHAPTER XIII. EXTERNAL INJURIES. Of the numerous accidents which are liable to happen every day, some are trifling in their character, and others, unless promptly relieved, are capable of producing severe suffering and sometimes death. It is well to know what to do in these cases, until the aid of a physician can be obtained, as from want of proper knowledge and in the excitement and confusion of the moment, steps are often taken productive of far more harm than good. We shall first notice BURNS AND SCALDS. These may be slight and unattended with danger, or they may involve a large surface and endanger life. For a superficial burn or scald, the part should be held as near the fire as possible; this, although it may at first increase the pain, in a short time produces entire relief. Where the skin is destroyed, or where the burn is exten- sive, though not deep, turpentine, alcohol, brandy or rum, warmed, should be applied. The burn should be con- stantly moistened with the spirits as long as the pain is aggravated. In these cases also raw cotton if applied im- mediately, is beneficial. In deep and severe burns, as well as those more super- ficial, soap is a very valuable remedy. Castile soap should be taken, scraped, and made into a salve with tepid water, and this spread on linen or muslin applied over the whole burn or scald. If blisters have formed, they should be punctured with a needle. The dressing may be changed, if necessary, once in twenty-four hours, being careful not to disturb the parts by washing them. FROZEN LIMBS.--SPRAINS. 431 The application should be continued, until the parts are well. Another very excellent application, especially where the soap is too irritating, is a linament composed of equal parts of sweet-oil and lime-water. It should be applied in the same way as the soap. Another application in extensive burns, is wheat flour dusted plentifully oyer the injured part. The parts should be kept covered with the flour, by new applications, if necessary. Urtica TJrens, or the tincture of nettles, is a very valuable application for fresh burns. The tincture may be mixed with an equal amount of tepid water and the parts kept constantly moist by means of rags, wet with the mixture. Six or eight drops of the tincture of cantharides, mixed with a tumbler half full of water, may also be used, applied in the same way as the Urtica TJrens. For burns in the mouth and throat, caused by steam or hot food, a few drops of spirits of soap, or of soap dissolved in alcohol, taken once in fifteen or twenty minutes, will produce relief. In dressing burns, the blisters should be punctured, the old skin removed and yet the parts exposed to the action of the air as little as possible. If much fever is present, Aconite may be given in- ternally once in three or four hours. If the nervous system is highly excited, Rhus may be taken, and if head symptoms should be developed, Belladonna. FROZEN LIMBS. For the treatment in cases of frozen limbs, see "chil- Hains" and " apparent death from cold." SPRAINS. Apply cloths wet with cold water, or a mixture, compos- ed of equal parts of Arnica and water. Keep the parts 4:32 external injuries. constantly wet. In persons on whom Arnica produces erysipelatous inflammation, or when the skin is broken and the part considerably bruised, Calendula may be applied. Where there are stiffness and lameness, par- ticularly after a strain, Bryonia or Rlius may be taken internally, a dose three or four times a day. The treat- ment I have given for sprains, is also that, which will prove most beneficial for bruises. CONCUSSIONS. A heavy blow or a fall may so jar the system as to produce disturbance in the brain and nervous system, and through them affect other organs. In these cases the appropriate remedies are Arnica and Belladonna. Arnica should be given, where some part of the body may have been bruised by a fall or blow, and Bella- donna, where there are indications of cerebral disturbance, such as convulsions, giddiness, or pain in the head, and stupor. A dose should be taken, where the symptoms are violent, every hour, increasing the intervals, as they subside to three or four hours. DISLOCATIONS. The severe pain and the appearance of the joint are suffi- cient indications of dislocation. To reduce the luxation without injury to the surrounding parts, a knowledge of the joint and the muscles is necessary, so that it is gene- rail)7 best, to obtain the assistance of a physician or surgeon. In the mean time external applications may be made of cold water or the tincture of Arnica. FRACTURES. There are several varieties of fractures. What is called a simple fracture, is a mere fracture of the bone, unattend- ed by contusions. In a compound fracture there is an external wound or a protruded bone. The presence of fracture can very readily be detected by the peculiar wounds. 433 crepitous or grating sound heard on moving the parts- There is also more or less pain and swelling present. In setting the bones the fractured parts are placed together, so that, when united, the limb shall be as nearly as possible as it was, before the bone was broken. While the union or knitting together of the bone is going on, the limb should be kept perfectly still. This is done by means of long splints and bandages, the bandages not applied very tightly, or they may prevent the free circulation of the blood. Both before and after the limb is set, if much swelling and heat are present, cold water or Arnica should be applied, the cloths which cover the part being kept constantly wet. Where there is much laceration of the parts, Calendula should be applied. It would be impossible and in fact unnecessary, to go into the minutia of the treatment of fractures here, as every one will see the importance of calling in the aid of the experienced surgeon. WOUNDS. Simple incisive wounds will usually heal by the first intention, that is, the incised parts on being brought together unite directly without suppuration, without much if any functional disturbance; but punctured, lacerated, or gunshot wounds generally suppurate5> new granulations forming, thus healing by the second inten tion, and when they are deep and extensive, give rise to considerable fever. Thus punctured wounds in any part of the body, sometimes made by the thrust of a sword, bayonet or knife, or in the foot by treading on a nail, are often exceedingly painful, and not unfrequently give rise to lockjaw. In gunshot and lacerated wounds the surrounding parts are often seriously injured, and the pain and fever which accompany them severe. In the punctured, lacerated or gunshot wound, and sometimes where the parts are very much contused, for want of 19 434 external injuries proper reaction in the system, mortification may take place. Our object of course in the treatment of all wounds is to heal them up quickly and prevent as much functional disturbance as possible. Incised wounds bleed freely, but lacerated or gunshot wounds seldom cause much haamorrhage, even though large blood-vessels are in- jured. In all wounds the parts should be carefully examined, to see that there are no foreign substances present, such as glass or dirt. The wound should be washed with cold water and any foreign substance which is not removed by this process carefully extracted. Steps should be taken to control the haemorrhage. This can often be done by pressing the parts together with the fingers, bathing them with cold water, with which may be mixed a little Arnica, or Kreasote may be placed on the bleeding parts. If, however, one of the arteries is severed, which may be known by the bright red blood spouting out in jets at every pulsation of the heart, and the bleed- ing cannot be controlled in the way indicated above, the current should be shut off by compressing the artery above the wound. The location of the artery can gene- rally be ascertained by pressing with the fingers on the inside o' the limb, when the beat may be felt beneath the fir.gers. Over this spot place a piece of cork, or a pebl ie stone, binding around the limb over the cork or pebble, a handkerchief. Now by introducing a small f tick under the handkerchief, and twisting it round, a very good tourniquet is formed, the pebble or cork is pressed against the artery, compressing its walls and checking the current of blood. Where the wound is below the knee the above application should be made in the hollow on the inside of the leg and the bend of the knee, and where it occurs in the arm below the elbow, the compression should be at the elbow. Of course a wounds. 435 surgeon should be obtained as speedily as possible. In the cut wound, as we have before said, if the parts are brought closely together and kept in that position they will heal in a short time. This may be done, where the wounds are deep and long, by taking two or three stitches with a needle and thread, thus drawing and holding the parts together. As a general thing however all that will be required, will be the application of adhesive plaster. This should be cut in long narrow strips, so as to extend well on either side; these strips, first warmed by the fire, should pass directly over the wound from side to side, drawing the lips closely together. A small space may be left between each strip, where it crosses the wound, to permit the escape of pus, should suppuration take place. Externally the only application necessary will be Arnica or cold water. In lacerated or contused wounds the parts may be elosed in a similar manner, bathing the parts freely with Calendula, and afterward, if much heat and swelling is present, applying cold water. In deep wounds, particu- larly in punctured, or gunshot wounds, great care should be taken, that the healing process should commence at the bottom. If the edges are brought together the wound may heal on the surface, while no union has taken place below. To prevent this, lint should be introduced into the wound, keeping the upper portion open while the healing process is going on at the bottom. This lint should be removed daily, and the parts washed with tepid water. If considerable fever should set in, Aconite should be given once in three or four hours. If the parts are swollen and exceedingly painful, Belladonna may be given at the same intervals. Where the suppuration seems unhealthy, a powder of Ilepar-s. may be taken in the morning, and of Silicea at night. 436 EXTERNAL INJURIES. POISONED WOUNDS. Stings of Insects, and Bites of Serpents. The sting of the bee, mosquito and other insects is often attended with considerable swelling and pain. Where attacked by bees, the better plan is not to fight them with the hands, but to cover the face by lying on the ground, face downwards, and remaining perfectly quiet. The sting of the bee, mosquito, spider, and most poi- sonous insects will be relieved by bathing the parts with spirits of Ammonia or Hartshorn, or black garden mould may be placed over the swollen parts, renewing the application, when the pain increases. For the sting of the bee in the mouth or eye, honey may be applied. Smoke, tobacco smoke, burning brown sugar on coals, will usually drive off musquitoes. In addition to the remedies, mentioned above, the parts may be held near the fire. Bites of poisonous serpents not unfrequently produce speedy death, and even where death is not the result, the victim always suffers intense pain. No time is to be lost, as the poison is speedily transmitted to other parts of the system. Dry heat should be applied, by means of a coal of fire, a hot iron, or even the stump of a segar. Great care should be taken that the heat should be steady and continuous The heated substance should be held as near the wound as possible without burning it, and continued until a stretching or shivering sensation is experienced. Where no fire can be obtained, a band may by drawn tightly above the wound, or the poison may be sucked out. Oil, soap, or saliva may be applied around the wound. A little salt and water, gun-powder or garlic may be taken into the mouth from time to time. If there are severe shooting pains, nausea, Arsenic may be given once in fifteen or twenty minutes, followed, if relief is not obtained, by Belladonna, POISONS AND THEIR ANTIDOTES. CHAPTER XIV. POISONS AND THEIR ANTIDOTES. It is an interesting fact, that if poisons are taken at first in minute quantities, the amount can be gradually increased, until at length, after years, the system becomes so far accustomed to them, that they may be taken in enormous doses without producing their peculiar poi- sonous effects, although not without injurious results. During a certain period, in Grecian and Roman history, a knowledge of poisons was considered an essential feature in the education of the nobility and diplomatists, and never was poisoning reduced to such a science as then. The apparently friendly grasp of the hand might communicate through the imperceptible prick of a signet ring, a poison so quick and subtle as speedily to destroy life; and the lady reclining on her couch in her luxu- riant boudoir might inhale in the rich perfume of flowers a poison which would infuse through the system a dreamy languor, but gradually lock up the senses in the sleep of death. So skilfully were the poisons prepared that they would leave no trace of their work, save death. Death was there, but the knife of the anatomist could not reveal the cause. Thus thousands perished in every grade of society, and the souls of kings and nobles were deeply stained with murder. To the criminal condemned to die was presented the poisoned chalice. Thus poison was compelled to do alike the work of justice and of vengeance. It is narrated of one of the kings that to guard him against the effect of poisons, they were administered to him in small quantities in infancy, and as he advanced in years he almost daily used some kind of poison. But he at length experienced reverses and wished to end his 438 POISONS AND THEIR ANTIDOTES. life r)y suicide, but the unhappy monarch found that he was proof even against the most subtle poisons. To him they would not bring death. But our object here is not to examine these subtlo poisons, but to ascertain how fatal effects may be pre- sented, when some of the common poisons have been taken, either from accident or design. Where poison has been taken into the stomach, we should endeavor to remove it if possible by means of vomiting or the stomach-pump. If this cannot be done, we should administer some remedy, which will destroy or neutralize the action of the poison. Vomiting can generally be produced by drinking a large quantity of tepid water, by introducing the finger into the throat, or tickling the throat with a feather; by placing snuff or mustard mixed with salt on the tongue, or by injecting, by means of a tobacco-pipe, tobac- co-smoke into the anus. In some cases Ipecac, Tartar- emetic, or Sulphate of Zinc may be administered. Guided by the effect which poisons are known to pro- duce on the system, we may arrange them into three distinct classes. 1. The Irritants, or those which corrode or inflame the parts. These may act as escharotics, destroying the parts, or as violent irritants, producing inflammation, which will speedily end in mortification or gangrene. These include the mineral, animal, and a portion of the vegetable poisons. 2. The Narcotics, producing delirium or coma. 3. The Narcotico-acrid, producing sometimes an irri- tating, and sometimes a narcotic effect. 1. The Irritants.—Iodine and Ilydriodate of Potash. —Where poisonous effects are produced by either of these drugs, starch, or wheat flour should be given mixed with water. After the poisonous effects have subsided POISONS AND THEIR ANTIDOTES. 439 the remaining symptoms may be removed by a few doses of Ilepar-s., or Belladonna, Muriatic, Nitric, or Sulphuric-acid.—If nothing else is at hand, drink freely of water, which will dilate the acid, and thus destroy its corrosive, but not its irritating properties. Give immediately, if possible, carbonate of magnesia, chedk, lime-stone, old mortar, or even plaster scraped from the wall; or soap-suds, or wood-ashes mixed with water. If these are not at hand, Saleratus or Car- bonate of Soda may be given. For the after treatment, consult the chapter under which the affections caused by these poisons may be found. Oxalic-acid.—The action of this poison is exceedingly rapid, and no time should be lost in administering chalk or Carbonate of Magnesia. When these are not at hand, Lime, Carbonate of Soda, or Saleratus maybe given. Arsenic—Vomiting should be induced of possible. Soap-suds, the white of eggs or, the Jiydrated peroxide of iron, should be given immediately, repeating the anti- dote after vomiting. The latter remedy has been found to act almost as a complete antidote, when taken in time. Corrosive Sublimate.—This form of mercury acts as a most powerful poison, and from the fact that it is fre- quently used in household-duties, it is very often taken by mistake. The whites of eggs should be mixed with cold water, and given every two or three minutes, so long as the matter vomited contains a white opaque material, admixed, but when the substance vomited be- comes transparent, no more should be given, as it will not only be useless but may prove injurious. Where white of eggs can not be obtained, soap and water, mixed with wheat flour, should be given plentifully. Emetics should be avoided. Copper.—Poisoning from the metal generally arises from allowing the acetate of copper, better known as verdigris, to form on cooking utensils. The white of 440 POISONS AND THEIR ANTIDOTES. eggs, or sugar, should be given, and vomiting induced. Carbonate of Soda should be administered without delay. Lead. —Poisoning by lead is very common both from lead paint, and the use of water which has been in con- tact for some length of time with lead pipe. Cases of sickness are constantly occurring in this city, which might be traced to drinking water which had been for some time in contact with lead pipe, which is now so extensively used in the connection with the croton-water. Where the smell of paint is very strong in a house, water should be kept standing in some part of the room. The decidedly poisonous effects which we wish to anti- dote, are generally obtained by taking, through mistake sugar of lead. Vomiting should be induced immediately, and diluted Sulphuric-acid given. If this is not at hand give Epsom-salts or Glauber-salts. Nitrate of Silver, Lunar Caustic—Give common salt, in water, afterward mucilaginous drinks. Antimony.—Poisonous effects are sometimes produced by Antimonial Wine, or Tartar-emetic A decoction of Nut-galls, Oak-bark, Strong Coffee, or Green Tea should be given. Tin.—Sour food allowed to remain for some time in tin-vessels, may occasion poisoning. Give the white of eggs, sugar, or milk. Nitre. Saltpetre.—Produce vomiting by tepid water, afterwards give copious draughts of mucilaginous drinks, such as gum-water, flaxseed-tea, &c. Cantharides.—Spanish flies. The best antidotes, to be used both inwardly, and applied externally, are white of eggs, and tepid, slimy substances. Shellfish.—Clams and muscles, as well as some other kinds of fish are sometimes poisonous. Encourage vomiting, and give charcoal, with sugar and water, or strong coffee without milk. Animal matter rendered poisonous by putrefaction or POISONS AND THEIR ANTIDOTES. 441 disease. Give diluted vinegar or lemon-juice, and after- wards, if necessary, strong black coffee without milk, or strong black tea. 2. Narcotics.—Prussic-acid.—This is often obtained from peach leaves and peach pits. Is is an exceedingly powerful poison, and very rapid in its action. At first the patient may be permitted to smell a little Sal Am- moniac, or a few drops may be administered in water, or he may smell Camphor or Vinegar. As soon as strong coffee can be prepared, give it freely. Opium,—This drug in its various forms, either in the gum, in laudanum or morphine, is frequently resorted to for the purpose of committing suicide, and Laudanum is often administered in mistake for paragoric Vomiting should be produced as speedily as possible, and for this purpose as much Tartar Emetic as can be placed on a five cent piece should be dissolved in a tumbler half-full of tepid water, and one-third of it given once in ten minutes, if the first has not operated; giving in the interval copious draughts of tepid water, or tepid sugar and water. Often, however, it is impos- sible to produce vomiting, and in these cases a stomach- pump should be used. After some of the poison has been evacuated from the stomach, strong coffee, vinegar, or lemon-juice should be given. Usually the patient has a strong desire to sleep; this should be prevented, for if he sleep, he may soon sleep in death.—He should be kept in motion, walked about in the open air, and cold water dashed on his face and head. In poisoning from Hyosciamus, Belladonna, Stram- monium, Hemlock, Digitalis, Nicotine, Camphor, Strych- nine, lobelia, Spigelia, Blood-root, the treatment is similar to that indicated for Opium. 19* 442 POISONS AND THEIR ANTIDOTES RECAPITULATION. Strong black coffee is a very powerful remedy for a large variety of poisons; such as Opium, Strychnine, Strammonium, Mushrooms, Prussic-acid, Belladonna, and Hemlock; also in poisoning from Antimony and Phosphorus. Camphor is a very valuable remedy in poisoning from corrosive vegetable substances. Mucilaginous drinks are useful against alkaline sub- stances. Soap is suitable principally for metallic poisoning, es- pecially Arsenic and lead. It is also suitable for cor- rosive acids and plants, with corrosive sap. It is in- jurious in poisoning by alkaline substances. Sugar against poisoning by metallic substances, and vegetables with corrosive juice. It should be given after the appropriate antidote. Vinegar is useful against alkaline substances, but is injurious in poisoning by mineral acids, arsenic, vege- tables with corrosive sap. White of egg, mixed with a suitable portion of water, is a very prominent remedy against poisoning by corro- sive sublimate, verdigris, tin, lead, sulphuric-acid. Arsenic and other metallic substances. REAL AND APPARENT DEATH. 443 CHAPTER XV. REAL AND APPARENT DEATH. In this chapter we shall glance briefly at the cause of death, the signs which denote its near approach, and its final presence; and lastly, we shall speak of apparent death, and its proper treatment. 1. ACTUAL DEATH. The direct cause of death and how it is that when a certain portion of the mechanism of the system is de- ranged, the whole machine may cease its motion, is an interesting subject of inquiry. In looking at the human system, we notice what ample provisions have been made for maintening life. We have, first, the heart and the blood-vessels, which con- nect with and are distributed to every part of the system. Next we have the lungs, and the case in which they are lodged. And lastly, the power which works and regu- lates the machine vested in the nervous system. The main organs of these systems, the heart, the lungs, the brain, are called vital organs, and if the functions of one are arrested, the other two speedily cease. That the heart may force the blood from its cham- bers, a certain power of contraction is necessary, and also, the presence of a sufficient quantity of blood in the chambers of the heart to stimulate them to contract. If this stimulus is withheld, or is difficient, the heart will soon cease to beat. Respiration is subservient to the circulation of the blood. The heart and the lungs respond to each other, the blood being sent from the right heart to the lungs to be arterialized, when it is conveyed back to the heart, and is then distributed to every part of the system. 444 REAL AND APPARENT DEATH. But to carry on respiration two things are necessary; first, air to enter the lungs and depart at intervals, and second, the movements of the chest, to cause its entrance and exit. These movements, although they may be re- gulated by the will, are essentially involuntary. The act of respiration depends on a certain condition of the medulla oblongata, and if this condition fails, there is no action of the chest, no expansion of the lungs, no in- halation of air, and consequently no chemical change in the blood. Respiration therefore is dependent directly on the nervous system, and the cases are by no means rare where the nervous system receives a heavy shock, that the chest is paralyzed, and the lungs rendered in- capable of performing their duty, thus causing death. In death by oznemia the supply of blood for the heart fails. The heart retains the power of contraction, but there is no blood to contract upon. We see a striking instance of this in sudden and profuse haemorrhage. The countenance and lips become exceedingly pale, cold sweats cover the body, the pupils are dilated, the sight becomes dim, the pulse is weak and faint, and insensi- bility speedily follows. In connection with these symp- toms there is often nausea, vomiting, excessive restless- ness, and tossing of the limbs, delirium, and convulsions; breathing faint and gasping, and this struggling for breath so violent that the cold sweat stands in drops upon the forehead, gradually grows fainter and fainter until death closes the scene. We see a train of symptoms similar to the above in the soldier bleeding to death on the battle-field, in the mother flooding after child-birth, and in those cases where large blood-vessels are wound- ed. In death by cenemia the cessation of the nervous functions is occasioned by the lack of blood which should pass to the brain. The effect of position illustrates this. Syncope will much more rapidly ensue on venesection, where the patient is in an upright posture than when ACTUAL DEATH. 445 he is reclining. Hence in case of syncope we place the head as low if not lower than the trunk of body, so that the blood may more readily pass to the brain. Death by asthenia is directly the converse of the above. Here the n rvous system is the part first affect- ed, and through it the heart or lungs. The heart may be full of blood, yet its power of contraction is gone. Death by asthenia is sometimes produced by causes which act primarily through the nervous system, such as intense grief, joy, and terror. Death occurring from blows on the epigastrium, from concussion where the brain is jarred, and from electricity—are of this kind. The phenomena are different, when death by asthenia occurs more slowly, from disease, especially in malignant cholera, mortification, and acute inflammation of the peritoneum. In these cases the muscular debility is ex- treme, but the intellect is clear, and the hearing some- times painfully acute. In lingering disorders where there is a long-continued drain on the system, the cause of death is owing in part to both anemia and asthenia. Death from want of a proper arterialization of the blood may be caused by some impediment which prevents the introduction of air into the lungs, or by insensibility of the muscles required for breathing, caused by disease or injury of the brain and nervous system. In the latter case it is generally denominated coma, in the former it is termed asphyxia. The means by which air, or oxygen, which is its vital principle, is prevented from entering the lungs are various. Azotic, hydrogen, or carbonic acid gases, all incapable of maintaining life, may be prevented by submersion, and to death from this cause we give the name of drowning ; or by stoppage of the mouth and nostrils— smothering; by mechanical ob- struction of the larynx and trachea from within, as by f00d__choking ; or from without, as with a cord—stran- gulation ; or by impeding the mechanical action neces- 446 REAL AND APPARENT DEATH. sary for the admission and expulsion of air. The me- chanism of respiration consists in an elevation and de- pression of the ribs, performed partly by the action of the intercostal muscles, and partly by the descent and ascent of the diaphragm and the action of the abdomi nal muscles. If motion both of the diaphragm and ribs be at the same time stopped, the result is death by as- phyxia. This happens with persons who in digging are buried, with the exception of their head, by a mass of earth. A cast was attempted to be taken in one entire piece, as an academic model, of the body of an athletic black man. As soon as the plaster began to set, he felt on a sudden, deprived of the power of respiration, and to add to his misfortune was cut off from the means of expressing his distress ; his situation was perceived just in time to save his life. The same immoveable state of the lung-case is sometimes produced in tetanus, or poi- soning by strychnine, or from disease or injury «f the spinal chord above the origin of the nerves that give off the phrenic nerve; by section of the phrenic and inter- costal nerves, and by ruptures in the walls of the thorax, through which air is admitted to the lungs, also when the pleura become filled with liquid of any kind. We can more readily watch the development of suc- cessive symptoms, which arise from the slight and in- sufficient admission of oxygen to the lungs, than where there is entire cessation of breathing. In the latter case fatal effects follow so speedily as to give us but little time for observation. The following external pheno- mena present themselves in cases of impeded respiration. The first sensation is one of distress about the region of the lungs, accompanied with violent struggles for breath, in which there is an involuntary effort to expand the chest by bringing into action the intercostal muscles, the diaphragm and all the muscles connected with breathing. These struggles become exceedingly violent ACTUAL DEATH. 447 and almost convulsive, and are accompanied with a sen- sation of extreme agony. This agony, however, is of short duration being speedily followed by a torpor, which gradually deprives the sufferer of all conscious- ness. The struggles, however, continue, assuming the form of convulsions both of the trunks and limbs, in which nature seems to be making giant efforts for free- dom, and to burst the fetters which are every moment pressing stronger and stronger on the seat of life. During these struggles the lips and face become blue and livid ; the veins in the head swell until they stand out like chords; the eyes become bloodshot, and seem as if starting from the head. At length the convulsions sub- side into a scarcely perceptible twitching of the limbs, and this soon ceases, and is followed by a fatal immo- bility. The muscles relax, and even the sphincter which retain their irritability to the last moment, give way. The pulse is still perceptible, and the heart flutters for a moment longer, contracting feebly and with quick vibra- tions. In a few moments this also stops, and the circu- lation ceases. Now is the time when life is almost ex- tinct, the lamp has gone out, leaving but a faint spark, and unless immediate and the most energetic measures are resorted to, no human power can fan that spark into a flame, and bring back warmth and life to the cold and torpid body. When asphyxia is more gradually induced, the sufferings are more protracted. The painful sense of anxiety is accompanied with vertigo, humming in the ears, scintillations before the vision, and various pheno- mena. The extinction of irritability is gradual, and is not attended with epileptic convulsions. There is a greater discoloration of the body but less of face. Asphyxia, causing sudden death, is not generally wit- nessed in disease, but more frequently occurs in acci- dents. In chronic as well as acute cases, there is often- times a tendency to asphyxia for some little time. In 448 REAL AND APPARENT DEATH. these cases we see a gasping for breath, energetic and violen^ action of the muscles, livid looks, blood-shot eyes, dilated pupils, an expression of extreme agony, cold sweat, frequently delirium and those various phenomena we observe in shorter cases, showing that the blood ia imperfectly arterialized. Examination after death gives us the same condition of the heart and blood-vessels as in shorter cases. Death by coma as well as asphyxia is very common. In the former case certain morbid states of the brain produce stupor, the respiration becomes slow, irregular and stertorous, the functions of the nerves which pro- duce the movement of the throat fail, the chest ceases to expand, the blood is no longer secreted and death ensues. The difference between death by coma and asphyxia is this—in the former case sensibility ceases first, then the movement of the thorax, and consequently the action of the lungs; in the latter case the chemical function of the lungs ceases first. Signs indicating the approach of death. There is often near the termination of life a comparative pause in the progress of the disease, when the mind emerges from the clouds which have hung around it, and shines with its accustomed brightness, and all physical suffer- ing seems to have subsided. This is sometimes called the " lightning" before death, and is frequently viewed by friends with joy, who think they see in that delusive calm—death's herald, a sign of returning health. The amendment is not real, unless the pulse has improved; the energies of life are otherwise worn out, and the lamp is only flashing up for a moment, before it goes out in darkness. When sensibility to outward impres- sions is lost, and the mind is either delirious or darkened by the mists of death, scenes which have been strongly impressed on the mind, may reappear and again pass before mental vision. ACTUAL DEATH. 449 Dr. Armstrong departed delivering medical precepts. Lord Tenderden, who passed straight from the judgment- seat to his death-bed, fancied himself still presiding at a trial, and expired with " Gentlemen of the jury, you will now consider of your verdict." Dr. Adam, the author of the Roman Antiquities, imagined himself in school, and uttering the then touching and expressive words—" But it grows dark—the boys may dismiss," in- stantly died. He mistook the darkness of death which was casting its film over his eyes, and the eternal rest on which he was entering, for the shades of evening and the welcome rest which they bring. Before the spirit of Napoleon, in his last moments was moving the mighty panorama of the past. He was again on the battle-field, at the bridge of Lodi, struggling by the Pyramids ; the thunder of battle was in his ears, and as there passed before his eyes that mighty army he had so often led to victory " Tete d'armee" broke from his dying lips. The symptoms indicating the near approach of death are not always the same. Some in their last moments toss the clothes from the chest, as if their weight was uncomfortable, and though the attendants anxious to carry out their own ideas of comfort, and not permit the dying to contract a cold, are resolute in replacing them, they are as often thrust back. The patient is often un- conscious of his acts, yet they indicate that the weight of the clothes is insupportable, and it is only a mistaken kindness to replace them, when he is using his utmost efforts to cast them aside. Too often are the dying sur- rounded by friends, who cluster around the bedside, for- getting, that to him every breath of air is a precious boon, and by their sobs and lamentations torture and agonize the soul in its last moments. The hearing is often painfully acute, even when the patient is supposed to be in a state of insensibility, and the frantic bursts of agony from weeping friends are often to the dying, al- 450 REAL AND APPARENT DEATH. though they may be unable to express it, the bitterest ingredient in their cup of death. Others pick the sheets or work them between their fingers. This may be to excite by friction the sense of touch or the restlessness produced by excited nerves. The functions of the eye become disordered, and black spots or motes and various illusions float before the vision, which the patient at- tempts to clutch with his hand, or brush away. Many, on beholding these symptoms, look upon them as an in- fallible sign of death, but in this they are sometimes mistaken. The awful shadows of death, which hang around the dying, seem at times to give the soul a glimpse, before it leaves the body, into the spirit world. In this peculiar state, when the spirit, although not separated from the body, seems partly in another state of existence, there is an expression on the countenance, almost unearthly, and occasionally words and disjointed sentences, which show, if the spirit is not passing the threshold of another world, and has become conscious of some of its scenes, it is unconscious of anything in this. A scene, which occurred several years since, produced at the time a strong impression on my mind. A young lady, a de- voted christian, accomplished and beautiful, and whose fondness for music amounted to a passion, was dying. She seemed entirely unconscious, her eyes closed, the limbs cold, the pulse imperceptible or faintly fluttering, the breathing so faint as scarcely to stir the down of a feather. Her friends were standing around in silent anguish, expecting every moment the lamp which was burning so feebly would go out. Suddenly her lips slightly parted and a strain of heavenly music was heard, at first faint and trembling and then swelling in volume and harmony, until it seemed gushing forth wave on wave of liquid melody; no words could be distinguished; the strain was like nothing earthly, surpassing in sweet- ACTUAL DEATH. 451 ness anything to which I had supposed the voice was capable of giving utterance. The strain ceased and she was silent for perhaps half an hour, when it again burst forth, gradually swelling into a song of triumph. It seemed as if she had already crossed the threshold of the spirit land, caught the symphony of the skies, and was tuning her harp to the song of angels. After the strain had ceased, which lasted about five minutes, she remained in the same unconscious state for an hour, and then breathed her last. When disease passes into dying, the symptoms assume a certain defined character, which generally tells the tale to every eye. The eyes half closed and turned up- wards, sunk in their sockets, wear a glazed and filmy appearance. Cheeks and temple are generally sunken, the nose sharp, the lips and face sometimes pale, and wearing that ashy hue, which involuntarily reminds one of death, or livid with the dark blood which creeps sluggishly through the veins. The voice loses its fami- liar tones, and becomes faint or comes with a muffled sound. The cold of death seizes on the extremities and gradually creeps towards the centre of life ; the breath is chill, cold and clammy sweat bedews the skin. The respiration whether faint and languid, or labored, grows slow and feeble. The breath comes with a gurgling sound, and the death rattle is heard at every expulsion of air. The lungs like the pulse are intermittent in their action, and the breathing is in broken gasps. The pulse is faint and intermittent, and the artery scarcely swells beneath the finger. The pulse ceases, trembles along the artery, and again ceases; the heart flutters, the chest faintly rises; it is the last effort of expiring vitality: again the pulse quivers beneath your finger —stops—and all is over. " Life's fitful dream is past," A finely moulded form is before you, but the spark of 452 REAL AND APPARENT DEATH. vitality has fled. Death has conquered, and his seal is on the cold pulseless form before you. Signs of death. Shakespeare, whose active brain al- lowed nothing to escape him, must have watched by many a death-bed, as in the description which the Friar gives to Juliet of the effects of the draught which is to transform her into the temporary likeness of a corpse, he thus sums up the more obvious characteristics of death: " No pulse shall keep His natural progress, but surcease to beat; No warmth, no breath, shall testify thou livest: The roses on thy lips and cheeks shall fade To paly ashes; thine eye's windows fall, Like death when he shuts up the day of life ; Each part, deprived of supple government, Shall stiff, and stark, and cold appear, like Death." Respiration is a function essential to life, as without it, we know there can be no arterialization of the blood, and therefore no circulation. Sir B. Brodie says, the heart never continues to act more than five minutes after respiration entirely ceases. The cessation of this function then may be considered a sure indication of death. To ascertain with certainty whether it had en- tirely ceased, it was formerly the custom, and is to a certain extent among the masses at present, to place a feather or mirror before the lips, and if the feather moved, or a mist stained the glass, they were convinced that life was not extinct. When Lear brings in Cor- delia, dead, he exclaims: 'l Lend me a looking glass ; If that her breath will mist or stain the stone, Why then she lives !" and immediately adds. " This feather moves: she lives!1 Prince Henry also was equally mistaken in believing his father dead, '; By these gates of breath There lies a downy feather, which stirs not: ACTUAL DEATH. 453 Did he suspire that light and weightless down Perforce must move!" Neither of these tests can be relied on, as the down may be moved by some agitation of the surrounding air, and the mirror be covered, by some exhalation of the body, presenting the appearance of condensed vapor of the breath. Owing to extreme physical exhaustion, respiration may be so faint, that to the casual observer it appears to have entirely ceased. It is frequently the case, that the transition from life to death is so quiet and gentle, that the observer is not conscious of the change, until the drooping jaw and stiffening features tell that life is extinct. Dr. Paris says, however slow and feeble respiration may become by disease, yet it must always be percep- tible, provided the naked breast and belly be exposed; for when the intercostal muscles act, the ribs are elevat- ed, and the sternum is pushed forward: when the dia- phragm acts, the abdomen swells, now this can never escape the attentive eye; and by looking at the chest and belly, we shall form a safer conclusion, than by the popular methods which have been usually adopted. No perceptible motion of the heart or arteries may be perceived, and yet respiration not have entirely ceased. The temperature of the body relied on by some, is by no means a correct guide. An icy skin, although sooner or later an unfailing accompaniment, is not of itself a sufficient evidence of death. The temperature of the body for hours after death will be owing in a great mea- sure to age, the disease of which the person died, habits of body and the temperature of the room, in which it is placed. The bodies of young persons retain heat longer than those of old. In old age or slow and exhausting disease the bodies are frequently cold even before the breath has left the body, certainly in a very short time after. In most kinds of asphyxia, except drowning 454 REAL AND APPARENT DEATH. the bodies grow cold very slowly, also in diseases which are very rapid in their progress. The change from warmth to cold will be slower where the body is well wrapped up, in summer than in winter, in still atmos- phere than in currents of air. There are numerous cases as in hysterics and various other forms of disease, where the coldness of the body is corpse-like, notwithstanding there are no immediate indications of death. The first apparent effect of death is relaxation of the muscles. The flesh is soft, the joints flexible, the lower jaw drops and the limbs hang heavily. This is followed by con- traction, in which the flesh is hard, the muscles rigid and the joints unbending. The rigidity commences in the trunk and neck; it then appears in the thoracic ex- tremities, then in the lower, and in receding passes off in the same way. Its appearance is varied by age, the constitution of the person, and the form of disease. It appears on an average five or six hours after death, and ordinarily continues from sixteen to twenty-four hours, In those who die of lingering diseases, old age, and where life slowly ebbs away, it comes on more quickly, sometimes in half an hour, and remains but a short time, continuing longer, where it commences latest. In the strong and athletic, in most of those who die a speedy or violent death, the contraction is strong in a ratio with the development of the muscular system at death, is slow in advancing and slow in going off. In these cases it is often a day or two before it commences, and sometimes lasts a week. When contraction of the muscles commences, we know that life is extinct, as this phenomenon never occurs as long as the body retains the least particle of vitality. When this rigidity passes off, the body again become flexible, and this is another strong indication of death. Flexibility after rigidity is not to be mistaken for that which occurs before. So ACTUAL DEATH. 455 long as the limbs continue flexible before rigidity we may suppose there may be some remains of life. After rigidity passes off, and, not before, begins putre- faction. It generally commences in the belly, the skin of which turns a bluish green, gradually increasing to brown or black, and progressively spreads over the body. Myston regards this stiffness as a measure of resistance opposed by organic to chemical forces. "Life on the point of extinction seems to take refuge in the muscles, and there causes the spasms we speak of, and during their continuance is able to resist the operation of che- mical forces." It will readily be perceived that the ri- gidity of the body is a point of great importance, and there is no necessity for the cadaverous stiffness to be mistaken for any other. In stiffness, occasioned by freezing where the body is not yet dead, not the muscles only but the entire body, belly, breasts, and skin are hard. This together with the crackling of the joints on forcible flexure, is a sufficiently marked point of distinc- tion. Neither can the stiffness, which occurs in certain forms of disease, well be mistaken for that which takes place after death. In the former case it occurs while the body has a certain amount of heat, and precedes ap- parent death—in the latter, the body is comparatively cold, and there is a distinct interregnum after apparent death. In both cases there is great difficulty in moving the limb, but in the former when bent, if the force is removed, it flies back to its former position, while in the latter, it continues its bent form; and if death takes place in these convulsive diseases, the stiffness passes off, and is followed at the proper time by the rigidity of death, which runs its usual course. But a mark which cannot be mistaken is the termination of cadaverous rigidity, in flexibility, which is a certain indication of dissolution. From what has been said, it will be seen that the de- 456 REAL AND APPARENT DEATH. tection of the presence of death is not generally a very difficult matter. Instances have undoubtedly occurred where persons have been buried alive; yet they were principally in days of ignorance and superstition, or during a period when some terrific pestilence was num- bering its victims by hundreds or thousands; when the change from life to apparent death covered over but a few hours, and when a person was hurried, in the clothes in which he died, into his coffin and grave. At these times when the community and friends are panic-stricken, we may reasonably suppose that occasionally cases oc- curred, where apparent was mistaken for real death. There are but few cases in which a physician would have any difficulty in detecting the presence of death. In opening graves for the purpose of removing the dead or for other causes, bodies have been found turned on their sides, the grave-clothes disarranged, and the flesh lacerated. Many a tender heart has been made sad, and many a bitter tear shed as these developments of life in the grave have been unfolded. These myste- ries, however, are very easily explained, without tortur- ing the heart with the idea that a friend has aroused from the stupor of apparent death to find himself in the grave, and there writhing and gnawing his flesh in the agony of despair, died. A gas sooner or later is deve- loped in the decaying body, which by its mechanical force, mimics many of the movements of life. It twists about the body, blows out the skin until it rends, and sometimes bursts the coffin. This gas is so powerful in corpses which have been some time in the water, that M. Devergie, the physician to the Morgue in Paris, says, that unless secured to the table they are often heaved up and thrown to the ground. The food is sometimes forced from the mouth, and the blood from the nose, and even the pores in the skin. The bloody sweatwhich in days of superstition was supposed to appear on the ACTUAL DEATH. 457 murdered body in the presence of the assassin, must have been produced by the struggling gas forcing out the fluid. Is dying painful f This question by the community at large has been answered in the affirmative. Thou- sands have looked forward with a thrill of fear to that period when the soul should make its final exit from the body ; not in all cases, that they feared for the future, or that they had any very strong attachments for life, but it was the sepulchral chill of that breeze which swept over them from the land of shadows, that fearful death agony forcing the cold sweat from every pore in the body, that appalling struggle with a power, whose grasp is the freezing grasp of death, a struggle in which the silver cord drawn to its utmost tension, breaks, which made death appear so terrible. And yet death is not painful. It comes in truth like a welcome sleep to a weary traveller. When dying commences, pain ceases, and the change is like that produced in an atmosphere laden with the narcotic exhalations of poppies in which the senses, while a feeling almost of delight pervades the system, are gradually overpowered. As death creeps on, the strength declines, a torpor steals over the ner- vous system, and notwithstanding there may be physical indications of pain, such as contortions of the counte- nance, and spasms of the limbs, suffering does not in reality exist. A few years since I was standing by the side of a patient, whose case I had watched with un- usual interest, and who had for several days been so near death, that every visit I made I trembled lest I should find her a corpse. Starting from a torpor in which she had been for some time, her breath came in hurried gasps, the countenance was distorted, the limbs convulsed, the body writhed, so that it was almost im- possible to hold her in the bed. Her friends believing that she was dying, burst into tears, but were somewhat 20 458 REAL AND APPARENT DEATH. quieted when I told them there was no immediate danger. She has since told me that during this period she had no control over these convulsions, yet was en- tirely free from pain excepting that occasioned by the agony of her friends. She retained even after her re- covery an almost vivid recollection of every thing which occurred during this period. We should suppose that the so-called agony could never be more formidable than where the brain is the last to yield, and the patient re- tains his consciousness to the last. Yet persons thus situated generally say there are few things in life less painful than the close. William Hunter said : " If I had strength enough to hold a pen I would write how easy and delightful it is to die." The observation very com- monly is heard from lips soon to be cold in death. " If this be dying, it is a pleasant thing to die." " I thought that dying had been more difficult, said Louis XIV." In those who retain their consciousness to the last, an agreeable disappointment seems to pervade the minds of all. The stream instead of growing turbulent, loses itself in a gentle placid current. There are but very few diseases more painful than asthma, before the sensibility is blunted and the strength enfeebled, and in this disease we should naturally sup- pose the patient would fight vehemently for life. Dr. Campbell, the well-known Scotch professor had an at- tack which well nigh carried him off a few months be- fore he finally succumbed to the disease. A cordial gave him speedy and unexpected relief, and his first words were those of astonishment at the sad countenances of his friends, because he said his own mind was in such a state at the crisis of the attack from the expec- tation of immediate dissolution, that there was no other way to describe his feelings than by saying he was in rapture. If physical agony had existed, it would not have been so entirely subdued by mental ecstacy. APPARENT DEATH. 459 Persons who have been rescued from drowning, have invariably said, that after the first struggle was over, the sensation was of the most pleasant character. A gentleman once stated to me who was rescued at the last moment, that as he sunk for the last time all con- sciousness of danger gave place to sensations of pleasure. At first he wondered whether his friends would be suc- cessful in rescuing him, hoping they would not, then as languor gradually crept over him, he watched the changes of light and shadow until complete insensi- bility took place. When being resuscitated, however, he suffered the most intense tortures; as the machinery of the system resumed its play, every nerve was full of the most exquisite pain. The account given by a distin- guished British naval officer of his own case is familiar to all. While in the water he said every event of his life flashed like lightning across his mind. There was also an absence of pain. Intense cold, instead of being attended after the first few moWnts with pain, brings on a stupor, which quickly passes into the sleep of death. In hanging, where the victim has been cut down at the last moment all agree, that the uneasi- ness is quite momentary, that a pleasurable feeling im- mediately succeeds, that colors of various hues start up before the sight, and that these having been gazed on for a trivial space, all is oblivion. As we have already said, unless the stage of agony is crossed at a stride, disease stupefies when it is about to kill. As the dis- ease has been painful, so generally is dying entirely the reverse. 2. APPARENT DEATH. Apparent Death from Drowning. The symptoms met with in drowning are varied. Some, on being precipitated into the water, paralyzed by fear, or stunned by the fall, sink like lead and die 460 REAL AND APPARENT DEATH. without a struggle. Others, still possessed of their fa- culties, struggle to keep themselves on the surface, but as their strength fails, their motions are made at ran- dom, and they clutch at every thing within their reach. Fiom the irregularity of their motions, they rise and sink several times. At every opportunity an attempt is made to obtain a breath of air, but usually water is, introduced with it, which exciting a cough, is expelled from the trachea, the same effort also expelling the air which had been introduced. A fresh demand for air is thus created, and a hurried attempt made to gra- tify it, but the very eagerness defeats its own object, for water is again introduced. Unless the head is fully raised, some portion of the water passes into the stomach, but the larger portion, together with the air taken in, is expelled by the spasms of the glottis. In this con- tinued struggle the blood rushes to the head, the brain becomes congested, and all effort for life ceases.^ The victim sinking for the last time, unable to obtain air, whereby respiration may be continued and the blood arterialized, the lungs become filled with venous blood, the strokes of the heart grow weaker and weaker, sensi- bility gradually departs, and the victim glides quietly and with a feeling of luxury creeping over him into the arms of death. From what has been already said, it will very readily be seen, that drowning is simply a kind of suffocation, caused not by the presence of water in the lungs or stomach, for there is but very little there, but by the shutting out the atmospheric air from the air-passages of the lungs, thus preventing the oxygenation of blood, and thereby extinguishing the lamp of life. Let us now inquire into the treatment to be pursued in resusitating persons taken from the water. If there are no marks of violence sufficient to have caused death, and there is reason to believe the person APPARENT DEATH. 461 was alive when immersed, or there is a possibility that life may not be quite extinct, the treatment should at once be judicious, active, and decided, yet there should be the utmost caution in avoiding every thing like rough usage. The mouth and nostrils should be cleaned. The wet clothes immediately stripped from the body, the body wiped dry, and immediately covered with warm dry clothes or blankets. The colder the weather, the more necessary it is that this should be done on the spot, unless there is some place very near at hand, where these matters can be more readily carried into execution. It cannot be too strongly impressed on the mind of those who are first on the ground, and generally non-profes- sional men, to confine themselves rigidly to these plain and simple directions. By doing this they will have paved the way for the more active treatment, which is to follow. An error in the first steps may prove fatal. There are hundreds lost in the confusion and want of order which prevails at first, that might have been saved, if the attendants would only bear in mind the fact, that every thing which is done, must be done at the right time, and in the right way. In removing the body, care should be taken that it is not lifted by the shoulders and legs, so that the head would fall backward, or forward, for this would be highly injurious. It should be placed on a door-board, or in a cart, in a recumbent posture with the head and breast raised. On reaching its destination, the body should be placed on a table of convenient height, strip- ped and covered with warm blankets, the head and chest raised, and the mouth and nostrils kept free and open. Artificial respiration should now be commenced. The tube of a common pair of bellows can be made, by the assistance of a strip of linen, riband,-or tape, to fit accurately into one nostril, while the other is closed 462 REAL AND APPARENT DEATH. by the hand of an assistant, who at the same time closes the mouth. Another assistant (who ought to be placed on the opposite or left hand of the body) is with his right hand to press backwards, and draw gently down- ward toward the chest the upper end of the wind-pipe, that part which lies a little below the chin, and which from its prominence in men, is vulgarly called AdamJs apple; by doing this, the gullet or passage into the stomach will be completely stopped, whilst the wind- pipe will be rendered more open to let the air pass freely to the lungs. The left hand of the second as- sistant is to be spread lightly over the pit of the stomach, ready to compress the chest and expel the air again, as soon as the lungs have been moderately filled by the bellows; the first assistant unstopping the mouth or nostril at the same time to let the air escape. The same operation is to be repeated in a regular and steady manner, either until natural respiration begins, or until this and the other measures recommended have been persisted in for three or four hours without any appear- ance of returning life, unless the stiffness of the limbs and other positive signs of death set in. In the absence of the bellows, until one can be procured, air can be blown into the lungs by applying the mouth of the ope- rator to that of the patient, and expelled from the chest in the manner directed above. To imitate the natural movements in respiration the motions in artificial respi- ration should be about fifteen times in a minute. While the process of artificial respiration is going on, some of the assistants should be engaged in communicating continued heat to the body. Dry warm blankets, bags of warm grain, bottles of hot water, hot bricks, or blan- kets wrung out in hot water, are among the means to be used. Should the accident happen in the vicinity where warm water can be readily obtained, a warm bath, moderated to a heat not exceeding 100° would be highly APPARENT DEATH. 463 advantageous. Bottles of hot water should be placed at the bottom of the feet, to the joints of the knees and under the arm pits. A bladder, filled with hot water, should be applied to the region of the stomach, and some warm substance, as a heated brick, wrapped in cloths, should be passed over the body, particularly along the back. The application of heat, however, should be gradual. Slight shocks of electricity or galvanism passed through the diaphragm and heart would pro- bably be of advantage, as this agent possesses an im- mense power over the nervous system. The first evi- dences of returning life are slight convulsive twitchings in the muscles of respiration, producing gasping or sighing. Our efforts on the approach of these signs should be increased as the life of the patient is still comparatively in our hands and can only be saved by the greatest effort, as it takes some time before the blood can be arterialized, and the mechanism of the body resumes its wonted motion; a little brandy may now from time be introduced in the stomach, and an enema of tepid water given. As the suspension of ani- mation is devoid of pain and attended with a feeling of luxury, so is the return of life agonizing in the ex- treme, so much so, that the patient often instead of expressing gratitude, curses the officiousness of friends, who have made him suffer such torture. Even when the breathing has become calm and the circulation apparently restored, there still remains a period of danger, and the patient for a few hours should be closely watched. The treatment we have detailed as necessary in drowning, would also be applicable in asphyxia from strangulation, or in fact from any cause, with those deviations which would naturally suggest themselves to the mind of every intelligent medical man, 464 REAL AND APPARENT DEATH. Apparent Death from Hanging, Choking, or Smothering. The treatment in apparent death from any of the above causes is similar to that indicated in apparent death from drowning. Apparent Death from noxious Gases. Deaths from Carbonic-acid Gas, Carburetted-Jiydrogen Gas, and other poisonous gases are very common. Car- bonic-acid gas is often found in the bottom of wells, and in large vessels, where fermentation has been going on. The presence of the gas may readily be detected by lowering a candle; if it goes out, of course the air will not support life, while if it burns brightly, there is no danger. In burning charcoal, the carbon of the coal uniting with the oxygen of the air, forms carbonic-acid gas, and unless the room is freely ventilated, the air soon becomes incapable of supporting life. Hence deaths often occur by burning a pan of charcoal in a tight room, the occupants unconscious of danger, having re- tired to rest. Death in this way is like the gliding into a dreamy and pleasant sleep. The body should immediately be removed into a cool, fresh current of air. Cold water should be freely dashed on the neck, face and breast, or if the body is cold, warmth should be applied. Artificial respiration and the application of galvanism may also be resorted to, as directed in drowning. After life has been restored, a drop of Opium may be mixed with a tumbler half-full of water, and a teaspoonful given once in half an hour. Apparent Death from Hunger. The agony endured where life slowly ebbs away from starvation, is beyond description. Small injections of warm milk should be repeatedly given, and cloths wet with warm milk or brandy placed on the stomach. As signs of returning life manifest themselves, warm milk may be given drop by drop, gradually increased to a APPARENT DEATH. 465 teaspoonful, followed after a short interval by a little beef tea, or a few drops of wine. After a little sleep, solid food may be taken, and the patient permitted gradually to return to a full diet. Apparent Death from Freezing. In freezing the first symptom of approaching danger is an intense and almost irresistible drowsiness. Notwith- standing the person knows that to sleep is to die, yet the desire to sleep is so strong that he often neglects to take the only precaution left him—exercise, but quietly lies down and dies. Where a person is found in the stupor or apparent death, caused by intense cold, he should be removed, not to a heated apartment, as we should thereby pre- clude all hope of restoring animation, but to a place of shelter, such as a barn or a room without a fire, where he can be protected from drafts of air. He should then, especially if there be stiffness or rigidity, be covered several inches with snow, leaving the nostrils free, or if snow cannot be obtained, he should be placed in a bath, the water being made as cold as possible by means of ice. After the stiffness is removed by this treatment, the clothes should gradually be removed, by cutting them off if necessary, and the body rubbed with snow until it becomes red, or if snow is not to be ob- tained, it should be wiped dry—placed in a room mo- derately warm—covered with, flannel, and briskly rub- bed with the hands of several, persons at the same time. If notwithstanding the above treatment, no signs of life show themselves, an enema of Camphor and water may be given once in fifteen minutes ; the rubbing being continued. As soon as symptoms of approaching life become apparent a little strong black coffee without milk may be administered in an enema, and the patient also be permitted to swallow a little as soon as able 20* 466 REAL AND APPARENT DEATH. For the severe pains which are often felt after life is restored, a powder of Carbo-veg. should be given once in fifteen or twenty minutes, followed or alternated, if ne- cessary, after five or six doses, with Arsenic. The patient should avoid for some time the heat of a fire, as it will produce intense pain, and have a tendency to cause serious derangement of the system. Apparent Death by Lightning. The body should be placed in the open air or an open room, and cold water freely dashed on, the face, neck, and chest. If the body be cold, warmth or friction may be applied. Artificial respiration should also be prac- ticed as recommended in drowning. Some have recommended that the patient should be placed in a recumbent posture, and covered with newly excavated earth until signs of returning life are appa- rent. A powder of Nux-v. may be placed on the tongue, and repeated if necessary in fifteen or twenty minutes. Apparent Death from a Fall. The patient should be placed gently on a bed with the head elevated. A little Arnica mixed with water may be introduced into the mouth, and the body care- fully examined to see if there are no fractures. If the pulse is full and slow the patient should be bled. PAKT SECOND. ANATOMY, PHYSIOLOGY, HYGIENE, THE TRUE THEORY OF CURE, AND MATERIA MEDICA. 467 DOMESTIC PRACTICE. PART SECOND. CHAPTER I. ANATOMY. The idea is somewhat startling that the dust, which ia blown in our faces on a windy day, once formed a part of living beings as active, intelligent, and full of life as ourselves; that the very water we drink has entered into strange and curious combinations. From the human system, water passes into the air in enormous quantities. The tiny flower that blooms almost unseen and which we may crush by a step, the grass covering the earth with its velvet mantle, the flowering shrub and the foliage of the mighty forest tree, all throw into the atmosphere which envelops the earth a vast amount of moisture. This, collecting in the upper re- gions of the air, descends again in refreshing showers, or distils upon the earth in gentle dew. Who can say whether the crystal fluid, which we quaff with such delicious pleasure, may not once have spark- led, on the leaf of a rose, or glittered on the swarthy brow of an African sweating at his daily toil beneath a scorching sun. The air, that great reservoir, which sur- rounds us on all sides, covers alike the negro and the prince, and mingles together the drop which falls from the brow of the dying monarch, and the tear of suffering in the hovel of the poor and lowly. In that vast re- public there is no distinction, all are alike. * 469 470 ANATOMY. Man from his infancy to his grave is constantly under- going change. There are at work within him forces, ever active, never tiring, until the heart ceases to beat and death and decay commence. Yet this change in health is attended with no pain, but is the simple and beauti- ful process of nature, bringing neV materials to take the place of worn out particles, keeping alive within us that process of combustion, which warms us in winter and cools us in summer, the derangement of which causes disease and death. We are to look in this and the following chapter, at the physical organization of man, and unfold step by step, the most wonderful and beautiful mechanism, which ever came from the hand of the Eternal. We are to unveil for a time the human frame, and gaze upon bone, and blood, and muscle, and nerve, and tissue, and ex- amine the various parts which make up this beautiful structure, and inquire into their organization, form and use, the process of health, of regeneration and decay, of life and death. We are to lift the curtain of nature and gaze into her secret chambers. We shall find these chambers irradiated with a pure and holy light, and, stamped upon all, the impress of the most perfect wis- dom. We shall learn here a lesson of simplicity, truth. and harmony, and admire the wisdom and love of that Being who made so perfect and beautiful an earthly habitation for the deathless soul. In examining the human system we shall look, 1st, at its bony frame-work, or skeleton. 2d, The muscles. 3d, The brain and nervous system. 4th, The organs connected with respiration and cir- culation. 5th, The organs connected with digestion, secretion, excretion and reproduction. 1st, The Bones or Skeleton. The bony frame-work THE BONES. 471 of the human system consists of two hundred and eight pieces. [See plate 2, fig. 1.] Of these, eight compose the skull—viz. The frontal-bone or forehead, the two parietal bones, forming the sides of the cranium and meeting at a line directly on the top of the skull, the occipital forming the back part of the skull, the temporal, the lower part of the sides of the head around the ears, and the ethmoid and sphenoid. The former passes from one temporal bone to the other across the base of the cranium, and the other is situated in the middle of the anterior portion of the cranium. These bones form a cavity for the- brain, which is thus in its bony covering guarded in the most perfect manner from external vio- lence. The edges of the bones are as it were dove-tailed into each other; they are soft and capable of expansion in infancy, but in after life become solid. The bones of the cranium as well as those of the face are perforated in several places, so that the nerves may pass out from the brain and perform their functions. The Face. The bones of the face are fourteen in number. The two nasal bones, form the arch or bridge of the nose; the vomer separates the two passages; the two malar bones, form the prominence of the cheek and are generally called check bones. The superior maxillary bone, forms the upper jaw, and the inferior maxillary bone, the lower jaw. Of the teeth we shall treat when speaking of their diseases. The Trunk. We are now to notice that curiously con- trived and beautifully arranged column, which, while it supports the head and trunk, holding in the centre that great nerve (spinal marrow) which passes off from the brain and gives out other branches to almost every part of the body, still permits us to bend in every direction with the most perfect ease. This column [Plate 2, fig. 3,] is composed of twenty. four distinct bones with projections, which, forming a 172 ANATOMY. canal behind the body of the vertebras for the spinal marrow, serve also to bind the bones together and as attachments for the muscles. Between the joints of the vertebras is a highly elastic cartilaginous tissue, which serves as a cushion to break the jar which would otherwise be felt in the brain at every step. With the aid of this elastic cushion and the backward and forward curve of the spine, no direct motion is com- municated to the head. The first seven bones are called cervical or neck bones, 5, then follow twelve dorsal bones, 6, then five lumbar vertebrae, 7, and last the sacrum and coccyx. We have thus the spinal column supporting the head as well as giving form and support to the trunk, but another bony cavity is required to contain and guard those vital organs, the lungs and heart. We therefore find them placed in the chest or thorax [Fig. 4,] which when well developed adds so much to the beauty and noble appearance of the human race. This cavity is formed by twenty-four ribs. Twelve on each side, start- ing from the twelve dorsal vertebras and coming forward in a curve, seven of the upper ones on each side unite directly by means of a cartilage with a bone in front, 2, called the sternum or breast-bone. Three lower ones united by a cartilage are called false-ribs, and the two remaining without anterior connection are called floating ribs. The natural form of the chest then resembles a pyramid or cone, the apex of which is at the top. It is not unusual in these days of fashion and artificial beauty, to find the order reversed, and the apex at the bottom. Rest assured, however, that nature's ways are the best, and that she generally contrives to punish severely those, who with fool-hardy temerity seek to fetter or restrain her movements. We have another bony cavity or basin forming the lower extremity of the trunk, essential to the support of the abdomen, as well as to those organs placed in its vicinity. This is called the pelvis [Plate THE BONES. 473 2, fig. 6.] There are posteriorly two bones forming the lower extremity of the spinal column, and sometimes called false vertebrae—viz., the sacrum and coccyx, 3. 5. From these proceed anteriorly in the form of a curve, a larger bone on either side, called the innominata, meet- ing in front at what is called the pubis. The upper portion of these bones, 7. 8. are known as the hip-bones, the lower portion, 9. 10. as the seat-bones. Lower Extremities. At about the middle of the in- nominata are two cavities, 2. 4. into which are inserted the thigh-bone or femur, forming what is called a ball and socket joint. The extremity of this bone articulates with the tibia, the large bone of the leg, the fibula, or smaller bone, being firmly bound to it at the knee, form- ing a hinge-joint. Over this joint, affording it protec- tion, is placed a smaller bone connected with the femur and leg bones by ligaments and muscles. It is called the patella or knee-pan. At the lower extremity of the leg we have the small tarsal bones, seven in number, forming the ankle. Articulating with one range of these bones are the metatarsal, five in number, to the extremi- ties of these are connected the bones of the toes, called the phalanges of the toes. Fig. 7. represents the bones of the ankle and foot. The tarsal or ankle-bones, 1, the metatarsal, 2, the pha- langes of the toes, 3, 4, 5. The Upper Extremities. The clavicle (collar-bone) is attached at one extremity to the sternum or breast-bone, at the other it is united to the scapula (or shoulder- blade.) It keeps the arm from sliding forward. The shoulder-blade is situated on the upper and back part of the chest and is held in its position by muscles. The humerus is united by a joint with the scapula, and at the elbow it is articulated with the ulna of the fore-arm. This bone is on the inside of the arm, while the radius, which articulate with the carpus, forming the wrist-joint, 474 ANATOMY. is on the outside. These bones at their extremities articulate with each other, the upper end of the radius, rolling on the ulna, and the lower end of the ulna roll- ing on the radius, thus permitting the varied and beauti- ful movements of the arm. The carpus, or wrist, is com- posed of eight small bones. Articulating with one range of these, is the metacarpus, composed of five bones, forming the body of the hand. United to these are the bones of the fingers, called the phalanges of the fingers. The articulation of the bones are covered with cartilage, a substance of the nature of bone, yet smooth, solid and much softer. Covering the cartilage and forming around the joint a shut sack, is the synovial membrane. It se- cretes a serous fluid, which serves to lubricate the joint 60 that the motion may be free, easy, and without pain. The joints are kept in their position by ligaments or shining, strong, and elastic bands, which generally sur- round the whole joint. The bones are composed of animal and earthy matter, the earthy part, giving them strength and solidity, while the animal imparts vitality. In infancy the animal sub- stance preponderates, causing the bones to be softer and and more liable to bend than in old age, when the earthy preponderates, leaving the joints stiff, the bones brittle and liable to break. Over the bones is spread a thin membrane called the periosteum. This membrane may become inflamed when it is peculiarly sensitive and painful. We have thus the frame-work of the human system. The bones are all in their places, but they are only in- animate bones, without life, unable to perform a single movement. Let us then take another step, cover them with muscles, and thus attach to them the bands and pulleys by means of which movement is to be performed The Muscles. On this part of the subject we shall of necessity be short, as a minute description would lead THE BONES. 475 us into those dry and technical details, which would be uninteresting to the general reader. The muscles are composed of bundles of small fibres enclosed in a membranous investment or sheath. To- wards the end of the muscles the fibres gradually change into the tendons or cords, by which they are strongly attached to the bones. The muscles not only enable us to move, perform re- spiration and the various duties of nature essential to life, but give form and beauty to the frame, form those cavities, within which are enclosed important organs re- quiring their protecting covering. The prominent characteristic of the muscles is, con- tractility on the application of the necessary stimuli, and relaxing when that stimuli is withdrawn. The natural stimuli is the will, which, flashing like lightning along the nerves, causes the muscles to relax, or contract, and produces those varied and rapid movements of which the body is capable. Each movement or expression is the result of the contraction and relaxing of the appro- priate muscles. It is in this way the eyes are opened or closed, the mouth extended, contracted, opened, or clos- ed, the face wears an expression of grief, or is merry with smiles, or convulsed with laughter. The jaw per- forms its rapid movements in mastication in this man- ner ; breathing is performed by the contraction and ex- pansion of the muscles of the chest and abdomen. The rapid movements of the fingers in the musical performer and the varied and rapid motions of the dancer, show how obedient the muscles are to the mandate of the will. In the upper and lower extremities the muscles which produce flexion and those which produce extension are placed on opposite sides. In the lower limbs the flexors are placed on the posterior and the extensors on the an- terior sides, while in the upper limbs their situation is directly the opposite. The strength and health of the 476 ANATOMY, muscles is increased by proper exercise. This fact is familiar to all, although all do not act upon the common- sense lesson it teaches, and take the necessary exercise. Thus we perceive when the stimuli is applied to one set of muscles, they contracting, flex or draw up the limb. Shut off the nervous stimuli from this class and direct it to another, and their fibres contract, and the limb is extended. Thus, by this beautiful process the chest expands, the bosom rises and falls, we eat, drink, move and live. If the world would more frequently follow the plain and simple teachings of nature, there would be far less sighing and groaning than at present. See Plate 3. We have now clothed the before naked and unsightly skeleton with flesh, giving it beauty and symmetry of form. Still there is no movement; all is as still and quiet as the form of the dead. The machine is ready for action, but has not yet felt the quickening influence of life. Let us then advance another step and examine the seat of that power, whose quickening influence is in- fused throughout the system, and whose mandate the muscles hasten to obey. THE BRAIN AND NERVOUS SYSTEM. We have seen that a cavity is formed by the bones of the skull and continued through an opening in its base down through the centre of the vertebras to their ex- tremity. It is to hold within its bony embrace that greyish white, soft and pulpy substance, called the cere* bro-spinal-axis. Of this, the part passing through the vertebras, giving off branches to every part of the sys- tem, is generally known as the spinal cord, while the upper or enlarged portion, also giving off branches, is called the brain. The brain, look at it closely, examine it minutely, bring to your aid, if you please, the powers of the mi- NERVOUS SYSTEM. 477 croscope, and what do you see ? A soft, pulpy, greyish white substance, and yet this is the seat of the death- less soul, here mind reigns and intellect forges those thoughts, which, like the thunderbolts of Jehovah, scatter ruin and death, rouse a nation to arms, shake a world, or infuse around an atmosphere of purity and love. Here are conceived the glowing thoughts of the poet, the bright visions and gorgeous pictures of the artist, plans pure and holy, or debasing, polluting and devilish. This is the fountain of purity and greatness, and of filth, abomination and discord. And yet do we see any of these workings in that mass before us ? Do we see how the thought is transmitted along those electric lines, the nerves, to the remotest extremity ? Or is the fluid so sub- tile as to elude our gaze? We feel the blow which fells us to the earth, but can our eyes see that nervous stimuli which induces the action ? Is it not natural to suppose, that when an agent so quick and subtile, so powerful in its influence on the system becomes diseased or derang- ed, it requires not the blow of the hammer to set it right, but rather a power quick and subtile, yet with sufficient strength to restore healthy action ? This cerebro-spinal-centre is enclosed in three mem- branes. The external one, forming the inside lining of the bone is called the dura mater. On the inner side of the dura mater is a thin serous membrane called the arachnoid. The serous fluid it secretes in a healthy state, seems to lubricate the brain; in a diseased state this fluid may increase in quantity and oppress that organ. The third membrane investing directly the brain, is highly vascular, composed of a net-work of innume- rable vessels held together by cellular tissue. It is the nutrient membrane of the brain, and is called the pia mater. Not only motion, but life itself depends on the healthy action of the nervous system. The cerebro* 478 ANATOMY. spinal-centre in its bony cavity guides and controls every action by means of branches of nerves, which ramify throughout every part of the body. Of these branches the brain proper sends off twe'vipairs. One pair rami- fies upon the membrane lining the nasal passages, creating the delicate sense of smell, and are called the ofactory nerves. A second pair, penetrates the coats of the eye, and expands into the retina, forming a surface upon which every object is pictured, and creating the sense of sight. These are the optic nerves. The third, fourth and sixth pairs are distributed among the muscles of the eyes. The fifth pair has three important branches. One branch passes out from the skull at a notch distinct- ly felt about the middle of the eyebrow, and sends branches to the forehead, eyes and nose. The second branch supplies the teeth of the upper jaw and passing out through a notch in the malar (or cheek) bone, sends a branch to the eye and ramifies over the face. The third branch supplies the teeth of the lower jaw by sending a small branch to each tooth. It also sends branches to the muscles of the lower jaw, the ear and the tongue. It is generally in this nerve and its branches that we have that most agonizing of all pain, prosopalgia or neuralgia of the face. Other nerves supply the ear, the glands of the mouth, the mouth, tongue, throat and muxdes of the neck. The tenth or pneumogastric nerve, gives out branches to the respiratory and digestive organs. As we descend from the brain to the spinal cord, we find it giving off thirty-one pairs of nerves, each arising by two roots, one of which is called the motor, the other the sensitive root. The motor root arises from a narrow white band on anterior columns of the cord, while the sensitive start from the internal part of the cord. Five pairs in the vicinity of the shoulder, unite, forming what is called the brachial plexus, and again NERVOUS SYSTEM. 479 separate in six nerves, which ramify on the muscles and skin of the upper extremities. For the sake of con- venience, we may mention, that the first eight pairs of nerves, commencing at the top of the column, are called cervical, the next twelve dorsal, the next five lumbar and the last six sacral nerves. Besides the brachial plexus, above mentioned, there is also a lumbar and sacral plexus, formed in the same manner, supplying the lower extremities, the hips, the abdomen and the organs in the vicinity of the pelvis. From what has been already said it will be perceived, that the nerves of the spine as well as the brain are of two kinds, the motor, or nerves of motion, and the si n- sitive, or nerves of sensation. The nerves of motion com- municate principally with the muscular tissues and the various organs of the body, while those of sensation ramify more particularly on the skin. Hence the pain in cutting through the skin is much more severe than in the tissue beneath. If the nerves of motion are in- jured so that they cannot act on either side, there is an entire paralysis of that side or organ, notwithstanding the sensation may be as acute as ever. So also when the nerves of sensation are paralized, notwithstanding there may be no diminution of motion in the part, with which they communicate, yet all sense of feeling is entirely gone. Sever the optic nerve, which is a nerve of sen- sation, and sight would be entirely destroyed, notwith- standing the motion of the eye would remain uninjured. Yet if the nerve of motion were severed, the sight would remain uninjured, but the eye becomes fixed and mo- tionless'; and so with the other nerves of the head and spine. Hence we are often unable to move some par- ticular part of the body in which feeling may be acute, and on the contrary, sensation may be absent and motion perfect. Besides the nerves already enumerated, there is still 480 ANATOMY. another, which performs a most important part in the economy of life, viz.: The sympathetic nerve. It con- sists of a chain of ganglia, or knots, extending the whole length of the spinal column on each side. It communi- cates by its branches, not only with the spinal but cranial nerves, and all the internal organs of the head and trunk. Every part of the body is more or less under its influence, as filaments from it, accompany all the blood-vessels throughout their course. Thus a sym- pathetic chain is kept up throughout the body both in health and disease. Digestion. A proper understanding of the organs con- nected with digestion is of course important, as their de- rangement is the fruitful source of a large share of our physical sufferings. Situated around the mouth, are six salivary glands, three on each side of the jaw, the parotid, submaxillary, and sublingual Their secretion called saliva, is dis- charged through small ducts into the mouth. Back of the cavity of the mouth, and connecting with it, is a large passage connecting above with the passages of the nose, and below with the larynx, by means of which air is passed to the lungs, and the oesophagus, through which food passes into the stomach, called the pharynx. The oesophagus is a muscular tube extending behind the larynx, heart and lungs, through the diaphragm into the stomach. The diaphragm is a muscular curtain, separating entirely the organs of the chest from those of the abdomen. It rises and falls with every respi- ration. The stomach is located on the left side of the abdomen, just below the diaphragm, it has two openings, the upper or cardiac orifice connecting with the oesophagus, and admitting the food, the lower or pyloric orifice, connected with the intestines, through which the food passes after undergoing the action of the stomach. DIGESTION. 481 The intestines are divided into large and small. The small intestine, which is about twenty-five feet in length, is divided into the duodenum, jejunum, and illium. The large intestine, about five feet in length, is divided into the ccecum, colon and rectum. The duodenum com- mences at the pyloric orifice of the stomach, and is about twelve fingers in length. Into it open the ducts from the liver and pancreas. The jejunum is a continuation of the duodenum, as is the illeum of the jejunum. These forming the small intestines, pass in convolution from one side to the other, until the illeum terminates in the colon by a valvular opening near the right hip- bone. The ccecum is a blind pouch at the commence- ment of the large intestines. From this point the large intestine or colon ascends on the right side, crosses the abdomen just below the liver and stomach, descends on the left side to the hip-bone, where curving on itself it passes downwards from the rectum and terminates in the anus. The peritoneum is a serous membrane adhering to the inner surface of the abdominal cavity, and is reflected over, invests, and supports the viscera of the cavity. After having completely invested an organ it passes double to the walls of the abdomen, to be there expanded. These duplicatures confine the organs in their place and support them. That which supports the intestines is called the mesentery, and a very large one, hanging loose before them, keeping them warm, is called the oementum. Tlie lacteals are small vessels commencing on the mucous membrane of the small intestine, in the upper portion of which they are the most numerous, passing between the membranes of the mesentery to several successive ranges of glands, diminishing in number and increasing in size at each successive range until they open into the enlarged portion of the thoracic duct. 482 ANATOMY. This duct passes through the diaphragm to the lower part of the neck, where it opens into a vein which passes directly to the heart. The food then, after it has been digested by the stomach, passes into the duodenum, and there mingling with the secretions of the liver and pancreas, is taken up in the form of chyle, as it passes along the intestines, by the innumerable mouths of these little absorbents, the lacteals, by them conveyed to the thoracic duct, and through it passed into the cir- culation, and thus conveyed to every part of the system. The liver is a large gland, weighing three or four pounds, situated on the right side below the diaphragm. On the under surface is the gall-bladder, which acts as a reservoir for the bile. Thie pancreas is a long gland situated behind the stomach transversely across the posterior part of the abdomen. From it as well as from the liver a duct passes into the duodenum. The spleen is a small body situated in the left side. Its use is unknown. URINARY ORGANS. The kidneys, whose office it is to secrete urine, are located on either side of the lumbar vertebras, below the last false-rib. The urine is conveyed from each kidney by a small tube, called ureter, to the bladder. The bladder is the reservoir for the urine, and is located behind the pubis, and above and before the lower part of the rectum. The passage by which the urine passes from the bladder, is called urethra. We are now very briefly to consider that part of the system by which oxygen is introduced into the body and the elements of life conveyed to every part of it. RESPIRATION AND CIRCULATION. The wind-pipe commences at the root of the tongue. and descends in front of the oesophagus to the lungs. RESPIRATION AND CIRCULATION. 483 Its upper orifice is covered by a valve, called the epi- glottis, to prevent the introduction of food, which passes directly over it. Laughter during eating, renders food liable, by the opening of this valve, to pass into the wind-pipe, thus producing violent cough or suffocation. The wind-pipe is composed of cartilaginous rings, united by membranes, and is divided into three parts. The upper portion is called larynx, the middle portion the trachea. The lower part or the bronchia bifurcates from the trachea about the third or fourth dorsal ver- tebra, and passes, one to each lung, where it terminates in an innumerable number of air-cells, which exist in every part of the lungs. These air-cells are separated only by a thin membrane from an equal number of cells filled with blood communicating with the heart. The lungs then are of a spongy texture, made up of cellular tissue, and these innumerable air and blood- cells. Respiration consists in filling these cells with air. The lungs are thus distended, and the dark venous blood passing in from the heart on the opposite side, give off through the thin intervening membrane its carbonic-acid and takes in return the oxygen from the air. The air then by the contraction of the proper muscles is forced out and the lungs contract in size. Thus the chest rises and falls with the respiration and expiration of air. There are two lungs, one on each side of the chest, embracing the heart, and separated from each other by a membranous partition. They are suspended in the chest by roots composed of the pul- monary arteries and veins, the bronchial tubes, &c. They are covered by a serous membrane, which is re- flected over the wall of the chest, forming a shut sack. This membrane is called the pleura, and when inflamed occasions that most agonizing disease pleurisy. The lungs rising and falling at each respiration, the inflamed 484 ANATOMY. surfaces rub against each other, occasioning the most acute pain Circulation. The Jicart is the great centre of circula tion, the main-spring in the beautiful mechanism of the system, its pulsations only ceasing with death. It is situated in the chest between the right and left lung, has two sides, each of which has two chambers or cavi- ties. The upper is called the auricle, the lower the ventricle. These chambers, the auricle and ventricle, are separated by valves. The right side of the heart is appropriated to the venous blood, the left to the arterial blood. As the venous blood passes into the right auricle, the auricle contracts and forces it through the valve into the right ventricle. The contraction of the ven- tricle closes the valve, thus preventing the return of blood, and forcing it into the pulmonary artery, through which it is conveyed to the lungs. Here, in the in- numerable cells prepared for its reception, it throws off, through the thin membrane separating it from the air cells, its carbonic acid, and receives in return oxygen from the air; changed now from dark and impure ve- nous blood, to bright and life-giving arterial blood, it passes on through the pulmonary veins to the left auricle of the heart. This chamber, contracting, forces the blood into the lower chamber or left ventricle, from whence it is prevented from returning by a similar valvular ar- rangement to that found in the right heart. The contrac- tion of the ventricle forces the blood into the great aorta. This great artery of the body gives off trunks to the head, the upper and lower extremities and the organs in the abdominal cavity. These branches, dividing and sub- dividing into innumerable branches, growing smaller and smaller, convey the arterial blood to every part of the system, and at length terminate in a curious net-work of vessels, called the capillary vessels. The arterial system has fulfilled its duty, conveyed the elements of THE SKIN. 485 life and nutrition to every part of the system, and the blood is now ready to be conveyed back to the heart, no longer bright and life-giving, but dark and impure, The veins then, commencing in this capillary net-work of vessels, at first innumerable in number, collect the blood, and flowing into each other, form at length two large trunks the ascending and descending vena cava, by which it is returned to the right auricle of the heart, and from thence in the manner already explained, passes on to the lungs. There throwing off its carbonic acid, and receiving in return oxygen from the air, it flows on to the right heart, when it is again ready to be distributed throughout the system. Thus we have the heart the great central point of the system, the arterial blood flowing outward, freighted with life, to every part of the body and the venous blood, charged with impurities, flowing inward to the heart. Each cavity of the heart holds two ounces, and as it contracts a.bout seventy times in a minute, more than two hogsheads traverse it every hour. And yet per- forming this mighty labor, it beats on year after year, never tiring, until paralyzed by the hand of death. For a more minute explanation of the structure of the heart and the circulation, see "Diseases of the Heart? also chapter on Physiology. The Skin. The skin is composed of two layers of membrane, the cuticle, and true skin. The cuticle has neither blood-vessels nor nerves, and serves as a pro- tection to the true skin. In the inner layers of the cuticle there is a peculiar coloring matter, black in the negro, copper-colored in the indian, and in the white, so transparent as to be scarcely perceptible. The true skin contains, besides arteries, veins, and absorbents, oil glands, perspiratory glands, and nerves. The nerves ramify on the surface, and render the skin sensitive to the touch. The absorbents are small vessels opening 486 ANATOMY. on the inner layers of the cuticle, and through these poisons being rubbed on the skin are conveyed into the system. From the perspiratory glands, which separate from the blood the perspiration, spiral ducts pass obliquely to the skin. In health, these glands are constantly in action, pouring out through the ducts an enormous amount of matter in the form of sensible and insensible perspiration. For a more full description of the func- tions of the skin, see chapter on Physiology. The Teeth. The teeth are divided into two parts. The crown rising above the gum is covered with a fine enamel, to protect it from decay and wear, and to render it more fit to perform its important functions. ^ The root is of a bony substance, and is firmly inserted in the jaw. Communicating to each tooth through the root, is a small nerve. When this is diseased or exposed by the decay of the tooth, that exquisite sensation is pro- duced known as tooth-achie. The first set, twenty in number, appearing in infancy, are only temporary, and are called mitt-teeth. The second, or permanent set, appearing between the ages of six and fourteen are thirty-two in number, sixteen in each jaw. The four front-teeth in each jaw are called incisors, the next on each side the cuspid or eye-tooth, the next two, bi-cuspids, the next two molars, and the last two on each side of the jaw, wisdom teeth, from their not appearing until about twenty, and then being of short duration. The molars on the upper jaw have three roots, those on the lower two, while the incisors, cuspids and bi-cuspids have each but one root. See also chapter on Diseases of Children. Vision. The eye is the most perfect and beautiful optical instrument in the world. It consists of a globe, held in its position by means of six muscles attached TEETH AND EYES. 487 externally to the sc7erotic coat near the cornea, and in- ternally to the bones of the orbit behind the eye. The sclera'ic coat, seen in the white of the eye, is dense and fibrous. It is the strong membrane which invests it, except the transparent part in front. This is called the cornea. It is united with the sclerotica in the same way that the crystal, which it resembles in form, is set in a watch. Within the sclerotica there is a vascular membrane called the choroid coat. It secretes on its internal sur- face the pigmentum nigrum, or black pigment, giving the dark color to the pupil of the eye, and is of vast im- portance in vision. It terminates near the cornea, in a white circle, called the ciliary circle. The internal layer of the edge is thrown into folds, the central border of which rests on the crystalline lens. These folds are called ciliary processes. Starting from the ciliary circle, is a beautifully con- trived curtain, with an opening in its centre, dividing the anterior portion of the eye into two chambers, the communication between which being at this opening. This curtain is capable of contraction and dilation, thus enlarging the central opening, and is called the iris. The central opening is called the pupil. The two chambers are filled with an aqueous humor. Behind the pupil is placed a lens, clear as crystal, and called the crystalline lens. Another and last coat within the choroid is called the retina. The optic nerve passes from the brain through the outer coats and expands on this. This is the seat of vision, and here every object we witness is pictured or daguerreotyped, and the impression thus transmitted to the brain. Within the coats already mentioned and back of the crystalline lens, is a chamber forming the larger portion of the ball of the eye, filled with a humor resembling the aqueous, but more dense, 488 ANATOMY. called the vitreous humor. Over the eye are the eye« lids, lined on the inside by a delicate membrane, which is also reflected over the ball of the eye, called the conjunctiva. It is liable to become inflamed when it appears blood-shot. It secretes a fluid which lubricates the eye. At the upper and outer angle of the orbit is the lachrymal gland. It secretes the tears which are poured on the ball of the eye, keeping it constantly moist. They pass off through small openings at the internal angle of the eye into the nose. We have, then, the cornea collecting and bending in- ward the rays of light; the aqueous humor transmitting the rays and giving free motion to the iris; the iris con- tracting and dilating, admitting only the necessary rays; the crystalline lens, the focus concentrating the rays which then, crossing each other, are transmitted through the vitreous humor to the retina, which serves as a daguerreotype-plate, upon which the image is pic- tured, and the impression through the expanded optic nerve transmitted to the brain. What instrument in the world could be more beautiful or perfect in its construction ? DESCRIPTION OF THE PLATES. PLATE I. Fig. 1. A vertical section of the eye. The optic nerve, 1.—The central artery of the retina, 2.—Envelope or sheath of the optic nerve, 3.—The sclerotic or white coat of the eye, 4.—Transparent cornea, 5.—Union of the sclerotic with the cornea, 6.—Choroid coat, 7.—Ciliary ligament, 8.—Iris, 10.—Pupil, 11.—Retina, 12.—Vitreous humor, 13. -Crystalline lens, 18.—The anterior chamber of the eye filled with aqueous humor, 19.—The posterior chamber also filled with aqueous humor, 20. TJatc J Iith.ofSchedler&Li-lJierl8lBrw;¥ew;YQrk Fio-i Fie J Iitkof ScKedler frXietlexBlBr^]WYr DESCRIPTION OF THE PLATES. 489 Fig. 2. 1. The sclerotic coat at the insertion of the optic nerve.—2. The sclerotic coat has been dissected leaving to view the choroid coat and the nerves which traverse it, and 3. represents their termination in the ciliary ligament.—4. The iris. •■*..■ Fig. 3. 1. Cilliary ligament. 2. Iris. 3. Pupil. - Fig. 4.—The Ball of the Eye. 1. Optic nerve. 2. Tenr dinous attachment of the muscles. Fig. 5. 1. Ciliary processes. 2. Posterior face of the Iris. 3. Pupil. Fig. 6.—A general View of the Nerves of the Face, Teeth, and Tongue. 6. 8. Represent branches of the den- tal nerves, and the passage of the filaments into the teeth. 10. Division of the superior maxillary branch into nerves communicating with the orbit of the eye. 11. Branch of the inferior maxillary branch of the fifth pair. 14. The lingual nerve or nerve of the tongue anastimosing also with other nerves. .16. Pneumo-gastric nerve. 18. Internal carotid artery. 17. Hypoglossal nerve. Branches of other nerves represented in the cut, it will be unnecessary to point out here. PLATE 2. Fig. 1. Is a back view of the human skeleton, a. Re- presents the collar bone or clavicle. F. The shoulder- blade or scapula, b. b. The shoulder-joint. G. The large bone of the arm or humerus. J. H. The small bones of the arm or the ulna and radius. g.M.M. The pelvis. D. The ribs. N.N. The femur or large bone of the leg. Q.P. The small bones of the leg or the tibia and fibula. Fig. 2. Represents the bones of the head. 4. Frontal bone of forehead. 3. Parietal, or side bones of the head. 5. Temporal bone. 6. Malar or cheek bone. 7. Bones forming the bridge of the nose. 8. Upper jaw- bone. 9. Lower jaw-bone. 21* 490 DESCRIPTION OF THE PLATES. Fig. 3.—The Spinal Column. 1.2.3.4. Spinous processes. 5. Cervical vertebras. 6. Dorsal vertebras. 7. Lumbar vertebras. 8. The two false vertebras or the sacrum and coccyx. FIG. 4.—The Chest. The ribs forming the chest are here represented, and at fig. 2 their union by cartilages with the sternum in front. Yig. 6.—The Bones of the Pelvis. 5. The sacrum at its union with the lumbar vertebras. 3. The coccyx. 7. 8. The innominata or hip-bones. 4. The ascetabulum or the cavity into which is inserted the head of the femur forming a ball and socket joint. 9. 10. The seat- bones. 6. The pubis. Fig. 7.—A View of the Bones of the Hand. 1. Carpal or wrist-bones. 2. Metacarpal-bones. 3.4.5. Phalanges of the fingers. Fig. 9.—A View of the Bones of the Foot. 1. Tarsal or ankle-bones. 2. Metatarsal. 3. 4. 5. Phalanges of the foot. PLATE 3. Fig. 1. A front View of the Muscles of the Body. A. a broad muscle helping to depress the angle of the mouth and also when the mouth is shut draws up the skin with which it is connected below the lower jaw. B. Deltoid muscle, used to raise the arm and assist it in all its motions except depressing it. C. Muscle used to bend the forearm. I. Moves the arm forward and up- ward toward the sternum. R. Assists in expiration and occasionally in discharging the contents of the stomach and belly. 0. Crosses the legs in the manner tailors are used to sit. P. Draws the legs and thigh outward. Q. Helps to bend the leg and assists in bringing it and the thigh inward. T. Pulls the thigh inward. V. W. X. Help to extend the leg. Y. Extends the foot. Fig. 2. Represents the extensors of the hand and Fid 1 fJitte J ith of Soh.-dJ.flr fl-LirblrrMl Brw NrwYnrt .Piute I is* % Lukot fH,,lkt,: Li^WBiVNcwYorlc DESCRIPTION OF THE PLATES. 491 forearm. The tendinous extremities are seen passing under the ligament at the root of the thumb and firmly bound by ligaments to the fingers. They serve to ex- tend the hand and forearm. The flexors placed on the opposite side of the hand not seen in the cut serve tc flex the hand and arm, and other muscles in connection with these and the extensors serve to rotate the hand and arm. Fig. 3. Represents in addition to the muscles on the front of the hand and arm the nerves and arteries. 1 Brachial artery. 2. Radial artery. 3. Cubital artery. 4. 5. 6. 7.8. 9.10.11.12.13.14.15. The nerves of the arms and hand and their various divisions and branches. Fig. 4. Represents the muscles of the anterior portion of the leg and foot together with the arteries and nerves. The muscles of the leg may be seen passing under the broad ligament at the ankle, and attached by their ten- dinous extremity to the foot. These serve to flex the foot, and also to extend and rotate the leg. 1. Tibial artery. 2. The great sciatic nerve which may be seen dividing into various branches along the leg and foot. PLATE 4. 1. The stomach. 4. Cardiac orifice. 5. Pyloric orifice. 6. Duodenum. 7. Pancreas. 11. Large lobe of the liver. 15. Gall bladder. 16. Duct leading from the gall-bladder to the duodenum. 17. Trunk of the portal vein. 18. Hepatic artery. 1. Circumvolutions of the small intestines. 2. Ccecum receiving the insertion of the small intestines, and pre- senting at a the appendix vermicularis. The colon or large intestine is seen passing around the smaller ones. 3. Ascending colon. 4. Transverse colon. 5. Descend ing colon, 7. Commencement of the rectum. 492 DESCRIPTION OF THE PLATES. PLATE 5. Fig. 1. Represents the heart, the great aorta passing off from it, and its division into arteries which supply the head and upper extremities with blood, also some of the muscles of the head and face. 1. The heart. 2. 3. Arteries of the heart. 4. Pulmonary artery. 5. The great aorta. 6. The brachial cephalic trunk. 7. The carotid artery branching off from the brachial cephalic on the left side. 9. Division of the brachial cephalic into the subclavian and carotid. 10. Division of the primitive carotid into the internal and external carotid. 11. Thyroid artery. 12. Lingual artery. 13. Facial ar- tery. 16. 17. Arteries of the lips. 26. Vertebral artery. In the face may be seen the muscles by which the various movements of the face may be performed, giving to it its varied expressions of life and animation, of joy and sorrow. Fig. 2. The lungs, heart with its arteries and veins, and the windpipe passing to the lungs. 1. Larynx. 2. Trachea. 3. 4. Lungs. 5. Heart. Fig. 3. The windpipe is seen with its divisions into larynx, trachea and bronchia. 3. 10. 11. Bifurcation of the bronchia, each branch giving off other branches, which divide into almost innumerable air-cells. Fial PJa-te 5 t\&3 iith.of Schedlei' & Lie.Uer JSlBrw. N ewYork / physiology. 493 CHAPTER II. PHYSIOLO GY. The bodies of all the higher animals are composed of a great variety of parts, different in their structure and action, and yet so beautifully adapted to each other as to act in perfect harmony. In the lowest forms of vegetable life we find a single cell making up the whole fabric. This cell, grows from its germ, absorbs and assimilates nutriment, converts a part of it into its own cell-wall, secretes another portion into its cavity, and from a third, produces the repro- ductive germs that are to continue its race. Having completed the germs, it bursts and sets them free. Each one of these germs is capable of going through the same set of operations. In the higher forms of vegetable life we find a multi- plication of similar cells, among which these operations are distributed, thus producing by the labor of all a more complete and permanent effect. At the extremities of the roots of plants we find suc- culent bodies made up of soft cells, known by the name of spongioles. These perform the absorption of nutri- tious fluid, which is conveyed by the vessels of the stem and branches to the leaves, and there in the cells, which make up the parenchyma of those organs, undergoes a change. The watery ascending sap is converted into thick glutinous latex, which like the blood of animals contains the material for the production of new tissue and the elements of the various secretions. This pro- cess of conversion comprises not only the exhalation of superfluous liquid, the action of light, and the inter- change of gaseous ingredients between the sap and air, but a new molecular arrangement of the particles of 494 PHYSIOLOGY sap, by which new products are generated. This process; which is such an immense step towards the production of living tissue from the crude material, is called assi- milation. As the latex descends in its proper vessels through the stem, it yields up to the growing parts the nutrition they severally require. Beside the ordinary tissue, of which most of the fabric is composed, in the growth of which the process of nutrition is considered as consist- ing, there are groups of cells, which separate peculiar products from the sap such as oil, starch, resin, &c, which are stored up against the time they are demand- ed. These are said to perform the act of secretion. All the cells by which the permanent fabric is provided for, have as individuals but a very transitory life. The ab- sorbents are continually renewed, some dying, and others forming the solid texture of the root. In the short du- ration of the assimilating cells, we have a convincing proof in the fall of the leaf and the opening buds. The secreting cells undergo a like transitory duration. The starting point both in the animal and the plant is the same. The embryo of the animal up to a certain grade of its development, consists, like that of the plant, of nothing else than an aggregation of cells. Among the higher class of animals, however, a large proportion of the fabric consists of tissues in which no distinct trace of cellular origin is apparent, and yet when we subject them to a close analysis, and examine them not only in their complete state but in their development, we find they are reduced to the same category with the tissues of the plants and lower animals. There are tis- sues peculiar to animals, and these we find referable to the plastic fluid prepared by the assimilating cells, and set free by their rupture. In plants, the tissues principally concerned in the vita7 operations retain their cellular form. We also see distinct groups of cells in PHYSIOLOGY. 495 the bodies of animals, which have not only the functions of absorption, assimilation, respiration, secretion, and re- production, which we also find in plants, but those of muscular contraction and nervous action, which they alone perform. The cell originates from a reproductive granule, pre- viously formed by some other cell; this granule attracts to itself, assimilates and organises the particles of the nutrient fluid in its neighborhood, and converts some of them into the substance of the cell-wall, and draws others into the cavity of the cell. In this way the cell gradually increases in size, and while it approaches its term of life, makes preparation for its renewal, by the development of reproductive granules in its interior, which may become the germs of new cells, when set free from the cavity of the parent by the rupture of the cell- wall. In the chyle, lymph, and blood, we find floating cells, called the chyle and lymph-corpuscles and colorless corpuscles of the blood, having no single nucleus, but several scattered particles, each of which is a reproduc- tive granule. These, when set free by the bursting or liquefaction of the walls, float in the current of fluid, and are in their turn developed into cells. In general however, the cells of animal tissue are furnished with a nucleus. The nucleus seems to be the chief instrument in the function of the cell. In some cells this function is restricted to the attraction of certain constituents, by which its cavity is filled. These constituents may be of a fluid nature readily passing into decomposition, such as the glandular structure, or they may give solidity to the texture. Thus the cells of the epidermis are strength- ened by a deposit of a horny nature, those of shell by the deposit of carbonate of lime, and those of the bones and teeth by mixture of earthy and mineral matter. These cells do not generally reproduce themselves, but 496 PHYSIOLOGY. successive crops of them are formed as fast as they are required from other sources. Cells are often elongated, and their cavities occupied by internal deposit, so that they may be mistaken for solid fibres, or the boundary of the cells may be lost by their coalescence with each other. The character of the cell may be completely changed by a solution in its wall in one or more spots so that its cavity is laid open and coalesces with some other. Thus, by the disappearance of the partition between the cells may be formed a tube, and this ma}7 coalesce with others to form a capillary net-work for the circulation of blood. In the blood we find two varieties of cells or cor- puscles. The red blood corpuscle owes its color to a se- cretion within its walls of a peculiar chemical nature. Notwithstanding, judging from analogy we should sup- pose that the red corpuscles in man and the other mam- malia would contain a nucleus, as they do in all other animals, yet they have never been discovered by the most careful microscopic examination. Their principal office seems to be the introduction of oxygen into the blood that circulates through the systemic capillaries, and the removal of the carbonic acid set free there, serving as a medium for bringing the tissues in relation with air, which is necessary for the maintenance of their vital activity. The colorless corpuscles seem to have a dif- ferent office to perform. While the red corpuscles are only found in the vertebrated classes and the higher invertebrata, the colorless are found throughout the whole animal scale. Hence we might suppose that the colorless corpuscles are closely connected with nutrition, while the functions of the red corpuscles must be of a more limited character. In animals, in a state of starvation, we find very few colorless corpuscles, while in those that are well fed, they exist in great abun- dance. In inflammation, colorless corpuscles rapidly PHYSIOLOGY. 497 increase in the inflamed part. There is then scarcely a reasonable doubt, that elaboration of fibrin is a conse- quence of this form of cell-life, and is one of its express objects. A class of cells next in independence to the cells in the animal fluid we find on the membranous surface of the body, forming the epidermis and epithelium. The epi- dermis is a thin semi-transparent pellicle, covering the entire body in close connection with the true skin. It consists of a series of flattened scale-like cells, the outer layers of which are constantly thrown off by desquama- tion, new ones having formed below. The epidermis is not traversed by nerves and blood-vessels, but is pierced by the excretory ducts of the sebaceous, sweat-glands and the hairs. These perspiratory tubes passing from the sweat-glands, which are only a short distance beneath the skin, and pouring out an enormous quantity of per- spiration are almost innumerable. Each of the perspi- ratory pores is the aperture of one of these tubes, about a quarter of an inch long. Wilson calculates the ave- rage number of these pores to the square inch to be 2800, making in an ordinary sized man 7,000,000. The number of inches of perspiratory tube then would be 1,750,000 or nearly twenty-eight miles. What an argu- ment for cleanliness! The office of the epidermis is, to protect the true skin from pain occasioned by slight abrasion, and the irritating effect of air and the changes of temperature. Other cells mingle with the epidermic and secrete coloring matter instead of horn, these are termed pig- ment-cells. They are not readily distinguished in the epidermis of the fair races of mankind, but in the color- ed races they are very marked. The layer of cells covering the internal free surface of the body is called the ephithelium. The principal forms in which we see them are the tesselated and cylindrical. 498 PHYSIOLOGY. The tesselated epithelium covers the serous and sy- novial membranes, the lining membrane of the blood- vessels, and the tubuli of most glandular structures con- nected with the skin or mucous membrane. The cylin- drical covers the mucous membrane of the alimentary canal, and is also found in the larger ducts of glands which open into it. Both forms of epithelial cells are frequently fringed at their free margin with delicate filaments called cilia. These, although of extreme mi- nuteness, are organs of vast importance in the animal economy. Their functions are to propel the secretions, which would otherwise accumulate on the membranes, towards the exterior orifices, whence they may be carried off. The secretions, both in the serous and mucous membrane are carried on through the epithelial cells, and the difference between the two membranes consists principally in the different arrangement of these cells. Let us now glance at the process of nutrition as it is carried on in the human system, and the various phe- nomena it produces. Every hour of our lives a change is going on in our system. Every motion of the hand, every movement of the body, is occasioned by a transformation of the struc- ture or its substance ; every mental affection is followed by changes in the secreting fluid ; every thought and every sensation is accompanied by a change in the com- position of the substance of the brain. We can neither move, nor think without a corresponding change in some portion of the system. The matter which composes the body to-day is constantly passing off in the form of per- spiration, urine, or the carbonic acid of the lungs, its place being supplied by new material taken into the system in the air we breathe and the food we eat. In this constant, never-ceasing change not only is nutrition supplied, but force produced. In the closed galvanic circuit, certain changes which a metal undergoes when PHYSIOLOGY. 499 brought in contact with an acid, produces a current of what we call electricity; so in the human system, in consequence of certain changes undergone by matter which previously constituted a part of the organism, phenomena of motion and activity are produced, which we call life or vitality. Man from his birth to his death, by night and by day, is constantly taking into his sys- tem through the organs of respiration, a vast amount of oxygen. Notwithstanding during the year this amounts to nearly eiglit hundred pounds, yet his weight is not materially increased, but it is oftentimes considerably diminished. The question now arises what becomes of this vast amount of oxygen ? It does not remain in the system, but passes off in the form of a compound of carbon or of hydrogen. These which once formed a part of the tissue entering into combina- tion with the oxygen, are given off in the. form of car- bonic acid and water. We find that blood yields 20 per cent, of dry residue ; the remaining 80 per cent, is water In 100 parts of dry residue we find carbon 51.96, hydrogen 7.25, nitrogen 15.07, oxygen 21.30, ashes 4.42. If we take the statement of Lavoisier and Seguin, man receives into his system daily 32i ounces of oxygen, (46.037 cubic inches = 15.661 grains French weight,) and the weight of the whole mass of blood, of which as we have stated 80 per cent, is water, is 24 pounds. In order to convert the whole of its carbon and hydrogen into carbonic-acid and water, 64,103 grains of oxygen are required. This quantity will be taken into the system of the adult in four days and five hours. We cannot then escape the conclusion, that if man takes into his system 32i ounces of oxygen in a day, he must also receive daily, in the form of nourishment, as much carbon and hydrogen as would make 24 pounds of blood, that is, if the weight of the body remain unchanged, and is in the same con- dition as it regards health. Experiments have been 500 PHYSIOLOGY. tried by which the actual amount of carbon consumed in the system during the day has been ascertained with great accuracy. The food of 30 soldiers in barracks was accurately weighed every day for a month, even to the most minute articles, such as pepper and salt, and each article of food was separately subjected to analysis. The fasces and urine were also weighed, and the amount of unburnt carbon ascertained and deducted. An adult taking moderate exercise consumes 13TV ounces of car- bon daily. This carbon escapes through the skin and lungs in the form of carbonic-acid gas, and requires to convert it into that state 37 ounces of oxygen. As no part of the oxygen taken into the system is given off in other combination than with carbon and hydrogen, and as the carbon and hydrogen must be re- placed by the food taken into the system, it is clear that the nourishment required must be in a ratio with the amount of oxygen taken into the body. Two animals which take up an unequal amount of oxygen require in the same ratio an unequal amount of food. The child whose respiration is very active, requires food much oftener than an adult. Deprive a bird of food and it dies in a few days, while a serpent, with its slow respi- ration, will live without food two or three months. The quantity of oxygen we respire is materially affected by the atmosphere, its density and change of temperature. In summer the air is not only rarefied, but contains a vast amount of aqueous vapor, while in winter it is not only dry, but condensed by cold. Thus the same volume of air contains more oxygen in cold northern climates than in tropical regions, in winter than in summer. The inhabitants of a warm climate therefore would require far less carbon to support life than those who are com- pelled to endure the intense cold of the frigid and upper portion of the temperate zones. For the same amount of force far more oxygen is inspired in cold than in warm PHYSIOLOGY. 501 weather, on the sea-shore than on the summit of high mountains. Nature, with the wisdom which governs all her movements, has so ordained, that the fruits and vegetables which compose a large proportion of the food in tropical climates should contain far less carbon than the food in colder regions, notwithstanding a larger amount in bulk may be used by the former than the latter. The fruit on which the natives of warm climates mostly feed, contains but about 12 per cent, of carbon, while the meat and train-oil in arctic regions contain from 6Q to 80 per cent. From what has been stated, it will readily be per- ceived, that the true source of animal heat is the action between the elements of food and the oxygen conveyed to every part of the body by means of the blood. Car- bon cannot combine with oxygen without heat being evolved. The amount of heat of course varies with the amount of oxygen introduced into the system. The tem- perature of a child whose respiration is very rapid, is higher than that of an adult; the former being 102°, the latter 99.5°. The heat of an adult is the same in every part of the world, where the thermometer con- tinues for weeks at 90a above zero and where it ranges for months from twenty to forty below, amid the ice which encircles the poles, and the rich vegetation which grows with amazing rapidity beneath a tropical sun. This will not appear strange when we look upon the animal body as a heated mass, giving out heat where the surrounding objects are colder than itself, and taking it in where they are warmer. What an enormous dif- ference there must be in the amount of heat given out in those warm climates where the temperature is nearly the same as the body and in those intensely cold regions where it is 100° lower, and what a vast difference there must also be in the amount of food required to keep up that combustion which produces animal heat. Deprive 502 PHYSIOLOGY. the native of the south of food, and death would be slow in its progress. Deprive the inhabitant of a frozen region of food, and death would be speedy. The enor- mous combustion required to be kept up to defend the system against the cold would in a short time exhaust the body of its carbon and death would ensue. There are many tribes of savages who go nearly naked where the climate is intensely cold, but they consume a vast amount of carbon, in the form of meat, train-oil and tallow. Clothes after all are only an equivalent for a certain amount of food. Food is regulated by the number and strength of the respirations, the tempera- ture of the air and the amount of heat given off The amount of oxygen consumed, depends upon the tempe- rature and density of the air, motion, and the amount and quality of food consumed. Without detriment to health no more carbon and hydrogen can be taken into the system than is given off in carbonic acid and water, and yet persons accustomed to large quantities of substantial food, on visiting a warm climate, think they must eat the same articles and as much of them as they did when the thermometer was thirty or forty degrees less. On finding their appetite flag and its relish for hearty food subside, they stimulate it, by means of cayenne pepper, mustard, brandy, wine, and a hundred other stimulants. The consequence is, an unnatural state is induced, the carbon is not consum- ed, disease ensues, and the patient stands a fair chance of paying for his ignorance and folly, with his life. The evils resulting from an abuse of intoxicating drinks have been sketched in such graphic colors as to almost curdle the blood with horror, and yet the question would be by no means a difficult one to decide—which has created more pain, and caused more deaths, intoxicating drinks or errors in diet ? If we hold that the increase of mass in the animal PHYSIOLOGY. 503 body, the development of organs, and the supply of waste, is dependent on the blood, to ascertain whether a substance contains nourishment, all that is necessary for us to do, is to compare its ingredients with those of the blood. The chief ingredients of blood will be found to be fibrin and albumen. Blood, after having been drawn from the body, coagulates and separates into a yellowish liquid, called the serum, and a gelatinous mass, adhering to a rod on stirring it, in soft elastic fibres. This is called ■fibrin, and is identical with a muscular fibre purified from foreign matter. The albumen is contained in the serum and gives to it the properties of the white of eggs; when heated it coagulates into a white elastic mass. Fibrin and albumen are shown by chemical analysis to contain the same ingredients in the same proportion. The particles are arranged however in different order, as is shown by the difference of their external properties. They also contain the earth of bones. The serum re- tains in solution sea salt, and other salts of potash and soda in which the acids are carbonic, phosphoric and sulphuric. The globules of the blood contain not only fibrin and albumen but a red coloring matter, in which iron is an element. Both albumen and fibrin in the pro- cess of nutrition are capable of being converted into muscular fibre, and muscular fibre is capable of being converted into blood. Every part of the body contains nitrogen, also carbon and the elements of water, but the latter in no case in proportion to form water. The blood contains 17 per cent, of nitrogen, and no organ in the body less than that amount. Experiments show conclusively that the body is utterly incapable of producing an elementary body, such as carbon or nitrogen, out of substances which do not contain them. No nitrogen is absorbed from the air, and as it enters into the composition of 504 PHYSIOLOGY. every part of the body, it is clear that it must exist in all kinds of food fit for the production of any portion of the body. There is another substance, identical in composition with albumen and fibrin, and that is caw inc. It is identical also with vegetable caseine, so that certain plants are capable of yielding the same substance that is formed from the blood of the mother. The young animal therefore receives caseine, which is extremely soluble, the chief constituents of its mother's blood. We have said that all the organs in the body contain a certain amount of nitrogen, and that this nitrogen must be taken into the body by means of food. These azotized forms of nutriment, may, in the vegetable world be divided into three parts. When the juices of vegetables are allowed to stand, we find in a few minutes a gelatinous precipitate, which we readily recognize as one of the azotized substances serving as nutriment to animals, viz. vegetable fibrin. Heat the remaining fluid to a boiling point, and it coagulates, resembling the white of an egg, or the serum of blood, when dilut- ed with water and heated to the boiling point. This is vegetable albumen, or the second nitrogenized substance. From these three azotized substances, vegetable fibrin, albumen, and caseine, are the principal azotized con- stituents of our food. These three substances, as has already been stated, contain the same organic elements, and are identical in composition with the chief con- stituents of blood. We have seen that nitrogen exists in every organ of the body, and that those substances necessary for nourishment are generally rich in nitrogen, and yet there are substances, such as sugar, starch, gum, pectine, &c, containing no nitrogen, a certain proportion of which is absolutely essential to our existence, and without which we could not survive. Milk contains one nitrogenized substance, caseine', PHYSIOLOGY. 505 besides this, its chief ingredients are butter, or fat, and sugar of milk which contain no nitrogen. From the caseine the young animal of course obtains its blood, muscle, cellular tissue, bone and nerve. Why is it then that the other ingredients, the butter and sugar of milk are absolutely essential to life ? By means of these compounds there is added to the nitrogenized constituents of blood an excess of carbon and hydrogen, which are expended in the production of animal heat. The food taken into the body goes in the first place to restore the waste of matter in the various organs, which, in the exercise of their functions are con- stantly undergoing a change, old particles being con- sumed and their places supplied by new matter constantly conveyed to all parts of the system by those never-idle channels, the arteries and their ramifications. What then becomes of the new compounds produced by the trans- formation of the different parts of the body, whose places have been taken by the new material ? The never-tiring, never-failing current of the blood constantly performs its office, and when not interfered with performs it well. The arterial blood flowing outward, carrying the prin- ciples of life and reproduction, as the transformation in tissues takes place crowds before it the new compounds into the channels prepared for them, the veins, by which in the form of venous blood, it is transmitted in part, to the heart, and from thence passing into the lungs, there subjected to the action of the atmosphere, throwing off its impurities, its character of dark venous blood is changed on the reception of oxygen to arterial, and is again distributed, divested of its impurities, and freight- ed with life passes to every part of the system. The venous blood, before reaching the heart, is made to pass through the liver, where there is taken from it those substances that are incapable of nutrition. From the arterial blood, the kidneys take up those new compounds 22 506 PHYSIOLOGY. containing the nitrogen of the transformed tissues, which, being no longer of any use, are expelled in the form of urine. Those on the contrary, which contain the carbon of the transformed tissues, are taken up by the liver, and pass into the gall-bladder in the form of a com- pound of soda, the bile. This is transmitted through the gall-duct into the duodenum, and there mingling with the chyme is taken up in part by the absorbents and returned into the system. By means of the blood a current of oxygen passes into every part of the body. This oxygen in passing through the capillary vessels, meets with the compound produced by the transforma- tion of tissues, combining with the carbon to form car- bonic acid, which passes off through the lungs, and with the hydrogen to form water, which passes off in the form of perspiration. What escapes this process of oxydation is sent back into the circulation in the form of bile, which by degrees completely disappears. In the vegetable world, the carbon which we find de- posited in seeds and fruits, in the form of oil and fat, was previously a constituent of the atmosphere and was absorbed by the plant as carbonic acid. By the in- fluence of light and the action of the vital force of the vegetable it was converted into fat. If we turn to the animal world, and examine their food, we are forced to the conclusion, that the fat found in the body, is formed in its organism. In the food of the cow, we find no butter, no suet in the fodder of cattle, and no lard in the food of swine. But we find on sepa- rating a certain amount of oxygen, which they contain, from the starch, gum, and sugar, that enter the composi- tion of one class of food, fat is produced. On separating a certain amount of oxygen from fibrin, albumen, and .caseine, contained in another class of food, we also ob- tain fat. In fatty bodies we have on an average for 120 equivalents carbon, 10 of oxygen. In vegetable fibrin PHYSIOLOGY. 507 albumen, and caseine for 120 equivalents of carbon there are 36 of oxygen. Therefore we have only to separate 26 equivalents of oxygen from these ele- ments to produce fat. In gum, sugar, and starch, we find the amount of oxygen varies from 100 to 140 equivalents to 120 of carbon, so that to form fat from these substances we have only to separate from 90 to 110 equivalents of oxygen. This oxygen is not given out in a free state, but in combination with other sub- stances, in the form of perspiration, urine and carbonic acid, the result of which combination is of course animal heat. The formation of fat then is occasioned by a de- ficient supply of oxygen taken into the system to equalize the amount of carbon. For the body to acquire no in- crease in size it is necessary that the same amount of carbon shall be consumed or given out that is taken into the system. Where a large quantity of carbonized food is taken into the body, and the amount of oxygen is not increased by exercise or labor, of course an accumulation of fat is the result. We have an illustration of this in the Bedouin whose active life would prevent the accumula- tion of much fat, and in the Turkish and Chinese ladies, where obesity is considered a requisite for beauty, and their indolence and gluttony are favorable to that con- dition. Whoever heard of a fat Bedouin ? The carbon contained in the fat thus deposited is capable of being consumed, and entering other combinations for the pur- pose of supplying animal heat. The substances of which our food is composed then, may be divided into two classes; the nitrogenized, capable of being converted into blood, and thus forming all the organized tissues, which might be called the elements of nutrition, and the non-nitrogenized, which are strictly elements of respiration. Let us now look at the process of digestion, and the change necessary for the food to undergo before it can be taken up by the ab- 508 PHYSIOLOGY. sorbents. All nitrogenized articles of food are undoubt- edly converted into albumen before they can contribute to nutrition. The food, in passing into the stomach, becomes min- gled with the saliva, which possesses to a certain extent, the power like the gastric juice, of acting on azotized compounds. With the saliva there is mingled a large quantity of atmospheric air; this entering the stomach, the oxygen aids digestion, the nitrogen passes off in respiration, perspiration, &c. The inner coat of the stomach, in its natural or healthy state is of a light or pale pink color, varying in its hues according to its full or empty state. It is of a soft or velvet-like appearance, and is constantly covered with a thin, transparent, viscid mucus, lining the whole interior of the organ. By applying irritants to the stomach and observing the effect through a magnifying glass, innumerable lucid points and very fine nervous or vascular papillas can be seen arising from the villous membrane, and protruding through the mucous coat, from which distils a pure, limpid, colorless, slightly viscid fluid. The fluid, thus excited, is invariably acid, and is called the gastric juice. The gastric juice never appears to accumulate in the stomach when fasting, and is seldom if ever discharged from its vessels, except when excited by the natural stimulus of aliment, mechanical irritation of the tubes, or other excitants. The quantity of the gastric juice secreted from the walls of the stomach depends on the general require- ments of the system rather than the amount of food. The juice refuses to dissolve only a certain amount of food, and when that is accomplished, if an excess has been taken, the residue either remains in the stomach or passes into the bowels in its crude form, becoming a source of irritation, pain, and disease. This abuse of the stomach by introducing into it more food than it PHYSIOLOGY. 509 can readily digest, is often considered a trouble of but few hours' duration, when in reality the worst effects are not felt at first, but the foundations of a disease are laid, oftentimes exceedingly troublesome and painful, and not unfrequently terminating in death. The gastric juice is decidedly acid, containing among other ingredients, a considerable amount of hydro-chloric or muriatic acid. The process of digestion, at one time, looked upon as the result of vital force, is now generally conceded to be carried on by chemical action. The food in passing into the stomach is subjected to a peculiar peristaltic movement, not only producing a thorough in- termixture of the gastric fluid with the alimentary mass, but causing the contents to revolve about the in- terior from point to point. As the process of digestion goes on, its result in the form of chyme, varying in color from that of cream to gruel, gradually passes through the pyloric orifice into the duodenum. Here, before it is taken up by the lac- teals, it is mingled with the bile and pancreatic juice, the soda in these fluids neutralizing the acidity of the chyme which it has obtained from the gastric juice. The effect of this admixture is to separate the chyme into three distinct parts,—a reddish brown sediment at the bottom,— a whey-colored fluid in the centre,—and a creamy pellicle at the top. The central portion with the creamy pellicle seems to constitute the chyle absorb- ed by the lacteals; the creamy matter being chiefly composed of oily particles, and the wheyey fluid having proteine-compounds, saccharine and saline matters in solution, the sediment, partly consisting of the insoluble portion of the food, and partly of the biliary matter it- self, is evidently excrementitious. Let us now glance briefly at the circulation of the blood. The popular explanation given to the circulation of the blood in man, makes the heart the prime-mover 510 PHYSIOLOGY. of the mechanism. This organ, they say, is devoted to a double purpose, that of a force-pump, in driving the ar- terial blood through the arteries to every part of the body, and of a suction-pump, to enable the venous blood to return to the heart. In order to accomplish this two- fold purpose, it is furnished with valvular and tubular arrangements, and, at specific periods, contracts and di- lates for the purpose of ejecting or sucking up the cir- culating liquid. Dr. Draper, professor of chemistry in the New-York University, has advanced another theory, which, to say the least, is plausible and worthy of careful investiga- tion. To keep a continuous flow of a liquid through a capillary tube it is necessary, either by evaporation, or some chemical action, to remove the superficial por- tions of the elevated liquid when they stand at the ex- tremity of the tube. Fill a lamp with oil, and unless you light the wick, no oil would be removed. In an al- cohol lamp, if the wick should be uncovered evaporation of the alcohol in the upper portion of the capillary tubes of the wick would take place, and thus a continuous flow of the alcohol would be kept up until the contents of the lamp were exhausted. Take for instance a bladder, which is of course full of capillary tubes, fill it with al- cohol, making the mouth of the bladder tight, so that none of the fluid can escape. On placing the bladder in a vessel of water, you find the alcohol gradually coming out of the bladder into the water, and the water flowing more readily, passing much more rapidly into the bladder, so in a short time you have an accumu- lation in the bladder which distends it, and finally causes it to burst. Thus a constant current is kept up through the walls of the bladder, that having the most affinity for the tubes flowing more rapidly. Watching these phenomena, Dr. Draper lays down the following principle: PHYSIOLOGY. 511 " If two liquids communicate with one another in a capillary tube, or in a porous or parenchymatous struc- ture, and have for that tube or structure different chemical affinities, movements will ensue ; that liquid having the most energetic affinity will move with the greatest velocity, and may even drive the other liquid entirely before it." Starting from this point, he endeavors to show, that the same forces which cause the circulation of sap in the vegetable world are brought into action in the cir- culation of blood in the human system; that in both cases the principle is the same. The arterial blood charged with oxygen, as soon as it reaches its destination in the minute capillary vessels, begins to carry on its process of oxydation, attacking in a measured way the various tissues through which it is flowing, burning out their effete carbonaceous matter and in the change of tissue which takes place, causing, as we have already shown, the evolution of heat. While this change is going on in the tissue the arterial blood also undergoes a change, in giving up its oxygen and gaining in exchange the result of the combustion. From crimson, it becomes dark ; from arterial it changes to venous blood. On the one side of the capillary tubes, we have of course arterial, on the other venous blood. The arterial blood, bearing its oxygen, ready to burn out any carbon or hydrogen in its way, substances of which the tube or structure is composed, possesses an intense affinity for those structures, which is at last ex- hibited by their destruction. The arterial blood has therefore an intense affinity for any of the structures with which it is brought in contact, but after its oxy- gen is exhausted and the arterial is changed into venous blood, this affinity no longer exists. Referring back to the principle already laid down, what is the phenomenon which that principle predicts as arising under these circumstances? Simply, that 512 PHYSIOLOGY. arterial blood will drive the venous blood before it, and drive it with an inexpressible force. From this train of reasoning Dr. Draper concludes that the true cause of the systemic circulation is the oxygenixed action of the arterial blood. In the systemic circulation, upon these principles, the flow must be from the artery to the vein. In pulmonary circulation we have venous blood pre- senting itself in the lungs to atmospheric air. The venous blood has an intense affinity for the oxygen in the air, and the arterial, of course none. Movement therefore must ensue, but as the conditions of the affi- nity are reversed, so also is the direction of the motion, for now the venous blood drives the arterial before it with great force to the heart. The pulmonary circula- tion is therefore due to the oxydation of the venous blood. Those who insist that the circulation is owing to the forcing and suction power of the heart, and to that alone are referred to plants wholly destitute of a heart and yet their juices circulate. There are multitudes of ani- mals in the same predicament. In insects no such cen- tral organ appears. In fishes the systemic circulation is carried on without a heart, and in cold-blooded ani- mals movements in the capillaries take place after the heart is cut out. When we inquire into the condition of the circulation in the earliest periods of existence, we find that the vessels themselves are the first to ap- pear, and the heart is subsequently developed. What then is the true office of the heart ? The sys- temic circulation originates in the deoxydation of the blood, the pulmonary, in its oxydation. There is no ne- cessary connexion between the chemical changes taking place in the lungs and those in the system. Both are determined by their own proper causes. If therefore on either of these points of change an ex- cess of action takes place, the result must be a disturb- PHYSIOLOGY. 513 ance of the equilibrium of the whole circulation. At some central point therefore, the current, going to the respiratory machine, and that going to the system must be intercepted—and intercepted by an apparatus which could hold both in check and time the movements of one to those of the other. The heart then by periodic muscular contractions serves to adjust the flowing cur- rents to one another, and prevent engorgements or de- ficiencies in any part of the route. How do these chemical principles apply when the system becomes diseased? Whenever the admission of oxygen into the lungs is stopped, the circulation through them ceases. What is the cause of that asphyxiated condition? Why does the blood cease to flow. The chemical theory of the circulation of the blood through the lungs points to the oxydation of that blood as the cause of its movement. It is the pressure of the de- oxydized upon the oxydized blood that drives the lat- ter along the pulmonary veins to the heart. But should anything intervene to prevent that oxydation taking place, no pressure can arise, and therefore no movement ensue; the conditions for asphyxia are all present; conditions which are removed by the readmission of oxygen into the lungs. 514 HYGIENE CHAPTER III. HYGIENE AND THE CAUSES OF DISEASE. A large class of diseases arise from ignorance ; igno. i-jmce of the laws of health, of the delicate and beauti- ful organization of the system, of the great end and aim of existence, of the harmonious play, which should ever esdst between all the organs and faculties of our being, between the mind and the body, the spiritual and the physical. Amid the wild and restless scenes of life, the cease- less wbirl and mad excitement of business, the feverish panting for fame, wealth or power, as well as in the more quiet paths of rural life, or the slothful walks of luxurious ease, but very few maintain that beautiful harmony between all the organs, that equilibrium throughout the system, which is essential not only to health, but true greatness. As well might we expect ripe fruit amid the cutting winds, the ice and snow of our northern winter, or the rich luxuriance of southern vegetation in our colder northern clime, as to expect health, a happy tempera- ment, and above all a clear and strong mind, unless an equilibrium be kept up in the system and each organ receive its necessary and only its necessary degree of attention and cultivation. There is no machine in the world so much abused as the human system, or which, if trifled with to the same extent, would last one half as long. It is not generally until often and repeated violations of the laws of health, that nature unable longer to bear the ill treatment, sinks. We know there is an inexorable sentence passed on all, from which there is no appeal. That sentence is. AND THE CAUSES OF DISEASE. 515 death. This dread conqueror tramples on all. His foot must rest on the necks of all, but must more than half the human race yield to his power in the first flush of life, before they have numbered five summers ? Must the strokes of death fall thick and fast on the young, the bright, the gay, the talented, the genius, the states- man, the poet, the scholar, the divine, before even time has marked his wrinkles on their brows or scattered his frosts on their heads ? Must earth be piled with the graves of the young ? Must the human family, filled with disease and racked with pain, go groaning and sighing through the world, with forms bent, and heavy steps and downcast eyes, and haggard looks ? No, we have not thus read the designs of Providence. Great laws have been ordained to govern our physical as well as moral being. The human system is a perfect instrument, which should ever be strung to harmony. Obey the laws of health, for they were all intended for our physical well-being, maintain a proper equili- brium in the system, and a perfect harmony will per- vade the whole, and the notes of this glorious instru- ment grow clearer and sweeter until it is broken not by disease, but time. The object of the present chapter, is to unfold some of the great laws of health, to show the causes of dis- ease, and how in many cases it may be prevented, re- serving for other chapters the treatment of disease xfter it has once sown its seeds in the system. In the investigation of this subject we shall consider 1. Climate, changes of temperature, c&c 2. Impure air, ventilation and cleanliness. 3. Diet, exercise, c&c 4. Bathing—its different varieties. 5. Influence of mind on disease. 6. Hereditary taint,predisposition to disease, c&c 7 Mental, moral and physical education. 516 HYGIENE 1. CLIMATE, CHANGES OF TEMPERATURE, &C The range of temperature and the amount of cold and heat the human system is capable of enduring is im- mense. Thus, we find human beings, as well as various forms of animal and vegetable life, flourishing in the intense cold of the frozen regions, when the thermometer sinks to 40 or 50° below zero, and the night is five or six months long, as well as in more temperate regions and in the torrid zone, where the thermometer remains for weeks from 100 to 110° above zero. The amount of heat and cold, which the human sys- tem is capable of enduring under certain circumstances has been proved by actual experiment to be so enormous, that had not the statements been well attested, we should have been inclined to doubt their truth. In some ex- periments tried in the years 1760 and 1761 in France, to devise means to destroy an insect which consumed the grain, a girl entered the oven and after remaining two or three minutes marked the point to which the mer- cury in the thermometer had risen at 260°. Insisting that she felt no inconvenience, she remained ten min- utes longer, during which time the mercury reached the 288 degree, or 76° of heat above water when it boils. On coming out, her complexion was heightened, but her respiration was neither quick nor labored. Another girl remained in the oven the same length of time with equal impunity, and even breathed for five minutes air heated to 325° or 113 above boiling water. At different times physicians and others have entered rooms heated to 240 and 260° and remained some time, sometimes with, and again without their clothes, and without inconvenience. During this time the animal heat, ascertained by placing the thermometer under the tongue, was scarcely increased at all, but the pulse was much quickened. The heat was so great, that pieces of AND THE CAUSES OF DISEASE. 517 metal about them could hardly be touched; breathing on the thermometer caused the mercury to fall several degrees, and they also cooled their fingers by breathing on them. In the same air, eggs were roasted hard in twenty minutes, and beefsteak well cooked in thirty. Taking the other extreme, we find the body capable of enduring under certain circumstances an intense de- gree of cold without injury. Air being a bad conductor, caloric is exhausted much more rapidly when the air is in motion than when still, and therefore a much greater amount of cold can be endured in the latter than in the former case. Capt. Parry mentions that where the thermometer was 55° below zero and no wind stirring, the hands could remain uncovered without inconvenience for a quarter of an hour, while with a fresh breeze and the thermometer at zero, the pain in the same length of time would be intense. In the recent expedition to the Arctic regions, under command of Capt. de Haven, in search of Sir John Franklin, the degree of cold to which the men were subject in a climate where the thermometer for weeks numbered from thirty to fifty degrees below zero, was beyond what we can well realize. Yet the men were generally healthy. There were but very few colds or in- flammatory diseases and I believe no deaths. Thus we see that the body is capable of enduring under certain circumstances, and for a certain time, great extremes of heat and cold. It was formerly supposed, and is to a certain extent now, that sudden changes of temperature are in all cases hurtful. But this is by no means always the case. The inhabitants of Russia are in the habit, while reeking from their vapor baths, of plunging directly into cold water, or rolling in snow, without injurious effects, and Capt. Parry remarked that during his northern expedition they were constantly in the habit in going from the cabin into the external air, 518 HYGIENE of undergoing a change of from 80 to 120° of tem- perature in one minute without the slightest unpleasant sensations. The sudden descent from one point to another in at- mospheric temperature, must of course vary in its effect, according to the state of the body at that time. We have heretofore explained the generation of animal heat, and shown that in health, nearly the same degree of inward temperature is maintained in every clime. If the external temperature be lower than that of the body, the heat carri- ed off is instantly replaced in health, by the combustion within, together with exercise and clothing. When it ap- proaches the natural heat of the body, sweat breaks out, and the superfluous heat is thus removed by evaporation. The internal evolution of heat is so constant, that an ex- ternal temperature of 98, which is about the heat of blood in man, when of course the atmosphere cannot abstract heat from the body, is exceeding oppressive. If the heat is carried off just as fast and no faster than it is developed, no particular sensation of either heat or cold is felt. Therefore the sensations must vary in a great measure with the power which different constitutions possess of evolving heat. Thus one person whose power of evolving heat may be less than another, will be cold in a temperature, which the other would consider warm. If this power of evolving heat, be entire, active, and continuous, no danger need be apprehended even from various alterations of temperature. Great heat of the . body, when the cold is applied, is really a condition of safety instead of danger, provided the heat is steady and permanent. Thus, how refreshing to the heated brow is the application of ice, and how grateful during the burning paroxysm of fever affusions of cold water. This principle also holds good of the application of cold, when the body has been heated by exercise, or from any other cause, pro- vided that cause remains steadily in action, there being no AND THE CAUSES OF DISEASE. 519 local disease, and the body not fatigued, and fast loosing its heat. But, if a person is exhausted and weakened by exercise, if he is perspiring and rapidly parting with heat, if the exercise is over and he remains at rest during, and immediately after the application of cold, then there is danger of mischief. The danger is not from the application of cold, when the body is hot, but when the body is cooling after having been heated. In all those cases where death is occasioned by drink- ing cold water, it will be found that the body, heated and fatigued by exertion, was rapidly losing heat by profuse perspiration, the person having generally at the time ceased his exertions. If the exertion had been continued, or at any rate the heat kept at its previous standard, no danger would have resulted. It was in this way, that Alexander lost more of his army than had ever been slain in his most bloody battle, when they, thirsty, weary, and perspiring with their long march across the desert, rushed wildy into the cold waters of the River Oxus. Following out the principle we have just laid down we are taught a vast number of useful facts. The traveler need apprehend but little danger from wet feet, or a wet skin, provided he keep up active ex- ercise, changes his clothes as soon as that exercise ceases, and avoids future applications of cold. It is very common with bathers, after having become heated by a walk or violent exercise, to pause for a while before plunging into the water, and, as they term it, " cool off," after which they rush in and remain some time. This, you will perceive, is not only unwise, but highly danger- ous. Far better plunge in at once, paddle about, remain but a few moments, then come out and dress. And so the young lady, fatigued and heated with dancing, had far better get' into her carriage, ride home and jump into bed than to stand in this state for a little while and 020 * HYGIENE partially " cool off" in the entrance hall before starting. And the gentleman similarly situated, will feel much better the next day from having put on his over coat and walked briskly home. Recollect that heat, preternaturally accumulated by exercise, is dissipated by profuse perspiration, and speedi- ly lost, when to this is added rest after fatigue, and that then the application of cold is liable to be followed by unpleasant results. A very constant effect of continued heat is, to stimu- late the organic functions of the body. We have evidence of this in the luxuriant vegetation of warm climates in comparison with the stunted growth of colder regions. As you approach nearer and nearer the poles, not only vegetables, but animals become stunted. The inhabi- tants of warm climates are much larger than those of frigid regions. Notwithstanding there may not be much difference in point of size between the inhabitants of the torrid and temperate zone, yet the former reach maturity much sooner than the latter, and it is not un- common to find among them females married and the mothers of children at the age of twelve or fourteen. Continued heat also produces a depressing influence on the animal functions, causing lassitude and want of en- ergy. Those nations who have most signalized them- selves in the world's history, and left the largest record on its pages, have been those, not in equatorial regions, but in the more northern and cold climates. From causes already explained, the prominent affections in warm climates are those of a dysenteric or bilious cha- racter. The effects produced by cold are directly the reverse to those of heat. It acts, when long continued, as a seda- tive on the animal functions. There is a shrinking of the external parts, and a paleness or deadness of the skin. One of the first effects of cold on the system, is AND THE CAUSES OF DISEASE. 521 extreme drowsiness, followed by a stupor or sleep, during which the poor victim glides without a pang into the arms of death. This sense of drowsiness is often so great, that notwithstanding the person is conscious, that to sleep is to die, he cannot rouse himself. There are times, however, when cold not too intense, produces an entirely different effect, acting as a tonic, stimulating, refreshing and invigorating the mind and body. It then becomes a most important curative agent. I have only to instance the well known effect of cold bathing, where it is followed by reaction. A momentary sensation of cold, however intense, is seldom injurious, but long-continued shivering will be very likely to end in disease. The effect of cold is more injurious when applied by currents of air. This is particularly the case when the current strikes only one portion of the body. Better expose the whole body to the same temperature, than have a current playing on one portion. Cold is far more prejudicial to health when accompanied with moisture. Hence a damp cold, foggy atmosphere is much more likely to produce dis- ease, than a clear and dryer one of the same tempera- ture. Wet and damp clothes prolong the sensation of cold, and extract more heat from the body than is ge- nerated within, and unless exercise or stimulants are made use of, deranges the circulation and creates inter- nal disturbance. We have seen that the amount of animal heat remains nearly the same in all temperatures and in all climates. That the air of colder regions is more condensed and with the same number of respirations we inhale a much greater amount of oxygen than in the rarefied atmos- phere of warmer climates, that it is absolutely essential to life that the rapidity with which animal heat is generated should vary in the different temperatures of the earth. 522 HYGIENE There is nothing which renders the system more liable to the injurious effects of cold than want of proper nourishment. Dissipation also prostrates the system and in a measure paralyzes the power of nature. In cold weather the food of course should be nourishing, the clothing warm, and exercise when in the open air, active. In our northern climates it is generally best to wear flannel next the skin throughout the year, thinner in summer of course than in winter. Being a bad conduc- tor of heat it prevents that of the body from being quickly dissipated, and therefore in a measure guards against the frequent changes of temperature so common in our climate. It also absorbs the perspiration, and by its constant friction in movement, gently stimulates the vessels and nerves of the skin. I fully appreciate and insist on the necessity of comfortable warmth to insure health, and yet I have no sympathy with the growing effeminacy of the present day. To see the young, who should be full of life and activity, and possess the strongest and most vigorous powers of generating heat, muffled up in cloaks, padded coats and furs, in this climate, forcibly reminds one that they may be better acquainted with the reeking fumes of the bar-room, the halls of revelry and the haunts of dissipation, or the heated air of the drawing-room, than the healthy, manly, and active duties of life. It certainly bespeaks a ridiculous effeminacy, and one from which they themselves will be the greatest sufferers. Pure and healthy recreation, manly and vi- gorous exercise in the open air, conquering cold by in- creased physical exertion, nourishing food, and mode- rately warm clothing, are far better than piles of furs or hosts of mufflers. In addition to this, prepare the sys- tem before going out by washing from head to foot in cold water. But in the training of children particularly, in avoid- AND THE CAUSES OF DISEASE. 523 ing effeminacy, there is danger of running into the other extreme, and in pursuing what is called " harden- ing^ soon harden them into their graves. The consti- tution of the ohild should be closely studied, and the utmost prudence observed in the " hardening" process. The child should be sufficiently clothed, and a continued sensation of chilliness never permitted. A cold bath every morning fortifies the body against the cold of the day, but even this should not be indulged in unless fol- lowed by a glow of warmth. In warm climates, if any thing, a greater amount of care is necessary to maintain health under the enervating and debilitating effect of continued heat, the animal functions should be kept naturally active and vigorous, and no organ overtasked beyond its strength. Expo- sure to the intense heat of the sun may produce fearful congestion, and dissipation of every kind may so impair the functions of nature as to render her an easy prey to the ravages of disease. The same amount of food or the same variety as in a colder climate would not only be unnecessary but highly injurious. The external tempe- rature is nearly if not quite the same as the internal. But little animal heat is therefore required, and but little oxygen in comparison with colder regions is in- spired, and consequently if a large amount of nutritious food is introduced into the system it is not consumed, but clogs and fetters the operations of nature. Nature in the abundant fruits and vegetables scattered through- out that climate has designated the proper food for use. Impure Air, Ventilation and Cleanliness.—A pure at- mosphere is essential to life and health, and when it be- comes poisoned by decaying vegetable matter or the gene- ration of unwholesome gases, disease is the consequence, either assuming the form of an epidemic, and sweeping over the land like a besom of destruction, or showing 524 HYGIENE its influence in the gradual decay and prostration of the vital powers. Local causes produce changes in the atmosphere, and give rise to peculiar diseases. Thus at the base of lofty mountains, as the Alps in Switzerland, we more generally find Goitre, or swelled neck ; the smiling plains of Italy are saddened by the presence of a loathsome cutaneous affection ; the Campagna, in the vicinity of Rome, pre- sents a smiling and beautiful appearance, yet its noxious exhalations poison the atmosphere, and often produce in those who have merely passed over its flowery sur- face, the seeds of an incurable disease. In new coun- tries, where the virgin soil is being turned up to the warmth of the sun, and even in old, where there is much standing water, and in the vicinity of swamps, the air is poisoned by a malaria, which gives rise to the chills and fever. Yet in either of these cases, what chemist is suf- ficiently skillful to tell the precise amount of this poison sufficient to produce disease. We can neither see, taste, nor smell anything more than usual, and yet we inhale a poison most destructive to health and even life. We sometimes find in nature infinitesimal doses, as well as in our peculiar school of medicine. The composition of atmospheric air we have already mentioned. When taken into the system it consists of about 78 per cent, of nitrogen, 21 of oxygen, and 1 of carbonic acid, but when expelled from the lungs it is loaded with moisture, and notwithstanding the amount of nitrogen remains nearly the same, from eight to nine per cent, of oxygen has disappeared and been replaced by carbonic acid. The inspirations of an adult are at least fifteen in a minute, and the average consumption of air not far from 20 cubic inches at each inspiration, so that a single in- dividual requires for respiration at least 300 cubic inches of air in one minute. Therefore in the same time 21 VENTILATION. CLEANLINESS. 525 inches of oxygen disappear and are replaced by the same amount of carbonic acid, and in one hour each individual take? in through the lungs at least 1440 cubic inches, the place of Which is supplied by the same amount of carbonic acid. Thus each averaged sized adult consumes about 45,000 cubic inches of oxygen, and gives out about 40,000 cubic inches of carbonic acid in 24 hours. The only part of the air capable of supporting life is the oxygen, and when the oxygen of the atmosphere is part- ly consumed or vitiated by means of the vast addition of carbonic acid, the lungs are deprived of their arte- rializing power, and respiration consequently is seriously impaired. Take, for instance a mouse and confine it in a tight glass jar full of air, and for a short time it seems to suffer no inconvenience, but as the consumption of oxygen, and the exhalation of carbonic acid goes on, the little victim pants as if struggling for air, and in a short time dies convulsed, as if drowned or strangulated. Does it require more than the simple statement of the above facts to convince all of the absolute necessity of pure air, and well-ventilated rooms. The practice of crowding several individuals in tight rooms cannot be too strongly condemned. And yet it is by no means rare to witness several persons occupying one room, and that heated by a tight iron stove, with no way of establish- ing a current of air or draft in the room. The air is not only vitiated by so many breaths, but the oxygen con- sumed by the stove. But a few years since I was called one evening to visit a poor person very sick with the ship fever. I found a kind of hovel, almost surrounded by water, con- sisting of one room, perhaps fifteen or sixteen feet square, in the centre of which stood a stove almost red hot, in which the cooking of the whole family was done. This room was occupied by nine persons, five of whom were under the full influence of the low, putrid, and 526 HYGIENE AND THE CAUSES OF DISEASE. sinking ship fever. This was by no means an isolated case. Every physician accustomed to practice in our towns is constantly meeting cases in close and crowded rooms where disease has its full sweep, and where the remedy they require, and without which they will die, is pure air. In cities, particularly among the poorer classes of our population, a fruitful source of crime, sickness, and those frightful epidemics, and pestilential diseases, which are so rife among them, and from them spreads through the community, is impure air, want of cleanliness and nourishing food. The smiling country is open before them with the pure air of heaven eddying around the hill-tops and along the valleys. The mighty west, with dark forests, running streams, cool and spark- ling fountains, a rich and virgin soil, beckons them to a home of peace and plenty, with less expense than they incur in the crowded rooms and confined air of the city. And yet it is often the case, that the poor prefer the city, with all its deprivations, to the country and plenty. You notice the effect of breathing vitiated air in pale and haggard faces, sunken eyes and cheeks, lassitude, want of energy, and dizziness or pain in the head. Happily the public mind is waking up to the neces- sity, if they wish to preserve health, of having well-ven- tilated homes, churches and school-rooms. Cleanliness is absolutely essential to vigorous health, as will be readily seen when we reflect on the intimate sympathy existing between the skin and all the internal organs. When we remember that the skin is perforated with an innumerable number of perspiratory tubes, which carry off from the system in the form of insen- sible perspiration an average amount of thirty-three ounces of changed and worn-out material, aside from what is thrown off in the form of visible perspiration, often amounting to two or three pounds in the course of an hour, and that if these pores are contracted or closed DIET AND EXERCISE. 527 by cold or any other cause, this large amount of useless matter must be retained in the system or thrown on other organs, such as the lungs, stomach, liver, and kid- neys, we can readily perceive how important it is that the skin should be kept vigorous and healthy. To avoid this closing of the pores, in the first place be careful to keep the clothing next the skin fresh and clean, as it very soon becomes saturated with perspira- tion. Clothing worn during the day should in no case be worn at night. The bed also should be thoroughly aired before being prepared for the night. The head should be kept clean, as a collection of dan- druff often produces pain and even eruptions on the scalp. Unguents, and washes of all kinds, with the ex- ception of water, should as a general thing be avoided. Many of these preparations contain poisons highly pre- judicial to health, and when applied to the hair create pain in the head, and general derangement of the ner- vous system. Thus, some of these washes and unguents contain arsenic, others Spanish Fly, and others still, lead and a variety of poisons. Above all to insure a healthy skin, water should be used in abundance. Thorough ablutions of the entire body should be just as much a part of the daily work as eating. DIET AND EXERCISE. Pure air, clothing, and cleanliness, are not the only things about which it is necessary to be particular in order to insure health. Without something for the oxy- gen taken into the lungs to consume, the air would do no good. Hence the amount of food used should be of the proper kind, in the proper quantities, and vary in kind and amount, according to the amount of oxygen inspired, and the quantity of heat necessary to be evolved to insure comfort and support life. We have 528 HYGIENE AND THE CAUSES OF DISEASE. already explained the evolution of animal heat, and thus, the process of digestion and nutrition. We have seen that the inhabitants of cold climates require food rich in carbon, such as meat and oil, that those of the torrid climate require food containing but little carbon, and should feed more on fruits and vegetables, while in temperate regions a judicious intermixture of both is necessary. We will now mention the time required, as has been ascertained by experiment, for the digestion of some of the prominent articles of food. h. m. Apples, sweet, raw, digested in 1. 50. " sour, hard, « u a 2. 50. Barley, boiled, « u 2. Bass, striped, fresh, broiled, K u 3. Beans, pod, boiled, u u 2. 30. " green corn, » u u 3. 45. Beef, fresh, lean, rare, roasted, U a 3. " " steak, broiled, u u 3. " old, hard, salted, boiled, u u 4. 15. Beets, » a u 3. 45. Bread, corn, baked, u u 3. 15. " wheat, fresh, u u u 3. 30. Butter, melted, a u 3. 30. Cabbage, raw, u u 2. 30. " with vinegar, u u a 2. u boiled, a a 4. 30. Cheese, old, raw, u u 3. 30. Chicken, fricasseed, u a 2. 45. Codfish, dry, boiled, « u 2. Duck, roasted, u u 4. Eggs, fresh, hard boiled « u 3. 30. « « soft boiled, u a 3. U U raw, u u 2. Goose, wild, roasted, u a 2. 30. Lamb, broiled, u u 2. 30. DIET AND EXERCISE. t)29 digested in m. 00. 30. raw, a stewed, u roasted, " stewed. " boiled, " roasted, baked, " boiled, " Liver, beefs, broiled, Meat and vegetables, hashed, Milk, " Mutton, " Oysters, u Pork, » Potatoes, Irish, « « Rice, Sago, u Salmon, salted, u Tapioca, u Tripe, a Trout, salmon, a Turkey, u Turnips, a Veal, broiled, Venison steak, " Pork is exceedingly difficult of digestion, while mut- ton, beef, and venison are not only highly nutritious but easy of digestion. Veal and lamb are nutritious, but not as easily digest- ed, Poultry is generally easy of digestion, and when young and tender, suitable to invalids. For invalids who are not able to digest meat and yet require its strength, "beef tea" is a very excellent pre- paration. Its ordinary way of preparing it is, to place some fresh meat cut in small pieces into a bottle with the necessary amount of water, cork it up and then place the bottle in boiling water where it can remain until the juice is extracted from the meat. Liebig gives the following formula, which is still bet- ter "Take a half a pound of fresh beef or chicken, 23 h. 2. 2. 2. 3. 2. 55. 3. 30. 5. 15. 3. 3. 30. 2. 30. 1. 1. 15. 4. 2. 1. 1. 30. 2. 25. 3. 30. 4. 1. 35. 530 HYGIENE AND THE CAUSES OF DISEASE. chop it finely, and mix it well with a pint and a half of ice cold water, to which has been added four drops of pure Hydrochloric-acid (Muriatic-acid) and a teaspoon- ful of common salt. After standing for one hour, the whole is thrown upon a hair-sieve and suffered to drain without any pressure. The first cloudy droppings are returned to the sieve until it flows quite clearly. A half pint is then thrown in, in small portions upon the resi- due in the sieve." This liquid extract of flesh must be administered to the patient cold and should be kept continually cold, as when heated it becomes cloudy, and gives rise to a thick deposit of flesh albumen and hasmatin, and is liable to turn sour. External ice cooling removes the difficulty completely. Eggs and oysters are nutritious, and if not cooked too much, easy of digestion. Rice is nutritious and easy of digestion, as well as sago, arrow-root, tapioca, and farina. The potato is more digestible when roasted or baked than when boiled. Fruits of all kinds are not generally nutritious, although they are refreshing and wholesome. They should be eaten, however, in the fore-part of the day, or at any rate not in the evening. As it regards the use of coffee, no particular directions can be given. It is highly injurious to some, while others can use it, not too strong, with plenty of milk, with entire safety. It is strictly prohibited in almost every form of disease, especially when taking medicine. Tea is subject to the same objections as coffee, although black tea can gene- rally be used with safety, while green tea is decidedly objectionable. Cold water is a very excellent substitute for either. Chocolate is a pleasant drink, preferable to either tea or coffee, when there is no disease of the stomach or ab- domen. Milk is highly nutritious, but to persons of ple- thoric habit it had better be in a great measure avoided. BATHING, ITS DIFFERENT VARIETIES AND USES. 531 Exercise is highly important to the health of the or- gans and the process of digestion. But vigorous violent exercise should not be indulged in immediately before or immediately after a meal, for in either case the harm would be far greater than any benefit which might re- sult. Exercise should be active, to a certain extent in the out-door air, and as regular as possible. Violent fatigue should of course be avoided, the exercise being gradually increased as the strength will bear it. Per- sons accustomed to a sedentary life should at certain hours exercise the whole system. Among children play- ing at ball, dancing, or jumping the rope, are pleasant recreations, while among adults, riding, swimming, walk- ing, fencing and dumb-bells are equally serviceable. In this way all the organs are kept active and full of vitality, the mind also is clear and capable of greater labor, and the body more robust, better proportioned and capable of greater exertion. BATHING, ITS DIFFERENT VARIETIES AND USES. The best time for bathing is undoubtedly in the morn- ing on getting out of bed or two or three hours after breakfast. Simple ablution or any form of cold bathing should be followed by rubbing and exercise. In a swimming or tub-bath it is best to remain for only a short time. Unless reaction comes on, and a warm glow is established, shortly after any of the varieties of bath- ing, cold bathing is producing more injury than good, and should therefore be discontinued and tepid water substituted in its place. By gradually decreasing its temperature, the system will soon become accustomed to cold water. In the winter season it is best to have the room slightly warmed, unless the ablution be quickly done, when it may be performed in the cold. Bathing, when followed by fullness of the head, should for the 532 HYGIENE AND THE CAUSES OF DISEASE. time, be suspended, or warm water substituted. As different forms of bathing are often advisable both in health and disease, and as we shall hereafter have fre- quent occasion to refer to water applications, we will enumerate some of them here. Shower Baths.—These are often most refreshing and highly advantageous. If the proper materials be not at hand for constructing one, the contents of a watering- pot poured over the body from a distance of three or four feet will answer every purpose. It acts as a gentle shock upon the skin and nervous system, and stimulates them to the performance of their duty. When the shock is too great it can be taken tepid. Sitting-Baths (Sitz-baths).—A tub, or better still, a bath prepared for the purpose, made of tin or wood, sufficiently large, that when a person is seated, the wa- ter shall come up around the hips to the navel, is all that is required. During the bath the upper as well as the lower part of the body should remain covered, while the abdomen is rubbed with a woolen cloth to increase the action of the skin. The temperature should gene- rally be from fifty to sixty degrees, and the bath con- tinued from five to twenty minutes. The best time for taking it is an hour before dinner or on going to bed. They are particularly serviceable in derangement of or- gans about the loins, of the hepatic viscera, and to re- lieve a tendency to congestion, in some of the upper parts of the body. The Drop-Bath.—In this bath single drops of water are allowed to fall a distance of five or six feet. It should not be used on any vital part, and seldom con- tinued more than fifteen or twenty minutes. It is fre- quently of great service in chronic and obstinate para- lysis. Active friction should be made over the part be- tween the drops. The Douche.—In this bath a small stream of water, BATHING, ITS DIFFERENT VARIETIES AND USES. 533 of a calibre of from half an inch to four or five inches, is permitted to fall from five to twenty feet, according to circumstances, upon the body. The stream should not be permitted to fall perpendicularly on the head, chest, region of liver, or spine. At first it would be better that it should fall so as to flow over the neck and spine, after which other parts of the body may be ex- posed to it, particularly the part affected. It should not be taken after a full meal, when fatigued, or in a state of perspiration. The length of time which it may be taken may be from one to ten minutes, and should be followed by active exercise. The douche is a powerful stimulant, but great caution should be exercised in its use. Very weak or nervous persons should avoid it. Wet Bandages.—The local application of cold water is of two kinds, viz. when we wish to produce a cooling effect, or warmth and sweating. In the former case, as in inflammation of the brain, several thicknesses of cloth wrung out in ice-cold water should be applied to the head, the cloth frequently changed, so that the parts are kept constantly cool. If the cloths are allowed to become warm, the result is worse than if they had not been applied; a still better application, is a beef-bladder filled with pounded ice. When warmth or sweating is required as in derangement of the abdomen, stomach, throat, &c. a bandage or napkin, should be wrung out in cold water, applied upon the part diseased, ana covered with a dry bandage. The warmth of the body soon warms the wet bandage, and the heat being confined by the external dry bandage, the result is a most soothing and excellent form of sweating poultice. In referring to this sweating application of water in the following pages, we shah speak of it as "the wet bandage." Wet Sheet.—This application of water is often highly serviceable in febrile diseases. Two or three blankets are spread on a mattress, and over these is spread a linen 534 hygiene and the causes of disease. sheet dipped in cold water and wrung out as dry as pos- sible. The patient, divested of clothing, is now placed on the sheet, which is then carefully folded around as well as the blankets that had been spread on the mat- tress. Cold applications should be made to the head if there be a tendency of fullness there. In acute cases the applications should be changed according to the de- gree of heat, every quarter or half hour until the dry and hot skin becomes softer and cooler; after each ap- plication the body should be washed with cold or tepid water. In chronic cases the patient may remain in the sheet a much longer time. This application may either be made to the whole or part of the body. Sulphur Baths.—The sulphur vapor-bath is some- times indicated in cutaneous and rheumatic persons. When a regular vapor-bath cannot be had a contrivance can be fixed which will answer very well. An old chair can be taken with simply a narrow board across for the seat. Upon this let the patient be seated. A blanket may then be placed about the patient tight at the throat but permitted to fall loosely about the person to the floor. Underneath the chair may be placed a small tub of warm water and directly over this may be held a hot shovel upon which has been thrown some powdered sul- phur. Now throw some hot stones into the water. The steam arising from the water mingling with that of the the heated sulphur, and all prevented from escaping by the blanket, gives a very good sulphur vapor-bath. Cold, tepid and vapor-baths, either applied to the whole or part of the body, as well as the plunge and swimming baths, are all highly serviceable under certain circumstances and conditions of the system. Bathing apparatus should be found in every private dwelling, and particularly in public schools; a good bath to a rest- less child, who either cannot or will not confine his mind to his studies, will often soothe the system quicker, and INFLUENCE OF THE MIND ON DISEASE. 535 invigorate the mind far better, than prosy lectures or any form of punishment. INFLUENCE OF THE MIND ON DISEASE. The sympathy between body and mind, and the in- fluence exerted by one over the other, we know exists to a very great extent. A man perplexed and annoyed about business-matters, which may be a little out of the regular course of his affairs, is very liable to feel the effect in some physical derangement. Cases are every day occurring where persons unfortunate in business, see- ing the fruits of years swept away in some financial cri- sis, or disappointed in domestic relations, finding friends false, the sanctuary of home outraged, or perhaps the young, lifting the cup of love, bright and sparkling with joy to their lips, only to see it dashed to the earth and shattered at their feet, or feeling in the orange blossoms of the wedding wreath the sting of the asp and the poi- son of death, in every circle of life, in every grade of so- ciety, these fearful blows are followed by slow decline, rapid and prostrating disease, the maniac shrieks, or an early death. On many a marble monument, and on many a simple gravestone, might with truth be traced: "Lied of a broken heart." Could we tear away the veil which hides the working of the mind from outward gaze,—and thank God we cannot,—how many bleeding hearts we should find, hearts crushed and broken, withering away beneath a grief more terrible than death itself. How the painful cause would flash upon us with the brightness of noon- day, of many a death, where disease was rapid, defying medical skill, or where, as in slow decline, the poor vic- tim sweetly faded away, or where the last breath was drawn when the light and breath of heaven came in through the grated windows of the home of the insane, 536 HYGIENE and the causes of disease. Intense grief, freely indulged, is very liable to under- mine the constitution, and also bring on severe and pain- ful forms of disease. Intense grief has in a single night blanched the blackest hair to a snowy white. Often- times the death of a loved companion, an idolized child, seems to change entirely the current of life, and wither the frame, as if it had been exposed to the poisonous breath of the upas. There are innumerable cases on record, where persons have died from the effect of fear alone. The history of every pestilence or epidemic shows that in thousands of cases the disease has been induced by fear. In the se. venteenth century, when the plague ravaged London, carrying off its victims by thousands, and turning the city into a vast charnel-house, simply looking on a per- son on whom the plague-spot had made its appearance was considered almost a sure passport to the grave. Terror and consternation filled the minds of nearly all, and thousands died whose lives might have been spared had they not given way to useless fears. An Eastern writer illustrates the effect of fear in a very beautiful and striking manner. "A traveler ap- proaching the gates of a city, beheld entering in a pesti- lence, and thus accosted it: Whither are you going? Into the city, replied the pestilence, to destroy three thousand lives, and sternly passed in to fulfil his fearful mission. The traveler paused, and soon from the city was heard the death cry, the wailings of friends for friends, and from the gates were carried forth thousands of corpses and hurriedly placed beneath the ground. Finally the traveler beheld the pestilence stalking forth, and said, why have you exceeded your mission, and de- stroyed thirty thousand lives instead of three thousand. I have destroyed but three thousand, was the reply— fear has done the rest." It was common for those who perished by violence to INFLUENCE OF THE MIND ON DISEASE. 537 summon their destroyers to appear within a stated time before the tribunal of God, and the guilty ones in many instances have withered away and died as speadily as if smitten by the breath of a pestilence. Pestilence does not kill with the rapidity of terror. The abbess of a convent the Princess Conzaga, and the Archbishop of Rheims, for a jest visited one of the nuns and exhorted her as a person visibly dying. While in the perform- ance of their scheme, they whispered to each other, " she is just departing." She departed in earnest, and the guilty pair discovered in the midst of their sport, they were making merry over a corpse. In France, several physicians obtained leave of government to ex- periment on a criminal who had just been condemned to death. The criminal gladly availed himself of the privilege of being bled to death instead of being exe- cuted in public. He was placed in a chair, his eyes blind-folded, his arm slightly pricked with a pin, and a slight jet of water so directed, as to fall on his arm, thence trickling down to fall into a basin prepared for the purpose. The physicians then conversed together on the tragic symptoms, stated the amount of blood in the body, the quantity he had lost, and the length of time he would probably be in dying. In the mean time the breathing of the victim gradually became fainter and in a few moments he expired, without having lost one drop of blood. Montaigne tells of a man, who was pardoned on the scaffold, and was found to have expired while awaiting the stroke. Despair produces a very strong impression on the mind, and thus on the system, and often either drives a person to idiocy, madness, or a speedy death. Almost every physician occasionally meets cases in his practice, when through the injudicious words of friends, or a variety of other causes, all hope vanishes in the patient's mind, and in utter despair he calmly waits what seems 23* 538 HYGIENE AND THE CAUSES OF DISEASE. to him an inevitable doom. Even though it may be at the turning-point of the disease, when a feather's weight may turn the scale for life or death, if he sees around him hopeful countenances, and hears words of encou- ragement, new life may be infused into his lagging pulse, and he called back from the verge of the grave on which he was trembling. Keep the lamp of hope burning brightly, unless all ground for hope is over. The influence of the mind on the system is, as we have already seen, all-powerful, tormenting existence, bringing on and hastening disease and death, or where exerted for good, smoothing the rough pathway of life, and imparting health, vigor and harmony to the whole system. We cannot look for health and happiness without har- mony, and this can only exist where there is a beautiful blending of the moral, the intellectual, and the physi- cal, and where man is in harmony with nature, with his own being, and thus with God. HEREDITARY TAINT AND PREDISPOSITION TO DISEASE. Many a child is born tainted with disease. The foun- tains of life are corrupted in the mother's womb, and the young being is ushered into the world with the seeds of disease and future suffering planted deeply within its system. Disease thus communicated from parent to child, is called lureditary. Let us glance at some few of those difficulties, which may as a general thing be classed under this head. We will first notice, that wide-wasting disease found in all classes of society, and which is at the root of a vast amount of chronic difficulties, viz. the class of affections popularly known as scrofula, but which Hahnemann might call psora, Hufeland dyscrasy, but by modern science is more cor- rectly termed tuberculosis. We shall use the latter HEREDITARY TAINT. 539 term in the few remarks we have to make of this class of affections. Tuberculosis revels in the human family to an extent but little dreamed of by many. Obscuring its origin and masking its real character in a hundred forms, thousands, even when its seeds are rapidly ripening within them, have not the least idea of the real character and cause of their sufferings. It manifests its terrible effects in the early months of foetal existence, and causes those spontaneous abortions, which destroy one quarter of those affected, before they see the light. After birth it frequently arrests their physical and moral develop- ment, and becoming complicated with various diseases, renders the period of infancy and youth full of dangers. Sometimes it affects particularly the mucous mem- brane, and frequently extends its effects to the mucous system generally. Hence arise ophthalmia, catarrh, af- fections of the ears, leucorrhcea, intestinal worms, mu- cous fevers, &c. Sometimes it attacks the skin and pro- duces chilblains in the hands, feet, and face; chronic eruptions of the lips, eyelids, and ears; pustules of various forms scattered over the face, forehead, and chest, and ulcers more or less numerous and extensive. Sometimes it acts particularly on the cellular tissue, and produces numerous abscesses and profuse suppu- ration. If it fixes itself on the osseous system, caries, and softening of the bones are among the effects pro- duced. Many of the bones may be affected at the same time, and, as is sometimes the case, the whole skeleton shows the presence of the disease. All these varieties of affections, so apparently dissimilar in their character, are notwithstanding traceable to the same origin and the same cause. It may, as we have before stated, be developed in one patient in the mucous system, in another in the cellular, and in a third, in the bony skeleton, pre- senting of course a different appearance in each. 540 HYGIENE AND THE CAUSES OF DISEASE. Tuberculosis, developing itself in the lungs, the brain, the stomach, the bowels, and in fact in every part of the system, for there is no tissue or organ into which it may not infuse its poison, is the most fearful destroyer of human life, which has ever cursed the world. Lifting its head in almost every clime, infusing its poison in every class of society, not the plague with its unnum bered victims, or the pestilence with its heaps of dead, can compare with it in destruction of human life. Wherever we find this disease, in its various modifi- cations and developments, whether we see it in loath- some sores, or in the slow or rapid wasting away of con- sumption, in blindness, deafness, or caries of the-bones, we can as a general thing, though not in every case, trace it back to hereditary taint. Notwithstanding the parents themselves may have been apparently healthy, showing no traces of tuber- culosis or a consumptive tendency, yet if we go back two or three generations, we find traces of it, or some affec- ftion, which will produce it, in some branch of the family. It is very common for it to have overleaped apparently, one, two, or even three generations, and develop itself in all its virulence in the unhappy victims, whose parents may, as they think, have escaped. Among the causes of hereditary tuberculosis we may place syphilitic taint. Several tuberculous diseases greatly resemble syphilitic maladies. The parent who has contracted syphilis, and believes himself entirely cured, may through error of treatment still retain in his system, apparently dormant, some portion of the poison, which may be transmitted to his offspring in the form of hereditary tuberculosis. Thus, the parent, in his thoughtless folly, while running his giddy round of youthful dissipation, digs the grave of his child, poi- sons its happiness, and in following it to an early grave, or gazing on its weak, puny and diseased form, reaps a HEREDITARY TAINT. 541 bitter harvest for his early sin. Oh, how fearfully do children suffer for a parent's sins. Abuse of venereal pleasures is another cause of tuber- culous children. Instances are by no means rare, parti- cularly among the higher classes of society, where from the manner of living, an artificial excitement usurps the place of the natural, and, as a matter of course, the off- spring are weak and puny. The too early marriages, so common both among the rich and poor, is a fruitful cause of hereditary tuber- culosis. For a man to beget healthy children, he must have passed somewhat beyond the age of puberty, and acquired fully his strength and development. These early marriages, where the bride is taken from the parental home at a time when she most needs a mother's care, or the bridegroom perhaps is a mere boy, are per- fectly suicidal, and can only result in the broken con- stitution and feeble health of the mother, or at least, in weak and puny children. The inevitable consequen- ces of these premature marriages are more to be dreaded when men, who have married too young, have previous- ly led dissipated lives, passing, as it were through a period of fifty years in sixteen. If too early a marriage has a tendency to produce dis- eased children, so also has a marriage contracted too late in life, when also the reproductive power is deficient in vigor. Unfortunately, men frequently live, until they are forty-five or fifty* before marriage, and are then connected with those much younger than themselves. The con- sequence, as a general thing, is feeble children, who often die prematurely. A considerable disproportion between the ages of parents is another fruitful cause not only of tub re ulcus offspring, but of ill health on the part of one of the parents. In a judicious marriage, there should be but 542 HYGIENE AND THE CAUSES OF DISEASE. a very fe^Y years difference between the ages of the parties. Old age cannot wed with youth with the expectation of vigorous and healthy offspring, any more than winter can mingle with summer. Flowers look sickly and are chilled by winter, and so is youth, when united to age. The young should not sleep with the old, though the difference in age may not be more than fifteen or twenty years, for the vital power in the young is rapidly exhausted by the old. For the same reason the cold and phlegmatic temperament should not sleep with one of warm and nervous temperament, for a similar result is produced. The manifest difference in age, temperament, and constitution, where the parties are placed in so close a relation, is pregnant with dis- astrous results to the weak and young, and also, if the parties are married, to their offspring. Marriage should never take place between relations, unless the connection is very remote, for by such a union tuberculous taint existing in one, would be likely to be found in both, and the result would be a frightful har- vest of disease in their children. Not for this reason only, but the marriage of relatives, will of itself often be sufficient to develop in their children tuberculous dis- ease, weakness of mind, and even idiocy. Hence the repeated intermarriages of some of the royal fami- lies in Europe has produced among them a variety of tuberculous affections, together, sometimes with insanity, weakness of mind, and almost idiocy. This disease is, as we have already stated, generally hereditary, although it is sometimes the result of moisture, bad air and food, changes of temperature, and also sometimes follows measles, small-pox and hooping- cough. Cases are by no means rare in this changeable climate, when it is developed in those whose ancestral blood has been untaited with the disease, as far back as they can trace. Persons of robust and strong consti- HEREDITARY TAINT. 543 tutions, showing no predisposition to consumption, have fallen victims to it from undue exposure to changes of temperature or too violent exertion of the chest. Notwithstanding tuberculosis, as a general thing, is hereditary, we should be very sorry to believe, that the descendants of a family, in whose systems are lurking the seeds of this poison, must necessarily be tainted, generation after generation, that there is no escape, no dispersing the dark cloud, which hangs like a pall over their future. If this were the case, it would indeed be a curse so dark and fearful, that the poor victims might well pray for death. But this is not the case. By a proper marriage, a marriage in which enlightened reason shall be called into action and not blind passion, a passing fancy, or pecuniary interest, and where in the physical and men- tal education and training of the children from the time of their birth, there is brought to bear a clear enlight- ened mind, and a proper understanding of the laws of health, I see no reason why such children may not be healthy and in the course of one or two generations all predisposition to the disease be removed. A person of consumptive habit, marrying one of tu- berculous diathesis, will be pretty sure to give birth to tuberculous children. In selecting a partner for life, fitness of mind and disposition are not the only things to be taken into con- sideration. There is another question quite as impor- tant, and that is healthy, predisposition to disease, and the prospect of having healthy children, for all on en- tering the marriage state expect, sooner or later, to become parents. These are questions of vast importance, and should not be lightly answered. Many a young mother after having given birth in rapid succession to several chil- dren, is called on to follow her husband to the grave, 544 HYGIENE AND THE CAUSES OF DISEASE. and weep in widowhood over blighted hopes, and feel that for years her existence must be a prolonged struggle to obtain the necessaries of life for her helpless children. Many a father looks upon children weak and puny, and follows his wife to the grave at a time, when they most need a mother's care, and he the com- fort and solace of a wife. And yet in the selection of a wife or husband, how little attention is paid to health, physical development and the probability, that in two or three years they will not be separated by death. We have seen in the investigation of this subject, that tuberculosis is developed not alone, as is sometimes sup- posed, in the chest in the form of pulmonary consump- tion, but in every part of the system, and in an hundred forms. Among the other forms of disease, to which there may be an hereditary predisposition, we have only space to mention gouty and rheumatic difficulties. MORAL, INTELLECTUAL, AND PHYSICAL EDUCATION. The harmonious blending, and proper education and training of this " trinity" of our being is essential not only to health and happiness, but to true greatness. The name of Washington, of Howard, and Hahnemann stand out in bold relief as glorious examples of the truth of this principle. There have been more powerful intellects than Wash- ington's, more wily and skilful diplomatists, minds more skilled in conceiving and arranging the minutia of war, more quick and rapid amid the thunder and carnage of the battle-field, but never did there exist a purer patriot, or one in whom self was more quickly and sternly sacri- ficed to his country's weal. Never since our Saviour, did there exist one in whom the patriot, the philanthropist, the christian and the statesman were so beautifully MORAL, INTELLECTUAL, AND PHYSICAL EDUCATION. 545 blended. Had Napoleon added to his daring genius, his almost superhuman intellect, the moral force of Washington, the down-trodden nations of Europe might not now gaze in silent horror, as the blood of their purest patriots streams from the scaffold, and the last scene of his eventful life might have closed more bright- ly, than in his ocean-girt prison. True greatness consists, not in the powerful develop- ment of any one faculty of the mind without regard to the others, but in the harmonious blending of all, to en- sure which, the moral, the intellectual, and physical must be properly trained and educated. The great les- sons of life are to be taught in childhood, and those principles inculcated, which will grow and expand into a ripe harvest of honor and usefulness. But this preparation for the training of the child should date previous to its birth, as a lasting impression is produced upon it, by the health of the father as well as the mother at the time of conception. The child is often punished and made to suffer keenly in the early days of its childhood for faults inherited directly from the parents. The health of the mother, the tone of her mind, her feelings, tastes, and pursuits, during the time she is carrying her child, are all-important to the future condition of the unborn babe. Dr. Gregory, in speaking of the influence of the pa- rental stock, says: " Parents frequently live over again in their offspring, for children certainly resemble their parents not merely in countenance and bodily confor- mation, but in the general features of their minds and in both virtues and vices. Thus, the imperious Clau- dian family long flourished in Rome ; unrelenting, cruel and despotic, it produced the merciless and detestible tyrant Tiberius, and at length ended, after a course of six hundred years, in the bloody Caligula, Claudius, and Agrippina, and then in the monster Nero.'' And 546 HYGIENE AND THE CAUSES OF DISEASE. thus we frequently see the vices and follies of the parents flourishing in luxuriant growth in the child. When speaking of hereditary taint, I referred parti- cularly to the diseases developed, and sufferings pro- duced by improper marriages. Even in our northern clime, nothing is more common, than for young ladies to enter the marriage-state at the age of fifteen, sixteen or seventeen years. Not only unhealthy children are the result of this early marriage, but as a general thing, the young wife is totally unfit for the duties and respon- sibilities of her station. What does she know of life and its stern duties, which all, the rich and kindly nur- tured as well as the poor and lowly, should know how to fulfil? She, whose form has scarcely changed to womanhood, and on whose cheek still lingers the down of childhood, where has she learned the great lesson of life, that she should boldly venture out on the untried ocean before her ? And when the young infant lies in her arms, a pure and holy thing, whose little heart beats quietly in happy innocence, can she take it by the hand and lead it safely past those quicksands, which are so thickly scattered around its path ? And then the mind, can she in her young girlhood direct it aright, at a period when its whole future may depend, in part on her guidance ? Need we wonder, as we look around upon society, and see so many rash and foolish marriages, that there are so many stillborn children, that so many of the rising generation are pale, sickly, and feeble, that so much vice abounds, that the peace of so many families is wrecked, that so many children are left motherless, and that so many young mothers are placed beneath the green sod ? What else could we expect from this violation of the laws of their being, from this offering themselves on the altar of fashion and blind passion. The gloomy records of the grave show, that nearly MORAL, INTELLECTUAL, AND PHY'SICAL EDUCATION. 547 one-half of those born into the world perish before reaching the age of five, and one-third before the age of three years. How very few live to a good old age, and how mighty that throng, from the ranks of infancy, childhood, and middle age, who follow each other in rapid succession into the realms of death. From these periods of life death reaps his richest harvest. Among those, who bright and joyous with the elasticity of youth and vigor of manhood, whose brilliant aspirations seem about being realized, death scatters his shafts and the cold waters of that river which lies between us and the grave, freezes with its icy current the warm pulsations of the young heart, and bears onward on its dark bosom all there is of life to the vast ocean of eternity. Look at the infant in its mother's arms, what does it know of sin, what of life, and how has it transgressed against, and excited the anger of its Maker ? And the child, surrounded by the golden haze of its young life, just as it begins to delight the parent's eye and gladden their hearts by its opening beauties, and stir within them the pure and holy depths of an affection, which none but parents can feel; just as the light of thought begins to gleam from the bright eye and set its impress on the expanding brow, the bright eye becomes dim, the flush- ed cheek pale as marble, the whole being withers be- neath a blight, which stagnates the youthful blood, lays a hand of ice on the heaving breast, and quenches in the darkness of death, bright hopes and glorious aspi- rations. Why is it, that earth is thus piled with the graves of the young ? Why is it, that death riots and revels in the haunts of childhood, and changes the joyous prattle and merry laugh of innocence to the wild wail of deep and bitter agony ? See the mother, with bleeding heart, clasping in deep and untold anguish the cold and pulseless form of her 548 HYGIENE AND THE CAUSES OK DISEASE. child to her heaving bosom, and hear her murmur with pallid lips, "my child, my bright, my beautiful, my loved one, how can I give you up, how take you from my warm bosom and lay you in the cold, dark, damp grave." And the father, the strong man, the iron will, he, who has struggled manfully and bared himself to the stern conflicts of life. 0! how he bends now, like a broken reed, how the cold drops start from the fore- head, as he gazes with glazed eye, and in speechless misery, for he cannot weep, on the little being, cold and pulseless before him. Hear that prayer, which daily goes up from thousands of bleeding hearts, "oh God! let this bitter cup pass from me." Glance for one moment at this misery, at this deep anguish, at those mourning weeds, at these sweet buds nipped by the frosts of death, and then lift your eyes in reverence to heaven, and say if you can, if you dare, "Thou, oh Father, in mercy, kindness and love, hast done it all. Thou, in mercy or in wrath, hast sent thy fearful messenger, death, through the earth to wither with his icy breath, the brightest, fairest flowers in their first bloom." The doctrine of "Divine Providence" as sometimes understood at the present day, is very convenient for physicians to hide behind, as a shield for their ignorance, or for patients or friends to preach, as an excuse for de- reliction from duty. But reflect whether you are not blaspheming, a pure and holy God by charging all this wo and misery on him, the result by far too often, of your own ignorance, folly or wickedness. In a reverence for the Supreme Being, and in a firm belief in his Providence, I yield to no one, but my soul shudders and sickens at the proneness of the human race, while madly or blindly rushing on in their owe MORAL, INTELLECTUAL, AND PHYSICAL EDUCATION 549 way, heedlessly trampling on laws, which form the basis of their existence, to make a "Divine Providence" accountable for the result of their own disobedience. If the parents had been properly trained, had given way to no dissipation during youth, and had entered the marriage-state as rational, intelligent beings, might not a large portion of this disease have been prevented? Cases of sickness however are frequently seen, where there has been no known disobedience of nature's law, but are the result of circumstances, apparently beyond our control. We can lay down then with perfect safety this broad principle.— If thie human race were properly educated, mentally, morally, and physically, and would follow closely the teachings of nature, appealing so strongly to the God implanted reason and common-sense within them, cul- tivating harmony in themselves and with the world, not only a large portion of disease which now devastates the earth would vanish, but we should have a race in beauty and intellect such as the world has never seen since the fall of man. The influence exerted by the mother on the child during the period of gestation, the general rules which should regulate her habits, as well as the treatment of the babe during the first few months of infancy will more appropriately come under the head of "Affections of women and children" which will be found in this work. Commencing with the child as it emerges from the nursery, leaving its peculiar diseases and training during infancy, for another chapter, let us glance at some of the prominent points deserving attention not only during childhood, but amid the bustle, the stern duties and ac- tive scenes of life. The food of the child is of vast importance. It should 5oO HYGIENE AND THE CAUSES OF DISEASE. be plain, simple, nourishing and in sufficient variety and quantity. The more simple its preparation the better. Spices, tea, and coffee, rich gravies and fatty food should be avoided. Pastry, rich cake, and confectionary of all kinds should form no part of its diet. Fruits and vege- tables, perfectly ripe and fresh, can generally be eaten with safety. Pure air and cleanliness are at no time more impor- tant than in childhood. The rooms and bed should be well aired daily. Feather beds are as injurious to chil- dren as to adults and should therefore be avoided. The clothing should be loose, to give ample play to the limbs and muscles, and of sufficient warmth to ensure comfort. Bathing the entire body every day should also be practiced, the temperature being guided by the strength and temperament of the child. (See Bathing.) Out- door exercise in the open air is absolutely essential. There are a hundred harmless and innocent sports in childhood, which can be safely indulged, such as, play- ing at ball, jumping the rope, skating, swimming, &c. Contrast the buoyant and elastic step, the ruddy cheek, the sparkling eye, the well developed form of the boys and girls who are accustomed to vigorous exercise in the open air, with those weak and puny children on whom the breath of heaven is scarcely permitted to blow. At the age of six or seven, and not before, by which time the physical system should have received a fair start, the child may be sent to school. Previous to this period, the physical should be developed, and its teach- ers be, the mother and nature. Learn it to think, incul- cate habits of observation, and when studying in nature's temple, check not with a careless word its eager ques- tionings. Let the great book of nature be the volume studied, and through it the holy principle of love and beauty so strongly stamped on every page, be infused MORAL, INTELLECTUAL, AND PHYSICAL EDUCATION. 551 into the mind with every breath, and every gaze on the bright world around. Sometimes immense harm is done in chaining the young mind, at too early an age, to books and abstract rules. The physical should first be permitted to become strong and healthy, or at least, developed to such an ex- tent, that the mind may be brought into activity with safety. You will find in almost every family, at least one child, that gives bright promise of a brilliant future. The parents, in the pride of their heart, determine it shall win a glorious name, and therefore, instead of at first holding back the mental, and fostering the physical, preserving a healthy equilibrium between them, the mind is pushed and goaded on, its pride constantly flattered by praise, until the brain by too violent exer- cise looses its elasticity, and sinks into a state of dull- ness, or like the mettled courser, goaded on by the spur, it rouses itself for a new effort, and then falls dead on the field. Thus, not unfrequently, is the pride of the parent doomed to a bitter disappointment. To no oae is out-door exercise more absolutely essential to health, than the student, and hence swimming, riding, fencing, dancing, and those gymnastic exercises, which contribute so much to health and to a proper development of the form, should hold a conspicuous rank in the education of all. Look into our colleges, and among those who study hard, and take but little care of their bodily health, and you will see pale and sickly countenances, bent forms, sallow or hectic cheeks, with disease and death stamped upon them in perfectly legible chaiac- ters. What can we call these men, who thus trample on the laws of their being, dig their own graves, and write their own death warrants, but madmen and suicides? What can they expect but disease and death? Unless the machinery of the body be kept unclogged, in vi- gorous health, and each part perform its proper func- 552 HYGIENE AND THE CAUSES OF DISEASE. tions, its infirmities will tinge with a sickly and un- healthy hue the strongest mind and the brightest genius. To have a healthy mind, there must be a healthy body, and with both, almost any purpose, however difficult, may be accomplished. In female education, the heart should be educated as well as the head. The cold and selfish reasoning of fashion, that female education should be confined to those superficial accomplishments and graces, which will enable them to shine in the drawing-room, should be denounced in the strongest terms. These accom- plishments are very well in their place, but without a solid basis, they form a poor support in the stern duties of life. The time may come when they will require something to make their home happy and their life pleasant, besides a superficial knowledge of drawing ac- complishments. They should be taught the great laws of their being, and the duties they will be called on to fulfil as wives and mothers. No false modesty should prevent their understanding thoroughly those great truths, which must have such an immense influence on their future happiness, and the welfare of their children. Equal care should be taken of the physical training as in the other sex, and out-door exercise is of quite as much importance. Swimming, skating, riding, dancing, walking, and those other exercises which give ease and freedom to the movements, and strength, elasticity and health to the whole form, should occupy a certain por- tion of their time. The influence exerted on the child beneath the pa- rental roof is as enduring as life. The seed planted then, will in after years yield a ripe harvest of good or evil. The child should be made to feel, that its home is the purest, sweetest place on earth, and that its parents are its best friends. Above all, it should never be per- mitted to witness there, wrangling, disputing and con- MORAL, INTELLECTUAL, AND PHYSICAL EDUCATION. 553 tention, bitterness and heart-burning, or to hear from its parents one angry word or unjust charge. Make the home happy, and let its atmosphere be one of love and harmony. I have often felt indignant at the treatment children meet with at the hands of those from whom they should only receive kindness and affection. As I have heard the harsh and angry word, the heavy blow, the bitter tone of rebuke and denunciation, the unjust and often foul-mouthed charge, and seen the flashing eye, and the cheek flushed with passion, I have felt like telling the unnatural parents or guardians they were training the child for a future of crime and bitter- ness. Need we wonder at the awful and terrible fruits of human passion, when its fearful lessons are instilled into the young mind in the sanctuary of home. If we cannot have unbounded confidence between parent and child in the family circle, where on this sin-stained earth can it be found? If this confidence existed, and the child were made to feel that its parent's ears were ever open to its troubles, in them it had warm and ready sympathisers, kind ad- visers and hearts whose strongest anxieties were for its future welfare, what untold misery and suffering might be avoided. Thousands would be prevented from enter- ino- on a career of vice and crime, and hundreds, instead offinding the dream of their youth blighted, their purest affections trampled on, would be saved from a career so dark and fearful. On the harmonious training of the child in its parental home, depends, in a measure, the career of the man, and the greatness and prosperity of the nation. From what has been already said, it will be readily seen, that a false system of education, incorrect train- ing of the child, and ignorance of the laws of health, beget a large amount of the vice and crime, which de- vastate society. 24 554 HYGIENE AND THE CAUSES OF DISEASE. Look at the various avenues to vice in every part of the land, the gambling, and scenes of debauchery and crime, at which even devils might blush ! Here in the city of New- York alone, with its churches and bene- volent institutions, its untold wealth, and untold misery, the central point of the arts and sciences, literature and refinement, we find gambling and drinking saloons in almost every street, and a population of at least twenty thousand, who have sold themselves, body and soul, into a slavery bitter as death, who eat their bread from the wages of prostitution. It is a hard thing, oh parent, to believe, that you are training that son for disease and death, for the peniten- tiary or the gibbet. It is a hard thing to believe and bitter to realize, that you are training that daughter, so bright and gay, so beautiful and joyous,for disease, pain and an early grave, for a childless wife, for the mother of children weak and puny, for contention, for a cold and heartless life with no aim but self, no God but fashion, for the halls of prostitution, and the lowest brothels of the depraved. But go into our prisons and among the haunts of vice, and read a secret page in the history of crime. Go be- yond the deed, to the imperceptible steps, which led to the crime ; get at the moral, physical, and intellectual training in youth, and you will find there notes of dis- cord and jarring strings. We build prisons, huge stone walls, with gloomy cells, in which to confine those, who have been convicted of outraging law; we build the scaffold, and twist the rope which is to send the victim into eternity ; we found hos- pitals, the clergy hurl the anathemas of God against vice, while it lifts its unabashed head and laughs at these puny efforts, these baby blows on its citadel. The victims of crime have but practiced the lessons taught, them by society, and in their homes, and less cunning MORAL, INTELLECTUAL, AND PHYSICAL EDUCATION. 555 or more venturesome than others have been detected in the act, and punished. They are punished for yielding to temptations, which society itself spreads out before them. After scattering traps all over the community, those who dare fall into them and are detected, are pu- nished for their folly. Year after year the abandoned women who throng our streets descend to the grave by hundreds, and their ranks are filled with new victims not from the city alone, but from country towns and rural villages. Year after year the young and beautiful go down to early graves, genius flashes out for a brief moment, when death seizes its victim; children fall by thousands; in the homes where should be peace, happiness and con- tentment, is discord and contention; the prisons groan with victims ; the scaffold trembles beneath its weight and society sleeps on, wondering at the amount of crime, and trying to lop off some of the branches of that mighty tree, whose dark shadow is cast over the earth. Let us strike at the root of this difficulty; let us make the intellectual, the moral and physical to move on in perfect harmony, each performing its proper duty, each leaning on the other, and all forming one glorious whole. Until we accomplish this, in attempting to arrest vice, we but beat the air. Until we accomplish this, disease will continue to devastate the earth, continue to pile it with graves, and fill it with weeping and sorrow. Abuse of either the moral, physical or intellectual, under- mines health and happiness. It is only in the proper blending and use of all we are to look for weapons, which will batter down prison-walls, make the gibbet a thing that was, and in the place of sorrow, darkness and gloom, light up the lamp of joy and happiness. 556 TRUE THEORY OF CURE. CHAPTER IV. TRUE THEORY OF CURE. ^Nature, in all its operations, in all its movements, is characterized by the utmost simplicity, order and har- mony. There is no confusion, no discord. Creation it- self is like a mighty instrument, its parts composed of worlds and systems of worlds. Touched by the hand of God, it gives forth only notes of music and harmony. If, with the aid of the telescope's mighty power we look upon the heavens, world on world, and system be- yond system start into view, stretching far away into the depths of space, even beyond the assisted gaze of man. And yet these unnumbered worlds, to which, in point of size, our earth is but a pigmy, roll on in silent majesty from year to year, and from age to age, sweep- ing through the heavens on their viewless track, almost with the lightning's swiftness, crossing and recrossing on their silvery paths, without interfering one with the other, but in the utmost harmony and order. The comets wander off into unknown regions, returning at their ap- pointed time after centuries of absence. Sweeping backward and forward through the heavens, they may rightly be called the pendulums of the universe, mark- ing the hours of eternity. If we look at the vegetable world, at the tree, which striking its roots deep into the ground, has wrestled with a century's storms and tem- pests, at the ivy, which twines around its trunk, at the flowers which bloom in wild and sweet profusion over the face of nature, at the green grass which forms a yielding carpet beneath our feet, we find them all obey- ing fixed and positive laws. In all the combinations of matter, which are every hour going on about us, TRUE THEORY OF CURE. 557 how harmonious the progress, and marriage, if I may so speak, of matter, how beautiful and grand the re- sult! In the vast laboratory of nature, how simple the ele- ments we see at work, yet how stupendous and mighty the result! Each particle of matter obeys a principle it cannot transgress, and combines in beautiful propor- tion with the element necessary to complete the plan. Each combination in nature, each step in the mighty plan of creation, is in obedience to fixed, unalterable laws. Science is unfolding one glorious truth after another, revealing in dazzling light, the beauty, har- mony and simplicity of nature, and the causes of her various phenomena. We see what causes have been at work to upheave the mountain, form the channels of rivers, dot the ocean with islands, and cover the earth with vegetation and beauty ; why spring is followed by summer, and summer by winter; why to-day we feel the soft and gentle breezes of the south, and to-mor- row swelter beneath the rays of a burning sun, tremble before the storm, or shiver in the cold winds from the north. Nature works by fixed laws. There is no chance, no guess-work in her combinations and movements. Science is gradually unfolding these principles and laws, and now, guided by those laws which have been already unfolded, we daily penetrate deeper and deeper into the temple of nature, and bring to light new won- ders and glories. The chemist in pursuing his labors, has fixed data to work upon, data the result of ex- perience and close and accurate observation. At each step of his progress he feels that he is treading on firm ground, that his pathway is surrounded with light, that the science he is cultivating is a positive science, and whenever he directs his footsteps into unexplored regions of investigation he goes forth with confidence, 558 TRUE THEORY CF CURE. confidence in immutable and unchangeable laws, and finds in all his researches, in all the glorious truths he brings to light from nature, no clashing with laws al- ready known, no contradiction of the true science of the past, but a beautiful harmony reigning through all. In what an endless labyrinth did the theories of the ancients involve them as it regards the movements of the heavenly bodies and the various phenomena of na- ture. Contradiction met them at every step, and they found themselves at every effort becoming more and more entangled in a net-work of mysteries. At length the philosopher detects in " attraction of cohesion and gravitation" the great levers which move worlds, and going on step by step, he discovers other truths, and finds in all, principles which are to guide him and cast light on his path in all future investigations. And now the astronomer, with his telescope, can calculate the movements of the heavenly bodies, predict with unerring certainty the return of the comet from its far off wan- derings, and unroll before our eager gaze the glorious map of the starry heavens. If we look back upon the history of medicine, what proofs do we find, until within the last half century, of its having any claim to rank among the positive scien- ces. We find the whole medical profession groping in fog, striving to catch shadows, and vainly searching in in the midst of bogs and quagmires for firm ground on which to stand. Now and then, as a ray of sunlight penetrates the mist by which they are surrounded, they perceive their error, and start off into another, and equally fruitless path. Thus confusion treads upon the heels of conjecture. Theory after theory is born, flour- ishes its brief span, and is then crowded from the stage to give place to another equally wild and fruitless. The theory of to-day is renounced to-morrow, consigned tc the tomb to be exumed by some modern JEsculapius, TRUE THEORY OF CURE. 559 clad in new garments, and proclaimed to the world with a flourish of trumpets as his own offspring. Time and space would fail us, and indeed it would be a useless task to attempt a description of the theories of disease, and its treatment, which have been advanced by the me- dical philosophers of the world from the days of Hippo- crates to the present. Let us briefly glance at the treat- ment the patient receives at the hands of the so-called, old or allopathic school of medicine, with its boasted an- tiquity, and its experience of thousands of years. Floating about on the wild sea of conjecture, without any leading principle to guide to the appropriate reme- dy, the treatment of disease is as various as the almost innumerable theories, which have been advanced. Minute and highly important symptoms are disre- garded, and facts are compelled to give way, that clash- ing theories may triumph. " Break down the disease, if in so doing, you break down the patient," is too often the result, although not generally the open preaching of the allopathic school. We will suppose a patient sick with fever, and glance at the treatment he would be likely to receive at the hands of different physicians. The cause of the disease to the unbiassed mind should be apparent, and the case perfectly plain and simple. Prostrate on his bed, the head dizzy and throbbing with pain, the heart beating with violence, the pulse quick and wiry, and the whole frame burning with fever, the patient tosses from side to side, eagerly watching for the approach of his phy- sician, filled, as his fancy pictures him, with the accu- mulated wisdom and experience of centuries, whose magic skill is to soothe the tortured frame, cool the fevered blood, and call back the pulse of health. At length the physician enters, looks at the flushed face, places his finger on the pulse, and says, unless we reduce the vital power, and deplete the patient, he will 560 TRUE THEORY OF CURE. die. The arm is bared, and the blood spouts from the vein until weakened by its loss, a faintness almost amounting to insensibility is felt. Bind up the arm, give a smart purgative, follow it by nauseating doses of antimony, and to-morrow, if no better, put in again the lancet and cathartics. As he leaves the room, he gives the comfortable assurance, that in addition to these pleasing remedies, the patient is to have for the coming few days, nothing to eat. But, perchance, a physician is called in having a dif- ferent theory. The fever, he says, undoubtedly arises, in this case, from an irritation of the intestinal canal. Clear out the canal then, with a gentle purgative, keep the patient perfectly quiet, and give him cooling drinks. But, still another physician may have been called in, and he says, that the fever is caused by an irritation of the brain, and we must deplete valiantly, bleed from the arm, apply leeches to the temples, put ice to the head, and be sure not to forget the cathartics. And these physicians, and a host besides, agreeing in a plain simple case, as to the cause of the disease and the treatment necessary, about as well as oil agrees with water, are all ranged under the worn and time-honored flag of allopathy. Godly allopaths all, steeped in the wisdom of the past, how their souls revolt at quackery, and their lips curl in scorn at those, who tired with the restless waves on which they had been tossing, of the shifting sands in which they had been enveloped, dare to set their feet on firm ground and drink of pure waters. But we will suppose, the fever was in reality produced by an inflammation of the brain. The capillaries of the brain are congested, and to relieve their congested state a large amount of blood is drawn from the system. The strength is reduced, but the congestion still con- tinues. An artificial inflammation must now be pro- TRUE THEORY OF CURE. 561 duced in some healthy part of the system, which shall supersede that already existing in the brain. Put on the blisters then, and ply drastic purgatives. But what effect do you produce by this treatment, and how do you touch beneficially the true seat of the dis- ease ? The serous vessels of the brain, from their loss of irritability and tone, are prevented from performing tiieir functions aright, and no cure can take place, until this tone and irritability is restored. Can you, by the most active depletion, prevent the red globules, freight- ed with oxygen, from entering the relaxed and en- feebled capillaries, and the whole remaining mass of blood from circulating through the brain every few mo- ments ? Certainly not, and by thus reducing the strength you take away one of the most important stimulants to these enfeebled vessels. And also by creating new in- flammations, you reduce the chance of recovery by weakening the system and taking away a portion of its power to struggle against disease. And more than this, you by your drugs may create new diseases frequently more serious than the old diseases, which in their long duration and the torture they produce in the system, often make the patient long to lay his weary head in the quiet of the grave. One would suppose that the allopath might devoutly pray, " Oh for some rest to this tossing bark; Oh! for some rock on which to stand, some ray of light to pene- trate this gloom, or one thread to guide me through this tangled maze!" But lest the reader should suppose the picture is over- drawn, let me quote from one whose virgin heart has never wandered from the shrine of allopathy or become tainted with heresy. Dr. Bushnan, in a little work, published in London, in 1850, on " cholera and its cures," paints us the following exquisite picture of allopathy. In speaking of the different remedies used in cholera by 562 TRUE THEORY OF CURE. the " regular profession? he says : " Let us pass in re- view these remedies, so as to obtain a bird's eye view of them. They defy classification. Omitting for a mo- ment the complex method by which cholera was to be vanquished, what were the simple specifics that were to cure, infallibly cure, the fearful enemy ? " Water of every temperature. Wrap the cholera pa- tient in a cold sheet, says one. Dash cold water repeat- edly over the sheet in which he is enveloped, says an- other. Ply him well with cold water internally,'says a third. Freeze him ; cool his blood to thirty below zero, adds a fourth. Fools that ye are, exclaims a fifth, ' thus to treat a patient half dead with cholera—I say, wrap him in sheets soaked in boiling water; and having thus half-cooked the shivering wretch, conclude the process by placing him over the boiler of a steam engine.' " Sage advice, learned Thebans! the blood is dark, and the surface cold. 'My theory,' shouts one man, is that oxygen reddens the blood, and by its action on that blood, generates heat; therefore make the patient in- hale oxygen.' ' Nay,' rejoins another, ' the blood in the lungs is too bright; oxygen has nothing to do with the generation of heat; stifle him with carbonic acid.' ' There are cramps present, which cause much suffering, and therefore are they the symptom especially to be treated, Chloroform annihilates pain—let him breathe chloroform.' " ' It is evident,' avows one sapient doctor,' that there is no bile in the stools; therefore calomel should be ad- ministered.' * It is plain,' says another, ' that diarrhoea is the great evil; therefore let him have opium, that is the drug which effectually prevents a free flow of bile.' ' He is cold and depressed—what so natural as to stimu- late.' The wisdom of the proposal is proved by the numbers who recommended its adoption—the folly of the many is manifested by the proportion who died TRUE THEORY OF CURE. 563 under the use of stimulants. ' Give him alkalies,' voci- ferates one man. ' Nay,' says another,' lemon-juice, and acids are the true remedies.' " ' It is simply a stage of intermittent fever,' maintain some; 'therefore,' they add, 'the drug for its prevention and its cure is quinine.' ' Not half potent enough,' whis- pers a supporter of the same theory, ' give him arsenic' " Certain fanatics refused the use of medicine, but in the course of their religious mummeries, administered to the credulous a cup of olive oil. A patient recovered, and ' Eureka !' shout the populace. Vox et praeterea ni- hil, say those who wait awhile before they decide. "Opium, in one man's mind, is a specific in small doses, the twentieth of a grain frequently repeated. ' Nonsense,' says another, ' opium is a specific, but let it be given in doses of from six to twelve grains.' The latter has one advantage ; if the power of absorption yet remains to the stomach, the patient will assuredly be saved all further pain, and, if he be a good man, mercifully provided for in a better world. " ' Calomel is the specific that will stay every symptom of the cholera, bring back the pulse, and restore life almost to the dead, if given,' says one,' in twenty or thirty grains at a dose.' ' No,' says another, ' give it in that way, and you will kill the patient. It must be given in small doses, at short intervals.' " Then come other infallible specifics—pitch, sulphur, phosphorus, and carbon; gold, silver, zinc, and lead; strychnine, salicine, morphine, and cannabine; ha.ch- shish, and zorabia ; abstraction of blood and injection of blood ; perfect repose and incessant motion; to the skin irritation the most severe, applications the most sooth- ing; stimulants the most violent, sedatives the most powerful." And this is medical science. Medical science to which man is to turn for relief when the body is racked with 564 TRUE THEORY OF CURE. pain, and in which he is to find hope when disease with stealthy footsteps enters his home. Oh! what a parody on true science, what a mockery of suffering humanity But does the medical history of the past two thousand years present no bright spots, has it placed no trophies in the temple of truth ? Have the thousands of noble and self-denying men who have filled its ranks accom- plished no good ? On the contrary, the history of medi- cine is full of brilliant discoveries, but they have most- ly been in the field of physiology. Here great truths have been developed, and the way prepared for the in- troduction of a law of cure of so beautiful and perfect a character that it is destined to banish all adverse theo- ries from the field. Notwithstanding, theories of disease almost innumerable have been advanced, but one law of cure has ever been established. Let us briefly examine this law, which we may do by answering the question of WHAT IS HOMCEOPATHY ? The disturbance created in the system by morbific causes produces in the organism a mass of symptoms, which represent the actual malady or disease. The ob- ject of the medicine then is to annihilate these symp- toms, in doing which the internal change on which the disease is founded is also removed. The object is not by means of opiates to palliate for the time, or by active depletion to decrease the severity of the symptoms,—for in either case the cause is not removed,—but to remove thoroughly, and effectually, in fact, annihilate the symp- toms, and thereby eradicate the disease. How is this to be done ? There surely must be some principle to guide us in the selection of a remedy and its appropriate administration. It cannot be possible that we are left to grope in the dark, striking about us at random in the hope that some of our blows will hit the mark. If this were the case, we should be far more WHAT IS HOMOEOPATHY ? 56b likely to hit the wrong than the right place, and be pretty sure of doing more injury than good. But this is not the way in which nature performs any of her operations. There is no chance, no guess-work, no confusion, in any of her movements. And certainly we should not expect to be thrown on the broad ocean of conjecture, where man the noblest and most beautiful of all its works is concerned. No, there is a law by which we are to be guided in the removal of disease, as immutable and un- changeable as the laws which govern the heavenly bo- dies. No cure can be performed, unless in obedience with this law, from which, if we depart, we embarrass, instead of aid nature in its operations. This law is perfectly plain and simple. A medicine taken into the healthy system produces a certain dis- turbance, which acting on the organism, gives rise to a peculiar class of symptoms. In other words, a disease is produced by artificial means, creating a peculiar dis- turbance, in the system, and producing a particular class of symptoms. Now, where a disease is produced by other causes, with symptoms similar in every respect to those produced, by the drug, we of course conclude, that there is a similar disturbance in the system, a similar inter- nal change, in fact, a like disease to that developed by artificial means. If then, we now give this drug, it is evident we pro- duce an artificial disease, occasioning the same distur- bance, producing the same internal change, giving rise to the some symptoms, in fact, precisely similar to the one already existing in the system. But these affections cannot exist together, for the more intense or powerful will destroy the weaker. If then with our drug we pro- duce an artificial affection, a little more intense or power- ful than the old, we of course demolish the old intruder, and expel it from the system. In a word, a weaker dy- namic affection in man is permanently extinguished by 5^6 TRUE THEORY OF CURE. one that is similar, of greater intensity, yet of a different origin. A reaction of nature is excited by the drug, and thus the disease expelled. Of course, the remedy must be allowed to produce its specific effect, and be given unmixed with any other. If two or three remedies are mixed together, and given at the same time, it is clear, that you get the pure effects of neither. The drug given must cover, or be capable of producing in health, not one symptom alone, but the entire group. An affection produced artificially, dissimilar to the one existing in the system, does not destroy that affec- tion, but if more powerful, simply causes its suspension until the new disease performs its course, or is cured, when the old disease re-appears. Thus the stronger may suspend the weaker, but they never cure each other reciprocally. Therefore the method frequently adopted in allopathy of producing contrary symptoms, is wrong, and cannot cure. If then, as has been already said, disease is removed by giving drugs, which when taken into the healthy sys- tem produce a train of symptoms similar to those exist- ing in the diseased, the absolute necessity of a pure Ma- teria Medica will be readily perceived. Each drug must be tried on the healthy system, and the symptoms deve- loped under its use carefully noted down. And this has been done not by one alone, but by hundreds, who have gladly endured the suffering to which they have thus submitted themselves, that in so doing they might be the better enabled to alleviate human suffering, and check the fearful desolations of disease. These investi- gations have been carried on by different persons, in coun- tries, widely separated from each other, at the same time. Thus the proving of the same drug may have been going on at the same time in Germany, France, England, and America, and the progress of each un- known to the other until the whole was finishod. When WHAT IS HOMCEOPATHY ? 567 compared they have been found to agree in every im- portant particular. Thus, by thoroughly proving each drug on the healthy system, the only pure Materia Me- dica ever made has been prepared. Each drug has been submitted to a laborious and painful investigation, and in no other way can a Materia Medica be produced on which any reliance can be placed. How different a Materia Medica thus prepared, from the loose, uncertain, and guess-work affair of allopathy. We know from actual experiment, that a drug will pro- duce such and such symptoms. In allopathy there is no such certainty. Not a drug has been thoroughly in- vestigated in the only correct way, that of a trial on the healthy system. The allopath then has no sure ground on which to stand. Somewhere he has read or heard that a certain drug will benefit in a certain disease, but how does he know the symptoms indicating it are pre- sent, or that his informant might not have received it from as uncertain a source as himself. We have presented a principle which experience has clearly established as the only law of cure ever discover- ed. On this broad principle has been produced the only pure Materia Medica the world has seen. Such then is Homoeopathy. The corner-stone of the edifice, the broad platform upon which is reared the whole glorious struc- ture is "similia similibus curantur," or "like is cured by like." This is the great law of cure, the law through which all cures must be performed, the principle for which we contend, which is inscribed on all our banners, and which will as surely triumph throughout the world as truth will triumph over error. This is Homoeopathy. Is there any thing so terrible about it ? Anything so contrary to reason, so awful and pernicious as to bring down upon it the vials of allo- pathic wrath ? But is it said, I did not suppose this was Homoeopathy ? I thought that it consisted in infi- 568 TRUE THEORY OF CURE. nitesimal doses. Then there never has been a greater mistake. Upon this man of straw have been poured vials of wrath and torrents of indignation. Homoeopathy con- sists not in the amount of the dose, but in that dose being given in obedience to the great principle already stated. The question then is, how large a dose, given strictly homoeopathically, is necessary to produce a cure with the greatest safety, and in the least amount of time. Hahnemann, when he commenced the practice of his new system gave his medicines in the ordinary-sized doses to which he had been accustomed in the allo- pathic school. But he very soon ascertained, that where medicines were given after a close and accurate study of the symptoms, and were intended to act specifically, this course would not answer. He must, from an inevi- table necessity, if he wished to cure his patient, obtain the drug in its purest form, and give it in minute doses. Hence arose the system of infinitesimal doses. It was the work of necessity, the direct result of the ho- moeopathic law. And yet this system of infinitesimal doses, without regard to the great homoeopathic law of which it is the natural result, has been held up as ho- moeopathy, and been made a target against which have been hurled the sneering and contemptible shafts of ridicule, falsehood, and misrepresentation. The sapient allopath, to show the inertness of homoeopathic medi- cines, has heroically swallowed a dozen of the medicated globules, never dreaming that in so doing, he was only showing his own ignorance and folly, for it is the great law of our system, that for these globules to produce their legitimate effect, a peculiar class of symptoms must be present, to which the remedy is homoeopathic. the diseased state of the system also far increases its susceptibility to medicines. Let us briefly examine this system of infinitesimal doses, and see if reason and experience do not teach us, WHAT IS HOMC30PATMY ? 569 that even small things, so far as appreciable quantity is concerned, are capable of producing a tremendous effect. It must be borne in mind, that in homoeopathy, the drug, in addition to its being administered in obedience to a fixed law, is obtained in its purest form, and, unmixed with any other medicinal substance, is allowed to pro- duce its specific effect. This is not the case in allo- pathy. There, as they themselves have often lamented, but very little dependence can be placed on their drugs, as it is almost impossible to obtain them pure, and as if this were not enough to destroy the little specific action *iiey might exert, three or four medicines are often com- bined together, thus, the one destroying in a great mea- sure the effect of the other. Where can be the neces- sity of pouring into the stomach an enormous quantity of drugs, when, if given in a pure state, a much smaller amount would produce a more decided effect? Who would think of crowding the stomach with crude Peru- vian bark, when the curative principle of the bark is at hand, in the form of quinine ? But let us look at nature, from whose vast store-house we can draw glorious lessons of wisdom and truth. Let us glance at those silent operations, which are capable of producing such mighty changes in the world of matter. It is true, our Creator might, if he chose, have made this world, which now moves on in such order and harmony, to have creaked and groaned in every joint, he might have made the smallest fly to have buzzed thunder, but He had no such absurd idea of order and power. Let those who ridicule the fact, that an infinitesimal amount of matter so small as to possess no appreciable weight, or taste, can exert any influence, creep out of their nar- row shell, and open their eyes to the wonders going on around them every day and every hour. The earthquake is on its fearful march, and the earth trembles before its mighty power. Cities are overwhelm- 570 TRUE THEORY OF CURE. ed and mountains rent and torn like paper. Volcanic fires burst from the quaking earth, and with tongues of flame and lava flood deluge in fiery ruin the surround- ing country. Touch, taste and weigh in human scales these subtile forces, which produce such tremendous power. The electric current strikes the traveler dead . to the earth. Gather up the particles and tell us their weight and measure. Standing in New-York a message is transmitted with lightning speed along the telegra- phic wires to New-Orleans. Tell us the amount and size of the electric particles, which bear the message on to its destination. When vegetable substances are subjected to heat and moisture, certain atoms or molecules are set free, which diffused in the atmosphere, may infect hundreds with intermittent fever. And yet do those moving through a miasmatic district, smell, taste or see the subtile poi- son which is so powerfully to affect them ? Can the chemist detect it by any process of analysis with which he is acquainted ? Minute particles are constantly escaping from per- sons affected with small-pox, scarlet fever, and other diseases, which passing into the air are capable of af- fecting hundreds and thousands of persons with the same disease. Cases are on record where a letter merely written in a house where a person was sick withtthe small-pox, and transmitted through the mail hundreds of miles, has communicated the disease at the end of the route and infected a whole neighborhood. In whatever part of the world we go, we find the needle of the compass pointing toward the magnetic pole, showing that the molecules or atoms, which escape from this magnetic deposit pervade the whole universe, Can we see or taste them, or if they were all collected together, could we weigh them ? The dog, as well as other animals, traces its prey by WHAT IS HOMOEOPATHY? 571 the sense of smell for miles, and a single grain of musk scents the room for days without any appreciable dimi- nution in quantity. Gold may be divided into particles of T-sinru'oTTuo of a square inch and still possesses the color and other characters of gold. A single drop of a solution of indigo, colors 1000 cubic inches of water, so that the particles of indigo must be smaller, than the twenty-five hundred millionth of a cubic inch. Linen yarn has been spun, a pound of which was 1.432 English miles in length. A visible portion of such thread could not have weighed more than x-rr."oVr-mr of a grain. If we look through the microscope we discover animals, living and perfect in all their parts, so minute that it would require the heaping together of millions on mil- lions to be visible to the naked eye. In all vegetable substances the real strength remains latent in the crude state, and requires certain prepara- tion to develop it. The more completely the essential principle is separated from the crudity, by which it is surrounded the more powerful it becomes. It has been clearly shown by science, that by friction, mixture, &c, principles of immense power may be liberated from sub- stances, which in their crude state are entirely inert. Inasmuch as the active properties of a medicinal sub- stance are developed from its surface, to develop its full powers, we must make it cover over as large a surface as possible. A grain of matter thoroughly triturated with one hundred grains of sugar of milk, may be made to pervade every part of it, and the matter may be still far- ther diffused by taking one grain of this substance and combining it in the same manner with another quantity of the medium. The drug thus separated, retains in each atom of its minute subdivision the power of exert- ing a specific influence on the system. We have thus endeavored to make clear two points, viz. the great homoeopathic law, and the system of infi- 572 TRUE THEORY OF CURE. nitesimal doses, and trust we have succeeded in show- ing that the former is the only true law of cure, and the latter not quite so ridiculous, as some, who are not ac- customed to think, seem inclined to suppose. We have said, that the law of " Similia similibus cu- rantur," is the only law of cure, and when cures are per- formed, they are in obedience with this law, no matter who the physician or what the drug given. Let us bring the allopathic school themselves to the bar, and apply the test to some of their cures. Nitric-acid is a favorite remedy for salivation and ul- ceration of the mouth, produced by mercury, and yet this drug is capable of exciting salivation and ulceration of the mouth. Preparations of copper are also given in cases of chorea and epilepsy, and yet the administration of copper produces symptoms precisely similar. Rhubarb and calomel are favorite allopathic reme- dies for diarrhoea and dysentery, and yet given in large quantities during health, produce inflammation of the tissues of the bowels, griping pain and frequent dis- charges. Cubebs and cantharides given in health, pro- duce inflammation of the mucous membrane of the uri- nary organs, and yet they are unhesitatingly prescribed when this state exists in disease. Ipecac, given in doses of twenty or thirty grains produces vomiting, but the allo- path has found by experience, that given in the tenth or twentieth part of a grain it will relieve vomiting. Mercury in all those cases where it is found indispen- sable by the allopath, is capable, if taken in large doses in health, of producing precisely a similar state. To an ordinary inflammation of the eye, they frequently apply a mild solution of nitrate of silver, and yet this drug ap- plied to the healthy eye, produces that inflamed state. Castor-oil is given to cure diarrhoea, and yet its primary effect is a diarrhoea. The mother has learned by expe- rience, that when her child is injured by a burn, to pro- WHAT IS H0MC30PATHY? 573 duce relief, she must hold it to the fire, or apply alcohol, or oil of turpentine. And so we might go on enumerat- ing, and we should find in every case, where a cure is performed by means of drugs, it is in obedience to the homoeopathic law. From what has been already said, we find, that in dis- ease, where the disturbing causes are slight, nature is sufficient of itself to produce a healthy reaction, but when the aid of medicines is required, those medicines must be given in obedience to the law of " Similia si- milibus curantur." The vital force reacts with far more power against im- pressions caused by specific medicinal influences, than against those produced by morbific agents, hence those produced by the latter, often assume a serious character and run on for a long time, while those produced by the former, result in rapid spontaneous recovery. The medicine acts directly on the part affected, so that as a general thing an exceedingly minute dose is all-sufficient to produce a cure. In conclusion we have only to say, that homoeopathy, founded as it is on truth, on an immutable, unchange- able law, is destined to triumph throughout the world. In Europe, Asia, Africa, America and the islands of the ocean, its influence is felt and acknowledged. In every land and in every clime it is working its rapid way, the current daily increasing in strength and size, bearing down before it all opposition, and those who are now rash or foolish enough, to oppose its progress must soon either fall in with its current, or be swept away before its rushing tide. 074 MATERIA MEDICA. CHAPTER V. MATERIA MEDICA. ACONITE. Monkls Hood. Inflammatory diseases and local congestions. The first stage of fevers and nearly all those diseases where there is a rapid increase of circulation, dry and hot skin. Also in spasmodic affections produced by fright. General Symptoms.—Thirst with redness of the checks. Bruised sensation and great sensitiveness to the touch; congestion of blood to the head and other organs; un- easiness as from a chill or suppressed perspiration; shivering sensation, or feeling as if the blood were stag- nant. Skin.—Fever with dry and burning skin. Scarlatina. Measles, Small-Pox, and other eruptive diseases, attended with fever. Sleep.—Drowsiness with dreams, or sleeplessness with great restlessness and tossing from side to side. Start- ings in sleep; nightly delirium. Fever.—Shivering with dry burning heat of the skin; burning heat with dry hot skin and great thirst; rapid pulse, at times hard, at others wiry and intermittent. Had.—Vertigo, particularly on raising the head. Piercing throbbing pain in the head, forehead, and temples, or fullness in the forehead, as if the brain would press out; pinching pain over the root of the nose, and bruised or tensive sensation; congestion to the head with heat of the face ; pains increased by movement. Eyes, Ears, and Nose.—Acute ophthalmia with great redness, heat, and shooting pain in the eyes. Roaring in the ears. Bleeding from the nose. Teeth, Mouth, and Throat.—Toothache, especially from ALUMINA. 575 a cold, with heat and throbbing pain in one side of the face. Rheumatic and congestive tooth and face-ache. Acute inflammation of the throat, with violent fever and difficulty in swallowing. Stomach and Abdomen.—Inflammation of the stomach. Inflammation of the bowels and intestines, with burn- ing lacerating pain; great sensitiveness of the abdomen and stomach to the touch. Faeces and Urinary organs.—Frequent, scanty and loose stools with tenesmus; watery diarrhoea. Retention or incontinence of urine; high-colored urine, with or without brick-dust sediment. Genital Organs.—Milk-fever, puerperal fever, de- rangement of the menses, especially when accompanied with fever. Larynx.—Short, dry cough, as if from a tickling sen- sation in the larynx; spasmodic cough, or cough with bloody or mucus expectoration. Dry cough, with heat, thirst, and restlessness. First stage of hooping cough, &c. Christ.—Anxious, quick, or labored breathing. Asth- matic suffering; aching pain in the chest. Pneumonia, pleurisy, and affections of the heart. ALUMINA. Pure Clay. Affections of the mucous membrane, sometimes with ulceration; scrofulous affections. Congestions arising from suppression of hasmorrhoidal flux; constipation; spasmodic conditions, twitching of the limbs, &c. Shan.—Corrosive itching, particularly in the evening; excorations, humid scurf, and itching tetters. Head.—Vertigo ; heaviness or lacerating in the head; itching eruption on the scalp. Eyes, Ears, and Nose.—Burning in the eyes; nightly agglutinations; humming, vibrations and other sounds in the ears; bleeding at the nose; stoppage of the nose, 576 MATERIA MEDICA. or nose painful, swollen or ulcerated ; itching eruptions on the face. Abdomen and Faeces.—Colic ; inactivity and paralysis of the rectum ; constipation, piles. Sexual Organs.—Headache before, and pain during the menses; profuse leucorrhcea, sometimes with itch- ing ; toothache, and constipation during pregnancy. AGAR1CUS. Particularly indicated in derangements of the nervous system. Skin.—Itching burning and redness as if frozen, and sometimes itching eruptions. Mental emotions.—Great restlessness; uneasiness of mind, sometimes developed in insanity. Head.—Vertigo or dullness in the head ; pressive pain or drawing tearing pain, particularly above the root of the nose and on the top of the head; painful sensitive- ness of the scalp; itching and redness of the face. Eyes, Ears, and Nose.—Burning sensation in the eyes, itching and tingling; indistinct sight, objects seen as if through turbid water, surrounded with mist and covered with a cobweb; itching and burning of the ears, and various sounds in the ears; itching and soreness of the nose, sometimes with discharge of blood. ARNICA. Leopard's Bane. Rheumatic and arthritic pains ; hot and shining swell- ings ; lacerating and shooting pains: paralysis or con- vulsions ; affections occasioned by sprains, bruises and falls; sores of bed-ridden persons. Fever.—Intermittent fever; pain in the bones, accom- panied by headache. Head.—Concussion of the brain by a blow or fall; great heat in the head ; lacerating or tearing pain in the head, particularly the forehead. ARSENIC. 577 Faeces.—Constipation ; blind-piles ; white diarrhoea. Larynx and Client.—Dry cough as from tickling in the throat; expectoration of blood; difficult breathing; aching and bruised-like sensation in the chest. ARSENIC. Arsenious-Acid. Rapid sinking of strength, great prostration and emaciation; spasms ; convulsions and epileptic fits ; dis- eases of the mucous membrane; dropsical complaints and scrofulous affections. Burning, especially in the interior of the affected parts. Skin.—Pustules, ulcers, and cancerous affections, ac- companied with burning; fetid secretions and tendency to run into mortification, general dropsy. Sleep.—Great weariness and restlessness, tossing about, or starting as if in affright; burning as if hot water were coursing through the veins. Fever.—General coldness, with dryness of the skin or profuse sweat; intermittent fever, the stages flowing im- perceptibly into each other, typhoid and putrid fever and other fevers, where there is rapid prostration, dry and burning skin. Head and Face.—Periodical headache, great weight in the head, humming in the ears; beating pain in the head ; painful sensitiveness of the scalp ; swelling in the head and face, and burning excoriating eruptions with fetid smell; sunken countenance or bloated and puffed face ; cancerous affections of the face. Eyes, Ears, and Nose.—Burning sensation in the eyes, and redness and congestion: scrofulous, rheumatic and catarrhal ophthalmia; swelling of the lids, specks and ulcers on the cornea; roaring in the ears; burning in the nose, sometimes with excoriation or ulceration; dry- 25 578 MATERIA MEDICA. ness of the nose, or discharge of an acrid fluid; profuse acrid discharge from the nose, with sneezing; stoppage. Teeth. Mouth, and Throat— Fetid smell from the mouth, tongue and lips, covered with burning vesicles; burning in the throat. Stomach and Abdomen.—Violent thirst, or absence of thirst; water-brash; nausea and excessive vomiting, sometimes of a chronic character and attended with burning sensation and pain in the stomach; vomiting sometimes of blood or of a blackish substance ; stomach painful to the touch, sometimes with burning and of a weight like a stone; great anguish in the stomach; cancer and inflammation of the stomach; dropsy of the abdomen ; spasmodic pain in the bowels ; burning in the abdomen or cold and chilly sensation; swelling of the abdomen, great anguish and sensitiveness of the touch. Faeces.—Constipation; or diarrhoea attended with co- lic ; vomiting; straining, the evacuations burning and fetid ; bloody evacuations with vomiting and colic. Genital Organs.—Acrid and corrosive leucorrhcea, cancer of the uterus. Larynx and Chest.—Dryness and burning in the larynx; consumption of the trachea; cough, dry, short and hack- ing ; difficult expectoration, sometimes of blood-streaked mucus, with burning in the whole body, or succeeded by nausea; suffocative cough, soreness and bruised sen- sation in the chest, oppressive and labored breathing, sometimes with debility; asthma; dropsy of the chest; short and anxious breathing. AURUM. Gold. Particularly useful in affections of the nervous system; scrofulous or dropsical affections ; complaints from the abuse of Mercury; severe nightly pain in the bones, BELLADONNA. 579 sometimes with inflammation and ulceration; syphilitic and mercurial affections of the bones. Skin.—Bony tumors on the head, arms and legs; drop- sical swellings; scrofulous and mercurial glandular affec- tions ; eruptions, ulcers and cancerous affections. Mental Emotions.—Fear; insanity; violent anger or dejected spirits and longing for death. Had and Face.—Rush of blood to the head; tumult and roaring in the head, especially of nervous persons; eruptions on the face; swollen and ulcerated lips, espe- cially of tuberculous persons. Eyes, Ens, and Nose.—Scrofulous affections of the eyes; incipient amaurosis; roaring in the ears; fetid discharge from the ears, hardness of hearing, and affec- tions from abuse of Mercury; caries of the nose; swell- ing, ulceration and soreness of the nose. Chest.—Palpitation of the heart; chronic affections of the heart. BELLADONNA. Deadly Night-shade. Scarlatina.— Rheumatic and erysipelatous inflamma- tions ; great derangement of the nervous system; con- gestion to the head; spasms; convulsions; neuralgia. Skin.—Scarlet spots and scarlet redness, sometimes with hot swelling of the parts ; erysipelatous and rheu- matic inflammations, with red and hot swellings ; boils and painful glandular swellings. S'eep.—Drowsiness, stupor, or great sleeplessness and restlessness, screaming, moaning and starting in sleep, with anxious and frightful dreams ; headache on waking. Fever.—Chilliness from a current of air ; violent burn- ing heat, redness of the face, congestion to the head, and violent thirst; pulse strong and quick, or full and slow. Mntal Emotions.—Melancholy, nightly delirium; in- sanity with changeable feelings; at times merry and foolish, at others sad with weeping, at others violent 580 MATERIA MEDICA. rage, howling and screaming; illusion of the senses; conversing with absent friends or imaginary things. Head.—Violent headache, especially in the forehead, so severe as to cause him to close the eyes, and increased by motion; headache above the orbits as if the brain were pressed out, violent pulsative and throbbing head- ache ; lacerating and shooting pains in the head; full- ness and heaviness of the head; congestion to the head. Face.—Redness of the face, sometimes swollen; ery- sipelatous inflammation; violent neuralgia. Eyes, Ears, and Nose.—Great sensitiveness to light, running at the eyes, and violent pain in the balls, severe pain in the orbit, as if the eyes would be forced out, spasms of the eyes; staring, shining or glistening eyes; amaurosis ; great dimness of sight, cloudiness of the head, sparks before the eyes. Lacerating, stitching pain in the ear; swelling of the parotid gland. Bleeding at the nose. Ulcers on the nostrils and the corners of the lips. Mouth and Throat.—Locked jaw; throbbing and ul- cerative pain in the gums, violent and lacerative tooth- ache, worse at night; rheumatic toothache, particularly during pregnancy ; toothache with red, hot face, beating in the head; swelling and inflammation of the mouth and tongue ; tremor of the tongue; roughness and sore- ness of the throat; sore throat with pain and swelling and difficult swallowing; inflammation of the tonsils, rawness of the throat; spasmodic constriction of the throat. Stomach and Abdomen.—Loss of appetite, hiccough, spasms of the stomach, resembling a cramp ; pain in the pit of the stomach, colic and shooting pain or cramp- like and constrictive pain in the bowels; great sensi- tiveness of the stomach and abdomen; peritonitis. Fceces and Urine.—Dysenteric or diarrhoeic stool with B1LY0NIA ALBA. 581 straining; paralysis of the neck of the bladder; inflam- mation of the bladder and kidneys. Genital Organs.—Derangement of the womb, affecting the head and nervous system; puerperal fever; spasms of parturient women ; toothache and colic of parturient women, swelling and pain in the breast. Larynx and C/iest.—Hoarseness, painfulness of the la- rynx when coughing; dry night-cough; hooping cough. Labored and difficult breathing; asthma; stitches or shooting pains in the chest; spasms of the chest and throat, palpitation, and tremor of the heart. Back and Extremities.— Rheumatic or neuralgic pains; stiffness of the parts; glandular swellings ; erysipelatous inflammation. BRYONIA ALBA. White Bryony. Inaction of the liver and bowels. Rheumatic and arthritic affections. Gastric and nervous affections. Steep.—Drowsiness during the day; inclination to sleep after a meal; sleep with twitchings in the face. Fever.—Chilliness and creeping chills ; pains in the bones, from cold. Intermittent fever; acute inflamma- tory fevers with irritation of the nervous system ; gastric and bilious fevers, and for the fever preceding the erup- tion of small-pox, measles, &c. Mental Emotions.—Lowness of spirits ; irritable tem- per ; delirious talk at night, with desire to escape. Head.—Headache in the morning on opening the eyes; rush of blood to the head and throbbing pulsations; heaviness of the head; headache when stooping as if the brain would burst from the forehead; pain aggra- vated by movement. Nose and Fac\—Swelling of the nose with ulcerative pain when touched and ulcerations; dryness and ob- struction of the nose; bleeding of the nose; pale or 582 MATERIA MEDICA. yellow face; bloatedness or swelling of the face ; swollen or chapped lips. Mouth and Throat.—Darting pain in the teeth; pain- ful soreness and looseness of the teeth and pain when chewing; hoarseness and sore throat with difficult swal- lowing. Stomach and Abdomen.—Loss of appetite or morbid hunger and frequently bitter, putrid, or sickly taste; eructations ; nausea, particularly in the morning on wak- ing ; empty retching; vomiting, sometimes bitter or bloody, frequently after eating or drinking. Pressure in the stomach as of a stone, particularly after eating, con- tractive pain, or darting, shooting or painful soreness in the stomach; spasms of the stomach; inflammation of the liver and stomach ; tension, burning and stinging in the region of the liver; colic; colic during pregnancy; dropsy of the abdomen; inaction of the bowels from sendentary habits. Faeces and Urine.—Constipation; chronic constipa- tion ; hard stool with protrusion of the rectum; diar- rhoea with previous colic, also from cold, alternating with constipation and spasms of the stomach; hot and red urine. Genital Organs.—Suppression of the menses with bleeding at the nose; profuse menstruation of dark red blood; pain in the small of the back and headache; puerperal fever, swelling and hardness of the breasts; milk-fever with rheumatic pains. Larynx and Chest.—Violent coryza without cough; violent cough with retching and sensation, as if the head and chest would fly in pieces; painful cough, the expec- toration sometimes streaked with blood; acute and chro- nic bronchitis ; difficult breathing; asthma ; pleurisy; pneumonia ; painful respiration and great pain in cough- ing ; stitches in the chest, shooting pains in the chest; rheumatic affection of the muscles of the chest. CALCAREA-CARBONICA. 583 Back and Extremities.—Painful stiffness in the nape of the neck, on moving the head; soreness and stiffness of the muscles of the trunk; bruised sensation in the small of the back; lumbago ; lacerating pain in the back. Lacerating pains in the arms and legs; shining, red, rheumatic swelling of the joints with lacerating and ten- sion on moving the parts. Coxagra; limping, cutting pain in the hips, lameness and drawing pains in the legs. CALCAREA-CARBONICA. Carbonate of Lime. Tuberculous affections. Eruptive diseases. Ulcers. Affections of drunkards. Skin.—Rough skin; nettle rash, going off in cool air; itching, vesicular eruption, herpes; readily ulcerated skin ; warts; ulcers ; polypus. Mental Emotions.—Low-spirited; peevishness, sadness or ill-humor. Head.—Dullness or dizziness in the head; stupefying, oppressive headache, violent throbbing headache as if the head would burst, hammering in the head, and seeth- ing of the blood ; itching eruption on the scalp and face ; falling out of the hair; glandular swellings. Eyes, Ears, and Nose.—Swelling and redness of the eyelids, readily ulcerating and stuck together with mat- ter; ulcers and spots on the cornea; amaurosis. Pulsa- tions in the ears ; purulent discharge; polypus; snap- ping, roaring, ringing and hammering in the ear. Sore and ulcerated nostrils; polypus and scrofulous swelling of the nose; stoppage of the nose or discharge of pus. Itching eruption on the face ; swelling of the glands. Mouth and Throat.—Throbbing or gnawing pain in the teeth ; swelling and bleeding of the gums. S'omach and Abdom //.—Waterbrash; nausea, and sour eructations; spasms in the stomach; swelling of the mesenteric glands. 584 MATERIA MEDICA. Larynx and Chest,—Dry spasmodic cough, particular- ly at night; palpitation of the heart, and excoriating pain in the chest. Trunk and Limbs.—Swelling of the glands. Boils, corns, &c. CAMPHOR. First stage of influenza. Dizziness ; loss of conscious- ness, and coldness of the body. Spasms; convulsions Cholera. Epileptic spasms. Skin,—Blue cold skin, with coldness of the body. Sleep.—Sopor and delirium; headache. Fever.—Chilliness and coldness of the body; heat with trembling. Head.—Dizziness of the head; loss of memory ; dull headache or violent throbbing pain in the head; inflam- mation of the brain; pale countenance; contortions of the muscles of the face. Nose.—First stage of influenza ; coryza. Stomac/i and Abdomxn.—Excessive thirst or absence of thirst; nausea ; vomiting, cold sweats and dizziness; burning in the stomach ; Asiatic cholera with cramps; abdominal spasms; bruised, pinching, or contractive pain in the abdomen. Faeces.—Difficult movement or involuntary diarrhoea. Larynx and Chest.—Roughness of the voice, with cough, occasioned by mucus in the air-passages ; oppres- sion of the chest; stitches in the chest after a cold. Extremities.—Drawing cramp-like pain in the muscles. CANNABIS. Hemp. Affections of the kidney and bladder. Rheumatic drawings in the bones. Complaints occasioned by fa- tigue. Urinary Organs.—Chronic retention of urine; pain- ful discharge of bloody urine; severe burning pain in CANTHARIS.--CAPSICUM. 585 the urethra during and after making water; inflamma- tion of the urethra; discharge of mucus from the urethra ; ulcerative pain in the kidneys. Chest.—Chronic catarrh. Inflammation of the chest and heart. CANTHARIS. Spanish Fly. Burning and itching in the skin. Rawness and sore- ness in the whole body; inflammation and gangrene of the parts; convulsions with distortion of the limbs. Skin,—Erysipelatous inflammation with blisters. Urinary and Genital Organ.<-.—Inflammation and pain in the kidneys, burning pain in the bladder; paralysis of the neck of the bladder; violent cutting in the ure- thra ; suppression or retention of urine ; constant desire to urinate, the urine passing in drops, sometimes streaked with blood, attended with burning pain; tenesmus of the bladder, strangury or discharge of drops of blood; eneuresis; discharge of pus and yellowish fluid from the urethra; painful gonorrhoea; inflammation of the neck of the uterus and the ovaries. CAPSICUM. Cayenne Pepper. Skin.—Burning itching over the whole body; shud- dering and chilliness ; intermittent fevers. Heael—Beating throbbing headache, as if the head would burst. ITww^.—Soreness of the throat, and painful swallow- ing ; smarting sensation in the throat, as if it had been gargled with red pepper. Larynx and Chest.—Hoarseness, cough, difficult breath- ing and sticking and throbbing pain in the chest 25* 586 MATERIA MEDICA. CARBO-VEGETABILIS. Vegetable Charcoal. Intermittent fever. Rheumatic drawing or bruised sensation in the limbs and joints. Attacks of weakness. Vertigo. General prostration. Skin.—Nettle-rash ; chilblains ; grandular and lym- phatic swellings; herpes and itching eruptions; un- healthy ulcers, and fetid smell. Sleep. —Drowsiness going off by motion; sleeplessness, pain in the head. Fever.—Chilliness, beating in the temples, and lace- rating in the bones and limbs; last stage of typhoid fever; collapse of pulse, morning or night sweats. Head.—Heaviness in the head, beating or pulsating headache, congestion to the head. Nose and Face.—Swelling and ulceration of the nose; bleeding at the nose, violent coryza or stoppage of the nose. Chapped lips; eruptions on the face. Mouthi and Throat.—Looseness and aching pain in the teeth; soreness of the gums. Rawness of the throat; sore throat after measles. Stomach and Abdomen.—Loss of appetite; nausea; waterbrash; spasms in the stomach; pain in the liver as if bruised ; stitches and lacerating pain in the liver; distension of the abdomen; aching and rumbling pain, with emission of flatulence. Faeces and Urine.—Constipation ; burning diarrhoea; or burning in the rectum after movement; bloody stool with tenesmus; piles; ascarides in the rectum. Genital Orgeins.—During the menses, cutting pain in the abdomen and headache. Leucorrhcea. Larynx and Chest,—Hoarseness ; cough when taking the least cold; cough, sometimes dry and hard, some- times accompanied with purulent expectoration and CAUSTICUM. 587 soreness in the chest; hooping cough and consumption ; spasmodic cough. Back and Extremities.—Bruised sensation in the back and limbs ; rheumatic drawing or lacerating pain in the joints and muscles. CAUSTICUM. Arthritic pain in the limbs. Lacerating in the joints and bones; stiffness in the joints ; bruised sensation or sticking pain in every part of the body. Epileptic fits. Paralysis, especially on one side. Skin.—Itching of the body, sometimes with burning pimples, warts. Sleep.—Great drowsiness, severe headache; general sweat with uneasy sleep. Eyes, Ears and Nose,—Sensations of sand in the eyes ; inflammation of the eyes, with burning and red- ness, especially in tuberculous individuals ; dimness of sight, and sensations as of objects or fiery sparks flitting before the eyes. Running of the ear, roaring and buzzing in the ear, bleeding of the nose, and obstructions of the nose, sometimes with dry coryza. Face, Mouth and Throat.—Pains in the lower jaw and in the face ; itching of the face ; burning ulcers of the lips ; throbbing or lacerating toothache ; painful sensi- tiveness, or looseness of the teeth, with sensation as if they were elongated; swelling and bleeding of the gums; paralysis of the tongue ; hoarseness and phlegm in the throat; soreness of the throat and constant disposition to swallow. Stomach and Abdomen.—Spasms of the stomach; griping and pressure in the stomach; dull, aching pain or pressure in the abdomen ; bruised sensation and dis- tension of the abdomen from flatulence. Faeces.—Constipation; bloody stool with burning and soreness; itching of the anus ; burning or cutting in 588 MATERIA MEDICA. the urethra on passing water; haemorrhage from the urethra. Larynx and C/iest.—Burning and roughness in the throat, or hoarseness and roughness; loss of voice; catarrh with dryness; cough and rawness of the throat; short hacking cough and tickling in the throat, soreness of the throat, when coughing; spasmodic asthma; pal- pitation of the heart; constriction of the chest, and dif- ficult breathing; shooting pains in the chest. Back and Ectremities.—Bruised sensation, lacerating or stiffness in the back, nape of the neck and extremities; violent itching and sometimes pimples; paralysis, numb sensation. CHAMOMILLA. Chamomile. Bilious affections, also in children and persons of a nervous temperament. Toothache. Affections arising from grief or passion. Spasms, especially of children. Drawing lacerating pain in the bones. Paralysis of the parts. Skin.—Rash of infants and nursing females; un- healthy skin. Erysipelas; great sensitiveness, especially to currents of air. Sleep.—Drowsiness; sleeplessness or soporous condi- tion ; anguish during sleep, with sudden cries. Fever.—Shuddering sensation ; great sensitiveness to the cold air. Intermittent fever, with nightly exacer- bations ; nausea, vomiting; colic and diarrhoea; heat with shuddering, inflammatory and gastric fevers. Moral Symptoms. — Great restlessness; peevishness and weeping. Head.—Oppressive heaviness, dizziness; throbbing headache ; hysteric, nervous or catarrhal headache. Eyes, Ears, and, Nose.—Twitchings of the muscles of the eyes, and yellowness of the whites; drawing in the CHAMOMILLA. 589 ears, and discharge from the ears; swelling of the parotid gland; bleeding from the nose. Face, Mouth and Throat.—Redness and burning heat on the face, particularly of one cheek while the other is cold and pale; erysipelas and swelling of one side of the face ; convulsive movement of the facial muscles; sore throat with swelling of the parotids ; stinging and burning in the throat, extending to the mouth and stomach. Grumbling and drawing toothache, aggravated by warm drinks and sometimes accompanied by swelling of the glands and stomach; nightly toothache, espe- cially in the warmth of bed ; throbbing and jerking toothache. Stomach and Abdomen.—Vomiting, sometimes sour preceded by nausea; acidity of the stomach; painful bloatedness and weight in the stomach as from a stone; spasms in the stomach, particularly after the use of coffee or after a meal; flatulent colic ; tensive or com- pressive pain in the abdomen; abdominal spasms; sen- sitiveness of the abdomen to the touch. Feces and Genital Organ*.—Undigested stools, hot diarrhoeic stools, with putrid smell, smelling like rotten eggs ; green or watery diarrhoea ; nightly diarrhoea with colic; diarrhoea during dentition, from cold, anger or chagrin. Corrosive leucorrhcea; cutting colic before the monthly period; profuse menstruation, sometimes with labor-like pains. Affections of females during and after pregnancy. Larynx and Chest.—Wheezing, hoarseness, cough, and rattling of mucus in the throat. Catarrhal cough of children; stitches in the chest, and difficult breathing. Back and Extremities —Pain in the back, especially at night, nightly pain in the limbs, sometimes with paralytic weakness. 590 MATrRIA MEDICA, CHINA. Peruvian Bark. Weakness from loss of animal fluids. Intermittent and other miasmatic fevers; slow and chronic fevers. Inaction of the stomach, liver and bowels. Painful weariness in the limbs; debility with disposition to sweat; weakness with trembling; great sensitiveness to the touch. Skin.—Yellow color of .the skin ; swelling of the limbs. Sleep.—Unrefreshing sleep, with frightful dreams. Fever.—Intermittent fever ; shuddering and chilliness, followed by violent fever, hot and dry skin, and this by profuse perspiration. Acute fevers with profuse sweat. Hectic and putrid fevers; exhausting night-sweats and sweat easily excited. Head,—Headache from suppressed coryza. Soreness or bruised sensation of the brain ; aching and heaviness of the head; congestion of the head, with heat and fullness. Sensation, as if the brain were balancing to and fro; headache, aggravated by contact or currents of air. Eyes, Ears and Nose.—Incipient amaurosis, dimness and weakness of sight, with sensation as of black motes floating before the eyes. Bleeding of the nose and mouth. Face and Mouth.—Pale or yellow face. Neuralgia, excited by the slightest touch; throbbing toothache; painful swelling of the tongue. Stomach and Abdomen.—Bitter taste of food; great languor and drowsiness, especially after eating; oppres- sion of the stomach ; nausea and vomiting ; swelling and pain in the liver; colic with nausea or thirst; distension of the abdomen, flatulent colic or violent pinching cutting colic; dropsical swellings, and asthmatic suf- ferings. CINA. 591 Faeces and Genital Organs.—Constipation and heat, and dizziness in the head; loose diarrhoeic and some- times undigested stools, exceedingly variable in their color. Suppression of the menses or profuse menses> with discharge of clots of black blood, sometimes with uterine spasms and colic. Leucorrhcea before the menses; bloody leucorrhcea. Larynx and Chest.—Suffocative or spasmodic cough, excited by laughing or movement. Haemorrhage from the lungs. Oppression in the chest and soreness in the larynx when coughing, difficult breathing; suffocative catarrh, and paralysis of the lungs in old people, stitches in the side ; congestion to the chest. CINA. Worm Seed. Affections arising from worms. Bronchial catarrhs remaining after measles. Sleep.—Restlessness with colic and anguish. Nose and Face.—Picking at the nose; stoppage of the nose; paleness of the face, especially around the lips ; grinding of the teeth. Stomach and Abdomen.—Variable appetite or exces- sive hunger; vomiting of worms and bilious vomiting ; pinching and cutting pain' in the abdomen, writhing in the abdomen. ive^.—-Diarrhoeic movements like pap; itching in the anus ; discharge of worms. Turbid and milky urine ; wetting of the bed. Cough with loss of consciousness ; hoarse, hollow cough or dry and spasmodic. Hooping cough, preceded by rigidity of the bowels, especially in tuberculous children, and those affected with worms. Oppression of the chest. Extremitie-s.—Paralytic sensation in the back and ex- tremities, contraction and twitching of the muscles. 592 MATERIA MEDICA. COCCULUS. Ind i a n C o c k el. Derangement of digestive organs; hysterical affections; paralytic affections and convulsions connected with men- struation. Paralysis of one side. Symptoms are aggra- vated by drinking, eating, sleeping, talking, and by to- bacco and coffee. Head.— Dizziness as from intoxication, sometimes with nausea; cloudiness of the head; aching pain in the forehead; lacerating and throbbing headache, as if the eyes would be torn out; sensation, as if the head were empty. Stomach and Abdomen.—Nausea with tendency to faint; nausea and inclination to vomit, especially when riding in a carriage or on the water; vomiting with headache and bruised sensation of the bowels; griping or lacerating pain in the stomach; flatulent colic, espe- cially at night; distension of the abdomen ; lacerating, cutting pain in the bowels. Genital Organs.—Nervous difficulties, attending men- struation ; painful menstruation with scanty or copious discharge of coagulated blood. Leucorrhcea resembling serum or pus. Chest.—Oppression of the chest as from a stone ; hys- teric or other spasms in the chest. Palpitation of the heart and rush of blood to the chest. Back and Extremities.—-Paralytic pain in the small of the back and sometimes in the extremities. Drawing lacerating pain in the joints; numb sensation. Hot swelling in the hands and knees. <~ COFFEA. Affections of the nervous system. Sleep.—Sleeplessness; drowsiness. General Symptoms.—Headache as if the brain would COLCHICUM.—COLOCYNTH. 593 be dashed in pieces; aching pain in the top of the head; headache in the morning and oa stooping for- ward ; darting in the teeth; toothache with restlessness and anguish ; neuralgia; violent cutting, shooting or neuralgic pain in the bowels or extremities. Oppres- sion of the chest. Convulsions with grinding of the teeth. Pains are generally worse in the open air. COLCHICUM. Meadow Saffron. Rheumatic and arthritic affections. Fall dysentery and diarrhoea. Skin.—General dropsy. General Symptoms.—Swelling of the abdomen, and dropsy; colicky pains in the abdomen. Violent vomiting, with trembling and spasms, excited by every motion; disposition to diarrhoea; stools preceded by colic; bloody stools mixed with a skinny substance or a jelly- like mucus; burning at the anus; constant desire to urinate, sometimes attended with pain and a burning sensation. Brown or black urine, sometimes however depositing a white sediment; difficulty of breathing, and lacerating cutting pains in the chest; dropsy of the chest and palpitation of the heart. Rheumatic and arthritic pains in the back and extremities; most of the pains are aggravated by mental exertion, and are worse from evening till morning. COLOCYNTH. Wild Cucumber. Complaints arising from indignation or grief. Neu- ralgic affections and violent colic. Head.—Pressing headache, most violent when stooping or lying on the back: headache confined to one side, increased by motion. Eyes, Face and Teeth.—Burning cutting in the eyes 594 MATERIA MEDICA. with pain in the head ; rheumatic ophthalmia ; lacerat- ing and tension, or burning and stinging in one side of the face, extending to the ear and head. Stomach and Abdomen.—Nausea and vomiting, some- times with diarrhoea ; pain in the stomach after eating ; squeezing or cramp-like pain in the stomach; colic and diarrhoea after the least nourishment; violent griping colic; cutting pain in the bowels as from knives; bruised feeling in the bowels. Faects. — Diarrhoea with tenesmus ; dysentery with griping cramp-like pain in the bowels. Back and Extremities.—Paralytic pain in the muscles; drawing or cutting pain. CONIUM. Hemlock. Cancerous affections. Affections of old people. Tu- berculous difficulties. Dropsy. Paralysis. Skin.—Chronic eruption. Stinging and itching sen- sation, as from flea-bites; fetid and bleeding ulcers with tendency to gangrene ; swelling of the glands, par- ticularly from contusion ; cancerous ulcers. Fever.—Catarrhal fever with sore-throat and aching pain in the throat; slow fever with loss of appetite and night-sweat. Head.—Stupefying semilateral headache, sometimes with nausea, and coming on in the morning when waking; lacerating headache, especially in the fore- head and back of the head. Dropsy of the brain Ver- tigo, dizziness, and wheeling sensation in the head, espe- cially on looking around ; apoplexy and paralysis of old people. Eyes, Ears and Nose.—Heat and redness of the eyes ; inflamed eyelids with styes; weakness of sight; sensi- tiveness to the light; fiery sparks or dark points before CROCUS. 59 o the eyes ; tingling or roaring in the ears. Affections of the nose from abuse of Mercury. Face and Mouth.— Cancerous ulcers of the face and lips ; itching and gnawing eruption. Neuralgia of the face; drawing or darting pain in the teeth; gums swollen and bleeding. Sore throat, with aching and pain on swallowing. Stomach and Abdomen.—Eructations and waterbrash; nausea and vomiting during pregnancy. Contractive pinching or spasmodic pains in the stomach; swelling and hardness of the abdomen, with soreness. Colic. Urinary and Genital, Organs.—Pain in passing water. Diabetes. Weakness of the genital organs. Suppression of or feeble menses, accompanied with spasms or cutting pain; smarting and excoriating leucorrhcea. Profuse lochia. Cancer of the womb and breast. Larynx and Chest.—Catarrhal fever, with soreness of the chest. Nightly cough; dry tickling or short and convulsive cough; hooping cough, with bloody expecto- ration. Cough during pregnancy, and also in scrofulous persons. Shortness of breath, particularly when taking exercise. Asthma ; shooting pain in the chest. Palpi- tation of the heart. CROCUS. Saffron. General Symptoms.—Restless sleep ; staggering and giddiness on raising the head. Alternation of cheerful and sad humor ; absence of mind. Bubbling sensation in the abdomen. Colic as if from a cold, or as if the menses would make their appearance. Profuse menses of black slimy blood. Haemorrhage from the womb on slightest movement. Colic and dragging pain preceding the menses. Seething of the blood, as if the body were filled with moving things. 596 MATERIA MEDICA. CUPRUM. Copper. Convulsions and spasmodic affections. Spasmodic asthma. Cholera. Hooping cough. Diarrhoea. General Symptoms.—General convulsions and convul- sive movement of the limbs. Epileptic convulsions; rigidity of the limbs and trunk. St. Vitus dance. Great weakness of the body. Paralysis and nervous affections. Head.—Insanity. Painful, hollow sensation in the head ; violent headache ; bruised sensation of the brain. Stomach.—Nausea; violent vomiting with nausea and diarrhoea; excessive vomiting with colic and diarrhoea ; violent pains in the stomach and its vicinity; pressure in the pit of the stomach ; violent spasms in the abdomen or cramp-like pain, also in the upper and lower limbs; cutting and lacerating in the bowels. Fceaes.—Constipation; violent and profuse diarrhoea. Asiatic cholera. Larynx and Cliest.—Continued hoarseness. Short and dry cough-like hooping cough; cough with almost sup- pressed breathing. Cough with expectoration of blood; spasmodic cough with rattling in the chest. Asthma. Trunk and Extremities.—Twitching of the muscles and cramps in the arms and legs. DIGITALIS. Foxglove. Painfulness of the whole body. Nervous affections. Convulsions. Serous apoplexy of old people. Sleep.—Uneasy, unrefreshing sleep or lethargy. Head.—Dizziness and trembling. Violent lancinating headache ; semi-lateral headache, sudden cracking in the head. Eyes and Ears.—Throbbing pain in the orbits; red- ness of the eyes with stinging pain; swelling of the lids. 21* DROSERA.--DULC AMAR A. 597 Ophthalmia, particularly in tuberculous or rheumatic individuals. Amaurosis; illusions of sight. Hissing before the ears. Stomach and Abdomen.—Nausea and vomiting; weak- ness of the stomach, particularly after eating; pressure, lancinating or burning in the stomach. Dropsy in the bowels. Cliest.—Painful asthma ; excoriating pain in the chest especially on coughing. Derangement of the circulation, indicated by the beats of the heart. DROSERA. Sun Dew. Rapid emaciation. Bruised sensation of the limbs. Hooping cough. Epileptic paroxysms, with subsequent sleep and discharge of blood. Eever. — Chilliness and shuddering. Intermittent fever; night-sweats; fever with headache and spas- modic cough. Head.— Dizziness in the open air. Headache on stooping; beating and hammering in the forehead. Eyes and Ears.—Weakness of the eyes with the ap- pearance of gauze and of vibrations before them. In- flammation of the ear. larynx and Chest.—Tickling sensation of the throat, producing a hacking cough. Pain in the stomach and region of the liver. Nightly cough ; cough with vomit- ing; cough with expectoration of blood; chronic ca- tarrh ; hacking cough ; dry spasmodic cough with gag- ging ; hooping cough, sometimes with haemorrhage from the mouth and nose; wheezing breathing, and suffocation. DULCAMARA. Bitter-Sweet. Affections in consequence of cold. Eruptions. 598 MATERIA MEDICA. Skin. — Itching and stinging eruptions of white blotches. Herpetic crusts over the body. ifr^.—Stupefying headache. Congestion of the head. Headache aggravated by exercise and conversation. Foq,, —Warts and scurfy eruptions on the face. Stomach and Abdomen.—Nausea. Pressure or aching in the stomach; colic as if from cold, or as if diarrhoea would come on. ^ea5.—Diarrhoea from cold, and accompanied with colic, particularly in the summer with nocturnal watery evacuations; slimy white or mucous diarrhoea; chronic, bloody diarrhoea. EUPHRASIA. Eye Bright. Affections of the eyes. Eyes.—-Smarting or stinging in the eyes with redness. Inflammation, ulceration and swelling of the margin of the eyelids. Eruption around the eyes; sensitiveness to light. Rheumatic ophthalmia. jyosc .—Soreness of the nose. Profuse bleeding at the nose ; profuse fluent coryza, with sneezing, discharge of mucus and smarting tears in the eyes. FERRUM. Aceticum. Acetate of Iron. Great weakness. Emaciation and languor. Haemor- rhage. Congestion of blood and chronic diarrhoea. Fever.—Want of animal heat, shuddering and ex- hausting sweats. Intermittent Fever. Head. —Dizziness, with reeling sensation and heavi- ness. Rush of blood to the head; hammering and throbbing headache. Face.—Livid or jaundiced complexion, puffiness of the face. Nceccs.—Chronic diarrhoea, frequent stools with burn- GRAPHITIS. 599 ing, itching or gnawing in the rectum, and sometimes with discharge of ascarides. Genital Organs.—Nocturnal emissions. Delay of the menses. Miscarriage. Whitish leucorrhcea, smarting and corroding. Larynx and Chest.—Spasmodic cough. Cough some- times with bloody expectoration, also of bloody phlegm. Asthma. GRAPHITIS. Black Lead. Various forms of eruptions. Tuberculous affections. ^m.—Dryness of the skin. Itching pimples; spots like flea-bites; unhealthy skin, every little itching pro- ducing suppuration ; thickness of the nails ; boils. Her- petic and other eruptions. J3W..—Itching of the scalp. Humid and scabby eruptions on the head ; burning on the top of the head, headache especially in the morning on waking. Eyes.—Redness of the eyes. Painful inflammation of the lids; profuse secretion of tears; intolerance of light. Jar*.—Eruptions around and in the ears; ulcerative pain in the ears; bloody discharge, or discharge of pus in the ear. Roaring in the ear. Yosc— Soreness and swelling of the nose ; scabs and dry soreness in the nose; sore, cracked and ulcerated nostrils. Bleeding at the nose. Face and Teeth.—Erysipelas. Incipient paralysis. Ul- cerated corners of the mouth, and eruptions of the face ; swelling of the glands and of the gums, stinging tooth- ache, especially at night, with heat in the face. Stomal.—Weakness of digestion. Nausea and VO- miting. -, • , 1 X Feces —Constipation. Hemorrhoidal tumors. Genitalorqans.—Itching and smarting eruptions on the 600 MATERIA MEDICA. labia. Soreness between limbs; itching in the genital organs. Derangement of the menses, generally delayed and insufficient. Back and E'treniities.—Pain and stiffness in the nape of the neck and back. Eruptions. Arthritic nodosities on the fingers. Soreness between the thighs. Ulcera and Herpes on different parts of the extremities. HELLEBORUS - NIGER. Blade Hellebore. Dropsical affections; affections of the head and nervous system. Skin.—Rash; watery swelling of the skin; general dropsy especially after suppressed eruptions. Heael.—Inflammation of the brain; hydrocephalus; dullness of the head and heaviness; painful stupefaction of the head ; violent headache with heaviness. Face.—(Edematous swelling of the face and lips. HEPAR-SULPHURIS. Sulphuret of lime. Skin and glandular affections. Affections from the abuse of Mercury. Croup and other inflammatory coughs. Chronic coughs. Skin.—Chapped skin. Unhealthy skin; injuries pro- duce suppuration. Nettle rash. Fever.—Burning feverish head, red face, violent head- ache during the night; profuse sweat. Head.—Headache when shaking the head; aching in the forehead, like a boil as if bruised; headache in the night or in the morning on waking. Blotches and humid eruptions on the scalp; falling off of hair. Boring pain at the root of the nose. Eyes.—Erysipelatous swelling of the eyes with soreness and bruised pain in the limbs. Redness, inflammation and swelling of the eyelids, sometimes with styes and HEPAR-SULPHURIS. 601 ulcerated edges. Specks and ulcers of the cornea, dimness of sight. Ears.—Scurfs in and behind the ears; itching, inflam- mation of the ears and discharge of pus; hardness of hearing. Nose.—Itching of the nose and formation of scurfs and scabs. Coryza. Inflammatory swelling of the nose, bleeding at the nose. Face.—Erysipelatous swelling of the cheeks. Pain of the bones of the face, when touching them. Pimples on the face of young people ; swelling of the lips. Ulcers or itching pimples on the chin and around the mouth. Swelling of the gums, looseness of the teeth and jerking toothache. Stomach and Abdomen.—Frequent attacks of nausea with coldness and paleness; swelling and suppuration of the inguinal glands. i^s.—Diarrhoea with colic and tenesmus; dysenteric diarrhoea; bloody or clay-colored stools, soreness of the rectum. Z7W?is . 149 Diarrhoea..... 128 ----, during pregna ncy . 354 ----, during pregnancy 355 , of infants . 396 ----, of infants 397 INDEX. 649 Page. Page Diarrhoea, of children . 415 Fainting during pregnancy . 3ot Diet .... 527 Fall, apparent death from 46C ----, rules for 15 Falling of the womb 345 ----, allowed • 16 Felon 87 ----, prohibited . 17 Females, diseases of . 328 ----, of infants . 378 Ferrum .... 598 Digestion, physiology of 508 Fever 25 Digitalis 596 ----, simple 29 Diseases, causes of 514 ----, inflammatory . 30 ----, of children 390 ----, typhoid or nervous . 31 ——, influence of mind on 535 ----, intermittent . 49 ----, predisposition to 538 ----, and ague 49 Dislocations 432 ----, yellow 39 Dizziness 224 ----, remittent 45 Dose and its repetition . 12 ----, infantile 409 Dropsy 323 —,—, bilious 45 ----, general 324 ----, eruptive 55 ---—, of the brain 404 ----, scarlet 58 ——. of the chest 324 ----, puerperal 369 ----, of the abdomen 324 ----, milk • 365 Drosera .... 597 Flatulent colic 108 Dulcamara 597 Flooding 334 Dysentery 134 Food for infants 378 Dysmenorrhoea . 332 Fluor albus . . 341 Dyspepsy . . 93 Fractures 432 Ear, inflammation of 246 Freezing, apparent death from 465 ----, pain in the 247 Frozen limbs 431 ----, noises in the 250 Gastralgia 102 ----, running of the . 251 Gastric affections 93 ----, foreign substances in t ie 252 Gastritis 121 Education 544 Gathered breasts 367 Electricity 604 Genital organs, affections of 271 Enteritis 124 Giddiness 224 Enuresis . 284 Glands, swelling of . 90 Epilepsy . 307 Gleet 287 Epistaxis 253 Glossary 635 Eruptive diseases 55 Glossitis 265 Erysipelas (Rose) . 67 Gonorrhoea 285 Eupatorium . 632 Gout, Arthritis . 296 Euphrasia . 598 Graphites . 59£ Excoriation 86 Gravel . 28C ---- of infants . 394 Green-sickness . 337 Exercise . 531 Gumboil 26^ Eyelids, inflammation of 242 Gums, abscess in the . . 265 ----, stye on the 243 Hemoptysis . 18C ----, ulceration of . 243 Hair, falling of 231 Eyes, affections of . 233 Hanging, apparent death fron i 464 ----, weakness of 233 Hardness of hearing . 248 ----, inflammation of 237 Head, affections of . 218 ----, — — in infants 393 ----•, swelling of infants 391 ----, watery . 243 ----, cold in the 160 ----, foreign substances in 244 ----, —-----of infants 391 Face-ache, Neuralgia 299 Headache 218 650 INDEX. Page. 218 221 221 222 223 223 224 196 201 303 93 354 396 600 180 253 . 154 . 358 . 600 . 113 . 538 . 83 305. 315 . 303 Headache from congestion ----. from cold ---- from constipation ---- from rheumatism ----from external causes ——, nervous ----. sick Heart, affections of . ----, palpitation of . ----, neuralgia of . Heartburn ----during pregnancy . Heat spots Helleborus nigcr Hemorrhage from the lungs . ---- from the nose Hemorrhoids . ---- during pregnancy Hepar. Hepatitis Hereditary taint Herpes Hip, disease ----, pain in the Hoarseness, Aphonia, Raucitas 158 Homoeopathy . . . 564 Hooping cough . . 422 Humming in the ears . 250 Hunger, apparent death from 464 Hyoscyamus . . 602 Hydrocephalus . . 404 Hydrophobia . . .311 Hydrothorax . . . 324 Hygiene . . .514 Hypochondria . .214 Hysteria . . .214 Icterus . . .117 Ignatia . . . 603 Incontinence of urine . 284 Indigestion . . .93 Infants, first treatment of . 371 —, clothing of . . 394 ----, food of . . 378 ■—■—----, artificial of . 382 ----, weaning of . . 385 ----, air and exercise for 386 ----, swelling of head of 391 ----, cold in the head of 391 ----, colic of . . . 392 ----, swelling of the breasts of 392 ----, excoriation of . . 394 Inflammation of liver . .113 ---- —spleen . 119 Inflammation of stomach ---- —. bowels ---- — lungs <---- — windpipe ---- —■ brain — eyes Page. 121 124 172 176 229 237 ---- — eyes of infants 393 — eyelids ---- — ear ---- — nose ---- — tongue. ---- — throat . ---- — kidneys ---- — bladder ---- — testes ---- — penis ---- — ovaries Influenza —■—, general Insanity Insects, stings of Intermittent fever Intertrigo Introduction Ipecacuanha . Iodium . Itch Itching of the skin Itching of the privates during pregnancy Jaundice, Icterus . ---- of infants Jealousy Joy, excessive Kali bichromatum . ----carbonicum. Kidneys, inflammation of Kreosote Labor, ----, false . ----, cramps after ----, convulsions during —■—, pain after Lachesis Laryngitis, Cynanche Laryn- gia . Lead colic Leucorrhcea Lid, falling of the . Liver, inflammation of Lochia, the Lockjaw Loin-ache 242 246 253 265 267 274 276 290 290 345 160 162 205 436 49 8C 1 605 606 77 78 357 117 394 214 214 608 606 274 609 303 362 363 363 364 609 176 108 341 245 113 368 309 297 INDEX. 651 Page. Page Loss of appetite 99 Nose, affections, of the . 252 Loss of voice .... 157 ——■, bleeding of the nose 253 Love, unhappy 214 ----, ulceration of the 255 Lumbago .... 297 Nux vomica .... 616 Lungs, inflammation of 172 Offensive breath 262 ----•, haemorrhage from 180 Ophthalmia 237 Lycopodium .... 610 ----, catarrhal 237 Magnetism 604 ----, rheumatic 239 Mania 210 ----■, scrofulous 240 ----, a potu 312 ----, purulent 393 Marriage . 541 ----, syphilitic 241 Materia Medica 574 Opium ..... 618 Measles, Morbilli 64 Otalgia..... 247 Medicines, list of 18 Otitis..... 246 Meningitis 229 Otorrhoea .... 251 Menorrhagia 334 Pains in the small of the back 297 Menses, cessation of 336 Pain in the hip . . 305. 315 ----, colic during 332 Painter's colic 108 —■—•, irregular 336 Palate, swelling of the . 273 ----, painful 332 Palpitation of the heart 201 ----, profuse 334 Palsy ... 306 ----. suppression of . 329 Paralysis .... 306 Menstruation, commencement of 328 Parturition .... 361 Mercurius .... 611 Penis, inflammation of 290 Milk crust .... 81 Petroleum .... 618 Milk fever .... 365 Phosphorus .... 619 Milk, suppressed secretion of 366 Phosphoric-acid 620 Mind, influence on disease 535 Phthisis pulmonalis 186 ----, affections of the 214 Physiology .... 493 Miscarriage .... 359 ----■ of the blood . 496 Monomania 209 ----■ ---- circulation 510 Morning sickness 353 ---- of digestion 508 Moschus .... 613 Piles..... 154 Mouth, sore, Canker of the 264 Plates, description of the 488 ---- affections of the 256 Platina ..... 620 Mumps .... 245 Pleurisy, Pleuritis. 168 Muriatic-acid .... 613 Pleurodynia, False pleurisy . 171 Natrum muriaticum 614 Pneumonia .... 172 Nausea .... 99 ----• notha 175 ----, general indications of . 8 Poisoned wounds . 436 ---- during pregnancy 353 Poisons and their antidotes . 437 Near-sightedness . 244 ---- from iodine 438 Nephritis .... 274 ---- from muriatic-, nitric- Neuralgia .... 298 and sulphuric-acid 439 ---- of the face 299 ---- from oxalic-acid 439 —■— ---- heart . 303 ----— arsenic 439 ----, spinal marrow 304 ---- — corrosive sublimat s439 ----of the hip 305 ---- — copper 439 -------------stomach 102 —— — lead 440 Nettle-rash .... 55 ---- — nitrate of silver . 440 Nipples, sore 367 ---- — tin, saltpetre, can- Nitric-acid .... 615 tharides, shell-fish, animal Nose, inflammation of the . 253 matter .... 44C 652 INDEX. Poisons from prussic-acid, opium and other narcotics . .441 Pregnancy .... 346 ----, general directions during 349 ----, diet during . . .351 ----, longings during . . 352 ----, derangements during . 353 ----, morning sickness dur- ing .... 353 —.—, constipation during . 354 ----j diarrhoea during . 355 ■----, headache during . . 355 ----, fainting and hysteria dur- ing .... 356 ----, toothache during . . 356 ----, piles during . . 358 ----, pains in the back and and side during . . 358 ----, cramps, during . 359. 363 ----, derangements of the uri-' nary organs, during . 359 ----, miscarriage, during . 359 ----, false pains, during . 362 ----, labor, during . . . 363 Prickly heat . . .396 Prosopalgia .... 298 Prolapsus Uteri . . . 345 Prurigo .... 78 Pruritis and Varicose Veins . 357 Puerperal fever . . . 369 Pulsatilla . . . .621 Pulse.....3 ---- healtliy ... 4 ---- in disease ... 5 Purple-rash, Miliaria purpurea 57 Quinsy sore-throat . . 267 Rash, nettle ... 55 ----, scarlet ... 57 ----■, purple ... 57 Remedies, administration of . 12 Remittent fever ... 45 ---- — infantile . 409 Rheumatism . . .291 Rhubarb, rheum. . . . 623 Rhus-toxicodendron . . 623 Rickets . . . .315 Ringworm .... 82 Running at the ears . .251 Sabina ..... 624 Salivation .... 265 Sambucus .... 624 Sanguinaria .... 625 Scabies . . . .77 Scald head Scalds . Scarlet rash ---- fever (Scarlatina) Sciatica Scirrhus Scrofula Scurvy, Scorbutus . Sea-sickness . Secale cornutum Seminal emissions Sepia . Serpents, bites of Shingles, or Nettlerash Shower-bath . Sick headache Sight, weakness Silicia. Sitting-bath Skin, itching of Small-pox Snuffles Sore moUth ----------of infants Sore throat ----------quinsy ----nipples Speech, defects of Spigelia Spleen, inflammation of Splenitis Spinal Marrow, Pain in the Spongia Sprains Stammering . St. Anthony's fire Stibium Stings of insects Stomach, spasms of ----, pain in the ----, inflammation of ——, neuralgia of the Stools, indications of St. Vitus' dance Stye on eyelid Sulphur Summer complaint Sun-stroke Suppression of menses ---- of milk ---- of lochia. Swelling of tonsils ----under the tongue 273 £6G INDEX. 653 Page. Swelling of the palate 273 -----------breast in infants 392 Syphilis 287 Tape-worm 412 Tartar emetic . 630 Teeth, affections of . 256 Teething 400 Temperaments 3 Temperature, changes of 516 Testes, inflammation of 290 Tetanus ^ . Tetter, ^|. Throat, sore . 309 83 267 ----, swelling of the 273 Thrush 395 Thuja .... 631 Tic-doloreux . 298 Tinea capitis . 80 Tongue, swelling under 266 Tonsils, swelling of the 273 Toothache 256 ---- during pregnancy . 356 Treatment after delivery 364 ---- of children 371 Tubercular consumption 186 Tuberculosis . . 314 539 Typhus fever . 31 Ulcers 87 ----, simple . 87 ----, irritable 88 ----, sloughing 88 ----, indolent S8 Urinary calculi 280 Urinary organs, affections of . 274 ---- during pregnancy 359 Urine varieties of 6 Page. Urine, suppression of 278 ----, retention 278 ----,----of infants 396 ----, incontinence of 284 Urticaria 55 Uterus, falling of 345 Vaccination 428 Variola 72 Varioloid 76 Veins, varicose 357 Ventilation 523 Veratrum-album 631 Vertigo 224 ----during pregnancy 355 Vomiting 99 ---- during pregnancy 353 Warts 91 Water, applications of 531 Waterbrash 93 Watery eyes . 243 Weakness of sight 233 Weaning 385 Wet bandage 533 Wet-nurse 389 ----sheet 533 Wetting the bed 281 Whites 341 White swelling 315 Whitlow N7 Windpipe, inflammation of 176 Woman, diseases of . 328 Womb, falling of 345 Worms 412 Wounds 433 ——> poisoned 436 Yellow fever 39 2_