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Many of the techniques and recipes in this chapter of the book are dangerous! They were written in a time before most of the advances of modern medicine. They advise the use of poisonous heavy metal salts, dangerously liberal bloodletting for inapropriate conditions, the use of drugs which it is now illegal to possess, unhealthy diet, etc. etc. There are much better treatments available today for all of the conditions described here, and none of these old techniques can be said to be any more "natural" or healthy than what we have now. Indeed, I regard this chapter as a potent reminder of just how grateful we should be for the medical treatment available today. |
Rule 1. - In every complaint, whatever it may be called, if you find the pulse quick, hard, full, and strong, the head aching, tongue foul, skin hot, or those marks which denote it to be of an inflammatory nature, remember the plan is to reduce excitement by purging, low diet, drinking plentifully of cold water and lemonade, rest, etc.
Rule 2. - If, on the contrary, the pulse be small, soft, feeble and intermitting, the tongue dark, and great debility or weakness is evident, reverse the whole plan; the diet must be generous and nourishing, the bowels opened with gentle laxatives, and the strength supported by bark, sulphate of quinine, wine, and tonics of various kinds.
It is necessary, however, to be careful in distinguishing the weakness which is here meant, from that state of debility which arises from excessive action, from the stuffing up of the vessels, and which requires the lancet. As a mistake might prove fatal, attention should be paid to the pulse by which they can be known. In that state which requires tonics, the pulse is small, soft - sometimes like a thread, and quick. In the other, it is slower and full, giving considerable resistance to the pressure of the finger.
Rule 3. - If, in addition to those symptoms mentioned in the second rule, the tongue be covered with a black coat - foul, dark-looking sores form about the gums and insides of the cheeks - the breath be offensive, etc., the same class of remedies is to be vigorously employed, with a free use of acids and other antiseptic articles.
Rule 4. - Severe local pains, as in the head, side, etc., may require the use of the lancet, purging, and blisters to the part.
Rule 5. - Incessant and earnest entreaties on the part of the sick for, or longing after, any particular article of diet, if steadily persevered in, may be safely indulged, whether the use of it agrees or not with our preconceived ideas on the subject.
Rule 6. - In all fevers, where the pulse is quick, full and strong, the skin burning to the touch, and there is no perspiration, apply gently cold water over the head and limbs of the patient, wipe him dry and cover him in bed. If, in consequence of this, a chill be experienced, and the pulse sink, give warm wine, etc., and omit the water for the future. Should a pleasant glow, over the whole frame, follow the effusion, and the patient feel relieved by it, repeat it as often as may be necessary.
Rule 7. - Observe carefully the effects of various articles of food, as well as physic, upon your own body, and choose those which experience proves to agree best with you. It is a vulgar, but true saying, that "What is one man's meat is another's poison." When, however, the stomach is out of order, do not conclude hastily that a particular article is injurious; as, at such a time, everything may seem to disagree, and the simplest things are then the best.
Rule 8. - Keep a sick room always well ventilated. Plenty of fresh air is an important remedial agent in all diseases.
It is not meant by this that the patient should be exposed to a direct current of air, which should be always avoided by well and sick.
The pulse is nothing more than the beating of an artery. Every time the heart contracts, a portion of blood is forced into the arteries, which dilate or swell to let it pass, and then immediately regain their former size, until by a second stroke of the same organ, a fresh column of blood is pushed through them, when a similar action is repeated. This swelling and contracting of the arteries then constitutes the pulse, and consequently it may be found in every part of the body where those vessels run near enough to the surface to be felt. Physicians look for it at the wrist from motives of convenience.
The strength and velocity of the pulse vary much in different persons, even in a state of perfect health. It averages about seventy boats a minute in adults. It is much more frequent in children than in adults; and in old men it grows more slow and feeble, owing to the decreased energy of the heart. The pulse is increased both in strength and velocity by running, walking, riding, and jumping; by eating, drinking, singing, speaking, and by joy, anger, etc. It is diminished, in like manner, by fear, want of nourishment, melancholy, excessive evacuations, or by whatever tends to debilitate the system.
In feeling the pulse, then, in sick persons, allowance should be made for these causes, or, what is better, we should wait until their temporary effects have ceased.
A full, tense, and strong pulse is when the artery swells boldly under the finger, and resists its pressure more or less; if, in addition to this, the pulsation be very rapid, it is called quick, full, and strong; if slow, the contrary.
A hard, corded pulse is that in which the artery feels like the string of a violin, or a piece of tightened cat-gut, giving considerable resistance to the pressure of the finger.
The soft and intermitting pulses are easily known by their names. In cases of extreme debility, on the approach of death, and in some particular diseases, the artery vibrates under the finger like a thread.
In feeling the pulse, three or four fingers should be laid on it at once. The most convenient spot to do this, as already mentioned, is the wrist, but it can be readily done in the temple, just before, and close to the ear, in the bend of the arms, at the under part of the lower end of the thing, among the hamstrings, and on the top of the foot.
There are two kinds of large blood-vessels in the human body: arteries and veins. The arteries carry the blood from the heart to the extremities of the body, where they are connected through the capillaries with the veins which bring it back again. An artery pulsates or beats; vein does not.
Fever is by far the most common complaint to which the human body is subject. It may be briefly described as a combination of heat, loss of appetite, weakness, and inability to sleep. It makes its appearance in two ways: either suddenly and violently, or gradually and gently. When it comes on in the first manner, a cold shaking, attended with sickness at the stomach, or vomiting, marks its access; the cold is more severe than in the latter, as is also the pain in the head, and other symptoms. When its attack is gradual, a feeling of soreness over the whole body such as is experienced after a hard day's work by one not accustomed to it, shows its approach. Nausea, pains in the head, chills, and more or less heat and thirst soon follow.
As these symptoms vary infinitely in their degrees of violence, the treatment to be pursued must differ accordingly. Thus the same directions that are given for simple inflammatory fever must be adhered to, in one whose symptoms are lighter, though similar, only there is no necessity for pushing them to so great an extent.
Symptoms. - Chills, flushed face, skin hot, eyes red, pulse quick, full, strong, and regular, great thirst, tongue white, urine high-colored and small in quantity, bowels costive, breathing quick, etc.
Causes. - Cold, violent exercise while exposed to the heat of the sun, intemperance, the indulgence of unruly passions.
Treatment. - Bleed the patient, if he be robust, at the very beginning of the attack. The quantity of blood to be taken should be regulated by the strength and age of the person, and the violence of the symptoms. In this country, where diseases are very acute, from twelve to fifteen ounces is an average quantity for a robust man. If there be great pain in the head, shave it and apply a blister, or cloths wrung out of iced vinegar and water, frequently renewed. The bowels are to be freely opened with Epsom salts or citrate of magnesia, and the diet should consist of plenty of cold water, rice water, or lemonade. If the heat of the body be excessive and burning to the touch, and there is no perspiration, let cold water be applied with a sponge to his head and limbs, and then wipe him dry and cover him in bed. If there be intense pain in the head or side, apply a blister. The saline mixture, below, will be found useful throughout. An emetic, at the very onset sometimes cuts short the disease. The room should be kept quiet, cool, and dark, every source of excitement being removed.
Saline Mixture. - Carbonate of potassa, 2 drachms; water, 6 ounces. When the salt is dissolved, add by degrees portions of fresh lemon juice till it ceases to effervesce. A tablespoonful may be taken every half hour.
Of this fever, there are several varieties, which differ from each other only in the length of time that elapses between their attacks. There is one called quotidian, in which it comes on every twenty-four hours; another named tertian, in which it arrives every forty-eight hours, and the third quartan, because the intermission lasts seventy two hours.
Symptoms. - The symptoms of fever and ague are, unfortunately, too well known among us, commencing with yawning, stretching and uneasiness; this is succeeded by slight chills or shiverings, that end in a violent or convulsive shaking of the whole body. This is the cold fit, and is immediately followed by the fever or hot fit. The pulse rises, the skin becomes hot, with pain in the head, tongue white, and all the marks of fever terminating in a profuse sweat, which gradually subsiding, leaves the patient in his natural state, though somewhat weakened.
Treatment. - On the first alarm that is given by a chill, or any of those feelings indicative of its approach, take 50 or 60 drops of laudanum in a glass of warm wine, with a little sugar and a few drops of the essence of peppermint, get into bed and cover yourself with several blankets; this seldom fails to out short the disease. If the cold fit, however, has passed by, the next accession should be carefully watched, and the same remedy resorted to. If the inflammatory symptoms seem to require it, open the bowels with senna and salts; when this is done, in the intervals use a quinine pill of one grain every hour; if it cannot be procured take as large doses Peruvian bark as the stomach will bear; in addition to this, endeavor during the cold fit to bring on the hot one, as speedily as possible, by warm drinks, bladders or bottles filled with warm water applied to the soles of the feet and the stomach. Weak whiskey punch answers this purpose very well; it also is of use by inducing sweat when the hot stage is formed. If the disease resists this treatment, try six drops of Fowler's Solution of Arsenic three times a day, with the bark, gradually increasing it to nine or ten drops at each dose. As this is a powerful remedy, care must be taken to watch its effects; if it produce sickness at the stomach, headache, or swelling of the face, it must be laid aside. To restore the tone of the system when getting better, remove to a healthy pure air, use gentle and daily exercise. with a generous diet, iron and bitters. If the liver or spleen become affected recourse may sometimes be had to mercury.
Much mischief is done by giving either the quinine or the hark too early in the disease, and before its inflammatory stage is passed. It should never be employed until the bowels have been well opened and the excitement reduced.
This is a kind of fever which occasionally abates, but does not entirely cease, before a fresh attack comes on, so that the patient is never completely free from it. The most usual form of it is called bilious fever, or bilious remittent.
Symptoms. - In this disease all the marks of great excitement and a superfluity of bile are visible; the skin is hot, the pulse tense and full, tongue white in the commencement, changing to brown, as the fever increases, breathing hurried and anxious, bowels very costive, and skin of a yellowish hue. In bad cases, there is great pain in the head, delirium, the patient picks at the bed clothes, a convulsive jerking of the tendons at the wrist, tongue black and furred, a deep yellow skin, vomiting, and hiccup.
Causes. - A peculiar poisonous vapor from ponds, marshes, and decaying vegetable matter.
Treatment. - This must be conducted on our general principles. As the inflammatory and bilious symptoms are the most prevalent at the commencement, bleed the patient if he be robust. The next step is to open his bowels. Ten grains of calomel, combined with a portion of jalap, may be given in molasses, and repeated or followed by a saline purgative, until copious evacuations are produced. If the pain in the head be very great, shave it and apply a blister. Should the skin be very hot, and great thirst and restlessness prevail, apply cold water over the body, as directed in simple inflammatory fever. The diet should consist of rice-water, lemonade etc., taking care to keep up a moderate discharge from the bowels by purgatives, during the whole of the disease.
If, however, in spite of all endeavors to the contrary, the complaint seems advancing, the patient should be brought carefully under the influence of quinine. As soon as symptoms of exhaustion or a typhoid state make their appearance, no mercury should be given internally; on the contrary, bark, wine, acids, etc., are necessary to support the patient, who should be kept clean, cool, and comfortable, excluding all noise. The extreme irritability of the stomach, which is frequently found in bilious fever, may be overcome by the saline draught, in a state of effervescence (to be found on page 123), and in the latter stage of it, when the pulse flags, and the system appears sinking, the quinine mixture, below, has been found extremely useful. Blisters and mustard poultices may also be applied in this case to the ankles, thighs, and wrists. The internal use of the quinine is an invaluable remedy in all such cases, and should never be omitted.
There are in fact two distinct stages in this disease that require two different plans of treatment. The first is bilious and inflammatory, and should be met by bleeding, vomiting, purging with calomel, blisters to the head, and the affusion of cold water.
The second is typhoid end bilious, and must be treated by wine, brandy, the quinine mixture, sound porter, and the peculiar plan recommended in typhoid fever.
Sulphate of quinine 32 grains; elixir of vitriol 1 drachm; peppermint water 4 ounces. The dose is a teaspoonful every hour or two.
Symptoms. - Languor, debility, dejection of mind, alternate flushes of heat and chills, bleeding at the nose, loathing of food, confusion of ideas. These are succeeded by vertigo, pain in the head, cough, frequent weak and sometimes intermitting pulse, the tongue dry and covered with a brown fur, the teeth and gums being encrusted with the same, the forehead is covered with sweat, while the hands are dry and glow with heat, the patient talks wildly. There is diarrheea and swelling of the abdomen.
Causes. - Grief, home-sickness, whatever tends to weaken the system, a poor diet, living in close filthy apartments. Distinguish it from typhus fever by the attack coming on more gradually, and by the greater mildness of the symptoms and the want of those marks mentioned in the former.
Treatment. - If the bowels be costive give some gentle laxative, as rhubarb or castor oil. As soon as this has operated, or even before (if the weakness of the patient seem to require it), exhibit wine whey and beef-tea, always remembering that if the strength of the patient be not supported by these means, he may die of debility. Applying cold water gently over the body is a remedy in this disease, of great value. If delirium or insensibility come on, shave the head and apply a blister to it, or cloths wrong out of iced vinegar and water. If a copious purging ensue it must be stopped or it will prove fatal; this may be done by the mixture No. 1, or by opium. Musk mixture No. 2. and the camphor mixture, No. 3, will also be found useful. Great reliance is sometimes placed upon the sulphate of quinine, which may be taken in doses of two or three grains four times a day, dissolved in a little gum arabic tea, or in pills.
The order of remedies, then, in typhoid fever, is to open the bowels with the mildest laxatives, to use wine or sometimes brandy, to apply cold water over the body, to give milk, chicken water, jellies, tapioca, sago, etc.; to check purging, keep the room cool and clean, use the quinine mixture, one or all of the different mixtures of camphor or musk, and if delirium come on to apply blisters to the head. Bleeding is, at best, a doubtful remedy in typhoid and should never be allowed without being ordered by a physician; nine times out of ten it is certain death to the patient.
No. 1. Astringent Mixture. - Chalk mixture 4 ounces; tincture of kino 1 drachm; lavender compound 1 drachm; laudanum 30 drops. Dose, a tablespoonful every two or three hours, as may be required.
No. 2. Musk Mixture. - Musk 1 drachm; gum arabic, powdered, 1 drachm; loaf sugar, the same; water 6 ounces. Rub up the musk and sugar, adding the water very gradually. The dose is a tablespoonful every two hours.
No. 3. Camphor Mixture. - Camphor 30 grains; powdered gum arabic 2 drachms; loaf sugar 1 1/2 drachms, peppermint water 6 ounces. Moisten the camphor with a few drops of spirits of wine, and rub it to a powder. The gum arabic and sugar beat to a paste, add the camphor, and pour in the water gradually. The dose is a tablespoonful every two or three hours.
Symptoms. - Severe chills, astonishing and sudden loss of strength, countenance livid and expressive of stupor, the skin sometimes burning to the touch, at others the heat is moderate, the pulse is quick, small and rarely hard, violent pain in the head, redness of the eyes, low, muttering delirium, the tongue is covered with a dark brown or blacklooking crust, blackish sores form about the gums, the breath is very offensive, and, in the latter stage, the urine also, which deposits a dark sediment; in extremely bad cases blood is poured out under the skin, forming purple spots, and breaks out from the nose and different parts of the body, the pulse flutters and sinks, hiccup comes on, and death closes the horrid scene.
Treatment. - As severe cases of this disease are apt to run their career with fatal rapidity, no time should be lost; bleeding is not admissible, the loss of a few ounces of blood being equivalent to a sentence of death. The first medicine given may be a mild purgative; castor oil will answer the purpose. If the heat of the patient's body be great, sponge him with vinegar and water. This practice produces the happiest results. As soon as he is wiped dry, and has taken the wine if chilled, give four drops of nitromuriatic acid in a wine glass of the cold infusion of bark every four hours. Wine and water should generally be liberally given in this disease as soon as the typhus symptoms show themselves. Liquid food, as milk or beef tea, should be given at short intervals. The sulphate of quinine in the same doses as mentioned in typhoid is a valuable remedy.
As a wash for the mouth, nothing is better than an ounce of alum dissolved in a pint of water. Rest at night must be procured by opium, if necessary. If towards the end of the complaint there arise a gentle looseness, accompanied with a moisture on the skin, that seems likely to prove critical, it should not be meddled with; but otherwise it must be stopped by astringents. As this is a contagious disease, all unnecessary communication with the sick should be forbidden. The chamber should be kept cool, clean, and frequently sprinkled with vinegar, and all nuisances be immediately removed. Much advantage will result from taking the patient, on the very commencement of the attack, into a new and healthy atmosphere.
This is never a primary disease, but is always found as a symptom of some other one, as consumption.
Symptoms. - Night sweats, bowels costive at first, then loose, alternate chills and flushes, a circumscribed spot on the cheeks, especially in the afternoon, a peculiar delicacy of complexion, and emaciation to so great a degree that the patient sometimes looks like a living skeleton
Treatment. - Remove the cause, if possible, by curing the disease of which it is a symptom; and support the strength of the patient.
Symptoms. - Intense pain in the head, the eyes incapable of bearing the light, delirium, face flushed, oppression at the breast, the pulse hard and very rapid, tongue at first of a fiery red, then yellow, brown or black.
Causes. - Exposure to excessive heat of the sun, blows on the head, intense application to study, intemperance. Distinguish it from inflammatory fever by the pulse, which in the one is full, strong and regular, in the other hard, quick and corded, and by the raving delirium. From typhus by the two latter marks.
Treatment. - Bleed the patient (as quickly as possible) until he nearly faints. Upon the resolute employment of the lancet in the onset we must place our chief dependence. The bowels should be freely opened with Epsom salts, the head shaved, and a blister or cloths dipped in iced vinegar and water, or pounded ice, be applied to it, and the room kept perfectly cool, dark and quiet. Rice-water, lemonade, or cold water is to be the only diet. Should the violence of the disease not give way to these remedies, repeat the purging, blistering, etc., as often as may be necessary. The most vigorous measures to reduce the inflammation are required, or death will be the consequence. Quietness of mind and body is also essential throughout the attack.
Causes. - Some particular disorder of which it is a symptom. Indigestion, a foul stomach, tight cravats or shirt collars, exposure to the heat of the sun, a rushing of blood into the head, neuralgia, etc.
Treatment. - This will vary according to the cause. If it arises from indigestion, that must be attended to. A foul stomach is one of the most usual causes of headache. In this case, from three to six grains of blue mass may be administered, which at a day's or night's interval, should be followed by a purgative. If from the beating of the artery in the temples, and a sense of fulness in the head, we suspect it to originate from an undue determination to that part, bleed freely or cup or leech, and apply cloths dipped in cold water to it. Long-continued and obstinate headache has been frequently benefited by a seton on the back of the neck.
Symptoms. - Pain, heat and swelling of the parts which appear bloodshot, the tears hot and scalding, fever, intolerance of light, sometimes when the lids are affected the edges become ulcerated.
Causes. - External injuries, as blows, particles of sand, etc., getting into them, exposure to cold, strong light, intemperance.
Treatment. - If the complaint is caused by foreign bodies, they must be removed with the point of a paint brush, or the end of a piece of wire covered with lint, or washed out by injecting warm milk and water into the eye with a small syringe. If particles of iron stick in it they may be drawn out by a magnet. From whatever circumstance it may originate, the inflammation is to be subdued by taking blood from the neighborhood of the eye by a dozen or more leeches. The bowels should be freely opened with Epsom salts, and a cold lead-water poultice, enclosed in a piece of thin gauze, be laid over the part. The room should be perfectly dark and the diet extremely low. Rose-water may be used as a lotion. If the pain is very severe, a small quantity of equal parts of laudanum and water may be dropped into the eye. If the eye-lids are ulcerated, touch them with the white vitriol ointment. Bathing the eye frequently with clear cold water is a refreshing and useful practice. If the eye-ball be ulcerated over the pupil, lead-water must be avoided; as, in that case, it might cause opacity.
There are many other diseases incident to the eyes, but none that can be managed by any but a physician or surgeon. When, therefore, any alteration in the structure of the eye is perceived, no time should be lost in having recourse to the one or the other.
Symptoms. - Pain in the ear, which at last either gradually ceases, or matter is discharged through the opening.
Causes. - The accumulation of hard wax, insects getting into it, injuries from blows, etc.
Treatment. - A little warm olive oil or glycerin with an equal part of laudanum, dropped into the ear, and retained there by a piece of wool or cotton, will frequently procure almost instant relief. If it be caused by hard wax, inject warm soapsuds or salt water to soften it, and then, with care, endeavor to extract it, when the oil and laudanum may again be employed. In cases of great severity a blister may be applied behind the ear. A temporary deafness frequently results from this complaint, and sometimes, when matter is formed, the bones of the organ are destroyed, and hearing is lost forever.
Causes. - Fullness of blood, violent exercise, particular positions of the body, blows, etc.
Treatment. - Keep the patient erect or sitting, with his head thrown a little backwards, take off his cravat, unbutton his shirt collar, and expose him freely to the cold air; apply ice or cold vinegar and water to the back of his neck. If the pulse be full, bleed him from the arm. If these are not sufficient, moisten a plug of linen or cotton with brandy, roll it in powdered alum. and screw it up the nostril. A piece of catgut may also be passed through the nostril into the throat, drawn out at the mouth, and a bit of sponge be fastened to it and drawn back again, so as to make the sponge block up the posterior nostril. In doing this it is necessary to leave a piece of the catgut so as to be got hold of, in order to withdraw the sponge. It is seldom, however, that the first remedies will not answer the purpose. The patient should avoid removing the clots which form until the bleeding has entirely ceased.
The nose is subject to two species of this tumor, the pear-shaped or pendulous polypus, and a flattened, irregular excrescence, which is extremely painful and is of a cancerous nature. As soon as any affection of this kind is suspected, apply to a surgeon.
This kind of cancer generally commences in a small crack, which, after a while, becomes exquisitely painful. If closely examined, this crack is found to be seated in a small, hard tumor, which soon ulcerates, and, if not checked, extends the disorder to the throat, thereby endangering life.
Treatment. - The knife is the only remedy for this, as well as every other species of cancer, and no time should be lost in resorting to a surgeon.
Large, dark-looking ulcers in the mouth are a common effect of the abuse of mercury. They may be known by the horrid smell of the breath, by the teeth being loosened from the gums, and by a coppery taste in the mouth.
Treatment. - Omit all mercurial preparations, wash the mouth frequently with sage tea or brandy and water, and keep the bowels open with sulphur.
Small pimples are occasionally found on the tongue, which at last form ulcers. Sometimes they are occasioned by the rough and projecting edge of a broken or decayed tooth: when this is the cause, the part must be rounded by a file or the tooth extracted, when the sore will heal without further trouble. Whitish-looking specks, which seem inclined to spread, are also met with on the inside of the cheeks and lips. They are easily removed by touching their surfaces with burnt alum.
Cancer of the tongue commences like that of the lip, being a crack or fissure in a small, hard, deep seated tumor on the side of the tongue.
Treatment. - No time should be lost in useless attempts to cure it by medicines. The only safety for the patient is in the knife, and that at an early period.
The uvula is that little tongue-like appendage that hangs down from the middle of the fleshy curtain which divides the mouth from the throat. It is very subject to inflammation, the consequence of which is that it becomes so long that its point touches, and sometimes even lies along the tongue, which creates considerable uneasiness, and is now and then the cause of a constant cough, which finally ends in consumption. It is commonly called the falling of the palate.
Treatment. - Strong gargles of vinegar and water, or a decoction of black-oak bark, or a watery solution of alum, will frequently cure the complaint. It happens very frequently, however, that in consequence of repeated attacks it becomes permanently lengthened, and then the only resource is to cut off the end of it. If you are near a physician apply to him; if not, the operation is so simple that any man of common dexterity can perform it, particularly as little or no blood follows the incision. All that is requisite is to seat the patient, seize the part with a hook, or a slender pair of pincers, draw it a little forward, and snap off its point with a pair of scissors.
The tonsils are two glands situated in the throat, one on each side, which are very apt to swell from inflammation by colds. They sometimes become so large as to threaten suffocation.
Treatment. - In the commencement this is the same as directed for inflammatory sore throat, which see. If it does not succeed, apply to a surgeon to take them away.
Symptoms. - Chills and flushes of heat succeeding each other; fever; the inside of the mouth, the throat and tonsils much inflammed;; swallowing is painful; hoarseness; heat and darting pains in the throat.
Causes. - Cold; sitting in damp clothes; wet feet; excessive exertions of voice.
Distinguish it from diphtheria by the fever being inflammatory, the absence of ash-colored patches near the tonsils, etc.
Treatment. - An emetic taken at a very early stage of this disorder will frequently prevent it from forming. The next step is to leech the patient freely and give him a large dose of Epsom salts. A mustard poultice or blister to the throat is an invaluable application, and should never be neglected. The room should be kept cool and quiet, and the diet consist of barley or rice-water. The throat may be gargled several times in the day with alum and water, inhaling the steam of hot water from the spout of a tea pot is of use.
Symptoms. - Difficulty of swallowing, respiration hurried; breath hot; skin dry and burning; a quick, weak and irregular pulse; scarlet patches break out about the lips, and the inside of the mouth and throat is of a fiery red color. About the second or third day, upon examining the throat, a number of specks or patches between an ash and a dark brown color are observed on the palate, uvula, tonsils, etc.; a brown fur covers the tongue: the lips are covered with little vesicles or bladders, which burst and give out a thin, acrid matter that produces ulceration wherever it touches. In bad cases the inside of the mouth and throat become black, and are covered with foul spreading ulcers, and all the symptoms that characterize low fever ensue.
Distinguish it from scarlet fever by the fever being a typhus and not inflammatory, and by the peculiar sore throat, and from measles by the absence of cough, sneezing, watering of the eyes, etc.
Treatment. - Bleeding in this disease is absolutely forbidden. The same may be said of active or strong purgatives. The bowels, however should be kept open by mild laxatives or clysters.
Emetics are used in the beginning with advantage, but the great and evident indication is to prevent and counteract the disposition to putrescency, and to support the strength. For this purpose the cold infusion of bark, or bark in substance, with ten or twelve drops of muriatic acid and eight or nine drops of laudanum, should be taken frequently, and in large doses Chlorate of potassa is a valuable article; it may be taken in solution, twenty grains for an adult every two hours, in a teaspoonful of water. To cleanse the throat, gargle frequently with vinegar or muriatic acid and water or glycerin. The diet should consist of milk, arrow-root, jelly, panada, tapioca and gruel, and the drink of wine whey, wine and water, etc., increasing the quantity of the wine according to the weakness and age of the patient. The greatest cleanliness is to be observed in the chamber. As this disease is thought by some to be contagious, all unnecessary communication with the sick room should be prevented.
Symptoms. - The first mark of an obstruction or stricture in the throat is a slight difficulty in swallowing solids, which continues increasing for months, or until the passage becomes so contracted that the smallest particle of food cannot pass, but having remained an instant in the strictured part is violently rejected. If the obstacle is not removed the patient starves.
Treatment. - Meddle not with the complaint yourself, for you can do nothing to relieve it, but apply with all speed to a surgeon, and remember that life is at stake.
Symptoms. - A dull pain in the head; swelling and redness of the eyes; the effusion of a thin, acrid mucus from the nose; hoarseness; cough; fever, etc.
Treatment. - If the symptoms be violent, bleed and give twenty drops of hartshorn in half a pint of warm vinegar whey. Hoarhound and boneset tea, taken in large quantities, are very useful. The patient should be confined to his bed, and be freely purged. If there is great pain in the breast, apply a blister to it. To ease the cough take one teaspoonful of No. 1 every thirty minutes, or till relief is obtained.
The Influenza is nothing more than an aggravated and epidemic state of catarrh, and is to be cured by the same remedies. No cough or cold is too light to merit attention. Neglected colds lay the foundations for diseases that every year send thousands to the grave
No. 1. Cough Mixture. - Paregoric 1/2 an ounce; syrup of squills 1 ounce; antimonial wine 2 drachms; water 6 ounces. Dose is one teaspoonfull every thirty minutes, or at longer intervals till the cough abates.
Symptoms. - A tightness across the breast, frequent short breathing, attended with a wheezing, increased by exertion and when in bed. It comes on in fits or paroxysms.
Treatment. - If the cough be violent and frequent, with great pain in the breast, and the patient be young and robust, it may be necessary to bleed or cup him. In old people it should be resorted to with caution. The tincture* of lobelia is highly recommended in asthma. It should be taken in doses of a very few drops at first, and cautiously increased. If the pulse sinks under it or nausea, giddiness, etc., is produced, it must be laid aside. In fact, it is hardly prudent to take this active and dangerous article, except under a physician's care. The dried roots of the thornapple and skunk-cabbage are sometimes smoked through a pipe for the same purpose, soaked in a solution of nitre and dried. Asthma is a disease that is seldom completely cured by art; nature, however, occasionally effects it.
(* Take a sufficient quantity of the leaves, stem and pods of the plant, put them into a bottle and fill it up a with brandy or spirits, and let it remain for a few days.)
Symptoms. - A sharp pain or stitch in the side, increased upon breathing, inability to lie on the affected side, pulse hard, quick and corded, tongue white.
Treatment. - Take away at once from twelve to fifteen ounces of blood, place a large blister over the side, and give a full dose of Epsom salts. Follow the bleeding by cups if relief is not obtained; and afterwards a blister. All the remedies for the reduction of inflammation must be actively employed. The patient should be confined to his bed, with the head and shoulders a little elevated, and if pain be severe, especially at night, 10 grains of Dover's powder may be given. The diet should always consist of rice or barleywater, gruel, etc.
Symptoms. - Blood of a bright red color, often frothy, brought up by coughing.
Causes. - Consumption, a fulness of blood, rupture of a blood vessel from any cause. Distinguish it from vomiting of blood by its bright color, and being brought up with coughing.
Treatment. - Give the patient at once a tablespoonful of common salt, and direct him to swallow it slowly. If the pulse be full, and he be robust, bleed him. The sugar of lead has much reputation in this complaint: two or three grains of it, with from a half to a whole grain of opium, may be taken every three or four hours, and in severe cases, where the blood flows rapidly, five or six grains, with two of opium, may be taken at once. The most perfect rest should be strictly enjoined, and the diet should be cooling and simple.
Symptoms. - A short, dry cough, languor and gradual loss of strength, pulse small, quick, and soft, pain in the breast, expectoration of a frothy matter, that at last becomes solid and yellow, the breathing grows more anxious and hurried, the emaciation and pain increase, hectic fever, night sweats, and a looseness of the bowels come on, and the patient, unsuspicious of danger, dies.
Causes. - Neglected colds, dissipation, hereditary tendency, etc. Distinguish it by the long-continued cough, pain in the breast, and great emaciation, by the substance thrown up containing pus, in common language, matter. It is known by its being opaque, mixing with water and heavier than it, so that if thrown into a vessel containing that fluid it sinks to the bottom. When thrown upon hot coals it yields an offensive odor.
Treatment. - In a confirmed state of consumption, nothing that art has hitherto been able to do can afford us any solid hopes of a cure. When once the disease is firmly seated in the lungs all that is possible is to smooth the passage to the grave, and perhaps for a while to retard it. If however, the disease is taken in its very bud, much may be done by a change of climate, a milk diet, cod-liver oil, moderate daily exercise on horseback, and by carefully avoiding cold and all exciting causes. A removal to a warm climate should be the first step taken, if practicable; if not, a voyage to sea or a long journey on horseback. A complete suit of flannel, worn next the skin, is an indispensable article for every one who is even inclined to this most fatal disorder.
The symptoms of this complaint must be obvious from its name. When it arises from organic disease of the heart or its vessels, nothing can be done to cure it. The patient should be careful to avoid a full habit of body, and abstain from violent exercise and sexual indulgences. He should live low, and keep as quiet and composed as possible. A fit of anger, or any imprudence, may cost him his life. There is a milder kind of this disease, resulting from debility, nervousness, indigestion, etc., which must be remedied by restoring the strength of the general system. It is also symptomatic of other diseases, and must be treated accordingly.
Symptoms. - Great difficulty of breathing, which is increased by lying down, oppression and weight at the breast, countenance pale or livid, and extremely anxious, great thirst, pulse irregular and intermitting, cough, violent palpitation of the heart, the patient can lie on one side only, or cannot lie down at all, so that he is obliged to sleep sitting, frightful dreams, a feeling of suffocation, etc.
Treatment. - All that can be done is to follow the same plan that is laid down for the treatment of dropsy in general, which consists of purging and diuretics. When the water appears to be confined to one cavity of the chest, and the oppression cannot be borne, some relief may be obtained by a surgical operation.
Symptoms. - A fixed, burning pain in the stomach, small, very quick hard pulse, sudden and great weakness, the pain in the stomach increased on the slightest pressure, vomiting, hiccup.
Causes. - Cold suddenly applied to the body or stomach, drinking largely of cold water while very warm. The striking in of eruptions, poisons, gout, rheumatism. Distinguish it from inflammation of the bowels by the seat of the pain, which is just below the breast bone, in what is called the pit of the stomach, the burning heat and pain there, by the hiccup and vomiting.
Treatment. - The softness of the pulse is here no rule to go by, for it is caused by the disease. The rule is to bleed or leech over the pit of the stomach. From ten to twenty ounces may be taken in a full stream from a robust man at the beginning. As soon as he is bled, or while the blood is flowing, put him into a warm bath, and have a large blister prepared, which, after he has remained some time in the bath, should be applied directly over the stomach. A warm laxative clyster is now to be thrown up, and when the stomach will retain it, give him small quantities of arrow root jelly or gum arabic tea from time to time, with a few drops of laudanum. The most rigid diet must be observed, and the patient kept very quiet.
When the inflammation is reduced, and the stomach will bear it, a grain of solid opium may be given occasionally with advantage. If the disease has been brought on by poison taken into the stomach, apply the remedies directed in such cases. If mortification ensues, death is the inevitable consequence. It is known to exist when from the state of torture we have just described there is a sudden change to one of perfect ease.
Symptoms. - Violent spasmodic pain in the stomach, which is so severe as nearly to occasion fainting.
Treatment. - Give thirty to sixty drops of laudanum, in a teaspoonful of ether, with a little hot wine. Apply a mustard plaster over the stomach, bladders or bottles filled with warm water to the soles of the feet, or put the patient into the warm bath. If the first dose of laudanum does not relieve the pain, repeat it.
Symptoms. - A spasmodic affection of the stomach and diaphragm, producing the peculiar noise which gives rise to the name.
Treatment. - When hiccups occur at the close of any disease, they may be considered the harbingers of death; they, however, frequently arise from acidity in the stomach and other causes. A long draught of cold water, a sudden surprise or fright puts an end to them. A blister over the stomach may be applied for the same purpose. I have succeeded in relieving a violent case of hiccups, that resisted every other remedy, by the oil of amber, in doses of five drops every ten minutes. It may be taken in a little mint-water. Camphor is also useful.
This common and distressing affection is generally connected with indigestion. To relieve it for the moment, magnesia, soda, or Seltzer water, or water acidulated with sulphuric acid, may be employed. To cure the complaint requires the digestive powers to be strengthened by tonics, bitters, and the different preparations of iron, etc., as directed for indigestion. The application of a blister over the stomach may be of use. The white oxide of bismuth in six grain doses, three times a day, taken in milk, has been found of service.
Symptoms. - Want of appetite; low spirits; pains and fullness in the stomach; belching; a sour water rising in the mouth; heartburn; the bowels irregular and generally costive; weakness and emaciation; pulse smell and slow; pain in the head; skin dry; great uneasiness after eating.
Causes. - All those which induce debility; eating too rapidly, without chewing the food; excessive indulgence in the pleasures of the table, or intemperance in any way; a sedentary life, or want of exercise; a diseased liver.
Treatment. - In every case of indigestion, the first thing the patient should do is to abstain from whatever may have tended to produce it. The diet should consist of animal food that is light, nourishing, and easily digested. Roasted beef or mutton is perhaps preferable to any other. Country air and constant exercise on horseback are invaluable remedies in this disease, which, as it is generally occasioned by a departure from natural habits and employments, must be relieved by a return to them. Flannel should be worn next the skin. and care taken to avoid cold or exposure to wet. A wine-glass of the infusion of bark and quassia (made by placing one ounce of powdered hark and one of ground quassia in a close vessel, to which is added a quart of boiling water; to be kept simmering near the fire until the whole is reduced to a pint), with ten or twelve drops of the elixir of vitriol, should be regularly taken three times a day, for months. The bowels are to be kept open by some warm laxative as rhubarb, and the whole frame braced by the daily use of the cold bath. Weak spirits and water, or a single glass of sound old Madeira may be taken at dinner. Much benefit has been found to result from a long-contained use of the wine of iron (made by taking iron-filings 4 ounces, and pouring on it 4 pints of Madeira wine; let it stand for a month, shaking it frequently), a glass of which may be taken twice a day. If the complaint arise from a diseased liver, recourse must be had to the plan laid down for its cure.
An attack of temporary indigestion may be treated by abstinence, rest, and a teaspoonful of magnesia, if the bowels be costive, otherwise a quarter of a teaspoonful of the bicarbonate of soda.
Symptoms. - A flow of dark blood from the stomach, preceded by a sense of weight and oppression in that organ. The blood is generally mixed with particles of food. etc.
Distinguish it from spitting of blood, by its dark color, and being mixed with food.
Treatment. - If the accompanying symptoms be inflammatory, bleed or cup, and use some cooling purge; if otherwise, try fifteen drops of the muriated tincture of iron, with six of laudanum, in a glass of water, every hour till the bleeding ceases. If the cause be a diseased liver, or tumor in the neighborhood, treat it accordingly.
Symptoms. - A dull pain in the right side below the rib, which is more sensible on pressure; an inability to lie on the left side; pain in the right shoulder; a sallow complexion. Such are the symptoms of an acute attack of this disease. There is another species of it called chronic, in which its approaches are so gradual that it is a difficult matter to determine its nature. It commences with all the symptoms of indigestion, and ends in jaundice or dropsy.
Causes. - Long-continued fever and ague: drunkenness, or a free use of spirituous liquors is a very common cause; injuries from blows, etc.
Distinguish it from pleurisy by the pain not being so severe, and by its extending to the top of the shoulder; by not being able to rest on the left side.
Treatment. - Bleed or cup the patient according to his age, strength, and the violence of the pain and, if necessary, apply a blister over the part which may be kept open by dressing it with the savin ointment. The bowels should be opened by Epsom salts or calomel and jalap. If this does not abate the symptoms in a few days, give a calomel pill of one-half grain every five hours, or rub a drachm of the strongest mercurial ointment into the side until the gums are found to be a little sore, when the frictions or pills must be discontinued until the mouth is well, and then again resorted to as before. If an abscess points outwardly, apply bread and milk poultices to the tumor, omit the mercury, use wine, bark, and a generous diet. As soon as matter is to be felt within it, open it at its lowest and most projecting part with the point of a sharp lancet, and let out its contents very slowly, taking care not to close the wound till this is completely effected. The nitromuriatic acid, in doses of four drops three times a day, steadily persevered in, will sometimes produce a cure. A tea made of the root or leaves of the dandelion is sometimes medicinal in liver complaint.
Symptoms. - Langour; loathing of food; a bitter taste in the mouth; vomiting; the skin and eyes of a yellow color; the stools clayey; and the urine giving a yellow tinge to rags dipped in it. There is a full pain in the right side, under the last rib, which is increased by pressure. When the pain is severe, there is fever, the pulse hard and full, etc.
Causes. - An interruption to the regular passage of the bile, which is retained in or carried into the blood. It may be occasioned by gall-stones, a diseased liver, etc. Intemperance is a very common cause, hence tipplers are more subject to it than others.
Treatment. - If the pulse be full and hard, the pain great, and other inflammatory symptoms be present, blood is to be taken away as freely as the age and strength of the patient, and the violence of the pain, seems to demand. He should then be placed in a warm bath, and allowed to remain there some time; when removed to bed, a grain or two of opium may be given every few hours until the pain is relieved. Bladders partly filled with warm water, or cloths wrung out of hot decoctions of herbs, may also be applied to the seat of the pain. If the stomach be so irritable as not to retain anything on it, try fomentations and the effervescing mixture, or a blister to the part. As soon as some degree of ease is obtained by these means, purgatives must be employed, and steadily persevered in; calomel and jalap or Epsom salts, in the ordinary doses, answer very well. If, however, this cannot be done, and, from the pain being acute at one particular spot, there is reason to suppose that a gall-stone is lodged there, the following remedy may be tried, of which one-fifth or a little less may be taken every morning, drinking freely of chicken broth, flaxseed tea, or barley water after it.
Ether 3 drachms; spirits of turpentine, 2 drachms; Mix them.
The diet ought to be vegetable, and should the disease have arisen from a neglected inflammation of the liver, it must be treated accordingly. (See Inflammation of the Liver.) Regular exercise (on horseback, if possible) should never be neglected by persons subject to this disease in its chronic form.
This is the vulgar appellation for an enlarged spleen, and expresses, with much brief meaning, the cause of the complaint, as it generally results from ill-treated or obstinate intermittents. It is, however, not productive of much uneasiness, and frequently disappears of itself. The plan of treatment, if there is acute pain in the part, is to purge and blister. If it remains enlarged after this, mercury may be carefully resorted to, as directed in chronic inflammation of the liver.
Symptoms. - Sharp pain in the bowels, which shoots round the navel, and which is increased by pressure, sudden loss of strength, vomiting of dark-colored, sometimes excrementitious matter, costiveness, small, quick, and hard pulse, high-colored urine.
Distinguish it from colic, by the pain being increased by pressure, whereas in colic it is relieved by it
Treatment. - This is another of those formidable diseases that require the most actively reducing measures in the onset. From ten to twenty ounces of blood ought to be taken away at once, and the patient placed in a warm bath, after which a large blister should be applied to the belly. Emollient and laxative clysters may be injected from time to time, and if the vomiting and irritability of the stomach permit it to be retained, give a dose of castor oil. If this be rejected too, the oil mixture No. 1. This, however, though one of great importance, is a secondary consideration, to subdue the inflammation, by bleeding or leeching, being the great object. The diet should consist of barley or rice-water only. If in the latter stages of the disease, when the inflammation has somewhat subsided, an obstinate costiveness be found to resist all the usual remedies, dashing cold water over the belly will sometimes succeed.
Remember that this complaint frequently runs its course in a day or two, and that, unless treatment be promptly employed in the very beginning, mortification and death will ensue. If a strangulated rupture occasion the disease, the same, and, if possible, still stronger reasons exist for bleeding, previously to any attempts at reduction.
When certain quantities are mentioned, it is always to be understood that they are applicable to robust men. Common sense will dictate the necessity of diminishing them, as the patient may fall more or less short of this description. If strangulated rupture be feared, surgical aid should be early obtained.
No. 1. Oil Mixture. - The yolk of one egg; castor oil, 2 ounces. Mix them well, and add lavender compound, 2 drachms; sugar, l ounce; water, 5 ounces. Mix them well. The dose is a tablespoonful every hour till it operates, or half the quantity at once; the remainder, in divided doses, if no passage is obtained after a space of four hours.
Symptoms. - A violent vomiting and purging of bile, preceded by a pain in the stomach and bowels; quick, weak, and fluttering pulse; heat, thirst, cold sweats, hiccups, and sometimes death in a few hours.
Treatment. - Bladders or bottles containing hot water should be applied to the feet, and flannel cloths wrung out of hot spirits, or a mustard plaster, be laid over the stomach. When it is supposed that the stomach is sufficiently cleared, give two grains of solid opium in a pill, and repeat half the quantity every few hours, as the case may require. If the weakness be very great, and the spasms so alarming as to cause a fear of the immediate result, the quantity of opium may be increased carefully. If the pill will not remain in the stomach, give eighty or ninety drops of laudanum, in a tablespoonful of thin starch, by clyster, and repeat it as often as may be necessary. Fifty or sixty drops of laudanum in a small quantity of strong mint tea, or the effervescing draught, will frequently succeed in allaying the irritation. If all these means fail, apply a blister to the stomach. For thirst, give ice; a little at once. To complete the recovery, and to guard against a second attack, a complete casing of flannel is requisite, together with the use of vegetable bitters and tonics. Persons subject to this disease should be cautious in their diet and avoid exposure to moist, cold air.
Symptoms. - Fever; frequent small stools, accompanied by griping, bearing down pains, the discharge consisting of pure blood or blood and matter, sometimes resembling the shreds or washings of raw flesh; a constant desire to go to stool.
Distinguish it from diarrhoea or lax by the fever, griping pains, and the constant desire to evacuate the bowels, by the discharge itself being blood, or matter streaked with blood, etc.
Treatment. - As dysentery or bloody flux is almost always in this country connected with considerable inflammation, it will be proper, in some cases, to bleed the patient at the beginning of the attack. Whether it be thought prudent to bleed or not, an early dose of castor oil, with clysters of the same, and the application of blisters to the belly should never be omitted. The stomach and bowels may be cleansed by barley or rice-water taken by the mouth and in clysters. As soon as this is effected give half a grain of opium with half a grain of ipecac every two, three or four hours. The diet should consist of gum arabic dissolved in milk, arrow-root jelly, barley-water, etc. Clysters of the same articles, with the addition of an ounce of olive oil and twenty drops of laudanum, may be likewise injected. Towards the latter end of the complaint, opium and astringents are proper, and indeed necessary. I say the latter end of it, for in the commencement they would be hurtful. In this stage of it also, if a severe tenesmus (or constant desire to go to stool) remains, anodyne clysters, as of forty to eighty drops of laudanum in an ounce of starch will be found useful, or what is more effectual, a couple of grains of opium placed just within the fundament. The various astringents which are proper for dysentery in its latter stages, are found below, and may be used, with port wine and water, as a drink:
Astringents. - Acetate of lead 1 scruple; opium 10 grains. Divide into twenty pills. Take one every two, three or four hours.
Tincture of catechu 2 ounces. Take two teaspoonsful in a little port wine every hour, or oftener if required; or,
Extract of logwood 20 grains; cinnamom water 2 ounces; tincture of kino 1 drachm; sugar 2 drachms. To be taken at once.
Symptoms. - Repeated and large discharges of a thin excrementitious matter by stool, sometimes attended with griping and a rumbling noise in the bowels.
Treatment. - If the disease arises from cold, a few doses of the chalk mixture, No. 1, will frequently put an end to it. It is, however, sometimes necessary to begin with an emetic of twenty grains of ipecacuanha, and then open the bowels by some mild purgative, as castor oil or rhubarb. Bathing the feet in warm water, and copious draughts of boneset tea, will be found of great benefit if it originate from suppressed perspiration. For the same purpose, also, from six to ten grains of Dover's powder may be taken at night, being careful not to drink much for some time after it. If worms are the cause, treat it as directed. When it is occasioned by mere weakness, and in the latter stages of it (proceed from what it may), when every irritating matter is expelled, opium, combined with astringents, is necessary as in the similar period of dysentery. The diet should consist, in the beginning, of rice, arrow-root, sago, etc., and subsequently of roasted chicken. Weak brandy and water, or port wine and water, may accompany the chicken for a common drink. Persons subject to complaints of this kind should defend their bowels from the action of cold by a flannel shirt; the feet and other parts of the body should also be kept warm.
No. 1. Chalk Mixture. - Prepared chalk 2 drachms; loaf sugar 1 drachm. Rub them well together in a mortar, and add gradually of mucilage of gum arabic 1 ounce; water 6 ounces; lavender compound 2 drachms; laudanum 30 drops. The dose is a tablespoonful every hour, or oftener. Shake the bottle well before pouring out the liquid, or the chalk will be at the bottom.
Symptoms. - Violent shooting pain that twists round the navel, the skin of the belly drawn into balls; obstinate costiveness; sometimes a vomiting of excrement.
Distinguish it from inflammation of the bowels by the pain being relieved by pressure, and from other diseases by the twisting round the navel, the skin being drawn into balls, etc.
Treatment. - The first thing to be done in this disease is to give a dose of oil or magnesia with laudanum in a little peppermint water, and apply a mustard poultice over or below the navel. Forty, sixty or seventy drops of laudanum may be given at once, as the pain is more or less violent, and the dose may be repeated in a half hour, or less time, if ease is not procured. During this time, if the first doses of laudanum are found ineffectual in reducing the pain, and it is very great, eighty or ninety drops may be given as a clyster in a gill of gruel or warm water. One great rule in the treatment of colic, where the pain is excessive, is to continue the use of opium in such increased doses as will relieve it. When this result is obtained, castor oil by the mouth and clyster must be employed to open the bowels.
In bilious colic, when there is vomiting of bile, the effervescing draught, with thirty drops of laudanum, may be taken to quiet the stomach, to which flannels wrung out of warm spirits may be applied. When the vomiting has abated, the oil mixture or the pills below should be taken until a free discharge is procured. If, notwithstanding our endeavors, the disease proceeds to such an extent as to induce a vomiting of excrement, the tobacco clyster must be tried, or an attempt be made to fill the intestines with warm water. This is done by forcibly injecting it in large quantities, at the same time the patient swallows as much as he is able. In this way, with a proper syringe, two gallons have been successfully introduced. In all cases of colic, when there is obstinate costivness, an examination of the fundament should be made with the finger. If there are any hard, dry pieces of excrement there, they may be removed either by the finger or the handle of a spoon. Examination of the groin and navel should also be made, to see if there be a rupture which may be strangulated.
Those who are subject to colic should avoid fermented liquors and much vegetable food, be always well clothed, and take care not to expose themselves to cold and wet. The bowels should never be allowed to remain costive.
Purgative Pill. - Of calomel and jalap each 10 grains; opium 1 1/2 grain; tartar emetic 1/2 a grain; oil of aniseed 1 drop. Make the whole into a mass. To be taken at once, or divided into pills, if the patient prefer it.
Symptoms. - Pain and weight in the belly; belching; constant desire to go to stool, which is ineffectual; quick, contracted pulse; the belly becomes painful to the touch, and is drawn into knots; constant colic pains; the patient sits in a bent position; after awhile palsy of part or of the whole body.
Treatment. - This disease is too apt to end in palsy, leaving the hands and limbs contracted and useless. In every case of colic, whose symptoms resemble the above, if the person has been exposed to lead in any of its shapes, all doubt on the subject vanishes.
Give laudanum in moderate doses, and rub the belly well with warm spirits, and place him in a bath as hot as he can bear. As soon as he is well dried, and has rested in bed a few minutes take him up and dash a bucket of cold water over his belly and thighs, or mix an ounce of sulphate of magnesia in a pint of water, and give a wineglassful every half hour until ease is obtained. If this with castor oil by the mouth and in clysters will not produce a stool, apply a large blister to the belly. As soon as the symptoms are somewhat abated, caster oil or laxative clysters may be resorted to for the purpose of keeping the bowels open, and to guard against a return small doses of opium should be taken from time to time. Bitters, the different preperations of iron, bark, etc., are necessary to restore the strength of the system.
Symptoms. - Intolerable itching at the nose, sometimes at the fundament; disagreeable breath; grinding of the teeth and starting during sleep; hardness of the belly; gradual emaciation; colic, and sometimes convulsions.
Treatment. - This will vary according to the kind of worm that is to be destroyed. They are of three kinds:
Resembles a small piece of white thread, and is usually found near the fundament, at the lower end of the guts, where it produces a contraction of the parts, and a most intolerable itching. Clysters of lime-water will frequently bring the whole nest of them away, and procure instant relief. The tincture of aloes below, however, is one of the best remedies known for not only this, but the round worm.
Tincture of Aloes. - Socotrine aloes 1 ounce; liquorice 2 ounces; coriander seed 1/2 an ounce; gin 1 pint. Digest in a bottle for a week, shaking the bottle frequently; then strain. The dose for a child is a teaspoonful every morning; for an adult two tablespoonsful, with half the quantity of a strong decoction of the Carolina pink root.
Santonin suppositories (three grains to a sufficient amount of cacao butter) are a certain cure for seat-worms.
Occupies the small intestines, and sometimes the stomach. It is of various lengths, from three to eight or more inches. If the tincture of aloes fail to remove it, the pink root may be taken in decoction, or in powder, in doses of sixty or eighty grains, to be followed after three or four days by ten or fifteen grains of calomel. Cowhage, in molasses or honey, with a dose of castor oil every third day, has been very highly extolled. In cases where all other means have failed, tobacco leaves, pounded with vinegar and applied to the belly, have produced the desired effect. They are dangerous, however, especially with young children.
Inhabits the whole of the internal canal, and sometimes defies all our efforts to get him out of it. Large doses of spirits of turpentine, from one to two ounces, in barley water, have been advantageously employed for this purpose. If the spirits of turpentine be tried, large quantities of gruel or barley water should be used with it in order to prevent its irritating the stomach and kidneys. Pumpkin seeds, taken largely on an empty stomach, will often expel the worm.
By whatever means these troublesome guests are got rid of, the patient should be careful to strengthen his system and bowels by a course of barks, bitters, wine, etc., and to use a great proportion of animal food in his diet. Repeated purging with calomel is, perhaps, as effectual a remedy for worms as we have, perticularly if succeeded by the pink root tea.
Symptoms. - Deep seated pain in the small of the back; urine high-colored and small in quantity, sometimes bloody; sickness at the stomach; vomiting.
Treatment. - This will depend upon the cause. If it proceed from gravel, the plan to be pursued will be detailed under that head. If it arise from any other, cup the back freely, repeat it in ten or twelve hours, if necessary, and put him into a warm bath. Twenty grains or more of the uva ursi, with half a grain of opium three times a day, accompanied by small quantities of warm barley or rice-water, is one of the most valuable remedies we are in possession of. The diet during the attack should consist of mucilaginous drinks only, which must be frequently taken, notwithstanding they may be rejected by vomiting.
Symptoms. - A fixed pain in the loins; numbness of the thigh; constant vomiting; retraction of the testicle; urine small in quantity, voided with pain and sometimes bloody. As the gravel passes from the kidney into the bladder the pain is so acute as to occasion fainting, etc.
Treatment. - Put him into a warm bath, where he should remain some time. Meanwhile an emolient and anodyne clyster should be got ready, which must be given to him as soon as he leaves it. Cloths wrung out of decoctions of herbs or spirits and water should be applied to the part, and small quantities of warm gum arabic tea or barley-water be taken frequently. A grain of opium every two hours will be found useful. Bicarbonate of soda in twenty-grain doses every three hours, often gives great relief. Strong coffee, without sugar or cream, sometimes acts like a charm in soothing the pain; twenty drops of the spirits of turpentine taken on a lump of sugar every half hour, is said by high authority to do the same. If the irritation of the stomach is very great, the effervescing draught, with thirty or forty drops of laudanum, may be tried. When the pain, etc., is somewhat abated, the bowels should be opened with castor oil. The uva ursi, as before mentioned, is one of the most valuable remedies in all diseases of the kidneys that we have. Blisters in all such cases are never to be applied. Persons subject to this distressing complaint should be careful to avoid acids and fermented liquors of all kinds, including the red wines, beer, pickles, etc. For a common drink soft water, or the seltzer and soda waters, are to be preferred. When any threatening symptoms are perceived, recourse should be had to the soda and uva ursi, with half a grain of opium three times a day, to be continued for weeks.
Symptoms. - Pain and swelling of the bladder, the pain increased by pressure; a frequent desire to make water, which either comes away in small quantities, or is totally suppressed.
Treatment. - Cup the patient freely, according to his age and strength, and put him into the warm bath. Inject mucilaginous and laxative clysters, and pursue the exact plan of treatment that is recommended for the cause from which it may proceed. See Suppression of Urine, etc.
Symptoms. - A frequent desire to make water, attended with pain, heat, and difficulty in doing so; a fullness in the bladder.
Treatment. - If it arise from simple irritation by blisters, etc., plentiful draughts of warm liquids, as gum arabic or barley-water, will be sufficient to remove it; if from any other cause, a bladder half filled with warm water, or cloths wrung out of a warm decoction of herbs, should be kept constantly applied over the parts, and occasionally clysters of thin starch with laudanum be injected.
Symptoms. - Pain and swelling of the bladder; violent and fruitless attempts to make water, attended with excruciating pain. etc.
Treatment. - As a total retention of urine is always attended with considerable danger, there should be no delay in endeavoring to remove it. The first step is to place the patient immediately in the warm bath. While he is there a laxative and anodyne clyster must be got ready, which is to be given as soon as he leaves it, and soon repeated. In the mean time the warm fomentations and bladder of hot water must be kept applied, and the mixture below be taken every three or four hours. If there be any difficulty in procuring it twenty drops of laudanum in a little warm barley or ricewater, or a decoction of the dandelion, will answer instead. Warm sweet oil or milk and water may be injected up the urethra, and three or four grains of camphor, in a little milk, be taken every hour.
If no relief is obtained by these means, leech the perineum, apply snow or ice to the bladder, or make the patient stand on a cold brick or stone pavement, and dash cold water over his thighs and, if this fail, try the tobacco clyster, which sometimes succeeds after everything else has been resorted to in vain. If a catheter can be procured, try gently to pass it into the bladder while in the bath. If the patient himself cannot do it, let a handy friend attempt it; if foiled in one position, try another. Success is of the utmost importance, for there is nothing but an operation, in the event of its not being obtained, that can save life.
In every case of retention of urine the order of remedies then is: the warm bath, laxatives and anodyne clysters, fomentations or bladders half filled with warm water over the lower belly, camphor and milk every hour or every three hours, passing the catheter, leeching, dashing cold water over the thighs and legs, or applying snow or ice to the bladder, and, lastly, the tobacco clyster.
Mixture. - Mucilage of gum arabic, 1 1/2 ounces; olive oil, 2 drachms. Rub them well together, and add ether, 1 drachm; laudanum, 30 drops.
Symptoms. - An involuntary dribbling or flow of urine.
Treatment. - If it arises from a relaxation or weakness of the parts, use the cold bath daily. Apply blisters between the fundament and the bag, and have recourse to bark and the different tonics, as iron, etc., recommended in indigestion. Twenty or thirty grains of the uva ursi, twice or three times a day, with half a pint of lime-water after each dose, may also be tried. If the disease is occasioned by a palsy of the parts, the tincture of Spanish flies may be of service. If a stone in the bladder is the cause, apply to a surgeon to cut it out. In the mean time some kind of vessel should be attached to the yard, to receive the urine, in order to prevent it from excoriating the parts.
Symptoms. - A frequent desire to make water which comes away in small quantities at a time, and is often suddenly interrupted, the last drops of it occasioning pain in the head of the yard; riding over a rough road, or any irregular motion or jolting, causes excruciating pain and bloody urine, accompanied with a constant desire to go to stool; itching of the fundament; a numbness in the thighs, etc.; retraction or drawing up of the testicle.
Treatment. - Cutting out or crushing the stone is the only remedy.
Symptoms. - Frequent discharges of large quantities of urine, which is sometimes of a sweet taste; skin dry, bowels costive, appetite ~ voracious, weakness, and gradual emaciation of the whole body.
Treatment. - The principal remedy for the cure of this disease consists in confining the patient to a diet composed almost exclusively of animal food. Blisters may, also, be applied over the kidneys, and kept open with the savin ointment. The prescription below has proved sometimes successful. The carbonate of ammonia, in doses of 11 or 12 grains three tissues a day, is strongly recommended, upon high authority. In addition to these, opium in liberal doses, exercise on horseback, the fleshbrush, and flannel next the skin, are not to be neglected. The bowels should be kept open by rhubarb.
Prescription. - Peruvian bark, uva ursi, of each 20 grains; opium, 1/2 grain. Make a powder, to be taken three times a day with lime-water.
Symptoms. - A swelling of the belly, from water contained in it, preceded by a diminution of urine, dry skin and oppression at the breast.
Treatment. - One of the most valuable remedies for dropsy is found in the elaterium, one-fourth of a grain of which is a dose. As it is a most active article, it is proper to begin with one-sixteenth of a grain daily, which may be cautiously increased to a fourth, or till it is found to exert its full powers by bringing away large watery stools. From an ounce to an ounce and a half of cream of tartar, dissolved in water, and taken daily, has frequently succeeded in removing the complaint. A tea made by stewing an ounce of bruised juniper berries in a pint of water may be freely drunk with advantage. Bathing the feet before going to bed, and taking immediately after 20 grains of Dover's powder, by producing copious sweating, has produced the same effect.
Dropsy is, notwithstanding, a difficult disease to cure. It must be attempted, however, by the use of such articles as we have mentioned, beginning with the first, and, if it fail, proceeding to the next and so on. If the swelling increases to such an extent as to be absolutely insupportable, send for a surgeon to draw off the water. At the decline of the disease the strength must be supported and restored by bark, wine, and the tonic plan recommended for indigestion. Elaterium or other purgatives must not be resorted to, if the patient be debilitated.
Symptoms. - The symptoms of tympany, or a collection of air either in the intestines themselves, or in the cavity of the belly, are more or less gradual in their approach. When the disease lies within the intestines, it commences with wind in the stomach and bowels, which keeps up a constant rumbling, belching, etc., colic, costivness, diminution of urine, want of appetite, etc. When it is in the cavity of the belly, and outside the intestines, the swelling is much greater, and very elastic, when it is struck, giving a hollow sound like a drum; there is no belching, etc.
Treatment. - If the complaint is within the intestines, keep the nozzle of a clyster-pipe up the fundament, to permit the wind to pass through it, in order to diminish the pressure on the bowels. Warm mint tea, ginger, horseradish, ether, Cayenne pepper, spices and essential oils, with laxative medicines and clysters, should be freely used, with a moderately tight broad bandage round the belly. If these means do not answer the end warm and active purges must be resorted to, such as the compound tincture of senna or jalap. Rubbing with turpentine may also prove useful. It is very apt to terminate in death.
Symptoms. - A tingling sensation at the end of the yard, which swells, looks red and inflamed, followed by a discharge of matter that stains the linen, first of a whitish, then of a yellow or green color, a scalding pain in making water, involuntary and painful erections.
Treatment. - There are two kinds of this affection, the mild and the virulent. The first is of so trivial a nature, that plentiful draughts of any soothing liquid, as barley-water or flaxseed tea with a low diet, are sufficient to remove it. The second produces effects more or less violent on different persons, and occasionally resists for months every remedy that can be thought of. If there be much pain and inflammation in the penis, apply a bread and milk poultice to it, take a dose of salts, and lose some blood. This is the more necessary if, in consequence of the swelling of the foreskin, it cannot be drawn back, or being back, cannot be drawn forward. In the meantime, take pretty large doses of the balsam copaiva daily. A very low diet should be adhered to, and the patient should remain perfectly quiet.
A painful incurvation of the yard, called a chordee, may be relieved by dipping it into cold water, or surrounding it with cloths soaked in laudanum. To prevent it, take fifty or sixty drops of the latter article, or two or three grains of camphor on going to bed.
If, in consequence of violent exercise, or strong injections, the testicles swell, confine the patient on his back, leech and purge him. Pounded ice or snow, or cloths dipped in cold vinegar or water, or lead-water should also be applied to the parts, and a very low diet strictly observed. If, from the same cause, the glands in the groin are enlarged, treat them in like manner.
Symptoms. - The weeping of a thin glairy fluid, like the white of an egg, from the penis, caused by a longcontinued clap.
Treatment. - A gleet is exceedingly difficult to get rid of, and frequently defies every effort that is made for that purpose. It must be attempted, however, by the daily use of the cold bath, and thirty drops of the muriated tincture of iron, taken three times a day, for months, in a glass of the cold infusion of bark. The best advice to be given in this case is to apply at once to an intelligent surgeon, who will prescribe injections of alum, sulphate of zinc, or nitrate of silver.
Symptoms. - An involuntary emission of semen during sleep, inducing great emaciation and debility.
Treatment. - Abstain from all sexual indulgence and lascivious ideas or books, sleep on a hard bed, use the cold bath daily, with a generous and nourishing diet. Chalybeate water and all the different preparations of iron, with the cold infusion of bark and elixir of vitriol, as directed for indigestion, should be freely employed.
Symptoms. - A difficulty in passing water, which, instead of flowing in a full stream, either dribbles away, twists like a corkscrew, or splits and forks in two or three directions. They are occasioned by strong injections, longcontinued or ill-treated clap. The cause, however, is not always to be satisfactorily ascertained.
Treatment. - Procure several bougies of different sizes. Take the largest one, dip it in sweet oil, and pass it into the urethra till it meets with the stricture, then make a mark on the bougie, so that when it is withdrawn you can tell how far down the passage the obstruction exists, and having ascertained this, take the smallest one, well oiled, and endeavor to pass it an inch or two beyond the stricture. If this can be accomplished let it remain so a few minutes. This must be repeated every day, letting the instrument remain somewhat longer each time it is passed, and after a few days using one a little larger, and so on progressively until the largest one can be introduced. If this fails, apply to a surgeon, who may destroy it with caustic or the knife.
Symptoms. - Chancres and buboes are among the first symptoms of this dreadful malady, which if not checked, goes on to cause an ulcerated throat, nodes, a destruction of the bones and cartilages of the nose, and the palate. The voice is lost, the hair falls off, foul spreading ulcers show themselves all over the body, the stench of which is insupportable, and before he dies the miserable victim to it becomes a loathsome mass of corruption.
A chancre at first resembles a pimple, with little pit or depression containing matter, which soon becomes an ulcer, with an irregular thickened edge, covered with a tough, ashcolored matter, the basis of which is hard and surrounded by inflammation. It is generally found on the foreskin or head of the yard.
A bubo is an enlargement of a gland in the groin. beginning in a smell hard lump, not bigger than a bean, and increasing to the size of a hen's egg.
A node is a hard tumor formed on a bone.
Treatment. - Apply at once to an intelligent physician. If this be impossible, confine the patient to a simple diet, and keep the part clean. Two or three grains of blue mass may be used daily, and all stimulating substances must be avoided. Every one has some infallible receipt to cure this disorder; but in nine cases out of ten the remedy proves worse than the disease. As for the chancres, touch them freely with lunar caustic, and apply a little piece of rag to them smeared with red precipitate ointment. If they are situated under the foreskin, which is held over the head of the yard by a permanent phymosis, it (the foreskin) may have to be slit up. If there is a bubo, apply thirty leeches. If this does not prevent its increasing, and the formation of matter is inevitable, apply poultices to it, and as soon as a fluctuation can be felt, let out its contents by several small punctures through the skin with a sharp lancet. To assist in the evacuation, press a soft sponge gently on the tumor.
Symptoms. - A small tumor, like a wart, upon the head of the yard or foreskin, followed by inflammation and ulceration, which discharges a thin, disagreeable fluid; after a time a cancerous fungus is produced, attended by a most intolerable burning and darting pain.
Treatment. - Apply at once to a surgeon, who will cut it out; death is the only alternative.
Crops of these animal mushrooms sometimes spring up round the head of the yard or on the foreskin. If flat, they may be destroyed by caustic or nitric acid; if mounted on a stem or foot-stalk, by tying a piece of thread tightly round it.
Symptoms. - A collection of water, which is first perceived at the bottom of the bag, increasing in size as it advances upwards, and forming a tumor of the shape of a pear. If examined as directed for dropsy of the belly, the wavy motion may be felt, and if a candle be placed behind it, it becomes partly transparent.
Treatment. - The only certain cure is an operation, for which, as there is no pressing danger, apply to a surgeon. There are three species of this dropsy, in one of which the water is contained within the lining of the bag; another, within the covering of the spermatic cord; and the third, in the cellular membrane of the bag, The first we have mentioned. The second occurs most frequently in children; it sometimes, however, is found in adults, and very much resembles a rupture. The treatment is the same as in the first. The third may be distinguished by a doughy feel and irregular shape. It is to be cured by punctures to let out the water, and by suspending the testicle.
Symptoms. - A hard knotty and irregular swelling of the vein, which sometimes increases to a large size. When lying down the swelling diminishes, which distinguishes it from a dropsy of the parts.
Treatment. - Suspend the testicles, or keep the patient on his back, apply lotions of lead-water to the parts; the cold bath.
Symptoms. - The testicle is enlarged, hardened, craggy and unequal in its surface, painful on being handled, with irregular pains shooting up the groin, into the back, without any previous inflammation disease, or external violence.
Treatment. - Apply immediately to a surgeon. Castration, and that at an early state of the disease, is the only remedy that can save life. Be careful, however, to distinguish it from simple swelling of the testicle by inflammation, blows, etc., which see.
This is of three kinds. The first arises from an original defect in the organs of generation. The second, from local debility of the parts, brought on by excessive venery, self-abuse, or some preceeding disease, while the third originates from fear, excess of passion, or want of confidence at the moment of coition.
The first is incurable. The second must ho treated by the general principles and remedies pointed out for restoring the strength of the system, consisting of the cold bath, preperations of iron, bark, elixir of vitriol, generous diet, exercise, and by steadily avoiding the onuses which may have produced it. The remedies for the third must be sought for in calming excessive agitation and acquiring, by habits of intimacy, that confidence they are sure to produce.
Symptoms. - Pain in the small joints, generally in the ball of the great toe, the parts swollen and red, the attack coming on in the night. Such are the striking symptoms of this disease, and generally the first that are noticed. It is occasionally however, preceded by all those attendant on indigestion. In the advanced stages chalky lumps are formed in the joints.
Treatment. - If the patient be young, vigorous, having the disease for the first time, bleed and purge him, confine him to a low diet, and treat it exactly as an inflammation arising from any other cause. To procure sweating, Dover's powder may be taken on going to bed. As soon as the inflammation, by these means, is reduced, use the cool or cold bath, and take strong exercise on foot daily; avoid highseasoned food, feather beds, wine, acids and fermented liquors, for the remainder of your life! Gout is the child of indolence and intemperance, and to avoid it the above means must be employed and steadily persevered in.
If, however, the patient is old or infirm, and subject to regular fits of it, he must not be handled so roughly. The most perfect rest should be observed, and the parts lightly covered with fleecy hosiery, and flannel cloths wetted with the lotion below, made milk warm, or with pure laudanum. The bowels should be opened with some warm laxative. Then give the alkaline mixture below. The degree of warmth that is applied to the part must be regulated by the feelings of the patient, who, if weak, may use a nourishing diet, if strong, a more abstemious one.
If from any cause the disease leaves the extremities and flies to the stomach, apply mustard poultices and blisters to the soles of the feet and ankles, give large doses of ether and laudanum, hot wine, brandy, etc., and endeavor by all such means (including the hot bath) to send it back again.
If the head be the part it is transferred to, and apoplexy is produced by it, take away fifteen or twenty ounces of blood immediately, and give active purgatives, as 10 or 15 grains of calomel, followed by senna tea or Epsom salts. If, in a few hours, the patient is not relieved, the head continuing confused and painful, and the pulse full and throbbing, cup him to the amount of eight or ten ounces, and apply cold vinegar and water constantly to the part.
Gout Lotion. - Alcohol 3 ounces; camphor mixture 9 ounces. Render the whole milk-warm by adding a sufficient quantity of boiling water.
Alkaline Mixture. - Carbonate of potassa 2 1/2 drachms; wine of colchicum root 1 1/2 fluidrachms; water 6 ounces. Take a tablespoonful three times daily.
Symptoms. - Pain; swelling and inflammation in some one (or several) of the larger joints, the pain shifting from one part to another, all the symptoms of fever, pulse full and hard, tongue white, bowels costive, and urine highcolored.
Treatment. - First purge with salts and magnesia; then give the alkaline mixture as above but without the colchicum, if the patient be not of a gouty habit. The Dover's powder should be taken to procure sweating, and a low diet should be strictly observed. In severe cases I have known it necessary to bleed. When the disease is overcome, if in consequence of the bleeding, etc., the patient is left very low and weak, wrap him up in blankets, give him warm, nourishing food, wine, etc., etc.
Symptoms. - A chronic rheumatism is nothing more than one of long standing. It is unaccompanied by fever, and makes its attacks on every change of weather, on getting wet, etc., etc. It is frequently caused by inflammatory rheumatism and sometimes seems to exist as a primary affection.
Treatment. - I have found no one plan of treatment in this species of the disease so effectual as the following: Purge moderately with senna and salts, rub the parts well with the volatile liniment, and use Cayenne pepper and mustard at dinner in large quantities, and on going to bed thirty drops of laudanum with a teaspoonful of the tincture of guaiacum. It is to be recollected that this is applicable only to chronic cases; if there is fever, etc., it will do much damage. Should there be any cause to suspect that a venereal taint is connected with it, have recourse to the iodide of potassium, five or ten grains thrice daily, in water. Warm liniments are useful. A large blister frequently relieves the whole of the symptoms in the course of a night. The best safeguard against the complaint is the use of flannel next to the skin winter and summer.
Symptoms. - Excruciating pain in the hip joint and knee, the leg becomes longer, then shorter than its fellow; when lying down the foot rolls outwards, the buttocks appearing flatter than usual; lameness; after a while abscesses in various parts of the thighs; hectic fever, etc.
Treatment. - Apply blisters to the part, and if there be much inflammation leech or cup; make a caustic tissue in the little hollow at the top and outside of the thigh, and use all the remedies directed for scrofula. The diet should be nourishing, and the limb kept at rest. Cod-liver oil, from a teaspoonful to a tablespoonful thrice daily, may be given. When matter is formed, bark, wine and a generous diet must be employed. It often proves incurable.
Symptoms. - The joint swells, the skin remaining of a natural color. By placing the hand on one side of it, and striking it gently on the other, the wavy or fluctuating motion is perceptible; steady pressure on one side will raise the other above its natural level.
Treatment. - Keep a perpetual blister on the joint, or make a caustic issue below it, on the inside of the leg; cold water from the spout of a tea-kettle is a useful application. Camphorated mercurial ointment to the knee, and iodine taken internally, have sometimes been of service.
Symptoms. - Deeply seated pains in the knee, unattended at first by swelling, which at last comes on with increase of pain. Atter a while the joint enlarges, matter is sometimes discharged, hectic fever follows, and cuts off the patient.
Treatment. - If from scrofula, use the general remedies directed for that disease, and apply a blister to the part, which may be kept open by the savin ointment for months; if from blows, apply the blister as before, leech and purge freely, and act as directed in cases of similar accidents. If in spite of these precautions the disease continues to advance, amputation may be the only resource.
Portions of cartilage are sometimes displaced in the joints, when they act like any other foreign body of a similar texture. While in the hollows of the part they give no uneasiness, but as they frequently slip in between the ends of the bones, causing excruciating pain, it is sometimes, though rarely, necessary to cut them out. For this purpose apply to a surgeon. As all openings into the cavities of the joints are attended with much danger, unless the pain be insupportable it is better to endure the inconvenience than to run the risk of the operation.
Symptoms. - Hard and indolent swellings of the glands of the neck, that when ripe, instead of matter discharge a whitish curd. It mostly occurs in persons of a fair complexion, blue eyes, and delicate make. In bad cases the joints swell with great pain, the limbs waste away, the ligaments and bones are destroyed, when hectic fever soon relieves the patient from his misery.
Treatment. - Sea-water is generally considered a great remedy in scrofula. It is to be used daily as a bath. Made milk warm it forms one of the most excellent local applications that we have. When the swellings break, a very strong decoction of hemlock may be advantageously used for the same purpose. The diet should be nourishing. After a fair trial of the waters of the ocean, recourse should be had to iodine and cod-liver oil. The former may be taken in Lugol's Solution, the dose of which is from three to six drops, according to age, twice or thrice daily.
Every gland in the body is subject to inflammation. Whenever one of them is perceived to be in this state, which may be known by the swelling and pain, measures should be taken to reduce it. Leeches, blisters and all the remedies directed for such purposes, should be actively employed, among which purging and a low diet must not be neglected.
Symptoms. - A hard tumor, unequal on its surface, and not very sensible, giving but little or no pain on being handled.
Treatment. - Do not meddle with the tumor, but apply to a surgeon as soon as possible.
Symptoms. - A tumor, differing from the preceding one, by being surrounded with enlarged veins. It is also, more painful, the skin being sometimes discolored and puckered. The whole tumor is particularly heavy, and at last breaks into a malignant ulcer, or sore, whose edges are raised, ragged, uneven, and curl over like the leaves of a flower; white streaks or bands cross it from the centre to the circumference. Acute and darting pains accompany both this and the preceding stage of the disease.
Treatment. - There is but one remedy that can be depended on for the cure of this painful and inveterate complaint, and even that should be resorted to early, in order to ensure success. All the diseased parts must be cut out. Arsenic, corrosive sublimate, phosphate of iron, and a thousand other articles have been recommended, both externally and internally, but without any effectual advantage. To relieve the pain, opium may be taken in large doses. The sore should be defended from the air, by some mild ointment. Powdered chalk, scraped carrots, fresh hemlock leaves and powdered charcoal may be used for the same purpose.
Symptoms. - A tumor in the fore part of the throat, seated in a gland close to the projection called "Adam's apple."
Treatment. - Goitre is sometimes incurable. When taken at the very beginning of the complaint, however, and in young persons, it is said to have been dispersed by a course of iodine joined to frictions of the part, with strong mercurial ointment. As it seldom causes any inconvenience, and is always unattended by pain, it is not a matter of much consequence. The inhabitants of the Alps consider it a mark of beauty, and there are some cantons where every man, woman and child is adorned with a tumor of this nature, of which they would feel very sorry to be deprived. It cannot be cut out, on account of the great number of blood-vessels of which it is composed.
Causes. - Sudden and violent emotions of the mind; bleeding; diseases of the heart and its great vessels.
Treatment. - Lay the person on his back, take off his cravat, then open the doors and windows, and sprinkle cold water in his face. Smelling salts may be held to his nose.
Symptoms. - Falling without sense or motion; profound sleep; face livid or flushed; eyes wide open or half closed, and immovable; breathing slow, laboring, and irregular; pulse full and slow.
Causes. - A rushing of blood to the head, excessive fat in persons with a short neck, gluttony, violent exercise, intense heat, anger, hearty meat suppers, blows on the head, intoxication, etc., etc.
Treatment. - If the pulse remains full, the face flushed, etc., take away twenty ounces or more of blood on the spot, remove the cravat, unbutton the shirt-collar, and place the patient in bed, with his head and shoulders a little elevated. The windows and doors must be thrown open, and no more persons than are necessary, be allowed to remain in the room. The head is to be shaved and cupped, a blister applied to the back of the neck and the head, and mustard poultices to the feet. An active purgative should always be administered as soon as the patient is bled, and its operation assisted by repeated clysters. If the patient cannot swallow pills, try liquids; if neither, have recourse to a strong purgative clyster. If, by these means, the breathing is not easier, and the pulse softer, bleed again, or cup the back of the neck.
If, however, the patient is old and infirm, and the attack has come on more gradually, if the pulse is weak, and the face pale, bleed moderately, or not at all, and give immediately a warm purgative, apply the blisters, etc. It it arises from swallowing vegetable poisons, give an active emetic, as thirty grains of white vitriol, and act as directed in cases of similar accidents. In this second kind of apoplexy, stimulants, as harts-horn to the nose, etc., may be used; in the first they are very injurious, and should never be employed.
This proceeds from exposure to the sun's rays, and exhibits the same symptoms as apoplexy, commencing with vertigo, loss of sight, ringing in the ears, etc., and must be treated by cupping or bleeding, and in every other respect as directed for apoplexy. Extreme heat sometimes, however, produces a state of prostration without head symptoms; for which cold effusion and rest are the best remedies.
Symptoms. - A fit, in which the patient falls to the ground in a convulsion; the eyes are distorted and turned up, hands clenched, foaming at the mouth, convulsions, the whole ending in a deep sleep.
Treatment. - Keep the patient from hurting himself, by holding gently his hands, legs, and particularly his head, which he is apt to dash violently against the ground, or surrounding objects. A piece of soft wood should be placed between his teeth, to prevent his tongue from being bitten. This is, in general, all that can be done during the fit. If, however, there are symptoms of great determination of blood to the head, bleeding should not be neglected. White vitriol, the mistletoe, carbonate of iron, etc., etc., have been recommended and tried for the cure of this complaint, but in vain.
The valerianate of zinc may, however, be tried. It is taken in pills of a grain each, one three times a day, gradually increasing this dose to five at a time. To reap any benefit from this medicine, it is necessary to persevere in it for months. If it fails, iron or some other tonic may be resorted to. Large doses of spirits of turpentine are said to have afforded relief. The diet, in all cases, should be vegetable, and if symptoms of fulness of blood be present, it will be proper to bleed. Persons subject to these fits, should never be left alone, or ride on horseback, for obvious reasons. It should be known that sexual excesses often produce or keep up this complaint.
Symptoms. - A partial or complete loss of the powers of motion, and the sensibility of particular parts of the body; the pulse soft and slow.
Treatment. - In a young and robust person, it may be proper to bleed, and give an active purgative. In old people, or where the powers of the body are much weakened, warm laxative medicines, with stimulating applications, as the flesh-brush, blisters, mustard poultices, and rubbing the spine with the volatile liniment, form the best plan of treatment. If it affect different parts of the body at once, horseradish, mustard, and Cayenne pepper should be used liberally, as they are prepared for table. If a swelling or tumor be found on the back-bone, or any injury has been done it, which may have caused the disease, caustic issues may be placed on each side of it, and as near the injured part as possible. The diet should be light and nourishing. The warm bath must not be neglected.
There are several very long and very learned names affixed to this disease, as it may happen to attack one part of the body or another. When it is confined to the muscles of the neck and jaws, lock-jaw is the common and expressive term for it. The affection, however, is always the same, requires similar treatment, and consists in an involuntary contraction and stiffening of a part of the muscles, the senses remaining perfect.
Symptoms. - A stiffness in the back of the neck, which renders it first painful, and at last impossible to turn the head round; difficulty in swallowing; pain in the breast, shooting to the back; the lower jaw becomes stiff and gradually closes.
Treatment. - If the disease is supposed to arise from a wounded nerve, or from an injury done to tendinous parts, by a pointed instrument, enlarge the wound with a sharp lancet or penknife, and pour laudanum or turpentine into it, as directed for similar accidents. Give 2 or 3 grains of opium at once, and repeat it every two hours, increasing the dose according to the violence of the symptoms and the effects produced by it, without too much regarding the quantity that has been taken. Cases are on record where 60 grains (a drachm) of solid opium have been taken at once, and with the happiest effect. This, however, is a large dose, and should never be ventured on but under the most desperate and alarming circumstances. Active purging with castor oil and senna tea must not be omitted, and if the power of swallowing be lost, laudanum, etc., must be given in clysters. Drawing a tooth is generally recommended by physicians in those cases where the jaws are firmly closed, for the purpose of transmitting medicines and food to the stomach. This has always appeared to me as every way calculated to increase the evil. If no opening exists between the teeth access can always be obtained by clysters, and in this way nourishment and remedies may be injected. It is always proper, however, when the disease is perceived to be coming on, to place two small pieces of soft wood between the grinders of the upper and lower jaw, one on each side, so that they may be kept asunder.
Madeira wine, in doses of a wineglassful every hour, continued for several days, and combined with the internal use of opium and the warm bath, has been found of great service. Cold water dashed freely over the patient every two or three hours may likewise be tried. After every affusion he should be well wiped and put into a warm bed, when a large dose of laudanum in warm Madeira wine should be given. The tobacco clyster has sometimes succeeded when everything else has failed. So has chloroform by inhalation. Blistering the whole length of the spine, and caustic issues on its sides, as nearly on a line with the parts affected as possible, are strongly recommended.
Although a valuable addition to our means of cure, the tobacco clyster is not to be employed lightly, or on common occasions. It should always be reserved to the last moment, never using it until everything else has failed. The prostration of the system, and other alarming symptoms it sometimes causes, renders this caution necessary.
This disease is also called tic-doloureux, neuralgia, etc.
Symptoms. - A very severe pain darting in particular directions, not lasting more than a second, but very rapidly repeated, and excited by the slightest touch; during the intervals there is no pain whatever. There is no inflammation or swelling of the cheek as in toothache, nor does the pain seem so deeply seated.
Treatment. - Blisters, tincture of aconite, mercurial ointment, opium, iron, and Fowler's Solution of Arsenic, with many other remedies of the same class, have been all recommended and used for the cure of this most painful of all the affections to which the human body is subject. Where the pains are so excessive as not to be borne, one or two grains of the extract of belladonna may be taken every three hours. When the pain is somewhat relieved, this quantity must be diminished. For a cure apply to a skilful surgeon, who may divide the nerves.
Symptoms. - An acute pain at the lower end of the breast-bone, shooting into the left arm; great difficulty of breathing; anxiety; palpitation of the heart; a feeling of suffocation. It usually comes on while ascending a hill or going up stairs.
Treatment. - During the fit place the patient's feet in a hot mustard foot-bath, and apply mustard plasters to the chest and back. Give one or two teaspoonfuls of Hoffmann's anodyne, in water, or forty drops of laudanum. If fainting, dash cold water in his face. Strips of linen, moistened with the solution below, applied several times a day to the breastbone for a month, are said to have effected complete cures. They act by producing a crop of pimples, on the appearance of which the disease sometimes declines.
Persons subject to this complaint should avoid all fermentable food, and excess in eating or drinking, taking care to live quietly and to keep the bowels open. Cupping and purging, followed by opium, to lessen the spasm, with the warm bath, and a perpetual blister or plaster of the tartar emetic ointment to the chest, are perhaps the best remedies that can be employed.
Tartar emetic, 1 drachm; spirits of camphor, 1/2 an ounce; boiling water, 1 pint. Mix.
Symptoms. - Irregular and convulsive motions of the limbs and head, usually occurring in children. It varies, however, in different persons, and is frequently counterfeited by beggars.
Treatment. - The daily use of the cold bath, with the Peruvian bark, has often succeeded in curing the complaint in young subjects. In addition to these, any of the preparations of iron combined with moderate doses of musk, opium, camphor, etc., may be tried. The disease is generally recovered from.
Symptoms. - Chills, heat, thirst, headache; the skin is marked with large red or scarlet patches, which at last unite, disappearing in a kind of branny scurf; sore throat.
Distinguish it from measles by the spots coming out on the second day of the fever. In measles they seldom appear until the fourth day. By their color, which is that of a boiled lobster, whereas in measles it is of a dark red.
Treatment. - An emetic (ipecacuanha) may be given on the first appearance of the disease, to be followed by a dose of salts, or eight grains of calomel, with as many of rhubarb. If the pulse is full and strong, the head aches, and the heat is great, draw blood, and apply cold water over the body freely and frequently. There is no disease in which the advantages of cold effusion are more striking. In order to reap the full benefit of it, however, it must be freely employed, that is, as often as heat, etc., seem to require it, or eight or ten times in the twenty-four hours. The saline mixture, (see), is of great use. If there is any soreness of the throat, the gargles recommended for that complaint should be used, and a mustard poultice be applied to the parts. If symptoms of putrescency appear, have recourse to the plan recommended for putrid sore throat. As scarlet fever is undoubtedly contagious, the usual precautions should of course be adopted.
Writers on this subject generally consider scarlet fever as consisting of three kinds, viz., the simple fever, the fever with sore throat, and the malignant fever. The treatment of the first should be like that of any other inflammatory fever; that of the second has been detailed in speaking of inflammatory sore throat; and the last is precisely that of putrid sore throat.
Symptoms. - Fever, delirium, vomiting; pulse strong or weak, as the fever inclines to the inflammatory or typhous kind. On the fourth day - sometimes on the second or third - the skin in some one part becomes red and inflamed, which is soon extended to others, the parts affected being swollen and of a bright scarlet. If the face is attacked, it spreads itself on the scalp, and the eyelids sometimes swell so as to prevent the patient from seeing. After a longer or shorter period, the eruption ends in small watery vesicles, or in branny scales. At this period the fever sometimes abates; at others, drowsiness or delirium comes on, which increases it, and destroys the patient by the eleventh day
Treatment. - This disease is of two kinds, one of which is principally confined to the skin, while the other affects the whole system. If the accompanying fever is inflammatory bleeding will be proper, otherwise not. This operation is to be cautiously employed in erysipelas, as it sometimes runs into a typhous state. If, however, the patient is robust, his head aches, and great marks of fullness and inflammation are evident, which is generally the case in this country, bleeding, purging with salts, and cooling drinks should be employed, to which, also, may be added Dover's powders, boneset tea, etc., to produce sweating. The room should be kept cool. If, on the contrary, the fever is typhous, or the patient is of a weak and irritable habit of body, bleeding should never be resorted to. Opium, wine, bark, elixir of vitriol, and tincture of chloride of iron (20 drops every three hours) are necessary in this case to guard against mortification, which sometimes ensues.
As local applications, bathing the parts with laudanum or lead-water, or dusting them with rye meal or wheat flour, are the best. Should the disease evidently be confined to the skin, the application of a blister will sometimes put an end to it. If it affect the face, it may be prevented from extending to the scalp by painting a line just beyond the eruption quite thickly with tincture of iodine. If abscesses form, large openings must be made, to let out the matter and the dead parts. When the first or inflammatory kind prevails, the diet should be barley, sago, or panada, etc., with lemonade, tamarind water, etc., for drink; and, on the contrary, when the second or typhous form of it (especially if accompanied by putrid symptoms) shows itself, a more generous diet, with a moderate quantity of wine, etc., must be employed.
It may not be useless again to observe, that in the United States erysipelas often calls for reducing and cooling measures. Among the various articles which are employed in this, as well as all inflammatory diseases, none ranks higher than lemonade, which should always, if possible, be made from the fresh fruit. When taken cold, and in liberal quantities, it is not only delicious to the palate of the patient, but tends powerfully to cure the complaint.
Symptoms. - Inflammatory fever, dry cough and hoarseness; sneezing, watering of the eyes, which itch; a running from the nose; great drowsiness. On the fourth day small red points break out, first on the face, and then gradually over the body. They are in clusters, and, on passing the hand over them, are found to be a little raised. On the fifth or sixth day the vivid red is changed to a brown, and the eruption goes off.
Distinguish it from small-pox and all other diseases by the dry cough and hoarseness, by the appearance of the eyes, which are red, swollen and loaded with tears.
Treatment. - The patient must be confined to a low diet, and kept in bed, with as much covering, but no more, as may be agreeable to his feelings. The room should be cool, and, if there is much fever and pain in the head, bleeding may necessary. Should there be pain and oppression at the breast, apply a blister. The bowels may be opened by salts. The mild form of measles ought to be treated like any other inflammatory complaint, taking care, however, not to repel the eruption by cold. If this happens, place the patient in a warm bath, give him warm wine, etc., internally, and apply mustard poultices and blisters to the feet and ankles.
There is another and more dangerous kind of this disease, which may be known by the fever being typhous, and by all the symptoms showing a depressing tendency. The moment this is perceived have recourse to bark wine, muriatic acid etc., etc., as directed in typhus fever.
Symptoms. - Fever; inability to sleep; pain in different parts of the body; a crop of small pimples or points on the back which, by the second day, are changed into little blisters, which are ripe on the third and disappear before the fifth day, without forming true pus or matter, and leaving no marks or pits behind them.
Distinguish it from small-pox by the eruption coming out on the back, by the mildness of the fever, by the fluid contained in the vesicles or blisters not being true pus, and by the whole falling off in scales on the fifth day.
Treatment. - Confine the patient to his bed, keep him cool and quiet, and give him a dose of salts. This is all that is necessary.
Symptoms. - A pimple at the spot where the matter was inserted, which gradually undergoes certain regular changes that characterize the complaint.
Changes of genuine Cow-Pox. - On the fourth day, or sooner, from the time of the operation, a small speck of inflammation is to be perceived, which, on the fifth day is a pimple, surrounded by a circle of inflammation. On the sixth this pimple changes to a vesicle containing a thin fluid. On the seventh this vesicle is more perfect, its margin forming a regular circle; it is also a little flattened on the top, the centre of which is of a dark color. On the eighth or ninth day slight chills, flushes of heat, etc., are sometimes felt, accompanied by swelling of the pustule and pains shooting up into the arm-pit, the glands or kernels of which occasionally swell.
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