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THE
AMERICAN
FAMILY   PHYSICIAN;
                    OB,
DOMESTIC  GUIDE TO  HEALTH.
PREPARED EXPRESSLY FOR THE USE OF FAMILIES, IN LANGUAGE
    ADAPTED TO THE UNDERSTANDING OF THE PEOPLE.
ARRANGED IN TWO DIVISIONS.
      By JOHN  KING,  M.D.,

PBOFESSOR OP OBSTETRICS AND DISEASES OP WOMEN AND CHILDREN, IN THE ECLECTIC COLLEOB
  OF MEDICINE, CINCINNATI; FORMERLY PROFESSOR OP MATERIA MEDICA, THERAPEUTICS,
   MEDICAL JURISPRUDENCE, IN THE MEMPHIS INSTITUTE; AUTHOR OP THE AMER-
     ICAN ECLECTIC DISPENSATORY, TOE AMERICAN ECLECTIC OBSTETRICS, ETC
SOLD ONLY TO SUBSCRIBERS, THROUGH DULY CONSTITUTED
   PARTIES, EACH OF WHOM HOLDS DEED OF TERRI-
       TORY'SIGNED BY THE PUBLISHERS.
DIVISION  I.
      INDIANAPOLIS, IND.:
A. D. STREIGHT, PUBLISHER.
   N. E. COR. WASHINGTON AND MERIDIAN STREETS.
             1864. 
W6fl
Entered according to Act of Congress, in the year 1860, by Streiqht & Adams, in the
   Clerk's Office of the District Court for the State of Indiana.  Copyright assigned to
                            A.  D. STREIGHT,
                                      1860.
                      STEREOTYPED  AT THE FRAKKUN TYPE FOUNDRY, CINCINNATI, 0. 
PREFACE.
  0
  In offering to my fellow-countrymen The American Family Phy-
sician, I have no apology to make.  It  has been my constant effort
to condense into as  small a compass as possible, the greatest amount
of useful information, in plain and familiar language, free from the
mysterious and incomprehensible  medical  terms in which physicians
endeavor to hide  their art;  and,  after a  long and tedious labor,  I
am  satisfied that I  have so  far succeeded in this object, as to  have
presented in the following pages,  vastly  more information in relation
to the laws of life, health, and disease, than has ever appeared in any
similar work heretofore placed before the public eye.
  During the active duties of my profession for a number of years
past, I have seen an amount of suffering, disease, and death resulting
from a want of proper and correct knowledge among  the people, suf-
ficient  to  induce me to  undertake the laborious task of preparing  a
work  which the  most  uneducated can  fully understand.  It  is  a
lamentable fact that at  least one-half of all suffering, disease, and
premature death  could and would  be prevented, were as much atten-
tion generally bestowed upon the cause,  nature, and  treatment of
disease, as there is upon  subjects of much less importance.  How often
is it the case, that a total ignorance of matters relating to health and
long life, and a consequent  timidity, together with bad management
in nursing, are the causes of false charges against the physician, and
of the death of the  patient ?  The frequent occurrence of such cases
in my own practice, and the innumerable complaints  upon this point
by many  other physicians of extensive  experience  and undoubted
ability, together with the unanimous report to the same effect, of the
numerous physicians to whom I have had the honor of being preceptor
                                                      (iii) 
iv
PREFACE.
within the last twenty-five years, have more thoroughly convinced me
of the absolute  necessity of  speedily completing  and bringing thia
work before the public.
  The ravages of disease are often so rapid that the only hope  of
life lies in immediate treatment.  Thus, a child is attacked with croup,
a disease easily removed,  if properly treated when the first symptoms
are visible.   What is  to  be done?   A  messenger is dispatched for
the physician; he is some miles  away, the night is dark and dreary,
perhaps cold and stormy, the road long, muddy,  or broken.   What
is the result ?  Long ere he  shall  have had time to obey the  summons,
"the silver cord is  loosed,  the golden bowl  and the pitcher at the
fountain  are  broken," the work  of death is accomplished, and the
medical man arrives only in time to witness the distress of the broken-
hearted father, the agony of the weeping and childless mother.  Alas !
their fondest hopes are blasted, their darling loved one is gone forever,
and they, alone,  are left to mourn in affliction.  Upon  witnessing  a
scene like this, every heart anxiously and tremblingly inquires, "Must
this be so?  is there, then, no remedy?"  Yes, fond parent, sympa-
thizing friend, there is a remedy.  All that  is required is to obtain
a knowledge of this disease,  by which  you  will be  enabled to use
those safe and salutary means, which will aid the natural  efforts of
the system in throwing off  this most  distressing and truly  alarming
malady.
  Croup, however, is  not the only disease  which  demands prompt
attention and treatment.  A  loved father, husband, or son may be
suddenly stricken with apoplexy—poison may have  been carelessly
or intentionally swallowed—an artery may have been severed—a pro-
fuse bleeding may occur  from the lungs—a  child or parent may be
in danger of death by suffocation,  from food or other substance getting
into  the  air-tubes and actually  choking it.   What  must be  done ?
Where is succor to be obtained ?   For if we wait until the physician
arrives from his distant residence, death will have claimed his victim •
and  how many hundreds  of similar instances are  constantly taking
place, in which even a slight  hint, obtained by  the perusal  of a few
printed lines, would  be  the  means of  saving  many valuable  lives.
Hence, the pressing importance of a good and reliable work, in which
is  contained proper and  correct  information on these various cases
given in language adapted to the  understanding  of all who read it so
that any person may at once avail himself of the means to cure disease
and save life  in all those instances where these become necessary.
  The fact that nearly all chronic diseases, or those of long standing 
PREFACE.
V
might, heretofore, have been prevented, had this subject of health
and disease been properly understood, has added new encouragement,
energy, and zeal to my labors, and made what might otherwise have
been  an irksome  task, comparatively  easy and  pleasant;  and  the
special attention which I have given to the part of the work devoted
to this class  of diseases,  can not fail to greatly enhance its value,
besides being the means of effecting an immense amount of good.
  I shall  not contend that  the physician is an unnecessary member
of society; for his assistance is, undoubtedly, on many occasions, both
necessary and  valuable.   But I  will not admit that he  is  the  only
person who should study well the science  of life.  And to say that
he is the only one who should or who can cure disease, is as  absurd
as it is untrue; for who does not know  of disease cured even  by un-
lettered individuals, in instances where the physician had pronounced
the patients beyond the resources of human skill.   Indeed, the  science
of medicine is not so strange and marvelous a thing as many suppose.
It is  as easy to understand the effect which an  article of  medicine
will have  on  the system, as that  produced by the use of food.  Why
not?  They both  enter the stomach, and from both  certain portions
are extracted and  carried through the  system,  by precisely  similar
processes.  Indeed,  food itself exerts a medical  influence upon the
system;  certain kinds operate  as laxatives, gently  loosening  the
bowels; some produce costiveness; others act as diuretics, increasing
the flow of urine; while others  again, being stimulants, increase the
activity of the  different organs, etc., etc.  Many  other ways  might be
named, in which various  articles  of food produce medicinal influences
upon the  system.  But as this subject has received proper  attention
in the body  of the work, I will omit further reference  to it here,
rendering thanks to kind Providence for the wisdom He has displayed
to man, in the arrangement of all matters  pertaining  to  his general
happiness and  welfare; and if  man would study His laws as  from
time  to time  they are revealed, he would be enabled to enjoy life
with its ten thousand blessings,  even to  a good, ripe  old age, passing
through it without pain  or sorrow, a stranger to disease, free from
expensive doctors'  bills,  a blessing  to society, and a  treasure to his
family and his  country;  and when the day of death arrived, in which
his body must  return to its original dust, and his soul  be  wafted into
the eternal hereafter, never yet  explored by living mortal, to meet its
Creator,  he would be  prepared  for this momentous event, free  from
all doubts, from all fears.
  I can not close my remarks upon the importance of a suitable work 
vi
PREFACE.
Of this kind, without referring to the diseases peculiar  to women, a
sex, whose formation, together with the  customs of society to which
they are obliged to  submit, render them particularly liable to many
distressing maladies.  How often  are we called upon to mourn the
loss of a dear mother, wife, sister, or daughter, who has been removed
from our midst by some one of the many  diseases peculiar to the sex ?
And the  loss becomes doubly severe and afflictive, when, having ascer-
tained the cause of the  disease, we learn that the most simple reme-
dies, administered in season, would have aroused nature to her wonted
tone, and saved the cherished  member of our family circle, unharmed
by  our side, cheerful, joyous, and  ever  ready to share  our  troubles
and sorrows.  From the nature of these diseases, young females, in
particular, have a delicacy, an invincible repugnance, to speak of them,
fearing that a single word of complaint would be the means of exposing
them to  a  physician's critical investigation.   It has frequently hap-
pened in my own practice, to be called  only after the patient, from
a natural sense  of modesty, had  allowed her malady to progress so
far  as to be beyond the  aid of medicine, it being impossible to arouse
the deranged organs to  any healthy action; and I have had the pain-
ful  task of communicating the sad and grievous intelligence that the
fair being before me would exist among her friends but a short time,
doomed to pain and suffering until death took her to himself.  Mothers,
let  me entreat you to lay  aside that morbid delicacy  so common at
this day, and to at once commence the  education of your daughters
with regard to  the  nature and functions of  their own constitutions,
and the diseases to  which they are subject, that they may know how
to protect and preserve  themselves from  the attacks  of disease.  Na-
ture has endowed  woman with a peculiar  disposition, rendering her
our natural  nurse,  always ready with kind and soothing words, ever
attentive to those little wants peculiar to the sick, and proving a most
valuable  companion in the  hour of pain, disease, and death.   Again,
it is to woman to whom we confide the training of our children, because
we  find her more capable of  reading their tender minds, and more
patient and better  calculated to understand their wants,  in health or
sickness, than man.   How many intelligent mothers are there who can
refer to their by-gone days, when they could have relieved some little
sufferer from pain, or saved some darling child from death, had they
understood the nature of such child's malady, and the simple means by
which it  could have been cured.   For none can gainsay the fact that
children almost always require only simple remedies to free them from
disease. 
PREFACE.
vii
  It is exceedingly strange  and unaccountable, that although the sub-
ject of health and  disease is one universally acknowledged to be of
the first importance, yet it receives the very least attention.   This is
an undeniable fact.   Go where we will, we find that the  great mass
of the people avail themselves of no means  of instruction on these
momentous matters, except, indeed,  in the sad history of their own
past experience, made manifest in doctors' bills, broken-down consti-
tutions, and  tombstones.  Alas!  when will man  learn to  be wise?
[f the pe*ople would thoroughly study those laws of nature governing
their own systems, and seek for  the various medicinal herbs, barks,
roots, etc., so profusely growing around them, testing their virtues in
disease, it would tend to close the offices of many physicians, it would
drive quackery into disgrace and oblivion, it would lessen the number
of our apothecary shops as  well as of our doctors, and those medical
men  alone  would  be able   to  succeed  in securing  patronage, who
were thoroughly  versed in  their  profession, were possessed of high
medical attainments,  and were the most successful in the curing of
disease.
  For the purpose  of imparting to the people much valuable  inform
ation relative to health and disease, enabling them to meet the  various
emergencies  heretofore referred to, this work is more especially pre-
pared, and,  as the title imports,  is  arranged  to meet  the wants of
families, farmers, sailors, planters, clergymen, and all persons to whom
health and  long  life are desirable  conditions.   No  less  than  three
hundred and seventy forms  of  disease, including diseases of women,
diseases  of  children, chronic diseases, as well as those of a surgical
nature,  are  accurately described, and the most  successful  methods ©f
treatment made known; nearly four hundred and fifty simple medi-
cines are  described, together with their virtues and  medicinal uses;
and the recipes for some two hundred and fifty valuable and successful
medicinal compounds and preparations, are given, together with much
other matter of a highly useful and practical character.  For the sim-
plification of the matter, the first division of the book is arranged into
four parts :
  Part I—Treats  upon all kinds of fevers,  inflammations, skin dis-
eases, dropsies, nervous and urinary diseases;  bleedings or floodings
from various parts; diseases of women and children, with some prac-
tical  observations in regard to women  raising families, newly-born
infants, etc., describing the  causes, symptoms, mode of distinguishing,
and treatment of these numerous diseases—the treatment being  the
result of  an  extensive and successful practice for the last twenty-five 
viii
PREFACE.
years.  A considerable portion of this part of the work  is occupied
with a description  of chronic diseases, and  the  treatment which the
author has found the most efficacious.
  Part II—Comprises surgical diseases and their management; as
cuts, wounds, broken bones, dislocated joints, ulcers, etc.
  Part III—Contains a description of the several  medicinal agents,
their  uses  and effects  upon the system,  the diseases in  which they
may be employed, and their doses; together with a list of the most
useful and valuable medical recipes.
  Part IV—Contains remarks on hydropathic,  or  cold water  appli-
ances, in the treatment of disease.  A copious index closes the first
division of the work.  To say more concerning  V would  be useless;
its pages must speak for it.                                 t  rr 
THE
AMERICAN   FAMILY   PHYSICIAN.
INTRODUCTORY   REMARKS.
                        CHAPTER  I.

                 Temperaments.—Air.— Ventilation.

  Health is the greatest earthly blessing which man can enjoy; without
it, life is  but a state of suffering and torment; with it,  the  comforts and
happiness of the human family are preserved and perfected.  Yet, however
necessary health may be to our welfare, it is one of those subjects, which,
as a general  rule, receive  but a small share of attention; and  while the
means necessary to promote health and longevity are seldom considered in
an important light,  those which tend to impair  it and lessen the term of
life, are by the majority of mankind almost worshipped.   Hence, although
when situated under the best circumstances,  man is liable to sickness and
death, yet the great majority of diseases, indeed I believe I may truly say
at least seven-tenths of the physical sufferings  of the human family, are
caused by inattention to those few and simple measures, which observation
and experience have proved to be the only true and never-failing sources of
sound, vigorous, and permanent sanity.
  The human body is composed of various tissues and organs, each having
separate and distinct duties, yet which are so harmoniously blended together,
and at the same time so dependent upon each other, that an interference
with the  operations of one necessarily impairs the integrity of  all the
others, in proportion to the extent and degree of the intrusion.  When the
structure  of these organs is perfect and well developed, being neither too
largely nor too deficiently proportioned, and  their  various functions are
executed with proper activity and regularity, without producing  mental or
physical suffering, or in any way diminishing or exalting the various capac-
ities of the individual, a state of health is said  to exist, and a  departure
from these conditions constitutes disease.
                                                      (9) 
14
AMERICAN FAMILY PHYSICIAN.
compound substance,  consisting of oxygen, azote or nitrogen,  carbonic acid
gas, ammonia, and aqueous vapor.  The constituent of air which is necessary
to respiration and health, is oxygen; the azote or mephitic air,  and the car-
bonic acid gas, are both unfit for respiration or combustion, and will speed-
ily destroy life when inhaled.   In consequence of these facts, oxygen is
frequently termed vital air.
   The distribution of oxygen throughout nature is absolutely  necessary for
the existence of organic bodies;  and the proportion of it which the atmos-
phere contains is just that required for the  preservation of all living ani-
mals and plants.  An excess of this gas, however, in  the  atmosphere will
sustain life for  a longer  period  than ordinary air;  while  a diminished
proportion  is prejudicial to health.
   The atmosphere consists of oxygen twenty-three, and nitrogen  seventy -
Beven parts, by weight; or twenty parts of the former,  and  eighty of the
latter,  by volume.  The carbonic acid gas is  not  necessarily a constituent
of air,  but originates from various sources, as, from the respiration of men
and animals, combustion of various  substances, putrefactive action, &c;
there are from one to  one and a half parts of it in every two  hundred and
fifty of atmosphere, and it exists  more largely in the  air of cities  than in
that of the  open  country, which explains why  persons in cities feel more
low spirited and  languid during a hot season, than those in the country at
the same degree  of temperature, and also, why disease and death are more
common among  the former.  Carbonic acid  gas  is  a highly deleterious
agent; one per cent, of it existing in the atmosphere,  is sufficient to cause
headache, weariness, drowsiness, &c,  and  twelve  per cent, will occasion
death.   The ammonia found in the atmosphere is in very minute quantity,
and is  more readily detected after a thunder storm; and the moisture varies
considerably in quantity from  time to time, even in the same  localities.
   Oxygen is that constituent of the air upon which health and life depend;
in the  performance of respiration it is  inhaled into the lungs, enters into
the circulation, and aids in the destruction of all those  matters which are
dangerous to the animal economy.  A healthy man will inhale about two
hundred and sixty-six cubic feet of air in the course of twenty-four hours,
of which from twenty-five to thirty-seven  ounces  consist of  oxygen; and
while  this is being inhaled, an exhalation of from  ten  to fifteen feet of car-
bonic acid gas ensues, or from eight to ten ounces, by weight. The quan-
tity of carbonic acid gas passed off is proportioned  to the amount of oxygen
inhaled, so that when there is a deficiency of oxygen, there is also a reten-
tion of carbonic acid  in the system, which will invariably produce  disease.
The decomposing influence of oxygen upon the effete matters of the  system
gives rise to various results; thus the blood which  is conveyed to the lungs
through the veins is dark-colored and filled with impurities, but as soon as
the oxygen has come into contact with it, these impurities  are destroyed,
or disintegrated  and passed off, and the blood becomes of a bright red color
and highly purified.   Nine pints of pure atmosphere will purify four pints
of blood, imparting to it a power which gives heat and activity to the whole 
VENTILATION.
15
system.  Some idea of this vital process may be had, when it is stated that
about nine pounds of blood are presented to the  atmosphere in the lungs
for oxygenization, every minute, or about  12,960  pounds  in  twenty-four
hours.  The  quantity of blood estimated in the  adult  system,  is about
twenty-eight  pounds, which performs its revolution in  two minutes and
a half;  or,  in other words,  the  circulating velocity  of this  fluid  is so
great that any given amount, on leaving the lungs, is distributed to impart
heat, health, and activity to the system, as  well  as to  remove  impurities,
and in the short space of two minutes and a half it returns again to the
lungs, laden with these impurities, having effectually accomplished its vital
mission.
  All living creatures must  breathe oxygen,  or death will speedily  and
inevitably take place.  Fresh, unadulterated air, holding  about  twenty-one
per cent, of oxygen, is as essential to the proper vitalization of  the blood,
and to the healthy action of the lungs, as well  as all other organs, as is
good, wholesome, and nutritious  food to the formation of healthy chyle,
and the normal action of the digestive organs.   From these facts it is very
evident, that the inspiration of air holding a diminished amount of oxygen,
or containing foreign  noxious substances, must  be detrimental  to health
and longevity in proportion as its purity is departed from.  And the influ-
ence of the condition of the atmosphere upon the  system, is well known
by those who have felt the refreshing and exhilarating  effects, so instanta-
neously occurring upon passing from a deteriorated city atmosphere to the
pure, unvitiated air of an open country; while, on  the other hand, but few
country people prefer a  residence in cities,  from the depressing  and un-
pleasant  sensations experienced almost as soon as they begin to breathe
the contaminated  atmosphere of such places.  Again, although  persons in
the enjoyment of  vigorous health may not observe the various changes
which occur in the atmosphere, from time to time, yet  they are always
noticed and sensibly felt by the invalid.
  As one great means, therefore, conducive to health and longevity,  it ia
highly important  that individuals  should  be extremely careful how they
expose themselves to the influences of unhealthy air; on this point too
much attention cannot be bestowed.  Statistics prove beyond a doubt,  that
the extension of  typhus, cholera, and other  fatal forms  of  disease, is
greatly promoted  by the vitiated air of  low and damp  situations, and the
virulence of these maladies is  still further  augmented  when, in addition,
the unhealthy animal exhalations  which are continually passing off from
the body, are allowed to circulate through the atmosphere, as may be wit-
nessed in  hospitals and  other places where individuals  are congregated
together in small  apartments, imperfectly ventilated.  Animals which are
kept in low, damp places, and fed upon bad food, will have tubercles devel-
oped in some part of their systems; and we find scrofula  to abound among
the inhabitants of damp and close situations, whose diet is of an unwhole-
some and innutritious character.   Individuals are  very apt to imagine that
because they do not immediately experience the  evil effects resulting from 
16
AMERICAN  FAMILY PHYSICIAN.
  an inattention to the laws of health, that,  therefore, they can continue
  their aggressions with  impunity; but  all must remember that the mis-
  chievous consequences proceed slowly or rapidly, according to the condition
  of the constitution, and the character of the exposure,  and that sooner or
  later they will suffer the inevitable  punishment of their folly  and disre-
  gard, by the appearance of some form of disease which will not only inter-
  fere with the proper enjoyments of life, but will tend, likewise, to more or
  less  speedily terminate that life.  More  than one-half of the numerous
  invalids who have applied to me for  relief, were made so by an inattention
  to the laws of health, as, breathing an  impure air, eating improper  food,
  the sedentary occupation of  hot rooms, uneleanliness,  intemperance, &c3
  and more commonly, by being exposed to one or several of these  noxiou3
  influences during the period of growth.
    All places where individuals congregate together in numbers, as churches,
  theatres, ball-rooms, &c,  should be so arranged that there may be kept up
 a constant circulation of fresh air, and to  effect this  there  are no better
 ventilators than large doors and windows; the various plans of ventilation
 by other means, are of but little service in  large and  crowded  assemblies.
 The air of such places is vitiated by  the enormous  consumption of oxygen,
 and the augmented quantity of carbonic acid exhaled and diffused through-
 out the atmosphere of the room.  It  is calculated that one thousand  per-
 sons  will, in one hour, consume four  thousand hogsheads of air; so  that
 in crowded assemblies we soon have  the evil effects of an air exhausted oi
 its normal proportion of oxygen, and poisoned by the exhalations from the
 lungs and skin, as well as by fires and  light  when these are used.   And
 the depressing sensations, the headaches, the faintings, &c, which occur in
 crowded places are not owing, as is generally supposed, to the heat, 'but to
 the inspiration of impure air.   All rooms,  whether private or public,
 should be well ventilated daily;  and  the apartments of  the sick  should
 especially, be furnished with  a  constant access of fresh air,—it is more
 refreshing, more reviving, and more beneficial  to them, than all the medi-
 cines which may be prescribed for them  without an attention to this point
' Yet the doors and windows are not to be  opened at random,—some  pru-
 dence must be observed,  that the patient  be not exposed to a current  or
 draught  of air, so as to expose him to any  dangers, and  much  benefit will
 accrue by frequently sprinkling  through the room and over the bed,  some
 vinegar or other vegetable acid; and, in the ease of epidemic or contagious
 diseases, some acid thrown upon chloride of lime, or chloride of soda  will
 by disengaging chlorine vapors,  tend much to purify the atmosphere.
   The management of schools at the present time is extremely prejudicial to
 the health of the rising generation; yet parents appear to act in this  mat-
 ter as though education was everything and health nothing—as if they  were
 perfectly contented, so they were free from  the rearing and governing of
 their children at home, resting perfectly satisfied to trust the health, happi-
 ness, and lives of their offspring to any one bearing the name of "teacher,"
 without investigating his capabilities, their only desire being, apparently, 
VENTILATION.
17
a freedom from the responsibilities of training noisy, boisterous, and trouble-
some boys and girls.  Children should never be sent to school until they
have reached their seventh  or  eighth year;  their  brains and nervous
systems are too immature previous to this  age,  too  susceptible,  and too
easily acted upon by extraneous influences,  to  be exposed to the  horrible
torture  of sitting silently for hours in a  close,  crowded room, under the
surveillance of a dreaded master,  who, to  please the parents and enjoy the
reputation of being a good teacher, is tasking their little tender  brains to
the utmost limit.  No wonder children hate school, hate teacher ; no won
der that intelligent infant scholars, have their brains  so injured as to make
dull men—no wonder that an immense amount of children die yearly from
this neglect of physical cultivation.
   Children need  exercise and pure air, not only exercise of the muscles
but of the lungs—rheumatism, bronchitis, laryngitis, consumption, liver
affections, are traceable, in six cases out of ten, to the unnatural, unscien-
tific, and tyrannical  modes of school government.   If it is desired to have
intelligent men, possessing minds of  strength  and activity, an  honor to
their parents, to  themselves, and to their  country,  cultivate first their
physical development.  Instead  of keeping  them in-doors, fashionably
dressed, so as to interfere  with all  natural thought and action,  let them
run, let them play, let them  laugh and  scream,  for  God  intended they
should do these things.  By these means they impart strength and vigor
to their muscles, to their nerves, to their lungs,  to their brains, and when
at their seventh or eighth year, they are for the first time placed in a prop-
erly conducted school, the parent will in a short  time find himself amply
repaid for all his apparent previous neglect of  his  child's  education, and
that, too, without any impairment of that  child's health.  Parents look to
this,  for teachers  will not change their course, nor  abate one whit of
authority, until you  require it of them.  It would be, however, ungenerous
to rank all teachers in the above category.  I am pleased  to say I know
many, who deeply feel the truth of what I have been stating, but  cannot
put their sanative views into operation, because many foolish and ignorant
parents will not permit it.
   School-rooms should be kept clean and  well  ventilated,  and  instead  of
illowing the children but  one intermission in the morning, and one in the
afternoon  session,  they should  be required  to perform some exercise, if
only of  five  minutes duration, at  least every hour,  or  after every lesson ;
indeed, previous to  engaging in each new lesson, or department of study,
as from reading to  spelling,  from  this to history, from this  to writing, &c,
a short time should be devoted to some physical  exercise which  will not
only give relief, both mentally and physically,  but will cause an increased
amount of air to be inhaled, and thus  invigorate the whole  system.  Ana
the pernicious course of making  children sit erect for hours  with their
arms  folded  across  their breasts,  should be  discountenanced by  every
parent and  teacher;  if their arms must be  folded,  always have them
across the back, which will assist in expanding the r> mcles of  the chest,
      2 
18
AMERICAN FAMILY PHYSICIAN.
 and preventing " round shoulders."   These remarks are equally applicable
 to the management of girls as well as boys.   The error of a mode of edu-
 cation, the most essential object of which i3, to keep children still, must be
 apparent to every observing mind.
   Impure air is also occasioned by burning lamps with long wicks, which,
 saturating the atmosphere*of a room with smoke, renders it very detriment-
 al to health.  The burning of fuel of any kind, also vitiates the air of an
 apartment, more especially if a stove be used for this purpose; and all rooms
 containing fires should be ventilated twice a day, by opening the doors  and
 windows, and permitting a fresh current of air to pass through.  Charcoal
 should never be burned in a close apartment, and particularly in a bedroom,
 the vapors of carbonic acid gas to which its combustion gives rise, soon fill
 the room, and occasion fatal results ; many deaths are on record, which were
 caused by an ignorance of this fact.  Sleeping apartments should be aired
 regularly, and, it is better that fires should never be kept in them, especially
 during sleeping hours; but when fires  are kept up  during the  night, some
 means should be devised by which fresh air may have constant access to the
 room, except when th.e house is in the neighborhood of a low  marsh, or  a
 lake or pond of stagnant water; in which case, means should be employed to
 screen one's self from the influence of  their damp and noxious  exhalations.
 It is a very pernicious course to place many persons in  one  sleeping apart-
 ment, and if persisted in, the  occupants will sooner or later  suffer from
 disease; much of the danger may be obviated by allowing a free circulation
 of pure air through the room during  the night.   Beds  should frequently
 be exposed to the action of the open air at mid-day.  Plants generally give
 off oxygen through the day, and carbonic acid  during the  night,  at  the
 same time imbibing the oxygen; hence, it is a dangerous and unwise practice
 to keep plants, flowers, &c, in the apartment devoted to sleeping.
  Cellars, wells, mines, the holds of vessels, and  places of similar character,
in which the air has been  long confined, frequently contain large quantities
 of carbonic acid gas, which is immediately destructive  to all who  impru-
dently enter and inhale the poisonous  gas.   Such places  should  never be
entered by any one, until it has been first ascertained if combustion can be
supported; this may be accomplished  by letting down, or  introducing  a
lighted candle within the cavity  or  place to be entered, and  observing
whether it burns or not—if  it continues to burn brightly, there is no  danger,
but if  it burns  dimly, or the flame is extinguished, instantaneous death
would happen  to whoever ventured within.   The introduction  of slaked
lime  into such places will  speedily  render the air pure and capable ot
sustaining animal life, because the carbonic  acid  gas having  a chemical
affinity for the lime, unites with it, forming a carbonate  of lime, and  the
pure air rushes in to supply the absence of this  gas.   Ammoniacal water
will also effect a similar result, the carbonic acid uniting with it to  form  a
carbonate of ammonia.
  All apartments in which crowds assemble very  often, and tn* Aoids of
vessels, should be cleansed and white-washed  frequently; or,  if white- 
VENTILATION.
19
washing is not permitted, arrangements should  be  made  by which  slaked
lime can  be kept in various parts of the rooms, and which should be freshly
renewed immediately previous to each meeting.  Damp  cellars  should  be
carefully attended to, especially in hot weather; they should be kept clean,
ventilated  often, and be sprinkled every week or two with unslaked lime.
I have known severe attacks of disease to occur in houses, where, although
cleanliness was bestowed upon all that portion  above the  cellar, this was
permitted to remain damp, and accumulate foul  and noxious vapors,  which
originated the attacks referred  to.   Rooms  under  ground  are  always
improper places of residence,  whether they  be used as kitchens,  offices,
workshops, or as sleeping rooms, and  should positively  be prohibited  by
law.  But some legislators, as with some parents, pay little attention to the
laws of health,  and more to the enactment of laws to favor wealth,  luxury,
and other matters  calculated  to destroy health, enfeeble  the  mind, and
shorten the duration  of life.  During the hot  summer  months, accumu-
lations of filth in cellars, rooms, or about houses, or  in the public streets,
Bhould not be permitted, and where they  exist, they should be  immediately
removed, and the  places at which they were collected purified'by sprinkling
with lime.  Frequent cleaning and white-washing  fences, out-houses, and
yards, will be found conducive to health, and  will abundantly  repay the
labor thus bestowed.
  The vapor of sinks or privies is  extremely disagreeable and  unhealthy,
and in  warm weather, means should be taken  to decompose it.   This gas is
a combination of sulphur and hydrogen, and is called sulphuretted hydro-
gen, or sulphydric acid, and blackens silver, copper, tin,  &c, with which it
comes in contact,   forming  sulphurets of these various metals.  Ammo-
niacal vapor often  exists with  it, being  evolved in  the  decomposition  of
urine.  Sulphydric acid is very deleterious to animal  life,  an  atmosphere
containing one  thousandth of its volume of this acid will kill a dog, and one
two hundred and fiftieth will  destroy a horse.  Six or  eight pounds  of
copperas  (the commercial sulphate of iron) thrown into a privy, will suffice
to decompose the sulphydric acid, and keep the place free from unpleasant
odor for two or  three months, and will not cost  over thirty cents.  Every
family  in cities should be required to use  this agent in their privies, two or
three times a year.   Prepared Charcoal in  powder, but in larger quantity, will
have a similar effect.   In the selection of a city  council Board, or Superin-
tendents  of a city, the  inhabitants should  appoint only those of intelligence
and liberality, and  whom they know to be acquainted with the laws of
hygiene, for it is only by a rigid observance of these laws that the health of
a city can be  maintained.  There are several  cities in  this country  where
from the ignorance of the authorities on  these matters, the citizens are no
allowed to cast their refuse matter in  the street,  nor  is any course, adopted
by which  they can get rid of it; the consequence is, that they are obliged to
have a collection of putrid matter in or around their houses, and which,  in
warm weather, is  sure  to  generate  disease.   And  as long as  the  people
passively submit to be the servants and subjects  of  these Agislators, they 
20
AMERICAN  FAMILY PHYSICIAN.
need not expect much reform on such points.   When will  the  people of a
free country learn their true position—that they are the masters—and must
have all legislation done correctly, to benefit the mass, and not individuals?
  The action of the sun's rays upon the atmosphere of the earth produces a
condition favorable  to health and  animal life—or, in other words,  the
atmosphere becomes more highly vitalized under the influence of the sun's
rays; hence, exercise in the open day air,  but not immediately under  the
intense action of the sun, imparts vigor and energy to the system.   My own
view of this matter is, that the electrical rays of the  sun   acting upon the
electricity of the earth's atmosphere, impart to it  a vivifying and highly
invigorating power.   But when this influence is withdrawn, as  during the
night, the temperature of the atmosphere  becomes reduced several  degrees,
dew and moisture is formed  and deposited,  noxious  vapors  which were
compelled to hide themselves from the presence of the sun,  stealthily diffuse
themselves, and disease is more readily  developed.   Hence an  exposure to
night air is  always  pernicious, more particularly  among those who  are
laboring under, or are disposed  to sickness, as well  as among  those  who
imprudently expose themselves to its influences.  When it becomes neces-
sary to brave the night air, the person must be properly clothed,  according
to the season; in intermittent or other epidemic locations,  exercise to any
great amount should be avoided; great  care should  be observed never to
leave a room, whether private or public, when in a state of perspiration, at
least, without the addition of some extra garment to protect the person from
the chill air; and while in  the  open air  of night,   moderate  exercise, as
walking or riding, should  be  taken.  Yet, although the  night air is  less
healthy than that of the day, it is much more healthy than  the  atmosphere
of a confined room,  in which several individuals have been  sleeping,  and
hence should always be permitted to circulate in such apartments, when there
are  no  contra-indicating circumstances.
  The atmosphere in the neighborhood of  marshes,  or  ponds  of stagnant
water, in consequence  of the noxious gases evolved from the decomposition
of vegetable matters contained therein, is peculiarly unhealthy, particular! v
during the latter part of summer and through  the  autumnal  season •  and
the pernicious results arising therefrom are more marked during the night
from sunset to sunrise.  I have not the least doubt,  however, that much of
the baneful action of marshy emanations, is owing more to the diffusion of
microscopic spores of poisonous cryptogamic plants, which are wafted along
by the night winds,  than to deleterious  gases.  Wherever  there  is decom-
position of organic matter, there will be  found this species  of vegetable
growth in greater or less abundance ; which if not visible to the naked eye,
is readily discoverable by the microscope.   Hence, it has frequently hap-
pened that on opening an old sewer or place of filth, these  spores have been
conveyed in a course which caused disease on  one side of a street while the
opposite side remained healthy.   This certainly could not be the case with a
gas, which would so diffuse and intermingle itself with the atmosphere, as to
affect both sides of a street in a similar manner. 
VENTILATION.
21
  Persons residing in marshy districts usually  present undoubted marks of
unhealthiness; their countenance is pale or sallow, the limbs and abdomen
are frequently bloated, and mental energy is impaired or almost destroyed;
they are subject to loss of appetite, indigestion, diarrhea, dysentery, bilious
fever, and intermittent fever; and, whatever may be  the form  of disease
under which they labor,  one  of its  most prominent symptoms, is, almost
universally, a well-marked periodicity.   To preserve perfect  health in such
locations is almost impossible.  The best course for one to  pursue, when
thus situated, is regularity and temperance in all things; keep the bowels
regular, the skin clean, and use a plain, nourishing, but  easily digestible
diet.  The early morning  air should be avoided as much as possible, not
going out to work or exercise  until the atmosphere has experienced the
genial influence of the sun's  rays, as evidenced by the disappearance of the
fog which had been covering the surface of the earth, and then work moder-
ately and without haste.  On the  setting of  the  sun,  retire within the
house, all the rooms of which must have been thoroughly ventilated through
the  day, and close the doors and windows.   In damp weather the sleeping
apartments, which should never be upon the ground floor, but in the upper
story, must be kept  dry by having a fire in  them  through the  day, which
should be extinguished on retiring to bed.  In the  fall of the year, fires
built close to the marsh  will  be found advantageous, not by decomposing
any poisonous gas, but by  creating a current, which will convey the crypto-
gamic spores to the flames and thus consume them.
  Many persons residing in districts to  which epidemics are common,  espe-
cially fever and ague, are, every spring and  fall,  in  the  habit of taking
some domestic "tonic bitters" every morning previous to breakfast  or going
out  into the morning  air,  and I have no doubt of its usefulness; these are
usually composed of some  simple bitter and stimulating agents combined,
as, for instance:—Take  of Wild Cherry Tree  Bark, Black  Cohosh Boot,
Prickly Ash Bark, Dog  Wood Bark, each, in powder, one ounce; Mandrake
Root,  half an ounce;  Cinnamon, Ginger,  Cloves,  each,  two drachms;
Capsicum, one drachm;Whisky, four pints.  Mix together, *&nd allow the
mixture to stand several days, frequently shaking  it;   the  dose is half a
wine-glassful every  morning.  This formula  I  obtained  from a farmer
residing in a section of country in which fever and  ague is  common, who
assured me that by using it every fall and spring, his family and  laborers
were not so liable to "take the chills," as in  seasons when  its  use was
neglected.  I knew two  planters in Mississippi, who, while their neighbors
lost a great number of their blacks by a severe form of bilious fever  prevail-
ing at the time, so managed their own servants, as to  lose very  few.  This
was effected by allowing them every morning, before they started for  their
work, a cup of coffee and  some bread.  And a similar course  pursued in
all marshy countries, or  locations  where epidemics  are common, among
those who are obliged to commence labor at early dawn, would undoubtedly
be found advantageous.  These means, beside  the stimulus they afford, aid
in preserving the bitter principle of the bile, which imparts to the system a 
22
AMERICAN FAMILY PHYSICIAN.
power of resisting the approach of the above forms of disease.   A residence
by the sea-side, or an exposure to the  sea-air is beneficial to all  healthy
persons, and the majority of invalids.  This  air  contains a purity  and
sharpness not to be met with elsewhere, and is especially adapted to patients
laboring under forms of  disease  attributable to the influence  of  noxious
vapors.   Scrofula,  rickets, chlorosis, many nervous affections, &c, may be
materially benefited by frequent sea-bathing and a continued exposure to
the influence of sea-air, particularly in situations where the climate is mild
and equable; but, as  in other instances, cold,  damp weather, or sudden
changes must be avoided.  Many diseases are benefited  or cured by a  sea-
voyage ; this is owing partly to the purity of the air, and partly to the shock
experienced by the system from sea-sickness, together with the change of
diet, scene, occupation, and the new mental excitement.
  There is a peculiar substance, found by Schonbein to exist in the atmos-
phere,  under certain circumstances,  to which the name of ozone has  been
given.   It is the most energetic oxidizing substance known,  as well as the
most effective bleaching principle.   In consequence of these properties it
acts as a potent disinfectant, consuming the unhealthy emanations which
float throughout the air.  It is said to  be present in the  greatest abundance
in winter when snow is on the ground; also in open country places, especially
those along the  sea-coast; as well  as directly following a thunder storm.
When absent, or  deficient in quantity, fatal  forms of disease manifest
themselves; it was said  to be absent especially during the seasons of Asiatic
Cholera.   When phosphorus is exposed to the action of moist air,  ozone
may be observed;  also, in  the spark obtained  from  the  electric machine.
Those who wish to discover its presence in the air, may accomplish it by the
following means :  To fifty grains of distilled water, add five grains of starch,
and half a grain of iodide of potassium; moisten a piece of paper with this
solution, and dry it.  When required for use, moisten the paper with water
and expose it to the  air; if ozone be present, the paper will  become  blue,
the depth of the color denoting the proportion contained in the atmosphere
CHAPTER  II.
  Food.—General Rules for Diet.—Quantity of Food.—Quality of
       Food.—Meals.—Condiments.—Mastication.—Attentions
                  to the Teeth.—Modes of Cooking.

  Food or aliment is necessary for the existence of all organized  beings
but the  requisite quantity and quality depends  very much  upon  the cli-
cumstances connected with each individual case.   Thus, some live entirely 
FOOD.
23
flapon a  vegetable diet, and enjoy excellent health; while with  others, a
portion of animal food is actually necessary.  When I was a young man, I
followed a strictly vegetable diet for three years,  at which time  I became
attacked with a scorbutic disease which resisted the various remedies pre-
scribed for its removal; by the advice of an old  physician I resumed the
use of animal food, and the disease left me in a  few weeks.   I have met
with many other individuals upon whom a strictly vegetable diet  produced
similar  influences.
  General rules for diet  are all that can  be given,  each  individual mus
make an application of them to himself;  for  it will be found that many
articles viewed and  recommended as healthy and nutritious,  will  produce
with some persons much distress, while others can use them with  benefit—
that one stomach will bear almost anything with  impunity,  while with
another, great care  must be observed  in  selecting suitable food  for it to
digest.   Hence, the necessity  of every person being thoroughly acquainted
with his own peculiarities in this respect.   I am acquainted with  a  gentle-
man  with whose stomach every article of diet  agrees,  save  custard;  the
instant  the first teaspoonful reaches his stomach,  he is  attacked  with a
diarrhea, which almost always requires medical aid before it can be removed.
This has proved a source of much annoyance to him,  especially at times
when away from home, and when in a moment of forgetfulness he has taken
a spoonful of this article, which invariably requires  him to leave  the table
immediately.
  An author justly remarks, " almost any common food is wholesome to a
temperate man, who'preserves his body and his mind in an active but not
hurried state; for  thus he ventilates and purifies  his  blood,  and brings
every fiber of  his frame into the best condition for the proper enjoyment
and use of life.   It is astonishing how much the health is often improved
by thinking nothing about it, but just going  about one's  business,  and
using the common means  of subsistence under  the guidance  of common
sense and a  good conscience.   But mere  ignorance  cannot do  this,  and we
must be able to consider  before we can  reasonably do  our  duty.   Even
savages have their rules of health, and no one has ever reached a hale old
age without due  attention  to exercise,  air, temperature, rest, and diet.
Although the  dieting of soldiers and sailors may prove what is the average
requirement in respect to food by persons laboriously employed,  yet this
average itself indicates that nature is very accommodating, or such a vari-
ety of constitutions eould not  all be treated in the same manner.  Positive
rules for the direction of appetite are not consistent with nature, and every
one who possesses reason will  ordinarily find a better guide in his own dis-
cretion  and  good sense than in any dietary that the doctor can direct."
  In partaking of food, much will depend upon the appetite; if this be
healthy or natural,  a proper amount of aliment will  refresh and invigorate
the system;  if it be  artificial, that is, excited by stimulants of various kinds,
not only will the stomach be  seriously  injured,  but irreparable  mischief
will frequently be done to the  system.  Some persons form an appetite ef 
24                  AMERICAN  FAMILY  PHYSICIAN.
habit,  that is, accustoming themselves to eat at certain hours, whether the
food is required or not, and often without any relish for it;  such individ-
uals, as well as those who take food without an appetite,  are very apt to be
complaining that "food does not seem to do them any good," as well as to
be laboring under a host of disagreeable  symptoms, which speedily destroy
health and life.
  Food taken  into the  stomach from an artificial appetite, is always imper-
fectly digested, and must, as an inevitable consequence,  produce disease,  if
such a course be persisted in; for as soon as the  influence of the stimulus
has passed, the stomach returns to its original  torpid condition, and instead
of the food being digested, it decomposes and putrefies, and passes out of
the stomach in a condition calculated to  create  disease and shorten  life.
I have observed among my own acquaintances, that of those who were in
the habit of provoking  their appetites by  stimulants, the great majority did
not live to exceed the prime of manhood, and I  have no  doubt but  that
this will be found true generally.  When an  individual  has no desire for
food,  it is always better  not to  eat,  because an abstinence for a certain
period, if not of too long duration, will cause a return of the natural appe-
tite ; yet, invalids who have no appetite frequently eat, not that they desire
food but because it is the regular  hour for meals, and in this manner they
perpetuate the want of appetite,  and increase the  severity and obstinacy
of their afflictions.  It is  much better to pass one,  two,  or even twelve
meals, than to injure the  stomach, and consequently the whole system, by
forcing food into  it, when it is neither craved nor relished.
  Occasionally the functions of the digestive organs may become so torpid
that a mere  abstinence  from  food  will  not  restore  them  to  a  healthful
activity, and should the person wait for  a  return of  his appetite, serious
and permanent mischief  might be the consequence.  However, in nearly
all such cases, an attention to the functions of the skin, and to exercise in
the open air,  with regularity in sleep, and proper medication,  will arouse
a sufficient degree of digestive energy for the purposes of animal existence,
and which, when developed, may be still further improved by a careful
observance of the quantity and quality of the food, as well as of its proper
mastication.  Very rarely, indeed, is it  necessary to  provoke  an appetite
by stimulating the coats of the stomach to a transitory activity, and he who
is guilty of such a transgression must not expect to live half of his days.
  The quantity of food  to be taken at a meal,  depends entirely  upon  cir-
cumstances; generally, individuals eat nearly  twice as  much as is neces-
sary for the requirements  of the system.  Laboring persons  require more
food than those of sedentary professions.   But this must be regulated by
the age, the amount of exercise, the  wear and tear of the body, and the
character of the climate, as well as by the composition and digestibility of
the food.  On an average,  a healthy adult,  in a  temperate  climate, who
takes  moderate  exercise  daily, may use from  twenty-five to thirty-five
ounces of solid food per day;  if the temperature  of his location is consid-
erably elevated,  much  less will suffice, and, if it be  considerably dimin- 
                        QUANTITY  OF   FOOD.                      25
I
ished, more will be required.  As a general rule,  the  proper quantity of
food to be taken at one meal can be better determined by the feelings of
the person than by any specific formula,  provided  it be  eaten  slowly and
with a due attention to its thorough  mastication.  By  this I do not mean
that individuals should abuse their stomachs and eat to  satiety, as this is
extremely improper and  unhealthy,  but  that  when  a  sensation of ease,
satisfaction,  and mental and physical quietude  is  felt, enough has been
received  into the stomach.  It were generally better for all persons to rise
from the table with an appetite, having eaten just sufficient to avoid a defi-
nite feeling of satisfaction,  and the necessary quantity may be  ascertained
in a short time, by each one observing, for several meals, what amount of
food is required to produce  the above-named effect in  his  particular case.
The same rule  holds good with patients  laboring  under chronic disease,
but without loss of appetite; fever patients,  and  others whose  appetites
are diminished, should never eat  largely, nor produce an artificial appe-
tite by any means whatever.  It may at first be a  severe  tax to  rise from
the table, not fully satisfied with what has been  eaten,  but custom will
soon make it easy, and whoever pursues this  course will  be fully repaid
for his forbearance, by a freedom from those discomforts,  and  unpleasant
sensations so frequently following the full  indulgence  of the appetite.
   Two meals a day with a moderate refreshment between, are sufficient for
health;  but they never should exceed three.  Breakfast, as a general rule,
Bhould be taken soon after rising and dressing, except  in those  cases where
an early breakfast disagrees, and where active exercise before this morning
meal appears to benefit the individual.   Children are frequently  injured
by working them or sending them to school, before they  have eaten break-
fast ; and the  danger of  infection  from  contagious  disorders,  epidemic
causes, &c, is greatly enhanced by an exposure to their influences before
breakfast. This meal should be of vegetables entirely, using no animal
diet at all, and generally  speaking, it may be a  full, healthy meal, more
particularly among laboring people.
   The dinner should  be  taken  about six hours  after  breakfast,  though
many persons who eat only two meals per day, enjoy excellent  health by
having an interval of  eight or ten hours between them.   The stomach can
easily be made to adapt its wants in this  respect to any length of intervals,
by attention and cultivation for a few meals.  With hard-working men,
 the dinner may be composed of an equal amount  of vegetable  and animal
 food; while with the sedentary, animal diet should be  eaten sparingly, and
 only once or twice a week.  A moderate amount  of fish,  soft-boiled eggs,
 or oysters, may be substituted for the  animal  diet  with benefit,  in all cases
 where they agree with the system.  This  meal with a  hard-working person
 should be a full one.
   Supper is generally an  unnecessary meal,  and those who can dispense
 with it,  will  find  it an  advantage  to  health, and  to  refreshing sleep.
 Yet those who  dine very early, or who exercise actively may find it neces-
 sary to take a  light vegetable meal at the close of  the day, in order to allay 
26                 AMERICAN FAMILY  PHYSICIAN.

hunger and dispose to sleep.   Supper should be light, and ought always to
be taken two or three hours before  retiring for the night, otherwise it will
be very apt to prevent  sleep, or occasion an  unrefreshing sleep  accompa-
nied with disagreeable dreams.
  The habit of taking a lunch  or luncheon between  meals is a most perni-
cious one,  particularly to persons not engaged in active exercise.  How-
ever, the  most sedentary sometimes experience a desire for food between
their ordinary meals, occasioned  frequently by a little  more exercise than
is usual with them ;  laboring  people may also  require a lunch, especially
when extraordinary labor  and the depressing influence of heat, produce a
sense of fatigue or debility with hunger.  In  all these cases, the  use of
ripe fruits will be found more beneficial than any  other article that can be
used.  But no person should provoke an appetite of habit for any species
of food, by eating between meals, when the  stomach does not call for it;
because,  if persevered  in,  it will give  rise to some form  of  disease.   The
tavern  lunch,  assisted as it usually is, by one or more  draughts of intoxi-
cating  liquors, is a most  dangerous custom,  being equally  destructive to
both the  physical and moral health of those  who engage in it.
  Although it is utterly impossible to sustain life upon  any single aliment-
ary  substance, no  matter how nutritive  it  may be,  it is  by no  means
proper that a  great variety of food should be taken at one meal.  Such a
course interferes with the functions of digestion, and will ultimately give
rise to disease.  The fewer the  articles of diet used at any meal, the better
will it  be  for  the health of the person,  and  the normal  condition of the
stomach.  An excess of food at any time causes giddiness, lassitude, unea-
siness, distension of the stomach, and drowsiness,  and if  persisted in,  will
ultimately destroy health and life.  And when  a person experiences  any of
these sensations, he is thereby warned that he has  eaten too much.   Those
who are disposed to apoplexy,  should eat a nourishing, digestible diet, but
always in  moderation, and on no account should they permit themselves to
sleep after a meal, particularly if it has been  a full one, on account of the
tendency at this time to an attack of the disease.
  The quality  of the food is  a  very  important  consideration.   Man  is
undoubtedly an  omnivorous animal, and requires  both animal and  veget-
able  food, the  first of which yields a much larger  amount of nourishment
than the latter; but it must not be forgotten  that a too highly nutritive
diet is  as  detrimental to  health and longevity as  that which contains an
insufficient quantity of nutriment.  Consequently it is better to use animal
diet in proportion to the quantity of vegetable  which is consumed, accord-
ing to  the requirements of the constitution.
   Vegetables  require a longer period for digestion than animal  diet  and
are likewise more apt to  produce acidity  and  flatulency;  those,  however
which are cooked, usually digest the more readily, though in this form they
are not always adapted to the  nutrition of the  system, from  the fact  that
the application of heat more or less completely  destroys their organization.
Animal food digests more readily than vegetable;  and  though the flesh of 
QUALITY OF  FOOD.
27
 young animals is more  tender and soluble than that of the adult animal.
 yet it is frequently less digestible.  For instance, it is well known that beef
 and mutton arc more  readily digested, and are more healthful than veal
 and lamb.   Yet  vegetable  diet  affords  as  much  nourishment  to  the
 system as animal, and without  occasioning as much  stimulation,  heat, or
 repletion of the blood-vessels; and, as a general rule, they who use animal
 food sparingly, have a better appearance, more strength, and more cheerful
 spirits than those wno  partake  largely of it; their  muscles are likewise
 firmer and more plump, and their  skins more clear and free  from disease
 Animal diet increases the action of the heart and arteries during digestion,
 renders the blood thicker, richer, and more stimulating, and causes a greater
 tendency to inflammatory and other forms of disease, than one of a vege-
 table character.
   In relation  to the kind of food best adapted for use, each individual
 should  observe what  articles  agree  best with his stomach,  for  it  is
 frequently the case that an article which  would be perfectly proper and
 quite  healthful for one class of persons, would produce much  derange-
 ment in others.  Again, the inhabitants of one climate will on account of
 the excessive heat or cold, require  directly opposite kinds of food to main-
 tain health and support life.  Thus, the natives of Greenland could not exist
 unless they largely used oil and fat meats, which causes a large quantity of
 carbon to be formed in the system, and  the combustion  of which by the
 oxygen of the  air, produces a great degree of heat, sufficient to enable the
 system to resist the intense coldness  of their climate.  Again,  in tropical
 climates, and  in temperate latitudes during the  hot season, the system
 requires a smaller quantity of food, and of less carbonaceous quality; because
 the  air being expanded, less oxygen is  inhaled at each inspiration than  in
 cold climates;  and, when the inhabitants  of warm countries consume large
 quantities  of food,  an excess of carbonaceous matter  is produced  in the
 system, which  not being destroyed by the  oxygen  of the air,  engenders
 disease of the  liver,  bilious fevers, &c.   On the contrary, a deficiency  of
 carbonaceous food in cold countries, or in cold seasons, when there  is an
 excess of oxygen, diminishes  the  animal  temperature^ and  gives  rise  to
 pulmonic diseases.
   There is one thing however, which I may state here, and that is, that
 many vegetables are rich in carbon,  containing  it probably more  largely
 than animal flesh;  and,  no doubt, a  diet from such  vegetables  would
 be  more beneficial to even those  residing in  cold  countries, than the
 excess  of animal food  so  commonly used.  Intellectual  activity is very
 much diminished by an excessive use of flesh, while on the contrary, those
 who eat  sparingly of it,  have a  greater  degree  of  intellectual and  moral
 power.  This fact may be  readily  ascertained by comparing  meat-eating
 nations with those whose  fare is principally derived  from the vegetable
 kingdom.
  Children require  much less animal  food  than adults, and females  than
males, and whatever may be the custom or business of  an  individual, the 
28
AMERICAN FAMILY PHYSICIAN.
 quantity of animal food should be greatly diminished in warm weather; in-
 deed, for the  sedentary, and  those of full habit,  it were better to eschew
 meat entirely  during the hot months of the year.  In cold weather, a more
 stimulating and persistent nourishment is needed than in summer, and a
 certain  amount of animal food will generally  be of benefit, more  espe-
 cially to  those  of active, laboring habits.
   There is no doubt that an excess of animal diet vitiates the fluids of the
 system;  and  we most commonly find  that those  who are laboring under
 " humors,"  as scrofula,  cancer,  cutaneous diseases,  &c, are either  great
 flesh-eaters  themselves,  or  their immediate predecessors were.   Animals
 are as liable to disease as human beings, and however apparently pure their
 flesh may be, a tendency to  disease  is  imparted  to those  who  consume
 it.  But when the animal itself is diseased, by the pernicious habit of stall-
 feeding,  to  fit it for  our markets,  or by a forced driving  from country
 pastures, the deleterious consequences arising from the use of their flesh as
 food must be, as is evident to every discerning mind, of a serious character.
 Large flesh-eaters,  and especially those in country places where pork in
 some form is eaten at every meal, are very liable  to epidemic and malignant
 diseases; and thousands have died of typhoid, bilious, and congestive fevers,
 of dysenteries, of cholera,  small pox,  &c, who  might have been  saved, il
 their systems  had  not been vitiated  by the gross character of their  food.
 And among children,  those who  are  the greatest flesh-eaters,  are  more
 subject to worms, diarrhea, &c.
  Condiments should  generally be avoided, because  they generally over-
 stimulate the stomach, causing an artificial demand for more food than is
 necessary, and a repetition of  which must ultimately  weaken, if not actu-
 ally disease that organ.   The plainer and  simpler the  diet, the greater will
 be the mental  and physical health and strength.  Hence,  persons who are
 constantly  indulging  in high-seasoned food,  rich  puddings and pastry,
 mince pies, plum pudding,  plum cake, hot bread, &c, are as constantly
 suffering from some kind  of  affliction, for which  they are  obliged to  be
 almost constantly under the physician's care.  It is not necessary, however,
 that food should be unpalatable, because  if this is the case,  the  stomach
 will refuse  it; it should be plain,  nutritious, and palatable, and sufficient
 should be eaten  to prevent the system from becoming debilitated.
  In  speaking  of the  various  articles of diet separately,  a few  pages
 beyond, further reference will be made to the above points.
  The manner of eating  is by no  means a trifling  consideration; it  is as
important to health and proper digestion,  as  an attention to the quantity
 and quality of the food.   But to witness  the major portion of American
 meals, and especially at  public places,  one would suppose  that  it was a
 matter of no interest how food was eaten,  so it became safely lodged in the
stomach.  A stranger to the habits of this country, on witnessing a meal
on a steamboat, or  at  a hotel, would  be led to  believe either  that the  par-
takers thereof were eating on a wager, and that the first one from the table
would be winner, or that the meal was so obnoxious a task, that every one 
MANNER OF EATING.
29
endeavored to hasten through it as rapidly as possible, pouring soups, fish,
meats, custards,  pies,  liquor, nuts,  oranges, raisins, &c,  into the stomach
en masse, without regard to quantity, or their preparation for the digestive
organs.  No wonder that  headaches, dyspepsia, consumption, hepatic affec-
tions, and  premature  old age,  are  so common among us;  and especially,
when we consider that the destructive influences of such a course are most
generally aided by a want of exercise, various dissipations, &c.
  For at least half an hour previous to  a meal, and an  hour  after, more
especially with the dinner or principal meal, active bodily and mental exer-
cise should be avoided as much as  possible;  thus, running, long and hur-
ried  walking, protracted  speaking  or singing, serious or active  study or
thought, &c,  are  exceedingly  improper  at  such times.  The individual
should endeavor to compose his system, and  thus prepare his  stomach for
the  meal, and maintain  this  state of quietude for  about  an  hour after
finishing the  meal, in  order  not to interfere with  the  digestive action.
Such a course will permit the stomach to properly digest the food, prevent
disease, impart strength and nourishment, and entirely obviate a tendency
to dyspepsia.
  During a meal, little or  no  fluid of any kind  should be drank, as it
distends the stomach,   dilutes the gastric juice, impairing its -digestive
solvency, and thereby increasing a disposition to gastric affections.  Observe
animals in  this respect, they never eat and drink at the same time.   When
drink is taken during or soon after  a meal, it should not be too  cold nor too
hot,  but moderately warm ; because heat  being necessary to digestion,  the
cold  beverage  arrests the digestive process, causes the  food to remain undi-
gested in the  stomach, often for several hours, thus  producing dyspepsia,
obstructions,  &c;  and  if the drink be too  hot,  the  stomach is too much
stimulated, from which, when reaction takes place, results debility, and loss
of action of the organs concerned in the function of digestion.
  Powerful mental excitement  should be avoided immediately  previous to,
during, or  for some time  after a  meal, especially anger; many a person
disposed to apoplexy,  epilepsy, or other form of disease, has brought on a
fatal attack by eating immediately  after  some intense excitement  of  the
mind, and even by becoming angry after a temperate  meal.  Sexual cohab-
itation after a meal, is frequently indulged in; this  is exceedingly perni-
cious,  and  though in  the young adult it  may be practiced with apparent
impunity, it will certainly and invariably  give rise to some  permanent and
serious disease'if persisted in.
  A  meal should always be made a time of mental and physical relaxation ;
instead of the gloomy,  melancholy, and hurriedly anxious appearance of
our  mysteriously  taciturn  eaters,  who,  at  a meal,  resemble criminals,
instead of honest,  intelligent  individuals,—cheerfulness  and  sociability
should prevail; conversation of a  light,  interesting  character should be
indulged in, so that all, even to children at the table, may participate;  the
meal should be consumed leisurely, without hurry, or any unpleasant, con-
strained feelings, each one endeavoring to render his neighbors happy and 
30
AMERICAN FAMILY  PHYSICIAN.
cheerful, and thus secure these same  feelings for himself.  At hast,  ha i
an hour should be devoted to a meal; money-worshippers may despise this
remark, but the day for regret and suffering  from an inattention to these
rules, is certain to come ; let all who value health and happiness, be strictly
observant in these matters.   How many are there, who have gained riches
at the expense of health, and instead of enjoying their possessions, are
rapidly parting with them to the physician,  &c, in the vain endeavor  to
regain former health and strength ?  To destroy the constitution in the
desire to amass a fortune, and then to dispense with  this fortune that the
system may be restored  to its former condition, seems to me folly in the
extreme; a life so passed is truly a misspent one.
  Food must always be well  and finely masticated before  it is swallowed,—
the finer the better; and the act of chewing  or masticating,  instead  of
being rapid, as is too often the  case,  should be  performed with  care and
moderation, taking  ample time to perfect the complete mastication  of the
food, thereby inviting a flow of saliva to the mouth, which, by mixing with
the food, assists in its thorough digestion in the  stomach, and, at the same
time prevents  us from putting into the stomach  more food than  is really
required for health.   Fast eaters seldom masticate  their food  sufficiently,
hence they not only throw into the stomach a quantity of solid matter not
fitted and prepared  for  the  digestive powers, but  from  the rapidity with
which it is  "bolted  down," the stomach  does not begin to fully realize its
presence until  too much has  been received  into it,  and dyspepsia  must
undoubtedly be the  result.
  Parents are inflicting a serious  injury  upon  their children  by urging
them to eat fast;  indeed, a great part of the dyspepsia of adult age may be
traced to the endeavor of the child  to  obey that  so frequently  repeated
command,—'-nuike haste, eat faster,—I am in a hurry, and don't want the
table to stand here all day."
  At some of our hydropathic establishments, they constantly recommend
a slow mastication of food, but take great care not to place any before their
patients, that they can masticate; the food being principally rice, corn, &c.
well seasoned with a large supply of water.   Slops of this kind used daily,
are as injurious to the stomach, as improperly masticated, solid food.
  'Minuteness of division of solid food is an essential and important aid to
digestion;  for the performance  of  this preparatory measure, nature has
provided us with cutting and grinding teeth,—they  are certainly necessary,
or else they would not be present.   They are  placed in our mouths for use,
for the preservation of  our  health and  lives by a proper employment ol
them.  These facts  are well known ; the toothless  undoubtedly appreciate
them, for they  find  artificial teeth valuable adjuvants to  the gastric  opera-
tions.  By  shewing,  the saliva flows into  the  mouth and mixes  with the
food, and it must be remembered that this is an important office, because
the  saliva  and  other fluids  of the  mouth  contain  ingredients  of much
value in  digestion.   I have  frequently cured the worst cases  of dyspepsia
by advising the patient to let all medicine alone, confine himself exclusively 
CARE OF THE TEETH.
31
to an animal diet, and use a3 little fluid as possible; the meats are not to be
Bwallowed, nor must any efforts at swallowing be attempted, but he must
continue chewing, chewing, and chewing slowly and carefully, each mouth-
ful, until there is nothing left in the mouth, when another mouthful may be
operated on in the same manner.   I  prefer  animal diet, in these cases,
because it is less apt to  produce flatulency than vegetable, and, because an
amount of nourishment  may be obtained from a much smaller quantity ; by
the constant and incessant  chewing, the food becomes  finely divided and
prepared for the stomach, and so  intimately mixed with the fluids of the
mouth as to form almost a perfect fluid, in which state it finds its way into
the stomach unconsciously, and without any effort  on the part of the patient.
When in the stomach, it is so thoroughly fitted  for  the digestive  action
as to  call forth  no unnatural  exertion of this organ, which has thus an
opportunity of gradually recovering its healthy condition.  Beside, the food
being thus slowly and carefully passed  into  the  stomach, the patient be-
comes satisfied with a much less quantity than if it were more rapidly swal-
lowed, and less perfectly masticated.
   Good  teeth are essential to good mastication and healthy digestion, and
as many persons are not aware of the value of teeth, or of the   method of
preserving them, a few words here, relative thereto, may not be out of place.
A writer observes :—"The expression and general appearance  of the face,
depend much upon the condition of the teeth.   If they are perfect, regular,
pure, and clean,  they contribute more to beauty,  than  any  of  the   other
features; but if neglected, diseased, or incrusted with an offensive accumu-
lation, they excite in the beholder both pity  and disgust."
  The teeth are destroyed from three causes :  First, An inattention to their
cleanliness and a healthy condition of the gums;  Second, From  the use of
mercurials, which invariably and permanently destroy  them ; and  Third,
From a peculiar condition of the system, as we frequently witness in persons
of strumous habits, whose teeth, notwithstanding every care, rapidly decay.
These last two causes can only be remedied, the one, by an  avoidance of
all mercurial agents,  the other, by treatment to remove or change the
diathesis of the person;  and with both,  the following additional measures
should be rigidly pursued :
  When food is permitted to remain between the teeth, it undergoes decom-
position, giving rise to lactic and other acids that  corrode the enamel, and
ultimately destroy the teeth; beside which, the presence of this decomposed
food, causes a  very offensive breath, rendering it sickening to converse with
a person, and in some cases, is almost insupportable; frequently, a whole room
will be filled with the stench arising from a person's mouth who is neglectful
of his teeth.  Now, whatever right an individual may have, to do witlthis
own person as may seem to him proper,  he certainly has no  right to offend
the senses or feelings of those around him, nor force upon them the baneful
effects of an inattention  to cleanliness.   I know of nothing more repulsive
than to converse with, and inhale the breath of, a  person from whose mouth
emanates a most fetid odor—it  is nauseating, loathsome in the extreme— 
32
AMERICAN FAMILY  PHYSICIAN.
 ind yet strange to say, such persons are commonly the  ones  who  cannot
 converse with another unless their mouths are placed almost in contact with
 his face.  This  unpleasant condition may be removed and prevented by a
 very simple process, namely, that of drawing a piece of flnss silk, or  linen
 thread (waxed), through the teeth,  daily,  and thereby dislodging the  accu-
 mulations between them; a tooth-pick will partially  accomplish this, but
 not so effectually as the waxed thread.  In addition to this, the teeth should
 be brushed every morning, at least, with a brush and water, or some one o
 the mixtures named below.  The greater part of the tooth brushes, as made
 at the present day  by manufacturers, are impositions, and really good for
 nothing, for after having been employed a few times,  the  bristles will fall
 out, to  the discomfort and annoyance of those who  use  them;  great care
 should, therefore, be  taken in  purchasing a brush, to select a  good one,
 the manufacture of some well-known and reputable brush-maker.
  An accumulation of deposit from  the fluids of the mouth,  called  tartar,
 and which consists chiefly of the phosphate of lime, is very apt to take  place
 on the teeth, especially if they are  not cleansed daily.   If this  deposit is
 allowed to remain, it causes a retraction of the gums  with exposure  of the
 neck of the tooth, spongy gums, foul breath, decay of the  teeth, &c.  When-
 ever it cannot be removed by brushing the teeth, a good  dentist  should be
 called upon to remove it.   And in order to secure good teeth, prevent  them
 from decay, or arrest this when  it is present, every individual should consult
 a dentist every four or six months, having  him to inspect the teeth.  But be
 careful to employ a well-educated dentist, for there are hundreds  of impos-
 tors in the country, who have ruined thousands of teeth, and have been the
 means of creating an unjust prejudice against intelligent dentists.
  The following rules will tend to keep the teeth good to an advanced age:
  1. Be careful  not to hold any fluid or solid substance in the mouth, either
 too hot  or too cold ; and  be very particular not to  bite  or mash any  hard
 substances, as nuts, &c, with the teeth.
  2. Have the teeth examined twice or three times a year, by a  competent
 dentist.
  3. Prevent any accumulation of tartar on the teeth.
  4. After every meal, thoroughly cleanse the mouth with clear water; and
 once every  day cleanse the spaces between the teeth, by a waxed  thread  as
 before stated.
  5. Every morning,  and every night if possible,  clean  the teeth with a
stiff brush, and one of the following preparations; and in using  the brush,
do not confine it to the front surface of the teeth, but pass it thoroughly over
the top^of the grinding teeth, and on the backs  of all.*
  a. Take of prepared Chalk,  one  ounce; pulverized gum  Myrrh,  three
scruples; Camphor, five grains; water, a sufficient quantity.
  *I am aware that many persona consider this course as too much trouble, they want a quickei
and less laborious method of effecting this result, the consequence is that in  a few years  their
teeth rapidly decay.  In one of cleanly habits, these attentions to the person are never neglected
nor hurried through with.                                           ' 
CARE OF THE TEETH.
33
  'b. Take burnt Alum, Sal Ammoniac, and common salt, of each, in powder,
equal parts; water, a sufficient quantity.
  c. Take of prepared Chalk, Peruvian bark, powdered old Windsor  soap,
each, equal  parts; combine them with  a  sufficient quantity of tincture of
Rhatany root to form a thki paste.  This will be found very beneficial in
cases where  the gums are  soft and spongy,  bleeding upon the slightest
touch, and the teeth  are loose.
  d. Another very good application for soft, spongy gums, is equal parts of
tinctures of  Tannic acid and gum  Myrrh.
  e. My colleague, Prof. C. H. Cleaveland, recommends the following as an
excellent wash for the teeth : Take of tincture of Myrrh, tincture of Peru-
vian bark, tincture of Gentian root, each,  one fluidounce;  Aqua Ammonia,
one fluidrachm ;  pure water, half a pint.  Mix  together,  and use with a
brush, after  each meal.  Charcoal is frequently used as a tooth powder, but
it is objectionable.  Some persons state that it cuts or scratches the enamel,
but whether it does or not, one thing is certain, it is very apt to insinuate
itself between the gums and teeth, and acting as an irritant,  injure  both.
Were it not  for  this objection it would form a very good tooth powder, being
a  well-known  antiseptic, correcting putrefaction, and  purifying  tainted
substances.   From the fact that charcoal  is used by blacksmiths in polish-
ing steel, to  take out the marks made by the file, there can be no doubt of
its mischievous  influence upon  the enamel  of the teeth  when  used as a
dentrifice.   The crust of bread, burned,  forms  a charcoal  which is not
objectionable on the above account.
  6. Never take any mercurial medicines, for any purpose whatever.
  7. Keep the stomach  in a good state by a moderate and unstimulating
diet, for the secretions of the mouth are  generally in sympathy with the
stomach.  Whenever a bad taste in the mouth is experienced, and no active
medicine is   required, reduce the diet a little, and  occasionally  take a
dose of cold  water with a little lemon juice.
  8. Whenever  the tooth aches, for a  permanent cure apply  to  a dentist.
However, where a dentist  cannot be had, or where circumstances do not
permit of  the immediate removal  of the diseased tooth, relief may  be pro-
cured by one of the following preparations:
  a. Take of Alum in fine powder, two drachms; nitric Ether,  seven flui-
drachms.  Mix together, apply to the tooth on cotton, having first cleansed
out the cavity.
  b. Dissolve gum Copal in Chloroform; clean out the  decayed cavity, and
introduce the solution on cotton.
  c.  Take of oil of Cloves, oil of Cajeput, oil of Amber,  Camphor, each equal
parts.  Rub well together, and apply in the same manner as with the pre-
vious ones.
  d. Take of Xanthoxylin, two drachms;  powdered Opium, powdered Cam-
phor, of each, one drachm; oil of Cloves, ten drops.   Mix, and triturate in a
Wedgewood mortar until a paste is  formed.  Apply as above.
  e,  Take of Opium, Nitre, each, two drachms; Camphor, one drachm and a
         3 
34
AMERICAN FAMILY PHYSICIAN.
 half; powdered  Nutgalls, four drachms; Alcohol, three fluidounces.  Mis
 and digest for fourteen days.   Apply as in the previous instances.
   The wisdom teeth as they are usually termed, are of but little importance
 in  mastication,  and  almost always decay  at  a  very early period.  They
 should always be extracted as soon as possible, whether decayed or not, as
 by retaining them, they are apt to hasten caries of the other teeth by press-
 ing them more closely upon each  other, thereby preventing  the  intervals
 between them from being properly cleansed.   By having them extracted
 early, this pressure is obviated, and the remaining teeth can  more readily
 be preserved to a good old age by an attention to  the rules above given.
   Those articles of food, such for instance as meats, amylaceous substances,
 &c, which are not eaten until cooked, are  generally prepared to suit  the
 taste of persons,  either by boiling, roasting, broiling, baking, stewing,  or
 frying; and, as there is an essential difference in the digestibility and nutri-
 tive character of the  same article when  differently prepared, a few  remarks
 on the several modes of cooking will be proper.
   The preparation of  food demands  as much attention  as  its selection ;
 because,  the most nutritious and appropriate articles may be rendered innu-
 tritious  and indigestible by an improper method of cooking.   Food should
 not be decomposed by cooking, but merely disintegrated, so as to facilitate
 its  decomposition and  digestion  in the  stomach; too much,  or too long-
 continued heat  decomposes animal substances, impairs their nutritive prin-
 ciples, and renders them unfit for diet.  So  also  does the preservation  of
 them by artificial means, as salting, smoking, and pickling; either of these
 means tend more or less to  impair the digestibility of animal flesh, by
 increasing the hardness of its texture, and combining with it  some foreign
 substance, which cannot be separated from it in cooking.  Perhaps the best
 and least objectionable mode of preserving fish, meat,  and fruit, is by sugar.
 It has the advantage over salt, in  not rendering meat less savory  nor less
 nutritive, and in preventing  putrefaction  with a much smaller quantity.
 Pyroligneous acid, is likewise an  useful preventive;  meat  and fish dipped
 in it for a few minutes, may be preserved for months  without having their
 virtues injured, and without being attacked by insects.  When this acid is
 used, the substances should be confined so as to prevent evaporation, other-
 wise, if exposed for a length of time in  the open air,   the  acid evaporates,
 and decomposition ensues from the action of  the atmosphere.
  Boiling is probably the most eligible mode of cooking, it softens the ani-
mal fiber, renders it more pulpy, and thus  enables it to be  more  readily
and effectually acted  upon by the juices of the stomach.   It  undoubtedly
decomposes some parts of the meat, depriving it of  a portion of its nutri-
tive properties, solidifying the albumen, and changing the gelatine into a
 glutinous matter, but still it does not so alter the relation of  the elements
 in meat, as to materially diminish its nutritious qualities.   Much, however
 depends on the manner in which the process is conducted; if the boilin°- be
 too quick, the albuminous matter of the meat is coagulated, the outside  of
 the flesh is rendered hard while the interior is not sufficiently done,  and the 
MODES OF COOKIXO.
35
digestibility of the meat is much diminished; if the boiling be too slow, or
too long-continued, a hard and  indigestible substance may be obtained, or,
if this be not the case, the nutritive quality of the meat will be considerably
lessened.  The best method of  boiling  meat,  so  as to  preserve its juices.
secure its tenderness, and  not materially  diminish its nutrient qualities,  is,
to first boil the water briskly, then introduce the meat,  continue  the boil-
ing for a few minutes, and then  diminish the  temperature of the water to
165° or 170°, by adding sufficient cold water—so as to keep the fluid in that
Btate which  approaches more to  simmering than boiling—at which temper-
ature it may be kept for two or three hours.   In this way all meat, except
poultry, should be prepared for  invalids  and  the dyspeptic.
   Beef, mutton, and  other matured animal  meats are always more  tender
and juicy when boiled in  hard water, because a layer of coagulated albu-
men is more readily produced on their surfaces, preventing the escape of
their juices.   On the contrary, fish should always be boiled in soft water, as
their firmness and consequent indigestibility is proportioned to the hard-
ness of the water.  Soups, broths, and jellies, require soft water.
   Boiling dissolves the cell-walls of vegetable substances, deprives them of
a quantity of air, and renders them more soluble in  the stomach.   Long
Bimmering is preferable to boiling, so that they may be  perfectly softened
throughout, but in no part quite dissolved.   Rain, or soft water with a little
Bait is better adapted to vegetables, such as potatoes, cabbage, greens, corn,
turnips,  cauliflower,  peas, &c,  and these always require a long boiling,
because they are  rendered indigestible and highly injurious, when boiled
too little.   Potatoes are most nutritious and digestible when boiled so as to*
be neither waxy nor mealy, but  so softened as to be readily mashed.   Over-
boiling lessens their nutritive quality.
   Roasting is the next best method of cooking; by this process, flesh is de-
prived of  part of its water, its fat is liquefied,  partially escaping, its albumen
is  coagulated, and its fibrine corrugated.  As the roasting proceeds, the sur-
face of the substance acted upon becomes gradually  darker  colored, and
finally scorched; and its tendinous portions are  rendered  viscid and  tender.
Meats when roasted  should not be underdone,  nor overdone—the popular
idea is that when underdone they are more nourishing, but this is an error;
beside, underdone roasted meats are less digestible  and  consequently less
nutritious, than when well done.  Boiling extracts  the gelatine of flesh,
while roasting does not.   By boiling, beef loses one-fourth of  its weight,
and mutton  one-fifth, but, by roasting  they lose one-third.    The starch
grains of vegetables are rendered more or less sc'ubleby roasting, and thus
many of them are rendered more digestible and u itritive than  they would
be in the raw state.  Vegetable  albumen is coagulau-1 by roasting.
   Broiling produces  changes in meat similar to those *aused by  roasting,
but the  process  is more  rapid. The  outside surface  becomes  suddenly
browned or  hardened, preventing the  internal  juices  from evaporating,  so
that the meat is rendered  peculiarly tender,  and more  savory  than when
rbasted.   For dyspeptics and those of delicate  Btomachs, broiled  meats  are
not as well fitted as when  boiled. 
36
AMERICAN KAMILY  PHYSICIAN.
   Baking, when mismanaged and not attended to, is a very objectionable
mode of cooking meats, and has probably,  from this cause, created some
prejudices against it; but when properly managed,  it is the most economi-
cal, the least troublesome, and the most useful method of  preparing nearly
every kind of food.   Most usually, too much heat is employed, which decom-
poses the  fat, and produces a disagreeable and injurious empyrcuma, which
renders the meat unpalatable and indigestible.  But if the heat be properly
regulated, and especially if the substance baking be slightly covered so as
to prevent scorching and drying,  the meat  will  be rendered tender and
juicy, of the flavor of a roasfc, having its  nutritious particles  preserved, and
without any  decomposition  or waste.   Baked meat  pies, and particularly
when the pastry is  rich with butter, are  more difficult of digestion, than
meat baked without any pastry.   Dyspeptics, and those whose stomachs are
weak, should avoid all baked food, except it  be light amylaceous puddings
made of arrow-root, sago, tapioca, rice, &c.
   Stewing is objectionable; it deprives the meat of much of its juices, and
decomposes, in a greater or less degree,  the  fatty and gelatinous portions.
The  fluid in which meat is stewed contains  a great part of  its  nutritious
elements,  but, being too fluid, they cannot be  digested, until their watery
parts  have been  absorbed by the stomach.  Stews are not adapted  as food
for the sedentary and dyspeptic,  and if they are habitually partaken of.
they will eventually produce painful and dangerous symptoms of  disease.
They are rendered  still more indigestible and unfit for the stomach, when
various spices, butter, wine, or other stimulating  ingredients are added to
improve their flavor.
   Frying is the most objectionable of all  the modes of cooking.   The heat
is  applied  to  the meat through the medium of boiling fat,  or oil, which is
rendered extremely indigestible and  obnoxious to  the stomach, on  account
of the chemical changes  which are thereby effected.  Invalids,  conva-
lescents, and dyspeptics, should never eat fries, as eggs, oysters,  pancakes,
omelettes, fritters, fried fish, liver, pork, beef, mutton, &c.
                        CHAPTER  III.

    Articles of Animal  Diet.—Meats.—Poultry.—Fish__Eaas__
                           Milk.—Butter.                  ™ '

  The articles from which food is prepared are very various, whether derived
from the animal or vegetable kingdom ;  and  as some  of  them are  preferable
to others on account of their being more readily digested, and their different
nutritive powers, a brief  reference to them will be necessary.   I  will com- 
BEEF.
37
mence with those from the animal kingdom, first observing that dark colored
meat is usually more digestible and nourishing than the white meat of ani-
mals,  on  account of its containing a greater amount of fibrin; and  the same
may be said of the flesh of animals which are permitted  to roam  unrestrain-
edly in the  open air,  when  compared with that of confined and stall-fed
beasts.   Again, the meat of hunted animals is tenderer  and  more digestible
than those which are killed without any previous exercise.  The flesh of the
female animal is almost always more savory than that of the male, while that
of a castrated or spayed animal is still more so.  All meats have their diges-
tibility as well as  nutrient  qualities impaired  by  salting  and  smoking.
Hence,  although salted  meats may be eaten  by healthy  persons  of  active
habits, yet as a general rule, they are unfit for convalescents,  dyspeptics, and
those  of sedentary occupations.
  Beef is a very healthy,  nutritious, and  easily digested meat;  it should  be
soft, pliable, fat, and taken from  an animal  neither too  young  nor too old,
and perfectly free from disease.   Its  fat part is not so easily digested as  its
lean,  hence, the great accumulation of fat upon prize beef does not contribute
any to its value; though, unless some fat be present,  the lean part  is not so
apt to be juicy and tender.  The tongue as  well  as the  tripe, are not so
easily digestible as other parts, and are, therefore, not proper food  for dys-
peptics and those having weak  stomachs.   Properly cornfed animals, that
have had plenty of exercise in the  open air,  furnish the most healthy and
delicious meat.
  The best mode of cooking beef  is by boiling  or roasting; though beef-
steaks are by no means indigestible, when, properly managed.  To be whole-
some, beef must not be too much done, nor  underdone.    As an  article of
diet for  convalescent  persons, it is best prepared in the form of beef tea.
which should be made as follows:—Cut half  a  pound of the lean  part of a
good rump-steak into thin  slices,  put  these in a dish, sprinkle  a  little  salt
over them, and pour on them a pint of boiling water.  Cover the dish with
a plate, and set it over a very gentle fire, that it may steep, not boil, for  an
hour.   Then put  the whole  into a pan, cover it,  and  allow it to boil for
fifteen minutes; after which strain off the fluid from the  meat through a fine
sieve  or napkin.  If this tea be too strong, it can be reduced by the addition
of boiling water.
  Generally, the firmer texture of beef renders it less readily digestible than
mutton, on which account this latter is the preferable meat for convalescents.
Dried or smoked beef  forms a  palatable  and wholesome relish  for healthy
stomachs, but the meat having been impaired  in its  digestibility by drying,
salting, and smoking,  it is not adapted to the weakly and dyspeptic.  The
density of fiber of every kind  of animal food is very much  lessened by keep-
ing it for a certain length  of time before cooking,  and which is  owing to an
incipient decomposition having ensued; but great care should be taken  not
to allow this process to advance so  far as  to taint the meat in the slightest
degree, for it would be very apt to give rise to disease, or,  in convalescents,
cause  a relapse. 
38
AMERICAN  FAMILY  PHYSICIAN.
   Mutton is probably more easily digested than any other animal food, being
at the same time highly nourishing and healthful.  . The flesh of the castrated
animal, or wether-mutton,  is by far more palatable and more digestible than
that of the male animal; this last is coarse, and so strong and unsavory  that
many persons cannot eat it at all.  Ewe-mutton  is  also  preferable to the
male, if the animal is not above three years old.   For  convalescents,  dys-
peptics, and persons of weak stomachs, there is  no meat so  wholesome and
digestible as wether-mutton: it is  best  cooked by boiling.   A mutton-tea
may be prepared for invalids as follows:—Cut half a pound of  the lean  part
of good mutton, into thin slices, put these in a dish,  with a pint of boiling,
soft water.  Cover the dish with a plate, and set  it  over a very gentle  fire,
that it may steep for an hour.   Then put the whole into  a  pan,  cover it, and
allow it to boil for half an hour, after which strain off the fluid through a
fine sieve or  napkin.   If  it is  desired  to  add barley to  this, an ounce  of
pearl barley, previously washed  and macerated in  boiling water for an hour,
may be boiled with the mutton-tea—separating the barley on straining.
   From the tendency of sheep to disease, care must be  taken never to eat
the meat of  a diseased animal.
   Venison is a nourishing,  palatable, healthful, and easily digested meat, and
from the fact that the deer  is usually killed in the  chase, its flesh, like most
varieties of game, is more tender than that of domestic animals killed in the
ordinary way,  and by some is considered a greater  delicacy.
   Pork is usually considered a  savory,  nutritious meat,  not  so digestible,
however,  nor even so healthful, as beef or mutton.   I  consider it  a very
unwholesome meat, notwithstanding its extensive preparation and use in this
country;  because, in  addition  to  its greater indigestibility,  it is  almost
always diseased.  There is  hardly a hog  fattened  for  the  market but  what
labors under a measly condition, or a  tuberculous affection of  the liver,  or
kidneys, or perhaps both, as well as of other organs, and it is no uncommon
thing for people eating pork to cut or bite into hardened tubercles in various
parts of the lean, and especially of the fat of the meat.  Surely, the meat  of
a diseased animal cannot be healthy, and yet this  diseased meat forms the
principal part of the diet of an immense portion of our population.  No wonder
that diseases of the skin, scrofula,  cancer, disordered  digestive  organs,  &c,
are so common in  those  sections of the  country where  it is  so constantly
eaten; or, that epidemics, as dysenteries, typhoid fevers,  &c, prove so fatal,
when they occur among a  class of  people  whose  principal diet is pork  in
some form, but more generally that known as bacon.   I  have  seen  persons
cut into a piece of pork containing tubercles, and actually eat it, even  after
having been told it was diseased—so great was their reverence for pork.  I
have no doubt but that, with many persons, the use  of whiskey, peach-brandy
apple-brandy,  or other alcoholic  drinks,  lessens the immediate effects of the
influence of pork upon their systems,  for it is a well-ascertained  fact, that
these liquors will prevent or  suspend the activity of  tuberculous affections
for a long time, frequently  effecting apparent cures.  But then, the remedy
is by far a greater evil, than the pork-eating; it were much  better  to  use 
MEASLES  IN PORK.--SAUSAGES.
39
neither.  Bestow the same attention  upon raising beef and mutton, and  it
will give better results, both as regards health and pecuniary profit
Fig. 1.
The animal in Measly Pork magnified.  1. Th«
                 One of the Teeth great-
  Even when the flesh of pork is
healthy,  it  is  not  so wholesome
and digestible as other meats, be-
ing better adapted to those whose
stomachs  are healthy and strong,
and whose occupations  are active
and laborious;  and  in all cases, its
long-continued use will invariably
give rise to disease,  sooner or later
in  life.  And as many will  con-
tinue to use it, notwithstanding
its  unwholesomeness,  a  few re-
marks may be made in reference
to its several modes  of preparation.
  Pork should never be eaten by
dyspeptics,  by those of sedentary
habits,  nor by those who are in-
clined to corpulency, or are liable
to affections of the skin, scrofula,
or other tuberculous forms of dis-
ease.   The flesh of the sucking
pig or shoat, is considered a dain-
ty  relish,  but it is much less di-
gestible than the  matured  meat,
and frequently  affects the  bowels
in a violent manner.
   Teeth or Booklets.
   ly magnified.
  When the sides and flanks of a full-grown hog are salted and dried,  (and
frequently smoked,) it is called bacon.   It is  a strong,  exciting  article of
food, hard to digest, and fit only for robust  persons who  work hard.   The
best method of cooking it, is to boil it with vegetables; when fried, with or
without eggs, it is unhealthy and is not fit to eat.
  When the thigh, or  ham of the hog, is salted and smoked, it forms  ham,
a stimulating food, fit  only for laborious persons, and which on account of
its difficult digestibility frequently  disagrees with many.   It proves whole-
some only to those with whom it agrees.  It is  best cooked by boiling;
when fried, it  is  rendered very indigestible,  and should not be eaten by
dyspeptics and  persons of sedentary occupations.
  Sausages may  be prepared from the  boiled flesh of several animals; in
this country they are principally made from  pork.  The meat is  made-fine,
seasoned with salt, pepper, and spices,  and  is  eaten in this state, or  more
commonly dried and smoked.   They are  a very indigestible article of diet,
being scarcely fit for the stomach of the robust and hardy; and they should
be especially rejected  by the sedentary and dyspeptic.  When exposed for
any length of time to dampness, they are  liable to experience certain chemi-
cal changes which render them poisonous. 
40                  AMERICAN  FAMILY  PHYSICIAN,

   In the Journal of  Organic and Medical  Chemistry,  is the following;—■
"Hog's lard, when fresh, is composed of stearine, margarine, andoleine;  but,
when rancid, it contains several poisonous acids, and a yellow coloring matter.
Pork contains more oleine, (a fusible, oily matter, incapable of assimilation,)
than other varieties of this class of meats.  According to Brande, pork con-
tains 76 per cent, of water, 19 of albumen and fibrine, and 5 of gelatine.   To-
tal  of nutritious matter,  twenty-four  parts  in a hundred.  We  see, then,
that the pork-eater not only takes a greater amount of  this indigestible mat-
ter into his stomach, than those who do not  feast on  swine dainties, but he  is
much more liable to disease.   *  *   *  *   We defy all hog-eaters,  chem-
ists, or physiologists, to prove that swine's flesh is a healthy article of diet.
*   *  *  *   Since the  days  of Moses, no small portion of the human
family have looked upon the swine as an impure animal, and entirely unfit for
food.  Its impurity consists, not merely in  the common mode of  rearing the
domestic swine with the most  filthy  offscouring  from every thing foul  and
corrupt, which constantly distends his diseased carcass;  but it consists in a
disease purely scrofulous in its character, which is inherent and peculiar to the
hog, and  is constantly being developed, especially  in the pig-stye.  How of-
ten does  the farmer, or those engaged in the fatting of swine, on beholding
their swelled appearance, imagine them quite ready for slaughter, when  a!
their subsequent visit  to the pen they find them dead!  Now all will agree that
this pork is not fit for food. Why? not because it is a dead  mass, but because
it  died of disease.  Now, suppose this swine had  been butchered the  day
previous  to its death by disease, would not the pork have been called  good?
Could the eater of that meat have detected  the disease  by the  taste ?  We
think not.  It is evident, therefore, that not only  would the pork have been
considered good, but in its assimilation to the system, the consumer  would
have partaken of the disease.   (Kidney-worm so common to swine, is  but  a
form of tuberculous disease—a kind of hydatid.)
   " The  name scrofula  had its  origin in the well-known fact that it was a dis-
ease peculiar to swine.  The analysis of the blood of  scrofulous subjects
shows that it differs materially from that of healthy individuals.  In the  for-
mer there is an excess  of serum, and a deficiency  of albumen and  fibrin.
Hence, the solids  formed from this blood are feeble, lax, and incapable ol
resisting  exposure,  fatigue, and disease.  It  is true, that for the most part,
scrofula is hereditary, still there are many well-marked cases of the acquired
disease, from the use of pork.
   " Dr. Marcey, speaking of the  origin of  scrofula, remarks.  'Let him (the
pork-eater) see in the slaughter-house how  often  tha internal  organs  and
surfaces of the vile  carcas^es^will  be studded with tuberculous formations or
scrofula,  and  then let  him return to  pork,  like a  dog to his  vomit  if he
chooses."
   " A strong  corroboration of our  views is  found  in the  fact,  that  in all
those countries where the swine is forbidden  to be  used  as  food  scrofula  is
almost unknown.  The same law obtains with the  Jews, who, abidino- by the
precepts  of their religion, inhabit almost every climate and country ^and are
Bcarcely ever afflicted  with scrofula. 
         VEAL.--LAMB.--SALTED MEATS.--GAME.--POULTRY.       41

   " It is absurd to argue that flesh contaminated with scrofulous miasm cannot
communicate to the healthy body, after digestion, its morbid particles.   The
poison pervades every atom of the affected flesh,  and no washing or digesting
can destroy or banish the noxious qualities."
   Veal, or the flesh of the calf, is not  so  digestible as beef; it  contains a
large amount  of gelatinous substance,  as  is the case  with  the  meat of all
young animals.   The best mode of cooking is by roasting or baking.  Broth
made from veal generally produces a laxative influence on the bowels, and may
be used with advantage  by persons  subject to constipation.  A  tea of veal
made in the same manner as beef-tea,  from a fillet or knuckle  of veal, is
sometimes of advantage to the invalid.
   Calves' feet Jelly is a very useful article for convalescents,  being nutritious,
grateful to the palate, and easy of digestion when used in  small quantities.
Like all  other concentrated aliment it is  not so readily changed into chyle, as
many other articles holding a less amount of nutriment.  It is an improper
diet for dyspeptics.   It is usually obtained by boiling calves' feet in water, for
a long time, straining and clarifying the  decoction,  and allowing  it to  cool;
sometimes it is previously sweetened with sugar;  the addition of spices, wine,
&c, renders it an improper diet for weak stomachs, convalescents, &c.
   Lamb, is a wholesome diet for persons in health, it is less  stimulating and
less  solid than mutton, but is not so digestible.   It maybe used by convales-
cents, but not by dyspeptics and  persons laboring under  affections of  the
stomach, with whom it will generally be found to disagree.  A lamb should not
be killed too young for diet; at the age of from five to seven  months is prefer-
able to an earlier period.
   Salted Meats, as before observed, are less nutritious, and  harder to digest
than fresh meats.  They should always be thoroughly boiled, and eaten with
a good proportion of  vegetable food.  The fat of meats is very nutritious, and
requires strong digestive powers, hence it is not so suitable for the sedentary,
dyspeptics, and persons of weak stomachs.   When eaten it should always be
with at least an equal amount of lean meat, and some bread, rice,  potato, or
other farinaceous article  of diet.  Too much fat causes uneasiness,  weight,
oppression, eructations, and affections of the digestive apparatus.   It is  posi-
tively unhealthy when fried, or roasted;  and should never be allowed to child-
ren and invalids in any form.
   Game, or birds and beasts, living in a natural state, and which  are killed
in this condition, are  in general more healthful, when cooked in a plain man-
ner than the same animals, when tamed, and killed in the usual mode.
  Pordtry, by which is generally meant all farm-yard birds, as chickens, hens,
ducks, turkies, &c, are generally very digestible and  healthy food for persona
having stomachs free from disease.  Chickens and turkies are considered the
most easy of digestion, if not  too richly seasoned; and geese and  ducks are
less  digestible and more stimulating, usually being obnoxious to  dyspeptics,
and  persons whose digestive  powers  are not  very   strong.  The dressing
usually employed when baking or roasting these birds, is extremely stimulav
fcing  and  indigestible,  on account of the fat and spices mixed therewith. 
42
AMERICAN FAMILY  PHYSICIAN.
    Chicken Soup, is a light, nourishing diet, and may be used  by many  sick
 persons and convalescents.  It is best when made from the  lean  portions  of
 the chicken, which should be boiled in water to which a little salt  has been
 added, and as the fat and scum arises, it should be  removed.  Cracker, rice,
 barley, or toast-bread, may be  added to  it, to increase its nutritiveness,  if
 desired, and  not contra-indicated.   When  highly  seasoned with  spices,  it
 becomes an improper diet, especially for dyspeptics and convalescents.
    Fish  furnish  an  almost  endless variety of food for man;  and in some
 countries, especially in the northern parts of the two continents, where vege-
 tation is scarce, they form the principal diet of the inhabitants.   However,
 they are not so  nourishing as  the meat  of warm-blooded animals, but are
 sufficiently so to  support health and strength.   With many  stomachs fish-meat
 is difficult to digest, and when it is  eaten habitually,  it  frequently induces
 disease of the bowels, and of  the skin.  Some individuals are very apt  to be
 affected by eating certain kinds of fish, experiencing a disagreeable, uneasy
 sensation at the stomach, a small amount  of fever, and an  eruption on  the
 surface of  the body;  these  symptoms are  also produced occasionally  in
 deranged conditions of the digestive apparatus. All kinds of fish when out of
 season, are of difficult digestion and very unhealthy,  and in  some situations
 they become poisonous.  Salt water fish are always better than those living in
 fresh water, as they possess a firmer and more palpable flesh,  which is less
 liable to putridity, and is less clammy or  slimy.   Many persons  cannot  eat
 fresh water fish at all, without inducing an attack of cholera-morbus or other
 difficulty.   Fishes  having scales are  usually  more digestible than  others-
 thus the cod, shad, trout,-perch, fresh herring, plaice, flounder, turbot, whiting,
 sole, &c, are the  most healthy and  nutritious, while eels, skate,  sturgeon
 mackerel, salmon, &c, are much less  digestible and wholesome.  Indeed  all
 fish which abound in oil, are stimulating, and difficult of digestion.
   Fish are best cooked by boiling;  when  fried or stewed they  are rendered
 quite indigestible.  Butter should not be used as a sauce for fish, nor the acid
 fruits or jellies, as they almost always produce heaviness or uneasiness of the
 stomach;  milk is a very improper article to be used  at the same  time with
 fish, frequently inducing severe diarrhea, cholera-morbus, &c.  When fish are
 dried and salted, they become less nutritious and digestible, and should never
 be eaten, except by the healthy and hard-working, and even by them should
 be used very sparingly.
   Crabs  and  Lobsters,  are  by no means  wholesome  or digestible, though
frequently eaten with impunity.  Perhaps the meat of the claws is the  most
easily digestible.  They are very apt to disagree with some persons, giving rise
to an acrid sensation in the throat, pain and heaviness at the stomach, nausea
depression, giddiness, and frequently a serious colic.  Many  persons are
attacked with a nettle-rash, whenever they eat the  meat of either of *these
crustacean animals.   Severe vomiting and purging frequently follow their use:
and when eaten in excess, they have occasioned stupefaction, unconsciousness
and other symptoms of apoplexy.  It is said that old English cheese, grated^
and freely partaken of,  will act as an antidote to the poisonous effects  of
these crustaceans. 
            TURTLE.---MUSSELS.---OYSTERS.---SOUPS.---EGGS.         43

   Turtle affords a healthy, nutritious flesh, when cooked in  a  plain  manner;
but when made into a rich soup  with a large  amount of spices, force-meat
balls, &c, it is destructive to both the stomach  and general health.
   Mussels are often used as an article of diet, yet they are extremely unheal-
thy and indigestible, frequently occasioning symptoms in some respects similar
to those produced by lobsters and crabs.
   Oysters furnish a delicious and favorite article of food : when  raw, or  but
slightly cooked, they are light, nourishing,  and of easy digestion, with  the
exception of the eye or tough white part, which should not  be eaten.  When
well cooked, as by stewing,  or frying, the albumen  is coagulated and har-
dened, and the fibrin is corrugated, when they become quite indigestible, and
should not  be eaten.  Salt water oysters are always better than those found,
or propagated, in rivers.  Oyster juice thickened with cracker in powder, and
warmed, is  frequently a wholesome and nutritious diet for persons having
weak stomachs, and convalescents.   With some constitutions oysters disagree,
producing similar symptoms to those caused by lobsters; and they frequently
prove injurious when eaten out of season.
   Clams somewhat resemble oysters in their effects  upon the  stomach and
system, yet are not so easily digestible.
   Soups, as ordinarily prepared, from beef, mutton, or veal, with the addition
of various vegetables, are a very healthy, nutritious, and inexpensive diet.  The
meat as well as the  vegetables should be  thoroughly boiled,  and too  much
seasoning should be avoided.   They may be improved by the addition of rice
or barley, stale bread, toast-bread,  &c, and will digest more readily when
eaten with bread, because liquid food is apt to swell out the  stomach,  and
render a greater action of the organ necessary for its perfect digestion.  Solid
aliments are, however, the best suited for weak stomachs, and dyspeptics.  The
addition of  dumplings to soups, or an excess of spices,  wine,  &c, are  very
improper, as they tend to provoke the appetite, by which a  greater quantity
of food is eaten  than is required,  beside which,  they are  rendered highly
indigestible; and if a course of this kind is persisted in,  the stomach will
certainly become diseased.  When meat has been boiled  for a long time in
water, to which a small quantity of salt has  been added, it  is termed broth.
This, eaten with bread, affords considerable nourishment, without unduly
stimulating the digestive apparatus, or augmenting the heat of the body.
   Eggs, when fresh, and lightly cooked, are  nutritive, and  moderately easy
of digestion.  The white of  the  egg is principally  composed of albumen,
while the yelk  contains  in  addition a yellow  oil.   When the albumen is
coagulated or hardened  by heat, it is not thereby rendered indigestible; but
the yelk is.  Although  hard-boiled eggs are, as a general  rule, difficult of
digestion, yet they are sometimes found to agree with certain  persons better
than" when in the soft state.  Vinegar is said to facilitate the digestibility of a
hard-cooked egg.  All articles in which eggs are cooked  by frying, as omelet-
tes, pancakes, fritters, &c, are hurtful to delicate stomachs.   When an  egg
is  whipped  up with  wine and sugar,  it forms a valuable restorative and
stimulant. 
44
AMERICAN FAMILY PHYSICIAN.
Fig. 2.
Microscopic view of good Milk.
                               Milk, when obtained from  a healthy, well-
                             fed animal, is very nutritious  and wholesome,
                             and it is more advantageous  in its raw state
                             than when boiled.  In combination with bread,
                             rice, eggs,  sugar,  &c, it ought to form the
                        fS°\ chief portion of the diet of children, until
                          &cP| they are ten or twelve years of age; and those
                             who are thus fed, will be found stronger,  and
                             more healthy and vigorous than those who are
                             allowed to  live  upon meat, pies, cakes,  and
                             other  delicacies of the culinary art.   It  is a
                             preferable drink to tea. coffee, liquors, &c, and
                             may be used pure or considerably diluted with
                             water.  A  glass of milk and water,  with a
small teaspoonful of salt added, is  said to  be  the best  refreshment that a
fatigued or famished person can take.  One part of lime-water added to  two
or three parts of milk, is useful to check obstinate  vomiting, and to allaj
irritability of the  stomach  especially  when  connected with  acidity, as in
phthisis, and other debilitating diseases.  Milk sometimes disagrees with adults,
probably owing to its oily constituent, butter.   It is very unfortunate  for the
inhabitants of large cities that no regulations can be adopted by which they
may be certain of obtaining good, pure milk.   The slop-milk from diseased
cows, together with the impurities  added to increase the quantity of artificial
milk, and thereby increase the profits pecuniarily of the vender, have undoubt-
edly caused a great  amount of the sickness in cities, especially among child-
ren.  It were much better to do entirely without milk, than make use of the
trash commonly sold for it in most of our cities.
  A  solidified  milk has recently been prepared, which possesses  all the
properties of good milk; the following in relation to it is  copied from the
American Medical Monthly:
  "To 112 pounds of milk, 28 pounds of Stuart's white sugar  were  added,
and a trivial proportion of bicarbonate of  soda, a teaspoonful, merely  enough
to insure the neutralizing of any acid which in the summer season is exhib-
ited even in a few  minutes after milking,  although inappreciable  to  the
organs of taste.    The  sweet  milk was  poured  into evaporating pans of
enamelled iron, embedded  in warm water heated  by steam.   A thermometer
was immersed in each -of these water-baths, that, by frequent inspection, the
temperature may not rise above the point which  years  of  experience have
shown advisable.
   "To facilitate the evaporation—by means of blowers and  other ingenious
apparatus—a  current  of air is established  between the cover of the nans
and the solidified milk. Connected with the  steam engine is an arrange-
ment of stirrers, for agitating  the milk slightly  whilst  evaporating,  and so
gently as not to churn it.  In  about three hours the milk and sugar assumed
a paste consistency, and  delighted the  palate of all present; by constant
manipulation  and warming it was  reduced  to  » rich,  creamy  looking pow- 
MILK.
45
der, then  exposed to  the air to cool, weighed into parcels  of a pound each,
and by a press, with the force of a ton or two, made to assume the compact
form of a  tablet,  (the size  of a  small brick,)  in  which shape, covered with
tin foil, it is presented to the public.
   " Some of  the solidified milk  which  had been  grated  and dissolved  in
water  the evening previous, was found  covered with a rich cream;  this,
skimmed  off,  was soon converted into excellent butter.   Another solution
was speedily converted into  wine-whey, by a treatment precisely similar  to
that employed in using ordinary milk.  It fully equalled the expectations  of
all; so that solidified milk will hereafter rank among the necessary appenda-
ges of the sick room.   In fine, this  article makes paps, custards, puddings,
and cakes, equal to the best milk; and one may be sure it  is  an  unadulter-
ated article, obtained from well-pastured cattle, and  not the produce of dis-
tillery slops—neither can it be watered.   For  our steamships, our packets,
for those traveling by land or by sea,  for hotel purposes, or  use  in private
families, for young or old, we recommend  it cordially as a substitute  for
fresh milk."  (See Butter.)
  4)The milk of confined and slop-fed cows, contains  the seeds of tuberculous
diseases, as  scrofula,  consumption, &c,  and traces of tuberculous deposits
mixed with an impure bloody-like matter, may be detected in such milk by
means of a microscope of three hundred diameters.  Sometimes, in our large
cities,  the milk  dealers,  in order to disguise the smell and taste of diseased
milk, add to it a  portion of good milk, and also of sugar of lead,  which last
is a slow but sure poison, and which may be detected by adding sulphureted
hydrogen to the  suspected milk, whioh occasions  a black,  or dark brown
color when lead  is present.   Every family,  and especially those living  in
cities,  where these  diabolical impositions are more apt to be pursued, should
be  provided with a good achromatic  microscope,  sulphureted  hydrogen.
and a  few other tests which will be named in the work at their appropri-
ate places, for the purpose  of detecting and thus  preserving their  health and
lives from these  and many other base frauds  which will  be referred to  here-
after.   The benefit to be derived from the possession of these  detective agents,
will repay their  expense more  than an  hundred-fold, physically,  morally,
and pecuniarily.  Milk, especially  the   milk  from  slop-fed cows, is  often
adulterated  with  animal substances,  as  the
brains of dogs, horses, calves, sheep,  hogs, &c,
also with water,  flour,  starch, chalk, &c, for
the purpose  of  improving its color,  smell,
taste,  and consistency.  Animal  matter may
always be detected by  the microscope; or,
the^suspected milk may be allowed to stand
in aVopen vessel, in a warm place,  for a  day
or two, when  it  will  be found to evolve the
odor peculiar  to animal matter in a state of
decomposition; while the odor of good milk
thus  exposed  will  be merely  sour, without
any putridity.
Microscopic view of Milk adulter
   ated with Calves' Brains, 
46
AMERICAN  FAMILY  PHYSICIAN.
    Flour or starch may be detected by adding  ten or twenty drops of the
  tincture of iodine to a wine-glass half-filled with the suspected milk, which
  will be rendered  of a blue color when either of these  articles are  present.
    Where chalk is present, it will form a deposit when the adulterated milk
  is permitted to stand for a few hours, and  to determine  that the sediment
  is chalk, or plaster of Paris, add some water to it,  and then  carefully pour,
  drop by drop, a small quantity of sulphuric acid on it, which will occasion
  a precipitate of sulphate of lime.
    Good milk should be of a pure, white  color,  and not of too thin consis-
  tence ; when very thin  or fluid, and having a bluish tint, it is owing to the
  addition of water.   The man who is detected in manufacturing  or selling
  diseased,  adulterated, or otherwise impure milk, is as guilty of crime as he
  who commits theft, arson, or  murder,  and should,  therefore, be  subjected
  to similar penalties.  For where is the difference between the  man  who
  takes your money stealthily and without any equivalent,  or  he who takes
 it openly, pretending to give  an equivalent, but  really  giving  an article
                              most certainly deleterious  to health and  life?
                              Or, where is the  difference between the  man
                              who  fires  your  dwellings,  regardless  and
                              ignorant of the lives he may thereby destroy,
                              or he who  knowingly sells you, as  a substi-
                              tute for a  pure and healthy article of diet, a
                              vile compound most certainly destructive to
                              health and life?  Again, the murderer gen-
                              erally finishes his deed by  an  immediate act,
                              but is it  any the less murder, when life is
                             slowly but certainly  destroyed by the substi-
                             tution of poisonous  and diseased manufac-
                             tures  for innocent and nutritious substances?
   Cream is that element of milk which floats  upon  its  surface when it  has
been standing for several hours; its  upper portion  is  richest  in butter, its
lowest in caseine; churning unites the  fatty globules to form butter, while
the residue is buttermilk.   Cream agrees  with many persons when used in
Bmall quantities; but with some stomachs  it disagrees in  the  same manner
as would a similar quantity of oil, butter,  or other fats.  The milk most
commonly sold in  cities, and used in cakes, &c, is known as skim-milk hav-
ing been deprived of the greater portion  of its  cream.  Ice-cream is'more
frequently  made from skimmed milk, than from that containing the cream
and when thus made it forms an excellent, refreshing diet for patients laboring
under fevers and  various  other forms of disease.   A good  ice-cream  foi
this purpose may be made as follows:—Take of good sweet milk, five quarts
ten eggs, two  pounds of white sugar,  and  sufficient essence of  lenrW te
give the desired flavor.   Add all together, having first thoroughly beaten  the
eggs.  Surround the tin vessel  in which these are contained, alternately with
a layer of ice and a layer of coarse salt, and freeze in the ordinary way   If
desired,  tincture of vanilla may be substituted for the essence of lemon  or
Poor Milk. 
CHEE8E.—BUTTERMILK.
47
the sugar may be made into a syrup by rubbing it with a sufficient quantity
of strawberries,  raspberries,  &c, according to the flavor desired.   Some
manufacturers of ice-cream omit the eggs, and substitute arrow-root, tapioca,
or starch.
  Be careful, when purchasing ice-cream, that it  is made of good milk, or
cream, and not of the poisonous articles above referred to.  The impurities
in cream, as lead, chalk, brains, etc., may  be detected  in  the same manner
as named for milk.  Arrow-root, when added to milk  to make it look  like
cream, may be known by the dark blue or purple color produced by adding
a few drops of the tincture of iodine to a small quantity of the fluid.  Pure
cream becomes faintly  yellowish when iodine is thus added to it.
   Cheese, when recent or new,  is not very easily digested, and should be
eaten only by those  who exercise much, and have good digestive powers; it
is a very unwholesome diet for children.  Old cheese is less digestible than
hew,  and becomes more exciting and less  nourishing.  When roasted, or
cooked, cheese becomes extremely indigestible, and is then decidedly objec-
tionable as an article of diet; yet many persons,  having powerful digestive
functions, partake of cheese  without any unpleasant results,  while  others
suffer from various disagreeable symptoms.  Cheese  should never  be eaten
with dessert as an aid  to digestion, for this is a mistaken  and very absurd
idea.
   Cheese is frequently contaminated with red lead, which may be  detected
by allowing a piece  of the  cheese to remain in a small quantity of water
for five or six hours; then filter, add a few drops of muriatic acid,  and  also
a small portion of sulphureted hydrogen, when,  if the smallest quantity of
lead be present,  the  water will become changed to a brown or black color.
  Sulphureted hydrogen may be made by placing, in a large  mouthed  vial
capable of  holding four fluidounces, about twenty grains of  sulphuret of
iron,  or sulphuret of antimony, in powder, and half a fluidounce of diluted
muriatic acid.  Close the mouth of the vial with  a well-fitted  cork,  which
has a bent glass tube in it, so arranged that  one end may remain in  the
cork and the  other be passed down into the liquid to  be  examined.  Such
bottles and prepared corks  can  be obtained of any good druggist.  As soon
as the acid acts upon the sulphuret,  it liberates  the sulphureted hydrogen
gas, which  passes through the glass tube into the liquid under examination
and produces its effects as it becomes diffused through the fluid.   This gas
is colorless, of a very offensive odor,  resembling putrid eggs, and is highly
deleterious when inhaled;  consequently, care should be taken  not to  inhale
it during the  experiment.
  Buttermilk  is the residue of milk after  its  butter has been  removed by
chiAing; it  consists of caseine, sugar, serum, and a little butter.   It forms
a very agreeable cooling beverage in warm weather, and is especially bene-
ficial  in fevers and inflammations.  It is very  slightly nutritive and of easy
digestion, but should not be allowed to become  too acid  before using it
Some persons are very fond of boiled rice and buttermilk,  while to  others
it is extremely disagreeable;  it is a nutritious, healthy  diet, however, whsn
it agrees with  the stomach. 
48
AMERICAN FAMILY PHYSICIAN.
  Butter is an oily substance, of soft consistence, procured from  the milk
of animals, by agitating it constantly for a length of  time,  which process
is termed "churning."    Ewe's milk contains the largest  amount of
caseiue  and butter,  is  consequently less digestible, and  unfit for dys-
peptics.   Goat's milk ranks  next, relative to its  nutritive principles,  and
of which the same remarks may be made as of ewe's milk.  Ass's milk  is
the least nutritive, but the most easy of digestion, and  on account  of the
small quantity of butter and large quantity of sugar of milk which it con-
tains, it is very useful in convalescence from  acute maladies,  consumption,
dyspepsia, &c.  It is sometimes prepared artificially by dissolving a couple
of ounces of sugar of milk in a pint of  skimmed cow's  milk.   The  butter
used at meals is obtained  from the cow's milk, which is  intermediate, in
nutritive and digestible properties, between goat's milk and ass's  milk.
  Butter is used rather as a condiment than as a direct alimentary matter.
It is very difficult of digestion, on account of the readiness with  which its
volatile fatty acids are set  free.   Yet when it is fresh and sweet, and spread
not too thick upon bread,  there are  very few  stomachs which it offends.
When it becomes rancid it  is peculiarly unpleasant and unhealthy,  and
should never be used for any purpose, as diet.  It is often added in large
quantities to cakes and pies, and enters  largely into many sauces for pud-
dings, &c, in either of which forms it is very injurious, and will ultimately
cause severe and obstinate affections of the stomach, as well as of the skin,
if its use be thus persisted  in.   When  heated,  butter becomes empyreu-
matic, and is  very  unhealthy.   Dyspeptics and persons  having  weak
stomachs, should  use but little  butter  in any  form.  Children who are
allowed  much butter, or cakes, pastry, &c, containing it, have generally a
coarse and diseased condition of body, and are subject to  eruptions on the
scalp and other parts of the skin, boils,  sores, discharges  from behind  the
ears, &c.
  In  our large cities it is frequently a very difficult matter to obtain good
sweet butter, from the fact  that various frauds are  practiced upon their
communities.  Thus, good butter is often mixed with a  certain proportion
of lard, and which  mixture speedily  becomes rancid; or,  rancid  butter is
mixed with the fresh article; and, there are several  individuals who  make
immense profits by purchasing old,  rancid butter, then removing its stale
and rancid character by a  certain process, and disposing of it thus changed,
with salt added, as new butter.  When butter has once  become changed
from  rancidity or decomposition,  there is  no known  process which can
restore it  to its original  purity and character.  Many, very many of the
diseases among inhabitants of  cities,  and more especially  among  children
are due  to the constant and excessive use of butter which has become ragieid.
The  community in every  city  and town, in  justice to themselves, Mould
appoint a sufficient number of honest and capable men as inspectors  of the
purity of all those articles  termed the "necessaries of life;" they should at
least, use as rigid measures for the protection of life and health, as they do
for that of property, and the "luxuries  of life." 
VEGETABLE DIET.
49
  All fixed fats and oils of animals are of more difficult  and slow digestion
than any other alimentary principles; and with dyspeptics they  are  very
imperfectly digested.  Still,  in small quantities,  they are frequently bene-
ficial among the robust and those of healthy stomachs; and in many diseases,
where the digestive functions are perfect, a moderate employment  of them
is followed by an improvement of the general health.  When they become
rancid, or acted upon by heat, they undergo chemical changes  which render
them more difficult of digestion, and exceedingly obnoxious to the stomach.
Bakers frequently  employ rancid lard or butter in making their cakes, pies,
<fec,  and  which not unfrequently  occasion distressing symptoms  among
children who eat them.   Lard  or  butter, when in  the least  rancid, will
change the blue color of  litmus paper to a red.   Good  lard is  white, ino-
dorous, tasteless,  and possesses a  granular feel.   Among the fat  or oily
articles of food which are offensive to dyspeptics and weak stomachs,  may be
named the following:—fat meats, marrow, oil, butter, livers, brains, yelk of
eggs, milk, cream, cheese, buttered toast, melted butter, butter-crackers, pastry,
marrow puddings, suet puddings, butter-sauce, salmon, herrings, sprats,
eels, fried dishes of all  kinds, gravies, oily seeds, as nuts,  walnuts, cocoa-
nuts, hashes, stews, broths, fat soups, and chocolate.   Sometimes dyspeptics
will be met with, whose stomachs  are not injured by some one or more of
these, but such cases are exceptions; for instance, the fat of salt pork, and
of bacon will frequently be  digested with perfect ease,  where  many other
apparently more appropriate articles of food will oppress  the  stomach for
hours.   The same  articles, rare broiled^  and given in small quantities  at a
time, to children laboring under cholera-infantum, have  remained  upon the
stomach,   when everything  else would  be  rejected, or, if  retained,  pass
through the alimentary  canal undigested; and I have frequently witnessed
excellent results from a  similar diet in convalescence from fevers and other
exhausting diseases.
                        CHAPTER   IV.

                     Articles of  Vegetable Diet.

  The varieties of food procured from the vegetable Kingdom, are much
more numerous than those had from the animal, among the most important
of which are, the Cereal grains, as wheat, corn,  oats,  barley, rye, rice, &c,
and the nourishing power of which depends principally upon the gluten,
starchjand gum, which form part of  their composition.  Vegetable gluten,
or vegetable  fibrin, is found in all farinaceous grains, as well as in several
parts  of many plants.  Wheat contains  much  more of it than  the other
farinaceous bodies, owing to which, wheat  flour forms a superior article to
any other for the preparation of bread.  Associated with starch, gluten is
exceedingly nutritious.
         4 
60                 AMERICAN  FAMILY PHYSICIAN.
                               Starch is likewise a proximate principle of
                            various vegetables, especially wheat, rye, corn,
                            barley, oats,  rice, peas, beans,  chestnuts,
                            acorns, potatoes, &c,   Wheat yields  one of
                            of its purest varieties.  It is very nutritious,
                            although rarely used alone as food, except in
                            the form  of  arrow-root boiled in water, and
                            given  to the sick.  It also  forms an  excel-
                            lent demulcent in  various affections of  the
                            bowels, and is stated to be an antidote to  the
                            effects of an overdose of  iodine.
                               Gum which is  obtained  from  the  peach,
    Microscopic view of Starch.    plum,  cherry, and  several other fruit  trees,
is  also nutritious.   The gum arabic of  the shops, which  is obtained from
the Egyptian thorn-tree, has afforded  nourishment  and strength  to large
caravans travelling over the deserts.  It is seldom used as  diet, except in
some cases of sickness, being principally employed in  solution as  a demul-
cent in irritation or inflammation of the lining  membrane  of the stomach
and bowels  and of other mucous surfaces.
   Sugar is a well-known vegetable  element, and is chiefly  obtained from
the sugar-cane, saccharinum officinarum, although it  is contained  in many
other plants, and exists in most ripe fruits; it is also met, with in animal
substances, as for  instance, milk.
   Sugar is usually considered a highly nutritive article  of  food;  Liebig
states it to be merely an  element of respiration.   It is of  easy digestion,
except among dyspeptics, with whom it  may occasion acidity and flatulence,
and when eaten in moderate quantities, in  combination with other aliment-
ary substances, it  is very wholesome.  Raw or brown sugar always contains
more or  less impurity, and is not so fit for general use as the purified or
refined  sugar.   Many persons  entertain the idea that  sugar is injurious to
the health and especially to the  teeth, but this is an erroneous  idea;  during
the seasons for making sugar, the  negroes, and animals on  the plantations
partake  of the sugar-cane juice and molasses very freely, and they inva-
riably fatten in consequence thereof, and  their teeth are  white, and in the
very best condition.   Sugar is  a destroyer of  worms  in  children, and an
appetite for it, should rather be encouraged and moderately gratified, than
repressed.
   The teeth may be injured by allowing sugar to remain  between them or
in their interstices, with other matters which undergo decomposition, giving
 rise to acids which destroy their enamel.   And  the injury to  health among
 children, arises not from the sugar, but from the many vile additioi^|which
 are made in the form of sugar-plums and candies, for the  purpose of pleas-
 ing the eye, or tickling the palate.  For  instance, the various colors are
 made by adding several poisonous substances to the sugar, while it is  oth-
 erwise rendered obnoxious to health, by the addition of spices, liquors, acids,
 and other deleterious agents.
 
MOLASSES.--HONEY.--WHEAT.
51
  The yellow color is produced by chrome yellow, a preparation into wlich
lead enters, as well as gamboge, which latter is a powerfully drastic and
irritating purgative.  Red, by vermilion, a mercurial preparation  which ifl
frequently adulterated  with red lead.   Green, by  Scheele's green, in the
composition of which arsenic and copper enter; and so of the other colors.
  To detect these poisons, throw some of the green candy on hot coals, and
if a garlicky odor is observed, it is due to the presence of arsenic.   If aqua
ammonia be  dropped upon the candy,  and changes its  color  to a blue,
copper is present.  If the candy  be dissolved in  water, and sulphureted
hydrogen be added to it, the  presence  of lead will be known by the liquid
becoming of a black or dark brown color.
  Molasses or Treacle,  is a dark  brown,  viscid fluid,  possessing properties
somewhat similar to those of sugar.  It is a syrup  containing uncrystalli-
zable saccharine  matter, mucilage, free acid, and water;  it is generally of
easy digestion, and used in moderate quantity forms an excellent addition
to bread, especially for children, with whom  it will be found more whole-
some than butter, or pastry, rich cakes, &c.
  Honey is a substance prepared by the honey-bee, apis mellifica,  from the
nectaries of flowers.  It is a thick,  viscid,  colorless  or pale straw-colored
fluid, of a peculiar fragrant odor, and an agreeable sweet taste.   It contains
two saccharine principles, an aromatic  principle, wax, an acid, and a little
mannite.  When  eaten  in moderation with bread,  it is wholesome and
nutritious, though it  is very  apt to  occasion griping, looseness, and other
unpleasant symptoms, among persons of weak stomachs, and dyspeptics.
  Honey  is frequently adulterated  with starch, sand, flour, &c, for the
purpose of improving  its color, or increasing its weight;  similar adultera-
tions are practiced with sugar.  Sand  may be detected, in either  sugar  or
honey, by dissolving  the article in  water,  when the sand will  sink to the
bottom.  The tincture of iodine added in small quantity, to the  water  in
which the article  has been dissolved, will be changed  to a blue color if flour
or starch be present.  When honey is very thin, and does not readily deposit
granular crystals,  it is owing to the  addition of water to increase its bulk,
and in this condition it will rapidly undergo fermentation in warm weather,
acquiring a deeper color and a pungent taste.
  Wheat,  (Triticum hybernum), forms one of the  most valuable  and nutri-
tious articles of food; there are several varieties of  it, from  which  flour is
manufactured, but all of which contain starch and gluten in larger propor-
tion  than any other seeds.  One hundred parts of wheat, contain, according
to its  quality, from G7 to 72 parts of starch, from 9  to  12 parts  of  gluten,
from 4 to  8 parts of sugar, from 2  to  6 parts of gum, and from  8 to  12
parts of water, beside the bran, which also varies in its proportions.  Wheat
flour is formed by grinding the seeds, and  passing the fine powder formed,
through cloth sieves of different grades of fineness;  the finest powder being
used, as a superfine or extra-superfine flour, in the preparation of bread, cakes,
&c. while the coarse powder, known as middlings,  is principally consumed in
Ihe manufacture of hard or sea biscuit.   The husks or shells  which remain 
52
AMERICAN FAMILY PHYSICIAN.
 in the bolting machine  are called  bran,  and  constitute the least  por-
 tion of the grain, say from 25 to 33 per cent.  Bran made into a decoction
 with water, is frequently used as a beverage  in acute diseases; it contains
 Borne nutriment, and is also said to possess  laxative properties.
   Oats, (Avcna Sativa) are nearly, if not quite equal to wheat, in point of
 nutrition.  Oat-meal forms a large part of the diet of Scotland, Ireland, and
 the north of England; countries which have always produced a  race  of
 healthy and vigorous men.   It  may be used either as a gruel,  or in the
 form of unfermented bread.  When made  into fermented  bread,  in  the
 ordinary way,  it is  unpalatable  and of difficult digestion.  Unfermented
 oat-bread is made by  boiling the  meal with water, forming it into thin
 cakes, and baking or roasting them; however it is apt to disagree with
 those unaccustomed  to it, as well as with dyspeptics, occasioning heartburn,
 and  other unpleasant symptoms.
   Oat-meal gruel is  made  by boiling  oat-meal  in water, its consistency
 depending on the condition under which it is employed as a diet, and which
 may be regulated by using a smaller or larger quantity of the meal as may
 be required.   It forms a very nutritious and salutary food for children and
 convalescents, as well as for females shortly after  confinement, and is much
 preferable with such persons to either tea or coffee.  The addition of milk,
 or milk and sugar, increases its nutritive powers,  and a little grated nutmeg
 improves its flavor.   Sometimes,  raisins are added for a similar purpose; and
 when used in the sick room, it may be rendered very palatable by acidulating
 a very thin gruel with  lemon-juice.   It is much  more nourishing for the
 sick, than the starchy  preparations,  arrow-root,  sago,  tapioca,  &c.  Oat-
 meal is not employed as much in this country as  Indian corn meal.
  Barley, (Ilordcum Distichon) of which there are several  varieties.  This
 plant is cultivated in almost all civilized countries, and  is prepared for use
 under the name of pearl-barley.   To obtain this, the husks of the  grain are
 removed, and the remaining  parts are  rounded  and polished into small,
 pearly white grains.  When the  pearl-barley thus  made is ground to powder.
 it is  called patent barley.  The husk of  barley is  slightly acrid, but, when
 deprived of this, the  seeds are very nutritious, less so, however, than wheat
 and are said to be more laxative  than  the other cereal grains.  Bread made
 of barley is not very palatable nor wholesome, and digests with more diffi
 culty than wheat bread.   The  best  form for using this  article  is that o/
 barley-water, which may be made according to the  following receipts, either
 in the simple form, or as a compound preparation:—
  1.  Simple barley-icater may be prepared by  taking two ounces and a half
 of pearl-barley, and  washing it clean in some cold  water; then add half a
 pint of water to it, boil for about fifteen minutes,  pour it off and  throw the
 fluid away.   Then to the barley thus  prepared, add two quarts of boiling
soft water; boil down to two pints, and strain.  If required, this may  be
flavored with sugar,  or a few  slices of lemon peel.  It forms an  excellent
drink in fevers and inflammatory diseases, assuaging thirst, and acting as a
demulcent and slight aperient.   When  mixed with an  equal quantity of 
RYE.---BUCKWHEAT.---RICE.                 53
fresh cow's milk, and a small portion of sugar of milk, simple barley-water
forms a good substitute for breast-milk, and may be given to infants who
have to be brought up "by hand."  An ounce of gum Arabic dissolved in
a pint of simple barley-water, is very useful in gravel, gonorrhea, and stran-
gury from a fly,  blistering plaster.
  2. Compound barley-water is made by adding to a quart of simple barley-
water, two ounces and a half of figs, sliced, two ounces and a half of raisins,
stoned,  half  an  ounce of  liquorice root, sliced and bruised,  and a  pint of
soft water.   Boil these together, down to a quart, and then strain.   It is used
Bimilar  to the above in febrile and inflammatory affections.  Pearl-barley
is frequently added to soups and broths with advantage.
  Rye,  (Secale Ccreale,)  is cultivated in nearly all  civilized countries.  It
contains less gluten than wheat, and  consequently  its nutritive  properties
are inferior.  Bread made of rye is not so suitable for dyspeptics and sed-
entary persons as that made from wheat, because it is of more difficult diges-
tion, is apt to acidify upon the stomach, and  to irritate the bowels, fre-
quently causing diarrhea.   A mixture of rye and wheat made into bread,
is more palatable,  wholesome, and digestible, than when rye  alone  is used.
Rye is subject to a disease producing the spurred rye, or ergot.  Should it
be  eaten in  this state  in  any quantity,  it is  very unhealthy,  producing
serious  forms of disease,  as convulsions  and mortification of the  lower
limbs.
  Buckwheat, (Polygonum  Fagopyrum^) is an Asiatic plant, cultivated in
many parts of the United States.   The flour or meal prepared from it may
be formed into bread, but it is  neither  palatable  nor  wholesome.  It is
piincipally used in this country in the form  of buckwheat cakes, which
though very  palatable,  contribute a very meager amount of nourishment,
ahd are of  difficult digestion.  With some persons a cutaneous eruption
always follows their use; probably this, and the other  unpleasant conse-
quences arising  from a use  of  buckwheat cakes, are owing to  the large
quantity of melted butter, grease, wines,  &c, which are eaten with  them.
Dyspeptics and invalids  should always shun  them.   Buckwheat flour may
be used to recall the flow of milk in the breasts of nurses where it has disap-
peared for several  days, as follows:—To any  quantity of buckwheat flour.
add a sufficient quantity of buttermilk to form a poultice; warm it, but do
not boil it, or make it hot.  Apply it thus warm over the whole breast, and
renew it every four or six hours.  Sometimes it requires to be used thus
three or four  days before its effects will  be produced;  usually,  however,
twenty-four hours  will be sufficient.
  Rice, or the seeds of the Oryza sativa, is a well-known grain, extensively
raised  in the East, and also in the United States, and some parts of Europe.
In the tropical countries of the East, it is the principal food on which the
inhabitants  subsist, being used and cultivated,  and  answering  the same
intentions as wheat or bread with  us.  Although a  nutritious article, yet it
is less  so than wheat.  Used alone, it is apt to "turn sour on the stomach,"
and should  therefore be eaten with bread,  milk, or meat.  When boiled 
54
AMERICAN  FAMILY PHYSICIAN.
with milk, eggs, and sugar, it furnishes a very light, savory, and  salutary
food; it may also be used in a variety of forms, as boiled rice,  eaten with
milk  or meats,  rice-puddings, rice-cakes,  and rice-water  or mucilage  of
rice.  It  is supposed  to possess  a binding or  constipating  quality, on
which account it is prescribed as a diet in dysentery and diarrhea, and will
be found  in most cases,  sufficient to check the  diarrhea  so  common  to
eastern  people,  who  for the first time make  use of our  western  river
waters.  Rice-water, and rice-jelly, are very useful in acute and chronic
affections  of the alimentary canal; nourishing while they soothe  the  irri-
tated  or inflamed mucous membrane.  The jelly may be made by boiling
two ounces of rice flour, and three ounces of loaf sugar in a pint of water,
until  it becomes thick and transparent, flavoring it with rose,  or orange-
flower water.  Or it  may be made by slowly and carefully boiling clean
rice in a small quantity of water, until it is reduced to the  state of pap  or
jelly,  when it may be sweetened and flavored with vanilla, essence of lemon,
&c;  on cooling, this assumes the form of a jelly, and may be eaten alone
or with milk, and  in  convalescence from exhausting diseases, dyspepsia,
summer complaints, &c.
  Indian  Corn  or Maize, (Zea mays,) is extensively  used  in  the United
States, as  well as in Asia, and some parts of Europe, as an article of food.
Corn  contains no gluten, and hence  its meal does  not rise  or undergo fer-
mentation, as with wheat and rye.   A yellow oil is obtained from it, which
may, perhaps, account  for its disagreeing with many persons.  It furnishes
a very healthy, nutritious, and palatable diet, and is especially adapted for
the support of the energetic and hard-working classes.
  With some persons,  and especially those who  are not  accustomed to its
use, corn  bread is at first rather unpalatable, is apt to  turn sour on the
stomach, and also occasion  diarrhea, and sick-headache ; but by persever-
ing in its  use they soon  learn to  prefer it to wheat bread as a  common
diet.  It is certainly preferable to the wheat bread as at present  made by
bakers,  which may be said to  occasion at least  one-third of the  sickness
met with  in cities.  Indian meal may be made into bread, or puddino--  in
the form of mush and  eaten with milk, it forms a very palatable and nour-
ishing food.  The  young ears boiled,  are in general  a  nutritious  and
digestible article of diet, but should be eaten with caution by those predis-
posed to,  or suffering from a disease of  the bowels.   Indian meal gruel  ia
frequently more grateful to the sick than that made from oat-meal  and is a
useful diet for convalescents from febrile diseases, as well as for those who
have  committed excesses in eating.   Some convalescents find  it  more
palatable  and  agreeable  when seasoned  with  a  proper amount of  salt
instead of sugar.  The proper way to make Indian meal gruel, is to boil a
small quantity of the meal in boiling water, for about half an hour, stirrin<*
it frequently, and seasoning it lightly with salt,—more may be added after-
ward  if required.  If milk  is not  forbidden, a  teacupful  may  be boiled
with a pint of the gruel, which should not be too thick.  An  infusion  of
parched corn, will allay the nausea  and vomiting  attendant  upon many 
BREAD.
55
diseases; it may be drank freely.  The  Italians form a dish called polenta,
which is made by mixing corn meal with cheese, and baking it into a kind
of pudding; perhaps this may be useful with those  in whom corn alone pro-
duces diarrhea.
   A bushel  of corn weighs  about 60 pounds,  which at fifty-six cents
would be about one cent per  pound, and one  pound  of corn cooked, will
support a  laboring  man daily.   If, however, to this be added potatoes
which average  about a cent per pound and of which  from three  to five
pounds a day are sufficient for an adult  individual, we find that six cents a
day is fully adequate for the  strength and nourishment of one  person; or
$21.90 per year.  And a family of five persons, consisting of a man, his wife,
and three children, can  be well and thoroughly supported on a solid diet,
amounting to about  875 per year.   Of course, milk, fruits, &c, are not in-
eluded in this estimate, but their cost is much greater in cities than in the
country.
   Bread may be made from rye, oats, rice, barley, and other plants contain-
ing  starch,  gluten,  and saccharine matter: but that which  is more uni-
versally used as an article of diet is prepared from  wheat flour.  The usual
method of making bread is to  mix water with the flour  in sufficient  quan-
tity to form a dough of a thick pasty consistence, having also added a small
quantity of salt to improve the flavor and color of the dough, as well as  to
impart stiffness  to it.   To  this yeast or leaven is added, and the whole is
then set aside for five or six hours in a  place not too cool, to undergo fer-
mentation, after which it is  divided into the proper sizes,  and baked  in an
oven having a temperature about 448°.  After the bread has been baked, if,
it has been properly fermented, it will be much more easily digestible than
the flour from which it was made, owing to its  having undergone  a change
which will  render it  impossible to detect its original ingredients.   Thus,
the yeast or leaven causing a vinous fermentation of the saccharine princi-
ple of the flour, carbonic acid gas is given off, and alcohol is formed.   The
tenacity of the dough, which is occasioned by  the gluten, prevents the es-
cape of the carbonic  acid, the gluten is thereby expanded, the whole mass
becomes extended and swollen, forming numerous small cells in a light and
Kponsry  dough.    The alcohol which is set free during the baking of the
?>read, may be collected, if desired, by a proper contrivance.
  Potatoes, though  less nutritive than  wheat flour, are frequently used  in
making bread, they assist fermentation and serve to  render the bread lighter,
and if not added in too large quantity they are  not objectionable.
  There is no doubt  but that the affections of the digestive organs, nervous
disorders,  kidney and skin diseases met with in the cities of this country,
are in a great measure, owing to  the common use of bakers' bread instead
of that of domestic  manufacture.   Not that  bakers cannot make  good
bread, but that they do not,  from the fact  that an  adulterated  bread
pays better.  The objections against bakers' bread,  are, principally, two:—
its adulteration, and  its improper fermentation.  The most commcin  adul-
teration is alum, which is added to improve the firmness and whiteness  of 
56
AMERICAN FAMILY PHYSICIAN.
the bread; and, on this account, an  inferior flour is made  use  of, whicfc
undergoes fermentation rapidly, and becomes acid—thus accounting for the
sour bread so frequently met with at the baker's shop.   Bread made thus,
may be eaten warm or recent without discovering  its acidity, but after it is-
twenty-four  or thirty-six hours old, this difficulty is very manifest.  So that
we not only have the evil consequences arising from the daily use of several
grains of alum, but also from the acidified condition of the bread.   And yet
notwithstanding this deleterious adulteration we find the inhabitants of cities
blindly and  carelessly swallowing whatever is given them as bread by  the
bakers, without stopping a moment to enquire whether such kind of food is
compatible with health and longevity.
  It is a very common  plan with many bakers to  purchase  old sour  flour,
which is entirely unfit for the sustenance of the human system, and mix it with
new, garlicky flour, in the proportion of one barrel of the former  to two of
the latter.  By this combination, the garlicky odor of the one and the acid-
ity of the other, are  almost  entirely overcome, while a little alum added
improves the whiteness and firmness of the bread.   And this stuff is palmed
off upon community to engender disease, because it puts a few more dollars
into the bakers' pockets.  This fact is well understood by flour-dealers.
  During our warm summer  months, we hear a great deal said about eating
those delicious fruits which nature so lavishly bestows upon us for the pur-
poses of health and nourishment in these seasons.  Diarrhea, cholera-mor-
bus,  summer-complaints, and cholera, are  all attributed  to these really
healthful agents, while the adulterated cake and bread of the baker, the ex-
cessive use of fat, gross meats, &c, are barely ever dreamed  of as  being the
principal offending causes. When will the people learn and practice common
sense in matters pertaining to health?  A quantity of arsenic placed in our
food causes death quickly, and the journals herald the awful results through-
out the country,  and community is shocked; but, that  which slowly and
gradually undermines life, occasioning diseases which do not appear  to  be
the immediate result of any unhealthy principle in food,  is  hardly, if ever
referred to, and the pernicious consequences are looked upon as a  matter of
course,—a fate to which mankind is  inevitably doomed,—and the  only  no-
tice observed, is a quiet statement, that Mr. So and So died of dyspepsia, 01
cholera-morbus,when the probable fact is, he died of a continued use of adul-
terated  and  otherwise deleterious bakers' bread.  But this is  a money-
making country, and health and life, and all matters relative thereto, must
be placed aside when dollars  and cents are brought into view.  In my own
practice I have frequently attended families in whom, and especially among
the children, symptoms have presented themselves for  which I  could  not
readily account, and which have  either proved intractable to medicine, or,
if yielding for a time, have been certain to make their reappearance.  Upon
persuading the heads of  these families to make their own bread and cakes,
and refrain from using those * of bakers' manufacture, all the unpleasant
symptoms have been permanently removed, and without the assistance of a
©article of medicine. 
                     SOUR BREAD.--BROWN BREAD.                  5 t
                 i
  Carbonate of ammonia is  frequently added, by unprincipled bakers,  to
aour flour, for the purpose of rendering the bread made from it  light and
porous.  Sulphate of copper, or blue vitriol, is also added to bread previous
to its being baked for the purpose of disguising the quality of the flour
from which it is made; this may be detected by soaking the  bread  in  rain
water, filtering and adding to the water  a  small  quantity of a solution  of
ferro-cyanide of potassium, (an article which can  be had at any drug store,
and which  being unsafe, should  be kept out of  the reach of servants and
children,) when, if any copper be present, there will be a reddish-brown pre-
cipitate.
  Alum may be detected in bread,  by  the following method:   Soak a small
quantity of the suspected bread in pure water, squeeze the mass through a
piece of cloth, and allow it to stand until  the liquid has become  clear and
transparent: carefully pour  off a portion of this, and add to it a few drops of
solution  of muriate of  lime, which  can be obtained at any drug  store.   If
alum be  present, a more or less dense white cloud will be  exhibited,  which
on standing will be precipitated in the form of a white powder, which is sul-
phate  of lime.   The action in this case is thus,—the sulphuric acid  of the
potassa and  alumina of the  alum, unite  and precipitate with the lime  of
the test,  while the muriatic acid  of the latter combines with the alkalies  of
the alum, and remains dissolved.
  Sour bread may be detected by  soaking crumbs of the bread in water, and
then applying a piece of blue litmus paper to it, which will  be reddened if
acid be present.   The litmus paper may also be obtained  of the druggist.
  Good wheat four may be  known by mixing  it with a  small portion  of
powdered guaiacum in water; if it be good, and  rich in gluten, a  fine blue
color is produced, but if bad, the  blue is hardly apparent.
  The fermentative process  would if allowed to  continue, ultimately ter-
minate in complete decomposition of the original  elements of the  flour, and
putrefaction, but the heat of the oven, by removing the moisture, arrests any
further fermentation.  It, isr however, frequently  the case,  that, in warm
weather when the season is damp, bread  absorbs moisture from the atmos-
phere, and  quickly passes through the alcoholic,  acetous,  and putrefactive
stages  of fermentation.  Weak stomachs, and those disposed to an excess  of
acidity are very  apt to occasion these results,  which may, however, be
avoided,  by thoroughly  toasting the bread, previous to eating it.
  Although bread is  very nutritive, yet alone it is not capable of sustain-
ing a prolonged  life, and the prison diet of bread and water is a very impro-
\erone, on this  account.  The most nutritious and digestible bread, is that
which  is  made from good, fine wheat flour.  Brown bread, sometimes  called
vrraham  bread, made from wheat flour containing  bran, is  very useful as a
laxative  in cases of habitual constipation, in diabetes, and for  sedentary
persons.  Sometimes, however, it will be found to disagree.  The bran is in-
digestible, but in passing through the bowels, it acts mechanically  upon
their mucous membrane, in most cases, exciting them to a healthy action.—
Hot rolls, hot biscuit, and warm or fresh bread,  are especially unwholesome 
58
AMERICAN FAMILY  PHYSICIAN.
 and indigestible, though healthy stomachs frequently manage to digest them
 when they are not too frequently used; but invalids and dyspeptics  should
 always avoid them.  Bread is always better when it is eaten on the day fol-
 lowing its preparation.  For invalids,  convalescents, and those of tender
 stomachs, toasted bread will be found a very useful article  of diet,  It is es-
 pecially adapted for those upon whose stomachs bread, in its  ordinary con-
 ditions, and most vegetables are liable to become sour, or produce flatulency
 and constipation.  It should be eaten with a very sparing  quantity of but-
 ter, which should not be placed upon it, till the toast is cold,  otherwise, the
 heat will so change the butter as to render it difficult of digestion and very
 obnoxious to the stomach.
   Mouldy bread, or bread made from diseased grain, as mildewed wheat, &c.,
 is more or less deprived of its nutritive qualities, and is very apt  to occasion
 serious symptoms,  as, headache, thirst,  dry tongue, colic,  rapid  pulse, stu-
 por, diseased stomach, diseased  kidneys, &c.  The preparer or vender  of
 diseased wheat  flour should  always be liable to some kind of punishment;
 for, he is more to be dreaded than the  man who attacks one openly with an
 avowed intent to destroy life.
   Biscuit  is an unfermented  bread, which is not  apt to become acid  in the
 stomach, and is therefore wholesome for children, and those whose stomachs
 are disposed to acidity.  It frequently agrees better  with the dyspeptic than
 fermented bread, and when reduced to powder, and formed into a  panada
 with hot water,  it forms a better article of food for an infant, than when the
 diet is made of fermented bread.   When  made with the  addition of butter,
 biscuits are  more difficult to  digest, and are consequently injurious to  dys-
 peptics, and those of weak stomachs.  On this account pastry and all cakes
 containing butter or lard, are unhealthy, and should seldom be used—never,
 by invalids and children.  These articles are very  agreeable to the  taste.
and are apt to be freely indulged in, especially by the young;  their common
 use occasions disease  of the stomach, disease of the skin, inflammatory affec-
tions, and a disposition to apoplexy in  certain constitutions.   Children who
are  indulged in cakes and  pastry, are almost always in  the physician's
hands.   Pancakes and fritters, made by mixing flour and yelk of e«-"-s  into
a paste, and frying in lard,  may  produce little inconvenience  to persons
whose digestive powers are energetic and strong—yet they are  very indi-
 gestible, and should  be carefully avoided by  the  convalescent,  the seden-
 tary, the dyspeptic, and those liable to attacks of apoplexy and epilepsy.
   Puddings are of various kinds, those made of bread and  milk,  or  of rice
 are digestible, and may be  partaken of,  temperately, with benefit.   Paste
-puddings or  dumplings, are  extremely indigestible  and  unwholesome, and
 should always be avoided  by those of weak or impaired  digestion.   It  is
 very doubtful whether a dough  made of wheat flour and boiled  is at all fit
 for food; it will always be heavy and  extremely difficult to  digest.   The
 best puddings are  those made «f stale bread, sago,  rice,  or  Indian  meal,
 baked.  The boiled dough of stews, soups,  &c,  is very  indigestible, and
 unfit for weak stomachs. 
SAGO.---POTATO.
59
   Gingerbread composed of flour, molasses, ginger, and  pearlash, is, when
properly baked and eaten in moderate quantity,  a useful  article of diet for
adults;  often remaining on the stomach when all other articles of food are
ejected, especially in instances  of  sea-sickness.   It gently  stimulates the
stomach, and forms an excellent lunch  for those  who  have to  travel,  or
expose themselves to the early morning air  before  breakfasting.   Children
should use it very seldom,  as alPspices or stimulants are unnecessary, and
hurtful  to their stomachs.  Ginger-bread made with butter, or eaten with it,
is not readily digestible, and should not be used by dyspeptics, and those of
delicate stomachs.
   Sago  is an article of diet prepared from the pith or medulla of  the stems
of various species  of palms.  There are three kinds met  with,  viz:  1st,
Sago meal or flour, a whitish powder; 2d, Pearl  Sago, consisting of small
yellowish, or pinkish grains, and  3,  Common Sago,  occurring in rather
large grains, and being colored white on  one part of  their surface, and
brownish on another.  Boiled with water or milk, sago forms a light, grate-
ful, nutritious, and easily digestible article of food, especially adapted  to
children, and convalescents from febrile and inflammatory diseases.  It is
considered, however, inferior to  arrow-root for the diet  of patients.  Two
ounces of Sago boiled in a quart of water until a  mucilage  is formed, may
be added to a mixture of half a pint of Sherry wine, a  half-ounce of loaf-
sugar, a few drops of  essence of lemon, and a teaspoonful  of tincture  of
ginger.   This forms an excellent cordial in  convalescence from exhausting
diseases, and  may be  used  every four or five hours,  in the  quantity of a
wineglassful at a  time.
                          CHAPTER   V.

Articles of  Vegetable Diet  Continued.—Fruits.—Nuts.—Condiments.

   Potato is the root of the  solanum tuberosum,  and was introduced into
Europe as an article of food by Sir Walter Raleigh,  about the beginning of
the seventeenth century.  At  present it is  one  of the  principal articles of
diet in this country and  Europe, and is extensively used among the poor
and laboring classes.   It is usually boiled or roasted, and  eaten with animal
food,  to which it  is  a  light,  nourishing,  and agreeable accompaniment.
When fried, or finely mashed, it is not so digestible as when boiled or roasted,
and frequently burdens and annoys the stomach.  Those potatoes which are
dry and  mealy are  superior to  those  which are firm and viscid.  Potatoes
contain  water,  starch,  amylaceous fiber, ligneous  matter,  vegetable fibrin,
vegetable albumen,  gluten, fat, gum, vegetable  acids, salts, &c.   When boiled
in water, the starch grains absorb the  watery portion of  the potato, swell up, 
60                 AMERICAN  FAMILY  PHYSICIAN.

and distend the cells  containing  them, while the  albumen  coagulates and
forms irregular fibers between the swollen starch grains, and finally, the cells
in which the starch grains are contained, separate from each other, and when
the process is  completed the  potato is mealy; if  the  process  is incomplete,
the potato is watery, or waxy.  New potatoes are  not  so mealy as old ones,
and consequently are not so easily digested.  Potato,  whether eaten  raw or
boiled, is an excellent anti-scorbutic, and fas been found to cure scurvy,  as
well  as to prevent it;  and this influence probably depends upon the citric
acid which is present in this tuber.  Potato starch, in  some respects,  agrees
with other amylaceous substances in its general dietetical properties;  it does
not, however, yield so firm a jelly as the majority of them,  and is more apt
to acidify upon the stomach than arrow-root.
   The root of the  convolvidus batata,  known  by  the  name of Sweet-potato,
when properly roasted or boiled affords an agreeable and  nutritious article
of food,  not so easily digested, however,  as  the  common  potato, and very
apt to produce flatulence and oppress the stomachs of dyspeptics, convales-
cents, and those whose digestive organs are weak.   It should always be eaten
in moderate quantity.  It contains farinaceous, as well as a large proportion
of saccharine matter.                     ♦
   The fleshy,  tuberculated roots of the helianthus tuberosus, a species of sun-
flower known by the name of Jerusalem artichoke, are  frequently boiled or
roasted, and eaten as food.  Properly prepared, they become  mealy like the
potato, with a saccharine taste, but are usually more watery and more pro-
ductive of flatulence than  that tuber.   They may be classed with the potato
as an article of food.
   Cabbage, (Brassica oleracea,) of which there are several varieties,  is much
employed as an article of diet throughout the United States; and for healthy.
hard-working  persons, and those having good digestive organs, it forms an
excellent accompaniment to a meal of animal food,  especially when partaken
of frugally.  Not much nourishment is obtained from  cabbage,  and when
eaten by dyspeptics, or those of delicate stomachs, as well as  when eaten in
large quantity by those with  whom it might  otherwise agree, it occasions an
uneasy and oppressive sensation,  with flatulence, colic, or  cholera-morbus.
on which  account  it should never  be eaten by the invalid, or those who
pursue sedentary and inactive occupations.  For table use, it should be boiled
in water until it is perfectly  tender.
   Cabbage leaves  cut into slices,  and deposited in  a vessel in layers, each
layer alternating with one of salt, and allowed to  undergo  acetous fermenta-
tion forms sour krout, or sauer-kraut.   From five to seven weeks is required
for this purpose,  according to the temperature.   This  forms a good anti-
scorbutic vegetable food for sailors  on long voyages, and is an excellent addi-
tion to the meat diet of healthy,  robust,  hard-working  persons.  It should
be eaten by no others, as  it is liable to the same objections as boiled or raw
cabbage.   The Germans  make much use of sauer-kraut cooked with some
fat meat.
   Cauliflower (Brassica Botrytis-cauliflora,')  is a variety of cabbage, which 
        BROCCOLI.--ARTICHOKE.--ASPARAGUS.--GREENS, ETC.      61

is  probably more easily  digested than  any other;  but it should  never be
eaten by those with whom cabbage is improper.
  Broccoli,  (Brassica Italica,) another of the cabbage family, though very
tender and palatable, is more liable to cause flatulency, colic, cholera-morbus,
&c, than the other species, and consequently should be avoided by dyspep-
tics,  and those of inactive habits.
  Artichoke, (Cynara  Scolymus) is a well-known  garden esculent,  being
somewhat of a spinous or thistle-like plant.  The part used  is the  fleshj
receptacle, or bottom of the flower-heads, which is gathered before the flowers
expand, and deprived of the thistles  and seed-down;  the base of the involu-
cral scales is also used.   When thoroughly boiled, these form a tender,  sweet,
mucilaginous, nutritious and easily digestible article of diet; but when eaten
with melted or drawn butter, they are rendered indigestible, and should not
be used by those whose digestive  powers are not strong and active.
  Asparagus, or the young shoots of Asparagus Officinale, when thoroughly
boiled,  forms a  delicious, wholesome, and  easily digestible article of food;
the use of it communicates a peculiar odor to the urine.  It is  usually eaten
with toast and melted butter, the  latter of which, although it  may render  it
more agreeable to the palate, interferes with its ready digestibility.
   Greens.—Under this  head are  comprised the  young leaves  or shoots of
various plants, which are boiled and eaten with or without vinegar,  during a
meal  of animal  food;  generally, they  form a  very  agreeable and  useful
accompaniment.  The  leaves, &c, commonly employed are those of  spinage,
poke, turnip, dandelion, and radishes.   The young leaves of  Spinage, the
Spinacia Oleracia, when well boiled, are the most healthy among all  the vege-
tables used as greens;  they have  a laxative effect and  are useful in cases of
habitual constipation.  The young and tender shoots of the poke, Phytolacca
decandria, when properly boiled,  form a delicious and healthy vegetable, very
much  resembling asparagus in  its  flavor.   Care  should be  observed  not
to use them when too  old, as they are then poisonous.  Turnip tops, as well
as radish tops, although frequently boiled and eaten as greens,  are very apt
to disorder the stomach.   The young leaves of dandelion  form  an  excellent
vegetable  for greens; they have  a slightly  diuretic influence.  It must be
recollected, however, that the above articles are not proper for dyspeptics and
persons of inactive life, and will  sometimes be  found to  disagree  with the
more healthy and active.
  Beet, (Beta Vulgaris,)  the root of which, when well boiled, affords an
excellent vegetable addition  to meat diet.  It  is of a  saccharine taste, red
color, sometimes whitish,  and contains a large proportion  of saccharine mat-
ter.   Its digestibility is lessened  by  eating it with vinegar.
   Turnip, the root of the  brassica rapa, when  well-boiled, affords a  moderate
degree of nourishment, and is easily digested.  Among dyspeptics and those
of weak stomachs, it is apt  to cause flatulence, more especially when not
thoroughly boiled.
  Parsnip, the root of the pasiinaca sativa, contains  a large proportion of
mucilaginous  and saccharine substance, rendering  it a  highly nourishing 
62
AMERICAN FAMILY PHYSICIAN.
article of diet, and one of easy digestibility,  when thoroughly boiled.   The
peculiar flavor of the parsnip is owing to its volatile oil, which renders it
offensive to many.   Parsnips should be  eaten when  young; old  roots  are
stringy, or contain  too much fibrous matter, which  interferes  considerably
with their digestibility.
   Carrot,  the root of the  daucus carota is very similar in its  properties  to
the parsnip.  Its volatile oil  also renders it disagreeable  to many stomachs.
   Radishes  are  the  roots of the raphanus sativus; they are much used  as
a condiment, being eaten with salt without cooking.  But little  nourishmen
is contained in the radish, beside which it is a very indigestible article, and
will occasion flatulence, colicky pains, oppression, &c, unless the digestive
organs are very  strong and active.  When eaten at all, the young and tender
roots, not stringy in the least, should be selected.
   Cucumber, the green fruit of the  cucumis sativa,  is  much  used in  the
raw  state during the summer  months,   as an agreeable addition to a meal.
However,  it possesses but very  little or no nutritive properties,  is very indi-
gestible, and should be carefully avoided by dyspeptics and  those  who  are
subject  to looseness of bowels, cholera-morbus, &c.  Green cucumbers stewed,
form an agreeable and digestible article of diet.   Young cucumbers, called
gherkins,  are in  great use as  a condiment in the form  of  pickles, and are  an
excellent  relish  for  strong stomachs,  but should  be  especially avoided  bj
those of weak digestive powers.
   To improve the appearance of pickles  they are  sometimes prepared with
the addition of some salt of copper, any  one of which is highly poisonous.
Frequently, pickles  are  unintentionally  rendered poisonous  by preparing
them, or allowing them to stand, in copper or brass vessels, by  which means
they become impregnated with  the poisonous metal.  If a pickle containing
the smallest quantity of copper be cut into pieces, and then placed in a glass
vessel containing a  mixture of equal parts, in  bulk, of aqua ammonia and
water, the clear  liquid will become changed to a blue color.
   Tomato, the fruit  of the solanum lycopersicum,  of which  there are several
varieties, is much used as an article of diet in this country.   It possesses  an
agrecnble acid  taste, and forms a very  healthy  article  of food, exerting a
marked influence on the biliary functions.  It is eaten in the raw state, and
also boiled, the latter being' the most  agreeable  and nourishing  mode of
preparation.  When eaten raw, with vinegar, or  combined  with onions and
cucumbers, it is rendered an indigestible  and hurtful article of  food, and in
this condition should be especially avoided by persons  having weak stomachs.
 Pickled tomatoes form an agreeable relish to many, but, like pickled cucum-
bers, possess no nutritive properties, and  should not be used by the dyspeptic
and delicate.  The egg-plant, or fruit of the solanum melongena, is also
whole-ome and  delicious article of food, the value of which, however, is much
injured by frying it in fat, a mode of preparation adopted by many persons,
   Salsify, or vegetable oyster, the root of  tragopogon porrifolius, which is long
and tapering, somewhat resembling parsnip  root.  When properly prepared
this is a nutritious article, having a mild, sweetish taste, somewhat resem- 
MUSHROOM.—ONION.--PEAS,  ETC.
63
bling that of the oyster.  It is less digestible in the  fried state, than  when
thoroughly boiled.
   Mushroom,  the agaricus campestris and  many other species of fungi, are
considered by epicures to be a very luscious  and nutritious  article of food.
But they really possess little or no nourishment,  are  very difficult of diges-
tion, are very liable to  occasion severe purging and vomiting, and other dis-
agreeable symptoms with certain individuals, and are often poisonous.  In-
deed, it  is a very difficult matter  to  discriminate between those which are
poisonous and those  which are not.   It is reported that some person  in
Europe has discovered a method by which all fungi may be deprived of their
poisonous principles, and rendered safely edible,  but I have  not met with
an explanation of the mode of effecting this;  and even should this be  done,
it will in no way render them more easily digestible.
   Onion, the bud of the allium ccpa,  and not the  bulbous  root  as  generally
supposed. The peculiar odor and flavor of the onion is owing  to an acrid,
volatile oil, which contains sulphur.  When  eaten raw this oil is absorbed,
increases the circulation, produces thirst,  and  communicates  an unpleasant
odor  to  the  breath,  perspiration  and urine.   Individuals whose digestive
organs are weak should never eat  raw onions, as they are apt to produce a
sense of heat, uneasiness, and occasionally griping.  When deprived of their
oil by boiling or roasting, they form a mild, nourishing, and easily digestible
vegetable for  most persons.  Raw onions  digest with difficulty.
   Leek,  the  allium porrum,  and  Shallot, the allium ascalonicum,  possess
similar properties, but are milder than the onion.   They are frequently eaten
raw as a condiment, and  form an addition to  soups and several sauces.
They are more nourishing and more easily digested when  boiled.   As  with
onions, they are apt to produce flatulency,  and oppress weak  stomachs.
   Garlic, the  allium sativum,  is more stimulating than the onion, and on
account  of its disagreeableness  to  many persons,  it is seldom  used  as an
article of food.  Its properties  are similar  to those of the onion.
   Peas, the pisum sativum, and its varieties, and Beans, the phaseolus vulgaris,
p. lunatus, p. nanus, &c, contain considerable nourishment,  but  are not
readily digested.  They should be well boiled, and eaten only by those hav-
ing strong digestive powers,  otherwise they  are apt  to occasion flatulence,
oppress the stomach,  and produce  other  unpleasant symptoms.   The green
fruit,  that is,  the green  pods of some beans,  and  peas, gathered before the
seeds are fully matured, are more readily soluble in the stomach, when prop-
erly boiled, than  the  dried preparations.
   Celery, the long leaf-stalks of apium graveolens, forms a pleasantigalad  to
eat with  meats.  It is eaten raw with the addition of a little salt.   Some per-
sons add to it vinegar, pepper, and even olive oil, which renders it very indi-
gestible.   Care should be taken to select tender and recently gathered stalks.
   Lettuce, the leaves of lactuca sativa, is a very common salad, and  is eaten
raw with salt.   The addition of pepper, mustard, oil, &c, renders  it extremely
indigestible.   As the leaves contain a bitter,  narcotic principle, care must be
taken to  select only the young and  tender  leaves for the table.   Persona 
64
AMERICAN FAMILY PHYSICIAN,
 who are disposed to wakefulness at night frequently obtain sleep by eating
 lettuce a short time previous to retiring; those having a tendency to apoplexy
 should avoid the use of this salad.  Although in very general  use,  it is the
 most objectionable salad we have, for the majority of persons.
   Cresses,  the leaves  of sisymbrium  nasturtium.   These  have a pleasant,
 pungent taste when eaten raw, and taken with moderation, form an excel-
 lent adjunct to  a  meat diet.   As  with  the  preceding salads;  they will  be
 found to disagree  with weak  stomachs,  and  are  rendered indigestible  by
 adding oil, vinegar, mustard, &c, to them.
   Rhubarb, the leaf stalks of rheum rhaponticum and other species, are
 frequently used  for making pies,  tarts, &c.   They possess a tartness and
 flavor extremely agreeable to some persons, and very unpleasant to others.
 On account of the oxalic  acid contained in these stalks, their use is highly
 objectionable  among dyspeptics, and  those  who  are disposed to  urinary
 depositions of oxalate of  lime.
   Apples, the fruit  of pyrus malus, and of which there are  numerous varie-
 ties.   Ripe and  mellow apples  are agreeable and wholesome fruits,  but on
 account of their firmness  of texture,  they are  more  slowly digested than
 many  other  fruits, and  therefore are  apt to  disagree with  the   dys-
 peptic.  Stewed,  roasted,  or baked apples are  more easily digested than
 raw ones, and possess  slightly  laxative properties, which  renders them  of
 especial benefit to  persons of constipated  habits.   Dried apples, when
 stewed, form  an agreeable, nourishing, and  aperient sauce.  The  skin  or
 peel of the fruit should never be eaten, as it is indigestible.  The acid con-
 tained in apples is  called malic acid, and exerts a very beneficial influence
 upon the biliary and digestive organs.
   It may be proper for me to  make  a few brief remarks  at this  place,, on
 the use of fruits generally. Much has  been said of the  unhealthy char-
 acter of fruits, and  their tendency to produce diarrhea,  dysentery, cholera-
 morbus, cholera, &c,  and the idea is prevalent,  that, on these  accounts,
 they are rather dangerous articles of diet.  This, however, is an extremely
 erroneous impression;  there is  no more agreeable, nutritious, and salutary
 food, than the ripe, edible fruits.  When  disease  occurs  from  the  use  of
 fruit, the fault is always with  the  consumer,  for  several  reasons, which I
 will state: —
   1st.  It is with fruit as with all other articles used as diet, a certain quan-
 tity will prove beneficial,  but beyond this, the stomach is overladen, the
digestive functions  become deranged, and  symptoms will  follow more or
less severe, in proportion to the amount of excess thrown into the stomach,
and the peculiar condition of the biliary and digestive organs of each indi-
vidual.   Hence, fruit should always be eaten with moderation.
   2d. Unripe fruit, and especially in  the  raw state, is  always unhealthy.
 Fruit that is not matured,  contains a principle which  must be  converted
into starch  or sugar before it is at  all digestible,  and if eaten  before  this
change takes place, it undergoes decomposition in the alimentary canal,
setting free irritating gases, which, together with the undigested particles,
 give rise to disease, by producing irritation of the mucous membrane. 
USE  OF FRUITS.
65
  Many persons have so little control over their appetites, and  are so little
governed by reason,  that,  whenever  fruit is brought to market, no matter
how unripe it may be, they evince a  species of insanity to obtain it, and it
seldom happens that  they  escape some unpleasant symptoms, after  having
partaken of it.   Again, when ripe fruit is collected for market, it is almost
always the  case that there will be found among it more  or  less that is
unripe ; these being eaten  together  by the consumer,  give rise to bowel
complaints, and  this is  one great  cause of such diseases among those who
profess  to  have eaten  only moderately, and of ripe fruits.  Hence, rip
fruits only should  be eaten, being  careful to remove from the fruit obtained
in market or elsewhere, every vestige of immaturity.
  3d. Fruit that is offered in the  markets of cities and towns, although it
may have been  collected when fully matured, is frequently kept  until
decomposition commences, and  if purchased and eaten  in this state, it is
almost certain to  cause disease.   This is more especially the case with
berries, and many  vegetables, which  the sordid huckster will dress up so as
to have them present a fair outside appearance,  and thus impose upon the
purchaser.   Hence,  no fruit  should be eaten except that  which has been
recently gathered, and in which  the process  of decomposition  has not
commenced.
  4th. Fruit will  prove injurious even when   ripe, if eaten  at improper
times, or when combined with certain  other kinds of food  in the stomach.
Thus, I have known  fatal  cholera-morbus to follow the eating of a quantity
of peaches after having previously partaken of  ice-cream,  and in a person
with whom either of these articles separately, would haveproduced no evil
results.  I have also known unpleasant consequences  to follow the use of
certain kinds of fruit after having eaten custard, soup, fish, milk, &c, &c.
This  influence will  be found to vary in different persons, being  more
constant among those  whose digestive functions  are  debilitated; conse-
quently, every person should endeavor to  remember the kind of fruit and
other food, which  disagree with him when placed together,  or shortly after
each other, within  his stomach.
  Fruits are especially  adapted  for use during  the  season of their matu-
rity; they  are agreeable,  nutritious, cooling,  and also exert  a  sanative
medicinal influence upon the system; some increase, the action of the liver,
some that of the bowels, others again influence  the kidneys, and nearly all
of them have a salutary action upon the  blood.  According to the above
observations, they  should  never be eaten in large quantity,  but in modera-
tion, and not then  unless they are thoroughly ripe, are  of recent gathering,
(with tiie exception of a few, as apples, &c.,) and are  compatible with the
condition of the  stomach, or the articles already  contained in it.  And that
city is not to be envied, whose legislators are so ignorant,   and so regard-
less of tne  lives of their fellow-citizens, as to permit hucksters to endanger
them by keeping stale and decomposed vegetables or  fruit for sale;  more
rigid attention to the condition of articles sold in our  markets would tend
materially to lessen  the disease  and mortality of our  cities.  If but one-
       5 
AMERICAN FAMILY  PHYSICIAN.
 fourth  of the  time  now devoted  to  the accumulation of  wealth  waa
 bestowed upon  these matters of hygiene, what a robust and long-lived
 people would be our successors!
   Pears,  the  fruit  of pyrus  communis,  and  other  varieties.  Ripe  and
 mellow pears,  have a  tender, juicy pulp, and an  agreeable taste,  and
 are more  easily digested than apples.  In other respects, their properties
 as a diet are similar to those of apples.    They also contain malic acid, but
 not so abundantly as apples.  Their digestibility may be much improved
 by baking or roasting with sugar or molasses.
   Peach,  the fruit of  amygdalus persica, contains  sugar, gum, pectine,
 malic acid, &c,  and is a most delicious,  as  well a most healthful fruit;
 when eaten ripe and  temperately, it will seldom produce any unpleasant
 results, except  among gouty individuals,  and those  disposed to looseness
 of the bowels.  The outer skin is not  digestible,  and  should  never be
 eaten.   Peaches, and indeed any kind of fruit, should  never be  partaken
 of after a hearty dinner, as they will be apt to occasion sour stomach, flat-
 ulence, and  other disagreeable symptoms. Stewed peaches, flavored with
 sugar, possess laxative properties, and are of service  to convalescents, and
 those subject to  constipation.
  Plums,  the Primus domestica  and other varieties,  are  wholesome and
 nutritive, when they are fully matured and mellow, and are eaten in mode-
 ration.  But when  eaten  freely, or in an unripe condition,  they are very
 apt to cause diarrhea, dysentery, and other disordered conditions  of the
 bowels.   The  outer skin  is not  digestible,  and  should  not be  eaten
Cooked plums, or  preserved plums, form  a delicious  dessert, and are very
beneficial in cases of fever.
  When plums are  dried, they are  called prunes, in which  state  they are
not so easy of digestion as after having  been cooked.  Cooked or stewed
prunes are laxative and  nutritious, and are useful in cases of constipation,
and during convalescence from acute attacks.  An infusion or tea of prunes
forms a very refreshing and beneficial draught for febrile patients.
   Cherries, cerasis vulgaris, and other varieties,  when perfectly ripe, and
partaken of with moderation, are very wholesome ; but they will frequently
be found to disagree with some individuals, even when used in the smallest
quantity,  producing .acidity,  flatulence,  colic,  and  diarrhea, especially
among dyspeptics, and  those of weak stomachs, and which may in some
measure, be owing to the indigestibility of their outer skin.   Ripe cherries
contain  sugar, gum, water,  malic acid. &c., in various proportions, accord-
ing to the varieties of the fruit,  of which there are  many.   Stewed or
 ooked  cherries are more wholesome and digestible than the raw  fruit
The stones or kernels of cherries, as well as of all other fruits,  grapes, &c,
should  never be  swallowed, as they  frequently occasion  inflammation
 or other  difficulty  of the bowels,  terminating  fatally,  which  is  owin<>
 to their being retained in  the folds of the intestines, or the appendix coecL
  Dates are the  fruit of the date-palm, phoenix dactylifera1 and are always
 brought to this country in the dried state.  They contain  a large amount 
              CRANBERRIES.--GOOSEBERRIES.--GRAPES,  ETC.        67

of sugar,  and are nutritious, but are apt to disagree with weak stomachs
and dyspeptics.   In habitual constipation they will be found useful, from
their laxative properties, in all persons with  whom they agree.
   Quince, the cydonia vulgaris, should never be eat in its raw state, as it
is extremely unwholesome and indigestible.   When  stewed alone,  or with
other fruits, as pears,  apples, &c, or made into  preserves, it forms a deli-
cious dessert for most persons.  Quince juice  and the  preserved fruit
possess  astringent properties,  and are useful  for  persons   subject  to
looseness  of the  bowels.   The seeds  of quince contain a large amount of
mucilage.
   Red currants, the fruit of Ribes rubrum,, contain sugar, citric and malic
acids, gum,  vegetable jelly, &c.  The outer skin and the seeds are indi-
gestible, but the  pulp  of the ripe fruit when eaten in moderation is whole-
some and slightly nutritious;  eaten  rather freely,  currants are laxative.   A
very delicious jelly or  jam is made from  them,  which forms a  cooling and
beneficial diet for febrile patients.   Dried currants, on  account of  the skin
and seeds are not readily  digestible, and frequently produce more  or less
irritation of  the alimentary  canal.  Black currants,  the  fruit of Ribes
nigrum, possess  properties somewhat similar to  those of the  red.   Both
kinds are diuretic.
   Cranberries, the fruit of oxycoccus palustris, and o. macrocarpus, are muoi
employed in  this  country, as  a sauce to  be  eaten with game,  poultry, fat
meats, &c.  They are always  cooked or made into a jelly, and  form a
wholesome and nutritious article, possessing a delicious  flavor.  They  are
not easily digestible when  eaten raw, but are most generally harmless when
made into a jelly, or cooked with  sugar.   Cranberry jelly is a cooling and
refreshing article for patients laboring under febrile diseases,
   Gooseberries, the fruit of Ribes grossularia, and other varieties,  contain
malic and citric  acids, sugar, gum, lime,  &c.    When perfectly ripe,  the
pulp of the fruit forms a healthy aud delicious article;  the outer skins  are
indigestible,  and should   not be swallowed. As with all kinds  of fruit,
gooseberries will  be found to disagree with some  persons, especially when
eaten raw.  Stewed with  sugar, or  otherwise cooked, they are  more easily
digested, and less apt to disturb the bowels.
   WJiortlebcrrics, the fruit  of vaccinium rcsinosum, and other varieties, are a
very wholesome article, having a rich and delicious  flavor.  They possess
cooling  and diuretic properties, and are  frequently employed in disorders
of the urinary organs, scurvy  and  dysentery, either eateh  alone, or with
milk and  sugar.   They are generally of easy digestion.  Dried whortle-
berries are diuretic, and when  cooked, form a wholesome sauce or  dessert
during the winter season.   The outer skin of these  berries is  much more
digestible than that of the preceding fruits.
   Grapes, the fruit of  vitis vinifera and other varieties, are among the most
delicious and salutary fruits of summer.  When  perfectly ripe, they contain
a large amount of sugar and mucilage, with malic  and  tartaric acids, lime,
potash, &c, and form a nutritious  and refrigerant article.  The sweeter kinds' 
68
AMERICAN  FAMILY  PHYSICIAN.
of grape are the most nourishing, and may be used as a dessert, to allay thirst
in acute diseases, and to promote the action of the bowels,  as  well as of the
urinary organs.  There is, probably, no fruit so  acceptable and beneficial to
the stomach of the  dyspeptic, as a general rule, than the grape,  when eaten
ripe and in moderation.  The skin and seeds of grapes are frequently eaten,
and as often give rise to severe and  even fatal disease of the bowels;  thej
are indigestible and should always be rejected.
  When grapes are dried, they are termed  raisins, in which state they ar«
not as digestible as in the recent state, on account of the  seeds and  tough
ness of the skin ; the pulpy substance, however,  is wholesome and nourish
ing.   Raisins  should never  be  eaten  by dyspeptics and persons of weak
stomachs.   They are frequently boiled in gruel  and other drinks for inva-
lids, to which they communicate an agreeable flavor.
  Figs, the fruit of fie us carica, contain, when ripe, a large amount of sugar,
with  mucilage, gum, phosphoric acid,  fatty  matter,  &c,  and form an
agreeable and wholesome food.  The dried fig, more frequently met  with
in this country, is more easy of digestion  than most of  the dried  fruits,
but should be eaten in moderation, as otherwise it is apt to occasion flatu-
lence, griping,  and other intestinal derangements.  Dried figs being laxa-
tive  are used  with advantage  by persons of  constipated  habits.   Figs
roasted or boiled,  and split  in  two, with the pulpy surface applied, are a
popular poultice for gum-boils.
  Oranges, the  fruit of citrus aurantium, contain  malic  and citric acids.
mucilage, albumen, sugar, water, &c, and are a most luscious fruit, allaying
thirst and diminishing excessive heat of the body; for which purpose  it is
frequently given to patients laboring under acute diseases.  The only  part
of the orange which should be swallowed is the  juice ;  the  pulp in  which
the juice is contained, the white, tough rind, the outer yellow rind, and the
seeds, are indigestible,  and should  never  be eaten.  The  outer rind, or
orange peel, is much used on account of the oil contained in  it, to commu-
nicate a flavor to various preparations.
  Lemons, the fruit of citrus acida, contain a large proportion of citric  acid,
with  malic acid, gum, bitter extractive, &c.  The juice  is  the only  part
which may be taken internally, and when taken in  moderation, furnishes
an agreeable  addition to many draughts, and is much used in this  way to
allay thirst, and as a refrigerant in acute diseases, and in hemorrhages.  It
is also  very  beneficial  as a beverage  in scorbutic  and putrid  diseases.
When lemon juice is added to a sufficient quantity of water, and  the  mix
ture is sweetened with sugar, it forms the delicious and refreshing beverage
known as  lemonade.   The lemon  peel is used for the same purposes as the
orange peel.   Citric acid is frequently employed as a medicinal substitute
for lemon juice, but is inferior to it, being  deprived of the malic acid and
mucilage which enters into  the latter;  the addition of an eighth or tenth
part of alcohol or brandy to lemon juice, will preserve it for a long time.
  Limes, the  fruit of citrus  limonium, are somewhat similar in their  pro-
perties and uses to those of the lemon, being, however, more intensely  acid, 
              STRAWBERRY.--RASPBERRY.--MELONS, ETC.           69

on Recount of the different  properties of their constituents.  When  the
juico of  either of these fruits is used freely, or habitually, it is apt to occa-
sion pain and irritation of the bowels, diarrhea, tuberculous disease, and
derangement of the  renal organs.  A most pernicious habit, destructive
to beauty, health, and life, is pursued by many young females, who, under
the  impression  that a tendency  to  corpulency will be overcome, or that
their skin will become  improved and made  fairer, make excessive use of
lemon  juice, lime juice,  vinegar, pickles,  and  similar  articles.   I  am
acquainted with several females who  have permanently injured their health
by such a course.
  Pmeapple, the fruit of bromelia ananas, a native of the tropics, contains
malic,  citric, and tartaric acids, sugar, gum,  peculiar aroma, &c.  The  ripe
pineapple is one of the most.delicious of fruits, and is beneficial  in dysen-
tery, and most acute diseases.   The fruit as  sold in this country, is picked
before it is thoroughly matured, in consequence of which, notwithstanding
its agreeable flavor,  it is quite indigestible, and is apt to occasion  consider-
able derangement of the bowels,  especially  when it is freely  partaken of.
Pineapple juice forms a very agreeable wash  for the mouth in  fevers, when
the tongue is coated dark, with sordes on the teeth.
  Strawberry, the fruit of fragaria vesca, contains citric and malic acids in
about  equal proportion, sugar,  mucilage, pectine,  peculiar volatile aroma,
pericarps, &c.   Strawberry is a  very  delicious fruit,  being wholesome and
digestible, though destitute of much nutritive matter.  When  the  ripe fruit
is eaten in moderation, it seldom causes any unpleasant symptoms.  Occa-
sionally,  persons are  found with whom strawberries disagree; and they should
never be eaten with cream by dyspeptics.  Strawberry juice, or syrup, added
to water, care being taken that  the grains or pericarps are removed by filter-
ing or  expressing the juice or syrup through  a piece of  muslin, forms  a re-
freshing and useful drink for febrile patients.
  Raspberry, the fruit of rubus strigosus, contains citric and malic acids,  pec-
tine, sugar, volatile oil, mucus, red coloring matter, &c.  This  fruit is some-
what similar in its properties to the strawberry and may be used as a substi-
tute.
  Melons, including the musk-melon,  cucumis melo, the water-melon, cucumis
citrullus,  the pumpkin, cucurbita pepo, and the squash, cucurbita  verrucosa,
with its varieties, are fruits much used in this country during the summer
and fall months.   The musk-melon and water-melon,  contain  sugar, pectic
acid, mucilage, vegetable albumen, &c, and  are very delicious fruits,  when
perfectly ripe.  But  they are not so  easily digestible as many other fruits,
and  are very apt to occasion diarrhea, and other derangements of the stomach
and bowels.   Persons whose digestive  organs are good may eat of them in
moderation  with  benefit,  but all others should  be careful how they  use
them.  The pumpkin and the squash, when  boiled, are very wholesome, and
when not eaten too freely, will agree with most persons.
  Mulberries,  the fruit of Morns Rubra,   contain  bitartrate of potassa,
pectine, sugar, coloring matter, &c.  They contain but little nutritive matter, 
70
AMERICAN FAMILY  PHYSICIAN.
but agree with most persons  when eaten in  moderation; partaken of  too
freely, they are apt to cause diarrhea.  Their juice forms a  very pleasant
drink for patients  suffering  with acute diseases, as  it  checks thirst and
lessens febrile heat.
   Tamarinds,  the fruit of tamarindus indica, contain citric, tartaric, and
malic acids, sugar, gum, pectine, bitartrate of potassa, &c.  They are seldom
met with in this country except as a  preserve;  in which  form they possess
slightly nutritive properties, and may be eaten in moderation with bread or
meats.  When eaten freely they act more or less powerfully upon the bowels.
Boiling water  poured upon them and allowed to cool, forms a very grateful
drink for patients with febrile or inflammatory diseases, diminishing febrile
heat and quenching thirst.
   Oily seeds, as the walnut, hazel-nut, filbert, pistachio-nut,  and cocoa-nut,
contain vegetable albumen and caseine, which render them very nutritious.
But,  beside these, they also  contain more or less fixed oil which impairs
their digestibility, except with those persons  whose  digestive powers are
active, and who partake of them sparingly, or with moderation.  Dyspeptics
and those of weak stomachs  should not eat these  oily nuts, as they will be
found to irritate the stomach, occasioning heart-burn,  acid eructations, pain
in the head, oppression at the stomach, increased temperature of the skin,
restlessness, and'other disagreeable and  even dangerous symptoms.  When
old or rancid, they are not fit to be eaten by  any  one.   The cocoa-nut  is
almost indigestible; the milky fluid contained within the nut,  forms a pleas-
ant draught to allay thirst.   Bitter almonds contain a poisonous principle,
and when eaten   in large  quantities  produce serious and even  fatal conse-
quences.  These oily nuts are frequently added to the dinner dessert, but
this is extremely  improper and unhealthy, they should never be  eaten  by
any  one except  when  the  stomach  is  empty,  or not already filled with
food.
   Chestnuts possess a large  quantity of  nutritive matter, without any oil.
When raw they are not readily digested, and occasion flatulence, griping,
colic, and looseness of the bowels.  Roasted or boiled chestnuts are  much
more easily digestible and nourishing, but should be avoided by dyspeptics
and those of weak digestive functions, on account of their tendency to cause
flatulency.
  CONDIMENTS  are  those articles which are  used with food for the
purpose of seasoning it,  or improving its flavor, favoring  its  digestion, and
counteracting  any deleterious properties  connected with it.   They are com-
posed of alimentary substances, as Sugar, Salt, Oil, or Fats, vegetable Acids,
&c, and those which are not nutritive, as Pepper, Nutmegs,  Mustard, and
other aromatics.   When used in small  proportion, condiments render the
food more palatable and inviting, and  undoubtedly  assist  its  digestion;
but the constant  and excessive use of them, so commonly  indulged  in by
the great majority of the present generation, is injurious to  the whole sys-
tem, debilitating  the  stomach, occasioning  organic disease  of the  liver
impairing the  peristaltic action of the bowels, producing various cutaneous 
COMMON SALT.
71
eruptions, and other disagreeable and sometimes  serious maladies.  Chil-
dren  and young persons  should never use any  seasoning in their food,
except salt; the great  mortality  among  the  children of some families  is
owing to their being permitted to use " high-seasoned" food, rich pastry,
rich cakes, much fat, &e.
  " Condiments," says Dr. W. Beaumont, " particularly those of the spicy
kind,  are non-essential to the process of  digestion, in a healthy state of the
system.  They afford no nutrition.   Though they may assist the action of
a debilitated stomach for a time,  their continual use never fails to produc
an indirect debility of that organ.  They affect it as alcohol or other stim-
ulants do—the present relief afforded is  at the expense of future suffering.
Salt and vinegar are exceptions, and are not  noxious to  this  charge when
used in moderation.  They both assist in digestion—vinegar, by rendering
muscular fiber more tender, and both together, by producing a fluid having
some  analogy to the gastric juice."
  Condiments may be divided into,
  1.   Saline condiments, as common salt.
  2.   Acidulous condiments, as vinegar, lemon juice, and citric acid.
  3.   Oily condiments, as the fixed oils  and  fats.
  4.   Saccharine condiments, as  sugar, molasses, honey, &c.
  5.   Aromatic and pungent condiments,  as spices, essential oils, &c.
  6.  Sauces.
  Common Salt or Chloride of Sodium, forms an essential constituent of the
blood, and from which fluid the gastric juice derives its  hydrochloric acid,
and the bile its soda; hence its use is not merely for the gratification of the
palate, but for the more important purpose of preserving health and main-
taining life.  It is, in fact, a necessary article of food, for which nature has
furnished us  an  appetite.   When more soda is taken into the system than is
required for the vital processes, the surplus quantity is  removed  from the
blood by the  kidneys; but if its excessive use be continued and habitual,
it will give rise to plethora, corpulency and  some  form  of  disease; conse-
quently, salt  should be eaten with moderation.   Salt, to be eaten, should be
free from the chlorides of lime and magnesia, which are frequently found
in  it, from carelessness  in its  manufacture;  these may be  detected  by
immersing a  strip of litmus paper into a  solution of the salt, when, if there
is an  excess of the chlorides present, the  color will be immediately changed.
Lime, or the  carbonate of lime may be detected by the brisk  effervescence
which ensues on placing some of the^salt in a little strong muriatic (hydro-
chloric) acid.   The best and purest salt  for table use, is that known a.s fine
table  salt;  the  coarser  kinds are better for the preservation of  fish  and
animal flesh.
  The vegetable acids which are frequently used as condiments to food, form
a valuable addition to fatty or gelatinous  matters, when used in moderation;
obviating any tendency to oppress the stomach, and aiding their  digestion.
Thus, the various sauces composed  of acidulous vegetables, as apple-sauce,
cranberry-jelly,  &c, eaten with a meal  of fat pork, venison, duck, geese,
beef,  &c, are very advantageous to digestion. 
72
AMERICAN FAMILY  PHYSICIAN.
   Vinegar is much employed with food as a condiment; when used in small
quantities, it is a grateful and healthy article, allaying thirst and diminish-
ing  preternatural heat;  the digestion of gelatinous and fatty meats is pro-
moted by its use, and they become less  likely to derange the stomach and
bowels;  the  flatulence frequently  following the use of raw  vegetables, is
usually prevented by the addition of vinegar, which also lessens or entirely
removes the fermentation which some kinds of food undergo when  taken
into the stomach.   In  large quantities it interferes with the  digestive pro-
cess, and occasions  considerable injury to  the system.   Its habitual us6
is also injurious, destroying the teeth, impairing the functions of the stom
ach, and giving rise to dyspepsia.  It has been used to remove obesity, but
its use for this purpose is as dangerous as that of other acids.   (See p. 69.)
   Unripe fruits preserved in vinegar, and termed pickles, are very  indigest-
ible, and should never be eaten.   When eaten  by dyspeptics, or persons
of weak stomachs, or when taken in excess, they are very  apt to cause disa-
greeable, and even dangerous results.
   There are  many frauds practiced in making vinegar, which may be
detected- as follows :  Sulphuric acid or oil of vitriol  is frequently  added,
and  indeed, the vinegar is, at times, chiefly  made  of a diluted sulphuric
acid; this may be detected by adding a solution of the acetate of baryta to
the suspected vinegar,  when a white precipitate of sulphate of baryta, not
soluble  in nitric  acid, takes place, if sulphuric acid  be present.  When
muriatic (hydrochloric) acid  is  the adulteration added, it  may be discov-
ered by  the addition of a solution of nitrate of silver to a wineglassful of
the suspected liquid, which will produce an abundant precipitate of muriate
of silver, not soluble in nitric acid,  but perfectly soluble in aqua ammonia.
When the vinegar is adulterated with nitric acid, it may be detected in two
ways.   1. Add a little common salt to a wineglassful of the liquid, satu-
rate it by adding carbonate  of potassa, and then evaporate to  dryness.
Upon the dry residue pour equal parts of sulphuric acid and water, through
which some gold leaf has been diffused, and  boil the  mixture.   If nitric
acid be  present, nitro-muriatic acid  will be generated, in consequence of the
decomposition  of the common salt, and the  gold leaf will be dissolved.
(Pereira on Food and Diet.)
  2.  Place a small quantity of the vinegar  in a tin cup, and put into it
cuttings and scrapings of  a common goose-quill; and then apply heal, and
if the pieces of the goose-quill are stained yellow, nitric acid is present.'
  When oxalic acid is added, it may be known by adding together  one part
of aqua  ammonia and two parts of the vinegar, then, if some lime water be
added to the mixture, there will be a copious white precipitate of oxalate of
.ime.
  The best and most healthful plan to procure good vinegar, is to  purchase *
acetic acid,—one pint of which maybe added  to six of water, and thus form
seven pints of strong vinegar for about fifty cents.   This is about double
the price of ordinary vinegar, but then it will always be known to  be una-
dulterated with any poisonous article.  When cider vinegar is made, early
cider is  not so good for the purpose as the late. 
MUSTARD.--HORSERADISH.--GINGER.
73
   Fixed oils, fats, and saccharine substances have already been referred to on
 pages 49, and 51—52.
   Mustard, the ground seeds of sinapis nigra, is a wholesome condiment when
 used in moderation, especially for those whose digestive powers are weak, yet
 there are many persons with whom  mustard causes an irritation or burnino-
 sensation at  the  stomach and  griping, even when used in the least quantity.
 The best method of preparing mustard for the table is, to mix the flour with
 water at the ordinary temperature of the atmosphere; for boiling, or uniting
 it with alcohol or acids, as vinegar, &c, impairs its active properties.   Black
 mustard seeds contain a volatile oil, a fixed oil,  sulphur, myronate of
 potassa, &c.
   The  ground mustard of commerce is hardly ever met with  in a genuine
 state, being almost always combined with other articles, which, however do
 not render it poisonous.  Thus, an excellent mustard is prepared by mix-
 ing 145 pounds of mustard  flour, made by grinding together two  parts of
 black and three  of white seed, with 56 pounds  of wheat flour to dimin-
 ish the pungency, and two pounds of turmeric to improve the color; then to
 restore the acrimony without the pungency, one pound of chilly pods  and
 half a pound of ginger are added.
   Some manufacturers add bay salt,  cayenne pepper, yellow  ochre,  &c.
 This last named article is injurious, and may be detected by  placing some
 mustard containing it in an iron vessel, and submitting it to heat until the
 mustard has  burned away; if any residue is left, it is ochre.  The same may
 be detected by placing some of the mustard on an iron  or platinum spoon,
 and by means of a blowpipe drive the flame of a  lamp upon it until  it is
 burned; but the ochre will not  burn or be consumed.
   Horseradish, the root of cochlearia armoracea, contains a very pungent
 volatile oil, bitter resin, starch, gum, sugar, albumen, acetic acid, &c.   It is
 usually grated or scraped, and added to vinegar, when it forms a wholesome
 and stimulating  condiment to be used in  moderation with animal food.
 When used too freely it is  very apt to produce an irritation or burning
 sensation  at  the  stomach, griping, &c.  It is* especially useful for those
 whose digestive powers are torpid, who are disposed to local palsy, or who
 are dropsical, being  a stimulant, diuretic,  and antiscorbutic agent.  The
 root when  dried loses its volatile oil, and consequently its pungency.
   Ginger,  the root of  amomum zingiber, contains a  volatile oil,  two resin-
 ous substances, gum,  starch, sulphur, acetic acid, &c.   It is a stimulating
 aromatic, increasing the secretion of the gastric juice, and the excitability
 of the muscular system of the bowels, and also removing flatulence.  Used
 in moderation it is a very valuable and healthy condiment, and should  be
 used more especially by persons  troubled with flatulency.  Persons whose
 digestive organs have  been impaired by the  use of intoxicating drinks, and
 who have determined to abandon  them, will find  much  benefit from  the
 occasional use of ginger, which will remove that sense of faintness or sink-
ing at the stomach, which is  apt to follow a discontinuance of these liquors.
The following will be  found  an excellent remedy to improve  the condition 
74
AMERICAN  FAMILY  PHYSICIAN.
 of the stomachs of those who have been previously addicted  to  intemper-
 ance:—Take an ounce of powdered quassia, add to it one pint and a half
 of boiling water, cover it, and allow it to remain  until cold, agitating it
 occasionally; then add a fluidrachm  of sulphuric acid,  and let it stand for
 twenty-four hours, frequently agitating it.
   Take of ginger, swamp milkweed,  sassafras, each,  half an ounce, add
 a pint of boiling water, cover and steep for three or four hours, and sweeten
 with loaf sugar.  Strain each of the above infusions, and mix them together;
 the  dose is one or two table-spoonfuls, three or four times a day.
   Nutmegs, the fruit of myristica moschata, owe their peculiar flavor to a vol-
 atile oil.  They form an agreeable and harmless addition  to gruel, panada,
 sauces, &c, but are very injurious when administered to females immedi-
 ately after confinement, to patients recovering from acute disease,  or when
 eaten too freely.   In purchasing nutmegs be careful to select those  without
 holes in them, which are heavy, and which have the peculiar  flavor of the
 article; those which have not the above characters,  have been deprived  of
 their  volatile oil,  on which their virtue depends, and are  consequently
 worthless.
   Pepper, the dried unripe berries of piper nigrum contains an acid  oil, vol-
 atile oil, &c.   Several varieties form the pepper of commerce.  It is a stim-
 ulating condiment, and when taken in moderation is not injurious, but when
 used, as it is frequently, in large quantities, to excite the appetite or please
 the palate, it is very injurious to the digestive organs.   The same remarks
 will  apply to red or cayenne pepper.
   Pepper, especially  when ground,  is  liable  to many adulterations, sev-
 eral  of which  are deleterious to health, and are difficult  to  detect.   The
 better  plan for housekeepers to adopt, in order to insure   pure  ground
 pepper, is to purchase the pepper-corns and reduce them to powder by grind-
 ing,  whenever it is wanted.  It is not unfrequently the case  that  cayenne
 pepper is prepared of the ground pods from which the oil has been obtained,
 mixed  with  a portion of good  pepper and powdered  cantharides,  colored
 with turmeric or yellow ochre, and its weight made  as  near natural as pos-
 sible by the addition of a small portion  of red  lead; such an article is truly
 dangerous to health and life.
   Cloves, the dried unexpanded flowers  of  caryophyllus aromaticus,  contain
 fixed and volatile oil, gum, resin, tannin, two crystalline principles, &c.
 They are sometimes employed as a condiment,  or as an addition to  sauces,
 cakes, pies, &c, but their habitual use, or when used too freely, is injurious
 irritating the  stomach and bowels,  impairing the  digestive  process, and
 causing constipation.  The habit of eating cloves for the  purpose  of dis-
guising the breath is extremely  pernicious.
   Cinnamon, the bark of cinnamomum zeylanicum,  contains a volatile oil
tannin, cinnamic acid, resin, mucilage, &c.   It is a very pleasant and  health-
ful stimulant when eaten in moderation, but  is injurious  when  taken in
large quantities, or habitually.   It is frequently the case that the ground
cinnamon of commerce is composed of inferior bark, or bark from  which 
              ALLSPICE.--SAUCES.--PICKLES.--PRESERVES.          75

the oil has been obtained, mixed with a sufficient quantity of good bark and
other articles, to secure the flavor and pungency of the pure bark.
  Allspice or Pimento, the unripe berries of myrtus pimenta, contains fixed
and volatile oils, tannin, gum resin, sugar, a peculiar oleaginous substance,
malic and gallic acids, &c.  It is considerably used as a condiment, and to
flavor various culinary dishes, and when used in  moderation,  produces no
unpleasant effects.  Like all spices, it is deleterious when taken in immod-
erate quantities.
  Sauces composed of salt, spices, vinegar, &c, as various kinds of Catsups
are very frequently used as condiments;   they are not  safe nor salutary
articles,  for  although they may not be eaten in sufficient quantity to effect
any  injury themselves, yet the artificial appetite which they are apt to pro-
voke, and thus cause an overloading of the stomach, perhaps, with indiges-
tible substances,  is pernicious to health.  Invalids should never partake of
them.
   Pickles, pickled olives, and anchovies, possess no nutritive properties,  and
are indigestible, frequently  occasioning unpleasant, and even serious symp-
toms; when eaten at all, it should be in great moderation, and only by those
who possess strong powers  of digestion, and are accustomed  to plenty of
daily exercise.  As a general rule, a healthy stomach requires no stimulus
to produce an appetite, while a weak stomach is certain  to be irreparably
injured by the use of agents to  provoke an appetite.
   Preserves or sweetmeats, are terms applied to various kinds of fruit, when
prepared by boiling, stewing, or otherwise, with sugar or  molasses.   The
fruit from which they are made, should always be tolerably ripe.   Eaten
in small quantities with bread, or  meat, or  milk,  they are  wholesome  and
nutritious; but they will be  found to disagree with weak stomachs, and dys-
peptics.  Many foreign preserves  are so tough, and contain so much fibrous
matter as to be indigestible and not fit to eat.   Glazed  earthen-ware con-
tains oxide of lead, and should never be used to  keep preserves or  pickles
in, for the vegetable acids by dissolving the lead glazing will cause the fruit
and its syrups to become poisonous.   The  same may be said  of those  air-
 tight, self-sealing cans which are covered with a leaden or pewter cover, or
 the  solder of which comes in contact with the syrup or juice of the preserves.
 If carbonic acid should be developed in the preserved fruit or its syrup, or,
 if air should at any time find an entrance within the can or jar, or be origin-
ally contained in it, a poisonous solution of lead will be formed.  In these
matters, too much care cannot be  observed. 
76
AMERICAN FAMILY  PHYSICIAN.
                         CHAPTER  VI.

      Water.—Whey.—Artificial Mineral  Water.—Tea.—Coffee.

   Water  is as essential to life as air, heat, or light, and it enters into the
composition of the majority of those substances which constitute the food of
man;  it is, indeed, the proper solvent of all solid nutritious  substances
Every drop of fluid which is taken into the stomach,  is conveyed into  the
blood, (to supply the loss of the fluids of the  body which is constantly tak-
ing place during life,) and before it is expelled from the system  it traverses
every part of the body.  When the system requires a resupply of fluid, we
are made aware of it by a peculiar sensation termed thirst; when solid nutri-
tious food is demanded,  the  sensation  of hunger is produced.  The immedi-
ate seat of  thirst is in the fauces, and when present  it indicates a deficiency
of fluid in  the system,  and  is at once relieved by introducing a sufficient
quantity of fluid  into the system,  whether by the mouth, skin,  or rectum,
and there is no doubt, that persons may cultivate  a habit or  abnormal desire
of the system, which will cause them to drink more fluid than is really need-
ed,—and when the  secreting and excreting organs are active, intemperance
in water drinking is  much safer than that in any other kind  of drink. ~
   When there is a great loss of fluid from the body, as by certain evacua-
tions,  diarrhea, perspiration, &c,  there is more or less constant  thirst,  pro-
portioned  to the amount of  fluid eliminated; thus, in warm seasons, when
the atmospherical temperature is considerably increased, a larger quantity of
fluid is expelled  from the system  in  the form of perspiration, than in  the
colder months when the atmosphere  is temperate or  cold.   Consequently,
thirst  is more urgent and  more constant, and more fluid is taken into the
system, during the former seasons.  Thirst may likewise be  excited  or aug-
mented by active exercise,  or by whatever stimulates  the secreting and ex-
creting functions.  Salt, spices, stimulating liquors,  &c, by  exciting  the
mucous lining of the alimentary tube from the mouth to the stomach,  and
by rendering the blood more viscid and stimulating, cause an  increased desire
for drink.
   The only fluid which is suitable for an ordinary drink, and which is the best
suited  for the nourishment of the system, for the dilution of solid food, and
for the maintenance of a proper degree of fluidity in the  blood is, water.
Indeed, water is the only agent that can satisfy thirst, or which the  taste of
man prefers when not  vitiated by  artificial appetites.   Yet, under  certain
circumstances, it is  frequently found  advisable to combine  with the  drink,
farinaceous, mucilaginous, acidulous,  or  aromatic substances, as  in cas'es of
sickness, convalescence,  debility,  during  excessive heat, and in instances
where water alone disagrees.
   The quantity of fluid  required at any time, depends much on circumstan-
ces.  If it  be used  during a meal, it will  be found that animal food  will re
quire a larger amount  than vegetable; and  salted and  high-seasoned  food 
WATER.
77
will require still more.  Generally,  during a warm day, from three to four
pints will be demanded by a healthy adult; while in cold weather, from half
a pint to a pint will be all-sufficient.   Some, however, and especially  those
who perspire freely, or who use much salt or salted food, will require much
more  than  the above named  quantities, while others again will be satisfied
with considerably less.  It is much better to cultivate a habit of not drinking
water  or any fluid, until  the sense of thirst is  very urgent, than  to swallow
large draughts from every slight call of this sensation.  For every unneces-
sary drop of water added to the circulation, increases  the demand upon the
vital energy, and causes  a rapid waste of the system.   As regards  the quan-
tity of fluid, and the  time for drinking, these must be left to the individual,
who will be upon the  safer side by not drinking too often, nor too largely at
a time.  It is supposed by some writers, that the excessive use of fluids, with
a small amount of solid food, favors leanness or emaciation; my own observa-
tion tends to a contrary  belief, for, as a general rule, I have found corpulent
persons to be great consumers of fluid  substances.
   It is extremely improper to flood the stomach with fluid, immediately pre-
vious  to a meal, as it  interferes with the subsequent digestive  process; and
during a meal, for the same  reason, no more fluid should be  taken  than is
necessary to facilitate proper mastication.   Usually, the temperature of the
drink  should be  that of the  surrounding atmosphere; occasionally warm
drinks may be required.   The use of  cold or iced  drinks is considered very
improper by most writers; this may probably be the case with some individ-
uals, or where such draughts are too freely indulged in ; but, for my own part,
I am  firmly of the opinion that the temperate use of iced water during the
hot summer months,  acts as a stimulating tonic to  the stomach, prevents
febrile attacks, and is greatly conducive to health.  Of course,  this  remark
does not apply to those who are so  situated that they can procure good, cool,
spring or rain-water, which are always preferable, but  to  those who  live  in
cities which are supplied with the heated and filthy water from rivers. When
the system is heated by  exercise and the thirst is excessive, much  care must
be  observed in drinking cold water, as  fatal results have frequently occurred
from a want of prudence; in such case, before drinking, the face and hands
should first be bathed freely in cold water, after which the thirst should be
allayed gradually, taking  only one or two sips at a time.   When a person
has fallen senseless from imprudently drinking  too freely of cold water
during a state  of excitement  of the  system, his feet  and  limbs  should be
immediately placed in warm  water, cold water  should  be  poured upon his
head, and as soon as possible some  stimulating  preparation should be intro-
duced  into the stomach, as spirits of camphor, tincture  of cayenne, &c.
  The purer the water, the better is it for  health and all  those purposes for
which  fluid is required.    Rain-water and spring-water approach nearer to
purity than any  other;  river-water stands next, when it contains no sub-
stance prejudicial  to health or life.  Hard water contains certain mineral
matters in solution, which lessen its solvent powers, and occasion abnormal
conditions of the blood,  from  which arise  many chronic  diseases, as  of the 
78
AMERICAN  FAMILY PHYSICIAN.
liver, spleen,  kidneys,  skin, &c.   Soft water,  or freestone  water,  should
always be used instead of hard water, or limestone water.   Soft water may be
known by forming a suds with soap, while hard water coagulates soap, and
is unfit for internal or domestic uses.  An excellent test for determining the
quality of water is the tincture of soap;  in distilled water, no action is observ-
able ; in  soft water, a faint, semi-transparency occurs; and in hard water,
a milky whiteness is  produced by the soap-tincture.
  Rain and snow-water may, by proper precautions, be  obtained tolerably
pure, from the roofs of houses on which they fall, by allowing the impurities
to be washed away in the commencement of a heavy rain, or  with  the first
water occasioned by a thaw.   Nitrogenous organic matter is usually found in
rain-water collected  in  large cities.   Both rain and snow-water may  be
applied to every domestic purpose,  as well as to most chemical and  pharma-
ceutical operations. But no water should ever be used which comes in con-
tact with lead — for the lead becomes oxydized by the oxygen of the water,
which oxide is reduced to a carbonate by the action of  the  carbonic acid
derived from the air, and the  water thus containing lead, may  produce the
poisonous effects of that  metal upon the system;  and the more soft and pure
the water, the greater the risk.
  Spring-water is that which springs from the earth, free from large amounts
of carbonic acid, or salts, and not possessing elevated temperatures; it is the
general beverage  of mankind, and is  applicable to all domestic  purposes.
Those  springs  arising  from trap-rocks, sandstone,  transition  rocks, and
primitive rocks,  are  the purest;  those from alluvial strata, limestone, and
coal formations, are the least pure.   Well-water very much resembles spring-
water in its  qualities, its purity being proportioned to its depth and  amount
of use.
  River-water, especially when passing through alluvial countries, and near
great cities, contains suspended in it, more or  less earthy  and vegeto-animal
impurities, which impair its  transparency.  When moderately pure, it is fit
for all ordinary purposes, though if it contain much vegeto-animal matter, it
is apt to occasion  dysentery and other affections  of the bowels.  The Croton
water of New-York, the  Schuylkill water of  Philadelphia, and the Ohio and
Mississippi river-water,  are when filtered, sufficiently pure for ordinary pur-
poses;  and they ought never to be used unless they are filtered.  The lake
waters of the United States  are generally wholesome, being similar to river-
water.
  Marsh  or staghant water  always  contains vegeto-animal matters in a state
of decomposition,  giving rise to  peculiar acids, or poisonous gases, hence
they are very unwholesome, occasioning ague,  dysentery, &c,  and  should
never be  used for domestic or medicinal purposes.  "Alkalies and boiling
render such  water less unwholesome ; and it is said that  astringent bitters,
such as the bark  of the willow and the Peruvian bark, not  only cure ague,
but purify the water that causes it.   The presence of trees diminishes malaria
and prevents the water near their  roots from becoming putrid;  and cleared
countries, if not well drained, are  far more  subject to intermittent  diseases 
WATER.
79
than those that are full of forest.  Here I would incidentally observe, that
bitters are more relished and more useful in marshy districts than in  those
more salubrious.  The poor on the coast of Sussex use a strong infusion of
that excellent bitter, the lesser centaury, with excellent success, in  brow
ague,  and the intermittent headache, so common among them.  The putrid
matter held in  solution by  stagnant  water acts, perhaps, as a  specific fer-
ment,  which propagates itself under favorable  circumstances;  and from
analogy, it is not unlikely that certain vegetable  principles, such a3 the
bitter alkaloids, quinia, &c, may arrest this fermentation both in the body '
and out of it, just  as the fermentation of yeast in beer is  arrested at a
certain point by the hop and other bitters, or by the addition of a sulphate."
G. Moore.  This view certainly favors the cryptogamic theory of intermit-
tent diseases, for  the fermentation  of yeast being occasioned by micro-
roscopic vegetation, may not a similar  fermenting  or  vegetable growth  in
the system  occasion those  diseases  termed  epidemic  or malarial?  This
view  which  originated with  Dr. Mitchell,  of Philadelphia, certainly is
deserving of more  attention from  the medical profession  than  has been
bestowed upon it.
  All waters are improved by boiling, but they should be poured from one
vessel to another, previous to internal use, in order to  regain iiu^  the air,
the oxygen which  they have lost.   Animal charcoal  purifies water that
passes slowly through it, but it requires to be renewed every two or three
days,  or it loses its purifying qualities.   Alum, or albumen, added to  water
will clarify it when  muddy,  but  it is  not always  convenient nor  proper to
employ them.  The  best mode of purifying water  is to pass  it through a
filter  composed of  sand,  gravel, and porous earth and stone; the  water
should then be kept covered,  especially during  the summer, in order that
it may not become filled with microscopic fungoids and animalcules, which,
although  harmless  when alive, may cause  sickness  by their  death and
decomposition.
  Hard water may be  rendered fit for washing by the  addition of substan-
ces  to it, which precipitate  the  salts it holds  in  solution.  Thus,  water
which contains the  bicarbonate or  sulphate  of lime,  may be softened by
the addition of carbonate of soda;  vegetable impurities may be precipi-
tated by adding ten grains of pure fresh lime to every  two quarts of water,
stirring it well, and filtering, or allowing it to stand till clear.   Oxalate of
potassa,  decomposes  salts  on which the hardness of  the water  usually
depends, and renders it sufficiently soft for washing.
  Mineral waters  contain  a  large proportion  of  carbonic acid, with  or
without saline,  alkaline, metallic, earthy, and other foreign substances, and
are  used  on  account of the therapeutical influences they exert upon  the
animal economy.
  Various substances are added to water to form nutritious, tonic, palatable,
or stimulating draughts, and U a brief  notice of some of which, I will call
the attention of the reader.
  Toast-water is water  to which toasted bread has  been added, communi- 
BO                  AMERICAN  FAMILY  PHYSICIAN.
eating its  taste and  soluble portions, without affecting the diluent proper-
ties of the water.  It forms an agreeable and healthy drink, and is used by
persons with  whose  stomachs  water alone  disagrees.    As  it  possesses
slightly nutritive qualities,  it is used in febrile  affections, and other cases
where diluents are required.
  Sir A. Carlisle recommends toast-water to be made by pouring boiling
ivater upon a hard biscuit which has been reduced by fire to a  coffee color.
is soon is it has cooled it  should be drank, on  account of its tendency to
acquire an unpleasant flavor in two or three hours.
  Whey.  When milk is  allowed to stand a sufficient  length of time, it
separates into  two parts, the curd,  or white  solid or coagulated  part,  and
the whey, or thin,  greenish-yellow or watery part, which has a  saccharine,
milk-like flavor; the same effect may be produced  by  curdling  milk, by
the addition of rennet.  Whey is an agreeable,  nutritious  and refreshing
drink, which  is readily digested,  augments the secretions and effects a
healthful change  in the fluids of the body.   Laborers will  find it a  much
safer and better article to allay thirst in hot weather, than stimulating or
intoxicating drinks.   (See Milk, Cream, and Buttermilk, pages 44  to 48.)
  Artificial  Mineral  Water, which consists of water  surcharged with car-
bonic acid gas,  and  flavored with some  kind of syrup,  is  a very grateful
ind healthful drink during the warm  seasons, if not taken  in  too great an
abundance.  Too much  care, however,  cannot be taken,  to avoid metallic
impurities, especially  of lead; when  it is on  draught from fountains fur-
nished with  leaden tubes, the first water drawn every day, should be thrown
away, as  its use might give  rise to unpleasant  symptoms.  This artificial
water allays  thirst, diminishes preternatural heat, favors perspiration, lessens
nausea and uneasiness of the stomach, and promotes the urinary discharge.
When on draught  from fountains, it is  called " soda water;"  when put up
in bottles, and flavored  with various syrups,  it is termed " mineral water."
  Vessels containing  carbonic  acid water  should be kept in a cold place,
perfectly tight, and free from lead, or any other  poisonous  metal.  Mineral
water should not be drank  immediately before, or directly after a meal, as
it may interfere with the appetite or digestive process, by the gas contained
in it unduly distending the stomach.
  Tea, an infusion prepared from  the  dried leaves  of various species of
±e tea-plant, which  grows in  China and Japan.   There are two  kinds
of tea used in  this  country, green tea and  black  tea, each  of which is
livided into several  qualities.   Green tea  contains gallic acid, tannic acid,
gum,  gluten,  lignin, bitter  extractive,  and volatile matter.  Black  tea
contains tannic acid, gum,  gluten, lignin,  and volatile matter.  A crystal
tine, salifiable base has been found in tea, to which the name  of  theine has
been given; it exists in tea in combination with tannic acid,  and is iden
Heal with the caffeine obtained  from coffee;  both  of these principles are
supposed to favor the formation of a substance  contained  in  bile termed
taurine.  The  infusions made  from both kinds of tea,  have a  peculiar,
refreshing, somewhat astringent, and agreeably  bitterish taste ; that of the
green tea, being more pleasant than that of the  black. 
TEA,
81
  Tea possesses gently exciting, and astringent properties, exerting also an
influence upon the brain and nervous system.  Its peculiar flavor depends
upon a  lemon-yellow  colored  volatile oil, lighter than water,  which acts
alone as a narcotic, but when combined with tannic acid, as  a diuretic and
diaphoretic.   Used in  moderation,  the infusion  of tea is  a  grateful and
harmless beverage, but  if used for a long time  in  large  quantity,  or of
great strength, it induces many unpleasant, nervous,  and dyspeptic symp-
toms, as wakefulness, tremors,   palpitations, anxiety,  and other distressing
feelings.  For a daily drink, black tea is preferable to green, as it contains
(ess  stimulating and  narcotic principles; and it should  never be used
except  at  the evening meal,   unless  in  cases of sickness,  debility,  &c.
Green tea is  best adapted in cases of sickness,  in  fevers and  inflammatory
diseases, colds, catarrhs, and after a fit of intemperance; it rarely disagrees
with the invalid, and almost always proves refreshing and agreeable, acting,
if drank warm, as  a diluent, diaphoretic, and diuretic.
  A great deal has been said  by ultra dietetical reformers,  relative to  the
poisonous or injurious properties of tea—'especially the green varieties. That
it is injurious when used in excessive quantity, or in strong  infusion, there
can be no doubt, for it is well known that small doses of the extract, or of a
strong infusion, will speedily destroy the lives of inferior animals.  Still,  it
must be admitted that when used with moderation,  by persons of active, labo-
rious habits,  its effects are rather beneficial than  otherwise, and I  see no
reason why a war should  be kept up against the article itself,  instead of its
intemperate  employment.  Tea, whether green  or black, should never be
used daily by persons in health; it should  only be drank in moderation at
p.n evening meal, when the system is depressed or languid from exercise or
labor of the day.  When the debility experienced  at this  time is owing to
the heat of the season only, there is no better fluid to  overcome it than pure
cold water,  other  drinks, however, are admissible,  and may  be used at the
supper table  instead of tea, as buttermilk,  toast-water,  sage-tea,  milk,  milk
and  water,  or even lemonade.   And persons should accustom themselves to
varying their breakfast and supper beverages, and  not  use the same liquid
daily, remembering that there  is no fluid so thoroughly adapted to the wants
of the system as pure cold water, and that the more  this is  interfered with
by the addition of foreign agents,  the less healthful and beneficial is it ren-
dered.  Many persons who use tea and coffee daily, are subject to  vertigo,
headache, incapability of mental reflection, or  oppression  at the stomach;
unpleasant symptoms which invariably disappear when water is substituted
for these stimulating drinks.   Children should  never  be  allowed to  drink
tea except  when required as a medicinal  refreshing draught.  Persons of
sedentary or inactive occupations require much  less tea as a stimulant than
those of active habits ; indeed,  they will, derive more  advantage from water,
milk, or milk and  water.
   Tea is frequently adulterated with other articles,  as elder leaves, ash leaves,
&c,  and it is not uncommon for some  unprincipled persons to  buy up the
tea leaves which have been used to form the infusion of tea,  and mix these
        6 
82
AMERICAN FAMILY  PHYSICIAN.
Fig. 6.
in various  proportions with good tea leaves, and  which  adulteration it is
                                      almost impossible to detect.  When
                                      other leaves  are added, it may be
                                      discovered  by  macerating  some of
                                      the leaves in  water for a short time,
                                      then spread them out between pieces
                                                   Fig. 7.
           Genuine Tea leaves.                     Spurious Tea leaves.
of paper, and press them till dry.   If the leaves are narrow and slender, with
deeply serrated edges, and their ends acutely pointed,  as  in  fig. 6, they are
genuine; but, if they are rounded,  more  obtusely pointed, the edges  not so
deeply serrated, as in fig. 7, or vary in other respects, they are spurious.
  Factitious  black  teas are  generally colored by  logwood;  the  green,  by
being laid on sheets of copper, and having Dutch pink and  verdigris added
to them.  This last is a highly poisonous addition,  and has  produced  dan-
gerous symptoms among those who have partaken of such  made-teas, as nau-
sea, vomiting, great pain in the stomach,  faintness,  great depression,  and
cold perspiration.  A very excellent work on the  subject of  adulterations of
food and drugs, as detected by the microscope, has been published in London
by A. H. Hassall; it  can  be obtained in this country for about four dollars
and a half.  It should be read by every person.
  Spurious  black tea, when slightly  moistened and rubbed on a sheet of
white paper,  produces  at once a bluish-black stain;  or, if thrown into  soft
cold water, it does not produce the amber color of the genuine leaves; but a
bluish-black, which, unlike the pure article, becomes reddened on the addi-
tion of a drop or two of oil of vitriol, (sulphuric acid.)
  Copper may be detected by placing^  small quantity of the tea in a vial,
adding some aqua ammonia  (spirits of. hartshorn,)  and a little  water,  and
then shaking them  together; if copper be  present, the fluid will acquire a
sapphire-blue tinge.  When carbonate of copper  is used to color  green tea,
it may be known by throwing some of the leaves  into water that has had
sulphureted hydrogen  passed through it, which will turn the  fluid of  a black
 '.olor.
   Coffee, the seed of coffea arabica, a native of Arabia Felix, and Ethiopia
and extensively cultivated in Asia and America.  There are  several varietie
of coffee, among which the Mocha,  Java,  and Havana,  are considered  the
best.   Raw coffee contains cellulose, fatty matter,  legumin,  chlorogenate of
potassa and caffeine, free caffeine,  volatile oil, &c.    Whan  roasted,  a  great
change occurs in coffee, it acquires a bitterness and a peculiar, quite agreeable 
COFFEE.
83
odor, which did not exist in it  before; at the same time the seeds expand
and lose nearly twenty per cent, in weight.   If the torrefaction be conducted
in a covered vessel, keeping the coffee  seeds constantly agitated  under expo-
sure to the heat of a moderate fire, and this action be  kept up for a proper
length of time, the roasted coffee imparts to  boiling water a  very agreeable
taste and odor.  If the  heat  be too long applied, the infusion becomes un-
pleasantly bitter;  and if it be insufficient, the peculiar aroma and  flavor of
good coffee will  not be obtained.   The sooner coffee is used after its roasting
and grinding, the  more agreeable and stimulating will it prove, as  it rapidly
loses its most desirable properties by being kept.
   The infusion of torrefied coffee  grains forms a well-known  favorite bever-
age.  Taken in  moderation it is a gentle stimulus to the digestive  apparatus,
and to the circulation,  generally occasioning  a  degree of wakefulness; in
large quantities  it  produces derangement of the nervous system, as well as of
the organs of digestion,  and if its use be thus persisted in, it will  occasion
headache, dyspepsia, &c.  A strong cup of coffee will cause  a  degree of
wakefulness  for several hours; and strong coffee, freely administered, has
been found  an excellent  antidote to the baneful effects of opium or alcohol
in many instances.
   Coffee is occasionally useful  in  the sick room;  it relieves  some forms of
headache, and has proved beneficial  in some cases of asthma and  hooping
cough; it is likewise a valuable cordial and restorative after exhaustion, great
fatigue, as well as  in cases of sudden withdrawal from spirituous beverages.
   Coffee should  never be taken in large quantities, nor  in very strong infu-
sion, because it seldom fails to derange the stomach and  injure the digestive
function, and  it  is, likewise, very apt to occasion wakefulness,  tremors, head-
ache, loss of memory, and many other unpleasant symptoms; indeed, there
are many individuals who cannot use it at all, on account of its disagreeable
effects.   The stimulating effects of coffee, like those of  intoxicating liquors,
are always followed by a  depression proportioned to the quantity and strength
of the infusion  employed and the degree of excitement occasioned by  it.
Although usually considered to be  a constipating agent, yet  I  know  many
persons on whom it produces a purgative, or  mild laxative effect,—in  some,-
so much so that they cannot make use of it at all  during the warm  summer
and fall months, on account of the continual tendency to diarrhea caused
thereby. During  the cholera years I relieved the  fears of many persons who
found themselves subject to a constant  looseness  of the bowels, by persuading
them to  dispense  with  the  use of coffee  altogether.   Persons of  sedentary
habits, dyspeptics,  and children should never use coffee, save, occasionally.
as a medicine; and those of more active habits and powerful digestion should
use it with moderation-—a weak infusion with a  goodly  proportion  of cream
or milk, and sugar, may be taken by them daily in the quantity of an ordi-
nary cupful  at breakfast or at dinner.   To exceed  this, or use  a strong.
infusion, is  as  much a  habit  of intemperance  as  the daily use of strong
drink, and though it may not so immediately develop the abnormal symp-
toms resulting from intemperance in  alcoholic  drinks, yet it is  certain to ■ 
84
AMERICAN FAMILY  PHYSICIAN.
 ultimately occasion them if its  improper use be persisted in.   I  have fre
 quently  traced many nervous diseases,  and unaccountable symptoms  of an
 alarming character, among children, to the excessive use of coffee,  in which
 they had been indulged by imprudent and  unwise parents.   Coffee should
 not be drank at night on account of the wakefulness it occasions, unless,
 indeed, this state be desired.
   Many persons make use of very strong coffee for the purpose of rendering
 the brain more active,  and thereby enriching the mind  with  ideas, a's wri-
 ters, speakers, &c.  And it is, unfortunately,  the case that  many females,
 previous to an attendance upon soirees,  parties, balls, &c, are  in  the  habit
 of drinking  strong coffee for the purpose of procuring  an  artificial flow of
 spirits, mirth, wit, hilarity, &c.   Although this does not produce the beastly
 condition resulting from the use of alcoholic liquors, nevertheless, it  is as
 censurable a feature of intemperance.   A French writer states, that although
 coffee excites the mind temporarily to unwonted activity,  yet " unfortunately
 it is not without great prejudice to mind and body that man  procures such
 overexcitements.   After them come  prostration, sadness,  and exhaustion of
 the moral and physical forces; the mind becomes enervated,  the body lan-
 guishes.   To a rich imagination  succeeds a penury of ideas;  and if the con-
 sumer does not stop, genius will  soon give place to stupidity."
  In  relation to the views of  some dietetical reformers who proscribe all
 kinds of stimulants as a drink, and, indeed, all liquids except water  and  milk,
 a recent writer remarks:—"We  should,  however, consider that cordials or
 stimulants are, at least, occasionally useful, and that, whether useful or not,
 mankind always have, and probably always will make use of them.  But of
 all those which have hitherto been introduced, none,  perhaps, combine so
 many excellencies, with so few evils, as that of coffee.   To moderately nutri-
 tive properties, it adds those of  a mild and cordial stimulant,  without pro-
 ducing those peculiar narcotic effects which so  often  accompany the  use of
 strong green tea.   We are persuaded that it is not wise to wholly proscribe
 coffee,  as it is eminently useful to those who are trying to wean themselves
 from the use of alcoholic stimulants, and if employed of moderate  strength
 with milk and sugar, it cannot  be considered injurious as a common bev-
 erage."
  The adulterations in coffee  are principally met with in that which is roasted
and ground for  sale, and to  which are  frequently added, by unprincipled
venders, peas, beans, rye, sawdust, old coffee grounds,  &c.  These  adultera-
tions are not very easily detected, save in the flavor of the infusion, and the
 best plan to  adopt, in order to avoid being imposed upon in this  matter, is
for every family to buy,green coffee, and roast and grind  it for themselves.
  Clwcolate is prepared by roasting the seeds of  Thcobroma cacao, and di-
vesting them of  their husks,  reducing  them to powder, forming them into
into a  pasty substance with   sugar or other saccharine matter,  and some
 aromatic added to  improve the flavor, and then placing it in molds to dry.
 Not unfrequently,  powdered sago or  potato starch is added,  in  order to
 give a thickening quality to the chocolate.  Whether boiled  in water or in 
COCOA.--CIDER.
85
milk, chocolate forms a rich,  nourishing diet, but is of difficult digestion,
owing to the  large  quantity of oil contained in it, and is, consequently,
unfit for  dyspeptics and  persons of sedentary occupations.  Even  among
the robust and laboring classes, it will often produce a  sense of oppression
at the stomach, with mental and physical dulness.
   Chocolate  is subject  to adulterations  with rice flour, wheat flour, potato
flour, the flour of  beans and peas, suet or other fat, &c, which can  only be
detected by a  tedious process.  If chocolate has  a rancid smell, it is prob-
ably adulterated with gum, fat, &c;  if  an  infusion of it  is changed to a
blue color by  the addition of tincture of iodine, it contains starchy sub-
stances—if to a yellowish, it is free from  starch.  Lead, which is some-
times  added in the form of the red oxide, to impart a  fine red  color, may
be detected by the process given for detecting  it in cheese, on page 47.
Sulphuret of  mercury has been  added for a similar purpose, and  may be
suspected  when a sediment of a brick-red color  is seen to take place in a
decoction, after  it has stood for a short  time; good chocolate has a deposit
of a dull brown color, which requires some time  in forming.
   Cocoa, is another  preparation  made by roasting the above-named seeds
and grinding  them, without depriving them of their husks, and sometimes
adding sago or  potato  starch.   Not unfrequently, the husks,  which are
separated  from  the seed  in the preparation of  chocolate,  are also  mixed
with the above.   Cocoa is less oily than  chocolate, and  boiled in water and
milk, with sugar  added, forms a pleasant and moderately nutritious drink,
which agrees very well with many persons.   A weak infusion is frequently
allowed  as a  nourishing  drink to  convalescents; but  great discretion is
required, as it is not always a proper article of diet for  them.  Containing
astringent properties, cocoa is not so applicable to those of  constipated
habits as to those  with relaxed bowels.
   Cider  is the fermented juice of apples, and is a refreshing  and  agree-
able drink when   not used too freely;  its daily use,  however, is  by  no
means advisable,  except during febrile diseases.  New cider, or that which
is imperfectly fermented, is apt to produce  flatulence, colic, and  acidity of
the stomach;  and with many persons it induces diarrhea.   When  thor-
oughly fermented, cider contains from five to ten per cent, of alcohol, and
will  cause  intoxication when drank in  too large quantities at a time;  its
constant, daily  use will  give rise  to  various  forms of chronic disease.
Drank occasionally at dinner-time, with animal food, and especially  in
warm weather, it  assists digestion  by imparting a gentle stimulus  to  the
digestive  organs, while at the same time the malic acid  contained in it,
assists in the softening  and chymification of the food  eaten.   Good  cider
not only forms a grateful  beverage for patients with fever,  but actually ex-
erts a salutary medicinal  influence,  especially when the tongue is  furred
black  or  brown;  patients thus  situated, are very  apt to crave cider,  or
other acidulous draughts, and which should  never be withheld from them.
It may likewise be used with advantage in some forms of dysentery, but is
generally injurious in diarrhea. 
86
AMERICAN  FAMILY PHYSICIAN.
   On account of the great amount of factitious wines, brandies, &c, now
a-days, manufactured by unprincipled men, and in which impositions cider
forms an important article, it is very difficult to obtain this agent in  many
of our towns and cities; and that which can be procured is very apt to be
either an unhealthy article formed of vinegar,  honey, and water, with per-
haps sulphuric acid, which mixture  has undergone a degree of fermenta-
tion;  or, alcoholic liquids  have been added  to the pure cider to render it
strong and more intoxicating, and sugar of lead to prevent its spoiling and
correct its taste.   It is very difficult  to detect many of these frauds;  when
brandy, whiskey, &c,  have been -added, they may sometimes  be known
by  their peculiar odor, or the flavor they impart.  Lead  may be deter-
mined by adding together equal parts of  cider and water in a  glass tum-
bler, slightly acidulating the  mixture with muriatic acid,  and then passing
sulphureted hydrogen  gas  through  it;  if it becomes of a dark-brown or
black color,  lead is  present.  Cider, which  has turned sour,  is frequently
corrected by the addition of chalk or lime.  These may be detected by ad-
ding a  small quantity of  a  solution  of oxalate  of  ammonia, which, if
they are present, occasions a copious, white precipitate.   All of the agents
named as tests in this work, even to the sulphureted  hydrogen gas, can be
obtained at  the establishment of any good druggist;  and  every family
in cities should keep them constantly in their respective houses, in  order
to detect frauds  and adulterations,  which  unfortunately for mankind  are
now so common.
  Spruce Beer, Ginger Beer,  and other drinks, made by sweetening  some
vegetable infusions with molasses, and causing them to ferment by the  addi-
tion of yeast, are quite common summer beverages in our large towns and
cities.  These are seldom intoxicating in their nature, but they do mischief,
especially among dyspeptics and those of  weak stomachs, by the carbonic
acid gas in them swelling the stomach and retarding digestion; while at the
same time, from  acidity of the stomach produced  by  their saccharine sub-
stances, irritation, pain, and diarrhea will be apt to follow.   However  the
use of these drinks is  preferable to that of  intoxicating draughts; and  for
those whose stomachs are active and strong, and who desire some other drink
during the  summer, than  water,  the following will  be found  a cooling
pleasant, and in most cases, healthful beverage: Take of Hops, one ounce ■
Wild  Cherry bark, one ounce;  Sassafras   bark,  two  ounces;  Guaiacum
shavings, one ounce; Ginger, half an ounce.   Make two gallons of strong
decoction, strain, sweeten with molasses, and when cool add a table-spoon-
ful or two of good yeast.  As soon as fermentation commences, it is fit for
use; it may  be bottled, and should  be  used moderately,  say two or three
ordinary tumblerfuls per day.  The man of wisdom seldom drinks  such
preparations, or when he does, it is with great prudence  and moderation •
hence,  he escapes many of the diseases of warm  weather, to which  they
who have no control over their animal tastes and  passions, and  who indis-
criminately use everything that gratifies for the moment, are very subject.
  Malt Liquors, as beer, porter, ale, &c, contain a large proportion of alcohol 
MALT  LIQUORS.
87
with carbonic acid, sugar, water, salts, &c.   When  properly  prepared,  they
form refreshing, stimulating and nourishing drinks, if used with moderation,
and are frequently very beneficial in many forms of disease, as in convales-
cence from exhausting diseases, consumption, debilitating chronic diseases,
in the stage of prostration of febrile affections, &c;  while, on the other hand,
they should be avoided by those who are dyspeptic, bilious, plethoric, or dis-
posed to apoplexy, an attack of which last  named affection they are very apt
to induce.   But as with all  other articles which are largely consumed, these
liquors  are almost always adulterated with poisonous substances, for the pur-
pose of  improving  their flavor,  color,  body, and the intoxicating effects
arising from their use.   Among the articles which may be named as adulter-
ations,  are  cocculus indicus, hyoscyamus,  belladonna, lauro-cerasus,  opium,
tobacco, nux-vomica, sulphate of iron or  green vitriol, &c.  While, instead of
using hops,— aloes, gentian, quassia, hoarhound, wormwood, Peruvian bark,
&c, are substituted, for the  purpose of communicating a bitter taste.  Salt is
frequently added to beer, lager beer, &c, in order to increase the thirst of the
consumers.  The greater part of these  adulterations  can  only be detected
by tedious chemical processes.   So that  were these drinks entirely discarded
from among  us, the community  would be greatly benefited  thereby; for
the small amount of good which an unadulterated  article would produce, is
vastly more than counterbalanced by the  immense amount of disease and
death annually caused by the use  of adulterated manufactures.
   There can be no doubt that malt liquors, in moderation, form stimulating,
refreshing and nutritious beverages, but their excessive  use is fraught with
serious consequences, and more especially when they  contain  some of the
poisonous  substances  just  referred  to.   Thus, they  distend  the stomach,
impair the digestive process, derange the regularity of the bowels and urinary
organs, and produce the worst  kind of intoxication; and when adulterated,
they cause serious and irreparable injury to the brain and nervous system.
Although  the effects  of malt  liquors take place less  rapidly than those of
alcoholic, yet when they do ensue, they  are more permanent, and  less easily
removed, and, instead of the  enlivening  influence usually caused  by the
latter, they exert a stupefying influence  on the brain, causing the most lively
person  to become dull and stupid.
   Beer, ale, and porter drinkers, usually  become very corpulent, or bloated
and stupid, and present no  very pleasing aspect to the beholder.   Their cir-
culation is very much  interfered with, the pulse being full, laboring, and
cord-like; when they  sleep they snore loudly and constantly, and a bleeding
from the nose, which not unfrequently happens, decidedly relieves them from
a sense of fulness in the blood-vessels, especially those  of the brain.   They
are  very subject to diseased liver, diseased kidneys, dropsy, and apoplexy;
and more than two-thirds of those who  indulge to  excess in the use of malt
liquors, die suddenly of apoplexy, or  are suddenly stricken with palsy.  All
beer drinkers are  very subject to inflammatory  attacks, which are always
more obstinate and unyielding in their character, than among  those not
addicted to the use of such  drinks. 
88
AMERICAN  FAMILY   PHYSICIAN.
CHAPTER   VII
                Wine.—Ardent Spirits.—Intemperance.

   Wine is the fermented juice of the grape; although the term is also given
to the fermented juice of the acidulous fruits.  Grape juice contains elements
which will render it vinous without extraneous aid;  while the juice of sub-
acid fruits, usually require some additional  substance, as sugar, &c, before
they can be made into wine.   The  juice of unripe  grapes is called verjuice,
and  contains malic, citric,  tartaric, and racemic acids, with  bitartrate of
potassa, sulphates of potassa and lime, a little tannin, &c.  The unfermented
juice of the ripe fruit  is called must, and contains sugar, gum,  malic  acid,
bitartrate of potassa, various inorganic salts, &c.   It differs from the juice of
other fruits  in containing  less malic  acid, and a large proportion of tartar,
and  which  is one reason why it is less apt to become sour than  the home-
made wines.  Climate, soil, and many other circumstances, have much influ-
ence upon the quality of the wine; and during its preparation, not only does
it require different treatment, according to the character of the wine, but it
also  requires great care,  attention, and practical skill, to manage the fermen-
tation properly.
  Alcohol enters into the composition of all wines, and is the substance upon
which their  stimulating  and intoxicating properties depend;  their  influence
in these respects being proportioned to the quantity of  alcohol present.  It
seems, however, that this fluid which is naturally formed in the wines, exerts
a less pernicious and inebriating  influence, than when the same amount of
it is  taken separately, either pure or diluted with water;  and this is  supposed
to be due to the presence  of certain  other  constituents of the wine which
have a qualifying influence  upon the alcohol.  Some persons, however be-
lieve that the alcohol obtained from wine is the result of changes  effected by
distillation,  and that it does not  naturally exist in this  liquor; or,  that it is
the result of a chemical  action, which we find to be the case  in obtaining
prussic acid from peach-kernels, &c.
  According to Mr. Brande, the  per-centage of alcohol in wines &c.  is as
follows:—
Alcohol,		—per cent
Port wine, from 19.00	to	25.83
Madeira, " 16.40	to	26-.00
Claret wine, " 12.91	to	17.11
Sherry, " 18.25	to	19.81
Teneriffe,		19.71
Champagne, average,		12.61
Hock, "		12.08
Burgundy, "■		14.57
Malaga, "		17.26
Lisbon, "		18.94
Currant, "		20.55
A Gooseberry, average,		cohol,—per ceni, 11.84
Orange^	u	11.26
Elder,	CI	8.79
Cider, from	5.21	to 9.87
Perry,		7.26.
Mead,		7.32
Burton ale,		8.88
Edinburgh ale,		6.20
Brown stout,		6.80
London porter,		4.20
Small beerr		1.28
 
WINES.                              89
   From this table it will be seen that most of the common wines in use con-
 tain from a fourth to a fifth of their volume of alcohol—a sufficient quantity
 to intoxicate and produce deleterious effects  upon  the  system, when intem-
 pcrately or habitually used, and which effects must necessarily be augmented
 by the additional presence of brandy, which is mixed with nearly all foreign
 wines, in order to preserve  them, when  imported into this country.  New
 wines are  always  more  intoxicating than old, and which is due to the fact.
 that the alcoholic strength of wines diminishes with their age.
   The peculiar flavor of different wines depends upon some unknown volatile
 principle, and  not  unfrequently, it is produced  by the addition of foreign
 substances.
   Wines are designated according to their color, red or white; also  according
 to their  other properties, taste, &c, as sweet, acidulous, light, strong or gener-
 ous,  dry, rough, sparkling, still, &c.  The wines of different countries are dis-
 tinguished in commerce by various names, thus : — Port wine is made from
 round, black grapes, and is exported from Oporto.  It  contains considerable
 foreign alcohol, added in the shape of brandy for the purpose of preserving
 it, and is very strong and astringent.   It is more apt to  constipate the bowels
 and disorder the head and  stomach than  sherry, and is frequently resorted
 to as a tonic in debilitated  systems, and as an astringent in cases of looseness
 of  the  bowels.  Very little Port  wine is received in this country, because,
 the amount annually exported from Oporto, is barely sufficient for the supply
 of England and her dependencies.   In  fact, it is a very difficult  matter to
 procure pure Port wine; the greater part of that which is sold in this coun-
 try, being  a factitious  article, prepared from cider, brandy, logwood, raisin-
 seeds, spoiled wine, &c;  so that it were better as a general rule to  dispense
 with the article entirely, either as a medicine or as a beverage.
  Sherry wine  is made at Xeres, in Andalusia, and is exported from  Cadiz.
 It is of an amber color, varying  in the depth of its tint, and has a pleasant
 flavor without  much acidity.  It  is peculiarly valuable on account of the
 small quantity  of free acid which it contains, which renders it useful among
 patients  troubled  with  gout, acid stomach, or uric acid deposits.  Much of
 the sherry  wine in this country, is  prepared from inferior wines, or is adul-
 terated with various foreign ingredients.
   Madeira icine is exported from the island of Madeira, and is the  strongest
 white wine in use, being stronger and more acid than  sherry.  It  is not fit
for a common drink, but is well adapted for old persons, invalids, and  debil-
itated constitutions, when its slight acidity does not disagree.   Like all for
eign wines, it is frequently  adulterated, and some  care must be taken, as with
all wines, in order  to obtain a pure article.
   Champagne wine is usually prepared from a black grape; its sparkling and
effervescing appearance is owing to the large amount of carbonic  acid  gas
which it contains.   It is an exhilarating  wine, producing speedy  intoxica-
tion  with subsequent acidity of stomach and headache,  and is, therefore not
fit for a  common drink.  It  is  occasionally  useful in  cases  of lowness of
spirits, and to allay nausea and vomiting.   The  small  province of Cham- 
90
AMERICAN FAMILY PHYSICIAN.
pagne does not manufacturo sufficient of this wine to  supply the extensive
demand for it, consequently more than two-thirds of the Champagne wine
met with in this country is a factitious article.   An excellent imitation  is
made in this country as follows, and which will tend to explain the cause  of
the scarcity and high price of crab-apple  cider:—Take of good crab-apple
cider twenty-eight gallons, fourth-proof brandy one gallon, genuine Cham-
pagne five gallons, milk one pint, bitartrate of potassa half a pound.  These
are mixed together, allowed  to stand for a time, and bottled while ferment-
ing.
   Claret wine is a French red wine, and ranks as  a light wine; it has a deep
purple color, and an astringent, acidulous-taste.   The best are the brands
Lafitte, Latour, Chautcau, Marguax, and Haut-Brion.  These wines are light
and  wholesome, and are less heating and more laxative than other wines;
used in excess they cause acidity of the stomach.   Claret is an  unfit wine
for persons disposed to gout, rheumatism, diarrhea, dyspepsia,  or to depo-
sitions of uric acid in the  urine.  Much of the claret wines  of ordinary
dealers is a most pernicious compound, being made of claret with spoiled
Port wine; of cider with coloring and astringent materials,  and a little
neutral spirits, together with various other unhealthy ingredients.
   The native  Catawba grape, introduced by Major  Adlum of Washington
city, forms an excellent wine, which will undoubtedly supersede the use  of
all foreign wines, at least for medical purposes.  Mr. N.  Longworth,  of
Cincinnati, has for a long time been engaged in the cultivation of this  and
other kinds of grape, as well as in the manufacture of native icines,  and by
dint of perseverance and careful investigation, he has succeeded in prepar-
ing wines which are fully equal  to those of foreign origin.   Longworth's
Catawba and  Sparkling Catawba,  are becoming  known  throughout the
country as superior  articles, and their purity and  freedom from adultera-
tions render them preferable in all instances where these agents are indi-
cated or  required.  It is much to be regretted that the price of our native
wines is  as high as we find it, being in some cases nearly, if not quite, equal,
to that of imported wines.   My own impression is, that, the  cultivation  of
the grape and the free use of our native wines will do more to remove the
vice  of drunkenness from among us than any other means which have yet
been tried.
   The acidity of stomach which follows the  drinking of wine,  is not  alto-
gether due to the small amount of uncombined acid contained in it, but  to
other causes, as debility or derangement of the  digestive organs, the over-
stimulation produced by the alcohol present, &c.
   The constituents of wine are, alcohol, which  in  a  considerable quantity
forms a strong wine; an odorous principle; blue coloring of the husk, in red
wine; tannin,  in  rough or  astringent  wines; bitter extractive;  grape sugar,
especially in sweet wines; gum; yeast; acetic acid; malic and tartaric acids;
bitartrate of potash ; carbonic acid  in the sparkling  wines; bitartrate of lime,
water;  &c, &c.  These  constituents vary in  their pr«pc-tiou» in  the differ-
ent wines, and some  of them are  frequently ah&e.pt  in eue k>od of wine,
but present in another. 
WINE.
91
   An excellent,  pure,  and sparkling wine may be made as follows:  Take
 twelve pounds of good raisins, cut each raisin in two, and  put them into a
 five gallon demijohn, nearly filled  with clean soft water;  let it stand  un-
 corked for twelve or fourteen days then filter, bottle, and cork well.   Upon
 the residue, after the wine is poured off, put as  much water as before, let it
 stand a sufficient time, and the result will be a good wine vinegar.
   Wine,  when used in moderation, slightly excites  the vital powers, aids
 the digestive  process, and enlivens  the spirits.   Persons in health, seldom
 require the use of wine, or indeed  any other stimulating drink; it is  only
 when the system is debilitated or depressed, the digestive functions impaired,
 &c,  that  any excitement of this  character will  be indicated, and,  then,
 probably, pure wine is  preferable to any other fluid in which alcohol enters
 as a constituent.   Wine is frequently employed  with advantage in convales-
 cence from fevers, in sinking of the  vital  powers, and  alone or conjoined
 with  Peruvian bark in  extensive ulceration and gangrene;  it has  also
 proved useful in some convulsive diseases.  It must  never be forgotten,
 that whatever degree of exhilaration may be produced in a healthy person
 by the use of wine, it will certainly be succeeded by a degree of nervous
 depression proportioned to the amount of previous excitement.  Hence the
 immoderate use of wine, or its habitual indulgence debilitates the brain and
 nervous system,  paralyzes the intellectual powers, impairs  the functions of
 the stomach,  producing  a perverted appetite or morbid  craving for  the
 renewal of the  intemperance, beside engendering  diseased  liver,  gout,
 rheumatism,  dropsy,  apoplexy, gravel,  and  other  painful and  serious
 affections.  The  wine-drinker is  most  commonly a  sufferer from  some
 disease occasioned by the use of his favorite liquor, for  when taken habit-
 ually it invariably leaves  its mark,  not only by the presence of disease, but
 by the wine-red cheeks which are commonly present, and the claret-colored
 carbuncles which grace his nose.   It renders him impatient, peevish, and
 irritable, frequently leading him into difficulties and quarrels, without any
 real cause, if we except that of wine  itself.
   In this  country, wine  is  adulterated  to  a very great extent; the  most
 dangerous- article used for this purpose is lead, which is added for the pur-
 pose  of rendering wine clear and  preventing its becoming acid.   It is a
 murderous practice, and those who are guilty of  it, should be dealt with by
 law as common murderers.  The presence of lead in wine may be known by
 the dark  brown  or black color produced when a stream of sulphureted
 hydrogen  gas  is passed through any portion of it.
   Lime or carbonate of lime is frequently added to sour wines to remove
 their acidity; the presence of lime may be ascertained by the large amount
 of precipitate occasioned by the addition of a solution of oxalate of ammonia.
 Carbonate  of  lime  may  be  detected by evaporating two fluidounces of
the wine  to  two fluidrachms, then  adding to  the remaining wine four
fluidrachms of alcohol;  tartrate and  sulphate of lime are precipitated,  and
the acetate of  lime is dissolved.  Then  strain the  solution, and evaporate
 carefully to dryness.  This dissolved in water,  will yield a very abundant 
92
AMERICAN FAMILY  PHYSICIAN.
precipitate with a solution of oxalate  of ammonia,  giving off at the same
time, the smell of vinegar, when decomposed by oil  of vitriol or  sulphuric
acid.
   If alum be added to wine it may be detected by adding an ounce of dis
tilled water to  an ounce of the  wine,  and  gradually  letting fall into the
mixture a solution of the muriate of barytes.   If a  copious white precipi-
tate takes place, add  a small quantity of pure  nitric acid, and  if alum be
present, the precipitate will not be redissolved.
   There are many other  articles added to wines  as  logwood,  carbonate of
soda,  brandy, elderberries, &c, &c, many of which  are difficult to detect;
beside which, the counterfeit or spurious wines, frequently contain articles
in their composition which are decidedly injurious in their effects  upon the
stomach, and  when  such wines  are  relied upon as  medicinal  agents in
disease, they always produce mischief and disappointment.
   Alcohol  is a fluid or  pure spirit  obtained by submitting the  juices or
infusions of certain fruits,  &c, to  the vinous fermentation, aud then distill-
ing and subsequently rectifying them.   It is the stimulating and intoxica-
ting principle of all malt, vinous, and  spirituous  liquors.   When  deprived
of its  water, it is termed absolute alcohol; the alcohol of commerce is termed
rectified spirit, and is imperfectly freed from water, and other foreign sub-
stances.  Proof spirit is diluted alcohol, having the  specific gravity 0.955.
The presence of water in alcohol may be known by dropping into the liquid
a piece of anhydrous baryta, which will fall to powder only when water is
present.
   Alcohol is inflammable, and burns without smoke or residue;  it  combines
with water and ether in all proportions.  It dissolves volatile oils, fixed oils,
resins, sulphur, most varieties of sugar, phosphorus, the vegetable  alkaloids,
caseine, iodine, tannic acid, ammonia, balsams, camphor, and a great number
of other substances, on which account it is extensively used in medicine and
in the arts.  The danger of manufacturing drunkards by the administration
of alcoholic drinks, as wine or brandy, &c,  in the form of bitters, cordials,
&c, which was  so common  a few years since in the  profession, we are glad
to say, has now almost ceased; and although alcoholic tinctures are sometimes
prescribed,  yet it is in such small doses, and so well diluted with water, that
no fear of intemperance can arise in  the mind of the physician.   Therei are
very few cases La which alcoholic stimulants are given,  and these are never
of a chronic character, nor in which these liquids have to be used more than
a few  days.  In regard to drunkenness, community  has more to  fear from
nostrums in the form of "bitters," "schnapps," "cordials," "elixirs," &c, than
from anything else.
   The several fluids, aside from wines and malt liquors, into  which  alcohol
enters, forming the stimulating or  intoxicating principle,  are as follows,—
they are known as alcoholic liquors , or ardent spirits:—
   Brandy, made by the distillation of wine, and which consists of  nearly 60
per cent, of pure alcohol.
   Rum, made by the distillation of the juice of the sugar-cane after its vinous
fermentation, and which consists of nearly 55 per  cent,  of pure alcohol. 
GIN.—WHISKEY.—BRANDY.
93
  Gin, the result of distillation of an  infusion  of grain after having under-
gone vinous fermentation, and which  is subsequently rectified from  juniper
berries;  nearly 52 per cent, of pure alcohol may be obtained from it.
   Whiskey, produced by distilling an infusion of grain after vinous ferment-
ation, or by distilling cider, or the juice of several fruits.   It usually contains
from 51 to 55 per cent, of pure alcohol.
  These are the principal liquors used as ardent spirits; they contain different
proportions of alcohol, and  have peculiar tastes, according to the substance
from which they are obtained.   Other liquors and mixtures are .likewise use^
as cordials or liqueurs, as the French term them, which are very poisonous and
dangerous preparations, being composed of distilled  spirits, sweetened,  with
the addition of aromatics, and flavored by articles which contain prussic acid.
Punch, juleps, and various other mixtures prepared to please  the palate and
stimulate the nervous system, are much  in vogue, especially during the
summer months, but they are all alike injurious to the stomach  and to the
general system when used habitually or too freely.  With the exception of
alcohol and whiskey, but very little pure liquors are to be had in this coun-
try, as they are  superseded by the domestic articles  manufactured by liquor
dealers.   An old dealer and manufacturer  has given the  following formulae:
   Domestic Brandy is made of neutral spirits, one  gallon; good brandy, one
pint; molasses, a sufficient quantity to color; and sweet spirits of nitre, eight
ounces; mix.  Domestic Gin is made  of neutral spirits,  forty gallons;  good
Holland Gin, four gallons; oil of Juniper, three ounces;  oil of Anise, one
ounce; mix.  And it is such trash as  this, and frequently even worse, which
is being poured  down the throats of our countrymen to their certain  destruc-
tion.  When I look around me, and observe the many thousands of our youth
addicted to the fashionable, but no less pernicious vice, of drunkenness, the
various  means taken to ensnare them, the poisonous trash which is presented
to them, (these manufactured liquors being more deleterious and  deadly in
their effects than pure articles,) and  the kind of men  engaged in manufac-
turing and retailing,  I  am frequently led  to believe that some agency is
silently and secretly at work to destroy the liberties of our country, by first
undermining the moral, mental, and physical health of our people  through
the influence of these means; for, there is no country under the sun in which
more ardent spirits are used than this.
  As a general  rule,  all liquors are injurious to the human constitution, the
only instances when they are beneficial being in a few diseases.   Those who
wish to preserve good health, promote longevity, and enjoy the full  vigor of
their systems, should  never indulge  in  alcoholic,  vinous, or malt  liquors.
Their habitual use  produces chronic  inflammation of the stomach, loss of
appetite, sour stomach, headache, peevish irritability,  loss of  memory,  fetid
breath,  nausea, diseased liver, jaundice, dropsy, impotency, gout,  colic, epi-
lepsy, apoplexy, and  mania.  No healthy man  living needs liquor; when  he
feels fatigued or depressed, there is no tonic, no stimulant, equal to a draught
of good cool water, which produces all the beneficial influences of stimulating
liquors  without  any of their evil effects.   It is said that  ardent spirits are 
94
AMERICAN FAMILY PHYSICIAN.
necessary in warm weather; so likewise is it said that they are necessary in
cold weather—and the advocates of the one doctrine, generally advocate the
other also, and practice both.  The fact is, that persons  who  use liquor in
cold weather are much more apt to suffer from cold than those who use water;
and in  warm weather, there are  no men less capable of standing any labor or
fatiguing exercise, than they who  drink intoxicating liquors.   It has been
observed that in all  the  epidemics which  have occurred in  this  country,
whether in warm  or  cold seasons, among  those  who  were attacked, hard
drinkers seldom escaped,  and were always more liable to fatal terminations
than any other class  of persons.  Sometimes we  meet with an  instance of
longevity in a  hard drinker,  but this is apt to be the case only occasionally,
and in  no  way disproves the  fact that alcoholic drinks are pernicious in their
effects.  Persons have occasionally recovered from  large doses of strychnine
or opium,  but  this does not prove  that these  poisonous  agents  are harmless
when thus used.  And it will almost always be found that these instances of
longevity  are  among persons  originally of strumous habit  of body, for
although with  such persons, alcoholic drinks produce intoxication as certainly
as with others, yet its pernicious influence on their constitutions are not
so immediately effected, or observed; indeed, in some instances, the moderate
use of  liquor with strumous persons has been found of advantage.   But this
is no excuse for the vice  of  intemperance, nor  any reason  why every body
should drink such fluids.
   In truth,  there is not a valid  reason in existence for the habitual use, even
in moderate quantity, of  intoxicating drinks, by  persons in health.  Some
pretend to think that a glass immediately before, or immediately after a meal
favors  digestion, and hence indulge daily at the dinner-table; but this  is a
mistaken idea, for the very reverse takes place; the stomach  being overstim-
ulated, soon loses its energy, digestion becomes impaired, and the general
system sooner or later suffers from these influences.  I have said above, that
there is no reason for the use of liquors by healthy persons,  and I will add,
that very few invalids require them, and when they do, they should be espe-
cially careful not to constitute themselves or their unprofessional friends, as
medical advisers.
   " It  is  too  much  the  custom  for  persons  whose  occupations do  not
require any degree  of bodily labor,  not only to eat at a meal more than is
really  demanded by  nature,  but likewise to eat very hastily, as though they
were eating for a wager, or as  if the renewing'the physical  sustenance  of
the system, was a task  imposed  upon them,  so  dreadful, so  hateful,  that
they would hasten through  it as rapidly and as carelessly as possible.  The
effect of this is,' that a most grievous burden is imposed  upon the organs of
digestion; and to perform  their  duties properly,  they have to call to their
aid the muscular and nervous  energy from nearly all parts of the system
this soon  produces a depression of spirits after the meal, or a sensation of
drowsiness, or perhaps, a distress and fulness at the stomach, which with
some  of our  more fashionable patterns  of morality, is removed  by their
wine or brandy,  either  during, or immediately at the close of  their meal, 
                          ABUSE  OF  LIQUORS.                       95

and which course they pursue daily.  Others, following the inclination to
sleep,  awake  only to feel  yet more depressed, unfit for active  thought or
exercise, and  fly to the bottle for relief.   In fact, how often have many of
our young ladies, after  having eaten what  they termed an excellent  meal,
been  heard to exclaim, ' Oh, how delicious a drink of cider, wine,  or ale
would be, it would do me so much good !'   With  the young man, however,
it is different; he expresses  his  thoughts only by his actions, as  may be
clearly ascertained  by  following him to  the bar-room of the  respectable
tavern.   A practice of this  kind pursued daily, confirms the habit, and
soon makes a  drunkard.
  " Again, certain conditions of the system, as a morbid  action  of the
liver, debility of the digestive powers, diminished secretion of  bile, or the
incipient stages of dyspepsia, often create in individuals at irregular and
various hours of the day, a desire, or preternatural appetite for  stimulants,
in  many instances so strong  and intense that it cannot be resisted, and the
individuals seek the bar-room, or the side-board,  that they may  satisfy this
annoying  desire.  When, were  they properly acquainted  with the  cause,
they would shun  those places as  the  most dangerous, and would  obtain
both relief and  benefit from other stimulants, more healthy, more benefi-
cial,  and  less tempting  and hazardous.   Indeed  I  have  known  many
persons  who  removed  the sensation whenever they  experienced  it, by a
good  hearty draught of cool water.  This circumstance,  by cultivating a
relish for liquor, has likewise made drunkards.
  "Again, behold the young man with all the freshness, energy, innocence,
and purity of youth, just emerging from the obscurity of some seminary, in
which his earlier years have been closeted,  and in which his juvenile mind
has been taught and impressed with  the importance  of virtue  both  in
precept and example.  His whole soul is filled with the praiseworthy ambi-
tion of  doing good, of  being good, and of  acquiring  the friendship and
love of all his fellow-creatures, and  he  leaps  into the  new and spacious
arena, bounded only by the heavens, with  all the exultation, with  all  the
animation, with all the undisguised sentiments of happiness,  so  peculiar to
those  just entering their career in  life,  and with principles of the most
correct character.
  " His friends perceive in him only the talented,  the fearless, the generous,
the noble, the endearing youth, and they bestow upon  him their love, their
praise, their encouragements, and their assistance.  And his parents—what
pleasures, what excellence, what unrivalled reputation  have their idolizing
hearts preformed for him?   Observe, while the youth's virtues  are spoken
of and approved,  how  the father's eyes sparkle, how his whole  features
become illuminated with the feelings of his soul,  how animated he appears,
while  the blood courses rapidly through its various canals; and how  the
tender mother's bosom heaves with  a tumultuous  emotion of joy, v-hile
the tear of delight  springs unbidden from its secret fountain,  and p \s in
the corner  of that maternal eye, a  dear and sacred gem, far richer th; 1 the
purest diamond, far lovelier than the most magnificent  works  of  art. 
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AMERICAN FAMILY PHYSICIAN.
  "With guiltless intentions, the spirit of sociality induces a friend to call
together a select company, for the combined purposes  of pleasure  and
improvement,  and our  highly favored  youth  is one among them.   The
unhallowed cup  of wine is passed around, and is presented to him,—he
hesitates, for the genius of Temperance whispers and forbids him—he does
not need the vile stimulus, for  already has he health, spirits,  and vivacity
to excess, flowing through his system—he perceives the smile playing upon
the lips of his friends, they laugh,  they joke, they ridicule him—he falters,
but is not yet conquered,—but alas! the coaxing, seducing, winning words
of that beautiful young  lady cannot be -resisted, her persuasions  triumph
over his firmness, while her brilliant, heart-piercing, bewitching  glances,
lull for  the time all  feelings of conscience into a dream of exalted happi-
ness never to be realized, and  to please the  fair enchantress he pours the
cursed fluid down,   and  breaks the  charm which his good genius  had
mercifully thrown around him.
  " How many  are  they,  who  could point  to some of your sex, young
ladies, as being the first to tempt them to taste of that which proved their
ultimate ruin, though done in every instance, with  the most innocent—the
purest of motives.
  " Having tasted once,  he needs but little persuasion to induce him to trj
it a second and a third time ;  and sooner  or later we find him surrounded
by his young friends at the bar-room of some respectable hotel; there he is
the life of the company,—his jokes are the best, his flashes of wit the live-
liest,  and his disposition  the  happiest among  them.  There is   no  nig-
gardliness about him, for he can swallow with his friends  glass after glass
of the pernicious liquid which  is rapidly destroying him,  and pay for it
too, like a gentleman, like a clever, whole-souled fellow.
  " And how was this brought about?  He had tasted one  glass at a party
to please that party, and whenever afterward he refused to drink with them,
that once,  that  first, that fatal moment affords a  precedent upon which
to concentrate their forces, and by their laughter and sarcasms, they have
finally prevailed.  Now, it  is impossible  for him ever  to refuse, he has not
only acquired  the habit of drinking, but he can no longer, even  for a
moment, withstand their jeers and ridicule;  besides, he has learned to love
their company and their praises; for they have sworn that he is the most
noble hearted fellow  that ever existed, and it is a pleasure to him that they
continue to think so.
  " In process of time, the fiend makes such rapid inroads upon his health,
his appearance, his language, and  his actions, that the hotel in  which he'
once held his station as the most respectable, now becomes too respectable
for  him; the jolly friends  among whom he was the  best, now  become  even
better than he,—he is cast off, thrown aside, and falls from one  degree of
gen eel  drunkenness to another, until the  gutter, that receptacle for all
imp trity and foulness,  is  made the  resting place,  the  sleeping place of
him, the  now disgraced and beastly  drunkard.  His friends forsake and
shun him, as they would a poisonous  reptile; the mind of  his gray-haired 
ABUSE OF  LIQUORS.
97
 father  becomes seared and blank,  and  his  heart-broken, but  still  fond
 mother, dies with her last words imploring mercy for her lost and wretched
 son.
   " There is hardly any vice but which can be laid aside by those addicted
 to it with but very little determination, in comparison to that which would
 cause the intemperate man to leave his  cup;  for with  him, in addition to
 the habit which he has contracted, and the consequent  feelings  produced,
  is nerves have become shattered,  his intellect  impaired, his energy and
  mbition destroyed, his firmness gone, his reason a  complete wreck, an
 his  whole man, both soul  and  body, the ruins only of what he  once was,
 now degraded and despised by all.
   "It is the moderate drinker  that forms the drunkard.  He professes to
 have such a stable,  impregnable fortress of firmness in his mind, that he
 can withstand any attack  of the enemy, both  openly  and secretly; and
 perhaps one out of a hundred may succeed.   But then, what immense, what
 irremediable mischief has that one caused ; he has  invited others to drink,
 who lacked the firmness of which he so loudly boasts; nay, he has insisted
 that his neighbor should take a glass with him, only  one, sjngle, harmless,
 friendly glass,  when that neighbor has already taken a  harmless glass too
 many;  he judges  of the firmness of others by his own ;  and though he may
 stand safe and unscathed, yet how many, through him, hare been helped to
 glide into the pool  of degradation  and wretchednsss.   He is the greatest
 obstacle, the greatest stumbling-block to the complete  success of the temper-
 ance reformation ; he boasts of  stability, and all who  hear and see, all  who
 govern   their actions  by his, will  not be underrated—it is not  in human
 nature to stand depreciation  of mind and intellect;  no, if he can be firm,
 why not they?  They are men  like unto himself,  and it is as much  their
 pleasure and glory to  boast of firmness, as it is  his; and the example he
 holds up to them,  is followed to  their complete overthrow.
   "If the moderate drinker is a  man of business,  he holds forth an example
 to his clerks or apprentices to sip  of the deadly draught,—if a father, he is but
 a model for his children, for  how natural is it among children  to imitate
 their parents,—if a man of high standing in society, those who look to him
 for a pattern of morals, copy his vices also;—and  be he  where  he may,  or
 what he may, it is  all the same, there will be persons who copy from him to
 their sorrow.
   "I consider that the moderate  drinker is a dangerous man to society,  and
 to himself.   It  matters not whether he obtains  his liquor at the three-penny
 grogshop from common glasses, or at the sideboard  in his splendid palace,
 from silver or  golden goblets,—the  sin, the danger is the same—and the
 wealthier; the more respectable the man, the greater is the hazard and the
 heavier  the responsibility that hangs over him.   The first lessons of all be-
 ginners,  in intoxication, were as moderate drinkers, but by dint of cultivation
 they have advanced to the rank of professed drunkards,  and so will it be
 with ©very moderate drinker,  who persists in the habitual  use of liquor.  He
maj I' ;°"h  at these  remarks,  but let him remember  that there was a time 
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AMERICAN  FAMILY PHYSICIAN.
when every drunkard likewise  laughed to scorn the idea of his falling into
the meshes, for he too/poor, deluded mortal, prided himself upon his respect-
ability, his judgment, his inflexibility, and his strength of mind.. Even now,
take the very moderate drinker who uses but one glass of wine daily; when
the hour for the stimulus arrives to which  he is accustomed, how unhappy,
how miserable are his sensations, until the liquid  is  swallowed; there is a
faintness at the stomach, a depression of spirits, a confusion of the intellect,
and an irresistible desire for the demon, all of which vanish with the draught.
  "Could  the spirits of all the departed drunkards who have ever existed be
roused from their deep slumbers, and summoned to appear  before  us, that
they might answer to the question, 'What made you drunkards?'—they would
raise a cry which would affright the earth,  and astound the heavens,—which
would pierce the inmost soul of every consumer of intoxicating liquors, and
make him stand aghast, while terror and dismay would seize upon him, and
the large drops of wretchedness, agony,  and despair would ooze from every
p0re—and the shrieking reply would echo  through the vaults of heaven—
'moderate drinking—moderate drinking.'
  "Moderate drinker, there was  a time  when the  poison had never entered
your lips,  and you were healthy and happy; there was a  time when one  glass
daily was  sufficient, and then  you exulted in your firmness,—but soon you
increased  to a second and a third glass, and with thefh increased your pro-
fessions of stability and strength of mind;—and, let me ask, do you not, even
now, feel at times  that  an extra glass  would do no  harm, nay,  that it is
required?   Ah! that extra glass will soon be added to  the list, and extra
glass after extra  glass will follow in  their turn,  until  your firmness  shall
disappear  like the stately oak before the thunderbolt, and utter ruin will  be
your portion.   If you are in reality the  man of firmness you  believe your-
Belf to be—if there is not the  least danger of your ever tasting a  drop too
much,—still I say, forbear, forbear!  Let not your example be the stumbling
block by which others of less power of mind, and who pattern after you, fall
into ruin.   If you have, indeed, a superior strength of mind,  show it to the
world by restraining from moderate drinking, and then we will believe you
but never,  never,  till then.
  " What  is drunkenness?  Go visit  your  prisons, and among  their dreary
cells behold the housebreaker,  the felon, the murderer, the outlaw who  fears
neither the laws of God nor man.  Go visit your hospitals, and among  their
inmates behold those who are afflicted with  dropsy, jaundice, paralysis,  con-
vulsions, and that most terrible calamity that can  befall man, insanity.  Go
visit your  rum-holes, your sinks of iniquity, and observe  the bleared eye, the
bloated countenance, the palsied and tottering frame, the  staggering  gait,
the poverty and wretchedness,  and the  detestable  deeds  of vice, everywhere
apparent;  and hear the oaths and curses, the vile  and  loathsome  language
which issue from the lips of the inhabitants of these den«. 0f sin#  And when
your soul, sickened with the sight of such human misery au^ depravity, has
turned away filled with horror, disgust,  and detestation—know -thjat all this
is drunkenness—all this  the effect of rum. 
ABUSE  OF  LIQUORS.
99
  " But I would not leave you here,—I would convey you to the drunkard's
parents,  they whose anticipated cup of pleasure is removed far from them;
whose hearts are bowed down with anguish, and filled  with desolation and
despair, almost to bursting;  behold the manifest heartfelt, but  yet untold
grief, exhibited  in  those  pale,  emaciated  countenances,—in  those heavy,
sunken eyes whose springs have  long since ceased to respond to  the united
feelings of parental  affection and distress.
  "Neither  can I pass over the drunkard himself;  we behold  him, perhaps
just arisen from the miry gutter, and reeling his steps  homeward; his eyes
inflamed, his face swollen  and bruised,  and his whole appearance indicating
extreme wretchedness;  there is  nothing to be observed,  however,  which
evinces any  feeling  of the inner man—yet the mind of  that man, ruined as
it is, suffers  to an intense degree.  He knows and fully experiences his con-
dition—he knows that he is degraded,  and  imagines that he never can  be
again received into  respectable society,—he knows  that through his folly the
wife of his bosom, and his little,  innocent children are in a state of starva-*.
tion,—he compares  his former with his present state,—and all these thoughts
eo harass him  that he hastens to  the bottle to silence them,  to bury them in
the insanity of alcohol.  And  it is now that the children,  the wife, are
cruelly beaten;  that everything  hateful and abominable is executed; per-
haps he steals, or murders, or performs some crime which entails a mark of
shame and infamy on him and his children  through life.  It is not the man
who does these things,—it is the drunkard—the man unmanned and  meta-
morphosed into  a monster by alcohol.
  "I would take you to his ragged, barefooted, and bareheaded little, harm-
less children, who are suffering from hunger, from cold, or from the unfeeling
blows of a drunken father; whose society, owing to the misdemeanor of the
parent, is avoided by all the other children of the neighborhood; who are
the innocent subjects of abuse and insult;  and who are made to bear the
disgrace attached to the parent, as though it were a mark set also upon them.
  "I  would have  you visit his residence;  everything  betokens poverty,
wretchedness,  and ruin.  There  is hardly any furniture, and what there is
has been nearly broken in pieces by him during his intoxication, perhaps in
beating  his  poor, unoffending wife; the windows  are  for  the  greater part
filled with old rags  or paper;- the necessary articles for  preparing food, and
from which  to eat it, have nearly all been pawned for rum, and  what remains
is broken, such as any of us would throw aside.  Although the cold, cutting
blast of a powerful  northwest wind is forcing its way through the cracks and
crevices, and broken panes,  yet there is no  wood,—no, nothing  to enliven
the scene, or create the least appearance of comfort,—all is the vacuity of
extreme misery.
  "The wife who once saw better times, who once smiled  at the golden pros-
pects of the future—now, with scarcely clothing  to  appear decently,  much
less  comfortably clad, perhaps  with her limbs and body marked with the
blows of a drunken husband,  and suffering severely  with the  pain arising
from them—sits mute and tearless, for  the fountain of her tears has long: 
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AMERICAN  FAMILY  PHYSICIAN.
 since become dried up.   She has done all that woman, all that wife, all that
 mother could do, to reclaim her miserable partner, and to administer to  her
 own wants, and those of her crying, half-starved children;—but it will  not
 do, one after another everything goes for rum, rum, rum, until exhausted na-
 ture, insulted  affection, and  disappointed  hope can hold out no longer.
 Herself and children  are beggars indeed.   For the beggary of honest poverty
 is bliss compared to this—she knows it—she feels it to her very heart's core,
 and who can describe the agonizing,  heart-rending thoughts  and feelings
 which exist in her soul, as a woman, as a wife, and as a mother?—All this is
 drunkenness!"—Part of a  Lecture by the  Author.
   It is too much the  case in this country to legislate upon morals, instead of
 striking at the root of the evil in a more rational manner.   Legislation may
 punish, but it can  never persuade nor convince;—indeed,  I  am fully con-
 vinced that all legislation upon this subject  at least, is followed  by much
 more mischief than benefit—mankind will not be driven, but they can always
 be gained by kind words, and proper encouragement and support.  Stop the
 use of rum by law,  and  the seekers after  stimulus  will  fly to opium—stop
 this, and they resort to strong coffee, schnapps, and cologne—stop these, and
 tobacco becomes in demand—stop this, and they find some other article,—for
 stimulus they will have^ even at the expense of health, life, and respectability,
 and this will continue  in  spite of law, tracts,  lectures, &c, until the right
 chord is made to vibrate—the  intellect, and  the intellect properly trained and
 directed.   Tell  a  man that the  law forbids  him to drink  liquor,  does this
 convince him of the error of drinking, any  more than if there were no law?
 Does it afford the least proof that he is injuring himself?  On  the  contrary,
 will it not be more  likely to irritate him, and to drive him to still greater
 excesses in drinking,  that he may show defiance to a law which he  considers
 unconstitutional, and an unwarrantable  interference  with his rights and
 privileges as  an American freeman?  In fact, he observes that every reform,
 no matter what it may be, or how  it may commence, is  ultimately employed
 as a political lever to further its own destruction, as  soon as the purposes  for
 which politicians seized upon it are accomplished, and he, therefore,  considers
 all legislation upon moral reforms, as so many political humbugs, and there-
 by, instead of his dangerous progress being retarded, it is very much  accel-
'erated.
   Let those  who are  so eager for the spread of temperance,  instead of shirk-
 ing all responsibility  upon the officers of the law, take it upon themselves—
 let them labor,  and labor, too, in the right way—lectures and tracts may
 do some good, but very little compared to that which  could be done by proper
 education—not the routine,  parrot-like teaching of  the  present day,  but a
 teaching which will impress and firmly establish  in  the  susceptible  minds o»
 our children, good and wholesome principles, so that when they are old they
 will not depart from them.   Teachers of morals, who shall not only explain,
 but who shall train, that is, cultivate and  firmly establish  in  the  minds  of
 children correct principles, are as necessary as teachers of reading, writing,
 music, dancing, &c,—when  these  are once   learned they are never forgotten. 
CLOTHING.
101
 The tender mind of the child is capable of receiving  impressions which will
 be lasting, and which will govern his future thoughts and actions, as a man,
 and as a citizen.   The virtues or vices imprinted on his early intelligence
 never forsake him, and when years have rolled him into his  dotage, when the
 finger of time has placed its  mark upon him, when he loses the remembrance
 of events  and incidents  which transpired while in the vigor and prime of
 manhood,  still he retains very forcibly a  recollection of the  scenes and
 impressions of childhood, and can bring them to view  as vividly as though
 they were  but the occurrences of yesterday.  Were there but one-fourth as
 much money  paid away, but  one-fourth as much time consumed, and but one-
 fourth as  much exertion and industry bestowed upon the proper cultivation
 of virtue and morality among children, as there is expended  upon  their
 improvement  and progress in writing, reading, and all scholastic attainments,
 (for one may  be a perfect Solomon in wisdom, and yet be vicious for want of
 correct early  education,—depth of knowledge does not necessarily imply
 depth of virtue,) what a glorious, moral generation would be the next!
   There is great resemblance between the state of intoxication, and an attack
 of incipient apoplexy or palsy; as witnessed in the  staggering  gait, loss  of
 perfect speech, stammering, double sight,  blunted feelings and  perceptions,
 &c, the  result of  an increased amount of blood in the  blood vessels of the
 brain.  When the intoxication is complete, the countenance is bloated  and
 dark-colored;  the sleep profound and comatose, the breathing stertorous, the
 eyes fixed, the pupils enlarged, the person quite unconscious, the same as in
 apoplexy.   Sometimes  spasms  of  an epileptic  character will  be present.
 When an individual is  in this condition,  he should be conveyed to  a cool
 room, all ligatures  or tight  clothing about the neck and limbs removed, in
 order that they may not interfere with the  circulation,  and he should  be
 placed in a horizontal position with his head somewhat elevated.   Cold water
 should be  poured  upon his head and neck, and  as  soon as he  is able to
 swallow,  a mixture of salt and mustard in  warm water should  be given fre-
 quently until  free emesis  is produced.  In  the meantime counter-irritation
 must be produced by whipping the soles of the feet rather energetically.  As
 soon as the patient recovers put him in bed with his head raised, and allow
 him to drink of  good fresh milk.  If, after six or seven hours, he is restless
 and wakeful,  a powder composed of one-fourth of a grain of  sulphate of
 morphia, and one grain of sulphate of quinia, may be given, and, if neces-
sary, it may be repeated in an hour or two.   I have pursued this course  in
many cases of the above character, and always with excellent results.
                        CHAPTER   Yin.

         Clothing.—Flannel.—Cotton.—Silk.—Lincv.—Hats.

  Clothing is required not only for the purpose of concealing nakedness,
but also to protect the body from the various changes of the atmosphere, and 
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AMERICAN FAMILY  PHYSICIAN.
 maintain it at a right temperature.   The latter objects  are  attained,  not by
 any warmth contained in the clothing itself, but from the fact that it hinders
 the heat of the body from being too rapidly carried off.   In  cold weather
 more clothing is required than in warm, though much depends upon habit, as
 many persons, and especially the natives of this country, pass safely through
 the most severe winters, with comparatively little  or no clothing.
   As a general rule, the amount of clothing necessary for each person must
 depend upon the ability of his system to resist the changes or  modifications
 of the seasons;  care being always taken that the  body  be  kept comfortably
 warm.  Too little clothing, or too much, is equally prejudicial to health, the
 former rendering one liable to attacks of disease  from  cold, &c,  the latter
 causing a degree of debility and lassitude corresponding to the superfluous
 amount of warmth produced, and which will eventually cause disease.   Seden-
 tary persons always require more clothing than those engaged in active phys-
 ical labor; aged persons require more than young ones; because the functions
 of the system in the latter are more regular and active, and the production of
 heat occurs more rapidly, and is of a higher temperature, than in the former.
 The invalid, and those of delicate constitution, require more than the healthy
 and robust; infants, from the small degree of resisting power in their systems
 against cold, should always be  warmly  clad.  Much  of the fatality  among
 children is owing to the absurd practice pursued by many parents, of attempt-
 ing to harden their systems, by exposing them to cold weather with  but slight
 clothing; the inhalation of pure, fresh air is beneficial to them, but the lack
 of clothing constitutes the principal danger.
   No arbitrary rules can be given relative to the precise quantity of apparel
 which should be worn  by persons, as  this will depend upon the various
 circumstances connected  with each  individual case.  We should so regulate
 the amount of our clothing as to keep the body comfortably warm, and at the
 same  time secure it from any dangerous impressions arising from sudden
 changes in the weather, being very careful not to  wear  summer clothing  to
 too advanced a period in the autumn, and not to remove the winter clothing
 too soon in the spring; this latter change should always be made gradually.
 Many persons have lost their lives by  imprudently removing  their  winter
 garments too early in the spring,  because a few  days of warm weather had
 rendered them rather uncomfortable.   As light-colored  clothes  have but
 little attraction  for heat, they are best adapted for  warm weather; while black
 clothes,  from their great attraction for heat, are more suitable in cold seasons.
 No objections  can be raised to a display of taste in the form, color, and ele-
gance of dress, for this exerts a moral and otherwise beneficial influence, both
in domestic and public life;  but these  should never  be  consulted  at the
expense of health.  In the  preparation and character  of  our habiliments,
health and elegance should be equally studied.  During the hot, sultry days
of summer, when copious perspiration and increased temperature of the body
 is produced even by the least exercise, making one feel very uncomfortable,
great  care must be taken not to  expose one's self to  cold  by  removing a
portion of the clothing  too soon, as well as to avoid sitting in  a current  of 
CLOTHING.
103
 air.  The body should always be allowed to become somewhat cooled before
 throwing off any garment.
   Much disease and loss  of  life occur annually from wearing damp clothes,
 as stockings, under garments, &c, as well as by sleeping in sheets not thor-
 oughly dried.  Too much attention cannot be paid to this matter,  as a disre-
 gard to it  is always attended with great risk; fevers, rheumatism, pleurisy,
 consumption, or other serious forms of  disease, being the penalty.  I have
 known many young ladies to hasten their death by wearing damp  clothes, or
 bathing their feet, or whole person in cold water,  at  the menstrual period;
 mothers should explain these matters to  their daughters,  or, if they feel a
 delicacy about it, then let them  purchase books on the subject for  their girls
 to read, that they may not foolishly sacrifice their lives.  Persons sleeping in
 betels, or on steamboats,  should always be especially careful to examine  the
 bed-sheets,  as it is in such  places  that damp or improperly aired or dried
 linen are more apt to be found.
   Dr.  W.   E.  Coale  says, in an  excellent little work,  entitled "Hints  on
 Health," and which should be in  the hands of every adult in  the land:—
 "Another important consideration in selecting  materials for our dress is, that
 they should be of such a  nature that they can  be readily cleansed from the
 exhalations from our persons.   It must be  remembered, that in the  coldest
 winter, as well as in the warmest summer, our perspiratory glands are at their
 work,  sending forth sensible or insensible  perspiration,—of which a large
 portion is lodged in our garments; it is poisonous there, and must  be dis-
 lodged.  For our outer woollens, the sun's rays are an admirable cleanser,
 decomposing and dispersing the condensed fluid; for those worn nearer the
 person, nothing but the wash-tub  will suit, and this used at very short inter-
 vals.  We,  therefore,  deprecate very strongly the habit of wearing cloth
 trowsers without cotton or some washable drawers beneath,  and  of women
 rearing quilted and flannel skirts  which are not  washed unless  they  look
 soiled.  A week's perspiration makes them more truly unfit for wear, than a
 month's dust, or any such clean dirt, could.   For  the same reason, a silk
 cravat, worn week after week, without  anything  between it and  the bare
 throat, is an equally objectionable fashion; he who does it  carries his own
 filth about with him.   We use  strong terms,  but we  do not conceive that
 any can be  too strong to express the repugnance that all ought to have  to
 the refuse of their own bodies.   Under  this head,  also, we suggest that the
 boots and shoes be  frequently sunned."  I consider these remarks  of Dr.
 Coale  so important, that  I would advise every reader to stop hfere, and re-
 peruse them.
  Clothing should always be commodious, not interfering with the motions
of the joints, nor occasioning inconvenience by its  weight or tightness,  and
although an attention to these conditions is  important at all  ages,  it is more
especially so in early life,  before the  body has become thoroughly developed.
 When  clothes are tight they interfere with the circulation  of the blood, giving
rise to venous  accumulations  in various  parts of  the body; they likewise
prevent the  perfect  development of  the muscles which they  may  compress, 
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AMERICAN FAMILY  PHYSICIAN.
 causing them to become emaciated and debilitated.   Tight garters prevenS
 the free use and action  of the muscles of the limbs, obstruct the flow of blood
 in the legs, and thereby interfere with the development and nutrition  of the
 parts, producing numbness and swelling of the limbs, or an incurable enlarge-
 ment and weakness  of them.  Stocks, cravats,  neck-kerchiefs, &c, when
 worn tightly  around the neck,  are decidedly dangerous;  by their  pressure
 they prevent the blood from flowing freely, in its  return  passage from the
 brain to the heart and lungs, and an undue quantity of this fluid  being thus
 forced upon the brain produces a more or less constant sense of over-fulness
 of the vessels of the head, headache, flushed face, vertigo, apoplexy, or other
 fatal  diseases.  When an undue  compression is made about  the chest and
 waist, the perfect development of the lungs is prevented, breathing  is inter-
 fered with, as well  as the normal  action of the  heart, which  effects must
 necessarily be detrimental to health and longevity.   When the abdomen is
 improperly compressed, the stomach, liver,  and intestines have their functions
 impeded,  indigestion is  produced, and, in  females, falling of the womb,  and
 from these arise a host  of painful and distressing symptoms.   The use of
 corsets, at  one time so fashionable a custom among females, is  highly repre-
 hensible.   Beside being of no advantage whatever, it is a cause of permanent
 and serious disease;—spitting of blood, consumption,  dyspepsia, falling of the
 womb, affections of  the  liver, &c,  &c, are a few of  the maladies resulting
 from its use;  and among married  women, miscarriages, sterility, deformed
 children, &c.   No sensible woman will  at this time be guilty of the practice
 of wearing corsets, and it is a subject of gratification  that females are acting
 with more wisdom  and  more  prudence, by totally  discarding this absurd
 article of dress for others more consistent with health,  beauty, and pro-
 longed life.
  Among  the  materials employed in the  manufacture  of  clothing,  the
 principal  are wool  or flannel,  cotton, silk,  and  linen.  Flannel serves to
 protect the body against the too rapid escape of heat, and should be worn
whenever  it is desired to accumulate heat, or to prevent its too rapid  dissi-
pation from the body; and also whenever  the climate is variable, the  chan-
ges being  sudden and frequent.  It is likewise very useful to invalids, espe-
cially those subject  to cough or repeated colds, rheumatism, neuralgia, gout
diarrhea,  nervousness,  and other  forms of disease.   The aged  almost al-
ways find  it of inestimable service to them; and even infants and young
children may wear it with much benefit during the  cold and damp seasons
of the year.  Healthy,  robust  persons do not require flannel,  unless they
arc  exposed to labors which render it necessary to use  means to protect
themselves from sudden changes of temperature or in. severe, cold weather;
it is only  during  the  decline of life, after forty  or  fifty  years,  that they
will, as a general rule, find flannel garments necessary or useful.  In cold
climates, under garments should be worn  steadily during  the  whole of the
cold and variable weather; and if no other part of the  person is protect-
ed, the chest, abdomen,  and back, should always be warmly covered.   It
 is  better not  to wear  flannel  next the surface of the body, but  to have a 
CLOTHING.
105
fignt cotton shirt between it and the body, which will be found more agree-
able and beneficial; at the same time it will obviate the itching or irrita-
tion of the skin to which  some persons are subject when flannel comes in
contact  with the body.  Flannel should always  be removed  previous to
retiring to  bed; it is not proper nor conducive to health, to wear it during
the sleeping  hours, beside,  it renders one more liable to the influence of
cold after arising from the bed and going out into  the air.  Flannel cloth-
ing should be  frequently changed, as  it very soon  becomes filled with the
foul impurities  emanating from the body.
   "Our summer evenings are often very chilly, and many a serious cold is
caught from too light clothing,  after a very hot day; but if we have  flan-
nel next the skin we  are in  a great measure preserved from sudden falls of
temperature.   The advantage of wearing flannel, even in hot climates, has
been settled  by the combined experience of the most intelligent observers
in both army and navy.  The wearing of flannel shirts and  drawers, and
keeping the lower decks of a ship very dry, have  been  the means of pre-
serving the health of  the  crew of one ship, in a climate where  others,  neg-
lecting  these precautions, have suffered much from sickness."   Beale.
   Clothing manufactured from cotton, forms a salutary and  comfortable ar-
ticle of dress during  warm  weather,  and, as a general rule, is superior to
any other; indeed, as a garment to be  worn  next the body, it may be  used
throughout the year in preference to flannel, silk,  or linen, the exceptions
in favor of the former having already been named above.  Cotton garments
preserve an equal temperature of the  surface of the  body, and protect it
from sudden changes  in the weather, though in cold weather it is not equal
to flannel for these purposes.  Many persons to whom the wearing of  flan-
nel is very disagreeable,  substitute for it during  cold weather canton or
cotton flannel;  this is a good article, while the nap^remains, for preserving
the warmth of the body, but when  it has become worn off, new material
should  be employed,  as the old has now lost its  principal character, viz.,
that of  being a bad conductor of heat.   Some individuals find  warmth  and
comfort, both during the summer and winter seasons, in cotton garments
alone, merely increasing their quantity or thickness in the colder months;
but  persons of delicate habit, or disposed to colds or other disease, should
be careful  how they imitate such measures.
   Silk, in some respects resembles cotton,  by retaining, and even exciting
the warmth of  the body.  It is in no respect superior to cotton, and is not
in very common use on account of its  high  price.
   Linen,  is by no means suitable for  a  dress, to  be worn in  contact with
the body,  at any time.  To retain warmth and protect the  surface  from
sudden  vicissitudes of temperature, the covering of the  body should  be a
bad  conductor of heat.  Linen  is a good conductor of heat,  and conse-
quently cannot maintain  an equilibrium at the surface,  nor shield it  from
the direct  effects of sudden changes.  It should never be worn  next the
body.   When  linen becomes moistened with  the  perspiration emanating 
106
AMERICAN FAMILY PHYSICIAN.
from the body, it imparts  an unpleasant  sense of chilliness as the  body
cools, to the parts with which it comes in proximity, while with cotton ma-
terial no such unpleasant effect is produced.
  Attention should always be paid to the apparel worn upon the head.   Caps,
or any kind of artificial covering, are not only unnecessary, but  frequently
injurious; by  irritating the  scalp and  keeping it continually at too high a
temperature, various diseases are produced, as sores,  eruptions,  and  other
difficulties about the scalp, forehead and  ears.   The cooler the head is kept,
not amounting to a painful sense of cold, and  the more it is exposed to the
action of the atmosphere, the less danger will there be  of these various affec-
tions   For the same reason, it is a very objectionable practice to wear night-
caps.   During the first weeks of infancy, when the hair of the child is not
profuse, (and in  cases of premature  baldness,) caps may probably be of ben-
efit in  cold weather, but not at other times : — protection from  too great a
degree of cold is always proper among all persons, but care should  be  taken
not to cultivate  a tenderness or susceptibility  to ordinary temperatures,  or
slight changes.
   The  out-of-door covering  to the head, as the cap, hat, or bonnet, should
be light, of sufficient amplitude, and suited to the particular form of the head.
If too weighty or warm, or if it fits too tightly, the covering will  cause pain
and discomfort.   Baldness is  occasioned much more frequently than is  imag-
ined,  by the constant use  of a warm hat or cap; the hair-glands becoming
debilitated in consequence of the high temperature incessantly maintained,
and the head being kept continually steamed with  its  own excretory fluids.
Whatever covering is worn upon the head, should not only possess the requi-
sites  referred  to  above,  but  it  should be  so  arranged  that by means  of
several apertures, the scalp may  be kept in constant contact with atmospheric
air, while at the  same time its  filthy excretions, instead  of  being  pent  up
within  the  hat, may pass  off,  leaving the head free from their  deleterious
influences.  Any hatter who  can devise a neat, light, and  tasty hat,  with this
improvement,  (several apertures instead of one,) will confer an immense bene-
fit  upon mankind.  As heat is attracted and retained by all dark-colored
substances, while the reverse happens with  those which are  white,  a  light-
colored hat or bonnet  is the best  cover for the head  during warm weather,
and a dark-colored for  cold  seasons.  The face and eyes should always be
well protected from the sun by means of a broad brim to the hat;  the present
fashion among  females, of using a mere apology for a bonnet, and  wearing
it almost between  the shoulders, giving to the eyes  no protection  whatever
during an  out-door promenade, is highly  favorable to diseases  of these
organs, as, weakness of sight, inflammation of the eyes, &c.
   The hat is frequently used as a general receptaculum for newspapers, bills,
papers, gloves, handkerchiefs, and indeed any thing that can conveniently be
placed within it, and the usual  result of such  a careless and imprudent meas-
ure, is premature baldness.   In some sections of country the hat is never
removed from the head even  on entering a room, but is worn in doors  and
 out of doors as  tenaciously as  though it were a part  of  the head, and  the 
EXERCISE.
107
removal of it would prove a serious  matter;  this is not only contrary to the
rules of etiquette, but also to the laws of health—the head should be ex-
posed to  atmospheric influence as  often as the opportunity for so doing is
presented.
                         CHAPTEli   IX.

 Exercise. — Rules for Exercise.— Sailing.— Walking.— Running.—
   Dancing.—Swimming.—Friction.—Shampooing.—Gymnastics.

  Exercise is indispensable to good health for both men and women;  it stim-
ulates  the circulation, and promotes the processes of digestion, nutrition, ab-
sorption, secretion, &c, by  arousing the several  organs of the body, and
causing them to perform their functions with a healthy activity.  A  life  of
indolence or inactivity is always  attended with a sluggishness, or torpid  con-
dition  of the several organs of the system, proportioned to the want of proper
exercise, and is almost invariably followed,  at a later or earlier period, by
some form of chronic  disease.  Consequently, we find that those persons who
are accustomed to daily exercise, or  labor in the open air, are more robust
and vigorous, and attain a more  advanced age than those who lead sedentary,
inactive lives, or who  are confined for the greater part of the time  within
doors.   There is nothing which  will so  effectually impart power and activity
to the  body, strengthen the appetite, improve the powers of  digestion, and
fully and perfectly develop every organ and part of the body, nor which will
so positively fortify and exhilarate the  mental powers,  as exercise.   This is
owing  to the fact that every organized part of the  system is affected by the
arterial blood, only in proportion to the active employment of  the vital force
of those parts; thus,  the individual, as  the blacksmith who gives daily exer-
cise to the  muscles of the arm and  back, acquires a great increase of these
muscles in size, firmness, and strength, together with a healthy, robust, vigor-
ous constitution; while in the  person  unaccustomed to active exercise, the
muscles are flabby, emaciated and feeble, and the constitution  becomes ener-
vated and invalid.  It is undoubtedly a correct  observation, that, nearly all
forms of disease can be cured by a constant course  of exercise and temper-
ance, without the use  of a particle of medicine.
  To derive the greatest advantage from exercise,  certain  rules  must be
attended to, and the benefits  received will be  proportioned to the degree of
attention bestowed upon them.  Among these rules  the following  are  the
most important: —
  1.   Exercise  should never be  taken as  a task, but as a recreation;  the
mind must be  agreeably occupied  as well as the body;  all serious  thinking
must be dispensed with for the time, and when possible, the society of one or
more agreeable and intelligent friends should be procured, because, the more
pleasing the mental excitement,  the more beneficial the physical: they mutu- 
108
AMERICAN FAMILY  PHYSICIAN.
ally depend upon each other for health and strength.  Hence, gymnasiums,
riding parties, sailing parties, swimming parties, pic-nics, &c, where  both
sexes congregate for exercise and amusement, and for relief from their daily
routine occupations, are extremely useful.   Amusing plays at parties within
doors, although less  common  than formerly, are, nevertheless, a source  of
health to children as well as adults, and should by all means  be encouraged
by  parents, teachers, and  those who  supervise the public morals; while at
the same time, card-playing, wine-drinking, the eating of rich and indigesti-
ble cake, candies, &c, and late hours should be discountenanced.
  2.  Exercise should never be carried to fatigue; no advantage is derived
from a violent,  fatiguing course  of  exercise,  especially when  irregularly
practiced.  He who would  be benefited by exercise, must commence  with
the gentler kinds and gradually proceed  to the more laborious, according to
the degree of improvement of his physical powers, and he must likewise prac-
tice daily and with  regularity.   A  good appetite after  exercise, or, a ready
rallying from the fatigue occasioned by it, are indications that it has not been
carried to excess.
  3.  Exercise in the open air is always preferable to that within doors; be-
cause the consumption of  the oxygen which is constantly being inhaled into
the lungs, is more rapidly replaced in the former than in the latter case, and
there is, likewise, no  accumulation of confined carbonic acid gas to be even-
tually retaken into the lungs by inspiration.   Hence,  out-of-door parties are
more useful to health than  those  within doors or under cover; though the
latter may be made less objectionable by permitting a free current of air  to
circulate through the rooms occupied for such purpose.  A damp atmos-
phere is less conducive to health than a dry one.
  4. The  clothing  worn while  taking exercise, and indeed at  all times,
should never be tight, so as  to compress  any portion of the body whatever,
but should be rather loose and easy, permitting a free  motion of the mus-
cles and joints of the limbs and body in  every direction.
  5. Exercise should never  be taken upon an empty stomach, nor immedi-
ately after a meal, nor should a meal  be taken immediately after exercise;
a neglect of either of these  precautions  may be followed by serious effects.
The best periods for exercise are in the morning, an hour before breakfast,
having first  eaten one or  two crackers; an  hour,  or an hour  and a half
before dinner, or an hour  after a light supper.
  A meal should never be eaten for at least an hour  after  having taken
active exercise, but if the appetite be keen,  a cracker  may  be taken,  or a
glass of milk,  or other light  article of diet,  which does not  disagree with
the person's stomach.
  Many business men, medical students,  and others of sedentary profes-
sions, entertain the erroneous idea that a long walk or ride immediately be-
fore  and after a meal is beneficial, and-consequently take their meals at a
considerable distance from their places of business.  A great  amount of in-
jury to health  is occasioned by such a course, and much  of the dyspepsia of
the present generation is  owing to  this ill-timed exercise, aided by a hasty
and  imperfect mastication of fond 
EXERCISE.                          109
   6. The exercise taken should vary in its  character, and not be  confined
to any particular part of the body.  All parts should be called into action,
as much as possible, which may be effected by walking, running,  leaping,
lifting, swimming, fencing, boxing, riding on horseback. &c.  And all these
modes of exercise will  be found  advantageous to male and female, for it
must be remembered, that the female  requires as  much fresh air to oxydize
her blood and  invigorate her  lungs—as  much exercise to strengthen her
muscles, and stimulate her digestive powers, as the male.   The more varied
the exercise  the greater will be the  number of  organs acted upon by it
The lungs may be exercised  by shouting, halloing,  singing, laughing, &c.
   7. After  having exercised,  be careful not  to expose the person to a
draught of air, to a decreased  temperature,  nor to any circumstance which
may give rise to cold, or an inflammatory attack.   This rule should be well
attended  to, because it is a very important one, a neglect of  which has
been followed by fatal  results.   It is much  better to add clothing  to the
body, after having taken considerable exercise,  and allow the  system to
become gradually reduced to the  natural  temperature, before removing it,
than to divest one's self of any part of the dress, for  the purpose of feeling
a momentary degree of comfort, by a rapid, but highly dangerous cooling of
the body.  The wearing of a flannel under garment will in a great measure
prevent any injury to the system from a rapid cooling of the surface of the
body.
   Exercise is of two kinds, passive and active.  Passive exercise, although
not of such decided advantage  to the system as  the  active, will, however,
frequently be found useful,  especially in those cases where the  latter  is
contra-indicated, or, where,  from various circumstances it cannot  be prac-
ticed ;  and,  as   there is only a very slight  activity of the  muscular and
mental system in this kind of  exercise, the  active form will, among by far
the greater  number  of persons,  be found  the  more  preferable.  Passive
exercise includes riding, swinging, sailing, and  friction to the surface when
made by another person;  active exercise includes  walking,  running,
dancing, swimming, friction to the surface, and all movements by which the
muscles of the individual are exercised without any  extraneous  assistance.
Some persons recommend sawing or splitting of wood, digging, working in
a garden, &c; these are very appropriate exercises for sedentary individuals
who have not lost their  health, but are extremely improper for invalids, on
account of the  lack of  any diverting mental excitement at the same time.
Invalids  whose  health  and  strength will permit, will find  considerable
advantage from  fencing, boxing, playing ball, hunting, dancing,  &c.
  Riding on horseback  is a very healthy exercise, particularly for  invalids,
but to be  of much benefit,  it must be rendered  agreeable and exciting; the
mere task of riding over the same ground daily, with no new novelties or
diversions to amuse  the mind, which is constantly occupied with  the idea
that the exercise is for health,  and with hopes  or doubts of the result, is
eminently calculated to  do more harm than benefit.   Several routes should
be taken, the scenes of each day should be varied, and, if possible, tho 
 110                AMERICAN  FAMILY PHYSICIAN.

 society of one or more  agreeable companions  should be  procured, that the
 attention of the invalid may be withdrawn from himself and become inter-
 ested in other matters.   The  distance to which horseback  riding must be
 carried, and the gait  of the horse,  as walking, pacing, trotting, or canter-
 ing, will depend entirely upon the strength of the individual, and the state
 of his health.  In most cases, an hour or two  on horseback, every pleasant
 day, will suffice, or, if possible, half an hour or an hour may be passed in
 this species of exercise every day,  when the  weather  is not damp or  too
 cold.  Benefit may be  derived  from this kind  of riding,  in  neatly  all
 unhealthy conditions  of the system.
  Riding in  a gig,  buggy,  or carriage, is of very  little service, except to
 those who are unable to walk, or ride  on horseback, and  in such  riding,
 the more the body is  jolted or exercised the greater will be the  amount of
 benefit derived; this  may be obtained by choosing a rough  road.   Biding
 in vehicles is very apt to occasion a  stiffness of the limbs, and a weakness
 of the muscles of the back or legs, and a benumbed, swollen condition of
 the  feet.   It  is  always an advantage for the invalid himself  to drive,
 because he thereby  exercises and excites the mind as well as the body; and
 if the  conveyance  is a carriage, a free circulation of air should be permit-
 ted,  by keeping the windows or blinds open.  Invalids should not expose
 themselves to  the morning air, until the  sun is an hour or two high; this
 is a very necessary precaution, especially in sickly or malarial situations.
  Sailing will frequently be found a very healthy exercise, depending, how-
 ever, upon the kind.  Thus, rowing a boat is adapted  only to  the more
 healthy and robust, to whom  it imparts strength,  besides  expanding the
 chest, and developing  the  muscles of the  arm; it  is an improper exercise
 for  most invalids, and should never  be pursued to the omission of other
 exercises by even the  healthy,  as it tends to develop only one part of the
 body, while the remainder continues unexpanded, themby producing  an
 ungainly aspect of the person.
  A journey by sea to Europe, or to some distant port in  this country,
will be found of  much service to  nearly all classes of invalids; the motions
of the  vessel, sea-sickness, change of scene and mental action, are all con-
ducive  to health; but all these advantages may be lost, if especial atten-
tion  be not paid  to diet and regularity of the bowels and kidneys.  Wines,
rich  cakes and pastry, high-seasoned  food, variety of dishes  at a meal, and
all species of high   living,  are incompatible with health, aud should ever
be discountenanced.   The  practice of sending persons in the last stages of
consumption  to  the South,  is extremely  improper ; it merely amounts to
saying, "that the physician cannot cure his patient, and not desiring to be
annoyed by bestowing further professional attendance, he recommends this
as a certain mode of getting rid of him."   Nearly all consumptives who are
ordered South, die while there, and, as a general rule, those who  do return
seldom live over a  few  months.   When a person with  a  long-standin°-  or
rapidly debilitating disease of the lungs is advised to go  South  by hix
physicians, he had  better make up his mind to pass  the few remaining days 
EXERCISE.
Ill
 of  his life at home, among relatives and friends who take some interest in
 his welfare, and who will cheerfully administer to his wants, instead of among
 strangers whose only humanity extends to  the contents  of his purse.  A
 well-educated and skilful  physician seldom advises his consumptive patients
 to  a southern residence; or if at all,  it is in the earlier stages, before the
 disease has fully developed itself.
   Sailing in a steamboat, or in a sail boat, is of no value as an exercise; its
 advantage depends entirely upon the change from an  impure city  atmos-
 phere to one of  greater purity, the change of scenery, and the pleasing
 applications of the mind; however, it will be found very beneficial to those
 who are convalescing from exhausting diseases,  as  well  as those who are
 unable to make any active exertion.
    Walking is the  most  natural exercise that an individual can take, as well
 as the most healthful; it calls every limb into operation, invigorates the cir-
 culation, increases pulmonary inspiration,  and at the same time inspires
 and amuses  the mind.  Some  rules are necessary to be  observed even in
 walking, especially by invalids; thus, they should never  walk against a high
 breeze, as the  exercise is too severe and  fatiguing, beside  being  apt to
 affect the lungs; neither should they select  a location for their promenade
 in  which the particles  of dust floating in  the atmosphere are  observable,
 as  these  would prove very injurious to the  lungs and air passages.
   In using this species of exercise  for health,  individuals should  select
 uneven ground, which  is preferable to plain ground,  from the fact that
 ascending and descending hills  afford more exercise  for  the  lungs,  and
 call into action a greater degree of muscular power.   Very weak persons,
 however, should choose plain ground only.   The place selected should be
 dry,  and where pure air  can be inhaled,  avoiding the neighborhood of
 marshes ; a rather elevated situation  is better than low ground.  An  agree-
 able companion to amuse the mind, and one who can "keep step," will be a
 very useful addition.  Beading or serious reflection should  never be indulged
 in while walking for health; the former is injurious to  the eyes, the  latter
 to the mind, and  either will destroy nearly all the beneficial  results that
 would otherwise be realized from the exercise.  During the summer months,
 it is better to walk in the morning and evening,  and not in the middle of
 the day,  unless a cool, shady place can be found, that the person will  not be
 exposed to the excessive heat of the sun.  In the winter, any portion of the
 day may be selected for engaging in this exercise; but at all seasons,  the
 best time for walking is about half an  hour or an hour after a light  break-
 fast.  The walk should be steady, uniform, and at a gait  not calculated to
 fatigue, being somewhat  slower  at the commencement than is afterward
 taken ; and the range of the  walk should be occasionally varied, so as to
 produce  new impressions upon the mind, which will  have a correspond-
 ing sanative  effect upon the body.  Persons in  the  country will find it
frequently beneficial to carry a gun with them while roaming through  the
woods, as the mind will  be happily engaged  in the search for game, or even
firing at a mark. 
112
AMERICAN  FAMILY  PHYSICIAN.
   Literary persons, and  those engaged in sedentary  occupations, who
 cannot take much exercise of this kind abroad, should endeavor to  accus-
 tom themselves to walking in  their rooms, from time to time,  instead of
 sitting constantly at a desk or table; and authors will find it advantageous
 to have a high desk at which  they can stand while  writing, and be allowed
 to walk up  and  down  their rooms  while reflecting or  forming  ideas.
 Although this  is not a  substitute for proper exercise, it is far better than
 no exercise at all.
   Running is only walking at a rapid gait; it is rather a severe and fatigu-
 ing exercise  for adults, unless they have been accustomed to it, or are of
 healthy, robust constitutions.   The  muscles are more rapidly  and more
 powerfully called into action, the lungs are more greatly exercised, and the
 jirculation more actively increased, than in simple walking.   It is a species
 }f exercise which  seems to  have been designed by nature more  especially
 for children, that all  their  various organs may  become  simultaneously
 developed, and it is certainly an exercise which they never fail  to  enjoy
 tvhen  the opportunity offers.   I would  call the attention  of parents and
 teachers to the fact, that exercise, and considerable exercise too, is absolutely
 necessary for the  strengthening and perfecting of both the mental and phys-
 ical organizations  of  children.  Hence, in all schools, at the end of every
 hour,  or  immediately  after  every  lesson,  about five  minutes should  be
 allowed for the  children to "run around the block,"  or in some neighboring
 place; and this course will be found highly advantageous to  them, increas-
 ing the activity of their minds, and  at the same time improving their bodies.
 Indeed, the teachers would find themselves  materially benefited by a little
 physical recreation  at such periods.   There is not enough attention paid to
 the physical training  of children ; many parents seem to think that as they
 pay teachers to cultivate the minds  of their boys and girls, all attempts  to
 improve them in bodily health are  impositions, not bargained for,  which
 consequently' ought not to be paid for.  When  will parents  learn common
 sense on  these points?
  Dancing is a very salutary  exercise when  properly  performed; it com-
bines   action  of  the  various  organs of  the body  with healthful mental
recreation.  Dancing should be performed  in  the  open  air, or in a  large
room well ventilated, and those who practice it should be careful not  to
persist in it too long at a time, nor engage in it too violently, as  either is
detrimental to health.  The dress  of those who dance should always be
sufficiently loose not to confine any  part of their body too  tightly,  allowing
&n uninterrupted circulation of the blood, and a free play of the  muscles.
When  dancing is continued to a late hour of the night, or to  an early hour
in the morning, in crowded,  heated and illy ventilated rooms, it cannot but
prove  deleterious  to  the system;  indeed, any  active exercise, continued
during the hours that the system should be at rest, is unhealthy ; and the
evils to the constitution arising from such unnatural modes  of enjoyment
are  increased tenfold by the use of rich, indigestible cakes, pastry and
confectionaries, alcoholic and  stimulating drinks, and an  exposure to the 
SWIMMING.—FRICTION.
113
Cold night air, when the body is in a state of fatigue and perspiration from
exercise.   Many, very many of the young and gay, have, from these causes,
had the germs of disease implanted in their systems, hastening  them,  in a
remarkably short time, to their graves.
   Dancing at pic-nics, at home,  or even at evening parties, is  to be com-
mended, when the above deleterious measures are not combined with it.
   Swimming is a  useful and agreeable exercise for those who are strong
and healthy.  It should not, however, be carried to fatigue.  In swimming
we not only have the advantages resulting from the constant and  powerfu
exercise  necessary, but likewise  from the bathing.  It is a mistaken  idea
that persons should be perfectly  cool  previous to  entering the water, for
the cold water exerts  a depressing influence upon  the system for the  time
being, and ther.e  is more danger  of contracting cold  or other  unpleasant
results from plunging into it while the body is cool, than when  it is some-
what excited.   Care, however, must be taken that the body be not too warm,
nor in any way fatigued; and those whose systems are debilitated will find
swimming in cold water not  so advantageous as is  popularly supposed.
Indeed, the observations made in relation to  the cold bath, [which see,] are
pertinent to swimming.  Every person, male and female, whose health and
strength will permit,  should be taught the art  of swimming,  not only  on
account of its utility as regards health, but also. that, when  persons  who
have not acquired the  art are in danger of drowning, they may be  enabled
to preserve them.
   Friction of the surface of the body is  a  species of exercise, that whether
performed by the  person himself, or by an assistant, will be found highly
serviceable to all classes, whether healthy or invalid.  It cleanses the  skin
from accidental  impurities,  facilitates the flow of blood in the small blood
vessels of the  skin—invigorates  the brain and nervous  system, assista
muscular  development and power, improves the organs of digestion-^com-
municates an  agreeable glow to  the entire system, and renders  it more
capable of resisting disease, as well as less liable to  attacks of cold or other
maladies arising from exposure to sudden changes of the weather.
   In the treatment of persons laboring under chronic diseases,  friction of
the skin  will be found a very  valuable  measure, especially in  cases  of
consumption, liver affections, dyspepsia,  rheumatism, gout,  all female diffi-
culties, &c; it will also prove highly useful in the case of delicate  individ-
uals,  and in children, promoting the growth and  physical energy of the
latter, and lessening their liability to attacks of  those diseases so  common
to early age.  Persons who are prone to wakefulness, may induce a dispo-
sition to  sleep, by the  use of very light  suppers, and by bathing the body,
previous  to retiring for the night, with  tepid water, and  drying  with brisk
friction.   All persons of sedentary occupations will  derive much benefit
from the use of frictions daily .
  Morning is the most appropriate time  for using friction,  immediately
after rising from the bed, when the  stomach is unoccupied with the diges-
tion  of food ; and where this period  of the day  cannot be spared,  the
       8 
114
AMERICAN FAMILY PHYSICIAN.
 exercise should then be taken previous to going to bed.   Every  individual
 should make use of it at least once daily, for the purpose of comfort, health,
 and strength.  A flesh-brush or coarse towel should be rubbed over all parts
 of the body and limbs, for a half an hour or  more, or until the surface
 assumes a red appearance and is accompanied with  an agreeable glow of
 heat.   If the body is previously sponged with cold or  tepid water, the ben-
 eficial effects will be augmented.   When from debility, corpulency, or other
 valid  cause, an individual cannot apply friction to his own body, he should
 secure the services of another.
   Shampooing, in which the  limbs and body  of a  person are  rubbed and
 kneaded by another,  although  seldom employed,  will  not be found less
 advantageous than friction;  indeed, in many instances of disease, it will be
 found a most important measure to aid in promoting health.  Persons who
 are corpulent, or too  lean, may be changed  to an opposite condition, by an
 attention to diet, and proper course of exercise, aided by shampooing and
 frictions of the skin.
   Gymnastic exercises are very useful, whether employed  by the  invalid, or
 those of robust health.  When properly regulated by a good teacher,  these
 exercises promote the healthful action of all parts of the body, invigorating
 and strengthening the constitution, and tending greatly to the  establish-
 ment of health and longevity.  All persons, and especially those  who lead
 a sedentary life, as clerks, shop-keepers, merchants, authors, engravers, &c,
 &c, will find it very profitable  to health and mind, to devote an  hour or
 two, daily,  to the exercises of the gymnasium, directed by an experienced
 teacher.  Indeed, the mechanic, whose daily labors call into action only a
 certain class  of  muscles,  while the others rest unemployed, will in the
 gymnasium, be enabled to reinstate harmony in the growth and vigor  of all
 parts of fhis body, by giving them a proper and equal degree of exercise.
  When we consider the little attention which is paid to  the laws of health
 and longevity, by the citizens of this country,  in their eagerness to accu-
 mulate wealth at  all risks, we cannot be surprised at the indifference mani-
 fested  by them in relation to  gymnasiums.   It is not because such institu-
 tions are overlooked or underrated, that they lack patronage, but because
 in this locomotive age of business, traveling,  and almost everything else,
 save reason and  common sense  on matters of health,  the great public
 cannot find the time to  attend to such  matters.  Every  city,  every  town,
 every village, should have its gymnasium, open to all classes of society,
 requiring only the payment  of a trifling sum by each citizen to keep the
 place in repairs, and furnish a salary for a good gymnastic teacher; or still
 better, these may be  paid from the  public  monies of such places.   I am
gratified to learn that  in many of our  cities, the sensible young men  have
formed gymnastic clubs, for the purpose of cultivating and improving  their
constitutions, and it is hoped  that in the absence of any public action ©n
this subject, these private associations will increase in numbers.  Still, k
 is always desirable to have a  good teacher, to direct the  exercises, because
 much  harm may arise from  an indiscriminate and improper use of them. 
CALISTHENICS.
115
  Nor arc females to  be  excluded from these institutions,  notwithstanding
the customs and  ridiculous prejudices of society are opposed to both girla
and women participating in those sports and exercises which are essential  to
a healthy development of mind  and body.   Indeed, when  we reflect upon
their  peculiar organization,  their delicacy of structure, and  their  special
functions on the one  hand, and their sedentary habits,  together with the
modes and customs of society, to which, in  a great measure,  they feel obliged
to conform, on the other,  we  cannot but be astonished that  disease is not
more  extensive and fatal  among  them than  we  find it.   Females require
exercise as much  as  males—they have muscles to develop—blood to aerate,
—nerves to invigorate, and brain to strengthen and improve, as well as men
—and if these are neglected, it will matter but little how much man strength-
ens himself—for  his offspring cannot be otherwise than deficient in  physical
and mental conformation.   Where bodily health and proper mental cultiva-
tion exist, with  true affection,  there we find domestic happiness—in such
families there needs no "woman's rights," nor "free love" associations  to
effect reforms.  These agitations are the results of a sickly morality in society
caused by a depraved condition  of the body and mind.   Improve these, cul-
tivate  them properly and thoroughly, and then  men and women will  be vir-
tuous, happy, and free.
   Calisthenics is the name  given to a  series of bodily exercises,  adapted  to
the development of the female system; they are inferior to the true gymnas-
tic training, but are preferable to  no exercise at all.   Females, from their
comparative inaction and confinement within doors,  should exercise in the
open air as much as possible.
  I must again advert to the fact that children at  school do not  have suffi-
cient exercise;  all the money, all the time, all the efforts are devoted to the
cultivation of the mind, while the physical is totally disregarded—this is very
wrong, very unnatural, and the only thing to  be wondered at is,  that the
amount of injury inflicted is  not much greater than  we find it.  Parents,
teachers, philanthropists, everybody,  should  pay especial  attention to this
matter, for it is a very important one, involving not only the  health of our
offspring, but the future destiny of this great republic.  Almost every regu-
lation  in our schools is faulty;—children are forced to sit still,  while nature
intended that they should be in constant motion.  The child of the savage,
following his natural instincts for action becomes a hardy man; the  child of
the civilized man, being compelled to obey the irksome and unnatural laws
of ignorant guardians, dies at an early age, or is made an invalid for life.   I
have attended hundreds of children whose  diseases were  the  results of im-
proper regulations in their  schools.   The  education of  children should  be
made  more a matter of pleasure, than a mere dull, repulsive task, and that it
can always be made so, I am well  convinced.   The safety of a  republic rests
not only in the mental acquirements of its citizens, but in their  physical
health and strength; it is the  right,  it is the duty of a free government  to
make  such laws as will perpetuate its blessings upon posterity without  in-
fringing upon individual rights.  Therefore, such  nations should make it  an 
116
AMERICAN  FAMILY PHYSICIAN.
imperative requirement, that all their children, both male and  female,  must
be physically and mentally educated.   This will not interfere with the rights
of any adult, for I hold that in a religious, social, and moral sense, no indi-
vidual has a right  to prevent the growth and  cultivation of those two great
gifts from Deity,  the body and the mind.  And, again, it-is the right of a
freeman's child to  demand and obtain from his country a thorough cultiva-
tion of these two  great levers of  happiness, virtue,  health, power, and free-
dom, in order that he may enjoy these when he becomes a citizen.  No man
can be said to enjoy freedom, whose mind and  body  are in a state  of sterility.
  Since having written the above,  I  have met with the following excellent
remarks in  the Boston Medical  and Surgical Journal of Oct. 18th, 1855,
from the pen of its editor.  The  article is headed,  "Evil Effects of Studies
out of School," and should be read by  every parent and teacher.   It is as
follows:—
  "The length  of time to  be employed in mental application by young per-
sons at  school,  is a question we are surprised not to see oftener discussed in
medical books and journals, since there are few subjects that have a greater
bearing on the  bodily health, as well as the intellectual advancement of the
young.  On the one hand, the importance of mental cultivation is denied by
no one; the education  of the people is the boast of our country, and is of
incalculable advantage to a republic  in preparing its  citizens for the responsi-
ble duties of self-government, and  in promoting to an indefinite extent  the
means of happiness of the individual.  On the  other hand, we must  take
into account the dangerous effects  of over-stimulation of the intellectual pow-
ers,  and of the  absence of a due  amount  of bodily exercise, at the expense
of the physical organization; and this view of  the subject, we  apprehend,
has  been  too much overlooked by the instructors of youth,  in their desire
to bestow  upon  their pupils the advantages of a highly accomplished educa-
tion.  The vast increase, of late  years, in  the  amount and variety of studies
taught in  our schools, leaves, we fear, too little time  for the proper recreation
necessary  both to  body and mind.   There  are few schools in our  city, where
the higher branches are taught, which do not  impose upon the scholars,  in
addition to at least six hours' mental labor in the school-room, lessons requir-
ing from one to two hours' hard study at home,  which time must, in some
cases, be greatly extended by those  of inferior powers of acquisition, whose
ambition will not  permit them to fall behirM their more  gifted  companions.
In many instances, we  are afraid, this extra  work  is prolonged  into  those
hours when both mind and body should be repairing the losses  of  the day
by sleep.
  "Now, young persons, especially, require both amusement and out-door
exercise, and much more of the  latter than most of  our young friends are
able or disposed to indulge in.  The bow which is always  kept bent, soon
loses its elasticity.  The  youthful  mind,  by too' much application, becomes
either heavy and incapable of healthful exertion, or  else, by over-stimulation,
is rendered visionary, eccentric, and impractical, prone to fanaticism, or even
to insanity.   Sedentary habits predispose  the  system to dyspepsia, phthisis, 
SLEET.
117
and a host of other diseases.   Over-use of the eyes, especially by lamp-lio-ht,
and on closely printed books, (often  in the crabbed characters of the Greek
or German,) when  it does not immediately give rise to acute  inflammation,
often  lays the  foundation of permanent weakness of sight, and constitutes a
source of misery which may last a lifetime.
  " The School Committee of this city have wisely  prohibited the imposition
of lessons out of school hours, in grammar schools.   We hope  they will, ere
long,  see the wisdom of introducing the same reform into the higher schools.
In our opinion, no lessons should, as a general rule, be learned out of school.
Six or seven hours daily, is quite enough time  to  be spent in  application to
books, especially by children who are passing through  that period, in which
the changes taking place in  the system  render it peculiarly susceptible to
evil  influences.   Nor would a diminution  of the  time spent in studying,
prove a real loss in the end; on the contrary, we believe that children would
work  with more interest,  and m;ike more progress  in their  studies,  if they
came  to  their books  with their minds refreshed and bodies invigorated by
exercise.  Children should study hard, but they should also play hard;  and
it is just as much our duty to  induce them to play as to make them  study.
The apparent progress made by incessant mental application in early years,
is too often compensated in after life by ruined  health and disappointed
expectations.  We have in our mind several cases which we could adduce in
support of the position  we have here assumed,  but, for  the present, we
forbear."
                         CHAPTER  X.

Sleep.—Means  to  promote   Sleep.—Beds.—How  long   to  Sleep.—
                         Dreams.—Nightmare.

  Best is as proper, both for mind and body, as exercise, from the fact that
the mental and physical  energies become fatigued and exhausted, after they
have been in action for a certain period; and as a restoration of their powers
cannot be effected while the muscles  or mind are engaged  in any efforts,  pe-
riods of complete muscular and mental repose are absolutely necessary, by
which the exhausted organs may be enabled to recruit their energies.   Over-
action of the powers of the constitution, or, too great an amount of rest, are
equally destructive  to health and life, and it therefore becomes an important
measure to ascertain how the periods of exercise and rest should be regulated
in order to  the attainment of the greatest degree of health and  longevity.
The first has been noticed in the preceding chapter.
  The various influences of the day,  as light, heat, sound, physical  and men-
tal exertions, &c, exhaust  the vitality, or stimulating powers natural to  the
system in  ordinary health; and if these  be continued  beyond a certain  ex- 
118
AMERICAN FAMILY  PHYSICIAN.
tent, without a proper amount of rest, disease will inevitably ensue.  And to
renew the functions of the  mind, recruit the vital  powers, resuscitate the
jaded constitution, and promote the prolongation of life, the rest or sleep
should be uniform, sound, and refreshing.   During a sleep of this character,
the action of the heart is diminished, the circulation is performed more slow-
ly, the respiration is less hurried, and the heat of the surface of  the body is
considerably reduced, rendering the person more liable to the unhealthy in-
fluence  of cold and atmospheric variations, especially when the  body is not
properly protected by covering; all the organic functions of  the system  are
less active than when awake, hence, among other things, the danger of sleep-
ing immediately after a meal, the food of which is not  only imperfectly  di-
gested at such time, but acts as an  irritant, deranging the  action of  the
nerves of the stomach,  and through them, the brain and nervous system.  In
a perfectly healthy sleep, the mind becomes wholly unconscious  of external
objects; all  its various  passions, emotions, thoughts, desires, &c,  are hushed
up, being in a  complete state of.torpor—the person does not even dream—
and the period occupied in this state  of rest, is, as  it were, blotted out of
existence.
  The proper period for sleep, is during the night.   Among  those who live
active and temperate lives, we find a slight acceleration  of the pulse as night
approaches,  and a  sensation of  languor gradually creeps over all the func-
tions  of the body, admonishing each person that the  energies of his system
are fatigued and  exhausted, requiring that  rest and  reparation  which can
only be  found in sleep.   As a general  rule  the earlier hours of the night
afford the most profound and the most refreshing sleep; yet it is frequently
the case, and more especially among invalids, that the  early morning hours
prove more beneficial in this respect.
  That  night is the proper period for sleep, the most conducive to health, is
proved, not only from the  fact of its being selected from a natural demand,
by all nations, whether  civilized or savage, but likewise from the fact that
those who turn night into day,  do it always at the expense of health.  They
who  lie half of the day  in bed, and  keep awake during the night, for  the
purpose of study, exercise, &c, no matter how  regular  their  habits  may be
in other respects, become effeminate and enervated,  gradually  losing that
health and  activity of the vital energies which render life of  value; but
when these hours are passed in riot, gambling, sensuality,  intoxication, or other
excesses, the effects upon the system are still more destructive; persons thus
engaged, in  disobedience to the demands of nature,  soon lose their natural
color, the blooming cheeks are supplanted by a pallid  and unhealthy appear-
ance, the eyes lose their sparkling and animating brilliancy and become per-
manently injured,  not only in consequence  of the unnatural hours, but like-
wise,  of the artificial  light to  which they are exposed.  The constitution
gradually gives way, it becomes  more susceptible of disease,  and in process
of time, the most robust and athletic person is certain to meet with an early
decay of the vital powers.  During the  day, while the whole surface of  the
earth is  refreshed and gladdened by the presence of the sun's rays, a princi- 
SLEEP.                              119
pie is diffused with them, supposed by some to  possess a galvanic or electric
power, which dispenses all noxious emanations, which  greatly adds to the
vitality of the atmosphere, if I may so express it, and which exerts an appre-
ciably favorable influence over all the organs of the animal  economy, exci-
ting in them a healthful activity.  While, on the contrary, during the night,
when the sun's rays are absent, the poisonous matters which had been driven
off through the day gradually steal throughout  the  atmosphere, engendering
serious diseases among all who are exposed to them; the active vitality of the
day is withdrawn with the  disappearance of the sun, and the already ex-
hausted system, feeling its  absence, becomes languid and courts sleep while
surrounding nature is in a state of passiveness.   This is  in strict  accordance
with the  laws of nature, which are ever in harmony with  each other.
   That sun-light is absolutely necessary for the preservation of health, has
been proven by experience.  It  has been found that armies who rest by night
and  march by day, are more healthy, and less  liable to disease, than  those
who  pursue the  opposite  course; that those who, in fashionable life, seek
repose in the day, and action of any  kind in the  night, are almost always
certain to find an early grave; or, if not this, life is rendered a state of tor-
ment to  them from the maladies which their systems have contracted from
such perversion of the natural  laws.  Those who work in mines where the
light of day never enters, are invariably subject to a premature decay of the
vital powers;  all  of which tend to establish the fact, that night is the natural
and  only period  for  sleep.  Very young children,  and  persons  laboring
under disease, are the only individuals who may be benefited by short  pe-
riods of sleep during the day.   Many persons allow themselves to sleep dur-
ing  the day, particularly after the dinner  meal, which is  an exceedingly
pernicious  practice, being  seldom followed by that renewed energy which
results from a similar amount of sleep taken at  night;  on the contrary, those
who  pursue this improper  habit, almost invariably experience disagreeable
sensations upon awakening, as, a bad taste in the mouth, nervous irritability,
derangement of the mind, with an unpleasant  feeling in the head, swollen
eye-lids  and a degree of pain or irritation in  the eyes,  unfitness for proper
mental exercise, &c.  And  this  is  owing  to  the fact  that sleep, being  a
passive condition  of the whole  system, including the  organs  of digestion,
the food  which has been received  in the stomach  remains undigested, irri-
tates  the nerves  of the  stomach, and through them a derangement of the
whole economy is effected,  which frequently occasions serious results.   It is
on this account that sleep  after  a hearty meal  is so apt to induce apoplexy,
in those  predisposed to it.   A short rest, or state of quietude, say an hour or
so, from  active mental or physical exertion, is always proper after a hearty
•meal,—the system undoubtedly demands it,  but it should never be permitted
to go so far  as sleeping; indeed, the disposition to sleep after a meal, is most
generally the result of having  taken too much  food.  Those who in past
times had  their jesters to  amuse themselves with for an hour or two after
dinner, although they may  not have understood the philosophy of the mat-
ter, nevertheless,  pursued a very sanative course, and it would prove profit- 
120
AMERICAN FAMILY  PHYSICIAN,
able, at least as regards health and longevity, were the method still pursued,
especially by the nervous, the dyspeptic, and the apoplectic.  An agreeable
state of the mind favors digestion;  while serious thought, disagreeable news,
anger,  grief, hard study or exercise, sleep, &c, greatly retard it.   Dyspepsia
and apoplexy will be more readily  removed by such a measure, than by all
the drugs in Christendom.
   The next consideration is, the means to  be employed to promote sleep.  All
persons in health will enjoy the proper extent  of sleep, if they avoid every
measure calculated to derange the harmony of action of the system.   Thus,
a proper  amount of exercise through the day  not only contributes to sleep,
but likewise renders it refreshing; and these effects are  greatly increased if
the exercise be  taken in the open air.   If, however, too great an  amount of
exercise be taken, and especially toward  bedtime, it will  generally prevent
sleep.  Students, sedentary persons, and those who are indolent, are gener-
ally more incommoded with the want of sleep, than  they who are active  and
laborious.  Individuals whose occupations afford  but little or no muscular
exertion through the day, and who do not in consequence enjoy the luxury
of sound  sleep, may, in a great measure, overcome the  difficulty, by exer-
cising moderately a short time before going to bed, as, by walking for twenty
or thirty minutes in a large room, hall, or in  the streets,  by gentle dancing,
by the use of  dumb-bells, and particularly  by engaging in some pleasant
sport.
   When sleep is generally unsound, a favorable effect will result from the
application of  friction to the body or limbs,  continued  for ten or  fifteen
minutes before retiring to bed; a coarse towel, or flesh-brush may  be briskly
used for this purpose.  Frequently, sleep may be obtained among those  who
have lain in a wakeful and restless condition for some time, by removing the
covering to the foot of the bed, so as to air the sheets, the person in the mean
time exercising by walking about the room, or by the employment of friction,
either of which should be continued until the system feels a glow of warmth,
when he may again lie down.
   Sleep is prevented by intense study, close meditation, anxiety of mind, &c;
and it is usually the case  that those who immoderately devote  themselves  to
mental labors, regardless  of the physical system, exhaust their energies,  and
bring on a premature decay of their constitutions.  All  uneasiness of mind,
anxiety, deep thought, &c, should be banished as much  as possible before
retiring to rest for the night;  and those only will have a sound and refreshing
sleep who can thus dissipate or forget  the excitements and annoyances of the
day.
   Sleep will be disturbed and unrefreshing to  those who neglect the condi-
tion of the alimentary organs  at bedtime.   Very few persons enjoy uninter-
rupted sleep who neglect this point.   No food  should be eaten for at  least
two  hours before bedtime, and then the supper should be very light, avoid-
ing strong infusions of  tea or coffee, which  alone will  frequently prevent
sleep,  and which are often  employed for this purpose  by the  votaries of
fashion and night-intemperance in the way of parties, balls, &c, which are
continued not only to late hours at night, but to the early hours of morning. 
SLEEP.
121
   With many persons, sound  and refreshing sleep  can never be  obtained,
except they  lie  with their heads  to  the  north,  and feet  to  the south,
which is supposed to  be due  to  the  influence of terrestrial  magnetism  on
exceedingly sensitive persons.  Delicate and nervous persons in particular,
should ascertain the  position which is the most favorable for them  to adopt
in sleeping, for it will be found that with many it will  be  almost impossible
to sleep with the body lying from west to east.   A physician  in  France has
published  the  opinion  that in  some instances  sleep will  be procured  by
placing the legs of the bedstead on glass blocks,  and thus insulating the bed.
   Persons who are restless and wakeful  during the night, frequently resort to
narcotics for the purpose of forcing themselves  to  sleep;  but this is a very
reprehensible plan in most cases.  An  attention to diet,  exercise,  friction,
bathing, the condition  of the mind, as well as of the bowels, will, in the
majority of instances, overcome the difficulty.  And, when this course  fails,
then, and not till then, should an endeavor be  made to procure  rest by the
use of  medicines.  Opiates should  never  be used for this purpose, unless
prescribed by a physician; hops,  or its pollen, lupidin, the extract of lettuce,
or an infusion  of scullcap, will  be found  sufficient, in most instances, to
induce  the desired repose.    Often  a cold wet  bandage applied for ten or
fifteen minutes to the head will be followed by sleep, particularly  if there  be
much heat in the head; if the body be warm, the forehead cool, and the pulse
slightly accelerated, a few drops of spirits of camphor in a wineglass of water
will be sufficient.  But among by far the greater number of wakeful persons,
exercise  and friction,  as referred to above, will be found the best soporifics.
   The apartment for sleeping should never be on the first or ground-floor,
but always above this, either on the second or third floors.  The room should
be spacious, and, if possible, exposed to the influence of the sun;  and during
the day,  instead of being closed or dwelt in, the  windows should be kept open
as much as the condition of the weather will  allow, for the admission of pure
air, and the dissipation  of the  noxious vapors collected during the night.
The windows, however, should be closed during  damp seasons, and even in
pleasant weather they should never be  kept open during  the night, unless
the person avoids lying in a draught of the night air.  Fires should never be
kept up  during  the  night in a bed-chamber, except in cases  of sickness,
dampness,  and  in malarial  districts; they fill the room with more or less
smoke, dust, and ashes, interfere with sound refreshing sleep, and if persisted
in will eventually relax  and  debilitate  the  system, rendering  it  liable to
attacks  of disease from the slightest causes,  and disposing the person to a
constant series of colds, catarrhs, and the like.
   More  than two persons  should never sleep in one bedroom;  indeed, as
these rooms are usually built, one person will exhale a quantity of carbonic
acid gas from the lungs, and other unpleasant vapors from the body during
a night, that will render the room very disagreeable for a second person to
enter it in the morning before it has been ventilated.
   It is not healthy to sleep in a confined room with  a diseased person,  more
especially when in the same bed; and when  nurses or others pass a night 
122
AMERICAN FAMILY PHYSICIAN.
with a sick person, they should have a current of air through it, in a manner
not to pass over nor expose the patient or themselves to its influence; of course
in very cold or damp seasons,  and in  miasmatic  countries, this would be
improper.
   When an old person sleeps  between  two  young ones, the communication
of animal  heat  increases and supports the vital energies of his system,  by
which his health  may be improved, and his life prolonged.  As far as my
own observations have gone, I am fully convinced that this increase of vigor
and activity is effected at the expense of the health of the young persons thus
exposed; and parents cannot be too careful how they permit their children to
sleep in the same beds with aged or diseased  persons.  The same remarks
apply to young adults.  Old persons should  always be well covered during
their sleeping hours, and in cold weather their feet should be rested upon a
warm stone, or bottles filled with hot water.
   Some attention should be paid to the materials forming the beds on which
we sleep, not only for the benefit of our sleep,  but likewise of our health.
The best material for beds is hair;  the worst, feathers.   Hair mattresses, or
mattresses  of straw, cotton, corn-shucks, moss, &c,  are always  superior to
feather beds, except, perhaps, for the aged during cold weather, who require
the preservation and increase of their heat.  The beds for children laboring
under rickets, scrofula, or debility, may be advantageously made of the leaves
of sweet-fern,  sweet-balsam, frostweed, dogwood, ptelea,  bittersweet,  &c.   A
feather bed causes one to become warmer than  is necessary, produces a ten-
dency to increased perspiration, and a consequent general  debility, together
with a constant state of  irritation;  from  these  causes the  system becomes
relaxed, and more prone to disease.  Feathers readily take up the exhalations
which are disengaged  from our bodies during  the  night,  and thus form  a
kind of bath of  animal vapors  which had been destined to leave the body,
but which may re-enter  it by  means of  absorption.   An old feather bed
should be looked upon as a depot in which all the products of animal exha-
lation are collected together.  While a mattress, which readily admits of the
escape of these vapors, has none of the inconveniences of those materials
which retain them.
   The bedclothes should be clean, changed frequently, and carefully pro-
tected from dampness; they should be aired every day,  whether the bed be
used during the night  or not.   By pursuing this  course,  many colds,
rheumatisms,  consumptions, &c,  may be avoided.   Persons traveling on
steamboats, or lodging at hotels, or in strange rooms, should never retire
without first inspecting the beds offered  to them, to learn  whether they'are
damp;  for  it  is  better to sleep, without  damp bedclothing,  on a  naked
mattress, than to run  the risk  of health and life by neglecting this precau
tion.  Hotels, steamboats, and other public  places, which are noted  for
damp beds, should be  avoided  by travelers,  as much  as houses infected
with the plague.   The covering should be light and cool in warm weather,
and in cold seasons  it should be just enough to keep  the body comfortably
warm.   The head should not be covered at all  The use of a large num- 
SLEEP.
123
 ber of heavy bed-clothes  is a covering, is extremely injurious to  health.
 Curtains are pernicious;  they interfere with the free circulation of air
 retaining the gas exhaled  from the lungs,  and obstructing the flow of the
 oxygen of the atmospheric air to those who lodge in the bed.  A free cir-
 culation of air, without any interference, is highly beneficial to all persons.
   Another point to be regarded, is the length of time which should be passed
 in sleep.  Children may sleep as often and as much as they please, for theirs
 is peculiarly an age of growth  and  development,  requiring  considerable
 activity of mind and  body, the restlessness of each demanding a corres-
 ponding degree  of repose.  Some authors allow from fifteen to  twenty
 hours of sleep  for an  infant, twelve hours for those from the ages of four
 to thirteen,  ten hours  from thirteen to eighteen, and from seven to nine
 sifter the age of eighteen.   As a general rule,  these periods may be safely
 permitted for the duration of sleep per day,  but there will be found many
* exceptions.   Delicate  persons will  almost always require more sleep than
 the robust and vigorous,  and the invalid  more than  the  possessor of good
 health.  Again, men who are ardently pursuing intellectual studies invari-
 ably require more sleep  than those who  are  merely occupied in  physical
 labors; and  they frequently  destroy  health and life by curtailing  their
 hours  of repose, that they may have more time to devote to their studies.
 Exhaustion of the  mind  requires  more time for complete re-invigoration
 than exhaustion of the body.   In the morning, the brain  has become quite
 refreshed and  strengthened after a  night of sound  sleep, and this is the
 best period of the day for study, say from five or six o'clock until noon ;
 after this time,  the balance of the day should be passed in light studies,
 recreation, &c.  Instead of cultivating this habit, most literary and scien-
 tific men  employ  the night hours,  when  the brain  is  exhausted  and
 demands rest,  for the  purposes  of study, and by so doing they  not only
 injure their health, but do not accomplish as  much in the way of  study or
 reflection, as they would  by adopting a different course.  "Early to bed
 and early to rise," with "early  hours of  the  day only for  study," will be
 found highly  advantageous  to  studious   persons especially,  if they  will
 practice accordingly.   The late hours of the day should always be devoted
 to recreation and amusements.
   All  persons in health  should avoid a second nap in the  morning; it is
 by  no  means salutary.  The better plan is to arise as soon as one has awak-
 ened, which  will counteract a disposition to indolence and late  morning
 hours.  On  the  contrary,  many  invalids derive the greatest amount  of
 benefit from a  morning nap, and I am not yet convinced  that early rising
 is so applicable to the invalid as to the healthy;  I consider that the resus-
 citation of the exhausted energies of the system in health, and the removal
 of morbid conditions in the unhealthy, is better effected  by sleep than by
 anything else, and consequently I have found  that my patients afflicted
 with chronic affections, are, as  a general rule, more  benefited by a short
 sleep in the morning, than by pursuing the course more commonly advised,
 of rising very early.   Every person in health should ascertain, by experi- 
124
AMERICAN  FAMILY PHYSICIAN.
 ment, the amount of sleep which  is necessary to render him comfortable
 and vigorous throughout the day, and regulate his sleeping hours in accord-
 ance therewith.   Six or seven hours is sufficient for the many; nine hours
 may be required by the few.   Too little sleep is as injurious  to the system
 as too much.
   The  following  rules  will  be found  serviceable:   Sound,  sweet,  and
 refreshing sleep  can be obtained  by a calmness  of mind,  without excite-
 ment or  anxiety, with  regularity  of the digestive organs, and  moderate
 exercise.  Too many persons sleeping in one room, by breathing a confined
 and vitiated atmosphere, will  surely become  diseased.  All bed-chambers
 should be thoroughly ventilated  and kept dry.  All beds and bed-clothing
 should be aired daily, and no dampness on them be  permitted to remain.
 A sleep or doze  immediately before  retiring to  bed,  will be very apt to
 interfere with a subsequent sound sleep.  Never read in bed; it is  injurious
 to the eyes,  straining them severely, and interfering with sleep, and if per-
 sisted in, it will destroy the health.   Fat people should never sleep during
 the day, and as little as possible during the night,  not to  exceed seven
 hours.   The early hours of night  are in all cases, the  best for resting;
 late night hours  are never  otherwise than detrimental to health.  Never
 sleep  on  a  feather bed.  A little  gentle  exercise  will  do  more toward
 removing a sensation of weariness in the morning, than a second  sleep.
  Dreams are an  indication of some  derangement of the  equilibrium  of
 the system.  A perfectly healthy man  never dreams  during his  hours of
 sleep, but in proportion as he departs  from  a  healthy  standard, will  his
 sleep be  attended  by dreams.  Thus, if for a few evenings he  should eat
 hearty suppers immediately before retiring, in consequence of the  derange-
 ment thereby caused he will dream, and in proportion  as his dreams are
 pleasant or unpleasant, will he more or less speedily be  relieved  from the
 evil effects of his conduct  upon his  health.  I consider dreaming as a kind
 of somnambulism, the same as that produced by the passes of the  mesmer-
 izer, and which is the result  of  a certain principle influencing the brain
 when in a passive condition;  this principle may be termed the vital princi-
ple, nervaura, or motive power of organized beings.
  Most all persons have troublesome dreams  for  some time previous to a
fever, or other acute disease ;  and in chronic cases  an individual invariably
enjoys himself much better after an agreeable dream, and almost always
feels worse after one  which has been unpleasant.  I conceive the  cause to
be this: the motive  power acts  more powerfully during sleep to restore
harmony to the system; therefore, whenever a person dreams he is in what
 he mesmerizers would  call a complete,  or incomplete  somnambulic crisis,
•f we examine him, we  find the same phenomena  exhibited as in  mesmer-
ized somnambulists, the hands and  feet  cold, and the head hot.   Yet he
may  be  sensible to  feeling,  noises, the presence of other persons,  &c,
because  the motive power in action is  derived  from  his own  nature, and
 not from another's; and from the same cause his dreams may be incongru-
ous and imperfect, inasmuch as he is not under the guidance  of an active, 
DREAMS.—NIGHTMARE.
125
well-directed will, but under his  own, which is passive;  hence,  his dreams
will generally partake of a confused mixture of the ideas and  species of
excitement which had been previously acting upon his brain while  in  the
waking state.
  If a person dreaming is in a perfect state of natural somnambulism, and
walks or talks in his sleep,  any  person  may obtain what mesmerizers call
the communication with him, and  thenceforth stop his  sleep-walking and
sleep-talking habits, which is a much better course than to attempt a cure
by means of some sudden shock, a plan which has  frequently resulted to
the disadvantage of the somnambulist.
  Dreams may generally be prevented by a proper attention to the rules
of hygiene, as moderate exercise taken daily, attention to  the condition of
the skin  and of the bowels,  avoiding late and heavy suppers, and in some
cases dispensing with supper altogether, and keeping the  mind free as much
as possible from excessive care, discontent, anxiety or excitement.
  The nightmare is a condition of the  system similar  to  the  preceding,
and most commonly arises from an  imperfect action  of  the digestive organs,
flatulence, and  very frequently from heavy suppers.   It differs from ordi-
nary dreaming, by having in connexion with it a diminished action of the
nervous system  as well as of the circulation of the blood,  producing diffi-
cult breathing,  great  weight  or pressure, or an inability to move,  which
seems  to require powerful efforts to overcome, and which conditions  are
frequently so excessive  as no doubt to  cause sudden deaths, even among
persons apparently in the enjoyment of perfect health.  In many persons,
nightmare  will occur whenever  they sleep lying on  their backs.   Those
who  are  subject to  nightmare  should never  eat  suppers,  should take
more or less exercise daily, should  keep the bowels regular, and  should  not
lie on their backs while sleeping; they should  likewise sleep  with their
heads and shoulders slightly elevated.   When acidity of the stomach and
flatulence cause nightmare,  an alkali with  some  aromatic may be taken at
bedtime; as for instance,  a  wineglassful of  solution of  super-carbonate of
eoda, or of common saleratus, to which twenty or thirty drops of essence of
peppermint may be added.
                        CHAPTER  XI.

 Clt-anliness.—The  Skin.—Cold Bath.—Bathing.—Douche.—Shower
     Bath.—Sea Bathing.— Warm Bath.—Soap.—Disinfectants.

   Cleanliness is a very important measure for the preservation of health;
the sympathetic relations which exist between the skin and the internal
organs, as the  lungs, liver, stomach, kidneys, &c, are much greater than
between  those  of any other organs of the body;  and,  as a  consequence, 
126
AMERICAN FAMILY PHYSICIAN.
whenever  the functions of the skin  are  deranged  or interfered  with,
whether from exposures to  sudden  changes of temperature, OT from an
accumulation of filth, the internal  organs suffer in proportion.   The skin,
besides affording an external covering to the body,  possesses a nervous sys-
tem  which renders it sensible  to  external impressions, which are trans-
mitted from  it  to the brain,  through the agency of the  nerves; it  is
likewise endowed  with  a system of bloodvessels which  play  an  important
part  in the animal  economy.
  Beside these, there is  contained within the skin numerous minute tubes,
ascertained by means  of the  microscope  to be spirally  and irregularly
coiled upon themselves,  each of which is in  close  proximity  with  a capil-
lary  bloodvessel,  and which separates  the  perspiration  from the blood in
the  capillaries.   These  perspiratory organs  discharge  the  perspiration
externally  through a minute  mouth or pore, which  under  ordinary cir-
cumstances passes off in the form of vapor,  being termed " insensible per-
spiration;" but when the system is over-heated by exercise, increased heat,
or mental  excitement, the perspiration is thrown off in such large quantity,
as to  form a watery fluid upon the  surface of the body, which is called
the "sensible  perspiration."   That the reader may form some idea of the
importance of these perspiratory organs, I  will give  an extract from Mr.
E. Wilson on this  subject, who  says:—
  "To arrive at something like an  estimate of the value of the perspiratory
system in  relation  to the rest of the organism, I counted the perspiratory
pores on the  palm of the hand, and found 3,528 in a square inch.  Now
each of these  pores being the aperture of a little tube about a quarter of
an inch long, it follows, that in a square inch of skin  on the palm of the
hand, there exists a length of tube equal to 882 inches, or 73-J  feet.   Surely
suc-h an amount of drainage as  seventy-three feet in every square inch of
skin, assuming this to be the average of the whole body, is something won-
derful ;  and the  thought naturally intrudes  itself, what  if this drainage
were  obstructed,—could we need  a stronger argument  for enforcing the
necessity of attention to the skin?   On the  pulps of  the fingers, where
the ridges of  the sensitive layer of the true  skin are somewhat  finer than
in the palm of the hand, the number  of pores  on a  square  inch a little
exceeded that of the palm; and on the heel, where the  ridges are coarser,
the number of pores on the square inch was 2,268, and  the length of tube
5G7 inches, or 47 feet.   To obtain an  estimate  of the  length of tube of
the perspiratory system  of the whole surface  of the  body, I think that 2800
might be taken as a fair average ofthe number of pores in the square inch,
and  700,  consequently,  of the number of  inches in length.   Now, the
number of square inches of  surface  in a  man  of ordinary height and
bulk is 2,500; the number of pores,  therefore, is 7,000,000, and the num-
ber  of inches of perspiratory  tube,  1,750,080; that  is, 145,833  feet, oi
48,000 yards, or  nearly twenty-eight miles."
   Among the uses  of perspiration, one is that of  reducing or graduating
the heat of our bodies, for it is a well-known fact that aqueous vapor con- 
THE  SKIN.
127
Fig. 8.
h—M
Eains  a large  amount of
latent heat.   In  cold
regions,  these perspira-
tory pores contract more
and more   closely,  and
give  off  but a  small
amount  of  perspiratory
vapor, thus retaining a
sufficient heat within  the
body to enable it to  en-
dure  the cold; while in
hot  climates,  they  are
more and more opened,
and discharge not only
an  invisible vapor,  but
a  watery   fluid,  which
regulates the tempera-
ture of the  body, so that
it may endure the  de-
gree of heat common to
its residing  place.
                           Skin magnified twenty diameters,  g. sweat glands ; h. sweat
  Hy  this   System  Of  canals ; i. sweat pores ; f. masses of fat.
glands, man  h enabled  to adapt himself to all  climates, from the frigid
to the torrid zone.  Yet a hot, moist air is more fatal to animal life than a
hot, dry one, because when the atmosphere is already loaded with moisture,
the evaporation of the insensible perspiration is prevented.   Consequently,
we find that in  places where such  weather  prevails, as in the  South,  the
inhabitants  experience  feelings  of languor  and  oppression during damp
seasons, and there is  more sickness among them than  in places where the
air, although hot,  is dry,  permitting a free evaporation from the body, and
the rapid dissipation  of the poisonous vapors exhaled.  Again,  the intense
heat of the  body in  acute fevers, is at once diminished  by a free perspi-
ration.
  As long as the proper amount of perspiration is discharged, our persons
experience  feelings of health and  comfort; but  when the action of the
sweat-glands  are  interfered with,  or   the perspiration obstructed in its
passage through the tubes, as by exposure to sudden reduction  of  temper-
ature, a cold, damp wind,  or sitting in a draught while the body is excited
and perspiring freely, &c, we feel a corresponding degree of discomfort, a
gradual derangement of  the  functions of all  the internal  organs, which
sensations continue  to  increase  if we  do not at once  remove the  con-
stricted, or congested condition of the perspiratory vessels, and thus relieve
the suffering organs.
  Besides these organs, the skin is also provided with  sebaceous or oil-
glands, which  although resembling the  perspiratory glands in their organi-
zation, are more complex, and are not so  uniformly disseminated over the 
128
AMERICAN FAMILY  PHYSICIAN.
Fig. 9.
 surface, being found over the nose, certain parts of the face, ear, &c, and
 wherever hair is present, while on the palms of the hands and soles of the
 feet they are absent.   These glands secrete an oily matter which protects
 the skin from the influence of fluids with which it is apt to be bathed, also
 from an  undue  action of the sun and atmospheric  changes,  keeping the
 hair and its roots  in a  soft and  pliable condition.  But  when  from  any
 cause the functions of the skin  are sluggishly performed,  the fatty matter
 instead of being  discharged  upon the skin,  is  retained  in the oil-duct,
 where it concretes into a matter  of the consistence of cheese; the oil-tube
 becomes gradually enlarged by the fresh deposition of oil globules, and at
 its mouth will be eventually observed a black  point, which  those  on whom
 it forms  are  in the habit of squeezing out,  supposing the mass of fatty
 matter, forced out, to be  a worm.   Although not a worm, the microscope has
 discovered to us that it contains animalcules, of elongated form, about the
 fortieth of an inch to the one hundred and thirtieth in length, having an
 obtuse head, which is  directed inward.   They are met with in  groups of
 from two to twenty, increasing  with  the  inactive state of  the skin,  and
 diminishing as it arrives at a normal activity.
   Perspiration  is gener-
 ally   mixed   with  the
 above  named  oily,  and
 other  matters;   it  has
 an acid smell and reac-
 tion,  which is  owing to
 the presence of  lactic or
 acetic acid, and contains
 about from one-half to
 one and a half  per cent.
 of solid matter, consist-
 ing principally of ani-
 mal  matter with  some
 saline  substances  dis-
 charged from the serum
or watery portion of the
blood.  When these per-
spiratory   matters   are
 permitted to remain  in
contact  with  the  skin
for a  length   of  time,
they rapidly decompose,
lessen the activity of the
skin,  frequently causing
 skin  diseases,  and contaminate the surrounding  atmosphere, which when
 confined,  will occasion fevers and other  maladies, often  of a dangerous
 character; and, undoubtedly, many lingering disorders are thus occasioned,
 especially of the lungs and kidneys.   The greater the  obstruction to the
  Steatozoon Folliculorum,
side.
seen upon its abdomen, back and 
-CLEANLINESS.
129
exhalent action of the  skin,  the greater  the  liability to serious  disease,
and  when it is  checked,  the  blood becomes imperfectly aerated,  the tem-
perature of  the body is rapidly reduced, and death soon ensues.
   From the above statements will be seen the vast importance of  keeping
the skin clean and healthy, in order that it may properly perform its func-
tions.   A person with a clean, healthy skin  preserves a greater amount of
health,  of good feeling, of pleasant disposition,  of proper nervous action,
than when the skin is neglected,—he feels sound all over, while  a filthy
or diseased skin is a source of constant annoyance to its possessor.
   But  while we attend to the condition of the skin, we must not  neglect
other matters of cleanliness which are fully as important  to the preserva-
tion of health.  All species of filth and stagnant water should be removed
from our dwellings,  out-houses, &c.;  they should  not be allowed  to accu-
mulate, otherwise their decomposition may comtaminate the air with nox-
ious effluvia,  and become a source of malignant disease, not only to an
 individual family, but to a whole community.
   Personal cleanliness  requires a frequent changing of dress, and daily
ablutions of the whole body with water.  If the dress be not often ohanged,
 the  effete matters  of the body which it contains, by coming in contact with
 the  skin, will eventually occasion some skin disease.  But to determine the
 blood  to  the surface, to  purify, invigorate, and duly oxygenate the skin,
and thereby add  to  the activity of all the organs of the  system,  there is
 nothing superior  to a rapid washing  of  the  body  and limbs daily with
water,  using a moderately coarse towel in  drying, with brisk-friction ;  and
every person should be trained, at as  early a period as possible,  to accus-
tom himself to a  weekly or semi-weekly cold bath, which will tend to re-
move  skin  diseases,  dispose to health and  longevity, and enable him to
overcome influences, which with persons less fortified might be productive
of serious consequences.   I consider a regular bathing of the whole body
daily,  commencing in childhood, as calling forth  too much  action of the
 skin, the evil consequences of which, though not appreciated in the fore-
 part of life, will be certainly felt as age advances.
   When  daily bathing is resorted to,  sponging  the body is the best mode
of cleansing it.  The sponge selected for this purpose  should be rather
coarse, slightly flat, having its corners rounded,  and should be sufficiently
large to hold about a pint and a half  or two pints of water.  It should be
 thoroughly, but quickly passed over the body and  limbs, immediately after
 which,  the surface must  be dried with a  coarse  towel, applying  it with a
 moderate degree of friction—too  much or too severe friction is improper.
 The coarseness and  roughness of the towel, as well as the degree of fric-
 tion, must be proportioned to the sensitiveness of the skin ; for it will be
found that some persons can endure a coarser towel and more friction than
 others.  After  having  produced  a  pleasurable glow by the friction, then
complete the dryness of the body by  gently passing over it another towel
of soft, lax  texture, possessing strong powers of absorption.  Many  per-
sons contract  severe and sometimes fatal colds, by not being aware  that
        9 
130
AMERICAN  FAMILY  PHYSICIAN.
when the surface of the body is wet and exposed to the air, the evaporation
which takes place causes a chilling sensation, together with a derangement
of the functions of the sweat-glands; on  this account the body should be
dried as speedily as possible.
  The drying having been  thoroughly effected, and the individual having
covered his body, or dressed himself, so as to prevent the influence of the
atmosphere upon the surface until  reaction comes on,  he should  dry the
sponge as much as possible, by squeezing out  the water, which will prevent
it from rotting, and  then place it in a  situation where any water  retained
in it may ooze out,  as, for instance, hanging it on a nail, or resting it on a
frame made of three or four small brass rods, soldered to a strip of tin at
each of their extremities, which may be laid across  the ordinary  washing
basin.  The whole time consumed in this bathing and drying  should not
exceed fifteen minutes ; some readily accomplish it in  half that time.  In
order to prevent the floor or carpet from becoming  wet, the  individual
should stand in a sufficiently large  tin  pan, having its margin raised  two
or three inches; or,  a large india-rubber cloth  may be  spread upon the
floor, and a piece of old carpet placed over this for  the person  to stand
upon.
  The temperature of the water used is a matter of considerable importance
for all persons cannot equally bear the same degree of cold; and that tem-
perature which would prove quite pleasant to one, would chill and depress
the system  of another.  The cold bath,  in whatever manner it may be em-
ployed,  is  a powerful sedative; its  depressing  influences being  propor-
tioned to the strength, debility, or weariness of the person submitted to its
action.  The beneficial results produced by its use,  depend upon  the re-
active powers of the system, after the influence of the depressing shock
imparted to it has passed off.  Hence, much care must be had in the appli-
cation of cold water  to the surface, that its temperature be not so  great as
to prevent the subsequent healthy reaction and agreeable glow.   No doubt,
many persons have injured themselves by cold bathing, from a popular but
very erroneous view, that it  possesses direct tonic and invigorating powers;
and  many young children,  invalids, and weakly persons, have  been made
to suffer severely from an application of this mistaken idea.  The temper-
ature of the water used in bathing should never be so depressing in its re-
sults, but that reaction may speedily take place.  And when this  point is
rigidly adhered to, a bath adapted  to the condition of the system, taken
once or twice a week, will be found serviceable in breaking up the tendency
to disease in invalids suffering with obstinate laryngeal or bronchial affec-
tions of the throat, dyspeptic symptoms, rheumatism, chronic inflammatory
conditions*of various parts,  &c.
  Another popular but erroneous opinion is, that the cold  bath should no
be taken while  the  system is somewhat excited or heated.  But the truth
is, that the most favorable time for taking a cold  bath is immediately after
gentle exercise, when the body, without being fatigued or exhausted,  is in
a moderate  state of  excitement  or increased  warmth; and all the evils 
SHOWER BATH.
131
resulting from cold bathing while the body is in a heated condition from
exercise, have been  owing to  the fact, that with the increased heat there
has been an accompanying exhaustion and weakness of the system, or a
too copious perspiration.
  Bathing by immersing the whole body in water is a very excellent plan,
but certain rules are necessary to be observed  in order to prevent any mis-
chievous effects.  1st.  The water should  be of  a temperature adapted to
the resisting power of the person; should a chilly sensation be experienced
a few minutes after immersion, the water is too cold,—the proper temper-
ature will  occasion  a  refreshing sensation,  with a  slight glow of heat.
2nd. Moderate exercise should be taken shortly previous to plunging in
the water, but not sufficient to fatigue  or cause copious perspiration.  3d.
The clothing should not be removed from the body,  until the  person is
ready to immerse himself;  to do  otherwise, might cool the body  too much
before the  bath is  taken.   4th.  The bather  should remain  in the water
until the bathing is finished; it is exceedingly improper to leave  the water
occasionally and again plunge in, as a chill followed by serious consequen-
ces may be the result.  5th.  The  person should not remain  too long in
the water, or the reaction of the  system will be prevented.   As a general
rule, five minutes is a sufficient length of time to be in the water,  and after
emerging from it, a coarse towel should be briskly applied to the whole
body, as remarked heretofore.  6th. The body  should be well-dried and
rubbed  after the bathing, and  then the clothing should be  immediately
put on,  lest the surface experience a chill.  7th. Should reaction be slow
in manifesting itself, a short walk may be taken, or a cup of warm tea or
coffee, or even a glass of wine.   Bathing by immersion is frequently prac-
ticed  by the healthy and robust for pleasure, for which almost  any time
of day may be selected,  except immediately after a hearty meal,  or while
the digestive organs are actively employed in disposing of the contents of
the stomach.
  Cold  bathing, in  consequence of its  sedative influence, by which the ac-
tion of  the  heart and  arteries is reduced,  is very useful in all diseases
attended with increased heat of the surface and accelerated circulation, as
in all those fevers in which the surface is hot and dry,  in various inflam-
matory  affections, in active hemorrhages,  sprains,  bruises, &c.
  When cold  or warm water is poured in a stream  upon any  part of the
body, it is called a douche,  and is frequently  employed  with advantage in
affections of the head, apoplexy, chronic difficulties of the joints and chron-
ic external  inflammations.,  When  the stream of water is introduced into
the vagina  or rectum,  it often proves decidedly beneficial in chronic dis-
eases of the uterus, leucorrhea, constipation, piles, &c.  Pregnant females,
however, should be careful not to use cold vaginal douches, as they are apt
to occasion  abortions.
  The shower bath is another form by which  cold or warm water may be
applied  to the body; the water rapidly descends upon the person in small
streams, and completely drenches him, imparting a powerful shock to the 
132
AMERICAN  FAMILY PHYSICIAN.
system.  The effects produced by a cold shower bath upon many persons of
strong constitution, as well as upon the delicate and those of extreme ner-
vous sensibility, are so severe and disagreeable, that its application under
ordinary circumstances would be very  improper.   I believe that the sud-
den application of cold water to the system, continued  daily, or frequently
repeated, is very seldom  beneficial, and  is more frequently a cause of dig-
ease than is supposed.  It is  very apt to  occasion a subsequent depression,
languor, headache, and in the plethoric, apoplexy.   It  should not be used
when disease of some internal organ exists.   A shower bath should  be so
made that the water will descend rapidly, and  be soon discharged; and im-
mediately after  the drenching, the person should., as in previous instances,
dry himself with friction.  A tepid shower bath is preferable  to any other,
and  as a means of preserving health and comfort,  should be in  common
use, that is, two or three times a week in warm seasons,  and not  so often in
cold.
  Bathing  in sea water, or the  water of salt  rivers, differs from ordinary
cold bathing, only in consequence of the stimulus produced upon the sur-
face of the  body by  the saline  particles of the water;  and  hence,  may be
adopted by many persons whose delicacy of frame would not admit the use
of the cold  bath.  The remarks, heretofore made  in reference  to the cold
bath by immersion,  will  apply to  bathing  in  the sea or in salt water.   It
should not  be attempted except before meals and while  the system is warm;
if the  skin be cool or freely perspiring, or if the  body  be  exhausted by
exercise, staying up late at night, or intemperance, sea bathing, the  same
as ordinary cold bathing, will  prove decidedly injurious.
  Sea  bathing is  frequently  useful in scrofulous affections,  chronic  affec-
tions of the liver, spleen, and  stomach,  many chronic  nervous  disorders,
some kinds of  debility, &c.  It should not be used when the skin is dis-
eased, and is rather dangerous in internal inflammations, in consumptive
persons, and in bleeding  from the lungs.
  The  warm bath,  not to exceed 95° Fahrenheit, is preferable for general
use to either the hot or cold  bath, both for the purpose of personal clean-
liness  and  for invigorating and improving the functions of the  skin.  In-
deed, notwithstanding what  may have been said to the contrary by some
ultra hygienists, there are  numerous individuals with whom warm bathing
is positively beneficial, while cold bathing is injurious.  It is erroneously
supposed by many  that  warm bathing, more  especially where  the person
remains in the  water for  some time, weakens and relaxes the body, dimin-
ishing its energies and tending  to produce disease; but the contrary  is the
case.   Thus we find it to occasion an agreeable,' refreshing sensation,  to ex-
hilarate the spirits,  to increase  the strength, to soften the skin and thereby
render the circulation of blood  in the capillary vessels more free and easy,
and also to more completely remove all  impurities from the surface of the
body.   A warm bath calms the nervous  system, invigorates the stomach,
bowels, and internal organs generally, regulates and equalizes the capillary
circulation, reduces any increased  action of the heart and arteries,  and ia 
SOAP.
133
admirably  adapted to  young  children  and infants,  preventing the skin
from becoming diseased, the digestive apparatus from becoming deranged,
and favoring the  growth and  amplification of their various  organs.  The
Eastern nations employ the warm bath, not only as a means of gratifica-
tion and delightful enjoyment, but also as a certain mode of renovating and
strengthening the system when depressed by any kind of fatiguing exercise.
  The warm bath will  be found more  especially suitable for nervous and
delicate persons, for children, for the aged, for those  laboring  under feeble-
ness of the vital powers, or in  whom the functions of the  skin are somewhat
torpid, as manifested by paleness of the surface and decreased temperature,
with cold feet and hands, and likewise for those who  have been exposed to
cold and wet, or who are fatigued by labor, exercise, or traveling.   It should
be used when the  stomach is not engaged in the digestion of food;  the best
time is about two hours before  dinner, and,  when  immersion is adopted, the
time one should remain in  the  water  must vary according to its influences
upon the system, from fifteen minutes to half an hour, seldom longer than
this.   Some persons suppose that they are more  liable to take cold after a
warm bath, and must therefore  add to their clothing, or use some stimulating
drinks to protect themselves from this liability; cither of these are unneces-
sary,  as it has been satisfactorily ascertained by experience that  such an
idea is an erroneous one.
  As the warm bath lessens the frequency of the pulse, improves respiration.
causing it to be performed with less rapidity and more freedom, tranquilizes
the nervous system, and equalizes the circulation, causing  a determination to
the surface, it has been  found very beneficial, in cases where there is a mor-
bid heat  of the  body; in  eruptive  fevers, where the  eruption does not
readily come  out, or where,  from cold, or otherwise, it has  receded;  in  ca-
tarrh;  rheumatism;  colds;  in skin  diseases; in febrile disturbance from
teething, or deranged bowels; and as a relaxing  agent in cases of suppres-
sion of urine;  spasmodic diseases of the bowels; convulsions of children:
rupture; gravel, &c.
  Although,  as a general rule,  bathing with pure water is  necessary for per-
sonal cleanliness, yet this cannot be effectually realized without an occasional
use of soap.  It was stated in a previous paragraph that an  oily matter was
thrown out by the sebaceous glands of the  skin  upon the  surface,  which
matter,  of course, will not unite with water.  When this  fatty substance is
discharged in large quantities,  the skin presents a soiled and greasy appear-
ance; when it is scanty, or insufficient, the skin is dry, rough and squamous
If it be allowed to remain upon the surface, it  interferes with the functions
of the skin, giving rise to itching, cutaneous diseases, and even to affection*
of the internal  organs, and  also occasions  an  unpleasant odor to  emanate
from the person.   It also causes particles of dust to adhere to the skin, ren-
dering this very unclean in a short time.
  This oily deposit, which is constantly increasing, must  be  removed from
time to time,  for comfort as  well as health;  and  there is  no  common sub
stance in use so well adapted for its removal as soap.  Soap  is a bland com- 
134
AMERICAN FAMILY PHYSICIAN.
pound, which should possess no irritating properties, and  is  made  by the
union of an oil or fat with an excess of caustic alkali; and it is the combina-
tion of this excess with the fatty matter upon the  skin  which  renders soap
so cleansing.   Some persons do not require the use of soap as frequently as
others, depending, however, upon their occupations; whether  these are very
dusty, and whether they give rise to much perspiration.   All persons should
wash the hands and arms daily with soap and water; the face, in all instances
should have soap and water applied to it once a week, and  in cases of hard-
working persons, or those exposed to dust, soot, or other foreign substances
it should be used daily.  Where the person is so exposed that dust, dirt, &c,
rapidly  accumulates upon the face, neck, and arms, as is the case with many
mechanics, these parts should be washed with soap and water,  at  least aa
often as before each meal, and previous to going to bed.   All persons should
apply soap and water to their bodies throughout, as often as twice a week in
the summer season, and once a week in winter.
   There are many  persons who,  although they bathe  frequently in  water,
seldom  or never use soap for the purpose of washing  the body, and  this is
especially the case in some sections of country,  among the farmers,  where
the only soap to be had is a strongly alkaline soffrsoap, prepared for washing
clothes, which would be highly injurious to the  skin if used  daily.   And
the tendency to obstinate skin  diseases, and  malignant fevers, &c,  among
this class of persons, is, in a great measure, owing to their  neglect of soap,
by which the skin becomes sluggish in  its action,  and its functions very
much impaired.  Country people, and especially those who  labor daily, can-
not be too  attentive to  the condition of their skin—they should procure good
soap, and use it frequently.
   Dr. J. Bullar, in speaking of the treatment of chronic diseases of the skin,
says:—" Indeed, to prevent the return of skin diseases  which  have been of
long standing, it is of primary importance that the whole surface of the body
should  be washed daily with soap and water;  for,  as eruptions  are often the
means which nature sets up for relieving a faulty state of the system through
the skin, it is  rational to suppose  that a free  and perspirable  condition of
that extensive surface will assist nature in removing  her  waste matter,  and
thus will prevent the necessity  of this scaly, or papular,  or  vesicular action.
What the older practitioners attempted  by means of issues, may be more
naturally effected by the daily use of soap and water to the whole cutaneous
surface.  In one case,  this practice alone, steadily persevered in for  several
months, and continued as a habit, permanently cured psoriasis palmaria of
more than twenty years' duration.  Washing the  whole surface daily with
soap and water will be found to be a very serviceable recommendation, not
as a mere matter of cleanliness, but as one of the  directions for the sieneral
treatment  of  many chronic diseases,  and  for  the preserving of health in
advancing life.  Its effect is very different to that of merely washing the body
with cold water, or using shower  baths, or bathing followed by dry friction.
It does not give the same shock as cold water alone ; and  it is thus much
more easily borne  by the delicate, who find  that the reaction  after cold 
SOAP.
135
sponging is exhausting.  It more effectually removes  the  waste  epidermis
than flesh-brushes or hair gloves; and  suits those whose delicate skins are
often irritated into eruptions by these rough appliances.  For those who are
very subject to colds, and  are  yet too  delicate to bear  cold sponging, the
addition of soap, by its  stimulating property, acts as  a  tonic to the  skin,
and  thus guards it against the effects of sudden changes of temperature,
beside  aiding in getting rid of the waste and superfluous matters which  often
require the actions which constitute a cold, for their discharge from the  over-
loaded system.  The yellow soap,  from  the resin it contains, is an  excellent
stimulant as well as detergent; and a better still,  in  many  cases, is a soap
containing a small quantity of Barbadoes tar, called Hendrie's petroline soap,
the daily use of which is peculiarly serviceable in keeping up a smooth and
perspirable state of the skin when  it is  naturally dry, and especially in
declining life, when the  loss of muscular power prevents  exercise  carried to
perspiration;  for, as man is organized to earn his  bread by  the  sweat of hia
brow, if he cannot do this, he must use some artificial means to produce the
same state of his perspiring organs, or  he will suffer.   A physician, distin-
guished in his day in  a  neighboring county,  who now, though verging  on
ninety, retains a freshness and vigor of intellect, as well as a sound condition
of health, which enable  him to enjoy his  existence  physically and  socially,
and  to devote a portion of each day to  the  cultivation of science,  informed
me that he attributed much of his health and  activity to  this  daily soaping
of his  skin, which .he had persevered in since he  was a very young  man.
And the elderly, who usually have much spare time at their  disposal, will
find  that the employment of a  portion of it  daily in  this way will repay
them for their pains.   In the  management  of the disorders of the general
health whieh so often attend the cessation of menstruation, this practice  is,
for obvious reasons, to be recommended."
  Common brown or yellow soap,  when properly made, is very useful for
the purposes above named;  but, unfortunately, it is very  frequently so  care-
lessly or improperly prepared,  containing too much alkali, or  rosin, as  to be
entirely unfit for application to  the skin, which it  irritates,  and causes to
become harsh, and covered with pimples.  The best soap  is  the white Wind-
sor, which is a compound of soda and  olive oil, and  next to  this, the  ordi-
siary variegated Castile soap; but care should be had to obtain a pure article,
as these soaps  are  frequently counterfeited  by unprincipled individuals.
The  transparent washballs manufactured in  this country by  Taylor, and also
by Ilauel,  will be found very unirritating, and useful  as an  application to
the skin for purposes of cleanliness.  Highly perfumed soaps should never
be used, for the essential oils  to which the  odor is almost always owing, are
most generally of an irritating character, even when used  in small quantities.
  The skin of many persons is apt to chap, especially in the winter  season;
this may always be prevented by washing it daily, with soap-water, and fine
sea-sand.   These may be  used to the  hands  daily, both in warm and cold
weather; they will not injure the skin,  but  on  the contrary  will render  it
very clean, smooth, soft and velvety, removing all dirt, roughness, and chaps. 
136
AMERICAN FAMILY PHYSICIAN.
When used to the  body, the daily use of fine sand is objectionable; indeed,
I do not think it is at all required, except for those portions of the surface
which are constantly exposed to the atmosphere, more  especially the hands.
Indian meal may be used as a substitute for the sand, but I do not think it is
so effectual, except when the skin  is very tender and sensitive, in which cases
it should be  used  in preference.  The sand soaps and washing powders, so
extensively advertised,  are,  from the pumice-stone, coarse sand, and other
foreign,  rough and  irritating particles contained in them, rather injurious to
to the skin, and should be avoided;  but if the soap contains only fine sea-
sand as  the mechanical agent, it cannot be in  the least objectionable as  a
soap for the hands.  I  have used soap  and fine sand to my hands, almost
daily, for  the last twenty-five years, and have found it rather  advantageous
than otherwise.
  The best cosmetic is proper bathing with soap and clean  water;  yet, not-
withstanding  this, there are  many persons, apparently  having good  sense,
who use various manufactured washes, powders, perfumes, &c,  under a mis-
taken notion, that they will beautify  the  skin.  These  preparations usually
contain  corrosive sublimate, oil of bitter almonds,  sulphur, white lead, bis-
muth, sugar of lead, or other harmful agents, and instead of improving the
skin, they invariably injure it.   If we have an opportunity of examining the
faces of those ladies who use cosmetics, paints,  &c,  immediately after they
have been washed, we will almost  invariably find the skin rough, coarse, and
sallow;  and those who once ruin  their skins by these  agents, are afterwards
compelled  to  employ  them, to hide the deformity  effected  by their use.
" The brilliancy  of the complexion, and the beauty and delicacy of the skin,
can in no way be so well preserved as when frequent ablutions with warm
water are resorted to," with the occasional use of  good white Windsor soap;
this, aided by temperance and regularity in  all things, moderate exercise,
and a calm mind, will have a greater tendency to  beautify the skin than any
thing else.
  I have  remarked in a previous  part of  this chapter, that as a general rule,
bathing of the whole person should be accomplished once  or twice a week.
Yet it must be borne in mind that this depends considerably upon the health,
habits,  and occupation of each  person.   With many, too frequent bathings
will be  found decidedly injurious; if the organs of the skin be over-stimu-
lated, so  that it excretes too much, and this  course be pursued daily, the
body will be gradually weakened,  from the undue loss constantly taking place.
No specific rule, can, therefore, be given in relation  to the frequency of bath-
ing for  purposes of health and cleanliness; this must be determined by com-
mon sense and attending circumstances.   It should not be used  intemper-
  tely by any.  Probably washing the whole body twice a week during warm
weather, and once a week during cold, will, in most cases, be sufficient  for
health,  comfort, and cleanliness, and will he found  preferable  to immersion.
   During sickness, the most rigid attention  to cleanliness  should be ob-
served ; the  surface of the patient, should, when  not contra-indicated, be
bathed  daily with a weak alkaline ley, made warm,  and to which,  some aleo* 
HAIR.
137
hoi or  whiskey may be added, to more readily arouse reaction; the clothes,
as well as the bedclothing should be  frequently changed, every thing offen-
sive must be immediately removed, the room must be kept clean and quiet,
and should be ventilated daily, and in times of epidemics or infectious dis-
eases, the atmosphere  may  be  purified by the following measure:—In a
large dish or plate, place half a pound of chloride of lime, so as to expose as
large a surface as possible to the action of the air, mix this with two gallons
of water, and allow it to stand in one corner of the sick room.  The vapor of
chlorine which is emitted, sometimes excites coughing in those unaccustomed
to breathe it, but this irritation  soon  abates.  The chloride of soda may be
used in a similar manner, as a substitute for the lime.  If one dish cannot be
obtained to hold  this amount, it may be divided  among  several,  and placed
in different parts of  the  room.   If a  piece of coarse calico be placed in the
bottom of the vessel containing either  of these chlorinated solutions, the chlo-
rine gas will be more quickly developed.  Foul, putrid ulcers, and all places
from which unpleasant odors emanate, should be washed or sprinkled with one
or either of these preparations.  Another method is to expose a solution of the
chloride of lime to the action of the air, in a sick room; it speedily removes the
most offensive odors,  and promptly arrests contagion.   The nitrous fumigation
has been used with advantage in seasons of malignant and infectious diseases ;
it is made by placing two ounces  of nitrate of potash, (saltpetre) in a bowl
containing half a pint of hot water; when it is dissolved, gradually pour two
ounces of sulphuric  acid upon it, and the  gas will be at once set free.
  In insane hospitals and other establishments, where the floors are wet and
dirty with the  excretions from patients, there is a constant  exhalation  of
ammoniacal vapor, and neither scrubbing nor scalding, will produce any per-
manent removal  of  it.  In such cases, if a solution  of sulphuric acid, one
fluidounce, added to twenty-four fluidounces of water, be poured over  the
floor, and allowed to remain for twenty-four hours, the volatile ammonia will
be  converted  into  a white film of sulphate of  ammonia, which  may be re-
moved by washing, and will leave the  room sweet.
                        CHAPTER   XII.

         Hair.—Baldness.—Feet.—Nails.—Eyes.—Light, §c.

  In connection  with the subject of cleanliness, a few remarks upon atten-
tions to  the  hair, feet, and  nails, may be  serviceable to the  reader.   The
attentions necessary for sound and clean  teeth and gums, have already been
referred to in Chapter II.
  In the fatty cushion  beneath the true skin, or in the true skin itself, are
small glands, consisting of sacs having eminences or papilla? at their bottoms,
and  which are well  supplied with nerves  and capillary bloodvessels, from 
138
AMERICAN FAMILY PHYSICIAN,
Fig. 10.
which last the hair is formed.   The hair, in its advance toward the surface,
passes through a tube or duct, somewhat similar to the perspiratory and  oil-
gland ducts, and into which one, and sometimes two ducts of the oil-glands
open, for the purpose of  oiling and softening the hair.  With the exception
of the palms of the hands and soles of the  feet, the whole surface of the hu-
man body is covered with hair, in some places being short, fine,  and scanty,
and in others, long, coarse, strong, and of luxuriant growth.
                               Upon examining the hair with the micro-
                            scope, its center is found to  be less dense than
                            its other parts, and to contain  a  number oi
                            cells lying loosely together and forming a kind
                            of pith;  immediately external to this central
                            pith are found fibers, formed by the splitting
                            of cells, and which impart strength  and density
                            to the hair; externally to these is another lay-
                            er of dried and flattened cells, forming  scales
                            or  plates overlaying each  other,  whose free
                            edges are directed toward the end of the hair;
                            so that it resembles somewhat  the twig of a
                            tree, having a central pith, a fibrous or woody
                            formation for strength, and scales or bark as a
                            covering  on the outside.   The color of the
                            hair is  owing entirely to the coloring matter
                            contained in its cells.— W. E. Coale.
                               Beside the perspiratory and sebaceous mat-
                            ters thrown out upon the skin,  there is also a
                            constant scaling off of the walls lining the hair
                            ducts, which accumulates around the hair bulbs,
                            forming what is commonly known by the name
                            of "dandruff," and the absence of which, or ita
                            redundance, is owing to disease, or some un-
                            healthy condition of the ducts.
                               The hair is not a ready conductor of caloric,
                            and that which  grows  upon  the  head, very
                            probably  tends to preserve an equalization of
                            the heat of the brain.   The  eyebrows prevent
                            the perspiration of  the forehead  from flowing
into the eyes, by conducting it to each side of them.  The hair within the
ears  and nostrils, protects these openings from  dust, insects, &c;  that  on
the upper lip, guards the mouth from the perspiration  of the face, and also
aids  in  fitting  very  cold and dusty air for the  lungs;  while the beard and
whiskers, serve to protect the throat from the effects of cold.
  In order to preserve the hair, and promote its growth and beauty, it must
be frequently washed, and the  comb  and brush be regularly and daily ap-
plied.  Some persons  suppose that water is injurious to the hair, but this is
a great mistake,—the finest, and most beautiful  hair  is seen  among those
H.....a
  Hair magnified fifty diameters, a,
hair-shaft; b, root of the hair; c, hair-
bulb; i, papilla of the hair; k, ex-
cretory ducts of the sebaceous glands;
o, end of the inner root sheath. 
BALDNESS.
139
 natives who pass the greater part  of  their lives in  bathing and swimming in
 the ocean.
   At least once in every  week, the head should be well washed with water
 and Castile soap, after which it should be thoroughly  dried  with a towel; it
 should also be brushed daily, not only passing the brush over the hair, but
 on the scalp at its roots, applying  sufficient friction upon the parts to produce
 an agreeable glow.  By this means the hair will improve in softness, luster,
 and firmness, and  there will  be  less liability  to  baldness.   An excellent
 preparation, much used as  a  shampoo  liquid by  hairdressers, is made  by
 dissolving salt of tartar, (pure carbonate of potash,) two  drachms,  in  clear
 rain-water, one pint.  A small portion of this is rubbed upon the head until
 a lather is formed, when the hair  and scalp is thoroughly cleansed  by rub-
 bing, the lather  is then  removed  by pouring on clear water, and the head
 well dried.  After the use  of this  or  any other wash, the scalp should be
 made to undergo a degree  of friction with a hairbrush.
   The custom  of braiding  or twisting the hair very firmly,  so as to prevent
 a free circulation  of the fluids  by  which it is nourished,  tends  very much to
 deprive it of its smooth and  glossy appearance, and favors baldness.  A sim-
 ilar result will follow an inattention to the hair, allowing it to become matted
 or entangled.  The coarse and fine  comb, followed by the brush, should be
 used daily; and care must be taken  that the scalp does not become  abraded
 or injured by forcibly pressing the comb upon it.
   There is a natural tendency  in the hair, to fall off, after it has  attained a
 certain growth, its place being resupplied by new hair;  but this dropping
 off may  be prevented, and the  hair rendered permanent, by cutting or shav-
 ing it at certain intervals.   This is more especially advantageous  to children,
 in whom an abundance of hair is apt to be accompanied with weak eyes, pale
 complexion, headache, scaldhead,  &c.   In them the hair should be cut  short,
 that the head may be protected from too much heat, beside which it renders
 it less liable to impediments  in the circulation of its fluids, and the scalp may
 be more easily kept clean.   When the hair is cut frequently, it is prevented
 from dividing at the ends and becoming forked, which is an evidence of  its
 unhealthiness.
   The baldness of age is owing to  a permanent absorption of the hair-glands,
 and cannot be remedied by any means whatever.  But a debilitated condition
 of the hair-glands may exist at almost any time, occasioning a thinness  or
 deficiency of hair, and ultimate baldness.  This abnormal condition of the
 hair-glands may be produced  by several causes; it is very apt to follow exhaust-
 ing  fevers, or long-continued,  debilitating chronic disease;  violent mental
 emotions, as excessive  fright, have also given rise to it.   Prostration of the
 nervous system by intemperance in eating and drinking,  late  hours, venereal
 excesses, and intense application of the mental powers, are almost certain  to
 be followed by premature  baldness.  One  great cause  of baldness in this
 country is the exalted temperature at which the head is kept by the constant
wearing of the hat;  the increased heat produced  gives rise to  an  augmented
perspiration, which is not allowed to escape from the head by evaporation, but 
140               AMERICAN  FAMILY   PHYSICIAN.
 is retained there by the continued presence of the hat.   This must, of course,
 ultimately impair the energies  of the hair-glands and cause baldness.  The
 use of the hat as a receptacle  for newspapers, handkerchiefs, gloves, books,
 &c, is improper, pernicious,  and ungentlemanly—yet how common  is it for
 individuals to thus transform it into  a kind  of pigeon-hole.  Keep the  head
 cool, is an old and very philosophical  precept, which should be rigidly regarded
 by every one,—yet, strange to say, in some sections of country, the hat once
 placed  upon the head in the morning, is pertinaciously kept there  all  day,
 both in the parlor, bedroom,  sick-room, and kitchen, as though there were
 danger in its removal;  its only periods of dislodgement being during meals,
 and at  bedtime.  Frequently the evil is perpetuated at night by substituting
 the cap for the hat.  If a cap be used  through the  night, it  should  be  a
 coarsely netted one, for the single purpose of keeping the hair smooth,—for it
 is of the utmost importance that the air should have free access to the hair and
 scalp at all times.
   Another cause of premature baldness is the application of cologne, essen-
 tial oils, rancid oils or  ointments, cosmetics, &c, to the hair and scalp.  These
 stimulate  or irritate the hair-bulbs,  deranging their healthy action, and by
 clogging or plastering  the hair, interfere with the escape  of the perspiration
 from the scalp, and keep it more or less in an unhealthyand uncleanly  con-
 dition.  This  state of things is also very much augmented by the entire
 neglect of  washing the hair, which  is always necessary  to its strength and
 beauty.  As a general rule, pomatum of any kind is an improper application
 to the hair ; but when persons are determined  to use it,  I know of no one
 equal to the following:—Take of fresh  beef  marrow, three pounds; good,
 sweet, fresh lard, half a pound; melt these together and strain; while cooling,
 add one pint of a tincture  made by macerating powdered Bed  Peruvian
 Bark one ounce, in good French Brandy one pint, for two weeks, and then
 filtering.  Stir the whole together, and when the mixture is nearly cold, add
 a small  quantity of Oil of Lavender,  or Oil of Bergamot, to impart a perfume
 to it.   This may be applied to  the  head  two or three times a week; but
 whenever it is used, great care should be taken  to wash the head weekly with
 the shampoo liquid above referred to.
  Another very common cause of injury to the hair-glands is, the practice in
families, also at the barbers, and while traveling, of using the combs  and
brushes of others.  Many diseases of the hair and scalp originate from  this
cause, as well as from wearing the hats,  bonnets, or head-dresses of  others;
and frequently a person with  a diseased head, by reclining it  upon the head
or shoulders of another, so that the heads of each come in contact,  has com-
municated the disease.   Syphilitic and other diseases are often  imparted in
this way.  I would as soon  think of  using the  toothbrush, or toothpick of
another, as to use his comb or  brush, and, independent of its pernicious
tendency, it is a very filthy  habit,—one which will never  be practiced by the
true gentleman  or lady. Every person, both young and  old, should use  a
comb and brush which  no one else is  allowed to employ, both for purposes of
health and  cleanliness.   Parents who take an interest in  everything condu- 
HAIR DYEING.
HI
 eive to the welfare of offspring, should see that each child is supplied with its
 own toothbrush, comb, and hairbrush.
   Many nostrums are before the public for the  restoration of the growth of
 the hair, after it has commenced falling out, and many of them are really
 worse than useless.   Persons  should be extremely careful how they employ
 these advertised mixtures, for frequently they facilitate, instead of retard, the
 falling out of the hair.  When the hair has fallen out from fevers, it is very-
 apt to return in a few months afterwards; or, if it do not naturally make its
 appearance, a very slight stimulation of the hair-glands,  by means of friction
 with the hairbrush,  with frequent  washing of the scalp,  will impart  a  new
 energy to them, resulting in a growth of the hair.
   But when the enfeebled state of the hair-gland is of some standing, or does
 not improve  under the  mild stimulus  above  referred  to, the following
 course will frequently  remove the difficulty,  and restore the organs to a
 healthy  condition,  thus insuring  a luxuriant and vigorous growth  of hair.
 First, brush the scalp daily with a stiff hairbrush, five or ten minutes  each
 time, for the purpose of cleansing the hair and removing any dandruff which
 may be present, as well as to give  a healthy  excitement to the  scalp  and
 surrounding parts; the most appropriate time for this is in the morning, when
 the system having been refreshed with sleep, is in its full strength and vigor
 and better prepared  to second our efforts, than when  it  is fatigued by a day
 of mental or physical labor.   After this friction,  apply upon the  scalp  and
 hair, a mixture composed of  Alcohol,  two pints; water  of Ammonia, half a
 pint, Castor Oil, one gill; Oil of Bergamot, enough to perfume.  A part of
 this should be well rubbed on the scalp, for several  minutes each time, with
 the pulpy ends of the fingers,  and particularly on those parts where baldness,
 or eruptive disease exists; its  application  for the first  two or three times
 generally occasions  considerable smarting, but this  soon  disappears.  The
 hair should not be disturbed again through the day, except a loose brushing
 to properly part and arrange it, and  the cooler the head can be  kept,  and
 the more easy the access of air to it, the more beneficial will it be.
   Every week or  two, the head  should be  washed by  the shampoo liquid
 named above,—the general health of the system must also be  attended to,—
 severe studies, late hours, intemperance, excesses of all kinds, hair-dyes, and
 curling the remaining hair with hot irons, must be avoided, as  they are all
 positively injurious to the growth of  the hair.  The hair on its  first appear-
 ance should be kept short, and for this purpose must be cut every two weeks,
 or at least, as often  as once a month, by  which course the hair-glands will
 ultimately  acquire renewed vigor  and health.   A preparation for  the hair
 somewhat similar to  the one just referred to, and which is sold as a nostrum,
 is composed  of powdered Cantharides, half an ounce;  neutral spirits,  two
 pints; strong Aqua Ammonia,  half a pint;  Castor Oil,  two pounds and a
 half; Oil  of Bergamot, two ounces and a half; mix, let them stand for a few
 days, and filter.
   The various preparations for dyeing the hair, are filthy,  troublesome and
destructive to the hair and its glands; they most generally contain nitrate of 
142
AMERICAN FAMILY  PHYSICIAN.
silver  as  the  chief constituent.   Twiggs' hair dye, as it is called, made of
Sugar  of Lead, Lac  Sulphur, and  Bose  Water, is an offensive compound.
frequently fails in producing any desired effect, and when constantly used,
permanently stains and disfigures any silver or gold which the individual h
accustomed to wear or carry about him.  I have known instances where  the
gold watches carried by persons using this abominable mixture, were materially
injured by it.  It acts by the sulphur being first absorbed into the systenr.
and  then excreted by the perspiratory vessels, in the same manner as who
taken internally.
  Attentions to the feet are as important to the general health, as any othei
measure to which reference has  been made.   They should be washed every
day, and in warm weather, if circumstances will permit, twice a day, wiping
and drying them thoroughly, especially between the toes.   The  nails  of  the
toes  require  as  much care as those of the  fingers;  they should never be
allowed to grow  too long, but should be properly clipped with scissors every
three or four weeks, or oftener,  if they require it from rapid  growth.  The
stockings may be made of cotton, or woollen, the former being better suited
for warm  weather, and the latter for cold—though some persons, subject to
cold feet,  require woollen  in all seasons.   They should fit well, being neither
too loose nor too tight, and the seams should not be so large as to make  the
feet feel uncomfortable.   The shoes should be exactly fitted to the shape of
the foot,  so as to allow the motions of the feet during walking to be made
with the utmost ease and freedom,  having them neither too loose, nor  made
so as to press uncomfortably  on  any part  of them.   The heels should  be
made sufficiently broad and not too high for males.   Females will  do better
not to wear heels to their shoes at all; they throw the weight  forward  upon
the toes, are very apt to be a cause  of corns, and impart  to the lady  a very
undignified  and ungraceful  appearance, as may  be seen  among those who
adopt the present fashion  of heels  to their shoes.  It is more  important  for
physical comfort that shoes should fit well, than that a coat or dress should,
and every person  whose circumstances will permit,  should have a pair of
lasts suited to  his own feet, and use only the boots or shoes made upon them.
Calf-skin, or horse-skin is the proper material for the-boots or  shoes of men,
while goat-skin may be worn by women.  Sometimes, individuals are troubled
with tender feet, which become chafed and irritated upon very slight causes;
for such, soft-dressed moose-skin will be found a very excellent material, and
in very  untoward cases,  shoes made  of  plush may be worn with advantage.
In addition to the  character of the stockings and  shoes among those whose
feet are  tender, they will materially add to the health and strength of their
feet,  by bathing them  with cold water, every night just before retiring to bed,
drying them with moderately rapid friction, so as to healthily excite the skin
and arouse the capillary  circulation.   An inattention to these matters is
always attended with  unpleasant consequences.  When shoes or stockings
are tight,  too  loose, or  improperly shaped,  they  not only render walking
uncomfortable and even painful,  but  occasion corns,  bunions,  distorted toes,
growing of the great toe nail into the flesh, &c.   When the feet  blister from 
CARE OF THE FEET.
143
 walking, I know of no better preparation than the following: Take of Bur-
 gundy pitch, two ounces; Beeswax, half an ounce; Olive Oil, a table-spoonful;
 melt together and strain.  This spread upon cotton batting and applied to
 the soles of the feet, affords prompt and permanent relief.
   The  feet of many  persons sweat excessively  and  occasion  disagreeable
 sensations as well as an unpleasant odor, especially if they are inattentive to
 cleanliness.  This may be lessened by daily bathing the feet with soap and
 water, or with water slightly acidulated  with nitric acid,  and drying them
 with considerable friction.  If the perspiration is attended with coldness, it is
 indicative of general weakness, which may be overcome by the use  of tonics
 and other appropriate treatment.
   Between the feet and other parts of the body there  exists a very intimate
 sympathy, in consequence of which, when these members are cold or chilled,
 it is very apt to cause disease of one or more of the internal  organs.  Conse-
 quently it is of great importance that the feet be shielded from cold and damp-
 ness,  which may be  accomplished by  wearing warm stockings adapted to
 the  temperature of the season as well as boots or shoes the soles of which are
 sufficiently thick.  In damp and cold weather, the  soles should always be
 thick, and the upper leather be doubled.  Boots and shoes made thus  are
 invaluable for winter wear.   An  excellent  method,  which is now being
 adopted by all prudent persons, is  to have  the inner sole of shoes  intended
 for wear in cold or unpleasant weather, made of cork and covered with a layer
 of woollen cloth; some have a layer of  India-rubber cemented to  the inner
 surface of  the sole, and  which is useful to protect the feet from wet.   But
 India-rubber over-shoes, although they protect the feet  most thoroughly from
 external dampness, are not proper  articles  for wear.   India-rubber being a
 conductor of heat, does not sufficiently prevent its escape from the sole of the
 shoes,  in consequence of which the  feet are not kept so  well warmed, as when
 thick leather uppers and soles only  are worn; beside, it prevents the escape
 of the perspiration of the feet, thus rendering them cold and wet, from which
 colds, coughs, rheumatism, and  many  other diseases  are  produced.   Thin
 shoes,  not sufficient to protect the feet from  damp, are a fruitful  source  of
 colds,  coughs, consumption,  rheumatism,  neuralgia,  piles, many  painful
 diseases peculiar  to women,  both periodical and otherwise,  sore-throat,
 enlarged tonsils, and many other affections of a serious  character.
   When the feet become casually wet, the shoes and stockings should be at
 once removed, the feet bathed in tepid water, and thoroughly dried by consid-
 erable friction with a coarse towel.  In cold and damp weather, many persons
 frequently contract colds and coughs without being sensible of any improper
 exposure; this is usually owing to damp feet from excessive perspiration.  On
 retiring, the foot dress is removed, and without any attention to the feet, the
 body is wrapped  up in  cold  sheets, the  feet become cold and chilled,  and
 colds, &c, are the result.   If one cannot attend to washing and thoroughly
 drying the feet every night, he should, especially in cold weather, toast them
some time at the fire before getting into bed.   I have cured severe colds in
hundreds of  instances  during cold and damp weather,  by simply having the 
144                 AMERICAN FAMILY PHYSICIAN.
Fig. 11.
soles of the feet toasted for half an hour or an hour at a time, before retiring,
continuing it for several nights in succession, with the application of a warm
iron or two to the feet  during each night.  Indeed, persons whose feet per-
spire freely in the winter, will find it advantageous to toast and  dry the feet
thoroughly every nn:ht.  The application of warm irons to the feet during
i,he night is only useful in cases of coughs, colds, and the like, and also where
the feet are habitually  cold,  as in  persons  advanced  in  years; when used
unnecessarily and constantly it renders the person too  susceptible to external
impressions.
                                         The   nails   are  metamorphosed
                                       parts of the epidermis  or scarfskin,
                                       and  consists of two  layers,  a soft,
                                       mucous,  and  a horny  layer.  The
                                       horny layer, or proper nail, as found
                                       by a microscopic investigation, con-
                                       sists of many layers of  thin, polyg-
                                       onal, flat scales or plates.  The bed
                                       of the nail or the surface from which
                                       it is produced, instead  of  being
                                       papillated like  the   epidermis  or
                                       scarfskin, forms  minute longitudi-
                                       nal folds, which are abundantly fur-
                                       nished with capillary vessels, from
                                       the exterior of which  is produced
                                       the  nail;  between these folds and
                                       firmly attached to them,  are  platea
                                       or scales, which are gradually pushed
                                       forward and  upward, to  coalesce with
                                       the nail proper.  Toward the root of
                                       the nail the part is of  a half-moon
  Transverse section of nail, magnified 250 diam-
eters,  a, layers of the bed of the nail; C, horny
layer; c, ridges of the proper substance of the nail;
e, upper flat cells of the mucous layer of the  nail.
shape, and is paler because of the diminished  quantity of capillary vessels;
and  instead of the folds, merely ridges and furrows are to be seen.  At the
root, the horny layer passes more or less deeply into the fold of the nail, and
at the same time runs, in a thin layer which becomes exceedingly  fine, upon
the upper free part of the nail.  The root itself is hidden between  two folda
of the dermis or true skin.   The nail grows by a continuous addition of new
matter from the fine  folds at its under surface, which  causes its thickness;
while a similar addition of new cells or matter at the edge of the root, causes
it to grow forward.  When  cut, the nails grow continually; but when uncut,
their growth is limited, and they curve forward, covering the entire ends of
the fingers.
   Many  causes may interfere with the formation of the  nail, by disorganiz-
ing the cells which  are formed  on its under  surface,  devitalizing them, as
for instance,  blows,  crushing,  burning,  suppurations, &c,  which  will
result in a partial or complete detachment of the nail from the  true skin.
But if  the  injury  has not irreparably  destroyed the  vitality  of  the 
EYES.
145
producing surface, a new nail will be  reproduced after a time, possessing
the same character as the old one.
  To properly preserve the  nails,  some  attention  is  necessary.  They
should be carefully trimmed, from  time to time, with a sharp knife or
Bcissors, and this is best done after having washed the hands and feet with
soap and water,  which renders the  nails more soft  and pliant, and  less
disposed  to  break.   Frequently, without this precaution, an attempt at cut-
ting the nails, however sharp the instrument used, will cause them to break
unevenly and roughly.  Any accumulations of dirt under their free edges,
should be removed by  a piece of soft wood,  or still better by a nail-brush;
dirty nails are always inexcusable,  they betoken negligence or filthiness,
even among those whose daily work necessarily soils them; except, however,
in cases of stains, which cannot always be  avoided.  Many persons  have
very thin and exceedingly brittle nails, which are constantly  breaking on
slight causes.   Such, should not allow their nails to grow  quite  up to a
level with the tips of their fingers, and should never enter upon any labor
which might break them, without having first placed them for a  short time
in soap and water.
   Besides trimming aiad cleansing the  nails, more especially of the fingers,
the  edge of the  scarf  skin  which grows over  the root, should be pushed
back every six or eight days with some smooth instrument, thus preventing
that condition of it  generally known as "hang nails."   This  skin should
not be cut, as  is sometimes  improperly done by ignorant persons; neither
should the nails ever be scraped, unless for the purpose  of removing super-
ficial stains, roughness, or similar conditions, because,  the  delicate  struc-
ture of the nail, on which its beauty and  excellence  depend, would be
thereby injured.
  Continued pressure upon  the nails is very improper,  especially on those
of the toes ; it pushes the nails against their roots, creating  pain and irri-
tation, and an ultimate thickening and distortion of them,  and which,  if
persevered in, will render these consequences incurable.  Inversion of the
toe-nail,  a very painful and  obstinate difficulty, is apt to  be  produced by a
continued compression of the toes and  nails.
   Biting the  nails is  a certain  cause  for their deformity, as well as of the
finger ends.  Whenever a  child is observed to be forming this habit,  it
should be checked at once, and the readiest way to accomplish  it, is to con-
fine each finger end  in a stall, or oblige it to  constantly wear gloves, until
the habit is  overcome.

  It may not be amiss at this place to make a few remarks in relation to
the management  of  the eyes.  These  delicate and complex organs which
afford us so great an amount of inexpressible enjoyment,  meet with less
attention from  the  majority ef individuals  than  any other organ of the
body, and are so constantly abused, that, it is rather a matter of wonder, we
do not meet with more eye diseases, and blindness, than are  found to exist,
I do not intend to enter into the anatomical  or mechanical construction of
       10 
146
AMERICAN FAMILY PHYSICIAN.
the eye, as  these are well described in many popular works, and school-
books of the  present day, but will merely refer to a few general rules for
the preservation of the sight and the healthy condition of these organs.
   During the day  the counting-rooms, parlors, school-rooms,  work-shops,
or other places where  the eyes  are employed in writing, reading,  sewing,
or in any continued exertion, should  be so well lighted that these organs
may be readily used without the least effort at straining whatever.  Inde-
pendent of any straining effort of the eyes, darkened rooms or those in which
there is a deficiency of  light, are very injurious to them, especially when
engaged in any occupation requiring their constant use.  And yet, notwith-
standing this fact, how common it is to create a species of gloomy darkness
in our  parlors and sitting-rooms,  by  means  of curtains,  or to have our
counting-rooms  and offices in places where very little light enters, except
through sky-lights  and other eye-destroying contrivances.   Beading, writ-
ing, sewing, and other straining employment of  the eyes, by twilight, or at
any time by an imperfect light, will eventually injure them beyond remedy,
if persevered in.
  Too great an  amount of  light,  is  as pernicious as a deficiency; thus,
writing or reading, in the glare of the sunshine; or at night with the blaze
immediately in front of the eyes; brilliancy of colors  at night, as  during
some  theatrical or other amusing representations ; sitting before the  intense
glow  of a coal fire; reflected sunshine from snow, white painted  houses,
white sand, or other light-colored bodies, &c, are all injurious to the sight,
and  should be avoided.   The artificial light employed during the night
should be of sufficient intensity to enable the eyes to be used without any
straining, and it should be so prepared, as to give a white color, resembling
as much as possible that of daylight; and the nearer it  approaches to
this the more salutary will it be for the eyes.  The light of a  solar lamp,
or that produced by burning gas,  approaches  the nearest in color  and
intensity to that of the day, but notwithstanding this, much  injury  may be
produced by an improper use of them.
  In  the majority of occupations,  and more particularly in those of reading,
writing, and sewing, the  light should be placed, either behind the individ-
ual, or at his left side, and should  be  allowed to strike from above down-
ward.  By this course, the glare  of the light reflected from the paper, or
object under examination, is  materially lessened by the eyes being placed
between the direct rays and reflected rays,  and, in consequence, they are
considerably less taxed than when the  full reflected rays of direct light are
allowed to be  thrown upon them.   Engravers,  watchmakers,  and  several
other artizans require the action of direct light;  they may  escape  the
violence of its reflected rays, and diminish the amount of injury to the eyes
by allowing the light to pass  through thin paper of a  greenish or  blueish
tint.   Experiment will determine the tint,  that being employed which  will
give a soft, white light; white tissue paper is not so beneficial to the eyea
as is generally supposed.
  The worst position is that in  which  the  light  strikes directly into  the 
LIGHT.
147
eye.   Women who sew, as well as many students, &c, are in the habit of
using a lamp or candle  which gives out a  deficient  amount of light, to
obviate this, they place the lamp as closely as possible  to the book or work
before them, a large portion of the light ascends into the eye, and ultimately
injures it.  All  persons  should remember that  light,  to be advantageous,
should strike from above downwards, and  never  from below upward.  All
lamps should have their flame considerably above the level of the eyes,  and
those short,  hand lamps, whose flame is below these organs, or even on a
level with them, are the best calculated to destroy vision.   True,  the  evil
 nfluence may be lessened by means of a shade, which would prevent the
light from passing  directly to the eyes, but then  the surrounding room
would be darkened, and in raising the eyes from the object to gaze around
the room, the sudden changes from brilliant  light to darkness, must effect
pernicious results; these, however, may be entirely avoided by having
another less brilliant  light in some other part of the  room.   Many persons
wear a shade over their  eyes, when  engaged in reading, or writing by a
brilliant light, which is certainly better  than to have  the  eyes  exposed
to its dazzling rays.
   The eyes are  frequently taxed  by the glare of the  reflected light from
white paper, especially when this is used continuedly  and for a length of
time.  To  obviate  this  difficulty,  the paper  of  books, and writing  paper,
should have a uniform bluish tint, which will at all times be found superior
to pure white paper.  The Gas Company of this  city  make all their bills
out  on yellow paper, the very worst  color for the  eyes, that  could be
selected.  One of the young men who prepares these bills, has so greatly
injured his sight, that he cannot read nor write readily, especially by arti-
ficial light, without the aid of spectacles; yet, notwithstanding this ruinous
course to the  eyes of their clerks, they still  persist in using yellow  paper
for their bills.  The injury to the eyes from this  cause may be greatly
obviated by wearing  plain, glass spectacles of a grayish-blue tint, of  that
depth which will present the paper to the eyes in its whitest aspect.   But
the remedy is nearly as bad, though  not so immediately, as the disease.
   The best light is daylight, but too much glare, even  from this, should be
avoided and rooms which are so situated as to require a modification of the
intensity  of  the light entering them, should be provided with curtains of
some transparent material, having a green or blue tint, so as not only to
admit a sufficient degree  of light, but likewise to impart that color to it
which i3 the most  grateful to the eye.   Nor is this all, the color  of the
walls of a room is fully as important as the proper character of its curtains.
A white wall is not suited to  all apartments, and instead of seeking a color
or combinations  of colors to please the fancy and injure the eye, we should
rather adopt those tints best calculated to  preserve  vision.   If a  room is
exposed to a constant and bright sunshine, its walls may be colored black,
brown,  gray,  blue,  or  green;  the  same colors, but lighter, may  be used
in rooms  having an eastern or  western  exposure, and  which are occupied
all day long.   If the sunshine  does  not enter these latter rooms, red,  sal- 
148
AMERICAN FAMILY  PHYSICIAN.
mon-color, re'ddish-brown, &c, will be the most appropriate  hues, as well
as for the walls of a room having a northern exposure.— W. E. Coale.
  I have often wondered at the erroneous custom  of  painting  houses in
cities, of a red or white color externally instead  of adopting the  more gen-
eral tints of nature, green or blue.  The glare of reflected sunshine coming
from a white or red painted house, must always be disagreeable and perni-
cious to the  eyes  of passers by, and opposite neighbors.  In the country,
the same objections do not exist, as regards the color of the houses  exter-
nally, because they are at greater distances from each other, and  the reflec-
tion from them is seldom encountered.
  A common cause of weakness of sight, at  the present day, is the custom
of printing works in very small type, which requires considerable straining
of the strongest eyes,  even when in the best kind of light.  Works,  which
when properly printed would make several volumes, are  thus contracted into
one, and though it may be immediately easier in a pecuniary sense, for the
purchaser of such books, yet it ultimately becomes more costly, both to
his sight and his pockets.   This fine printing, now-a-days, is a fashion, and
it is a difficult matter  to overthrow a fashion, however  silly or injurious it
may be, but it is to be hoped, that the time is not  far distant when both
publishers and purchasers, will be more attentive to  their interests in this
respect, individually and  collectively.   Fine  type is  fit,  principally for the
notes on the several pages of a work, and  when these  notes are lengthy,
there should be leads  between each line.
  To preserve the sight to a good  old age,  the following rules  should  be
attended to; viz;—
  Attend to the general health of the system, maintaining as much as pos-
sible the integrity of all the excreting organs, as the skin, lungs, bowels,
kidneys, and liver, also adopting correct rules of diet and hygeine; for the
eyes always  participate, in a greater or less  degree, in any  departure  of the
system from its healthy standard.   Avoid, all the following causes of injury
to the eyes,  as, intoxicating liquors; rich and high-seasoned food; indigest-
ible food; excess in venery; exposure to strong, cold winds, especially tho
north-west,  and  easterly; dusty, smoky, and vapory places; irritating the
eyes by  rubbing them,  or  by wiping them with a cotton handkerchief;
all  brilliant  or dazzling  light,  as facing  a hot fire,  a lamp, candle,  or
other intense light, likewise the reflected light of the sun from white, red,
or any brilliant and reflecting surfaces ; all places of instruction,  or amuse-
ment, where the  lights are placed  so low, or in such a situation as to throw
a glare into the  eyes, requiring an effort to look at the  lecturer or per-
former ;  any attempts at  employing the eyes by deficient light, whether
natural or artificial, and  above all do not strain them to see minute objects
by  such imperfect light; all sudden transitions from darkness to light, and
vice versa; all books  which are printed in fine  type, requiring a straining
of the  eyes to read them any length of time; and lastly, avoid reading, or
sewing,  &c, for any great length of time, by artificial light.
   When the eyes are exposed to a glaring  light, and especially if they bo 
SPECTACLES.
149
 weak, a green or black shade, or some other defence should be worn before
 them, and, in many instances, plain spectacles, of a green  or neutral blue
 tint,  will be required.
   When the eyes begin to fail in vision, so  that an effort  or straining  is
 required  to read or sew, a  continuation  of  their unaided use will prove
 very  injurious to them.   Persons, who have the proper  regard for these
 organs, will, when thus deficient, at once  wear spectacles.   These should
 never be procured  of jewelers, watchmakers,  or simple opticians, because
 such  are generally ignorant of the correct mode of adapting glasses to the
 eye,  and from their want of correct knowledge on this point, thousands  of
 eyes  have been permanently injured.   Always have the glasses selected by a
 well-known oculist or optician; trust none but those who have a reputation
 in this matter, with the management of these  delicate organs.   The feeblest
 powers should be chosen at  first, and should not be increased  until abso-
 lutely required.  The  glasses selected,  should  be such  as will enable
 the wearer to read at the ordinary distance, with ease and distinctness, and
 with  as little  magnifying of the letters as  possible;  and although glasses
 for this purpose are not adapted for seeing  distant objects, yet, at the same
 time  that the above-named requisites, ease and distinctness in reading, are
 found, those among them which will enable the wearer to see the farthest
 off, will  be found  the most suitable.   Or in other words,  select glasses
 which, while they  do not interfere with clear, easy, and distinct  observa-
 tion of letters held at the usual distance from the eyes when reading, with-
 out too greatly magnifying them, will at the same time, render the wearer
 capable of seeing objects at a greater distance than glasses of increased
 convexity.  This is  more especially important during the  first  years  of
 wearing spectacles; for, if too convex glasses be used from  the start, the
 eyes become much  more rapidly impaired.
   The best form for spectacles is that known as the pulpit or  barrister's,
 in which  the lower half only of the convex lenses are set in semi-circular
 frames;  so that, while in  reading, one looks through the  glasses, yet when
 he raises his eyes, he may readily discern ordinary and distant objects over
 the upper straight edge of the frame.   The frame of the  spectacles should
 not be too heavy,  nor too  clumsy; the center of each glass should be
 exactly opposite  to  the pupil  of the eye, and the glasses, which may be
 beneficially made of good crown glass, should be sufficiently  large to com-
 mand the field of vision immediately  before  the  wearer.   When made so
 small as to materially lessen this field,  it renders their use painful and inju-
 rious  to the eyes.   In wearing them,  the glasses should be  placed as close
 as possible  to the eyes,  without touching the eye-lashes, otherwise the
 eyelids will become irritated.   Persons advanced in years, although requir-
 ing convex glasses  for sewing and reading,  will frequently  be unable to
 recognize distant objects without the aid of concave lenses;  such may have
 circular eye-pieces  to the spectacle frame,  the lower  half being filled by
convex glasses for reading,  and the  upper half by  concave for distant
 ?ision. 
150                AMERICAN  FAMILY PHYSICIAN.
  Near-sighted,  or myopic eyes require concave glasses, and much care is
necessary that the proper degree of concavity be obtained,  for if they be
either too concave, or too convex,  the eyes  may be  permanently injured.
Occasionally persons are met with, who cannot read at all, without holding
the print almost against their eye-balls, and  such persons find it an impos-
sibility to obtain  glasses which will afford them the least  benefit in this
respect.  Such eyes require a peculiar construction of lenses, and which I
will take this opportunity of stating may be obtained of Messrs.  Spencer
& Eaton, opticians, Canastota, N. Y., for twenty or thirty dollars, the price
depending  on the character  of the abnormal  vision,  and  the  skill and
labor required in the  formation of suitable glasses.   These gentlemen have
been successful in preparing  lenses for a number of persons, who found
the ordinary spectacles worse  than useless.
                      CHAPTER  XIII.

Attentions to the Bowels.—Constipation.—Kidneys.—Passions.—Love.
           Fear.—Anger.—Grief.—Joy.—Occupations, §c.

  Beside an attention to the external condition of the  body, it  is highly
important to health and comfort, that the bowels and kidneys be  kept in a
healthy condition.  These organs are intended by nature for the removal of
those refuse and worn-out particles of matter, which are not only  of no far
ther utility to the system, but which are actually pernicious when  retained.
  No person can continue in the enjoyment of good health, while  the evac-
uations from the bowels are imperfectly  discharged.  As a general rule,
we find that among those persons whose digestive  organs  are  strong and
healthy, the bowels are evacuated once in every  twenty-four hours.  There
may be occasional exceptions, as in the case of some plethoric or corpulent
individuals, who find two evacuations per  day necessary to prevent head-
ache, and other unpleasant symptoms; while on the other hand, cases will
be met with, in whom the bowels  regularly perform their offices once in
every forty-eight  hours, and without any unpleasant  consequences to the
system.  Beyond this period, it is unsafe  for any one to allow the bowels
to remain unmoved.
  A very  common  cause of  disease is constipation of the  bowels,  or cos-
tiveness, and which may be  occasioned  by numerous circumstances which
tend to debilitate the general system, as well  as the organs  subservient to
digestion;  among these circumstances, the following may be named as the
most usual:—improper diet,  as the use of high-seasoned and indigestible
food, much fat or butter, warm bread, hot drinks, spirituous liquors, astrin-
gent wines, &c, sedentary habits, or  a want of proper exercise; indolence,
laziness, irregularity  of habits, late  rising in  the morning, and various 
BOWELS.
151
excesses.  A very common cause of costiveness is  an inattention  to the
natural calls of the bowels, neglecting their evacuations at such times, and
thereby cultivating a condition  of habitual torpor of these organs.   This
neglect is always followed by its consequent  suffering and wretchedness.
Individuals wholly absorbed in business and money-making are very prone
to disregard the calls of nature in this respect; persons who travel consid-
erably, from not having the  opportunities of retiring in a proper  manner,
or who fail to avail themselves of the occasions when they  do offer, speedily
become constipated.  Many  persons  who pass most of their time in com-
pany,  from  a mistaken delicacy,  withstand  or disregard these natural
promptings, and thus induce a permanent torpor of the bowels.
  A constipated condition of the bowels will  give rise to many evils,  thus,
it will eventually cause  a derangement of the digestive functions,  whereby
the blood will become impaired from the formation of an impure and  faulty
chyle.   It interferes with the free circulation of the  blood, frequently occa-
sioning a pressure of this fluid on the brain, which is a very serious matter,
especially for those of plethoric or apoplectic habits.  It effects  a  derange-
ment of the nervous system, giving rise to lowness of spirits, nervous head-
ache, nervous  excitability, spasmodic  affections,  &c.   Flatulence, loss  of
appetite, disturbed sleep,  bad dreams, swelling of  the bowels, headache,
debility, piles, and not unfrequently  convulsions, may all originate from that
condition of the bowels  which is being now considered.   Indeed,  the  suffer-
ings produced by this cause, are too numerous to be detailed in this work.
  Habitual  costiveness  should always be overcome,  either by  proper disci-
pline, or by a correct course of medication; of  these two means,  the former
is by far the better.   No individual should ever resist the inclination to evac-
uate the bowels, whenever there is the least opportunity for attending  to  it.
If we would obviate the mischief occasioned by deferring these evacuations,
we should never hesitate a  moment to comply with the calls of  nature; it is
much better to be accused of a want  of delicacy by the over-fastidious, than
to have the  train  of evils consequent upon neglect.
  The proper discipline to  adopt in this matter, is, in the first place, to avoid
all those circumstances  which are apt to cause  the constipation; abstaining
from high-seasoned,  or other improper food, wines, liquors, &c.   Secondly,
to strengthen the whole system  by habits of regularity and exercise,—dis-
pensing  with the late  hours of  the night for study or amusement, rising
early in the morning, and exercising daily in the open air, either by walking,
running, jumping, dancing, or other active movements,  and also attending
to the condition of the skin.   Daily frictions over the stomach and bowels
will  be found a valuable aid  in our means for  obviating costiveness.  This
may be effected  by  the individual  himself,  but is much  better  when per-
formed by the hands of a  second person,  rubbing and slightly working or
kneading the parts for  ten or twelve minutes each time.   Thirdly, to adopt
that kind of food which does not disagree with the stomach, and which will
act as a gentle laxative.   Instead of consuming large  quantities of animal
food, the diet should be principally vegetable,  care being always taken to 
152
AMERICAN FAMILY PHYSICIAN.
masticate it thoroughly before swallowing.  Among the articles proper to be
used, are, ripe fruit, stewed fruit, which may be sweetened or not to suit the
taste, especially whortleberries, dates, prunes,  dried  apples, dried peaches,
raisins, figs, &c; boiled greens, brown bread, wheat bread with a large pro-
portion of  Indian meal, cornbread, molasses, &c, and for drink,  molasses
and water,, prune water, and other liquids slightly acidulated with vinegar or
lemon juice, buttermilk, and sweet whey.  Of course,  among the articles just
named, those which disagree with the stomach are not to be used-   A tum-
bler  of good eider,, taken every morning before  breakfast, will frequently  be
found beneficial; with some, a small piece  of saleratus or bicarbonate of
soda added to it, will improve its action; while with  others  again it will
prove an improper remedy, on account of its disagreeing with the stomach.
Fourthly, the mind itself may be so cultivated as to eventually aid in induc-
ing  natural habits of regularity of the  bowels.   Locke  recommends as a
means of removing costiveness, "to solicit natureyby going regularly to stool
every morning, whether one has a call or not."  Dr. L. B. Coles, in a valu-
able little work entitled " Philosophy of Health," and which contains much
very excellent matter, says truly on  this subject,— " The  operation of the
mind on the physical system, is always great, especially in chronic complaints.
A person with costive bowels, should have a mental determination to have a
natural evacuation of the  bowels at some regular hour in the morning; just
after breakfast should be preferred.  By a mental calculation—by bearing
the subject in mind—by thinking and desiring—by  electrifying the bowels
into action by the force of thought—by intending to  have them move about
that hour,—very much may be done by way of facilitating  such a result."
   Among the medicinal measures for removing costiveness, daily  injections
are to be preferred, whenever they will answer the purpose.   They  should
consist merely of cold  water, or of cold  infusions  of some  gentle  laxative
agent; occasionally,  tepid injections will agree  best with certain persons, but
a long-continued use of them will relax the parts and produce the  very diffi-
culty which it is intended to obviate.   The proper period for employing an in-
jection, is immediately after rising in  the morning; but in all cases, it should
be aided by the means above recommended, so that the bowels may ultimate-
ly act regularly, without requiring its use.
   In some obstinate  cases of costiveness,  it may become necessary to adminis-
ter purgative medicines, more, however, for the purpose of removing the accu-
mulated feculent matter, than for remedying the torpor of the bowels.  The
great quantity of cathartic pills, powders, and mixtures, which are annually
swallowed by the people of this country, from a desire to regulate the functions
of the bowels, has been productive of immensely more  mischief than is gener-
ally  suspected..  True, the physic  unloads the bowels, but in  so  doing,  ita
action tends to diminish the tone of the intestines, so  that instead  of remov-
ing the costiveness, it aggravates it, leaving the bowels in a more torpid con
dition than before, and thus requiring a more frequent repetition of the dose,
so that eventually, an operation cannot  be obtained  without it.   Beside
which, it not unfrequently occasions piles, strictures  of the rectum, dyspep'
sia, torpor  of the liver, dropsical affections, See. 
KIDNEYS.
153
   Unless the constipation be owing to, or is accompanied with, some chronic
 disease of the liver, stomach, bowels, or other  organ, it is always safer and
 more efficacious to remove it by diet and regimen, than  by means of medi-
 cine.  And where medicine is actually required  in these cases, the course to
 he pursued will be found under the treatment for  Constipation, in that por-
 tion of the work devoted to diseases and  their remedies, which see.
   Sometimes, instead of a costive state of the bowels, they will be evacuated
 too frequently, not  amounting, however, to  a diarrhea.  This is generally
 owing to a relaxed and irritable condition of them, requiring a suitable treat-
 ment, depending upon the cause of the difficulty, and for  which a skilful
 physician  should always be consulted.   However, it may be  proper to re-
 mark,, that even in this  state, the unhealthy  condition  of the bowels may
 frequently be overcome by a rigid attention to diet, regimen,  and the usual
 hygienic measures.

   Begular and sufficient action of the kidneys is as important to health, nay,
 even more so than regularity of  the bowels.   The kidneys remove from the
 blood those  effete matters which, if permitted to remain, would speedily de-
 stroy  life,—uric acid, urea, urates, &c.  It  may likewise contain  various
 other matters,  the result of certain abnormal changes  taking place in the
 system, as phosphates, oxalate of lime, grape sugar, pus, albumen, &c, the
 presence of which, affords the practitioner a true indication of the  peculiar
 character of those changes.  When the functions of the kidneys become im-
 perfectly  performed, or  suspended, the above matters, urea and  urates, are
 retained in the circulation, giving rise to affections of the kidneys, dropsy,
 and many other serious diseases.   A total suspension of the urinary dis-
 charge will occasion death in from  thirty-six  to  forty-eight  hours.  When
 the urine is voided  in small quantities at a  time, or when there is a disposi-
 tion to urinate more frequently than natural, or when the urine is high-col-
 ored, or scalding, these are indications of some  derangement in the system,
 and means should  be employed to stimulate the kidneys, or cause them  to
 excrete an increased quantity, or  proper quality, of urine.  If the derange-
 ment be owing to cold, the means recommended  in the  treatment of Cold,
 should be employed, aided by an infusion of diuretics, as of marsh-mallow
 root, and spearmint.  If the cause of the difficulty be not known, an attempt
 may be made to regulate the action of  the kidneys by an infusion of parsley
 root,  or,  of  queen  of the meadow root,  or, of hair-cap moss, &c,  the use
 of many fruits, as whortleberries, watermelons, grapes, apples, &c, will fre-
 quently restore the organs to a healthy condition.
  Should these simple means fail to effect any relief, the difficulty then as-
 sumes a more serious aspect, as it may be connected with  certain acute  or
 chronic affections of one or more of the  organs of the body.  Under such cir-
 cumstances the difficulty should not be trifled with by delay or self-treatment;
 a physician should at once be consulted,  who, if he be thoroughly versed
in his profession, and a skilful practitioner, will not only make a minute en-
quiry relative tc all  th« various  symptoms of the case, but will subject the 
154
AMERICAN FAMILY PHYSICIAN.
urine itself, to a careful  chemical  and microscopical analysis, that he may,
from its constituents,  understand the character of the  changes taking place
within the system, and thereby be  able to prescribe the proper treatment.
In the present improved state of medical  science, no practitioner can be con-
sidered thoroughly conversant with his profession, who  neglects the aid of,
or does not use a microscope;  true, it is not required in all  diseases, but
there are a vast number in which its  employment can not be safely dispensed
with,  and it will be found useful in all.
  By this, I have no reference to certain individuals who, under  the name
of uroscopists or urine doctors,  pretend to know the character of all diseases
by a mere inspection of the urine; I would rather guard the public against
the impositions practiced  by this class of men, who, however correctly they
may occasionally guess, seldom effect any cures.  It must be recollected that
the,appearance of the urine  is very  uncertain, and cannot be relied upon as
a discriminating mark of disease.   Its appearance, as well as its composition,
may be affected by various circumstances; thus, changes in the weather, de-
pressed or excited passions, change in the quantity and quality of the food,
as well as in exercise and clothing, together with numerous other causes, may
materially modify the condition of the urinary discharge, as to quantity, ap-
pearance, and chemical  composition. The urine  may  present  in different
specimens, the same color, the  same apparent deposits,  but its true character
can only be known by a scientific chemical and microscopical analysis; sim-
ple inspection alone, can never enable any one to correctly diagnose disease,
and he who attempts it, is a mere quack.   A writer on this subject observes:
"Any one who attends to this," (the  cause of change in the urine,) "will  be
astonished at the impudence of those daring quacks, who pretend to find out
diseases, and prescribe to patients, from the bare inspection of their urine.
These impostors,  however,  are very common  in  some parts, and, by the
amazing credulity of the populace, many of them amass considerable for-
tunes.  Of all the medical prejudices which prevail in this country, that in
favor of urine doctors is the strongest. The  common  people have still  an
unlimited faith  in their skill, although it  has  been frequently demonstrated,
that not one of them is able to distinguish the urine of a horse, or any other
animal, from that of a man."
  In  relation to the skin, the  checking of  perspiration by uncleanliness,
Budden exposures, colds,  damp houses, damp  clothes and bedding, wet feet,
&c, sufficient has been said in the preceding pages.   For treatment see Colds.

  There is a  direct and intimate sympathy existing between the mind and
the body, and so powerful is this that any disturbance of the one produces a
disturbing influence upon the  other; hence, it becomes necessary, not only
that the condition of the body be properly attended to, but also what is of
equal import, the  condition of the  mind.  How  mental action affects the
body, or, how the state of the  body controls that of the mind, are  mysteries
not yet solved by the philosopher,  though it is well known that this recipro-
cal action between the  two positively exists.   And it is not a matter of as- 
LOVE.---FEAR.
155
tonishment to observe the amount of disease and premature  death in this
country, when we understand the excessive and continued action of the minds
of its citizens, in search of pleasure, profit, or discovery.   A certain  amount
of mental exercise is necessary for health of the body as well as health  of
the brain; and either an augmented, or decreased amount of this action ex-
erts a proportional deleterious influence upon the whole man.   The natural
passions of the human mind, which, when controlled within proper bounds,
are intended for  salutary  and  useful purposes, become powerful  causes of
disease when permitted to be aroused  by improper objects, or when allowed
to proceed to an unreasonable  or ungovernable extent; and these, in partic-
ular, should  be  studied, in order that they  may be held subservient to the
health and proper  comfort of each individual.
  Love, is one of  the most  powerful  passions of the  human  mind, and  to
produce  a  happy  and sanative influence  upon the whole  constitution, it
should  not  only  be  directed  upon a proper object, but  should  likewise  be
held in obedience  to reason and common sense.  When this passion is dis-
turbed  by other  passions, as fear, or jealousy, it is calculated to produce
much physical mischief, especially upon the brain and nervous system, grad-
ually undermining the constitution; and  the same may be said when the
passion exists in an ungovernable degree, or, is placed upon  some unworthy
object.   A continued and unsuccessful love,  is generally accompanied with
grief, or despair, and if not overcome by appropriate measures, will terminate
in some acute affection, insanity, or death.  Not unfrequently the abnormal
state of the brain  occasioned by this cause, will lead the sufferer to commit
suicide.  It is very rarely the  case but that persons who are under the influ-
ence of a violent attachment, may be cured by proper  treatment, which will
consist of absence  from the object beloved, change of scenery,  cheerful soci-
ety, and an introduction to new faces and forms, with the hope of distracting,
dividing, and eventually removing the former passion.   Medicines are not
required, unless symptoms indicating physical disease, manifest  themselves.
No special  rule can be given for the cure  of this passion, as much will de-
pend upon  the peculiar mental conformation of each  individual under its
power, and the advances correctly taken thereof.
   Fear, or dread  of  evil or danger,  is a passion to which all mankind are
more or less subject; with some, however,  it exists habitually in a great
degree,  giving  rise  to disease  and  various  unpleasant symptoms.  With
many  persons,  a  sudden attack of fear  causes an involuntary discharge of
urine, or an alvine evacuation; it  has  likewise  produced  fever, fainting,
diarrhea, convulsions, mania,  and even sudden  death.  The influence of
fear varies with different persons; many become quite talkative, some very
silent, and others, again, become restless, moving about from place to place
constantly.   Instances are on record where  violent fear has produced im-
mediate idiocy, where the hair has been  suddenly changed to a white color,
and even where its vitality has  been destroyed so that it fell from its roots,
leaving the head bald.  Paleness of the countenance, a suspension of all the
vital functions, tremors, a momentary paralysis of the nerves of sense, &c, 
156               AMERICAN  FAMILY PHYSICIAN.
are usually present among those who become suddenly affected by fear.   All
these effects are caused by the greater or less degree of depression of the vital
powers which invariably accompanies  this passion.  During  fatal epidem-
ics, there is no doubt that more persons suffer and die from the effects of
fear, than would,  were  this passion unknown.   In  the  season  of Asiatic
cholera,  I met with many persons in whom all the symptoms of that epi-
demic were  produced solely by the  debilitating  influence of fear, and I
have no doubt but that many practitioners have met with similar instances.
  Persons who are undaunted in some situations,  may be extremely fearful
in others; thus, many have a fear of remaining in the dark, some experi-
ence fear only during a thunder-storm, others have  a fear of ghosts, of
sailing on the  water, of riding in the cars, or on horseback, &c.   But these
are very apt to be owing to an  improper education during early life, or to
certain unpleasant  mental  associations.
  The subjugation of this passion is a very difficult task; persons who are
subject to it may, however, overcome it to a great  extent, by  keeping a
careful and constant watch upon themselves, endeavoring  to cultivate a dis-
position to retain presence of mind under all  circumstance', and to check
the first manifestations of fear,  and also by the exercise  «v, much as possi-
ble of mental  fortitude.  These measures, aided  by  a correct  training of
the reasoning  powers, will frequently completely  subdud  the passion, even
when it exists in  excess.   In the  education of children,  parents, guardi-
ans, and teachers,  should be extremely careful nevv»r to adopt means of
punishment, which will call this passion into  existence;  cowards are made
by the  tyranny of teachers and parents over the  young.   The truly brave
seldom commit crimes.  But he, who calls the passion of fear  into action
among children, is manufacturing for the country, both cowards  and crim-
inals.
  Anger  is a passion most generally excited on the moment, which  sub-
sides more or less rapidly, according  to the nature of its  cause.  It always
exerts a  powerful and deleterious influence upon the system, which be-
comes augmented in proportion as the passion approaches toward insanity,
as, when it becomes furious and ungovernable.  A person in a fit of anger
may be at once recognized by  the redness of his face, the furious spark-
ling of his eyes, and the violent agitation of his  whole system.   Some are
unable to speak, while others  are  extremely voluble and vociferous ; not
unfrequently,  persons foam at the mouth in a fit of anger.  Some persons,
when angry, gesticulate violently, stamp their feet, and display an uncom
mon degree  of physical strength; others, involuntarily shed tears.
  Violent anger is very deleterious to health,  and the more often it is suf-
fered to be aroused, the more frequently will it  develop itself upon even
trivial causes.   From its action  upon all the functions of the system, it is
liable to  cause epilepsy, the rupture of a bloodvessel, convulsions, fainting,
apoplexy, and even sudden death.  Moderate anger  is  apt to  be longer
continued,  and accompanied with hatred, malice, revenge, regrets, &c,
rendering the  person fretful and  petulant, and  gradually inducing some 
ANGER.—GRIEF.
157
 permanent  disease.   They who lead a life of voluptuousness and  dissipa-
 tion, are the more ready subjects of this  passion.  Suckling infants have
 often been  thrown into  convulsions, after having partaken of the breast-
 milk of a previously angered nurse.
   To overcome the propensity to angry feelings, requires much resolution
 and perseverance.   As with fear, it is necessary to have a constant watch
 upon our minds, maintaining a degree of  presence of mind upon  the most
 sudden emergencies, and promptly repressing every angry feeling as it ari-
 ses.  The most powerful means of  suppressing this passion is at once  to
 concentrate the whole of the  mental powers and resolve to overcome it;
 let the higher  powers of the mind control the person.   It is the  power of
 thinking, reasoning,  and judging, that renders man superior to the brute;
 let then, the  man govern, and not the brute.   When angry, contentious
 words only tend to fan  the flame; it is better,  therefore,  to be  silent,  to
 take a draught of cold  water,  to withdraw  one's self from the exciting
 cause,  or adopt any other simple means,  until the anger  has passed away
 and  reason resumed  its sway.   Never attempt to settle business, when the
 mind is  in an irritable or fretful condition.  Persons of an inflammable
 disposition should be temperate in  food and drink, especially avoiding the
 use of stimulating food and intoxicating drinks.  The true gentleman, the
 man of proper education, can always hold  command over this passion.
   Children should  be carefully  guarded from those causes which will
 arouse and  cultivate  their angry  passions.  Improper punishment, disap-
 pointments, tyrannical  conduct,  partial  justice,  &c, should be carefully
 avoided.  Children have their rights, which should be held sacred by every
 parent and  teacher.  Instead  of being treated as mere machines,  slaves,
 or brutes, they should he governed by such  methods as will repress evil
 and cultivate virtuous propensities, remembering  that they are but men
 and women in  miniature, possessing every mental attribute common to the
 adult,  though  more keenly susceptible and alive to  external impressions.
 ■' Train up a child in the way he should go, and when he is old he will not
 depart from it," is a truth too  little understood,  or  too little acted  upon
 in the  present age; for instead of training and properly educating them,
 they are more frequently driven up,  as one would drive  cattle  to  market.
   Grief,  unlike fear and anger, is a passion of long duration, which  slowly
 ruins the constitution and produces  permanently injurious results to both
 the mind and body.   It exerts a debilitating influence upon  the whole sys-
 tem, enervating the brain and  nervous system, reducing the action  of the
 heart,  and embarrassing the flow of the circulating fluids; when long-con-
 tinued, it occasions paleness of the countenance, emaciation, fretfulness,
 impaired appetite, obstinate wakefulness, and a derangement of the functions
 of one or more  of the vital organs; persons suffering  under the depressing
 influences of this passion, are, like those governed  by  fear,  strongly predis-
 posed to attacks of prevailing epidemics.  It not unfrequently causes a loss
 of memory, premature old age, apoplexy, insanity, and, occasionally, sudden
death.   Pregnant females are liable to abortion from this cause.   Sometimes 
 158                AMERICAN  FAMILY  PHYSICIAN.

 this passion induces a  great  tendency to sleep,  instead cf wakefulness.  A
 continual grief always  causes more or  less pernicious influences upon the
 constitution, which are  rarely recovered  from.  On  these  accounts, sad
 tidings should never be communicated suddenly; a previous preparation of
 the mind of the individual by consolatory and  moral references,  accompa-
 nied by a gradual unfolding of the. evils to be  made  known,  is  the better
 course in all cases.
  Grief is one of the most difficult passions to overcome, more especially
 during its  early violence;—when  it attacks unexpectedly and powerfully,
 occasioning unpleasant symptoms, sleep should be induced as speedily as
 possible by the administration of opium, hyoscyamus,  or other agents which
 will effect the purpose; sometimes,  cool water  poured upon the head will
 answer a much better  purpose than the exhibition of internal medicines.
 A constipated condition of the bowels, so commonly attending this  passion,
 should be promptly removed by some purgative medicine.
  In cases  of continued grief, the individual affected should not be allowed
 to remain alone, as solitude increases its distressing effects; the cause of the
 grief should not be  alluded to in his or her presence, except by persons
 whose tone and manner are known to produce a soothing, tranquil condition
 of the mind; the friends to whom the cause of the passion is confided by
 the sufferer, should  endeavor to console him, and by all the means in then
 power lessen his sorrows.  Change  of  scenery,  traveling,  sailing,  cheerful
 society, and every method to draw the attention from its affliction, should be
 resorted to.  The mind of the patient should be kept constantly occupied by
 business, scientific investigations, reading, writing,  conversations, &e.  The
 diet should be nutritious, not heating or too stimulating, and all intoxicating
 draughts should be positively avoided.
  Joy, when not too sudden and exciting, is a passion which rather  exerts  a
 salutary influence upon the mind  and body,  causing  pleasurable emotions,
 and an increased action of the various organic functions.  But whe*h sud-
 denly and unexpectedly aroused to an excessive degree, it is apt to  occasion
 disease, and even immediate death;  this latter effect is more  to be dreaded
 when the joy has been  preceded by some depressing agency, as grief, or fear.
 It frequently occasions tears,  wild laughter, and pain in the  region  of the
 heart;  of these the latter is the most serious symptom.  When joyful news
 are  to be communicated, the same course should be pursued as recommended
 under " Grief."
  When  the symptoms of joy appear to be  of a serious character, it is better
 to arouse an opposite passion, as moderate anger, or fear, and which may be
effected by  suddenly dashing cold water in the face of  the person, or causing
artificial pain, by some  prompt and unexpected action.  When it occasions
excessive laughter, danger may be apprehended from the  rupture  of some
bloodvessel; the paroxysm of laughter may  be overcome in the same manner
as above  stated, by promptly inducing a state of  fear,  anger, or other coun-
ter-passion.
  The above are the principal passions which exert the most ordinary influ- 
OCCUPATIONS.
159
ences on the healthy or diseased conditions of the system; but an excess of
any passion, or a continuation of passions which keep the mind, and through
it the body, in a  constant  state of excitement,  or depression, are always
unfavorable to  health and longevity.   Thus, jealousy, hatred, malice, envy,
&c, tend to destroy the  pleasurable condition of the mind,  render  it con-
stantly more or less excited,  fretful, and petulant, gradually impair it, and,
as a consequence, the physical energies from their close relation to and  cor-
respondence with the mind, suffer in proportion  to the degree of mental
abnormality.  The mind should be kept as free as possible from any irregu-
lar action of the passions, and everything calculated to  keep up a constant
state of anxious thought should be avoided.  No danger can be apprehended
when  any of the  passions are kept  within proper limits—but a contrary
course is invariably  attended  with more or  less danger  to health or  life.
Persons  subject to powerful or  irregular action of any passion, should  at
once discipline the mind rigidly and  vigorously; this can be done, and by
perseverance, an undue action of the most dangerous passions  can be over-
come and regulated.   Great  care  is required  in the education of children,
that the evil passions  be not cultivated,  and also that  they learn how  to
command them.  This, however, is a matter to which  parents  and  teachers
pay but  little attention; whatever  feelings or emotions may be produced  in
the, mind of a child by its correction, or by other causes, are points  seldom
thought  of,  so the  child  is  made to yield to the wishes of its governors.
The very worst mode  of training children, is that which causes them to lose
all dependence upon themselves, to have no  will of their own, to submit
silently to the commands of one superior in strength, to  become mere  ma-
chines, thinking and acting only at the desire of others, and  receiving pun-
ishment for any resistance to what their  young and tender minds  cannot
understand, and which but little effort is  made to  enable them to  compre-
hend, save by some kind of chastisement.  The minds of children are gener-
ally much more sensitive and  observing than those of adults, and any ill-
humor, caprice, unkindness, partiality, neglect, &c, is deeply felt, and causes
a pernicious influence which  is very apt to be lasting and  permanent.   These
are matters  requiring the serious attention of every person  interested in the
welfare and education of the  youth of this country.

   A few words in relation to  the  various  occupations of life,  before I close
this part of  the work.   The business  occupations pursued  in  this country,
vary considerably in  their effects upon  the system.   Those which  are
of  a  sedentary  character, are  liable to  produce affections of the lungs,
stomach, or liver, according  to the peculiar  position in  which the body
is required  to be  held,  or  the  influences  exerted upon it by an open,
pure atmosphere,   or  one confined,  and  vitiated by impure vapors,  and
irritating and  dusty  matters.  Those  which are carried on in the open
air, calling  into action considerable muscular power,  are the  most  advan-
tageous to health;  but, even these may prove  destructive to the  constitu-
tion,  by daily over-action of  the muscles,  producing great fatigue;  by 
160
AMERICAN FAMILY PHYSICIAN.
the action of only one set of muscles, the others not being exercised at all,
and more especially, when the body has to be kept in one constrained or
unnatural position;  and  by improper  exposures  to  sudden  changes  or
unhealthy conditions of the weather.  Any employment, however unhealthy
it is, may be  rendered less prejudicial  to health, by the adoption  of the
measures  heretofore referred to,  as temperance,  cleanliness,  attention to
diet, exercise,  bowels, &c; while on  the other hand, a neglect  of these
important and salutary rules, will induce disease among those whose daily
labors are of the most wholesome character.
  A very great error exists among parents and guardians in the  selection
of trades and professions for children.  Those who are delicate and weakly
instead  of being placed at occupations which will tend to develop and
strengthen their systems and thus promote longevity, have usually selected
for them some sedentary profession, as painter, engraver, watch-maker, &c,
which will most certainly assist in hastening  the downward tendency of
their systems.   While on  the other hand, those of robust, hardy  constitu-
tions  are placed at the  most active,  and consequently the most healthy
employments.   There is no objection to  this latter plan, but the former is
decidedly wrong.  Those of healthy, robust systems are better capacitated to
follow sedentary occupations, because, their condition  of health, enables
them to ward  off disease,  and even attain long  life by  an attention to the
proper hygienic measures in connection with their business; while the sickly
and debilitated cannot attain this  end,  unless, with  their attentions  to
hygiene, they  have active  employment  in the  pure, open  air.   The most
active and healthy occupations should invariably be selected for the  tender
and delicate youth.
  The influence of trades  and occupations upon the system, ought to be
much better known by the public generally than they are, in order  that
artisans may adopt the proper measures to protect  their systems  from the
injuries which may be effected by their peculiar kind of employment.  The
following brief relation of the effects of the more common occupations, upon
the system, may prove of much utility to the reader :—
  Bakers are subject to sudden changes of temperature, as, from the vapors
of a hot  oven to a  cold  atmosphere,  and vice versa; they are likewise
deprived of much of their rest at night,  especially those who make  bread;
they are constantly inhaling more or  less dust, which is common to  their
trade.   These  various exposures render  them liable to rheumatic affections,
colds, coughs,  pulmonary  affections, and derangements of the  digestive
organs.   There  is a disease which commonly affects the hands, known  by
the name of "Baker's itch," and  which is  supposed to be owing  to the
irritation which  the skin  undergoes during  the  process of working or
kneading dough; (See Grocers)—this is  sometimes a very difficult affection
to cure, but I  have removed it in a number of instances, by the application
of an ointment made of two parts of stramonium ointment,  and one  part of
hop ointment, mixed together; a portion of this  is to be rubbed  on the
affected part, and kept there, during the time the hands are not employed in 
OCCUPATIONS.                        16^
 working the dough.  I have likewise succeeded in some  obstinate cases by
 the daily application of a saturated solution of oxalic acid—care should be
 taken when  using this solution, to wash the hands  well  with water and
 Castile soap, previous to kneading dough.  Most bakers are unhealthy and
 have a pale countenance, owing more I  believe, to an inattention to  hygienic
, measures than to any other fault of their occupation.  This trade is only
 suited to robust and healthy persons.
   Bookbinders may  experience  unpleasant  symptoms,  from  too close a
 confinement within  doors, or from a  careless exposure to the vapors of
 burning charcoal used in heating the finishing tools.  But when  working
 in a well-ventilated apartment, and not addicted to  intemperance or other
 bad  habits, their trade does not dispose them  to  any special  diseases.
 Persons with  a tendency to throat or lung diseases, had better avoid this
 trade.
    Braziers,  and those who work in  brass, are exposed to the vapors thrown
 off by the melted brass, as well as to the dust or filings made in working the
 metal.  The  inhalation of these  may occasion  pulmonary diseases and
 affections of the stomach; but if a  proper degree of care be taken  to avoid
 their inhalation,  the trade will be  found quite healthy.  Flues  with good
 draughts will obviate one of these   difficulties, and wire-gauze  or  network
 worn over the mouth and nostrils will  counteract the other.  This trade is
 suitable for all persons not disposed to  throat or lung  diseases.
   Brewers, from exposures to sudden changes of temperature, are subject to
 colds and rheumatic affections ; but the greatest  evils  to  which  they are
 disposed, are those caused by the inhalation of the carbonic acid gas which
 escapes during  fermentation, as  well  as by  the excessive use of malt
 liquors.
   Brushmakeit, are usually healthy; the principal objections to their trade
 are the exposure to dust from the bristles,  and  the vapors of  burning
 charcoal used in heating pitch, in consequence of which, it is an unsuitable
 business for one disposed to throat  or lung diseases.
   Bricklayers are usually sturdy and healthy individuals;  the only diffi-
 culties encountered by  them  are exposure to  the immediate rays of a hot
 summer's sun,  which may occasion  sunstroke or affections of the  brain, and
 to lime-dust which frequently irritates the eyes and the skin.  Bricklaying is
 a suitable employment for all persons.
   Brickmakers are generally a healthy  sturdy,  class  of  people; but from
 careless exposures to cold and damp, they are apt to suffer from  rheuma-
 tism, colds,  acute pulmonary affections,  ague, &c.
   Butchers,  when not careless or intemperate, are among the most healthy of
 our tradesmen.  This is an occupation especially suitable to the delicate, and
 those disposed  to  throat or lung disease.  Those who use much animal food,
are liable to diseases of the skin, scrofula, &c.
   Cabinet-makers, in consequence of the improper ventilation of their work-
shops, and the dust to which they are exposed, are liable to affections of the
throat,  lunjrs, and stomach; if their work requires a constant,  unnatural
        11^ 
162
AMERICAN FAMILY PHYSICIAN.
constrained position, the liability is increased.   An attention to proper hygi-
enic measures will render this a healthy employment.
  Carvers and  Gilders become diseased  in consequence of the sedentary
character of their business, and its being confined within  doors,  in  addition
to which,  there is generally a  continual bent  or unnatural position of the
body.  Gilders  and those who work much in quicksilver, are subject to severe
diseases occasioned  by the vapors of this metal.
  Carpenters  are generally healthy,  when care is taken to avoid improper
exposures and intemperance.   It  is,  however, a trade requiring too mucl?
muscular action for some persons, and is particularly unsuited to those who
are  disposed to  bleeding from the lungs or stomach.
  Coachmen  and stable-keepers derive no injury to health from their  occupa-
tion; but they are subject to several inflammatory affections from exposure tc
cold and dampness.
  Cooks from an exposure to changes of heat and  cold and steam, as well aa
to excessive  or improper eating, are liable to derangements of the digestive
organs, various  inflammatory attacks, and diseases of the face and hands.
  Coopers, when temperate, are generally robust and healthy.  The stooping
position required in their  trade  frequently causes disagreeable pains in the
thighs and back; and this position, aided by the  noise of hammering, is apt
to induce in young beginners, headache, more or less deafness, &c.
  Coppersmiths are  exposed to  inconveniences  similar to  those  mentioned
under the head of Braziers.
  Curriers are generally healthy.  The trade, however,  is  objectionable for
those persons who have occasion to continue in a curved position, as  pains of
the head, bleeding from the nose, derangement of the stomach,  &c, are apt
to be induced.
  Dyers are exposed to aqueous vapors, damp,  and the fumes from the vari-
ous articles used as dyes, in consequence of which, colds, catarrhs, rheuma-
tism, pleurisy, inflammation of the lungs, and  affections of the eyes, are apt
to attack  them.  It is not a suitable occupation for persons laboring under
affections of the throat and lungs.
  Engravers,  see watchmakers.
  Farmers, when temperate, are about as healthy a class of men as can be
found, though from careless or improper exposures they are liable to various
diseases the same as other persons.  Individuals of  delicate  habits, or dis-
posed  to  pulmonary  affections, will find  properly regulated work  upon a
farm the most  salutary  occupation that they  can select; though, of course,
they must avoid improper and unhealthy locations.
   Gardeners  are healthy, the only inconvenience being a pain in the lowei
portion of the back, caused by remaining too long in a  bent position during
work.   It is  a suitable business for those of delicate constitutions.
   Glass-ioorkcrs are exposed to sudden changes of temperature, to the vapors
of lead, arsenic, or  other injurious articles employed in their trade, and to too
constant  light  of  a  glaring  nature;  from which may be occasioned colds,
derangements of the lungs and stomach, rheumatism, inflammatory attacks, 
OCCUPATIONS.
163
 cataracts, &c.   Sudden death  is by  no means unfrequent among  glass-
 blowers.  Individuals disposed to throat or lung diseases, should not embrace
 this business.
   Glue-makers, from too long stooping may have pain in the loins, but gener-
 ally they are quite healthy, the only diseases to which they are  liable, being
 those caused by improper exposure, or intemperance.
   Grocers have a healthy occupation;  though too much handling of  sugar,
 molasses, &c,  is apt to produce the  "Grocer's itch," a disease somewhat
 resembling "Baker's itch," undoubtedly produced by the same cause, prob-
 ably microscopic animals oracari.  The treatment recommended for "Baker's
 itch" will be found efficacious in this.
   Hatters, beside the stooping  position  required during work, are  exposed
 to the  fumes from  the  vat, and to changes  from hot to cold, subjecting
 them to colds,  catarrhs, pleurisy, rheumatism, and  derangement of the
 digestive organs. The finger ends and  nails are apt to be injured by the
 employment of acids.  It is an unsuitable trade for those disposed to pul-
 monary complaints.
   Iron-workers are subject to throat and lung  diseases, from the dust and
 filings  of iron which are constantly more or less inhaled; and  also  to
 rheumatism and various other acute attacks from sudden  changes  of tem-
 perature, the latter  especially among foundry-men.  Yet  by a life  of tem-
 perance and prudence, and using means to prevent the inhalation of dust,
 &c, as  by wearing a wire gauze over the mouth and nostrils, these deleteri-
 ous  effects can be obviated to a great extent.
   Lawyers, when engaged in  active  business,  have a healthy profession;
 those only who are too sedentary are injured by it.   In law, as in medicine,
 the varied excitements of  the mind,  and its proper employment, together
 with moderate  physical exercise, are always attended with beneficial results.
 Persons disposed to  diseases  of the throat, heart or lungs, to bleeding from
 the lungs or stomach,  or  to dyspepsia,  should never engage  in  law or
 theology, especially when  the habits  are  to become  too sedentary,  or, on
 the  contrary, when  the lungs and vocal organs  are to be  too  constantly
 and  excessively  employed in pleading or preaching.  In the professions
 of law, theology, and  medicine,  strong,  healthy,  intellectual men are
 required, not weekly, delicate, effeminate  creatures, as we  find to be too
 much the case in the present day.
   Masons, from the active character of their trade, and its being conducted
 in the open  air, are  commonly strong and healthy persons; yet their sub-
 jection to wet, and to the inhalation of minute particles of dust, lime, and
 stone, renders  them  very liable  to catarrh,  rheumatism, and  affections of
 the lungs and stomach.
   Millers are very subject to asthma, cough,  consumption, and derange-
ment of the appetite  and digestive powers, induced by the  inhalation of the
dusty particles  to which they are constantly exposed;  they commonly have
a pallid  and unhealthy appearance.
  Painters are  extremely subject to various unpleasant symptoms,  arising 
164               AMERICAN  FAMILY  PHYSICIAN.

from  the vapors of the several  lead  oxides to which  they are constantly
exposed; vertigo, vomiting, impaired  digestion, constipation, &c, are very
common'among them, and  especially a serious disease  known as  lead or
Painter's colic, which  is apt  to  end  in  palsy or death.  Intemperance
hastens these effects.   Workers in lead mines are liable to similar affections,
and which are always  very difficult of cure.
  Paper-makers from their exposures to dampness, to the vapors occasioned
by bleaching,  and to  the dusty particles from  the rags employed in their
trade, are very subject to colds, rheumatism, and diseases of the lungs and
^tnnifioh                      "^
  Physicians, engaged in moderate practice usually enjoy excellent health;
but when they are too sedentary in their habits, or permit  themselves to
worry in consequence of non-paying  patients, and especially  when  their
pecuniary means are not abundant, they are subject to diseases of  the heart,
and other serious affections.  Physicians exposed to changeable weather, and
to constant  tiresome  practice, not having sufficient rest, as is  more fre-
quently the case among country practitioners,  are peculiarly liable to dis-
ease,  and to  a premature  decay  of  the  system;  and the  disposition to
which is augmented when residing in  unhealthy or malarious districts.
   Plasterers being subjected to a damp atmosphere,  and lime-dust, suffei
principally from colds, rheumatism, lung diseases, and affections of the eyes.
   Plumbers and Potters, are subject to  the same diseases as  painters, occa-
sioned by the lead used in their respective occupations.   Almost all kinds
of  common earthenware  have lead entering into their glazed surface, ren-
dering the ware not only deleterious to the manufacturer, but also to those
who use it.
   Printers are  exposed to the fumes of the lead and antimony  of the type,
they  have  but little exercise, and most commonly  occupy a confined or
improperly  ventilated room,  all  of which exerts a  deleterious influence
upon health.   Swelling of the limbs,  and dilation of their veins  are fre-
quently occasioned  by the erect, standing position in which  they  are
required to continue  for hours.  The eyes are often  injured by  a constant
and strained  employment  of them upon small  objects, Indigestion and
 diseases of the lungs, are the more common diseases among printers; and
 among female  compositors,  in addition to the  above, diseases of the womb
 and  reproductive organs,   are by  no  means unfrequent. Pressmen, who
 have a greater degree of activity and variety in their  labors, are not quite
 so liable to the above affections as compositors.   Persons of delicate habits,
 or disposed to throat or lung diseases, or to  bleeding from  the lungs or
 stomach, as well as females who are not robust and of masculine composi-
 tion, should not enter upon this occupation.
    Rope-makers become diseased more from intemperance or improper expo-
 sures, than from any deleterious influences arising from their  trade.
    Saddlers, although confined within  doors, and in  stooping positions,
 may, by a proper course of hygiene, overcome the attacks of  loss of appe-
 tite,  and impaired digestion, &c, to which they are liable. 
OCCUPATIONS.
165
  Shoemakers, from the constrained, unnatural position in which they are
placed during work,  and the  confined, or improperly  ventilated rooms
which they occupy as  workshops,  are especially liable to dyspepsia, liver-
complaints,  and diseases of the lungs, the results  of imperfect digestion
and nutrition, and obstructed circulation.   This class of  mechanics should
be strictly temperate, and  should exercise regularly and daily at various
hours, either with the dumb-bells, or at jumping, fencing, boxing, playing
ball, &c.
  Shopkeepers,  clerks,  and bookkeepers, generally  suffer  more  from  the
sedentary character of their employment, than the active;  the injurious
influences of which are  much aided by confinement within doors. Beside
these, there is usually an irregularity in  the  time and manner  of eating,
from  all  of which they become subject to dyspepsia,  muscular debility,
indolence, and  a general torpor of the various functions of the system.
To overcome these evil influences  they should  exercise  daily,—an atten-
dance at the gymnasium  would be  especially advantageous; and among
other hygienic measures, they should be particularly observant of the rules
laid down in relation  to food, mastication, time for eating, &c.   It is a great
misfortune,  undoubtedly owing to a want of proper physiological knowl-
edge, that a  majority  of employers  require from  their sedentary  employ-
ees, not only all the hours of the day, but often several hours of the night,
allowing them no time to attend to such duties as their mental and physical
systems demand for the promotion of health and longevity; and, as a con-
sequence, these late hours which are spared, and in which no gymnasium
can be found open, nor any profitable mental or physical associations or
exercises be enjoyed, are very apt to be passed in dissipation  and debauch-
ery, to the ultimate detriment of both employer and employee.
  Smiths, as blacksmiths,  whitesmiths, &c, are a sturdy, healthy, athletic
class  of men, being  disposed  to disease  only from intemperance or  im-
proper exposures.  As the muscles of the arms and  upper part of the body
are more  thoroughly  developed in  smiths  than those of the lower limbs,
the latter should be improved  by running, leaping, dancing,  and similar
exercises.
  Starch-makers  are  subject to coughs, colds, and pulmonary  affections,
arising from exposures to damp, and from  the  inhalation  of the dusty par-
ticles arising from starch.
  Students and authors render  themselves  unhealthy by their own impru-
dences and follies; a proper attention to exercise, diet,  cleanliness, hours
for study and for sleep, &c, will  tend not only to  increase  the powers of
the mind, but likewise those of the body.   Too close an attention to study
or writing, in confined rooms, and also during  the late hours of night, will
induce similar unhealthy influences upon  the system  as those referred to
under the heads of  lawyers,  physicians,  shoemakers, shopkeepers,  and
tailors.
  Tailors, from their  sedentary occupation, and  the  unnatural  positions
which their work  requires them to assume, are subject to  dyspepsia, livei 
166               AMERICAN   FAMILY  PHYSICIAN.
affection, diseases of the throat and lungs, and a torpor of all the functions
of the system.   And these are more apt to  be present with  the youth of
delicate constitutions who are apprenticed  to the  trade.  They quickly
have the functions  of nutrition,  respiration, and circulation  embarrassed,
from which result  the diseases so fatal to many.  Tailors should be tem-
perate,  and,  as recommended for shoemakers, clerks, and others of seden-
tary employments, should exercise daily and regularly, either in a gymnas
ium or  some other proper place; by pursuing  a proper hygienic course
they may obviate entirely, or to a very great extent, all the unhealthy con-
sequences of their trade;' their workshops should be well-ventilated.
   Tallow-chandlers  are not  disposed to  any disease  peculiar to  their
employment.
   Tanners are commonly sturdy, and  healthy, but  are liable to  colds,
catarrh, rheumatism, &c, from the exposure to cold and damp required in
their business.
   Tinmen are not  disposed to any particular disease, except from intern
perance, or when their workshops are improperly ventilated.
   Tobacconists, are apt to suffer from  cough, indigestion, headache, nervous
ness, affections of the throat, &c, in consequence of the sedentary nature
of their  occupation,  their  confinement  in close  rooms, and of the inha-
lation of the dusty particles of the tobacco.   Temperance, cleanliness, and
daily  exercise are necessary for  the preservation  of health among this
class of tradesmen.
   Turners are liable to the  diseases common  to  carvers, and other trades
requiring a bent position of the body, constant standing, and inhalation of
dusty particles.  Proper exercise, temperance, and other hygienic atten
tions, will obviate the disadvantages  attending this trade.
   Watch-makers and engravers, are  very sedentary, are confined in their
rooms, and perform their labors with the  body in a bent posture; in conse
quence of which they are subject to dyspepsia, liver  affections, constipa-
tion, piles, cough, consumption, and a general torpor of the several func-
tions of the  system.  The  contrast  and straining application of the eyes
to small objects, frequently  injures the sight.  To  overcome  these evil
effects, much may be done  by pursuing the course recommended for shop-
keepers, students, tailors, &c.
   Weavers most generally pursue  their labors  in damp and confined rooms,
filled  with  dusty particles of the  material  they are using;  in addition to
this they soon assume a bent  position of the  body.   These  circumstances
are apt to induce cough, asthma, dyspepsia, piles, constipation, and diseases
of the lungs and throat.  When temperate, and working in well-ventilated
and dry apartments,  and attending to exercises of amusement, &c,  they
may enjoy health to a good old age.
  Many occupations are not mentioned herein, but enough are referred to,
by which the reader will be enabled  to judge of the healthy or unhealthy
nature of any particular one.   Thus, ascertain whether the occupation be
one requiring muscular  exertion in the  open  air, whether too great exer- 
MICROSCOPE.
167
tion of the muscles is  required, whether  all the muscles of the body, or
only a portion, are called into action, and whether the body is to be held
constantly  in  a  bent  or unnatural  position.  Again, is the occupation
Bedentary, or not, requiring confinement in close rooms, the inhalation of an
impure or  dusty atmosphere, any exposure  to  steam, obnoxious  vapors,
cold, damp, &c?   An explanation to  these and similar inquiries will enable
any one to  select and determine for himself the healthy or unhealthy char-
acter of any kind of business.
  All persons, whether sedentary  or very active, require amusement and
exercise, which should  be taken frequently.   Too much attention to busi-
ness and little or no recreation, is certain to bring on a premature decay of
the system.   Foreigners, in this  respect, enjoy themselves much better
than Americans; they frequently  have little parties, pic-nics, and other
agreeable  and healthful associations, which, undoubtedly, is one cause
of  the health  and longevity of even  those among them who  follow  rather
unhealthy  employments.   When will our  own countrymen  manifest a
greater  interest than they now do, in matters pertaining to  health  and
long life ?
                       CHAPTER   XIV.

   The Microscope.—Its  Importance.—Detection of Adulterations.—
                         Microscope Makers.

   Before closing this  part of the work,  I wish  to  make  a few remarks
relative to the microscope, an instrument  to which frequent reference has
been made in the previous chapters.   But a few years since  it was looked
upon as a mere toy, unworthy the attention of men of science ; at this day,
the many improvements which have been made  upon it, render it useful
equally to philosophical  investigators and the public  generally.  Every
person who is interested in matters pertaining to his own health and com-
fort,  as  well as to  his  instruction  and amusement, should  possess an
achromatic microscope.
   The microscope opens to the observer a new  and  unexpected world, full
of beauty, perfection  and  magnificence; in a single  drop of water it pre-
sents to the astonished vision, living creatures, of most beautiful and varied
forms, entirely unlike all  former conceptions of organic existences, and so
extremely minute that it would require from twenty-five thousand to eighty
millions to fill the narrow  space of one square inch.  And yet, as small as
they are, the microscope reveals to us  their  existence,  their spontaneous
motion, and their external and internal  structures; it  also makes known
the fact that these minute  living beings are extremely  reproductive,  and
"constitute  the  chief proportion  of living bodies  upon the  face  of the 
163
AMERICAN FAMILY  PHYSICIAN.
uirth.""  They are  found not only in  the  fresh water of ponds,  brook^
rivers, and lakes, but even in the salty waters of the  great deep, in  some
strong acids, in terraqueous  matter,  and in vegetable and animal fluids;
indeed, there is no part of the world, either upon  its external surface, or
internally, but in which these microscopic beings can  be found, either in a
living or fossil state.   The mortar  of the builder,  the  chalky cliffs of
Albion, extensive tracts of country in various parts of the world, as well
as chains of mountains, the coral foundation of the- Polynesian Archipela-
goes, of the reefs and islets  of the Indian  Ocean,  as well  as many  other
places, besides slate, flint, sandstone,  limestone, rocks, &c, all contain, and
are,  in  fact,  chiefly  composed of  the  remains of once living,  invisible
animalcules.   "Of  the  myriads upon myriads of organized beings created
to work out the grand designs of Providence, all calculation seems futile;
as the result  would be far beyond the grasp of human  comprehension.
And the remains of these minute animals  have added much more to the
mass  of materials which comprise the exterior crust of the globe, than the
bones of elephants, mammoths, hippopotami, and whales."
   But the  microscope does not terminate  its utility here; it is  equally
necessary and useful to the geologist, the botanist, the mineralogist, the
chemist, and the physician.   To the latter in particular,  it has  demon-
strated the minute  structure of parts of the  human  system,  which were
previously altogether a mystery, and has assisted in affording a more per-
fect comprehension  of the organic functions.  The structure of the various
parts  of the system has, within a few  years past, been  thoroughly and cor-
rectly made known  by the  aid of this mighty instrument,  so that no man
can, at the present  day, hold the title of even a " respectable  physician,"
who  is not conversant with its revelations.  Nor has  its value  ceased with
a knowledge of the healthy structure ;  it affords a certainty in the  diagnosis
or detection of diseases, several of which cannot be  correctly  determined
without it.
   It is no less useful to the non-professional man,  and to  the  community
in general, who, by  its employment, may frequently learn certain unhealthy
conditions of the system,  without having immediate recourse  to a physi-
cian.   Thus, the character of urine, as  known by  its uric acid, its urates,
phosphates, oxalate  of lime, blood-corpuscles, &c, as seen under the micro*
scope, may enable an individual to  become  aware of changes taking  place
in the system not consistent with health, at a very early period, even before
any  appreciable symptoms have developed themselves, and  thus  afford
him information which will lead him to  adopt a proper course of treatment
long before the attack becomes serious or of  a permanent nature.   Engrav-
ings of the most common appearances of the urinary deposits under the
microscope, are given in that part of the work treating upon  affections of
the kidneys, to which the reader is referred.
  The non-professional man  may also ascertain that many diseases of the
skin depend upon, or are accompanied with  microscopic vegetable growths,
of a  fungous or algous  character, as ring-worm of the scalp, dow-worm, 
MICROSCOPE.
169
 some apthous ulcerations of the throat, mouth, &c, and that other diseases
 again, are accompanied with microscopic animals, as the itch,  acarus folli-
 culorum, &c.   The globules of blood seen  under the microscope, appear as
 numerous "pale, red,  rough, bi-concave discs, having a tendency to  turn
 upon their edges, and to arrange themselves in rolls  like rouleaux of coins;
 a very few white  corpuscles, irregular in form,  granular  in  surface, and
 rather larger than the red globules,  will also be readily distinguished."
 To discover whether  any stain  consists of blood, it must be moistened with
 some white of egg, then  scraped off the material holding the stain, and
 examined under the microscope; if the stain  consists of blood, blood-cor-
 puscles,  as above described, will be distinctly visible. In this manner, in
 supposed cases of murder,  may we distinguish between  blood stains, and
 red spots resembling blood.
   Beside the above named applications of the
 microscope,  there are  others  of still  more
 importance to  community, as  the  detection of
 adulterations  in  food and drugs.   A writer
 observes,  "to such a pitch of refinement has
 the art of falsification of alimentary 3-ubstances
 reached, that the very articles used to adulter-
 ate are adulterated.   And while one tradesman
 is picking the  pockets of his customers, a  still
 more cunning rogue  is, unknown to himself,  c Blood-^usdeT^hering.
 deep in his own!                              d. Blood-corpuscles separate.
  "The manner in which food is adulterated is  not only one of degree but of
 kind.  The most simple of all  sophistications, and that which  is the most
 harmless, is the mixture of inferior qualities of the same substance.   *  *  *
 Secondly,  the mixture of  cheaper  articles of another kind; thirdly, the
 surreptitious introduction of materials which, taken in large quantities are
 prejudicial to health;  and fourthly, the admixture of the most deadly poisons
 in order  to improve the appearance of the article 'doctored.'
   "The microscope alone is capable of detecting at  one operation the nature
 and extent of the more  harmless but  general  of  these frauds."  It distin-
 guishes with unerring  nicety an admixture  of the common Circuma arrow
 root with the finer Maranta; it detects genuine ground coffee, from  its adul-
 teration with  peas, beans,  oats, dried  bones,  oak, or  mahogany,  sawdust,
 chicory, &c; it determines the presence of mildew in flour; of turmeric and
 flour  in  mustard; of red lead  in cayenne  pepper; of water, chalk, calves'
 brains, molasses,  annato, flour,  oxide of iron, &c, in milk, as  well as the
 richness of milk; it exposes fraudulent  mixtures of lard with butter; of Prus-
 sian blue, turmeric, chalk, and  copperas in  green  tea; of gum, black lead,
 Dutch pink, and leaves of other plants  in black tea; of roasted wheat, beans,
carrots, parsnips,  horsechestnuts, oxide of iron, baked horse's liver, &c, in
chicory;  and of wheat flour, hundreds of sugar-insects, sand, and albumen of
bullock's  blood  in sugar.   Impurities  in butter, bread,  cheese,  molasses,
spices, vinegar, and other necessaries of life may at once be detected by  this
 
170                AMERICAN  FAMILY PHYSICIAN.
powerful instrument, so that as a saving to the pocket as well as to the health,
it should form a part of the domestic apparatus of every family.
  The most useful and  fascinating study,  is that  belonging to microscopic
observation, and it is much to be regretted that means have  not been hereto-
fore employed to introduce its charms and value into the homes of the people
__to their firesides.  A more valuable gift from father to son, from husband
to wife, from friend to friend, than that of a microscope, cannot be made; for
unlike any other instrument, it can bestow  upon its  possessor, amusement,
profit, instruction, health, and happiness.  Its astonishing  and magnificent
revelations  are  of so bewitching  a nature,  that the parent, the son, or the
man of common sense, who has once  become  fairly acquainted with them,
would rather pass his unoccupied hours at home,  in the circle of his family,
displaying to its members the powers and excellencies of his  microscope, thus
cultivating in their minds a taste for scientific  pursuits, than  to waste those
hours away from home in the turmoil and strife of  political excitements, in
the mind and soul-destroying region of a  porter-house, or,  in any of  those
many dens of  dissipation, debauchery, and vice, which throw out the most
alluring temptations, to catch the indolent, the unwary, the  careless and the
ignorant; to rob wives  of the affections of their  husbands, to make sons rebel
against and cause anguish to their parents,  despoil wives and daughters of
all self-respect, and render them among the vilest of the vile.
  Unfortunately, some have  conceived  the microscope to be a mysterious
instrument, capable of being managed or understood only by certain partic-
ular persons.  This, however, is a great error; it  is intended as an improve-
ment upon our sense of sight.  Objects which can be seen well by the natural
eye, do not require  its  assistance; but with  those which are too small  to he
thus seen, we aid the  power of vision by employing the  microscope, and
which every individual  possessed  of sight can readily  use.   Persons with
imperfect sight, use spectacles to  improve  this sense; and the microscope
improves the magnifying and defining powers of the eyes.
  A great obstacle to  the more  common  use  of the compound achromatic
microscope, heretofore, has been in its expensiveness, but  instruments are
now made by our best opticians, called "student's microscopes," which will
accomplish all that any person need desire.  The  value of a microscope does
not lie so much  in the  beauty or workmanship of its brass mountings and
other metallic accompaniments, as  in the quality  of its object-glasses and
eye-glasses.  An object-glass  itself, however  great may be its magnifying
power, is useless unless it possesses penetrating and defining powers also.  It
is from a want of these latter powers in their objectives, that the French
microscopes imported  into this country are inferior in quality, notwithstand-
ing the excellence of their brass-work and their low prices.
  In  purchasing a microscope, the name of its  manufacturer ought always to
be learned, from the fact that our best microscope makers never permit poor
glasses to leave their workshops.   Among the  first microscope  makers  of
England, are Boss, Powell  & Lealand,  Smith  &  Beck, and, perhaps, Pilli-
scher, but their  instruments seldom reach this country unless ordered, and are
very  expensive. 
MICROSCOPE.
171
                       Fig. 13.                          The  best  micro-
                                                   scopes in the world as
                                                   to magnifying power,
                                                   large  angle of  aper-
                                                   ture,   definition, and
                                                   penetration, are  made
                                                   in this country in Can-
                                                   astota, N. Y.,  by th
                                                   firm of Spencer & Ea
                                                   ton; their largest mi-
                                                   croscopes  are  une-
                                                   qualled by any known.
                                                   This  firm  manufac-
                                                   ture a "student's mi-
                                                   croscope,"  (See  Fig.
                                                   13,)  with  one eye-
                                                   glass, and two object-
                                                   glasses inch and  quar-
                                                   ter-inch, for $53, and
                                                   which is sufficient foi
                                                   all the  various pur-
                                                   poses  referred  to
                                                   above.   The  instru-
                                                   ment is so made that
                                                   as  the   purchaser's
                                                   means will allow, he
                                                   may   p r o c u re  the
                                                   higher powers, polar-
                                                   ise o p e,  diaphragm,
                                                   &c, should he desire
                                                   them.   The inch ob-
                                                   jective  is  about  60
                                                   diameters, or  magni-
              Spenoer's Student's Microscope.             fie9  the  object about
3,600 times superficially; the quarter-inch is about 300 diameters,  magnify-
ing the object 90,000 times superficially.  If the quarter-inch objective only
is taken,  the price  is $30; but all  who are able should procure both ob-
jectives.
  Messrs  J. & W. Grunow, of New Haven, Conn., make excellent micro-
scopes, which have thus far given satisfaction to all who have used them.  In
this country, I believe they stand second, only to the above  firm of Spencer
& Eaton.    They also  manufacture "student's microscopes," with  inch and
quarter-inch object-glasses  and two  eye-glasses, for $55, giving magnifying
powers of about 30, 50, 200 and 350 diameters.
  The above instruments of these two makers are mounted each on a tripod
base, and uprights of japanned cast-iron, with joint to incline the body at any
~^=^ STILLAUII. 
172
AMERICAN FAMILY PHYSICIAN.
angle desired; the stage is large, and plain, with a spring clamp  to hold tha
slides containing the objects, and each instrument is provided with a concave
mirror.   (For manner of using the microscope, description of  microscopes,
&c,  see " The Aficroscopist's Companion, or a Popular Manual of Pratlical
Microscopy,&c, by J. King, M. D.")

                                 Fig. 14.
Grunow's Student's Microscope. 
PART    I.
SYMPTOMS,   CAUSES,  AND  TREATMENT OF   DISEASES.
FEBRILE  DISEASES.
   Symptoms.  There is no class of diseases so frequently met with, nor to
 which the human family are so subject, as this of Fever; which is, probably,
 owing to the fact that they are more or less constantly exposed to those causes
 producing fever, as exposures to cold, or sudden changes of temperature, damp
 atmosphere, great heat,  noxious vapors from decomposing animal and veget-
 able substances,  unhealthy emanations from diseased persons, &c.   Let the
 character of the fever be what it may, there are certain symptoms common to
 all forms of febrile disease, and which vary only in their degree of severity,
 depending upon the activity of the attack.   Thus,  the first  symptom experi-
 enced, is most commonly a degree of languor  and lassitude, an inaptitude
 for mental or bodily exertion,  sometimes a dull headache, unsound sleep,
 unpleasant dreams, and  other symptoms of depression.   In  a few instances,
 these precursory symptoms are wanting; but when present,  they may remain
 for several days,  or even  weeks before any further  indications of  fever are
 manifested,—and it will most generally be found, that the duration of these
 early symptoms will be proportioned to the  severity and  obstinacy of the
 subsequent febrile  affection.   Not  unfrequently, as the above symptoms
 gradually increase, the  patient will experience  an unpleasant soreness and
 lameness over the whole system, which he will  express to be an "aching of
 the bones."
   In a longer or shorter time these symptoms will be followed by chills, at
 first  passing down the back, with cutis anserina (goose pimples,) and paleness
 of the surface, and the patient places himself as near a  fire as possible,  but
 without being in any way  benefited by so doing.  These chills  may be very
 slight, or may amount to a severe shaking of the whole body, over which the
 patient has no control, and in severe cases will be accompanied with blueness
 of the lips and nails, hollow appearance of the eyes, and the previous soreness
 and  aching complained of,  are  now supplanted by  a distressing  pain.
 With the chills a  great degree of  thirst  is usually experienced; there will
 be a  hurried and  more or  less difficult breathing; the  pulse will  be  small
 and depressed, but very frequent; sometimes it will be small and feeling like
 a thread, at others it will be barely distinguishable. The tongue, at this
period of the disease, is pale, with a white coat on its  upper surface of greater
or less consistency.  Sometimes  nausea and  vomiting are present;  the urine
is generally abundant and  colorless.   In  some forms  of fever, and especially
                                                        (173) 
174
AMERICAN  FAMILY  PHYSICIAN.
at the South, the depression accompanying this stage is so great as to occa-
sion the death of the patient in the first, second, or third chill.
  The duration of the  chill varies with the  character and severity of the
attack, and the resisting capability of the patient's constitution, and  is  fol-
lowed by the hot stage, in which those  symptoms are developed, which, taken
together,  are termed "fever."  These come on  gradually,_  the  breathing
becomes more natural, the blood returns to the veins and capillaries, as man-
ifested by the flushed cheeks, and the disappearance of the sunken and hol-
low expression of the  eyes and  countenance generally; the  surface  and
extremities become warm, and the heat continues to increase so as to impart
a sense of pungency when the attendant's hand is  applied to the surface, but
the skin remains dry.  Occasionally instances are  met with in which the hot
stage  is accompanied with profuse  perspiration.  The pulse  varies from sixty
to one hundred and twenty beats in a minute; it may be full and  bounding,
soft and compressible, hard and wiry, &c; the mind is more or less sprightly
and excited,  sometimes amounting  to  a  transient delirium; in  the  higher
grades of fever there will  be seen and felt a powerful pulsation of the arter-
ies along  the neck, (carotids,) with a determination to the brain,  a hot  and
painful sensation  in the head, restlessness, wakefulness,  delirium  or  a con-
stant  disposition to drowsiness.  Frequently, the senses of taste, smell, hear-
ing, and even feeling, become very obtuse.   Thirst is generally present,  and
when it is not, I look upon the disease with a degree of uneasiness, as I con-
sider  this symptom a favorable indication; the appetite, as well as the diges-
tive functions are impaired; the mouth is commonly dry and parched, some
times it remains moist; the tongue becomes of a deeper red than in the  pre-
vious stage of chill, and its surface is  at first coated with a thick, white,
clammy substance, which gradually  changes to a  yellowish-brown, or even
black; sometimes  the surface of the tongue,  as  well as its body, will be
unnaturally red, with a dry and parched condition of the mouth; the teeth,
not unfrequently,  are covered with a dark-colored  sordes; the urine is dimin-
ished in  quantity, high-colored, and of a peculiar  odor;  and the bowels are
generally constipated, though frequently they will be loose, approaching to
diarrhea.
   The fever, after a certain duration, gradually subsides, the patient becomes
easy and  free from suffering;  the  pulse becomes more natural,  the skin soft
and moist,  or, the perspiration may be copious;  the appetite  returns; the
urine becomes more abundant, and the functions of the various organs of the
body are  gradually renewed.  In intermittent fevers this last  stage may  con-
tinue for a definite number of hours, to be followed successively by the vari-
ous cold, hot and  sweating stages,  until a cure has been effected by medicinal
measures.  And, in other forms of fever, the  hot stage,  instead of terminat-
ing in the above condition,  may pass  into  a  state, known as the "typhoid
stage," and which is frequently, but incorrectly, considered to be  a  typhoid
fever.
   Causes.   There is no class of diseases, the nature  of which has given rise
to so  much speculation and hypothesis  as that of fevers.  And, notwithstand-
ing the untiring investigation of the most eminent men in the profession, for
several centuries past the true character of fever  still remains to be deter-
mined.   The exciting cause of this class of maladies has already been briefly
referred  to at the  commencement of this article.   The immediate cause may
require a few words of explanation.
   In a work like the present, any lengthy  remarks in relation to points of
discussion in the medical profession, would be entirely out  of place, for  such
matters should be laid only before medical  men for their investigation, and 
FEVEK.
175
 not before the people whc cannot be expected to bestow that rigid attention
 which such subjects require, and who, in fact, adapt  their ideas of medical
 matters  to  the prevailing hypotheses of  the profession.  I  will,  therefore,
 give, as  briefly as possible, my own view  of fever, leaving its correctness  ot
 incorrectness to be decided hereafter by careful examination.
   An opinion has lately gained ground that fever is a "healthy effort of na-
 ture" to remove from the system some deleterious agent, and for some  years
 I adopted the same view.  A mere superficial glance at the course and symp-
 toms of fever, would, undoubtedly,  lead one  to suppose that this idea was
 really correct, but on a closer and more careful inquiry, it will be  seen thai
 there is  no  foundation  for  it.  As  well  might we  call the  effort made  to
 remove a heavy load from one's back, or  the blow following  a deep insult, a
 healthy  effort of nature, as fever.   Nor can I conceive how any  abnormal
 action taking place in the system, can be regarded as a healthy effort, whether
 that action  be one of depression, or of excitation.  But I will not dwell upon
 this point.
   In the human system are manifested three actions, viz: vital action, chem-
 ical action,  and electrical action.   Vital action is an effect of that unknown
 agenoy by which  life is sustained,  and from which results mind, sensation,
 voluntary and involuntary motion, and reproduction; this action is  perfect
 only when  the chemical and electrical actions of the system are also perfect.
 It may be a separate and distinct action, or it may be  the result of a proper
 combination of the chemical and electrical actions of the constitution.  Chem-
 ical action is an effort of those laws which  give constitution, cohesion, den-
 sity, &c, to the various tissues of the system, and from  which results  heat,
 the property of being acted upon by external and internal agents,  powers of
 regeneration and decay, &c, and which, in the animal system, leads to disso-
 lution of all its parts when not preserved  in a proper  condition  by the vital
 action.   Electrical action is a result of, or is connected with  chemical action,
 in which, during the processes of composition and decomposition of the vari-
 ous animal  tissues, electricity is developed to be either retained in the system
 or set free,  and which in many of its actions  bears  a  close  analogy, almost
 amounting  to absolute  identity,  with vital action;  it,  likewise, frequently
 answers  as a substitute  for vital action, preserving health and life in instan-
 ces where this latter action is impaired.   There  is no doubt, in my mind,
 that it is also intimately connected with vital force,  but  of this we have  no
 positive  data.  Polarization of various organs, growth, &c, depend upon this
 action.  Health consists  of an  equilibrium or correct proportion of these
 several actions in the system, and when there is a derangement of this equi-
 librium,  or  a departure  from this proportion, disease or death ensues.
   Fever  is  a disease of the fluids of the system only,  which  may be caused
 by retention of those decomposed  and unhealthy particles which should  be
 eliminated through the various excretory organs of the body, or by the  pres-
 ence of foreign and  noxious matters circulating with  the fluids,  which have
 been introduced into  them,  either by  absorption, inhalation, or during the
 nutritive  process.   These  morbific agents, whatever  may be  their nature,
 produce a depressing influence upon  the vital force, which is  known as the
 first or cool  stage of fever; and the degree of this depression is proportioned
 to the malignancy or venomousness of its cause and  the capability  of resist-
 ing power of  the vital force.  All the various functions of the system, be-
come impaired or suspended, in proportion  to the depressing influences, and
when these  influences are very noxious, the patient usually dies in this stage.
   As the vital action of the system is depressed, the chemical action  pre-
ponderates,  and the various tissues  involved in this disease undergo chem- 
176
AMERICAN FAMILY  PHYSICIAN.
ical changes, according to the  reduction of their vital energy ;  the  blood,
nervous  system,  and brain,  more  especially suffer  from  these  changes.
Thus if there be, so  to speak, two degrees of depression, there will be a
subsequent chemical action of two degrees exerted upon those parts whose
vitality is reduced the most.  But  this chemical action, in the first place,
evolves heat and electricity, as we find to be the case with nearly all chem-
ical action ;  and the electricity being one of the best substitutes for vital
action with which we are acquainted, assists it in sustaining the brain and
nervous system from the more deadly influences of the chemical decompo-
sitions going on, and thus  preserves the system from immediate decay, un-
til the normal function of its various  organs are restored.
  In  the next place, the chemical action increases the amount of carbon or
other combustible elements in the blood,  to  be consumed  by the oxygen,
which consumption  contributes to augment the temperature of the body.
And from this action results fever,  and its various symptoms,  from which
the patient recovers more or less rapidly, according to the degree of perni-
cious influence  exerted upon the  system, the degree and kind >of chemical
action produced,  and the capability of the  vital force to resist  or subdue
this influence.
  The character of the poison circulating  in  the fluids  determines the
peculiarity of the fever;  thus, a poison which exerts a constant influence,
produces what is termed a "continued fever," and the less  constant the in
fluence the more marked will be those symptoms termed  " remittent, inter
mittent, or periodical."
  This is, in brief,  my own  view of fever.   The data  upon which it is
founded, as well as remarks bearing upon objections or  inquiries that may
be made in relation  thereto, would hardly interest the popular reader; but,
the physician who has kept himself posted up with the discoveries  in med-
ical science  to the present date, may perceive in this view, at least, an ap-
proach toward the truth, and  may by dint of a little reflection,  be enabled
to satisfactorily solve  the various  difficulties  which  may present  them-
selves on several points connected therewith.
  The prognosis of fevers  depends  upon  the symptoms  present.   When
they are complicated with other affections, they are more or less unfavora-
ble, according to the character and severity of the complication.  Conges-
tion  of internal organs is always dangerous according to its extensiveness.
When the symptoms of a fever are mild, the disease is more favorable than
when they are  severe.   When a fever  does not readily yield to treatment,
but runs into the stage of prostration, it is very unfavorable.   The more
distinct the remissions or intermissions,  the more favorable is  the prog-
nosis,  while  obscure or hardly appreciable  remissions  are  indicative of
danger.
  General Treatment  of Fevers.— In the treatment of all fevers the
most important indication, is  to restore the excretory organs, as the skin,
kidneys, and bowels, to a healthy condition, and for the production of which,
physicians have found two modes of medication more commonly  successful.
The  one is,  to  make use of those  means, which will arouse the various
excretory organs, to a  state of action,  as by  vomiting, purging, sweating,
&c;, and thus cause  the morbific agents to be eliminated  from the  system.
The other is to administer agents having a neutralizing influence upon the
morbid matter, as Sulphate of Quinia  in  intermittent, bilious, and typhoid
fevers, aided in most instances by medicines which allay nervous irritation,
and produce relaxation.  In  many cases, the action  of the latter  relaxing
agents alone  will overcome the fever, in consequence of their influence upon 
EMETICS—PU RG ATI VES.
177
ihte nervous system, producing in the excretory organs a condition favorable
to the removal of all unhealthy agents from the circulation.
   A few remarks relative to the first named method above referred to, may
not be inappropriate at this place.   In many instances, an emetic exhibited
at the onset of a fever, will break up the disease at once.  This  beneficial
result arises not so much from the cleansing of the  stomach thereby pro-
duced, as from the stimulating shock imparted to the whole system, which
arouses in the several organs a degree, of activity sufficient to enable them
at once to remove the unhealthy poisonous material.   It is more especially
in the early stage  of fever that emetics are found  the most useful; yet
when judiciously administered even in the advanced  stage, they  have fre-
quently  been followed by the most happy results.  It is very seldom, how-
ever, that our practitioners of the present day administer emetics in fever,
from the fact, that  recent  additions to the Materia  Medica and improve-
ments in treatment, have caused them to be nearly  set aside.  Still cases
are  occasionally met with, in which their exhibition  is demanded, as when
there are accumulations in the stomach and bowels, and when there is great
want of  nervous action.
   When an emetic is to be administered to  an adult, one of the following
compounds will  be found  to  act  promptly and without any unpleasant
consequences:—
   The Compound Powder of Lobelia,  of which the  dose is about half a
teaspoonful in a small quantity of infusion of Boneset, and it should be
repeated every fifteen minutes, for three or four times in succession, until
it has produced free emesis, or  given  a proper shock to the system.  Its
operation will be very much facilitated by causing the patient to drink freely
of a warm infusion of Boneset.  I consider  this preferable  to the Compound
Acetated Tincture  of  Bloodroot,  which is  used  by some  practitioners.
The dose of this  tincture is  a tablespoonful every  ten or fifteen minutes
until vomiting is produced:  A child six years  old may take  a teaspoonful
for a dose ; but for children I prefer the Compound Tincture of Lobelia as
an emetic.  To a child a year old,  the dose  is half a  teaspoonful in a table-
spoonful of warm water  and  molasses, and which  may be repeated every
ton or fifteen minutes, until it vomits.  A child from two to six months old
may take from half a teaspoonful to a teaspoonful for a dose; and one less
than two months old, from ten to twenty-five drops.
   Purgative  medicines are generally of the greatest  utility when given at
the commencement of fevers; occasionally they  are useful during the pro-
gress of the disease, but care should always be taken not to greatly prostrate
the system by too active cathartieising.  The beneficial  results obtained
from purgatives in febrile cases, are owing to a removal of morbid accumu-
lations  in the alimentary canal, as well as to their revulsive  influence,
from which the  functions of the liver, skin, and  kidneys are promoted ;
there being an intimate velation of action  existing  between these various
organs, by which the augmented or depressed action of one exerts a corres-
ponding  degree of action in  all the others, and through  them  upou  the
whole  system.
   Yet it must not be forgotten that while  the  poisonous matters causing
the fever remain in the system, no permanent good can be derived from pur-
gatives alone ; and,  in many instances, as in intermittent, bilious and
congestive forms of fever, even when the bowels are  torpid,  more  benefit
will be obtained from one or two doses of Sulphate  of Quinia or other indi-
cated remedy, than from the use of purgatives, whether exhibited only once
or for several days together.   Though, it may be proper to remark, that the 
178
AMERICAN FAMILY  PHYSICIAN.
Quinia is frequently apt to produce more decided and marked results, whea>
preceded by an alvine operation.   But in urgent and serious cases, it  ia
better to omit the purgative and exhibit the Quinia  at once, as much val-
uable time may be lost by waiting  for a catharsis.  The use of Sulphate  of
Quinia in fevers, originated with the late Dr. I. G. Jones of Columbus, who
had for years observed the malarial origin and periodic  character  of the
generality of fevers, and to whom, not only the profession, but mankind  at
large, are deeply indebted.
  There are some practitioners who discard the use  of purgatives not only
in the treatment of fevers, but in every other class of disease, and, as I
think, without any good  reasons for so doing; indeed, I have frequently
been called to patients previously attended by this class of physicians, who,
after  having suffered  severely from their  sickness,  without any tendency
toward  recovery, were  promptly  benefited  by the  administration of  a
cathartic.  And I have known similar results  to happen in the practice of
my medical friends, in numerous instances.  It is true that purgatives must
be exhibited with a proper care, adapting  their operation  to the strength
and condition of the patient, being  extremely  careful how we employ them
in diseases in which there is tendency to rapid dissolution with  excessive
prostration ; but, at the same time, it is equally true, that in active diseases,
as a general rule, these agents are  not only useful, but frequently indis-
pensable.  It is by no means an uncommon occurrence, to find that other
means which may have been  pursued in the  treatment of fever, produce
more  marked and prompt results  after  the action of a purgative dose of
medicine,  than before.   The  best  and most  successful physicians of the
present day, are found to  be those who do  not hesitate to prescribe cathar-
tics in all cases where they are indicated.
  In the early periods of fever, purgatives  may be administered every day,
or every two  or three days, if required ; but there is  no necessity for active
purgation after the evacuations of  the first day ; one or two moderate  dis-
charges on the subsequent occasions will be found sufficient.   And this  is
more especially necessary  in typhus and continued fever, when there are no
contra-indicating symptoms present.  In many cases  of fever, a cure can be
effected, without a particle  of cathartic medicine.   I am aware that some
practitioners treat their febrile patients with daily heroic doses of cathartic
medicine for some days in succession,  and  that the patients recover; but, I
likewise know that many patients  are lost by this  course of medication,
and, that among those who recover, many  are left with  some permanent
chronic-'affliction.  The scientific physician proceeds with care  and prudence,
in all cases husbanding the vital  force as  much as possible, and avoiding
the production of all unnecessary irritations either in the intestines  or else-
where ; the charlatan, (whether he have  a  diploma  or  not,) prescribes
indiscriminately and at random, expects to satisfy the patient  and friends
that he is really doing something by  his  active measures, and though  he
may effect some  good  in  a continued course  of practice, he  unfortunately
accomplishes a much  greater amount of evil.
   Among the  purgatives more commonly administered in fevers is the
Compound Powder of Jalap, known universally by the name of "Antibilious
Physic,"—the dose of it  is a drachm,  or a teaspoonful.  Many persons add
a small portion of some aromatic to it, for the purpose of preventing grip-
ing, which it sometimes causes.  Thus, a few grains of Ginger, Cloves, Cap-
sicum, or Peppermint, may be added to the  dose for  that purpose.  The
powder is usually added to boiling water, which, when cold, is well agitated,
and the whole  contents taken at a draught.  When not contra-indicated, it 
DIAPHORETICS.
179
 may be exhibited in cider, coffee, lemonade,  aromatic infusions, &c.   In
 febrile diseases, ten grains of Cream of Tartar  added to  the  dose, will fre-
 quently improve its  influence.   Weakly persons, females, and children, will
 take less for a  dose, according to their age, or  strength.
    Podophyllin is also frequently prescribed as a cathartic, either alone,  or
 combined with Leptandrin.  Its dose  for an adult, is, from one-eighth of a
 grain to a grain, (as its action is  more powerful on  some  persons than
 others ;) or, to each dose may be added half a grain or a grain of Leptand-
 rin, and if necessary, ten grains of Cream of Tartar.
    Diaphoretir or sudorific medicines are beneficial in the treatment of fevers,
 in which class of maladies, the functions of the skin are always more or less
 deranged.  The  greater part  of the effete matters found in  the system  is
 eliminated through  the skin  by sensible  or insensible perspiration.  The
 surface of the  skin itself  is very  extensive, and this covering bears a very
 intimate  relation to the several organs of the body, so  much so, that any
 derangement of its functions is certain to  be followed by impaired action of
 one or more internal organs.   Hence, if from a suspension  of the skin, the
 noxious substances causing and caused by fevers, and which  should be  re-
 moved through the  perspiratory vessels, are retained in  the circulation, we
 can readily perceive  the immense amount of injury thereby  effected, as well
 as the great advantages to be derived  from a restoration of these functions.
 Indeed, experience has proven that, the production of perspiration in febrile
 patients, is followed  by an abatement  of all the symptoms; and  physicians
 always prognosticate favorably in fevers, when  the  skin is found moist and
 soft, with a natural temperature,—and  unfavorably when this condition can-
 not be produced. •
    Diaphoretics  act not only by causing a determination  to the  surface,
 removing its constricted condition, promoting the healthy  action of the per-
 spiratory vessels, and thereby  causing an evacuation of poisonous matters
 through these vessels, but they, in consequence, lessen the great  irritability
 of the nervous system, producing relaxation of nervous and muscular action,
 thus  diminishing the excitement  or  exalted   condition  of the  heart and
 arteries.  It is much better and more scientific treatment, to  deplete through
 the perspiratory vessels  of the skin, than  by opening a vein with a lancet;
 tho former removes only  noxious substances and those of no farther use to
 the system, the  latter removes the very essence of'life, taking away the  good
 and the bad together, and producing an evil influence upon the nervous sys
 tern and brain, which is seldom permanently recovered from.
   Diaphoretics  are generally  tho  most  beneficial during the first days of
 fever,  though, it is always desirable  to maintain  a moderate degree of moist-
 ure throughout  the  whole  of the febrile stage.   But, in no  case of fever,  is
 violent, excessive sweating  admissible, for debility and death may be as cer-
 tainly caused  by an improper degree of  perspiratory action,  as  by undue ■
 venesection.
   The  means employed  for the purpose of restoring the functions of the
 skin are various, and are divided into external  and internal.   The external
 are, warm water, cold water, and the spirit vapor bath, or  such other  vapor
 bath as may be preferred.   The warm  water acts by relaxing the skin and
 removing its  constriction;  usually, some  alkali is added  to it,  in  suffi-
 cient quantity to form weak ley, as soda,  saleratus, wood  ashes, etc., and
 which  removes from  the surface, any viscid or sebaceous matter which  may
 aid in  obstructing the pores.  The whole surface of the body and limbs is to
 be bathed in this weak ley, which  may  be done by raising  the  bedclothes
and washing one side of the patient's surface from the neck  to the feet with 
180
AMERICAN FAMILY PHYSICIAN.
a sponge or flannel moistened  with the fluid, then after drying, the patient
must be turned, and the bathing repeated on the opposite side.  This bathing
should never be omitted in febrile  diseases, and may be repeated one, two,
three, or four  times  a day,  depending  upon the violence of the  heat, the
severity of the pain  in the  head, and the  degree  of dryness of  the skin.
Sometimes a small quantity of  alcohol or whisky is added to the ley, for the
purpose of increasing  its stimulant action.   The spirit vapor  bath, described
in part III., acts similarly;  the heat determines to the surface, relaxes the
constricted  condition of the  skin, restores  capillary  action, and,  aided by
warm diluents,  promotes free  perspiration.
  Among  the  internal means  are numerous agents, among which may be
named the  Diaphoretic Powder,  (Compound Powdlr  of Ipecacuanha and
Opium,) the Sudorific Tincture, (Compound Tincture of Virginia Snakeroot,)
Ipecacuanha, &c,  which are used either  alone, or  in connection  with a
free  use  of cold water internally, or various warm infusions, as of Catnip,
Sage, Balm, Spearmint, Pennyroyal, Crawley, &c.  For  the proper method of
administering these medicines, or their compounds, the reader is referred to
part  III.,  as well  as  to  the  various  forms of  disease  in which  they  are
recommended.
  Another very important class of agents in the treatment of fevers, is that
of diuretics.  The  functions  of the kidneys are generally impaired or sus-
pended, so  that the urine  is  very  scanty,  or altogether suppressed.  The
retention of those matters which should  be eliminated through the kidneys,
are of themselves sufficient  to produce death, as witnessed in cases of ischuria
renalis, in  which death has occurred in  from thirty-six to forty-eight hours
after the kidneys  have ceased to  eliminate urine.  And when the presence
of these urinary elements in the circulation is combined with the other mor-
bific  principles  causing the  disease, or produced by it, the serious consequen-
ces to the patient can  readily be  comprehended.  It is therefore  of much
consequence, to restore and  maintain, as much  as  possible,  the function of
the kidneys, if  for no other purpose than the  disengagement of the urinary
elements from the circulation.  It is frequently the case that febrile mala-
dies terminate favorably by a spontaneous urinary discharge;   in  which is
usually  found  other  elements  than those peculiar to healthy urine.  And
when the fever is not' cured by  a urinary evacuation,  we find, in most cases,
at least a diminution  of nervous, muscular, and arterial excitement.  The
peculiar diuretic agents to be administered, will be named in the treatment
for each form of fever.
  It  will be observed  under the treatment hereafter laid down for each form
of fever, that I prefer a combination of the two modes referred to above in
the first paragraph after  "General Treatment,"  which I have  found to
be more generally efficacious  than a rigid adherence to either one separately.
  Auxiliary Treatment.  During the treatment of  febrile diseases, it is
very  important  to relieve certain symptoms when they become painful, or of
a serious nature.  Thus, there may be a  very severe and distressing pain in
the head.   For  this, Mustard poultices should be applied to the  soles of  the
feet,  having first, in all  cases  where the condition of the patient will allow,
bathed the  feet  for fifteen or twenty minutes, in warm  ley water, and then
dried them.  In very  obstinate pain, a Mustard poultice may also be applied
to the back of the neck, and  even along  the whole course of the spinal col-
umn, permitting it to  remain until a redness of  the skin, but not blistering,
is produced, when,  if necessary, its situation may be  changed.   In children
under  three  years  of age, bruised Garlic or Onions may be substituted in
nearly all cases where Mustard  poultices  are reebmmended or indicated, and 
AUXILIARY  TREATMENT.
181
 in  many instances they will be found  to  answer a much better purpose.
 The head and temjJes may also  be bathed with cold water  or vinegar; or
 warm  water may be applied, evaporating  it by fanning the parts; or the
 Cooling  Lotion may be frequently applied to  the head on a compress of
 muslin  or  linen  cloth; using it cool or tepid, as found to be  the  most
 serviceable.
   When there is much pain in the stomach, or bowels, or when they are  swot
 ten, a fomentation  of bitter herbs, as Tansy, Hops, Boneset,  &c, steeped in
 equal  parts of vinegar  and  water, may  be  applied over the affected  part.
 as  hot as the patient can  bear,  and which should be changed  frequently,
 not allowing it to cool.  When this does  not answer, a Mustard poultice over
 the part, allowed to remain  until  considerable redness has been produced,
 followed by the above fomentation, will, in most  cases, afford relief.
   For nausea, or vomiting, an infusion of Spearmint, Peppermint, or  Horse-
 mint,  may be drank.  In some cases a solution  of  saleratus,  or bicarbonate
 of  soda, given in  tablespoonful  doses, and  repeated every fifteen  or thirty
 minutes, will be found effectual in allaying  the  difficulty.  An  infusion of
 powdered  oatmeal  browned like  coffee,  or of  parched corn, will frequently
 check vomiting.  Sometimes in addition  to the above means, it will become
 necessary to apply a Mustard poultice over the stomach.
   When there  is soreness of the  mouth,  or  throat, they may  be frequently
 washed or gargled with a decoction of equal  parts of Sage and  Hyssop, sweet-
 ened with Honey,  and a small proportion of Borax added;  or, a decoction of
 the Prim or Privet leaves may be used similarly with benefit.   In  some cases,
 the application of  Opodeldoc,  or common Hartshorn liniment, to the  throat,
 two or three times a day, followed  by a fomentation of Hops and Mullein
 leaves, will be found an excellent addition to the above measures.
   When there is gangrene or mortification of the inside of the mouth and face,
 as sometimes happens in scarlet fever, &c, and more especially in those cases
 where Mercury has been employed, the mouth should be frequently washed
 with yeast, and a poultice of Slippery Elm bark and Wild Indigo leaves kept
 in constant application.   Or, a wash may be advantageously used, composed
 of  a  strong  infusion of equal parts of  Golden  Seal, White  Oak bark, and
 Sumach  berries.
   For suppression of urine, a warm fomentation of Hops and Vinegar may be
 applied over the region of the bladder, and a strong infusion  of  the Marsh-
 mallow root two parts, Spearmint  one part, should be drank freely.  Among
 children, bruised Garlics or Onions, will be found more efficacious than the
 above  named fomentation.
  For troublesome cough, a decoction  of Hoarhound  and Pleurisy root, equal
 parts, sweetened with Honey,  may be given.  In cases where there is much
 mucus or phlegm, the Compound Tincture of Lobelia may be administered.
 When there is  much fever, with a scanty discharge of urine, and a  cough
 accompanying, equal parts  of Lemon juice, Sweet Spirits of  Nitre, Honey.
 and Sweet Oil, will prove  very efficacious, in doses  of a.teaspoonful several
 times a day.
  When  there is great debility, prostration of strength, pulse low, or weak and
rapid,  Wine, pure, or in the form of sling, or whey, Brandy, &c, should be
promptly given.  In the continued forms of fever, or in typhoid  conditions,
when in  the latter  stage there is low  delirium,  the patient  being  hardly
aroused by shaking and loud calling, with rapid, fluttering, but weak pulse,
twitching of the tendons and cold extremities, in  addition to the internal
use of stimulants, external  measures must be promptly pursued.  Mustard
poultices must be applied to  the legs, from  the  knees  to the feet, and the 
182
AMERICAN  FAMILY PHYSICIAN.
parts should he surrounded by hot bricks, rocks, or bottles of hot water, and
which must be persevered in until  reaction comes  on^  If these cannot be
readily obtained,  cloths wet with warm water, in which  considerable salt has
been dissolved, will be found an excellent substitute;  they should be renewed
every hour or two.   At the same time, cooling  applications must be made to
the head, and, if necessary, the hair must be removed with the scissors.
  The Saturated Tincture  of Prickly-Ash berries, will, in the form of an
injection, be  found a very useful stimulant to  the  whole system; for an
adult, a tablespoonful of the Tincture, may be  added to an equal  quantity
of Ale, Porter, Brandy and water, or mutton tea, &c,  and given as an in-
jection,—if the  patient cannot retain  it,  the  nurse or  some assistant, by
pressing against the anus with a compress of folded  muslin, will be able to
detain it in the bowel for any length of time.  This  injection should be
repeated every half-hour, or hour,  according to  the exigencies  of the case.
  When diarrhea  comes on with the sinking stage, Opium or Laudanum
may be administered in proper doses, with the Wine, or Brandy exhibited to
the patient.   An  infusion of White  Oak bark drank freely, bathing the sur-
face often  with it, will likewise  be found very useful in all cases of fever
accompanied with diarrhea.  Ten  drops of the  Tincture of Muriate of Iron
in a wineglass half  full of water, is also useful  in this kind of diarrhea.
  When putrid symptoms manifest themselves, a mixture of Sweet Oil and
Yeast, equal parts of each, may be administered in tablespoonful doses,  sev-
eral times a day.  Or, Charcoal may be given in an infusion made by steep-
ing three ounces of Elm bark, and half an ounce of Wild Indigo root, in four
pints of water; of  this, one fluidounce is a dose, to  which a  teaspoonful of
the Charcoal may be added.
  The condition of the tongue, must be particularly observed.   In  the  first
stage of chill,  or depression, it will generally  be found pale and moist; when
the  fever commences, there  will  be  more or  less of a white coat upon its
upper surface, which is sometimes  complicated  with other appearances.   As
a general rule, the following indications will be found correct:—
  1.  A white fur,  body of the tongue pale, indicates a mild degree of fever,
and particularly if moist.
  2.  White fur, sides of the  tongue red, indicates  inflammation of some
portion of the alimentary canal, more commonly the stomach.   If the tongue
be dry, the inflammation will be more intense.  In  this case, Mustard poul-
tices should be applied over the region of the stomach and abdomen, followed
by fomentations and frequent bathings of the  body.  Cold  water  may be
drank freely,or an infusion of Slippery Elm bark and Peach leaves; the Tinc-
ture of Gelseminum, Aconite, &c, may also be exhibited as hereafter laid down.
  3.  White fur, sides of tongue  slightly red,  febrile pulse, with chills and
intermissions,  not amounting, however, to a positive intermittent fever, indi-
cates great torpor of the biliary organs, with  a  disposition to  active inflam-
mation  of  some  portion of  the alimentary  canal, and the disease is apt to
prove tedious and  troublesome.   Emetics  are  useful in this case.  But the
difficulty may also be overcome by  doses of Quinia and Gelseminum, without
emesis.
  4.  A white fur,  with a circular or oval portion of the center of the tongue
red, and sometimes its edges and inferior surface, indicates inflammation of
the stomach and  spleen,  in proportion  to the redness manifested.  Treat-
ment as above in No. 3.
  5.  The upper surface of the tongue white, with the exception of its cen-
tral portion, especially toward the  root, which  is covered with a brown or
yellow fur,  pulse small and quick, indicates a disposition to debility,  or  a 
TONGUE IN  FEVER.                      183
typhoid  state.   Bitter tonics and  stimulants are to be preferred, and occa-
sionally  saline laxatives, as Seidlitz water.  This appearance  is sometimes
met with in patients who have a tedious convalescence,  though the tongue
will be more natural.
   In the last stage of fever, when the liver has  been aroused to action,  the
fur on the tongue gradually becomes brown or even black,  or  it assumes a
red  appearance.   If it be permanently coated brown  or  dark, unlike many
physicians,  I pronounce my patients safe—though it may be proper to state
that if, in this condition, cold water or acid drinks be not craved,   the case
is a serious one, indicating a great loss of  vital force.  When these are craved
I permit my patients to use them freely, as tamarind  water, lemonade, orange-
juice, lime-juice, eider,  and even vinegar.  As soon as the  tongue  loses  its
dark cr at,  and assumes the white,  acids  must be  omitted, and  if convales-
cence ensues, mild bitter tonics should be exhibited.  The  acids neutralize
the acrid alkaline quality of the matters   first secreted, as the biliary and
digestive organs recover their functions.
   When the tongue is red, moist, and  presenting an appearance of rawness
on its surface,  it is indicative of inflammation of the mucous coat  of some
 part of the  alimentary canal;  when red, dry, and chapped, the inflammation
 is intense, with perhaps ulceration, or a disposition thereto.  Aphthous ulcer-
 ations of the tongue, mouth, and lips, on  the subsidence of the inflammatory
symptoms, indicate a fatal termination.
   I have often had  patients in the last stage of fever,  when their  tongues
were coated very dark, who, when asked if they preferred to drink lemonade,
or cider, &c, would  quickly brighten up, and  eagerly exclaim, "Yes, yes,
 but I would not ask for it, Doctor,  expecting you  would not allow me to
have it."  And how truly thankful were they for a beneficial medical agent,
to which they were irresistibly prompted by the  natural demands of the sys-
tem.   I  am aware that many authors recommend acid drinks in febrile dis-
eases; not, however, as a remedial agent,  but as a  harmless, pleasant, and
grateful  beverage, and principally from the fact  that patients almost invaria-
bly  crave  such drinks; I believe,  however,  it has never heretofore been
;;dvised upon the above grounds.  It is during this stage that death  so often
results in that practice which has debilitated the system by  excessive bleed-
ings, and which forbids the use of water or acids when they  are imperatively
required, thus surely rendering fatal, a disease which could have been  brought
to a successful termination by proper management.
   The incessant and earnest entreaties of  a patient, for any particular article
of food or drink, if steadily persevered in, may, as a  general  rule,  be safely
indulged, whether the use of it agrees or not with our preconceived ideas  on
the subject.  It has frequently been the case that  much benefit has ensued,
by allowing the use of articles excessively  craved, even though they seemed
to be improper.   Some judgment, however, is required,  as  it would be ex-
ti'cmely injudicious to indulge a merely capricious  appetite.
   The sick room should always be kept well ventilated,  as  fresh  air is  an
important remedial agent in all forms of disease, and especially in those of a
febrile character; it exerts a salutary influence upon  the lungs,  and  through
them upon the whole system.   In many diseases it  will  be  necessary to
cleanse the atmosphere of the room by one of the disinfecting agents named
on page  137.  The clothing should also  be kept clean,  and changed every
three or  four days, or oftener if necessary.   At first,  the diet should  be light,
as barley-water, Indian meal gruel, toast-water, arrowroot,  apple-sauce, prune
tea, orangevjuice, buttermilk, &c, regulating the  latter by the fur on  the
tongue;  and as convalescence advances, beef tea  chicken tea, &c,  maybe 
184                AMERICAN  FAMILY PHYSICIAN.
allowed, with wine, or other stimulants, when much debility is present.  The
patient should not be allowed to eat any solid food, it is not  only injurious
but is frequently dangerous.  Solid food is not required in febrile diseases,
as a general rule.   There are many ignorant persons, however, who judge of
a patient's improvement entirely by his ability to eat, whether with or with-
out an appetite; their constant aim is to have  him eat, eat, eat, and their
greatest anxiety is expressed to the physician  in one continued series of
questions, the beginning, middle, and end of which, is, "Doctor,  what may
the sick person eat?"  Get rid of such well-meaning but ignorant persons as
speedily as possible.
  A good nurse should  always  be  procured, if possible,  for more depends
upon such  an one than upon the physician.   The  nurse  should not fail to
carry out all the directions of the physician, for if he be worthy of the confi-
dence of the patient and friends,  his treatment should be  punctually and
faithfully pursued by the nurse; if he be unworthy, it is to be  supposed he
would not have been employed.  Much mischief has been done by ignorant,,
careless, or self-wise nurses  in neglecting the directions of the medical attend-
ant.   Too much care cannot be employed in the selection of a nurse.  In
addition, the nurse should attend to all the wants of the patient, as to food,
drink, changing linen and bed-clothes, bathing, ventilating the room, pre-
venting loud talking, and especially of any conversation tending  to destroy
the patient's confidence in the physician ; a nurse who- interferes with a phy-
sician, by speaking disparagingly of him, or by recommending another, is
an unsafe and mischievous attendant upon the sick, and should be at once-
dismissed.   And persons who enter the sick chamber to find  fault with the
treatment, or to recommend patent medicines,  or their  favorite physicians,
&c, should,, as soon as known, not be again allowed to enter it.  Conduct of
this kind has not only, in many instances, unjustly injured the reputation of
the medical attendant,  but has as frequently  effected great mischief to the
patient.  Such  persons are  to be avoided as one would a rabid animal.
  During convalescence from  all  exhausting diseases, much care must be
taken, not only in the diet, but also in the exposure and exercise.  From
the debilitated condition of the digestive powers at this stage, and indeed of
the system generally, a  great amount of food or exercise  would be exceed-
ingly improper; and an inattention to these points has frequently occasioned
death.   Every means should  be taken  to guard against  a relapse,  and to
gradually impart strength to the invalid, by a judicious course of diet and
exercise.
   Having  thus laid down in general terms the course which may  be suc-
cessfully pursued in  the treatment of Fevers, I  will now proceed to treat ot
each form of fever specially, making known  that selection from the above
course,  which  experience has demonstrated to be the safest and  most suc-
cessful.  But before entering upon the subject,  I would observe to the gen-
eral reader, that although the means indicated will  be found valuable,  still
under no consideration  should a person neglect to procure the services of a
skilful and»properly educated physician, in  all  cases where such can be
had.  But when he is at some  distance, or cannot be in immediate attend-
ance and  the case requires treatment,  the course  herein  laid down will be
found efficacious, and may be  persevered in until the arrival of the physi-
cian,  or until the patient  is cured, provided a practitioner cannot be ob-
tained.   I  may  here  remark  that one  reason  for the fatality  attending
acute disease in country places, is the tardiness in sending for  the  physi-
cian.   If the farmer or his hands are engaged  in labor, the patient, no
matter  what may  be the nature of his disease, is permitted to lie in hia 
INTERMITTENT FEVER.
185
room until the labors of the day are finished, when some oner is despatched
for the doctor, who arrives in many instances in time to  learn that the fa-
vorable  period for relieving or curing  the patient'has passed; he  does the
best  he  can, but his patient dies, not because of his unskilfulness, but be-
cause of the neglect of the farmer or his family.   This  custom is a cruel
one for  the patient, and an unjust one  for the physician.   Whenever there
is  a patient requiring the services of a medical man, send for him  at once,
no matter what other considerations may present themselves.  Let all per-
sons living in  the country, impress this subject firmly upon their minds;  it
will, if acted upon, prove a saving of health, life, and money.
           INTEBMITTENT  FEVEB.  (Febris Intermittens.)

   Intermittent fever, also  known  by the names of fever and ague, chill and
fever, &c, is characterized by  several distinct  paroxysms of fever, which
recur at regular  periods, having a perfect intermission between each, and
during which the patient enjoys apparent good health.   When the parox-
ysms occur at the same period of time every day, or every twenty-four hours,
the fever is called quotidian, or every day fever; when they occur regularly
on every other day, or every forty-eight hours, it is called a tertian; and
when  they occur every third day,  or every seventy-two hours, the interve-
ning days being free from any symptoms of the disease, it is called a Quar-
tan.  These are  the most  common or regular types of  intermittent fever;
but it sometimes  happens that other types, called irregular, are manifested.
Thus, there may  be two paroxysms a day, which is termed double quotidian,
and in which although one may be removed, the other will continue unless
it be treated independent of the previous associated paroxysms.   There may
likewise be a double  tertian, in which there are two paroxysms on alternate
days most generally  occurring,  however,  at different hours, with  a complete
intermission of one  day.   Usually, the attacks vary, one  being  less severe
than the other, and, like the double quotidian, while the one tertian is cured,
the other may continue unless  it receive exclusive treatment.  A triple ter-
tian sometimes occurs, having two paroxysms on one day, and one on the
next.  A double quartan, as well as a triple quartan, may also occur, but it is
unnecessary to enter into a minute description of their peculiarities.
   There are several other varieties  of intermittent  mentioned, and which
are occasionally  met with.   The  above forms of types  of  fever and ague
frequently change into  one another, so  that the tertian and  quartan may
become quotidian, while quotidian  are liable to be converted into  remittents,
or even continued fevers.  Intermittent  fevers occurring in the  spring, are
called  vernal, and the attack frequently disappears as  summer advances.
Those which take place  in autumn, are  called autumnal, and are  usually
more severe and  obstinate, being often complicated with chronic affections
of the abdominal viscera.  In warm  climates especially, they are very ob
stinate, frequently  resisting every  mode of cure, and degenerating into
chronic affections of the spleen, liver, dropsy, &c.  Each paroxysm of in-
termittent fever  consists of  three stages,  viz.  the add, hot, and sweating,
which run their course in this  order of succession, generally, in the space
of from three to eight hours.
  Symptoms.   The cold stage commences with languor,  a sense of debility,
yawning, and stretching, and  an aversion  to food and  exercise; the face and
extremities become pale; the skin over the whole body seems constricted,
as if cold had been applied to it, and resembles the skin of a picked goose, 
1«6
AMERICAN FAMILY  PHYSICIAN.
and is hence termed cutis anserina.  The nails become purple, the lips blue,
the countenance  assumes a shrivelled  appearance, and the teeth chatter.
Finally, severe chills with shivering,  or  a universal shaking,  come on,
which are very distressing, and are accompanied by dull  pains in  several
parts  of the system, and sometimes by nausea and vomiting.   The pulse is
small, frequent, and irregular; respiration short, rapid, and laborious; the
mind  is irritable,  unsteady, confused, and  sometimes there will be complete
stupor;  the urine is copious  and colorless;  the tongue pale, with,  more
commonly, a white fur; and  the mouth is  dry and  clammy, with  great
thirst.  These symptoms vary in different individuals, being almost imper-
ceptible in  some,  and very severe  in others, especially in the old and debili-
tated, and  those  who  have impaired   their  constitutions  by  dissipation.
After a  longer or  shorter time,  the chills abate, and the hot stage com-
mences.
  In  the hot stage, there is a gradual return to  warmth, at first manifested
by slight flashes of heat, but which soon become steady and intense.  The
skin becomes warm, smooth, red, and  dry, and very sensitive; the heat of
the body increases  considerably above  the natural standard,  sometimes to
110°  Fahrenheit.   The  pulse becomes more regular, quick, strong, and
hard; respiration  hurried, but more free and regular; pain in the head
increases, with more or less throbbing of the  temples; if the  attack has
been severe, delirium  maybe present; the  urine is  scanty and  high-col-
ored ; the tongue more natural in  appearance, with a white or brownish fur,
and is sometimes  red, dry and cracked; the mouth is  dry and husky, and
there  is still considerable thirst.  Sometimes diarrhea, or obstinate consti-
pation will be  present, and  children are frequently attacked with convul-
sions.  Generally, there  is more or less severe pain in the limbs and back.
After a certain time, varying with individuals,  these symptoms  gradually
subside, and the sweating stage comes on.
  In  the sweating stage the  skin  gradually recovers its natural condition,
becoming soft and cool;  a moisture breaks out upon the forehead and neck,
which by degrees  becomes a more or less  profuse sweat, and  extends over
the whole body.   The heat of  the  body descends to its usual standard, the
pulse abates in frequency, and is  less full  and hard; respiration is free and
full;  the  various  pains in the  system  disappear,  the urine deposits  a
reddish sediment; the  tongue becomes  moist and natural, with  but little
thirst, and  most of the functions return to their ordinary state; all febrile
symptoms  disappearing, and  leaving  the patient in a weak and wearied
condition.   After a specific interval, according  to the type of the fever,
the paroxysms return, commencing with the chill, and passing through the
hot and sweating  stages.
  When the paroxysms are  of short duration, regular in their  occurrence,
leaving the  intervals  quite  free,  we  may expect a  speedy recovery; but
when they are long-continued, violent, and  attended with much anxiety
and delirium,  the termination  is apt to be  fatal.
  Ague sometimes presents  itself in a form  known by the various names
of sun-pain, masked ague, dumb-ague,  &c.   There is a  severe  pain  in one
side of the head,  or extending over the whole of it, with an excited condi-
tion  of the arteries of the neck, and which is not  only periodic  in  its
attacks, but is  frequently preceded by slight chills, or sensation of cold,
with more or less depression of spirits.  Sometimes the pain will be in the
face,  in one or more teeth, in  the chest, stomach, womb, or any other part
of the body, and  may be determined by its periodicity, slight chills, &c.
  Causes.—In consequence  of the prevalence  of this fever in  marshy 
INTERMITTENT  FEVER.
187
countries, it is generally attributed to  marsh effluvia, under  the name of
" malaria," but what the character of this malaria is, remains yet undeter-
mined, though both heat and moisture seem to  be required for its produc-
tion.  Some eminent medical men  believe it to be a species of microscopic
aniinalcuke, the result of vegetable decomposition; while others consider
it to be owing to the presence of innumerable swarms of spores from micro-
scopic cryptogamous growths of a poisonous nature, being the offspring of
vegetable decay.  The summer of 1854  was a  very hot and dry one, so
much so  that many  ponds and  marshes were completely  dried, exposing
surfaces of soil favorable  to cryptogamous growths; this was followed by
the summer of 1855, sickly throughout the whole country with the higher
grades of epidemic forms of  disease, and which was hot and wet, favorable
to the development and maturity of the above growths.   During  the rains
of the latter part of the summer of 1855, as well as in the early part of the
fall, almost invariably after each rain  occurring in the  night, a green sub-
stance was found covering the earth next morning; some of this I exam-
ined under the microscope, and found it to consist of microscopic vegeta-
tion and spores.  On placing some of  it in cold  rain-water, which had been
previously boiled and  filtered, in two days' time the water  was filled with
monadal infusoria.  Whether such a  condition  of the  atmosphere would
produce  disease or not, I am not prepared to say, though I believe it will,
and on this belief, as my friends well recollect, I predicted a sickly season,
and which, as is well known,  was fully verified.   An objection was made to
my view, that  similar products have  been collected and  taken into the
stomach  without any deleterious influences ;  this may be true, but I con-
ceive that their inhalation into the lungs, and  not their  digestion in the
stomach, constitutes the mischief.
  Persons living  in malarial  districts, whose systems are debilitated, who
make use of a poor  diet, who  live in damp houses,  and  are exposed to
dampness and night air, who  exercise to  fatigue, who sit up late at nights,
and who are under the influence of depressing  circumstances of whatever
character, are much more subject to attacks of intermittent fever, and of a
6evere form,  than those who are placed  under  influences  of an opposite
nature.   Individuals  addicted  to intemperance in spirituous liquors, are
particularly liable to the severer forms  of this disease.
  The most common consequences  of this  disease,  especially when  its
attacks have been frequent, or long-continued, and also when it has been
improperly  treated,  are enlargements of the liver, or  spleen, jaundice,
dropsy, dyspepsia, diarrhea, dysentery, induration of the pancreas,  discol-
oration of the skin, impotency,  general debility, &c.
  Under ordinary circumstances,  the prognosis  of intermittent fever is
favorable ; but it becomes less  so when complicated with other difficulties,
as great  congestion  of the internal organs, nervous prostration,  inflamma-
tory conditions, &c.   The more severe and  obstinate the  symptoms,  the
more difficult, as a general rule, will be the cure.
  Treatment.—The indications in the treatment of intermittent  fever,
are : 1st. To shorten  each stage of the paroxysm as much  as possible, and
render the intermission  perfect, by which means the disease is  not only
rendered milder,  but is frequently broken up at once.  2d. Give remedies
through  the intermission,  which will prevent a return of the paroxysm.
  In the cold stage,  or just before its commencement, the patient should be
placed in bed and warmly covered, and hot bricks, or bottles of hot water
placed to his feet, thighs,  sides and armpits, being careful, however, not to
injure  the skin by  too great a  heat.   In  addition to  this, he should  be 
188
AMERICAN  FAMILY  PHYSICIAN.
urged to drink freely of warm drinks, as an infusion of Boneset, Virginia
Snakeroot, or Catnip, to a teacupful of which, in violent cases, a teaspoonful
or two of the Compound Tincture of Virginia Snakeroot  may  be  added.
Bleeding in  this, or any stage of the  disease, should  never,  under any
circumstances, be permitted.   When the symptoms are very violent, with
great heat in the head, severe pain in the back, and a tendency to delirium,
or coma, more energetic  measures should be  adopted.  Stimulating lini-
ments should  be applied to the feet  and legs with  considerable friction,
cold water should be applied to the head, or some other cooling lotion, and
a  Mustard poultice should be  applied along the whole length of the back-
bone, or spinal column.
   Sometimes it will prove highly beneficial  to administer  an emetic just
before the fit  is expected,  as  it often prevents  the paroxysm, frequently
breaking up the disease at  once.   The  Compound Powder of  Lobelia,  is
the  emetic  I  should  prefer,  (See  Pharmacy.)   After  the vomiting has
ceased, it will occasionally be found advisable to follow with a full dose of the
Compound Powder of Jalap,  or other  Cathartic, which will prevent the
liver and spleen  from becoming tumefied, which is often the case in  violent
intermittents, which will likewise prepare the system, and  render it more
susceptible to the influences of other remedies. Should it be deemed inju-
dicious from any cause to administer  an emetic, it may be  dispensed with,
and the  purgative only given.  However, these  active agents  are  seldom
required, except in the more severe attacks.  When there is a torpid condi-
tion of the  liver, Podophyllin and  Leptandrin may be given in doses  of
from one-eighth  to one-fourth of a grain of the former, to one grain of the
latter for a dose, and which may be repeated for several evenings in succes-
sion ; the dose should  be so proportioned as to produce a moderate laxa-
tive effect daily,  and not an active purgation.
   Sometimes it happens that the disease assumes a malignant or congestive
form; the cold stage  is very much lengthened, and  there  is great  pain in
the head, a  feeble pulse, vertigo, a sense of weight  and oppression of the
chest, with other symptoms indicating a highly congested condition at the
abdominal organs.  The hot stage comes on slowly, and is imperfect, the
pulse being  frequent, small, and tense,  the  countenance anxious, the skin
hardly warm, perhaps an internal heat complained of, and little or no thirst.
The perspiration in the sweating stage  is copious and fetid, with perhaps
colliquative  hemorrhages from various  parts of  the body,  &c.   Death
usually happens during  the cold  stage, and  more commonly in the third
paroxysm.  In  the treatment of this  form, the most active  measures must
be employed to determine the circulation to the  surface, and thus relieve
the congested organs; for this purpose, the body and limbs should be well
rubbed with stimulating washes or liniments,  and exposed  to the action of
confined steam,  by placing hot rocks enveloped in moist cloths  around  the
whole body; friction to the surface should not be suspended until reaction
ensues,  and the symptoms improve.   Internally,  the  following must be
given,  and  continued until  the  peculiar  effects of the Gelseminum  are
induced, which may be known by the patient's inability to  raise his eyelids,
although perfectly conscious of  all  around  him.  Take  of  Sulphate of
Quinia  one drachm,  Elixir Vitriol three fluidrachms, Tincture of Gelse-
minum seven fluidrachms; mix together.   The dose is a teaspoonful every
fifteen  or twenty minutes, in  a small  quantity of some warm tea,  or infu-
sion of Capsicum.   In addition to this, catharsis should be induced if pos-
sible, by active purgative injections,  and by  Podophyllin  administered
internally, in one or two grain doses, and repeated as required.   In describ- 
INTERMITTENT FEVER.
189
ing the symptoms of congestive chill, a writer observes, " it commences with
a sensation of languor, weariness,  disinclination to exercise, and a want of
appetite.   The chill  comes on with a shrunken condition of the  extremi-
ties, and  is not always clearly felt by the patient, and is followed by parox-
ysms of fever of greater or less intensity, with a yellowness of  the surface,
and of the  conjunctiva.   Not  unfrequently  the  patient may be able  to
move about  for  some days,  but eventually  becomes prostrated by  an
increase in the severity of all the symptoms.   The stomach becomes greatly
irritated, the bowels very torpid, being  scarcely acted  upon by  the more
energetic purgatives.  The  cold stage frequently continues for five or  six
hours, during which, the patient suffers excessively from the irritable con-
dition of the stomach, which obstinately resists all medication for its relief.
The tongue varies in its appearance,  being coated from a pale-brown  to
black, but commonly moist; the pulse is thread-like,  weak, and but little
increased in frequency above natural.  Usually, the attacks manifest them-
selves every other day with  great severity, a light  chill being experienced,
however, every day.  A  sensation of acute  burning is frequently felt  by
the patient, who will desire  to be placed where he may have the cool air to
pass over him, and this will  be the case when  the parts in which the burn-
ing is felt, are very  much below  the  ordinary temperature of the  body;
which  will  also  be  the  case with  the  surface  of the limbs and body
generally."
   During the liot stage, I am in  the  habit of  administering  the  following
preparation.   Take of Sulphate of Quinia  twenty grains,  Elixir Vitriol
one fluidrachm,  Tincture of Black  Cohosh root, and Tincture of Gelsemi-
num, each, seven fluidrachms;  mix.   The  dose  is from  twenty to  thirty
drops in  a tablespoonful of water  every half hour.   If this  cannot  be
obtained, the patient may be bathed  with weak tepid ley water, and may
drink  cold  lemonade,  currant jelly  water,  apple water,  or even cold
water, if he desires it.  Should  there  be pain in  the  stomach or bowels,
with nausea or vomiting, Mustard poultices may be applied  over the pain-
ful region,  and the  following may be given  every fifteen minutes, in a
little Peppermint water:—Take of Powdered Bhubarb fifteen  grains, Sal-
eratus  seven  grains, Sulphate  of Morphia  one-twentieth of a  grain; mix
well together, for a dose.   Should there be great pain  in  the head,  the
pulse being hard, full, and  rapid,  Mustard should  be applied  to  the feet,
and along the whole course  of the spinal column, and a  dose of some
active purgative exhibited, as the Compound Powder of Jalap ;  cold appli-
cations should likewise be made  to the head.
   In the sweating stage, but  little treatment is  required, except  to keep the
patient quiet, and not adopt measures to check the perspiration.   In both
the hot and sweating stages, it will be  better to  keep  the patient in bed,
with some light covering over him.
   During the intermission, means must be used to fulfil the second indica-
tion, viz: to prevent a return  of the paroxysm,  for  which there  is  no
remedy equal to Peruvian bark, or its alkaloid salt, the Sulphate of Quinia.
In many sections of country there is a decided aversion among the people
to the use of Quinia, because they say  it injures the  system, producing
ague-cake, dropsy, &c.  .But this is an erroneous idea, for these diseases are
the legitimate consequences  of the chills and  fever; and when they occur
after the  use of Quinia,  it is either because the  attack was a very violent
one, or because the remedy was not given in a proper manner to  overcome
the disease.   But it must be remembered, that" persons living in a malari-
ous district, exposed to all its influences on the system, and  suffering from 
190
AMERICAN FAMILY  PHYSICIAN.
 repeated attacks of chills and fever, will  necessarily become affected  with
 the above diseases, no matter what may have been the remedies employed.
 Beside  it is undoubtedly true that Sulphate of Quinia has been frequently
 adulterated with arsenic,  and other agents, but this should only render us
 more cautious  of  whom we  purchase our medicine, and not cause  us to
 speak disparagingly of the genuine, unadulterated article.
   Many preparations have been found successful in preventing  the return
 of the paroxysm, among which I will name the following as the best  with
 which I am acquainted.
   1.  Take of Sulphate of  Quinia  twenty  grains,  Elixir Vitriol  one
 fluidrachm, mix, and dissolve the Quinia,  and then add Tincture of Black
 Cohosh  root fourteen fluidrachms.  I use this preparation more frequently
 than  any other in  the treatment of fever  and ague, and it is seldom  that
 more  than  one chill is  experienced after  having  commenced its use.  The
 dose is twenty drops in  a  little  water, to be repeated every hour.   Should
 the bowels be costive, and the tongue furred white, a combination of Rhu-
 barb two parts, and Saleratus one part, may be  given in dose's of five or ten
 grains, or sufficient to produce  one or  two moderate evacuations from the
 bowels daily, and which dose  must be repeated three times a day.
  2."  Take of Sulphate of Quinia, and Prussiate of Iron, each, three grains;
 mix, for a dose; to be repeated every two hours.—/.  G. Jones, M. D.
  3.  Take of Extract of Stramonium one grain, Capsicum one grain, Sul-
 phate of Quinia eight grains  ; rub  well together, and divide into four doses,
 one of which is to be taken every hour, commencing four hours before the
 expected chill.
  4.  Extract of Stramonium one grain,  Sulphate of Morphia one grain,
 Sulphate of Quinia eight  grains; rub well together,  and divide into foui
 doses.  To be taken as  the preceding in cases where there is much pain in
 the stomach, and nausea or vomiting.
  5.  I have never used the following preparation, though I have seen it
 used in  domestic practice and with the most successful results.  Take  one
 Nutmeg and burn  or char it over a flame;  pulverize it.  then add to it an
 equal quantity by weight of dried or burnt Alum, and divide the mixture into
 three  powders.   First purge the  bowels,  and then  administer one powder
 every time the chill comes on; frequently, the first dose will effect the cure
 and it is very seldom that the three doses will be required for that purpose.
  6.  Take of Valerianate of Quinia four  grains,  Prussiate of Iron  six
grains, Alcoholic extract of Black  Cohosh a sufficient quantity to form the
whole into  a pill mass.  Divide into four pills, of which one is to be  given
every hour, in cases  where there  is excessive  irritability of the  nervous
system,  commencing four hours previous to the  anticipated chill.
  Various other agents have been recommended in the cure of this  disease.
as Cornine, Salicin, Bebeerine, &c, they may occasionally be useful, but are
inferior  to  the preparations given  above.   Common spider web one grain,
mixed with Extract of Stramonium one-eighth of a grain, and  made into
a pill  for a dose, has  been found successful in many instances; the dose is
to be  repeated every hour or two during the intermission.  Of course, if a
person is residing  in a malarial distrie't, constantly exposed to the causes
which occasion chills and fever,  he  cannot  expect any medicine to  perma-
nently screen  him from  its  attacks,  the  only certain preventive, is an
immediate  removal to  a  more  healthy neighborhood.   One  may cure a
burn,  but this will not prevent the person from being burned again whenever
exposed to  the action  of fire ; and so it is with chills and fever, a cure  can
be made, but as long as the person is influenced by the  originating causes 
REMITTENT FEVER.
193
of the disease, so long will he be subject to its attacks.   After an  attack  of
intermittent fever has been cured, in order to prevent a return  during that
season, it will be a safe, proper, and prudent course  to take some  vegeta-
ble  Tonic Mixture, and continue its use for several weeks; the  following
will be found an excellent preparation for this  purpose :—Take of Poplar
bark, Dogwood bark, Wild Cherry bark, Ginseng root, each, in coarse pow-
der, half an ounce ; Peruvian bark, Plantain root, of each,  in  powder, one
ounce; Capsicum, Cloves, Cinnamon, of each, two drachms, good Whisky
three pints.   Mix all together and let them stand for several  days before
using.  The  dose is from a table-spoonful to  half a wineglassful  three
times a  day,  previous to  each  meal.  In "sunpain,"  'masked  ague," or
"dumb ague," a similar treatment is to be  pursued.   Cleanse the bowels by
a moderate catharsis,  and  then  administer  the  preparation  of Sulphate of
Quinia, and Saturated Tincture of Black Cohosh root, above-named in form-
ula, No. 1.
  Persons  subject to fever and ague,  especially those residing in  situations
in which it is prevalent, should avoid the damp air of the morning and even-
ing, also exposure to a hot sun;  during damp seasons,  fires  should  be kept
in the sitting  and  sleeping rooms.   (See  Chapter I., page 21.)  The diet
during the hot and sweating stage should be very light, and principally com-
posed of gruel, arrowroot,  barley-water, prune tea, <&c.  During  the inter-
mission,  and for some time after  a cure has been effected, the diet should be
regular,  consisting  of nutritious but easily digestible  food,  as boiled rice,
bread and  butter, beef tea, chicken or mutton broth, toast-water, plain bread
pudding, &c.  All high-seasoned, flatulent, stimulating,  or indigestible food,
must be carefully avoided;  hot bread, hot drinks,  fat or  greasy food, and
especially pork, must also  be  positively prohibited.  Tender wild game is
frequently  beneficial.
  Moderate exercise should be  taken daily, but not  to fatigue,  nor when
exposed to  a hot sun; and frictions  to the  whole service  of the body will be
found very serviceable.  Flannel worn next the skin  will  keep  the body
warm, and  protect it from the influences of sudden changes.  When individ-
uals residing in malarious localities, are obliged  to expose  themselves to the
early morning air during the sickly season, they should always fortify the
system beforehand, by a cup of coffee, and  a slice or two  of bread, &c, which
will render them less disposed to be acted upon by the malarial influences.
  Engorgement or induration of the liver or spleen, remaining or  occurring
after the removal of intermittent  fever, must be treated  the  same as when
these organs are thus affected under other circumstances.
               BEMITTENT  OB  BILIOUS  FEVEB.

  This disease partakes in some degree of the nature of intermittent  fever,
being generally produced by similar causes.  There  is.  however, this differ-
ence between the two, in Intermittent fever the paroxysms return at stated
periods, and  on subsiding leave the patient  entirely free from all febrile
symptoms; while in the Bemittent there is only an  abatement between  the
paroxysms, and an irregularity in the time of their recurrence;  or, in other
words, one paroxysm succeeds another so quickly, that the patient is  never
without some degree  of fever.   It is a form of  disease very common to  our
southern and middle States, and may occur  at any  season of the year,  but
principally during  the summer and fall months.   It is met with under  the
various types of a  remittent,  continued, or  highly  malignant fever,  being 
192
AMERICAN FAMILY  PHYSICIAN.
attended with a greater or less amount of arterial excitement.   The  names,
African fever, Bengal fever, Michigan fever, &c, have also been applied to
it, from its prevalence in these places, and many physicians have erroneously
called it "Typhoid fever," because of the presence of typhoid symptoms in
its  latter stage.   The term " Bilious  fever," by which the disease  is more
commonly known in this country, originated in an erroneous opinion that it
was caused by a derangement of the biliary functions; when the fact is, mias-
matic influences alone give rise to  it.
  Symptoms.   This form of fever  usually commences with weakness, lowness
of spirits, yawning and stretching, aversion to food, more or less severe pain
in the  head, alternate flashes of heat and cold, and  which  may frequently
continue for several days before the disease is fully developed; the sensation
of  coldness gradually increases to a more or less well-marked chill, rarely,
however, amounting to a shake; the chill or sense of cold is felt more partic-
ularly about the back.    After a short  time, febrile  symptoms succeed this
stage of depression;  as,  flushed face,  heat and  dryness of the skin, suffused
eyes, hurried or difficult breathing, great debility, pain in the back, and in
the head, the latter being frequently  very severe, nausea  or vomiting from
irritability of the stomach, thirst, and sometimes delirium.   The pulse is full
and frequent; the urine scanty and high-colored; the  bowels usually  costive;
the tongue,  at first covered with a  white fur, or, if the  biliary functions  be
considerably deranged, a light-brown, eventually becomes much darker col-
ored.  When  there  is much irritation  of the alimentary canal, diarrhea is
apt to be present; and when there is considerable prostration of the vital force,
the pulse instead of  being  quick,  may  be slower than usual, or it may  be
quick and weak.  The fever continues from eight to twelve,  or even twenty-
four hours; when the pulse gradually  approaches to nearly its natural stand-
ard, the skin becomes of somewhat diminished temperature, but  rarely below
that which  is natural to it; it is usually dry and softer, although  occasionally,
a slight moisture may be observed  on the surface.  The urine is more copious
and deposits a sediment.  But there is not a complete  subsidence of the fever,
only an abatement of its severity, which is termed a remission.  The remis-
sion may occur at any period of the day,  but more commonly in the morning,
varying in its duration; more frequently it will continue for two or three hours;
but sometimes it is hardly perceptible,  and is immediately followed by another
paroxysm, with an aggravation of  all  the symptoms.
  In the more severe forms,the tongue  soon becomes dry, and covered with
a dark-brown,'or nearly black coating;  the eyes are languid, dull, and of a
yellowish hue, or red and fiery; respiration is laborious;  there is  intense pain
in the back  and head, with an aversion  to light and  sound, and frequently
delirium^ the pulse is full, frequent, and corded, sometimes irregular;  nausea
and vomiting of a thick, ropy, green or  yellow  fluid;  great restlessness and
wakefulness; tenderness and even  pain  in the region of the stomach; and
there is either an obstinate constipation, or discharge, of a thin, watery fluid,
with griping and  tenesmus.  The evacuations caused by cathartics are slimy,
fetid, and dark-colored.
  The symptoms, in this disease,  vary very much in  severity and character
according to the situation and constitution of the patient, the season  of th
year, the treatment  adopted,  and many other circumstances.  Sometimes
symptoms indicating great disturbance of the biliary functions predominate;
sometimes   of  the  nervous;  and, at  others,  putridity  manifests  itself.
And it is   not  uncommon to  find  a  succession, or  even  a  complication
of them in the same person and at the same time.  The disease may be com-
plicated with a torpid ar d engorged liver, witl disease of the stomach, spleen, 
REMITTENT FEVER.
193
cr bowels, with congestion or inflammation of the brain, and sometimes with
inflammation of the lungs.
  If the more active symptoms are not removed, they are apt to be followed
by a stage of nervous prostration, or a typhoid condition, which has led many
practitioners to miscall the disease "typhoid fever."   This condition is fre-
quently owing to a neglect of the  disease at its  early period, or to an improper
treatment by powerful  emetics,  drastic purgatives, bloodletting,  &c.  The
tongue becomes parched, tremulous, and  dark-colored, or dry, contracted,
anof red, the pulse rapid and wiry,  with twitching of the tendons, (subsultus
tendinum,) respiration short, quick, and laborious, a peculiar anxious expres-
sion of countenance, the skin dry, or cool and covered with a clammy moist-
ure, the head hot, the feet and  legs cold, stupor, and low muttering when an
attempt is made to arouse the patient, picking at the bedclothes, or grasping
at imaginary objects in  the air, involuntary discharges from the bowels, and
finally death.
   Causes.   Bilious or  remittent fever, is undoubtedly caused  by malarial
influences, or exhalations from putrefying  materials,  whether these emanate
from a  marshy district,  a newly dug canal or drain, or a damp house.    And
it may  be, as probably with intermittent fever, that the exhalations consist of
the spores of microscopic vegetations or animalcules,  growing in these moist
places.   I place no confidence  in the opinion  that cold,  excessive  fatigue,
intemperance,  &c, develop  the  disease,  though in a proper location they
may  render the  system more  susceptible  to  an attack.  Those  of relaxed
habits,  who have a poor, in nutritious diet, who labor hard, or are exposed  to
an impure atmosphere,  and those who lead a life of dissipation, are especially
liable to this fever.
   The prognosis in remittent fever is usually favorable, and the more marked
the remissions,, and the nearer they approach to complete intermissions, the
less difficulty will there be in curing it.  When complicated with congestion
or inflammation of internal organs, or with great nervous prostration, or loss
of  vital force, running  into low,  typhoid conditions, it is always of  an unfa-
vorable nature.
   Treatment.   The treatment  of remittent fever will  depend  somewhat
upon the period at which the practitioner  is called.  When the premonitory
symptoms are present, previous to the chilly stage, an emetic, or a purgative
will frequently be of value, but  after  the  disease has fully developed itself,
they will be found mischievous, except under certain circumstances hereafter
referred to.
   In the hot stage,  or  while  the fever is on, the surface of the body and
limbs should be frequently bathed  with warm weak  ley water, to  which a
little whisky may be added, and  the  following preparation  may be  given
internally:—Take of Tincture of Gelseminum half a fluidounee; Tincture of
Aconite twenty drops.   Mix, and give twenty  drops for a  dose in  a tea-
spoonful of water, repeating the  dose every half-hour or hour.  As soon as
the fever abates, or the peculiar  relaxing  effects of the Gelseminum* occur,
cease the further administration of the medicine, until the next febrile par-
oxysm.
   In some cases, the Compound Powder of Ipecacuanha and Opium will be
more servicable in the febrile stage, and may  be administered in doses of
three or five grains, repeated  every  two or  three hours.  When water is
desired let the patient have it.
  *These effects will be explained in the Materia Medica, Part HI, under the head of Yellow
Jessamine.
       13 
194                AMERICAN  FAMILY PHYSICIAN.
  When the remission occurs, whether the fever has sensibly abated or not,
one of the following preparations must be given, the same as in intermittent
fever:—
  1. Take of Sulphate of  Quinia twenty grains;  Elixir  Vitriol one flui-
drachm; mix, and dissolve the Quinia, and then add Tincture of Black Cohosh
root, Tincture of Gelseminum, of each, seven  fluidrachms,—mix together.
The dose is twenty drops every half-hour or hour, in a little water.   Should
the bowels be constipated, or the liver torpid and congested, as manifested by
the dark coat on the tongue and the yellowishness of the  eyes and perhaps
the skin also, the first dose may be preceded  by a  mixture of Podophyllin
one-fourth of a grain,  with Leptandrin one grain, and which may be repeated
every six hours until the bowels have been acted upon.   In many instances
the Compound Powder of Jalap will  act with the most  advantage.
  Formulas No. 2, and No. 6, under  the treatment of intermittent fever, may
be substituted for the  above in  some instances, according to the directions
therein  given.   In the  early days  of the disease, an emetic will sometimes
arouse the liver, and produce a favorable shock upon the system, if adminis-
tered at an early period  during the remission; but  when too often, or too
frequently repeated, emetics will be found hurtful.   If, instead of constipa-
tion, diarrhea  should  be  present, it may be checked by a  mixture of Gera-
nin, two grains; Sulphate of Morphia one-eighth of a  grain; and which dose
may be  repeated every  two or four  hours,  according  to the character and
frequency of the discharge.
  When there is considerable irritation of the stomach and bowels, indicated
by distress in the abdomen, tenderness in the region of the stomach,  nausea,
vomiting, red tongue, and slimy and light-colored fluid discharges, it will  he
well to omit any active internal medicines,  until this  condition is subdued.
An infusion of Marsh-mallow  root and Peach leaves should be drank freely;
Mustard poultices applied over the stomach and bowels, and to the feet and
along the spinal column;  and when those upon the abdomen are removed,
they should be replaced  by a warm fomentation of Hops and Boneset, or of
Stramonium leaves.   In some instances, an eighth of a grain of Sulphate of
Morphia will be found useful.  But the best agent w ill be a combination of
Tincture of Gelseminum half a fluidounce, with Tincture of Aconite  twenty
drops, of which twenty drops may be, given every half-hour or hour, in  a tea-
spoonful of water.
  Severe pain in the head may be overcome by  Mustard poultices to the feet,
and along the spinal column, together with cooling  applications to the head,
and, if not contra-indicated, a cathartic.  (See Auxiliary Treatment of Fevers,
page 180.)
  When the  tongue  is coated yellow, dark-brown, or black, let the patient
drink freely of acidulous beverages, as tamarind water, orange juice, lemon-
ade, cider, and even vinegar, when craved.   (See page 182.)
   If the disease is not cured by the above measures, it will probably assume
the typhoid condition previously referred to,  and which must be  treated with
great care, or  the patient will inevitably sink.   The principal indication here,
is to stimulate the system and support it, until the powers of the vital force
have  become  sufficiently established to preserve  the  patient.   All  active
internal measures must be  stopped,, and stimulants must be freely adminis-
tered, pursuing the course named on page 181,  under Auxiliary  Treatment o,
 Fevers.
   During the whole course of treatment, the patient should be kept perfectly
 quiet, and  any  excess of  heat,  noise,  motion, or strong light, removed or
 avoided, as these often  tend to increase the violence of the fever,  or at all 
CONGESTIVE  FEVER.
195
 ©vents, the patient's restlessness.   The body-linen, as well as that of the bed,
 should be frequently  changed;  the chamber ventilated daily, and sprinkled
 with vinegar, or the atmosphere purified with one of the disinfecting agents
 named on page 137; and the discharges from his bowels  should always be
 immediately removed.  The friends of the  sick in their anxiety to manifest
 their kindly feelings,  generally  overshoot the mark, and render themselves
 exceedingly troublesome and annoying to the patient, by their ill-timed visits
 and their constant inquiries as to how he feels, &c.  This  is generally worse
 in small country  places than in large cities.  The chamber of a sick person
 should be kept entirely free from visitors, and especially  those  disposed to
 much conversation, gossip, or queries; the  physician,  the  family^ and the
 nurse, are the only persons who should ever be allowed to enter a sick room,
 unless circumstances require the presence of others, and then these should
 be carefully selected.  A  neglect of these matters has frequently brought
 discredit upon a physician, and death upon his patient.  To the nurse always
 belongs the control of the sick chamber, in the absence of the physician, and
 the family and friends of the sick should always aid her in carrying  out the
 advice and intentions of the medical attendant.
    During convalescence great care should  be  taken  to avoid every  thing
• calculated to bring on a relapse.  Much prudence must be  regarded in the
 diet and exercise.   The diet should be  light and nutritious at first, as meat
 broths, boiled rice, cooked ripe fruit in small quantity, &c,  gradually allow-
 ing parboiled eggs and oysters, as the strength improves,  until the ordinary
 diet  can be resumed.  Both mental and physical  exercise  must be moderate,
 never fatiguing body or mind; a cheerful companion will be of much service,
 if he be judicious.  Exercise in the open air as soon as strength and  circum-
 stances will permit.   Sometimes,  convalescence is very tedious, the person
 not recovering his health rapidly; under such circumstances,  if the tongue be
 pale  and the  pulse slow, some stimulating tonic will be required, as cold infu-
 sion  of  Virginia Snakeroot, in doses of a table-spoonful several times a day,
 or, the following compound may be taken:—Take  of Golden  Seal, Juniper
 Berries, Prickly-Ash bark, Wild Cherry bark, each,  coarsely bruised, one
 ounce; Podophyllum,  Tansy, of each, half an ounce.  Pour on these two
 pints of  boiling water, cover thorn, and steep for an hour  in some hot place,
 as on a hot stove, or hot ashes.  Let the  whole stand until cold, and  add two
 pints of whisky, and one of molasses.   Allow the mixture  to stand for a few
 days, when it will be fit for use.   The dose  is a table-spoonful, three or four
 times a day.   The Compound Tincture of  Tamarac is  a still better prepara-
 tion for the above purpose.  Or, in the absence of these, Scotch Ale will fre-
 quently be found advantageous.   However, if the pulse  be quick, and the
 tongue red, tonics will be contra-indicated; in such cases, small doses of Tinct-
 ures  of Stramonium,  Belladonna, or Aconite, will  prove  of much utility.
 The  Valerianate of Morphia will be found exceedingly beneficial in this con-
 dition, in doses of one-eighth or one-fourth of a grain, three times a day,
 with a diet of arrowroot, infusion of elm   bark, or of gum  arabic, gruel,
 panada, &c.
                       CONGESTIVE FEVEB.
  This cksease  is also termed congestive bilious fever, and  in  many points
resembles typhus. • Some practitioners consider it a typhus fever.  It occa-
sionally attacks with great suddenness, and runs its course rapidly.  It is a
disease more common in malarial districts, especially in the southern and
western States. 
196       .         AMERICAN  FAMILY PHYSICIAN.
   Symptoms.   It commences as with ordinary remittent fever, with general
debility and lassitude, a weakness of the limbs, confusion of the mind, ver-
tigo, and sometimes a sense of heaviness, or a deep-seated pain.  A chill  or
coolness of the extremities is sometimes experienced, but, as frequently, the
patient is  not sensible of any diminution of temperature of the body.   Tho
paroxysms and remissions are  more or  less distinct,  sometimes they are
hardly appreciable, at others they amount to a perfect intermission.  As the
fever progresses, the skin will be dry, husky, and  parched, with  a pungent
heat, which is succeeded after a time by a cold, clammy sensation ; sometimes
it will vary in temperature, being cold, or hot, only in particular parts.   The
eyes are dull, suffused, and frequently glassy;  the pulse is variable,  being
full, bounding, and tense, or weak and slow, or irregular and readily  com-
pressed; the respiration is hurried and difficult, with frequent  sighing; the
countenance assumes a dull, sleepy, haggard, and distressed appearance; the
tongue, at first little changed, or covered with a white fur, soon becomes dark
brown, or  black; sometimes it is moist, at others dry, turgid, and crisped; and
not unfrequently, especially in  very serious cases,  it remains free from any
coat, sleek, and  glossy,  resembling raw  beef, and  it is  most usually  quite
tremulous.  When there is great inflammation or congestion of the liver, the
tongue will be frequently red, parched, fissured, and bleeding.  The voice is
languid and rumbling, or inarticulate and hesitating; the lips  are  dry and
livid; the teeth frequently become covered with a dark sordes which may
spread to  the  gums  and lips; there is commonly more or less irritability  of
the  alimentary canal, the stomach rejecting all  food,  and accompanied  at
times with frequent and prostrating diarrheal discharges; if the bowels are
costive, the evacuations obtained by medicine are dark and fetid.  The  urine
is deficient in quantity, hot, and at times high-colored.   Pain will be pro-
duced  on  making pressure  on the abdomen,  over the region of  the stomach,
and over the liver.  From the commencement of the disease the mind is dis-
ordered, and  soon falls into a state of lethargy, or  low delirium, from which
the patient may be partially aroused;  and this  stupor  and drowsiness will
most frequently continue during the remission until the  next paroxysm.
   During  the whole of the  disease the patient, although disposed to stupor,
is very restless and  uneasy; his senses  appear to  be  obtuse,  and there  is
involuntary jerking of  the muscles.   If the disease be not subdued, the
prostration of the nervous system becomes more marked, the head hot, the
extremities cold, with coma,  or low,  muttering  delirium, twitching of the
tendons, and  a reaching or picking in the air or at  the bedclothes.   Dark-
colored bleedings from the nose, mouth,  or bowels, or  livid spots  on the
skin, are the  frequent forerunners of death.
   Causes.  The same as Bemittent Fever.
   The prognosis in this form of fever is less favorable  in proportion to the
degree of  nervous prostration, stupor, internal  irritations and  congestions,
and severity of ordinary symptoms.   When there is not a great degree of
drowsiness, and  the  treatment exerts a marked influence on the  disease
within a reasonable time, the mind becoming less confused and stupid, the
tongue and pulse more natural, and the surface moist and of ordinary  tem-
perature, with a gradual diminution of other febrile symptoms  the prog-
nosis is decidedly favorable.
   Treatment.  When called to the disease in its early stage, before there
has been much prostration  of the  system, an emetic, followed  by a cathartic,
will  frequently be found useful.   These are given more especially on ac-
count of the shock they impart to the system, than to any removal of  mor-
bid accumulations in the alimentary passages, and  are often followed either 
CONGESTIVE  FEVER.                      197
 by a complete removal of the disease, or by changing it into a milder form.
 As an emetic, the Compound Powder of Lobelia will be found useful, when
 administered according to the directions given under its head in Pharmacy,
 Part III.  But after the first or second day of the disease, great care must
 be used not to employ depleting, or revulsive measures.
   The surface of the body must be  bathed with  a warm, weak ley water;
 and the use of stimulating liniments to the extremities, with considerable
 friction, and mustard poultices applied to the feet, wrists, ankles, and along
 the spinal column, will be found decidedly beneficial.
   Internally, the Sulphate of Quinia should be exhibited as soon as possi-
 ble. ; a mixture of the Quinia three  grains, with an equal quantity of the
 Prussiate of Iron, may be given every two or  three hours  thoughout  the
 whole course of the disease; or, when there is inflammation or  irritation of
 the stomach and bowels, it will be better to give the Quinia in doses of one
 or two grains every hour, at the same time giving a mixture of Tincture of
 Gelseminum four fluidrachms, and Tincture of Aconite twenty-four drops,
 —the dose of which is about  thirty  drops, and which should be continued
 until the symptoms of irritation are removed, or until the Gelseminum  has
 induced its peculiar relaxing  effects upon the system.  Or, formula No. 4,
 on page 190, may be substituted in  some cases, where the above does  not
 appear to act promptly.
   As soon as the tongue assumes the dark or  brown coat, acidulous drinks
 must  be  given, among which I  know of none  better than good cider, of
 which the patient may drink freely;  in addition to its acidity,  it possesses
 mild stimulating properties.  In its absence, lemonade, vinegar and water,
 orange juice, &c, may be  substituted.   Cold  water may also be  drank
 freely, if  the patient craves it.   Much pain and  distress  in the  bowels may
 be overcome by the  application of warm fomentations of Hops  and Tansy;
 and great heat in the head, or severe pain,'will require  cooling lotions to
 the head,  as in auxiliary treatment of fevers, page 180, which see.
   As this disease is more generally accompanied with a torpid, or congested
 condition of the liver, I am in the habit of producing one or two very mod-
 erate  evacuations from the bowels, daily, by the employment of a strong
 infusion of  Blackroot, (Leptandra Virginica,) in doses of a table-spoonful
 every hour or two, or sufficiently often to produce the desired effect, being
 very careful not to cause any degree of active purgation.   I find  it decidedly
 beneficial, very few patients having the torpidity, or congestion, to  remain
 after the paroxysms  have been checked, or the cure effected.  The  Black-
 root appears to me to possess both an anti-malarial, if I  may so express it,
 and a cholagogue influence, and which is not found in its concentrated pre-
 paration,  Leptandrin, which I never employ in this malady.   Occasionally,
 in  some very obstinate  cases, a small portion of Mandrake root, say one-
 Bixth  or one-eighth  of the  quantity  of Blackroot,  may be  advantageously
 added to the infusion.
   Should the disease not  be arrested  by the above measures, but continue
 its course until the latter stage of great prostration takes  place, the same
 means must be  adopted  as named in  remittent  fever, the particulars of
 which will be found on page 181, under Auxiliary Treatment of  Fevers.
   During the disease lightly nutritious  drinks  may be  allowed, as toast-
 water,  barley-water,  rice-water,  &c.;  but if the disease becomes  tedious,
 it will be necessary to give something  more substantial, as apple-sauce,
 currant jelly, orange juice, guava, light custard, &c.
   The general management of the patient, both during the disease and in
 the convalescent  state, will  be the same as mentioned under the head of
yemittent  fever, on page 195. 
198                AMERICAN FAMILY PHYSICIAN.
                       PEBNICIOUS  FEVEB.

   This disease, like the preceding, is a modification of bilious, or remittent
fever*  it is occasionally met with in the middle and western States, but is
of more frequent occurrence in the South.
   Symptoms.   The early symptoms of this fever resemble those of a severe
remittent, or intermittent.   The symptoms by which it may be determined
from the previous forms are, the  coldness of the extremities, which fre-
quently spreads over the  surface of the whole body; though  it  is by no
means uncommon  for the head and extremities to  have a marble-like cold-
ness, while the temperature on the body will be very much exalted.   The
skin over the parts affected with coldness, have a livid, contracted, wrin-
kled appearance, particularly on the face, hands, and feet; the countenance
assumes  an expression of  anxiety or dread;  the  pulse varies; it may be
weak and  tremulous, and  generally unequal; it  may be tense and  hard,
but compressible  under the fingers; it may intermit; it may be frequent,
even to 150 or 160 beats in a minute; it  may be flickering, or it may be
imperceptible at the wrist.   The tongue varies also ;  it it almost invariably
pale, but may be contracted and dry, or natural and moist; and, as in cases
of great prostration  generally, it will be  tremulous, or there may be an
inability to protrude it.  The thirst is excessive and  annoying ;  and from
the  disturbed condition of the  stomach,  the  water  is ejected  soon after
jswallowing it.  Respiration is rapid and  short, frequently unequal, with
more or  less sighing.   The bowels may be very costive, or they may be
loose, with watery discharges,  either whitish or red.   The mind is  some-
times  clear, at others  stupid, or  lethargic.   Constant restlessness is an
almost invariable symptom, the patient rolling and tossing about from one
side of the bed to the other.  There  seems  to  be  an extreme depression of
nervous action, or vital force, almost amounting to paralysis.
   The paroxysms  are  periodical, assuming  the quotidian or  tertian  type,
with a more or less perfect remission or intermission; but each  paroxysm
increases in malignancy, until cured by proper remedies, or until  death en-
sues, which is not long delayed.
   The Causes are the same as those of intermittent and remittent fevers.
   The prognosis is  always unfavorable.   If  by prompt measures, the parox-
ysms can be  shortened, and their severity mitigated, with a restoration of
nervous action, the case will, probably, terminate favorably.
   Treatment.  In  this disease, prompt and  energetic measures are de-
manded.  The whole surface of  the body as well as of the limbs should be
well rubbed  with  stimulating applications.   The Tincture of  Capsicum, or
Capsicum in powder, may be rubbed upon the surface by means of a piece of
flannel or sponge  moistened with cold water; or, a mixture of Alcohol two
parts, and Aqua Ammonia one part, may be applied.   Strong Mustard poul-
tices should be placed on the back, over the whole length of the spinal col-
umn, as well as to  the wrists and ankles; and in cases of nausea or vomiting,
the Mustard should  also be applied, (after considerable friction  with the
stimulants) over the stomach and entire surface of the bowels, and when it
has produced redness and warmth, and can  be borne no longer on the bowels,
fomentations of Hops in water  and vinegar must be rapidly applied, as hot
as can be tolerated.
   In the administration of internal remedies,  there should be no delay; five
grains of Sulphate of Quinia should be at  once administered, and the dose
repeated every hour or two; and, as frequently happens, the medicine will
be immediately rejected from the stomach, when another dose must be imme- 
YELLOW   FEVER.
199
ahitely given, and so continued.   In addition to this, in obstinate cases, the
following may be injected  into the bowels, and should be retained there as
long as possible:—Take of Sulphate  of Quinia ten grains, Elixir Vitriol
half a fluidrachm, dissolve, and  add Tincture  of Gelseminum, water, each
half a fluidounce.  llepeat  the  injection as well as  the internal doses of
Quinia as frequently as the urgency of  the symptoms may require.
  Quinia will be found to act more promptly when in a state of solution; and
when there is no great irritability of the stomach it  may be given in this
form of fever, dissolved in Whisky or Brandy;  and in every instance the use
of the Sulphate of Quinia  should be continued  until the disease has yielded
to it.   The treatment of other symptoms occurring in the course of this form
of fever, as well as the management of convalescence, will be the same as in
the preceding forms of Bilious fever.
                         YELLOW  FEVEB.

  This is especially a disease of warm climates, seldom occurring above 40°
north latitude; it is rarely met with in country places, being confined almost
always to large seaport towns, and cities.  It makes its appearance  during
■the latter weeks of summer, or in  the commencement of autumn, and always
disappears on  the return of frost.  It is endemic  or common to southern
cities, but may from certain circumstances, prevail as an epidemic intemper-
ate climates, as in the cases of its presence in Boston, New-York, and Phil-
adelphia.  The disease  is generally malignant in proportion to the heat of
the season.
  Symptoms.   The symptoms  of yellow fever are very diversified, being at
some  seasons  quite mild, and  at others, quite  unmanageable.   Most fre-
quently it is ushered in with a chill, or  cold  sensation of short duration;
sometimes this symptom is absent.   Severe pains  in  the  head,  back, and
limbs, with, occasionally, nausea and vomiting from the commencement, and
a sense of lassitude or weariness,  are frequently present in  the early period
of the attack.   At the commencement of the disease, there appears to be  a
regurgitation of bile into the stomach, which is ejected by spontaneous or ex-
cited vomiting; but  as  the disease progresses, and especially in the  violent
and dangerous cases, there is an evident deficiency of this secretion.   As the
febrile symptoms  develop  themselves, the pulse  becomes full and quick,
though  sometimes it  is slower than natural; the skin is hot and dry, often
having a feeling of great constriction;  the respiration  is hurried, with fre-
quent sighing; the  eyes are red  and watery, with an  intolerance of light;
-ihe fiice is flushed, resembling, in some cases, that of an intoxicated person;
there is a sense of tightness and  oppression, or a burning pain at the stom-
ach, with  nausea,  retching, and flatulence,—pressure over the region of the
6tomach  usually occasions  pain;  the thirst is excessive,  cold drinks being
more generally demanded;  the  bowels  are most  commonly  costive, and
respond with  difficulty to the action of purgatives, and the urine is  scanty,
turbid, and  high-colored.  The patient  is excessively restless and fearful.
One of the most tormenting symptoms is a constant wakefulness; it is seldom
that even delirium  comes to the relief of the patient  to make him forget
himself for a moment,—but he continues  wide awake, night and  day,  with
his reason and  senses  sound, and  in a state of  the most uneasy agitation.
  As  the disease advances, the pain across the forehead and eyes increases;
the pain in the back and limbs becomes  intolerably acute  in  many cases;
the mind  is much agitated and anxious, and sometimes a greater or  less de- 
200
AMERICAN FAMILY PHYSICIAN.
gree of  delirium is manifested ;  in some cases, there is a constant tendency
to stupor.  The tongue is usually moist, and coated with a whitisli, or yellow-
ish-white fur and sometimes there is soreness of the throat, with a difficulty
in swallowing.   Occasionally the tongue is of a bright red color.
   These febrile symptoms  continue, more  commonly  for about thirty-six
hours, when  there is a gradual abatement of the  symptoms, followed by a
o-reater  or less  remission, or  even a complete intermission,  terminating in
convalescence.   Sometimes these continue only a few hours, being of longer
duration in the mild cases, and very  brief in the more serious.  During the
remission, it is frequently the ease that the patient will  sit up, with  the de-
lusive belief that he is  well.  But  there will be certain symptoms present
indicative of the continuance and aggravated condition  of the disease, as:—
an increased  tenderness upon pressing  over  the stomach, a yellowish or saf-
fron color of the face and eyes, instead of the previous  redness, and which
color ultimately extends over the whole body, the urine assumes a yellow
tinge, and the pulse becomes depressed, in some even to forty beats in a
minute.   In dangerous cases, there will be some drowsiness, or coma.  This
stage may last from three hours to thirty-six, when it is  succeeded by another
class of symptoms, viz: those of depression.
   The pulse sinks  and  is irregular and quick; the muscular prostration is
great; there is a pain and sense of burning at the  stomach, with more or
less  retching of a small quantity of a thick, green, viscid fluid;  the skin as-
sumes the peculiar yellow or bronzed  appearance common  to  the  disease;
the  respiration is slow, with sighing,  and  hiccough; the tongue is brown
and  dry, or red, glossy, and cracked;  occasionally the  teeth and gums are
covered with sordes; the urine is natural or suppressed; and passive hem-
orrhages occur from various parts of the system, as gums, nostrils, bowels,
etc.,  and from the extravasation of blood, purple spots, (petechia: and vibices),
are visible upon the  surface.  Accompanying this  last symptom, is the vom-
iting, not only of everything received  into  the stomach, but  also of a dark
brown or blackish fluid, known as the black vomit.   In very malignant cases
this  last symptom may occur on the  first day of the attack.   The heat and
pain of  the stomach now cease; respiration becomes slow, with hiccough; the
breath is very offensive;  the skin becomes  cold and clammy; large quanti-
ties  of  dark and fetid matters are discharged from the bowels;  the eyes be-
come hollow or sunken ; the countenance sombre or contracted and wrinkled;
the  pulse is almost quiescent; and at last the patient dies, either in convul-
sions, or a  comatose condition.   These  are  the  usual symptoms, but thej
will be  found to differ  considerably in different patients, and  at various sea-
sons.  Sometimes patients  die without exhibiting  the dark  color of skin,
black vomit and hemorrhage; and again  in  very  malignant cases,  it some-
times happens that the symptoms above named in the third or collapsed stage,
are  the  first which give indications of the presence of the disease.
   Causes.   The causes of yellow fever are  not well understood, although it
is very  probable, that  they will  be  found  to consist,  as with  the previous
fevers, in a specific poison  in the atmosphere; perhaps the conjunction of
vegetable and animal malaria.   Persons unacclimated to a yellow fever dis-
trict, as well as those exposed  to heat  or cold, or who fatigue themselves by
much exercise,—those  who are intemperate or irregular in  their habits, or
who labor under depressing influences of mind or  body, are more predisposed
 to the disease than others.   The disease, it  is said,  may arise from the foul
 air  of a ship, from infectious effluvia,  or from putrefaction  that  sometimes
 takes place in  the holds of vessels which have been neglected.   Ordinarily,
 it is entirely confined to those who have recently arrived from a cold or tern- 
YELLOW  FEVER.                       201
 perate climate, or who have  been exposed to unwholesome air, to too much
 exercise in the heat of the sun, or to intemperance;  when malignant it at-
 tacks  indiscriminately.  The young and  plethoric are the most apt to he
 attacked.
   Yellow fever is not contagious, that is, a person  with the fever  upon re-
 moval to a healthy district will  not communicate  it  to others; but, in an
 infected district,  where every person is exposed to the specific influence pro-
 ducing it,  persons who otherwise  might have escaped it, may become attacked
 by too  close attendance upon those laboring under  it,  especially when it
 assumes a violent character.
   The prognosis  will  be favorable when the primary  fever is prolonged be-
 yond the usual period, when a moderate secondary fever occurs, or when a
 mild perspiration takes place at any time from the fourth to the seventh day.
 The gradual cleaning  of the tongue, cessation  of nausea and vomiting,  the
 absence of pain when pressure is made over the region of  the  stomach, a
 return of  nervous energy, and a  prompt susceptibility to the action of medi-
 cines, are all favorable indications.  After the third  stage, if, instead of a
 fatal termination, a secondary fever should  set in  it is favorable, inasmuch
 as it indicates that the vital forces are not completely exhausted.  The unfa-
 vorable symptoms are, a short and  severe febrile stage, insupportable  pain in
 the forehead, back, and limbs, frequent and weak pulse, languid respiration,
 with heavy sighs, the eyes are bloodshot, yellowish-brown color of the skin,
 constant restlessness,  an indifference to everything,  hiccough, a ravenous
 appetite in the last stage, black vomit, petechial spots  with hemorrhage,  and
 suppression of urine.   Sometimes patients have recovered even after  having
 black vomit.
   Treatment.   At  the commencement of an  attack of yellow fever,  an
 emetic is almost always indicated.  Indeed, as all febrile symptoms occurring
 during an  epidemic of this disease  may be suspected to  be its forerunners,
 the emetic should be given at as  early a period as  possible;  and the agent
 which I prefer is the Compound  Powder of Lobelia, administered according
 to the directions named in Pharmacy, Part III.  In addition to the elimina-
 tion of morbid or irritating matters in the stomach,  it will give a shock to the
 nervous  system which  is always rendered torpid by  the peculiar poison gen-
 erating the disease, inciting it to an augmented action, promoting the func-
 tions of the liver  and other  secuetory organs, determining  the blood  to  the
 surface, and rendering the system more susceptible  to the influence of other
 remedies.  In those severe and malignant cases where  the  patient is almost
 immediately stricken down with the prostrating stage of the disease,  emetics
 will be found less serviceable; indeed, in such cases,  they are contra-indicated,
 as well as all other depletive or exhausting measures.
   Some care must be employed in the use of  a purgative,  which is  seldom
 indicated on account of the great irritability of the  stomach and bowels, and
 which may be increased to an ungovernable extent by  the imprudent  admin-
 istration of a purgative.   Should, however, evident accumulations exist in
 the bowels, a mild cathartic may be administered, and  that which I prefer is
 Castor Oil.  Many years ago I was  informed  by an  old physician, who had
 formerly had an extensive and successful practice in  yellow fever, that  he
 derived more benefit from the following purgative dose, than any other prep-
 aration ;  "indeed," said he, "as soon as it operated on my patients I  consid-
ered them safe:"—Take of good Vinegar, Castor Oil, each, half a wineglass-
ful, Salt, a teaspoonful.   Mix for  a dose, and repeat it every hour until it
purges.   It appears to  be a severe dose, but there is undoubtedly virtue  in
it;  the salt, it must be  recollected, is a neutralizer of malarial  poison  in  the
system. 
202
AMERICAN  FAMILY PHYSICIAN.
  Durin^ the febrile stage, while the skin is hot and dry, the whole surface
of the body and limbs  should be thoroughly bathed every hour or two with
warm  weak ley water, to which a small portion of whisky has been added,
using'some degree of friction in drying.  This will be found to have a very
happy influence in allaying the more severe symptoms of the fever, and dis-
posing the patient to sleep.   In many cases, especially when the skin is very
hot frequent bathing of the  surface with cold water, or with the above weak
ley,' cold,  will be found more grateful, and  more beneficial in abating the
fever, than when warm fluids are employed.  These bathings should be sus-
pended whenever the fever diminishes, and renewed as soon  as  it returns.
  Counter-irritation is always indicated early in the disease; strong Mustard
poultices should be  applied  along  the whole course of the spinal column,
over the region of the  stomach, to the feet and ankles,  and  to the wrists;
every means should be promptly and energetically employed to  arouse the
nervous system, allay irritability of the stomach, and determine the fluids to
the surface.  (Previous to the application of these Mustard poultices, some
practitioners place the  feet and legs in hot water, but not  so hot as to scald,
allowing them  to  remain  there  for  five or ten  minutes; after which  they
place the patient in bed, and endeavor to produce free perspiration by hot
drinks, and hot rocks,  bottles of water, &c, in the bed, and placed  at the
feet, sides, axilla, &c.  This  course may be useful  in  some  mild  cases, but
too much  time  will be lost in the severe ones by pursuing it, unless the mus-
tard be applied at  the  same time.)
  Internally, Sulphate of Quinia in doses of from four to  six grains should
be administered every  hour or two, both during the febrile stage,  as well  as
in its absence* in order to neutralize the morbific cause of the disease, while
at the same time acids  should be freely drank,  as lemonade,  lime-juice,  sour
cider, vinegar,  «fcc, and which should be kept  cold  by means of ice  placed
around the vessels containing them.  A piece of ice frequently  placed in the
patient's mouth will prove very grateful and  refreshing.   In the febrile stage
as well as  in the stage  of prostration or remission, should  the stomach be so
irritable as to reject the above medicine, it must be administered by injection,
prepared  as follows:—Take  of Sulphate of  Quinia,  Tartaric Acid,  each
twelve grains, Lime-juice, or sour Lemonade, one fluidounce.   Mix, and use
for an injection, repeating the dose every hour or two, and  causing the pa-
tient to retain it if possible, for some  hours.  Indeed,  in malignant cases, it
will be proper to use the Quinia, as above, both by mouth and  by injection.
Some practitioners, during the febrile stage,  administer  in  connection  with
the Quinia, Tincture of Gelseminum, in doses of from half a teaspoonful to a
teaspoonful every hour or two, and with manifest benefit.   Knowing the
utility of  this agent in other fevers, I would suppose  that  cases might  be
frequently met with, in which its action upon the system in conjunction with
that of the Quinia, would terminate in most happy results.   But I should be
inclined to use  it with  great  care and much  hesitancy in  those cases where
great nervous depression existed from the commencement of the  attack, at
least, until further trials have determined  its true value  in  such  instances.
During the stage of remission or collapse, there should  be no  delay in the
administration  of the Quinia, and patients who, when in health, are naturally
pale or anemic, should also  take in connection with  each dose of it,  from
three to five grains of  either the Citrate of Iron and Quinia, or the Tartrate
  * I am aware that this is contrary to the views of some practitioners, but I am thoroughly sat-
isfied that the judicious employment of Quinia, even in the febrile stage, will always be found to
produce a beneficial influence.  I think, that instead of acting as a tonic, it exerts, in connectioa
with its neutralization of malarial poison, a sedative action upon the whole system. 
YELLOW   FEVER.
203
 of Iron and Quinia.  Oil of Turpentine has been found very useful  in this
 stage of the disease; about ten .or fifteen drops, with two or three grains of
 Capsicum, may be given every hour  or two in some acidulated drink.   The
 Turpentine may also be combined with equal parts of Olive Oil, and rubbed
 on the body and limbs with a moderate degree of friction.   The drink in this
 stage should be acid, and when much prostration is present, requiring stimu-
 lants, ale, port wine, champagne or brandy may be given internally,  and by
 injection, and the limbs and body should  also be  bathed with a mixture of
 good Brandy four fluidounces,  Sulphate of Quinia half a  drachm, to which,
 if necessary, one or two fluidounces of Oil  of Turpentine may be added.   The
 injection of Saturated  Tincture of Prickly-Ash Berries, named on page 182,
 under Auxiliary Treatment, will also be found very advantageous.
   For excessive pain in the head,  derangement of the  kidneys,  suppression
 of urine, pain and distress  of the bowels, and other urgent symptoms requir-
 ing relief, pursue the measures heretofore  named under Auxiliary Treatment
 of fevers, page 180.
   Should the  patient become convalescent, great care must be taken to  avoid
 a relapse.   The diet should at first consist of prune, tamarind, or apple-water,
 with the addition of a little wine, and if there be considerable debility a
 strong beef tea is allowable;  Indian meal  gruel,  mush and  boiled  milk,
 boiled rice, and other light and nutritious  articles, should  be used  as  food,
 gradually approaching the ordinary  articles of diet, as the strength of the
 stomach will  permit.  Tonics  should likewise be  administered, as, a cold
 infusion of Virginia Snakeroot, with or without wine as  the case may require;
 or, an infusion of the Shrubby Trefoil may be used instead.  Other tonics
 may be used,  as, a cold infusion of Quassia, Boneset, Golden Seal, &c.   The
 convalescent should be kept quiet at  first,  and supplied with cool and  pure
air, and as strength will permit, exercise moderately within doors; if possi-
 ble,  remove at once to  a  healthy district as soon as  it can be done safely.
 And pursue generally, the rules  heretofore  named  for the management of
 convalescence  from exhausting fevers.
  The rules referred to in the Introduction should be rigidly adopted by all
 persons exposed to the  infectious poison; removing  at once  to a healthy
district if they are able,—if not, they should  not  expose themselves to the
 night air, nor  to the early morning air, and at no time  should  they venture
into  the out door air on an  empty stomach, nor when the system is laboring
under  fatigue or any  depressing influence whatever;  sudden  changes  of
temperature should be  avoided, as well as  intemperance, or other excesses;
exercise should be moderate, and never in  the sun; food should be nourish-
ing,  and easily digestible, but not stimulating; bowels  and kidneys  should
be kept regular, but not over-tasked;  body should be  kept clean by  daily
bathing; sleep should be taken in the highest room in  the house; and the
house should  be thoroughly cleansed from garret to cellar.   The clothing
should be comfortable,  not  too warm  nor too cool.
  The public  authorities should also  attend to the condition of the town or
city,  inspecting all backyards, cellars, sewers, ponds, and the like, wherever
putridity or decomposition is going on, and be rigid in  their laws requiring
the community to cleanse or remove them.   Large fires are sometimes bene-
ficial, when built in many places at once, or,  when made over the marsh and
swampy places which generate the poison. 
204
AMERICAN FAMILY PHYSICIAN.
                         TYPHUS  FEVER.

  This disease has been called by several names, as nervous fever, jail, camp
or ship fever, putrid  fever,  spotted fever,  congestive fever, &c.   However, I
believe there is  a marked difference between the congestive  fever of this
country,  and ordinary typhus, as well as between spotted fever and typhus.
It more  commonly attacks those  of weak constitutions,  and is  apt to be
produced in damp, dirty,  filthy places, jails, prisons, hospitals, ships, and
in badly ventilated  houses.  Unlike typhoid  fever, it may  occur at any
season of the year, and all ages  are equally obnoxious to it.   It is not met
with so frequently as in former years,  probably on account of the greater
attention to cleanliness and ventilation.
  Symptoms.  Typhus fever is  divided into two forms, the mild and the
malignant, and it will be  well to explain  the symptoms common to each
form.  The mild form commences  slowly and imperceptibly, with general
languor,  dejection of mind, loss of appetite,  alternate chills and flushes,
dulness and confusion of thought, face pale and sunken, and the eyes dull
and heavy.  As the  disease progresses, there is an oppression  at the chest
with difficult  breathing, frequently headache, giddiness, confusion of intel-
lect, and great nervous prostration, tho  patient often fainting  when  he
attempts  to sit up.  The pulse is small, feeble, and  irregular; the tongue
at first moist and covered with a whitish fur, becomes red,  or coated with a
brownish  substance, and  the teeth are often  incrusted  with the same.
Thirst is  seldom complained of.  A cold,  clammy,  perspiration breaks out
on the forehead and back of the  hands,  while  the palms are  quite hot.
The urine is pale and watery.  As the disease advances, the heat  and other
febrile symptoms increase, the cheeks assume  a  dull red, dusky, or  dingy
hue, the urine becomes high-colored; bowels costive; sometimes, but rarely,
a diarrhea comes on; there is a  low, muttering delirium,  seldom of a
raving character; a starting  and twitching of the tendons;  dilatation of
the  pupils, involuntary motion of  the muscles and tendons ; picking at the
bedclothes, or grasping at the air  ; coldness of the extremities ;  hiccough,
and finally dissolution.  It may be known from the  malignant form by the
more gradual character of the attack, and the mildness of the symptoms.
. In malignant  typhus, the  attack  is more sudden; the  patient is hardly
able to stand, and from the first moment seems ready to faint without any
apparent cause.   There is an intense pain in  the head;  strong  pulsation
and throbbing in the temples ; sometimes delirium, and nausea.  The eyes
appear full,  heavy, yellowish, and sometimes  inflamed;  the face presents
a dingy  or  livid appearance;  the tongue is  dry, parched, and coated
brown or yellow; the respiration  is laborious,  with deep sighs, and the
breath is  hot. and offensive ;  there is a loss of hearing,  and  sometimes of
sight.  The urine is pale ; bowels costive;  and the pulse quick and small,
or fluttering and  irregular.   Sometimes there is great heat, pain, and heavi-
ness at the pit of the stomach, slightly increased by pressure, and vomiting
of a dark  fluid substance.   As  the disease  progresses,  these  symptoms
increase; the skin becomes dry and of a pungent, biting heat; the pulse
increases in frequency, being frequently over 190 beats in a minute;  thirst
is greatly increased; the tongue, mouth, lips, and teeth are covered with a
brown or black tenacious fur;  and the speech  is inarticulate, and scarcely
intelligible.  From  the  fourth  to the eighth  day, dark petechial spots
frequently appear on the surface of the body; they are of small size, not
elevated, and imperfectly disappear on pressure; sometimes  this symptom
is absent. 
TYPHUS  FEVER.                         205
   Finally, symptoms  of putrefaction  manifest  themselves,  the breath
 becomes highly offensive, and the body  exhales a  peculiar ammoniacal
 odor;  the pulse sinks;  the urine gives a dark and fetid deposit; the dis-
 charges from the bowels, whether obtained by medicine or not,  are  dark
 and offensive, and toward the termination pass off involuntarily; twitehings
 of the  tendons; coldness of  the extremities; hemorrhages  from various
 parts of the body;  hiccough;  excessive stupor or insensibility, and death.
   In many of its symptoms this  fever resembles the typhoid, but may be
 discriminated from that by  the characters  named under the  head of
 " Typhoid Fever," which see.
   The prognosis is always uncertain.   If on  or about the 7th, 14th, or 21st
 days, there is an abatement of the febrile symptoms, the thirst becoming
 less, the tongue becoming moist and clean, the pulse stronger and more
 natural, respiration more free,  a gentle perspiration over the whole surface
 of the  body, urine free and  turbid, bowels loose,  stupor  giving way to
 more mental activity, with tumors in the throat, under the arms, or in the
 groins, or scabby sores appearing about the  lips, nose, and behind  the ears,
 a favorable issue may be expected.   But, on the contrary, if the  nervous
 and muscular prostration increases,  respiration  becoming more laborious,
 with difficulty of swallowing,  constant restlessness, profuse  and fetid per-
 spiration, or excessive diarrhea,  the discharges being very offensive, trem-
 bling of the tongue when put  out,  or an inability to protrude  it,  dark-
 colored spots, pulse sinking,  hemorrhages,  mutterings,  twitehings of the
 tendons, picking at the bedclothes,  hiccough, and loss  of sight and hear-
 ing, a fatal termination will be inevitable.
   Causes.  The causes of typhus fever are not well understood.  It seems
 to be confined to filthy and  uncleanly places, and on this account is more
 common among the poor, in jails,  ships,  hospitals, &c,  especially  when
 these places  are not  kept clean and well-ventilated.  Exposures to the
 effluvia from decomposing animal  or vegetable  matter,  use of tainted or
 putrid animal food, and, under  proper  circumstances, intemperance,  late
 hours, depressing passions, &c, are apt to give rise to the disease.
  With regard to the contagiousness of typhus  fever,  there is much dis-
 cordance of opinion among medical men ;  but as  there are  strong reasons
 advanced in favor of its  contagious character, it will be better  to  act as if
 this were the case, until the contrary has been satisfactorily proven.
 ^ Treatment.  The main object is to sustain the strength, and prevent the
 diseasefrom passing into the stage of putrefaction.  For this purpose, the
 first thing to be done,  is to  remove the patient from the unhealthy apart-
 ments in which  he may reside, to a large, clean,  and well-ventilated room,
 and  if this  cannot be done,  the house he inhabits should be  at  once
 cleansed throughout.   All  his clothing should be removed,  and  his body
 well washed with soap  and warm water,  or a warm weak  alkaline  solution,
 and after perfectly drying him, place him in a clean and dry bed, but not
 a feather bed.   In the early part of the disease,   the administration  of an
 emetic will almost always be beneficial;  though it will be improper to give
 this  class of agents as the disease progresses, or in the  malignant form of
 it.   The emetic advised is  the  Compound  Powder of Lobelia,  given as
 heretofore directed.  In the  mild form of the fever, the  emetic may be fol-
 lowed by a purgative, but this should be avoided in the malignant form  ;
 the Compound Powder  of Jalap, or the  Compound Powder of Leptandrin,
 may be given in doses sufficient to produce about two gentle evacuations.
  During the febrile symptoms, the body should be frequently bathed with
a warm, weak, ley water, or,  if the skin  be excessively hot, it may be used 
206
AMERICAN  FAMILY  PHYSICIAN.
cold.  And this frequent bathing of the whole surface, will be found the
most important part of the treatment during the febrile stage.   When there
is much pain in the  head,  or delirium, or when  the febrile symptoms run
high, Mustard  poultices should be applied to the feet, and along the whole
length of the spinal  column, being careful not to allow them to blister the
skin, but simply redden it; and cold  applications  should be made to the
head, as of vinegar and water, or vinegar, water, and salt.   Although thirst
may not be complained of,  yet  it is very important  that the patient should'
be made to drink of cold acidulous  liquids, as lemonade, tamarind water,
&c, and it will  be found that, notwithstanding  his apparent  indifference
to drinks,  he will, when they are offered to him, greedily partake of them.
They have a tendency to prevent putrefaction.
  The following should be  given, in order  to produce moderate evacuation
from the bowels, daily :—Take of  Blackroot, (Leptandra Virginica,) four
ounces;  Wild  Indigo root, half an ounce ; mix,  and make a  strong  infu-
sion, by steeping in  four pints of boiling  water; when  cold, administer a
table-spoonful every hour, or sufficiently often to produce the desired effect,
The Blackroot thus  exhibited  has an influence upon the system not to be
obtained from  Leptandrin, which latter article is far inferior, in this  disease,
to the crude root.
  For the restlessness which frequently accompanies this  disease, I prefer
an infusion of Scullcap, or  Scullcap and Ladies' slipper, to any thing else.
Opium, or any of its preparations, are seldom indicated,  and, when given,
often occasion  more harm than  benefit.  When  severe  headache is present,
should the means heretofore recommended be of no benefit, the following
may be used :—Take of Fluid Extract of Scullcap,  Fluid Extract of Vale-
rian, each, one fluidounce;  Tincture of Aconite root forty-eight drops; mix,
The dose for an  adult is a teaspoonful every hour or two; children  in pro-
portion.  This may likewise  be used during the  low stage, when there arc
spasmodic twitehings of the muscles.   Excessive wakefulness may be over-
ccune by the use of Lactucarium, Lupulin,  or a combination of these two;
the powdered  root of  Ice-plant, (Monotropa  Unifiora,) will be found very
valuable in causing sleep,  it may be given in doses of half a drachm, and
repeated every hour or two.
  In  the  malignant form of the disease, in addition  to what  has  already
been advised, the following should be exhibited during the fever stage :—
Take of Sulphate of Quinia twenty  grains, Elixir Vitriol one fluidrachm,
Tincture  of Black Cohosh  root fourteen  fluidrachms.  Dissolve the Qui-
nia in the Elixir  Vitriol,  and  then  add the Tincture  of Black  Cohosh.
This may be given in  doses of twenty drops every  hour, in some  cold
water, or  cold infusion of  Scullcap.   And this  preparation may  also he
given with advantage  during the stage of prostration, combining it with
the drinks at  that time  administered  to the patient.   Though  it  may be
proper to state that the beneficial influence of Quinia is not so well  marked
in typhus, as in typhoid fever.
  The various urgent  symptoms which may appear  during the progress of
this disease, are to be treated the same as in the  preceding forms of fever.
(See Auxiliary Treatment of Fevers, page 180.)
  The stage of prostration  must be narrowly watched,  and the same means
adopted to sustain the strength until the vital force has rallied,  as recom-
mended heretofore under remittent and yellow fevers; preferring, when they
will answer, ale and porter  to the more stimulating liquors.  And whenever
the system has been aroused from its sinking condition by these stimulants,
they should be omitted, and nourishing fluids exhibited, as very concentra- 
TYPHOID FEVER.
207
ted mutton tea, or beef tea ; returning to the stimulants again on the first
Bymptoms cf sinking.  The injection of a  Saturated Tincture of Prickly-
Ash berries, will be found  remarkably efficient  during the low stage of
typhus; see page 182.   Putrid symptoms  may be met by the administra-
tion of Brewer's Yeast, given in table-spoonful doses, every hour or  two
throughout the day ; this is both laxative and  antiseptic.  Or, diluted Py-
roligneous Acid may be given;  or, the means named on page 182.
  In the course of this disease,  the room should be well ventilated, without
exposing the patient to a current of  air; the covering should be light,  but
not too cool; the  clothing and bedlinen should   be frequently  changed;
the mouth, lips, and teeth, should be  cleansed two  or three times a day with
vinegar,  or  vinegar and water; and one of the disinfecting preparations
named on page 137, should be kept  more  or  less constantly in  the room.
The condition of the bladder should be frequently attended  to,  for it will
happen, that even  when this organ is filled, the patient will  evince no dis-
position to empty it, and it may become necessary to remove the urine by
means of a catheter.  The  patient must be kept as quiet as  possible, and
all visitors and unnecessary attendants positively prohibited  from entering
the room.   For nourishment, the patient may use thin gruel, toast-water,
barley-water, gum Arabic-water, and  thin panado, but on no account must
he be allowed solid  food; and even wine, or similar stimulants, mutton or
beef tea, &c, are improper, unless indicated during the prostrating stage.
  During convalescence, the same rules must be observed in  diet and regi-
men, as were named in  the articles on remittent and yellow fevers.  Being
always extremely careful not to allow  too early a resort to solid animal food,
after a recovery from either typhus  or typhoid fevers.
                         TYPHOID  FEVER.

   This disease has been called by various  names, as nervous fever, abdomi-
 nal typhus, common continued fever, enteric fever, dothin-enteritis, &c, and for
 a long time it was confounded with typhus fever, which, in many respects,
 it strongly resembles.  The name "typhoid fever," has  also been errone-
 ously given by many practitioners, to  those remittent  fevers which are at-
 tended in  the last stage with a low, or typhoid condition.   Typhoid fever
 is more liable to prevail  during  the fall and winter months, and persons
 over thirty years of age are less liable  to  contract it than those who are
 younger.   It is much more frequently met with than typhus fever.  I con-
 sider it an  eruptive fever.
   Symptoms.   Typhoid fever comes on very gradually, the patient hardly
 being able  to  determine the commencement of the first symptoms.  For a
 period of time varying from two  days to  two or three weeks, there will be
 an indefinite sensation of indisposition, accompanied, perhaps, with a slight
 disturbance of the mind, or a dull heavy sensation  in  the head ; this feel-
 ing  is  eventually followed  by  weariness,  languor, general uneasiness,  a
 vague sense of soreness in the limbs, with an aversion to any kind of exer-
 cise.  These, with a slight headache, alternate flashes of heat and cold, and
 impaired appetite, lead him to suppose  that he has "caught a severe  cold."
 Constipation is present, or, perhaps, a disposition to diarrhea.
  As the  symptoms  develop themselves, the skin  becomes  dry and hot
with occasional flashes of a chilly sensation along the back, rarely amounting
to  rigors, the pain in  the head  increases, the pulse  is accelerated,  the ton- 
208                AMERICAN FAMILY PHYSICIAN.
gue scarcely coated, if at all, considerable thirst, and frequently nausea and
vomiting are present.   Epistaxis, or bleeding from the nose, is not uncom-
mon even at this early  stage.
  As the fever stage advances, the skin becomes  hot, dry, and  harsh; the
pulse frequent, hard, and wiry; rarely over  100 beats in a minute;  head-
ache still severe; great thirst;  bowels disposed to diarrhea, and easily acted
on  by medicine ;  nausea, dark-red  and shining face, but not so dark as in
typhus ;  pains in the bowels increased upon pressure, and a tendency to a
tympanitic swelling of the abdomen ; tongue but little coated, or red  at the
tip  and  edges ;  and symptoms  of  pulmonic inflammation,  as  cough, &c.
Restlessness and uneasiness is quite common, but some rest  or relief is
generally obtained soon after daylight.   It is not uncommon to observe per-
spiration on the  forehead, face, and neck, appearing often during the day,
and at irregular periods.  It will be found  that in this disease there is a
tendency to imperfect remissions every day, or every other day, according
to the periodical type it assumes; thus, there will be found at such times a
slight decrease of the fever, and a diminution  in the severity of its symp-
toms, and which remissions are more commonly met with in the early part
of the day, while toward evening the symptoms reach their height.
  The symptoms increase in intensity;  the  tongue is drier, red at the tip,
and perhaps dark-colored in the center, and when thrust out it has a ten-
dency to curve upward at the tip and  sides; the throat is  dry and  sore,
with more or less difficulty in swallowing ; fetid discharges of a watery con-
sistence, and a dirty-yellow appearance, take  place from the bowels, and any
purgative medicines  increase  the difficulty.  These discharges will  gene-
rally be found to contain red  specks floating among them, resembling mi-
nute grains of bloody mucus.  Tympanitic  distension of the abdomen, in
which it is swollen and tense like a drum, is a common and prominent  symp-
tom, with tenderness or pain on pressure, more especially on the right side,
as well as a gurgling sound at  the same time.   The patient usually lies  on
his back, having his knees bent  upward, and will be constantly sliding to-
ward the foot of the bed.   About the ninth day, there will be observed upon
the abdomen small, oval, rose-colored spots, like flea-bites, which are slightly
elevated, and  which momentarily disappear on pressure ;  these petechia},
as  they are called, ultimately spread over  the whole  body to a greater or
less extent.  About the  same time, sudamina will be  observed  upon the
neck and chest,—these are small vesicles containing lymph, and which may
readily  be detected by the roughness they impart to the  skin when the hand
is lightly passed over its surface.
   The symptoms of nervous derangement now become more marked; there
may  be a disposition to  stupor, but more frequently a  wild delirium, pre-
ceded by an augmented brilliancy of the eyes;  there is a ringing, or whiz-
ring  noise in the ears ;  the eyes become full, red, and can hardly distinguish
objects; the tongue is tremulous, and cannot be readily protruded.   This
condition continues for several days, increasing in severity until finally the
typhoid  symptoms present themselves, being similar to those  observed in
other forms of fever.   The patient lies in a stupid or comatose state, from
which,  however, he  may be momentarily aroused;  he lies with his  mouth
open, and breathes hard and heavy;  the  tongue is very dry, and the teeth
are covered with sordes,  (a dark substance ;) the pulse gradually becomes
more feeble and frequent, though sometimes it may be almost natural in its
number of heats ; the  feet and legs are cold, while the head is usually hot;
the breath, as well as the exhalations from  the body, are very peculiar and
 offensive ; involuutary motions  of  the muscles; picking at the bedclothes, 
TYPHOID  FEVER.
209
or catching in the air;  involuntary discharges from the bowels ; frequently
hemorrhage from various  mucous  surfaces, especially from  the intestines j
hiccough; a  great liability of  the skin  to  slough ; a cold, clammy sweat
over the whole surface, and finally death.   Sometimes the  patient dies in
agony, with severe  physical and  convulsive efforts.   The  above are  the
usual symptoms, and the  general course pursued by this  fever, when it
proves fatal; however,  the order of the symptoms and their duration, as
well ag their severity, will frequently be found to vary.
  Causes.   Typhoid fever is probably generated by some animal malaria.
It ifl, like typhus fever, met with in prisons, hospitals, ships and other places
where many  persons are  crowded together, where the apartments are  not
thoroughly ventilated, and not properly cleansed.  But, whatever may be its
cause, the disposition to an attack may be increased by the following circum-
stances, viz:—debility, great fatigue, violent exercise, insufficient or unwhole-
some food, late hours, fasting, intemperance, debauchery, excessive evacua-
tions, filthiness,  and  mental or physical  depressing influences.  In relation
to its contagious character, the  same remarks apply to this,  as are given in
typhus fever.
  The principal discriminating marks  between  typhus and  typhoid fevers,
are as follows:—
         in typhus fever.
  1. May occur equally at any season
of the year, and at any age.
  2. Bleeding
happens.
from the  nose  rarely
  3. Capillary congestion of the face
and body, of a dull red, dusky, or din
gy hue.
  4. Sometimes  tenderness  on pres-
sure over the abdomen.
   5.  Low,  muttering delirium;   the
 patient muttering to himself all day;
 and on attempting to get out of bed,
 is easily restrained.
   6.  Tympanitic distension of the  ab-
 domen seldom present.
   7.  Bowels costive, rarely loose.

   8.  Pulse very frequent, from  100 to
 160 beats in a minute.
   9.  Sometimes a dull  red eruption,
 of small size, not elevated; the red-
 ness imperfectly disappearing on pres-
 sure.
   10. Deafness is common.
   11. Tongue, mouth, teeth, and lips
covered with a dark fur, or  sordes.
         IN TYPHOID FEVER.
   1.  Occurs more  frequently during
 fall  and  winter, and is less  liable to
 attack those under  thirty years of age.
   2.  Bleeding from the nose is com-
 mon;  frequently  being  among  the
 first symptoms.
   3.  Sometimes  capillary  congestion
 of the face, with considerable redness.

   4.  Always  tenderness on  pressure
 over the abdomen, especially the right
 side, and accompanied with a gurgling
 sound.
   5. Active delirium, requiring forci-
 ble restraint;  talks to himself loudly
 and vehemently.

   6. Tympanitic distension of the  ab-
 domen, always present.
   7.  Bowels  tending  to diarrhea;
 sometimes constipation.
   8. Pulse  frequent, rarely over 100
 beats in a minute;  never over 120.
   9. Almost  always a  rose colored
eruption, oval, slightly  elevated;  the
redness disappearing momentarily on
pressure.  With sudamina.
   10. Rarely deafness.
   11. Teeth covered with sordes; sel-
dom other parts  of the mouth.
though mild cases are not always free
  The prognosis is usually favorable ;
from danger, and patients frequently recover, even when the lowest"symp 
210
AMERICAN  FAMILY PHYSICIAN.
toms have appeared.   The  unfavorable  symptoms are, unabated depression
of the powers of the mind, or constant delirium; deep and  profound sleep;
stertorous  breathing;  great  twitching  of the tendons;  immoderate dis-
charges from the bowels;  copious sweating; great debility and exhaustion;
very frequent pulse; excessive tympanitic swelling  of the abdomen; and
hemorrhage, especially from the bowels.
  Treatment.  As in typhus fever, the principal indication is to husband
the strength of the system by mild measures, and at the same time endeavor
to remove or neutralize the morbid poison producing it.  The patient should
be placed in a cool  and well-ventilated  apartment, not, however, allowing a
current of air to pass directly upon him, and measures of cleanliness pursued
as named in treatment of  typhus fever.
  In the early part of the disease, should there be nausea or vomiting, occa-
sioned by irritating matters  in.the stomach, a mild  emetic may be given, as
the Compound  Powder of  Lobelia.  But on  no account is'an emetic to be
given at any other period, as all exhausting or depleting measures are decid-
edly injurious.  As to purgatives, they are  seldom  required, and should
there be  accumulations in  the bowels, it will be the better plan to remove
them, if possible, by injections; for, from  the great  tendency to diarrhea,
and to  hypercatharsis from the use of physic, it will be safer to risk the
drawbacks which may arise from intestinal accumulations, than to cause pur-
gation.   However, should there be obstinate  constipation,  with torpidity ol
the liver,  and the constipation cannot be removed with an injection,- the fol-
lowing  may  be  administered:—Take of Blackroot two drachms,  Rhubarb
one drachm, boiling water half a pint; infuse the roots in the water for an
hour or two, strain, and give a table-spoonful  every hour until a mild laxa-
tive effect is produced.  And  great care must be taken, not to produce too
much  purgation, as well as  in relation to a repetition of  the medicine as a
laxative.  The patient should never be allowed  to  stool or urinate, in the
erect position, as long as there is any inflammation or pain or tension of the
bowels; a bedpan must be made use of for these purposes.
  During the fever, it will be proper to bathe  the body and  limbs frequently
with a warm, weak ley water, as in  the  previous fevers;  applying tepid or
cooling applications to the head when hot, when there is pain in the head,
or,  when delirium is present,  together with Mustard poultices to the feet,
and along the whole length  of the spinal column.
  Internally the preparation of Sulphate of Quinia, Elixir Vitriol, and Tinc-
ture of Black Cohosh, named under the treatment of typhus, should be given
in doses of  twenty drops every hour, in  some cold water, or infusion of
Scullcap.   Should there be a very irritable condition of the nervous system,
Valerianate of Quinia may be substituted  for the above, in doses of half a
grain every hour or two, with an infusion of Hops and Scullcap.   It is gen-
erally advised not to give  Quinia during the febrile excitement, but I exhibit
it, and have always found beneficial effects to  arise therefrom.  Many prac-
titioners prescribe  the Quinia, in this disease, in much larger doses than 1
have named above; but I have never had  occasion to increase the quantity,
the preparation, having, in my hands, almost  invariably produced the most
desirable  results.
  Diuretic medicines are  very useful, especially during the presence of fever;
should  the tongue be red, indicating irritation of the  stomach, aa infusion oi
Marshmallow root  and Peach leaves, may  be exhibited freely; or, the Hair-
eap moss, in infusion; Cleavers and Mullein  are also unirritating diuretics.
For constant drink the patient may use cold water, an infusion of balm, lem-
onade, tamarind water, or other acidulous draughts, as he may prefer; these
will allay thirst, and relieve the dryness  of the mouth. 
SPOTTED FEVER.                      211
  Diarrhea may be  favorably influenced by the internal administration of
Geraniin, or Tannic Acid, one  or two grains, to be repeated every hour; or,
Oil of Turpentine may be given in doses of six or eight drops, repeated every
hour or two; and these may also be administered by injection.  When the
discharges are mucous, or hemorrhagic, some authors recommend the use
of Nitrate of Silver, in doses of  from one-eighth to one-twelfth of a grain,
repeated  every  three hours; omitting its use  after the  eighth dose.  It is
said to exert a very beneficial  influence upon the whole system, as well as
upon the discharges.   I have never used it.
  For the pain and tympanitic swelling  of  the  abdomen, fomentations of
Hops, Lobelia, and Tansy, should be applied over the abdomen, frequently
renewing  them,  not  permitting  them to remain on when cool, and the pa-
tient should  not  be  made uncomfortable  by applying them so wet as to
jampen his bed.  Oil of Turpentine  added to them, a  teaspoonful  or two,
will be found very advantageous in  many  instances. These fomentations
must be continued until pressure can be made upon the parts without caus-
ing pain or tenderness, or, until  the  stage  of prostration  comes  on, when
they must be dispensed with.   In addition to these measures, the  following
injection will be found of great benefit:—Take  of Sulphate  of Quinia  five
grains, Elixir Vitriol fifteen  drops, mix and  dissolve the Quinia, and add
Tincture of Prickly-Ash  berries  a fluidrachm, Oil of Turpentine half a flui-
drachm;  mix.   This is to be injected into the  rectum,  and  retained there
by compress, or otherwise; and it should  be repeated every hour or two ac-
cording to the urgency of the symptoms.  Should there be considerable irri-
tation of the lower bowels, with tenesmus  or bearing down and an ineffectual
desire to stool constantly, a few drops of Laudanum, say  ten or twenty, may
be added to the above injection, and repeated as required.  AVhen connected
with diarrhea, the  above  named  astringents may be added to the injection.
for the purpose merely, of lessening the number of enemas given.
  Other urgent symptoms which may appear during the progress of the dis-
ease, as well as the stages of prostration and convalescence, are to be treated
the same as mentioned under the  head of  Typhus Fever.
                         SPOTTED  FEVER.
   This disease is supposed by many medical men, to be a species of typhus,
or congestive  fever.   It  appeared  in this country in 1806, in the town of
Medfield, Massachusetts,  and raged as an epidemic in various sections of
New England, for several years, proving very fatal.   At present, it appears
to have become extinct, or at all events, to have disappeared from among us.
  Symptoms.   Dr. Thacher says:—" The invasion of the disease is generally
sudden and violent.   The patient is seized in the midst of his usual labors.
and oftentimes is struck down suddenly, almost as by a stroke of lightning!
The  first symptoms  are  exceedingly various, scarcely two case3 resembling
each other, and the  diversity of symptoms are not to be comprised in any
enumeration.  The disease often  commences with shifting pains sometimes-
beginning  in one joint, or  one limb, in the side, back, neck, or head, either
a sensation like the stinging of a bee, or most excruciating pain moving from
place to place, with great violence, and is often confined  to one side of the
body.    The pain in  the head is often so intolerably severe, that it is com-
pared to the beating of hammers  upon  the part.  Partial loss of sensibility,
numbness  and paralysis  of the limbs, deafness, dimness of sight, or total
blindness;  delirium, cither  mild or furious, stupor and  coma and occasion- 
212
AMERICAN FAMILY  PHYSICIAN.
ally spasms and convulsions.   There is great prostration of strength, some-
times accompanied or followed by severe chills; dry and pale skin, eyes dull
and glassy, pupils contracted, and again suddenly dilated; the  tongue white
at first, and assumes a reddish color; face livid, with  paleness  about  the
mouth; countenance anxious and distressed.   The body becomes cold, res-
piration very laborious, pulse small, feeble, and irregular;  great oppression
and faintriess, with  indescribable distress about the precordia; eructations,
nausea, and vomiting, more or less obstinate.  Sometimes death takes place
in the first twenty-four hours.  In  the second  stage,  about the third day,
the pulse becomes more  full  and regular, the  skin  warmer,  countenance
flushed, respiration short  and  very  difficult, eyelids swollen,  staring eyes,
with restlessness, anxiety,  and delirium."   Large  spots  appeared in various
parts of the body from a scarlet to a black color, and bleedings were frequent
from different parts of the  body.  Sometimes there were no spots at all, and,
in many cases the patient died before fever could form.
  Cause.   The cause is not known, though supposed to originate from some
peculiar poison in the atmosphere.
  Treatment.  It is stated that more patients were cured, by the adminis-
tration of active diaphoretics, than by any other  treatment.  I would there-
fore advise the use of the Compound Tincture of Virginia Snakeroot, in tea-
spoonful doses, every half hour, until perspiration ensued; at the same time
drinking freely of a warm infusion of Balm, Pennyroyal, Spearmint, or other
similar agents.   And probably, the  Spirit vapor bath, or  the  Lime bath
would also be found useful.  In addition to this, it will be  proper to pursue
the same course of treatment for the several symptoms, as laid down for Con-
gestive Fever, which see.
               INFANTILE  BEMITTENT  FEVEB.
  Children from birth to the fifth or sixth year,  are  especially liable to
this disease.  Its attack is very gradual,  and  is sometimes attended with
looseness, at others with obstinate constipation.
  Symptoms.   The approach of infantile remittent  fever is insidious, and
various in its forms.  Generally,  there is some degree of fever for  many
hours, or even for several days before the severer symptoms come on.   The
child  is fretful and thirsty; the lips are dry and parched; the hands hot;
the breath short; the head warm and painful; and the pulse frequent, often
120 in a minute.   In the night the sleep is disturbed by startings, and the
thirst is so troublesome that the little patient cries out constantly for water,
and scarcely has it been given, ere the mother is again aroused by the same
plaintive cry.   The appetite is lost;  the bowels are either costive, or loose,
with slimy,  mucous discharges.   Some children are drowsy and stupid, and
some  are unable to speak.  During the day there are several  slight  acces-
sions  of fever, during which the child is usually drowsy; in  the  intervals
of these paroxysms, he appears tolerably well, though at times more peevish
than usual.
  These  symptoms manifest themselves, more or less, for eight or ten days,
when the heat of the body, and especially of  the forehead, is augmented;
the skin  is very dry;  the  pulse increases to 140 in  a minute;  the  cheeks
become reddened, and a kind of stupor comes on, so that little or no pain
is complained of, unless the child is questioned particularly, when it  places
its hand  on the belly, or on the forehead.   The  child picks almost con-
stantly at the skin of the lips, nose,  and  angles of the eyes.   The  tongue 
INFANTILE  REMITTENT  FEVER.
213
 in a little time becomes foul; and sometimes there is a moibid craving for
 food, instead of  the  previous  loss of appetite.  The stools grow worse,
 being either fetid, dark-colored, pitchy kind of discharges,  or thin, green,
 and curdly, sometimes mixed with blood.   Sometimes worms are  found in
 not only the stools, but also in  the matter vomited from the stomach.  The
 drowsiness  is often  exchanged for a state of excitement,  and  the child
 laughs and  appears in good spirits, though its flushed countenance, and
 heated, dry skin, proclaim, but too truly, the presence of disease.
   But the fever does  not continue alike all  the  day; there  is generally a
 remission toward the  morning and the evening,  when the patient is com-
 paratively cool; and this remission is more marked if the  child  be  taken
 into the open air.  But as the day or night advances,  the  fever  returns,
 bringing again its distressing  symptoms of general disorder.   When  the
 disease has  thus continued for many days, unchecked by the  treatment
 pursued,  delirium comes on ; the child is with difficulty roused to conscious-
 ness by the voice of its parent;  the debility is  very great; the body wastes
 away; the strength is exhausted ; the belly swells;  stupor  increases, and
 death closes the scene.
   Causes.   It most usually attacks those of weak constitutions, of delicate
 stomachs, during dentition, &c; probably the only cause lies in the condi-
 tion of the  digestive organs.  Some suppose it to be connected  with mala-
 rial or morbid matter in the atmosphere.
   This fever may be mistaken for dropsy in the head;  but in  this  latter
 there are occasional screamings, with much tossing of the hands above the
 head, intolerance of light, dilatation of the pupil of the eye, or, more or less
 squinting, while in infantile  remittent fever, these symptoms are absent.
 In this fever the appetite is generally lost, while in dropsy of the head the
 child will partake of whatever is given him.
   Prognosis.  The prognosis in this disease is almost always favorable, as
 it soon yields to proper treatment.  Occasionally, however,  when  there is
 a lack of vital stamina in the constitution the child will  continue to sink.
 manifesting symptoms of great  debility, stupor or delirium, swelling of the
 abdomen, and frequent but very weak pulse.
   Treatment.   At the commencement of the fever, a  gentle emetic may
 be given, both for the purpose of cleansing the stomach and arousing the
 nervous system; the Compound Tincture of Lobelia may be administered for
 this purpose, according to the  directions  in  Pharmacy, Part III., which
 see.  This should be followed by a purgative dose, as, the Compound Tinc-
 ture of Senna, and which may, if required, be repeated in two or three days.
 The body should be bathed with warm, weak ley water, several times a day,
 when the fever is present; and  Mustard poultices should be  applied to the
 feet, and along the whole  course of the spinal column.   The child may
 drink warm infusions of Balm, Catnip, or Elder-flowers, and, if the fever be
 very severe, from five  to twenty drops of the Compound Tincture of Vir
 ginia Snakeroot, according to the patient's age, may be added to  its drink,
 and repeated every hour or two.  Cold water  may also  be  allowed,  when
 called for.   But when there is much irritation of the stomach, mucilaginous
 diuretic draughts will  be found  the best, as an infusion of  Marshmallows
 and Peach leaves; and  Mustard poultices,  or  bruised Garlics  or  Onions,
 should be placed  over the region of the stomach.   When  there  is much
 pain in the head, cloths wet with  water and vinegar  may be applied, and
Mustard, or bruised Garlics to the soles of the feet.
  Sometimes there is considerable spasmodic action, which will  usually be
overcome  by warm baths;  if  it  should amount to actual convulsions, em- 
214
AMERICAN FAMILY  PHYSICIAN.
ploy the Tincture of Lobelia and Capsicum, both by mouth  and by injec-
tion.   It may be given in doses of from ten to  thirty drops,  in  mucilage,
according to the child's age;  and about a teaspoonful  or two  in  a table-
spoonful of starch water, injected into the rectum.  These may be repeated
in fifteen or twenty minutes,  if required.
   When there is much vomiting, and the ejected fluid is of an acid nature,
the Compound Syrup of Rhubarb and Potassa,  may be given with advantage.
   During the remissions, the  combination of Quinia with Tincture of Black
Cohosh root, as  mentioned in formula  1,  page 190,  in  the treatment of
intermittent fever, should be  given in doses of five or  ten drops, in water,
and repeated every hour,  omitting it only during the height of the fever,
and commencing its use as the fever abates.  This may also be given for a
short time after convalescence has ensued.
   During the fever,  the diet should consist of barley-water,  toast-water,
rice-water, prune tea,  and apple-water;  but during  convalescence, it may
be improved by the addition  of arrowroot,  sago, milk, or light  vegetable
food; and  with  these  some  mild tonic may be given, as, an infusion of
equal parts of Colombo, Gentian, and Chamomile flowers; or,  an infusion
of Shrubby Trefoil.   Particular care should be paid to the bowels to keep
them  regular, and to the food, that the stomach be  not overloaded.  Flan-
nel should, in every case, be  worn next the skin, and a change of air can-
not be too much  insisted on, as it has been often highly beneficial in remov-
ing the  fever rapidly, in cases where every other remedy had been used for
the previous six  or eight days, with scarcely any other  prospect than a fatal
termination  of the case.
                          HECTIC  FEVER.

  This fever is generally symptomatic of some other  disease, particularly oi
tubercular  consumption, and arises from an absorption of pus in this and
various other diseases;  a persistent irritation of any obstinate local affection
upon the system, may likewise occasion it.
  Symptoms.   It  is characterized more particularly by  emaciation; soft,
quick,  and  small pulse; flushes of the face especially after eating;  difficult
and laborious  respiration; burning sensation  in the palms of the bands and
soles of  the feet.   These are  soon succeeded by a full, hard, and frequent
pulse;  urine  copious, high-colored, depositing a  red  sediment; the  appetite
varies; the tongue is clean and  usually moist;  sometimes the  whole body of
the tongue  is red, at others only its edges, and when about to  prove fatal, it
is not uncommon to observe aphthous sores on  the tongue and gums—in some
instances the papillae are enlarged; the  cheeks become  flushed  with  a cir-
cumscribed redness, which is more commonly  observed every afternoon;  pro-
fuse, debilitating sweats take  place, either toward midnight, or early in the
morning, and are more often confined to  the head and upper part of the body;
flashes of heat and chills are not uncommon.   In the latter stage diarrhea
supervenes, which may  appear at intervals, alternating with  the sweats;  there
is usually a diminution of the  perspiration when  the  diarrhea  is  present.
The fever is remittent in its character.
  Treatment.  Whether hectic  fever arises  from the absorption of pus, or
other  cause,  the original disease must be removed, before  the  fever will
cease.  But when the primary malady cannot be cured, the severity of  the
fever may usually be palliated by  proper treatment.
  In many cases, ten or twenty drops  of Elixir Vitriol, taken  three or four 
ERUPTIVE FEVERS.—SCARLET FEVER.
215
times daily, in a wineglass half-full of water, will be very useful.  A decoc-
tion of Crawley root, drank several times through the day, has likewise been
found very serviceable.   A mixture of Gallic Acid five grains, and Muriate
of Morphia one-eighth of a grain, has also afforded considerable benefit, in
the night  sweats of consumption.  Equal parts of White weed,  Beth root,
and  Wild Cherry  bark,  made,  into  a  strong  infusion,  and drank freely
through the day, has likewise proven efficacious.   At the Brompton Hospi-
tal, England, the most benefit has been derived from a pill composed of  Ex-
tract of Hyoscyamus, Oxide of Zinc, four grains of each; mix; of these, one,
two,  or four, may be taken daily.   Many very severe  cases are mitigated by
a mixture of  Tannic Acid,  Nitric  Acid,  and Lupulin; administered inter-
nally.
  But whatever agent is given internally, the surface of the body must  also
be attended to; bathing  it with a mixture of water two  pints, Alcohol one
pint, Tannic  Acid  four  drachms, Essence  of  Cinnamon four fluidounces,
will be found of much advantage; rubefaction must not be produced, but only
an agreeable  glow and dryness of the skin.  This is best used at noon and
night, and also on the first appearance  of  the sweat.  Acetic Acid, water,
and  Tannic Acid,  mixed together, have also been used as a lotion; likewise
Olive Oil, in  some  cases.
   The diet should  be nutritious  and of a  non-stimulating  character,  and
great care should be taken  not to oppress  the  stomach with  either food or
medicine.  Moderate exercise  in the open air, when this can be done,  will
prove decidedly beneficial; if this cannot be done, the exercise must be taken
within doors, being proportioned to the strength and capability of the patient.
The  diarrhea that sometimes attends this fever, may  frequently be relieved
by the following:—Take of prepared Chareoal  two table-spoonfuls,  Nitrate
of Bismuth one drachm, strong decoction of  Logwood half a pint; mix.  ^ Of
this  give a table-spoonful every hour, stirring it well each time before taking,
as the articles do not combine chemically with each other.
                        ERUPTIVE FEVERS.
  Eruptive or exanthematous diseases  are usually characterized by various
symptoms of fever, as heat of the surface, rapid pulse, nausea, vomiting, &c,
and the development  at a later or earlier period of an eruption upon the
surface of the body.  Generally, they attack persons but once  in their lives,
though instances have been  met with where even smallpox has attacked the
name individual at  three separate periods of life; and similar instances have
been met with in the several  other forms of eruptive diseases.
  Some of the diseases grouped under this head by nosologists, do not exactly
correspond with the brief  definition given above, but it would be useless in
the present work to form a new classification.  I have already remarked that
I think typhoid fever should be ranked among the eruptive diseases.
                SCARLET FEVER, or  SCARLATINA.
  Scarlet fever is known in some sections of country, by the name of uCank-
rr-rash."  The term '^Scarlatina," said to have been introduced into medical
nomenclature by Sydenham, is employed to designate a disease, the  general
character of which cm<i*t.<  iu fever, usually preoeding, by a day or two, the 
216                AMERICAN  FAMILY PHYSICIAN.
appearance of a scarlet efflorescence of the  skin, and of the  mucous  mem-
brane of the mouth and fauces, with inflammation of the throat in most cases;
the inflammation  terminating by desquamation toward the  end of the first
week.   As the course of this disease is very variable, the symptoms  being
sometimes very slight,  and at others very severe, it has been divided into
three forms, Scarlatina Simplex, S. Anginosa,.  and S. Maligna.  All these va-
rieties from the simplest to the most malignant are  occasionally met with  in
different individuals of the same family.   I  do not look upon the urease as
contagious, but rather infectious, the same as Yellow Fever.   See page 199.
  Symptoms.   Scarlatina simplex  usually commences  with  the ordinary
symptoms of fever, as languor, debility loss of appetite, &c,  which  are fol-
lowed with slight chills, pains in the head, back, and limbs, nausea, and often
vomiting.   These are succeeded by heat and dryness of the skin, thirst, more
or less violent headache, sore throat  with some difficulty of swallowing,  accel-
erated pulse, frequent and interrupted breathing, the eyes red, and  the eye-
lids swollen.   Sometimes the first symptom  of this  disease is violent vomit-
ing and purging, with pale countenance and great prostration; at others, espe-
cially in nervous  children, the disease is ushered  in with convulsions, or,
perhaps, a comatose stupor;  again  there may  be a  bleeding from the nose.
About the second or third day, the skin is observed to be swollen, the patient
frequently  complains of a pricking  sensation, and  a finely dotted eruption
appears on the body, of a vivid red  color.  This eruption  usually  appears
first on  the face and upper parts of the body, extending over the whole body
in the course  of  twenty-four  hours.  About  the  fourth day  the eruption
reaches  its  maximum,  a gentle moisture appears  on the surface,  and the
eruption disappears, with,  perhaps,  a troublesome  itching;  and a  kind  of
branny  scales fall off from the skin.
  The fever is generally highest at night, with a remission and paler color of
the eruption in the morning;  the  tongue is fiery red during the progress  oi
the disease, being usually  dry and  parched; the patient is excessively restless,.
tossing  from side  to side, and not unfrequently being slightly delirious; the
bowels are  frequently loose throughout the disease;  and sometimes the erup-
tion is  accompanied with  small blisters, which, on  the termination of the
disease, may form ulcers.
  Scarlet  fever, the same as measles, occasionally presents itself without any
eruption on the surface, the disease confining  itself to the mucous membrane
lining the mouth  and throat, and will  generally be  met  with during an epi-
demic of scarlatina.  It frequently assumes a serious character,  and  is  as
infectious as any  of  the other forms.  Some writers call  this Scarlatina sine
exanthemata, or scarlet fever without eruption.
  Scarlatina Anginosa.  Attacking the throat.  In  this  form all the symp-
toms are much more severe, and are attended with  stiffness in the neck, and
severe pain in the back of the head.   The soreness and inflammation of the
throat, is the most marked symptom, and is accompanied with an  enlarge-
ment of the glands of the throat, and  extreme difficulty of swallowing.  On
inspecting  the fauces, they will exhibit a shining redness of a deeper color
than in common inflammatory sore throat, and interspersed with pale or ash-
colored  spots;  the breath is very offensive; respiration frequent and irregular;
pulse quick and small,  or, hard and full; excessive thirst; eyes red; tongue
red and dry, with the papillaa enlarged, or,  furred yellow or brown; the lips
are beset with vesicles filled with an  acrid matter which corrodes the skin
wherever it comes in contact.   The teeth  are frequently covered with a dark
substance;  the inside of the nose becomes dry, red, and inflamed, and  a thin
acrid matter issues from the nostrils, excoriating the skin wherever  applied, 
SCARLET  FEVER.
217
 while thfc obstruction in the nostrils obliges the patient  to breathe with hi3
 mouth open.  The eruption is fuller and more general, presenting one uni-
 versal redness of the face, body, and limbs, but, sometimes, this  symptom is
 irregular in its appearance  and extension.   The  appearance of  the redness
 does not tend to  mitigate the  disease.   Diarrhea is not uncommon.   This
 form is more irregular in its course, and  more fatal than the previous  one,
 frequently cutting off the patient in a few days.
   Scarlatina  Maligna.    Malignant scarlet fever.  This form presents the
 symptoms of scarlatina  anginosa at the commencement of the attack, but soon
 dev3lops a state of prostration of the vital forces.  The pulse  is small, indis-
 tinct, irregular, easily compressed, and so rapid as hardly to be counted; the
 eyes exhibit a dull  redness, and there is an  intolerance of light; the cheeks
 are flushed  of a dull red color; deafness is frequently present;  and the patient
 is either delirious or comatose.  The tongue, teeth, and lips are covered  with
 a dark incrustation; the breath is  exceedingly fetid,  and the respiration is
 rattling and laborious;  and swallowing is painful and difficult.  Frequently
 the whole neck assumes a livid color; the throat ulcerates, sloughs,  and pre-
 sents a black appearance;  and looseness and vomiting  are  present.   The
 eruption is  faint, appearing in irregular  patches;  but it soon changes  to a
 dark or purple color,  and  is  frequently mixed with dark  petechial spots.
 Sometimes it appears and disappears at uncertain intervals.  Continual coma,
 extreme difficulty in breathing, profuse  diarrhea, numerous petechial spots,
 followed by death,  on the second, third, or fourth day.
   Scarlet fever may be  discriminated from measles,  by the eruptions of the
 former being more  of a fiery redness, like a boiled lobster, and diffused  over
 the whole body,  and not,  as  in  measles, in distinct  spots; it also  appears
 sooner than the latter, occurring on the second or third day, while the erup-
 tion of measles is seldom observed  until  the fourth,  is  dark-red in color,
 somewhat the hue of a red  raspberry, and a little elevated, so as to  impart a
 feeling of roughness when  the finger is passed over it.  There is no harsh,
 obstinate cough, sneezing, weeping  or watering of the eyes,  and other ca-
 tarrhal symptoms, as in measles.
                                The prognosis of scarlet fever depends upon
                              the severity of the attack; when about  to termi-
                              nate favorably, the scarlet color of the erup-
                              tion,  as well as the tumefied condition of the
                              skin,gradually disappear, large brownish scales
                              fall from the  skin, which is rendered rough
                              from their presence;  the urine has a mucous
                              deposit,  seen by the microscope  to consist
                              almost entirely of epithelial scales,—and  the
                              patient  is  not safe until this urinary  desqua-
                              mation has ceased, as well as  the  cutaneous.
                              On the other hand,  high febrile  symptoms,
                              rapid and  small pulse,  extreme difficulty  o»
                              breathing  and swallowing, profuse diarrhea,
                              continual  coma or  delirium, bleedings  from
                              the mouth and  nose, and large, dark-purple
                              spots appearing among the eruption, are signs
                              of dissolution.
  Sometimes, as the skin assumes its natural appearance, the patient becomes
dropsical, which proves fatal in a few weeks if  not properly treated;  at other
times, bronchitis, enteritis, opthalmia, abscesses of the ear, obstinate diarrhea,
&c,  remain as consequences of the  disease.  (See Fig's.  15 and  16.)
Fig. 15.
a. Epithelium from the bladder.
 . Epithelial cells of the urethra.
e. Columnar epithelium, from tho fun
   dus of the bladder. 
218
AMERICAN FAMILY PHYSICIAN.
           pig# ie#               Causes.   The disease appears to be  pro-
                             duced by a specific poison, and almost always
                             appears as  an  epidemic  during  cold  and
                             changeable seasons.  Children are more pecu-
                             liarly liable to it than adults, and it may occur
                             two or three times in the same  person.
                               Treatment.  This will vary  according  to
                             the severity of the attack  and  the  stage  at
                             which treatment commences.   The very sligh
                             attacks which sometimes occur, hardly  need
                             other treatment than careful nursing; but in
                             all other cases, I make it an invariable rule to
                             commence  the treatment with an emetic, for
                             which purpose the Compound Powder of Lobe-
  a. Large flattened cells, mth a very Ha will be found the best article; however, in
aistinct nucleus and nucleolus, from the very young children the Compound lincture
trigone of the bladder,  b. Glandular Qf T^^lia mav ^ given,  or the  Compound
^utm^i^rSSct nud^ Acetated Tincture of Bloodroot.   And this
from the ureters.                 emetic may be repeated daily for  three  or
four days in succession, according to the  severity and general  character of
the attack;  the  more  dangerous the febrile symptoms appear, the greater
will be the benefit derived  from  the emetic.  Not much advantage, however,
will be derived from emesis, after the first three or four days.
   As the poison  is apt to remain  in the system, in consequence of the
obstructed or  diminished action of the excretory  organs,  and particularly
that of the skin, it will be necessary, unless otherwise indicated, to attend
to the surface  of the body  from  the first.   A weak ley water, made by put-
ting some sal  soda, or wood  ashes into a  basin of hot rain-water  and  used
tepid, should be applied over the whole surface of the body and limbs, when-
ever the febrile symptoms  run high; and in some instances, a spirit vapor
bath will be found very beneficial,  especially when  there is a tardiness in
the progress of the eruption, or when it  has a  disposition to " strike in."
Warm infusions of Balm, Catnip, &c, warm lemonade, or warm water,  acid-
ulated with vinegar,  may  be drank  freely,  omitting these measures as the
febrile symptoms  decline,  or when a typhoid condition manifests itself*
   When there are accumulations in the  bowels, or a very constipated con-
dition on  the  first days of the attack,  a purgative should  be given, as
Castor Oil, or the Compound  Powder of Jalap; this will tend to relieve
pain in  the head,  remove  any existing torpor of liver or digestive organs,
and moderate  arterial  action.  Purgatives,  however, are seldom indicated,
and should not be given when  diarrhea is present.  Some practitioners
prefer as a laxative, the Compound Powder of Rhubarb and Potassa.
   To moderate the fever,  instead of the above  sweating, I am in the  habit
of prescribing  Tincture  of Gelseminum one  fluidrachm, mixed with six
drops of Tincture of Aconite,  of which  about from  six to eight drops may
 be given to a child six  years old  in a teaspoonful of water,  and repeated
 every hour until  the relaxing symptoms of the  Gelseminum  come on.  In
 some cases I  substitute six or ten drops  of  Tincture of Belladonna for the
 Aconite.
    I have found the following to form a very valuable remedy in the more

   * It may be proper  to remark, that however useful  the above mode of producing and main-
 taining perspiration maybe in this disease, it is only occasionally employed by physicians at the
 present day; but it is well that people who cannot always attain the necessary medicines show
 be made acqua;nted with it. 
SCARLET  FEVER
219
 malignant forms of the disease;  take of Sulphate of Quinia twenty grains,
 Elixir Vitriol one fluidrachm ; dissolve the Quinia m the Elixir, and add to
 the solution, Saturated Tincture  of Black  Cohosh  root twelve fluidrachms,
 Tincture of Belladonna two fluidrachms.  Of this, the  dose to a child six
 years old is  six drops, to  an adult  twenty drops,  which should  be  given
 in a teaspoonful of water, and repeafed every hour, commencing  its use at
 midnight, and stopping each day at ten or  twelve  o'clock  in the  moruing.
 That is, it is to be given during  the period of tendency to remission.
   The inflammation  of the  throat, as known by soreness,  and difficulty of
 swallowing,  &c, should be attended to at an early period.  The Compound
 Tincture of Camphor may be applied three or four times daily to the throat;
 or the Compound  Liniment of Oil  of Amber, or,  Compound Liniment of
 Stillingia may be used instead.  Each time after bathing with or.e of the
 above liniments, a warm poultice of  Hops and Mullein leaves, equal parts,
 or of mashed Cranberries, stewed, should be  placed around the  neck and
 throat.  A  towel  moistened with cold water and applied to the throat,
 changing it  every two  or three  hours, so as to  keep the  parts moist and
 cool, has been highly recommended,  and will, no doubt,  prove beneficial in
 many cases.
   The following gargle must likewise be used freely through the day ; take
 equal parts, by weight, of Sumach berries and Golden Seal,  make a strong
 infusion, sweeten  well with  honey, and add as much  Borax  by weight, as
 would amount to one-fourth the  weight of the plants.   A  small portion of
 this, taken into the stomach will not be disadvantageous.
   In the sore throat I have  found more advantage from lemon-juice than
 any thing else.  The lemon  to be cut in two, fill a part with powdered loaf
 sugar, and let the patient suck the juice and sugar together,  and thus keep
 doing as often as may be necessary.  Warm lemonade may also  be drank
 freely.
   In the malignant fbrm the following has been recommended;  to one gill
 of boiling water, add four drachms of Cayenne Pepper, and one drachm of
 Salt, let it simmer for ten  or fifteen minutes, and add one gill of  Vinegar.
 After it has stood for about  an hour, strain it, and administer a table-spoon-
 ful every half-hour or hour, according to the urgency of the  case.   Or, the
 mouth and throat may be  swabbed with it.
   An excellent gargle or wash, which may frequently be used with benefit
 in the less malignant  forms of sore  throat, is  made of  powdered Golden
 Seal, Cranesbill,  and Witch Hazel bark, of each equal  parts.  To a tea-
 spoonful of  this powder, pour on two gills of boiling water, let it stand till
 cold, and  swab or gargle  often with  it.  Black Cohosh  root in decoction,
 has  been highly recommended as a gargle in  the malignant sore throat.
 No harm will be done, if a portion of any these gargles are swallowed.
  If there is much pain in the head, or a disposition to  inflammation  of
 the brain, Mustard plasters  must be  applied to the soles  of the  feet, and
 cooling lotions to the head, as a  mixture of vinegar and  water, spirits and
 water, &c, as recommended in fevers.
  If putrid  symptoms manifest  themselves, which they generally do in
 malignant cases, a table-spoonful of the following, should be given to adults,
 every hour or two: Take of Sweet Oil, and good  Yeast, equal parts, and
mix together; for children, the dose should be  in proportion to their age.
The throat may also  be gargled  with yeast; or  equal parts of milk  and
yeast may be added  together, and sweetened with  honey, with which the
mouth may be washed or gargled.
  If mortification of  the mouth or cheek takes place, as sometimes happens 
220                AMERICAN FAMILY  PHYSICIAN.
from the use of mercurials, it may be treated as recommended for Cancrua
Oris.
  Frequently, the urinary discharge becomes suppressed, when the patient
may be placed in a warm bath for ten or  fifteen  minutes,  after which  a
fomentation of bitter herbs or pounded Garlic may be placed on the lower
part of the bowels, immediately over* the bladder; diuretic infusions may
also be freely given, as of Goldenrod, Spearmint, Hair-cap  moss, &c.
  Other  symptoms as excessive restlessness, &c, to be treated the same
as mentioned under Auxiliary Treatment of Fevers, page 180.  When the
low, typhoid symptoms  are  present, treat  as named heretofore on pages
181 and  182.
  When  the ears  discharge, a small portion of infusion  of Golden Seal
may be injected into them three or four times a day; or, if the discharge be
offensive, a weak solution of the Chloride of Soda  may be used.
  The patient may use acidulous drinks freely  while the tongue is furred
yellow or brown, as diluted  acetic acid, prune water, tamarind  water, &c.
The linen and bedclothes should be frequently changed;  the atmosphere
of the room impregnated from time to time with the vapor from  one of the
disinfectants named on page 137; the room must also be kept well venti-
lated, and the healthy members  of the family prevented from entering the
apartment  of  the  sick.  Belladonna may be used as a preventive  to this
disease, having been  highly recommended by many physicians  for that
purpose,  but my  own  observations have not fully satisfied  me as to its
powers of prevention.
  In the dropsy that follows scarlet fever, I have, out of over one hundred
cases, treated previously according to old school rules, lost but one patient;
and that  was owing to the fact that the child, being greatly indulged by its
parents, was not  made to take  the  means  prescribed,  because whenever
offered him, he began  to make a great  outcry.  The agents  I use are as
follows:  Take of Nitre  ten grains,  Cream of Tartar twenty grains, infu-
sion of Parsley root twelve fluidounces; dissolve.  For a child from five to
eight years  of age, the dose  is  a  table-spoonful  every hour, so that the
whole twelve fluidounces  is taken up in twenty-four hours.   This must he
repeated  daily until the  dropsical  swelling has  disappeared, and a free
urinary discharge produced, which will vary from three to seven days, when
its use must be omitted, and  some diuretic infusion, as of Parsley root, or
Haircap moss, used freely.  Should there be a white coat on the  tongue, or
other symptoms of acidity of the  stomach, a table-spoonful of the follow-
ing may be administered every hour  or two,  and  continued  until it is
removed:  Take  Saleratus a teaspoonful, dissolve in a  pint of soft water.
While  the above  is  being  used,  should the patient be very  weak, his
strength  may be sustained by wine, or other stimulant,  until the  dropsy
has been removed.  As soon  as the swelling has disappeared,  tonic prepa-
tions must be given, as Wine Bitters, &c; the  following will  be found an
excellent tonic:   Take of Gentian  root, Colombo  root,  Calamus, or Sweet
Flag root, Golden Seal root,  Cayenne pepper, of each in coarse  powder, a
heaping teaspoonful;  add to them one pint of good Lisbon wine, and take,
after it has  stood  a few  days, from  a  teaspoonful  to half a wineglassful
three or four times a day.  It may be sweetened with loaf sugar.
  An infusion of Elder bark (Sambucus Nigra) and  Parsley root,  is also
recommended to remove dropsical effusions following scarlet fever ; or, half
an ounce each, of the articles may be steeped in Sherry wine ; of which a
wineglassful may  be taken four or five times a day.
  The diet and regimen in convalescence from  scarlet fever, must be  the 
MEASLES.
221
same as recommended in  Yellow, Typhus, and Typhoid fevers, which see.
Scrofulous affections,  enlarged  tonsils, and other diseases remaining as a
consequence of scarlet fever, must be treated as hereafter  named under
each affection.
                     MEASLES,  or   RUBEOLA.

   Symptoms.  An attack of the measles is generally preceded by catarrhal
 and febrile symptoms, as lassitude and uneasiness, chilliness and shivering,
 pain in the head, and, sometimes among children, more or less soreness of
 the throat.  These are succeeded by heat, thirst, pains in the head, back,
 and  loins, impaired  appetite, furred tongue, and rapid pulse, the same as
 occur in most  fevers ; but the characteristic  symptoms are a heaviness and
 redness of the  face and eyes, swelling of the eyelids, a watery discharge from
 the eyes, and  an acuteness  of sensation so that they cannot bear the light
 without pain, together with more or less sneezing, and an acrid watery dis-
 charge from the  nostrils.  Frequently there is inflammation of the fauces,
 sore throat, hoarseness, and a  dry, hard, harassing  cough.  The febrile
 symptoms augment rapidly, with hoarseness, difficulty  of breathing, a sense
 of tightness or oppression  across the chest, a frequent and dry cough, se-
 vere pains in the loins, and nausea or vomiting.  There  is generally  a
 remission of the symptoms  toward  morning, with an increased severity of
 them at night.
   The febrile symptoms vary much in severity, sometimes being very mild,
 and at others being accompanied with great heat, excessive thirst, flightiness
 or coma, excessive  perspiration, looseness of the  bowels, the tongue furred
 white, and great restlessness.  In  three or four  days from the appearance
 of the catarrhal symptoms, an eruption of small, red, slightly elevated, circu-
 lar spots may be  observed on the surface, very much resembling flea-bites.
 It appears first on the head, along the edges of the  hair, back of the ears,
 and on the temples, from thence it spreads on the forehead, face, and neck,
 and subsequently extends over the whole body.   As the red spots run to-
 gether they form small patches, which gradually become  larger, and have
 the form of a crescent.  Generally, the eruption is at its maximum in about
 thirty-six hours;  and on about the  fifth or sixth  day from its first appear-
 ance, the swelling of the skin subsides, and the  eruption disappears, first
 on the head, then  on the face, &c, in the same gradation in which it ad-
 vanced.  All the symptoms of fever, cough, &c, gradually pass away with
 the  disappearance of the eruption, and  in  the places where it manifested
 itself, there is a desquamation of the skin, or a shedding of minute branny
 scales.  In some instances  an  annoying itching will  remain  for a short
 time.
   The above is a description of a mild attack of  measles;  but the disease
 will frequently  be found to vary in its symptoms.   Thus, the eruption may
 make its first appearance upon the body, and subsequently upon  the face.
 And, again, it may present itself  in a very severe form, or even with  con-
 siderable malignancy.   In such instances, it is apt to leave the patient with
 a severe cough  and inflammation of the bronchial tubes; or, an exhausting
 diarrhea; or, perhaps, a chronic inflammation of  the eyes, pneumonia, &c.
   Indeed, the sequels of measles are often as serious as the disease itself,
so that considerable caution is required in the after management.   In chil-
dren disposed to scrofula, this disease is apt to be excited into action, attack-
ing various organs,  as scrofulous  sore eyes, enlarged glands of the  neck, 
222
AMERICAN  FAMILY  PHYSICIAN.
tubercles of the lungs, &c.  Occasionally, a severe dysentery has followed,
or, a discharge of pus from the windpipe, &c.
  In the more alarming cases of measles, the fever assumes the typhoid type,
the pulse becomes feeble, small, and rapid, the eruption recedes and does
not appear again, or it manifests  itself very irregularly; instead of beino
red, it becomes pale, or livid, and  sometimes nearly  black.  And with this
condition will be observed twitching of the tendons, spasmodic movements
of the  limbs,  and the usual symptoms attending typhoid conditions.
  Causes.   This  disease appears  as  an epidemic, attacking only those
whose  systems are predisposed  to it; and is supposed to be owing to  some
specific infectious or contagious poison.  It may prevail at any period of
the year, generally during cold and variable seasons,  at  which times it
proves more fatal.  Children are more  liable to it than adults, and it is sel-
dom that a person is attacked with it the second time.
  Measles may be sometimes confounded with scarlet fever.  They  may be
distinguished,  however,  by the eruption in measles  being less vivid  than in
scarlatina, it is also rougher to the  touch, with a tendency to a crescentic
form,  while in  scarlet fever it is more smooth and  uniform.   In  measles
there is a watery discharge from the eyes and nose,  with sneezing,  and in-
tolerance of light; while  in scarlet  fever these parts remain  dry and less
sensitive.   Cough and difficult breathing  are  common in measles;  the
fauces  do not exhibit the slough-like masses of mucus, nor the ulcerations
which  belong to scarlatina, nor does the tongue show the red, elongated
papillae, projecting upward.  In scarlet fever the pulse is  more rapid, the
heat of the body more elevated, and delirium  and  convulsions  are more
common.  In measles  the eruption appears on the third, fourth,  or  fifth
day; while in scarlatina it is  observed on the second  day, rarely on the
third.   The shedding of the skin is in  small scales in measles, but in good-
sized pieces in scarlet fever.
  The prognosis of measles is favorable in mild  cases, when the progress of
the  disease  is regular, when a free  and copious expectoration  ensues, with
a moisture  on the skin after the eruption  appears, and  a gentle  diarrhea.
When  the  fever  is very high,  unusually hard  pulse, hurried  and  difficult
breathing, excessive dry cough, severe  diarrhea, and  coma, or delirium, the
prognosis is unfavorable;  and  much more so, when the eruption recedes,or
becomes of a livid color, with petechia), small, intermittent pulse, great pros-
tration of strength, twitching of the  tendons, &c.
  Treatment.  In the  mild   cases but little medicine is required; the
limbs  and body may be bathed with a warm, weak ley water, and the patient
may drink  freely of a  tea made of equal parts of Saffron, Virginia  Snake-
root, and Spearmint;  and some care should be taken that he does not ex-
pose himself  to cold, or sudden changes of temperature.
  When, however, the  fever is high, or the eruption does not readily ap-
pear, some warm  Gin or Whisky toddy may be  given with much advantage,
and without any fear of increasing the  danger of the disease.  And  in very
severe  and  obstinate cases, the Compound  Tincture  of  Virginia Snakeroot
may also be given, in doses according to the patient's age, and which should
be aided by the hot toddy, or warm  infusion of Virginia Snakeroot, Spear-
mint,   Ginger, or other simple aromatics; not forgetting to bathe the  sur-
face of the  body frequently with the warm, weak ley, while the febrile stage
is present.   Infants  may be placed  in a warm  bath, at the same time ad-
ministering the above tincture, or some warm toddy.
  In very obstinate eases where the  eruption had receded, or would not ap-
pear by the ordinary means, I have invariably succeeded in bringing it out 
MEASLES.
223
 by applying Mustard poultices over the whole abdomen, to the feet, ankles,
 and wrists, allowing a  considerable degree of redness to be produced.  It
 also proves of utility where there is a severe cough, and drowsiness, with a
 rapid  pulse; likewise, when' the eruption  has a tendency to become of a
 dark color.  When warm fomentations have been  applied over the abdo-
 men, I have in a number of instances witnessed unpleasant results, and feel
 disposed to condemn their use.
   Should the premonitory symptoms of measles be severe, indicating a seri
 ous attack, it will be allowable to commence the treatment at an early period
 with a gentle emetic, as the Compound Tincture of Lobelia for a child, or
 the Compound  Powder of Lobelia for an adult;  but  in ordinary cases,
 emetics are not required.
   Purgatives are not demanded in this disease; if  the bowels are costive,
 an injection may be given; I have never observed any peculiar, unpleasant
 effects arising from a constipated condition of the bowels for two or three
 days in this disease; and  always prefer an injection, when it is desired to
 evacuate  them, to physic  by mouth, on account of  the great susceptibility
 of the mucous lining  membrane of the intestines, which  is almost always
 present.
   For the cough which attends, much benefit will  be derived from the use
 of the Compound  Tincture of Lobelia, given every hour or two in some
 Slippery Elm, or Marshmallow infusion, and in a sufficient quantity to pro-
 duce a slight sensation of nausea.  A syrup of Boneset has been  found of
 service in cough; so, also, has  an  infusion of equal  parts of Pleurisy root
 and Boneset;  and in those cases where the febrile symptoms have run very
 high, with scanty or suppressed urine, the following will prove very advan-
 tageous :—Take of Spirits of Nitre, Lemon Juice,  Honey, Salad Oil, each,
 equal  parts; mix.  The dose  for  an adult is a teaspoonful  every hour or
 two.  When  there  is great dryness of the mouth and throat, much relief
 will be afforded by causing the  patient to frequently inhale the vapor  of
 vinegar, from a hot brick or shovel.
   The eyes, as well as the nostrils, will frequently be relieved, by washing
 them with distilled Rose-water, with Borax-water, or with an infusion of
 Slippery Elm.
   If the tongue is coated  brown or yellow, acidulous draughts may be al-
 lowed, as  Cream of Tartar water, lemonade, &c.  If there is much pain ir_
 the head,  the feet should be bathed often, and Mustard poultices applied to
 the feet and back of the neck ; and the head may be  bathed with some cool-
 ing wash, as vinegar, water, and whisky, equal  parts of each.  Excessive
 nausea or vomiting may be overcome by an infusion of Spearmint, aided by
 a Mustard poultice over the region of the stomach.
   When there are decided symptoms of  pneumonia  present, a Mustard
 poultice should be applied over the whole chest, and after it has produced
 considerable redness of the parts, a fomentation of Hops and Lobelia leaves
 should be applied as warm as the patient can bear it, changing it every half
 hour or hour, and being very careful not to expose the patient while chang-
 ing them, so as to cause the eruption to recede.  Apply warmth and stimu-
 lus to the feet  and legs, and order  the vapor of vinegar to be inhaled fre-
 quently.   A similar  course may be pursued when symptoms of bronchitis
 are present.   When inflammation of the  larynx is present, in addition  to
 the above  measures, a gentle emetic may be given occasionally, and a warm
fomentation of Hops and Mullein placed around the throat, changing it sev-
eral times a day.^  Nauseating doses of  the Compound Tincture of Lobelia
should also be given, as recommended above for cough.  I would state here, 
224                AMERICAN FAMILY PHYSICIAN.
that in measles complicated with the above pulmonary inflammations, when
the fever is very intense, great  heat and dryness of the mouth and fauces,
also of the skin, rapid pulse, &c, I have succeeded in  overcoming the more
formidable  symptoms, by the following compound:—Take of Tincture of
Gelseminum  half  a  fluidounce, Tincture of Aconite twenty drops;  mix,
and give to an adult  twenty drops for a dose, in a teaspoonful of water, re-
peating the dose every half-hour or hour.  The dose  for children must he
proportioned  to their ages.   As soon as the violent symptoms abate, or the
peculiar  relaxing influences of the  Gelseminum  occur,  omit the medicine
until it is again required.
  Diarrhea occurring during the disease, when severe, will be checked by an
infusion of Blackberry root, or  Dewberry root, to be drank freely; in addi-
tion to which,  injections of  starch-water a table-spoonful,  may be given
two or three times a day, adding to each injection a few drops of Laudanum.
  When malignant or putrid symptoms occur, the system should be sup-
ported by wine, stimulants, &c, the same as named heretofore in typhoid
conditions of febrile diseases ; and for putrescency, Yeast, mixed with Sweet
Oil and Molasses, may be given several times a day.   In two cases of mea-
sles, in which the eruptions  became  dark-colored, with an accompanying
diarrhea and symptoms of a typhoid  nature, I effected  cures by the inter-
nal use of the Tincture of Chloride  of Iron.
  During measles, the diet  must be of the lightest kind, as barley-water,
flax-seed infusion, toast-water, baked or roasted ripe fruits, &c.  The room
should be well  ventilated, of a  moderate temperature, and  kept clean; the
patient's covering should be light and comfortable, and   changed often.
The apartment  should be kept quiet and darkened.  During  convales-
cence,  it is better for the patient to continue a light diet for several days,
on  account of the continued tendency to intestinal irritation ; gruel, pan-
ado, currant jelly, buttermilk, whey, &c, may be used  in addition to the
above, and great care  should be taken to guard against the  influence of
cold, for many  days after the desquamation is completed.
  The diseases which remain as a consequence of measles, as chronic oph-
thalmia, diarrhea, &c, must be  treated according to  the directions given
under  their appropriate heads.
                            SMALL-POX.

  Small-pox, or Variola, is a very loathsome and offensive disease, of a con
tagious nature, prevailing at all seasons of the year, but usually in the spring
and summer, and frequently occurring as an epidemic.  All persons  are lia-
ble to it, but the young more especially.  In this country it seemed to follow
epidemic Asiatic cholera.  It rarely attacks a person the second time, though
instances have happened where it has appeared, even, the third time in one
person.
  Symptoms.   Small-pox  may  be so mild  in  its character, as to produce
hardly any observable symptoms.   More  generally, however, it commences
with a feeling of lassitude, and dull, heavy sensation in the head, which, after
a greater or less duration is followed by pains in the head, back,  and loins,
more or less severe chills, the patient frequently imagining he has caught a
severe cold, or he may mistake the first symptoms for influenza, rheumatism,
or pleurisy.   The chills are succeeded by heat of the skin, severe pain in the
head, quick pulse, furred tongue, redness of the  eyes, great thirst, tenderness 
SMALL-POX.
225
 jtt the region of the stomach, ana  not unfrequently nausea  and vomiting.
 As the febrile symptoms increase, especially in the confluent and more unfa-
 vorable cases, there will  be more»or less delirium, or stupor; and children
 are frequently attacked with convulsions. The fever having continued about
 two days, and in some instances, three or four, the eruption appears.   In my
 own  case the chills occurred at night, and on the following morning, about
 fourteen hours having passed, the eruption  appeared as a small rash all over
 the  body; it was, however, undoubtedly hastened by a  Spirit vapor  bath
 which was given me on the morning of its appearance.  The eruption at first
 appears in minute red specks on the face and  neck, and  gradually  extends
 itself over the  body, becoming  more and  more prominent.   In mild cases,
 there may be found only  six or eight of these pimples.   Generally, but few
 will be found on the face.  These  elevations, from their first formation are
 surrounded with a  redness at their base, and which extends to some distance
 beyon 1 their margins.   There is generally a remission or cessation of the
 febrile symptoms shortly after the appearance of this eruption.
   As the elevation of the pimples proceed, they first present a  vesicular char-
 acter of a white or  yellowish white hue, with a dark depressed spot or pit at
 tneir center.   As the vesicles fill and proceed to maturation, the head and
 face  swell  more  or less, according to the character of the disease, so  as  to
 materially disfigure  the  patient, which swelling extends over the body
 wherever the eruption is  manifested; the eyelids are more or less closed up
 so that often the patient cannot see, and in  consequence of the mucous mem-
 branes becoming affected  during this stage,  the eyes, nose and mouth are apt
 to be attacked, in a greater or less degree, with the eruption.   There is also a
 troublesome itching attending this stage, frequently so annoying  as to cause
 the patient to scratch himself severely until blood oozes from the part, which
 invariably marks the face or whatever part  has been scratched.  A peculiar,
 faint, greasy, and sickly odor emanates from the surface of the body du-ing
 this  stage, and  which is  especially  observed when the matu.*atnn is  at its
 height.  In adults a  salivation usually  attends this stage,  in  children  a
 diarrhea is more «ommon;
  From the sixth to the eighth  day o? tl\e  (Tuption, or from  the eighth  to
 the  twelfth day of the disease, the vesicles have acquired the character of
 well-developed  pustules, convex, without any depression in their  center, and
 gradually change to a brown or  dark color.   The pustules become converted
 from  a conical elevation to a circular and flattened one, drying up from the
 center to the circumference, forming scabs which eventually fall  off, leaving
 circular, brownish spots which  remain for some weeks, together with perma-
 nent  scars or pits, more especially on the face.   Not unfrequently the pus-
 tules burst,  and give out a fluid that forms  into  brown or  black  crusts,
 leaving similar appearances and marks, when they drop off, as in the former
 instance.  At this  period, when the eruptive process is concluded, and ma-
 turation perfected, a secondary fever usually comes on, the severity of which,
 is owing to the extent of the disease, and the  vital energies of the patient;
 and, it is frequently the case, that a severe and  harassing cough  takes place
 about this time.  As the  pustules dry up and  form scabs, the fever abates,
 and the swelling of the face rapidly disappears.
  Small-pox is  divided into two forms, the distinct and the confluent.   In the
 distinct variety,  the pu.stules vary in number from a few to an eruption over
 the whole surface,  but they are isolated, distended, circular, and  of  the size
 of small peas;  the  spaces between  them are red, and in which an abortive
 eruption frequently appears, resembling scarlet fever, or erysipelas.   The
 accompanying fever is  of an  inflammatory character, and ceases  when  th«
eruption is complete.                                            15 
226
AMERICAN FAMILY  PHYSICIAN.
  In  the  confluent kind, vomiting almost always attends, and all the symp-
toms are more severe and violent;  convulsions are more common, delirium is
more violent;  and stupor more profound;  and from the violence of the symp-
toms during the febrile stage, the patient may die before the eruption is man-
ifest,   The pustules run together, do not fill so thoroughly as in the distinct
variety, are  dark, flaccid, and irregularly circumscribed, and  the  spaces be-
tween them, if any exist, are pale; the secondary fever is of a typhoid char-
acter, and the fetor that accompanies the maturating stage toward  its termi-
nation is very offensive and disgusting.   In children  diarrhea, and in adults
a salivation ; and when crusts form, the whole  face  is covered with a mask
composed  of the scab.
  Sometimes the disease  assumes a malignant character, symptoms of pu-
trescency  take place at an early period of  the disease, livid spots appear, and
hemorrhages ensue from various parts of the body.
  The cause of small-pox  is not known.  The disease generally prevails
either endemically or epidemically, and is infectious.   There  is no doubt in
my mind  that it  depends  on causes connected with the condition of the
atmosphere.   The disease is more readily communicated from one person to
another during its season of attack, from the period of the eruption until the
desquamation  takes place;  and a person having a mild attack may commu-
nicate a severe form of disease, and vice versa, depending on the state of the
constitution receiving the infection.
  Prognosis.  The distinct small-pox is considered  as being attended with
the least danger, except when the eruptive fever is very violent, when it at-
tacks pregnant women, or when it approaches nearly in its nature to that of
the confluent.  But  the confluent small-pox is  always accompanied with a
considerable risk, the degree  of which is in proportion to the violence and
permanence of the fever, the number of pustules on the face, and the dispo-
sition to  putrescency which prevails.  When the disease proves  fatal, death
commonly occurs between the eighth  and eleventh day; but in some cases
death is protracted to the fourteenth or sixteenth.
  The confluent species, when  not fatal, is  apt to  induce various morbid
affections, as diseases of the eye, chest, scrofula, &c.  Frequently, however,
it will leave persons previously unhealthy, in the possession of perfect health.
  If the hands and feet swell regularly, while the swelling of the face  sub-
sides at the  same time, it is favorable; while delirium, violent fever, stupor,
severe vomiting, sudden disappearance of the eruption or subsidence of the
swelling of  the face or extremities, suppression  of saliva, depression of pus-
tules, with  loss of strength,  pallor of the skin, great  anxiety, fainting or
convulsions, denote the greatest danger.   If the patient does not appear to
to be heart-sick, keeps in good spirits, is  talkative &c, after the maturating
period is  completed, it is in all cases a favorable indication.  Infants seldom
recover from small-pox.
   Varioloid is only a modified  small-pox, and requires a  treatment similar
to it, in all respects, according to the grade of its symptoms.   I do  not con-
sider an attack of varioloid, by  any means a preventive of small-pox.  The
eruption  of varioloid does not assume the flattened pustular form, but ia
more spherical, and is filled with  yellow  serum  or pus.   After  a few days,
the  vesicles  or pustules dry up and form  small round scabs, which fall of?
and leave no indentation after them.
   Treatment.   The great difficulty  in  the management of small-pox, is
that of doing too much, and the friends are apt to  suppose that if the prac-
titioner is not constantly prescribing medicine, he is not doing justice to the
 patient.   But this is a wrong  opinion, for, under  ordinary  circumstance?, 
SMALL-POX.
227
 small-pox requires but little medicinal  treatment.  When the symptoms are
 mild, let the patient alone, any interference with the natural progress of the
 disease may induce a fatal result.   It is only when the symptoms  are  very
 severe, or when certain troublesome symptoms appear, that medicines are to
 be employed.   And I have  no  doubt but that the great fatality in former
 times, was more owing to the measures of  the physician than  to the disease.
   In nearly all cases of small-pox, excepting the very mild forms, an emetic
 administered early in  the disease, will prove very beneficial, often  lessening
 its subsequent severity and danger, and  checking the nausea or  vomiting
 which may be present; and  for this purpose the  Compound Powder of Lo-
 belia  may  be administered to   an adult, or the Compound  Tincture  of
 Lobelia to a young child.
   After the operation of the emetic, should the febrile symptoms run high,
 or if the patient has previously been costive, or, if there are evident vitiated
 accumulations in the  bowels,  the bowels should be opened by an  injection,
 and the internal  administration  of a Seidlitz powder.   No active purgation
 must be produced; it  is much better to repeat  the  Seidlitz powder in the
 course of five or  six hours, than to give a harsh cathartic agent.
   Should there be great irritability of the  stomach, with nausea, or constant
 vomiting, an infusion of equal parts of Marshmallow root and Peach leaves,
 may be given, and a Mustard poultice be applied over the  region  of the
 stomach.  Mustard applied  along the whole length of the spinal  column,
 will frequently relieve the great  pain in the head, back, and  loins,  as  well
 as aid in allaying irritability of the stomach.
   The body should be frequently bathed  with  warm weak ley water,  and
 which should be continued daily  until  the appearance of the eruption.
   When the  primary or secondary febrile symptoms are very  active, I
 usually administer about twenty drops of the  Tincture of Black Cohosh,
 every two or three hours; and when very intense or inflammatory, I add
 two or three drops of the Tincture of Aconite to each dose.   This is all the
 medicine which I ever give  in this disease, save when there is  excessive
 restlessness and wakefulness, in  which case eight or ten grains of the Com-
 pound Powder of Ipecacuanha and Opium may be administered at  bedtime^,
 and repeated in an hour or two,  if necessary.
   When there is  excessive pain in the  head, or delirium, the feet may be
 bathed in warm  water for  fifteen  or  twenty minutes, after  which apply
 Mustard poultices to them.   If  these symptoms are very severe, the Mus-
 tard may also be  applied  to the back  of  the neck,  and along the whole
 course of the spinal column, and  allowed to remain until a redness of the
 skin is produced, when, if necessary, its situation must be  changed.   The
 head and temples must also  be bathed with some cooling  lotion, as a mix-
 ture of spirits, vinegar,  rain-water, one  gill of each, salt a teaspoonful.
 This may be used tepid or cold,  as appears to be  best suited  to the case.
 In case of soreness of the  mouth, or throat, these may be washed or gargled
 with a decoction of Sage and  Hyssop, to which powdered Borax may be
 added, and the whole  sweetened  with honey.
  When there appears to be a flabbiness of the pustules, or they  do  not
 till well, wine whey, or milk punch may be given freely until  an improve-
 ment has taken place in their  appearance; and should they recede or strike
 in, in addition to  the above,  a teaspoonful of the Compound Tincture of
 Virginia Snakeroot must be  given in a  teacupful of Balm tea; but be care-
ful not to apply warm poultices or fomentations to the bowels or stomach
at this period,—I have seen them invariably followed with rapidly fatal
results.  These conditions are apt to be attended with  great  prostration of
itrength, requiring wine, ale, &c, with  some Peruvian bark. 
«
 228               AMERICAN  FAMILY- PHYSICIAN.

   If putrid or malignant symptoms appear, give a table-spoonful of a mix-
 ture of equal parts of Yeast and Sweet Oil, and repeat it every hour or two.
 Where Yeast  cannot be obtained,  small doses of dilute  Pyroligneous Acid
 may  be substituted.   Other  symptoms  to  be treated as named in the
 previous febrile diseases.
   The  room  in which  the patient lies  should be  kept moderately cool
 should  be well-ventilated every day, and be frequently  filled with one of
 the disinfectant vapors named on page 137.  He should be kept  not too
 warmly covered, and his clothing as well as the bedlinen  should be changed
 every day or two.   If he desires water to drink let him have it; and always
 allow acids when the tongue is  coated yellow,  brown, or  black.  The  diet
 should  be barley-water,  thin Indian  meal  gruel, buttermilk, apple-water,
 roasted apples, lemonade, currant jelly,  guava jelly, sour  orange juice, &c.
 I have known patients to use the juice of sour oranges for a number of days
 in succession,  and with much advantage.  To  prevent the eyes from becom-
 ing injured by the disease, they should be frequently washed with Hose-water,
 or mucilage of Slippery Elm, more especially when the fluid from the pustules
 flows into them.  And the nostrils may be  kept free by passing a well-oiled
 camel's hair pencil into them several times  a day.
   To prevent pitting resulting  from small-pox, I have for the last fifteen
 years pursued  the  following course,  by which all who were attentive to the
 directions have been cured  without a single pit.   The  body in small pox is
 seldom pitted,  because it is kept from the light, and the action of the atmos-
 phere upon the pustules is  greatly modified; we  must then protect the pa-
 tient's face from the action of both the light and the air.
   To accomplish this the room  in which the patient lies must be kept con-
 stantly dark, but not so closed as to prevent a free circulation of fresh air for
 inhalation, and the face must be kept constantly well-oiled with  Sweet Oil,
 which must be put on by gently touching, (not rubbing) the face with a soft
 feather which has been dipped  in the oil.  Sweet Oil or  Almond  Oil will
 answer.  The oil must by no means be allowed to  dry on the face.   The
 patient must not touch his  face with his hands at all, and  should he be delir-
 ious, the hands must be secured; neither must the face  be rubbed  against
 the pillow or bed-coverings.
  The room must be kept dark, using a lamp or candle only, when a light is
required, and the oil must be applied from the commencement of the appear-
ance of the pustules until they have all scaled off.   At the same time a piece
of black oil-silk, well-oiled, and having an aperture cut in it  for the mouth
and nose,  to enable the patient to  breathe, must be kept  upon the face,
removing it only to oil the  face.
               COW-POX,  or,  VACCINE  DISEASE.
  The Cow-pox is an artificial disease, introduced by  Dr. Jenner in 1798,
for the prevention of small pox, protecting the system  from its infection;
and mankind are  deeply indebted  to  him for having  conceived  the happy
thought of employing it.  The vaccine virus is taken from the cow, which,
when laboring under the disease, manifests symptoms of considerable sick-
ness, with a vesicular eruption on their udders.  And, it had been observed
by Jenner, that those who milked them at this time were liable to an ulcer
with some degree  of fever, and subsequently were  apparently safe from the
infection of small-pox.
  Vaccination with the virus from the cow  is  in  most cases a  protection 
COW-POX.
229
  against small-pox, or,  at all events, it greatly modifies its  severity.   And
  when small-pox appears after vaccination, the presumption is, that the vac-
  cine matter was not good or genuine.   As the virus of cow-pox does  not
  seem to lose its influence by passing through the human system,  it is more
  commonly collected for use from individuals.   The  following rules must be
  observed in obtaining it:—
    1. It is better to procure the matter from a child of from two to six months
  old, who  has been vaccinated, and who is perfectly healthy.
    2. The matter  should be taken while the fluid  is perfectly transparent,
  and not later than the  eighth day.
    '■>. The matter,  if not used immediately, should be collected on small pieces
  of quill, and allowed to dry gradually and thoroughly, after which it should
  be kept in a well-closed vial and in  a cool place.   A recent and  very excel-
  lent plan is, to preserve the matter in a concavity made in  a small square or
  round slip of glass, and cover this with a plain slip of glass; the surfaces
  designed to come in contact with each other being ground.
    In vaccinating  or inserting the matter, the  upper and front part of the left
  arm  is usually selected ; a very superficial scratch or puncture must be made,
  and the matter, moistened by a drop of water, rubbed thoroughly into the
  puncture.  If the part bleed a few  drops, the vaccination will not be likelv
  to "take."                                                             J
    Some practitioners instead of collecting the vaccine fluid on the eighth or
  ninth day, prefer waiting until the fourteenth or fifteenth day, and obtain
  the dried scab, a portion of which is dissolved in a little water, from time to
  time, and used as  required.   It is equally as good as  the fluid; and  should
  be preserved in a similar manner.
    The best age for vaccinating is from two to  six months, though it may be
 safely and effectually done at any subsequent period, and the most appropri-
 ate time is cold weather, though, when needed, it may be  performed at any
 season of  the year. In cold weather it is less troublesome.  It is proper to
 repeat the operation two or three times,  should it prove  unsuccessful, and in
 seasons of small-pox, there is no harm in repeating it carefully a dozen times.
 It is  generally considered,  that a person  who is not susceptible to the vac-
 cine disease, is equally unsusceptible to  small-pox.   It is believed by  some
 that the vaccine virus affords protection for only a limited number of years,
 and that it should  be repeated after  six  or eight years; that its influence  in
 this respect,  differs with various individuals there can be no doubt, but these
 individuals who are the exceptions, are fortunately nearly as few as  those
 who may have a second  attack of small-pox.   Among persons who have been
 vaccinated, it will be well, however, to have the operation repeated whenever
 small-pox  prevails, as no harm can thereby ensue.  The operation is simple.
 and soon  accomplished, the  disease  not  usually troublesome or severe, and
 the results will test the susceptibility of the system to the small-pox influence.
   Soon after the insertion of the  matter, a slight redness is seen, which
 soon disappears, leaving only the  mark of the incision or puncture.  On
 the third or fourth day,  a little red speck, slightly raised, appears,  which on
 the fourth or  fifth  day becomes a vesicle,  somewhat flattened on  the top,
 and contains a clear,  transparent lymph.   By the seventh or  eighth day,
 the vesicle is well-developed, with a regular, round, well-defined  margin, a
 depression at its  center, and having its  base surrounded with a circular
 redness or inflammation.  The vesicle continues to enlarge gradually, until
the tenth or eleventh day, when it assumes a pearl color, is perfectly circu-
lar, well elevated and from three to six lines* in diameter, and with a circular
* A lino is the twelfth of an inch. 
230
AMERICAN FAMILY  PHYSICIAN.
redness around its base about  two inches in  diameter.  The redness and
hardness now begin to diminish, the vesicle contains a viscid, dark-colored
fluid, a dark-brownish scab forms,  and, on the fourteenth or fifteenth day,
falls off, when it may be used for vaccination, if the matter has not  been
previously evacuated  for this  purpose.   The scar left after the part has
healed is circular, more or less indented, with a well-defined  border, and
having on its base or bottom a  number of minute pits or depressions.
  Treatment is seldom required during the course of the  vaccine disease
Some persons experience constitutional  symptoms, with more or less fever
swelling  of the axillary glands, &c; such require  quiet,  moderate  diet,
and regularity of bowels.  As during the  development of the vesicle, there
may be a burning or itching  sensation, great care should be taken with
children that they do not interrupt its progress by scratching or  rubbing
it off.
                 CHICKEN-POX, or  VARICELLA.

  Chicken-Pox, sometimes called swine-pox, is an eruptive disease, some-
what similar to small-pox; it appears to depend upon a specific contagion,
attacks a person  but once during life,  but is not  a  protective against
small-pox.
  Symptoms.   Frequently the  eruption appears without any premonitory
symptoms.   In most  cases,  however, there  is a slight  febrile  action, as
slight chilliness, flashes of heat, more or less  pain in the head, thirst, rest-
lessness, and a quick pulse.   These febrile symptoms may continue from a
few hours to two days, when a slight eruption appears on the breast, back,
and shoulders, gradually extending itself to the face, head, and extremities.
This eruption is at first in the form of bright red spots,  somewhat resem-
bling those of small-pox, and is often attended with an incessant  tingling
and itching, occasioning the patient to scratch and rub off the tops of the
vesicles during their  progress  to  maturity.   In  two or three  days  these
spots become converted into  transparent vesicles, covered with a very thin
skin,  and containing a clear  fluid.  About the  fifth  day, these vesicles
having matured, gradually dry away, and on the ninth or  tenth day the
scabs fall off, and leave no permanent scar or pit, unless the eruption has
been improperly interfered with by scratching.
  This disease  may be mistaken  for small-pox,  but may be distinguished
from it, by the  slight febrile symptoms  and their short duration in chicken-
pox, by the earlier appearance of  the vesicles, and by their  never acquir-
ing the purulent,  dark-yellow, or mahogany color of the small-pox pustules.
The vesicles on being punctured are diminished in size, which is not the
case with those of small-pox; beside which they are very few in  number,
and seldom have a pit or depression in  their center.
  Treatment.  Treatment is seldom required in this disease, further than
to keep the patient comfortable, and free  from any exposure  that may occa
sion a cold.   Should,  however,  the febrile symptoms be of unusual charac-
ter, the bowels  may be opened by Seidlitz powders; warm drinks of simple
herbs administered; and tb.3 patient kept upon a mild, unstimulating diet. 
INFLAMMATORY  DISEASES.
231
                        MILIARY  FEVER.

  This disease was formerly more common than at present, and principally
among parturient  females, appearing in from two to twelve  days  after
delivery.  Those of  debilitated constitutions are  more subject to  it,  and
among its causes are enumerated impure, over-heated  air, stimulants, rich
food, fatigue, uncleanliness, excessive discharges, &c.
  Symptoms.   Miliary fever is ushered in with chills, followed by ordinary
febrile symptoms, and an acid perspiration, of a penetrating odor somewhat
like that of rotten straw.  There is a suppression  or diminution of the
secretion of milk, as well as of the  lochial  discharge.  The  skin becomes
rough, with a pricking or itching  sensation, and sometimes aphthous  ulcera-
tions of the mouth and throat take place.  In a few  days,  minute round
vesicles, about the  size of millet seeds, appear upon the neck,  breast,  and
back,  and also on the forehead, and gradually manifest themselves over the
whole body and limbs.   These vesicles are usually distinct,  have a  rash or
slight inflammation around their base, and seldom appear on the face.   In
about thirty hours the vesicles assume a white or pearly appearance, and,
after a few days dry up,  leaving scabs or branny scales  which fall off.  The
tongue is coated white, with red edges, and  prominent papillae. As long
as the fevor and sweating continue, the patient is liable to frequent  attacks
of the eruption.
   Treatment.  The room should be well cooled  and ventilated, and only
light bedclothing allowed, being careful not to reduce the temperature so
:is to permit  the patient to " catch cold."  Regulate the bowels by mild
laxatives, and administer an infusion  made of equal  parts  of  Maidenhair
and Elder blows.  All  the  drinks  should  be cool.   If the  stomach  and
biliary organs are much deranged, a mild emetic may be given at the com-
mencement of the attack.  The drinks should be cool.
  When the disease is severe, Sulphate of Quinia may be given in doses of
a grain three or four times a day.  Ulcerations of the mouth may be bathed
or gargled with Borax, dissolved  in water, to which some Honey is added;
or the infusion of  Golden Seal and  Blue Cohosh, named  under Thrush,
may be employed.   The  chief point is to prevent a recession of the erup-
tion, or a sudden checking of the perspiration,  either of which would be
apt to  cause  a  fatal termination.  The  diet  should be light,  bland,  and
nutritious; and the perspiration must not be increased too much lest great
debility be induced.
                   INFLAMMATORY DISEASES.
   Inflammatory diseases are characterized by increased redness in the
part affected,  heat, pain, general swelling, and  more  or less secondary
constitutional  symptoms.  It is termed general,  when the whole system is
affected; and local when  only one part of the system is involved.   When
an internal organ is affected it is called an internal inflammation, and when
it is confined to  a part near  the surface, it is called external.  When the
symptoms are very severe, with heat,  pain, redness, quick pulse, &c, the
inflammation is acute; when  of long  standing,  or when the more  active
symptoms have subsided, it is chronic.  Writers  have also divided inflam-
mations into the phlegmonous, and the  erysipelatous.  Phlegmonous inflam-
mation is the term applied to ordinary inflammation occurring in all parts
of the body, in which there  is a circumscribed inflammatory affection  of 
232
AMERICAN  FAMILY PHYSICIAN.
the skin and cellular membrane, with more or less swelling, of a bright red
color, and in which any effusion that happens to take place is usually con-
verted into pus.  Erysipelatous  inflammation is confined to  the skin, or
internal  mucous  membranes, with more  or less redness, which disappears
transitorily upon pressure,  and which is not  distinctly circumscribed, but
is gradually shaded into the color of the surrounding tissues, and which is
attended with heat and a burning pain; there is  but  little  swelling, but
more  frequently vesications of various sizes  arise, followed by desquama-
tion of the cuticle.  When  phlegmonous and  erysipelatous inflammation
 ccur in  combination, it constitutes what is termed erysipelas phlegmonodes
                            ERYSIPELAS.

  Erysipelas or St. Anthony's Fire, is a spreading inflammation, character-
ized by a circumscribed redness of the skin, accompanied by a sensation of
heat and itching, and more or less  constitutional  derangement, with vesica-
tion or swelling  of the subcutaneous cellular tissue, commonly ending in res-
olution and desquamation, sometimes in suppuration,  and rarely in gangrene.
Every part of the body is  liable to erysipelatous inflammation, but it more
frequently appears on the face, legs,  and feet,  when seated externally.  It
appears to be confined to no particular  age,  sex,  or constitution;  persons
about the middle period of life are not so liable to it as those younger or
older.   Females are more subject to it than males; especially  those of san-
guine and irritable habits, or who are intemperate.
  Symptoms.   Erysipelas generally commences with  chills, loss of appetite,
nausea,  costiveness, and other common  symptoms of fever, succeeded, in from
two to four days, by an inflammation of some parts  of  the  body, attended
with great pain,  heat, itching, or a pricking sensation,  a remarkable  florid
redness and swelling of the skin, which redness is characterized by disappear-
ing and leaving  a white spot for a short time, after being slightly touched by
the end of the finger; and  if the disease is extensive, all the symptoms of
typhoid fever ensue.   The part most commonly  affected is the head, when it
commences with stupor,  some degree  of delirium, and a full and frequent
pulse, and when the inflammation is extensive, there  is generally no remis-
sion of febrile symptoms.  The face swells and presents  a red appearance—
the eyes being often closed up with the swelling;  breathing is difficult; the
fauces and nose  are very  dry; and if the disease  is violent, the patient gen-
erally dies on  the ninth or eleventh day of its attack, from inflammation, or
other affection of the brain.
  When the disease  affects the breasts, they swell and  become  very hard
and. painful—often suppurating,—there  is also, in many instances, a severe
pain in the glands of the armpits, in which abscesses will sometimes  form.
When the feet are affected, the contiguous parts present a shining appear-
ance, attended with  pain, scarcely  bearing the slightest touch,  and often
ascending into the legs.   In mild cases there will be heat,  roughness, and
redness  of the skin, with  slight febrile  symptoms, which after a few days will
cease, the surface of the part affected  becoming yellow, and the cuticle or
scarf-skin falling off in scales.
  When the attack is severe, with  high inflammatory symptoms,  there will
be pains in the head and back, great heat, thirst, restlessness, the pulse will
become  small and frequent, and after a longer or shorter time, small vesicles,
similar to those produced by blisters, present themselves, sometimes having
more  the appearance of a small-pox vesicle,  which are  filled with a watery 
ERYSIPELAS.
233
fluid at first containing a free acid,  and of a colorless, but more commonly,
yellowish  cast, which becomes more opaque and thicker—the cuticle breaks
and falls off in scales, leaving the skin either sound, or ulcerated; and when
this last is the case, the ulcers are  frequently of a disagreeable, ill-condi-
tioned, and indolent character, sometimes, but rarely, assuming a tendency
to gangrene.
  Causes.  Erysipelas may be considered a humoral  and constitutional in-
flammatory disease, proceeding from a vitiated state of the blood; and whether
it be epidemic,  or sporadic, this peculiar condition  of  the blood must be
present.   When it occurs as an epidemic, it is connected with some particu-
lar state of the atmosphere.  The condition of the blood necessary to dispose
to this  disease, is   undoubtedly produced by  intemperance in eating or
drinking,  or by using improper diet.   And  it will  be found  that persons
accustomed to a free indulgence in all kinds of food and drink,  will develop
the disposition to erysipelas, either in their own persons, or in that  of their
offspring,  and frequently in both.
  The various causes which have been named as producing causes,  have, as
far as my observation has  led me to believe, merely called into action mor
bific humors previously  produced by unhealthy food, or intemperance in eat-
ing and drinking.  And it may have been  observed, that a meal,  whether
composed of improper, or of healthy food eaten in excess, is most  commonly
followed,  in erysipelatous habits, by a severe attack of the disease; while,  on
the other hand, a strict attention to diet will lessen the  severity  of the dis-
ease, and  often  entirely prevent its reappearance.
  Although  erysipelas  is observed  as  comparatively confining itself to  the
true skin, I feel fully convinced that it very frequently attacks internal or-
gans, causing sudden and unexpected loss of life ; and this may be the result
of its recession  from the surface; or, it may primarily attack an internal or-
gan, as in child-bed fever.  A disease, known as black-tongue, is probably a
malignant form of erysipelas occurring without an eruption.
  The prognosis in ordinary cases of .erysipelas is favorable.  But, when  the
symptoms are severe, with delirium or coma, and typhoid symptoms; when it
occurs in  the aged, the intemperate, or those of debilitated constitutions; and
when it recedes or  "strikes in," the prognosis is unfavorable.   When con-
nected with phlegmonous  inflammation, or complicated with other diseases,
or occurring as  the sequel of dropsy, it is always unfavorable.  It frequently
occurs in  new-born infants, and is apt to prove fatal.
  Treatment.   I  invariably  commence  the treatment  of  all erysipelatous
attacks accompanied with febrile symptoms, with a purgative, and for which,
I prefer the following powder:—Take of Podophyllin  one grain, Leptandrin
four grains, Cream of Tartar  twenty grains; mix, and divide into two pow-
ders.  One of these powders may be given  every six hours, until free ca-
tharsis is  produced.  It is necessary to keep the  bowels in  a regular condi-
tion daily, during the progress of the disease, and for  which the same meas-
ures may be pursued as  recommended for a similar purpose in Typhus Fever,
page 206.  Some authors recommend an emetic at the commencement of the
attack, but I have  not  used  it, except in  those cases where the symptoms
were very severe.
  After the action of the cathartic, the following must be  given in those cases
attended with high inflammatory symptoms:—Take of Tincture of  Chloride
of Iron one fluidrachm,  Sweet Spirits of Nitre two fluidrachms;  mix.  The
dose is thirty drops every hour or two, in a wineglass of  a diuretic infusion
made by infusing one ounce, each, of Elder flowers and Maiden hair, in  two
pints of boiling  water.   If these articles cannot be readily obtained, some 
234                AMERICAN  FAMILY PHYSICIAN.
other diuretic  infusion  may  be substituted, as of Marsh mallow, Cleavers,
Haircap moss, &c.   Diuretics will be  found of much  utility  in  those cases
attended with a difficulty in urination, high color, and heat of urine, &c.
  When the disease occurs as an epidemic, the above preparation may  be
omitted, and  the following substituted;  and which will be found to exert a
decided influence on the disease:—Take of Sulphate of Quinia, Prussiate of
Iron, each, twelve grains; mix, and divide into four powders, of which three
may be given a day, and continued, until the disease yields.
  Should there be a tendency to a recession of the eruption, a determination
to the surface must be kept up by the administration of diaphoretics; either
of the following may be used  for this purpose :—Take  of Bloodroot, Pleurisy
root, Ipecacuanha, Nitre, each, in powder, one drachm ; mix; the dose is ten or
fifteen grains every three or four hours.   Or, take of Ipecacuanha, Crawley
root, Pleurisy root, Nitre,  each, in powder, one drachm; mix; the  dose, same
as above.   When there is much restlessness,  an infusion of Ladies' Slip-
per and Scullcap may be given; or a pill composed of equal parts of Cypri-
pedin and  Scutellarine ; or,  a  pill  composed of equal  parts of  Extract of
Hyoscyamus and Lupulin.
  As a local  application to allay the burning and  itching of the parts, I
have found more benefit to attend the use of the following, than any thing
else :—Take of Tincture of Lobelia, Tincture of Bayberry bark, Saturated
Solution of Muriate of Ammonia, each, a fluidounce; mix.  Bathe  the af-
fected parts with this  several times a day; and in cases  of great heat and
burning, moisten a  piece  of linen with it, and keep it constantly upon the
parts.   If  these articles cannot be obtained, burnt or scorched  flour, or a
Slippery Elm  poultice may be used instead.   In some cases I have found
the following mixture advantageous:—Take of Tincture of Poison Hemlock,
(Conium Mac.) one fluidounce, Distilled water one fluidounce, Muriate  of
Ammonia two drachms.  Dissolve the Ammonia in the water, and add the
Tincture.   To be used the same as the first-named application above.
  Dr. Fahnestock, of Pittsburgh, recommends, both  in  simple and phleg-
monous erysipelas, to  pencil the diseased  surface with pure Creosote, ex-
tending it  to some  distance beyond the inflamed part.  In  phlegmonous
erysipelas,  repeated applications are required, but in  no case is the skin
permanently marked.  A brisk cathartic, as of Podophyllin and Leptandrin,
may be given at the same time.  If the  Creosote is pure, it causes an imme-
diate whiteness of the skin to which  it is applied.  In some cases, I have
relaxed the skin with hot water, or its vapor, and after  each fomentation
saturated the  inflamed surface with  Lard one  ounce, Oil of Lobelia half a
drachm, Tincture of Muriate of Iron half a fluidounce;  mix.  After its ap-
plication, cover the surface with wool.
  When the  disease attacks the face with pain, heat, swelling, more or less
delirium, and a tendency to lividity of the  eruption, the whole face and
head should be exposed, several times a day, to the following vapor bath,
taking care to cover the head that the vapor may not escape; take  Catnip,
Wormwood, Tansy, and Boneset, of each  equal parts, boil in water, and
allow the vapor to  act on the face for  ten  or  fifteen  minutes  at  a time
Should symptoms of putrescency appear, Yeast and tonics may be given inter-
nally and the Chloride of Lime sprinkled over the parts, which will frequent-
ly  arrest the putrefactive, or gangrenous action.  A  Saturated Solution of
Sulphate of Zinc, will also be found useful in mortification ; it may be ap
plied to the parts, and when they are whitened, an  Elm poultice must be
placed over  them, and continued, changing twice  a day, until the white
eschar sloughs off.   As a tonic, the best that I have found in this disease is 
INFLAMMATION  OF THE BRAIN.
235
compoecd of Red Peruvian bark two ounces, Camomile flowers one ounce,
Port wine a  pint.  This  preparation may be  administered  three  or  four
times a day,  in wineglassful (or half full) doses.
  When ulcerations follow the scaling of the skin, they are commonly of
an indolent nature; to remove which, promote suppuration, and thus facili-
tate  the ? cure, the parts, if practicable, should  be steamed every  twenty-
four hours over an infusion of bitter herbs, after which a very  small quan-
tity of Spirits of Turpentine, not to exceed one drop, should be  placed upon
the center of each ulcer by means of a camel's hair pencil, not allowing
any to get on the edges of the sore, or on the surrounding skin ; over which
apply Indigo weed Ointment, spread  on linen, bandage  tightly, and keep
excluded from the air, and enjoin rest until the next dressing.   The Spirits
of Turpentine will often occasion considerable pain for a few minutes, but
in every case it changes the character of the ulcer  to that of a healthy one.
It should be applied but once in twenty-four hours—omitted when the sore
presents a proper aspect, and re-applied as soon as it assumes the indolent
form.  As the fever is generally off in such cases, tonics, and mild laxatives
may be given.   In cleansing the  ulcers, they should never be rubbed, but
pressed lightly  with a soft piece of sponge.
   The diet during the inflammatory symptoms should be light, as barley-
water, panado, sago,  &c.; but where there is much  debility, and symptoms
of irritation, animal broths, and  a moderate  use of wine, may be allowed.
Some persons are subject to frequent attacks of erysipelas, occurring with
little or no constitutional derangement; and  for such the following means
will be found to effect a  cure :—Take  of  Ground Centaury four  ounces,
Beech drops two ounces, Burdock seed  two ounces; pour on these  articles,
coarsely  bruised, four pints of boiling  water, cover them, and when  cold
add two pints of good Whisky; let the whole stand a few days, frequently
agitating.  The dose is  a wineglassful three times a  day.   The  bowels
should be kept regular, procuring one,  but not over two evacuations daily;
and  for which purpose, if necessary,  the  Compound  Powder  of Rhubarb
and  Potassa may be taken in doses of from five to  ten grains, and repeated
three times  daily.   This will  be found of  service  in eradicating both the
simple and phlegmonous forms of erysipelas ; but in all cases, whether ery-
sipelas be in an active or" passive condition, if we place all our dependence
on medicine, we will be subject to the mortification of witnessing frequent
returns of the attack, or  its apparent intractability to the most active  and
efficient articles of the Materia Medica; diet is, therefore, an all-important
measure  in  the treatment, as well as proper remedies, it should be light,
nutritious, easy of digestion, not fat or greasy, anti-acid, &c.   Sweets—as
preserves, candies, &c, raw fruits and vegetables,  fish, veal broths, lemon-   •
ade,  or other causes of acidity, should not be used.  Milk, although it has
been advised, is an improper article in  all  erysipelatous cases, owing to the
existing disposition of the stomach to acidity.
               INFLAMMATION  OF  THE  BRAIN.
  Inflammation of the Brain, or Phrenitis, is known in some sections of
country, by the improper name of "brain fever."  Among medical men it
is variously termed, meningitis, encephalitis, arachnitis, &c, according to the
several parts affected.   The term phrenitis may include any, or all of these,
the treatment being very similar in each variety.
  Symptoms.  An attack of  this disease may take  place either  gradually, 
236
AMERICAN FAMILY  PHYSICIAN.
or very suddenly, more commonly the former.  The premonitory symptoms
are, at first, depression of spirits, impaired appetite, mental uneasiness, and
confusion of ideas, especially when in the recumbent posture, debility, and
sometimes ringing in the ears, and even blindness.  These  are succeeded
in most instances by a more or  less severe chill, and  constant headache,
which are soon followed by violent fever, hot and  dry ski-_; Pushed coun-
tenance, suffused eyes, or a haggard,  anxious,  fearful expression of them,
the pulse is quick and  hard, and the pulsation of the carotid arteries, in the
neck, is rapid and  forcible.  The intensity of the headache increases, as also
the ringing in  the ears, sometimes changing to a  humming or rumbling
sound ;  the senses become morbidly acute,  as known by the sensitiveness
and restlessness manifested on exposure  to either light or sound.   The pu-
pils of the eyes are constantly contracted;  the  patient is extremely restless
and wakeful, with  more or less delirium ;  he frequently imagines that some
one designs to  injure him, and cannot bear restraint or contradiction, and
the delirium is often of a furious raving nature.  The head  is remarkably
hot, while the extremities are cold; the tongue is  furred white, red at  its
edges, dry, pointed, and the papillae elevated; the bowels are obstinately
constipated, and nausea or vomiting are  common.   Respiration is accele-
rated  and  laborious, seldom hurried  as in  fevers,  but  irregular and with
frequent sighs.  Generally there will be  spasmodic  movements of the mus-
cles and of the tendons.   The urine is scanty and deep colored.
  As the disease advances, a change occurs in  the symptoms, the  previous
delirium is succeeded  by a stupor which gradually passes into coma; the
formerly contracted pupils are now dilated, and there is less sensibility to
light; the eye loses its brightness, sometimes  there  is squinting,  and the
countenance is vacant or idiotic; picking at the bedclothes, or grasping in
the air,  are almost always  present.  The hearing is much  diminished, and
indeed,  all the  senses are more or less blunted;  the  limbs become per
fectly relaxed ; the pulse is  slow, sluggish, and irregular or intermittent;
the respiration is deep, slow, and often stertorous; the urine  is very scanty,
if passed at all, and the feces are involuntarily discharged.  Convulsions, or
paralytic attacks, frequently ensue.
  Finally, the pulse becomes hurried, small, and unequal, the countenance
pale and sunken, the skin has a cold and  clammy perspiration upon it, the
urine passes involuntarily, the  coma becomes more profound, and death
terminates the scene.   It  must be remembered, that these  symptoms vary,
being very mild with some, and  extremely violent  with others, depending
upon  the degree of vital  energy of the  system, the severity of the cause,
and other attending circumstances.
  Some care is required in  discriminating inflammation of the brain from
fever; the headache of phrenitis is more constant than that of fever, and ap-
pears to be confined to no particular spot; the sleep  in  phrenitis is dis-
turbed with bad dreams,  and sudden startings, or awaking  in fear, and,
with children, a scream on awakening.  In  typhus, the urine is scanty,
 cid in the earlier part of the disease, with increased uric acid, and dimin-
 shed urea.  In phrenitis, there  is an excess of the  phosphates.
  Causes.  Inflammation of the brain may be produced by falls, blows, or
other injuries inflicted upon the head; long-continued  and intense study;
cold; fatigue; intemperance in eating and drinking ;  long-continued expo-
sure to  the heat of the  sun ; violent exercise ; suppression of habitual evac-
uations ; excessive anger; and whatever  causes a determination of blood to
the head.  It frequently  occurs as a secondary attack, by the recession or
metastasis of some disease,  as  erysipelas,  rheumatism, cholera-infautum,
cutaneous affections, &c. 
INFLAMMATION OF THE BRAIN.
237
  The prognosis is generally doubtful.   Much depends upon the cause of
the attack; if it be produced accidentally by blows, &c, it is more favorable
than where it is owing to some constitutional difficulty.   The milder the
symptoms, the more favorable are the indications; but we should not des-
pair even of the worst cases.
  Treatment.  Inflammation of the brain requires the most prompt and
energetic measures; the principal indication being to equalize the circula-
tion, by determining the blood from the  brain.  In  the early part of the
disease, when  there are accumulations  in the stomach,  an emetic, as the
Compound Powder of Lobelia, may be given ;  but more generally, the bet-
ter agent will  be an active  cathartic, which not only unloads  the  bowels,
but by its derivative influence, causes a determination from the brain.   The
most useful cathartic  is the  Compound Powder of  Jalap, one drachm of
which may be administered with about ten  grains of Cream of Tartar.  And
this cathartic  must be administered every day, for some days, or until the
inflammatory symptoms have subsided.  But when there  is great constitu-
tional debility connected with the disease,  it will be improper to administer
cathartics, and, in such cases, the bowels must be opened by injections, and
mild aperients, as infusion  of Blackroot, Rhubarb, &c.
   As soon as possible, in the early stage of the  disease, the feet should be
bathed in warm weak  ley water, which may be repeated twice a day;  and if
the  strength and condition of the patient will admit, a Spirit vapor bath
should be given  without delay, which will  tend materially to lessen the se-
verity of the attack.   On placing the patient in bed, after these operations,
Mustard poultices should be applied to the feet, and  along the whole course
of the spinal column,  and kept on  until considerable redness is produced.
And this course may be followed daily, as long as the headache and inflam-
matory symptoms are  present.
  Ligatures to the thighs, for the purpose  of  diminishing the flow of blood
to the brain, will  be found  of decided advantage in severe  cases ; but this
should  always be done by a physician, lest  the ligatures be applied  so
tightly as to interfere with the arterial circulation, or else not tight enough.
See article Hemastasis in part III.
  Local applications  should  also be made to the head to relieve the pain
and delirium ;  warm water may be frequently applied to the head, and then
evaporated by fanning;  or,  a fomentation of equal parts of Hops  and
Stramonium Leaves, infused  in  hot water, may be  enclosed in  a muslin
bag  and applied to the head; it should  be changed from time to time,
not allowing it to become cold.
  In cases where the  headache is very intense, or the delirium violent and
raving, and the above  measures do not lessen the symptoms, it may become
necessary to apply cups to the temples and  nape of the neck, and repeat
the application two or three times a day, until the symptoms are relieved.
Though I have had no occasion to adopt this  measure as a mode of relief,
for  the last sixteen years, the other means  having in  my hands, succeeded
admirably.
  When there is great restlessness, or want of sleep, five or ten  grains  of
the Compound Powder of Ipecacuanha and Opium  may be given every
two, three, or four hours; or, a teaspoonful of the Compound Tincture  of
Virginia Snakeroot in some infusion  of  Scullcap,  may be given every
night.
  The patient must be kept cool, in a dark room, free from noise or other
disturbance, with his  head  considerably elevated, and no food should be
allowed  him, except toast-water,  thin barley-water,  cold  water, lemonade, 
238
AMERICAN FAMILY PHYSICIAN.
orange juice, &c, given in small quantities merely to quench his thirst.
He should be closely watched, lest he get out  of bed, and do some injury
while in his delirium.
  In the stage of coma, when there is no paralysis, no squinting, and the
patient can  be aroused  to  consciousness, stimulants, nourishment,  and
tonics may be tried.  Carbonate of Ammonia may be given, in conjunction
with a small quantity of Ale or Porter, to  which Camphor one-fourth of a
grain, and Sulphate  of Quinia  one-half of a  grain, have been added.
This may be repeated as often as required.
  When  phrenitis occurs as a consequence of some suppressed evacuation,
or a recession of some eruption, these must always be restored as promptly
as possible.
  During convalescence, great care  should be taken to avoid a relapse;
the same course  must  be  pursued as named under convalescence  from
fevers.
                INFLAMMATION OF  THE EAR.

  Inflammation of the Ear, or Otitis is a disease common to children, and
frequently met with in adults.  The disease may be confined to the internal
wall of the ear, or it may involve the drum or tympanum.
  Symptoms.  Inflammation  of the  ear is  attended with acute pain, fre-
quently without much fever, but sometimes  the febrile symptoms run very
high, the brain  becomes involved, and  delirium, coma or convulsions take
place.  Swelling and redness, attended  with  throbbing, may be perceived
by  a careful examination, and which  will  serve  to  distinguish  it  from
neuralgia, which last likewise manifests a periodicity in its symptoms not
met with in otitis.   Occasionally suppuration takes place, and sometimes
remains for years, obstinately resisting all treatment.
  The causes of otitis are usually,  exposures to cold, as, exposing the ear
to a draught of air, or trimming the hair  of the head too  short in cold
weather, &c.  Local injuries may also give rise to it, as inserting paper and
other  foreign bodies into  the ear, as is often  done by children; insects
getting  into the ear may produce inflammation ; and it frequently occurs
as a sequel to other diseases, scarlet fever for  instance.
  Treatment.   If the  disease  be  owing to foreign  bodies in the ear, or
an  accumulation of hardened wax, these  must first be removed; and to
accomplish which  will frequently cause some  trouble and  perseverance.
Syringing the ear forcibly with  tepid water thrown from a small syringe,
is recommended for this  purpose.
  When the otitis  is caused by exposure  to cold, the feet may be bathed
in warm  water, and a warm fomentation of Hops applied  over the ear, and
occasionally renewed.  If this does not ease  the pain, two drops of Sweet
Oil  of Almonds to which one drop  of Laudanum has been added, may be
warmed and dropped into the ear two or three times in the  course  of the
day.  Or, the juice of Onion, and Laudanum, equal parts of each, may be
dropped into the ear.  Or, take Oil  of  Sassafras half a  fluidrachm, Olive
Oil  one  fluidrachm, powdered Camphor fifteen grains ;  mix, and dissolve
the  Camphor in the Oils.   A few drops of this mixture, warmed, may be
dropped  into the ear, and a pledget of cotton may also be worn in the ear,
moistened with  the  same.   A few drops of Tincture of Digitalis in the ear,
nave been recommended.  When the pain is very severe, with general de-
rangement, a Mustard poultice may be placed behind the ear, and a purga- 
INFLAMMATION OF THE EYES.
239
live be given.  If the stomach is deranged, or filled with irritating matter,
an emetic will be found beneficial.
  When the fever is violent, with great pain, coma or delirium, in addition
to the above local means, the general treatment recommended in inflamma-
tion of the brain must  be  pursued.  When the disease is of a periodical
nature, or  is accompanied with periodic fever,  Sulphate of Quinia, in
some form, will be found useful.
  When suppuration  ensues, the ear must be syringed with warm soap-
suds, after which, an infusion of Golden  Seal, to which a small portion of
Pyroligneous Acid has been added to correct the fetor, should be injected;
and this course may be repeated  once or twice every d,iy.   Or,  a decoction
of equal parts of Golden Seal  and Wild Indigo  root, may be used  instead
of the  above. Sometimes  it will become necessary to  use instead of the
above,  a solution of Sesquicarbonate of Potash.  In conjunction with these
local means, the  bowels  should be kept regular by small doses of  the Com-
pound  Powder of Rhubarb and Potassa;  and the Compound Syrup of
Yellow Dock, or some other alterative, should  be given  and persisted in
for some months.
                INFLAMMATION  OF THE EYES.

  Ophthalmia is  a term applied to Inflammation of the Eyes, whether of
the acute or chronic form.  All parts of the eye are subject to inflamma-
tion, more especially its outer covering, (conjunctiva) and the inner surface
of the lids.  At this  place, catarrhal ophthalmia, purulent ophthalmia, and,
inflammation of the iris, will be  considered.
                   CATARRHAL  OPHTHALMIA.

  Symptoms.   The conjunctiva or white of the  eye becomes swelled, and
of a scarlet color, being more or less covered with bloodvessels, presenting
the  appearance  of what is usually termed  bloodshot;  with this  there is a
sensation  of hoat, smarting, and pain, as if particles of sand were  in the
eye, and which  pain  is aggravated by rubbing  the eye.   There is much
pain and uneasiness on exposing the eye to  the light, and sometimes even
on the least motion  of the eyeball, so that the patient usually keeps the
lids  closed.  A copious  flow of hot, or  excoriating tears, is also present.
When the disease is very violent, or, in  irritable habits, febrile symptoms
are manifested.
  Causes.  Catarrhal ophthalmia  may  be produced by exposure to cold,
sudden changes of temperature, blows and other injuries upon the eyeball,
irritating vapors, foreign particles in the eye, improper  exposure of the eye
to strong light, overtasking the eyes by reading or writing late at night,
intemperance,  and other causes  similar to  those producing inflammation
of other.mucous surfaces.
  This disease may  be determined from rheumatic ophthalmia, by the pres-
ence of headache, the greater intolerance of light, and the severe,  throbbing
pain, common  to the latter; beside in catarrhal ophthalmia the bloodvessels
are tortuous and of a scarlet red color, and in the rheumatic form, they are
straight, hair-like, radiated, and  of a pink  or violet hue.  In rheumatic
ophthalmia the sensation of roughness or foreign bodies in the eye is never 
240
AMERICAN  FAMILY  PHYSICIAN.
present.  There is  seldom any danger  to be  apprehended  in catarrhal
ophthalmia, when properly treated.
  Treatment.  The eye should  first be examined, in all cases where it is
inflamed, to ascertain that no  foreign  body is present irritating it; and if
such are found, they must be at once extracted.   The feet should be bathed
in warm water for fifteen or twenty minutes, and which should be repeated
two  or  three  times  a day; and  during the intervals Mustard poultices
should also be applied to them.  Mustard may  also be  placed to the back
of the neck when the inflammation is violent.   In severe cases a cathartic,
every day or two, until  the active inflammatory symptoms have subsided,
will be found very serviceable; and an attention to the surface of the body,
bathing it occasionally with a weak alkaline solution, will materially aid in
allaying the severer symptoms.
  Applications should also be made to the  eyes, as a fomentation of Hops
in water, or a fomentation of Poppy leaves; and, when the pain is very
severe,  Stramonium leaves  may  be applied—the  green leaves  may be
bruised and  laid over  the  eye,—the  dried leaves should  be  steeped  in
hot  water, and employed as a  fomentation.  In some  very  severe  in-
stances, in which all previous remedies had resulted in no benefit, I have
met with the most marked  and immediate  benefit, by applying cloths wet
with cold water to the affected eyes, and changing them every two  or three
minutes.  In one very aggravated case, in particular,  this course had to be
pursued for about  thirty-six  hours before any permanency  of  the benefit
obtained was established.  Other  agents have been advised  as local appli-
cations, as  a poultice of Slippery Elm,—or a  strong mucilage made  by
immersing the pith of  Sassafras  in distilled Rose-water.   A poultice of
Slippery Elm  bark  one  drachm, Lupulin half a drachm, powdered Lobelia
seed twelve grains,  with sufficient  hot water,  has proved  efficacious as a
local application in severe cases; it should be changed every three hours.
  When there  is considerable restlessness, wakefulness, or  nervous irrita-
bility, one  or two doses of the Compound Powder  of Ipecacuanha and
Opium  may  be given  toward bedtime,  or the  mixture  of Tinctures of
Gelseminum and Aconite,  (see page 193,) may be given through the latter
part of the day.   I have found the  tincture of Kalmia Angustifolia a very
excellent remedy in inflammation  of the eye.
  During the  above treatment, the patient must be kept in  a darkened
room, and the diet should be very light.
  When the active  inflammatory symptoms have subsided, the  disease
passes into the chronic stage, in which the eye still looks red and inflamed,
with a great diminution of the pain, intolerance  of light, and  watery dis-
charge.   The treatment must now be changed, and means used to  increase
the activity of the absorbent vessels, and strengthen the eye.  Various means
are employed for this purpose, among which I will name the following:—
  1. In most cases  I find that a fluidrachm of Tincture of  Aconite added
to a fluidounce of a strong  decoction of Golden  Seal, has a very desirable
effect.  The eye should be bathed with it frequently during  the day.
  2. Take of Sulphate of Zinc one ounce, Rock  Salt three  ounces, Crocus
Martis eight grains,  rain-water two  pints.  Add  the  articles together, dis-
solve the salts, and,  after allowing the mixture  to stand twenty-four hours,
filter.   To be applied to the eyes as above.
  3.  Take of Golden Seal,  Witch  Hazel leaves,  of each, in  powder, a
drachm, boiling water a gill.  Infuse the powder in the boiling water for
ten or twenty minutes, and when cold, strain.   The eye must be frequently
bathed with this. 
OPHTHALMIA.
241.
  4.  The Compound Myrrh Lotion.
  5.  The Compound Lotion of Golden Seal.
  G.  The Compound Lotion of Zinc.
  7.  The Compound Ointment of Oxide  of Zinc.
  In conjunction with this  treatment, the bowels  must be kept regular,
mild tonics administered, with a  light, nourishing diet.
  Ophthalmia  tarsi, is  an inflammation of the glands in the tarsus or
edges of the eyelids.  It is a chronic affection, occurs generally in scrofu-
lous  persons,  occasions considerable irritation,  and frequently causes a
destruction of the eyelashes.   It may be a termination of catarrhal ophthal-
mia,  and should  be treated by stimulating applications, as tincture of Red
Pepper, either diluted or  not, as the case may require.  Should there be
a small ulcer  at the roots  of the eyelashes, it  may be touched with a solu-
tion  of Alum, or a solution  of Sulphate of Zinc.   The application of the
Compound Ointment of Oxide  of  Zinc,  every  'ight,  will have  a  ten-
dency to prevent the lids from sticking together  in  the  morning; but
should this occur, the lids may be washed carefully with warm milk, until
they open without  pain.  The peculiar sticky or gummy matter which is
secreted  on the  lids in this  disease, must always be removed  by washing
with warm milk, previous to the application of any remedy.
   I  have found  the following a very effectual application in ophthalmia
tarsi;—to one fluidounce of a Saturated Solution of Sal Ammoniac, add one
fluidounce of rain-water, and from  two to six fluidrachms of  Tincture of
Capsicum, according to the degree of smarting it produces.   This may be
applied four or  five  times  a day to the lids; and  it should be aided by
internal  treatment,  as the Compound Syrup of Yellow Dock, or the Com-
pound Syrup of Stillingia.
                    PURULENT  OPHTHALMIA.

  Symptoms.  Usually a great itching is felt in the eye, or a sensation as if
a p.u^iole of dust were between the lids and  the  eyeball,  and this usually
happens at night; this is succeeded by a sticking together of the  lids,  gen-
erally in the morning, owing to a secretion of mucus.  The lids  are some-
what stiff, there is great and  uniform redness of the eye,  but without pain,
tension, or intolerance of light,  and a watery fluid is discharged.   The dis-
ease soon extends to the globe  of the eye, with  high vascular action and
bright redness, great tumefaction of the membrane, and increased  discharge.
The conjunctiva suddenly swells, and becomes considerably  elevated around
the cornea, the cornea appearing, as it were, at the bottom of a  pit.   This
swelling is called chemosis, and  is often so  great as  to overlap, and  nearly
cover  the cornea.    The eyelids  swell, and  are almost immovable, the dis-
charge is profuse and of a yellow color,  and may  continue for ten or fifteen
days without  much  change.  Finally the chemosis begins to shrink, the dis-
charge diminishes, and becomes thin and  gleety, and the parts which were
the first attacked are the last in  which  the  disease disappears.
  The inflammatory symptoms vary from a mild  character  to one of great
violence, being accompanied  with sharp,  lancinating pain, situated deep in
the eyeball, and which is usually worse at night; sometimes a deep-seated,
throbbing pain in the eye, comes on in paroxysms;  or it may be violent and
continuous, without any mitigation until the cornea bursts.   The disease may
terminate in bursting of the cornea, abscess of the cornea,  ulceration of the
cornea, opacity of the cornea, thickening or granulation of the lids. &c.
      lb' 
242
AMERICAN FAMILY  PHYSICIAN.
  Purulent ophthalmia may be discriminated from catarrhal by the chemosiSj
the bright red membrane, and the profuse  purulent discharge.  The right
eye suffers more frequently  and  more  severely than  the  left, though  the
disease may attack either one, or both.   *
  Causes.   The disease is supposed to be propagated by contagion, though
there is a diversity of opinions among medical  men on  this point.   It fre-
quently occurs epidemically, and seems to depend upon some peculiar con-
dition of the atmosphere.  And, under some circumstances, there is no doubt
but it may be produced by exposures, injuries, and other circumstances that
will occasion the catarrhal form.
  The prognosis of purulent ophthalmia in the adult is not very favorable, as
the disease  is  frequently  unmanageable.  If the cornea retain its natural
transparency, the inflammation may be arrested by vigorous treatment; but
if it bo dull, with deep-seated pain in  the eye and head, indicative of exten-
sive inflammation of the eyeball, the termination will  be doubtful.   After
partial suppuration, considerable ulceration,  or  interstitial deposition, recov-
ery of  sight may take place, especially if these changes occur toward the
circumference and not in the centre of the eye.
  Treatment.  Everything must be done to subdue inflammation as rapidly
as  possible.  The feet must  be bathed in warm water for fifteen  or twenty
minutes, which  should  be repeated two or three times a  day; and during
the intervals Mustard should be applied to them,  and  along the spinal col-
umn.  The bowels must be actively purged at first,  after which they should
be kept free, daily, by laxatives.
  Local applications, similar to those  mentioned under Catarrhal Ophthal-
mia, should be kept upon the eye, and it will be found,  in most cases, more
beneficial to apply them cold than warm, changing frequently.  Much advan-
tage will be derived from the cold water, used as  described in  the previous
treatment.  In addition to these applications, the eyes should  be frequently
washed with the following:—Take of Sulphate of Quinia twenty grains, Elixir
Vitriol one fluidrachm, strong decoction of Black Cohosh four fluidounces.
Mix.   This will sometimes occasion an intense  pain upon the first, second;
and third bathings, but afterward it will be found to have an excellent sooth-
ing and cooling effect.   The severity of its first application should not pre-
vent the practitioner from using it.
  Internally, the inflammatory action may be mitigated by the administration
of the mixture of Gelseminum and Aconite,  in tincture, as  recommended on
page 193 ;  or, a slight degree of nausea may be constantly kept up by small
doses of Lobelia, either in powder or tincture,  and  which will be found to
exert a powerful influence in overcoming the inflammation.   The diet should
be light, and the patient kept in a darkened room.
   ilfter the inflammatory symptoms have subsided,  the bright redness of the
conjunctiva gone, as well as the pain, and the  membrane  appearing paler,
relaxed,  and flabby, with a profuse discharge, the treatment must be changed.
The diet should be more nutritious, and  astringents applied to the eye, as,
a strong decoction of Golden Seal and Geranium, in which a  small portion
of Alum has been dissolved.  This may be  dropped in the eye two or three
times a day';  but if it increases the pain  and redness, it must be  omitted,
and not again used until tho inflammatory symptoms have been subdued
Or, some one of the preparations named in  the treatment of catarrhal oph-
thalmia, may be used.   The patient should be allowed to exercise in the
open air, exposing the eye to light, as much as  it will bear,  and should he ho
much debilitated, tonics and alteratives must be used.  The  towels, linen,
&c.,>used by the patient, must not be used by any other person, lest the dis- 
INFLAMMATION  OF   THE  HUP.
243
 ease  be communicated to them; too much care in this respect, cannot be
 taken.
   Any remaining granulation, or ulceration of the lids may be removed by
 the following:—Through a stout piece of a limb of tag alder, bore a  hole
 lengthwise, from half an inch to  an inch  in  diameter;  fill  this with finely
 powdered salt,  close it at each end, and place it in hot  ashes, where it  can
 remain for some twenty-four hours or longer and  slowly char.   When  the
 tag is almost all charred, remove it from the ashes, split it open, and remove
 the salt, which will be in the form of a roll; powder this finely,  and keep it
 in a well-corked vial.  To use it, blow some of the powder in the eye, through
   quill, and repeat it two or three times daily.  This  will  be  found a most
 valuable application for the above, and several other affections of the eye.
   Infantile Purulent Ophthalmia is very apt to terminate in loss of sight, if
 not timely attended to.  It comes on a few days  after birth, with a redness
 of the lids, and at first a slight discharge which causes a sticking of  the lids
 together, when the child  awakes from sleep.   As there is  pain on exposure
 to light, the eyelids are kept closed.  If the disease  be allowed to progress,
 the lids swell and become red even externally,  and a profuse discharge of a
 yellowish  purulent  fluid takes place,  which frequently flows over the face,
 staining the cap and linen.   When the lids are separated,  the eye cannot be
 seen  until the discharge which covers it is removed.
   This form of ophthalmia may arise from exposure of the  child during its
 birth, to leucorrheal, gonorrheal, or other matter with which its mother may
 be laboring under; it may  also  originate from  not properly washing the
 child, and other circumstances, as cold and damp, bad or insufficient food,
 &c.  A similar affection is also met with in children  three or four years  old.
 If treated  in an early  stage before the cornea has become affected,' the  dis-
 ease can always be cured.  The eyes should be cleansed of all  the matter
 discharged, by frequently bathing them with Rose-water or mucilage of Slip-
 pery Elm,  and, in the meantime,  cold  or  tepid water should be kept  con-
 stantly applied over the eyes by means of linen  cloths moistened with it  and
 which should be frequently changed;  or a poultice of Slippery Elm may be
 applied to the eyes,  when there  is much redness and swelling of the lids.
 The bowels  should be  kept regular by means of  injections,  and the action
 of light upon the child's eyes should be prevented as much as possible both
 during the treatment and for some days after a cure has been made.
   When the inflammation has subsided,  the eyes must be  bathed  several
 times  a day, with a decoction of equal parts of  Golden Seal and Witch Ha-
 zel leaves;  or, if a more active application is desired, five or ten  grains of
 the Sesquicarbonate of  Potash may be dissolved in a fluidounce of the  de-
coction.
                 INFLAMMATION  OF  THE  IRIS.

   Inflammation of the Iris,  or  Iritis, may be accompanied with rheuma-
tism,  sometimes with gout, and not  unfrequently with syphilis;  hence the
names rheumatic iritis, syphilitic iritis, &c, have been applied to these va-
rious forms.  The  disease is, however, in all instances, only a  modification
of one and the same affection.
  Symptoms.   Uneasy  sensations  are  experienced in the  neighborhood of
the eye,  with  pains about the forehead,  brow, and orbit,  extending to the
side of the head; there is also a  redness of the sclerotica or white of the
eye. with intolerance of light and watery discharge.  As these symptoms in- 
244
AMERICAN  FAMILY PHYSICIAN.
crease in severity, the iris or that part of the eye which surrounds the pupil
and from which wo judge of the  color of the eye, whether blue,  black, &c,
becomes involved; its color undergoes  a  change, first in the lesser circle
which becomes of a darker hue, and afterward in the greater which becomes
green if it were originally blue or greyish,  and reddish if it were brown or
black.  The pupil  is contracted,  its opening  being deprived of the  bright
black color it  naturally possesses, and the  motions of the  iris are impeded.
Headache  and feverish  disturbance of the system are generally present.
After a violent attack, with  great diminution of sight, the symptoms subside,
the eye recovers,  and sight is restored.  The iris is found to be connected to
the capsule  by adhesions of white  color.  The  inflammation returns again
and again, new adhesions take place, the pupil becomes more and more con-
tracted, and finally vision is lost.  Occasionally,  the first attack  may be so
violent, as to occasion loss of sight.
  Causes.   It may be produced  by cold,  and  is frequently attended with
rheumatism, syphilis, &c.  Some  rheumatic persons have an attack or more
every year, in which the sight becomes gradually destroyed.
  Treatment.   The treatment is the  same as recommended in the previous
inflammations of  the eye, being prompt and energetic in proportion to the
violence of the attack.  It will  also be proper to give an active cathartic for
the first two or three days',  and  subsequently keep the bowels  regular by
laxatives.   And any wakefulness  may  be overcome by the  administration of
the Compound Powder of Ipecacuanha and Opium, five  or ten grains at
bedtime.
  In this disease, as well as  in  cases of almost insupportable pain in the eye
from  an active attack of inflammatory rheumatism of the eyeball, I have
derived immediate  benefit by the application of  fresh Stramonium leaves,
bruised, slightly moistened,  and placed as a poultice over the eye; frequently
every painful feeling will be removed in five minutes after the poultice  haa
been applied.   When the fresh leaves cannot he obtained,  the  inspissated
juice of the leaves may be rubbed with Elm poultice and applied; the pro-
portions being about two drachms of the inspissated juice to  enough Elm
poultice to  cover  both eyes.   The dried leaves will not be found so beneficial.
  In conjunction with this,  when rheumatism  is present, the following may
be administered internally:—Take of Tincture of Black Cohosh  one fluid-
ounce, Tincture of  Colchicum seeds half a fluidounce,  Tincture  of Aconite
two fluidrachms.   Mix.   The dose  is twenty or thirty drops, three or four
times a day.   After  the disease  in the eye is  subdued, if rheumatism be
present, treat the system according to the directions given under treatment
of Rheumatism.
  After the inflammation of the  eye is completely overcome, there will he
a debility,  and morbid  sensibility remaining, which must be  treated by
some local  stimulant, as  a strong decoction of Golden Seal, one  fluidounce,
to which a half fluidounce of Tincture of Prickly Elder may be  added; or,
if greater stimulation is desired, from one to  four fluidrachms of Tincture
of Capsicum,  may be likewise  added.  A few drops of this may be placed
in the debilitated eye, one,  two, or three times a day, according  to its capa-
bility of enduring the stimulating action.   Indeed, the preparations named
in the preceding  articles, will frequently be found very useful for the above
purpose.
  In several cases where the virus from chancre  had accidentally entered
the eye, producing the usual  symptoms, tending to a destruction of it, I
have saved the organ by bathing it several times  a day with a wash mad
by dissolving ten grains of the  Chloride  of  Gold and  Soda, in  one fluid'
^unce of rain-water. 
QUINSY.                            245
        INFLAMMATORY  SORE  THROAT,  or  QUINSY.

  Quinsy is an inflammation of the Tonsils, (or  almonds of the ears,) but
which may  extend throughout the whole mucous membrane of the  throat
or fauces ; and sometimes even to the Eustachian tube,  causing more or
less deafness.
  Symptoms.  Quinsy usually commences with alternate sensations of heat
and chills, soon  after which  a soreness  and difficulty of swallowing and
breathing is perceived, succeeded  by an enlargement  of the  tonsils and
swelling of the back part of  the throat,  attended with redness and pain.
The pain is of an acute, lancinating  character, and  may extend to one or
both  ears.   The voice becomes hoarse  and nasal, the tongue  is  coated
and  there  is  a  frequent but  difficult  expectoration  of  mucus,  with
more or less fever.  As the disease advances, the difficulty of swallowing
and breathing  increases;  the speech becomes indistinct; the  throat very-
dry, with great  thirst, and on attempting to swallow fluids they are fre-
quently ejected  through the nose;  the tongue swells  and  is incrusted with
a dark fur, and  the pulse is  full, hard,  and frequent, beating from  100 to
140 in a minute.  Sometimes, small white sloughy spots are to  be observed
on the tonsils, and in  very violent attacks,  there is  a  complete  deafness.
When the inflammation  is very violent, the  eyes become  red, swollen, and
watery;  the cheeks florid and swelled;  the  patient is  unable to  open his
mouth ; respiration is performed with difficulty;  and the patient is obliged
to be supported  in nearly an  erect posture to prevent suffocation.   Large
tumors can be seen or felt on each side of the jaws, and which are painful
on pressure.   Sometimes  delirium, or coma  supervene.   Both tonsils are
frequently so much inflamed and swollen, that it is exceedingly difficult for
the patient to  swallow anything.   Occasionally the  tonsils swell so  enor-
mously as to touch  each  other,  rendering  the patient  unable to speak or
swallow, and even checking respiration, and thus occasioning death.
  In some cases  the inflammation  rapidly subsides, terminating in resolu-
tion ;  but more frequently it terminates in abscess or suppuration, and occa-
sionally in sloughing.  When suppuration is about taking place, the parts
affected become paler and less painful, a throbbing or sense of pulsation  is
felt,  and there  are  slight chills.  The  matter  may be discharged  by the
mouth, or it may pass  into the stomach;  in  either case, being  followed by
immediate relief  When sloughing is about to ensue, a whitish or greyish
spot  may be seen on the  tonsil, which will  gradually cover its whole sur-
face ;  it finally comes  off, leaving  a deep ulcer,  which may be ultimately
healed.   Scrofulous  persons are apt to  be left with a chronic form  of the
disease, which  may be excited into increased activity on exposures to cold,
improper diet,  &c.
  Causes.   The most common causes of quinsy are,  sudden changes  ot
temperature, dampness, wet feet, wet clothes, drunkenness,  acrid or stim-
ulating food; sitting near an open window while in a heated condition,  or
in a room  recently plastered, or  whitewashed;  sharp substances  lodged
in the throat;  and it frequently occurs as an epidemic.   Strumous persons
are most liable to it.
  The prognosis is  generally favorable; but occasionally instances are met
with, where suffocation is threatened from the enlarged tonsils completely
closing the air-passages, and  in which the only  chance is for the surgeon
to make an aperture in the trachea,  and  form  an artificial air-passage for
respiration, until the inflammatory symptoms have subsided.
  Treatment.  An emetic given at the  commencement of the attack will 
246
AMERICAN FAMILY  PHYSICIAN.
not only remove any accumulations in the  stomach,  but will render the
subsequent symptoms of a milder character, and sometimes will  arrest the
disease at once.  But the emetic should not be given when  the disease has
so far advanced as  to render  swallowing painful and  difficult.   After the
operation of the emetic, an active cathartic, as the Compound  Powder of
Jalap, should  be administered, for the  purpose of removing any morbid
matters  in the bowels.   And  it will be  found salutary to  procure  daily
evacuations from the bowels, if possible, by the administration of Seidlitz
powders.
  In order to  aid in allaying the inflammation  and relaxing the parts, the
throat must be bathed externally three  or four times a day, with  the  Com-
pound Tincture  of Camphor, applying it warm  and with considerable fric-
tion, after which place a fomentation on the throat, as warm as can be borne,
composed of equal parts of Hops, Mullein  and Lobelia  leaves, infused for
a short  time in hot water;  or a fomentation of other bitter herbs may be
substituted.   If the Compound  Tincture of Camphor  is not at hand,  a
liniment may be substituted for it, composed of  Olive  Oil, Oil of Sassafras,
Water of Ammonia, each, one fluidounce, powdered Camphor two drachms;
mix.  Some medical men object to these  external stimulating applications,
but they undoubtedly exert a useful counter-irritating effect.
  The vapor of a hot decoction of bitter herbs, inhaled several times a day,
will prove of much  benefit; the following will be found to answer admira-
bly:  Take equal parts of Hops, Wormwood, and Mullein leaves, boil them
in equal parts of water  and vinegar; then put  the decoction in  some con-
venient  vessel, over which place a funnel, and inhale  the steam arising for
ten or twenty minutes  each time.   A  common teapot will  answer  to put
the decoction in, inhaling the vapor from its spout.
  During the  course of the disease, the  feet should  be frequently bathed
in warm, weak ley water ; and the surface of the body should also be bathed
with the same two or three times a day, especially when  there are high
febrile symptoms.   Any restlessness  or uneasiness may be overcome by a
dose of  the Compound  Powder of  Ipecacuanha and Opium, administered
at bedtime.   When the  disease occurs as an epidemic,  and the symptoms
are of a periodical  character, one of  the preparations  of Quinia,  named
under the treatment of intermittent fever, may  be used with advantage.
  Gargles have been recommended in this  disease, but it is seldom that
the patient can employ them,  on account of the pain  and difficulty attend-
ing their use; indeed  they are not required when the  tonsils are red and
shining.  More  benefit will be derived from the inhalation of warm vapor,
Lemon juice and honey, mixed together, and  administered to the patient
frequently  through the day, allowing it to pass slowly over the parts, will
prove very serviceable  and refreshing, and  of much greater utility than
gargles.  But when aphthous spots appear,  or  when the tonsils become of
a dark livid color, a gargle will be serviceable ;  the following may be used:
Take of Sumach berries one ounce, Cayenne Pepper one drachm, Salt three
drachms, boiling water half a pint; mix, and when cold, add Vinegar half
a pint.  If this cannot be gargled, it may be thrown upon the parts by
means of a syringe, or the patient  may occasionally  allow  a little of it to
trickle  down his throat.  Sometimes more  benefit will be  derived from a
lotion of Nitrate of Silver  ten grains, water  one fluidounce, applied  to the
parts by means  of a camels' hair brush.
   I have  known  some very severe cases benefited by a  poultice worn
around the neck, made  by roasting fresh Poke root, in hot ashes till  it is
softened, then mash and form it into a poultice.  It must be applied warm, 
CYNANCHE MALIGNA.
247
a«d changed every two or three hours.   This,  of course, was  aided by the
inhalations of warm vapor.
  After the more  active inflammatory symptoms have subsided, a stimu-
lating and  astringent  gargle  may be used  with advantage; thus, take of
Sumach berries, Golden Seal, Witch Hazel bark, Geraniui.i, each, equal
parts:  make a  strong  decoction, add two drachms of Alum to  each pint,
sweeten with honey, and gargle the throat frequently with it, while it is
warm.   Should symptoms of suppuration  be present, known by the soft,
pliable fluctuation of the tonsil, much  suffering may be prevented, and any
tendency to suffocation obviated by puncturing the part;  the  tongue must
be pressed down with  the handle  of a spoon,  and the swelling  punctured
with a common lancet, which, in order to prevent any accident, must be so
covered with two  pieces of pine, or other substance, as to  leave only a
small portion  of the  extremity of the lancet exposed.  After the opera-
tion the above  stimulating gargle may be used.
  After the disease has been cured, relapses must be guarded against,  by
avoiding exposures to cold and damp,  and by wearing  flannel about the
neck for several days afterward.  Those  who  are subject to  this  disease,
may prevent its attacking them by daily sponging the throat and neck with
cold water, using a light  but nutritious diet, and avoiding exposures to cold
or sudden changes.  When  the disease  assumes a chronic character, the
following will be found  a very valuable application :  Take of a Saturated
Solution of Sal Ammoniac  four fluidounces, Tincture of Cayenne Pepper
one fluidounce; mix.   Gargle with this several times daily, or apply it to
the tonsils  by  means  of a camel's hair brush.  When  a  permanent and
troublesome enlargement of the tonsils remains, a portion will have to be
excised by the surgeon.
  Through the  whole course of the active symptoms, the diet must  be
very light,  consisting principally of  barley-water,  toast-water,  orange-
juice, &c.
             INFLAMMATION  OF  THE  PHARYNX.

  Inflammation of the  Pharynx, or  Pharyngitis, is commonly known as
" sore throat."  The symptoms are similar to those of quinsy, but with less
fever, and no difficulty of breathing, although there is  some difficulty in
swallowing, and a copious mucous secretion from the part.  The same causes
that produce quinsy  may also give rise  to  pharyngitis,  and the treatment
must be similar to that of quinsy.
                      CYNANCHE  MALIGNA.

  Cynanche Maligna, or Putrid Sore Throat, is" considered by the major
part of practitioners, to be  a variety  of scarlatina.  The symptoms arc
chills, fever, quick pulse, pain and soreness of the throat, and  frequently
nausea and vomiting.   As motion increases the pain, the neck is held con-
stantly in one position.   As the disease progresses^ greyish, aphthous spots
form upon the  inflamed glands of the throat, which leave deep  purple or
black ulcers;  the  voice and  respiration is rough and  difficult,  the pulse
sinks, being quick and weak, the  breath  becomes  fetid, and if the disease
terminates unfavorably, bleedings take place from the nose, mouth, &c.  It
may be produced by any cause which will give rise to putrid diseases. 
248
AMERICAN FAMILY PHYSICIAN.
  Treatment.   This disease may be treated the same as malignant sor
throat  in scarlet  fever.   The  inhalation  of vapor,  as  mentioned undei
quinsy,  may likewise be  used, together with external  fomentations.  A
plaster, made by melting Rosin, and adding to it equal parts, each, of Honey,
and powdered Camphor, spread upon a piece of  flannel, and worn around
the throat for several dajs, has been highly recommended.
              INFLAMMATION OF  THE  MOUTH.

  Inflammation of the Mouth, or Stomatitis, is an affection which is com-
mon to children of all ages.
  Symptoms.  The mucous membrane of the mouth and tongue is unnat-
urally red and hot, and exceedingly painful when foreign bodies are brought
into contact with them.  The mouth is usually dry, but frequently there is
a copious  discharge of saliva  at  the  commencement  of the attack.   The
whole surface of the mouth may  be  involved, or only  parts of it,  as the
tongue, cheeks, gums, &c.  The child is  uneasy, restless,  and fretful, and
is evidently in much pain when eating or suckling.  Sometimes the bowels
are disordered with flatulence  and griping, and if  the child  be suffering
from dentition, there may be some fever present, but not withotit.
  Causes.  The disease may be caused by irritating substances taken into
the mouth, a disordered condition of the stomach and bowels, and painful
dentition.  Sometimes  it occurs  in certain  eruptive  diseases, as measles,
scarlet fever,  &c.   It  may also be occasioned in those  more advanced in
years, by dental  operations, or by the accumulation of  tartar around the
teeth.
  Treatment.  Simple applications  to the mouth are generally all that
will be required,  as a wash or gargle of an infusion  of Elm bark and
Borax; or, a mixture  of water and Honey7, each, seven parts, Alum  one
part.  A  very  excellent remedy is a  decoction of equal parts of Blue
Cohosh  root and Golden  Seal.   If  diarrhea be  present,  the Compound
Syrup of Rhubarb and Potassa may be given;  if the  stomach and bowels
are otherwise deranged, a dose of the Compound Powder of Jalap, may be
given.   If the  child is teething, cut the gums;  and  in older persons
remove carious teeth when they are present.
      FOLLICULAR  INFLAMMATION  OF  THE  MOUTH.

  This disease is commonly known by the names of Thrush or Aphtha.  It
is a common disease of infancy and childhood, but may appear at any period
of life.
  Symptoms.  Small white specks are first seen upon the tongue, lips, and
the interior  surface of the mouth  and throat, which spread more or less
rapidly over these parts, and  in severe cases, are continued  through the
alimentary canal to the anus.  These  specks proceed to  ulceration, and
terminate by exfoliation or shedding  of whitish crusts.   Sometimes a small
quantity of blood is exhaled from these ulcers, which  dries, and forms a
slight brown scab.   The mouth is hot, the lips often swollen, the saliva con-
stantly dribbling from the mouth, the breath  unusually disagreeable, and
suckling  or eating  is difficult, producing much pain.   The pulse is quick
but feeble, the bowels out  of order, with watery er green stools, and vomit
?rig is frequent.  The child becomes  pale, anxious, fretful, with  an expres-
sion of  distress, and rapid emaciation. 
THRUSH.
249
     When the disease is  mild, but few of these  symptoms are present; but
   when severe, we find frequently in addition, much headache, severe pain in
   the bowels, and often typhoid  symptoms,  under  which the  patient  may
   sink rapidly.   If  the disease extends to the pharynx, the glands are apt to
   enlarge, and if extended to the trachea, the voice becomes altered, harsh,
   and hissing.
     Causes.  The disease is most common among pale, delicate, and unhealthy
„  children, as well as those who  are brought up by hand.  It may be caused
   by neglect, bad food, impure air, want of cleanliness, and is frequent in pla-
   ces where  children  are overcrowded.  More often it is a secondary affection
   to derangements of the  digestive organs, or to impaired health.
     Prognosis.  AVhen the disease  is mild, the white crusts will fall off, and
   the little ulcers heal  in a few days.  In the severe and unfavorable form the
   aphthae run together, forming more or less considerable ulcers, which have a
   dai-h  or unhealthy appearance,  with vomiting,  diarrhea, small, quick pulse,
   and rapid  emaciation.
     Treatment.   As the bowels are usually deranged, the Compound Syrup
   of Rhubarb and  Potassa, should be given daily to keep up a regular action,
   to remove acidity  of  the  stomach, and  to  overcome  diarrhea.   The mouth
   should be  frequently washed or gargled with a  strong decoction of Blue Co-
   hosh root and Golden Seal, sweetened with Honey, and  rendered  astringent
   by the addition of some Alum; and a portion of this swallowed several times
   a day, will be of much advantage.
     When the ulcers have  formed, they may be touched once or twice a day
   with  a solution of five or ten grains of Nitrate of Silver  to an ounce of dis-
   tilled water.  In a number of instances I  have  derived decided  benefit by
   washing them three or four times  a  day with  the Tincture of Chloride  of
,   Iron, which may be slightly diluted at first lest  it smart too severely; and in
   very young infants, a drop or two, or more,  according to age, may be given
   every one,  two, or  three hours, in a sufficient quantity of  water.
     As an internal remedy Persesquinitrate of Iron has been highly extolled:
   Take of Solution  of  Persesquinitrate of Iron forty  drops, -Syrup  of  Orange
   half a fluidounce, water  five and a half fluidounces; mix.  The dose is a wine-
   glass  half full,  four  times  a day,  to a child three  or four years old;  or in
   proportion to its age.
     AVhen the ulcers assume a brown hue, manifesting a tendency to gangrene,
   the mouth  may be frequently washed with Yeast, or a solution of Chlorate of
   Potassa; and Yeast may be given internally, either alone, or in combination
   with equal parts of Olive Oil, and Sweet Spirits  of Nitre; or, the Chlorate  of
   I'otassa may be administered internally in doses of three grains dissolved in
   sweetened water, to a child three years old, and  repeated every four hours.
    Should the anus become excoriated, wash it  frequently with warm water,
   and after each bathing apply Lapis Calaminaris or the impure Carbonate  of
   Zinc.   And the surface of the body and limbs should be kept clean by daily
   bathing.
    It will frequently be found beneficial to change the nurse of the child, and
   in older children to change the diet, which is best when consisting of milk,
   barley-water, toast-water, arrowroot,—and when much  debility  is  present.
   wine whey, milk and wine, ale, porter, chicken broth, &c.
    In  nearly all cases of this disease, alteratives will be of much service, more
   especially in children of scrofulous habits; the  Compound Syrup  of Stillin-
   gia, or the  Compound Syrup of  Yellow  Dock,  may be given in appropriate
   doses in conjunction with Iodide of Potassium. 
250
AMERICAN FAMILY  PHYSICIAN.
                 MUGUET   OR  WHITE  THRUSH.

  This disease differs from true Thrush in being a morbid secretion upon the
mucous membrane of the mouth, and not occasioning any ulcers.
  Symptoms-.  It usually comes on with inflammation of the mouth, more or
less severe, and which may not attract attention until small curd-like patches
or exudations are discovered on the inside of the lips and about  the end of
the tongue, and which, if the  child be suckling, may be mistaken for parti-
cles of milk.  These spots gradually become more numerous, and run together
forming irregular patches, and covering more or less of the mouth and throat;
they are exfoliated and renewed, leaving  the mucous surface from which they
are thrown off, of a  bright red color but without any ulceration.  The skin
is hot and dry, the pulse seldom affected, and thirst rather inordinate; but
when the disease is severe, and especially when it has  extended  into the
esophagus or tube leading to the'stomach, it is painful to suck or drink, and
in some cases either of these  are impossible.  When it  extends into  the ali-
mentary canal, it is apt to prove fatal.
  Causes.   This affection is  more prevalent among infants, and may be
occasioned by bad food, impure air, insufficient clothing, too much purgation,
or insufficient removal of the meconium, the crowding too many children
together in a small space, and it may also be propagated by contagion by the
nipple.  Sometimes it prevails as an epidemic.
  Treatment.   In  the milder forms of the disease, the treatment recom
mended for inflammation of the mouth  will  be sufficient. ' In  the severe
forms the mouth may be frequently Washed with a decoction of Golden Seal,
in which some Alum has been dissolved; or the  preparation named under
Thrush may be used, of Golden Seal, Blue Cohosh, Honey, and Alum.  In
some cases a solution of Nitrate of Silver  from two  to six grains to an ounce
of water will be found serviceable.  The  Tincture of Chloride of Iron used
locally and internally, as named under  Thrush, will very often be followed
by prompt benefit.
  If the bowels are deranged, Tincture of Podophyllin  one part, Tincture of
Leptandrin four  parts,  may  be mixed together, and administered in  small
doses,  sufficient to keep  them regular  without purgation.   If  diarrhea is
present, or if the disease has  extended through the alimentary canal, with
excoriation of the anus, treat the same  as recommended under Thrush.  If
much debility is present, Quinia and stimulants will be indicated.  The diet
will be the same as that advised in Thrush.
  When the disease occurs as a secondary affection to some other disease, the
primary one must be  removed,  before the local remedies will have any per-
manent effect.
       ULCERATIVE  INFLAMMATION  OF  THE MOUTH.
  This disease,  known as "Ulcerated Sore  Mouth,"  somewhat resembles
Thrush, but differs from it, in the character of the ulceration, which instead
of being confined to the follicles of the mucous membrane of the mouth, maj
take place in any part of this membrane, and extend in an irregular manner.
By  some it is  viewed as  Cancrum Oris,  but  there is a material difference
between the two.  The disease may occur during infancy, but is more fre-
quent among boys, and between  the ages of five and ten.
  Symptoms.   The disease usually commences in the gums, which  become
red, swollen, soft, and bleeding, and are  soon covered  with a soft  layer of 
CANCRUM  ORIS.
251
greyish matter.  The inflammation and ulceration extend to the correspond-
ing portion of the mucous membrane lining the mouth and lips, commencing
with small whitish spots, which  enlarge and run together,  until they form
the large grey patches covering the erosion or  ulceration.   Usually  the dis-
ease is limited to a small extent,  but  occasionally it extends over all parts of
the mouth.  If not relieved, the inflammation  continues, and the ulceration
deepens; the greyish layers of false membrane become detached and quickly
renewed, thus perpetuating the disease.   If the disease is severe, the sub-
maxillary glands (situated beneath the jaw)  are swollen, hard, and painful,
the breath offensive,  with more or less  salivation.   The  suffering is severe,
and the child is  restless and uneasy, unable to suck, or eat.  More or less
fever is generally present,  with a quick, weak pulse, loss of appetite, and ema-
ciation.  Sometimes  the ulceration spreads so extensively that the teeth are
loosened, and  occasionally fall out.
  Causes.   It may be owing to a deteriorated constitution resulting from
improper or  insufficient food, want  of cleanliness, unwholesome air,  damp
dwellings, or a disordered condition of the stomach and bowels.   Occasion-
ally it appears as an  epidemic, and may also occur in the course of other-dis-
eases which produce  constitutional debility.
  Treatment.  The bowels must be attended to, using astringent infusions
if diarrhea be present, and mild laxatives for constipation.   The child should
be kept clean, removed to  a dry,  airy situation, and fed upon good nutritious
diet, especially if it be debilitated.
  The mouth  should be frequently washed with some warm astringent infu-
sion, and the ulcers touched with a solution of Nitrate of Silver.   The Tinct-
ure of Chloride of Iron will also be found very valuable as a local application
to the ulcers.  Various other remedies have been found useful, as an infusion
of Golden Seal and Geranium with Alum; an infusion of Red Root,  Witch
Hazel bark and Geranium; or a solution of Tannic Acid in Port Wine.
  If the child  be weak, Wine, Wine Whey, Sulphate of Quiniar &c, may be
given;  and in all cases, when no fever is present, the  Compound Syrup  of
Stillingia with Iodide of Potassium should be administered  daily.
  In cases where the stomach is loaded, the treatment may commence with
an active emetic.  And where there is torpor of the liver, small doses of Pod-
ophyllin and Leptandrin will be of service.
       GANGRENOUS INFLAMMATION OF  THE  MOUTH.
   This disease, also known by the name of  "Cancrum Oris," is one of the
 most terrific forms of inflammation of the mouth.   All the preceding forms
 of inflammation of the  mouth  may be followed by gangrene in one form or
 other, but none of them are so rapid and destructive in their effects as the
 one under consideration.   It  is mostly observed in children, and following
 after some disease, but I have frequently seen it in adults.
  Symptoms.   The  symptoms vary.   In some  cases small vesicles,  of an
 ashy, dark-red, or even black color,  are observed within the mouth on the
 lips or cheeks, encircled by a red base, with little pain or swelling, more or less
 salivation, and a peculiar fetor.   These vesicles pass rapidly into a gangrenous
 condition, with an augmentation of the pain, heat, and tumefaction.   Dark or
purplish spots appear in the neighborhood of the vesicles, which eventually
form large sloughs; and they progress so rapidly, that in the short space of
forty-eight hours, all the fleshy parts of the mouth and  face may be destroyed
by the gangrenous action.   In  other instances, the ulceration commences on 
252
AMERICAN FAMILY  PHYSICIAN.
the gums, which at first present a white and spongy appearance, but which rap-
idly passes into  ulceration and gangrene, also spreading and involving  the
jawrs, cheeks, and lips.  The breath becomes intolerably offensive, the teeth
fall out,  the  soft tissues  swell,  become hard  and purple, ulceration with
sloughing ensues,  and  the discharge from the diseased parts are usually so
acrid as to excoriate the parts over which it is permitted to flow.
  At first the general health does not appear to be  much affected, but as the
disease progresses and the soft tissues are destroyed, an irritative fever ensues,
with loss of appetite, emaciation, diarrhea, and death.
  Causes.  Authors tell  us that it may be occasioned by impure air,  bad
food, and congregating children together in small rooms; but I am  not dis-
posed to believe this, as in all the cases I have seen the patients were under
the influence of mercury, or had been previously treated by it.  We are also
told by authors that the disease  is often a sequence of an attack of  measles,
scarlatina, etc.  We are likewise informed that it  never exists as a primary
affection, but appears in children enfeebled  by previous disease.  One writer
observes "that in all the cases he had seen, the children had a pale, bloated,
sickly look* large belly, &c."  My own opinion is, that cancrum oris is owing
to the previous mercurial treatment employed in  the  various diseases under
which the patients may have been suffering.   Children and persons of a stru-
mous habit are the most liable to this disease, and with such, mercury is very
apt to produce its deleterious effects.  And, indeed, dissection reveals tuber-
cles in some portion of  the system,  in  by  far the greater number of cases,
with occasional ulceration of the lining mucous membrane of the intestines,
or enlargement of the follicular glands.
   Treatment.   The bowels must  be  kept regular by doses of a mixture
composed of Charcoal three parts,  Rhubarb one part, which may be added
to some Indian meal gruel, and administered in doses sufficient to produce
a daily  evacuation;  active purgation must be avoided.  If diarrhea be pres-
ent, it must be restrained  by astringent infusions, with prepared Charcoal
added;  in some cases, the Tincture of Chloride  of Iron, may be given four
or five times a day, in doses suited to the age of the patient.
   The surface  of the gangrenous ulcers  must be washed by a Saturated So-
lution of Sulphate of Zinc.  Or, either diluted Muriatic or Pyroligneous acid,
or Tincture of Chloride of Iron may be used  instead.  When the gangrene
is external, various  agents have been advised as local applications, thus—a
poultice of Wild Indigo  leaves, Charcoal, Yeast, and Pyroligneous Acid;
or, Bethroot, Black Cohosh, Witch Hazel,  and  Sumach ; or, Golden Seal,
Wild Indigo leaves, and Nitre.   An infusion or decoction of any of these,
may likewise be used to wash or syringe the ulcers in the mouth.  In very
bad cases, the gangrenous surface may have to be cut away, because, to have
any effect, the local  applications must reach the healthy tissue.   It has been
advised  by some, to apply strong  Nitric Acid to  cauterize the  parts;  the
tongue, or other healthy parts, may be held on one side with a gilt or  pla-
tinized  spatula, and then apply the acid by means of soft lint tied to a quill.
The cauterization should be complete,  so as to  obtain a healthy surface of
 he sore at all its  parts.  In twelve  hours, examine the parts, and retouch
wherever the  mortification seems  unchecked; and repeat this examination
and retouching every twelve hours, until the sloughing process is  arrested.
In the interim, the  mouth should  be frequently washed or syringed with a
solution of Chloride of Lime.  As  this is a very painful treatment, a careful
administration of the vapor of Chloroform is recommended.
   The  patient should  be  kept clean, and the room well ventilated; his
strength should  be sustained by a proper  diet, as arrowroot, sago, tapioca, 
MUMPS.
253
jellies, beef tea, and broths,  with wine in each, wine, wine whey, &c.   Sul-
phate of  Quinia may be  administered  internally, and  in some cases  with
Phosphate of Iron.  The Chlorate of Potassa has been recommended as al-
most a specific in this  disease; three grains  may be given to a child three
years of age, in  some sweetened water, or wine, or porter, and repeated every
four hours ;  it is said to complete  the cure in from six to twelve days.   The
Compound Powder of Ipecacuanha and Opium may be given to allay  pain
and restlessness.
                     PAROTITIS,  or  MUMPS.
  Mumps, Parotitis, or Cynanche  Parotidoea, is  a disease chiefly attacking
children,  though it  is occasionally met with  in  adults.   Generally the
person is affected but once with it,  during life.  As it does not terminate
in the manner usual  to inflammatory diseases, some authors consider it not
to belong strictly to this class of maladies.
   Symptoms.  The affection commences with a soreness and stiffness about
the neck, which  is followed by a hard  movable and painful swelling of the
parotid glands, which continues  to increase  until about  the fourth day.
when it  gradually subsides, generally  disappearing in  from seven to nine
days from its first attack.  The swelling usually affects both glands at the
same time, sometimes after the disease has left  one gland it appears in the
other, and occasionally it is confined  to  but one  gland.  In severe cases
the  swelling attains  a considerable size,  causing pain and  difficulty in
breathing, swallowing, and opening  the mouth.   In mild cases there is but
little fever, but when the swelling is great, there is commonly more  or less
heat and dryness of the skin, quick  pulse,  constipated bowels,  high-colored
and  scanty  urine, and furred tongue; and frequently  the  neighboring
glands are involved.   The skin over the swollen  parts  often becomes tense
and tender, but seldom manifests  any  redness.
   As the enlargement of  the glands subsides, it will very frequently be
found that the breasts of females and  the testicles of males become swelled
and more or less painful, and  this translation of the disease is very apt to
occur during the active stage,  when the patient has imprudently exposed
himself to cold  and wet; and, from the same cause, it has occurred three
or four days after the subsidence  of the  swelling in the jaws.  Generally
this translation of the disease is not unfavorable, and passes away in a few
days, but sometimes  it proves fatal,  or occasions some permanent difficulty.
I  know  of one  man  who, at  the  age of forty, suffered  so severely from
neuralgic attacks of  the testicles,  that  the operation of castration was per-
formed at his urgent request;  the attacks had existed from youth, at which
time mumps, and its translation to the parts occurred.
   Causes.  Mumps  appears to be  a  contagious affection, and frequently
exists  as an epidemic.  From its  tendency to  attack distant parts, it is
believed  by some, and perhaps correctly, to be of nervous origin.
   Treatment.  Mild cases of mumps require hardly any treatment,  the
bowels may be kept regular by mild laxatives;  the  parts  attacked,  as well
as the  face and head, should be kept warm ; and great  care should be taken
to avoid  exposure to cold and wet.   Sometimes, bathing the feet during
the  febrile  symptoms, as well as  drinking freely of warm  infusions of
Balm,  Catnip, Spearmint, Sage, &c.   When the symptoms are severe, the
Compound Powder of Ipecacuanha, and Opium should be given, and  the
swelling  may be bathed with some  stimulating liniment, after which keep 
254
AMERICAN  FAMILY  PHYSICIAN.
the part covered with flannel.  A dose of the Compound Powder of Jalap,
should also be given.
  When the disease has been translated to the testicles or breasts, perspira-
tion must be produced by the Compound Tincture of Virginia Snake Root,
given in sufficient doses for the purpose;  after which moderate diaphoresis
must be kept up by the use of the Compound Powder of Ipecacuanha, and
Opium.  The patient must be kept in bed, and a fomentation of Hops and
Stramonium leaves, equal  parts of each,  should be applied to the swelled
parts, as hot as can  be  borne, and frequently renewed.   A fomentation of
Elm bark and Stramonium leaves will  likewise be found useful.   One or
two active cathartics may also be given, avoiding exposure to cold during
their  action.   And for some  time  after recovery, it will be well for the
patient to wear a suspensory bandage.
  The principal  requirements in mumps are  quiet and rest on the part of
the patient, and  an avoidance of cold; the diet should be very light
             INFLAMMATION  OF  THE  LARYNX.

  Inflammation of the Larynx,  or upper  part of the windpipe, is a rare
disease, but when present is very rapid in its  progress often  destroying
life, by suffocation, in a day or  two.   It is  more frequently met with in
connection with inflammation of the  trachea.   It is a very  dangerous
disease, and  demands prompt  and energetic  treatment.  The milder form
of this disease is considered under the head of catarrh, or influenza.
  Symptoms.  The disease  commences with  the  usual symptoms of fever,
as chilliness, succeeded by heat and dryness of the skin, and  quick  pulse;
the  voice  quickly becomes hoarse and indistinct, and sometimes entirely
gone; the breathir-j is painful and laborious, with a  sense of stricture in
the throat, sometimes almost amounting to suffocation ; the pulse is quick
and feeble, the  eyes somewhat protruding and  "bloodshot," the counte-
nance livid or swollen,  and the tongue  furred.  On examining  the  throat,
there will  be found a reddened appearance of  its back part, the palate, and
tonsils, and  the epiglottis, (a  valve over the  upper part  of the  windpipe,
situated behind the base of  the tongue,) will be seen raised, swollen, and
of a bright red appearance.   This  latter condition renders every attempt to
swallow difficult and  distressing, as in the act of swallowing  it  must close
the glottis (or upper part of the larynx,) to prevent food or medicine falling
into the larynx  and causing  strangulation.  The muscles of the throat and
chest are thrown into violent spasmodic action, threatening instant suffoca-
tion, causing the patient to be extremely restless and uneasy, changing his
position often to obtain relief,  and crying out for the admission of more
air into the room.   The pulse is  now rapid and  full, the skin dry and of
augmented heat, tongue furred, urine  scanty and  reddish, and bowels con-
stipated; in  some respects the symptoms resemble those of croup.
  Ultimately, the  patient becomes weary and  disposed to  sleep, which,
however, is prevented  or interrupted  by  coughing and  expectoration of a
tough, gelatinous  mucus ; the  face  becomes pale and  sunken ; the lips
purplish;  the eyes glaring, protruding and watery, with a purplish circle
around them; the  extremities  grow cold ; the pulse  feeble and unequal;
respiration becomes more difficult and distressing;—sinking  comes  on, the
pulse  fails, stupor or coma takes place, cold sweat, and finally death.
  Causes.  Exposure  to cold  is  the most common cause.  It may  be pro- 
INFLAMMATION OF THE  LARYNX.
255
 duced by long and loud speaking, by inhalation of irritants or irritating
 vapors, and is sometimes connected with measles, scarlet fever, croup, &c.
   It may  be discriminated from  croup  by the  following symptoms:—in
 croup, there is  difficult breathing, cough with  a metallic, ringing sound,
 but no swelling of  the fauces or difficulty in swallowing; in inflammation
 of the  larynx, the  cough  is  a  suppressed  wheezing, accompanied with a
 painful effort and a sense of suffocation, swallowing is painful and difficult,
 the voice hoarse, reduced to a whisper, or extinct, and the fauces and sur-
 rounding parts more or less swollen.
   Treatment.  In the early stage of the disease, an  emetic should be
 given, for which purpose the Compound Powder of Lobelia may be given
 to adults, or the Compound  Tincture  of Lobelia to very young children.
 The emetic should  be followed by a cathartic, as the Compound Powder of
 Jalap, with five or ten grains of Cream of Tartar added.  When the least
 sense  of constriction  returns, or, if the  symptoms are  very urgent, the
 emetic  may be  repeated once in  every twenty-four hours.  In the mean-
 time the Compound Tincture of Lobelia should be given in nauseating
 doses, to favor expectoration, and allay the inflammatory action; or some
 other  nauseant and expectorant may be administered, if this be  not at
 hand.
   The  warm vapor of vinegar should be inhaled several times a day, and
 when it can  be used, a gargle, composed of vinegar and water, half a gill
 of each, salt, a  teaspoonful, may also  be  used several times  a  day, with
 much advantage.
   In addition to these means the throat and neck should be bathed two or
 three times  a  day  with some stimulating application, as the Compound
 Tincture^of Camphor, followed by fomentations, as hot as can be borne, of
 Hops and  Mullein, or,  Stramonium leaves, or  a poultice of  Onions; in
 several  cases, I have met  with  most  decided benefit from  a  poultice of
 warmed Cranberries around the neck.
   The surface of the body should be frequently bathed with a warm weak
 alkaline solution, and the feet and legs may be immersed in it for fifteen or
 twenty minutes, after which Mustard may be applied to them, and, in very
 severe cases, along the course of the spinal column.  Moderate perspiration
 should  also  be kept up, either  by  the nauseants above named,  or by the
 administration of the Compound  Tincture of Virginia Snake Root.
   Upon  the subsidence of the more  active symptoms, there will frequently
 remain  a harassing cough with more or less irritation of the throat and
 fauces, for  which I have found the following  compound very useful:—
 Take of a Saturated Solution of Alum, Syrup of Balsam of Tolu,  each, two
 fluidounces,  Elixir  Paregoric one  fluidounce.   Mix.  The dose  for an
 adult is a table-spoonful several times a day, or, whenever the above  symp-
 toms are troublesome; children must take  it in  proportion  to their ages.
 And in connection with this, the above gargle of vinegar, water, and salt,
should be used several times a day.
   Until the severe symptoms have subsided, but little food is demanded,—
lemonade, orange-juice, cold water, &c, will be sufficient when  they can be
swallowed; on the decline of the symptoms, rice-water, barley-water, toast-
water, &c, should alone be given, until the  disease is thoroughly removed,
The patient should be kept in a warm room, and after recovery, the utmost •
caution must be observed, that a relapse  is  not  produced by  exposure to
cold or  damp.
  When  all other measures fail in affording relief in this disease, it has
been advised to  make an artificial opening into the windpipe, for the pur- 
256
AMERICAN FAMILY  PHYSICIAN.
pose of allowing the patient to breathe, while various efforts  are at the
same time being made to subdue the inflammation.  This  operation is not
very painful, and in itself is not dangerous ; it has succeeded in  saving life
in several desperate cases.   The earlier it is performed  the greater are the
chances for success.
                      CHRONIC  LARYNGITIS.

  Chronic Laryngitis, or clergyman's sore throat, sometimes, but erroneously
called chronic bronchitis, is  a disease very common  to lawyers, clergymen,
teachers, auctioneers, and all  persons who are in the habit  of loud and
long-continued speaking.  The seat of the disease  is  principally in the
glands  of the  mucous  covering of the  throat.   The disease may extend
along the windpipe until it reaches  the  lungs, and  produces a  true con-
sumption.
  Symptoms.   At first  there is a slight irritation, or tickling  sensation in
the throat, with more or less dryness, giving rise to a hacking, hemming,
or an endeavor to clear  the throat, and  this is usually worse in the winter
than in  the summer, and the  expectoration  is generally more copious in
the morning.   On attempting to speak, especially after  a long silence,
there will frequently be an inability to  produce a proper sound,  until the
throat has first been cleared by hemming or hawking.  Loud or  long con-
tinued talking or reading produces irritation, hoarseness, or cough, with a
dryness of the throat, causing the person  to  frequently drink water with
the vain hope  of  relieving the dryness.   The expectoration is white and
frothy, but as the disease advances, dark or bluish  spots or masses will  he
observed in it, and, sometimes it will  be streaked with more or^ess blood.
Passing from a warm to a cold atmosphere or room, produces  difficulty of
breathing, and in the advanced stage irritates  the parts  and  gives rise to
more or less cough ; the  same symptoms follow an exposure to dust, or when
walking  against the  wind.  In  damp and cold weather  the symptoms are
generally aggravated, so much so, that the patient supposes himself liable
to contract cold from the slightest changes of the weather.
  Several or all of these symptoms may be present in any one  person, and
continue through life without causing any alarm, except when hoarseness
and cough have been  caused by some unusual effort of the vocal organs.
Sometimes they disappear entirely, but return  as soon as, the  organs have
been tasked too much, or when a slight cold has been contracted.  If the
disease is permitted to progress without relief, the palate becomes swelled
and elongated, frequently coming in contact with the base of the tongue,
increasing the  irritation or  tickling, as well  as the cough.  The cough
finally becomes very severe  and troublesome, and is  accompanied with an
expectoration of a darker color than at first; upon examining the throat it
will  be  found  much  redder than usual, and presents a  rough, granulated
appearance, in  consequence of the enlargement of the glands or follicles,
The voice becomes hoarse  and rougher, and is more or  less subdued, and
in some cases there is a complete  loss of  the  voice, but this aphonia hap-
pens only when the muscular organization of the vocal organs is affected
by the disease.   The system begins to  suffer, the appetite is  changeable
digestion impaired, the pulse gradually becomes more accelerated, the skin
becomes dry and rough, and  there  is unequal temperature  of  the body,
with debility and emaciation.  When ulceration is  present, it is  indicated
by a sharp, pricking  pain on  speaking and coughing;  if it has extended 
CHRONIC LARYNGITIS.
257
into the bronchial glands the expectoration becomes streaked at times with
blood, and in other respects  greatly resembles pus.  Sometimes the disease
runs its course rapidly, terminating fatally in a few months.
   Causes.  It may continue as the sequel of an acute laryngeal inflamma-
tion ; or, it may be produced by an exposure to atmospheric changes, frequent
colds, constant inhalation of dusty particles, especially of limestone dust in
cities where this is used to  pave the center of the streets.   Loud and con-
tinued speaking frequently occasions it, and  I have often met with persons
who immediately  after an unusual  effort of this kind,  were affected with
hoarseness,  irritation of the throat, &c, terminating in confirmed chronic
laryngitis.   From my observations, I have every reason to suppose that much
of this disease is occasioned by that secret and solitary vice, onanism or mas-
turbation ; and I have frequently seen scrofulous persons, who were given to
this unnatural indulgence, die of laryngitis, called, however, by their  phys'
nan, "consumption."    And it will be  noticed that  chronic laryngitis is
always more dangerous among the scrofulous, and those disposed  to affections
of the lungs.
   Treatment.   I must here testify to the  fact, that  I  have known more
cases of this disease cured by adopting the mode of speaking and  lecturing,
taught some years since  by Prof. C. P. Bronson, than by the use of medica-
tion.  And I would therefore advise all persons  afflicted with the malady, te
adopt his method of speaking, if it be a possible  matter.
   The treatment by medication consists in local  and general remedies.  The
local remedies are the application of a solution of crystals of Nitrate of Silver
to the parts, in the proportion of from  forty to sixty grains to the fluidounce
of distilled water; it is  applied by means of a sponge fastened to the end of a
whalebone probang, and should never be attempted by any one except a phy-
sician.
   I  have frequently found  a solution of  Chloride of Lime, applied  as just
named (say from five to ten  grains, or even more, to the fluidounce  of water,)
to answer a better purpose than the Nitrate of Silver; and in some  instances
a solution of Sesquicarbonate of Potash.
   In the milder cases I have found the inhalation of the vapor of Vinegar,
frequently gargling the throat with  a mixture of Vinegar,  rain-water, and
Salt, together with an absolute quietness of the voice, sufficient to remove all
symptoms of the disease.   And in the winter season, I recommend toasting
the feet for  half an hour or an hour before a fire previous to  going to  bed,
and repeating it every  night through cold and changeable weather.   When
the palate is found elongated, a  portion of  it may be  cut off by a surgeon,
without any danger, and this should always be done to  lessen the irritation
caused by it, and should the tonsils be  enlarged they  should  likewise be
properly excised by a surgeon.   In severe cases, and when there is a loss of
voice, an irritating plaster may be placed to the throat,  and kept  discharging
as long as possible; and when the ulcer caused by it has healed, another may
be placed upon the back of the neck.   But I  do not advise such a painful
measure, except in severe and alarming cases.  Ordinarily, a small  portion uf
the following liniment will answer to apply once  or twice a day to the throat
and  neck,—it produces  an eruption:—Take of Oil of  Turpentine,  Oil o.
Olive, each, one fluidrachm,  Croton  Oil half a fluidounce, Oil of Origanum
two fluidrachms.   Mix, and  apply.
   The general measures  are  an attention to the bowels,  keeping them in a
state of regularity by diet, if  possible;  exercise  in the  open  air,  avoiding,
however, dusty and vapory places, as well as damp and windy weather; keep-
ing the surface of the body in a  healthy  condition  by  frequent  bathings;
       17 
258
AMERICAN FAMILY PHYSICIAN.
using a nutritious but easily digestible diet, avoiding spices, stimulants, ae-'J
all vinous or spirituous liquors, as well as loud speaking, reading, or singing
and the internal use of the following mixture:—Take of Compound Syrup o4
Spikenard  twelve fluidounces, Fluid  Extract of Stillingia  four fluidounces,
Iodide of Potassium half an ounce; mix.   The dose is a teaspoonful or two
in half a gill of water, to be repeated three or four times a day.  A very use-
ful agent to be used by persons in the earlier stages of  this disease is com-
posed of Canada Balsam one fluidrachm, Oil of Cubebs two fluidrachms, Oil
of Stillingia half a fluidrachm; mix.  The dose is five  or ten drops on sugar
three or four times a day, and allowed to pass slowly down the throat.
             CYNANCHE  TRACHEALIS,  or,  CROUP.

  This disease has received many names, but that of Croup is the one ordi-
narily preferred.   It is one of the most alarming diseases to which children
are subject, being sudden in its attack, and rapid in its results.   Children
between the ages of one and  twelve, are more liable to it, especially  those
under five years, and it occurs more frequently among  males  than females.
Children of an irritable, nervous habit, and great susceptibility, are the most
liable to its  attacks, and with some children there is almost a constant ten-
dency to a return of the disease,  until the advance of age has removed the
predisposition.   It has occasionally been  met with in adults, even as far ad-
vanced as seventy  years.
  Symptoms.   Croup may be divided into three stages.  1st.  The catarrhal,
or precursory stage, which is often absent.  2nd.  The stage of development.
3rd. The stage of collapse or threatened suffocation.   For  the excellent
description of symptoms which follow, I am mainly indebted to Dr. Churchill.
  In the first or precursory stage, there are usually some catarrhal symptoms,
sneezing, weeping  of the eyes, and coughing,  with a hot skin, quick pulse,
and much thirst.  But the most certain symptom, to which great importance
has been attached, as indicative of an approaching attack of croup, is the
change  in  the voice, a degree of hoarseness, or  huskiness, as though the
throat  needed  clearing.  The cough is usually short and dry, with evident
uneasiness  in  the  windpipe, but an examination of the pharynx will detect
no traces of disease.  The tongue will be moist and coated, and the breath-
ing will be proportionably  rapid, in accordance with the  amount of fever,
quick pulse, and other catarrhal symptoms.  This stage may last from a few
hours,  to one or two days, but commonly, seldom more  than twenty-four
hours.   Sometimes the disease occurs fully formed, without  any  previous
catarrhal symptoms.
  In the second stage, or stage of development, after the first stage has increased
in severity, or, frequently without any premonitions,  the child is suddenly
startled from his sleep by a sense of suffocation, with a hoarse, ringing cough,
hurried and hissing respiration, and a rough, hoarse voice, with great alarm
and distress.   It is a peculiarity of this disease, that  the first  occurrence of
the croupy  cough takes place at night.  The fits of coughing  become  more
frequent and spasmodic, during which the inspiration is almost  suspended,
and the action of the heart accelerated.   The efforts  of the child  are verj
great;  the  countenance becomes flushed,  almost livid, and  covered with
sweat,—the  hands are clenched,—the arms thrown  about, all covering is
rejected, and whatever might impede  the  access of air hastily removed; the
body is erect, or  recumbent,  and  occasionally with the  head rigidly bent
backward, but in  whatever position he places himself no relief is obtained. 
CROUP.
259
 The eyes project, are red and watery, the arteries of the neck beat strongly,
 the pulse is quick and hard, skin very hot,  breathing  rough and wheezing,
 voice hoarse, thirst very great, with scarcely any expectoration.   The hand
 is frequently carried to  the larynx as the seat of distress, as if to remove
 some obstruction.  The sound of the cough is very peculiar, somewhat resem-
 bling the crowing of a cock, or more like succussions of air through a brass
 tube, with a ringing metallic tone.  During all  these symptoms  there is  no
 difficulty in swallowing.
   The cough, hoarseness, and difficult breathing appear in the  night, and
 increase, together with the fever, until the morning,  when  they diminish
 considerably.   This intermission may remain during  a  greater  part of the
 day, the pulse, however, being frequent, the cough hoarse, and the breathing
 somewhat impeded. Toward evening, probably after  a  sleep,  a still more
 violent paroxysm than that of the preceding night occurs, all the  symptoms
 above-named  become rapidly  aggravated, the remissions are less perceptible,
 the cough more difficult, suppressed and strangulating—-suffocation is more
 imminent, and there is an occasional vomiting and the expulsion of a glairy
 mucus, sometimes mixed with flocculent or membranous threads,  affording
 temporary relief, occasionally there are streaks of blood in it.   The croupal
 breathing is permanent and increases, the voice becomes broken, whispering,
 and suppressed, the bowels are costive, and the urine may be  scanty, thick,
 and high-colored,—abundant, pale,  and clear,—or,  especially toward the
 close of the second stage, turbid and whitish.  It is in this second stage that
 the secretion of false membrane occurs.
   The third stage, or stage of collapse, may set in  from the third to the sev-
 enth day, or even sooner, according to the intensity of the  inflammation,  or
 the peculiar constitution of the child.   In this  stage all the symptoms are
 aggravated, and there are no longer any remissions.  The pulse is quick and
 weak, and often unequal and intermittent.   The cough is less frequent, less
 sonorous, suppressed and suffocative.   The voice low, whispering, or entirely
 lost.  The respiration is difficult, loud  and hissing, the movements of the
 larynx are extensive and incessant, the nostrils widely expanded,  to°-ether
 with a  powerful action of the muscles of the ne :k, chest, diaphragm, and
 abdomen.   The head is constantly thrown back,  cold  and clammy perspira-
 tion on  the forehead, sunken and dull eyes, livid or leaden color of the coun-
 tenance, and  the veins  of the neck  unusually  distended.  The tongue  is
 coated and dark-colored, great thirst,  and some  little expectoration.0  The
 whole appearance of the child is one of great distress,  of the agony of op-
 pressed  breathing, of the horrible dread of suffocation.   It tries  in vain for
 relief, turns_ on every side, changes its position, with  anxiety and restless-
 ness.  Sleeping or  awake the  distress continues.   From this  condition  it
 rarely recovers; there may be occasional remissions, after the  expectoration
 of mucus and lymph, but it is only temporary,  the distress increases, the
 respiration assumes a convulsive character, the air passes  with more and
 more difficulty through the larynx, and in a short time, seldom above twenty-
 four hours, the child expires with signs of convulsive suffocation, or falls into
 a state of stupor and dies lethargic.   Occasionally,  when  we  imagine the
 symptoms to be more favorable, the child  is instantly suffocated, owing  to
 the partial detachment of the  false membrane which  forms  a valve whose
 closure has proved  fatal.
  Croup may be milder,  and run a less fatal course,  but whether mild  or
severe, it must always be recollected that  the disease  very  often suddenly
acquires great  intensity, and a few hours lost can  never  be  regained.  The
disease has proved fatal in twenty-four hours, and again  has lasted nine  or 
260
AMERICAN FAMILY  PHYSICIAN.
ten days.   There is a great liability in croup to relapse,  hence the patient
should be diligently wTatched, until he has perfectly recovered.
  Croup has been termed inflammatory, when there is a predominance of the
inflammatory symptoms.   It Usually attacks plethoric  children,  of a sanguine
temperament,  and is the  severest form of the disease.  It is  preceded by
chills, strong,  rapid pulse, difficult and forcible breathing, redness  or lividity
of the cheeks  and lips, a hot, burning skin, and is marked  by a more  con-
tinuous  and unremitting severity of symptoms.
  When confined to  the larynx, it has been called laryngeal croup, and is
accompanied with  unusual pain and swelling of the  larynx, and  occasional
convulsions.   It  may terminate fatally in twelve  hours, but rarely longer
than five days.
  When confined  to the  trachea it  has been called tracheal  croup.  This
form is  less rapid, and has a  less fatal progress; the cough and  breathing
though  sonorous, have not the brazen sound of ordinary croup ; the voice is
less affected, and the suffocation is not so  oppressive.   This form may be
prolonged to fifteen days,  and may terminate in a chronic form of  croup, or,
extending downwards, terminate in bronchitis.
  Spasmodic croup is wdiere  there is a  predominance  of nervous or  spas-
modic symptoms.  In this form the child may go to  bed perfectly well, and
in one or two hours be awakened with perfectly formed croup,  hoarse voice,
ringing  cough, difficult breathing,  and threatened  suffocation, which,  if not
relieved, will continue through the night, increasing  in severity, but having
a remission  through  the day.   If taken early it is far more  manageable than
the inflammatory form, and the spasmodic irritation may be relieved before
there has been time for the false membranes to form.
  Croup is sometimes  complicated with bronchitis,  pneumonia,  and  other
diseases, and also exists as a  secondary affection of quinsy, malignant scar-
let fever, &c.
  Causes.   Croup is undoubtedly an irritation of the larynx  and trachea
primarily, (but which may extend into the bronchial  tubes,) giving rise to
a peculiar lymphatic  secretion, and a degree of spasmodic action, both of
which affect the  voice and breathing.   The principal  exciting  cause is cold,
a damp, changeable atmosphere, insufficient clothing,  and epidemic miasma.
Occasionally it is caused by dentition,  the  suppression of eruptions on the
skin, inhalation  of noxious gases, &c.
  Croup may be determined from " spasm of the glottis,"  by  the  catarrhal
stage, which is only present in croup, by the  rough,  hissing breathing, the
hoarse voice, the cough, and the difficult inspiration and expiration, of croup.
In spasm of the glottis the voice is unaltered, there  is  no cough, and the
difficult breathing is not permanent, the inspiratory effort only being arrested,
and, for the time,  inspiration  is absolutely stopped.  There is high fever,
quick pulse, thirst, and no convulsions in croup, except in the  last stage; in
spasm of the glottis there  are no febrile symptoms, and there is a disposition
to general convulsions.
  It may be determined from " simple inflammation of the larynx," by the
difference in the sound of the cough, and by this latter affection having no
hissing, rough breathing, and no paroxysms of suffocation, as in croup.
  It may be determined from " hooping-cough" by the hurried  breathing,
not difficult or hissing, as in croup, no metallic sound to the cough, and the
complete relief during the intervals of coughing, without hoarseness or diffi-
cult breathing.
  Treatment.   Promptness and decision is always required in the treatment
of this disease, as if there be any delay or inattention, or should it be improp- 
CROUP.
261
erly  treated,  it may prove  fatal within twenty-four hours.  The first  or
catarrhal symptoms, must be treated according to the  plan named under
Catarrh.   In  the second stage it is always proper to commence the treatment
with an emetic; I invariably administer the Compound Tincture of Lobelia
for that purpose.—many others prefer the Compound Acotated  Tincture  of
Bloodroot. After free emesis has been produce 1., either of these Tinctures
must be administered in small doses  for the  purpose of  causing slight nau-
sea and easy  expectoration.  And, whenever there is  great obstruction and
difficulty in breathing,  with the other distressing symptoms peculiar to this
stage, the emetic should be repeated.
  As soon as possible  after the  operation of the emetic,  the throat, neck,
and chest must be bathed with the Compound  Liniment of Oil of Amber,
after which apply a fomentation as hot as can be  borne, composed of equal
parts of Hops and Lobelia, infused  in a mixture of equal parts of vinegar
and water.  These local measures should  be  repeated three or four times a
day, and continued until the disease  is removed, or until the patient has  so
far passed into the  collapse stage as to render any further use of them un-
profitable. The Compound  Tincture of Lobelia and  Capsicum may be sub-
stituted for the above liniment in cases where this cannot  be readily obtained.
In  some instances,  I have derived decided benefit from the application of a
warm  fomentation of Stramonium  leaves; if these  are used,  the patient
should be watched,  to  observe that  the depressive effects are not too exces-
sive.   I entertain no fears in relation to the employment of this herb in croup
—it has always been followed by favorable results in my hands.  Roasted
onions, roasted apples, cranberries, hot water,  &c,  have been advised as local
applications to the throat, and have  no doubt proved useful  in some cases.
So, likewise, has the plaster of Scotch Snuff, made by sprinkling the dry snuff
on a greased  linen, and applying it over the throat  and upper part of the
chest;  in my own  practice,  this has proved serviceable in several  instances.
In very young children,  a poultice of Hops  boiled in water,  on the surface
of which pounded  Garlics arc placed, will  be found an excellent application
to the  throat  and chest.
  Beside the  above, when the inflammatory symptoms run high, with  some
determination to the head, the whole  surface of  the body should be bathed
with a warm weak alkaline  solution, the feet should be bathed in the same
liquid  for some ten or twenty minutes,  after which Mustard  poultices may
be applied to the soles.   If the head continue hot, and the feet cool, the feet
and lower part of the legs may be enveloped  in a cloth moistened with a
strong solution of salt in water, and which may  be changed every hour.
  Much advantage will be derived from the frequent inhalation during the
day, and at night, of vapor  arising from vinegar in which hops have been
boiled; and the benefit  is no doubt owing to the fact that the  vapor exerts
a softening influence on the false membrane,  which is readily  soluble  in
Acetic Acid,—being changed into a diffluent and  transparent mucus.
  In obstinate cases, and  where there are  morbid accumulations in the
bowels, a cathartic may  be given soon after the operation of the emetic; but
in other instances, the cathartic may be delayed  until the following morning.
The Compound Powder  of Jalap will be found the best cathartic that can  be
given in this  disease; when this cannot be obtained,  Castor Oil may be sub-
stituted.
  During the day, when there is a remission of symptoms,  the Compound
Tincture of Lobelia may be given in  small expectorant doses, and  the Com-
pound Liniment of Oil  of Amber be applied frequently to  the throat and
chest.   But,  after the operation of a  mild cathartic,  I  have derived more 
262
AMERICAN  FAMILY PHYSICIAN.
benefit from a mixture of Belladonna and Sulphate of Quinia than any other
remedy;  it may be given in the following form :—Take of Sulphate of Quinia
ten grains, Tartaric Acid ten grains, water one fluidrachm; mix, dissolve the
Quinia, and add Tincture of Belladonna three fluidrachms.
  The dose is from three to seven drops  every hour or two, for a child four
years old;  it may be given  in some syrup, and should be omitted as soon as
the croupy paroxysms return.   The above liniment to be used in conjunction
with it.
  These  are the means to be employed during the  second  stage of croup
and great care must be taken to administer no more medicine than is actually
necessary.   If the  disease appears  to subside under the influence of the
emetic and local applications, nothing further will be required except careful
watching.  The child should be kept warmly clad, removed to a dry atmos-
phere, and placed upon a light diet, as,  toast-water,  barley-water,  and the
like;  and it should likewise be kept in nearly an upright position in bed, to
guard against suffocation.
  It is seldom that the stage of collapse will follow the above course of treat-
ment,  if it be promptly instituted from  the commencement of the attack.
Should this stage, however, take place, and  the patient be  rapidly sinking,
stimulants must be given, as wine, burnt brandy and ammonia,  and concen-
trated infusions of mutton or beef; the surface should be bathed with whisky,
salt and water; and injections of  a Saturated Tincture of Prickly Ash Ber-
ries in Ale or Porter should be given.  See page 181.  In this stage, active
medication is improper, perhaps the Scotch Snuff plaster will be found useful.
  The operation of tracheotomy has been advised, as a last resource, in those
cases  which threaten suffocation, and in a few cases it has proved successful.
If performed at all, it should not  be delayed too long; the commencement of
lividity in the face, or of a tendency to coma, are indications for the opera-
tion.   I  believe, however, that this operation will  very rarely be  required
among those cases in which the treatment just recommended, has been faith-
fully  pursued.
                            BRONCHITIS.

  Bronchitis, or Inflammation of the Windpipe or Bronchial Tubes,  is an
inflammation of the mucous membrane of the bronchial tubes;  it is  a  com-
mon disease of childhood,  and is by  no means rare among  adults.  It is
divided into two stages, the acute, and the chronic.
  Symptoms.   The acute form of bronchitis generally commences with the
symptoms of a  common cold, as chilly sensations, succeeded by fever, cough,
accelerated breathing, and rapid pulse, wdth  pain and soreness  at the upper
part of the sternum or breast-bone.   At  first  the  cough  is hard, dry, and
painful, but in from twenty-four to thirty-six  hours, an  expectoration of a
clear, tenacious mucus takes place,  which  gradually  becomes  opaque and
purulent.
  This expectoration is  frequently  very profuse, rendering  the breathing
laborious, especially in young infants, it being more difficult in the  recum-
bent than in the erect position, and is  attended with a  wheezing,  rattling
sound in the chest.  When there is  considerable obstruction to respiration,
the countenance becomes bluish, on account of the imperfect oxygenation  of
the blood; at other times the face is flushed, with an  expression of  anxiety
or distress.  There is apt to be pain in the forehead, which is  much aggra-
vated on coughing.  Shortly after expectoration has commenced, the severity 
BRONCHITIS.
263
of the cough is somewhat lessened, and in a week or ten days convalescence
ensues.  .
  In severe cases the  symptoms are  much  more intense;  the lever active,
pulse full and rapid,'skin hot and dry, breathing rapid, wheezing, and diffi-
cult, and great thirst,  cough more frequent  and painful, and occurring ih
paroxysms, bowels costive^ tongue loaded and the urine scanty and high-
colored.  Among children and  weakly persons, there is apt  to  be a great
depression  of the vital powers, sometimes almost amounting to collapse, and
the surface becomes cold and purplish from imperfect oxygenation of the
blood.   In these cases the  pulse is small and rapid, and if the disease is
about to terminate fatally, there will be drowsiness,  insensibility,  coma,  or
perhaps convulsions from suffocation.
  Acute bronchitis is very common  as a secondary affection in small-pox,
measles, scarlet-fever, hooping-cough, and infantile remittent fever; and is
frequently complicated with pneumonia.  Bronchitis often  arouses  a latent
tubercular disposition into activity, and tubercular consumption frequently
dates from its occurrence.
   The expectoration in the first stage is transparent and watery,  as the dis-
ease advances it becomes viscid, somewhat resembling the white of egg, and
in the last stage is frequently streaked with blood.   When the inflammation
is about terminating without suppuration, the  expectorated matter becomes
 opaque, yellow,  white, or greenish, and is attended  with a  great abatement
 of the symptoms.
   Causes.   Cold, or exposures to wet, sudden changes of  temperature, and
 ■he like, are  the most common causes, though  it may be occasioned by the
inhalation of irritating vapors or particles.  It is almost always present with
epidemic influenza.
   Treatment.   When the  disease occurs in a mild form in adults, all that
is necessary will be to bathe the feet for some fifteen or twenty minutes,  dry
them well, and afterwards keep them warm by a fire, or, if in bed, apply hot
irons, rocks,  or bottles of hot water to them; giving internally  some warm
lemonade for the purpose of producing a moderate degree of perspiration on
the surface of the body; the bowels should be gently opened by some mild
physic, as  Seidlitz powder, or Rhubarb and Magnesia, &c.   Sugar moistened
with lemon juice will be found very beneficial for the cough; it may be used
freely.
   In infants a different course  is required;  it is  generally safer to  give at
 first an emetic;  and afterwards an expectorant in some mucilaginous draught,
as infusion of Slippery Elm, or of Flaxseed, should be administered every
hour or two.   The Compound Tincture of  Lobelia will answer  for  infants,
as an emetic, and, in  smaller doses, as an expectorant.  The bowels^ should
be kept regular, the feet bathed in a warm alkaline solution, and considerable
warmth be applied to the body.
   When the disease is severe in its character, more active  measures are de-
manded.   An emetic should at once be given, and,  for an  adult,  the Com-
pound  Powder  of Lobelia,  or,  the Acetated  Tincture of Bloodroot,  will
answer.   This should be followed by a purgative, as, the Compound Powder
of Jalap, or,  a mixture  composed of Podophyllin half a grain,  Leptandrin
two grains.  And whenever the difficulty of breathing is considerable, with
a wheezing, rattling sound,  and high fever,  the  emetic  may  be repeated.
The room in which the  patient remains should  be kept so warm  that tho
surface of the  lungs  may  not be irritated  by respiring cold air; and the
inhalation of warm vapor of vinegar, or  of  the steam from a hot infusion of
bitter herbs, should be practiced several times a day; the most decided relief 
2tf4
AMERICAN  FAMILY PHYSICIAN.
is  frequently obtained from these  inhalations.   The  surface of the body
should be frequently bathed, and perspiration promoted by the administration
of the Compound Powder of Ipecacuanha and Opium, or,  still better, by
the Compound Tincture of Virginia Snakeroot.  In many instances a spirit
vapor bath  will be followed by happy results.  Mustard may likewise be
applied to the soles of the feet,  and a hot fomentation of Hops to the chest.
In some eases, especially among children, a warm bath  will be found useful.
  For the cough various remedies have been recommended; I have found
the following preparations more successful in my own practice:—
  1. Take of Honey, Olive Oil, Sweet Spirits of Nitre, and Lemon juice,
each,  equal parts ; mix.   The dose for an adult is a teaspoonful three or four
times a day, or whenever the cough is severe.   This may be given at any
stage  of the  disease.
  2. Take of Syrup of Squill, Syrup of Ipecacuanha, Syrup of Balsam Tolu,
Tincture of  Bloodroot, and Elixir Paregoric,  each, equal parts;  mix.   The
dose is the same as above.  This is best adapted  to the  second stage of the
disease.
  3. Take of Fluid Extract of  Stillingia one fluidrachm, Syrup of Balsam
Tolu, Syrup of Senega, each two fluidrachms ; mix.  Dose from ten to thirty
drops whenever the  cough is troublesome.
  4. After the  more active symptoms have subsided, much  benefit will be
received from  the following mixture:—Take of Gum  Arabic two ounces,
Vinegar half a pint, Molasses half a pint; boil these together until  the Gum
Arabic is dissolved,  then add to it Laudanum  two fluidounces, Tincture of
Balsam Tolu four fluidounces.   The dose is a teaspoonful three or four times
a day, or whenever the cough  is severe.   This is also useful  in chronic
bronchitis.
  When the secretion is profuse, and the  fever not very high,  astringents
may be administered, as, small doses  of Tannic Acid and Ipecacuanha; or,
G-eraniin and  ipecacuanha, or,  Alum.  The following has  been recom-
mended :—-Take of Alum forty-eight  grains,  water  two fluidounces; mix,
dissolve the  Alum, and add to the solution three  fluidounces of  Compound
Syrup of Spikenard.   The dose  for an adult is a table-spoonful, three or four
times a day.  Or, in place of this,  the Alum mixture mentioned in Inflam-
mation of the Larynx, page 255, may be used.
  During the  disease, the diet must be confined to barley-water,  rice-water,
toast-water,  apple-water, &c.  Children should wear flannel,  and some  care
should be taken  that the feet  be kept dry.   Frequently toasting the feet
before a fire, will be found very advantageous in  this affection,  among adults
as well as children.
                     CHRONIC  BRONCHITIS.
  Symptoms.  Chronic Bronchitis is attended with very little if any fever,
the cough is more or less troublesome during cold and changeable weather,
but is absent during pleasant, warm seasons, and the disease may continue
thus for even a lifetime, without  causing  any serious  consequences.  But
frequently it is more  serious in  its character;  the cough  is very trouble-
some with more or  less  expectoration, and is apt to be more distressing at
night, and in the morning, particularly if the feet, damp with perspiration,
are placed in contact with a ejold floor, cold sheets, &c.   The cough is very
apt to occur in violent paroxysms, and is always worse in changeable seasons,
or when irritating vapors, or floating particles of matter are Inhaled;  upon 
CBW.ONiC blvONCHrTIS.
265
the expectoration of mucus, the fit of coughing becomes somewhat relieved.
Sometimes  slight  transient pains are  experienced in the chesty and fre-
quently, after a severe paroxysm of  cough,  a general aching  pain will be
felt for a few seconds in the breast.   The  expectoration at first, a  whitish,
viscid  frothy matter, becomes  thick,  and  of a muco-punform character,
and is' occasionally streaked with blood.   The skin will be found  dry and
harsh, the urine high-colored, the tongue coated, especially in the morning,
the appetite more or less impaired, and the bowels irregular in their action.
As the  disease  advances,  the  pulse becomes quick,  weak and  small, tho
breathing short, more hurried and oppressed, with emaciation, night sweats
pale  face, hollowness of the eyes, great debility, colliquative diarrhea, sore
nose, purplishness of the lips, and the expectoration becomes more  copious,
as well as purulent, and sometimes quite fetid.  This form  may continue
from  one to several  months, and then prove fatal.-  It presents many of the
characteristics  of tubercular consumption,  from which  it is  difficult  to
detect it, except by auscultation and percussion.
   Causes.  Chronic Bronchitis may occur as the sequence  of the  acute
form, or it may result from measles,  and  other exanthematous diseases,
hooping-cough, protracted biliary affections, repeated changes from heat to
cold, or from constant  exposure to irritating powders, as  among stone cut-
ters,  millers, workers in metals, &c.
   Tkkatment.   Emetics  are a very valuable class of agents in this disease,
and  they may be  repeated once in every week, and continued until  the
disease is  removed.  The Compound Powder  of Lobelia is  the emetic
which I prefer  using in this affection.  Active purgation is  by no means
required;  indeed, I consider it injurious in the chronic form of bronchitis ;
but the bowels  should  be  kept regular, daily, by some mild .laxative, and
the following will be found the  best:—Take of Powdered  Rhubarb one
ounce, Bicarbonate  of  Potash half an ounce; mix well together.  The dose
is from five to ten grains  three times a day, in a  table-spoonful of water,
or sufficient to  procure one daily evacuation from  the bowels.  In some
cases, the following may be administered  every night, for the purpose of
regulating the  bowels:  Take of Podophyllin one fourth of a grain,  Lep-
tandrin  one or ttvo grains, loaf sugar five grains; mix, and  triturate well
together for a dose.
   Diuretics are always useful, and those of a stimulating or balsamic char-
acter are  to be  preferred, as Canada Balsam,  Balsam  Copaiva,  Cubebs,
Queen of the Meadow  root, Horseradish root, Uva Ursi, &c.
   The skin must by no  means  be neglected ; the  whole surface of the
body should be bathed every  day or  two,  with weak ley water; the best
time being previous to retiring for the night.  And if a Spirit vapor  bath
be taken once in  every week or two, according to the patient's strength, it
will  tend much to facilitate the cure.  And, after  the  patient has become
stronger, and the circulation of the capillaries  more vigorous, the throat,
neck, and  chest  may  be  sponged daily  with cold water.  To relieve the
cough, various  agents have been successfully employed, as the cough prep-
arations named in the  acute form of bronchitis, or some of the  following:
   1.  Take of Inspissated juice of Poison Hemlock four grains  Ipecac-
uanha one grain,  Sulphate of Morphia one-fourth of a grain ;  mix together,
and  divide into two pills, one of which  may be taken when  the cough  is
severe, and if necessary, repeated in half an hour, or an hour.
   2.  Take  of  Extract of  Hyoscyamus,  Ipecacuanha,  Canada  Balsam,
Muriate of Ammouia,  each, one ounce; mix together,  and  divide into
pills of four grains  each j  the dose is one pill every  two or three hours. 
266
AMERICAN FAMILY PHYSICIAN.
  3. Take of Fluid Extract of Stillingia one fluidounce, Compound Syrup
of Spikenard  two  fluidounces, Iodide of  Potassium  one drachm; mix
together.   The dose is a teaspoonful three times a day.
  4. A very excellent  preparation for  chronic  bronchitis,  ift  made  of
Extract of Hyoscyamus, Alcoholic Extract of Black  Cohosh,  Iodide  of
Potassium, each, one drachm, Sulphate of Quinia  half  a  drachm; mix
thoroughly together,  and divide  into  pills  of foui grains each,  of which
one may be given every two or three hours.
  Diarrhea is best  combated  by the Tincture  of Chloride of Iron,  of
which  twenty drops  may  be given in a wineglassfil  of  some astringent
infusion, and repeated three or four times a  day.
  This Tincture also  forms a very excellent chalybeate for those cases  in
which  the blood requires to be  improved.  When much debility is present,
or when the digestive process is torpid, much  beneiit will be derived from
the moderate use of English Porter,  and Scotch  Ale,  or Brown  Stout  to
be taken at meal time.
 ,.When the expectoration is too copious, astringent i may be used in con-
junction with the other agents, as, Alum, Ceraniin, Tannic Acid, &c; a
very excellent  preparation is  composed of two  parts of Geraniin, and
Hydrastin, with  four of  Alum, of which  from four to  six grains may be
administered for a dose, in some honey, and repeated  every three or four
hours.
  The  patient should exercise in the open air during pleasant weather, and
the use of  flannel will be found advantageous in  maintaining  an equable
degree  of temperature of the surface of the body, and on retiring at night
much relief and benefit  will be derived by  drying and toasting  the feet
before  a fire, more especially in  cold  weather.   The  sleeping apartment
should  be largej  not occupied by more than  one other  person,—should be
well ventilated, and properly aired every day.  The diet should be nutri-
tious, and easily digestible, avoiding acids and greasy food; and the meals
should be regular.   In very severe and obstinate cases, it will be  advisable
for the patient to remove to a warm climate.
                   CATARRH  or  INFLUENZA.
  These are also,  when  very mild  in  their character,  termed "colds."
When the seasons  are changeable, aii persons are liable to contract colds,
no matter what  climate they may inhabit, especially when they neglect
the precautions  necessary to  observe  in sudden  and  variable changes
of the condition and  temperature of the atmosphere.  More persons are
destroyed by colds,  than by any other cause; and should a cold  not termi-
nate in some febrile or inflammatory disease, it  becomes  dangerous from
repetition, gathering strength to destroy from neglect and delay.  A simple
cold is not always dangerous  in itself, hence most people  are indifferent to
it, but this is wrong, for a cold is one of the worst enemies of the human
race, and should be avoided as much as possible.
  The mucous membrane, which commences  in  the  mouth and nostrils,
extends  over the fauces, to the pharynx, esophagus, larynx, and windpipe,
terminating  in the air-cells of the lungs.  When certain  portions  of this
membrane are inflamed, we may have acute laryngitis, or  acute bronchitis,
&c, independent of disease of any other part, but  in catarrh or influenza,
this whole  membrane may be involved.  Generally,  however,  a  cold or
catarrh  is considered to  be  that affection of the mucous membrane, in 
CATARRH.
267
which  the  inflammation  does not extend beyond the larger  subdivisions
of the bronchia.
  Symptoms.   A cold or catarrh  usually comes  on with a dull  pain and
sense of weight in the forehead, oppression at the chest, and some  diffi-
culty in breathing ;  the eyes become more or less red and watery, there is
a sense of fullness and  heat in  the nostrils,  soreness of the throat, dry
cough, hoarseness, frequent sneezing, and general lassitude.   In a short
time a thin, acrid fluid  is discharged from the nose, the cough becomes
more moist, the expectoration being at first thin, white, and of difficult
ejection, but soon  becomes  free, yellow, and thicker, with  considerable
mitigation  of  the cough.  The patient is almost always worse at night,
with increased fever, accelerated pulse, more  severe pains in various parts,
and more or less restlessness.  Accompanying  the disease there is always
more or less aching in  the  limbs and body, thirst,  loss of appetite and
flushes  of  heat, alternating  with chilliness, especially when the  patient
is in an atmosphere somewhat colder  than usual.   Sneezing  and a sense of
chilliness are often the first symptoms of an attack.
  When the inflammation is confined to the mucous membrane of the nos-
trils, there is sneezing, a fullness and heat of the parts, with a thin, mucous
discharge; when it extends to the lining membrane of the frontal sinus, it
produces a sense of weight and  pain in the  forehead; when it spreads to
the fauces  and  to the ears,  it  occasions more or less deafness;  when to the
larynx, or  upper part of the windpipe, cough, hoarseness, and  tightness, or
pain at the upper part of the chest are present.
  When catarrh prevails epidemically, it is termed influenza, during which
the symptoms are much more severe than in ordinary catarrh, and  the dis-
ease has heretofore proved  more fatal in its results.
  Ordinary catarrh occurring in aged  persons, those of delicate  constitu-
tions, or those disposed to consumption, is very apt to terminate fatally,  by
giving rise to chronic bronchitis or tubercular consumption, and the  same
may be said of epidemic  influenza.   Similar results  will follow repeated
attacks of cold, or its improper treatment.   Sometimes, asthma, or dropsy
of the chest, follow as  a  sequence  of catarrh.   Infants  laboring under
catarrh, are said to have the " snuffles."
  Causes.   Sudden changes or exposures from a dry and warm, to a damp
and cool atmosphere, or  exposures to cold, damp, &c,  especially when the
body is heated  and perspiring, are among the most common  causes.   Long
standing on a cold ground, sitting when heated or fatigued in  a cool place,
imprudently diminishing  the amount of dress, sleeping between  damp sheets,
want of proper clothing, and whatever will  tend to  check perspiration or
chill the body will give rise to catarrh.  When a  person has  once labored
under  a severe attack of the catarrh,  the  system  in  many instances,
becomes more  liable to subsequent  attacks, even  upon  the most  trifling
changes of temperature,  or exposure.  But  it must be recollected  that,
although those  laboring  under chronic laryngitis, or chronic bronchitis,
are morbidly susceptible to atmospheric changes, yet it does not necessarily
follow that the  presence of lassitude, increased  cough,  &c,  during such
changes, are always owing to a fresh  attack of cold.
  Treatment.   When  the attack is mild, but  little medicine  will  be
required.   In general,  it will be  sufficient to bathe the feet at night, in a
warm weak alkaline solution, and confine the patient  to bed, or during the
day in a warm chamber,  allowing him to  drink freely of warm mucilagi-
nous fluids, as barley-water, thin gruel, &c, which may be  acidulated with
lemou-juice, or, he  may  drink freely of warm  lemonade.   No physic will 
268
AMERICAN FAMILY PHYSICIAN.
be required unless there has been  either previous constipation, or an aceu-
mulation of morbid matters in  the  alimentary canal, when  a dose of the
Compound Powder of Jalap  may be  administered.   In  ordinary cases of
cold, most persons are in the  habit of bathing and drying the feet well at
bedtime, then  drinking a good draught of some  hot spirits and water,
which produces perspiration during  the  night,  followed by great relief in
the morning.   This is a pleasant  curative mode, but  the danger  lies in an
improper exposure the next  day, which the  patient is apt  to  hazard on
account of his improved condition.
  Among infants, keeping the bowels  regular, the body warm, and admin-
istering  some  warm  diaphoretic  drinks, will  be  all-sufficient,   with the
exception of greasing the nose and  forehead externally with  tallow  or
goose oil, which,  notwithstanding the light  in which physicians view it,
will be found very useful, or, in its stead, fomentations of warm water may
be applied.
  When the attack is severe,  perspiration should be promoted Jjy means of
the Spirit vapor bath, which will frequently remove  it without any further
treatment; the patient  keeping up perspiration for  a few hours while in
bed.  If this does not answer, an active purgative may be given, and during
its operation, great care should be taken  not to allow  the patient  to become
chilled.  Should  the larynx,  trachea,  or bronchial vessels  become impli-
cated in the attack, they must be treated as  heretofore recommended under
their particular heads.
  When it is not convenient  to  administer the Spirit vapor bath, the Com-
pound Tincture of Virginia Snakeroot may be given every hour  or two, in
doses to  cause perspiration, and which may be  assisted by drinking freelj
of warm diaphoretic infusions.   For the cough, the  agents named undei
bronchitis  maybe used with  advantage; and to  relieve  irritation of the
throat, it may be frequently gargled with a  mixture  of vinegar and water,
equal parts, to which a little  salt  is  added.  Inhalation of warm vapor is
always useful when the inflammation extends into any part of the  windpipe.
A very common,  and at the same  time a very  efficacious domestic prepara-
tion for the cough attending  catarrh,  is  composed  of honey or  molasses,
and vinegar, heated together, and  some fresh butter melted in the mixture;
of this, a teaspoonful or two may be taken for a dose, and repeated as occa-
sion may require.
   When the attack is severe  among infants, I consider it  better  to admin-
ister the Compound Tincture of  Lobelia, to  produce free  vomiting, after
which  the treatment may be similar to the above, keeping the infant warm,
and in some  cases repeating  the  emetic  in twenty-four  hours.   Both  in
adults and children, the Compound Tincture of Golden Seal, either diluted
with water or not, according to its severity of action, may be applied to the
lining membrane of the nostrils, by  means of a  camel's  hair pencil, and
repeated several  times a day; it  will exert a very favorable influence on
the parts.
   Among infants there is  danger of asphyxia, from the obstruction in the
nostrils, especially while they are sucking,  and unable to breathe through
the mouth.   In such cases the passages should be kept as open and free as
possible, and sometimes it will be well to feed them  with a spoon, keeping
them away from the breast for a few days.  The following is said to be use-
ful for adults in freeing the  nostrils from the sense  of obstruction experi-
enced  in catarrh:  Take of Powdered Cubebs two drachms, Balsam Tolu
six grains; mix well  together,  and add Powdered  Extract of  Liquorice
one ounce, Syrup of Balsam Peru one fluidrachm, Powdered Gum Arabic 
CHRONIC CATARRH.
269
a sufficient quantity; mix  all thoroughly together, and  divide  into loz-
enges of ten grains each.  One is to be placed in  the mouth and allowed
to dissolve gradually ; repeating the dose as required.
  Sometimes in severe attacks of catarrh and  influenza, much benefit will
be derived from keeping the patient slightly nauseated  all the time during
the severe symptoms, in  conjunction with the other treatment; and should
Bymptoms of pleurisy, pneumonia, or other pulmonary affection, present
themselves, they should  be treated according to the directions given under
the head of the particular disease developed.  In epidemic influenza, after
the more  active  symptoms have  subsided, Sulphate of Quinia should  be
administered in some form, so  that at least three  or four  grains of it may
be taken daily; and this will be more especially necessary in  case of much
debility.
  The diet should  be very light, using liquids  principally, as gruel, weak
broths, &c.  The patient should  keep warm,  and rather  quiet; and after
convalescence, he should be cautious not to expose  himself too quickly to
the external air. Should a cough remain after all the inflammatory symp-
toms have disappeared, the Cough Mixtures, Nos. 1,  2, 3, or 4, named under
Bronchitis may be used, or the following:  Take of Oil  of  Anise, Oil of
Almonds, Canada  Balsam,  Tincture  of  Balsam Tolu,  Sherry Wine, each,
half  a fluidrachm ;  mix  together.  The dose is half a teaspoonful, three or
four  times a day.
         CHRONIC  CATARRH,  or  CHRONIC  CORYZA.

   Acute Catarrh, from improper treatment, or from a series of attacks,
 is apt to degenerate into a chronic condition, which is commonly known as
 " catarrh," or "catarrh in  the head," and which is by no means an uncom-
 mon disease in this country.  The disease  may continue for years, causing
 pain in the eyes, drowsiness,  cough, and emaciation.  It may also follow as
 a sequence of other diseases, as  scarlet fever, measles, &c; and when the
 discharge is of a purulent character, it is most generally owing to syphilitic
 ulceration of the parts affected.
   Symptoms.  There is a discharge of mucus from the nostrils, varying in
 quantity, which irritates the nose, occasioning sneezing, or, by falling into
 the throat and windpipe, it gives rise to more or less severe cough, which,
 if neglected, may terminate in consumption.  Sometimes this discharge is
 so profuse, as almost to suffocate  the patient, and  not unfrequently the eyes
 become very sensitive and tender, and deafness may be present.  The breath
 is apt to be offensive, and sometimes even the discharge.
   Treatment.  Frequently this affection will gradually disappear without
 any treatment; sometimes it will require medication ; and  in a few cases it
 becomes obstinate, debilitating the system very much, and requiring great
 care in  the  treatment.  Ordinarily, an  attention to  diet,  regularity  of
 the bowels, moderate exercise daily, an avoidance  of exposures to sudden
 changes of heat, cold, and dampness, together with the use of one of the
 following snuffs, will effect a cure:
   1. Take of Bloodroot, Bayberry bark, each, in fine powder,  one ounce,
 Powdered Myrrh, half an ounce; mix well together, and use several times
 a day as a snuff.
  2. Take  of Bloodroot,  Lobelia, Bayberry, each,  in fine powder, one
ounce, Sesquicarbonate  of Potash, half an  ounce; mix together, and use
as a snuff. 
270
AMERICAN FAMILY  PHYSICIAN.
  3. Take of Powdered Camphor half a drachm,  Benzoic Acid ten grains
Powdered Opium three grains, Red Peruvian bark two drachms; mix thor-
oughly together, and scent with Oil of Bergamot, and use  as a snuff;  the
above is  sufficient to last five or six days.
  In very obstinate cases it will be proper to apply the following Tincture
to the nasal membrane as  far as can be reached  by means of a  sponge
probang  or camel's  hair pencil:  Take  of Cubebs, Golden Seal,  Lobelia,
Bloodroot,  of each, one ounce, Capsicum two drachms,  diluted Alcohol
three pints; mix together,  and let the articles stand  for several days, fre-
quently shaking them.  In addition  to this,  the warm vapor of Vinegar,
or of Vinegar  in which Hops, or  Stramonium  leaves have been boiled,
should be inhaled through the nostrils, keeping the mouth closed,  and
repeating the inhalation several times a day.
  In cases  of scrofulous habits, or where  the disease is of syphilitic origin,
the  internal treatment recommended for either scrofula or syphilis, must be
pursued in  addition to  the above.
               INFLAMMATION  OF  THE  LUNGS.

   Inflammation of the Lungg, or Pneumonia, are the terms applied to
 an inflammation  of the  substance of the  lungs;  it is  a disease to which
 adults are liable, and is by no means uncommon among children.  In some
 places it is  termed " lung  fever."  It is  very apt to be  complicated with
 pleurisy.
   Symptoms.  Pneumonia is usually ushered in by a chill, or sensation of
 coldness, followed by febrile symptoms  more  or  less  marked; in a  short
 time a dull  and obtuse pain  in the chest is experienced, which is not so
 severe in  its character as the pain in  pleurisy, and which is considerably
 increased on  coughing,  or making  a full  inspiration.  The breathing is
 hurried and difficult, especially when lying  on the   affected side; a dry,
 painful cough is present from  the beginning, but  sometimes it is moist,
 and the  expectoration varies both in  color  and consistence, being white,
 transparent and tenacious, semi-transparent or rust-colored, and frequently
 it is streaked with blood, which, however, is not an alarming symptom; the
 skin is dry  with  heat of the body, thirst, anxiety, and  flushed  face, which
 is sometimes swollen and of a  purplish hue.   At the   commencement, the
 pulse is usually full, strong, hard and frequent, but as the disease progresses,
 it becomes  weak,  soft,  and  often irregular.   The  bowels are frequently
 (o.stive in the commencement, but are apt to become liable to diarrhea; the
 urine is scanty and  high-colored,  and  often is of  a  yellowish-brown color,
 The tongue is  generally dry, and thickly coated with a white substance,
•and when the disease is connected with some derangement of the liver, the
 coat will  be of a yellow, or  yellowish-brown hue.   If  timely relief be not
 obtained,  there  will be considerable danger from  the severity of the
 inflammation ; the veins of the neck will enlarge, the  face  assume  a livid
 aspect, and if the blood be effused into the substance of the lungs, it will
 cause a fatal termination.
   Pneumonia is often associated  with pleurisy,  and also with bronchitis,
 which complications may render the  true character  of  the disease very ob-
 scure ; these are very common  complications  among children.  The treat-
 ment, however, will  be nearly the same.  The bronchial  complication in chil-
 dren may be suspected by observing  a short, difficult, wheezing respiration;
 by the restlessness they  manifest  when lying down ; by a cough of a bron- 
INFLAMMATION  OF THE  LUNGS.                271
 chial character; by the paleness of the countenance and the anxiety depicted
 upon- it; by the hard, frequent pulse;  pungent  heat  of the skin,  with the
 exception of the feet  and hands which  are cool.   The respiration may  at
 times be free, and then suffocative,  and as the disease progresses, the lips
 become purple, coma ensues, and in from three to six days the child dies.
   Causes.   Pneumonia is most commonly caused by exposure to cold and
 moisture, or to sudden atmospheric changes.  It  may likewise be produced
 by severe exertion of the lungs, as singing, loud speaking, or playing on
 wind instruments, and may  likewise  arise from the inhalation  of irritating
 particles or gases, repelled eruptions, suppressed evacuations,  &c.  It occurs
 most frequently during the  spring and winter, and ocr asionally during the
 other seasons when very cold and danrp, or variable.   In  the complications
 with other  diseases, and even when uncomplicated,  the physician should
 always examine the chest by auscultation and percussion
   Prognosis.  One of the earliest symptoms of the decline of the disease is
 a free evacuation of urine, depositing a copious sediment on  cooling; some-
 times a  diarrhea,  bleeding from  the  nose, or an abundant perspiration,
 are the indications of  its decline by resolution; more frequently, however, a
 slightly bloody,  whitish, or yellowish  expectoration,  freely  and profusely
 discharged, is a manifestation of an abatoment of the disease.  When the
 febrile symptoms subside, the pain in  the chest  diminishing, the expectora-
 tion becoming free and copious, and especially, when with these the difficulty
 of breathing is materially lessened, a favorable termination may be expected.
 On the contrary,  delirium  is a very unfavorable symptom, especially when
 accompanying a high degree of fever, great difficulty of breathing, dry cough,
 and acute pain.   Sometimes the  inflammation termiiates  in suppuration, in
 which an abscess  forms on the affected lung, and the matter may  be expecto-
 rated ; or, the abscess  may open into the pleura,  occasioning pleurisy,  and
 causing sudden death.   When an  abscess  has  formed it may be known by
 an  abatement of the pain and sense of fulness of the part, by frequent, slight
 shiverings, and by the  patient being able  to lie on  the affected side  without
 much uneasiness.   The  formation of an abscess is not always necessarily
 fatal, but it is more dangerous among  strumous persons.   Short, dry,  and
 obstinate cough, short and difficult breathing, an ability to lie only on the
 affected side, pale countenance, turbid urine, flush of cheeks toward evening,
 emaciation, night sweats, and diarrhea,  are the usual symptoms accompany-
 ing an abscess.  The prognosis of inflammation of  the lungs  is always unfa-
 vorable when both lungs are affected.
  Death usually  takes place in pneumonia from suffocation, occasioned by
 blood being effused into the  cellular substance of the lungs,  and which may
 occur at any time from the third  to the ninth day.  It may also terminate in
 suppuration or gangrene.   Gangrene  rarely occurs, and is indicated by  a
 sudden  discontinuance of  all pain, a  pale or purplish countenance, a very
 weak and intermittent pulse, cold, clammy perspiration, dark-colored, offen-
 sive expectoration, fetid breath, hiccups, stupor, and death.   Sometimes in-
 flammation of the lungs terminates in hepatization, in which  the air cells of
 the lungs are obliterated, and converted into a solid, flesh-like mass; some-
 times in dropsy, aud not unfrequently, adhesions form between the pleura
 or membrane covering  the lungs, and  that lining  the cavity of the chest.
 Persons once attacked by the disease, are more liable to returns of it, on being
 exposed to its causes.
  Treatment.  In all cases of inflammation of the lungs, an emetic admin-
istered at the commencement will be found  very useful to remove accumula-
tions in the stomach, unload the air-passages, promote  the  secretions gener- 
272
AMERICAN  FAMILY  PHYSICIAN.
ally, and equalize the circulation.   The Compound Powder of Lobelia may
be administered to an adult, for this purpose, and the Compound Tincture of
Lobelia to a child.   In severe and obstinate cases, a repetition of the emetic
in the first days of the disease may become necessary.   After the operation
of the emetic, free perspiration must be produced, which may  be best accom-
plished in the  adult,  when circumstances will permit, by the Spirit  vapor
bath—In children by  the Compound Tincture  of Virginia  Snakeroot—in
both,  aiding the perspiration by the administration of warm infusion of Pleu-
risy root, or of Balm.  Infants, however, and very  young  children must he
placed in a warm bath  for several minutes,  then have a fomentation of  bittei
herbs, as Hops, Tansy,  Wormwood, &c, applied over the chest  as warm as can
be borne, and changed often; and Mustard draughts, or draughts of bruised
Garlics, may  be applied to the feet and ankles.   The application of bruised
Onions or Garlics to the chest and back of infants and children, even  when
nine and ten  years of age, will be found very advantageous, not only in thia
disease, but in many other pulmonary  affections.   I almost  invariably use
them, and find that their efficacy much more than counterbalances their dis-
agreeableness.   I have seen many obstinate and serious attacks  terminate
favorably by the continued use of these applications.
  As  more or less derangement of the liver  is  commonly present in thia
affection, it will be necessary to administer a purgative  that will exert some
influence on this organ; one grain of Podophyllin mixed with two grains of
Leptandrin, may be administered every three or four hours until a free  evac-
uation is produced.  The  purgative may be given during the  time perspira-
tion is being  effected, so that its action may take place as the  copiousness of
the sweat diminishes, and  care should be taken when the bowels are moving
not to expose the patient to cold.   In  many cases an infusion of the root of
Leptandra exhibited daily, according to the plan recommended in the treat-
men of  Typhus fever, will prove very useful.
  If the pain still continues to any extent,  fomentation of bitter herbs  must
be placed over the chest as hot as can be borne, and these should be changed
or renewed every hour  or two.   Inhaling the vapor of a hot infusion of hitter
herbs, repeated several times a day, will afford much relief to  the  pain and
cough; and mucilaginous drinks, as infusion of Marshmallow root, Elm  bark,
Flaxseed, &c, frequently repeated, during the active inflammatory stage, will
be found to render the cough  less troublesome.   Bathing the  surface of the
body  and extremities frequently with a warm,  weak, alkaline  solution,  must
never be omitted in these  cases, especially when the inflammatory symptoms
run high; and Mustard may also be applied to the feet and on  the back along
the whole course of the spinal column, being careful however,  not to allow it
to vesicate or raise a blister.
  In  cases where the inflammatory symptoms were very severe, I have given
the following mixture with invariable success:—Take of Tincture of Gelsemi-
num four fluidrachms,  Tincture of Aconite twenty-four drops ; mix; the dose
ir, thirty drops every half-hour or hour, until the peculiar effects of the Gel-
seminum are  produced.  It allays the cough, pain, and intensity of the act-
ive symptoms, affording great relief to the patient.   In those instances where
periodicity is present, great care must be taken to observe the time of the
remissions, that antiperiodics may be exhibited; two or three  grains  of Sul-
phate of Quinia may be given every hour during  the remission, and which
will frequently relieve all the severer symptoms  of the disease with prompt-
ness.
  After the  more  active  symptoms  have somewhat subsided, it will become
proper to exhibit expectorants, to relieve the cough, difficulty and oppression 
                          rATHOID PNEUMONIA.                    273

 l»f breathing, and facilitate the raising of mucus.   The c-i.mpound Tincture
 of Lobelia will be found a very elegant preparation  for  this purpose.   Or,
 the  Compound Acetated Tincture of Bloodroot may be used.   A mixture of
 equal parts of Syrup of  Senega, Syrup of Squills, and Tincture of  Lobelia,
 exhibited  in  teaspoonful doses every hour or two, will also be found an ex-
 cellent expectorant.  A  powder composed  of Capsicum, Ipecacuanha, each,
 one grain, powdered Opium half a grain, and a dose administered every three
 or four hours, mixed with Honey, will frequently afford  permanent  relief to
 the  cough.
   As the inflammation declines, if the pulse becomes weak with great debil
 ity of the patient, tonics and even stimulants will be required.   Sulphate of
 Quinia. or decoction of Virginia Snakeroot may be given, and, if necessary,
 aie,  porter, wine, or even brandy;  wine whey, with from one to three grains of
 Carbonate of Ammonia added to each draught, will prove a valuable stimulant.
   ^.;o diet should be light  and  cooling,  as barley  water, mucilage  of  elm,
 lemonade, orange-juice, Indian meal gruel, roasted apples, arrowroot, panada,
 &c.   The patient should be kept  as still as possible during the  disease, and
 not  be permitted to speak more than is necessary, in  order to make known
 his  feelings  and wants; and the sick chamber should be kept  at a proper
 temperature, from 54° to 00° Fahrenheit.    Great care should be taken du-
 ring convalescence to prevent a relapse, which  is very apt to occur on very
 slight causes, and  may  lead to tubercular  consumption.  If during conva-
 lescence, or afterwards, a troublesome cough remains, one of the cough prep-
 arations mentioned under Bronchitis may be given ; or, the Compound Syrup
 of Spikenard ; or, either of the following compounds:—1.  To one gallon of
 good Cider Vinegar, add half a pound,  each, of Balsam Tolu and Gum Ara-
 bic ; dissolve  these by means  of heat, and  add Refined  Sugar, six  pounds.
 When all  is dissolved, remove from  the fire  and add Laudanum, eighteen
 fluidounces.  Sometimes Molasses, or Honey, may be beneficially substituted
 for the Suga.'   The dose ;s a teaspoonful, three, four, or five  times a day, or
 whenever the cou&I; >'s severe.   2. Take Comfrey root, Spikenard root, Ele-
 campane root, and Hoarhound, of each, one ounce; boil in '!>x pints  of water
 to four jif^ts, strain, then add four pounds of Loaf Sugar, and boil slowly to
 four pints. . Th? dose for an adult is a wineglassful three  or four times a day.
   In cases of  abscess, the life of  the patient has frequency been saved,  by
 making an opening between the ribs into the abscess, and allowing the mat-
 ter to discharge; this however is seldom  accomplished when  the abscess is
 deep-seated in the substance of the lungs.
   In recent cases of hepatization of  the lungs, I have sometimes found con-
siderable benefit from the following mixture:—Take of Muriate of  Ammo-
nia sixty-four grains, Fluid  Extract  of Wild Cherry four fluidounces; dis-
solve the Ammonia in the liquid.  The dose for an adult is from half a table-
spoonful to a table-spoonful, three or four times a day, at the same time using
external irritation, if necessary.
                     TYPHOID  PNEUMONIA.

  This disease has been called by various names, as pneumonia notha, cold
plague, winter fever,  and congestive winter  fever; it appears to-be a combi-
nation of pneumonia with typhus symptoms.   It is very common to some
sections of count -y, and proves more fatal among the weak, aged, and those
who have broken clown their constitutions by excesses.
  Symptoms.  The symptoms of typhoid pneumonia are similar to those of 
274
AMERICAN FAMILY  PHYSICIAN.
pneumonia, with the exception of the additional typhus condition present.
The inflammation, however,  is  of a less  acute  character  than in pneu-
monia.   The disease generally commences as a catarrhal affection with great
weariness,  apathy, dizziness, and pain of the head and back, but without
any great degree of fever.  As the  disease advances there is much difficulty
of breathing, with wheezing  or rattling in  the chest, together with a sense
of tightness or constriction across  the breast; an acute pain in the side is
very frequently experienced, with  cough.  The  cough  is short, dry, and
distressing, being,  however, attended  at times  with an expectoration of
mucus, clear or streaked with blood; occasionally, no cough is present. When
the cough  is very violent, it  not only increases the pain in the chest, but
causes severe headache, and  sometimes vomiting.  Pains are  at times ex-
perienced in the limbs.  As the disease continues  to  progress, the more
active symptoms disappear, a  dull pain  is experienced across the chest,
which is seldom complained of, unless the patient is questioned concerning
it, the difficulty of breathing is increased, more or less drowsiness or stupor
comes on, together with some of the symptoms common to  typhus fever in
the prostrating stage.  The skin  becomes harsh and  dry, with an  uneven-
ness of temperature; in most cases,  the tip and edges of the tongue will pre-
sent a very red  appearance, while the upper surface of  this organ  will fre-
quently be thickly coated with a yellow or  brownish  fur;  the bowels will
be tender, and rather disposed to swelling and tension, feeling like  a drum;
and diarrhea is very common, the  discharges being  of a  dirty-yellowish
color, and often containing flakes of mucus.
  Causes.   The disease is supposed  to be epidemic at times, or caused bj
malarial  influence, and is usually connected  with a cold,  damp, and change-
ble condition of the atmosphere.     It is more prevalent during winter and
spring, than the other seasons.
  Prognosis.   When  the difficulty of breathing is  less difficult  and op-
pressed, the expectoration  more free and copious, and  the  pulse becomea
more natural, the disease will  be apt to terminate favorably.  When the
breathing becomes hurried and laborious, the expectoration scanty and not
freely discharged, with great  prostration,  the case is almost hopeless. De-
lirium is a  very unfavorable symptom.
  Treatment.   This will  be similar to that named for pneumonia, while
the symptoms of inflammation  are  present;  and  similar to that for typhus
fever, when the symptoms of oppression and  exhaustion manifest themselves,
A mild emetic in the early stage of the attack, when the breathing  is much
oppressed,  and  the expectoration scanty, will be of service, and may be re-
peated if the symptoms require it.   Active cathartics must be avoided, yet
the bowels should  be  gently evacuated daily, during the whole course of
the disease, for which  purpose an infusion  of Leptandra may be given, as
directed  under  typhus fever;  or, Podophyllin one grain, Leptandrin eight
grains, may be  thoroughly mixed, and divided into four powders, of which
one .may be given for a dose, and  repeated  two or three times every day,
according to its action.   As there will frequently be remissions, or  periodic
symptoms  present,  the Sulphate  of Quinia, or the Valerianate of Quinia,
may be given in grain doses every hour of two, during the remissions.  Id
other respects,  the surface of the body, cough, &c, will require a treatment
similar to that  recommended  in pneumonia.
  Great care should be taken to avoid all harsh and  active depletory mea-
sures when the symptoms of  debility come on.   Mustard  should be ap-
plied to  the extremities, chest,  and between the shoulders;  ale, porter,
wine, or  even brandy, will  be required according  to the degree of  prostra- 
PLEURISY.
275
tion, and the susceptibility of the system.   Injections of the  Tincture of
Prickly-Ash berries must by no means be omitted, not merely to lessen the
tendency to  tympanitic distension of the abdomen, but also as a stimulant
to arouse and preserve the action of the vital powers.  Carbonate of Am-
monia five or ten  grains to a fluidounce  of water, or other liquid, has also
been recommended  as a stimulant, to be occasionally administered in tea-
spoonful doses.   With  the use of stimulants do not neglect  nutrition, as
mutton  or beef tea, calves' foot jelly, &c, which should be exhibited as the
stomach will bear  them.   I have found the following a very efficacious prep-
aration in this stage of the disease :—Take of Sulphate of Quinia six grains,
Leptandrin twelve grains ; mix, and divide into twelve powders, of which
one is to be given every hour.  In other respects, treat similar to the low
stage of typhus  fever, not forgetting expectorants to relieve  the breath-
ing and expectoration.  But the stimulating expectorants must be used, as
Senega, Ammoniac, Squill, Balsam Tolu, Canada Balsam,  &c.   The follow-
ing will  be found a useful expectorant:—Take of Syrup of Senega, Syrup
of Balsam Tolu, Emulsion of Ammoniac, and Tincture of Prickly-Ash  ber-
ries, each, one fluidounce; mix.  The dose is from half a teaspoonful  to a
teaspoonful four,  five, or six times a day, according to the exigencies of the
case.
  During the course of the disease, the  patient should lie in bed with his
head and shoulders  considerably elevated, and in other respects, the man-
agement should be the same as in pneumonia.
                   PLEURISY,   or  PLEURITIS.

   Pleurisy, or Pleuritis,  is an inflammation of the pleura,  a  membran
 which lines the chest and also forms a covering which envelopes the lungs,
 and is frequently associated with inflammation of the lungs.  It  is more
 usually met with during the spring and winter seasons.
   Symptoms.   Pleurisy usually commences with chills,  succeeded  by heat,
 thirst, restlessness, and  other ordinary febrile  symptoms.   These are fol-
 lowed sooner or later by an acute pain in the side or chest, which is much
 aggravated on making a full  inspiration, and is accompanied with  hurried,
 difficult breathing, and a dry, hacking cough.   Sometimes the pain occurs
 as  the very first symptom.  Coughing, breathing, and  moving  about, in-
 crease the  pain, as well as  lying upon the affected side.  Persons  laboring
 under an attack, lie upon the unaffected side, and endeavor as much as pos-
 sible to breathe without much expansion of the chest, respiration being chiefly
 performed by the muscles of the abdomen.  And when effusion takes place,
 the patient will shift his position and lie on his back.   The pulse is hard,
 strong, and frequent; the tongue is coated; the patient very restless ; the
 urine scanty and high-colored, and the bowels torpid.
  The pain may be located  to one spot, but generally it extends over a large
 extent, and sometimes implicates  both sides of the chest.   When the sub-
 stance of the lung is also inflamed, there may be an expectoration of mucus
 which will be streaked with blood, if the disease has extended to the bron-
 chial mucous membrane.  In from forty-eight to sixty hours, the pain les-
sens, or ceases entirely, indicating that effusion has taken place ;  but in se-
vere attacks, the pain will continue long after effusion has occurred.
  Causes.   The most common cause of pleurisy is cold,  from improper ex-
posure.  It may also be occasioned  by draughts of cold water, after being
heated by active exercise, by the suppression of certain  discharges, by the 
276                 AMERICAN  FAMILY  PHYSICIAN.

recession of exanthematous affections, by the excessive use of ardent spirits,
and  by all the causes which  usually give rise  to  other  inflammatory com-
plaints.
  Discrimination.   Pleurisy may  be mistaken  for  pleurodynia, a rheu-
matic affection of the intercostal muscles, but in this latter there is usually
an entire absence of febrile symptoms as well as cough; in pleurisy both
expiration  and inspiration are  carefully and  slowly performed, while in
pleurodynia the expiration is performed as in ordinary breathing, the in-
spiration alone being  slow  and cautious ;  beside, in  this  latter affection,
rheumatic pains will  have  been felt in other parts.
  Prognosis.  By a proper course of treatment, pleurisy usually terminates
favorably by resolution or absorption, the febrile  symptoms abating gradu-
ally, the pain  becoming much  diminished,  and  the  respiration becoming
more easy  and  natural.   But  if the inflammatory symptoms  have  been
severe, the  pain  ceasing suddenly, with a  small and  feeble pulse, pallid
countenance, cold  extremities, and  general prostration, the prognosis is
very unfavorable.   When  the disease occurs in strumous habits it is apt to
prove more obstinate.  When it arises from tuberculous ulcerations of the
lungs, or other complications, and especially when pus is discharged in the
pleural cavity, it almost always proves fatal.
   Treatment.  In  a  practice  of twenty-four years, during which time I
have treated many  hundred cases of pleurisy, I have not lost one patient,
in whom the disease  appeared in an uncomplicated form.  The first  object
is to produce perspiration, which will promptly relieve the pain, and lessen
the inflammation.  If the strength and condition of the patient will admit,
a Spirit vapor  bath should be  administered;  otherwise,  the  Compound
Tincture of Virginia Snakeroot may be given  in teaspoonful doses, and
repeated every half hour until  free perspiration ensues, and which  will
generally be followed by prompt relief.   This tincture  may be given in an
infusion of Pleurisy root, Catnip, or Balm.   In  conjunction with this, the
whole of the affected side  should be covered with  a  fomentation of bitter
herbs, as Hops, Tansy, Wormwood, &c, applied as hot as can  be borne,
and which should  be  renewed  every five  or  ten  minutes, and continued
until positive relief is obtained.   This course will in almost every instance
be followed by great alleviation  or a total cessation of the pain and other
inflammatory symptoms.   If the pain ceases entirely, nothing further than
care and an avoidance  of  exposure which may produce  a  relapse is neces-
sary.  If there is merely a slight relief of suffering, or, if the pain returns,
an emetic must be given as soon as possible, for which  purpose, the Com-
pound Powder of Lobelia will  be  found useful.  And this should he fol-
lowed by an  active  cathartic, as  the Compound Powder of Jalap, or, the
Compound Powder of Leptandrin.   After the administration of the purga-
tive, instead of waiting for its  operation, it will be advisable to at once
produce perspiration again, as above, with the use of hot fomentations. It
will rarely be found that the disease will continue after  this active medica-
tion, especially, if  it has been attended to at an early period.  But should
more or less pain continue, with cough, the following may be given with
great advantage : take of Tincture of Gelseminum  four  fluidrachms, Tinc-
ture  of Aconite  twenty-four  drops.  Mix, and administer thirty drop!
every half-hour, or hour, until the peculiar effects  of the  Gelseminum are
produced, after which" the intervals  between the doses may be lengthened,
Or, in  the  absence of this mixture, the  Compound Tincture  of Virginu
Snakeroot  may be given in half teaspoonful  doses every two  or three
hours, to keep up moisture of the surface.   An  infusion of Pleurisy root. 
CHRONIC PLEURISV.
277
or, of Crawley root, or cf equal  parts of both, may also  be drank freely.
When a severe cough remains it may be overcome by an infusion of Pleu-
risy root, Wild Cherry bark, each two parts, Bloodroot one part—adminis-
ter it in small doses, frequently repeated, and sufficient to keep up a slight
nausea.
  After this treatment, should cough and pain still continue, treat the case
similar to that  named for  inflammation of the lungs.   During the active
febrile  symptoms should they assume a well-marked periodical character,
Sulphate of Quinia should be administered during the remissions, or when
the active symptoms are at  their  minimum.
  The  diet  and regimen should be the same  as in inflammation of the
lungs, and great care should be observed to guard against any fresh expo-
sure  to cold, as  a relapse is  apt to prove fatal.
                       CHRONIC  PLEURISY.

   Ciiuoniu Pleurisy may be the sequence of an  acute  attack, or it may
assume this form from the beginning.
   Symptoms.   There  is but little  fever, and when present it generally
appears at night; the cough is slight, dry, or attended with a small expec-
toration of mucus ;  dry, vague pains in  the chest; shivering;  pulse hard;
countenance  pallid and  emaciated ; loss of  appetite,  and night  sweats.
Sometimes the affected side  swells or becomes enlarged in consequence of
the great effusion, with protrusion of the intercostal spaces, (spaces between
the ribs,)  and occasionally there  is displacement of the heart.   When the
substance of the lung is involved, the cough is very troublesome.
   Prognosis.   This is usualiy  unfavorable, especially when  hectic  fever
and night sweats are present.  The disease may be cured spontaneously by
reabsorption of the effused fluid ; by its making a passage through the pul-
monary tissue  into  the bronchial  tube, when  it is coughed up ;  or, by a
spontaneous opening through the walls  of the chest, when it is discharged
externally.
   Trkatment.   Although a very  disagreeable  and  painful  course, yet
there is no measure so beneficial as the application of the Compound Tar
Plaster over the seat of the disease, which should be continued  until a free
discharge ensues, and which discharge should be  kept up for several weeks,
if the patient can possibly bear it.  And this plaster may  be intermittently
applied until the pain has been permanently removed.
   Internally, for the purpose of  stimulating the  absorbents to  take up the
effused fluid, as well as to promote the action of the kidneys, the Compound
Syrup of Stillingia may be given in teaspoonful doses, and repeated every
three or four hours, and to each close of the syrup, from four to six grains
of the Iodide of Potassium should  be added.  Another excellent agent for
the promotion  of absorption is composed of Muriate of  Ammonia sixty-
four  grains, Fluid  Extract  of Wild Cherry four fluidounces;  dissolve.
The  dose is a table-spoonful  three times a day.
   In  addition to these measures,  the cough must be relieved by some of the
expectorant preparations, heretofore named under Bronchitis, Pneumonia,
&c.   The  bowels must be kept regular by small  doses  of  Podophyllin and
Leptandrin,  but they should not be  actively purged.  The surface of the
body should be bathed two  or three times daily with a stimulating wash,
made by adding spirits to a weak alkaline solution, and the drying should
be done with brisk friction until a glow and redness of the  skin is produced.
*!H 
278
AMERICAN FAMILY  PHYSICIAN.
Diuretics will often be found beneficial;  equal parts of Pleurisy root, Hair-
cap moss, and Burdock seed, may  be made into a decoction, and drank
freely.
  The diet should be  nutritious and  easily digestible, as  bread  and milk
roasted potatoes, cooked eggs, oysters, boiled meats, birds, &c, and in cases
of great debility, ale, porter, wine, &c.  The patient  should be kept quiet
and free from exposure to cold, sudden atmospheric changes, night air, &c,-
in some, a short ride in an  open vehicle  during warm, pleasant weather
will be very beneficial.  In some cases when the effusion is so great as to
threaten  suffocation, the  operation  of paracentesis,  has occasionally been
the means of saving  the patient's life  by allowing the  effused liquid to
escape externally.
               INFLAMMATION  OF  THE  HEART.

  Under this head, I will have reference to inflammation of the muscular
structure of the heart, carditis,—inflammation of the lining membrane of
the heart, endocarditis,—and inflammation of the membranous sac which
envelopes the  heart, pericarditis.   These  are  generally  treated upon, as
separate  and distinct diseases, but  as  their symptoms are very similar, as
well as the treatment recommended for  them, I have judged it best to em
brace  them under one head.
  Symptoms.   Inflammation of the heart  or its  membranes, usually com-
mences with the symptoms common to most inflammatory attacks, as chills,
heat and  dryness  of skin, thirst, flushed face, full  pulse, &c.  These are
succeeded by rapid, imperfect, and  often  unequal breathing, and an acute
lancinating  pain  about the  region of the  heart, which may extend to
the shoulder.   This pain, especially in  pericarditis, is aggravated by pres-
sure over the heart, as well as by a full inspiration.  There will also be a
dry, harassing cough, which  augments  the patient's sufferings, and gener-
ally a sense of suffocation will be  experienced.  Motion, or exercise will
increase  the  pain and  difficulty of breathing to a greater or less extent.
The features are haggard  and expressive of much suffering, with a degree
of anxiety ;  the heart beats violently and irregularly ; a sensation of faint-
ing is present more or less constantly;  at  first the pulse  is  full, hard, and
bounding, but  speedily becomes small, frequent,  and  unequal,  and fre-
quently cannot be observed at the wrist; the appetite is  deficient; the
tongue coated  white; the bowels constipated; the  urine insufficient and
high-colored;  the  skin  is often bathed in  sweat, as in acute rheumatism;
and when the  diaphragm  or midriff is involved, there will  be a distressing,
and painful hiccough.
  Causes.  These affections  are most commonly  owing to the presence of
acute  rheumatism, the  disease either  attacking the  heart primarily, or.
being  translated to it  from  some  other  part of the system.  They may
likewise occur from other causes, and are  sometimes met with in combina-
tion with pleurisy, Bright's disease of the kidney, &c.
  Prognosis.   These attacks are of a very serious character, and may ter-
minate fatally in a  very  short time; though  it is stated that, even when
left entirely to themselves, without any care or  treatment,  not more than
one in six cases is wont to prove fatal.   The principal evils to fear are the
secondary or chronic affections resulting from the acute  attack.
  Treatment.  I have obtained more  benefit in treating  these affections,
by sudorific or sweating medicines than by any other.  Copious perspin- 
INFLAMMATION  OF  THE  HEART.
279
 tion may be produced by the Spirit vapor bath ;  but I prefer the adminis-
 tration of the Compound  Tincture  of Virginia  Snakeroot, in teaspoonful
 doses, repeated every half-hour or hour, its action being aided by drinking
 frceiy of a warm infusion of Pleurisy root, or  Pleurisy root and Crawley.
 After free perspiration has occurred, it should  be kept up for one, two, or
 three  hours,,  or  longer,  according  to the  degree of pain  and difficult
 breathing.  If the bowels  are  costive, or contain accumulations of fecal
 matters, an active cathartic may be advantageously  administered,  as, the
 Compound Powder of Jalap, adding about ten grains of Cream of Tartar
 to the dose ;  or, the Compound  Powder of Leptandrin may be substituted
 The cathartic may be occasionally repeated through the course of the disease,
 whenever found necessary from the presence of costiveness, pain, difficult
 breathing, &c.  An excellent cathartic in this disease  is an infusion of two
 parts of Leptandra root, and one part of Blue  Flag root,  a table-spoonful
 of which may be given  every hour or two,  or sufficiently often to produce
 the desired result.  Mustard plasters applied to the feet, on the  chest over
 the region of the heart, and along the whole course of the spinal column,
 will be very useful in severe and obstinate cases.
   Tho above course will frequently overcome  the disease at once;  but should
 tho  pain  and  difficulty still remain, though in a minor  degree, it will be
 advisable to attend to the surface of the body, bathing  it several times a day
 with a warm, weak alkaline solution; and administering  internally  one of
 the following  preparations:  1. Take  of Tincture  of Gelseminum four flui-
 drachms, Tincture of Aconite root one fluidrachm; mix.   The dose is from
 fifteen to thirty drops every half-hour  or hour, until the peculiar effects of
 the Gelseminum are produced, after which the medicine should be given at
 intervals sufficiently often to continue these effects in a mild degree. 2. Take
 of Tincture of Colchicum Seed,  Tincture of Black Cohosh, each, one fluid-
 ounce; mix.    The  dose is from thirty to sixty  drops every  half-hour or
 hour, according to the degree of inflammatory action, and the influence of
 the remedy.   In cases of severe pain, from  three to six drops of the Tinc-
 ture of Aconite root may  be added to every dose, or, to  every  second or
 third dose, according to the influence  it exerts upon the  system.  3. Tincture
 of Sheep Laurel may be given in doses of from five to  ten drops every hour
 or two, according  to its influence.  Either of these agents will  lessen the
 violent action of the heart,  allay the inflammation, and thereby modify the
 pain  and  difficulty of breathing.   Digitalis is an agent I  do not prefer in
 these inflammations, and, therefore, do not recommend it.
  Diuretics will be found a very important class of agents, and among them
 I know of none  equal  to  an infusion  of Hair-cap moss; it may be used
 abne, or in combination with Cleavers.  The bathing and Mustard poultices,
 above  named,  must be used as required, with an occasional cathartic.  Too
 much depletion is hurtful;  therefore, after the first copious perspiration is
 maintained for three or four hours a repetition will not be necessary.   Any
 res lessness, or want of sleep, may be overcome by a pill of the Inspissated
Juice of Poison Hemlock, say two, three, or four grains, at bedtime; or,
 Iron  eight to ten grains  of the Compound Powder  of Ipecacuanha and
Opiim; or, Lactucarium, Lupulin, &c, may be given in sufficient doses.
  Tie patient should be kept free and  quiet,  not permitting him   to be
annoyed by anything;  the temperature of  his  room should  not be  too
elevated, but rather cool and comfortable;  the  diet  should be simple and
not stimulating, principally fluids and farinaceous  vegetable infusions.   The
period of convalescence  must be closely watched,  both to  avoid  a relapse,
and <o ascertain if  any chronic difficulty is about to ensue. 
280                AMERICAN  FAMILY  PHYSICIAN.

  Should an effusion remain in the pericardium, or, chronic disease of the
valves of the heart remain, as known by difficulty or shortness of breathing
palpitation of the heart, jerking and intermittent pulse, &c, the patient must
be placed upon an alterative course.  The Compound Syrup of Stillingia with
the Iodide of Potassium, will be found very valuable.   The Compound Tar
Plaster may, in addition, be worn  between the shoulders, or over the region
of the heart, and the discharge produced by it kept up for along time, inter-
mittingly.   And any excessive palpitation  of the heart may be lessened by
the Tincture of Sheep Laurel, or,  by a pill, as above, of  the Inspissated
Juice of Poison Hemlock.
              INFLAMMATION  OF  THE  STOMACH.

  Inflammation  of the  Stomach, or Gastritis, is  an inflammation  of the
lining mucous membrane of the stomach, which may also, in a greater or less
degree,  involve its peritoneal coat or- covering.   The inflammation may be
either acute or chronic.
  Symptoms.   Acute  inflammation of the mucous  lining of the stomach
most usually involves the peritoneal covering, and the patient experiences a
burning heat in the region of the stomach, with  more or less pain, swelling,
nausea,  and vomiting; and which symptoms  are aggravated  by everything
taken in the  stomach, by motion, deep inspiration,  and by pressure on the
part.  In all  inflammations  solely of mucous tissues, pain will not be an
accompanying symptom;  but  it  will always  be present as other tissues
become  involved, either from sympathy, or from  an  extension of the inflam-
mation in them.   Intense and most distressing thirst is  present, which it is
very difficult to allay, for, unless fluids be given in very small  quantities, say
a teaspoonful  at a time, they are immediately ejected,  with an  increase of
pain.   There  it, likewise considerable trouble  in swallowing, from spasmodic
action of the esophagus.  Great  restlessness, with  constant  rolling of tho
body, wakefulness, small, contracted,  hard, and IVequent pulse, dryness and
heat of  the skin, great anxiety, oppression and great prostration of strength,
are present when  the disease  is fully  developed.  A  harassing  cough ii
usually  an  attendant symptom;  the countenance  is  shrunk and contracted;
the tongue clean, with elevated papilke, and pretcrnaturally red at the poin;
and edges;  the bowels are constipated, except in  protracted cases, when fron
extension of the  inflammation  to the bowels, diarrhea will take place.  Ai
the diseases augments in violence, the difficulty of breathing increases, is
well as the pain caused by deep inspiration; there is great loss of strengta,
with faintness, hiccough,  an intermittent pulse, cold, clammy sweats, cold-
ness of  the extremities, perhaps tympanitis, delirium, stupor or  convulsiois,
and death.
  Causes.   Acute Gastritis is seldom met  with, except  as a complicaton
with some   other  disease, as gout, repelled exanthemata, bilious  fever, 1c.,
or,  it may be caused by acrid substances taken into  the  stomach, as arseuc,
corrosive ■sublimate,  mineral  acids, oxalic acid, improper food, or an uniiM
quantity of liquor; drinking cold water when the body is heated or ever-
fatigued by exercise, wounds, blows, &c, have also occasioned it.
  Prognosis.  The termination of gastritis is always doubtful; it may sud-
denly destroy the  patient, even in the course of a few hours, especially yhen
violent; or, when  less severe, it may be followed by a train of  distressing
and painful symptoms, embittering the  subsequent existence of the patient
When it is caused  by corrosive  poisons, producing  disorganization  cf tM 
INFLAMMATION  OF THE STOMACH.
281
stomach, the countenance  is pale and sunken from the jeginning, and no
reaction occurs,  the  patient sinking rapidly.  When gastritis  is about to
terminate  favorably,  the pain and  vomiting gradually subside, the urine  is
free with a brick-dust  sediment, the bowels are  moved, the pulse becomes
more  soft, full, and compressible, and a  moderate moisture of the surface
takes  place.
  Treatment.  When inflammation of the stomach is  caused by  some
poisonous  substance taken into the stomach, the  first measure should be its
prompt evacuation by an emetic—for which purpose the Compound  Powder
of Lobelia in  a  heaping teaspoonful dose, and given  in some Boneset tea,
will be prompt and effectual.  At  the same time, as well as for a time after
the emesis, the proper antidote to the poison must be administered.  In cases
of mineral acids and caustic alkalies, the antidote should precede all other
measures in order to neutralize them at once; in  such  cases, vomiting is of
little importance.
  After the ejection or neutralization of the poison,  the  inflammation at
first excited may continue, and must be combated by the ordinary means for
subduing  inflammation of this organ; these are, the application of Mustard
poultices to the feet, along the whole length of the spinal column, and over
the pit of the  stomach; and as  soon as  considerable redness  has been pro-
duced remove them, applying hot fomentations  of Hops  and Stramonium
leaves in  their  stead.   These  Mustard  poultices,  as  well  as the fomenta-
tions,   may be  renewed  from  time  to  time,   according  to the urgency
of the symptoms;  and  in  all  instances,  the whole surface of the  body
should  be bathed several times a day  with a  weak alkaline bath, drying
with considerable friction.  If the  patient is  able  to have  perspiration in-
duced by means  of the Spirit vapor bath, it will  afford great  relief; but he
should not be  placed to any great inconvenience  to  further this indication.
To relieve the  thirst, and at the same time aid in lessening the inflammation,
cold  and  mucilaginous  drinks must be  given in very small quantities at a
time, say a teaspoonful, adding to each draught, a few drops of  Tincture of
Aconite root;  and the patient may be permitted to hold from time  to time
a small lump of  ice in  his mouth to slowly dissolve away, or it may even be
swallowed.  Cold infusion of Marshmallow root, Elm  bark, or of Elm bark
and Peach  leaves, may be exhibited for the same purpose.   The bowels
should be  moved once or twice a day by means of stimulating laxative injec-
tions, as, take  of Castor Oil two  fluidounces, Tincture of Prickly Ash ber-
ries half a fluidounce, Compound Tincture of Virginia Snakeroot two flui-
drachms, Infusion of equal parts of Boneset and  Senna, half  a  pint.  Mix,
for an injection.
  l\ metics should never be given in inflammation of the stomach, except to
remove acrid or poisonous substances; and the administration of drinks or
medicines  must  bo given  in very small quantities, or they will certainly be
thrown  up by vomiting.  Indeed, the less the stomach is disturbed by any-
thing thrown into it, the better will it be for the patient.  Care should be
taken not to administer stimulants, as wine, ale, &c, from  a  mistaken idea
that the weakness of the  patient demands  them; for, if this be done, the
symptoms will be aggravated, and the patient may die  suddenly.
  In very severe attacks of gastritis dry cupping over the region of the
stomach, in conjunction with the preceding measures, has proved beneficial;
a large  tumbler  is generally used for this  purpose.   In some cases, cold
water applied to  the  pit of the stomach,  by means of  towels,  and  repeated
every  half hour or hour, has answered a most excellent purpose toward allay-
ing the inflammatory symptoms. 
282
AMERICAN FAMILY  PHYSICIAN.
  The various measures adopted should be  perseveringly and energetically
pursued, until all tenderness or pressure over the region of the stomach dis-
appears,  and the other symptoms are  rapidly subsiding.  Should it become
necessary to use means for promoting the tone  and energy of the stomach.
after the inflammatory symptoms have been subdued, the following will be
found a very excellent preparation for this purpose :—Take of Golden  Seal,
Swamp Milkweed, Quassia, and Sassafras bark,  equal  parts,  make a strong
infusion, and administer it several  times a day in teaspoonful doses.  In this
instance, I prefer this infusion to the use of Hydrastin, which is not so read-
ily soluble  in the stomach.  Or, equal parts of Unicorn  root  and Golden
Seal, may be prepared and administered in a similar manner.
  During convalescence great ca*e should  be taken not to  overload or  dis-
tend the  stomach with too  large a  quantity  of food.   At first, Gum Arabic
water, barley-water, toast-water, rice-water, &c,  maybe given; and when the
inflammation is entirely overcome and the stomach somewhat  strengthened,
arrowroot, sago, milk, chicken-broth, beef-tea, soft-boiled egg, &c, gradually
and carefully accustoming the stomach to its usual diet.
       CHBONIC  INFLAMMATION  OF  THE  STOMACH.

  Chronic Inflammation of the Stomach, or Chronic Gastritis, is an affection
not unfrequently met with, and is often mistaken for dyspepsia.   The term
" Dyspepsia," is applied to a disease of the stomach which  differs in many
respects from the one under consideration, and which will be treated of here-
after; indigestion,  however, is a common attendant of chronic gastritis, and
some  writers consider  that  this latter affection  is a variety of dyspepsia.
Still,  it will  be necessary to  bear  in  mind  that if, from a  mistaken view,
chronic inflammation of the stomach be treated the same  as the ordinary
forms of dyspepsia, the symptoms will be rendered more severe, and a lasting
injury be inflicted  upon the patient.
  Symptoms.   The patient will experience more or less distress and pain in
the region of the stomach, especially after eating,  and also when pressure is
made; his appetite becomes irregular and fastidious; the food is imperfectly
digested, in  consequence of which accumulations of gas  take place, which,
when passed by mouth, are sometimes  exceedingly offensive.  The appetite
will sometimes  be very craving, but on eating a mouthful or two the patient
is satisfied, or perhaps becomes nauseated.   At other times  the appetite will
be entirely lost, with an unpleasant taste in the mouth.  Nausea and vomit-
ing frequently follow eating; and,  generally, after a full meal, there will be
an aggravation  of the tenderness or pain in the stomach, together with head-
ache.  The thirst is as variable as the appetite, being more commonly aug-
mented.   The uneasiness in the stomach may pass into pain, which may be
acute,  dull, or lancinating, and may extend  to the back, and edges of the
ribs;  or, there  may be a sense of fulness, weight,  distension, constriction, or
a tormenting heat  or burning in the stomach.  The tongue  is covered with
a whitish fur, and  is almost always of a vivid red at its tip and edges;  or the
whole  surface of the tongue may be smooth, glossy, and increased in redness;
occasionally there  will  be no preternatural redness,  nor any fur.  With  this
increased redness of the tongue, the pulse  will be  found small,  tense,  and
thread-like, and between eighty to  ninety beats or more in a minute.   If the
inflammation has not extended beyond the stomach, the bowels will  be  cos-
tive ; but diarrhea may be present from an extension of the disease to the
mucous lining membrane of the intestines.   The  urine is variable in quan- 
CHRONIC  INFLAMMATION  OF  THE  STOMACH.        283
 tity, generally high-colored, giving a deposit upon standing.   Coldness ot
 the extremities is a common symptom in an advanced stage, and if the dis-
 ease is not removed, emaciation takes place more or less rapidly, the patient
 becomes hypochondriacal, and may linger out a term of years in  constant
 misery.  In some instances, cough is present, the pulmonary organs become
 implicated, and with all the symptoms of tubercular consumption, dissolution
 occurs in the course of a few months.
    Causes.  Chronic inflammation of the  stomach  occasionally follows the
 acute form;  it  more often  supervenes  on febrile  attacks,  as  scarlet fever
 small-pox,  typhus fever, &c, and especially when the already debilitate
 stomach, after convalescence from these  diseases, is irritated by an improper
 amount of indigestible  food thrown into  it.  Intemperance in eating and
 drinking may occasion  it.   Excessive venery, and especially masturbation,
 is a frequent cause.  The improper use  of emetics and purgatives is likewise
 a common cause.  With some persons there is a  peculiar predisposition to
 chronic gastritis.
    Prognosis.  A recent affection of this kind, when not  complicated with
 any other obstinate or serious malady, may be cured in the course of several
 weeks; but when the disease is confirmed, it will require a long time to effect
 a recovery, perhaps a year or two.  In the advanced stages, when aphthous
 ulcerations appear upon the tongue, and inside of the lips,  it is an unfavor-
 able symptom, indicative of approaching dissolution.   Chronic inflammation
 of the stomach  usually terminates in ulceration of this organ, and occasion-
 ally in softening and gangrene.
    Treatment.  One of the most important points of treatment  in chronic
 gastritis, is to regulate the patient's diet.  While the more  urgent inflamma-
 tory symptoms are present, Gum Arabic water,  rice-water,  barley-water,
 arrowroot, toast and tea, and other  mild,  unirritating, and easily digested
 articles of food may be allowed; but when these symptoms  have subsided,
 and especially when debility is present, more substantial and nourishing diet
 should be permitted, as oysters,  animal jellies, venison, poultry, tender beef-
 steaks, roasted, mealy  potatoes, and  other easily  digested substances, and
 which will require to  be changed  or  adapted to  suit  the stomach of the
 patient.   Sometimes the patient will have  a  constant desire or craving for
 some article  of food, not exactly in accordance with  the views of the physi-
 cian, but by granting a gradual and cautious use of it, permanent  benefit
 will frequently follow.   All  solid food should be slowly and thoroughly mas-
 ticated before it is allowed to pass into the stomach.  Milk may be  allowed
 to persons who are fond  of it, except in case it  is  found  to  disagree  with
 them, causing nausea, heartburn, sense of weight, increased  heat,  diarrhea,
 or other disagreeable symptoms.  The meals should be regular, and in cases
 of great debility, it will  be better to make several meals a day, eating only a
 small quantity at each;  too  much attention to this point cannot be observed.
   If the strength of the patient will permit he should take  gentle  outdoor
 exercise, either by walking,  riding, or sailing,—but  no violent or long-con-
 tinued exercise  must be  allowed.  Cheerful company is always beneficial.
 The surface of the body should be bathed twice a day with  a weak  alkaline
 solution to which some spirits is added, and, in drying, considerable friction
 must be used.  Mustard  poultices, or other mild counter-irritants should be
 applied to the region of the stomach, and continued until all tenderness upon
 pressure is removed; and at the same time  the  shoulders should be kept
 back, so as not to allow the lower part of the breastbone or  sternum to press
 upon  the stomach.  In this disease never exhibit medicines internally unless
they are imperatively required, and then  be very careful as  to the character
of the agents  employed.
* 
284
AMERICAN  FAMILY PHYSICIAN.
   As an internal medicine I have derived much benefit from the Fluid Ex-
 tract of Cubebs.   The following mixture, though  not a strictly chemical one
 has  proved decidedly beneficial in my hands, in the treatment of chronic
 gastritis:—Take of Fluid  Extract of Cubebs one fluidounce,  Mucilage  of
 Gum Arabic two  fluidounces, Essence of Lemon  one fluidrachm,  Lupulin
 Trisnitrate of Bismuth, each, eight scruples;  mix.  The  dose is a teaspoon-
 ful, to be  repeated three or four times a day, shaking the mixture well, each
 time previous to administering it.   In conjunction with this, an infusion  of
 equal  parts of Golden  Seal  and  Solomon's Seal, may  be administered  in
 table-spoonful doses, repeated every hour or two.
   If obstinate constipation is present, which cannot be removed by a proper
 diet and injections, it may become necessary to  administer mild laxatives.
 But great care should be taken'in the selection of the article, lest the symp-
 toms be aggravated.   I usually prefer Bhubarb  in  doses of from  three  to
 ten grains, or, in sufficient quantity to produce one gentle evacuation daily;
 the dose should be so apportioned that it may be  repeated three times a day
 to produce the desired effect, and should acidity of stomach be  present, half
 the quantity of Bicarbonate of Potassa may be added to  each  dose, or, the
 Bicarbonate of Soda.
   Diarrhea may be overcome by the use of the following  compound:—Take
 of Compound Syrup of Bhubarb and Potassa three fluidounces, Tincture of
 Prickly-Ash berries one fluidounce, Paregoric, four fluidrachms; mix. The
 dose is a teaspoonful every hour or two.   While  using  this internally, the
 following injection may also be used:—Take of Tincture of Prickly-Ash ber-
 ries four fluidounces, Saturated Tincture of Nux Vomica three fluidrachms;
 mix.  Inject a teaspoonful of this, diluted with a teaspoonful of an infusion
 of Solomon's Seal, into the bowels, and repeat it three times a day; it should
 be retained in the bowels as long as possible.  This injection  will likewise
 be found very useful in those cases of diarrhea which occur  whenever the
 patient sits up, and which are owing to excessive debility.
   When troublesome cough is present, the following mixture will be  found
 very valuable :—Take of Syrup of Wild Cherry bark, Syrup of Balsam Tolu,
 Syrup  of  Ipecacuanha, Tincture of Hyoscyamus, each,  half  a fluidounce;
mix.  The dose is half a teaspoonful, or a teaspoonful whenever the cough
 is  harassing.
   When this disease occurs in persons who have been  in the habit of using
 liquors intemperately, it will  frequently become necessary to  resort to  the
use of ale, wine, or brandy, before any decided relief can be obtained.  But
these are not allowable in ordinary instances, except in cases of great debility,
in which I have seen brandy  taken several times a day without any appre-
ciable bad effects, and without aggravating any of the symptoms; still, these
stimulating liquors must be used with great caution,  never permitting them
unless  their use is absolutely necessary and  non-injurious.  (See Remedy
 for Drunkenness, Introduction, page 101.)
   Flatulency is frequently a very annoying symptom, and may be  removed
by the  use of Essence of Anise, Essence of Peppermint, &c, given in a small
 quantity of sweetened water.   I have  derived much benefit in this symptom
from the following mixture:—Take of Tincture of Prickly-Ash berries one
fluidounce, Essence of Anise half a fluidounce, Dioscorein  half a  drachm;
 mix.  Triturate the mixture until  the Dioscorein  is dissolved.   The dose  is
 half a teaspoonful in a teaspoonful of  an  infusion  of Pleurisy root, and re-
 peated  according to the urgency of the case.
   After the inflammatory symptoms have entirely disappeared, it will be well
 for the patient to continue the use of the above infusion of Golden  Seal and 
INFLAMMATION  OF THE  BOWELS.
285
Sol anion's Seal, for two or three  subsequent weeks;  or, an  infusion of the
bark of Shrubby Trefoil (Ptelea  Trifoliata) may be taken in table-spoonful
dosas, repeated several times a day,  and which will  increase the tone and
energy of the stomach.   A gradual return to  the ordinary food must  be
made, as in convalescence from the acute form of the  disease.
              INFLAMMATION OF  THE  BOWELS.

  Inflammation of the Bowels, or Enteritis, is the term applied to inflam-
mation of the lining mucous  membrane of the small intestines;  when the
large intestines are attacked, it is known as " Dysentery."
  Svml'to.ms.   Acute Enteritis commences  with a slight chill or sense of
coldness, and more or less uneasiness in the neighborhood of the bowels, with
slight griping pains, which gradually increase until they become of a severe,
burning character.   The pain generally extends over the whole of the  abdo-
men, but is more severe around the navel, and usually comes on in parox-
ysms, with intervals of more  or less suffering.  The pain is  greatly aggra-
vated on pressure over the affected part.  Sometimes the pain is violent from
the beginning; and, when the inflammation  is confined solely to the mucous
membrane, involving no  other tissue, there will be no  pain  at all.  Nausea
and frequently vomiting are present, and the matters ejected  are either bil-
ious, or dark and fetid.   There is more or less fever,  hot and dry skin, dry,
slightly furred, and  red tongue, thirst,  great anxiety,  obstinate costiveness,
painful, difficult, and  scanty urination, the fluid  being high-colored; the
breathing is short and laborious, and the pulse small, hard and frequent, or,
sometimes full and hard.   Eructations of wind are constant,  and in severe
cases the motion of the intestines  becomes  inverted, and  the  patient  dis-
charges fecal matter by the mouth. The patient prefers  to  lie  upon the
back, with the legs flexed  toward the abdomen, which lessens the compres-
sion of the abdominal muscles on the affected parts, as well as prevents pres-
sure of the bedclothes.   Not unfrequently,  instead  of costiveness,  there
will be a diarrhea, the discharges being either watery, or, mucus tinged with
blood, and sometimes they will be of a  greenish color,  or, perhaps, bilious.
Usually the bowels are flat and sunken, but in protracted cases from accumu-
lations of gas, they may become more or less swollen and tympanitic.   If the
disease is not subdued, the patient is suddenly relieved from his agony, the
pulse becomes intermittent and can hardly be felt, the countenance assumes
a pale and livid hue, the extremities become  cold, together with other symp-
toms of approaching dissolution, from mortification having occurred.
  Discrimination.  Enteritis may be mistaken for colic,  or  for  peritoneal
inflammation.   It may be distinguished from colic by the quick, small,  and
hard pulse, the febrile symptoms, and the increased pain on pressure,  all of
which are absent in colic; in colic the pains have perfect and complete  inter-
missions, and are relieved by  pressure.  It may be  determined  from perito-
neal inflammation by observing that diarrhea is rarely present  in this  latter
affection; tympanitic tension of the abdomen with soreness on  pressure are
always present in peritonitis, and are more severe than  when they happen in
enteritis.   The pulse is also much  more rapid in  peritonitis, and  the pain
more intense.
  Causes.   Enteritis may be caused by the same means that  produce gas-
tritis ; acrid or irritating  substances,  hardened feces, acrid bile,  obstinate
constipation, spasmodic colic,  strangulation of any portion of the intestines,
kc, frequently occasion it. But the most common cause is cold, or sudden 
286                 AMERICAN FAMILY PHYSICIAN.

exposures to variable temperature, atmospheric changes, or from cold drink
taken when the body is heated by exercise.   It  may  also be occasioned by
the sudden  recession of cutaneous or exanthematous eruptions, translated
gout or rheumatism, and the suppression of customary discharges.
  Prognosis.   This affection is  not commonly severe, and is apt to termi-
nate favorably; sometimes, however, it is attended  with great  danger,  and
may terminate in gangrene in  a  few hours.  Gangrene or mortification may
be known by a sudden  cessation from pain,  weak and irregular pulse, sink-
ing of the features, cold sweats, fainting,  hiccough,  suppressed urine, and a
tympanitic distension of the belly.  When there is no great amount of pain,
no fever, little or no diarrhea, the case is favorable.   If,  in  the severe form,
the pain gradually abates, the  stools become natural,  a  moisture covers the
whole surface of the body, the  urine passes freely, with a more natural pulse,
the case will terminate favorably by resolution.
  Treatment.  This will be similar to that recommended for gastritis, de-
pending, however, on the cause of the attack.  When it  is caused by cold
or exposure, the whole surface of the body should be  bathed with a warm,
weak alkaline solution, after which Mustard poultices  should be applied over
the bowels, soles of the feet, and along the whole course of the spinal  col-
umn, and  continued until they produce considerable redness; and, if neces-
sary, these may be repeated daily.  After removing the  Mustard from over
the bowels, a hot fomentation of Hops and Tansy, or  Hops and Stramonium
leaves, should be applied, renewing them every half-hour or hour, according
to the intensity of the pain.  The feet and legs should also be kept warm by
hot rocks, or bottles of hot water, &c.   In conjunction with these measures,
the Compound Tincture of Virginia Snakeroot, may be administered in some
warm infusion of Balm or Catnip, giving  it in fluidrachm doses,  and  repeat-
ing it every hour or two, until free and  copious perspiration is produced,
which should be kept up for two or three hours.  When  the Spirit vapor
bath can be used, it will answer  the purpose,  without  a  necessity for giving
the above  tincture.  The same course  may be pursued  when the disease is
owing to translated gout, or rheumatism,  or  to  a recession of an eruptive
affection from the surface.  When a malarial  fever is present this should be
first arrested, by the means already named  under Intermittent, and Bilious
Bemittent fevers; and if the inflammation should continue, treat it  as just
named above.
  As an internal agent, I have recently succeeded in promptly subduing the
disease, when from cold, by the  following;—Take of Tincture  of Gelsemi-
num four  fluidrachms, Tincture  of Aconite root ten or twenty drops;  mix.
Give half  a teaspoonful  every fifteen or twenty minutes until the effects of
the Gelseminum are manifested,  when the intervals  between  the doses may
be increased.  At the  same time, the above local measures, Mustard,  hot
fomentations, &c, should not be  omitted.
  When the inflammation is owing to acrid  or irritating substances in the
intestines, the lower bowels must be freely evacuated by means of stimulating
cathartic injections; after which the  Compound Powder of Bhubarb  and
Potassa should be given in half teaspoonful doses, in some sweetened water,
and repeated every  hour until a  free evacuation from  the bowels have  been
obtained;  and, in the meantime, hot fomentations  must  be applied to the
abdomen,  or, cloths wet with hot water may be placed over the  bowels, re-
newing them every  five  or ten minutes, until  relief is  obtained.   Should any
mild inflammation remain,  it may be  removed  by  mucilaginous drinks, as
infu-ion of Elm and Peach leaves, Marshmallow, &c; adding a small portion
of Laudanum should diarrhea be present. 
            CHRONIC INFLAMMATION OF  THE  INTESTINES.         287

  When the disease is owing to excessive bile, of an acrid quality, an infu-
sion of a mixture of the root of Leptandra Virginica  two parts, Bhubarb
one part, may be given  in  table-spoonful  doses  every hour, until  bilious
evacuations are obtained; and, in some instances, much benefit will be de-
rived from the use of acids,  as lemonade, orange-juice,  tamarind-water, &c,
especially when the fur on the tongue is yellowish or dark-brown.  If diar-
rhea be present, equal  parts of Paregoric  and the Tincture of Catechu,
may be given in teaspoonful doses, as often as required;  and an injection
should be frequently used, composed of  five or six  grains of Tannic Acid,
in a fluidrachm, each, of Tincture of Prickly-Ash berries, and  Infusion of
Elm.
  When the inflammation is due to strangulation  of the intestine, this must
fir;*t be overcome, if possible.   It is a very difficult condition, which fre-
quently baffles the best medical skill.  It has  been reduced, in some cases.,
by passing the tube of a stomach-pump into the rectum, as far up as prac-
ticable, and  then filling the bowels with  water.  It has likewise been over-
come  by placing  a large glass vessel upon the abdomen, and producing a
partial vacuum in it by means of an air-pump, or  otherwise.
  With regard to diet, and the management of convalescence, the rules laid
down under Acute Inflammation of the Stomach, must  be followed.
       CHRONIC INFLAMMATION  OF THE  INTESTINES.

   Chronic Inflammation of the Intestines, or Chronic Enteritis, is one of
the most  troublesome  diseases that afflict man.  It may follow the acute
form, but  more frequently it is produced by an improper treatment of bil-
ious and other fevers, the use of drastic cathartics, &c.  Many of our soldiers
in the late war with Mexico suffered with it, under the name of " Mexican
diarrhea," and it proved fatal to a great number.
   Symptoms.  The most constant and formidable symptom attending this
disease, is an obstinate diarrhea;  the evacuations being of a dirty, slimy,
watery character, varying very much in  quantity, as well as in frequency.
Generally, there are from two to four stools a day, and of a feculent, bloody,
or mucous character.  The  tip and edges of the tongue are vividly red, and
frequently the whole tongue and mouth ;  sometimes, the body of the tongue
will  be paler  than natural,  with  a slight coat, and  perhaps aphthous
ulcerations.   There is a dull pain in the  region  of the affected part, in-
creased by pressure, by jolts, and by eating a full meal, as in many instances,
the pain will  be more sensible at a certain period after eating.   The abdo-
men is sometimes distended, at others, flat and  concave; the skin  dry and
husky; the extremities cold; the appetite more or less impaired; considerable
thirst; deficient and high-colored urine ;  great depression of spirits; small
and frequent  pulse, and emaciation.  In some instances, the only symp-
toms complained of, are debility, emaciation, and diarrhea.   Sometimes the
lungs become implicated, giving rise to a harassing cough.
   Treatment.   Among  the returned soldiers from  Mexico, I had numer-
ous opportunities of witnessing and treating the  disease,  and found that
course which I am about to recommend, more  efficacious than  any other.
In the more active stage of the disease, I, at first, adopted a treatment similar
to that named under Chronic Inflammation of the Stomach;  as soon as these
were subdued, the Compound Syrup of Bhubarb  and Potassa, was given in
table-spoonful doses, every two or three hours, or in doses sufficient to act as
a mild laxative; at the same time the patient was made to take a table-spoon- 
288                AMERICAN  FAMILY  PHYSICIAN.
ful  every hour during the day, of an infusion of equal parts of  Solomon's
Seal, Wild Cherry bark, and Geranium.  In addition to these means, the
Compound Tar Plaster was sometimes applied over the whole abdomen, and
kept discharging for  three or  four weeks,  as  the  patient  could  bear it.
This plaster, however, is to be used in those cases  only which stubbornly
resist the other  measures ; as a general rule, its application  will not be re-
quired, as the disease can be cured without it.
  When the disease  obstinately resisted these measures, or the diarrhea re-
turned, shortly after an  apparent cure, I administered the  following pill,
for  the purpose  of removing the tubercular  condition which is almost al-
ways present in  this  affection, as well as to restrain, but not  completely ar-
rest, the  looseness of the bowels :—Take of Iodine eight grains, Sulphate of
Morphia two  grains, Geraniin  thirty-two grains.   Triturate these articles
thoroughly together, form them into a pill mass with Simple Syrup, or Ex-
tract of Liquorice, and divide into thirty-two pills.   The dose is one pill, to
be repeated every three hours, or four times a day.   The  diet must be sim-
ple, nutritious, and  easily digestible,  avoiding  animal food, butter, milk,
acids, grease, stimulants, and all liquors.  Moderate exercise  to be taken
daily in the open air, whenever the strength of the patient  would permit.
If it became  necessary, in  obstinate cases, to re-apply the Compound Tar
Plaster, I usually placed it over the spine, so as to  cover the ninth, tenth,
and eleventh dorsal vertebra).
  Occasionally,  I met with much success from a powder composed of Gera-
niin, Hydrastin, each, thirty grains, Strychnia  half a grain  ; triturate the
powders  thoroughly together, and divide into thirty  powders, of which one
was a dose, to be repeated  three times a  day ;  carefully observing the in-
fluence of the Strychnia, and  omitting it when its  action was felt in the
least appreciable degree—but returning to its use again after several days,
and thus alternating its employment.
  In cases of  extreme debility and  emaciation, considerable  advantage has
been derived from the use of a syrup made from equal parts of  Black Co-
hosh root, Golden Seal, Solomon's Seal, and Geranium, to  every pint of
which, half an ounce of Iodide of Potassium was added.   The  dose is from
one to three fluidrachms two, three, or four times a day.
                DYSENTEBY, or  COLO-BECTITIS.
  This disease, likewise  known by the names of colitis, bloody-flux, &c, is
an inflammation of the mucou3 lining membrane of the lower, or larger in-
testines, and is divided into two forms, viz:  acute and chronic.   Most per-
sons consider diarrhea and dysentery to be the same disease, but there is a
material difference between the two.
  Symptoms.   Acute dysentery may  present itself without any previous
constitutional  disturbance, but generally it comes on with loss of appetite,
constipation, flatulence, and nausea,  which are followed by shivering, lassi-
tude, uneasiness, heat of the surface, and  frequent pulse.   These premoni-
tory symptoms are succeeded by more or less frequent discharges from the
bowels, accompanied at first with a  sensation of uneasiness, but which, as
the  disease progresses, becomes changed to a soreness and weight in the
lower  portion of the intestines; every evacuation is preceded  by severe
griping pains, with a rumbling noise, owing to the unusual quantity of gas
in the  bowels;  and a very distressing tenesmus, or constant desire to stool,
with bearing down of the parts, is experienced after each discharge, which 
DYSENTERY.
289
fVequently occasions  the patient  to  make efforts to evacuate the  bowels,
without being  able to pass any thing, or only a small amount of bloody
mucus.  The discharges at first have scarcely any odor, but  as the disease
advances, they acquire a peculiar  offensiveness ; they likewise vary both in
color  and consistence ; sometimes  being  pure mucus,  at others mucus
streaked with blood, and not unfrequently pure blood  will_ be voided.   In
some  instances, and  especially when the disease is epidemic, a fetid, acrid,
watery liquid is passed, resembling  the washings of fresh  meat.   Again,
pus will be passed in an advanced stage.  It is very seldom that any  nat-
ural feces are observed in the discharges, but when  they are present, they
are in small hard balls, called "scybala," and occasion much pain, but when
passed,  they always afford  some relief from the griping and  tenesmijs.
The number of discharges per day, varies from fifteen to a hundred  or more,
tmd they always occasion more or less severe burning sensation in the  rec-
tum.   Conjoined with these symptoms, the  tongue  may be moist and  cov-
ered with a whitish  substance ; or, if  the  liver is implicated, the coat will
be yellowish, and sometimes, in severe cases, the edges and tip of the tongue
as well as  its  whole  surface,  will  present  a  fiery-red  appearance.   The
pulse generally hard and accelerated at first, becomes  changed to  natural,
or feeble and irregular, according to  the  favorable or unfavorable character
of the  disease.   The  urine is  commonly deficient and high-colored,  and
sometimes  passed with pain and  difficulty; the liver is almost always de-
ranged ; and sometimes nausea and vomiting are present.
   Causes.   Acute dysentery may be produced  by exposure to  cold  and
dampness, by the presence of acrid and indigestible substances in the bowels,
as crude, indigestible vegetables of any kind ; but I do  not believe it is  ever
occasioned by the moderate use of ripe fruits.   It frequently occurs in places^
where  the air is vitiated, the food insufficient, indigestible, or improperly
prepared, and the laws of hygiene are  disregarded,  as in camps, hospitals,
jails, ships, &c, in which cases,  it most usually assumes a typhoid character.
Drastic cathartics frequently occasion it.   Excessive physical labor in hot
and damp weather, or during an epidemic season, will be very likely to bring
on an attack.   And  it more often occurs in this country in the form of an
epidemic; but I do not consider it by any means a contagious disease, un-
der any form.  It most generally prevails  in the summer and fall  months
of hot and damp seasons.
   Prognosis.  Generally, dysentery is a disease easily  cured;  occasionally,
it proves obstinate and fatal.  The typhoid  form is the most unfavorable.
When the febrile symptoms are high, with excessive pains,  great prostra-
tion of strength, emaciation, strangury, hiccough, aphthous  ulcerations of
the mouth and  fauces, tense abdomen, weak, irregular  pulse, cold, clammy
sweats, and fetid and involuntary discharges, the case is unfavorable ; but it
is favorable, when a gentle moisture is developed over the surface, the fever,
thirst, gripings, and tenesmus  gradually ceasing, and  the stools becoming
of a natural color and consistence.  Persons whose constitutions have been
impaired by scrofula,  or other tuberculous diseases,  by severe attacks of
intermittent fever, or other  disorders, are very apt to fall under an attack,
especially when severe.
  Treatment.  Before  undertaking the treatment of dysentery, we must
first ascertain its cause, if possible.  Should it result from cold, or exposure
to variable temperature, it will be proper to produce perspiration, for which
purpose the Compound Tincture of Virginia Snakeroot will  be found  pre-
ferable to any other  agent.  If there be severe pain in  the bowels, a hot
fomentation of Hops, or Hops and Stramonium leaves may be placed over the
       19 
290
AMERICAN  FAMILY PHYSICIAN.
painful part, or it may be preceded by a Mustard  poultice.   When the dis.
charges  are  frequent or painful, injections  must be used;  three  parts  of
Starch-water and one of the Compound  Tincture of Virginia Snakeroot
may be mixed  together, and about half a fluidounce be injected into the
rectum, and  repeated  after every discharge, the  patient retaining it each
time as long as he possibly can.  If the above tincture cannot be obtained,
ten or twenty drops of Laudanum  may be substituted.   As in all  cases of
dysentery, whatever its cause, the patient  must be kept  quiet and in a re-
cumbent  position as much as possible, and he should also be advised to
resist, as much as possible, any desire to get up, because the erect position,
as well as every  evacuation, or straining,  tends to aggravate  the disease
and on this account it is always better  to use a bedpan whenever an evacu-
ation occurs.  If after these means, a discharge should still continue, it will
in most cases yield to the Compound Syrup of Bhubarb and  Potassa, and
the use of the above injections.
   When  dysentery is  owing to acrid  or irritating matters in the  bowels,
these should be first removed; for this purpose, the Compound Syrup of
Rhubarb  and Potassa may be given in table-spoonful doses, and repeated
every hour, until a free action on  the  bowels is  produced; or, a  powder
composed of half a grain of Podophyllin, two grains of Leptandrin, and two
grains of Sugar of Milk, may be administered every  three hours until free
catharsis is produced.   In connection with this, the local  applications, as
Mustard to the bowels, hot fomentations,  and injections, as named  above,
must likewise be used.   Mucilaginous  drinks  are always useful in dysen-
tery, not  only for the purpose  of  assuaging  thirst, but because of their
soothing effect upon the inflamed mucous  membrane ; an infusion  of Elm
bark, or Marshmallow root, may be  drank freely, and, after the bowels have
been  evacuated  by the medicine, an equal amount of the leaves of Rasp-
berry may be added to either infusion.
   When dysentery occurs as an epidemic, it will  frequently vary in manj
of its features.  In these cases,, the bowels should first be acted upon by
medicines, and the one found to be the  most efficacious, is the following:—
Take of Podophyllin  two  grains,  Leptandrin eight grains, Quinia eight
grains; mix.  Divide into  four powders., and  administer one every three
hours, or until a free operation is produced on the bowels.  However, should
there be great irritability of the system, connected with the disease, as will
frequently be the case when it exists as  an epidemic,  the Podophyllin must
be omitted, as it will be apt to aggravate the symptoms.  The local mea-
sures, recommended above, as fomentations, injections, &c, should  also be
employed.
  After the  operation of the above preparation,  in order to act upon the
liver, produce moisture of the surface,  restore tone to the  intestines, pre-
vent further discharges, and overcome the tendency to periodicity, the fol-
lowing may be given :—Take, of Sulphate of Quinia eight grains, Sulphate
of Morphia one grain,  Powdered Ipecacuanha two grains; mix, and divide
into eight powders, of which one  powder may be administered every two oi
three hours, gradually lengthening the intervals  between the  doses, until
three powders a day, only, are taken ;  and these should  be exhibited daily
for two or three days.   But should the dysenteric  discharges, tenesmus.
and griping pains return, the above cathartic  powders will have to be re-
peated, following them in the same manner as explained  heretofore.  Any
great amount of debility caused by  the  purgative,  may be readily overcome
by the use of Brandy sling, burnt  Brandy,  or  other grateful stimulant,
given frequently, and  in small quantity at a time.   In  the typhoid form, 
DYSENTERY.
291
 two grains of Carbonate of Ammonia, one grain of Sulphate of Quinia, and
 half a grain of Camphor, mixed  together for a dose, and repeated three or
 four times a day, will be found very useful as a stimulant and tonic.
   Large injections should never be used in dysentery, because they tend to
 counteract the end aimed at, viz: to relieve tenesmus, allay inflammation,
 and check the discharges; and they should  always  be given immediately
 after each evacuation  from the  bowels, and retained as long as possible.
 When the disease has continued  two or three days, a very excellent injec-
 tion for the above purpose is composed of a cold  infusion  of  Golden Seal
 one fluidounce, Laudanum ten to twenty drops.  Or, a  mixture of a solu-
 tion of the Inspissated Juice of  Poke berries  one fluidounce, Tincture of
 Prickly-Ash  berries one fluidrachm, may  be injected, and repeated as re-
 quired, especially in the typhoid form of the  disease.
   When the disease manifests a disposition to  be obstinate, the dysenteric
 discharges being constant and fetid, with or without tenesmus, inability to
 retain anything on the stomach, or if retained, followed shortly after by a
 desire to  stool, with much prostration,—in addition to the other treatment,
 the surface of the body and limbs should be  bathed with an alkaline wash,
 warm or cold to suit the nature of the case and the  patient's feelings, and
 which may be repeated  two  or  three  times  a day; and Mustard poultices
 may be applied alternately over the bowels, and whole length of the  spinal
 column.  If  the  tongue be  coated yellow,  or brown,  ripe fruits or their
 acid juices will  prove  very beneficial.  Nausea,  and excessive irritability
 of the  stomach, when  present, may be checked by an infusion of parched
 corn, or by an oatmeal  coffee, made  by forming  the  oatmeal  into  a cake
 with water, baking it, browning it similar to coffee, and then  making a
 strong infusion of it. It is likewise nourishing, and must be used without
 milk and sugar.   For  thirst and nausea,  pieces of ice  may be held in the
 mouth or swallowed.
   In dysentery from any cause, but  more especially when it is epidemic, I
 have met with much success by the use of the White Liquid Physic,  under
 the use of which  recoveries have  taken place where dissolution seemed in-
 evitable.  It may be safely and effectually  used at any stage of the disease.
 The following has been  recommended in dysentery, as an  excellent course
 of treatment: Take of Camphor mixture eight fluidounces, Nitric Acid one
 fluidrachm, Laudanum   two fluidrachms.   Mix.   The dose is half a tea-
 spoonful every three hours.  Bice-water  only is  to be taken as food, and
 the  pain  and tenesmus relieved by the  injection named  above.  I have
 sometimes cured dysentery, by the administration  of half a wineglass of the
 following mixture, repeated every four hours:—Take of very finely powdered
 Guaiacum  five drachms, Mucilage of  Gum Arabic, Simple  Syrup,  each,
 three fluidounces, water eight fluidounces.   Mix.
  The diet throughout the treatment must  be very light and simple, as in
 the previous intestinal inflammations, and great care should be taken during
 convalescence to  keep the bowels regular,  use mild, non-stimulating food,
 and to avoid all exposures which may cause  a return of the disease.  Some-
 times, worms in the intestinal canal cause so much irritation  as to induce
dysc-ntcry; they should  be removed by proper worm  medicines, and the
cases then treated as heretofore advised. 
292
AMERICAN FAMILY  PHYSICIAN.
                      CHRONIC  DYSENTEBY.

  Chronic Dysentery is sometimes the result of an acute attack ; it may
also  take place  from improper  diet, exposures, checked perspiration, &c.;
and it is at times met with as a complication of chronic enteritis, &c.
  Symptoms.   The bowels are quite irritable with more or less  looseness,
the evacuations are unhealthy, the discharges amounting to from three to
forty  a  day, are  streaked  more or less with  blood, and attended with a
bearing-down  sensation  or tenesmus.  . The  skin  is dry and parched, the
countenance pallid,  or sallow,  and usually  a bloating of  the  face ; the
tongue  is slightly furred;  the  appetite capricious or lost;  the  pulse fre-
quent and weak, sometimes wiry; the patient is very much debilitated and
emaciated, and is often attacked with dropsy.   The discharges may be light-
colored  and alternate with constipation ; or they may be small, consisting
of blood-stained  mucus; again, they may occur with evacuations of fecal
matter,  &c; but, however they may appear, they are always more  or less
fetid.   The disease  if not relieved, ultimately destroys the constitution,
and the patient finally sinks.
  Treatment.  The treatment which I have  found best  adapted  to this
disease,  is similar to  that recommended  for the cure of Chronic Inflamma-
tion of the Bowels, which see on page 287.   Using at the same time injec-
tions with some opiate to relieve the  bearing-down  sensations,  the same as
in acute dysentery.
  Among the astringent preparations which have been  found efficacious in
chronic  dysentery, are the following, which may be used in connection with
the other treatment,  when the discharges continue of an obstinate and un-
yielding character :—
  1.  Take of Bhubarb four ounces, Black Cohosh root,  Wild Cherry bark,
Geranium, each, two ounces ; coarsely  powder them, and  mix.  Pour on
the articles two pints of good French Brandy and two pints of water; let
the mixture stand for five or six days, frequently agitating it, then  strain;
add four pints  of water to the dregs, boil slowly to two pints, strain, add to
the  strained liquor  the previous tincture,  and sweeten with  loaf sugar.
The dose is a table-spoonful every one, two, or three hours.
  2.  Take  of  Beth  root,  Geranium,  Blackberry root,  Wild Cherry bark,
Cinnamon, each, in powder, one ounce, good  Brandy one pint  and  a  half,
water one pint and a half.  Mix, and let the articles stand for several  days,
frequently agitating, when it  will be  fit for  use ;  it may be sweetened if
desired.  The  dose is one or two teaspoonfuls every two or three hours.
  3.  Take  of  Baspberry  leaves, Geranium,  Blackberry root,  Leptandra
root, each, equal  parts; mix, and make three  pints of strong decoction.
The dose is a table-spoonful every hour.
  Among the other astringents  which have  been  found valuable in this
disease,  may be named Marsh Bosemary, or Statice Caroliniaha, Rockbrake
or Pteris Atropurpurea, Mouse-eared Chickweed or  Cerastrium  Vulgo'-Mh
and Alum root or Heuchera Americana.
  The injections  which  should be used, may be composed of decoctions of
one or more of the following articles,—Golden Seal, Solomon's Seal, Gera-
nium, to which the  Tincture of  Prickly-Ash  berries may be  added, as in
the preceding cases.   When the discharges show evidence of ulceration, a
solution of Nitrate of Silver, in the proportion  of from ten to thirty grains
of the nitrate to a fluidounce of  water, should be injected into the rectum,
and  carried up  as  high as possible  into the  bowels by means of a long
tube. 
INFLAMMATION OF THE  LIVER.
293
  The  diet  is of great importance ; it should be  nutritious and easy of
digestion, taken in moderate quantities, eaten slowly, and thoroughly mas-
ticated before allowing it to pass into the stomach.  Aery moderate exer-
cise is allowable in some cases; but usually a state of quiet will be found
of much more advantage toward facilitating a cure.
      INFLAMMATION  OF  THE  LIVER,  or  HEPATITIS.

   Inflammation of the Liver, or Acute  Hepatitis may be confined to th
 peritoneal covering of the liver, to the  substance of the liver, or a part of
 it, or, it may involve the whole of these.   The inflammation has  been di-
 vided into two forms, acute, and chronic.
   In diseases of the liver there is a great amount  of ignorance displayed
 both by professional men and their patients, who not only attribute nearly
 every form of disease to an abnormal condition  of  this organ, but are im-
 pressed with the mistaken idea, that Blue  Pill or Calomel only are  the true
 remedies for its cure.  The consequences of such  views have  been truly
 lamentable ;  for it is rarely that a patient thus treated has escaped without
 some permanent and harassing affliction.  No  preparation of mercury is
 required in the treatment of diseases of the liver.
   Svml'toms.   Acute inflammation of the liver commences with symptoms
 peculiar to other inflammatory attacks of  the abdominal organs, as a sense
 of chilliness, followed by more or less general febrile excitement.   These
 are soon succeeded by pain in the right  side  in the region of the liver,
 which varies  in intensity, being  more acute and lancinating  when the
 peritoneal covering of the organ is affected, and  much  duller  when the
 inflammation is confined to the substance  of the  liver.  The pain may be
 fixed  and seated, or  it may shoot upward,  extending to  the  breast, the
 collar-bone, and the  right shoulder; it is also much aggravated on making
 pressure  upon the  affected part, during  inspiration, or cough, and also
 when the patient lies upon his left  side.   The breathing is hurried, and
 more or less impeded, and  a dry, short, frequent cough is usually present.
 When the stomach is implicated, obstinate nausea, and vomiting of bilious
 matter takes  place;  hiccough genorally occurs during the  course of the
 disease.   The pulse  is strong, hard, and frequent, sometimes intermitting;
 occasionally it is weak and small from the commencement.   The tongue is
 coated with a yellowish,  dark-brown, or  even black substance, and will
 sometimes have its tip and edges very red, especially when  the  stomach is
 implicated; and there  is  frequently an  unpleasant, bitter  taste  in the
 mouth.  The  bowels are almost always costive, but sometimes, and espe-
 cially in warm climates, there  will be  a  diarrhea, with griping and  bilious
 or slimy discharges.   The urine is scanty, and of a deep saffron color; the
 skin is hot and dry, and frequently the  eyes and  the skin  become tinged
 of a deep yellow.  Loss of appetite, great thirst, great depression of the
 mind, restlessness, and  wakefulness,  arc  usually present,  and sometimes
 delirium.   Generally, several of the symptoms just described, are present,
 varying,  according to circumstances, in  their degree of  severity.   Some-
 times, the symptoms  are so trifling as hardly to attract the patient's notice,
 as abscesses, probably the result of previous inflammation, have been found
 upon  dissection, in the liver, and which occasioned no inconvenience during
the person's life-time.
  Inflammation of the liver usually terminates in resolution, which is often
announced by a bleeding from the lio^e, by  profuse  perspiration, by more
!* 
294
AMERICAN FAMILY  PHYSICIAN.
or less copious  discharge  of mucus from the lungs, by bilious discharges
from the bowels, or by an  abundant flow of deep-colored urine giving a
red, or whitish  deposit  on  standing.   It  may also terminate  in  suppura-
tion, or the formation of an  abscess which is the more unfavorable as it is
more deeply situated in  the  substance of the liver,  and the favorable char-
acter of which likewise depends upon the direction in which the abscess is
discharged ;  thus, if the matter is evacuated into the  respiratory passages
or into  the bowels, the  case is much more serious, than when the abscess
is seated on the external surface of the  liver, which may be known  by the
presence of swelling, giving a  sense of  fluctuation  to the touch, and which
is located on the right side,  immediately below the ribs :  and  in  this ease,
the  matter may be discharged externally by making an  incision into the
swelling, thus saving the patient in most cases.
  When an abscess is formed, the pain ceases, and the patient experiences a
sense of weight, with throbbing, the first of which is aggravated by lying on
the  left side; there will also be frequent shiverings, and  ultimately symp-
toms of hectic fever.  Adhesions not unfrequently take  place between the
liver and the  neighboring organs.   Sometimes acute hepatitis terminates in
enlargement  and induration of  the liver; and very  rarely, in  gangrene,
When the febrile symptoms gradually abate, the pulse  lessening in rapidity,
the system becoming more  calm, the complexion more  natural,  the extremi-
ties  being  warm, with  a  gentle perspiration  on the  body,  and a gradual
return  of the appetite, the prognosis is favorable.   But it is  unfavorable,
when the pain is intense  and  obstinate, the  pulse  continuing full and fre-
quent with dryness of the skin,  thirst, and costiveness;  and still more so,
when the extremities become  cold,  the  patient very restless, the  pulse fre-
quent, and the urine very deficient.
  Causes.   Acute hepatitis  may be occasioned  by numerous circumstances,
Cold is the most common cause, in whatever  manner it may be contracted;
it may also result from injuries to, or blows over, the organ, high  living, in-
temperance, violent mental  passions, suppression  of  habitual discharges,
violent exercise, intense  summer heat, and other causes which are capable
of producing  inflammation.  In  miasmatic countries it  is always more  or
less complicated  with the influences  peculiar to such places,  and  known as
"malarial.'1   Adults are more liable  to the disease than children.
  Discrimination.  Acute hepatitis may be determined from pleurisy, by
the yellow appearance of the skin in the former;  by the breathing being
effected in hepatitis, chiefly by the muscles of  the chest—and in pleurisy, by
those of the abdomen.  In pleurisy  a greater degree of pain follows a full
inspiration, and  the accompanying cough is more violent and harassing.  It
may be determined from inflammation of the lungs by the breathing being
effected with greater difficulty  in the latter, as  well as by the presence  of
more frequent and severe cough.   In both pleurisy and pneumonia, the skin
is more natural, with a redness  of the cheek not present in hepatitis, and the
breathing is  effected chiefly  by the  muscles of  the  abdomen; pressure over
the region of the liver produces no pain in these two diseases,  but is always
a constant  symptom of hepatitis.   Bloody expectoration  is not present in
hepatitis, unless complicated  with one of the above maladies.
  Hepatitis may be known from inflammation of the stomach, by the burning
sensation  accompanying the  pain in the  latter, as well as by the small, tense
pulse, the  great prostration, and the immediate vomiting of warm fluids
when swallowed; in hepatitis, the pulse is full and strong, the prostration tf
not so excessive, and warm fluids are retained upon  the stomach.   In sj9«sW
of the gall duct,  the skin is almost natural, and the pain intermits; in hepa- 
INFLAMMATION  OF  THE  LIVER.
295
 litis the skin  is considerably above the natural  temperature of the  body, is
 quite dry, and the pain is constant.
   Treatment.  In all  cases, at the commencement of the disease, and if
 the strength and condition of the patient will  allow, the  Spirit vapor bath
 should be used, causing  the patient to perspire freely; after which it should
 be kept  up four or five  hours by  means of  coverlets, warm drinks, &c.
 This will always afford prompt relief, and in mild cases will subdue the in-
 flammation at once.  But if the attack be violent, and the  pain, though
 relieved  by the  perspiration, still continues with some severity,  an emetic
 should be administered  soon after the vapor bath has been taken, and while
 the patient is  perspiring;  either the Compound Powder of Lobelia, or, the
 Compound Acetated Tincture of Bloodroot, will  be found  valuable  for this
 purpose,  and whichever is  used, must be administered until free vomiting is
 produced.  In about an  hour or two after the vomiting, it will  be proper to
 give  a cathartic,  for  the  purpose of removing  any accumulations in  the
 bowels, as well as  to relieve the  congested condition of the liver.   A full
 dose of the Compound Powder of Jalap may now be  exhibited, or, the com-
 bination  of Podophyllin and Leptandrin, one grain of the former to two
 grains of the latter, may be given as a dose, and repeated every two or three
 hours until free evacuations  are produced.
   To relieve the pain and  distress in  the side, as well as to aid  in subduing
 ihe inflammation, Mustard poultices should  be applied over the seat of the
 disease, and along the whole course of the spinal column, and  be allowed to
 remain until considerable redness is produced.   After removing the poultice
 from the  region of the  liver, fomentations  of Hops and Boneset, or, Hops
 and Wormwood, or, Stramonium leaves, should  be applied as hot as can be
 borne, renewing them every twenty or thirty minutes,  or  according to the
 violence of the pain  and inflammation.   And this course may be repeated
 on the next day, should the disease prove obstinate, and violent pain and
 inflammation still continue, or, daily, as long as  the acute symptoms  remain.
   After  the perspiration caused by the Spirit vapor bath  has considerably
 diminished, it will be requisite to maintain a gentle moisture. of the  surface
 While the inflammation lasts;  to effect which, the body and  limbs should be
 bathed with a warm, weak alkaline  solution, and rubbed" off dry  with a
 ','oarse towel, and this should be repeated whenever the inflammatory symp-
 toms  increase, or when the skin becomes hot with a tendency to dryness.
 In additions this, hot bricks, or bottles of  hot water, should be kept to the
 feet; and either of the following  powders may be administered internally
 for the purpose of keeping up moderate perspiration:
   1. Take of  Pleurisy root, Boneset, each, in  powder, four ounces;  Blood-
 root,  Nitre, each, three  drachms;  mix.  The dose  is from ten  to fifteen
 grains, every three hours.
   2. Take of  Pleurisy root, Bloodroot, Ipecacuanha, Nitre, each, in powder,
 one drachm; mix.  The  dose is  the same as  the preceding.
   3. Take of Leptandrin two drachms, Ipecacuanha,  Camphor, Nitre, each,
 half a drachm; mix.  The dose is from three to six grains every hour or
 two.  Either of these diaphoretic powders may be given  in some warm in-
 fusion of  Balm, Catnip, Spearmint, <fcc, or in some acidulated syrup.
   In cases where the inflammation runs high, with scanty and  high-colored
 urine, diuretics will be found  very useful, as  an infusion of Hair-cap Moss,
 or, of Cleavers, or, of Marshmallow root, &c.
   The  disease  will frequently be so mild, that nauseants, aperients, diapho-
retics, and rubefacients,  will  effect a cure  without the use of emetics and
active cathartics.  Opiates are not proper in acute hepatitis, as they cheek 
296
AMERICAN  FAMILY   THYSICIAN.
the secretions of the liver, and aggravate  the congested state  of its vessels;
In cases connected with malarial influences, some one of the agents in which
Sulphate of Quinia enters, named under Intermittent Fever, should be ad-
ministered.   And  toward  the  termination  of the disease, should there be
any great debility, or other unpleasant symptoms, treat the  same as men-
tioned in previous diseases, by  tonics,  stimulants,  &c,  according to the
circumstances.
  The diet should consist of rice-water, gruel, toast-water, &c; and durin°
convalescence, which  is generally slow, the nourishment  may be gradually
increased, exhibiting  mild tonics when indicated.  Should an abscess form
the patient  must be  supported by generous  measures, as wine, ale, porter,
oysters, soft-boiled eggs, &c.  Two ounces  of Bed Peruvian  bark, and one
ounce of Chamomile Flowers, may be placed in a quart of good Port wine,
and after it has stood  for three or four days, it may be  administered to the
patient in doses of half a wineglassful, or more, repeated three or four times
a day, and will be found a valuable tonic.
             CHBONIC DISEASE  OF  THE  LIVEB.

  Chronic Disease  of the  Liver, or  Chronic Hepatitis, is one of the most
common  forms of chronic  disease with  which we meet, especially in warm
and temperate climates.  In some sections of country it is looked upon as
an incurable  affection, but  I am satisfied from my  own  experience in its
treatment, that it is absolutely under the control of proper  remedial agents,
and can be permanently and effectually cured.
  Symptoms.   The symptoms of chronic disease of the liver are numerous,
and vary very much  in different individuals, according to the extent and
character of the disease, and its complications.   Among the symptoms more
commonly met with are the  following:  a  dull pain in the  right side, which
frequently  extends even  to the shoulder blades, and pit  of the stomach;
more or less tenderness on pressure over the region of the liver, and not un-
frequently an enlargement of this organ;  at times a sense of uneasiness and
tightness in  the  neighborhood of the stomach and liver; dry, harsh, and
sallow skin; yellowness of the  eyes; bowels irregular, generally disposed to
looseness; irregular  appetite; a slight hacking  or dry cough; shortness  of
breathing,  and sometimes  asthmatic symptoms;  feet and  hands generally
cold;  tongue coated white, but frequently brown  or yellow toward  its root;
at times a bitter and  disagreeable taste  is experienced; the urine varies in
character, being scanty or copious, but generally of a high color, and often
unnaturally hot, or scalding, and  depositing a sediment on standing; and
piles.   There  is  more  or less depression of spirits, despondency, or capri-
ciousness, irritability  of temper, and peevishness.
  It is often the case  that the skin may present an unnatural greasy appear-
ance ; or, yellowish and scaly, or branny eruptions, or pimples and  blotches,
will be developed on the face and neck;  and sometimes there will be  a trou-
blesome itching of the skin.   Dyspeptic symptoms are most commonly pres-
ent, as impaired or capricious appetite ; flatulency  ; acidity  of stomach, and
acid eructations;  heartburn  ; fulness  and distress at the stomach; palpitation
of the heart; disturbed sleep; nightmare ;  disinclination to mental or bo lily
exertion; and, indeed, a host of symptoms to which the term "nervous" has
been applied.  In nearly every case of chronic hepatitis, several of the above
symptoms may be found existing together, but varying according to  the pe-
culiarity  of the case.   When the disease  has been  of long continuance, there 
CHRONIC LIVER COMPLAINT.
297
 will be an increase in the violence of the ordinary symptoms, with great ema-
 ciation, night-sweats, and a prostrating diarrhea.  The disease may terminate
 in chronic enlargement and  induration  of the liver; atrophy of  the liver J
 tuberculated liver; dropsy of the abdomen, or general dropsy; hemorrhages
 from the stomach or  bowels, &c.
   Causes.  Chronic disease of the liver may be the result of the acute form,
 but more generally it arises from  other causes; as  repeated attacks of cold;
 sedentary and inactive habits; irritations produced in the neighborhood of
 the organ; improper diet; drastic cathartics; intemperate use of intoxicating
 liquors; excesses of  all kinds;  use of  mercury as a medicine; and deficient
 amount of sleep.  In hot countries the long-continued influence of malaria,
 is an important agent in developing the disease.
   Prognosis.  Chronic Hepatitis is a disease which, when treated in season,
 can always be cured  by  proper means, but as with all other chronic affections,
 it cannot be cured rapidly—it requires time.   And  it  should  be borne in
 mind by every patient, that in the treatment of chronic diseases, perseverance
 is absolutely necessary,  because, it is rarely, indeed, that quick cures are made
 by the  most skilful  physicians.   The fact that  acute  maladies run their
 course rapidly and must be promptly checked lest they prove fatal, has been
 a great stumbling-block in the way of both physicians and patients  in  the
 treatment of chronic affections; and more injury has  been effected, and more
 disease fastened permanently upon invalids by  endeavors to make immediate
 cures of this class of diseases, than by almost anything else.   Time and pa-
 tience, together with proper remedies, are always required in the  medication
 of chronic diseases.
   Treatment.   It is usually the case that physicians commence the treat-
 ment of this disease by the administration  of an emetic, followed by an active
 purgative.   This I never do, unless the liver is very  torpid,  or when there
 are symptoms  of decided inflammation present.   Then  I prefer the Com-
 pound Powder of Lobelia as the emetic, and either  the  Compound Pills of
 Podophyllin, the Compound Pills of Leptandrin, or the Compound Powder
 of Leptandrin, as the cholagogue cathartic.   Ordinarily,  however, the follow-
 ing course of  treatment will be  found effectual:—Keep the bowels regular
 every day, so that one and not more than  two  evacuations will be produced,
 approaching as nearly as possible in character and consistence to the healthy
 discharges.   And this may be accomplished by the administration of one of
 the above-named  compounds of  Podophyllin and Leptandrin, in just suffi-
 cient quantity every night to produce the desired result.   Should  there be
 acidity of the stomach,  this must always  be removed, by the  use of small
 quantities of Saleratus, or Carbonate of Soda, or by Magnesia; and in many
 instances, prepared Charcoal in teaspoonful doses, repeated three times a day,
 will be found very efficient.
   During the  day, alteratives must be used, and as there are many very val-
 uable ones, I will name several of them, any one of which may be taken with
 benefit:—
   1. Take of the Compound Syrup of Stillingia one pint,  Tincture of Black
 Cohosh two fluidounces,  Iodide  of Potassium four drachms; mix.  The dose
 is a teaspoonful three times a day in a wineglassful of water.
   2. Take of  the Compound Syrup of Sarsaparilla eight fluidounces, Tinct-
 ure of Bloodroot two  fluidounces, Tincture  of Sheep Laurel leaves one fluid-
 ounce ; mix.  Dose same as the above.
  3. Take of the Tincture of Black Cohosh, Tincture of  the Bark of  Bitter-
sweet root, each two fluidounces, Tincture of Bloodroot one fluidounce, Tinct-
ure of  Sheep Laurel  leaves half a fluidounce ; mix.   The dose is from ten to
thirty drops three times a day in a little sweetened water. 
298
AMERICAN FAMILY PIIYSiCIAN.
  In addition to these measures, it will frequently become necessary to make
use of diuretics to render the urine free, and remove its  high color and un-
natural heat, and  for this purpose, an infusion of two parts of Marshmallow
roots, and one of  Spearmint leaves, may be drank freely.   Other diuretics
however, may be used, principally those of a stimulating character, as Queen
of the  Meadow root, Wild Carrot, Wintergreen, &c.   The Compound Tinct-
ure of Tamarac has been used by many physicians in liver complaints, as a
tonic,  alterative, laxative, and diuretic, and has in several instances effected
cures ; the only associated measures being attention  to the skin, the diet, and
exercise.
  The skin must likewise be kept in a healthy condition, to effect which, the
body and limbs should be bathed every day or  two with  a  warm, weak ley
water,  and in drying, a coarse  towel should be used with considerable fric-
tion ; a Spirit vapor bath should also be  taken  every week or two.   This
course  will soften the skin,  regulate its  action, and eventually produce  a
healthy condition  of it.  These measures must by no means  be omitted, as
there is an intimate sympathy between the skin and the liver.
  When symptoms of dyspepsia are present, they must  be managed accord-
ing to  the plan advised under the treatment of dyspepsia.
  In obstinate and unyielding cases, the Compound Tar plaster placed overthfl
region of the liver, and used intermittingly  will be found very serviceable;
but this painful measure should not be adopted until we are  positively satis-
fied  that the ordinary means afford but little or no benefit.
  When the liver  is enlarged as a consequence of long-continued intermit-
tents, the following preparation  will  prove very useful, in conjunction with
the  above cholagogue agents:—Take of Muriate of  Ammonia two drachms,
distilled or rain water one fluidounce; dissolve the  Ammonia, and then add
of Tincture of Poison Hemlock  five drachms ; of this, from half a teaspoon-
ful to a teaspoonful may be  taken three  times  a day.   The  parts over the
region of the liver may likewise be bathed two or three times a day, with  the
same.
  The diet of the  patient  must be nourishing but easy of digestion, avoiding
tea, coffee, milk, alcoholic stimulants, acids,  and all fats—the food should be
taken in moderate quantities at a time, and  always be thoroughly  masticated
before  swallowing  it.   I have named  milk as an injurious article, and it will
be found  so, among by far the greater number of  cases ; yet, when it does
not disagree, it may be used.  Acids are likewise  objected to from a similar
cause,  but often ripe fruits,  and  dried fruits stewed will be found serviceable;
these points must  be determined by actual  trial.   Moderate  exercise, regu-
larly taken in  the open air, should always be had when the weather will
permit; otherwise, it must  be pursued within doors.   Cold, damp, sudden
exposures and malarial influences are important causes of relapse, to be care-
fully avoided as much as possible.  Pure water is the best drink for the pa-
tient, or water very slightly acidulated with Nitro-Muriatic acid.
  For  certain conditions associated  with chronic disease of the liver,  see
Jaundice and Gall Stones.
               INFLAMMATION  OF  THE  SPLEEN.
  Acute inflammation of  the  Spleen, or Splenitis may attack the peritoneal
covering of the spleen, the proper structure of the organ, or, both of these
together.   It is a disease not met with very frequently, and is often associa-
ted with some febrile complaint. 
CHRONIC  DISEASE  OF  THE  SPLEEN.
299
  Symptoms.  The disease is  generally ushered in with chills,  which are
soon followed by heat, thirst, and other febrile symptoms.   Pain in tho left
side, in the region of the spleen, is a prominent symptom, with much tender-
ness on pressure ; when the pain is dull and obtuse, the proper structure of
the spleen is affected; and when it is severe and cutting, with high inflam-
matory symptoms, the peritoneal covering of the organ is  more particularly
involved.  The pain frequently extends through the whole abdominal region,
or shoots through the diaphragm, and into the left shoulder._   A dry cough
is sometimes present, which aggravates the pain; a deep inspiration,  or lying
upon the affected side, will also be found to increase the pain, as well as when
any attempt is made to turn over.   In some instances the affected side be-
comes greatly enlarged.   The skin is hot, dry, and harsh; the  tongue coated
white, or when the liver is involved, as, is frequently the case, it is yellow or
dark; the pulse is  much  accelerated; the various functions of the body are
more or less deranged ; nausea and vomiting are frequently present, the mat-
ters ejected being sometimes a green bilious substance, at others a dark, clot-
ted blood.   The bowels are usually constipated, but occasionally a diarrhea
comes  on, the discharges being  colored by black blood.   Urine scanty,
voided with difficulty, and high-colored.   Sometimes there is lassitude, loss of
strength, wakefulness and even delirium; at other times there will be faint-
ings, and bleeding from the nose.    Acute Splenitis  may terminate in reso-
lution, enlargement of the organ, or suppuration.
   Causes.  External violence, suppression of habitual discharges, depres-
sing emotions, violent muscular efforts, and the same causes that originate
other inflammatory affections may occasion  splenitis.  But in this country,
it is so almost universally associated with  malarial fevers,  that it is gener-
ally believed to be, in a great measure, owing to  the same  influences  that
develop these fevers.  Inflammation of the spleen seldom  proves immedi-
ately fatal.
  Treatment.  This will be similar   to that  recommended  under Acute
Hepatitis, using the  Spirit vapor  bath,  emetic, and cathartic, in the man-
ner described;  applying the sinapisms and hot fomentations over the left
side, and attending to the surface by bathings, &c.  And in all cases, it
will be proper to use Sulphate of Quinia in some one of the  forms named
under  Intermittent  Fever, which will be  found  to exert a prompt and
marked influence on  the disease; and the best period for the administration
of this anti-periodic  is, when  there is a remission,  or intermission.  Diet,
and other measures, to be the same as in Acute Inflammation of the Liver.
            CHBONIC  DISEASE  OF  THE  SPLEEN.
  CnRONic Disease of the Spleen, or Chronic  Splenitis, is a very common
affection in miasmatic districts,  and is a difficult disease to cure,  nearly, if
not quite as much so as  tubercular consumption,  more especially when the
organ has become  enlarged to any considerable extent.  It is  not usually
immediately fatal,  but continues for a number of  years, constantly harass-
ing the patient, and ultimately terminating in dropsy; occasionally, instan-
ces are met with in which a simple enlargement of the spleen has continued
for years without any great inconvenience  to the patient.
  Symptoms. ^ The symptoms  of Chronic Splenitis are  frequentiy very
obscure, especially at its commencement.   More  commonly a  sensation of
uneasiness, weight, or tension in the left side is complained of, or perhaps
a pain; and sometimes no pain or soreness is experienced until pressure ia 
300
AMERICAN FAMILY  PHYSICIAN.
made over the affected organ.   Obstinate constipation, a blue  tinge of the
white  of the  eyes,  and  occasional chilly  sensations, are most generally
present.  As the organ enlarges,  it can be detected  by passing  the hand
over the  left side with some degree  of pressure, and the  name of " ague
cake" has been given to it, which enlargement may be so great as to occupy
all the front part of the abdomen; and as it increases, a variety of symptoms
are developed, among which are debility of the lower limbs, with coldness
and numbness, difficulty in breathing, palpitation of the heart, emaciation,
periodical pains and difficulties, periodic pain of the head, inability to take
much exercise, nightmare, ejection of food  from  the  stomach,  piles, irreg-
ular action of the kidneys, a sense of  tightness or  constriction around the
chest, variable appetite,  dry skin,  irregular  pulse,  scanty urine,  tongue
coated white,  sometimes  red,  more or  less despondency, and frequently
thoughts of suicide, which are  sometimes  acted  upon, partial impotency,
dropsical affections, and in females, painful  menstruation and sterility.   All
these symptoms will not be developed in any one  case, but several of them
will almost invariably be met with.  In the advanced stages of the disease,
the patient becomes greatly  emaciated and much  debilitated,  the counte-
nance grows darker,  the  appetite  fails, and  the  disease will  terminate in
hectic fever, diarrhea, vomitings of blood,  dropsy, or abscess.
   In the early stage of this  disease,  patients are  sometimes  periodically
attacked with uneasy sensations, prostration of strength,  inability to exer-
cise of any kind, constipation, &c, for which they call in  the aid of a phy-
sician, but as they usually present no very unhealthy appearance, nor any
alarming symptoms, are able to eat with an  appetite most of the time, are
suddenly revived by excitement, &c, they unfortunately receive no sympa-
thy from those around them, who look  upon  them  as "spleeny," or, as
"lazy, good for  nothing fellows,"  or, as "being touched with hypo."
   Causes.   Chronic Disease of the Spleen may be occasioned  by the same
causes that give  rise to  chronic liver  affections; but it more generally
results from repeated attacks,  or the long-continued action of malarial
fevers, as intermittents, remittents, &c.
   Treatment.   As  with other chronic affections,  no rapid  cure can be
made in this ;  patience  and perseverance are  especially required in its
treatment,  together with a rigid  attention  to the rules  of hygiene.  The
medicinal  course  laid  down for the  treatment  of Chronic Disease of the
Liver, may be pursued  in this, and  will  be found  beneficial.  When the
spleen is extremely enlarged, currents of electro-magnetism passed through
it, once  or  twice a day, and persisted  in for a long time, in addition to the
 other remedial measures, will be  found very useful;  in some  instances, the
 Compound Tar Plaster, applied over the region of the  enlarged organ, will
 prove an important measure in the treatment.  The discharge produced by
 it  should be kept up intermittingly, until the affection is subdued.
    One drachm  of common Salt taken for a dose, and repeated three times
 a day, for  a long time, has effected cures in some cases of chronic splenitis.
 The  Bromide* of  Potassium, in  doses of  three  grains, repeated  thrice
 daily, gradually increasing the dose,  has been highly spoken of as a rem-
 edy.  The inner bark  of the White  Ash,  (Fraxinus acuminata) boiled in
 White Wine, and used in wineglassful doses, three or four times a day, has
 likewise been very highly recommended in " ague cake."
    The obstinate constipation common to chronic affections  of the spleen,
 should  never be  treated  by cathartics.  When  active cathartics are used,
 they usually leave the patient more obstinately costive than before, requir-
 ing, in  most cases,  larger  doses of purgatives to produce  an action.  If 
INFLAMMATION  OF THE KIDNEYS.
301
the means named under Liver Complaint will not keep up a regular condi-
tion of the bowels  daily,  the following may be used:   Take of Podophyl-
lin four grains,  Sulphate of Quinia  eight grains, Alcoholic Extract  of
Nux Vomica two grains;  mix the articles thoroughly together, and divide
into  sixteen powders;  or,  they may  be made into a  pill mass,  by the
addition of a sufficient  quantity of the Alcoholic Extract of Black Cohosh,
and divided  into sixteen pills.   The dose is one, two, or three of these pills,
or powders,  according to   their influence, to be taken  at  bedtime.    The
Compound Tincture of  Tamarac has been used with advantage in this dis-
ease, as a  tonic, laxative, alterative, and diuretic.
   When the countenance  of the patient is pale  and sallow, much benefit
will be derived from  the Tincture  of the Muriate  of Iron, which may be
given in doses of  ten drops in a wineglassful of water, and repeated  three
or four times a day.   Dropsical affections will require a similar treatment
to that named under the several varieties of dropsy.
INFLAMMATION  OF  THE  KIDNEYS.
   Acute Inflammation  of  the Kidneys,  or
 Acute Nephritis, may be located in the struc-
 ture of the kidney, or  in  its lining mem-
 brane, but more commonly both  are impli-
 cated.   One  kidney may be affected, while
 the other remains healthy; and from sympa-
 thy, the bladder, testicles, and other parts  of
 the urinary organs may become affected.
   Symptoms.   The  disease is  usually  pre-
 ceded by chilly sensations and febrile synjjp-
 tonis,  as  in  other inflammatory  attacks;
 these  are followed  by  a  deep-seated  pain
 about the loins, in the region of the kidney
 affected,  which  pain is  aggravated  by  firm
 pressure,  by jolts,  and by  moving about.
 The pain frequently shoots downward to the
 groin, with a numbness of the thigh of the
 affected side, with pain and a drawing up  of
 the testicle  of tho  same side.  The pain  is
 diminished by curving the body forwards ; it
 is  sometimes  obtuse or dull,  but more  com-
 monly it is acute, pungent, and darting down-
 ward.   There  is  a frequent desire  to  pass
 urine, and the effort is attended with much
 pain and  difficulty.  The skin is  hot  and
 dry;  the  pulse  hard  and  frequent;  the
 tongue furred  yellow;  more or less  nausea,
 and often vomiting of bilious matter; the
 bowels constipated; and the patient lies with
 the most  ease on the  affected side.   When
 both kidneys  are affected,  there may be a
 suppression  of urine, with stupor  or coma-
 tose symptoms, terminating rapidly in death.
  The  condition of the urine varies in dif-
ferent cases of inflammation of the kidneys,
Fig. ir.

  a. Torula Cerevisiae, found in urine
after it has undergone saccharine fer-
mentation, b. Tesselated epithelium
from the pelvis of the kidney.
          Fig. 18.
  a. Mucus found in urine; b. Mucua
acted on by acetic acid; c. Oil Glob-
ules 
302
AMERICAN  FAMILY  PHYSICIAN.
Fig. 19.
  a. Coagulated Albumen; b. Vibri-
ones found in the urine of debili-
tated persons.

and by violent exercise.   It
being  almost  always  of an acrid,  irritating character.  Sometimes  on
standing, it will deposit  mucus,  and which may be known  by being solu-
ble in  liquor potassa, and forming an opaque, corrugated membrane when
acetic  acid is added to it.  (See Fig. 18.)   At other times, and especially
                              when  the structure  of the kidney  itself is
                              affected,  there will  be a deposit of albumen,
                              which may be known  by  its  coagulating
                              when  heated,  and also when nitric  acid is
                              added to it.   (See Fig. 19.)   As to the con-
                              ditions of the urine  in gravel and other dis-
                              eases  which may cause inflammation  of the
                              kidneys, they  will  be  referred  to  in their
                              proper places.
                                Acute nephritis  runs  its course rapidly,
                              and may terminate  in resolution, suppura-
                              tion,  occasionally in induration, and rarely
                              in  gangrene.
                                Causes.   Acute  inflammation  may  be
                              induced  by  cold, mechanical injuries, intem-
                              perance,  strains of the back,  irritating diu-
                              retics, as Oil of Turpentine, Cantharides, &e.,
                              may also be produced by the  presence of
gravelly concretions,  translation of  gout,  rheumatism, recession  of cuta-
neous  eruptions,  and  sometimes  it is  the result  of badly treated acute
diseases.
  Prognosis.  When there is a gradual subsidence  of all the symptoms, the
health being slowly  recovered,  the   disease  will  terminate favorably,  in
                             resolution.    When   the  febrile  symptoms
                              together  with  the pain  and tension gradu-
                              ally cease, and there is  a profuse discharge
                              of high-colored urine containing  consider-
                              able mucus, or a general  copious sweat,  or
                              bleeding from  the rectum,- the   prognosis is
                              favorable.   If the disease is protracted be-
                              yond  the seventh day, and an obtuse, throb-
                              bing pain in the part is  experienced, with
                              frequent  returns of chilliness  and  shiver-
                              ings,  it is about terminating in  suppuration.
                              When the abscess opens  into the  pelvis of
                              the kidney,  the pus  or matter is discharged
                              with the  urine, and may end in  health, or in
                              hectic fever  and death.  (See Fig.  20.)
                              Sometimes  it opens  externally,  and at other
                              times  into the  colon, abdominal cavity, &c,
                              most generally  terminating fatally.
  Pus  may be known by being readily diffused through  the urine by agita-
tion ;  while mucus forms irregular, tenacious, ropy masses; a  few drops of
liquor  potassa,  added  to pus  converts  it  into  a viscid, gelatinous mass;
acetic acid added to a deposit of  pus, renders the pus globules more trans-
parent, with one or more internal nuclei.
  Discrimination.   Acute  Nephritis may be detected  from colic, by the
deep-seated character of the  pain, which is increased on firm  pressure^by
the frequent and scanty discharge of a deep red-colored urine,  all of which
are absent in colic, in which the pain is located more anteriorly, about the
20.
  a. Pus globules in urine, 400 diame
ters ; b. Pus globules acted on by ace
tic acid. 
INFLAMMATION  OF  THE  KIDNEYS.
303
 umbilicus, and is  relieved by  pressure.  It may  be determined from  an
 attack of gravel, by the paroxysms  of acute spasmodic pain, bloody urine,
 and the want  of febrile  symptoms  in the latter difficulty.  In  Lumbago,
 with which it may also be confounded, the pain is more superficial, and is
 aggravated on muscular motion in the loins, as in attempting to rise from
 the sitting posture, beside, there is no  pain in the scrotum, no  retraction
 of the testicle, no diminution  of  the  urine,   nor pain  in  passing  it,  no
 numbness of the thigh, and seldom any great degree of fever.
   Treatment.  From the rapidity with which acute inflammation of the
 kidneys runs its course, it is all-important to institute a proper treatment at
 as  early a period  as  possible;  and the course  to be  pursued, will depend
 entirely on the cause  of the attack.
   When it has been  caused  by cold, or exposure,  it will be  proper  to
 produce perspiration as soon as possible, either  by the Spirit vapor bath, or
 by the administration of the  Compound Tincture of Virginia Snakeroot,
 which may be given  in  teaspoonful  doses,  and repeated  every  half-hour
 until copious  perspiration takes place.   The perspiration  should  be kept
 up for three or four hours, and afterward the same  tincture administered
 every hour  or  two in small  doses,  sufficient to allay pain,  lessen nervous
 irritability, and maintain a constant,  gentle moisture on  the surface.  In
 addition to this, the surface of the body should be frequently bathed, with
 a warm, weak alkaline lotion, as in  the previous diseases.
   Should the  bowels bo constipated,  a  cathartic  must be  administered
 as soon after perspiration is produced  as possible, for which purpose either
 the Compound Powder of Jalap may  be used, or the Compound Powder of
 Leptandrin ;  and this may be  repeated every day, or every other day dur-
 ing  the inflammatory symptoms, should the  constipation continue very
 obstinate.
   To relieve the pain, hot fomentations of Hops and Stramonium leaves, or
 of Hops and Tansy, &c, may be applied over the region  of the  affected
 kidney, and these  should be renewed frequently.   In very violent  cases,
 cupping over the part has been found  efficacious.  Mustard may be applied
 along the lower half of the  spinal column, previous to the use  of  the
 fomentations.
   In addition  to these measures, mucilaginous  diuretic infusions must be
 freely drank after  the  more active  inflammation has been subdued,  as an
 infusion of Marshmallow root,  of Marshmallow root  and  Peach  leaves,  of
 Flaxseed, Mullein, &c, which will be  found  to have an excellent influence
 in lessening the inflammation.   Other diuretics  will be found of efficacy, as
 infusion of Cleavers, Maidenhair, Elder blows, Haircap moss, &c.
  A course similar to the above may be  pursued when the inflammation is
 occasioned by a recession of cutaneous eruptions, or  by translated gout or
 rheumatism.
  The Tincture of Grelseminum, administered in an infusion of Marshmal-
 low root, has been  found valuable in this disease.   It may be administered
 in half-teaspoonful doses every  half-hour,  until its peculiar effects are pro-
 duced, after which  these should be kept up for  some  time.  When  there is
 acute pain, from two  to five drops  of Tincture of Aconite root,  may be
 added to each  dose.   This is  useful in all cases, whatever may have been
 the cause.
   When mechanical injuries have  caused the  disease,  the application of
cups to the part will be found beneficial, in addition to the measures previ-
ously advised.   If  irritating diuretics have  occasioned the inflammation,
cheir use must be stopped, and mucilaginous diuretic draughts, with sweat- 
304
AMERICAN  FAMILY PHYSICIAN.
Fig. 21.
ing and hot fomentations, will  generally be all-sufficient to allay the pain
and inflammation.
                                If the  inflammation has been  caused by
                              urinary  calculi in  the kidney,  or passing
                              through   the  ureters,  which  may be  sus-
                              pected by the brick dust sediment of urio
                              acid in the urine,  before pursuing the  pre-
                              ceding treatment, it will sometimes be found
                              very advantageous to administer a grain or
                              two of Opium, in pill  or powder, and place
                              the patient in  a warm  bath.  A  solution of
                              the Bicarbonate of Soda may be  given in
                              table-spoonful doses every hour, when there
                              is a deposit of uric acid in the urine.   (See
                              Fig. 21.)
                                The above treatment should be persevered
                              in daily,  until the  inflammation is subdued,
                              or  begins to subside,  when  mucilaginous
                              diuretics should be freely administered.
                                The patient should be kept quiet, and free
                              from excitement; his diet during  the inflam-
                              matory stage  should consist only of mucilag-
                              inous  drinks,  as infusion of Flax seed, Gum
                              Arabic water, barley-water,  &c.  And great
Care must be taken during convalescence, not to allow at too early a period a
more  stimulating  food;  a very gradual  approach  toward the  ordinary diet
is  the proper course to pursue.
  a. Crystals of  uric acid with ser-
rated  edges, deposited from very
acid urine ; b. crystals of urio acid,
rhomboid form, generally flat: e. crys-
tals of uric acid  often found  mixed
with urate of ammonia, or oxalate
of lime.
  N. B. All the crystals vary in color,
from pale fawn to deep red.
        CHIIONIC  INFLAMMATION  OF  THE  KIDNEYS.
  Chronic Inflammation of the Kidneys, or Chronic Nephritis, is frequently
the result of an acute attack;  though it may occur from the peculiar charac-
ter of the urine, or from mechanical injuries, &c.
  Symptoms.   There is usually an obtuse, heavy pain in the neighborhood
of the kidneys, a weakness in the small of the back, the  urine is evacuated
Fig. 22.
  a. Prismatic crystals of triple phos
phate. b. Stellar and foliaceous crys- finally death
tals of triple phosphate.
irregularly, usually in small quantity, and at
oft-repeated intervals, and yields a deposit on
standing.  The urine is most commonly alka-
line, and the deposits consist of phosphate of
lime, or triple phosphates; (See Fig. 22,)  and
sometimes  pus will be  found.  The  urine is
occasionally  turbid, or white, and milky in
appearance.  Partial  impotency is frequently
present,  and sometimes the bladder becomes
irritable  and painful.   Dropsical swellings,
and weakness of the  lower  limbs, are often
met with in the advanced stages of this  dis-
ease.   The pulse, in bad cases, becomes small
and frequent, hectic  fever ensues,  with ema-
ciation,  night-sweats,  great debility,  and 
                INFLAMMATION OF  Til!'.  1'IJKirONEUM.            305

  Treatment.  In this affection the bowels should be kept regular, daily,
by some mild laxative, as a combination of two parts  of powdered Rhubarb,
with one of Bicarbonate of Potassa, of which from throe to ten grains may
be administered for a dose, or sufficient to procure one, but  not  to exceed
two evacuations, as nearly approaching to those of health  as possible, and
this dose must be repeated three times a day.  In addition  to  this the sur-
face of the body should be bathed  every day or two with  a weak alkaline
solution, to which  some spirits or whisky has been  added, and, in  drying,
considerable friction should be used.  Every week or two, according to the
strength of the patient, a Spirit vapor bath should be  taken.
  Internally  stimulating  diuretics  will  be found very useful, and among
these  are Uva Ursi, Pipsissewa, Queen of the Meadow,  Trailing Arbutus,
Wild Carrot, &c.   One or several of these may be made into an infusion,
and taken freely.   In some cases, the Compound Pills of Soap, or the Com-
pound Pills of Dandelion, may be used.   Frequently, much benefit will  be
derived from the use of the Compound Copaiba mixture.
  When pus is discovered in  the urine, the Tincture  of Muriate of Iron
may be administered in doses  of  ten or  twenty drops every two  hours in a
wine-glass of  water,  and a decoction of Thimble  weed, (Rudbeckia La-
ciniata,) may be drank freely.
  In long-standing, obstinate cases  of chronic inflammation of the kidney,
much benefit will be derived from the  Compound Tar plaster placed on the
back over  the region of the kidneys, and a discharge kept up as long as the
patient will submit to  it.   This  is a very painful and annoying measure,
which should not be used unless  it  becomes absolutely necessary, and then
its advantages  will  great overbalance its disadvantages. Sometimes a current
of electro-magnetism passed through  the kidneys, will be  found of much
service, and then the above plaster can be dispensed with.
  The diet should  be nutritious,  and easy of  digestion, avoiding acids, fats,
and all stimulating drinks; if the patient can take moderate exercise in the
air, daily, he should do so; and should also attend, as much as possible, to
the general hygienic  rules.   Sec Blight's Disease, Diabetes,  Gravel, Stone,
Suppression of Urine, Retention of Urine,  &c.
            INFLAMMATION  OF  THE  PEEITONEUM.

 _  Inflammation of the Peritoneum or Acute Peritonitis, is an inflamma-
tion of the peritoneal or serous covering of the  abdominal viscera.  It is
more frequently met with among parturient females under the names, child-
bed fever, puerperal fever,  and puerperal peritonitis.   However, it occurs
among females at other times, and  is  by no means an uncommon disease
among males.   It may affect the whole peritoneum, or only certain portions
of it.                                                 J        r
   Symptoms.   As with  other forms of inflammation, peritonitis is generally
preceded by chills, followed by the ordinary symptoms of fever or inflam-
mation, as increased  temperature  of  the surface,  great thirst,  pulse  full,
strong, and  frequent, from  110 to 140 in a minute, dryness of the skin,
flushing  of the  face,  redness of the eyes, white  and dry tongue,  with  red
edges  diminished  appetite, restlessness and wakefulness, short and quick
breathing, frequently nausea and vomiting, and  among parturient women, a
violent pain across the forehead.  Occasionally these premonitory symptoms
are very slight, or they may be entirely  absent.  A sensation of pain and
sori;:lss is experienced either in a particular  part  of the abdomen, or  over 
306
AMERICAN  FAMILY  PHYSICIAN.
the whole  of it, and which in the early part  of the  disease may be  con-
founded, among parturient females, with after-pains; but they may be dis-
tinguished  from them by the pain or soreness produced on pressure over the
parts  affected, which is not  present during  after-pains.  The urine is defi-
cient, muddy, or high-colored,  and is voided  with  difficulty;  the bowels are
obstinately costive; and among parturient females the secretion of milk, as
well as the lochial flow, are  usually diminished, or entirely  suppressed, and
the breasts become loose and flabby.
  As the disease progresses, the pain and uneasiness increase  rapidly; the
bowels which were  at  the  onset soft and yielding, become  puffed up and
tympanitic; the pain is very much aggravated on the slightest motion, as
coughing, vomiting,  moving  the limbs, or turning in the bed, &c, as well as
by the pressure of the bedclothes; and to obtain relief the patient lies upon
the back, with the knees raised and flexed, which  affords relaxation  to the
muscles of the abdomen, and at the same  time holds up the bed-covers.  The
sufferings  are expressed  by groans  or  screams, and by constantly tossing
the arms, or  rolling  the head about.  It is not unusual  for patients to defer
the evacuations  of the bowels  and bladder, as long as  possible, in order to
avoid the pain occasioned by attending to them.   The  pulse  becomes much
accelerated, small, and  wiry, from  120 to 160, and even more, per minute,
the tongue becomes furred yellowish or brown, and diarrhea usually comes on.
  No one patient will  exhibit  all the above symptoms, which will be found
to vary;  thus, the pain may be slight, and the tension of the bowels may be
absent altogether, or it  may not manifest  itself until in  the last stage.  But
the most common  and  uniform symptoms are, the rapid pulse, chills, pain,
vomiting, and swollen abdomen.  The pain may diminish with the subsidence
of the abdominal swelling, or  it  may be  very much  increased.  The coun-
tenance of the patient  is indicative of the extent of anguish, presenting a
pallid, anxious, and haggard appearance, with a purple tint beneath the eyes,
and not unfrequently a circumscribed redness on the  cheeks, which is rather
a serious symptom.
   Finally  the  symptoms change, the matters vomited  are  dark-colored, or
green, the  discharges from the  bowels are dark and offensive, and frequently
diarrhea occurs; a cold and clammy perspiration covers the surface; there is
a  cessation of  the  pain; a low state  of delirium, hiccough, involuntary
evacuation of the urine and feces, picking or grasping at the bedclothes or
in the air,  a small and very frequent pulse, gradually diminishing, and death
takes place from the sixth to the ninth day.
   Causes.  Peritonitis is generally occasioned by cold, injuries to the ab-
dominal organs, long-continued  and violent exertions, suppression of cus-
tomary discharges, and the  ordinary causes of inflammation.  Among par-
turient females it usually comes  on in from two  days to three weeks  after
delivery, and the earlier the attack the more serious is  the disease apt to he;
it may be caused by cold, neglecting to  apply  the bandage, improper food,
severe mental  or physical  exertions,  neglecting to evacuate the bowels,
getting  out  of bed  too  soon,  retention  of pieces of the after-birth, and it
often follows manual or  instrumental labors.  It frequently occurs among
recently-delivered females, as  an epidemic, when  it is  more malignant and
formidable in its character, being most commonly associated with an erysipe-
latous condition of  the parts attacked.
   The medical  world is about equally divided in opinion as  to the contagious
or non-contagious character of puerperal peritonitis, some viewing it to be
 extremely contagious, and  others  the opposite.   But, as the question  is not
 definitely  settled, the better  plan is to act in all cases as if the contagion! 
CHILD-BED FEVER.
307
 nature of the disease had been completely demonstrated.  Pregnant females
 should not be allowed to enter the room of a child-bed fever patient, and the
 physician or midwife who is attending a patient with puerperal fever, should
 not attend to any obstetric practice, at least, for some time.
   Discrimination.   Peritonitis may be distinguished  from after-pains, by
 observing that in the latter, pressure does not increase nor produce pain, nor
 is the pulse so rapid as in the former,  being most commonly natural.  It
 may be  determined  from colic, by the  relief afforded by  pressure in the
 latter, the pain occurring in paroxysms, and the pulse  being natural or but
 slightly accelerated.   From inflammation of  the  bowels by the disposition to
 costiveness in peritonitis, and by the pain  being more acute, the  tympanitic
 condition of the bowels, augmented pain on pressing over the affected part,
 and by no mitigation of the  pain when the -bowels are spontaneously evacu-
 ated.   In inflammation of the bowels, the discharges contain serum, mucus,
 or blood.
   Prognosis.  Although peritonitis rapidly  runs its course toward an un-
 favorable termination, it is by no means an  incurable disease, and will  gen-
 erally yield to active and correct medication.  It is far more dangerous when
 it attacks  parturient females, especially when in the form of an epidemic.
 If the pulse becomes less rapid and more natural; the great heat of the skin
 diminishing with a  moisture upon the  surface;  the breathing  being lesa
 laborious, the patient being able to make a full inspiration;  a free and more
 regular-^flow of urine which gives a deposit  on standing, either  of uric acid,
 or phosphate of lime;  the  pain and tension  of  the abdomen  gradually
 diminishing, with  an ability to  move in bed, or sit up; thirst  less  urgent;
 tongue becoming clean;  bowels more easily acted upon, or, perhaps, a gentle
 diarrhea; and the sleep being more  refreshing—these are favorable symp-
 toms.  Among parturient women the lochial discharge reappears, and  the
 milk returns in the breasts.
  When  the disease  is  about to  prove fatal, there  is a sudden cessation of
 pain, or it is much less severe on pressure;  the  pulse is sinking, fluttering,
 and thready; the tympanitis  is unyielding; the skin cold and clammy;  with
 hiccough, dark-colored, or greenish vomitings, dilated pupils, perhaps slight
 delirium, diarrhea, involuntary discharge of urine and feces, and  picking at
 the bedclothes.  The most serious period of the disease is from the third to
 the fifth  days.
  Treatment.  The most important indication is to subdue the inflamma-
 tion as promptly as possible,  and  bring about resolution; for if the disease
 terminates in effusion, the patient seldom recovers.   At the commencement
 of the  disease,  active purgation should be effected  as soon as possible, for
 which purpose the Compound Powder of  Jalap may be given in combination
 with ten  or twelve grains of  Cream of Tartar;  this  may be repeated every
 three hours until the desired  effect is produced.  In  some instances, a com-
 bination  of Podophyllin two  grains, Leptandrin  four grains, and Cream of
 Tartar ten grains, may be substituted for the  above,  and administered every
 three  or  four hours,  until the cathartic effect is induced.   The action of
 these purgatives may be greatly facilitated by injecting into the rectum,  after
 two or three hours have elapsed, about  half a  table-spoonful  of the Com-
 pound Tincture of Lobelia and Capsicum, diluted with  a fluidounce or two
 of a warm  infusion  of Boneset,  Senna,  or  Lobelia.  Much suffering and
annoyance will  be saved  the patient by not permitting her to get up when
the bowels or bladder require to be  evacuated—receiving  the discharges oa
Bome refuse  cloths, or in a bedpan,  while she  lies on  her back, with  the
head and shoulders not raised by pillows. 
308
AMERICAN  FAMILY PHYSICIAN.
  If the strength of the patient will permit, the cathartics should be given
every day, for two or three days, after which, one  gentle evacuation should
be procured  daily, by injection, or  laxatives, as, a decoction of Lcptandra
root, (See Typhus Fever,)  or, when  tympanitis is  present. Castor Oil  and
Turpentine, equal parts of each,  may  be given in  half-fluidounee, or fluid-
ounce  doses.
  After the purgative, referred to above, has been  given, we must not  lose
time by waiting for its operation, but proceed  at  once to produce  copious
perspiration,  and which will aid the action of the cathartic.  If the condition
of the patient will permit, the Spirit vapor bath may be used;  otherwise, the
Compound Tincture of Virginia Snakeroot may be given  in doses of a tea-
spoonful every hour or two, in a warm infusion  of Balm, Catnip, Crawley,
Pleurisy root, or other simple  herb.   After a copious perspiration has  been
induced, the  tincture should  be given in smaller  doses, repeated at longer
intervals to maintain  the state of perspiration during  the presence of the
inflammatory symptoms.
  Before giving the tincture, as  above, it will be advantageous to  bathe the
surface of the body with a warm alkaline fluid, drying with a coarse towel;
and this bathing may be repeated several  times a  day whenever the inflam-
matory symptoms are severe, or  the skin becomes hot and dry.
  When the  pain and inflammation are violent, the Tincture of Gelseminum
may be given in half-teaspoonful or teaspoonful doses, repeated  every hour,
and from three to five drops of the Tincture of Aconite root, may be added
to each dose.  And when the  peculiar effects of  the Gelseminum are pro-
duced, its further use may be omitted, until the symptoms of inflammation
return with severity.  In some instances, fifteen or twenty drops of a mix-
ture of equal parts of the Tinctures  of Digitalis and Stramonium, repeated
every hour or two, will be found advantageous.
  For relieving the tension, pain, and soreness in the abdomen, fomentations
of Hops and Tansy should be  placed over the abdomen,  as hot as can be
borne; renewing them often, not allowing them to  become cool.   Some care
is required not to annoy the patient by wetting the  sheet or bedclothes with
these fomentations.  Hops and Lobelia, or Hops,  Lobelia, and  Stramonium
leaves, may be used with benefit.  There is no agent so decidedly advanta-
geous as a fomentation in all abdominal inflammations, as Stramonium leaves;
the recent leaves bruised, warmed, and applied, are more prompt and effica-
cious than the dried leaves; the latter should be combined with  equal parts
of Hops and Lobelia.   In very  violent cases of peritoneal inflammation, I
have continued the use  of Stramonium fomentations even  after  its narcotic
symptoms, as double vision, &c,  had  continued for some time, and in all
cases with advantage, allaying pain, and effecting a permanent subsidence of
the inflammation.  When the  bowels are tympanitic, Oil  of  Turpentine
should be added to this fomentation.   As soon as the pain and inflammation
subside, or when prostration takes place, the fomentations should be omitted.
In very severe cases, in addition to the above  measures,  Mustard poultices
may be applied to the legs, inside of the thighs, and along the  spinal column.
  The drink of the patient should be of a mild diuretic character, as Cleavers,
Elder flowers, Maidenhair, of each  an ounce, made into  an  infusion  with
three pints of water—or an infusion of Marshmallow root and Peach leaves—
of Horsemint and Mayweed—Hair-cap moss, &c.; these may be drank freely,
and will not only assuage thirst, but will also aid in lessening  the severity of
the attack.  Acidulated drinks,  as lemonade,  tamarind water, &c,  may be
allowed whenever there is a dark or brown fur on the tongue.   When the
thirst is excessive, ice and iced-water will  be found not only useful in allay- 
CHILD-BED FEVER.
309
  ing the thirst, but to overcome vomiting and  gastric  irritability when  pres-
  ent.  The vomiting may  likewise be frequently allayed by the use of Pep-
  permint, Anise, or Spearmint water, with  Laudanum added; or, perhaps a
  draught of Soda  or Seidlitz water, with Lemon juice  and a few drops of
  Laudanum.  A  Mustard  poultice over  the region of the stomach will fre-
  quently be of service.
    Of course, the  promptness and energy with which the  above treatment
  may be pushed, will depend upon the degree of violence of the attack, being
  less active in the  mild forms, and more active in the severe.  But after the
  more severe symptoms  have been subdued, the remaining treatment may
  consist of the administration of the Compound Powder  of Ipecacuanha and
  Opium, in the proper  doses, repeating  it every two  or three  hours ;  or
  the Compound Powder of Quinia may be substituted.   In parturient wo-
  men, the Tincture of Muriate of Iron will  be found more efficacious.
    Beside  the external applications to the abdomen,  it will frequently be-
  come necessary to administer internal means to aid in overcoming the tym-
  panitic  distension; Castor Oil, Oil of Turpentine, each, half a fluidounce,
  Paregoric two fluidrachms, may be added  together, and injected into the'
  rectum, repeating it  every two or three hours, until an evacuation ensues;
  and while using this injection, no internal  cathartics must be given, except
  in very obstinate  cases of constipation.  The Tincture of Prickly-Ash  ber-
  ries internally, and used as an injection,  has proved serviceable in tympani-
  tis.  One  or two table-spoonfuls added to a similar quantity of water  may
  be  used  as an  injection, repeating it every hour, or oftener if required.
  Half a teaspoonful of Laudanum may be  added  to each  injection, when
  there is severe pain.   Or  it may be added to the Compound Tincture of
  Lobelia and Capsicum ; or, to the above Castor Oil, &c,  injection.  It must
  not be used until  the more active inflammatory symptoms have  somewhat
  subsided.
   Among  parturient women, the vagina should be injected several times a
 day, with a warm decoction of Golden Seal, or of Golden Seal and Lobelia
 or even of warm water, in order to cleanse the parts from all putrid matters!
 and thus render the patient more comfortable.                      - -  '.
   Sometimes, and  more  especially among  females recently delivered  the
 disease assumes a  typhoid form, in which the previously named active treat-
 ment must be stopped ; though the means for tympanitis must be continued,
 should it be present.                                                  '
   The bowels must now be kept free, producing one, but not to exceed  two
 moderate evacuations daily; and the same means may  be used for this pur-
 pose as  recommended in  Typhus Fever, page 206.  To aid in keeping up a
 gentle moisture of the surface, the following may be given :-Take of Com-
 Pwontv    ■     •IPecac1uaJnlla1and Op^m forty grains, Sulphate  of  Quinia
 twenty grains; mix, and divide into  ten powders, of which one may be

 Enhvll7    °\   T, ,°UrS-  I* S°me inStances' a sma11 Proportion of
 lodophylhn may be added to each dose,  sufficient to produce a mild laxa-
 tive effect;  in which case omit the  other laxatives
  Among parturient females, the  Tincture  of Muriate of Iron, in doses of
 LJL  i,W? 7 '?r°pS' *n a wineSIass °f  water, repeated every hour, will be
generally found superior to every other remedy, especially,  if the dLease be
associated with erysipe as.  Indeed, I  have frequently obtained  the most
T?nctuTnfT tB-tby admiQistering from  the beginning of the disease  the
Tincture of Aconite  root, and the Tincture of Muriate of Iron, by turns
successively every half hour, or hour.                            J
  When the tongue is furred yellow or dark, acidulous draughts should be 
310
AMERICAN FAMILY  PHYSICIAN.
used, not forgetting that good tart Cider is not only agreeable and reviving
but is very salutary in its action on the system at this time.   If the pros-
tration be very great, stimulants must be given to sustain the system until
the reactive efforts ensue, as Sparkling Catawba, Porter, Sherry,  Brandy, &c.
And the other symptoms of a typhoid nature must be treated as  heretofore
named under the typhoid conditions of fevers, and in Typhus Fever, which
Bee.  For diarrhea, see Typhoid Fever, page 211, also Diarrhea.
  The diet during the inflammatory stage must be light and cooling, con-
sisting  principally  of barley-water, rice-water, prune-water, &c.; in the
latter stages, gruel,  panada, apple sauce, toast-water, &c,  may  be  given.
And when there is but little  to fear from a relapse, during the convales-
cence, the patient should  be gradually accustomed  to  a  more hearty and
nourishing diet, commencing with chicken-broth,  veal tea, beef tea, &c,,
and  cautiously permitting  solids.   Throughout the whole  disease, the pa-
tient should be kept in a state of quiet and rest;  and the room  should be
kept cool, and be frequently ventilated.
      CHRONIC  INFLAMMATION  OF  THE  PERITONEUM.

  Chronic Inflammation of the Peritoneum, or Chronic  Peritonitis, may
follow as a result of the acute form;  but it is frequently met with indepen-
dent of  any previous  active inflammation.  All  ages  are  liable to it, and
among children, especially those of a scrofulous diathesis, it is by no  means
uncommon ; constituting one of the forms of marasmus, more popularly
known as "consumption of the bowels."
  When chronic peritonitis is not the result of the acute  form, it is grad-
ual  and  insidious  in its approach, and often serious  organic disorder, or
effusion, takes place before the physician is called  to treat the case.  Among
females, it frequently  follows miscarriages, or difficult,  protracted labors, in
which, from some  cause, a low grade of inflammation has been produced,
not sufficiently  active  to attract the patient's particular attention.
  Symptoms.   During the early stage of chronic peritonitis, the patient is
capable  of continuing ordinary occupations, but always complains of an in-
crease of pain or soreness across the  abdomen, from any motion or fatigue;
and  these sensations  are aggravated slightly when  pressure  is applied,
After a  time, the belly becomes more or less enlarged, and  somewhat tense,
which is the  greatest  toward evening.  Upon  percussing  or striking  the
abdomen on one side, with the ends  of the fingers of one hand, and apply-
ing the  palm of the other over the opposite side, a sense  of fluctuation will
be observed, indicating the presence of a fluid within the abdomen; and
this act of percussion, as well as  any sudden jolt, or  quick motion of the
body, coughing, sneezing, &c, will produce a degree of pain.  In general,
the appetite remains unaltered, and  digestion continues  regularly.   Some-
times, there is thirst,  and want of  sleep and appetite ;  occasionally, vomit-
ing.   In some instances, a sensation is experienced as if a ball were rolling
about in the belly, and rising toward the throat.  As the diseases advances.
the features appear sharp and contracted, and the countenance, pale, sallow,
and  doughy ; obstinate costiveness  usually prevails, and often chills and
fever, somewhat like  those  of  intermitting fever, accompany the disease.
Debility, emaciation, cough, difficult  breathing, and slight fever toward eve-
ning, come on, the  patient becomes exhausted, and hectic fever, or a dropsical
swelling of the  legs and abdomen takes place, in  either case terminating in
death.  The  disease may continue for  an indefinite period with a swollen 
INFLAMMATION OF  THE  WOMB.
311
and hard abdomen, and but little pain or uneasiness ;  and the constipated
condition of the bowels may alternate with diarrhea.
  Treatment.   The bowels must be kept regular  daily by means of mild
aperients, as, for instance, the Powder of Rhubarb and Bicarbonate of Po-
tassa, on page  284.   The  surface of the body and  limbs must be kept as
healthy as possible, by  daily bathing with a weak alkaline  solution, or salt
water; and the Spirit vapor bath should  be used every week or two, accord-
ing to the strength of the patient.  Internally, the Compound Syrup of Yel-
low Dock, or some similar alterative should be administered, and, in addition,
a Solution of Iodide of Potassium should be used daily; thus,  Iodide of
Potassium from twenty to forty grains may be dissolved  in distilled water,
half a pint,  of which from half a wineglassful  to  a wineglassful, may be
taken three or four times a day.   This will be especially necessary to pro-
mote  the activity of the absorbents, and  remove or prevent effusion.  Diu-
retics of a stimulating character should also be used, as  infusions of Haircap
moss, Queen of the Meadow root, Dwarf Elder bark, &c, and in which the
Iodide of Potassium may be dissolved instead of the distilled water  above-
named.  In long-standing, or obstinate  cases, the  Compound  Tar plaster
placed over the whole of the abdomen, and a constant discharge of purulent
matter kept up for a  long time, will be found a very effectual means of cure,
in conjunction with ,the preceding measures.  But if effusion to any extent,
has taken place, and  the disease will not  yield to the above means, pursued
for a  reasonable length of time, then, the case should  be treated  the same
as recommended for Dropsy of the Abdomen.
  The diet should be nourishing, avoiding all acids, fats,  and other articles
which disagree with the patient;  moderate exercise should be taken regu-
larly and daily; and  if the patient be pale and  anemic,  some  preparation
of iron should  be given, as Carbonate of Iron, Citrate  of Iron and Quinia,
&c.  Should any  febrile or inflammatory symptoms  be manifested, they
must  be promptly subdued by means similar to those  named "in the  treat-
ment  of Acute Peritonitis.
                INFLAMMATION OF  THE  WOMB.

   Inflammation of the Womb,  or Acute Metritis, seldom  happens, except
in women who have aborted, or in parturient or lying-in women, in whom
it may occur  at different periods, varying  from  delivery to one  or two
weeks afterward, or even later; more commonly it appears on the second
or third day after the birth of the  child,  and the inflammation  is  more
especially confined to the proper substance of the womb.
   Symptoms.  It is  generally preceded by shiverings, and a general feel-
ing of uneasiness and  anxiety, followed  by a hot, dry skin, pain in the
head, thirst, rapid pulse, furred  tongue, and other symptoms common to
inflammations.   Constant  pain is felt  in the neighborhood of  the womb,
which is much increased when deep pressure is  made.  The secretion of
milk is diminished, or entirely ceases, and the lochial discharge is suspend-
ed.  The urine is deficient, and is passed with pain and difficulty; and the
mouth of the womb will be found tender and very hot.   The bowels fre-
quently become tympanitic, and when the inflammation extends to  the pe-
ritoneal covering of the uterus, the pain increases, as well as the febrile
symptoms, and the counte'nance is indicative of great  suffering and appre-
hension.  As the  disease  progresses to an  unfavorable termination, the
surface becomes  cold with a clammy sweat, the pulse  frequent  and weak, 
312
AMERICAN FAMILY PHYSICIAN.
the breathing quick and oppressed, with sudden muscular prostration, tyn>.
panitis, vomiting, dark coat on the tongue, and sordes on the lips and teeth
diarrhea,  low delirium, mutterings, twitching of the tendons, coma, and
death.
  Inflammation of the womb terminates  favorably by resolution; unfavor-
ably, by abscess, softening of the womb, or gangrene.
  Causes.  This disease may be caused by cold, by tedious or difficult labor
by improper  interference  during labor, by endeavors to force the delivery
of the  child and after-birth, by strong  diet during confinement, by heating
or alcoholic drinks, and sometimes it occurs without any assignable cause.
  Treatment.  Inflammation  of  the womb  is very rapid  and fatal  in its
progress, and must be treated  promptly and  energetically.  The treatment
named for Acute Inflammation of the Peritoneum must be pursued,—see
page 307, and the acrid and fetid discharges must be cleansed  from time to
time by injections of warm water, or warm infusion of Peach leaves, wild
Indigo leaves, &c, into  the vagina.  The diet and subsequent management
in convalescence will be the same as advised in  Acute Peritonitis.
             INFLAMMATION  OF  THE  BLADDER.

  Inflammation of the Bladder, or Cystitis may attack the mucous mem-
brane of the  bladder, or  its muscular  coat, more commonly the former,
and it may be  confined  to one  portion of it, or  involve  the  whole  mem-
brane.  Like  inflammation  of other organs, it  may be  either acute or
chronic  in  its character; the former is a rare affection, the latter is more
common.
  Symptoms.  Acute inflammation  of the  bladder, is seldom ushered in
with  chills, and other febrile symptoms as in ordinary inflammatory at-
tacks  ; usually there is a severe burning and throbbing pain with some
degree of tenseness  in the region of the bladder, and which is increased by
pressure upon the part.   The desire to urinate is  constant, and it is voided
with extreme difficulty, occasioning an increase of pain ; it may pass away
drop by drop, or it  may be  entirely suppressed, causing a swelling of the
bladder  and great  distress.   The urine commonly contains mucus.  The
pain may extend to the penis, the scrotum,  the perineum, and other parts
in the vicinity of the bladder.  There is generally more  or  less fever at-
tending, with  hot and  dry  skin, frequent  and  hard pulse,  great thirst,
tongue coated, and constipation,  or frequent  but ineffectual efforts to evacu-
ate the bowels.   Not unfrequently, nausea, vomiting, restlessness  and great
anxiety  are present.   In unfavorable cases, as the disease advances,  a low,
typhoid condition ensues, there  is low delirium, or stupidity,  pale, hollow,
and death-like countenance, and the patient dies in coma, or in con-
vulsions.
  Causes.   Acute cystitis may be produced by direct injuries, as the care-
less introduction of bougies  or catheters into the bladder, wounds, horse-
back riding, and stone in the bladder; strictures in the  urethra, enlarge-
ment  of the  prostate  gland, translation  of gonorrhea, gout, rheumatism,
&c, exposures to cold, acrid diuretics as Cantharides, Oil of Turpentine, as
well  as  injections  of irritating  substances  into the bladder, may occasion
the disease.  In severe cases the treatment must be prompt and energetic,
or the patient may die in a week or  two.
  Treatment.  This will be nearly the  same as advised for Acute Inflam-
mation  of  the Kidneys.  Perspiration  should be  produced by the Spirit 
CHRONIC INFLAMMATION  OF THE BLADDER.          313
vapor bath, c. by the  use  of the Compound Tincture of Virginia  Snake-
root;  and the bowels  should be evacuated by the Compound Powder of
Jalap, ten or twelve grains of Cream of Tartar  being added to  the dose.
At an early period, hot fomentations of Hops and Lobelia, or Hops and
Stramonium leaves, or other bitter  or  narcotic  herbs, should  be applied
over the region  of the  bladder, and to the perineum;  and mucilaginous
diuretic infusions may be freely drank, as an infusion of  Marshmallow and
Peach leaves, or an infusion of Marshmallow and Cleavers.  Other diuretics
will frequently be  found beneficial,  as  Hair-cap moss, Wild Carrot, Elder
blows, &c.
  To lessen the constant desire to evacuate the bowels  as well as to urinate,
an injection composed of twenty or  thirty drops of Laudanum added to a
fluidounce of  Marshmallow or  Elm  infusion, may be given, and  repeated
as often as required.   And in very violent cases, it has been recommended
to apply cups to  the perineum, to the sacrum, and over the region  of the
bladder; or the Compound Tar plaster may be  applied  on  the back over
the region of the kidneys.
  The diet must be confined, during the inflammatory stage, to mucilagi-
nous draughts ; and if the urine is suppressed, or the bladder becomes much
distended, this fluid must  be  drawn  off by means of a catheter.  The pa-
tient must be kept as quiet as possible.  In the  typhoid  condition, means
similar to those advised  in such a condition following other acute attacks
must  be employed.  During convalescence, the  same care is necessary  as
in Nephritis.
       CHRONIC  INFLAMMATION  OF  THE  BLADDER.

   Tins difficulty has  also  received the names " Chronic Cystitis," " Cys-
 tirrhea," and " Catarrh of the Bladder."  It is  a  chronic inflammation of
 the mucous lining membrane of the bladder, and  is  more commonly met
 with among the aged,  being generally associated with some disease of the
 prostate gland, and among whom it is very apt to prove fatal.
   Symptoms.  When the disease comes on gradually there will be noticed
 at first a deposition of more or less mucus on allowing the urine to stand
 for a time, (See fig. 18,) but as it advances, as well as when it  comes on
 more rapidly,  there will be a dull, uneasy sensation in the region of the
 bladder, with  more or less frequent desire  to urinate, and a difficulty in
 retaining  the fluid in  the bladder.   The flow may be increased or natural,
 but as the affection proceeds, the mucus becomes  much  augmented,  and
 always settles to the  bottom  of the  urine  on  standing, leaving the fluid
 above perfectly clear, and  in cases of long  standing, pus, and even small
 quantities of  blood will be found mixed with the mucus, more especially
 when abscesses have formed.  Several  pints of this tenacious mucus have
 been voided  by some  patients in  one  day.   Large  deposits of the  phos-
 phates  are usually met with in the urine, particularly the triple phosphate
 of .Magnesia and  Ammonia.  (See fig. 22.)  Generally, when the calls to
 urinate are frequent, its discharge will be accompanied by spasmodic con-
 traction of the bladder, and a painful burning sensation along the urethra.
   Most generally there is a persistent feeling of uneasiness  in the vicinity
of the bladder, a degree of heaviness in  the perineum, pain and  weakness
in the back and loins,  sometimes extending  into the testicles, with irrita-
bility of the rectum.   There may also be in  some cases a mild fever, thirst,
tongue somewhat coated, restlessness, hot and dry skin, &c. 
314
AMERICAN FAMILY  PHYSICIAN.
  If the disease is allowed to progress, ulceration of the bladder, and dis-
ease of  the prostate  gland occur,  the  system  becomes debilitated,  the
various secretory organs become deranged, debility and emaciation super-
vene, with hectic fever, nervous irritability, and finally dissolution.
  Causes.   Chronic Cystitis may follow the acute form ;  and it may also
be produced by causes similar to those occasioning this latter form.  It is
also frequently caused by intemperance, a constant habit of retaining the'
urine for a long  time before  evacuating it, high-seasoned food, excessive
venery, sedentary habits, and masturbation, which last I have found in my
own practice to be a more common cause than is generally suspected.  The
disease is more readily curable among the young than the old, and in some
cases even when pus is discharged with the urine.
  Treatment.   Stimulating  diuretics will  be  required  in  the treatment
of this disease, and their employment  should be alternated, as otherwise
the system may become habituated  to  their use, and  no  good  results be
obtained.  Among the  most valuable diuretics  of the above  character, the
leaves  of Uva Ursi, of  Buchu, of Trailing Arbutus, and the roots of Queen
of the  Meadow, may be  used in infusion or decoction.  A  most valuable
agent which I have successfully used for twenty  years past, is the the Com-
pound  Infusion  of Trailing Arbutus; but, in  some  cases, especially those
attended with a  low grade of fever, it may become necessary to omit the
Gin, making a simple  decoction of the articles.
  Considerable advantage will frequently be derived  from the internal ad-
ministration of the following mixture:—Dissolve  Alum ten grains, in a gill
of water, stir in it Benzoic Acid ten  or twenty grains,  and take for a dose;
this may be repeated three or four times a day, and will found more particu-
larly beneficial in case  of excessive mucous discharges with phosphatic depos-
its.   In similar  instances I  have likewise witnessed the  most decided and
permanent effects from the daily  use for some  days  or weeks, of the Com-
pound  Balsam of Sulphur.   I have, in many obstinate cases, where Copaiba,
Buchu, Uva Ursi, &c, were unproductive of benefit, advised  the free use of
an infusion  of the pods or hulls of  the common bean, and which has been
invariably followed with the most happy results.   The Compound Copaiba
Mixture will frequently be found of service, in this malady, as a  stimulating
diuretic,  exerting an especial influence on mucous tissues.
  It will likewise be proper to inject into the bladder once  or twice a  day,
a tepid infusion of equal parts of Golden Seal  and Solomon's  Seal  roots; it
should be  injected through a  gum elastic  catheter  by means  of  a  small
syringe, in the quantity  of half  a  fluidounce  or a fluidounce at  a time, and
may be alirwed to remain in the bladder as long  as it does not occasion pain
or uneasiness.  Great  care should be taken to  filter the  infusion,  that no
solid substance be passed into the bladder with it, to form  the nucleus for a
subsequent stone.   When pus or blood appears in the urine, an equal part of
Geranium root  may be  added to the above mixture for an injection; or, an
infusion  of equal  parts  of  Golden  Seal, Geranium, and Witch Hazle bark,
may be used.
  In addition to the above measures, the bowels  must be kept open  by mild
aperients, as the mixture of Rhubarb and Bicarbonate of Potassa,  referred
to on page 284; the skin should be frequently bathed with a  weak  alkaline
solution, and  a  Spirit  vapor bath administered  every two  or  three weeks.
The diet should be light but nutritious, easy of  digestion,  avoiding fats, spi-
ces, and stimulating drinks, according to the excited  or depressed condition
of the system.   In cases where there is a gouty or rheumatic condition, the
patient may take from ten  to  thirty drops of a mixture of equal parts of 
GONORRHEA.
315
Tincture of Colchicum seed, and Tincture of Black Cohosh root; it should
be taken in some water, or mucilaginous infusion,  and  be repeated three  or
four times a day.   If there is a scrofulous habit of body, the Compound Syr-
up of Stillingia with the Iodide of Potassium  should be administered.  If
there  is a venereal  taint in  the  system,  the following will be found effica-
cious:—Take of Compound Syrup of Stillingia, Tincture of Poke root, Tinct-
ure of Sheep Laurel, each, four fluidounces; mix.    The  dose varies from  a
teaspoonful to half a table-spoonful three times a day, in some water, accord-
ing to the effects of the Laurel upon the system.
  Chronic inflammation of the neck of the bladder is a disease very seldom
cured by the treatment ordinarily pursued by physicians, but the above course
will be found very  effective; by it, I  have succeeded in curing quite a num-
ber of cases.   The worst case I ever  saw  of this malady, was that of Dr.
S------, who had labored  under it for several  years,  and had faithfully
followed the prescriptions  and advice of the most eminent medical men in the
country, but  without  the  least benefit.  Immediately after  urinating, he
always experienced a violent indescribable, cramp-like,  aching pain in the
perineum and region of the neck of the bladder, which frequently extended
over the whole of  the lower region  of the  pelvis,  and low down into the
thigh; the urine, from time to time, passed through the urethra as though it
were poured into it, the neck of the bladder was  distended  and  painful to
the touch, as well as on standing or  sitting;  and  standing often caused a
paralytic sensation  and uneasiness in one or both of the thighs.  Occasionally,
the urine would pass with much pain  and difficulty.  Beside these symptoms
he suffered from cold feet, swelled feet, hectic fever, night-sweats,  and a dis-
tressing cough.  Notwithstanding  these  unfavorable symptoms, the treat-
ment I pursued effected a rapid and permanent cure.
                            GONORRHEA.

  Gonorrhea or Clap, is  an inflammation of  the  mucous  membrane lining
the canal  of the urethra, accompanied with an infectious discharge, and is
owing to the application of a morbid matter, generally, at the time of an im-
pure cohabitation.
  By most writers this disease is placed among those peculiar to the depart-
ment of surgery, but I can see  no satisfactory reason for so doing.   We may
have an inflammation of the urethra, same as of the eye,  without any infec-
tious discharge; and like  a certain inflammation of the eye, we may likewise
have one of the urethra, discharging matter  of an infectious nature.  I have
placed this  disease where I believe  it should be, among affections of an
inflammatory character.
  Symptoms. _  Gonorrhea most generally shows itself  in from two  to four
days after an improper connexion, but with  some persons,  there will be no
appearance of it until after two or three weeks.   It commences with a sense
of uneasiness, as an itching in the glans penis, and a soreness and tingling
sensation along the whole course  of the urethra, with a slight degree of burn-
ing or smarting on making water, and a  small quantity of a whitish matter
may be observed at the orifice.    In  a day  or two the discharge of matter
increases, becomes thinner,  less  adhesive,   and of a greenish or  yellowish
color, the glans penis presents a red  and inflamed appearance, especially at
the orince, the stream of urine becomes smaller, and whenever passed occa-
sions much pain and scalding.   The bladder,  most generally, from sympa-
thy, becomes irritable and incapable of retaining the urine for any  length of 
316
AMERICAN FAMILY  PHYSICIAN.
time, causing the patient to  urinate frequently,  with a constant uneasiness
about the scrotum, perineum, and fundament.  The patient becomes pale and
loses flesh rapidly.
  Sometimes,  when  the inflammation is considerable, there will be observed
a slight quantity of blood in  the discharge.   When it exists in a very high
degree, it produces what is called a chordec, in which, at the time of erection
the penis is curved downward,  with great pain.   This is very apt to occui
when the patient is warm  in bed,  depriving him of sleep,  and sometimes
causing an involuntary emission of semen.   From the inflammation phymosk
is apt to  ensue, in which the  foreskin becomes so swelled over the glans penis,
that it cannot be drawn back;  when this  swelling takes  place behind the
glans, so that it cannot be  drawn forward, it is called paraphymosis.   Some-
times small, hard swellings may be observed on  the lower  surface  of the
penis, along the course of the urethra,,  and  these  may  suppurate  and form
troublesome fistulous  sores.
  The glands of the groin often become swollen and  indurated from the ex-
cessive inflammation present; or, one of the testicles becomes  swelled  and
inflamed, occasioning  excruciating pains, extending from the seat of the com-
plaint up into the small of  the back, with a symptomatic fever.
   If Gonorrhea be  properly attended to, it may be cured in from three to
seven days; some persons,  however, will require as many  weeks, or even
longer, and especially in those cases where  the cure is attempted  by medi-
cines per mouth.  Patients  who continue using intoxicating liquors, high-
seasoned food, much exercise, &c, may not be cured for months, and in such
cases it is very apt to leave  a gleet behind, besides being accompanied with the
risk of giving rise at some distant period to  a constitutional affection, espe-
cially if there has been a neglect  of proper cleanliness, occasioning excoria-
tions or ulcers on the  glans penis, sore throat and  mouth, sores  on the body
and head, loss of hair, &c.
  When the disease has remained for some time, from the  falling  of the
matter on the various parts of generation, numerous and  troublesome warty
excrescences are apt to arise.  When gonorrhea is of long standing,  or has
been improperly treated, stricture of the urethra is  very apt to follow, which
may be known by more or less difficulty and pain in making water,  the dimi-
nution of the stream,  which passes spirally,  or  splits  into  two streams,  and
by  the involuntary escape of a few drops of urine  after the evacuation of the
bladder.
  Among females similar symptoms are present, but usually of less severity,
—heat and soreness in urinating; a discharge of colored matter, slight pain
in walking, and uneasiness in sitting; stricture is uncommon among them,
being seldom,  if ever, met  with.  Instances  have  occurred where  the hus-
band has contracted an  inflammation of the urethra from his wife,  who  was
suffering only from leucorrhea, or perhaps some inflammatory affection of the
vagina;  great  care  is,  therefore, necessary, before  pronouncing upon the
disease, as the health  and reputation of the parties, as  well as the character
of the physician, may be jeopardized by too premature or hasty conclusions.
Still I have good reasons for  considering, in many instances,  the  inflamma-
tion thus produced, as  infectious as that ordinarily termed  gonorrhea.  I
can see no reason why an acrid  discharge from vaginal inflammation, or an
acrid leucorrhea, when it does develop urethritis in the male,  may not be of
an  infectious nature.    Indeed,  I consider these conditions, together  with
uncleanliness of the parts,  as the true  and original source of gonorrhea.  I
have likewise no doubt  but that many persons who have cohabited with fe-
males in the above  situations might have escaped gonorrhea had  they  not 
GONORRHEA.
317
 aided the exciting cause by excessive drinking immediately before or after
 the act, thus rendering the urine more acrid and  irritating in its character.
 I have known gonorrhea caused by the  parts coming in contact with gon-
 orrheal matter, and though this mode of contracting the disease is denied by
 Borne, I have  no doubt of its  correctness.  With some persons, a drop or two
 of a saturated solution of Muriate of Ammonia, let fall into the urethra and
 allowed to remain there, will cause urethral inflammation of a severe charac-
 ter,  with a  discharge which  will  prove equally as infectious as that from
 gonorrhea.   All of which, with other circumstances which cannot be referred
 to in a work as limited as this, lead me to believe that ordinary gonorrhea is
 nothing more nor less than the same character of  urethral inflammation
 which is occasionally produced by other causes  than that of improper cohab-
 itation.
  Treatment.  When gonorrhea makes its appearance for the first time, it
 is generally accompanied|fwith a greater degree  of inflammation  than in any
 subsequent attacks, and is very apt to be  more  obstinate  in its character.
 When symptoms of active inflammation are present, a purgative must be
 given, and repeated daily if the inflammatory  symptoms continue  violent;
 the  Compound Powder of Jalap with ten or fifteen grains of Cream of Tartar
 to the dose, will answer every purpose.  After the operation of the purgative
 some one of the various compounds which have been  found efficacious, may
 be  used—among them are the following :
   1. Take of Canada Balsam one  fluidounce,  Spirits of Nitre  Dulce four
 fluidounces,  Oil of  Turpentine  two fluidrachms, Powdered Camphor one
 drachm; mix well  together.   The dose  is a teaspoonful three times a day.
 When  the inflammatory symptoms have been subdued, Powdered Kino one
 drachm, may be added to the above.  I make more use of this  preparation
 internally, than any other, in this disease, having the  patient to use with it
 as a drink,  during the inflammatory stage,  an infusion of Marshmallow and
 Burdock roots.
  2. Take of  Balsam Copaiba, Spirits of Nitre Dulce, Compound  Spirits of
 Lavender,  Tincture of Muriate of Iron, each,  one fluidounce;  mix.  The
 dose is a teaspoonful  three times a day.   This mixture and  the one following
 are very disagreeable to the taste, but are very efficacious after the inflamma-
 tory symptoms have subsided.  They must be  shaken thoroughly previous
 to taking each dose, and  in  order to protect the teeth  from the  injurious
 action of the acid in the Tincture of Muriate of Iron,  it  is advisable to rinse
 the mouth immediately after  taking each dose, with a solution of saleratus,
 or supercarbonate of soda.
  3. Take  of Oil  of  Cubebs, Oil of Anise, Balsam Copaiba, Laudanum,
 Tincture of Muriate of Iron,  each, one fluidounce; mix.   The dose is a tea-
 spoonful three times a day.
  -f. Take of Solidified Balsam Copaiba two ounces, White Wax one ounce,
 Oil  of Cubebs, Oil of Spearmint, each, one fluidrachm, finely powdered Nitre
 two drachms.   Melt the wax, add the oils, and then the Copaiba;  stir  all
 thoroughly together, and finally add the Nitre.   This forms  a  paste much
 used for the  cure  of gonorrhea;  the dose is from ten  to thirty grains
 three times a  day.
  5  Take of powdered Alum one drachm, Precipitated Carbonate of Iron
 half an ounce, Pulverized Cubebs  one  ounce,  Balsam Copaiba  a  sufficient
quantity to form a paste.  The dose is the same as the preceding.
, (*: 1^ke of CamPnor one drachm, Calcined Magnesia  one drachm and a
half, Nitre, Golden Seal,  each, two drachms, Gum Arabic three drachms;
mix together,  in very fine powder, and add  Powdered  Cubebs  one ounce and 
318                AMERICAN  FAMILY PHYSICIAN.
a half, Balsam Copaiba enough to form a paste.  The  dose is  the same as
the preceding.  This is much used in Cincinnati.   I have the  formula for
many other mixtures which have been found efficacious, but  the- above will
be more than sufficient to effect cures when skilfully employed.  A physician
informs me he has been very successful  by the following mixture:—Take of
Sulphur, Nitre, Alum,  each,  one-third of an ounce, Alcohol,  water, each,
one pint;  mix.  The  dose is a table-spoonful three  times a day.  I have
never used it.   (See Compound Copaiba  Mixture.)
  From the difficulty, however, in procuring pure  Copaiba, I have of late
years dispensed with its use,  and at present cure  this  disease without any
internal medicine,  save a purgative or two;  using mild injections alone, and
which have proved as beneficial as similar applications  to  an inflamed eye,
or other mucous surface.   The kind of injection, however, will  depend on
the stage of the disease, its peculiarity, and the influence produced upon it
by the application; several are used, among which the following have been
found the most efficient:—
  1. Take of Chloride  of Zinc from one to three grains,  distilled water one
fluidounce; mix.   Inject a teasponful of this every  six or eight hours, along
the urethra.  This may be used in any stage.
  2. Take of Iodide of Zinc from one to three grains,  distilled water one
fluidounce; mix.   Use as the preceding.
  3. Take of Decoction of Golden Seal, Cold Infusion of Wild Cherry bark,
each, one  fluidounce and a half, Tannic Acid thirty grains, Sulphate of Mor-
phia dissolved  in  the  least quantity possible of Alcohol,  five  grains; mix.
Inject a teaspoonful every four or  six hours along the urethra.
  4. Take of Decoction of Golden Seal one fluidounce,  Sulphate of Zinc
three grains ; mix.  Use as the preceding.
  5. Take of Nitrate of Silver two grains, distilled water  eight fluidounces;
mix.  Inject as the preceding, gradually increasing the strength as long as
no irritation is produced.
  Many other injections have been recommended, but I have found the above
the best;  the injection should always be used immediately after  urinating,
and the patient should not urinate afterward for at least half an hour; and a
glass syringe should always be used in preference to a metallic one.  In the
female, the vagina and  neighboring parts  should   be  injected and bathed
three or four times daily, with one of the above liquids.
  In the treatment of gonorrhea, the patient should keep as quiet as possible,
for exercise irritates the parts and  keeps up the disease, rendering it more
intractable to  medicine.
  When chordee attends, the following may be taken about an  hour  before
bedtime;  take  Powdered Opium one or two grains,  Camphor ten grains;
mix for a dose.  In cases where Opium disagrees, the following taken once
or twice in the latter part  of the day, will  be  useful:—Take of Extract of
Hyoscyamus  one  scruple;  Powdered Camphor hnlf a  drachm; mix,  and
divide into twelve  pills.  Two or three pills are to be taken for a dose.  La-
pulin, in doses of five or ten  grains, and repeated occasionally,  if necessary,
has also proved serviceable.  I have most generally overcome the  tendency
to chordee by having the patient rub the parts two  or three times a day with
the following liniment:—Take of Oil of Stillingia one fluidrachm, Oil of Lo-
belia half a fluidrachm, Tincture of Stramonium seed two fluidrachms, Olive
Oil four fluidrachms;  mix.   Or, in its absence,  the male  organ maybe
enveloped in a poultice of equal parts of Lobelia and Stramonium leaves, to
which a small quantity of Laudanum  is  added; and  these  will be found
preferable to medicines by mouth. 
GONORXHEA.                         319
   After gonorrhea which  has been accompanied by a severe and  obstinate
 chordee is cured, there sometimes remains a contraction of the froenum by
 which the penis is drawn down the same as in chordee, which may be termed
 chronic chordee; for  this apply either of  the following liniments  over the
 parts, on  apiece of lint, to be changed two or three times a day.  1.. Take of
 Inspissated Juice of Conium Maculatum, or, Belladonna, one ounce,  Oil of
 Stillingia two fluidrachms, Camphor,  Laudanum, each, one ounce;  mix, and
 thoroughly triturate together.   2. Take of Oil of Sassafras one fluidounce,
 Camphor one drachm, Opium  one drachm, Iodine twenty grains; mix,  and
 thoroughly triturate together.
   If pbymosis or  paraphymosis attends,  an operation is  seldom necessary.
 Apply twice  a day, over the swollen part, a warm fomentation of Stramonium
 leaves, Lobelia leaves, and ilops, equal parts.   Sometimes it will  be more
 beneficial to  apply this fomentation cold, renewing it as often as  it becomes
 warm.  Leeches may also be applied, especially if the symptom  appears to
 be obstinate.  When either of these  difficulties  are of  long-standing,  the
 following astringent poultice applied  two or three  times a day will prove use-
 ful:—Take of Lobelia, Bayberry, Witch-Hazle bark and Bloodroot, each, in
 powder, equal parts;  mix.   To a table-spoonful of Powdered Elm bark  add
 two teaspoonfuls of the above mixture and  make  a poultice.  Phymosis re-
 quires more  attention than  paraphymosis,  as it  may conceal a phagedenic
 ulcer, which  may prove serious.
   If swelling of the testicle comes on, either during  the  disease or at  any
 su^»equent  period, a poultice of Lobelia and  Stramonium leaves may be
 applied to the parts, which should be held up in a suspensory bag,  and  the
 patient should  exercise as  little as  possible; the poultice may be renewed
 two or three  times a day.
   When the  glands in the groin enlarge, giving rise to sympathetic bubo, a
 complete disappearance of the indurated swelling can hardly be expected till
 the gonorrhea is cured or  much abated.   As these  seldom suppurate,  the
 patient should remain as  still  as possible,  and  keep  the  tumor constantly
 moistened with the following:—Take  of  Tincture  of Conium Maculatum,
 water, each,   one fluidounce, Muriate of Ammonia two drachms;  mix  and
 make a lotion.
   Warty  excrescences may be  removed by applying the Nitrate of Silver to
 them daily;   or, a Saturated Solution  of Muriate of Ammonia; or, what  has
 been  found the most successful, powdered  Savin leaves.  When large they
 maybe nipped  off by a  sharp  scissors,  applying Nitrate of,Silver  to  the
 remaining cut surface.  (See Warts.)
   When gonorrhea has been improperly treated,  and even in cases  where
 proper treatment has been pursued, a chronic discharge, termed gleet, is very
 apt. to follow, and which is occasionally very difficult to remove.  It is often
 nving to a morbid irritation of the prostate gland.   I have frequently  cured
 gleet by the internal administration of formula No. 2,  for  the  cure of gon-
 orrhea, on page 317, together with an injection of  the following preparation
 into the urethra, and even into the bladder,  repeating it two or three times
 a  day:—Take  of Geranium two drachms,  Bloodroot one drachm, boiling
 water half a pint; mix, and digest for some hours, and then add Sulphate of
 Zinc half a drachm.  When this is dissolved, strain for use.   A teaspoonful
 may be injected at a time;  and if it act too severely dilute it  with a  small
quantity of water.   In some cases I have cured gleet by the following prepa-
ration;—Take of Tinctures of Blue Flag  and  Mandrake, each, seven flui-
drachms,  Saturated Tincture of Nux Vomica two fluidrachms; mix.   The
dose is from ten to fifteen drops, two or three times a day. 
320
AMERICAN  FAMILY PHYSICIAN.
   But the most  efficient means I have  ever  employed, and suited to the
greater number of cases, is  as follows:—Take of Extract  of Nux Vomica
twelve  grains, Sulphate of Quinia,  Extract of Hyoscyamus, each, twenty-
four grains;  mix and divide into twenty-four pills.   The  dose is one or two
pills three times a day, about an hour previous to each meal.  In connection
with  this the  following injection  must  be used:—Take of Strychnia two
grains,  strong Nitric Acid four drops, distilled water  two fluidounces; mix.
Inject a teaspoonful of this into the bladder, repeating it three times a day
after urinating, and retaining it in  the bladder as long as  possible;  if too
severe it may be  diluted by the  addition of more water.    Stricture of the
urethra will be treated of in a subsequent part of the work.
   The diet in gonorrhea and gleet should be light but nutritious and easy of
digestion, avoiding high-seasoned food, all kinds of acid food or drink, fat
or greasy articles, salt, salted meats, saccharine articles of diet, and all intox-
icating liquors; and the patieut should keep as still as possible.
                 INFLAMMATORY  RHEUMATISM.

  There is considerable diversity of opinion among medical men as to the
true character of rheumatism, some  locating  it in the fibrous  or  muscular
tissues of the system, and other viewing it as  an acute nervous  disease; and
there are strong reasons for considering this  latter view the correct one,
although  it is  not  entirely in  accordance with my  own opinion.  In this
uncertainty concerning its true nature, I have deemed it better to treat of
the disease among others of an  inflammatory character, as has been generally
done by authors, not only because of the accompanying symptoms of inflam-
mation, but also the similarity in treatment.   The disease is divided into two
forms,  the acute or  inflammatory, and the chronic.   Acute  rheumatism is
principally a disease of youth, rarely occurring after forty years of age, unless
it has existed previously.
  Symptoms.   Acute rheumatism may come on without any previous febrile
symptoms, but more generally  it is  preceded with  languor,  chilliness suc-
ceeded by heat, thirst, anxiety, restlessness, and a full and quick pulse, sel-
dom exceeding, however,  110 in  the minute, the tongue  is usually coated
white, occasionally red or dry.   Accompanying, or  soon after  these symp-
toms, a stiffness is felt in the muscles, with a sense of soreness, which is more
or less speedily followed by excruciating pains in one or several parts of the
            Fig. 23.             body,  particularly  in the joints of  the toes,
                              ancles,  knees,  wrists,  elbows,  and shoulders.
                              The pains shift  about from one joint to the
                              other, and are always accompanied with swell-
                              ing of the part, redness, and extreme tender-
                              ness to the touch; this tenderness is frequent-
                              ly so great that the patient  cannot even bear
                              to have a person walk across the floor of his
                              chamber.  Sometimes  the attack is  confined
                              to one joint or limb,  but more generally it
                              changes about, and the pain and swelling of
                              one  part may continue, or gradually subside,
                              as the disease appears at another part.   Fre>
                              quently the heart or its covering is attacked,
                              causing endocarditis, or pericarditis, and oi
                              which, delirium gives an ominous indication.
Varieties of Urio Acid Crystals. 
                     INFLAMMATORY  RHEUMATISM.                321

 The bowels are generally costive, and the urine is scanty and high-colored,
 depositing a  brickdust-colored  sediment of uric acid.   (See  Fig. 23.)  In
 the course of the disease there is often a profuse sweating, of an  acid  odor,
 which, however, affords no relief.   Both  the pain and febrile symptoms be-
 come more severe toward the evening, and abate considerably in the morn-
 ing.   The fever rarely lasts over two or three weeks, but the pain and swell-
 ing may continue for a much longer period.   Throughout all the febrile dis-
 turbance there is no marked trouble of the stomach or bowels,  no diarrhea,
 no petechia?,  no aphthae, and no sordes about the mouth,  nor does the fever
 have any tendency to degenerate into a typhoid condition.
   The acute form of rheumatism may be translated to any part of  the  sys
 tem,  as the  heart, lungs, diaphragm,  liver, stomach,  bowels, womb, &c.
 When the heart is attacked, there is acute pain over that region, with palpi-
 tation,  difficult breathing,  partial  fainting, great anxiety, pale, distressed
 countenance,  and delirium. . When the brain is attacked, there is acute pain
 in the head,  intolerance of light, a wild and anxious expression of the face,
 heaviness, and sometimes delirium.   When  the disease fastens upon the
 Btomach, there is pain in its  region, with nausea,  vomiting, &c.  And when
 these internal organs are attacked,  the disease is  liable to terminate fatally,
 unless prompt and efficient treatment be adopted.
   When the symptoms are less  severe in their character, the term sub-acute
 rheumatism has been applied to the disease.  Pleurodynia is subacute rheu-
 matism when located in the respiratory muscles; lumbago, when the musclea
 of the back are affected with it;  hemicrania, when the scalp is its seat;  and
 sciatica,  when it  attacks the neurilemma of the  sciatic  nerve.  And these
 affections will require a treatment similar to that hereafter recommended.
   Discrimination.  The only disease with which inflammatory rheumatism
 is liable  to be confounded is, gout.   But gout  is usually confined to one spot,
 attacks the sinalkr joints, comes on suddenly, is preceded by dyspeptic symp-
 toms, has not a great increase of fever and pain at night, and concretions are
 formed about  the small joints; whereas acute rheumatism is very changeable,
 is chiefly confined to the larger joints, comes on by a slow and gradual in-
 crease of the  pain, is not preceded, necessarily, by symptoms of indigestion,
 and is worse  at night.
   Acute  rheumatism  has been  divided  by authors  into the  fibrous form
 and the synovial or diffused.  In the fibrous form, the inflammatory symp-
 toms run high, tongue thickly furred, pulse round, full, and bounding, pro-
 fuse, acid, spontaneous perspirations, which exhaust the patient's strength
 without alleviating his suffering, urine acid, high-colored, depositing a co-
 pious brickdust sediment of uric  acid. The inflammation usually commences
 in the immediate neighborhood of one of the  larger joints, not in the joint,
 but near it.  At first, there is much redness or swelling, but after the pain
 has been of some  duration, there is a puffiness around the parts affected,
 and, at  length, slight  edema, or pitting on pressure, may supervene from
 effusion into the surrounding areolar  tissue.
   The synovial or diffused form,  frequently termed " rheumatic gout," more
 frequently attacks  the knee, or large joint of the great toe, the fever is either
 less intense from  the beginning, or  moderates soon after the joints begin to
 swell, the tongue  is less coated, the patient sweats much less, the swelling
 of the joints,  being the result of fulness and distension of the synovial mem-
 brane, is tight and elastic, and, as  it were, protrudes through the spaces
 that intervene between the tendons and ligaments  by which it is in other
 parts bound down and restrained.  Fluctuation is also distinctly percepti-
ble in the superficial joints.   A most important difference between  heae 
322                AMERICAN  FAMILY PHYSICIAN.
two forms, is that there is a greater tendency to settle upon the membranes
of the heart in the fibrous than in the synovial form.
  Causes.   Acute rheumatism is said to be generally produced by an expo-
sure to cold or damp, as by wearing damp  clothing, lying in damp beds, or
on cold and  damp  floors, or on the ground, &c.; but these exposures are
frequently made, and to their fullest extent, without a subsequent attack of
rheumatism.   Beside, the disease frequently occurs without any exposure
.f this kind whatever.  I  have frequently seen it well  developed in cases
where the only previous apparent cause was the daily and continued use of
alcoholic drinks in  small doses, or, in other words, where the whole system
was kept for a time in an irritable condition by constant tippling.  I  con-
sider rheumatism  to be a disease of the blood altogether, and probably of
those constituents of it upon which the integrity of muscular tissues depends.
Upon the approach of damp weather, the  unhealthy muscles expand, and
by pressing upon  their accompanying  nerves, produce  more or less pain,
according to the degree of pressure,  as well as the degree of sensitiveness
of these nerves; and  as  soon as clear, pleasant weather approaches, the
muscles become reduced to their original size, the pressure upon the nerves is
removed, and the patient is then free from pain, and comparatively well.  But
when, in addition to this peculiar tendency of the disease, the system is ex-
posed to certain exciting causes,  as cold, thereby increasing the  debility of
the parts attacked, and rendering them more sensitive to an attack when it
does occur, the symptoms will be more or less severe and persistent, accord-
ing to the degree of debility and sensitiveness effected by the exposure.
Perhaps, this condition of the blood may he  a diminution of  some of its-
alkaline constituents,  or an excess of its acid.   It would be a very  desira-
ble matter to learn whether  the injection  of a small  proportion of a Solu-
tion of Uric Acid,  or of Lactic Acid, into the synovial fluid of  the joints,
would cause the active characteristic  symptoms of acute rheumatism.  The
presence of lactic acid  probably  occasions rheumatism, while gout may de-
pend upon excess of uric acid in the circulation.   The pain,  although gene-
rally looked upon as the disease itself, is only a symptom of it—the disease
is located  in the  blood.  A rheumatic pain may be produced by pressing
with a finger upon  that branch of the median nerve which  lies between
the knuckles of the second and third fingers;  if the pressure be continued,
a severe neuralgic pain will  soon take place;  and if the pressure be main-
tained sufficiently long, provided the person can sustain it, the  pain grad-
ually ceases, a sensation of numbness will follow, and a subsequent paralysis,
which will  require several days to thoroughly remove.   A  similar effect is
produced when persons accideutly hit the  elbow on some prominent object,
in which the ulnar nerve is  suddenly pressed, pain is produced, and fre-
quently a slight paralysis for a few minutes.   And it will be  found  that
these results will be more readily and  severely experienced by  individuals
who are disposed to rheumatism.
   Treatment.  The great  difficulty in curing rheumatism in any of its
forms, lies in the fact that patients instead of  pursuing a curative course of
treatment, turn all their attention  to a removal of one of its symptoms,
pain, and when this is accomplished, all  further  medication  is dispensed
with, until a second exposure is followed  by a second  attack of pain,  when
 this is again energetically treated, and removed; and  this course persisted
 in for several times, ultimately produces such  a condition of the tissues and
 parts attacked, as to render a permanent  cure entirely  out of the question.
 Rheumatism is as curable a  disease as  any other, but to effect this result,
  not only must a treatment  be  adopted to relieve the  pain produced  by  n"i
9 
INFLAMMATORY  RHEUMATISM.
323
 but likewise to remove tho condition of the fluids of the system upon which
 it depends.  I would c;ill the attention of both the  profession and the pub-
 lic, to the  above views concerning this disease, which, as far as  I am aware,
 have never before been presented to them.
   In  the  cure of inflammatory rheumatism,  the indications of  treatment
 are two-fold:  firstly, to relieve the pain and  suffering during an attack;  ,
 and secondly, to make use of means subsequently,  in order to  prevent any
 further  attacks, or, in other words, to  remove that condition of the blood
 which occasions the disease.
   During  an  acute attack of rheumatism, the first thing  to be effected is
 the production of a copious perspiration; for which purpose, the  Spirit va-
 por bath  may be used, or, if  the  condition of the  patient is such that he
 cannot employ this, the Compound Tincture of Virginia Snakeroot, may be
 given in some warm infusion of Pleurisy root, or Crawley, and continued
 until free sweating is induced.  But the sweating should not be continued
 too long, as it will relax the skin, and occasion great exhaustion, neither of
 which are  desirable.   In the meantime, the bowels should be acted upon by
 an active cathartic, as the  Compound Powder of Jalap, or the Compound
 Powder of Leptandrin;  and the cathartic may be  repeated  every day for
 two or three days in succession.   Over the painful and swollen joints, warm
 or cold  fomentations,  according to the influence exerted by the degree of
 temperature, should  be applied,  as of Hops and Lobelia, Hops and Cicuta
 leaves, or Hops and Stramonium leaves, &c, and the water used in prepar-
 ing the fomentations should be slightly alkaline, or  a weak  ley water.   But
 the best application that I have ever used, is the fresh leaves of Stramonium
 pounded, bruised, moistened with a little water, and applied over the parts,
 renewing it three or four times a day.  In some very violent cases in which
 I have employed  this agent, the  pain has ceased in fifteen minutes from its
 application, but its use requires to  be continued for a considerable time,
 else the pain will return.   In the absence of the recent leaves, an inspissa-
 ted juice of them may be used, or the articles  named above.  Beside these,
 it will be proper to apply a Mustard poultice along the whole course of the
 spinal column, and, in very violent cases, Firing should be employed, (See
 Part III.,) especially over  those portions of the spinal column which are
 very painful on pressure.  Liniments are of no service, and should not be
 used.
   Internally,  the best remedy to overcome the peculiar condition of the
 blood, which  disposes to the disease,  is  a  mixture of equal parts of the
 Tincture of Black Cohosh root,  and the Tincture of Colchicum  seeds, of
 which from ten to sixty drops  may be administered, as  circumstances indi-
 cate, every one, two, or three hours.  During the severity of the symptoms,
 which  are  apt  to occur in the latter part of the day, from three  to eight
 drops of the Tincture  of Aconite root may be added to each dose;  and du-
 ring the  remissions, which usually occur in the early part of the  day, the
 Aconite should be omitted, substituting for it a grain  or two of Sulphate
 of Quinia to each  dose.  And this course should be pursued  daily as long
 as the inflammatory symptoms remain, which may be from ten days to four
 or eight weeks; more generally, however,  the disease will yield in from five
 to twelve days.
  Other  agents have been advised  for the above  purpose, and which  may
occasionally be found useful, as:—1. Take of Tincture of Black Cohosh root
two  fluidounces, Saturated  Tincture of Nux Vomica one fluidounce; mix.
The dose is from  twenty to forty drops, three or four times a day, accord-
ing to the  influence  produced: this is a good  preparation,  but  should be
used with great care. 
324
AMERICAN  FAMILY  PHYSICIAN.
   2. Take of recent White Hellebore root six ounces, Opium half an ounce
Alcohol one pint; add the articles together, macerate for fourteen days, and
filter.  The dose is from ten to sixty drops, three or four times a day,  suffi.
cient to affect the head without producing nausea.
   3. Take of Saturated Tincture of Rhus Toxicodendron half a fluidounce
Tincture of Aconite root two  fluidrachms, Volatile Tincture of Guaiacum
two  fluidrachms;  mix.  The  dose is thirty or forty drops every three or
four hours.
   4. Take of Nitre five  grains, Opium, Ipecacuanha, each, one grain; mix
for a dose, to be repeated every two or three hours.  Administer an alka-
line  purgative,  and apply dry wool to the affected joints.
   5. When called upon to treat the first attack of acute  rheumatism, admin-
ister a sufficient quantity of the  Tincture of Black Cohosh, (from three to
sixty drops,) every two  hours, night and day, until the head becomes af-
fected; then lengthen  the intervals  between the  doses to three, four, or six
hours,  sufficient to keep up the action on the brain, and which action must
be continued for not less than seven days, or until the disease is completely
removed.   It changes  the rheumatic diathesis, so  that a second acute attack
will rarely occur.
   In connection with the above measures, diuretic infusions must be drank
freely through the inflammatory stage; as of Cleavers,  Haircap Moss, Bur-
dock seed, Wild Carrot, &c.   Lemonade has been recommended as a drink,
or even Lemon juice,  but although occasional  benefit may ensue from  it, 1
do not place confidence in it as a curative agent.
   During the acute stage, the patient must be kept quiet, and in the recum-
bent position ;  the atmosphere of the room which he  occupies,  should be
uniformly maintained at a moderate temperature, and his diet  must be verj
light, as barley-water,  toast-water, thin gruel, &c.  When one of the inter-
nal organs becomes  attacked, the Compound Tincture of Virginia Snake-
root should be given every ten or fifteen minutes  in teaspoonful doses, until
free  perspiration, followed by relief, is obtained.
   When  the pain and  inflammatory symptoms  have subsided,  the diet must
be more nutritious, as  soft-boiled eggs, bread,  biscuit, fowls, &c, returning
gradually to the  ordinary diet.   All fats, acids, and every thing that  will
cause acidity of stomach,  or flatulence, and all stimulants, especially liquors
of all kinds, whether cider, vinous,  malt, or spirituous, must positively be
avoided.   The surface  of the body must be rubbed once or twice a day with
a coarse towel,  using sufficient friction to cause an agreeable  glow of heat,
and the patient should use moderate exercise, both within doors and in the
open air, being extremely careful, however, not  to fatigue  himself, and to
avoid all  exposures which may  excite a new attack.  Any stiffness or swell-
ing which may remain, may be overcome by one of the following applica-
tions :—Take of Muriate of Ammonia two drachms, distilled water one fluid-
ounce; dissolve the Ammonia  in the water, and  add  Tincture of Hemlock
one fluidounce.  The parts may be bathed with this several times a day, or
lint may  be moistened  with it,  and applied over the parts, renewing the ap-
plication several times  a day.   Or the Compound Plaster of Belladonna maj
be applied.
   In order to make  a  thorough  and permanent  cure  of the disease, not
only must the preceding hygienic measures be rigidly attended to, but the
subsequent remedial means should be perseveringly employed, and  which
will  require to be  continued for one or two years, depending, however,
apou the natural resisting powers of the organ to disease, and other condi-
tions and circumstances.  The mixture of the tinctures of Black  Cohosh 
CHRONIC RHEUMATISM.
32b
and Colchicum seed, above referred to, should be  taken  three  times every
day, in doses of from half a teaspoonful to a teaspoonful.  And in addition
to this the Compound Syrup  of  Stillingia with  the  Iodide of Potassium
added, in the proportion  of one ounce of the Iodide  to  each  pint of  the
Syrup, should likewise betaken daily in teaspoonful doses.   And, if neces-
sary, other measures,  named in the  treatment of chronic rheumatism may
be pursued.
   The following have been recommended for acute rheumatism, after  the
subsidence of the inflammatory symptoms :  1. Take  of powdered Guaia-
cum,  Nitre,  each, one drachm,  Ipecacuanha three  grains, Opium  two
grains; mix, and divide  into  six powders.  The dose is one  powder in
jelly or molasses, to be repeated every three hours, and continued for some
days.   2. Take  of decoction  of  Peruvian bark one ounce and a half, dis-
solve in it Nitre  twelve grains, for a dose, to be repeated  every four hours.
3. Take of the dried Inspissated Juice of Poke berries, White Pine pitch,
each twenty grains, Cimicifugin, ten  grains; mix, and divide into twenty
pills,' one of  which may be given every four hours.  In the synovial form
of rheumatism known as gouty rheumatism, I have derived excellent results
by the intermittent application over the affected part, of the Com[%iind  Tar
plaster, maintaining the discharge each  time, as  long as the patient  can
bear it, together with the  internal use  of the Stillingia syrup as above.
An ice poultice,  referred  to in gout, will frequently be found serviceable
in allaying the paroxysm of pain.
                     CIIIIONIC  RHEUMATISM.

   Chronic Rheumatism may follow as the sequel to an acute attack, but it
 is more  frequently found to exist entirely  independent of any previous
 inflammation.   It differs from the acute form  in being seldom accompanied
 with any marked febrile  symptoms.  It is a very  tedious  and obstinate
 disease to cure, on account of the inattention  bestowed upon it, during the
 absence of actual suffering;  but when early and properly attended  to,  is as
 readily curable as most maladies.
   Symptoms.   The pains in chronic rheumatism are usually confined to
 the large joints, most frequently to the hips, loins, knees, ankles, shoulders,
 &c, though every joint is  liable to suffer;  and the pain may  be confined to
 one particular  part, or may shift from one joint to  another, being  at one
 time in the head, at another in  the knees, wrists, fingers, or shoulders, &c.;
 and this shifting  is more especially present in  those cases accompanied
 with a slight degree  of inflammation.  The  pain  is generally worse  at
 night, commencing on going to bed,  while that occasioned  by syphilis or
 mercury, begins at from three to five o'clock in the afternoon, and is seated
 :n the long or flat bones.  Some persons are  hardly ever  free from pain,
 while others suffer only on the approach of cold or  damp weather,  or from
 improper exposures.   The joints are usually swollen but not to that extent
 as in the acute form, and the skin is not attended  with the redness of the
 inflammatory variety, but is pale, cold, and stiff, and cannot easily be made
 to sweat.  ^ When the patient remains at rest for a short time, he will expe-
 rience pain and stiffnes#in the affected part on attempting to moverit;  but,
 on exercising until the body becomes warm, both the pain  and stiffuess dis-
 appear.   The pulse is generally quick and  tense, more particularly toward
night; the appetite more or less impaired; urine  variable; bowels irregu-
lar;  with a tendency to coldness of the  hands and feet, numbness of the 
326
AMERICAN FAMILY  PHYSICIAN.
limbs, and not unfrequently, a partial impotency.   When chronic rheuma
tism  is permitted  to  progress  without attempting a  permanent cure  it
causes organic disease of the tendons, permanent stiffness of the joints, and
a wasting and hardening  of the  muscular structure about the parts, with
considerable deformity.  Sometimes there is an effusion of a jelly-like sub-
stance in the cavity of the affected joints.   But these results rarely follow
an early and proper treatment of the disease.
  Causes.  The causes of chronic rheumatism are the same as those which
produce the acute species.
  Treatment.  This is divided  into, firstly, palliative means to remove
the pain, and secondly, constitutional  remedies to prevent a return  of the
pain, and  ultimately cure  the disease ;  and without a proper attention to
these, a permanent  cure cannot be expected.
  To remove the pain and  stiffness  of the limb  or part affected, it will he
proper to attend to  the condition of the  stomach  and bowels, commencing
the  treatment  with a mild  laxative  should the  bowels  be  constipated.
After the operation, a Spirit vapor bath should be used, and the patient be
permitted to perspire  freely, at the same time applying Mustard along the
whole co#-se of the spinal  column.  However, these  measures will not  be
required, unless febrile symptoms arc present,  in a minor degree.
  Ordinarily,  if the pain and stiffness cannot be  removed by rubbing the
parts, and  by exercising them; or,  if exercise should increase  the pain,
much benefit may be  derived by exposing the part  to the vapor of hot
water until a perspiration is induced;  this should be  continued for half an
hour or an hour, when  the parts should be  thoroughly dried, and some
stimulant applied, as  the Compound  Tincture of Camphor.  Shampooing
the diseased parts, according to the practice of the eastern nations, will be
found a very valuable  mode of stimulating and exercising them, and may
be put into operation  while the  stimulating  tincture  or liniment  is being
applied.  In many  instances, water,  at 100° F., poured from the spout of a
tea-kettle  or. other vessel at a height of four or five feet, upon an affected
joint, and continued for two or four  minutes, followed by thorough friction
with some stimulating liniment, together with gentle movement of the joint,
will  frequently be found decidedly beneficial.—/.  G. Jones.
  After the pain is  removed, the above stimulating tincture, or some other
similar  preparation should be applied  two  or three times,  daily, to  the
parts, and a current of the electro-magnetic fluid  should likewise be passed
through them, continuing it for fifteen or twenty minutes each day.  Elec
tro-magnetism, although of great value in the treatment of many chronic
diseases, will rarely be found to  effect  a  permanent cure, unless the proper
medicinal  agents be  administered in connection with it, when, it will
greatly facilitate the cure.   I have  known  many persons to rely solely on
electro-magnetism in  certain maladies, and  become apparently well, but as
soon as they ceased its use the affection gradually returned.  Proper reme-
dies must always be employed with it, if permanence of recovery is desired.
Firing, over  the diseased  joints, and over  those parts along the  spinal
column which are  tender on  pressure, will  likewise  be found a  valuable
mode of stimulation and counter-irritation.
  The bowels must be kept  regular daily, by the administration of a mix-
ture  of Rhubarb two parts, and Bicarbonate offPotassa one part, and
which must be given  in doses varying from  three to  twelve grains, or, suf-
ficient  to produce  one  natural evacuation  daily, and  which  dose must be
repeated three times  a day.   The constitutional  treatment will require to
be pursued perseveringly for many months, perhaps for a year or two, and 
                        CHRONIC  KHEUMA'iWM.                     327

 it will vary much, depending on the individual's temperament.   The follow-
 ing are among the best preparations with which I have effected permanent
 cures:—
   1.  rl'ake of Black  Cohosh root, Prickly-Ash  berries,  Pipsissiway, and
 Sassafras bark, each, one  ounce, good French Brandy four pints..  Macerate
 the drugs, coarsely  powdered, in the Brandy for  fourteen days.  The dose
 is a table-spoonful in  a wineglassful of sweetened water, and which may be
 repeated three times a day.
   2.  Take of Twin leaf,  Black Cohosh, Poke berries, Resin of Guaiacum,
 Prickly-Ash  bark,  each, one  ounce, good French Brandy  four  pints.
 Macerate  the drugs, coarsely powdered, in the Brandy for fourteen  days.
 The dose  is the same  as in the preceding.
   :).  Take of Blue Flag, Poke berries, Prickly-Ash bark, and Black Cohosh,
 each, one ounce, good French Brandy four pints.  Prepare and use as the pre-
 ceding, being careful in all instances to lessen the dose if it prove too active.
   4.  Take of Alcoholic  Extract of Black Cohosh, Alcoholic Extract of
 Blue Flag, Extract of Poke, each, one drachm, Guaiacum in powder, suffi-
 cient to form with the above a pill mass.   Divide into four grain pills, and
 administer one every three or four hours daily.
   5.  Take of Compound Syrup of Stillingia twelve fluidounces, Tincture
 ■of Klaek Cohosh  four  fluidounces, Iodide of Potassium one ounce; mix.
 The dose is one or  two teaspoonfuls in half a gill of water, to be repeated
 three times a day.
   G.  Melt and strain White  Gum Turpentine  one ounce, and add to it
 powdered Guaiacum  and Inspissated Juice  of Poke berry,  of each, one
 ounce.  Divide into three or four grain pills, and administer one pill every
 hour  or two.
   Many other agents could be  named,  but the  above will be found suffi-
 sient to meet nearly all  cases which may be met with.   A very excellent
 agent, and one  which 1  have used extensively in the ordinary forms of
 chronic rheumatism is made as follows:—Take of Cimicifugin, Xanthoxy-
 Iin, and Apocyuin, each, one  drachm,  Whisky or good Gin one  pint.
 Mix the  articles in  the  liquor, and  then dissolve them.  The dose is a
 table-spoonful,  repeated three  times a day, or a sufficient quantity to keep
 the head very slightly affected.
   In  warm weather, rheumatic patients should  wear  silk next the  skin,
 and in cold weather,  flannel.  The  whole surface of the body should be
 frequently bathed with a weak alkaline bath, and  the Spirit vapor bath
 should be taken every two or three weeks.  The body should always be
 kept comfortably clad, and much care is necessary  to guard against cold,
 and dampness.   Exercise should be  taken daily, but  never  carried to fa-
 tigue, and the diet should be light and nutritious, avoiding acids, fats, and
 vinous and malt liquors, or the same as is recommended after convalescence
 from the acute form.  The above treatment is applicable  also to Lumbago
and Sciatica.
   Be lore closing this subject, it may be well to refer to several compounds
 which  have  been  highly recommended  as  local applications in chronic
 rheumatism.
   1. Take of Oil of Hemlock,  Oil of Tar, Oil of Sassafras, Pyroligneous
 Acid,  Alcohol,  Aqua Ammonia  FFF,  each, one fluidounce;  mix  for a
Jiniment.
   li. Olive Oil, Oil of Turpentine, Oil of Peppermint, Laudanum, Alcohol,
Aqua Ammonia FFF,  each,, one fluidounce;  mix, for  a liniment.
   '.'>. Oil of Origanum, Oil of Hemlock, Oil  of Cajeput, Camphor, of each,
one pound, Capsicum, half a pound;  mix, digest for two weeks, and filter. 
328
AMERICAN  FAMILY  PHYSICIAN.
  4. The- Compound Liniment of Oil of Amber.
  5. For that form of chronic rheumatism connected with a syphilitic raint
the following will be found  valuable as a  constitutional remedy; take  of
Blue Flag, Prickly-Ash bark. Poke, Stillingia, each, one ounce, Sheep Laurel
leaves, Stramonium  seed, each, three drachms.   Pour  on these  articles  in
coarse powder, two pints of boiling water, and when cold add two pints  of
Whisky, two pounds  of white sugar, and four ounces  of Iodide  of Potas-
sium.  Allow the articles to digest for ten or twelve days, when the prepara-
tion will be ready for use.  The dose is  from a teaspoonful to a table-spoon-
ful, three  or four  times a  day.  I have  recently  cured several  cases  of
rheumatism, (in which the urine was devoid  of earthy salts but  contained
an  abundance  of  Urate of  Ammonia,) by the administration  of diluted
Nitric Acid internally, together with the exhibition of Nitrate of Iron as a
tonic.
                        GOUT,  or  PODAGRA.   ,

  Although this affection is not strictly an inflammatory disease, yet I have
placed it in this relation, for  reasons  similar to  those given for rheumatism.
Gout generally attacks men, and especially those  of sedentary and indolent
habits, who live generously, using freely of animal food, rich sauces, wines,
malt liquors, &c.  Occasionally it is met with  among females.  Three vari-
eties of  gout have been described, viz., the acute, chronic, and nervous.
  Symptoms.  An attack of acute  (or regular) gout sometimes  comes on
suddenly, without any premonitory indications, but most commonly it is pre-
ceded by indigestion, drowsiness, flatulence, headache,  nausea, an unusual
coldness of the feet and legs, a suppression of perspiration  in  them, numb-
ness, or a pricking sensation along the whole of  the lower limbs, great lassi-
tude, constipation, and pale urine.  Patients frequently complain of a feeling
as if something cold were moving along the thigh downward, sometimes com-
paring it to water, at other times to wind, &c.  The paroxysm usually cornea
on during the sleeping hours, but more frequently from one to four o'clock in
the morning, with a most  acute  and tearing  pain in the great toe, the heel,
calf of the leg, or perhaps, the whole of  the foot; but the ball or  first  joint
of the great toe is the part more frequently attacked.   The pain  continues
to increase in violence, causing a sensation as  if the  parts  were dislocated,
and, at the same time,  were having boiling water poured upon them.   Cold
shiverings are felt  from  the  commencement  of the pain, the parts become
swollen,  hot,  and  red,  with  more or less severe throbbing, and the least
motion augments the pain.  The patient  becomes exceedingly  restless, the
pulse  is full, hard^,  and frequent, and the skin dry and hot.   In about six or
eight hours there is a remission, the symptoms diminish in severity, except
the swelling, which continues, a gentle  sweat breaks out,  and the patient
obtains  some sleep; but about the same time on the succeeding evening a*
that in which the first attack occurred, the paroxysm is renewed, with  more
or less violence, and continues in this manner, having remissions and re-
newed paroxysms for several days or  weeks in succession;  more commonly,
about fourteen days.   Finally, the  redness and swelling abate, the parox-
ysms become milder, and the disease goes off either by  perspiration, copious
discharge of lateritious urine, or  diarrhea;  an  itching of the parts  takes
place, and the scarf-skin  covering them peels  off in branny scales.  The
patient is generally left with some lameness and soreness  for  a  length  of
time,  but his appetite and spirits are much improved. 
GOUT.
329
  The disease sometimes attacks  the  other  foot, after leaving the first, and,
in some cases, it attacks  both feet at  the same  time.  At first, two or three
years may elapse before a second  attack is experienced, depending consider-
ably on the habits and constitutional  vigor of the person, but if  allowed to
continue, it ultimately becomes more  frequent, the  paroxysms  recurring at
intervals of from one to  three months, the  disease  becoming habitual  and
chronic.  When  gout continues for  any length  of time, a stiffness  and
swelling of the joints takes  place, the  limbs become  painful and crippled,
and deposits of urate of soda take place in the joints as well as in the
lingers, and  to which the  term  "chalky concretions,"  has been applied;
these concretions  form small, hard swellings, termed "nodosities."
  When the gout suddenly leaves a joint, and is translated to some internal
part, it is termed  rctrocc.dmt or repelled gout.  When it falls on the stomach,
it occasions nausea, vomiting, coldness in the region of the stomach, violent
cramp-like pains, kc, and patients  have died in a few minutes after such an
attack; when on the heart, severe pain in  that region, with palpitation, diffi-
cult breathing, and faintings; when on the lungs, asthmatic symptoms;  and
when it is translated  to the head,  delirium, headache, coma, apoplexy, or
palsy, are the results.
  Chronic or irregular gout is generally a consequence of the acute; there
are  no febrile symptoms, but the parts become stiff, purplish, and  edema-
tous.  It may also  assume the retrocedent form.   Chronic gout  is the dis-
ease of a  degenerated or impaired constitution, and although  absolutely
incurable  by  any of the means  at present  known,  it  may be  materially
benefited  by a proper attention  to hygienic measures.   In this form the
patient is subject  to symptoms of a  disordered  digestion, with more or less
depression of spirits and  irritability  of temper.
  Nervous gout is peculiar to nervous  persons, and  those gouty individuals
who have become somewhat careful in their habits; and  it has been  fre-
quently confounded with neuralgia.   The  pain is dull or lancinating, limited
to a single joint or  shifting, and  often  occasions dyspepsia,  troublesome
cough, difficult breathing, palpitation of the heart, kc.  Like the other forms
it may occasion death by a sudden translation to some internal organ.
  Causes.   Gout is owing to an excess of uric  acid in the blood, the result
probably of some defect  in the depurativc function of the kidneys, or, per-
haps, a fault of assimilation, either primary,  secondary, or both.   It may be
excited into action, by exposure to cold and damp, long want of rest, violent
mental emotions,  improper diet, free use of acid wines or fermented liquors,
all excesses, constipation, accumulation of acidity in the stomach, sedentary
and  studious habits, severe  or  violent exercise, &c, but more especially by
an indolent or sedentary  mode of  life conjoined with luxurious diet.
  Discrimination.  Cout may be determined from rheumatism, by observ-
ing  that rheumatism principally occurs among young persons, or middle-aged,
while gout chiefly selects the elderly; rheumatism occupies the larger joints,
and  is very  liable to shift, gout seizes the  smaller joints, especially those of
the  feet and hands, and is not so apt to change about;  rheumatism is seldom
preceded by  dyspeptic symptoms, gout almost invariably; besides, in gout
the  pain is more like burning or scalding sensation,  and  the  parts are more
swollen and red  than in rheumatism.  The profuse acid perspirations so
common in acute rheumatism are seldom observed in gout.
  Treatment.  This will be divided into  that which  is  proper  during the
attack, to relieve  it, and  that which  is applicable to  the intervals,  to prevent
:i return of the paroxysm.
  The treatment during the  paroxysm, will consist of measures to lessen tha 
330
AMERICAN  FAMILY PHYSICIAN.
 pain and inflammation, for which purpose, the patient should be placed at
 once upon a light diet, being careful, however, not to withdraw stimuli too
 suddenly from those who  have been  greatly accustomed to it.   The foot
 attacked must be exposed  to the action of vapor of water for some  time  say
 half an hour, after which, tepid water should be applied, keeping the parts
 constantly moistened,  by a sponge or wet cloths, and renewing as often as
 they become dry; this will produce a  safe and powerful refrigerating influ-
 ence.
    Frequently much relief  may be obtained by placing the foot in tepid
 weak ley water, and holding it there for fifteen or twenty minutes, and after-
 ward applying a poultice of recent Stramonium leaves bruised, and moistened
 with the tepid weak ley.   Or, a fomentation of Stramonium leaves, Hops, and
 Lobelia, in weak ley water, may be applied tepid, renewing it  before it be-
 comes dry.   Liniments are entirely useless, unless indeed the  following be
 found  of service :—Take of Laudanum  one  fluidounce, Oil of Lobelia half a
 fluidounce, Neat's Foot Oil, and Spirits of Hartshorn, each, two fluidounces;
 mix.   This may be carefully rubbed upon the part,  or, it may be applied on
 a piece of flannel to the affected joint.  In cases of chronic Gout, where there
 is no tendency to a shifting  of the disease, I have derived  more immediate
 and permanent benefit from an ice poultice than anything else;  the ice is to
 be finely pounded;  loosely  put into a thin bag, and placed around the painful
 joint, where it may remain for  a few minutes, being careful not  to allow it to
 freeze  the parts.  Several individuals who used it according to my directions
 a year or two since, have  not yet had a return of the paroxysm, which oc-
 curred previously every three or four months.   And I would also remark that
 a permanent discharge kept up from the affected part, by the Compound Tar
 plaster, has in several instances wrought the most happy effects.
   Internally, some preparation of Colchicum should be administered, as this ■
 agent has the power of augmenting the quantity of urea and uric acid in the
 urine,  and thus conveying  it from the blood.   The  Tincture of Colchicum
 seed may be administered  in doses of from thirty to sixty drops, every three
 or four hours, after having first thoroughly evacuated the bowels by a com-
 bination of Podophyllin one  or two grains, Cream of Tartar  half a drachm,
 Should the Colchicum  produce  much nausea, or much irritation of the bow-
 els, the quantity should be reduced; and its use should be continued until
 the paroxysm is subdued.  The Colchicum may also be administered in con-
junction with other agents  which will render the uric acid and urate of soda
 more soluble, thus:—
  1. Take of Tincture of Colchicum seed one fluidounce, distilled  water two
 fluidounces, Iodide of Potassium  one drachm; mix.  The dose is a teaspoon-
 ful every two or three  hours.
   2. Take of Tincture  of Colchicum  seed one fluidounce,  Liquor Potassa
 one fluidounce; mix.   The dose is a teaspoonful every three or four hours,in
 some sweetened water, or some aromatic infusion.
  Particular attention should be paid to the kidneys,  keeping up a free uri-
 nary discharge by means of diuretic infusions with Cream of Tartar.  Infu-
 sion of Trailing Arbutus, of Dwarf Elder bark, or of Wild Carrot root, maj
 be used freely; and the Cream  of Tartar may be given in doses of ten grains
 every hour or two.   A concentrated decoction of the root and tops of Rest-
 harrow (Ononis Spinosi, or, 0.  Arvcnsis,)  will be found powerfully diuretic.
 Regular action of the bowels should likewise be obtained by the exhibition
 of Podophyllin, or  the Compound Powder of Jalap ;  and any existing acidity
 of  the  stomach must at  once  be corrected by the use of a solution of Bl-
 ear Donate of Potassa,  in table-spoonful doses  every hour. 
DROPSY  OF THE BRAIN.                     331
  To secure rest and ease from pain,  the Compound Powder of Ipecacuanha
and Opium may be given ;  or the Sulphate or Acetate of Morphia may be
exhibited in quarter-grain  or half-grain doses every one, two. or three hours,
until sleep and quiet is produced.  When opiates disagree, Hyoscyamus may
be substituted.
  When the disease suddenly attacks the stomach, heart, &c, place the feet
immediately in strong hot mustard  water,  apply  stimulants^ and Mustard
along the whole course of  the  spinal column, and administer internally full
doses of the Compound Tincture of Virginia Snakeroot, or other stimulating
diaphoretic, repeating it every ten or twenty minutes, until relief is obtained
and the disease has  returned to its original location.  After which  the bow
els should be evacuated  by a moderate cathartic.
  After the paroxysm of gout has disappeared, the only chance for prevent-
ing a renewal of it  lies  in the persistence of proper hygienic measures, for,
after a few attacks, it is  very difficult to obtain a permanency of cure, and, in
long standing cases, more  or less  of its symptoms will be present occasion-
ally, whatever course is  pursued.  The principal means by which  to effect  a
thorough cure,  are exercise, temperance, and a spare regimen.    A gradual
approach must be made to a  frugal  and  temperate style of living, moderate
and regular exercise should be taken daily,  late night hours  must be avoided
as well as heavy suppers.  The surface of the body must  be attended to, by
frequent bathings with a weak alkaline solution, and an occasional Spirit
vapor bath; the bowels should be kept regular by mild aperients, as the Com-
pound Powder of Rhubarb, and Bicarbonate of Potassa heretofore spoken of;
and to facilitate the cure, some tonic or strengthening preparation, in which no
liquor enters, should be constantly and regularly used.  All idle, indolent, sen-
sual, and intemperate  habits must be abandoned.   Gout is the disease of the
glutton, the sensualist, the intemperate, and the fool.
                      DROPSICAL  DISEASES.

  Dropsy is the morbid accumulation of a serous or watery fluid in several
parts of the body, which impedes or prevents the functions of the organs  in
its vicinity.   It is occasioned by a decrease of absorption, or  an  augmented
effusion, or  both combined, and is merely symptomatic of some  present  or
previous disease ;  thus peritoneal inflammation is often followed by a dropsi-
cal effusion ; pleurisy often terminates in dropsy of the chest,  and inflamma-
tion of the brain of a child, frequently terminates in dropsy of the brain.   It
likewise follows as the result of all those causes  which create  debility in va-
rious organs.
                    DROPSY  OF  THE  BRAIN.
  Acute Hydrocephalus or  Dropsy of the Brain, is not a primary disease,
but is the result of a peculiar inflammation of the brain, to which the terms
i;meningitis," and "tuberculous meningitis" have been appropriately applied.
It is peculiar to children, being quite frequent during the first six years of
life, but rarely occurring after the  twelfth or fourteenth year;  and appears
to be more frequently, if not entirely met with among those of  a  scrofulous
habit. ^ It is of much importance that the premonitory symptoms be attended
to, for it is only during the early period of the disease, that we can hope for
any favorable results from medication. 
332
AMERICAN FAMILY PHYSICIAN.
  Symptoms.   There may be three stages to the disease, viz :—the forma-
tive stage, the  stage of excitement  or inflammation, and that of  effusion.
The formative period may be entirely absent, but when present, it may be
known by the child losing his cheerfulness and spirits,  exhibiting a distaste
for  his  usual  enjoyments; there will be more or  less headache,  frequent
knitting of the eyebrows,  occasional deep-drawn sighings,  grinding of the
teeth, a lack  of luster of the eye, with a pale  or collapsed appearance of
the face.  Disturbed rest at night,  with sudden startings from  sleep in
alarm, or with a scream,  should always awaken a  suspicion of the disease
especially when the appetite  is good, the tongue clean, no worms present
and the evacuations from  the bowels healthy.
  As the disease  progresses, the appetite becomes  impaired, the bowels
constipated, there  is more weakness in one leg than in the other,  the tem-
per is irritable, headache is complained of, or if  too young to express its
sensations, the hands are  raised to the head, with pain in the bowels, irreg-
ular pulse, febrile symptoms, unpleasant smell  of the  breath, vomiting
especially on moving the child,  tenderness  of the abdomen  on pressure
which is not  tumid but'  concave,  and the urine  is scanty and frequently
voided.   All the senses are at first morbidly acute, but gradually lose their
power, as effusion  takes place.
  More commonly, however,  the disease is manifested suddenly, with obsti-
nate vomiting,  high fever, thirst,  heat of the surface and especially of the
head, face pale and alternating with flushes,  throbbing of the  temporal
arteries, redness of the eyes, quick pulse,  aversion to light and sound, and
severe pain in the  head, which,  if the child is  too  young to complain, it
manifests by clasping its  head, or constantly raising its hand  to that part;
the head is either  rolled about  incessantly,  or the child lies  still, heavy,
and dull, with  an  occasional cry of  pain.  The appetite is lost, the bowels
constipated, the urine scanty and high-colored, and the  breathing hurried
unequal,  and  irregular.   The  pupil of  the  eye  is more  commonly con-
tracted  during  the  early period of the disease, and in some  instances the
child occasionally utters a sudden cry or scream without any obvious cause,
Sometimes a convulsion  is the  first symptom of the disease.   Frequently,
toward  the termination of this  stage, delirium ensues, with  spasmodic or
tetanic  contractions of the  muscles of the head and trunk, also dilata-
tion of the pupils, with squinting,*and the pulse becomes slow.
  The stage of effusion  may be preceded  by a sleep, or an apparent trans-
itory improvement of all the symptoms, which, however, are delusive.  The
delirium subsides, or  occurs occasionally, the pupil of the eye is perma-
nently dilated, and ceases to contract on the approach of light, the  eye is
rolled about, turned upward, or squints, the pulse becomes quick, irregular,
and weak,  the child falls into a state of stupor, from  time  to time, and
more frequently than in the previous stage,  a sharp,  piercing, agonizing
scream  is uttered,  the result of pressure upon  some particular portion of
the brain, and there is an almost constant moaning.  Swallowing is diffi-
cult; in some cases the head is permanently bent back;  and paralysis of a
hand, arm, or leg may take  place.  The  child lies quiet, occasionally mov-
ing the  head, or throwing about a  limb unconsciously,  the  eyes are usu-
ally half closed, exhibiting a glazed appearance, with  mucus  at the  corner
of the eyelids,  the bowels are  evacuated unconsciously, and the disease
terminates by  a  convulsion  or  in coma.  The  disease  may  last  from two
days to two months; three weeks is the average duration.
   The  symptoms  will, in each  stage, be  found  to vary considerably, and
even the appearance and progress  of the several stages  themselves may 
DROPSY OF  THE BRAIN.
333
differ materially from  that which has been stated.   Sometimes the pulse
does not become slow during the whole course of the disease, and occasion-
ally the  dilation or  contraction of the pupil will  not be  permanent;  and
sometimes the senses will remain perfect  to the  last moment.  At times,
the attack comes on  suddenly, with convulsions, or a comatose condition,
the head bent back, squinting, &c,  and terminates fatally in a short time
notwithstanding that prompt, vigorous, and appropriate means have been
pursued.
   Cai'sks.   Acute Hydrocephalus is an affection which has been observed
to pervade families,  affecting all  or the greater  part of the children at a
certain period of their  life; and  those  of a scrofulous or strumous habit
appear to be more especially liable to it.   The exciting  causes which have
induced the inflammation terminating in  this disease, are, unhealthy milk
or food, mental distress in the nurse,  prolonged  suckling, the sudden sup-
pression of an eruption on the  head, or behind the ears, recession  of feb-
rile eruptive  diseases,  falls or  blows  on  the head, dentition,  cold,  fright,
and indigestible substances taken into the stomach.   And in some cases it
has occurred without any assignable cause.
   Hydrocephalus may  be discriminated from apoplexy by its being attended
with high febrile symptoms, which are absent in this latter disease.   From
typhus  by the  very irregular  paroxysms, with  complete  intermissions,
which occur  several times a day.  From  infantile remittent  fever, by its
irregular paroxysms, and dark-greenish mucous discharges, while  in  the
infantile febrile affection the feverish symptoms  and the remissions  are
regular  in their appearance, and the discharges are of a deep-brown color,
and very offensive.
   Puounosis.   This is always unfavorable, especially if the first stage be
neglected.  If tranquil sleep occurs, with a diminution of the startings, the
pulse becoming slower, tho eyes  more steady and less sensitive  to light,
and tho expression of the face more natural and calm, these  are favorable
signs; while the rapid,  small pulse, quick,  irregular respiration, dry, furred
tongue,  livid face, increase of the startings and twitehings, disturbed sleep,
wakefulness or coma, all  indicate a fatal  termination.   It  has,  however,
frequently  been the case, that  where headache, stupor, dilated  pupils,
squinting, &c, have  been present, the children have recovered by prompt
and energetic  treatment; and this fact may lead us not to despair too soon,
or cease to employ further remedial measures.
   Treatment.  The indications  of treatment are  to subdue  inflammatory
action, and thereby prevent effusion;  or, when effusion has taken place, to
excite the absorbents to remove it.  To fulfil the first indication, the treat-
ment must be  commenced with  an active hydragogue cathartic, for which
purpose a dose of the Compound Powder of Jalap,  to which an equal quan-
tity of Cream  of Tartar  is added, may be given,  and  which should  be
repeated every hour or  two, until  it causes a profuse discharge from  the
bowels,  of a watery  character.   Or,  Podophyllin  one grain,  Leptandrin
two grains,  Cream  of  Tartar one drachm, may be  rubbed  together and
divided  into six or eight powders, according to  the age of the child, and
a powder may be administered  every  two  or three hours.  In recent and
very violent cases the Hydragogue may be repeated every day, but in mild
cases, or when protracted, their repetition every two or three  days  will be
sufficient.  As a constant drink, the following should be given to the child:
Take  of Hair-cap  moss two ounces,  Dwarf Elder bark, Juniper  berries,
each, one ounce; mix,  and make a strong infusion.  From  half a table-
spoonful to a table-spoonful at least, should be given every hour. 
334
AMERICAN FAMILY  PHYSICIAN.
  Great  attention must  also be paid to  the condition of the skin, using
means to arouse the cutaneous capillaries from their languid and inactive
condition.   The whole  surface should be bathed daily with an alkaline, or
salt-water bath, repeating it  three  or four times a day, and drying with
considerable friction.   When the inflammatory symptoms  are violent, and
are not  promptly mitigated by the  above measures, advantage will  fre-
quently be derived from the use of sudorifics, producing a free perspiration.
When the condition of the  child will  allow, the Spirit  vapor bath may be
used, but under other  circumstances,  the Compound Tincture of Virginia
Snakeroot may be exhibited in an infusion of  Spearmint, or Crawley root.
Some practitioners have  derived much benefit  from Nitre,  dissolved in an
infusion  of Crawley root, the quantity being according to the age and con-
dition of the patient.
  To relieve the  heat, pain, and  inflammation in the head,  a mixture of
equal parts of Whisky, Vinegar, and rain-water, to a pint of which a table-
spoonful of Salt has been added, may be applied to the  head by  means oi
cloths wet with the mixture, and  this should  be  constantly pursued and
frequently renewed.   In some cases  it will be found that more benefit will
ensue from its use when tepid, than  when cold.  But  I have found the
greatest  advantages from the application of a powerful  fomentation of
Hops and  Stramonium leaves to the head, which is  usually  followed by a
diminution of the great excitement or delirium present, causing a relaxed
condition of the system  throughout,  and followed by sweating, urination,
and other symptoms of improvement.  The fomentation must be renewed
before it becomes dry.
  Mustard applied to the feet and legs,  and along the whole  course of the
spinal column, will not only exert a  favorable influence as a counter-irri-
tant, but will aid in lessening the  tendency to  vomiting which is generally
present; and  in addition to this,  an infusion  of Spearmint will be found
efficacious, as it has a  tendency to allay any  irritability  of  the  stomach.
Stimulating liniments  containing a portion of  the Tincture of Stramonium
seed, will be serviceable, applied along the spinal column.
  Occasionally, from  acidity of the  stomach, there  will  be a  diarrhea,
which may be removed by the Compound  Syrup of Rhubarb and Potassa.
  The child should be kept in a state of quiet  and rest,  avoiding all possi-
ble sources of  irritation ; the room should  be  darkened,  the gums  should
be cut if teething is in process, and if there be the slightest suspicion that
the nurse's milk docs not agree with  it, a change must be made.  The diet
should be light, consisting  principally of arrowroot, gruel, panada, milk,
kc, and if it cannot be taken  by  mouth, it may be given  by way of injec-
tion.  Toward the decline of the  inflammation,  a solution of the Iodide of
Potassium  may be advantageously given.  I have, in many cases, found
the inflammatory symptoms  to promptly yield to a mixture of  Tincture ot
 Digitalis one fluidrachm, Sweet Spirits of Nitre one fluidounce; of which
live drops may be given to  a child a year old,  in an infusion  of  Parsley
root, repeating it three or four times a day.
   When the symptoms  of effusion are present, the case is almost hopeless,
 yet patients have recovered, although it  is very doubtful whether actual
 effusion, so as to press upon the  brain,  had taken place.   The hydragogue
 cathartics, diuretics,  and applications to the head should be continued; a
 Solution of the  Iodide of Potassium, in doses  adapted  to the age of the
 child, should  be persevered  in, and the  Compound Tar plaster  may be
 placed   to the  nape of the neck, and  the discharge kept up  as long aa
 deemed necessary   (See Puncturing of the Cranium in  the next  article.) 
DROPSY Of  THE  ERAIN.
335>
  in families where children  are  disposed  to  dropsy of the  orain, much
,are is required in rearing them.   They  should be permitted to exercise in
the open air, the various secretory organs of the body, as the skin, kidneys
 nd bowels, must be kept in a regular and  healthy  condition, they should
not be subject to harsh usage, nor be made to  task their brains too much
with study  and all  measures calculated to irritate or wound their sensitive-
ness must be avoided.  A careful attention should be bestowed upon their
diet, allowing them a hearty, nutritious,  but easily digestible kind of food,
omitting fats"acids, and tough meats-their sleeping periods  should be
limited to about nine hours, and their beds  should be of cotton, hair, &c,
but in  no instance should  feathers be  used.  And  above  all things, no
blows about the head should be permitted.
CHRONIC  HYDROCEPHALUS.
  Chronic Hydrocephalus, or Dropsy of the Brain is not so frequently met
with as the acute form.  It occurs from infancy to  adult  age, and when
it is observed in the former, it i3 supposed to have commenced before birth.
  Symptoms.   The ordinary symptoms are headache, drowsiness, dulnesa
of mind, inactivity, vertigo, pale countenance, with a look of bewilderment,
and confused intellect.   The skin  is generally natural, the pulse quick, and
convulsions  occasionally occur.  For a time, respiration, circulation,  and
digestion, continue unchanged, but they soon become affected, the appetite
diminishes, as well as the heat and moisture  of the skin ; the breathing is
labored  and  difficult,  and emaciation  takes place more or  less rapidly.
The limbs become debilitated, the walk uncertain  and trembling, requiring
assistance, until from atrophy of  the muscles, the child becomes unable  to
walk; the head  is seldom carried  erect.  The most striking feature of the
disease is the enlargement  of  the  head.   In infants it commences soon,
and proceeds rapidly, owing to the separation of the bones  of the head,
or sutures; but even when the sutures are ossified, the enlargement has
taken place.   This increase of  size is confined to  the vault of the cranium
only,  or upper part  of the head, the base or  lower  portion  remaining
unchanged.   As the disease  progresses,  all the  organs  of sense become
more or less affected, the pupil of  the eyes become dilated, the sight weak-
ened, with more or less squinting, or obliquity of the eyeball.   The intellect
gradually becomes destroyed, the  child looks and acts the idiot, and sinks
into stupor,  indifference and coma.  Frequently, convulsions  take place,
followed by paralysis,  and giving rise to difficulty in  swallowing, reten-
tion of urine, constipation, or involuntary evacuations.
  Causes.   There is but little known with certainty regarding the cause of
this disease ;  a strong predisposition to  it appears  to exist in some families,
and it is also supposed to be owing to some malformation during fetal life.
Among  the exciting  causes may be named cold, blows,  falls, teething, dis-
ordered stomach and bowels, tumors, or tubercles of the brain, &c, and in
a large  number of cases, it is undoubtedly the  result of chronic inflamma-
tory action.
  Discrimination.   The only difficulty in determining the disease is pre-
vious to  the  enlargement of the head,  and our judgment must be formed
from  a careful observation of the  functional disturbances, as an unsteadi-
ness of  the muscles of the limbs,  difficulty in  standing or balancing,  the
inclination of the head to  one side, &c.   It  may be  distinguished from
infantile remittent fever, if any fever be present, by the absence of remis-
sions, and the gradual increase of  cerebral  symptoms. 
336
AMERICAN  FAMILY PHYSICIAN.
  Treatment.   This will  be very similar to that of the acute  form, using
hydragogue cathartics, diuretics, sudorifics, local applications to the head, and
bathing the surface.   In addition to this the Compound Tar plaster may be
applied to the nape of the neck, and the  discharge kept  up  as  the patient
can bear it.   The Compound Syrup of Stillingia with the Iodide of Potas-
sium, should also be given, three or four times  a  day.   The  diet should be
nutritious, and the same rules observed as laid down in  the  preceding form
of the disease. In some cases, the administration of Elaterium will be found
useful as a hydragogue cathartic, thus, take of Elaterium four  grains, Alcohol
a fluidounce, Nitric Acid six drops; mix.  The  dose is from five to ten drops
in water, for a  child a year or two  old, and which  may  be  repeated if
necessary.
  " From a  belief that effusion  might be the  result of want of firm resist-
ance by the  unossified cranium, compression has been tried, and  has proved
successful in a number of instances, and in others  has  brought on convul-
sions.   To  produce any good  effect, the compression must be graduallj
increased, and continued for a considerable time, loosening the bandages, if
symptoms of compression appear, or removing them if the skin be irritated."
  "Puncturing of  the cranium has occasionally proved  successful, and in so
hopeless a  disease, when all other means have  failed, wre  are  justified in
having recourse to an operation which has even occasionally saved life.  In
performing the operation, a fine, lancet-shaped trocar is  to be passed in the
coronal suture perpendicularly to the surface, through the scalp and mem-
branes, about an inch and a half below the edge  of the anterior fontanelle,
so as to avoid the sinus if possible, and  the  great veins.  The fluid should
be allowed to escape very slowly, the head being gently compressed in pro-
portion, and the whole fluid  should not be evacuated  at once,  only a few
ounces at a time,  and due pressure  should be maintained both  during and
after the escape of the  fluid.   If the pulse becomes weak, the pupils con-
tract,  or the child faints, remove the canula and administer a stimulantr-if
inflammation arise treat accordingly."—Churchill.   Dr. Conquest states:—
"I have now tapped nineteen cases, and of these  ten  were living when last
heard of.  Several  of the children before the operation were reduced to the
most deplorable  condition, having frequent  convulsions, with loss of sight,
emaciation, &c;  but the diminution or  disappearance of the symptoms has
been very remarkable."   He adds, however: "In  no  instance  has clearly
marked congenital disease been benefited, and those cases have done best in
which  effusion  manifestly resulted from inflammatory action, and in which
cerebral excitement follows the operation."
  Dr. Watson states that the above two mechanical  measures  " are opposite
measures and adapted to opposite conditions of  the brain, the one supplying
a defect of pressure, and the other relieving  its excess;  and  that the appli-
cation  of either requires  a clear and cool judgment  and  a constant attention
to the symptoms which  may arise  during the treatment adopted."
                     DROPSY  OF  THE  CHEST.

  Dropsy of the Chest, or Hydrothorax, are terms applied to an  accumula-
tion of  serous or w7atery fluid within the cavity of the pleura.  It produces
injurious results more by its  mechanical compression than by any peculiar
quality  it possesses, frequently reducing the size of the lungs by its pressure,
and even displacing the heart.   It may exist alone, but g-enerally  prevails a
part of  a more  universal dropsy. 
DROPSY "OF  THE CHEST.
337
  SYMPTOMS.  At an early stage of the disease an oppression and difficulty
of breathing  is experienced, which is  increased on every sudden or uncus-
tomary exercise,  or when the body is in a horizontal posture; and when  the
fluid is  present  in both cavities the breathing is still  more short and  labo-
rious.  The patient cannot lie  on the side of the chest opposite to the one
affected, and most  generally, especially in the advanced stages, assumes more
or less of the sitting posture.   There are frequent shiverings;  a short, dry
cou"di;  sense of heaviness at  the pit of the stomach; confused and painful
sleep, with unpleasant dreams and sudden startings; palpitation of the heart;
feeble, irregular, or intermittent pulse; occasional faintings; and paleness of
the face.  As the  effusion increases,  the face, lips, and hands have a livid or
mottled appearance, a dropsical swelling of the feet  and legs  takes place,
there is considerable thirst, a sense of  numbness is complained of in one or
both arms,  the eyes have a peculiar stare  expressive of great anxiousness,
the lower eyelid is  frequently swollen, the throat  is  dry, and  the urine is
scanty and very  high-colored,  and on  cooling deposits a  pink or red sedi-
ment.   In  some cases a sensation of fluid in motion  can  be distinctly per-
ceived by the patient on making certain sudden changes in the  position of
the body.
   The  affected  side  becomes  enlarged and round,  the  intercostal  spaces
(between the ribs) become extended  by the gradual divergence  of the ribs.
Upon percussing or striking the side in which the effusion exists, it will give
a dull sound  like that produced by striking upon solid flesh, as the thigh or
buttock; when the patient is erect, sitting or standing, the fluid moves down-
ward, and the dull sound on percussion is then only heard  in the inferior
part of the chest.  As the disease advances the natural respiratory murmur
will gradually subside until it can scarcely be heard.
   The continued accumulation of fluid is marked by intolerable difficulty of
breathing;  the patient is obliged to remain  in  the erect posture, with  his
mouth open, and his body leaning toward  the side  in which the effusion is
greatest,  while he  incessantly  manifests  the greatest anxiety for fresh air.
The  face, hands, arms, and feet become swollen and cold; a cold, clammy
sweat occurs upon  the face and upper part of the body, drowsiness, coma, or
delirium, occasioned by the difficult  transmission of the  blood through  the
lungs, and want of sleep, frequently attend the latter periods of hydrothorax,
and from the same cause the expectoration is sometimes bloody.  Death may
take place suddenly; in  some cases it is preceded for a few days by a spitting
of blood; but more commonly the patient  dies  gradually from suffocation
or apoplexy,  the first, the result of the increased pressure  of  the accumu-
lated fluid on the lungs, the second, from pressure of the dark, venous blood
on the brain, which is often accompanied with serous effusion on the surface,
or in the ventricles of this organ.   Occasionally hydrothorax ends in gen-
eral dropsy, and which may, indeed,  accompany it from the beginning.
  Causes.   Dropsy  of the chest  may be produced  by  the various  causes
which originate other forms of  dropsy, as cold,  injuries, obstructions  to  the
circulating  system, recession  of cutaneous  eruptions, organic  diseases of
various  organs,  want of  proper nourishment,  general debility,  long-pro-
tracted fevers, low  grade  of inflammation of certain parts, and frequent and
excessive evacuations.  It is very apt to be the  result  of an intemperate  use
of liquors,  especially among beer,  gin,  and whisky drinkers;  very common
causes are frequent bleedings,  frequent and excessive purgings, as well as
sweatings, and urinations, and  it has  occurred from the too free  use of mer-
curials.   Inflammation of the  pleura often gives  rise  to  it.   Injuries to  the
internal viscera  especially the  liver, are not  unfrequently followed  by hy-
drothorax.       22 
338
AMERICAN FAMILY  PHYSICIAN.
   Hydropericarditjm, or Dropsy of the Heart, may be included in the tera
Hydrothorax.  In this affection there is an effusion of water in the pericar-
dium, or membranous sac covering the heart, but there are no well-deter-
mined symptoms by which it can be distinguished from several other maladies
of this organ.  The symptoms in many respects resemble those of dropsy
in the pleural cavity, with palpitations of  the heart, irregular or intermitting
pulse, excessive shortness  of breath, amounting often to suffocation, or an
inability to breathe except in the  erect posture,  and dulness or percussion
as in the previous disease.  It is not commonly preceded by  some inflam-
matory or other diseased condition of the heart, and is often associated with
other dropsical affections.  Causes similar  to  those  named under hydro-
thorax will produce it, and the treatment will likewise be the same.
   Treatment.   In the treatment of these diseases-, a very important class
of remedial agents is Hydragogue Cathartics.   The one which I generally
prefer is the following: Take of Jalap fifteen grains, Cream  of Tartar thirty
grains, Elaterium from an eighth  to  the  half of a grain.  Administer this
for a dose, and repeat it every  six hours;  should the  Elaterium occasion
nausea or vomiting, a  grain  or  two of Capsicum added  to each dose will
generally prevent it.   As soon as the  discharges are watery, and especially
if vomiting be present, the Elaterium may be omitted, continuing the use of
the powder every six  hours  until benefit  is obtained.   Other hydragogues
may be used with advantage, as Compound  Powder  of Jalap twenty grains,
Cream of Tartar  twenty grains, Podophyllin half a grain, or a grain; mix.
This may be given for a dose, and likewise be repeated every six  hours.
Another very valuable hydragogue  cathartic in dropsical  diseases is the
Large Flowering  Spurge, which may  be given in doses  of fifteen or twenty
grains, repeating  it every day or two;  it produces copious  watery evacuations,
and is apt to cause vomiting.  Of course, should the patient be so debilitated
as to be unable to bear too much purgation, they should  be repeated only
two, three, or  four  times a  week, according to his strength.   Should the
hydragogues  produce  great  debility  arid  prostration, the strength of the
patient must be properly sustained by stimulants.
  For a constant  drink the patient must take a strong infusion of a mixture
of Hair-cap moss two ounces, Dwarf Elder Bark, Juniper Berries, each, one
ounce.  From  half  a wineglassful to a  wineglassful may  be taken every
hour, and also whenever the  patient is thirsty.  Or, other diuretics may he
drank, as  an  infusion of equal parts of  Spearmint, Parsley  root, Elder
flowers,  and  Indian  Hemp root.  An infusion of Queen of the Meadow,
Dwarf Elder, and Indian Hemp, each, equal parts, has  been highly recom-
mended for a purpose similar to the preceding.  And to promote an absorp-
tion  of the effused  serum, as  well  as  to  increase the  secretions of the
kidneys,  a solution  of Iodide of  Potassium  has  been  advised; this  will
undoubtedly be found efficient in many cases, but, as  a general agent for
these purposes, I  prefer the Compound Infusion of Parsley.
  In  this,  as in  other dropsical affections,  the skin should  be bathed daily
with a weak alkaline solution, using considerable friction  in drying; and the
Compound Tar plaster should be applied over the affected side, and worn as
long as the patient can bear it, renewing  it  from time to time  as the dis
charge ceases, and before the part has thoroughly healed.
  When the effused fluid has been carried  off, in order to prevent its return,
the Compound Infusion of Parsley should be used daily,  for several months
in succession; but, a resort to the preceding  measures should be  adopted as
soon as symptoms of a returning effusion are manifested.
  This diet should be light,  nutritious and  digestible, and  adapted to the 
DROPSY OF THE  ABDOMEN.
339
condition  of the stomach, as well  as that of the general system.  Pepper-
Bauce, mustard, garlic, onions,  horseradish, cresses, and  cayenne  pepper,
may  be  taken with  the  food, if  contra-indicating circumstances are not
present.  Gentle exercise taken regularly will be found serviceable, as the
strength of the patient improves, but he  should  carefully  avoid all  causes
which may ultimate in cold or other diseases.
  In hydrothorax and hydropericarditis, Dr. Debreyne recommends the fol-
lowing:  Take of Jalap, Squill, two and a half  drachms, Nitre five drachms,
White Wine one pound;  mix, and let  them stand  for twelve  or fourteen
days, frequently agitating.  The  dose is a table-spoonful from one to three
times a day, or sufficient to procure six or  eight evacuations every twenty-
four hours.  Or, if patients object  to this, or it disagrees with the stomach,
use the following pills:  Take  of Powdered Digitalis  four drachms, Pow-
dered Scammony, Powdered Squill, each, two drachms, Extract of Juniper
a sufficient quantity to form a pill-mass with the other articles.  _ Divide the
mass into 120  pills, and give one or two pills for  a dose, repeating it three
times a day, and washing them down with a table-spoonful or two of White
Wine or  Water,  in  a bottle of  which  half an  ounce of Nitre has been
dissolved.
                  DROPSY  OF THE  ABDOMEN.

  Dropsy of the Abdomen, or Ascites, is a collection of water in the peri-
toneal sac, or general cavity of the abdomen ;  sometimes it is found between
the peritoneum and abdominal muscles, and occasionally it is contained in
sacs upon or connected with some of the viscera, as the ovaries, liver, &c,
and is then termed encysted dropsy.  Ascites may occur in either sex, or at
any age, but,  like the other forms of dropsy, is  chiefly to  be  met with in
persons advanced in life.
  Symptoms.  Dropsy of the Abdomen is sometimes, but not always, pre-
ceded by a loss of appetite,  dry skin, cough, oppression at  the chest,  scanty
urine, and costiveness.  Occasionally it commences by cellular dropsy, espe-
cially of the lower extremities.  In a short time a slight enlargement of the
inferior part of the abdomen is observed, together with a disagreeable  feel-
ing, and some tenderness when pressure is  made; the enlargement gradually
increases, until the whole abdomen becomes uniformly  swollen  and tense.
As the fluid  accumulates,  the difficulty of breathing  generally  increases,
being worse when the patient lies  down; the face is pale and  bloated, fre-
quently pitting when pressure is  made  with  a finger;  great thirst ensues;
the urine is very scanty, thick, and high colored, and on standing deposits a
brickdust-colored sediment;  the  stomach and  bowels  are  frequently de-
ranged, with  colic-pains, flatulence, nausea, and a sense of weight  in the
abdomen:  the pulse is variable, being sometimes slower, and at others faster
than natural.   In most cases, by applying  one hand on one side of the ab-
domen, while the patient is  sitting or standing,  and striking gently  on the
opposite side  with the tips of the fingers of the  other  hand, a'distinct fluc-
tuation will be felt;  sometimes it can even  be detected by the ear.
  Discrimination.   Dropsy of the abdomen may be detected from tympani-
tis, by the want of fluctuation in the latter  difficulty, and the clear sound on
percussion; from ovarian or encysted dropsy by the indistinct and limited fluc-
tuation,  and by observing that instead of the uniform swelling of the  abdo-
men  found in ascites, only one side, or  some particular  part of the abdomen,
is more protuberant than the rest.   If ovarian  dropsy be watched from it? 
340
AMERICAN FAMILY  PHYSICIAN.
beginning, a moveable tumor, falling from side to side as the patient changes
her position, will  be observed before much enlargement takes place; and at
a later period, the unequal prominence,  above mentioned,  will be  noticed.
Ascites may be distinguished from dropsy of the womb, by observing that the
tumor is confined to the region of that organ, and as  it increases, somewhat
resembles the shape of the pregnant womb.  It yields upon pressure; there is
a less marked sense of fluctuation, and the urine is but slightly diminished if
at all.   It also requires to be carefully distinguished from pregnancy.  Some-
times pregnancy and ascites may  exist together, which renders the case ex-
ceedingly perplexing.   The  modes  of  distinguishing these cases  are too
lengthy to name here; though it  may be observed that  in  dropsy the com-
plexion is pale and sickly, with dropsical swellings generally of the feet and
ankles, while in pregnancy the complexion is clear.   But the discrimination
between all the above conditions is frequently very difficult.
   Causes.    In addition to the causes heretofore named, in dropsy of the
chest, ascites may be produced by diseases of the liver or spleen, scarlet fever,
intermittent and remittent fevers, erysipelas, protracted diarrhea, diseases of
the heart, peritoneal inflammation, &c.
  Prognosis.  When not complicated with or dependent upon some incura-
ble disease of an internal organ, ascites is generally curable; but it frequently
remains unyielding to  any treatment, until the patient is destroyed by it.
In some cases life  has  been  prolonged  by tapping repeatedly,  and in a few
rare instances, this has eventually removed the disease.   When tapping is
performed, a greater chance for-effecting a  cure may be had, if the subsequent
treatment be as vigorously followed for some time, as though the operation
had not been performed.
  Treatment.  This will be  similar to that named for Dropsy of the Chest;
administering hydragogue cathartics,  diuretics,  and subsequently the Com-
pound Infusion of Parsley.   As the water  is carried off, a broad bandage
must be worn around the abdomen, sufficiently tight not to  be uncomfortable,
and gradually increasing its pressure, as the enlargement decreases.  Two or
three times a day the bowels should be kneaded or shampooed by hand, more
especially after the fluid has  been  removed, and should any tenderness re-
main, the following limiment may be applied over the whole abdomen imme'
diately previous to each shampooing:—Take of Oil of Juniper, Oil of Sassa-
fras, Oil of Cajeput, Oil of Spearmint, each, half an  ounce;  mix for a lini
ment.   This application should  be continued for several  months after the
removal of  the  water,  as well as the  use of the  Compound Infusion of
Parsley.
  When the stomach and bowels  are irritable, as manifested by a smooth red
tongue, by tenderness upon pressing over the region  of the stomach, and by
the ejection of the hydragogue administered, the following may be substitu-
ted for it:—Take of Hydro-alcoholic Extract of Indian Hemp two drachms.
Hydro-alcoholic Extract of Blue  Flag one drachm, Eupurpurin one drachm;
mix, and divide into sixty pills, of which one may be given every four or six
hours.  While using these, continue the other external measures heretofore
named.
   When the disease is complicated  with  disease of the liver or  spleen, the
Compound Tar plaster  should be applied  over  the  region  of the  affected
organ, and a discharge kept up as long  as  the  patient can  bear it, renewing
the application from time to time,  until there is decided evidence of convales-
cence.  At the same time the  treatment adapted to the affections of these or-
gans must be conjoined with that for dropsy.   In two cases of dropsy of tl«
abdomen, I have  observed the most marked benefit from  the application of 
GENERAL  DROPSY.
341
tho above plaster, over the greater part of the abdomen, in connexion  with
the other treatment.
  The diet, regimen, &c, recommended in dropsy of the chest, is also appli
cable to this and the succeeding forms of dropsy.  The above  treatment will
l>e found useful in dropsy of the womb  and of the ovaries;  but  it sometimes
happens that no  measures will avail  in these affections, and the only resort
left, to prolong the patient's life, "will be tapping.   Occasionally, by proper
management, cures are effected even after tapping has been performed.
                 CELLULAR,  or GENERAL  DROPSY.

   By Cellular Dropsy, or Anasarca, is meant a collection of fluid in the cellu
 lar membrane of the external parts of the body, chiefly beneath the skin.   It
 may be limited to the inferior extremities, or it may spread over the whole
 body.  The swelling in dropsy is always regular and uniform,  and of a soft
 doughy feel, leaving a pit  or depression when  pressed upon by the  finger,
 which  slowly returns to its former fulness.   When there is an accumulation
 of water around the joints, or when it is confined to a limited  space, the swel-
 ling occasioned by it, is known  by its pitting on pressure,  and is termed
 "edematous."
   Symptoms.   Cellular dropsy most commonly manifests itself at first, by  a
 swelling of the feet and ankles, which is  more evident  in the evening, espe-
 cially  when the person has been standing or walking considerably; and,
 toward morning, or when the recumbent position has been maintained for some
 hours,  the swelling partially or entirely disappears for  the time.  The swell-
 ing is  soft,  inelastic,  and pits upon pressure, and the  skin presents a paler
 appearance than usual.   As the  fluid continues to accumulate, the swelling
 extends upward  into the legs, thighs, and  trunk  of the body, and in many
 instances when  the  accumulation is very great, the face and eyelids appear
 swelled and bloated, especially in the morning.  Sometimes the fluid oozes
 out through the pores of the  skin, or raises the skin in  elevations resembling
 blisters.   The bowels are usually  costive, the skin dry, tense, and shining,
 the pulse usually small  and weak, the  countenance is  sallow,  the thirst  is
 more or less increased, the appetite impaired, the urine  scanty and high-col-
 ored, and depositing a copious reddish sediment on standing.  As the disease
 progresses there is a sensation of general debility, with sluggishness and inac-
 tivity, and a slow fever.  Occasionally, in  the more advanced stages, the skin
 presents a  livid  hue.  When  the watery accumulation has become very gen-
 eral^ the vesicular and cellular structures of the lungs become  affected, occa-
 sioning difficult breathing, coughing, and  a watery expectoration.   Some-
 times the disease is connected with dropsy of the abdomen  or chest, and  is
 then apt to be more difficult of cure.
  Causes.   Anasarca is a symptom indicating a functional or structural dis-
 ease of  the system, or  some portion of it;  and it may be caused by any cir-
 cumstances which will produce a general state of debility of the body.   Thus
 it fVequently follows febrile, and  inflammatory attacks,  hemorrhages  or ex-
 cessive bleedings, the constant and  excessive  use  of drastic  cathartics, ob-
 structed menstruation,  chlorosis,  pressure upon  the   blood-vessels  which
 return the blood from the lower extremities, exposures to  cold and  damp,
and the excessive use of spirituous liquors.  Sometimes it is owing to incu-
rable diseases of the heart, spleen,  liver, or kidneys, and will of course prove
fatal.
  Prognosis.    When  the skin becomes moist, the thirst diminishing, the 
342
AMERICAN FAMILY PHYSICIAN.
swelling gradually disappearing, and the urine flowing more copiously, these
are favorable symptoms.   But when there is some organic disease associated
with the dropsy, when the thirst continues great, with great emaciation, ery-
sipelatous inflammation, quick, small pulse, low fever,  lividity of the skin
and drowsiness, these are  unfavorable symptoms.   A recent anasarca is gen-
erally more curable than one of long standing, and when it arises from mere
debility than when it is occasioned by some disease of internal organs.  Oc
casionally a spontaneous cure is effected, by a critical vomiting, purging or
increase  of the urinary discharge.
   Treatment.    This will  depend very much upon the  cause.  If it be a
sequel to scarlet fever, or  other febrile diseases, it may be treated as already
mentioned on page 220.   If it be owing  to intemperance, no benefit can be
expected by medical measures, unless the bad habit be dispensed with entirely.
If it be  owing to accompanying disease, this must be removed,  if possible
either before or immediately after the evacuation of the water by the means
to be named.  And if it be owing to debility, we should endeavor to restore
the tone of the system, and strengthen the general habit.
   The treatment for the evacuation  of  the dropsical fluid will be similar to
that named for Dropsy of the Chest; administering  hydragogue cathartics,
diuretics, and subsequently the Compound Infusion of Parsley.   As the
water is removed, the limbs should be bandaged as tightly as the patient can
comfortably bear, renewing the  application  of the bandage once  or twice
daily, particularly in the morning, when the swelling has somewhat dimin-
ished from diffusion of the fluid, owing to the recumbent position.  The skin
should be  frequently bathed with a  mixture of weak ley and decoction of
White Oak bark, followed  by friction with  a brush, or coarse towel; and this
friction should always be employed on every renewal of the bandage.   In some
cases, the application  of  a mixture of two parts of  Sweet Oil with one of
Tincture of Capsicum, to the legs, will be found useful.
   When the  disease is complicated with  disease of the liver, or other or-
gans, use the Compound Tar plaster, in  the manner recommended for Drop-
sy of the Abdomen, page  340, with the  appropriate treatment for disease of
the particular organ or organs affected.
   These means should be continued more or less actively, according to the
strength and condition of the patient, when  the use of the Compound Infu-
sion of  Parsley, together  with some tonic, as  for  instance, the  Compound
Wine of Comfrey, should  be  continued for some months afterward,  in
order to  render the cure permanent.  And with these, the external frictions
should be used twice every day.   ,
   The diet, regimen, &c, should be similar  to that named in the preceding
forms of dropsy.
   Among the many useful means which have been used for the removal of
the dropsical effusion, and for effecting  a cure of the disease, may be named
the following:
   1. Take of common Whortleberries four  ounces,  Parsley root eight
ounces,  good Holland Gin, or Whisky two quarts.  Mix together, and heat
to the boiling point;  then let the mixture stand till cold, and give half a
wineglassful three or four times a day, diluted with some sweetened water.
This, however, will  not   answer  in cases  of  dropsy among intemperate
persons.
   2. Take of Indian  Hemp, Milk weed, Juniper berries, and dwarf Elder
bark, each, one ounce.  Add  to  these  articles in coarse powder, two pints
of boiling Cider.   When cold give a wineglassful three or four times a day.
(For Dropsy from Affection of the Kidneys, see Bright's Disease.) 
DROPSY OF  THE SCROTUM.
343
                  DROPSY  OF  THE  SCROTUM.

   DivotsY of the Scrotum, or Hydrocele, is a  collection of watery fluid in
the scrotum,  or  bag which contains the testicles,  in  some part of the
testicle itself,  or in the spermatic cord.  It is seldom a fatal disease, but
may increase so as to  become  a source of annoyance  and interfere with
the free motions of the body.   When  it occurs in children, it frequently
disappears spontaneously.
   Symptoms.   Generally, a smooth, soft, elastic,  and often transparent
swelling  commences in the lower part of the scrotum, and gradually ex-
tends upward; the tumor finally becomes somewhat pear-shaped, and feels
somewhat like a bladder distended with fluid.   No pain is produced upon
making pressure, unless the testicle be compressed.
   Discrimination.  Hydrocele may be distinguished from rupture, by its
forming slowly, while rupture takes place suddenly;  the swelling of hydro-
cele does not disappear on pressure, or change of posture, in rupture it
does ;  in hydrocele the swelling begins at the lower part of the scrotum, in
rupture at the upper ; in rupture coughing enlarges the swelling, in hydro-
cele it does not; in  hydrocele, when recent, a candle placed  behind the
swelling will  show a translucency, which  is not the case in rupture.  The
absence of pain will distinguish hydrocele from those diseases of the testi-
cles, which are accompanied with pain.
   Treatment.  It is  desirable to cure the disease in infants, without an
operation, if possible; for this purpose the scrotum may be enveloped in a
bandage, making as much  equable pressure on this part, as the child can
bear, and keeping the parts  stimulated by the  application  of a solution of
.Muriate of Ammonia in water, or vinegar, with which the bandage may be
kept constantly moistened.  As the swelling diminishes, the bandage will
require to be  readjusted.  In  connection with  this, administer  diuretics
and keep the bowels regular.
   If this  should fail, it will be necessary to  evacuate the  water, and  use
means  calculated to produce  a slight  degree  of adhesive inflammation,
which  will cause the outer covering of the testicle to adhere to the inner
wall of the  bag, thus destroying the cavity,  and  leaving  no room for
water to accumulate.   This course is also necessary in adults, especially
when there  is a large amount of fluid, and  a  thickening of some cf the
tissues.  This is done by the surgeon's introducing a trocar and canula in
front and at the lower part  of  the scrotum, and nearly but not exactly in
its center, so as to keep clear of the testicle and all large veins.  On with-
drawing  the trocar, the fluid will  pass out of the canula, and when all is
drawn  off, then inject  through  the canula some Wine, Brandy and water,
Lime-water, or a solution  of Sulphate of Zinc one drachm in a pint of
water, or,  a  mixture of Tincture of Iodine half a fluidrachm, and  water
three fluidounces.   Do not  allow  the  injection  to pass away, until it has
caused a degree of smarting or pain; then let it run off, and remove the
canula, but not before.   If too much inflammation  he produced, it will re-
quire to be allayed by hot fomentations of herbs, as Stramonium, Hops,
&c, with  diaphoretics, diuretics, and  cathartics.  If not sufficient inflam-
mation is  induced, a tent, or piece of linen or silk twisted  into a cord, may
be introduced in the opening, and changed every  day, until the  required
adhesion has taken place. 
344                AMERICAN  FAMILY PHYSICIAN,
                       NERVOUS  DISEASES.
  Under this caption, I will consider those difficulties which are generally
attributed  to  derangement of the nervous system, as well as those which
are supposed to proceed from an impaired condition of the functions of the
brain.
                              APOPLEXY.

    Apoplexy is  a  sudden suspension  of consciousness and voluntary mo-
  tion, with a slow, labored, and stertorous or snoring breathing.   It most
  generally attacks persons somewhat advanced in years, or middle-aged;
  and corpulent persons with short, thick necks, florid cheeks, and good-sized
  heads, are said to be the most liable  to  it, especially when they are seden-
  tary and use a full, stimulating diet, or indulge in the enjoyments of the
  table and wine-board; but it has equally occurred in  persons whose necks
  were  long and  slender, and  whose  countenances  were  naturally pale or
  colorless.
    Sybiptoms.  Apoplexy is  most usually preceded by one or more symp-
  toms, which, if properly attended to may prevent an attack;  these symp
  toms are as  follows, but will  be found to vary in different individuals:—a
  dull pain in the head, with a sense  of weight or heaviness; giddiness;
  drowsiness ;  frequent fits of nightmare ; cramps or spasms in various parts
.  of the body; fulness and redness  of the countenance and eyes; obscurity
  of vision ; bleeding from the nose ; ringing in the ears; faltering in speech
  or using one word for another;  and loss of memory.   The most important
  of these symptoms  are giddiness, particularly on  stooping down, on strain-
  ing at stool, on coughing,  on pulling on a tight boot, and especially when
  conjoined witn debility;  heavy and unrefreshing sleep,  with more or less
  drowsiness  through  the  day; cramps  of the legs at night; a constant in
  clination  to sigh;  and, a numbness, or  palsy of some  part.  But more
  generally the attack occurs  suddenly,  without any previous warning, and
  the patient falls to  the ground in a state of unconsciousness from which he
  cannot be aroused.   His breathing is usually of a loud,  snoring character,
  is hiow  and laborious, the  face is  dark, reel, and  turgid, the veins of the
  neck and head are swollen, the head is  hot, and often in a profuse sweat,
  the  eyes  project, and are bloodshot, and  either closed  or half open, the
  pupils are usually dilated, but occasionally are  much  contracted ; a frothy
  saliva is often blown from the mouth with considerable force, and the pulse
  from being  strong,  full, and  regular or slow, soon becomes weak, rapid, and
  unequal or  intermitting.   The fit may  last from  four hours to twenty, and
  even to forty or more.  Sometimes the  patient will be insensible and mo-
  tionless for several days, and gradually  recover his intellect and strength;
  but more commonly in these instances, the powers  of  the mind become
  permanently impaired to a  greater or  less extent.  Frequently the first
  attack  terminates  fatally, but it  is  very rarely the  patient survives the
  third attack.
    The mode of attack varies ; thus some persons fall down suddenly, with
  an entire  suspension of sense and motion, flushed face, full pulse, and
  a snorting respiration; occasionally spasmodic  contraction of some of the
  muscles take place,  or convulsions.   Death  may ensue from this attack, or
  perfect recovery  may gradually take place, or,  recovery with a transient or
  permanent paralysis of one side.  Again, the person  experiences a sudden 
APOPLEXY.
345
 attack of pain in the head, becomes pale, sick, and faint, vomits, and falls
 down in a state resembling syncope ;  the  face  being pale, the  body cold,
 and the pulse feeble,—perhaps a slight convulsion may ensue.  Occasion-
 ally there is  no falling  down, but  a slight and transient forgetfulness.
 From either of these, recovery generally takes place  in a few minutes, but
 soon after, it may  be a few hours  or  several days, a sense of oppression
 comes  on,  with forgetfulness,  incoherency,  coma,  and  death.  Another
 mode of attack, is that in  which the loss of the powers of speech, and of
 one side of the body occurs suddenly, without  stupor, or at all events any
 long continuance of it, from which recovery may take place, or it may pass
 gradually into apoplexy in a few hours.
   Persons subject to apoplexy may be attacked  at any time, but more gen-
 erally soon after a  hearty meal, during  great or uncommon  exercise, and
 during a  state of mental excitement.
   Causes.   Whatever will cause a determination to the brain, accumula-
 ting blood in its vessels, and  pressing upon this organ with or without
 effusion of blood or serum, may be an immediate cause of apoplexy; thus
 it is frequently found to  follow violent exercise, excessive venereal indul-
 gences, too free use of alcoholic drinks, intemperance in eating, use of nar-
 cotics, sudden mental excitements, violent fits of coughing or sneezing, ex-
 posure to the heat of the sun, straining  at stool, &c.  Any obstruction to
 the return of the blood from the head, by producing  excessive  dilatation of
 the blood vessels, or an efflux within the cranium, is  likewise an immediate
 cause, as  tight  cravats or ligatures around the  neck.  Apoplexy has like-
 wise been occasioned by large  bleedings, exposures to excessive cold, inju-
 dicious employment of the warm bath, innutritious diet, and whatever will
 produce an anemic condition of the system.
   The predisposing causes are various, with some it  appears to be heredi-
 tary, with others it follows as  a result of frequent  bleedings,  sedentary
 habits, suppression of accustomed evacuations, long-continued  mental de-
 pression,  use of snuff, &c, as  well  as  certain  diseases, as Bright's disease,
 enlargement of the heart, fatty degeneration of the blood-vessels, as well as
 other abnormal conditions of the brain or its vessels.
   Discrimination.   Apoplexy  may be distinguished  from epilepsy, by the
 absence of convulsions in the former, or which, if present at  all, are very
 slight and affect only a part of the body;  in epilepsy there is usually a foam-
 ing at the mouth, and frequently a gnashing of the teeth, and a noise some-
 what resembling the barking of a dog; but there  is seldom any snoring or
 stertorous breathing. Apoplexy is more common to middle age—epilepsy to
 early age, and is a chronic  disease, the attacks  occuring  more or less fre-
 quently;  the  fit is also of shorter duration, and  the  patient more readily
 aroused from it.  A comatose  condition, with or without convulsive action,
 is frequently caused by excessive  intemperance  in the use of intoxicating
 liquor, the odor of  which may be  discerned in  the breath;  and  in these
 cases, the patient may be partly aroused by shouting in his ear, or apply-
 ing a strong odoriferous stimulant to his nostrils.  When apoplexy is caused
 by  narcotics, the respiration will be more  tranquil but not stertorous, the
 pulse will be more  rapid, the face  pale and calm, and, in most  cases, the
 patient can be aroused by violent agitation.
  Prognosis.   Apoplexy does not always immediately terminate  fatally;
 nevertheless, it is always  to be considered a serious  disease.   The  second
and third  fits of apoplexy are more fatal in their character than first, or,
if recovered from, are more apt to leave permanent impairment  of the mea-
tal faculties, as well as paralysis. 
346
AMERICAN  FAMILY  PHYSICIAN,
   Treatment.   The most prompt and energetic measures must be pursued
in the treatment of apoplexy.   The  patient should be removed  to a cool
airy place, and all bandages or cravats around the neck be at once removed.'
Then slightly elevating the head, and holding it between the  knees, or in
some other convenient manner, let one person pour a stream of cold water
upon the  head and neck, while another holding some common  table salt in
his hand,  must rub it on the head and temples, until  the  patient is suffi-
ciently restored to take medicine.  At the same time, the limbs should  be
ligated, (see  Hoemastasis, Part III,) to retard the venous circulation, con-
tinuing this until  other measures can  have  time to prove efficacious.  But
the ligatures should not be allowed to remain on too long,  removing them
as soon as' symptoms of  a restoration commence.  When  there  are  °x>od
reasons for supposing the stomach to be filled with food, as, for instance
when the  attack  occurs  after a meal, an emetic should be administered
using either the Compound Powder of Lobelia for this purpose,  or the Com-
pound Acetated Tincture of Bloodroot.   But under ordinary circumstances,
emetics are  to be avoided in  apoplexy.  If there is no necessity for an
emetic, then  an active purgative  should be at  once administered, as the
Compound Powder of Jalap.
  When the  patient does not readily recover from the use of ligatures, cold
water, and salt applied as above named, other measures must be used  to aid
in lessening  or overcoming the determination  to the  head.  The soles of
the feet should be thoroughly bastinadoed, repeating it from time to time
as the urgency of the case may require, at the same time adopting means to
obtain an  evacuation from the  bowels.   An injection  composed of Castoi
Oil a gill,  Compound Tincture of Lobelia and Capsicum two fluidrachms,
warm water one pint, molasses one gill, fine table salt a drachm, should be
thrown into the rectum, and  repeated  every fifteen minutes, until free ca-
tharsis is produced; and  it may be aided in  producing this effect by plac-
ing a little sugar (with which a drop or two of Croton Oil has been rubbed)
on the tongue as  far back as possible; if symptoms of sinking commence,
these measures must be stopped.   In  cases where the comatose  condition is
induced by intoxication, instead of causing  free catharsis at first, it will be
better to administer an emetic of Salt, Mustard, and Lobelia, in some cold
water; and after  the induction of free vomiting, good fresh milk may be
drank by  the patient.  He should also be placed  in bed, with  warm irons
or bricks applied  to the extremities, and covered wTarmly, and  be made to
take the following  powder, every hour for two or  three times, and subse-
quently for every three or four hours:—Take of Sulphate of Quinia four
grains, Sulphate of Morphia, Podophyllin,  each, one grain; mix, and di-
vide into eight powders.  As soon as purgation is effected, the powders may
be omitted for twenty hours, or longer, according to the circumstances.
  When the  case is one produced by Opium, it will be well to give  freely
of strong  Coffee, and apply the electro-galvanic current along the spinal
column, and  from the stomach to the back of the neck, beside  keeping the
patient awake by forcing him to walk  about between two attendants.   Ad-
ministering, likewise, at first an emetic, and following it by an active cathartic,
  After an attack of apoplexy, the patient  should endeavor to prevent a
subsequent one, by pursuing  the  proper hygienic and remedial measures.
The former will be the same as hereafter named for those predisposed  to the
disease ; the  latter will consist of tonic and alterative  treatment; the sur-
face of the body should be kept healthy by frequent bathings and friction;
the bowels should be kept regular, once a day, either by natural or artificial
means.  After  the first few days  following an  attack, active purgation  is 
APOPLEXY.
347
 unnecessary and dangerous.  The Compound Syrup of Stillingia, with Iodide
 of Potassium, should be taken daily, and diuretics should be used, as infu-
 sions of  Hair-cap moss, Queen of the Meadow, &c;  in  cases  of  effusion,
 these tend to render  absorption more active.   Those who are anemic, should
 take  small quantities of Iron daily, either in powder, tincture, or in their
 food; one to three grains of any preparation  of Iron  per day, will be fully
 sufficient, as the system will be unable to dispose of any more.   If paraly-
 sis be a consequence of apoplexy, treat as directed under  its  appropriate
 head.  In many instances, after recovery from an apoplectic attack, much
 benefit will  be derived from the Compound Tar plaster applied  to the back
 of the neck, and keeping up the discharge from it as long as possible.
  All persons disposed to apoplexy, should adopt certain hygienic measures
 to fortify their systems, and  thereby prevent an  attack.   The diet may be
 nutritious, but it  should be light, or  spare, and easy of digestion, being
 careful to have the meals at regular  hours, and taking great  care to masti-
 cate  the food thoroughly;  animal  diet should not be used during the hot
 summer months, and with great moderation in cold seasons.   All high sea-
 soned food, stimulants, and intoxicating  liquors,  should  be positively
 avoided.  Moderate  exercise should  be taken daily and  at regular hours,
 but  not sufficient to excite heat, or hurry respiration.  All excesses or ex-
 citements should be avoided as much as possible, as long-continued exertions
 of mind, anger, or  other violent mental excitements, late hours at night,
 exercise immediately after a meal.   Venery should be indulged in  only oc-
 casionally.   The neck should be kept free from all tight cravats,  or other
 compression, which might obstruct the return of  blood from the head; the
 feet  should be kept warm and dry; exposures to cold, and especially to cold
 feet  are  dangerous.  Flatulency and  sour stomach, should always be re-
 moved, if possible, as soon as known to exist.  Care should be taken not to
 use  the warm bath too frequently, or too long  at a time.   The hours of
 sleep should be regulated not to exceed nine hours, and the bed should  be
 a hard matress, having the head slightly elevated.  During warm weather,
 or whenever there is a giddiness of the head, or other symptom of fulness
 of its vessels, cold water poured on the head, and along the spinal column,
 will  be found a very pleasant, safe, and  salutary  measure.  Good,  pure air
 in the rooms at home, and when abroad, is an important item.   Direct ex-
 posure to the sun's rays should invariably be shunned ; neither should the
 head be exposed to the continued action of heat produced artificially.   Sud-
 den  turning of the head, or straining the muscles of the neck ia look  up-
 ward, sideways,  or behind, should also be  carefully avoided, as well  as
 straining at  stool, &c.  For at least two hours previous to retiring to bed,
 no food must be allowed to enter the stomach.   Indeed,  without the most
 rigid attention to the above measures, and the rules of hygiene generally, it
 will be a very difficult matter to prevent an attack of apoplexy in those pre-
 disposed to  it;  while, on the other hand, care and  prudence in observing
them, will remove the predisposition, and be productive of the most essen-
tial benefit.   Bleeding  from the  arm or elsewhere, although recommended
by some  to overcome the tendency to  apoplexy, is  exceedingly improper,
and should never be  permitted under any circumstances whatever, as it will
produce the  very disease it is intended  to overcome. 
348
AMERICAN  FAMILY PHYSICIAN.
                       PALSY,  or  PARALYSIS.

   Palsy is a diminution of mobility and sensibility, or a partial loss of eon
trol or power over one or both of them; it may be confined to one part of
the body, or be extended to several parts.   When it is confined to a single
limb, or to certain muscles  of one part of the body, it is called local, or par-
tial palsy; when it affects one complete half of the body,  from the head to
the foot, it is called  hemiplegia, the left side being  more commonly affected
than the right;  when one-half of the body is attacked,  in a transverse direc-
tion, as the  lower limbs from the hips downward,  it is termed paraphaw
and when there is a continual tremor attending, it is  called shaking palsy
though this condition will frequently be found a symptom of chorea  instead
of palsy.  Sometimes the powers of sensation are but little  affected, while
those of voluntary motion are considerably so; at others, both  motion and
sensation are impaired to a  greater or less extent.
   Symptoms.  Palsy is most generally a symptom indicating that the roots
of the spinal nerves, the spinal cord, and  even the brain  itself, are in an
abnormal condition.  It most commonly manifests itself by a sudden loss of
sensation and motion of the part attacked.    Occasionally, however, there are
certain symptoms previous  to the  attack,  as a coldness of the parts, with
more or less  numbness, want of natural color, and slight spasmodic twitches.
The loss of motion may increase until it is apparently complete,  or  it mav
remain partial and fixed.  In cases where the brain is  much  diseased, there
will generally be a drawing  of the eye and mouth to" one side, with unintelli-
gible and disordered speech, and more  or  less deterioration of the  mental
faculties.  When the extremities have been affected for a long time, in addi-
tion to the loss of motion and sensation, the muscles of  the parts become
soft and weak, and waste away.
  There are likewise various other paralytic  affections met with,  as, palsy of
the optic nerve,  or amaurosis, palsy of the neck of the bladder, palsy of the
muscles of the back, producing curved spine, lead palsy, &c, some of which
will be hereafter treated of,  but many of which are not easy to account for.
  Causes.  Paralysis may be produced by whatever affects  the brain, the
nerves, or their roots, as apoplexy, pressure on  certain parts,  by tumors,
effusion, over-distension, &c,  recession of eruptions,  or  translation  of dis-
ease, injuries, intemperance, &c, &c.  Hemiplegia  more commonly follows
an attack of apoplexy; paraplegia may be the result of an injury to the spine,
or of some affection of the  spinal nerves;  local palsy  is generally a conse-
quence of injury to certain parts,  of disease,  or continued pressure.
  Prognosis.  The  termination of palsy will depend much upon the condi-
tion of the nervous system at the time of the attack.  When not complicated
with some chronic disease, the patient may recover in a few days, weeks, or
months; but if the brain or nervous system  be permanently diseased, a per-
fect recovery will not be likely to take place.  Usually, in paralytic attacks.
there is a slow but gradual and  imperfect amendment, in which the patient
may remain for some months or even years, and ultimately die from  disease
of the brain, apoplexy,  or some other disease.  If there be  a  sensation of
warmth in the affected parts, a slight pricking pain, or  a slight  stinging or
crawling sensation, it is a favorable indication.  When there is  any serious
disease, or mechanical injury of the brain,  or spinal marrow,  recovery is not
to be hoped for.  Effusions  occasioning  paralysis, usually terminate fatally
  Treatment.  When  palsy suddenly and  violently attacks a  person, the
same treatment should be pursued as named for apoplexy.  Should this not
succeed,  or but slightly, in  removing the attack, (also in cases of palsy of
some standing,) the  following course will be found very successful. 
                               PARALYSIS.                          349

   The bowels should be kept regular daily, but this will frequently be found
 very difficult to accomplish, from the obstinate  constipation which is some-
 times present, and in which instances it will be  necessary to purge the bow-
 els daily, for some days, by doses of Podophyllin and Leptandrin, aided by
 purgative injections; the injection advised in apoplexy will be very useful.
 But in all cases where regularity of the  bowels can be had, without  active
 purgation, it will'be the better course.
   The  skin should be bathed daily with  an alkaline solution to which^some
 alcohol  has  been added, and in  drying,  a coarse  towel with brisk friction
 should be used.
   Internally the patient should take the Compound Syrup of Stillingia with
 Iodide  of Potassium, three times a day, or some other preparation in  which
 Iodine  enters.   He  should likewise use in connection with the alterative, one
 of the following preparations :—
   1. Take of Strychnia two grains, Extract of Belladonna five grains,  Alco-
 holic Extract of Black Cohosh forty grains; mix  together, and divide into
 forty pills.   The dose is one pill, to be repeated two, three, or four times a
 day.  This pill will be found  more useful in paraplegia  than hemiplegia,
 although it frequently proves useful in each form.                ,
   2. Take of Saturated Tincture of Rhus Toxicodendron half a fluidounce,
 Saturated Tincture of Aconitum root,  Volatile Tincture of  Guaiacum, each,
 two fluidrachms; mix.   The dose is forty drops every three hours.
   3. Take of Alcoholic Extract of Nux Vomica eight grains,  Protoxide of
 Iron one grain; mix,  and divide into twenty-four pills.   The dose  is  two
 pills twice a day, gradually increased to four;  it is also useful in paralysis of
 the bladder.
   4.  Take of  Xanthoxylin, Iridin, each,  one drachm,  Horseradish,  two
 ounces, Mustard one ounce, Sweet Flag one ounce, Whisky four pints.  Add
 the drugs to the whisky, and allow them to stand for fourteen days, frequently
 agitating.  The dose varies from a teaspoonful to a  table-spoonful, three or
 four times a day, either alone or diluted with sweetened water.  This is very
 useful in cases  of long standing, accompanied with much debility.
   In addition to this, local or counter-irritant measures must be employed;
 thus, Firing may be applied  along the whole  course of the spinal column,
 and  repeated every day or two. * Or, in hemiplegia the Compound  Tar plas-
 ter may be placed at the nape of the neck, and a discharge kept up as long
 as the patient can bear it, renewing it, from  time to time, before perfect
 healing has taken  place.  In paraplegia, this plaster should  be placed over
 the affected part of the spine.  Galvanic  or electro-magnetic currents  should
 also  be  passed through  the affected parts, placing  one pole of the  battery
 over the spine just below the Compound Tar plaster, and the other along the
 extremities of the affected parts; and in some cases these currents should
 also be passed through the brain.  But, in each instance, care must be taken
 not to produce too powerful shocks, which is an incorrect course pursued by
 some persons not acquainted with the true action of  this agent.  The object
 is to stimulate, not to exhaust.   The above  course should  be  persisted in,
 if any benefit is found to follow, after a persevering trial of several weeks;
 but,  if no benefit follow after a reasonable time, some other  course must be
 adopted.  And as soon as the patient has  recovered sufficiently, he should
 take moderate exercise daily, as riding, walking, &c; the shower-bath will
 be found an excellent auxiliary, or cold douches  to the head and  along  the
 spinal column.
  When first attacked the diet should be  light and not too  solid;  after  the
more active symptoms have disappeared, it should  be more nutritious, and 
350
AMERICAN  FAMILY   PHYSICIAN.
even  stimulating,  using spices,  aromatics, &c,  but no  liquors.   Flannel
clothing should be worn next the skin.
                              EPILEPSY.

  Epilepsy, or,  Falling Sickness, as it is  frequently termed,  is a disease
common to early age, and consists in a sudden deprivation of the senses, or
insensibility, with  more  or  less violent  contortions or  convulsions of the
whole system, and as the attack declines, the patient  passes into a state re-
sembling a deep sleep, which continues for an hour or two, or longer.  It is
a chronic disease and frequently ends in insanity.
  Symptoms.  Epilepsy frequently attacks persons in apparent good health
suddenly, without any premonitions, but with many there  are several symp-
toms indicative of an approaching paroxysm,  which usually occur a few
seconds immediately before the attack, enabling the patient to prepare for it.
The most usual warning symptoms are, a heavy pain  in the head, dimness of
sight, noises in the ears, palpitation of the heart, flatulency, weariness, flashes
of light darting before the eyes, or coldness of the limbs; and  one or  more
of these may precede the attack.   Frequently there  is a sense as of a cold
vapor, or the crawling of  an insect, which passes from  some point of the
body or limbs to  the head, and when  it reaches that part, the attack occurs;
this sensation is called the aura epileptica.   In some cases the patient imag-
ines he  sees a specter coming toward him, and falls into  a paroxysm as soon
as this figure comes in contact with him.
  But whether there be  premonitory symptoms or  not, the patient, when
attacked, either  falls or  is thrown to the ground with convulsions and a
deprivation of sense and power.  There is generally a shriek,  or a strange
sound, somewhat resembling the barking of a dog, which  accompanies the
commencing part of the attack.  The convulsions are frequently so terrific
in appearance,  as even for a time  to disturb the calmness  and presence of
mind of the physician; the muscles of the body act with great violence, dis-
torting the parts  affected into various shapes.   Thus, the head  is jerked to
one side, sometimes backward; the face is thrown into very distressing and
alarming contortions; the eyes stare, opening  and  closing rapidly, or are
distorted or inverted, the whites of them only being seen ; the muscles of the
jaws contract and  relax  alternately,  frequently biting the tongue severely
when  it is thrust forward ;  the teeth gnash together;  the power of swallow-
ing being lost,  the saliva is forced out of the mouth in a foam;  the limbs are
violently agitated and jerked in various directions ; the breathing is unequal
ind difficult; the pulse is usually  small and contracted;  the urine and feces
are  frequently voided involuntarily; and the sense of feeling appears to be
completely lost.  Sometimes priapism and  a spontaneous emission of semen
takes place.  I have seen persons  when attacked, reel round and round fora
number of times  before falling, having the head violently drawn toward that
.-ride to which they  were rotating, and at the same time uttering a most dis-
tressing kind of noise.
  After a time, varying from a few minutes to half an hour, or longer, the
fit ceases, and the person passes into  an apparent deep sleep, from which he
gradually recovers,  having no  distinct recollection of what has  transpired
from the commencement of the paroxysm.  He remains  more or less ex-
hausted and  sore,  requiring one  or  more days for  a restoration to  usual
health; sometimes a sense of oppression in the head, or stupor will remain
for  a time; or,  perhaps a mild degree of insanity;  and, occasionally, apoplexy
followed by death will be the result. 
EPILEPSY.
351
  This course, however, will be found to vary; with some persons the con-
vulsions may subside, either partially or completely, for a short time, and be
a"-ain renewed; and this alternation of convulsions and remissions may con-
tinue for many hours before they pass off entirely.  With others  the  attack
is imperfect,' the patient may remain with his eyes fixed  and open,  pupils
dilated, motionless, and for a minute or two be entirely deprived of conscious-
ness, but without falling;  or, there may be a roaring sensation in the head,
a sense of oppression at the heart, with a feeling of intense  alarm which  is
strongly depicted on  the  countenance,  consciousness, however, remaining,
and  the business engaged in at the time not being materially interfered with.
These mild attacks  may occur  from time to time, gradually increasing in
severity until the genuine epileptic convulsion is established.
  An epileptic attack may take  place at any time, but more frequently  it
commences  sometime during the night; and it  often occurs  periodically.
The  intervals between the attacks  vary also; sometimes a single paroxysm
happens, and may not be followed by another for  months  or  even years; at
other times  it will take place regularly once  in  every  month; and again,  it
will  be met  with daily, one or more  paroxysms  occurring  every twenty-four
hours.  In many instances, and especially when the attacks are of frequent
recurrence,  the constitution becomes impaired,  the mental faculties  decay,
and  sooner or later apoplexy, palsy, mania, or idiotcy  are the  consequences.
  Causes.  Epilepsy occasionally exists as an  hereditary disease, but more
commonly it is an acquired one, and appears to be owing to  excessive ner-
vous susceptibility.   The exciting causes are  numerous, as gastro-intestinal
derangement from acid stomach, improper food, worms, &c;  painful  denti-
tion  ; irritation of the womb;  falls;  blows ;  wounds ;  external  violence to
the head or  spine;  disease of the brain or  spinal  marrow; spicula of bone
pressing into the brain; the presence of stone or gravel  in the kidneys or
bladder, or of gall stones in the excretory duct of the liver;  suppression of
customary evacuations;  translation of gout or rheumatism to  the brain;  and
excessive venereal indulgences.  It  may also be  produced by violent affec-
tions of the  mind, sudden frights, fits of passion,  distress  of  mind, frequent
intoxications,  excessive hemorrhages,  disagreeable or terrific sights, acute
pains in any part of  the system, poisons taken into the  body, and among
very sensitive persons the fit has been  caused by  merely seeing others in a
paroxysm.   A very fruitful source of epilepsy among women is derangement
of the functions of the womb and reproductive organs.  Masturbation  is a
most prolific source of this disease; among thirty-seven epileptic patients, I
ascertained that masturbation had been carried to a great extent in thirteen,
and  moderately in seven.
  Discrimination.  Epilepsy may be  mistaken for hysteria, or  apoplexy.
It may be distinguished from hysteria by the  foaming at the  mouth, the
gnashing of the teeth, the biting of the tongue,  the hissing  breathing,  and
dark appearance of the face,  common to epilepsy, and  by  the absence of
those symptoms common to hysteria, as, the  globus hystericus,  or  sensation
as if a round ball were rising to the throat,  the involuntary  fits of weeping
and  laughing, the absence of  complete insensibility,  and the  pale counte-
nance.   It  may be  determined from  apoplexy,  by this  being more usual
to middle-aged persons than epilepsy, except when there have been previous
attacks of the latter;  in  apoplexy the breathing is stertorous or snorting, the
muscles become flaccid and powerless, or if any convulsive action is mani-
fested at first, it is slight,  and is not repeated, and  the  pulse is slow and
laborious.  In epilepsy, the breathing is hissing,  the  muscles are violently
and  continuedly convulsed, and the pulse is usually small and contracted 
352
AMERICAN FAMILY PHYSICIAN.
  Prognosis.  The more recent the attack of epilepsy the more curable is it
except in those cases depending upon a deformity or disease in the bones of
the skull, tumors, polypi, concretions, &c, of the brain.   It is, likewise, sel
dom cured when  it is hereditary, or when it  has existed for  so  long a  time
as to  materially injure the mind.   Among children it frequently disappears
with those changes of the  system  which  occur at the age of puberty, and
with females on the delivery of the first child.   Cases are on record in which
an attack of intermittent fever, the appearance of the menstrual  discharge, or
the presence of a cutaneous eruption, have  been  followed by a permanent
removal  of the  epileptic paroxysms.   When  it is  produced by frights, or
powerful mental emotions, it is seldom cured.
  Treatment.   This should  be based upon the cause of the disease,  if it
can be ascertained, and is divided into that of the paroxysm, to shorten its
duration, and that of the intervals, to prevent a return.   When  the patient
is attacked with epileptic convulsions,  he  should  be placed  as  speedily as
possible in a position calculated to protect him from injury, and if it can be
done, a roll of leather, a soft piece of wood, cork, or other substance not too
hard, should be placed between the molar or  back teeth to prevent the tongue
from being bitten,  but there is no necessity for interfering  with the move-
ments of  the  patient, further than to protect him from injuring himself
His neck should be at once  freed from all cravats or  cloths, and the shirt
unbuttoned or loosened,  as  well  as his  underclothing generally.   A cloth
wet with cold water should  be laid  upon  the neck and upper part of the
chest, and be renewed frequently, or, in its stead,  cold water may be poured
upon  these parts.   Emetics, cathartics, or injections, though they may he
indicated, will be found very  difficult of  administration, on  account of the
violent muscular movement,  and the difficulty of swallowing;  which  last,
however, will be considerably overcome by the cold applications recommended
above.  But there is one preparation which may be used with advantage,
and which should be given  as soon as possible,—it is, the  Compound Tinc-
ture of Lobelia and Capsicum, varying the dose according to the age, from
half a teaspoonful for a  child a year old,  to  a  table-spoonful for an adult,
A finger may be  placed  in  one corner of the patient's mouth, and the lips
be drawn outwardly, so as to permit the above tincture to be gradually poured
in, and which will be certain to reach the stomach,—or, at least, the greater
portion of it will.   Should the convulsions continue,  the dose  may  be re-
peated every ten  or  fifteen minutes.
  When the attacks happen during the night, the application of a cloth wet
with cold water, to the neck, either through the  night,  or just before the
period when the attack occurs, will frequently prevent a paroxysm.
  After a recovery from the fit, it will be advisable, in cases where there is
an over-loaded condition of the stomach and bowels, or a state of constipation,
to administer a cathartic.
  In  those cases  where  the  paroxysm continues for a long time, with  con-
vulsions and remissions  alternately, in  addition  to the  previously named
measures it will be proper during a period  of remission, to administer an
injection composed  of warm  water,  Molasses, each, half a pint, Salt two
drachms, Compound Tincture of Lobelia  and Capsicum a fluidounce;  mix.
And this injection may be  repeated from time to  time, as  the urgency of
the  symptoms will  require.   Beside this, counter-irritation should^ be
applied to the feet and extremities.  A mixture composed of Spirits, Vine-
gar, each, half a  pint, Capsicum four drachms, Tincture of Stramonium seed
four fluidounces,  should  be warmed and applied on flannel  to the  back
along the whole length of the spinal column, and to the feet and legs; this 
EPILEPSY.
353
 thould be renewed occasionally, using considerable friction at each time of
 ipplication.   These  means  combined, will most commonly succeed  in
 relieving the spasms and shortening the paroxysms.
  The treatment to be pursued during the interval between the paroxysms,
 will depend  entirely on the cause of the  attacks, when this can be ascer-
 tained.
  If the epilepsy be owing to depression of the skull frcyn  injury, to  a
 spicula of bone pressing upon the brain, or to bony excrescences, the  only
 mode of cure is to  trephine and remove  the obnoxious portion of bone;
 subsequently strengthening  the brain and  nervous  systems by tonics.
 Instances are on  record, where an  operation of this  kind has at  once
 removed epilepsies which had  existed for several years.
  When the epilepsy is sympathetic, and  is  occasioned by  worms in the
 bowels, means must be used to remove them, such as will  be found named
 under the treatment for Worms, which see.
  When teething appears to be the exciting cause of  epilepsy, that part of
 the gums which appears to be inflamed should be cut,  passing the  gum
 lancet down to  the  crown of the advancing tooth; the bowels should also
 be kept regular,  the head  cool,  and bitter tonics in  infusion administered
 internally, with a  light diet.  In some  cases  an  anodyne plaster behind
 each ear will be of service.
  If the epilepsy be owing to any  derangement of the uterine functions,
 as may generally  be known by an attack occurring at or near the menstrual
 period, the means hereafter named under these derangements, must be pur-
 sued.   The  most  usual  difficulties  of this kind  are   too  scanty or  very
 painful menstration.  And should the paroxysms be due to any other sup-
 pressed  discharges,  as  piles,  ulcers,  &c, they  should be  reproduced if
 possible.
  When masturbation is  a cause  of epilepsy, and especially  when it has
 been long-continued, the cure  is always doubtful, and  more particularly so,
 when, with involuntary  emissions, we find  a  decay or derangement  of the
 mental faculties.   In no case, however, can a cure be  accomplished, unless
 the habit be at  once and permanently given up, and then the means named
 in the  treatment for masturbation, conjoined with that in the following par-
 agraphs must be perseveringly pursued for many months.
  In every case of epilepsy when its cause can be  ascertained, this should
 be removed  if possible, by appropriate measures, in connection with  means
 to allay irritability of the nerves,  and strengthen them.   But when its
 causes are obscure, I have found the  most  advantage from the  course I am
 now about to mention.
  The following pills are to be used daily:   Take of Iodine twenty-four
 grains, Extract of Belladonna six grains, Sulphate of Morphia four  and a
 half grains, Simple Syrup, a sufficient quantity to make a pill-mass.   Rub
 the  medicines thoroughly together,  forming a very fine powder, then add
 the  Syrup; make a pill-mass and divide into forty-eight pills.   One pill is
 a dose, to be  given  an  houi after  each  meal,  and repeated two  or  three
 times each day.   Beside these, the following pills  must also be used at the
 same  time:   Take  of  Prussiate of Iron,  Sulphate of Quinia, Alcoholic
 Extract of Black Cohosh,  each, four scruples;  triturate the powders thor-
oughly together, add the Extract, and form a  pill-mass; divide into forty
eight pills, one of which is a dose,  to be  given an hour previous  to each
meal, and also repeated three times a day.
  If these pills are given in sufficiently large doses to keep up a constant,
but  not too decided an effect upon the head, as a slight pain, heaviness, or 
354
AMERICAN FAMILY PHYSICIAN.
giddiness, it will be found to answer a much better purpose than otherwise
  In addition to these, the bowels must be kept regular by mild laxatives-
and in some  cases, a purgative may be administered once or twice a week,
If there is acidity of the stomach, some alkaline preparation may be exhib-
ited, among  which,  in this  disease, I prefer the Carbonate of Ammonia.
The cold douche should be applied to the head and along the spinal column
every morning^ or every other morning, as seems  serviceable, and at night
a stimulant should be applied along the spinal column, and on each side of
it, as the Compound Liniment of Oil of Amber, or,  the following mixture:
Take  of Oil  of Origanum, Oil of Peppermint,  Oil of Amber,  Camphor
Tincture of Stramonium seed, each,  equal  parts; mix together.  Firing,
every few days, over the spine from the base of the  skull to the last verte-
bral bone, will frequently be found very advantageous ;  and, in some cases,
the Compound Tar plaster applied, first over the base of the skull and upper
part of  the neck, and then between the shoulders, alternating its site from
time to  time will be productive of the most  happy effects with some, while
with others  it  will  seem to aggravate the  disease.   A  mild current of
electro-magnetism passed daily through the  brain and spinal marrow, will
be of much service in nearly all instances.
  The diet in epilepsy  should be light, nutritious,  and easy of digestion,
avoiding fats, acids,  liquors,  and food disposed  to cause flatulency.  Ani-
mal food should be used moderately, tea and coffee  abstained from, and in
their place the patient may drink the following infusion :   Take of Scull-
cap, Peony root, Valerian, Peach leaves,  each,  one ounce, Sassafras three
ounces; mix.   A teaspoonful of this mixture, in  powder, may be added to
half a pint of boiling  water,  infused for a few minutes,  sweetened, with
milk added if wished, and  drank.   This may also be  used as a constant
drink through the day.  The hours for sleep  and  rising should be properly
regulated, the exercise should be regular but gentle, avoiding all improper
exposures, as well as all mental excitement, violent passions, &c.  The sur-
face of  the body must be bathed  once or twice a week with a weak alka-
line solution, with considerable friction, when drying, by a second person;
the head should be kept as cool as possible;  the  cold  shower bath daily is
generally  useful; and it will be well for  all epileptics to  avoid dangerous
places, lest a fit should come on, and they be precipitated to the ground,—
as, standing or working upon houses, ladders, and precipices, or near deep
ponds, rivers, &c.
  Sometimes it may  be found advisable to  change the Iron and Quinia
pill above advised, or, to use it alternately with  some other agents;  and
among those  which have proved  the most beneficial  in my own practice,
are the  following :—
  1.  Take of Extract of Stramonium three grains, Valerianate  of Quinia
twelve  grains,  Alcoholic Extract  of Black  Cohosh  twenty-four  grains;
mix, and divide into twenty-four pills.   One pill  is  a  dose, to be repeated
three or four times a day.
  2.  Take of Extract of Water Pepper, Extract of  Indian Hemp, (Canna-
bis Sativa,) Extract of Stramonium, Sulphate of Quinia, each, one drachm;
mix thoroughly together, and divide into sixty pills.   The dose is one pill,
to be repeated four times a day.
  3. Take of bruised  Stramonium  seed, Assafetida,  Lupulin,  Powdered
Black Cohosh root, each, one ounce, Spirits one quart.  Macerate for four-
teen days, frequently shaking.  This forms a very valuable preparation foi
this disease, which I have found second to none;  the  dose to an adult is a
table-spoonful three times a  day. 
                             CATALEPSY.

  Among the agents which have been highly recommended in this disease,
may  be named,  Ice  plant, Peony,  Blue Cohosh,  Ladies' Slipper, Skunk
Cabbage, Rue, Masterwort, Round  Leaved Pyrola, kc.  The following is
the formula for a preparation which has acquired  considerable reputation
in curing epilepsy:  Half fill a gallon bottle with equal  parts of green
Rue  and Garlic, add Assafetida seven  ounces, and fill the bottle with old
Whisky.  In a few days  it will be fit for use.  Dose, a wiaeglassful every
morning, on an empty stomach, and also on going to bed.
                            CATALEPSY.

   Catalepsy is that condition  in  which, without any fever necessarily, a
 person loses the power of voluntary motion for a longer or shorter time, with
 a partial or complete suspension of the five senses; the muscles being some-
 times rigid, and at others movable, keeping the position in which they were
 when attacked, or in which  they may be placed  by other persons subse-
 quently.  It continues for a longer or shorter time, when it subsides, leaving
 the  person in his usual health, but without any  recollection of what has
 passed; it very much resembles the condition  produced by mesmerism.
   Symptoms.  In a  few  instances premonitory symptoms are  present,  as
 headache, giddiness,  flushed  face, pain in the breast, lassitude, yawning,
 flatulence,  forgetfulness, depressed spirits, &c.  But more commonly the
 attack is sudden, the patient remaining in  the position he held  at the  time
 of the attack, being  unable  to move, and if a limb is moved by  another
 person, or an eye opened, &c, it remains so, fixedly.  I have, however, wit-
 nessed instances wherein patients would move about  and converse  with
 others, having no recollection  of these events upon recovering from the
 cataleptic condition.   There is  always a partial „or complete suspension of
 the senses.   In some instances,  if the paroxysm comes on while the  patient
 is conversing, or in  the performance of any other continuous  act, he will
 resume the thread  of the conversation, or  even finish the half-pronounced
 word, or continue his acts, as  soon as the paroxj-sm is  over,  apparently
 being unaware that any  interruption has taken  place.   A  trance; as it is
 ealled, and a state of ecstacy, are cataleptic  conditions.   Catalepsy is  seldom
 dangerous, and sometimes is followed by the cure of previously existing dis-
 eases of the brain and nervous system, as epilepsy, hysteria, &c.  Occasion-
 ally it is followed by epilepsy, apoplexy, or melancholy, and may terminate
 fatally in a few days, and these will be more apt to  follow any violent efforts
 made by friends to recover the patient from the cataleptic state.  Very rarely
 it is followed by death.
  Causes.   These  are  not  well  understood;   suppressed  menstruation,
 worms, painful emotions of the mind,  deranged condition  of the stomach,
 intense study, excesses, constipation, &c, have been named as the exciting
 causes.
  Treatment.  Catalepsy  requires  no treatment during the  paroxysm,
 unless there  are  certain symptoms  demanding it, as determination to the
 head, palpitation of the heart, feeble  pulse, &c.   Generally, it is better  to
 let the patient alone until she recovers from it spontaneously.   I have  seen
a mesmerizer  make his mesmeric  passes for a few  minutes over a cataleptic
patient, and immediately after, either awaken them, or. be  able  to converse
with them freely during the paroxysm; and I  have seen night-somnambu-
lism cured by the same method—but I do not profess to understand  how 035
why this peculiar influence was effected. 
356                 AMERICAN FAMILY  PHYSICIAN.

  When catalepsy occurs frequently, and  is accompanied with debility or
some derangement of the system, remedial measures may be pursued durin«
the intervals.   The deranged condition, whatever it may be, must be appro-
priately treated, the bowels kept  regular, the skin in a clean, healthy state,
moderate exercise should be taken daily, and  internally, tonics,  antispas-
modics, (and in  anemic cases,  Chalybeates,) should  be administered daily
with a diet adapted to the wants and condition of the system.  Sudden, rude ■
or violent attempts ,to recover one from this state are highly improper.
              CONVULSIONS, or  FITS OF CHILDREN.

   The brain and  nervous system of an infant,  especially previous to its
third year, owing to their immaturity and delicacy of structure, are extremely
impressible and liable to derangements, from which  convulsions will readily
ensue, on  the  application of even the slightest exciting causes.   The most
formidable, and probably the most fatal diseases to which infants are subject,
are convulsions, which attack  those of different constitutions,  at all  ages,
and under diverse circumstances.   They may be  connected with disease of
the head and spine, and they may occur during the course  of fevers or other
diseases.
   Symptoms.   In  most cases the infant is  dull, heavy, and feverish for a
day or two previously, or it may be restless and irritable with an  uncertain
oscillation  of its eyes, or an occasional  wide stare, more or  less debility, dis-
ordered and irregular respiration, and a spasmodic turning in of the thumbs,
Sometimes the attack is sudden  without any premonitions.   The  child falls
into a state of unconsciousness with more or less violent spasmodic action of
the muscles of  the  limbs  and face.   The mouth, cheeks, &c,  are thrown
into irregular and distorted action,  being jerked  in different directions; the
eyes are either  stationary,  or roll about in every direction; the pupils may
be either  contracted or dilated; the jaws are forcibly closed, or  only moved
laterally, so as to grind the teeth;  the head is thrown strongly backward, or
to one side, or it is  rapidly rotated  from side to side; the  child  frequently
froths at the mouth, and respiration has a short, broken, hissing sound; the
muscles of the  back are rigid, or act  with  sudden  or irregular jerks; the
arms  are half bent, or thrown about irregularly,, and  the hands are clenched
with  the thumbs usually  turned into the palms of the hands;  the legs are
similarly but less severely affected,  and the feet  are  generally bent upward
and inward.  The face becomes livid, the pulse small and hard, often irregu-
lar, and from 100 to 160 in a minute; the head is usually hot, the feet cold,
and not unfrequently a cold, clammy perspiration breaks out upon the head,
face, and neck.  Frequently the feces and urine are involuntarily evacuated,
These symptoms vary considerably  with different  children, both  in number
and severity; and the  attack may occur during sleep, or in  the waking state.
The convulsion may last  for only a  few seconds, five or ten  minutes, or
several hours; the convulsive  agitations gradually cease, the  face becomes
pale, the eyelids closed, the limbs  flaccid,  breathing calm  and regular, the
pulse slower and weak, and sleep supervenes, from which  the child awakes
conscious and intelligent, but frequently dull and  exhausted.  The fit may
terminate here, or it may return again after longer or shorter intervals, and
ultimately  destroy the patient.   Sometimes, only a part of  the body will he
affected, and  at other times  the  convulsive  paroxysm will  be imperfect,
giving rise to what  is generally termed  "inward fits,"  in  which the eyes are
half-closed with the globe  turned upward, the  breathing  is disturbed, the 
CONVULSIONS.
357
 child cries or moans almost constantly, and is apt to give spasmodic starts
 frequently without any apparent cause, and during which there is a slight
 but transient  rigidity  of the  limbs,  with the fingers  firmly  clenched, or
 widely separated.   Finally, vomiting or purging come on,  and some relief is
 obtained.
   During the period  of teething,  if the child becomes fretful  and restless,
 with capricious and irregular appetite,  continual rubbing of the  nose  and
 eyes, considerable  fever through  the night,  with  hard and swollen belly,
 hoth of  which disappear as sunrise approaches, startings during sleep, with
 ueavy or difficult breathing, and a slight dilation of the pupil of the eye on
 awakening in the morning, with a  dull appearance  of the  eye—-these are
 premonitory symptoms of. a convulsive attack.
   It is seldom that the first paroxysm  occasions  death;  but  if  the cause of
 the disease  is not removed, and continues its influence, the child will not
 recover  its natural sprightliness,  but will continue dull and uneasy, and fit
 will  follow  fit, with  a certain length of intervals between, until the little
 sufferer  is relieved by death.
   Causks.   Anything which will irritate or derange tho brain  and nervous
 system will give rise to convulsions in children.  The most  frequent causes
 are, improper food, overloading the infant's stomach, unhealthy  milk of the
 mother  or nurse, want of cleanliness, teething, worms, falls or blows on the
 head, flatulence, recession of rash, measles, small-pox, &c,  sudden  mental
 emotions, kc.
   It has been  supposed by many medical men, that in children who are sub-
 ject to convulsions there  must  be  a peculiarity of constitution, which may
 have been transmitted from their progenitors, who were themselves, when
 young, similarly disposed; to a certain extent this may be  correct,  for we
 find that in nearly  all  cases of  disease,  the peculiarity of the  formation and
 of the constituent properties of any organ or organs, and their relation with
 the blood, give rise to  the particular character, location, and  form of  disease
 to which every individual is predisposed.   Hence, the exciting causes which
 would produce convulsions in one child, may cause pneumonia, or hydro-
 cephalus, &c, in another, while others would remain unaffected.
   Convulsions will at times attack nearly all the children of a  family from
 parents who  were always exempt from them.   This is  more particularly the
 case  where  a  strumous diathesis .exists  in  one or both of the parents, or
 where they  have  injured their nervous  powers  by excesses, debaucheries,
 masturbation, intemperance, &c.   Cohabitation during pregnancy is almost
 certain to injure the offspring, and render it liable to this form of disease.
   Treatment.  This must vary according  to the excfting cause, when it can
 be ascertained.  If convulsions arise from teething, the child must be placed
 as soon as possible  in a warm bath; but as some time may elapse before this
 can be prepared, the Compound Tincture of Lobelia and Capsicum  must be
 given  in doses of from  fifteen to thirty  drops, for a child  a year old, and
 repeated  in  ten minutes if the fit  does not cease.   In a  majority of cases
 the first  dose will break the fit immediately.  As  soon as the fit ceases, and
 after having employed  the warm bath, Mustard poultices should be applied
 to the feet,_and as soon as convenient a purgative should  be administered;
 the Kntozoie Powder is decidedly the best,  because, should worms  be pres-
 sent, it counteracts  their pernicious effects.  The gums should also be cut by
 one who  is well skilled.  I am aware that many are opposed  to  cutting the
gums, but I have always found it the best course to pursue; it allays the irri-
tation, and, of  course,  lessens the disposition to a return of the  fit, and has,
in many  instances, been the means of saving the  child. 
358
AMERICAN FAMILY  PHYSICIAN.
  There is no foundation for the common idea that  cutting the gums  may
destroy the child by bleeding to death;  as  this can only happen when the
child has a hemorrhagic  diathesis, (that is, a want of sufficient coagulable
substance, from which cause, as no clot or coagula can form, the blood con-
tinues to flow,) which is a very  rare  case, or when some  bungler not ac-
quainted with his business should cut in an unskilful manner.
  The after-treatment should be mild  laxatives every day, and tonics, with
an anodyne or strengthening plaster behind  the ears.   The following tonic
tincture will  be found  useful:  Take of Gentian,  Golden Seal, Balmony.
each, in powder, one  drachm, Cardamom seeds, Sassafras bark, Prickly-Ash
berries, each, bruised, half a drachm,  good  Cognac Brandy half a pint;
mix  together, and let  them stand a few days; the dose is half  a teaspoonful
or a  teaspoonful, in sweetened water, three times a day.
  When the convulsions depend upon worms in the intestines, some  Salt
and water may be given as soon as the child can drink, and adopt a course
similar  to the above; the following injection must be given as soon as it
can be made, and repeated  at intervals of one, two, or three hours; take of
Balmony an  ounce,  Mandrake two  drachms, water half a pint; boil toge-
ther, then strain, and add Tincture of Assafetida half a fluidounce, Molasses
four fluidounces, Salt two drachms.   Inject a quantity suitable .to the age
of the child.
  When the convulsions originate  from acrid, irritating substances in the
stomach, as unripe fruit, &c,  the Compound Tincture of Lobelia and Cap-
sicum must be given,  together with the following injection :—Take of Bone-
set two  parts, Senna one part, water sufficient to make a strong  decoction; to
each pint of  the decoction add four drachms of Salt, and a drachm each of
powdered Bayberry bark and Lobelia.   This injection must be used every
ten or fifteen minutes, in quantities adapted to the age of the child.  Cloths
wet with as warm wrater as can be borne, constantly applied to the stomach
and  bowels, and changed often; Jlustard draughts may also be applied over
the stomach and bowels, frequently renewing them;  they may also be placed
to the soles of the feet.  This course must be perseveringly and energeti-
cally pursued until the termination of the fit, without in the least changing
or altering the treatment, even if the  convulsions should wholly or partially
continue for  several hours.
  When convulsions appear, and the  cause is unknown, they should be
treated by first administering the Compound Tincture of Lobelia and Cap-
sicum, until they cease, or until the child can freely swallow;  for the sooner
we destroy the spasmodic action, the less is the danger to be  apprehended.
As soon as the child  is so far recovered as to be able to swallow, the Com-
pound Tincture of Lobelia must be administered in doses to produce vomit-
ing; after which  the above Assafetida  injection  must  be given, and Mus-
tard poultices be applied to the feet.   In all cases where there is an accu-
mulation of mucus or phlegm, give  the Compound Tincture of Lobelia, to
vomit as soon as possible.
   If there is a constant and rapid succession of convulsions, cloths must bt
applied, as above mentioned, over the  stomach and bowels;  the injections
must be repeated once at least in every twenty minutes, with half a flui-
drachm of the Compound Tincture of Lobelia and Capsicum added to each;
and the same tincture must be repeated  every ten or  fifteen minutes, or
every half-hour, as the urgency of the case  may  require; cold water and
Vinegar should  be  applied  to  the  forehead and  temples, if they be hot,
This is a very active form of convulsions, and must be treated actively and
with energy, never desponding or ceasing while life exists.   In some cases, 
CONVULSIONS.                         359
 i have had to continue the above course for from six to tWenty-four hours,
 before gaining the least apparent advantage over the disease.   In the great
 majority, however, imfroni thirty minutes to an hour, the child will be  safe
 and free from convulsions.
   In  all cases of convulsions, and after the emetic has operated, a purga-
 tive should always be  administered; the Entozoic powder is the best,  and
 answers a two-fold purpose, as a purgative and as a vermifuge, should worms
 exist  in the bowels, and which maybe employed for several days  afterward;
 after which give the above tonic tincture.  If this powder cannot be admin-
 istered, the Compound Powder of Jalap will answer.
   When convulsions occur from a  recession, or "striking in" of the erup-
 tion of measles, sc&let fever, &c, in addition to the above  treatment, per-
 spiration must be produced by the warm bath, and maintained by the ad-
 ministration of warm infusions of simple herbs, &c.
   It sometimes  happens that  after a convulsion, the child becomes unable
 to  pass his water, for which  he  may be placed in  a warm bath, and kept
 there for ten minutes, and then  onions or garlic, pounded, and  slightly
 warmed, but  without in the least  cooking them, must be placed over the
 region of  the bladder, and  Marshmallow root,  Parsley root, Cleavers, or
 Pumpkin seed tea administered freely.
   If a troublesome cough, either dry or attended with  considerable phlegm
 or mucus, succeeds an attack of  convulsions, the best remedy that can  be
 used is the Compound  Syrup of Spikenard.
   AVhen the stools are  slimy and green, a little Supercarbonate of Soda may
 be given several times  a day, dissolved in water; or Soot tea will be found
 of much benefit; it may be sweetened, and some essence of Peppermint or
 Spearmint  added.  The Compound Syrup of Rhubarb and Potassa will also
 be found beneficial.
  After the convulsions, or during the intervals between them, every care
 must be taken that the child's diet  is of the proper character; if he nurses,
 the mother must ascertain that there is no cause existing with her which
 demands the  weaning of the  child.  Unripe fruits, fruits having skins or
 kernels which are difficult of digestion, should not be permitted to either
 the child or the mother if nursing; the  bowels should be kept  free;  and
 due pains be taken to strengthen the nervous system by exercise in the open
 air, and by the tepid or cold bath.   Where the predisposition laid in or-
 ganization  is considerable, the only safety for the child  is in avoiding  the
 exciting causes.
   When convulsions occur from a fall or blow  on the head, they  are apt to
 prove fatal; although  the above treatment has been the means  of saving
 many.   When a child  has received a severe fall  or blow on the head, cold
 water  should  be immediately applied to the head, either by pouring it from
a short distance above, or by means of cloths,  and it should  be  continued
 for  fifteen or twenty minutes; then apply Mustard poultices  to the feet,
 back of the neck, and over the pit of the stomach, allowing them  to remain
 until  they produce considerable redness; after wdiich administer a dose of
 the Compound Powder  of Jalap.
  A treatment similar  to the above must be pursued in  those convulsions
 which often occur in children and adults, from  recession of exanthematous
eruptions, &c, and which assume no specific character. 
360
AMERICAN FAMILY  PHYSICIAN.
                   HYSTERIA,  or  HYSTERICS.

  Hysteria, or Hysterics, is a spasmodic affection common to females, and
very rarely met with in males.   It appears under such various shapes, and
with so many symptoms, that it will be almost impossible  to give a special
definition of it; it must be described by taking all its symptoms collectively
or rather the most prominent among them.   It attacks pregnant as well as
non-pregnant females,  and however alarming a paroxysm may appear, it is
seldom attended with danger, unless it merges into epilepsy.  Retention of
urine is to be feared in a long-continued paroxysm of hysteria.
  Symptoms.  Usually, the female from a calm or excited condition, but in
which no symptoms of disease are manifested, by an unlucky word, and  often
from no apparent immediate reason, commences crying and laughing at in-
tervals, perhaps also venting reproaches; peal upon peal of immoderate cry-
ing and laughter, sobs, floods of tears, stolid silence, wringing  of hands,
tearing of hair, clonic  convulsions, tonic spasms, and smiles, are all wildly
and irregularly combined, and followed by a profound calm of the constitu
tion, and a feeling of complacency.  During these symptoms the  female, at
the commencement, is  attacked with a sense  of tightness about the throat,
with sobbing, or repeated attempts at swallowing.  Sometimes a  sensation
as if a ball passed upward to the throat and  lodged  there, is experienced,
and which is called the "globus  hystericus."
  She  may roll about  from side to side, or she may lie perfectly still and
motionless.  She  frequently presses her breasts with her hands,  or carries
them to the neck as if  to  remove some obstruction.  The  face  is usually
pale,  though not always,  and is not distorted;  no froth  issues  from the
mouth, nor are there convulsive motions of the lower jaw, but the large mus-
cles oS the back  are violently contracted, so as in many instances to cause
the body to describe an arch backward.  The trunk of the body is twisted
forward and backward, the  limbs are variously agitated, and  the  fists are
firmly closed.  Sometimes these is obstinate constipation and retention of
urine, at others the urine is copious and of a paje color.  More or less flat-
ulency, with a rumbling sound in the bowels, is very apt to be present.
  The paroxysm continues'for a  longer or shorter time,  the sobbing be-
comes more violent, or the patient screams  and sheds tears, and thus the
fit ends.   Sometimes they will lie apparently insensible and immovable for
a longer or shorter time.  The  attack is often preceded  by dejection of
spirits, anxiety, yawning, effusion of tears, difficult breathing, nausea, pal-
pitation of the heart, numbness of the extremities, &c.
  It is not uncommon,for hysterical patients to complain  of dreadful and
excruciating pain  in the  hips, knee, spine, &c, with excessive tenderness
to the  touch, and which are owing to severe muscular contraction, instead
of any disease of the parts.  I know of one female who was  nearly destroyed
by treatment for uterine inflammation, when  the whole difficulty was  hys-
terical contraction'of the  muscles of the thigh and abdomen, causing con-
siderable soreness in  the parts.   Sometimes, a species of paralysis accom-
panies hysteria ; and, occasionally, females will imagine many strange things,
and even practice more or less deception, speaking in a whisper, pretending
to vomit blood, meat, &c, &c.
  In  some women, and especially during pregnancy, with a very slight
warning,  they may be attacked with  a  severe  fit  of hysterical convul-
sions, which may occur daily, every other day,  or at longer intervals, and
which if not removed will induce a miscarriage, which usually occurs at the
time of the fit. 
HYSTERIA.
361
  Causes.  Hysteria may be produced by various causes, as want of sleep,
excessive fatigue, disordered digestion, sudden mental shocks, as joy, fear,
Krief &c; excitement of the reproductive organs, or of the venereal sense,
indolence' high living, sedentary habits, &c.  Females of an irritable, ner-
vous system,  are most subject  to it, and  those who are  single or widows
more so than the married;  and the paroxysms occur oftener about the period
of menstruation than at any other time.  Excessive discharges and exhaust-
ing diseases, frequently give rise to attacks of hysteria, which occur  during
convalescence, and are renewed subsequently upon the slightest causes.
   Discrimination.   Hysterical convulsions may be  determined from epi
leptic by observing that in the latter there is no frothing at the mouth,  no
protrusion of the tongue or biting it, and  after the paroxysm is over, the
patient recovers her usual state, and does not fall into a sleep as in epilepsy.
From apoplexy, by observing that in this  the  patient loses consciousness
and voluntary motion first, and finally all motion ceases, and the breathing
is stertorous.  From puerperal  convulsions, by observing that in these the
actions of the muscles are violent and irregular, the head is strongly rotated
to the right or left, and backward, with violent jerking contractions of the
muscles of the back, abdomen, and upper and lower extremities; spasmodic
action  of the muscles of the face is rapidly repeated; the lips  and teeth are
firmly  closed; the  breathing is loud and  hissing; the tongue is very livid,
protruded forward, and often bitten, so that the blood and saliva is thrown
to some distance through the compressed lips; the face becomes livid; and
the attack usually occurs  in first labors among  females with short, thick
necks.
   Treatment.  The treatment will be 1st., to overcome the paroxysm; 2d,
to adopt means during the interval which will strengthen the nervous sys-
tem and lessen  its excitability, and thus prevent a return of the attack.
   During the paroxysm in mild cases, a teaspoonful of the Compound Spirits
of Lavender may be added to a little sweetened water and administered, and
this may be repeated every five, ten, or fifteen minutes, as the case may  re-
quire.   The dress, and all tight strings must  be loosened, and the  female
placed  where there is a free admission of air.  In  severe cases, the Com-
pound  Tincture of Lobelia and. Capsicum  may be given, in doses of from a
teaspoonful to a table-spoonful, repeated every ten  or twenty minutes.  Or,
the following heterogeneous mixture will be found especially useful, notwith-
standing its singular construction:—Take of Skunk Cabbage root, Scullcap,
Ladies' Slipper root, Lobelia, each, half an ounce,  Capsicum two drachms,
Alcohol  one  pint, Compound  Spirits  of Lavender half a pint, Ether, Am-
monia, each, four fluidounces;  mix together, and let it stand fourteen days,
frequently agitating; keep it in a well-stopped bottle.  The  dose  is from
one to  three teaspoonfuls, repeated as required.
   Patients in apparently the most  distressing hysterical spasms, are yet
very sensible of wdiat is passing around them,  and this  may frequently be
taken advantage of to lessen a fit,  by arousing their fears  in some way.
One practitioner says, that among married females  he has frequently termi-
nated the  paroxysm by pushing up the  uterus into the upper part of the
pelvic  cavity, as far as possible, and holding it balanced upon the end ot
the index finger.   The only cause of the benefit in such cases is, the men-
tal or moral impression produced upon the patient.
   As a general rule it is better not to interfere with the  movements of an
hysterical patient, further than to prevent her  from injuring herself; and
any attempts to subdue  a paroxysm by  bleeding, or violent or  forcible
measures are  extremely improper.  If the bowels  are costive, and the par- 
36'2
AMERICAN FAMILY  PHYSICIAN.
 oxysm  is  of long continuance a purgative injection may be given, di the
 one named under epilepsy, page 352.   Sometimes, cold water dashed over
 the extremities and face is attended with a good effect.
   The treatment in the intervals between  the fits, will be to keep the stom-
 ach and  bowels  in a  healthy condition, obtaining  one alvine  evacuation
 daily, to keep up the functions of the skin by bathing and friction, and to
 improve the condition of the nervous  and uterine  systems by  one of the
 following agents:—
   1.  Take of Aletridin twelve grains,  Senecin twelve  grains, Sulphate of
 Quinia six grains ; mix together, and divide into twelve pills.  The dose is
 one pill, repeated  three or four times a day.
   2.  Take of  Extract of Belladonna  one grain and a half, Sulphate of
 Quinia  six grains, Alcoholic  Extract  of Black Cohosh  eighteen grains1
 mix together, and divide into twelve pills.  The dose as above.
   3.  Take of Aletridin twelve grains, Senecin twelve grains, Alcoholic Ex-
 tract of Nux Vomica one grain ; mix together, and divide into twelve pills.
 The dose is one pill three times a day.
   4.  Take of Aletridin twelve grains, Dioscorein twelve grains, Capsicum
 twelve grains ; mix together, and  divide  into  twelve  pills.   The dose as
 above.
   5.  The Compound Syrup of Partridge berry.
   Whichever of these agents are used, they must be  persevered  in, and if
 the patient is of a strumous habit, an alterative  with Iodide  of  Potassium
 must be  administered; or, if she be  anemic, some  preparation of Iron.
 When any tenderness is discovered along the spinal column, counter-irrita-
 tion should be applied every day or two, as the Compound Liniment of Oil
 of Amber, dry Cupping, or  Firing.   Among  the agents recommended in
 this disease  are  powdered  Valerian,  fifteen  grains  for  a  dose;  Castor
 Musk; Assafetida, <fcc, but these seldom effect cures.
   The diet should  be nutritious  and  of easy digestion, avoiding acids,
 grease, flatulent food, and pastry.   The mind of the patient should be kept
 constantly easy and cheerful, and occupied if  possible in  some pleasant
 pursuit;  exercise must be taken daily, all  high living avoided; and, where
 it produces no bad influence, an  occasional douche to the head and spine,
 or, a  cold  shower-bath, will be found  decidedly beneficial.   Idleness is a
 great cause of renewed paroxysms.
   When  hysterical  convulsions occur  during pregnancy, the Compound
 Tincture of Lobelia and Capsicum should  be administered in doses of from
 a teaspoonful to a table-spoonful, repeating them every ten or twenty min-
 utes,  until the paroxysm subsides.   If  the  first dose be large  enough, it
 will commonly afford relief without any more being required; sometimes,
 however, a second, or a third dose may be  necessary.   During the intervals
 between these hysterical attacks, the diet of the patient must  be  regulated,
 giving her a hearty, nourishing, but easily digested food, with some pleas-
 ant stimulant, if  the  patient  be weak, as Ale, Porter, or  Wine, &c, in
 moderate  quantity; the  bowels must be  kept regular, obtaining a daily
evacuation from them ; and this course  should be pursued  until delivery
 takes place.  All influences tending to depress or excite the mind must be
avoided,  the patient should  be kept in a calm and tranquil state, powerful
medicines as cathartics, sudorifics, &c, are inadmissible ; and  cohabitation
during the remainder of the pregnancy must be  positively abstained from.
At the time of labor a  vial  of the above  tincture should be at hand, to
promptly subdue any paroxysms which may take place at  that time, by its
immediate  administration. 
SAINT  VITUS' DANCE.
363
                     SAINT  VITUS'  DANCE.

  Saint Vitus' Dance, or Chorea  Sancti Viti, is a singular disease,, which
may occur at any period of life from one year old and upward, and is much
more common among females than males.   Although a disagreeable affec-
tion, it is rarely attended with danger, unless complicated with epilepsy, or
some  other  serious disease.  It may affect only one  part  of the  system
alone, or, more frequently, several.
  Symptoms.  Chorea is frequently preceded  by a changeable, and often a
voracious appetite,  loss  of sportiveness and spirits, a swelling and hardness
of the abdomen, with  more  or less  obstinate constipation.  Convulsive
movements, or rather twitches of the fingers, muscles of the face, or other
parts  of the body, are  observed, being at first very slight, but gradually
increasing, and  extending  themselves so as  to  interfere  with walking,
speaking,  and even  mastication.   These movements  are involuntary and
irregular, varying  much in different  individuals, sometimes affecting  one
complete half of the body.  Some of them border much upon the ludicrous,
especially when the disease  is limited  to the muscles of the face, and are
very mortifying  to the patient.  The face may be contorted into various
shapes, looking as  if the individual was making "wry faces," on purpose;
the head  may be  constantly in a state  of motion, trembling, moving up
and down, or occasionally drawn suddenly and momentarily to the right or
left; the gait will  be very unsteady, or the leg dragged along in an awk-
ward manner.   The bowels  are almost always constipated,  and as the dis-
ease advances we  occasionally find an impaired appetite  and digestion,
flaceidity and wasting of the muscles, and sometimes  a debility of the in-
tellectual  powers, to such  a  degree as to threaten idiotcy.  Fever is not
necessarily present, the  pulse  is about regular, the skin cool, and  very
seldom any pain or distress.
  Children  laboring under  this affection are very apt to be capricious,
fretful, and easily alarmed;  the motions becoming much more severe when
they meet with  any opposition or contradiction.  The motions are less
marked, and frequently entirely suspended during sleep, while the brain is
occupied in its' own acts.
  Causes.   These are   not well understood;  sex and age  appear to have
much influence in  predisposing to it, as females are more liable  to  it  than
males, in the proportion of  three  to one, and it more commonly attacks
those of the ages  from  five  to fifteen years.   Among the exciting causes
may be named, powerful mental emotions, worms, fright, falls, blows,  sup-
pressed  eruptions  or customary discharges, rheumatic translation to the
membranes  of the spinal cord, excessive  venery, masturbation, and other
causes productive of debility and extreme  irritability of the nervous system.
In all the  cases which I have seen, I have not yet met with one, except in
persons of a strumous diathesis.
  Prognosis.  If the disease be neglected it may lead to more  serious re-
sults, but  if treated  properly, it may almost  invariably be cured—except
when complicated with  other affections of a severe and extensive character.
When  the mind shows  evident impairment, a  cure  is always doubtful.
When  chorea  is complicated  with other diseases,  as chlorosis, hysteria,
amenorrhea, dysmenorrhea,  rheumatism, erysipelas, cerebral affections, &c,
these maladies  must be treated in precisely the same manner as if the
chorea were  not present; and after their removal or amendment, the chorea
may be treated. 
364
AMERICAN  FAMILY  PHYSICIAN.
  Treatment.   The indications in  treatment, are  to  keep the intestinal
canal in a healthy condition, relieve the nervous affection, and remove any
existing complications.
  For the first few days of treatment, it will  be proper to unload the ali-
mentary canal of all  accumulations by  some  purgative  medicine, as the
Compound Pill,  or Powder of Leptandrin, either of which I prefer, in this
disease, to any other known purgative.   After the bowels  have  been thus
evacuated daily for a few days, they must subsequently be kept regular by
procuring one, but never  to exceed  two daily evacuations, approaching as
nearly as  possible to natural, healthy discharges ; for this purpose, two
parts of Bhubarb may be mixed  with one part of Bicarbonate of Potassa,
and from three to fifteen grains, according to the  effect, be administered in
a little water, for a dose, repeating it three times  daily.  If the  bowels do
not  readily respond  to  the action  of this powder, from one-twelfth to
the one-twentieth of a grain of Alcoholic Extract of Nux Vomica may be
added to each dose, for an adult.
  To relieve  the nervous affection, &c, the  following  measures will be
found useful; as a constitutional means to remove  a strumous  condition,
and  anemia, which  are  commonly  present, administer a pill composed of
Iodine twelve grains, Sulphate of Morphia one  grain and a half, Iron by
Hydrogen twenty-four grains,  Extract of Liquorice, a sufficient quantity to
form a pill-mass ; mix thoroughly, and divide into twenty-four pills.  The
dose for an adult is one pill, to be repeated two or three times a  day.  To
influence the brain and nervous system, one of the  several agents about to
be named will be found very useful, and  in long standing  cases it will be
advisable  to occasionally  change them  that  the system shall not become
habituated to them.   1.  The  Compound Pill of Black Cohosh may be
used, and it is the one which I more generally employ.   2. The Compound
Pill  of Valerian. 3.  The Compound  Tincture  of High  Cranberry bark.
4. In a few rare cases, especially when  there has been a tendency to numb-
ness or paralysis, I have found very advantageous a pill composed  of Ex-
tract of Belladonna one-eighth of a  grain, Strychnia from one-twentieth to
one-fortieth of  a grain, Alcoholic  Extract of Black  Cohosh two grains;
mix, make a pill.  One of these pills to be given  three times a day. In  a
majority of cases a very gentle electro-magnetic current passed through the
brain, spine, and  affected  muscles,  will  aid materially  in hastening the
cure.
   The diet  should be full, nutritious and easy of digestion, avoiding acids,
grease, coffee, and liquors; the body should be bathed  with a weak alkaline
solution once  or twice a week,  and every night and  morning friction with  a
coarse towel or flesh-brush, so as to  produce an agreeable glow on the sur-
face, should be performed by a second  person.  Moderate  exercise should
be taken regularly every day, and  the  patient should avoid company and
all associations calculated to mortify or excite, and  thus increase and per-
petuate the motions.   The shower-bath may be useful  in some  instances,
but  it must be used with care, as I have seen the disease very much aggra-
vated by it.   When it is  associated with worms, rheumatism, &c, pursue
the treatment named for these.
   I  have known cures of St. Vitus'  Dance effected by  the following simple
means:—Take of Horse-radish  root,  White Mustard seed, each, half a pound,
hard Cider one gallon; mix, and let the mixture infuse  for a few days before
using.  The dose is from half a wineglassful to a wineglassful three times a
day.  In conjunction with this, give from half a teaspoonful to two teaspoon- 
CRAMP.
365
fuls of a preparation composed of Russian  Castor two ounces, and Port Wine
two pints;  repeat the  dose  three or  four times a day*
                                     CRAMP.

   Cramp is a sudden, violent, and very painful  contraction  of a  muscle  or
muscles, which is more generally experienced in the lower extremities, being
symptomatic of debility or other disease.   It may also  attack  the muscles  of
the neck, and the stomach.   When  the stomach is attacked with cramps, it
is sometimes of a dangerous character;  there is a sudden, violent, and  most
painful spasmodic action of the muscular coat  of the stomach, with a sense of
constriction in that region.
   Causes.    The most usual causes are sudden exposures  to  cold, damp,_ or
night  air,  drinking  cold  liquids  during great heat  or perspiration, eating
crude and  indigestible food,  and debility of the nervous  and muscular sys-
tem, caused by masturbation, intemperance, excesses, idleness, &c.

_----------------------------.-------------------------------------     ■  ----------------------------#■------------------■------------------------------—
   *Mis.iH——, aged 19, was afflicted with St. Vitas Dance, of sixteen years  standing, during
which time, her friends informed me that she had consulted various physicians in this country
and Europe, had been bled, cupped, blistered, mercurialized, tested nitrate of silver, ammoniated
copper, &c, &c; cold shower-baths had been used until they caused convulsions, and music, 60
highly rccommonded by  some writers, was of no avail; in fact,  they informed me that the inva-
riable result of tho treatment which she had undergone was an aggravation of her symptoms, and
they wore almost fearful to subject her to any  new treatment.  I found her excessively debili-
tated, the mental energies somewhat impaired,  the thumbs and fingers incessantly in motion, the
head constantly shaking, and every two or three minutes the mouth would be rapidly and con-
vulsively drawn to the left side of the face, accompanied with an audible noise, somewhat resem-
bling that produced by sucking in the air.  When seated, her feet were  not in motion, but while
walking, they were involuntarily  thrown in all directions, yet not to  interfere with her walking.
In addition to this, she was laboring under chronic erysipelas, and had, beside,  an almost insur-
mountable repugnance to anything bearing the most distant relation to medicine, from the fact
of having taken such immense quantities of it,  at various times,  without the smallest iota of ben-
efit; and it required  much coaxing and argument to persuade her to try a new course of treatment.
  As the bowels were constipated, with acidity  of stomach, tho Compound Syrup of Khubarb and
Potassa, was given three times a  day, in doses sufficient to produce one, but not over two evacu-
ations daily, and this course was continued for  two weeks, and she was then placed upon the fol-
lowing treatment: — Take Alcoholic Extract of Black Cohosh one scruple, Alcoholic  Extract oJ
Scullcap two scruples, Alcoholic Extract of Nux Vomica one and a half grains; mix thoroughly
together, and  divide  into forty pills.  One of these to be given every two hours, or six pills daily.
The only change made in this prescription, was the gradual increase of the Extract of Nux Vom-
ica to four or  five grains to the above quantity, and then decreasing  again to the original quan-
tity, and so on alternately.  The  Compound Syrup of Rhubarb and Potassa was  administered
whenever  the bowels manifested a disposition to constipation, or  whenever, as shown  by the
white coat on  tho tongue, acidity  of stomach was present.   The only restriction in diet was the
avoidance of  fat and acids; the whole body  and limbs were bathed  once  every week with a
warm, weak alkaline  wash, and once in every two weeks, a Spirit vapor bath was used.  Dancing,
■umping, and  similar exercises in the open air was advised, and as  little attendance  as possible
at crowded assemblies.  Coffee and tea were prohibited, but in  their place a warm infusion of
Peaoh leaves and Scullcap, the use of which soon became agreeable to her.
  This course  was continued for about ten months, when all the involuntary motions ceased, with
the exception  of that of the thumbs, which proved exceedingly obstinate.  At this time, in addi-
tion to the above treatment, I ordered the following pill: — Take of  Red Oxide of  Iron twenty-
four grains, Iodine six grains, Sulphate of Quinia twelve grains, Extract of Liquorice a sufficient
quantity ;  mix  thoroughly, and  divide  into twelve pills.   Dose, one pill, to be repeated three
times daily, for three weeks, after which, one pill night and morning.
  Soon after the use  of this last pill, she commenced improving rapidly, her appetite became reg-
ular, as  well as  the bowels ;• her  strength  gradually returned, and the improvement in her mind
was very marked; and the erysipelatous  affection which appeared from time to time, did not
again manifest itself. She was thus treated for nearly two years, before being cured of her dis-
tressing affection ; yet I believe her recovery would ha»e been more rapid, were it not, that dur-
ing this tiino,  she was attacked with a painful affection of the  chest, which lasted for  several
weeks; afterwards with  inflammatory rheumatism, accompanied with severe pain in the head,
and occasional delirium, and in a  f ow months after this last, an obstinate attack of acute hepatitis.
Ihis case was  curod about fifteen years ago, since which time  she  has  remained  in excellent
boalth, and the cure is undoubtedly permanent. 
366
AMERICAN FAMILY PHYSICIAN.
   Treatment.  When the cramp is in the calf of the leg a ligature may be
placed around the limb above the affected muscles,  and apply friction to the
parts with the naked hand, or with some stimulating  or camphorated lini-
ment,  as the Compound Tincture  of Camphor.   Most persons overcome
cramp in the legs by drawing the top of the foot as closely as possible toward
the shin, and holding it thus until the spasm  passes off, and which occurs
usually in two or three seconds.
   When cramps occur in the muscles  of  the neck, the parts may be rubbed
with the  Compound  Tincture of Camphor.
   When the cramp is in the stomach it may be overcome by applying strong
friction over the region of the stomach, and continuing it for some time, rub-
bing over the part at the same time,  a  mixture of equal parts of Laudanum
Tincture of Camphor, Essence of Peppermint, and Oil of Amber, or  the
Compound Liniment of the Oil of Amber.   At the same time should be  ad-
ministered internally, either the  Compound Cajeput Mixture, Ammoniated
Tincture of Castor, Compound Tincture of  Lobelia and Capsicum, or Com-
pound Tincture  of High Cranberry  bark,  in their appropriate  doses.   In
some, cases relaxing doseg of the  Tincture of Gelseminum will be of service.
   Gastrodynia, commonly termed spasm or cramp of the stomach, frequently
occurs during pregnancy, attacking very suddenly.   It  may  frequently be
traced to some irregularity  of diet; though the action of cold will induce it,
as well as violent emotions  of the  mind.   It is more transient in its charac-
ter, but at the same time more severe and  painful than heartburn.  In thia
form there are violent neuralgic pains darting through from the sternum to
the back and shoulders, and not  as in heartburn, confined to the stomach;
there is great distention and flatulence, and the patient  is restless and anx-
ious.   It may be sufficiently severe to bring on premature labor, or cause the
death of  the fetus;  and, both from this cause as well as from the great sever-
ity of suffering, it requires much  more speedy and energetic treatment than
heartburn.   The bowels should be at once evacuated by a laxative injection;
and warm fomentations  of bitter herbs should be placed  over the region of
the stomach,  followed  by a Mustard  poultice.    Internally,  the  Compound
Powder of Ipecacuanha and Opium, may be administered as often as required;
and in some cases,  to lessen the spasm, the  Compound  Tincture of Lobelia
and Capsicum will  answer a better purpose.   If the  complaint is protracted,
and the attacks of frequent occurrence, a combination of Sulphate of Quinia
with Tincture of Gelseminum, will be found very advantageous.  The bow-
els should be kept  regular,  and the diet should be carefully regulated, being
careful to use no fatty, acidulous,  stimulating, or indigestible food.
   Cramps in the  limbs frequently  occur during pregnancy, more especially in
the latter weeks, and are at  times quite violent.   They  take place suddenly,
and can be relieved by friction of the affected part  and change of position,
i n order  to prevent their return the bowels should  be kept regular by mild
laxatives or injections, and the Compound Syrup of Partridgeberry be given
internally.   I have frequently found the following preparation useful in pre-
venting cramps:—Take of High Cranberry bark one ounce, Skunk  Cabbage
root, Scullcap, each,  half an ounce, Cardamom seeds,  Capsicum, each, two
drachms; digest  these articles,  bruised, in  one quart of Malaga or other wine
for three or four days.   A tablespoonful may be given daily repeating it every
two, three, or four hours.   After the cramps have been removed, should any
tenderness or soreness of the part remain,  some stimulating liniment may be
rubbf 4 on. 
LOCKED-JAW.
367
                   LOCKED-JAW,  or  TETANUS.
   Tetanus  is a disease or symptom of disease, which consists in a violent,
 extensive, and  permanent  contraction  of all or only some  of the muscles,
 without periods of relaxation, and attended with tension and rigidity of the
 parts affected,—the powers of sensation and intellect being uninjured.   It is
 a very alarming  affection.  When the  body is rigidly bent forward, it is
 termed "emprosthotonos;" when  the body is curved backward it  is termed
 "opisthotonos," and when to one side "pleurothotonos."   When limited to
 the muscles  of the jaws, it is called "trismus or locked-jaw."
   Symptoms.   Sometimes tetanus comes on suddenly, and with great vio-
 lence; but more generally it  occurs gradually,  differing greatly in various
 cases, both in the severity of its symptoms, and in  the manner of attack.
 Usually, the first symptom  is a slight sensation of stiffness in the back part
 of the neck,  which increases, rendering any motion of the head both difficult
 and painful, with an uneasy sensation at the root of the tongue, and difficulty
 in swallowing.  A great tightness about the chest, and a severe pain at the
 lower part of the breast-bone  shooting into the back,  is  also  present.   The
 Bpasms of the neck become more violent, the jaws gradually become stiff with
 the teeth closely set together;  spasms at the pit of the stomach and  of the
 muscles of the abdomen take place, the abdomen feels very hard, the body is
 siirvod in some direction, or remains rigidly erect,  with obstinate constipa-
 tion and excruciating pain, and finally convulsions and death.   Generally, in (
 this disease,  the eyes are rigid and  immovable in their sockets, the counte-
 nance is hideously distorted and manifests great distress, the pulse becomes
 irregular, the strength exhausted, and there is frequently a cold, clammy per-
 spiration.  Death may also be produced from suffocation,  or exhaustion.
 When it proves fatal it is generally from the fifth to the tenth day, and the
 younger the  patient, the more rapidly fatal is it;  sometimes one universal
 spasm terminates life.
   Causes.   The most common causes of tetanus are injuries,  as punctures,
 wounds, lacerations,  scratches, splinters, pieces of glass, or  nails, &c, which
 have been forced into some part of the body, dislocations, fractures, &c.  It
 may likewise be caused by irritating substances in the  stomach and bowels,
 worms, exposure to cold and moisture, and is more common in warm than in
 temperate climates, and in marshy than in dry, elevated locations.  Males of
 a sturdy and lusty constitution appear to be more subject to it, than females,
 or the we,ak of their own sex.
   Treatment.  Administer at once to the patient half a table-spoonful of
 the Compound Tincture of Lobelia and Capsicum, pouring it slowly in at the
 corner of the mouth, and repeating the dose every five  minutes until such a
 degree of relaxation is produced as  will enable the patient  to  swallow.   At
 the same time, uive an injection composed of half a fluidounce each, of water
 and the above Tincture, and repeat this every ten or twenty minutes.   This
 will  produce great relaxation  and prostration with nausea  and vomiting.
 Generally the first or second dose will cause a sufficient degree of  relaxation
 to enable the patient to swallow, when a large dose of the Compound Powder
 of Jalap should be at once administered.
  The part injured should  be at once  attended to, removing any foreign
 bodies that may be present, and if it be a wound  that has healed, it should
 be opened immediately by the application of Caustic Potassa.    Then to the
 injured part,  and if possible, along the whole course of the pain, apply a poul-
 tice made of  powdered Lobelia and Elm  bark, equal parts,  with-sufficient
weak, hot ley water.  This poultice should be frequently renewed, as long as
any pain or irritation continues. 
368
AMERICAN  FAMILY PHYSICIAN.
  The patient must be kept quiet for some days subsequently, and should an
anodyne be required, Lupulin, Lactucarin, Cypripedin, or Extract of Hyoscy-
amus may be given.
  When the tetanus continues for several days, in addition to  the  above
means, it will be advisable to apply along the whole course of the  spinal col-
umn, a fomentation of equal parts of Lobelia and Stramonium leaves, to which
considerable Tincture of Camphor has been added, and this should be fre-
quently renewed.   Likewise give internally, a mixture  of Tincture of Gel-
seminum one fluidounce,  Sulphate of Quinia  eight grains,  Scutellarin one
scruple.  Shake these together, and give in doses, repeated sufficiently often
to keep the patient under  the relaxing influence of the Gelseminum.
  The patient should be kept in a dark room, free from  noise or excitement,
he must not be disturbed  by speaking, and his strength must be sustained by
strong tea or broth  of meats, administering them by injection if he cannot
swallow.   The injured part if it be an ulcer, or puncture, &c, must have a
discharge kept up from it; and, in obstinate cases, means should be used to
keep up a moderate degree of perspiration.
                           HYDKOPHOBIA.

  Hydrophobia, Eabies,-or Canine Madness, arises from the bite of.a rabid,
animal, as a dog, cat, fox, &c.   The term, Hydrophobia, meaning  an aver-
sion to water, does not properly designate the disease, as the spasms or con-
vulsions are frequently induced by the sight of shining  or  polished bodies,
mirrors, &c.   All persons who may be bitten by a rabid animal, do not nec-
essarily have hydrophobia, perhaps not more than one  in ten, especially when
the bite is through clothing which may wipe the poisonous  saliva  from the
teeth.
  Symptoms.  The  first indication of the action of the virus is pain or unea-
siness in the bitten  part, which may have healed so  as to  leave scarcely a
vestige of the injury, and never more than a scar.   This first symptom may
occur at an indefinite period, from a day  even to two or  three months.  A
burning or itching sensation is sometimes complained of, and occasionally red
pimples have appeared immediately over the marks of the animal's teeth.  In
a short time, sharp, lancinating pains are felt in the bitten limb which gradu
ally extend' throughout  the  body, and are more particularly experienced in
the region of the stomach, with dulness or dejection of spirits, heaviness of
the head, restless nights, disturbed and frightful dreams, .thirst, loss of appe-
tite, and an indescribable expression of alarm and anxiety in the countenance,
With these,  and  sometimes  directly succeeding,  the patient experiences a
sense of coldness, with pale face, frequent yawnings and stretchings,. twiteh-
ings of the muscles,  acute pains in the bones  and muscles, considerable tre-
mors, and a disinclination to exercise.  As the case progresses, the stomach
becomes sour, with acute pain and burning in its region, thirst, perversion of
taste, nausea, and vomiting of a glutinous, brown or greenish substance.  The
pulse is quick and  irregular,  the skin cold,  but the temperature unequal,
breathing is difficult, with a sense of stricture about the throat, causing pain
and difficulty in swallowing fluids.
  As the disease advances, the  symptoms increase  and new ones are added.
Sleep is short and disturbed by frightful dreams, light is painful to the eyes,
and the sight of liquids,  or of any polished surface,  or a flash of light,  or the
least noise, or a sensation of chilliness by being exposed to a draught of air,
may excite an attack of the most  horrible convulsions.   It is impossible to 
HYDROPHOBIA.
369
contemplate the situation of a patient at this stage without emotions of horror
and regret.   To all we  have  said is added an  aspect ghastly and full of
despair.   The muscles of the face  are distorted, the eyes fierce,  "dismally
wild, red, and inflamed,"  with the pupil much dilated, gaping of the mouth,
lolling of the tongue, which is dry or rough,  with a collection of froth about
the mouth, attended by great  heat, and thirst  which cannot be allayed, for
the very sight of water excites violent spasms and often madness, and in this
frenzied moment endeavors are seemingly made to spit the frothy saliva upon
the attendants.   The spasms  and convulsions recur constantly, and  from
stricture of the glottis a peculiar noise is heard somewhat resembling the
barking of a dog.    There is  no tendency to bite, as is generally supposed,
from the spasms of the muscles of the jaws causing  a kind of chattering of
the teeth.    The scene closes with a weak and thready pulse, cold extremi-
ties, clammy  sweats, deep sighing, vomiting,  hiccough,  difficult breathing,
and finally a fatal and awful convulsion.  Sometimes the disease proves fatal
in twenty-four hours; at others not for several days.
   Causes.   The cause of rabies is unknown; in the human family it is the
result of the  bite of some rabid animal.
   The moment a dog evinces any traces of illness it is no longer to be trusted;
and it would be well to lock it up, or fasten it to a stout chain.   But when
it begins to gnaw wood, to show a dull eye, to snap at animals with which it
had become familiarized, and to bark hoarsely; when it attempts to run away
or to  break its chain ; eats and drinks with a snapping gesture; appears lively
at intervals, and then again sneaks sulkily to its kennel;  when it disregards
its master's call, and contrary to its former habits, growls and snarls at well-
known persons, the animal ought to be killed, for there can no longer remain
a doubt of its being rabid.  In rabies in the dog, as well as in the lower ani-
mals,  there is no dread of water, as is generally supposed; on the contrary,
the animal flies to it with eagerness, but is unable to swallow it, and all other
rabid  quadrupeds, with perhaps an  occasional exception of the horse, are said
to drink with ease and increased avidity.
   Treatment.  The most effectual way to prevent  this disease, is to imme
diately cut out the bitten parts, carrying the knife into sufficient of the sur-
rounding flesh, that none of the virus will come in contact with it; and the
sooner this is done the better.  If a few hours or days have elapsed after the
bite, before the excision be effected, a discharge should be kept up from the
cut surface by applying Caustic Potassa to it.   When the wounded part is so
situated that  excision will be dangerous or difficult,  a strong Caustic solution
of Ammonia  should be applied, and a discharge maintained.
   When the  symptoms of hydrophobia come on, many measures have  been
recommended, but *hcy  have  generally  been  found unavailable.  Prom  a
series of experiments instituted by myself several years since, I was  led to
firmly believe that the disease is owing entirely to the absorption of a poison-
ous acid into  the system,  and that a stimulating, diffusible alkaline prepara-
tion, might, by neutralizing this acid, overcome the  disease.   I,  therefore,
having the opportunity, used the treatment I am about to  mention,  on six
persons, two in the commencement of the  second  stage, and four in the  first,
and with success.   In these cases, the wounds had healed, and  presented  a
scar of a dark purplish appearance.   The  persons were bitten by dogs known
to be  mad, and had  the symptoms peculiar to the disease.
   When ihe  symptoms  of hydrophobia  begin to  manifest  themselves, or
during any stage of the  disease, the following  is the course I invariably
pursued :   Take of the  strongest Aqua  Ammonia  one teaspoonful, finely
powdered  Scullcap  leaves one teaspoonful;  put into a tin cup,  to which 
370
AMERICAN  FAMILY  PHYSICIAN.
add half a gill of cold water,  Then holding the patient's nose, to  prevent
the ammoniacal vapor from being inspired therein,  cause him to make as
full  an  exhalation  as  possible,  and immediately drink the mixture well
stirred together, while inspiring ; if this cannot be done at once, the opera-
tion must be repeated until the  whole  is taken.  If from spasms the
patient is unable to swallow, then blindfold the eyes, and use all the persua-
sion that can be employed,  to induce him  to force it down.  Perhaps a
stomach  tube might be  employed,  covering  that part  which comes in
contact with the teeth with cork,  or other soft wood;  I have always suc-
ceeded without  it.   If the attack is severe, it may be  necessary to fasten
the legs  and arms of the patient to  prevent him from injuring others.
Bandaging the eyes will be found  to have a soothing effect, particularly if
cotton or some soft substance is  placed  over them so that the patient can
certainly see no light.  It has been suggested to me, that when the patient
is unable to swallow this alkaline  preparation, in addition to blindfold-
ing, the Compound Tincture of Lobelia and Capsicum be given in teaspoon.
ful  doses every few minutes, (by  pouring it into the corners  of his  mouth,)
until the Ammonia can be taken.  Of this, I  know  nothing from experi-
ence, although it may prove useful.
  Care must be taken  to  procure  good  Ammonia ; the ordinary  Ammo-
nia  of the shops  will  not do.   That used by me was prepared  by Dr.
Chilton of New York city, put up  in  French  glass-stoppered vials of two
ounces each, and  covered with bladder.   I prefer this size, as in larger
vials, the Ammonia loses  considerable  strength while  using it  from them.
The Scullcap was used only on account of its reputed efficacy.
  The dose above  named, must be repeated every half-hour,  and continued
for two hours ;  and in the severe cases, I repeated it every fifteen minutes.
[n an hour and a  half,  or two hours after commencing its use, the more
severe and  distressing  symptoms  will generally disappear, the face and
whole body will present a more  or less fiery  red  appearance,  and a heat
nearly amounting  to a sensation  of burning  will be experienced.   The
alkali has now diffused itself throughout the  system; but  as I view the
matter, it must, at this crisis, be  forced as it were, to pass even further, to
the surface of the  body.  To accomplish this, and considering that a great
affinity exists between an  acid and  an alkali, an  acidulous vapor bath must
be employed.  For  this purpose the following acetous vapor bath  must
have been prepared to  use at the  expiration of the two  hours:   Take of
Stramonium leaves,  Cicuta leaves,  Hops, Scullcap, of  each,  half a pound,
Vinegar four or five  gallons; boil  all  together for  ten or fifteen  minutes,
Likewise have several large stones well heated.
   Half an hour after the last dose, undress the patient, place him on an
open bottom chair, and envelop him with blankets,  leaving however, an
opportunity for him to inhale fresh atmospheric air now and then during
the bath.  Then place the above  acetous decoction under him, and keep him
there until he perspires freely and copiously.   As  the vapor lessens, the
gradual  addition of  the hot stones will increase it again.  Although I used
the  above  herbs with the vinegar, I believe  that  vinegar alone  will be
sufficient.
   After this vapor bath, which must always be carried  to a powerful extent,
the  patient must be  well  dried, and another  dose  of the  Ammonia and
Scullcap given, repeating  it every three hours for fourteen days in succes-
sion ; at least I carried the treatment thus far.
   On the first night of treatment,  a full dose of the Compound Powder of
Jalap must be  given,  which should  be repeated every other night f<tf 
MANIA.
371
six nights, and then every third night.   The  acetous vapor bath must be
repeated  on the second, fourth,  eighth, and  twelfth days  of treatment.
AmonK my patients, this  active course,  especially during the first and sec-
ond days, reduced their flesh most astonishingly.  An infusion of Scullcap
should be drank freely every day, and  the diet must  be light  but  nutri-
tious and easy of digestion, avoiding all  acids, greasy or fat food, milk and
liquors   The following is reputed successful,  and may be used instead ot
the Scullcap :  Take four or five ounces of Bed Chickweed, boil  it in two
quarts of Ale, or Hop Beer, until*it is  evaporated to one-half; press out
and strain  the  liquid, and add to it two fluidrachms of Laudanum,   lhe
dose is half a gill  every morning, or oftener  if the symptoms  are  mani-
fest; and in severe cases, the whole may be taken in one day.
  From the commencement of the treatment, the part must be kept con-
stantly discharging by the  application  of Sesquicarbonate of  Potassa, and
Elm poultices.
  In  case the person is very much convulsed in the first part of thetreat-
ment, the best course  will be to apply the acetous vapor bath  immediately,
and administer the Ammonia as  soon  as it can be swallowed; in  other
respects  pursue the same course as above.
                     MANIA,  or  INSANITY.

  By Insanity or Mania, is meant a derangement of the intellect,  with
erroneous judgment, or hallucinations, producing various influences  upon
the actions of the patient, according to  the  peculiarity  of the  insanity.
Authors have variously arranged the several forms of  mental  derangement
into Insanity, Mania, Monomania, Dementia, Idiotcy,  &c, but as I cannot,
consistently with  the plan of this  work, enter into a  description of their
hypotheses, classifications, and definitions concerning these several varieties,
I shall merely confine myself to some of  the  more ordinary symptoms of
insanity,  as usually understood by the extra-professional  reader, referring
those who desire more minute information on the subject to the several val-
uable works which have gone into a more extensive investigation of it.
  Symptoms.  The symptoms of insanity are so various and diversified,
that it would be  impossible to give any perfect description of them;  a
statement of some of the most distinguishable  symptoms is all that can be
expected in a work like the present.
  The most  common  form of insanity  is termed  intermitting,  in  conse-
quence of its occurring in paroxysms, the patient  being sane  in the inter-
vals ;  it may come on at  any period of life, but more commonly between
the ages of twenty-five and forty-five.  Sometimes it is permanent, contin-
uing steadily  without  lucid  intervals, until a cure is  effected, or until the
patient dies.   Insanity may come on gradually, or it may  attack suddenly,
the latter is  most  commonly the case;  the  former being principally met
with among those with whom the malady is hereditary, and in whom some
eccentricities  or peculiarities may be observed  for sometime before insanity
is suspected  by the friends  of the patient.   Two  kinds  of insanity have
been described by writers, the melancholic and the furious; and these have
been again subdivided into several  varieties, which subdivisions, however,
I shall not enter into.
  There  are no two patients in whom the symptoms  exhibit pretisely the
same appearances, for the cause of the attack, together with the habits and
propensities   of each  patient,  develop   ideas, expressions,  and actions 
372                 AMERICAN FAMILY  PHYSICIAN.
peculiar  only to  his  individual case.  Very frequently, whatever may be
the form of the insanity, it is preceded by certain symptoms, as  a want of
appetite, constipation, a sense of tightness at the region of the stomach
and of heat in  the  bowels;  an indescribable  uneasiness  is experienced
Bometimes  amounting to fear or actual  terror, and there is more or less
wakefulness.  As the malady  progresses,  it manifests itself more plainly by
extraordinary actions,  more  or less  absurd conversation  and  ideas,  and
peculiar  expressions and movements of the features.  If the insanity be of
the melancholy form, it  will  be  accompenied  with sadness, dejection of
spirits,  love of  solitude, indisposition to exercise, and unwillingness to
talk,—or the patient may walk in a great hurry, exhibiting strange ges-
tures, and betray much inconsistency and absurdity of ideas in his remarks.
Some express  their  misfortune by  tears,  others  are  remarkably good-
humored, as manifested by paroxysms of loud and excessive laughter;  one
holds his head upward to the  heavens, another looks toward the ground as
if in profound meditation ; while others will be  met with, who maintain a
perpetual silence.  This class of patients are usually timid, prone to anger
very changeable  in their  temper,  with pale countenance, slow,  and some
times weak  and small pulse, flatulent bowels, great watchfulness andconsti
pation.   They are very apt to commit suicide.
   On the other hand,  the furious form of insanity  is attended with violent
headache, flushed face, unpleasant  sounds  in the ears, violent and  furious
conduct, grinding of the teeth, staring and rolling of the eyes, great muscu-
lar exertions, attempts to injure persons who are near them, absurd, inconsis-
tent, or obscene remarks, a display of maliciousness toward certain individ-
uals, more  especially friends and  relations, an  aversion to former  habita-
tions and sights, and the  sensation so  much impaired as to  enable them to
resist the effects  of cold,  hunger, and want of sleep,  and endure an exces-
sive degree of cold.   Their  muscular strength is  astonishingly increased,
so as to require several men to restrain them from committing violence.
   When a person is irrational on only one particular subject, being sane on
all others,  it  is termed  monomania.  When the  perceptive powers,  the
memory, the  faculty of forming ideas, &c,  are  all impaired or lost, with
loss of judgment and reasoning  powers,  it is termed  dementia, in which
there is  generally considerable variation in the  temper, being at one time
very kind and amiable,  and at the next moment  very  violent, malicious,
and quarrelsome.   Dementia is commonly incurable,  and is apt to follow
other disorders of the mind or brain,  delirium tremens, apoplexy, neuralgia,
epilepsy, &c.
   Causes.   The cause of insanity is not understood; all that we know is,
that when the brain is subjected to the  influence  of certain emotions, or
sensations, the principle which gives the capability of framing compatible,
harmonious, and rational ideas and actions, becomes  more or less perma-
nently deranged ; what part of the brain or nervous system is  principally
interested,  is still a problem.   But as there is a very intimate  association
between the mind and body, it is highly probable  that the deranged intel-
lect is always more  or less complicated with some  unhealthy condition ot
the brain or other organs.
   The exciting causes of insanity are various; injuries may give rise to\\
as blows upon the head, blows upon  the spinal column, &c; it may  also
 originate from intemperance,  suppressed discharges or eruptions, the use
 of mercury,  the occurrence  of febrile or inflammatory diseases, apoplexy]
 paralysis,  chorea, violent mental emotions, as grief, love, jealousy, auger.
joy, disappointment, misfortune, religious excitement, and profound study 
MANIA.
373
  Profuse evacuations by cathartics,  diaphoretics,  bleedings, &c,  may occa-
  sion it.   Sexual excesses are a frequent cause,  and a very prevalent prac-
  tice  among young  men  and women, masturbation, is another  cause, too
  little suspected.  Dyspepsia, derangements of the liver, or of other organs
  are  not  unfrequently  connected with  insanity.  In  many cases the ten-
  dency to insanity appears to be  inherited from one or both of the parents,
  and persons should be exceedingly careful how they intermarry with those
  who are the descendants or offspring of insane or very eccentric individu-
  als.  " When, as it sometimes happens, an hereditary disposition or bias to
  this disease appears to sleep through one generation, it will often be found
  to awaken  in the next with even aggravated horrors.   Should the child of
  a maniac escape his parent's malady,  the chance is small  that the  grand-
  child will be equally fortunate."   Marrying with blood relations,  as  first or
  second cousins, &c, disposes the offspring to idiotcy or insanity.
    Prognosis.  AYhen insanity  is a consequence  of  some other  disorder,
  attacking slightly, and with long intervals between  the paroxysm, a  radical
  cure may be effected; the same may be said of those cases which are  recent,
  occurring in young persons, with lengthy lucid intervals.   The unfavorable
  cases are, when it occurs among aged persons, when it is hereditary, when.it
  follows apoplexy, epilepsy, or palsy, when it is permanent without any lucid
  intervals, and when the mind has been  disorganized by  intoxication,  de-
  bauchery,  or the corroding operation  of any chronic passion, as  love, jeal-
  ousy, kc.   Furious  insanity is oftener recovered from than  the melancholic
  kind.
   Treatment.   As a general rule, insane patients should  never be treated
 at home,  but should at once  be removed to one^of those institutions espe-
 cially prepared for them, and in which all the necessary arrangements  are in
 readiness, as proper  rooms, experienced  physicians,  nurses,  &c.  Recoveries
 are found to occur much oftener in well-regulated  institutions of this  kind,
 than in the  homes of the patients.
   The first  andniost important thing to be done in the  treatment  of  insane
 persons is to gain their confidence and  consequent  respect  and obedience,
 and this can only be effected by kindness toward  them, and a strict regard
 Tor truth  in everything  relating  to them.  That method which  authorizes
 Acts of deception, indignity, and cruelty is improper, and should not be pur-
 sued under  any  consideration whatever.   A harsh, tyrannical course of con-
 duct toward lunatics is  reprehensible, and serves to retard their  recovery.
 And even in those cases where coercion  becomes absolutely necessary, harsh-
 ness and severity are unnecessary;  but  inflexibility of character, with firm-
 ness, veracity, and kindness should be invariably observed, and will be found
 much more  effective.   It  is always better never to contradict an insane
 patient, however absurd his opinions or assertions may be;  but when they
 are recovering, their iiicoherencies may be opposed by reasoning, contradic-
 tion, and even ridicule.
  The following tale will  convey a faint idea of the mode of governing a
 lunatic under certain circumstances:  It is stated that  one of the attending
 physicians of the New York Hospital having gone  up to the cupola of that
 budding, was, unknown to him, followed by an insane man, who, upon reach-
 ing the top of the building, seized the physician by the arm roughly, saying,
 "Now let's immortalize ourselves by jumping off,"  and endeavored to force
 him into the measure.  The physician, however, looking calmly and undis-
 mayed at the lunatic, answered, "My friend, I'll  tell you a better method
 than that for immortalizing ourselves."   "What is that?" responded the un-
fortunate.  "Let us both go down to the ground, and jump up here, for that 
374
AMERICAN  FAMILY PHYSICIAN.
is a feat nobody has ever yet performed."   "Agreed,"  said the patient; and
the physician taking his arm, immediately hastened down with him, and had
him secured.  In this case  the  least indecision, the least opposition might
have cost the physician his  life.
  When coercion is actually necessary,  it being  requisite to  protect by-
standers  as well as the patient himself from injury, the straight-jacket is the
safest and best resource, being much preferable to the painful and even
injurious plan of permitting the patient to struggle with his keepers.  Al-
though a recourse to the straight-jacket may be very repugnant  to the views
and feelings of friends and relatives, it  is the  most merciful and  kindest
course that can be pursued, as it occasions no  pain, and  is very apt to calm
the patient as soon as he finds that  his  struggles are useless.  In some in-
stances the application of the cold douche to the head and spinal column of
the patient when he exhibits a spirit of unruliness, conjoined with kind and
pleasant  measures when he  is obedient, has effected the most happy results.
Sometimes a mere reference to the straight-jacket, or the cold douche, in the
hearing of the patient, has  at once quieted the most furious lunatic.
  Insane persons  should be kept constantly occupied when their condition
will permit; reading, writing, gardening, mechanical operations, walking^ or
riding out, music, sewing, knitting,  drawing, &c, and in selecting the kind
of employment the patient should be indulged in that  which he prefers, if
it  is  not calculated to produce any allusions to the cause of the  disease,
The most agreeable  exercise,  calling into play  the greatest bodily action,
with the  least fatigue, will generally be found the best.  Lunatics should not
be  too soon removed to their homes by friends or relations, because they
frequently display much cunning, deceiving the inexperienced by conducting
themselves with great propriety, but becoming  furious  and ungovernable
upon  reaching their homes.
   The diet of maniacs should be  light,  nourishing, and easy of digestion,
and in proportion to  their strength, and the amount of  exercise they  take;
in cold weather care should be taken that their  rooms are  warm, for if ex-
posed to a great degree of cold, ulceration and mortification of portions of
the limbs may take place.   Great care should be  taken  that all instruments
which may be  dangerously used are  kept out of their  way, and their win-
dows  and doors should be properly secured, that they cannot escape or injure
themselves.  They should be kept apart from each other as much as possible,
lest one  contract an additional degree of insanity from  another; this, how-
ever,  may not be necessary in the milder cases.   The above may be said^ to
comprise the general principles of treatment for the insane, without entering
into details, for which the reader is  referred to works  especially devoted to
this subject.   Confirmed maniacs need no medical measures further than to
obviate costiveness,  and occasionally administer a warm bath.
   An English author makes the following remarks in relation to this matter:
"In the management of the insane, the great objects to be  aimed at are, in
the first place, that the invalids be separately  and properly classed,  both in
respect to their ages, sexes, condition in life, and kind or degree of their dis-
order.   Those who are violent, noisy, and dirty, should not be placed in the
same room with those who  are quiet and orderly, or in a state  of convales-
cence.   Secondly, free  ventilation,  so  insured  as to  guard against undue
exposure to the  inclemencies of  the  weather.   Thirdly, a rigid system of
cleanliness.   Fourthly,  such a  judicious regulation both of  mental and
bodily exercise as shall excite  without- fatigue, and exhilarate without ex-
haustion ;  and  lastly, a combination of tenderness, lenity,  and conciliation,
 with  proper firmness, at the same time, on the part of  the keepers. 
MANIA.
375
   "It should always be the object of the superintendent to gain the confi-
dence of the patient, and to awake in  him proper  respect and obedience, ^
which is to be effected by  discipline  of temper and dignity of manners. *
Tyrannical  severity  may  excite fear in the  lunatic, but it will be mingled
probably with contempt.  In the management of insane  persons the  super-
intendent must endeavor to obtain a moral  ascendency over them.   When
this is once effected, he will  be enabled on all future occasions to direct and
regulate their conduct according as his judgment may suggest.
   "Prudent management will generally restrain fury, and sometimes restoro
rationality very speedily.  The patient  must always  be  treated with  lenity
and kindness, and with the manners due to his station in life; for it is ob-
vious that a system of rigid order and  discipline, combined with lenity and
conciliation, is the only  rational and successful method of combating the
extravagances of lunatics.
   " To  obtain a salutary influence over the wanderings of a maniac, we ought
first to  secure his confidence.  This cannot be done without behaving toward
him with a delicacy  due to  his unfortunate state, which, for the most part,
ought to be regarded,  not as an abolition, but as a suppression merely  of the
rational faculties.  There is, indeed, ground to  apprehend that fugitive folly
has been  too  often  converted into a fixed and settled frenzy;  a transient
guest into an irremovable tenant of the mind; an occasional aberration of in-
tellect  into a confirmed and  inveterate habit of dereliction, by a premature
and too precipitate adoption of measures and methods of management, which
arc  only  necessary  in cases of extreme  desperation.   Experience has now
abundantly proved that the best effects have resulted from a system, the pre-
vailing feature of which is kindness, combined with certain  degrees  of in-
dulgence.        *       *       '^       *      *       *      *
   Insane persons should be made to rise early,  to take such exercise as their
condition  will  admit  of,  and have their food  served up to them at stated
times. Independently of such regularity contributing to health, it also renders
them more manageable.  In all cases of madness it will be proper to remove
the patient from those objects with which he was  formerly acquainted, as
these might call up ideas and the various associations; and on this account
a change of situation and removal from his friends will be advisable; for it
is a fact well known to those who superintend lunatics, that patients seldom,
if ever, recover at home.  It not unfrequently happens, indeed, that maniacs
who have  been brought immediately from their  families, and who are said to
be in a violent  and  ferocious state  at home, become suddenly calm and
tractable when placed in a lunatic asylum.  On the bther hand, it is equally
a  fact, that there are  many  patients  whose disorder speedily recurs after
having  been suffered to return to their families, although they have for a
length  of time conducted themselves, under confinement, in a very orderly
manner.  The  restraint,  cunning,  and dissimulation, which many insaDe
persons are  capable of, are well known to those  who are much  with  them;
but the ignorant are apt to  cry out against excluding them  from society,
because they probably  happen to  conduct themselves with propriety  before
strangers,  and in  short conversations appear coherent and rational."
   As regards medicinal means, the bowels should be kept regular, with occa-
sional cathartics, for which purpose the Compound Powder  or Pills  of Lep-
tandrin may be used, bearing in mind  that the action  of medicine is fre-
quently so  strongly resisted by the system, that larger doses than usual will
be required, and even these will have to be perseveringly used for a consid-
erable length of time;  the skin should  be kept in a healthy condition by
frequent bathings.   When there is much determination to the head the cold 
376
AMERICAN FAMILY PHYSICIAN.
 douche, with Mustard to the feet and between the shoulders, may be advanta-
 geously used, and in severe cases the Compound Tar plaster may be placed
 over the nape of the neck, and kept discharging for some time.  For wake-
 fulness, Extract of Hyoscyamus, Laetucarin, or Opium, may be administered
 in appropriate doses.   And infusions of Valerian,  Scullcap, Skunk Cabbage
 &c, may be used as substitutes for Tea and Coffee;  in those of anemic habits
 some  preparation  of iron must  be  used.  And in all cases, when it can be
 done, it will be better to medicate the food and  drink of the patient  rather
 than to administer medicines  as such.  When the condition of the'patient
 will permit, vegetable tonics should be administered.   Perhaps the  relaxing
 influence of Gelseminum might be found useful  in some of the furious forms
 of insanity.   When  insanity  occurs in consequence of great  debility and
 exhaustion, as sometimes happens at the close  of typhus fever, great care
 should be taken to avoid further debility by  evacuating agents; a nutritive
 and restorative course should be pursued, with  vegetable "tonic bitters  and
 preparations of iron.  Insanity from masturbation, is; generally, of very dif-
 ficult cure, though it should be  attempted  by a strengthening  course  and
 means to prevent the patient from continuing the vice.
   Melancholy,  or Melancholia, is a variety  of insanity,  in which  the
 patient is fearful and low-spirited, shunning  society,  and courting solitude.
 The face is pale, the urine scant and pale, and the bowels costive and flatu-
 lent.   The patient is peevish, whimsical, and  curious, constantly brooding
 over some misfortune, considering all mankind as  enemies, and themselves
 as  guilty of some great crime  against  Heaven or man; tears, deep sighs,
 painful breathings, and constant indolence are common, and one very usual
 propensity is, to  commit suicide.  The appetite is variable, and  food is fre-
 quently  refused  from a  wish to die, the pulse is very feeble, the voice low,
 and very expressive  of mental  despondency, sleep  imperfect,  and  often a
 very fetid broi'b.
   This form of  insanity may be caused by disappointment in love or other
 matters, gloomy and extravagant ideas concerning religion and a future state,
 belief in spiritual rappings,  immoderate venery, masturbation,  suppression
 of habitual evacuations, intoxication, injuries of the head, &c.
   The treatment must be mental as well as physical.  The patient should
 be made to exercise, to associate and  converse with  cheerful friends, to visit
 places of amusement, to travel if  possible, and to have his mind constantly
 occupied with some agreeable employment, being never left alone, and never
 opposed or contradicted directly, although he may be  reasoned with, or have
 some of his ideas presented in  a manner to appear ridiculous even to himself.
 His bowels should be kept regular, his body frequently bathed, with friction
in drying, and in some  cases  the cold  shower-bath  will prove beneficial;
tonics should be  given  daily, as  the  Compound Wine  of Comfrey, for  in-
stance, and  his diet should be light, but nutritious and easy of digestion,
avoiding fats and acids.   His hours of sleep should be regulated, his bed
should not be too soft,  he should not be  allowed to sleep  alone, and  he
should be made to exercise daily in  the open air, either walking, riding,
sailing, fishing, playing  ball, billiards, &e.
                       DELIRIUM  TREMENS.
  Delirium Tremens is a disease to which persons addicted to the intem-
perate use of intoxicating drinks are very subject.   It is a dangerous disfise,
frequently destroying the patient,  or causing a state of dementia. 
DELIRIUM   TREMENS.
377
   Symptoms.  Delirium tremens most usually commences with some decree
 of nausea, vomiting, and loss of appetite, especially for breakfast, which are
 soon followed by constant wakefulness,  incessant  talking,  walking  about
 restlessly, and sometimes raving from the first.  There  is a  constant  trem-
 bling and unsteadiness of the limbs, the hand is  unsteady,  the  tongue is
 tremulous when protruded, the gait is staggering, the skin is cool, and the
 pulse weak  and rapid.  As the disease  progresses the  symptoms  become
 worse, the patient is not silent for a moment, he is constantly talking, scold-
 ing, or laughing; changing from one thing to another rapidly, arranging his
 clothes, room, bed, &c, with more or less agitation and  mental  suffering.
 He conceives the presence of things which he is aware are  illusions,  or they
 may appear so real as for a time to make him actually believe that they truly
 exist; but most generally this deranged perception may be explained  away
 for the moment by some kind friend.  Among  these imaginary objects are
 rats, mice, serpents, fiends, witches, guns, dragons, bugs, insects, &c, &c, to
 free himself from which he will have  the most fearful struggles,  with expres-
 sions of disgust, distress, and even fear and horror.   It is impossible to  name
 the various fancies which he creates, at one time laughing, at  another,  beg-
 ging with tears in his eyes for life,  then humbly asking pardon for  some
 imaginary wrong, again, pointing with various expressions  to the  objects
 conjured  up in his disordered mind, and finally, raving almost like a maniac.
 His eyes  are bloodshot, and in constant motion, with a peculiar glare, glanc-
 ing fearfully and suspiciously at every object around him; the countenance
 is usually pale, haggard, and distressed, the tongue coated with a thick, yel-
 lowish mucus, the head hot, and the bowels costive,  with,  occasionally, nau-
 sea and vomiting.   If the patient be  not relieved, he becomes worn  out,  is
 compelled to lie down from sheer debility, and may die  suddenly in an apo-
 plectic or  epileptic condition, or, he may gradually sink, the surface becom-
 ing cold, with clammy sweats, low, muttering delirium, stupor,  picking at the
 bedclothes, twitching of the tendons, and death.   I have witnessed cases in
 which the first symptom was an epileptic convulsion, or apoplexy,  on a re-
 covery from which, well-inarked delirium tremens occurred.
   Causes.  The exciting cause of this disease is more commonly a sudden
 abstinence from intoxicating drinks among those who have been habituated
 to their use, whereby the functions of the brain become excessively weakened
 and impaired.  It likewise frequently happens while the person is  in his
 career of dissipation; and, occasionally, it occurs after a long-continued but
 moderate  use  of alcoholic drinks.   It usually comes on in from  one  to five
 days after the discontinuance of the inordinate alcoholic  excitement.
 _  Treatment.  In the treatment of a patient with delirium tremens, oppo-
 sition and the use of force should be avoided as  much as  possible,  because
 they give rise to irritation and increase the difficulty.  Gentle and persuasive
 means are the  best, with a  degree of firmness;  and at no time must the
 practitioner yield to the fancies of  the  patient, but rather  reason  or laugh
 him out of them, and this course will accomplish much more in gaining con-
 trol and confidence, than an opposite  one.   Many writers  have  objected to
 the use  of stimulants in  this affection,  but upon what grounds I must confess
 myself at a loss to determine : and I have witnessed more deaths in the non-
 Btimulating course, than in the opposite.  I have treated some  hundreds o.
 cases of delirium tremens,  and  invariably with  success by the medication
about to be described.  Take  of Sulphate of Quinia  eight grains,  Sulphate
of Morphia one grain;  mix,  and divide intc *<mr powders.   One of these
powders should be given every hour, and in sok. "Hses I  have given them
every half-hour for the first  two or  three doses.   "%en  the use of these 
378
AMERICAN  FAMILY PHYSICIAN.
 powders has  to  be continued for some time, the intervals must  be  lentrth
 ened, that too much morphia be not thrown into the patient's system •  in
 most cases, sleep will follow the second dose.   Shortly  after the first dose
 give the patient a table-spoonful of  good brandy,  made into a  sling  with
 water and  sugar, as a reward  if he will  lie quietly in  bed and  try to sleep
 He will promise  this, but will soon forget his promise, when he must be re-
 minded of it,  and thus kept in bed as long as possible, until he no longer
 cares for keeping his word, when another dose of the brandy may be given
 as a still further  stimulus to induce him to lie still, and this course must be
 pursued until he falls asleep,  when he should not be disturbed.   The room
 must be kept  perfectly quiet  not only while  the  patient is awake,  but espe-
 cially during  his sleep, and it should also be  kept darkened, so  as to favor
 sleep as much as possible.   The great object is to procure sleep,  after which
 the danger is  over.   He may  sleep for six, eight, or ten hours, and will gen-
 erally awake with his mind recovered, and desiring some nourishment. Some
 light, nutritious diet may now be given him,  and in  an hour or two after-
 ward, a mild cathartic should  be administered,  as Rhubarb and  Magnesia
 Podophyllin and  Leptandrin,  &c.   And should symptoms of any disease be
 manifested, these must be treated  according  to their indications.
  It has been recommended by some authors to apply cold water to the head
 and Mustard to the feet, but I have never found any benefit from them, and'
 in most cases,  an  attempt to use them will arouse a spirit of  decided opposi
 tion on the part of the patient, tending to increase his disease.
  The treatment  after the action of the cathartic, for the purpose of strength-
ening the stomach and system,  should  consist of infusions  of bitter tonics
as Quassia, Gentian, Golden Seal, Hops, Colombo, &c, especially the Quassia;
should the  patient be anemic,  some preparation of iron will prove advanta-
geous as an additional measure.
HYPOCHONDRIA.
  Hypochondria is a species of mental alienation, owing to debility of the
brain and nervous system, which is observed in some persons who, although
of sound judgment in other respects, reason erroneously on matters concern-
ing their own health.  The disease is known by several  other names, as, low
spirits, the vapors, spleeny, hypo, &c.
  Symptoms.  There  is  an inactivity,  an irresolution in attempting any
project, the spirits are  low and dejected, with more or less despondency, and
an infinite diversity of gloomy ideas.   The patient imagines that he is labor-
ing under one or more diseases;  he looks upon the most trifling symptom ae
of the greatest importance;  he fancies that some living animal is within him;
he fears tuat he will become very poor and needy; imagines that he has not
a friend living;  or, that he  must soon  die.  Every little pain or unpleasant
feeling is exaggerated; there is  a constant apprehension of evil,  or some
anticipated dangers; a whimsical repugnance to certain persons, locations,
&c;—the disposition is  fretful   and wayward,  with  peevishness and great
fickleness;  quarreling  with friends; discontented with  almost everything;
often tempted to commit suicide; and  a host of strange,  fanciful, and absurd
notions too numerous to  mention.  Each  patient has his  peculiar  state of
feeling and ideas, seldom  any two being exactly alike; and they are  usually
highly offended when any person attempts to prove to them the inconsistency
or groundlessness of their fancies.  The appetite  is  impaired, irregular, or
entirely lost, the bowels  are constipated,  flatulency, and eructations of an 
HYPOCHONDRIA.
379
 acid fluid  are common;  the urine is usually copious and pale, there is swim-
 ming of the head, impaired vision, spasmodic pains in one  or more parts of
 the system, palpitation of the heart, wakefulness, indifference to surrounding
 circumstances, and  a feeling of indolence rendering the  person unfit for any
 mental or physical exertion.
   Hypochondriacal and nervous people, and those who read and write much
 without proper physical exercise, are apt to be troubled with what are termed
 muscuo volitantes, (little black specks floating before the eyes, or remaining
 in one position,) these, though harmless,  often excite alarm and apprehen-
 sion on the part of such persons, who mistake them for cataract or amaurosis.
 But whenever the  appearance of these specks is unaccompanied with the
 Bensation of a mist Avhich more or less obscures  the appearance of objects,
 we may safely conclude that it is not a symptom of cataract; and whenever
 this appearance is not accompanied with a fixed state of the pupil, it may be
 safely  inferred that it is not a symptom of amaurosis.
   Causes.   Hypochondria  may be caused  by  any circumstance that  will
 lessen the  tone and energy of the nervous system, as close and severe study,
 especially when protracted to late hours of the night, great mental anxiety,
 an inactive, indolent, or sedentary life, intemperate habits, excesses in eating
 and drinking, immoderate venery, masturbation, active cathartics, long-con-
 tinued evacuations, the immoderate use of mercury, the suppression of cus-
 tomary discharges or of an eruptive  disease of long standing, crude, flatulent,
 or unwholesome food, &c.  It is often connected  with dyspepsia, liver-com-
 plaint,  and especially affections of the spleen.  It appears to  be produced,
 also, by sympathy,  as it frequently happens that persons of  a cheerful  tem-
 per become decidedly dejected and despondent from long-continued and con-
 stant association with those of a hypochondriacal disposition.
   Treatment.  Hypochondriacs should be treated more by hygienical  and
 moral measures than medical; and although we should not treat their imag-
 inary complaints as realities, yet their lamentations should be attended to as
 though they were based upon a genuine malady.  We should not attempt to
 exasperate  an excitable mind by treating  its imaginary difficulties with too
 much lightness, nor subject an abnormally sensitive  person  to  censure  and
 insolence.  "Compassion and not raillery is to be bestowed on the hypo-
 chondriac,  as the firm persuasion which  he entertains will not allow his
 feelings to  be treated as imaginary, nor his  apprehension of danger to be
 considered  as groundless, however the physician may be of  opinion  that it
 is the case  in both respects."   The patient should  be compelled to take exer-
 cise daily and regularly in company with some cheerful associates; amuse-
 ments, as gunning,  fishing, riding, billiard playing, traveling, &c, are  very
 important;  the mind must  be kept constantly occupied, not allowing  time
 for it to dwell upon self.   Good, cheerful, lively company is always desirable.
 The patient should  go to bed early, sleep upon a  hard bed,  rise  early,  and
 exercise in  the open morning air, whenever the weather is proper.  Bathing
 with cold water,  or the  cold shower-bath, will be found useful, especially
 when followed by brisk frictions.  The diet should be light, nutritious,  and
 generous, avoiding fats, acids, flatulent food, liquors, tea ancLsoffee; the food
 should  be  well masticated, and the stomach should never^e  overloaded,
 neither should it be  suffered to remain perfectly empty.  The clothing should
 be comfortably warm, but not too much so.
  As to medicines, unless there is actual disease, but  little will be re-
quired; if  the bowels are costive they may be kept regular  daily by a mix-
lure of  Rhubarb two parts, and  Bicarbonate  of Potassa one part, of which
From three to fifteen grains may be given for a dose, according to its action ■ 
380
AMERICAN FAMILY PHYSICIAN.
in very obstinate cases, the twelfth of a grain of the Alcoholic Extract ol
Nux Aromica may be added to each  dose.   Or, the following pills may be
administered:—Take of Leptandrin three drachms, Podophyllin, Apocynin
each, one drachm, Alcoholic Extract of Nux Vomica twelve grains, Castile
Soap, a sufficient quantity to  make a  pill-mass;  mix  together, and divide
into pills of three grains each, of which one may be given every night.  Too
active purgation must be avoided.  These mild laxatives correct the morbid
condition of the stomach and intestines, cleanse them of accumulations and
impart new action  and tone to them, and through  them to  the nervous
system.
  In addition to this, some tonic may be given, as the Compound Powdei
of Xanthoxylin, the Compound Powder of Colden  Seal, the Compound Pilla
of Quinia, &c,  which should be ordered to be taken at positive and regular
periods of the day.   " The times for taking the different draughts, or doses,
are so  many epochs in the chronology of a hypochondriac, which, by divid-
ing, help to conquer the tedium of his day.   However sceptical a physician
may be with regard to the inherent or  permanent qualities of any medicine,
it is his  duty, perhaps, to  take advantage of the tide of opinion; and he
may honestly make use of his patient's credulity, in order to relieve him
from the pressure of his disease, and render the partial weakness of his mind
instrumental to the general restoration of his corporeal strength."
   When obstinate hypochondria occurs in young lads and girls, it is mucil
to be feared that it is due to the horrible vice of masturbation, and there
can be no hope of recovery unless the habits which have induced the mal-
ady be at once  and entirely abandoned.   When other  diseases accompany
hypochondria, they must  be treated  as  directed  under  their appropriate
heads; and for flatulency, which  is a very common  attendant, treat it  as
named under Dyspepsia.
   For  spasmodic pains in  the  head  and  stomach, Cypripedin, Scutellarin,
Ether, Caulophyllin, Aletridin, &c, may be given either alone, or in vari-
ous combinations; the following  will be found very efficacious:—Take of
Ether, Spirits  of Nitre Dulce, each,  eight fluidounces,  Oil of Cinnamon,
Oil of  Anise, each, half a fluidounce, Cypripedin  one and a half drachms;
mix together;  the dose is from twenty to  sixty drops in some  sweetened
water,  every three or four hours.  This is very useful in  hysteria, hypo-
chondria, and  other diseases of nervous debility.  When the patient loses
confidence in one preparation,  we can  readily substitute another, hypochon-
driacs  being seldom  satisfied unless they are liberally supplied with medi-
cine in some form or other.  Anemic hypochondriacs must take some prep-
aration of Iron.
                          MASTURBATION.
  Masturbation, Onanism, or  Self-pollution, is the production of the ve-
nereal orgasm by artificial means.   Unfortunately, it is a vice by no means
uncommon anj|png  the  youth of both sexes,  and is frequently continued
even into riper years.  In the course of the last twenty years, I have treated
no less than twenty-five hundred patients whose ailments were brought on
by this horrid habit, and among these  about  one-third were females.  Al-
though at the commencement there may be  no abnormal disposition of the
system, yet eventually, if the practice be continued, it produces such a state
of derangement in the brain and nervous system of its victim, as to prove a
disease in itself very difficult to remove; and  the more the vice is induged 
MASTURBATION.
381
 In, like drunkenness, the greater will be the desire to continue it.   A host
 of symptoms are produced by it, which the physician, as well as the patient's
 friends frequently disregard, or do not even mistrust.
   Symptoms.   The symptoms which are produced by this vice, are so many
 and multifarious, that it would be almost a  Herculean task  to enumerate
 them, and all that can be done in  a work like the present, will be to merely
 refer to the  more common ones.  When the habit commences in early life,
 it usually retards the growth, impairs the mental faculties, and brings  on
 premature old age, with debasement of the human soul, and the mind filled
 with obscenity and  beastliness.  One very common symptom, more espe-
 cially among young females, is a disposition to solitude, to seclude them-
 selves  from society;  and this  is by no means unfrequent among males.
 Headache,  wakefulness, and uneasy nights, pains in various parts of the
 body, indolence, inaptitude  to study, forgetfulness, hypochondria,  melan-
 choly,  hysteria, great mental despondency, fluor albus, weakness in the back
 and in the reproductive organs, variable appetite, and a lack  of confidence
 in their  own  abilities, are very usual symptoms.   Cowardice is a striking
 peculiarity,—an  onanist cannot  look a person full in  the  face, for they
 fancy their  sin is known, or at least suspected.  When the evil has been
 pursued for several years, or has been carried to a great extent, there will be
 an irritable, feverish condition of the system, with sudden flashes of heat over
 the  face ; the eyes  have a sheepish,  undecided look;  the countenance be-
 comes  pale, gloomy, distrustful in its expression ; dark spots under the eyea
 are common, especially among females ;  the  pulse is variable  ; the hair be-
 comes  dry and splits at its ends in nearly all long-continued  cases ; gene-
 ral debility  and emaciation occurs, with  shortness of breath and palpitation
 of the heart on the slightest  exercise; sometimes there is a pain extending
 from the region of the heart into the left shoulder and  arm; constant pain
 in the head, especially in the back part, with  a preternatural heat of that
 part; the eyes become weak; there is more or less extensive  spinal irrita-
 tion; a sensation as of ants crawling along  the back, or on the  thighs;
 eruptions break out on  the  skin;  and the genital organ of the male grad-
 ually dwindles  away in size, loses its muscular power, requiring  extraordi-
 nary efforts  to excite it.   Symptoms of dyspepsia, with cough, irritation of
 the throat, pains in the chest, and also in the  loins, costiveness, unrefresh-
 ing sleep, disturbed dreams,  and a desire to lie long in bed in  the morning,
 are likewise frequently met with.   Several of the above  symptoms, with
 many more, will usually be found  in individual cases; rarely will  they  all
 be found together.
  The  children of parents whose nervous systems  have been impaired  by
 masturbation, are never robust and vigorous;  they  are subject to convul-
sions in  infancy, to epilepsy, to  scrofula, their mental qualifications are
 never extraordinary, and they are rather apt to be diminutive  in stature.
  The  consequences of  masturbation are, premature old age,  mental imbe-
cility, hypochondria, consumption, epilepsy, mania, apoplexy,  paralysis, &c.
Among females, in addition, fluor albus, menstrual derangement, hysteria,
catalepsy, furor uterinus, various strange and  often unaccountable nervous
symptoms; among males, the most common and serious result  is spermator-
rhea, or an  involuntary discharge of the  seminal  fluid immediately after
urinating or stooling, but more commonly during sleep.  Though this  con-
dition  may  be brought on by other causes, as worms  in the  rectum, piles,
fistula, irritation or chronic  inflammation of the prostate gland, or of the
urethra, and sexual  excesses.  Spermatorrhea is most injurious  to the pa-
tient's  health; it causes him  to become thin, pale,  and feeble, impairs  his 
382
AMERICAN  FAMILY  PHYSICIAN.
vision, gives him a languid, sickly look, with a disinclination to active bodily
            yj   24.            or  mental  labor,  together  with symptoms
                              simulating  various affections of the  brain
                              throat, lungs,  liver, stomach, &c.  By care-
                              ful observation with the microscope, of the
                              urine  of a masturbator, the  seminal animal-
                              cules,  or  spermatozoa,  can  always be found
                              in greater or less abundance.  (See Fig. 24.)
                              They are more or  less  oval  in form, and are
                              furnished with long and delicate tails. In
                              their native fluid, the semen, they move about
                              actively, but in urine,  unless a  considerable
                              quantity of pus is also present, they are never
                              found alive.  In seminal urine  may also be
                              detected a  few minute granular corpuscles
    „.,.,,            of  a round or oval form, and rather larger
  a. Seminal animalcules or sperma-           ,   ..     „  .    '              »
tozoa, and seminal granules.         than  the bodies ot the spermatozoa, called
  6.. Dodecahedrai crystals of Oxalate  spermatic granules.  Traces  of albumen may
of Lim0,                        also be generally detected  in seminal urine,
by the application of heat and Nitric Acid; and  large octohedrons  of Ox-
alate of Lime, are of common occurrence.
  To show the evils  arising from the habit of masturbation,  I would re-
mark that I have frequently had married men of middle age, who had been
guilty of this practice in their early manhood, apply to me in  order to ob-
tain relief from the difficulties and  debility to which they were subjected,
as a result of the early  habit.  Some of whom  confessed to me that they
would have committed suicide had they not obtained relief from my treat-
ment.   And death by suicide, is  by no means an  uncommon  termination
of the masturbator.   Unfortunately, this  vice is  too  generally commenced
at an early period in  life, when its dangers and awful  results are not known,
or  cannot be thoroughly realized, and the victim discovers his fault only
when  some permanent or very obstinate injury has  been  inflicted thereby
upon his system.  It is  a very common practice in female boarding-schools
and theological seminaries.
   Treatment.  In the treatment of the effects of masturbation, much will
depend upon their  character, for they frequently vary so much, that what
would be  applicable  to one  patient, would not to another.  In  a work
limited as the present, it will be impossible to enter into a minute descrip-
tion of the various  symptoms which may be met with, and their especial
treatment, all that I can do, will be to lay before the reader the  general
principles which must govern him in attempting to  effect cures.  In a fu-
ture work, devoted entirely to the treatment of chronic diseases, I will enter
into a more detailed  account of their nature and  treatment.
   The first and most important  measure in the treatment is, that  the pa-
tient  at once  abandon  the  pernicious  habit, for without  this  is done, all
treatment will be useless and  ineffectual.   This  will  frequently be found a
vciy difficult task for the patient to accomplish, for from the mental and
moral debility already effected, he will relapse into  the habit unconsciously;
and it will require, in many cases, much  firmness, patience, and persever-
ance on the part of the  physician, before  he will  be able to permanently re-
move this vexatious obstacle.  But he must not become discouraged, noi
leave  his patient to suffer the horrible consequences  of this unnatural prac
tice, without making the most powerful and oft-repeated  endeavors to per
suade, convince, encourage, and strengthen  his reason raid resolution.  U 
MASTURBATION.
383
 further this object, every means should be used to improve his moral feel-
 ings, and to  restrain his imagination; every thing of a lascivious character
 must positively be avoided; the society of virtuous and intellectual feraales
 is always proper, notwithstanding this is prohibited by some authors;  his
 mind  should be directed  to  some  useful  occupation  or  amusement, but
 without causing fatigue ;  he must not be left alone  more than is unavoid-
 able ;  and should never be permitted to sleep alone.  The constant super-
 intendence of a friend is necessary, especially in the worst cases.   The cure
 will proceed more  rapidly when these  means can be pursued, but, where
 they cannot, as is  frequently the case, we  must manage  the case  as cau-
 tiously as possible.
   In  recent cases where no great amount of debility has been produced,
 the patient will  recover  under a stimulating and tonic treatment, as, take
 of lied Peruvian bark two ounces, Chamomile flowers one ounce, good Port
 Wine one quart.  Mix together, let it stand a few days, frequently shaking,
 when  it will  be  fit for  use.  A wineglassful may be taken three or four
 times a  day.  If there should be nervous exhaustion with sadness, depres-
 sion, no disposition to exertion, &c, the  following may be also used : Take
 of Chloroform, Tincture  of Ginger, of  each, half a fluidounce, Aromatic
 Spirit of Ammonia two fluidrachms;  mix.  The dose is  twenty-five drops
 in a wineglass of milk, to be repeated three times a day.
   When there is debility with a sense of lassitude or indolence, one of the
 following preparations may be  given :—1.  Take of Acetate  of Strychnia
 one grain, Acetous Acid twenty minims, Alcohol two fluidrachms, distilled
 water six fluidrachms; mix.  The  dose is ten  drops three times a day;
 each dose containing one-fiftieth of a grain of Strychnia.  2.  Take of Sul-
 phate  of Quinia, Alcoholic Extract of  Nux Vomica, each, twelve grains
 Extract  of Hyoscyamus twenty-four grains; mix, and  divide into twenty
 four pills, of which one  may be given  every three or four hours.  3.  In
 long standing cases, with  more or less anemia, and virile weakness, take of
 Phosphate of  Quinia,  Metabasic Phosphate of  Iron, each, twenty-four
 grains, Alcoholic Extract of Nux Vomica twelve grains, Aletridin, only a
 sufficient quantity  to make a pill-mass  with  the preceding articles; mix
 them well together, and  divide into twenty-four pills.  The dose is one
 pill, to be repeated three times a day.   These preparations of Strychnia
 and Nux Vomica should be used with great care, as,  improperly used, they
 will produce  serious effects.  The dose of either should rather be propor-
 tioned to their influence upon  the system of the patient using them ;  and it
 will be found that in some individuals the one-fiftieth of a grain will pro-
 duce powerful results, and will have to be lessened to the one-sixtieth, one-
 seventieth, or even  one-eightieth  of a  grain.   The proper  dose, in any
 given  case, is  to fall short  of  producing any  immediately appreciable
 effects.
  The bowels of the patient  should be kept regular; his diet should be
 nutritious, easy of digestion, and the food well masticated;  the surface of
 the body bathed with a weak  alkaline solution once or twice a week, with
 considerable friction in drying; a cold douche to the back  of the head and
 along  the spinal  column every night  and morning  will  almost  always
 prove serviceable ;  and moderate  exercise  should  be taken every day.  The
 sleep should invariably be on a hard bed, with as  little covering as possible,
and  the  patient should be  advised  never to  permit himself to  lie on his
back.
  When  there is severe pain in the back  of  the  head, or a constant, dull
disagreeable soreness, the  Compound Tar plaster may  be  applied  to the 
384
AMERICAN FAMILY PHYSICIAN.
 part;  first shaving  off the  hair.  And  stimulating applications  along the
 spinal column will frequently be of advantage.
   When there  is spermatorrhea, pressure shomld be  made on the prostate
 gland through the perineum, and if there be found any soreness, the Com-
 pound  Tar plaster, about the size of half a dollar, should be placed upon
 the perineum, so  as  to keep  up a  free purulent discharge for some time.
 At the same time a weak solution of Sulphate of Zinc may be injected into
 the bladder, three or four times a day; or, an infusion of Golden Seal and
 Geranium;  or, the  following—take of Strychnia one  grain, Nitric Acid
 four drops,  distilled  water two  fluidounces ; mix, dissolve the  Strychnia
 and filter.   A teaspoonful  of  this  maybe  injected  into the bladder three
 times  a day.   These injections  should always  be  employed  immediately
 after urination, and be retained as  long as possible.   In some  instances I
 have succeeded in removing  the  spermatorrhea by the following pill:—
 Take of Camphor twenty-four grains, Extract of Belladonna four grains,
 Oil  of Cubebs twenty drops; mix, and make into a pill-mass with equal
 parts of powdered  Magnesia  and  Gum Arabic.  Divide into twenty-four
 pills, of which one is the dose, to be repeated three times a day.  In some
 cases of spermatorrhea it becomes actually necessary to cauterize the neck
 of the  bladder, before  relief can be obtained, and this must only be done
 by a competent physician; but it is  not so often  required  as has been gen-
 erally supposed.  Cold douche to the perineum,  daily, should never  be'
 omitted, except when the Compound Tar plaster is on the part.
  When there  is impotency, with  a diminution in  the size of the male
 organ, the organ should be shampooed every day, and a liniment applied to
 it and the neighboring parts, composed of, Oil of Rosemary one fluidounce,
 Phosphorus twelve grains ; mix in a flask, and dissolve it over a lamp, then
 while warm, add, Oil of Sweet  Almonds one fluidounce, Tincture of Musk
 one fluidounce.  In addition to this,  the glass  exhauster should be care-
 fully applied to tho part, once  every day.*   If necessary the following may
 be  given  internally:—take of  Musk six grains, Phosphorus  one grain,
 Ether one  fluidrachm ; mix, and dissolve the Phosphorus,  The dose is
 from ten to twenty drops,  to be repeated three times a day.  A gentle cur-
 rent of electro-magnetism  passed through the parts, and  along the spinal
 column, will also prove beneficial.  In all these cases, I either have the
 patient bathe the parts every night  and morning, in a  vessel containing
 cold water;  or, else  I apply a cold douche thus:—Have a tin vessel made
 capable of holding a quart or two, with a tube at its lower part, so fitted as
 to throw an upward jet, which should  be quite small; the patient  holding
 this by its  handle, may douche the perineum, scrotum, thighs, nates, &c.,
 twice a day, continuing it  for ten or fifteen  minutes each time.   Impotency
 is sometimes occasioned in healthy persons  by a want of sufficient confi-
 dence, too excessive a degree of excitability,  and also, a degree of fear, or a
 sensation of disgust, at the time of coition ;  the use of liquors will likewise
 give rise to  it.   A low degree  of inflammation  of the  prostate gland is a
 common cause of its presence  among middle-aged married men, as I have
witnessed in numerous  instances.
  In cases of great excitement of the genital organs,  this may be subdued

  * The glass exhauster is a cylindrical glass tube, about nine inches in length, and twoinc^1^
diamoter; one end is open, the other is  fitted with a nipple for a small exhausting Puf?p!?. y
placed upon, the same as in a cupping glass.  The male organ being placed in this glass, tne
exhausted, the blood fills the vessels of  the part, and thus  excites a new action.  Great care m
be taken not to exhaust the air too rapidly, or to too great a degree, as injury to the parts wo
follow. 
ASTHMA,
385
by pills  of the  Inspissated Juice of Conium Maculatum, or, by drinking
freely of a strong infusion of the aments  or catkins of the Black Willow,
(Salix Nigra) ;  but, under ordinary circumstances antaphrodisiacs should
never be prescribed, as I believe them to  be ultimately of more harm than
benefit.   Moral strength is the best antaphrodisiac, and this should be well
cultivated.
            FUROR  UTERINUS,  or  NYMPHOMANIA.

  This is a morbid and  uncontrollable desire for coition ; when it is vio-
lent, and accompanied with libidinous speeches and actions, it is  a  species
of insanity, and must be treated as such.  But when it occurs  in a minor
degree, as among hysterical women, it will generally be found associated
with a displacement of the womb, an unhealthy condition of  the vaginal
canal, leucorrhea, or an  intense  itching  of the parts.  A very common
cause,  among young females in particular, is masturbation, which is fre-
quently commenced as early as at the eighth or tenth year, and continued
for  years afterward.
  Females who masturbate have a very pale countenance, dilated pupils, a
livid circle around the eyes constantly, a great  tendency to palpitation of
the heart, hysterical faintings, a retiring,  diffident manner, and a peculiar
reserve in answering the common questions relating to health.  Not unfre-
quently there will be sores round the  nails of the index and second  finger,
or one or more very rough and broad warts.
  Treatment.   Open the bowels by  an active cathartic, and apply cooling
washes or lotions to the  organs  of  generation; warm  hip baths are also
useful.  When leucorrhea is present, use one of the injections named under
the  treatment of that disease.  When the  nymphomania is owing to itching
of the parts,  it may be overcome by washing them with the Borax  Lotion
with Morphia, or, by applying a solution of* Nitrate of Silver to them,  from
five to eight grains of the Nitrate to a  fluidounce of distilled water.  When
owing to masturbation, it must be  treated by abandoning the  habit,  with
cold bath to the  parts, cold douche  to the head, hip  baths, use of tonics,
and sfMnc preparations of  Iron, constant  employment  of mind and body,
and such other measures as the case may require from time to time—some-
what similar to those of the preceding subject.
                             ASTHMA.

  Asthma or Phthisic, is a spasmodic affection of the lungs which  comes
on at uncertain periods, most generally at night, and gives rise to tempo-
rary difficulty of breathing accompanied with a wheezing sound, a sense of
tightness across the  chest, cough and mucous  expectoration.   There are
two  species, the dry, nervous, or spasmodic  asthma,  and the humid  or
habitual asthma; the former attacks  suddenly and violently, with spasmo-
dic constriction of the chest, slight cough, and but  little expectoration to-
ward the termination  of the paroxysm ;  the latter comes  on slowly, with
full  but laborious respiration, severe cough, and profuse expectoration,—
it is the form more commonly met with, and attacks males more frequently
than females.
  Symptoms.  Asthma is frequently preceded for  some days  by warning
symptoms, as, a sense of fulness about the stomach, with lassitude, drowsi-
       25 
386                AMERICAN  FAMILY PHYSICIAN.
ness, headache, flatulency, nausea, pale urine, itching of the skin, and dig.
turbed  rest; sometimes the  attack  is sudden, and  most generally takes
place at night.   The patient  experiences  a sense of tightness  across the
chest, with difficult breathing, and a wheezing  sound ; the speech becomes
uneasy  and  difficult, and  there  is a  tendency  to  cough.   These symptoms
progress more or less rapidly, becoming more  and more alarming in their
character, and threatening suffocation, so that the patient is compelled to
start up from the horizontal position and seek a window or door for fresh air.
The breathing is slow and difficult, more of a gasping character,  and is ac-
companied with  a wheezing sound.   The face is purplish and distended, or
very pale and collapsed, a cold perspiration oozes from the surface of the
body, the tongue is coated, flatulency and  constipation are usually present,
the pulse may  be  small,  rapid, and unequal, or, it  may  be  slower than
usual, or, full and regular, the urine is generally  in considerable quantity,
pale and inodorous, but  on the  close of the paroxysm becomes high-
colored, less in  quantity, and deposits  a sediment on  cooling.  These
symptoms continue  for a  longer or a shorter period; but usually they de-
cline gradually on the approach of morning, the  breathing  becomes more
free, coughing  and  speaking is less difficult, more or less expectoration
takes  place,  much  relief  is  experienced,  and the patient generally falls
asleep.
  The paroxysm may end  for the time, in  these  symptoms  of relief, or it
may be  only a remission; in  the latter case, a sense of tightness across the
chest, slight difficulty of breathing, uneasiness on motion,  and  an inability
to remain in the recumbent position, will continue in  a slight  degree
through the succeeding day;  on the approach of night, drowsiness, flatu-
lency, difficulty of breathing, and the other symptoms will gradually como
on, until they become as violent as on the preceding night.  And the par-
oxysms  and  remissions may continue in this manner, for several  successive
days, leaving the patient  in  an exhausted condition, with a slight feeling
of tightness  across the chest,  and considerable tenderness of the muscles on
motion.   When a paroxysm of asthma has once taken place, it is very apt
to return at various and  uncertain  periods ; sometimes every year or two,
at others upon  every appreciable variation  in  the condition of the atmos-
phere ;  and  again they may return regularly at stated periods, varying from
one to several weeks.
  Causes.  Asthma is considered to be owing to a spasmodic constriction
of the muscular fibers of the  bronchia, which  by diminishing their  caliber
and causing in  them a  degree of rigidity, prevents a free  and full expira-
tion.  This  spasm may be produced by various exciting causes, as, a cold,
moist atmosphere, sudden changes  of temperature,  noxious or irritating
vapors,  dusty or smoky atmosphere, violent mental  emotions, suppression
of customary evacuations, severe  exercise, inattention to diet, and what-
ever will cause  irritation  of  the bronchial mucous  surfaces.  With some
persons an attack of asthma  is induced only by certain  odors or vapors, as
hay, Ipecacuanha, tobacco smoke, &c.
  Sometimes asthma depends on metastasis of  rheumatism or gout, dyspep-
sia, frequent catarrhal attacks, scrofulous  taint, enlarged  liver, aneurisms,
polypi,  &c.   Sometimes it is hereditary, and at others appears to be owing
to a faulty conformation of the chest.
   Uncomplicated asthma is generally curable, but when it comes on in ad-
vanced  life,  and is connected with disease  of the lungs, heart, or other vital
organs,  but  little encouragement can be given.   When  the breathing be-
comes suddenly quick and short, the pulse weak and irregular, with paraly- 
ASTHMA.
387
 sis of the arms, great depression of strength, scanty urine, and  frothing at
 the mouth, the danger is imminent.
   Treatment.   This consists in  firstly relieving  the paroxysm, and sec-
 ondly making use of means to prevent its return.  For arresting or miti-
 gating the asthmatic  paroxysm,  there  is no more valuable remedy than
 Lobelia.  In the majority of cases the  administration  of  this article in the
 preparation known as the Compound Tincture  of Lobelia  and Capsicum,
 will afford prompt relief; but, as in many instances  there  will  be  found
 more or less derangement of the digestive organs, it will be preferable, as a
 general rule, to commence the  treatment  during the paroxysm with an
 emetic, for which purpose the Compound Powder of Lobelia may be given,
 or the Compound Acetated Tincture of Bloodroot.  After the action  of  the
 emetic, should the symptoms still continue, the Compound Tincture  of Lo-
 belia and Capsicum  may be given in small nauseating  doses,  every half-
 hour, or oftener, for the purpose of producing relaxation of the spasm.  In
 connection with this the throat, neck, chest, and upper part of the back,
 Bhould be bathed with the Compound Liniment of Oil of Amber;  applying
 it  with considerable friction, and  repeating it  two  or three times in as
 many hours.
   Very frequently, I have succeeded in not only relieving the paroxysm
 of uncomplicated asthma, but in also effecting permanent cures,  by the  use
 of the following Tincture: Take of Lobelia seed, Skunk Cabbage  balls, each,
 one ounce, High Cranberry bark  two ounces, Stramonium seed, Capsicum,
 each, half an ounce,  Alcohol five pints; mix, and let it stand for fourteen
 days, frequently agitating.   The dose is from twenty to  sixty drops three
 times a day; or, during a paroxysm as  often as may be required.
   In spasmodic asthma  the following has been advised:   Dip unglazed
 white paper in a saturated solution of Nitre, let  it soak fifteen  or twenty
 minutes, then  fold  it, dry in an  oven  or elsewhere, and  set aside for use.
 To use it, ignite one end, and let it burn in a close room  in which the pa-
 tient is  seated, so that he can inhale its fumes.   One  pound of Nitre fur-
 nishes, when heated to redness, four hundred pints of oxygen gas.
   Another preparation, for similar use, is made by breaking down  paste-
 board with hot water  four fluidounces, into  a kind of paste, and mixing
 with it the following:—Nitrate of Potassa two ounces, Belladonna, Stramo-
 nium, Lobelia, of each, in powder, twenty grains, Myrrh, Olibanum, each,
 two and a half drachms.  After mixing all thoroughly, roll into sheets, and
 cut into small squares.  Burn them in small saucers in a close room.
   If the paroxysm be owing to checked perspiration, or to translation of
 rheumatism, perspiration should  be produced as promptly as possible by
 placing hot irons, hot bottles  of water,  or  hot bricks around the feet and
 limbs of the patient as he sits in bed, and administer  teaspoonful  doses of
 the Compound Tincture  of  Virginia Snakeroot, every hour  or two.   And
 in cases of rheumatism dry Cups along the spinal  column, or Firing, will
 be found beneficial.   Indeed, whenever the  causes of the  attack can  be
 ascertained, the proper measures to remove them should be immediately
 put into requisition.
   In  the  intervals  between the  paroxysms,  treatment must be pursued
 either to cure the disease, or to palliate its  more  urgent symptoms.  If
 there be_ any complication, the  appropriate treatment for it must be pur
sued,  before much benefit can be derived from the measures for relieving
asthma.  In uncomplicated asthma, the most rigid attention  must be paid
to hygienic measures; the bowels must  be  kept regular daily; the surface
of the body must be bathed every day or two with a weak alkaline solution 
388
AMERICAN FAMILY PHYSICIAN.
drying with considerable friction; exercise should be taken in the open air
every fine day, but it should not  be carried  to fatigue; night air, and all
causes of asthma should  be positively avoided; the duration of sleep should
not exceed eight or nine hours daily,  the bed should be rather  bard, and
the bedroom should always be  kept well ventilated.   The  diet  should be
nutritious but of a simple character, easy of digestion, and well masticated.
Tea, coffee, fats, acids, pastry,  hot bread, high-seasoned food, sweetmeats
and all  intoxicating liquors  should be strictly prohibited.  Late suppers
as well as hearty meals at any time,  must be  avoided.  In addition to these
the above Tincture of  Lobelia seed,  Skunk Cabbage balls, Hiuh  Cranberry
bark, &c, must  be used daily and persistently for  some time; and the
throat and chest should  be  rubbed  twice a  day with  the Compound Lini-
ment of Oil of Amber.
   When the asthma  is periodical,  or complicated  with other diseases, I
have found the following pill very valuable:  Take  of Sulphate of Quinia,
Extract of Stramonium,  each, one scruple, Sulphate  of Morphia two grains,
Ipecacuanha six  grains, Capsicum  twenty grains; mix,  and divide into
twenty pills.  To  make  the pill-mass, it  will sometimes require the addi-
tion of a little Simple Syrup.   The dose is one pill, to be repeated three or
four times a day.   This  is intended for the  asthma, and not its complica-
tion, which, of course, will require  additional means.  This  pill may alsc
be used  every hour  in  the remissions of asthma, in order  to prevent or
mitigate the subsequent  paroxysm.
   Among the agents  that  have been occasionally found useful in asthma,
may be named, a cupful  of clear, strong coffee, every half-hour or so; smo-
king Stramonium leaves; inhalation of Chloroform and Nitrous Ether; and
the following:—Take  of Lobelia one  pound, Alcohol,  Spirit of Nitrous
Ether, four pints, Sulphuric Ether four fluidrachms;  Macerate for fourteen
days, and keep perfectly  excluded from the light.  The  dose is a teaspoon-
ful or two as often as required.  In  one case of asthma of  about  twelve
years standing, I effected a permanent cure by the application of the Com-
pound Tar  plaster between  the shoulder blades, and the internal use of
Quinia and Tincture of  Black Cohosh, prepared and given as named under
the treatment of Intermittent Fever.
                        ANGINA  PECTORIS.
  Angina Pectoris, also known by the names of Breast-Pang, Spasm of the
Heart, and Neuralgia of the Heart,  is a disease the pathology of which is
not positively determined.   It is a very dangerous disease, being often as-
sociated with ossification, or other abnormal condition of the heart.  The
disease occurs in paroxysms, arising suddenly, and ceasing suddenly.
  Symptoms.   In the first attack, which is generally experienced af'Wr some
unusual exertion, as going up a hill, or up stairs, or walking quickly, espe-
cially after a full meal, the  symptoms are usually rather mild in  most in-
stances;  but as the  disease advances the symptoms become  more severe,
and are excited by very slight  causes, as mental emotions, walking, riding,
coughing, sneezing, talking, straining at stool,  &c.   Sometimes the patient
is attacked early in the morning,  and often without any previous exertion
or obvious cause.
  The patient when  attacked,  suddenly experiences  an acute  pain at the
lower extremity of the breast-bone, which extends to the left side and back-
bone, and up into the left arm, and is accompanied with a sense of impend' 
ANGINA PECTORIS.                      389
ing suffocation, great anxiety, and a feeling of approaching death ;  the pulse
becomes feeble and irregular, or it may be strong and regular, the face pale
and covered with a cold sweat, and the patient appears to  have  lost both
sense and motion.  After a few minutes, the pain suddenly subsides, and the
patient is enabled to move and talk again ;  and thus these  attacks may go
on, recurring at irregular intervals, varying from a few weeks to a year, or
more, the intervals  becoming shorter and shorter, with the persistence of
the malady, until the patient is carried off in one of these sudden paroxysms.
Those symptoms will be found to vary much in their severity, as well as in
the regularity of their attacks.
  Causes.   It appears to be owing to a convulsive or  spasmodic action of
the heart, and attacks those who are apoplectic, sedentary, corpulent, and
of gouty or rheumatic habit.  Persons under fifty years of age, are seldom
attacked by it;  and males  are  more liable to it than  females.   It  is fre-
quently associated with organic diseases of  the heart, or its  arteries, and in
such cases, a cure is rarely effected.
  Treatment.  This is  divided into that  during the  paroxysm, and that
during the interval.   In  the paroxysm, stimulants and antispasmodics must
be given, and  probably the  most effective  among them  is  the  Compound
Tiiicture of Virginia  Snakeroot, a teaspoonful or two of which should  be
administered at once  in a little  wafer, and  repeated every few minutes du-
ring the continuance or recurrence of the fit.  Other preparations, however,
have been used with success, as equal parts  of Ether, Laudanum, and Tinc-
ture of  Castor, in teaspoonful doses;  or Am-moniatcd  Tincture of Castor;
or the Compound Tincture of High Cranberry bark.  In addition to these,
dry Cupping, or Firing should  be freely applied along the chest, over the
heart, and along the upper part of the spinal column, the patient should be
kept perfectly quiet, and the extremities should be well  rubbed  to aid  in
recovering  the accustomed action of the heart.   In cases of fainting, Ether,
or Spirits of Ammonia, may be  sprinkled  on  the face, neck, and breast;
and if it continues too long, slight electro-magnetic shocks may be passed
through the region of the heart, with frictions of stimulating mixtures to
the limbs.  After a recovery so that the patient can swallow, a mild cathar-
tic may be given, if we know that  there aie accumulations  in the bowels,
but not without; and  in  pale, bloodless countenances, the purgative had
better be omitted entirely.
  During the  intervals, the  treatment must be to prevent any subsequent
attack.  And to do this effectually, the general health  of the patient must
be enquired into, and if it be found that he  is laboring under any other dis-
ease,  as gout, rheumatism, kt..  these  must be combated by their  appro-
priate treatment, while, at the same time, means must be pursued designed
to lessen or withdraw the  irritation, and at least check the  tendency to
attars from minor causes.
  The bowels should be  kept regular daily, the surface of  the  body fre-
quently bathed with a weak  alkaline solution,  the kidneys kept in healthy
activity, and  the Compound  Tincture of High Cranberry bark, the Com-
pound Pills of Aconite, the Compound Pills of Black Cohosh, or  the Com-
pound Pills of Hyoscyamus, administered internally.   Either of these will
be found very efficacious, but I prefer the first-named tincture.  Acidity of
the stomach, when present, is best removed  by Carbonate of Ammonia.   In
addition  to these measures,  the  Compound Tar plaster should be applied
alternately over  the region of the heart, and  between the shoulders, keep-
ing up a discharge  from  each  location as long as  the  patient can bear it.
All sources of irritation, mental  inquietude, and sudden gusts of passion, 
390
AMERICAN  FAMILY PHYSICIAN.
Bhould  be vigilantly guarded against; moderate  exercise in  the open air
by riding or sailing, will be useful, and  in  ascending hills, or stairs &c.
the utmost care and deliberation must.be taken.  The other necessary hy'
gienic measures will be similar to those already named under asthma.   In
three cases,  I have found  marked  benefit from the use of the Compound
Tincture of High Cranberry bark,  and Compound Tar plaster, in conjunc-
tion  with the  following:—Take of  Muriate of Ammonia  sixty-four grains
Fluid Extract of Wild  Cherry bark  four fluidounces; mix.   The dose is
half a table-spoonful three times a  day.
                          HOOPING-COUGH.

  HooPiNG-Cough, or Pertussis, is a disease which commonly occurs hut
once in a lifetime, and almost always in infancy or childhood, or the first
time the  person is exposed  to the peculiar exciting  cause.  The  ages in
which  it more generally appears, vary from two to ten years.  Occasion-
ally, instances have occurred where individuals have been attacked with it
at two, or even three different times.
  Symptoms.   The disease has  been divided into two stages.  The first
stage presents the usual symptoms of catarrh, as languor, restlessness, fever-
ishness, loss of appetite,  sneezing, coughing, and after the first day or two,
an increased secretion of mucus from the nose.   Sometimes these symptoms
are  much  more severe, with considerable oppression and general distress,
And in a few cases, the first  stage is absent, the child being at once seized
with the characteristic cough.
  After twelve or fourteen days, the catarrhal symptoms gradually subside,
the pulse becomes more natural, and  the appetite returns.  The cough,
however, remains, or  even appears aggravated, and changes its character.
Instead of being a simple cough with few suceussions, it is  prolonged by a
number of expiratory efforts in succession, and at its termination, we occa-
sionally hear a forcible inspiration, accompanied by a loud, ringing sound.
  The  cough  usually comes  on  suddenly, and the paroxysm consists of a
number of short expirations,  in such quick succession, and made with such
violence, as would appear  to threaten  the patient with suffocation.  The
extremities become cold, the face and neck turgid and livid, the forehead
covered with sweat, the eyes protruded and full of  tears.   This is followed
by one or two full, violent, and noisy inspirations, producing the character-
istic hooping  sound,—this is succeeded by another  fit of  coughing, and
another hoop, and thus continued in the same manner, until  a quantity of
mucus  is vomited  or  coughed up, and  the paroxysm is terminated.  The
paroxysm, or  several  of  them in succession, may last from  one to fifteen
minutes,  and if it be very violent, some small vessels may be rupturejpand
blood escape from the mouth or nose, or mixed with the expectoration. In
the intervals between  the paroxysms, after a recovery from the  exhaustion
produced, the child appears  tolerably well and cheerful, except when the
attack has been severe, it will then be pale, thin, and languid.   The fits of
coughing  vary in frequency, they may come on every five,  ten, or fifteen
minutes through the day, or only every hour or two;  sometimes they assume
a periodic character, returning at a given hour, and proving very obstinate.
  In the  first stage,  the  expectoration  is a frothy mucus; in the second
stage, it may be clear, transparent, yellow, or even  puriform, }ret so thick,
tenacious, and ropy, that it may be drawn out  of the child's mouth ly the
fingers.  The second  stage lasts from six weeks to  six months, but usually
the entire duration of the disease is from two to four months. 
HOOPING-COUGH.
391
   Causes.  It seems to  depend upon a specific contagion ;  and it is very
 Tardy we meet with single cases of hooping-cough, for almost invariably, it
 spreads through a whole city or town, either by epidemic influence, or by
 a contagion,  of the peculiar  nature  of which we  are  at present quite
 ignorant.
   Prognosis.  Simple hooping cough is rarely fatal;  the greatest danger
 is from exhaustion.   But when it is  complicated with  some other  disease,
 as bronchitis, pneumonia, congestion of the brain, apoplexy, dysentery, &c,
 it is apt to prove more or less serious, according to the  nature of the attack,
 and the  character and severity of the complication.   Hence,  every organ
 of the body should be carefully examined in hooping cough, and the com-
 plications treated as named under their respective heads.
   Treatment.   During the first stage, the treatment will  be similar to
 that named under Catarrh; but it is seldom that a physician is called to a
 case until in  the second stage, and  frequently not until  this is somewhat
 advanced.   When the hooping cough is  uncomplicated,  I have found the
 following a most valuable preparation :   Take of Alcoholic Extract of Bel-
 ladonna five grains,  water one fluidounce  and a half, Alcohol one flui-
 drachm ; rub these  up together,  and add to  them  Salt of Tartar (Subcar-
 bonafe of Potassa,) fifteen grains, finely  powdered Cochineal  ten  grains,
 Loaf Sugar sufficient to make it palatable.  The dose of this for a child  two
 or three years old,  is  half a teaspoonful  or one teaspoonful  four, or  five
 times  a day, or enough to produce a dilatation of the pupils, and when this
 dilatation is produced the medicine must be omitted till next day, and then
 repeated and so on daily.   In conjunction with this, the  bowels must be kept
 regular daily, by doses of the Compound Powder of Rhubarb and Potassa,
 and the neck, throat,  chest, and upper  portion of the spinal  column  be
 rubbed twice a day, or oftener,  if desired, with the Compound  Liniment of
 Oil of Amber.  An infusion of Maidenhair may be drank freely, and will
 be found a very valuable and pleasant drink.  This  course I have found
 most  generally to check the disease promptly, or  at  all events  lessen its
 severity.
   A host of remedies have been  recommended from  time  to time  for  the
 cure of this disease, and among them I have  found the following to be  the
 most efficacious, either of which may be used in the absence  of the above
 Belladonna mixture:—
   1. Compound Tincture of Lobelia.
   2. The Compound Tincture of High  Cranberry bark, is  a most valuable
 preparation, especially for advanced children. . In conjunction with Quinia,
 it will  be found useful in those obstinate cases, which resist the ordinary
 treatment.
   ."{. Take of Tincture of Black Cohosh root, Tincture of Bloodroot, Tino-
 turojlf Skunk Cabbage, each,  one fluidounce,  Essence of Anise,  half a
 fluidounce;  mix.   To a child a year  old, the dose is  ten or twenty drops
 iu sweetened water, repeating it several times a day.
   Dr.  C. D. Gibbs has recommended the following, and its  use has been
 followed  by  beneficial effects:   Take  of dilute Nitric Acid  twelve flui-
 drachms, Simple  Syrup enough to fill  a  four ounce  vial; mix.   To  an
 infant, the dose is a teaspoonful, to a  child two years old, two teaspoonfuls,
 repeating the dose every  two  or three  hours.  He says it is a  tonic, sup-
pies the Hood with  nitrogen, which  removes or neutralizes the excess of
fibrin  existing in that fluid at the  time,  and which is a great source  of dan-
ger   It am-sts the  paroxysms,  and removes the hoop; but should,,not be
used in cases of complications.                              .^ ...|J 
392
AMERICAN FAMILY  PHYSICIAN.
  When there is a profuse discharge of mucus, it may be lessened by Tannio
Acid, Benzoic Acid,  Balsam of Canada,' or Alum, in doses suited  to the
child's age.
  The child should be permitted to go out in pleasant Aveather  during the
warm part of the day, and exercise moderately.  His diet should be nutri-
tious, but easy of digestion, as bread-pudding, chicken-broth, Indian meal
gruel, and if there  be no fever,  a little boiled chicken,  or tender  meats.
The rooms  in which he passes the day and night should be well ventilated
and of a comfortable  temperature.   In  some instances a change of air will
effect a cure, when every thing else fails.   I have seen good results accom-
pany the inhalation  of an atmosphere  moderately impregnated with Sul-
phureted Hydrogen  gas.   Tincture  of  Cantharides  has  been  recom-
mended as an efficacious remedy in hooping-cough, but I have not tested it.
                             HICCOUGH.

  Hiccough, or Singultus is a spasmodic affection of the stomach and dia-
phragm, or midriff, and is generally caused by some irritation of the nerves
of these parts.   When hiccough is present toward the  close of  some acute
or long standing disease, or after mortification has taken place, it is an indi-
cation' of approaching dissolution; at other times it generally occurs from
acidity of stomach, eating too  rapidly, eating or drinking too much, flatu-
lency, use  of intoxicating liquors,  indigestible  food, &c,  and  is usually
removed without trouble.
  Treatment.  Ordinary hiccough  may frequently be  removed by sud-
denly starting the person affected,  arousing a feeling of surprise, fear, or
anger; a few small draughts of cold water in quick  succession, will also
remove it, as woll as holding the  breath  for a certain length  of time.
When these simple measures fail,  recourse may be had to the  Compound
Spirits of Lavender,  Essence of Peppermint, Ether, or a teaspoonful of
Vinegar, or of  Lemon juice, or a little peppermint water, acidulated with a
few drops of Sulphuric Acid.  When the stomach is acid, a little Magne-
sia, or Solution of Bicarbonate of Soda may be combined with the aromatic.
or a small quantity of Aqua Ammonia may be taken.  Sometimes, in obsti-
nate  hiccough, a  Mustard poultice over the region  of the  stomach will
afford relief.  Chloroform inhaled  as  often  as the hiccough returns will
frequently be  effectual.   Intermittent or  periodical  hiccough  may he
removed by the following, administered as  often as  required:  Take of
Bicarbonate of Soda  three grains,  Sulphate  of  Quinia one  grain, Opium
half a grain ; mix for a dose.
                     SYNCOPE,  or  FAINTING.
  Syncope, or  Fainting is  owing  to  a diminished  action of the heart,
amounting sometimes to a total cessation.
  Symptoms.   It  is  frequently  preceded with an indescribable, anxious
sensation as it were, about the heart, with a sense of fulness passing from
the stomach up to the  head, vertigo or a confusion  of ideas, dimness ot
sight, and cold extremities.   Sometimes the patient retains his senses, hav-
ing a pale  countenance, cold surface,  weak pulse, and trembling of the
heart, the breathing being barely perceptible;  but in perfect syncope, there
is a sudden annihilation, apparently of the animal and vital powers; not 
VERTIGO.
393
the least indication of life can be discovered, the pulse  is not perceptible,
the eyes are shut or half-closed, the face is  cold  and deathly pale,  the
limbs are relaxed, and there is hardly any apparent  breathing.  On recov-
ery, the patient sighs deep and heavily.  Sometimes syncope terminates in
vomiting or epileptic convulsions.
  Causes.  Syncope may be  produced by anything that exerts a  depres-
sing influence  upon the vital  powers, as, profuse evacuations, especially of
blood, violent and long-continued exertions, great external heat, disgusting
sights,  excessive pain, sudden and violent mental emotions, intense appli-
cation to study,  certain odors,  and  derangement of the digestive organs.
It sometimes follows the operation of tapping, in dropsy, and  is a symp-
tom of affections of the heart and brain, aneurism of the aorta, polypus of
the heart, kc.
  Treatment.  The patient should be  placed  in  a recumbent position,
where  there is a free  admission  of pure,  Cool air; the  face should  be
sprinkled with cold water or Spirits of Ammonia, and considerable friction
should be applied to the arms and legs.  As soon as possible, a teaspoonful
of Compound  Spirits  of  Lavender may  be placed in  a  little sweetened
water,  and  ten or twelve drops of Aqua Ammonia be added to it, and  the
whole given for a dose, repeating it in a few minutes, if  necessary.   When
the syncope is owing to great  loss of blood, the strength of the patient must
be sustained until proper  reaction  takes place by powerful  stimulants,  as
Brandy, Ether, Ammonia, &c.   Individuals who are subject to fainting,
should avoid all crowded or confined places,  should endeavor  to keep  an
equable mind,  not  allowing  themselves to be suddenly acted  upon, and
should not wear any cravats,  or  other tight bandages.  They should also
strengthen the system by cold bathing, proper diet,  and  the  use of vegeta-
ble bitter tonics.
                             VERTIGO.

  Vertioo, or Giddiness in the Head is generally owing to a fulness of the
bloodvessels of the head, and may be symptomatic of dyspepsia, apoplexy,
hysteria,  hypochondria,  or epilepsy.  When it  arises from  hysteria, or
other nervous disorder, it is seldom dangerous,  but is always more or less
so, when it arises from an undue amount of blood in the head, frequently
terminating in palsy or apoplexy.  Difficult or painful  menstruation often
occasions it.
  Symptoms.   There is a sudden seizure of swimming  in the head, objects
appear dim, and as if they were  turning round, and the patient  staggers,
and is liable to fall.   This lasts for a few minutes, and either disappears, or
is followed by apoplexy, an attack of hysteria, or epilepsy.
  Treatment.   Ascertain  the cause of the difficulty,  and remove that, if
possible, by appropriate treatment.  Usually, the application of cold water
to the head, and a brisk cathartic will remove it.   Persons subject to giddi-
ness should eat sparingly and  of easily digestible  food, keep  their bowels
regular  daily, take  moderate exercise every day,  keep  the feet warm  and
dry,  not lose too many hours per day in  sleep, and avoid tea, coffee, fats
indigestible meats, suppers, intoxicating liquors,  and every thing  calcu-
lated to injure the brain and nervous system. 
394
AMERICAN  FAMILY   PHYSICIAN.
                 PALPITATION  OF  THE  HEART.

  Palpitation of the  Heart is symptomatic of  some other disease, but is
often so severe as to require a distinct consideration.   There Is a rapid beat-
ing or fluttering motion of the heart, which  may be felt veiy plainly when
the hand is placed upon the chest over this organ.   Various other symptoms
may accompany it, as, a shortness of respiration, a sense of pain in the neigh-
borhood of the heart, a feeling of constriction across  the chest, inability to
lie down, pale countenance, swollen feet, great debility, irregular  or inter-
mittent pulse, much distress on slight exertions, &c.  The palpitation maj
vary from a simple, full, uniform, powerful beating of the  heart, to a rapid
violent, confused and irregular action, shaking the  whole system,  and pro-
ducing very disagreeable sensations.
  Causes.  Palpitation of the heart is generally owing to dyspepsia, or some
derangement of the digestive functions;  occasionally it occurs  as a symptom
of some nervous disorders; and it frequently accompanies enlargement of
the heart, dropsy of the heart,  and other diseases of this organ and its arter-
ies.  It may also be brought on by great mental excitement, intemperance,
masturbation,  excess in venery, &c.
  Treatment.   When the palpitation is owing  to disease of the heart, relief
is all that can be expected unless the disease be cured, and the same may be
said when it is owing to  dyspepsia or other  affections; but diseases of the
heart are not so readily curable as many other maladies.  Whatever may be
the disease occasioning the palpitation, it should be treated and  removed if
possible.
  In nearly all cases, palpitation of the heart may be lessened or checked by
the administration of ten or  fifteen drops  of Tincture of Digitalis, repeated
three or four  times a day; or, by a similar dose of the Tincture of Sheep
Laurel.   I have found the following an excellent preparation for palpitation:
Take of Tincture of Musk, Tincture of Sheep Laurel,  Ether, and Essence
of Cinnamon, each, equal parts;  mix.   The  dose is from ten to thirty drops,
in a little water,  and may be  repeated  three  or four times a day.  When
there is acidity of stomach, this should be  neutralized by Magnesia, Carbon-
ate of Ammonia, or Prepared Charcoal.   In palpitation of the heart accom-
panying hypertrophy of the organ, I have witnessed the  happiest results from
a pill composed of two or three grains of  the Inspissated  Juice of Conium
Maculatum.   The diet and regimen should be the same as mentioned undei
Asthma and Angina Pectoris.
                             NIGHTMARE.

  The Nightmare, or Incubus,  is a certain uneasy sensation during sleep,
of weight and oppression upon the chest, with more or less  difficult breath-
ing, great anxiety, and dreams of monsters, or else of some  terrific circum-
stances, being most always  accompanied with terror, and paralysis of the
voluntary muscles; in the ineffectual efforts made by the patient to rid him-
self of his imaginary trouble, he frequently utters a loud and rather frightful
noise.   It is impossible to describe the various unpleasant dreams which are
present in nightmare; the person is generally exposed to some  danger from
monsters, wild animals, assassins, &c, and is unable to free  himself from
them, being deprived of motion.   Sometimes the patient lies in a  half-wak-
ing state, and is aware that  he is in bed and dreaming, but he cannot imme-
diately divest himself of the impressions made upon his mind, and frequent!/.
* 
DYSPEPSIA.
395
even after awaking, will, for some time, remain uneasy,  from a feeling  that
some one is in his bedchamber.  There  is often a  sense of weight at the
Btomach, an unpleasant taste in the mouth,  and palpitation of  the  heart.
Nightmare is considered a trifling complaint, but it is by no means improba-
ble* that many persons who have been  found dead in their beds were de-
stroyed by it.
  Cai'seb.  This symptom is common to hypochondriacal and nervous  per-
sons, to those who lead a sedentary or  indolent life, and even  sailors are
subject to it.  But the healthiest  person may be attacked by  it when  any
indigestible food remains in his stomach during the hours of sleep.  It prin
cipally arises from indigestion, and is very apt to follow a late and hearty
supper, and more certainly,  if the food be indigestible or of  a  flatulent na-
ture.  It more commonly occurs when the individual lies on his back, though
I have  known it to take place while lying on one side.  It may also be  pro-
duced by great anxiety of mind,  profound  meditation, fatigue, late hours,
intemperance, a constipated condition of the bowels, and  the use of Opium.
Acidity of  stomach is generally present, and  produces  the worst kind of
dreams.
  Treatment.  Dyspeptic  persons may free themselves from this disagree-
able symptom,  by keeping the bowels regular, and neutralizing any acidity
of stomach.  They should not use flatulent food, or  that which is difficult of
digestion, and  should eat no suppers; regular exercise daily, lively company,
temperance, and an avoidance of all gloomy meditations, severe study,  and
indolence, are important measures to be attended to in  the treatment.   Be-
Bide, they should accustom themselves not to lie on  the  back, and should
have some friend to sleep near them, so as to be immediately awakened on
their moaning or making a noise in the fit, for the sooner a person is roused
from a  paroxysm of the nightmare, the better, as, when  in a very high de-
gree, it differs little from a fit of epilepsy.  On awaking from the nightmare
a teaspoonful of the Compound Spirits of Lavender in a little  water  will
remove flatulency and uneasiness of the stomach, and prevent another attack.
Where persons are subject to nightmare,  from  flatulency and acid stomach,
the  following, taken before retiring to bed, will  usually prevent an attack;
Take of Essence of Peppermint ten drops, Carbonate of Potassa ten grains,
Tincture of Capsicum  five drops, water one fluidounce;  mix, for  a draught.
            GASTRIC AND  INTESTINAL  DISEASES.
  Under  the above caption are meant those  diseases which are located in
the stomach, as well as  in one or more of the abdominal viscera, not includ-
ing those which have been referred to in other parts of the work.
                 INDIGESTION,  or DYSPEPSIA.

  Dyspepsia is one of the most frequent diseases with  which the  physician
meets; it is found in every country, at every season of the year, and among
all classes of society, and is more  generally a malady of middle age,  young
poivmis being, as a common rule, exempt from  it.   It usually commences
gradually and in a very insidious manner, producing more or  less distress,
•jul, in many instances, rendering life a burden.  (See Chronic Inflamma-
 ion of the Stomach, page 280.)
  Symptoms.  The  symptoms  of dyspepsia are various, scarcely any two 
396
AMERICAN FAMILY PHYSICIAN.
persons experiencing exactly  the same, though there arc a few common to
all.  At first there may be a sense of fulness,  distension, or weight in the
stomach, a changeable appetite, generally feeble, and sometimes entirely lost'
occasionally the appetite is voracious, or morbidly craving, and  if the patient
makes a full  or hearty meal, he  becomes low-spirited, with  more or  less
weight or pain in the region of the stomach which  continues for some time
after eating,—sometimes there is a desire to eat after having already eaten
and the first mouthful satisfies; there is a constant uneasy feeling, or weight,
or pain, in the region of the stomach; flatulence and acidity of the  stomach
are very common symptoms, and frequently, eructations of a sour or disagree-
able  nature;  not  unfrequently, there  is water-brash, or the vomiting of a
clear, glairy liquor, more especially when the stomach is empty; a sensation
of sinking, or  a fluttering at  the pit of the  stomach;  tenderness  over the
stomach upon pressure;  and sometimes nausea, and even  vomiting; occa-
sionally a loathing of food; the mind is usually depressed or languid; there
is a disagreeable taste in the mouth, especially in the morning  on first wak-
ing ; the tongue is covered with a whitish fur, and sometimes its papillae arc
enlarged; headache is common; heartburn; palpitation of the heart, or strong
pulsation in the region  of the stomach; constipation; urine high-colored and
scalding.   When the nervous system is implicated, the whole system becomes
languid, with great depression  of spirits, hypochondria,  and fear of death, or
impending evil.  As  the disease progresses  the pulse becomes corded  and
frequent, all  the previous symptoms are aggravated, the mind frequently be-
comes  irascible, dissatisfied, and  despondent; colic pains  occur more  fre-
quently and more violent; constipation is more obstinate, or a diarrhea may
take place, in which  the food  passes imperfectly digested;  emaciation  and
loss of strength ensue, the countenance becomes sallow with a  wild,  anxious
appearance, the skin  dry and wrinkled; there is  often  a difficulty  in lying
on the left side, and a morbid susceptibility to cold.   Nightmare is a common
occurrence among dyspeptics.
   Dr. Avery divides derangement of the digestive organs, into  three species,
although other writers have enumerated several.  He considers the  first spe-
cies to "consist in an enfeebled condition of  the stomach, which secretes a
preternatural quantity of highly acid fluid, unfit for the process of healthy
digestion.  The prominent symptoms are, incessant, dull headache, especially
aggravated after dinner, flatulence, an uneasy gnawing sensation in the stom-
ach when empty,  usually  mistaken  for hunger, heartburn,  acid eructations
and belching, especially after eating, profuse flow of saliva into the mouth,
tongue lightly coated, and an unpleasant taste  in the mouth in the  morning,
There is sometimes thrown up a short time after eating, especially the break-
fast, a considerable quantity of limpid, sour fluid, so acrid as to give a scalded
appearance to the tongue and  throat; sometimes it  is mixed  with bitter and
oily matters, but rarely with any of the food taken.  If indigestible food, as
fatty meats, or a considerable  quantity of any fluid be taken at meals, for
some hours after, the distress is increased, all the symptoms aggravated, and
a general feverish disposition induced.  Notwithstanding all this disturbance
in the stomach, the  bowels often  continue nearly regular, and the  action of
the liver not seriously deranged, particularly  in  such  as have frequent acid
eructations.   This species is often attended with a train of symptoms, which
pass for nervous, and which are only to be overcome by  correcting the acidity
of the stomach.   A part of this acid no doubt arises from the ingesta under-
going the acetous fermentation during digestion ;  but much the greater par'
of it is a secretion of the stomach,—a vitiated gastric juice, caused by indi-
gestible or improper food  taken into an enfeebled stomach." 
DYSPEPSIA.
397
  "The second species is marked by hepatic derangement combined  with  im-
perfect digestion.   This form is apt to occur, or  become aggravated,  during
summer, and to remit as cold weather approaches.   Its  leading  features are
connected with bilious  disorder, as remarkable depression  of strength, with
languor and listlessness, especially on rising in the morning, bitter,  disagree-
able taste in the mouth, yellow  fur on the tongue, torpid and irregular bow-
els, high-colored urine, restless, feverish nights,  and progressive emaciation.
The patient often complains of vague pains shooting in  various directions,
sometimes in the shoulders, back  of the neck, and at other times in  the sides
or pit of the stomach, and a sense of weariness in all his limbs ^ almost con-
stant aching  in the back and loins, with a numbness  of the right side and
arm. or a burning sensation at the pit of  the stomach.  The complexion is
often of a dingy hue, and the eyes have occasionally a yellow  tinge.  The
state of his strength is  very uncertain and variable, sometimes he can scarcely
lift up his hand, and soon after he will  walk a mile without much fatigue.
All his complaints are  greatly aggravated  by eating, and he obtains^ so much
relief from fasting,  that he dreads the return of  meals, which invariably add
to his mental,  as well as his bodily suffering, by plunging him into gloom and
melancholy, till finally his temper is rendered so irritable and impatient, that
no  fortitude can repress its sallies.
    '-The third species depends upon a morbid sensibility or irritability of the
inner surface of the stomach and bowels, with more or less hepatic  derange-
ment.   It presents  itself in two forms, either with or without marked  symp-
toms of indigestion.  In the former,  it often goes to the  extent of painful
iudigestion, especially on taking any stimulant article; in some cases, any
solid substance, as a crust of bread, will bring it on,  so that the patient is
obliged to confine himself to light fluid nourishment, in order  to avoid  the
gastric distress, the tormenting headache,  the  nervous agitations, the palpi-
tations, and finally,  the faintness,  nausea, and vomiting, that  is apt to   ensue
on the least error of diet.   When the disease arrives at this stage, the head is
Beldom  free from  pain; solid food is  rejected without having undergone the
least change,  after  remaining for hours in the stomach; the bowels become
torpid; the complexion  dingy; the  strength and flesh waste  rapidly,  and  the
nights  are restless, feverish, and disturbed by frightful dreams.    The func-
tions of the liver are generally much deranged, producing  pain in  the side,
slight,  hacking cough, a sensation  of  weariness, or pain in the  back, loins, and
limbs;  listlessness, with dejection of mind and gloominess.   A most distress-
ing train of nervous symptoms is often connected with this form of the dis-
ease.   The most trifling occurrence frightens and agitates the patient,  produ-
ces  palpitations, and shows his whole nervous system to be acutely sensible.
His bowels also become so morbidly irritable, as to be acted  on violently by
the  smallest quantity of cathartic medicine, producing pain and  uneasiness
which induces the patient to delay its repetition as long as  he possibly can.
   "The other form of  this species is the most  melancholy of  all these
derangements.   Ifis usually known by the name of low spirits, hypochondria,
melancholy, &c, and is extremely various  in its character and forms.   Indi-
gestion seldom forms a prominent feature of the disease; often, indeed, there
are but few or  no symptoms of such derangement  present,  in  which  case the
true seat and nature of the disease may be wholly overlooked.   The persons
most subject to this form are generally past the meridian of life, and such as
have been engaged in active business, particularly in  hot climates.   Flatu-
lence, eructations, sense of distension and weight  at the stomach after eating,
irregular bowels, kc, are present in some cases; in  others,  there are no indi-
cations of bad digestion, or at least very slight ones.   When they do exist, 
398
AMERICAN  FAMILY  PHYSICIAN.
however, they are apt to be overlooked in anxiously attending to the sympa-
thetic affections of other parts.   In some instances the head is affected with
giddiness, and confusion of ideas, ringing in the  ears, and indistinct vision.
In others, the action of the heart becomes exceedingly irregular, throbbing
and beating violently against the side, now and then intermitting, and occa-
sioning great distress and anxiety.  Sometimes there is a severe smarting and
pain in voiding the urine,  which  is often scanty, turbid,  and high-colored
then again abundant and colorless.    But it would be fruitless to attempt to
give a description of all the varied forms of this  Protean  disease ;  one char-
acter, however? is common  to them all, and that is the most dreadful mental
dejection, and a disposition to magnify every unpleasant feeling, and to look
upon their complaints as incurable and fatal.   The bile, in the worst forms
of this species, is often greatly altered from its healthy condition ;  it becomes
thick, ropy, and tenacious, like birdlime, and so  acrid as to irritate and ex-
cite excessive pain in the parts it passes over."
                                 Upon  a microscopical examination of the
                               urine  of  dyspeptic  persons, three kinds  of
                               deposit may be met with, namely, Oxalate  of
                               Lime,  Urates,  and  Triple  Phosphates.  The
                               Oxalate of Lime,  which may be known by ita
                               octohedral crystals, (See Fig. 25,)  is gener-
                               ally  due  to  the  absorption  of oxalic acid
                               itself taken as food, or to  mal-assimilation of
                               saccharine principles, and  is often accompa-
                               nied by more  marked and  obstinate disturb-
                               ance of the heart's action  than accompanies
                               other forms  of dyspepsia.   It may  be pres-
                               sent  in the urine without the existence of any
                               appreciable disease,  disappearing after a time;
  a. Octohedral crystals of oxalate of but when connected with indigestion, the pa-
lime
b. The same, when dry.

       Fig. 26.
                               tient is troubled with  flatulency, is weak and
                               readily fatigued, perhaps grows thinner, sleeps
                               badly, has palpitation  of the  heart, becomes
                               depressed in spirits, and irritable in temper,
                               and has, or fancies he has,  deficiency of sex-
                               ual power.  Sometimes he has a sense of un-
                               easiness or pain across the  loins, empties his
                               bladder frequently,  and in  some cases is af-
                               fected  with boils, or a scaly eruption.  The
                               urate of ammonia,  or  uric acid gravel, (Sea
                               Figs. 26 and 27,) may be the  passing conse-
                               quence  of an excess at  table, or may result
                               from habitual  high living, or be connected
                               with a gouty  constitution;  an  abundant de-
                               posit is  usually  associated with deep-seated
                             „, disease of the liver.  With this species of in-
      b.  Crystals of  uric acid, rare digestion, there is often a torpor of the liver,
                               yellow  complexion, coated  tongue, which
Bometimes dries at nitrht, costive bowels, and  heavy or disturbed and unre-
freshing sleep.  The  triple phosphates,  known by their  minute triangular
prisms, sometimes  truncated  at  their edges, and bevelled at their ext.r^
ties, are  associated with  a state of depressed nervous  energy, and  will W
found in  the  urine passed  sometime  after meals,  or in  the morning urine.
(See Figs. 22 and  28.)
  a. Crystals of
nubes.
forms.
uric acid, squares or 
DYSPEPSIA.
399
  Ordinary appearance of urate of
imonia.  b. Urate of ammonia, lead
   Causes.  One of the most common causes
of dyspepsia is  hasty and  imperfect mastica-
tion of food with want of exercise.  To insure
health, both  the mind  and body should  be
properly  and regularly exercised, with  ap-
propriate  intervals of rest or recreation.  Dys-
pepsia is especially common to those who eat
hastily and in large quantity,  as among mer-
chants, travelers, and hotel boarders.  It may
also arise  from improper food thrown into the
stomach, use of powerful stimulants, alcoholic
liquors, high-seasoned  dishes,  too  frequent
use of warm  fluids, use of tobacco either chew-
ing  or smoking, late hours, profuse  evacua-
tions, excess in venery, masturbation, seden-
tary life,  indolence,  mental depression, great
anxiety, and  anything  which diminishes the ^mon than the preceding.
energies of the  stomach and destroys or  im-
pairs its susceptibilities.  It is frequently as-
sociated  with deficient secretion of bile or
gastric juice, diseases  of  the liver,  spleen,
and womb, rheumatism, gout,  chlorosis, &c.
   Treatment.    This  may  be divided into
medical and  hygienical;  but as no  positive
rules can be given to suit all cases,  without
entering  into a  lengthy detail, I will merely
give  the  general principles of management
of this disease.
   In the  first place,  a  very important point
is, to keep the bowels regular, and it will  be
found that in this respect there will be a great
diversity  in  the  action of medicines  upon
various patients;  hardly any two being oper- ph^f X^^aW
ated on exactly alike.   1  am decidedly  op- phous phosphate of lime.
posed  to  the use of emetics in the treat-
ment of this disease,  except when given, and very  rarely  too, to remove
offending matters from the stomach, or to arouse  a torpid  liver.   But  laxa-
tives, and occasional purgatives, are almost always  necessary.   In former
years I treated dyspepsia very successfully by the administration of one of
the  following powders:  1.  Take  of Bayberry  bark,  Prickly-Ash  bark,
(1 olden Seal, Bittenoot, Bicarbonate  of Soda or Potassa, each,  in powder,
equal parts;  mix. This is for recent cases with want of tone in the stomach,
slight  constipation, and acidity; the dose is from half a teaspoonful to a
teaspoonful three times a  day.  2. Take  of Blue  Flag, Mandrake, Bitter-
root, each, in powder, one ounce, powdered Bloodroot half an ounce, Capsi-
cum two drachms; mix.  This is for old, long-standing cases, with obstinate
constipation;  if acidity  is present  add Bicarbonate of Soda or Potassa one
ounce.  The dose is the same  as the preceding.   These are  excellent medi-
oincs, and will be found occasionally useful even at the present day, but the
recent improvements in  the Materia Medica enable us in  the great majority
of cases to dispense with them.
  The articles I now employ to regulate the bowels, vary according to  their
action.  That which I employ the  most frequently in this and all other dis-
eases of a chronic character, is composed of Powdered Rhubarb two ounces,
 
400                 AMERICAN  FAMILY PIIYSICIAN.

Bicarbonate of Potassa one ounce;  of this mixture  enough  is  given for a
dose,  and-repeated  three  times a day, to produce one, but never more than
two daily alvine evacuations, approaching as nearly  as possible  to those of
health.   It neutralizes acidity, arouses  hepatic  and peristaltic action, and
imparts tone to the whole alimentary canal.  But occasionally, instances will
be met with, in which, even in large doses, this will  produce  no effect, and
then other remedies will have to be  used, among which I will name the fob
lowing:—
  1. Take of Leptandrin  three drachms, Podophyllin, Apocynin,  each, one
drachm,  Alcoholic Extract of Nux Vomica twelve grains, Castile Soap, a suf-
ficient quantity to make a  pill-mass; mix together, and  divide into pills of
three grains each, of which one may be given every  night.
  2. Take of  Tincture of  Mandrake, Tincture of Blue Flag, each, one fluid-
ounce, Saturated  Tincture  of Nux Vomica,  according to its action  on the
person;  mix.   The dose is ten or twelve  drops, to be repeated three  times a
day.  (See Constipation.)
  Another important indication in  treatment will be to neutralize and re-
move acidity  of the stomach;  in  many  cases  the above preparation of
Rhubarb and Potassa will  effect this, but sometimes  it will be found a very
troublesome matter,  requiring various agents before  any  benefit  will be ob-
tained.   Prepared Charcoal in  teaspoonful doses, three times a day, will be
frequently effective; or Magnesia  may be given, either alone,  or in  combina-
tion with the Trisnitrate of Bismuth.   A very excellent preparation is equal
parts of Powdered  Gruaiacum,  Bhubarb and  Prepared  Charcoal,  of which
mixture  a teaspoonful may be given two or three times  a day in milk, yelk
of egg, or Indian meal gruel;  omitting, of course,  other laxatives,  should
this act  as such.  Another good remedy  is composed  of Leptandrin  two
grains, Hydrastin one  grain,  Dried Ox Gall  five or ten grains; mix for a
dose, and repeat two or three times  a day; if there be much debility of the
stomach, a grain  or two of Capsicum may be added.   When there  is  acidity
of the stomach  in the  oxalate of lime dyspepsia, the best remedy is Nitro-
Muriatic acid in doses of five drops every four hours, in  a cold  infusion of
Colombo and Golden Seal.  Or, the Tincture of Muriate of Iron in doses of
ten drops may  be advantageously  substituted in some cases.  But be very
careful to administer none of the  above remedies unless  they are positively
and distinctly indicated, for many are  the  dyspeptic stomachs which have
been  "torn to pieces,"  and ruined forever by the injudicious exhibition of
medicines.  Medicine  should  never be given  except with the view of pro-
ducing  a certain  necessary effect;  if this effect is not known, spare the
patient and administer no  medicine.  It is better to trust to the resources of
nature than to throw drugs blindly into the system.   The  true  practice of
medicine consists, not in enormous doses of drugs, to ascertain how much a
patient may take and recover, but in curing any given disease with the least
medicine possible;  and he is the best physician who can cure his patients
without any physic ;* but, strange  to say, the public have, unfortunately lor
themselves, formed a different opinion.                                .
  The principal object in dyspepsia  is to restore  tone to the stomach, all
other means are merely auxiliary, instituted to  meet certain urgent symp-
toms.  The agents for this purpose  are, chiefly Hydrastin, Aletridin, Alco-
holic Extract  of  Nux Vomica, Black Alder bark, Solomon's Seal,  Colombo,
Gentian,  Compound Tincture of Tamarac bark, and Compound Pills «
Eupurpurin.  But the agent which I prefer to any  other is the Compound
Pill of  Ptelein, composed as  follows: Take  of Ptelein, Hydrastin, eacfl,
twenty-four grains, Extract of Belladonna three grains, Alcoholic Jtftraci 
DYSPEPSIA.
401
 of Nux Vomica two grains;  mix, and divide into twenty-four pills, of which,
 one is the dose, to be repeated three times a day.  This is to  be administered
 in conjunction  with the free use of an infusion of equal parts of Solomon's
 Seal and Black Alder bark.   In most cases these pills may  be used without
 any  auxiliary  measures, and  with the most permanent benefit.  In long-
 standing cases,  or in patients of strumous habits, the following may be given
 in addition: Take of Iodine twelve grains, Sulphate of Morphia three grains,
 Burnt Sponge twenty-four grains,  Extract of Liquorice a sufficient quantity
 to make a pill-mass;  mix all thoroughly together,  and divide into twenty-
 four pills, of which, one may  be given every night and morning.   I hava
 often found the most beneficial results to accrue from the»use of the follow-
 ing mixture:  Take  of Precipitated Carbonate of Iron ten drachms, Inspis-
 sated Juice of Conium Maculatum five drachms, Tincture  of Balsam Tolu
 six fluidounces, Oils of Cinnamon  and Wintergreen,  each, twelve drops,
 White Sugar,  two ounces, Madeira Wine,  Water, of each, half a pint; mix
 together; in a week the mixture will be ready for use.   It may  be  given in
 doses  of from  a  fluidrachm to half an ounce, from three to  six times a day.
   I will now mention some other auxiliary treatment which  may be  pursued
 to remove  certain unpleasant  symptoms.  A high-colored and scalding urine
 may be removed by an infusion of Marshmallow root  and Spearmint, or by
 the use of the Compound Infusion of Trailing Arbutus; this urine will gen-
 erally contain  the urates  and uric  acid.   When phosphates  are deposited
 there is no better agent than the Compound Balsam of Sulphur.
   Excessive flatulence, borborygmi, and colic, may be removed by one or two
 drops  of Oil of Cajeput on Sugar;  by Dioscorein two grains, Ginger four
 grains, mix for a dose; by Dioscorein,  Asclepidin, each, two grains, Ginger
 four grains, mix for a dose;  by small doses of Creosote taken at meal times;
 or, by the  Bisulphite of Soda, taken an hour two after meals, or as soon as
 the evolution of gas  in the stomach begins  to be felt.   In ordinary  cases of
 flatulency, the Compound Spirits of Lavender will be useful.
  For distress or pain in the region of the stomach, which  many persons ex-
 perience, the following will be found prompt and efficacious: Take  of Ale-
 tridin and mix  it up with as much Capsicum as will not injure its  consist-
 ency for forming  pills;  divide into  three  grain  pills, of which one or two
 may be taken shortly after each meal;  this will likewise be found to remove
 nausea, and the sinking sensation which some dyspeptics experience in tho
 region of the stomach.  If there be considerable  irritation of  the stomach,
 the Capsicum must be omitted, and Opium, or Sulphate of Morphia in ap-
 propriate quantity added.  Occasional'.y, a  pill composed of equal parts of
 Aletridin,  Hydrastin, and Capsicum, will  be useful.   Or,  Assafetida and
 dried Ox Gall may be made into a pill,  by means of a little  water,  and ad-
 ministered.  Equal parts of Hydrastin, Caulophyllin,  and Dioscorein,  given
 in doses of six or eight grains, will be useful when the distress is accom-
 panied with, or  is  owing to flatulency.
  Diarrhea, with  acidity  of the alimentary canal, may be  removed by the
 Compound  Syrup  of Rhubarb and Potassa.  two parts, combined with the
 Fluid  Extract  of Wild Cherry, one part;  this will  also be  beneficial in
checking vomiting; give it in  table-spoonful doses  every hour or two.  If,
however, it should  not answer in either of these  symptoms,  equal parts of
Laudanum, Chloroform,  and Tincture of Wild Cherry  may then be given io
doses of twenty or thirty drops, every one, two, or three hours.
  Water Brash and headache will require the same treatment as  laid  down
under their respective heads, which see.
  Gastralgia, or a burning pain in the stomach, may generally be removed 
402
AMERICAN  FAMILY   PHYSICIAN.
by  the administration of Trisnitrate of Bismuth ten  grains, Lupulin two
grains,  Sulphate of Quinia half a grain; mix for  a dose,  to  be repeated
every four hours.   Spasm of the stomach will yield  to a few drops of Chlo-
roform and Laudanum in some Elm Mucilage, or infusion of Scullcap; or
a teaspoonful  of the  Compound Tincture of  Virginia  Snakeroot may be
given in a warm infusion of Scullcap, or Ladies-Slipper  root.  (See Cramp
page 366.)   When dyspepsia is complicated with spinal  tenderness or  pres-
sure, counter-irritation,  as dry cupping,  firing, stimulating liniments, &o.
must be applied to the tender parts.   When it is owing to  other diseases, as
of  the  liver, kidneys, womb,  &%.,  these  must be  treated  as  the primary
affection.
  Although remedial measures are fisquently necessary in  the removal of
dyspepsia, yet, they will accomplish very little if a strict hygienic discipline
be not attended to; indeed, a proper attention to hygienical  rules will often
accomplish cures, without the aid of even a particle  of medicine.  And too
much care cannot be taken to impress this on the mind of the patient.  In
the first place, the skin should be closely attended  to;  between  it and the
stomach there are close sympathetic relations, and the healthy or  unhealthy
condition of the one will exert a corresponding influence upon  the healthy
or unhealthy condition of the other.  It should be  bathed every day or twe
with a weak alkaline solution, and in drying, considerable  friction should be
used; an occasional shower-bath or cold douche to the spinal column, will be
&f much importance in some cases.   The  food  should be  plain, simple, nu-
tritious, but easy of digestion, and great pains  should be  taken to masticate
it well  before allowing it  to enter the  stomach; indeed, I  have cured many
cases of dyspepsia, by simply placing the patients upon  a  meat diet, enjoin-
ing it  upon  them not to swallow  any food,  but  to  keep chewing  each
mouthful until it is gone;  for when well chewed, the food will pass into the
stomach spontaneously.   All fats, tough meats, pastries, hot bread, hot bis-
cuit, eggs, soups, puddings,  highly seasoned dishes, acids,  and all  articles
which disagree with the stomach, producing uneasiness  or flatulence, must
positively  be avoided.  The best meat is the lean of tender beef, cooked
rare, but  codfish and most kinds  of wild game will be admissible where
they agree.   Tender mutton,  venison, the white  flesh  of chickens  and
turkeys, raw oysters,  roasted, baked, or boiled ripe fruits,  mealy potatoes,
brown bread, wheat bread, at least one day old, may be  used.   Hard-boiled
eggs,  cabbage,  lettuce,  onions,  radishes,  turnips,  cheese, sweatmeats, tea,
coffee, all intoxicating drinks, pickles, dumplings, and sausages, are exceed-
ingly improper.   (See articles of diet, page 36.)  The  best drink is water,
and, where it can be used without any  unpleasant symptoms, milk may be
used.    Indeed, as a general rule, the  patient  should eat  what best agrees
with his digestive organs, 'partaking of only a few articles  at each meal, and
in very moderate quantity, and slowly and thoroughly masticating them, h
is best not to use much liquid at a meal, or during the process of digestion.
The stomach should  never be overloaded at  a meal, neither should it be
allowed  to fast so long  as  to cause a  sense of exhaustion.  It is better to
make several moderate meals per day, at short  intervals, than  to  make ful
meals only two or three  times a  day.  The supper should always be light,
and taken at  least an hour and a half before retiring for the night. A"
much laughing, cheerful  conversation, and liveliness as possible, should be a
constant attendant at meals; they assist digestion materially.  After exercise
of any kind, whether  walking or riding, &c, a  rest of at least half an  hour
should  be taken  previous to eating a meal;  and after the meal a rest ol
about the same period of time should likewise follow before  any mild exer-
cise is taken. 
FLATULENT COLIC.
403
  Exercise is of great importance, and that kind of exercise should be taken
which will call all the muscles  of the  system into action, without straining
or fatiguing  them.  Walking, running, jumping, dancing, playing ball, foot-
ball, sawing  wood, rowing a boat, &c,  are healthful, and should be practised
regularly every day, according  to the strength and condition of the patient.
Traveling is  serviceable, likewise a  change from the contaminated air of a
city to the pure, refreshing atmosphere of the country.  Retire to bed early,
rise  early, improve the  morning air on every fine day; avoid  late hours,
crowded  rooms, habits of indolence,  dissipation, and  fashion. ^ Keep the
mind cheerful and  pleasantly occupied, driving away care, anxiety, gloom,
melancholy,  and deep study.   Indeed, I may say that the hygienic  meas-
ures referred to in the Introduction, relative to air, food, mastication,  cloth-
ing, exercise, sleep, cleanliness, &c, should be strictly followed by the dys-
peptic as an  important and indispensable part of the curative  treatment.   I
would remark here that where  the concentrated preparations above referred
to in the medicinal  treatment cannot be obtained, the crude articles in
powder, or infusion, may be substituted in proper doses.
                        FLATULENT  COLIC.

   Tiie term Colic or Enteralgia, is generally applied  to any severe griping
 pain of the bowels.  There have been many varieties  admitted  by different
 writers;  the chief forms  may, however, be  divided into:  1. Common or
 Flatulent Colic ;  2. Bilious Colic; and  3. Painter's Colic.
   Symptoms.   Flatulent  or spasmodic colic is a very painful affection, sel-
 dom proving fatal, and is very apt to occur in dyspeptic subjects and  in-
 fants.  There  is a violent pain in some  part of the abdomen, with  a sense
 of twisting or griping about the navel.   The  pain  is severe, but  is not in-
 creased on pressure, and presents all the  character of spasm, by remitting
 or partially subsiding.  There is more or  less fulness  or distension of the
 abdomen, and costiveness, with a rumbling noise, nausea, and  coldness of
 the extremities.   The  pain frequently  shifts about in the bowels, and is
 considerably relieved upon the  escape of wind either by the mouth or rec-
 tum.   The pulse  is small, and often  unaffected.   If not relieved, a severe
 inflammation of the bowels may ensue.
   Discrimination.  Colic may be known from inflammation of  the small
 intestines by the  state of  the  pulse,  and  by  the pain  in the former being
 lessened  on pressure, and aggravated in the  latter ; in colic there is  no
 fever.
  Causes.  A weak or enfeebled condition of the digestive organs disposes
 one to  this form of colic; and  it  may be excited by crude, indigestible
 aliment, acid food, wind, over-distension of the stomach by flatulent articles
 of diet, a redundance of acid bile, constipation, exposure to cold, &c.
  Treatment.  When  colic occurs  shortly  after  a meal, or after eating
 crude substances,  the stomach should be  at  once  evacuated  by an emetic,
 and this followed  by a cathartic; but under other circumstances the emetic
 may be dispensed with.  A cathartic  should be administered in most cases,
and the Compound Powder of Jalap, or,  a  full dose of Castor Oil with Oil
of Turpentine  ten drops, and Essence of  Peppermint  thirty  drops, added,
may bo employed.   In severe cases, much  benefit will  be  received, by un-
loading (he lower bowels, with a cathartic injection, similar to  that named
 under Convulsions, on page 358, or under Apoplexy, on page 346.
  \\ hen  the pain  is very severe, temporary, and  in many instances perma- 
404
AMERICAN FAMILY  PHYSICIAN.
nent relief may be obtained by the administration of tho Compound  Caje-
put mixture, or, by a mixture of equal parts of Laudanum, Tincture of
Camphor, and Essence of Peppermint, in teaspoonful doses.   The stomach
and bowels should be rubbed briskly, bathing them often with  a mixture
of equal parts of Tincture of Capsicum, Tincture  of  Camphor, and Essence
of Peppermint.  In  many  cases,  the  Compound  Tincture of  Virginia
Snakeroot will be found an effectual internal remedy.
  Infants are  subject to flatulent  colic, which may be occasioned from a
retention  of the meconium, from  a constipated condition of the bowels,
from overfeeding, improper diet of the mother or nurse, feeding the infant
solid  food at too early an age, cold, &c,   Its attack is  apt to be sudden,
occasioning great pain.   The cries  and screams of  the child are constant
and agonizing, the bowels are hard and swollen, the  limbs are tossed about
in various  directions, the legs being alternately  thrown  downward, and
then up toward the bowels, and the child is in a constant state of restless-
ness and agitation.   To relieve this  condition, an injection must be admin-
istered as speedily as possible, composed of a table-spoonful of  Castor Oil
and a fluidounce of  a warm  infusion  of  Peppermint.   At the same time
some carminative and antacid must be administered internally, as, a warm
infusion of Peppermint, in which  a minute proportion of Bicarbonate of
Soda is dissolved; this may be sweetened with loaf sugar, and administered
freely.  In some instances, especially when it is required to act  upon the
bowels, the Compound Syrup of Rhubarb  and Potassa, may be given, in-
stead of the  above.   Should there be a cessation  or  difficulty in passing
urine, an infusion of Spearmint may be  substituted for  that of the  Pep-
permint.
  In  violent attacks, in addition to the above measures, the whole body of
the infant should be  enveloped in hot flannel, and then resting its belly on
the nurse's knee, she should  trot it  thus for a considerable time, while she
also strikes its back lightly with her hand, keeping  up a constant series of
strokes along the whole length of the backbone.   I have relieved the most
violent attacks of colic by this course, where the infant had  been suffering
and shrieking for several hours, and had been subjected to the baneful and
inefficacious  influence of hot slings, Paregoric,  Godfrey's Cordial, &c.
Where attacks of this kind  are common to  infants, they may be remedied
by the use of the following:  Take of Pleurisy root, Hops, each, one ounce,
Scullcap, Valerian, each, half an ounce, Anise an ounce and a half, boil-
ing water three pints; mix, and digest by a gentle  heat for two  or three
hours, and then sweeten  with molasses.  The dose is from five drops to a
teaspoonful.
   Persons who are subject to colic should abstain from all crude, indigesti-
ble, and  flatulent food, from fermented liquors, and  should avoid expo-
sures to cold and damp, keeping the bowels regular, and the stomach free
from acidity by the use of some alkaline laxative.
BILIOUS  COLIC.
  Bilious Colic is often confounded with  flatulent colic, but it is a more
grave and alarming  disease.  It is  common during summer and autumn,
especially in warm and temperate latitudes.                          .
  Symptoms.   Previous to the manifestation of the positive symp'™
bilious colic, the person generally labors under  more or less derangei
of the stomach and bowels, as, loss of appetite, bitter taste in the mout, 
BILIOUS  COLIC.
405
 oonstipation, white or yellow fur on the tongue, chilliness, nausea, vomit-
 ing, and a sensation of weight or heaviness at the pit  of the stomach.   As
 the disease advances, the colic pain comes on, and becomes more and more
 severe,  being of a cutting and  screwing  character.   Sometimes  it com-
 mences in the neighborhood of the stomach, and extends to the back; at
 others, it attacks the bowels generally, twisting around  the  navel as in
 common colic.  This pain  is aggravated by pressure.  As the disease pro-
 gresses the fur on the tongue becomes yellow, vomiting of a bilious matter
 takes  place,  the  bowels are swollen,  tender  and  painful  on  pressure
 obstinate costiveness  is present, and  febrile symptoms, with great thirst
 unxiety, &c.   If speedy relief be not obtained,  a complete  inversion of the
 peristaltic action  of the bowels may ensue, and in violent cases, even the
 feces have been passed by the mouth.
   Causes.  Bilious  colic  appears to be a spasmodic  or neuralgic affection
 of the muscular coat of the bowels, which may be brought about by irrita-
 ting substances in  the bowels, vitiated bile, exposures to  cold, translation
 of rheumatic or neuralgic affections, recession of cutaneous eruptions, con-
 stipation, &c.  If it  be  left to  itself, or be not properly treated, bilious
 colic may terminate in inflammation, mortification, and death.
   Prognosis.  When the bowels are moved, with an  amelioration of the
 general symptoms, it augurs  favorably;  but excessive  febrile action, rapid
 pulse, sallow countenance, great swelling and tenderness of the bowels, with
 the constipation remaining obstinate, and great uneasiness or restlessness,
 arc  unfavorable  symptoms.  A  sudden  cessation of  pain, cold  sweats, a
 weak, tremulous pulse, faintings, and hiccough, indicate a  fatal termination
 by gangrene.
   Treatment.   An active cathartic injection  should be administered as
 Bpeedily as possible, in order to  remove  the constipated  condition of the
 bowels ; the  one  I generally prefer  is  composed of  Boneset two ounces,
 Senna one  ounce,  water a  pint;  mix,  boil  together, and make  a very
 strong decoction.   To one pint of this decoction  add  half a table-spoonful
 of salt, half a  pint of molasses, and a tablespoonful of the  Compound Tinc-
 ture of Lobelia and Capsicum.  Give  the  whole, warm, for an  injection,
 and repeat every  fifteen minutes  until an  operation  is produced, and the
 pain eased.   Fomentations of bitter herbs  should also be  applied over the
 whole stomach and abdomen, as warm as the patient can bear, and  should
 be frequently renewed; Hops and Stramonium leaves, or Hops and Lo-
 belia, or Hops, Boneset, Wormwood, &c, may be used for  this purpose,
   Internally, a strong decoction  of the Wild Yam root, should  be given in
 tumblerful doses, and repeated every fifteen or thirty minutes;  there is  no
 agent that will act so promptly and so permanently as this.  Or, three or
 four grains of Dioscorein may be  rubbed up with a little  Brandy, and ad-
 ministered for a dose,  repeating it every ten or twenty minutes, until relief
 is  obtained; after which, a  mild  cathartic should be  administered, as  the
 Compound  Powder of Jalap.  In  case the Wild Yam cannot be obtained,
 a strong decoction of equal  parts  of Scullcap and High Cranberry bark,
 may be substituted, to each dose  of which  a teaspoonful of the Compound
 Tincture of Virginia Snakeroot may be added.  To prevent a relapse of the
 disease, the following should be taken for several days after the attack :—
 Take of Pleurisy root, Unicorn root, Button  Snakeroot, of each,  eigh|
 ounces, Capsicum four ounces; mix.  The dose is a teaspoonful, in sweet-
ened water, to be  repeated three times a day.  Or, it may be used in decoc-
tion.  This compound administered every half-hour, has likewise cured an
attack of bilious colic. 
406
AMERICAN  FAMILY PHYSICIAN.
  In the treatment of this disease, perspiration must not  be  overlooked
All means must be made use of to promote it, as soaking  the feet in warm
weak  ley water, and warm  bricks  applied  to  the limbs and body;  and
where it can be done, a Spirit vapor bath will prove highly beneficial.
  Persons subject .0 bilious colic should be careful in  their diet, keep the
bowels in a regular condition, the  skin  clean and healthy, and avoid all
causes  which  may induce an attack.  The  following pill used constantly
for some months, will effect a  permanent removal of the disposition to this
pisease, if the  other hygienic measures be attended to at the same time :—
Take  Extract of High  Cranberry  bark, Aletridin, Dioscorein, Capsicum
each equal parts;  mix thoroughly together, and divide into pills of four
grains each.   The dose is one pill, to be repeated three times a  day, about
one hour after each meal.
                  PAINTER'S  or  LEAD  COLIC.

  Painter's Colic,  (Colica Pictonum,) is a disease caused by lead.   Those
occupations in which lead is the most used, are the most subject to it; and
the more volatile the lead is  rendered, the  more readily does it affect the
system.  Painters, plumbers, type-founders,  miners, and  all who use lead
in its various forms,  are the persons liable to this affection.
  Symptoms.   Lead colic comes on gradually, being preceded by a sense
of depression or sinking, despondency,  disinclination to mental or physical
efforts, derangement of the stomach  and  bowels, scanty  and not frequent
discharges  from the  bowels, and  an uneasy sensation in the  pit of the
stomach.   This sensation gradually increases until it becomes an excrucia-
ting pain, extending downward into the bowels, especially about the navel,
and which  is described as a severe, twisting  pain.  Nausea, vomiting, con-
etipation, headache, ineffectual efforts to  evacuate the bowels, scanty and
often suppressed urine, great thirst, and pains in the wrists and ankles, are
generally accompanying  symptoms.  Nearly all the external  muscles are
tender to the touch,  sometimes so  much so that the patient cannot bear the
weight of the bedclothes.   The  twisting pain is not increased by pressure,
and exhibits remissions and exacerbations ; the bowels are retracted, while
their walls  are hard and tense, and their  muscles contract into hard and
irregular lumps or knots; the patient is  constantly restless.  Paralysis of
some part of the system is frequently an  accompanying  symptom, princi-
pally of the muscles  of the forearms.
  Burton says, that in many instances where lead is absorbed into the sys
tern, the edges of the gums attached  to the necks of two  or more teeth oi
either jaw,  are distinctly bordered  by a narrow leaden-blue line, about the
twentieth of an inch  in diameter;  but it is not always present.  Pereira de-
tected lead upon the surface of the body by applying to it a wash made of
half an ounce of Sulphuret of Potassium dissolved in about three and three-
quarter gallons of water; if lead be present, it blackens the solution, or the
part to which it is applied.
  Treatment.  The indications are to remove all irritating agents in the
bowels, to  neutralize the  poisonous influence  of the  lead, and to check
vomiting,  for which  purpose,  the following will  be found an admirable
agent:—Take of Sulphate of Magnesia half  a pound, Powdered Alum one
ounce, Sulphuric Acid, (pure, without any arsenic in  it,) one fluidrachm
and a half,  boiling water one pint  and a half; mix.  The  dose of this solu-
tion  is a table-spoonful  in a gill of water, and which should  be repeated 
                           WATER BRASH.                        407

every hour  until It operates  freely upon  the bowels; to prevent the teeth
from being  acted upon by the acid, the solution  may be sucked through a
quill, or glass tube.   After it has operated freely, its use should be contin-
ued daily for some weeks or months afterward, in  doses sufficient to pro-
duce one or two evacuations every twenty-four hours.  The Sulphuric Acid
of the mixture, by uniting with the Oxide of Lead in the system, forms the
harmless and insoluble salt, Sulphate of Lead.   A decoction of Ground Ivy,
(N-peia (,'lechoma,) used freely, is  stated not only  to ward off the  disease,
but to cure it when  once  developed;  it is  certainly worth a trial.   Malic
Acid will also  be found a very useful  agent in  preventing  and removing
this painful disease ;  it exists plentifully in the juice of barberries, in apples,
currants, and other fruits.
  In addition to this, when the pains are very severe, local applications to
the abdomen, and injections, the same as those  mentioned  under Bilious
Colic, should be used more or less energetically, according to the urgency
of the symptoms.
  Alum has been recommended in this  disease,  thus:—Take of Powdered
Alum fifteen grains, Cuaiacum ten grains, Aloes  three grains; mix for a
'h>«.',, and repeat every two or three hours.
   Persons  who work in lead should observe great care not to permit the
metal to touch*theskin; they should frequently wash their hands and faces,
and should always rinse their mouths previous to eating.  Once or twice a
week, the whole body should be bathed with a weak solution of Sulphuric
acid in water.  Their food should  not be kept in places exposed to lead or
its vapors.   Their working clothes should never be worn at home, and should
be  frequently washed; and  their heads  should  be protected by a cap of
paper, or other material that will prevent the particles of lead from getting
into the hair.   A free draught of air should be passing constantly through
their working  rooms.  The  diet should be nutritious and hearty, but all
intemperance or excesses must  be avoided.   The bowels must positively be
kept regular daily;  and the individual  may frequently drink diluted Sul-
phuric Acid sweetened, or the following will be  found  a very pleasant  and
useful drink:—Take  of Elixir Vitriol half a fluidounce, Tincture of Prickly-
Ash berries a fluidounce: mix.  A teaspoonful  of this may be added  to a
gill of sweetened water, and  taken at a  draught;  and it may be repeated
three or four times a day; or the water  may be sweetened with  Barberry
preserves.   Persons should never occupy nor sleep in newly painted houses
or rooms, as frequently very unpleasant  symptoms  are produced therefrom.
                         WATER  BRASH.

  Water Brash, or Pyrosis,  consists in  the  discharge of a thin, watery
liquid from  the  stomach, sometimes insipid, and at others extremely acid,
and is commonly attended with a sense of burning heat in the region of the
stoniiirh.  It chiefly attacks persons of middle age, especially females who
labor under leucorrhea.
  Symptoms.  Pyrosis more commonly makes its attack in the morning, or
when the  stomach is empty.  The  patient first perceives a pain at the pit
of the stomach, with a sense of constriction, as if  the  stomach was  drawn
toward the back, and the erect posture is apt to aggravate it.  Sometimes
the pain is very severe; after it has continued for a certain time, frequently
repeated eructations occur, with the ejection of a considerable  quantity of
thin, watery fluid, either insipid, or very acid, and occasionally of a ropy, 
408                AMERICAN  FAMILY PHYSICIAN.
tenacious consistence.   After a time, the eructations and discharges, as well
as the pain, cease.  The paroxysm may  occur daily, or only occasionally
and the quantity of fluid ejected  may vary from a fluidounce  to a pint or
more.  The disease rarely proves fatal, but is frequently a very troublesome
one to remove, depending, however, much upon its cause.
  Causes.   Water brash most frequently occurs  in anemic and dyspeptic
patients; and, when severe, exhausts the system, rendering the person pale
thin, weak, and in bad spirits.  A poor,  coarse, innutritious diet is a very
common  cause;  insufficient clothing, loss of blood, excessive purgation or
emesis, excessive labor, constipation, distressing mental emotions, pregnancy
and all circumstances that exhaust the body, or disorder the functions of th«
stomach, may give rise to it.
  Treatment.  In ordinary cases of water brash, the following taken every
morning, fasting, will be found well calculated  to remove it:—Take of the
Compound Tincture of Senna, Tincture  of Balsam  Tolu, each, one fluid-
ounce; mix.   The dose is a table-spoonful.   In many instances, I have
found  the following preparation a most effectual  one, not only in pyrosis,
but also  in  flatulency, colic, hysteria, depression of spirits, &c.:—Take  ol
Balsam Tolu, Guaiacum, Gruui Hemlock, Myrrh, of each, coarsely powdered,
two ounces, Oil of Hemlock three fluidounces, Oil of Wintergreen two fluid-
ounces, Alcohol one gallon; mix, and allow them to maceratevfor two weekSj
frequently agitating.  The dose  is a teaspoonful in  half  a wineglass  of
sweetened water; in severe cases, it may be  increased.
  Among the many agents that have been advised in this affection, are :—
1. Trisnitrate of Bismuth  five grains, Sulphate of Morphia one tenth of a
grain; mix  for  a  dose.  2. Alcoholic Extract  of  Nux Vomica one grain,
Hydrastin twenty grains; mix and divide into twenty powders, one of which
may be given three times a day.  3.  Powdered Kino, Alum, Geraniin, each,
one grain, Opium half a grain; mix for a dose.  4. The mixture of Guaia-
cum, Rhubarb,  and Charcoal, mentioned on page 400, under the treatment
of Dyspepsia, will sometimes be found efficacious, especially when  acidity
and constipation are present.
  Persons laboring under  pyrosis, should live on a nutritious diet,, should
not expose themselves to cold and moisture, and should not exercise to fa-
tigue.  The skin  should be kept healthy, the bowels regular, and means
should be taken to strengthen the stomach.  (See Dyspepsia and Chronic
Inflammation of the Stomach.)  Long fasting must be avoided; it is better
to make frequent and light meals,  than to  permit the  stomach to get empty.
When anemia is connected with pyrosis, some preparation of Iron must be
given, as the Tincture of Muriate  of Iron, Citrate of Iron and Quinia, or a
pill composed of equal parts of Sulphate of Iron, Capsicum, and Aletridin.
Acidity of stomach may be removed by Magnesia, Charcoal, or Carbonate
of Ammonia.   In  very severe  cases, the Compound Tar plaster, applied over
the pit of the stomach, will generally, in connection with the other measures,
afford relief.
  There  is  sometimes vomiting  of a fluid  of a frothy character, or which
 oon  becomes so  after standing  for a few  hours, and which may be con-
founded with pyrosis.   This fluid  has a faint acid odor, and is filled with a
torulous  or  fungous growth, to which the term sarciua  ventriculi has been
applied.   It ordinarily consists of minute square,  oblong, or even irregular
masses, of considerable  consistence, composed of four, eight, sixteen, sixty-
four, or more, squarish cells, having a slight brownish color, each cell being
about the 1.16,000th of an inch in diameter; they somewhat resemble small
pockets  bound with cords  crossing each other at right angles, and then 
HEARTBURN.
409
presence can only be determined by examining a drop of the fluid vomited
under the microscope, when they may be usually seen in abundance.  It
may be attended with pain or distress, as in ordinary pyrosis, and has oc-
curred without either.
  When sarcinse ventriculi are present with pain, heartburn, distension of
the stomach, disturbed sleep, and  loss of flesh, means must be used to pre-
vent the fermentation of the food in the stomach, and to destroy the fungi.
For the  accomplishment of the first, a drop or two of Creosote, in  the form
of pill, should be taken at every meal.   Or, what is still better, the Sulphite,
or Bisulphite of Soda, may be given, in  doses of from fifteen grains to a
drachm, dissolved in water, and repeated two  or three times  a day, soon
after meals.  To destroy the parasitical fungus, vegetable bitter tonics may
be given, thus;—Take of  Quassia, Unicorn root, Bark of Shrubby Trefoil,
each, in  powder, three drachms, water twelve fluidounces; mix, and make a
strong infusion, to which add from four to six drachms of the Sulphite of
Soda, and give  a table-spoonful soon after each meal, three  times a day.
This Sulphite, or Bisulphite, owes its virtues to .the fact, that it is decom-
posed by almost any vegetable acid,  or  by the  hydrochloric acid of  the
stomach, and that this decomposition  liberates sulphurous acid, which has
great power to prevent alcoholic and acetous fermentation.  The diet should
be of the least* irritating kind.
  Other  agents have  been recommended to prevent  the  fermentation,
as Salt in doses of from one to four drachms, dissolved in water, and re-
peated two or three times a day.  Or, take of Solution of Chloride of Lime
one fluidrachm,  water  seven fluidrachms; mix.  A table-spoonful of this
to be taken three times a day, shortly after each meal.
                            HEARTBURN.

   Heartburn, or Cardialgia, is a very unpleasant symptom, and is usually
 owing to excessive acidity of stomach.   It is a very common affection among
 dyspeptics and pregnant women.  It may be  occasioned by debility of the
 stomach, fats, high-seasoned food, acids, indigestible substances, liquors, &e.
   Symptoms.  There is an uneasy sensation at the pit of the stomach, with
 great heat and  burning, sometimes amounting  to actual  pain, and which
 frequently extends up into the  throat.  There may be difficult breathing,
 vomiting, coldness of the extremities, and great restlessness,  and anxiety
 accompanying it.  The fluids vomited are clear, sour, and bitter.
   Treatment.  Temporary relief may be obtained by Chalk, Soda, Mag-
 nesia, Lime  water, or any other antacid.  In some cases, Carbonate of Am-
 monia will be useful;  in others, especially when constipation is present,
 the Compound Syrup of  Rhubarb and  Potassa.  When there is flatulency,
 aromatics may be added to the alkalies.   If the use of alkalies be persisted
 in for a considerable time, the tone of the  stomach will  become injured
 thereby.   Not unfrequently,  no benefit will  be  derived from the  use  of
 alkalies,  especially among pregnant females; but, on the contrary, acids
 will prove efficacious, as solutions of Tartaric or Citric Acids, Lemon Juice,
 Elixir Vitriol, .fee.
   In all cases of heartburn, in order to prevent  its return, means must be
 taken to  strengthen the stomach, for which purpose the following pill may
 be used:—-Take of Sulphate of Quinia twenty grains, Alcoholic Extract of
Nux Vomica two grains, Ptelein enough  to make the whole  into a mass Ox
pilular consistency;  mix.  Divide into forty pills, and  give one for a dose,
repeating it three times a day. 
410
AMERICAN FAMILY  PHYSICIAN.
  A rigid attention must be paid to the diet, which should be light, nourish-
ing and easy of digestion.  All articles which become sour or flatulent in the
stomach must be avoided.  Cleanliness, regularity- of bowels, and proper ex-
ercise are likewise necessary.
                               VOMITING.

   Vomiting frequently occurs without any manifest  cause, and  sometimes
proves very troublesome.   If it be owing to acidity, Magnesia or  some ant-
acid may be given to overcome it.   If it be owing to constipation, the Com-
pound Powder of Rhubarb and Potassa may be given.  If irritability of the
stomach cause it,  equal  parts of Essence of  Peppermint, Laudanum and
Tincture of Camphor, may be given in half teaspoonful doses, in an infusion
of Spearmint.   If it be owing to a depressed condition of the stomach, a few
drops of Aqua Ammonia and Tincture of Capsicum in Brandy, will check it
But frequently these will fail, and other means will have to be resorted to  as
Soda Powders, Champagne, an infusion of Parched Corn, an infusion of Oat
Meal made into a cake with water and then browned like coffee, or a drop or
two of Creosote in pill.   The patient should be kept in the horizontal posi-
tion, and in severe cases, will require a Mustard poultice over the pit of the
Btomach.  Sometimes the Trisnitrate of Bismuth five or ten grains, with one-
eighth of a grain of Sulphate of Morphia, will answer admirably.
  The vomiting produced by the motion of a vessel at sea, called sea-sickness,
is a very annoying difficulty, and  may generally be relieved by  the person
lying upon his back, remaining perfectly quiet and motionless, and occasion-
ally  taking a draught of Brandy, Spirits, or Champagne,  being careful, how-
ever not to take too much.    When  the weather is  fine,  more benefit will  be
derived by lying upon deck, about the middle of the vessel, instead of in the
cabin berth, where there is not a free exposure to the atmosphere.   A draught
or two  of good Cider, with ten or twenty drops  of  Laudanum to each, will
frequently be of service.
  For the vomiting of pregnant women, there is  no specific remedy; fre-
quently it will continue in  spite  of all the  means  employed  to check  it
Sometimes, alkalies and aromatics combined will be found efficacious; at oth-
ers vegetable acids,  as Lemon juice,  a solution of Citric or Tartaric Acid;  in
some instances, Soda Powders,  Seidlitz Powders, and even Champagne taken
in the morning, have prevented the vomiting.   A piece of toast and a cup of
coffee taken by the  female while in bed, and immediately followed by sleep
of half an hour or  an hour, will prevent any nausea  or vomiting upon her
subsequently arising, in most  instances.   The bowels should be kept reg-
ular, and proper diet used; and in severe cases cohabitation  should  be pro-
hibited.
                              JAUNDICE.
  Jaundice or Icterus is characterized by yellowness of the skin  and eye?,
whitish or clay-colored  stools,  and a bilious or saffron-tinted urine, which
stains linen a deep yellow color.   Bile may readily be detected in the urine
by the following methods:—1. Liquor Potassa will dissolve the coloring mat'
ter, and render the urine almost transparent.   2. Place a small quantity of
the urine on a white plate, and let foil a few drops of Nitric Acid upon it; ij
bile be present there will be a play of colors, from green to red, violet, and
pink. 
JAUNDICE.
411
  Symptoms.   Jaundice usually commences with a feeling of languor, inac-
tivity, disposition to sleep, loss of appetite, flatulency, and constipation.  As
it advances, the skin and eyes assume a deep yellow tinge, and which, on dis-
section of those who die of the disease, pervades the most interior parts of the
body; the mouth frequently has a bitterish taste; the tongue is covered with
a dirty yellow fur; there is often pain in the head,  and almost always a more
or less severe pain in the right side, which is increased  on pressure;  some-
times there is a sense of heat and itching of the skin; nausea and vomiting
are not uncommon ; the urine is very high-colored ; the  bowels constipated,
with greyish stools, and pulse variable.  When the color of the eyes and skin
is of a green tinge, it is called green jaundice, and when it becomes very dark-
colored, it is termed black jaundice.   It  is no uncommon result for the dis-
ease in this latter form to terminate in an incurable dropsy, or fatal hemor-
rhage from some part of the body.
  Causes.   Jaundice  may be produced by  various  causes, as gall stones,
viscid bile, tumors pressing  on the bile duct, spasm of the gall duct, diseased
liver,  disease  of the heart, and mental emotions.  It is frequently brought on
by  intemperance, an inactive, sedentary life,  obstinate costiveness, or any-
thing that may interfere with the regular functions of the liver.  It may fol-
low inordinate  action of the  liver, but is more commonly met with in instan-
ces where this  organ is torpid and inactive.
  Prognosis.   Under ordinary circumstances, jaundice is rarely fatal, and
when the symptoms gradually subside under treatment, it will be very likely
to prove  successful.   The jaundice occurring  during pregnancy, generally
disappears after delivery.  The unfavorable symptoms of jaundice are, a vio-
lent pain in the right side, or pit of the stomach, quick pulse, loss of strength
and flesh, dark  or livid color of the skin, dropsical  swellings of  the feet and
legs, chilliness,  great wakefulness, melancholy,  and hiccough.
  Treatment.    In cases of great inactivity of the liver, it will be well  to
commence the treatment with an emetic, as the Compound Powder of  Lobe-
lia.  But in most instances this may be dispensed with, and an active cathar-
tic given; for  this purpose the Compound Pills, or  Powder of Leptandrin,
may be given until free catharsis is produced, after which  sufficient should
be given  to produce one or two moderate evacuations daily.  However, should
the disease be associated with gastro-intestinal irritations as manifested by a
frequent  pulse,  soreness on pressure over the region of the stomach, and red
tongue, these active measures will have to be omitted, and the chief reliance
placed upon the several measures now about to be  named,  always, however,
keeping the bowels regular.
  The skin should be bathed daily with a weak alkaline solution, using con-
siderable friction in drying.  In some instances, a bath of vinegar and water,
or, very much diluted Nitro-Muri&tic Acid, will be  found preferable.   When
there is any tenderness in the region of the liver, stomach, <&c, Mustard poul-
tices, and fomentations of bitter herbs, should be applied over the part from
time to time,  until such tenderness is removed.
  In addition to these measures, one of the following preparations  must be
given, and continued until the disease is cured:—
  1. Take of Sheep Laurel leaves, Wild Cherry bark, Prickly Ash bark, and
Bloodroot, each, in coarse powder, one ounce,  good Cider  four pints; mix,
and infuse for several  hours.  The dose is a  table-spoonful three or four
times a day.
  2. Take of Horse-radish root, Bayberry bark, Wild  Cherry bark, Golden
Seal, each, in coarse powder, one ounce, good Cider four pints; mix, prepare,
and administer  the same as the preceding. 
412
AMERICAN FAMILY PHYSICIAN.
   3.  Take of Wild Cherry  bark,  Sheep  Laurel leaves, Barberry bark, and
 Bitterroot, each, in  coarse  powder, one ounce, good Cider four  pints-'mix
 prepare, and administer the same as the preceding.
   The diet should be plain but nutritious, and  composed  chiefly  of vegeta-
 bles.   Good  Cider may be drank several times a day, it forms an useful med-
 icine  in this disease; and stewed  Barberries, or Barberry preserves, may be
 advantageously used.   Moderate exercise  should be taken, when there are
 no symptoms of irritation or inflammation.   Raw eggs are very useful  and
 may  be  taken every morning.   The patient should by all means resist the
 tendency to mental and physical inactivity when this is present.
   Among the agents recommended for  the  cure of jaundice are the follow-
ing:—Take of good hard wood Soot one ounce, Salt,  Black Pepper, each, half
an ounce, and mix together with the white of two eggs.  The dose is  half a
table-spoonful every morning, the patient drinking an infusion of Wild Cherry
bark through the day.
   When jaundice is due to biliary concretions  or gall stones, the following
has been recommended as a solvent:—Take of  Sulphuric Ether three  parts
Oil of Turpentine two parts;  mix.  The dose is from half a teaspoonful to a
teaspoonful every morning.   Care should be used in its administration, as it
is  apt to cause nausea, and vomiting, and increased pain.   One very bad case
of jaundice I cured by giving a mixture of equal parts of Leptandrin,  Myri-
cin, and Apocynin, in doses of five grains, three times a  day, and allowing
the patient a tumblerful of  Cider,  also three times  a day.   May not Malic
Acid prove a valuable agent in this malady ?
ASIATIC CHOLERA.
   Asiatic Cholera has been variously termed Epidemic Cholera, Malignant
Cholera, Spasmodic Cholera, and Cholera Asphyxia.   It is characterized by
frequent and violent vomiting  and purging, the discharges resembling rice'
water, with severe griping, and cramps in the extremities.   It is not my  in
tention  here to enter into any history of this fatal  disease; though I may
remark  that it prevailed in Asia as far back as 1774, and perhaps earlier, for
Bontius mentions a similar disease in 1629.   In 1817  it burst out at Jessore,
in Bengal, where it was first especially noticed by the profession on account
of the great havoc it committed in the British army.  From Bengal it spread
westward, visiting the various countries of Europe, and in 1832, it crossed
the Atlantic, appearing in the month of June, first at Quebec, and from thence
throughout Canada and the United  States.
   Symptoms.  Asiatic Cholera is divided into three stages, viz:—The first,
forming, incipient, or premonitory stage; the second, confirmed, or active stage;
and the third or collapsed stage; to which some writers have added a fourth
stage of reaction and convalescence.   The first stage  is characterized by a
deranged  condition of the digestive organs, a languid feeling and disinclina-
tion to mental or physical exertion; a rumbling  noise in  the bowels, as of
wind passing through fluid; there is often pain in the head, or in the knee?,
and loins, with slight spasmodic twitches in the calves of the legs.  Fre-
quently there is a feeling of fulness, heaviness, or burning and distress in the
bowels; and  sometimes  griping pains in both the stomach and bowels;  the
tongue  is  furred  white or yellowish;  the appetite  is impaired, and the thirst
augmented; the pulse varies, being sometimes feeble and contracted, and at
others full and strong.    As the symptoms progress there will be slight dys-
enteric  or diarrheal discharges, and which may continue several  days before 
ASIATIC  CHOLERA.
413
the second stage occurs; and these symptoms have been  termed "cholerine
bv Home writers.   During the prevalence of the epidemic but few persons in
the affected district escape having one or more of these  premonitory symp-
toms- and it has occasionally happened that symptoms of the above  nature
have existed during the epidemic, without a subsequent development ot ma-
lignant cholera; but such cases  are very rare.  Sometimes costiveness  has
needed an attack, and a purgative dose  has  induced the  symptoms ot the
second sta"e.   More or less  nervous disorder is almost  always present
There may'"be a slight feverishness, but more commonly the skin  is relaxed
and in a state of perspiration, with scanty  urine.   These symptoms vary very
much with different individuals, being very  slight, and few in number with
Borne  and more active in others, and may  continue for a period varying from
one hour to several days.   Sometimes the  active stage of  cholera appears
suddenly without  any premonitions.
  The second or active stage is marked by more or less  constant vomiting
and  purging of a thin,  flocculent, colorless fluid resembling rice-water,
with cramps in the legs, which speedily  ascend to the  bowels and chest.
These cramps are very violent and painful, drawing the muscles into  firm
knots, with twitehings of the muscles  throughout the whole body; some-
times the cramps are  regular in their attacks,  first  affecting one set of
muscles and then another, twisting  the  limbs and body in various direc-
tions.   As this stage advances, the tongue  will be found pale and moist, or
perhaps covered with a slight white  mucus; the pulse gradually becomes
frequent and feeble, or may continue full and firm; respiration is hurried,
with distress about the heart; there will be a feeling of warmth internally;
the thirst will be  inordinate; the skin  covered with a profuse sweat;  the
extremities are cool, while the bowels feel quite hot; the ur^ne is scanty or
suspended;  the  countenance expressive  of  much  suffering;  a slight
approach  to duskiness may be observed on the skin, but frequently, in  this
stage, no discoloration will be observed, except around the nails  and under
the eyes; but as the disease progresses toward the third stage it becomes of
a livid or bluish appearance, yielding,  and corrugated; and if no relief is
afforded, the patient passes into the third stage.
  The symptoms described may  be more or less  severe, and vary in  dura-
tion, continuing from one to fourteen hours, unless relieved or removed.
  The third or collapsed stage is one of great prostration, the  pulse at the
wrist is barely, if at all, perceptible; the skin is cold, and bedewed with a
profuse clammy sweat; the face is of a deep blue or purple color, and col-
lapsed ; the eyes  are sunken; the tongue  and inside  of the mouth is icy
cold; the hands and feet are dark-colored,  corrugated, somewhat in appear-
ance like the hands of a washerwoman, and have a doughy, death-like feel,
the whole surface of the body assumes a leaden-blue, purple, or brown tint,
according to the  complexion of  the individual,  and varying in shade with
the intensity of the  attack;  the voice is weak  dry,  and nearly gone ; the
breathing is short and quick, with a laborious action of the chest;  a sense
of great heat is experienced at the stomach; his cry is incessantly for fresh
air, cold water or ice, and he is very restless,  throwing himself about in
various directions; or  he may lie with his eyes partly opened, in a dozing
condition, from which he may be readily aroused; the powers of the mind
continue  unimpaired, although  the  greatest indifference  is manifested to
his condition, or  to surrounding incidents; the evacuations cease altogether,
or they may be spontaneously discharged; the  cramps continue, or  they
may cease until just previous to dissolution.  Tho patient continues in this
Btate for a period varying from an hour  or two 4o tweJty-four hours, and 
414
AMERICAN FAMILY THYSICIAN.
expires; the period  of dissolution  being  announced  by  a few  gasping
attempts at breathing.                                           5    °
  Occasionally a few patients  recover from  this collapsed state, which has
been termed the stage of convalescence or reaction.   The discharges cease the
surface of  the body gradually acquires its natural heat; the  skin  assumes
more of its ordinary appearance; the pulse becomes fuller, stronger and
more natural: respiration  is performed with greater ease, and the  sense of
oppression about the heart abates ; the  spasms generally cease;  the liver
and kidneys become more active;  and the patient sleeps.  On awakin<* he
may desire some light food, but is so  feeble and prostrated, that the slight-
est error may cause a fatal  relapse.   Sometimes during  convalescence a
secondary  fever, or some  other  difficulty, may  set in,  and destroy the
patient in a longer or shorter time.
  Sometimes cholera occurs without  any nausea or vomiting, and  perhaps
no diarrhea; and the cramps have  even been absent; but these instances
are rare, and when  they  do happen,  are no  less  dangerous  than when the
disease is perfectly  developed.
  Causes.   The cause of  cholera is  yet  a matter of obscurity; much has
been said and advanced in the way of hypothesis, but nothing definite or
satisfactory has yet been discovered.   One writer attributes the disease to
the presence  of microscopic animalculae  in  the  atmosphere, another to a
deficiency of electrical power, a third to a scorbutic taint, a fourth to mic-
roscopic plants floating in the air, &c.  That it depends upon some morbid
condition of the atmosphere, there can be no doubt, but the exact nature
of this  condition remains  to be determined.  But, although we are igno-
rant of the true cause of this epidemic, yet, from the close observations of
medical men, much has been learned with regard  to its  exciting causes.
  Those places in which cholera has prevailed more extensively, and with
great mortality, have been  in low, wet districts of country,  in the  vicinity
of marshes, along the low muddy banks of rivers, in countries where the
limestone formation occupies the surface, in crowded towns  and cities, and
low, damp, filthy rooms and cellars.   The persons who are most liable to it,
are the aged and infirm, those who are  debilitated from some previous dis-
ease, the intemperate, the  ill-fed  and uncleanly, and those who reside in
damp,  cold,  dwellings,  or  in  confined  and illy ventilated apartments.
When  persons  in easy circumstances have been  attacked, it has generally
been from  one of the following causes: intemperance in eating and drink-
ing; eating improper food, or that which disagrees  with  the digestive
organs ;  improper use of intoxicating drinks ; excessive fatigue ; exposure
to cold, damp,  or night  air;  too long  fasting; the use of limestone or
impure water; excessive use of acids ; drastic  purgatives;  late hours at
night,  and depressing emotions of the mind.  One great  cause of  cholera,
and which has undoubtedly been the means of destroying thousands, is
fear.   Indeed any other causes calculated to depress the nervous system, or
derange the constitutional equilibrium, will be very likely to produce chol-
era in persons exposed to its epidemic influence.
  Treatment.   In the first stage of the disease, before  the active symp-
toms of cholera have become fully developed, I  have found  the following
to answer an admirable  purpose :  Take of Compound  Syrup of Rhubarb
and Potassa four fluidounces,  Tincture of  Prickly-Ash  berries one fluid-
ounce,  Essence of Peppermint one  fluidrachm,  Elixir of  Paregoric foul
fluidrachms ; mix.   The dose is a table-spoonful every half-hour  or hour,
until it operates gently on the bowels, after which a table-spoonful three
or four times a day.  In some cases  this will not  chock  the  progress of the 
ASIATIC  CHOLERA.
415
disease, when the following  powder  may  be given :  Take of Camphor,
Kino, each, one  grain, Opium, Capsicum, each,  half a  grain;  mix for a
dose,  and give one powder  immediately after each  evacuation  from the
bowels, or oftener if  the case requires it.  Other agents have been  used
with advantage in this stage  of the disease, as,  a mixture  of Compound
Syrup of Rhubarb and  Potassa four  parts, with Compound Tincture of
Virginia Snakeroot  one  part,  of which a table-spoonful  may be adminis-
tered every hour or two.  The principal indication  is  to check the  dis-
charge as speedily as possible, and when this  is accomplished, the  patient
should not rise too soon, but should use measures to strengthen tho nervous
By si em.  One thing should not be forgotten, and that is  to empty  the
stomach  by means of an emetic, if the diarrhea  occurs soon  after  a meal.
If, at any time, a purgative is demanded, and great care  should be taken
in determining this matter,  I have found  the following superior  to  any
other, as being less likely to  induce excessive discharges:  Take of Com-
pound Powder of Jalap one  drachm,  Compound  Powder of Rhubarb  and
Potassa,  Powdered  Prickly Elder bark,  each, two drachms, boiling water
half a pint;  mix, and infuse  for ten or fifteen minutes.   When cold, give
a table-spoonful every hour until it operates.   Should the discharges pro-
duced by it be too copious or too continuous,  exhibit the above  astringent
powders.  A .Mustard poultice over the whole abdomen, will  always be
advantageous.  A very effectual remedy  in checking  diarrhea, is composed
of Cinnamon, ('loves, and Resin of Guaiacum, each, in powder, one ounce,
good French Brandy one quart; mix.  The dose is two teaspoonfuls in hot
sweetened water, every fifteen or thirty minutes, until relief is obtained.
  In  the second or active stage, the treatment must be active and energetic.
To allay  the vomiting, the following may be given :   Camphor water, Pep-
permint water, Spearmint water, each,  one fluidounce, Elixir Paregoric, two
fluidrachms;  mix.  From a teaspoonful to a  table-spoonful may be given
every five, ten, or fifteen minutes; and should this not- check the nausea or
vomiting within a reasonable  time, cease its  administration,  and give the
following :  Take of Salt, Black Pepper, each, one  drachm, Vinegar five
fluidrachms, hot water four fluidounces; mix.  The dose is a table-spoon-
ful every  ten or fifteen  minutes.  I  have known this to arrest  vomiting
promptly, when all  other means  had failed.   In  some very obstinate cases
of vomiting, I have found an emetic, followed by the above measures, to be
effectual in allaying this symptom.   Emetics, however must not be used,
when there is too great an exhaustion  or prostration of the system.
  To check the discharges, a powder, composed of Camphor, Kino,  Tannic
Acid, each,  one  grain,  and  Opium  half  a grain, may be  administered,
repeating the dose every half-hour, and lengthening  the interval  between
the doses as  the patient mends.  But  if the discharges are frequent, a
powder should be administered immediately after each evacuation from the
bowels.  And the following  injection  should  also be given  after each dis-
charge :  Take of Saturated Tincture  of Prickly-Ash berries, half  a fluid-
ounce, Laudanum twenty drops, water  half a fluidounce;  mix for an injec-
tion.   The patient should be urged to  retain this  in the bowels as  long as
be possibly can.  The great danger  exists in the practitioner becoming
excited, and  changing from  one course  of  treatment to  another,  without
giving any one a  proper trial.  Be cool, calm, and collected, and do not
give  up the treatment too soon, always wait a  sufficient time for the reme-
dies to act, before changing  them, especially when it is known  that they
are generally efficacious.  During the. whole course of cholera, from the first
to the last stage, tlie patient must be kept  in a recumbent position, and, if possi- 
416
AMERICAN  FAMILY  PHYSICIAN.
ble, a bedpan should be  used to receive the  discharges, instead of permit.
ting him to rise for the purpose  of attending  to  them.  This is a very
important point in the treatment, which should  never be forgotten;  I have
frequently seen patients who were recovering from  the  second stage, doins?
nicely, have a relapse merely from setting up ten or fifteen minutes.
  To remove the cramps common to this stage,  the  limbs should be held as
straight as possible, and the affected muscles should  be rubbed briskly, either
with the hands alone, or by means of warm flannel.   The Tincture of Capsi-
cum should be well rubbed along the  whole course of the  spinal column
after which a  Mustard  poultice  should be  applied; Mustard may also be
placed on the feet, ancles, thighs,  and wrists.   Heated stones,  bricks, irons,
bottles of hot water, small bags filled with hot sand, bran,  or salt, should he
applied to the hands, arms, thighs, legs, and feet, as well as  on each side of
the body; and cloths wet with water as hot as the patient can bear, must be
placed upon the abdomen, renewing them every  few minutes.  The produc-
tion of full, free, and copious perspiration,  will  be  found a very important
indication to be fulfilled in the treatment.   In some cases  where there is no
great irritability of stomach, the Compound  Cajeput  Mixture, given every ten
or twenty minutes, in half-teaspoonful doses,  in a sweetened mixture of hot
brandy  and water, will be found peculiarly applicable;  at the same time, the
parts affected with cramps may be thoroughly rubbed with the same Mixture.
  In cases where there is much internal congestion, or a great determination
to the head, dry cupping along each side  of the spinal  column  from the
occiput to the coccyx, followed by the application of Mustard  poultices, will
be found very advantageous.
  The excessive thirst, common to the  second and  third stages, may be re-
lieved by table-spoonful doses of cold Gum  Arabic water, or iced water; but
the best agent to allay this symptom is  ice, which may be held in the mouth,
and small pieces of it be occasionally swallowed.
  In the third or collapsed stage, but little more  can be  done, except to pur-
sue the measures recommended above with increased energy; for, although
the patient is now in a hopeless condition, there  is a possibility of recovery;
and success has frequently crowned the efforts of those who  have energeti-
cally and unremittingly continued their treatment.   It will be found of great
advantage to envelope the patient in blankets wet with  water as hot  as can
be borne, giving internally, at the  same time, for a stimulant,  a mixture of
one part of Tincture of Camphor, and three of Tincture of Prickly-Ash ber-
ries, of which from a teaspoonful  to a table-spoonful may be given every ten
or twenty minutes, in a small quantity of water;  these may be added to the
means above advised for the treatment  of the second stage.   In some cases
of collapse, large doses of brandy,  say a gill at a  dose, and renewed in a short
time, have been followed  by a restoration to  health; this, however, will be
inapplicable to patients with excessively irritable stomachs.
   I would remark here, that in ten or  twelve cases of cholera in 1849—50,
I made use of the Tincture of Muriate of Iron, in  the second stage of the
disease, with the happiest results;  thirty drops, added to half a gill of iced
water, was given for a dose,  and  repeated  immediately after each attack o
vomiting.  This was used in connection  with the injections and externa
measures above mentioned.
   After a recovery from cholera,  great care should  be  observed during the
stage of convalescence.  The  liver will frequently be  left  in a very torpid
condition, with a constipated  state of the bowels.   A Mustard poultice placed
over the region of the liver, and the careful administration of the purgative
mentioned in the first part of the treatment composed of Compound Powder 
CHOLERA MOKBUS.
417
of Jalap, Compound Powder of Rhubarb and Potassa, and Powdered Prickly
Klder, will overcome this condition ; but the practitioner cannot be too  ob-
servant that he does not cause large evacuations by the medicine.   The diet
must also be properly regulated, because the least imprudence or inattention
may bring on a relapse which almost  invariably proves  fatal.   When there
is much exhaustion  of the system,  mild  stimulants,  and stimulating tonics
may be given, with a light, nutritious, and very easily digestible  diet.
  During epidemics of Asiatic Cholera, we  find  that it has been the most
destructive in its ravages among  those who live in  damp and filthy places;
hence, the necessity of cleanliness in every part of a house, as well as in  the
person.  All dwellings should be cleansed from top  to bottom;  all filthy or
putrid accumulations should be at once removed; the rooms  should  be well
aired every clear day;  and places of  damp and disagreeable odor should
have their atmosphere purified by lime, chloride of lime and other antisep-
tics.  The body of every individual should be thoroughly washed and dried,
at least once  in  every three or four days.  Persons residing in  a cholera
atmosphere should  avoid long fasting, excessive fatigue, exposures to  wet
and cold, especially at night,  intemperance in food,  and, more  particularly,
should intoxication  be avoided.  As a general rule  all green fruits must be
dispensed with,  also  fats,  indigestible articles,  as,  pickles, nuts, &c, and
whatever is found to disagree with the stomach.  With these exceptions  no
other change is required in the diet to which one is generally accustomed;
this should be of  a  nourishing  character,—and well-cooked vegetables, or
the moderate use of ripe or preserved fruits, are not objectionable when they
agree with the stomach.  The clothing should  be warm ; regular  and suffi-
cient sleep should be had; any sudden changes in the way  of living  or in
the general habits of a person should be avoided; and on  the first  appear-
ance of looseness of  the bowels, or other derangement of the alimentary canal,
the proper measures should be immediately  taken, without a moment's  de-
lay. Persons who are  prone to fear should use  all means to  avoid this emo-
tion, as  it has, undoubtedly, produced more diarrhea and death by cholera,
than any other single cause; the mind should be kept patient, cheerful,  and
submissive, and constantly occupied with its regular duties.   In seasons of
cholera the proper  officers of a  city,  town, village,  &c, should, under  the
direction of an intelligent Board  of Health, adopt and enforce the most strin-
gent laws for the preservation of their community from  this, or any other,
uncommonly destructive disease.   Good fermented cider has been named,  not
only as a preventive of cholera, but as a remedial agent; according to obser-
vations which have been  made by several physicians, those who  used  fer-
mented cider were less liable to an attack of cholera,  and more readily recov ■
ercd from it when attacked, than others.
                        CHOLERA  MORBUS.

  Cholera Morbus  is a disease common in warm  seasons, and  especially
in warm climates.  The principal features of the disease are, vomiting, purg-
ing, and severe griping pains in the abdomen.
  Symptoms.   The disease is occasionally preceded  by chills, headache, gid-
diness, and a numb sensation of the limbs;  but more  generally its attack is
sudden, commencing with nausea and distress at the stomach, succeeded by
violent gripings in the bowels; these are followed  by frequent vomitings of
a thin, dirty-yellowish, whitish, greenish or  even  colorless fluid, with dis-
charges from the bowels of a similar character  to  that vomited,  and which
       21 
418                 AMERICAN FAMILY  PHYSICIAN.
occur as frequently as the vomitings.  During the intervals between the
vomiting and purging, there is much nausea and uneasiness at the stomach'
but, in some cases, a sensation of relief is afforded, and the patient lies in
bed much fatigued and apparently free from any distress.   These attacks of
vomiting and purging usually take place every ten  or twenty minutes, being
either concurrent, or the one evacuation being immediately followed by the
other.   Sometimes the pain is so severe as to cause  the patient to be drawn
up, and even to cry aloud.  Generally there is great thirst,  but  as soon as
any fluid  is swallowed it  is at  once  ejected; the tongue is dry; the urine
high-colored, deficient, or suppressed; and the pulse rapid, soon becoming
small and feeble.  If the disease is allowed to progress unchecked, the pulse
sinks, the extremities become cold, the countenance pale  and indicative of
much suffering, the respiration hurried, cramps in the limbs, hiccup, a cold
clammy sweat breaks out,  great  prostration, and death.    The disease fre-
quently proves fatal in twenty-four hours, and when  malignant,  even in a
few hours; sometimes  it subsides spontaneously.
  Sometimes patients with cholera morbus complain of a great burning sen-
sation  internally; and in the more malignant forms of the disease it is  not
uncommon for the discharges in  the last stage  to resemble  the "rice-water"
evacuations of Asiatic  Cholera.
  Cholera morbus may be  known from diarrhea and dysentery, by the char-
acter of the discharges from the bowels, which  are purely of a bilious nature,
not mixed with blood or mucus, and with scarcely  any fecal matter.
  Causes.  Cholera morbus  is  owing to an irritation of the stomach and
bowels, with a greater or less derangement of the functions of the liver, and
which is ordinarily  caused by improper substances taken into the stomach,
as unripe fruits, acids, much fat food, certain species of fish, lobsters, unfer-
mented cider,  improper use of alcoholic drinks, or  any articles that will irri-
tate the mucous membrane of the  stomach and bowels,  by  undergoing an
acid fermentation.  It may also be produced by exposures to sudden changes;
by sitting in a draught of cool air while in a state of perspiration; by excessive
heat, rendering the bile more  acrid, or secreted in  preternatural quantity; or
by malarial influences.  Persons of gross habits,  or  intemperate in eating
and drinking, and those of sedentary habits, are the most  subject to it.
  Prognosis.  When the symptoms  gradually  improve,  vomiting ceasing
or becoming less frequent  and distressing, with a  gentle moisture upon the
surface, succeeded by  sleep, they augur favorably.  But frequent and severe
vomitings, with great prostration of strength, swelling of  the bowels, inter-
mittent pulse, cold, clammy sweats, short,  hurried breathing, constant hic-
cough, spasms of the extremities, or convulsions,  are unfavorable symptoms.
   Treatment.  In the early stage  of the disease, when the contents of the
stomach are not  thoroughly evacuated,  it will be  proper to give freely of
warm water, or warm  infusion of Catnip, or of Boneset, to aid in producing
free vomiting, that the stomach may be completely emptied.  After this has
been accomplished, should the vomiting still  continue, a large Mustard
poultice may  be placed over the  region of the stomach and bowels,  and the
Compound  Syrup of Rhubarb and Potassa be  given in  doses  of a table-
spoonful, repeated every half hour.   The first doses will  frequently be vom-
ited up for several  times in succession.—in such  cases,  immediately repeat
the dose,  and continue thus until  it does remain  on  the stomach; in  very
severe cases of vomiting,  ten  or fifteen drops of Laudanum may be added to
each dose until it is checked.  The patient must remain very quiet, and if he
be very thirsty, a small lump of ice maybe allowed to dissolve in his mouth,
 a?, a teaspoonful of an infusion  of Peppermint or  Spearmint may be given 
MILK  SICKNESS.
419
occasionally,—but  too  large  a  quantity of any  fluid will excite vomiting.
Nothing should be  taken into the stomach unless it is absolutely necessary.
  After the vomiting has been checked,  the  intervals between the doses  of
the Compound Syrup of Rhubarb and Potassa, maybe increased to one, two,
or three hours, according to the  urgency of the case,  and should be contin-
ued as long as there is any looseness of the bowels.
  When the pains  in the  bowels are severe, or there are cramps in the limbs,
a course similar to  that named for these symptoms in  Asiatic Cholera, page
410 may be pursued, viz :—hot fomentations to the bowels, and frictions  to
the limbs with some stimulating mixture; the following will be found a use-
ful stimulant:—Take of  Tincture of Capsicum,  Tincture of Camphor, Es-
sence of Peppermint, each, equal parts;  mix,  and  apply  with considerable
friction.  Injections will likewise be found very useful,  when  there is great
pain in the bowels; one composed of Mucilage of Elm or Starch water, two
fluidounces, and Laudanum twenty drops, will be efficacious.
  I have in a few cases checked the vomiting in  cholera morbus, as well  as
the more distressing symptoms, by the administration of a mixture of Bisul-
phite of Soda two drachms, water one and a half fluidounces, Laudanum one
fluidrachm, to be  given in  teaspoonful  doses  every  ten or  fifteen minutes,
until the desired effect is produced.  After which give the Compound Syrup
of Rhubarb  and Potassa in table-spoonful doses, repeating  it  four times a
day until it acts upon the bowels.
  When the disease is owing to  malarial influences, occurring periodically,
it should be treated the same as just named, while  the  active symptoms  of
cholera morbus  are present; but, during the intermission, some one  of the
antipcriodics named on page 190, under the treatment of Intermittent  Fever,
should be persistently employed until the tendency to the periodical attacks
is overcome.
  During convalescence the patient should be very careful in his diet; using
light, digestible, nourishing food, abstaining from all articles which are indi-
gestible or disposed to acidify on the stomach.   He should  keep himself
warm, guard  against night air,  and exposures to cold and  damp, and be
careful to avoid  all  kinds of intemperance.  Oatmeal  made into a cake with
water, baked,  then  browned like coffee, and made into a coffee-like infusion,
is not only useful in allaying the distress and vomiting, but is also nourishing.
                         MILK  SICKNESS.
  Milk  Sickness,  or  Sick Stomach, is a disease sometimes met with in the
Western  States, and which has, in most instances,  proved fatal.   The  cause
of this disease is not known, though it is  supposed to originate from some
poison eaten by cows,  which is communicated to the milk and butter.   The
cattle that are affected with this poison,  whatever it may be, tremble, stagger,
and soon die;  and any animal preying upon their  flesh becomes likewise
poisoned.  The milk, the butter, the cheese,  or  the meat of an animal  hav-
ing this disease,  is certain  to  communicate it to those who eat of them, al-
though these  articles present no appearances by which they may be detected
from healthy  ones.
  Symptoms.  Soon after partaking of  the poisoned article of diet, the per-
son experiences a sensation of languor and  lassitude, or extreme  debility,
especially in the lower extremities;  the appetite  becomes impaired, there is a
disagreeable,  sickening sensation at the stomach,  and a peculiar  offensive
breath, readily recognized by any one conversant  with the  disease.  These 
420
AMERICAN  FAMILY PHYSICIAN.
symptoms, with an occasional vomiting, may exist for several weeks, without
any others being manifested.  Again, they may gradually increase in'severity
being followed by extreme loathing, nausea, and vomiting, or distressed retch-
ing to vomit; the vomiting occurs every half-hour,  or.hour,  and sometimes
oftener, and the patient usually experiences' some  relief after  each  effort
The liquid ejected is very acrid  and possesses a singular acid odor, and seems
to be little else than the drinks taken, mixed probably with the fluids of the
stomach;  in severe cases, a dark-colored, flaky substance, is mixed with the
ejected material.   Sometimes the attack comes on suddenly, with severe vom-
iting, thirst, &c.
  In connection with the characteristic  symptoms above described, there will
be a sense of great oppression about the heart, anxiety,  deep respiration a
burning sensation in the region of the  stomach,  likened to boilino- water
great thirst, violent palpitation  of the heart,  troublesome hiccough, hot
belchings, and obstinate costiveness.   The  tongue  is slightly coated and
swollen, the skin cold and clammy, there is, in most cases, a strong pulsation
over the abdomen, especially at the right of the navel, and vertigo,  pain in
the head,  ringing in the ears, and even delirium are frequently present.  In
the fatal cases there is dilatation of the  pupils, stupor during  the intervals
between vomiting, and the fluids ejected are of a  dark color.
  Treatment.   To overcome  the  irritable condition of the stomach, and
check the vomiting, the Compound Powder of Rhubarb and Potassa should
be given every half-hour or  hour,  according  to the severity of  the case, in
table-spoonful doses; and at the same time a large  Mustard poultice should
be placed  over the region of the stomach and  liver, and in  severe  cases to
the feet, wrists, and along the whole course of the  spinal column.  The ap-
plication of some stimulating tincture or liniment to the whole surface of the
body and  limbs, with considerable friction,  will be found of great advantage,
especially in those cases where  the surface is  cold.   As soon as the nausea
and vomiting have subsided, an active cathartic dose of the Compound Pow-
der of Jalap should be given, the action of which will always be followed by
great relief.  And if necessary, this course should be repeated until a com-
plete cure is effected, giving the  cathartic  daily  during the  continuance of
the disease.
  In those cases where the vomiting is very obstinate, stimulating injections
should be employed,  and as soon as thorough evacuations have been pro-
cured the  vomiting will generally subside.  A good injection for this purpose
is the one named on page 346, under the treatment of Apoplexy. To allay
the excessive thirst, the patient  may hold a small  piece of ice in his mouth,
or may even swallow some small pieces,  but on  no account must he be al-
lowed water, as it will be at once vomited up.   An infusion of Water-pepper
has been highly recommended in this disease; it  may be tried  as a drink,
and allowed if found to be beneficial.  Perhaps a solution of the Sulphite of
Soda, as named on page 419, under the  treatment of  Cholera Morbus, may
be found efficacious in allaying the vomiting.  I  am  not aware that any of
our physicians have examined the character of the ejected fluid  in this dis-
ease, under the microscope,—it  is very desirable that this should be done.
  The stomach should not be overloaded with any  food  or drink whatever
during the treatment,—if diet be required,  it  should  be of the  mildest and
least irritating nature, as thin  Indian meal gruel, barley-water, toast-water,
rice-water, &c.

  • 
DIARRHEA.
421
                             DIARRHEA.

  Diarrhea, or Looseness of the Bowels, is a disease of frequent occurrence,
manifesting itself more especially during the warm months of the year, though
it may take place at any season.   All persons are alike subject to it, when
exposed to the causes.
  Symptoms.   Diarrhea consists infrequent evacuations from the  bowels,
of a more fluid nature than usual, each discharge being preceded by a rum-
bling noise in the bowels,  together with a sense of weight or pressing down,
and considerable uneasiness in the lower  part of the bowels, which sensations
are relieved as soon as the  evacuation takes place,  but are renewed before
the one which is to succeed ensues.  More or less  griping is present,  and
not unfrequently nausea and vomiting.   Fever and tenesmus are not  pres-
ent in diarrhea.  When the discharges are very frequent, or in large quan
tity, they rapidly reduce the strength of the system; emaciation takes place;
the functions of the system become impaired; the  skin  becomes  pale,  dry,
rigid, and eventually sallow; and if  the  disease continues for  any length of
time, the feet and legs become dropsical.   The discharges become more and
more offensive, a slow fever ensues, and  the patient dies in a state of great
exhaustion.
   According to the character of the  evacuations, and the exciting causes,
diarrhea has been divided into several varieties, thus:—
   1.  [jieutcric  Di>errhea, in which the food is  rapidly passed into the intes-
tines, and appears in an undigested condition in the evacuations,  and is due
to an impairment or suspension  of the functions of  the stomach,  with  great
irritation in the intestinal  canal.
   '1.  Chylous, or Caliac Diarrhea, in  which  the discharges  are of a milky
white or dirty white  color,  and is due either to a  congested condition of the
mucous membrane of the   small intestines, or to tubercular  disease of the
mesenteric glands.
   3.  Mucous Diarrhea, in which  considerable mucus is found  in the dis-
charges, being  occasionally slightly streaked with blood.
  4. Bilious Diarrhea, in  which the  evacuations are mixed with  much yel-
lowish, or greenish looking bile, are very copious, and most generally accom-
panied with nausea and vomiting.
  5.  Feculent Diarrhea, in which the feces are more liquid than natural, and
voided in greater quantity.
  The  diarrhea attending inflammatory conditions, or  the latter stages  of
disease, is considered under the  various diseases in wdiich it may occur.
  Causes.  Diarrhea may be caused  by improper exposures to excessive heat
or cold,  by the use  of acid,  unripe,  indigestible,  or other irritating  food,
from the presence of worms, from overloading the stomach with food, sudden
frights, itc; certain  articles of  diet or drink  occasion diarrhea  with  some
persons, wdiich  are quite agreeable and salutary to others.  A  very frequent
cause of diarrhea among  suckling infants, is  the  use of spoon-meats,  and
other gross articles of diet; it may also arise from a bad quality of the nurse's
milk, from the  irritation caused  by teething, &c.  Mental depression, reces-
sion of cutaneous eruptions, fermented liquors, &c, are also among the excit-
ing causes.
  Treatment.   In  the treatment of these various  forms of diarrhea, there
is no  better agent to neutralize excess of  acid, restore the bile to a healthy
condition, remove flatulence,  and unhealthy accumulations in the  bowels
and allay irritation and strengthen the stomach and bowels, than the Com-
pound Syrup of Rhubarb  and  Potassa; a table-spoonful  of which  may be
i 
422                 AMERICAN FAMILY PHYSICIAN.
given every hour until it acts upon the bowels, changing the consistence and
appearance of the discharges; after which it  may  be repeated every two
three, or four hours, as required.  I frequently prescribe it thus :—Take of
the Compound Syrup of Rhubarb and Potassa four  fluidounces, Essence of
Peppermint one fluidrachm,  Paregoric four fluidrachms; dose as above.
  The unpleasant weight and distress in the lower part of the  bowels, may
be overcome by  injections of half a teaspoonful of the Compound Tincture
of Virginia Snakeroot, mixed with a table-spoonful of water, and injected into
the bowels  immediately after each evacuation;  being retained as long as
possible.  Nausea or vomiting is occasionally present, and when severe, will
require  the application of a Mustard  poultice over  the region of the  stom-
ach, together with a few drops of Laudanum or Paregoric  to each dose of the
above named Compound Syrup.  Vomiting, both in this disease and in chol-
era morbus, when severe, has been frequently checked in a short time by the
following:—Make a cake of Oatmeal and water, bake it, brown it like coffee,
then powder it,  and make an  infusion.  Of this  oatmeal  coffee or infusion,
the patient may drink freely.
  When there is any pain or  griping, an injection  may be given composed
of Castor Oil one  gill, molasses, warm water, of each half a pint, Laudanum
from twenty to sixty drops; mix.  This may be repeated as often as the cir-
cumstances of the case require.   When the pains are severe,  warm fomenta-
tions of bitter herbs, as Hops, Tansy, Wormwood, &c, should be applied over
the bowels.   In  all cases of diarrhea,  it is of importance that the functions
of the skin be attended to; the alkaline bath should be applied to the sur-
face, drying  with considerable friction.   In some cases, especially  when
caused by exposures to  cold or damp, the  production of perspiration by
the Spirit vapor  bath  will be found  highly  beneficial.   If  the patient be
anemic, or the blood in an impoverished condition,  the Tincture of Muriate
of Iron, will be  found a most excellent agent; it may be  given in doses of
ten drops every  hour, in a wineglassful of water.
  I have frequently met with a form of diarrhea, occurring in malarious dis-
tricts, or during certain epidemics, in  which there is a constant, dull, heavy,
or sore sensation in the neighborhood of the navel,   amounting to a cutting
or griping pain just before an evacuation  from the bowels, with debility, loss
of appetite, and great restlessness; the discharges will be copious,  but not
exceeding four or five in the course of twenty-four hours.  I have invariably
cured this by the following  powder:—Take of Leptandrin eighteen grains,
Camphor, Ipecacuanha,  each, four grains,  Sulphate of Quinia six grains;
mix, and divide  into twelve powders, of which three or four  must be  taken
in the course of the twenty-four hours, continuing their use for several days
in succession.  Others have met with success by the administration of a pow-
der composed of Powdered Catechu ten grains, Powdered Opium half a gram
or a grain,  Sulphate of Quinia two grains; mix for  a dose, and repeat  it two
or three  times a  day.
  The diet during  diarrhea  may  consist of barley-water, rice-water, Gum
Arabic water, infusion of Elm bark, Iceland, or Irish moss, Arrowroot, Sago,
or Tapioca, with or without boiled milk, and  toast-water.  Well-boiled rice
flavored  with powdered Cinnamon, is one of the most digestible aliments,
and is, therefore, very appropriate;  or boiled  milk  with  Cinnamon powder
may be used. Fats, all acids, juicy  vegetables, and unripe  fruits must be
proscribed.    Brandy-water,  made  weak, sweetened  with loaf sugar, and
flavored  with grated nutmeg, will be found very acceptable and  useful.  Ale,
porter, and  beer must not be  used.  As soon as the appetite  returns, annua
food, as  the tender part of the sirloin of beef, or boiled mutton or  chicken, 
SUMMER COMPLAINT.
423
arc more appropriate, and will be more readily digested than strong soups,
which are exceedingly improper.  The diarrhea which persons from the East
experience from drinking the Western waters, may be overcome  by eating
freely of boiled rice, and adding a small quantity of good French brandy
to  the water drank.
                       CHRONIC  DIARRHEA.

    After existing for  some time in  the acute  form, and particularly if the
 treatment pursued is not correct, diarrhea often becomes chronic in its char-
 acter, being sometimes very  obstinate.  The discharges continue frequent,
 with more or less pain or griping, restlessness, thirst, peevishness, impaired
 appetite, debility, emaciation, &c.  The skin becomes rough, dry, and  of a
 sallow hue, the tongue is dry, and of a dark color, and, frequently, whatever
 is  taken into the stomach is passed  in the evacuations imperfectly digested.
 This disease  is generally owing to a morbid  condition of the liver; or, to a
 chronic inflammation of the bowels.
   Treatment.   In the treatment of chronic diarrhea, after having exhibited
 the Compound Syrup of Rhubarb and Potassa, until it has  operated on the
 bowels, it will  be proper  to  administer astringents,  as infusions of Black-
 berry root, Geranium, Bethroot, &c.  The  following will  be found a very
 excellent remedy:  Take  of Leptandrin, Geraniin, Myricin, each, twelve
 grains; mix, divide into twelve powders, and give one for a dose, repeating
 it three or four times a day.  In some cases  the Tincture of Muriate of  Iron
 in doses of twenty drops  in  a  gill of water, repeated three or four times a
 day, and persisted in for some time, will effect  a  permanent cure.   Astrin-
 gent injections will frequently prove serviceable, especially when there are
 griping pains or tenesmus; five or ten grains of Tannic Acid, dissolved in a
 fluidounce of water, to which half a teaspoonful of the  Compound Tincture
 of  Virginia Snakeroot, is added, may be injected into the bowels, and be re-
 peated several  times  a day, according  to the severity of the  case.  The
 patient should be requested to retain the injection  as long as possible,  each
 time.  The skin must be attended to, bathing it frequently, with frictions in
 drying.  When  the  diarrhea is owing to a  chronic inflammation of the in-
 testines, it must be treated as named  under this affection on page 287.   The
diet must be the same as in the  preceding instance of ordinary diarrhea.
  Several agents have been  successfully used  in  the treatment of chronic
diarrhea, among which may be named the following:
  1. Take of Powdered Catechu ten grains,  Opium one  grain, Sulphate of
Quinia two grains; mix for a  dose.  Two or  three  of these powders  may be
taken per day;  and they will  also be found useful  in the  diarrhea of mala-
rial districts.
  2. Take of powdered Alum, powdered Galls, each, two  grains, pulverized
Camphor one  grain; mix for a dose.  One powder to be taken immediately
after each stool.
  :>. Take  of  Leptandrin,  Geraniin, Kino,  Camphor, each  twelve  grains;
mix, and divide into twelve powders.   One of these is a dose to be repeated
fhree or four times a day.
             SPAIMER  COMPLAINT OF  CHILDREN.
  Summer Complaint of Children, also known  by the name "Cholera In-
fantum," is a very common and fatal disease peculiar to infants  during the
« 
424
AMERICAN  FAMILY  PHYSICIAN.
warm summer and autumnal months; it is more commonly met with
those who are teething.
  Symptoms.  The disease  commences  gradually with  a looseness of the
bowels, which may continue for several days before there is an evident de-
rangement of the bowels; frequently, however, nausea, vomiting,  and purg-
ing, with more or less fever, exist from the  first.  The discharges from the
bowels may be inodorous, or have a sour  smell, but more commonly they are
very offensive; they vary in color, being  greenish or yellowish at first, and
frequently mixed with mucus and blood;  or, the food eaten may  pass away
imperfectly digested;  and, in severe cases, the evacuations become clear and
watery.  The child is restless and fretful, constantly  changing its position
frequently drawing up its feet and legs, and  crying out most vehemently, or
in piercing screams.   The pain which it suffers appears to be of a spasmodic
character, very much like that of  cholera  morbus in the adult.   In many
cases the looseness will  continue without much, if any, pain or  vomiting.
The pulse is quick, small, and somewhat  tense; the thirst excessive, and any
fluid taken to assuage it is at once ejected; the tongue has a slight white fur
at first, but gradually becomes bright, dry, and glossy;  the skin  is usually
dry, harsh, and shrivelled; and the  head and body are preternaturally warm,
while the extremities are  cold.  The fever is of the remitting kind, and be-
comes aggravated toward evening.   The abdomen is frequently swollen and
tense,, and sometimes there is a swelling of the face and  limbs.  Not unfre-
quently delirium  occurs* as known by a forcible throwing or jerking of the
head, wild semblance of the eyes, endeavors to bite or scratch, &c.  Emacia-
tion takes place rapidly, the face becomes very pale and  contracted, the lips
thin,  dry,  and wrinkled, the  eyes  dull  and  sunken, and half-closed when
asleep, the child  being more  or less  insensible  to external impressions, and
death may occur in six hours;  though  the  disease may  continue for many
months before it proves  fatal.  When the disease  assumes a chronic form
the child becomes reduced to  almost a skeleton,  the  skin acquires a dark-
brown tinge, with livid spots, the mouth becomes affected with aphthous ulcer-
ations, and the discharges from the bowels are extremely acrid  and fetid,
excoriating the parts.  The abdomen is  either swollen  or sunken; worms
are frequently discharged; hiccough, or convulsions, and death;  sometimes
dropsy in the head ensues, which eventually destroys the little  sufferer.
  Causes.   Cholera  Infantum  is seldom met with in country places, but is
very  common  in  cities  where  the  air is impure, and especially among the
children of those who are uncleanly in their persons  and dwellings, who
reside in damp or otherwise unhealthy  locations,  and who use improper or
innutritious  diet.  It may be caused by excessive heat, inattention to clean-
liness, exposure to cold and damp,  impure atmosphere,  and  defective diet.
It is more apt to  occur during the period of teething, which process appears
to be an exciting cause.   Worms- are likewise said to be an exciting cause.
  Treatment.   The best and most effectual agent that  can be used in the
treatment of this affection, is the Compound Syrup of Rhubarb and Pota^a,
which neutralizes any acidity  of the alimentary canal,  removes  fetid  and
morbid accumulations, and strengthens  the stomach and bowels,  It may
be given in doses of one or two teaspoonfuls, every half-hour, until it oper-
ates on  the bowels,  after which repeat  the dose three, four, or five times a
day.  The addition of one part of the Tincture of Prickly-Ash berries to three
parts of the above Syrup, will be found  very useful.  To assuage  the! inor-
dinate thirst, the child may freely drink  of a cold infusion of Wild Ineirj
and Elm barks, each,  an  equal quantity;  but this should not be given until
the vomiting has been checked; a few leaves of the Bcnne Plant,  (Sesamua 
CONSTIPATION.
425
 tfrientalc,) stirred in about two gills of cool water, soon renders the latter
 quite mucilaginous, forming a tasteless,  demulcent draught, which  may be
 used as a substitute for the one preceding.
   In severe cases of vomiting, a Mustard  poultice applied along the whole
 course of the spinal column, and one over the region  of the stomach, in ad-
 dition to the internal  measures, will prove  very  efficacious.  Injections are
 always proper to allay vomiting, pain, and tenesmus, and fomentations to the
 abdomen will likewise prove effectual in  removing gripings  and spasmodic
 pains.  The injection may be composed  of  Elm  or Starch water one  fluid-
 ounce, Tincture of Prickly-Ash berries two  fluidrachms, Compound Tinc-
 ture of  Virginia  Snakeroot  five  or ten  drops;  mix, and use one-half for a
 child about a year old.  The skin should be bathed at least once a day,  with
 a weak alkaline solution, to which some spirits has been added, drying with a
 gentle degree of friction.
   When the disease proves obstinate, I  have succeeded in effecting its re-
 moval by the following  compound: Take  of Swamp  Milkweed,  Colombo,
 Rhubarb, Prickly-Ash berries, each,  bruised, half an  ounce, Brandy two
 pints; mix, and macerate for ten or twelve days.  A child two years old may
 take half a teaspoonful for a dose, in  some  sweetened water, repeating it
 three or four times a  day.  In some very obstinate cases I have permanently
 cured them by administering a mixture of Leptandrin two parts, Sulphate of
 Quinia  one part, in doses suited to the child's age, say one grain of the mix-
 ture to  a child  a year old, and repeated  every two or three  hours; in  con-
 junction with this, the Worm Cordial, named under the treatment of worms,
 was used three times a day.   Sometimes in  obstinate cases, astringents will
 be found advantageous, after a proper evacuation of the bowels  by  the above
 Compound Syrup of Rhubarb and Potassa; infusions of Geranium,  Black-
 berry root, Dewberry root, Wild  Cherry bark, Bethroot, &c, may be used.
 Kino, in powder, has likewise proved beneficial in the advanced stages; the
 following has been very highly recommended: Take of Extract of Logwood,
 Ammoniated  Tincture of Opium, each,  two drachms, Tincture of Catechu
three  fluidrachms, Compound Spirits of Lavender one fluidrachm,  Simple
Syrup, Boiling Water, each, four fluidounces; dissolve the extract in boiling
water, and addthe^ other articles.   The  dose is a teaspoonful to a child a
year old, repeating it every three or four hours.
  If  it can be done, the child should be  at once removed to some healthy
location  in the country, where it can have the benefit of pure, cool air; or
if this cannot be done, it should be frequently taken  out in the  open air'
avoiding a heated, confined air as much as possible; sailing in an open  boat
will be found  serviceable.   The body should be kept clean, and the clothing
should be changed frequently; the child's  apartment,  as well  as its bed-
clothing, should be thoroughly  aired every  day; and all  improper food
should be avoided.  Mucilaginous drinks,  Gum Arabic water, and  boiled
milk  with powdered Cinnamon  added,  and which may be thickened with
wheat or rice fl^ur, will be the most appropriate diet.
CONSTIPATION.
  By t onstipation or Costiveness is meant a partial or complete retention of
the feces, they being hard, dry, and in diminished quantity when passed, and
voided with difficulty or much straining, and  sometimes with  pain   It 'mav
occur as a constitutional condition, but is more frequently symptomatic of
some disease or impropriety.  Sometimes nausea, want of appetite, flatulency 
426
AMERICAN FAMILY  PHYSICIAN.
headache, dizziness, and  feverish  symptoms accompany it.   All persona
should use  every  means  to  avoid  or overcome  a  costive condition of the
bowels, especially pregnant women, plethoric individuals, and those disposed
to apoplexy, epilepsy, chorea, hysteria, bilious colic, &c.   A want of atten-
tion to the regular periods for evacuating  the bowels, the use  of opium as-
tringents, and some kinds of diet will give rise to constipation,  and whenever
any article  is found to produce this effect, it should  be strictly avoided,
When it  is owing to disease,  this must of  course  be cured before any per
manent benefit can be expected.
   Treatment.  In ordinary cases, the means named  on page 151 will be
sufficient; but when medicines are  actually required, I more commonly em-
ploy a mixture of  Rhubarb two parts, Bicarbonate of Potassa one part of
which from  two to twelve grains must be given three times a day, in a little
water, about an  hour after each meal.  The doses must be sufficiently large
to produce one evacuation daily, resembling in quantity and consistence as
nearly as possible, those of healthy discharges ;  on no account should these
evacuations  exceed two  per day.  In all diseases  requiring regularity of the
bowels, I make use of this preparation, when it agrees with the patient, not
causing gripings, &c.   Sometimes,  however, this powder will not have the
desired effect, unless it  be given in large doses, when  other  remedies will
become necessary, as:—Take of Aletridin twenty grains, Extract of  Nux
Vomica  one or two grains, Podophyllin five grains; mix, and divide into
twenty pills, one or two of which may be taken every night.   Or, the follow-
ing may  be used:—Take of Tincture of Mandrake, Tincture of Blue Flag,
each,  five and a half  fluidrachms, Saturated Tincture of Nux Vomica two
and a half drachms ; 'mix.  The dose is ten or twelve drops, three times a
day.  Or, the Compound Pills, or Compound Powder of Leptandrin,  may
be used.   A very good pill for obstinate constipation, is composed of Podo-
phyllin, Apocynin, each, one drachm, Leptandrin three drachms, Alcoholic
Extract of Nux Vomica twelve grains, Castile Soap a sufficient quantity to
make  the whole  into a pill-mass; divide into three  grain pills, of which one
may be taken  every night, or  every other night.  It must be remembered
that the use of purgatives creates a necessity for  their repetition, which im-
pairs  the energy of the bowels,—consequently, it is  better in all cases to
solicit natural evacuations, than to become habituated to cathartic medicines.
Constipation during pregnancy,  may be overcome  by the use of the Rhu-
barb and Potassa powder above named, or by injections of some vegetable
bitter infusion, as of  Boneset, with the addition of Molasses; and the diet
should consist of  stewed fruits, prunes,  figs, mush and molasses, brown
bread, dates, ripe fruits, Indian meal gruel, &c.
   Constipation in  infants, may generally be overcome by the introduction
of a piece of Soap into the rectum, as ordinarily used by nurses; if this does
not answer, a strong infusion of Leptandra, (Blackroot,)  to which about
one-third of its measure of Molasses has been added, may be administered
in doses  of  from ten drops to a teaspoonful, depending up^p the age of the
infant, repeating the dose every three or four hours;  and this should be
exhibited daily for several  successive days or  weeks.   At the same time
the following  injection should  be thrown into the rectum twice a day, caus
ing the child to hold it in the gut as long  as possible, and using a compre»»
over the  anus, if it be required, to prevent its immediate discharge:—Take
of a strong infusion of Golden Seal  two  fluidrachms, Tincture of Prickly*
Ash berries twenty or thirty drops; mix for an injection. 
HEADACHE.
427
                              HEADACHE.

    Headache may he primary, but more generally it is symptomatic of some
  other disease, and will cease on a removal thereof.  When owing to consti-
  pation, it may be overcome by the appropriate measures for inducing regu-
  larity of the bowels.  When  it is owing to  indigestible food, or  acidity of
  the stomach, it is termed "sick headache," which generally commences with
  a blurred, obscure, or double vision, gradually growing more and more se-
  vere ; a pain in the forepart of the head, at first hardly appreciable, but
  becoming very intense with  more or less rapidity, and accompanied with
  nausea  and vomiting, is present, and, when it reaches its height, the indis-
  tinctness of vision passes off.   The  face is  pale,  the  patient is frequently
  chilly, and seeks to lie down in a place free from light and noise.  Usually,
  after vomiting, a sleep ensues, from which the patient awakes free from the
  pain, but with a soreness in the front part of the head, which may continue
  for several days  before it passes away.  Attacks of sick headache may occur
  every few days, or at much longer  intervals ; they usually pass away in a
  few hours, when not treated medicinally, and sometimes an attack will con-
  tinue for two or three days.  Persons disposed to  apoplexy are  more liable
  to this  kind of headache.
    There is also a " nervous headache," which may be periodical in its* attacks,
  or may be constantly present, but having periods of remission  or diminu-
  tion  of  its severity.   This may  also be owing to derangement of the stomach
  and bowels, and  is generally connected with some nervous affection.
    Treatment.  Sick headache is sometimes cured at once by  an emetic;
  but the most efficient preparation  that I have ever used, is composed  of
  Super-carbonate  of Soda half a drachm, Prepared Charcoal a drachm, Pare-
  goric a  fluidrachm, water a fluidounce; mix well together, and  give for a
  dose.  This should be given as soon as the indistinctness of vision  comes
 on, and  must  be repeated every fifteen minutes until relief is obtained.
 The patient must lie still, on his back, in a darkened  room, where he wili
 not be disturbed  by any noise or conversation.  In some patients, the em-
 ployment of  Essence of Peppermint instead of Paregoric, will be  found
 more advantageous.   If  the headache is actually present, the same must be
 administered,  and the head bathed with a cold mixture of  Vinegar Spirits
 and rain water, equal  parts.   The patient should  also endeavor to  sleep'
 from which he must  be  allowed to  awake naturally, and after  which the
 pain will have more or less completely subsided.  Persons subject to  sick
 headache, should keep their bowels regular, avoid all articles of  diet  which
 are indigestible,  or which will  produce acidity of stomach, and  should be
 careful not to  permit any intense mental action or  excitement at any time.
 Indmduals liable to attacks of sick headache, will frequently ascertain that
 some peculiar  articles  of  diet, which may be used by others with impunity,
 will induce the disease in them; in such cases, these articles should always
 be avoided.  In the intervals between the attacks, means should  be used to
 strengthen the stomach and nervous system ;  the following will be  found
 excellent for this  purpose ;-Take of Aletridin, Alcoholic Extract of  Black
 Cohosh, each, two grains, Sulphate of Quinia, Prussiate of Iron, each, one
 gra n;  mix and divide into two  pills, of which one may be taken for a dose
 repeating it three times  a day, and  continuing  their  use daily for some

  Nervous headache may  be cured by the following pill:—Take of Extract
of Aconite half a grain, Extract of Stramonium one-eighth of a grain Va
lenanate  of Quinia one-fourth of a grain; mix for a pill.   The dose is one 
428                AMERICAN  FAMILY PHYSICIAN.
pill, to be repeated every one, two, or three hours, according to the severity
of the attack.  At the same time, the patient should drink freely of an in-
fusion of equal parts of Catnip, Scullcap, and Valerian.  Another very use-
ful agent  for nervous headache,  is composed of Powdered  Assafetida four
grains, Sulphate of Quinia one grain, Piperine two grains, Sulphate of Mor-
phia  one-eighth of a grain; mix for a dose, to be  taken in a little water,
The Extract of Belladonna, in doses of one or two grains, repeated every
two hours, during the continuance of the pain, has been found very effica
cious in intermittent and neuralgic forms  of headache.  Of course, the pa
tient should be apprised  of  the liability it will have  to  produce doutlc
vision.  In a few cases, I have derived much benefit from the Tincture of
Gelseminum, given in doses sufficient to induce its peculiar symptoms.
  Sometimes intermittent headache may be cured by the following snuff:—
Take of Benzoic Acid two drachms, Sulphate of Quinia fifteen grains, To-
bacco Snuff six drachms;  mix thoroughly together, and divide into six equal
parts, one of which must be daily used as a snuff.
  In ordinary severe headaches, the  feet and  legs should be frequently
bathed in  a warm, stimulating alkaline  solution, and Mustard  poultices
should be applied to the feet and along the whole course of the spinal col-
umn ; the head should be bathed with some  cooling lotion, and in all cases
the bowels should  be kept regular, the surface of the  body frequently bathed,
and  the diet  should be  light, nutritious, and  easy of  digestion, selecting
such articles as agree best with the patient.   Gentle and  regular exercise
daily in the open air, with regular hours for sleep and rising, will be found
important hygienic measures.   Persons subject to headache, should never
wear any thing tight around the neck, or upper part of the body.
                            TYMPANITES.

  Typanites, or Windy Distension of the Abdomen, is a  disease  chiefly
attacking those of debilitated and relaxed habits, occasioned by fevers, pro-
fuse discharges,  acute  intestinal disease, improper or flatulent food, or too
strict an abstinence from food, and all other debilitating causes.
  Symptoms.   Tympanites is usually preceded by great flatulency, with ex-
pulsion of air, both upward and downward, a rumbling noise in the bowels,
and frequently colicky pains.   The swelling of the abdomen may come on
slowly or suddenly, it distends the  abdomen to a greater  or less extent,
does not yield readily to pressure, and is  very tense and  elastic, without
any fluctuation.   As the disease  progresses, there will  be  thirst, impaired
appetite, costiveness, febrile symptoms, difficulty of breathing, pain in the
loins, difficult urination, and even a total suppression of this discharge, with
a general emaciation.  Cough is apt to be present, especially in an advanced
stage.   It is an  obstinate and dangerous disease, slow in its progress, and
terminating either in dropsy or gangrene.   When the constitution is unim-
paired, and  wind can be expelled from the bowels, the case  is favorable.
  The disease may exist in the intestines, or in the abdominal cavity; when
in the latter,  the swelling is more uniform, the tension greater, and, more
elastic,  giving a sound on percussion  like that of a drum; there  are no
discharges of  wind as in the  first form, and the disease is likewise more
serious.
  Treatment.   Stimulating  injections should  be given two or three times
a day, for the purpose of effecting a discharge of wind from the bowels,
which will  be found to afford much relief.   To a pint of a strong infusion 
worms.                           429
 of Spearmint, add a gill of Tincture of Prickly-Ash berries, half a gill of
 Tincture of Assafetida, and a teaspoonful of Ginger ;  inject as much of this
 liquid into the bowels each time as possible, and repeat it two or three times
 a day, or even oftener, according to the symptoms,—the patient should en-
 deavor to retain it for some time, unless it produces an immediate discharge
 of gas.   In connection with this, the abdomen  of  the  patient should be
 slowly and continually  rubbed downward with the  hand of an attendant,
 for several hours in succession, or until the swelling has disappeared, making
 as much pressure  as can be borne.   During this friction, or shampooing of
 the bowels, the following  mixture  may be rubbed  on them, from  time  to
 time, in small quantities :—Take of Oil of Prickly-Ash berries, Oil  of Caje-
 put, each, one fluidrachm,  Oil of Stillingia half a fluidrachm, Oil of Sassa-
 fras half a fluidounce; mix.   Or a mixture of equal parts of Oil of Turpen-
 tine, Oil of Sassafras,  and  Camphor, may be substituted.  This friction and
 pressure upon the abdomen, will be found an  important part of the treat-
 ment.  To assuage the thirst of the patient, infusions of Ginger, Horseradish,
 Spearmint, Horsemint, Dioscorea, Pleurisy root, &c, may be administered.
  Should these means fail, it will become necessary, in addition, to admin-
 ister an active purgative, as the Compound Powder of Jalap,—and this will
 be almost always necessary, even at the commencement of the treatment, in
 those cases where there  has been a constipation of the bowels for a day or
 two previous to the attack.
  In  obstinate cases  of abdominal tympanites,  it may become necessary to
 tap the patient, as in  dropsy, and thus  permit  the gas to escape from the
 cavity of the abdomen; giving tonics internally.
  During the disease, the  diet should be light, digestible, and of a nutri-
 tious character; all food which will cause acidity or flatulency, should be
 avoided, and to check  the fermentation of the food, the solution of Sulphite
 of Soda, on page 419,  a few drops of Creosote,  some  Brandy, or one of the
 mineral acids, as Nitric, Muriatic, Sulphuric, or the Tincture of Muriate of
 Iron, may be  given.   After the removal of the tympanites,  the  patient
should use means to  strengthen the stomach and bowels, and to maintain
regularity in the alvine  evacuations.   He  should also attend to the skin,
by frequent bathings and  frictions, exercise moderately and daily,  and be
careful as to the nature of his food and drink.
VERMES, or  WORMS.
  Worms are found in all animals, and in various parts of them.   In man
they have been met with in the kidneys, liver, eye, lungs, brain, &c, but
those which  are more frequently met  with, infest  the  intestinal canal.
These  are, 1. The  Tricocephnlus dispar, or long  thread worm, which is a
round, white worm, about one  or  two inches  in  length, and occupies the
largo intestines.  2. The Oxyuris vermicular is, maw, or thread worm, usually
called  ascandes; it is a small, thin, white worm, not exceeding an  inch  in
length, with a pointed tail, and chiefly lodges in the rectum, where it gives
rise to much itching and uneasiness.  These worms  are very common  to
children, though adults may have  them.  3.  The ascaris lumbricoides,  or
long, round worm, which is  a  round worm varying from  three to  twelve
inches in length, and from the twelfth to the sixth of an inch in diameter •
its color varies according to that of the food, being frequently milkv or  of
a brown-ash-and occasionally blood-red.   It is more commonly found in
the small intestines.  4. The Tcenia solum, or long tape worm  is a flat, ar
i 
430
AMERICAN FAMILY PHYSICIAN.
ticulated,  or jointed worm, with  four  suckers at its head, of a white color
and varying in length from a few feet to several  hundred.   It inhabits the
small intestines.   5.  The Bothriocephalus  latus, or broad tape worm, is flat
or nearly  so, from ten to twenty feet long, and from one-sixth of an inch to
half an inch broad.  It is seldom met with in this country.
  Symptoms.   When  worms are discharged during  the progress of any
disease, it is usual to  consider this as sufficient proof that the malady is oc-
casioned by them, but this is frequently a  mistaken conclusion.  In febrile
and inflammatory diseases especially, the deranged state of the secretions,
the increased temperature and altered diet, renders  the  situation  of the
worms incommodious, and they remove to  some  other part, and may  pass
by mouth or by stool; yet they may not have  been at all instrumental in
the production  of these  diseases.   However,  in all  such  cases,  the  best
course to  adopt  is always  to  administer  worm medicines, as the presence
of these parasites almost invariably aggravates,  and often  renders fatal, a
disease, in the production of  which  they  had  no  creative  agency, yet the
presence of which has caused them to migrate, or as commonly termed,  "set
the worms  to  moving."  With  children,  particularly,  this course  is the
best, more especially when  they are cutting their teeth, and have  fevers,
convulsions, &c,  for although among delicate infants an increase of worms
in the bowels  will produce many unpleasant  symptoms,  as convulsions,
fevers, apparent  dropsy of the head, &c, yet, they are  not  so often the
cause of these affections, as they are of their obstinacy and fatality;  hence
in such cases, vermifuge cathartics  will always  be found  decidedly bene
ficial.
  The symptoms of the presence  of worms are very equivocal, with the ex
ception of the maw, or thread worm, which may be known by  the annoying
and almost intolerable itching which they occasion within the anus, and
by their being frequently seen  in considerable number in the feces; not
unfrequently they occasion tenesmus, and even a falling of the  fundament,
prolapsus ani.
  In  children, a  paleness of  the countenance, itching  of the nose, starting
and grinding  of  the  teeth during  sleep, irregular appetite, fetid breath,
hard swelled belly, upper lip considerably swollen, sore mouth at times,
picking of the nose, and one of the cheeks more or less constantly flushed,
with more or less fever, may be considered certain  evidences of worms.  In
all diseases of children, the above flush on the cheeks,  which may remain
constantly, or appear at intervals, should be noticed, as, with  the exception
of true hectic,  it is almost invariably an evidence of the presence of worms,
either as a cause, or an aggravation  of the disease.
   The  more constant  and less  uncertain symptoms of worms, are: fetid
breath, especially in the morning;  bad gums;  itching of the anus, irregu-
lar appetite, sometimes bad, at other times quite voracious; looseness,  with
slimy discharges; irregular colics;  gripings; great thirst; and involuntary
discharge of saliva, especially  when asleep; frequent pains of the side; a
short, dry cough; unequal  pulse;  pale, whitish, and  frothy  urine; desire
for salted meats  and fish;  peculiar  pale, unhealthy and  bloated counte-
nance, with a  dark, hollow circle around  the eyes.  Sometimes slow fever,
swoonings,  drowsiness, palpitation  of the heart, cold sweats, convulsions,
and many unaccountable nervous symptoms.
   Tape worm may be known by a gnawing pain in the stomach, irregular
appetite, but generally voracious, and the  food eaten does not  nourish the
system, as evident from emaciation ; a hard' cough, with considerable expec-
toration of mucus, great thirst at times ; debility;  and small bodies in the
excrements, resembling melon  or cucumber seeds. 
WORMS.
431
  Treatment.   The indications are to remove the worms whether dead or
alive, and then  impart tone and  vigor to the intestinal  canal, in order to
prevent their future generation.
  In most cases, and especially among children, the following Worm Cor-
dial will be found to not only remove the worms, but also to strengthen  the
bowels, thus fulfilling both  the  above indications:—Take  of fresh Black
Alder 'Berries one  pint, Cedar or Juniper Apples (recent)  one  pound;
bruise  them, and digest in a quart  of Alcohol  for  fourteen days; then
Btraiu and add one pint of Molasses.  The dose  is  a teaspoonful, repeated
three times a day, for children one or  two years of age; a  table-spoonful,
 hree times  a day, for adults.  As soon as it has  purged sufficiently,  the
dose may be lessened,  when  it  will  act  as a  tonic,  and  its use should
be continued for several  weeks.   It is pleasant,  and  children  generally
love it.
  Several other  vermifuge  remedies have  been  successfully  used, and
among them the following:—1.  Take  of  Castor Oil, Wormseed Oil,  each,
one fluidounce,  Oil  of Turpentine, Oil of Anise, each, half a fluidounce;
mix.  The dose is ten or twenty drops for  a child  one  or two years old, to
be  repeated  every  three  or  four hours;  and, after using  it two or  three
days in succession, a purgative must be administered.   2. Take of Castor
Oil, Wormseed  Oil, each, one fluidounce, Oil of Anise half a fluidounce,
Tincture of Myrrh  half a fluidrachm, Oil of Turpentine twenty minims,
Croton Oil  two drops;  mix.   The dose is a teaspoonful every two hours
for ten or twelve hours, to be followed, if necessary, by a purgative.
  The  Entozoic Powder  I have used for many years, and  it  has never dis-
appointed me in any one instance; it is probably unsurpassed in removing
any kind of worm which may exist in the human intestines.  It is very
bitter and  disagreeable  to the  taste, but it may be relied on  as certain in
destroying and removing worms, whether in adults or children.  It acts  by
destroying not only the worms themselves, but likewise  removes that slimy
substance in which they  abound, and which is so favorable to their produc-
tion.  It will be observed, that in all cases where worms  exist in the  bow-
els, the  passages  produced by this remedy are slimy, sometimes  whitish,
with specks presenting the appearance of worms cut up.   On account of its
bitterness some  children cannot take it without immediately vomiting it
up; among such, other means must be used.
  After removing the worms, in all cases without exception, when not contra-
indicated, some  tonic medicine to strengthen the bowels  should be  used to
prevent their forming again.   I commonly use the following tonic cordial:
Take of Gentian, Golden Seal, Colombo, each, in powder, one drachm, Cin-
uainon, Cardamom seeds, Prickly-Ash berries, each, bruised, half a drachm,
good Brandy one pint; mix, and let  them macerate for a few days.  The
dose for a child  is from half a teaspoonful to a table-spoonful, three times
a day, in  sweetened water.
  The thread worms are  frequently difficult to remove;  in nearly all cases,
however,  a  strong decoction of the Entozoic Powder will  dislodge  them
when in the rectum, if used as an injection.  Or, the  following  will   be
found very efficacious:—Take of Balmony one  ounce,  Mandrake half  an
ounce, water one pint; mix, and boil to form a pint of strong decoction, to
which add  a gill of Molasses, a teaspoonful of Salt, and a fluidounce of
Tincture  of Assafetida.   Use this as an injection, in the quantity of half a
gill or a gill at a time, according  to the child's age, repeating it two  or
three times a day for several successive days.
  Children are often troubled with a  choking, or difficulty of swallowing, 
432
AMERICAN FAMILY  PHYSICIAN.
as if something were in the throat—the nurses  sometimes call it "a rising
of the worms "—it  may be, perhaps, owing  to worms working their way
upwards—but at all events, a draught of salt and water,  will generally be
found effectual in removing it.
  The diet for children who are troubled with worms, or who are using tho
above tonic tincture, should be  salt, as  salt mackerel, herring, salmon  &c.
and their ordinary food may contain an  extra quantity  of  salt.  Onions
and garlics, with salt, are  also  useful.   All acid, fat, or  greasy articles of
diet  must be avoided, when worms are  suspected,  or where the child is
subject to them; the diet may be full and nutritious.
  The following preparations have been  highly extolled for their anthel-
mintic properties:   1.  Pulverized bark of the root of Black Alder, (Prinos
Verticillatus,) in teaspoonful doses and in Molasses, three  times a day,
brings the worms away whole.  2. The juice of Blue Flag, (Iris Versicolor,)
for tape worm.   3.  Eat freely  of Garlic  and  Salt,  and  administer every
other  day a purgative of Mandrake root;—this has  expelled  tape worm,
4. Make  a strong decoction of Rue, Balmony, and Wormwood;  take equal
parts  of  this decoction and  beef's gall, to which add a little Aloes and
Assafetida; boil the  whole together, to the consistence of a plaster. Apply
a plaster  of this, about three inches square, on the pit of the stomach, for
two or three days, changing it every day,—at the end of  which  time give a
strong purge.   5. Take of Santonine, (prepared from Semen Contra Vermes,)
one drachm, Sugar five ounces,  Gum Tragacanth half a drachm,  water suffi-
cient to form into lozenges.   Divide into one hundred and  forty-four loz-
enges, and let the child eat  from  five  to ten a day.   6. Take  of the bark
of the root of the Pomegranate  tw6 ounces, water  two pints.  Boil to one
and a half pints.  Dose, half a  gill, every hour.  For tape worm,—four or
five doses are generally sufficient to expel the worm.
   DISEASES  OF  THE  URINARY
                ORGANS.
  Under this head will  be  considered  the
several  derangements  which may be  met
with in  the functions of the urinary appara-
tus, and which are not referred to in other
parts of the  work.  Acute  or Chronic  In-
flammation of the Kidneys, and of the Blad-
der, will be found among  Inflammatory dis-
eases, and Hematuria among Hemorrhages.
BRIGHT'S  DISEASE  OF  THE
            KIDNEY.
Fig. 29.
Evaporated residue of healthy urine
  Albuminuria, or Bright's Disease of the  Kidney, is known by a mor-
bid condition of the urine, which is habitually impregnated with albumen.
Healthy urine  contains no  albumen; but that  in which it exists  is more
frothy than usual when  shaken, and on blowing into it through a tube.
bubbles are formed as in soapy water.   Its specific gravity varies from 10-0
to 1004, being  lessened as the disease progresses;  it is usually found with 
BRlGHT's  DISEASE.
433
epithelial scales, mucus, blood-discs* fibrous casts of the uriniferous  tubes,
and saline sediments.  Albumen may always be detected in  urine by the
aid of heat and nitric acid;  a small  quantity being  placed in a test tube,
and heated  by the  flame of a spirit lamp,  if albumen be present,  it will
coagulate, forming a whitish cloud; or, if in considerable quantity it will
form into flakes or small curdy fragments.  Nitric Acid added to this will
not dissolve  the albuminous  opacity.  Again, to another  portion of  urine,
add a small quantity of Nitric Acid, which will precipitate any albumen- in
a whitish flaky or pulpy form ; and if heat  be applied to this  it will not be
dissolved.  In the urine of  those  who have long  been taking Copaiba or
Cubebs, Nitric Acid will produce coagulation/which, however, may be known
from albumen,  by the  coagulum  thus formed  floating on the  top of the
urine, while  albumen  sinks.  When  the urine is  alkaline, as determined
by its restoring the original blue color to reddened litmus paper, it must
be rendered acid before albumen will be precipitated.  Acetic and Tartaric
Acids do not precipitate albumen.  When  albumen is found in  the  urine,
this should be examined from time to time to ascertain if it continues, for
it frequently exists  without any  serious difficulty; its habitual presence
is indicative of structural change in the  kidney.
   Symptoms.  The only positive symptom of the disease under  considera-
tion, is the  persistency of albumen in the  urine, but with this  are gener-
ally found  certain secondary or indirect symptoms, which,  however, vary
considerably in different persons.   The  patients are subject to  disordered
digestion;  obscure pains or uneasiness in the loins; sickness  and vomiting
at different  times; debility;  the blood becomes modified, with  considera-
ble loss of its red particles;  the urine may be  red, brown, or dingy, con-
taining albumen,  fibrinous particles, and  epithelial scales with fat; dropsi-
eal swelling  of the  face,  or some other part  of  the system occurs and
continues to  spread and  increase; firm pressure  over the region of the
kidneys produces  more or less pain; the  skin is dry and hard, not perspir-
ing even under exercise ;  pale, anemic, and bloated; drowsiness is a com-
mon symptom,  and not unfrequently convulsions or apoplexy.
  Sometimes the patients are annoyed by a frequent desire to urinate,  by
flatulence of the  stomach and  bowels,  or, by obstinate costiveness,  or
diarrhea.  In some cases the urine is very abundant, in others quite scanty,
and always  of low specific  gravity.   The  pale, bloodless countenance, drop
Bical  condition of the  cellular tissue,  and albuminous urine, are certain
indications  of Bright's disease.   Toward the  termination of the disease,
the drowsiness  increases,  coma ensues,  and death; and before  death, the
albumen  may have disappeared  from the  urine.  Acute inflammation of
the serous membranes, disease of the heart, and dyspepsia are very apt to
be induced by this affection of the kidneys.
  Causes.   Albumen may be found in the urine, owing to some  temporary
irritation, and may pass away without leaving  any permanent injury;  but
when it is persistent, as previously remarked,  it is owing to a congested
condition  of the  kidneys;  fungus hematodes  of  the kidneys; granular
disease  of  the  kidneys; or   fatty  degeneration of  the kidneys, to  all of
which, the term Bright's disease is commonly applied.   These  conditions
of the kidneys may arise from  external injuries,  recession of cutaneous
eruptions, long-continued  use of stimulating diuretics, frequent exposures
to cold,  intemperance, excessive  masturbation or  debauchery,  neglect of
proper exercise, and, probably, various other causes at present  unknown.

  *Soe fig. 12 on page 169; fig. 16 on page 218; fig. 17 on page 301; fig 18  on page 301, sate
fig. 19 on page 302.
       28 
434
AMERICAN FAMILY  PHYSICIAN.
   Treatment.   From the obscurity which still  enshrouds  this diseases
 there has been no treatment yet adopted, which can be relied upon as posi-
 tive or special;  and it has been found that according to the nature of the
 secondary diseases which arise out of and complicate it, must the treatment
 be modified.  The indications, however,  are  firstly to  relieve any looal
 excitement or irritation  which may be present, and, secondly,  to restore
 the blood to a state of health.
   To fulfil the first indication, the skin should be frequently bathed with
 an alkaline solution rendered slightly stimulant by the addition of Whisky,
 and frictions  should also be frequently employed.  Perspiration should be
 produced every  few days  by means of  the Spirit vapor  bath, and counter-
 irritation should be applied over the region of the kidneys, as by Firing,
 Cupping, or the intermitting use of the Compound Tar plaster, which will
 be found a very important agent  in  the  curative treatment.   The bowels
 should be kept regular by small doses  of Podophyllin and Leptandrin—in
 some instances by the White Liquid Physic.  And whenever there is a dis-
'position to drowsiness or coma, they should be actively purged, in order to
 relieve the head symptoms.   When  there is a deficient action of the kid-
 neys, they may be gently urged by mild diuretics, as an infusion of Queen
 of the  Meadow and  Peach leaves,  or of Marshmallow root.  In many
 instances I have found the use of  unfermented cider, or of the Compound
 Infusion of Parsley, very valuable agents in restoring the urinary secretion,
 removing the dropsical swelling of the system, and causing the albumen to
 disappear.  Can it be that the  Malic  Acid of the cider exerts any salutary
 influence upon the diseased kidney?
   To restore  the blood to a healthy condition, I have found the most bene-
 fit from  the  Tincture of Muriate of Iron, giving  about twenty drops of it,
 in a wineglassful  of water, and  repeating this  dose three times a day.  In
 some instances I have used in connection with this, the Iodine pill two or
 three times a day ; and in others,  a  Solution of the Iodide of Iron.  The
 Iron in the Compound Infusion of Parsley, will likewise be found to exert
 a  beneficial  influence.  .The  Lactate of  Iron,  in doses  of five  grains,
 repeated three of four times a  day, has been found efficacious;  and prob-
 ably some other ferruginous preparations might  be  found useful, as the
 Ammonio-Tartrate of Iron, or the Ammonio-Citrate,  or the Citrate of Iron
 and Quinia.  Probably a solution  of the Malate of Iron will be found very
 valuable.   The use  of Malic  Acid, and the Malates,  the  greater part of
 which are more or less soluble,  has  been entirely neglected in the practice
 of medicine, and I would here invite the attention of  the  profession to
 them.   Malic Acid added to many insoluble agents will have  the  effect at
 least,  of rendering  them soluble  in the  stomach.   In addition to  these
 means,  if symptoms  of periodicity are  present,  Sulphate of Quinia and
 Prussiate of  Iron, equal  parts of each,  may be  administered in doses of
 two or three  grains every hour during the remission or intermission.
   The diet must be plain, nutritious, and easy of digestion, avoiding all fate,
 high-seasoned food, hot bread,  pastries, butter, aromatics,  stimulants, &c.
 Regularity in eating, sleeping, and gently exercising in the open air is indis-
 pensable, and all the exciting or  disposing causes of the disease  must be
 avoided.  I will here give briefly the case of a man about thirty years of age,
 a carpenter, who was cured of Bright's Disease.  On the 12th of May, 1854,
 he had the following symptoms.—Vomiting almost daily, and  which had ex-
 isted for the  last three years;  sometimes  it occurred on rising in the morn-
 ing, but more generally between meals, frequently continuing for three  oi
 four hours at a time; appetite lost; much emaciated; pale, dry, and unperspi- 
BRIGHT'S DISEASE.
435
ring skin, which had been thus for about two years; the bowels very irregu-
lar, being sometimes costive, and at others loose, and the food passed imper-
fectly digested; for over four years he has experienced a dull pain  commen-
cing in  the loins and extending to the bladder, peritoneum, andleft pleura;
at times the sensation of heat is so great as to increase perspiration, says it
feels like a flame; he has experienced this sensation more or lessfor the last
three years, and for the last year  it has  occurred daily,  sometimes in the
morning, at other times both in the morning and evening, and usually con-
tinuing for about an hour.   Has some cough, not so severe as about a year
Bince, when he was supposed  to be laboring  under consumption; dizziness,
and pain in the head almost constantly for the last three years, often falling
asleep suddenly in the  midst of conversation ;  rheumatic pains in the right
knee and ankle ; palpitation of the heart, and more or less difficulty of breath-
ing for the last three years; soreness in the right side.   Seven years ago he
had an eruption on the back and legs, which continued for two years; for
eighteen months has had frequent  numb sensations in the  hips and thighs,
continuing for two  hours  at a time;  while eating, his penis and  testicles
retract, almost disappearing, and a thick  white  perspiration appears on the
inside of the  thighs, of the  consistency of cream, which continues for about
fifteen minutes after the meals; urinates  frequently during  the twenty-four
hours, small  in quantity,  of various colors  and fetid;  acids  and bitter agents
most acceptable to his palate and stomach.   About  four years  since  he
hurt himself  by lifting timber, and shortly after  discharged blood with his
urine ; has been treated by various  physicians for  gonorrhea,  consumption,
diarrhea, stone in the bladder, &c,  &c.    On  examining  the  urine by heat
and Nitric Acid, albumen was  discovered.
   The  treatment was as follows:—Twice a day, as soon as the symptoms of
irritation in the kidneys commenced, a tepid  pack, or sheet-bath,  the sheet
being wet with a strong decoction of Hoarhound, was  applied;  on  coming
out of this bath, the right side, and especially  over  the region of the liver
was rubbed for about ten  minutes, with diluted Nitro-Muriatic  Acid, strong
enough, however, to cause a tingling sensation.  About fifteen minutes before
each meal, the following was administered:—take of  Decoction of Peruvian
bark a table-spoonful, Tincture of Muriate of Iron ten drops ; mix.   His diet
consisted of a few spoonfuls  of fresh milk and toasted corn bread, as much as
could be retained on the stomach.
   l!)th May.    Vomiting is not continued  so long;  stools changed from a
white to a slightly yellowish color;  stomach retains half a  tumbler of milk ;
falls asleep in the bath; rests better than for a long time.   Ordered a band-
ai;o of four thicknesses  of sheet, extending from the region of the stomach to
the hips, and  wet with the decoction of Hoarhound to be worn  all the time,
covering it with oil silk.  Continue previous treatment.
   2d June. Perspires freely, appetite improved, burning sensation  not con-
tinued so long, but more  albumen in  the urine, with small balls, probably
fibrinous,  forming a layer about half an inch in  depth, when the urine is in
a quart  bottle; all other symptoms improved.   Continue the treatment.
   22d June.   Head symptoms decidedly improved, little or no nausea, appe-
tite increased, sleeps better at night, the heat and irritative symptoms checked
when in the bath.   Ordered soups for food, Compound Tar  plaster  over the
loins, and to  use the above sheet-bath cold, as it now seems to be more agree-
able.  Other  treatment to be kept up.
   10th July.   Burning sensation seems to be arrested, urine  increased in
quantity, an eruption all over the body—the Tar plaster has produced a large
sore over the  loins, which discharges nicely.   Continue treatment. 
436
AMERICAN  FAMILY  PHYSICIAN.
  15th July.   Six pints of urine discharged in twenty-four hours ; no alhu-
men detected by heat or  Nitric Acid ;  bowels loose:  burning sensation on
urinating.   Continue treatment.
  1st August.   White sand in urine, about an ounce per day, with albumen-
Nitric Acid  dissolves the sand  but leaves the albumen.   Ordered .\itro-
Muriatic Acid, ten drops in water, to be repeated three times a day.
  10th August.  Decrease of phosphates; urine diminished, and alkaline; all
the former symptoms much improved; sleeps well at night; no nausea;  no
head symptoms.   Ordered the sheet to be  wet in vinegar instead of the
decoction.
  20th August.  Urine acid; no phosphates; two and a half  pints of urine
discharged per day; much improved in flesh;  stands erect; skin natural.
  2d September.   Complains  of no  former symptoms, says he feels better
than for seven years past; wants to be at work, as he has not done anything
for four years,  and states that it has cost him nearly $2,000 for medical ad-
vice and treatment.   Dismissed him, but advised him to continue the acid for
a few weeks.
  1855,  Nov. 6th.  Saw him again ; appears  to be well, can  do a good day's
work, has gained fifty-eight pounds in flesh,  and  considers himself perma-
nently cured.
DIABETES.
  Symptoms.   Diabetes may come on suddenly, or gradually;  in the latter
case, there will  be frequent discharges of urine, and which will disturb the
patient frequently during  the  night.   The  appetite is generally voracious,
with unquenchable thirst.   The sexual appetite is  deficient.  The  digestion
becomes imperfect; the skin dry and harsh ; the tongue clammy, and often
furred dark, or red, with  a secretion  of thick, viscid  saliva; the gums are
swollen and inflamed, often bleeding upon the least touch; the breath has an
odor similar to that  of the urine, like the smell of hay, and frequently the
same scent issues from the body ; the bowels are costive, with occasional pains
of a colicky nature.  Frequent attacks of dizziness and pain in the head, are
most usually present; the patient becomes restless, dissatisfied, and the moral
and intellectual faculties are  gradually blunted; emaciation, diarrhea, and
dropsical  swelling of the limbs make greater and greater progress, and ulti-
mately hectic fever and death.
   The most prominent feature in the  disease is the character of the urine; it
is very large in quantity, frequently amounting to four or five gallons in the
course of twenty-four hours.   It  is  very clear, paler than natural, though
sometimes tinged with green of a specific gravity varying from 1025 to 1055,
has a sweet taste, an odor like hay or apples, and ferments very readily,  h
is apt to be deficient in urea, though  it may contain  urates or phosphates.
 Diabetic  urine  contains a large amount of grape sugar, for the detection ot
which several methods  have  been recommended, the following are among
 the best:—1.  Trommers test.—Add a few drops of a solution of Sulphate ot
 Copper to the urine, enough  to give it a pale blue  tint,  (a pale blue Phos-
 phate of Copper may be precipitated); now add an excess of Liquor Potassa,
 if sugar be present, a purplish-blue solution is formed, and if the mixture
 be carefully boiled for a few minutes, a reddish or yellowish-brown precipi-
 tate ensues ;  if no sugar, a black precipitate.  2. Moore s test— Add to t
 urine about half its bulk of pure Liquor Potassa, and boil gently f°raleoi
 minutes; if sugar be present, the  liquid will assume an  orange-brown, 
DIABETES.
437
bi-tretint.   3. Ilorslefs test.—Mix together equal parts of Neutral  Chro-
mate of Pota-h and Liquor Potassa.  Place a small quantity of this test in
some urine in a test tube, and boil;  if sugar be  present, a deep sap-green
color will ensue from the decomposition  of the Chromic Acid;  the reduced
Oxide  of  Chromium is held in suspension  by the Potash.   To test cane
bu-'W substitute a solution of the Bichromate  of Potash for that of the
  "utral Chromate.  4. Lu/ons  test.—To  a  cold saturated
N
               solution of
Sulphuric Acid in  such  a
         Fig. 30.
Penicilium glaucum, a fungtu
Hichromate  of  Potassa  add  an  excess  of
manner  that some free Sulphuric Acid will
be present when  all  the  Chromic  Acid
is  liberated.  The liquid will be of a beau-
tiful  limpid red color, and is  composed  of
water, Chiomic Acid, Bisulphatc of Potassa,
and  an  excess of  Sulphuric  Acid.   Add
enough of this test to the suspected urine to
impart a red color to it, then warm  the  mix-
ture, a brisk effervescence ensues,  and  the
color changes  from red to emerald green, if
sugar be present.
   When  exposed  to the  air, a  fungous
growth  called penicilium  glaucum, may fre-
quently  be seen in diabetic urine; and a
few drops  of yeast  added to such  urine, at
at 7<>°  or  Sl)° Fahrenheit, will Cause  it  to growth in acid urine containing albu-
undergo  vinous fermentation.               men or suSar>whcn exposed to the air.
   C.vrsKS.   Diabetes is met with  in both  sexes  and at various ages, but
chiefly among  males at  an advanced  age.   It may be induced by  any
means 'that will derange  the  digestive functions, impoverish the blood,
and debilitate  the  system, as intemperance, excess in  venery, immoderate
evacuations, constant use of acid  drinks, crude, unwholesome diet, expo-
sures to cold, use of mercury, &c.
   Treatment.  The bowels in this disease must be kept regular by means
of Rhubarb in small  doses repeated three times a  day, or, minute doses of
Podophyllin and Leptandrin ;  active  purgation must be avoided.    The
skin must  especially be attended  to,   it should  be  bathed daily  with a
stimulating liquid, and dried with  considerable friction.   The application
of cold water along the whole length of the spinal column every morning,
with brisk friction subsequently, will be found  very advantageous.  Coun-
ter-irritation  along the vertebral  column, by dry  Cupping, or  by Firing,
should be  frequently used, and will have a very happy influence.   As a
tonic, to  restore  the  digestive  organs  to a healthy condition, and cause a
rapid decrease of the urinary discharge, I know of no better agent than an
infusion  of equal parts of Unicorn root  and Bugle weed, which  should be
drank frequently during the day.   When there  is great nervous irritability,
in connection  with this, equal  parts of Opium and Ipecacuanha may be
given in doses of three grains, and repeated as  often as necessary.  When
the system appears to become  habituated to the above infusion, it may be
laid  aside, ana the following  substituted:—Take of  Laudanum one flui-
drachm  and  a half,  Tincture of Muriate  of Iron two fluidrachms, Muriate
of Quinia,  (or the Sulphate) eight  grains, water six fluidounces;  mix.   Of
this mixture one fluidounce  is a dose, and should be repeated three times a
day.  This preparation and the above  decoction may be  used alternately,
from time to time, as they lose  their active influence over the disease.   As
there is more or less debility attending  this  disease, the Phosphate of Iron 
438
AMERICAN  FAMILY PHYSICIAN.
Bhould be administered in doses  of from three to six grains, repeating the
dose three or four  times daily.   Creosote, and  the  solution of Bisulphate
of Soda, named under Water Brash on  page 407, have occasionally been
found efficacious.
   The  patient  should  take  moderate  exercise daily in the open air if his
strength will permit;  his sleep should be limited  to nine hours out of the
twenty-four;  and all sexual indulgence must positively be prohibited.  His
diet should  be mixed, consisting of animal and vegetable food, avoiding
however all  articles that contain large amounts of sugar and starch • the
cruciferous vegetables will be found the best, as, water-cresses, turnip-tops
dandelion  greens,  spinach, celery, cabbage, &c.  Meats, game, poultry
eggs, rice, and  milk, may also be  used; but  sugar, beets, parsnips, pota-
toes, arrow-root, bread,  corn  in any shape, and all fruits, must  positively
be avoided.  If bread be used,  it must  be such  as is well-fermented, stale
and eaten very sparingly.  For drink the patient may use a cold infusion
of green  tea, water acidulated with Nitric, Muriatic, or Phosphoric Acids
animal soups, and milk  and lime-water; and he should be urged  merely to
sip at frequent intervals, rather than to indulge in large draughts at once,
which latter will be certain  to increase  the disease.  No liquors must be
used except to sustain strength, and those which are better adapted to this
purpose, are  brandy,  whisky,  claret, and pale rum—but no ale, porter,
cider, wines,  &c.  Not long since  a  diabetic patient of mine, who had taken
cold, was advised  to take a domestic preparation of Butter, Vinegar, and
Molasses; he made  a  mistake,  substituted Alum  for the  Butter, and used
the mixture very freely.  It had such a beneficial effect upon the urinary
discharge, that  as  a matter  of experiment I advised him to continue its
use; he did so, and a permanent cure was the result.
SUPPRESSION  OF  URINE.
  Suppression of Urine,  Ischuria Renalis, is generally symptomatic of
Borne other disease, but is sometimes idiopathic.   It is  sometimes used as
            p.   „,             synonymous with retention of urine, but it is
                              entirely a different  symptom, being a greatly
                              diminished or complete  suspension  of the
                              urinary  excretion by the  kidneys.  The dis-
                              ease  is  more  apt to  occur among corpulent
                              persons  of advanced age.
                                Symptoms.    In   the  adult  the  symp-
                              toms  of  the  disease  in  the  earlier pe-
                              riods arS those  merely  of depending ill-
                              ness, the  patient makes  little or no water,
                              and  feels anxious, restless,  and cannot say
                              exactly  what  ails  him.   There  will be  a
                              sense of  uneasiness or  pain  in the loins,
                              extending to the flanks and bowels.   Nausea
                              comes on, and at length vomiting.   The pa-
  a. Chloride of Sodium, in combina- ti   t hag    d  U   d abstracted look, and IS
tion with urea, and evaporated quickly      ,.     ,         ,  ...         ,  1 aver.
from urine.                      not disposed  to any bodily  or mental exer
  b. Chloride of Sodium resembling tj0n  QQ feeling  Over  the region of tQC
t^(^inrti^^mA°W9n^^^^t^e  is n0 fulneSS  or Pain»and,,°D
  c. Chloride of  Sodium crystallized passing a catheter into the  bladder, a table-
slowly from urine, also resembles Oxa- spoonful,  a few drops, or  even no urine may
late of Lime, but differs in being solu- . r  ,,  . '  ,    m  *L l„„i„„j0,0  tlmre does
bie in water!                     be obtained,   lo the  bystanders  tneic uu«
 
ISCHURIA  RENALIS.
439
not appear to be much the matter, and they are apt to be surprised that the
physician should attach so much importance to  the case.  In a little while
the patient becomes drowsy, wanders in his
mind,  talks  incoherently, hiccoughs,  and
eructates, and  in from thirty to forty hours
dies suddenly in a comatose  condition, or
in  convulsions.   In  one case,  the  patient
asked for drink, and as he was raised in bed
to  enable him to  swallow it, he  fell back
dead.  The cause of death in suppression of
urine is the retention  of  urea in the  system,
which  i-i a  poisonous excrementitious mat-
ter, and which if not passed off  is  as certain
to produce  death, as when the lungs do not
set free carbonic acid  gas.  It  is sometimes
the  case that a  suppression  of urine  may
continue for a considerable time,  and not
prove  fatal, the urea being carried  off by  «• Nitrate of Urea.
excessive  sweating, or  diarrhea—but such  *• 0xalate of Ure*'
instances are  rare.  When  urea is present in  healthy urine containing
Chloride of Sodium, crosslets and daggers, as in fig. 31, will  be seen as the
urine evaporates from a glass slip under the  microscope.  When an equal
bulk of Nitric Acid i3 added to  urine, and exposed  to  the action of cold,
crystals of Nitrate of Urea will form, more or less readily in proportion to
the excess of Urea, as in fig. 32.
   Causes.   These are not clearly known.   It may be induced  by exposure
to cold ; by injuries to the back or loins ; by irritation of the kidneys, in-
duced  by the lodgment of a calculus  in the kidneys or ureters; and by
6ympathetical irritation, the effect  of powerful  medicines.  A  slight sup-
pression may continue for a  considerable time without  being followed by
any unpleasant consequences ;  but when it is complete, and the symptoms
of lethargy or coma ensue, they are evidences that the  brain and  nervous
system are succumbing under the noiious agency of  the urea, and in such
eases a cure is rarely effected.  Some consider this affection due to a par-
alysis of the nerve-centers, or of the kidneys, others, to the fact  that the
urea is not formed  in the kidneys as usual.
   Trkatmext.   The patient should be at once placed in a bath as  warm as
he can bear, and should remain in for some fifteen or  twenty minutes.  As
soon as he has been removed from it and dried,  apply cups freely  over the
region  of the kidneys, and follow  them  by hot fomentations.  .An  active
cathartic will be found efficient, and the  Compound Powder of Jalap, to a
dose of which about fifteen grains  of Cream of  Tartar may be  added, will
probably be equal to any.  An infusion of Queen of the Meadow root, and
Peach leaves, equal parts of each, may be drank freely, as well as of Marsh-
mallows, Hair-cap moss, &c.   Stimulating injections will also be found use-
ful, among which,  I prefer the  following:—Take of a  strong infusion of
Horseradish root eight fluidounces,  Tincture  of Prickly-Ash  berries four
fluidounces, Tincture of Nux Vomica three  fluidrachms; mix.   Inject into
the bowels about half a fluidounce, and repeat itthree'or four times a day, as
the c.twe may require.   This treatment  should be pursued very  energeti-
cally ;  the bath may be required  two or  three times  in  the  course of the
day.  A very valuable pill is composed of Eupurpurin two scruples, Xan-
thoxyMn one scruple, Strychnia one  grain;  mix  thoroughly  and divide
into twenty pills, of which one  may be  given two or three times a day.
 
440                 AMERICAN FAMILY PHYSICIAH.

Any disease co-existing with the suppression,  must, of course, be treated
according to its indications.
  As we cannot determine really upon the cause of the suppression  it is
always proper  to administer active,  but not stimulating diuretics, and if
these do not relieve after a reasonable time, with the other  measures, very
little encouragement  can be afforded.   The same may be  said where the
suppression follows a long-contiuued organic disease of the  kidneys.
                     RETENTION  OF  URINE.

  Retention of Urine is applied to those cases where the urine is excreted
by the kidneys, but from some cause in the ureters,  urethra, or bladder is
not discharged externally.
  Symptoms.  There is  an inability to  void the urine on attempting to do
so, and after several ineffectual attempts, the patient becomes fatigued with
his efforts, and also alarmed.  An uneasiness and pain is felt in the region
of the bladder, which extends to the thighs and loins, the bladder can be
felt above the pubes, hard and enlarged, and "pressure  upon it causes
increased  pain.  The desire to urinate becomes more and more urgent, the
patient strains, but accomplishes  nothing in the way of urinating.   As this
state  progresses,  the pulse becomes  hard and frequent,  the face  flushed,
the skin hot, the heart beats rapidly, and the  tongue is covered with a white
fur.   As the kidneys go  on excreting urine, the danger lies in a rupture of
the bladder, or in  inflammation of the peritoneum.   Sometimes the  urine
dribbles away, from the fact that the distending force of the  accumulated
fluid  equals the resistance, and  this  condition though  not followed by a
rupture of the bladder, may give rise to a serious inflammation.  The blad-
der has been known to contain one gallon of urine without rupturing; and
the rupture when it does occur is usually on the third or fourth day.
  Some writers have divided Retention of Urine into three degrees, viz:—
Dysuria, in which the urine is passed  with  pain, and considerable  heat 01
scalding;  Strangury, in which the urine is voided drop by drop, with great
difficulty,  and is attended with heat or scalding pain, tenesmus of the neck
of the bladder, See.;  Ischury or  Ischuria  Vera, in which  the urine having
passed from the  kidneys  to the bladder, the patient cannot void it, notwith-
standing the desire which is incessantly harassing him.
  Causes.  Retention of urine  may be  owing to a paralysis of the blad-
der ;  mechanical obstruction at the neck of the bladder,, or in the  urethral
canal; inflammation of the neck of the bladder; injuries to the bladder, 01
in its neighborhood; irritation of the parts from gravel  or  stone,  or from
cantharides taken internally, or absorbed from a blister;  tumors;  enlarged
prostate glands,  &c.                                                 •
  Treatment.  This will vary according  to the cause.  Should  there be
some  mechanical impediment to the flow of urine, at the  neck of the blad-
der, or in  some part of the urethra, it  may be proper to  introduce  a cathe-
ter;  but if from stricture  or other cause, this is not deemed advisable; a
surgical operation may have to be resorted to.
  When  the  retention  is owing to inflammation  about the neck of the
bladder, the patient may be  placed in a warm hip  bath, and remain there
for fifteen or  twenty minutes, and on coming out, a hot  fomentation of
equal parts of II ops and  Lobelia leaves should be applied to the perineum,
renewing  it frequently;  if, after an hour, the urine does not pass, a  catheter
may be introduced.   In  some severe cases, it may become necessary to pro- 
RETENTION  OF URINE.
441
duce perspiration by administering a dose or two  of the Compound Tinc-
ture of Virginia  Snakeroot,  and also to effect relaxation of  any spasm
which may be present, by injections into the bowels of equal partsof the
Compound Tincture of Lobelia and Capsicum, and warm water, having the
patient to retain the injection as long as possible.   If the bowels be costive,
an active dose of the  Compound  Powder of Jalap should be  given.  In
one case which I attended, the feces were hard and impacted in the rectum,
and could not be dislodged by purgatives or injections, and it became neces-
Bary to scoop out a portion of the fecal matter before an alvine operation
could be procured.  When  fresh Stramonium leaves  can be procured, they
Bhould be bruised and applied to the perineum;  they are a superior agent
in relieving inflammation  and congestion about  the neck of the bladder.
In from half an hour to an hour  after their application, it will  found that
the catheter will readily pass into the bladder.  (It will  also be_ found  a
valuable application in retention from enlarged prostate.)  In the introduc-
tion of  the catheter, great  care should be used; it should be passed with
gentleness, lest the urethra become inflamed or  injured, effects which are
very apt to follow unskilful and improper attempts.  Again, in  these cases
of retention, they should not be permitted  to continue too  long  without
treatment, lest serious mischief ensue.
   When paralysis of the bladder is a cause of retention of urine, the bladder
should be  evacuated once  or twice a day with the catheter,  while, at the
same time, means should be employed to cure the paralysis.   Should the
catheter be passed with difficulty and pain, it will  be better not to remove
it after its introduction, unless too much irritation be kept up by its pres-
ence ; and when it is allowed to  remain  in, the  open extremity should be
plugged, so that the  urine can be passed as  often as required.  To over-
come the paralysis, a current of electro-magnetism may be passed through
the parts once or  twice a day; and a constant discharge should be kept up,
by means of the  Compound. Tar  plaster applied over  the spinal  column
immediately below the small of the back, or over the lumbosacral region.
The bowels should be kept regular, and the skin bathed and  rubbed daily.
Internally, the following will be  found very useful,  as its  effect upon the
nervous system is most potent:  Take of Strychnia  one-sixteenth  of  a
grain, Cantharides one-eighth of a grain,  Powdered Arnica leaves  from
three to five grains; mix for a dose.  Three of these powders may be given
in the course of every twenty-four hours.   Great care and  watchfulness is
requisite in the administration of this mixture, as it will be found that the
strychnia will  produce an active  influence  on some  persons, requiring  a
diminution of its quantity in each dose,  or its entire suspension.   I  have
frequently met with patients in whom  the one-fiftieth of a grain of Strych-
nia caused symptoms manifesting its presence in a very decided  manner.
Another very valuable mixture, useful in paralysis, as  well as neuralgia of
the bladder, is composed as  follows r  Take of Strychnia one-sixteenth of a
grain,  Extract  of Aconite, Extract of Hyoscyamus,  each,  half a grain,
Sulphate of Quinia two grains; mix, and form  into  a pill.  One of these
pills is a dose, to be repeated two or three times  in  every twenty-four hours.
Another excellent pill is composed of Eupurpurin two scruples, Xanthoxylin
one scruple, Strychnia one grain;  mix well together, and divide into twenty
pills, of which one may be given  two  or three times a day.
  When the paralysis of the bladder is merely temporary, and  in connection
with debility caused by fevers, &c, the Tincture of Muriate of  Iron  in dosea
of ten  drops every hour  or  two, may be  exhibited in  an  infusion of Uva
Ursi, Queen of the Meadow,  Spearmint, or Trailing  Arbutus;  and one of 
442
AMERICAN  FAMILY PHYSICIAN.
these infusions may be drank freely.  Oil of Turpentine, in doses of twentv
drops three times a day, has been recommended in these cases.  When there
is a retention of urine during an  attack of hysteria, the catheter should not
be used, though its use may be threatened  in the  hearing of the patient- a
cold douche to the genital parts will answer a much better purpose.
 _ Strangury will generally be overcome by warm hip-baths, warm  fomenta-
tions, and a free use of cooling and mucilaginous diuretics, as  infusions of
Watermelon seeds,  Pumpkin seeds,  Marshmallow, Cleavers, Parsley, &c
Retention of urine in  infants and children may  be cured in most cases by
the warm bath, application of powdered Garlics or Onions over the region of
the bladder, and the use of Sweet Spirits of Nitre, in appropriate  doses  in
some one of  the above-named diuretic infusions.
  In ordinary urinary difficulties where the urine is high-colored,  scalding
or in diminished quantity, one of the  following  remedies may be used with
advantage:  1. Compound Infusion of Trailing Arbutus;  2.  Compound
Pills  of Soap;  3. Cold Infusion of  Sickle grass, or Cleavers; 4. Oil of
Pumpkin seeds, six to twelve drops, four or five times a day, &c.
                    INCONTINENCE  OP  URINE.

  Incontinence of Urine, or Enuresis, is  a disease  common to children,
in which they involuntarily discharge their urine, especially at night.  Some-
times instances are met  with in which  the  child has no ability whatever to
retain the urine, which is  more  or less constantly escaping from it.  This
difficulty is occasionally met with among adults,  especially those advanced
in life.
  Causes.  Incontinence of urine may be owing to distension  of the blad-
der, with great irritability; to paralysis of the bladder, as is frequently the
case  among  the  aged; to enlargement of the prostate  gland;  to injury of
the spinal nerves;  to mechanical pressure, as from tumors, pregnancy, &c;
to masturbation; and to the presence of foreign bodies in the bladder, as
gravel, and which is frequently met with among rheumatic and gouty persons.
  Treatment.  In those cases in which the  incontinence is owing to irrita-
tion  of the  bladder,  the  cause of the irritation  will have to  be removed
before any permanent benefit can be expected.  Much  relief,  however, may
be derived from  the following pleasant remedy, and among children it will
frequently effect cures:  Take of Isinglass (long staple)  one roll; boil it in
one  pint of water until it is dissolved; then strain,  and add one pint of
sweet milk, put it again over the fire,  and let it "just boil up," then sweeten
with loaf sugar, and  grate nutmeg upon it.   When properly  made, it re-
sembles custard.  An adult may take  of this a tumblerful three  or four times
a day.   The Compound Infusion of  Trailing Arbutus  will frequently over-
come irritation;  and, in some instances,  among adults, the following mix-
ture  : Take  of Tincture of Cantharides, Tincture of Digitalis, Tincture of
Colchicum seed, each, one fluidounce, Tincture of Lupulin one fluidounce
and a half;  mix.  The  dose is  twenty or thirty  drops,  three or four times
a day.
  When the disease is connected with irritation  of the spinal nerves, the
back may be douched with cold water twice a day, counter-irritation should
also  be applied along the spinal column, as, firing, and  the electro-magnetic
current may be passed through  the bladder and  along the spinal column,
daily.   In some cases  the Compound Tar  plaster upon the  back, over the
tender parts, will be useful. 
GRAVEL.
443
  When the incontinence is owing to debility or relaxation  of the  bladder,
the  Compound Infusion of Trailing Arbutus may be given,  in connexion
with the free use of a strong infusion of equal parts of Beth root, Bayberry
bark, and Wild Cherry bark. In these cases of want of tone m the bladder,
the  following  preparations  have been  used with  advantage:  1.  Take  of
Tincture of Acetate  of  Iron, Tincture  of Nux Vomica,  each, equal parts;
mix  The dose is ten or fifteen drops,  to be repeated twice each  evening,
at intervals of two or three hours.   2. Take of Black Oxide of_Iron forty-
eight grains, Extract of Nux Vomica one grain; mix, and divide into twenty-
four powders, of which one may be given every night and morning.  3. Take
of Tincture of Muriate  of Iron two fluidrachms. Balsam Copaiba  one flui-
drachm, Tincture of Strychnia one grain, Infusion  of Quassia twelve fluid-
ounces ; mix, and administer a fluidounce three times a day.
  Incontinence in children is often the result of habit or carelessness in not
being made to urinate immediately before going to bed; it will, therefore, be
necessary to attend to this, and also to awaken the  child at certain periods
through the night, for the purpose of emptying the  bladder.^   In some cases
it may be found that the urine is passed during sleep while in  one particular
position, as, for instance, on the back—by changing this position, some benefit
may, at times, result.
  Where children an. in the habit of taking suppers very little fluid should
be allowed them, and tea and coffee must be  abstained from, even  for some
time after a cure has been effected.  The diet should be principally boiled milk
and wheat flour, with a little Cinnamon or Nutmeg sprinkled on it;  or the
above Isinglass Custard  may be used every day.  In most cases a stimulating
strengthening plaster worn on the lower half of the  back will be  found a
valuable auxiliary.  In cases where no relief can be  obtained, contrivances
must be resorted to prevent the constant  discharge  of urine, and to protect
the  neighboring parts from being excoriated by contact with it.
                               GRAVEL.

   The  waste  or disintegrated portions of the tissues of the system are, to a
great extent, carried off in a soluble  state in the urine, under the form of
several  acids, alkalies,  calcareous  earth, and  other substances;  but from
irregularities in  diet, or from actual disease,  one or more  of these  matters
may exist in excess, and will be deposited at the bottom of  the urine voided,
after it  has stood for a short time.   Occasionally, however, the  accumulation
of these matters becomes so great that the deposit occurs in the kidneys or
some part of the urinary organs, from whence  it passes into the bladder,
thus giving  rise  to gravel.   In  perfect health no deposit is found  in  the
urine, until  it has undergone decomposition.   (See Fig. 29.)
   Healthy urine is  of  a light amber color, transparent, reddens  litmus
paper, has an  aromatic,  violet-like  odor,  a saline,  bitter,  and rather disa-
greeable taste, a temperature  on being  passed varying from  92° to 100°
Fahrenheit,  and a specific gravity  from 1.003  to  1.030.  From twenty to
fifty ounces is passed in twenty-four hours, holding 600 or 700 grains of
solid matter in solution,  and averaging  in  specific  gravity  from 1.015  to
1.020.   That which is passed after  drinking  much water or other fluid, ia
usually  pale,  of specific gravity 1.003 to  1.009, and is called urina potus;
that which  is passed after the  digestion of a full  meal, urina chyli, has a
specific  gravity 1.030; and that which is passed after  a night's  rest,  urina
tanguinis, furnishes the  best specimen of the average density of the whole 
444
AMERICAN  FAMILY  PHYSICIAN.
urine,  varying  from 1.015  to 1.025.  The urine of infants  is inodorous
colorless, of low specific gravity, and but little reaction on litmus paper.  In
the examination of urine the  different specimens  passed  at  various periods
of the day, should be tested both singly and combined, their color, opacity
transparency, &c, should be noted,  and that recently discharged  should be
examined, as well as after it has stood for twelve or twenty-four hours.
  Urea is a healthy constituent of urine, it is neither acid nor alkaline and
is formed by the oxygenization of  Uric Acid.  When Nitric or Oxalic Acid
is added to urine containing urea, the Nitrate or Oxalate separates in the
crystalline form.  (See Fig. 82.)
  When there is an excess of urea, owing to too great a degree of oxygeni-
zation  of Uric Acid, we usually find it be associated with dyspeptic affections
disorder of the functions of  the skin, in plethoric conditions, &c.   The urine
is generally clear and free from sediments, and has a high specific gravity
1.020  to  1.030.   It  is usually deficient in Bright's  disease, hepatic dropsy,
cirrhosis, anemic conditions, and various chronic and nervous diseases; the
quantity of urine is considerably augmented, and its specific  gravity ranges
between 1.001  and 1.008.  Urine generally contains Chloride of Soda, which
on  evaporation forms crosslets  or daggers  when  urea is present.  (See a,
Fig. 31.)
  In the treatment of cases where urea is in excess, the bowels must be kept
regular, the functions of the skin maintained  in as  healthy a condition as
possible  by bathing,  frictions, and diaphoretics;  vegetable and chalybeate
tonics  may be given ; moderate exercise should be  taken daily; and the diet
should be light, consisting of poultry, fish, vegetables, and as a drink, wine
or beer.   When urea is deficient,  the skin  must  have particular  attention
paid to it; medicines to influence the liver and kidneys must be given; the
bowels must be kept regular, with  vegetable tonics and a  good nourish-
ing diet.
  Symptoms.  Persons laboring under  gravel are frequently attacked with
such acute pain, as the calculus passes from the kidney to the bladder,  as to
occasion fainting, and even convulsions; relief, however, is frequently afford-
ed by  the use of opium and the warm bath, in such cases.  There is a severe
and permanent pain in the region of the kidney, extending down to the groin
and upper part of the thigh, with a  numbness on the parts of the affected
side, and a violent  drawing up of the corresponding testicle; the pain is
periodically excessively severe, causing  sickness and  even vomiting.  There
is often a degree of irritation at the neck of the bladder,  which may extend
along the urethral canal, with  a constant disposition to urinate.  When the
stone reaches the bladder, these symptoms  disappear, to return on the forma-
tion and passage of another.
  Sometimes the only symptom observed will be the passage of sand or gravel
with the urine, the gravel being formed in  the bladder, or, if in the kidneys,
being so small  as to  readily pass through  the ureters.  When the gravelly
deposits are not expelled with  the urine, they form layers upon each other
an 1 develop  a stone or calculus in the bladder, which sooner or  later gives
rise to severe suffering, and ultimately terminates in the death of the patient,
unless it be removed by a successful surgical operation.
  As the character of the deposits, met with in urine, differ materially fron>
each other, and as their treatment also varies according to the character ot
the deposit, each one will be considered under a distinct head,  that no con-
fusion  may exist relative thereto in the mind of the reader. 
GRAVEL.
445
               URIC,  or  LITHIC  ACID  GRAVEL.

  In the urine of persons who have the Uric
Acid Gravel, after it has become cool, will be
found dirty-white, yellow, pink, or red depos-
its, which adhere to the sides of the vessel,
forming incrustations if permitted to remain,
and in which the microscope will expose to
view crystals of Urio Acid.   Sometimes pure
Uric Acid passes with.the urine in the shape
of fine sand,  or even  in  large crystals, and
which constitutes true Uric Acid Gravel.  The
urine itself is usually scanty, much  higher-
colored than  natural, somewhat of the color
of brown Sherry, and is highly acid,  giving
to litmus paper a  deeper shade of red than
healthy urine.  Uric acid  is very soluble in   Varieties of Uric Acid Crystals.
Liquor Potassa, from which it may be precipitated by Nitric or Muriatic Acids.
It is also soluble in an excess of Nitric Acid,  by means of heat, dissolving
with effervescence, and leaving a  pink residue when the  solution is evapo-
rated.   Concentrated Sulphuric Acid dissolves it, from which solution water
precipitates it.   It is insoluble in water, Ether, Alcohol, and Acetic, Nitric,
and Muriatic Acids.  Exposed to the heat of the blewpipe it evolves an odor
of Bitter Almonds, and leaves a small  quantity of white ashes.  (See Figs.
21, 23, 26, and 33.)
   Causes.   Uric Acid is the result of the  decomposition  or destruction of
the tissues of the human body; a large amount of effete nitrogen  is elimi-
nated from the system under this form; it is usually converted into soluble
urea by the action of oxygen,  and when the oxygenization is deficient, Uric
Acid will be found in the urine in excess.   It is generally present in inflam-
matory conditions, gouty and  rheumatic diseases,  disordered conditions of
the skin, some dyspeptic affections, febrile diseases,  diseases of the reproduc-
tive organs,  injuries or  excessive straining  of the  loins,  and several  com-
plaints of a chronic nature, particularly when associated with great weakness
and emaciation;  it is also common among the intemperate  in alcoholic drinks
and meats.   Persons who indulge in lying long in bed,  who have a  habit of
retaining the urine in the bladder for a long time,  who are exposed more or
less continually to changes of temperature,  or who use much  animal food
with but little exercise, are very apt to have  this form of gravel.
   Treatment.   In the treatment of Uric Acid Gravel, the bowels should be
kept regular every day by means of the mixture of Rhubarb and Bicarbonate
of Potassa,  mentioned  under  Costiveness,  on page 426,  and occasionally
Magnesia may be substituted for  a few days.   Especial attention  must be
paid to the functions of the skin by frequent bathings and frictions ; moder-
ate exercise should be taken daily, and the diet should be nutritious, partak-
ing sparingly of animal food, and avoiding all  indigestible articles,  or arti-
cles which will acidify upon the stomach, no wine,  beer, or other alcoholic
drinks must be used.  Fruits which contain  Acetic, Citric, or Tartaric Acid,
in combination with Potassa, may be eaten in moderation.
  As a medicine, the Compound Infusion of Trailing Arbutus will, probably,
be found one of  the best agents for the removal of this kind of gravel,  yet
offered to the profession.   It should be taken daily,  in wineglassful doses,
three, four, or five times a  day, and its  use persisted in until a complete cure
is effected.  Where  the patient is of an anemic habit, some preparation of
 
446
AMERICAN FAMILY PHYSICIAN.
 iron may a!s<. be given.   In some cases, where other diseases are associated
 with the gravel, Colchicum, vegetable tonics, alteratives, or other agents will
 be required, according to the nature of the complication.
  As solvents to hold the Uric Acid in solution in the  urine, the  following
 agents have been recommended: Carbonates of Soda or Potassa, in doses
 varying from ten to thirty grains, and repeated two or three times  a day
 these alkalies should not be given too long, nor in too large doses—and care
 should be taken not to  destroy the acidity of the urine  entirely, as a new
 form of gravel,  phosphatic, may be thereby occasioned.   Phosphate of Soda
 and Benzoic Acid have likewise been found useful;  likewise Borax, but thia
 last is improper for females  as it is apt to cause abortion or  some menstrual
 derangement.  Among the agents which have been successfully used in Uric
 Acid Gravel may be  named the  Compound Pills of Soap;  cold infusion of
 Cleavers, Broad-leafed Cactus, and Sickleweed; infusion of Wild Carrot root'
syrup of Appletree bark; and Oil  of Pumpkin seed ten drops  every three
hours.
PHOSPHATIC  GRAVEL.
   When the earthy phosphates exist in the urine  in  excess, this fluid will
be found to vary much both in its color and  specific gravity.  More com-
monly it is pale, frequently white like whey; sometimes  dark-brown, or
greenish-brown;  very  offensive;  usually  alkaline,  with  a dense,  tough,
stringy mucus, and often stained with blood.   Occasionally it may be some-
what acid immediately after leaving the bladder, but speedily assumes a neu-
tral, or alkaline character.  When pale its specific  gravity varies from 1.005
to 1.014; when of an ambe^hue with urea in excess, it varies from 1.020 to
1.030.  The phosphatic  depositions  generally occur  in  the form of white
sand or gravel, which may be amorphous or crystallized.  When amorphous
it is commonly a Phosphate of Lime, (See Fig. 28.) which is white, not dis-
solved by Liquor Potassa, the urine being opaque,  and of high specific grav-
ity;  it is more frequently met with among aged persons, and is indicative of
disease of the bladder, prostate gland, or both, of a dangerous character.
   When the deposits are crystalline, they are composed of minute shining
crystals of a triple salt, the  Phosphate  of Ammonia and Magnesia, which
may assume various forms under the  microscope, as  seen in Figs,  22 and
28.  Sometimes the amorphous and crystalline sediments are met with to-
gether, forming what  is  termed  mixed jot fusible phosphates; the urine
containing them is of  low specific gravity, more or less opaque, of an alka-
line  character, and becomes speedily   offensive;  on  standing, it deposits
Phosphate of Lime, mucus, and a trace  or more of Amorphous  Carbonates;
the  triple  Phosphate is not  deposited,  but  remains dissolved in the urine,
from which it may be precipitated  by adding an excess of Aqua Ammonia.
The  calculus formed from this combination  is white, friable, similar to lime.
dissolves readily in Muriatic Acid, and melts in the flame of the blowpipe.
Nitric  Acid, or Muriatic Acid, dissolves the Phosphates; but the Alkaline
Carbonates, or Potassa, or Ammonia, in solution, do not affect them. The
triple Phosphates are  more usually observed among young persons.
   Causes.  Excess of  Phosphatic deposits  in  the urine, accompanies a de-
bilitated  condition of the system, and may be owing to injuries of the back
or spine;  to dyspepsia;  mal-assimilation of food;  innutritious food; irri-
tability, or exhaustion of the nervous system; sedentary habits; excessive
mental exertion ; general weakness of the system ; some organic disease of
the kidneys; or diseased mucous membrane of the  bladder, &c. 
GRAVEL.                           447
  Treatment   There is no agent with which I am acquainted, which ex-
erts such a prompt and permanent influence in removing the white or phos-
phatic travel, as the Compound Balsam of Sulphur.  The Compound Infu-
sion  of Trailing Arbutus  has frequently proved efficacious, and may be
used when the other cannot  be obtained,  but it is inferior in efficacy   In
addition to these means, others must be employed, according to the charac-
ter of the symptoms present.  As in the  other instances, the bowels must
be kept regular, the functions of the skin attended to by bathing and fric-
tion  with moderate exercise.   Vegetable  tonics may be exhibited, or alter-
atives  if indicated ; any derangement of the  liver  must be removed by
appropriate remedies; anodynes, as the Compound Powder of Ipecacuanha
and  Opium, may be administered to allay any general or  local irritation;
the body must be kept warmly clad;  and  the diet must be generous,  avoid-
ing,  however, all greasy food.  Syrup, or  sugar, used at meal time, has fre-
quently been found  to prevent a  phosphatic  deposition  in  the  urine.
Traveling and change of scenery, will always be of service.  In those cases,
where  there is a discharge of white, long, tough ropes of puriform  mucus
with the urine, an infusion of Golden Seal may be injected into the bladder,
two  or three  times a day.  Infusions of Buchu, or Pareira Brava, are some-
times useful, especially when pus is present; when  a ropy mucus is found
to exist, Oil  of Turpentine,  Copaiba, or Cubebs, have occasionally proved
advantageous.  The Fluid Extract of Hydrangea Arborescens is very useful
in phosphatic deposits, and  alkaline urine, in chronic gleet, and mucous
irritations of the bladder in aged persons.

  The above two forms of gravel, uric and  phosphatic, frequently alternate
with each other, so  that the treatment required must vary according to the
character of the deposit prevailing at the time.
Fig. 34.
                        OXALIC  GRAVEL.
                              Tins form of gravel or calculi, is occasioned
                            by the presence of oxalate of lime in the
                            urine, in  the form of octohedral crystals, or
                            dumb-bells, (see Figs. 2-1, 25, and 34;) when
                            they form large calculi, they are usually of a
                            deep brown  or black color,  with  a rough,
                            tuberculated surface, which has caused  them
                            to be named "mulberry calculi."   The urine
                            is generally clear and bright, of a dark, am-
                            ber color, of acid  reaction,  occasionally neu-
                            tral or alkaline, and of specific gravity vary-
                            ing from 1.015 to 1.025 ;  in a  majority  of
                            instances, urea will  be  present in excess.
                            Epithelial cells are very common  in urine
                            containing oxalate of lime,  (see Figs. 15, 16,
                            17 ;) and should there be considerable urate
                            of ammonia, the urine will frequently become
thick  or jelly-like when exposed to the action of heat.   It will frequently
be the case, when oxalate of lime and urate of ammonia are combined  in a
deposit,  that  the former cannot be seen  under  the microscope  until tho
latter have been  dissolved, which may be accomplished by adding a drop  of
Liquor Potassa to the drop of urine on  the glass slide.
.1. Dumb-bells—OxaWate of Lime.
b. Oval forms of.Oxalurate of Lime. 
448                AMERICAN FAMILY  PHYSICIAN.
   When the  urine  presents a greenish hue in oxalate of lime formations,
the coloring principle of blood is mixed with it; and when quite pale, more
so than is  natural, it is commonly of diminished specific gravity; the odor
is generally urinary, occasionally resembling that of mignonette.   It is by
no means uncommon to observe an excess of phosphates with the oxalate
of lime deposit.
   Oxalate of lime is  not dissolved by water, Liquor Potassa, or Acetic Acid ;
Nitric and Muriatic Acids dissolve it without causing effervescence; in the
flame of the blowpipe, it is changed into carbonate of lime,  and if the heat
be raised and  kept up for a length of time, the Carbonic Acid will be driven
off, and caustic lime be left.  The dumb-bell deposits arc slowly converted
into octohedral crystals, when preserved for a long time in liquid.
   Causes.  Oxalate deposits are supposed to be the result  of an imperfect
oxygenization, and a want of proper assimilation of food during  the diges-
tive process.   They are usually associated with functional  disease of the
organs of digestion of a grave nature ; great prostration of the vital powers;
mental  depression;  irritable temper;  mental or physical inactivity; fond-
ness for solitude; masturbation ; partial  or  complete impotency; pain or
distress  about the  small of the  back  and  loins;  debaucheries; irritable
bladder; habitual debility, &c.   Severe injuries across the back or loins,
intemperance, venereal excesses, forcible or improper attempts at passing a
catheter into the  bladder, extravagant use  of the rhubarb plant in pies, &c,
may likewise give rise to  these  deposits.   When the bladder is  diseased,
or when a stone is lodged  in it, the urine will generally be either neutral
or alkaline.
   Treatment.   The  treatment in oxalic gravel must be principally ad-
dressed to the digestive organs  and of a tonic character.  Nitro-muriatic
Acid, composed of two parts of Nitric Acid and one of Muriatic, may be given
in some vegetable tonic infusion,  and  continued until the deposits have
changed to Uric Acid, or Urate of Ammonia, when its use must be suspended
until the oxalate crystals  reappear, when it must  be again administered;
this course must be pursued, in conjunction with the other  measures, until
a cure is effected. About five or six drops of Nitro-muriatic Acid may he
given every four or five hours in half a table-spoonful of infusion of Colombo,
or Golden  Seal, the  whole being added to  a wineglassful of water.   In con-
nection with this, a pill composed of Aletridin one  grain, Hydrastin one
grain, and Extract of Nux Vomica one-twentieth of a grain, may be given,
repeating it three times every day.   And any peculiar dyspeptic symptoms
which may be present, will require to be treated according  to their indica-
tions.  The bowels  should be kept regular, if  necessary, by small doses of
Podophyllin,  triturated with common  Salt.  The skin must not be ne-
glected, the whole surface should  be  sponged  every  morning with cold or
tepid water, and  in  drying considerable  friction should  be used;  a Spirit
vapor bath every two or three weeks will  be of much benefit.  If the pa-
tient be anemic,  some preparation of Iron may be substituted for the Nitro-
muriatic Acid, as the Tincture of Muriate of Iron, which  may be  used  in
doses often drops every three hours in the above vegetable tonic infusion;
or the Ammonia-tartrate  of Iron  may be administered in  doses of five or
ten grains every three or four hours.   A plain  but nutritious diet must be
used, always masticating the food  thoroughly;  all spirituous or  fermented
liquors must be avoided, also all food which contains Oxalic  Acid, as sorrel,
rhubarb plant, salads, onions, &c.  Sugar and all saccharine substances
should also be prohibited  as a diet, as well as pickles, and fat or greasy arti-
cles -t hard water, which contains lime, is exceedingly improper; pure, free- 
GRAVEL.
449
Stone, rain, or  distilled water  being alone  proper for drink.  Moderate
exercise in the  open air, avoiding fatigue, however, should  be taken every
dav; and sexual excesses, indolence, excessive study, and every thing cal-
culated to depress the nervous system or impair the digestive organs, should
be studiously abstained from. When the oxalate deposits have disappeared,
and Uric Acid or Urate of Ammonia exists, it will be proper to omit the iN ltro-
muriatic Acid,  and  administer instead the Tincture of Colchicum seed, in
doses of ten or  fifteen drops in a little water, three  times  a day; at the
same time, continuing the tonic  treatment,—returning to tho mineral acid
as soon  as the oxalic deposits reappear.
               URATE  OF  AMMONIA  DEPOSITS.
           Fig. 35.              It may be proper to notice a few other de-
                             posits met with in urine, and refer briefly to
                             their  treatment.   Among these,  the most
                             common  is the Lithate, or Urate of Ammo-
                             nia,  (See Figs.  27 and  35.)   This deposit
                             presents various colors, from white to reddish-
                             purple, or pink, and is a very soluble  urate.
                             When there is a considerable quantity of this
                             urate  in  the  urine, it will  present various
                             characters.  Commonly,  the  urine  is  very
                             high-colored,  thick,  muddy,  and  somewhat
                             acid, of the specific gravity of 1.025, and de-
                             posits, on cooling, a reddish-brown, or brick-
                             red  sediment.   When  the  urine is pale, but
  a. Rare forms of Urate of Ammo- becomes opaqueon standing for a short time,
nia, the spicula being, probably, Uric its specific gravity is usually 1.012 ;' when it
Acid; occasionally observed in albumi- j^g  &   le amber h     jth   eopious  chest_
nous urine, and  occurring in arop.'y      r,.      ,   ,  ' .        r    ,.    .
after scarlatina.                  nut  or hvcr-colored sediment on standing, its
  b. Urate of Soda, usual forms in uri- specific gravity is generally 1.018.  Some-
nary  eposits.                   times, urine containing an excess of Urate of
Ammonia will be met with of an alkaline reaction, or neutral.
   Urate of Ammonia when precipitated from urine,  may be redisso.ved  by
heating this fluid, but it will be deposited again as soon as it cools; solu-
tions of alkalies likewise dissolve it.  If Potassa be added to the urine and
heat applied, the vapors which escape, will have the  odor of Ammonia.  If
Muriatic Acid be added  to urine  containing Urate of Ammonia, the acid
will combine with the Ammonia, forming Muriate of jVmmonia in solution,
while, at the same time, crystals of the liberated Uric Acid will be deposited.
   Urate of Soda, (see Fig. 35,) is  occasionally  met with in  the urine, its
chemical reactions are similar to those of Urate  of Ammonia, with the ex-
ception of not giving an odor of Ammonia when heated with Potassa.
   When  these urates are present  in excess, it is generally owing  to some
derangement of the functions of the skin, or to intemperance in eating or
drinking,  and may  be found associated with the same forms of disease as
named under  Uric  Acid.   When they are present to such an extent as to
be precipitated in the bladder before the urine  has been evacuated, it is an
indication of a more serious difficulty.
   Treatment.  This will be the  same  as advised in Uric Acid Deposits,
on page 445.
29 
450
AMERICAN FAMILY PHYSICIAN.
Fig. 36.
  rt. Ordinary forms of Hippuric Acid
when Benzoic Acid is administered.
  b. Different forms of Hippuric Acid
in healthy urine.

            Fig. 37.
  a. Crystals of Hippuric Acid evapo-
rated from an Alcoholic solution.
  b. Crystals of Hippuric Acid after the
aotion of Muriatic Acid on the urine
eontaining it in excess.
  c. Crystals of Hippuric Acid in nee-
dle-like tufts.

             Fig. 38.
     HIPPURIC  ACID  DEPOSITS.

  When Benzoic Acid, or articles containing
it, are administered internally, it undergoes
decomposition, and is converted into Hippu-
ric Acid, which may be observed in the urine.
This acid is likewise a healthy constituent of
the urine of the cow and horse.
  Human urine in which  Hippuric Acid ex-
ists, is slightly  acid, with a whey-like odor,
and  a  specific  gravity varying from 1.006 to
1.008.   It is sometimes neutral, or even alka-
line, and frequently deposits the crystalline
triple  Phosphates.   It  may be procured by
evaporating the urine  containing it until it
is quite thick, and  then  adding about half
the  bulk of Muriatic  Acid;  on letting thia
stand for a few hours, a sediment will be pre-
cipitated, which must be  boiled in Alcohol,
then filtered, and evaporated to dryness.  It
forms long, narrow, four-sided prismatic crys-
tals, (see  Figs. 36 and  37,)  which are very
readily dissolved in boiling  water, or Alco-
hol, and but slightly  so in cold water, or
Ether.  Muriatic  Acid dissolves it without
decomposing it.  Nitric Acid changes it into
Benzoic Acid.  Its  taste is  bitter, and when
exposed  to a  powerful  heat, it melts, and
forms  an  oily substance of a reddish color,
and an odor very similar to that of the Ton-
ka bean.   Its presence in the urine of man,
is attributed to want of nitrogenous diet, ot
derangement of the lungs, liver, or skin. _
  Treatment.   This consists in an attention
to the skin; regularity of bowels;  exercise;
pure air;  nitrogenous diet,  and the  use of
some preparation of Iron
  a. Cystine as an urinary deposit.
  b. Cystine, crystallized from an Am-
moniacal solution.
          CYSTINE  DEPOSITS.

  Deposits of  Cystine are occasionally met
with.  The urine containing it is generally
paler than the urine  of  health, -sometimes
presents an oily appearance, and  not wine-
quently has a greenish color.  It is ordinarily
neutral,  but when it is acid on  being passe
it speedily becomes alkaline.   It usually Ms
a low specific  gravity, an odor like that o.
Sweet Briar,  with a  deficiency of Urea an
Uric Acid.   On  cooling, crystals of cystine
and triple phosphate will be seen floating
its surface.                            ifl#
  Cystine may  be precipitated from its sw 
HEMORRHAGES.
451
fon in Ammonia, or from urine containing it,  by the addition of Acetic
Acid   It forms crystalline plates of many angles, or rosettes with sharply
indented margins, which are less transparent in the center than around the
borders ; sometimes the plates are four-sided, at  others six.  A deposit of
cvstine is of a white or pale chestnut color ;  dissolves in the caustic alkalies,
as Soda Potassa, and Ammonia, as well as in the carbonates of the first two;
is slowly dissolved by Oxalic, Muriatic, Nitric,  Phosphoric  or Sulphuric
Acid • and  is not dissolved  by Citric,  Tartaric,  or Acetic Acid, Alcohol,
and the Carbonate of Ammonia.  When allowed to evaporate spontaneously
from its solution in Ammonia, it  forms six.-sided plates.  Upon boiling it
in a solution of Potassa, and adding Acetate of Lead to it, a  black precipi-
tate  ensues;  owing  to the  Sulphur  it  contains — about  one-fourth  its
weight.   On burning it, a disagreeable smell is produced, and  the flame is
of aT greenish-blue color.  They somewhat resemble the crystals of Chloride
of Sodium, or Salt, (see Fig. 31,) but may be distinguished  by being dis-
solved more  slowly in water, and by not vanishing on exposing the urine
to heat.                                                      .  .
  The origin of cystine in the  urine, is a matter of  conjecture ;  it is sup-
posed to be owing  to a perverted assimilation of the albuminous and gelat-
inous tissues; imperfect secretion of bile; deficient oxygenization; scrofula;
fatty  liver; and oxidation of the tissues, as  in chlorosis.
  The treatment which has been found to answer the best purpose in diseases
developing cystine in the urine, is a tonic and alterative one, as the use of
preparations  of Iron; Iodine; Iodide of Iron;  Nitro-muriatic Acid, _&c,
with medicines to act upon the liver, as Podophyllin, Leptandrin, &c.;  aided
by bathings and frictions to  the surface;  regularity of bowels; daily exer-
cise ;  nourishing and digestible food,  and  the judicious use  of Wine  or
Brandy.

  When the causes of the above deposits in the  urine are not removed by
appropriate treatment, and  especially when  these have been permitted to
remain in the bladder, they increase in size by the formation of new layers,
become adherent, and form a calculus or stone, of a size which cannot be
expelled through the urethra, and which can only be removed by a surgical
operation.
HEMORRHAGE, or  INVOLUNTARY DISCHARGES OF  BLOOD.
  By Hemorrhage is meant any discharge of blood from the blood-vessels,
whether in small or large quantity :  some of these discharges  are natural;
as, for instance, that of menstruation, and they become hemorrhages, path-
ologically, when  they are too profuse, or exceed the usual  amount.  Hem-
orrhages are  divided into active and passive.  Active hemorrhage occurs
chiefly in the young and plethoric, and the blood  evacuated is  generally of
a bright rod color.  Passive hemorrhage is the more serious form, it usually
oci-urs in those of weak  constitutions  from  disease or otherwise, and  the
blood discharged is of a dark color.
  Under the  microscope, blood is  found to contain red and white globules,
and  globulin.  The red globules are  circular, flattened, biconcave  bodies,
being thinner in the center than at the edges, and presenting consequently
an apparent but not  real  nucleus;  when seen by reflected light, they are
red; when by transmitted, they are yellowish.  (See  Fig. 12.)  They are
about the 1.5000th of  an inc*  in diameter, and  have a tendency to turn 
452
AMERICAN  FAMILY  PHYSICIAN.
upon their edges, and to arrange themselves into rolls like roleaiix of coin
The white globules are much less numerous, and of larger  diameter than
the red, being about 1.2000th of an inch in diameter, arc round, not colored*
and have  no central nucleus, but contain granulations on  their surface.
   When it is desirable to discover whether a certain stain consists of'biood
it must first be moistened with the white of egg, then scraped off the mate-
rial  holding it, and examined under the microscope with a quarter of an
inch object glass ; if the stain consists of blood, blood-corpuscles will be
rendered distinctly visible.
   The treatment of Menorrhagia, or Excessive Menstruation, will  be found
among the Diseases of Women, which see.
                HEMORRHAGE  FROM  THE  NOSE.

   Epistaxis,  or  Hemorrhage from  the  Nose, is frequently  met with in
 practice, and may occur at any period  of life, more particularly among young
 persons.   When it happens among those somewhat advanced in life, being
 profuse and frequent, it is indicative  of an approaching apoplexy, palsy, or
 other serious attack.
   Symptoms.  A bleeding from  the  nose may come  on suddenly without
 any previous warning: or  it may be  preceded by heat  and  itching in the
 nostrils, pain and weight in the head, giddiness, ringing in the ears, flushed
 countenance, and  throbbing of  the temporal  arteries : though it  must be
 recollected that pale  and delicate persons are more apt to be afflicted with
 this hemorrhage.   Some persons suffer from cold feet, costiveness, and slight
 chilliness.  Ordinarily, the blood flows from one nostril only :  but in seri-
 ous cases, it may be discharged from both.  In some cases, but a few drops
 escape, in others the  flow may be profuse, and  even  continue  for several
 days :  and its  periods of return will vary from every  twenty-four hours, to
 several weeks,  months, or even years.
   Causes.  Epistaxis  may  be induced  by any  circumstance  which will
 derange the circulation, and determine an  undue amount of blood to the
 head, as active or  laborious exercise, fatigue, application of cold to the feet,
 sneezing, long-continued study, exposure,  to the direct  rays of the sun, over-
 eating, violent coughing, fits of passion, intemperance, any thing tight around
 the neck, sudden or long-continued stooping, &c.   It may likewise be occa-
 sioned by injuries, as falls, blows, irritating particles inhaled into the nos-
 trils, picking the nose and abrading the delicate  membrane which lines the
 internal surface of the nostrils, &c.  Among scrofulous persons, the bleeding
 will frequently be owing to an abrasion or ulceration of this membrane.
   Nose bleeding occurs at times as a critical discharge,  as in apoplexy, com-
 mencing fevers, &c, in which cases it may prove salutary, and should not be
 checked too suddenly,  unless very  profuse.   When it happens  during the
 latter part of acute diseases, in scurvy, anemia, jaundice, &c,  it is apt to
 prove troublesome and even serious.
   Treatment.   Generally, bleeding from the nose demands but little medi-
 cal attention ; occasionally, however, it becomes  very profuse and repeated,
 when it should be checked by prompt measures.   In  these  instances, the
 bowels should  be  kept regular, the surface  of the body should be bathed
 daily, and a pitcher of cold  water  may be poured  on the  back of the head
 and spinal column  every morning, or a cold shower-bath may be substituted,
 drying at once  with considerable friction.   All ligatures, cravats, &c, around
the neck, limbs or body, must be removed  or loosened, and during the bleed- 
HEMORRHAGE FROM  THE LUXHS.                453
 in"-, the patient should keep quiet, and in a sitting posture.  In severe cases
 it will also be proper to bathe the feet in warm water every night previous
 to getting into bed.    If the patient  be anemic, small doses o*' some prepara-
 tion of iron  should  be administered.  Moderate  exercise  s  proper, but fa-
 tigue must be avoided; the hours of sleep must be regv.ated;  and the diet
 must be plain, nutritious, and easily digestible, partakiug of it in moderation.
  Among the many means found successful in che .King ordinary epistaxis,
 may be named, cold applications to the forehead, nose, and  nape of the  neck ;
 external pressure upon the nose as high up as the lower extremity of the
 bones of the nose, and which pressure should be sufficiently firm to close the
 passage, continuing it for some time; plugging the nostrils with grated dried
 beef,  or  with lint or Cotton moistened with some astringent,  as, an infusion
 of Ceranium, or Marsh-rosemary, or a solution of Sulphate of Zinc, &c; hold-
 ing up both  arms above the head in  a vertical direction, for a length of time,
 ke.   When  the hemorrhage is severe and protracted, and cannot be checked
 by any of the means named, a piece  of soft, dry sponge, or lint, by means of
 a string fastened to  it,  passed through the  nostril, and  drawn out through
 the mouth, is introduced into the  nostril until it presses against the bleeding
 vessels, where it is allowed to remain until the discharge  has permanently
 ceased.   Other agents, upon a similar principle, have  been passe4 into  the
 nose with good results, as, a small bladder, portion of the intestine of a pig,
 <fce.  And it will always be proper to aid these measures by means calculated
 to divert the circulation to the extremities, as purgation,  bathing the feet  in
 warm Mustard water, and the application of cold to the head.
  When the bleeding  is connected  with fevers, scurvy, jaundice, &c, there
 will commonly be  an  unhealthy condition of the blood, which must be re-
 moved, if  possible, by  appropriate remedies in connection  with the local
 means just advised.  Oil of Turpentine, Tannic Acid, preparations of Iron,
and alterative remedies, are among  the means suited  to  effect a healthy
change in  the blood; depending, however,  upon  the peculiar character of
the disease to which the bleeding is due.
               HEMORRHAGE FROM THE  LUNGS.

   Hemoptysis, or Hemorrhage from the Lungs, is a discharge of blood of
 a florid color, and often frothy, which is brought up from the lungs or wind-
 pipe withmore or less hawking or coughing.  It may occur at  any period of
 life, but is  more commonly met with  between the ages  of  eighteen  and
 twenty-five.
   Symptoms.   Bleeding from the  lungs is most commonly preceded by a
 sense of weight and  pains about the breast, anxiety, a greater or less diffi-
 culty of breathing, and  sometimes a. considerable  degree of warmth under
 the breast-bone, which shifts around,  and very frequently a saltish taste will
 be experienced  shortly before the bleeding occurs.  The bleeding may be
 ushered in with shiverings, weariness  of the extremities, pains in the back
 and head, costiveness, flatulence,  and a rapid,  full pulse;  or  it  may com-
 mence with a tickling sensation at the upper part of the windpipe, occasion-
 ing a slight hawking or cough.  The amount discharged varies, being some-
 times so small as merely to speckle the mucus expectorated, and at others so
 profuse as to produce sudden and alarming debility, and even a hasty death;
 and it may  appear daily, or even continue without cessation for many days'
together;  or, it may  happen only once  or twice during a lifetime.    It is
occasionally  so profuse as to be ejected through the  nose as well  as the  mouth 
454
AMERICAN FAMILY PHYSICIAN.
The blood  is usually very  thin and of a florid red color,  but it may be
thick,  and of a dark or blackish cast, as in cases  when it has remained for
some time in tbe lungs previous to its being coughed up.
  Causes.  Bleeding from the lungs or bronchial  vessels may occur from
rupture of bloodvessels of the parts, or from the escape of blood by exudation
or exhalation.  The ex siting causes are severe exercise; injuries to the chest'
violent straining; improper exercise of the lungs in  singing or speaking, &c
a decrease in the weight of the  atmosphere; inhalation of irritating substan-
ces  ; suppression of accustomed evacuations;  mal-formation of th^  chest'
organic diseases of the heart; tuberculous disease of the lungs, &c  It is not
apt  to be dangerous, or of an alarming character,  unless it occurs in persons
with narrow chests, round shoulders, and in whom there is a tendency co con-
sumption as manifested by cough, pains in the chest, and difficult breathing,
When it occurs in slight quantity toward the termination  of pleurisy, inflam-
mation of the lungs, small pox,  and some  fevers,  it  is generally a favorable
indication.
  Hemoptysis may be distinguished from bleeding from the stomach, by the
discharge of this last being in much larger quantity than that from the lungs,
of a darker color, thicker, and often mixed with the  contents of the stomach;
the  discharge from  the  lungs is  hawked  or coughed up, while that from the
stomach is vomited up without cough or hawking.
  Treatment.   In cases of bleeding from the lungs the most perfect quiet
must be enjoined, and  the patient prohibited from talking, and requested to
suppress cough as much as possible;  he must be placed in a semi-recumbent
position and the  room should be well ventilated, allowing, in warm weather,
the  fresh air to blow upon his chest,  or fanning hjm.  A half teaspoonful of
common table salt or of Spirits of Turpentine may be administered, and re-
peated every twenty or thirty minutes, until the bleeding is checked. Should
the  patient be uneasy and restless, and the discharge be large,  a powder com-
posed of Capsicum five grains, Ipecacuanha one grain, and  Opium half a grain,
may be given for a dose,  repeating it every half-hour, hour, or two hours,
according to its influence and the urgency of the case.  At the same time, an
astringent decoction of Black Cohosh root,  Beth root, and Bugle weed, should
be drank in doses  of a wineglass half-full, every hour.   The feet should be
frequently bathed in warm Mustard water,  and Mustard  may be applied to
them; and the legs should be well rubbed with some stimulating preparation.
If the above astringent decoction cannot be obtained, a mixture of Tincture
of Cinnamon, Tincture  of Rhatany, Spirits of  Turpentine, each,  equal parts,
may be given in some convenient vehicle, in doses of a half-teaspoonful or a
teaspoonful, repeating it as often as required; this has frequently  proved suc-
cessful.  Or, a mixture of equal parts of Tincture of Cinnamon,  Tincture of
Ergot, and Tannic Acid, will be found an excellent substitute in many cases;
but this must not be used in cases  where pregnancy is present.  The Oil of
Fleabane, or of Fireweed, in doses of from  five to  fifteen drops every half-
hour or.hour, mixed with some sugar, or even salt,  and continued until the
bleeding is arrested, will frequently prove very  useful;  in some cases, an
equal quantity of Oil of Turpentine added to either of these oils, will improve
their efficacy.  Warren's Styptic Balsam, has also been highly recommended.
  Should the bleeding be very profuse and alarming, in addition to the above
measures, it will be proper to apply ligatures to the upper  part of the arms
and legs, near the body, being careful, however, not to tighten them so much
as to interfere with the circulation in the arteries,  but only that in the  veins;
and after the discharge has  become arrested, gradually  loosen and remove
them. 
HEMORRHAGE  FROM THE STOMACH.               455
  When the bleeding occurs in a patient of full habit, much advantage will
follow the operation of an active cathartic, as a full dose of the  Compound
Powder of Jalap, to which ten or fifteen grains of Cream of Tartar have  been
added.   When the pulse is full and rapid, it may be  reduced by the use of
Tincture of Digitalis or Tincture of Sheep Laurel, in  doses of ten or fifteen
drops every hour or two;  and if cough be present,  the Tincture of Blood-
root, an equal quantity, may be added to either of the previous Tinctures,
and the mixture be given in sufficient doses to produce a very slight degree
of nausea.                                   _
  When persons of an enfeebled, anemic condition are attacked with hemop-
tysis, they must take a mild, nourishing diet, consisting principally of milk,
eggs' oysters, gruel, panada, strong beef tea, &c, and in  passive bleedings
three or four grains of some preparation of iron should be used daily; being
very careful,  however, not to use iron  in active hemorrhages, as it will in-
crease the  difficulty;  they should exercise moderately in the open air, increas-
ing the exercise  as they gain in  strength, and the  exercise should be  of a
character especially to expand and strengthen the organs of the chest.  Per-
sons of full habit should confine themselves,  for a time, to  a bread and milk
diet, and boiled green corn during its season; they should  avoid all animal
food, all liquors, tea and coffee, and every article of diet that is indigestible,
flatulent, or stimulating; oranges, lemons, ripe acid fruits are very proper, and
all  drinks should  be taken cold;  moderate exercise in the open air, is also
useful.
  Those subject to bleeding from the lungs should keep their bowels regular,
their digestive organs in  a  healthy condition, the surface  clean and warm;
should not indulge in singing, long and loud talking, or  blowing  on wind
instruments;  and should avoid  elevated, cold situations, choosing  a flat or
low country where the air is heavy.
              HEMORRHAGE FROM THE STOMACH.

   Hematemesis, Hemorrhage from the Stomach, or vomiting of blood, is
a disease not very frequently met with, and is rarely so profuse as to destroy
the patient suddenly.
   Symptoms.  Bleeding from the stomach is usually preceded by a sense of
weight and oppression in the stomach, nausea, appetite lost or voracious, flatu-
lence, acid eructations, pain or uneasiness of  the left side, sense of  constric-
tion across the chest, chilliness, contracted pulse, coldness of the extremities,
pale face,  palpitation of the heart, and anxiety; one or several of these symp-
toms are  generally present.  The blood is vomited up without coughing or
hawking,  is dark and clotted, frequently mixed with a portion of the contents
of the titomach, and sometimes appears in the  stools.   The quantity raised is
considerable, and may be discharged at short intervals, very much exhausting
the patient.  After the blood has been vomited, the patient is relieved from
his previous  disagreeable sensations.  The pulse  is generally depressed.
   Causes.  Bleeding from the stomach may be occasioned by anything that
will derange the functions of the stomach, and it is frequently associated with
diseases of the liver and spleen,  and when this last is the case, it is an un-
favorable  indication.  It may be occasioned by the abuse of emetics and  ca-
thartics ; acrid substances taken into the stomach; blows, bruises; suppression
of menstruation, or of the discharge from bleeding piles; intoxicating drinks;
intemperance  in  eating and drinking; costiveness; violent  and depressing
passions, and it may occur toward the close of other  diseases, as scarlatina,
typhus, yellow fever, &c. 
456
AMERICAN  FAMILY PHYSICIAN.
   Its discrimination from hemoptysis has been already described in the pre*
ceding article; but, sometimes, a hemorrhage from the gums, mouth, or nos-
trils, may be mistaken for it,  especially when the blood has been swallowed
and subsequently vomited up, in such cases  the  usual  symptoms  attending
hematemesis will be absent.
   Treatment.   The feet should be  placed  in warm  mustard water,  dried
with considerable friction, and if necessary, mustard poultices should be ap-
plied to them.  The patient should then be kept quiet and in a recumbent po-
sition.  Dry cupping over the region of the  stomach, followed  by the appli-
cation of a mustard poultice,  will often be found beneficial.   Internally a
half teaspoonful of salt may be given, or the Oil of Fleabane, or Fireweed and
repeated,  as in bleeding  of  the lungs, (see page 454.)   The Tincture ot
Muriate of Iron in  doses  of twenty drops,  in some cold water, and repeated
every hour or two, till the bleeding ceases, has acted with efficacy.   If  these
fail, Warren's Styptic Balsam  may be administered.   A solution of the Per-
oxide of Iron has  been used with great success.  Small pieces of ice swallowed
from time to time until the bleeding ceases, have frequently proved useful.
   In  addition to these measures, when there are evident accumulations in
the bowels, a purgative must be administered as a fluidounce or two of  Cas-
tor Oil with twenty or thirty drops of Oil of Turpentine, and which maybe
repeated in two or three hours, if necessary.
   When there are  accompanying derangements of the liver or spleen, as
manifested by costiveness, sallow skin, yellowness of the eyes, &c, they must
be  treated as recommended for these affections  on pages 296 and 299; and
any other derangement must be treated as  the nature of the  case requires.
Any acidity of stomach may be removed by doses of the Compound Powder
of Rhubarb and Potassa.
   If the hemorrhage occurs in  the course of putrid  diseases, as malignant
scarlet fever, typhus, &c.   Antiseptics must be used, as, Vinegar, Citric Acid,
Lemonade,  Sulphuric  Acid  diluted,  Porter,  Brown  Stout,  Champagne,
Sparkling Catawba,  Yeast, Chloride of Soda,  and Chloride of Lime in solu-
tion, &c,—together writh means to strengthen the system.
   When the bleeding from the stomach is owing to suppression of the men-
strual or other habitual discharges,  measures should  be adopted to restore
these discharges,  before any permanent benefit can be expected.
   During the discharge,  gruel, rice  or barley-water, may be allowed, but
after its arrest,  the  diet must  be more  nutritious,  as  beef tea, buttermilk,
toast-bread, custards, soft-boiled eggs, 'oysters, oyster soup,  &c, and if there
be very much debility, ale,  porter and wine whey may be allowed,  together
with tonics, as for instance the Compound Wine of Comfrey.
              HEMORRHAGE FROM  THE  BLADDER,
  Hematuria,  or Hemorrhage from  the Bladder,  means  an evacuation
of blood from the urinary passage, whether it originally proceeds from the
kidneys, ureters, bladder, or urethra.  Generally, it is not a painful nor seri-
ous disease, unless it be mixed with purulent matter,  or where it occurs as
symptomatic of some malignant or putrid  malady.
  Symptoms.   These will vary somewhat according to the part from which
the blood emanates.  There is, generally,  in  all  cases, a sense of uneasiness
or pain, which precedes and follows the discharge, and which appears to be
located at the point whence the  blood  issues.   If th% seat of the hemor-
rhage be in the  kidneys, the  urine and  blood,  when  passed, will  resemble 
HEMORRHAGE  FROM  THE  BLADDER.              457
bloody water; considerable heat and distress will be experienced in the loins,
and pressure over the region  of the kidneys, will produce more or less sore-
ness-  sometimes elongated masses of fibrin, like worms, will be seen in the
urine   If the blood emanates from the ureters, or canals, which convey the
urine  from the kidneys to the bladder, there will be more or less pain along
their  tract, somewhat like that  produced by the presence of a small stone
passin- toward the bladder;  the urine passed will resemble that m the pre-
eedin^ease with more elongated clots.  If the  bladder be the seat of the
hemorrhage, there will be a dull pain in the region of this organ,  sometimes
accompanied with painful erections and considerable heat in the glans penis;
the blood does not mix intimately with the urine, but remains  suspended m
it, usually in small, flaky clots.   Sometimes the clot formed in the  bladder
may prevent the urine from being passed, in which case the catheter will be
required.  When  the urethra is the part from which the bleeding issues, it is
voided cither by drops, or in a small stream, and is not mixed with the urine.
When the  blood passed in  the urine is mixed with mucus, and especially
when  pus is present, abrasion or ulceration must exist somewhere; if the
blood be dark-colored, and mixed with  putrid  offensive matters,  it  is  indi-
cative of a malignant affection, and will prove fatal.
   As in other  hemorrhages, the quantity of blood will_ vary from a few
drops to a quantity sufficient to  jeopardize the patient's life.  Sometimes it
will flow freely  without any unpleasant symptoms; and again  there will be
considerable difficulty in voiding it, with weight in the parts, pain, and other
disagreeable symptoms.
   The administration of several medicines, or use of certain articles of  food,
will frequently  give a bloody aspect to the urine, as with cochineal, madder,
red beets, kc.;  it likewise has a  dark-reddish color, with a dense deposit on
standing, in several forms of disease.  But we can always  determine with
certainty whether blood exists in the  urine by a microscopic  investigation.
A drop of urine placed  on  a glass  slide covered with thin glass, and then
placed under a microscope  of 300  or 350  diameters  will show  the blood
globules  as  represented in  Fig. 12,  page 169;  they will be entire, smooth,
non-granular, flat, yellow, and either detached or adhering.  Previous to the
examination, the  urine should be allowed to stand an hour or two so that the
globules  may settle at the  bottom.   Bloody  urine  stains linen of  a red
color; high-colored urine does not.
   Causes.   Voiding of bloody  urine may be occasioned by many causes, as
injuries  from  falls, blows,  bruises,  hard  riding, jumping,  lifting  heavy
weights,  or other violent exertion; it may be produced by a stone lodged in
the kidney or ureter;  it may be  occasioned by  the long-continued  or im-
proper use  of  Spirits  of Turpentine, or Cantharides; it sometimes occurs
when  the menses arc suddenly suppressed, or, the  discharge from bleeding
piles;  disease of the prostate gland often gives  rise to it;  and sometimes it
takes  place without any assignable cause.
   Treatment.    When hematuria is occasioned  by some external injury, or
when  the patient is of full habit, it will be proper to give  a cathartic every
second or third day; and allow him to drink freely of an infusion of equal
parts  of  Queen of the Meadow  root and  Peach leaves.   In  some  cases it
will become necessary to apply the Compound Tar plaster over the region of
tho kidneys, and  keep up a discharge for some  time.   When it is caused by
the use of Spirits of Turpentine  or Cantharides, an infusion of Peach leaves
and Marshmallow root should be drank freely, and a fomentation of Hops or
Stramonium leaves be placed over the seat of the pain or distress.   Hema-
turia from a stone in the  kidney, or ureter, must be treated the same as 
458
AMERICAN  FAMILY  PHYSICIAN.
gravel.   (See page 445.)  When it is the result of some suppression, the
original  discharge must be  restored by  appropriate measures.  When' the
bleeding  is periodical, or,connected with malarial influence, Sulphate of
Quinia, Tincture  of Muriate of Iron, with Nitric, Muriatic, or Sulphurio
Acid, diluted with water, will be found useful in proper doses.
   When the cause of the hemorrhage is  not known, and  it is profuse and
continued, the bowels should be evacuated either by an internal purgative
or a cathartic injection, after which some  diuretic may be given, as  an infu-'
sion of Peach leaves and Queen of the Meadow root; or, the Compound In-
fusion of Trailing Arbutus  may be advantageously  administered.  When
there is a mucous  deposit, an infusion of  Uva Ursi will prove useful;  if pua
is present, an infusion  of Peach  leaves  and Pareira Brava may be used
freely.  A strong decoction of Peach  leaves, and Trailing Arbutus, equal
parts, will be found a most excellent agent in this affection, from  whatever
cause.
  If the  patient  is debilitated,  as in  typhus or scurvy,  the mineral acids
should be given, or Tincture of Muriate of Iron;  and when the hemorrhage
is passive, Oil of  Turpentine in doses of ten  or twenty drops  every two
hours, will be found of great efficacy.  When the bladder becomes distended
with blood, so that the urine cannot be discharged, a catheter should  be in-
troduced into the bladder, and  an  infusion of Golden Seal and Geranium,
or of Alum Water, should  be injected, that the clots may be broken  down
and removed.
  In  all  cases the bowels should be  kept regular,  stimulants  should be
avoided, and when the hemorrhage is active,  the patient should  be kept as
quiet as possible.  Painful erections may be overcome by the constant ap-
plication of cold water to the parts.  The diet must be regulated according
to the state of the system.   Whortle berries, or a decoction  of  the leaves,
have been used with success in this form of hemorrhage.
                   CONSTITUTIONAL DISEASES.
  By this classification is intended  those diseases  not  heretofore  named,
which, although manifesting themselves at some particular part or organ of
the body, owe their origin to a peculiar taint or predisposition of the  system.
It will be seen that among  them are  included some which are  generally
ranked among surgical affections.
                     CANCER, or CARCINOMA.
  Cancer is one of the most formidable and distressing diseases to which
mankind is subject, one which has given rise to a great amount of quackery
and imposition by ignorant  pretenders, who, by their  extravagant puffings
and publications, together with their false statistics, have induced the credu-
lous and miserable sufferer to apply  for a cure, to be subjected to the painful
action of  caustics, wheedled  out of large sums of money, and finally to meet
with naught save bitter disappointment.
  It is a disease occasionally met with in early life, but is more common to
those advanced in years, especially females at the "turn of life," and attacks
various  organs, as the womb, testicle, penis, rectum, tongue, nose, lips, es-
pecially the lower one, and eye; it is more commonly, however, met with in
the breast, and particularly among females. 
CANCER.
459
  Symptoms   Cancer exists  in  two stages:  one as a tumor or scirrhus,
Wt considered the "-^J^^^^


whchinav remain dormant for an indefinite time, but which, when aroused
tow-tiS,Gradually  spreads, forming  a tumor of varied size  shape  and
 on istVnce    Frequently,  the first symptom  noticed is  the tumor itself
The uS of thVtumor is knotty and irregular, the skin being somewhat
wrhikted  of natural color, sometimes of a leaden tint, and not unfrequently
J- k or  livid; it generally spreads very slowly,  and  sometimes rapidly, de
Pondin-  probably on  the condition of the system, forming adhesions to the
 uiroundLg part's as  it progresses, and the glands of  the ™"I^™5
enlarged in cancer of the breast,  on the same side of  the body, and those ot
 WroinTn cancer of the testicle.  One symptom accompanying the tumor
 nd which has been considered characteristic of the disease is; the peculiarity
of the pains which recur more or less frequently,  they being at first of a slight
shooting nature,  but eventually becoming  sharp and lancinating,  as  it a
knife, or sharp-pointed  instrument was  darting through the tumor.   The
veins in the neighborhood of the swelling frequently enlarge, and the parts
feel uneasy and painful.  After a  longer or shorter  time the tumor  com-
mences  to soften, with increased redness, and  finally  ends m ulceration  or
the second stage of the disease.  The  ulcer is ragged  with inverted  or
everted  edges, its surface dark colored,  and  the  surrounding  skin is  hard,
and puts on a livid aspect;  as it  progresses deep evacuations_ are  formed
with sanious or ichorous discharges, having a  peculiarly  offensive  odor, and
very often blood is mixed with them ; the matter  discharged from a  carcinom-
atous ulcer very rarely resembles pus in any of  its  characters, but is almost
always thin and watery,  frequently excoriating the parts with which it comes
in contact.  The pain in the ulcer-                 Fig. 3%
ative stage is more or less constant.
Soon after ulceration the constitu-
tion  becomes contaminated,  the
countenance  is  pale, sallow,  and
wan, with an appearance of  sad-
 ness  and anguish,   the digestion
 becomes deranged, neuralgic pains
in  various parts  of the system are
 frequent accompaniments, the sys-
 tem grows emaciated and  feeble,
 and the  patient is destroyed sooner
 or  later.
  Notwithstanding the above symp-
 toms  have heretofore  been  des-
 cribed  as those  constituting  can-
 cer,  yet it  is  well known  that
 they have sometimes been  pres-
 ent in   tumors  of  a  non-malig-
 nant character, and which has led
 to considerable  obscurity  in  the
 diagnosis of  the disease.  But for-
 tunately by  the aid of the  micro-
 scope, cancer can now be detected
 and discriminated from other dis-
 eases,  having an apparent  resem-
a. Five free cancer nuclei. I.  Small cancer cell.
c. Large oancer cell.  d. A cell with two nuclei.
e.e.e. Compound or mother cancer cells, containing
  two, three, or more nuclei.
/. A mother cell containing a simple nucleus, and
  a nucleated oell.
g. Irregular and bifurcated cancer cells, the most
  usual forms.
h. Cells containing double nuclei;  cancer of the
  bladder invariably contains this variety. 
460                AMERICAN  FAMILY  PHYSICIAN.
blanee to it, by the peculiarity of the cells  entering into its formation and
which we will  now describe.   (See Fig. 38-J.)
   The element of cancer consists  of three parts,  cell,  nucleus, and nucle-
olus,  all  of which are peculiar to it,  and should be  studied  under a micro-
scope of at least 500 diameters, and giving a clear definition.   A drop of the
matter of cancer  may be placed on a glass slide and covered with a thin "lass
or, the cut surface of the tumor may be scraped with a scalpel, and a little
water added to it, and then placed on the slide as above, and then examined
   "In all the varieties of cancerous tissue,  nuclei are to be  found either
enveloped by a cell, or floating free, generally more or less of both;  in some
specimens there exists a large number of free nuclei with only an occasional
cell.  The form and appearance of  these nuclei is the  most constant and
unvarying of all cancer elements.   They are ovoid,  (See Fig. 38, a,) or more
or less round;  the latter are found more particularly when the eye or the
lymphatic glands  are the organs diseased.   *  *   They  have, ordinarily, in
width, a  diameter of from 1.100th  of a millimetre, (a millimetre being equal
to .039th of an inch,)  or of .0039th of an inch, to 1.66th of a millimetre,—in
one instance we met with one as wide as 1.38th of a  millimetre; in length
they measure from 1.133d to 1.100th of a millimetre.  Their contour is dark
and well-defined, with the interior containing very minute dark granulations;
indeed, when the  specimen is perfectly fresh,  they have  a homogeneous as-
pect,  the granulations being so  small as to  give the  appearance of a mere
shading;  if the specimen is kept a day or two, we find the interior filling up
with larger granulations.  Within these  nuclei, when  they have not been
obscured by granular or fatty degeneration, there is found habitually a small
body,  or nucleolus,  averaging in  diameter about  1.500th of a millimetre,
These nucleoli have somewhat of a yellowish tinge, with a brilliant centre
and dark borders, refracting light like the fat vesicles.   "We would call atten-
tion, particularly, to the peculiar brilliancy  of the centres of these nucleoli,
which, we think, is characteristic."—Donaldson, in  American  Journal of
Medical Sciences,  No.  LXIX., new series, Jan. 1853,  page 59.  Paul Broca
of Paris, in a publication on  Cancerous Tumors, translated by Geo. W. Otis,
M. D., of  Springfield, Mass., says:—"The fundamental and  characteristic
element  is the cancer nucleus.   The nucleus is  sometimes  free, sometimes
included in a cell wall.   Free nuclei are never absent.  They occasionally
exist  alone, constituting nuclear cancer.  The free nuclei (a Fig. 38,) are
exactly similar to those contained in cells.  They are remarkable for their
large  size,  their uniformity,  and the  dimensions of their  nucleoli.  There
are commonly only one  or two nucleoli in each  nucleus but  there may be
three.  The diversity of the cells is in striking contrast  with the uniformity
of the nucleus.   Some, (b,) are small and regular;  sometimes  they preserve
their  regularity as they increase, (c,) but in other  cases (d, g,) they assume
the oddest and most irregular forms.   Most of the cells contain only a single
nucleus;  but not unfrequently two or more  nuclei  are  found  in the same
cell (d,).  Lastly, it is not rare to find cells that contain  one or more nucle-
ated cells (e,);  these are called  mother  cells.   This extreme variety in  the
form  of cancer cells has been thought to prove that there was nothing specific
in these  elements.  This is  perfectly true.   The  nucleus alone is  specific]
but the capricious variations  in the cells, far from embarrassing the diagn^i
is one of the best characteristics of cancerous tumors.  No other accidental
product  exhibits such changing forms; besides, the nucleus is always pres-
ent, to establish  the identity of these varied cells.   Apart from these nucleo-
cellular elements, cancerous tumors contain accessory elements, to which the
diversities in  their aspect and consistency are due.   The most important ot 
CANCER.
461
these is fibrous tissue.   If this is abundant, the tumor is hard,  and takes
the name of scirrhus; if it  is sparingly developed, the tumor is soft, and is
termed encephaloid, &c."                                        .
  C vuses.  Of the causes of cancer but little is known;  though, in some
instances, the predisposition to it appears to be common to certain families,
being, as it were, transmitted from one  generation to another; and  among
whom the disease is excited into action by local injuries.   Blows,  long-con-
tinued  pressure, ligatures, an unhealthy state of the fluids of the system, &c,
may cause  an  enfeebled vitality in the parts exposed, or an  obstruction,
whhh may  result in a gradual decomposition of  the  matter of such parts.
Decomposition of organic substances is always followed by inferior organic
formations, owing their  peculiar form and existence, to the rapidity of the
decomposition, the character of the tissues acted upon, as well as of the fluids
with which such tissues are supplied;  and there is no  doubt in  my mind,
that the local existence of cancer, and the several forms under which it ap-
pears, are owing to one, or a combination of all the above circumstances, pro-
ducing and attending a decomposition  of the tissues affected.
  Treatment.  That  cancer has been occasionally cured, heretofore, by the
employment of local and constitutional measures,  I have no doubt; but the
great  misfortune has been that many non-malignant diseases have been mis-
taken for cancer, for it is only within a short time  that any positive method
of determining true cancer has been discovered, and on this account there is
great  uncertainty connected with the remedies which have  from time to time
been lauded for their efficacy.  So that even at the present day there is no
curative treatment for the disease upon which any great reliance can be placed.
At one time I was greatly in hopes that a noted  advertising Cancer  Doctor
of this city possessed a treatment which was effectual and permanent,  but
from what I have  witnessed among  his cancer patients  for  several years
past,—in some a return of the disease, in others a total failure, and in sev-
eral a rapid fatality,—I find that  his treatment is attended with no  greater
success than  that  of physicians  generally;  indeed, his  course  in  fungus
hematodes, cancer of the breast, eye, and some other parts, is that which has
been pursued by surgeons for years past, viz : extirpation by the knife—so
that he does not seem to place much confidence  in any local application or
specific remedy with which he is  acquainted.  Although I regret that such
is  the  case,  more especially on account of suffering humanity,   yet truth
and science demand this statement.
  I would  remark here that patients afflicted with tumors or ulcers supposed
to be cancers, should be extremely cautious in relation to  the character  and
standing of the medical man into  whose hands they submit their cases, for I
have known an abscess of the breast to be mistaken  for cancer, and the
breast  consequently removed by the knife,—also a  bubo  to  be extirpated,
having been diagnosed a cancer, &c.   A medical writer makes the following
judicious remarks:—"Finally and especially,  let the unhappy  patients  and
their friends be on their guard against the false pretences of interested
quacks, who, without the slightest portion of medical  skill, promise a  safe
and speedy cure of cancer: who, though scarcely able to read or write, boast
if having  succeeded wrhere  learning,  extensive experience, and  skill  have
failed; and who, pretending to be in  possession of a secret  by which the
acutest sufferings of humanity can be  alleviated, mysteriously conceal  their
nostrums from the candid practitioner,  and deal only with  hopeless  misery,
credulity, and ignorance."
  It may be proper, however, to refer to the means which may  be tried in
cancer, with the hope that success may follow; and  I would observe, that 
462
AMERICAN FAMILY  PHYSICIAN.
cases of cancer, at least so called by various  physicians from the peculiar
malignity and other symptoms present, have been effectually cured by soma
of the subsequent modes.
  Whether the cancer be in a  state of tumor or ulcer, the only internal
means upon which I would  rely, with any degree of confidence, is the fob
lowing:—Take of Arrow wood bark, ( Viburnum Dentatum) Button  grass
root, White Pond Lily root, Yellow Dock root, each, equal parts; mix, and
make a decoction or syrup, of which the patient may take a wineglassful
three or four times a day.   In  addition to this, a three or four grain pill
may be  given every four or five hours, according  to the  symptoms pro-
duced,  composed  of the Inspissated Juice of Conium Maculatum into which
as much Bed Oxide of Iron, or Peroxide of Iron, has been worked, as will
not interfere  with  its pilular consistence.  The Button grass above-named
grows plentifully in Virginia and North  Carolina, and is probably an Eryn-
gium,—I  am not acquainted with  its true botanical character, although I
have frequently used the  root.  The bowels, of course, must be kept regu-
lar by appropriate means.
  As a local  application  to  the tumor  several  means have been recom-
mended, as, a poultice of Arrow wood  bark, White Pond  Lily root, and
Poke root, equal parts of each.   Or, should  there be much pain in the tu-
mor, a preparation may be applied composed of equal parts of Extract of
Hound's  Tongue  and  strong  Tobacco.  These applications  should be
changed  two or  three  times a  day. In  cutaneous cancer, I have found
much benefit from the application of a saturated  solution of Oxalic Acid to
the affected part,  several times a day.  Constant compression of the tumor,
and the application of ice to destroy it, have their advocates, and have oc-
casionally been found successful.
  But, although  the above measures have removed tumors  supposed to he
cancers, we have  no positive evidence that they were such, and must not
be  disappointed,  therefore, in  meeting  with  cases in  which the disease
steadily progresses to a  state of  ulceration.  Many remedies have been
used for the cure of open or ulcerated cancer, and with  variable success—
and we cannot regard any of them  with reliance, until the character of the
disease has been  fully  determined  by the microscope.   The agents gener-
ally employed have been  those of a caustic nature, and in relation to all of
which I will make a few remarks :—If the ulcer be large, the caustic should
be applied to only a portion of it at a time, and any great degree  of pain
occasioned by it must be kept down by anodynes internally, and the appli-
cation  of Stramonium, or Cicuta, or  Tobacco leaves, over the part.  When
the pain  has diminished, apply an Elm, or  a  Bread and Milk poultice,
changing it two or three  times a day, and continuing it  until the eschar is
loosened sufficiently to be removed with  the forceps. When the surface of
the ulcer  is again exposed, it must  be carefully examined, firstly observing
whether there are any reddish lines or fibers to be  seen  in  any part of it,
sometimes called the "roots" of the, cancer; if any are found, more of the
caustic must be applied to such  spots ; secondly, the whole surface of the
ulcer must be carefully explored by pressure, taking the blunt point or  a
knife,  or  probe, and making slight pressure on every part of the surface,
and wherever this causes pain or tenderness, the caustic  must be reapplied,
thirdly, the  discharge  from  the ulcer, or  a  portion  of surface carefully
scraped off, should always be examined  from time to  time, under the mi-
croscope,  and as  long a3 the characteristic cancer cells are present, the dis-
ease is not cured, and the treatment must be continued.  After  the malig-
nant condition of the ulcer is removed, it may then be  treated as a siraple
ulcer. 
CANCER.
463
  I have in my possession nearly fifty formulas for agents said to  have
cured cancer, many of which have been obtained  from celebrated "cancer
doctors,"—some of them are composed of active substances so united as to
make inert  mixtures, others  of them  contain agents I would  not  Use, as
Aiscnic  Corrosive Sublimate, Red Precipitate, &c, and others again ap-
pear to be  founded  upon  a belief in dreams,  astrology, witchcraft, and
credulity.  Among the agents, however, which may be tried, I will name
the following:—
  1  Vegetable Caustic, applied as above.
  2. Sulphate of Zinc applied as above; this was the  before-mentione
Cancer Doctor's celebrated remedy for cancer, but by itself is inefficacious
  3. Take  of Sulphate of Zinc, Sulphate  of Copper,  each,  one  ounce,
Sulphate of Morphia one drachm ;  mix.  This has cured a very formidable
malignant  disease of the  face and jaw.
  4. Take   of  Lard  three  pounds,  Verdigris two ounces, Beeswax two
ounces, Scotch Snuff one pound;  melt  the  Lard  and Beeswax, and then
stir  in  the other articles.  This  I  know to have cured several so-called
cases of cancer in the face.
  5. Chromic Acid applied to the ulcer.
  0. Oxalate of Copper, or Oxalate of Tin, dissolved in a weak  solution of
Oxalic Acid.
  7. Take  of Sulphate of Zinc one drachm, Sanguinarin two drachms, Ex-
tract of lied  Clover, (Trifolium Pratense,) a sufficient  quantity to  form a
plaster.
  8. Take  of Chloride of Bromine three  parts, Chloride of Zinc two parts,
Chloride of Antimony, Chloride of Gold, each, one part.  To be mixed in
the air,  on  account of the fumes disengaged.—Landolfi.
  The surface of a cancerous ulcer when not treated by caustic should be
kept perfectly clean,  and  the best agent with which  I am acquainted for
this  purpose, is the  Tincture of Muriate of Iron, which  may be applied
three or four times a day.   Or, one of  the following may be used as often
as required :—1. Take of Creosote twenty  drops, Laudanum  twenty-five
drops, Castile  Soapsuds one fluidounce; mix. 2.  Take of Vinegar half a
pint, Bloodroot one ounce, Acetate of Iron half an ounce, Creosote  twenty
drops; mix.
  The diet of the patient should be very light and meagre; and attention
should be bestowed upon  the  skin  as well a3 the kidneys.  I have  known
some apparently cancerous diseases to be cured  by the  internal use  of a
solution of Peroxide of Iron, with vegetable alteratives, at the same time
keeping the ulcer constantly moistened with the Iron in solution.
  Dr. Gilbert, who has acquired considerable celebrity in  the  cure  of ma-
lignant  diseases,  makes  use  of the  following agents:—Take of  strong
Apple  Vinegar one  gallon,  Verdigris  one pound,  Honey  one  quart.
Place these in a copper kettle  with eight  or ten bars of Pewter  Solder.
Boil very slowly, or rather simmer  by means of a  moderate fire, until re-
duced to one-half the original quantity.  Keep in  a well-closed glass ves-
sel, as exposure to the  air decomposes it.  To use it, first wash the ulcer
with Castile Soapsuds, and  if any fungous flesh  or unhealthy granulation
exists, apply Vegetable Caustic, or other caustic best suited to the case, then
moisten lint with the above, and fill the ulcer with it; over this  place a
piece of  folded muslin large enough to cover all the inflamed parts, and
bandage.   Keep the  whole constantly moistened with the preparation, not
allowing it  to become dry.  The ulcer may be dressed as required from one
to three times a day. 
4t34
AMERICAN FAMILY  PHYSICIAN.
  His  Vegetable Caustic is composed of the  powdered, dried, inner bark of
Chestnut Oak, and burnt Alum, each, equal parts.   If it is too painful
warm water poured on, will relieve it.
                  SCROFULA,  or  KING'S  EVIL.

   Scrofula, or King's Evil, is a very common affection, manifesting itself
under many forms, as consumption, hip disease, white  swelling,  rickets
dow worm, bronchocele, &c.  As ordinarily understood, it consists of an
enlargement of glandular parts, inflaming and suppurating, forming ulcers
which discharge a white curdy matter, and which are often  very trouble-
some to heal.
   Symptoms.   The first, most common, and distinctive symptom of scrofula,
is, enlargement of the lymphatic glands, especially those about  the neck.
These enlargements or tumors  may remain in an indolent condition for a
long  time, neither increasing nor diminishing  in size, and causing no pain
or other disagreeable symptoms.   Occasionally they may disappear, being re-
moved by the  powers of the system, but  more generally, they  gradually ad-
vance, become inflamed and painful, soften, and eventually discharge matter
of a thin, ichorous nature, mixed with curdy or cheese-like flakes.  At first
this matter is discharged from several small sinuses or openings;  but even-
tually these combine, forming ulcers with  jagged and uneven edges, which
are very  indolent, healing  slowly, and leaving unsightly scars when  they
do heal.   They are apt to be succeeded by other tumors,  which run a simi-
lar course, and the disease may continue in this  manner for a number of
years until it is cured, or the system is destroyed by it.
   Hufeland observes that at first the swellings  are "small, movable under
the finger, elastic, not  painful,  and without  any change of color in the
skin.   Those on the sides and back part of the neck are commonly the first
to feel the influence of the scrofulous taint; the examination  of these parts
is, therefore of the utmost importance in establishing the diagnosis.  After
these, and even sometimes before, the glands of the arm-pits begin to swell
in their turn, then come those of the groin, and in some  instances those of
the whole body.  Their size and  consistence gradually augment, engorge-
ment of the surrounding parts take  place, and  thus  they lose  their mobili-
ty.  It is uncommon for a single gland to  be affected;  the  contagion ordi-
narily extends to several;  indeed they are often  confounded  together,'and
form an enormous tumor, or become united without  being confounded, so
as to resemble a sort of chain.  At length, when the  disease has  reached a
certain height, the lymphatic vessels themselves are engorged, -and feel
like catgut.  *  *  These tumors may  remain in the same  state  during
several years ; but at  the commencement they are variable, appearing and
disappearing alternately.  In proportion as the scrofulous taint  increases,
the glandular  tumors  become  harder and less  movable.  In some cases
they remain cold and  indolent;  in others, the skin above them reddens,
pain is felt in the  center  of the gland, inflammation  slowly takes place,
and suppuration follows;  but the pus is  always of a bad quality."
  Causes.  The predisposition to scrofula may be transmitted from gene-
ration  to generation, not  manifesting   itself  in one  generation, while
severely afflicting another; yet it is not  invariably the case, that children
born of scrofulous parents should be affected with scrofulous  diseases; for
often but one child is affected, while the  rest of the children, to all appear-
ance,  present  no symptoms of it  whatever.   One of the most  important 
                              -SCROFULA.                          465

 oints in the selection of a husband or wife, should be, that he or she shall
 e free from the scrofulous taint, and thus  secure one  great means of  not
generating scrofulous children.   Auain, the disease is often  present among
persons whose  ancestors, as far as can be ascertained, have never had a
symptom of it; this fate is especially reserved for the children of those
who marry after having abused their youthful powers, or exhausted their
nervous  energies by indulging too  freely  in  venereal pleasures; it  also
arises among the offspring  of  those who have  debilitated  the organs  of
reproduction'by masturbation;  frequent copulation during pregnancy, will
effect a  disposition to scrofula  in the child.  Intermarrying among blood
relations, as among cousins, &c, is a great source not only of scrofula, but
of idiotcy, insanity, and a host of terrible afflictions.  Children of a mother,
and particularly of a father far  advanced in years,  often  bring into  the
world a disposition  to scrofula,  which will be developed at an  early period.
Scrofula is  often a consequence of  syphilitic disease of  the  parent,  in
which case it partakes in part of the character of each disease.
  The scrofulous diathesis may also be produced in children, not otherwise
disposed to it, by improper food; artificial suckling; the use of farinaceous
preparations that have not been fermented or well  cooked; food that is  too
watery; impure atmosphere; excessive use of pork or fat meats; acidity;
use of opium, mercury,  bleeding, &c; want of exercise; want of  cleanli-
ness ; too great a degree  of heat; too early mental application; and  the
too early exercise of the sexual organs. It is frequently excited  into action
anion"; those predisposed to it, by measles, small-pox, scarlet fever, vaccina-
nation,  &c, following as a sequel to these diseases.  Children having a soft
fine skin, fair hair;  rosy cheeks, and  delicate complexion, are  more com-
monly attacked with scrofula,  though  those of  a dark  complexion  and  of
stronger constitutions,  are not  entirely exempt  from it.  They  are often
born with the  disease fully formed;  some  being affected soon  after birth
with ophthalmia; others present eruptions of the skin,  ulcerations, or dis-
charges of matter ; while others  have glandular  engorgements, or spina
bifida.   Children who have a large belly,  whose joints are large, with blue
eyes, smooth, fine skin, and  large, prominent  forehead, are  generally  of
a scrofulous diathesis.   The attacks of scrofula are much influenced by  the
climate, and the seasons of the year;  prevailing more extensively in tem-
perate  latitudes, where the climate is variable, or cool and moist, commenc-
ing generally  in the winter or  spring, and disappearing,  or  considerably
amending in Summer or Autumn.   In itself, scrofula is not a mortal affec-
tion, but may,  and too commonly does  become  so, either by attacking
organs that arc essential to life, or in effecting  extensive disorganizations.
  Treatment.  The  treatment of scrofula may be  divided into constitu-
tional  and  local.   The constitutional consists in the administration  of
agents internally, of an alterative character, and which  possess  the power
of gradually  removing  that condition  of the system upon  which the  dis-
ease depends.   The principal agents for this purpose, are  the  Compound
Syrup of Stillingia, and the Compound Syrup of Yellow Dock;  these may
be used either with, or without  the addition of Iodide of Potassium, and it
will be  found very  advantageous, to  use first one  Syrup for a  few weeks,
and then the other, and so on alternately until the cure is effected.   Some-
times,  in conjunction with these preparations, I  administer a pill composed
of Iodine half  a grain, Sulphate of Morphia, one-eighth of a grain, Burnt
Sponge one grain. Extract of Liquorice a sufficient quantity to form a pill;
one of  these may be given every morning, about an hour  after breakfast,
and one at bedtime.  It will be found that in  all  cases of  scrofula, those
       30 
466
AMERICAN FAMILY PHYSICIAN.
alteratives which exert an influence on the kidneys, increasing the quantity
of urine and improving its character, will prove the most efficacious.  The
above constitutional treatment must be pursued in every stage of scrofula.
  In addition to these means, the bowels must  be kept regular by a use
of the Powder of Rhubarb and Bicarbonate of Potassa,  named under Dys-
pepsia, page 399.  And if there is no necessity for this, the  bowels being
regular,  acidity of  the stomach  must be carefully guarded against, and
removed when present by the use of some alkaline solution, or  charcoal
lime-water, &c.
  The local treatment will vary according to the condition of the affected
parts; thus, if the tumor be free from any great soreness, and from inflam-
mation, it may be dispersed by one of the following preparations:—
  1. Take of Muriate of Ammonia two drachms, Distilled water one fluid-
ounce ;  dissolve the  Ammonia in the water, and  add Tincture of Conium
Maculatum one fluidounce.   A piece of lint,  cotton, or a compress,  must
be kept over the tumor, constantly moistened with this lotion.
  2. Boil  Gum Ammoniac in Vinegar of Squills to  the  consistency of a
plaster, to every pound of which  add of very finely powdered  Muriate of
Ammonia two ounces.  Spread some of this on  leather and place  over the
tumor, allowing it to remain as long as it will adhere, before renewing it.
  3. Use the  Compound  Plaster  of Belladonna.
  I  name these several applications because it will  frequently  be found
that while one of them may exert but little or no influence in dispersing the
tumor, the other will act with power and efficacy.
  If the tumor  is in a state of inflammation, it will be necessary to subdue
this by the application  of poultices;  these  may consist of Elm bark and
Cicuta leaves, equal parts;  Elm bark  and powdered Bayberry bark;  pow-
dered root of  Indian Turnip mixed with warm water ; or, Elm bark,  pow-
dered Poke root, and powdered Blue Flag, equal parts.   Whichever poul-
tice is employed, it should be changed three  times a day.  In some cases a
poultice  of roasted Poke root will be found very beneficial; and frequently
the lotion above named of Muriate of Ammonia and Tincture  of Conium,
will be all-sufficient, whether inflammation be present or not.   When sup-
puration has  occurred, the  earlier the matter is discharged,  the better;
therefore, as soon as the suppuration has become sufficiently matured, the
abscess should  be opened,  not with  a lancet, but by  the application of
Caustic Potash, which should be passed into the cavity of the  suppurated
tumor.
   The local treatment for a scrofulous ulcer or abscess, will vary consider-
ably from the preceding; the ulcer must be washed or syringed daily, with
a mixture of  Castile Soap suds, water and Spirits, followed by a solution of
Vegetable Caustic;  or this  last may be introduced in powder on tents, into
the sinuses or openings;  after which apply to  the ulcer, the Ointment of
Bayberry, or  the  Red  Oxide of Lead Plaster,  spread  on  some  lint.  A
night, a poultice of equal  parts of Elm bark and Bayberry bark, may be
applied, especially  if some degree of inflammation  be present.  A very
excellent poultice for a scrofulous  ulcer is made  of equal parts  of Frost-
weed, Figwort,  and  Wild Indigo leaves.   Whatever may be  the  dressing
employed,  they should be  changed  two or three times  every day.   T°e
matter from scrofulous ulcers  cannot produce scrofula, even by iu°cu"
lation.
   An attention to hygienic measures is as important in this affection, as to
the medicinal.  The patient should eat as much  nutritious  food  as he can,
 avoiding, however,  acids,  indigestible, and   fat or greasy articles, taking 
SCROFULA.
467
<arc in all instances, not to overload the stomach.  Salt is very useful  in
scrofula, and  may be eaten freely by those attacked with it   Ale,  porter,
wine, and  even brandy, are  admissible and useful m  scrofulous disease,
when used in  moderation.   The patient  should take regular and moderate
exercise in the open  air, every day,  according to his strength, but never to
create fati-uc.  The whole  surface  should be bathed  daily with a mixture
of rain-water, Vinegar, each,  one  pint, Whisky half  a  pint,  Salt a table-
spoonful; and friction  with the  flesh-brush, or flannel, to the  body  and
limbs once or twice a day will  be found  of much service in  effecting a
healthy condition  of the skin and capillary organs.  Sometimes a bpint
vapor  bath,  every week or two, will aid very much in facilitating the cure.
The clothing should  be  warm  and comfortable, and  the hours oi sleep
should  be regulated according  to  the plan  advised  on page  119.   When
much debility is present,  the patient may use  a  preparation of Port Wine
one  pint,  Red  Peruvian  bark one ounce, in doses of a wineglassful three
times a day;  or, some  preparation  of Iron may be used, as Wine of Iron.
Citrate of Quinia and  Iron,  Tincture of Muriate  of Iron, &c.   Occasion-
ally, cases of scrofula  will be met with, which obstinately resist all treat-
ment until the  glandular system  has been aroused to  a state of susceptibil-
ity,  and  which may be effected  by  the administration of the following
remedies, continued until they  cause a salivation,  which, however,  need
not  be feared, as it  will be  entirely of a different character from mercurial
Balivation, producing no dangerous  results whatever:  1.  Take of Blue Flag,
Mandrake, Prickly-Ash bark, each, in powder,  one drachm;  mix.   The
dose is five or  ten  grains  every  two or three hours,  not to act upon the
bowels, and  continued until salivation is produced.—2.  Take of Iridin,
Podophyllin, and Xanthoxylin,  equal  parts;  mix, and give  as above,  in
doses of a grain.
  Scrofulous  Disease of  the Eyelids,  or Scrofulous  Ophthalmia, will
require the constitutional treatment just  bud down,  but  the  local means
will  vary.  The Compound Ointment of the Oxide of Zinc may be  applied
to tne lids, or  the  following:—Bore a hole  lengthwise  through a stout
piccw of a recent  limb  of  Tag Alder,  (Alnus Rubra,)  fill the opening with
tincly powdered Salt, and close it  at each end.  Put this  into hot ashes, and
let it remain  till the Tag Alder is almost all charred, (three or  four days,)
then wplit it  open, take out the salt which will be in a roll like brimstone,
powdor, and keep  it in a vial.  To use it, blow  some  of the powder upon
the ey«J  through a quill.   Or, the  Compound Ointment of Bayberry may
be used.*
  * Mrs. t. Armington, aged 32, discovered scrofulous swellings in her throat and neck some twelve
yoars previous to her calling on me,  and, notwithstanding  the treatment of several celebrated
physicians, tho disease slowly progressed until ulceration ensued, which would alternately heal
i ver and agr.fn ulcerate, discharging large quantities of pus.  After a few years a large tumor
inado its apptnraace in the axilla, which finally suppurated forming very painful ulcers, and dis-
charging pus finui several openings.  Eventually tumors succeeded by ulcers, attacked  the hips,
knees, and hnido; which in tho first two resembled hip disease  (coxalgia) and white swelling
(hydrarthvt.) and from which enormous quantities of pus were thrown out—about this time also
commenced a lateral curvature of the spine.  Her appetite was very irregular, sometimes not be-
ing able to retain the least particle of  food or drink "upon tho stomach, for two and three weeks
at a time, and during which period she would discharge from the bladder from two to four gallons
of water daily, and vomit fluid of a greenish  cast once or twice a day, especially if she ate or
drank anything;  and during such times, her exhaustion became so great, that on several different
oocasions her friends had collected around her, expecting every minute would prove her last.
She had been under the treatment, of many physicians, had taken quantities of  different mercu-
rial preparations, iodine, panaceas, syrups, and tho various nostrums of the day, but all to no pur-
pose.
  The above is the history which I received from the patient.  On her application  to me I found
her in tho following condition:—Several large ulcers in the throat, through some of which I could
pass a prole from one side of the throat to the other.  These ulcers were spread all around the 
468
AMERICAN  FAMILY  PHYSIC I AX.
                                 CONSUMPTION.

                    CONSUMPTION,  OR PHTHISIS  PULMONALIS.

   Consumption is a distressing and  fatal disease,  characterized  by cough,
debility,  emaciation,  purulent  expectoration, and  hectic  fever;  it chiefly
attacks the young, the fair,  and  the  amiable,  and  is  generally considered
incurable.   In certain northern latitudes, it prevails with the  greatest vio-
lence,  owing probably to  the frequent atmospheiical changes from heat to
cold,  dryness  to  dampness, &c;  it  is also  found to  exist  in some warm
climates.   Some persons  consider  it  contagious;  this, however, if true at
all, must occur very rarely,  and only  among  those who, having a predispo-
sition  to the disease,  sleep with a patient in whom the disease  exists in an
ulcerated stage, and is attended  with fetid expectoration, and  cadaverous
smelling  night-sweats.

throat, and on the left side extended to  the axilla and left mamma,  forming a large scrofulous
ulcer of a most hideous appearance.  Ulcers were also on the hands, hips, and knees, which dis-
charged enormous quantities of a thin, yellowish-white matter ; several pieces of bone had been
thrown out, and the left hand and knee  wore useless, anchylosed.  The spinal curvature was still
present.  I informed her friends that a cure was very doubtful, and that I would rather not un-
dertake the case, as in all probability she could not live but a few months longer; however, having
been acquainted with several cures  which had taken place while under my treatment, they im-
portuned and insisted very strongly, yet I should have positively declined had not the patient,
with tears in her eyes, begged me at least to relieve her from some of her sufferings, even if she
could not be cured.                                                    .   ,,,...
  To make an impression upon the glandular system, I administered fivo grains of the following
powder, every two hours, until ptyaiism  was produced:—Take of Blue Flag,  Mandrake, each, in
powder, ten grains, powdered bark of Prickly Ash twenty grains; mix.  When this effect was
produced, the intervals between the doses were  lengthened to three, four, or five hours, sufficient
to maintain this influence for several days, without causing active catharsis.  In this manner 1
salivated my patient every third week,  for a period of some  five or  six months.  la the mean
time, the following preparation was administered every two hours, in doses of twenty drops, mixed
with a gill of water :—Take of Saturated Tinctures of Yellow Dock, Black Cohosh, leaves of Bit-
tersweet, each, two fluidounces, Tincture of Wild Indigo root one fluidounce; mix.
  The use of this was always omitted during the week for salivation.  A poultice of Elm bark,
two parts, and the leaves of Wild Indigo, one part,  was the only application to the ulcers, which
was changed three times a day, washing the ulcers  and injecting into the sinuses at each change
of dressing, a mixture composed of equal parts of Castile Soapsuds and Tinct»re of Bayberry bark,
(made of Jamaica spirits.)  The whole  body was bathed every night and morning with cool water,
and occasionally the alkaline bath, and  the only restrictions in diet were to use no acid or greasy
food; tender lean meat, salt or salted food to be eaten whenever desired.  The only article out
of many used, which procured relief and lessened the copious discharges from the bladder during
the attacks, above related, was. unadulterated Jamaica spirits, taken  in doses of a wineglassful
every hour; the third or fourth dose was followed by a cessation of the  discharge, and she would
rapidly regain her strength, and the intervals between these attacks gradually increased, until in
about six months from the commencement of my treatment, they left  her entirely.  At this time
I deemed it unnecessary for any further salivation, and continued the above course persevenngly
with the addition of the internal administration of the Compound Tincture of Iodine, three times
a day, commencing with five drops for a dose, and gradually increasing to twenty drops. As
soon as her strength would permit, I placed her upon a system of calisthenic exercises, to be prac-
tised daily, and likewise the use of  electro-magnetism to the muscles of the back, for the  purpose
of removing the spinal curvature.                                                     .
   While under this treatment it was a matter of astonishment to observe the gradual but positive
improvement which followed, and it was this fact alone which determined me to make no altera-
tion in the remedies, until they ceased  to produce  any benefit.  In. about thirteen !?0°thJ, "
ulcers had all healed, the curvature was removed, and she had  gained  considerable  flesh, mere
remaining only the scars, a distortion of the left hand, and anchylosis of the left Knee.
   To many, especially those who have been accustomed to treat this class of diseases with large
doses of medicine, it may appear strange that such simple treatment should effect a euro in wn
would at once be called a hopeless  case;—but it is in. accordance with,  and corroborates  tne cor-
rectness of the views which I have maintained for the last twenty years, that in the treatmen <j
any chronic diseases more positive  and  permanent benefit results from small doses of reme™*
given sufficiently often to keep the patient constantly under their influence, without mmihs
any immediate powerful action, than is ever witnessed among patients submitted to direct, a
 getic, and heroic  measures.  As to  the salivation produced by the powder described, it « «
 gether different ieom that caused by mercurial remedies, it renders the system more reaauy
 ceptible to the action of other agents, and is easily controlled,  as, unlike that from n*™"*.
 gradually ceases when the remedy  is omitted, effecting no unpleasant nor unhealthy cnang»
 the condition of the patient. 
CONSUMPTION.
469
  Symptoms.  The general symptoms  of this  disease  are,  an habitual
cou-b • morbid expectoration ;  pains in the breast; casual flush or feverish
heat in the hands, feet, and cheeks ; change of voice ; thin fingers and nose;
bent or crooked nails; falling of the hair, &e.   The disease has been divided
inte three, four, and even  five stages, by medical writers; but for practical
purposes,  three  stages will be  found best adapted to the course  of the

  In 'the first or incipient stage, there will be found some difficulty in breath-
ing perhaps amounting to a shortness of breath, more especially on exer-
v\<\n^; eou-h is a very early symptom; it may be slight  and hacking at
first,°but gradually  becomes more and more distressing and frequent; at
first'it is'dry, but is  soon attended with an  expectoration of a thinor
frothy character, or resembling mucus.  Very frequently the expectoration
will be streaked with blood, and sometimes the first observable symptom of
consumption will be more or less profuse bleeding from the lungs.   Slight,
transient pains will be felt in various  parts of the  chest,  and as the  disease
advances,  the breathing will become more difficult, the cough  more severe
and distressing, the skin  hot and  dry, with a  burning sensation  in the
palms of the  hands and  soles  of the feet: the appetite  is variable  and
capricious;  the  bowels  irregular;  the  urine  turbid; the pulse a  little
quicker than usual; the tongue  clean, or  furred white in the  center,  and
red at the tip and edges;  and often, night-sweats arc met with even in this
stage.  The  fever accompanying  this disease is of the remittent kind, the
remissions occurring toward evening; sometimes there will be two exacer-
bations  daily, one about  noon, and the other during the night or toward
morning, which usually terminates in a profuse perspiration.   These symp-
toms will be found  to vary with different persons, according to the extent
of the disease, and the several modifying circumstances  to which they  may
be exposed.
  It is very frequently the case that the first symptoms of consumption are
observed only after an exposure to cold, an attack of pleurisy, or pneumo-
nia, or some imprudence in diet; hence those predisposed to  it cannot be
too careful to avoid all these exciting causes.  The white of the eye has  a
pearly white, or slightly bluish appearance.
  In the second stage, the expectoration presents small, cheese-like particles,
of a light-yellowish hue,  owing to softening of the tubercles in  the lungs ;
the cough increases in severity, and is more frequent;  breathing becomes
more hurried or difficult;  chilly sensations which were slightly felt in the
first  stage, now amount to actual chills, which occur in the latter  part of
the day, and  are followed by heat of skin and  abundant  morning perspira-
tion.  The face is flushed considerably toward evening ;  the pulse increases
in frequency; emaciation  takes place  with  debility; the  appetite fails ; the
features assume a sharp appearance; there is a sense of constriction across
the chest, and frequently a  pain  is experienced in one  side, which   is
increased  upon  lying on  that side, or the cough may  be augmented by
lying on the  affected side, and perhaps the difficulty of  breathing  may be
also  exasperated.   Very  often a deep  inhalation, or even a fit of coughing,
will give rise to more or less pain in some portion of the chest.  Bleeding
from  the lungs,  is common in this stage, owing to  erosion of small blood-
vessels by ulceration.   It  must be remembered, however,  that bleeding  of
the lungs is not a certain sign  of consumption,  it being  frequently met
with as an independent affection.   Sometimes an obstinate and debilitating
diarrhea occurs, which assists still further to weaken the patient.   In this
Btage, pains in the bowels, irregular chills, hectic fever, thirst, and night- 
470
AMERICAN FAMILY  PHYSICIAN.
sweats, are very common;  but, as in the first stage, all these symptoms will
vary in different individuals.
  In true third stage all the preceding symptoms are aggravated ;  the breath-
ing is short and hurried; the cough almost constant, and very distressing•
the voice weak  and hoarse  ; the expectoration is  purulent, and contains the
cheesy particles referred to in the second stage.  The emaciation and debil-
ity are very much increased,  the features  become  sharp,  the  eyes hollow
and languid, the hair falls  off, the nails curve inward, and are more or less
livid in color, the feet and ankles swell; diarrhea  continues obstinate and
unyielding;  a   few  weeks  previous  to  dissolution,  the mouth becomes
attacked with aphthous ulcerations, and  occasionally the patient becomes
delirious.   More generally, however,  the  senses  remain  to the end not
much impaired, and a peculiar symptom  attendant  on this  disease is, that
those who  labor under  it,  are  seldom  apprehensive of  danger, but natter
themselves with a speedy recovery, the mind being confident and  full of
hope.  In  this  last stage, the embarrassment in breathing is often exces-
sive, and most  generally,  bed-sores are produced, which add much to the
sufferings of the patient.   Death may occur  in several ways ; from debility;
from peritonitis, brought  on by ulceration of the bowels; from sudden
congestion of the  lungs; from pulmonary hemorrhage  ; or, from an accu-
mulation of air in the pleural cavity.
  No thorough-bred  physician of the  present  day,  will attempt to form a
a diagnosis in pulmonary diseases, without  calling  the stethoscope to his
aid; though it  may be proper to remark that  considerable experience and
much practice is required to enable any one to form an accurate judgment
from auscultation and percussion.  Hence, in a work intended for the public,
who cannot be expected to cultivate a stethoscopic ear,  it would be useless
to occupy a portion of its pages  in discussing this method of examination.
  Causes.   Phthisis  Pulmonalis is owing to a tuberculous condition of the
lungs, which more or less rapidly  undergoes  a process  of softening and
ulceration, giving rise to the various symptoms just named, as it progresses.
These tubercles may, however, exist for many years, even to old age, with-
out any disagreeable  symptoms, unless aroused into action by some of the
exciting causes.   The predisposition to the disease  appears to be transmit-
ted from parent to child; and those who are most liable,  are generally of
slender make, with long necks,  prominent  shoulders, narrow chests,  fine,
clear skin, fair hair, and delicate, rosy complexions.   Sometimes there will
be a disproportionate thickness of the upper  lip, a weak  voice, perhaps
large veins, and great sensitiveness.   Of  80  cases described by  Dr. Glover,
42  furnished clear  evidence of transmission  of the  predisposition from |
progenitors.  Among 1010 consumptive patients admitted into the Brompton
Hospital, nearly one in every four was born  of a phthisical parent.  Other
causes which may produce the disease or excite it into activity when existing
in a latent condition, are colds ; unwholesome and inefficient food ; sedentary
habits, and want of exercise; too early study and application ;  thin cloth-
ing; excessive   cares,  grief, or  other depressing influences of the mind
masturbation;  indulgence   of the passions; premature or  unsound  mai
riages ;  late watching ; frequent and excessive  debaucheries ; continuing to
suckle too  long, under  a  state  of debility •  frequent exposure  to dust, ae
among millers, bakers, stone-cutters, &c; bad treatment of certain diseases,
as measles, small pox, syphilis, ke.;  dwelling in  damp and confined places;
tight lacing; inhalation of deleterious gases ;  use of improper  medicine!*;
suppression  of accustomed evacuations, as of  fever sores, menstruation,
fistula in  ano,  &c.  Most people date the beginning of the disease  froa. 
CONSUMPTION.
471
T.cttin" their feet, lying in damp beds, wearing wet clothes, being exposed
to thought air, suddenly passing in a state of perspiration from  a heated
room to cold air, as from a ball room or other crowded place, and to other
circumstances of a similar character.   Females appear  to  be particularly
liable to the disease, owing to their sedentary habits, tight lacing, thin  or
imperfect mode of dressing excessive  lactation, menstrual  derangements,
&c ;  and the  siges at which the disease is most common, are from twenty to
thirty, or in tins old  from  fifty to eighty.
  Prognosis.   That consumption is a curable  disease,  does  not admit  ot
doubt—but its curability depends much upon the strength of  the predispo-
sition, the condition of the constitution, the extent of the tuberculous for-
mations, and the stage in which the treatment  is commenced.   Of course,
no sensible  mind would  anticipate  such favorable  results  from medicinal
treatment in the latter stages as in the early; and, indeed, the sooner  treat-
ment is adopted the greater will  be the chances  for the patient.   After
softening or ulceration of the tubercles the prognosis is always unfavorable,
but even then, the patient may be saved if the  tuberculous diathesis exists
in a  minor degree, and the tubercles formed occupy but a limited portion  of
the lunu'.   The greater the tuberculous disposition, and the more extensive
the ulceration, the more unfavorable will be the prognosis.   It  will  some-
times  be  the case that severe cough, profuse  expectoration,  quick  pulse,
hectic fever and night-sweats will be present,  without any tuberculous diffi-
cult v of the lungs, these symptoms originating from other causes, and yield-
iug to appropriate treatment.
  Treatment.   The treatment for consumption may be divided  into the
hygienical and the therapeutical, each of which are of great importance, and
should  on  no account be omitted.  Indeed, the  adoption  of only one  of
these, dispensing with the other is seldom attended with benefit;  though, if
preference has to be  given to either, it should be to the hygienical measures.
  Among  these  an attention to diet deserves the first consideration.  The
plan of attempting to cure  consumption by means of a low diet, which was
the general course a few years since, has  been productive  of a vast  deal  of
harm, because the excessive debility or premature state of emaciation effected
thereby, is as destructive to vital action as the disease itself.  In this disease,
especially, it is required to sustain and nourish the body, by proper and nu-
tritious diet, so that the blood may bo thereby enriched, as well  as  deprived
of those elements which favor tuberculous deposits.  The food must not only
be nutritious, but easy of  digestion, and  not disposed to  cause flatulence or
:ieidity  of stomach.  Among meats,  beef is preferable to any other;   an
•■underdone," or "rare," tender steak,  or roast piece, is a very  desirable
article of diet for consumptives.   Mutton, not too old, young  fowls, tender
g.ime,  moist and well-cured hams, rare-boiled  eggs,  oysters, &c, may like-
wise  be advantageously  used.   Among vegetables may be  named  baked
pot.itocs, wheat  bread,  boiled  rice,  rice pudding,  ripe fruits, lettuce, &c.
avoiding all pastries, warm cakes and bread, and an excess of the fat of meats.
Full meals, and especially when repeated several times a day,  are injurious;
light meals are always preferable, and they may be repeated  three or foui
times a day  without overloading or debilitating the digestive organs.   Salt is
of essential  service in all tuberculous affections, and may be used freely.  As
a drink, water, milk, milk and water, and in cases of acid stomach milk two
parts,  lime-water one part; tea or cocoa  may be used  as  best suits the  pa-
tient's taste.   The milk used should be fresh, and taken from a healthy and
well-fed cow.  Stimulants will also be advantageous, if used in moderation,
not sufficient to excite the brain, as ale, porter, wines,  and in many cases
even good French brandy. 
172
AMERICAN  FAMILY PHYSICIAN.
  Exercise  in the open air is the next important hygienic measure, and this
should be taken regularly and daily, and made as much as possible a matter-
of amusement, instead of a task for the preservation  of life.  Agreeable
company should  always be in attendance, if possible.  The patient should
when standing, sitting, or walking, always  assume a perfectly straight con-
dition of the body, with the  shoulders thrown  back, the small of the back
curved inward, and the head erect;  this position must also be attended to in
reading, writing, sewing, &c, avoiding any pressure of the chest or stomach
agninst'a desk or counter, or sitting with 'the body doubled forward. By not
attending to this erect posture, the stomach is pressed against the diaphragm,
the capacity of the chest is consequently contracted, and various unpleasant
symptoms are  occasioned thereby.  One of the objects in exercising is  to ex-
pand the chest, and give greater  capacity  for the action of the lungs;  and
this should  never be lost sight of.  The  sleep must be regular, and any pro-
pensity to indolence, oversleeping, or sleeplessness, must be overcome.  Pas-
sions, cares, and meditations, must by all means be  avoided; moderation in
all  things, even in conversation,  is needful—excesses are  injurious.  Mod-
erate labor,  cheerful company, healthy diversions, indulgence of hopes, and
a cheerful temper, are  all conducive  to  a proper state  of body and  mind,
which tends to facilitate  the cure.
  Bathing every day, with brisk  friction when drying, using  a coarse  towel,
will be found of great  advantage, not only removing effete  matters from the
skin, but likewise exciting a  salutary influence upon the  capillary system,
and thereby upon the whole  body.  An  attention  to the rules laid down in
the introductory  part of this work,  under hygiene, especially relative to
food, exercise, diet, clothing, bathing, &c, will  prove highly beneficial in all
cases.
  Cold air,  or rather sudden  changes from heat to cold, or cold to heat, must
must be avoided.  Cotton, wool, or fur, may be worn, (on the breast chiefly,)
to  prevent  the  bad effects of these changes,  if unavoidable, or to keep the
breast at an even temperature, if not  the whole  body.   Changes  of air, or
occupations, are to be resorted to when we can find better; but we must avoid
changing  for  the  worse.  Cities  are to  be preferred to the country, because
the air is less  bleak and sharp; better attendance and remedies can also be
procured.   Sea voyages are to be avoided, as the sea air is too keen, lacking
good  diet, attendance, &c.   In  cases of confirmed  consumption,  in  which
the lungs are extensively diseased, when hectic fever, emaciation, and other
symptoms  which characterize its advanced stages are present, change of
climate can be of no service, and may even accelerate  the progress of the
disease.  In the incipient stages a change will hardly prove beneficial, unless
the patient  can reside for a number of years in some suitable climate; to
visit some distant place for a few months,  or even a year, and then to return
uncured, is  not only prejudicial  to life but is a waste  of  time and money.
The climate which I consider the best for a consumptive is among the tem-
perate latitudes of the  Southern hemisphere, as,  for instance, in Buenos
Ayres—and I believe a hotel and gymnasium  for consumptives  in that or
some neighboring place, would prove of immense advantage to consumptive
patients, especially those in the commencing stages.   In advanced consump-
tion, artificially heated rooms are beneficial, and often tend to  prolong hie
but in the incipient stages they are injurious.
   The therapeutic means will consist of alteratives to remove the  tubercu-
lous disposition of the system, and tonics to impart strength and vigor.  lt«
Compound  Syrup  of  Yellow  Dock, with the  addition  of Iodide  of  Potas-
sium, possesses both tonic  and alterative properties, and will be found highly 
CONSUMPTION.
473
 useful in the treatment of consumption.   Or, as an  alterative  only, the
 Iodine Pills may be used.  As the blood is deficient in red globules in this
 disease, preparations of Iron will prove highly useful; among these may be
 mimed a solution of Iodide of Iron in doses of from twenty to  forty drops,
 well diluted with sweetened water, and repeated three or four  times a day;
 the Tincture of  Muriate of Iron in doses of five drops in a wineglassful of
 water, and repeated every two  or three hours; or the Citrate of Iron in doses
 of five grains, repeated four or five times a day, &c.  A very useful altera-
 tive is  composed of Tincture  of Bloodroot one fluidrachm,  Fluid Extract
 of Wild Cherry three  fluidrachms,  infusion of Liquorice  half  a  pint, Mu-
 riate of Ammonia one  drachm ; mix.  The dose is a table-spoonful every two
 hours.   In  addition to these  internal remedies, an  alterative influence will
 frequently be obtained by means of inhalations, and these will vary with dif-
 ferent individual cases, according to the effects they produce.  Among the
 agents which have been found the most useful in inhalation, and which have
 been used with  success in the Brompton Hospital, are Chlorine, Creosote,
 Conium, Benzoic Acid, Hydrocyanic Acid diluted,  pure Deodorized Alcohol,
 Oil of Bitter Almonds, Nitric, Benzoic, Acetic, and Tannic Acids, Camphor,
 Balsam  of Tolu, and  Bloodroot, Canada Balsam,  Aqua  Ammonia, Iodine,
 &c.   These require to  be used in various combinations;  thus, the following
 will frequently be of marked  benefit:—Take of  Nitric Acid twenty-five
 drops, Camphor four drachms, Tannic Acid four drachms, pure Deodorized
 Alcohol six  fluidounces; mix.   Or,  take  of Acetic Acid, Benzoic  Acid,
 Tincture of Conium, each, four drachms, pure Deodorized Alcohol four fluid-
 ounces;  mix.   Or,  take  of Iodine, Iodide  of Potassium, each, six grains,
 Tincture of Conium two fluidounces,  pure Deodorized  Alcohol two fluid-
 ounces ;  mix.   A piece of sponge may be moistened with a teaspoonful or
 two of one of these mixtures,  and then  placed in a tumbler, which, being
 held to the mouth and  nostrils, the patient may inhale the vapor for ten or
 fifteen minutes  at  a time, repeating the inhalation several times a  day.
 Another very useful preparation for inhalation is composed of Nitre twenty
 grains, common  salt one  drachm, Muriate of Ammonia  one drachm, water
 one pint; mix.   Heat  this solution, and  inhale the warm vapor which ema-
 nates.   A table-spoonful of Tar Water, to which twenty  drops  of  Tincture
 of Iodine have been added, may be heated, and the vapor inhaled with much
 advantage in some  cases.  These inhalations not  only bring the  remedies
 in immediate contact with the diseased parts,  but  habituate the patient to
 full  inspiration and expansion of the chest.
   One of the most  troublesome and tormenting symptoms attending  con-
 sumption is cough, and which  will frequently resist every measure to relieve
 it.  I have met  with much advantage from  the following  mixture:—Take
 Fluid Extract of Black Cohosh, Fluid Extract of Wild Cherry,  Tincture of
 Bloodroot, each, one fluidounce, Tincture of Sulphate of Morphia, (60 grains
 to Alcohol  1 pint,) two fluidrachms; mix.  The dose is a teaspoonful  three
 or four times a day, or  whenever the cough is severe.  Other preparations
 will frequently be found advantageous in relieving cough, as a pill composed
 of half a grain  each of Opium and Camphor, and one grain of White Soap-
 or a pill composed of Extract  of Hyoscyamus, Balsam of Canada, Ipecacu-
 anha  Alchohc Extract of Black Cohosh, each, equal parts; mix, and divide
 into three or four grain pills, one of which maybe given several  times a day.
 Another  very excellent cough mixture is prepared  thus:—Take of Fluid
Extract ot Wild  Cherry, Syrup  of Ipecacuanha, Syrup of Balsam  Tolu, Tinc-
ture ot Hyoscyamus, each, one fluidounce; mix.  The dose is a teaspoonful
Whenever the cough is severe.   In some cases,  a pill composed  of equal parts 
474
AMERICAN FAMILY  PHYSICIAN.
of Lactucarium, Extract of Hyoscyamus, and Extract of Cypripedium, will be
■of efficacy.  In very severe cough I have found more benefit from the mod-
erate inhalation of Chloroform than from the use of any other remedy; per
haps Ether might answer a similar purpose.   Professor Tully says,  " In  all
cases allay the cough  by some  preparation of Opium in  uniform  doses at
short and regular intervals, and used continually.  The greater the quantity
of Opium required in the twenty-four hours, the  greater the  number  of
doses to be made, and the shorter the intervals between them.   Where  much
is required, repeat the doses as often as  every three hours; where only a
moderate quantity is required, repeat the dose about every six hours—never
have the interval longer than this.  Always give sufficient to restrain the
cough as much as possible. If the cough be difficult of restraint, the Opium
may be conjoined  with some  other  narcotics, particularly those which act
more especially upon the nerves of respiratory motion, as Conium, Cyanogen,
Hydroguret of Benzyle, Nicotiana, Aconite, &c."
  Profuse night sweats are another source  of much discomfort to the pa-
tient ; these may sometimes  be  relieved by ten or twelve drops of Elixir
Vitriol, taken  at bedtime, in a wineglass half full of water.  They  may fre-
quently be checked by the free use of an infusion of Sage and Whiteweed;
or, by a pill composed of  Tannic Acid, Lupulin, and Extract of Hyoscya-
mus, one grain of each, to be taken at bedtime.  In  addition to these in-
ternal  means, the  whole surface of the body  and limbs should  also be
bathed or sponged with a mixture of Alcohol  and water, to which some Oil
of Cinnamon, Tannic  Acid, or fixed Oil of Capsicum has been added; and
this  should not be pushed so far  as  to produce rubefaction,  but only an
agreeable glow and dryness of the skin.   In some cases, a  mixture of Acetic
Acid, water, and Tannic Acid, may be used as an amplication to the body.
The  flannel which is worn next the body may, in many instances, be moist-
ened with the  Tincture of Capsicum, or other stimulant,  and when dry, be
worn;  or, it may be sprinkled from time to time  with the following:—
Take of  Capsicum  one drachm, Wild  Ginger half a pound, Canella Alba
one pound; mix these, in powder, intimately together.
  When diarrhea  is present, it must be checked by some astringent prep-
aration, as an infusion of Blackberry root, Geranium, or  Marsh liosemary;
the use of Tincture of Muriate  of Iron ; or, teaspoonful doses of equal parts
of Paregoric and Tincture of Catechu.  In  some cases,  Camphor,  Opium,
Tannic  Acid,  Kino, equal parts  of each, may be given  in three  or  four
grain doses, and  be repeated as often as the  symptoms require.  Other
agents have been recommended,  and  may be tried in  obstinate cases, as
Trisnitrate of Bismuth, Solomon's Seal and Tincture of  Prickly-Ash ber-
ries, and the following injection:—Take of Tincture of Nux Vomica three
fluidrachms, Tincture  of  Prickly-Ash berries  four  fluidounces; mix, and
add  one teaspoonful to a table-spoonful of a strong infusion of  equal parts
of Solomon's  Seal and Golden  Seal, for an injection.   The injection may
be repeated two  or three times a day.  I have known a solution of Sulphate
of Iron  four  drachms  in  whisky half a pint, to .have a beneficial effect iu
this  disease, relieving cough, checking night-sweats and  diarrhea, and im-
parting strength'to the patient, in doses of half a teaspoonful every two
hours.  But I am not yet prepared to say whether these effects were  tran-
sient or permanent.
  When bleeding of  the lungs occurs, the patient  may drink freely of an
infusion of equal parts of  Beth root  and Bugle weed.   Or, equal  parts ot
Tincture  of Bhatany, Tincture  of Cinnamon, and Oil of Turpentine, may
be administered in half-teaspoonful or teaspoonful  doses, and repeated  as 
CONSUMPTION.
475
often as required.  When the hemorrhage is slight, a little salt and water
will often check it.  When  the  bleeding  is profuse, ligatures to the limbs
will  sometimes prove  serviceable.   See  Hemorrhage  from the  Lungs,

'''other symptoms  must be  met by appropriate treatment, giving  bitter
tonics  and  aromatics  for  deficiency of appetite  and digestive power, as
Tincture of Gentian made pungent by the addition of Tincture of  Grains
of Paradise ; diuretics for deficient action of kidneys, &c— remembering,
that  in the  whole  treatment great care must be taken not to disquiet, o
oppress the stomach in any way—endeavor to counteract and overcome, a
fur as possible, all the various and diverse morbid symptoms of the case, of
whatever nature they may be, by such remedies, so managed, as will accom-
plish it the most effectually without producing at the  same time any unde-
sirable effects.
  I have said nothing of Cod-Liver Oil, not because I deem it useless, but
that  it  is  almost impossible to obtain a pure article ;  and from this fact,
patients will do better without the article  altogether, than to run the  almost
certain risk  of  having a  spurious article  imposed upon  them. ^When a
pure article  of Cod-Liver Oil can be  had, it will be found efficacious, and
may be given in teaspoonful  doses  twice a day, gradually increasing the
dose  to a table-spoonful three times a  day.  To obviate the  unpleasant
taste it may be taken in Brandy and water,  or Gin, or in infusion of Wal-
nut leaves.  To some, it proves palatable when taken in  the milk of Cocoa-
nut, which by the way is a useful  liquid for consumptives.  If a piece of
Orange peel, Lemon peel, or  Cinnamon bark be chewed  after taking the
unmixed Oil, it will lessen any remaining unpleasant taste.
  In the incipient stage of consumption much benefit may be derived from
the use of electro-magnetism, currents of which may be passed through the
affected parts once  or  twice  daily, continuing their application each time
for fifteen or thirty minutes.  In the latter stages, not much benefit  can be
anticipated from it; and I  think  I have met with cases in the advanced
stages when  its employment has been productive of decided injury.
  Before closing this subject, I  will make a few remarks for the considera-
tion of scrofulous and  consumptive parents.  The major  part  of persons
who inherit  the tendency to consumption, are frequently beyond hope be-
fore they are aware of danger, for it  is seldom a physician is applied to until
cough, difficult breathing, spitting of blood, &c, takes place,  and  which
symptoms  in these inherited  cases are  almost  positive  proof that if not
absolutely incurable, yet the disease is bordering on incurability, and more
especially if the patient be round-shouldered, narrow-chested, with elevated
or winged-like shoulders, &c.  Notwithstanding  this, it is a  singular  fact
that the majority of parents whose  offspring  inherit a  scrofulous or con-
sumptive tendency, bestow little or no  attention to the subject, until the
disease becomes active  and  manifests  itself beyond a doubt, and then, in
most cases, it is too late for a cure  to  be effected.  Such  children usually
eviuee a great fondness for  study, and are  apt  to improve rapidly: the
parents encourage' them, and take pride  in  that  which too certainly leads
to a premature grave.
  If parents fully understand this matter, and if physicians would do their
duty they  would make them acquainted with it,  they would know that ac-
tive and continuous mental efforts,  and more  especially in scrofulous chil-
dren, tend to impair the physical forces and  lead to rapid  dissolution;  and
that the proper and only cultivation which such  children require is, of the
body—its health, its strength—and instead  of sending them to a school for 
476                 AMERICAN FAMILY  PHYSICIAN.
study and exercise of the brain, they would prefer one where exercise and
amusement, applicable to the child, were taught exclusively, together with
such knowledge  as could be  derived  from a careful play, not close study
of the reflective and perceptive faculties.  Such  a course  persevered in for
twelve or fifteen years, with the proper remedial measures, would effectually
cure the disease,  destroy the inherent  disposition to it, and be  the means
of prolonging a life, which, as  at present guarded, is certain to terminate in
a few years.   With regard to the  mental improvement  of children thus
trained,  there  need  be  no uneasiness, for  by such  a  course  much, very
much, will have been learned already;  and, at the age of fifteen or eighteen
years, the system having become healthy,  and the brain  strengthened and
matured, they will  be able to learn from books much faster, be  less  liable
to forget their studies, comprehend more readily, feel more interested in
the acquirement of knowledge, and better than all, have more healthy con-
stitutions than our present method of raising children  has ever been, or
ever will be able  to effect.   I believe it is a  fact, that generally speaking,
persons who  commence their studies at the ages of sixteen or eighteen, be-
come much better informed, and prove  better scholars, than those who com-
mence in early life.
   Let us suppose a child  of consumptive parents,  who, as manifested  by
his general appearance, will  certainly have an  attack of the disease at an
early period of his life.  The question is asked,  Can the child be cured? I
unhesitatingly reply, not only can he be cured, but  the  inherited disposi-
tion can be thoroughly removed, for I am  firmly of opinion that all persons
disposed to tuberculous disease of whatever nature can be permanently and
radically cured by proper treatment.  And this proper  treatment does not
consist in waiting until the disease has  become active in adult age, and then
commence  medication, but to  apply the remedies during childhood, com-
mencing at the third or fourth year, administering  medicinal agents to re-
move the disease, with gymnastic sports to overcome the peculiar unhealthy
form of the body, whatever that may be, and to strengthen and invigorate
the constitution,  and other sanative measures, continuing them until the
individual has reached the maximum of  growth.   An  institution for this
purpose  could be  established, where not only  the  above views could  be
effectually carried out, but in which the person could receive a liberal edu-
cation, without ever having had  a book in  his hand—study being made a
matter  of  exercise  and amusement, instead of a task.   If it is desired to
alter the form of a tree, do we wait until it has reached maturity, or do we
not rather commence to work and mould it to the fashion we require while
yet a mere twig ?   So must we commence  in childhood to  alter the peculiar
form, predisposition, &c, of a  consumptive or scrofulous  individual, at the
same time using  appropriate medication to destroy the tendency to disease.
If parents and the community generally were not so much devoted to self
and the  acquirement of wealth—if they would bestow more attention to the
health of their offspring while young,  and were not  so anxious to impair
their energies  by overburdening  their mental faculties, keeping them in a
constant state of nervous  excitability by studying and fretting  over books
at school and  at home, there would be  less deaths among children, and
fewer eases of consumption even among those of consumptive parents, and
instead of a puny,  sickly, imbecile race of men, our country would be able
to boast of citizens powerful  in  the physical,  and  gigantic in the  intel-
lectual.  This is a  subject which demands the serious consideration ol
every member of the human family. 
WHITE SWELLING.
477
              DISEASED  MESENTERIC  GLANDS.

  The Mesenteric  Glands of scrofulous children, are frequently affected
with an enlargement, and accompanied with symptoms to which the name
Tabes Mesenterica has been given.   There is a deep-seated, lancinating pain
in the abdomen, which gradually  enlarges, while the rest of the body be-
comes emaciated; the bowels are generally loose, with discharges of a milky
or chalky appearance, and sometimes frothy.   The appetite is good, often
voracious, but  no health or strength is derived from the food eaten   As
the disease  advances, the child becomes  inactive, peevish, andI fretful;  the
skin  is dry  and rough, sometimes scaly;  the thirst not much above natural;
the tongue  coated white, and its body pale;  the pulse from 100 to  120 in a
minute, and an accession of fever toward the after part of the day.   ioward
the termination of the disease, dropsical  swelling of the feet and ankles are
common.   This  disease  is also  popularly  termed "Consumption of  the
Bowels."                                                  ...     .
  Causes.   The causes of this disease are the same as those which excite
scrofula into action, as deficient  or improper  food, unhealthy residences,
irritation of the lining membrane of the intestines, too early weaning  &c.
   Treatment.  Keep the bowels  regular by doses of Bhubarb and Bicar-
bonate of Potassa, the skin healthy by daily bathing and frictions ;  andsus-
tain  the strength by a plain, unstimulating, but nutritious and easily diges-
tible diet.  To remove the scrofulous taint, pursue the same constitutional
measures as recommended in Scrofula.  Excessive acidity of stomach,.or
irritability  of  the bowels, may be  remedied by a  drink of equal  parts of
Lime-water and Milk; it may be made more  palatable  by sweetening it,
and adding a little Cinnamon, or, if there is much  debility,_ a little  Brandy.
The hygienic means named in scrofula, must be adhered to in this.  Among
very young children, I have  found advantage from the use of the following
preparation:—Take of Compound Syrup  of Yellow Dock, Tincture of Black
Cohosh, Worm Cordial, (on page 431,)  each, equal parts;  mix.   The dose
is from a teaspoonful to  a table-spoonful three  or four times a day.
WHITE  SWELLING.
  White  Swelling, or  Hydrarthus, is a very formidable and painful  dis-
ease, affecting various joints, but more especially the knee joint.  The term
"White Swelling," is applied to it because, notwithstanding the inflamma-
tion, and the enlarged condition of the joint, the color of the skin surround-
ing it remains natural.  Children, particularly those  of scrofulous habits,
are  more especially subject to it, though adults are by  no means exempt.
  Svmptoms.  At first there will be  more  or  less swelling of the knee,
which gradually increases, with a sense of uneasiness  in the joint.   Slight
pain is soon felt which  may continue for a longer or shorter time, but event-
ually it becomes  very  severe.  Sometimes the pain  is the first symptom
which attracts the patient's notice.  It becomes so intense that the  patient
cannot bear to move; he does not place the sole of his foot firmly upon the
ground, but merely touches  it with his toes, while the knee-joint  is kept
constantly flexed.  The center of the joint appears to be the most  affected
part, and the greatest pain is produced at this part upon pressure over a
space not  more than half an inch in diameter.   As the pain increases, so
does the swelling, and  the skin  presents a smooth, white, shining  appear-
ance, with enlarged veins  running through  it.   A great sense of heat in 
478
AMERICAN  FAMILY PHYSICIAN.
the part is experienced.   The joint may continue  in this state for months
or years, without any considerable change, or it  may proceed  rapidly to
suppuration.  Finally,  collections of matter form round the joint, and a
number of openings are produced  through which tho matter is discharged.
Sometimes the ulcers formed heal, but more  generally other  ones succeed
The  affected limb wastes, and becomes permanently flexed; the patient gra
dually emaciates, and there  is  much  constitutional disturbance, with bad
appetite, sleeplessness, small and frequent pulse, hectic fever, night-sweats
and  frequently  an obstinate diarrhea.   Under the  great irritation  thus
effected in the system, the patient gradually succumbs.
  Treatment.   In the early part of the disease, before ulceration has taken
place, and when  there  is  pain  and swelling, it will  be  proper  to cup the
whole surface  of  the joint; after which  the joint should  be exposed to the
influence  of the hot vapor arising  from  the following  decoction:—Take of
Hops,  Wormwood, Lobelia, and Stramonium, each  equal  parts, make a
strong decoction, and expose the joint to its vapor, which  may be confined
to the part by throwing a blanket over both the limb and the vessel contain-
ing the decoction.  This having been done, apply the Compound Tar plaster.
This plaster must be respread every day, and its use continued until it has
effected a free discharge  from the surface of the swollen joint; and at each
dressing, the limb may be exposed  to the action of a vapor of a decoction of
Bitter Herbs, as above, for fifteen or thirty minutes each time.  After some
twelve or fifteen days, there will commonly be a subsidence of the pain and
swelling, when the sore produced by the plaster may be allowed to heal; after
which rub the limb twice a day with a stimulating liniment, as, for instance,
the  Compound  Tincture of Camphor, and  bandage  the joint  as tightly
as the  patient can  comfortably bear—or, if any soreness should  remain in
the joint,  apply a poultice of Hops, Lobelia, Wormwood, and Stramonium,
infused in some hot, weak ley water, and continue this course until all the
pain and swelling have disappeared.
  If the  joint has  suppurated,  and ulcers have formed, with one or more
openings, these should be washed or syringed one or twice a day  with some
Castile Soap suds, and immediately afterward with a solution of the Vegeta-
ble Caustic, as strong as the patient can bear; and  any great amount of pain
may be lessened  by a continuation of  the local vapor bath.  This caustic
treatment  should be continued  as  long  as ulceration  continues,  or as long
as any pieces of diseased bone are discharged.  Occasionally, a solution of
Iodide of Potassium, injected into the openings, will be found advantageous.
  In whatever stage the  disease  may exist, local measures will effect no per-
manent benefit, unless constitutional means be  at the same time  instituted,
The  Compound Syrup of Yellow Dock, or the Compound Syrup  of Stillin-
gia, with  Iodide of Potassium added to  either,  must be administered three
or four times daily; and in cases of marked strumous diathesis,  the Iodine
.pills should  likewise be given.   If the patient be very much debilitated,
his strength must be sustained  by a nourishing, easily digestible diet, and
by the use of half or full wineglass doses of Bed Peruvian bark two ounces,
Port Wine one quart.   This is a troublesome disease, frequently requiring
 everal  months before any permanent benefit  can bo effected. 
RICKETS.
479
                          HIP  DISEASE.

  flip  Disease is of a character similar to white swelling, the treatment
will be  the same, with the exception that from the difficulty in  exposing the
part to  vapor, it will be better to apply a fomentation of the articles directly
over the painful part—placing them also over the Compound Tar plaster,
which should be applied  on the first manifestations of the disease.  In both
these affections, the bowels should be kept regular by mild laxatives, and
the kidneys should be maintained in a state of healthful  action, by  mean
of diuretic infusions, whenever required.
                              RICKETS.
   Rickets, or Rachitis, is a disease in which the bones become softened
 in consequence of a deficiency of the calcareous or earthy deposits natural
 to them, and is generally met with among scrofulous children.   It may be
 caused by debility, want of exercise, deficient food, impure  air,  damp and
 cold residence, uncleanliness, and bad nursing.
   Symptoms.  The disease  generally manifests  itself  gradually, the  flesh
 becomes flabby;  the body emaciated, but with a prominent belly;  the coun-
 tenance  becomes pale, and the face appears swelled or bloated; the head
 appears  unusually large, and  the  neck small;  teething  takes  place  very
 slowly, and the teeth  that have appeared are liable to fall out;  the bones
 being soft and unable to  support the  body, curve  unnaturally  in various
 directions,  especially those  upon which there  is  much pressure, or upon
 which is  exerted a long-continued  action of the muscles; the ribs become
 flattened, or lose their convexity;  the breast-bone projects;  the  spinal col-
 umn becomes curved, somewhat in the form of the letter  S, and various other
 distortions of the  bones occur; the joints become much  enlarged, while the
 limbs between the joints appear very slender.  Deformity of the female pel-
 vis is sometimes owing to this disease in early life.   Most generally, rickets
 commences  in the bones of  the legs, and gradually extends to the pelvis,
 spinal column, ribs, &c.  If  the child is not eventually destroyed by great
 constitutional derangement, and should  live  to adult age, the diseased bones
 eventually  become very firm  and solid, but the deformity remains.
   Treatment.  When a child  is afflicted with rickets,  it  should  be placed
 in the recumbent position, and continued thus nearly all the time, keeping
 it as quiet as possible; the bed on which it lies should not be too hard, nor
 so soft as to yield much to the weight of the body.   If,  instead of feathers,
 luiir, kc, the bed be composed of equal  parts of the leaves of Dogwood and
 Sweet Fern, it will be found to have a very salutary effect.   Frictions and
 bathings of the whole  surface will also be a necessary part of the treatment;
 a solution of Salt in water, or in Brandy, may be used  for these  purposes.
 A good animal diet should be allowed; the bowels should be kept regular
 daily, without active purging; and as a constitutional  and  curative treat-
 ment, the following internal  medicines must be  exhibited:—Take of Buck-
 horn Brake roots two ounces, Solomon's Seal  one ounce, Comfrey root half an
 ounce,, bruise these roots, and add sufficient boiling water to  them to form a
 paste or  mucilage somewhat thicker  than the white of egg.  Add to this,
 when prepared, the following mixture:—Take of the  root-bark of False
 Bittersweet, Yellow Dock root, Prickly-Ash berries, Caraway seed, each, in
fine powder, half an ounce, White Sugar one pound, good French  Brandy
a pint and  a half. Let the whole stand for several days before using it, 
480
AMERICAN  FAMILY  PHYSICIAN.
frequently shaking  it,—or, it may be used  at  once, by first heatin^ it to
nearly the boiling point, and then allowing it to cool.   The dose is from a
teaspoonful to a wineglass half full,  depending upon  the child's age to be
repeated every three or four hours, through  the day.
  In addition to this the whole spinal column, as well as the affected joints
and limbs, should have some stimulating preparation applied to them two or
three times a day.   The  Compound Tincture of Camphor may be used for
this purpose, or a liniment composed  of two  parts of Linseed Oil,  and one
part each, of Oil  of Origanum,  Oil  of Sassafras, Oil of Wintergreen and
Camphor;  rub them thoroughly together in a mortar.   If children laboring
under  rickets are permitted  to  creep or walk  too  soon, a permanently de-
formed pelvis may ensue; it is more  especially  necessary to attend to this
among female patients.
                             CARBUNCLE.

  Carbuncle, or Anthrax, is  a malignant boil, which seldom suppurates,
but discharges a thin acrid humor, and exhibits a great tendency to gangrene
or mortification.
  Symptoms.   Carbuncle commences with great heat and pain in the affected
part, and also  more or less itching; a small pimple  will be observed which
extends deeper  and deeper, forming a circumscribed, deep-seated, and very
hard tumor.  Not unfrequently the patient will suffer from the commencement
with chills, nausea, faintings, great prostration, weak pulse, &c.  As the
tumor progresses it soon becomes of a dark-red or purplish color at its mid-
dle,  but of a  lighter  shade toward  its margin.  A small vesicle or blister
forms on the top of the tumor, which, on account  of the  excessive itching
produced, is liable to be scratched by the invalid, and  which, when broken,
discharges a thin, acrid, dark-colored fluid, excoriating the parts with which
it comes in contact.  As the disease progresses several of these openings are (
formed.  Carbuncles  proceed very rapidly to a state of gangrene; and it is
very common for internal sloughing to have made considerable progress even
when no external signs of mortification are present.   The  tumors may be of
various  sizes, from half an  inch  in  diameter to five or six inches, or even
larger.
  Middle aged persons, and especially those  whose  constitutions have been
impaired by intemperance, debaucheries, &c, are more frequently attacked;
and  it  is more generally located on some part of the back.  Close study,
trouble, mental depression, bad food, &c, have also been named among the
causes.
  Treatment.   Apply  Caustic  Potash freely to every part of the tumor,
and when there are apertures pass the caustic within them.  After this apply
a poultice made  of  equal parts of  powdered  Marshmallow,  Wild Indigo
leaves, and leaves of Ground Centaury  (Polygala Nuttaliii).  This poultice
should be frequently changed, reapplying the Caustic at each fresh dressing,
until the parts slough off, and  a  healthy appearance is assumed, when the
ulcer left may be healed as an ordinary ulcer.  The odor emanating from the
carbuncle is very offensive, and may be  removed by the application of Pyro-
ligneous Acid, or Yeast and Charcoal, and either of which may be added to
the above poultice.
  In addition to these local means, the  general system must be sustained by
tonics and nourishing diet.  Take of Red Peruvian  bark one ounce, Ground
Centaury half an ounce, wine or whisky two pints;  mix.   The patient may 
PURPURA   HEMORRHAGICA.
48]
take a wineglassful of this two, three, or four times a day.  Ale, porter, &c,
may also be used as tonic stimulants.  The bowels  must be kept regular but
care should be taken not to debilitate by any active medication   Ihe linc-
turc of Muriate of Iron will sometimes  be found very beneficial as an inter-
nal agent.   Elixir Vitriol and Sulphate of Quinia  will frequently lessen the
constitutional sufferings.
                   PURPURA HEMORRHAGICA.

  Purpura  Hemorrhagica, sometimes  termed Land  Scurvy, consists of
livid spots on the skin from  extravasation  of blood, of different sizes, and
irregularly scattered over various parts of the person.  There are two forms
of this affection, one termed Purpura Simplex, in which the petechial spots are
small like flea-bites, distinct, purple,  and commonly distributed on every
part of the body, being accompanied  with languor,  debility, yellow  coat on
tongue,  nausea,  impaired  appetite, constipation,  &c, and which may be
readily cured  by pure air, nourishing food,  regular exercise, use of wine,
Quinia, and the mineral acids.   The most dangerous form  is the one under
consideration—Purpura  Hemorrhagica.
  Symptoms.  Purpura Hemorrhagica may come on suddenly, or it  may be
preceded for some time by  great debility, pains, and faintness, rendering the
patient incapable of any exertion.  The petechial spots  are frequently quite
lanre, resembling the marks left by a severe bruise, and  are more commonly
met with on the  limbs and  body, the face usually being  free  from them, or
nearly so.  Blood frequently  issues from the  mouth, gums,  nostrils, lips,
tongue, ear,  urethra, vagina,  &c,  and sometimes profuse, and even dan-
gerous  bleedings take place from  the stomach,  lungs, bladder, womb, &c.
The slightest pressure on any part of the surface of the body will produce a
purplish blotch like  those already present.  Accompanying the disease  will
often be extreme debility, depression of spirits, feeble or rapid pulse, febrile
Bymptoms, deep-seated pains in various parts, constipation, emaciation, bloat-
ing of the feet and legs,  impaired appetite, &c.
  Causes.   These  are  but imperfectly  known.   Its duration  varies very
much;  in some instances it disappears  in  three or four  days; in others, it
may remain for months, and even years, eventually causing death by a sud-
den  and  profuse discharge of  blood  from  some  important organ,  as the
stomach,  lungs, womb, &c, or by a less profuse but constant discharge from
two or more  organs simultaneously.
  Treatment.  I have never met with but three cases of this disease in the
whole course of  my practice;  one was a young girl about fifteen years of
age with  suppression of the menses,  the others were  females  further ad-
vanced in years.  In the  first  case I administered a dose of the Compound
Powder  of Jalap, and after  it  had purged moderately, the following was
given:—Take  of Sulphate  of Iron, Cimicifugin,  each,  forty grains, Podo-
phyllin ten grains, Extract  of Gentian a sufficient quantity to form the whole
into a pill-mass;  mix, and  divide into forty pills, of which  one was adminis-
tered every two  hours.   In the  other  two  the  same medicines were given,
with die  exception that Kino was substituted fur the Cimicifugin.   Avery
nourishing diet was used, wine and  brandy were ordered in moderate pro-
portions,  light exercise taken regularly every clay in the open air,  and tho
period of sleep was confined to nine hours  in  every twenty-four.  Cheerful
society was  recommended, and a total neglect of  all  household or  other
cares and duties.  The skin was bathed daily with tepid water made  slightly
pungent  with  Tincture of  Capsicum.   All the  cases were cured.     31 
182
AMERICAN  FAMILY PHYSICIAN
  Among  he internal remedies which have been recommended  in this dig-
ease,  and which may be  of benefit,  are:—Tincture of Muriate of Iron in
doses of from ten to twenty drops, in  water, and repeated four or five times
a day;  Gallic Acid  five grains every three  or four hours;  Alum ten or
twenty grains in some astringent vegetable infusion or decoction; and Oil of
Turpentine  in doses of half a drachm, added to a similar quantity of Castor
Oil, and six drachms  of Peppermint Water;  to  be repeated three, four  or
more  times a day.   When  blood is  passed with the urine, use astringent
diuretics.  (See Hemorrhage  from the Bladder, page 456.)
                                 SCURVY.

   Scurvy or Scorbutus, is a disease in some respects  resembling the pre-
ceding, but differing entirely from it both  in its nature  and the treatment
proper for its cure.  It was in former times met with frequently in camps in
beseiged towns, and in vessels making long voyages, but is less common at
the present day, owing to the great improvements which have been made in
relation to diet.  It may  occur in all  climates, and on land as  well as at
sea—among persons who use fresh meats as well as those who eat salt meats'
and especially when exposed to the  several exciting causes which favor an
attack  of the disease, by impairing the energy of the nervous forces.
   Symptoms.  Scurvy manifests  itself gradually;  the commencing symp-
toms are a general debility  both  of the mental  and physical powers, with
fatigue on the slightest exertion, and a difficult or  hurried breathing. The
face assumes a pale or sallow and bloated appearance, and as the disease pro-
gresses becomes of a dusky hue; the gums are soft, spongy,  of a purple or
dark color, and bleed easily; the teeth become loose; the breath is offensive;
dark, purplish spots appear in various parts of the body;  bleedings take
place  from  the nose,  throat, stomach,  bowels,  and other mucous surfaces;
hard tumors appear on the.  limbs and jaws,  occasioning considerable pain;
the joints become swollen and stiff;  severe wandering pains are felt, par-
ticularly at  night; the skin is dry; the pulse is small, feeble,  and generally
slow, occasionally  frequent, and in the last  stages  intermittent; the  bowels
are usually  constipated, but sometimes loose, with dark,  clotted blood  in the
discharges;  the urine  is  scanty, high-colored, and sometimes colored with
blood; and as the disease advances the patient becomes more and more pros-
trated.   Not unfrequently old wounds, which have long been healed up,
break  out afresh, and  eruptions  upon  the  surface of the body, frequently
discharge blood, or are converted into malignant formations.   Death  occurs
from extreme prostration,  profuse, bloody discharges, diarrhea, or, perhaps,
from mortification of the  bowels.
   The disease is  very variable, generally progressing gradually, but some-
times appearing very  suddenly, and with great malignancy.  The intellect
generally remains clear and  distinct to the last.
   Causes.  The theories in relation to the cause of scurvy have  heretofore
been varied and conflicting.   The disease  was  at one time thought to have
been owing to the use of stale or  salt provisions, but facts appear to have
disproved this view, and to have proven that a deprivation or deficiency ot
certain succulent and acescent vegetables containing ingredients required to'
the healthy composition  of the blood, will  give rise  to  scurvy; and more
especially when in connection with this the patients are  exposed to cause*
which  depress the nervous energy, as exposure to  cold  and  moisture, mo -
lence,  confinement, want of  exercise, uncleanliness, excessive labor and 
SCURVY.
483
fatigue, sadness, despondency, &c.   According to Dr. Baly, a diet deficient
in  succulent vegetables  continued from  three-  to  six  months, will  fully
develop the disease.
  Scurvy may be discriminated from purpura hemorrhagica, by the dusky,
sallow hue of the skin, the sponginess of the gums, the indurated and pain-
ful swellings about the jaws and limbs, and  the  hard and unyielding livid
blotches met with in scurvy, and which are absent in purpura.   In pur-
pura, the blotches are soft and impressible, and  the joints are not so  fixed
and inflexible as in scurvy.   In purpura the blood contains a great diminu-
tion of fibrin, and are scarcely coagulable; while in scurvy the  salts of this
fluid and  fibrin is very  much  increased, the blood-corpuscles are greatly
diminished, and the  blood  is  coagulable ; the  albumen is  also increased.
Scurvy more usually  appears in the end of Winter or beginning of Spring;
purpura is most common  in Summer and Autumn.
  Treatment.   Very little medicine is required in the treatment of scur-
vy, except for  the purpose  of  overcoming urgent symptoms.  A proper
change  in  the  diet  is the most  important, and  indeed  the only curable
measure.  Fresh succulent and acid fruits must be administered freely, as
oranges, lemons, limes,  unripe grapes, apples,  strawberries, gooseberries,
pine-apples, and similar  articles.  Radishes, and water-cresses, eaten  raw,
turnips, and the  sour-krout  of the  Germans, are all valuable against the
attacks of scurvy.  The  potato boiled, or in its raw state, grated, and eaten
with vinegar, has  also been found  to possess  most valuable antiscorbutic
properties.  In the  absence  of the above vegetables, a solution of Citric
Acid, sweetened, and, if required, added  to some Wine, or Porter, may be
substituted with advantage;  for it is  to  this acid that many of the above
fruits owe their antiscorbutic virtues.  Nitric Vinegar, made by dissolving
from two to four ounces of Nitre in a quart  of Vinegar, has also been found
an excellent remedy; it  should be used in half-ounce  doses, considerably
diluted with water, repeating the dose two, three, or four times a day.   As
for medicines, should there be obstinate constipation, some Cream of Tartar
may be taken in Tamarind water ; or, a dose of  Castor Oil may be given in
some Lemon juice or a weak solution of  Citric  Acid.   If diarrhea be pres-
ent, an infusion of Blackberry root, Geranium,  or other astringent may be
given; or, the Tinctures of Kino,  or Catechu, with or without the addition
of Paregoric, will frequently be of service.  If the stomach  is acid, the
Compound  Powder  of Bhubarb and Potassa may be exhibited.  Pains of
the  abdomen may be relieved by  warm fomentations;  sponginess and
bleeding of the gums with looseness of the teeth, may be removed by
washing the gums and teeth freely with a mixture composed of equal parts
of Tincture of Bhatany, Tincture  of Red Peruvian bark, and  Tincture of
Myrrh ;  at the same time, having the patient to  chew some grated  raw po-
tato, with or without the addition  of Lime or Lemon juice.   Obstinate and
foul ulcers may  be washed with Lemon  juice, or the above mixture, and
then dressed with a poultice of  SofTel leaves, or a Yeast poultice—a Cran-
berry poultice  will   be found excellent.   Sleeplessness may  be  removed
by the  use  of  Lupulin,  Laetucarin, Scutellarin,  Valerianate of  Quinia,
Cypripedin, &c.
  The patient should be  cautioned against  any  sudden movement or exer-
; l"ii. as  these have frequently been followed by immediate death; but as
 w. :igth returns, moderate  exercise will  prove of advantage.   He should
: -  kept  clean, bathing the  surface  daily, and  have  a  constant  supply of
V< h air.  The  diet should be generous and nutritious, consisting of soups,
 1  il; > e£gs- m'^'K: ;uld mashed  potatoes, at least, until  the condition of the 
484                 AMERICAN FAMILY  PHYSICIAN.

teeth and gums will  admit of more  solid food.   Spinage, lettuce, parsley
dandelion, wild sorrel, garden-cresses, &c, with the addition of the  above
named fruits and vegetables must be used; the rhubarb or pie plant is also
beneficial.   For drink he  may  use wines, ale, porter, whey,  buttermilk,
cider,  spruce beer, infusion  of  the  tops  of the  spruce fir, lemonade, &c.
And as soon as the condition of the system will  permit, that is, after con-
siderable benefit has  been derived  from the acid  vegetables, the Tincture
of Muriate of Iron may be given in doses  of twenty or thirty drops, three
times a day, in an infusion  of Golden Seal, Gentian, or Quassia.
                                YAWS.

  Yaws, or Framboesia, is a disease supposed to have been  imported from
Africa, and which is common to negroes on sugar plantations, especially in
the West India Islands.  It is  propagated by frequent contact  with those
affected by it, or, by inoculation with the  matter from  a  yaw pustule or
sore, and which it is said the negroes frequently perform in  order to obtain
an exemption from labor.   The white people sometimes become tainted with
the disease, particularly those who are frequently in attendance upon the
diseased blacks.
  Symptoms.  The disease is preceded by pains in the limbs, somewhat re-
sembling rheumatism, and  which  are  severe especially around the joints;
languor and  debility are usually present.  After a time febrile  symptoms,
as chills, pains in  the limbs, back, and joints, headache, fever, and loss of
appetite, manifest themselves; these are  succeeded  after a few days by a
pustular eruption on various parts of the body, particularly the forehead,
face, neck, arm-pits, &c.  At first these  are not  larger than a pin's head,
but gradually enlarge until  they are half an inch or more in  diameter; they
are filled with an opaque, whitish fluid, and  discharge, when they burst, a
thick, glutinous matter, which forms a thick and disagreeable scab.  These
pustules do not cover the whole body at any  one time, nor do they appear
in regular  succession like the eruption of small-pox ;  but when one crop is
passing away, a new one is appearing  in another place,  each crop being
attended with febrile symptoms.  From  the  larger pustules a rough, mul-
berrv-looking fungous excrescence is apt to arise, discharging an unhealthy
viscid fluid, and which  forms  a scab  around the edges of the excrescence.
When any part of the body covered with hair is  attacked with the erup-
tions the hair gradually changes from a black to a white color.  Ine dis-
ease may last from four weeks to three  months, according to the stauj or
the system.  It frequently causes foul and sloughy  ulcers of considerate
extent, and, sometimes, even caries of the bones.  The disease occurs Dut
once in a lifetime.                              •                ,
   Treatment.  As soon as it is ascertained that the negro has tne ya»,
he should  at once be removed to some private place where he can nave
communication with those  who  have  never had it, otherwise it my
propagated over a whole plantation.  In the early stage of ^disease,
fore the eruption has fully  appeared,  some diaphoretic should be jven,
the Compound Tincture of Virginia Snakeroot, and  the patient may i
wise drink freely  of a decoction of Sarsaparilla, G-Tiaxacum staving,-^- ^
fras bark,  and Elder  flowers.  The  body should be bathed dal*L The
warm, weak alkaline bath,  and the diet should be strictly vegetable
clothing should be  warm and comfortable, and moderate exercise w
daily.  And this course may  be pursued until the second stage comes 
NEGRO CACHEXY.
485
  In the second stage, when the eruptions begin to dry off, mild purgatives
should be given to keep  the  bowels  regular, and the Compound Syrup of
Sarsaparilla, or the Compound Syrup of Stillingia may be administered, in
doses of two or three fluidrachms, repeated  several times a day ;  and this
should be continued until all the scabs become thoroughly dry, and fall off.
Should a foul ulcer remain, the Compound Ointment of Oxide of Zinc may
be applied to it;  or, an ointment composed of the  Subcarbonate  of Iron
with Citric Acid and prepared  Lard;  the  ulcer may frequently be washed
with the Tincture of Muriate of Iron.   The sole of the feet, consisting of
thick cuticle, is apt to confine  the  discharge, when the yaws  attacks this
part, thereby producing  extensive and obstinate ulceration of the feet, ren-
dering it painful to walk.   The best application in such cases, is, a poultice
of the fresh Cassava root, which  is  common  to the  West Indies ; or,  a
dressing of the Red Oxide  of  Lead plaster, with a poultice  of Elm and
Poppy leaves. Any hard swellings which  remain on the feet, may be re-
moved by  bathing the feet in warm  water until the swellings become some-
what soft,  and then touch them with Caustic Potash, to produce an eschar
and sore, dressing it with an Elm poultice,.to  which yeast may be added,
if necessary.
                        NEGRO  CACHEXY.
  Negro  Cachexy,  or Cachexia  Africana, is a disease of the nutritive
functions, which attacks negroes of the  South and of the West Indies, in
which there is a great propensity for  eating earth.   It  presents many
symptoms resembling Chlorosis, which,  however,  differs from  it,  as males
and even young children are affected by  it.
  Symptoms.  The  patient indulges in  grief, depression of spirits, seeks
solitude, is drowsy,  inactive, much debilitated, and is both unwilling and
unable to perform labor.   There is a loss of appetite ;  constant pain in the
stomach ;  difficult breathing, especially  on the least exertion ; palpitation
of the heart; paleness of the lips, face, and palms of the hands; whiteness
of the tongue, with  dark, ink-like spots  upon it; the conjunctiva  is glossy
white;  the skin cold, and of an olive color; the face, eyelids, and  extremi-
ities appear edematous or  bloated;  the stools are of a white or clay color;
the urine is scanty ; and the pulse is small, being commonly quicker toward
nb'-kt.  When there is a collection of  water in the  cavity of the abdomen
and chest, the patient can only breathe  in the erect posture.  Acidity of
the stomach is present, occasioning a disposition to eat  articles which will
neutralize the  acidity, as earth, chalk, &c.  As the disease progresses, the
lymphatic glands become  indurated and inflamed;  the  liver enlarged and
hard; the blood poor,  colorless, and its red globules diminished ; and death
occurs suddenly, by asphyxia.
  Causes.   The disease arises from a want of proper energy in the system,
induced by grief,  despondency, harsh treatmeut, bad food,  excessive labor,
kc  With some it  is occasioned  by an  inactive,  indolent life, and some-
times it appears to be constitutional.  Badly  nursed children  are  liable to
its attacks.
  Treatment.  The  patient must  be placed  upon  a generous and nutri-
tious diet, animal food,  eggs,  ale, porter, &c; the  body should be bathed
daily with a slightly acidulated wash, drying  it with considerable friction;
a wash of Vinegar,  Salt, and Capsicum will be found  very useful.   Mode-
rate exercise should be  taken  daily;  cheerfulness should  be encouraged,
and the clothing must be warm, but adapted to the season.  Cold and damp 
486
AMERICAN  FAMILY  PHYSICIAN.
air, night air,  pork,  the fat of meats, and fatiguing exercise must be
avoided; a pure, dry air, of moderate temperature is by far the best.
  Costiveness must be obviated  by the  Powder of Rhubarb and Bicarbon^
ate of Potassa,  mentioned under Indigestion, page 399; or, by Podophyllin
and Leptandrin ;  or, by the Compound Tincture  of Tamarac, which will be
found very valuable  as a tonic,  laxative, and  alterative.  In  conjunction
with this, some preparation of iron should be used to lestore the blood to a
normal condition, as the Iodide of Iron, Carbonate of Iron, Iron by Hydro-
gen,  &c.  The urinary organs  must  be attended  to,  giving  stimulating
diuretics whenever the urine is scanty, as  an infusion of Queen of the
Meadow, the Compound Infusion of Parsley, or the Compound Infusion of
Trailing Arbutus.
  Negroes frequently present very peculiar and  singular symptoms, many
of which cannot be accounted for,  but which  they attribute to poisoning,
I have treated many of these  cases, and find no  remedy equal to that of a
combination  of Rock Salt two parts, Capsicum one  part; mix.  The dose
of this  varies  from a  teaspoonful to half a table-spoonful, every  two or
three hours; at the same time  making use of external means to produce
copious sweating.  This course must  be repeated  every day or two, until
the cure is effected.
BRONCHOCELE.
  Bronchocele, Goitre, or Swelled Neck, sometimes called Big Neck, is a
tumor on the forepart of the neck or throat, formed by an enlargement of
the thyroid gland.  The progress of this swelling is  usually extremely
gradual, and the skin will retain its natural appearance for a long time.  It
is very common among the inhabitants of certain mountainous districts, in
whom it occurs  endemically, but isolated cases are met with in every sec-
tion of the globe, especially in moist places.   Females are more subject to
bronchocele than males, and it will not  unfrequently be  found associated
with some derangement of the uterine functions, a restoration of which to
a healthy condition  will very much hasten the  disappearance of the bron-
chocele.   The  cause of this  disease  is not understood, though many rea-
sons have been  assigned for its  production, as the use of snow water, or
some particular saline or calcareous impregnation of the water in common
use as a drink.  The predisposition to the disease is often transmitted from
parent to child.
  Symptoms.   The  swelling takes place on one or both sides of the wind-
pipe, is at  first  without  pain,  without any  fluctuation, and without^ any
change in the natural  color of the  skin.  As the tumor increases in size it
grows hard and irregular ; sometimes it, extends back on each side of the
neck so regularly as hardly to appear like a well marked tumor.  It gener-
ally  increases slowly,  and not unfrequently it will remain stationary for a
number of years, and then commence growing again, attaining an enormous
size, and interfering with breathing.   In most  cases, the tumor is soft or
spongy at first,  and not sensible  to feeling, but as it enlarges, it acquires a
great degree of hardness, the skin assumes a brownish or copper color, ana
the veins  are  varicose or  knotty.   The  face is subject to flushings; an
headache and shooting pains through the tumor are  not uncommon,  yit
a few persons the disease  does  not  prove  deleterious, although the deform-
ity caused  by it is of a  painful  and  mortifying nature;  usually, « )* M
allowed to continue, the constitution  gradually fails, and the  patient dies. 
ENLARGEMENT OF THE  HEART.                487
  Treatment.   I have cured several cases of this disease with the Iodine
pill, made as follows :—Take  of Iodine half a  grain, Sulphate of Morphia
one-eighth of a grain, Burnt Sponge one grain,  Extract of Liquorice
enough to form the whole  into a pill.   One of these  pills  is  a dose, which
may be repeated two or three times a day.  In  conjunction with this, a
strong electro-magnetic current must be passed through  the tumor daily.
The Compound Plaster of Belladonna should  likewise be worn constantly
over  the tumor.   I have  seen  the  Compound Tar Plaster used in  many
instances of Bronchocele,  but have  not yet observed any benefits arising
from it, although several experienced practitioners  have  recommended it
very highly.   The general  hygienic measures must be  similar  to  those
named in scrofula.  When possible, a change of residence to a dry, pleas-
ant spot will  be advantageous.  Water,  boiled, and  then  allowed to  cool,
will afford the best fluid for drink.  When bronchocele is  of long standing,
the tumor very large, with large bloodvessels  passing over various parts of
it, a cure will be found very difficult; the earlier treatment is  commenced,
the greater will be the  chance of its removal.
                ENLARGEMENT  OF  THE  HEART.

   Enlargement, or Hypertrophy of the Heart is an unnatural growth  or
 increase of its fibrous or muscular structure, generally confined to the* left
 ventricle,  and sometimes affecting the right, and, occasionally,  the  auricles.
 The enlargement may exist alone, not increasing the size of the cavity of the
 affected portion, or,  it may exist with a diminution or augmentation of the
 cavity;  hence the names, simple hypertrophy, hypertrophy with contraction,
 and hypertrophy witJi dilatation.  .
   Symptoms.   There is shortness of breath on the slightest exertion; palpi-
 tation of the heart, frequently so severe as to jerk the whole body; and often
 an uneasiness around the region of the heart.   Not unfrequently, headache,
 giddiness,  ringing or buzzing in the ears, flashes of light, flushed and swelled
 face, nose-bleeding, and a very hard and strong  pulse are accompanying
 symptoms.  The stomach, liver, lungs, and kidneys eventually become impli-
 cated;  there will  be  a dry skin; deficient and high-colored  urine;  swollen
 and purplish appearance of the face and extremities; cough; and the patient
 finally  is forced to remain in  an upright or sitting posture,  with  the  body
 leaning forward, on account of the extreme difficulty of breathing.   If death
 does not occur suddenly, the vital powers gradually fail,  coma  and insensi-
 bility come on,  and the patient dies.  When there is no  dilatation with the
 hypertrophy,  the  pulse will be full, strong, and forcible,  shaking the whole
 body at every pulsation, with  frequent paroxysms of giddiness, headache and
 nose-bleedings.   AVhen there is dilatation, the pulse will  be more feeble, and
 the countenance of the. patient paler, the lips purplish, faintness, edematous
 swelling of the  feet, and great difficulty of breathing.   Certain sounds are
 conveyed  through the stethoscope in this disease,  which enables the culti-
 vated ear  of the physician to more readily determine its correct character.
   Causes.  Whatever tends to over-stimulate the heart, thereby producing
 eventually a diminution of its power, and a softening and enfeebling of  its
 fibrous  structure, may occasion this disease, as  indulgence in intoxicating
 liquors, violent and  long-continued muscular exertion,  mental depression,
 or  great  excitements, excessive  venery,  masturbation, rheumatic,  gouty,
 and syphilitic affections, intense study or application of  the mind with little
or no bodily exorcise, kc. 
488
%
AMERICAN FAMILY  PHYSICIAN.
  Treatment.  Hypertrophy  of the heart is  very  difficult of cure  the
chances being  much greater in early life, than among those who have ad-
vanced in years.   The treatment  from which I  have met with the greatest
:;uccess, is the following :—Keep the bowels regular by small  doses of Podo-
phyllin and Leptandrin, or of the laxative powder  heretofore named, com-
posed of Rhubarb and Bicarbonate of Potassa ; bathe the surface daily with
a weak ley-water, to which some Alcohol has been .added, and dry with con-
siderable friction.   To effect a diminution  of the enlargement, the Iodine
pill must be given daily, two or three a day, according to the  severity of the
disease, and the Compound Syrup of Stillingia may likewise be exhibited
with great advantage.  Palpitation of the heart may be overcome by the em-
ployment of the Tincture  of Sheep Laurel, in doses of ten or twenty  drops
repeated two or three times a day.  Or, the following will be found very use-
ful in many cases:—Take of Tincture of Musk,  Essence of Cinnamon, Sul-
phuric Ether, and  Tincture of Sheep Laurel, each,  one fluidounce; mix.
The dose is from ten to thirty drops, repeated three times a day.  In seve-
ral cases of excessive palpitation, with great  nervous agitation, I have de-
rived  the  most benefit from a  pill composed of one or two grains of  the
Inspissated Juice of Conium Maculatum.
  The diet must be  principally composed of tender animal food; and intoxi-
cating or stimulating drinks must be used with great cautiousness, if used at
all; all mental or  bodily  exertion must be  avoided, as well as excitements
or depressions  of the  mind.   Cheerful company is of great service; and
whatever will produce moderate laughter and pleasantness of feeling, should
be encouraged.  Sometimes,  an  electro-magnetic  current passed through
the heart,  of moderate strength, will be found beneficial.
                       ENLARGED  TONSILS.

  The Tonsils, or "Almonds  of  the  Ear," as  they are  popularly called,
frequently become permanently swelled and indurated, as a consequence of
quinsy, scarlet fever, &c, and are frequently owing to an irritation of these
glands, in children of a scrofulous habit.   Sometimes the swelling becomes
so great as to render the voice  hoarse, the breathing difficult, and  interfer-
ing with  swallowing.  Deafness  is  sometimes produced by it, and, rarely,
suffocation.
  Treatment.  The general health of the patient must be attended to by
the proper hygienic and  therapeutic means, and if the patient be of a scrof-
ulous habit, adopt the measures named  finder scrofula.  Not unfrequently,
the enlargement can be removed by local  applications, and especially when
it is of recent formation.  Among the agents which have been successfully
used for this purpose, are:—
  1. Take  of Iodine one scruple,  Ointment  of Roses one  ounce; mix.
Apply a portion of  this to the  diseased  tonsils every morning and evening,
by means of a small brush, continuing its  daily application for three or four
months;  if any inflammation is present, reduce  it first.
  2. Extract of Green Walnut shells six grains, water  fifty  grains; mix.
Apply as above.
  3. Take of Tannic Acid ten  grains, common Salt twenty grains, Soft Ex-
tract of Bloodroot five grains, Ointment of Roses one drachm ;  mix.  Apply
as above.
  4. The dried powder of Sesquicarbonate of Potassa,  applied  to the tonsils
by means of a camel's hair pencil, repeating it every day or  two as required- 
AMAUROSIS.
489
  In addition, the Compound Tar plaster must be applied  externally ove?
the region of the enlarged glands, and a discharge be maintained from it as
Ion"  as the patient can bear; repeating its application after a time, if neces-
sary.  When these  measures fail, the last resort is to excise the tonsils, an
operation which should be performed only by a skilful surgeon.
                            AMAUROSIS.

   Amaurosis, (jutta Serena, or Black Cataract, is a decay or loss of sigH
 owing to a partial or complete paralysis of the optic nerve, or a change in
 its structure from disease,—the eye presenting no  apparent defect, except
 a slight dilation of the pupil, and remaining uninfluenced when exposed to
 the action  of light.   It may be owing to violent blows on the head or eye-
 ball, apoplexy, long-continued use of the  eye by improper light, exposure
 of the eyes to intense light, severe exercise, strong excitements of the mind,
 intoxication, masturbation,  tumors in the skull  or orbit, undue  pressure,
 and other  causes which  may debilitate the nervous system, and especially
 the optic nerve.  Amaurosis may occur at any period of life, and is exceed-
 ingly  difficult of cure, especially among those advanced in years.  When it
 occurs among the young, or is owing to the suppression of habitual evacu-
 ations, pregnancy, or is a sequel of certain fevers, the chances,of cure  are
 much  greater.
   Symptoms.  At first there are various perversions of sight, as  a  cloudi-
 ness or smokiness before  the eyes; brilliant stars or bright spots dancing
 before the eyes; colored  specks flitting across the  sight; and sometimes
 there is headache, pain in the  eyes, and a sensation as if dirt or dust were
 upon them.  These symptoms may appear at various times, and either dis-
 appear altogether, or eventuate in blindness.  Occasionally, the patient is
 not aware that  any  thing  is the matter with his eyes, until made aware of
 it by a more or less complete loss of sight.   The disease commonly attacks
 both eyes at the same time;  rarely one eye alone is affected.
   Treatment.  The bowels must be kept regular;  the surface  of the  body
 regularly bathed and rubbed;  all  close or continued exertion of the eyes
 must be prohibited;  reading, writing, fine needle-work, exposure of the eye
 to bright light or brilliant colors, must be avoided ;  moderate  exercise in
 the open air must be taken daily; the feet should be bathed in warm water
 every night;  and the head dipped in cold or tepid water every morning, or
 a shower bath may be cautiously used.   Cold water poured in a small stream,
 from a  considerable bight, upon ^he  temples,  repeating  it two  or three
 times  a day, will  frequently prove of much utility.  A good, nutritious,
 easily digested diet,  with stimulating condiments, will be found the best in
 most cases.
  Internally, I have found some advantage  from a pill composed of Iodine
 ten grains, Sulphate of Morphia two grains and a half, Strychnia one grain,
 Alcoholic Extract of Black Cohosh, a sufficient quantity to form the whole
 into a  pill-mass; mix carefully and thoroughly together, and  divide into
 twenty pills.  The dose is one  pill,  repeated two or three times a day.  It
 must be used with great circumspection on account of the Strychnia, which
 will be found to strongly affect  many persons, even in a dose of the 1.40th
 of a grain; and in these cases, its quantity in the above pills must be di-
 minished.   In addition, mild currents of electro-magnetism may be passed
 through the eyes, continuing them for half an hour at a time, and repeating
daily.    Sometimes, much benefit will be found from a Compound Tar plas 
490                AMERICAN  FAMILY PHYSICIAN.
ter applied to the back of the neck, extending across from one joint to th«
other, and down the neck to the large joint, or seventh  cervical vertebra,
keeping up a discharge from it as long as the patient can endure it, and
repeating the application  from  time to time.   If the patient be weak or
anemic, he must be supported by tonics, as Gentian, Quassia, Colombo, and
some preparation of Iron.
DEAFNESS.
  Deafness may be owing to acute or chronic inflammation of the internal
ear, to a relaxed condition of the tympanum or drum of the ear, to paralysis
of the auditory nerve  or  the nerve of hearing, or, to a collection of wax in
the ear.  In the majority of cases it is difficult  to correctly determine the
cause of the deafness, and the treatment is consequently, empirical.
  Treatment.  When the deafness is owing to an accumulation of matter
in the Eustachian  tube, this must  be removed by syringing  the canal with
air  or water, and  thus dislodging the obstruction, but  no one should be
allowed to perform this operation except a well-educated practitioner, other-
wise permanent injury might follow.  When the deafness is due to paralysis
of the auditory nerve, a treatment similar  to that named for Amaurosis may
be pursued; passing the  electro-magnetic  current through the ear.  When
there is a relaxation  of the tympanum, stimulants may be dropped into the
ear, as,  Burnt Alum ten grains, Sweet Oil  of Almonds one fluidounce; trit-
urate together.  A few drops  may be placed in the ear daily, which should
also be  injected two or three times a day with a decoction of equal parts of
White  Oak bark, Bethroot, and Rose  leaves.   Or, the  following may be
dropped in  the  ear: —Take of  Oil  of Cajeput  one drachm, Oil of Bitter
Almonds ten  drops, Glycerin two  fluidrachms, Olive Oil half a fluidounce;

  When there is  an accumulation of wax, a mixture of Sassafras Oil  ten
drops, Glycerin one fluidrachm, Olive Oil half a fluidounce, may be dropped
into the ear once or twice a day.  Sometimes deafness is  occasioned by a
partial  or entire  loss  of  the tympanum, for  which a small piece  of cotton
wool moistened with Glycerin may be introduced into the ear so as to come
m contact with  what  portios of the drum  remains;  or, an artificial drum
may be inserted.  A deficiency of wax  in the  ear, may  be remedied by a
mixture of  Glycerin one fluidrachm, Oil  of  Turpentine  half a fluidrachm.
Linseed Oil half a fluidounce.   The proper hygienic measures should in all
cases be carefully  attended to.
   When any  foreign  bodies  get into the  ear, they should be caretully re-
moved, if possible, by syringing the  ear with warm water; and if this will
not  dislodge them, a bent probe, small scoop, or small forceps may extract
them.  Insects in  the  ear may be killed by filling the ear with spirits and
then removed by injecting warm water into the ear; and all these operations
about the ear, will be best performed by an educated physician when one
can  be procured.   These substances in  the ear, have  frequently caused
great pain, deafness, palsy, and even convulsions, which have ceased on tnew
removal.  When  the  eggs  of insects hatch in the ear, they often produce
severe symptoms. 
HERPES.
491
                     DISEASES  OF THE  SKIN.
                       SALT RHEUM, (PSORIASIS.)
  The name of Salt Rheum  or Tetter, is  applied to several diseases of the
Bkin, among the most common of which  is Psoriasis, characterized by irreg-
ular elevated patches of inflammation of the skin, covered by thin, irregular,
and whitish scales.  Generally there is great itching and pricking attending
the disease, and but little or no  constitutional disturbance.  The hands are
the parts  more generally attacked, and  the skin is often divided by deep
fissures.   When the  disease attacks washerwomen, and bakers, grocers, and
others who are exposed to the action of powdered substances,  it presents
large, dry, and hard scales on the back of the hands and fingers, with deep
and painful fissures.
  Caches.  The causes of this  disease are not well understood; some con-
sider it owing to morbid  humors in the  system,  but I  think  this is an
error.  Of late years microscopists have found parasitical plants presents
cutaneous diseases, but whether these are a cause or merely an effect, remains
to be determined.  We find that persons who are exposed to cold and damp-
ness*, who use improper food, or are  irregular in their meals, whose hands
are exposed  to the irritating action of flour, sugar, soap, wax, resin, &c, are
more  especially liable  to the  disease. A variety  of other causes have  also
been named.  The disease is not contagious.
  Treatment.  In the treatment of this  disease, should there be any dis-
ease in connection with it, as of the liver, stomach, &c, or any scrofulous
taint of the system, it will be proper to  remove it by the appropriate reme-
dies.  In all cases it will be important to avoid the exciting causes  of the
malady, and  to make  use  of all  those hygienic measures calculated to  give
health, tone, and vigor to the  system.  Locally, one of the following prepa-
rations should  be  applied to  the affected part:—
  1. Take of Stramonium Ointment three  parts, Hop  Ointment one part,
mix.  Keep a  portion  of this constantly applied to the humor; and in wash-
ing the hands, instead  of using soap, employ only warm water, or water with
a small quantity of Oxalic Acid, or vinegar added.
  2. A saturated solution  of Oxalic Acid may be applied to the part two or
three times a day, when there is not much irritation  or inflammation.
  3. Take of finely powdered Sulphate  of  Zinc four ounces, Liquid  Styrax
one ounce, Lard one pound; mix, and boil slowly together for an hour,  stir-
ring all the time.  This may be applied twice a day.
  4. Use the Compound Ointment  of Bayberry.
                              HERPES.
  Tins  is another affection of the skin,  which  has  received  the  popular
name of Salt Rheum.   The disease is characterized by an eruption of vesi-
cles grouped on a limited and inflamed part of the skin, presenting distinct
spots with intervals of sound skin.  The most common among  this class of
cutaneous diseases are, Herpes Zoster, or Shingles, and Herpes  Circinnatus,
or Ringworm.
 ^ Herpes Zoster, or Shingles is characterized by irregular patches of various
sizes, and of a  vivid, red color, which are  covered with clustered vesicles,
forming a zone or half-belt on the body, which  usually commences  at the
middle line,  in front of some part of the trunk of the body, and extends to
the middle line behind, without ever passing  this  line.   A vulgar opinion 
492
AMERICAN FAMILY PHYSICIAN.
prevails that if this belt encircles the whole'body the case would terminal
fatally.  But it is not unfrequently the case that  this entire  encircling of
the body occurs without any fatal result.   These spots  are occasionally "pre-
ceded by a painful and burning sensation;  the vesicles are distinct, transpa-
rent, and of a pearly appearance, attain their full  development in three or
four days, rarely  exceeding the size of  a large pea, and toward the fourth or
fifth day having  gradually become opaque  and blackish, they shrivel and
become wrinkled, leaving  small, dark-brown scabs, which  fall  off on the
tenth or twelfth day, leaving a redness of  the  skin which  gradually disap-
pears.   Sometimes pus is  found in  the vesicles.  In  connection with this
eruption, febrile  symptoms will be  present, as  chills, heat of skin, quick
pulse, a sensation of  tension about  the seat of the eruption, and in some
cases irritation of the stomach  and  bowels.   The disease  most generally
attacks young  persons with fine and delicate skins, is more  common in the
sumiter and autumn, and frequently leaves large and painful ulcers, especially
among weak and  aged persons.
  Herpes Circinnatus or Ringworm is characterized by small globular vesicles
upon patches of inflamed  skin, which assume  the form of  a  circular ring,
varying in size from that of a dime to that of a half-dollar or  over.   These
vesicles are situated more especially near the edges of the ring, while in the
center the skin becomes pale or of its natural color.   There is a slight prick-
ing or smarting  sensation, with  itching.    The transparent vesicles become
turbid and milky, and are  succeeded by small, thin scabs, which fall off in
eight or ten days, leaving  a redness which  slowly disappears.   The disease
may attack any part of the body, but more generally appears on the face and
neck, the rings appearing  successively, and  the  disease continuing for two
or three weeks, or even longer.   The  causes of these  diseases are not well
understood, though they may, undoubtedly, be occasioned  by exposure to
cold, damp, fatigue, improper diet, and other depressing influences.
  Treatment.   Shingles  generally disappear under a simple  treatment, as
regulating the bowels  by some mild  cathartic, administering the Compound
Syrup of Yellow Dock, and applying to the eruption  the Compound Oint-
ment of  Oxide of Zinc, Compound Ointment of Bayberry, or Ointment of
Woodsoot.   The  leaves of  Houseleek, bruised, and applied as a poultice, will
be  found very efficacious.   Among weak,  or aged persons, the Tincture.of
Muriate of Iron  should be used,  and the system supported by a generous,
nourishing diet.
  Bingworm may be  cured by keeping the  bowels regular, bathing the sur-
face daily with a weak ley water, and  applying to the eruption, the  Com-
pound Ointment of Bayberry, or a saturated solution of Oxalic Acid.  In
obstinate  cases, the Compound Syrup of  Yellow Dock may be given inter-
nally.   The Tincture  of Iodine has occasionally been used with effect.
                  MILK  CRUST, or  MILK  SCALL.
  This disease has  received several names, as Crusta Lactea, Tinea Lactea,
Porrigo Larvalis, &c.  It is common to young infants, being more commonly
noticed upon the face, though it is frequently seen upon the extremities, and
various parts of the  body.   Generally it appears first upon the forehead, and
sometimes on the scalp;  and then  often extends half way over the face.  It
is characterized by an eruption of  small superficial pustules of a yellowish-
white color, more or less confluent, grouped on an inflamed surface of greater
or less extent.   The fluid within the pustules is  at first whitish or transpa- 
SCALD HEAD.
493
 rent, which  soon  becomes of a dark color, and  opaque, and when it is dis-
 charged externally, it is viscid and yellowish, forming tmn. soft crusts of a
 yellowish-gre<-n color.  The discharge continues;  new crusts porm, the first
 increase in  thickness, and  become  thick, soft, and rounded in one place,
 while tbcy are thin and in scales or  plates at another.   When the crusts fall
 off, they leave a red  surface, highly inflamed, upon which  fresh  crusts are
 formed.  Sometimes the discharge is very slight,  forming a  very thin, brown
 scale on the skin; again it may be  so profuse that scabs do not form.   Oc-
 casionally the forehead, cheeks, or chin, are covered with a large thick crust,
 like a mask, the nose and eyelids alone being exempt.  When the disease is
 of  certain extent, the itching and  pain  are often very violent;  but  some
 itching is always present, even in the mildest form.
   When the disease  is approaching  a cure, the discharge lessens, the crusts
 form more slowly, become thinner and whiter, the surface on which they rest
 becomes  less and less red, the crusts fall off, and do not form again.  The
 skin gradually recovers its natural appearance, without any  scar or disfigura-
 tion,  unless  the  child has  been permitted to  abrade  its  face by  violent
 scratching.
   Milk ('rust may remain  for only a few weeks or for several months; it
 usually disappears  soon after teething  occurs, though if it begin  after
 the first teeth  have  appeared, it may continue until  second teething  com-
 mences.   The disease sometimes appears on adults.   Its causes are not
 ascertained.  Care must  be  taken  not to allow the child to scratch its face,
 lest it thereby disfigure it.  It is not a contagious affection.
   Treatmu.vt.  It will be proper in all instances to ascertain if the stomach
 and liver  are performing their functions healthily; if not, it will be neces-
 sary to gently stimulate  them by the administration of the Compound Syrup
 of Rhubarb and Potassa in doses to  produce one  mild evacuation daily.   As
 an alterative and tonic the following may  be given  every four hours through
 the day:—Take of Tincture  of Black Cohosh, Tincture of  Shrubby Trefoil,
 each, two fluidounces; mix.   The dose is from five to twenty drops,  accord-
 ing to the child's age, and may be given in about a teaspoonful of sweetened
 water, adding from one to four drops of the Tincture of Muriate of Iron to
 each doso.   An ointment mav be applied  to the parts affected, after gently
 bathing them witn Castile soap suds,  and drying, composed of the  fresh
 leaves  of  Tricolored  Violet  (Viola  Tricolor) simmered in cream,  adding
 enough of the leaves  to form an ointment when finished.   To this ointment
 add Sweet Gum, in the proportion of three parts of the latter to eight  parts
 of the former, combining them by a gentle heat.   It may tee used three or
 four times a day.  I  have occasionally derived  benefit from an  ointment
 composed of Mutton  Tallow one ounce, Oxide of Zinc, one drachm, Tincture
 of Camphor  two  fluidrachms, Glycerin one  fluidrachm;  mix.   Attention
should be paid to the diet, its amount as well  as the regularity of meals,
exercise in the open  air is  an important measure.  Not unfrequently, the •
disease will gradually pass away, after having changed the wet nurse, giving
 the infant other and healthy breast-milk.
                 SCALD-HEAD,  or  DOW  WORM.
  Scald-head, or Tinea Capitis, is a term too generally  applied to pustular
diseases of the scalp, some of which differ essentially in their characters, and
at the present day, are arranged into several  species under various  names.
Thus the true scald-head is termed Porrigo Favosa, Tinea Favosa, &c.  When 
494
AMERICAN  FAMILY PHYSICIAN.
  first observed,  this consists of an eruption of minute  pale  yellow  pustules
  around the cylinders of the hair, and dispersed in various situations on the
  scalp.  Although generally isolated, yet it is not uncommon for them to be
  so crowded as to form something like a continuous punctated surface.  These
  yellow pustules increase in size and number,  are surrounded with an inflam-
  matory blush, which does not rise above the level of the skin, and are accom-
  panied during their development with an intense  itching.  Almost from the
  moment of their formation,  they may be seen, either by the naked eye or
  with the help of a magnifier, to be depressed or cupped on their surface- this
  is owing to the escape of the yellow fluid contained within the hair  follicles
  which  desiccates into small cup-shaped crusts of a  bright yellow color, porous
  and friable in texture, and having inverted borders.  These  crusts  or scabs
  slowly increase in size, the cupping  of their surface becomes more and more
  apparent, and they finally attain a diameter of several  lines.  They adhere
  very firmly to the skin, and can scarcely be removed in the dry state, with-
  out being followed by bleeding.  When the pustules have been crowded, the
  scabs blend and become united on their edges, so as  to form a continuous
  incrustation of very considerable extent,  upon the surface of which the de-
  pressions, indicative of the nature of the original  pustules, may still be  dis-
  tinguished.   When exposed some time to the action of the%air,  the  crusts
  break easily, and are interspersed with fissures.   The disease  may continue
  for months and even years,  until the entire scalp becomes  covered by  one
  dense  and uniform crust.   Sometimes the  whole scalp,  even down  to the
  bones of the head, are involved in the unhealthy action, and not unfrequently
  the lymphatic glands in'the vicinity become enlarged.   A rank and disgust-
  ing odor is exhaled from the disease, and without great care the head will
  become filled with parasitic  pediculi.  Occasionally ophthalmic affections
  will be produced.   The hair may readily be pulled out  by the roots, leaving
  white,  smooth, shining bald spots, and when it grows  again it will be of a
  permanent light or grey color.
     The disease spreads rapidly among children who are  much together, who
  sleep in the same bed, make use of  the same comb, hairbrush,  towel, &c,
  yet direct inoculation has failed to produce it.  It principally  attacks  children
  between the ages of three and six, and appears to consist in  the transmission
  of simple cells  to the hair-follicles of  a sound person,   and  which cells are
  capable of extending themselves  by the ordinary process of multiplication.
  Improper or deficient diet, moist atmosphere,  want of  ventilation,  confined
  and unhealthy localities, weak,  or scrofulous condition of the  system, favor
  an attack of the disease.
     No other  disease of the skin, except ringworm  of the scalp, is character-
  ized by minute yellow pustules, whose contents concrete almost  as soon as
  they are visible, into cup-shaped, hard, and extremely dry, yellow scabs.  In
  this disease the scabs adhere firmly, and can scarcely be removed in the dry
• state, without being followed by a little bleeding.
     A parasitical fungus plant is found on the parts affected with this disease.
  called  "Achorion Schoenleinii," which may be seen by the microscope.
     Treatment.  The hair must be cut as closely as possible, and a poultice
  of Elm bark applied, mixed with a solution of Subcarbonate of Soda, having
  first carefully washed the parts with Castile soap and  water.  The poultice
  may be placed on at bedtime, and remain during  the night;  the object is to
  lessen irritation and consequent inflammation, and to loosen the crusts. Upon
  removing the poultice,  examine the head carefully and remove all loose in-
  crustations, after which cleanse the  head with Castile soap and water,  dry it,
  and during  the day apply two or three times to the scalp an ointment com- 
RINGWORM  OF  THE  SCALP.
495
posed of Lard six ounces, Sulphate of Zinc one ounce, Woodsoot one ounce,
and Sulphur half an ounce.   During  the intervals between these dressings
the head must be kept closely covered.   After the  crusts have all been re-
moved, the poultice may be omitted.  By pursuing  this  course daily  the
disease will soon be removed.  Internally the Compound  Syrup of Yellow
Dock may be given, and the bowels kept regular; if the child be debilitated
the Compound Powder of Quinia may be given.   The whole  surface of the
body should be  bathed daily with soap and water.
  I have known several most inveterate cases cured  by substituting for  the
ointment just named, another made by taking green rye,  when  it is about
Bix or eight inches in height,  and simmering it  with  fresh cream so as to
form an ointment.
  When the disease is not very extensive, the application of a Saturated Solu-
tion of Oxalic Acid will be found effectual; or, half a fluidrachm of Creosote
may be added to two fluidounces of the above Saturated Solution, and used
with advantage in some cases.  A preparation has been used with benefit com-
posed of an ointment of Sheep Laurel, (made by boiling the leaves, collected
in autumn, in lard until they are crisp,) two pounds, Powdered root of Amer-
ican Hellebore, half a pound, Hard woodsoot, one pound; mix  the articles
thoroughly together, and anoint the scalp with it twice a day.
  It has been highly recommended to apply  Concentrated Acetic, or Pyro-
ligneous Acid to the parts, by means  of a fine sponge  fastened to the end of
a stick.  The parts, as well  as a short distance around them, are to be thor-
oughly imbued  with the acid, for the space of three or four minutes, and the
business is finished.  Occasionally,  however,  four  or  five touchings will be
necessary; to be applied, of course, after the removal of the  poultice, and
washing and drying the parts.
                  RINGWORM  OF  THE  SCALP.

  Another disease of the scalp to which the name "Scaldhead" has been
applied, is Ringworm of the Scalp,  variously called by authors Porrigo Scu-
tulata, Favus Confertus, Trichosis Furfuracea, &c.   This affection commences
in the shape of one or more circular red patches attended  with intense itch-
ing, upon which  numerous  very minute  yellow pustular points, level with
the skin, or but  slightly elevated, make their appearance.  These pustules
are deeply embedded in the skin, and much  crowded,  especially in the  cir-
cumference of the patches ;  they are circular, depressed, and almost univer-
sally traversed by a hair.   The fluid within them dries up very soon after it
is poured out, forming a minute cupped scab, which adheres by its edges to
those  in its immediate  neighborhood, so that a continuous incrustation is thus
produced of the form and dimensions of the original pustular patch.  The
crusts, however, in this disease,  unlike those of the previous true scaldhead,
do not usually continue long adherent,  nor indeed does the  primary patch
long retain its first dimensions; for successive eruptions  of pustules in its
circumference speedily  enlarges its  diameter,  and the  crusts falling  out
of their cells in the central  parts,  the integument  there becomes dry and
subject to an habitual  desquamation.
  As in the previous disease, the hair, in this form,  soon  looks altered,  be-
comes thin, and is then lost, so that the circular patches are all but bald, the
few hairs that still sprout from their surface being crisp, woolly,  and readily
detached.   When the  disease has continued long,  even this imperfect hair is
no longer produced, and  it may happen that the hair-bulbs are so  deeply 
496                AMERICAN   FAMILY  PHYSICIAN.
affected as to be incapable, when the disease is cured, of resuming their func-
tions, in which case,  irremediable baldness is the consequence.   The disease
not only attacks the scalp, but parts thickly covered with down.  Generallv
several  circular patches appear in succession  on different parts of the scalp
probably  from  inoculation,  performed  by  the fingers  of the patient in
scratching.   These extend  until  they are  one, two,  or even more inches in
diameter, and frequently meet by  their  corresponding  edges,  so that the
entire  surface of the scalp,  and even parts of the forehead and  cheeks an
occasionally covered by the disease.   The desquamation is of a furfuraceous
character, and the skin beneath the crusts is red and glossy, with small pur-
ulent points.
  The disease is a very obstinate one, never yielding readily to any remedial
treatment, so that between the want of perseverance on the part of practi-
tioners and the anxiety of teachers to get rid  of those children  affected with
it, lest they should contaminate others, the disease has been considered an
opprobrium, not only to the  physician, but likewise to  the unfortunate child
who is affected.  It may continue an indefinite period of time, and is apt to
leave a permanent baldness, or, if hair should grow again it will remain light-
er than the rest.   It spreads rapidly among children who wear each other's
hats, or make use of the same comb, hair-brush, towel,  bed,  &c.  Sometimes
it occurs spontaneously among children, or from causes similar  to the pre-
ceding variety.  If left to itself it may give rise to the  most disastrous con-
sequences, even producing caries of the bones of  the  head.  A parasitical
fungus plant is found on the  parts affected with this disease, called "Trico-
phyton Tonsurans,"  which may be seen by the microscope.
  The clustering of  the pustules,  their circular arrangement, the cup-like
and  greyish-yellow  appearance of the crusts, their easy removal, the bald-
ness occasioned by the disease, and its contagiousness,  will determine it from
any other disease of the s-calp.
  Treatment.  Poultice the head with the Elm and solution of Subcarbon-
ate of Soda, as in the previous disease, wash it  with  Castile soap and warm
water, and then all loose scabs and loose  hairs  must be  gently removed by
forceps, the head dried as  thoroughly as possible, and  the Compound Oint-
ment of Bayberry applied to it, three times daily—or  an ointment  may be
made of equal  parts  of Sweet Gum  and  Mutton Tallow.  At night, again
wash the head with Castile soap and warm  water, re-apply the poultice, and
so continue daily.   The bowels must be kept regular, the surface of the body
bathed daily, the child must not be allowed fatiguing or excessive exercise, and
the food must be nourishing, digestible, and free from fats, acids, and stimu-
lants.  Internally, administer five drops of the Tincture of Muriate of Iron
in water,  four or five times a day to a child about five  years of age,  or in
proportion.   If the disease prove intractable in a scrofulous child, the Com-
pound Syrup of Yellow Dock should be given.  Sometimes a Saturated Solu-
tion of Oxalic Acid  will be found an effectual application.
                 BARBER'S,  or JACKSON'S  ITCH.
  Barber's Itch has received the names of Mentagra, and  Sycosis Menu.
It is a chronic inflammation of the skin, somewhat similar to  Acne, appear-
ing,  however, more commonly on  the chin, but which may attack every p&rt
of the face occupied by the beard.  The disease, when severe, is usually pre-
ceded by many small pustular eruptions, either on the upper lip, the chin,
or on the lower jaw; these are attended with a sense of tension,  unpleasant 
barber's  itch.
497
 tching, and even pain.  In a  few days  the pustules  shrink,  and are suc-
 ceeded by thin scabs, which dry, and fall off in a few days more.   When the
 jruptions become more abundant, so as to attract the attention of the patient,
 here will be numerous bright red points visible, and the feeling of tension,
 jeat, and itching will be increased*.   In  about three days  these points will
 jecome distinctly pustular, the pustules being small, acuminated, distinct, in
 groups, occupying the chin, upper lip, or other parts of the face  on which
 the beard grows,  having their center traversed by a hair,  and  containing a
 yellowish-white fluid, which exudes when they are punctured.  In about six
 or seven days the  pustules burst, without any discharge of matter,  though
 the indurated masses that surround them and give a deformed aspect  to  the
 countenance,  are frequently observed to be  moistened on their surface  by
 an  exudation of  the  pustular contents; brownish scabs  eventually  follow,
 which insensibly detach themselves, and the  disease terminates from the tenth
 to the fifteenth day, if a new eruption  does not take place.   Sometimes only a
 few pustules are developed, disappear, and are followed by others for  an  in-
 definite period, the skin  becomes rough, and small white crusts or scales are
 thrown off, under  the center of which may be  seen  new pustule.   Most
 commonly the disease continues,  there  is a succession of partial  eruptions,
 and the skin becomes the seat of a chronic eruption over a larger  or smaller
 surface, frequently being deeply inflamed, with heat, violent pain,  and thick
 scabs.
   This disease is confined principally to the male sex, being very  rarely
 met with  among females;  it may continue for  an indefinite  period, and,
 occasionally, after a number of years it disappears spontaneously.   It attacks
 all classes of society, but  is more common to those whose faces are habitually
 exposed to strong heat, as smiths, cooks,  bakers, founders, &c, and  especially
 if they are intemperate.  It may also arise from uncleanliness, bad food, and
 the frequent employment of a towel used in common by many persons.   It
 may be occasioned by the use of a dull  razor, which irritates a susceptible
 skin; and if the eruption is once developed,  the use of a razor will increase
 its severity.  In most cases, it is not the razor which produces the disease,
 but uncleanliness, intemperance and other causes which render  the skin lia
 ble to the affection, and the attack of which  is hastened by the application
 of the razor.   A parasitical fungus plant is found on the parts affected with
 this disease, called "Microsporon Mentagrophytes," which may be seen by
 the microscope.
  Treatment.  The patient must avoid  the exciting causes of the disease,
 as, exposure of the face to excessive heat, intemperance, bad food,  &c.  The
 razor must be  laid aside until the disease is cured, and, instead of shaving,
 the  beard should be carefully clipped short with a  pair of flat,  curved, and
 very sharp scissors.   The bowels must be kept regular, and the diet  should
 be of a light and cooling  character.  If there be much irritation or inflam-
 mation around the  eruption, a warm poultice of Elm and  Lobelia  leaves
should be applied, and after the irritation has been removed, one of the fol-
lowing applications  should be used:—
  1. A Saturated Solution of Oxalic Acid, with which the parts should be
washed several times a day.   I have met with more success from this solution
 than from any other remedy.   In some cases it tends to increase irritation,
but this may be avoided  in such instances by diluting  the solution,  or,  by
employing the above-named poultice of Elm  and Lobelia, every night,  and
applying the saturated solution through the day.
  2.  The preparation No. 3, of Sulphate  of Zinc,  Liquid Styrax, and Lard,
mentioned uuder Salt Rheum, on na°-e 491.
      oJ 
498
AMERICAN  FAMILY PHYSICIAN.
   3.  Take of Muriate of Ammonia  two drachms,  distilled water one fluid-
ounce,  Tincture of Conium Maculatum one fluidounce;  mix.   This should
be applied as a wash to the parts several times a day, and will be found es-
pecially useful in those eases where  the disease lasts  for a long time and
where there are large  tubercles  and chronic indurations of the skin.  In
some cases half a fluidounce of the Compound Solution of Iodine  added to
the above mixture will increase its efficacy.   Any loose hairs  should always
be at once removed, as they are apt to irritate the parts.  Internal treatment
is of  little value, except to remove any complication which may exist.
                           ITCH,  or  PSORA.

  Itch,  or Scabies is a contagious affection of the skin,  which is character-
terized by an eruption of distinct, slightly  acuminated and conical vesicles
transparent in their summits, presenting a  slight red tinge in young persons
and accompanied by excessive itching which is increased by warmth, heat of
the bed, and the use of spirituous liquors  or  high-seasoned food.  These
vessels contain a viscid and serous fluid, which is discharged  when tb*y are
ruptured by  scratching or otherwise,  and they are replaced  by numerous
small, red, inflamed spots.  The disease may appear on all parts of the body
except the face, which is always exempt; but the spaces  between  the fingers,
the wrists, elbows, axilla, and abdomen are the  parts more especially liable
to be affected.   All classes of society are liable  to it, but certain professions
are  more obnoxious to"it than others, as tailors,  seamstresses,  mattress-mak-
ers, dyers,  &c.   When the vesicles  are very large and attended  with much
inflammation, they are apt to assume a pustular character, discharging pus.
  In the young and healthy the disease will show itself  in  from  twe to six
days after contact; in the debilitated it will require a longer time. In the
adult from seven to ten days  is required in the spring and summer, &vi from
fifteen  to twenty in winter; older persons require a still longer time before
the vesicles will be manifested.

                                  Fig.  3».
Xi.'f A~ t/\
    Hale (smallest) ani Female Itch Insect, magnified 100 diameters, or 10,000 times.

  Causes.  The cause  of itch is a microscopic insect  called the Acarv*
Scabiei, or Sarcoptcs Hominis, see Fig. 39, which is transferred from one 
ITCH.
499
person to another by actual contact, as, in sleeping together, shaking hands
L' or  through the medium of clothing which has been worn by an infected
individual   Persons who neglect personal cleanliness are especially liable to
it  hence it is very frequent among the lower classes, and when the disease
is'met with in respectable families, it will generally be found that laundresses,
servants, or hired persons, have communicated it.            _
  The  itch insect varies from l-77th of an inch to l-147th in length,  and
from 1-91th to  l-303d  of an inch in breadth.   It "is a minute whitish
creature  having  no true head, but is  provided anteriorly with proboscis-like
mandibular organs furnished with four bristles.   There are eight legs, four
anterior are inserted into the thorax by the side of the proboscis, are jointed,
and furnished with hairs and  bristles, the last joint of each terminating m
an adherent  disk.  The posterior legs without adherent disks, terminate in
very long bristles.   The animal burrows in the epidermis, and forms minute
channels, at the  end of which it may  often be discovered; it does not inhabit
the vesicles or pustules which constitute the eruption, and are simply excited
by  the  irritative proceedings  of the animal."  With a bright  light, and a
good pair of  eyes, a small spot or streak will be observed upon some part of
the affected  surface, at an early part of the disease; this is  the original
opening made by the insect on entering the skin, and from this spot will be
traced  a whitish  streak or  line of a few lines in length, which is the burrow
of the acarus, and at its termination the insect will be found—there will be
a slight elevation over it, beneath which the insect will be seen as a greyish
speck; it can readily be removed by carefully raising the skin with the point
of a needle, exposing it to view.   It must  be recollected that the primitive
vesicles only, and which are produced by the entrance of the  insect,  will
represent the above white  streak ;  the insect is never found within  a vesicle
or pustule.
  Treatment.   Itch is a purely local disease, and does not appear  to exert
any influence upon the general  constitution.   When  left to itself it may
continue for years, or even during life.  Many remedies  have been recom-
mended for it, among which the following are the most effectual:—
  1. The Compound Ointment of Sulphur, which should be rubbed upon the
affected parts once a day, continuing its  use for a week or ten days,  in order
to destroy any eggs which may have been previously uninfluenced by it.
  2. Oil of Turpentine applied externally, and  taken internally in doses of
five or six drops, two or three times a day, has proved efficacious.
  3. Sulphuret  of Potassium  one  drachm, Soft Soap  two drachms,  Water
half a pint;  mix, and dissolve.  Wash daily with this; it does not smell bad,
nor soil the linen.   To be used for ten or twelve days.
  4. Use as a wash a solution of Chloride of  Lime.
  5. Ointment of White or American Hellebore.
  G. I  have  cured several cases of  itch by simply bathing the surface twice
a day  with  a mixture of Cologne Water one pint, Sulphuric  Acid  half  a
fluidounce.
  7. Take Tincture of Camphor  four fluidrachms, Vinegar one fluidounce,
Cologne four fluidounces;  mix, and use twice a day as a wash.
  8. Take of Brown Soap one ounce, Table Salt half an ounce, Sulphur  half
an ounce, Chloride of Lime half an  ounce, Alcohol one fluidrachm, Vinegar
two fluidrachms; mix all together thoroughly.   One-fourth  of this is to be
used at a time, rubbing it on  every night and morning.
  9. Take of Flowers of Sulphur sixteen parts, Sulphate of Zinc two parts,
Powdered White Hellebore four parts, Soft Soap thirty-one parts, Lard sixty-
two parts; mix.  Use a little  of this twice a day.  In this and the prceding. 
4)00
AMERICAN  FAMILY PHYSICIAN.
preparations the  use of either must always be preceded every  niornin"1 and
night, with  a strong, soft soap water, employed as a wash to  the whole sur-
face of the body  and limbs, which must then be dried.
  The clothing of the patient, as well as the bedding, should be exposed  to
the vapor of Sulphur, in  order to destroy any of  the insects,  that may have
been deposited among them;  and in cases where the disease has proved un-
commonly obstinate, it would be desirable to destroy the infected clothing.
BLOTCHED  FACE.
  Blotched Face, or Acne, is a chronic pustular affection, characterized by
a deep-seated and very  indolent  inflammation of the tissues immediately
surrounding the sebaceous follicles,  and  of their excretory hair follicles'
followed by small, hard, conical, and isolated pimples or pustules, of vari-
ous degrees of redness.   These are  sometimes permanent for a consider-
able length  of time, the tops gradually become pustular and burst, while the
bases  continue  in an indolent state  for some time  before they disappear,
leaving minute  scars behind  them.   They appear on the face, especially on
the forehead, temples, and chin, and sometimes on  the neck, shoulders, upper
part of the  breast and back;  but never descend to the extremities and lower
parts  of the body.  Acne is  divided into the varieties,  Acne Vulgaris and
Acne  Rosacea.
  Acne Vulgaris is characterized by small,  red, and inflamed pimples, which
rise gradually, assume a conoid shape, with pale, yellow heads; these even-
tually burst, a small quantity of sero-purulent fluid  escapes which forms a
flimsy scab which is detached in a few days, while the base of each pustule
remains hard, and of a deep red color.  Each pustule runs its course inde-
pendently of the others.   The tubercle or indurated base is a very long time
in disappearing, and leaves a small, white scar.  The suppurative period is
not completed in these pimples until six or eight days have passed, when it
bursts, as above.  No pain or heat is produced, unless the pimple is devel-
oped near a  filament of a sensitive nerve, wdren the pain may be severe.
  Sometimes, in the center of each conical pimple,  or in  the majority of
them, a small, round, blackish spot may be perceived, which is the  external
opening of  a hair follicle, distended  with a concrete sebaceous matter, and
the black spot  is the adhering dust of the atmosphere;  these pimples sup-
purate, discharge the sebaceous  matter, diminish  in  size, become  purplish
and livid, then  whitish,  and disappear very slowly.   This  form has received
the name of Acne Punctata.  When  the pimple or  tubercle  is quite large,
hard, deeply seated,  and  very  indolent, having  its  suppurative  stage pro-
longed two  or three weeks before it matures,  and frequently not suppurating
at all, and afterward forming purplish or  livid prominences,  which require
months before they disappear, and at times becoming permanent, it is called
Acne  Indurata.   In this  form the features  are much disfigured by the deep
red or livid tubercles, and after a cure there  are apt to be left' traces of its
presence in the shape of small  oblong scars.   Acne  Vulgaris, and its sev-
eral forms  more generally attacks young persons about the period of pu-
berty, and who  are apparently in good health; though  it may be developed
at any period between puberty and middle age.  Those addicted to masturba-
tion are very apt to be  troubled with this affection, especially the variety
acne  indurata.   Other causes, however, will give rise to the malady, as cer-
tain  occupations in  which it is necessary to keep the head low and near a
furnace; irritations of the abdomen; excesses at the  table; strong vum 
BLOTCHED   FACE.
50]
affections; neglect of soap and water  to the face;  irritating lotions or cos-
metke ■ frequently the causes are involved in much obscurity.
  T^cea * especially characterized by the unusual  redness and con-
,e ion which  attend its  conoidal pimples, by the prominence of he veins,
the slowness of the progress and suppuration of the pimples, and  the  indo-
   t   racter of thi livid and indurated tubercles  or knots which they leave
behind   The most usual  seat  of acne rosacea is the nose, forming the red,
Prnplc,!  or Uotehednose; the nose is frequently enlarged  the surrounding
parts hypertrophied, and  the veins  become  varicose and  bluish, forming a
contrast with the redness  present.  The redness and congestion "gently
increased after a meal, and especially after the use of any stimulant.  When
 he disease has lasted for  some time the  skin  of the affected parts becomes
rough and granulated; and even if thedisease disappears, permanent  scars,
roughness, and inequalities are left behind.                       .
   Acne Rosacea is frequently associated with intemperance,but this is by no
means a necessary  cause, for it is often owing  to chronic  disease  of  the
stomach, intestines, and  liver, and any circumstance which will obstruct or
lessen the circulation of the capillary vessels.  In  females it may be asso-
ciated  with amenorrhea.   And in  many cases its causes  are obscure.   It is
more  frequently  met with after thirty-five years of age, seldom appearing
among those younger unless they are naturally predisposed to it, or indulge
too freely in liquors; and a perfect cure  is seldom  accomplished.  _
   Tkkatment.  In the treatment of both forms of acne  the  patient should
live temperately and  abstemiously, avoiding all stimulants, tea, coffee,  and
liquors, and using but very little animal food.  The bowels should be kept
regular, the surface of the body should be bathed  with a weak alkaline solu-
tion  daily, and every week or two  a Spirit vapor-bath should  be  taken.
Mental anil physical fatigue, exposures to the sun, to hot rooms, to sudden
changes of temperature are especially to be avoided.  In  females the condi-
tion of the menstrual function must be attended to.  In  all cases any  dis-
eased  condition of other parts which  may be present  must be  removed by
appropriate treatment.
   As  local applications  various agents have been used. In many cases a
wash composed of Muriate  of Ammonia two drachms, Tincture of Conium
Maculatum one fluidounce, Distilled Water one  fluidounce,  will be  found
very efficacious, touching the  parts with  it several  times a day; when there
is little or no irritation present the Conium may be omitted, and some stimu-
lant added as Tincture of Capsicum, or Myrrh, &c.
   Frequently  a mixture  of two fluidrachms of Oil of Stillingia, one  flui-
drachm of Oil of Lobelia, and four fluidounces of Cologne, will  be found a
very excellent  local application, especially in the more obstinate forms  of the
disease.
   Equal parts of Cologne and a Saturated Solution  of Oxalic  Acid have
proved beneficial, especially when the disease has  been of recent standing.
But whatever application  is employed, it must be perseveringly used for some
time.   The loduret of Sulphur in the proportion of  a scruple to an ounce
of Elder Flower Ointment, or simple Cerate, and rubbed upon the elevationa
two or three times a day,  has  been highly recommended.
                      GRUBS  IX THE  SKIN.
  Comepones is a disease  in which  the sebaceous secretion of the skin ia
concreted, and distends the hair follicles of the affected parts.   It is popu- 
502
AMERICAN FAMILY  PHYSICIAN.
larly known as grubs, or worms in the skin.  It is more commoniy observed
on the face, especially the nose, presenting the appearance of round, black
spots, which are more or less thickly clustered together, and which, when the
skin, including one of these spots, is pressed between the fingers, discharges
the concrete substance in the form of a minute  white  cylinder with one of
its  extremities  blackened.   When  this  cylinder is examined under  the
microscope it will  most generally be found  to contain  onet two, or more
insects, called Acarus folliculorum, or Steatozoon folliculorum, and  which ig
also frequently met with in  acne, especially acne punctata.  (See Fig. 9.)
  This insect  is from  l-75th to l-125th of an inch long, and about l-500th
of an  inch broad;  it has an elongated figure, a long thorax with four pairs
of short, conical legs,  and an abdomen three times as long  as the thorax
which  gradually tapers to an obtusely pointed extremity.   The  head is con-
tinuous directly with  the thorax,  and  has two large  palpi, and a proboscis
situated between them.  The abdomen is  marked by a  number  of trans-
verse  lines or  grooves, and contains round, oval, and quadrate transparent
places  among granules; the legs are terminated  each  by three claws,  one
of which is longer than the  other.  The insect is slow in its movements,  but
retains its  vitality for some time after being removed from the skin.
  Comedones  is generally met with among persons in whom  the circulation
of the capillary vessels is less active  than  natural, especially among those
laboring under diseases of the  various  organs  of the  body, or, who exhaust
the vital energies by overtasking the brain and nervous system; it is a com-
mon associate  of acne.
  Treatment.  The parts should  be washed daily with soap  and water, and
in drying should be briskly  rubbed with a rough towel until  a glowing sen-
sation  is felt;  after which the parts may be bathed several times a day with
the mixture of Muriate of Ammonia, Tincture of Conium, and water, named
as a local application in acne, page 501,  or a lotion  of equal parts of a Satu-
rated Solution of Oxalic Acid and Cologne may be used.  The surface should
be kept healthy by daily ablutions, the regularity  of the  bowels preserved,
and the system sustained  by good nutritious, easily digested food, avoiding
all liquors.  In obstinate cases, twenty drops of the Tincture of Muriate of
Iron in a wineglass of water may be taken, and repeated three times a day.
Any disease connected with the cutaneous difficulty must be removed by the
appropriate treatment.
                              FRECKLES.
  Lentigo, or Freckles, are small, rounded, brownish-yellow, or greenish-
yellow spots that appear upon the face, throat, bosom, hands, &c, of indi-
viduals, especially those of light complexion and  hair, and those who have
red hair.  They differ from ephelis or sunburn, by not disappearing in the
winter.   The  cause  of these spots is not known, though they are popularly
supposed  to be owing to  an  exposure  to the  sun's rays; but they are fre-
quently met with among newly born infants, and  persons who have never
been exposed to the  light of the sun.
  Treatment.   It  is not always that  freckles can  be cured by any treat-
ment, but occasionally they have been  removed by  local applications, as a
weak solution of Citric Acid in an infusion  of  Roses;  a liniment of Lime-
water and Oil, to which a small quantity of  Liquor  Ammonia has been
added; a mixture of three" parts of Cologne, and one  of Oxalic Acid in solu-
tion; a weak solution of Lactic Acid, &c.  In several instances, the follow- 
BOIL.
503
 ing has proved useful:—Take of Lobelia seed half an ounce, Beef Gall half
'an ounce, Gum Guaiacum one drachm, Bicarbonate of Potassa one drachm
 Oil of Turpentine one fluidrachm, Spirits half a pint.  Let the articles stand
 for ten or twelve days in a glass vessel, frequently shaking.   Use as a wash
 twc> or throe times a day.
                                BOIL.

   Boil, or  Furunculus, is a well-known hard, conical shaped swelling, the
 size of a pea or larger, accompanied with a degree of  pain, and which may
 be situated  on almost any part of the  body.   The swelling rapidly increases
 in size, becomes of a florid red color,  its base  penetrating deeply, and after
 five or six days the summit of the enlarged boil  becomes pointed and yel-
 lowish-white, bursts, and  discharges a small quantity  of a bloody pus.  In
 the  opening of the boil thus  formed, will be perceived  a sloughy piece of
 cellular membrane, commonly termed the core of the boil, which beeomes
 loosened in ten to fifteen days, and is expelled naturally or artificially.
 The pain now ceases, the swelling rapidly disappears,  and in a few days the
 part heals, leaving a permanent scar, and a transient,  dusky redness.  Fre-
 quently, instead of one boil only appearing, there will be several or more,
 and which will  sometimes  continue to form in succession for months and
 even years.   They are more eommon  to the young, and are generally con-
 nected with some derangement of the liver and stomach, and, probably,  an
 unhealthy condition of the blood.
   Treatment.  If the swelling be touched freely with Nitrate of Silver at
 an early period, or with a saturated  solution of Oxalic Acid, or with Oil of
 Turpentine, it may frequently be checked; the application of an Ice poul-
 tice will often retard its further advance.  When it is in a state of inflam-
 mation and  pain, it may be poulticed with a Flaxseed, Elm bark, or bread
 and milk poultice, in order to hasten suppuration.  If there be  much pain,
 Hops, or Lobelia leaves in poultice, may be applied.   The bowels  should
 be kept regular, diet  regulated, and patient  remain  as  quiet as possible.
 After the tumor bursts and  discharges, but little or no treatment is required,
 except it assume a*i indolent form, when the sore  left  may be  touched with
 the Sesquicarbonate of Potassa, and dressed with  the Red Oxide of Lead
 plaster.   When  the tendency  to  boils continues for  months, the patient
 should use a generous diet,  moderate exercise, and the following:—Take of
 Ground Centaury, (Polygala Nuttallii,) half an ounce, Burdock  seed one
 ounce, water one pint;  mix, boil, and use in doses of a table-spoonful three
 or four times a day.   In addition to this, the following  may be  used :—Take
 of Sulphate  of Quinia two grains, Sulphate of Iron eight grains, Leptan-
 drin four grains; mix, divide into four powders, of which one is a dose  to
 be repeated three times a day.
   A Stye on the eyelid, or Hordeolum, is a kind of boil seldom requiring
 treatment; when it returns frequently, and becomes  painful  and trouble-
some, this may be obviated by taking the  decoction  of Ground Centaury
and Burdock seed, above named.
                              WARTS.
  Warts, or Verruca, are too well known to need a description ;  the cause
of their appearance is  not understood.  I have met with great success in 
504
AMERICAN  FAMILY  PHYSICIAN.
destroying warts by touching them  daily with Nitric  Acid,  Nitro muriatio
Acid, or Concentrated Acetic Acid, removing the disorganized parts as fast'
as they are formed.   A saturated solution of Muriate of Ammonia in Vine-
gar, applied several  times a day, for three or four consecutive months, has
removed them.   The Juice of Milkweed, of Celandine, and  of Mari'i^Id
Flowers, are popular remedies in the country.   The Bichromate of Potassa
in a saturated solution, has also been  successfully used;  it should  be ap-
plied carefully, and  allowed to touch no other part but the wart.  Probably
Chromic Acid might answer.   A mixture of equal parts of Nitre and tin-
slacked Lime added to sufficient Vinegar to  form a thick paste, has proved
an effectual application.   Indeed, there is no end to the remedies.
  Syphilitic warty excrescences occasioned  by the matter of gonorrhea or
chancre  lodging on  parts, are often  numerous and troublesome; they may
be removed by  the  application of powdered Savine leaves, by Muriate of
Ammonia dissolved  in Vinegar, by Nitrate of Silver,  by ligature when the
base is broad, or  by clipping them off with the scissors when small, and touch-
ing the cut surface with Caustic.   Or, moisten the excrescence with a mix-
ture of equal parts of Winfe and water, then  cover with a powder composed
of two parts of  Alum and one of Savine  leaves, and  place some lint on to
preserve the powder in its situation;  repeat  this dressing twice a day.
                                CORNS.

  Corns, Callosities, or Clavus, need no description; they are produced by
pressure or friction of some hard substance on certain  parts, as from boots,
shoes, pressure of the toes on each other,  pressure of scissors, or other tools
on the fingers  or hands, and  on the knees by much kneeling.  There are
three kinds of corns, viz:  the laminated corn, in which the hardened epider-
mis exists in  layers ; the fibrous com, in which fibres appear to pass through
it, giving rise to the idea that  the corn  has a core and root, but which are
really elongated papillae ; and  the soft corn, which is very painful and trou-
blesome, and sometimes occasions ulcers.
  Corns are not difficult of removal  if persons suffering from them would
adopt the proper measures, but these are seldom attended  to, and  conse-
quently palliative means alone are  employed, as cutting or filing the corn,
after having well soaked and  softened  it in an alkaline solution.   After
this is done, however, a permanent cure may be effected by keeping the corn
covered with  a  plaster of Soap, with lint  moistened  with Tincture of Cam-
phor, or with Red Oxide of Lead plaster;  preserving  the corn from pres-
sure by means  of a  plaster of thick leather, softened  with oil, and having an
opening to fit the corn, and wearing it constantly during the day.   And as
fest as  possible any indurated  skin  must be removed.   Soft corns between
the toes, may  be cured by applying  lint or cotton wool, moistened with
Tincture of Camphor,  so as to  keep  the toes apart, and the dressing should
be renewed three times a day.   The  same tincture  frequently applied, will
remove  the callosities, or soft corns, formed on the hands from the pressure
of scissors, &c, always taking care to remove from time  to time any loosened
hard skin which may be met with.
  Various mixtures are used  by c%rn-doctors  for the cure of corns, as the
following :—1.  Make a thick paste with White  Lead and Linseed Oil, add
enough powdered Bloodroot to color  it; spread this on a piece of bladder
and apply, renewing it in three or  four  days.  2. Take Nitric Acid, Muri-
atic Acid, of each, half a fluidounce, Red Sanders, Opium, Muriate of Ammo 
CHILBLAINS.
505
„ia  of  each, one drachm; mix.  Make a very light  incision around  the
corn rub for a few minutes with  the stopper of the vial in which the mix-
 ure'is made having first shaken it well that the stopper may be moistened
with it, and the  corn will ultimately be  loosened  and may be  removed.
■>, Take Tartaric Acid, Muriatic Acid, rain water, of each, one fluidounce;
mix, and add a  lump of Mutton Tallow the size of a small marble   By
means of a  small stick, apply this to  the corn three or four several times,
and then carefully remove it with a penknife.   When corns are once re-
moved, they are very apt  to  return, unless  care be taken to wear  proper
sized soft shoes, and not walk too  much, especially during warm weather
                           CHILBLAINS.

  Chilblains, or Pernio, is a painful, inflammatory swelling, of a red, purple,
or blueish color, which affects the fingers, toes, heels, and other parts of the
extremities, in consequence of their exposure to severe cold.  The pain is
not constant but appears at  certain  times,  and is rather of a shooting and
pungent character, and an annoying itching is present; these symptoms ar*
more commonly aggravated in cold and damp seasons.   The skin may re-
main entire, it  may break  and discharge a thin fluid, or it may, when the
cold has been intense or long-continued, slough around the affected parts
and leave a foul, irregular, and painful ulcer.  Children  and old persons
are  more apt to be affected with chilblains, from exposure to cold, than those
of middle age ; more especially those of a scrofulous taint.  Those who are
subject to  this species of "frost-bite," should be careful, in cold and damp
weather, to keep the feet well warmed and dry, and when cold to warm them
by friction or exercise, and not by placing them near a fire or warm stove.
  Treatment.   In chilblain where there is no ulceration, it is a very diffi-
cult matter to effect a  permanent cure, although great relief may be afforded.
Various stimulating applications have been advised, and  among  them the
following :—1.  Soak the parts in ley-water as hot and as strong as can be
borne, then dry, and  rub on the following, heating it in by a brisk fire:—
Take of Neats' foot oil, Oil of Sweet Almonds, each, twelve ounces, Yellow
Beeswax four ouuees,  melt  together  by a gentle heat,  and when nearly cold
add  Oil of Lavender  three fluidounces, strong Aqua  Ammonia two fluid-
ounces, Camphor one ounce,  Tincture of Capsicum two  fluidounces; tritu-
rate all together  in a  mortar.   2. Take of Muriate of Ammonia two parts,
water four parts, Tincture  of Capsicum eight parts;  mix, and rub on the
affected parts.   3. Use the Compound Tincture of Camphor.  4. Take of
Rectified  Oil of Turpentine one fluidrachm, Sulphuric Acid fifteen drops,
Olive Oil two and a half fluidrachms;  mix.  Rub  it on the chilblains two
or three times a day.
  If the skin is  broken, or  if ulceration is present, a poultice of Elm bark
and Yeast may be used for a few days,  after which apply one of the follow-
ing  mixtures:—Take  of Opodeldoc twelve fluidounces, strong Aqua Ammo-
nia, Tincture of Camphor, Tincture  of  Cantharides, each, four fluidounces;
mix.  2.  Take of Balsam Peru half an ounce, Alcohol four fluidounces,
dissolve, and add Muriatic  Acid one drachm, Tincture of Benzoin half an
ounce ; mix, and keep the mixture in a dark  bottle.   Rub on the affected
part several times a day. 3.  In some cases, treat the same as an  indolent
ulcer. 
506
AMERICAN  FAMILY PHYSICIAN.
                    FROSTBITE,  or  GELATUS.

  When  an intense degree of cold is experienced, giving rise to loss of
vitality, and mortification of the parts attacked, it is termed "frost-bite"
The symptoms  of a frost-bitten  part, are a deep  bluish-red color of the
skin, from the diminution of the supply of arterial blood, and the retarda-
tion of the circulation of the venous blood, contraction of the blood-vessels
followed by a livid tallowy paleness of  the part, with loss of sensation and
motion.   If the whole  body be affected, a disposition to sleep  comes on
which terminates in death.
  In the treatment of frost-bite, whether it be confined to  a limb, or affect
the whole body, any violent reaction must be restrained, and  the natural
heat of the body must be restored gradually.  If the person who is frozen
be brought into a warm room, or be placed in a warm bath, it will certainly
kill him, and the same  will happen to any part thus improperly exposed.
The patient must be kept in a cool place, the part should be gently rubbed
with cold  water  or snow, continuing the  friction until the circulation is
restored as well  as the natural heat of the parts; the cold water should be
used  for some  time after the return of the  circulation.  If mortification
has taken place, the dead parts must be allowed to separate, and be treated
as named  under the head of Mortification.
  A frozen  person should  be gently rubbed  all over with snow or  cold
water, or he may be placed in a cold water bath.  As soon  as the body is
somewhat thawed, there  will commonly be  a sort  of icy crust around it;
then remove the patient from the bath, rub  the body and limbs with cold
water  mixed with  brandy or whisky, and as  soon as the  limbs become
supple, dry the surface carefully, and put  the patient into a cold bed in a
cold room.  Scents and agents which cause sneezing are to  be held to his
nose;  if natural breathing does not come on, carefully blow air into his
lungs; inject warm water mixed with Camphorated Vinegar  into  the bow-
els ;  tickle the throat with a feather; and  dash  cold water upon the pit of
the  stomach.  Gradually introduce him into rather warmer  air, and cause
mild perspiration by Balm, Catnip, or Pennyroyal teas, warm Wine, &c.
DISEASES  OF  WOMEN.
  Under this classification are  included certain affections peculiar to fe-
males  only, and which have not been treated upon in other parts of the
work.  Nymphomania, Childbed Fever, Inflammation of the Womb, Milia-
ry Fever, Hysteria, Cramps during Pregnancy, Vomiting during Preg-
nancy, &c, &c, will be found  in other  parts of the work, for which see
Index.
  Beside the peculiarity of her  structure, the female differs from the  male
in presenting certain functions  altogether absent in the latter, as the func-
tions of menstruation, childbearing, and suckling;  and these three  func-
tions, although materially differing from each other, are entirely dependent
for their normal continuance the one upon the other.
  The establishment of the function  of menstruation varies in different
climates, appearing as early as at the eleventh or twelfth year in warm lati-
tudes,  and a few years later in temperate climes.   In this climate it usually
appears at the fourteenth  or  fifteenth year, though it  may appear at an
earlier or later period.   When  it appears as early as the twelfth or  thir-
teenth year, it is termed precocious menstruation, and is a phenomena muc 
AMENORRHEA.
507
to be regretted, as  it indicates a  premature or too rapid development of
certain  parts, while others, fully as important, are delayed and incomplete.
Precocious menstruation is  apt to be  followed  by  early death, more espe-
cially if marriage, followed by pregnancy, should unfortunately take place
as a consequence of such  indications of maturity.   When menstruation is
delayed until the seventeenth or eighteenth year, it  is called tardy;  and is
an indication of some disease or debility, which  may eventually prove fatal
to the  female.                                            .     . ,   e
  In healthy females the menstrual discharge returns at regular periods ot
twcnty-ei-dit days,  amounts on an average  to from four to eight ounces
and continues each time from three to  seven days, according to the consti-
tution of the female.  With the exception of  disease or pregnancy, it con-
tinues thus with great regularity, until about the age of forty or fifty, when
it ceases permanently, and this cessation is called the "turn of life.    Oc-
casionally, exceptions are met with in  the above matters.   The appearance
of the menstrual discharge is usually indicative of  the maturity of the fe-
male, and  her capability of becoming a mother; while its cessation mani-
fests the loss of such capability.                                 u
  The  discharge often  appears without any  premonitory symptoms; most
generally, however, it is  preceded by  a sense  of  heat and weight in the
lower part of the body, colicky pains, headache, full pulse, &c.  At first it is
rather  small  in  quantity, and of a muco-serolent character, but soon be-
comes  bloody and  in proper amount; in a  few days, it lessens, becomes
paler,  and gradually ceases,  to  be again renewed at  the expiration of
auother month.  There has been a great deal  of speculation among  physi-
ologists relative to  this  function;  at the  present day, the general  opinion
is, that it is a symptom of the maturity and discharge of ova from the fe-
male ovaries.
  31 others, and female guardians, instead of keeping  a strict silence upon
matters connected  with menstruation, should, by all means, instruct  and
explain these subjects  to their  daughters  and wards, as soon as they are
approaching toward  this period; informing  them  how  to manage them-
selves,  so as to  keep free  from the difficulties arising from exposures to
cold, excessive heat, and other causes.   It is much to be regretted  that a
false delicacy prevents mothers from conversing with  their daughters upon
these important  topics of  health and life;  were  it a customary duty for
parents, much suffering and misery would be spared the sex annually.
  The  menstrual phenomenon is subject to several  derangements, which I
will now proceed to consider.
         ABSENT,  or  INTERRUPTED  MENSTRUATION.

  The term  Amenorrhea  is applied to that condition of the menstrual
function  in which its flow is interrupted or suspended;  and it may occur
under two forms, one, in which  the discharge has never appeared, termed
emansio matsium, or absent menstruation,—and the other, in which, after
its appearance, it has become obstructed, termed suppressio mensium, or sup-
prer-M'd menstruation.  Each of these will require a separate consideration.
  Symptoms.  In  the first form, or absent menstruation, at the time when
the menstrual effort comes on, there are usually shiverings, pain in the back
and loins, aching along the thighs, weight at the lower part  of the  body,
general lassitude  and  uneasiness.   Sometimes  severe  headache will be
picr-cnt, with a fulness and throbbing in the  head, intolerance of light and 
508
AMERICAN  FAMILY PHYSICIAN.
  sound, pale  countenance, irregular action of  the  stomach  and bowels
  debility,  difficult breathing,  and  hysteria; these symptoms will vary ac-
  cording to the constitution of the patient, and the particular causes which
  are present.
    Causes.  This form of amenorrhea may be  owing to an absence of the
  ovaries, or of the womb, or closure  of  the vagina, and other  defective for-
  mations,  in which case, but little relief can be obtained, except in those cases
  where the  aid of surgery may remove, or properly alter  the malformation.
  When there  is no  deficient formation, the derangement of the function
  may be owing to an anemic  or chlorotic  condition of the system, in which
  case, other symptoms will be present, which are peculiar to chlorosis, and
  the case must be treated for this last  disease, before any attempt be made
  to restore the menstrual discharge.   In the absence of the above causes
  the disease will usually be found owing to the habits of the females, being
  more common among those who enervate the general system by a sedentary
  and indolent life, gross and  luxurious diet, hot rooms, soft beds, too much
  sleep, &c.
 j   Treatment.  In all cases of absent menstruation, where the genera]
/ health is undisturbed,  no treatment  whatever should be employed; it is
I only when the health suffers  in these instances, that  the  aid of medicine is
\ required.   Many females  have been  injured  for life, by the injudicious
 \treatment of friends or physicians,—interfering with  medicines to force
  the menstrual floWj when  their health was excellent, and no medicinal aid
  was needed.
    When the  health  of  the female is manifestly deteriorated, in connection
  with the  menstrual absence, the  physician should, if possible,  determine
  whether this  be owing to malformation, defect of organs,  or to  the presence
  of other  diseases ; and in  the latter instance, the maladies,  whatever they
  may be, must be removed previous to any  attempts to restore the menstrual
  discharge.  If,  however,  none of the  above difficulties  are  present, and
  there is likewise an absence  of chlorosis, the case is one of simple amen-
  orrhea, and must be treated  as such.                  .■&■■
    The treatment will vary according to the condition of the patient; if she
  be of a full habit, it will be  necessary to keep the bowels regular, by mild
  laxatives, giving an occasional active' cathartic, say  every week or two, of
  the Compound   Powder of  Leptandrin ;  the  whole surface of the body
  should be bathed  every day  or£two with  a weak alkaline solution, drying
  with considerable friction.   About  the time of the menstrual effort, warm
  infusions of  herbs  which  exert an  influence  on this  function  should  be
  administered, as of Tansy, Black Cohosh, Blue Cohosh, Life root, &c, and
  the Spirit vapor bath may be given, and  repeated for a  few nights at this
  period.   One very important measure in  the management of these cases, is
  exercise; the female should  be made to  take  plenty of daily exercise, in
  the open air.
     If the patient be nervous, weakly, or delicate, the bowels should be kept
  regular  by  the  use of' mild  laxatives,  as, the  Powder of Rhubarb and
  Bicarbonate  of  Potassa, named  under Dyspepsia, on page 399, and should
  take some tonic preparation, as the Compound Wine of  Comfrey, or Com-
  pound  Syrup  of Partridge-berry.  Her diet should be  composed of good,
  nourishing,  and easily digested food, avoiding fats  and acids,  and sne
  should  be made  to  take moderate exercise daily, in the open air
  Should there be much pain or suffering at the menstrual period, a warm
fomentation over the bowels, of Hops and Tansy, in Spirits, will in  moss
cases afford relief; but should this fail, Anodynes may be given, as un 
AMENORRHEA.
509
Compound  Powder of Ipecacuanha and Opium, or, Tincture of Gelsemi-
num, Tincture of H< lladonna, &c, giving these in  small  doses, and repeat-
in" them at short intervals, until relief  is obtained.
   It will sometimes happen, however, that although the general health will
be improved by the above means, the catamenial  discharge will not make
its appearance,  in which case, it will  become necessary to make use  of
those means which are stated to exert a specific influence upon the womb.
Among these arc the following:—                                 .    .
   1. The Iodine pill.  This  will  be found  more  especially  beneficial  in
those of a strumous or scrofulous diathesis.
   2. Take of Caulophyllin, Aletridin,  each, ten grains, Extract of Bella-
donna  one grain; mix together, and divide into ten pills, of which one is
the dose, to  be repeated three times a day.
   3. The Compound Tincture of Blue Cohosh.
   4. 'lake of Podophyllin one grain, Carbonate of Iron eight grains, Cimi-
cifugin four grains, White Turpentine a  sufficient quantity to form the whole
into a pill-mass; mix, divide into four  pills,  and administer one pill every
fouv hours.
   These remedies are to be used daily, during the intervals  between the
menstrual efforts, and their influence will be materially aided, if in addi-
tion, a current of electro-magnetism be  passed  through the womb  and
ovaries, two or  three times daily ; continuing its application each  time for
about half an hour.
   Occasionally instances will  be met with, in which the monthly discharge
instead of being red is of a white color, and which will  prove a source  of
much anxiety to the patient.   This is "-vicarious uterine leucorrhea,'" and is
owing to an  unhealthy condition of the blood.   The patient in these cases
is usually weak,  not  capable of much exertion,  and frequently, there  will
be a leucorrheal discharge  in  the intervals between the catamenial periods.
Care must be taken   not to treat  these cases as simple amenorrhea,  nor
attempt to use means for the purpose  of forcing the red discharge to appear.
The fact that the womb is  acting regularly is determined by the periodical
appearance of the white discharge, and  all that the physician must do, is
to  restore the blood to a healthy condition, and thus gradually bring about
the red or natural appearance of the secretion.
  This  may be accomplished by  a nourishing and  digestible  diet,  with
plenty  of exercise in the open air, and keeping the bowels regular.  If the
patient is scrofulous, the Compound Syrup of Yellow Dock must be given,
in  connection with the following pills :—Take of Sulphate of Iron, Cimici-
fugin,  each, forty grains,  Podophyllin  ten grains, Extract of  Gentian a
sufficient quantity to form the whole into a pill-mass; mix, and divide  into
forty pills, of which  one may be given  every four hours.  Just before the
return of the catamenial period, it will be proper  to  bathe the feet every
evening in warm water.   When no scrofulous taint is present,  the Com-
pound  Wine of Comfrey may be used instead of the above-mentioned syrup.
                 SUPPRESSED  MENSTRUATION.
  Tins is the second form of amenorrhea, and is applied to those cases in
which  the menstruation has  previously appeared; it  may  occur at any
tune from the  commencement  to the  cessation of the menses.  AVhen it
occurs  suddenly, it is called acute amenorrhea, and when gradually, chronic
amenorrhea. 
510
AMERICAN FAMILY  PHYSICIAN.
  Symptoms.   In acute amenorrhea, there is generally more or less fever
headache, thirst, nausea, quick pulse, &c; or, the brain, lungs, bowels, womb,
&c, may be attacked  with inflammation.   The symptoms, however, will be
found*to vary very much.   The patient will be subject to attacks of fainting,
hysterics, loss  of voice, amaurosis,  and cutaneous diseases, and sometimes
Bevere neuralgic  pains will attack the womb.   Paralysis and apoplexy have
followed a sudden suppression of the menses.   This is the  most serious form
of amenorrhea.
  Causes.  Acute  amenorrhea  is usually the  result of a cold contracted
during the catamenial  discharge, as by getting the feet wet, lying in damp
beds,  or other exposures.   It  may also be  occasioned by violent mental or
physical disturbance during the menstrual period, from fever or other severe
diseases setting in at that period, from sexual intercourse during the monthly
flow, &c.
  Treatment.   The discharge should be recalled as soon as possible, either
by a warm hip bath, or a Spirit vapor bath.  If the  bowels are constipated
an active cathartic must be administered, as the Compound Powder of Jalap,
or Compound Powder of Leptandrin; and to relieve any pain in the region
of the womb, a warm fomentation may be placed over the  abdomen, of Hops
and Tansy in spirits; and the Compound Powder of Ipecacuanha and Opium,
or, the Compound Tincture of Virginia Snakeroot, or the Tincture of Gel-
seminum, may be  given  in  small  doses,  and repeated at  short intervals.
Warm infusions  of Pennyroyal,  Liferoot, Tansy, Featherfew,  Motherwort,
&c, may be drank  freely.  If the  discharge be  restored, great care should
be taken to  observe that it  appears properly at the next menstrual period;
and in the interval the patient  may use the Compound Syrup of Partridge-
berry.
  If  the catamenial discharge  is not  properly restored, the difficulty may
lerminate in Chronic Amenorrhea.  This, however, may be caused by other
circumstances,  as diseases  of the womb, ovaries, or other organs, or from a
gradual loss of health.
  Symptoms.   Chronic amenorrhea, when not the result of an acute attack,
may come on gradually, the discharge being uncertain and  irregular in its
appearance, but slowly diminishing until it ceases entirely; or, there maybe
a white  fluid, alternating with  the  red.   There will usually be pains in the
head, back, and  side,  irregular  and deficient appetite, a gradual  failure of
the vital powers,  ending in a confirmed deterioration of health, most favor-
able  to an attack of some of the fatal organic diseases peculiar to the climate
in which the patient resides.                                     ,
   Treatment.  We  must be  careful to ascertain that the case is one of
chronic amenorrhea,  and  not  of pregnancy, before attempting  treatment.
And, again, should  the suppression occur at that period when the "turnot
Hie" is expected, great care  should be taken not to use too active medica-
tion, but only to palliate severe symptoms, else, much mischief  might bi
done.                                                    .       ,
   Whenever we  can ascertain the cause of chronic suppression ot the men-
ses, as, for instance, the disease present which occasions it, we  must pursue
measures calculated to overcome this, whatever it may be, and it will gene-
rally be found, that  on  the  patients' recovery, the menses will return.
 Under other circumstances the  better course will be a tonic and a"®"*"
 treatment, giving the  Compound Syrup of Stillingia with Iodide ot 1 ota*
 sium, three times a day, in conjunction with a pill composed of equal par
 of Aletridin. Caulophyllin, and Sulphate  of Iron;  make three grain piig
 and  administer one every four hours.  In some case3 considerable bene 
DIFFICULT  MENSTRUATION.
511
will be derived  from the use of the Compound Tincture of Tamarac, taken
in connection with the above pills, or with those named on page 509, No. 4,
in the treatment of Absent Menstruation.
  The bowels should be kept regular, the surface of the body bathed every
day or two with a weak  alkaline  solution, rendered slightly stimulating by
the  addition of alcohol,  and once in every week, a Spirit vapor bath must
be taken.   Exercise in  the  open air,  proportioned to the strength of the
patient, is a very important  measure, and must by no means_ be neglected;
indeed females, as a general rule,  do not have sufficient exercise, and a great
part of their difficulties will be  found owing to those sedentary and unnatu-
ral  customs  which society unjustly  imposes upon them.   They are  home,
home, all the time,  or should  they venture abroad daily for exercise, that
they may benefit their own  health  and thereby secure a robust and healthy
offspring, they are insulted and  discouraged on almost every side, by that
epithet so  disgraceful to its utterers,  "street-yarn spinners."   Nutritious
and digestible food must be used, carefully avoiding every article which dis-
agrees with the system.   In obstinate cases currents of electro-magnetism
may be passed through the uterus daily; and with some, the Compound Tar
plaster placed over the sacrum, or low down on the spinal column, and kept
discharging for some time, will  be found an excellent auxiliary measure.
           PAINFUL  or  DIFFICULT  MENSTRUATION.

   Dysmenorrhea is the term applied to menstruation which is attended with
 more or less distressing pain.   It is sometimes very unyielding in its nature,
 continuing until  the "turn  of life."   The  pain  may be moderate,  or  it
 may be very violent, rendering the patient a permanent invalid, from its re-
 peated shocks to the constitution.  It may occur shortly before the discharge
 appears, or simultaneously with it, and, sometimes  docs  not  come on, until
 near the termination of the discharge.   The character of the pain, and the
 accompanying symptoms vary according to the  constitution  of the indi-
 vidual; and from this circumstance, the disease has been divided into three
 species, viz: the neuralgic, the inflammatory, and the mechanical.
   Symptoms.   The neuralgic variety of dysmenorrhea is generally met with
 among delicate or nervous females.  The menstrual flow is either preceded  or
 succeeded by a headache, which sometimes alternates with pain low down  in
 the back,  and  extending to  the  lower part  of the  abdomen  and  down the
 thighs.  The pain may be constant, or may occur in paroxysms, with intervals
 of ease, and it is frequently so violent as to be almost insupportable.   It usually
 lasts from six to twelve hours, when  the appearance of the flow relieves it  in
 a great measure.   The discharge may be  diminished, paler than  usual, and
 mixed with clots; and sometimes there is a membrane passed, looking some-
 what  like the  thin  skin  situated between the white  and shell of an egg.
 Ordinarily the general health suffers but little, though sometimes it becomes
 permanently impaired.
   Ini  the inflammatory variety there is a severe pain across the back, aching
 of the limbs, weariness, intolerance of light and sound, flushed face, hot
 skin,  and  a full, bounding and quick pulse, often  over 100 beats in a min-
 ute,   the  fever may run  so high that temporary delirium will  supervene.
 there will also be considerable swelling and congestion of the cervix, and
great  heat about the parts.  The  menstrual flow is usually more abundant
than in the neuralgic variety, and  when it occurs,  all  the severe symptoms
are relieved.  I he thin membrane found in the preceding variety may also 
512
AMERICAN FAMILY PHYSICIAN.
be met with in this.   Inflammatory Dysmenorrhea may be accompanied with
falling of the womb, uterine leucorrhea, or  ulceration  of the neck of the
womb, the last of which can  only be detected by the speculum, and each of
which must  be  removed by appropriate  treatment before a permanent cure
can  be  made.  During the  intervals  between  menstruation, the patient's
general health is but seldom  affected.
  The symptoms of mechanical dysmenorrhea, are  somewhat similar to the
preceding, varying according to the causes occasioning it, and  tho attending
circumstances.  In all the varieties of  dysmenorrhea, sterility is the general
rule, pregnancy the exception.
  Causes.   Neuralgic dysmenorrhea may be caused  by cold taken during
menstruation, or subsequent  to a miscarriage, or delivery; or, it may follow
some sudden or severe shock, or mental emotion, occurring at the  menstrual
term.  It may be  mistaken  for  an abortion, but may be distinguished from
it by a knowledge of its previous  monthly character, and by the amount of
blood being less than in an  abortion.   Inflammatory dysmenorrhea is more
common  to plethoric females, and those of sanguine temperament, and may
be caused by the same circumstances which will give rise to the  preceding
form.  Mechanical dysmenorrhea  is owing to a narrowing or constriction of
the canal of the neck  of  the womb, which may be the result of  inflamma-
tion, or a long-continued  falling of the womb  and bending of the uterine
neck.
  Treatment.  The  indications  of treatment  are first, to lessen the pain
during an attack; second to prevent its subsequent return by proper treat-
ment during the menstrual intervals.
  To relieve the pain  during the attack, a hot fomentation  of  Hops and
Tansy in spirits must be placed  over the abdomen, frequently renewing it,
and  internally, the Compound Powder of Ipecacuanha  and Opium may be
given, or, what I have found to answer a most excellent purpose, the Tinc-
ture of Gelseminum, in doses of from  half a teaspoonful to a teaspoonful or
two, every half-hour until the patient experiences the peculiar effects of the
remedy.  AVhen  the  pain is very severe  from  three to five drops of the
Tincture of Aconite  may be added to each dose of the Gelseminum.  In
many cases, a Spirit vapor bath  affords almost instant relief.   In  some cases
the Compound  Tincture of Virginia Snakeroot will be found to have a very
excellent influence.  If the bowels have had  a tendency to constipation,
they should first be acted upon by some purgative medicine, previous to the
administration of the other agent.  The above  measures are suited to either
form of  dysmenorrhea.  The following will  occasionally be found useful:—
Take of Oil of A'alerian, Ethereal Oil  of Lupulin,  each, two fluidrachms,
Sulphuric Ether half a fluidounce; mix.   The  dose  is from thirty to sixty
drops  every two  or three hours in  a  wineglassful of  a warm infusion of
Camomile flowers.
   During the intervals between menstruation, the following means must be
employed to prevent  a return of  the disease :—Take of Camphor one scru-
ple and  a half,  Sulphate  of  Quinia two scruples,  Extract of Stramonium
one scruple, Aletridin a  sufficient quantity to form the  whole into a pill-
mass; mix, and divide into  eighty pills, of  which one may be given every
four or  five  hours.   Another valuable  pill   is composed of Extract ot
Conium  Maculatum  one drachm, Extract  of  High Cranberry  bark,  Bed
Oxide of Iron, each,  two drachms;  mix, and divide into  thirty pills, ot
which one is the dose, to be repeated three times daily.   I have  known the
long-continued use  of the  Compound Syrup  of Partridge  berry to  cure
many very  severe cases. 
MENORRHAGIA.
513
  The bowels must be kept regular, the  surface bathed daily, and the diet
must be nutritious and easy of digestion.   An occasional Spirit vapor bath
will be found of much benefit.  Exercise in the open air is very important,
and must not be neglected.   If there be  ulceration of the neck of the
womb, it must be touched by a solution of  Nitrate of Silver,  or, Sesquicar-
bonate of Potassa,  introducing  these agents by means of a speculum.  If
there  be falling of the womb, this must be  reduced before any benefit can
be expected to result from the other measures.
  The mechanical form of dysmenorrhea can only be remedied by the deli
cate and cautious employment of bougies,  commencing with one  of small
size,  and gradually increasing it  until  the canal is sufficiently  dilated.
These must be allowed to remain in for only a few minutes at a time, and
should be reapplied in two or three  days, according to the irritability of the
patient, and the symptoms  produced.  Any inflammatory symptoms of the
part caused by their employment, will  give way to rest and  quiet,  keeping
the  bowels regular, and an injection of warm water into the  vagina two or
three times a day.
            I3IMODERATE  FLOAV  OF  THE  MENSES.

   Menorrhagia, or Immoderate Flow of the Menses, are terms applied to
 all large discharges of blood  which take place from  the  womb, at other
 times than during pregnancy or  labor.   The term Uterine Hemorrhage, or
 Flooding, is  applied to all discharges  occurring during  labor, pregnancy
 or which are owing to ulcers, polypi, wounds, &c., of the  womb.
   Menorrhagia  may exist in  two ways; the  menstrual  flow  may  appear
 every two or three weeks, instead of every four, or  it  may occur  at  the
 regular time, but in profuse  quantity, or, it may occur at unexpected and
 uncommon seasons, as during  pregnancy, or in the  early months  of suck-
 ling.   It is divided into two forms, viz :  the active and the passive.
   Symptoms   In active, menorrhagia, beside the  profuse discharge  there
 will be several other symptoms present, as,  sudden  flushings, alternating
 with chilliness, a sense of heat  and general fulness,  frequent, throbbin°
 pulse, pains in the back and loins, which are frequently relieved upon  the
 escape of blood.   The  blood is ot a florid,  red color.   The  discharge fre-
 quently continues from thirty to  forty days,  but in most cases, it ceases in
 irom eight to ten days, reappearing at the next catamenial period
   • t?Ef-  ! 1 ,  -^ uienorr!iaSia may  be  occasioned by   lifting  heavy
 weights,  tight lacing, excessive use of strong  tea and  coffee,  cold,  strong
 SKb7 °f fm"}™^ excessive venery,  and  whatever will occasion
 debility of the womb.  Its periodical character will serve  to  distinguish it
 though it may exist in connection with a uterine polypus

 rJniJ^T   ^VH ^fi* iS f fuH habit' not ™*'treatment will be
 Ei  ' Z        ° /°Und ^^ ?e """^tion is  suffering from the dis-
 on Sr. J !  P""^1™™9 *>  check it are, to keep the  patient in a hori-
 e    ,T   ?'MbSTing  ^^^t quietness; the bowels  must be kept
 IS1  J   l1 i ^ftlV?' and  ^ straininS at stool must be avoided   I
water mnvbe^n?-'!"^ T^-' ^^ cloths diPPcd ™ Viue^r and
wutu  may be applied over the private parts.  Internally; astrin-ents should 
 514                AMERICAN  FAMILY PHYSICIAN.

 and Fleabane,  will  frequently  be found serviceable.   I have frequently
 succeeded in checking the flow by administering every hour or two, a now.
 der composed of Capsicum five  grains,  Opium half a grain, Ipecacuanha
 one grain ; mix.  A combination of Tincture of Cinnamon bark and Tinc-
 ture of Yarrow, equal parts,  taken in table-spoonful  doses, and  repeated
 three times a day, has often  proved serviceable; a little Oil of Cinnamon
 may be added to cover  its disagreeable  taste.  Warren's Styptic Balsam
 has been found prompt and effectual in many instances.   In quite a num-
 ber of cases recently, I have found a Tincture of the inner bark of Cotton
 root, made in Sweet Spirits of Nitre, a very effectual remedy, in doses of
, from thirty to sixty drops, three, four, or five times a day.
   While using  either of the above remedies, the patient may drink freely
 of some  astringent  decoction,  as, one made of equal  parts of Beth  root
 Blackberry root, and Geranium; or,  other vegetable  astringents.  If the
 flow be very profuse,  Hemastasis may be adopted with advantage.  If much
 pain be  present, a  mixture of Sulphate of Morphia  one-fourth or  one-
 eighth of a grain, Capsicum five grains, Rosin five  grains, may be adminis-
 tered every two or three hours  in some Blackberry Syrup.
   During the intervals  between the flow,  measures must be taken to pre-
 vent its  return ; the patient should be kept quiet;  the  diet should be spare
 but nutritious;  if married, she  should live  apart from her husband for a
 time ; and the bowels, as well as the surface,  should be attended to, as in
 the preceding forms of  menstrual derangement,   The  astringent decoction
 above named may be  continued, or some other used as a substitute, and the
 following may  be administered daily:—Take of  Sulphate  of Quinia ten
 grains,  Extract of Belladonna three grains, Extract of Rhatany forty
 grains;  niix,  and divide into  twenty pills.  The  dose is one  pill,  to be
 repeated three times a day.
   Passive Menorrhagia may be the result of the active form, or it may have
 been passive from its commencement, as is apt to be the case among females
 of weakly, irritable,  and delicate habits.  It is a  more serious form of
 hemorrhage than the  active, and if not speedily arrested, may assume a
 formidable character.
   Symptoms.   In the passive form of menorrhagia, the blood discharged is
 dark-colored, resembling venous blood; the strength of the patient becomes
 rapidly  reduced, the  countenance pale, the pulse quick and  feeble, the ex-
 tremities cold,  and  sometimes the whole surface of the body; a distressing
 sensation of faintness is generally experienced, giddiness, and occasionally
 nausea and vomiting; and a very common symptom is  a sense of weight
 and pain in the head, especially over the  eyebrows and  forehead.  In the
 more severe and dangerous forms, difficult and laborious  breathing will be
 present.
    Treatment.  As in active menorrhagia, various agents may be required
 before any benefit will  be  experienced.   In very mild cases, the  Tincture
 of Cinnamon given in teaspoonful doses  every hour or two, in a wineglass-
 ful of sweetened water, will be found of service.  The  Tincture of Cotton-
 root bark made in Sweet Spirits of Nitre, as named in  the preceding form,
 will be  found  of great advantage in many instances.   The preparation ot
 Nitre, Alum, and Kino, named in the  preceding  variety, will also prove
 beneficial.  Frequently, even in some very severe  attacks of menorrhagia,
 I have  derived  much  benefit from  the use of the Tincture of Muriate ot
 Iron, in  doses  of  from fifteen  to twenty drops, every half-hour, hour, or
 two hours, according tq the urgency of the case, administering each dose in
 about half a gill of water.   Warren's  Styptic Balsam has been used wiu 
                    CESSATION  OF  MENSTRUATION.                515

 good results in many cases;  and the following will  prove very effectual in
 arresting  the  flow, with many females:—Take  of Tincture of Cinnamon,
 Tincture of Rhatany, Spirits of Turpentine, each, equal  parts : mix.   The
 dose is from half a teaspoonful to a teaspoonful,  ever/ hour or two, in some
 Port Wine, or other  convenient vehicle.  Another very valuable prepara
 tion, is composed of Tincture of Cottonroot bark, Tincture of Ergot, and
 Tincture of Cinnamon, each, equal parts: mix.  Dose, the  same as  the
 preceding.
   In  very severe cases, wdicn there  is  not too  great a depression of the
 vital forces, cold vinegar and water maybe applied to the parts on cloths,
 but if there is much  depression, with coldness of the whole surface of the
 body, warmth must be  applied  to the feet, knees, arm-pits, &c, by means
 of bottles of  warm  water, warm  bricks, irons,  &c.   Sometimes, when  the
 discharge is very profuse and prostrating, it may become necessary to  in-
 ject a solution  of Alum, or  other astringent,  into the  womb; this course
 has often proved effectual in checking the flow.   A soft piece of sponge, or
 a  number  of soft pieces  of linen, muslin, or silk, moistened with  some
 astringent fluid, and  passed  into  the vagina  so as  to  plug it up, will, by
 causing a clot to form around the  openings of the bleeding vessels, pre-
 vent,  at least for some time,  any further effusion.  But the plug thus  made
 must  not be  removed  too  soon, or the hemorrhage will recur—it should
 remain for three or four days.  If it causes bearing-down pains, a desire to
 stool or to urinate, it must be removed.   During the whole period of the
 attack, whatever may be the  treatment pursued, it  will be proper for the
 patient to drink freely of vegetable astringent decoctions.
  The bowels must be kept regular by gentle laxatives, and the diet should
 bo nutritious, allowing wine,  ale, porter, &c, if the patient be much debili-
 tated.   During the intervals  between these  profuse  menstrual discharges,
means  should  be used to  prevent, if possible, the  menorrhagia; Gfor
this purpose  the  Compound Wine  of  Comfrey  may be given, and  the
patient may drink freely of  a decoction  of some  vegetable astringent, as i
Blackberry root, Beth root, &c, and  the  same may be injected into the
vagina several times  a day.  When much debilitated  the Sulphate  of
Quinia may be used in combination with Cimicifugin, or some preparation
of Iron.
                CESSATION  OF  MENSTRUATION.
   Cessation of Menstruation generally occurs after the menstrual function
 has been performed for thirty or thirty-five years, or about the forty-fifth
 or fiftieth year of life, and  is always  looked upon  by females with some
 degree of anxiety.  In  consequence of the difficulties which occasionally
 develop themselves  at this  time, it  has been variously called the « critical
 age,   the " turn of life," the i; change of life," &c.
  Symptoms.  Among healthy females it is not common for them to suffer
 much —they generally become stouter, and the abdomen and breasts fre-
 quently enlarge to such  an extent as to lead them  to  think they are preg-
 nant.  Ihe discharge usually diminishes gradually, assumes a paler color
 ad eventually ceases permanently;  or it  may occur at uncertain,  or dis-
 tant periods, or alternate with a white discharge.   Sometimes  there will be
reSderoflife  dlSCharge'and  the  function becomes suspended for the

,.,^Tffng dcl,icat<:.fem?les> and~ those who have suffered from previous dis-
eases of menstruation, it  is not uncommon  to meet with excessive menor- 
516                AMERICAN  FAMILY  PHYSICIAN.

rhagia, or severe and  repeated attacks of uterine hcinorihage, jeopardizing
life.   The same may be said of those who have Ifeen intemperate in their
passions and pleasures.  The symptoms attacking these vary considerably
much pelvic irritation, with a bearing-down  sensation, a desire to stool or
a forcing backwards, frequent inclination to  urinate, heat and smarting 0f
the parts, and tenderness of  the  vagina, are very apt to  be present.  A
troublesome itching of the parts of generation is a common accompaniment.
The  person becomes irritable, uneasy, restless, with  more or less consider-
able changes of the moral  and mental dispositions.   With  some, the skin
loses its color and suppleness, becomes sallow  and wrinkled, the hair falls
off, or turns gray, the  breasts, at first flaccid and pendulous, finally disap-
pear, and the  voice becomes  masculine.
  At this  time, various  diseases are apt to  become  manifested, some of
which may probably have  existed for some time in  a latent state, as, ver-
tigo, hysterics, colic, piles, cutaneous  eruptions,  ulcers of the legs,  hemor-
rhages from  different parts, inflammations of  various organs,  dyspepsia,
palsy, apoplexy, insanity, cancer of the womb, profuse sweats, etc, &c.
   Treatment.  Generally,  but  little else is required in  the  treatment,
than to keep the bowels regular, the skin clean and  healthy, adopt a light,
nutritious diet, and proper regimen, and to avoid exposure to cold,  or any
causes which may excite  local disease.   When  the  discharge ceases sud-
denly, or when there  is giddiness, or occasional pains in the head, a mild
purgative may be taken, as the  Compound Powder of Jalap, or the Com-
pound Powder of Leptandrin,  and this  may  be  repeated whenever the
symptoms require.  If menorrhagia is  present, treat  it as  already  recom-
mended, as  well as hemorrhages from various  organs.  When there is a
tendency  to  secondary attacks,  the disease  which  is  developed must be
treated as though it were a primary affection.   In most cases where there
is a tendency to secondary diseases, alteratives will  be required, and none
will be found to excel the Iodine pill, in conjunction  with  the Compound
Syrup of Stillingia.  Any  nervous derangement must be  combated wW
stimulants, antispasmodics, or sedatives.
CHLOROSIS.
  Chlorosis, or Green Sickness, is a disease common to females, especially
at the  age of puberty, and is very apt to be associated  with a retention of
the menses;  though this may and does frequently occur without any chlo-
rotic tendency.
  Symptoms.  Chlorosis is characterized by a state of melancholy and dis-
position  to  inactivity ; the female becomes silent and  gloomy, frequently
sighing involuntarily, or shedding tears without cause;  the countenance
becomes  pale, of a greenish tint, and bloated; the  eyes  languid, and the
eyelids swollen, with a dark areola around them, especially in the morning,
the skin  is dry and cool, and has a flabby or doughy feel; the pulse w fre-
quent  and  easily compressed; the breathing  is hurried or laborious; tne
digestive functions deranged; the bowels  costive or irregular; the_stoos
sometimes  become white  and hard, at other  times  fluid; the^ sleep is dis-
turbed, and the  dreams unpleasant;  the  intellect  becomes dull,  and t
mind  is  occupied with fanciful  notions or projects;  headache is usualy
present; ringing  of the ears; the face cold; the  nostrils  dry; neura'ghe
pains,  and palpitation in  the neighborhood of the  heart or stomach.
tongue is  generally coated white, and acid regurgitations  take place 
CHLOROSIS.
517
cuently, with nausea, especially in the morning.   There is often an accom-
nanvinK cough, of an irritable and distressing nature, leading the friends
 o suppose the patient is laboring under consumption.  Sometimes dropsica
HWclliiUs occur in various parts of the body, or the patient may be attacked
with St° Vitus' Dance, hysterics, or epilepsy.   Leucorrhea is generally pre-
sent with a retention or suppression of the menstrual  discharge ;  or, if any
fluid escapes monthly, it contains  but little coloring matter, and less hbrine
than usual   All the above symptoms will not be present in any one patient,
but a great proportion  of  them will; and they will vary in their character
aceonfimr. to the circumstances attending each  case.
   A peculiarity of this disease is the wonderfully capricious  character of
the  appetite, sometimes exhibiting  a strong  desire  for  acids, at others,
greedily devouring substances having no nutritive properties whatever, as
earth, chalk, ashes, charcoal, &c.  If the  disease is  allowed to progress
without any beneficial treatment, severe pain attacks the head, mostly in the
back part;  the abdomen becomes  swollen and hard; the difficulty of breath-
ing, palpitation, fainting, and debility increase; thirst becomes annoying;
diarrhea ensues, with hectic fever, rapid emaciation, and death.
   Caksks.   The causes of chlorosis are  various and numerous.  It may be
owing  to indigestion;  to living in low, damp,  and cold situations, secluded
from the rays of the sun; bad  food; late hours ;  excessive use of vinegar,
green fruits, and all crude articles;  indulgence in warm  drinks ; want of
exercise ; and a sedentary, lazy, and voluptuous mode of life.   Females of
rapid and  premature  growth, those  of  a weak, delicate constitution, of a
scrofulous habit, or of a nervous temperament,  are more especially liable to
it, as well as those who practice masturbation, who labor  under great de-
pression of mind, who  are affected with  some menstrual derangement, and
who continue for a long time in a state of widowhood.
   Treatment.  In chlorosis, there is a general debility of the whole  ner-
vous system, accompanied with  an unhealthy condition of  the  blood,  which
is very deficient in iron and the  red globules.  The  treatment, therefore.
must be directed to both of these  conditions, and  no permanent benefit can
be expected, unless the medicinal  measures be  assisted by a strict attention
to the hygienical.   It  is very important that the patient be removed from
all causes which may predispose to the malady, transferring her from an im-
proper atmosphere to one pure, dry, and  moderately warm.   She should be
made to exercise every day, no matter how averse she may be to it,—'any
indulgence  in  this matter may lead  to  a fatal  result.   Exercise must be
taken, it is  imperatively necessary; walking, riding, swimming, ball-play-
ing, boat-excursions, and  calisthenie exercises, according to her capability,
must be practised.  If  her friends are able, traveling will be  of much ad-
vantage, in consequence of the change of scenery, air, exercise, and other
circumstances  tending  to  keep  up an excitement of both  mind  and body.
A visit to some chalybeate  springs,  with a free  use of the water, will be
found of great benefit.   Tight corsets, and all tight ligatures on any part of
the body, must be forbidden.   The hours of sleep must be regulated, having
certain hours for retiring  to bed, and for rising ;  never  allowing the  sleep
to exceed nine hours.   Sleeping in the day must not be alkwed.   The bed
occupied by the patient must be neither too warm nor too soft—a mattress is
to be preferred—a feather-bed  is abominable.   The diet should be generous
and easy of digestion,  consisting of farinaceous vegetables, ripe fruits, bitter
and aromatic plants, fresh eggs, roast meats, &c.  ^During  meals, some Ma-
deira or Champagne wine  may be  drank,  or even good French brandy, ale,
porter,  Ac.   For a common  drink, some chalybeate water should be  pre-
ferred; tea and coffee should not be used. 
518                 AMERICAN  FAMILY PHYSICIAN.
  As a medicinal  treatment, the bowels  should be kept regular, but noj
actively purged; the Compound Pill of Leptandrin may be°usod for thig
purpose, and if constipation be very obstinate, one-twentieth of a grain of
Extract of Nux Vomica may be added to each  pill, provided that not more
than two pills are required every night for a dose.   The surface of the body
should be frequently bathed with a weak  alkaline solution, to which some
Alcohol  is added, in order to excite  the action of the capillary vessels in-
vite the  blood  into them, and  promote perspiration.   A Spirit vapor bath
every week or two,  will  be of great benefit.   Flannel should always be worn
next the skin;  and daily frictions with a coarse towel, aided by all other
means to bring about a healthy condition of the capillary system, should be
persevered in.   Acidity of the  stomach may be overcome by Bicarbonate of
Soda, or  Potassa, or by Magnesia, aided by vegetable tonics, to impart tone
to this organ,  as  Golden  Seal, Swamp Milkweed, Quassia, Gentian, &c.
which may be given in  infusion or extract.
  To change the condition of the blood, some preparation of Iron must be
given,  as the Sulphate  of Iron, Carbqnate-of Iron, Tincture of Muriate of
Iron, &c, and  in scrofulous  patients the  Iodide of Iron.   The following
have  been used with  good  results:—1.  Take of Carbonate of Iron five
drachms, Assafetida  seventy-five grains,  Podophyllin  nine grains; mix,
and divide into twenty-five powders,  of which one is a dose, to be repeated
three times a day.  2. Take  of Sulphate of Iron  twenty-four grains, Sul-
phate of Quinia twelve grains, Sulphate of  Morphia one grain and a half,
Extract of Gentian  a sufficient quantity to form the whole into a pill-mass;
mix, and  divide into twelve  pills.   The  dose  is one pill, to be repeated
three times a  day.  3. The  Compound Pills of Ferrocyanuret  of Iron.
Occasionally, marriage cures chlorosis.  The various unpleasant symptoms
which may present from time to time, must  be met according to their indi-
cations.
                   LEUCORRHEA,  or  WHITES.
  By the terms Leucorrhea, Fluor-albus, or Whites, are meant a whitish or
colorless discharge from the vagina, being  the result of an unhealthy con-
dition of the vagina, the womb, or of both combined.  It is a very common
malady  among women, but few passing through life without having one or
more attacks of it.
  Symptoms.   The leucorrhea! discharge is more or less profuse, and varies
much, both in quantity and color;  in mild  cases, it is whitish, in others, it
is of a brownish or greenish hue, and frequently so acrid as to excoriate the
external parts.   When  the discharge is abundant, or of long standing, it
occasions much debility, with a sense of pain and weight in the back and
loins, pain in the stomach, colic, impaired or depraved appetite, acid stomach,
headache, paleness of the countenance,  hollowness of the eyes, chilliness,
palpitation  of  the heart, and  great  mental depression.   If no beneficial
measures be pursued, the constitution soon becomes impaired and exhausted,
emaciation  ensues, the  flesh becomes loose, the pulse small and frequent,
the breasts soft, the  breath  fetid, the eyelids bloated, hysterics are  common,
and the feet and ankles swell, and are constantly cold.  The menstrual dis-
charge frequently becomes diminished or suppressed, obstinate constipation
is a common symptom,  and the urine is  generally turbid, flocculent, and
scanty.   Dropsical swelling of the whole body is often present.
  Leucorrhea  is divided into two varieties, the mucous and the purulent' 
LEUCORRHEA.
519
 of the raucous, there are two  forms, characterized  by the properties of the
 discharge, and the part from which it is secreted.
   When the mucous discharge is from the neck of the womb, or its canal,
 it is a transparent, glairy fluid, of the consistence  of  the white of egg, has
 an alkaline reaction, changing reddened litmus paper to its  original blue,
 communicates no stain, but only a  starchy hardness to linen  upon which it
 has been allowed to dry, has such a slimy, ropy,  and tenacious consistence,
 that it is with great difficulty it can be removed from the neck of the womb,
 and examined under the microscope, it is found to contain a large numbei
 of mucus-corpuscles, (see Fig. 18.)  This is a common and most obstinate
 form of leucorrhea.
   When the  mucous  discharge  is from  the            Fig. 40.
 vagina, it  is of an opaque, whitish  charac-
 ter, of the consistence of  cream,  has an  acid
 reaction, changing blue litmus paper to red,
 communicates a stiffness to linen upon which
 it has dried, leaving a greyish spot, deepest
 at  its edges,  is never ropy,  and under  the
 microscope exhibits a large number of epi-
 thelial scales.  (See  Fig.  40.)  This form is
 frequently accompanied with a relaxed condi-
 tion  of the vagina, and troublesome  itching
 '.f the parts.
   When  the  leucorrheal  discharge is of a
 purulent character, it is colored  greenish, or
 any intermediate shade between a light  yel-   a< Scaly epithelium from the vagina.
 low and  dark  brown,  leaves deep  stains on b. Large organic globules, resembling
 linen, which are  removed  with difficulty by pus globules,  sometimes found in the
 washing, and exhibits under the microscope a
 large number of pus  globules.  (See Fig. 20.)  Most  generally this  dis-
 charge issues from an excoriated  or ulcerated  surface  on some part  of the
 neck of the womb; occasionally  it proceeds from  the  vagina.  This, how-
 ever,  may  be determined by  its acidity  or alkalinity.  Women laboring
 under this form of leucorrhea, are very subject to abortions.
   Leucorrhea sometimes becomes of so acrid and irritating a character as to
 communicate a disease very closely resembling gonorrhea.  And the determi-
 nation of this matter,  upon which the  happiness  of a family depends, is at-
 tended with much difficulty.   Great care  must  be  taken by the physician in
 pronouncing positively in cases of this kind, as a mistaken diagnosis will be a
 source of much misery and mortification.   Dr. Donne,  of Paris, states that
 when the  syphilitic  matter is  examined  under a microscope of about 300
 diameters, a multitude of  transparent  animalcules are  seen, of a round or
 oval form, in groups of from two  to six, and which move in every direction
 ■i very delicate, thread-like appendage;  in  leucorrheal matter  these are ab-
 sent.  But as leucorrhea is frequently the result of secondary syphilis in the
 iiusbaud, it is possible that when  it originates  from this cause, animalcules
 of a similar character may be present,  and a diagnosis  based upon  this
 microscopical investigation  would condemn  an  innocent  female to  disgrace
 and wretchedness.
   Caisi:s.   Leucorrhea arises from  many causes,  the most common among
which  is excessive  coition; and on this account a women wedded to a sen-
sual, animal husband, whose only consideration for his wife is to compel her
to gratify his  selfish passions  without regard  to her health, is much to bo
pitied, as she  is constantly liable not only to the present disease, but to
 
52 (I
AMERICAN  FAMILY PHYSICIAN.
   every  malady which may afflict her sex.   And to this cause, is, no doubl
   attributable by far the greater number of those  diseases so common at  the
   present day among women in  all sections  of  the country.  Other causes
   however, may produce leucorrhea, as a rapid succession of children  colds'
   dampness, difficult deliveries, masturbation, abuse of warm baths, purgatives'
   or emmenagogues, prolonged suckling, irritation of the rectum by thread-
   worms, relaxation of the system by too much warmth, abortions, mechanical
   injury by pessaries, secondary syphilis of the husband, sedentary  life sud-
   den, mental, or physical shocks, excessive menstruation, &c.
    Treatment.   In the treatment of  leucorrhea, as in the previous diseases
   the bowels must be kept regular, and the surface of the body attended to by
   daily bathings and frictions.  Internally, the  Compound  Wine  of Comfrey
   may be given in conjunction with some preparation of iron, as the Citrate of
   Iron, Sulphate of Iron, &c.; in strumous or scrofulous patients the Iodide
   of Iron will be found of great value; in cases with excessive  menstruation
   the Tincture of  Muriate of  Iron will be preferable.   I  have  found a pill
   composed of Sulphate of Iron,  Leptandrin, each, eight grains, Podophyllin
   two grains, Alcoholic Extract of Black Cohosh  a sufficient quantity to form
   a pill-mass, a very valuable  preparation.  The  mass  is  to be divided into
   eight pills, one of which may be given for a dose, and repeated three or four
   times a day.   In the purulent form of leucorrhea which is generally accom-
   panied with a hypertrophied, indurated, excoriated, or ulcerated condition
   of the  neck  of the womb, alteratives will  be required,  as the Compound
   Syrup  of Stillingia with Iodide  of Potassium, or, the Iodine Pill.   Among
   females subject  to gouty, rheumatic, or neuralgic diseases, the Compound
   Tincture of  Colchicum should be  used,  alternately,  with the Compound
   Wine of Comfrey, changing them every week or two.
    Local applications must not be omitted in the treatment of this affection.
   Injections  into the vagina three or four times a day will be found very use-
  ful;  they may be composed of a strong decoction of Black Cohosh root, with
   Tannic Acid added;  or a solution of  Tannic Acid in Port Wine may be in-
   jected.  A very excellent vaginal injection is composed by dissolving one or
   two  drachms  of Tannic Acid,  and half an ounce of Alum  in a quart of
  water;  this may be used three times a day, employing one-third  of the mix-
   ture each time.  In using injections, they should be retained for some time
  in the vagina, which may be accomplished  by the  female lying upon her
   back with the hips well elevated.  It will frequently be of importance, espe-
  cially in vaginal leucorrhea, to keep the vaginal  walls from coming  in con-
*  tact with each other, and this may be done by introducing soft sponge or lint,
   moistened  with  one of the above astringent  fluids  into the vagina.  Other
  agents have occasionally been found efficacious, as  an injection of a diluted
  Tincture of Acetate of Iron, a Super-saturated Solution of the Protosulphate
  of Iron, or, a decoction of equal parts of Black Cohosh and Geranium.
    When the discharge is  acrid  and  excoriating, and manifests a decidedly
   alkaline reaction, the injections should be composed of  a solution of Bicar-
   bonate of Potassa or Soda, in an infusion of  Elm bark, Marshmallow root,
   Hops,  or Stramonium leaves; and they should be continued until  the irri-
   tating quality of the leucorrheal matter is removed.  A decoction of BlacK
   Willow bark, (Salix nigra,)  used internally  and as an  injection, has been
  recommended as efficacious.   I have known  the  following domestic prepara-
  tion to cure several obstinate cases:—Take of finely grated Nutmeg, ana
   powdered  Alum, each, equal parts;  mix.  The dose is a teaspoonful in some
   molasses, repeated three times a  day.                                   .
    When the neck of the uterus is excoriated or ulcerated, the part affected 
LEUCORRHEA.
521
following may be applied:—Take of Sulphate of Quinia  forty-eight grains,
Elixir of Vitriol two fluidrachms, Distilled "Water six fluidounces; mix.  If
 must be thoroughly  touched or bathed, two or three times a day, with the
 Tincture of Muriate of Iron, diluted or not, according to its action; or tho
 fo
 f;
 the  canal of the uterine neck  appears  to be in  an excoriated or ulcerated
 condition, some lint, moistened with one of the above liquids, may be  care-
 fully introduced within the canal by means of a probe.   The application of
 agents to the neck of the womb will require  the introduction of the specu-
 lum to bring the part into view, as  well  as to facilitate  the  introduction of
 the remedies, and in all cases, previous to their application, the neck should
 be cleansed  from all adhering mucus or  pus  by means of a piece of sponge
 or  lint attached to the end  of a  stick; and  by a similar means apply the
 above liquids.
  The patient should use a light,  nutritious, easily digested diet, avoiding
 the use of tea and coffee, and should take moderate exercise  daily.   Where
 there is any pain,  or irritation  of the parts,  tenderness, or disposition to
 slight bleedings, not only should  the patient keep quiet,  avoiding all fa
 ligue, but sexual intercourse must be positively forbidden.
   figure 41 is a  re-                       Fig> .^
 presentation of llic-
 ord's four-valved  va-
 ginal speculum, which
 is generally used  by
 physicians.  However,
 there arc several other
 forms of this instru-
 ment suitable to vari-
 ous conditions,  views
 of physicians, ke. The
 object of a  speculum
 is to examine the con-
 dition of the  lower
 part of the neck of the
 womb, and  the walls  of  the vagina, as well as to afford facilities for the ap-
 plication of  remedies  to these parts.   It  is more especially adapted to  mar-
 ried women  and widows, being used among unmarried females only in severe
 and  obstinate  affections, which resist the  ordinary means  of treatment.
 Since the introduction of this instrument into medical practice, the diseases
 of females   have been much better understood, and their sufferings more
 speedily and permanently arrested; and from the immense benefits following
 its employment, the sex are under many obligations to its originator.   But,
 notwithstanding its value, there is no  doubt that while some physicians
 neglect  to avail themselves of  its advantages,  others resort to  its use entirely
 too  freely,  instituting uterine examinations  upon the most trivial grounds,
 and sometimes  to an injurious and unwarrantable extent.  Great care should
 therefore be had in selecting a careful, experienced, and moral physician, in
 those cases wherein the use of a speculum is  advised or required.
  The introduction of the speculum requires no unnecessary exposure on the
 part of  the female; she may wear a pair  of drawers, or  a loose underdress
 with an opening in it  sufficiently large for the physician to pass the instru-
 ment through,  into the vagina, and  which should be done carefully,  without
causing any pain; and the speculum should always be warmed and well oiled
or grea-ed to admit its easy introduction.   The position  of the female at the
time of introducing the speculum will be  on her back, with the hips elevated,

•ots^jj,,^
Ricord's four-valved Spoculum. 
522
AMERICAN FAMILY  PHYSICIAN.
and each foot resting on a chair; or, as required  in  many cases, she may He
upon her left side, with the knees drawn up as closely as possible to the ab-
domen.  The parts must be so  situated that when the speculum  is  intro-
duced  the  light  may pass into it, and give a clear and distinct view of the
several diseased surfaces.
                     FALLING OF  THE WOMB.

  Among the various displacements of the womb, there is none so common
as Prolapsus, or Falling of the Womb, by which is meant a condition of this
organ  in which it is much lower than  it should  be.   It is more generally
met with among married women, especially those who have borne children
but may occur among the unmarried.  When the womb has fallen so low as
to pass out externally, it is termed perfect prolapsus; when it remains within
the pelvis, it is termed procidentia uteri, or  imperfect prolapsus.  It is some-
times of a most obstinate  character, resisting all  remedial measures, and
proving a source of suffering to the female for the remainder of her life.
  Symptoms.  Prolapsus of the  womb  varies from  a  very slight descent
below the natural position of the uterus,  to its projection through  the exter-
nal parts, occasioning alterations in the relative  situation of neighboring
organs, from which many unpleasant  symptoms arise.  It generally comes
on with a feeling of fulness in the pelvis; a weight and  bearing down in the
parts, with a sensation  of dragging, which extends from the  navel to the
loins;  pains in the back extending round into the groins;  considerable dis-
tress  in  standing or walking;  the bowTels  are usually constipated; and the
urine will be unnaturally hot, and pass with more or less difficulty. Most of
these symptoms are relieved when the patient lies down.  Leucorrhea, exces-
sive menstruation,  or painful  menstruation, are frequent attendants upon
prolapsus  of the womb.
  From its intimate relation with the womb, the stomach soon  becomes de-
ranged, the  appetite is irregular or deficient;  the stomach  and bowels lose
their  tone;  rolling of wind in the  bowels, accompanied with a rumbling
noise, is common;  the spirits  become  depressed;  and the  patient loses all
desire for exercise, employment, or  even life.  The symptoms common to
this complaint  are varied and numerous, so much so, that a careless practi-
tioner will be led to suspect disease of various other organs, which these fre-
quently simulate.
  Causes.  Falling of the  womb is owing  to a relaxation and want of tone
of the vagina, and of the ligaments  which  sustain this organ.  This may
arise from over-exertion, straining at lifting, coughing, violent vomiting, &c;
it  may be the result of many childbearings, or repeated floodings, menor-
rhagia, leucorrhea, and frequently occurs from a general debility of the sys-
tem.   It may take place from getting  up too soon after delivery, and may
also happen during pregnancy, or even  parturition.   It is sometimes  com-
plicated with stone in the bladder, or with polypus of  the womb.
  Treatment.  In  recent cases of  prolapsus the  influence of agents  upon
the mucous  membrane of the vagina, aided by rest in  the recumbent pos-
ture, will generally effect a cure, if persevered in.   The agent's used may be
injections of cold water, or  of  astringent infusions, as of White  Oak  bark,
Geranium, Bethroot, Marsh Rosemary, &c, or a solution of Alum.  Colo
water applied to the abdomen,  back, and genital parts, will likewise be bene-
ficial.  It must be remembered that an  inflamed  condition of the vaginal
avails, or uterus, will be aggravated by the  use of  astringents;  hence,  when 
FALLING  OF  THE  WOMB.
523
 any inflammation is present, it must  first be reduced before employing the
 astringent local applications.
   But when the case is of long standing, or the  prolapsus is very great, it
 may become necessary in conjunction with the preceding means to give arti-
 ficial support to the fallen womb by means of pessaries.
   When there is irritation or inflammation of the vagina or uterus, or any-
 organic disease of the parts  or of the neighboring organs, a pessary must not
 be used, as it will only tend  to aggravate the existing difficulty; these  con-
 ditions must,  therefore,  in  all  instances, be  first  reduced  by appropriate
 means before  the introduction of a pessary is attempted.  Irritation or in-
 flammation may be  overcome by the internal  use  of Tincture of Aconite.
 Kxtract of Belladonna, or Compound Powder  of Ipecacuanha  and Opium,
 aided by injections  of  an infusion of Hops and Lobelia, an infusion of  Bel-
 ladonna, or of Elm bark and Stramonium leaves.  Equal parts  of Peach
 leaves, Solomon's Seal, and  Hops, in an infusion or decoction, will form a
 very excellent vaginal  injection.   If ulceration of  the neck of the womb be
 present, it must first be cured by appropriate means; in most cases the rem-
 edies named  for excoriation and ulceration  under Leucorrhea,  on page  520,
 will be found sufficient.   Other difficulties  must be met according to their
 indications.
   Pessaries are of various forms, and are made of sponge, wood, ivory, gum-
 clastic, glass, and silver coated with gold.   Among  these I prefer the latter,
 and the one  known  as  Blundell's pessary, although costly, will be found
 adapted to more  cases  than  any other;  one  great advantage attending it is,
 that it can readily be removed at night, for when the patient is in a horizon-
 tal position, a pessary is not required.  To introduce it, warm and oil it, and
 carefully and gradually pass it into the vagina as high up as possible.   The
 instrument can be held in its place by means of pieces  of tape fastened to
 each end of the cross-bar at the lower  end of the stem, the upper ends of
 which  pieces of tape are attached  both  before  and behind to a bandage
 passing around the abdomen.  In the absence of this, an egg-shaped sponge
 pessary, or an elastic  pessary inflated with  air, may be  used, but they re-
 quire to be frequently removed and cleansed, and are not as useful as  the
 preceding.  The selection of a pessary is usually according to the physi-
 cian's ideas, and they will be found to vary considerably in their choice.  If
 pregnancy should happen, there will^e  no occasion  for the pessary after the
 third month, and by a careful and proper course of treatment after delivery,
 a return of the prolapsus may be prevented.
  The  bowels must  be kept regular by mild laxatives; and any  heat or diffi-
 culty  in  urinating  may be  relieved by drinking freely of an  infusion of
 Marshmallow and Spearmint.  The diet must be light, but nutritious  and
 easy of digestion, and, in some instances, careful and moderate exercise  may
be allowed.   If the patient is pale and anemic, or much  debilitated, the
Compound Wine of Comfrey may be used, or some  preparation of Iron, as,
the Citrate of Iron and Quinia, Iodide of Iron, &c.   There is a method of
curing prolapsus by certain  species of  exercise and manipulations, without
the use of pessaries, and which I have found decidedly beneficial, but it
 would  be  impossible to give a  satisfactory explanation of these means in a
work like  the present, as it would require almost a volume of itself to fairly
present the matter. 
524
AMERICAN  FAMILY  PHYSICIAN.
                    DISEASES  OF  PREGNANCY.

  There are certain  symptoms common to the pregnant female, which are
peculiar to this  condition, and are in fact indications of the healthy act of
conception, and should  not, as a general rule, be interfered with.  In some
cases, however, they become so much  increased in severity or protracted in
duration, that they  may be termed  the "diseases of pregnancy," and will
require treatment to remedy them.
  Females, when pregnant, should never ligate or compress any part of the
body  or  limbs, with belts,  corsets, &c, as this  may not  only  give rise to
abortions, enlarged veins of the legs, and  other difficulties, but will likewise
tend to produce dropsy of the head, or deformity of the  child, as well as
positions of the infant in the womb, known as cross-births, breech-labors
&c, which frequently  render instruments  necessary to  bring the child into
the world, and may prove fatal to both mother and offspring.  The diet also
requires particular attention, using light and nutritious food, and avoidhi"
all alcoholic drinks, fatty, acidulous, and indigestible food.   Gentle exercise
daily, out of  doors, is very important during the first months of pregnancy;
fresh, pure air, with bathings of  the whole body once or twice every week,
cannot be  too  highly recommended.  It is a very common practice among
married persons to indulge in cohabitation during pregnancy; but this is a very
erroneous and irrational custom, and though positive evil does not immediately
follow, yet it  is certain to happen in time;  we find that females thus exposed
are more  liable to attacks of fluor-albus, excessive floodings, miscarriages,
&c, or some derangement  of the  mind or body  of the  offspring.  Those
females, especially, who  labor under fluor-albus, who  are subject to  large
or excessive  menstrual  discharges, who abort  frequently, who are  exceed-
ingly delicate and sensitive  in their nervous formation, cannot be too care-
ful not to permit the sexual act when they are pregnant.
  The following are among some of the most common diseases of pregnancy:
vomiting,  diarrhea,  cramps, and  heartburn, may  be treated as  heretofore
recommended.
   Constipation, should always be avoided if possible,  it is a common and
annoying symptom  during pregnancy.   It may commonly be overcome by
warm injections, as an infusion of two  parts of Boneset and one of Senna,
to a pint and a half of  which, half  a pint of Molasses may be  added, and
half a wineglass of Castor Oil; one-half of this may be  taken  as an injec-
tion, and  repeated in about  twenty minutes if necessary.  The injection
must be repeated  so as  to  keep the  bowels regular daily.   Purgative medi-
cines by mouth are  not often needed, and should be avoided, because of
their liability to occasion miscarriage.  If physic is required, use the powder
of Rhubarb  and  Bicarbonate of  Potassa. named under  the treatment of
Dyspepsia.   It is much better to use a diet which will keep the bowels open,
as stewed, ripe, or dried fruits, brown  bread, figs,  dates,  mush, and molas-
ses, &c.
   Severe Headache may  be relieved by an infusion of Scullcap, or Valerian,
or Ladies' Slipper, &c;  sometimes the  narcotic Extracts will answer, as of
Hyoscyamus, Stramonium,  &c. One of the  following pills for a dose, and
repeated three times a day, will be very useful:—Take of Sulphate of Qui-
nia six grains,  Extract of Belladonna a grain  and a half,  Alcoholic _ Extract
of Black Cohosh eighteen grains;  mix, and  divide into  twelve pills. In
females  of full habit, active  diuretics,  may  be given  as an infusion ol
Cleavers,  Haircap moss,  &c, keeping the bowels regular.
   Convulsions  during  pregnancy, are generally of an hysterical nature, and 
DISEASES OF  PREGNANCY.                    525
 must be treated as recommended under Hysteria; if they are epileptic, treat
 as advised for Epilepsy.
   Cough may be  remedied by some one of the agents named on pages 264
 and  205.  When  it is severe, constant, hacking, and harassing without ex-
 pectoration,  in addition to the internal means, a plaster may be placed on
 the  back, extending  from one  shoulder-blade to the other, as the Com-
 pound Capsicum   piaster, or Compound Resin  plaster.    Two parts each
 of the Tincture of Scullcap and Tincture of Lupulin, mixed with one  part
 of Tincture  of  Hyoscyamus, and given in doses of a teaspoonful during a
 severe paroxysm of cough, has frequently proved very efficacious.
   (Edematous swellings of the limbs may be benefited by keeping the bowels
 regular, using freely of diuretic infusions, as Queen of the Meadow, Dwarf
 Elder, II air-cap Moss, &c, and keeping the limbs constantly supported with
 a properly applied bandage.                              #            . .
   Enlarged  or varicose veins cannot be removed, at least during the condition
 of pregnancy.  The patient should  use  a very light diet, keep the bowels
 regular, and apply bandages, to compress and support the veins;  too much
 pressure will be injurious.   Elastic  stockings  are superior to the bandages.
 The patient must be as little as possible on her feet, chiefly keeping in the
 recumbent position.
   Piles are  common during  pregnancy, and are more apt to be present when
 the bowels are costive ; though they are sometimes met with during an attack
 of diarrhea.  If costiveness be  present, it must be  obviated by the  means
 already named.  To relieve  the piles, (for it is an almost impossible matter
 to remove them while the pregnancy continues) the following preparation
 may be employed:—Take of Stramonium ointment, half an ounce, powdered
 Alum  one drachm, Sulphate of Morphia one grain; mix well together, and
 apply on a  small  piece of cotton.  For other applications, see Piles, in the
 Surgical Part of the work.
  If the piles are very painful, cold applications, or a fomentation of Poke
 leaves, or an Elm  poultice may be applied to them; sometimes the applica-
 tion  of two  or three leeches will be necessary.   If they bleed,  apply astrin-
 gents,  or use the  means named under Piles, in a  subsequent  part  of the
 book.  The  attempt to cure  piles by ligating, or cutting, &c, while pregnancy
 exists, is dangerous.  When piles are present during gestation, great atten-
 tion  sbould  be  paid to the bowels  and to the diet, avoiding liquors, spices,
 heating and constipating articles, and exercising  or "being on foot" as little
 as possible.
  Pain in the right side is occasioned by the enlarged womb pressing against
 the liver; this  cannot be removed until after  the  birth of the child, but
 some relief will be apt to  follow the use of a light diet, a regular condition
 of the bowels, and resting on the left side during the'hours of rest.
  Itching of the genitals,  or an eruption of the parts with  excessive itching,
 will  be relieved by washing the parts two  or three times a day, with the
 Borax Lotion with Morphia.
  Suppression of Urine, as well  as difficulty in  urinating, will be benefited
 by a free use of mucilaginous diuretics, as an infusion of Marshmallow root
 and  Trailing Arbutus;  or, of Marshmallow and Peach leaves.    Ten or
 twenty drops of sweet Spirits of Nitre  may also  be advantageously taken in
 the infusion, repeating the dose three or four times a day.  Liquor Potassa
 is frequently efficacious.
  Retention  of Urine  requires stimulating diuretics, as, Dwarf Elder, Wild
Carrot-root  or seed, Queen of the Meadow, &c.   The  urine  must not be
allowed to remain  too long in the bladder before  its removal either by a 
526                 AMERICAN FAMILY  PHYSICIAN.
catheter or naturally.   The female must endeavor to urinate frequently nol
allowing the bladder to become filled with fluid.
   Toothache may be palliated by some of the means mentioned on par-e 32
   Longings or Capricious Appetite when not directed to absolutely unhealthy
or pernicious food  or drink may safely be indulged.  The dislikes of the
patient should not be meddled with.
   Swelling and Pain in the Breasts is sometimes very distressing;  to relieve
them, a warm fomentation of Hops may be applied, together with a liniment
composed  of Oil of Sassafras, Sweet Oil, and  Laudanum, equal parts.  The
bowels must be attended to, and the breasts kept free from any compression.
ABORTION,  or MISCARRIAGE.
  When the fetus is expelled from the womb  at  any time  previous to the
seventh month, it is impossible for it to continue its existence, and this pro-
cess of expulsion is  termed an abortion.   After the seventh month the child
may live, and its  expulsion at any time from the seventh  month to the full
period, is called a premature delivery.  An abortion is dangerous chiefly on
account of  the flooding which  may ensue, and which  becomes of a more
hazardous nature in the  latter  months  of  pregnancy.  In  the  first two
or three months, hemorrhage is seldom so excessive as to threaten life.
  Symptoms.  These depend considerably  upon the causes, and the time of
the pregnancy.   Thus, for the  first ten or  twenty days after conception,
there may be hardly any pain, and  but  little blood, so that the female will
be more disposed to  look upon it as a menstrual derangement  instead of an
abortion.  But in the  later periods of  pregnancy, and especially after the
third month, various symptoms  may  usher in the abortion;  there will be
more or less febrile symptoms, nervous excitability, deranged appetite, cold-
ness of the  feet  and legs, a purplish  discoloration of the skin around the
eyelids, which are more or less puffed up, shooting pains are frequently felt
in the breasts, which become soft and lose their elasticity, lowness of spirits,
a feeling of  pressure or bearing down in the lower part of the bowels, fre-
quent calls to evacuate the bowels or bladder, and  slight pains in the back,
which  come  on at  intervals, gradually increasing  in  severity, extending in
front, and eventually becoming severe and expulsive,  or true labor-pains.
As  the pains advance,  a discharge  of a  bloody character  ensues, becoming
more profuse as the abortion progresses; finally the bag of waters are bro-
ken, and the fetus is expelled; occasionally it comes away entire, being sur-
rounded by  the bag  of waters.  It is often  the case that the first indication
of an abortion is the flooding, followed  by pains, absence of motion in the
child, and its ultimate expulsion.
  After the  child has been expelled  the flooding and pains generally dis-
appear gradually; but if a portion  of the placenta or after-birth be left
within the womb, the pains may continue with  more or less severity and ir-
regularity, the flooding will frequently become excessive and alarming, and
offensive, putrid discharges will take place from the vagina.
  The most  dangerous  period in which  an abortion  can occur, is from the
third to  the sixth  month  of pregnancy, the germ being;of large size, and
the  mouth of the womb not in a condition to properly dilate and permit its
ready egress.  If an abortion occurs during a severe fever, a high inflam-
matory attack, &c,  it is very dangerous.   Commonly, in  an abortion that
progresses gradually, the  flooding is less than  in  one which advances with
\uiekness;  but the  system is more apt to  be injured by the former 
ABORTION.
527
   Causes.  Many circumstances are capable of inducing abortion, and those
 which would affect one female, will frequently be found to have no influence
 upon others.  Abortion may be owing to  attacks of epilepsy, hysteria, dys-
 entery, &c; to acute attacks, as scarlet fever, small-pox, ke.  Females whose
 systems are tainted with syphilitic disease, or scrofula, or who labor under
 excessive leucorrhea, are apt to abort; tumors in  the pelvis or other abnor-
 mal formations, displacements of  the  womb, ulceration of the neck of the
 womb, rheumatic  affection  of  the womb, &c, are  all causes of abortion
 Disease of the fetus  is a common  cause, being generally  received from the
 parent, as syphilis, small-pox, &c.  Vaccination during pregnancy will often
 occasion a miscarriage;  and it is dangerous  even to vaccinate a woman who
 has been recently delivered.  Accidents also give rise to abortion, as power-
 ful exercise, heavy lifting, blows,  bruises, severe jars, long-continued and
 violent dancing, rough riding, excessive coition, &c.  Sometimes the bag of
 waters may be so thin and  delicate that the mere  act of sneezing, laughing,
 slight straining, hanging up curtains,  bed-making, pushing in a drawer with
 the foot, &c,  will rupture it, and thus cause an  abortion; it  has also been
 caused by emetics, powerful purgation, and great mental excitement.  In
 many instances  it is produced by long-continued suckling  of a child, and
 also by the criminal  means frequently employed for this purpose.  Females
 of full habit and voluptuous are very apt to  abort.  When the motions of
 the fetus  cease, the  morning sickness disappears, and the breasts  become
 Boft and lax, it is an indication of the  death  of the  child, and abortion will
 certainly  come  on;  the same will  happen  when  the waters  have  been
 evacuated.
   Treatment.  The female constitution is apt to be permanently impaired
 by an abortion,  or disposed to constant repetitions of the  accident, on
 which account all proper measures  should be adopted to prevent its progress,
 if possible ; except when  there are  good reasons  for believing that  the
 child  is  dead,  in which case, measures should  be pursued to facilitate its
 rapid expulsion, and conduct the  female  safely through the  process.  In
 many cases presenting the  symptoms of an approaching abortion, but little
 more  will  be demanded, than a state of quietness in the horizontal posture,
 having the hips elevated higher than the head,  and  using cold lemonade
 or other refrigerant drinks.  Two  or three  grains of the Compound  Pow-
 der of Ipecacuanha and Opium may be given  every hour or two, to lessen
 any excitability of the  system, and remove  the pains.  Should the symp-
 toms still progress,  notwithstanding these means, in  most  cases they will
 cease  entirely in a few hours after  having placed a blister or a Mustard
 plaster, about four inches square, over the lower part of the spinal column,
 (sacrum.)
  Any excessive flooding  may be arrested by  the application of cloths
 moistened with some cold fluid, to  the parts, and over the lower  part of the
 bowels ;  cold water, iced water, or  vinegar and water may be  used.  Inter-
 ternally, a  mixtaro of five grains  of powdered Alum, and  one grain of
 grated Nutmeg,  may be given for a dose, repeating it every fifteen or thirty
 minutes, or every hour.  The Oil of Fireweed, or the Oil of  Fleabane, are
 also serviceable,  and may be given  in  doses of five or six drops rubbed up
 with sugar, repeating them  every ten or twenty minutes, or at longer inter-
 vals depend,ng  upon the urgency  of  the  case.    The  course  recommended
in Menorrhagia,  on page 513, will frequently  be useful in  checking the
flooding.                                                          °
  Whey cho flooding is very profuse, and  there is no doubt but that the
letus will be expelled, the vagina may be plugged with pieces of silk, linen, 
'528                 AMERICAN  FAMILY PHYSICIAN.

or muslin, with which it must be well closed up, keeping them in this situ*
ation by means of a compress and bandage.   In the course of six or seven
hours this plug must be removed;  but on no account must it remain in tho
vagina longer than twenty-four hours.  By  this method, the flow of blood
will frequently be checked.  But it  must be recollected, that  it is exceed-
ingly improper to employ the plug, except during the first five months of
pregnancy ; if used after  this  period, it will give  rise to what is called a
"concealed  hemorrhage," in which  the flooding continues,  but does  not
appear externally, owing to  the  presence of the plug, which obstructs its
flow.   When the symptoms of  an abortion   have  been stopped, the female
should subsequently continue for some time  in a recumbent posture
very careful in her movements and exercise, lest a return of the
take place.
   If, by the means recommended, the pains,  flooding, and other symptoms
of abortion continue, gradually increasing  in severity, or,  if there is no
doubt that the fetus will be expelled, the only course to pursue is to permit
the case to proceed  the same as  in  natural labor,  keeping a strict surveil-
lance upon it to promptly meet any dangerous  symptom.   When  the
womb is  acting energetically,  and  the abortion is favorably progressing,
any intermeddling, not actually demanded, would be exceedingly reprehen-
sible, and might create  fatal results.   And  all  the discharges, instead of
being thrown away,  should be shown  to the  physician, that he may be
enabled  to determine with  certainty, whether  the whole  of the ovum or
germ has been expelled.  This  should  be  the invariable  rule  of every
aborting female.
   If the efforts or pains of the womb are not powerful enough to complete
the delivery within  a reasonable time, it may be  assisted in its action by
the aid  of*  medicines which will  increase  its contractile power; thus, a
warm  and  strong infusion  of  Blue  Cohosh,  Black Cohosh, or Ergot,
may be  administered, or these articles  may be  mixed  together  in equal
parts,  and given  in  infusion.   The  inner bark of  fresh  Cottonroot,
made into a strong infusion, will in  most cases, excite the uterus to ener-
getic action.   Should these measures fail, the flooding still continuing, with
feeble and inefficient pains,  it  will be proper for  a physician, (and no one
else,) to pass  a finger, or a small wire blunt hook through the canal of the
neck of the womb, for the purpose of gently and  carefully  removing the
membranes, which, when effected, will at once expedite the abortion.
   Cold applications to the parts, and internal means to check the fb
should be continued, as Tincture  of Cinnamon in half-teaspoonful
every ten or twenty minutes, according to  the profusion  of the discharge,
each dose of which may be given in about half a wineglass of water, sweet-
ened with loaf sugar.   Or, the Oils of Fleabane, or Fireweed may be used,
 as named above.  Sometimes a flooding will take place, or continue for a
 number of days  after there has been  a cessation of the abortion, or an
 expulsion of the contents  of the  womb;  this is  owing to the fact that a
 part of the  membranes, or after-birth  have been retained; a physician
 should remove them, as stated above, by a small blunt hook.
   The abortion having  been completed, a  course  similar to  that pursued
 after natural  labor should be  instituted; the abdomen should be properly
 supported by a bandage, and  the female should  be kept quiet, and in a
 recumbent position for  some days.  If she  be  very much debilitated from
 the floodings, adopt the same course as to diet, &c, as named in  flo°din£'
 following labor proper.  Means should also be  taken to strengthen tne
 womb, and to remove any disease under which the female may be laboring, 
LABOR,  OR DELIVERY.
529
in order to prevent subsequent abortions.   (See King's American Electio
Obstetrics.)                     _____________

                     LABOR,  or  DELIVERY.

   Labor, Delivery, or  Parturition, is that process by which the womb, at
full term, expels its  contents, consisting of the child,  after-birth, mem-
branes, and fluids.  Nine calender months and seven days constitute "full
term;" some authors  say about two hundred and eighty days from the last
menstruation, and  others say about  one hundred  and forty days after  lifa
or motion of the  child has  been distinctly felt.   It  may occur within a
few days  previous or  subsequent to this time,  and in  some cases  has not
come on until some weeks afterward.   The process of labor is accomplished
by the contractions of  the womb, assisted  in the latter stage  by  contrac-
tions of the muscles  of the abdomen, which being accompanied  with pain,
are therefore termed  "  labor-pains."  The period occupied in the  process,
varies considerably;  but on  an  average, it continues from three  to six
hours; and more children  are  born  between  sunset and sunrise, than
through the day, in the proportion of ten to seven.
   The symptoms of approaching labor are, a  settling down of the  womb,
which relieves the female very much,  causing her to have a lighter feeling,
to breathe more freely,  to be in better spirits,  and  to  move  more actively
than for  some two or three months before.  Not unfrequently, there  will
bo a constant desire to  evacuate the bowels  or bladder.  A flow of bloody
mucus also takes place  inmost  instances,  called " the  show;" and  flying
pains in the back and loins, wakefulness, .nervous excitability, &c,  are apt
to be present.   Sometimes, owing to costiveness, great weariness, rheuma-
tism, &c, a  kind of pain  will be felt  in the  latter weeks of  pregnancy,
which are termed  u false pains," and which may be determined  from " true
pains," by  observing that  the  latter commonly begin  in  the  back,  and
spread around to the belly, in the region of the womb, that they come on
regularly, with intervals of freedom from  pain, and that they acquire more
severity, as  well as frequency, with  the advance  of the  labor; if during
their presence, pressure with the  hand be made upon the belly so as to feel
the womb, this organ  will be felt  firm, hard, and contracting, somewhat  like
a hard tumor, becoming soft as the pain ceases.
   False pains begin at the upper part  of the womb, are seldom  felt in  the
back, do not extend so  greatly around the lower part of the body as the
true pains, are either  on all the time,  or appear with great irregularity, and
do not cause the womb  to  become firm and hard.   They are usually very
annoying, and may be relieved by a purgative injection, or a laxative inter-
nally, aided by the  subsequent administration  of an infusion of Scullcap;
or, aldose or two of the  Compound Powder of Ipecacuanha and Opium, or
the Compound Tincture of Virginia Snakeroot may be given.
   Labor is divided into  four varieties, viz:—
   1. Natural Labor, in  which the child's head presents so as to be the  first
part born, and where the process of expulsion  does not exceed twenty-four
hours, being accomplished by the unaided efforts of nature, or with the aid
ordinarily bestowed.
   2. Protracted, Tedious, or Difficult Labor, the same as the preceding, with
the exception that  the  process  of expulsion  extends beyond twenty-four
hours, and may need some kind of artificial aid before it can be completed,
as turning, &c, by the  hand, or, the  use  of Ergot, &c,  or, the application
et instruments.
      a4 
530
AMERICAN FAMILY  PHYSICIAN.
  4. Preternatural Labor, in  which  any part of the child presents at tta
mouth of the womb, except the head ; where  the cord, or navel-string falls
down so as to show itself on  the  outside when " the waters  break •" and
where  there are two or more children.
  4. Complicated  Labor, in which  some  dangerous  symptoms  occur  not
necessarily belonging  to the labor, as convulsions, severe flooding, &c.
  Natural labor is divided  into three stages.   The first stage occupies from
the beginning of labor, until the  mouth  of the womb  has  become thor-
oughly dilated or opened, which is generally known  by the rupturing of the
membranes and discharging of "the waters," or amniotic liquid.  During
this stage the female is very apt  to be  uneasy and restless, peevish and
fretful,  and   sometimes  quite  low-spirited;  she  frequently  experiences
flashes of cold and heat, and the desire to  evacuate the bladder is more
frequent than ordinarily.  Sometimes, and more especially toward the latter
part of this stage,  there will be vomiting;  or, each pain may be ushered iu
by a slight shivering.   The pains are of a " grinding, cutting, or sawing"
character; they occur  with  regularity, gradually become stronger and more
continuous, with intervals of ten or fifteen minutes between them, in which
the female is comparatively easy.  These pains may be  occasionally bene-
fited by firm  pressure over the small of  the  back, which  should  always be
done by  the friends of the woman and not by the physician, who must avoid
wearying or exhausting his  strength in the earlier part of the labor, lest he
thereby incapacitate himself from rendering necessary and more valuable
assistance, should  it be demanded in the latter stage of the delivery.
  Unless there be flooding, or  some untoward symptom, during the first
stage of labor> the female need not  be confined to one  posture; but she
should not  make  violent motions  of the body, and, above all, she should
not bear  down in this  stage ;  any efforts of  this kind are improper.  The
condition of the bowels must be noticed, and if they have not been evacu-
ated, an  injection  should be given.   It  should also be observed that the
urine is passed regularly.   The room must be kept  cool  and cheerful, and
the presence of more than one or  two females, beside the physician, is un-
necessary.  Too much gossiping, or the administration of cordials or stimu-
lants are injurious.  When the pains are  regular and pretty frequent, the
physician will desf$e to make an examination to ascertain  the  condition of
the parts and the progress  of the labor, which is very proper, as it may
eventually save  the patient much suffering, and, in  some instances, even
her life; but there is no necessity for frequent examinations.
   Every thing having been found correct, the female's bed should be pro-
perly prepared ; it should be  a cot, or hard mattress,—a feather bed should
not be used,  as it  is, to say  the  least of it, very unhandy.  Upon the mat-
tress a folded blanket, dressed skin,  or oil-cloth must be placed, to prevent
its becoming  soiled by the discharges, and  over the whole a sheet may be
thrown for the patient to lie upon ;  the  rest of the bedclothing may be put
on in the ordinary way.  The female's dress should be light and simple, so
as not to over-heat her,  or be in the way of assistance should it be required.
The scissors,  ligatures for  tying the cord  or navel string, bandage for the
woman,  &c, must now be secured, and  placed where they can  readily be
had.   Tbe female may,  if she desire it, use a light diet, consisting of toas
and tea, toast-water, thin Indian meal gruel, cold water, Ac, but anima
food, and all  stimulants must be prohibited.   As some  time  may pass be-
fore the second stage  arrives, it  will  be proper for the  physician to occa
sionally leave the room  for a few minutes, that  the woman  may have an
opportunity of  evacuating  the bladder or bowels. 
LABOR.
531
   The second stage of labor occupies  the period between  the discharge of
 '•the waters," or the complete dilatation of the mouth of the womb, until,
 and including the birth of the child.  After the first stage  has terminated,
 the female usually  has  a short interval of freedom from pain, and some
 have several  hours  of repose, before the  second stage commences.   The
 pains in this stage  are different from those of the preceding, being of a
 forcing down or expulsive character, and the advance of the child is aided
 by the muscles  of the abdomen.  In this  stage the female should not be
 allowed to leave her bed on any account, lest the child be  suddenly ex-
 pelled and destroyed before the physician can bestow the  necessary atten-
 tion ; and which may cause an inversion of the womb, or subject the woman
 to dangerous flooding.   There will  frequently be a desire to stool,  but  this
 will cease after  the  head is born.  The position assumed  by the  female iu
 this stage, varies  in different countries, the most common is, to have her lie
 on the left side with the knees well drawn up toward the  abdomen, or, to
 lie upon her back;  I prefer the latter.
   When the pains are on, there will generally be  sufficient bearing down
 without any  effort on the  part  of the  patient, but if they are weak, or of
 short duration, she may assist the delivery by bearing down only when the
 pains are present.  The physician will be constantly by the bedside to give
 the necessary support to the parts,  and as the head of the  child advances,
 he will  ascertain  whether the cord is around  its neck, that he may at once
 remove it.
   As soon as born, the child cries vigorously; but should it make no noise,
 a finger may be introduced into its  mouth to remove any mucus or other
 Bubstance which  may interfere  with its  breathing.  A few minutes after
 delivery of the  child, the pulsation in the  cord will cease  to  beat, when it
 may be  tied with a strong ligature  in two places,  the first being about an
 inch and a half from the child's  body, and the  other about  an  inch from
 the first ligature,  and then, by means of a sharp pair of scissors,  separate     :P%
 the cord between these two  ligatures.  The child may then be  removed
 from the mother,  and given into the care of the nurse.
   After the  delivery of the child, the female  experiences much relief,  and
 feels more comfortable and cheerful, usually having an entire freedom from
 pain for a few minutes, or even  an  hour, when the third stage commences,
 iu which the after-birth, or placenta and membranes  are expelled.   Slight
 pains are felt,  and  with one,  two,  or three, the  after-birth is  expelled.
 Sometimes the child and the  after-birth  are  delivered with the same pain.
 No rash or strong pulling must be  attempted to  remove  the after-birth,
 provided it does  not  pass away soon after the delivery of the child; if
 there be much delay in its expulsion, the physician in attendance will give
 the proper aid.  I state  this, because no one but  a  well-educated physician
should ever be allowed to attend a case of labor; ignorant  persons may at-
tend many natural cases without doing much injury to the female, but in
instances where skill and address  is  required, they will be almost certain
to  lose their  patients.
  After the  delivery of the  after-birth, the bandage  should be applied
around  the  body  sufficiently  tight  to  give support  to  the relaxed abdo-
men, and  this should always  be done by the nurse,—never by the physi
cian; he should,  however, ascertain  whether  it is  properly adjusted, after
its application, and when the  female  is  properly  covered.   The female
should now,  or as soon as her strength and condition will permit, be care-
iully removed to the bed which  she is to occupy for the next ten or twelve
Jays; cloths must be  loosely  placed to the  genital  parts to receive  tho 
532                 AMERICAN  FAMILY 1'IIYSICIAN.

blood and other discharges, that they may not soil the patient's garments.
And, for a few days, she should on no consideration  be  allowed \o sit up
in bed, or  to  rise; it has frequently happened  that a momentary sitting-
posture at this period,  has  caused sudden death, or a  most alarmin°
flooding.
  The other varieties of labor,  viz: difficult: preternatural, and complicated,
occur so seldom when compared with  natural labors, that it  will  be unnec-
essary to  make any remarks concerning them, as they should always be
attended to by a medical man only.  Those, however, who desire a full ex-
planation of the symptoms and  treatment of labor in its various forms will
find a very detailed  account in a work lately published  by  the author en-
titled "American Eclectic Obstetrics."
                 TREATMENT  AFTER  DELIVERY.

  The  discharge from  the womb, which continues for several days after
delivery, is  termed  lochia, or lochial discharge.  Its  amounts varies with
different women,  being very slight with one  class, and very  profuse with
another, so as to soil twelve or eighteen cloths in the course of twenty-four
hours.  Its amount gradually lessens until it ceases entirely, and it changes
from a bloody to a greenish color, or almost colorless.   No treatment is re-
quired for the lochia, unless it is very excessive, or very much diminished in
quantity. When it is excessive, enfeebling the patient, astringents may be given
to lessen it, as infusions of Geranium, White Oak bark, Witch Hazel bark,
&c; or two grain doses of a mixture of a scruple, each, of Caulophyllin and
Geraniin, may be given every hour.  It will also be proper to bathe the parts
with cool water, four  or five times a day.  When the augmented discharge is
caused by retained pieces of the after-birth within the womb,  the above
astringent  infusions  may be  injected  into  the vagina.  For  any debility
occasioned by the  discharge, tonics must be administered, as Sulphate of
Quinia, Citrate of Iron and  Quinia, Gentian, &c, with a  nutritious, easily
digested, but non-stimulating diet; a state of quiet in the recumbent posi-
tion is very necessary.  In profuse lochial discharges, Ergot, Caulophyllin,
Oil of Fireweed, Oil of Fleabane, Tincture ot Cinnamon, Geraniin, Warren's
Styptic Balsam, &c, are among the articles that maybe  efficaciously admin-
istered.
  When the lochia is less than it should be, or ceases too soon, it is com-
monly owing to cold, and if it be not promptly reinstated, it  may cause a
serious result.   The bowels should be opened by a gentle cathartic, and then
a strong infusion of Motherwort should be  administered.   This  should be
drank as hot as possible, and the  patient should use  it  plentifully.  The
legs and inside  of the thighs, should also be bathed with  some stimulating
compound, as the Compound Tincture  of Camphor.  If febrile  symptoms
and pain are present, warm fomentations of  Hops and Tansy should be ap-
plied  to the abdomen; and,  internally,  the  Compound Powder of Ipecacu-
anha and Opium, may be given ; or eight drops in a teaspoonful  of water, an
repeated every hour or two, of a mixture composed of two  parts of Tincture
of Black Cohosh, and one part of Tincture of Aconite root.
  After-pains are frequently very distressing, and require means for rehe.
That  which I have found the most efficient in  severe cases, is the applica-
tion over the abdomen of a fomentation of equal parts of Hops and lansj
digested in some Whisky, or other spirits, which should be renewed two o
three times a day; together  with the  administration of a mixture ot U ' 
TREATMENT  AFTER  DELIVERY.                 533
 lophyllin two and a half grains, Compound Powder of Ipecacuanha and Opium
 five grains, repeating this dose every three hours, until  relief is afforded.
 In some  cases, I have met with success from a powder composed of Ergot
 three  grains, Camphor and Opium, each, half a grain; repeating this  dose
 as often  as required.  Ordinarily, the  Compound Powder of Ipecacuanha
 and Opium will  relieve after-pains.   Care must be taken that thepains ex
 pericnccd are after-pains, and not some more serious disease, as inflamma-
 tion of the peritoneum.
   Milk-fver may commonly be prevented by putting the child to the breast
 as soon as possible after it has been washed and dressed, if the state of the
 mother will permit;  and by giving a  purgative within twelve or twenty-four
 hours after delivery.  If the  symptoms are  severe, one or twoSeidlitz pow-
 ders, warm fomentations upon the breasts,  should they be painful and dis-
 tended, together with frequent evacuations of the breast-milk by the child,
 or otherwise, will overcome  them.  In some  instances, the administration
 of the Compound Powder of Ipecacuanha and Opium, will be useful.
   Few nursing females escape one or more  attacks of ulcerated  ox excoriated
 nipples; and some are subject to it every time they give suck.  Frequently
 when the child sucks, the pain is  severe, and more or less blood flows from
 tho part.  Sometimes painful ulcers, or deep fissures are present, and in a
 few instances the nipple is lost.  The artificial teats sold in the drug stores,
 will  remove or  prevent this difficulty, when the child will draw through
 them; but it will often decline their use, when  other means must be em-
 ployed.  The first thing is to reduce any inflammation which may be pres-
 ent; and which  may be accomplished by by a poultice of Elm bark, or  Elm
 and  Hops, Elm and powdered  Lobelia, &c, which  should be made large
 enough to extend over the nipples, and  for some distance around it.  Occa-
 sionally, the severity of the  inflammation will be such  that two or three
 leeches will  be necessary before the poultice will be of any  advantage;  the
 leeches may be placed on that part of the breast just beyond the areola or
 colored circle which surrounds the base of the nipple.  Sometimes the  pain
 and inflammation maybe subdued by washing the nipple three or four times
 a day with a solution of four or five  grains  of Nitrate of Silver in a fluid-
 ounce of distilled water.
  After the severe inflammation of the part  has subsided,  one of the subse-
 quent compounds will perfect the cure:—Take of Mutton Tallow half  an
 ounce, Balsam of Peru one drachm,  Glycerine, Honey, each, half a drachm;
 melt the suet, strain it, and then mix in the other ingredients.  A little of
 this may be applied to the nipple four or five times a day.  2. Take of Bal-
 sam of Tolu, and Peru, and Honey, each, three and a half drachms, Opium,
 Camphor, each,  half a drachm, Alcohol half a  pint; mix, and  let them
 stand a week, shaking them wellawery day.   Moisten a soft piece of linen
 with this, and keep  it upon the  nipple during  the intervals of  nursing, oc-
 casionally removing  it.  Wash the nipple always with a  little warm water
 before allowing  the  child to  suck.  It should smart a little, but if  this be
 too severe, it must be diluted with water.
  It is generally necessary that  the female should be kept quiet and as free
 from physical or mental excitement as possible, for nine days at least, that
 the womb may gradually assume its original non-impregnated state, without
 attacks of flooding,  or other  derangements,  as well as to permit the consti-
 tution to regain its former strength and vigor.  She should not be allowed
 to arise at all, for any purpose whatever, until after the third or fourth day,
 particularly if she has had a  tedious  or otherwise debilitating labor;  and
▼hen it is permitted  her to get up, she  may at first be bolstered  up in bed 
534
AMERICAN FAMILY  PHYSICIAN.
for a few minutes, in a sitting posture, then in a chair, and so on, gradually
prolonging  the  time,  until  she need not  occupy  the  bed  any longer
through the day.  The apartment  should be kept free from filth  and dis-
agreeable smells, maintaining a comfortable  degree of warmth, and  being
very careful to prevent her from "catching cold."  Her person should be
kept in a state of cleanliness, particularly  about  the organs of generation
bathing them once a day with warm water, to which a little spirits has been
added.  A light, easily digestible diet should be allowed, particularly for
the first six or seven days, as toast and tea, oat-meal or Indian-meal  gruel
boiled rice, arrowroot, &c, when, if every  thing  is progressing favorably
her food may be more nutritious, as  soups, broths, soft-boiled eggs, tender
chickens, &c.   And thus must she gradually have her ordinary diet restored.
Ale and porter may be used after the tenth or twelfth day, if she continue
to be feeble.   If she is subject to falling of the womb, it will be better for
her to keep  in  the  horizontal position for two or  three months after de-
livery, in order to aid in effecting a permanent cure.
                              FLOODING.

  Flooding, or Hemorrhage from the Womb, is one of the most dangerous
symptoms which may come on during labor.  Its appearance is  generally
sudden and unexpected,  requiring  an immediate^and vigorous management,
and demanding, on the  part of the physician, calmness, presence  of mind,
firmness, and a perfect knowledge of  all the means for successful  treatment
that are known to the profession.  There are no symptoms by which a phy-
sician can determine whether flooding will accompany a labor or not; it may
come on in the midst of what appears to be a favorable labor, and that so
formidably as  to destroy the female in a few minutes, if  her  physician he
ignorant or tardy in using  the proper measures.  Hence  the  necessity for
well-educated midwives,  to lessen the  chances for mortality among females
in labor, as well as among their infants.
  Flooding  may occur from various causes, but it is  more commonly met
with after the child has been born,  while the after-birth still remains in the
womb, and also after the  expulsion of  the after-birth.  When it occurs short-
ly after the delivery of the  child, the after-birth remaining  in the womb, it is
generally owing to a partial loosening of  the after-birth from the inner sur-
face of the womb, whereby large bleeding orifices are exposed, and sometimes
makes its  attack with suddenness and  alarming profuseness.  The face of the
patient becomes pale, the pulse weak  and frequent; she becomes,  in a very
short space of time, not merely faint,  but perfectly  unconscious of every-
thing that is going on around her;  she neither sees nor hears anything.  If
immediate benefit be not afforded,  she wrU  rapidly succumb.   If  the  hand
be applied upon the belly,  instead of feeling the  hard, contracted womb,
through its walls, it  will  be  felt soft and lax,  or perhaps, will not  be distin-
guished from the other contents of the abdomen.
  Treatment.  This  must only be  attempted  by an educated physician,
who, instead of trifling with his patient's life by giving medicines and apply-
ing cold fluids  to the parts, or by pulling upon the cord to remove the after-
birth in this way,  will at once tightly bandage the female  around the abdo
men,  placing a compress underneath  the  bandage and.over that part of the
belly directly opposite the  upper portion  of the womb, in  order that it may
press firmly upon that part.   Then, taking off his coat and turning up his
shirt sleeves, he will put the cord upon the stretch with one hand, while he 
FLOODING.
535
will pass the other, usually the right hand, quickly along the cord as a guide,
and into the womb,  carrying  it on  until  he reaches the after-birth;  if the
mouth of the womb be contracted, he must dilate it with his fingers suffi-
ciently to admit the hand.  When the after-birth is reached, he will place the
outside hand on the abdomen  to sustain and fix the womb, and then with
the other hand will carefully separate the after-birth from the womb, with the
pulps of his fingers, commencing at its edges, and pressing or peeling it off
from the  surface of the womb, as though he were removing the peel from an
orange,  being very careful not to  scratch  the  womb with his finger  nails.
As soon as he has loosened the after-birth, the womb usually contracts and
discharges both it and the hand; or, if this is not the case, the hand must
not be removed until contractions of the organ have been aroused, which will
expel it.   After the after-birth has been thus  removed, the management of
the case must be pursued with great care,  that the flooding may not return,
and to prevent inflammation.   The strength of the patient must be supported
by the means named at the end of this article.   In these cases, the life of the
female will be saved or  destroyed in a few  minutes—the measures named
must be  quickly and energetically pursued—and if the  physician lose  his
self-possession,  or become appalled at  the  copious flow of blood, he should
not perform the operation, lest he still  further endanger his patient's life by
a careless or awkward management,—but he should send at once for another
physician.

   The other division of flooding occurs shortly after  the  expulsion  of  the
after-birth; it is a very serious accident depending upon a  want of tone  or
action of the womb, and often proves fatal.   It is  not  the amount of  blood
lost that is to be feared, so much as the effects upon the system.  This form
of flooding  may occur as soon as the after-birth has been delivered, and  in
cases where no untoward symptom has thus far been manifested during the
labor, or,  it may not come on again until half an  hour, an hour,  or several
hours have passed.  Its attack is apt to be sudden, the patient complains of
great faintness,  of a feeling of weight about the stomach; the face becomes
pale, the breathing short and  quick, the pulse is small, weak, and rapid, per-
haps hardly observable at the wrist, there is a dimness of vision, and finally
a complete loss  of sight and hearing, or an unconscious condition.   Drops of
cold sweat will form upon  the brow, and the feet and  legs  become deathly
cold.  In  this form of flooding a large amount of blood may pass externally
■md stain  the cloths and bedclothes, or, if there be an obstruction to its ex-
ternal discharge, but a small quantity may be visible, while the  internal loss
of blood, filling up the womb, is very profuse.  If the patient  should survive
the first copious discharge of blood, she will slowly recover from her state of
unconsciousness, the pulse becoqite fuller  and more natural,  the system
somewhat  recovers its strength, theieet and legs grow warmer,  breathing is
performed with  greater ease, the cheeks become  slightly flushed,  and con-
sciousness returns.   She now  exhibits much restlessness,  tossing about, cry-
ing for fresh air, and desiring to  be fanned, and frequently making such
exclamations as,  "Oh, I shall die," &c.
  This reaction of the system, however, soon passes away,  another gush of
blood takes place which  may prove fatal, or  she may lapse  into  a state of
unconsciousness, from which she again recruits, and thus continue for several
attacks^ until eventually death closes the scene.  As in the preceding form
of flooding the hand placed upon the belly will find the womb soft and lax,
and upon  pressing  it a  gurgling  sound will be  produced, together with a
gush of blood from the parts either in clots or fluid. 
536                AMERICAN FAMILY PHYSICIAN.

  Treatment.  This flooding depends upon a non-contractile state of the
womb, whereby the mouths or openings of its bloodvessels instead of beine
closed, remain open and exposed;  the  safety of the  female, therefore  rests
wholly upon the production of contraction in the womb, which, when estab-
lished, will close the mouths of the bleeding vessels and check the flooding
The physician must proceed with steadiness and energy.  And the bystand-
ers must not perplex him with questions of any kind, nor interfere with his
movements, but should promptly and actively obey all his requests; for this
is the most trying  situation in which a  physician can be placed, one calcu-
lated to unnerve him, requiring all his fortitude and  energy to combat.  He
should be cheerfully seconded in all his efforts.
  The physician, placing his hand upon the bowels, will press firmly upon
the womb, keeping up this pressure steadily until the womb contracts, and
also seizing the womb, through  the walls  of the  abdomen, between the
fingers, working and pressing it from time to time, alternately.  If several
hours of compression are necessary, other  parties  may assist him.  This
will answer a  much better purpose in arousing the womb to action than
a bandage, and  will  also keep  it free  from much  clotted blood.  This
course may cause  some pain,  and the patient may beg  to have it stopped,
but to this no attention should be paid, and the exertions should continue
unremittingly, until the  contraction of the organ, and  consequent cessa-
tion of the flooding has ensued.   Be careful, however, not to press or work
the womb so  violently as to turn it inside out.  As soon as the flooding
becomes checked,  the womb becoming firmer, harder, and contracted, a
bandage may be placed around the abdomen, with a sufficiently thick com-
press  between it and the belly,  so as  to  continue a steady, firm pressure
upon  the womb.
  While the  pressure and  working is being  accomplished, as above, an
assistant should apply cold to the parts, thus: plunge a large napkin in a
basin of eold water, and  dash it suddenly against  the external  parts, the
inside of the thighs, the buttocks, &c, repeating it every minute or two;
or, cold water, cold water and vinegar,  &c,  should be poured from a height
of four or five feet  upon the  naked abdomen.  And  these  means should
be continued without cessation,  until the  shocks thus  occasioned, have
aroused  the  womb into action.   One  thing,  however, must be  borne in
mind, if the  system be very much prostrated, some judgment must be dis-
played in the  use of these external  refrigerants, as  a too  free employment
of them may  produce evil instead of good consequences.
   Hemastasis, or ligatures around the thighs should  be  one of the very
first means called into requisition, as it lessens the amount of venous blood
thrown into the body, and thus aids in lessening the loss  of blood.
   Internally, the Tincture of Cinnamon should be administered in doses
of a teaspoonful in about half a wineglass of sweetened water, repeating it
every five or  fifteen minutes, or at longer intervals, depending  upon the
copiousness and  constitutional effects of the flooding.  Other  agents have
also been found  efficacious when used in  connexion  with the preceding
measures, as, Calcined Deer's Horn,  which  is  to be given in teaspoonful
doses, added  to about a wdneglassful of hot water, repeating it in the same
manner as the preceding tincture;  this  has arrested the flooding when
other means had proved useless.   A mixture of equal parts of Tincture o
Rhatany, Tincture of Cinnamon, and Spirits of Turpentine, in half-teaspoon-
ful doses, has likewise been of advantage ;  it may be given in an infusion ot
 Geranium, or Beth root.   Galvanic, and  electro-magnetic currents passed
through the womb, have  been  recommended  by the  highest  authority. 
MILK LEG.
537
Alum water may be given,  when  no other agent is directly at hand,  in
dopes of a wineglassful.
  When the constitution has become very much  exhausted and prostrated
from the  great  loss of blood,  the vital  powers  must be invigorated and
supported'by  stimulating  agents;  Brandy or  other  Spirits,  Carbonate
of Ammonia, Wine, Ether, &c,  maybe  exhibited,  continuing their use
until they have  effected a marked  and favorable influence on the constitu-
tion, as indicated by a more natural pulse, an increased temperature of the
feet'and legs, a  return of color to the lips, and greater mental and physi-
cal  sensibility.   It will  be found better  to  give  the liquors  in table-
spoouful doses,  without any water, repeating them every twenty or thirty
minutes, or even oftener, if the prostrated condition of the vital forces are
Buch as to require it.
  As soon as the flooding has been arrested, a  bandage should be carefully
[.laced around the body, with a compress, as stated above,_ and it should be
closely attended to, noticing every half-hour or  hour, that it has not slipped,
but continues in the position  in  which it was placed at first; for there
may be a continued disposition to laxity and inactivity  of the womb, and a
consequent return  of the flooding, so  that the female  will not be out  of
danger for a number of hours.  The ligatures  on the limbs  may be slack
ened, but they  must not be taken off until the woman is under  no  further
danger from the flooding.   She must be kept perfectly quiet and still, and
be  positively prohibited  from  even  moving  for several hours after the
cessation of the flow;  and many days should pass before she be permitted
to raise in a sitting position;  the  time in these cases,  depending upon the
degree of  injury undergone by the system.  The wakefulness and irritable
condition of the system, remaining  after a severe flooding, may be over-
come by five or six grain doses of the following powder, repeated every
two or three hours:—Take  equal  parts of the  Compound Powder  of Ipe-
cacuanha and Opium, and  Capsicum ;  mix. If the  patient sleeps,  do not
awaken her, unless symptoms  of  flooding  come on, as suspected by the
bloodless  appearance of the face,  and indistinct, rapid pulse.   The room
should be  kept dark, not too warm, and fresh air  should be admitted, being
careful not to have it pass over or upon  the  patient, so as to  occasion a
cold  or fever.   A'isitors, whisperings or  loud talking, &c, must  on no
account be allowed; the patient should be kept still, free from  noise, and
not allowed to talk or  make the least exertion.  At first,  the diet  should
consist of light, nutritious fluids, as cold gruel, cold  boiled  milk,  chicken
broth, arrowroot, beef tea, custard,  calf's foot jelly, &c, and when the debil-
ity and exhaustion  is very great, stimulants may be added to these, as  wine
or brandy.
                            MILK  LEG.
  Milk Leg, or more properly,  Phlegmasia Dolens,  is a swelling of the
legs, which  sometimes attacks  females shortly  after confinement,  being
attended with more or less pain.  The name milk leg  was applied to it
from an erroneous impression that it was due  to the milk from  the breasts
finding its way into the legs.  The nature of the disease is not yet satisfac-
torily understood, and many hypotheses have been  advanced concerning it.
Some have looked upon it as an inflammation of  the absorbents, others, as
an inflammation  of the veins,  and a  third party have considered the blood
as the seat of the disease.  My own  opinion is, that the lymphatics are at
first affected, and the  inflammation of  the veins  occurs as a secondary con. 
538
AMERICAN FAMILY PHYSICIAN.
sequence.  And the disposition to an attack, may very likely be strength-
ened by some mal-condition of the  blood.   Scrofulous females, and those
subject to rheumatism,  cancer,  &c,  are  more subject to an  attack  of
this  affection, in  whom  it  may be brought on  by exposures to cold
compression of the nerves and  veins of the  pelvis, disease of the womb'
injuries,  &c.
  Symptoms.   Phlegmasia Dolens seldom appears before the fifth or sixth
day of confinement, and sometimes three or four weeks will elapse before
it makes  the attack.  A heavy, dull pain in  the  lower part of the  bowels
groin,  or upper part of the thigh, is first complained of, with a weak low-
spirited,  or peevish state of mind and body,  and some febrile or inflamma-
tory symptoms.   Sometimes there are no preceding symptoms, the  disease
being ushered in suddenly,  with violent  chills, succeeded by more or less
heat, and accompanied with a more or less severe pain in  the neighborhood
of the thigh.  The pain is  more violent when the thigh is extended, and
the easiest position for  the limb is a state of semiflexion ; the least motion
or pressure aggravates  the pain.   In the course of a  day or two, the pain
diminishes, and the limb commences swelling, first at the groin, and thence
gradually downwards.   The inside and  front part  of the  limb are those
which  are most apt to  swell.   Very frequently,  the  swelling  attacks the
calf of the leg first, and then  advances upward; in this case, the calf will
be hard,  swollen, and very painful.  The skin  becomes of a dead white,
aniooth and glossy, hard, very painful on being touched, and the diseased
limb is much  hotter than the other, and feels  stiff and heavy.  Pressure
does* not  leave a pit as in dropsical swellings,  except on  those parts in
which  there is no  pain,  and at  the close  of the acute symptoms.  The
patient soon becomes unable to move her leg, from absolute want of power.
In connection with this,  the whole system  suffers with considerable fever,
as small and rapid pulse, great thirst, sleeplessness, &c.  The disease seldom
attacks both limbs  at the same time,  but it is often  the case  that as one
limb recovers, the other becomes affected,  or the arm  of the same side will
become swollen and painful.  Most commonly the  breasts become flaccid,
and the lochia disappears.
  The acute stage may continue from five or six days to as many weeks,
terminating in a restoration of the  limb to its natural size,  freedom from
pain, and a  capability of using it the same as before.   Frequently, how-
ever, the disease  assumes a chronic form, in which the leg continues swol-
len and  almost useless for the remainder of life.  Occasionally, it termi-
nates in  the formation of abscesses, which, from the great drain upon the
system, ultimately  prove fatal.
   The disease may be distingidshed by its coming on within a certain time
after  confinement;  by  the pain along the front or inside of the leg; the
feverish  symptoms;  the elastic  character  of  the swelling;   the glossy,
white  appearance of the skin; the  powerlessness  of the limb; the pain
produced by  compressing the calf of the  leg,  or by slighly rotating the
thigh in its socket.  The left leg is more generally affected.
   It is a tedious disease,  and of difficult cure, though  rarely immediately
fatal.  When the pain  slowly lessens, with a slight  numbness  of the limb,
the swelling becoming softer and pitting upon pressure, and the febrile
symptoms diminishing, the case is about to  terminate favorably.  _
   Treatment.   The first indication is to  subdue  the inflammation; the
second to bring about  an  absorption of effused fluids, and establish a
healthy condition of the  veins.                                     »
   If the bowels are not already loose, they  should be purged freely; 101 
MILK  LEG.
539
which purpose the  Compound Powder of Jalap, with ten or  fifteen grains
of Cream of Tartar to each dose, should be  given, repeating it every two
or three days during  the inflammatory stage.   The bowels should  likewise
be kept free,  producing one evacuation daily, by a use of the infusion of
Lcptandra and Blue Flag, named under Typhoid Fever.
  To subdue the pain and inflammation, half-teaspoonful or teaspoonful
doses of the Compound Tincture of Colchicum may be given, every one,
two, or four  hours,  owing to the intensity of the symptoms, and  the action
of the  medicine.   From three,  to six or eight drops of the Tincture of
Aconite root, added to each dose of the above, will frequently aid materi
ally in overcoming the more severe symptoms.  In some cases a mixture 01
Tincture of  Gelseminum thirty  drops, with Tincture of Aconite five or six
drops, may be given for a dose,  substituting  it for the preceding remedy,
and repeating it every hour or two.   When the  patient is peevish, wake-
ful, and very uneasy, Sulphate of Morphia may be given as often as neces-
sary, in doses  of one-fourth or  one-half of a grain.
  Non-stimulating diuretics are very useful,  and should be freely given to
the patient,  as, a cold infusion of Haircap moss, or of Elder blows, or of
Cleavers ; or, these may be combined.
  Applications to  the  diseased limb must not be omitted.   A warm infu-
Bion of equal parts  of  Hops,  Lobelia, and  Stramonium leaves,  may be
u^plicd to the  whole limb, enveloping  it in flannel  moistened with the
infusion, and renewing it as soon  as cool.   Or,  an infusion of  Hops in
Vinegar, or  a strong infusion  of  Water-pepper  may  be similarly used.
Sometimes cold applications will answer a better purpose  than warm ones.
When  fresh  Stramonium  leaves can be had, bruised,  moistened with  hot
water, and placed over the  whole limb, they will be found to exert an almost
immediately  beneficial influence.  Some physicians have  derived great
advantage from cups or  leeches applied  in the direction of the  pain; and
others have  found  happy results to follow the application of a  blister, or
Mustard poultices to the groin of the diseased leg.  The  diet and  regimen
of the patient should be the same as in Inflammatory Diseases generally,
which see.

  In the second or  chronic stage of the disease, the bowels must be kept
regular, and  the Compound Tincture of Colchicum be  administered three
or four times a day, together with  a continuation of the diuretics.  The
Tincture of Arnica has  been found effectual after  the subsidence of the
more active inflammatory symptoms, in doses  of from twenty to sixty drops
repeated every three or four hours.
  In this stage a bandage  may be applied around the limb, enveloping it
from the toes to the groin,  but  it should not be uncomfortably tight.  It
must be reapplied  whenever it  becomes loose; and  at  these times, some
stimulating mixture as the Compound Tincture of Camphor may be applied
along  the limb with considerable friction ; or, the bandage may be kept
constantly moistened with the  same.
  In the more advanced chronic stages  alteratives should be used, as, the
Compound Syrup of Stillingia, with Iodide of Potassium; Iodine pill; or
other alterative.  The limb may also be subjected  to the action  of electro-
magnetism.   A» Compound Tar plaster  over the lower part  of the spinal
column, will be of immense service. Jn both the  acute and chronic stages
the  limb  should be kept in a horizontal position, not allowing it to hang
down.
  The diet in the chronic  stage  should  be nutritious and digestible, and 
540
AMERICAN  FAMILY  PHYSICIAN.
when debility is present, tonics, or mild  stimulating liquors may be used
as ale, porter, wine, &c, or Peruvian  bark in wine.   When ulcers occur
treat the same as directed under Ulcers.
                     NURSING  SORE  MOUTH.

  Women who give suck, or who have advanced  to the latter months of
pregnancy, are sometimes affected with a sore mouth peculiar to themselves
other females and men being exempt from it.  It is commonly termed the
sore mouth of nursing women.   The most  robust constitution, or the sickly
and delicate, are indiscriminately attacked by it;  those, however, of costive
habits, dyspeptic symptoms, and hepatic affections, seem to be  more liable
to its attacks than others.   It also attacks those disposed to consumption
erysipelas, or whose systems  have  been impaired by  the  employment of
mercurials.   The children are generally healthy and  robust, except in the
last stages when the secretion of milk diminishes.
  Symptoms.  The  disease generally comes on suddenly, the first symptom
being a severe  scalding sensation of the tongue, with pain, at times intense.
The  tongue and roof of the mouth, is of a pink color, especially in  the se-
verer instances, and there  is  a profuse watery discharge from the mouth,
extremely hot,  so much so as to give a scalding sensation to the face when
passing over it.  Any food or drink taken  into the mouth  occasions more
or less intense  pain.  After  a few days, slight  ulcerations on the tongue,
as well as about the throat, manifest themselves, and this with the scalding,
flow  of saliva, pain,  &c, will continue until the child  is weaned, or the pa-
tient has been  cured.  The  bowels are  generally costive.  When  the dis-
ease  extends into the bowels, diarrhea ensues, and the case is much more
dangerous.   It is  a singular disease,  nearly  always  disappearing  upon
weaning the child;  yet  weaning  is not always necessary, nor is  it at all
desirable, as there is always a greater disposition to a return of the disease
at every future delivery than in  those cases  where proper treatment has
effected a cure, and  restored the constitution to its usual healthy condition.
The  disease has terminated in death in three, four, or six weeks after the
birth of the child; sometimes it will not prove fatal  until  after it has oc-
curred several  times.
  Treatment.  In severe cases, if the strength or condition of the patient
will  admit, an  emetic must be administered and repeated twice every week,
continuing  it  as  long as  the symptoms  of the case, and the obstinately
torpid state of the liver require ; I prefer the Compound Powder of Lobelia.
After the effects of the emetic have subsided, a cathartic must be given, as
the Compound Powder of Jalap, Compound Powder of Leptandrin, or Com-
pound  Pills of Leptandrin, a sufficient dose of which  must be  repeated
every day or two.  When diarrhea is present, omit the physic. Internally,
the  Tincture of Muriate of Iron, may  be given in doses  of ten or twenty
drops in about a gill of an infusion of Queen of  the Meadow root, or other
diuretic, repeating it every two or three hours.  And should there be any
derangement  of  the kidneys,  with  scanty,  high-colored, and  scalding
urine,  diuretics  will  be  beneficial,  as  an   infusion  of Haircap moss.
Cleavers,  Marshmallow,  &c.  Sometimes  Canada Balsanf will  be  found
advantageous.                                                       .
   The  soreness of  the  mouth and  throat may be relieved by applying J°
them once a day, a  wash composed of Nitrate of Silver from forty  to eighty
grains, dissolved  iu a fluidounce of  distilled water.  The best period lor 
INFLAMMATION OF THE BREAST.               541
it? application will  be just  previous to retiring  to  bed, in order that the
patient may procure sleep.
  Through the day, the mouth as well as the  throat should be washed or
gar-led, several times, with  one of the following astringent mixtures, a tea-
L,onfu'l or no of which may be occasionally swallowed with advantage :—
Take of Geranium,  Blue Cohosh, Golden Seal, Solomon's Seal, each, half an
ounce; mix and make one  pint of  a very strong infusion, to which, when
strained,  add powdered  Borax two drachms, Honey a  gill.   Or, take  of
Geranium, Marshmallow,  Rosemary, Golden Seal, and  Wild Indigo  root,
each, one ounce. Prepare the same as the previous infusion.
  The body should be bathed  daily with  an  alkaline solution  rendered
stimulating by the  addition  of Alcohol or  Whisky ; and  as soon  after the
delivery as may be  prudent, the Spirit vapor bath should be administered
once or twice a week, if the  condition of tiie patient  will admit.  The diet
should be  nutritious and readily digestible;  and must not be  of  a greasy
nature, coarse, liable to occasion flatulency,  or sour stomach, or in any way
obstruct or impair  the functions of the stomach or liver.  Liquors are not
to be used, unless  in  cases  of much debility,  when wine may be allowed.
It is always advisable to cure  this affection, if possible, without weaning
the  child,  as the female is thereby rendered  less liable to  its  recurrence at
another parturient  period; but, if the symptoms continue to  increase, and
the  strength of the patient to fail, with violent diarrhea, weaning may be-
come absolutely necessary in order  to save the patient's  life.
              INFLAMMATION  OF  THE  BREAST.

  Inflammation of the Breast, or Ague in the Breast, as it is-sometimes
popularly called, is an affection frequently met with among nursing women,
and which may  take place at any period during  suckling.  It is  generally
caused by cold,  though it may be occasioned by permitting the breasts to
become distended with milk, as in  sore  nipples, or among those mothers
who  remain  long at parties, balls, theaters, &c, leaving  their infants at
home.  It may  also  follow  improper pressure on  the breasts, mechanical
injuries, &c.
  Symptoms.   The first indication is generally a chill, succeeded by more
or less feverish symptoms; slight darting pains  are felt in the breast,
which are more  painful when this oigan is compressed, and which increase
in severity as the disease progresses;  in  severe cases the  pain frequently
extends to the  arm-pit.  At the same time the  breast  swells, becoming
hard, unequal, and glossy,  but retaining  its  color.   Finally, the  skin
becomes dark-red, matter forms, the enlarged breast becomes  considerably
softer, with throbbing, and a sense of fluctuation.  The severe  pain renders
the  patient very fretful  and irritable, especially when it is  accompanied
with a constant  wakefulness, night-sweats, irregular chills, impaired  appe-
tite, debility, and emaciation.  It is sometimes a very obstinate malady to
cure.
  Treatment.  This must have in view to prevent the formation of  matter
if possible; but if the first three or four days have been  allowed to  pass
without treatment, it will be a difficult thing to prevent suppuration.  When
matter commences to form we must use  means  to  hasten  its progress;  in
from nine to twelve days it  is generally completed,   For the first three  or
four days the breast should  be bathed three times a day, with a stimulating
liniment-, as for instance,  a combination of one ounce each of Camphor, Oil 
542                AMERICAN  FAMILY   PHYSICIAN.

of Sassafras, Oil of Cajeput, and Olive Oil.
                                                                   Noap
                                        .   Immediately after this bathing
apply the following ointment:—Take of finely cut or shaved Castile  Soar
an ounce and a half, Lard one ounce, yellow Beeswax  half an  ounce- melt
these ingredients  together  by a gentle heat, then  take from the fire and
when nearly cool,  add slowly eight fluidrachms of Jamaica Spirits in which
thirty grains of Camphor have been  dissolved.   To apply it:—Cut a piece
of linen in a circular  form, of the size of the whole breast, leaving a hole
in the center sufficiently large for the nipple to pass  through.  Then par-
tially remelting this ointment, spread it  on the linen.  Apply it to the
breast as warm as  can  be borne;  in  about every four or six hours, remove it
from the breast, heat it again to make it soft, and reapply as before, havbf
every time, first bathed with the above liniment.   The female should remain
in bed, as still as possible,  and the milk must be drawn from the breast fre-
quently, by any one who can accomplish it.  The ointment thus used will
frequently check any further progress  of the disease in the course of twenty-
four hours.  Any nervous  excitability may be  lessened  by the administra-
tion of six  or eight grains  of the Compound Powder of Ipecacuanha and
Opium, repeated  every three  or  four  hours.  The bowels should be kept
regular  daily; and the infant should be fed by a spoon, or a wet  nurse be
engaged for a time.  Should this fail,  and matter form, the suppuration may
be hastened by an Elm poultice, or a bread and milk poultice placed over the
breast, and renewed frequently.  Or, if it can be obtained, fresh Pokeroot may
be roasted in hot ashes, until it is soft, then mashed, mixed with about an equal
quantity of  powdered Lobelia, and sufficient hot water  added, which may U
applied over the breast, renewing it three times a day. When the suppuration
is  completed, the severe pain will be materially diminished by permitting a
physician to  open the  abscess with a probe or lancet, and thus give free
egress to the matter.   The ulcer may be treated upon the same principle as
explained under Ulcers, which see.   The diet and regimen must be the same
as in the preceding inflammatory diseases; and great prostration of the
system may be overcome with stimulating tonics, as red Peruvian Bark and
Port Wine,  or the Compound Wine of Comfrey.
PUERPERAL  MANIA.
  Puerperal  Mania or Insanity, may occur both after abortion and deliv-
ery.   It is generally sudden in its attack, and is apt to be accompanied with
a suppression  of the  lochial discharge, secretion of milk, or both.  It may
hi owing  to irritation of the womb, or of the breasts, sudden cessation of
the lochia, tedious or instrumental labor, powerful emotions of the  mind,
cold, &c  Sometimes its causes are very obscure.
  Like ordinary mania, it may assume a raving  character, or a melancholic,
and  the  symptoms very much resemble those which  are  common  to other
forms  of  insanity.   The premonitory symptoms are various, and usually so
slight  as  to excite but little  apprehension,  as headache, excitability  of  the
nervous system, loss of appetite, or an irregular appetite,  constipation, rest-
less  nights, irascibility of temper, &c.   And, like ordinary mania, it may
continue for only a few hours, for several years,  the mind becoming sane, or
it may remain incurable during life.   (See Mania, page 371.)
  The more  excitement or fury there is displayed, the  more dangerous u
the insanity.    A violent and  unmanageable insanity, with a frequent pulse,
is apt to be much more fatal in its  results when it comes  on soon after con-
finement, than when it is manifested at a more distan* period.  Goocn says, 
NEURALGIA.
543
 "Mania is more  dangerous to life—Melancholia to reason."  This  latter
 form of insanity,  the melancholic,  is much more  obstinate and permanent
 than the furious.   When the female obtains  sleep, without being  much en-
 feebled, the pulse becoming more  regular, and  the  bowels  more  open,  the
 prognosis  is favorable;  but is very unfavorable when the bowels continue
 costive, the pulse  frequent, and the system becomes weak and emaciated.
   Trkatment.   The general treatment will be similar to that already named
 for ordinary mania, on page 373.   The bowels must be  kept regular, or as
 much so as possible, the surface of the body should  be attended to, with the
 use of a tepid or  cold douche to the head and along the spinal  column, re
 peating it two or three  times  a day.  Sometimes  counter-irritation, as con
 siderable friction, and stimulating preparations to  the back and limbs, will
 be  of much efficacy.   At other  times sedatives will  be valuable, as  the
 Tincture of Gelseminum; or the  following mixture:—Take of  Tincture of
 Gelseminum half a fluidounce, Tincture of Belladonna one fluidrachm, Sul-
 phate of Quinine eight grains; mix.  Of this, half a teaspoonful may be
 given, and repeated every hour or two, to keep up  the narcotic  influence of
 the preparation  in a slight degree.  Other medicines of a similar character
 will frequently be found valuable, as Tincture of Stramonium,  Tincture of
 Hyoscyamus,  Sulphate  of Morphia,  &c, in various combinations.   The
 principal efforts should be to calm the mind  and quiet  nervous excitability
 by the production of sleep.
   The apartment occupied by the  patient should  be kept somewhat dark-
 ened, and perfectly quiet.  A good nurse should  be engaged, one who has
 some  experience  in  the management of insane  persons;  all  weapons or
 things which might be used to  injure or destroy, must be placed out of  the
 way, as garters,  towels,  handkerchiefs, cutting instruments,  &c,  and  the
 windows must  be properly fastened.   A nourishing diet is necessary, with
 stimulants  in  case of great debility or  exhaustion.  If she be  pale  and
 anemic,  some preparation of Iron  will be very advantageous.  No person
 should be allowed to visit her,  not  even her child  or husband, until the  in-
 sanity has  considerably abated; and  even then, some care is  required in
 allowing her to take  the child in  her own possession, as it might be mal-
 treated, perhaps to a fatal extent,  should a paroxysm of insanity suddenly
 seize upon her.  As soon as the violence of the malady has become greatly
 lessened, the female should be allowed to take daily promenades and other
gentle exercise in  the open air.
                           NEURALGIA.*

  Symptoms   Neuralgia or Tic Douloureux is one of the most painful affre-
 10ns  to which the  human family is subject.  It more  commonly occurs in
the nerves of the face, though  it is met with in different parts of the head,
in the breast  side, hip-joint, and other parts of the body and limbs.  Its
attack is usually sudden, and the paroxysm of pain varies in its duration.
i lie pain  is agonizing, lancinating, and shooting along the nerves like a
shock of electricity, frequently feeling as if red-hot wires were thrust into
 no parts,  and after the pain passes away, a numbness remains for some
tune.   Sometimes, instead of attacking suddenly, it commences with a slight
heat, or sense of itching, or numbness, which augments  in severity more or
Whs rapidly.  1 he pain occurs from time to time, at longer or shorter inter-
isease should have been placed among Nervous Diseases. 
M4
AMERICAN FAMILY  PHYSICIAN.
vals, and is often  produced  by the  most trifling  causes.  If not cured the
system suffers, and the patient eventually dies, worn out from the repeated
shocks and nervous irritation.
  Causes.  The  causes  of  this  disease  are  not well  understood, though
there are strong reasons for supposing it to be in some way connected with
derangement of the digestive organs, at least  in the majority of cases.
  Discrimination.   Neuralgia may be  distinguished from rheumatism by
the intensity of the pain, its short continuance, and its liability to return on
the slightest touch; in acute rheumatism there is  fever, redness, heat in the
part affected, and some swelling, all of which are absent in Neuralgia; in
chronic rheumatism the pain is continuous, less  severe, and often worse at
night.  From  toothache, by the shortness of the paroxysm, the  rapidity of
its succession, and the frequent convulsive twitehings.
  Treatment.   The bowels must be kept regular by laxative doses of the
powder of  Rhubarb and Bicarbonate of Potassa, administered daily as stated
under Chronic Diseases of the Liver;  the skin must be bathed twice a week
with an alkaline solution;  and the kidneys must be kept in healthy condi
iion by means of non-stimulating  diuretics.  The diet must be especially
attended to, avoiding  everything  which will  oppress  the stomach, or cause
acidity, flatulence, irritation, or constipation,  or  in  any other way disagree
with the patient.
  When the disease is in  the face a Compound Tar plaster must be placed
on the head behind the ear of the affected side, and kept discharging for as
long a period as the patient can bear,—reapplying it,  after a short interval,
should the cure not be permanent.  If the pain is in any other part of the
system, the plaster must be placed  over  those parts of  the spinal column,
which are sore, tender, or painful  on pressure.
  Internally,  the  following tincture may be given in doses of twenty drops,
every two hours, in about a table-spoonful of water, continuing its daily use
until the disease is cured:—Take of Sulphate of Quinia twenty grains, Elixir
Vitriol one fluidrachm, dissolve the Quinia and add Tincture of Black Co-
hosh fourteen fluidrachms.   Or, one of the following pills may be given, re-
peating it three times a day:—Take of Sulphate of Quinia, Prussiate of Iron,
Alcoholic  Extract of Black  Cohosh, each,  twenty-four grains; mix, and
divide into twenty-four pills.
  Many other agents have been recommended, as the  external  application
over the affected part of Aconitine ; Extract of Belladonna and Stramonium,
both externally and internally ;  external use of Cyanuret of Potassium, Chlo-
roform, &c; but I have cured many severe cases by the above means.  Those
cases which cannot be cured by medicines, and which are owing to preter-
natural bony growths, affections of the brain, &c, may sometimes be relievec
by  a division of the affected nerve.
                     DISEASES  OF  CHILDREN.
  Many of the diseases to which children are subject, have been treated upon
in previous pages of the work,  and to these  the  reader  is referred, under-
standing that in those diseases common to  both adults and children, the
treatment will be the same as laid down, the  only exception being in jhe
quantity of the doses of the medicines given.  Thus, Scarlet Fever, Measles,
Chicken Pox, Thrush, Ophthalmia, Cholera-Infantum, Infantile Remittent
Fever,  Colic, Rickets,  Scald-head, Constipation, Catarrh,  Hooping-Cougb,
Hydrocele, Inflammation of the Mouth, Milk Scall, Convulsions, &c, will be 
ATTENTIONS  AFTER  LIRTH.
545
found described on other pages, for which see Index.  In  the  present place
I shall briefly refer to a few difficulties more common to young infants,  and
their management.


                  ATTENTIONS  AFTER  BIRTH.

  After the expulsion of the after-birth the female is bandaged  and " put
to bed " as soon as possible, unless her fatigue or enfeebled condition require
some rest  before  this  is  done.  In the meantime,  while the physician is
attending to the state of the mother, the child is  taken from its place of
deposit, and if not too weak, is washed and clothed.   Every part of the sur
face of the child's body and limbs should be  first smeared with fresh lard,
oil,  or other unctuous matter, which will facilitate the removal of the creamy,
suet-like substance with which its skin is coated at this time,  and which 13
called " Vernix Caseosa."   This being done,  the child should  then be care-
fully washed with lukewarm  water and Castile soap; for  if the above-men-
tioned creamy substance be not thoroughly cleansed from the skin in one or
two washings, eight or ten hours apart from  each  other,  it  may  occasion
either chafings, or some disagreeable affection of the skin.   During the pro-
cess of washing, as well as in  drying the surface,  great care should be taken
not to injure the skin of the infant.   Some persons wash the child with cold
water, but this is very improper,  being often followed by fatal consequences,
even among the most robust constitutions.  An infant just born  has left a
place, the temperature of which is considerably above that of the atmosphere,
find to create a new influence  upon its system,  by a sudden diminution of
this temperature, must be followed by serious results; the  shock  would be
almost too great for even an  adult.   Having  dried  the  child,  the  cord, or
navel-string, is to be attended to; a soft, fine, square slip of linen, greased
with tallow,  may be wrapped around it;  or,  a hole of sufficient size may be
cut or burned in the center of the linen, through which the cord  is passed;
then laying  the cord a little to the left side in order to prevent it from press-
iivg upon the liver, another soft square of greased linen is placed upon it, and
the whole  is then secured by a bandage, surrounding the child's body.   This
bandage, called the " belly-band" by nurses, should not confine the belly too
closely.   Before dressing the cord, as above stated, should any  drops of
blood be observed to flow from it, it must have a new ligature applied  just
below the  first.  The cord is  usually inspected by the  nurse whenever she
washes the child, until it conies off, which may happen in from three to fen
or twelve days.  The dress of the child, which is applied after having dressed
the cord, should  be adapted to the season, light and loose, so as to  admit of
a free play of the limbs.
  If the condition of the mother will permit,  the  child, after its dressing,
should be  allowed to suck, for it will frequently happen  that  the  milk  will
flow in abundance;  but should it refuse the breast, or be able  to  obtain no
milk upon sucking, it should not be fed for at least some three  or four hours,
unless it be very fretful, and then some fresh cow's milk to which  about one-
third part of water but no sugar  has been added, will be  all-sufficient,  until
the breast-milk flows, when no other food must be permitted.
  The black substance collected in the bowels of the child before  birth, is
called '• Meconium," and should be removed  as soon as possible,  else it will
give rise to colicky pains, Ac.   The milk which is  the  first secreted in the
breast after delivery, is superior to any medicine for  purging away the meco-
nium ;  if  the child, from any  cause, cannot  obtain  this  milk  within five or
       85 
546
AMERICAN  FAMILY PHYSICIAN
six hours after its birth, a teaspoonful of Castor Oil, or two teaspoonfuls of
Sweet Oil may be administ^ed for this purpose.  Never give molasses and
water,  nor  that  detestable mixture which  some persons advise,  urine and
molasses.  As before said,  the infant's dress should be  light,  comfortably
warm, and sufficiently loose for the limbs to be readily moved about; a hi<di
necked  dress should always be worn for the first two or three weeks  even&in
summer, and caps are useless and  calculated to do  harm.   The diapers or
napkins must be pliable and of an absorbing  nature, and  should never be
allowed to dry upon the child and become rough and  rigid with the salts
left after the evaporation of the watery part  of the urine, as they will  thereby
ehafe the parts.  Allowing the child to remain with a wet  napkin about it
exposes if to distress  and cold; and the repeated application of the  same'
diaper without washing it, merely  hanging it up to dry, is very apt to irritate
and excoriate those parts of the infant over which it is placed.   There can
be but two reasons for this filthy practice,—laziness  or poverty.
  When the child  does not pass urine within a reasonable time after birth
or the urine is quite deficient in quantity,—the urinary organs being  perfect,
not needing any surgical interference,—Garlics or Onions bruised and placed
over the region of the bladder, will generally induce a copious discharge of
urine;  and this may be further promoted by the use of mild diuretic infu-
sions, as of Marshmallow, Parsley root, Pumpkin seed, Watermelon seed, &c.
  The  mother's milk is the food naturally intended for the infant, and is
decidedly the best; no other is required for at least six or eight months after
birth, where a good supply of  it is furnished.  The various paps, cordials,
and other mixtures  so frequently given to infants by ignorant nurses, is
almost certain to produce various unpleasant,  and even serious maladies, as
flatulent colic,  looseness of the bowels, ulceration of the mouth, convulsions,
&c; parents cannot be too  careful in  this  matter.   When  from  any good
and proper cause the mother cannot give suck to her child, a wet-nurse must
be obtained.   One should be selected whose child is about the  same age as
the one she is to suckle, who is of good  temper, not liable to fits of passion,
free from any vicious propensity,   not  exposed to any trouble or anxiety of
mind, of good health,  with clear,   sound skin, perfect  teeth, clean  mouth,
moderately sized breasts, firm, not  flabby, and  a  prominent nipple, not too
large, and whose milk is thin,  clear, very limpid, sweet, of a bluish-white
color, and, if allowed to stand for awhile, covered with cream.  Great  care
should be taken to learn that she  is cleanly  in  her  person,  and not  tainted
with any disease.   And it should  always be stipulated that,  if the child  does
not thrive upon the milk of a wet-nurse,  her engagement is at an end.
  If a wet nurse cannot be obtained, the infant will have to be "raised by
hand,"  or by artificial feeding.   Over  one-half of the children attempted to
be  brought up this way, die quite  young.  Cow's milk is the best substitute
for the  mother's milk, and it should be always obtained from one  cow only,
and be  fed to the child in as fresh a state as possible ; the older the milk,
the more it becomes unfit for the  child.  The milk may be diluted with one
half or one-third its  quantity  of  water,  and be fed to the child, warm, and
without the  addition of sugar, or  if sweetening at all is required, let it be
with sugar of milk, which can be  had at any respectable drugstore.  Oidi-
nary cane sugar should  not be given to infants, it is  injurious  to them,
frequently occasioning diseases which  are difficult to remove, and  thecau&e
of which is unsuspected.  A chemical examination of cow's milk will no
it to contain nearly the same proportion  of sugar as the human milk;  hence,
there is no  necessity for increasing its sweetness,  and especially, by can
sugar.   In giving  the child its artificial  food, it should be attended to wi» 
ATTENTIONS  AFTER BIRTH.
547
 regularity and punctuality, feeding it only at certain hours, and permitting
 it to suck the  fluid from a  bottle instead of pouring it  down  the child's
 throat with  a spoon.  The act of sucking causes an increased flow of saliva
 in the child's mouth, which materially aids in the digestion of its food ;  in
 pouring from a spoon, the flow of saliva  is limited.
   An  infant should be washed all  over with  soap  and warm water every
 morning; cleanliness of its person, and  of its clothing, is a very important
 measure to secure its health and comfort.  After washing, those parts which
 are liable to friction, as the arm-pits, buttocks, folds of the groin, creases
 of the neck, &c, should be well dried and then dusted with powdered starch
 to prevent chafing.  A little  pomatum rubbed  on the head at night, and
 washed off on the  next morning, and continued daily, will remove the scurf
 from the head  much better than a comb, which irritates and increases the
 difficulty.  This course of cleanliness will prevent diseases of the skin, and
 of the  scalp.   The dress should always be loose and  comfortably warm, and
 exercise, talking and laughing with the  child,  walking with it in the open
 air frequently in fine weather, are all advantageous.  Be careful, however,
 not to lift or toss the child too violently, or carelessly, as great mischief
 may result;  never lift it by its arms,  lest  dislocation or fracture be produced.
 All the contrivances of the present  day  to have the child walk at an early
 period, are  unnatural and  injurious, causing deformity of the limbs and
 body.   The muscles of the back must be strengthened, as well as those of the
 limbs, before the  child can walk firmly  and  erect, and this can be accom-
 plished in no way  so perfectly and naturally as by allowing it to creep.  Yet
 to avoid trouble, and prevent the child from soiling its clothes, some parents
 appear to  be willing to sacrifice its goodly proportions.
   The sleeping periods of an infant should  be properly regulated, so that
 it may be accustomed to certain  hours  for sleep, as well as for food.  It
 should be so arranged that once or twice nursing it during the night will
 be sufficient: if this be done, and the child  be kept cleanly, and properly
 exercised  through its waking  hours  during the  day, it  will not be restless
 nor fretful,  unless it be sick or in distress of <some kind.  Accustom  it as
 much  as possible  to regularity in every thing, washing, dressing, feeding,
 exercising, sleeping, &c.  And when it  appears to be  restless or wakeful,
 do not dose  it with Godfrey's Cordial, Laudanum,  Paregoric,  hot Gin sling,
 &c, which though they produce quiet and sleep, do it at the expense of the
 health, and sometimes even the life of the child; but ascertain what is the
 cause,  and use means to  overcome  it.   Frequently, placing  it in a warm
 bath for a few minutes, will soothe it, and cause it to fall asleep.
  The  child, as a general  rule, should  be weaned  at  the  ninth or tenth
 month, except it be unwell  or suffering from  teething, at which times it
 must not be weaned.  Winter  and summer  are inconvenient seasons for
 weaning, spring and autumn are the best periods for this purpose.  Suck-
ling continued beyond the twelfth month, is unnecessary for the child, and,
in most cases, positively injurious  to the mother ;  too long nursing is apt
to occasion a tendency to diseases of the  brain  among children.  Previous
to attempting  to wean the child, it should be prepared for the change by
being fed occasionally with such food as it is  to subsequently be a partaker,
of. 
548
AMERICAN  FAMILY PHYSICIAN
         EXTERNAL SIGNS  OF  DISEASE  IN INFANTS

   Beside discoloration of the skin, tumors, flaccid abdomen, swollen abdo-
men, increased heat of the body, &c,  there are certain symptoms which in-
dicate disease in infants, to which attention will be briefly called.   Thus a
permanent dilatation of the pupil of the eye, with a livid tint of the coun-
tenance, and a flaccid condition of the face, is usually an indication of effu-
sion, or water on the brain.  Squinting  occurring suddenly, manifests
danger, more especially when other  symptoms are present; when it occurs
gradually, without other symptoms,  it may be owing to worms, or derange-
ment of the  digestive organs.  When the pupil  of  the  eye  is very much
contracted, with the eye half-closed, a red, streaked condition of the white
of the eye, and the  eyebrows knit or  frowning, it is an  indication of some
active inflammation  of the brain;  and, in  hooping-cough, the permanently
contracted or dilated  condition of the pupil, shows that the brain is about
to suffer.  Convulsions may  be expected, when  the eyeball  is  fixed and
turned  upward, the  eye bright and glassy, and the pupil dilating and con-
tracting.  A hollowness of the eyes, with a dark  circle around them, is an
evidence of great  debility.  Any  peculiar and not usual movement about
the nose and lips,  is an indication of disease about the chest and abdomen.
A transient swelling of the nose and upper lip, is  common when worms are
present, or when there is  irritation of the bowels; but  if the swelling  be
permanent, it may be  an  indication of a scrofulous diathesis.   When the
nose is pinched or drawn in during respiration, the mouth being open, and
the lips sometimes livid  and puckered, there is  some  obstacle to the free
passage of air to the lungs.   When the inside of the nose is dry, the lips
pale and cracked, and especially if there are spasmodic motions of the lower
jaw, the brain is in danger of an attack of disease.   In acute bronchitis, tho
face is remarkably pale, but becomes more or less livid  in the latter stage,
especially if  about to terminate fatally.  In  infantile remittent and typhus
fevers, the face is  constantly flushed, becoming pale and shrunken toward
the termination of the disease.
   When one  limb  is  unusually quiet, or  is  moved  by  sudden  jerks, it is
probably the seat of pain ; when the legs are forcibly drawn up toward the
belly, there may be pain or inflammation of the bowels;  if the body be dou-
bled up, it is an indication of pain  or inflammation in the chest.   Spas-
modic contraction of the  muscles of the face, neck, limbs, fingers, or toes,
may be the premonitory sign of convulsions from irritation of the brain,
and may be met with during the cutting of teeth.  Painful dentition is also
often accompanied with acid  stomach, and diseases of the skin.  Palsy of
the limbs may occur during  teething, irritation of the  stomach, or,  on the
decline of fever, it may likewise depend on disease of the brain or spinal
marrow.
   Crying is not always a  manifestation of pain, except when severe, sharp,
and long-continued.   Fretting is always a sign of uneasiness ; it may arise
from fatigue, want of sleep, want of food, too much  food on the stomach,
irritation from pins, bandages, &c.   Long-continued fretting indicates some
commencing disease, and should  be at  once attended to, especially, when
there is also a frequent disposition  to doze, or to short sleep, from which
the child starts suddenly on the least'noise or motion.  Protracted, shrill,
and piercing screaming, manifests pain, or inflammation at an early period
of the attack; when the  organs of* breathing are attacked, the  screaming
will be  by fits and starts.   Moaning i3 a symptom of pain accompanied with
debility or depression ; when it is preceded  by deep sighs, there is a ten- 
INFANTILE DISEASES.
549
dcncy to effusion on the brain ;  when the legs or body are drawn up in ad-
dition, there is suffering in the stomach and bowels ;  and when  the moan-
ing follows violent and shrill screaming, with extreme languor and stupor,
the case is very dangerous.
  Wakefulness  is an indication of irritation of the  brain, or of great ex
haustion.  Starting during sleep is usually connected with worms, irritation
of the bowels, or indigestion.  Intolerance of light and tossing of the head,
is symptomatic of pain in the head.  A short, catching inspiration, with
more or less cough,  and an expression of pain or suffering on the counte-
nance, at each inspiration, is an evidence of inflammation of some of the or
gans of the chest. A pale countenance, and wheezing and laborious breath-
ing, is a symptom of acute bronchitis.  A spasmodic cough is usually a
mark of some affection of the brain ; a cough with mucous expectoration is
of the lungs or bronchia; a dry and irritative cough arises from  disordered
stomach ; and a crowing sound directs us to the larynx, as in croup.   Cough
with a hollow sound denotes irritation of the stomach or bowels, worms, &c.
Panting, or quick breathing will point out the  lungs  as involved; palpita-
tions,  the  heart; constipation or  diarrhea,  the bowels; nausea  or  vomit-
ing, the stomach. When the discharges from the bowels are ash-colored
or clay-colored, it is an indication of deficient bile, or an obstruction to its
regular  flow into the intestines.   When they are liquid, and of a bright
green color,  a great  amount of acid is in the bowels.   Bile is never green,
but yellow, and  however dark  the stools may be containing bile, if water
be added, a yellow color will be communicated to it.
                      INFANTILE  DISEASES.

  Red  Gum (Strophulus Intertinctus)  is a  disease of the skin, usually
appearing within four or five days after birth.  It consists  of minute red
points or elevations, occurring in irregular patches, and which pass off in a
few days.   Sometimes yellowish  vesicles are formed, and a slight ulceration
of the skin may follow.   It is not a dangerous affection, and appears to be
owing to the stimulating action of the atmosphere upon the skin, to the
stimulus given to the  blood by its  augmented  oxygenization, and to the
efforts to relieve  the  alimentary passage.  It seldom requires any  treat-
ment.   It is customary to give the child an infusion of Saffron and Catnip,
which cannot be  objected to  as it does no harm.  It is well enough to dust
the skin often with powdered Elm, Starch, Arrowroot, &c.; and should the
liver, stomach, or bowels appear  to be  disordered, the Compound Syrup of
Rhubarb and Potassa in small, laxative doses will usually effect the cure.

  Jaundice, or Yellow Gum, is  an  affection occurring in the first days of
the  infant.   A dull yellow tinge, frequently extending over  the whole sur-
face of the skin, nails, and eyes; and  even to the urine, which imparts a
yellowish stain to the napkins.   This may be  owing  to a  slight torpor of
the  liver, or some transient obstruction of the bile ducts, and is rarely of a
serious nature.  An infusion of  Catnip and Saffron  is the  usual remedy.
Sometimes, there  may be fever, with light, or ash-colored stools, in which
cases, the  Compound  Syrup  of  Rhubarb and Potassa  will generally  be
found efficacious; or  an infusion of the Leptandra root.   Occasionally,
jaundice of a dangerous character occurs during  infancy, which is due to
actual disease of the biliary organs, and must  be treated  as  named undei
Chronic Inflammation of the Liver. 
550
AMERICAN FAMILY PHYSICIAN.
  When there is a Rupture of the Navel, it is termed "Umbilical Hernia "
and  may appear at  any period of infancy, being  caused  by any kind  of
straining, as from flatulent colic, excessive  crying, violent coughing sneez-
ing,  &c.   Any delay in treating it increases  the difficulty of cure.  The
operator, having the child lying on its back,  with the legs drawn  up to-
ward the belly, so as to relax the abdominal muscles, will gently press tho
projecting swelling within the  umbilical orifice,  then  apply a pad or com-
press of sponge covered with linen, and keep it in its place  by a strip  of
adhesive plaster and  a bandage.   The pad  should be of a conical shape
and may be made also of linen filled with bran, or a properly shaped piece
of cork covered with soft linen.  This must be worn until  the difficulty is
removed.   In  obstinate cases,  an "umbilical truss" may be  required.
Those made by Mr. Marsh  of New York, and  those  made  by Mr. A.  J.
Howe, of Cincinnati, will be found equal to any.   The bowels of the child
should not be allowed to become constipated.

  Excoriation op the Navel yields to cleanliness, bathing it with Cas-
tile soap and water, and then applying to it the mild Zinc  Ointment; or,
the ointment named  in the Introduction  for  blistered  feet, on page 143.
Should a disposition to mortification be manifested, powdered Sulphate  of
Zinc, or its solution in water, may  be  placed upon the  part, and covered
with a bread and milk, or Elm poultice ; and tonics, as  infusion  of Peru-
vian bark, Colombo, or Gentian, &c, should be given to sustain the child's
strength.   A poultice of powdered Marshmallow root, Wild Indigo root,
and Charcoal, equal parts, mixed together with a  weak solution of Sulphate
of Zinc, will frequently arrest gangrene.
  When the Cord bleeds, as before stated, place another ligature imme-
diately below the one first applied.
  Sometimes, there will be a Bleeding prom the Navel,  after the navel-
string has, fallen off; constant compression  with  lint dipped into some
astringent infusion, will in a few  days  overcome this.  However, should
there be "proud flesh" sprouting forth, powdered burnt Alum, or Sulphate
of Zinc may be sprinkled upon it, or even  the  Sesquicarbonate of Potassa,
after which dress the  part with the mild  Zinc Ointment, or Red Oxide of
Lead plaster.  Inflammation must be allayed by an Elm  poultice.

  Children have sometimes  a swelling of the  breasts after  birth, owing  to
cold, injuries, or a  milky secretion;  the  breasts  frequently become very
hard.  A mixture of three parts of  Olive  Oil, and one part of Tincture  of
Camphor, rubbed over the affected  breast,  and followed  by Mullen leaves,
or St. John's wort flowers, in fomentation,  or a poultice of Elm, if there  be
much inflammation, will generally effect a removal of the  difficulty.  Should
ulceration be produced, treat the same as an ordinary ulcer. 
PAET    II.
               SURGICAL   DISEASES.

  Under  this head will be  considered several  accidents and diseases of
common occurrence, which  have heretofore  been assigned to the depart-
ment of the surgeon only, and which have  not  been treated upon in a pre-
vious part of the work.  I shall not enter into any unnecessary disquisition
upon these subjects, as it would prove of little or no interest to the general
reader, but will at once proceed briefly to recommend measures that may
be pursued for the relief of persons, who cannot  readily procure the aid of
a surgeon.
                GANGRENE,  or  MORTIFICATION.

   By Gangrene, or Mortification, is  meant the death or decomposition of
 one part of the body, while the remaining parts continue to live in a more
 or less  healthy condition.   When the  part  has  become  motionless, cold,
 without any feeling, and of a livid or dark color, it is  called sphacelus ;
 the term gangrene is applied to the first or incipient  stage.   Mortification is
 one  of  the terminations of active, inflammatory diseases, as well  as those
 of a passive, debilitated character ; thus it may follow violent inflammatory
 affections, burns, intense cold, caustic applications, severe wounds or inju-
 ries, compression on large bloodvessels, scurvy, dropsy, ossification of the
 arteries, &c.
   Symptoms.  When it follows inflammation of the external parts, the symp-
 toms are about as follows:—The pain is excessive, the inflammation exten-
 sive, and frequently there is delirium; the  pain finally ceases, the  part be-
 comes flaccid, loses  its heat and sensibility,  and is of a dark, livid color;
 the skin is raised in various parts like blisters, of a brown color; the blood
 coagulates in  the vessels  of the  mortified part, and the circulation is de-
 stroyed ;  the part soon becomes black, and emits a fetid odor.  In connec-
 tion with this the system is  very apt to suffer, the  pulse  becomes quick,
 very small  and thready, and  often irregular; there is an irritative fever;
 a fixed flush on the countenance; great  anxiety ; prostration  of strength;
 sometimes a slight delirium; vomiting;  hiccough; and death.
  Old persons are subject to a kind of gangrene which is termed dry mor-
 tification;  it commences  in  one or more of  the toes or foot, and passes to
 the upper part of the leg, destroying-all  the parts attacked  by it.   In this
 form, unlike the previous, the  diseased parts  are dry and hard, and not so
subject to  putrefaction.   Persons who are very much debilitated by disease,
 or intemperance, are seldom cured of this complaint; while on the other
 hand, those of ordinary health may be cured by proper treatment.
                                                         (551) 
552
AMERICAN FAMILY PHYSICIAiT.
  Treatment.   Means must be used internally to  sustain the strength of
the patient, as a decoction  of Peruvian  bark aided by a nourishing diet •
if the debility be very great, Wine may be administered, as Port Wine and
Peruvian bark, the Compound Wine of Comfrey, or Carbonate of Ammo-
nia, &c, being careful  not to administer these stimulants as long as any
inflammatory symptoms remain, and the pulse is strong.
  Local applications must  also be used;  thus, a poultice of Elm  bark to
which  some Yeast and Charcoal  have been added, will be found very effi-
cient  in correcting the fetor, and arresting the  gangrene.  As the sur-
rounding parts are subject  to destruction  from the extension of the gan-
grene,  it will  be well to  add  some gentle stimulus to  the poultice for the
purpose of supporting their action—and for  which Brandy, Port Wine
stale Beer, &c, may be used.   A poultice of Elm  bark and Pyroligneous
Acid  has  promptly arrested gangrene; or, pulverized  Marshmallow root
may be used as a substitute for the Elm  bark.  A mixture  of powdered
Black Cohosh root and Wild Indigo leaves or root, used as a poultice, or,
scraped Carrots and Indian meal, have been used with  much  advantage iu
cases of gangrene; likewise  the  following :—Marshmallow, Wild  Indigo,
Charcoal, and Yeast; and also  Black Willow bark,  Wild Indigo, and But-
ton Snakeroot.  Sulphate of Zinc, in powder, placed over the affected part
has been found very beneficial.
  When the further progress  of  the gangrene has  been arrested, and the
dead parts are about to separate  from the living, the  first indication is a
white line at the  verge of the sound part, the skin is elevated at this line,
and separates, the dead from the living, in a few  days;  after which the
various decomposed tissues  slough  away, leaving  a healthy, suppurating
ulcer, which must be treated as a simple ulcer.
  In dry mortification, beside the above local applications, much benefit
will be derived  from  the  internal use of Peruvian bark, or  a pill of Sul-
phate of Quinia and Opium, and Carbonate of Ammonia.
                              WOUNDS.
  Wounds are  divided  into several classes, according to the instruments
producing them; thus,  a simple incised wound, occasioned by a sharp, cut-
ting instrument;  a  lacerated, and  contused wound, effected by a rough in-
strument, as  a  saw, ox club; a punctured wound, when it is the result of a
sharp pointed  weapon,  as a sword, bayonet,  &c;  a gunshot wound, when
occasioned  by the explosion of gunpowder;  and a poisoned wound, inflicted
by some venomous animal  or  insect.  Wounds  of arteries, large veins, of
the abdomen, chest, throat, of joints, and tendons, should always be treated
by a medical  man; though bleeding may be arrested until his arrival, by
the bystanders  using the plan  named below.
  Treatment.  The most favorable kind of wound is the simple incised,
and in  its  treatment  three things  are to be observed, viz:—To check the
bleeding as soon as possible; to remove from the wound  all dirt or foreign
matters ; and to bring  the parts  properly together and  have them remain
so.   When the bleeding is rather profuse, it may be checked by a steady,
continued pressure made upon the surface  of the  wound with a finger, a
soft piece  of sponge, soft lint, or a piece  of linen; and, frequently, the
arrest of the  bleeding may be  facilitated by moistening  the compress with
some astringent, as a solution  of Tannic Acid, or of Alum, or a  decoction
of White Oak bark.  When the bleeding has ceased, any coagulated blood, 
WOUNDS.
553
 dirt pieces of glass, &c, must be sponged away from the surface and edges
 of the wound, the edges brought carefully together, and strips  of adhesive
 plaster applied across  the wound in such  a  manner as to hold the edges
 together, and, if necessary, securing the whole by light bandages.   When
 the wound is extensive, or is made in some part of the body very difficult
 for the adhesive  plaster alone  to  hold the parts together, a few stitches
 will have to be taken.   Simple  incised wounds  usually heal readily, with-
 out any matter being formed.   The part should be kept quiet and cool, and
 should not  be  disturbed  for three  or four days,  when, if necessary, th
 dressing  may be removed ;  but,  in large wounds,  it  will be  better  t
 allow it to remain  a few days longer.   The applications of Balsam^ Tur-
 pentine, Salt and Vinegar, Rum and Sugar, &c, to incised wounds, inter-
 fere with  the healing  of the wound by causing undue inflammation, and
 should, therefore, never be used.
  It is frequently the case, in wounds, that some  large bloodvessel is divided
 or lacerated, and which from  the  continued discharge of blood, causes con-
 siderable difficulty as well as  delay in the treatment of the wound.  When
 the bleeding is  from an artery, the  blood  is  of a  bright scarlet  color, and
 gushes out by jets in  a rapid manner; when  from a vein the blood is of a
 dark purple red color, and flows in an  even, unbroken stream.  If it be a
 vein which is divided, unless very large, the flow of blood may be arrested
 by gentle pressure, effected with a compress and bandage.   If it be a di-
 vided artery from which the blood is gushing,  and especially if  it be a large
 one, a ligature will  have to be placed around it by a surgeon,  for no other
 person should attempt  such an  operation.  But  as  the patient may bleed to
 death before the arrival of the surgeon, it is  proper  to  state what may be
 done to check the bleeding, and thus  save his life, for a few minutes delay in
 a case  of this kind,  often proves fatal.  The person wounded, or some other
 person present, should  make  firm,  and if ne-
 cessary, powerful pressure  on  the  artery, just
 above  the  wound,  and always between the
 wound and the heart.  The pressure may be
 made with the thumbs, the ring of a key, or
 other solid substance.   The position of the
 artery may be ascertained  by observing the
 direction  from which the  blood gushes,  and
 if the wound be  deep, as on a limb, firm  and
 powerful pressure, so as to feel the resistance     Arresting Hemorrhage.
 of the  bone underneath, may be  required.  If the bleeding continue, the
 pressure is not upon  the artery, and  its  direction must be at once changed.
 As  soon  as  possible a strong bandage, or  a twisted handkerchief, must be
 applied round the limb, and  as before, between the  wound and the heart, for
 on any other part it would be useless; after this has been fastened around
 the limb, a stick  may be passed through it, with which it may  be twisted
 and  tightened  sufficiently to
 check the hemorrhage until the
 artery  can  be secured with
 ligature ;  in some cases, a com-
 press  will have  to   be placed
 over the  artery,  between  the
 bandage and  surface  of  the
limb.   By this means  a man's              Arresting Hemorrhage.
life may be preserved for hours, in  places where physicians live at a distance,
and cannot be immediately had.   It is not  proper,  however, to apply such a
ligature to a divided  vein.
Fig. 42
Fig. 43.
 
554
AMERICAN FAMILY  PHYSICIAN.
 ^ Lacerated  Wounds  are  accompanied with  much  less bleeding than
simple incised wounds;  the largest arteries may be torn without any severe
hemorrhage taking place, but the danger lies in subsequent or secondary
hemorrhage.   They are generally followed by great inflammation and sup-
puration, and  do not heal very kindly.  Chills, spasms, lockjaw, and erysi-
pelatous inflammation, are not uncommon effects of laceration.  The treat-
ment is somewhat similar to the  preceding:  the wound must  be  carefully
cleansed from  all foreign bodies,  and the torn parts brought together as
nearly and  as  perfectly as possible, and held thus by  straps of adhesive
plaster, or stitches and plaster; but too many stitches are to be avoided as
they will  aid  in  augmenting the  subsequent inflammation.   Any  great
amount of inflammation may  be lessened by a poultice of Elm, of Elm and
Lobelia leaves, &c, and sometimes by the application of Tincture of Arnica
or of St. John's wort.  In many instances a cloth kept moist with cool water
will  answer every purpose.  If, however, the parts  show no disposition to
unite, it will be better to  remove  all adhesive  straps, allay inflammation as
above, and apply the red Oxide  of Lead plaster  over  the  wound.  The
bowels must be kept  open, constitutional symptoms met according to their
nature, together with a cooling regimen.  If gangrene manifests itself, treat
as recommended for this,  on page  552.   Any fungus or proud flesh may be
kept down by sprinkling on it some Sesquicarbonate of Potassa, or powdered
Bloodroot.
  Contused Wounds are frequently very obstinate, and are apt to occasion
much pain when not severe,  and but little  or no pain when very severe,
because in the  latter instances, the injury has been so great as to destroy
the sensibility, if not the  organization, of the part wounded.   The principal
danger lies in the presence of excessive inflammation, followed by mortifi-
cation, &c.
  Treatment.  In slight bruises the Tincture of Arnica, or of St. John's
wort, may be  kept constantly applied on the part by means of lint, or a
piece of linen.   When the wounds are severe,  and there is considerable ex-
travasation of blood, as known by the  large purple or dark colored spots,
leeches applied over the spots  at an early period will lessen the tendency to
severe inflammation and expedite  the cure.   The rest  of the treatment will
be similar to that named for lacerated wounds.
  Punctured  Wounds are not  always  injurious, as much will depend on
the  state and disposition  of  the constitution.  Thus, one person may he
pricked with a pin from which  no unpleasant  results will  follow, while a
similar wound  in  another will occasion  lockjaw.   This class of wounds are
dangerous on account of their depth, injury to bloodvessels, nerves, or vital
organs, and the degree of inflammation they  occasion.
  Treatment.   The hemorrhage must  be  checked,  foreign bodies  re-
moved  if any  have been  left in, and inflammation kept down by cooling
applications, leeches, &c.   The edges of the wound should be kept separated,
being careful to heal the wound along from  the bottom first, and not at the
external part of it, so that if the wound should suppurate, the matter may
be  discharged  through the external opening.   The patient must be kept
perfectly quiet, and when the  pain is severe, a pill of Opium, or a dose of the
Compound Powder of Ipecacuanha and Opium, may be administered.  Any
matter that forms must be evacuated as quickly as possible, so as to avow
an  extensive abscess.  It will sometimes be  necessary,  when the wound is
not in the vicinity of any important vessels or organs, to enlarge  the open-
ing with a lancet, and thus convert the cut into a simple incised wound.
   Gunshot Wounds vary much  in their effects upon  persons, some suffer- 
WOUNDS.
555
in- but little and recovering even when  the wounds are considerable, while
others will  suffer  much, and  even die  of lockjaw from  apparently  slight
wounds.  They frequently require amputation of the injured limb in order

l° Treatment.  When amputation is not demanded, the wound should be
examined, and if possible, the ball, shot, pieces of clothing, &c, which have
been forced in, must  be removed.  There is no necessity however, for being
too anxious about removing the ball, &c, particularly when it is so situated
as to be almost impossible  to  take hold of it; for it may be discharged by
subsequent  suppuration, or, as has frequently happened, it may remain in
the flesh without being  at all incommodious.  After cleansing the wound,
inflammation must be  kept down  by cooling applications, Elm poultice, &c.
The  patient must be  kept quiet,  and in  other respects treated the same as
named for punctured wounds.  Be careful never to enlarge a gunshot wound
by cutting it, or by the introduction of  tents.  After suppuration has taken
place  support the strength by Peruvian bark, nourishing diet, &c, and be
ready to arrest  any bleeding which may occur from subsequent gangrene,
or destruction of the exposed portion of some large bloodvessel.
  The most common among Poisoned Wounds are the bites and stings ot
insects and snakes.   The bite of a rabid animal  has already been treated
 n
  Treatment.   The  bite of a gnat, wasp, hornet, bee, spider, &c, may be
treated by applying a poultice of  equal  parts of Elm bark and Lobelia
leaves with ley water, to the  affected part, renewing it three or four times a
day, and at each time  bathing  the part in some  ley water for ten or  fifteen
minutes;  if the pain be very severe, a few drops of Laudanum may be added
to the poultice.   Other articles have also been found to answer, as the ap-
plication of the  cut surface of a raw onion or garlic to the wound, changing
it every fifteen  minutes; a poultice  of Plantain  leaves,  common salt, and
water of  Ammonia, has likewise been successfully employed, as well as
smearing  the part with  Olive  Oil.  When a bee, wasp, or hornet stings, it
not unfrequently happens  that a part  of the sting remains in  the wound,
and which should always be carefully pulled  out with a pair of tweezers.
   The bite  of the viper as well as of the rattlesnake is very dangerous, and
especially that of the latter.   As soon as bitten, a  ligature made of twine or
handkerchief, bark, &c, must be placed around the limb or part, if the  situ-
ation will admit  of it, between the wound and the  heart, so as to prevent the
blood circulating from  the wound to the heart;  this ligature must not be too
long continued.   Then wash  the  wound freely with Aqua Ammonia,  or it
may  be cauterized by Caustic Potash, Nitrate  of Silver, or  hot iron. If
symptoms of depression  come on,  Brandy may be given, or Whisky, Brandy
and Sweet Oil, Brandy  and  Ammonia, &c; a peculiarity  attending those
who have been bitten by poisonous snakes is, that  alcoholic drinks, even in
almost inconceivable quantities, not only cause no intoxicating influences,
but tend powerfully to restore the patient from the dangerous effects of the
bite.   Many articles have been  recommended as  antidotes to snake bites,
among which are the Bellwort, Uvularia  Perfoliata, boiled in milk, and the
decoction  drank  freely, with a poultice of the root applied to the wound; an
infusion of the Rattlesnake Violet, Viola Ovata;  Lion'sFoot, Nabulus Albus,
in decoction; Button  Snakeroot, Liatris  Spicata; Hawkweed, Hieracium
Venosum; Net-leaf Plantain,  Goodyera Pubescens; Water Eryngo, Eryn-
gium Aquaticum; False Aloe, Agave Virginica, &c.   Many of _ these,_  how-
ever, have fallen  into disrepute, but whether from  the result of impartial in-
vestigations, or improper prejudices, I am unable to say.   Undoubtedly, the 
556                 AMERICAN  FAMILY PHYSICIAN.
Indians, who previous to the settlement of this  country by the whites wer
daily exposed to the bites of the rattlesnake, adder, &c, must have known
and used some antidotes, notwithstanding what  may  be said by  prejudiced
persons at this day.
  The Anemone Cylindrica of Gray is used by the Indians for the cure of a
rattlesnake bite.   Their mode of using it is, to chew some of the tops of the
plant,  swallowing  but  little  of the  saliva,  and then applying it to the bite
soon after its occurrence;  it a few minutes the poison is rendered harmless
When chewed the tops  havo a hot, pungent taste, somewhat like Capsicum!
  The absorption  of the poison  may also  be removed by cupping in the
ordinary way, and afterward applying Aqua Ammonia to the part, or a solu-
tion of Sesquicarbonate of Potassa.
FRACTURES.
   When a bone is broken it is said to be fractured, and which is commonly
caused by blows, or similar  accidents.  If the  bone is  broken into two or
more pieces,  without any external wound, it is called a simple fracture; but
where, in addition, there is an  outward  wound,  communicating with the
fractured edges of the bone, it is  called a  compound fracture,  which is the
more serious form of fracture.
   The symptoms of fracture are sometimes very obscure; there  will be pain
and an inability to move the limb, but these may be owing to a bruise, a dis-
location, &c.   Usually, there is a  loss of motion  in the  injured limb, pain,
swelling, shortening of the limb, as well as  a  change  in  its form, together
with a grating noise or sensation  when  the fractured ends of the bone are
moved and rubbed against each other; when the bone is superficial, and its
separation and the irregularities of its fractured ends can be felt, we have a
positive symptom of fracture.
   Treatment.   When, from an accident, there are reasons to believe that
some one or more bones have been fractured,  the patient  must be handled
and removed with great care from the place where the injury occurred. If
                    Fig. 44.                    he  be at some distance from
                                              a  dwelling,  he should he
                                              placed upon a board, a shut-
                                              ter,  a sled,  or something of
                                              the  kind on which he can
                                              rest easily  and be carried
                                              without  jarring  him,  and
                                              thereby causing unnecessary
    Hurdle to carry a person with a Fractured Limb.    pain.  In removing him up-
on the board or shutter, &c, no more persons should  assist than are suffi-
cient to raise him gently and quickly, act together,  and not interfere with
each other.   As to the position in which the patient may be placed, he will
generally find out for himself which is the easiest, unless he be drunk or
insensible; on no account should the injured limb  be  permitted to hang
down, dangling or rolling about, but should be supported  by pads of straw,
leaves, &c, to steady it, and  prevent it from moving.
   In all cases of fracture the attendance of an experienced physician is neces-
sary ; but it sometimes happens on shipboard,  in newly-settled districts, &c.,
not only that no physician is at hand, but often  that one cannot be procured
for days  or weeks.   Therefore, in  such cases, when the patient has arrived at
his dwelling-place, or bed, it will be well for some intelligent person to insn-
 
FRACTURES.                          557
 tute an examination to ascertain if a bone be fractured.   The thumb or finger
 passed along the course of the bone  will  generally detect the fracture, by
 the sensation of roughness or unevenness communicated, or, a depression of
 one part of the bone and an elevation of the other will be found; on rotating
 or moving the fractured part of the limb, a grating noise called  crepitus will
 be heard, with a grating sensation or  a jar imparted to the feeling;  there
 will  be an inability to move or raise the limb,  and which will generally be
 shorter than its fellow.
  Having ascertained that a fracture exists, there are three things to accom-
 plish, 1st, to replace  or reduce the  pieces of bone into their natural situa
 tion, with their fractured ends in perfect contact; 2d,  to secure and keep
 them in this state; and 3d, to prevent and relieve any unpleasant symptoms
 that may arise, as excessive inflammation and pain.
  To replace the bones the patient must be conveniently placed upon a bed
 or mattress, and if the edges of the fracture have passed by each other, or
 are not in exact adjustment, the physician, or person  acting as such, should
 grasp the lower part of the fractured limb, while an assistant takes hold of
 its upper part,  and each  should  gently pull,  but with gradually increasing
 force, in directly opposite directions,  making extension and counter-extension,
 as it is termed, which will enable  the operator to ascertain, with his own
 hand, whether the fractured  bones are in a  direct line with  each other,
 whether they are properly adjusted, forming no prominences or depressions,
 and  to make such changes in the  limb as may be required.   The  degree of
 force necessary in making extension and counter-extension will  vary in dif-
 ferent cases, according to the degree of resistance met  with from the contrac-
 tion  of muscles.  Sometimes it may be neeessary for two assistants to  make
 the extension  and counter-extension, so that the operator may have both
 bands at,liberty to arrange the limb.
  The bones having been brought properly together,  they must  now be se-
 3ured by splints and bandages.  The splints may be made  of  narrow flat
 pieces of light wood, tin, or stout pasteboard, of the length of the  limb, and
 these are to be placed lengthwise along the limb, on various  parts of it, for
 the purpose of keeping it immovable,—protecting the skin from chafing or
 other injury by placing a thin layer of cotton  between  it and  the  splints.
 The  splints must be secured by a  bandage  made of muslin  or linen, about
 three or four inches wide, and several  yards  in length,  or  long enough to
 bandage the limb with.  The bandage must be rolled up for use.  The splints
 being held  in place by one or two assistants, the operator will commence ap-
 plying the  bandage, always at the lower part  of the limb and advancing
 toward the  upper, securing the splints  by a sufficient degree of compression.
 Considerable skill is required in the application of the bandage, to  have  it
 smooth and make a proper degree of compression, which, however, cannot
 be described in words; if it be placed on bunglingly it will soon loosen and
 Blip down;  if it be too tight it will increase the swelling  and cause unneces-
 sary  pain.
  The limb having been thus attended to, it may rest  on a pillow, supported
 in a bent position, or, if it be the arm, it may be carried  in a properly  made
 box and sling; and excessive inflammation may be prevented or diminished
 by the application of cold water, or equal parts of water, spirits and vinegar,
preventing its too rapid evaporation  by covering  it  with  a dry cloth.   The
patient should be kept still, obviating any irritability of the system, or twitch-
ing of the tendons, by one or more doses of the  Compound  Powder of Ipe-
cacuanha and Opium.   In about a week,  if there is no  reason in the mean-
time to believe that anything is wrong, the bandage and  splints  may be re- 
558
AMERICAN FAMILY  PHYSICIAN.
moved to examine and ascertain that the parts are in proper condition after
which  they must  be  reapplied; a second examination  may be  made aftei
eight or ten days longer have passed.  The  patient should be kept upon a
light diet, and should not be allowed to make use of his limb, too soon after
the fracture has united.  One daily evacuation must be  had from the bowels
but without causing the patient to move the injured limb.  At sea, in order
to overcome the bad results which might happen from the tossing and  rolling
motion of the ship, the patient should be placed in a swing cot or hammock'
and this should be observed in all cases of fracture or dislocation occurring
on shipboard.
   Fracture of the ribs, and of the collar-bones require prompt attention; but
in broken limbs, where there is much swelling and inflammation, these may
first be overcome before attempting to  set the  limb, so that three or four
days may  pass before  the application of the  splints and  bandages.  When a
limb is bandaged tightly, before the swelling has been reduced,  it not only
causes much pain  but is apt to cause mortification.  Severe pain is an indi-
cation that the  bandage is too tight and must be loosened.
   In  Compound Fractures  we must be guided by the same general rules
as in simple fractures.  Any splinters of bone, dirt, or other foreign matters
must be carefully and gently removed;  the  bones placed together properly
as in simple fractures by extension and  counter-extension, and the  splints
and bandages must be so arranged that the  external wound can be dressed
daily, without having to remove them and thereby hazarding subsequent dis-
placement of the fractured bones.   Any great degree of inflammation may
be prevented or diminished, by the application of Tincture of Arnica, espe-
cially at an early stage, cold water, poultice  of Elm and Lobelia,  &c. Pur-
gatives may also be necessary,  as,  Seidlitz Powders, Compound Powder of
Jalap, with ten or fifteen grains of Cream of Tartar added to the dose,  or,
Podophyllin and Cream of Tartar.   The wound must be treated the same as
any other, bringing the edges  together  as much as possible, and securing
them by straps of adhesive plaster.   Gangrene must  be  met by the  means
recommended on page 552.
   In the examination of all fractures, as well as after their treatment, com-
pare the parts with the opposite sound parts,  or with  the  parts of another
person.  Sometimes, in compound fractures, amputation of the limb will be
required in order to preserve the patient's life, hence the necessity of always
having a medical attendant as soon as possible.  I will  now refer to a few
particular fractures.
                   FRACTURE  OF  THE  NOSE.

  The bones of the nose are frequently fractured, being generally depressed.
  Treatment.  As a general rule, they may be readily adjusted by means
of a quill, a female catheter, or any similar instrument, passed into the nos-
trils, using it as a lever to push out the broken bones; while the fingers ot
the other hand placed on the outside of the  nose, will prevent them from
being pushed out too far.   Inflammation and swelling  may be kept down
by the application of cloths  wet in cold water, or other cooling liquii 
FRACTURE  OF THE LOWER JAW.              559
             FRACTURE  OF  THE  LOWER  JAW.

  The  lower  jaw may be fractured at several          Fig. 45.
points, and the fracture may be simple or com-
pound; it usually takes place  about the chin,
sometimes near the angles of the jaw, and  may
be known by the pain on moving the jaw, the
cavity felt at the fractured part by the finger, the
 rregular position of the teeth, and by the grat-
 ng sensation on moving the bone.
  Treatment.  Introduce one or both thumbs
into  the mouth, and  by depressing,  or keepings
 he back-part of the bone stationary, at the same^
time  elevating or bringing the fore-part forward
with  the fingers,  the fracture can readily be ad-
justed.   After accurately replacing the parts, the mouth should be shut, a
thick compress of lint should  be placed  over the seat of the fracture, and
over  this a piece of stout leather, or wet pasteboard should be applied, and
the whole secured by a bandage.  The  bandage  may be made of  strong
muslin, about two inches and a half wide, with a small bag or purse to re-
ceive and hold the chin, with four ends to be so fastened as to hold the jaw
                               Fig. 46.
Fracture of the Lower Jaw.
Adjustment of Frnctured Lower Jaw. 
560                AMERICAN  FAMILY PHYSICIAN.
firmly upward,  as  well  as  backward—two being carried  over  the top of
the head, and two  to the back;  or as is shown in Figure 46.  The paste*
board  must be wet, the  better to mould  it to the shape of the jaw.   The
patient should be kept quiet, and until  the  bone is firmly united should
be fed on broths, soups, jellies, &c, by means of a spoon, not being allowed
to exercise his jaws in chewing food.
FRACTURE OF THE COLLAR-BONE.
                  Fig. 47.
                             Fractured Clavicle.
  The clavicle or collar-bone is usually fractured  obliquely and near its
middle ; occasionally it may give way nearer to one or the other of its ex-
tremities.   A fracture  of this kind may be known by the pain produced on
motion ; the patient  not being able  to raise his hand to his head; the arm
of the fractured side falling upon the breast; the shoulder falling forward
and inward;  and the  crepitus or grating noise occasioned by moving the
arm or shoulder.   If the finger be passed along the collar-bone, one of the
fractured extremities will  be felt to  project over the other, causing a protu-
berance not to be found in the opposite unbroken collar-bone
Fig. 48.
                           Treatment.  In the treatment of a fractured
                         collar-bone, an  assistant,  standing behind the
                         patient, will firmly draw backward both arms and
                         shoulders,  until the fractured ends of the bone
                         meet and come into proper contact with each other.
                         Then place well up in the axilla, or arm-pit, of
                         the affected side, the base of a wedge-shaped pad
                         or cushion, whose  measurement is six inches in
                         length, four  or  five in width, and three inches
                         thick at its base.  "This pad  must be kept in its
                         place by pieces of tape attached to each end of the
                         base, which are to be passed (one in front of the
                         chest,  and the other on  the back) around the
                         neck;  placing a small pad on the opposite side of
                         the neck where the tapes meet, to prevent excoria-
                         tion of the skin.   A bandage about two or three
                         inches wide, is now to be passed once or twice
                         around the arm just above the  elbow, in such a
manner as to leave two  long ends, both of which  are to be passed aroun
the chest, one before and the other behind, repeating the  operation four^
Fractured Clavicle. 
               FRACTURE  OF  THE  SHOULDER-BLADE.            561

five times, carrying the bandage each time a little upward, and also including
the arm so as to keep it and  the elbow as close to the side as the pad will
permit  A short  sling, which will contain  the elbow and greater part of
the forearm, and at the same time will lift up the shoulder and  not permit
it to hang its full  weight, is now to be nassed  over the neck on the sound
Bide and the elbow and fore-arm placed within  it.  This should be worn for
four or five weeks, in order that the bone may firmly unite.  The  more com-
plctely the shoulders are drawn backward, and held so until the operation is
finished the better will be the result of the operation.  Where there  is a dis-
position to excoriation of the skin from  the tapes or bandages,  raw cotton
may be placed under them to prevent it.  The forearm must be kept still,
else there will be a necessity for passing a few turns of a bandage around it,
tho sling, and the  chest, to prevent motion.
  This is the plan usually recommended  to be pursued in the management
of fractured collar-bone, but it frequently occasions accidents from  pres-
sure of certain nerves or arteries, occasioning neuralgic pains, paralysis,
&c.  The best mode  of treating  this fracture  is  that introduced  into the
Philadelphia Hospital, in 1823, by Dr. George  Fox, as  follows ;—A dress-
ing for fractured clavicle  consisting of a stuffed ring made of muslin with
the opening in the ring large enough to allow it to slip up  the  arm to the
shoulder;  a pad  about  five inches in  length, four  in  width, and two or
three  inches thick at the base and considerably thinner at the apex; and a
slino-  or cot for the elbow or forearm made  of muslin and in form resem-
bling  the half of so much of the sleeve of a coat as covers the forearm and
elbow. The stuffed ring is slipped on the sound arm quite over the shoul-
der, the pad is placed in the axilla of the injured  side and kept in  place by
two tapes one in front and one across the back and tied  to the ring over
the sound shoulder.  Then the forearm of the  afflicted side is  flexed, the
hand carried to the opposite  shoulder and the  elbows placed in the sling,
which is fastened  by tapes near  the wrist and near the elbow to the ring
on the shoulder.
  In 1855 Dr. Bartlett introduced a modification  of Fox's apparatus by
using  in place of the  wedge-shaped pad in the axilla, a cylindrical pad four
or five inches in length  and  of the diameter required, and this is kept in
place by one tape  or  strap  passing through its  center, the ends of which
are united upon the opposite shoulder.— C. II.  Cleaveland, M. D.
           FRACTURE  OF  THE  SHOULDER-BLADE.
  The Shoulder-blade or Scapula  is  rarely fractured, except from direct
and violent external force.  When this accident does occur, it more gene-
rally happens that the body wf the bone is fractured across, or else that the
acromion process (the top of the shoulder,) is fractured, owing to the char-
acter of the injury, whether it be directed upon  the body or  the bone, or
upon the point of the shoulder.
  When .he body of the bone is broken, the part will be painful and swol-
len ;  and there will be a stiffness and perhaps an  immobility of  the corres-
ponding arm.   There will  be  no  deformity as  the displacement will  be
trifling,^ but upon making pressure upon the bone with the flat hand, and
imparting a degree of motion to it, the grating sensation or crepitus will at
once be perceived.
  Treatment.   This injury must be treated by replacing the fractured
parts as nearly exact as possible, and then passing a bandage firmly around
       30 
562
AMERICAN FAMILY  PHYSICIAN.
the chest and over the shoulder, so  as  to  prevent motion.  The loiearm
should be plaoed in a sling which will slightly elevate the shoulder.  The
parts should be  kept very quiet, and  any severe inflammation be met with
cooling applications, regularity of bowels, &c.
  When the fracture is of the acromion process, or that prominence of the
end of the bone  which articulates or moves with the collar-bone, it may be
known by a concavity or natness of the shoulder, by the pain at the part,
and by the collar-bone, together  with the broken  portion  of the process,
beino- drawn forward and somewhat downward by the  muscles of the part
If the upper arm be pushed upward, the grating sensation common to frac-
tured bones will be perceived, but not if the arm be merely rotated.
  To remedy this, the  upper arm must be raised so  as to bring the fractured
edges in correct contact with each other, which position must be  maintained
by&means of a bandage firmly applied around the arm and the chest, giving
several  full circular turns in this manner, and then securing the elbow and
forearm in a sling, the same as in fracture of the collar-bone.   Quiet, &c,
are as necessary as in  the preceding instance.
               FRACTURE  OF  THE  UPPER ARM.

  The Upper Arm or Humerus is more frequently fractured near its central
portion, though it may occur in any part of it.  It may readily be detected
by the patient  being unable to raise  the  elbow or forearm, by the grating
sensation perceived, when each part of  the bone is taken in the hand and
the fractured edges moved  freely upon each other, and, if the fracture be
oblique, by the shortening of the arm.
  Treatment.  In the treatment of this accident, the elbow should be bent
in order to relax  the  muscles, when  an assistant  should make slow and
eareful extension upon the lower  portion of the bone, gradually bringing it
downward so as to place the ends correctly together, and  give to the arm
its natural length, holding it thus till all is properlf secured by splints and
bandages, more particularly when the fracture is  an oblique cne.  A ban-
dage must now be applied, but not  tightly, around the arm from the elbow
to the shoulder, over which four  splints made of thin wocd cr pasteboard,
about an inch and a half wide, should be  applied, thus:—The first in front
of the arm, reaching  from the  shoulder  to the  bend  of the elbow, and
around which a few turns of the  bandage  should be made in  order to hold
                             it  in  place;  the  second, behind, reaching
                             from the shoulder to the  point of the elbow,
                             and  around which  a few turns of the ban-
                             dage must  also be made;  the third, on the
                             inside, reaching  from the arm-pit, (but not
                             so high up as to cause  excoriation,) to the
                             knob  or protuberance inside of the elbow,
                             and  around which the bandage must likewise
                             be applied, as in the preceding instance!'
                             and  then the fourth splint is to be placed oo
                             the  outside of the  arm,  reaching fron ™
                             shoulder to the knob outside of the elbow.
                             The whole  is now to be secured by a bafldage
                             carefully applied around  them, swathing tw
         Fractured Arm.         whole arm  from the elbow  to the arm-pi ,
 some recommend tapes or straps  as being  lighter and cooler  than the ban-
 
FRACTURE  OF  THE  ELBOW.
563
dagc, as in Fig. <19.  The forearm and wrist must be supported in a sling,
in a hanging position, being careful  that the sling  does not elevate the
upper arm, but rather  permit  its weight  to  resist the  contraction of the
muscles, and thus serve  to keep  the  edges  of the bone in their proper
place.
  To prevent chafing or excoriation it is  a good plan to place some soft
substance as raw cotton, under the splints;  and the  bandages should be
applied around them sufficiently tight to support  the fractured bone but
without interfering with  the circulation  in the  bloodvessels.   About^ the
seventh or tenth day, it is proper, in all fractures, to remove the dressings
bo as to ascertain  if the bone be properly placed,  so that it may be adjusted
if it be found necessary.   The splints  and bandages should then be reap-
plied as before, and  should  bo worn four or  five weeks; though the  arm
must not be used for several weeks afterward.   A fracture near the center
of the bone is  much more readily and successfully treated,  and with less
deformity than when it occurs toward  either extremity.
                 FRACTURE  OF  THE  ELBOW.
  The Elbow, or Olecranon process may be fractured, and detected by the
severe pain at the part, or by the patient  being able  to  bend the arm but
not to straighten it,  by the depression between {he broken points, and by
the grating sensation perceived when the hand of the affected arm is moved
slightly forward and inward, and then  slightly backward  and  outward, one
hand  of the operator being placed upon  the  seat of the injury, while the
other  is  employed in making the above movements on the fractured limb.
  Treatment.   In  treating this fracture, the limb should be straightened,
and, after swelling and inflammation have been reduced, when present, a
bandage should  be firmly appplied  to the forearm, commencing from the
fingers' ends and  coi|tinuing  it upward  to the bend of the elbow.  The
fractured end must^hen  be  brought down into  its proper position, and
secured  in  its place  by continuing the bandage upward for four or  five
inches.  Secure it at this point, and bring it back  again, carrying it above
and below the elbow-joint,  somewhat in the form of a figure 8, for several
times, and then carry it upward bandaging the whole upper arm.   A splint,
extending from the hand nearly to the shoulder, should now be bound over
the inner side of the arm, in order to prevent it from being flexed, which
would interfere with  the proper union of the bone.  Unless the parts be
properly secured there will  be  a disposition for the process to be drawn up
by the contraction of the muscles.   The joint may be kept moistened with
some cooling lotion; and no motion of it  should be attempted for three or
four weeks.
                FRACTURE  OF  THE  FOREAM.

  There are two bones in the forearm, one called the ulna, which  passes
along the inner side of the arm,  extending from  the point of the  elbow,
(where it forms the olecranon process.)  to that part of the wrist at the root
of the  little finger;  the  other  is  the  shortest and smallest bone, and is
called the radius.   One, or both of these bones may be broken at the same
time.   When  both are broken, the accident is  easily ascertained; when
only one, its detection becomes more  difficult, because the uninjured bone 
564
AMERICAN FAMILY  PHYSICIAN.
keeps the injured one pretty nearly in its place.   There is generally pain
in tho fractured part, loss  of motion  in  the hand, and when the limb is
grasped  firmly above  and below  the  fracture, and the lower part rotated
slightly, a grating sensation will  be perceived.   The  finger passed  firmly
alono- the bones from the  wrist upward will at once detect the fractured
part.
                                 Fie. 50.

Fig. 51.
Fig. 53.
                            Fractured Forearm.
  Treatment.  Whether one or both bones be broken the treatment will
be the same.   Relax the muscles by bending the elbow, then by extension
and counter-extension, place  the fractured bones  in  correct position, and
apply two narrow flat splints covered with flannel, tBbs : one on the inside
of the arm reaching from the ends  of the fingers  in  front of the hand, to
the inner knob of the elbow, and the other on the outside of the arm, ex-
tending from the ends of the  fingers, along  the back  of the  hand to the
                                outer knob  of  the  elbow.   These^ splints
                                must be placed  as  much  as  possible be-
                                tween the bones, to  keep them separated,
                                and prevent them  from rolling on each
                                other.   They are to be secured in their
                                place by a bandage  firmly applied around
                                the arm, passing from the fingers upward
                                to  the  elbow.  The  whole  forearm and
                                hand should then  be  placed in a  sling,
                                with the  palm toward the chest, and the
                                thumb  uppermost.   The arm should be
                                kept thus for four  or five  weeks, being
                                careful  not  to use it too soon.  Instead of
                                a sling, some  use  a thin board-box made
                                for  the purpose, and  which  is supported
                                by a narrow sling.
Fractured Forearm. 
FRACTURE OF THE RIBS
565
     FRACTURES  OF THE  WRIST,  HANDS  AND FINGERS.

  TRrvrMENT.-In these cases, the bones should be replaced, by extension
if necessary, and the parts  secured  by splints and bandage.  If'it be,a
LTsev Jal small splints of thin wood or moistened pasteboard should be
phfeed around  the  finger lengthwise, and secured by a narrow bandage,
after which  bandage the whole hand and wrist, carrying the bandage up to
midwav of the  forearm.  Rest the hand and forearm in a sling.
  If the bones of the hand be broken, apply a pad or compress to the palm
of the hand, then place a broad  splint  over  it, and  bandage firmly, and
with equal pressure from the wrist to the fingers.  If the wrist be the in-
jured part, the  splint should be applied to the sides in front and back, and,
toother with the bandage,  should be  carried at  least half way along the
f■ 0
° iTthese  accidents, the hand  should be carried in a sling for at least four
weeks   Should the finger be stiff after removing the dressings, it may be
soaked in warm water several times a  day, fifteen  or  twenty minutes each
time, and afterward  gently bending  it  forward and backward, as far as can
be borne without pain.  It is sometimes the case, in  these accidents that
portions of broken bone have to be removed, and occasionally the hand will
require to be amputated.  Severe inflammation is common, and must be met
bv cooling  lotions, opiates, diaphoretics, cooling  laxatives, &c.
   These are the more ordinary fractures of the arm ; sometimes,  however,
the several bones become fractured in  such a manner, and  under  such cir-
cumstances, that it would be improper  for any one but a surgeon to attempt
their treatment, consequently it would be useless to refer to them in a work
like the present.


                    FRACTURE  OF  THE RIBS.

   One, two, or more ribs may be broken from a violent blow or  fall, and
the injury  is more apt to occur behind or at the side, owing, however, to the
direction of the force.  This accident is accompanied  with a difficulty in
breathing,  and pain or a pricking sensation at the fractured part.   If the
hand be "placed on  the part, and pressure  be made  during  a deep inspi-
ration, the grating  noise, or crepitus  will  be observed.  Occasionally,
however, this noise cannot be detected.
   Treatment.—The treatment consists in requesting the patient to draw
in as deep  a breath as  possible, and while he is thus holding in  the air, a
flannel bandage about six or eight  inches wide, should be wound rather
tightly around the chest, extending from the arm pits to  the pit  of the
stomach, in order to prevent the ribs from moving during respiration, which
must be carried on by the diaphragm and the muscles of the abdomen only.
It may be  proper to remark, that as  the bandage is very apt to slip down, it
should be secured by sewing the  turns together at various parts, as it is be-
ing applied, which will be found a much better  plan than pinning it, and will
also prevent the necessity for  its re-application.  Before  placing  on the
banda-e, observe that the edges of the broken ribs are in their proper place.
The patient should be confined to his  bed, sitting up occasionally after the
fifth or sixth day.  In four weeks the bandage may be removed, and a large
adhesive plaster be  placed  over the  injured part.
   If the  lungs or pleura be injured by the fractured bone, there will be a
cough, spitting of blood, and inflammatory symptoms  which must  be treated 
566
AMERICAN FAMILY PHYSICIAN.
in the slime manner as inflammation of the lungs.   Emphysema or  anv
effusion of air into the cellular tissue, puffing up the chest, scalp, eyes abdo-
men, &c, must be treated by a physician, who will make incisions as maybe
required;  this symptom is owing to a puncture of the lungs by the broken
end of the ribs.   When the ribs are fractured on  both sides of the ch«st
no bandage must be used, but the patient must be kept very quiet.   The
same course must be pursued when the breast-bone is likewise broken.
               FRACTURE OF  THE BREAST-BONE.

  The breast-bone, or sternum, is rarely broken, except from  direct and
powerful violence, and is generally accompanied with more or less injury to
the chest, and a tendency to severe and dangerous inflammation.  It may be
known by a depression  or elevation at the  broken part, difficult breathing
more or less cough, pain, spitting of blood, palpitation of the heart and an
inability  to lie on the back.   Respiration creates the grating noise, or crep-
itus, with an unusual mobility of the injured part.
  Treatment.  The treatment consists in lessening the movements of the
chest during respiration, by the application  of a bandage  round the chest
the same as in fracture of the ribs, causing the patient to  breathe by the
action of the diaphragm and abdominal muscles.  If there be a depression
at the  point of fracture, an  incision must be made  by a surgeon, who will
raise the  depressed piece by means of an elevator.   Cooling  applications  to
the parts are required, together with a low diet, quiet, and regularity of the
bowels.   Inflammatory  symptoms  must be met in the same  manner aa
named under fracture of the ribs.
               FRACTURE OF THE THIGH-BONE.

  The thigh-bone may be broken at any part from the knee to the thigh,
but the parts most frequently fractured are, near its middle, and at its neck
or upper portion,  close to the hip joint.   The fracture at its middle portion
may be transverse  or oblique, the latter being more  difficult to manage.
This accident may be  known by the  pain, by the limb being unable to
move, or bear any weight upon it, and by the usual  grating noise when
the fractured ends  are  pressed  against  each other.   If the  fracture be a
transverse one, the ends will form a prominence, and may pierce a neigh-
boring muscle ; if it be oblique,  the limb will be shortened, and the preven-
tion of this  shortening must always be an important indication in the
treatment.
  Treatment.  The  patient must be placed on his back, and two strong
assistants are to make gentle  but sufficiently powerful extension and counter-
extension, one drawing downward from the knee, the other holding the limb
at its upper part, just below  the groin.  A  folded sheet passed around the
groin, instead of the hands, will be the best, as the assistant will have a bet-
ter purchase, and with  less fatigue;  pulling upon  it  in the  longitudinal
direction of  the  limb.   This extension must be  steadily continued for
some time,  and must be of sufficient  force to bring the  limb to its natural
length, as well  as to  allow  the  operator to properly adjust the fractured
edges.   This accomplished,  four splints are to be applied thus : one in
front, reaching from the knee pan to the groin; another on the inner side
of the  limb, from  the upper end of the thi^h to the inner side of the knto; 
FRACTURE  OF THE THIGH-BONE.
567
• third short one behind ;  and a fourth about four inches wide, and extend-
M from the arm pit beyond the sole of the foot.   These splints must not
bc°so wide as to touch each other,  nor so narrow as to permit the bandage to
touch the skin ;  and cotton may be placed on their ends, and under them, to
nrotget the  skin from injury.  The splints  having been properly applied,
tl c extension and counter-extension still being maintained, when the frac-
 ure is oblique, secure them in their places by a  bandage  firmly applied,
 nd extending from the foot to the thigh.  It is better  for several banda-
ges five or  six yards in length, to be used, tacking their ends together as
fhc'v are wanted   One bandage of  the whole length required will be found
 ery inconvenient.   The  long splint must be secured  to  the body by strips
of bandage  passing round it and the body at several points.  The bandage
bein- applied, the  assistants may cease their traction.   It will require six
or se°ven weeks  for the bones to unite, during which  time the  patient will
continue to lie upon his back ; but in the mean  time the splints and banda-
1 may be removed now and then, and readjusted.  If the outer splint is
carried upward no further than the hip joint, the limb may rest in a flexed
position upon a double inclined plane, which, in some instances, is superior
to the first named method.  There are several  other  modes of treating frac-
ture of the thi«h bone, but the above course is the best for those who un-
dertake the  management of a case when a surgeon cannot be obtained.
The object  is to put the  bones in their proper place, get the limb extended
to its natural length, as  compared with the uninjured one, and to secure
these points, as soon as  effected, by  a  proper  application of splints and
bandages  without any pain, and as little inconvenience to the  patient as
possible '  The  figures show the various modes of dressing fractured thigh.
In  Fi"-  54  no  splints are used, the patient resting upon a low bed, and
which.0™i»-ht answer for a transverse fracture ; Fig. 55 is the treatment with
a single long splint and bandage ; Fig. 56 is the double inclined  plane
upon which the fractured limb may rest.
                                Fig. 54.
                          Fractured Thigh.
When the nkck of  the thigh-bone is fractured, the knee and  foot are 
568
AMERICAN FAMILY PHYSICIAN.
turned outward considerably, the limb is an inch or so shorter than its  fel-
low, and may be  moved sbghtly in any direction, but with pain, and gen
erally, but not always, the gratir.g  sensation will be observed on extending
the leg to its  natural length.  Old persons are more  subject to this acci-
dent, though it may occur at any age.   A perfect bony reunion is seldom
effected, the union being generally ligamentous.
  The treatment consist's in, first allaying inflammation, then straighten-
ing the limb so as to bring the fractured edges  together properly, if possible
and preserve the  natural length  of the  leg.  A long splint passing up into
the arm pit and  extending downward beyond  the sole of the foot, must bo
applied, and the bandage employed in the  same manner as in the preceding
case of fracture at the center of the thigh-bone; securing the upp_,r part of
the splint to the  body also, in a  similar manner.   The  limb must be kept
extended; the foot and ankle must be firmly attached  to their fellows on the
opposite leg, by means of a bandage, keeping  both limbs straight and  im-
movable;  a broad leathern strap should be firmly buckled around  the hips
and upper part of the thigh-bone;  and the patient must  be kept thus  for
several weeks, before attempting,  to get up, which he  should not be allowed
to do if the attempt cause much pain.  The  effort of raising and particu-
larly  of walking  must be  made with great care, and  very gradually. It is
very possible that upon  recovery,  the limb will be shortened, for  this fre-
quently happens even under the care of the most  skilful surgeons.  If  the
bone unites it will require two, three, or even  more months, for its perfect
union.
                 FRACTURE  OF  THE  KNEE-PAN.

  The knee-pan  or patella  is occasionally broken  longitudinally, the result
of direct violence; more commonly, however,  the  fracture is transverse, oc-
casioned by some sudden muscular action, as in  the  effort  made to protect
one's self from a fall, or a false step upon  stairs, kc.  Unless  exceedingly
well treated, these fractures  are apt to cause a stiff joint; and it is very sel-
dom the bones  unite  by the formation of bony matter, but more generally
liy ligamentous.   Bony union is more  common in those  cases where the
fractured  edges are  kept in close and proper contact with each other; the
dightest separation disposes to a ligamentous union.
   Transverse fracture of the knee-pan may be known by the inability of the
person to stand upon the injured limb;  by the incapability of extending the
leg, though it  may be easily flexed;  by the upper  portion of the broken
knee-pan being drawn upward, leaving a wide  depression or pit at the point
where the knee-cap should be, in which  the  fingers may frequently be laid,
and above and  below which  will be felt  the fractured edges of  the movable
bones.  Soon after the accident, the parts become livid from  extravasation,
but this is removed  in a few days by absorption, and inflammation is apt to
be present.
   Treatment.  Should there be much  inflammation, it must^ first be re
duced  by the  application  of Tincture of Arnica,  cooling lotions, and if
necessary, leeches.   In case of much swelling and inflammation, and where
the bones are widely separated, they  may be brought nearly in  contact, and
retained so by bandages, continuing the  above measures  to reduce the in-
flammation, Arc.  In a day or two, or  as soon as the  inflammation and swell-
ing have subsided, place the limb on  an inclined plane having an elevation
of about two feet, which will cause the thigh  to be flexed upon the abdomen, 
FRACTURE  OF THE LEG.
569
straighten the knee, and relax the muscles.  Then, having applied a bandage
around the thigh from the groin to within about five or six inches above the
knee, bring the fractured edges together, in as close contact as possible, and
continue the bandage  in the form of figure  8, both above  and below the
knee-pan, in order to keep the broken bones in close approximation.   The
bandage must be  sufficiently tight around  the limb to prevent the upper
portion of the knee-pan  from slipping under it;  and should be examined
daily to ascertain  that  it  is firmly secured, and of the necessary tightness.
In about seven  or eight days after the accident, it is a good plan to fasten a
strap or  handkerchief tightly around  the leg, immediately above the knee,
and  another in the same  manner directly below the knee, then by means ox"
a stout piece of tape or riband,  passed  through or beneath  each handker-
chief, one on  each side  of the knee, the circular bandages thus  made  may
be drawn toward each  other, and which will  at the same  time, bring the
fractured edges of  the bone together;  after  drawing  the ends of  the tape to
the extent required, they must be tied.  To prevent any motion  of or bend-
ing at the knee-joint, a wide splint may be  attached and secured  by tapes to
the under part of the leg, extending from the ham to the heel.
  If no inflammation ensues  after the  application  of the bandage, it should
not be removed for twelve or fourteen days;  after which the limb  maybe
moderately flexed, carefully repeating  it every other day, in order that  the
patient may not have a stiff joint.  When  the parts have united with suffi-
cient firmness, the patient may be seated upon a table in such a manner that
the lower leg will hang over  it, so  that he can swing it carefully to and fro,
until he can raise it on a level with his thigh.  Of  course this  measure is
applicable only in those instances in which  the joint is disposed to stiffness,
and  where the patient loses the command over the  motions of the limb.   By
carefully proceeding in  this  manner, the motion  of the joint will be  pre-
served ;  and the support of the weight of the body, as well as the attempt
to walk, must be  made with  much caution.   The great difficulty in  these
cases is, to keep the bones in  close approximation, and to secure motion to
the joint after union has been effected.
  Longitudinal fracture  of  the  knee-pan  will  present  somewhat  similar
symptoms to the above, with the  exception that the broken bones are not so
widely separated by the action of the muscles.  It may be treated by bringing
the fractured edges together, placing a straight splint behind the knee joint
to prevent its motion, and retaining the splint in its place, as well as main-
taining the contact of the fractured edges, by carefully bandaging the parts.
In other respects pursue the same measures, if required, as in the preceding
instance.
                    FRACTURE  OF  THE  LEG.
  The leg, or that part between the  knee and ankle  and sometimes called
the lower leg, has  two  bones in it;  one  the smaller bone, situated  toward
the outer part of the leg, and called  the fibula, or splinter-bone, and which
cannot be readily felt, except near the ankle, on  account of the flesh cover-
ing it.  The other, situated on the  inner side of the fibula,  is called the
tibia, or shin-bone; its front edge is known  as the shin, and can be dis-
tinctly traced by the finger from the ankle to the knee.  One or both of these
bones may be broken at the same time; more frequently the latter.  When
both bones are fractured,  there is pain, an inability to walk or bear  upon the
limb, a change in  its shape and direction, a mobility of the  limb  and the 
570                 AMERICAN FAMILY PHYSICIAN.
peculiar  grating sensation  on rubbing the fractured edges together.  By
passing the finger along the shin-bone a projection will be felt at the injured
part.
  Treatment.   The treatment  consists in first reducing the swelling and
inflammation;  then, probably in from two to four days, or immediately  if
there have not been any considerable amount of inflammation, by means of
                                             extension and counter-exten-
                                             sion, properly adapt the frac-
                                             tured  edges together,  apply
                                             two splints, one on the out-
                                             side of the  leg  extending
                                             from the knee to the sole of
                                             the foot;  the other on the
                                             inside of  the leg, and secure
                                             the whole by means  of a
                                             bandage firmly applied, and
                                             extending from the toes to
                                             the knee.  Some prefer straps
                 Fractured Leg.                Qr ^^ ^ th(j ban<j    &g
in Fig 57.   The extension and counter-extension  should be continue until the
bandage  has been  applied  and  secured, especially in cases  of an oblique
fracture,  where there is a tendency for the broken edges to slide by each
other.  The splints used, should be about three inches wide, and should have
a circular opening  made  in  them at the part which will come against the
ankle.  The leg may rest on its side upon a pillow, with the knee a littiu
bent, which is the easiest position, being careful that the great toe is kept
in a direct line with the inner edge of the  knee-pan.   To ascertain that the
limb is of the right length, it  should be  measured and  compared with its
fellow.   The heel  should be supported by a pad or cushion, and the foot
instead of  being  allowed to hang down,  must  be brought  up to nearly a
right angle with the limb by a bandage passing over the ball of the foot and
then attached to a point near the knee;  or, a box may be made, the  lower
partition of which is so arranged  as to  support the  heel, as well  as to give
the proper degree of flexion  to the foot.  In  five  or six weeks the dressing
maybe removed;  but  the  patient should gradually accustom the limb to
bear his  weight; at first walking with crutches.   In six  or seven days after
the accident, it is always proper to remove  the dressing, to ascertain that the
parts are in proper position, and if not, they must be brought into correct
proximity, after which  the dressing must be readjusted.
  When the fibula alone is  broken, it is not always that even a surgeon can
positively  ascertain it;  but  this is of little  consequence.   There will be
pain and tenderness on moving the limb, or on attempting to walk or stand,
sometimes a grating sensation will be perceived,  and the foot will frequently
turn outwardly.  In this accident, the shin bone supports the other in its
place, acting as a splint, and preserving  the figure  of the  leg.   All the
treatment required is, a state  of quiet in the recumbent posture; and, in
some few instances, the limb may need the same management as when both
bones are broken.
  When the shin bone alone is broken, it may be ascertained by  the irreg-
ularity or projection at the injured part, a mobility of the  bone at that place,
and crepitus  or the grating noise.   Although a surgeon  may  treat this
fracture  without splints  or  bandage, non-medical persons will do best bj
jpursuing the course laid down for a fracture of both bones. 
DISLOCATIONS.
571
         FRACTURE  OF THE  BONES  OF THE  FOOT.

  These injuries require a treatment similar to  that pursued in fracture
of the bones of the hand, and finger bones.  It may be proper to state that
fractures of the lower extremities are usually more  serious in their nature
than those of the upper, being more troublesome in their treatment,  often
requiring amputation of  a part of the limb, and sometimes occasioning the
death of the patient by lockjaw or otherwise.  In old as well as in intemper-
ate persons they are generally more troublesome and dangerous than among
the young, and temperate.
  Fractures may occur at other places, than those referred to, or the bones
of the limbs may be fractured  near their ends  or  joints; these  accidents
cannot be managed with  any degree  of comfort or security to the patient by
any other than a  properly  educated medical  man.   Consequently, I  have
omitted any notice of their treatment.
                           DISLOCATIONS.

  When a bone is removed from its socket by force or otherwise, it is said
to be ':put out of joint," or dislocated; the term  luxated is also applied to
this accident.  When the bone is merely displaced, it is termed a simple dis-
location; when the neighboring soft parts are injured in addition it is called
a compound dislocation, and is the more serious form  of dislocation.   When
the bone is returned to its proper place it is said to have been reduced.
  The symptoms of a dislocation  are  frequently very obscure, owing to the
great amount of swelling accompanying it, and the most experienced surgeon
is often at a loss to discover the true character of the injury.  The ordinary
Bymptoms are, pain and inability to move the  limb,  the limb is  longer or
shorter than the other, an unnatural prominence or  depression may be felt
at the joint, which  may be ascertained by a careful comparison of the parts
around the joint, with those of the opposite uninjured joint, and, in some
instances,  by  rotating the dislocated limb, the head of the bone will be felt
out of its place.  Some dislocations, as of the  jaw and shoulder, are very
apt to recur at various times, after having been once produced.
  The sooner a dislocated bone is replaced or reduced, after the accident, the
more easily can this be effected;  and the difficulty of reduction  is  in  pro-
portion to the time which has been permitted to elapse after the reception of
the injury.  When there has been a long delay in "setting the bone" vari-
ous changes will  occur  in  the  part, which will interfere with its reduction,
the bone and soft parts accommodate  themselves  to  the change of position,
and a new but unnatural socket will be formed for the head of the bone to
move in.   Replacement has  been accomplished,  but with great pain to the
patient, and difficulty  to the operator,  even  after the expiration of three or
four weeks; but this is only to be  attempted by a skilful  and experienced
surgeon.   The greatest obstacle to contend with in dislocations is, the pow-
erful, rigid, involuntary contractions of the muscles, which increase with time
as the reduction is delayed, and which is overcome by extension and counter-
extension, as in fractures, in some cases assisted by internal relaxing medicines.
  Partial  dislocations should be closely  examined;  they are  frequently
treated as sprains or bruises, leaving the patient lame for life.
  Sometimes  a fracture and dislocation  occur at the  same  time;  in  such
cases it is  '■ best to reduce the dislocation  at once, taking care that the frac-
tured  part be  strongly bandaged in splints to prevent any injury being done 
572
AMERICAN  FAMILY  PHYSICIAN.
Fig. 58.
 to tne muscles: for if this be not done, at first, it cannot afterward, without,
 in all  probability,  disuniting  the  fracture."   These  cases can be managed
 only by a medical man.
   When dislocations are caused by diseases of the  joint or its appendages
 paralyzed muscles- relaxation of the ligaments, destruction of the cartilages'
 ligaments, &c, from disease, they are less  easily reduced than when occa-
 sioned by external violence, as falls, blows, and  the  like; and, in  some in-
 stances,  reduction becomes  impossible.  A  delay in  reducing a dislocation is
 followed by an effusion of synovial  fluid, an  adhesive  matter, into the sur-
 rounding parts; or, an adhesion of  the tissues may take place, giving rise to
 a crackling noise,  somewhat like that of crepitus, on moving the joint.  Oc-
 casionally  the  inflamma-
 tion caused by the acci-
 dent is followed by gan-
 grene.
  Treatment.  Having
 ascertained that a dislo-
 cation  exists, it must  be
 reduced  as  speedily  as
 possible;   inflammation
 must be kept  down   by
 local cooling applications, and  the other ap-
propriate measures referred to under the head
of Fractures; and means must be pursued to
retain  the  bone in its place until  the sur-
rounding parts recover their wonted  strength.
  To "set" or  reduce the dislocation, that is,
to place"the "bone into its natural socket, ex-
tension and counter-extension  must be made
to overcome the powerful contractions of the
neighboring muscles, and which may be made
by the hands alone, or with the aid of towels,
sheets,  ligatures, &c.    The  limb  must be
bent, which also aids in the relax-
ation of the muscles, and the force
applied must be gentle  and con-
 tinued, and gradually increased as
 may be necessary;  any sudden or
 powerful force  will be productive
 of permanent or serious evil. The
 most powerful  muscles may  be
 wearied  out and relaxed by grad-
ual, long-continued and unremit-
ting extension.  As soon as  the
head of  the dislocated  bone has
been brought to a level with  its
socket, the muscles will  generally
carry it into its proper place; this
usually  takes  place suddenly,  is
accompanied with a loud cracking
 noise, and is followed by a mate-
rial diminution of  pain.  The  at-
i           j     it   ,i:,.l~™+;™   iliese ngures exQiou exbuuaiuii <vn^ w-.—-    .
tempts to reduce  the  dislocation, sioDj as  £equenlly practised in Dislocations of tw
 even when made with  a sufficient Shoulder.
 
DISLOCATIONS.
573
 decree of extension, may  fail, unless the bone in which tho socket is placed,
 bc°kept fixed and motionless by counter-extension, exerting a force equal  to
 that employed in extension, but in a directly opposite line.^
   It is sometimes the case that  before the muscles will yield, the assistants
 become "tired out," and, in other instances, the muscles resist all the efforts
 made to relax them.  When this occurs, constitutional  remedies  must ^ be
 given in order to produce  a general relaxation  of the system.   Nauseating
 doses of the Tincture of Lobelia may be given; or the Compound  Tincture
 of Lobelia and Capsicum.   The Spirit vapor bath  will likewise be found use-
 ful in some cases, either alone or combined with the internal  use of some
 preparation of Lobelia.   Care must be taken not to cause vomiting, as this
 will interfere with the attempts at relaxation.   As soon as a sufficient degree
 of muscular relaxation is  established,  then  the above  mechanical means for
 the reduction of the bone must be undertaken.
   After  the dislocation has been reduced, means must be  taken  to prevent a
 return of the accident, which is best accomplished by keeping the limb very
 quiet, and iu a partially flexed position;  sometimes, however, bandages, and
 even splints, will be required for a time, until the parts have recovered their
 tone.
   Fain and inflammatory  symptoms may be lessened by cooling applications
 or anodyne lotions, Seidlitz Powders as a laxative, and anodynes internally.
 The patient must be very  careful in the use of the limb for some time after-
 ward;  if the joint be moved too early, it is apt to be destroyed by ulceration.
   By jntssivc motion is meant the gradual bending  and straightening  of a
 joint, repeated once or several times daily, in order to prevent  anchylosis or
 permanent stiffness of the joint.  This  motion is usually given to a  joint
 some three or six weeks after its reduction, before allowing the patiout to
 use it.   In the examination of all dislocations, as well as after  their reduc-
 tion, compare the parts with the opposite sound parte, or with  similar parts
 on another person..
   Compound Dislocations are often attended with much  danger, being
 followed  by severe febrile symptoms, gangrene,  delirium,  and  death; which,
 however, may be prevented by amputating the injured limb.  This, however,
 is not always necessary, as a careful, judicious  course of  treatment  will fre-
 quently result in benefit, even in apparently hopeless cases. In old persons,
 and persons of unhealthy, irritable constitutions, compound dislocations are
 apt to have a fatal termination.
   Treatment.   The first thing to be done in this  class of accidents is, to
 check bleeding, should any be present, and then to cleanse the *-.and from
 any pieces of broken bone, dirt, or foreign  matters.   This accomplished, as
 gently and as soon as possible, reduce the dislocation, then bring the edges
 of the wound together, and secure them thus by strips of adhesive plaster,
 and in some instances, compresses  and bandages will be  likewise required.
 The limb must rest  quiet, and be kept constantly moistened by the applica-
 tion of cold water, or some cooling lotion, but  no poultices must  be  used,
 as they interfere with the adhesive inflammatory process,  and  tend to  pro-
 duce the formation of matter, which is to be avoided as  much  as  possible.
 Any febrile or inflammatory symptoms  must  be met by laxative  doses of
 Seidlitz Powder,  and the  usual internal means recommended  in inflamma-
 tory affections, meeting the various symptoms  as  they present, according to
 their indications.   The Tincture  of Gelseminum, given  in doses to produce
its peculiar relaxing effects, will be found very valuable  in  overcoming the
more severe inflammatory symptoms attending  compound dislocations.  See
Compound Fractures, page 558. 
574                AMERICAN  FAMILY PHYSICIAN.
  I will now refer to a few particular dislocations, observing here,  however
that no attempt should be made to reduce a  dislocation  by a non-medical-
man, when it is possible to secure the attendance of a physician.
             DISLOCATION  OF  THE  LOWER  JAW.

             Fig- go.               Tbe  lower  jaw  is dislocated  forward
                               and   downward,  and  is  commonly oc-
                               casioned by  gaping.   One or  both  sides
                               of the jaw may be  dislocated, that is, the
                               dislocation may  be partial  or  complete.
                               The  dislocation may be  known  by the
                               mouth being wide  open, the chin  thrown
                               forward and downward, the patient is un-
                               able to close the mouth, and any efforts to
                               accomplish  this  by  pressure are  painful
                               and useless;  the saliva is  much increased
                               in quantity, and dribbles  over the mouth.
                               In  partial dislocation, when but one side
                               of the jaw is dislocated, the mouth is not
                               so widely opened as  in the  complete dis-
                               location, and  the face  has a twisted ap-
                            |§pearance owing to the chin being  thrown
                          vS*^ to the opposite side of the  dislocation.
                          ^5|^  Treatment.  The reduction of this dis-
               r> fjv    '   ^ location is  easily  effected.  The  patient
       Dislocation of the Jaw.       must be seated on the floor, or on a low
seat;  the operator standing in  front will place his thumbs as far back on
each side of the lower jaw as he can well reach, or if the back molar teeth
are present, the thumbs may be  placed upon  them, and firm but gradual
                        pressure  must  be  made  downwards, while the
          Fig. 61.         lingers of the operator, or an assistant standing
                        behind the  patient, elevates the chin, also, grad-
                        ually.  As soon as  the  ends of  the jaw become
                        disengaged from their situation, the muscles draw «
                        them  suddenly and powerfully into their proper
                       » position, and if the operator does  not immediately
                        remove his thumbs outward between the jaw and
                        cheek, they  may be severely bitten.  It is always
                        proper to protect the  thumbs still further,  by
                        covering them with a silk handkerchief, or strip
                        of linen. Sometimes, two  pieces of wood, a couple
                        of knife handles, or cork  are used  as substitutes
                        for the thumbs, being placed one  on each side of
                        the jaw  between the  back  teeth, when the chin u
                        gradually but  firmly drawn upward.  If but one
                        side of the jaw is dislocated, that  side  only should
       Dislocated Jaw.      be operated upon.
   After  reducinfj^jhe dislocation,  the  jaw should  be kept bandaged for a
few days, passing the bandage  once or twice round the top  of the head and
under the chin, and no food should be used which  will  require chewing or
motion of the jaws.   AVhen  the jaws have once been  dislocated,  they are
more liable  to subsequent repetitions of the  accident; hence, the patient
should be careful  not to laugh or gape too widely.
 
DISLOCATION  OF  THE  SHOULDER.             575
            DISLOCATION  OF  THE  COLLAR-BONE.
  The Collar-Bone or Clavicle is more liable to be broken than dislocated;
but it may be displaced at either end, more commonly at  its junction with
the breast-bone, and  the  end of the  bone may be thrown backward, or,
usually, forward.   The dislocation backward leaves  a depression  at the
upper part of the breast-bone, while the end of the bone will  feel like a
tumor at the root of the neck, and there may also be difficulty of swallow-
ing.  The forward displacement is recognized by the swelling made on the
upper part of the breast-bone by the projecting end of the dislocated bone,
and if  the knee be pressed against  the back  and  the  skoulders be drawn
backward,  this swelling disappears, but returns again as loon as the exten-
sien is removed.   If the shoulder be raised, the swelling descends ; if it be
drawn  downward, the protuberance ascends  toward the neck.   There  is
great pain and difficulty in moving the shoulder.
  Treatment.   In reducing the forward displacement the  shoulder must
be pulled backward and outward, which will cause the collar-bone to take
its proper  position  with  the  breast-bone; then press the collar-bone into
its place, and retain it there  by a pad  or compress, and a bandage applied
around the chest, the same as recommended in fracture of the collar-bone.
(See page5G0.) The arm should be raised high in a short sling, and the pa-
tient must be kept quiet for at least three weeks, and  the  dressings must
not be removed too soon.   The great difficulty in these dislocations of the
collar-bone is to retain the head of the bone in its place after its reduction,
and which can only be accomplished by the pad, bandage, and sling being
carefully and properly applied.  Generally, notwithstanding the  ability of
the surgeon, there will be more or less  deformity of the part, but which
will be productive of no serious inconvenience.
  Frequently, from -a  fall upon the shoulder, the collar-bone becomes dislo-
cated at its junction with the  shoulder-blade, or scapula.   In this  luxation
the shoulder will be depressed and drawn inward toward tho breast-bone,
and the end of the collar-bone may be  felt projecting at the top  of the
shoulder.  To reduce  this luxation, place a knee  between the  patient's
shoulders,  and draw them backward and outward,  until the collar-bone is
brought into its place ; then  put a thick pad  or cushion  into each armpit
to keep the shoulder-blade from the side, and to raise it, and then apply
the  bandage  as in the former instance, supporting the forearm in a short
sling, so as to keep the shoulder-blade well up.   The same  difficulties and
results may follow this accident, as in  the previous one.
             DISLOCATION  OF  THE  SHOULDER.

  The upper end of the humerus or upper arm, may be dislocated by falling
on the elbow, suddenly jerking up the elbow, and by the careless practice
which inconsiderate persons have of jerking  a child from off its feet, and
swinging him round in a circle, or by jerking him over a gutter, &c, while
holding him by the hand.  In  these dislocations the head of the bone will
be forced from its socket, and  may take four different directions; the
first and most common one, is where the head of the bone is driven inward
and downward  into the armpit; the  second, where it is thrown forward
bcucath the collar-bone upon the second rib ;  the third where it is thrown
backward on the posterior  surface of  the  shoulder-blade, just beneath the
epine ; and the fourth, where  the head of the bone is thrown forward and 
676                AMERICAN FAMILY PHYSICIAN.

inward on  the coracoid process, a short, thick, bony eminence, situated at
the front part of the upper  margin of the shoulder-Made, forming an in-
complete or partial dislocation.
   AVhen the head of the bone is thrown into  the  armpit, the arm is some-
what longer than  the  other, and  the elbow is carried from the side; the
natural rotundity of the  shoulder is lost,  and the patient  cannot raise his
arm nor extend it outwardly;  there is considerable pain, and  the patient
usually keeps the forearm  bent, supporting the  arm with the  other hand.
Not unfrequently the fingers experience a sensation  of numbness.  If the
elbow be carried outward, nearly at right angles with the body, the head
of the bone can be distinctly felt in the armpit or axilla.   An attempt to
carry the elbow toward the side causes great pain.
   Treatment.   To reduce this  dislocation,  various  modes   have  been
devised,  but the best for ordinary purposes is the following : The patient is
placed on his back upon  the floor,  and the operator, having removed his
shoe, also places himself  upon the floor, but in a  directly opposite position.
A folded towel is placed in the armpit of  the patient, and the operator puts
his heel  upon it, between the arm and the chest, using the  left foot if the
left shoulder be dislocated, and the  right,  if the right shoulder.   The fore-
arm being  bent, the operator seizes  the arm above the elbow with his hands,
or a towel  may be fastened around  the arm at that point, and keeping the
heel in the armpit, he  makes a  steady pull in a line toward  himself, in-
creasing the force gradually, and  in  five or  six minutes the bone returns
into its  place with a loud  snap.   (In Fig. 62 the mode advised is  seen,
but the  engraver has not shown the  forearm  bent as recommended.)
                                   Fie. 62.
Dislocated Arm.
  If, while the operator is pulling, he requests the patient to slightly change
his position, or anything else to divert his attention for the time, and then
at that moment adroitly pulls a little more vigorously, he will  succeed in
more quickly effecting the reduction.  But when this cannot be done, and
the operator requires more force than he is able to give, the towel may be
lengthened, so that  two or three persons may  take  hold and  aid lngmng
the desired amount of force gradually and steadily, the heel being still kept
in the  axilla.  When the arm  has been  once dislocated, it is very liable to
subsequent dislocations from the slightest causes, even in the act of putting
on the coat.  After  its reduction,  it will be well to carry the arm in a sling
and allow it to rest for three or four weeks, that the neighboring parts may
recover their tone.   In some cases it may be necessary  to nauseate the p-
tient with  Lobelia  before the  muscles  will readily yield.  Long stanainb
dislocations require the aid of  a skilful  surgeon.
  When the head of a bone is thrown upon the second  rib, beneath the com
bone, it may be known by the great prominence at the point  of tlie sno
der, the depression or hollow beneath it being more considerable, ana tner 
DISLOCATION  OF  THE ELBOW JOINT.              577
is less pain than in the previous instance ;  the elbow is  thrown from the
side and backward ; the arm is shortened, and the head of the bone may be
felt to roll below the central part of the collar-bone, when the arm is rota-
ted.  The difficulty of moving the arm is  greater than in the preceding case.
  The reduction of this form of dislocation is to  be effected in the same
manner as in the previous instance, with  the exception that the  heel of the
operator must be placed nearer toward the  front part  of the arm pit, and
the pulling or extension must be made at first obliquely downward and back-
ward, and, after a  few minutes, the arm may be raised in a horizontal direc-
tion, but without  relaxing any of the  force  employed in  the  extension.
Keep the arm afterward in a sling, the same as  recommended when a dis-
location  into the arm pit has been reduced.
  When the head of the bone is thrown  backward on the posterior surface
of the shoulder blade, it may be known by the prominent  tumor at that
place, which  turns as the arm is  rotated ; by  the arm  and forearm being
close to and  across the chest, together  with  the other signs common  to
dislocation of this joint.  The dislocation is reduced by the same means as
in the  first  instance, making the  extension in  the same direction, being
careful, however, to  rotate the head of the  bone inward.
  When  the head of the bone is thrown  against the coracoid process there
is a hollow at the back part of the shoulder  joint, the axis of the arm is
thrown inward and forward, and the arm cannot be raised, together with
pain, Ac.  This luxation is reduced in the same manner as  that in which the
head of the bone is thrown forward upon the second rib, being careful, how-
ever, to draw the shoulders backward, that the  head of the  bone may  pass
into  its socket.  After the reduction, secure the shoulders by the bandage
named in fracture of the collar-bone, or the bones will be apt to again shp out.
              DISLOCATION OF THE ELBOAV JOINT.

   The most common dislocation at the  elbow joint, is  that in which both
 bones of the forearm are thrown backward and upward.  The point of the
 elbow is more prominent than usual"; on each side of the elbow there is a
 hollow place;_ the hand and forearm are carried  outward, so that the palm
 of the hand is turned  upward, and cannot be restored to its natural posi-
 tion ;  and the  elbow joint is slightly flexed, but cannot be moved.   This
 accident usually happens  by a  person, in falling, throwing out his hands
 to ssve himself.
   Treatment.   To reduce this luxation,  seat the patient on a chair, take
 hold of his wrist, and put your knee on the inner side of the elbow-joint,
 then bend the  forearm, and, at the  same time, press the knee on the dislo-
 cated  bones of the forearm, so as to  separate them  from the end of the
 upper arm, and allow them to pass into their proper situation.  AVhile this
 pressure is  being made with the knee, the arm is to be forcibly but grad-
ually  bent, and the bones will  slip into their  places.   After the reduction,
keep the arm fixed in a bent position, and apply a bandage, which should
be kept wet with  some cooling lotion.   The forearm  should be bent at
rather less than a right  angle with the upper arm, and supported in a sling
1) ing  across the abdomen.  After eight or ten  days, the joint must be care-
lullyand  gradually moved, in  order to prevent  it  from  becoming perma-
nently faxed and immovable, and the motion should be increased daily.  The
joint should not  be used otherwise for  six or  seven  weeks.  Any other
terms ot dislocation of the shoulder joint may be treated in the same manner
    o 1 
578
AMERICAN FAMILY PHYSICIAN,
                 DISLOCATION OF THE WRIST.

  The wrist becomes occasionally dislocated,  and may be  known by trie
pain, the hand being changed in its situation, the relations of the bones to
each other  becoming also changed, together with swelling on the fore part
and back part of the hand.  In sprains of the wrist there is but one swel-
ling, and that comes on  gradually.
  Treatment.   In the  reduction  of this luxation, full extension is all that
will be necessary, as the muscles will direct the bones into their  proper
situation.  Grasp the patient's hand with your right, and support his fore-
arm with your  left  hand; then  let  an assistant place  his hands  firmly
around the arm just above the elbow, and if both parties now make exten-
sion, the bones  will soon be replaced.  As soon as  this is effected, place a
                                Fig. 63.
Dislocated Wrist.
compress over the part, apply splints before and  behind the forearm, ex-
tending to the  fingers' ends, and bandage  from the fingers to the elbow
Keep down pain and inflammation  by cooling applications, and support
the hand and forearm in  a sling.
       DISLOCATIONS  OF  THE  FINGERS  AND  TOES,
  Are to be treated upon similar principles.   Extension must be made by
mean3 of a tape or  bandage fastened to their lower end; and when suffi-
cient extension is made, the muscles will carry the  bones into their proper
places.  Rest and quiet to the parts, will  be necessary for  some time, and
in twelve or fourteen days, passive motion should be given to the joints to
prevent permanent  stiffness.   Dislocation of the thumb is often very diffi-
cult to reduce, but may be frequently accomplished  by first soaking it in a
warm infusion of Lobelia, for half an hour or so, and afterward employing a
steady, continued, and powerful extending force, while, at the  same time,
the dislocated  bone  is firmly pressed upon, to push it into its place.  Some-
times, it may become necessary to amputate the thumb.
             DISLOCATION  OF  THE  HIP JOINT.

  The hip joint or head of the thigh-bone, may be dislocated in four direc
tions, viz:                                                        ,
  1. The head of the thigh-bone is thrown upward on the back part of the
haunch-bone, where it may be felt by rotating the limb inward; the symp-
toms are,—the leg is shorter than its fellow by about two inches;  the knee
and foot are turned:inward, and the foot lies over the  opposite foot, the ba
of the great  toe being toward  the opposite instep ;  any attempt to turn we
leg  outward, produces great  pain; there  is likewise, as in  all  these ais
cations, lameness, diminution of  motion  in  the limb, pain, swelling, »c 
DISLOCATION OF  THE  THIGH-BONE.
579
 Care must be  taken  not to confound  this dislocation with a fracture of the
 neck of the thigh-bone.
   Treatment.  To  reduce this dislocation, various means  have been eni-
  Eloyed and recommended;  but I shall describe only such as may be used
  y non-medical persons with the greatest chance of success.  First, place
 the  patient upon  his opposite or uninjured side, upon a bed or table, and,
 if necessary, produce muscular relaxation  by the means  heretofore  named ;
 then pass a sheet or strong towel inside of the thigh, between the fork of
 the leg  and the dislocated thigh, and fasten the end
 of this to some point behind the patient, which will
 not yield  to the force applied in the  opposite direc-
 tion; this is the counter-extending apparatus.   Then
 apply a towel or strap around the limb, just above the
 knee, having it sufficiently long and strong for five or
 six stout  men to  take  hold of, and make extension,
 pulling the limb downward, and a little across  the
 other leg, just above the knee.   The extending force
 must be given with care, and be gradually increased;
 and both the extension  and counter-extension, though
 in opposite directions, must  be in the  same  line.
 When the muscles have been sufficiently elongated,
 and  the limb brought to a level with the edge of the
 socket, the bone will usually return to its place with
a snap.   Or, should it not do so, the limb may be gen-
tly rotated inward; and if this  fails, a strong towel,
or even the arm of  the operator, should  be  passed
round the  thigh, high up toward the  body, and the
head of  the bone be lifted by it over the edge of the
Bocket.
  The counter-extending sheet or strap must be so
placed between the thigh and fork of the leg, as not
to cause an injury to the parts of generation in either
the male or female;  and  in making the  extending
force, when great pain is complained of, the assistants
may stop for a  few moments, and  then  renew  the
Upward Dislocation of
    Thigh-bone.
Fig. 65.
                Reduction of Upward Dislocation of Thi-h Bone

Jl^dy -ahicd "unHMrT  '}%"}** the ^ t0 Iose what «>ey ^ave
Sr^ui^tit* of the bone  passes  into  the sockel,  and
  In thi,Ln    •  Ju\- ?nap wluch haPPens at that time.

^oi"^t^S^^ni °f thG hlp j°int' after thG reducti0<b
   patient  should  be kept in bed  for two or three weeks,  and the limbs 
580
AMERICAN  FAMILY   PHYSICIAN.
should be kept parallel with  each other, by  means  of a  bandage passed
around  both, and extending  nearly to the knees;  because it may happen
that, from a trifling cause, even that of removing the patient to the bed the
dislocation  may again  occur,—the neighboring muscles being at this time
much relaxed.   Pain and  inflammation  must  be kept down by the means
heretofore named ; and previous to permitting  the use of the limb, a passive
motion  should be given to it, for  several days, five or  six times each day
gently and carefully flexing the joint upward and downward.
                       2.  The Second Dislocation is downward, the head
                     of the thigh bone being  thrown into a large opening
                     in the lower part of the haunch-bone, called the Obtu-
                     rator  Foramen.   The leg is about two inches lon"ei
                     than its fellow, the  knee is  widely separated from the
                     other one, on attempting to stand the  body is thrown
                    i forward, the toes of the foot point to the ground, though
                     the foot may be outward, inward, or straight; the promi-
                     nence on the outside of  the hip-joint  is considerably
                     less than that of the other side,  and by making pres-
                     sure upon the upper and inner  part of the thigh, the
                     head of the bone  can be felt,  more especially in  thin
                     persons.
                       Treatment.   To reduce  this  dislocation, place the
                     patient upon, his  back, separate the thighs as widely as
                     possible, then pass a girth or towel around and inside
                     of the injured thigh, to which the force is to be applied.
                     Pass another girth around the lower and outside part
                     of the haunch-bone, just above or over the hip joint,
                     and fasten this to some fixed and unyielding point, in
                     order to prevent  the lower part of the body from mov-
                     ing as the thigh is  moved.  Force is now to be care-
                     fully  and gradually made with the first girth in a di-
                     rection outward and obliquely upward, or transversely
  Downward Dislocation   and outward from the injured side, at an angle of about
    of Thigh-bone.     115=^ 120°, or 125°, with the dislocated hip, and as tho
head of the bone begins to rise, the  operator will seize the limb by the ankle,
and gently but firmly draw it toward the other, which will  cause the bone
to slip into its socket with a snap.  In this dislocation, no extension ;«re-

                                 Fig. 67.
Seduction of Dov?nward Dislocation of Thigh Bone.
t: 
DISLOCATION  OF  THE  THIGH-BONE.              581
  quired, or if any, it must be very slight.  The subsequent  treatment will
  be the same as in the previous case.   The girth which is fastened firmly to
  prevent the body from  moving, must  also be so placed as to form an angle
  of 100°, 110°, or 120°, with the sound hip,  its resistance to the force used,
  being made transversely at this angle, and  not in a directly opposite  line
  with the traction.
   It may be proper to state  here, that  in  all these dislocations, a great
  uiiount  of force is frequently necessary, so much so, that large drops of
  sweat will  stand on the forehead of the operator and assistants, even before
  the reduction has been  effected.
   3. The  Third .Dislocation is  backward,
  into  a cavity called the  Sciatic Notch ;  this
 dislocation  is very difficult to detect, as  well
 as  to  reduce.   The limb  is  slightly  shorter
 than  natural, the knee and  foot are  turned
 inward, not so much, however,  as in the  first
 dislocation, and the toe rests  against the  ball
 ef  the great  tee of vhe opposite foot;   on
 standing, the toes reach the floor, but not so
 the heel; the limb is fixed so that it is almost
 impossible  to rotate or  flex it.  The head of
 the thigh-bone is not readily felt, perhaps not
 at all.
   Treatment.   To reduce this accident, place s
 the patient  in the same manner as in the first!
 dislocation; make the extension in a line across W
 the middle  of  the sound  thigh, and  at  the j
 same  time  raise  the head of the dislocated4
 bono  out of its position and across the edge K
 of its socket, by means of a napkin  or strap §
 passed round and  beneath the upper part of
 the thigh, the other end being carried over  the
 shoulders of an assistant,  who,  resting both
 hands  on  the haunch-bone, raises  his body
gently, and with it the thigh-bone.  The sub-
sequent treatment will  be the  same as  in  the
preceding cases.
Backward Dislocation of Thigh-bono.
Fig. 69.
Reduction of Backward Dislocation of Thijdi Bone
  4. In the Fourth Dislocation the head of the thigh-bone is thrown up
ward and inward, in front of the share-bone or pubic bone.   The  limb  is 
582
AMERICAN  FAMILY PHYSICIAN.
                       about an inch shorter than its  fellow, the kneo
                       and foot are turned outward, aud cannot bo rotated
                       inward;  and the head of the bone can be felt like
                       a hard ball at the groin, moving when the knee is
                       rotated or the thigh bent.
                         Treatment.   To reduce this luxation, place the
                       patient upon his sound side, and apply the counter-
                       extending  fixture, the same as in the.first disloca-
                       tion, with  the  exception  that  the strap  or  sheet
                       must be carried in front of the patient's body, and
                       fixed to a firm, unyielding point, as a staple driven
                       in a wall, or a  post, &c.  Extension  is then  to be
                       made in the same manner  as  in the first disloca-
                     _ tion, but it3 direction must  be such, that the limb
                    JjTwill be drawn backward and slightly outward; and
                       at the same time, the head of the bone must be
                       lifted over the  pubic bone and edge of the socket,
                       by means  of   a  napkin  passed  under the upper
                       part of the thigh, the same as in the third disloca-
                       tion, remembering that, as  the patient lies  upon
                       his side, the head of  the bone must be lifted up-
                       ward, and a little forward.   The subsequent  treat-
                       ment will be the same as in the preceding instances.
                         Sometimes dislocations of the thigh-bone may
                       be reduced by pursuing the plan recommended for
                       dislocation of the upper arm into the armpit.   The
F^a^DislocatTo^of Thigh-P,atient  is P^edcm his  back upon the floor and
         bone.          the operator having removed his shoe, also places
                                 Fig. 71.

                 Reduction t-.i' Forward Dislocation of Thigh-bono.
himself on the floor, but in an opposite position.   While  assistants hold
the hips of the patient, the operator presses his foot close  up  to the fork,
which must be protected with a folded towel, and grasping the ankle of the
dislocated limb with both hands, he pulls downward for  a  time; then en-
gages the  patient's attention  by requesting him to change his position a
little, when, with a more vigorous pull, the bone passes into its socket with
a snap.
  Frequently, these dislocations may be reduced upon the  Sweet principle,
thus:—Having the patient on his back, secure the hips firmly by assistants
then seize the limb by the  knee with one hand, and by the  ankle with the
other, bend or flex the leg upon its  upper part or thigh, and then rotate the
thigh a  little  outward, gradually carrying the limb outward  and then push 
DISLOCATION OF THE KNEE-PAN.               583
an the leg toward the face of the patient, bending the thigh so  as to bring
its front surface as  closely as possible against the abdomen or lower belly;
this having been done, rotate the limb in various directions, which will en-
able the head of the bone to pass over the edge of the socket into its  natural
position.
               DISLOCATION  OF  THE KNEE-PAN.

   The  knee-pan  or  patella  may  he  dislocated  in  three ways, outward, in
 ward, and upward.   The outward luxation is the most common, and may be
 known  by the great  projection or tumor on the outside of the knee-joint
 instead  of in front, with pain, stiffness of the knee, and inability to walk.
 The inward luxation is very uncommon, and only differs  in its symptoms
 from the preceding, by the knie-pan forming a projection on the inside of
 the knee-joint.
   Treatment.  To  reduce either of  these  dislocations,  place the patient
 upon his back, and then raise the  leg by the heel, which relaxes the muscles
 of the thigh; then press down the edge of the knee-pan forming the projec-
 tion <»r tumor, and when  this is done to a sufficient extent, the muscles will
 draw the bono into its proper position.  After its reduction, allay swelling
 and inflammation  by  cooling lotions, and in two or three days, apply a  band-
 age.  The  limb should not' be used for three or four weeks, except a little
 passive motion toward the latter part of this period, to prevent a stiff  joint.
   The upward dislocation is caused  by a rupture  of the  ligament of  the
 knee-pan, from which the knee-pan is drawti  on  the  upper and fore part of
 the thigh-bone, sometimes for several  inches, above the knee-joint, and may
 be known by the ease with which the knee-pan may be moved from side to
 side; by the depression felt in the place from which it has been forced; by
 the inability of the limb to  bear the weight of the  body; and by the great
 amount of subsequent inflammation.
  Treatment.  To reduce this luxation, the joint must first be treated with
 cold applications, &c, for six  or seven days, in  order to overcome the  in-
 flammation; after which, the whole limb should be bandaged from the toes
 to the  groin, the patient being in a sitting posture to relax the muscles; and
 the bandage should  be  applied in the  same manner at the knee-joint as
 recommended in  transverse fracture of the knee-pan, (page 569) in  order
to keep the bone in its proper place.   In about one  month afterward,  the
 joint may be moved passively, to overcome any stiffness, and the patient
tnust not bear his weight upon, nor actively use the limb too soon.
  Partial outward  dislocations of the knee-pan may occur, in which the knee
is slightly bent and immovable, and a sickening pain at the part, with  faint-
•icss, is experienced.  The treatment is somewhat similar to that described
ibove for complete dislocations.
             DISLOCATION  OF  THE  KNEE  JOINT.

   Tf* principal bone below the knee joint is the tibia or shin-bone, and
this may be dislocated  in  four  directions, backward, forward, inward, and
outward, and which  may be readily detected.  The lackward dislocation is
complete, and  maybe known by the shortening of the limb; by the pro-
jecting bony condyle at the knee, and  the depression below it; and by the
kg being bent forward.   The forward dislocation is also complete, and may 
:.S4
AMERICAN  FASIiLY PHYSICIAN.
be known by the tibia being felt above and forward of the thigh bone, which
is depressed and thrown rather to one  side.  The  inward dislocation is in-
complete, and rare, and may be known  by the projection of the tibia on the
inner side of the knee joint, while there is a slight  outward projection of tho
lower end of the  thigh bone.   The outer dislocation is also rare and incom-
plete, and may be known by the tibia being prominent on  the outer side of
the knee joint, while the lower end of  the thigh-bone projects inwardly.
  Treatment.  These dislocations may  all be reduced  by extension and
counter-extension; the thigh  must be firmly fixed, when  the leg is to be
drawn downward by an assistant, until the edges of  the dislocated bones are
entirely clear of each  other, and then, by pressing  directly on  the  ends of
the bones-, in a proper direction, they  are  easily brought  into their  natural
position.  The patient may be seated in a  chair during the  operation, havin»
the knee slightly flexed and resting upon some solid body.
  Injuries at the knee joint  are  almost  always attended with  considerable
inflammation;  consequently, after  the reduction,  the  limb must  be  kept
quiet, using the general means heretofore  named to  overcome the inflamma-
tion.  In about  three weeks,  passive  motion  may  be given to  the joint,
bending and extending it gently every  day, in order to prevent stiffness.
  Sometimes in walking with  the  foot turned outward, the toe will strike
against  some hard body, and which is  followed by an immediate pain in the
knee, which cannot be completely  straightened; the same may occur from
a sudden twist inward, when the foot is turned.  This is a partial dislocation
of the thigh bone from what  are called the semilunar cartilages.   It may be
reduced  by bending the leg as  far back as possible,  which, by removing the
pressure made by the  thigh bone, enables  the cartilage to slip into its place.
As this  accident is very liable  to happen again, the  return of it is best pre-
vented by a bandage made with a piece of  linen having four straps  attached
to it, and these are bound lightly above and below the knee-pan.
            DISLOCATIONS  OF  THE  ANKLE  JOINT.

  Dislocations at the ankle joint are very rare, except when accompanied
by fracture; they may occur  inwardly, outwardly, forward, and very seldom
Ixickward.
  The dislocation  inward is  the most eomnion, and may be  known by the
foot  being thrown outward,  its  inner edge resting on  the ground; it may
also be easily rotated on its axis; there is a hard tumor on the inside of the
ankle, and a depression on  the outside, with great pain, and a fracture of
the fibula or splinter bone, which may be known by the crepitus  or grating
sensation perceived about three inches above the ankle.
  Treatment.  In reducing this accident, place  the patient on his  back,
somewhat inclined toward the injured side, and bend the leg at right angles
with the thigh, so  as  to relax the muscles; then while one  assistant holds
the thigh firmly just above the knee, another grasps the foot by the heel and
toes, and makes extension, gradually drawing  it downward in- a line with the
leg.   As soon  as  sufficient  extension has  been made, the  operator should
press downward upon the  tibia, which will replace it.  Then apply splints
and bandages, keep the foot quiet, resting on its outer side, and bent at nghi
angles with the leg, and overcome inflammation by keeping, the  parts con-
stantly wet with cold  water, or  other cooling lotion.   At  the end of nve
weeks, the patient may leave his bed and walk on crutches;  at the end ot
eight weeks, frictions and passive motion to the  joint may be  made; and 
ANCHYLOSIS.
585
twelve or fourteen weeks will elapse before there will be perfect  motion in

* Tile'dislocation outward is more  dangerous than either of the others; the
foot is thrown inward, its outer edge rests  upon the  ground, the  toes  and
foot are  pointed downward, and there is a hard tumor outside of  the ankle.
The splinter bone, and ankle bones are usually fractured.
  Treatment  To reduce this dislocation, the same means must be used as
in the preceding case;  pressing the tibia  inward instead of downward, that
is pressinrr it toward the inner side of the an V.e.  After the reduction, place
a pad over the fibula or splinter bone, above the outer ankle, extending it a
little way up the limb, and applying two splints  one to  each side  of the leg
and ankle, with a foot-board to keep the  foot at right  angles with the leg;
bandage the foot  and leg to  the  splints, &c, and  let the limb rest on its
outer side.  The remaining treatment will be the same as in the fornter case.
  The other dislocations are  rare, but when  they do occur, they must he
treated by extension  and counter-extension, as in the above varieties, with
pressure on the  tibia to place  it in its natural position; after which apply
splints and bandages, and adopt a course very  similar to those of the pre-
ceding varieties.
                 ANCHYLOSIS, or STIFF JOINT.
  Anchylosis is a stiffness or immobility of a joint, occasioned  by disease
of tho joint, or  a severe  injury.   There are three forms  of anchylosis,
viz:  one,  in which the cartilage of the bone  is  destroyed, and  ossifica-
tion, or  the fusion  of the ends of  the  bones into one, ensues.   This
form is incurable.  The other form is apt to follow compound  dislocations,
or ulceration of cartilage;  the joints are held together by ligament.  They
admit of passive  motion, but are incurable.  The third form is that in which
a thickening takes  place  involving the  ligaments, muscles, tendons,  &c,
around the joint.  This form is  frequently curable.  Gouty and rheumatio
persons are often troubled with stiff joints.
  Pain and inflammation of the  joints, from whatever cause, should always
be promptly  attended to, in order to prevent anchylosis; the ordinary means
must be employed to combat them, as,  regularity of the bowels, fomentations
to the parts,  and  frequently leeches or cupping; in some instances, cooling
applications will prove more beneficial than warm.
  Treatment.  When the third form of anchylosis is present, the treatment
consists in applying frictions to the joint and  neighboring muscles, two or
three times daily, at the same time using some stimulating liniment, as the
common Opodeldoc, Camphor Liniment,  Compound Capsicum  Liniment,
Compound Liniment of Oil of Amber, or Compound Tincture of Camphor.
The joints as well as  the muscles, should likewise  be shampooed vigorously
every day, fifteen  or twenty minutes each time.  Warm fomentations, or an
exposure  of the  part to the action of hot vapor  for half  an hour or so
daily, and made previous to the shampooing and frictions, will facilitate the
cure.  The joint  should be gently bent, and straightened as much as possible
without causing  pain;  and this  passive motion  should  be imparted daily.
Any dull pain in the joint  may be removed by cupping, or by an Irritating
plaster.
  Upon  ascertaining  that  the  anchylosis cannot  be prevented, the  limb
should be placed in a position most favorable for the patient's use;  thus, the
legs should be kept straight or extended;  when the  iwjury is at  the elbow, 
586
AMERICAN FAMILY  PHYSICIAN.
the arm should be flexed; and when at the wrist, the hand should be
tended, and kept so by means of splints and bandage.
                               SPRAINS.

  When the neighborhood of a joint is forcibly stretched, or otherwise in-
jured so as to cause pain  and inflammatory swelling, without a dislocation
it is called a sprain.   The parts more generally exposed to this accident are
the wrists and ankles.   Pain, tenderness, swelling, inflammation, and a dark
or black color of the parts, are the ordinary symptoms.   Great care should
be taken in accidents of this  kind to ascertain that no partial dislocation of
the bones of  the joint injured has happened, for by an inattention  to this
point nrany have  been rendered permanently lame.   A sprain may be dis-
criminated from a dislocation  by observing that the swelling comes on grad-
ually, and the usual movements of the joint  can be  made  immediately aftef
the injury, (though these motions become impeded  as the swelling occurs);
while in dislocation, the swelling and  loss of  motion of the joint happen
immediately after the accident.
  Dr. South  says, truly, " Sprains are among the most severe accidents to
which we are subject, as  regards the part itself; the  pain is at the moment
excruciating, often returns on the slightest  movement, and too frequently
lays the foundation of what  is commonly called white swelling.  If one,
therefore, might have a choice of  the two  evils, it would be better to break
a limb than sprain a joint, as the  former is  always the less evil of the two,
in ninety-nine cases out of a hundred being cured  in the course of a few
weeks, if the skin has not been broken, while the effects of the latter may,
at best, remain for weeks  or  months, as weakness or stiffness  in the joint.
There are few things for which medical men are more  unjustly blamed than for
the consequences of a sprain, and we often hear,  ' Why, such an one has only
sprained his wrist or  his ankle, and he has  been under Dr----'s hands so
many weeks; I wonder he does not have other advice.'  And so he may, and
at last be like the woman who  ' suffered many things of many physicians,
and was nothing  bettered,  but rather grew worse.' "
  Treatment.   Keep the limb in  a flexed and quiet position, and keep
down the inflammation by  a warm poultice of Elm bark and Lobelia leaves,
or of Stramonium Leaves, or of Hops, Wormwood and Tansy, in vinegar.
When  the injury  has  been  very severe, and the inflammation great, leeches
may .be applied  with benefit,  followed by cooling lotions.  Cold water,
poured upon the  injured joint from a height, has been recommended, but
it  is more suitable to those  sprains which  are not very severe, though it
may be tried in all cases, being careful not to produce too much sedation in
the parij by its use.   The  bowels should be kept free by Seidlitz powders.
Iodine  thirty to sixty grains, dissolved  in Alcohol  one fluidounce, and ap-
plied freely to the part, has  been used with success, especially in  cases of
erysipelatous inflammation ; at first it inflames considerably, and causes great
pain, but in from twelve to twenty-four hours it effects a cure.  In all cases of
 prain, after the pain, swelling, &c, have subsided, a stimulating plaster, large
enough to cover the part, as the Compound Resin plaster, should be wornJor
some weeks,  and  the joint should be carefully exercised  and be gradually
restored to its ordinary uses.  Electro-magnetism will frequently cure the
worst sprains, after a  few applications.  I have found the most success in
sprains, by keeping the patient perfectly still, and doing nothing in the way
of  treatment;  the many applications  only  tend  to prolong the pain an(l
difficulty, while,  by doing  nothing, the patient recovers much quicker. 
NECROSIS.—CARIES.
587
  When the  sprain is obstinate, or when, after the most acute  symptoms
have been overcome, there still remains a soreness of the joint  with consid-
enble swelling weakness  of the part, and  discoloration  of the skin, some
SmulatTn" lot on  should  be used, and I know of no  better one than the
Corpound°Tincture of Camphor, with which the parts maybe  bathed three
or four times daily.
                       NECROSIS.—CARIES.

  Necrosis is a condition of the bone in which its vitality and nutritive
functions cease altogether ;  the  bone, or a part of it is dead and is ulti-
mately replaced by new  bone.   It may be  caused by wounds, fractures,
bruises, exposures to heat and cold, &c;  sometimes it is constitutional.  it
may be known by a general swelling of the limb, with increased heat, pain,
and throbbing ; the pain is  generally acute and deep-seated.  In the more
active form of the disease, there  are febrile symptoms, as tnirst, white coat
on the tongue, quick pulse, loss  of appetite, and  frequently delirium.  At
first  the swelling is hard, but as  the disease progresses, one or more fistulous
abscesses  form, through which  matter and small  pieces of bone are dis-
charged.   When a  bone dies, or a part of it, and  the dead part separates
from0the living, it is called exfoliation.  Sometimes no  loose bone or pieces
of bone can be discovered ; at others, rather large fragments of the diseased
bone may be felt and removed;  and again, the abscesses may heal,  the old
bone being absorbed.  Persons between the ages of twelve and twenty-five
are more liable to this affection.
   Caries  is a kind  of ulcer on the bone, the nutrition  of which, alone, is
impaired, thereby rendering it softer and lighter than  natural.  It may be
caused by external  injuries, or  may be the reoun of some  constitutional
taint, as scrofula, scurvy, syphilis, use  of mercury, &c.   The  symptoms are
somewhat similar to  those of necrosis ;  the  bone appears enlarged, one or
more fistulous abscesses form externally, their external  edges being soft, red
and sunken, the matter discharged is thin, dark-colored and offensive, and
a  probe, when passed into one of the openings, and  carried to the bone,
will feel the yielding of the softened bone,  together with a gritty sensation.
   Treatment.   The treatment  of each of  these  conditions will be  the
same.  If the disease be recognized at an early period, the surgeon  will at
once form an opening to the bone by caustic potash, or the  knife, that he
may direct his remedies upon it.   Generally, however,  the disease advances
considerably before its nature is suspected by the patient.
   When  the abscess forms, a strong solution of the mild Vegetable Caustic
should be injected into its fistulous canals, once, twice, or thrice a day;  and
if any loose bone be discovered,  it should be gently and carefully removed ;
if it adhere at one end, it may be eventually detached  by raising up the
loose extremity during each dressing, and keeping  it thus by means of lint
moistened with the  above solution.   Every day increase the elevation of
the loose end, as well as the amount of lint to sustain it, until the bone can
be removed  by the forceps.  In  removing  the  exfoliated  portions of bone,
a  twisting, semi-rotating motion  should be given to them; sometimes, they
are so large, or present in such a manner, as to require an incision into the
soft parts before they can be removed.  As little pain as possible  must be
caused in this operation.  Any  undue  amount  of pain or inflammation
may be met with a poultice of Elm and Lobelia.   This course must  be pur-
6ued until all the diseased  bone has  been removed, and the parts  show a 
588
AMERICAN FAMILY  PHYSICIAN.
disposition to  heal, which may be facilitated by the use of the Red Oxiifcof
Lead plaster.
  In addition to  these  local  means,  constitutional measures  must be
adopted, using such agents as are recommended for scrofula, constitutional
syphilis, &c, according to the  nature of the cause.   The  diet of the pa-
tient should be nutritious, generous,  and  of easy digestion ;  the  bowels
should be kept regular by mild  laxatives, and  any debility, or hectic fever
will  require the use of tonics and stimulants, as the Compound  Wine of
Comfrey, Port wine and red Peruvian bark, &c.   Bathing the whole surface
of the body, once or twice a week, will be advantageous.  The cure generally
requires considerable time.  I have had no difficulty, however, in effecting
cures, in many instances, upon the above principle.  In bad  cases, the cure
may be  facilitated by forming one large  opening of the several small ones
which are present, and which may be  done by passing a ligature along one
and  through  another, or, by cutting  the partitions between them  with a
knife.
               WHITLOW, OR  FELON.   (Paronychia.)

  Whitlow, frequently called  felon, is an inflammation of a very painful
character, situated at the last joint of the fingers or toes, and which termi-
nates in a burrowing abscess.   It is caused by injuries, from exposures of
the part to sudden  changes  of temperature, or to the action  of irritating
substances, the pricking of pins, needles, broken glass, &c, and frequently
arises without any known cause.   A bad condition of the system may occa-
sion it.   Sometimes it appears  to develop itself as an  epidemic disease,.
  There are four kinds of whitlow mentioned by  writers, viz : 1. Where it
is situated just under the oki^at the root and sides of the nail.  2. Where
it is situated in the fleshy fore  part of the end of the finger.   3. Where it
is within the sheath which contains the tendons of the finger; and 4. Where
the periosteum, or covering of  the bone,  is inflamed.   As far as treatment
is concerned, it matters but  little where the  inflammation may be seated.
Whitlow is a very painful  disease, the first form being the mildest;  and if
it be not  properly attended  to, it  may not only  cause  a deformity  of the
hand, or a loss of one or more  of the  finger bones, but even a loss  of the
hand itself.   It  commences with a deep-seated pain, redness, swelling, and
throbbing; the  pain soon becomes  excruciating, preventing the patient
from sleeping, and, sooner or later, matter forms, and burrows through the
finger and hand, until it finds an external discharging place.
  Treatment.  The earlier this affection is  attended to, the better will it
be for the patient.   I have frequently removed the  disease by resolution,
by keeping the following poultice constantly applied to it, changing it three
times a  day,  and continuing its use for  a few days after all pricking, ten-
derness, and  pain had  ceased:—Take of Elm bark, Pokeroot, Blue Flag
root, and  Lobelia seed, each, in powder, equal parts, mix with hot ley to
form a poultice ; apply  it as hot as can be borne.   The hand and arm must
be carried in a sling with the elbow flexed so that the forearm will form an
acute angle with  the  upper arm, and thus have  the hand somewhat raised
and  resting upon the chest.
  Should  this method fail, or the disease have progressed too far to  cure»
by resolution, means  must be  taken  to  form an opening, that the  matter
may be discharged  as fast as it -forms, instead of burrowing under the tis-
sues. This is best effected by applying Caustic Potash to that part of the 
GANGLION.
589
gwelling at which there is a whitish-yellow appearance, as  if the abscess
wlS pointing at the  part, and cauterizing directly through  the flesh  until
the abscess is reached ;  after which the above poultice may be applied, or
an ordinary Kim poultice.  It is usually advised to cut into the part,  even
down to the bone, but besides the pain produced, it does not afford as much
relief as t!-:e cauterization ;  and if, after twenty-four hours have passed the
cauterizing has not opened the abscess, the knife may then be used without
causing any great amount of pain.  If, however, the abscess  be not deep,
the matter appearing near the surface, it may be discharged  by means of a
probe or lancet; continuing  afterward to apply the  above  poultice.   Any
fungous flesh, (proud flesh,) which  springs up may be removed by sprink-
ling the mild Vegetable Caustic upon it, or burnt alum.  Any febrile symp-
toms, sleeplessness, costiveness, &c, are best overcome with a  purgative or
two, bathing the surface of  the  body,  and administering the Compound
Tincture of Virginia Snakeroot.  In severe cases, the use of Burdock seed
and Polygala, as named under Boils, page 503, will be found very benefi-
cial ; and will also be of great service during the epidemic form of the dis-
ease, as well as  among those who are liable to frequent attacks of it.^
  Sometimes the bone becomes wholly or partially destroyed;  in this  case,
a strong solution of mild Vegetable Caustic must be  injected into the  part,
or the  finger may be held in  it for some fifteen or twenty minutes, repeat-
ing it two or three times a day, and applying the above poultice during the
intervals.   As soon as  the bone  is  loose,  remove it with a pair of forceps.
Any stiffness of the joint which 'remains after the healing of  the whitlow,
may bo treated  the same as recommended  on page 585, under Anchylosis.
During the treatment of whitlow, the  decoction of Ground Centaury and
Burdock  seed, named under  Boils,  on page 503, may be used with benefit;
this will likewise be found valuable in  instances where there appears to  be
a frequent disposition to the disease.
  The following have been recommended  as applications in the early part
of the disease:—
  1. Add enough very fine Salt to Oil  of  Turpentine to form a thin paste,
and apply it to the finger, binding it on very tightly.  It must not be re-
moved for some  days, keeping it constantly moist by dropping Oil of  Tur-
pentine on the bandage  several times a day, or whenever there is a disposi-
tion in  it to become dry.  It  occasions  much heat and pain at first.
  2. Keep a plaster  of some  good Extract of Belladonna to the part, and
after all pain has ceased, apply  the common diachylon, or Lead plaster.
               GANGLION,  or  BURSAL  TUMOR.

  Ganglion,  or  Weeping Sinew as some  term it, is an  encysted, circum-
scribed, elastic, movable  swelling  on  the  tendons  in various parts  of  the
body, but more commonly upon the back  of the hand, and over the wrist;
it frequently occurs just below the  knee-pan among housemaids and others,
who are much upon their knees when laboring.   It occasions no change in
the color of the skin, is not usually accompanied with any pain,  but when
occurring  at the wrist, is very  apt to cause a permanent weakness  of  the
hand, continuing even after the disappearance of the  tumor.  It is  gene-
rally caused  by slight blows, falls,  twists, sprains, or great and continued
friction or pressure upon the parts.  Sometimes  it occurs without any  ap-
parent cause.  When opened, it is found  to contain a transparent, glairy
fluid, resembling the white of egg.   It is very indolent in its  character, fre- 
590
AMERICAN FAMILY  PHYSICIAN.
quently resisting all attempts at removal, and is apt, at times, to de"enerati
into a malignant fungous affection, especially when irritated too much.
  Treatment.  This  consists principally in arousing the absorbents, that
the fluid may be carried off  by them;  to  effect which, the best  plan is to
properly adapt and bind a piece of Lead upon the tumor, so as to make firm
and continued compression.  And this course may be aided by stimulating
liniments, and strong  currents of electro-magnetism, being careful not to
produce too much irritation in the tumor.   It may become necessary as the
tumor  diminishes, to remove the  lead, and reapply it, in order to keep up
firm  pressure.   Compression should be continued for some  time after the
tumor has disappeared, that the cure may be permanent.
  AVhen the swelling  is large, and of long standing, as is frequently the
case at the knee, in addition to the above measures, it may become neces-
sary not only to apply cups to  the whole surface of the tumor, but the Com-
pound  Tar plaster may have to be used, keeping up a discharge from it for
six or eight weeks.  When the symptoms of irritation or  inflammation are
present to any extent, they are best  removed  by rest, cooling washes, or
warm bitter herb fomentations, omitting the previous treatment until the
troublesome symptoms are reduced.
  Sometimes, the disease has been cured by painting  the tumor well with
Tincture of Iodine, three  times  a day, covering with oil silk, and then
firmly compressing it with a bandage.
  It usually requires  several months to effect  a cure ; and in those cases
where the above  means  fail, after having been  perseveringly tried, it will
need the aid of the surgeon to remove the swelling by the knife.
                               ULCERS.

  When the surface of any part of the body is removed Dy disease or other-
wise, whether it be internal or external, and a discharge of matter is thrown
out from the portion thus  exposed, it is termed ulceration ; and the ulcer
thus produced may belong to one  of the following varieties:—
  1. If it be a simple purulent ulcer, it will present a bright red appearance,
the matter discharged will  be thick, easily removed from the exposed sur-
face, having no  offensive odor, the ulcer  does not extend, but manifests a
disposition to diminish in size and  heal, the granulations will be red, healthy,
and moist, appearing like very fine pimples or granules, of regular size, and
the edge  of the  ulcer will be whitish.  All the treatment required is a
proper  position, rest in  the recumbent posture, and no  applications to the
part, save a  little dry lint loosely applied, to absorb the pus or matter as it
forms.  AVhen the parts around an ulcer are too weak to carry on the  actions
necessary to their recovery, it will be necessary to stimulate the ulcer, as
named hereafter, support the parts by  bandages, destroy fungous growths by
escharotics,  and give tonics, or alteratives, nutritious diet, &c, as the pecu
liarity of each case may  demand.
   2. If it be an  indolent ulcer, it will  present a pale, flabby appearance, the
pus will be  thin and watery, or of a dark-yellow color, very difficult of re-
moval from the  surface of the ulcer, and frequently giving out a more or
loss unpleasant odor, the granulations will be high, rounded, smooth, insen-
sible, and pale,  often with a tendency  to fungous or "proud flesh," and the
edge  of the ulcer will  be  glo.-sy, thick, rounded, and  everted, and the sur-
rounding parts unhealthy and  dark  colored.   The greater part of the ulcers
met with in practice are of tlm character, and  are more  commonly located
on the  legs. 
ULCERS.
591
  7  If it be an irritable ulcer, it will present an excavation, with  rough,
-Jlod inverted, or overhanging edge, the pus will be very small in quan-
fe very thin, watery, and often acrid  and offensive, there are  no granula-
 ns but the surface of the  ulcer will be covered by a gray, or dusky red,
 pongy substance, which when touched,  is not only very painful but also
Eds and the  surrounding  parts will be swollen, red, and painful.  The
pain frequently comes on ^paroxysms, producing spasmodic motions of the

''"These may be said to include the varieties of ulcers ordinarily met with,
although surgeons recognize many more, as scrofulous, cancerous, syphi-
litic, callous, varicose, &c.  The first three of these are treated upon under
their respective heads, Scrofula, Cancer, and Syphilis.  Ulcers may arise
from various causes, as bruises, blows,  burns, inflammation, constitutional
taint, &c; but whatever may be their cause, the general principles ot treat-
ment will be the same.
  Treatment.   When inflammation is  present, this must first be subdued
before any other measures are employed.  Various means may be used for
this purpose, according to  the influence  they  exert; thus, with  some, a
Btrcam of cold water will exert a beneficial effect;  with others, warm  fomen-
tations of Hops and Lobelia, or Poppy leaves, will produce the best result;
but in most instances, if the  ulcer be exposed to the vapor from hot water,
or from a decoction of bitter  or anodyne  herbs, and then be  carefully cov-
ered with an Elm poultice, not allowing it  to bear on the parts too much
when they are irritable and painful, much relief will beobtained.^ And
whatever course is found  to  answer in allaying inflammation or irritation,
it should be repeated two or  three  times daily, and be continued until these
symptoms have been subdued.
  Should much fetor arise from the  ulcer, Yeast  may be  mixed with  the
poultice,  or some  Pyroligneous Acid.  A poultice of scraped Carrots has
been recommended for the same purpose.   After  all  the above  symptoms
have disappeared, the  ulcer may assume  a healthy character;  and  if not,
then the treatment must vary according  to the indications.
  If it manifest a disposition to become  indolent, it must be stimulated, for
the purpose of exciting healthy granulations.  For  this purpose it should
be washed every time of dressing with Castile soapsuds  to  which  a little
Spirits has been added, and carefully dried;  then  sprinkle over its surface,
some mild Vegetable Caustic, or finely powdered Bloodroot, cover this with
a thin layer of dry lint, place  over this  the Red  Oxide  of Lead plaster,
spread on linen, and sufficiently large  to extend  a short distance  beyond
the edge of the ulcer, put over this a compress  or piece of muslin folded
once or twice, and  apply a bandage to  the limb enclosing the  above dress-
ings.  Of course this would be inapplicable to an irritable ulcer.  As soon
as the ulcer assumes a  healthy aspect, adopt the  simple  treatment above-
named.
  Sometimes, however, ulcers will  be found  so  obstinate  and  indolent in
their character, as to require a stimulating treatment  up to the moment  of
their healing ; after which, if the proper measures be  not pursued, they
will be very apt to reappear.   This is especially the  case in  that  class of
ulcers known as "fever sores," and among persons who are addicted to the
intemperate use of stimulating liquors.  In these cases I have met with
invariable success, by the use of electro-magnetism, in addition to the above
treatment; the current is to  be passed, two or three times a day, as strong
as tho patient can  possibly bear, not only through and directly upon tho
ulcer, but likewise along the  whole course of the limb thus affected. 
592
AMERICAN FAMILY  PHYSICIAN.
  In addition  to  these local  means,  constitutional  treatment must be
adopted.   Where there  is much debility, the use of tonics, nourishing diet
and  moderate exercise of all  parts save the  affected limb, are  necessary-
if there is  much pain and inflammation, anodynes, cathartics, diaphoretics'
and  in all  cases of obstinate ulcer, an alterative, as the Compound Syrup of
Stillingia,  will be found  of much service.  The bowels should be kept rem-
lar, diet should be  nutritious  and  easy of digestion, and  acids, fats, and
especially  liquors, must  be avoided.   Intemperate patients must be short-
ened in their allowance of liquor, stopping it  altogether if possible, and
exhibiting other stimulants, as  Carbonate of Ammonia, &c, as a substitute
for the  Alcoholic drinks.  By pursuing a treatment based upon the abov*
principles, I have effected cures where  the  ulcers were of ten,  twelve, and
in one instance, twenty years standing.
  I have known several  instances of the so called "fever sores," to be per-
manently  cured by the  application  of pounded fresh Chickweed leaves
(Stellaria Media), to the ulcer,  repeating the application twice a day.
                     •    FISTULA  IN  ANO.

  Fistula in Ano is a sinous ulcer in the neighborhood  of the anus and
rectum, of a very obstinate character,  which will continue  for years under-
mining the patient's health, if not properly treated, constantly  discharging
more or less of a thin, watery, offensive fluid, and  having the walls of its
little fistulous pipes or canals very hard or callous.   There are two varie-
ties  of fistula  in  ano; one, complete  fistula, the pipes or  sinous canals of
which  open upon some external part in the  neighborhood  of the anus, and
pass either directly straight, or, more  commonly, in a crooked  direction to
the rectum, forming an open communication between  this intestine and the
external surface of the body.  The other, incomplete fistula,  sometimes called
blind fistula, one end of the pipes of which remain closed;  if the open end
is on the outside, it is termed a blind  external fistula ;  if it  is on the inside,
opening into  the rectum,  it is a blind internal fistula  whose external posi-
tion may be ascertained by the redness and hardness  of the part immedi-
ately over it.   These  distinctions, however, are of  no  particular importance
in a practical point.
  Fistula in ano may be occasioned by various causes, as.  derangement of
the  liver, constipation, piles, relaxation  of the bowels, sedentary  habits,
injuries, riding on  horseback, intemperate living, &c.; it is frequently con-
nected with disease of the  lungs.
  The disease usually commences the same as any  other abscess, with a
swelling,  and more or less  inflammation ; sometimes  the constitution suf-
fers, there being  high fever, hard,  full  pulse, nausea, thirst, and other
febrile symptoms.   Not unfrequently  there  is  no  pain whatever, and very
slight  swelling, and the patient is not aware of the difficulty until it opens
 nd discharges matter.  When there  is pain it is usually very  severe, ren-
dering it almost  a torture to discharge the  contents of the bowels and
bladder.   The progress toward suppuration is generally very slow, and the
matter discharged at  first, is  in  large quantity, and  exceedingly offensive.
The opening may occur near the anus, in the  perineum, or at a distance
from the anus in the  buttocks.  There may be one  opening or canal; or
there  may  be several; and these may  communicate  with the  bladder,
vagina, or other neighboring parts, but more commonly with the rectum,--
and it is not uncommon, in complete  fistula, for the feces  to be partly dis- 
FISTULA IN ANO.
593
 charged through these openings.   Frequently the external orifices of the
 canals will be found, some on each buttock.   The edges and walls of these
 nines are very hard and callous, and the hardness appears to  be propor.
 tioned to the duration  of the disease ; and, on this account, a recent fistula
 is more readily and quickly cured than one of long standing    It is rarely
 that a cure occurs spontaneously.   Upon passing a probe through one of
 the fistulous canals, the end of it  may be felt  in  the  rectum,  by oiling the
 index finger and passing it into this intestine.
   Treatment.  Ordinarily, patients do not apply for treatment during the
 early stage of fistula, in consequence  of which,  from two to six  or more
 months are usually  required before a  perfect cure can be effected.  Ihe
 treatment will vary according to the stage  of  the disease.  If it be in the
 forming stage, and accompanied with  much  pain  and inflammation, these
 may be"'diminished by  the local application of warm emollient poultices, fo-
 mentations of  bitter  herbs, Poppy leaves, Stramonium leaves, &c, together
 with the internal use of agents generally advised  in inflammatory affections,
 as cathartics, diaphoretics, anodynes, diuretics, &c.  The poultice named for
 whitlow will be found a valuable  local  application.  This treatment will not
 only allay the severe symptoms but will hasten the suppurative process.
   As soon as there  is a pointing of the abscess, a softening of the tumor,
 and the redness disappearing, with the  ordinary symptoms of  complete sup-
 puration, the part may be opened  either with the knife, or by the application
 of caustic potash, that  the pus may escape.  The caustic is usually preferable
 to the knife; and when the abscess is deep or  some distance from the exter-
 nal surface, it is better to wait for a time,  and apply poultices for the pur-
 pose of inviting the  suppurative  action more directly toward the surface.
 After the  opening  of the  abscess, all the  canals  should be injected two or
 throe times a day with  Castile Soap suds to which a little spirits have been
 added, in order to cleanse their walls, and cause them to heal; being careful
 to heal from the bottom, and  not  allow the  outside to  heal first.   If there is
 a tendency to assume an indolent  character, a weak alkaline solution may be
 used, or the Copaiva preparation  hereafter  named.  The patient must keep
 quiet, keep his bowels regular, and moderately use a nutritious diet.
   When the disease assumes a chronic form, which is the form to which the
 surgeon's attention is  more usually called, the treatment will be  somewhat
 different.  If it be a "blind internal fistula,"  an  external opening must be
 made, either with  the knife or caustic  potash,  in  order to enable the prac-
 titioner to reach, and apply his remedies to  the  fistulous pipe;  if it be  a
 "blind external fistula," it may become necessary to pass up a probe and
 open  the  canal into  the  rectum, but this  is  not  always  required  nor
 advisable.
  The treatment consists in the application of  vegetable caustic  to the walla
of the canals, which may be introduced on long  pieces of cord which have
been dipped in wax,  or on  masses of lint, which  must  be  pushed in the
sinuses as far as possible.  This will  occasion  pain for several minutes.   A
compress may be applied over the parts, and  be  secured in its  place by a
bandage.  The caustic  should be  introduced daily, and when  the canals are
very tortuous a strong solution of it may also be injected  into them; if,
however, the fistula be very tender and irritable at first, it should be treated
with  anodyne  and  emollient  poultices, fomentations  of bitter  herbs, &c,
before attempting to examine it with a probe, or to  apply the  caustic.  And
in  the treatment of the disease generally, great care must  be taken not  to
cause too much pain, being governed in the  strength  and frequency of our
applications by the patients feelings.
       00 
594
AMERICAN FAMILY  PHYSICIAN.
  After having continued this treatment for a week or two, it will be well to
change it, for a constant use of caustics is  not desirable.   A  mixture may
be injected  into the  sinuses two  or three times a day, composed of Balsam
Copaiva one fluidrachm, Creosote two  drachms, PowTdered  Gum Arabic ono
drachm, Camphor mixture  eight fluidounces;  mix.  After which apply the
following  ointment;  take of Ointment of Acetate of Lead,  Ointment of
Oxide of Zinc, of each one ounce; mix.   This must be spread on pledgets
of lint or floss silk, and crowded in  to the sinuses as  firmly as possible
without causing  unnecessary pain, in  order to make  pressure upon  their
walls, and  thus promote absorption  of their  callosity.  In  the  course of
twelve or fourteen days return to the caustic, and so alternate the treatment
until  the  parts  assume  a healthy character, being  careful always  to heal
from the bottom, or else the disease will be apt to  return.  Frequently, and
especially in cases of recent origin the above treatment without the caustic,
will be found sufficient to effect a cure.  The cure may often  be  facilitated
by the application of a ligature to cut the principal sinus through; this is
accomplished by passing saddler's silk on a probe through the sinus; a finger
introduced into the rectum upon  feeling the end  of the probe, will bend it
and carry it through the rectum externally, carrying the ligature with it; or
the eye of the probe may be introduced first, so that the finger may fasten
on the thread  and bring that  through, without the probe.  The ligature
when  passed, is then to be tied by its two  ends somewhat tightly, and every
day it should be more and more tightened until the parts are cut through,
making one common  opening of the rectum and fistula.  The tightening of
the ligature may be accomplished by  twisting  it from day to day, by means
of a small piece of wood passed under it;  it must  not be permitted to cause
too much pain.  Should the ligature cause severe  pain, much relief will be
afforded by  anodyne and bitter herb fomentations, and emollient poultices.
During the  ligating, and subsequently, the same course  should be pursued
as named above, as if  no ligature were used.   The best time  for dressing a
fistula is shortly after the bowels have been emptied.
  As  the constitution  suffers more  or less from this disease, internal rem-
edies  must  be administered, as the Compound Syrup  of Yellow Dock with
Iodide of Potassium, or the Compound Syrup of Stillingia, &c.  The decoc-
tion of ground Centaury, and Burdock seed, named under Boils, on page 503,
will be found very valuable in all cases.  The  bowels must be kept regular,
diet must be nutritious, liquors must be positively  prohibited,  and moderate
exercise  is  admissible.   If symptoms of  Pulmonary disease are present,
treat them the same as if no fistula existed.   By  the above course I have
cured fistulas of many years' standing, several  of which had been unsuccecs
fully operated on with the knife, three or four times.   There is no difficulty
in curing fistula in ano, but there will be  considerable in curing the accom-
panying  pulmonary affection, if it be allowed to remain too long, before
proper treatment is pursued.
   Mr. Henry J. Miller, aged 35, was  attacked with  fistula and confined to
his room for a number of  weeks, laboring under  very severe pain and ex-
treme debility, so as to affect his mind;  his friends advised him to enter the
New York City Hospital;  he followed- their advice and remained there four
months,  during which time he was operated on, by cutting with the kuiie
some  two or three times.   Having received  no benefit by this treatment, ne
left in a most deplorable condition; his mind  shattered,  his nervous system
prostrated,  suffering the most excruciating pain  and  distressing feelinga,
together with symptoms of pulmonary disease.  In this condition he apphe
to  me,  I undertook  his case with great  hesitation, but, by pursuing toe 
PILES.
595
course above mentioned, succeeded in effecting a thorough cure in the course
of nine months.  Many similar instances could be named, to show; the su-
periority of the above treatment, would the limits of the work permit.
  Fissure  op  the  Anus, is a very  troublesome  complaint,  frequently
being very obstinate in its character, and affecting the general  health.   It
may be known by fissures  or  cracks around the anus, of various lengths,
which are very irritable and painful, and discharge a thin fluid.   The edges
of these cracks gradually become hard.  The treatment will be similar to
that for fistula in ano; apply fomentations to relieve the tenderness of  the
part, after which sprinkle the Vegetable Caustic along the cracks, and cover
with an ointment spread on lint, made of Extract of Belladonna one drachm,
rubbed well with melted Spermaceti seven drachms.
PILES,  or HEMORRHOIDS.
   Piles are a very common affection, there  being but few persons who are
 not troubled with them at some period of their life.  The disease consists in
 small tumors in the rectum or about the anus, which are divided into, first
 those which are owing  to a distended  state of the veins of the part;  and
 second, those which present the character of a solid tumor.   When the tu-
 mors are within the rectum they are called internal piles;  when without and
 around the anus,  external.  When  they discharge blood they are  termed
 bleeding piles,  and  when no blood appears, blind piles.
   Piles may be caused by anything  that will irritate the lower bowels, pro-
 ducing a determination of blood to  the  rectum, as drastic cathartics, from
 the extensive use of which  in past years, the disease has become very com-
 mon, habitual  constipation, straining at stool, diseases of the liver, much
 riding on horse-back, tight stays,  sedentary habits, high living, heating,
 irritating food, &c.
   During pregnancy, the constipation to which females are subject,  as well
 as the pressure  of the  enlarged womb  on  the pelvic veins, render them
 extremely liable  to  attacks of piles.
   Piles are frequently preceded by a sense of weight in  the back, loins,  and
 lower part  of the abdomen,  causing the patient  to suppose he has some
 affection  of the  kidneys, or neighboring organs; at  times,  symptoms of
 indigestion  are present, as flatulency, uneasiness  of the  stomach, &c.   A
 disagreeable itching about the  anus is a  common  attendant.  Upon going
 to stool, a stinging  or burning pain is experienced, being often very severe,
 and after the fecal  discharge, there is more or less  bearing down, or tenes-
 mus.   On examining the part, small tumors of a  livid appearance will be
 found,  which are usually  firm, round, elastic, and  of various sizes.   If the
 inflammation is excessive, the patient suffers not only during an evacuation,
 but all the time; and any effort at  returning the  pile, or  pushing  it  up,
 which affords  relief under ordinary circumstances, will occasion so much
 pain as to oblige him to desist.   The suffering may be so great as to  confine
 the patient  to his bed for several days. When the piles  are situated high up
 the rectum, they are less painful  than when low down, and around the verge
ot the anus   When  blood is  discharged,  the pain  and uneasiness are
diminished  ; but when there is no discharge, and especially when the tumors
are external, much  suffering is experienced, and frequently sitting  upon a
hard seat causes great uneasiness.  Piles  may continue  for a long time with-
out affecting the general health, or they may occasion many disagreeable
symptoms,  and if  not timely attended to, they may produce falling of the 
596
AMERICAN FAMILY  PHYSICIAN.
bowel, fistula  in ano, &c; and  instances are not wanting where persons
have died from the excessive bleeding accompanying the disease.
  Treatment.  In all cases of piles, whether blind or bleeding, the con-
stipated condition of the bowels must be obviated, and they must be kept
in as regular a state as possible by means of mild  laxatives, or injections,
and in some instances by stewed dried fruits.  (See remarks on Constipation,
pages  150 and 425.)   Any deranged condition of the liver or digestive
organs  must  also be  overcome by appropriate means ; a permanent cure
cannot be expected unless the  patient dispenses with  those  habits which
produce and keep up the disease.
  When the disease is of the kind known as " bleeding piles," I have met
with great success by giving the following preparation  internally: Take of
Rhubarb, common Rosin,  of each, in powder, one ounce, powdered Alum
fialf an ounce,; mix.   A tablespoonful of this may be added to half a gill
of molasses, of which a tablespoonful may be taken for a dose, and repeated
every two, three,  or four  hours, as  the urgency of the case  will require.
At the same  time, the following ointment must be used: Take of Styptic
powder one*part, Canada balsam one part, Stramonium ointment six parts;
mix them well together.   A small portion of this should be passed as far
up the bowel  as possible with the finger, or on a piece  of lint or cotton, or
it may be warmed and injected into  the rectum  while  in a fluid state.  It
should be applied  two  or three times a day, and be  retained as long  m
possible.
   In  the blind piles, or when in a  state of tumor, and  there is much pain
and inflammation, a poultice should  be applied to the parts, made of equal
parts  of Elm bark and  Lobelia leaves ; or Stramonium leaves, or Poke
leaves.  In fact,  I  know of no agent so highly beneficial, in these cases,
as the Poke leaf, which should  be gathered just previous to the ripening of
the  berries.  When the  inflammatory symptoms are  very obstinate, the
patient may steam the parts by sitting over a hot decoction of bitter herbs,
as Hops, Tansy, Poke leaf, Stramonium leaf, &c.  Sometimes, cooling appli-
cations, sitting in  cold water, or  applying compresses to the part, moist-
ened in cold  water, &c, will prove very beneficial.   After the more severe
symptoms have  been removed, a strong decoction of  Poke leaves may
be injected into  the rectum two or three  times a day, while, at the same
 time, the  patient  drinks freely of  an  infusion made of equal parts  of
 Solomon's Seal, Golden Seal, and Elder Flowers.   The bowels  should  be
 kept regular, the diet should  be nutritious, easy of digestion, and rather
 calculated  to keep  the  bowels open, and  all  spices, liquors, and heating
 articles must be positively avoided.
   Many articles have been successfully used in the treatment of this dis-
 ease, as local applications, especially when  recent, among which may be
 named the following: 1. Take of Cream three parts, Oil of Pennyroyal one
 part; mix.   2. Take of Tannic  Acid  one scruple, Cerate  of Acetate ot
 Lead one  ounce,  Extract  of  Stramonium  one drachm ; rub thorough
 together.   3. Add  a sufficient quantity of grated nutmeg to Stramonium
 ointment, to  form a stiff paste.  4.  Mix together equal quantities of Usto
 Oil and  Copal varnish.  5.  Take of Acetate of Lead thirty grains, bum
 Cork, Tobacco ointment, inspissated juice  of Poke, each, three  dracnms,
 mix.  Either of the above may be  applied to the parts on  cotton or lin ,
 and repeated two or three  times a  day.   6.  Fresh Linseed Oil is saw
 have effected permanent cures in two or three weeks, by giving it twic
 day, in doses of two ounces, avoiding at the same  time alcoholic drinks a
 stimulating  diet.   It may increase  the stools, but causes no  bad  resu 
FALLING OF  THE  BOWEL.
597
7  When the bleeding is excessive, it has been checked by the following .
Take pure Oil of Turpentine half a fluidrachm, Tincture of Kino, Syrup of
Gin 'e? each, one fluidrachm, Cinnamon, rain-water, each, three fluidrachms,
muclSrc of gum Arabic half a fluidounce, or more; mix for a dose, to be
Seated two or three timesa day.  Cold water injected  daily will give tone
  Pthe veins of'the rectum.  In  preparing  the above  the  Turpentine and
Lei age should first be rubbed  together.  8. The following  has  afforded
™o»s derablo  relief to pregnant females, and  others, affected with bleeding
Piles  and has often made cures :-Take of Solomon's Seal four ounces  boil-
ing water two pints, Molasses one pint; mix, and simmer  gradually to one
pint and a half, and strain.  To this add two ounces  of powdered Rosin.
The dose is a wineglassful, three or  four times a day, shaking the mixture
each  time before using it.
  When the piles are callous and hard, various means have  been used, as
the application daily of a solution of Nitrate  of Silver,  Nitric Acid, Caustic
Potash,  &c.; but these should  only be used by the surgeon.   Chromic
Acid  applied freely over the whole of the tumor, has been found successful.
This'acid consists of a thick crystalline pap,  which, when rightly managed,
does  not spread  beyond the prescribed  limits.  It occasions uneasiness for
some  hours, sometimes acute, burning  pain.  A slough passes away, and
the tumor shrinks and  becomes insensible.  As soon  as the erosive influ-
ence  of this acid is finished, it passes into a state of  inert,  pulverulent
sesquioxide.
   If these measures fail, the tumor will require to be removed by ligature,
an operation which none  but a medical man should attempt.   (For Piles
during pregnancy, see page 525.)
FALLING OF  THE BOWEL.
  Falling of the  bowel, or Prolapsus Ani, is a complaint  in  which the
rectum protrudes in a greater or less degree  at the verge of the anus.   It
may occur at  any period of life, but infants and elderly persons are more
subject to it.  It may be owing to an irritation of the rectum by the use of
aloetic  purgatives, worms,  piles, straining at stool, violent coughing, long-
continued crying, or loud  talking,  &c.   It may depend  upon a  relaxation
of the parts, constipation, diarrhea, stricture in the urethra, enlarged pros-
tate, kc, and its size may vary from  the slightest appearance of the intestine
at the anus, to its external protrusion nearly as large as  a child's head.
  When there is violent pain, inflammation, and febrile symptoms, or when
it is complicated with  strangulation, the case is  of a serious nature.   In
adults, the disease is often connected with piles.
  Treatment.  Among children, ascertain the cause, and remove it if pos-
sible.   Keep the bowels regular; always  return the bowel immediately after
its protrusion; let the evacuations be made while lying down; avoid crying
and other straining efforts as much as possible; bathe or inject the parts with
cold water and astringent liquids, and  administer internally an  infusion of
equal parts of Solomon's Seal and Golden Seal.
  Among adults, the protruded  part should  be  replaced at once, which, if
the patient cannot accomplish himself, may  be done by placing him upon
his back, or knees, having the hips elevated, and then, oiling  the  fingers,
carefully press and push the bowel back  into the anus; when this is accom-
plished, inject into the rectum about an  ounce of a strong infusion of Solo-
mon's Seal root, Crowfoot root, and  Poke leaves, apply a compress of cotton 
598
AMERICAN FAMILY  PHYSICIAN.
over the anus, support it  by means of a T bandage, and have the injection
retained as long as possible.  The injection may be repeated two or three
times a day.   An injection composed of one fluidounce  of  Geranium, in
which one  or two grains of Sulphate of Iron have been dissolved, has also
been used with benefit.
  Sometimes, however, the pain and inflammation are so severe, as to render
it impossible to return the intestine;  when this is the case, these symptoms
must  be removed by the means named  for similar ones in piles, and after
their removal, attempts must be made to return it.
  Persons  who are subject  to this  complaint, should keep their bowels reg
ular by proper diet, should be careful not to strain, nor stoop too much when
at stool, should avoid all severe  exercise, and  should constantly support the
parts  by means of a compress  and T bandage.  A suppository passed into
the rectum and supported  as above, has  proved  useful; it may be made as
follows:—Take of Spermaceti two ounces, Wax half an ounce, Canada Bal-
sam one drachm, melt  together, and when  nearly  cold, add of Tannic Acid
two drachms.   If this  be  found too  firm for a  suppository it may be ren-
dered less  so  by the addition of a sufficient quantity of  Linseed Oil.  It
may be  worn constantly.
  I have derived  considerable benefit  in many instances, by the following
injection, one teaspoonful of which may  be injected into the rectum, and
retained there as  long as possible,  repeating it three or four times a day:—
Take of Tincture of Prickly-Ash berries four fluidounces, Tincture of Nux
Vomica three fluidrachms;  mix.
                               TUMORS.
  A tumor is an  unnatural  rising or prominence, of greater or less size,
developed on any part of the body, and owing its  origin to some unhealthy
action.  There are several varieties of  tumor, as scrofulous, cancerous, poly-
pous, fatty, encysted, &c, some of which have  been treated upon under the
heads of Scrofula, Cancer, Polypus, &c.   At this place I shall confine my
remarks to fatty and encysted tumors, which are  more commonly met with
in the region of the head.
  The fatty tumor, also known as the  adipose and steatomatous, usually pre-
sents a soft, inelastic, and frequently lobulated appearance, without any pain
or discoloration of the  skin.  It commences very small, but slowly attains
to a very large size, its  bulk being the only inconvenience to the patient;
its contents are of an adipose character.
  The Encysted Tumor or Wen commences with a small swelling, gradually
increasing in size, seldom, however, reaching the great bulk of the preced-
ing.  The tumor is round, circumscribed,  elastic,  movable, without pain or
discoloration of the skin, and is composed of a  sac  or cyst, within  which
various matters are contained.
  Either of these tumors may become inflamed and painful; and occasion-
ally degenerate  into a  malignant  condition.    Such changes,  sometimes
happen.
  Treatment.   These tumors may frequently be removed by the applica-
tion of Caustic Potash over them, being careful not to allow it, when applied,
to run upon the adjacent parts.   Then cover with an Elm poultice, renewing
it two or three times a day; when the  slough formed separates, the contents
of the tumor may be removed; or, if necessary, the caustic may be applied
a second time.  The  pain for five or  ten  minutes is  very severe, after the 
POLYPUS.
599
u«e of the  caustic.   The  Elm  poultice favors the sloughing, as well as

-rKt^ "these  cases, is to remove the tumors by the
kne  because the operation is  less painful and tedious.  Sornetrme.s they
  '  be reived by ligature; either of these  operations should be conducted
bv a medical man, to avoid accidents of a serious nature.   If an obstinate
ulccrTeinains afte'r the  removal  of  the  tumor, treat  it the same as named

"tns'S'cSnaUy been removed  by rubbing them  three or four
tim s  a day, with a  mixture made by saturating  five fluidounces of water
wkh Sal-Ammoniac, and then  adding one  ounce  of  Hydrochloric  acid
 \nothcr preparation, composed  of Sal-ammoniac two drachms, dissolved in
water  a fluidounce, to which add Tincture of Conium Maculatum a fluidounce,
has likewise been used with success in many tumors; the parts are to be bathed
with it, and a compress kept over them, constantly moistened with it  borne
tumors have been removed by the use of the Compound plaster of Belladonna.
                              POLYPUS,

  Polypus is a tumor  frequently met with growing in the nose and uterus,
and occasionally they are found in the ear, stomach, intestines, &c.  They
have been divided into  several  species, according to their peculiar character,
thus, they arc  mucous,  soft, and vesicular; and when hard they  are either
fibrous (fleshy) or scirrhous (cancerous.)
  The  polypi met with in the  nose  are  usually of a gelatinous character,
soft and slightly vascular, their color is yellow, or yellowish-white, and they
are somewhat transparent.  The tumors grow from the mucous membrane,
and have a narrow base, or neck, as it is  termed, but  sometimes  their base
is very  broad.   They generally increase in size, giving rise to sneezing, ca-
tarrhal  symptoms, fulness and  dull pain in the head, &c, and  when very
large, they fill up the cavity of the nose,  and interfere with respiration, es-
pecially during sleep, the individual breathing with his mouth open.  These
large polypi may be  seen in  front at the nostril, or protruding in  the back
part of the throat.   The nostril attacked is  usually larger than  its fellow,
but if both are affected, the whole nose enlarges.
  (ienerally, the only trouble with polypus of the nose  is its interference
with respiration, and the sense  of pressure or fulness occasioned  by it;  but,
sometimes it causes much pain, and  headache, the bones  become carious,
discharging  a  fetid, bloody fluid, and eventually the patient sinks under
hemorrhages and hectic fever.   This is more commonly the case with old
persons than others.  The causes of  polypus are  not understood, it is sup-
posed to be a kind of cell, or zoophytic parasitical growth.
  Treatment.   These nasal polypi  should be removed  with the polypus
forceps; seize the tumor high up, compress it, twist it, and at the same time
pull upon it, and it will readily detach itself.  The compression, twisting,
aud pulling  should  be done simultaneously, forming an "all-together" ac-
tion , but little if any pain is experienced, and the bleeding which follows is
slight; should  it be considerable, it  may be checked  by the  application of
styptics.  After the detachment of the' tumor, it will be  proper to use the
following powder to destroy any portions which may have been left behind,
as well as to prevent a  re-growth of the polypus:—Take of Bloodroot,  Bay-
berry  bark, mild A'egetable  Caustic,  each, equal parts;  mix.   This may be
used as a snuff, or be applied directly to the parts on lint, or with a camel's 
600
AMERICAN FAMILY PHYSICIAN.
hair pencil.  Or, the following may be used instead:—Tako of Sulphate of
Zinc two scruples, dissolve  it in one  fluidounce of water; introduce this
upon lint well moistened with it, as far up into  the nostril as possible re-
peating the operation four or five times a day.  Polypus  has occasionally
been cured by either of these applications without the use of the forceps.
  When the general health is affected, attention must also  be directed to it
giving tonics,  laxatives, alteratives, &c, as  the particular symptoms of each
ease demand,  not neglecting  the  functions  of  the  skin, diet,  and exercise.
As  an  alterative,  the Compound Syrup  of Stillingia  with  the Iodide of Po-
tassium, will be found adapted to most cases.
  The womb is sometimes affected with  polypus, giving rise to frequent dis-
charges of blood, and when  large,  occasioning bearing-down  sensations a
fetid, vaginal discharge, and a gradual failure of the general health.  When
these symptoms are present the female should at  once  apply for aid; and
none but a medical man should be permitted to  treat the case.
                  STRICTURE  OF THE  RECTUM.

  Sedentary persons, and those who are subject to constipation, are liable
to a thickeniog and hardening  of the rectum, the result of chronic inflam-
mation  of the  part, and which is called "stricture  of the rectum."  The
stricture is usually situated  about two  inches above  the anus, sometimes
more, at others less, but seldom beyond the  reach  of the finger.   It may
present merely a hardened ring, not  exceeding half  an inch in width, or it
may extend upwards some four or five inches.   Its approach is gradual, and
at first it is very apt to be mistaken for costiveness, but does not yield to the
proper  treatment  for this difficulty.  Hardened  feces, piles, constipation,
straining at stool, cathartics, &c, may produce stricture of the rectum.
  The symptoms of this disease are  not always readily recognized; at first
there is costiveness, and the  patient is obliged to  strain considerably, in
order to evacuate the feces ; if  these be  hard, they pass in narrow, flattened
pieces ; if liquid,  they escape with force, as if ejected from a syringe.  Af-
ter a time, a dull,  heavy pain is experienced  around the loins, the feces are
voided  with more difficulty, and even with  pain, frequently with more or
less  tenesmus or bearing down.  The neighboring organs become irritated,
the  legs  are attacked with  cramps, and  the general health is  gradually
impaired, with symptoms of  dyspepsia.  Upon passing the finger into the
rectum, the strictured part will  generally be recognized.   The disease some-
times assumes a malignant form.  Flattened feces  are also a symptom  of
enlarged  prostate, but in  this  case, the projecting  gland, by its pressure,
forms a groowe or  channel on one side of the fecal matter.
  Treatment.  The patient should constantly wear a bougie, which must
be oiled and carefully  passed into the rectum beyond the strictured part,
and retained in its place by a  T bandage.  This should be worn, every time
after its introduction, as long as the  patient can bear it.   A small bougie is
to be used first, and the size should be gradually  increased, as the dilatation
of the part will allow, until a full sized bougie can be worn.
  When  there is  a discharge  of matter, or when  the part is very hard and
unyielding, Vegetable Caustic may be applied to the parts, on lint, sprinkled
on the bougie, or  by injecting a strong  solution  of  it.   Medicated  bougies
will frequently be useful; these  may be composed  of Bloodroot, Sulphate
of Zinc, balsam of Copaiba, Vegetable  Caustic,  Canada balsam, Strychnia,
Extract of  Belladonna, &c,  in various combinations, with  spermaceti,
tallow, wax, honey, &c, to give the  required solidity. 
RUPTURE.
601
  The bowels should be kept regular, producing soft stools daily  so as not
to occasion any  bearing-down efforts;  the skin  should be bathed once or
 wice a week, the proper diet made use of, and constitutional remedies must
be administered, according to the existing indications, when there is any
disturbance of the general health.
                     RUPTURE,  or  HERNIA.
   When a portion of the omentum or intestines, escapes from its natural
 Bituation in  the  cavity of the abdomen, it is termed a hernia, or rupture;
 it is sometimes called a breech, or burst.   This is a very common  accident,
 especially among laboring persons, and is one that requires a knowledge of
 the anatomical relations  of the parts, as well as  of the proper mode of
 treatment; for, frequently, in these cases, an indecision on the part of the
 practitioner, or a delay of an hour, will cost  the patient his life.
   Hernia may be occasioned by any thing that will weaken the walls of the
 abdomen, as pregnancy, dropsy, sedentary  habits,  straining  at stool, &c,
 and it very frequently follows severe lifting, straining, or other  violent
 muscular exercise, and may occur from  long, tiresome walking, or  even
 riding, more especially when exposed  to these causes, after recovery from
 some debilitating disease.   Fat persons are very liable to hernia ; and it is
 also caused by wearing tight clothes.
   Hernia may occur at several different  parts, and has accordingly been
 divided into:  1.  Umbilical hernia, which is a protrusion  at the umbilicus,
 or  navel; 2. Inguinal hernia, when  the  bowel protrudes at the groin; 3.
 Scrotal hernia, when it descends into the bag,  or scrotum; 4.  Ventral hernia,
 when it occurs at any part in  front of the abdomen, but not at the  navel;
 5. Femoral hernia, when  seated in the upper and fore part of the thigh.
 In  some persons hernia comes  on gradually, causing but little inconven-
 ience, except what  arises from  the  size  of the  swelling.   In  others, it
 comes on suddenly, being  attended with  a sensation  as  if something had
 given way, and considerable pain.  The swelling in hernia is  subject to a
 change in size, being smaller  when the patient lies down on his back, and
 larger when he  stands up and  holds his breath;  it  also  enlarges upon
 coughing.  It  frequently diminishes  when pressed, and  increases in size
 again when the pressure  is  removed.   It is frequently accompanied  with
 constipation, colic, and vomiting.
  A rupture is reducible, irreducible, or strangulated.   When it is reducible,
 the symptoms  are the same as just named. -  The patient must be placed
 upon his back, with the thighs bent toward  the abdomen, and attempts be
 made, by careful and gentle pressure, to return the protruding parts.  The
 fingers of one hand may be occupied in this operation, while the other hand
 supports and gradually raises  the swelling.   The return of the intestine  is
 followed with a peculiar gurgling  noise.    No attempts should be made to
 reduce a rupture accompanied with pain and inflammation, until these have
 first been overcome.   If  too  much force be  employed  in  replacing the
 tumor it may  burst the intestine.  About ten or twenty minutes  is  fre-
 quently required to return the protruding parts.   As there  is  a constant
 liability to a return of the rupture, it is necessary to wear a truss in order
 to prevent this.  In  my own experience, I  have  found  the  trusses of
Messrs. Marsh  & Co., New York City, or Messrs. A.  J. Howe.  & Co.,  Cin-
cinnati,  0., superior  to any others; they not only support the part, pre-
 venting any return of the protrusion,  but, if worn  according to the direc- 
602
AMERICAN  FAMILY  PHYSICIAN.
tions given by the proprietors, will, in by far the great majority of cases,
effect permanent cures.
  When the hernia is irreducible, and cannot be returned, which is gen-
erally owing to adhesions, and there are no  unpleasant  symptoms  present
the swelling should  be worn in a suspensory bandage, and much attention
should  be paid to  keeping the  bowels  regular, and avoiding any c»reat
amount of exercise.
  When a hernia is  strangulated, there is  a swelling at the ruptured place
with  pain, which  extends over  the neighboring  parts, and  followed  by
nausea, retching, costiveness, and  febrile  symptoms.  If the  reduction b
delayed, there will be a small, quick,  and hard pulse, great anxiety, rest
lessness, and coldness of the extremities.   If the case is about to terminate
suddenly, mortification ensues, hiccough  occurs, the swelling  subsides, the
patient feels easier,  has a discharge  by stool, and fancies  himself better •
cold  sweats take place, the  pulse is  hardly perceptible, respiration weak
and the  patient dies, probably in convulsions.  The cause  of the strangu-
lation is the compression made on the prolapsed intestine  by the  opening
through which it passes.
  Treatment.  In  the treatment of strangulated hernia, muscular relaxa-
tion must be produced as speedily as possible.   A poultice  of Lobelia and
Stramonium leaves,  should be applied  over the part, as warm as the patient
can bear; an injection should be administered, composed of a strong decoc-
tion of Boneset and  Senna,  to a pint of which half a fluidounce, or a fluid-
ounce of the Compound Tincture of Lobelia and Capsicum has been added.
This Compound Tincture should also  be given by mouth, in order to cause
nausea and  a relaxed state of the system.   The warm bath is also an excel-
lent method of producing relaxation, the  patient being  kept in it  until  he
feels faint.  After thorough  relaxation of  the muscular system has been
produced, attempts should then be made to return the protruding intestine,
in the same manner as for reducible hernia.   In  some instances, when the
strangulation is recent, the  Tincture of Gelseminum may be administered
to produce the desired relaxation ; but the Lobelia preparation is generally
preferable on account of its prompt influence, which does not always attend
the use of Gelseminum.  After the reduction  of  the hernia, means should
be taken to  retain  the  parts, until a truss can be  worn, and the  patient
should have a slightly stimulating treatment  to overcome  the depressing
effects of the relaxants employed.
  If the various means employed do not cause the relaxation in seasonable
time, so that the reduction  can  be safely accomplished, an operation may
be required with the knife, which should  be undertaken only by a skilful
surgeon,—and even  then the chances  are against the patient's recovery.
  After the reduction  of hernia  a permanent cure may frequently be ef-
fected by the  application of the Compound  Tar plaster over the parts,
keeping up a discharge for six or seven weeks, at the same  time maintain-
ing regularity of the bowels, and  keeping the  patient in bed on his back,
with  compresses over  the part to  prevent  a return of  the rupture.  Any
motion or straining must be avoided during this treatment, lest a protrusion
take place.  This  cures by exciting adhesive inflammation.  After the sore
produced by the plaster has healed, a  truss  should be worn over  the part
for two or three months, gradually lessening its pressure.
  In an  excellent  English work, by Dr. J. F. South,  called " Household
Surgery," the following valuable remarks  are made on this subject:
  " Whenever any one finds a swelling at the  groin or  navel, especially "
it have come on suddenly after exertion, he  should lose no  time in going 
RUPTURE.
603
 to the doctor for the purpose of knowing what its true nature is for if it be
 a runturc it will require immediate attention ; and from want of this many
 nersons have lost  their lives.  Females  are  often  subject to a rupture,
 which, from  motives of modesty, they conceal, and ask for no assistance
 till it is too late.  The  celebrated Queen Caroline, wife of George II., lost
 her life in this way.                                                  ...
  "If  the medical  man  determine the swelling to be a rupture,  he will
 recommend a truss or instrument to prevent the bowel slipping out of the
 belly   If a truss is to  be of real use,  it should be  made  specially  for the
 person.  The usual  way is to go to a truss society, or a surgeons'  instru
 ment maker and get a truss fitted.     *    *    *     *    *    *     *
  " If  tho  person wish to get cured of his rupture, he should never take
 his truss off, except for a few minutes to cleanse his skin with a sponge,
 and this even  should never be  done but while he lies down. The truss
 Bhould always be kept  on, whether up or  in bed, and if this plan be pur-
 sued by young  people  under eighteen or twenty years of  age,  and they be
 careful  not to use violent exertion, a rupture will  generally be  cured  after
 wearing a truss three or four  years.  (Howe & Co.'s truss seldom requires
 this time.—K.)
  " It  is always well for those who can afford it to have two trusses of the
 same size and strength at the same time, so that in case of the spring of
 the one in use snapping, or it requiring to be  mended, the other may be
 ready  to take its place. For  if, even  for a day, the person be about with-
 out his truss, the advantage gained by six  or eight months' previous wear
 will be  lost, and all will have  to be begun again.  *****
  "Persons who have ruptures should be especially attentive to keep their
 bowels regular,  so as to be moved every day, and not allowed to  become
 costive.
  " If persons who have ruptures do not wear a truss, or  if the truss they
 wear do not keep the bowel  up in  its place, but allow it to slip down by
 the side of the pad, either from  the instrument not fitting, or  from it not
 being strong enough to resist  the  constant exertions of daily  labor;  or if
 tho truss be worn broken, as is very frequently the case,  the  person goes
 about at the risk of  his life.   It may indeed be, that a person will  have a
 rupture  for years, nay, even for his whole life, may wear no truss, and when
 he  lies  down the rupture  may be returned, or it may continue down and
 incapable of being returned at all, and yet  he suffer no  inconvenience be-
 yond a  little occasional lassitude.   But this is the exception, not the rule,
 and from some trifling circumstance or other the bowel becomes strangled,
 and the person is certainly destroyed, if not relieved by mean's  presently to
 be mentioned, or, on failure of them,  by an operation, which,  however, is
 not always sure  of saving life.
  " When a person has been costive two  or three days, and  he  becomes
violently and frequently sick, at first throwing up stuff like coffee grounds,
and after some hours, like stools, very  offensive; if there be a  feeling of a
cord tied round  the midriff, constant feeling of sickness, much uneasiness
and anxiety, there is great reason for supposing that this has something to
do with a rupture.  The inquiry must  be  made if  the  person have any
swelling in the groin or its neighborhood,  at the navel,  or any where else
upon the belly;  and if there  be any such swelling, how long it has been,
whether it  ever returned, or could be returned,  and  when  it first was
unable   to be returned;  and  whether a  truss had  been worn or not;
whether the rupture had ever been thus fixed  before, and whether it had
been accompanied with  vomiting or costiveness, and how  these had  been
then relieved. 
604
AMERICAN FAMILY  PHYSICIAN.
   " If it be answered  that the swelling  had always disappeared on lying
down, or that it could be returned while in that posture, till such time when
the person  had  over-exerted himself, the  swelling  had suddenly become
larger, and would not return with  all  his efforts, that then he had become
sick and vomited, and that the vomiting had  become more severe and more
frequent, and that the bowels were costive, and whatever medicine was'given
or other fluid taken, was almost immediately rejected; then there is little
doubt that the bowel has  become  strangled, and that its contents  cannot
pass though it to be voided as stools, and are consequently vomited.
   " What is then to be done?   It very commonly  happens that persons who
do not wear a truss, and who are  aware  of the  nature of their  complaint,
now and  then have some  difficulty in getting their rupture up, and feel
sickish, and uncomfortable from it being larger and less readily inclined to
return than usual.   They learn, however, some mode of handling the part
and after more or less effort, replace it, and therefore often rely upon their
own capabilities, till they get into a very dangerous condition.
   "In these cases, a medical may should always be sent for immediately
for if circumstances  should require the performance of an  operation, its
safety mainly depends on its being performed early, and its danger on its being
delayed.   While the doctor is being  fetched, the patient may be.put into a
warm bath up to his neck, and kept there till he feel very faint;" (orthe
means named above may be used.—K.,)  "he  may then attempt, according
to his own usual method, to  put the rupture up, by pressing it gently, if it
be in  the groin, or by lifting it up if  in the  bag, and  gently squeezing it
toward the belly, but no violence must be used, or the gut will burst."
              SYPHILIS,  or VENEREAL DISEASE.
  Gonorrhea has  already been treated upon in a previous part of the
work, at present, I shall confine my remarks to that form of syphilis vul-
garly called " pox," a disease which, though it may be  communicated  by
other means, as contact with syphilitic virus in water-closets, &c, is more
commonly produced by cohabitation with persons  already diseased. The
parts through which the  poison is  received  into  the system, are delicate
mucous  surfaces,  as  the  glans penis,  and abraded cutaneous  surfaces.
Syphilis may manifest itself in several ways, in the form of chancre, bubo,
and  secondary or constitutional symptoms.
   Chancre usually manifests itself in from  five to  fourteen days  after ex-
posure, appearing at first as a small pimple, filled with a transparent fluid,
and  surrounded by a slight inflammation.   It  is most always accompanied
with a slight itching, assumes a yellowish color, breaks, and forms an ulcer
from which is discharged an infectious syphilitic matter.   Sometimes there
is inflammation followed by ulceration, without any appearance of the pim-
ple.   The organs of generation are more commonly the  seat of chancre,
though they have been met with around the anus,  on the lips, nostrils, and
other parts.                                                        ,
   Chancre  may manifest itself under  four  forms,  and which appear to be
owing to the constitution of the patient, and his mode of living, they are as
follows:—                                                         .^
   1. Ihe simple chancre, characterized  by presenting an excavated sorewitn
the surrounding parts red, swollen,  and inflamed, and more or less painful)
finally, the  base of the ulcer is raised to the level of the  surrounding struc-
tures by granulations, which bleed  readily.   The  ulcer spreads in breaatn 
SYPHILIS.
605
m(Jrc than in  depth, has but little hardness about it, and when seated on
thp irenum or bridle, is very apt to destroy it.  •
  iCLrferf chancre, Which has a hardened  base, and sometimes its
pdrres are also hard and elevated.
  3 The phagedenic chancre, which presents a sharp, irregular margin, or
uneven ragged surface  of an ash color, with a thin  ichorous discharge  and
no granulations; it is more or less-painful, readily bleeds when touched,
and more or less rapidly destroys the  neighboring parts.  Sometimes  it is
accompanied by slight redness around it, or by swelling.  It occurs in im-
paired and irritable constitutions.
  4 The sloughing chancre, this is usually the  result of neglect and  un-
cleanliness.  The surface of the ulcer is of a dark, black color, and  the
parts around it are inflamed  and dark red; there is pain, swelling and a
rapid destruction  of the parts  by sloughing.   Phymosis, or a swelling of
the foreskin so that it  cannot be drawn back, is apt to  be present, conceal-
in- the ulcer from view, but which may be known to exist by the offensive,
ichorous discharge which takes place from the  contracted orifice of the fore-
skin.  This form of chancre is generally attended with more or less severe
febrile symptoms, and among intemperate persons, with typhoid symptoms.
  Bubo  generally commences with a  pain in the  groin, accompanied by
swelling  and hardness, which  increases in size, with  redness of the skin,
and throbbing in the tumor, and causing some difficulty in walking.  After
a longer or shorter period  it opens, and discharges  matter; or, as  the_in-
flammatory appearances subside, the  bubo goes off without  suppurating.
Generally there is but one bubo, occasionally, two will be present, one in
each groin.   A bubo  may be  healthy, irritable, indolent, or phagedenic,
the latter two of which are the  more  troublesome.   The indolent bubo is
more common in strumous habits ; while the  phagedenic is usually owing
to an  erysipelatous  inflammation.  When chancre  or gonorrhea are not
present, care must be taken to distinguish bubo from other swellings which
may occur in the groin from strains, cold, rupture, aneurism, scirrhous glan-
dular swellings, &c.  Bubo is often present as a sympathetic affection caused
by gonorrhea.—(See Gonorrhea, page 315.)
  Persons affected with syphilitic diseases must be careful not to permit any
of the virus to come in contact with the eyes, mouth, or parts which are
slightly cut or scratched, as it will give rise to unpleasant symptoms in'these
as well as other parts of the system, and will be very apt to destroy the eye
exposed to its direct action; the utmost care and cleanliness  is required in
all syphilitic diseases.
  Treatment.  For  many years past, when a chancre remains unbroken,
and in the pustular form, in which condition it  is not acted upon by the oxy-
gen of the atmosphere, I have  been in the habit of rupturing  the pimple
with a needle, and then at  once applying a few drops of Nitric or Muriatic
Acid.   I do not believe that absorption of the syphilitic virus, to any  dan-
gerous extent, takes place until  after the exposure of the open ulcer to the
atmosphere.   In some few  cases, the acid causes pain for a short time, but
in most instances, the  pain is slight.   No other treatment is  required, un-
less to allay any fears the patient may entertain in regard to a perfect  cure,
for which purpose the chancre may be kept in contact with the Tincture of
Muriate of Iron on lint, as named hereafter.  I have treated some hundreds
of oases in the above manner, and have not yet heard of any return of the
disease in a constitutional form.
  When  the chancre is open,  I know of no better  application  than the
Tincture of Muriate of Iron, which must contain sufficient Muriatic  Acid 
606                AMERICAN  FAMILY PHYSICIAN.
to enable it to  mix with water, without giving any deposit on standing for
twenty-four hours, and which deposit may be prevented  from occurring in
the Tincture of the shops, by the addition of a sufficient amount of Muriatic
Acid.   This Tincture  I  have used  in this disease  since 1834; it is to  be
gently applied  to the chancre, three  or four times a day, by means of a fea-
ther or piece of lint, being careful not to rub or treat the sore roughly; and
during the intervals, a piece of lint  moistened with the  Tincture, must  be
kept in constant contact with the ulcer.   Occasionally, it causes severe pain
when it should be diluted with as little water as possible, but in most cases
after the  first or second  applications, patients hardly  notice it.  It keep?
the surface of the ulcer clean and soft, and prevents any absorption of the
venereal virus  by destroying or  neutralizing it as fast as it is discharged.
In a day or two after its  use, the chancre becomes  changed  into a  simple
sore, and is frequently difficult to detect from the surrounding healthy in-
teguments,  by  which  appearance  the patient must not  be misled, and,  in
consequence, cease his internal medicines too early.
  Previous to having used this tincture in practice, I employed the follow-
ing preparation, which will also be found beneficial:—Take Sulphate of Quin-
ia forty-eight  grains,  distilled  Water  six  fluidounces,  Sulphuric Acid  a
sufficient  quantity to  dissolve the Quinia.   Wash  the chancres first  with
Castile  Soap, then with the mixture, and dress with  lint  moistened with  it.
  Phagedenic and sloughing chancres should  be washed with a Saturated So-
lution  of  Sulphate of Zinc, or, it may be  applied on lint, and covered with
an Elm poultice.   If the parts are healthy after a slough passes away, use
the Tincture of Muriate of Iron; but if  they remain  the same as before  in
appearance, reapply the Zinc.   In Phymosis there  may be an ulcer on the
glans; to determine this, slightly curve the end of a probe, cover it with lint,
and pass it  around the organ between the  glans penis and foreskin; pain
will usually be  produced when it touches the ulcer, and some portion of the
lint, on withdrawing it, will be found stained with purulent matter; but  if
there is no ulceration, but merely a  discharge from  the glans, no  pain will
be occasioned, and the lint  will  be  equally  stained with the  discharge all
over its surface.  Remove Phymosis  as named on page 316.
  When a bubo is present, we should endeavor to disperse it as speedily  as
possible, on account of the many inconveniences attending its suppuration.
For this purpose, it should be well painted twice a day with a mixture com-
posed  of Iodine  one  scruple,  Iodide  of Potassium two  scruples, Water
one ounce.  After this, apply a Poke-root poultice, made by roasting the fresh
root in hot ashes  until it becomes soft, and then mashing it;  or, a poultice
of Elm and Stramonium leaves may be used.  If the bubo have not advanced
too  far, this course  will  disperse  it;  but if it  obstinately continues its
course to suppuration, the Poke-root poultice alone will hasten its progress.
   As soon as the suppurative stage has matured, the bubo should be opened
by Caustic  Potash, instead of the knife.    The knife causes everted edges,
hard to heal, while  the Potash  disposes them to heal  kindly.   When the
bubo  has opened, it will be well to inject it  once or twice a day with  Cas-
tile Soap  Suds  and  spirits, followed  by  an  injection  of the  Tincture  ol
Muriate of  Iron, either diluted or not. When indolent, stimulants may be in-
jected, as a solution of Vegetable Caustic, &c.; and in scrofulous patients, the
following will be found useful as an injection into it:—Take of Iodine, tour
grains, Iodide of  Potassium  eight  grains,  Water eight  fluidounces.   JiM
and dissolve.                                   ,.           .  .    ennanf
   Gangrenous bubo may be  treated by applying lint to the whole surface"
the ulcer, having previously moistened it with a solution of buqmateot dine, 
SECONDARY  SYPHILIS.
607
 or, a lotion composed of two drachms of Borax, dissolved in a pint of water.
 This should be changed several times a day.
   When a bubo is very  indolent,  showing but little disposition to disperse
 or suppurate, the Compound Tar plaster applied over it, and a discharge kept
 up for some time, will be very apt to remove it.
   No matter under what form the venereal disease may manifest itself, wheth-
 er that of chancre, bubo, or both together, no reliable cure can be expected,
 unless internal remedies be administered; except it be in the destruction of
 chancre in its early form of pimple, as heretofore named.  Many reme-
 dies have been successfully used in this disease, the principal ones of which
 are the Compound  Syrup  of Sarsaparilla, the Compound Syrup of Stillin-
 gia, cither being used with the Iodide of Potassium; or,  the Compound So-
 lution of Iodine.   The preparation, however, which I have found the most
 efficient, acting promptly and permanently, is the following :—Take of Com-
 pound Syrup of Stillingia, Saturated Tincture of Poke-root, Saturated Tinc-
 ture of Sheep Laurel, each four fluidounces; mix.  The dose varies from a
 teaspoonful to half a table-spoonful, three times a day, according to the effects
 of the Sheep Laurel upon the system.  Sometimes, I  use in addition, the
 Chloride of Gold and Soda, repeating it two or three times a day; it may be
 rubbed up with Starch,  or Sugar of Milk, be given in solution, or made into
 a pill mass with extract of Poke.                  ^
   A very bad case of  syphilis of five weeks standing, and which had not
 received any  kind of treatment during that period, was successfully treated
 upon  the above principles. The patient at the time I saw him had several
 chancres; the surface of the  body and head was  covered  with  small  red
 pimples, elevated above a jaundiced skin,  and he was in a very debilitated
 condition.  In four weeks a cure was effected, the jaundice being removed
 at the same time.
  The diet of patients affected with  these forms of syphilis should be gen-
 erous,  nutritious, and easy of digestion, avoiding acids, all fat  or greasy
 food, stimulating  or alcoholic  drinks, and  much  exercise. Exposures to
 cold  or damp must  be  carefully avoided, and  the body should  be very
 comfortably clad in cold  and  damp seasons.  The  use  of salt is not pro-
 hibited, its former prohibition having originated from  the fact  of its de-
 composing  the mercurial preparations which were  so  freely used in the
 disease.  Persons free from syphilis should not sleep in  the same bed with
 those  who are laboring under  it; there is  always danger in so doing; and
both in gonorrhea  and  syphilis, patients should  be very particular not to
get any matter upon the fingers or towels,  lest it accidentally come in con-
tact with  the eyes, and  occasion  loss of sight.   Women  are to be treated
the same as men, care being  taken  to examine  the parts thoroughly,  lest
there  be  some hidden chancre  within  the organs of  generation.  And
chancres within the male urethra, which  frequently occur, will require to
be treated with Nitrate  of Silver; or  by diluted Tincture of Muriate of
Iron on lint, when they are within reach.
        CONSTITUTIONAL,  or  SECONDARY  SYPHILIS.
  When Syphilis affects  the constitution,  it  appears under  two forms,
known as the secondary and tertiary;  the latter form  being due more to the
mercury administered than  to  the venereal  virus, and having  symptoms
closely allied to those of the secondary kind.   These forms are owing to an
absorption  of the venereal virus  into the  general system, either from a
chancre or bubo, whether with or without the use of mercurials. 
608
AMERICAN FAMILY  PHYSICIAN
  The secondary form of syphilis may manifest itself in from seven to nin«
weeks, sometimes sooner, and frequently several months or even years will
elapse before its existence  is  suspected  from the symptoms.  It appears
under a variety of shapes, which probably depend upon the difference of
constitution, the difference  in  constitution of the several parts attacked
and  other circumstances.  It may be transmitted to offspring, and fre-
quently gives rise to abortions about  the  fourth  or  fifth  month  of preg-
nancy ;  sometimes, the child is born at the full term, but with copper-eol-
ored  blotches  and ulcers in  various parts of the body, as well as having
other symptoms indicative  of  the  taint; and, it  is not uncommon for the
wife herself to  become tainted with the secondary disease when existing in
the husband.
  Usually the  first symptoms appear on  the  skin, and in the mouth and
throat.   The eruptions on the skin appear upon the generative parts, about
the anus, the  forehead, mouth, back, legs and forearms;  they may appear
as a  copper-colored rash, with slight itching; as a  copper-colored scaly
eruption; as distinct  pustules, the  base  of which is copper-colored, and
which eventually form round,  deep ulcers, with a pale greyish  bottom; as
large, flattened, dusky-brown tumors, filled with  a fluid, and which burst
after a time, forming scabs under which the skin  is ulcerated more or less
extensively,—this is common on the  thighs  and legs, or on the arms, but
may form on any part of the body, and  occasionally, when the ulcers are
deep and foul,  they penetrate to the bones of the nose, the shin, the fore-
arm,  skull, &c, causing ulceration and caries of those parts.  Sometimes
red,  inflammatory tubercles form, which eventually pustulate, and give rise
to deep, irregular ulcers, and which  are  more frequently met with on the
cheeks and sides  of the nose.   Occasionally, there are soft red fungous for-
mations around the parts of generation ; frequently the  hair falls out; and
periostitis, inflammation of the thin membrane covering the bone, or exos-
tosis, inflammation of  the  bone itself, occurs in the shin.  These symp-
toms, whatever may be their form, are usually preceded or accompanied by
febrile symptoms, rheumatic pains in the ends of the long bones, violent
nervous headache usually in the forehead, and want  of appetite and sleep,
The syphilitic  rheumatic pains are commonly more severe during the latter
part of the afternoon before bedtime.  One characteristic of all these cuta-
neous eruptions  is the copper color, and  the  peculiar, disagreeable odor
emitted from the ulcers, which sometimes become very extensive.
   The mouth and throat may also  be variously affected;  the parts may be
swollen and sore;  or raw and  red, and covered with a white secretion; or
there may be a foul, yellow, deep ulcer of the throat- or tonsil, with raised
and ragged edges;  or there may be a sloughing ulcer, with irregular edges,
ash-colored base, and dark, livid, and swollen surrounding mucous  mem-
brane, which may extend to various  parts about the throat and nose, de-
stroying  them, and sometimes causing  death from  hemorrhage when an
artery is opened.   This ulcer is generally attended with febrile symptoms
and considerable pain.   These affections of  the  mouth and throat cause a
soreness and difficulty in swallowing, a hoarseness in the voice, an offen-
sive breath; and  not  unfrequently they  destroy the palate, the soft bones
of the parts, and even the nose itself.  With  these symptoms the cou^te,
nance assumes an  unhealthy aspect,  the  patient  loses strength and flesh,
his sleep is disturbed, he suffers from dull  pains in various parts, and, it
not benefited,  hectic fever  will  arise, followed eventually by death. ^ lae
hard, painful swellings which  form on  the bones are called " nodes, and
are  owing to a deposit occurring between the bone and its covering. 
STRICTURE OF  THE  URETHRA.                 609
   The ulcers which appear on the surface are generally of an eating char-
 acter, and more or less rapidly destroy the surrounding parts.   The ulcers
 of the throat may attack the almonds of the ear, the palate, the back  part
 of the throat, or all these together; there is a constant  heat and irritation
 of the parts with soreness, and  the  formation of a tough, acrid mucus,
 which is difficult to expectorate.   Deafness frequently accompanies ulcera-
 tion of the throat.   When  the  ulceration extends to  the nose, there is a
 stoppage in one of the nostrils,  with  pain and tenderness ata particular
 part, where the sore is located, and the discharge from it, is thin and fetid.
   Treatment.  In both the secondary and  tertiary forms of syphilis the
 treatment will be similar.  Alteratives must  be taken  for a long  time, as
 the Compound  Syrup of Sarsaparilla; Compound Syrup of Stillingia; or
 the preparation containg Sheep Laurel, named on page 607; and in con-
 nection with this the Iodine pill must be given ; or the Compound  Solution
 of Iodine.  The bowels of the patient must  be kept regular; the surface
 of the body must be bathed with a warm alkaline  solution every two or
 three days, and if his  strength will permit a Spirit vapor bath may  be taken
 once in every two weeks.  The  diet will be the same as named for chancre
 and bubo.
   The ulcers which  appear  externally, may be treated with the Tincture
 ">f Muriate of Iron;  and with poultices, at  night, of  powdered Elm and
 Poke root.  Or, a solution of two  grains of the Chloride of Gold and  Soda
 to a fluidounce of water, may be  applied to  them on  lint, repeating the
 application three times a day.  The ulcers  may  be  inflamed, irritable, or
 indolent, and must be treated accordingly.  Ulcers in the throat and nose,
 may  be touched with Nitrate of Silver;  or Tincture of Iodine; or Tincture
 of Chloride of Iron; and  when  inflammation  is present, it  will be found
 advantageous to steam the throat, and apply anodyne fomentations exter-
 nally.
   AVhen sleep is disturbed from rheumatic pains or otherwise, Sulphate of
 Morphia, or the Compound  Powder  of Ipecacuanha  and Opium, may be
 given at bedtime, to procure rest.   Pains in  the bones, may generally be
 benefited by the use of a pill composed of one or two grains'of Inspissated
 Juice of Poke, and a quarter  or half a grain of Extract of Stramonium;
 two or  three of these  pills may be given per day.   Nodes will generally
 disappear by the application over them of the  Compound Plaster of Bella-
donna; if they suppurate and burst, there may be  more or less caries, and
the soft parts are apt to form ulcers difficult to heal.  It is not advisable to
open  nodes.   Warts require a treatment  similar to  that named for them
under Gonorrhea, page 319.
_ During pregnancy where  there  is a suspicion of the syphilitic  taint, or
in  repeated miscarriages, or the production of  infected  children  caused by
this virus, one or both  parents should be subjected to  the above  treatment.
               STRICTURE  OF   THE  URETHRA.

  Stricture of the Urethra, or of that canal which passes through the
perns, trom without to the bladder, is a disease  the result  of urethral in
Hamniation, and when permitted to  go on without proper treatment is apt
to prove fatal   Most commonly it is the consequence of gonorrhea, espe-
cially when this is  neglected or badly treated ;  but it may arise from mas-
turbation,  and the forcible or improper introduction of foreign bodies into
the urethra, &c.
       39 
610
AMERICAN FAMILY  PHYSICIAN.
  Strictures  of the urethra, are of three kinds, viz:—'the permanent  tha
spasmodic, and the inflammatory.
  Permanent stricture is a very serious, and the most common form of this
disease ;  it is  owing to a thickening or hardening of the walls  of the ure-
thra, and may be located at any part of the urethral canal, more generally
that portion situated  behind the bulbous, and  which is named the mem-
branous  portion.  More commonly, the stricture is located about three or
four inches  from the external opening of the urethra; and in bad  cases
there  may be several strictures.  The  symptoms of stricture are as follows*:
The patient having  thoroughly emptied his  bladder, as  he imagines
observes a few drops remaining, which may moisten his linen ; the stream
of urine is flattened, or splits in two, or passes in a spiral, or screw-like
manner,  and gradually diminishes in  size; it becomes more painful and
difficult to urinate, and the calls to urinate become more frequent;  he  draws
the penis out  with considerable force, in the advanced stages, for the pur-
pose of facilitating the escape of the urine, which now passes drop by drop,
Frequently the urine is mingled with pus, and at times becomes  very thick,
and accompanying this condition, the patient  will suffer from  frequent
shivering fits.   When the urine is white, or bloody, the disease  is of a very
serious nature.   From the  great straining effort to empty the bladder, in
the advanced stage, piles, and inguinal hernia, are often  produced.  Per-
manent stricture frequently occasions a weakness of the erectile  power of
the organ.
  If stricture be allowed to go on, a great dilatation of the urethra behind
the strictured part,  will ensue; the coats of the  bladder become thickened;
the prostate  gland  frequently enlarges; ulceration of the bladder  takes
place ; and finally abscesses are formed, with fistulous canals in  and around
the perineum, and  the patient is  eventually destroyed.  Stricture is fre-
quently accompanied with  pain along the spermatic cord, in the testicle,
loins, perineum, &c, a tingling or itching at the head of the penis, or  along
the whole course of the urethra, and sometimes a pain.  There is fre
quently a loss of sexual desire and power of erection.
  Treatment.   This consists  principally in the careful  introduction 01
metallic bougies into the urethra, from time to time, thereby promoting an
absorption of  the morbid thickening.   When  the stricture is very small, or
the urethra irritable,  catgut  or gum  elastic  bougies may be at  first em-
ployed.
  At first, a  bougie  must be used  which will pass  through the stricture
without much difficulty ; it should be  oiled, or anointed with some anodyne
ointment, as of Belladonna,  Stramonium, Conium, &c, passed slowly and
gently through the urethra, almost allowing its  own weight to carry it, and
When  it  comes to the stricture, it should  not be  forced through, but should
be  held between the thumb  and  fore-finger, making a gentle_pressure, so
that its  extremity will press upon the stricture, and  by holding it thus,
gently but perseveringly continuing  the pressure for five or ten minutes,
the stricture will be felt to yield, and the bougie will slowly pass through
the part; and whenever the instrument meets with an obstacle, pursue the
same  course.  If too much  pressure  be made, the urethra may be torn
through, which is frequently the case with careless or ignorant operators,
when°this happens, immediately withdraw the bougie, instruct thepatien
not to urinate for a few hours, and do not attempt to pass the bougie again
until twelve or fourteen days have passed.                           f
   At first,  the bougie should be allowed to remain  withiu the urethra
half  an  hour, but subsequently the  time may be  gradually increased, » 
STRICTURE  OF  THE  URETHRA. -               611
  the parts can  bear without irritation.  The next day, provided there be no
  existing  inflammation to prevent it, or as soon as  this  is removed, two
  bougies' should be introduced, commencing with one  of  the same size as
  that used the  last time, and after allowing  it to remain for a few minutes,   »
  withdraw it, and immediately  pass the other, which should^be a size larger.
  Thus, on every occasion, using two bougies, always beginning with one the
  same size as that with which the preceding operation had been finished, and
  concluding with one  a size  larger.  The irritation arising from the_pres-
  sure, will  usually occasion  a  mucous discharge from the urethra; if the
  bougie is dry when removed, it is rather an unfavorable indication.
   The patient may stand during the operation, sit upon the edge of a bed,
  or lie  down upon it,  and the  bladder should always  be first evacuated^ as
  the instrument causes a desire to urinate, when  it comes in contact with
  the neck of the bladder.
   The following rules are given by an  English writer, and are proper to
  observe, in the introduction of bougies :
   " 1. To begin with one of a moderate size, and to increase  it very grad-
 ually,  but previous to its introduction, it  should be bent in the shape of a
 catheter, so as  to adapt it to the curvature of the urethra,  by which means
 its passage will be greatly facilitated.
   " 2.  To employ no force in introducing it;  but where we  meet with resist-
 ance, to be content with merely causing its point to press against the stric-
 ture for a short time each day, with the hope  that, by a perseverance in
 this plan, a dilatation of the contracted part may at last be effected.
   " 3.  Never  to pass it  into the bladder,  except at  first  to ascertain the
 extent of the disease, but merely to carry its point some small distance be-
 yond the stricture or strictures.
   " 4.  To  guard against its slipping into the bladder, by  bending its end,
 and tying it with a cotton thread or tape fastened to the penis.
   " 5.  To avoid all exercise during its presence in the urethra.
   " 6.  To continue its occasional use for a considerable length of time after
 the disappearance of the  stricture ;  and again to have recourse to it on the
 least return of the  obstruction.   As the canal  of the  urethra  regains its
 natural size, and admits the more ready passage of a larger instrument, the
 patient may be taught to  perform this simple  operation for himself, which
 he should  not  fail  to do occasionally, at  increasing  intervals, for many
 months, or even years."  This is necessary on account  of the tendency to
 contraction which remains.
   In addition to the introduction of  the  bougie, other means must be pur-
 sued, in order to facilitate the cure, and render it permanent;  thus : an
 hour or so previous to the introduction of  the bougie, the  penis should be
 kept in a poultice of bruised fresh Stramonium leaves, or  of Elm and Lo-
 belia leaves; and two or  three times a day the part immediately external
 to the stricture  should be thoroughly anointed with an ointment composed
 of Belladonna ointment one ounce, Iodine ten grains, Strychnia, dissolved
 in sufficient  Alcohol  by means of  a  drop  or  two of Nitric  Acid, two
 grains; rub the articles thoroughly together, and use but a small  portion
at a time.   Be careful not to let this come in contact with abraded surfaces,
or the  eyes, nose, and mouth.
  In some cases, an injection of a solution  of Sal Soda,  Vegetable Caustic,
or Alum, will hasten the cure, by causing an irritation of the parts favora-
ble to absorption ; or one of these agents, in powder, may be applied upon
the strictured part, by means of a proper instrument.   And whenever an
undue amount of irritation or  inflammation is produced, it must be  over-
■% ■ 
612
*  AMERICAN  FAMILY  PH1SICIAN.
come by mucilaginous diuretics, cathartics, warm hip baths, fomentations,
&c.  before re-introducing the bougie, or the above agents.
  As internal measures,  when  these are necessary, I usually have the
patient  drink freely of an  infusion of Horsemint, Water Pepper, or Buchu,
and  take  one of the  following pills two  or three times a day :—Take of
powdered Digitalis one scruple, Strychnia one grain, Extract  of Stramo-
nium five grains,  Extract  of Belladonna four  grains;  mix  thoroughly
together, and divide into twenty pills.
  The patient must keep  his  bowels regular, avoid exposures to cold and
damp, as well as any great amount of exercise, and the diet should be plain,
but  nutritious and easy of digestion, particularly avoiding all  stimulating
food or  drinks.
  By the above means I  have successfully treated a great number of pa-
tients;  but should  they not remove the stricture after a fair trial, it may be-
come necessary for the surgeon to divide  the stricture, or adopt some other
course for its relief.  And surgical advice  should always be had  as speedily
as possible in all cases of urethral  stricture.
  Spasmodic Stricture  usually comes on  suddenly, but  without pain, the
patient  being unable  to void  his  urine, or it may pass with difficulty; the
bladder becomes  distended, there  is  an anxiety of countenance, a hot skin,
and  a quick pulse.   It is more common among those who are laboring under
permanent stricture, who have phosphatic deposits in the urine, or who have
irritability of the urethra caused by  the use of acids, wines, cantharides, ex-
posures to cold and damp, improper  injections, &c.
  The treatment consists in evacuating  the bladder  as soon  as possible,
by the introduction of a catheter.  This may be readily effected by placing
the patient at first in a warm bath.  When the catheter reaches the strictured
part, it  should be held firmly but  not  forcibly,  as in the preceding case, for
some ten or fifteen minutes, when it will overcome the stricture and pass into
the bladder.   If, however, the stricture be very obstinate, a fomentation of
fresh Stramonium  leaves,  or Hops and Lobelia may be  applied around the
penis and over the perineum, and kept there for some  time, aided by nau-
seating and relaxing doses of some  preparation of Lobelia, after which the
introduction of the catheter may be  attempted.            #  #
   Dr Thomas says, "In  spasmodic stricture, where the irritability ot the
urethra is so considerable  as to forbid the introduction of a common bougie,
this  may be readily  lessened by  touching the  point  of  the instrument
slightly with Liquor Potassa,  after it has been  oiled, and is ready for intro-
duction  The effect of Potassa employed in this  manner upon an  lrntaDie
urethra is often astonishing, and a full sized bougie may be thus easily got
into the bladder, which had been previously  regarded as impracticable.
   The  after-treatment should be  regularity of  the bowels, temperance ana
 the  use of  a pill  composed of Sulphate  of Quinia one grain, Extract ot
 Belladonna  one-eighth of a grain,  Eupurpurin two grains; nux:ior afl<*
 and repeat it two or three times a day.  In bad cases a liniment may also m
 allied daily to the perineum and along the course of the urethra, compo e
 of Olive Oif, Oil  of Amber, each, one fluidounce, Oil of Lobelia, Liniment
 of Aconite,  each, two fluidrachms; mix                      „nnnrrhe» or
   Inflammatory Stricture is owing to inflammation caused bjg°»°™ea be
 the improper introduction of foreign bodies into the ^^,^7^.
 removed by cathartics, Spirit vapor bath, anodynes, warm fomentations,
 seants, and  other similar measures. 
BURNS  AND  SCALDS.
613
                      INVERTED  TOE-NAI]

   This is a very painful disease, generally the re-
 sult of wearing tight shoes, and is usually accom-
 panied with  more or less inflammation,  and at
 times, ulceration.  The great toe is the one usually
 attacked.  At first there is only a little uneasiness
 which  ceases when the  shoe or boot  is  removed
 from the foot; after a time the part becomes ten-
 der and  inflamed, and the corner or edge of the
 nail is  found pressing deeply into  the  flesh, while
 the whole nail is narrow and  much arched  acros
 ensues, fungous growths or proud flesh appear, the pain becomes very severe,
 and the patient cannot walk, nor wear a shoe; and  sometimes the pain is so
 severe as to render him feverish, and destroy his appetite and sleep.  Occa-
 sionally,  the severity of the pain gives rise to spasms.
   Treatment.  The foot must be bathed daily in warm ley water, for twenty
 or thirty minutes each time, after which apply an Elm poultice, made by adding
 weak ley to the powdered Elm bark, and  change the poultice  two  or three
 times a day.  As soon as  this course has removed the inflammation, then
 after each bathing of the foot, press  some lint under the embedded part of
 the nail so as to elevate it as much as possible without occasioning too much
 pain;  cover with  the  red Oxide of  Lead plaster, and bandage; or, if there
 be much pain, the Elm poultice may be continued.  Dress it  thus once or
 twice a day.
  The object of this treatment is to raise the nail from the flesh, that it may
 be cut  off in small pieces  from time to  time, continuing the introduction
 of the lint, and cutting off the  nail, until the offending  portion of it has
 been removed.
  When there is considerable tenderness of the part, some Stramonium oint-
 ment may be spread upon the lint; and anyNproud flesh may be removed by
 the application of the Vegetable Caustic.   After the nail  has been sufficiently
 removed, and the proud flesh  destroyed, the  part  readily heals.  Another
 plan  is  to scrape the  nail along its  middle until it is  as  thin as writing
 aper, and will readily bend under slight pressure; in  some cases this may
 e pursued in addition to the above means.  And the person must not wear
tight shoes or boots again, or the difficulty will return.  It may require from
one to three or four months, in order to make a permanent cure.
                       BURNS AND SCALDS.

 _ Burns are  produced by fire, hot solid substances, and  gunpowder explo-
sions; scalds are caused by hot liquids.  Burns and scalds are dangerous in
proportion  to their severity  and extent, which may vary from a simple in-
flammation of the skin to a deep and extensive destruction not only of the
skin, but also of the parts beneath.   When severe, burns are accompanied
with chills, small, rapid pulse, hot skin, and difficult breathing; when very
severe, there is generally vomiting, anxiety,  coldness of the  extremities,
and other symptoms  of violent  constitutional  irritation, in addition.   Fre-
quently, however, in  cases where  death follows in a few hours after the re-
ception of the burn  or scald, the  patients  appear free from  pain, and with
unimpaired intellect, until within a  short  time  previous  to death.    On
account of the debilitated condition  caused in a part by a burn or scald, the
Fig. 72.
 
614                 AMERICAN FAMILY  PHYSICIAN.

ulcers formed  thereby are apt  to heal with  much  difficulty, profusely dis-
charging  a thin fluid, and presenting flabby granulations.  When  severe
burns occasion death, this usually happens very shortly after the accident.
Severe injuries of this kind should always  be  treated by a medical man.
  Treatment.  There is  nothing peculiar in the treatment of burns and
scalds, although from the many agents which have been recommended from
time to time, it might be supposed that these accidents required some spe-
cific methods or agents different from ordinary ulcers or inflammation. But
this is not the case;  the indications of treatment,  are, to  protect the part
from the action of the atmosphere; to allay  inflammation; to stimulate the
ulcers formed when they appear to be indolent;  and to remove febrile symp-
toms  by the usual means, and  support  the system  when  in  a  depressed
condition.
  To  fulfil the  first and  second indications, there is no agent superior to an
Elm poultice made with Elm bark and warm milk, and this will be found to
answer in nearly all cases of burns and scalds.   It should be placed thickly
over the burn.
  Other agents have, however proved very effectual, probably from their in-
fluence in protecting  the injured surface from the  air, and also, perhaps,
from some anodyne or stimulating action  beside, according with the  condi-
tion of the burned parts  at the  time  of  their employment.  Thus,  I have
found immediate relief to ensue in many instancies, by the application of the
following:  Procure some of the hard wood soot from  the chimney, pound it
fine, mix  it with fresh lard  to  form a thick  ointment, spread it thickly on
raw cotton, and apply it  over the burn, renewing it  occasionally. Soot is
frequently useful in  erysipelatous inflammations,  and hence, aided  by the
absence of atmospheric  action, it probably* effects  its beneficial  results in
burns, the inflammation accompanying which  is usually  somewhat  of an
erysipelatous character.
  In  burns, scalds, and blistered feet, where  the skin is broken, the follow-
ing ointment spread  on  raw cotton will  be found  effectual, after  having
allayed inflammation  by  an Elm poultice:—Take  of Burgundy  pitch two
ounces, Beeswax half  an ounce, Lard  or Olive Oil one table-spoonful; melt
together, and  strain.   This is useful  on account of its slightly stimulating
properties, and the protection it affords against the air.
  When the burn is severe, the following  have been used with much advan-
tage:—Add slaked Lime to Linseed Oil, and  apply,  renewing it twice  a day;
this should be made only as required.   Or, a  still better preparation in cases
where a greater stimulus is required, is, Lime water two fluidounces,  Oil of
Turpentine, Olive Oil, each, one fluidounce; mix, and apply.  If used im-
mediately after a burn, an ounce of Oil of Pennyroyal may be added.
  Red Oxide of Lead  plaster will be found useful as an application  to any
kind  of burn  or scald.   The  Compound  Ointment  of Oxide  of Zinc will
also frequently prove  useful as a mild stimulating  application.  (See Com-
pound Lead Plaster.)
  When  ulcers are formed, they are  to  be  treated the same  as any other
ulcer, after the first inflammatory symptoms have been overcome.  And care
must  be taken  to keep the fingers and toes apart when the skin on them has
been  removed by the burn or scald, in  order  to prevent them from adhering
together;  and also to resist any disposition to contract and produce deform-
ity, by fixing  splints  to the limbs, head,  &c, and  mechanically  stretching
the parts.
  To fulfil the last indication, that  is, reducing febrile symptoms, or over-
coming prostration, these conditions must  be treated  on general principles, 
SUBSTANCES IN THE WINDPIPE OR NOSE.
615
laeetine urgent symptoms as they present  themselves, by  the  appropriate
remedies   When hot fluids are taken in the mouth, or swallowed, Sweet
Oil  should be immediately drank, and repeated occasionally; at the  same
time, a free use should be made  of the mucilage of Slippery Elm, both as a
wash and a drink.
                CHAFING  AND  EXCORIATION.

  The ears, neck, arm-pits, inside of the thighs, &c, are apt to chafe or
excoriate  in children, from a neglect of proper cleanliness; and ini corpu-
lent persons from excessive perspiration and friction of parts.   In children,
it may be remedied by keeping the parts clean, and dusting them with hair-
powder, powdered starch, elm, &c.   If this does not answer, apply the oint-
ment mentioned under Burns and Scalds, made of Burgundy Pitch, Bees-
wax, Lard, and Sweet Oil.  When an obstinate sore is produced from chaf-
ing, it may be washed with a solution of eight grains of Sulphate of Zinc
to four ounces of water, and then dressed with the above ointment.
  In adults, these difficulties may be overcome by washing the parts daily
with Castile  soap and cold water, and then, after drying, sprinkling some
powdered Calamine, (native, impure  Carbonate of Zinc,) over them.  Where
certain parts rub against each other, as the buttocks, &c, causing chafing
and excoriation, it may be prevented by wearing raw cotton between them.
        SUBSTANCES  IN  THE  WINDPIPE  OR  NOSE.

  When a small substance gets lodged in that part of the throat which
leads to the lungs, it may choke and kill the person in a few minutes, by
preventing  the air from passing through the windpipe.   There are several
methods to  pursue in these  cases; one is to press the  tongue down, and
pass the finger and  thumb as far back  into the throat as possible, and if
there be any thing there, to pull it out at once; or if the fingers cannot
seize it, a small  pair of forceps may be used.  Another  plan  is to immedi-
ately seize the person choking, and hold him  up in the air  by the heels,
and while thus with his head  hanging down, have some other person give
sudden blows between the shoulders.  When the articles lodged cannot in-
jure the soft parts, and are  out of the reach of the fingers or forceps, they
may be pushed further onward to the stomach by a bougie; but when pins,
needles, and the like have  been swallowed, this should  not be done, as it
might give rise to fatal results.
  When the foreign body passes into the icindpipe, it creates  irritation, in-
flammation, cough, and difficult breathing, and may destroy the person in a
few days; sometimes, it will remain for  a long time, causing cough, expec-
toration of  matter, and finally a fatal disease of the lungs.  The hanging
position, named above, may  be tried;  and if this does not answer, endeavor
to make the person sneeze, or laugh heartily.  A young lady in New York
city some years  since, while  laughing, had a button which she was holding
in her mouth, to pass  low down in  the windpipe.  Her  physicians said
nothing effectual could be done for  her, but to  prolong her life placed her
upon a low diet.   Many persons called to see her, and among others an elderly
lady, who offered the patient a pinch of snuff; she took it, was attacked with
Bneezing, which caused the button to be forcibly expelled, after having been
in the windpipe  nearly two weeks;  it was covered  with matter.  When the 
610
AMERICAN FAMILY  PHYSICIAN.
above means will not answer, recourse should be had to a surgeon, for it io
frequently the case that a surgical operation will save the patient's life.
  Substances in the nose may be removed by holding the mouth and oppo-
site nostril closed, and  then blowing forcibly through  the nostril in which
the substance is lodged; if this does not succeed, press the thumb  against
the nose, above the foreign body, and then pass up a bent probe or knitting
needle between the nose and the substance, using  it as a hook to bring the
thing down.  If this fails, do not push the body back any further, but apply
to a physician.   Children are very apt to push things into their nostrils and
ears.
  Insects in the ear  may be killed by filling the ear with Sweet Oil, and then
syringing out the  ear with warm water.   But when any  solid substance as
a pea, bean, pin, &c, gets into the ear, the person  should lie upon the side
corresponding with  the affected ear, and a physician be obtained as  soon as
possible.  The difficulty should not be interfered with, except by a medical
man, lest much mischief be thereby occasioned.
             POISONS,  MINERAL,  VEGETABLE,  &c.

  When Arsenic is taken, the most certain antidote is the Hydrated Sesqui-
oxide of Iron, which should be taken  in doses of a table-spoonful mixed
with water, repeating the dose every five or  ten minutes; it requires twelve
parts of this Oxide of Iron to neutralize one part of Arsenic.  While this is
being obtained  from the  apothecary, the patient should  be vomited, and
made to drink large draughts of warm  milk, flaxseed  tea,  warm water, &c.
The  stomach-pump should be used.
  When Corrosive  Sublimate  is the poison taken, the best  remedy is the
white of egg, mixing up the whites of twelve eggs with a quart of water  or
milk, and giving a glassful every two or  three minutes, until the stomach
can bear no more.  The stomach-pump  should be used at once, if one is  at
hand.   The same  course may be pursued in poisoning by preparations  of
Copper.
  Poisoning by  Opium, Laudanum, or Morphia, should be treated by giving
an emetic, dashing cold water on the person, rousing the patient by various
means, as walking him rapidly between two persons, applying currents  of
electro-magnetism, &c, and administering coffee.   The stomach-pump should
be used when at hand.   As soon as the patient has partly recovered, a cathar-
tic should be given.   A similar course  is required in poisoning by Colchi-
cum, Hyoscyamus, Stramonium,  Belladonna, Conium,  Hellebore,  &c.  The
stomach-pump, emetics, cold to  the head, and purgatives, with  Ammonia
internally, and stimulants externally in the comatose stage,  are  the means
usually employed in poisoning by these narcotics.
  Poisoning by Oxalic Acid is best overcome by giving Chalk, Lime, Mag-
nesia,  (not Calcined,) or plaster from  the  ceiling, mixing either thick in
cold water, and drinking it freely.
  When any poisonous salt  of Lead is  swallowed, a large dose  of Epsom
Salts or Glauber's Salts should be taken, or Plaster of Paris mixed with hard
water.  These form an insoluble Sulphate of Lead.  An overdose of Tartar
Emetic  or Antimonial  wine, is apt to cause  serious consequences; the anti-
dotes are Tannic Acid, infusion of Oak bark, Peruvian bark, Green tea, or
other astringent infusions containing Tannic Acid.
  A poisonous dose  of Nitrate of Silver may be neutralized  by drinking
freely of a solution of common table  salt.   When  any Corrosive Acid, a* 
POISONS.
617
 Sulphuric, Nitric, Muriatic, &c, has been swallowed, the best antidotes are
 Lime water, Magnesia, Chalk, Carbonate of Soda, Milk, or Olive Oil.
   Prussic Acid, when swallowed, may be treated by Aqua Ammonia, Brandy,
 Oil of Turpentine, and  cold water  thrown upon the head  and along the
 spine, together with artificial respiration.
   When an acrid alkali has been swallowed, as Caustic Potash, strong Aqua
 Ammonia, &c, Vinegar should be given, pure, or diluted with water.
   Sometimes muscles,  lobsters, oysters, fish, &c, cause dangerous symptoms
 which may be overcome if they have  been  recently eaten,  by giving an
 emetic, followed  by a  dose of Epsom Salts.  The patient may drink freely
 of Lemonade, or diluted Vinegar.  Old  English Cheese grated  and eaten,
 is said to be valuable in  these cases.
   In  all the above cases of poisoning, after the more  immediately danger-
 ous effects of the poison have been neutralized, should any inflammatory
 symptoms remain, or prostration of strength, these must be treated on gen-
 eral principles.
   Many persons when exposed to the Poison Vine, (Rhus Radicans,) are sub-
 ject to an irritation or inflammation, accompanied with heat, pain, itching,
 and vesication, and sometimes symptomatic fever.  To remove these  effects,
 the parts may be bathed with a solution of Borax or  Copperas; or  a wash
 made by boiling Elder bark in Buttermilk; accompanied with a light, cool-
 ing regimen, and cooling  purgatives or diuretics.   The  bruised  leaves of
 Hardhaek,  (Collinsonia Canadensis) externally applied, with  an infusion of
 Nettie-leaved  Vervain,  (Verbena Urticifolia,) in  milk  and  water,  drank
 freely, are said to be excellent antidotes  for internal or external poisoning
 by the above plant.   The leaves and twigs of Bush Honeysuckle, (Diervilla
 Canadensis,)  bruised in  water, and  the inflamed parts washed with  the in-
 fusion thus made, will remove the erythematic inflammation  caused  by the
 poison vine or poison  ivy.
   Persons who have been  rendered insensible  by descending into cellars,
 wells, caves, privies, or  other places containing foul  air, whether this be
 Carbonic Acid gas, or Sulphuretted  Hydrogen, should be removed at once,
 stripped, and the head, neck, chest, and back,  be freely dashed with cold
 water.   The lungs should also be emptied of the air  they contain, that they
 may be  filled with fresh  air; and this may be done by one person pressing
 the breast-bone  firmly toward the back, while, at the same time, another
 pushes the whole of the belly, covered with both hands, upward  toward the
 midriff; this  done, both persons remove their  hands suddenly;  and this
 operation may be repeated several times.  Warmth should now be applied
 to the surface of the whole body, as well  as stimulating applications, and as
soon as the  patient  can  swallow, some  Wine, Brandy, or  other stimulant
 should be administered.  Currents of electro-magnetism through  the chest
and along the spinal column, will also be found useful.  If vomiting can be
excited by tickling the throat with a feather, it will frequently prove bene-
ficial.—(For Snake-bites, Stings  of  Insects, &c, see '-Poisoned Wounds*"
page  555.) 
PART  III.
MATERIA   MEDIC A  AND   PHARMACY,
MATERIA  MEDICA.
  Materia Medica is a term applied to that department of Medicine which
treats upon  the various remedies, employed  in the management of disease,
their respective influences on the human system, and their doses, or mode of
using.   They comprise agents selected from  the mineral, animal, and vege-
table kingdoms, principally, however, from the latter.
  Agents from the vegetable kingdom, consist of roots, barks, leaves, flow-
ers, and seeds, which should be collected at proper seasons,  in order to ob-
tain their full medicinal virtues.   Roots of annual plants,  are useless, unless
gathered  shortly  before they  are in  flower;  those of  biennial  plants
are most active   during the autumn of  their first  year's growth, soon
after  the falling  of  their leaves;  while those of perennial  plants pos-
sess their greatest medicinal  activity during the fall  and spring, or just
before  and after their vegetation.   In the collection of roots, those whichare
decayed or worm-eaten, should be rejected; while those which are retained,
should be washed, and the fibers and little roots, when  not essential, should
be cut off and thrown away.   Large roots should be cut into transverse
slices,  and dried either by artificial heat,  or in a room through which a con-
stant  current of  air is passing;  to prevent them from becoming  moldy,they
should be stirred and turned every day.   Roots which consist principally of
fibers* and have  but  a small top,  may be immediately dried.   Thick and
strong roots  may be cut into slices, strung upon threads, and  hung up to
dry.   The tough bark of roots, when inert, should be peeled off before dry-
ing.   Some roots lose their virtues by drying, but which may be retained for
along time by burying them in dry sand.
   Bulbous roots,  or bulbs are to be gathered at the time of the completion of
the new  bulb, have their outer covering rejected, sliced, strung upon threads,
and dried in a warm, airy room.   After roots have been dried, they shouldbe
packed away in barrels,  or boxes, &c, in order to keep them as free from
moisture as  possible.  Roots, when powdered, generally lose their strength
rapidly, and such powders are seldom fit  for  use after  they have  become a
year old.
   Barks should be gathered  in  the spring and fall, or when they are most
readily removed  from the trunk or  stem; they should  be freed from their
outer coat, decaved parts, and all impurities, and dried in the same manner
               J                                         (618) 
MATERIA  MEDICA. '                     619
as
   roots being careful to keep them as free as possible from a damp atmos-
 phere  ' Young trees  usually afford  the  most  energetic barks.    Resinous
 barks'are generally better when gathered in the spring, and those that are

 ^ThJstems of herbaceous plants and twigs are most active between the
 time of shooting out their leaves and flowering; woody stems  during the
 Winter.  They are to be dried in the same manner as roots.
   Leaves should'be collected in dry  weather, while the plant  is  in  flower,
 freed from decayed parts, spread thinly on the floor of a dry room through
 which there is a constant current of air, and dried as quickly as possible,
 after which they should be packed in vessels  to keep  them free from mois-
 ture and insects.   The leaves of biennial  plants  should not be gathered
 until the second year.
   Flowers are to be collected in clearf dry weather, just before  or immedi-
 ately after they have  opened.  They  should  be dried quickly, and packed
 away in the same  manner as leaves.  They  must not be dried in the sun,
 but artificial heat may be used.
   Seeds,  berries, and juicy fruits are to be gathered when ripe, spread thinly
 upon the floor of a dry, darkened room, and  be frequently turned while dry-
 ing. Or, fruits and berries may be gathered with the  stems to which they are
 attached, and hung up to dry in bundles.  When dried, they should be kept
 secure from moisture and insects.
   Plants present the greatest degree of medicinal activity, when collected in
 their places of natural growth; cultivated plants, with the exception of the
 aromatic herbs, usually have their virtues diminished in a greater or less de-
 gree.   All  vegetable  medicines, whether in  the crude form, or powdered,
 should be kept in a dry and dark place, as, for instance, in tin cannisters, which
 are superior to any other kind of vessel for powders.   Crude roots are best
 kept in well made and covered boxes or barrels.  Tinctures, Oils, Syrups, &c, are
 best kept in  glass bottles, whose outsides are painted black, in order to protect
 the articles from the injurious action  of light.   All fluid medicines should
 be kept constantly well corked, or .stopped, when not in immediate use.
   The constituents of plants which Chemistry has, up to this period, detected,
 and to which they owe their respective medicinal virtues, are Gum, Mucilage,
 Starch,Gluten, Fixed Oil, Volatile Oil, Resin, Balsam, Acids, Sugar, Wax, Albu-
 men, Camphor, Alkaloids, &c, &c, which are variously distributed through-
 out this vast department of Nature, no two  plants  being found  to  possess
 exactly the same constituent  formation.   These  constituents  differ materi-
 ally in their actions upon the system, as do likewise those met with in the
 animal and mineral kingdoms; and, hence, for the sake of greater conveni-
 ence, they have been  arranged into  classes,  according to some prominent
 peculiarity  of action, as follows:—
   Emetics, medicines which produce a peculiar  influence upon the stomach,
inverting its natural action, and causing it to vomit or eject its contents by
the mouth.   In small  doses, some emetics prove nauseant, expectorant, and
 relaxant.
   Cathartics, medicines which increase the number of evacuations from the
 bowels, generally by stimulating some portion of the alimentary canal, and
 thereby increasing the peristaltic action of the  intestines.  When their ac-
 tion is very mild, they are termed Laxatives, Eccoprotics, or Aperients ;  when
 they occasion three or four stools, they are called Purgatives; when their ac-
 tion is severe, accompanied by pain and irritation, they  are  Drastic purga-
tives ; when they produce large and copious watery stools, they are known as
Hydragogues. 
620                AMERICAN  FAMILY  PHYSICIAN.
   Nauseants, medicines which cause nausea, or a  disposition  to vomit, in
which case they frequently prove expectorant or relaxant.
   Expectorants, agents which from their peculiar influence upon the system
facilitate the discharge of mucus and other substances from the air passages!
   Pectorals,  agents which relieve or cure diseases of the chest.
   Relaxants, remedies that relax the tension of muscles, so that they do not
respond to the will of the patient; some produce their action being attended
with nausea, as Lobelia; others,  without nausea, as Gelseminum.
   Stimulants, or Excitants, medicines which increase the activity of the sys-
tem, or of one  or more parts.  When they excite the whole system, they are
termed general stimulants;  when  one or several  organs, local;  those whose
effects continue for a long time, are called permanent, or persistent; while
the diffusible stimulants exert ar^ action with promptness, but  which is of
short continuance.
   Carminatives, agents which cause the expulsion of wind, and, consequently
allay the pain caused by it.
   Stomachics, agents which impart tone to the stomach.
   Tonics, agents which gradually give tone and  vigor  to debilitated organs,
or to the whole system.  Some  produce  their results by acting  upon the
nervous  system; while  others, as Iron, for  instance,  act by restoring the
blood to a healthy condition.   Uterine tonics are agents which exert an in-
fluence upon the female  reproductive  organs, restoring their healthy func-
tions, when these are deranged.
   Antiperiodics, agents which exert an influence antagonistic to that condi-
tion of the system  which favors the  presence of diseases  of a periodical
character, thereby curing them.
   Astringents, remedies which have the property of constringing, or "puck-
ering up" the tissues  with which they come in contact, thereby lessening or
checking their discharges.  When they exert their action upon  the external
surface of the body, they are termed Styptics.
   Narcotics, medicines which depress nervous action by their influence upon
the brain and spinal marrow; they deaden sensibility,  lessen the disposition
to move, and produce sleep; in large doses, they act as sedatives, frequently
causing headache, giddiness, double vision, &c;  in small doses,  they gener-
ally act as stimulants.
   Anodynes, medicines which allay  or  remove pain, by blunting the sensi-
bility of the brain.
   Hypnotics, agents which produce sleep.
   Sedatives, medicines which  diminish the nervous, muscular, and arterial
forces, and which are used when there is an exalted action of the  functions
of either or all of these systems.
   Antispasmodics, medicines which have the power of  allaying  or removing
spasms.   They vary materially  in their  mode  of action,  for while some
agents of this class are undoubted stimulants, others again are sedative, or
relaxant.   Hence,  spasms from debility, will require the former, while those
due to mechanical irritation, will  call for the latter.
   Tetanies, agents which by their action  upon the nerves, produce twiteh-
ings, or convulsive action of the muscles.
   Diaphoretics, medicines which promote and moderately increase perspira-
tion ; when  copious perspiration is  produced, the agents  causing  it are
termed Sudorifics.
   Diuretics, medicines which increase the urinary excretion.
   Diluents, watery fluids which increase the fluidity of  the blood, thereby
lessening the acridity or viscidity of the excretions and secretions. 
MATERIA  MEDICA.
621
   Vsfriaerants, remedies which diminish the  heat of the body, without in-
 fluencing the nervous sensibility and energy.   A refrigerant  effect may be
 gecondanly produced  from the action of a cathartic, sudorific, diuretic, or
 emetic, &c.                                   ,111     .-         xv.
   Alteratives, medicines which gradually restore health,  by  acting upon the
 nutritive system, or  by changing or neutralizing morbid  or redundant
 matters in the circulation, and without any  sensible increase of perspira-
 tion, urine, or other excretions.  Antiscrofulous medicines, are those which
 cure'scrofula.   Antisyphilitic, those which cure the venereal disease.   Anti-
 scorbutic, those  which cure  scurvy and  kindred  affections.   Deobstrucnt,
 those which remove obstructions,—-this term  conveys no definite idea, fur-
 ther than may be had from the word " alterative."
   Diseutients  or Resolvents,  agents which  discuss,  resolve,  or  disperse
 tumors.
   Aphrodisiacs,  agents supposed to excite and promote  the sexual propen-
 sities.                                                          .  .
   Antaphrodisiacs, agents which lessen or blunt the sexual propensities.
   Emmenagogues, medicines  supposed to have the power of exciting or
 promoting  the  menses.   The  greater number of agents arranged  in  this
 class are uterine tonics.
   Parturifacients, or Parturients, medicines which promote labor, by arous-
 ing the contractions of the womb.
   Abortives, or Ecbolics, agents which produce abortion.
   Anthelmintics, Vermifuges,  or Helminthagogues,  medicines which  remove
 worms.   They may  act by mechanically destroying the worms, by poisoning
 them, by removing  the mucus which is necessary to their  presence, or, by
 giving tone to the stomach and bowels, and thus  preventing  their further
 development.
   Antacids, agents which neutralize acidity of the stomach.
   Antalkalies, agents which neutralize alkaline preparations.
   Andlithics, or Lithontriptics, remedies supposed to prevent the formation
 of urinary calculi, as well as to dissolve them.   Urinary calculi are owing
 to morbid conditions of the system, and when these are removed and health
 restored, any further calculous deposits will cease;  but it is very doubtful
 whether any agents are known which, when  taken by  mouth, possess the
 power of dissolving stone in the bladder.
   Disinfectants, agents which are capable of neutralizing offensive  or  un-
 healthy effluvia.
   Antiseptics, agents which remove putrefaction.
   Demulcents, bland substances which soothe irritated or inflamed parts,
and by lubricating them afford protection against  irritating matters.
   Emollients, agents applied externally which soften and  relax tense  and
inflamed surfaces; and the influence of which may  extend  to  deeper seated
parts.
   Detergents, remedies  which deterge or cleanse parts, as wounds, ulcers.
 &c, stimulating them to  healthy conditions.
   Suppositories, solid medicinal substances of a conical or cylindrical shape,
which are designed  to  be introduced into the rectum for the purpose of
relieving constipation, overcoming  stricture  of  the rectum, or removing
piles, &c.
   Errhincs, or Sternutatories, agents which, when  snuffed up the nose, cause
sneezing and a more or less copious discharge of  mucus.
   Sialagogues, remedies which increase the discharge of saliva
  Rubefacients, agents which  cause a redness  of the skin. 
622                 AMERICAN FAMILY  PHYSICIAN.
  Epispastics, or Vesicants  agents  which  inflame  the  skin,  and  raise th«
epidermis, inducing a vesicle or blister.
  Escharotics, or Caustics, articles  which corrode,  burn, or disorganize the
animal tissues ;  escharotics give rise to an eschar or slough.   When a sub-
stance forms an ulcer, without an eschar, from which a discharge  of pus or
matter takes place, it is called a Suppurant.
  Counter-irritants, Derivatives,  Revellents, or Revulsives,  are  agents which
by increasing the action  of one part, or  irritating it, will determine  from
and  relieve morbid conditions of another part.   This  action  may result
from  the use of cathartics,  emetics,  sudorifics,  epispastics, &c.  When
these agents are used externally, it is more commonly called counter-irrita-
tion;  when internally, revulsion.
  N. B.  For a botanical description of the plants herein named, common
to this country, the reader is referred to " Wood's Class-Book of Botany,"
"Gray's Botany of the Northern United States," and the author's "Ameri-
can Dispensatory."   The common names of the various  medicinal agents
are given in capitals, and their botanical or systematic names, in italics.
  Unless otherwise  mentioned under the head  of each article, the infusion
or decoction is to be  made by placing one ounce  of the plant, bruised, in a
pint of water,  and steeping, or boiling it; the tincture, by adding an ounce
of the powdered article to a pint of alcohol, brandy, or diluted spirit, and
allowing it to stand  for twelve  or fourteen  days, frequently .shaking; and
the essence, by dissolving  one ounce  of an essential  oil in a pint of alcohol
It is better, however, to purchase all tinctures, essences, oils, extracts, pills
syrups, &c, of a druggist who has them properly prepared.

  ACETIC ACID.   Aeidum Aceticum.  This is a clear, colorless liquid of
a very sour, acrid  taste, and a  strong, rather agreeable  odor; it dissolves
volatile  oils, resins,  albumen, &c, unites readily with water, but only par-
tially with alcohol.  It is stimulant, vesicant, and  escharotic, and  may be
used externally as a counter-irritant, applied on muslin or blotting paper.
Applied to warts  it destroys them, as well as corns.   Its vapor is useful in
headache when snuffed up the nostrils.   One part  to seven  of water forma
an excellent vinegar.

  ACONITE.  Aconitum Napellus.   This is a perennial plant, also known
by the name of 3Ionkshood;  the leaves and  root are the parts generally
used ;  it  possesses  anodyne,  sedative, and  diaphoretic  properties,  and is
useful in all febrile and inflammatory  diseases, gout, neuralgia, and epi-
lepsy.   Its influence is more especially manifested in the more severe forms
of fever and inflammatory diseases.  The best preparations are an Alcoholic
Extract of the root, or a Tincture.   The dose of  the Extract is one-eighth of
a grain, two or three times a day; of  the Tincture from three to five drops
every one, two, or three hours.   When  improperly given  in large doses it
produces alarming and fatal symptoms.  Aconitina is the  name of its alka-
loid, which is  a white  or brownish substance, and has never been used in-
ternally on account of its highly poisonous action.

  ALCOHOL.  Alcohol is the result of vinous or  alcoholic fermentation
in the juices of  many vegetables,  or in their  infusions.  It  exists in a
greater  or less quantity  in  cider,  beer, whisky, rum, brandy, gin, wines, 
MATERIA  MEDICA.                       623
&c, and is their stimulating and intoxicating constituent.   When alcohol
is pure, containing no  water, it is called absolute alcohol; the ordinary
alcohol of the shops contains a certain per centage of water, but is gener-
ally of sufficient strength for all medical and pharmaceutical purposes.  It
is capable of dissolving a great number of substances, and  especially most
of the active principles of medicinal plants ;  and forms ethers with several
acids.  Its  principal use in medicine  is  in the preparation of tinctures,
essences, extracts, &c.; also as an external stimulant, when it is applied and
prevented from evaporating by placing a compress over it;  or, as a refrige-
rant, when evaporation is allowed.   In the form of wines, brandy, &c, it is
often used internally as  a stimulant in cases of great prostration, or great
depression of the vital forces; it should  never be  used internally unless
diluted.   When deprived of its odor, it  is called  deodorized alcohol.    One
part  of water to two  of  the  alcohol of the shops, forms  diluted alcohol, or
diluted spirit.

  ALLSPICE.   This is the dried unripe  berries of the Myrtus Pimenta, a
South American tree.   It is an aromatic stimulant and carminative,  and is
used in cases of flatulency, and  to render  other medicines more agreeable.
The  dose of its powder is from ten  to thirty grains; of the tincture from
one to two fluidrachms.

  ALMONDS.  The Almond  tree, Amygdala Communis, is a tree growing
in the warm parts of Europe and Asia, and which yields the Sweet Almond,
Amygdala Dulcis, and the Bitter Almond,  Amygdala Amara.  The kernels
of the Sweet Almond  are agreeable to the taste, and yield a  fixed oil known
as the Oil  of Sweet Almonds, which is used as a demulcent  in cough, irri-
tation of the intestines, scalding  or acrid urine, &c.   Its dose is a teaspoon-
ful.  The kernels of  the Bitter Almond, has a taste resembling that of the
peach kernel, and yields a fixed oil, and a  poisonous essential oil called the
Oil of Bitter Almonds, which has  been occasionally used as a sedative, in
doses varying from a quarter of a drop to a drop.   Its poisonous properties
are owing to the Hydrocyanic Acid contained in it.  An essence of almonds
is prepared from it, which is used to flavor cakes and confectionaries.

  ALOES.  Aloes is the inspissated juice of the  leaves of several plants,
as the Aloe Spicata of South Africa, Aloe  Socotrina of the  Island of  Soco-
tra, Aloe Vulgaris of Southern Europe  and  Northern Africa, &c.  The A.
Spicata yields the Cape Aloes; the A. Vulgaris, the Barbadoes Aloes ; and
the A. Socotrina, the Socotrine Aloes, which is the  medicinal article, the
others being used principally in veterinary practice.   Aloes  yields its active
principles  to water  or alcohol.  It is  a purgative in doses of five or ten
grains, but when repeatedly used is apt to induce piles, or aggravate them
when already existing.   It forms the basis of the  empirical  purgative pills,
with  which the country has been flooded for  many years past.   It has been
much used  as  a  purgative  in  dyspepsia, constipation, thread-worm, sup-
pressed menses, &c.  It should  never be  given in inflammatory diseases,
piles, during pregnancy, nor to females subject  to large evacuations from
the womb.   Its griping properties  may be  modified  by combining it with
soap, or Carbonate of Potash.  In doses of half a grain or a grain, repeated
two or three times a  day, it acts  as a tonic.

  ALUM.   Alumen.  This is a Sulphate of Alumina and Potash, which has
an astringent, sweetish taste, and is soluble  in twelve or thirteen times its 
B24
AMERICAN FAMILY  PHYSICIAN.
weight of water.  It is used as an astringent in passive hemorrhages, ni<*ht
sweats, diarrheas, and dysentery, in doses of ten or fifteen grains, given^in
water or syrup, and  repeated every three or four  hours.  Dissolved in an
infusion of Marshmallow root, it has also been found useful in the inflam
matory stage of gonorrhea.  A strong solution is useful as a gargle in soro
throat, and falling down of the palate, and  as an  injection in. leucorrhea.
The solution or powder acts as a styptic in bleeding from the nose, or from
cut surfaces; it should be applied to the  bleeding point on  lint, or a piece
of soft sponge.  Thirty or forty grains  of  Alum at  a dose, and repeated
every three or four hours, act as a purgative, and are thus useful in
painters' colic ; if the  same dose be repeated every ten or fifteen minutes
it causes vomiting,  and has been recommended in some forms of croup.
Alum whey, made by  boiling  Alum in  milk, and straining off the thin
liquor, has  been applied as a poultice over the  eye, in  common inflamma-
tions of that organ.   When Alum is exposed to heat until ebullition ceases
it becomes dry, and  is then called dried or burnt Alum, which is frequently
used as a mild  escharotic, to destroy fungous flesh  or " proud flesh."

  ALUM  ROOT.   Heuchera Americana.  This is a  perennial plant com-
mon to this country, and having rose-colored  or purplish white flowers in
June and July.  The root is knotty, flattened, yellowish, and of a power-
fully astringent taste.  The decoction is  useful in ulceration of the mouth
and throat,  and as an injection in  bleeding piles, and  leucorrhea; it has
also  been  given internally, with advantage, in  diabetes.   The powdered
root forms a good application to foul and indolent  ulcers, wounds, cuts, &c.
The  aqueous extract may be used in chronic  diarrhea and dysentery.  Dose
of the  decoction, internally, a wineglass  half full, and  repeated three or
four times a day.

  AMBER.  Succinum.  This is supposed to  be a fossil resin, the produce
of an extinct  plant.  It is found in Sicily, Prussia, New Jersey, Maryland,
&c, and  is a light yellowish, or dark yellowish, brittle, translucent, resin-
ous-like substance, emitting a fragrant odor, when heated.   When rubbed,
it becomes  negatively electric.   An oil  is  prepared from  it,  the Oil of
Amber,  which is rectified for medicinal purposes, and is usually of a light
yellowish or pale color, a disagreeable odor  and a pungent  taste.   It dis-
solves in eight parts of ordinary Alcohol.   Oil  of  Amber is stimulant,
diuretic,  and  antispasmodic, and  has been  beneficially administered in
hysteria, painful menstruation, hooping-cough, and various spasmodic affec-
tions, in doses of from five to thirty drops  on sugar, repeated as often as
required.  Externally it is a rubefacient, and may be used in palsy, chronic
rheumatism, and, rubbed along the spinal column, in  infantile convulsions.
Roche's Embrocation, for hooping-cough, and some other spasmodic affections,
is composed of Olive Oil, Oil of Cloves, each, one fluidounce, Oil of Amber
naif a fluidrachm; mix.

  AMERICAN HELLEBORE.   Veratrum Viride.  This  is a perennial
plantcommon to this country, growing in moist places, and having numerous,
yellowish-green flowers from May to July.    The root, or rhizome, is the
part used, and should be collected in autumn.  It is a sedative, and has been
found efficient in gout, neuralgia, rheumatism, and other diseases of a febrile
or inflammatory character.   The Tincture of  the fresh root is  the best prepa-
ration, which may be given in doses of ten drops, three or four times a day,
until the pulse is reduced to 65 or 70 beats  in a minute.  In large doses it 
MATERIA  MEDICA.
625
 is apt to prove a violent emetic.  Norwood's Tincture, which has been con-
 siderably used in various acute forms of disease, is a Saturated Tincture of
 the fresh root.

   AMERICAN  IPECACUANHA.   Euphorbia Ipecacuanha.  This is a
 perennial plant, growing in  dry, sandy soils, in  the  Middle and Southern
 States, which yields a milky juice when broken, and which causes a pustular
 eruption when applied to the skin.   The root is the  part used; it is light
 and brittle, and yields a speckled, light, snuff-colored  powder.  It possesses
 emetic, cathartic, and  diaphoretic properties.  In doses  of from  ten  to
 twelve grains of the powdered root, it acts as a  hydragogue cathartic, and
 has been used  with benefit  in dropsy of the chest  and abdomen,  and in
 suppression  of the menses; in dropsical  affections it  should be repeated
 two or three times weekly.  Four grains, given  every three or four hours,
 in fevers, will produce diaphoresis.   In dyspepsia, one or two grains, given
 three  times daily, will  be of service. It is  occasionally used in jaundice,
 and obstinate torpidity of the liver.

   AMERICAN IVY.   Ampelopsis  Quinquefolia.  This is a woody vine,
 growing  throughout the United States, with toothed leaves, in fives, and
 flowering in July.  It  is also known by the names  of Five Leaves, False
 Grape, Wild Woodbine,  &c.   It possesses alterative, tonic,  astringent, and
 expectorant properties, and  is used  in scrofula, syphilis, and wherever an
 alterative is required.   It has also  been recommended  in  bronchitis, and
 other pulmonary complaints.  Dose  of the  decoction,  or  syrup, from twe
 to four fluidounces, three times a day.

   AMERICAN  LARCH.   Larix   Americana.   This  plant, sometime*
 known by  the name  of Tamarac,  is a  tree common  to  moist grounds
 throughout New England.   The bark is said to be laxative, tonic, diuretic,
 and alterative, and is recommended  in  obstructions  of the liver, rheuma-
 tism, jaundice, and some cutaneous diseases; a decoction of the leaves has
 been used in piles, spitting of blood, excessive menstruation, diarrhea, and
 dysentery.   The dose of the decoction of the bark is  from half a wineglass
 to a wineglassful, from two to four times a day.  Equal parts of the bark,
 Spearmint,  Juniper  Berries, and Horse  Radish, infused in cider  or gin,
 have proved valuable in  some forms of dropsy.

   AMERICAN  SENNA.   Cassia  Marilandica.  This is a perennial plant,
 tommon to the  United States, and growing in low, moist situations.  It is
 a safe and certain cathartic, and  may be substituted for the foreign Senna,
 in doses one-third larger than this.

   AMMONIA.  This is a clear, colorless gas, possessing an alkaline, acrid
taste,   and  a sharp,  suffocating odor, which renders  it impossible to be
inhaled.  It is never used alone iu medicine,  but in combination with water
 or acids.   The ordinary  preparations  of Ammonia are as follows:—
   1. Aqua  Ammonia, Liquor Ammonia,  and sometimes called Spirits of
 Hartshorn, is formed by the union of  the Ammonia gas with water, the latter
of which will absorb over 650 times its volume of the gas.   It is found in
commerce of  three strengths  marked F,  FF and FFF.   The latter FFF
usually called strong Liquor Ammonia is colorless, having a powerful ammonia-
cal odor, and an alkaline, caustic taste; it is a powerful irritant, and  is used
externally as a vesicant.   It should  not be used internally, except when much 
626
AMERICAN  FAMILY PHYSICIAN.
diluted, otherwise it acts as a corrosive poison, and when accidentally swab
lowed, its best antidotes are vinegar or lemon juice, which should be prompt-
ly administered.  The vials in which it is  kept should be  well  corked, else
the solutions will lose their strength,  by the escape of the Ammonia.  Gon-
dret's  Vesicating Ammoniacal Ointment is made by gently heating thirty-two
parts of lard with two parts of Oil of Sweet Almonds, and when melted pour
into a wide mouthed vial, to which add seventeen parts of strong Liquor of
Ammonia; shake the mixture together till cold, and keep  well corked.  If
well prepared,  it will vesicate in ten minutes.
   2. Aqua Ammonia, or Spirits of Hartshorn is a milder preparation than the
above, but has an acrid taste, and a suffocating odor.  It is used internally
as a stimulant  in hooping-cough, delirium tremens, and in  prostration from
exhausting discharges;  as an antacid in  heartburn, acid stomach, and sick
headache caused by acid stomach; and applied to the nostrils as a stimulant,
in fainting, hysterics, headache, &c.   As it stimulates the heart and arteries,
without unduly exciting the brain, it is useful in those cases where alcoholic
drinks would be inadmissible.   It is used externally as a rubefacient, in com-
bination with oils.   The dose internally is from  ten  to thirty drops largely
diluted with water, and which may be repeated as required.
   3. Carbonate of Ammonia is a white, fibrous, moderately hard salt, having a
powerful ammoniacal odor and taste;  when exposed to the air, it loses some
of its Ammonia.  It is soluble in alcohol,  and in about four times its weight
of water;  boiling water decomposes it.   It is used as a stimulant in the low
stages of typhoid and typhus fevers, as well as in other  prostrated conditions of
the system; also in atonic gout and in derangements of the stomach, arising
from dissipation.  As an antacid, it is useful in all cases attended with acidity
of the stomach; and is used in the form of smelling salts in hysterics and faint-
ing.  The dose internally is from five to twenty grains every three or four
hours, in the form of pill, or dissolved in water.
   4. Hydrochlorate, or Muriate of Ammonia, commonly known as Sal Ammo-
niac, is a white, tough, inodorous salt, having an alkaline, acrid taste.  It is
commonly met with in masses which are convex on one side, and concave on
the other;  it is friable, and not easily pulverized, unless by boiling  a satur-
ated solution of it, and stirring it,—as it cools, it forms small grains, which,
when dried, are readily powdered.  It becomes moist in a damp atmosphere.
It is dissolved  in three parts of cold water, causing an increased cold during
its solution;  one part of boiling water dissolves it.   In doses of from five to
thirty grains, in sugar, syrup, or mucilage, repeated three or four times a day,
it acts as a stimulating alterative, and has been found useful  in all  tubercu-
lous diseases, scrofula, rheumatism, uterine diseases, and all  chronic affections
of mucous or serous tissues.  In large  doses it produces  dangerous symp-
toms.  The solution in  water has been  used  externally in indolent tumors
and ulcers, bruises, chilblains, chronic affections of the eyes, itch, erysipelas,
and other  cutaneous diseases.  A solution of it in vinegar and water, is use-
ful to allay excessive heat of the head in inflammation of the brain.  As a
wash for ulcers, or as an injection in leucorrhea, from  one  to four  drachms
of the salt may be dissolved in a pint of water.

   AMMONIAC.   Gum Ammoniac  is the  concrete juice of a perennial,
umbelliferous  plant, the Dorema Ammoniacum, growing on dry gravelly soils
in Persia,  and which exudes from the plant  after having been pierced by a
beetle-like insect.   It is a gum-resin, and  is met with  in irregular, globulai
tears, of an external yellowish color, whitish internally, of  a characteristic
odor, and  a sweetish,  bitter, and acrid  taste.  Vinegar,  alcohol, ether, and 
MATERIA  MEDICA.
627
alkaline solutions partially  dissolve it; water forms an  opaque milky emul-
8 on on being rubbed with it.  It possesses stimulant and  expectorant  pro-
perties, and has been advantageously  used in cough, chronic catarrh,  asth-
matic affections of old persons, and in debilitated conditions of the mucous
membrane of the air-tubes.   It has been advised in chronic^ menstrual  sup-
pression and hysterics.  The dose is from ten to thirty grains in  the  form
of pill or in an emulsion, made by rubbing two  drachms of the gum-resin,
with half a pint of water.  It has also been applied in the form of a plaster
to various indolent tumors, as a stimulant and resolvent.

  ANISE.   Pimpinella Anisum.   This is a perennial plant, native of Egypt;
the fruit,  called aniseed is aromatic and carminative,  and is used  in flatulent
colic and  nausea, and is also  added to other medicines, to render them  more
agreeable.  They  contain  an oil which is soluble  in alcohol, forming the
Essence of Anise, which is used in flatulency, and, combined with Aqua Ammo-
nia, in spasmodic cough.   The dose of the powdered seed is from twenty  to
forty grains; of the oil  from five to fifteen drops;  of  the essence  from
twenty to sixty drops in sweetened water.  The  essence is formed by dissolv-
ing one fluidounce of the oil in nine fluidounces of  alcohol.   Half a fluid-
ounce, mixed with a fluidounce, each,  of Laudanum, and  Aqua  Ammonia,
forms a pleasant mixture for cough; to be given in doses4 of from twenty  to
sixty drops.

  ARNICA.  Arnica Montana.  This is an European and Siberian peren-
nial plant, growing in moist, shady places.  The flowers are generally used
in the form of  tincture.  It is known by the name of Leopard's bane.   It is
commonly used as an external stimulating application to bruises,  and local
inflammations,  either in the form of a poultice of the leaves or tincture.   In
small doses internally, it quickens the pulse, increases the urinary discharge,
and promotes perspiration, and has been occasionally used in  typhoid fever,
and other acute  diseases,  accompanied  with  prostration.  The Extract  of
Arnica is also used internally, in doses of five or ten grains three or  four
times a day, and, as a local application to bruises, sprains, and chronic rheu-
matic affections.

  ARROWROOT.  This is a starch prepared from a West Indian plant, the
Maranta Arundinacea; it is  in the form of white, easily powdered grains of
various sizes, inodorous,  nearly  tasteless, and  forms a jelly with boiling
water, which is much used as a diet for children, and  during convalescence
from exhausting diseases.  Add  a  little cold water  to a half table-spoonful
of arrowroot, and mix this well together with the water, by rubbing  with  a
spoon ; then add sufficient boiling water to make half a pint, stirring con-
stantly until a soft, mucilaginous substance is formed, and lastly boil for five
minutes.   It may be made more  palatable by adding a little sugar, or lemon
juice, fruit-jellies, &c,  but no astringents must  be added to it as  cinnamon,
port wine, &c, as they  precipitate the starch.   When prepared for infants,
milk is generally used instead of water.

   ARROW WOOD.   Viburnum Dentatum.   A small shrub growing in  low
damp grounds throughout the United States.   Its  bark is ash-colored, and
is  employed as a diuretic and detergent, and has been highly recommended
as an internal and external agent  in  cancer. The  infusion may be used
freely.   It may also be used in extract, pills, or plaster. 
628
AMERICAN FAMILY  PHYSICIAN.
  ASSAFETIDA.   This is the concrete juice of the root of a Persian
plant, the Ferula Assafoztida, or Narthex Assafoctida, obtained by slicing the
root, and scraping off the milky exudation as it hardens.  It is a gum-resin
and  is found in  masses of various sizes, rather soft, of a dull yellowish-
brown, or reddish  color, difficult to pulverize  except in very cold weather
of an offensive, garlicky odor, and an  unpleasant, peculiar, somewhat acrid
taste.  It is stimulant, antispasmodic,  and expectorant; and should not bo
used in inflammatory diseases.  It has  been U3ed with benefit in hypochon-
dria, hysterics, spasmodic nervous diseases of females, and various irregular
nervous disorders.   Combined with Sulphate of Morphia  and Sulphate of
Quinia, it is useful in sick or nervous headache; with Podophyllin and Ex-
tract of Black Cohosh, in chorea.  It has also been used in spasmodic asthma,
hooping-cough, infantile cough, neuralgic  dysmenorrhea,  and  whenever
there is a want of nervous  energy.  Injected  into  the rectum, it removes
the thread  or pin worms.   The  dose in powder or pill, is from five t© ten
grains;  of the tincture, made by macerating four  ounces of Assafetida in
two pints  of rectified Alcohol, from  thirty to sixty drops.   Water separates
the resin,  and makes the tincture milky.

  BALM.  Melissa  Officinalis.   This is  a perennial  plant,  common to
Europe and this country, and which should be gathered just before flowering.
It is moderately stimulant, and diaphoretic.  A warm infusion is of service
in febrile  diseases, causing perspiration, and  promoting the action of other
diaphoretic medicines; it is  also  used  to assist  menstruation, and to relieve
painful menstruation.   It may be drank freely; in  fevers, the  addition of
lemon juice will render it more agreeable.

  BALM  OF GILEAD.   Populus Candicans.  A tree growing  in  the
northern parts of the country.   The buds are  considered stimulant, tonic,
diuretic, and antiscorbutic.   A tincture of them, in doses of from  one to
four fluidrachms, has been of service in affections of the chest, and kidneys,
scurvy and  rheumatism.  Steeped in  oil  or Lard, they form  an  ointment
said to be useful in  some cutaneous  diseases, wounds, bruises, tumors, local
rheumatism, &c.   The  buds of the  Balsam  Poplar, or Tacamahac Populiu
Balsamifera, possesses similar virtues;  its  bark is tonic and cathartic, and is
said to have proved of service  in gout and rheumatism, taken internally.

  BALMONY.  Chclone Glabra.  A  valuable perennial, medicinal plant,
common to the United States, having no odor, but an exceedingly bitter taste.
It is  tonic, cathartic, and  anthelmintic.   As a cathartic it is beneficial in
jaundice,  disorders of the  liver,  and worms.  In small doses,  it  forms an
excellent tonic in dyspepsia, loss of appetite, debility of the digestive organs,
and during convalescence from debilitating diseases.  The dose of the pow-
dered leaves is one drachm ;  of the tincture one or two fluidrachms;  of  the
decoction  one or two fluidounces.   For worms,  the decoction should be used
internally, and by injection  combined with Tincture of Assafetida. _ An
ointment made of the fresh  leaves forms an excellent application to painful
and inflamed tumors, irritable and painful ulcers, inflamed breasts, piles, &c.
An extract will also be found valuable.

  BALSAM  COPAIVA.  This is an oleo-resinous juice, obtained from a
South  American tree, the Copaifera Officinalis.  It is  a clear, transparent,
sometimes yellowish fluid, not  quite as thick in consistence as new honey,
having a  peculiar, resinous odor, and a nauseous, acrid, persistent taste, f 
MATERIA MEDICA.
629
 is soluble in alcohol, fixed and volatile oils, and  ether, and forms a  solid
 mass after being triturated  for some time with magnesia.   It is frequently
 adulterated with Castor Oil, Oil of Turpentine, &c.   Balsam of  Copaiba is a
 stimulating  diuretic in  doses of from  twenty to sixty drops two or three
 times a day, and is beneficial in chronic gonorrhea,  gleet, irritable conditions
 of the bladder, chronic catarrh, chronic bronchitis, and  painful piles.  The
 addition  of  Liquor Potassa increases its efficacy in gonorrhea.   With many
 persons its use occasions an eruption on the skin, with formication and itching.
 As an external application  it has  been found useful  in  fistulous ulcers, the
 callous walls of which it  softens;  also in indolent ulcers, chilblains, &c.  Its
 unpleasant taste requires it to be taken in some vehicle which will cover this,
 as, in some  aromatic water, in the  form of pill, in combination with  other
 agents, or in the form of capsules.   Large doses  act  as a cathartic, and fre-
 quently cause  painful and disagreeable symptoms.   It should pot be used in
 active inflammations.  As it does not contain Benzoic Acid, it is not properly
 a balsam.  Solidified Copaiba is made by mixing a drachm  of recently pre-
 pared  Magnesia with two  ounces  of  Copaiba; when the  mass assumes a
 pilular consistence, it may  be divided into two hundred pills, of which from
 two to five may be taken two or three times a  day.

   BALSAM PERU.  This is the juice of a South American tree, the My-
 rospermum Peruiferum, which is obtained by making incisions in  the  bark,
 and collecting the juice as  it flows.  It is of a dark-reddish color, of a syr-
 npy consistence, a pleasant balsamic  odor, and a  bitterish, acrid,  aromatic
 taste.  It is soluble in alcohol.  Balsam of Peru is a stimulating tonic and
 expectorant, acting principally on  mucous  tissues.   Its internal  uses  are
 similar to those of Balsam of Tolu, being given  in doses  of  from ten to
 thirty drops in mucilage of Gum Arabic, or diffused in water with sugar and
 yelk of egg.  Applied externally alone, or made into an ointment with equal
 parts  of  tallow, it  forms  an  excellent application to sore nipples, indolent
 ulcers, ringworm of the scalp, and some other diseases of the skin.

   BALSAM TOLU.  This is the juice of a South American tree, the My-
 rospermum  Toluiferum, which is obtained in the same manner as the Balsam
 of Peru.  It is a soft, tenacious, pale brown, fragrant substance,  becoming
 harder by age, with a sweetish, balsamic, rather pleasant taste.  It is soluble
 in alcohol, ether, and volatile oils.   Its properties are similar to those of the
 Balsam of Peru; and it  has been  used in  asthma, cough,  chronic catarrh,
 bronchitis, laryngitis, mucous  inflammation  of  the  stomach  and bowels,
 chronic diarrhea, and gleet.  The dose is from ten to  thirty  grains, in muci-
 lage or syrup.

  BARBERRY.  Berberis Vulgaris.   This is a shrub found along the At-
 lantic coast from Canada to Virginia.   The bark and berries are used.  The
 bark is bitter, and possesses tonic and laxative properties, and has  been used
 in doses of a teaspoonful  of the powder in  jaundice, chronic diarrhea, and
 chronic dysentery.   The bark from the root is the most efficient.   A decoc-
 tion of the berries forms  an agreeable acidulous draught, in fevers, dysen-
 tery,  diarrhea, cholera-infantum, painters' colic, &c.   A  decoction of the
 bark or berries is useful as a wash or gargle in ulcers of the mouth, chronic
 inflammation of the eyes, and as an injection in leucorrhea.  Berberina, is
 the active alkaline principle of the bark; it is a soft, brownish-yellow, bitter
mass, soluble in alcohol, though it has been obtained in crystals.   It is tonio
and laxative in doses of from two to ten or even twenty grain, 
630
AMERICAN  FAMILY PHYSICIAN.
   BAYBERRY.  Myrica Cerifera.  This plant is  common  to many parts
of the United States, especially New Jersey, growing in damp soils.  The
bark is the part used; also, the wax which is procured by placing the berries
in boiling water, which melts and congeals on becoming  cool.  The bark of
the root is the most  active, and should be gathered late in the fall.  Bay-
berry bark is  stimulant  and  astringent  in  doses  of from twenty to thirty
grains of the  powder; it has  been successfully employed in  scrofula, jaun-
dice,  diarrhea, dysentery, &c.   Combined  with powdered  Blood-root  it
forms an excellent application to indolent ulcers, and  has  been used as a
snuff to cure  polypus of the  nose.   In the  form of poultice  alone, or com-
bined with Elm, it is of service when applied to scrofulous tumors or ulcers.
The decoction forms  an excellent wash for sore mouth and throat, for tender
spongy, and bleeding gums, and is of service as an injection in leucorrhea.
Bayberry  Wax is  of a  pale,  grayish-green color, nearly inodorous,  and
Blightly bitter; it is insoluble  in ether, alcohol, or water, but boiling alcohol
dissolves it.   It  is astringent  and slightly narcotic, and has  been success-
fully used  in  powder in epidemic  typhoid dysentery, the  dose  being  one
drachm, and repeated three or four times a day.  It has also been  used in
the form of ointment and plaster to  scrofulous and other ulcers.   Myrkin
is the dried alcoholic extract  of the  bark; it is a light  grayish-brown pow-
der, soluble in alcohol and in  water to which ammonia has been added.   It
has the virtues of the bark in  doses of from  two to ten grains, and may be
used in the diarrhea of consumption, in typhoid dysentery, and in the same
diseases in which the bark is given.  Combined with Geraniin, it  will be
found very serviceable in chronic diarrhea, and cholera.

  BEECH  DROPS.   Orobanche  Virginiana.  This is  a parasitical plant,
found in various parts of North America, growing upon the' roots of beech
trees.  The plant has a nauseously bitter and astringent taste, and has been
used beneficially in  various hemorrhages, diarrhea, erysipelas, &c.  It is
also beneficial as an application to obstinate  ulcers, gangrenous ulcers,  and
leucorrhea;  its decoction  may be used  in gleet,  and as  a wash in ulcerated
mouth.  The  dose  of the powder is from ten to fifteen grains. It is said to
be injurious when applied to scrofulous ulcers.

  BEEF'S  GALL.  Fel Bovi»um.  Ox-gall  when dried  by spontaneous
evaporation forms a tonic and laxative  substance, which has  been success-
fully  used in  torpor of  the  liver, jaundice,  dyspepsia, colic, costiveness,
diarrhea, &c.   The dose is from one to ten grains.   Five parts  of dried
gall neutralize the  constipating  and  narcotic effects of  one  part of opium,
without injuring its sedative influence.

   BELLADONNA.  Atropa Belladonna.  This  is a perennial plant, native
of Europe, having a faint odor, and  a  sweetish, rather  nauseous taste.   In
large  or improper doses, it is  an  energetic  narcotic poison.   In medicinal
doses, it is anodyne, antispasmodic and calmative,  being exceedingly valuable
in spasms, epilepsy,  neuralgia, hooping-cough, St. Vitus' dance,  amaurosis,
rheumatism,  dysmenorrhea,  rigid os  uteri, and  all diseases  in  which  the
nervous system is involved.  It is considered as  a preventive of scarlet fe-
ver by some practitioners.  The dose of the leaves, in  powder, is one or two
grains, once or twice a  day; of the extract, from one-eighth to  one-half a
grain.  The extract is also used  in  the above  diseases,  and also  as a local
application, for dilating the pupil  of the  eye  in various  operations on  that
organ, to  remove spasmodic stricture of the urethra,  neck of the bladder. 
                           MATERIA MEDIC A.                       631

  and anus, rigid os uteri, phymosis, chordee, &c.   Atropia or Atropine is the
  name given to the alkaline principle of Belladonna; it possesses properties
  in common with  those  of the plant, but in a much more concentrated  de-
  gree, and is generally used only as a local application in neuralgic affections,
  and to dilate the  pupil of the eye.  Its dose internally is from one-twentieth
  to one-fortieth of a grain.

    BENZOIN.  This is the concrete juice of a tree  growing in Sumatra,
  Borneo, &c, the  Styrax Benzoin, and is obtained by making incisionsinto
  the bark of trees six or seven years old, and collecting the  exuded juice
  after it has hardened.   Benzoin is of a whitish or reddish-brown color, very
  brittle, of a sweet, balsamic, rather acrid taste, and an agreeable odor when
  rubbed.   When pure, it is wholly soluble in Alcohol or Ether.  It is stimu-
  lant and expectorant, and is used in coughs, and mucous irritations; to im-
 .prove the taste of other medicines;  as an application to wounds, in tincture,
  and to assist in the manufacture of Court plaster.   A preparation has been
  recently used with some degree of success in hemorrhages, called PagliarCs
  Hemostatic or Styptic.   It is made  by boiling together for six hours in a
 glazed earthen vessel,  Alum one pound, Tincture of Benzoin eight ounces,
 water ten pounds.  As the water evaporates, it must be constantly replaced
 by hot water, so as not to interrupt ebullition, and the resinous mass must
 be stirred constantly.   Then filter the fluid and keep in stoppered bottles.
 It is limpid,  color of champagne, styptic  in taste, and  aromatic in  odor.
 White resin has been successfully substituted for Benzoin.  Every drop of
 this fluid poured into a glass containing human blood, produces an instan-
 taneous  magma;  and  by increasing  the proportion of the styptic to  the
 quantity of the blood, a dense, homogeneous, blackish mass results.  It is
 said to be useful in all  arterial and venous bleedings.   In applying it, lint
 and bandages should bo used to prevent the coagula which forms from be-
 ing removed  from the  mouths of bloodvessels; an application of them for
 24 or 48 hours is sufficient.
   Benzoic Acid is prepared by heating or subliming Benzoin; it is in silky
 feathery  crystals,  white  and soft, is soluble in Alcohol and fixed oils, and
 is sa'd to be useful in  the phosphatic form of gravel, and, combined with
 Carbonate of  Potassa, in gout and  rheumatism.   The dose is from ten to
 thirty grains.

   Bl,THROOT.   Trillium Pendulum.  This is a perennial  plant, common
 to the Middle and Western States, and growing in rich soils.  There  are
 several species, all of which possess analogous medical properties.  The root
 is astringent, tonic and antiseptic, and has been efficient in bleeding from the
 lungs, kidneys, womb, and stomach, excessive menstruation,  cough, asthma,
 and difficult breathing;  and, boiled in milk, in diarrhea and  dysentery.    It
 may be used in powder or  strong infusion;  the dose of the former is one
 teaspoonful,—of the latter, from two to four fluidounces.   The decoction is
 also useful as a local application to ulcers, and sore-mouth, and as  an injec-
 tion in leucorrhea and gleet.  The root, made into a poultice, is of service in
 tumors, indolent or offensive ulcers, carbuncle, bubos, stings  of insects, and
 to restrain mortification.  An infusion of equal parts of Bethroot and Bugle-
 weed  has been highly recommended in diabetes.

   BITTER ROOT.  Apocynum  Androseamifolium.   This is a  perennial
plant, common to  North America, growing in dry, sandy soil, and exuding a
milky juice when  any part of it is wounded.   The root  has a bitter taste 
632                 AMERICAN FAMILY PHYSICIAN.
 and is laxative and tonic.   It has been found very efficient in dyspepsir
 chronic affections of the liver, constipation, and  in typhoid diseases.  The
 dose of the powder is twenty or thirty grains as a laxative;  and five  or ten
 grains as a tonic.  Forty or sixty grains will cause vomiting, without much
 aausea or muscular relaxation.
   Apocynin, is the name given to an oily preparation, as well as to a powder
 obtained from the plant, each of which is supposed to contain its active prin-
 ciples.  One or two grains of the powdered preparation, or  from one  to four
 grains of the oleo-extract, are the doses.

   BISMUTH.   The only preparation of this metal used in medicine, is the
 Subnitrate of Bismuth, also known  as  the  White Oxide,  Trisnitrate,  and
 Nitrate of Bismuth.   It is a white heavy powder, without odor,  nearly taste-
 less, insoluble in water, but quite soluble in nitric acid.   The hydrosulphu-
 rets blacken it, as well as light, when it contains silver.   The Subnitrate of,
 Bismuth has a very soothing influence upon  irritated  mucous  surfaces, or
 when these are in a state of  chronic  inflammation; hence it has been very
 useful in some  forms of dyspepsia, chronic inflammation  of the  stomach,
 heartburn, water-brash, colliquative diarrhoea,  &c.  In  chronic  diarrhoea it
 has been  found serviceable in doses of ten or  twenty grains every hour or
 two; in the diarrhoea attending typhus and consumption, five grains of the
 subnitrate combined with three grains each, of Magnesia and Gum Arabic,
 has proved efficacious,—the dose to be repeated every four or six hours.  It
 is considered tonic and antispasmodic also.  In large doses it causes unplea-
 sant symptoms, for which the remedies  are, albuminous and mucilaginous
 drinks, milk, leeching, injections, and warm fomentations,  perhaps diluted
 Nitric Acid would also bo useful.  The granular, amorphous, hydrated oxide
 , f bismuth must not be used in medicine; it may be known from the subni-
 trate by the crystalline character  of  the  latter, under the microscope; when
 using bismuth, the stools are generally black.   The Valerianate of Bismuth
 is a white, amorphous powder, with a strong valerian odor; it has been highly
 recommended in  dyspepsia with nervous irritability, in doses of one or two
 grains, in pill form, repeated four or  five times  a day.

   BITTERSWEET.   Solanum  Dulcamara.   This is  a woody vine, com-
 mon  to  Europe  and  this country, the root and twigs  of which are used in
 medicine.  It possesses feebly narcotic, alterative and diuretic properties, and
 has been used in scaly cutaneous diseases, syphilitic affections, rheumatism,
 scrofula, jaundice, and obstructed menstruation.  The dose  of the decoction
 or syrup is one or two fluidounces; of the extract,  from two to five grains.
 The decoction is  reputed antaphrodisiac, and has proved of service in  mania
 in which the sexual desires were  strongly manifested.   A very efficient syrup
 for scrofula is prepared from the  twigs  of Bittersweet, Stillingia, and Yellow
 Dock root, each equal quantities.  Made into an ointment with lard, it forms
 an  excellent discutient  to painful tumors,  and has  been efficacious when
 applied to ulcers, erysipelatous affections, and some forms of cutaneous dis-
 ease.  Solania is the name of its active alkaline principle, but has  not been
used  in  medicine.   In  large doses,  Bittersweet  causes  nausea, vomiting,
drowsiness, &c.

   BLACK ALDER.  Prinos  Verticillatus.  This shrub is  common to the
 United States, the bark and berries being the parts used.  The bark is tonic,
alterative, and astringent, and has been used with  good effect  in jaundice,
diarrhea, diseases connected with a debilitated  state of the  system, and in 
 
 
Slv-unk CaWmge.   (Ictodes Fcetida.)        Indian Turnip.   (Antm Triphj-IluinO
Wild Carrot.   (Dancas Carota.) 
 
MATERIA  MEDICA.
633
 mortification.  An infusion of two parts of the powdered bark,  and one part
 of Golden Seal, forms an  excellent agent in dyspepsia; the dose  being a
 winejrla«sful. when  cold, repeated four or five times a day.   Externally the
 decoction forms  an excellent  local application  to  ill-conditioned  ulcers
 chronic cutaneous eruptions, mortification,  &c.    The  dose of the powdered
 bark is from half a drachm to a drachm ; of the decoction, from two to four
 fluidounces.   The berries are cathartic, vermifuge and tonic,  and form,  with
 cedar apples, a pleasant and effectual worm medicine for children.

   BLACKBERRY.   Rubus  Villoma.   This shrub is common to the North-
 ern United States.   The bark of the root  is tonic and strongly astringent,
 and in powder, or decoction, it has been found an excellent remedy in  diar-
 rhea,  dysentery, cholera-infantum, relaxed conditions of the intestines in
 children, passive hemorrhage from the nose, stomach, or womb,  and in  diar-
 rhea attending consumption and  hectic fever.   Used as  an injection, the
 decoction is useful in gleet, leucorrhea,  and prolapsus of the rectum, or of
 the womb;  in the latter, it may be used alone, or combined  with the inter-
 nal use of a decoction of equal parts of Black Cohosh and Blackberry Roots,
 taken  freely.  The  red raspberry, Rubus  Strigosus, and  Dewberry, Rubus
 Trivialis, possess similar  properties.  The red  raspberry leaves are  more
 commonly used.  Blackberries form an excellent syrup, which is of service
 in dysentery.  Water flavored with raspberry syrup, is a very agreeable and
 salutary drink  for patients during fevers, also  in  the convalescent stage;
 raspberry jelly or jam is also  useful.   Blackberry jelly is better suited to
 cases  of diarrhea, dysentery and summer complaint.   The dose  of  the  pow-
 dered root-bark of these plants, is  from  twenty to forty grains;  of a decoc-
 tion, from one to four fluidounces several times a day.

   BLACK COHOSH.  Cimicifuga Racemosa.   Also known by the name
 of Rattle-root.  Is a  perennial plant common  to rich grounds  throughout
 the United States.  The root is the part used, and should be gathered early
 in autumn,  and dried in the shade.  It has a faint, unpleasant  odor, and  a
 bitterish, somewhat acrid and astringent taste.    This is a very active and
 useful agent, the exact influences  of which upon  the system are  not  well
 understood.   It  appears  to be slightly narcotic, antispasmodic, alterative,
 ami to exert a marked influence on all  the tissues of the system, more espe-
 cially in nervous, scrofulous, and uterine diseases.  It has been  successfully
 employed in St. Vitus' Dance, convulsions of a periodical character, epilepsy,
 asthma, pertussis, nervous  excitability, and delirium  tremens; also  in  con-
 sumption, cough, acute rheumatism, neuralgia,  scrofula, phlegmasia dolens,
 all derangements of the menstrual function, leucorrhea, &c.  As an antipe-
 riodic it has  proved decidedly beneficial in  intermittent and remittent fevers,
 especially among children,  where there  exists a marked tendency  to affec-
 tions of the brain ; it uniformly lessens the force and frequency  of the pulse,
 soothes pain, allays irritability, and lessens the disposition to irritation and
 congestion of the brain.  The best preparations are the tincture,  and alcohol-
 ic extract;  the dose of the former varies from five to sixty drops; that of
 the latter, from  one to ten grains, three  times a day.  Persons subject to
 eramps will be speedily and permanently relieved by the employment of the
extract combined with the  Extract of High Cranberry Bark.   The warm
decoction is  frequently used instead of Ergot, during labor,  in order to pro-
mote  the contractions of the womb, when  they grow weak.  The fluid ex-
tract is another excellent mode of  preparing it for use, and may  be taken
in doses of  from half a fluidrachm to two fluidrachms.   In overdoses 
634
AMERICAN FAMILY PHYSICIAN.
it  is  said to cause vertigo, impaired vision, nausea, vomiting, and an abate-
ment of the pulse, but no  serious narcotic influence.
   Cimicifugin, or Macrotin, is the name given to a preparation obtained from
it, by adding water,  or a solution  of Alum to a  saturated tincture of the
root; it falls as a dark brown  or yellowish  precipitate.   It is used in the
same  diseases as the tincture or extract, in doses of from one to six grains
three times a day.  Combined with  some of the uterine tonics, as Senecin,
Asclepidin, Caulophyllin, or  Aletridin, it proves very efficacious in diseases of
the female reproductive organs, and forms a pill of much utility in painful
menstruation, cramps, especially during pregnancy, spasmodic diseases, flatu-
lent and bilious colic, &c, when mixed with equal parts of Extract of High
Cranberry bark,  and Dioscorein.
   Prof. E. S.  Wayne, one of our most thorough chemists, has made a supe-
rior article from  Black Cohosh root, which  possesses all its medicinal virtues
in a concentrated form.   Upon a spontaneous evaporation of the saturated
tincture, a solid mass is precipitated, which, (after removing any remaining
fluid), is dissolved in alcohol;  this alcoholic solution is then gradually eva-
porated to the consistence of syrup, placed upon  glass in thin layers, and
then dried, forming thin  scales,  having the  odor, taste, and virtues of the
root.

   BLACK  HAW.   Viburnum Prunifolium.  A small tree growing in the
Middle  and Southern States.  Its bark, and  especially that of the root, ia
tonic  and astringent.   A decoction has been  used in  chronic diarrhea and
dysentery, and in palpitation of the heart;  and has  also been useful  as a
gargle in  ulcers of the mouth and throat, as a wash to  indolent ulcers, and
chronic inflammation of the eyes,  and as an injection in  leucorrhea, and
relaxation of the vaginal walls.  It also acts as  an uterine  tonic, and has
been  of service  in females subject  to frequent miscarriages, using it a few
weeks prior to the aborting  period, and continuing its use throughout the
remaining term of pregnancy.   It has proved efficacious in allaying the seve-
rity of  after-pains.  Dose of the powder, from half a drachm to  a drachm;
of the decoction, a table-spoonful several times a day.

   BLACK  PEPPER.  Piper Nigrum.  A perennial  vine, growing in  vari-
ous parts of  the East Indies,  the dried unripe berries of which, form the
Black Pepper of commerce.   They are stimulant,  and used to correct flatu-
lence, and arouse debilitated stomachs, in doses of from five to twenty grains.
It is  very common as a condiment.
   Piperin is a yellow crystalline substance prepared from Black Pepper, hav-
ing no  odor, and but little taste.  It has been used in fever and ague, colic,
diarrhea  and scarlet fever,  flatulency, &c; its  dose is from one to  eight
grains.

   BLACK WILLOW.   Salix Nigra.  Also known as Pussy Willow.  This
is a tree found  in 6ome parts  of the Northern States, along the banks of
rivers,  especially in New York and  Pennsylvania.   The branches are much
used in making  baskets, &c.  The  bark is rough and blackish, and when
powdered and simmered in cream, forms an excellent poultice in mortification,
and foul  and indolent ulcers.   Internally it  is a bitter tonic, and has been
used in fever and ague.   The buds  or aments, in decoction, and drank freely,
is a powerful antaphrodisiac, suppressing sexual desires for a long time, and
is highly recommended in the treatment of  spermatorrhea. 
MATERIA  MEDICA.
635
   HLOODROOT.   Sanguinaria Canadensis.   This  is  a  perennial plant,
 found in rich light soil, in most parts of the United States.^  The dried root
 has a faint odor? and an acrid,  bitterish taste.  It is a stimulant narcotic,
 emetic, expectorant, alterative, escharotic, and errhine, and exercises a power-
 ful influence on the system.   From three to five grains every three or four
 hours, stimulates the digestive organs,  and accelerates the  circulation; ten
 or twenty grains act as an emetic, with depression of the pulse;  halt a grain
 to two grains is the dose as an alterative ; five to ten grains causes nausea.
 Overdoses cause alarming  symptoms.  It has been successfully used in pul-
 monary and liver affections, catarrh, croup, hooping-cough, jaundice, rheu
 matism, dyspepsia and dropsy of the chest.  As a snuff it has been  used
 alone, or with  bayberry bark, in headaches,  coryza, and nasal polypus.
 Applied to fungous growths, indolent and ill-conditioned ulcers, and fleshy
 excrescences, the powder often removes the fungous growth by its escharotic
 action creating a new and healthy energy in the ulcers.   An infusion of the
 fresh root in vinegar, has cured warts, tetter and  ringworm.   The Extract
 of Bloodroot, has been used with benefit in diseases  of the air-vessels,  liver
 affections,  jaundice,  and suppressed menstruation,  in doses  of from one-
 eighth of a grain to a grain.   It may be advantageously applied as  a mild
 caustic to indolent ulcers, and fistula in ano.
   Sanguinarina,  is the alkaloid principle  of  Bloodroot;  it  is  a  white,
 or light yellow substance, of an acrid taste, and soluble in ether or alcohol.
 Its dose is  from one-tenth to one-twentieth  of  a  grain, well  rubbed  with
 sugar of milk.
   Sauguinarin,  the alka-resinous  principle,  is  of a  deep reddish-brown
 color, a peculiar odor, and a nauseously bitter taste ;  it is a tonic and alter-
 ative, and has been used in affections of the liver and lungs, jaundice, rheu-
 matism, &c, in doses of from one-fourth  of a  grain to two grains.  The
 following  forms an  excellent pill in  liver affections :—Take of  Leptandrin
 one  grain, Podophyllin half a grain,  Sanguinarin one-fourth  of a grain,
 Alcoholic Extract of Black Cohosh, enough to form a pill; the dose is one
 pill every night and morning.  Derangements  of the menstrual  function
 are benefited by a pill composed of one grain of Caulophyllin, half a grain
 of Sanguinarin, and  two grains of Alcoholic  Extract of Black  Cohosh ;
 the dose is one pill three  times a day.

   BLUE  COHOSH.  Caulophyllum  Thalictroides.  This  is  a perennial
 plant, growing in jow, moist, rich  grounds, in various parts of the United
 States.  The root is an uterine tonic, and antispasmodic, and has been suc-
 cessfully used in all  derangements of the menstrual function, in rheuma-
 tism colic, cramps, hysterics, epilepsy, &e.  The  decoction, taken  during
 the last one or two months of pregnancy, renders the labor less tedious and
 painful, by the tonicity it imparts to the womb; and in cases of lingering
 labor, occasioned  by fatigue, or debility of the womb, it is fully as effica-
cious  as Ergot in accelerating the delivery, without being liable  to any
objections.   In ulcerations of the mouth and throat, it is very efficient, and
may be used alone, or in combination with  Golden Seal.   The  dose of the
decoction is from two to four fluidounces, three or four times daily ; of the
tincture from half a  fluidrachm  to a fluidrachm.  The alcoholic extract is
also  useful  in  uterine difficulties, and may be combined with Senecin,
Umitugin,  Aletridin, or  Extract of  High Cranberry bark.    Its dose  is
trom one to five grains, three  times a day.
   Caulophyllin is the name given to  the  concentrated preparation  from
the rout;  it is of a  light brown color, a peculiar odor,  and a slightly 
636
AMERICAN  FAMILY  PHYSICIAN.
bitterish pungent taste.  It appears to influence the uterus directly, and u
used in nearly all the chronic  affections of this organ, as well as in the
same diseases in which the root is used.  Its dose  is from half a grain to
two  grains,  three or four times daily.  It lessens the  griping of Podo-
phyllin.

  BLUE FLAG.   Iris  Versicolor.  This is a  perennial  plant, growing in
low, wet places, in  nearly all parts of the United States.  The root  has a
nauseous, acrid  taste, and a peculiar  smell.  It  is cathartic, alterative
sialagogue, and diuretic, and has been used with  success in scrofula, syph-
ilis, dropsical diseases, chronic affections of the liver, spleen, and kidneys
dyspepsia, rheumatism, constipation, &c.  In obstinate affections of various
organs, they may be rendered susceptible  to the  influence of the remedies
administered, by first salivating the patient with a mixture composed of
equal part3 of Blue Flag, Mandrake, and Prickly-Ash bark, of which from
five to ten grains may be given every two or three hours, so as to fall short
of purging, and which will act as a powerful  alterative, causing a copious
salivation, without rendering the breath offensive, or injuring the teeth and
gums.   The  dose of Blue Flag, in powder, is from five to twenty grains; of
the tincture, from ten to sixty drops ; of the alcoholic extract, from half a
a grain to two grains, three times a day.
  Iridin,  the oleo-resinous principle  of Blue  Flag,  possesses  the  active
properties of the root, and  may be used as an alterative in syphilis, gon-
orrhea, and other diseases in which the root is  used.  Combined with Cimi-
cifugin, it is very useful as  a laxative  and tonic in uterine derangements.
Any harshness of action of Iridin, or Blue Flag root, may be  lessened or
removed entirely, by the  addition of a few grains of Ginger, or Capsicum,
a grain of Camphor, two  or three grains of  Caulophyllin, or half a grain of
Extract of Hyoscyamus.   The dose of Iridin is from half a a grain to three
or four grains.   In  some  cases, it is preferable as a cathartic to Podophyllin,

  BONESET.   Eupatorium Perfoliatum.  This a perennial plant, common
throughout the  United States, and known also by the name of Through-
wort.   The tops  and leaves, in cold infusion, powder or extract, is an excel-
lent tonic, useful in remittent, intermittent, and typhoid fevers, dyspepsia,
and general  debility.  The  warm infusion  is  emetic  and diaphoretic, and
has been efficient in intermittent and  other febrile diseases, epidemic influ-
enza, catarrh, colds, &c, whenever  a diaphoretic  or emetic is required; it
is likewise administered  to  promote the action of other emetics.  Exter
nally,  it has  been used as a  fomentation to painful and inflammatory parts,
being  used  either alone,  or with Hops, Tansy, &c.  Dose of the powdered
leaves, from  ten to twenty grains ; of the extract, from two to four grains;
of the infusion,from two  to four fluidounces.

  BUCHU.   Barosma Grenata.   This is  a perennial shrub, growing  in
Southern Africa.  The leaves are the  parts used ; they are slightly bitter
and aromatic, and have a strong aromatic odor.  They are stimulant, diu-
retic, antispasmodic, and  tonic, and have been used in  catarrh of the blad-
der, incontinence of urine, connected  with  disease  of the prostate gland,
irritation of  the bladder and urethra attending gravel, and in all diseases ot
the urinary organs attended with  uric acid deposits.  The dose of the powder
is from twenty to thirty grains, three or four times a day ; of the infusion,
from two to four fluidounces; of the fluid extract, one or two fluidrachm*, 
MATERIA  MEDICA.
637
   HTTKIIORN BRAKE.   Osmunda Regalis.   This is a  beautiful fern,
 trowin, in moist grounds in various  parts of the United States   During
 fhe latter  part of May, and in the  month  of August, the root should  be
 fathered and, as it is very liable to mouldiness, much care should  be used
 in drvin- it   It is mucilaginous and tonic.   Used in  coughs, diarrhea, and
 dvsenterv; also used as a tonic during convalescence  from exhausting dis-
 tlw   One root, infused in a pint of hot water for half an  hour, will con-
 cert the whole into a thick jelly.  It is valuable in leucorrhea, and other
 female weaknesses, and is said to be an almost certain cure for rickets, in
 doses of a wineglassful, several times a day.   The  mucilage  mixed with
 brandy, is a  popular  remedy as an external application for  sprains, and
 weakness of the  back.   When used internally, the roots may be placed in
 hot water,  and the mucilage thus formed may be sweetened with sugar,and,
 when  there are no contra indications, it may be flavored with brandy, cinna-
 mon, nutmeg, ginger, &e.

   BUGLEWEED.  Lycopus Virginicus.  This is a perennial plant, found iu
 moist and shady situations, in most parts of the United  States.  It has a
 slightly bitter taste, and a peculiar  balsamic odor.   It appears to possess
 sedative, tonic, and astringent properties; allaying irritation,  diminishing
 the frequency of the  pulse,  lessening cough, and  checking hemorrhages.
 It has been successfully used in incipient  consumption, bleeding from  the
 lungs, stomach, &c, diseases of the heart, chronic diarrhea and dysentery,
 inflammatory diseases  of drunkards, and  especially in diabetes.  Dose of
 the powdered leaves, from  one to two drachms; of the infusion, from two
 to four fluidounces.

   BURDOCK.   Arctium Lappa.  This is a biennial  plant, well known in
 this country and  Europe.  The root is alterative and diuretic, and  has
 been efficient  in scurvy, gout, leprosy, syphilis, scrofula, and diseases of the
 kidneys.   To  be of service, its use must be continued for a long time.   An
 infusion of the seeds is more active than that of the root, and will be found
 useful in cases where persons are subject to boils, stye on  the eye, whitlow,
 &c.  An ointment  of the leaves, or  their juice, has  proved beneficial  in
 cutaneous  diseases,  and obstinate ulcers.  Dose of a decoction, or syrup,
 a wineglassful several  times a day; of the  extract, from five to  ten  grains.

  BURGUNDY PITCH.  This is the concrete juice or turpentine of the
Norway Pine, Abies  Excelsa, a native  tree of Europe  and Northern Asia,
and of the European  Silver Fir tree, Abies Picea.  It is a gentle rubefa-
cient,  and  sometimes causes  a papillary or vesicular  eruption.   It is gen-
erally  applied in the form of a plaster, in weakness  of the back, chronic
rheumatism, &c, and forms an ingredient of various  plasters.

  BUSH  HONEYSUCKLE.   Diervilla   Canadensis.  This  is a woody
shrub, growing in various parts of the United States.   Its roots, leaves and
twigs, freely used in cold infusion, are diuretic, astringent  and alterative,
tud have  been of benefit in gonorrhea, inflammation of  the bladder, with
gravelly deposit in the urine, and  in diseases  of the kidneys.  The  root
has been  recommended in syphilis,  in  the  form  of syrup, or decoction.
Applied externally to erysipelatous inflammation, or to the inflamed surface
caused liy  the Rhus  Radicans, or Poison Vine, it soon relieves the itching,
burning, A;c. 
638
AMERICAN  FAMILY  PHYSICIAN.
  BUTTERNUT.   Juglans Oinerea.   Also known as the White Walnut.  The
inner bark of the  root  of this well-known tree, is a pleasant and mild
cathartic, suited to cases  of habitual constipation, and  where moderate ca-
tharsis is desired.   It is usually administered in the form of extract, the dose
of which is from ten  to  thirty grains.  Juglandin  is a jet-black  principle
obtained from the bark, by adding water to a Saturated  Tincture, and distil-
ling off the Alcohol.  It  is a laxative and cathartic,  in doses of from one to
five grains; operating more promptly when combined with  Castile Soap.
The juice of the rind of the Black Walnut, Juglans Nigra, is said to have re-
moved ringworm and tetter; and a decoction has been used for a vermifuge.
The leaves of the above  trees, in strong infusion or extract, has proved as
useful in scrofulous  affections as the European Walnut.

  BUTTON SNAKEROOT.   Liatris Spicata.   This is a perennial plant,
common  to the  United  States, having  tuberous  roots;  there  are several
species which possess  analagous medicinal virtues.  The roots are diuretic,
and in  doses of from two to four fluidounces of the  decoction, have been
efficacious in gonorrhea, gleet,  and affections of the kidneys;  combined with
equal parts of Unicorn root and Bugleweed, a decoction has proved of service in
Bright's disease.  A decoction of the  root forms an excellent gargle in sore
throat, and injection in leucorrhea.   Said also to be useful in snake-bites.

  CALCINED or BURNT DEER'S  HORN.   Cornu  Cervince  Ustum.  In
the interval between August and December, the  horns of the deer, Germ
Virginianus,  are said  to be in velvet.    During this time only, the horns
which have fallen, are  collected, coarsely rasped, and the raspings placed in
a vessel of Iron, which is then tightly covered, and placed in an oven, or
elsewhere, where it may be  subjected to a heat of 196°  or 200° F, continued
for about forty-eight hours, or until the rasped horn assumes the color of
light chocolate, or roasted coffee, and can be easily powdered by trituration.
This effected, let the whole cool, reduce the burnt raspings to powder, and
preserve in closely stopped  vials.
  This preparation is a powerful styptic, and is of much efficacy in floodings
from the womb, and in excessive  menstruation.  In flooding, a teaspoonful
of the powder may be  added to a gill of hot water, and a table-spoonful of
this be given every five or ten  minutes; or a teaspoonful of the powder may
be given  every half-hour.   Generally,  the first dose,  if sufficiently large,
diminishes the flow, and  it is  rarely that  over three doses are required to
permanently check it.

  CAMPHOR.   This is a white, shiny crystalline substance, obtained by
boiling the wood, roots, &c, of an evergreen tree, growing in the East Indies,
the Laurus Camphora.  Camphor thus obtained, is subsequently purified by
sublimation.   It possesses  a penetrating, peculiar, diffusible odor, and  a
bitter,  pungent, cooling taste.   It is  soluble in  Alcohol, Ether, Acetic
Acid, and Fixed and Volatile Oils; and is not'easily  pulverized, unless a
few drops of Alcohol be added  to it.   Camphor is  sedative, anodyne, anti-
spasmodic, and diaphoretic, and is used to allay nervous excitement, subdue
pain,  arrest spasm, and also to  induce sleep.   It is of much utility in the
delirium, tremors, and wakefulness, attending  typhoid  conditions; and has
been  advantageously  employed  in  gout, neuralgia,  rheumatism, painful
menstruation, after-pains, and all irritations of the sexual organs.   In large
doses, it produces unpleasant symptoms.   Combined with Opium, it  is ot
service in chordee, hysteric nymphomania, and painful affections of the urinary 
MATERIA  MEDICA.
63^
 organs  It enters into many liniments and mixtures for external application
 in bruises, sprains, chilblains, indolent and gangrenous ulcers, and all pain-
 ful diseases.  Its vapor is sometimes useful in headache.  Dose of the pow-
 der from one to five grains, depending upon  the severity of the disease.

   CANADA BALSAM.  This is a terebinthinate fluid, obtained from  the
 Fir Balsam, Abies Balsamea, a tree growing in Canada, Maine, &c.  It  is a
 stimulating diuretic, and, in large doses, cathartic; it  acts more especially
 on the mucous tissues, and if its use be persevered in  for a length of time, it
 will create irritation in them, more especially  those of the urinary apparatus,
 frequently occasioning  strangury.  It has been used  in gonorrhea,  gleet,
 piles, leucorrhea, chronic urinary difficulties, rheumatism, chronic catarrhal
 affections, chronic inflammations, or ulcerations of the  bowels, &c.  The dose
 is from ten to twenty drops two or three times a day, in pills or in emulsion.
 Externally, it is a rubefacient, and is frequently used as a stimulant to wounds
 and ulcers; it likewise enters into the composition of several  ointments  and
 plasters.    It is much used  in microscopic research, to mnunt objects,  &c.
 Balsam of Fir is a name by which it is sometimes known.

   CANADA FLEABANE.  Erigeron Canadense..  This is an annual plant,
 growing in the northern and middle parts of the United States.  The plant,
 Bhould be gathered while in flower.  It possesses diuretic, astringent, and
 tonio properties, and  has been found useful in diarrhea,  gravel, diabetes,
 dropsical  affections, painful urination,  and  in  affections of  the kidneys.
 Dose of the infusion from two to four fluidounces, three or four times a day.
 A volatile oil is prepared from it which has been found serviceable in diar-
 rhea, dysentery, and bleeding from the lungs, stomach, kidneys, &c.  In  ex-
 cessive menstruation and floodings, it is a prompt and efficient agent.  Dose
 of the Oil, from  four to six drops on Sugar, or dissolved in  Alcohol, and
 given in a little sweetened water, repeating it every five or ten minutes, if
 demanded.   Castor  Oil,  (or  Stramonium Ointment,) five parts, mixed with
 one part  of  Oil  of Erigeron, makes an ointment of much efficacy   in
 piles.

  CANELLA.   Canella Alba.  This is a  South  American tree.   Its bark
is  an aromatic stimulant and gentle tonic, useful in debility of the digestive
organs, &c.   It is often added to tobacco, to remove  its disagreeable odor
when smoked, and to give a pleasant aroma to the atmosphere of the smokiDg
room
  CANTHARIDES.   Also called Spanish Flies.  These insects, Chntharis
 Vesicatona, are obtained from various parts of Southern Europe.  They are
diuretic and  stimulant, and are occasionally given in  chronic  gonorrhea
gleet, seminal weakness, paralysis of the bladder, and also in chronic inflam-
mation of this organ.   Dose of  powdered Cantharides, from half a grain to
two grains; of the Tincture, from twenty to  forty drops, repeated three or
tour times a day.  In large doses,  its use is dangerous,  producing painful
and violent inflammatory symptoms.   Stangury caused by Cantharides, is said
to be removed by thirty drops of Liquor Potassa in water, repeated  every
Hour.  Applied  externally, Cantharides  cause redness and vesication, and
are much used for this purpose  in the form of an ordinary  blister plaster.
  ±nc -Potato  bly, CantJiaridcs Vittata, of this country, possesses similar
Properties w^th the  foreign insect; as  also some other species, common to 
640
AMERICAN FAMILY  PHYSICIAN.
  CAPSICUM.  Capsicum Annuum.  Also known by the name of Oiyennt
or Red Pepper.   This is an annual  plant  growing in various parts of the
globe in  hot climates.  There are several species, all of which possess simi-
lar properties.   The fruit or berry is the part used;  it has a faint, peculiar
odor, and an intensely hot, pungent, and  acrid taste.  Capsicum is a pure
powerful stimulant, and is much used in warm infusions, in colds, catarrhs'
hoarseness, &c.   It has also been used to  stimulate the stomach  in dyspep-
sia, intermittents, &c, and  has  been found efficient  in some hemorrhages
especially that from the uterus.   It may be used in all cases of diminished
vital action, and is frequently combined with other  medicines to promote
their action.  Dose of the  powder, from  one to ten grains, three or four
times a day.  Externally, the infusion and tincture  is useful as a gargle in
the ulcerated throat of scarlet fever, or in chronic quinsy; also as a coun-
ter-irritant in indolent ulcers,  and in chronic ophthalmia.   It enters into
several stimulating preparations.  The Ethereal Oil of Capsicum, is pre-
pared  by evaporating an ethereal tincture of the pods;  it is of  a brilliant
yellowish color, and  filled  with crystals  of Capsicin of curious dendroid
forms.  It is sometimes used as a rubefacient.

  CARAWAY.   Carum  Carui.   This  is  a biennial  plant growing  in
Europe.   The seeds  or half-fruits  are  aromatic and carminative, used in
flatulent  colic, and to improve the flavor of other medicines.  The dose is
from ten to sixty grains.  The volatile oil is  more commonly used, in doses
of from one to five or ten drops.   Both the seeds and oil are much used in
cakes and confectionary.

  CARDAMOM.  Alpinia  Cardamomum.   This   is   a  perennial plant
growing on the mountains of Malabar; its fruit or seed is used in medicine.
The seeds  have an aromatic, warm taste, and a  pleasant odor, and impart
their virtues to  alcohol or water.  A volatile oil is  obtained from them,
possessing properties  similar to  those  of the seed.  Cardamom seeds  are
aromatic  and carminative, and are used in  flatulency, and also  to render
medicines  more  agreeable.  They should be allowed to  remain in their
three-sided capsules, until required for  use.   Dose  of the  seeds from ten
grains to two drachms.

  CASTOR.  Castoreum.  A peculiar substance obtained from the Beaver,
which has  a nauseous, aromatic taste, and  a strong, heavy, peculiar odor.
Alcohol extracts its virtues, which diminish by age.   Castor is a stimulant,
antispasmodic, and emmenagogue, and has been found useful in hysterics,
retention of menses,  epilepsy, and many  nervous affections.  Its dose is
from ten to twenty grains;  of the  tincture from half a fluidrachm to two
fluidrachms.

  CASTOR OIL.  Oleum Ricini.   This  oil is  obtained from the seeds of
the Castor Oil bush, Ricinus Communis, by expression, in this country; but
in some  other places, by  decoction or tincture.   The oil  obtained by  ex-
pression  is the best;  it is thick, colorless, faintly odorous, with  a nauseous
and somewhat sweetish taste, and  is  soluble in  alcohol or ether. When
exposed  to the  air it becomes  rancid, thickens, and gradually div*  up.
The cold drawn Castor Oil is considered the best.  Castor Oil scedk ...j dan-
gerous, twenty of them having proved fatal; but the  oil obtained from them
is a mild cathartic, especially adapted to young children, pregnant females,
or after delivery, and  is likewise useful  in  piles, colic,  obstinate constipa- 
MATERIA  MEDICA.                       641
 tion worms, &c.  One part  of  Oil  of Turpentine added to three or four
 parts of Castor Oil, increases its purgative  and anthelmintic action.  The
 objection to Castor Oil is its  nauseous taste, and tendency to cause sickness
 at the stomach ;  which may  generally be overcome by adding a small por-
 tion of  some aromatic oil  to it, as Oil  of Wintergreen, Sassafras, Pepper-
 mint, or Cinnamon, &c.   If the  dose of Castor Oil be boiled for a few min-
 utes in  about  a gill  of sweet milk, then sweetened  with loaf sugar, and
 flavored with  any aromatic,  as,  Essence of  Cinnamon, &c, it forms a, mix-
 ture very much like custard, which  is pleasant to the taste, and will not
 offend the  most fastidious stomach.  Castor Oil forms a soap with Soda,
 which may be  made into  pills and  used as  a purgative.   Used externally,
 Castor Oil has proved efficacious in itch, ringworm, and other affections  of
 the skin.  The dose of Castor Oil for an adult is, two or three table-spoon-
 fuls; for an infant, one,  two, or three teaspoonfuls, according to its age.
 As an  injection, double  the above  doses  may be used, mixed with some
 mucilaginous fluid.

   CATECHU.  This is an aqueous extract  of the wood of the  Acacia
 Catechu, and  other  trees  growing in the East Indies and other parts  of
 Asia.   It is met with in  dark-brown, irregular, and brittle pieces, inodor-
 ous, astringent, and soluble  in alcohol.   It  is a powerful astringent, and is
 used in chronic  diarrhea, chronic  dysentery, and hemorrhage  from the
 stomach or bowels.   As a wash  or gargle it  is useful in sore mouth, elonga-
 tion of  the palate, tender and spongy gums, sore and cracked nipples, and
 indolent ulcers;  its infusion  may be  used in  injection in leucorrhea, and
 gleet, also bleeding from the  nose.   The dose of the powder is from ten  to
 thirty grains in some mucilage, every three  or  four hours;  of the tincture
 from a teaspoonful to a table-spoonful.

  CATNIP.   Nepcta Cataria.   This is  a perennial herb common  to this
 country and  Europe;  the  tops  and  leaves  have a strong, unpleasant,
 aromatic odor, and a  bitterish,  rather agreeably aromatic  taste, and yield
 their virtues to boiling water.   The  warm  infusion is diaphoretic and car-
 minative, and  is  much  used as a drink in fevers, colds, and in the acute
 diseases of infants ; it is very useful in the flatulent colic of children.   It
 likewise appears  to  possess  antispasmodic  and  uterine  tonic properties,
 having proved efficacious  in hysterics, nervous  headache, painful menstru-
 ation, suppressed  menstruation,  &c.  The infusion may be drank  freely.
 The expressed juice  of the herb, in tablespoonful doses, repeated three or
 four times a day, is a valuable remedy in suppressed menstruation.

 _ CHAMOMILE.  Anthemis Nobilis.  This is a  perennial herb growing
 in hurope  the flowers  of which are medicinal.   The whitest flowers are
 the best, they have a pleasant odor, and an agreeably bitter taste.   They
are tonic in small  doses, and are generally  used in cold infusion in weak
or irritable  stomachs, dyspepsia, typhus, &c.   The warm  infusion  is dia-
piioretic in small quantity, but acts as an emetic when taken freely.  The
uii oi Lbamomilc is carminative and antispasmodic, in doses  of from five
 o mtcen drops,™ sugar; and has been used in flatulency, colic, cramp in
  PI °u^n PTamfalYmcnstr^tion, hysterics, &c.
  LliAhlOAL   Carbo Ligni.  This is prepared by charring wood when
not exposed  to the action  of  the  air.  The charcoal found in ovens, stoves
w  is not lit for medical purposes.   Charcoal  is absorbent and antiseptic'
and is very useful in acidity  of  the  stomach, flatulency, constipation  dys- 
642
AMERICAN FAMILY PHYSICIAN.
pepsia attended with fetid breath and putrid eructations, &c.  The dose is
from twenty grains to half an ounce, repeated as required.  Externally, it
may be added to poultices to correct the smell of foul or gangrenous ulcers
&c.  Charcoal prepared from bread is the best for tooth powders.

  CHLOROFORM.   Chloroformum.  This agent was discovered in 1831
by Guthrie of this country, Liebig of Germany, and Souberain  of France.
It is a clear, colorless, neutral, very volatile  fluid, having  an odor similar
to ether, and a sweetish, warm taste.  It is non-inflammable, and readily
soluble in ether or alcohol, but not in water.  Its range of solvent power is
very extensive.  When Chloroform is pure, it leaves no stain or odor on
a clean sheet of white  paper after  it has evaporated.   It  is generally used
as an anaesthetic  to produce insensibility  during surgical operations, and
which  is effected by inhaling it.  A teaspoonful  or more  is poured  on a
handkerchief and held to the patient's nose, but not so  closely as to pre-
vent the admission of atmospheric air;  in  a few minutes  the inhalation is
followed by drowsiness,  mutterings, sometimes  cough, and insensibility.
As soon as the patient becomes insensible, the Chloroform  must be removed
from the nose, and should be reapplied from time to time  during the  ope-
ration, only as consciousness returns, removing  it as  soon as this is over-
come.   Its inhalation  has also been  used in painful diseases, as hysterics,
asthma,  neuralgia, lock-jaw,  &c.  Whenever unpleasant  symptoms  arise
from its inhalation, a bottle of strong Aqua  Ammonia  should be at hand,
and the patient be made to inhale this fluid poured on another handker-
chief;  the face may also  be  fanned, cold  water  applied  to the head  and
face, and frictions made upon the body and limbs.  As  an  anaesthetic agent,
chloroform  should never be used except  under the superintendance of a
medical man.
   It may be used internally as a sedative narcotic, in asthma, spasmodic
cough,  neuralgia,  hysterics, &c.   Externally it  has been applied in the
form of liniment to various painful affections, as nervous headache, rheu-
matic, neuralgic, hepatic, nephritic, &c, pains.   One part of Chloroform to
six of Oil  of Sweet  Almonds forms a good  liniment for these purposes.
The dose of Chloroform internally is from  ten  to sixty drops in mucilage
of Gum Arabic, or infusion of Flaxseed, and which may be repeated every
hour or  two, if necessary.

   CHROMIC ACID.  Acidum Chromicum.  This is a very strong acid, in
needle-like crystals of a deep red color, highly deliquescent, and very soluble
in water.  It  destroys most animal and vegetable coloring matters^ and is
a powerful  oxidizing  agent, yielding half its oxygen  readily to oxidizable
bodies, and  being reduced to sesquioxide.   It is erosive in its  action, pro-
ducing pain or burning for a time, but soon  becomes inert.  It has been
recommended  in  piles,  malignant tumors,  cancers, warts, &c.   It is never
used internally.

   CINNAMON.  This is the bark of  several species of tree, growing in
Ceylon, Malabar,  Sumatra, &c,  the  principal one being the Cinnarnomw
Zeylanicum.  The Cinnamon of Commerce is a  stimulant  tonic, astringent
and carminative, and has been used in  flatulent colic, cramp  of the stom-
ach,  diarrhea, nausea and  vomiting, and  to improve the flavor of otner
medicines.  In uterine  hemorrhage, the tincture of the  bark  has prove
efficacious when given in teaspoonful  doses, mixed with  sweetened wate,
and repeated  every  five or  ten  minutes, as  required.  The following a*3 
MATERIA  MEDICA.
643
als0 prove-l useful in flooding :-Take of Tincture of Cinnamon^ Tincture
 f Rhatlny, Tincture  of Ergot, each, one  fluidrachm;  Port Wine  three
fluidounces  mix.   The dosels a fluidounce, as oft en as required.  T he Oil
of C nnamo'n possesses similar properties with the bark.   A child who  is
restless, or ve/y fretful from colicky pains, or wind in the bowels, may fre-
nucntlybe calmed, and made to sleep, by rubbing along  its spine a gently
heated mixture of ten  drops of Oil of Cinnamon added to a teaspoonful  of
Olive Oil;  the rubefacient power of this mixture may be increased by com-
bining  with it  ten drops of Aqua Ammonia.  The  dose of Cinnamon,  in
powder, is from five to twenty grains ; of the tincture, from ten to  sixty
drops;  of the essence, from ten to sixty drops.

  CITRIC ACID.  Acidum  Citricum. * This acid  is obtained from  Lime
juice, or Lemon juice, though it exists in many other fruits.  It has a very
acid  taste, and is  solublo  in water or alcohol.  In  solution, citric acid is
refrigerant and anti-scorbutic, and  forms a very beneficial  drink in fevers,
scurvy, acid stomach, and some  forms  of headache.   A good lemonade
may  be made by putting a teaspoonful of the following mixture to a pint of
watcr :—Take  of Citric Acid one ounce and a half; white sugar one pound ;
powder these, and mix together with Oil of  Lemon five drops.

  CLEAVERS.   Galium Aparine.  This  is an annual plant,  common  to
Europe and this  country, having, when dried, an acidulous, bitterish,
astringent taste, and no odor.   There are several species, which possess sim-
ilar properties.   The whole herb is used  in infusion as a refrigerant and
diuretic, in suppression of the urine, gravel, inflammation of the  kidneys
and bladder, scalding urine, &c.  It should  not be used in passive diseases.
In fevers and all acute diseases it may be  used freely, and has been found
useful in psoriasis, eczema, lichen, cancer, lepra, and other cutaneous  erup-
tions, also in scrofulous diseases.  The best form of administration is that
of the inspissated juice, which may be given  in one or two  teaspoonful
doses, three times a day.   The infusion is made by adding two ounces  of
the herb to a pint and a half of warm water, letting them stand for  three
or four hours,  and, when  cold, it may be drank freely.  During the inflam-
matory stages  of erysipelas,  scarlet fever, and other  eruptive  diseases, a
very refreshing and salutary drink may be  made of equal parts of Elder-
blows, Cleavers, and Maidenhair;  this infusion, when cold, may  be taken in
wineglassful doses, and repeated several times a day.

  CLOVES.   Caryophyllus Aromaticus.  This tree  is a native  of tropical
climates.   The flowers, collected  before they are fully developed, form the
Cloves  of commerce.  They are aromatic  and  stimulant, and  are  used in
flatulency to give tone to the digestive apparatus, to  lessen nausea or vom-
iting, and to correct the taste or modify the action of other remedies.   The
dose, in powder, is five or ten grains.  The Oil of Cloves  is frequently used
for  the same purposes,  and as an  external counter-irritant.   Its dose is
from two to five drops on  sugar, or  in mucilage.  Toothache is frequently
relieved by placing into the cavity of the decayed tooth, a piece of cotton,
or lint, moistened with the Oil of  Cloves.

  COCniNEAL.  Coccus Cacti.  This  is  an insect found in  Mexico and
the neighboring countries, having a peculiar odor, and a  bitter  taste.   It is
anodyne, and has been used with advantage  in hooping-cough, neuralgia
and in fevers, to produce sleep.  The  dose is from five to ten grains  three 
644
AMERICAN FAMILY  PHYSICIAN.
or four times a day.   Tinctures and ointments are frequently colored by it
and the Carmine of commerce is prepared from it.

   COD LIVER OIL.   Oleum Morrhuce.  This oil is nutritive and altera-
tive, and has long been a popular remedy in scrofula, chronic rheumatic dis-
eases, consumption, and all afi'ections in which there is an impairment of tho
digestive, assimilative, and nutritive functions.  The dose is a table-spoonful
two or  three times a  day, which may  be taken in  brandy, claret,  or with
sugar, in  aromatic oils.  It is best  to  begin with teaspoonful doses, and
gradually increase  them, to  avoid  nausea and  vomiting.   It must  be used
five or  six weeks before much advantage will be apparent,  Whether Cod
Liver Oil really deserves all the encomiums  passed upon it, is yet a matter
of uncertainty, and will doubtless continue so as long as unprincipled per-
sons adulterate it with lard, or other oils, or manufacture a spurious article;
a pure article is now seldom to be obtained.

   COLCHICUM    Colchicum Autumnale.   This is an annual or perennial
plant, common to England, the seeds and bulbs of which are used in med-
icine, and which yield their virtues to alcohol, wine  or vinegar.  They are
sedative, diuretic and cathartic, and have been used in gout, gouty rheuma-
tism, enlarged  prostate, gonorrhea, and in some febrile and inflammatory
affections.   In  large doses  it  is a  narcotic  poison.  It is more generally
used in the form of tincture, which see in the Pharmacy.   The dose of the
powdered  bulb is from one to eight grains, every four or six hours.

  COLLODION.   This is a solution of Gun Cotton  in ether.   It is a col-
orless, syrupy fluid, having the odor of ether, and  should be kept in well
stopped bottles, as it evaporates and becomes unfit for use.   It is generally
applied, by  means of a brush, to cut wounds, abrasions of the skin, burns,
leech bites,  sore nipples, &c, over wdiich it forms a  thin scale, protecting
the parts from the action of the atmosphere.  The following is said to form
a pliable or flexible film or  scale : Take of Collodion thirty parts; Castor
Oil, and soft Turpentine, of each, fifty parts ;  mix.

  COLOMBO.    Cocculus Palmatus.  This is a perennial, climbing plant,
growing in East Africa, and cultivated  in the  Isle of France;  the root is
the part used; it  is easily powdered, has a faint odor, and a  very bitter
taste, which  it  yields  to alcohol, water or ether.   The powder should be
kept in a  dry  place,  as it  absorbs moisture  from  the atmosphere, and
undergoes decomposition.  It  possesses  tonic  properties,  and  is  used in
dyspepsia, chronic  diarrhea and dysentery, convalescence  from exhausting
diseases, muscular  debility of children, and  in  debility of the digestive
organs.  Its dose is from ten to thirty grains, three onfour times a day; of
the infusion, from one to two fluidounces ;  of the tincture, from one to two
teaspoonfuls.  The American Columbo, Frasera Carolinensis, possesses sim-
ilar properties in the same doses.

  COMFREY.   Symphytum  Officinale.   This  is an  European perennial
plant, cultivated in this country.   The root is the part used ; it has a very
faint odor, and a mucilaginous taste.  It is demulcent, and slightly astrin-
gent, and is of service in diseases of the mucous tissues, and in scrofulous
and anemic habits.   It has  been found  useful  in diarrhea,  dysentery,
coughs, bleeding from the lungs, leucorrhea, and female debility.  It may
be  boiled in water, wine, or  made into a syrup, and  be taken  in  doses o 
MATERIA  MEDICA.
645
from one to  four fluidounces, two or three times a day   The fresh root,
bruTsedI, forms  an excellent application to ulcers, sore  breasts, white swel-
lings, fresh wounds, bruises, &c.

  COMMON SILKWEED.   Asclepias Syriaca.  This  perennial  plant
abo known^by the  name of Milkweed, is common throughout the  United
States   Upon  being wounded, the plant gives out a milky juice, which, it
is said  will  cure  warts when rubbed  upon  them.   The root  possesses
diuretic,  alterative, emmenagogue, and anodyne properties, and has been
used in dropsy, retention of urine, suppressed  menstruation, dyspepsia,
Bcrofula, and rheumatism.  Both the root and  milky juice are anodyne.
D.kc of the  powder, from eight to twenty-five  grains ;  of the decoction,
from one to  three  fluidounces ;  of the  tincture, from ten  drops to  a flui-
drachm.

  COPPKR.  Cuprum.  Several salts  of  this metal  are used  in medicine,
the  most common'of which are the two following:—
  1. Subacetate of Copper.  Cupri Subacetas.   This is of a pale green color,
has a disagreeable, vinegary* smell, and a nauseous,  styptic, coppery taste.
It is only partially soluble in  water, but  insoluble in  alcohol, and is  known
by the popular name of Verdigris, which name is also applied,  but wrongly,
to the green rust found on copper vessels  used in kitchens, &c, this being
a carbonate of copper.  Subacetate of copper is used as an escharotic and
detergent, to remove warts and fungous  growths, and as  an application  to
foul ulcers, ring-worm, disease of  the eye-lids, &c;  it is  sprinkled  in the
form of powder, on  the surface, or it may be used in the  form  of ointment.
When taken  internally it is poisonous, and the best  antidotes are white of
eggs, and a free use of sugared water.  A  moderate heat  removes its water
of crystallization, in which form  it is  best used  as an escharotic;  too great
a heat decomposes it, driving  off the acetic acid, and  leaving  the oxide of
copper.
  2. Sulphate  of Copper.  Cupri Sulphas.  This  salt, also  known as Blue
Vitriol, is usually  met with in large, beautiful, azure-blue crystals, which
are  inodorous,  have a disagreeable, styptic,  metallic taste, and are soluble in
water but not in alcohol.   It is employed as a stimulant or escharotic appli-
cation  to warts, ill-conditioned  ulcers,  fungous  granulations, leech-bites,
Ac   From  two to  eight grains dissolved in a fluidounce  of water forms an
excellent collyrium for chronic ophthalmia.  It is not used internally, and
when poisonous symptoms  are present from swallowing it, treat the same as
in the preceding.

  COTTON.   Gossypium Hcrbaceum.  This is an annual herb, a native of
Asia, but extensively cultivated in the Southern States.   The inner bark of
the  root is emmenagogue, parturient, and abortive.  A strong  decoction  of
the  bark is used by the southern female slaves for producing abortion, which
it does without any apparent injury to health.   A tincture made with Sweet
Spirits of Nitre, has proved efficacious in suppressed and painful  menstrua-
tion.  The decoction will be  found to invigorate  the uterine contractions
during labor, when these are weak and inefficient.  An alcoholic  extract of
the bark may be  usefully combined  with  Senecin, Caulophyllin, or other
uterine  tonics, in derangements of the functions of the  uterus.  The bark
rapidly loses its virtues by drying.  A decoction of the seeds of the cotton
plant have been efficacious in  fever and  ague.   They contain a drying fixed
oil,  which might  be  profitably  procured from  them for many purposes. 
646
AMERICAN  FAMILY  PHYSICIAN.
The filamentous matter surrounding the seeds, and popularly known as cotton
forms an excellent application to burns,  scalds, blisters, wounds, erysipelas'
rheumatic pains, &c, producing its beneficial results probably, by protecting
the parts from the action of the air.                                    °

  CRAWLEY.   Corallorhiza Odontorhiza.  This is a perennial plant, found
on barren hills and in hard  clay soil in  the State of New York.  The root
is the part used, it is small, dark-brown, resembling cloves, or a hen's claw
has a  strong, nitrous smell, and a mucilaginous, slightly  bitter, astringent
taste.  It is sedative  and diaphoretic, and is used in  all febrile and  inflam-
matory diseases, especially in the typhoid  stages; it is useful, likewise, in
flatulency, cramps, hectic fever, and night-sweats.   When  it is required to
influence the liver, or act on the bowels,  in febrile diseases, it may be given
in connection with Podophyllin or Leptandrin.  In  bilious  or flatulent colic
it may be advantageously combined with  Dioscorein; and with Caulophyllin
in painful menstruation, suppression of the lochial discharge,  after-pains
neuralgia of the womb, &c.  The powdered root should be kept in well-
closed vials; its dose  is from twenty to thirty grains, in  warm  water, and
repeated every hour or two,  according to  circumstances.

  CREOSOTE.   Creasotum.  This is a  substance obtained by the distilla-
tion of tar,  and sometimes from crude pyroligneous acid.   When pure it is
an  oily, colorless fluid, having a emoky odor, and  a burning, peculiar
taste;  that found in  the shops  has commonly a brownish color.  It com-
bines with naphtha,  ether, or alcohol, and dissolves sulphur, phosphorus,
iodine, &c.   When meats are dipped  into it, they are  preserved from de-
composition.  Creosote is more generally used externally in scaly cutaneous
diseases, burns, bleeding from the vessels of the  skin, indolent and gangre-
nous ulcers, scrofulous ophthalmia, &c, in the form of mixture, solution, or
ointment.   Occasionally it is applied on cotton to the cavity of a decayed
tooth  to relieve  toothache.  A  large dose  internally, produces poisonous
symptoms, which are best overcome by white of egg, ammonia, and other
stimulants.   Creosote  added to ink or  infusions, in the quantity of three
or four drops to a pint, will prevent them from becoming moldy.

   CROTON OIL.   Oleum  Tiglii.  This oil is obtained from the seeds of
an  East India plant,  the Croton  Tiglium; its color varies from a  pale amber
to  deep  sherry, it is thick like  Castor Oil, becoming more so by age, has a
faint odor, and a persistent, hot, and acrid taste.   Ether and the fixed and
volatile oils dissolve it.   Croton Oil is a hydragogue cathartic, in the dose
of  from one to six drops  on sugar, or crumb of bread, and has  been used
in  cases of obstinate constipation, dropsy, coma, apoplexy, epilepsy, mania,
&c.  Combined with  Olive Oil, or Oil of Turpentine, it has been employed
externally as a counter-irritant, causing redness,  heat, and  pimples, and has
thus been found  useful in  diseases of the throat and  chest, rheumatic and
neuralgic affections, &c.   One part  to three  or  four of Olive  Oil  may be
rubbed upon the  affected place, or over it,  and repeated three or four times
a day.

   CUBEBS.   Piper Cubeba.  This is a climbing perennial plant, common
to the East India Islands, the berries of which are the parts used.  They are
mildly stimulant, expectorant, and  carminative, acting  especially upon mu-
cous tissues, and have been found useful  in gonorrhea, gleet catarrh ot in
bladder, leucorrhea, chronic inflammation of the bronchial  tubes, &c.  m J 
MATERIA MEDICA.
647
should not be used during active inflammation.  The dose of powdered Cu-
bebs is from thirty to sixty grains, three times a day;  of the  tincture, one
or two teaspoonfuls.   They are frequently combined with Copaiba, and other
articles, in the form of paste or pills for the cure of gonorrhea.  A volatile
oil is obtained by distilling Cubebs with water, having a greenish or yellowish
tint, and possessing the peculiar taste  and  odor of the  berries.  It may be
used in the same diseases as the berries, in the dose  of ten or twelve drops,
three times a day, and is  best given  in  syrup, emulsion, or  in the form of
capsules.

  DANDELION.   Taraxacum  Dens-Leonis.   This  is  a perennial  herb,
common to  most parts of the globe, the root of which, when fresh, possesses
diuretic and aperient properties, which are increased by the addition of Cream
of Tartar.  It has been used  in affections of  the liver and spleen, diseases
of the skin, dropsy, and in derangement of the digestive organs.  The pre-
sence of acute inflammation,  or  an irritable  condition  of the stomach or
bowels, contra-indicate its employment.  Dose of the  decoction, one or two
fluidounces, three or four times a day;  of the extract, from five to thirty
grains.  The fresh root gathered in the autumn is the best.


  DIGITALIS.  Digitalis Purpurea.  This is a biennial  plant, growing in
the temperate parts  of Europe, and is also known by the  name of Foxglove.
The leaves are the parts used;  they are faintly odorous, have  a  nauseous and
bitter taste, and impart  their virtues  to water, ether, alcohol,  or diluted
acids.  In  large doses, Digitalis  is a narcotic poison;  in medicinal doses,
it is a sedative and  diuretic, reducing the pulse, and increasing the urinary
discharge.  As it is liable to  accumulate  in the system, developing its poi-
sonous symptoms suddenly, when it has been given  for some time in small
doses, its effect should be carefully watched.   It is much used  in all febrile
and inflammatory diseases, palpitation  of the  heart, spitting of blood, hoop-
ing-cough,  asthma,  and in dropsy connected with diseased heart  or kidneys.
The dose of the leaves in powder, is from one to three grains, two or three
times a day;  of the tincture from ten to  fifteen drops.   Its poisonous effects
are  best  overcome  by the free use of warm  fluids to cause vomiting, with
brandy, wine, Ammonia, or other stimulants  to counteract the depression;
and also  mustard to the ankles and wrists.


  DOGWOOD.  Comus  Florida.   This  is  a small  tree common  to the
United States, the  bark of which is used in medicine as a tonic, astringent,
and antiperiodic.   It  is considered by many as a good substitute for Peru-
vian bark in intermittent fever, and may be used in all cases where Quinia is
indicated, as in periodical fevers,  typhoid fevers, &c.   Dose of  the powdered
bark, from  ten to sixty grains, as often as required; of the extract, five to
ten  grains.
  Comine  is a principle  obtained  by Mr. W. S. Merrell; a tincture of the
bark is made,  to which water is added, and then the alcohol  is distilled off.
The Cor nine is precipitated in the water; it is of a light  grayish brown
color, a peculiar odor, and a  slightly bitter and astringent  taste.   Alcohol
almost wholly dissolves it, and  Ammonia renders  the solution complete;
ether wholly dissolves it.  It possesses the properties of the bark, and may
be variously combined with Xanthoxylin, Salicin, Hydrastin, &c.   The dose
of Oornine is from  one to ten grains or more. 
 

Male Fern.  (Aspidium Filix Mas.) 
 
MATERIA  MEDICA.                       649
forms an ointment useful in burns, scalds, and some  diseases of the skin.
The expressed juice of the root forms an efficient  diuretic and  hydragogue
cathartic in all dropsical diseases.

  ELECAMPANE.   Inula Helenium.  This is a  perennial plant, native of
Europe  and Japan, and cultivated  in  this  country.  The root should  be
gathered in autumn, in the second year of its growth.   It has a pleasant
odor, and a spicy, bitterish taste.  Elecampane root is  a stimulant and tonic,
and 'is also said to be diuretic and expectorant.  It is much used in  chronic
affections of the lungs and air-tubes, dyspepsia, debility of the stomach, tor-
por of the liver, &c.   Externally, the decoction forms  a good  application in
itch, tetter, and other  skin diseases.   Dose of the powdered root from  one
scruple to one drachm;  of the infusion or  decoction, one or two fluidounces.

  ELECTRO-MAGNETISM.  Electricity has for many years been used as a
remedial agent in the  treatment of various diseases; but it is  only within a
few years past that that modification of it, termed Electro-Magnetism,  has
been employed.  There are various forms  of electro-magnetic machines in
vo"-ue, but the one which I consider the best, is that in which the current is
produced by the zinc and copper battery;  this is more  troublesome than the
crank machine, but, according to my experience, is superior to it, on many
accounts.   The limits of this work will not allow me to enter into any expla-
nation of Electro-Magnetism, the various  modes  of applying it,  &c.  I  can
merely refer to it as a valuable agent in the  treatment of nearly every  dis-
ease to which the system is subject.   And, though it may,  alone,  produce
permanent cures, I believe these to  be  very rare, unless,  with  its use,  the
proper internal means  be  also administered.  An electro-magnetic  current
passed through a diseased organ, renders it more susceptible to the therapeu-
tical influence of  internal  remedies,  and  thereby facilitates  its progress
toward recovery; which is about all that can be done  by  the  action  of  this
imponderable, and even this is very valuable to both physician and  patient.
The use of electro-magnetism alone,  has apparently cured long-standing  dis-
eases, as palsy, rheumatism, &c, but in most of these  cases,  on  suspending
the use  of the machine, the disease  has gradually returned, and  this  will
almost always be the case, unless the proper remedial agents be administered
internally,  at the  same time.   In  nervous  diseases  especially, very light
shocks will be found highly advantageous; while  powerful ones, so much in
the habit  of being given by inexperienced  persons,  will prove decidedly
injurious.

  ERGOT.   Secale Cornutum.  The diseased seeds of rye, known as Spurred
or Smut Rye.  It is in cylindrical grains,  curved  like a cock's spur, from a
third of an inch to an inch and a half in  length, from a twelfth to  a fourth
of an inch thick, solid, of a dark-purplish  color  externally,  grayish-red or
violet-white internally, of a  musty, unpleasant odor, and a sweetish, bitter,
feebly acrid taste,  In medicine, Ergot is used to promote the contractions of
the uterus, when these are weak and inefficient; the free  and long-continued
use of it gives rise  to terrible and dangerous symptoms.   It should never be
used in  first labors;  and in subsequent  labors,  its  use is  only admissible
when the pains are weak, the mouth of the womb  being soft and dilated, the
lead presenting, the woman nearly exhausted, and no  obstacle to delivery ex-
.sting, as a deformed or small  pelvis, tumor, large  head of the child, &c.
Under no other circumstances, is its  administration during labor, proper. It
aas, however, been given to facilitate abortion, when this has  commenced, to 
650
AMERICAN FAMILY PHYSICIAN.
aid in expelling a  mole, hydatids, &c, when  the womb  has once begun ta
act, and to check uterine  hemorrhage.   It should never be prescribed  ex-
cept by a physician.  Scald-head may be cured,  by applying to the scalp
twice a day, an ointment made of green rye, collected when six or ten inches
high, and gently heating it in fresh cream.

   ETHER.   This  is also  known  as Sulphuric  Ether.   It is a colorless
transparent fluid, having a peculiar, penetrating odor, and a cooling, pungent,
aromatic taste.  It is highly inflammable, and should never be brought near
a candle, or other flame.   It decomposes by  too long keeping.  Ether is a
diffusible stimulant and antispasmodic, and  has been successfully used in
low fevers attended with twitching of the tendons, nervous headache, cramp
of the stomach, fainting, hysterics, flatulent colic, palpitation of the heart,
asthma, &c.   Its dose is from ten to sixty drops.   When combined with  Oil
of Turpentine, it is useful  in relieving the pain  and spasm caused  by  the
passage of gall stones.  When applied externally and allowed to evaporate,
it acts as a  refrigerant, and  is thus used in nervous headache, external in-
flammations, &c;  when covered, so as  to repress its evaporation, it acts as a
rubefacient.   Letheon is the name given to pure Ether, prepared for inhala-
tion ; but it is not so frequently used for the  production of insensibility as
Chloroform.

   FALSE BITTERSWEET.   Celastrus Scandens.   This is a woody, twin-
ing  shrub, common to the United States, having a  long, creeping, bright
orange-colored root, and  a  thick red, or yellowish-red bark, which has a
sweetish, rather nauseous taste.   This root-bark is al terative and diuretic, with
slight narcotic powers, and has been successfully used in scrofula, secondary
syphilis, chronic disease of the liver, diseases of the skin, rheumatism, leu-
corrhea, and  obstructed menstruation.  The  dose of the decoction is from
two to four fluidounces, three or four times a day;  of the  extract, from  five
to ten grains.  Externally, an ointment  of the fresh root has been used in
inflamed and indurated breasts of nursing women.

   FEVERFEW.  Pyrethrum Parthenium.   This is a  European perennial
plant, introduced into this  country.   The herb in warm infusion, is an ex-
cellent remedy in  recent  colds, flatulency, worms, irregular menstruation,
hysterics, suppression of the urine, and  in some febrile  diseases.  It may be
drank freely.  The cold  infusion,  or extract, makes a valuable tonic. A
poultice of leaves is useful in severe pain, or  swelling of the bowels, &c.

   FIGWORT.  Scrophularia Nodosa.  This is a European perennial plant,
 introduced into this country.  The leaves and roots are the parts used; they
 have a nauseous odor, and  a disagreeable, bitter, or subaend taste.   Jngwo"
 is alterative,  diuretic, and anodyne; and is efficacious in liver diseases, scroi-
 ula, dropsy, diseases of the skin, and, as a general deobstruent to the g ano
 ular system.  Dose, in infusion or syrup, from two to four fluidoMceMbM
 times a day.  Externally, in fomentation or ointment it is valuable in bruises
 ringworm, piles, inflammation of the breasts  itch Ac.   A decoction o
 root, drank freely, is said to restore the lochial discharge, and to relieve
 painful menstruation.

   FIREWEED.   Erechthites Hieracifolius.    This is a  rank, annual.«£
 common to the United States.   It emits a peculiar, aromatic, and fetid o  ,
 and has a bitterish, slightly astringent, rather disagreeable taste,   ine 
MATERIA  MEDICA.
651
 plant is used as a tonic, astringent, and alterative, exerting a beneficial influ-
 ence, especially on mucous tissues.  An  alcoholic extract of the plant has
 proved very useful in diarrhea, summer-complaint of children, and in dysen-
 tery ;  in the last named disease, it promptly allays the pain, checks the dis-
 charges of bloody mucus, and  hastens  a cure.   The Volatile Oil of Fire-
 weed,  obtained by the distillation of the fresh plant with water, has a strong.
 rather unpleasant odor, and a disagreeable, pungent,  bitterish taste.  It has
 been used with advantage, in the same diseases as the plant, and likewise in
 hooping-cough, hysterk,  hiccough, colic,  and spasmodic affections of the
 stomach and bowels.   Its dose  is from five to ten drops, on Sugar, or rubbed
 up with Gum Arabic mucilage.  When rubbed with Extract of Stramonium,
 it forms a valuable local application for  piles.

   FIRING.   Obtain a thick iron-wire shank, about two inches long, and in-
 serted  into a small wooden handle; on its extremity, which must be slightly
 curved, have a disk,  or button of iron, exactly one-quarter of an inch thick,
 and half an inch in  diameter.   The whole instrument to be only six inches
 in length.  The face of the disk for application, must be flat.  Every family
 should be in possession of one  of these instruments.
   To  apply  it, light  a small alcohol  lamp, and hold the  button over the
 flame,  keeping the fore-finger of the hand holding the instrument, at the dis-
 tance of about half  an inch from the button.  As  soon as the finger feels
 uncomfortably hot,  the instrument is  ready for use, and the time required
 for heating it to this degree, will be about half  a minute.  It is to be ap-
 plied as quickly as possible to the parts, the skin being tipped successively,
 at intervals  of half  an inch over the affected part, as lightly and  as rap-
 idly as possible, always taking care to bring the flat surface of the disk fairly
 in contact with the skin.  In this way,  the process of firing a whole limb,
 or the  loins, making about one  hundred applications, does not occupy a min-
 ute, and the one heating by the lamp suffices.   To ascertain whether the heat
 be sufficient, look sideways at the spots, as you touch them, and each spot will
 be observed of a shining white, much whiter than the surrounding skin.   In
 from five to thirty minutes, the skin becomes bright red, and a glow of heat
 is felt over the part.   The iron must never be made red-hot—it is very little
 hotter than boiling water—should never make an eschar, and rarely raise a
 blister.  On the next  day after its application,  a number  of circular red
 marks  will be  seen on the skin, the cuticle not even  being  raised, .and the
 surface ready, if necessary, for  a fresh application.  It is much superior to
 a blister in many cases, and the most delicate female will not object to its
 frequent  repetition, when  required.   This acts as a  powerful counter-irri-
 tant in paralysis,  local muscular rheumatism, sciatica, lumbago, neuralgic
 pain3, Ac.  Also applied along  each side of the spinal column in intermit-
 tents, epilepsy, mania, and similar diseases.

  FLAXSEED.   Linum  Usitatissimum.  Flax  is  a well-known  annual
 plant, the seeds of which, as well as the oil procured from them, are used in
 medicine.   An infusion  of Flaxseed is demulcent,  and nutritive, and is
 much used in cough,  catarrhal  affections, inflammation of the urinary organs,
 bowels, or lungs.  One ounce of the seeds, not bruised, may be infused in a
 pint of hot water, and may be  sweetened with honey or loaf sugar, and fla-
vored  with lemon-juice; the dose is one or two pints  daily.  Used as an
injection, the  infusion  has been employed with  benefit in dysentery, piles,
and thread worms in the rectum.  Piles have been cured in a few weeks, by
the use of Linseed Oil, in  half-gill doses,  repeated  twice  a day, avoiding, 
652
AMERICAN FAMILY PHYSICIAN.
while using it, all liquors and stimulating food.  It has also been given with
advantage in colic, for the  removal of the long, round worm, and in dysen
tery.   Carron Oil, an efficacious application to burns, is composed of  Linseed
Oil and Lime Water.  One pint of  Linseed Oil combined with half an ounce
each of Oils of Origanum and Wintergreen,  forms a pleasant cathartic  in
doses of two or three table-spoonfuls.

  FROSTWEED.  Hclianthemum  Canadense.  This  is a perennial  herb
common to  dry, sandy soils, throughout the  United States, and flowering
from  May to  July.  It  is also known by the  name  of Rock-Rose, Frost
Plant, &c.   It is tonic, astringent, and alterative, and may  be used either in
decoction, syrup, or fluid extract.   It is a valuable agent in scrofulous dis-
eases, and combined with  Turkey Corn and Stillingia, has effected cures  ia
secondary syphilis.   The decoction  has been administered  in diarrhea- also
used as a gargle in ulcerations of the mouth and  throat,  attending scarlet
fever and other diseases, and, as a wash in scrofplous ophthalmia,  and various
affections of the skin.  The fluid extract is  the best  for internal use.  Its
dose is one  or two teaspoonfuls,  three or four  times a day.   Externally the
leaves have been advantageously applied in  the form  of poultice, to scrofu-
lous tumors  and ulcers.

  GALLIC ACID.  Acidum Gallicum.  This Acid is  generally obtained
from Galls ;  when pure it is colorless, in slender, satiny  crystals, inodorous,
and astringent—acid in taste.   The Gallic Acid of the shops has a brown-
ish tinge.   It is soluble in alcohol, and partially so in water.   Gallic Acid
has been found very valuable in bleeding from  the lungs, stomach, womb,
and kidneys, in excessive menstruation, and in  chronic  mucous discharges
from the bowels or bladder.  The dose is from three to twelve grains, three
or four times a day, in the form of  pill, powder, or in  solution.

  GALLS.   These are the morbid  excrescences found upon the shoots and
young boughs of a plant growing in the middle latitudes of Asia, the Dyer's
Oak,  Quercus Infectoria,  and which  are caused by the  puncture  of a fly or
insect, made for the deposition of its eggs.  The best Galls are hard, heavy,
lead color externally, brownish-white internally, with a small hole in the
center, the original place of deposit of  the egg, and the habitation of the
larva; they are  inodorous, astringent,  easily powdered,  and  yield their
astringency to water.  Galls  may be used  whenever astringents are indi-
cated, as in chronic diarrhea  and dysentery, passive hemorrhage, and also
in poisoning by Tartar Emetic, or the poisonous vegetable  alkaloids. Dose
of  the powder, from five  to  twenty grains;  of the decoction from one to
two table-spoonfuls.  The decoction forms an excellent gargle  in indolent
ulceration  of the mouth and throat, relaxed palate, the chronic stage of
mercurial action on the mouth ; aad a useful  injection in  gleet, leucorrhea
and prolapsus ani; its efficacy may  be increased by the addition of Alum.

  GAMBOGE.  This is  the concrete juice  of trees growing in Siam and
Cochin China, the characters of which are not yet positively known, though
supposed to be the Hebradendron Gambogioides, and the Garcinia Cambogja.
Gamboge is met with in rolls and in lumps, of a yellow  orange color which
becomes darker when exposed  to  the air, faintly odorous, an  acrid  taste
after chewing it for a short time, and easily powdered.   Its active principle
is a resin, which is soluble in alcohol or ether.  This gum-resin is a hydra-
gogue cathartic, occasioning, however, in large  doses, inflammation ot 
MATERIA  MEDICA.
653
 Btomach and bowels, and death.   It is seldom  employed alone, but  com-
 monly in combination with other cathartics, which renders its action much
 safer  When mixed with Cream of Tartar, or Squill, it is  sometimes used
 in dropsy as a hydragogue,  but it is apt to produce nausea and more or less
 eripin"  United with an alkali, it acts as a  diuretic.   It should never be
 used during pregnancy, in  inflammation  of the stomach  or  bowels, piles,
 diseased womb,  excessive menstruation, &c.  When it  produces dangerous
 symptoms,  its best antidote is  some  alkaline water, as pearlash, and any
 inflammatory symptoms must be treated upon general principles.  The dose
 of  Gamboge  is  one  or two  grains, repeated at  short intervals until  it
 operates.

  GARLIC.  Allium Sativum.   This is a well-known perennial plant, the
 bulb of which is the part used.   It is stimulant, diuretic, expectorant, and
 rubefacient; when taken internally it has proved useful in coughs, catarrhs,
 hoarseness, hooping-cough, worms,  and  in  the  nervous  and spasmodic
 coughs of  young children.  The  dose of Garlic, when eaten, varies  from
 twenty grains to three drachms ; of the juice  mixed with sugar, from half a
 teaspoonful to a teaspoonful.   When  eaten too freely,  it is apt to disorder
 the  stomach, causing  distress and flatulency, with headache, and  febrile
 restlessness.  Deafness is  said to have been cured by placing in the ear,
 a few drops of a mixture of equal parts  of Garlic juice, Glycerin,  Oil  of
 Sweet  Almonds.  Externally, the  bruised bulbs, applied as a poultice over
 the bladder, have produced a flow of urine  in  cases where this discharge
 was suspended from debility of the bladder.   They may also  be applied,  as
 a counter-irritant, along the spine and to  the  chests of  infants and young
 children  in inflammation of the  lungs, and to the feet and limbs in fevers
 and affections of the head.

  GENTIAN.   Gentiana Lutea.   This is a perennial plant common to the
 mountainous  parts of Europe.  The root is met with in pieces of  various
 sizes, not over an inch  thick, reddish-yellow externally, grayish-yellow  or
•reddish at  the center, feebly aromatic in odor, and intensely bitter to the
 taste.  Water, alcohol,  wine, or  ether, extracts its virtues.  Gentian  is a
 powerful bitter tonic,  very  useful  in all cases  of debility and exhaustion,  as
 in dyspepsia,  gout, hysteria, suppressed menstruation, scrofula, intermit-
 tents, chronic diarrhea, worms, &c.  It should not be given in cases of irri-
 table stomach.   The dose of the powdered root is from ten  to thirty grains;
 of the  infusion, one or two fluidounces;  of the tincture,  one or two flui-
 drachms ; of the extract, from one to ten grains.   Large  doses are apt to
 distress the stomach, and cause vomiting.  Gentianin is the name proposed
 for  its  concentrated bitter principle, which may be used  as a substitute for
 Quinia, and in enlargement of the spleen, in doses of from  five to twenty
 grains  twice a day.
  The  Blue or  American  Gentian,  Gentiana Catesbei, Soapwort Gentian.
 Gentiana Saponaria, Blue Fringed Gentian, Gentiana Crinita, and others  of
 this country,  possess similar "medicinal virtues, and may be used as  a sub-
 stitute  for it in  all cases, in the same doses and preparations.
  The  Five-flowered  Gentian,  Gentiana Quinquefiora, sometimes called
 Gallweed, on account  of its intense bitterness, has been found of great effi-
 cacy in headache, jaundice, liver affections, &e.; it is common in woods and
 pastures  from  Vermont  to  Pennsylvania,  flowering  in  September and
 October.   A variety of it is common throughout the Western States. 
654
AMERICAN  FAMILY  PHYSICIAN.
  GERANIUM.   Geranium Maculatum.   This is a perennial plant com-
nion to the United States, and known  by the names Crowfoot, Crane'sbill
&c.   The root  should be gathered in the latter part of the fall; when
dried it is flatfish, rough,  knotty, and dark-brown  externally, internally
dingy white, with a reddish tinge, having a feeble odor, and an astringent
slightly bitter taste.  Its virtues are extracted by water or alcohol.  Gera-
nium is a powerful astringent, and may be used in chronic dysentery, and
diarrhea, and in cholera infantum in infusion with milk.   And both inter-
nally and externally it may be used whenever astringents are indicated as
in hemorrhages, indolent ulcers, ulcerated  mouth and throat, chronic oph-
thalmia, gleet, excessive menstruation, diabetes, leucorrhea, and all profuse
chronic mucous discharges.   Relaxed palate may be  benefited by garglin*
with a decoction of the root; and bleeding piles have been cured by injec°
tions of the  decoction into the  rectum.   As it is not nauseous, it is well
adapted to the most fastidious  stomachs.   The root, reduced to an impal-
pable powder and applied to leech-bites, wounds from small vessels, nose-
bleeding, &c, covering the part with cotton, will at once  check the flow of
blood.  Dose of the root in powder from five to  thirty grains ; of the de-
coction,  one  or  two table-spoonfuls, three or four times a day.
   Geraniin is the  name  applied  to the  concentrated extract  of the root,
prepared by distilling off the alcohol from a  tincture made  by adding the
root to equal parts of alcohol and water; and then evaporating to dryness.
It forms  a  black  or dark brown shining  powder,  of a  feeble odor, very
astringent taste, and insoluble in cold water,  alcohol, ether,  chloroform, or
oil  of turpentine; liquor potassa dissolves it.  It  has  an  acid reaction.
Geraniin  possesses  the virtues  of the  root in a powerful  degree, and may
be  substituted for it in all  cases of internal exhibition, in doses of from
one to five grains  or more, repeated as  required.  It is now in  general use,
being preferred  in most cases to the powdered root.

  GINGER.  Zingiber Officinale.  This well  known  article is the root of a
biennial plant,  growing in  the  East and  West  Indies.   It is stimulant,
rubefacient, errhine, and  sialagogue.   It is eminently suited to dyspeptic
habits, flatulency,  hysterics, nausea, pains  and cramps in the stomach and
bowels, the feeble state of the  stomach and  bowels  accompanying atonic
gout, and to obviate tenesmus.   It  is frequently used to  disguise other
medicines.  Dose  of ginger, from ten to  thirty  grains;  of the infusion,
one or two table-spoonfuls.  A  large quantity taken  internally might pro-
duce serious effects.  Combined with Black Willow bark, it forms an excel-
lent poultice  for indolent ulcers ;  and is at times used as a local remedy in
relaxed palate, and paralysis of the tongue.

   GINSENG.  Panax Quinquefolium.  This  is a perennial plant, common
to most of the  middle  and  Southern States.   The root is  spindle-shaped,
and when dried, is wrinkled and yellowish white externally, with a faint
odor, and an agreeably  bitter taste.  It is a mild tonic and stimulant, useful
in loss  of  appetite,  slight  nervous  debility, weak  stomach, worms, &e.
Dose of the powder, from ten to sixty grains ; of the infusion, from two to
four fluidounces.

  GLYCERIN.  Glycerina.  This is  a colorless, or straw-colored, some-
what  syrupy fluid, having  a feeble odor, and  a sweetish  taste, and ia
obtained from oils and fits.   It mixes readily with water, alcohol, or oils,
dissolves many  gums and resinous substances, and is destroyed  by boiling. 
MATERIA  MEDICA.
655
 Glvcerin is stimulant, antiseptic, and demulcent.  It acts as an emollient
 and  soothing application, when used externally, absorbing  moisture from
 the air, and preventing the parts to which it is applied  from  becoming too
 dry • on which  account it has proved useful in a variety of skin diseases.
 It may be applied alone, in lotion, or added to  poultices.   It has also been
 used in cases of deafness, occasioned by a want of the waxy secretion of the
 ear or when this becomes hard; a piece of wool is  moistened with the
 Glycerin, and introduced into the ear.  It also enters  into many prepara
 tions for chapped hands, lips, &c, and excoriations of the skin  or  nipples.
 An ointment for this  purpose is made by melting together Spermaceti an
 ounce, White Wax two drachms, and Oil  of  Sweet Almonds  four fluid-
 ounces ; then place the mixture in a wedgewood mortar, add Glycerin two
 fluidounces, and rub the whole together  until  well mixed and  cold.   One
 ounce of Gum  Arabic, dissolved in two  fluidounces  of boiling water, to
 which two  fluidrachms of Glycerin are  subsequently added, forms a very
 adhesive paste for attaching labels  to glass, tin, and other smooth surfaces.

   GOLD.  One of the salts  of this metal used in medicine is  the Muriate
 or Chloride of Gold  and  Soda,  Sodii Auro-Terchloridum.  It is a bright
 yellow  salt, in  quadrangular, prismatic,  elongated  crystals^ permanent in
 the air, and soluble in water.  In large  doses, it  is a corrosive  poison ; in
 medicinal doses it is diuretic and alterative, and is used in syphilitic, scrof-
 ulous and  skin diseases, goitre, scirrhous tumors, ophthalmic affections,
 dropsy,  &e.   The dose is from one-twelfth of a grain to one-thirtieth, and
 may be  given dissolved in water, or made into  a  pill with Starch and Gum
 Arabic.   Externally, it may be applied to scrofulous and  syphilitic ulcers,
 in solution, or in ointment, in the proportion of seven or nine grains to the
 ounce of water or prepared lard.

   GOLDEN  SEAL.   Hydrastis Canadensis.   This is a well  known peren-
 nial plant, growing throughout  the United States,  more  especially in the
 West.   The rootstock is crooked, knotty, wrinkled,  one or two inches long,
 giving off a number of long,  yellow fibres ;  it is  of a  bright yellow color,
 has a faint narcotic odor when  dried, and an exceedingly bitter taste.  It
 is a powerful tonic, and exerts an especial influence upon mucous surfaces
 and tissues.   It has  proved  efficacious in dyspepsia, chronic affections of
 the mucous coat of the stomach, typhoid and intermittent fevers, torpor of
 the liver, and wherever tonics  are  indicated.  As a  local application, the
 decoction has been advantageous in some forms  of ophthalmic disease ;  and a
 decoction  of four parts of Golden Seal and  two of Geranium, has been
 efficacious in  gleet,  chronic gonorrhea, leucorrhea,  spermatorrhea, and
 inflammation  and ulceration of the internal coat of the bladder, being used
 in injection.   A decoction of Golden Seal and  Blue Cohosh, used as a wash
 or gargle, is useful in sore mouth and throat.  Dose of the  powdered root,
 from ten to thirty grains ; of the decoction,  one or two table-spoonfuls ;  of
 the tincture, one or two teaspoonfuls.
   Hydrastin is  the name given  to  the concentrated preparation  obtained
 from the root, by distilling off  the  alcohol from a saturated tincture, add-
 ing hot water  to the residuum, allowing it to stand for a  few days, pouring
 off the liquor, and then adding muriatic acid.   The mode of preparation
 is fully described in the author's American Eclectic Dispensatory.  Hydras-
 tin forms  in  yellow, translucent, delicate, acicular  crystals, neutral, and
insoluble in alcohol, ether, water, or oil of turpentine, though each of these
 fluids becomes colored yellow.  Acetic acid added to water, renders Hydras- 
656
AMERICAN FAMILY  PHYSICIAN.
tin more soluble in this fluid.   Hydrastin is a tonic, possessing, in an emi.
nent  degree,  the  virtues  of the root, for which, in most cases, it may be
substituted.   It is especially adapted as a tonic during convalescence from
exhausting  diseases, in  dyspepsia, chronic inflammation  of the stomach
jaundice, remittent and intermittent fevers, &c.   The dose is from three to
five grains, three or four times a day.

   GROUND  CENTAURY.   Polygala Nuttalli.  This is an annual plant
growing on Long Island, Martha's Vineyard, and  from  Rhode Island to
Louisiana.  The stem is eight or ten feet high ; leaves linear, acutish, and
scattered ;  flowers rose-purple ; seeds black.   The  plant sometimes grows
in bunches of fifteen or twenty stems from one root, and on the root will be
observed something resembling a nearly developed flower.  It grows in
very poor  soil, and  flowers in August.   This plant has the reputation of
being  almost infallible as a  remedy in fever and  ague.   Two  or  three
drachms of the plant made into a strong decoction, will  act as a cathartic,
It is an useful tonic and alterative, very efficacious in boils, some eruptions
of the skin, and especially in  erysipelas.  Two  drachms of the plant to a
pint of whiskey, and taken three times a day, in table-spoonful doses, will
be found very useful in these  diseases, proving actively diuretic.

   GROUND  IVY,   Nepeta  Glechoma.  This is a perennial herb, with a
creeping stem, common to the United States and  Europe, and known in
some places by the name of Gill-ovcr-the-ground.  The leaves are the parts
used;  they have  a  disagreeable odor,  and a rough,  bitterish, somewhat
aromatic taste.   They  are stimulant, tonic and pectoral, and have been
recommended in diseases of the lungs and kidneys, asthma, jaundice, &c.
An infusion is said to prevent and remove painter's colic, when used daily,
The fresh juice, snuffed up  the nose, is said  to  cure  the most inveterate
headache.  Dose of the leaves, in powder, from  thirty to  sixty grains; of
the infusion, one or two fluidounces.

   GUAIACUM.  Guaiacum Officinale.   This is a tree growing in the West
Indies, the wood and  resin of which are used in medicine.  The wood is
usually met with in  the form of shavings or chips,  being a mixture of yel-
low and greenish-brown pieces.  It has no odor, unless  rubbed, but a bit-
terish, acrid  taste, followed  by a pricking sensation in the  throat. The
resin is in lumps of  various sizes, brownish-red, with a greenish hue exter-
nally, and brownish yellow internally.  It  has a  faint odor, a sweetish-
bitter taste, succeeded  by heat and pungency, and is readily powdered. _ It
is soluble in alcohol.   Both the wood and resin are stimulant and alterative.
A warm decoction of the  wood acts as a diaphoretic, if the  body be kept
warm while using it; and as a diuretic, if kept cool.   These agents have
 been  used in  chronic rheumatism,  diseases of the skin, scrofula, and
venereal diseases.   The resin acts  as a  purgative in large doses.   In small
doses it has been found beneficial  in painful and suppressed menstruation,
acute dysentery, and as an antidote to the poisonous effects of the Poison
Oak.   If  sickness, loss  of  appetite,  or irregularity of the bowels occur
while taking  the preparations  of Guaiacum, their use must be discontinued.
The dose of a decoction of the root is from two to  four fluidounces, three
or four times a day; of the powdered resin, from five to twenty grains;  o
the tincture of  the  resin, from one to four teaspoonfuls.

   GUM ARABIC.   This is the concrete juice of  trees growing in Egypt, 
MATERIA  MEDICA.
657
 Arabia, and other tropical countries, as the Acacia Arabica, Acacia Vera, &c.
 The best Gum  Arabic is  of a pale  straw color, translucent,  inodorous,
 viscid and insipid, and readily soluble in water, dilute acids, and alkaline
 solutions.  It is nutritive and demulcent,  and is much used in irritations
 or inflammations  of mucous  surfaces, as,  hoarseness, cough, sore throat,
 gonorrhea, catarrh of the bladder, dysentery, diarrhea, strangury and tenes-
 mus.  As  a  medicine,  it may be  taken freely  in solution.  Where  it is
 necessary to pursue a soothing, non-stimulating, nutritious diet, a drachm of
 powdered Gum  Arabic may be dissolved in a pint of water, and rendered
 palatable  by  the  addition of a sufficient quantity of loaf sugar; of this
 table-spoonful may be  administered every hour or two.  In  the  typhoid
 stages of fevers, or wherever a gentle  stimulant is indicated,  about  two
 fluidrachms of a saturated solution of Camphor (in ether) may be mixed
 with the preceding mucilage.   Hemorrhages  from razor cuts, leech bites,
 small wounds, &c, may be checked by applying to them a powder composed
 of equal parts of finely powdered  Gum Arabic and Alum.
   The following preparation has been  found of much service in  very obsti-
 nate cough from  colds, laryngitis, &c:—Take  of Gum Arabic four ounces,
 good cider Vinegar one pint, apply heat and dissolve the gum, then add half
 a pint  of molasses, and gradually evaporate to one pint;  to  this add  four
 fluidounces of Tincture of Balsam Tolu, and two fluidounces of Laudanum.
 The dose is one  or two  teaspoonfuls. three  or four times a day, or whenever
 the cough is troublesome.
   Mucilage of Gum Arabic is made by dissolving four ounces  of powdered
 gum in  a pint of boiling water.  Externally, the mucilage has proved  ser-
 viceable in burns and scalds, repeating its application until a complete coat-
 ing is formed over the injured part.

   GUM HEMLOCK.   This  is the concrete juice of the Hemlock Spruce,
 Alies Canadensis,  a tree common  to  Canada,  and the  mountains of New
 England.   The gum,  also known  by the name of  Canada Pitch, is of a
 dark yellowish-brown color, easily powdered, -having  a faint odor  and  but
 little taste.  It dissolves in alcohol, and melts at a heat of 198° F.  Gum
 Hemlock is a mild rubefacient, and is used  for the same purposes  as Bur-
 gundy Pitch, which it resembles in  its  properties.  A tincture of the gum
 is  diuretic  and stimulant.  The Volatile Oil, or  Oil  of Hemlock, has been
 used in  form  of  liniment as an application to the throat in croup,  to parts
 affected  with rheumatic pains, and in other affections requiring a local stim-
 ulant.   The Essence  of Hemlock, in doses of five or ten  drops in water,
 repeated every ten or twenty minutes, has proved efficacious in irritation of
 the stomach,  in  checking vomiting of cholera-morbus, &c.   A  strong de-
 coction of the bark of the tree, has been found useful in leucorrhea, prolap-
 sus of the womb, diarrhea, &c; and as a local application in gangrene.

  H.FMASTASIS.  This is a term applied to  the retention of venous blood
in  the extremities by ligature.   A handkerchief or any suitable cord is  to
be tied  around the upper part of  the  arms, and the thighs, and  then, by
■neans of a piece of wood, the ligature is to be  turned or twisted sufficiently
■i-ht, to  check the circulation of the venous blood, but not the arterial, which
i.  t when checked  will cease to give pulsations  in the limbs thus ligatured.
 In a short time the arms and legs will be much distended, and an  amount
<■!'  blood removed from  the trunk and retained in  the limbs, which the most
;vm lie practitioner  would not dare to remove by the lancet.  If the subject
:'.;.[.t, promptly loosen  or remove the ligatures; if  he be plethoric  and of
      42 
658                  AMERICAN FAMILY PHYSICIAN.
firm, vigorous constitution, he must be  reduced by cathartics, diuretics, and
sudorifics, and, at the time of the operation, be under the influence of gentle
nauseants.  Ilsemastasis has been found very useful  in bleedings from the
womb, lungs, stomach, &c,  congestions, puerperal convulsions, inflamma-
tions of the brain, lungs, bowels, and in cases where it is deemed advisable
to lessen the amount of blood in the head and trunk, without debilitating or
injuring the system by its entire removal.

   HAIR-CAP  MOSS.   Polytrichum  Juniperum.   This is an evergreen
plant found  on  poor, sandy soils, in the Northern States; it is of a darker
green color than the generality of mosses.   A strong infusion  of this plant
is a powerful diuretic; two fluidounces  taken every half-hour, has removed
from dropsical patients, from twenty to forty pounds of water in the space
of twenty-four  hours.   It possesses but little  smell or  taste, and never
causes any nausea or disagreeable sensation  in the  stomach.   It  is very
useful in fevers, inflammations, dropsies, gravel, and all urinary obstructions.

   HARDLEAF  GOLDENROD.  Solidago Rigida.  This is a perennial
plant growing throughout  the United  States, and common  in the western
prairies.  It is the styptic plant of old Dr. Bone of New Jersey, who is said
to have  suppressed hemorrhages from  large bloodvessels, by  applying the
powdered leaves locally.  The leaves and blossoms are the parts used; water
or alcohol extracts their properties.   They are tonic, astringent, and  styptic,
and are beneficial in all  external hemorrhages, as  bleeding  from the nose,
lungs, stomach, bowels, &c;  they may  be  used both externally and inter-
nally in powder or infusion.   In the form of poultice, they  may be  applied
to old ulcers.  The oil is diuretic.  The European Goldenrod, Solidago Fir-
gaurea is said to possess similar properties.

   HELONIAS.   Helonias Dioica.   This is a perennial  herb common to
the United States, and known also by the name of  False Unicom root.  The
root is the part used; it is tapering, fibrous, about  an inch and a quarter in
length, and from two to six-eighths of an inch in diameter, very hard, trans-
versely wrinkled,  the end appearing as  though it had  been cut or bitten off;
it has a feeble, peculiar odor, and a bitter taste.  Helonias  is tonic, diuretic,
and vermifuge;  in large doses, emetic; and when fresh, sialagogue.  In
doses of five or ten grains of the powdered root, repeated three times a day,
it has proved efficacious in  dyspepsia, loss of appetite, worms, colic, atony of
the organs of reproduction, &c.  It is an excellent uterine tonic, gradually
removing  debility of the womb, and imparting  strength  and  energy to it.
Leucorrhea, and painful or suppressed  menstruation have been cured by its
use, and  the disposition to habitual abortion, when due to want of  tone in
the' generative  organs, has been wholly overcome.   Dose  of  the powder,
from ten to forty grains; of  the decoction, from two to four fluidounces; oi
the  hydro-alcoholic extract,  from two  to five  grains.  The  plant is said to
 kill cattle feeding on it;  and  its decoction to kill  insects, bugs, and lice.
 The Helonias Bullata possesses similar  properties.

   HEMP.   Cannabis Sativa.   This is  a well-known annual plant common
 te this  country,  but a native of Persia, and the Northern  parts oi iw»»j
 The concrete resinous exudation from  the Asiatic plant is called c™rm>
 is narcotic, and may be used in the  place of Opium, in all casesjbere^
 drug disagrees  with  the patient.  It alleviates pain, exhilarates the: sp>   <
 promotes the appetite, and is said to augment  the  sexual passion.  «  b 
MATERIA  MEDICA.
659
j    •♦ ,.„«. delirium and a peculiar kind of intoxication.   The dose of a
doses >t c^es d 1^« ana a pec              churrug Qf ^       .g fre

^^nt^o weak as Srcqule' fr^n to thirty grains to affect the system.
?Hnsyb en  £entlj used in cholera, neuralgia, rheumatism, tetanus and
fns  ntv   A tincture  of the  resinous  extract  made  by  dissolving three
™ins in a fluidrachm of proof spirit has also been advantageously used in
a dose to correspond with that of the resin.

  HIGH CRANBERRY.  Viburnum Opulus.   This is a shrub growing in
rich soi   in Canada, and the northern parts of the United States flowering
 nJune   The bark also known as Cramp-bark is.the  part used.  It is a
powerful antispasmodic, and has been found very efficacious in cramps, and
Lsms of  all kinds, asthma, hysterics, cramps during pregnancy and is said
to be highly beneficial to those who are subject to convulsions during preg-
nancy or at the time of parturition, preventing the attacks entirely^ if  used
daily for the last two or three months of gestation   A decoction or infusion
of the bark in wine may be used in doses of a table-spoonful, two or  three
times a day.   A mixture of High Cranberry bark two  ounces, Scullcap,
Skunk cabbage,  each one ounce, Cloves  half an ounce  <Capsicum two
drachms, added to two quarts of Sherry wine, and  allowed  to macerate for
ten or twelve days, forms an excellent preparation for the relief of spasmodic
ottacks;  the dose is one or two  fluidounces, three times a day.   Ihe hydro-
alcoholic extract will  be found  very valuable in all cases where  the bark is
indicated.  In difficulties of the  womb, it may be beneficially added  to
Caulophyllin,  Cimicifugin, Aletridin, Senecin, Asclepidin, &c.   In  bilious
 and flatulent colic, spasmodic pains of the stomach and bowels, the addition
 of  Dioscorein  to it, will be found advantageous. Dose of the extract, from
 one to five grains three times a day.

  HO \RIIOUND.  Marrubium Vulgare.  Tbis is a well-known perennial
 herb, a  native of Europe, but  naturalized  in  some parts of this  country,
 which has a peculiar, rather agreeable odor,  and  an aromatic, bitter taste.
 It k a stimulant tonic, expectorant, and diuretic, and is much employed in
 coindis, colds, catarrhs, and other diseases of the air-passages.  The infusion,
 taken warm will cause perspiration, or, if the  body be kept cool, will  in-
 crease the urinary discharge,  and has been  successfully used  in  asthma,
 jaundice, and suppressed menstruation.   The cold  infusion will  remove
 worms, cure  mercurial salivation,  and is of efficacy as a tonic  in dyspepsia.
 Dose of  the  powdered herb, one drachm;  of the infusion, or syrup, from
 two to four fluidounces.

   HOPS. Humulus Lupulus.   This is a well-known plant, the  strobiles or
 cones of which are tonic, hypnotic, antilithic, and  anthelmintic.  They are
 principally used as a sedative,  or  hypnotic—promoting sleep, and relieving
 pain and irritability of the nervous system.   A pillow stuffed with Hops
 in  hot water, has long been a popular remedy for procuring sleep.   In the
 form of  fomentation, either alone, or combined with Lobelia,_ Boneset, or
 other bitter herbs, Hops have  proved beneficial in pleurisy, inflammation
 of the lungs, stomach, or bowels, and  in painful swellings,  or tumors.  An
 ointment of  Hops and  Stramonium   leaves   has  cured  salt-rheum,  and
 also  proved useful in ulcers  and painful tumors.  Lupulin is the yellow
 powder  procured by threshing the Hops, and  is always preferable to  the
 Hop, for internal use.   It is very useful in delirium tremens, wakefulness
 in  connection  with  nervous  irritation,  anxiety, or exhaustion, in  after-
 pains, to prevent chordee, suppress venereal desires, and allay the pain at- 
660
AMERICAN  FAMILY PHYSICIAN.
tendant on  gonorrhea.  Its use does not disorder the stomach, nor cause
constipation.   The dose of  Lupulin, is from six  to  ten grains in powder
or pill;  of the Tincture, from a  teaspoonful to  a  table-spoonful.  The
Ethereal Oil of Lupulin, is  made by allowing the Tincture, prepared with
Ether, to evaporate spontaneously.   It is very useful in allaying pain and
calming  the nervous system, in doses of from ten to thirty drops.

  HORSEMINT.  Monarda Punctata.  This is  a well-known plant, com-
mon to the  United States, which possesses carminative, stimulant, sudorific
diuretic, and anti-emetic properties.   The warm Infusion, or Essence  is
used in flatulence, nausea, vomiting, suppressed  menstruation, and to pro-
duce perspiration.   If the body be kept cool,  it acts as a diuretic, and is
useful in suppression of the urine, and other urinary disorders.   It may
be drank freely.   The Volatile Oil is much used to allay nausea and vom-
iting, and as an  antispasmodic.  Its dose is from two to six drops, on su-
gar; of the Essence, from ten to forty drops in  sweetened water.  Exter-
nally, the Oil is rubefacient, and has been used in low forms of fever, chol-
era infantum, paralysis, rheumatic  and neuralgic pains, &c.

  HORSERADISH.   Cochlearia Amoracia.  This is a well-known peren-
nial, succulent plant, the fresh root of which is stimulant, diuretic, anti-
scorbutic and rubefacient.  The infusion is emetic.  Horseradish has proved
serviceable in rheumatic, paralytic, scorbutic, and dropsical affections, weak-
ness of the digestive apparatus, &c.   A warm infusion of the  fresh root in
cider, drank in sufficient quantity to cause  perspiration, and repeated every
night,  has -cured dropsy in two or three weeks, producing a more or less co-
pious flow  of urine.  Hoarseness  is frequently  removed by occasionally
using a teaspoonful or two of a Syrup, made by  grating the root in a mix-
ture of sugar and water.   Grated in vinegar, it  promotes digestion, when
used in moderate quantities during a meal, strengthening the stomach when
enfeebled, and forms  a useful spring medicine.

  HOUND'S TONGUE.   Cynoglossum Officinale.  This is a biennial plant,
common  to Europe and this country.   It has an unpleasant odor, and a bit-
terish, viscid taste.   The fresh leaves and root are anodyne, demulcent, and
astringent, and have  been used in coughs, catarrh, diarrhea, dysentery, and
spitting of blood.  A poultice of the leaves has  been found valuable in
scrofulous tumors, goitre, recent bruises, inflammations, and  also to remove
the pain and soreness  attending irritated, bruised, or chafed parts, giving
complete relief, especially in excoriation of the  feet from  much traveling.
The fresh leaves bruised, or a Tincture of them, is a good application to re-
move the swelling and  discoloration of parts, caused by blows or bruises.

   HOUSELEEK.   Sempervivum  Tcctorum.   This is a well-known peren-
nial plant, the recent leaves of which, when bruised, form a cooling applica-
tion to burns, stings of insects, ulcers, erysipelas, and other external in-
flammations.  They are said to  remove warts, when applied twice a day.
The bruised leaves,  or their juice, applied locally,  have cured ringworm,
shingles, and other diseases of the skin.

   HYDRANGEA.  Hydrangea Arborescens.   This shrub is common to the
Southern, Middle, and  Western States, and is sometimes called Seven Barb,
or Nine  Barks.  The root is the part used.   It is formed of numerous ratt-
icles, of  more or less considerable length, and from two or three lines to nv 
MATERIA   MEDICA.
661
lines iu diameter.  A strong decoction or syrup of the root, has been found
very valuable in  gravelly complaints, causing the bladder  to  throw off all
such gravelly formations  as  are  not too large to pass through the urinary
canal.   It also affords great  relief in  the  excruciating pain accompanying
the passage of  gravel through the ureters, from the kidneys to the bladder.
The Concentrated Decoction or  Syrup may be taken  in teaspoonful doses,
several times a day,  not to cause  dizziness, oppression  of the chest, or other
unpleasant symptoms.

  IIYDRIODIC  ETHER.   jEther  Hydriodicus.  This  preparation  also
called Iodide of Ethyl; is a powerful anaesthetic, when inhaled, but it must
be entirely free from Phosphorus.   It  is a  most valuable  remedial^ agent,
patients being able  to bear  a much larger quantity of  Iodine in this form,
than they possibly could  bear in any  other  manner.   It has been used in-
ternally with  success in scrofulous diseases, by inhalation in diseases  of
the lungs and heart, and as a local  application  to  painful and irritable
ulcers, and scrofulous ulcers.  From  fifteen to thirty grains of the Ether,
poured in a vial containing a fluidrachm or two of  water, maybe inhaled for
about  ten minutes  at a time, repeating the  inhalation four  or  five times
a day.

  HYDROCHLORIC ACID.  Acidum Hydrochloricum. This is also known
by the name of Muriatic Acid.   When diluted with water, this acid is tonic,
refrigerant, and antiseptic.   It has been used with advantage in some forms
of syphilis, fevers, and to counteract phosphatic deposits in urine.   Given in
a strong infusion of Quassia, it  has proved  beneficial in malignant cases of
typhus and scarlet fevers.  As a  local  application, it  may be used when di-
luted, as a gargle in various ulcers of the mouth and throat, and elongated
palate.  The concentrated acid has also been  used externally, in some  ob-
stinate ulcerations and  diseases  of the skin.  The dose of diluted Hydro-
chloric Acid  is from  five to  twenty drops  in  a  wineglassful  of water.   It
should be sucked through a quill  or  tube, to  prevent its injuring the teeth.
One ounce of acid to three ounces of water forms  the diluted  acid.  When
the pure acid, is accidentally swallowed, its  best antidotes are chalk, magne-
sia, or soap dissolved in water, and taken freely,  together with  the free  use
of mucilaginous fluids.

  HYOSCYAMUS.  Hyoscyamus Niger.  This is a biennial plant, growing
in Europe and the northern parts of this country,  and is known more com-
monly by the name  of Henbane.   The leaves of the plant in its second year,
are the parts used.   They have a strong, unpleasant odor, and a  disagree-
able, rather acrid taste, which is  very much lost by drying.  In large doses,
Hyoscyamus is a narcotic poison.  In medicinal doses, it is anodyne, hypnotic,
sedative, and antispasmodic, and  does not cause constipation like Opium, for
which drug it is frequently substituted. It is  used to calm nervous excita-
bility, diminish pain, promote sleep, and remove  spasmodic action, and may
be  administered  in neuralgic, gouty,  rheumatic, and spasmodic  affections,
asthma, chronic cough, irritations of the urinary organs,  and   all irregular
nervous actions.   When added to cathartics, it prevents their griping, with-
out lessening their energy.  Dose of the powdered leaves, from five to ten grains;
of *hc  Tincture,  from half a fluidrachm to  two  fluidrachms;  of the Alco-
holic Extract,  from  one-fourth of a grain to two  grains, which  may be grad-
ually  increased,  if  necessary, to ten grains.   Hyoscyamia  is  its active al-
kaline principle.   It is in colorless, satiny, inodorous,  needle-like crystals, 
662
AMERICAN FAMILY  PHYSICIAN.
having a disagreeable, acrid taste, and soluble in Alcohol or Ether.   R ls a
very active poison, and is principally used to dilate the pupil of the eye pre-
paratory to an operation for cataract.  One drop  to  twenty-four of water
makes a solution, a drop of which on the eye, will dilate the pupil in a few
hours.

  HYSSOP.  Hyssopus Officinalis.   This is a well-known  perennial plant
common to Europe and this country.  The  tops  and leaves are  the parts
used.  They have a pleasant odor, and a warm, slightly bitter taste.  Hys-
sop is stimulant, aromatic, carminative, and tonic.  It is principally used in
warm infusion as a gargle  in quinsy and other sore throats.  It may be used
alone,  or combined with Sage and Alum in infusion, sweetened with honey.
Internally, it has been recommended as an expectorant in dry asthma, cou<di
and other affections of the chest.   The  fresh leaves, bruised and applied'to
the contusions speedily relieve the pain, and  disperse every spot or mark
from the part affected.

  ICE PLANT.  Monotropa Unifiora.   This is a perennial plant, found in
various parts of the  Union.  The  whole, plant  is snow-white, resemblin"
frozen jelly, and is very juicy  and tender, dissolving and melting away in
the hands like ice.  The flowers appear between June and September, and
have some resemblance to a pipe—hence the plant has been called Indian
Pipe, or Pipe Plant.   The root  is the part used.  It should be collected in
autumn, carefully dried and kept in well-stopped  bottles.   It  is tonic, ner-
vine, and  antispasmodic.   The powder has been used as a sedative and dia-
phoretic in fevers, and in all cases where Opium is indicated but cannot, be
used on account of idiosyncrasy, &c.  Diseases of a periodical character are
said to be cured by it.  In convulsions of children, epilepsy, chorea, and
other spasmodic affections, its use has been followed with prompt success.
It may be used in the place of Opium, wdthout any of the objectionable influ-
ences of this drug.   Dose of the  powdered root, from half a drachm to a
drachm, two or three times a day.  The  juice of the plant, alone or combined
with Rose Water,  has been found an excellent local  application to chronic
inflammations of the  eye, to ulcers,  and as an injection in gonorrhea, and
inflammation and ulceration of the bladder.

  INDIAN HEMP.   Apocynum  Cannabinum.- This is a perennial plant,
closely resembling the Bitterroot, and growing in the same  situations.  The
root is the part used;  when dried,  it is of an unpleasant odor, a bitterish
taste, and is very easily powdered.  It is emeto-cathartic, diuretic, and dia-
phoretic.  As a diuretic or hydragogue, it has been used in dropsy, in the
form of decoction, from two to four  fluidounces, three or more times a day.
Smaller quantities of the decoction, warm, will cause diaphoresis, and have
proved beneficial in periodic fevers,  and affections of  the lungs. _ From fif-
teen to thirty grains  of the powdered  root  will act as an emetic. _ A full
dose of the root lessens the pulse, causes nausea,  drowsiness, vomiting, and
copious watery stools, with  more  or less perspiration.   Used as a snuff it
causes sneezing.   The aqueous extract will purge iu doses  of from three to
gix grains.

  INDIAN TURNIP.  Arum  Triphyllum.   This is a perennial plant com-
mon to damp places in North and South America, and  known also by the
names of Dragon root, Wake Robin, &c.  The root or  cormus is the pari
used;  it is  turnip-shaped, with a  dark external coat, a white potato-u" 
MATERIA  MEDIC A.
663
  substance internally, and  causes when chewed an  acrid, biting  sensation
  which continues for some time, and which may be  modified or relieved by
  the use of milk.   The fresh root is acrid, expectorant, and diaphoretic, and
  has been used in flatulence, asthma, hooping-cough, chronic catarrh, chronic
  rheumatism, bronchitis, aphthous sore mouth, colic, low stage of typhus, and
  various  affections connected  with constitutional  debility.  Externally,  it
  has been used in scrofulous  tumors, scald-head, and other diseases of the
  skin.  Dose of the grated root, in  syrup or mucilage, ten grains, three or
  four times a day.  When dried the root becomes inert, and a white, starchy
  substance can be obtained from it, having the appearance of fine arrow
  root.

   IODINE.  Indinium.   Iodine is a non-metallic body, prepared from the
  ashes  of sea-weed; it is usually in small, grayish-black or bluish-black, shin-
  ing scales, having a peculiar, irritating odor, and an acrid taste.  Sometimes
  it is in solid masses.  It is easily powdered, and is soluble in  alcohol, ether,
  the volatile oils, and in solutions of chloride of sodium, nitrate of ammonia,
  or iodide of potassium.   In  large doses, Iodine is a corrosive poison, caus-
  ing many unpleasant and alarming symptoms, as muscular weakness, fever,
  great  thirst, restlessness, rapid emaciation, cramps,  small  and  frequent
  pulse, &c.   In  medicinal doses it is  a  diuretic  and alterative,  and  has
 proved astonishingly beneficial in  many diseases,  as bronchocele, scrofula,
 syphilis, glandular obstructions, ulcers, rheumatism, derangements of the
 female reproductive  organs, and chronic diseases  generally.   It appears to
 be most  efficacious  in kypertrophical, strumous, or cachectic conditions.
 Among  females,  the  internal  use of  Iodine frequently augments  the
 monthly flow, or  causes it to  appear much oftener  than ordinarily—these
 effects, whenever they become troublesome, not passing off in a short time,
 may be checked  by  a suspension of the  use of the medicine.  A patient
 under  the^ beneficial  influence of Iodine will find an  increase of urine, this
 fluid holding Iodine in solution, his appetite will improve,  and his strength
 be gradually restored.   Dose of Iodine in substance,  half a grain, two°or
 three times a day, in pill form; of  the tincture, from five to ten drops, two
 or three  times a day.  Its best form of administration is the Compound
 Solution  of Iodine.   It  is combined with many other  valuable agents,
 thereby rendering them more beneficial.

  ^ IPECACUANHA.   Cephaelis Ipecacuanha.   This is a  small perennial
 Hirubby  plant  found  in  the  moist woods  of  several countries in South
 America.   The root is seldom seen in this country, except  when powdered,
 when it is of a greyish-yellow color, with a faint, peculiar odor, and a  bit-
 terish,  slightly acrid taste.  In doses of twenty or  thirty grains, it forms a
 very valuable emetic, for which  it is frequently administered;  in  doses of
 live  or ten grains it  acts as  a nauseant, and  has  proved serviceable in
 asthma, catarrh, cough, sore throat, &c.   In doses of from half a grain to two
 or three grains, it produces perspiration with diminution of arterial action
 and  is useful un  febrile  and  inflammatory diseases,  diarrhea, dysenterY
 hemorrhages, Ac.   From one-quarter of a grain to  a  grain of the powder
 acts  as a tonic, improving digestion, increasing the appetite, and curing
 some forms  ot dyspepsia.   Combined with Opium,  its diaphoretic influence
 is greatly augmented.  With Podophyllin, it increases the activity of  that
resiucud,  and induces perspiration.  It is  frequently combined with Lobe-
lia, B oodroot, Ac, to hasten  vomiting and render it more effective   Ex-
ternally, Ipecacuanha rubbed  with  Olive Oil and  applied  to the skin with 
664
AMERICAN EAMILY PHYSICIAN.
friction for ten or twenty minutes at a time, will cause a pustular eruption ■
it has thus  been^ found a useful counter-irritant in rheumatic affections'
infantile convulsions, and chronic inflammation of the synovial membrane
of the knee; it should be applied  three  or four times a day, covering the
part with flannel after each application.   Two drachms, each, of Ipecacu-
anha and Olive Oil, with half an ounce of lard, form an excellent liniment
for this purpose.

  IRON.   Ferrum.   The various  preparations of Iron are tonic, and are
useful in  diseases of debility, as chlorosis, scrofula, rickets, chorea, passive
bleedings, epilepsy, neuralgia, &c.   They should not be used  in febrile or
inflammatory diseases, nor in persons subject to determinations of blood to
the head, or affected with habitual constipation.  The Salts of the Protox-
ide of Iron  are commonly more active than those of the Sesquioxide.  The
Salts of Iron, generally render the stools more or less black.   The dose of
clean Iron filings is two or three grains daily, as  a tonic.   The following
are among the several medicinal preparations of this metal:—
  1. Acetate of Iron.  Ferri Acetas.   This is generally used  in  the form
of solution or tincture, each  of which has a deep red  color,  and a stron"
chalybeate taste.   They are tonic and astringent, and are useful in all cases
where Iron is indicated, in doses of from  five to thirty drops, in a  sufficient
quantity of water.   A few drops  of Creosote added  to a  diluted solution,
will be found a valuable injection in leucorrhea.
  2. Ammonio-tartrate of Iron.    Ferri  Ammonio-tartras.    This double
Salt of Iron is in dark-brown, brilliant scales, or  in  grains somewhat like
Kino, which have  a pleasant taste, and  are  readily soluble  in water.  It
possesses  the tonic properties  of Iron  preparations, and may be  given in
pill or solution, in doses of from  four to six grains, three times a day.
  3. Black Oxide  of Iron.  Ferri Oxidum Nigrum.  This  is of a  dark
color, and does not become changed by exposure  to  the air and moisture.
It is a valuable chalybeate in doses of from five to ten  grains, two or  three
times a day.
  4. Citrate of Iron.  Ferri Citras.  This  is of a  beautiful garnet red
color, in thin scales, which  are  soluble  in water.  It is a pleasant chaly-
beate tonic, and may be given in  pill or solution, in the dose of four to ten
grains, two  or three times a day.
  5. Citrate of Iron  and Quinia.   Ferri  et Quiniae Citras.  This is in the
form of garnet-colored shining  scales,  which are  readily soluble in water,
It is a valuable tonic and antiperiodic in  doses of five or ten grains, two or
three times a day.
   6. Ferrocyanuret of Iron.  Ferri Ferrocyanuretum.   This Salt of Iron is
also known by the names of Prussiate of Iron, and Prussian Blue.   It is of
a beautiful  dark blue  color, inodorous, without taste, and not soluble in
alcohol or  water.  It possesses  tonic, sedative, and febrifuge virtues, and
is much used in conjunction with Sulphate  of Quinia  in intermittent, con-
gestive, bilious and typhoid fevers,  also in typhoid pneumonia; the dose is
from two to four grains of each, repeated every three, four, or five hours
Prussiate of Iron has likewise been used  in diarrhea, summer-complaint of
children, hooping-cough, dyspepsia, epilepsy, chorea, and  neuralgia of the
face ; its  dose is  from one to five grains, three times a day.          _ ,
  7. Hydratcd Sesquioxide of  Iron.  Ferri Oxidum Hydratum.  This is a
reddish-brown,  moist mass, which is used as an  antidote to poisoning  by
arsenic ; it  should always be freshly made, and taken in table-spoonful doses
every five or ten minutes, until twelve times the amount of arsenic  swat- 
\ 
 
Comfrey   (Symphytum Officinale.)
Spikenard.   (Aralia  Iiucenios-a.)
Elecampane.  (Inula  Ifelenium.") 
 
MATERIA  MEDICA.
665
 lowed, or even more, of this  preparation  has been given.  The effects of
 this antidote are more marked and certain when administered shortly after
 the poison has been swallowed.
   8.  iodide of Iron.  Ferri Iodidum.  This salt is of a grayish black color,
 with an  astringent, chalybeate taste, and  rapidly decomposes on exposure
 to  the air.  It is commonly employed in the form of solution, which is of
 a palo-green color.  It is tonic,  alterative,  diuretic, and emmenagogue ;
 improving the appetite and the digestive powers, and has been efficaciously
 used in scrofula, chlorosis, secondary syphilis, amenorrhea, chronic diseases
 of  the skin, leucorrhea, chronic  rheumatism, and in all  cases where there
 is a strumous  condition of the system in connection with a poverty of the
 red globules of the blood, (anemia).  The  dose is  from twenty to forty
 drops, three times a day ;  it should be well diluted with water, and to pre-
 serve the teeth from injury, the  mouth  should  be well rinsed immediately
 after each time of taking  it.
   9.  Iron by Hydrogen.   Ferri Pulvis.   This is a fine powder of iron ob-
 tained by means of hydrogen acting on  the sesquioxide, at a  dull red heat.
 It  is of  a grayish-iron color, and without taste;  when black it  is useless.
 It is  the best form of metallic iron for  internal use, and  may be given in
 liusrs of from three to six grains, in pill  form, three or four times a day.
   10.  Lactate of Iron.   Ferri Lactas.   This is in white plates or powder,
 having a feeble chalybeate taste.   It is very  useful in anemic and chlorotic
 conditions,  commencing  with doses of  one  or  two  grains, three or  four
 times a day, and gradually increasing them  to  three  or  four.  It may be
 used in pill or solution.
  11.  Phosphate of Iron.   Ferri Phosphas.  This is generally in the form
 of a bluish-white, or bright slate colored powder, insoluble in water.   It is
 an  efficient  chalybeate, and has been used internally in  cancer, periodical
 diseases, and to invigorate the virile powers, in doses of from one to ten
 grains, three times a day.   A so-called Metabasic Phosphate of Iron, (mono-
 basic,) has been made, by adding  to monobasic phosporic acid in a boiling
 state as much phosphate of iron  as it would take up, and then allowing  it
 to cool.   It forms  a semitransparent, slaty  or greenish-colored solution
 which  hardens on exposure to the air for a day;  but it may be made into
 pills with liquorice or flour.  It  does  not  gripe or  constipate, and  has
 proved useful in cases of nervous  debility, virile weakness from onanism,
 anemia brought  on by any kind of excesses, and  in phosphatic  deposits.
 The dose is one or two grains, three times a day,—in some instances com-
 bined with an equal proportion of Phosphate  of  Quinia.
  \'2. Precipitated Cn-luuatc of Iron.   Ferri Subcarbonas.  This prepara-
 tion forms a reddish powder,_ of a styptic, unpleasant  taste, and insoluble
 iu water.   It  is tonic, alterative  and emmenagogue, and  has  been used in
 neuralgia, chorea, chlorosis, anemia, epilepsy, dropsy, scrofula, diseases of
 the liver, spleen, and urinary organs, &c, in the dose of from five to thirty
 grains, three times a day, in some water, wine, syrup, or other fluid.
  lo. Protoxide of Iron.   Ferri Protoxidum.   This oxide is of a dark blue
 color, and has a tendency to absorb oxygen from  the air, and become con-
 verted  into a sesquioxide.  It possesses the tonic properties of iron, in
 doses of from two lo six grains, three times a clay.
  11.^ Ssquiuxideaf Iron.  Ferri Sesquioxidum."  This  oxide is also called
 the  AW oxide of Iron; it  is a reddish-brown, tasteless,  insoluble powder,
 so me times known as crocus martis, and  eoleothar.   It  possesses  tonic and
 shjitiy styptic properties, and is used  principally in strumous and neural-
gic  ailections, in pill form with Inspi.^ated  Juice of Conium Maculatum.
 Its dose is from two to ten grains, three or four  times a dav. 
€66
AMERICAN FAMILY PHYSICIAN.
   15.  Sulphate of Iron.  Ferri  Sulphas.   This  is in the  form of pale
bluish-green crystals,  or powder,  soluble  in water; it  is  known  by the
names of copperas and green vitriol.  It absorbs oxygen  from the air and
becomes  somewhat changed.  It  is irritant, tonic,  and astringent.  In
large doses it causes nausea, vomiting, and griping; and its long-continued
use injures the stomach.   It  has  been used in scrofula, dyspepsia, chlorosis
suppressed  menstruation, and  in debility following protracted diseases as
a tonic, in doses of from one to five grains, in pill.  It is also employed' as
an astringent in  diseases with immoderate  discharges, as  passive hemor
rhages, night-sweats,  diabetes, chronic mucous catarrh,  leucorrhea, gleet
&c.   In an overdose  it acts  as a poison.   Externally, a solution of  one or
two, to ten grains of the iron salt to a fluidounce  of water, has been  found
useful in eruptions on the face, chronic ophthalmia, and as an injection in
gleet.   The Dried Sulphate of Iron, Ferri Sulphas Exsiccatum, is made by
exposing any quantity of Sulphate of Iron  to a moderate heat, in a  porce-
lain or earthen-ware vessel, not  glazed with  lead, till it is  converted into
a dry, grayish-white  mass, which must be reduced to  powder.  It has the
same properties as the Sulphate of Iron, three grains of the dried or  anhy-
drous  salt being equivalent to five of the crystallized sulphate.  A solution
of it may be used externally as an astringent for indolent ulcers, and as an
injection in leucorrhea, and gonorrhea of females.
   The Styptic  or Red Powder is  made, by exposing Sulphate of  Iron to a
red  heat, and  continuing it  until  the mass  assumes  a reddish color; it is
powerfully styptic, and is used internally, and in the form of ointment as
an application  to bleeding piles, and external hemorrhages.
   16.  Tartrate of Iron and Quinia.  Ferri et Quinise Tartras.   This is in the
form of  beautiful  crimson-colored  scales, very soluble in water. It is a
valuable  tonic and antiperiodic, and  may be used in febrile diseases, in
cases of debility, and  in scrofulous and anemic affections, likewise, in sup-
pressed menstruation.   The  dose is from three to five grains, three times
a day, in solution or  pill form.   (See Solution of  Iodide of Iron, Tincture
of Acetate of Iron, and Tincture of Chloride  of Iron, in Pharmacy.)

   IRON WEED.  Vernonia Fasciculata.   This is a perennial plant, very
common in the Western States,  wdth heads of dark-purple  flowers from
July to September.  The root is  a bitter tonic, deobstruent,  and  alterative,
and in the form of powder or decoction is beneficial in suppression of the
menses,  painful  menstruation,  leucorrhea,  and  excessive  menstruation.
The decoction  or a saturated tincture has  been recommended in intermit-
tent, remittent, and bilious fevers.  It is also reputed  efficacious  in scrofu-
la and  some diseases of the skin.   Dose of  the powder, from ten to thirty
grains; of the decoction, one or two fluidounces; of  the tincture, one or
two' fluidrachms.   The  leaves  or powdered  root in  the form of poultice
make  an excellent discutient application  to tumors; and a decoction of
the leaves forms a good gargle for sore throat.

   IRON WOOD.   Ostrya Virginica.   This  is a small tree growing in va-
rious  parts of  the country, the bark  and inner wood of which are bitter;
there  is another tree called  Iron wood, the  Carpinus  Americana, which is
not bitter, and  must not be mistaken for the Ostrya.   Iron wood is anti-
periodic, tonic, and alterative.  It has been beneficially employed in inter-
mittent  fevers,  neuralgic  affections,  dyspepsia, scrofula, and all diseases
where an  antiperiodic tonic  is indicated.   Dose of the decoction, one or
two fluidounces, three or four times a day. 
MATERIA  MEDICA.
667
    ISINGLASS.  Ichthyocolla.   This is a gelatinous substance  prepared
  from the swimming bladder of various fishes.  There are  several kinds in
  commerce, known as  staple isinglass, short staple,  long staple, leaf isinglass,
  Cuopi rs gelatin, &c.   It is soluble in alkaline solutions, dilute acids, insolu-
  ble in alcohol, and  is dissolved when boiled in water, forming a  jelly on
  cooling.  It is generally  used  as a nutritive diet, in the form of jelly, and
  exerts a soothing influence upon irritated mucous surfaces, for which pur-
  pose it is sometimes used in some urinary difficulties.

    JALAP.   Ipomosa Jalapa.   This is a Mexican plant, the root of which
  is much used in medicine  as a cathartic.   It generally operates actively, pro-
  ducing several liquid stools with  more  or less griping, and occasionally
  nausea and vomiting.  When Cream of Tartar is added to it, its hydragogue
  powers are augmented, which renders it useful in dropsies.   It is a safe and
  certain purgative, and may be given in all case3 where copious  evacuations
  are desired, except in inflammatory conditions  of  the stomach and  bowels.
  The dose of the powdered root is from fifteen to thirty grains; of the tincture,
  from one to four fluidrachms; of the resin, from four to eight grains in syrup
  or mucilage.

    JUNIPER.   Junipcrus Communis.  This is an evergreen shrub, native of
  Europe,  and naturalized in some parts of this country.   The fruit or berries
  arc the parts used; they are about the size of a pea, globular, wrinkled, of a
  dark purple color, and contain, each, three seeds; their odor is rather pleas-
  ant, and  their taste sweetish, and like Turpentine.   They are gently stimu-
  lant and  diuretic, and have been used in scurvy,  diseases of the skin, catarrh
  of the bladder, and atonic conditions of  the uterus  and alimentary canal.
  They are principally used as an  addition  to more  powerful  diuretics.  The
  Oil of Juniper, obtained from the berries, is frequently  employed to arrest
 chronic mucous discharges from the urethra.   It has also been used in dropsv;
 live minims of the Oil, with one fluidrachm of  Sweet  Spirits of Nitre, given
 three times a day in any common vehicle, produces  a large discharge of urine
 in  dropsy when other means fail.  The flavor of Holland Gin is owing to the
 presence  of this Oil.  Dose of the berries, from one to two drachms;' of the
 Oil, from five to fifteen drops.

   KINO.  This is the inspissated juice of  an East Indian  tree,  the Ptero-
 carpus Mtrsupium.   It is  generally  met with in small blackish, or dark-
 reddish, shining angular grains, of various sizes, easily powdered,  inodorous,
 and of a very astringent taste.  It is likewise obtained from trees  growing in
 Botany Ray, Africa, South America,  &c.   Kino is a pure astringent, and is
 recommended in excessive  menstruation, chronic diarrhea and dysentery, and
 in all instances where an internal astringent is indicated.  It has also proved
 beneficial as a  local application in leucorrhea, sore-throat, relaxation of the
 palate, Ac.   An infusion of it thrown into the nostril has suppressed bleed-
 ing from  the nasal  mucous membrane;  and  the powder or lint has checked
 bleeding  from a wound  in the  palate,  which  has  resisted  various means.
 Dose of the powder, from ten to thirty grains; of the  tincture, from half a
 fluidrachm to two fluidrachms.

  L AUG E FLOWERING SPURGE. Euphorbia  Corolla ta.   This is a tall
 percunial  plant, growing in Canada and the United  States,-yielding a milky
juice when broken, which, when applied to the skin, causes a pustular erup-
 tion,—especially the juice of the fresh root.  The bark of the root is the  part 
668                 AMERICAN FAMILY PHYSICIAN.
 used; it is emetic, diaphoretic, and expectorant.   Vomiting may be produced
 by about a scruple of the powdered bark of the root; in doses of from two
 to four grains, three or four times a day, it is a good  expectorant, and may
 be given  in some saccharine vehicle;  catharsis will be produced by from sij
 to fifteen grains.   It is used in dropsy  of the  chest, and of  the  abdomen
 as a hydragogue, the dose being fifteen or thirty grains, repeated two or three
 times a week.

   LEAD.   Plumbum.   Several preparations of lead are used in medicine
 principally, however, as external agents.   When taken internally, and espe-
 cially if continued for a long time, they are apt  to produce  lead  colic, dys-
 pepsia, constipation, lead palsy, and symptoms of apoplexy.    The followin»
 are among the lead agents used medicinally:—
   1. Acetate of Lead.  Plumbi Acetas.   Also known by the name of Sugar
 of Lead.   It is in white prismatic crystals, having a vinegar odor, a sweetish
 astringent taste,  and soluble in water or alcohol.   A solution made by dis-
 solving one drachm of the salt in six or  eight fluidounces of distilled water
 and a teaspoonful of  distilled vinegar, is used as  a local application in ery-
 sipelas, superficial inflammations, and some  diseases of the skin.   A grain or
 two dissolved in a fluidounce of water, is  also employed  as a wash in some
 inflammations of the eye.  It is sometimes given internally to check bleed-
 ing from the lungs; two or three grains being combined with half a grain of
 Opium and one grain of Capsicum for a dose, and repeated  every  three  or
 four hours.
   2.  Red Oxide of Lead.  Plumbi  Oxidum Rubrum.   Also called Red-
 Lead, Minium, &c.   This is a heavy, bright scarlet-colored, and tasteless
powder, insoluble in water or alcohol  and is used in the  formation of plas-
ters.

  LEMON.   Citrus Limonum,.  An evergreen tropical tree, the juice of the
fruit of which has a strong but grateful acid taste, and is much used in the
form of lemonade as an agreeable drink in febrile and inflammatory diseases.
It is tonic, refrigerant, and antiscorbutic.    Ships about  entering  upon long
voyages, should always be plentifully supplied with Citric Acid and  Oil  of
Lemon, or Lemon Syrup.   Sufficient of the Acid maybe dissolved in water,
to impart the degree of acidity belonging  to Lemon juice, flavoring it with
the Oil of  Lemon, and of this  solution, or of the juice itself, one or two
fluidounces per day, will prevent an attack of scurvy, and six or eight fluid-
ounces daily, will cure it when present.
   Externally, Lemon  juice has  been used successfully  as an application  in
troublesome itching of the scrotum.   The Oil of Lemon is obtained from the
fresh rind of the Lemon, and is principally used  in perfumery, and to render
medicines, &c, more  agreeable to the taste.  Citric Acid is obtained from
the juice of Lemon, as well as from that of limes, citrus acida.

  LEPTANDRA.   Leptandra Virginica.  This is a perennial plant common
 n limestone countries of the United  States, the root  of which  should dc
gathered in the second year of the plant's growth, and during  autumn. The
root is the part used.   It is of various  lengths, from three to six lines  in
thickness, having a blackish bark enclosing a  brownish woody interior, and
giving off many delicate, dark-colored fibres.   Its  medicinal properties are
lost by age; the more recent the root, the greater is its activity.   The plant
is commonly known by the name of  Black Root, or Culver's Physic.  The
fresh root produces emesis, bloody stools, dizziness, vertigo, and, in pregnant 
MATERIA  MEDICA.
669
fcmiles abortion, unless used with care.  The root, when dried, is laxative
5,0  o' ue, and  tonic.   It is useful  in affections of the liver, bilious  and
 VPh id'Wers, diarrhea,  and dysentery.   In bilious and  typhoid fevers  it
 X black, tarry discharges, without impairing the functions of the bowels,
  weakening the system. In small doses, it is useful in dyspepsia.  It effects its
 nfluenceupon  the  liver, exciting this  organ to renewed energy  without
 au<in" active purgation.   Dose of the powdered root, as a cathartic, from
twcntYnto sixty grains; of the infusion, in typhoid conditions, a table-spoon-
ful every  hour until it operates, and to  be   repeated daily; of the hydro-
alcoholic extract, from one to five grains, in pills.
   Leptandrin, is the name  given to the concentrated agent prepared from
the root  by adding water to a strong tincture, and distilling off the alcohol.
(See Am. Ec. Dispensatory.)    It is a jet-black, or greyish-brown shining
substance, having a faint peach kernel odor and taste, with some bitterness.
It is partially soluble in alcohol, but becomes wholly so upon the addition^
a small portion of Aqua Ammonia; it is soluble in diluted Aqua Ammonia,
or Liquor Potassa,  from which it is thrown down by acids.  Leptandrin  is
a powerful cholagogue, with but little or no action upon the bowels.  It may
be safely  and advantageously given  in  diarrhea, cholera-infantum, typhoid
fever, some forms of dyspepsia, and all diseases connected with  derangements
of the biliary organs.   Combined with Podophyllin it is a prompt  and effect-
ual remedy in epidemic dysentery, when unconnected with irritability of the
nervous system, often effecting permanent cures in from twelve to eighteen
hours,  flic dose of Leptandrin is from one to six grains every three or four
hours, according to the  effect desired.

  LETTUCE.  Lactuca Sativa.   This plant, as well as the Lactuca Virosa,
contains a lactescent juice,  which flows from the stem when  this is cut or
wounded; when dried, the juice forms Lettuce Opium, or Lactucarium, which
is sometimes employed as a substitute for Opium, in cases where this  drug
disagrees, in doses  of from  five to  twenty  grains; it  is preferred, in many
instances, to Opium, on  account of  its freedom from  constipation, cerebral
excitement, and other unpleasant after effects.   The Tincture of Lactuca-
rium may be given in doses of from thirty to sixty drops.

  LIFE  ROOT.  Senecio Aureus.  This is a  perennial  herb, growing  in
damp places in  the Northern and Western States, and frequently known by
the name of Ragwort.  It,  together with another species found  on rocky
shores, the Senecio Gracilis, Unkum, or Female  Regulator, is used princi-
pally on  account of its efficiency in uterine difficulties.  The S. Gracilis
is generally preferred.  An infusion or decoction of it is very efficacious in
promoting the menstrual flow, when suppressed; in relieving painful men-
struation ; and, combined  with cinnamon  and  red  raspberry  leaves,  in
checking excessive menstruation, for which it may be given at the time of
the discharge, and during the intervals.  Dose  of the decoction or infusion,
from two to four fluidounces, three or four times a day.
  Senecin  is the  name of the oleo-resinous  concentrated  preparation
obtained from the  herb.  In quantity it is black,  but dark  green in thin
layers; has the odor of the herb, and a bitter, rather disagreeable  taste.
The Senecin recently prepared  by  Mr. Merrill is in  the form  of powder.
Either of these preparations possesses the medicinal properties of the herb
in a concentrated degree, and may be employed in all the derangements of
the female  reproductive organs in which  the plant is used.  Its dose ia
from three to five grains, three times a day. 
670
AMERICAN  FAMILY  PHYSICIAN.
  LIME.   Calx.   This is sometimes used  in  medicine in  the form of an
escharotic mixture, known as the Vienna powder ox paste, and which is mado
by mixing Caustic  Potash one and a half parts, with two  parts of quick-
lime.   Lime may be used  to produce perspiration, where it is not desirable
to disturb the patient, thus :—Take  a piece of Lime about the  size of an
orange, wrap a moistened rag around it, and cover this with several thick-
nesses of dry muslin or cloth.  Place  one thus prepared  on each side of
the patient,  and by both thighs; they will soon induce copious perspiration.
Milk  of Lime is a thick liquid, made by adding Lime to  an  excess of
water.  When water is gradually added to Lime, it falls to powder, and is
termed Hydrate of Lime, or slaked Lime, which is less caustic than unslaked
Lime.  The following are among the  Lime  preparations used in medi-
cine :—
  1.  Cliloride of Lime.  Calx Chlorinata.   This is a grayish-white, dry or
slightly moist substance, having a chlorine  odor, and a strong, astringent
and bitter taste.   It is  usually applied  to gangrenous  ulcers, chilblains
burns, and diseases of the skin, &c, to  keep the parts dry, and remove  any
disagreeable fetor.   Its  solution is sometimes  combined with poultices, for
similar purposes, and  may be used as a wash or gargle  in all cases  of gan-
grene, or fetid emanations.
  2.  Lime  Water.   Aqua  Calcis.  This is  made by stirring about four
ounces of unslaked Lime  in one gallon of distilled water; then setting it
aside  for a few hours, and pouring off the clear liquor as it may be wanted.
It is  antacid, antilithic, tonic and astringent.   It  is recommended in all
diseases  accompanied with acidity  of  the  stomach, in diabetes,  chronic
diarrhea and dysentery, and  to allay vomiting.  If its use be too long con-
tinued, it weakens the stomach.   The dose is from four  fluidrachms to  two
fluidounces, and it is best taken in an equal quantity of  milk.  Externally,
it has been used as a wash in scald-head, foul  ulcers, and mixed  with Lin-
seed Oil as an application for burns and scalds.
  Prepared  Clialk.   Creta Preparata.   This is  a Carbonate  of Lime, which
is used in acidity of the stomach,  heartburn and diarrhea, either alone, or
combined with aromatics and opium.   Its dose is from  ten  to sixty grains.
Externally,  it is used to absorb the ichorous discharge from burns  and
ulcers, and to prevent excoriation from  pressure or friction.

  LIQUORICE.   Glycyrrhiza Glabra.   This is a perennial plant, common
to the south  of Europe,  and Asia.   The  root is  the part used.  It is
a demulcent and expectorant, and is very useful  in catarrh, cough,  and
irritations of mucous  surfaces.  The decoction may be used freely.  The
well-known   black   Extract  of Liquorice   may  be  used  for   the same
purpose ; this, when dissolved in water, strained, evaporated to the proper
consistence, and rolled  into long pipe-like cylinders,  is  termed  Refirud
Liquorice.

  LOBELIA.  Lobelia Infiata.   This is a well-known weed, common to the
United States, the leaves  and seeds of which are used in medicine.  They
possess emetic, nauseant, expectorant, relaxant,  sedative, and anti-spasmodio
properties.   Ten or twenty grains of  the leaves  or seeds will occasion
vomiting; it is commonly used in combination with other emetics, in all
diseases  requiring  the use of such agents.  In small  nauseating doses of
five or ten  grains, it  excites  djaphoresis, promotes expectoration, lessens
cough,  and   overcomes spasmodic action,  and hence is useful  in  croup,
hooping-cough, catarrh, inflammation of the  lungs, asthma, cramp, hys- 
MATERIA  MEDICA.
671
 teria  convulsions, &c.   It may likewise be  given to  produce relaxation in
 lockjaw, in strangulated hernia, in tedious  labors from rigid os uteri, and)
 in fractures or dislocations to relax the muscles.   Externally, the infusion
 has been found useful in some diseases of the eye.  The stings or  bites of
 insects, erysipelatous affections, spasm  of the muscles  of the  limbs, and
 Bevere pains, may be readily relieved by the application of a  poultice of
 Lobelia and Elm  bark, mixed with weak ley, or a weak alkaline solution ;
 this will likewise relieve pain, and relax  the muscles, in case  of fractures,
 dislocations, &c, when such  effect is desirable.   The  tincture is an effica-
 cious local application to sprains, bruises, rheumatic  pains, erysipelatous
 inflammations, some diseases of the skin,  as well as a remedy for the poison*
 from poison Ivy or poison Dogwood.  The  Oil of Lobelia is  occasionally
 used  internally in very small doses; in  doses to occasion vomiting, it is-
 apt to cause inflammation of the stomach.   Its more  common employment
 is as an external application, either alone, or combined with other oils to
 form a liniment, to produce muscular relaxation, relieve pain, and remove
 nervous irritability.

   LOGWOOD.  Hmmatoxylon  Campechianum.  This is  a tree growing iu
 tropical America,  the wood of which is the part used.  It is a non-irritating
 tonic and astringent, and is useful in diarrhea, dysentery, and  the  relaxed
 condition  of the  bowels  succeeding  summer-complaint of children.  In
 constitutions broken down by disease, dissipation, or the use of mercury,
 in  addition  to the  other remedies,  the  administration of Logwood,  in
 decoction, will be  found of much service.  The urine, as well as the stools,
 become colored red, when the preparations of logwood are taken internally.
 As Chalk  and Limewater are not  compatible with logwood, they should
 never be taken together.

   MAGNESIA.  Magnesia Usta.   Calcined Magnesia is a white inodorous
 powder, of an earthy taste.   It is  antacid,  antilithic, and  laxative.  It ia
 useful  in  dyspepsia, with acid  stomach,  constipation, sick headache, &c,
 and is sometimes combined with Rhubarb as a laxative and antacid.  As an
 antilithic, it corrects acidity of the stomach, and  where Urate of Ammo-
 nia or free Uric Acid abounds, it forms the more soluble Urate of Magnesia.
 When no acidity is present, it is very liable to remain in the bowels, pro-
 ducing no purgative effect, on which account it is  always useful to  admin-
 ister it iu combination  with lemonade or  Lemon juice.  The dose, as a
 laxative, is  from half a drachm to a drachm ; as  an antacid  or antilithic,
 from ten to thirty grains, once or twice daily.  (See Sulphate of Magnesia.)

  MAIDENHAIR.   Adiantum Pcdqtum.  This is a perennial fern, found
 on rich, moist  soil  throughout the United States.   The  whole plant  ia
 used;  it  has  a  faintly  aromatic  bitterish  taste.   Maidenhair  is  tonic,
 refrigerant, expectorant, and sub-astringent.   The decoction forms a cool-
 ing drink in erysipelas, febrile and inflammatory diseases, and is also bene-
 ficial in coughs, chronic catarrh, influenza, asthma, &c.  It is said to be
 beneficial in pleurisy and jaundice.  The  decoction may  be used freely,  aa
 well as the syrup.

  MANDRAKE.   Podophyllum Peltatum.   This is a perennial herb, grow-
ing in almost all parts of the United States, and  known in some sections
by the name of May Apple.   The  root is the part used, and it should be
collected  soon after  the  ripening of the  fruit.   It is  cathartic,  emetic, 
®72                AMERICAN  FAMILY  PHYSICIAN.
alterative, anthelmintic, hydragogue and sialagogue.   As  a cathartic it is
equal to Jalap, and, like this drug, produces watery stools, when combined
with Cream of Tartar, on which account it has been used in dropsical affec-
tions.  In chronic affections of the liver, it is  one of the  most valuable
remedies we have, arousing the organ to healthy  action, increasing the flow
of bile, and keeping up these actions for a great  length of time.   In alter-
ative  doses, it is valuable in erysipelas,  scrofula, rheumatism, and  many
other forms of chronic disease.  It has been likewise found very beneficial
in constipation,  painful  menstruation, suppressed  menstruation  inconti-
nence of urine, and some affections of the bladder.   Dose  of the powdered
root, as a cathartic, from ten to thirty grains;  of the tincture, from ten to
sixty drops  ; as a sialagogue  and alterative, from three to ten grains of  the
powder, or from five to twenty drops of the tincture.
   Podophyllin is  the  name  given to the  impure  resin  obtained from  the
root, by adding water to a saturated tincture, and distilling off the alcohol.
It varies in color according  to its mode of preparation, being dark-browD
light browrnish yellow, or greenish olive.  It is nearly soluble in alcohol.  It
possesses  the virtues  of the root in  a superior  degree, and is generally
used instead of the root.  It should be given in  very fine powder, or tritu-
rated with  loaf sugar, Sugar of Milk, &e.; its  tendency to cause nausea
and  griping pains, may be  overcome  by combining it with Castile  Soap,
Alkalies,  Ginger, or Caulophyllin.  The dose, as a cathartic, varies from
one-fourth of a grain to two or even  four grains; as  an  alterative, aperi-
ent, or sialagogue, from one-fourth of  a grain to one-half  of a grain,  every
three or four hours, according to its influence.

   MARSH  ROSEMARY.  Stat ice Caroliniana.   This is a perennial plant
found along the  coast in  marshy situations  from Maine to  Florida.  The
root is the part used; it  is of a reddish, or purplish brown color, inodorous,
bitter and astringent.   An  infusion or decoction of  it is much used in
diarrhea, dysentery, and other diseases  requiring the use of tonics and  as-
tringents.  The decoction is likewise useful as a gargle in  affections  of  the
throat, scarlet  fever, ulcerated  sore  mouth, and  as an injection  in  gleet,
leucorrhea, falling  of the  womb, and also  of the rectum.   Externally,  the
powdered root may be applied to old ulcers.  Dose of the decoction, one or
two table-spoonfuls every hour or two.

   MARSHMALLOW.   Althcea Officinalis.   This perennial  herb grows
in salt marshes and wet  situations in many parts of Europe, and  has been
cultivated in this country.   The root is the part used, it is in round pieces
of various lengths, white, downy, having a feeble odor, and a sweetish, mu-
cilaginous taste.   Marshmallow root  is demulcent and  diuretic.   The infu-
sion, either  in hot or cold water is valuable  in  all irritations of  the mucous
membranes, as hoarseness, catarrh, inflammation  of the lungs, stomach, or
intestines, catarrh of the bladder, irritation of the kidneys, acute dysentery,
and  diarrhea;  also in retention of the urine, hemorrhage from the kidneys,
inflammation  of the bladder, some  forms of gravel, and  in nearly  every
affection of  the kidneys and bladder.   It may be drank freely.   Externally,
a  poultice may be  formed of  the  root,  to 'discuss  painful,  inflammatory
tumors, of all kinds, and to prevent or check mortification.

   MASTERWORT.  Heraclum Lanatum.  This is a perennial plant found
growing from Canada to Pennsylvania,  and is sometimes  known  by  the
name of €ow-Parsnep.  The root is  the part used, it  somewhat resembles 
MATERIA MEMCA.                       673
 that of common parsley.   It  is stimulant, antispasmodic, and carminative,
 and is useful in flatulency and dyspepsia, in decoction.   Recommended also
 in  colic, asthma, painful menstruation, palsy, intermittents, &c, in doses of
 one drachm of the powdered root.  In epilepsy, two or three drachms daily,
 with a strong infusion of the tops and leaves at night,-has proved successful.

   MOTHERWORT.  Leonurus Cardiaca.  This is a well-known perennial
 plant,  introduced into this country, and possessing nervine, emmenagogue^
 antispasmodic, and laxative properties.   In warm infusion, the tops and
 leaves are beneficial in suppressed menstruation  from  colds, suppressed lo-
 chial discharge, and  in hysteria.   An extract of  the plant  is valuable in
 nervous  complaints,  pains peculiar to females, in  irritable  habits, typhoid
 stages with morbid  nervous irritation,  neuralgic  pains in the stomach and
 head, and all diseases attended with  restlessness,  wakefulness, and disturbed
 irritation.  Combined with  Blue Cohosh and  Skunk Cabbage  it forms a
 superior nervine, antispasmodic, and emmenagogue.  Externally, it may be
 used as a fomentation to the bowels, in suppressed or painful menstruation.
 Dose of the decoction from two to four fluidounces every one, two, or three
 hours; of the extract from three to six grains.  An infusion of the root ia
 diuretic.

   MULLEIN.  Verbascum Thapsus.  This is  a  well-known biennial plant
 common to this country; the leaves and flowers  are the parts used.  They
 are  demulcent, diuretic, and  antispasmodic.   The infusion is  useful in
 coughs, catarrh, diarrhea, dysentery, and piles, and to allay the acidity of
 urine in many diseases.   It may be drank freely.  In bowel complaints, the
 leaves  and  flowers may be  boiled in milk, and sweetened.   A fomentation
 of the leaves  in vinegar and water, forms  an  excellent  application' to the
 throat in quinsy, malignant sore throat, mumps, &c, also  to  ulcers, tumors1
 and inflamed piles.  The seeds are narcotic, and have been  used in asthma,
 infantile convulsions,  and to poison fish.

  MUSTARD.  There  are two mustard plants, one the White Mustard,
 Sinapis Alba, and the other the Black  Mustard, Sinapis Nigra; they are
 annual plants common to this country, but  natives of Europe.   The seeds
 are the parts used.   Internally, taken  in  small quantities, as a condiment,
 they are a safe stimulant of the digestive organs;  in large  doses they are
 emetic; and in excessive doses they are poisonous, producing inflammation
 of the  stomach and bowels.  They are commonly used  in powder;  though
 the white mustard seeds, taken  whole, were formerly used as a tonic  and
 laxative in dyspepsia.   When applied to  the  skin,  mustard excites redness
 and a stinging or burning sensation, and if too  long applied, it will occasion
 inflammation, ulceration, and even sloughing.   It is frequently applied as a
 rubefacient in all  cases where  such  action  is desirable;  the burning  pain
 caused by it may be removed by sponging the part with cold  water, milk, or
 dropping ether upon it.  It should never be allowed to remain long enough
 to produce vesication.   The volatile  oil  of mustard is a powerful rubefacient,
 and may be used as a  substitute for a mustard poultice in  the following mix-
 ture:—Take of Olive  Oil ten parts,  Oil of Mustard one part; mix, and rub
 on the  part.

  MYRRH.   This  is the gummy resinous exudation  of a  tree (the Bal-
samodendron Myrrha) growing in Arabia, Abyssinia, &c.  It is in irregular
pieces,  of a  reddish-brown  color, easily powdered,  of a peculiar agreeable 
674                 AMERICAN FAMILY  PHYSICIAN.
odor, an aromatic bitter taste, and is soluble in alcohol.   Myrrh is s-timulan-B
tonic, antiseptic, expectorant, and emmenagogue.   It is useful in debilitated
states of the system, chronic catarrh, humoral asthma, and  other  affections
of the air-tubes in which mucous secretion though abundant, is  not easily
expectorated; also in suppressed menstruation, chronic dysentery, &c.  As
a local application it  is useful in sponginess of the  gums, aphthous sore
mouth, and indolent and gangrenous ulcers.  Dose of  the powder, from ten
to thirty grains;  of the tincture, one or two fluidrachms.

  NITRATE  OF  SILVER.   Argenti Nitras.   This salt is  commonly
«ermed Lunar Caustic.   It is met with in small rods, or in crystals, and has
a persistent, bitter, metallic taste, is soluble  in water, and in  four times its
weight of  alcohol, stains the skin  of  a dark color, and corrodes the soft
animal textures.   According to Dr. W. B. Herapath, if a few drops of Tinc-
ture of Iodide be placed in contact with a stain caused by Nitrate of Silver,
this salt will be converted  into  an Iodide of Silver, which is soluble in a
solution  of half a  drachm  of  the Hyposulphite  of Soda to a fluidounce of
water, and after the application of which, the stains may be readily removed
by  washing with warm water.  Nitrate  of Silver is sometimes employed in-
ternally in ulceration  of the intestines  during typhoid fever, diarrhea, &c,
in  doses of the fourth of a grain made into a  pill with  crumb  of bread,
and repeated every three  or*four hours.  It is more commonly used exter-
nally, as an  escharotic,  either in the solid  form, or in solution  of various
strengths.   It has thus  been beneficially employed in warts, and other ex-
crescences, ulceration  of the mouth, ulcerations  of the neck of  the womb,
chrOnie laryngitis, stricture of  the urethra, some diseases of the eye, &c, &c.
Its  solution varies, according to the condition of  the parts to be acted upon,
and the character of the affection,—from five to  eighty grains to the fluid-
ounce  of flistilled water.  Common salt  is the best antidote to the poisonous
effects of large doses of Nitrate of Silver, as well  as to relieve any excessive
pain caused by its application.

  NITRIC ACID.  Acidum Nitricum.   This is  a transparent, colorless, or
straw-colored fluid, of a peculiar irritating odor, and a strong acid, corrosive
taste.  The acid of commerce is known  as Aqua  Fortis.  It stains the skin
yellow, and corrodes and dissolves all  soft animal textures.   When left ex-
posed to the air, it absorbs moisture, and becomes weakened.   When largely
diluted with water, it forms a good drink in febrile diseases, especially where
there is a  disposition  to  prostration or putrescency;  and  has also proved
serviceable in affections of the  liver, and  syphilitic diseases.   The dose ia
five or ten drops in a large quantity of  water, to  be repeated three or four
times- a day.  Twelve  or twenty drops  to a pint  cf water, forms a good ap-
plication to indolent or phagedenic  ulcers, and various diseases of the skin,
warts, and poisoned wounds.  The strong acid has been used to destroy pile
tumors, and  to immediately  destroy the venereal virus  in a chancre during
its pustular form.   When swallowed internally not diluted, it almost always
proves fatal;  its best antidotes  are, the  free use of  Magnesia,  chalk, or
soap-water, and mucilaginous drinks.

  NITRO-HYDROCHLORIC ACID.   Acidum Nitrohydrochloricum. Also
called  Nitro-Muriatic Acid, and Aqua Regia.   This is  made by mixing to-
gether equal parts of Nitric and Hydrochloric Acids; though when used for
dissolving gold, &c, one part of Nitric  is mixed with  two parts of Hydro-
chloric Acid.   It possesses properties similar to those of the acids entering 
MATERIA  MEDIC A.
675
 into its formation; its dose is from three to five drops, sufficiently diluted
 with water.   One part of this acid to six parts of water, and used as a wash
 over the bowels, loins, and  thighs, is said to  cure obstinate constipation.

   NUTMEG.  Myristica Moschata.   The  tree which furnishes  nutmeg ia
 a native of the Molucca Isles, and is cultivated in various tropical countries.
 The best nutmegs are small, firm, and  heavy.  They possess stimulant and
 carminative properties,' and are used to remove flatulency, as well as to ren-
 der other drugs more palatable.   It is much  used to  flavor some articles of,
 diet or drink, being  grated over them.  It  is sometimes mixed with lard
 as an application to piles; and when charred  has cured intermittent fever.
 The dose internally is from  five to twenty  grains.  Large  doses will pro-
'duce stupor and delirium,   Mace, is the arillus or exterior covering of  the
 nutmeg, it possesses  similar properties in the same doses.

   NUX VOMICA.   Strychnos Nux Vomica.   This tree is a native of the
 East Indies, the seeds of which are used in medicine.  They are circular,
 compressed,  nearly an inch- in diameter, about the sixth of  an inch thick,
 thickly covered with short, brownish, silky hairs, exceedingly tough, almost
 horny, very  difficult  to powder, and of an intensely bitter taste.  Alcohol
 takes up their virtues.  Nux Vomica is an  energetic poison, causing vio-
 lent convulsions, asphyxia, and  death, when  given  in too large doses.  Not
 unfrequently small doses will  cause a  burning  sensation in the stomach,
 shocks or twitehings of the muscles of the limbs,  dizziness, a  sense of tight-
 ness or stricture across the  head, a pricking  or tingling upon  the surface,
 and a confused condition of the  mind.   It is more  commonly used in cases
 of paralysis, and nervous debility, and has been found of service in dyspep-
 sia, obstinate constipation, amaurosis, paralysis, spermatorrhea, impotence,
 suppressed menstruation, chorea, neuralgia, painful menstruation, rheuma-
 tism, intermittent fever, and  in some forms  of  mania.  The  dose of the
 powder is five grains three  or four times a  day;  of the alcoholic extract,
 which is  the best form for internal use,  from  one-twelfth to one-thirtieth of
 a grain, as a tonic, and from a quarter of a grain to half a grain  in paraly-
 sis ; of the saturated tincture, from  five to thirty drops, but  this is a disa-
 greeable preparation  for internal use.
   Strychnia., is the active alkaloid principle  of Nux Vomica; in commerce
 it is met  with in the  form of a white, inodorous,  but  intensely bitter pow-
 der.  It is a most powerful poison, frequently causing death  in the dose of
 half a grain;  too much caution cannot  be employed  in its  medicinal em-
 ployment, as some persons  are  powerfully affected by the minutest doses.
 It is used in the same diseases as the Nux Vomica, in dose3 varying  from
 one-twentieth to one-sixtieth of a grain, in form of pill.  The addition of a
 few drops of Acetic, Nitric, or  Muriatic Acid, will render it soluble in water
 or alcohol.   Camphor and  Sweet  Oil have  been advised as its  antidotes  ;
 hut no certain antidote is  yet known.   None of the preparations of Nux
 Vomica must be used in local irritation of the brain  or spinal chord, when
 there is a determination of blood to the  head, nor in corpulent or apoplecti
 persons.   In  the administration  of   Nux   Vomica or Strychnia,  great
 caution must  be observed, and  the  patient be  carefully watched during
 their use,  ceasing   to  administer them,  when  their  effects  become too
 manifest.

   OIL OF  CAJEPUT.   Oleum  Cajuputi.    This  is a transparent, grass-
 green oil, obtained from the leaves of  an  Ea-t  Indian tree, the Melaleuca 
676
AMERICAN FAMILY  PHYSICIAN.
Cajuputi; it has a strong, penetrating, aromatic odor, and a warm, pungent
taste..  It is a powerful diffusive stimulant, diaphoretic, and antispasmodic,
and  may  be advantageously employed in chronic  rheumatism, hysterics,
colic, flatulence,  spasms  or  cramps  of the  stomach  and bowels, cholera
morbus, and where a powerful stimulant is required.   In combination with
other oils in the form of liniment, it is used  externally in all painful affec-
tions, as rheumatism, neuralgia, &c.  It is sometimes applied on  cotton to
the cavity of a carious tooth, for toothache.   The dose  is from one to five
^rops on sugar, or in emulsion.

  OIL  OF  TURPENTINE.    Oleum  Terebinthincv.  Sometimes called
Spirit of Turpentine.  This is obtained by  distilling  the  turpentine from
various trees, with or without water.   It is an irritant, stimulant, cathartic,
diuretic, anthelmintic, and, in  chronic mucous discharges, astringent.   In
large doses it causes strangury, and many other unpleasant symptoms.   In
medicinal doses,  it has been used to  increase the urine, and to diminish
excessive  mucous  discharges, as  in  chronic  catarrh,  chronic  diarrhea,
chronic dysentery, gleet, chronic  inflammation of the bladder, &c.  It is
also  used in the typhoid stage  of fevers, in  tympanitis, and  in ulceration
of the bowels.  The dose is from five to thirty drops, repeated every two or
three hours.   In doses of from twenty to sixty drops, repeated every three
or four hours, it  has  proved effieacious in  bleeding from the nose, lungs,
stomach, womb, &c.  Combined with Castor  Oil, it forms an excellent ver-
mifuge, and has removed tape worm.   It is best administered on sugar, in
some aromatic syrup, cinnamon-water, &c.   Externally it enters  into seve-
ral lotions and liniments, as a rubefacient and counter-irritant in rheumatic
and  paralytic affections, indolent tumors, chilblains, indolent and erysipel-
atous ulcers, caries, sloughing, and in  burns  and  scalds  combined with
Linseed Oil.  It  has  also been  used as an injection in tympanitis, sup-
pressed menstruation^ obstinate constipation, and for the removal  of thread
worms.

  OLIVE OIL.   Oleum Olivoz.   This is expressed from the fruit of the
Olive tree, the Olea Europcea.  It  is  a  colorless or pale greenish-yellow
fluid, unotuous, nearly inodorous, and with a sweetish, mucilaginous taste.
By long keeping it becomes rancid.  It is  nutrient, and emollient;  and
laxative in doses  of one or two fluidounces.   It has been  used  in coughs,
catarrh, irritation of the intestinal mucous membrane, and as an antidote
in poisoning  by alkalies.  It  is  said  to be serviceable  in  scarlet fever,
plague, and some other febrile eruptive diseases, when  applied over the
whole surface of the body.  It is generally employed in the composition of
cerates, liniments, plasters, &c.   When  prepared for  table use, it is called
Sweet or Salad Oil, but is improper for dyspeptics.

   ONION.  Allium  Cepa.  This well-known  article  possesses  virtues
,somewhat similar to to those of Garlic.  The juice, with  sugar, to forma
syrup, is  a popular remedy for cough, croup, and colds  of infants.  Boils,
and all suppurating  tumors, foul and indolent ulcers,  &c, are frequently
benefited by a poultice of roasted Onions.   When  boiled, the Onion forms
an excellent article of diet;  eaten raw, it is  very apt to  occasion flatulence,
distress about the stomach, and other unpleasant  symptoms.  It may  be
used externally,  in the same manner as Garlic, though  it is much milder
in its action. 
MATERIA  MEDIC A.
677
   OPIUM.   This is the concrete juice of the unripe capsules or seed-ves-
 sels of the Poppy, Papaver Somniferum.   In large doses  it is a stimulant
 narcotic, causing at first an increased action of all the powers of the system,
 followed by  sleep, and  subsequent giddiness, nausea,  headache,  tremors,
 and general  nervous derangement, with  constipation, and often, retention
 of urine.  These  unpleasant symptoms  maybe relieved by strong coffee,
 lemon-juice, or a  cathartic.  In still  larger doses, there will  be  a small,
 Boft, and slow pulse, contraction of the pupils, coldness of the limbs, more
 or less  insensibility, and  if not soon relieved, death.   The remedies, when
 thus taken, are emetics of Mustard and Lobelia, with strong coffee,  stomach
 pump, external counter-irritation, cold water to head and spine, forced ex-
 ercise, and electro-magnetism.  To be followed, after consciousness is re-
 stored,  by stimulants and a cathartic.   Poisoning by any of its preparations
 requires the  same treatment.
   Opium is  used in medicine to produce perspiration, allay pain, and lessen
 nervous excitability in all febrile and inflammatory diseases; also as an an-
 odyne-diaphoretic in rheumatic, neuralgic, and gouty diseases, morbid watch-
 fulness,  nervous  excitability,  restlessness, diarrhea, dysentery, &c.  As an
 antispasmodic  in  hysterics, colic, convulsive affections, cough, &c,  and, in-
 deed, it is very valuable in all forms of disease, where pain, spasm, morbid
 watchfulness, nervous irritability, and morbid mucous discharges are  pres-
 ent.  It should not be used in most cases of constipation  or where  there is
 a determination of blood to the head.  Externally, in  the form of liniment
 or plaster, it is used to relieve  pain, and subdue local inflammation, as in
 neuralgia, rheumatism, irritable blistered surfaces, erysipelas, &c, and as an
 addition to injections in gonorrhea, dysentery, tenesmus, &c.   The dose of
 Opium  varies according to the susceptibility of the patient to its influence,
 from one-fourth of a grain to two and  even three grains, and in some severely
 painful  affections, still larger doses may be required.   For the purpose of
 causing sleep and  relief from  pain under ordinary circumstances, the  dose
 is  one grain; or of the Tincture, from ten to forty drops.  When the stom-
 ach will  not  retain  it, it may be injected into the rectum, in about double
 the above quantities for a dose, added to a little water.  Poppy flowers are
 sometimes used in fomentation, to calm irritation, lessen pain, and promote
 rest.

  MORPHIA is the name given to one of the alkaloid principles of  Opium.
 It  is more commonly used in the form of a salt, on account of its insolubil-
 ity when not  combined with an acid.  The several salts employed more gen-
 erally, are,  the Sulphate, the Muriate, and the  Acetate  and the  Valerianate
 of Morphia.  These preparations have essentially all the narcotic properties
 of Opium,  and are generally used in doses  varying from one-eighth of a
 grain to one-half of a grain—one-sixth of a grain being equivalent  to  one
 grain of  Opium.  A solution may be made of either of them, by adding ten
 grains of the salt to one fluidounce and a half of distilled water, to which
 add half an ounce of diluted Alcohol, and two  or three drops of the particu-
 lar acid  which  distinguishes them  from  each  other as salts, as, Sulphuric,
 Muriatic, or Acetic, &c.   The dose of  this will  be from ten to  fifteen drops.
 The Valerianate of Morphia will  be found very useful in febrile and in-
flammatory diseases, to relieve restlessness, wakefulness, or nervous irrita-
bility ; also in spasmodic affections, delirium tremens, &c.

  ORANGE,   Citrus Aurantium.  This well-known fruit is the product of
a tree, common to  tropical climates.  Orange-juice is an agreeable refriger- 
678
AMERICAN FAMILY  PHYSICIAN.
ant, useful in fevers, measles, small-pox, &c, and as an antiscorbutic in scurvy
It may be used freely  in febrile  diseases, more  especially when there is a
dark or brown coat on the tongue.  When the juice is sucked from an Or-
ange, by the patient, care should be taken that he does not swallow any of
the membranous portion, or peel, &c,  as these are hard to digest, and there ■
fore, unfit for the stomachs of the sick.  Orange-peel  is frequently used to
flavor  various medicinal preparations.  It is  mildly  tonic and stomachic.
When used in large quantities, it has produced serious, and even fatal symp-
toms.  The Oil of Orange is prepared from the  rind; Oil of Neroli, from
the flowers.

  ORIGANUM.   Origanum Vulgare.  This is a perennial herb, common
to Europe and this country.  A  warm infusion  causes perspiration, and
tends to promote menstruation, when suppressed from cold.  The Oil of Or-
iganum is chiefly used as a stimulant and gentle rubefacient, and enters into
many liniments, tooth-ache  drops, &c.

  OXALIC ACID.  Acidum Oxalicum.   This acid is in colorless crystals,
having a strong acrid  taste, and  is soluble  in  about nine or ten times its
weight of cold water.   It is a poison, and  unfit for  internal use.  Exter-
nally, a solution of it has proved useful in cutaneous cancer, scald-head, and
several forms of disease of the  skin.   Its antidotes, when  taken internally
in poisonous doses, are, Chalk, or Magnesia,  mixed with water,  and followed
by emetics.

  PANSY.   Viola  Tricolor.  This is a  perennial plant, sometimes called
Hearts-ease, and which  is  cultivated  in gardens.   Combined with Turkey-
eorn,  the plant is a good antisyphilitic.  It  has also been used in affections
of the chest, kidneys, and  skin, especially in milk-scall.  In doses of from
forty to sixty grains, the root is emetic ; from twenty-five to thirty grains,
purgative;  from six to twelve grains, tonic.   Both the plant and root should
be used when fresh, as drying destroys their  active properties.

  PARSLEY.   Apium Petroselinum.   This is a well-known biennial plant,
the root of  which is used as a diuretic in  infusion with water or wine.  It
has been found very useful in dropsy,  especially that following scarlet fever,
and other  exanthematous  diseases; and has also been used in retention of
urine, gonorrhea,  and  strangury.  The seeds are carminative and diuretic,
and are said to poison the parrot, when eaten by that bird.  Dose of the in-
fusion, from two to four fluidounces, three or four times a day.   The leaves,
bruised  are  a good application  to contusions, swelled-breasts, and enlarged
glands;  reputed to "dry up the milk" of wet nurses.

   PARTRIDGE-BERRY.  Mitchella Repens.  This is a perennial evergreen,
creeping herb, growing in dry woods  and swampy places,  throughout the
United °States, and having  white, very fragrant flowers in  June and  July,
always in pairs, and often tinged with red.   The  whole vine is used.   It is
tonic,  diuretic, and. astringent, and has been used  in decoction in suppressed
urine, diarrhea, and dropsy.  It. exerts a powerful tonic influence on the re-
productive organs, and  is used  in decoction, for  the  purpose of imparting
tone  and vi«-or to the  uterus, and  thereby rendering labor  less tedious and
painful.  Dose of the decoction, from  two to four fluidounces, two or  threa
times a day.  An  ounce of the  fresh  plant, made into a strong decoction
with  half a pint of water, strained and  an equal quantity of good cream 
MATERIA   MEDICA.
679
 added,  and then  the whole  evaporated  to the consistence of an ointment,
 forms a good remedy for sore and  excoriated  nipples; the nipple should be
 kept anointed with it all the time,  except wThen the child is sucking.

   PEACH.   Amygdalus Persica.  The leaves of the Peach-tree are seda-
 tive and slightly laxative, and are  useful in all  inflammations of the stom-
 ach and intestines, in doses of a table-spoonful of the cold infusion, every
 hour or two.   They  also have been found  beneficial in  irritable  bladder,
 ischuria, hooping-cough, nek-stomach, hematuria, and dysentery.   The ker-
 nels possess similar properties, and may be used in the form of tincture, in-
 fusion, or syrup.   Four ounces of  the bruised  kernels to a quart of  Brandy,
 forms a good tonic, and has been successfully used in intermittents and leu-
 corrhea,  in doses of a teaspoonful, three or four times a day.

   PENNYROYAL.  Hedeoma  Pulegioidcs.   This well-known annual plant
 is stimulant,  diaphoretic, emmenagogue, and  carminative.  It is generally
 employed in warm infusion to promote perspiration, restore suppressed lochia,
 and suppressed menstruation, when not of long standing.  It  is also used
 in the flatulent colic of  infants.   The Oil of Pennyroyal, or its Tincture, ia
 used in hysteria,  hooping-cough, spasms, &c;  and  externally, as a rubefa-
 cient in rheumatism and similar affections. Mixed with Linseed Oil, it proves
 a good application to burns.  Dose of the Oil, from two to ten drops.

   PEONY.    Pceonia  Officinalis.    This is a well known  perennial plant,
 cultivated in gardens on  account of the beauty of its flowers.    The root is
 tonic and antispasmodic; it has been used alone, or in combination with other
 agents, in St.  Vitus' dance, epilepsy, spasms, hooping-cough,  and various
 nervous affections.  Dose of the powdered root, one drachm; of the tincture,
 one or two fluidounces;  of the juice of the fresh root, one or two  fluidrachms;
 which doses may be repeated  three or four times a day.   The seeds are said
 to possess similar  virtues, in doses of thirty or forty grains.

  PEPPERMINT.  Mentha  Piperita.    This  well-known perennial plant is
 a stimulant, antispasmodic, carminative, and stomachic; it is much useain the
 form of essence of peppermint, in flatulent colic, hysterics, spasms or cramps
 of the stomachy to check nausea or vomiting, to allay the griping of cathar-
 tics, and  to disguise the  unpleasant taste of other  medicines.  The dose is
 from ten  to sixty  drops in sweetened water.   The  warm  infusion  may be
 drank freely.   The fresh herb bruised,  and applied over the stomach and
 bowels, will often  allay sick stomach, and is useful  in the summer-complaint
 of children.

  PERSIMMON.   Diospyros Virginiana.   This tree is common in the Mid-
 dle and Southern  States.   The  bark and  unripe  fruit are the parts used.
They are astringent and tonic, and have been efficacious in chronic  diarrhea,
 chronic dysentery, flooding from  the womb, &c.  The bark has been used in
fever and ague.  An infusion, syrup, or vinous tincture  of these agents may
be employed in doses of a table-spoonful or more, every two or three hours.
The infusion forms an excellent wash and gargle in ulcerated sore mouth and
throat; and an injection  in leucorrhea.   The ripe fruit is grateful and
healthy.

  PERUVIAN BARK.   This  is  obtained from  several  South  American
trees,  as the Cinchona Calisaya, C.  Condaminea,  C. Micrantha, &c.   There 
680
AMERICAN  FAMILY PHYSICIAN.
are three varieties, the Pale, the Yellow, and the Red barks.   The Pale barfe
yields a bitter, slightly astringent, pale or greyish fawn-colored powder, which
contains a large  amount  of Cinchonia, and but little Quinia.   The Yellow
bark is of a brownish-yellow color, more bitter than the Pale, and contains
more  Quinia than Cinchonia.   The Red bark forms a reddish-brown powder,
and contains both  Quinia  and  Cinchonia in quantity.   There are several
other varieties, but the  above are the principal ones.   Boiling water, proof-
spirit, alcohol,  and diluted acids,  take up the 'active constituents of theso
barks.   Peruvian bark is tonic  and antiperiodic,  and is used in all diseases
of a periodical character,  as fever  and ague, remittent fever, neuralgia, epi-
lepsy, epidemic diseases, &c.   It is also employed as a tonic in typhoid con-
ditions,  small-pox, scarlet fever, carbuncle, gangrenous erysipelas, and in all
cases where there is much exhaustion of the system.  The dose of the bark,
in powder, as a tonic, is from  ten  to sixty grains; as an anti-periodic, from
twenty to sixty grains; of the infusion  or decoction, one or two fluidoun(i«j-
of the extract, from five to  thirty  grains.    Externally,  the  powdered tt0rc
has been efficaciously applied  as a poultice to felons, fetid and gangreacffe
ulcers, &c.   The following are the several preparations obtained from Peru-
vian bark:—
   1.  Cinchonia.   This is  a white, bitter, alkaline,  crystalline substance,
which is insoluble in Chloroform, water, or Alcohol,   Its salts, the Acetate,
and Disulphate of Cinchonia, are also white, crystalline bodies, and are much
more  soluble than the pure alkaloid.   They are used as substitutes for Qui-
nia, and its salts, in doses of from one to four grains, three times a day.
   2. Sulphate of Quinia.  Quinice Sulphas.  Pure Quinia is  seldom used on
account of its insolubility; but in the form of a salt with some acid, as the
Sulphate, Acetate, Muriate, &c, it is a common remedy.  The Yellow bark
is generally employed in the preparation of Quinia or its salts.   Sulphate of
Quinia, is in snow-white, thread-like, satiny crystals, without odor, but pos-
sessed of a very bitter taste,  and  soluble  to a certain extent  in alcohol or
water, but completely so on the addition of  a  few  drops of  Sulphuric Acid.
It is febrifuge, tonic, and antiperiodic, and is very useful in all febrile dis-
eases, acute rheumatism, neuralgia, dyspepsia, debility, epidemic diseases, and
every disease characterized by  periodicity.  It should not be used when there
is irritation or inflammation of the stomach, or when symptoms of nervous
irritability, wakefulness, or restlessness, are present in  fevers.   These must
first be  overcome.  In  some persons its use causes headache,  sickness, or
irregular action of  the bowels, which effects may  be  generally obviated, by
combining it with  Sulphate of Morphia, Extract  of Stramonium,  or  both.
Large doses produce many unpleasant symptoms.  The evil results following
large doses or the  injudicious  administration  of Quinia, has  caused  many
persons to object to it as a medicine.   This is wrong.   Quinia is a safe and
very superior remedy, in proper hands.    As well might we  reject all active
and useful agents, because, when  improperly used, they produce deleterious
consequences.   Again, the Quinia, especially that imported into the Western
States for many years past, has  been much adulterated with agents calcula-
ted to cause the mischief attributed to  the  salt;  and,  it must also be remem-
bered, that many of the symptoms following the use of Quinia, are the legit-
imate results of disease itself, as an enlarged spleen, a deranged condition of
the nervous system, &c; or, are the deplorable consequences of a combined
mercurial  treatment, which  has been  and still  continues to be a common
practrce in many parts of this  country.
   Quinia may be used in all  diseases connected with an enfeebled state of
the system,  and especially in the debility attending convalescence from moM 
 

 
 
MATERIA  MEDICA.
681
 acute and chronic diseases; it is not so useful in anemia  or chlorosis as the
 preparations of Iron.   Its dose is from half a grain to three grains, repeated
 every one, two, or four hours, as the urgency of the case may require.   Ten
 grains of Sulphate of Quinia dissolved in half a fluidrachm of Elixir of Vit-
 riol, and added  to a fluidounce of water, forms a very  excellent solution,
 which may be given in doses of twenty  drops,  every hour or two, in a little
 Water, aromatic syrup, or wine.   A solution is frequently made  by adding
 equal parts of Sulphate of Quinia and Tartaric Acid to any desired quantity
 of water, and apportioning the dose according to the strength of the solution.
 Externally, a solution of Sulphate of Quinia, forms a valuable application to
 indolent ulcers,  bubos, chancres, and chronic mucous inflammations.   The
 Acetate, Muriate, Phosphate, and Citrate  of Quinia, possess analogous prop-
 erties, in similar doses, but are not  usually adopted in the practice of this
 country.
  3.  Valerianate of Quinia.   Quiniae Valerianas.   This salt is a combina-
 tion of Quinia with Valerianic Acid.  It is in white, satiny, acicular crystals,
 having the unpleasant odor of Valerianic Acid, soluble in alcohol,  and partly
 so in ,water.   It loses its strength upon exposure to the atmosphere, the
 Valerianic Acid  gradually evaporating from it.   It is tonic, febrifuge,  and
 sedative, and is recommended in  headache  of a periodic character, and in
 febrile and other diseases,  to relieve  wakefulness, restlessness, or nervous
 irritability; the dose is from half a grain to two grains, as often  as required.

  PHOSPHORUS.  This  is a colorless or yellowish, translucent, flexible
 and wax-like substance, prepared from bones; it is tasteless, has a strong,
 peculiar, garlicky odor, and is to a  certain extent soluble in alcohol, ether,
 and the oils; heat aids  its solution.  It is very inflammable, burns when
 exposed to the air, on which account it should  be kept covered with water.
 It is apt to cause inflammation of the stomach and death, when  swallowed
 in substance, on  which account it should always be administered in solution,
 and even then its effects must be closely watched.  The following is a good
 formula for its internal administration:—Take of Phosphorus, cut in pieces,
 four parts;  Ether, two hundred parts; mix, and let it stand in a dark place
 for a month, keeping it well stopped; then  add one hundred parts of Oil
 of Cinnamon, and mix thoroughly together.   The dose is from ten to fifteen
 drops, every three hours, in some mucilaginous fluid.   Keep the  mixture
 well  closed  to prevent the evaporation of Ether.   Phosphorus  has been
 recommended in the impotence of old and  debilitated persons, in dropsy,
 typhus fever, marasmus, amaurosis, paralysis, mania, and in extreme pros-
 tration of the vital powers.   Emetics, with  copious draughts of  water and
 magnesia, are the antidotes to it when taken in substance, or in a  poisonous
 dose.

  PINK ROOT.  Spigelia Marilandica.   This is a perennial herb growing
 in dry rich soils  in the Middle and Southern States.  The root is  yellowish-
 brown  externally, in small, numerous, crooked, and wrinkled fibers, has a
 faint odor, and a sweetish-bitter taste.  It is an anthelmintic, and is much
used to remove worms in children, in doses of from five to twenty grains o*
 the  powdered root, for a child two or three years old;  or a fluidounce  or
two of a strong infusion.  Large doses purge,  and produce narcotic symp-
 toms.  The  dose for an adult is  one or two  drachms twice a day for several
successive days, and then followed by a cathartic.

  PIPSISSEWA.  Chimaphila  Umbellata.  This  is  a small evergreen 
682
AMERICAN FAMILY  PHYSICIAN.
perennial herb,  common  in the woods of the  United States,  and is also
known by the name of Prince's Pine.  The herb is diuretic, tonic, alterative,
and astringent.   It has been used in scrofula, chronic rheumatism, dropsy,
affections of the  kidneys, catarrh of  the bladder, &c.  It lessens the lithic
acid in the urine.  Dose of the decoction, from one to four fluidounces ; of
the extract, from ten  to twenty grains, three  or four times a day.

  PLANTAIN.   Plantago Major.  This is  a well known  perennial herb,
common to Europe and America.   The tops and roots in strong decoction,
have  been  highly recommended  in syphilitic, mercurial,  and scrofulous
diseases, in  the dose of from two to four fluidounces, three or four times a
day.  It is likewise reputed beneficial in excessive menstruation, leucorrhea,
hematuria, diarrhea, dysentery,  and  piles.   The juice taken  internally  in
doses of a fluidounce every hour, has been  advised as an  antidote to the
bites of  venomous serpents, spiders,  and insects; it must,  likewise, be ap-
plied to  the wound.  Externally, the bruised  leaves, or an ointment made
with them, is useful  in wounds, ulcers, ophthalmia, salt-rheum, erysipelas,
and some other affections of the skin.

  PLEURISY ROOT.   Asclepias  Tuberosa.  This is a perennial plant,
common to this country.   The root is white and fleshy, and when dried has
a bitterish, not unpleasant taste, and is readily powdered.  In  warm infu-
sion or  decoction, it  is diaphoretic, expectorant, and  carminative, without
stimulating, and  is useful in febrile diseases, pleurisy, inflammation of the
lungs, acute dysentery,  acute rheumatism, &c.   A warm  infusion of equal
parts of Pleurisy  Root,  and Wild  Yam Root, is very efficient,  in flatulency
and colic.  And two parts of Pleurisy Root, in powder, mixed with one part
of Unicorn  Root, will be found of much service in cases of falling of the
womb caused by congestion of that organ; it may be given in doses of from
thirty to sixty grains, three or four times a day.  Dose of the powder, from
twenty to sixty grains, three or four times a  day;  of the decoction or infu-
sion, from two to  four fluidounces, every hour  or two, until free perspira-
tion is induced.
  Asclepidin is the concentrated  preparation obtained  from the root;  it is
obtained by distillation of the alcohol from  a saturated  tincture  added  to
water.   It  possesses all the properties of the root, in  doses of from one  to
five grains, three  or four  times a day.  Combined with equal parts of Ale-
tridin  and Alcoholic Extract of Black Cohosh, it forms a valuable pill for
various derangements of the uterine functions.

  POISON HEMLOCK.   Conium Maculatum.  This is a" biennial,  um-
belliferous  plant, a native, of Europe and Asia, and  naturalized in  this
country.  The leaves and "seeds are the parts used.  The leaves when dry
are dark-green in color, with a powerful narcotic odor, and a bitter, disa:
greeable taste?   The  seeds are of an orange-gray color,  faint odor, and a
taste similar to that of the leaves.   The whole plant  is a poisonous narcotic;
and  its best form of  administration is that of  the  inspissated juice,—the
extract  is worthless.  It promotes  sleep;  lessens inordinate action of the
heart,  when this organ ia enlarged; affords relief in the neuralgic pains
attending cancerous diseases; and is very useful in  scrofula, goitre, and all
tuberculous affections, either alone, or conjoined with  the Iodide of Iron.
All affections attended with an excited or excitable condition of the circu-
lation, will  be ameliorated  by its  employment.  The  venereal  appetite  is
lessened by its use.   The dose of the inspissated juice is from half a grain 
MATERIA  MEDICA.                       683
 to two  grains, three or four times a day.  The leaves may be used as a
 poultice to painful tumors, ulcers, &c.   The fresh leaves made into a satu-
 rated tincture with ether, then filtered, and the ether allowed to evaporate,
 form a rich dark-green ethereal extract, which  may be used in doses vary-
 ing from one-sixteenth of a grain  to one-half.  As a  narcotic and resolvent
 poultice the leaves  of another  plant,  the Cictjta  Maculata or Water
 Hemlock, are sometimes  substituted for the above; it is more powerful
 than the Conium.

   POISON OAK.   Rhus Toxicodendron.   This is a creeping shrub commo
 to this country,  the leaves of which  possess medicinal properties.  The
 Poison Sumach, or Poison Ash, Rhus Venenata,  and the Poison  Vine, or
 Poison Icy, Rhus Radicans, possess similar virtues; the R. Toxicodendron
 and R. Radicans, are vines or creeping shrubs; while the R. Venenata  is
 a  small tree, sometimes,  but  erroneously, called Poison Elder, and  Poison
 Dog-wood.  These vines grow in woods, fields,  and along fences, and yield
 a  milky juice when  wounded,  which gradually grows black.  The fresh
 leaves  are the parts  used, and their best form for use is that of a saturated
 tincture, which should be preserved in well-corked vials.   It has  been
 successfully used in  paralysis of the lower half of the body, of the bladder,
 and of the rectum,  in chronic rheumatism, cutaneous diseases, and some
 diseases of the eye.   Dose  of the tincture, from  five to ten drops, three
 times a day.  Large  doses are dangerous.  The Rhus Pumilum is consid-
 ered the most poisonous plant of this genus.   These  plants  produce vesi-
 cation and even febrile symptoms when in contact with some persons—and
 even the  emanations from  them  are said to produce the same effects on
 certain constitutions.  (See Poisons.)

   POKE.  Phytolacca Dccandra.   This is a well  known  perennial plant,
 eommon to nearly all parts of the United States, and is also known  by the
 names of Garget,  Scoke, Pigeon-berry, &c.  The root, leaves, and  berries,
 are the parts  used.   Poke is  emetic and cathartic, in doses of from twelve
 grains to half a drachm, being, however, rather slow in its action.  Large
 doses occasion prostration, with  hyperemesis or hypercatharsis, a peculiar
 tingling feeling over the body, and  other  alarming  symptoms.  In small
 doses, say from  two  to six grains, it exerts an  alterative influence which
 renders it valuable in syphilis, rheumatism, scrofula, diseases of the skin,
 &c.  Roasted in hot ashes until  soft, and  then mashed and  applied as a
 poultice, the  root is  unrivalled in  felons and tumors  of various kinds.  It
 discusses them rapidly, or, if too  far advanced  hastens their  suppuration.
 The leaves in warm fomentation  form  a valuable application in  painful
 piles.  The  inspissated juice of the leaves,  in doses of  from one to five
 grains, three times a day, is very efficacious in  syphilis, chronic rheuma-
 tism, and pains in the bones from syphilis.   Externally it.has been  recom-
 mended as an application  to  indolent  ulcers,  and  cancer.   A saturated
 tincture of the leaves  has been successfully employed in chronic rheumatism,
and in  syphilitic diseases, in doses of one or two teaspoonfuls, two, three,
or  four times a day.  An  ointment made  by adding one drachm  of the
powdered  leaves,  or  root, to one ounce of lard, has been used as an appli-
cation to ulcers, porrigo, itch, scald-head, &c.

  POMEGRANATE.  Punica Granatum.  This  is  a beautiful shrub, a
native of Syria, Persia, the warm  parts of Europe, West Indies, &c. ^ffhe
bark of the root, and the  rind of the fruit are the parts used.   The bark of 
684
AMERICAN FAMILY PHYSICIAN.
 the root is of a grayish-yellow color externally, with green  specks, yellovf
 internally, and brittle.   The  rind of the fruit  is brown externally, yellow
 internally, hard, brittle, inodorous, but of a very astringent, bitter taste.
 A decoction  of these is astringent,  and may be used in all cases where
 this class of agents is  indicated.  Its principal employment, however, ia
 for the expulsion of tape-worm; two ounces of the bark are steeped in two
 pints of water for twelve hours, then  the whole boiled down to one pint,
 strained, and given in  wineglassful doses every two hours, until the whole
 is taken.  It usually causes  several stools, an  increased flow of urine, or
 nausea and vomiting.  The doses usually require  to be taken for several
 successive  mornings before the whole of the worm passes away.   Laxatives
 should be  taken from time to time.  It is said to act with the greatest cer-
 tainty when  the joints  of the worm come away  naturally.

   POTASSA.  This is used in  medicine under the name of Caustic Potash,
 or Hydrate of Potassa.   It  is  obtained in the form of cylindrical sticks, or
 in flattened fragments,  with an alkaline odor and taste; it attracts carbonic
 acid  from the atmosphere, and  is soluble  in  water or  alcohol.  Caustic
 Potash is  very corrosive, rapidly destroying the soft tissues with which it
 comes in contact, causing considerable inflammation, followed ultimately by
 the separation of a slough.  In  using it, the caustic  rod must  be  covered
 with paper  to protect  the  finger, and care must be taken to  prevent it
 from spreading on the  integuments around  the part to be acted on; in ap-
 plying it, one end of  the  rod is moistened, and gently rubbed over the
 affected part.   It is generally applied to the destruction of cancers,  tumors,
 &c, and to  unhealthy or malignant ulcers.  Acids  combine with it and
 render it harmless.  Among the preparations of Potassa used in medicine,
 are the following:—
  1. Bicarbonate of Potassa.  Potassse Bicarbonas.   This is  a well-known
 salt under the  name of saleratus; but the pure salt is in colorless, transpa-
 rent crystals, inodorous, of  a slightly alkaline taste,  and  soluble in water.
 It is  antacid,  antilithic, and  diuretic, and is  generally preferred to the
 carbonate,  being  less irritating  and unpleasant.  The  dose  as an  antacid
 and  antilithic is  from five  to  twenty grains;  as a diuretic, one  or two
 drachms.
  2. Bichromate of Potassa.  Potassae Bichromas.   This salt is in  orange-
 red, prismatic  crystals, having a cooling and bitter  taste, and soluble in
 water.  It  is a caustic and  irritant, and has been used  in a saturated solu-
 tion, as an  application  to indolent ulcers, warts, piles, tumors, &c.   From
 thirty  to sixty grains may be dissolved in a fluidounce of water.
  3. Bitartrate of Potassa.   Potassae Bitartras.  This is generally known
 as Cream of  Tartar.  It is refrigerant, diuretic, and  cathartic.   Dissolved
 in water, and sweetened with sugar, it forms an agreeable refrigerant drink
 in fevers.  Combined with  sulphur, it is used as a laxative and alterative,
 and is often given  in some  diseases of the skin.  In large doses it causes
 watery stools and an increased discharge of urine, on which account it is
 much employed alone,  or with other agents, in  dropsical affections.  The
 dose as a cathartic is foom two  to six drachms ; as a laxative, one or  two
 drachms.  In dropsy it may be given in doses of from one to three drachms,
 in water, several times  a day.
  4. Carbonate of Potassa.   Potassae  Carbonas.  This  salt when  impure
 forms the ordinary Pearlash of Commerce.   When pure it is known by the
ancient name, Salt of Tartar.  It is in small, white, opaque grains, having a
caustic, alkaline  taste,  and  deliquesces on exposure to  the air;  it  is very 
MATERIA MEDICA.                       685
Boluble in water.   In large doses it is poisonous; and its  proper antidotes
are vinegar, lemon-juice, or sweet oil.  In  medicinal doses, it is antacid,
antilithic, and diuretic.   It has  been used  in urinary  affections attended
with lithic acid deposits, in the dose of seven grains, repeated  five times a
day.  It has also  been used in dyspepsia with acid stomach, dropsy, jaun-
dice, &c.  Externally, it has been used in lotion or ointment, in some skin
diseases; two or three drachms being added to a pint of water, or, from  ten
to sixty grains rubbed with an ounce of prepared lard.
  5. Chlorate of Potassa.  Potassae  Chloras.  This is  a w.hite crystalline
6alt, in pearly, four or six-sided  rhomboidal plates,  permanent in  the  air,
and soluble in water; it has a cooling, saline taste.  It is  refrigerant and
diuretic, and is said to give a  bright scarlet color to  the venous blood, and
to pass unchanged into  the urine.  It has been  beneficially used in scurvy,
syphilis, liver affections, cholera and malignant  fevers ;  its dose is from  ten
to thirty grains.  The solution made by dissolving a drachm of the salt in
four fluidounces of water, is useful  as a mouth wash in cancrum oris, and
erysipelatous inflammation of the mouth and fauces,  occurring in black
tongue.  It lessens the  fetor and salivation in cancrum  oris, and promotes
granulation.
  6. Nitrate  of  Potassa.  Potassas  Nitras.  This  is  a well-known salt,
under the names of Saltpetre or Nitre.  In large doses  it is  an irritant and
cathartic, and produces  alarming symptoms.   No antidote is known to its
more serious effects; the  best course  is to administer  mucilaginous diu-
retics in large quantity, opiates, &c, to allay pain and irritation, and stim-
ulants  to  obviate prostration.   It  is usually employed as a diuretic,  in
doses of from ten to  sixty grains, and as a  sedative refrigerant, in doses
of from ten to twenty grains.   It should always be well diluted with water
before swallowing it.  It has been used in fevers, acute rheumatism, inflam-
matory diseases, dropsical affections, and active hemorrhages.  Paper, sat-
urated  with a  solution  of Nitre,  dried, burned, and  the  nitrous fumes
inhaled, is said to have relieved spasmodic asthma.  When too long contin-
ued, its use occasions pain in  the stomach.
  7. Sesquicarbonate  of Potassa.  Potassae  Sesquicarbonas.   This  is  the
name given to the Vegetable Caustic of the  present day, which differs ma-
terially from that formerly made, being milder and less severe in its action
Whether it is a true Sesquicarbonate  remains yet  to be determined.   Il
forms a white powder, having an alkaline taste and odor, rapidly attracting
moisture from the atmosphere, and is very soluble in water.  It should be
kept in green glass bottles, and well corked.   The original  Vegetable Caustic
is much more severe in  its action, and is prepared by evaporating a strong
ley of Oak or Hickory  ashes  to dryness, powdering it,  and  keeping it well
Becured in vials.   It forms  a  dingy-gray, or  greenish, impure  Caustic
Potassa, and is very deliquescent.   These  preparations  are  escharotic,  and
are  used  as external  applications  to cancers, indolent ulcers,  fungous
growths, chronic inflammation of mucous  surfaces, fistulas, &c.  They  are
less painful than Caustic Potassa, excite but little inflammation, and have a
very feeble action on healthy  tissues.
  br.  Solution of Potassa.  Liquor Potassae.   This is a clear, transparent,
caustic fluid, of an  alkaline odor and taste,  and which should be  kept in
green glass bottles, thoroughly corked, as it acts on  white flint glass,  and
absorbs carbonic acid from the atmosphere.  It is used  as an antacid, anti-
lithic, and  diuretic.   In  scalding of the  urethra from gonorrhea, a*nd in
combination with ten  or  twelve drops of laudanum,  it will  give  prompt
relief.  When too long  used it injures the stomach.   The dose is from  ten 
686
AMERICAN FAMILY  PHTSICIAN.
to thirty drops in sweetened water or mucilage, repeated two or three times
a day.   If not well diluted, it will soon impair the stomach ; the antidotes
to it, when taken  not sufficiently  diluted, are  lemon juice, vinegar,  or
sweet oil.

  POTASSIUM.   This is  a soft, bluish-white metal, which  forms the
Alkali Potassa, by the action of oxygen.  There are several preparations of
it used in medicine, among which are the following :—
  1. Bromide of Potassium.  Potassii Bromidum.   This is a  colorless salt,
in cubic or quadrangular crystals, having a pungent or salt-like taste, and
being very soluble in water.   It is considered alterative and resolvent, and
has been used in enlarged spleen, scrofula, and secondary syphilis, in doses
of from three to ten grains, three times a  day, iu pill or solution.  The
ointment, made  by adding  from two scruples to two drachms of the Bro-
mide with an ounce of lard, is said to be efficient in  goitre, and  scrofulous
affections, in conjunction with its  internal  use.
  2.   Cyanuret  of Potassium.  Potassii Cyanuretum.   This is a  white,
amorphous salt, deliquescent in moist air, soluble in water, having a bitter-
almond odor and  taste.  When of a yellow color, it contains iron.   It is
poisonous, acting  precisely like Prussic (Hydrocyanic) Acid.  It has been
proposed as  a substitute for this Acid, in  doses of  one-eighth of a grain,
dissolved in distilled water.   It acts  as  a sedative  and  antispasmodic.
relieving cough, asthma,  hooping-cough,  and  morbid irritability  of the
stomach.
  3. Iodide of Potassium.   Potassii  Iodidum.   This  salt  forms in white,
opaque, cubic or quadrangular crystals, having a feeble odor of Iodine, and
a sharp, saline taste.   They are deliquescent in moist air, freely soluble in
Alcohol, and in about two-thirds their weight  of water.   They are  very
liable to adulterations, and the salt is sometimes erroneously called Hydrio-
date of Potash.  Iodide of Potassium is  an irritant in large doses,  pro-
ducing many unpleasant symptoms.  In  medicinal  doses,  it is alterative
and diuretic, and has  been found very efficacious in  goitre,  scrofulous dis-
eases, rheumatism,  secondary syphilis, affections of the  liver, enlargement
of the heart, derangement of the functions of the womb, and all tubercu-
lar diseases.  When taken for a length of time, it is apt to cause salivation,
and sometimes a catarrhal affection, &c, which  go off upon the suspension
of the medicine.   The dose is from two to ten grains;  it should always be
given in the state of  a well-diluted solution, and on  account of  its numer-
ous chemical relations with other bodies,  ought  to be  prescribed in the
simplest possible shape.
  4.  Sulphuret  of  Potassium.  Potassii Sulphuretum.  This preparation,
also called Liver of Sulphur, and  Hepar, is a mixture of Sulphur and
Potassium.  It is a brittle solid, of a liver-brown  color,  inodorous, except
when moistened with water, which disengages an  offensive gas, and of an
unpleasant, alkaline  taste ;  it is  soluble in water.  Large  doses  produce
dangerous symptoms.   In doses of from two to ten  grains,  three  or four
times  a day, in solution with syrup, or given  in pill-form with liquorice, it
is said to increase the pulse, as well as the  mucous secretions. It has been
used in chronic rheumatism, catarrh, asthma, hooping-cough, &c.   Exter
nally, ten to thirty grains, dissolved in a  fluidounce  of water, has  been
found efficacious in scabies, liver-marks, morph, and other skin diseases.
       •
   PRICKLY  ASH.   Xanihoxylum  Fraxineum.   This is a shrub, common
to the United States, the bark and berries  of which  are  used in medicine. 
MATERIA  MEDICA.
687
 The bark is met with in quilled fragments  of various sizes, of a grayish-
 white  color, externally, and  occasionally armed with prickles;  it is light,
 easily  powdered, and nearly inodorous, and having an acrid, bitterish taste.
 The capsule of the fruit or berries are about two or three lines in diameter,
 brownish, and  covered  with excavated dots; they  have a faint,  aromatic
 odor, and a  warm, pungent, peculiar, aromatic taste, and contain the medici-
 nal  virtues of the fruit.   Prickly-Ash bark is  stimulant, tonic, alterative,
 and sialagogue, and has  been efficacious  in chronic rheumatism, syphilis,
 liver affections, colic, scrofula, and paralysis of the tongue and mouth.   It
 will produce salivation,  when given in small doses, and combined with blue
 flag and mandrake.  Externally, it forms an excellent stimulating applica-
 tion to indolent  and malignant ulcers.   A  dark-greenish-black  ethereal
 oil has been obtained from the bark, possessing uts virtues in a concentrated
 degree; it is soluble in alcohol, ether,  and alkaline solutions.  Dose  of
 powdered Prickly-Ash bark, from ten to thirty grains, three times a day.
   Prickly-Ash Berries are stimulant, carminative, and anti-spasmodic, act
 ing  especially on  mucous  tissues.   Combined with Poke-Berries, in the
 form of tincture, they are invaluable in chronic rheumatism, and syphilitic
 diseases.  The  tincture  of the berries is also useful  in all nervous diseases,
 spasms of the bowels, flatulency, and in diarrhea.   In  tympanitic disten-
 sion of the bowels, during peritoneal inflammation, it is a safe and superior
 remedy, when used internally, and as an injection.   It  has also been used
 with great benefit in Asiatic Cholera.   An oil is prepared from the berries,
 of a dark-brown color, possessing all their virtues  in a concentrated degree.
 One pound  of  the  berries yields about four fluidounces  of the oil.   Dose
 of the  tincture  of the berries, from ten drops to a fluidrachm,  as often  as
 required, in sweetened water; of the  oil, from  two to ten drops on sugar,
 in mucilage or in tincture.
   Xanthoxylin, is the name given to  the blackish  oleo-resinous principle
 obtained from the  bark, by adding a saturated tincture to water, and distil-
 ling-off the alcohol; it is  soluble in  ether  or  alcohol, and has a peculiar,
 bitterish taste, succeeded by a persistent pungency.  It possesses stimulant,
 tonic, alterative, and sialagogue  properties; and is useful in  chronic rheu-
 matism, dyspepsia with distress after eating, in low typhoid conditions, and
 in debility following  long  protracted  or  exhausting diseases.  Its dose ia
 from one to three grains, three or four times a day.

   PRICKLY  ELDER.   Aralia  Spinosa.   This  tree is found in  the
 Southern and Western States, growing in low, damp woods, and known  by
 the names  of Toothache Tree and Southern Prickly-Ash.  The bark is  the
 part used; it is  thin, grayish externally, yellowish-white within, beset with
 prickles, having  a peculiar, aromatic  odor, and a bitterish, pungent, acrid
 taste.  It is  stimulant, diaphoretic, and alterative; the fresh bark is emetic
 and cathartic.   The tincture  or powder has been of service in chronic rheu-
 matism, syphilis, and in some diseases  of the skin.  In the cholera of 1849
 —50, it was much used, in cases where cathartics were required, but where
 their action was very difficult to control, in the following combination:—Take
 of Compound Powder of Jalap one  drachm, Prickly Elder  bark, powdered,
 one drachm, Compound  Powder of Rhubarb two drachms; mix,  and give
 in half-teaspoonful doses, every half-hour or hour, until it operated.  In  no
 case  in which it was given, did  it produce a tendency to looseness or chol-
eraic discharges.    The bark is a powerful sialagogue, and  is valuable  in
diseases where the mouth and throat  are  dry and parched, as a very small
portion of the powder will cause a moisture, and relieve  difficult bre.athing*
also useful in sore throat. 
688
AMERICAN FAMILY PHYSICIAN.
  PRIVET.  Ligustrum Vulgare.   This is a small shrub growing in Europe
and the United States, also known by the name of Prim; the leaves are tho
parts used.  They are astringent, and useful in chronic diarrhea and dys-
entery, summer-complaint of children, ulceration of the stomach and bowels,
and diabetes.  They may be used either in  decoction or powder;  from thirty
to sixty grains of  the latter, three times a day; or from two to  four fluid-
ounces of the former.  The decoction  is also efficient as a gargle in ulcers,
of the  mouth and throat, and as  an injection in gleet, ulceration of the
bladder, leucorrhea, and ulcerated  ears with offensive discharges.

  PUMPKIN.  Cucurbita Pepo.  The seeds  of this well-known  plant are
mucilaginous and diuretic; they are used in infusion, the seeds being placed
in water without bruising them.  The infusion  may be used in strangury,
scalding  of  urine,  and other urinary affections; also  in inflammation of the
stomach  and  bowels, and  in fevers;  it may  be drank freely.  An Oil  of
Pumpkin seeds  is  obtained  by expression, which in doses  of from  six to
twelve  drops several  times a day, is said to be a most certain and efficient
diuretic, giving quick relief in scalding of  the urine, spasmodic affections of
the urinary passages, and  has cured gonorrhea.  The  oil  is likewise em-
ployed to remove tape-worm.

  PYROLIGNEOUS ACID.   Acidum Pyroligneum.   Acidum Aceticum
Empyreumaticum.   This is an impure acetic  acid  obtained  from wood  by
distillation.   It is  a brown, transparent liquid, having a strong smoky smell.
It is stimulant and antiseptic, and is used as a loca*b application for arresting
or preventing  sloughing, for cleansing old sores, abscesses, &c;  also used
in burns, scalds, ring-worm, scald-head, excoriated nipples, and as a gargle
in inflamed  and ulcerated sore throat, and malignant scarlet fever.  Inter-
nally, it is useful in all cases where an  antiseptic is indicated, in  doses  of
from ten to thirty drops.  The  pyroligneous  tar forms a valuable irritating
plaster.

  QUASSIA.  Picrcena Excelsa.   This is  a  tall tree growing in Surinam
and some of the West India Islands.   The wood is the part used; it is  in-
odorous and intensely bitter.  Quassia is tonic, febrifuge and anthelmintic;
it has  been used  in intermittent  and  remittent fevers, dyspepsia, debility
during convalescence from exhausting diseases, and for worms. It preserves
animal matters from  decay, and acts as a powerful narcotic  poison on flies
and  other insects.  Dose of the powder, thirty  grains; of the infusion or
decoction, from  one  to three fluidounces;  of  the tincture, one or two flui-
drachms; of the  extract,  from  two to  ten grains.   An injection of  the
decoction will remove the pin or thread worms.

  QUEEN OF  THE  MEADOW.   Eupatorium  Purpureum.    Likewise
known by  the  names of  gravel-root,  trumpet-weed, &c.   It is a perennial
herb, common to the country in low, swampy places, the  root of which is  the
part used; it consists of a blackish woody head from which  proceed numer-
ous long fibres of  a dark brown color.   Its smell resembles old hay, and its
taste is  aromatic,  slightly  bitter and astringent.   It is  a valuable diuretic,
stimulant, and tonic,  and is useful in dropsical affections, gravel, strangury,
all chronic diseases of the urinary organs,  hematuria, gout and rheumatism.
It is generally used in decoction, from two to four fluidounces, three or four
times a day.
   Eupurpurin is the name given to a thick, dark greenish-brown oleo-resin 
MATERIA  MED1CA.                       689
prepared from the root by adding the tincture to water, and distilling off the
alcohol.  It has a faint smell, and  a disagreeable taste, and is  soluble in
ether or alcohol.   In  three-grain doses, repeated  three  or four times a  day,
it is an active diuretic, and may be used alone, or in combination with Castile
Soap, in all diseases in which the root is of service.

  QUEEN'S ROOT.   Stillingia Sylvafica, more commonly called Stillingia.
This is a perennial herb common to the sandy  soils of the Southern States,
anil which yields a milky juice on being wounded.  The root is large, thick,
and woody, has a  peculiar odor, and  a bitter,  acrid, persistent  taste.   In
large doses it is emetic and cathartic, producing, in many instances, a pecu-
liar, disagreeable, burning sensation in the stomach, or in  some part of the
intestines, with more or less prostration of the system.  In small doses  it is
an alterative of much value in  scrofulous,  syphilitic, rheumatic, liver, and
Bkin diseases;  or wherever an alterative is indicated.   It has also been ben-
eficial in the cure of  chronic  laryngitis and  bronchitis, and in leucorrhea.
Tho dose is from ten to twenty grains of the powder;  from  thirty to sixty
drops of the tincture; and  one or two fluidounces of the decoction.   The
oil obtained from the  root is very penetrating, acrid and stimulating, and is
used externally, with  other agents, in various diseases.  The root loses its
virtues by age.

  RED CEDAR.   Juniperus Virginiana.  This is a well-known evergreen
tree common throughout the United States.   The leaves are  emmenagogue,
diuretic, diaphoretic, and anthelmintic, and  are useful in  suppressed men-
struation, chronic rheumatism, scalding of urine, and derangements of the
kidneys and bladder.   The oil makes a valuable stimulating  application for
rheumatic pains,  bruises, &c.  Dose of  the  powdered  leaves, one or  two
drachms; of the infusion, from one to four table-spoonfuls;  of the oil, from
five to fifteen drops.   The excrescences produced  on  the small branches by
the puncture of an insect, are called Cedar Apples, and are very useful when
recent, as a vermifuge, in  doses of from  ten to  twenty grains, three times a
day.

  RED CIIICKWEED.  Anagallis Arvcnsis.   This is  an annual plant
growing in Europe and this country, bearing  small scarlet flowers in June
and July.   The leaves have  been  recommended in hydrophobia, dropsy,
mania, epilepsy, delirium, and nervous diseases  generally.   In the form of
poultice, the fresh plant, bruised, forms a good application  to old and ill-
conditioned  ulcers.  Its  precise properties  and mode of action when taken
internally, are not fully known.

  RED CLOVER.   Trifolium Pratense.  This  is a  well-known  biennial
plant, common to the  United  States.  A strong decoction  of the blossoms
evaporated to an extract is said to be an excellent remedy  in ill-conditioned
and malignant ulcers, cancers, and deep, ragged, indolent sores from burns.
It possesses a peculiar soothing property, proves an efficacious detergent
;md promotes a healthful granulation.

  RED ROOT.  Ceanothus Americanus.   This shrubby plant is found  in
all parts of the United States, and  is also  known  by the  names of  New
Jersey Tea, and Wild  Snowball.  The bark of the root has  a taste and  odor
resembling those of the peach leaf;  it is astringent, expectorant, sedative,
and antispasmodic.  A table-spoonful of the decoction, three or four timea 
690                 AMERICAN FAMILY PHYSICIAN.
 a  day is useful in gonorrhea, after  the  inflammatory symptoms have sub-
 sided, dysentery,  diarrhea, asthma,  hooping-cough, chronic bronchitis, &c.
 The decoction is also useful as an injection  in  gleet, and leucorrhea, and as
 a wash or gargle in all ulcerations of the mouth and throat.

   RED  ROSE.   Rosa  Gallica.   The petals  of the red rose are  slightly
 tonic and astringent; a decoction of  them has been used in bowel-complaiuts
 passive hemorrhages, and in excessive  mucous discharges.   It is more com-
 monly employed as an application in chronic inflammations of the eye.  The
 confection  of roses is much used for the purpose of giving medicines in pill
 form.  Rose water is distilled from  the  petals of the Hundred-leaved rose
 Rosa Centifolia; it is much used in collyria, and  lotions.

   RED  SAUNDERS.   Pterocarpus Santalinus.   This  tree is a native of
 Ceylon, the wood of which has a peculiar, feeble  odor a  slightly astringent
 taste, and  imparts a red color, to spirituous preparations but not to water.
 It possesses tonic and astringent properties, but is  seldom  employed unless
 for coloring tinctures, &c.

   RESIN  or ROSIN,  Resina.   After the oil has been distilled from the
 turpentine of the pine trees, a solid  substance  is left, which is the ordinary
rosin of  commerce.  It is seldom given internally, though  it will be found
advantageous in weak  stomachs, and  in bleeding  piles, in doses of from
twenty to sixty grains of the powder, in molasses or syrup.  Its principal
use is to  give consistency and adhesiveness to plasters, and  ointments.   The
vapor from resin, when heated, has been inhaled in chronic bronchitis, and
laryngitis,  with benefit;  and the fumes from burning resin,  if received upon
the parts, will, it is said, remove the  irritation attending piles and prolapsus
ani.

  RHATANY.   Kramcria Triandria.   This is a South American shrubby
plant, the  root of which is a powerful astringent, and  has been of much
service in  excessive menstruation, passive  hemorrhages, chronic diarrhea,
chronic mucous discharges, &c; and  in decoction as  an injection in  leucor-
rhea, and gleet.   It is an  excellent  styptic in nose-bleeding, bleeding from
the cavity of an extracted tooth, or the surface of a wound, in spongy and
bleeding gums, and as a local application to falling  of the bowel.  Dose of
the  powder,  from ten to thirty grains;- of the tincture, from  one  to four
fluidrachms;  of the infusion or decoction, from one  to four fluidounces; of
the extract, from ten to twenty grains.

   RHUBARB.   Rheum Paimatum.   The  drug, rhubarb root, is obtained
from several  species  of Rheum, which  are found in various  parts of the
world, and which constitute  the  several  varieties  known  as Russian, or
 Turkey Rhubarb,  Chinese or East India  Rhubarb, and European Rhubarb
The best rhubarb ha3  a strong, peculiar odor, a peculiar, aromatic, bitter
ish taste, with a sense of grittiness, and is readily reduced to a lively yellow
powder.  It imparts its virtues to water, but more readily to proof spirit.  Rhu-
barb is cathartic, astringent, and tonic.   In doses of from ten to thirty grains,
it acts as a purgative, increasing the muscular action of the  intestines, rather
than  augmenting their  secretions, and affects the  whole  intestinal canal.
From five to ten grains act as a laxative, and are useful in cases of constipa-
tion, dyspepsia, piles, derangements  of the liver. &c.; its mildness and tonic
qualities render it peculiarly applicable to  infants, as a  laxative, especially 
MATERIA  MEDICA.
691
when enfeebled digestion and irritation of the alimentary canal are present.
In acute or chronic diarrhea or dysentery,  in  convalescence from exhaust-
ing diseases, and  in  some irritable habits where the mildest of all other
laxatives are apt to excite hypercatharsis, Rhubarb is an appropriate medi-
cine ; it  causes fecal, rather  than watery  discharges.  Its astringency  is
counteracted by the addition of Soap, or an alkali;  toasting it, improves its
astringency but lessens its purgative properties.  From one to five grains
act as a tonic.   The tincture or  syrup is  laxative in doses of one or two
drachms.

  ROCK-BRAKE.   Pteris Atropurpurea.   This is a perennial fern, com-
mon to the United States, and possessing astringent and anthelmintic pro-
perties.  A decoction of the plant, taken moderately, is useful in diarrhea,
dysentery, night-sweats, and hemorrhages; it also  forms an excellent local
application to obstinate and ill-conditioned ulcers, ulcerations of the mouth
and throat, and leucorrhea.  A strong decoction is useful as a remedy for
worms.

   ROSEMARY.   Rosmarinus  Officinalis.  This is a perennial, evergreen
shrub, native  of  the Mediterranean countries,  and  introduced  into  this
country;  the tops are the parts  used.   They are stimulant, antispasmodic,
and emmenagogue; but seldom used  in this country, except as a perfume
for ointments,  liniments, &c.   The oil is stimulant and  rubefacient, but is
seldom used in medicine; its dose is from  three to  six drops.

   ROUND-LEAVED PYROLA.  Pyrola Rotundifolia,   This is a peren-
nial, evergreen, low shrub,  common in various parts  of the United States,
bearing numerous white flowers in June.   It  is  also  known by the names
of Pear-leaf Wintergreen, Canker Lettuce, Shin-leaf, &c.  The herb is tonic,
astringent, diuretic, and  antispasmodic.  It  has been  used  in  decoction,
both externally and internally, in various cutaneous eruptions, in  cancer,
scrofula, leucorrhea, and some  diseases of the  womb.  Internally, the de-
coction, or an extract, has been used with  success in gravel, bleeding from
the kidneys, ulceration  of  the  bladder, epilepsy, and several nervous  dis-
eases. Externally, the decoction will  be found an  excellent local  applica-
tion, in sore throat, ulcerations of the mouth, indolent ulcers, ophthalmia,
&c, and  forms a  soothing poultice for boils, carbuncles, and all  painful
tumors or swellings.  One  or ten fluidounces of the decoction, or from one
to six grains of the extract, may be taken for  a  dose,  and repeated three  or
four times daily.

  RUE.   Ruta Graveolens.  This is a well-known perennial plant, possess-
ing emmenagogue, ecbolic, anthelmintic,  and  antispasmodic virtues.   In
large doses it is an acrid narcotic poison.  It has been taken by pregnant
women, and  produced dangerous symptoms of derangement of the brain,
and inflammation  of the stomach  and bowels, terminating in miscarriage.
It has been successfully used  in  flatulent  colic, hysterics, worms, epilepsy,
and some nervous affections.  A volatile oil is obtained from it, possessing
stimulating,  emmenagogue, and antispasmodic properties.  Dose of the
leaves, in powder, from ten to twenty grains;  of the  infusion, from one  to
lour fluidounces;  of the oil, from two to eight drops.

  SAFFRON.   Crocus Sativus.   This perennial plant is a native of  Asia
Minor, and is cultivated in  many  parts of Europe ; the stigmas are the parts 
692
AMERICAN  FAMILY  PHYSICIAN.
used.  There are two kinds of Saffron, the Hay Saffron, which is the best;
and the Cake Saffron, which is in flexible cakes.  Saffron has a stupefying,
aromatic odor, and a bitterish, balsamic, somewhat  acrid  taste ;  it  is best
when recent, as it loses its virtues by age ; and should be kept in well-closed
bottles.   It possesses emmenagogue and  diuretic properties, and has been
used in warm infusion in  suppressed menstruation, painful menstruation,
suppression of the lochial flow, and in febrile diseases, especially of children.
Dose of powdered Saffron, from ten to forty grains ;  of the tincture or syrup,
 ne or two fluidrachms;  of the infusion, from one to three  fluidounces.

  SAGE.   Salvia  Officinalis.   This is a  well-known  perennial, shrubby
plant, cultivated  in gardens.   The tops and  leaves  are astringent, feebly
tonic, expectorant,  and diaphoretic, with properties common to  aromatics.
The infusion is useful in flatulence connected with  debility of the stomach,
and  to check night-sweats; used warm, it causes diaphoresis, and acts as an
anthelmintic.   It is much  used as a gargle for inflammation and ulceration
of the  throat,  relaxed  uvula, &c, either  alone, or  combined  with  Alum,
Honey, Vinegar, and Sumach berries.  The infusion is also reputed to have
the  property of allaying strong sexual desires.  When used  internally it
may be taken freely.

  ST. JOHN'S WORT.   Hypericum Perforatum.   This  is a well-known
perennial plant, very common throughout the country.   The tops and flow-
ers possess astringent, sedative, and diuretic properties, arrd have been used
in infusion, in suppression of the urine, chronic urinary affections, diarrhea,
dysentery, worms, jaundice, hysterics, excessive menstruation, nervous irri-
tability, &c.  The dose of  the infusion  is one or two fluidounces, three or
four times a day.   Externally, they may be used in  fomentation, or in the
form of an ointment to dispel hard tumors, caked breasts, bruises, ecchy-
mosis, swellings, &c.  The saturated tincture may be  used for  the same
purpose.

  SARSAPARILLA.   Smilax Officinalis.  This  drug is the  root of  a
genus of climbing or trailing plants, inhabiting the  tropical countries of the
Western Continent.  Many of them are worthless ;  and  those are generally
selected which leave a pungent acrid sensation in  the  mouth and  throat,
after being chewed  for a  few minutes.  Sarsaparilla is commonly used in
infusion or syrup, as an alterative in scrofula, syphilis, chronic rheumatism,
skin diseases, and  all  other diseases in  which an alterative is required, in
the  dose of three or four fluidounces, three times a day.  The powder is
occasionally given in doses of from twenty to thirty grains.   The Honduras
Sarsaparilla is considered the best.

   SASSAFRAS.   Laurus Sassafras.  This tree  is  common to the United
States.   The bark of the root is a warm aromatic stimulant, alterative, dia-
phoretic, and diuretic ;  it is more commonly used with other alteratives, in
scrofulous, syphilitic, rheumatic, and  skin diseases.  The  pith of the ex-
tremities of the branches forms a mucilage which is useful as a local appli-
cation in acute ophthalmia, and as a demulcent drink in  disorders  of the
chest, bowels, kidneys,  and bladder.   Oil of Sassafras affords relief in pain-
ful menstruation,  and is efficacious in diseases of the kidneys and bladder;
the  dose is from two to ten drops, on sugar, or in mucilage.  It is a rube-
facient when applied externally, and is thus employed in all painful swell-
ings, sprains, bruises, rheumatism, &c. 
MATERIA  MEDICA.
693
    SAVIN.  Juniperus Sabina.   This is an  eve;green shrub  common to
  Europe, and some parts of North America.  p'he tops and leaves possess
  emmenagogue, diuretic, diaphoretic,  and  an* _telmintic  properties.   The
  warm infusion  has been used in  suppressed  nenstruation,  and for the re-
  moval of worms.   It should never be  giv a when much general or local
  inflammation exists, nor during pregnancy  is it is liable to produce  abor-
  tion, violently  affecting the stomach  am'  bowels,  and bringing  life  into
  extreme danger.   Dose of the powdered  eaves, from five to fifteen grains,
  three times a day ; of the infusion from  aalf a fluidounce to two fluidounces.
  Overdoses will  produce inflammatiot  of the stomach and bowels.   The
  powdered leaves in the form  of cerate, have been used as a stimulant to
  indolent ulcers, and to  keep up a discharge from  blistered  surfaces; and,
  mixed withv an  equal weight of  Verdigris, the  powder  has been used for
  destroying venereal warts.  The Oil of Savin may be used in doses of from
  two to five drops, on sugar, as a substitute for the infusion.

    SCAMMONY.   Convolvulus  Scammonia.  This is  a perennial plant,
  common to Turkey, Syria, Persia, &c.; the  root, when cut across, yields a
  milky juice, which upon concreting,  forms  the  gum-resin  of commerce,
  Scammony.   When pure it is light, in irregular pieces, and  easily reduced
  to powder of a pale ash-grey color, with  a greenish tint; its odor is pecu-
  liar, and its taste feeble, but followed  by acidity.   Alcohol is its best sol-
  vent.  It is very liable  to  adulteration.   Scammony is a powerful drastic
  cathartic, and is generally used  in combination with other cathartics, which
  increases their  action, while its own  harshness is lessened.   The dose is
  from five to fifteen grains.   It should  never be used when  the  stomach or
  bowels are inflamed.

   SCULLCAP.   Scutellaria Lateriflora.   This is a perennial plant common
  to the United  States, which possesses  tonic, nervine, and  antispasmodic
  properties.  It  is  efficacious in  convulsions,  St.  Vitus' dance, intermittent
  fever, tremors, neuralgia, and all nervous affections.  In delirium tremens,
  the infusion drank freely will soon produce  a  calm sleep.   The warm infu-
  sion may be drank freely, and will be found beneficial in  all  cases of ner-
  vous excitability, restlessness, or wakefulness, attending  acute  or. chronic
 diseases,  nervous  headache, mental  excitement  during pregnancy,   and
 among children whose health is impaired by teething.
   Scutellarine, is  the concentrated agent obtained from the plant, it is a
 green powder, and is obtained from the evaporated tincture by precipitation
 with Alum, and subsequent  washings.   It is a valuable tonic and nervine,
 and may  be used in depression of  the  nervous and vital  powers from  any
 over-exciting cause, as well  as in all those cases in which the herb is appli-
 cable.   It may  be  used alone, or in combination with Caulophyllin, Cypri-
 pedin, or  Alcoholic Extract of Black Cohosh.   Its dose is from one to six
 grains, three or four times a  day, or even  more.

  SENEKA.  Polygala Senega.   This is a perennial plant growing in  vari-
 ous parts of the  United States, and usually called Seneca Snake Root.   The
 root is emetic and  cathartic in  large doses; in ordinary doses, it is a siala-
 gogue, expectorant, diuretic, and emmenagogue.    It is used as  an expecto-
rant in chronic catarrh, protracted pneumonia,  croup, and asthma; as a  local
stimulant in relaxed sore throat; as a diaphoretic and diuretic in rheumatism;
and as an emmenagogue in suppressed menstruation.  It should  not be used 
694
AMERICAN FAMILY PHYSICIAN.
 in active inflammation.   1 ->se of the powder, from ten to twenty grains;  of
 the decoction, or syrup, from half a fluidounce to two fluidounces.

   SENNA.   Cassia Acutifolia.   There are several species of the Cassia plant
 which are supposed to yield the ^enna of commerce; they grow in E"ypt'
 Arabia,  India, &c.  The best kin  is the Alexandria Senna.   This druo-  ig
 cathartic, and is used in febrile  u. --eases, and whenever catharsis is desired.
 It does not depress the circulation, v ">r cool the system, but exerts a slightly
 stimulating influence.   Its action is  xerted chiefly on the small intestines
 producing loose, brown, mucous evacuations.   It enters into several cathar-
 tic preparations.   Its  nauseating taste, and tendency to occasion griping
 pains, may be obviated by the addition of ginger, cloves, cinnamon, sassafras,
 or other aromatics, as well as by sugar, manna, liquorice, &c.  It should not
 be used in piles, falling of the bowel, inflammation of the stomach or bowels
 &c.   Dose of the powder from thirty to fifty grains; of  the infusion, from
 two  to four fluidounces;  of the  tincture, from  half a fluidounce to two
 fluidounces.
                                                                     i
   SHEEP LAUREL.   Kalmia Angustifolia.  This shrub is also known by
 the name of Narrow-leaf Laurel, and is common  to most parts of the United
 States, on hills and mountains.   The Big Ivy or  Calico-bush, Kalmia Lati-
 folia, is also as common a shrub.  The leaves of these plants when taken in
 large doses produce vertigo, dimness of sight, great depression  of the action
 of the heart, cold extremities, and sometimes death.   In medicinal doses,
 they are sedative, antisyphilitic, and astringent.   Internally, a decoction or
 tincture  is successfully  used in syphilitic diseases, active hemorrhages, diar-
 rhea, dysentery, febrile and inflammatory diseases, hypertrophy of the heart,
 ophthalmic neuralgia, and jaundice.   The best form of administration is the
 saturated tincture, which may  be given in doses of from ten to twenty drops,
 every two or three hours.   It must  be used with prudence, and when the
 above  named symptoms  appear,  the  dose must be diminished, or the use of
 the remedy be suspended for a few days.  Dose of the powdered leaves, from
 five to twenty grains; of the decoction, a table-spoonful.  Applied in the form
 of an ointment,  the leaves have been  efficient in scald-head, ring-worm, itch,
 and other diseases of the skin.

  SHRUBBY TREFOIL.   Plelea Trifoliata.    This shrub is common to
 the Western States, where it is known by  the names of Wingseed, Wafer-
 Ash, &c.   The bark of the root is the part used.   It possesses tonic proper-
 ties,  and has been used  in intermittent and  remittent fevers, in convalescence
 after exhausting diseases, in debility  connected  with irritation of the stom-
 ach or bowels, in some affections of the lungs, and in erysipelas.   The extract
 may  be used in doses of from three to five grains, three or four times a day;
 the cold infusion,  in  table-spoonful doses,  every one, two, or  three hours.
 By the use of this medicine the appetite is  improved, digestion is re-estab-
 lished and strengthened,  and the stomach  will  be rendered  able to endure
 proper diet.
  Ptelein, is the name given to the Oleo-resinous principle of the crude bark,
prepared by adding to a saturated tincture, twice its bulk of water, and dis-
tilling off the Alcohol.   It forms a dark-brown,  sirupy substance,  having the
peculiar  odor of the bark, and an acrid, permanent, rather unpleasant taste,
and is soluble in Ether, and Alcohol.   It is a powerful,  unirritating tonic,
and may be used in all instances where the  bark is indicated, in doses of one
©r two grains, repeated three or four times a day. 
MATERIA MEDICA.                      695
   SKUNK  CABBAGE.   Symplocarpus Foetid'us.  This is a perennial plant
 growing in moist situations throughout various  parts  of the  United States,
 and is frequently termed Meadow Cabbage.  The root  and the seeds are the
 parts used, the latter being more generally preferred ;  by  age their virtues
 become much impaired.    In  large  doses, Skunk  Cabbage  causes nausea,
 vomiting,  headache, vertigo, and  dimness of sight.   In  small doses, it is
 stimulant,  expectorant, antispasmodic, and  slightly narcotic, and has been
 efficacious in hooping-cough, asthma, nervous irritability, hysterics, epilepsy,
 convulsions attending pregnancy and parturition, chronic  catarrh,  and pul-
 monary and bronchial affections.   Dose of the powdered root or seed, from
 ten to thirty grains, three times a day; of the infusion, one or two fluid-
 ounces; of a saturated tincture, one or two fluidrachms.

   SLIPPERY ELM.    Ulmus Fulva.   This well-known substance is  the
 inner bark of a tree common to this  country, and which is sometimes  called
 Red PI in.   It   possesses  nutritive, expectorant, diuretic, demulcent and
 emollient  properties.   As  a diuretic and demulcent it is valuable in all mu-
 cous inflammations of the lungs, stomach, bowels, bladder, or kidneys.   It
 is used in  the form of a mucilaginous drink, taken freely; coughs, strangury,
 &c, are benefited by its use;  and it is useful  in  preventing summer-com-
 plaint of infants.  Its external application  has  proved serviceable  in  many
 obstinate diseases of the skin; and, as a poultice, it is very valuable in burns,
 scalds, bruises,  ulcers,  local  inflammations,   suppurating   tumors,  fresh
 wounds, Ac, also in the excruciating pains of the testicles  which accompany
 the metastasis of mumps.   In injection, the cold infusion is valuable in diar-
 rhea, dysentery, tenesmus,  piles, gonorrhea, gleet, &c.  The powdered bark,
 sprinkled on the surface of the body, will prevent and  heal excoriations, and
 chafings, and allay the  heat and itching of erysipelas.

   SMALL SPIKENARD.  Aralia Nudicaulis.  This is  a perennial  plant,
 growing in rocky woods and rich soils,  in the Northern  and  Middle States.
 The root has a fragrant odor, and  a  sweetish, aromatic taste.  It is altera-
 tive and gently stimulant,  and has  been used  in  decoction or syrup, as a
 substitute  for Sarsaparilla,  in  syphilitic, rheumatic, and skin diseases; also
 in  diseases of tho  lungs.   Externally,  a  strong decoction  of  it has been
 efficacious  as an application  to shingles, and as a stimulating wash  to old
 ulcers.  Dose of the Decoction or Syrup, from two  to four  fluidounces, three
 times a day.  The Aralia Racemosa  Spikenard,  or  Pettymorcl,  possesses
 similar properties, and is much employed in diseases of the lungs.

   SOAP.   Sapo.  Castile Soap, either the plain  white, or mottled variety, is
 more commonly  used in medicine.  It  possesses slightly  laxative,  antacid,
 and antilithic properties, and is usually given in combination  with active ca-
 thartics, to lessen  their irritating effects.   Given alone,  or in  combination
 with Oils of Sassafras, Juniper, Spearmint, &c, it is very useful in many uri-
 nary diseases.   It is  also  of service in acid stomach.   Externally it is a
 stimulating  discutient,  and has  been used by friction, or in  the form of
 plaster, in  sprains, bruises,  and various  tumors.   A stroqg Solution of Soap
 forms a good injection in constipation, especially when  arising from hardened
 feces in the rectum.  Dose of Castile Soap, from five to  thirty grains,  in
 solution or pill-form.

  SODIUM.  Sodium  is a soft, white, silver-like  metal, which forms with
Oxygen, a Protoxide, the alkali Soda, and Hydrate of  Soda, or Caustic Soda. 
696                AMERICAN  FAMILY   PHYSICIAN.
The Protoxide is the most important oxide, as several salts are made with id,
and which are used in medicine.   Among them are the following:—
  1. Bicarbonate of Soda.  Sodse Bicarbonas. » Sometimes called Supercar-
bonate of  Soda.   It is a white powder, inodorous, and of a slightly alkaline
taste, and is soluble  in thirteen parts of water.  It is antacid and antilithic
and possesses similar properties with the Bicarbonate of Potassa, though less
diuretic, and is used in the same diseases as that salt.   The dose is from five
to sixty grains, dissolved  in water.   Soda Powders are prepared by placing
in a blue  paper, twenty-five grains of Tartaric Acid, and in a white paper
thirty grains of Bicarbonate  of  Soda.    In  using these,  they are placed  in
separate portions of water, and  dissolved. . The  solutions, to one of which
some aromatic Syrup may be added, are mixed, and the liquid drank during
the effervescence, which at once  takes place.   It forms a pleasant, cooling,
and slightly laxative draught.   The Yeast, or Baking Poicders now in such
common use, are composed of about two and a half parts of Cream of Tar-
tar, and one part, each, of Corn Starch and Bicarbonate of Soda.
  2.  Borate of Soda.   Sodae Boras.  This is the  Borax of commerce, which
exists naturally formed in several parts of the world, and is also extensively
manufactured.   It is in white, translucent, opaque, rhombic prisms, inodor-
ous, of a sweetish,  feebly alkaline  taste, and  is soluble in twelve parts of
cold water.   In  doses of from thirty to forty  grains, Borax is an excellent
remedy in nephritic and  calculous complaints, in  which an excess of Uric
Acid is found in the urine.  It exerts an influence upon  the womb, and has
been successfully used in suppressed menstruation,  painful menstruation, to
produce abortion, facilitate labor, &c, either alone, or in combination  with
other agents.   The dose of Borax is from ten  to thirty  grains, in solution.
A solution of one  drachm of Borax in  five fluidounces of water, is a good
wash for aphthous and  inflammatory  affections of the mouth and throat,
mercurial salivntion, &c.   It may be sweetened with honey or sugar.   Half
a drachm of Borax dissolved in a fluidounce  of distilled vinegar is an ad-
mirable wash for ringworm  of  the  scalp.   It is also used in several other
affections of the  skin.
  3.  Chloride  of Sodium.  Sodii  Chloridum, also called  Muriate of  Soda
and Common Salt.   This is so  well-known as to need  no  description. In
small  doses, it  is tonic, alterative, and  anthelmintic, and is useful in all
chronic diseases characterized by  paleness of the  tongue with  a white fur
upon it.  In teaspoonful doses,  taken  dry,  it often checks bleeding of the
lungs;  and used moderately, it promotes digestion, removes strumous dis-
eases, cures some form of dyspepsia, and gives tone to the digestive organs
of  weakly children, thereby correcting  the  disposition  to  generate worms.
In  spasms  of  an  epileptic or apopleetic character, the  effects of intemper-
ance, Salt and Mustard, a teaspoonful  or two of  each, given in warm water,
every ten or fifteen minutes, until free emesis is produced, will be found the
most efficient emetic.   In  these  cases, counter-irritation may be produced
by  bastinadoing the feet, and after the vomiting, the patient may drink freely
of  fresh  milk.   The dose of Salt, as an alterative and tonic, is from ten to
sixty o-rains.   A Solution of Salt is useful as a fomentation in bruises or
sprains, as  a tonic and excitant  application in depraved conditions of the
system, as a collyrium in  some ophthalmic diseases, and is  frequently used
as  a stimulating ingredient in injections.
   4. Sulphate of Soda.  Sodae Sulphas.  Also known as Glauber's Sails, is
a cathartic in doses of from four to eight drachms, dissolved in eight or ten
ounces of water; smaller doses are diuretic and  laxative.   A few drops of
Sulphuric Acid, a little Lemon-juice, or some Cream of Tartar added to the
Solution, will lessen its nauseous and bitter taste. 
Marsh  Mallows.  (Althaea OfScinalis.) 
>J1h-
 
MATERIA MEDICA.
697
  5. Sulphite of Soda.  Sodae Sulpliis.   This Salt forms transparent crys-
 tals, soluble in four parts of cold water.   It has been used with success in
 cases of frothy vomiting, in which the microscopic fungi, Sarcina Ventriculi
 and Turrda Cercvisice,  were  found.    Its dose is sixty grains, three times a
 day.  The Hyposulphite or Bisulphite of Soda is used for the same purpose,
 in doses of  from ten to  fifteen grains in half a fluidounce  of infusion
 of Quassia, repeated  three times a day.   It  has also been used as  a wash
 in thrush, and some diseases of the skin.
  G. Tartrate of  Potassa  and  Soda.   Sodas  et  Potassae  Tartras.  Also
 known as Rochelle Salt, is a mild,  cooling purgative, suited to delicate and
 irritable  stomachs, having a more   agreeable  taste  than other purgatives
 among the  neutral Salts.   The  dose is from two drachms to one ounce, in
 eight or ten parts of water.  The gentle aperient known as Seidlitz Powder,
 is composed of thirty-five grains of Tartaric Acid in the white paper, and two
 drachms of Rochelle Salt, added to two scruples of Bicarbonate of Soda in
 the blue.   Dissolve the contents  of each paper, separately,  in  half  a tum-
 bler of water; mix the two solutions, and drink immediately during the effer-
 vescence.

  SOLOMON'S  SEAL.   Convallaria  Multifiora.   This  is  a  perennial
 plant, growing in various parts of the United States.  The root is tonic,
 Blightly astringent, and  mucilaginous.   It has an  especial influence  on
 irritation and chronic inflammation  of mucous tissues, and, hence, has been
 found very valuable  in chronic inflammation of the stomach  and  bowels
 piles, chronic  dysentery, laryngitis, &c.   It is generally used in  decoction
 or infusion, in doses of from one to  four fluidounces, three or four times a
 day; a large dose proves nauseant and cathartic.  It  has also been effica-
 cious in female debility, excessive menstruation, affections of the air-passa-
 ges, &c.  As  a local  application, the decoction will be found  useful in
 erysipelatous inflammation, some diseases of the skin, and in the inflamma-
 tion of the skin caused by the Poison Vine.

  SOOT.  Fuligo Ligni.  Woodsoot is  useful  in acid conditions  of the
 stomach, dyspepsia, hysterics, inflammation of mucous membranes, and as
 an injection in thread-worms.   It  may be used in  powder, from  five to
 twenty grains, three or four times a day; or in decoction, one or two fluid-
 ounces for a dose.  An ointment of Soot is useful in burns, scalds, erysi-
 pelatous affections, scald-head, fistula, scrofulous ophthalmia, &c.

  SPANISH   FLIES.   Cantharis  Vesicatoria.  Spanish  Flies,  or Can-
 tharides, are natives of Europe;  they are irritant and narcotic,  in large
 doses, and stimulant and diuretic in medicinal doses.   Large doses cause
 dangerous symptoms, as violent inflammation, strangury of the alimentary
 canal  and  urinary organs,  irritation  of the sexual organs,  headache,
 delirium, convulsions and  death; and there  is no antidote  to its alarming
 effects, upon which we can rely with any certainty.   They are sometimes
 given  internally, in chronic gonorrhea,  gleet,  leucorrhea,  seminal weak-
 ness, paralysis of the bladder, &c.  The  dose is from half a grain  to  two
 grains  of the powder, or  from twenty to sixty drops of the  tincture
 Thirty drops  of solution  of Potassa, given  every hour, is said to be an
 effectual remedy for strangury, caused by Cantharides.  Externally, Span-
 ish Flies  are generally used to cause vesication or blistering  of the skin,
in various diseases.  The Cantharis Vittata, or Potatoe Fly, of this country,
is fully equal  to the European insect. 
                    AMERICAN  FAMILY  PHYSICIAN.

  SPEARMINT.   Mentha Viridis.   This is a well-known, perennial herb,
possessing carminative,  diuretic,  and anti-spasmodic virtues.   The warm
infusion is useful in febrile diseases to cause perspiration ;  the cold infu-
sion acts  as an efficacious diuretic in heat of urine, pain in urinating, &c.
A saturated tincture of the fresh herb in gin has been found serviceable in
gonorrhea, strangury, gravel, suppressed urine, and as a  local application to
painful piles.   The Oil of Spearmint is diuretic, stimulant, antispasmodic
and rubefacient, and is used externally in rheumatic and other pains.  The
decoction  may be drank  freely; dose of the oil,  five or  ten drops on sugar

  SPERMACETI.   Cetaceum.   This is a white, concrete, crystalline sub-
stance,  inodorous, tasteless, partially soluble in ether,  wholly so  in fixed
and  volatile oils, and melted fats ;  it  is  obtained from the head of the
spermaceti whale.  It is  used in domestic  practice  for the coughs, colds,
and  catarrhal affections of children, being  generally combined with equal
parts of loaf sugar.  It also enters into several cerates  and ointments.

  SPIDER'S WEB.  Tela Aranece.   The cobweb of the brown or blackish
spider, found in barns, cellars, and other  dark places, when given in dosea
of five or six grains, every two  or three hours, in pill-form, is reputed effi-
cacious in  fever  and ague, hysterics,  periodical headache, asthma, hectic
fever, St.  Vitus dance, and various nervous and spasmodic affections. Also
said to be useful in checking bleeding, when applied  externally.

  SPIRIT  OF NITRIC  ETHER.  Spiritus uEtheris Nilrici.   This liquid
is more  commonly known by the name  of Sweet  Spirits of Nitre; when
long  kept it becomes acid and unfit for  medical  use, but this may be obvia-
ted by keeping it on crystals of Bicarbonate of Potassa.  It is stimulant,
antispasmodic, diuretic,  and diaphoretic ;  in large doses it is a narcotic poi-
son, and  the  inhalation of its vapor  has occasioned death.  It has been
used  in dropsy, strangury, gonorrhea, and in febrile  diseases, either alone,
or combined with sedatives, or other diuretics.  In  gonorrhea, it is gener-
ally added to Copaiba, to lessen the acrimony of the urine.  If taken when
old, it will  occasion pain  in the  stomach, and griping.  The dose is from
twenty drops  to  two fluidrachms,, three or four times a day, in water.

  SPIRIT  VAPOR BATH.   This bath exerts a most powerful, yet bene-
ficial influence upon the  whole  system, aiding very materially our endea-
vors  to remove*disease.   This highly valuable mode  of producing  activity
of the  cutaneous vessels,  has long been practised in many sections of the
country as  a remedial agent, and was first introduced  to the  notice of the
medical profession  by myself,  about twenty years ago, since  which it is
much in  use among physicians.  The  advantages to be derived from this
method of  producing perspiration are  very great, and it is  not followed
with  any of those injurious consequences which often  attend  the internal
administration of a sudorific.
  It  is to be given as follows :—The patient is undressed, ready for getting
into  bed, having removed the shirt and underclothing worn  through the
day,  and  put on a  night-shirt, or other clothing, to be  worn only while
sweating, and  during the night, if  the bath is taken  at  bedtime.  He is
then seated on  a high Windsor, or  wooden-bottomed  chair, or instead
thereof, a bench or board may  be  placed  on a common open-bottomed
chair, care  being taken  that the bottom is so covered that the flame will not
burn him.  After seating himself, a large blanket or coverlid  is thrown 
MATERIA  MEDICA.                       699
 around him from behind, covering  the back  part of his head and body, as
 tvcII as the chair, and another must be passed around him in front, which
 last is to be pinned at the  neck, loosely, so that he can raise it and cover
 his face, or  remove it  down from his face, from time to time,  as occasion
 requires, during the operation of the bath.  The blankets must  reach down
 to the floor, and cover each other at the sides, so as to retain  the vapor, and
 prevent it from passing off.
   This having been done, a saucer  or tin vessel, into which is  put one or
 two table-spoonfuls of whiskey, brandy, spirits, alcohol, or any liquor that
 will burn, is then  placed upon the  floor, directly under the  centre of the
 bottom of the chair, raising a part  of the blanket from behind, to place it
 there; then light a piece of paper, apply the  flame  to the  liquor, and as
 soon as it kindles, let down the part of the blanket which has been raised,
 and allow the liquor to burn until it is consumed, watching it from time to
 time, to see  that the blankets are not burned; as soon as  consumed, put
 more liquor  into the saucer, about as much as before, and again set it on
 fire—being careful  to put no liquor into  the saucer while  the flame exists,
 as there would be danger of burning the  blanket, patient, and perhaps the
 house.  Continue this until the patient sweats or perspires freely,  which in
 the majority of cases, will be in five or ten minutes.
   If, during the operation, the patient feels faint or thirsty,  cold  water
 must be sprinkled  or dashed in his face, or he may drink one or two swal-
 lows of it—and in some cases the head may be bathed in cold water.
   As soon as free  perspiration is produced, wrap the blankets around him,
 place him in bed, and cover him  up warm, giving  him  about a pint of
 either good store tea, ginger, or some herb tea to drink,  as warm as he can
 take it.  After two or three hours, remove the  covering, piece  by piece, at
 intervals of twenty or twenty-five minutes between  each, that he may grad-
 ually cease perspiring.
   There  is no danger of taking cold  after this Spirit  vapor bath, if the
 patient uses ordinary precaution,  and if  his disease will allow,  he can
 attend to his business the next day the same as usual.  In fact, the whole
 is a very easy,  safe, agreeable and beneficial operation, much  more so than
 the mere reading of the above explanation would lead one to suppose.
   This mode of producing  perspiration is highly beneficial in severe colds,
 pleurisy, rheumatism, and  all febrile and inflammatory attacks, diarrhea,
 dysentery, sluggishness of cutaneous vessels, &c.   In  acute  diseases, it
 may be repeated once a day, if required; in chronic diseases, once or twice
 a week(> or once a  fortnight, according  to indications, or  the strength of
 the patient.  Where it can be  done, it  is always preferable to bathe the
 patient with an alkaline wash, both  before and after this vapor bath.

  SPONGE.  Spongia.  Sponge, when burned, Spongia  Usta, is said to be
 alterative  and  anti-scrofulous, and  has been  used in  goitre,  scrofulous
 tumors,  and  obstinate cutaneous  eruptions, in  the dose  of from  one  to
 three drachms,  mixed in honey or syrup.  Since the discovery of Iodine,
 it is less used than  formerly.

  SQUILL.  Scilla Maritima.   This is  a perennial plant,  native  of the
Mediterranean countries.  In large doses, it is a dangerous, irritant poison,
proving fatal in the dose of twenty-four grains.  Some persons cannot use it
it all, unless combined with opium.   In small doses, it causes nausea, and
depression of the pulse, never stimulating the  circulation.   It has been
used  as an expectorant in  bronchial  and  laryngeal diseases, in  asthma, 
700                AMERICAN  FAMILY PHYSICIAN.
catarrh, and diseases of the lungs, and as a  diuretic in asthenic dropsy
generally in combination with Digitalis.  It must not be given where there
is much excitement or inflammation.   The dose of the  powder is from one
to three grains, as a diuretic and expectorant, or one or two fluidrachms of
the syrup.

  STORAX.  Styrax Officinale.   Storax  Tree is a  native of the  Mediter-
ranean countries, the juice of which, when hardened, forms  the common
brittle, reddish-brown Storax of the shops.  Liquid Storax is a semi-fluid
substance, whose  source  is  not positively known.  Both of  these  agents
have  a stimulating influence upon mucous tissues, and  have been found
useful, in  doses  of from ten  to twenty grains, in cough, chronic catarrh
laryngitis, bronchitis, asthma,  chronic gonorrhea, gleet, &c.   Externally
made into an ointment, with  equal parts of lard or tallow, it is efficacious
in ringworm, scald-head, and other cutaneous diseases.

  STRAMONIUM.   Datura Stramonium.    This is a well-known annual
weed bearing the names  of Jamestown weed, Stink weed,  Thorn apple, &c.
The leaves and seeds are the parts used;  in large doses they are highly poi-
sonous.   In medicinal  doses, they act as  anodyne-antispasmodics, without
producing constipation, and have been efficacious in mania, epilepsy, inflam-
mation of the stomach and bowels,  also in  rheumatic, syphilitic, and neural-
gic pains.   Combined with Quinia, Stramonium is useful in fever and ague,
headache, painful menstruation, &c.   Externally,  the fresh leaves, bruised,
are valuable as  a poultice in rheumatism, acute  ophthalmia,  swollen and
painful breasts, painful ulcers, and inflammation of the stomach and bowels.
The ointment is serviceable in many skin diseases.   It should never be given
internally in plethora, or where there is a determination to the  head.   Dose
of the powdered leaves, from one to  five grains; of the tincture of the seeds,
not bruised, from five to thirty drops; of the alcoholic extract, from one-eighth
of a grain to two grains.

  SULPHUR.   This well-known elementary, non-metallic substance, is a
stimulant, laxative, diaphoretic, and alterative.   It is considered a specific for
the cure of itch.  It has been used in piles, combined with Cream of Tartar,
also in some diseases of the skin, chronic rheumatism, chronic hooping-cough,
&c.   Its  dose is twenty or thirty grains, in molasses, two or three times a
day.   When used with  Cream of Tartar, one part of the Sulphur may be
added to four parts of the Tartar.   Externally, Sulphur has been found very
valuable  in scrofulous, rheumatic, paralytic,  syphilitic, and skin-diseases,
either in form of ointment or  bath.   Care should  be taken never to inhale
the gas arising from  heated Sulphur, as it may prove fatal   When Sulphur
is sublimed, it is  called Flowers of  Sulphur,  which, when washed  to re-
move any acidity which may  be present, is  the best form for medicinal pur-
poses.

  SULPHURIC ACID.   Acidum  Sulphuricum.   This acid when pure is a
powerful caustic, acting  powerfully on all organic substances, and rapidly
decomposing them.  When diluted with sufficient water, it has beenusedas
a tonic in low typhoid conditions, and in convalescence from exhausting dis-
eases; likewise as an astringent in  diarrhea, night-sweats, and passive bleed-
ing.  It has also been applied externally to diseases of the skin, unhealthy
ulcers, ulcerated throat and mouth, &c.    One fluidounce of  Sulphuric Acid
may be gradually added to thirteen fluidounces  of distilled water,  of vhicn 
MATERIA MEDICA.
701
  from ten to thirty drops may be given in a wineglassful of water, three times
  a day.   The teeth may be preserved by sucking the mixture through a quill
  or glass tube.  See Elixir of Vitriol.

    SUMACH.   Rhus Glabrum.   This is a shrub common to various parts of
  the United States, the bark and berries of which are used in medicine.  The
  bark is tonic, astringent, and antiseptic;  the  berries contain malic  acid, and
  are refrigerant and diuretic.   In decoction or syrup, the bark of the root has
  been found  valuable  in gonorrhea,  diarrhea,  dysentery,  hectic fever, and
«, scrofula.  Combined  with Elm bark, and  White Pine  bark, in decoction, it
  is said to have proved highly beneficial in  gonorrhea.  A decoction of the inner
  bark of the root is serviceable in the sore mouth resulting from mercurial saliva-
  tion; it is also useful as an injection in falling of the bowel, and leucorrhea, and
  as a wash in some diseases of the skin.   The powdered bark of the root, applied
  as a poultice to old ulcers, forms an excellent antiseptic.  The berries may be
  used in infusion in febrile  diseases,  diarrhea, dysentery, diabetes, &c, and
  as a gargle in quinsy  and ulcerations of the mouth and throat, and as a wash
  for ringworm, tetter, offensive ulcers, &c.  The excrescences which form upon
  the leaves, are nearly equal in astringency to  galls, and if pulverized and
  made into an ointment with lard, they afford a soothing application for piles.
  The gum which exudes from the  bark on being punctured,  during  the sum-
  mer, is beneficial in gonorrhea, gleet, and obstruction of the urine; it is best
  when formed  into  four-grain pills with  equal parts  of Canada  Balsam and
  sufficient powdered Poke root to form a pill-mass,—one or two of these pills
  may be taken three times a day.   Dose  of the decoction of Sumach, one or
  two fluidounces, three or four times a day.

   SUNFLOWER.  Helianthus Annuus.   The seeds, as well as the leaves of
  this well-known plant, possess expectorant and diuretic properties,  and have
  been found very beneficial in cough,  laryngitis, bronchitis, &c.  A  syrup has
  been made from the seeds, which is very valuable in many  pulmonary affec-
  tions, thus:—Bruise one pound of Sunflower seeds, add them to two and a half
  gallons of water, and  boil slowly down to one gallon and a half;  strain  off
  the liquid, add six  pounds of loaf sugar,  and  six pints of Holland Gin.  The
  dose is from half a table-spoonful to two  table-spoonfuls, four or  five  times a
  day.  By expression, the seeds yield a fixed oil, upon which their  virtues
  principally depend; in doses of ten or twenty drops three or four  times a
  day, it will be found useful in all mucous inflammations; in treble  this dose,
  it will greatly increase the flow of urine.  The pith of the Sunflower stalk,
  in infusion, is diuretic, and may likewise be used with advantage as  a wash
  in acute  inflammation of the eyes.

   SWAMP DOGWOOD.   Comus Sericea.  This shrub  is found  in damp
  woods, and along the banks of rivers in various sections of the  United States,
  and is also kno\vn by  the names of Rose-willow,  Red-willow, Red  Ozicr, &c.
  The bark is the part used; it is slightly  tonic and stimulant, and astringent,
 and has been used  for the same purposes as Dogwood bark.   It has also been
 recommended in dropsy, dyspepsia,  diarrhea, malignant fevers and to check
 the vomiting of pregnant women ;  also as an application to  foul and  ill-con-
 ditioned  ulcers.  Dose of the powdered bark, from twenty to sixty  grains; of
 the infusion,  from  two to four fluidounces.

   SWAMP MILKWEED.  Asclepias  Incarnata.   This  perennial plant
 grows in  damp soils throughout the  United States, bearing red flowers from 
702
AMERICAN FAMILY  PHYSICIAN.
June to August.  Upon being wounded the plant emits a milky juice.   It is
also  known by  the  names,  White Indian Hemp,  Flesh-colored  Asclepias,
Sivamp Silkwced, &c.  The powdered root is anthelmintic in doses of ten or
twenty grains, three times a day; or a decoction may be used in doses of from
two to four flujdounces.  It has also been recommended  in catarrh, asthma,
syphilis, and rheumatism.

  SWEET FERN.   Comptonia  Asplenifolia.   This  shrub  is common in
sandy soils and stony woods, from New England to Virginia.   The whole
plant is aromatic,  and possesses  tonic, astringent, and alterative properties.
It is efficacious in diarrhea, dysentery, summer-complaint of children, bleed-
ing from the lungs, rheumatism, debility succeeding fevers, rickets, &c.
Dose  of the decoction, from one to four fluidounces,  three or four times a
day; externally, it is useful as an injection in  Leucorrhea.

  SWEET FLAG.   Acorus Calamus.  This  well-known perennial plant is
found in damp situations in most parts of the world, and  is frequently called
Calamus.   The root is a stimulating tonic and aromatic, and is useful in flat-
ulent colic, dyspepsia, atonic  conditions of the stomach, and as an adjuvant
to Quinia, and Peruvian bark, in fever and ague.   In flatulent colic of  in-
fants, it is best combined with Magnesia.    Dose of the root, from a scruple
to a drachm; of the infusion, from two to four  fluidounces.

  SWEET GUM.  Liquidambar Styraciflua.  This tree is common to the
Middle and Southern States; when wounded, a balsamic juice flows  from
its trunk, of the consistence of thin honey, yellowish-white, and of  an
agreeable,  balsamic odor, and a warm, bitter, and acrid taste.   It finally
hardens into a soft, resinous, dark-colored mass, which is soluble in alco-
hol, oils, lard, or fats.   Melted with equal parts of lard or tallow, it forms
an ointment decidedly beneficial in piles, itch, ringworm of the  scalp, and
many other diseases of the skin, also in "fever  sores," fistula in ano, &c.
Internally it may be used in  chronic catarrh, laryngitis, and other affec-
tions of the air-passages.

  TAG ALDER.   Alnus Rubra.   This shrub is common in swamps and
damp places in the Northern States.  The bark is  alterative, emetic, and
astringent.  The decoction or extract is useful in scrofula, secondary syph-
ilis, and several forms of disease of the skin.  The inner bark of the root
is emetic,  and a decoction of the cones  is said  to  be  useful in various
hemorrhages.   A powder,  very efficacious in some  chronic affections of the
eye, is made by boring a hole about  half  an  inch in diameter, lengthwise
through a stout piece of a Tag Alder limb.  Fill this with finely powdered
salt, and close it at each end.   Put it into hot ashes, and let it remain  for
three or four days, or until  the  piece of  limb is almost all charred; then
split it  open,  remove the  salt, powder it finely, and  keep it in a vial.  To
use it, blow some of the powder in the eye, through a quill.

  TANNIC ACID OR TANNIN.  Acidum Tannicum.  This acid exists in
most astringent plants, but is more commonly prepared from galls.  It is a
pure astringent, and has been advantageously employed in chronic diarrhea
and dysentery, passive hemorrhages, diabetes, Ac.  Externally, its solution
in water has been used as a wash in excoriations,  fissure of the  anus, sore
nipples, ulcers of the mouth, severe salivation, &c; and as an injection it
gonorrhea, gleet, leucorrhea, piles, falling  of the bowel, &c.   It should  not 
MATERIA  MEDIC A.
703
 be used  in cases of  obstinate constipation, nor  during the presence of ac-
 tive inflammation.  Dose of the powder, from half a grain to five grains.

  TANSY.   Tanacctum  Vulgare.  This  is a  well-known  perennial  herb,
 possessing tonic, emmenagogue, and diaphoretic  properties.  A warm  in-
 fusion is diaphoretic  and emmenagogue, and is of much  service in.sup-
 pressed menstruation,  and in tardy labor-pains.   A cold infusion is tonic,
 and has  been efficacious  in dyspepsia with troublesome flatulence, debility
 from long-continued disease, jaundice, worms, &c.  Used as a fomentation,
 the herb is useful  in swellings, tumors, local inflammations, and applied to
 he bowels in painful dysmenorrhea, and after-pains.  Dose of the infusion
 from one to four fluidounces  two or three times a day.

  TAB.   Pix Liquida.  This  well-known  substance, has  virtues similar
 to those of the Turpentines, and has been used in chronic coughs, chronic
 bronchial and laryngeal inflammation,   and its vapor inhaled  into  the
 lungs, has  been serviceable in cases of bronchial disease.  Externally, in
 the form of ointment, it  has proved an efficient remedy in scald-head, and
 some cases of scaly tetter, also, in foul  and  indolent  ulcers.  The Oil of
 Tar possesses similar properties, in doses  of from three to six  drops.

  TARTARIC ACID.   Acidum Tartaricum.   This is  a white, six-sided,
 crystallized  solid, prepared  from Cream of Tartar.  It is soluble in water,
 and has an agreeably acid taste.   It  possesses refrigerant, antiseptic, and
 antiscorbutic properties.  A solution of it may be used as a drink in febrile
 and inflammatory  diseases, as a grateful  acid refrigerant draught, forming
 an excellent substitute for  lemonade.

  THIMBLEWEED.   Rudbeckia Laciniata.  This is a  perennial  plant
 growing in various parts  of the United States, in damp  places.  The whole
 herb is a valuable  balsamic, diuretic, and tonic, and has proved useful in
 many diseases of the urinary organs; it has  been highly recommended in
 strangury, Bright's disease,  and wasting of  the kidneys.   The decoction
 may be used freely.

  TOBACCO.   Nicotiana  Tabacum.   This is an annual  plant, the leaves
 of which are used.  They possess acrid, narcotic, and poisonous properties,
 and are  commonly used  in the form of  ointment in many skin diseases,
 croup, spasm of the glottis, obstinate ulcers, painful  tumors, piles, &c.

  TRAILING ARBUTUS.  Epigea Repens.  This  is a woody  plant com-
 mon  to the United  States, and sometimes  called  Gravel-weed, Mountain
 Pink, Ac.  The leaves in infusion are diuretic and astringent, and have
 been very efficacious in all diseases of the urinary organs, gravel, diarrhea,
 and bowel complaints of  children.  It  may be  drank freely.   This is a
 very valuable medicinal plant.

  TULIP TREE.  Liriodendron  Tulipifera.  This  is a large and magnifi-
 cent tree, growing in nearly all parts of the  United States.  The bark of
 the root or trunk is the part used, that from the root being the best.  It is
 of a yellowish color, and a bitter, aromatic  taste.  It  should be collected
 during the winter.  It possesses  aromatic, stimulant,  tonic,  and in  warm
infusion, diaphoretic properties; and has proved beneficial  in fever  and
ague, chronic rheumatism, chronic diseases of the stomach and bowels, 
704
AMERICAN FAMILY  PHYSICIAN.
worms, &e.   It is also called Poplar, White Poplar, &c.  Dose of the pow-
dered bark, from a scruple to two  drachms;  of the  infusion, one  or two
fluidounces.

  TURKEY  CORN.  Corydalis Formosa.   This is a  perennial  plant,
growing  in rich soil in the Western and Southern States, being also known
by the names of Wild Turkey-pea,  Stagger-weed, &c.  The tuberous root
should be collected only while the plant is in flower, early in the  spring.
It possesses  tonic, diuretic, and alterative  properties, and is an excellent
remedy in syphilis and scrofula.   As a tonic, it  may be  used in all cases
where these agents are indicated.   Dose of the infusion, from one to four
fluidounces, three or four times a day; of the  saturated tincture, from half
a fluidrachm  to two fluidrachms.

  TWIN LEAF.  Jeffersonia Diphylla.  This is a perennial plant, found
in the Middle, and  in  many  parts of  the Western  States.   The  root is
diuretic,  alterative, antispasmodic, and a stimulating diaphoretic.  It has
been successfully used in chronic  rheumatism, secondary syphilis,  syphi-
litic pains, spasms, cramps, and many nervous affections. As a gargle, it
has been beneficial in diseases of  the throat, ulcers  about  the  throat, in
scarlet fever, chronic inflammation of the eye, indolent ulcers, &c.  Dose of
the decoction, from  two  to  four fluidounces,  three  times  a day;  of the
tincture, one or two fluidrachms, three or four times a day.

  UNICORN ROOT.  Aletris  Farinosa.  This is a perennial plant grow-
ing in dry sandy soils and barrens,  in most parts of  the United States, and
is variously known by the names Star-grass, Crowcorn, Ague-root, &c.  The
root is intensely bitter, and  possesses,  when  dried,  tonic properties. It
has proved efficacious  in dyspepsia,  to improve the tone of the stomach, in
flatulent colic, and  hysterics.   But  its most valuable property consists in
the influence it exerts upon  the female generative organs, giving tone and
energy to the uterus, and thus proving useful  iu tendencies to miscarriage.
In  chlorosis, suppressed  menstruation, painful  menstruation,  engorged
conditions of the womb, with falling of this  organ, it is one of our best
agents.   Dose of the powdered root, from five to ten  grains, three times a
day;  of the tin.cture, five to ten drops, in water.
  Aletridin is the name given to the alcoholic extract.  It possesses the
properties of the root, and wall  be found very efficacious in  all diseases in
which the root is indicated, in doses of  from  half a grain to two  grains,
three times a day.  In uterine  diseases  it may be combined  with Senecin,
Caulophyllin, Asclepidin, &c.

  UVA  URSI.  Arctostaphylos  Uva Ursi. This perennial plant, also known
by the names of Bearberry, and  Upland Cranberry, is an evergreen, common
in the northern parts of Europe and America.  The leaves are diuretic,
tonic, and astringent, and have  been used with advantage in chronic dys-
entery, diabetes,  chronic affections of the kidneys, chronic  gonorrhea, ca-
tarrh of the bladder, and  in  gravel  with uric acid deposits.  Dose of the
powder, from ten to forty .grains; of the decoction, two or three fluid-
ounces.

  VALERIAN.   Valeriana  Officinalis. This  is a  perennial  European
plant, the root of which consists  of a short body, from which proceed
numerous long,  slender, fibers,  of a  yellowish or brownish color externallyi 
MATERIA  MEDICA.
705
^itc internally, of a fetid odor, and a bitter  and aromatic  taste.   These
fibers are tonic, antispasmodic, and  calmative, and have  been successfully
used in  all case3 of irregular nervous action, as in  hysterics, restlessness
and irritability of the nervous system  in febrile  diseases, morbid wakeful-
ness, lowness of spirits, epilepsy, headache, &c.   Its virtues  depend  upon
a pale-greenish volatile oil, which  may be  substituted for the root.   Doso
of the infusion, one or two fluidounces three times a  day;  of the tincture,
from half a fluidrachm  to two  fluidrachms;  of the  oil, five or six drops.
In large doses it produces a sense of heaviness and dull pain in the  head
with other effects indicating nervous disturbance.

  VEXICK TURPENTINE.   This is a thick, viscid liquid, which exudes
from the trunk of the Abies  Larix, an European  tree.  It has  a tere-
binthine odor and taste, and is soluble in alcohol.  It possesses  properties
similar to those of the Oil  of  Turpentine, and  the  turpentines generally.
Much of the Venice Turpentine sold in this country is a  factitious article.

  VERVAIN.    Verbena  Hastata.   This is a  perennial  plant common to
the United States.   The  root  is emetic, expectorant, sudorific, and tonic.
The warm infusion produces vomiting and sweating, and  is useful in inter-
mittent fevers, colds, obstructed menstruation, &c.  The cold infusion forms
a good tonic in some eases of debility,  loss of appetite, during convalescence
from acute diseases, and  is  reputed efficacious in scrofula, gravel, worms,
&c.  Equal parts of powdered  Vervain, Senna, and White Pepper, mixed
with white of egg, is said  to form an excellent poultice in bruises, allaying
the pain, and promoting the absorption of the effused blood.  Dose of the
powdered root, one or two  scruples; of  the infusion, from two  to four
ounces, three or four times a day, or oftener if it is desired to vomit.

  VINEGAR.   Acetum.  Vinegar  possesses diuretic, refrigerant, astrin-
gent, and tonic properties.  It is useful in febrile and  inflammatory com-
plaints, especially when the tongue is coated dark or brown; also in typhus
»nd scurvy, as an antiseptic.   In urinary affections, attended  with a white
Bediment, consisting mainly of phosphate of lime  and ammoniaco-magnesian
phosphate,  it has been   recommended.  In  dysentery and  scarlet fever,
Vinegar saturated with  table  Salt, has  been very  beneficial;  it  is also
useful as an external application in external inflammations, bruises, sprains,
swel.'ings, &c.   As a gargle, Vinegar is useful in putrid sore throat, ulcera-
tion of the throat, laryngitis, hoarseness, &c; and forms a good application
to several cutaneous diseases, in some cases of  ophthalmia, nose-bleeding,
Ac, and as a cooling wash in headache during fevers or other attacks.  The
rapor of Vinegar inhaled into  the  lungs  is useful in diseases of these or-
gans, sore throat, dryness and irritation of the air-tubes in  febrile diseases,
and, diffused through the  rooms of  the sick, is both agreeable and whole-
some to the patient and attendants.
  Distilled Vinegar should always be used for medicinal purposes.  Dose
of Vinegar, internally, from one to four fluidrachms,  in water.

  VIRGINIA  SNAKEROOT.  Aristolochia Serpentaria.  This perennia1
herb is common to the Middle  and  Southern  States ;  the  root  consists of
numerous  long, slender,  interlaced  fibers, having a camphor-like, rather
agreeable odor, and a bitterish, camphor-like taste.  It possesses stimulant,
tonic, and diaphoretic properties.   A warm infusion causes sweating, and
may be  used in  all forms  of  fever, in measles, small-pox, &c, where the
        45 
706
AMERICAN  FAMILY PHYSICIAN.
eruption does not readily make its appearance, and in suppressed or pain
ful menstruation.  A cold  infusion is useful in dyspepsia, convalescence
from fevers, &c.  Dose  of the powder, from  ten to thirty grains;  of the
decoction, one or two fluidounces; of the tincture, one or two fluidrachms.

  WATERMELON.  Cucurbita Citrullus.  The  seeds of this well-known
fruit,  infused  in water,  form an  excellent  mucilaginous diuretic, which is
valuable in strangury, heat  of urine, inflammation of the stomach and bow-
els, gonorrhea, &c.;  it may be drank freely.  The  red  pulp  of the ripe
fruit,  forms a pleasant refrigerant, diuretic, and  nutrient for patients with
fever, when there are no indications forbidding its use.

  WATER PEPPER.    Polygonum Punctatum.   This  well-known annual
plant, also called Smart-ioeed, possesses  stimulant, diuretic, emmenagogue,
antiseptic, diaphoretic, and  vesicant properties.  The saturated tincture, in
doses of a fluidrachm, two or  three  times a day, has  been highly recom-
mended in suppressed menstruation.   Infused in cold water, the plant has
been  found  serviceable  in gravel, colds, and coughs.   A fomentation ap-
plied  externally, the plant being simmered in water and vinegar, is good
in gangrene, foul and indolent ulcers, and piles.  The infusion forms an
excellent wash in chronic  erysipelatous inflammations.   The  fresh weed
bruised and applied  to  the skin will  cause vesication.   Dose  of the cold
infusion from two  to  four fluidounces;  of  the tincture, from two to four
fluidrachms ; of the extract, from four to six grains.

  WAX.  Wax is the product of the  common Bee, Apis Mellifica.   There
are two  kinds, yellow wax, Cera  Flava, and white wax, Cera Alba.   These
are used in medicine chiefly as  an ingredient of plasters, ointments, &c,
though  they have been  recommended in diarrhea, dysentery, and inflam-
mation of the alimentary mucous membrane, combined with Olive Oil, and
the yolk of an  Egg.

  WHITE HELLEBORE.  Vcratrum Album.   This is a  perennial Eu-
ropean plant, the rhizoma or root of which is used.  It is a violent emetic
and purgative, and in large doses, poisonous.   It is seldom used  internally;
its  most ordinary employment is in  the form  of ointment or decoction,
as an  application  for the  cure  of itch, and several other diseases  of the
skin.   Occasionally it has  been used in gout,  amaurosis, and in mental
diseases.

   WHITE OAK.   Quercus Alba.  The bark of this well-known tree is
astringent,  tonic,  and  antiseptic.  It has been advantageously used in
intermittent fever,  chronic  diarrhea,  chronic   mucous  discharges, and
passive hemorrhages; likewise in consumption, and diseases attended with
great prostration,  night-sweats,  &c, in which a decoction of it may be
combined  with lime-water.   In sickly,  weakly  children, and in  severe
diarrhea, especially when the result of fever, the  decoction given internally,
and used as a bath to the body and limbs, two or three times a  day, will be
found very efficacious.   The  decoction  forms an excellent gargle for re
laxed  palate  and  sore   throat,—a good stimulating wash for  ulcers with
spongy granulations,-—and an astringent injection  for leucorrhea,  falling
of the  bowel,  bleeding  piles, &c.  A poultice of the powdered  bark haa
often proved of service  in  gangrene.   Dose  of  the  decoction,  one  or two
fluidounces ; of the extract, from five to twenty grains. 
MATERIA  MEDICA.
707
  A coffee made from roasted acorns, has  been highly recommended  in
 the treatment of scrofula.

  WHITE POND LILY.  Nymphcea Odorata.  This is a perennial plant
 CTOwin0, in ponds and marshes in many parts of the United States.,  The
 root is astringent, demulcent, anodyne, and antiscrofulous.   It has been
 efficacious  in  dysentery, diarrhea, gonorrhea, leucorrhea, and scrofula, and
 combined with Wild Cherry in bronchial  and laryngeal affections.  Exter-
 nally, the leaves and roots have been used in the form of poultice to  boils,
 tumors, scrofulous ulcers, and inflamed skin.  An infusion, may be used as
 a gargle in ulcers of the mouth and throat, and as an  injection in leucor-
 rhea.  Dose of the infusion, from two to four fluidounces.

  WHITE TURPENTINE.  This  is the concrete  juice, obtained  by
 making  incisions  in  the Long-leaved Pine, or  Yellow-pitch  Pine tree,
 Pinus Palustris.   It is of a yellowish-white color, of a  consistence depend-
 ing Bomewhat on the  degree of temperature, though it finally becomes dry
 and hard in consequence  of the  loss  of  essential  oil.  It is dissolved by
 alcohol or ether, and combines with  fixed  oils.   White  Turpentine pos-
 sesses stimulant, diuretic, and anthelmintic  properties, and  in  large doses
 it is laxative.  It has  been used  in gonorrhea, gleet, leucorrhea, chronic
 diseases of the urinary passages, chronic catarrhal  diseases, chronic  rheu-
 matism, piles, chronic inflammation or ulceration of  the  bowels,  and  in
 suppressed menstruation.  Externally it is rubefacient and  stimulant, and
 enters into various plasters and ointments.   The dose is from  a scruple to
 a drachm,  in  pill-form, or in  emulsion with Gum Arabic, or yolk of egg,
 Bugar, and water.

  WHITE WEED.   Chrysanthemum  Leucanthemum.   This is  a perennial
 weed, growing in almost every part of the United States, and is very trouble-
 some to farmers.   It is also called Ox-eye-Daisy.   It is tonic, diuretic, anti-
 spasmodic,  and in large doses, emetic.   The cold  decoction, in doses of
 two or three  fluidounces, three or  four  times  a day,  has been useful  in
 hooping-cough, asthma, nervous excitability, night-sweats, and externally and
 internally in  leucorrhea, as a  tonic, it may be  substituted for  Chamomile
 flowers.  Externally,  it has been applied to  wounds, ulcers, scald-head, and
 some diseases of  the skin.

  WHORTLEBERRY.   Vaccinium Frondosum.  This is a shrub, the fruit
 of which is large, dark-blue, and covered  with a  whitish, fine  powder.
 There are several varieties of Whortleberry or Huckleberry, common to the
 Northern States.  The fruit is diuretic, and  is very  useful, eaten alone,  or
 with milk or sugar, in scurvy, dysentery, and derangements of the urinary
 organs.  The  berries  and root, bruised and  steeped in Gin, form an excel-
 lent diuretic, which  has proved beneficial in dropsy and gravel.  A decoc-
 tion of the leaves, or  bark of the root, is astringent, and  may be used  in
 diarrhea, or as a local  apolication to ulcers, leucorrhea, and sore mouth and
 throat.

  WILD CARROT.   Daucus  Carota.   This is a biennial plant, common to
 Europe and the United States.  The root and seeds are stimulant and diu-
retic, and have been used in infusion, in dropsy, chronic affections of the kid-
neys, gravel, and  to  relieve strangury produced by Cantharides.   The seeds
»re also useful in flatulency.  Externally, scraped or grated, the root forms an 
70$
AMERICAN  FAMILY PHYSICIAN.
 excellent application as a poultice to gangrenous, cancerous, malignant, and
 indolent ulcers, relieving the pain, correcting the fetor, lessening the discharge,
 and altering the morbid condition of the parts.   Dose of the infusion, two
 or three fluidounces, three or four times a day.

   WILD CHERRY.   Primus Virginiana.   This tree is common to many
 parts of the United States.  The bark of the root is the part used.  It is a
 tonic and stimulant in its operation on the digestive organs, at the same time
 exerting a  sedative influence  on the circulatory  and nervous systems.  It
 has been used a tonic in convalescence from  inflammatory attacks, in con-
 sumption, diseases  of the air-vessels and organs in  the chest, cough, scrof-
. ula,  hectic  fever,  &c.  The  dose  of  the  powdered bark, is one  or  two
 drachms; of the cold infusion, from one to three or four fluidounces,  several
 times a day; and of the  fluid extract, which is the best preparation for use,
 from half a fluidrachm to two fluidrachms.

   WILD GINGER.   Asarum Canadense.   This is a perennial plant, com-
 mon  to  nearly all parts of the United  States, and is also known  by  the
 name of Canada Snakeroot, Colt's foot, &c.   The  root is an aromatic stimu-
 lant, tonic, diaphoretic, and expectorant, and has been  used in colic, and
 other painful  affections of the stomach and bowels  where no inflammation
 exists, in cough, laryngitis, and  chronic pulmonary affections.   It  is also
 used as  a  snuff in catarrh.   Dose of  the  powder,  half a drachm;  of  the
 Tincture, from half a fluidrachm to two fluidrachms.

   WILD INDIGO.    Baptisia   Tinctoria.   This  is  a  perennial, small
 shrubby  plant, found in most parts of the  United States.   The leaves and
 bark  of  the root,  are  the  parts used.  The root-bark is purgative, emetic,
 stimulant, astringent, and antiseptic.  It is principally used  on account of
 its antiseptic virtues.    The decoction acts powerfully on  the glandular and
 nervous systems, increasing all the glandular secretions, and arousing the
 liver to a normal action.   It has  been  used with success in scarlet fever,
 typhus, and all cases where there is a tendency to putrescency, pneumonia,
 and acute rheumatism.   Externally, it forms an excellent application to  all
 ulcers, malignant sore-mouth, mercurial sore-mouth,  scrofulous or syphilitic
 ophthalmia, gangrenous ulcers, &c.   A  fomentation  of the  leaves has dis-
 cussed tumors of the breast.   Dose of the Decoction, a table-spoonful every
 one, two, or four hours, as required.  If it purge, produce nausea, or a dis-
 agreeable relaxation of the nervous system, lessen the dose, or omit its use
 entirely for a time.

   WILD YAM.  Dioscorea Villosa.   This is a perennial  vine, found in va-
 rious parts of  the United States, especially in the Southern.  It is antispas-
 modic, and  has been found almost a specific  in bilious colic, promptly afford-
 ing relief in the most violent cases, in doses of  half a pint of the  decoc-
 tion, every half-hour or hour.   It allays nausea, and spasms of the bowels,
 and is very useful in the nausea attending pregnancy.  Dose of the  decoc-
 tion, two or three fluidounces, every thirty or  forty minutes, until relief is
 obtained; of the tincture, from twenty drops to a fluidrachm.
   Dioscorein is the  name given to the  concentrated principle, obtained from
 a saturated tincture of the  root,  by adding its volume of water to  it, and
 evaporating or distilling off the Alcohol.  It is  of a light yellowish-brown
 color, with a feeble odor,  and a disagreeable taste, with acridity.  It has the
 virtues of t> *  root  in  doses of one  to four grains, repeated as often  as the 
MATERIA  MEDICA.
709
 urgency of the case requires; it may be taken in powder, or rubbed up with
 a little Brandy.

   WILLOW.   Salix Alba.  This tree is  common  to the temperate parts
 of Europe  and America.  There  are over one hundred  species of Willow,
 common to these two countries.  The bark is  the part used;  it is tonic and
 astringent,  and has been used in intermittent fever, as an inferior substitute
 for Peruvian bark.  It is a very eligible article in  the treatment of chronic
 diarrhea and dysentery.  The decoction is useful as an application to  foul
 ulcers.  Dose of the powdered bark, one drachm; of the decoction, one or
 two fluidounces, four or five times a  day.
   Salicin  is the active principle of the Willow; it is  a neutral substance,
 white, inodorous, and of a bitter taste.   A small portion placed upon a glass
 slide, slightly fused and then immediately  covered with  thin glass,  presents
 a most gorgeous array of colors under the polariscope.   Salicin is tonic and
 antiperiodic, and may be  used as a substitute for Quinia, to which,  how-
 ever,  it is inferior, though it is less apt to offend the stomach.  When Quinia
 is adulterated  with Salicin,  it may be  known by adding a drop or two of
 Sulphuric Acid to it, which will turn the Salicin red.   The dose is from two
 to twelve grains, three or four times  a day.

   WINTERGREEN.  Gaultheria Procumbens.  This is an evergreen  plant,
 common to mountainous tracts, dry barrens,  &c, throughout the United
 States.  The leaves  have a  pleasant aromatic odor  and taste, and possess
 Btimulant,  aromatic, and astringent properties.   The infusion has been used
 in chronic  diarrhea, as a diuretic in dysuria, as an emmenagogue, and in in-
 termittent fever.   The Oil, or its Essence, is used in flatulent colic, in  inter-
 mittent  fever, and to  flavor various medical  preparations.   The Infusion
 may be drank freely.   Dose of the Oil, from five to ten drops  on  sugar ; of
 the Essence, from  thirty to sixty drops  in sweetened water.

   WITCH  IIAZLE.   Hamamclis  Virginica.   This shrub  is common to
 most  all parts of the United States.   The leaves and bark are tonic, astrin-
 gent, and sedative.   A decoction has been  used with advantage in diarrhea,
 dysentery, hemorrhage, excessive  mucous  discharges, &c;  and  externally,
 as an  application to piles, painful  tumors,  falling  of the  bowel, leucorrhea,
 gleet,  sore  mouth,  and chronic ophthalmia.  Dose of the  decoction,  from
 two to four fluidounces, three or four times a day.

   WORMSEED.  Chenopodium Anihelminticum.   This is a perennial plant
 growing in waste places,  in nearly all parts of the United  States, and  also
 known as Jerusalem Oak.  The seeds yield volatile oil by distillation, which
 is  anthelmintic, and  much used for  the removal of the round worm.   It is
 more commonly used in doses of from four to eight drops, for a child, morn-
 ing and evening, continuing its use thus for four or five  days,  and then
 giving a brisk cathartic.  A strong infusion of the tops, is also said to ex-
 pel worms.

   WORMWOOD.   Artemisia  Absinthium.   This is a well-known peren-
 nial, shrubby plant, the tops and leaves of  which  possess tonic and anthel-
 mintic properties.   The powder  or cold  infusion  has been  used to  pro-
 mote the appetite in dyspepsia, in gonorrhea, intermittent fever,  suppressed
 menstruation, worms,  &c.   Dose of the powder, from  ten  to  thirty grains;
 "f  the infusion, one or two fluidounces.   Externally, the herb is useful as a
fomentation in bruises, local inflammations, &c. 
710
AMERICAN  FAMILY PHYSICIAN.
    YARROW.  Achillea Millefolium.  This is a perennial herb, common to
 Europe^ and  North America.  It possesses tonic, astringent, and alterative
 properties, and has been used with "advantage in intermittent fever, bleeding
 from  the  lungs, kidneys and stomach, excessive menstruation, incontinence
 of urine, diabetes, piles, flatulent colic, chronic dysentery, and some nervous
 affections.  The infusion may be taken  three or four times a day in wine-
 glassful doses; the volatile oil obtained from  the plant, in doses of from ten
 to thirty drops.


    YEAST.    Cereviswe Fermentum.   Yeast is  stimulant, tonic,  nutritious
 antiseptic, and laxative.   It  may be  used in typhoid  fevers by mouth and
 injection, and in tympanitis  by injection.   In all  malignant ulcerations of
 the throat and mouth, in diseases where  there  is a disposition  to  putridity
 in scarlatina, low stages  of fevers, with or without  the addition of Olive Oil'
 which renders it more laxative, it will be found very beneficial.  Given with
 Quinia it is very effectual in  felons, carbuncles, and boils.  The dose is half
 a fluidounce or a fluidounce,  repeated every two or  three hours.  Externally
 in combination with Elm bark and charcoal it forms an  excellent emollient
 and antiseptic poultice in sloughing ulcers, stimulating the vessels, removing
 the tendency to gangrene, and correcting the fetor.


   YELLOW  DOCK.  Rumex Gdspus.  This is a perennial plant growing
 in various  parts  of the United  States, in dry fields, waste  grounds, &c.
 The root is alterative, tonic, diuretic, and detergent, and  is eminently useful
 in scorbutic,  cutaneous,  scrofulous, scirrhous, and syphilitic affections, lep-
 rosy, elephantiasis, &c.   The fresh root bruised in lard  or butter, forms an
 excellent ointment  for scrofulous  ulcers, scrofulous ophthalmia, itch, and a
 discutient for indolent glandular tumors.   Dose  of the decoction  or syrup,
 from one to four fluidounces,  three times a day.


   YELLOW JESSAMINE.   Gelseminum Sempervirens. This is a peren
 nial, twining  plant, common  to the  Southern  States.  The  root is the part
 used.  It possesses narcotic, relaxing, and febrifuge properties; quieting all
 nervous  irritability or  excitement,  equalizing  the  circulation, promoting
 perspiration, and rectifying the various secretions,  without  causing nausea,
 vomiting, or purging.   It may be used  in  all acute diseases, nervous head-
 ache, rheumatism, neuralgia, painful  menstruation, spasmodic attacks, lock-
 jaw, and wherever relaxation  of the  system is indicated to  lessen pain, ir-
 ritability, inflammation, or spasm, &c.   It should not be  used in congestive
 fever, where  there  is  muscular or nervous prostration,  or relaxation of the
 system with exhaustion, nor when there is a tendency to fulness of the head.
 The dose of the tincture is from ten  drops  to a fluidrachm or more, accord-
 ing  to its influence.   Its  effects  are clouded  vision,  double  sightedness,
 complete prostration, inability to open  the  eyes, but which  gradually pass
 off in  a few hours leaving the patient refreshed and relieved, or completely
restored.  And so soon  as the  heaviness  or partial closing of the eyes is
induced, no  more  of  the remedy  will be necessary in  most cases, at least
until these symptoms  have passed away.   Large and  continued doses ar
dangerous, and have  proved  fatal.   The  antidotes to  improper doses of it
are Aqua Ammonia to the nose; stimulants, or Turk's  Island salt, about
the size of a large pea, internally;  Quinia and  Capsicum; and electro-mag-
netism.  The  tincture loses its strength by age. 
MATERIA MEDICA.
711
   YELLOW LADIES'  SLIPPER.    Cypripedium Pubescens.    This is  a
 perennial plant found in most parts of the United States, and  also known
 bv the  names of American Valerian, Umbel, Nerve  Root,  &c.   There  are
 peveral varieties of the plant, all of which possess similar virtues.  The root
 \s tonic, stimulant, diaphoretic, and  antispasmodic,  and  has been  found
 beneficial in hysterics, St. Vitus' dance, nervous headache, and  all,cases of
 nervous irritability or excitability.   Dose of the powder, from ten to thirty
 grains;  of the infusion, from  one to four fluidounces;  of  the tincture, from
 one to'three fluidrachms;  of the extract, from one  to  five grains, three or
 four times a day.
   Cypripedin is the principle obtained from the root by adding the tincture
 to an equal volume of water, and distilling off the alcohol.  It possesses
 the virtues of the root, in doses of from one to three grains.

   YELLOW PARILLA.  Menispcrmum Canadense.   This is a  perennial
 plant common in woods  and near streams  throughout the country.   The
 root is tonic, laxative, alterative, and  diuretic.  It is much esteemed as  a
 remedy in scrofulous, cutaneous, gouty, rheumatic, syphilitic, and mercurial
 diseases; also in  dyspepsia, general  debility,  and  chronic inflammation of
 the stomach and  bowels.   Dose of the  decoction, from  two to four fluid-
 ounces three times a day; of the extract, from two to four grains three or
 four times a day.

   ZINC.  The following are the  preparations of this metal employed in
 medicine:—
   1. Chloride of Zinc.   Zinci  Chloridum.   This is a grayish-white, soft,
 deliquescent salt,  soluble  in water, ether, or alcohol.   It  is a powerful  es-
 charotic, and has been used as an application to cancers, malignant tumors,
 and obstinate  ulcers; it  destroys the  diseased parts, and develops healthy
 action in the structures beneath.   A solution  of it nas been used in gon-
 orrhea; two or three  grains being dissolved in one or two  fluidounces of
 water, and injected into the vagina every four or five hours, or into the male
 urethra, extending only an inch or two within it.   This  is also  useful in
 leucorrhea, purulent discharge from  the womb, ulceration  of the neck of
 the womb, Ac.  Internally, it is seldom used; and in  overdoses it is a cor-
 rosive poison.
  2. Impure Carbonate of  Zinc.   Also  called calamine, and  lapis  cala-
 minaris. This is a native salt found in  Europe and this country, which when
 calcined and powdered, forms a flesh-colored powder, resembling earth.  It
 is sprinkled on  chafed or excoriated  parts, to dry and heal  them; and is
 sometimes made into a cerate or  ointment for this purpose.
  3.  1-odidc of Zinc.   Zinci Iodidum.   This is a white, needle-like salt,
 very apt to decompose spontaneously.   Ten or twenty grains dissolved in  a
 fluidounce of water, has been found useful as an application in enlargement
 of the tonsils, and in indolent  scrofulous tumors.  Or, it may be prepared
 for this purpose by placing a piece of  clean Zinc in an  inclined position
 over a glass  jar, and sprinkling  iodine  upon it.  In a little time, the iodide
 drops  into the jar, as a  deliquescent  semifluid;  this may  be  applied by
 means of a piece of sponge, or camels  hair pencil, repeating the application
 two or three times a week.
  4.  Oxide  of Zinc.  Zinei Oxidum.   This is a white, or yellowish-white
powder, without  odor or taste, and insoluble in water or alcohol.  It is ap-
plied to chafed and  excoriated  parts, either in powder, or in the form of
ointment, and for which it answers an excellent purpose. 
712
AMERICAN FAMILY  PHYSICIAN.
  5. Sulphate of Zinc.   Zinci  Sulphas.   This is  also called Wliite Jltriol
Et is a colorless, four-sided, prismatic salt, soluble in water.   It is sometimes
used internally as an  emetic, in cases of poisoning, to produce immediate
vomiting; the dose is from ten to thirty grains.   Its more common use is as
an external application  to  old  ulcers,  gangrene or  mortification, malignant
ulcers, cancers, &c.  A solution of it in water, from one to  six grains to the
fluidounce, is used as a wash in chronic  ophthalmia, and as an injection in
chronic gonorrhea, gleet, ulceration of the neck  of the womb, and leucor-
rhea.  The powder mixed with  powdered Bloodroot and applied to polypus
•f the nose, has effected cures.
PHARMACY.
  Pharmacy is that part of medical science which relates to the selection,
preservation, and preparation of the various simple and compound remedies,
which may be required in the management of disease.  And this is so im-
portant a branch of  medicine that it is generally confided to a class of men,
termed  Apothecaries or Druggists, who are taught all  the necessary rules
and  principles for the proper preparation  and  combination  of medicines.
The  beneficial effects of a remedy can be obtained only  when it is  skilfully
exhibited, and the improper administration of even a valuable remedy may
produce  serious results; and again, a safe  and salutary prescription, when
improperly prepared, may prove as inefficacious or as  injurious as in either
of the preceding cases.  Hence,  the necessity  for a separate department
requiring intelligent, careful, and well-educated persons.
  Medicines are either administered separately, or in combination, and the
several forms in which they are generally prescribed, are—
      1.  Balsams,                       13.  Liniments,
      2.  Cataplasms, or Poultices,        14.  Liquors, or Solutions,
      3.  Caustics,                       15.  Lotions, or Washes,
      4.  Cerates,                        16.  Medicated Waters,
      5.  Confections,                    17.  Medicated Wines,
      6.  Decoctions,                     18.  Mixtures,
      7.  Essences,                       19.  Ointments,
      8.  Extracts,                       20.  Pills,
      9.  Fluid Extracts,                 21.  Plasters,
     10.  Fomentations,                  22.  Powders,
     11.  Infusions,                      23.  Syrups,
     12.  Injections,  or Clysters,          24.  Tinctures,
                         25. Vinegars.
  The weights and measures used by the physician and apothecary in pro-
paring medicines for use, are as follows:—             t
            20 grains  (grs. xx)  make  one   scruple, (Bj.)
            3 scruples  (Biij)     make  one   drachm, J3j.)
            8 drachms (Sviif)    make  one   ounce,  (Sj.)
            12 ounces  (gxii)     make  one   pound, (lbj.)
  The  characters or symbols  in brackets  represent  the weights  to wnica
they are annexed, and are generally made use of by medical men; when lj
is intended to  represent "a half" two  letters "ss" are added, thus, tor nau
a drachm, 3ss—for  two and a half ounces, Sijss, &c. 
Ipecacuanha.   (Calficocca  Ipecacuanha.) 
 
 
PHARMACY.
713
  Fluids are measured as follows :—
        60 minims («tlx)      make  one  fluidrachm, (f3j.)
        8 fluidrachms (f3viii)  make  one  fluidounce, (fgj.)
        16 fluidounces (fgxvi  make  one  pint, (oct.j.)
        8 pints (oct.viii)       make  one gallon, (cong.j.)
  For the "pint"—octarius, 0. or Oct. is used ;  for the "gallon"—congius,
Cong, is the  abbreviation,  au, or ana,  means "of each.''   There are also
certain approximate measurements used in domestic practice, but which are
never employed  by  the properly instructed  apothecary.   Thus,   drops
(gutta?) are  frequently named or  prescribed; in  medicine,  a  drop  (gtt.)
means a minim, but when liquids are dropped from vessels they vary  much
in size according  to the form of the mouth of the vessel, its size, and the
consistency of the fluid, so that the drop of some liquids would be  quite
small, mttch less than a minim, while that of others would be much greater;
hence, drops, as commonly understood are a very indefinite measure.   The
other measures referred  to, are nearly as indefinite on account of the vari-
ation in size of the vessels used.  They are as follows :—
  A spoonful, (Cochleare, or Coch.) equal to one fluidrachm.
  A teaspoonful, (Cochleare parvum, or Coch. par.) equal to one fluidrachm.
  A dessert-spoonful,  (Cochleare  modicum, or Coch. mod.) equal to  three
fluidrachms.
  A table-spoonful, (Cochleare magnum, or Coch. mag.) equal to half a
fluidounce.
  A wineglassful, (Cyathus vinarius,  or Cyath.  vin.) equal to  two  fluid-
ounces.
  A teacupful, (Cyathus theat, or  Cyath. the.) equal to six fluidounces.
  Very powerful or active medicines, and especially those which exert in-
jurious influences  upon  the system in large doses, should always be accu-
rately weighed or measured, and  when  added to other  agents, should be
well and thoroughly mixed together.
  Some attention should likewise be bestowed upon  the doses  of medicine.
Medicines  should always be  given  in the smallest  possible quantity that
will produce  an influence upon the system.  An emetic, a cathartic, and
similar agents, require to be administered in  quantities which will effect an
almost immediate  operation, as  such is their object; but other agents, as
tonics, alteratives, diaphoretics, &c,  should be given in small doses, and be
repeated more or  less frequently, the  intervals  between the  doses  being
regulated according to the influence exerted  by the  medicine.   Some per-
sons will require  larger doses of  a particular  agent than  others,  and
frequently, even the same person will be differently influenced  by the same
remedy, on different  occasions, owing to the condition of his  system, and
the  attending  circumstances  at each time.  The action of medicines may
be modified not only by certain peculiarities or idiosyncrasies  as they are
termed, but also by the condition of the stomach, as well as of the nervous
system; climate, temperament, and the habit of taking medicines, so influ-
ence the nervous system, that a marked difference will be observed in the
action of the same agent when given under these  various conditions.   The
doses, as well as the action of a medicine, will  also be found to vary when
taken during health,  and again when in a state of disease.   The habit oi
taking stimulating food,  or indulging in strong  drink, will  render a person
less  susceptible to the action of stimulating  agents, narcotics,  &c.  By the
exhibition of medicines in small doses, and at certain  periods, we have them
completely under our control, and  can continue or  suspend  their  use,
without fear of any unpleasant after-consequences. 
714
AMERICAN FAMILY  PHYSICIAN.
  The doses named in this work, are the average ones, and it will be always
better to commence with the smaller quantities, gradually increasing them
until  the desired influence is produced, being careful,  however, never to
obtain the full  and immediate  action of any agent, except  cathartics, &c
There is no doubt, but that much mischief has been accomplished by giving
those agents, whose use requires to be continued  from day to day, in doses
sufficiently large to produce and continue an active and powerful influence.
The following table of medicinal doses, proportioned to the ages of persons
will be found  adapted to most  cases,  though, a few instances will be  met
with, in which children will require more than is here proportioned to them
as in the case of Castor Oil.  Whatever  may be the quantity of a medicine
required as a dose for  an adult, we will call  it 1, and then  younger persona
will, according to their age, have  the  doses proportioned  to them  in frac-
tions or parts of this 1, as described in the

                         TABLE OF  DOSES.

  Dose for an adult, over 21 years.............1
   do. for a person between 14 and 21  years,......•  •   I
   do.        do.            7 and 14   do..........£
   do.        do.            4 and 7   do..........$
   do.        do. 4 years old,.............|
   do.        do. 3  do.......j........-|
   do.        do. 2  do................£
   do.        do. 1  do...............1-12
   do.        do. 6 months old,...........1-16
  Females, weakly or delicate constitutions,  and those of sanguine tempera-
ment, usually require less powerful doses than others.   Yfhere, from idio-
syncrasy or otherwise,  a medicine  produces  uncertain or unpleasant results,
its use should be dispensed with,  and  some agent selected as a substitute,
whose actions are similar but without the objectionable  effects.
BALSAMS.
  Strictly speaking, the  term Balsam is confined to those agents which
contain Cinnamic  or  Benzoic Acid, as Balsam of Tolu, Balsam of Peru,
&c.   I  employ  it  here  to  distinguish  those pharmaceutical  compounds,
whose consistency is similar to that  of the liquid true balsams, and which
have  not been otherwise classified ; more properly, they are mixtures.

  COMPOUND BALSAM OF  SULPHUR.   Take  of  recently Precipi-
tated Sulphur, sometimes called  " Milk  of Sulphur," two ounces; Linseed
Oil one pound; mix, and boil together until all the Sulphur is  dissolved,
stirring it constantly.  After  the Sulphur is dissolved, add Oil  of Amber
two fluidounces, and Oil of Turpentine a sufficient quantity to make the
mixture of a consistence resembling molasses.
  In  preparing  this, if the Sulphur is not all  dissolved, the mixture will
be spoiled ;  if it be boiled too long, it will be apt to inflame, and  be, conse-
quently, useless.  As the preparation, while  being made, gives out a very
disagreeable, irritating  gas, it should be made in  the open air, or in a fire-
place with a tall  chimney having  a  strong draught.  While boiling, the
mixture must be constantly stirred, and a  piece of wet woollen carpet must
be at hand, to throw  over  the vessel  at once, should the mixture at any
time inflame.  As  soon as the Sulphur  is dissolved, remove from the fire,
and add the other articles when it is  nearly cold. 
PHARMACY.
715
  This preparation is very useful in diseases of the kidneys and. bladder,
especially when there is a  great amount of phosphatic  deposits and mucus
in the alkaline urine ; in uric acid and  phosphatic  gravel ;  in  gonorrhea,
gleet, fluor albus, &c.   Among the Germans, it is highly prized, and is sold
as a nostrum called Harlem Oil.   The dose is from ten to thirty drops once
a day, or once in two days ; it may be taken in water, milk, mucilage, or, if
not contra-indicated, in gin.

  STYPTIC BALSAM.   ( Warren's.)   Take of Sulphuric Acid, by weight,
five drachms ; Oil of Turpentine two fluidrachms ;  Alcohol two fluidrachms.
These materials should be of the purest kind.
  Place the Sulphuric Acid in  a wedgewood mortar,  and slowly add the
Turpentine to it, stirring the mixture constantly with the pestle ; then add
the Alcohol in  the same  manner, and continue stirring until the fumes
cease to arise, when place in a bottle well stopped with  a glass stopper.   If
properly prepared, the  mixture will be of a dark but clear red color, like
dark blood; but if it be of a pale, dirty-red color, it will not be fit for use.
After a few days, a pellicle forms upon the surface, which must be broken,
and the liquid below it used.
  This balsam has been used by its originator for nearly thirty years, and
with uniform  success.  It acts both by its sedative power, in diminishing
the force of the circulation, and  by its astringent qualities, in contact with
the  bleeding vessels.   He has used it in bleeding from  the lungs, stomach,
nose, and uterus, and in  excessive menstruation; in which complaint it is
not necessary to confine the patient to the  room, suppress  the voice, nor
neglect  business, nor is any auxiliary treatment required, except, perhaps,
a purgative dose, where there is  evidence that blood has  been swallowed.
Exercise in the open  air is preferable to inaction.  Into an ordinary tea-
cup place a teaspoonful of brown sugar, add forty drops of the above Bal-
sam to it, and thoroughly incorporate the two by rubbing them together;
then slowly stir in water until the cup  is nearly full,  when  it should be
immediately swallowed.  This  dose  may be repeated every hour for three
or four hours, and  its use should be discontinued as soon as fresh  blood
ceases to flow.
                 CATAPLASMS, or  POULTICES.
  Cataplasms are designed for application to external parts, and are more
 commonly called poultices :  they must be soft and moist, without sticking to
 the skin, from  which they should  be  readily removed, when needed, and
 also without running over the surrounding parts.   Poultices are generally
 applied warm,  and  renewed before becoming  completely dry.  They  are
 intended  for several actions, viz :  to discuss tumors ; to hasten suppura-
 tion ;  to  lessen inflammation ; to  stimulate parts ; to check  gangrenous
 action, &c.

  CARROT  POULTICE.   Take  of  the roots  of garden  Carrots two
 ounces; Flour, or Elm bark,  half an  ounce; boiling water  a  sufficient
quantity to form a poultice.   This is used in the  same cases as the Char-
coal poultice, also  to tumors of a painful character.

  CHARCOAL POULTICE.  Add Bread one ounce, to  hot water fivo
fluidounces, and let them stand for five or ten minutes near a fire; then 
716               AMERICAN   FAMILY  PHYSICIAN.
add powdered Flaxseed five drachms, and powdered Charcoal two drachms,
stirring these in so as to form a soft poultice.  Or, this  poultice may be
made by adding to the Common Elm poultice a sufficient quantity of pow-
dered Charcoal.
  This poultice is used as an application to foul ulcers, gangrenous condi-
tions, &c ;  it removes the offensive odor, and aids in restoring them to a
healthy condition.   It should be changed three or four times in the course
of the day.

  ELM POULTICE.   Take of Elm bark, in powder, half an ounce; hot
water, a sufficient quantity to form a poultice of the proper consistence •
mix.  This poultice is very valuable in all  cases of burns, scalds, inflamed
swellings and  ulcers, painful tumors, abscesses, and  wherever a soothing,
emollient poultice is required.

  LOBELIA POULTICE.   Take  of Lobelia  and Elm bark,  each,  in
powder, one ounce ; weak ley, hot, a sufficient quantity to form a poultice;
mix.   This is  an  useful  poultice in fistula,  wounds, whitlow, boils, erysi-
pelatous  inflammations, stings by insects, and all external  inflammations,
swellings, &c, accompanied with pain.

  POKE ROOT POULTICE.  Take of fresh Poke root a sufficient quan-
tity;  place it  among  hot ashes, and allow it to roast; when it  becomes
quite soft, pound it, and form a poultice.  This poultice may be applied to
all tumors, for the purpose of discussing them, which it will do, unless they
have advanced  to the  suppurative stage, when it will hasten their matura-
tion, and during which its action is apt to  be attended with more or less
pain.  It may be renewed every four hours.
                             CAUSTICS.
  Caustics  are agents which decompose the several  tissues  of the body,
whether these are in a healthy*or diseased condition;  some act more power-
fully than others.  They are obtained from both the vegetable and mineral
kingdoms, and  are  usually employed to destroy unhealthy growths, or to
stimulate indolent parts to greater activity.

  MILD  VEGETABLE CAUSTIC.   Dissolve Bicarbonate  of Potassa
four ounces, in water one pint; strain the solution, and evaporate by a heat
slightly above the boiling point,  and when sufficiently evaporated, set the
residue aside to cool; if it be damp, it may be dried in a gently-heated,
dry air.
  This caustic is much used as an application  in  the  treatment of fistulas,
cancers, fungous growths, indolent or malignant ulcers, &c.  Its action is
principally expended  on unhealthy tissues, arousing them to a  state  of
health without causing any  great amount  of inflammation.  It  has also
been used, either in powder, or in solutions of various strengths, in chronio
inflammatory conditions of the mucous tissues, as in diseases  of the eye,
nose, mouth, throat, vagina, urethra, &c.  A weak solutionis been found
useful as an  injection  in  leucorrhea,  chronic inflammation of  the rec-
tum, &c.

  STRONG  VEGETABLE   CAUSTIC.  Place  any quantity of strong
Ley, prepared from the  ashes of Hickory or  Oak, in an iron vessel; Bet 
PHARMACY.                          717
this over a fire, and evaporate the fluid  to dryness.  Remove the residuum
from the vessel as quickly as possible, break it into small fragments, and
place these  immediately in  a  green glass  bottle.  As  this  preparation
rapidly attracts moisture from the air,  it should be kept well  corked con-
stantly,  pulverising it for use only as required.   It is a much  more active
and powerful agent than the  preceding caustic, and is used for  similar pur-
poses, in cases where  greater  activity is  desired.
                             CERATES.

  The term Cerate being derived from Cera,, wax, indicates mixtures con-
 aining this  substance as one of their ingredients;  however,  wax often
 enters into the composition of plasters and ointments.   Cerates are usually
 composed of lard, tallow or oil, combined  with wax, spermaceti, &c, with
 the addition  of  medicines to  impart the  desired action to them.  They
 Bhould be prepared from  good, fresh articles, and with the use of a very
 moderate  heat.

  CAMPHOR ICE.   Take Spermaceti one drachm,  Almond Oil one fluid-
 ounce; melt these together, and  add Camphor, in powder, one drachm.
  This is a very  useful article for  chapped lips, hands and face, excoriations,
 chafings, &c.   A somewhat similar preparation called Camphor-ball is made
 by melting together Spermaceti three drachms, White  Wax four drachms,
 Almond Oil  one  fluidounce, and stirring  in Camphor, in powder, three
 drachms.

  CALAMINE  CERATE.  Turner's Cerate.  Take of Lard half a pound,
 Yellow Wax an ounce and a half; melt these together  and strain.  When,
 upon cooling, the mixture commences to thicken, gradually add Prepared
 Calamine  an  ounce and a half, and stir constantly till cold.    This cerate
 possesses a slight degree of astringency, and may be applied to burns, scalds,
 simple ulcers, chafing of the skin, excoriations, &c.

  COLD  CREAM.   Take of  Spermaceti  ten drachms, White  Wax  one
 drachm, Oil of Almonds two fluidounces; melt these together by a very gen-
 tle heat, then add Glycerin four fluidrachms, in which Oil of Roses three
 drops have been  placed, and stir constantly  till cold.   This is a  cooling ap-
 plication, much used for chapped hands and lips, to abraded surfaces, &c.

  CROTON  OIL  CERATE.   Take of White Wax two ounces, Lard ten
 ounces; melt these together,  and when  nearly  cool, add  Croton Oil  four
 ounces, stirring constantly until cold.
  This is rubbed on external parts to produce rubefaction or pustulation,  as
 a counter-irritant.

  RESIN  CERATE.  Take  of Resin, ten ounces, Lard sixteen ounces,
 Yellow Wax four  ounces; melt these together,  strain,  and stir  constantly
 until cold.
  This is commonly known by  the name of Basilicon Ointment, and forms a
mild  stimulating  application to  burns, blistered surfaces, ulcers, &c.  A
somewhat similar preparation is made by melting together  Burgundy Pitch
two ounces, Beeswax half an  ounce, Lard or  Sweet Oil half an ounce. 
718
AMERICAN FAMILY  PHYSICIAN.
  SIMPLE CERATE.   Take of Lard two ounces, White Wax  one ounce;
melt together, and stir until cold.
  Used for similar purposes as the Calamine Cerate.
                 CONFECTIONS  or  CONSERVES.

  COMPOUND  CONFECTION OF  SENNA.   Compound Electuary of
Senna.  Pile Electuary.   Take of Confection of Senna one ounce; Cream
of Tartar  half  an ounce ;  Powdered  Jalap  three  drachms; Nitre and
Flowers of Sulphur, each, two drachms; Extract of Butternut a  sufficient
quantity to form into a pill mass. • Mix.
  This is excellent for the blind and bleeding piles,  and  constipation.  It
should be formed into four grain pills, of which three or four may be taken
every night and morning, or enough to gently open the bowels.
                            DECOCTIONS.

  Decoctions are waters containing the active principle of medicines, obtained
by boiling.  The agents used are  reduced to a coarse powder, or sliced,
placed in clean, pure water, and boiled for a sufficient length of time to obtain
their virtues; after which, while still hot, the fluid is strained.   Some arti-
cles are injured by long boiling, and  consequently  should not be used in
decoction, as those which contain volatile matters.    The action of the air
frequently impairs the  activity of medicinal principles obtained by decoc-
tion,  hence, whenever  decoctions are made,  they  should be kept covered
during the boiling process.   The  usual proportion of vegetable substances,
in preparing decoctions, is  one ounce of the plant or root used to a pint of
water, of which the dose is from one to four ounces, depending on the activ-
ity of the medicine, or the  therapeutical effect which is required.
                             ESSENCES.

  Essences are tinctures of the essential oils of plants, and are prepared by
dissolving two fluidounces of the oil in one pint of Alcohol;  in this manner
are prepared the essences of Anise, Caraway, Cinnamon, Peppermint, Spear-
mint, Sassafras, &c.   The properties of essences are similar to those of the
oils from which they are prepared, and their doses vary from ten drops to a
teaspoonful in a little sweetened water.
                             EXTRACTS.

  Extracts are soft substances, of pilular consistence, obtained from  various
agents,  by  the  evaporation  of their decoctions, tinctures, or juices, &c.
Those obtained by the agency of water, are called watery or aqueous extracts;
those by means of Alcohol, Alcoholic extracts; and  those  where both are
used, Hydro-Alcoholic extracts.   Much skill and  knowledge is required to
prepare reliable extracts,  and  the  ordinary  method  of  making a strong
decoction and evaporating it down to the proper consistence, generally pro-
duces a substance either inert,  or having the active  principles  materially
impaired.   The limits of this work will not permit an  explanation of the 
PHARMACY.
719
correct mode of preparing this class of agents, nor,  indeed,  is  it necessary,
as they can be procured  with greater activity and at less  cost, than any one
not engaged  in their manufacture could possibly  effect.    There are many
manufacturers of extracts.  I principally  use those prepared  by Tilden &
Co., Lebanon, N. Y., W. S. Merrill &  Co., and F. D. Hill, Cincinnati, 0., and
find them to be superior  articles, upon which the physician may confidently
rely.   The properties  of extracts are  the same as the plants from which they
are obtained and their doses are as follows:
EXTRACTS.
DOSES.
Belladonna, Alcoholic..........% grain
Black Cohosh,  "       .  .  :......
Conium,        "       .  . _.......
Cypripedium, Hydro-Alcoholic......
Gentian, Aqueous     ..........
Hyoscyamus, Alcoholic.........
High Cranberry Bark, Hydro-Alcoholic    .  .  .
Motherwort, Hydro-Alcoholic........2
Nux Vomica, Alcoholic.........1-20
Poke, Alcoholic       ...........-|
Rhatany, Aqueous...........3
Stramonium, Alcoholic..........-J
Unicorn Root,   do.  (aletridin).......-^
Walnut Shells, Aqueous.........2
Water Pepper,     do       .........2

  These doses  may be repeated two or three times a day, according to their
influence.    Inspissated  Juices are  prepared by grinding the  root or herb,
expressing the juice, and allowing it to evaporate in a moderately warm apart-
ment; the doses are similar to that  of the  extracts.   Both extracts and in
Bpissated juices, should always be kept well covered, or they will spoil.
lin to	1	gram
' to	5 grains	
' to	3	< <
' to	5	( c
' to	10	' It
' to	3	I(
' to	10	i I
< to	6	I i
' to	1	<(
< to	5	((
' to	15	( I
' to	1	i t
' to	3	c I
' to	15	I I
' to	10	t i
                         FLUID  EXTRACTS.

   This is a form in which many valuable remedies are  prepared.   In some
 respects these preparations are preferable to extracts, tinctures, or decoctions,
 because they are not so liable to injury or decomposition, by great or long-
 continued heat, as is apt  to  be  the case with extracts,—do  not contain so
 much Alcohol  as tinctures,—and possess more of the active properties of an
 agent, and in smaller doses  than  are  required  for  decoctions  or  infusions.
 Considerable skill is dem|nded to produce a proper fluid extract, which can-
 not be well imparted by reading or writing,  and  those  who  offer  the best
 articles of this kind  to the profession,  are they who have had some consid-
 erable experience in their manufacture.   The fluid extracts manufactured by
 the firms named in the preceding  article, and especially those of the Messrs.
 Tilden, are  not surpassed by any in the country.   Those who use fluid ex-
 tracts, will do better by procuring the articles made by the above gentlemen,
or other reliable manufacturers, than by  individually attempting the prena-
ration.
  Fluid  extracts possess the medicinal virtues of the plants from which they
we obtained, and their doses are as follows:— 
720
AMERICAN FAMILY PHYSICIAN.
  FLUID EXTRACTS.                              DOSES.
Black Cohosh,......     •   •   i fluidrachm  to  2 fluidrachms.
Buchu,...........1     do     to  3     do
Chamomile,........•   •   i     do     to  1     do
Cubebs,............5 minims     to 30 minims.
Dogwood,..........\ fluidrachm  to  2 fluidrachms.
Gentian,...........\     do     to  1     do
Life root,..........\     do     to  1     do
Lobelia,...........10 minims     to 60 minims.
Prickly-Ash,.........10   do       to 30   do
Rhubarb,..........30   do       to 60   do
Sarsaparilla,.........1 fluidrachm  to  2 fluidrachms.
Scullcap,...........\     do     to  1     do
Stillingia,  •.........2 minims     to  5 minims.
Trailing Arbutus,........1 fluidrachm  to  2 fluidrachms.
Water Pepper,.........10 minims     to 60 minims.
Wild Cherry,  ..........  10   do       to 60   do
               ♦
  These doses may be repeated three or four times a day, according to the
influence they exert.  There are also one or two Compound Fluid Extracts,
the formula for which will now be given.

  FLUID EXTRACT OF RHUBARB AND  POTASSA.  Fluid Neu-
tralizing  Extract.   Take  of the  best  India Rhubarb Root two pounds,
avoirdupois; Cassia or Cinnamon, and  Golden  Seal,  each, one pound.
Grind, or  coarsely bruise the  articles and mix  them.   Macerate them for
twenty-four hours, or  longer, in  best  fourth  proof Brandy, one gallon;
then express the tincture with  strong pressure, and  add to it, Oil of Pep-
permint one fluidrachm, previously dissolved in a little  alcohol.  Break up
the cake or compressed  residue, from the press,  and  place it in a displace-
ment apparatus, and gradually add warm  water, until the strength of the
articles is exhausted.   Evaporate this solution to four pints,  and while the
liquor is  still  hot, dissolve in it  Bicarbonate  of Potassa two pounds, and
Refined Sugar three pounds.   Continue  the evaporation, if necessary, until,
when added to the tincture first obtained, it  will make one  gallon  and a
half, and  mix the  two solutions together.
   This is an improvement upon the Syrup of Rhubarb and Potassa, by W.
S. Merrell, and is used for the same diseases  as  the Compound Powder of
Rhubarb, and is a more eligible form of administration.   The  dose is one
fluidrachm, which is equivalent to half a drachm  of the powder.

   FLUID EXTRACT OF SPIGELIA AND  SENNA.   Take of Pink
root, in coarse powder, one pound;  Senna, in  coarse powder, six ounces;
macerate  them for two days in diluted  Alcohol'two pints; then put the
mixture into a percolator, and  add gradually of diluted Alcohol, until four
pints have passed.  Evaporate the tincture thus obtained, by means of a
water bath, to sixteen  fluidounces;  add Carbonate  of  Potassa  one  ounce,
by which the resinous sediment is dissolved, and then add Sugar one pound
and a half, previously triturated with* Oil  of Caraway, and  Oil of  Anise,
each, half a fluidrachm, effecting the solution of the sugar by a gentle heat.
This is useful as a vermifuge, in doses of half  a fluidounce for an adult;
and from  half a fluidrachm to a fluidrachm, for a child two years old.—An.
Jour, of Pharm. 
PHARMACY-.
721
                        FOMENTATIONS.

  Fomentations are employed for the purpose of relaxing parts5> relieving
them from tension or spasmodic action, and lessening  pain and inflamma-
tion.  They are usually composed  of bitter  or anodyne herbs, which are
bteeped for  a time in hot water, or hot vinegar and water, the herbs placed
in a piece of muslin cloth, and applied over  the  affected part as warm as
can be borne, care being taken that they be not applied  so moist as to wet
the under-clothing and bed of the  patient.  They should be renewed fre-
quently; the more severe  the  pain  or inflammation, the oftener  should
they be changed and renewed.
  Fomentations are usually prepared of:—
  1. Hops, Tansy, Wormwood, equal parts of each.
  2. Hops, Lobelia, and Stramonium  leaves, of each, equal parts j useful
in severe inflammations.
  3. Poppy Capsules.
                            INFUSIONS.

   There are many medicinal articles whose virtues are injured or entirely
 destroyed by boiling, especially those of a  volatile nature; consequently,
 such are, when  required, made  into  infusions, either by cold or  boiling
 water.  The article is placed  in  the  water  and allowed to stand for a cer-
 tain time, until its medicinal strength is extracted.   The proportions are,
 usually, half an  ounce, or an ounce of the root, herb, or bark, to a pint of
 water;  the preparation is best made in  a porcelain or glass vessel,  instead
 of a metallic one, and should be kept covered.   The doses of infusions vary
 from a  table-spoonful to a teacupful, depending on the activity of the med-
 icine, and the effect to be produced.  In warm weather, infusions  for the
 sick should be prepared daily;  in cold weather, every other  day,  as they
 are not so liable to change and become acid  or  moldy in the latter seasons.
 There are a few  Compound Infusions  of a valuable character, which I will
 now describe.

  COMPOUND INFUSION OF GERANIUM.   Take of Geranium root,
 Black Cohosh root, Golden  Seal  root, Witch  Hazel bark,  each, in coarse
 powder, one ounce; boiling  water four pints.  Place the  articles in the
 water, and allow them to stand in a close vessel, for about two  hours, under
 the influence of a gentle heat, after which strain, and if required, add pow-
 dered Alum two  drachms.
  This  astringent infusion is useful in chronic  diarrhea  and dysentery, in
 doses of one or two table-spoonfuls every two  or three hours.  It is also
 of service as an injection in gleet, prolapsus  of  the rectum,  leucorrhea, and
 slight ulceration or excoriation of the neck  of  the womb, and as a wash or
 garglo in various ulcerations of the mouth and  throat.

  COMPOUND  INFUSION OF PARSLEY.  "Take of Parsley roots
 and seeds, and  Subcarbonate of  Iron, each,  two ounces ;  Horse-radish
 root one  ounce  ; Squill, Juniper  berries, White  Mustard  seed, Mandrake
 root, nnd Queen  of the Meadow root, each, half an ounce; coarsely slice or
 bruise these articles, and place them in boiling Cider three quarts ;  cover
 the  vessel, which should be  earthen, and  expose it to  a  gentle  heat for
twenty-four hours.   The cider should not be hard, nor too new, but spark-
klinc; and pleasantly tart;  and after digestion  by heat, that it may become
      46 
722
AMERICAN  FAMILY  PHYSICIAN.
still further  impregnated with the properties of the medicines, it should
be allowed to remain upon the articles, not straining it off.
  " This is useful in several varieties of dropsy, increasing  the action of
the kidneys, regulating the bowels, improving the digestive functions, and
promoting activity of the absorbent vessels.   The dose is one or two fluid-
ounces three  or four times a day."—Am. Ec. Disp.

  COMPOUND INFUSION  OF  SAGE.   Take of Hyssop leaves, and
Sage, each, half an  ounce, boiling water one pint.  Add the herbs to  tho
water, expose to a gentle heat  about thirty minutes, and then add Borax,
in powder, thirty grains.
  This  forms an  excellent gargle  or  wash for ulcerations and inflamed
conditions of the mouth and throat.

  COMPOUND  INFUSION  OF  TRAILING ARBUTUS.   Take  of
Queen of the Meadow root, Dwarf Elder bark, Marshmallow  root, Trailing
Arbutus, each,  coarsely  bruised,  half an  ounce; place them  in boiling
water one pint, and good Holland Gin one pint, and steep by a gentle heat,
in a closely covered vessel, for  four hours; then strain, and sweeten well
with Honey a sufficient quantity.
   This  is an useful diuretic compound  in  gravel, (but  not the oxalate de-
posits,) suppression of urine, high-colored  or scalding  urine, urethral in-
flammation, and many  other  urinary disorders.  In severe  cases, a wine-
glassful  may be  given every  hour until relief is  obtained, after which,
every three or four hours.  In some cases, a  similar  quantity of Wild
Carrot root may be added to the above.
                   INJECTIONS,  or CLYSTERS.

  These are composed of decoctions or infusions, &c, and are designed to
be introduced into the  rectum or lower  bowels, by  means of a syringe.
They are more commonly exhibited for the purpose of aiding in the evacu-
ation of the bowels;  sometimes, however they are of  a soothing character,
at others stimulant, nutritive, relaxant, or  anodyne, &c.   Injections  are a
very useful class  of remedies, and, indeed, it would be very difficult to
treat some diseases  without  them.  When the fluid is  intended for the
vagina, it is termed  a vaginal injection.  The following  remarks on this
subject are extracted from the author's "American Eclectic Dispensatory."
  " Injections are  a very valuable mode of treatment in many diseases;
indeed some affections  cannot  be readily nor  permanently cured without
them.   They are found  especially beneficial in bilious  colic, in bilious,
typhus, yellow, and congestive forms of fever, in dysentery, diarrhea, &c.
Among infants, life has  often been preserved by their timely application;
and  the pains and  dangers of the  parturient woman,  have frequently been
very materially  lessened  by  their use.  And yet, notwithstanding  their
value and importance, there are hundreds of families, especially in country
places  who do not supply themselves with  the articles necessary for their
administration, but who  depend entirely upon the physician, or perhaps a
neighbor, for the use of a syringe.  This  is  a very reprehensible omis-
sion ;»_« every individual, and more  especially every family, is liable to
sickness which may require the use of a syringe, and  to  depend upon tfte
physician for  its supply  is certainly bad  policy, for very  few, especia y
amono- those practicing  in the country,  furnish themselves with a quantuv 
PHARMACY.
723
sufficient to meet the demands of the various families under their profes-
sional care; beside, very few physicians carry an article of this kind, ana
in some diseases, the delay occasioned  by sending for it, may be deathto
the patient.   No doubt, an immense number of patients, and more partic-
ularly among those in the country, die yearly, solely from the want of an
instrument with which to administer an injection.   It  is, therefore, a mat-
ter of duty with the practitioner,  both  to  himself  and to his patients, to
strongly impress these facts upon those who patronize him professionally,
and urge them by all means to make the necessary provision.  A metallic
syringe capable of holding a pint, and a smaller one of three or four fluid-
ounce's should be found in the possession of every family, as these can be
adapted to meet any emergency requiring their use."

  COMPOUND INJECTION, or CLYSTER OF ASSAFETIDA.   Take
of Mandrake in powder, half an ounce, Quassia in coarse powder, an ounce,
and make  a strong decoction with water one pint; then strain and add Tinc-
ture of Assafetida six fluidrachms.
  The injection is very useful to remove the thread or pin worms, which are
liable to be lodged in the rectum.  A gill may be injected into the rectum
of a child two or three years old, and repeated as often as required.

  COMPOUND  INJECTION, or CLYSTER OF LOBELIA.   To water
one fluidounce, add Compound Tincture of Lobelia and Capsicum one flui-
drachm.
  This is a valuable antispasmodic injection, which may be used in all eases
of spasmodic action, as epilepsy, convulsions, lockjaw, and in a rigid state
of the os uteri.  An infant laboring under convulsions, may have half the
above administered as an injection; an adult, may use four or six times the
quantity named in the formula.   Half a fluidounce of the Compound Tinc-
ture to a fluidounce of water, forms a good injection for adults.

  COMPOUND INJECTION, or CLYSTER OF PRICKLY-ASH.  Take
of Tincture of Prickly-Ash berries one fluidounce, Tincture of Opium
two and a  half fluidrachms, water four fluidounces ; mix.
  This injection  is useful in  diarrhea, Asiatic cholera, summer-complaint
of children, and as a stimulant in  typhoid conditions of fever.   It is also
very efficacious in tympanitis.  The quantity used.for an adult should be
one-eighth of the formula, which  may be  repeated as often as required, al-
ways desiring the patient to retain it in the bowels as long as possible.  In
bowel complaints, it should be administered immediately  after an  operation.

  COMPOUND  INJECTION, or CLYSTER OF  SENNA.   Take  of
Senna and Boneset,  each,  two ounces, boiling water one pint; digest the
herbs in the water by a gentle heat for ten or fifteen minutes ; then strain,
and add molasses, two fluidounces, Salt, Lobelia Seed, Capsicum, of  each  in
powder, one drachm, powdered Bayberry bark, one ounce.
  This injection should be administered as hot as the patient can bear; it
is very useful in  bilious colic, in which it may be repeated every ten  or
fifteen minutes, until a free evacuation has been procured.  In connection
with the injection, use the means  named under Bilious Colic. 
m
AMERICAN  FAMILY PHYSICIAN.
                           LINIMENTS.

  Liniments are liquid mixtures of oils, tinctures,  solutions and varioui
other substances, designed for external  application to painful or torpid
parts, swellings, rheumatism, &c; they may be  rubefacient,  stimulant, or
anodyne and sedative, and  are usually applied  upon the parts by gentle
rubbing with the hand, or flannel.

  ACONITE  LINIMENT.   Take of  Aconite Root,  in  powder,  four
ounces, and  place it  in  Alcohol  half a  pint; macerate for twenty-four
hours, then pack it in a small displacer, and add  Alcohol gradually, until a
pint of the tincture has passed.   Distil off  twelve fluidounces, and evaporate
the residue until it measures twelve fluidrachms.   To this add Alcohol and
Glycerin, of each, two fluidrachms.
  This Liniment is useful in  gout, rheumatism, neuralgia, &c.  It is used
thus:—Cut  a  piece  of lint of the  required size, and  saturate  it with the
Liniment;  when applied to  the surface, a piece  of oiled silk should be
kept over it.   It must be  used with great care, never applying it to an
abraded surface, nor  in  eontact with the nostrils, lips,  or eyes.—W. Proc-
ter, Jr.

  CAMPHOR  LINIMENT.   Take of Camphor six drachms;  dissolve it
in Chloroform  one fluidrachm, and add Olive Oil  one  fluidounce.
  This is an anodyne liniment, useful in rheumatism, neuralgia,  sprains, &c.

  COMMON  LINIMENT.  Take of  solution  of Ammonia, (Aqua Am-
monia,') two fluidounces, Olive Oil four-.fluidounces;  mix together.
  This is  a rubefacient,  useful  in  inflammations of the glands, or parts
around the throat, and in pains, colds, &c, of children ; when too strong, it
may be weakened by the  addition of more Olive Oil.

  COMPOUND CAPSICUM  LINIMENT. RHEUMATIC LINIMENT.
Take of Tincture  of Capsicum one and "a half fluidounces; Tincture of
Opium and  Aqua Ammonia, each, one and  a  half fluidrachms ; Oil of
Origanum one  fluidrachm; Oil of Cinnamon and  Tincture of Camphor, each,
half a fluidrachm; mix.
  This Liniment is used  in rheumatic, pleuritic, neuralgic, and other pains.

  COMPOUND LINIMENT  OF  OIL OF AMBER.  Mix together Oil
of Stillingia and Rectified Oil of Amber, of each, four  fluidrachms, Oil of
Lobelia one and a half fluidrachms,  and Olive Oil one fluidounce.
  This is a stimulant and antispasmodic liniment, useful in asthma, rheum-
atism, spasmodic affections,  hooping-cough. &c, it is usually  applied along
the whole  spinal column, repeating the application two or three times a day,
also rubbed over the affected parts.   It must not be  used in too large quan-
tity at a time.

  COMPOUND LINIMENT  OF  STILLINGIA.   Mix  together Oil of
Stillingia  four fluidrachms, Oil of Cajeput two fluidrachms, Oil  of Lobelia
one fluidrachm, and Alcohol, one fluidounce.
  This Liniment possesses  properties similar to the  preceding, and is used
in the same diseases.  In asthma, the neck, chest, and spinal column must
be bathed with it; and frequently,  as with  the  above liniment,  the patient
will experience a taste of the articles, when thus used externa*iy.

  CROTON OIL LINIMENT.  Mix together Croton Oil four fluidrachms,
with Oil of Turpentine three and a half fluidounces. 
PHARMACY.
725
  This is a rubefacient application, and which if used continuously for sev-
eral days, will  cause pustulation.   Fifteen or twenty drops may be applied
at a time, repeating  it two or three times a day, according to the effect de-
sired.

  OPODELDOC.   Take of  common white Soap two ounces, Camphor one
ounce, Oil of Rosemary three fluidrachms, Oil of Origanum two fluidrachms,
strong Aqua Ammonia one fluidounce, Alcohol  one  pint and a half.  Di-
gest the Soap with the Alcohol, by means of a sand bath, till it is dissolved ;
then add the Camphor,  Oils, and Ammonia, and when they are dissolved,
pour the liquor into broad-mouthed bottles.   This Liniment, when cold, has
the consistence of a  soft ointment.
  It is used as an application in sprains,  rheumatic  pains, &e.  It is also
called Camphorated Soap Liniment.

  WHITE LINIMENT.  To the yelk of one egg, slowly, add Rose Water
two and a half fluidounces,  rubbing them together in a mortar; then add
Oil of Turpentine, three  fluidounces, Oil  of Lemon  half a  fluidrachm.
Pour the whole into  a pint bottle, and agitate to mix thoroughly ; then add
Pyroligneous Acid, (or in its absence, Acetic Acid,)  one fluidounce;  shake
quickly and briskly.   Keep it well corked.
  This liniment is used  in asthma and inflammation of the lungs, rubbing
it on the throat and chest with a sponge or cloth, from the throat to  the pit
of thcstomach; it is also useful wherever a counter-irritant is required.
                    LIQUORS,  or  SOLUTIONS.

   SOLUTION  OF  IODIDE  OF IRON.  Mix, in a porcelain or glass
 vessel, Iodine one ounce with Distilled Water two and a half fluidounces,
 and gradually add Iron Filings half an ounce, stirring  constantly.  Heat
 the mixture  gently until  it acquires  a greenish-tint; then  filter the solu-
 tion  into a glass bottle containing Powdered Sugar six ounces, and  pass
 afterward through the filter Distilled Water, a  sufficient quantity to  make
 altogether ten fluidounces.   Keep in closely stopped bottles.  This is an alter-
 ative chalybeate tonic, and diuretic, and has been used in scrofula, chlorosis,
 suppressed menstruation,  leucorrhea,  dyspepsia, and many other forms of
 chronic disease  attended with  a strumous  or anemic habit of body.  The
 dose  is from ten to forty drops, three times a day, well diluted with water.
 After taking  each dose wash the mouth carefully, that the teeth may not be
 injured by it.

  COMPOUND  SOLUTION  OF IODINE.    Take  of Iodine half an
 ounce, Iodide of Potassium one ounce, Rose Water, or Distilled  Water,  a
 pint.   Dissolve the Iodine and the Iodide of the Potassium in the water.
  This solution should be  kept in a well-stopped bottle, and in a dark place.
 It is a stimulant, alterative, diuretic, and emmenagogue, and is  useful in all
 syphilitic, rheumatic, and  scrofulous diseases, and in suppressed  menstru-
 ation, and  other functional  derangements  of the womb.   The dose is five
 drops, three times a day, in half a  fluidounce of water, gradually increasing
 it to fifteen or twenty drops.

  SOLUTION OF  POTASSA.   Liquor  Potassa.   Dissolve  Carbonate of
Potassa half a pound in boiling Distilled Water two  pints.   On Lime four 
726
AMERICAN  FAMILY PHYSICIAN.
ounces, pour a little boiling Distilled Water taken from another measure of
two pints, and when it is slaked add the  remainder.   Mix the hot liquors
and boil for ten minutes, constantly stirring;  then set the mixture aside, in
a covered vessel, until it becomes clear; pour the clear liquor into green glass
bottles, and  keep them well stopped.   For  properties  see  Solution of
Potassa, page 685.
                       LOTIONS,  or WASHES.

   These comprise all compounds used as external washes, where  remedial
agents are dissolved in water or spirits, and which do not strictly class with
infusions, liniments, mixtures, or tinctures.

   ALKALINE WASH.  Take  of Sal  Soda (Carbonate of Soda), or Sal-
eratus (Bicarbonate of Potassa)  one drachm; warm rain water one pint.
Dissolve.   Or, make a weak ley of hot water and hard wood ashes.
   This is used as a wash to bathe the  surface of the body and limbs, in all
fevers and acute diseases;  also, in many chronic  affections.   After bathing,
the body should be well dried, with considerable friction. When it is also
required to stimulate the skin, some alcohol or whisky may be added.

   BORAX LOTION.   Cooling   Wash.    Take  of  Powdered Borax two
drachms ; Rose Water half a pint; dissolve.   This is useful in inflammation
of the eyes, and inflammation or ulceration of the nipples, and of the mouth
and fauces.   Rain Water may be substituted for the Rose Water.

   BORAX  LOTION WITH MORPHIA.  Take of powdered Borax two
drachms, Sulphate of Morphia three grains, Decoction of Golden Seal foui
fluidounces.  Dissolve the powders in the decoction.
   This is useful in itching  of the  genital parts during pregnancy, or  at
other times; also in the same diseases as the preceding wash.

   COMPOUND LOTION OF GOLDEN SEAL.   To  a strong decoction
of Green Tea, and Golden Seal, each, half a pint, add of Sulphate of Zinc,
Gunpowder, and dried Sulphate  of Iron, each, one  drachm.   Dissolve the
powders in the mixed decoctions, and  after decomposition has ceased, and
the precipitate has subsided, pour off the clear liquid.
   This lotion is used in  chronic diseases of the eye;  it may be applied three
or four times a day.

   COMPOUND  MYRRH  LOTION.  Stimulating Eyewater.  Take of
powdered Myrrh two drachms;   Sulphate of Zinc two  scruples;  Acetate
of Lead one drachm; Boiling water  one pint.   Add the powders  to the
water, let them macerate for eight or ten days, and filter.  In the prepara-
tion of this lotion, a decomposition necessarily ensues.
   This is used principally in chronic  inflammation of the eyes; it may be
applied two, three, or four times daily, and if its action be too severe, it may
be weakened by the addition of water.

   COMPOUND LOTION  OF  ZINC.   Take of Sulphate  of Zinc, Rock
Alum, each, ten grains,  water one pint;  dissolve and filter.
   This is a  stimulating wash, used  for  films, specks, opacities, &c, of the
eyes;  also to indolent ulcers, and  chronic inflammations of mucous surfaces. 
PHARMACY.
727
  COMPOUND SODA LOTION.  Take of Rock Salt three ounces, Sul-
phate of Zinc one ounce, Red  Oxide of Iron (Crocus Martis) eight  grains,
rain Water one pint.  Dissolve these together, and when the precipitate has
eubsided, pour off the clear liquid.
  This is used in the same cases as the Compound Myrrh Lotion.

  COOLING-  LOTION.   Saline  Wash.  Take of fine Salt half an ounce
Vinegar, Soft Water, each,  four fluidounces;  Whisky, or Brandy, two
fluidounces; mix together, and dissolve the salt.
  This is used as a cooling wash  in headaches, inflammation of the brain
dropsy of the head, &c.   It is sometimes used tepid.

  EVAPORATING LOTION.  Compound  Ethereal Lotion.  Take of Sul-
phuric Ether,  Rectified  Alcohol, Solution of Acetate of Ammonia, each,
Bix fluidrachms, Rose Water,  fourteen fluidrachms; mix.
  This lotion is refrigerant, if allowed to evaporate by free exposure; stim-
ulant, if evaporation  is prevented, by covering the part to which it is applied
with the hand or a cloth.

  LOTION  OF GOLDEN SEAL AND ACONITE.  To a concentrated
decoction of Golden  Seal one fluidounce,  add Tincture  of Aconite  half a
fluidrachm; mix.
  This is useful in many affections of the eye, and in chronic inflammations
of mucous surfaces;  a drop or two may be placed  on the eye-ball  two or
three times a day.  In some cases the Tincture of Aconite may be omitted,
and  Tincture of Black Cohosh, half a fluidrachm, or a fluidrachm, be  ad-
vantageously substituted.
                      MEDICATED WATERS.
   These consist of waters which have been  impregnated with some  med-
 icinal agent.   Medicated waters when prepared from volatile oils, are usually
 prepared by triturating a certain  proportion of the oil with Carbonate  of
 Magnesia one drachm,  and then gradually adding,  while continui&g the
 trituration, Distilled water two pints;  finally filtering through  paper.  The
 proportions of oil to the above materials are as follows:—
   Bitter Almond Water  ... of oil of Bitter Almonds, sixteen minims.
   Cinnamon Water   .....of oil of Cinnamon, half a fluidrachm.
   Peppermint Water.....of oil of Peppermint, half  a fluidrachm.
   Spearmint Water   ...... of oil of Spearmint, half a fluidrachm.
   Pennyroyal Water.....of oil of Pennyroyal, half  a fluidrachm.
   The properties of these  medicated waters are similar to  those of the oils
 from which they are prepared; and the doses vary from half a  fluidounce to
 two fluidounces, three or four times a day.   Bitter Almond Water, however,
 is  an exception, its dose is one or two fluidrachms.

  CAMPHOR WATER.   Take  of Camphor one  drachm, triturate it with
 Alcohol  twenty  minims, then with Carbonate of Magnesia two drachms,
 and lastly- with  Distilled  Water, added  gradually,  one  pint;  then  filter
 through paper.
  This is useful in the low stages  of fevers, and  typhoid states of the sys-
tem, to  relieve after-pains, and in all cases where Camphor  is indicated.
One fluidounce contains about three grains of Camphor.  The  dose is from
half a -fluidounce to a fluidounce every hour or two. 
728                AMERICAN  FAMILY PHYSICIAN.

                       MEDICATED WINES.

  Medicated Wines  are the tinctures of medicinal agents in wine, either
pure or diluted; the  common name of Wine Bitters  has  heretofore been
applied to  them.  As they are much more liable to decomposition than
syrups or tinctures, they should be made only in  small quantities at a
time.

  COMPOUND WINE OF  GOLDEN SEAL.  Wine Bitters.  Take of
Golden Seal root, Tulip Tree  bark, Bitter root, each, bruised, one drachm •
Prickly-Ash berries, Sassafras bark, Capsicum, each, half a drachm ; Sherry
Wine, three pints.  Macerate for fourteen days, with  occasional agitation •
then express  and filter.
  This is useful in  dyspepsia, and  in  all cases where tonics  are required.
The dose is from half a fluidounce to two fluidounces,  three times a day.

  COMPOUND WINE OF COMFREY.   Restorative Wine Bitters.  Take
of Comfrey,  Solomon's Seal,  Helonias, each,  bruised, one ounce; Chamo-
mile  flowers, Colombo,  Gentian,  Cardamom seeds,  Sassafras bark, each,
bruised,  half an ounce.  Let  these articles macerate for twenty-four hours,
in sufficient boiling water to cover them, keeping them closely covered; then
add Sherry Wine four pints.  Macerate for fourteen days, express and strain.
  This is a valuable tonic, especially beneficial in leucorrhea, and all dis-
eases  peculiar to females.   The dose is from half a fluidounce to two fluid-
ounces, three or four times  a  day.
                            MIXTURES.

  By mixtures, is meant all those preparations containing substances of a
saccharine, oily, albuminous, or  mucilaginous nature, which cannot pro-
perly be classed  with infusions, decoctions,  syrups, tinctures,  &c.; also
compounds in which insoluble substances are suspended in watery prepara-
tions by the intervention of some viscid matter.

  CAMPHOR MIXTURE.  Take  of Camphor water two fluidounces,
Nitrous Acid fifteen minims, Tincture  of Opium from twenty to forty
drops; mix.
  This  is very useful  in diarrhea, dysentery,  and  cholera morbus.  The
dose is a table-spoonful every two or three hours.

  COMPOUND CAJEPUT MIXTURE.  Hunn's  Drops.   Dissolve  Oil
of Cajeput, Oil of Cloves, Oil of Peppermint, Oil of Anise, each, one flui-
drachm, in rectified Alcohol four fluidrachms.
  This  is useful in  colic, cramp  of the  stomach, or elsewhere, flatulence,
pains in the  stomach or  bowels, painful diarrhea, cholera morbus, Asiatic
Cholera, and in all cases where a stimulant and anti-spasmodic is required.
The dose is  from  twenty drops to a fluidrachm, in some sweetened water.
in simple syrup, or mucilage of slippery Elm.

  COMPOUND COPAIBA MIXTURE.   Diuretic Drops.  Take of Sweet
Spirits of  Nitre  one fluidounce; Copaiba, Canada Balsam,  each, half a
fluidounce;  Oil of  Juniper, Oil of Cubebs, Oil of Anise,  each,  two flui-
drachms ; mix.
  This is useful in  gonorrhea, gleet, scalding of  urine, and  kidney affec* 
 
Baj berry.  (Myrica Cerifera.) 
I'hxntnin.   MM-tntapo Mnjr.r.")
rojuKrmint.   (Mentha  Piperita
'•<iho-;h    (A<-t:r>n  Raccinosn.) 
 
PHARMACY.
729
lions.  The dose is a teaspoonful, three  times a day, in some tea or muci-
lage, shaking it well before taking.

  COMPOUND  MIXTURE  OF  BLOODROOT.   Cough Drops.  Take
of Syrup of Squills, Syrup of Ipecacuanha, Tincture  of  Bloodroot, and
Paregoric, each, half a fluidounce ;  mix.
  This is a valuable  mixture, useful  in severe coughs from colds.  The
dose is from  half a teaspoonful  to a  teaspoonful, whenever the cough is
severe.

  COMPOUND MIXTURE OF CAMPHOR.  Take  of Camphor water,
Peppermint water, and Spearmint water, each, one fluidounce ; Paregoric
two fluidrachms ;  mix together.  This is valuable in  allaying nausea, and
checking vomiting  in cholera morbus, Asiatic Cholera, &c.  The dose is
from a fluidrachm to half a fluidounce, every five minutes, if the patient be
vomiting; every ten minutes, if  he be only nauseated.

  ERIGERON MIXTURE.  Triturate Oil of Erigeron half a fluidrachm,
with powdered  G um Arabic half  a drachm ;  White Sugar one drachm; and
then gradually  add  water eleven fluidrachms, triturating constantly.
  This is useful in  flooding from the uterus, stomach, kidneys, &c, and in,
diarrhea and dysentery.  The dose is a  table-spoonful, in excessive  flood-
in"',  every five, ten or twenty minutes; in  ordinary cases, three or four
times a day.  Each fluidrachm contains'  five drops of  the oil.

  SALINE MIXTURE.   White Liquid  Physic.   Take  of Sulphate  of
Soda half a pound; water one  and  a half pints ; mix, and  dissolve  the
Soda; then add Nitro-Muriatic Acid two fluidounces ; powdered Alum one
drachm and eight grains.
  This preparation  is used  as a cooling purgative, and  to allay nausea and
vomiting.  It has been found very useful  in  colic,  diseases  of the liver,
diarrhea, dysentery,  intermittent  fevers, &c.   It is  a  most  excellent
remedy.  The  dose is a  table-spoonful  in a gill of water, repeated  every
hour or  two, until it causes one or two evacuations from the bowels ; to be
repeated daily.
                          OINTMENTS.

  Ointments  are  fatty materials,  impregnated with certain  medicines, or
 their medicinal  principles, of a consistence  similar to  that of butter, and
 intended to be applied to the surface by rubbing, or on  lint.  They are apt
 to become rancid  by long keeping, which, it is said, may be  prevented by
 adding  either Benzoic Acid, Poplar Buds, or Slippery Elm bark to the
 Ointment.

  OINTMENT OF  ACETATE OF LEAD.   Take  of White Wax two
 ounces,  Lard four ounces ; melt these together, and  then add Acetate of
 Lead, in fine powder, two and a  half drachms; stir constantly till  cold.
 This Ointment is useful in  ulcers, burns, scalds, blisters, excoriations, &e.

  OINTMENT OF  ACONITE.  Take of Alcoholic Extract of Aconite
one drachm;  add a small  quantity of Alcohol  to  it to soften it, and  then 
730
AMERICAN FAMILY PHYSICIAN.
 triturate it thoroughly with Lard ene ounce.  Tilden & Co.'s Extract will
 be found the best to use for this purpose.
   This is used in violent neuralgic and rheumatic pains.

   OINTMENT  OF BAYBERRY.   Take  of Bayberry Wax, White Gum
 Turpentine, each, four ounces;  Olive  Oil two ounces; melt together and
 strain.—H.  Whiting.

   OINTMENT  OF BELLADONNA.  Take of  Extract  of Belladonna
 one drachm ;  soften it  by trituration with  some hot water, and  then add
 Lard one ounce ; mix.
   This is  an anodyne application, useful  in local neuralgia, painful joints
 &c;  also  to dilate  the pupils, as well as the os uteri.  Tilden & Co.'s Ex-
 tract will  be found the best for this purpose.

   OINTMENT  OF HOPS.  Take  of Lupulin  one ounce;  Lard half a
 pound,' triturate thoroughly together.   This is used to relieve the pain of
 malignant ulcers, and  in some cutaneous diseases, &c.

   OINTMENT  OF OXIDE OF ZINC.   Take of Oxide  of Zinc half
 an ounce; Lard three  ounces; triturate  them together.  This is a mild
 astringent, useful in chronic inflammation of the eyes, diseases of  the skin,
 sore nipples, excoriations, &c.

   OINTMENT OF POISON HEMLOCK.  Take of Extract of Poison
 Hemlock (Conium  Maculatum) one drachm ;  soften it by trituration with
 a little hot water, and then add Lard one  ounce; mix.  Tilden & Co.'s
 Extract may be used.
   This is  a mild anodyne, useful  as an application to  painful swellings of
 the glands, painful and malignant ulcers, piles, &c.

   OINTMENT OF POKE.   Take  of  Extract   of Poke one  drachm;
 soften it, if necessary, by trituration with a little hot water, and  then add
 Lard one ounce ; mix.
   This is  useful in malignant ulcers, scald-head, itch, and several diseases
 of the skin.

   OINTMENT OF STRAMONIUM.   Take  of  Extract of Stramonium
 one drachm ; soften it by trituration with a little hot water, and  then add
 Lard one  ounce; mix.   Tilden  & Co.'s  Extract may likewise  be used in
 this preparation.
   This is  an  anodyne  application, useful  in  some diseases of the skin,
 painful piles, painful ulcers, burns, scalds, &c.

  OINTMENT OF SULPHATE  OF  ZINC.    Triturate Sulphate oi
 Zinc, in fine powder, one scruple, with fresh  butter,  containing no  salt, two
 drachms.
  This  is  useful in fungous  growths, gangrenous and indolent ulcers,
 fistula, diseases of the skin, &c.

  OINTMENT OF WHITE HELLEBORE.  Take of White Hellebore
root, in powder, one ounce, Lard four ounces,  Oil of Lemons ten  minims;
triturate thoroughly together. 
PHARMACY.
731
  This ointment is used to  cure the itch;  its employment among children
requires caution.

  OINTMENT OF  WILD INDIGO.  Take of Wild Indigo root, in pow-
der one pound;  thoroughly moisten it with alcohol, allowing it to stand for
twenty-four hours, then transfer it to a percolator, and add alcohol as long
as any passes containing the  taste  and virtue of the root.  Distil  off the
alcohol from this filtered tincture until half a gallon of tincture is obtained.
  Melt fresh Butter,  containing no  salt, one pound, add the above tincture,
and carefully evaporate the  rest of the alcohol; constantly stirring till cold,
after the alcohol has  nearly  passed off.  The original formula,  according to
Dr. H. Whiting, would require to be added to the above, about two ounces
of tallow, and five  of beeswax.  This is an antiseptic, resolvent, and healing
ointment, useful in  many diseases of the  skin, scrofulous, erysipelatous,
malignant, and gangrenous ulcers, piles, &c.

  OINTMENT OF  WOODSOOT.  Triturate  together, clean Woodsoot,
very finely powdered, one ounce, with Lard four ounces.
  This is useful  in burns, tinea  capitis, erysipelatous inflammations, and
Borne diseases of the skin.   It should  be spread on cotton batting, and then
   COMPOUND  LEAD  OINTMENT.   Mayer's Ointment.  To  Olive Oil
 two pounds and a half, add White Turpentine half a pound, Beeswax, Un-
 called Butter,  of each, four ounces; melt them  together, strain, and  then
 heat them to nearly the  boiling point,  and add gradually Red  Lead one
 pound, and stir  constantly until  the  mixture  becomes black or  brown.
 Then remove from the fire, and when it has become somewhat cool, add to
 it a mixture of Honey twelve ounces, powdered Camphor, half a pound.
   This ointment is much  used as an application  to all ulcers, cuts, wounds,
 burns, and some diseases  of the skin.  It is a healing ointment.

  COMPOUND OINTMENT OF  BAYBERRY.  Take of Bayberry Tal-
 low, Sweet Gum, each, half an ounce, Mutton Suet an ounce; melt together
 and strain.  Am. Eg. Disp.
  This ointment is useful in ringworm of the scalp, itch, scald-head, piles,
 Balt-rheum, and some other diseases of the skin.

  COMPOUND  OINTMENT OF  IODINE.  Triturate Iodine  fifteen
 grains, and Iodide of Potassium half a drachm, with Alcohol half a fluidrachm;
 then add Lard  one ounce, and continue the trituration until they are well
 mixed.
  This is used  in scrofulous and other  tumors, bronchocele, enlarged ton-
 sils, &c.  The  discoloration of the skin  occasioned  by its use  gradually
 disappears.

  COMPOUND OINTMENT OF  OXIDE  OF ZINC.  Mild Zinc OinU
 ment.  Triturate together  in a mortar, until  all is reduced to a fine powder,
 Uxide of Zinc three and a half ounces,  Benzoic Acid one drachm, Sulphate
 ?;;,P ,f twenty-four  grains, and Oil of Roses ten minims ; then add to
 jt the following  melted  mass, stiring  constantly until  nearly cold; Olive
 Uil one pound, White Wax two ounces, Spermaceti six ounces.
  I his is a gently stimulating and astringent application, which has proved
serviceable in  affections of the eye, ulcers, wounds, and some diseases of
we skin. 
732
AMERICAN  FAMILY  PHYSICIAN.
  COMPOUND  OINTMENT OF  SULPHUR.   Take  of Sulphur  two
ounces, powdered White  Hellebore one drachm, Nitrate of  Potassa fifteen
grains, Soft Soap two ounces, Ointment of Poke six ounces, Oil of Berga-
mot half  a fluidrachm.  Rub these articles  thoroughly together.
  This ointment is efficacious in itch, when it proves obstinate, and  will
not disappear by the use of simple Sulphur Ointment.
                                PILLS.

  Pills are round masses of various sizes, containing medicinal substances
and which are a very popular form for administration, as most persons pre-
fer  medicines when in pill form.   They usually weigh from two to five
grains, according to the substances entering  into their composition and the
size best adapted for swallowing.  In the preparation of pills, much care
Bhould be taken  to have the  articles  thoroughly mixed together so that
active or powerful agents shall be equally distributed throughout the whole
pill-mass.  To prevent their adhering  together, as well as to cover any un-
pleasant taste, they may be  placed  in  some dry powder of Liquorice root
Cinnamon, or calcined Magnesia; the Liquorice is more commonly used.

  COMPOUND PILLS OF ALOES.  Aniidyspeptic Pills.  Mix thorough-
ly together, Powdered Aloes  two ounces, Powdered Gamboge one ounce
Capsicum, and Lobelia, each,  in powder, two  drachms,  Castile  Soap one
ounce.  Then add Extract of Boneset, Extract of  Mandrake, and Extract
of Ginseng, of each, half an  ounce.   Beat and work the mass well together,
and add five drops of Oil of Cloves.   Divide into pills of four grains each.
  These pills are useful in dyspepsia, constipation, jaundice, suppressed
menstruation, and in all ordinary cases where cathartics are required.  The
dose is two, three, or four pills.

  COMPOUND PILLS OF ACONITE.  Take  of Valerianate of Quinia
ten grains, Extract of Stramonium  two grains, Extract of Aconite fifteen
grains; mix the articles together, and divide into thirty pills.
  These pills  will be found beneficial  in fevers, and inflammatory diseases,
especially where there  is much irritability of the system, wakefulness, &c,
also in nervous headache and several derangements of the nervous system,
The dose is one pill, which may be repeated as  required, every one, two, oi
four hours.

  COMPOUND PILLS OF ASSAFETIDA.  Mix together by a moderate
heat,  Opium, and Assafetida,  each, in powder, twelve grains, and then,
while  soft, add Carbonate of Ammonia  twelve grains; divide into twelve
pills.,  H. Whiting.
  These pills are anodyne and antispasmodic, and may be used in hysterics,
and  spasmodic affections.   The  dose  is one pill, every two, or four hours,
according to  the severity of the symptoms.   Each pill  contains  one gram
of Opium.

  COMPOUND PILLS OF BLACK  COHOSH.  Take of Valerianate ol
Quinia fifteen grains, Scutellarin half a drachm, Alcoholic Extract of Black
Cohosh half a drachm;  mix  thoroughly together, and divide into  thirty
pills.
  These pills are useful in chorea, and other derangements of the nervous
system;  also  in fevers, or other diseases attended with much restlessness 
PHARMACY.
733
 or wakefulness, and in several uterine affections.   Dose, one pill every one,
 two, or three hours, daily, according to the urgency of the symptoms.

  COMPOUND  PILLS OF CAMPHOR.   Cholera Pills.  Take of Cam-
 phor, Opium, Kino, each, in powder, thirty grains, Capsicum five grains,
 Con/erve of Roses a sufficient quantity;  mix together, and divide into thirty
 pills.                                      ...
  These pills are  stimulant, antispasmodic, anodyne and astringent, and are
 useful in diarrhea, and Asiatic cholera; in  cholera,  one pill must be given
 after each discharge from the bowels, or oftener if the urgency of the  case
 require it.   When powders are preferred to pills, the Conserve of Roses may
 be omitted

  COMPOUND  PILLS  OF  DANDELION.  Take of Podophyllin one
 scruple, powdered Bloodroot, and Extract  of Dandelion two drachms, Oil of
 Spearmint ten minims; mix together and divide into  one hundred pills.
  These pills are laxative,  diuretic, and  slightly nauseating; they are useful
 in jaundice, liver affections, and diseases of the kidneys.   Dose, one or two
 pills, two or three times a day.

  COMPOUND  PILLS  OF FERROCYANURET  OF  IRON.   Take of
 Sulphate of Quinia,  Ferrocyanuret  of  Iron,  Alcoholic Extract  of  Black
 Cohosh, each, one drachm; mix together and divide into sixty pills.
  These pills are very useful in  periodical  diseases, as fever and ague, epi-
 lepsy, St. Vitus' dance,  &c; they possess alterative, anti-periodic, and  tonic
 virtues, and may be given in  doses of one  pill  every three or four hours.

  COMPOUND  PILLS  OF HIGH CRANBERRY.  Take of Aletridin,
 Alcoholic Extract of Blue Cohosh, Extract  of Partridge Berry, each, one
 drachm; Alcoholic Extract of High Cranberry two drachms; mix thoroughly
 together, and divide into eighty  pills.
  These pills are very efficacious in female diseases, as suppressed menstrua-
 tion, painful menstruation, leucorrhea, sterility, &c; also in spasmodic affec-
 tions, cramps during pregnancy, &c.   One or two pills may be taken two or
 three times a day.

  COMPOUND  PILLS OF HYOSCYAMUS.   Take of Sulphate of Qui-
 nia, Extract of Aconite, each, half a drachm; Extract of Cimicifuga, Extract of
 Hyoscyamus, each, one  drachm;  mix, and divide into sixty pills.
  These pills are of service in rheumatic, and neuralgic affections, St. Vitus'
 dance, painful menstruation,  &c.  One pill may be taken every two or  three
 hours, as the symptoms may require.

  COMPOUND  PILLS  OF  LEPTANDRIN.  Take of Leptandrin one
 drachm, Podophyllin half a drachm, Extract of Rhubarb a sufficient  quan-
 tity.  Mix together and divide into sixty pills.
  These pills are useful as  a cholagogue  medicine,  and have  been used in
 affections of the liver, dysentery, obstinate constipation,  &c.    One or two
 pills may be taken twice a day.

  COMPOUND  PILLS  OF  MOTHERWORT.   Take of  Leptandrin,
 Alcoholic Extract of Black Cohosh, each, one drachm;  Aletridin, Hydro-
Alcoholic  Extract of Motherwort,  each,  two  drachms.   Mix thoroughly
together, and divide into sixty pills. 
734                AMERICAN FAMILY  PHYSICIAN.
  These pills are useful in many diseases of the womb, acting as an uterine
tonic and alterative.  The dose is one pill  every  one,  two, or four  hours,
according to the urgency of the case.

  COMPOUND PILLS  OF PODOPHYLLIN.   Take of Podophyllin,
Scammony, Gamboge, Capsicum,  each, in powder, one drachm, Castile Soap
half a drachm.   Mix, and beat the whole together, till they are thoroughly
incorporated, and divide into one hundred  and twenty  pills.
  These pills are cathartic, and are very useful in  dyspepsia, affections of the
liver, &c.  The dose is one or two pills every night.

   COMPOUND  PILLS   OF   QUINIA.   Take of Sulphate  of Quinia,
Leptandrin, and Tartaric Acid,  each,  one drachm,  Alcoholic  Extract of
Black Cohosh a sufficient quantity; mix together, and divide into four-grain
pills.
  These pills are useful in fever and ague,  and all diseases of a periodical
nature.   The dose is one pill every one, two, or three hours, according to the
severity of the  attack.

  COMPOUND PILLS  OF SOAP.   Diuretic Pilh.    Take of Oil of
Spearmint,  Oil of Juniper, Oil of Sassafras, each, one drachm; Castile
Soap, two drachms.  Put these in an iron mortar, beat and mix thoroughly
together, and divide into twenty  pills.
    These pills are useful  in gravel, and all  chronic urinary affections
requiring a  stimulant  diuretic.   The dose  is  two or three pills, three times
a day.

  COMPOUND PILLS OF VALERIAN.  Take of Scutellarin, Extract
of  Chamomile, each, two drachms;  Sulphate  of Quinia, Extract of Boneset,
each, one drachm, Capsicum one scruple, Oil of Valerian half a drachm.  Mix
thoroughly together, and divide into four-grain pills.
  These pills are tonic  and  nervine, and may be used wherever they are indi-
cated.   Dose, one  pill, every two  or three hours.

   IODINE  PILLS.   Take of  Iodine  twenty grains, Sulphate of Morphia
two grains, Leptandrin forty grains; triturate  together in a glass or wedge-
wood mortar, and  make into a  pill-mass with simple syrup or Extract ot
 Liquorice a sufficient quantity, and divide into forty pills.    ,.,.,.   •
   These pills are very useful in scrofula, and all diseases in which Iodine u
 recommended.   One pill may be taken every  night and morning.
                             PLASTERS.
   Plasters are mixtures of oils, fats, resins, wax, Ac, with or without the
addition of active  medicinal agents, and  which, although solid at ordinary
tom^BS, become soft and adhesive at the heat of the body without me-
mo-   Thev are o-enerally spread upon leather, muslin, or linen, and in sort
enL Sem for spreading upon the'se articles, great care should be taken n
to exnose them to too high  a heat, as volatile principles may thereby  be da
 ipated  or decomposition ensue.   Their  uses are, to produce medicinal influ-
ents, to protect pParts from contact with the air, or, to give support to debil-
itated parts.
   BAYBERRY PLASTER.  Take of  White Gum Turpentine and Bay 
PHARMACY.
735
 berry Wax, each, four ounces,   Melt together, strain, and stir till cold.   In
 winter, if necessary, a small quantity of Olive Oil may be added.   It may be
 worked into rolls.  H. Whiting.
   This forms a very  valuable plaster, useful in scrofula  and other ulcers.

   COMPOUND CAPSICUM  PLASTER.  Common Strengthening Plaster.
 Melt  together Rosin  half a pound, Beeswax two  ounces, and  strain. ^ To
 this add Spirit one pint in which powdered Capsicum two ounces, contained
 loosely in a muslin bag, has been  digested  by a gentle heat for one hour.
 Evaporate the Spirit  by a moderate heat, and add powdered Camphor one
 ounce, Oil of Sassafras one fluidrachm and a half; stir constantly till cold.
   This is rubefacient and stimulant, and may be used whenever a stimulating
 plaster is required.  H. mating.

   COMPOUND LEAD  PLASTER.   Take of Lead  Plaster one pound;
 melt it by a moderate heat, and then  add to it Linseed Oil, Tincture of
 Opium, two fluidounces, Oil of Turpentine six fluidounces, Oil of Origanum
 two-thirds of a pound; stir together, until cold.
   This is useful in burns, scalds, some diseases of the skin, chilblains, &c.
 Tho  affected part  must be thickly covered  with the plaster, over which a
 layer of raw cotton must be secured, allowing it to  remain until the burn,
 ic, is well.

   COMPOUND PLASTER  OF  BELLADONNA.   Take of Resin Plas-
 ter three  ounces,  Extract of Belladonna,  Extract of  Poison Hemlock,
 [Conium Mac.) each, one ounce and a half, powdered Iodine half a drachm.
 Melt the Resin plaster, then  add in the extracts,  triturate thoroughly to-
 gether, and when nearly cool, add the Iodine.
   This plaster is an efficacious application to scrofulous and  other tumors,
 goitre, white swelling, neuralgic, syphilitic, and rheumatic pains, &c.

   COMPOUND RESIN PLASTER.   Adhesive and Strengthening Plaster.
 Take  of Bosin three pounds, Beeswax four ounces;  melt  the  articles  to-
 gether, then remove from  the  fire, and when nearly cold, add gradually,
 Camphor half  an ounce, dissolved in Oil  of  Hemlock, Oil of Sassafras, and
 Olive  Oil, each, one fluidounce, Oil of Turpentine half a fluidounce.  Pour
 the whole into cold  water, and work in the hands till cold, forming the
 plaster into rolls or sticks.
   This is an elegant  plaster, useful in rheumatism, weakness of the joints,
 wounds, ulcers, Ac.

   COMPOUND TAR  PLASTER.   Irritating Plaster.   Boil Tar three
 pounds, for half an  hour;  then add  Burgundy Pitch one  pound and a
 half, White Gum  Turpentine one pound, (having  previously melted them
 together, and strained.)   Stir them together, remove from the fire, and add
 finely  powdered Mandrake root, Bloodroot, Poke root, Indian Turnip, of
 each, ten ounces.   Incorporate well together.
  This plaster is irritant, rubefacient, and suppurative, and may be used in
 all cases where  counter-irritation or powerful revulsion is required.   It has
 been  used with success in  neuralgia, rheumatism, and  other painful affec-
tions, as well as in chronic inflammation of internal organs.  It  should be
spread thinly on soft  leather, renewing  it every day, on the  same leather.
Three  or four  days  generally pass before  it produces suppuration, after
which  it should be  reuewed as often as the discharge may require.  The sore 
736                AMERICAN  FAMILY PHYSICIAN.
produced by it should not be wet, as it will be rendered more painful.  If
too much suffering be  caused by this plaster, it may be removed, and the
part healed by simply applying a  linen  cloth  on which mutton  tallow has
been spread.   Any great degree of inflammation or irritation caused by it
may be removed by an Elm poultice.


  RED OXIDE  OF LEAD PLASTER.   Black Salve.   Melt together
Olive Oil one quart, Resin and  Beeswax, each, one  ounce; raise the heat
until  a feather  dipped into it will scorch, that is,  to the boiling point, and
then add  gradually powdered Red Lead three quarters  of a pound.  Stir
constantly, until the oil and lead unite,  as known by the black color of the
preparation ; then set the mixture aside, stirring  it until it becomes cool,
when powdered  Camphor, four scruples, may be added.—TL Wliiting.  Do
not remove the above from  the fire until it becomes brownish or black, and
forms  a thick salve when allowed to cool upon a knife dipped into it.
   This plaster is a valuable application  to scrofulous,  syphilitic,  and other
ulcers, burns, scalds, and several diseases of the skin.

   LEAD PLASTER.   Diachylon.   Take of Semivitrified  Oxide of Lead,
{Litharge) in very fine powder,  one pound and a quarter, Olive Oil one
quart, water  half a  pint.   Boil  them  together over a  moderate fire, con-
stantly stirring until  the Oil and  Litharge unite to form a plaster.  If the
water be nearly  all evaporated before the end of the process, a little boiling
water must be added.
   This plaster  is useful in burns,  slight  wounds, excoriated surfaces, ul-
cers, &c

   RESIN PLASTER.  Melt together by a gentle fire,  Lead Plaster, one
pound and a half, Resin one  quarter of a pound.  This is used for holding
the edges of wounds together, for dressing ulcers, &c.  It is generally spread
on muslin, and sold in  the  shops  under the name  of adhesive plaster.  The
following is  said to  form  a very elegant adhesive plaster:—Melt together
Lead Plaster twenty-seven  drachms,  Resin  Plaster six  ounces, Soap, sliced,
five drachms; when thoroughly incorporated, spread on linen.
POWDERS.
  Powders, when not in  too  bulky doses, are a very convenient and useful
mode of administering  many  remedies; very nauseous  or corrosive agents,
or those which  change rapidly on exposure to the air, are best given in pill,
tincture  or some other form.  The finer an article is powdered, as a general
rule, the more active it becomes.  When one agent alone is pulverized, it is
termed a simple powder; when two  or more simple powders are mixed to-
gether the preparation is called a compound powder.  Powdered articles
become deteriorated in activity when acted on by light and air, consequently
they should be kept in well covered tin  vessels, or in  glass bottles, cioseij
stopped, and excluded from the light by being painted black or else kept m
a dark  place.   They are usually given in water, gruel milk, syrup, mo-
lasses, or honey, &c, always bearing  in mind whether  the vehicle be com
patible with the active ingredients of the powder. 
PHARMACY.
737
  COMPOUND POWDER OF CAMPHOR.  Mix together Camphor, Tan-
 nic Acid Kino, of each, in powder, ten grains; Opium in powder, five grains;
 and divide into ten powders.  This powder should be prepared only as wanted.
  It possesses astringent and anodyne properties, and will be found highly
 efficacious in  Asiatic  Cholera,  Cholera  Morbus,  and severe diarrhea.   In
 gevere cases, one powder should  be given immediately after each discharge,
 or if the symptoms  are urgent, even more  frequently.   In ordinary cases,
 three or four powders a day, will be sufficient.  They may be given in syrup
 or jelly, and when a stimulating action is indicated, ten  or twenty grains,
 of powdered Capsicum may be added to  the formula.

  COMPOUND  POWDER OF  CHARCOAL.  Mix together,  prepared
 Charcoal one ounce,  powdered Rhubarb half an ounce, Bicarbonate of Soda
 two drachms.
  Persons laboring under dyspepsia, loss of appetite, sour stomach, derange-
 ment of the bowels,  &c, will find this very valuable, in doses of a teaspoon-
 ful every three or four hours during the day.  It may be taken in water, or
 Indian meal gruel.

  COMPOUND  POWDER  OF GOLDEN SEAL.   Mix together,  Blue
 Cohosh, Helonias, Golden Seal, of each,  in powder, two drachms.
  This preparation will be found useful in dyspepsia attended with distress-
 ing sensations  in the stomach shortly after a meal, also in chronic inflamma-
 mation of mucous tissues, and ulcerations of the mouth and throat.   The
 dose is from half a teaspoonful to a teaspoonful every three or four hours.

  COMPOUND  POWDER OF  HYDRASTIN.   Take  of Hydrastin,
 Myricin, Rhubarb, each, in powder, half a drachm; mix together, and divide
 iuto thirty powders.
  This is a tonic and  slightly  laxative  preparation, and may be used in
 some forms of dyspepsia, chronic inflammation  of the  stomach, jaundice,
 and during recovery  from acute diseases.   One powder may be taken every
 three or four hours during the  day,  but not so  often as to occasion  more
 than one or two daily evacuations from the bowels.

  COMPOUND  POWDER  OF IPECACUANHA AND  OPIUM.   Di-
 aphoretic Powder.  Take  of Opium, in powder, ten grains, Camphor, in
 powder, two scruples, Ipecacuanha, in powder, one scruple, Nitrate of Potassa
 eight scruples; mix thoroughly together.
  This is an anodyne  and diaphoretic preparation, useful in all febrile, in-
 flammatory, rheumatic, nervous, and painful  affections.  It relieves  pain,
 allays  nervous irritation,  promotes  perspiration,  quiets  the  system, and
 disposes to sleep.  The dose is from  three to five grains every  three or four
 hours, or oftener, if required.   Warm herb  teas, drank  freely,  promote its
 diaphoretic action.

  COMPOUND  POWDER  OF JALAP.   Antibilious Physic.   Take of
 Alexandria Senna,  in powder,  half an ounce;  Jalap,  in powder,  two
 drachms;  Ginger, half a drachm; mix thoroughly together.—H. Whiting.
  This is a valuable purgative, useful in nearly all cases where  such action
is required; being contra-indicated  in severe inflammation of the stomach
 or bowels, in excessive menstruation, during pregnancy, &c.  The dose is a
teaspoonful, which may be  taken in milk, wine, cider, lemonade, coffee, &c;
the usual mode is to  place the  dose in  about a  gill of boiling water, lei it
itand till cold, then sweeten, if desired; and drink the whole contents.
      17 
738
AMERICAN FAMILY PHYSICIAN.
  COMPOUND POWDER OF LEPTANDRIN.  Mix together powdered
Podophyllin  ten grains, Leptandrin  one  scruple,  Sugar of Milk  five
scruples; when thoroughly  triturated, divide into sixteen powders.
  This is  a cholagogue cathartic of immense benefit  in  epidemic dysen-
tery;  a powder  maybe given  every hour or two, until it operates freely
It is also useful in typhoid,  remittent, and intermittent fevers with or with-
out the addition of Sulphate  of Quinia, and in all derangements of the
biliary apparatus.  In  doses of three or  four grains, every three  or four
hours, it is an excellent alterative.

  COMPOUND  POWDER  OF  LOBELIA.    Emetic  PoUer. Take
of Lobelia in  powder, one  ounce, Bloodroot and Skunk Cabbage, each in
powder, half  an  ounce, Ipecacuanha  five  and  a half  drachms, Capsicum
four scruples;  mix  thoroughly together.
  This is useful in all cases where an emetic is required, producing a free and
easy vomiting, without causing cramps,  or unpleasant prostration.  Tho
dose is half a  teaspoonful repeated every fifteen minutes, and exhibited
three  or four times, until free vomiting is caused; it may be given in com-
mon water, or warm Boneset tea, either of which  may be drank freely to
facilitate the  operation.

  COMPOUND POWDER OF PODOPHYLLIN.  Take of Podophyllin
four grains, Cream of Tartar three drachms, Capsicum one  scruple; mix in
timately.
  This is used in dropsy, obstructed menstruation, and wherever an active
hydragogue is indicated.   The dose  is  one scruple,  repeated every two
hours, until a sufficient evacuation has been procured.

  COMPOUND  POWDER  OF  QUINIA.   Mix together,  thoroughly,
Prussiate of Iron and Sulphate of Quinia, each, one scruple.
  This is tonic and antiperiodic, and may  be used in all febrile, inflammatory
and chronic  diseases,  attended with symptoms  of a periodical character.
The dose is from two to six grains, every one, two, or four  hours, according
the severity of the symptoms.

   COMPOUND POWDER  OF  RHUBARB  AND  POTASSA. Neu-
tralizing Powder.  Take of Rhubarb, two drachms ; Bicarbonate of Potassa,
one drachm ; mix thoroughly together.
   This is a valuable  medicine in diarrhea, cholera-morbus. dysentery, sum-
mer-complaint of children,  acid stomach,  heart-burn, and as a mild laxative
during pregnancy.   The dose is from  half  a teaspoonful to a  teaspoonful,
every one, two, or three hours, as required, in some peppermint water.

   COMPOUND POWDER OF XANTHOXYLIN.  Take of Sulphate of
Quinia, Hydrastin, and Xanthoxylin, each,  one scruple ; mix together  with
Sugar of  Milk  a sufficient quantity to form  a  powder;  divide this  into
twenty powders.                                              .  ,
   This preparation is stimulant, alterative, and tonic, and  is useful in ays-
peptic  affections, weakness of the digestive  powers, periodical headache
and  many chronic diseases.   The  dose  is one powder in syrup, water, or
wine, and repeated every three or four hours during the day.

    ENTOZOIC POWDER.    Worm  Powder.   Take of White  Indian
 Hemp root, (AsclepiasIncarnata,) Mandrake,  Pink-root,Bitter-root, [Afoaf. 
PHARMACY.
739
Andros) of each, in powder, one ounce, Balmony, in powdei, two ounces,
So o r ne Aloes, in powder, four scruples ;  mix thoroughly together.
  Th  is a very bitter, but certain  remedy for any worm that may exist in
thc human alimentary canal.  For a child  a year old, place a teaspoonful
of the powder in  a gill of molasses, and  give a teaspoonful of the mixtur
1 v one or two hours, until it operates freely; after which give a teaspoonful
force times a day for several  days in succession ;  or less, if it purges too
freely.  Adults may take half a table-spoonful every hour.
                             SYRUPS.

  Syrups are strong infusions or decoctions. &c, of one or more medicinal
substances, which  are kept in a state of preservation by the addition of a
certain amount of  sugar.   A mere concentrated solution of sugar in water,
is called simple syrup;  the  others are  medicated  syrups.  Syrups  should
always be kept in well-stopped vessels, and in a cool place.  The usual
mode of making Syrups,  is according to Mr. Wm.  S. Merrell's plan,  which
is named under Compound  Syrup of Sarsaparilla; this plan may be pur-
sued  in the following Syrups, when  not  otherwise ordered, taking care to
correctly proportion the quantities of sugar, alcohol, &c, to the amount in
weight of medicines used.  The following Syrups may be made according to
the directions, or they may be obtained of Messrs. W. S. Merrell & Co., and
F. D. Hill, Druggists of Cincinnati, 0., who prepare efficacious and reliable
articles, which they furnish at reasonable rates.

  COMPOUND SYRUP OF PARTRIDGE-BERRY.  Mother's Cordial.
Take of Partridge-berry half  a   pound;  Helonias,   Blue  Cohosh,  and
Hi^h Cranberry bark, each, two ounces; cover the whole with good Brandy
two pints, and let  them macerate for three or four days.   Then press out
the Brandy, and there  will be about one pint  and a half obtained,  which
reserve.  Place the herbs in boiling  water six pints,  and slowly boil down
to two and  a half pints.  Strain,  add sugar one pound, and  evaporate to
two and a  half pints.   Remove  from the fire, and when nearly cold, add
the reserved pint and a half of Tincture.
  This is a valuable agent in all derangements of the female reproductive
organs,  as suppressed menstruation, painful menstruation, profuse menstru-
ation, leucorrhea,  and habitual abortions.   It imparts tone and vigor to the
uterus, on which account it is very useful for those females who are  apt to
have  tedious labors from a proper want of uterine action; in these instances,
it should be taken during the last  two or three months of pregnancy.   The
dose is from half a wineglassful to a wineglassful, two or three times  a day.
  Thc "Parturient Balm" is a preparation used by  some practitioners for
similar purposes to the  above.  It is made as follows :—Take of Spikenard
and  Blue  Cohosh, each,  half  a  pound;  Partridge-berry, Queen  of the
Meadow, and Black Cohosh, each, four ounces; Comfrey and Ladies'Slipper
root two ounces.   Cover the whole with a pint and a half of good Brandy,
let them macerate  for  three days, and  press  out the Brandy, which will
amount to one pint, which reserve.   Place the herbs  in boiling water one
gallon and  a half; boil  slowly down to  one gallon,  add sugar six pounds,
and evaporate to one gallon; remove from the fire, and when nearly cold,
add the reserved pint of Tincture.   The dose is a table-spoonful three oi
four times a day. 
740                 AMERICAN FAMILY  PHYSICIAN.
  COMPOUND  SYRUP  OF  RHUBARB AND  POTASSA   Neutral
izing Cordial.   Take of best India Rhubarb, in  coarse powder, and Bicar-
bonate of Potassa, each, half a pound ;  Cinnamon, Golden Seal, each, four
ounces; macerate for two days in best fourth proof Brandy one gallon; then
express the Tincture with strong pressure, and  add to it Oil  of Pepper-
mint two fluidrachms, previously dissolved in  a little Alcohol.
  Break up the cake or compound residue from the  press, and place it in a
displacement apparatus, and  gradually add warm water until the strength
of the articles is exhausted.    Evaporate  this solution to eight pints, and
while the liquor is still hot, dissolve  in  it  refined sugar six pounds. Con-
tinue the evaporation,  if necessary, until when added to the  Tincture fir.st
obtained, it will make three gallons  and mix the  two solutions together.
  This is a pleasant antacid  and laxative preparation, very useful in diar-
rhea, dysentery, cholera-morbus, summer-complaint of children, and in the
same diseases  as the  Compound Powder  of Rhubarb.  It may likewise  be
used in cases of piles, in habitual costiveness, and  to act on the  bowels during
pregnancy.   The dose for an  adult  is a table-spoonful every half-hour,
hour, or two hours, according to the urgency  of  the symptoms.

  COMPOUND  SYRUP  OF  SARSAPARILLA.   Alterative Syrup.
Take of the roots of Honduras Sarsaparilla, Yellow Parilla,  Burdock, and
ground  Guaiacum wood,  each, ten ounces, avoirdupois; bark of  Sassafras
root, Blue Flag root, and Elder Flowers, each, eight ounces, avoirdupois.
  1. Grind and mix the articles together , place  the whole four pounds in
a convenient vessel; cover them with Alcohol of seventy-six  per cent, and
macerate for two days;  then transfer the  whole to a  common displacement
apparatus or percolator, and gradually add hot water, until  two pints  have
been obtained, which retain and  set aside.
  2.  Then continue the percolation,  and of the second solution reserve so
much  as contains a  sensible  amount  of spirit,  and distil or  evaporate the
Alcohol from it.                                                   .
  3.  Continue the displacement by hot water, until the solution obtained
is almost tasteless, and boil down  this weaker  infusion till it begins to
thicken, or until, when added to the balance remaining of the second portion,
after the evaporation of the Alcohol, it will make twelve pints.
  4.  To these two solutions combined, add refined  Sugar sixteen  pounds,
and by heat dissolve—carefully removing any  scum which arises, as it comes
to the point of boiling.   Then, if it exceeds fourteen pints, evaporate the
Syrup with constant stirring to  this quantity;  remove from the fire, and
when nearly cold, add the two pints of Tincture first obtained, and make
two gallons of Syrup.   Each  pint  will  contain the virtues of four ounces
of  the ingredients.                                           .    '   .
   This forms  an excellent alterative Syrup,  and  is  much used in chronic
affections of the liver, rheumatism,  syphilis, scrofula, diseases of  the skin,
ulcers, white  swellings,  rickets, necrosis, and every taint of the system.
Some physicians  add Iodide  of Potassium half an ounce to  every pint ot
Syrup.  The dose is a table-spoonful every three or four hours, in an equal
quantity or more of water.

  COMPOUND SYRUP OF  SPIKENARD.   Pulmonary Balsam. Take
of  Red root  one pound, the roots of Elecampane  Comfrey,  Wild Uerry
Bark, and  Leaves and Flowers of Hoarhound, each,  half a pound, Blooa
root  four ounces.                            „   ,.    .      .    », i}.*
  Proceed to make into  a Syrup, similar to the directions  given for tne
Compound  Syrup of  Sarsaparilla,  reserving two  pints of  the  strongest 
PHARMACY.
741
 tincture, using twelve pounds of Refined Sugar, and  making  one gallon
 and a half of Syrup.
   This is used in coughs, pulmonary affections,  and diseases of the liver.
 The dose is a table-spoonful three or four times a day.

   COMPOUND SYRUP OF STILLINGIA.   Take of Queen's Root, and
 Turkey-corn, each, one pound; Blue Flag Root, Pipsissewa Leaves, and
 Elder Flowers,  each, half a pound; Prickly Ash Berries, and Cardamom
 seeds, each,  four ounces.   Proceed  to make into a Syrup,  similar to the
 directions given for  the Compound  Syrup of Sarsaparilla,  reserving two
 pints of the strongest tincture, using twelve pounds of Refined Sugar, and
 making two gallons of Syrup.
   This syrup is a most powerful and effective alterative, and is successfully
 used in all syphilitic, scrofulous,  osseous, mercurial, glandular, and liver
 affections, and in all cases where  an  alterative is required.  The dose is
 from a teaspoonful to a table-spoonful, every three or four hours, in a small
 quantity of water.  Some practitioners add Iodide of Potassium,  half  an
 ounce to every pint of syrup.
   Dr. J. Z. Hall, has kindly forwarded me the following formula for the
 preparation of  this  Syrup by Mr. Glenn of St.  Louis, Mo., and which  he
 values very highly:  Take of Stillingia four pounds, Yellow Dock, and Pip-
 sissewa, each, two pounds,  Blue  Flag one pound and a half, Coriander,
 Turkey-corn, Prickly Ash Berries,  each, one  pound,  Bloodroot half a
 pound.  Make  into  a Syrup,  as  above,  with  Refined Sugar  thirty-four
 pounds; making seven gallons when finished.

   COMPOUND SYRUP OF YELLOW DOCK. Scrofulous Syrup.  Take
 of Yellow Dock root two pounds, Bark  of the Root of False Bittersweet,
 one pound,  American  Ivy,  [Ampclopsis  Quinqjj  and Root and  Herb of
 Fi^wort, [Scroph. Mariland."] each, half a pound.
   Proceed to  make  into a Syrup, similar to the directions given for the
 Compound Syrup of  Sarsaparilla, reserving two pints of the strongest  tinc-
 ture, using sixteen  pounds of Refined Sugar, and making two gallons  of
 Syrup.
  This is an alterative  preparation, very efficacious in  scrofula,  and  all
 chronic tuberculous  diseases.   The  dose is a table-spoonful three or  four
 times a day.  Iodide of Potassium is sometimes added to it, half an ounce
 to every half-pint of the Syrup.

  LEMON SYRUP.  To Water one gallon, add Citric Acid half a pound,
 Ivory Black one pound, and Refined Sugar thirteen pounds.  Boil together,
 filter, and add Oil of  Lemon one fluidrachm; or, it may be made by adding
 a drachm of  powdered Citric Acid, to a pint of Simple Syrup, and two or
 three drops of Oil of Lemons.
  This  forms an agreeable and refrigerant beverage when added to water,
 or other fluids intended for persons laboring under febrile complaints.

  SIMPLE  SYRUP.  Dissolve Refined  Sugar two and a half  pounds in
^ atcr  a pint, by means of heat, removing any scum which may rise to the
surface, and strain while hot.
  This syrup is much employed in making medicated syrups,  pills,  mix-
tures, &c.

  SYRUP OF  BALSAM PERU.   Take of Tincture of Balsam Peru, one 
742
AMERICAN  FAMILY  PHYSICIAN.
fluidounce, warm  Simple Syrup, two pounds; mix, and shake thoroughly
together.
  This is useful in cough, chronic catarrh, bronchitis, and laryngeal affec-
tions.  The dose is a teaspoonful as often as required.   The Tincture of
Balsam Peru may be made by dissolving one  ounce of the Balsam in Alco-
hol eight fluidounces.

  SYRUP OF GARLIC.  To Distilled Vinegar one pint, add Garlic, cut
in slices, two ounces ;  digest by a gentle heat, for three or four days, then
express  and  strain, and add Refined Sugar two  pounds;  dissolve with the
aid of a gentle heat.
  This is a useful expectorant  in chronic catarrh,  cough,  &c, of children
in doses of a teaspoonful as often as required.

  SYRUP OF GINGER.  To two pints of Simple Syrup add Tincture of
best Jamaica Ginger two  fluidounces;  evaporate  the Alcohol by a gentle
heat.
  This is stimulating and  carminative, removing flatulency, giving tone to
the  stomach and  bowels, and is  frequently  added to other  medicines to
modify  their action, or improve their flavor.   The dose is from half a tea-
spoonful to a table-spoonful, as may be  required.

  SYRUP  OF  IPECACUANHA.  Macerate  Ipecacuanha, in powder,
eight ounces, Troy, in Alcohol of specific gravity 0.835, twelve fluidounces,
for twelve  hours; then add of Alcohol, a sufficient quantity to  make the
mixture of the consistence of Syrup, and introduce  the whole into a filter,
or suitable displacer, laying a piece of  muslin on the surface.  When the
mass has settled  down  uniformly, add more Alcohol to make the filtered
liquid measure half a gallon, reserving the first half-pint that comes through.
The remainder must be evaporated to half a pint, and then add the reserved
half-pint.  Two fluidounces of this fluid extract are equal  to one Troy ounce
of the root.
  To Simple Syrup four pints, add of the  above Fluid Extract of Ipecacu-
anha eight fluidounces, and evaporate the mixture to three pints ; then add
of  Simple Syrup four pints, Water one pint, thus  making  one gallon of
Syrup of Ipecacuanha.
   This is used as an emetic and  expectorant, principally among children
affected with colds, coughs, &c.  As an  emetic, the dose for an adult is one
or two fluidounces—for a child a year or two old, one or two teaspoonfuls,—
to be repeated every ten or twenty minutes,  until  it operates.  As an ex-
pectorant, one or two teaspoonfuls may  be  given to an adult, and from five
to thirty drops to a child.

   SYRUP OF SENEKA.  Prepare an Alcoholic Fluid Extract of Seneka
root, in  the same manner  as described for Syrup of Ipecacuanha; from
which the Syrup of  Seneka may be made, also in a similar manner.
   This is a stimulating  expectorant and  may  be used  in  colds, coughs,
catarrhs,  and affections of the chest, after the active or inflammatory symp-
toms have subsided.  The dose  for an adult  is one or two teaspoonfuls, as
often as required.

   SYRUP OF  SQUILL.  By the aid  of a moderate heat, dissolve Refined
Sugar one pound in Vinegar of Squill half a  pint; remove any scum which
may arise, and strain while hot. 
PHARMACY.
743
  This syrup is used as an expectorant in coughs  and catarrhs, especially
among infants and children; also as an  emetic for infants.  The dose  is
from half a teaspoonful to a teaspoonful.

  SYRUP  OF  TOLU.  To Simple Syrup one pint, add Tincture of Tolu
two fluidounces; gently heat the mixture to evaporate the Alcohol.
  This is used in  coughs, and to give an agreeable flavor to several prep-
arations ; the dose is from half a teaspoonful to a table-spoonful, as may
be required.

  SYRUP  OF  WILD CHERRY.  To hot  simple Syrup  one pint  ada
finely powdered Wild Cherry bark, loosely placed  in a coarse muslin bag,
five ounces.  Suspend the bag in the Syrup,  and  cover the vessel;  digest
by a gentle heat for twenty-four hours, and then express all  fluid from the
powder in the bag, and add  it to the rest of the syrup,
  This is tonic and sedative, and  may be  used in all cases where the bark
is indicated or desired, in doses of  a table-spoonful.  It may also be pre-
pared by moistening the bark with water, placing it in a percolator, adding
water until  a pint  of liquor is obtained;  this may be made into a syrup by
dissolving in it, with agitation, two pounds of refined sugar.
TINCTURES.
   Tinctures are the  solutions of medicines  in various fluids, effected by
 simply standing  in them for a certain length of time, being frequently
 shaken; by digestion with a gentle heat;  or  by percolation.  When pre-
 pared with  alcohol, or diluted alcohol, they are simply  called tinctures;
 when aqua ammonia is the solvent, they are termed ammoniated tinctures;
 and when it is ether, ethereal tinctures.   Gin, brandy, &c, form spirituous tinc-
 tures; wines, vinous tinctures, or medicated wines.  When diluted alcohol is
 designated,  it is about the strength of a mixture of two parts of  rectified
 alcohol, with one part of water, or of specific gravity, 0.935.  The article
 to be tinctured should always be reduced to a very fine powder, placed in a
 vessel with the solvent liquid, and be kept well stopped, frequently shaking
 ^thoroughly.  Macerating, is allowing the articles to stand without heat;
 digesting, is  effecting the  solution with the aid of a 'gentle heat; expressing,
 is to press out  all the liquid from roots, herbs, &c, used in making tinc-
 tures, and is commonly effected by a small  press made for the  purpose,
 though, where  this cannot be  had, it will be  better to allow the herbs to
 deposit at the bottom  of  the vessel, and use the  clear fluid above, as it may
 be wanted from time to time.  This course will  also dispense with filtering,
 winch is generally accomplished  by passing the  tincture  through  filtering
 paper.  All tinctures should be kept in well closed bottles, at a low tem-
 perature, and free from exposure to  light; they should also be made only
 in small quantities at a time.
  Most tinctures of the present  day are made by percolation, which is the
 better plan ; but where this cannot be done, the ordinary method by mace-
 ration,  or digestion, will be found  to answer  the  purpose, but  is more
 tedious and  troublesome.  Percolation is effected  as follows :—Thoroughly
 moisten the  powdered article to be used with the solvent, whatever this may
 be, and then place it in a percolator, being careful not to pack it so tightly
as to cause the fluid to pass through too slowly, nor so loosely as to allow the
nma to run  through rapidly.   The solvent is now gradually poured upon 
744
AMERICAN  FAMILY  PHYSICIAN.
the article, from  time to time, until  the  desired quantity of tincture  hag
percolated or filtered through.

  AMMONIATED TINCTURE OF CASTOR.   Take of Castor, bruised,
two and a half ounces ;  Assafetida, in small pieces, ten drachms;  spirit of
Ammonia two pints, (Imperial measure.)  Digest for seven days in a well-
closed  vessel; strain, and strongly  express the residuum, and filter  the
liquor.
  This is a stimulant to the nervous system, and is very useful in spas-
modic affections, as hysteria, &c.; it is contra-indicated when inflammatory
symptoms are present.   The dose is  from thirty to sixty drops, or more.

  AROMATIC  SPIRIT OF AMMONIA.   Take of Muriate of Ammo-
nia two and a half ounces ; Carbonate  of Potassa four  ounces ;  Lemon
Peel two ounces; Cloves, Cinnamon, of  each,  bruised, one drachm; Alco-
hol, water, of each, two  and a half pints.  Add the articles together in a
retort, and distil off three and three quarter pints.
   This is an aromatic stimulant and antacid, and may be used in hysteria,
fainting, flatulent colic, sour stomach,  sick  headache, &c.  The dose is
from thirty to sixty drops, in sweetened  water.

  AROMATIC TINCTURE OF GUAIACUM.   Greenhow's Cholera Mix-
ture.  Take  of  Guaiacum, Cloves, and Cinnamon, in powder, each, half an
ounce ;  Brandy one pint; macerate for fourteen days, and filter.
  This is an  excellent aromatic stimulant and astringent, and was much
used by the late Prof. T. V. Morrow, in Asiatic cholera.  The  dose is from
a teaspoonful  to  a table-spoonful,  in  sweetened  water,  every fifteen or
twenty minutes, until relief is obtained.

  CAMPHORATED  TINCTURE  OF  OPIUM.   Paregoric.  Take of
Opium one drachm ; reduce it to an emulsion in  boiling water one fluid-
ounce, then  add  Benzoic Acid one  drachm; Oil of Anise a  fluidrachm;
clarified  Honey two ounces; Camphor  two  scruples; Alcohol, of 76 per
cent., twenty-two  fluidounces;  distilled  water nine fluidounces; macerate
for seven days and filter.
  This  is an agreeable anodyne, and is much used  to relieve asthmatic
affections, hooping-cough, cough, nausea, diarrhea, pains in  the  bowels,
&c.; also to cause sleep  among young children.  The  dose for an adult is
one or two teaspoonfuls; for an infant, five or ten  drops.

   COLOGNE.    Take   of Oil of Rosemary,  Oil  of Lemon, each, two
fluidrachms;  Oil  of Lavender, Oil of  Bergamot,  each,  one  fluidrachm;
Oil of Cinnamon, Oil  of Cloves, Oil of Roses, each, ten drops;  Alcohol
one pint.  Mix, and allow the mixture to stand for a few days, frequently
Bhaking it, and, if necessary, filter.
   This forms a  pleasant perfume, very much  resembling  the  German
Cologne.  Rubbed upon the head, or on  the body, it speedily destroys lice;
 t should be used for several days in succession for this purpose.

   COMPOUND  ACETATED  TINCTURE  OF  BLOODROOT.   Ace
tons  Emetic  Tincture.   Take of Bloodroot, Lobelia Seed, Skunk  Cabbage
Root, each, in powder, one ounce;  distilled Vinegar one pint.  Mix, and
macerate in a close  glass vessel for fourteen days; then express, filter, and
to the filtered liquor add alcohol one fluidounce.
   This is used in all cases where an emetic is  required ; and  is alsp useful 
 
'athip.  (Nepeta  Cataria.)
Pink-root.   (Spiglia Marilandka.) 
t>  a£@
 
PHARMACY.
745
 as an external application to erysipelas, tetter, and other forms of skin dis-
 ease.  The dose is from  one to four fluidrachms, in some  sweetened aro-
 matic infusion, repeating it every ten or fifteen  minutes until vomiting is
 produced.  In  smaller doses, repeated every hour or two, it  acts  as an
 expectorant.

   COMPOUND  TINCTURE  OF  ASSAFETIDA.  Take of  Lupulin,
 Assafetida, in small pieces, Stramonium seeds bruised, powdered  Valerian
 root, each, half an ounce; Alcohol one pint and a half.  Let them stand
 for two weeks, frequently shaking ; then express and filter.
   This is anodyne and antispasmodic, and is very useful in all nervous dis-
 orders, as epilepsy, St. Vitus' dance, hysterics,  &c.  It may be  given in
 teaspoonful doses, repeating them every two or three hours, and may be
 taken alone, or diluted with water or wine.

   COMPOUND  TINCTURE  OF BENZOIN.  Take  of  Benzoin one
 ounce  and a half;  purified Storax one ounce ; Balsam of Tolu half an
 ounce ; powdered Aloes two drachms ; Alcohol one pint.  Let them stand
 for two weeks, frequently shaking, and filter.
   This tincture is  sometimes used as a local  application to  burns and
 scalds, of some standing,  and to obstinate ulcers; it is also used in chronic
 diseases of the air passages, in doses of from thirty to sixty  drops.

   COMPOUND TINCTURE  OF  BLACK  COHOSH.    Mix  together
 tincture  of Black  Cohosh  one  fluidounce;  tincture of Bloodroot  half a
 fluidounce, and  tincture of Pokeroot two fluidrachms.
   This is expectorant and alterative, and is useful in diseases of the lungs,
 liver and stomach ; it allays nervous  excitability, lessens the action of the
 pulse, and relieves cough.  The  dose is from twenty to sixty drops, three
 or four times a day, or  sufficient to produce a very slight sensation of
 nausea.

   COMPOUND  TINCTURE OF BLUE COHOSH.  Take of powdered
 Blue Cohosh  root one ounce; Water Pepper, Ergot, each, bruised, half an
 ounce;  Oil of Savin  two  fluidrachms ; Alcohol twelve fluidounces.  Mix,
 macerate for fourteen days, and filter.
   This forms  a  useful uterine tonic, and  is valuable in suppressed men-
 struation, painful menstruation, and other functional derangements of the
 womb.   A teaspoonful may be taken two or three times a day.

   COMPOUND  TINCTURE  OF CAMPHOR.  Rheumatic Tincture, ,ot
 Liniment.  Take of Camphor four ounces; Oil of Origanum, Oil  of Henl-
 lock, each, two  ounces;  Oil  of Sassafras,  Oil of Cajeput,  each, half an
 ounce;  Oil of Turpentine two fluidrachms; Capsicum one  ounce; Alco-
 hol two pints.  Mix,  macerate for fourteen days, and filter.
   This is an efficacious external application  in almost every painful  affec-
 tion ; and is  of advantage in chronic rheumatism,  bruises, sprains, chil-
 blains, lameness, numbness, &c.  In ordinary cases, apply from two to four
 teaspoonfuls to the affected part, and  rub it well by the fire; and apply
 warm flannel over the region of the affected part, several times a day.  In
 severe and obstinate cases, after bathing as above directed, apply an addi-
 tional piece of flannel, which must be  kept constantly wet with the drops,
until relieved.   When applied to the teeth, wet a small quantity of cotton,
and  introduce it into the cavity of the  decayed  tooth; if the face ia
Bwollen, bathe with it likewise.  Internally,  twenty drops on sugar may bo
taken for a dose, and repeated three or four times a day. 
746
AMERICAN  FAMILY PHYSICIAN.
   COMPOUND TINCTURE OF COLCHICUM.   Take of Tincture of
 Black Cohosh, Tincture of Colchicum Seed, each, one fluidounce; mix.
   This is an excellent remedy in  inflammatory rheumatism and  gout and
 Has proved  a  superior remedy in phlegmasia dolens, or the swelled leg of
 lying-in women.   The dose is from  ten drops to a teaspoonful, or more as
 circumstances  indicate, to be  repeated every one, two, or four hours.   Ten
 or fifteen grains of Iodide of Potassium added to each fluidounce of the tinct-
 ure, will  in some cases improve its efficacy.

   COMPOUND  TINCTURE  OF  GENTIAN.    Take  of Swamp Milk-
 weed, Colombo, Sassafras, Rhubarb,  Gentian, Prickly-Ash berries, each in
 coarse powder, two drachms, Brandy one pint.  Mix; let them stand for two
 weeks with frequent shaking,  and then filter.
   ^ This is a pleasant stimulating tonic and laxative, very efficacious among
 children  with  weak  stomachs, impaired  digestion, worms, &c; and during
 recovery from summer-complaint, diarrhea, fevers, &c.   From twelve drops
 to a fluidrachm in sweetened  water,  may be taken  for a dose, and repeated
 every three or four hours.

   COMPOUND TINCTURE OF GOLDEN SEAL.  Take of Lobelia seed,
 Golden Seal, each, in powder, one ounce,  diluted  Alcohol  one pint.   Mac-
 erate for fourteen days, express, and filter through paper.
   This  is used  as a  local application to diseased mucous surfaces, as in
 chronic ophthalmia, chronic catarrh,  leucorrhea, gleet, &c.   It may be ap-
 plied on a sponge, or by means of a camel's hair pencil; in some cases, it must
 be diluted with water.

  COMPOUND TINCTURE OF  HEMLOCK.   Golden  Tincture.   Take
 of  Balsam  of Tolu,  Guaiacum,  Gum  Hemlock,  Gum Myrrh, each,  in
 powder, one ounce, Oil of Hemlock  one  ounce and a half, Oil of Winter-
 green one ounce, Alcohol four pints.  Mix, and let them  stand for two weeks
 with frequent shaking, and then filter.
  This is a very useful internal remedy in rheumatism, flatulent colic, water-
 brash, pain or soreness of the chest  or stomach, hysterics, depressed spirits,
 &c.  A teaspoonful may be taken in a wineglassful of sweetened water, and
 repeated every three or four hours; in severe cases a table-spoonful may be
 taken.

   COMPOUND TINCTURE OF HIGH CRANBERRY.  Take of pow-
 dered High  Cranberry Bark  one  ounce,  powdered  Lobelia Seed,  bruised
 Skunk Cabbage seed, each,  half an ounce, bruised Stramonium Seed, pow-
 iered Bloodroot, and  Capsicum,  each,  two  drachms,  Alcohol two pints.
 Macerate for fourteen days,  express,  and filter.
   This is a stimulating antispasmodic, and is useful in all nervous and spas-
 modic  diseases, especially in hysterics, asthma, &c.    The dose varies from
 twenty drops to a teaspoonful  three times  a day; or,  during a paroxysm, it
 may be repeated as often as desired.

  COMPOUND TINCTURE OF IODINE.   Take of Iodine two drachms,
 Iodide of Potassium four drachms, Alcohol half a pint; mix together.
  This Tincture may be employed internally, for all the purposes which
 Iodine is capable of answering.   It does  not decompose on the addition of
 water, as is the case with the  simple Tincture of Iodine.   The dose is six
drops every four  hours, gradually  increased,  if necessary, to  twenty oi
 thirty. 
PHARMACY.
747
   COMPOUND TINCTURE  OF  LAVENDER.    Compound Spirits oj
 lavender.   Take  of Oil of Lavender three fluidrachms, Oil of Anise  one
 drachm and a half, Cloves, in powder, one ounce, Mace three drachms, Red
 Saunders two ounces, Brandy four fluidrachms, Jamaica Rum  one gallon.
 Mix, and macerate for fourteen days, express, and filter through paper.
   This makes a much more agreeable compound  than the formula usually
 given, and is equally beneficial.    It may be  used  as an adjuvant and corri-
 gent of other medicines, and as a remedy for gastric uneasiness, nausea, flat-
 ulence, hysteria, and general languor or faintness.   Dose, from thirty dropi
 to two teaspoonfuls in a little sweetened water.

   COMPOUND  TINCTURE  OF  LOBELIA.   Dr. J. King's  Expecto-
 rant Tincture.   Take of Lobelia, Bloodroot, Skunk Cabbage, Wild Ginger,
 and Pleurisy root, each, coarsely powdered, one ounce.    Place them in  a
 vessel, cover with boiling water (or Vinegar) one pint,  and cover tightly.
 When cold, add Alcohol three pints.   Macerate for fourteen days, express,
 and filter through paper.
   This forms an excellent emetic for children and infants, and may  be safely
 used in croup,  hooping cough,  bronchitis, asthma,  convulsions, and in all
 cases where an emetic is  required.   Also useful as an  expectorant or nau-
 seant in coughs, pleurisy, asthma, and whenever expectorants are indicated.
 The dose for an emetic varies from half a teaspoonful for  a child from two to
 six months old to a table-spoonful  for children from  three  to six  years of
 age.   It should be given in a little molasses  and  water, repeating the dose
 every ten minutes until  vomiting is produced; warm  water  or  Boneset  tea
 will facilitate its operation.   Smaller doses taken in an infusion of  Slippery
 Elm will act as expectorants.

 , COMPOUND TINCTURE OF  LOBELIA AND CAPSICUM.   Anti-
 spasmodic Tincture.  Take of Lobelia, Capsicum, Skunk  Cabbage,  each, in
 powder, one ounce, diluted Alcohol one pint.    Mix, macerate for  fourteen
 days, express, and filter through paper.
  This is a very prompt  and efficacious antispasmodic, highly beneficial in
 cramps, spasms, convulsions, lockjaw, hysteric convulsions during pregnancy,
 &c.  The dose is from half a  teaspoonful to a teaspoonful, every ten or twenty
 minutes, or as often as  required.  In convulsions  and lockjaw, it may be
 poured into the  corner of the mouth,  and repeated as often as necessary;
 generally,  the effect is almost instantaneous.

  COMPOUND TINCTURE OF  MYRRH.   Compound Tincture of Cap-
 sicum.  Hot Drops.  Take of Myrrh,  bruised, four  ounces, Capsicum  two
 ounces, Alcohol,, four pints.   Mix, macerate for fourteen days, and filter.
  This is sometimes used as  an external application in rheumatism, sprains,
 bruises, cuts, offensive ulcers, &c.  Occasionally it is  administered inter-
 nally, in nausea, flatulence, dyspepsia, distress at stomach after eating &c,
 in doses of from half a teaspoonful to half a table-spoonful, in some sweet-
 ened  water.

  COMPOUND  TINCTURE  OF  RHUBARB.   Take of coarsely pow-
 dered  Rhubarb two ounces; Golden Seal, Gentian, Prickly-Ash  Berries,
each, coarsely powdered, one ounce; Cardamom,  Sassafras,  each,  bruised,
half an  ounce; add  these to Diluted Alcohol, or  Brandy, two and a half
pints,  let it stand for  two weeks,  frequently shaking,  then express  and
filter. 
748
AMERICAN FAMILY  PHYSICIAN.
  This is an excellent aromatic tonic and laxative, and is  meful in torpid
liver, costiveness, weak digestion, and to strengthen the stomach and bowels
after expelling worms, or  recovering from diarrhea, &c.   From half a tea-
spoonful to a table-spoonful, in sweetened water, may be taken every four
or five hours;  if it causes more than two mild evacuations from the bowels
lessen the dose.

  COMPOUND  TINCTURE OF  SENNA.   Elixir Salutis.   Take of
Alexandria Senna three ounces;  powdered Jalap  one ounce;  Coriander
Caraway seed,  each, bruised, balf an  ounce;   Cardamom, bruised,  two
drachms ; Diluted Alcohol three pints and a half.   Mix,  macerate for four-
teen days, express, and filter.  Useful in flatulency, and as a laxative for
children, in doses of a teaspoonful for  those a year old, in sweetened water.

  COMPOUND TINCTURE OF  TAMARAC.   Bone's Bitters.  Take of
Tamarac bark, Juniper berries, each, three  ounces, Prickly-Ash  bark two
ounces,  Wild  Cherry bark, Seneca Snake root, each, one ounce and a half,
Tansy half an ounce; let  these articles be coarsely powdered and mixed to-
gether.   To the  mixture add Whisky one pint and a half, and  let them
stand twenty-four hours ; then place  the whole  in a vapor displacement
apparatus, and force through the articles, the steam, or vapor, of additional
Whisky one pint, after which, the steam  from water sufficient to make the
whole amount of tincture  equal  to twelve pints.   To this  add  Molasses
twelve ounces, and six drachms of  Alcoholic Extract of Mandrake, which
last must be thoroughly dissolved.
  This preparation may also be made by adding the above herbs to Boiling
Water nine pints and a half;  digest by a gentle heat for  twenty-four hours,
then  add the Molasses and two and  a half pints of Whisky,—let them
macerate for seven days, express, and strain ;  and then dissolve in the liquid
the Alcoholic  Extract of  Mandrake.
  This  is an  excellent alterative  tonic, aperient, and diuretic; useful in
dyspepsia, menstrual obstructions, and other diseases where such a combi-
nation of action is indicated.   The  dose is a table-spoonful, three times a
day.

  COMPOUND TINCTURE OF VIRGINIA SNAKE  ROOT.  Sudorific
 Tincture.  Take of  Virginia  Snake Root,  Ipecacuanha, Saffron, Opium,
Camphor, each, in coarse powder, eight scruples, Holland  Gin, or Diluted
Alcohol, one  pint;  mix, macerate  for  fourteen  days, express, and  filter
through paper.  H.  Whiting.
   This  tincture is a powerful sudorific, and may be used  in all  cases where
a copious perspiration  is required, or where it is desired to lessen pain, allay
nervous excitability, procure sleep, and keep  up a determination to the sur-
face.  The dose is from ten to sixty drops, in warm catnip  or balm tea, and
repeated every  one, two, or four  hours.  When  it is required to relieve
severe pain, as in painful menstruation, cramp in the stomach, &c, or where
copious perspiration is desired as in pleurisy, puerperal fever, &c, the doses
may be increased to one or two teaspoonfuls.

   ELIXIR VITRIOL.   Into Alcohol half a pint, gradually drop Sulphu-
ric Acid seven fluidrachms, and digest  in a close vessel for three days;  then
add Ginger, in powder, two drachms; Cinnamon, in powder, three dracnms,
macerate for a week, and  filter.                                       «
   This  is tonic and astringent, and is  useful in diarrhea, dysentery, loss 
PHARMACY.
749
appetite, night-sweats, &c.  The dose is from five drops to half a fluidrachm,
in two fluidounces of water, and repeated  three  or  four times a day. _ It
will injure the teeth, unless the mouth be immediately washed, after taking
each dose, with a solution of supercarbonate of soda, or saleratus.

  TINCTURE  OF  ACETATE OF  IRON.   To Distilled  Water,  nine
fluidounces, add pure Sulphuric Acid six fluidrachms, and  in the mixture,
with the aid of heat, dissolve Sulphate of Iron eight ounces, avoirdupois.
Then add pure Nitric Acid half a fluidounce, first diluted with  Distilled
Water one fluidounce, and evaporate the resulting solution to the consis-
 ence of a thick syrup.  Dissolve this in one quart of Rectified Alcohol;
also dissolve separately, Acetate of Potassa eight ounces avoir., in Rectified
Alcohol one quart; mix these two solutions together, shake repeatedly in a
large bottle, and  then place the whole upon a  calico filter.   When any
further liquid ceases to trickle through, subject the filter, with its contents,
to expression, and, having  cleared the  turbid tincture thus  procured by fil-
tration through  paper, let it be added to that  already obtained.  N. B.
The above measures are Imperial.
  This is a chalybeate tonic and astringent tincture, and  is useful  in  all
cases where such agents  are required, in doses of from ten to sixty drops,
well diluted with water.  It may also be added to a sufficient  quantity of
water, and be injected into  the vagina, for leucorrhea.

  TINCTURE  OF ACONITE  ROOT.  Take of Aconite Root, in powder,
eight ounces, Alcohol one  pint;  mix, let  them stand  for  two weeks, fre-
quently shaking, express, and filter.
  This tincture may be given in febrile and inflammatory  diseases, and in
all cases where Aconite is indicated.  Three drops may be given every hour
or two, in about a teaspoonful of water, and be increased or diminished in
quantity and  intervals, according to  its influence.  In large  doses it  is
poisonous.

  TINCTURE OF ARNICA.   Take of Arnica Flowers an ounce and a half,
Diluted Alcohol one pint;  mix, macerate for two weeks, express, and filter.
  This tincture may be used in all cases where Arnica is indicated, in doses
of from five to thirty drops.  It also  forms a valuable external application
to bruises, sprains, &c.

  TINCTURE OF ASSAFETIDA.  Take of Assafetida two ounces, Alco-
hol one pint; mix, macerate for two weeks, and filter.  This possesses the
medicinal virtues of Assafetida,  and may  be used in doses of from thirty
to sixty drops.

  TINCTURE  OF  BITTERSWEET.  Take-of the  bark of Bittersweet
root, in coarse  powder, two ounces, diluted Alcohol one pint; mix,  mac-
erate for fourteen days, express, and filter.
  This possesses the virtues of the Bittersweet bark, and may be used in all
cases where this is applicable,  in doses of from half a fluidrachm  to two
fluidrachms.

  TINCTURE OF  BELLADONNA.  Take of recently dried Belladonna
leaves  one ounce,  diluted Alcohol half a pint; mix, and let them stand for
two weeks, frequently shaking, then express, and  filter.
  This may be used whenever Belladonna is indicated, in doses  of from five
to twenty drops, every three, four, or six hours. 
750
AMERICAN FAMILY PHYSICIAN.
  TINCTURE OF BENZOIN.  Take of Benzoin one  ounce, Alcohol
half a pint;  mix, macerate for two weeks, and filter.
  Used as  a carminative  and  stomachic, also in mucous diseases of the
throat and bladder, in doses of  from ten to thirty drops, three times a day.
It is also added to syrups, tinctures. &c, to improve  their flavor.

  TINCTURE OF BLACK COHOSH.   Take  of very finely  powdered
Black Cohosh root two ounces, Alcohol half a pint; macerate for fourteen
days, express, and filter.
  This Tincture possesses all the virtues of Black Cohosh, and may be used
in various chronic diseases, pulmonary affections, rheumatism, derangements
of the  functions of the womb,  nervous disorders, and wherever this medi-
cine is indicated.  The dose is  from five  to sixty drops, every one, two or
four hours.

  TINCTURE  OF BLOODROOT.  Take of Bloodroot, in fine powder,
three ounces,  diluted Alcohol  one  pint;  macerate  for  fourteen  days, ex-
press, and filter.
  This is an emetic in three or four fluidrachm doses.  From ten to sixty
drops will act as an expectorant and alterative, and will  be found useful in
affections of the lungs, stomach, and liver.

  TINCTURE  OF BLUE FLAG.  Take of Blue Flag root, in powder,
three ounces, Alcohol one  pint; macerate for fourteen days, express, and
filter.
  This possesses the cathartic  and alterative properties of the  root, and
may be given in doses of from  ten to  thirty drops, every four or five hours,
in a little water.

  TINCTURE  OF  CAMPHOR.   Take of Camphor two ounces, dissolve
it in Alcohol one pint.
  This is used internally as a stimulant and antispasmodic, in doses of from
five to thirty drops in some sweetened water.   It is also  employed  as an ex-
ternal anodyne application  in bruises,  sprains, rheumatism, and other painful
affections.

   TINCTURE  OF CAPSICUM.   Take of Cayenne Pepper half an ounce,
diluted Alcohol one pint;  mix,  macerate for fourteen days, and filter.
   This is a  useful and permanent stimulant, very  useful in many low and
depressed conditions of the system.   Its dose is from five to  sixty drops in
water,  every three or four hours.  It is also used externally as a stimulating
application  to indolent ulcers,  tumors, chronic inflammation of  the eyes,
painful affections, &c; and  is frequently used as a wash or gargle  in ulcera-
tion of the throat, and falling down, or relaxation of the palate.

   TINCTURE  OF CATECHU.   Take of Catechu one ounce and a half,
bruised Cinnamon one ounce, diluted Alcohol one pint; mix, let them stand
two weeks, frequently shaking;  express and filter.
   This is an  astringent, and will be  found useful  in chronic diarrhea, &c
The dose is from thirty drops to half  a table-spoonful, every two, three, or
four hours in mucilage of Gum  Arabic or  sweetened water.

   TINCTURE  OF CHLORIDE OF IRON.  Tincture of Muriate of Iron.
Upon Subcarbonate of Iron four ounces in a glass vessel, pour Hydrochloric
Acid half a pint, and when effervescence has ceased, apply a gentle heat, 
PHARMACY.
751
 and continue it, stirring occasionally, until the Carbonate is dissolved ; then
 filter, and add Alcohol one pint and a half.—U. S. Phar.
   This  is  a chalybeate tonic, diuretic, and  astringent.   It is  useful in
 scrofula, gleet, old gonorrhea, leucorrhea, dysury  depending on spasmodic
 stricture, passive hemorrhage from the uterus, kidneys, or bladder, and col-
 liquative diarrhea.  Thedose  is from ten to thirty drops, two or three times a
 day, diluted with a sufficient  quantity of water.   In doses of from ten to
 twenty drops in water, and repeated  every two hours, it has been found a
 valuable agent in the treatment of erysipelas, usually effecting a cure  in from
 two to six days, and during the employment of which, the only local appli-
 cations  necessary, are hair powder and  cotton  wadding; the bowels to be
 kept open.  Externally, it has proved useful in destroying  venereal warts;
 as a styptic and detergent in cancerous and  fungous ulcers, and is  one of
 the best applications that can  be applied to a venereal chancre, for which
 puipose I have successfully used it since the year 1836.

   TINCTURE  OF  CINNAMON.   Take  of Cinnamon,  in  powder, one
 ounce and a half, diluted Alcohol  one  pint; mix, let them  stand for two
 weeks, frequently stirring; express and filter.
   This is an astringent tincture, useful in  diarrhea, dysentery, excessive men-
 struation,   and hemorrhage from the womb.   Dose from one to four tea-
 Bpooufuls in sweetened water,  as often as required.

   TINCTURE OF  COLCHICUM  SEED.  Take of bruised  Colchicum
 seed one ounce, Alcohol half  a pint; mix, let them stand for two weeks,
 frequently shaking; express and filter.
   This possesses the active virtues of the seed, and may be  administered
 whenever  Colchicum is required, in doses of from thirty  drops to half a
 table-spoonful, two or  three times a day, in a little  water or  mucilage.  It is
 also used externally in rheumatic and other painful affections.

   TINCTURE OF COTTON  BARK.   Take of the  recently gathered in-
 ner bark of the Cotton root, coarsely bruised, four ounces,  diluted Alcohol
 two pints;  macerate for fourteen days, express and  filter.
  This tincture is useful in the various derangements  of the menstrual dis-
 charge,  as  painful  menstruation, suspended menstruation, and excessive
 menstruation;  it is also useful  to excite the contractions of the womb during
 labor, when these are weak.  The dose is  from twenty drops to a teaspoonful
 three or four times a day.  Sometimes Sweet Spirits of Nitre  is substituted
 for the diluted Alcohol in making this tincture.
                                                             I
  TINCTURE  OF   DIGITALIS.   Take  of Digitalis,  (Foxglove,) one
 ounce, diluted Alcohol half a pint; macerate for fourteen days; express and
 filter.
  This tincture may be used whenever  Digitalis is indicated, in doses of
 from  five  to ten drops, every  three,  four, or five hours, carefully watching
 its effect, and ceasing its use  whenever the pulse becomes lessened by it.

  TINCTURE  OF ERGOT.   Take of coarsely powdered  Ergot of recent
growth, four ounces, diluted Alcohol  two pints;  macerate for fourteen  days;
express and filter.
  This may be substituted for  Ergot  in powder, whenever desired, in  dosei
of from half a teaspoonful to half a table-spoonful. 
752               AMERICAN  FAMILY  PHYSICIAN.
  TINCTURE  OF  GELSEMINUM.   Take  of the fresh root of Yellow
Jessamine, cut in slices, four ounces, diluted Alcohol, or Whisky, one pint-
mix, let tbem stand two  weeks ;  express, filter,  and  keep in well-stopped
bottles.
  This tincture possesses the virtues of the root, and is the form in which
it is usually given.   The dose varies from ten drops to  a teaspoonful, every
one, two, or four hours, according  to its influence, and the circumstances
attending each case.

  TINCTURE  OF  GENTIAN.  Take of Gentian,  in powder, one ounce,
diluted  Alcohol one pint;  macerate for fourteen days; express and filter.
  This is a tonic Tincture, useful in weak digestion loss of appetite, dys-
pepsia, worms, &c.   The  dose is from half a fluidrachm to two fluidrachms,
three times a day.

  TINCTURE OF GINGER.  Take  of bruised Ginger  two  ounces;
Alcohol half a  pint; mix, and  let them stand  for two  weeks, frequently
shaking, then express and filter.
  This  a pleasant aromatic, useful in flatulency, weakness of the digestive
apparatus, &c, and is frequently added to other preparations.  The dose is
from ten drops to a teaspoonful, in sweetened  water, syrup, &c.

  TINCTURE OF GRAINS  OF PARADISE.  Take of Grains of Par-
adise, bruised,  one ounce ;  Alcohol half a  pint; macerate  for fourteen
days, express and filter.
  This  tincture is a stimulant,  acting  somewhat similar to the tincture of
Capsicum ; Its  dose is similar to the latter, which  may be advantageously
substituted for it.

  TINCTURE OF HEMLOCK. Take of Gum Hemlock one ounce;
Alcohol one pint;  dissolve the  gum in the Alcohol, and filter.
  This, as well as the essence of Hemlock, is stimulant and diuretic, and
may be  used in irritability of the stomach, nausea, vomiting, and in cases
where the Turpentine diuretics are indicated.  The dose  is  ten or twenty
drops in sweetened water, every two or  three hours, and  in severe cases,
every fifteen minutes, until relief is obtained.

  TINCTURE  OF  HYOSCYAMUS.   Tincture  of Henbane.  Take of
Henbane leaves one ounce ; diluted Alcohol half a  pint; mix, let them
stand for two weeks, express and filter.
  This  tincture is frequently substituted for Laudanum, especially when
the  latter does not agree with  the person to  whom it is  administered; it
relieves pain, and causes  sleep,  without occasioning costiveness.  The dose
is from twenty drops to a fluidrachm.

  TINCTURE OF IODINE.  Dissolve Iodine four drachms in Alcohol

  aThisPtincture possesses the  active  properties of Iodine,  but is_ rarely
given internally, on account of its tendency to  decomposition.   It is more
commonly used locally as an application to erysipelas, some diseases of the
skin indolent  ulcers, chilblains, &c.  The dose internally is from ten to
twenty  drops, in wine or water, three  times a day.

  TINCTURE OF LEPTANDRIN.   Take of Leptandrin half an  ounce; 
PHARMACY.
753
Alcohol  half a  pint, to  which add  Aqua Ammonia, merely a  sufficient
quantity to take up the whole of the Leptandrin.  The Ammonia must be
added after the Alcohol has dissolved all the Leptandrin possible.
  This is an  aperient and cholagogue tincture, useful in various derange-
ments of  the biliary organs, in doses of from half a teaspoonful  to half a
table-spoonful, two  or three times a day.  It is less energetic than the tinc-
ture made from the powdered root, three ounces of which may be macerated
in diluted Alcohol one pint.

  TINCTURE OF  LOBELIA.   Take  of Lobelia four ounces;  distilled
Vinegar,  Alcohol,  each,  one pint;  macerate for  fourteen days, express
and filter.
  Half a fluidounce of this, or more, may be given to produce  vomiting;
from thirty to sixty drops to cause nausea and expectoration.  Externally,
it is beneficial as a local  application in tetter, and similar  cutaneous erup-
tions, and also in the poison by Rhus Toxicodendron upon the skin.

  TINCTURE  OF  LUPULIN.   Take of fresh  Lupulin  one  ounce;
Alcohol half a pint.  Macerate for fourteen  days and filter.
  This is preferable to the tincture of Hops, and  may be employed in after
pains, chordee, cough, and in all cases where Opium  is inadmissible.   The
dose is one or two teaspoonfuls in  sweetened water.

  TINCTURE  OF  MUSK.  Take of Musk one drachm; Alcohol  one
fluidounce ; macerate for fourteen days, and filter.
  This is a stimulant and anti-spasmodic preparation, useful in  hysterics,
hooping-cough, low fevers, and various  spasmodic  and nervous disorders.
The dose is from twenty to sixty drops, three or four times a day.   One
fluidrachm of this tincture is equal to seven  and  a half grains of musk.

  TINCTURE OF  MYRRH.  Take of  bruised Myrrh one ounce; Alco-
hol  twelve fluidounces.   Let them  stand for  fourteen  days,  frequently
shaking, and then filter.
  This is generally used externally as a stimulating  application to spongy
gums, ulcerations of the mouth  and throat,  obstinate  ulcers,  diseased
bones, &c. Sometimes it is used  in chronic, dry cough, and in suppressed
menses, in doses of from half a teaspoonful  to a  teaspoonful.

  TINCTURE OF NUX VOMICA.  Take of  rasped  Nux  Vomica two
ounces; Alcohol half a pint.   Let them stand for fourteen days, frequently
Bhaking, then express and filter.                                      *
  This tincture is seldom used alone on account of its bitterness.  It pos-
sesses the active properties of Nux Vomica,  in doses  of from five to fifteen
drops.  Combined with  equal parts of the tinctures of Blue  Flag and
Mandrake, in doses of twelve or fifteen drops, three  times a day, it is effi-
cacious in obstinate constipation, gleet, stricture  of the urethra, impotenc
from masturbation,  and recent disease of  the prostate gland.

  TINCTURE OF  OPIUM.  Laudanum.  Take  of good Turkey Opium
one ounce and two  drachms ;  slice it, and pour upon it boiling water four
fluidounces, and with the hand or pestle reduce it  to an emulsion ;  then
pour it into a bottle, and rinse the pestle or hand with one fluidounce of
warm water,  which  add to the above, together with Alcohol of 76 per cent.
     48 
754
AMERICAN  FAMILY  PHYSICIAN.
ten fluidounces.  Agitate well, and set  it aside;  in twenty-four hours it
will be of full strength.
  This tincture may be used for all  purposes in which Opium is indicated
in doses of from ten  to thirty drops.  If Vinegar be employed  in  the
above, instead of water, it forms a much  better tincture, and less liable to
vary in strength.

  TINCTURE OF PODOPHYLLIN.   Take of Podophyllin one drachm;
Alcohol half a pint; mix, and dissolve the Podophyllin.
  This tincture may be  used in all  oases where Podophyllin is indicated.
The dose is from ten to sixty drops every two, three, or  four hours.  A full
purgative dose will not require repetition for several days, unless demanded
by the exigencies of the case.

  TINCTURE OF POISON  HEMLOCK.   Tincture of Conium Macula-
turn.  Take  of  the recently dried  leaves of Poison Hemlock three ounces ■
diluted Alcohol one pint.  Macerate for fourteen  days, express and filter.
  Tihis is a discutient and  alterative preparation, and may be used both
internally and externally, to remove  glandular and visceral enlargements •
it is likewise an anodyne and antispasmodic.   It has been found useful in
scrofula, diseases of the skin, tumors of various kinds, bronchocele, hoop-
ing-cough, chorea, asthma,  troublesome cough, &c.   The  dose is from
twenty to sixty drops, two  or three times a day,  gradually increased, if
necessary.

  TINCTURE OF POKE.  Take  of Poke  Root, in powder, two ounces;
diluted Alcohol one pint;  macerate for fourteen days, express and filter.
  This tincture may be used in  all cases where  the influence of Poke is
desired, in doses of from twenty to  sixty drops, three or four times a day.

  TINCTURE OF PRICKLY-ASH BERRIES.   Take of  Prickly-Ash
berries four  ounces ;  diluted  Alcohol  one  pint; macerate for  fourteen
days, express and filter.
  This is an excellent stimulating and  carminative  tincture, and  may be
used in Asiatic cholera, low  stages of fevers, tympanitis, &c.  The dose is
from one to  four  fluidrachms every ten  or twenty minutes, or every hour
or two, according to the  urgency of  the case, and the effects produced.  It
gives tone to diseased and relaxed mucous tissues.

  TINCTURE OF  PRICKLY-ELDER.    Take  of  Prickly-Elder, in
powder, one ounce and a half; diluted Alcohol  half a  pint; macerate  for
ftfurteen days, express and filter.
  This is stimulant, tonic  and alterative, useful  in chronic rheumatism,
colic, flatulency and cholera.  The dose is from  ten to sixty drops, three er
four times a day.

  TINCTURE OF RHATANY.   Take of powdered Rhatany root, thr*
ounces j  diluted Alcohol one pint;  macerate for  fourteen days, express and
Alter.
  This is an astringent, and may be used in diarrhea, and hemorrhage*
from the stomach, bowels, or womb, in  doses of  one or  two fluidrachms,
repeated as often as  required.  Externally,  it forms an  excellent local
application to the gums, where they are tender,  spongy, and bleed.

  TINCTURE OF SHEEP LAUREL.   Take of Sheep Laurel leaves, in 
PHARMACY.                         755
  powder, three ounces ; diluted Alcohol one  pint;  macerate for  fourteen
  days, express and filter.
    This a sedative tincture, and possesses antisyphilitic properties.  It has
  been efficacious  in jaundice, syphilitic  diseases, palpitation of the heart,
  neuralgia of the eye, &c.   The dose is ten drops, carefully and gradually
  increased to thirty.   Externally, it  forms an  excellent application to  itch,
  syphilitic ulcers, and some skin diseases.

    TINCTURE OF SHRUBBY TREFOIL.   Take  of  Shrubby  Trefoil,
  in coarse  powder, two ounces ; diluted Alcohol one pint; macerate for
  fourteen days, express and filter.
    This is an excellent tonic, possessing all the  properties  of the  bark  of
  the root from which it is  obtained.  The dose is from half a  teaspoonful
  to two teaspoonfuls three  times a day.

    TINCTURE OF SPANISH  FLIES.  Tincture  of Cantharides.  Take
  of Spanish Flies, in  coarse  powder, half an  ounce; diluted Alcohol one
  pint;  mix, let them  stand for two weeks, express and filter.
    This is used in  chronic  leucorrhea,  suppressed menstruation, gleet, and
  some urinary derangements ; externally used  as a rubefacient.   Dose  from
  ten to sixty drops, three or four times a day.

    TINCTURE OF STRAMONIUM.  Take of Stramonium seed, bruised,
  three ounces; diluted Alcohol  one pint; mix, let them  stand   for two
  weeks, express and filter.
    This may be used for all the purposes for which Stramonium is given,  in
  doses of from ten to forty drops,  two or three times a  day, gradually
  increased till  it affects the system.

    TINCTURE OF  TOLU.   Dissolve  Balsam  of Tolu one ounce and a
  half, in a pint of hot water, and filter.
    This is useful in cough, and chronic catarrh, and is often added to expec
  torant and  other mixtures,  intended to influence  mucous  tissues.  The
  dose is from half a teaspoonful to  two  teaspoonfuls, in sweetened water,
  three or four times a  day.

    TINCTURE OF  TOXICODENDRON.  Take of the recently  collected
  Leaves of Poison Oak two ounces, Alcohol one and a half fluidounces;  mix,
  let them stand for two weeks, express, and filter.
    This is a narcotic and stimulant, and should be used with great caution.
  It has been used in obstinate diseases of the skin, chronic rheumatism, par-
  alysis, &c.   The  dose is  three  drops, in water, three or four times a  day,
  gradually increased to ten drops.  It must be  kept in well-stopped  vials.

    TINCTURE OF WHITE  HELLEBORE.   Take of the  fresh  Root
  of White Hellebore, cut in slices, three ounces, diluted  Alcohol one pint;
  macerate for  fourteen days, express and filter;  and keep in well stopped
  bottles.
    This tincture possesses the virtues of the root, and  is much used in febrile
  and inflammatory diseases; it reduces the pulse, lessens inflammatory aetion,
  and allays pain.  The dose is  three drops, every hour or two, gradually in-
t  creased to five or ten, or until some effect is produced.

    TINCTURE  OF  YARROW.   Take  of  the leaves of Yarrow three 
7b6
AMERICAN FAMILY PHYSICIAN.
ounces, diluted Aloohol one  pint; macerate for fourteen days, express, and
filter.
  This is a tonic and astringent, and may be used  in  chronic diarrhea and
dysentery, weak  stomach, diabetes,  excessive menstruation,  bleeding from
the lungs, flooding, &c.   The dose is from a teaspoonful to a  table-spoonful,
three or four times a day, or as often as required.   A few drops of Oil of
Anise  or  Oil  of Cinnamon, will  remove  the unpleasant  taste of this
tincture.

  VOLATILE  TINCTURE  OF   GUAIACUM.   (Dewees.)  '  Take  of
Guaiacum, in powder, ten ounces, Carbonate of Soda, or of Potassa forty-
five  grains, Allspice, in  powder,  half an  ounce, diluted Alcohol one pint.
Macerate for seven days, and filter.   When to  be  used, to each fluidounce
of the tincture, add fifteen or thirty drops of Aqua Ammonia.
  This is used sometimes in painful menstruation,  and suppressed  menstru-
ation.  The dose is a teaspoonful, three times a day, in wine  or milk.
                             VINEGARS.
  These  are  fluid preparations, consisting of  vinegar impregnated with
various medicinal substances, to which a small quantity of alcohol is usually
added, to  prevent them from spoiling.  They should  be  made of distilled
Vinegar, and in small quantities at a time, on account of their liability to
change.

  VINEGAR  OF  LOBELIA.   Take  of powdered Lobelia seed  two
ounces,  distilled Vinegar one  pint;  macerate in  a close glass vessel for
seven days;  then express, filter, and add Alcohol one fluidounce.
  This is  used  as an  emetic, nauseant,  and expectorant;  also as a relaxant
in spasmodic affections;  externally, it is valuable  in  diseases of the skin.
The dose is from one to four teaspoonfuls,  repeated as  required.

  VINEGAR OF SQUILL.   Take  of Squill, sliced, two ounces, distilled
Vinegar one pint, macerate in a close  glass vessel for seven days; then ex-
press, strain, and add Alcohol one fluidounce.                   <
  This is an  expectorant  and  diuretic,  and is occasionally used in  cough,
diseases of the chest, and dropsy, in doses of from ten to sixty drops, three
or four  times a day.  The Syrup of Squill is the best form for use.
MISCELLANEOUS.
  The character of several popular nostrums is herein given, that they may
be understood by the community, they are not recommended, however, ior
use.
  BUTE'S  RHEUMATiC LINIMENT.   Take  of Oil  of Turpentine,
Tincture of Camphor, Olive Oil, Oil of Amber, Beef's Gall, each, one fluid-
ounce; Aqua Ammonia, Oil of Juniper, each, one fluidrachm; mix.

  BRANDRETH'S  PILLS.  Take of Aloes  two pounds, Gamboge  one 
PHARMACY.
757
nound, Extract of Colocynth four ounces, Castile Soap half a pound. Oil of
Peppermint two fluidrachms, Oil of Cinnamon one fluidrachm.  Mix, and
form into pills.

  CONKLIN'S SALVE.  Take of Resin twelve ounces, Beeswax, Mutton
Tallow, each, one  ounce;  melt together, strain, and work it into  rolls in
cold water.
  WUITWITH RED DROPS.  Oil of Thyme four fluidrachms  Tincture
of Camphor two  fluidrachms,  Tincture of Myrrh,  Essence  of Lavender,
each, two fluidrachms, Alcohol half a pint.  Dose, twenty-five drops.   .

  LORD'S SALVE.  Mutton Tallow one pound, Beeswax, White Turpen
tine, each, half  a pound; melt together, and  add  finely powdered Verdi-
gris one table-spoonful.  m

  SWEET'S SALVE,  or  STRENGTHENING  PLASTER.-   Take of
Bole Armenia,  Nitre, Camphor, each in powder, one ounce;  mix  together,
and add to the following articles melted together; Rosin  eight ounces,
Beeswax two ounces; work in cold water.

  WHITE'S PLASTER.  Melt together  White Rosin three pounds, Mut-
ton Tallow, Beeswax, Burgundy Pitch, of  each four ounces, strain, and add
British Oil, Cedar Oil, Camphor, of each half an  ounce, W. I. Rum one
gill.   Work in  cold water into rolls.

  TRIPP'S PECTORAL  BALSAM.   Take of Tincture of Balsam Tolu
twelve fluidounces, Balsam  of Canada six ounces, Oil of Anise three fluid-
ounces; mix.

  ANODYNE  BALSAM.  White  Spanish  Soap  one ounce, Opium two
drachms, Alcohol nine fluidounces; digest at a gentle heat in a close vessel,
for three days, strain, and add powdered Camphor three drachms.

   BLACK OIL.  For removing callous  tumors, &c, in horses, also corns,
warts, &c.   To Oil of Spike  one fluidounce  gradually and  carefully add
Sulphuric Acid one fluidounce; when mixed add Olive Oil half a gill.

   HIBBEN'S  NERVE  AND BONE LINIMENT.   Take Oil  of Ori-
ganum, Oil of Rosemary, each, one pound, Olive Oil two pounds, Tincture
of Spanish flies, Oil  of Turpentine, each,  half a pound, strong Tincture  of
Camphor one fluidounce; mix.

   HUNTER'S  RED DROP.  Take of Corrosive  Sublimate ten grains,
Muriatic Acid twelve drops,  Compound Spirits  of Lavender  one fluidounce.
The dose is five, ten, or twenty drops in water, or white wine, sufficient fr>
produce one evacuation daily, but  not  over  two.  Sometimes Antimonial
Wine is substituted for the Spirits of Lavender.  It is an improper medicine
originally taken from "Marryatt's Therapeutics."

   AYER'S CHERRY  PECTORAL.   Take  of Acetate  of Morphia four
grains, Tincture  of Bloodroot two fluidrachms, Antimonial Wine, Wine of
Ipecacuanha,  each, three fluidrachms, Syrup of Wild Cherry three fluid-
ounces; mix. 
758                AMERICAN  FAMILY  PHYSICIAN.
  KITRIDGE'S  COUGH  DROPS.   Take of  Lobelia  Seed, Bloodroot,
each, in powder, eight grains, Ipecacuanha, Capsicum, each, five grains; add
water and spirits, equal parts  of each, and simmer to one gill; then add
half a  gill of honey, and of cider,  and when  cold add powdered Opium
Camphor, each, five  grains.   Dose, a teaspoonful  three or four times a day.

  MACKENZIE'S  SYRUP FOR  CONSUMPTION.  Take  of Colombo,
Hoarhound, each, two  ounces,  Boneset  one  ounce, Pleurisy  root  four
ounces, water one gallon.  Mix, and boil slowly to one gallon; add  sugar
five pounds, Canada Balsam one pound, Liquid Storax eight ounces, Wheat
Bran two  pints.   Simmer the whole slowly for two hours, add one pound
of Beeswax;  let the mixture  stand for twenty-four hours, strain, and add
yeast one pint.  Allow the whole to stand for use, and bottle.  Dose, half
a table-spoonful four or six times a day.   A very heterogeneous compound I

  GERMAN  CHOLERA MIXTURE.  Take  of Geranium one pound,
Gentian, Elecampane, Angelica root, each, two ounces, Valerian, Aniseed,
each, one  ounce, Rue three  drachms, Camphor, Saffron, each, two drachms,
Canada Fleabane one drachm, Brandy one gallon.   Mix  and digest for
ten days.   Dose, from half a table-spoonful to a table-spoonful every fifteen
or thirty minutes.

  SWEET'S  RHEUMATIC  WASH.  Take of Winter Green, Bayberry
bark, Wild Indigo  Root, each, half a pound, new Rum two quarts, boil to
one quart, strain, and add Oil of Turpentine half  a gill, Vinegar one gill.

'  MACKENZIE'S  OINTMENT.  For tetter, scald-head, and other diseases
of the  skin.   Take  of powdered  Sulphate of Zinc four ounces, Liquid Sto-
rax one ounce, Lard one pint; mix, and boil slowly for one hour, stirring
all the time.   To be applied  twice a day, washing  the part with Castile soap
suds daily.

  FAHNESTOCK'S VERMIFUGE.  Take of Castor Oil, Oil of Worm
seed,  each,  one fluidounce,  Oil of Anise half a fluidounce, Tincture of
Myrrh half a fluidrachm, Oil of Turpentine ten  minims, Croton Oil one or
two drops; mix.

  TURLINGTON'S  BALSAM.   Take  of Benzoin three  ounces, Liquid
Storax one ounce, Socotrine Aloes, Myrrh, each, two drachms, Balsam  Peru,
Balsam Tolu,  Extract of Liquorice,  each, half an  ounce, Angelica root one
drachm, Alcohol one pint.   Mix them together, let them  stand for ten or
twelve days, frequently shaking, and then strain. 
KING'S    MEDICINE   CHEST.
For   Families,   Plantations,   Ships,   Steamboats,

                             Hotels,  &c.
                     --------------  ■■ Q !■



  For the benefit of the subscribers to the present work, I would state that this Chest is
prepared for the use of persons who are not  situated so as to conveniently obtain the medicines
herein named, and which may be had of Dr.  F. D. Hill, corner of Race and Fifth streets, Cincin-
nati, 0., who alone is authorized to manufacture them for sale, and who will, likewise, furnish
euch medicines from time to time as may be ordered.  Persons sending  their  orders to him for
tho Medicine Chest, will  be particular ic giving directions, naming the  town, county, State, and
iow to forward—clearly and distinctly.

  There are two sizes of the Medicine Chest, one for $25, the other for $40 ; the Chest is compact
and strongly made; the vials are strong and well corked, and all the articles are properly labelled.
Persons can have any medicines they desire added to those already in the Chest, at a reasonable
advance.

  The $25 Chest  contains the following:

            In  8 oz. Vials.

Fluid Extract of Rhubarb and Potassa, or Neu-
  tralizing Cordial.
Compound Capsicum Liniment, or Rheumatic
  Liniment.
Compound Powder  of  Jalap, or  Antibilious
  Physic.
Powdered Leptandra (Black root).
Bi-carbonate of Soda.
Castor Oil.
Antiperiodic  Tincture, in  the proportion  of
  Quinia  ten grains, Elixir Vitriol  one flui-
  drachm, and Tincture of Black Cohosh four-
  teen fluidrachms.
            In 4 oz. Vials.

Fluid Extract of Spigelia and Senna.
Compound Tincture of Myrrh, or Hot Drops.
Compound Tincture of Lobelia, or King's Ex-
 pectorant Tincture.
Tincture of Prickly Ash Berries.
Compound Powder of  Lobelia, or Emetic Pow-
 der.
Essence of Peppermint.
Cough Drops.
Powdered Rhubarb.
Flowers of Sulphur.
Laxative  Powder, composed of Podophyllin one
 part, Leptandrin two parts,  Cream of Tartar
 twenty parts.
            In 2 oz. Vials.

Compound Tincture of  Lobelia and  Capsicum,
  or Antispasmodic Tincture.
Compound Tincture of  Virginia Snakeroot, or
  Sudorific Tincture.
Powdered calcined Deer's-horn.
                                                                  (759)
Faregonc.
Tincture of Camphor.
Tincture of Gelseminum,
Laudanum.
Tincture of Assafetida.
Powder) composed of equal parts of Blue Cohosh
  and Golden Seal.
             In 1 oz. Vials.

Compound Powder of Ipecacuanha and Opium,
  or Diaphoretic Powder.
Camphor.
Geraniin.
Mild Vegetable Caustic.
Tincture of Aconite root.
Tincture of Arnica.
Tincture of Muriate of Iron.
Sulphate of Quinia.
% drachm, Sulphate of Morphia.
% drachm, Dioscorein.
            Also in Pots, &c.

% lb. Resin Plaster, (Adhesive, on cloth.)
% lb. Compound Tar Plaster, (Irritating.)
% lb. Compound Lead Ointment, (Mayer's.)
2 oz. Compound Ointment of Oxide of Zinc,
  (llild Zinc.)
100 Antidyspeptic Pills.
Box of Scales and Weights.
1 oz. glass graduate Measure.
% lb. Lint.
1 Spatula.
1 pint Syringe.
2 oz. Syringe.
1 Gum elastic Catheter. 
PAET    IV.
HYDROPATHIC  APPLIANCES.
                   INTRODUCTORY  REMARKS.

  Dry details of the succesive steps by which water has attained its present
popularity as a remedial agent are uninteresting to the majority of those for
whom these  pages  are intended.   Priessnitz was an original  man and has
been a benefactor to his race, by his development of the remedial powers of
water   Yet,  to  other minds,  more learned and comprehensive, the public
are indebted for  improved processes and correct principles of action.  Weiss,
Rausse,  Richtur, Preifs, &c,  in Germany; Wilson, Gully,  and Johnson, in
England; Shew,  Trail, Nichols, and others, in the United States, have added
much to the stock of general knowledge in this direction.
  From the use  of  excessive cold water and long-continued baths,  progress
has been made to a  milder and safer method of treatment.   More attention
has been paid to the adaptation  of the  bath to  the peculiar constitution
and symptoms of each  patient.   As no two persons are alike, variations in
the temperature,  form, and duration of the bath are required to render the
treatment of disease either judicious or rational.  At one time, the wet sheet
pack was continued  with nearly every  patient till perspiration was induced;
as a natural consequence, nervous  and  debilitated patients were prostrated by
its  lowering effects upon the system.   Experience taught the same thing in
regard to the use of the douche, plunge, &c.  It became evident that to ren-
der the use of water universally beneficial, more attention must be paid to
an analysis of the symptoms  of each case,  and the relations  which the differ-
ent modes of using water bear thereto.
   In the following  pages, an  attempt has been made to give in as full and
complete a manner as the limited space would allow, a description of the dif-
ferent methods of using water and the  principles which govern their employ-
ment in the treatment of disease—combining the results of several years ex-
perience in the  treatment of  both acute  and chronic disease, with the pub-
lished observations  of the best Water-Cure practitioners of England and
Germany.   Use  and adaptability to the wants of the people were the objects
aimed at, in the  preparation  of the following pages.

        (760} 
HYDROPATHIC  APPLIANCES.
761
                   TOWEL  OR  SPONGE  BATH.

   In the treatment of acute disease, this form of bathing has been most gen-
 erally used, from its simplicity and availability.    In chronic disease,  where
 the vitality of the patient is  very low, and the skin comparatively blood-
 less, it is generally  the first means employed to cleanse the skin and
 increase its action.  By the increased flow of blood to the surface it produ-
 ce?, the system is prepared for the more severe and  thorough baths.
   Persons who are much reduced in physical vigor, may  bathe part of the
 body first, as the head, face, arms, and chest, drying and applying thorough
 friction with a dry towel or the, dry hand, before bathing the rest of the body.
 Also in fevers or other acute diseases, this  form of sponging the patient's
 body, practiced by the nurse,  is  often better  than exposure  of the  whole
 surface.
   Thc temperature of the  water used must be governed wholly by the vigor
 of the patient, in chronic disease; it being often necessary to commence with
 water at 85° or 90°, gradually reducing it to cool or entirely  cold water, as
 the patient may be able  to bear;  or substituting other forms of bathing in
 its stead.
  Thc  cold sponge-bath  quickly applied, is a very valuable remedy in the
 night-sweats of consumption, and the clammy sweats which so often appear
 during convalescence from intermittent and other fevers.    The patient who
 wakes and finds himself in a cold, clammy sweat, by immediately rising and
 washing over the whole surface with a towel or  sponge dipped in cold water,
 drying as  usual, and putting on dry night-clothes,  will most generally be
 able  to entirely check  that disagreeable  symptom and avoid its prostrating
 effects.   Cold sponging, is tonic, and stimulant to- the skin, thus antagonizing
 the debility of which night-sweats are but symptomatic.
  In acute disease, when the object is to allay fever, I  have found  water at
 a temperature of 75° or 85° better  to reduce the fever, than colder water.
 For,  while in chronic disease, it  is desired to excite action of the skin, in
 febrile  attacks  the  design is to modify the excited  action  already  exist-
 ing, cleanse the skin, and hasten perspiratory action.
  Persons whose motto has been :—"Cold water—the colder the better"—
 have been  very much surprised,  after the application of cold water, to find
 in a short time a new accession of fever.
  Having  the principle above named in view, a judicious nurse will continue
 the tepid bath till the  feverish action  is  reduced.   In convalescence  from
 fevers and other debilitated states,  the  same principle and course must be
 adopted as in chronic diseases characterized by debility—the object being to
 stimulate the skin and the nervous and arterial systems.
  Some sit or stand in an empty wash-tub or half-bath tub, and with a large
sponge  well filled with water,  make it pass freely  over the  different  parts
of the  body.   Or,  the  patient  may  pour water  over himself.
  This  is mild, but more stimulating than  the  towel bath.
                            WASH-DOWN.
  This is a form of towel bath, given with the assistance of an attendant,
both the subject and the operator  being engaged in its administration.
  The patient stands in a bathing-tub during its application.   The tow-
els  are used dripping wet, and are  rewet  and  reapplied several  times  if
desired.  It is used mainly in various stages of chronic disease. 
762
AMERICAN FAMILY PHYSICIAN.
                             AFFUSION.
  The patient standing in an empty bathing-tub, has an assistant pour wa-
ter over the neck, chest, and shoulders, from a pail or pitcher.   It is a very
good form for general bathing; and is very useful to cool the body in febrile
and inflammatory conditions.  The quantity of the water and the tempera-
ture used vary according to the necessities of the case.
  Dr. Currie of England employed it very extensively in a great variety
of febrile  diseases, such  as  typhus and scarlet fever,  small-pox, measles
tetanus, convulsions, &c.
                      THE WASH-TUB BATH.
            Fig. 73.
                                In domestic practice, is a convenient and
                              invaluable resort, in the treatment of feb-
                              rile conditions of the system.   Fill a tub a
                              third or  half full of water of the proper
                              temperature, in  which place  the patient,
                              having his feet in a smaller tub or pail con-
                              taining similar proportions  of  water.   The
                              patient, if able, may wash himself, with the
                              aid of one attendant; but if feeble or suffer-
                              ing from any prostrating disease as typhoid
                              fever, should have two bath-attendants and
                              remain quiet himself.   The body and  limbs
                              can  be  thoroughly washed, pouring  occa-
                              sionally water of the same temperature upon
         Wash-Tub Bath.         and over  ^g shoulders and body to effect a
more  thorough cooling of the  system.   As a general rule,  tepid water,
ranging from 72° to 85° or 90°, is best,   being less liable  to produce  a re-
turn of the febrile action of the skin.  The bath may  be given from two to
five, ten or fifteen minutes, according  to  the strength of  the  patient and
heighth of the fever.   But it should not  be prolonged so far as to produce
chilliness or blueness of the nails and pallor of the skin which indicate the
reflow of  the blood to the internal organs.  Dry with towels or the dry
rubbing sheet,  which protects  the body of the  patient from  the action of
eurrents  of air and  renders him less liable to chill.
  In  the  treatment  of fever, should it return, the  bath may be again re-
sorted to till the feverishness is reduced.   It is very useful in the treatment
of the eruptive fevers, in bilious remittents, the hot stage of interniittents,
and in hectic  and typhoid fevers.  It is also an appropriate bath after the
wet-sheet pack  where that is  administered in chronic affections; when, it
may be used of a cooler temperature, or followed by the pouring of a pail-
ful  of cooler water over the shoulders of the patient, to tone up the skin
after  it has been thoroughly cleansed by this process.
  It cleanses  the surface,  reduces the  excessive heat of the  system, and
possesses also a derivative  effect upon the circulation from the  head, lungs,
and heart, to the lower abdomen and extremities, antagonizes congestion oi
those organs and soothes the nervous system.
 
HYDROPATHIC  APPLIANCES.
763
             THE RUBBING OR DRIPPING SHEET.

  This is of such general availability in home practice, and applicability to
various diseases and states of the system, that it proves one of the most use-
ful measures in  the whole list of Water-Cure processes.
  Take  a  coarse linen  or cotton sheet—             Fig. 74.
well-wrung, if  you wish it for  a rubbing-
sheet—loosely wrung for a dripping-sheet;
throw it quickly about the patient's  body,
from behind, and  let the patient and at-
tendant  both rub briskly over the  sheet for
one, two, three, or  four, or more  minutes,
until the surface becomes thoroughly warm.
Follow it with the dry sheet, and towel and
hand-rubbing.
  It is a very pleasant and useful form for
general  bathing, and as described above is
very  generally  used in  the  treatment of
chronic  disorders, during  all  stages,  but
more especially in the earlier,  when only
the milder appliances of Water-Cure can        Rubbing Wet Sheet.
be borne.
  Used  as cool  as it can be borne and secure  proper reaction, it is a tonic
and stimulant.  The blood-vessels of the skin  contract on the first applica-
tion of the sheet, and subsequently relax, with an increased flow of blood
into their calibre—which double action is increased by the friction, until a
good amount of blood is fixed in the skin, as seen by the glow produced by
a bath of proper length and temperature.   Thus congestion of the internal
organs, the brain, lungs, stomach, liver, &c, is antagonized by an increased
action of the skin, and  the nervous  system also is  soothed or stimulated,
and a  corresponding equilibrium produced.   It  takes off  languor,  gives
new vigor  to mind and limb, removes feverish thirst, generates appetite,
&c.   It  is often very useful in  spasmodic and neuralgic affections of  the
limbs and  trunk.   With feeble  patients, it is best to commence with a sheet
of mild temperature, from 80° to 90°, gradually reducing it as the vigor of
the system is  increased.  When the  sedative or soothing effect is wished,
mild temperatures must be used.  But when used for the purpose of invig-
oration and stimulation of the  nerves of the vegetative system and brain,
or for reducing  their painful or  spasmodic  affections, it should be  cool or
cold and of longer duration—the  sheet being re-wet and re-applied several
times in succession.  For  feverish pulse and  heat  in chronic  disease  the
dripping-sheet taken at bedtime, of a mild temperature and short duration,
induces  sleep by relieving the  brain from the irritation of the skin, and
thus allaying nervous excitability.
  As a remedy  for the febrile stage  of acute  attacks, the dripping sheet,
repeated as many times as necessary,  is very useful.   It should be  tepid or
slightly cool to  produce this sedative or febrifuge effect.   It is  valuable in
all cases where a strong diversion  to the skin from the mucous membrane of
the alimentary canal or from the internal viscera is needed, as in the early
stages of diarrhea, dysentery, cholera, colic,  &c.  It is one of the best  forms
of bath to  follow the wet-sheet pack.   Is valuable in  mental diseases in case
of brain-exhaustion, some forms  of  insanity,  nearly all spasmodic and epi-
leptic conditions, &c.
  A short, cool  bath of this kind, taken at bedtime, will often prevent night-
sweats in those who are afflicted with them.
 
764                 AMERICAN FAMILY  PHYSICLAN.
                               •

 _ In this case, as in other forms of general bathing, the patieut should wash
his face, and wet his head in cold water, before taking it.
  When patients are too feeble to stand while taking  this bath, they may
sit on a stool and have a sheet thrown over them, following out  in  other
respects the directions given above.   And, in cases of great prostration, hav-
ing spread under the patient a woollen blanket, the sheet well-wrung may
be applied, while lying upon the  side, thus bathing one side at a time, and
preserving the strength of the patient.  Thus applied,  it rallies the feeble
powers of the system and  hastens convalescence more  than can be effected
merely by the use  of the towel or sponge-bath.
                           PAIL  DOUCHE.

   This is a far more stimulating bath than the preceding, as a greater body
of water comes in direct contact with the system, and by the shock produced,
excites greater nervous action.
   The patient stands  in an empty bathing-tub, and  the attendant having
prepared two pails of water, one  five or ten degrees milder than the other in
temperature, dashes the  warmest pailful half upon his chest, half upon his
back, following with the second pailful  in the same manner;  then dries and
uses friction as in other forms of general bathing.
   It is not advisable to use it in cases of great nervousness, as it gives too
great a shock to  the over-excited, sensitive nerves and adds to the nervous
derangement already existing.  More sedative appliances, as the rubbing wet-
sheet, short tepid half-baths, &c, are indicated in such cases.  Nor  is the
pail douche advisable where there is serious disease of the heart or lungs, espe-
cially in the latter case,  as its use tends to the too sudden stimulation of the
circulation in the ,thoracic  organs, and may produce fatal hemorrhage from
bursting of the cell-structure of the lungs.    It is mostly used where the
temperament is sluggish, or,  the lungs comparatively sound and vigorous,
the disease being of a general nature, or, if local, affecting other parts of the
system.  It is stimulant, tonic, and  alterative.
                          THE  HALF  BATH.
   The bathing-tub for this bath may be made of wood or tin.  (For form of tin
or copper half-bath tub, see Fig. 74.)   Priessnitz's half-bath tubs were made
of wood, four or five feet long, about two  and a half feet wide, and twenty
inches deep.  The ordinary bathing-tubs made of tin, about five and a half
feet long at top  and four and a half at bottom, two and a half feet wide at top
and one and a half at bottom, and one and a half feet deep, is, perhaps, the
best form.   A valve is placed in the bottom, through which the water escapes
from the bath tub.
   When but four inches of water are put into the tub, it forms the shallow
batho£ the English practitioners.   It is  milder in its effects, than when  a
greater depth of water is used.  The usual  depth is from  six to ten inches.
Having filled the tub to the depth desired, with water of appropriate temper-
ature,  the patient seats  himself in it, with  his  lower limbs immersed, rubs
bis chest and limbs vigorously, while the bath attendant is busily  at work
behind; continuing the process for the length  of time demanded by the se-
verity of the ease.  When there are two bath-attendants,  one rubs  the back 
HYDROPATHIC  APPLIANCES.
765
  and body, the other the extremities.   In ordinary cases,  the  length of the
  bath will last from two  to ten minutes,  varying with the reactive ability of
  the patient and the coldness of the water.
    It is a more powerful stimulus than the  rubbing  wet-sheet, as the con-
  stant bathing brings  a larger amount of water  in contact with the surface.
  More heat is extracted, and greater reaction, especially to the feet, is secured.
  It is well adapted to the majority of chronic patients, and to those who have
  been under treatment for some  time and are able to react against a more
  powerful impression than that given by  the sponge-bath or rubbing sheet.
    The temperature of the bath is a matter of much importance ; for, if given
  to feeble patients too  cold,  a feeble reaction  takes place, and the blood,
  instead of being called to the skin, is repelled  from it, and  more or less
  congestion of the internal viscera results. When given too warm, a relaxed,
  bloodless, and flabby state of the surface is induced.   Some practitioners use
  the hot full half-bath, of a temperature as hot as can be borne, and a dura-
  tion of from fifteen minutes  to an  hour, as an alterative in chronic nervous
 rheumatism, dyspepsia complicated with  disease  of the liver, and some forms
 of uterine disease.  But the long-continued  application of a high heat to the
 surface, debilitates the skin, and depresses the  nervous  system, so that the
 most robust patients do not regain their  wonted vigor for  several days, and
 others of a  more nervous constitution, by one injudicious application  of this
 bath, have had their hopes of returning  health completely  dispelled.
   When given alone as a morning bath,  the design  is to keep  up a healthy
 circulation on the surface,  and for this purpose, the  bath should be as  cold
 as the individual can  bear and secure a  thorough reaction.  The best time
 for this to be  taken is immediately on rising in  the morning, when the cir-
 culation of the system  is generally best equalized, or at ten o'clock in the
 forenoon, at which time  the  system seems to reach the  acme of physical
 vigor.
   It is  one  of the most appropriate forms  of  bath after sweating in the
 blanket  pack  or with  the wet  sheet pack, and also after the vapor-bath.
 Its object is to restore the tone of the  relaxed  capillaries, to  powerfully
 stimulate the whole system, and to arouse to action the secretory organs, as
 well as  to call the blood to the lower extremities.  Thus it is tonic,  stimu-
 lant, and alterative, each effect harmonizing with a healthful secretion, and
 with each other.
   When used of a cool or  cold  temperature, the  bath  should  be of a
 shorter  duration than  when  used  of a  higher temperature.   It  is often
 advantageous  to give a  half-bath of four or  five minutes' duration,  of a
 temperature of from 80° to 90°, then reduce  the temperature ten degrees,
 and continue  the bath one  minute,  or follow  it with a pail-douche of one
 pail of water,  ten degrees lower than that  of the half-bath, thus  securing
 better reaction and more stimulation than  would have  been the case with
 the employment of a colder  temperature at first.  It should be discontin-
 ued at  any time when the patient chills, and  does  not react  in the bath,
 and the circulation should be restored by vigorous friction.
  In the treatment of acute diseases, it is not so much used, as it would be
 were each family to provide itself with a proper  bathing tub for its admin-
 istration.  Its object in these cases, is, instead of stimulating and exciting
 the system to  violent  reaction, to soothe, relax, and  reduce the heightened
 inflammatory action of the body, and  at the same time produce an equal-
 ization of the  circulation.  To do this, the  temperature of the bath should
 vary from 75° to 80b, and the duration from  ten  minutes  to an hour,
according to the strength of  the patient  and the severity of the fever.   As 
T66
AMERICAN FAMILY  PHYSICIAN.
remarked heretofore, too cold a  bath will depress the  life-powers, or will
call forth more vigorous action, and  increase the fever.   Prudence, rather
than heroic treatment, will  secure the  best results.  No more appropriate
agent can be found for safely and surely controlling inflammatory condi-
tions of  the body, than the tepid half-bath.  It is invaluable in the treat-
ment of  the hot stage of intermittents, inflammation of the abdominal and
thoracic  viscera, eruptive, remittent  and typhoid fevers.   Of a tempera-
ture varying from 65°  to 90°, it is  successfully used in the  treatment oi
mineral diseases, mercurial affections of the joints, sick  headache, apoplec-
tic and congestive fulness of  the brain, epileptic, paralytic and hysterical
affections,  in  " sun  stroke,"  intoxication,  delirium  tremens,  acute insan-
ity, &c.
                         WET SHEET PACK.
            ?ig 75.
                               This remedy can be had at all  times and
                             places.  It is only necessary to have an ordi-
                             nary supply of common  bedding and water.
                             The sheet for  packing is of cotton, or coarse
                             linen,  sufficiently  long  to  reach  from  the
                             patient's  head to  the  soles of the feet, and
                             two yards in width.  In  feeble chronic cases
                             it is better to  have it  come not quite to the
                             ankles.  The  bed is then stripped  of its cov-
                             ering,  one or two pillows being left for  the
        Wet Sheet Pack.        patient's  head.  One  or two comfortables are
then spread evenly upon the  bed, and upon these two woollen blankets are
in like manner spread.  The  blankets are not so much injured from wet as
cotton comfortables, and by  their  contiguity to the  wet sheet which is
placed upon them, they secure  a better reaction.  In cases of much debil-
ity, the reactive powers are feeble, and the nervous system liable to irregu-
lar action ; hence the patient,  though the skin may be warm to  the touch,
will complain of chilly sensations up  and down the  spine, thence running
over the whole surface, which are very unpleasant,  render him uneasy and
fidgety, and  counteract  the favorable  results which ordinarily follow its
use.   To prevent  this, place  a folded towel, or  strip of flannel, of four
thicknesses, three  or four inches  wide, next the  spine, as the patient
reclines upon the sheet.  This  saves the spinal  nervous system from the
shock it would otherwise  receive, and secures a pleasant and fine reaction.
In such cases, as well as in all cases where the patient  is liable to coldness
of feet, ho should have a  jug  or can of hot  water, or hot  bricks, placed to
the feet, as the sheet and blankets are wrapped around them, having one or
two thicknesses  of the blanket  between, to  protect the feet  from contact
with  too high  a heat.  The  patient,  having undressed, reclines at full
length upon his  back on the sheet, and raises  his arms, while the assistant
laps  one  side of the  sheet over  the body and  lower  limbs, and tucks it
elosely to the body; the arms are then dropped by the side—never crossed
over the chest—and the other side  quickly lapped  and tucked; the  blan-
kets  and comfortables are  brought  over  and tucked in  the same manner,
care  being taken not to draw them too  closely over the chest,  as oppres-
sion and sense of suffocation  might be produced  by so doing.   The pack-
ing clothes should, also, be  snugly tucked around the  neck and under the
shoulders,  so that the heat developed by the  body may be retained. When
 
HYDROPATHIC  APPLIANCES.
767
 well done, the moist heat retained near the surface acts as a solvent of the
 morbid material in the  system, and eliminates it  by the increased action
 it imparts to the excretory functions of the skin.   It thus proves a power-
 ful agent in the purification of the blood.
   When  there  is excessive  determination of blood to  the head,  or the
 patient is subject to headache, a towel, folded and wet in  cold water, is laid
 upon his forehead when he is enveloped, and is  renewed as  often as  it
 becomes hot;  thus, an excessive flow of blood to the head, which the hori-
 zontal posture favors, is prevented.
   This is the ordinary mode of packing in chronic cases.  In  this  envel-
 opment the patient remains from  thirty  minutes to  an hour  and a half
 according to the reactive powers of his system.   He should get  thoroughly
 warm  in  the  sheet, in order to determine  the heat  to the surface, and
 secure a full reaction  in  the bath which follows.   If  he should get com-
 fortably warm in fifteen or twenty minutes, thirty or forty minutes would be
 a sufficient length  of time to remain  in the pack;  but if he warms  more
 slowly, he must remain from an hour to an hour and a quarter.  If sweat-
 ing is  desired, the  patient must remain till  perspiration appears  on the
 forehead ; the time may vary from forty-five minutes to two or three hours,
 If this be the object sought, the  dry blanket pack,  or  the vapor bath are
 generally used instead of the sheet.                   #
  In  the early  days of  Water Cure, and  especially in Germany, sweating
 was thought  to  be the main  object  of  the  pack, and it was carried to a
 great excess.   But  it is used now to produce a milder stimulus  of the skin
 and to determine the blood to the surface, and thus  equalize the  circulation,
 rather than to excite excessive action of the perspiratory glands.
  Generally when the patient lies long enough to produce perspiration, just
 before it appears, he will feel less warm, and, perhaps, have a slight sensation
 of chilliness which will be succeeded by copious perspiration.
  Where the object is not to produce perspiration, but to stop short of that,
 the patient should  be taken out when a  full and thorough  sensation of
 warmth is felt,  aiming  to have  him  reach  the  fullest degree of heat
 of the  surface he  can obtain without producing perspiration.   But this
 period will vary with the reactive vigor of  the patient;  some being ready
 to be taken out in half an hour, others requiring an hour and a half.
  Nervous persons will not bear as long, nor as frequent packs,  as those of
 a more muscular or lymphatic temperament.
  In all cases, after a pack, some form  of bath must be taken to  cleanse
 the skin of the refuse matter eliminated  during  the  process,  and  by its
 tonic effect to render permanent the  increased action of the cutaneous cir-
 culation produced  by the envelopment.  The kind of bath will vary with
 the strength of the patient and  the means at command.  If the  patient has
 any distance to go, to reach the place where  the bath  is to be given, the
 blankets must not be untucked as he rises  from the bed, but pinned at the
 top so that they will remain over the sheet, till he is ready to have the bath
 administered to him; the attendant loosening them and  the sheet as well,
 and holding them up so that he can walk.  But in home-practice, as the bath
 is usually a sponge-bath,  dripping-sheet, wash-down, or half-bath, it can be
given iu the room where the patient is packed;  and here the blankets are at
once untucked and the bath given.   If very feeble, he may be sponged off
in the bed, always taking care to dry with the  towel  or dry rubbing sheet,
using friction  enough to produce reaction.
  In acute diseases, where there is great febrile excitement, it is sometimes
used for the purpose  of extracting as much heat as possible, and as  rapidly 
768
AMERICAN FAMILY PHYSICIAN.
as possible.  Here  the patient is merely enveloped in one or two blankets
outside the sheet, so as to allow the evaporating process to go on, the sheet
being wrung out of fresh water  every half hour, or  oftener  if there is ex-
treme  heat, until the  fever  is reduced.   In some cases, the envelopment
may be opened and the sheet rewet by sprinkling with cold  water; or, two
sheets  should be used, one soaking in the cold water while  the  patient is
lying in the other.   In the feverish stages of remittents and intermittents
and in the various inflammatory fevers, this form is very advantageous.
  No agent is  more useful when properly used, yet but few persons under
stand its employment  so thoroughly as  to prescribe it with  benefit to the
patient.   It is directly lowering in its effects upon the system, and  yet in-
directly  gives tone and strength where there is  mal-distribution of blood
inasmuch  as it relieves an  accumulation in one  part, by supplying a de-
ficiency in another.  Repeated  from  day to  day,  it  relieves  irritation  and
congestion of any of the visceral organs, and congestion  or inflammation of
their mucous linings, and restores the blood to the surface and extremities
thus producing an  equilibrium in the whole system.  When the patient is
chilly, the pack is  contra-indicated, as its use would  drive the blood still
more from the  skin upon the internal organs, and  increase their congestion.
Hence, its employment in the cold stage of intermittents is very hazardous.
  In treating chronic difficulties  and very feeble  cases, it frequently occurs
that the patient haS not vitality enough  to warm  the whole  sheet at  first,
and the  half-pack or towel pack  is used in the commencement of the treat-
ment.   Often one towel is sufficient, laid  across the chest and bowels, the
rest of the system being enveloped in dry blankets.  In a few days, a second
towel  may be  added the whole  length  of the spine, and  these  continued
till the reactive energy of the system will  have increased sufficiently to bear
the half-pack, and then the full wet-sheet.
  Too frequent application of the wet-sheet must be avoided,  as its lowering
effect will  prostrate  feeble patients, if used  too  often or too  long at a time.
This point can be  determined, by the deficient reaction of the patient after
his usual baths, and by his torpitude,  lack of nervous energy, and tendency
to chill.
  The pack is used in the treatment of most fevers, in inflammation of the
kidneys, liver, spleen,  lungs, &c, and in some eases, in inflammation of the
stomach and bowels.   In skin  diseases, dysentery, diarrhea, summer-com-
plaint,  coughs, colds,  bronchial  affections,  and in the  great  majority of
chronic diseases, it is also prescribed.
        THE BLANKET PACK, or SWEATING BLANKET.
  The  envelopment  having been prepared as for the wet-sheet pack, omit-
ting the sheet and having two blankets next the patient, he lies down, and
the assistant brings over the blankets  and comfortables, tucking him closely
as he does in the process just  mentioned.  Other blankets or comfortables,
or a  feather bed, are then  placed  over  all, and closely  tucked, the great
point being to  seal  hermetically the upper end of the  trunk, over  the
shoulders, and round the  throat and neck, and als'o at the feet, so that the
hot  air within cannot  escape, nor the cold air  without find  an entrance.
The heat  evolved from the  body is thus  confined, producing an excited or
feverish state of the skin, which is followed by opening of the pores and
perspiration.  To expedite the process, a  jug of hot water may be placed to
the feet, especially if they have a deficient supply of blood. 
HYDROPATHIC APPLIANCES.
769
  If the head get hot and uncomfortable, a wet towel may be applied to the
forehead.  If the patient  desires, a tumblerful of water may be given him
from time to time.
  The windows of the room  should be opened as soon as the  patient is
packed, to keep him well supplied with fresh air.
  Thc average time required to  produce perspiration is from two to three
hours.  The patient then remains in as long as the  indications of the case
require.
  Thc blanket-pack is followed instantly, in  every case by some form of
bath, the pail douche, rubbing-sheet,  or half-bath.
  It is indicated, where a powerful action  of the skin is required; as, in
skin diseases, torpidity of  the liver, and fo*ms  of indigestion characterized
by loss  of tone, rather than an  irritation of the nerves of the stomach and
bowels.   Also, in chronic rheumatism  and rheumatic gout.
                         THE  VAPOR BATH.

   Tnis is so well-known, that a description of it is  hardly necessary.  The
 domestic mode  of using it,  is as  follows:  The patient is undressed, and is
 then  seated on  a high Windsor, or  wooden-bottomed  chair,  so  that  the
 steam shall not strike him directly as it issues from the vessel in which it is
 generated.   After seating himself, a  large  blanket  or  coverlid is thrown
 around him from behind, covering the back part of  his body, and  also  the
 chair, and is then pinned in front; another is passed around him  in front,
 and pinned  behind, and thus the body  is so completely  covered,  that  the
 escape of the steam is prevented.   The  steam is generated with an appa-
 ratus  in  which water is  boiled by a spirit lamp, or from  a vessel containing
 water, placed under  the chairs in which  hot bricks, stones, or smoothing-
 irons are immersed.
   The time  required to  produce perspiration will vary from ten to twenty
 minutes,  and it  should  seldom be kept up more than ten minutes.-  If  the
 bath affects the head unpleasantly, producing faintness, sickness, or fulness
 of blood in the  head, it  should be discontinued.   Bathing the face with
 cold water,  or drinking  it in sips, often  counteracts this tendency,  and  en-
 ables the patient to remain in the bath the full length of time desired.   A
 folded wet towel,  often rewet to keep it cool, should be placed on the head at
 the commencement of the-ba-th, to prevent too great a determination  of blood
 to the brain.
   Another form of the vapor bath, is the  Spirit-vapor bath, or hot air bath,
 first introduced to the notice  of the  profession by Prof. J. King, nineteen
 years  ago.
   Its  mode of administration differs  from the preceding in producing per-
 spiration by heated air, instead of  steam.   A saucer or tin vessel,  contain-
 ing about two table-spoonfuls of whisky or alcohol, is placed upon the floor,
 under the chair, and kindled to a flame by touching to it a piece of burning
 paper,^ dropping the part of the blanket which has been raised, and  allowing
 the spirits to burn till  it  is consumed; taking  care that the flame does  not
 burn the  blankets.  As  soon  as  consumed entirely, and the flame extin-
 guished, add the same quantity of spirits, and again  ignite.  Continue  this
 till the patient perspires freely; this  will be in  five or  ten minutes, as a
general rule.
  After using both these forms of  vapor-bath, some form of full  bath should
be used, to  cleanse the skin, restore tone  to its relaxed blood-vessels, and by 
770
AMERICAN  FAMILY PHYSICIAN.
fixing an increased amount of blood in its cell-structures, establish a moro
vigorous capillary circulation.
  It is of use in skin diseases, colds, febrile and inflammatory attacks, and
recent amenorrhea and dysmenorrhea, and  sometimes  in suspended lochia,
and some of the inflammatory attacks  during the puerperal period.
  It should  not be administered to those who have great weakness of the
lungs, in whom the process of decarbonization of the blood goes on imper-
fectly, or it will be attended with  injurious consequences.   For it quickens
the pulse and circulation remarkably, without increasing the respiration, and
thus the relation  between  these functions  is destroyed—the respiration
which is not quickened, not bringing oxygen  enough into the lungs to decar-
bonize the increased amount of blood, hurried through them  by the vapor-
bath.  The pure blood of the arteries becomes defiled  by the excess of im-
pure, unoxygenized  blood,  and the symptoms of a  sensation of a rush of
blood to  the head,  giddiness, fainting, nausea, &c, ensue.   Hence, care
should  be observed in  its use, not employing it in doubtful  cases without
the advice and superintendence of a.physician.
                           THE DOUCHE.

  This is one-of the  most powerful of all the Hydropathic appliances, and
the least  adapted for family use.   Much injury has been occasioned by its
injudicious employment.
  It consists of a stream of water, varying in size from  half an inch to two
inches in diameter, and having a fall of from ten to twenty feet.  In home-
practice,  a minor form of douche may be had, by pouring water from a tea-
kettle, from an elevated position, the attendant standing at an upper window or
upon a chair or box, so that the stream may fall with some force  upon the
part, refilling the kettle when empty, till  the process has been continued a
sufficient length of time.
Douche.                               Hose.
  The Aose-bath is a stream  of water  flowing through an India-rubber or
Gutta-percha tube, having less force than the douche, and capable of being
directed against any part of the body.
  In taking the douche, the  patient should first place himself  beside the
column of water as it  falls, and having wet his face and head, extend his 
HYDROPATHIC APPLIANCES.
771
ri"ht arm under it, making it run up and  down his arm for a moment or
two.   The stream  should then  cross over the back of the neck  and down
and up his left arm.  Then, bend himself backwards and sidewise and let
the column of water fall obliquely upon and across his chest and abdomen,
taking care not to let  it strike  upon the pit of the stomach.  Then let it
play upon the shoulder-blades, and up and down each side of the spine, not
upon it, and from  side to side.   He  should then let it play up and down
the legs and thighs, the soles of  the feet, &c.  The douche  may be taken
from one to fifteen minutes ;  commencing  with  it for a short time at first
and gradually extending the length of the bath.
  Caution  should be used not  to take it on the  head,  nor to suffer  the
stream to rest upon any part of the body, especially the spine.   It is danger-
ous from the powerful shock which  would be given to the  brain  and ner-
vous system,  and also from the  too great abstraction of heat suddenly from
those parts.  Very few patients are able to endure  the  powerful  effects of
the douche, compared  with  those who  can bear  the half-bath and other
milder forms.   Hence, great  care should  be taken in  its application  to
diseased conditions.
  From the stimulus it gives to  the  circulatory system,  it is an invaluable
aid where there is  torpor of the liver, chalky and rheumatic enlargements of
the joints,  stiff joints, tumors,  ulcers upon  the  lower extremities, and in
paralysis, gout and rheumatism.  Sometimes a douche of four or five min-
utes will at once relieve an  attack of lumbago or crick in the back.   It
should be allowed  to play up and down each side of the spine, and especially
at the  small of the back.  In chronic rheumatism the force of the stream
should fall mainly on the rheumatic joints and muscles connected therewith,
to excite greater action and induce absorption of enlargements or  deposits,
generally present in such cases.    In the treatment  of various forms of dys-
pepsia and in some forms of disease of the uterus, it  is employed, after
other means have  secured good reactive energy, to  stimulate the  system
Btill more and heighten the nervous vigor.
                      THE HEAD DOUCHE.

  Tins bath may be given ordinarily as follows:—The patient kneels down
 and stoops his head forward and downward into an empty bath or tub.  An
 assistant then pours one, two, or more pails of water upon the back of the
 skull, so that it runs forward over  the head into the bath.   If very cold
 water is used, a dipperfull should first be poured on the back of the head,
 and the assistant shampoo  it so as to excite the surface to action and pre-
 vent too sudden abstraction of heat from the brain; then pour  on  the re-
 mainder.   Or, a milder temperature may be used for the water first  applied
 to the head, following it with cold water.
  Another form of administration is to have the patient lie upon a lounge
 or bed and  extend  his  head beyond  it,  over a  tub,  having the assistant
 support it while he pours the water on as in the  previous case.   This mode
 is in very general  use  in fevers, where  there  is great heat in the head
 and an oppressive fulness of blood.   Here the water  may be applied, till
 the patient feels relieved frGm the heat and fulness, and  used again when
 the fever returns.   But it  will be  better not to use  too  cold water, for a
gradual and  long-continued abstraction of heat is better  and safer for the
patient, than a too sudden cooling of the brain.   The head should be dried
frith  a towel, so that  the  water will not drip from  the hair, and then the 
772
AMERICAN FAMILY  PHYSICIAN.
process of evaporation, which is in itself cooling, allowed to go on.  In the
congestive fulness of the brain  which often is present in intermittents and
remittents, the head douche thus applied will give immediate relief.  In the
earlier stages of tonsillitis, the head-douche, given three times a day, of
two or three pails of cold water, is beneficial.
  In delirium tremens, it  is also  useful, driving the blood from the brain
and producing quietness of the nervous  system.  Here, it should be used
quite cold, administering according to the form first given.  It is also ben-
eficial  in common inflammation of  the eye.  Will  often relieve the sick-
headache at once, and afford great relief in nervous headache.
  The ordinary head-douche consists of two pails.  It relieves the torpidity
of the  brain, arising from congestive fulness of that organ, as well as the en-
feebled condition of the nerves which have their origin within the cranium.
Hence its use in chronic  congestive fulness of the brain, in chronic in-
flammation of the eye, in epilepsy, and in dyspepsia, where it has arisen from
excessive brain-work.
   The rationale of the second form used in fevers may be deduced from the
fact, that in health the brain  receives one-third of the blood thrown out
by each pulsation of the heart; and in acute  diseases a still larger propor-
tion is sent to it.  By the constant and  continued  application of the cool
water to the skull, it cools the circulation very rapidly  and effectually.
                       THE HEAD-BATH.
The patient lies on his back, and places the back of his head in a shallow
dish containing an inch or two of water
             Fig. 78
Fig. 79.
                      Head-bath, and vessel for taking it.
  Fig  79 represents the most convenient utensil for the head-bath.  Length
from a to b, eleven inches ;  breadth from c to d, eight inches; depth, three
and a half inches ; height from ground, seven  inches ;  height from ground
to bottom of notch d,  five  and  three quarter  inches.   The bottom is con-

  In taking it, the patient lies down on his  back, with  a couple of pillows
placed under his shoulders, which raise  his head so that  the back ot_ the
head rests on the bottom of the bath.  The  water should be about an inch
and a quarter deep.  The duration of the bath usually is fifteen or twenty

m The^mmersion  of the back  part of  the head diverts the blood from the
frontal region, and  often gives relief in sick and nervous headache, ana
neuralgic affections of  the head and face.  When the pain is located on one
Bide of the head, the other side should be immersed. 
HYDROPATHIC APPLIANCES.                  773
  When the object is to cool the head, the wet  scull-cap, made double of
coarse linen, fitting close to the head, covering the ears, and coming pretty
well  over the  forehead, is very useful.   It  is dipped in cold  water and
lightly wrung out, and then placed  upon the head.   It  should be  rewet
before it becomes very hot or dry; thus, by the  constant  evaporation pro-
duced, it keeps the head cool and relieves headache.
  In inflammation of the brain and those stages of high inflammatory fevers
where the brain is involved, the  application of ice-cold bandages, or snow
or pounded ice enclosed in an oil-silk covering,  is a valuable  remedy.   It
should be continued constantly till the  inflammation  subsides, or it proves
chilling or unpleasant to the patient, when it should be removed.
                  THE  EYE  AND  EAR  BATH.

  Fine, small, ascending douches, formed by forcing water with a light pressure
'hrough a hose,  are useful in various diseases of these parts.   In  films on
the  eye-ball,  or granulations on the eye-lids, the ascending douche is admin-
istered, applying it for two or three minutes—the water used not being very
cold.  Immersing the  eyes in water is also very useful.  In  diseases of the
ear,  where the ear-douche cannot be had,  tepid, cool, or cold water may be
injected into the ear from a small syringe.
                        THE  NOSE BATH.

  In a variety of nasal affections, catarrh, colds in the head, inflammation
and ulceration of the nasal passages, nose-bleed, &c,  this remedy proves
beneficial.  Water should be sniffed freely through the nostrils and drawn
back, if possible, so that it is ejected by the mouth.   This should be repeated
several times a day, when the object is to tone the debilitated  mucous mem-
brane of the nose, and should be used cool or cold.    When, as in ulcerated
surfaces, the design is to cleanse  them,  it may be used tepid, following with
cold water for a tonic effect.
                    MOUTH, or ORAL BATH.   >

  For inflammation of the gums, mouth, throat, and palate, in toothache,
catarrh, colds, chronic hoarseness and in bronchial affections, baths for the
mouth and throat, and garglings, are beneficial.  In mucous secretions, occa-
sioned by exhalations from a foul stomach, or diseased air-tubes, deposited on
the tongue and the back part of the mouth  and upper part of the throat,
frequent rinsing and gargling of these parts will remove a large amount of
Blimy material.
                            SITZ  BATH.

  Convenient tubs, either wooden or metallic, are constructed for this bath,
having the back  higher, so as to serve as a Bupport; but, an ordinary wash- 
774
AMERICAN  FAMILY PHYSICIAN.
tub will answer.  (See Fig. 80.)   It should             Fig. 80.
be large enough to admit the motion of the
arms in rubbing the abdomen,  sides, and
hips, first with one hand and then with the
other; and it should  be sufficiently deep to
allow the lower extremities to bend  over
the edge without  producing pressure, or
cheeking the circulation.   From four to six
inches of water is  poured into  the tub.
Some undress completely, and place a blan-
ket or sheet over the upper part of the body;
but generally,  only the parts of the  person
to be immersed in  the  water are uncov-
ered.
   When the tonic effect of the  bath is re-
quired, it may be used  cold, varying in time
from five to ten or  fifteen minutes.   But feeble  persons must use it  of a
more moderate temperature, and take it from one  to five minutes, gradually
reducing it, until the system will endure the cold bath and full length of
time.
   It acts by causing the bloodvessels of  the parts  with which the water
comes in  contact, to contract and rid themselves of any excess of blood, and
as the stimulus has not been  carried to any  great extent, there will  be but
very little subsequent relaxation in these vessels which  may  be obviated by
reapplying the stimulus after short intervals.   The tonic sitz-bath always re-
quires frequent repetition, from three to six times  a day.  It is applicable in
all cases where there is  an enfeebled or congested state of the parts contained
within  the hips;  as, excessive menstruation, leucorrhea, loss of muscular
tone and prostration of the lower bowels, and prolapsus uteri.
   The derivative sitz-bath is more  frequently  used than the  tonic, as it is
particularly beneficial in obstruction of the liver and kidneys, dyspepsia, and
congestion of  the nerves of  the  stomach, congestion of the lungs,  asthma,
bronchial affections, determination of blood to the head, constipation of the
bowels, and various forms of nervous  complaints.   The  temperature of the
water should be milder than for  the  tonic form,  varying from 60° to 85°,
according to  the vitality  of  the patient; feeble patients requiring a higher
temperature than more robust persons, especially at the  commencement of
the treatment.  The derivative effect is not reached till the patient has been
about fifteen minutes in the bath.  For after the contraction of the blood-
vessels of the skin caused at  first, there is  a subsequent relaxation of the
capillary blood-vessels of the hips and contiguous  parts of the  pelvis, which
allows a greater accumulation of  blood, and thus  relieves congestion of the
stomach, liver, lungs, and head.   In  case of costiveness where there is  defi-
cient circulation in the lower bowel,  by thus causing a greater  flow of blood
to it, the natural secretion is established and the most obstinate constipation
is cured.
   When administered  for piles and  chronic affections of the genital organs,
it should in most cases partake of a derivative character—the duration being
from twenty to forty-five minutes.   The long derivative  bath of an hour or
an hour and a half's duration  is prescribed  where there is  fulness  of blood
in the head and chest.    In all cases  when the derivative action is desired,
the water should be warm enough not to produce  a chill, but  not too warm
or the reaction sought will not ensue, and no derivative  action be had. It
the patient be chilled during the bath, he should  either take a hot foot-bath 
HYDROPATHIC  APPLIANCES.
775
tB cold as can be borne, or at once discontinue it.  Perhaps no local bath is
of more general service in domestic practice than this; especially when corn-
bind with the warm foot-bath.   By this combination a colder degree of tem-
perature can be borne, and greater derivative effect produced, the blood being
drawn to the extremities as well as to the hips, and better equalization ol the
circulation effected.
  The sitz-bath should not be taken immediately before eating, nor within
two hours and a half after a meal.  Moderate exercise after each bath should
be taken when the strength of the patient will admit; if not, active friction
enough to secure a reaction should be used.
LEG AND ARM BATHS.
Fig. 81.
   The leg-bath is useful in cases of ulcers,
 swellings, eruptions, gout,  or  rheumatism,
 sprains, wounds, and  other affections of
 the leg and thigh.   A common  wooden
 tub similar to that in fig. 81 is a very good
.form.   The temperature should  be mild,
 varying from G5° to 80°, and may be con-
 tinued from fifteen minutes to an hour.
   The immersing of an inflamed or dis-
 eased part in water, either warm, tepid, or
 cool, according  to the circumstance of each
 case,  will exert a  powerful  influence  in
 modifying the inflammation.  A vessel like
 that in  fig. 82 is suitable for this purpose.
 The fluid, thus not only covers the inflamed            Leg-Bath.
  art of the arm, but contiguous parts, and cools the blood which flows to it.
Fig. 82.
In felons by immersing the elbow in cool
water, and continuing the immersion, the
circulation is cooled, and an  antagonistic
action set up, thus lessening the inflamma-
tion of the finger or thumb.
  Another mode of applying water to in-
flamed parts of the leg or arm is irrigation.
Two  forms  are  represented in figures  83
and 84.                                              Arm-Bath.
  The affected limb is laid upon a pillow or cushion with a piece of oilcloth
covering it and so arranged as to convey the water into a vessel placed below
to receive it.   A vessel containing water is suspended over the bed.  The
inflamed part is covered with lint on soft linen cloths, and the water con-
ducted by means of a strip of woollen  or other  cloth, wide  at the upper
end which lies  in the water,  and pointed  at  the lower end  which hangs
from the bucket and touches the limb so that a continuous  stream of  fluid
is conveyed, on  the principle of the syphon, to  the inflamed part.  The tem-
perature of the water may be varied to  suit the sensibilities of the  patient
and the height of the inflammation.  In French surgical practice, the bucket
or vessel is made of tin  or other metal, and the  water kept at the required
temperature  by means of a spirit-lamp  placed  under it.  The  sensations of
the patient is the best guide in determining the degree of heat or cold to be
used.  Tepid water is preferable in the majority of cases. 
776                AMERICAN  FAMILY PHYSICIAN.

              Fig. 83.                               Fig. St.
Irrigation.                               Irrigation.
  Another method, is to convey the water by means of two ropes of candle-
wicking suspended from  the bucket, as in fig. 81.  Another still by a stop-
cock, spigot, or other means which will convey a steady, small stream of
water to the part.
                           FOMENTATIONS

  May be used either warm or hot.   Warm  fomentations are soothing and
should be used where a sedative effect is desired.   Hot fomentations where
active  counter-irritation is  indicated, as in  colic,  peritoneal  inflammation,
pleurisy, &c.
  Two forms of application  are  used, either of which is effectual.   The
usual method is as follows:—Fold a small blanket so that its  breadth when
folded  will reach from the  bottom of the spine to the arm-pits, and  place
it upon the bed under the patient, who has undressed as for sleep.   Take flam
one-half to  one yard of flannel cloth and fold it  several  times, so that its
breadth shall be from eight to twelve inches, and  length sufficient to cover
the abdomen and sides; place  it in the bottom of a wash-bowl and pour on
boiling water till it is saturated; remove and  enclose in a towel, and wring it
as dry  as possible; then place  it upon the abdomen, covering both with the
ends of the  blanket closely tucked,  so as to retain  the heat at as high a
temperature  as possible.  Every three or five  minutes, remove the flannel,
and place a  freshly wrung one instead, continuing the process from half an
hour to an hour, or until the desired  impression  has been secured.  This is
the ordinary mode of applying hot fomentations to the abdomen.  A similar
application may be made to any part of the body, as to the face for neuralgia,
to the  joints for  rheumatic pains  in them, over the lungs for pleurisy, over
the pelvic region for the pain  in dysmenorrhea, &c.
  Another and more convenient form is  the  use of tin fomenters as seen in
figs. 85 and 86.
  Fig. 85 is the  form  used to foment the neck.  It constitutes half of a
four-inch circle, being  two  by two inches.    Fig. 8G is the best shaped in-
strument  for the  stomach and bowels.   It is 9^ by 6J inches, with a curve
two inches deep.  The space between the inner and outer plates or surfaces 
HYDROPATHIC APPLIANCES.
777
is one inch; the tube three-fourths of an inch in diameter and length.   The
orifices are made tight by corks.          _                            ^
  The fomentors can be made of any desirable  curve to fit any part ot the
body  The temperature of the  water with which the  fomenters are filled,
varies from 130° to 160°.  Under the  fomenter should be placed two or
more folds of flannel, wrung out of warm water.  The application may be
           Tin Fomenter.
                                                  Tin Fomenter.
 continued from  twenty minutes to an  hour as the case requires.  A wet
 bandage should be applied  to the surface, or the part should be sponged off
 with cool or cold water immediately after the application of the fomentations.
 This process diminishes the sensitiveness that would occur from its frequent
 use,  and by its tonic effect, fixes an increased amount of  blood  in the
 capillary vessels of the part which has been fomented.
  In the early treatment of many chronic  diseases which arise from, or are
 connected with disease of the abdominal viscera, and especially in the treat-
 ment of  indigestion,  the warm  abdominal fomentation is of great  use in
 the early stages of  the treatment, to soothe the  nervous irritability and re-
 lieve internal congestion.   It should be  discontinued after this irritability
 has been allayed and the patient can bear other forms of treatment.
  The  hot  form  of fomentation may be  applied where the object is  to pro-
 duce a powerful diversion of blood to the  surface from some internal organ.
 In bilious and painter's colic, pleuritic and puerperal pains, in  spasms of the
 stomach,  bowels, and uterus, in the intense congestion of  the  liver  and
 spleen which is present in the chill stage  of intermittents, and in congestive
 fever and the later stages of Asiatic cholera,  fomentations applied  as hot as
 they  can be wrung out, and continued till an amelioration of the symptoms
 takes place, have proved a valuable and reliable  remedy.
  A  similar application  of  hot fomentations to the feet, where there  is con-
 gestion of the womb  causing pain  in the pelvic region and lower part of
 the spine, congestion of  the lungs as in hemorrhage from them, congestion
 of the brain which  occurs in some forms  of  acute  disease or results  from
 concussion  of the  brain by blows, falls, &c, has  proved of very decided
 value.  It allays nervous irritability and equalizes the circulation,  diverting
 it from the oppressed brain  or lungs.
  In  spitting of blood, the  hot fomentations may be applied till some reliei
 has been obtained and a diversion of blood  to the  feet partially effected,
 when  cold  bandages can be applied, covered with  several thicknesses of
 flannel, to retain the heat which will be evolved,  and thus produce a poultice
 effect to the surface.   The  reaction from  the application of  the cold ban-
 dage, will create a permanent diversion from the lungs, and check  hemor-
 rhage.  An eminent  German Water-Cure  practitioner, uses  the cold  ban-
dage only; this may be safe for robust patients, but the  preparatory use of
hot fomentations is the most judicious for feeble cases. 
778                AMERICAN  FAMILY  PHYSICIAN.
                        WET  COMPRESSES.
  These are cooling, when a piece of cloth, two or three  times  double is
wet in cold water and placed over the affected part, being left uncovered
to favor evaporation.  Or, they may be frequently rewet, in snow .or ice
water.  They should  be used on bruises, sprains, local inflammations, &c.
where the aim is to reduce feverish heat.
  They may be converted into heating bandages by covering them with oil
silk, or  several folds of cotton or flannel, so as to  prevent evaporation, and
retain the heat.
  The wet girdle, or body compress, is made of sheeting  or table linen, of
double thickness, and  eight or ten inches in  width.  Where the spine is
easily chilled, it should  not meet over it  by about four inches.  But as a
general  rule it may extend around the body, reaching from the pit of the
stomach downward to the hips.   It should be covered by a dry bandage of
cotton or flannel, about two inches wide, of double fold, and long enough
to reach around the body two or three times.  In chronic cases, it may be
worn wet in front only, at first, and at night.   Afterward, in addition, from
9 A. M. through the day and  night.   It should be rewet  every five or six
hours, or oftener,  if it becomes dry; in some cases, sponging  off  the parts
to which it  has been  applied, and  using  friction.   It may be secured by
pins or  tapes.  See fig. 87.

                                Fig. 87.
The Wet Girdle.
  It is very extensively used  in the  treatment  of fevers, especially inter-
mittent and typhoid fevers.  A temporary bandage may be made by folding
lengthwise a cotton  bed-sheet—a single one, if it can be had—and wetting
just enough to pass  around the body once, wringing it well, and  bringing
the dry part over the wet as a covering.  This  form will generally reach
from the arm-pits to the hips.  Changed  every four or five hours, or of-
tener, if the feverish heat requires, it proves a very valuable agent in allay-
ing the internal inflammation common in these fevers.
  The  wet compress of four  thicknesses, covered  with  a  dry one, and
changed often, controls effectually inflammation of the liver, stomach and
lungs.   Where the inflammation is very intense, the clothes may need to
be  rewet every ten  or fifteen minutes; in  other cases, once  in  half an
hour or an hour, as the height of the inflammation  may indicate.  They
should be discontinued with  the subsidence of the inflammatory action.
  The wet girdle  is often  used as  a substitute for supporters;  the lower
edge of it being drawn more tightly than  the upper, it presses the relaxed
bowels upwards, and by relieving the downward  pressure upon  the uterus,
affords relief in falling of the womb.  It also allays irritation of the organs
contained in the pelvic cavity, and  regulates the  action of the bowels, kid-
neys, liver, &c.
  The  Chest  Jacket is made of similar material—a dry bandage, three
thicknesses of twilled cotton, covering the inside wet bandage—in  the form
of a double breasted vest, fitting  closely to the chest, and secured by pms 
HYDROPATHIC  APPLIANCES.
779
or tapes.  It is very useful in all diseases where there is chronic irritability
of the stomach, throat and lungs.   Many persons whose  duties  through
the day do not permit its use, find great relief from wearing it at night, in
the morning taking it off and sponging the chest with cold water.
                           FOOT BATHS.

  These are tonic  or derivative.   Tonic, when  the  feet are placed ankle
deep in cold water,  for one  or  five minutes, rubbing one foot against the
other during the bath.  They are then dried, and well rubbed with coarse
towels and the  hand.  Derivative—taken ten minutes at a time, generally
just before going to bed, where the object is to warm habitually cold  feet.
Students,  and others who use  the brain  actively, will  find great benefit
from the use of  the derivative foot-bath at bed-time.
  The shallow foot-bath  differs from the  preceding in  the  depth  of the
water used; being  an  inch  deep, only, when the feet are immersed.  The
feet may remain in two or three minutes, then taken out, dried, rubbed by an
attendant, again put in the  water for a  few minutes, and the  drying and
rubbing repeated, and  after another repetition, dried, and reaction secured
by thorough friction.
  The warm or hot foot-bath is used at a temperature varying from 100° to
110°.  Taken for five minutes,  it is a valuable  means of warming the feet
so that reaction  will ensue, when they are put in water of a colder temper-
ature.  When combined  with a derivative sitz-bath,  the water should  be
renewed every ten minutes, to keep up a  constant derivative effect.
                           INJECTIONS.

  This term is generally applied to clysters, or injections of water into the
bowels.  Simple water, of various temperatures, can  thus be used in a very
great proportion of cases of disease, as the bowels are more or less irregular
in their action, where patients are suffering from ill health.
  Syringes, or injection instruments,  are  of very numerous  patterns;  but
among the best now in use, combining utility, convenience, and durability,
are Mattson's  Patent Elastic  Syringe, and  a  more  recent invention, the
"Davidson Syringe.']   The accompanying  cut and explanation will give the
reader an idea  of this instrument and  the manner in which it is worked.

                                           Fig. 89.
      Fig- 88.
Mattson's Patent
Elastio Syringe.
 
780
AMERICAN FAMILY PHYSICIAN.
   The bulb (a) and the tubes (b) anil (c) are  made of vulcanized rubber
 and all the other parts of block tin.   The valve boxes (d) and (e), fixed in
 each end of the bulb, contain valves which open inward and outward  or
 to and from the bulb respectively.  The suction pipe (c) is  attached to the
 box (d) and its other extremity is terminated by the end piece (/).  The
 delivery pipe (b) is  attached to  the box  (e) and is terminated at its other
 extremity, so that either the anal pipe (g) or the  vaginal pipe (h) may  be
 used.
   By introducing the extremity (/) of the  suction pipe into the enema
 and by the alternate compression  and expansion  of the  bulb (cr) any re-
 quired  amount may be administered without  removing the  instrument
 which possesses the further advantages of durability, portability, facilities
 for cleansing, and adaptation  to every use of an  injecting  syringe.  The
 ease with which  this instrument can be managed, in any position of the
 body, by  an  invalid, and its adaptation to those cases in which the injec-
 tion requires for its efficient action, a  level or  an elevated  position of the
 pelvis, recommend it to favorable notice.

   Both work easily, and are  the best forms of self-injecting syringes now
 in the market.
   Where there is diarrhea, and acrid,  irritating matter is present in the
 bowels, large  tepid  injections should be used,  taking from six to twelve
 ounces of water at a  time, retaining it for a short time, if possible; then when
 a  desire  for  an evacuation of the bowels is apparent, permitting it, and
 repeating the clyster, if necessary, till a thorough evacuation of the  morbid
 accumulation has been secured.   Then follow with small cold injections of
 one or two ounces, immediately after each evacuation, retaining the injec-
 tion, if  possible.
   When constipation is to be removed, to produce  an immediate evacuation,
 use the full injection of a temperature of from 75° to 85°.  But to restore
 healthy action to the bowels, the small cool injection taken from two to foui
 times in the twenty-four hours, is most efficacious.   It allays the  feverish
heat and dryness,  quickens the action  of  the  secretory vessels of the lower
bowel, and gives tone to the nervous system connected therewith.  As a gen-
eral rule,  tepid injections  should be avoided in cases of constipation, and
 the small  cold injection used.
   In the early stages of most fevers, there are accumulations in the bowels,
 which, in  many cases, have been exciting causes of these attacks. By a free
 use of injections of a temperature of 80°, these may be  removed, and the
 fever cut short.
   In all acute attacks of diarrhea, in dysentery  and in cholera, the small
 injections are indicated, and should be used.
   In treatment of falling  of the womb,  cool rectal  injections give tone to
 the bowels and to the appendages of the womb,  and are valuable aids in re-
 storing healthy action of the reproductive organs.
   Vaginal injections have been used of various temperatures, to remedy dis-
 ordered action of the mucous surfaces of the vagina.   Taken three or four
times a day, cold,  they are useful  in  leucorrhea and various inflammations
of the womb.   In some  forms of acute  inflammations of the uterus, the
tepid vaginal injection is much used to reduce the feverish action. 
HYDROPATHIC  APPLIANCES.                   781
                    GENERAL OBSERVATIONS.

   All full ablutions should be taken when the body  is warm, as the system
 ■hr.uld  be in the best possible  condition to  react against the coldness
 of the water.  In chronic cases, the  bath should be  followed _ at  once by
 walking, or  other active exercise, where the patient's strength will admit.
   No meal should be eaten within an hour after bathing, nor bath be taken
 vithin two hours after eating.   For when food is taken  into the stomach, it
 incites a greater  flow of blood to that organ, to enable it to digest the food,
 vhile the^intent  of the bath is to cause the blood  to flow to the surface in
 mater quantity—thus the two processes counteract  each other,  and  either
 disturbance  of the  digestive  function, or deficient action of the skin takes

   The usual times for bathing are, on rising  in the morning, at 10 A. M.,
 and 3 P. M., and at bedtime.   But no bath of an exciting, or  stimulating
 character, should be taken at bedtime by nervous patients.
   Each  full bath should  be  taken rapidly,  the patient, if able,  rubbing
 himself vigorously, So as to increase the action of the heart and  lungs,  and
 secure a  better reaction.  Then dress  and exercise.   But in acute disease,
 where the design is to  save the patient's strength, or where  baths are given
 to reduce inflammatory heat, exercise  is contra-indicated.
   A sufficient interval  should  elapse between  baths, to allow of full reaction
 after each, or the patient will receive injury from their use.
   Each patient  should commence treatment  with water of a temperature
 Buited to his own constitution.  Some will bear water at 60°, others at 80°,
 and cases are not unfrequent where baths  cannot be taken at a  temperature
 below 8")°, without injury.  As the patient's  reactive powers increase, he
 may lower the temperature, and will finally be able to use cold water for his
 usual baths.   But sensitive persons must use mild temperatures, and even
 may not be able to bear a full ablution of the surface every day.   If good
 reaction is not secured,  then the bath  should be omitted, and thorough fric-
 tion used instead.
   In  acute diseases, when the  tongue  is foul and the fever high,  with either
 deficient  or morbidly voracious appetite, fasting should be pursued till the
 appetite returns,  or becomes normal.   There is far less danger of "starving
 to death" than people imagine.  As a general rule,  patients keep up their
 strength well with no sustenance but water, or mucilaginous and demulcent
 drinks.   When the tongue begins to  clean off, a  natural appetite returns,
 and food  may be  taken.   But where the tip and edges of the whole tongue
 are of-a vivid red, indicating high inflammation of the digestive organs, food
 is contra-indicated till the irritation is reduced, or the indiscretion of  eating
 may induce a fatal termination.
  In chronic  cases,  there is  a deficient  and irregular  circulation  of the
 blood,  congestion of one or more of the internal  organs,  and inefficient
 action of  the nutritive   and secretory functions.  The water-cure processes
 quicken and  equalize the circulation,  diverting the blood from the internal
 congested organs to  the surface and extremities ; they allay irritability, and
 strengthen the nervous  system,  and  by the  stimulus of the  cold, hasten
 all the vital processes,  and build up again the enfeebled constitution.   Or
 more correctly speaking, they remove obstructions,  and place the system
in  the best possible condition  to  rally all its  powers, and  regenerate the
physical structure. Air, exercise, diet, regulation of all the voluntary habits,
are  aids  to water, in  affording proper  hygienic  conditions for the vital
force? to remove  the results of diseased action. 
INDEX.
Abdomen, Dropsy  of......339
Abortion,.................526
Absent Menstruation,......507
Acetate of  Iron,...........664
Acetate of Iron, Tincture of-749
Acetate of  Lead,..........668
Acetate of  Lead Ointment,-729
Acetic Acid,..............622
Acetous  Emetic Tincture, "744
Acid, Acetic..............622
Acid, Benzoic.............631
Acid, Chromic...........642
Acid, Citric..............643
Acid, Gallic..............652
Acid, Hydrochloric........661
Acid, Muriatic............661
Acid, Nitric..............674
Acid, Nitro-hydrochloric • • • 674
Acid, Nitro-muriatic.......674
Acid, Oxalic..............678
Acid, Pyroligneous,........688
Acid, Sulphuric...........700
Acid, Tannic..............702
Acid, Tartaric............703
Acids, Vegetable...........71
Aconite, ..............?--622
Aconite  Liniment,.........724
Aconite  Ointment,........729
Aconite, Compound Pills of-732
Aconite  Root, Tincture of "749
Aconitina,..............
Acne Rosacea,..........
Acne Vulgaris,..........
Acute Amenorrhea,.....
 Acute Bronchitis,.......
 Acute Hepatitis,........
 Acute Hydrocephalus, • • ■
 Acute Menorrhagia,.....
 Acute Metritis,..........
 Acute Nephritis,........
 Acute  Peritonitis,.......
 Acute Rheumatism,.....
 Acute Splenitis,---
 Adhesive  Plaster,-••
 Affusion,...........
 After Pains,........
 Ague and Fever, •••
 Ague Cake,........
 Ague, Dumb.......
 Ague in the Breasts,
 Air,................
 Albuminuria,......
 Alcohol,............
 Alder, Black........
Aloes,....................623
Aloes,  Compound Pills of  • • 732
Allspice,..............75, 623
Alterative Syrup,.........740
Alum,...................623
Alum,  Burnt or Dried.....624
Alum  in Bread, to Detect "57
Alum  Root,...............624
Amaurosis,...............489
Amber,...................624
Amenorrhea,..............507
Amenorrhea, Acute........510
Amenorrhea, Chronic......510
American Colombo,.......644
American Hellebore,.......624
     622
 • •-•500
 • •••500
 ••••510
 ....262
----293
----331
.....513
.....311
----301
.....305
.....320
.....298
735, 736
.....762
.....532
.....185
.....300
.....186
.....541
......13
.....432
..92, 622
.....632
Alder, Ta
Ale,
American Ipecacuanha,---625
American Ivy,............625
American Larch,..........625
American Senna,..........625
Ammonia,.............  • • 625
Ammonia, Carbonate of •• • • 626
Ammonia, Hydrochlorate of 626
Ammonia, Muriate of......626
Ammoniac, Gum..........626
Ammoniac, Sal...........626
Ammoniated Tincture of Cas-
      tor, ................714
Ammonio-Tartrate of Iron,-664
Anasarca,.................341
Anchylosis,...............585
Anger,...................156
Angina Pectoris,
Ankle-joint, Dislocation of -584
Animal Diet,..............36
Anise,....................627
Anthrax,.................480
Antibilious  Physic,........737
Antidyspeptic Pills,.......732
Antispasmodic Tincture, ••• 747
Anus, Fissure of..........595
Aphthae,..................248
Apocynin,................632
Apoplexy,................344
Appetites,.................23
Appetite, Capricious, during
      Pregnancy,.........526
Apples,...........•_........64
Apples,  Cedar---•'.......689
Aqua Ammonia,..........625
Aqua Fortis,.............674
Aqua Regia,..............674
Arnica,...................627
Arnica,  Tincture of.......749
Aromatic Spirit of Ammonia,74i
Aromatic Tincture of Guai-
       acum, ..............744
                           627
Artiohoke, Jerusalem---  • M
Articles of Animal Diet,—38
Articles of Vegetable Diet,-49
Artificial Feoding,........516
Artificial Mineral Wators,"80
Ascites, ..................339
Asclepidin,...............682
Asiatic  Cholera,...........412
Asparagus,................61
Assafetida,...............628
Assafetida, Compound Clys-
      ter of ..............723
Assafetida, Compound Pills-732 <
Assafetida, Compound Tino-
      ture of.............745
Assafetida, Tincture of  ••••749
Asthma,..................385
Atropia,..................631
Attentions to Bowels,.....150
Attentions to Child after
      Birth,..............545
Attentions to Eyes,........145
Attentions to Feet,........142
Attentions to Hair,........137
Attentions to Kidneys,  ••••153
Attentions to Nails,.......144
Attentions to Teeth,.......31
Auxiliary Treatment in Fe-
      vers, ...............18P
Ale'tridin,.................704 Arrow Root-.............627
Aliment  ..................22 I Arrow Wood,.............627
ailment,,__               .,.,,,._.„•.„  w.„,.„}c  ,.f.......riw
Alkaline W;>.sb,
Almond.-*
•723  Arterk
• 6231 Article
Wounds of.......553
                   61
Bacon,............
Baker's Itch,.......
Baking,...........
Baking Powders,-"
Balm,.............
Balm, Parturient-"
Balm of Gilead,
Balmony,.........
Balsam Canada,
Balsam Copaiba, • • ■
Balsam of Fir,.....
Balsam of Sulphur, Com-
      pound...........
Balsam Peru,..........
Balsam Peru, Syrup of ■
Balsam Poplar,.........
Balsam, Pulmonary----
Balsam Tolu,..........
Balsam, Warren's Styptic ••715
Balsams,..................71*
Barberry,.................°f«
Barber's  Itch,........■■■■■m
Bark of Cotton  Root, Tinc-
       t™ ................52
Barley,..................."
Barley-water,.............'"
Bath, Cold...............""
Bath, Eye and Ear........''*
Bath, Foot.............."'
Bath, Half...............™
• 628
•739
•628
.628
■ 639
• 628
■ 639

■ 714
■ 629
■ 741
■ 628
• 740
.629
(782) 
INDEX.
783
 Bath, Head.........
 lUili, Hoso.........
 Batn, Mouth  or Oral
 Bath, Koso.........
 Bath, Sitz..........
 B»th, Sponge.......
 Bath, Towel..............761
 Bath, Warm..............132
 Bath, Wash-tub..........
 Bath, Vapor.............
 Batln, Leg and Arm.....
 Bayberry,................
 Bayberry, Compound Oint
     ment of...........
 Bayberry, Ointment of---
 Bayberry Plaster,........
 Bayberry Wax,..........
 Beans,..................
 Bcarberry,  ..............
 Beech Drops,.............
 Boef,....................
 Boef, Dried............•
 Boef'sGall,..............
 Beef Tea,..............■
 Beer,......................86
 B«er, Ginger...............8(5
Beer, Spruce..............86
Beet,......................61
762
769
■ 775
630

731
■ 730
■ 7
• 630
-63
704
• 630
-37
■ •37
• 630
-37
 Belladonna,...............630
 Belladonna, Compound Plas-
      ter of..............735
 Belladonna, Ointment of"-730
 Belladonna, Tincture of ""749
 Benzoic Acid,.............631 Blue Flag,
 Benzoin,..................631|Blue Flag,  Tincture of
 Benzoin,  Compound Tine
      ture  of.............745
 Benzoin,  Tinoturo of......750
 Berbcrina,................629
 Beth Root,................631
 Bicarbonato of Potassa, • • •• 684
 Biearbonate of Soda,
 Bichromate  of Potassa,.....684
 Big Ivy,..................694
 Big Neck,..............
 Bilious Colic,.............404
 Bilious Fever,............191
 Biscuit,...................58
 Bismuth,  Trisnitrate of---632
 Bismuth,  Valerianate of • -632
 Bisulphite of Soda,........697
 Bitartrate of Potassa,......684
 Bites of Snakes, Insects, &c. 555
 Bitter Root...............631
 Bitters, Bone's............748
 Bittors, Restorative Wine- -728
 Bitters, Wine.............728
 Bittersweet,..............632
 Bittersweet, False.........650
 Blaok  Alder,..............632
 Blaokbirry,...............633
 Blaok  Cataract,...........489
 Black  Cohosh,............633
 Black  Cohosh,  Compound
      Pills of--».........732
 Black  Cohosh,  Compound
      Tincturo of.........745
 Black Cohosh, Tincture of-750
 Black Currants, • •...........67
 Black  Haw,...............634
 Black  Oxide of Iron,......664
Black Pepper,.............634
Black Root,...............668
Blaok  Walnut,............638
 Black Willow,
 Black Salve,..............736
 Bladder, Bleeding from- ■ • -456
 Bladder, Catarrh of.......313
 Bladder, Chronic Inflamma-
       tion of.............313
 Bladder, Chronic Inflamma-
       tion of  neck of......315
 Bladder, Inf.ammation of • • 312
 Blanket Pack,............
 Blanket, Sweating........
 Bleeding from the Bladder,-456
 Bleeding from the Cord, • • • • 550
 Bleeding from the Kidneys, 456
 Bleeding from the Lungs, • • 453
 Bleeding from the Navel,- • -550
 Bleeding from the Nose,---452
 Bleeding from the Stomach, 455
 Bleeding from the Womb, - -534
 Bleeding3,................451
 Blood, Involuntary discharges
       of.........•.......451
 Bloodroot,................635
 Bloodroot, Compound Ace
       tated Tincture of---744
 Bloodroot, Compound Mix-
       ture of.............729
 Bloodroot,  Tincture of.....750
 Bloody Flux,...........-"288
 Blotched Face,............500
 Blue Cohosh,.............635
 Blue  Cohosh,   Compound
       Tincture of.........745
                        -636
                        ••750
 Blue Vitriol,..............645
 Boils,....................503
 Boiling,...................34
 Bone, Diseased............587
 Bone's Bitters,...........748
 Bones of the Foot, Fractures
       of.................571
 Boneset,..................636
 Borate of Soda,...........696
 Borax,.........
 Borax Lotion,.............726
 Borax Lotion with Morphia, 726
 Bowels, Attentions to the --150
 Bowels, Consumption of 310,477
 Bowels, Chronic Inflamma-
      tion of .............287
 Bowels, Inflammation of--285
 Brain, Dropsy of..........331
 Brain, Inflammation of---235
Brandy,...................92
Bread,....................55
Bread, Brown..............57
 Bread, Toasted............58
Bread, to Detect Alum in • —57
Breast-bone, Fracture of---566
Breasts, Ague in the.......541
Breasts, Painful during Preg-
      nancy ..............526
Breasts, Swelling of in  In-
      fants, ..............550
Bright's Disease,..........432
Broccoli,...................61
 Broiling,..................35
 Bromide of Potassium,.....686
 Bronchitis,  Acute.........262
 Bronchitis,  Chronic........264
 Bronohocele,
 Broth,.....................43
634 Bwwn Bread, .............57
    Bruises,..................554
    Bubo,--.................60&
    Bubo, Sympathetic........319
    Buchu,...................636
    Buckhorn  Brake,.......-"637
    Buckwheat,................53
    Bugle Weed,..............637
    Burdock,.................637
    Burgundy Pitch,..........637
    Burns,....................613
Broth, Veal................41 (Carbuncle, i
 Burnt Alum,..............624
 Burnt De er's Horn,........638
 Burnt Sponge,............699
 Bursal Tumor,............589
 Burst,...................601
 Bush Honeysuckle,........637
 Butter,....................48
 Buttermilk,................47
 Butternut,................638
 Button Snakeroot,........638

 Cabbage,..................60
 Cabbage, Meadow.........695
 Cachexia Africana,........485
 Cajeput, Oil of............675
 Calamine Cerate,..........717
 Calamus,.................702
 Calcined Deer's Horn,.....638
 Calcined Magnesia;........671
 Callosities,................504
 Calves' Feet Jelly,.........41
 Camphor,.................638
 Camphor Ball,............717
 Camphor,  Compound  Mix-
      ture of..............729
 Camphor, Compound Pills of 733
 Camphor,  Compound  Pow-
      der of..............737
 Camphor,  Compound Tinc-
       ture of............745
 Camphor Ice,.............717
 Camphor Liniment,........724
 Camphor Mixture,........728
 Camphor, Tincture of.....750
 Camphor Water,..........727
 Camphorated  Tincture  of
      Opium,.............744
 Canada Balsam,...........639
 Canada Fleabane,.........639
 Canada Pitch,............657
 Cancer,...................458
 Cancrum Oris,............251
 Candies,  ..................50
Canella Alba,.............639
Canker Lettuce,..........691
Cantharides,..........639,  697
Cantharides, Tincture of- • -755
Capricious  Appetite during
      Pregnancy,..........526
Capsicum,  Ethereal Oil of • -640
Capsicum,................640
Capsicum,  Compound  Plas-
      ter of ••"..........735
 Capsicum,  Compound  Tinc-
       ture of.............747
 Capsicum,   Tincture  of" "750
 Caraway,.................640
 Carbonate of Ammonia,•• • • 626
 Carbonate  of Potassa,......684
 Carbonate  of Zinc, impure, 711
 Carbonic Acid Gas, Poison-
       ing by..............617
                         ■m 
784
INDEX.
Carcinoma,..............458
Cardamom,..............640
Carditis,..................278
Caries,...................587
Carrot,....................02
Carrot Poultice,...........715
Carrot, Wild..............707
Castile  Soap,.............695
Castor,...................640
Castor, Amnion. Tincture of 744
Casto*Oil,................640
Catalepsy,................355
Cataplasms,...............715
Cataract,  Black...........489
Catarrh,.................266
Catarrh,  Chronic..........269
Catarrh of the Bladder, • • • ■ 313
Catarrh Snuff,............269
Catarrhal Ophthalmia, •  • • 23'J
Catechu,  .................641
Catechu,  Tincture of......750
Catnip,...................641
Cauliflower,.......-.......60
Caulophyllin,.............636
Causes of Febrile Diseases, 175
Caustic, Mild Vegetable 685,710
Caustic Potash, • <•..........684
Caustic,  Strong Vegetable
                       685, 716
Caustics,.................716
Cayenne  Pepper,..........640
Cedar Apples,............689
Cedar, Red  ..............689
Celery,....................63
Cellular Dropsy,........-341
Cerate,  Calamine..........717
Cerate,  Croton Oil........717
Cerate,  Resin............717
Cerate,  Simple.........."718
Cerate, Turner's..........717
Cerates,..................717
Cessation of Menstruation, "515
Chaf ings,................615
Chalk, Prepared..........670
Chamomile,..............641
Chancre,  ................604
Change of Life,  ..........515
Charcoal,................642
Charcoal, Comp. Powder of  737
Charcoal  Poultice, ........715
Cheese,...................47
Cherries,..................66
Cherry, Wild.............708
Chest, Dropsy of the......336
Chestnuts,................70
Chicken Pox,............230
Chicken Soup,...........42
duckweed, Red..........689
Chilblain,................505
Child, Attentions to after
      Birth,..............545
Ohild-bed Fever,..........305
Child, Dressing the........545
Child, Washing the........545
Child, Weaning the........547
Children, Convulsions of •• -356
Children, Diseases of......544
Chlorate of Potassa,.......685
Chloride of Gold and Soda, 655
Chloride of Iron, Tine, of- 750
Chloride of Lime,.........670
Chloride of Sodium,.......696
Chloride of Zinc,..........711
Chlorosis,.................516
Chloroform,...............642
Chocolate,.................84
Cholera,  Asiatic...........412
Cholera Infantum,  ........423
Cholera Mixture,Greenhow's 744
Cholera Morbus,...........417
Cholera  Pills,.............733
Chordee,..................316
Chorea,.................363
Chromic  Acid,............642
Chronic  Amenorrhea,......510
Chronic  Bronchitis,........264
Chronic  Catarrh,..........269
Chronic  Coryza,...........269
Chronic  Cystitis,..........313
Chronic  Diarrhea,.........423
Chronic Disease of the Liver,296
Chronic Disease of the  Spleen,
                           299
Chronic  Dysentery,........292
Chronic  Enteritis,--'......287
Chronic  Gastritis,.........281
Chronic  Hepatitis,.........296
Chronic  Hydrocephalus,---335
Chronic  Inflammation of the
       Bladder,............313
Chronic  Inflammation of the
       Intestines,..........287
Chronic  Inflammation of the
       Kidneys,...........304
Chronic Inflammation of the
       Neck of the Bladder, 315
Chronic Inflammation of the
       Peritoneum,........310
Chronic Inflammation of the
       Stomach,...........281
Chronic  Laryngitis,........256
Chronic  Menorrhagia,.....514
Chronic  Nephritis,.........304
Chronic  Peritonitis,........310
Chronic  Pleurisy,.........277
Chronic  Rheumatism,......325
Chronic  Splenitis,.........299
Churrus,.................658
Cicuta Maculata,..........683
Cider,.....................85
Cimicifugin,..............634
Cinchonia,................680
Cinnamon,............74, 642
Cinnamon, Tincture of---751
Citrate of Iron,...........664
Citrate of Iron and Quinia, 664
Citric Acid,  ..............643
Clams,....................43
Clap,.....................315
Classification of Medicines, 619
Clavus,...................504
Cleanliness,...............125
Cleavers,.................643
Clergyman's  Sore Throat,--256
Clothing,.................101
Clover, Red  ..............689
Cloves,................74, 643
Clysters,..................722
Cochineal,................644
Cocoa,.....................85
Cod-liver Oil,.............644
Coffee,....................82
Cohosh,  Black............633
Cohosh,  Blue.............635
Colchicum,...............644
Colchicum, Compound Tinc-
       ture of.............746
Colchicum Seed, Tincture of 751
Colcothar,................fjaj
Cold Bath,................]3j
Cold Cream,..............717
folds,....................266
Colic, ••••................403
Colic, Bilious.............404
Colic, Flatulont...........403
Colic, Lead...............406
Colic, Painter's...........405
Colica  Pictonuni,..........403
Collarbone,  Dislocation of--575
Collarbone,  Fracture of ••••560
Collecting  and Drying of
      Plants,.............618
Collodion,................644
Colo-rectitis,..............288
Cologne, .................744
Colombo,.................644
Colombo, American........644
Colt'sfoot,................708
Comedones,..............1501
Comfrey,.................641
Common Liniment,........724
Common Silkweed,........645
Common Strengthening Plas-
      ter, ................735
Compound Acetated Tincture
      of Bloodroot,........744
    Balsam  of Sulphur,""714
    Cajuput Mixture,.....728
    Capsicum  Liniment,-- -724
    Capsicum Plaster,....."'■',:>
    Clyster of Assafetida,--723
    Clyster of Lobelia, • • • ■ 723
    Clyster of Prickly-Ash, 723
    Clyster of Senna,.....723
    Copaiba Mixture,......723
    Confection of Senna,--718
    Dislocations,..........573
    Electuary of Senna,-"718
    Ethereal Lotion,......727
    Fractures,............558
    Infusion of Geranium, -721
    Infusion of Parsley,-• ••721
    Infusion of Sage,......722
    Infusion of Trailing Ar-
      butus,..............722
    Lead  Ointment,.......731
    Lead Plaster, •........735
    Liniment of Oil of Am-
      ber,..............- - 724
    Liniment of Oil of Stil-
      lingia,..............724
    Lotion of Golden Seal, 726
    Lotion of Zinc,........726
    Mixture of Bloodroot, •• 729
    Mixtare of Camphor, -729
    Myrrh Lotion,........726
    Ointment of Bayberry, 731
    Ointment of Iodine, ■••731
    Ointment  of Oxide of
      Zinc,..............731
    Ointment of Sulphur,--732
    Pills of  Aconite,......732
    Pills of Aloes,.......732
    Pills of Assafetida, — 732
    Pills of Black Cohosh,--732
    Pills of Camphor,.....733
    Pills of Dandelion, ••••733
    Pills of Ferrocyannretof
      Iron,...............733
    Pills of High Cranberry, Ui
    Pills of Hyoscyamus, ■•73*
    Pills  of Leptandrin,••-731 
INDEX.
785
 Cemp- P'Hsof Motherwort, -733
     Pills of Podophyllin,••  734
     I'illg of Quinia,........734
     Pills of Soap,.........734
     Pills of Valerian,.....734
     Plaster of Belladonna,  735
     Powder of Camphor,- • -737
     Powder of Charcoal, •• -737
     Powder of Golden Seal, 737
     Powder of Hydrastin,- -737
     Powder of Ipecacuanha
      and  Opium,.........737
     Powder of Jalap,......737
     Powder of Leptandrin,  738
     Powder of Lobelia,  • • • 738
     Powder of Podophyllin, 738
     Powder of Quinia, ---738
     Powder of Rhubarb,--738
     Powder of Rhubarb and
      Potassa,............738
     Powder of Xanthoxylin, 738
     Resin  Plaster.........735
     Soda Lotion,..........727
     Solution of  Iodine,---725
     Spirits of Lavender, • • ■ 747
     Syrup of I'artridgeber-
      ry,.................739
     Syrup of Rhubarb  and
      Potassa,.......•---740
     Syrup of Sarsaparilla,-710
     Syrup  of Spikenard,- -740
     Syrup  of Stillingia,---741
     Syrup of Yellow-Dock,-741
     Tar Plaster,..........735
     Tincture of Assafetida,-745
     Tinoture of Benzoin, • • • 745
     Tincture of  Black Co-
      hosh,...............745
     Tincture of Blue Cohosh,745
     Tincture of Camphor, •• 745
     Tincture of Capsicum, • • 747
     Tincture of Colchicum,-746
     Tincture of Gentian,- —746
     Tincture of Goldenseal, • 74fi
     Tinoture of Hemlock,--746
     Tincture of High Cran-
      berry, ..............746
     Tincture of Iodino,.....74fi
     Tincture of Lavender, • • 747
    Tincture of Lobelia,---747
    Tincture of Lobelia and
      Capsicum,..........747
    Tinoture of Myrrh,.....747
    Tincturo of Rhubarb,-747
    Tincture of Senna,---748
    Tincture of Tamarac,--748
    Tincture  of  Virginia
      Snakoroot,..........748
    Wine of Comfrey,......728
    Wine of Goldenseal,--72S
tompresses, Wet..........778
Condiments,..............v. 70
Condition of the Tongue in
      Fevers,.............182
Confection?,..............718
Congestive Chill,..........189
Congestive Fever,..........195
Conium  Maculatum,  Tinc-
      ture  of.............754
Conserves,................718
Constipation,..........150,425
Constipation during  Preg-
      nancy, .............524
Constitutional Syphilis-
Consumption, .............**>'
Consumption of  the  Bow-
      els,.............310,477
>54
Pi
Contused Wounds,
Convulsions  during
      nancy,.............524
Convulsions of Children,- • 356
Cooking, Modes of..........34
Cooling Lotion,............727
Cooling Wash,--.........726
Copaiba, Balsam of........628
Copper, ..................645
Copper, Subacetate of.....645
Copper, Sulphate of.......645
Copperas,.................666
Cord, Bleeding from.......550
Cordial, Mother's..........738
Cordial, Neutralizing......740
Corn, Indian-
Corn, Turkey-
Cornine......
Corns,........
Costiveness,-- ■
Cotton.
         -54
.........704
.........647
.........504
■ 150,425,524
.........645
Cotton Bark, Tincture of •• -751
Cough Drops,.........264,729
Cough during Pregnancy,•■ 525
Cough Remedies,..........264
607|Dementia,................372
    Dewberry,...............• 633
    Diabetes,---•#...........436
    Diachylon,................736
    Diaphoretic Powder,.......737
    Diaphoretics in Fevers,.....179
    Diarrhea,.................421
    Diarrhea,  Chronic.........423
    Diarrhea, Mexican.........287
    Difficult Menstruation,---511
    Difficulty  in Urinating, dur-
          ing  Pregnancy,......525
    Digitalis,.................647
    Digitalis, Tincture of......751
    Dioscorein,...............708
    Discharges of  Blood, Invol-
          untary •••..........451
    Disease, Bright's..........432
    Disease, External Signs  of,
          in Infants,..........548
    Disease, Hip..............479
    Disease of the Liver,Chronic 296
    Disease of the Spleen, Chron-
          ic-................299
    Disease, Venereal.........604
    Diseased Bone, • • -■.........587
    Diseased Mesenteric Glands, 477
Constitutional Diseases,".
             50
 Cow-pox,.................228
 Crabs,.....................42
 Cramp,...............• •• • 365
 Cramp-bark,..........•• "659
 Cramp in the Leg,.........366
 Cramp in the Stomach,.....366
 Cramps during Pregnancy,- -366
 Cranberries,  ...............67
 Cranberry, High...........659
 Cranesbill,................654
 Crawley,  .................646
 Cream,....................46
 Cream of Tartar,..........684
 Creosote,
 Cresses,...................64
 Crocus Martis, • •...........665
 Croton  Oil,...............646
 Croton Oil Cerate,--------717
 Croton  Oil Liniment,......724
 Croup,...................258
 Crowfoot,.................654
 Crusta  Lactea,•• •.........492
 Cubebs,..........•.......646
 Cucumbers, •• •.............62
 Culver's Physic,...........668
 Currants,  Black............67
Currants,  Dried............67
Currants,  Red..............67
Cyanuret  of  Potassium,---686,
Cynanche Maligna,........247
Cynanche Parotidce,.......253
Cynanche Traehealis,......258
Cypripedin,..............711
Cystine Deposits in Urine,"450
Cystitis,..................312
Cystitis,  Chronic..........313

 Dandelion,................647
 Dandelion, Comp. Pills  of--73:'
 Dates,.....................66
 Deafness,.............---490
 Decoctions,...............718
 Deer's horn, Calcined......638
 Delirium  Tremens,........376JDried Currants,-
45SI Delivery,
Diseases, Dropsical.........331
Diseases, Febrile —........173
Diseases, Gastric.....••• —395
Diseases, Infantile.........549
Diseases,  Inflammatory---231
Diseases, Intestinal........395
Diseases,  Nervous.........344
Diseases of Children,......544
Diseases, Constitutional---458
Diseases of Pregnancy,---524
Diseases of the Skin,......491
Diseases of the Stomach and
      Bowels,.............395
Diseases of the Urinary Or-
      gans, ...............432
Diseases of Women,.......506
Diseases, Surgical.........551
Dislocation  of Ankle Joint, • 584
    Collar Bone,..........575
    Elbow Joint,..........577
    Fingers and Toes......578
    Hip-joint,  ............578
    Knee-joint,...........583
    Knee-pan,............583
    Lower-jaw,...........574
    Shoulder,.............575
    Wrist,................578
Dislocations,..........•• • • 571
Dislocations, Compound---573
Dislocations, Simple.......571
Diuretic Drops,............728
Diuretic Pills,............734
Diuretics in Fevers,........180
Dock, Yellow..............710
Dogwood,.................647
Dogwood, Swamp.........701
Doses of Medicines,........714
Douche, ..........•-----770
Douche, Head---..........771
Douche, Pail..............764
Dow-worm,...............493
Dressing theChild,--^.....545
Dressing the Navel,........545
Dried Alum...............624
Dried Beef,................37
                            67
■ 529—532lDried Sulphate of Iron,- 
786
INDEX.
Dripping Sheet,...........761
Drops, Cough.............264
Drops, Diuretic ?...........728
Drops, Hot--  •"...........747
Drops, Hunn's.............728
D ropsical Diseases,.........331
Dropsy, Cellular...........341
Dropsy, General...........341
Dropsy of the Abdomen,"-339
    Brain,.........--331—335
    Chest,................336
    Head,...........331-335
    Heart,................33S
    Scrotum,.............343
Dry Mortification,.........551
Drying of Plants,..........618
Dumb Ague,..............186
Dumplings,................58
Dwarf Elder,..............648
Dysentery,...........
Dysentery,  Chronic........292
Dysmenorrhea,............511
Dyspepsia,................395
Dysuria,..................440

Ear, Inflammation of......238
Ears, Foreign Bodies in-490,616
Egg-Plant,.................62
Eggs,.................43,648
Elaterium,................648
Elbow, Fracture  of.......563
Elbow-Joint, Dislocation of-577
Elder,....................648
Elder, Dwarf..............648
Elder, Prickly.............687
Elecampane,..............649
Electro-Magnetism,........
Electuary of Senna,Comp. • •
Electuary, Pile............
Elixir Paregoric,...........
Elixir Salutis,............
Elixir Vitriol,............
Elm Poultice,.............
Elm, Slippery.............
Emetics in Fevers,.........
Emetic Powder,...........
Emetic Tincture, Acetous-
Endocarditis, .............
Enlarged  Tonsils,..........
Enlargement of the Heart,—
Enteritis,.................
Entozoic Powder,..........
Enuresis,.................
Epidemic Cholera,.........
Epilepsy,................
Epistaxis,................
Ergot,....................
Ergot, Tincture of---
Erigeron  Mixture,.........
Eruptive Fevers,..........
Erysipelas,................
Essences,.................
Ether,....................
Ether, Hydriodic..........
Ethereal  Lotion, Compound
Ethereal  Oil of Capsicum,-
Ethyle, Iodide of.........
Eupurpurin,.............
Exercise,................
Excessive Menstruation,—
Excoriated  Nipples,.......
Excoriation of the Navel, • •
Excoriations and Chafings,
Expectorant Tincture, King'
External Signs of Disease in
      Infants,............548
Extract, Fluid Neutralizing 720
Extract of Rhubarb and Po-
      tassa, Fluid.........720
Extract of Spigelia and Sen-
      na, Fluid...........720
Extracts,.................718
Extracts, Fluid............719
Eye and Ear -Bath,........773
Eyes, Attention to the.....145
Eyes, Inflammation of.....239
Eye-water,  Stimulating---726
Evaporating Lotion,........727

Face, Blotched............500
Fainting,.................392
Falling of  the Bowel,......597
    Womb,...............522
Falling Sickness,..........350
False Bittersweet,  ...."..650
False Grape,..............625
False Pains,..............529
False Unicorn-root,........658
Fats,......................49
Fats, Fixed...............
Fear,--;........•  .......155
Febrile Diseases,•• •.......173
    Auxiliary Treatment of 180
    Causes of.............175
    Condition of Tongue in 182
    Diaphoretics in........179
    Diuretics in..........180
    Emetics in............177
    General Treatment of "176
    Prognosis of...........176
    Purgatives in  ........177
    Symptoms of..........173
Febris Intermittens,........185
Feeding, Artificial........546
Feet, Attentions  to the•• •• 142
Felon,....................588
Female Regulator,........669
Fern,  Sweet..............702
Ferrocyanuret of Iron,.....664
    Pills of,..............733
Fever and Ague,..........185
Fever, Bilious............191
    Childbed.............305
    Congestive  ...........195
    Hectic................214
    Infantile Remittent" "212
    Intermittent..........185
    Lung................270
    Miliary...............231
    Milk.................533
    Pernicious............198
    Puerperal.............305
    Remittent,............191
    S"carlet...............215
    Spotted..............211
    Typhoid..............207
    Typhus...............204
    Yellow...............199
Feverfew,................650
Fevers, Eruptive..........215
Fevers, Tongue  in.........182
Figs,......................68
Figwort,..................650
Fingers, Dislocation  of.....578
Fingers, Fracture of.......565
Firewood,................650
iFiring,...................651
(Fish,.....................42
Fissuro of tho Anus,.......593
Fistula in Ano,............593
Fits  of Children,..........355
Five-flowered Gentian,.....653
Five Leaves,..............625
Fixed  Fats,................49
Fixed  Oils,................49
Flag, Blue................636
Flag, Sweet...............702
Flatulent Colic,...........403
Flaxseed,.................651
Fleaban e, Canada..........639
Flies, Spanish.........639,697
Floodings,................534
Fiow,  Lochial.............532
Flowers of Sulphur,.......700
Fluid Neutralizing Extract,-720
     Extract of Rhubarb and
       Potassa,............720
     Extract of Spigelia and
       Senna,.............720
     Extracts,.............719
Fluor-Albus,..............518
Flux, Bloodj..............288
Follicular Inflammation  of
       the  Mouth,.........248
Fomentations,.........721,776
Food,.....................22
     Kind of...............27
     Preparation of.........34
     Quality of.............26
     Quantity of............24
Forearm, Fracture of......564
Foreign Bodies in the Ear,-490
     Nose,.................615
     Windpipe,............615
Foxglove,.................647
Fracture of the Bones of the
       Foot,...............571
Fracture of the Breast-bone, 566
     Collar-bone,..........560
     Elbow,...............563
     Fingers,..............565
     Forearm,.............564
     Hand,................565
     Knee-pan,............568
     Leg, •■...............569
     Lower-jaw,...........559
     Nose,.................558
     Ribs,.................565
     Shoulder-blade,.......561
     Thigh Bone,..........566
     Upper arm,...........562
     Wrist, ...............565
Fractures,................556
     Compound,...........558
     Simple, ..............556
Framboesia,...............4B*
Freckles,.................5°2
Fritters,..................•»
Frostbite,.................J06
Frostweed,................6£
Frying,...................\f.
Fumigation of Sick-room, ••«<
Furor  Uterinus,...........385
Furunculus,  ........
503
Gallic Acid,..............852
Galls,....................»"
Gallweed,.................°"
Gamboge,..............."5g8
            !"!''!'.'.»'."»4i
Game, • • •
Gangrene,
-551 
INDEX.
787
 Gangrenous Inflammation of
      theMouth,..........251
 Garlic,..........•.....63, 653
 Garlic, Syrup of..........742
 Gastrio Diseases,..........oVo
 Gastritis,.................280
 (Jaitritis, Chronic.........281
 Ga-trodynia,..............366
 Golatus,..................506
 Gelseminum,..............710
 Gelseminum, Tincture of- -752
 General Dropsy,  ..........341
 General Observations on Hy-
      dropathic Treatment, 781
 Gunoral Treatment of  Fe-
      vers, ...............176
 Gontian,..................653
 Gontian, Comp. Tincturo of 746
 Gentian, Five-flowered---653
 Gontian, Tincture of.......752
 Gentianin,...............653
 Geranium,................654
 Geranium, Comp.  Infusion of 721
 Geraniin,.................654
 Giddiness in the  Head, • • • • 393
 Gill over tho Ground,......656
 Gin,  ......................93
 Ginger,...............73, 654
 Ginger Boor,...........•
 Ginger,  Syrup of..........742
 Ginger,  Tincturo  of........752
 Ginger,  Wild.............708
 Gingerbread,...............59
 Ginseng,.................654
 Glauber's Salts,...........696
 Gleet,....................319
 Glossary,.................782
 Gluten, Vegotablo..........49
 Glycorin,.................654
 Goitre,...................486
 Gold and Soda, Chloride of 655
 Goldenrod, Hardleaf —""658
 Golden Seal,..............655
    Compound Powdor  of -737
    Compound Tincture of  746
    Compound Wine of •• "72S
 Golden Tincture,..........746
 Gondret's Vesicating Ammo-
      niacal Ointment,---626
 Gonorrhea, ..............315
 Gooseberries,..............67
 Gout,....................328
 Grains of Paradise, Tine, of 752
 Grapes,....................67
 Gravel,  ..................443
 Gravel, Oxalic............447
 Gravel, Phosphatic........446
 Gravel, Uric Acid........445
 GreenSickness, ..........516
 Green Vitriol,............666
 Grecnhow's Cholera Mixture,744
 Greens,....................61
 Grief,....................157
 Grocer's  Itch,............496
 Ground Centaury,........656
 Ground  Ivy,..............656
 Grubs in the Skin,........501
 Gruel, Indian  Meal........54
 Gruel, Oatmeal............52
 Guaiacum,................656
   Aromatic Tincturo of  -744
   Volatile Tincturo of • • -756
Qam,.....................50
Gum  Ammoniac,..........626
Gum Arabic,..........• ■
Gum Arabic, Mucilage of-
Gum Hemlock,..........
Gum, Red,..............
Gum, Sweet,...........
Gum, Yellow, ---  .....
Gunshot Wounds,.......
Gutta Serena,..........
• 656
-657
• 657
■ 549
• 702
• 549
■ 554
• 489
Hair, Attentions to the —
Haircap  Moss,...........'
Half-bath,...............
Ham,...................
Hand, Fracture of........
Hardleaf Golden  Rod, ••••
Hardness of Breasts in In-
       fants, ..............550
Harlem  Oil,..............714
Hartshorn, Spirits of......626
Head Bath,...............772
Head Douche,............771
Head, Giddiness of.......393
Head, Scald..............493
Headache,................427
Headache during Pregnancy, 524
Headache, Nervous........427
Headache, Sick...........427
Health,.....................9
Health,  How influenced by
      Occupations,........159
Heart, Dropsy of the  — - -338
    Enlargement of.......487
    Hypertrophy of........487
    Inflammation of.......278
    Palpitation of.........394
Heartburn,...............409
    During Pregnancy,---409
Heart's Ease,.............678
Hectic Fever,.............214
Hellebore, American  ......624
Hellebore, Whito..........706
Helonias,.................658
Hemastasis,...............657
Hematomesis,.............455
Hematuria,...............456
Hemicrania,..............321
Hemlock, Comp. Tincture of 746
Hemlock, Gum............657
Hemlock, Poison..........682
Hemlock, Water..........683
Hemlock, Tincture of......752
Hemoptysis,..............453
Hemorrhage from the Blad-
      der, ..........•.....456
    Kidneys,.............456
    Lungs,...............453
    Nose, ................452
    Stomach,.............455
    Womb,..............534
Hemorrhages,........451, 534
Hemorrhoids,.............595
Hemp,...................658
Hemp, Indian  ............662
Hemp, Whito Indian......701
Henbane, • • •-......~.....661
Henbane, Tincture of......752
Hepar,...................686
Hepatitis, Acute..........293
Hepatitis, Chronic ........296
Hernia,  ..................601
Hernia, Umbilical.........550
Herpes,...................491
Herpes Circinnatus,.......491
Herpes Zoster,............491
Hiccough,................392
High-cranberry,...........659
    Compound Pills of.....733
    Compound Tincture of 746
Hip Disease,..............479
Hip-joint, Dislocations of  "578
Hippuric Acid  deposits in
      Urine, .............450
Hoarhound,...............659
Honey,....................51
Hooping-Cough,..........390
Hops,....................659
Hops, Ointment of........730
Hordeolum,...............503
Horsemint, ...............660
Horseradish,...........73, 660
770
747
660
• 728
477
665
Hose-bath
Hot Drops,......
Hound's Tongue,
Houseleek,......
Hunn's Drops,"
Hydrangea,.....
Hydrarthrus,---
Hydrastin,......
    Compound Powder of-737
Hydrated Sesquioxide of Iron,
                         .664
Hydriodic Ether,..........661
Hydrocele,................343
Hydrocephalus, Acute •••••331
Hydrocephalus, Chronic -"335
Hydrochlorate  of Ammonia, 626
Hydrochloric Acid,........661
Hydrogen, Sulphuretted "f47
Hydropathic Treatment, Gen-
      eral directions for • •• 781
Hydropathic Appliances, •• -760
Hydropericardium,........338
Hydrophobia,............368
Hydrothorax,.............336
Hyoscyamia,...............661
Hyoscyamus,..............661
    Compound Pills of.....733
    Tincture of...........752
Hypertrophy of the Heart, • • 487
Hypochondria,............378
Hyposulphite of Soda,.....697
Hyssop,..................662
Hysteria,................360
Hysterics, ................360

Ice-Cream,.................46
Ice Plant,.................662
Icterus,...................410
Immoderate  Flow of Menses,513
Impotency,...............384
Impure Carbonate of Zinc,- -711
Incontinence of Urine,.....442
Incubus,..................394
Indian Corn,...............54
Indian Hemp,.............662
Indian Hemp, White.......701
Indian Meal Gruel,.........54
Indian Turnip,;---•*•.....662
Indigestion,...............395
Indigo, Wild..............708
Infantile Diseases,.........549
    Purulent  Ophthalmia,--243
    Remittent Fever,......212
Infants, Bleeding from  Cord
       of.........  ........550
    Bleeding from Navel of-550
    Excoriation of Navel of 550
    Jaundice of..........549 
788                                    INDEX.
Infants, Red Gum in......549
    Rupture of Navel of— -550
    Swelling of Breasts  of-550
    Umbilical Hernia of —-550
    Yellow Gum in........549
Inflammation of the Bladder,312
    Bladder, Chronic......313
    Bowels,...............285
    Bowels, Chronic.......287
    Brain,................235
    Breasts,.............541
    Ears,.................238
    Eyes,  ................239
    Heart,--...............278
    Intestines,............285
    Intestines, Chronic---287
    Iris,..................243
    Kidneys,.............301
    Kidneys, Chronic......304
    Larynx,..............254
    Larynx, Chronic.......256
    Liver,................293
    Livor, Chronic........296
    Lungs,...............270
    Mouth,...............248
    Mouth, Follicular......248
    Mouth, Gangrenous---251
    Mouth, Ulcerative.....250
    Neck  of the  Bladder,
       Chronic............315
    Peritoneum,..........305
    Peritoneum, Chronic—-310
    Pharynx,.............247
    Pleura,...............275
    Pleura, Chronic........277
    Spleen,...............298
    Spleen, Chronic.......299
    Stomach,.............280
    Stomach, Chronic.....281
    Urethra,..............315
    Windpipe,............262
    Windpipe, Chronic---264
    Womb,...............311
Inflammatory Diseases,.....231
    Rheumatism,..........320
    Sore Throat,-••_......245
Influence of Occupations on
      Health,.............159
Influenza,................266
Infusion of Geranium, Comp.721
    Parsley,  Compound---721
    Sage, Compound......722
    Trailing Arbutus, Comp.722
Infusions, ................721
Injections,............722, 779
Insanity,................371
Insects, Bites of........
Intermittent Fever,......
Interrupted Menstruation
Intestinal Diseases,......
Inverted Toe Nail,.......
Involuntary  Discharges
       Blood,...........•
Iodide of Ethyle,.......
    Iron,..............
    Iron, Solution of —
    Potassium,.........
    Zinc,..............
Iodine,................
    Compound Ointment of-731
    Compound Solution of-725
    Compound Tincture of-746
    Pills,.................734
    Tincture of...........752
Ipecacuanha,..............663
    American.............625
    and Opium, Compound
      Powder  of..........7157
    Syrup of.............742
Iridin,....................636
Iritis,....................243
Iron,.....................664
    Acetate of............664
    Ammonio-Tartrate  of--664
    and Quinia, Citrate of •-664
    and Quinia, Tartrate of-666
    Black Oxide of........664
    by Hydrogen,.........665
    Citrate of.............664
    Dried Sulphate of.....666
    Ferrocyanuret of......664
    flydrated   Sesquioxide
      of................664
    Iodide  of.............665
    Lactate of............665
    Phosphate of..........665
    Precipit. Carbonate of— 665
    Protoxide of.........665
    Prussiate of..........664
    Red Oxide  of..........665
    Sesquioxide of........665
    Sulphate of...........666
    Tincture of Acetate of 749
    Tincture of Chloride of-750
    Tincture of Muriate of-750
Ironweed,.................666
Iron wood,................666
Irrigation,................775
Irritating Plaster,.........735
Ischuria,.................440
Isinglass,.................667
Itch,.....................498
Itch,  Barber's.............496
Itching of  Genitals, during
    Pregnancy,...........525
Ivy, American............625
    Big..................094
    Ground...............656

Jackson's Itch,............496
Jalap,....................667
Jalap, Compound Powder of 737
Jamestown  weed,..........700
Jaundice,.................410
Jaundice  of Infants,.......549
Jaw,  Dislocat. of the Lower-574
Jaw, Fracture of the Lower-559
of
Jelly, Calves' Feet-
Jerusalem  Artichoke,-
Jessamine,  Yellow•••■
Joy,................
Juglandin,...........
Juniper,.............
                           41
                         ■•60
                         •710
                         • 158
                         ■638
                         • 667

Kidneys,.................153
    Attentions to the......153
    Bleeding  from........456
    Bright's Disease of"—432
    Inflammation of......301
    Inflammation of, Chron.304
Kind of Food,..............27
King's Evil,..............464
King's Expectorant Tincture,747
Kino,....................667
Knee-joint, Dislocation of--583
Knee-pan, Dislocation  of---583
    Fracture of...........568
Labor,...................529
    Management of........530
Lacerated Wounds,........jji
Lactate of  Iron,...........605
Lactucarium,.............fidg
Ladies'Slipper, Yellow — 711
Lamb,.....................41
Land Scurvy..............481
Lapis Calaminaris,.........711
Larch, American ..........625
Largo Flowering Spurge,- - - G67
Laryngitis, ...............254
    Chronic,.............256
Laudanum,...............753
Laurel, Sheep.............694
    Sheep, Tincturo  of—754
Lavender, Comp. Spirits of-747
    Compound Tincture of-747
Lead, ^...................668
    Acetate of............668
    Colic,................406
    Ointment, Compound-731
    Plaster, ..............736
    Plaster, Compound — 735
    Plaster, Red Oxide of • • 736
    Red..................668
    Red Oxide of.........668
    Sugar of.............668
Leek, .....................63
Leg and Arm Baths........775
Leg, Fractures of the......569
Leg, Milk.................537
Lemon Syrup,............741
Lemons,...............68,  668
Lentigo,..................502
Leopard's bane,...........627
Leptandra,................668
Leptandrin,...............669
    Compound Pills of.....733
     Compound Powder of--738
     Tincture of...........752
Lettuce,...............63,669
Leucorrhea,...............518
Life root,.................669
Life, Turn of..........: • • 515
Limbs, Swelling  of,  during
    Pregnancy,...........525
Lime,....................670
     Chloride of...........670
    Water,  ..............670
Limes,.................68,668
Liniment, Aconite.........724
     Camphor.............724
     Common..............724
     Compound Capsicum • • -724
     Croton Oil............724
     of Oil of Amber, Comp. 724
     of Stillingia, Compound 724
     Rheumatic........724,745
   725
— 724
—651
—729
....625
685,725
   670
    White  ..........
Liniments,..........
Linseed Oil,........
Liquid Physic, White
Liquor Ammonia,
Liquor Potassa,......
Liquorice,................"'"
Liquors,-.......;•••;.....'*
Liver, Inflammation of.....;"»
    Inflam. of, Chronic —ZW
    of Sulphur,...........6»°
Lobelia,.............•••••twu
    and  Capsicum,- torn-
      pound Tincture of •■•7«
    Compound Clyster of ■••Hi 
INDEX.
789
Lobelia, Comp. Powder of-738
    Compound Tincture of-747
    Poukico, .............716
    Tincturo of...........75J
    Vinegar of...........756
Lobsters,.................-42
Lochial Flow,.............532
Loeko.l Jaw,..............367
Ugwood,  ................671
Lotion, Borax.............726
    liorax with Morphia-•-726
    ('ompound Ethereal---727
    Compound Myrrh
    Compound Soda,
    Cooling............
    Evaporating........
    of Golden Seal, Comp.
    of Zinc, Compound —
Lotions,................
Love,.............
Lower Jaw, Dislocation of
    Fracturos of..........559
Lumbago, ................321
Lunar Caustic,............674
Lung Fcvor,..............270
Lungs, Bleeding from......453
    Hemorrhage from......453
    Inflammation of......270
Lupulin,  .................659
    Tincturo of...........753

Mace.....................675
Macrotin,.................634
Magnesia, ................671
    Calcined..............671
    Sulphate of...........671
Maidenhair,...............671
Maize,.....................54
Malt Liquors,..............86
Management of Labor,.....530
Mandrake,................671
Mania,...................371
Mania,  Puerperal..........542
Manner of Eating,..........28
Marsh-mallow,...........672
Marsh-rosemary, ..........672
Masked Ague,.............186
Mastcrwort,...............672
Mastication,................30
Masturbation,.............380
Materia Medica,...........618
May Applo,...............671
Mayor's Ointment,.........731
Meadow Cabbage,.........695
Measles,..................221
Measures and Weights,.....712
Meconium, Purging off.....545
Medicated Waters,.........727
    Wines,...............728
Modioines, Classification of-619
    Doses of..............714
Melancholy,...............376
Molons,....................69
Monorrhagia,..............513
    Acute................513
    Passive...............514
Menses, Immoderate Flow of 513
Menstruation,.............506
    Absent...............507
    Cessation of...........515
    Difficult.............511
    Excessive.............513
    Interrupted...........507
    Painful..............511
Menstruation,  Suppressed•• 509
Mentagra,........— '""*'w
Mesenteric Glands, Diseased 477
Metritis,..;---............|11
Mexican Diarrhea,.........*°>
Microscope, Value of- • • •■■ • -167
Mild Vegetable Caustic, 685,710
Mild Zinc Ointment,.......731
Miliary  Fever,............231
Milk,......................44
Milk Crust,--
Milk Fever,---
Milk-leg.......
MilkScall,.....
Milk Sickness,- •
Milk Solidified,
Milkweed,................645
     Swamp...............701
Mineral and Vegetable  Poi-
      sons, ...............616
Mineral Waters, Artificial
Minerals, Poisoning by.....616
Miscarriage,...............526
Miscellaneous, ............756
Mixture, Camphor  ........728
     Compound Cajeput,---728
     Compound Copaiba---728
     Erigeron.............729
     Greenhow's Cholera---744
     Bloodroot, Compound • • 729
     Camphor,  Compound —729
     Saline...............729
Mixtures,................728
Modes of Cooking,..........34
Molasses,......«...........51
Monkshood,...............622
Monomania,...............372
Morphia,..................677
    Sulphate of ..........677
    Valerianate of........677
Mortification,............551
Mortification, Dry........551
Mother's Cordial,..........739
Motherwort,..............673
    Compound  Pills of ---733
Mountain Pink,...........703
Mouth-bath,..............773
Mouth, Follicular Inflamma
      tion of............248
    Gangrenous Inflamma
      tion of.............251
    Inflammation of......248
    Nursing Sore.........540
    Ulcerated  Sore........250
    Ulcerative Inflammation
      of .................250
Mucilage of Gum Arabic, --657
Muguet,..................250
Mulberries,.............
Mullein,..................673
Mumps,..................253
Muriate of  Ammonia,......626
    Gold and Soda,........655
    Iron, Tincture of......750
    Soda,................696
Muriatic Acid,............661
Mushroom,  ................63
Musk, Tincture of ......-753
Mussels,..................43
Mustard,..............73, 673
Mutton,...................38'
Mutton Tea,...............38
Myricin,......•...........630
Myrrh,...................673
Myrrh, Compound Tincture 747
Lotion, Compound-
Tincture of .......
720
753
Nails, Attentions to the---144
Natural Passions,..........155
Navel, Bleeding from the  --550
    Dressing the..........545
    Excoriation of the.....550
    Rupture of the........550
Neck, Big................486
Neck of the Bladder,  Chronic
      Inflammation of  ---315
Neck, Swelled,............486
Necrosis,..................587
Negro Cachexy,...........485
Negro Poisoning,..........486
Nephritis, Acute.........301
Nephritis, Chronic ........304
Nerve Root,...............711
Nervous Diseases,......  • • 344
Nervous Headache,........427
Neuralgia,................543
Neutralizing Cordial,......740
Neutralizing Extract, fluid, 720
Neutralizing Powder,......738
Nightmare,...............394
Nipples, Excoriated........533
Nitrate of Potassa,........685
Nitrate of Silver,..........674
Nitre,....................685
Nitre, Sweet Spirits  of--698
Nitric Acid,..............674
Nitro-hydrochloric Acid,---674
Nitro-muriatic  Acid,.......674
Nose-bath,................773
Nose, Bleeding from •.....452
    Foreign bodies in......615
    Fracture of...........558
Nurse, Wet...............546
Nursing Sore Mouth,......540
Nutmegs,..............74, 675
Nuts, Oily  ................70
Nux  Vomica,.............675
    Tincture of..........753
Nymphomania,............385
Oak, Poison.........•"•• "683
Oak. White..............706
Oatmeal  Gruel,............52
Oats,......................52
Occupations, their influence
      on Health,..........159
Oil, Harlem..............714
Oil of Cajeput,............675
Oil of Olives,.............676
Oil of Stillingia,  Compound
      Liniment of........724
Oil of Turpentine,.........676
Oils, Fixed................49
Oily Nuts,.................70
Oily Seeds,................70
Ointment, Compound Lead 731
    Compound Iodine.....731
    Gondret's Vesicating
      Ammoniacal........676
    Mayer's,..............731
    Mild Zinc............731
     Acetate of Lead,......729
     Aconite,..............729
     Bayberry, ............730
     Belladonna,...........730
     Bayberry, Compound-731
     Hops,.................730 
790
INDEX.
Ointment of Oxide of Zinc, 730
    Oxide of Zinc, Comp.-731
    Poison Hemlock,......730
    Poke,................730
    Stramonium,..........730
    Sulphate of Zinc,----- 730
    Sulphur, Compound-—732
    White Hellebore,......730
    Wild Indigo,........731
    Woodsoot,............731
Ointments, ...............729
Olive Oil,................676
Onanism,.................380
Onion,................63,676
Ophthalmia,..............239
    Catarrhal,............239
    Purulent,.............241
    Purulent,  Infantile"--243
    Scrofulous............467
Ophthalmia Tarsi,.........241
Opium,..................677
    Camphorated Tine, of--744
    Tincture of...........753
Opodeldoc,................724
Oral Bath,................773
Oranges,..............OS, 677
Origanum,................678
Otitis,....................238
Oxalic Acid,..............678
Oxalic Gravel,..........-447
Oxide of Lead,  Red....... 668
Oxide of Zinc,............711
    Ointment,............730
    Ointment,  Compound--731
Oysters,...................43
Oysters, Vegetable.........62
Ozone, • •;.................22
Pack, Blanket............
Pack, Wet Sheet.........
Pagliari's  Styptic.........
Pail Douche,..............
Pain in the  Right Side dur-
      ing Pregnancy,......
Painful Breasts during Preg
      nancy, .............
Painful Menstruation,.....
Pains,  After..............
Pains,  False .............
Pains,  True...............
Painter's Colic,...........
Palpitation of the Heart, • • ■
Palsy,...................
Pancakes, ................
Pansy,...................
Paralysis,.................
Paraphymosis,............
Paregoric,................
Parilla, Yellow...........
Parotitis,.................
Parsley,..................
     Compound Infusion of
Parsnip,..................
Partridge Berry,..........
     Compound Syrup of • • •
Parturient Balm,..........
Parturition,...............
Passions, Natural.........
Passive Me norrhagia,......
Pastry,..................
Peach,................66,
Pears,  • ••'•...............■
Peas,....................■
Pennyroyal,..............
631
764

525

526
511
532
529
529
406
394
348
• 58
678
348
316
744
711
253
678
721
■ 61
678
739
739
529
155
514
-58
678
Peony,...................679
Pepper,...............74, 634
    Cayenne,.............640
    Red..................640
    Wrater...............706
Peppermint,..............679
Pericarditis,..............27
Peritoneum,Inflammation of 305
    Inflammation of, Chronic 310
Peritonitis, Acute.........305
Peritonitis, Chronic.......310
Pernicious Fever,.........198
Pernio,...................505
Persimmon,...............679
Pertussis,.................390
Peru, Balsam.............629
Peruvian  Bark,...........679
Petty-morel,..............695
Pharmacy,................712
Pharyngitis,..............247
Pharynx,  Inflammation of-247
Phlegmasia Dolens,........637
Phosphate of Iron,........665
Phosphate of Quinia,......681
Phosphatic Gravel,........446
Phosphorus,...............681
Phrenitis,.................235
Phthisis Pulmonalis,.......468
Phthisic,.................385
Phymosis,................316
Physic, Antibilious.......737
Physic, Culver's ..........668
Physic, White  Liquid.....729
Pickles,................62, 75
Pile Electuary,............718
Piles,......•.............595
Piles during Pregnancy, • • • • 525
Pills,....................732
Pills, Antidyspoptic.......732
    Cholera..............733
    Diuretic..............734
    Iodine................734
    Aconite,  Compound  - - -732
    Aloes, Compound.....732
    Assafetida, Compound 732
    Black Cohosh, Comp. -732
    Camphor, Compound "733
    Dandelion,  Compound • • 733
    Ferrocyanuret of Iron,
      Compound..........733
    High-cranberry, Comp. 733
    Hyoscyamus, Compound 733
    Leptandrin, Compound 733
    Motherwort, Compound 733
    Podophyllin, Compound 734
    Quinia, Compound.....734
    Soap, Compound......734
    Valerian, Compound-"734
Pimento,..................75
Pine Apple,................69
Pink Root,................681
Pipsisse way,..............681
Pitch, Burgundy..........637
Pitch, Canada............657
Plantain,.................682
Plants, Collecting and Dry-
      ing of..............618
Plaster, Adhesive......735, 736
    Bayberry.............734
    Common  Strengthening 735
    Compound  Capsicum, •• 735
    Compound  Lead......735
    Compound  Tar,.......735
    Irritating.............735,
Plaster, Load  ............7;;«
    Belladonna, Compound 7:ij
    Resin, Compound......7;)5
    Rod Oxide of Load • • ■ 73ft
    Kesin,................73c,
Plasters, ................. 734
Pleura, Inflammation of — 275
Pleura,  Inflammation of,
       Chronio............277
Pleurisy,.................275
Pleurisy,  Chronic .........277
Pleurisy Root,............632
Pleuritis,.................275
Pleurodynia,..............321
Plums, ...................6g
Pneumonia,..............270
Pneumonia, Typhoid......273
Podagra,.................328
Podophyllin,.............672
    Compound Pills of.....734
    Compound Powder of-7:58
    Tincture of...........754
Poison Hemlock,..........682
    Ointment of..........730
    Tincture of...........754
Poison Oak, ..............683
Poison Sumach,...........683
Poison Vine,..............683
Poisoned Wounds,.........555
Poisoning by Carbonic Acid
       Gas,  .............617
Poisoning by Minerals,.....616
Poisoning by Vegetables,- -616
Poisoning, Negro..........486
Poisons,..................616
    Mineral and Vegetable 616
Poke,....................683
    Ointment of..........730
    Tincture of...........751
Pokeroot Poultice,  ........716
Pollution, Self............380
Polypus,..................599
Pomegranate,...........'"683
Pond Lily, Whito.........707
Poplar,...................703
Pork,......................38
Porrigo Favosa,...........493
Porrigo Larvalis,..........492
Porrigo Scutulata,.........495
Porter,....................86
Potash, Caustic...........684
Potassa,..................634
Potassa and Soda, Tartrate 697
    Bicarbonate  of........684
    Bichromate of.........684
    Bitartrate of..........684
    Carbonate of..........684
    Caustic...............684
    Chlorate of...........685
    Liquor...............685
    Nitrate of ............685
    Sesquicarbonate of — 685
    Solution of...........685
Potassium,................686
Potassium, Bromide of.....686
    Cyanuretof..........686
    Iodide of............686
    Sulphuret of..........686
Potato,....................59
Potato, Sweet .............JO
Poultice, Carrot...........J15
    Charcoal.............ll\
    Elm .................J
    Lobelia,..............7» 
INDEX.
791
Poultice, PokeToot-
i::::!^:::::"::"""""^™,
71t> Prussian  Blue,--
715 Prussiate of Iron,
■ 664 Rhubarb,  Compound  Pow-
Poultryj
Powder, Diaphoretic
   Emetic.......'
   Kntozoic
                     7371 Psoriasis,..........
                     738[Ptelein,  ...........
                     738 Puddings,.........
S«.......738:P«erperal Fever,-
of Camphor, Compound 737'Puerperal Mania,-•
of Charcoal, Compound 737 Pulmonary Balsam,-
of Golden Seal, Comp.  737 Pumpkins ••;••••■
of Hydrastin, Comp. •• -737!Punctured Wounds-
of Ipecacuanha and Opi-
-664
• 498
.491
■ 694
-58
• 305
■ 542
• 740
• 688
■ 554
■ 177
     um, Compound
   of Jalap, Compound • ■
   of Leptandrin, Comp.
   of Lobelia, Compound
   of Podophyllin, Comp.
   of Quinia, Compound--738
   of Rhubarb and Potassa,
     Compound..........738
   of Xanthoxylin, Comp. -738
   Styptic...............666
   Worm................738
Powders,.................736
   Baking...............696
   Seidlitz.............697
   Soda  ................696
   Yeast................696
Pox,  ....................604
   Chicken..............230
   Cow   ................228
   Small................224
Precipitated Carb. of Iron,-665
Pregnancy, Capricious Appe-
     tite during..........526
   Constipation during — 524
   Convulsions during• • •• 524
   Cough during.........525
   Cramps during........366
   Difficulty in Urinating
     during.............525
   Diseases of............524
   Headache during......524
   Heartburn during......409
   Itching of Genitals dur
Purgatives  in Fevers,
Purging off the Meconium,-545
Purpura Hemorrhagica,
Purulent Ophthalmia,
    Infantile.......
Pussy Willow,.......
Putrid Sore Throat,-
Pyroligneous  Acid, ••
  der of..............738
Compound  Tincture ot-747
ing
•525
   Pain in the Right Side
     during.............525
   Painful Breasts during-526
   Piles during..........525
   Retention of Urine dur-
     ing ................525
   Suppression  of  Urine
     during.............525
   Swelling of Limbs dur-
     ing ...............525
   Varicose Veins during-525
   Vomiting during......410
Preparation of Food,........34
Prepared Chalk,...........070
Preserves,..................75
Prickly Ash,............
   Henries, Tincture of---754
   Compound Clyster of--723
Prickly Elder,.............687
   Tincture  of...........754
Prim,....................688
Princos' Pine,.............681
Privet,...................688
Prognosis of FobrileDiseuses 176
■Prolapsus Ani.............597
Prolapsus of tho Womb,---522
Protoxido of Iron,.........665
Prunes..................66
Quality of Food,.........
Quantity of  Food,........
Quassia,.................
Queon of Meadow,........
Queen's root,.............
Quince,.................
Quinia, Compound Pills of-
    Compound Powder of-
    Phosphate of.........
    Sulphate of..........
    Valerianate  of.......
Quinsy,.................
689
-67
734
738
681
680
681
245
Ribs, Fractures of
Rice,  ...............
Riekets,.............
Ringworm,............
    of the Scalp,.....
Roasting,............
Rochelle Salt,.........
Roche's Embrocation,-
Rock  Brake,.........
Rock Rose,...........
Rosemary,...........
Rosewillow,..........
Rosin,...............
Round-Leaved Pyrola,
Rue,................
Rubbing  Sheet,......
Rum,  ...............
Rupture,............
    of the Navel,.....
Rye,......;.........
    Spurred,.........
■ 368
■ 479
-62
Rabies Canina,......
Rachitis,  ...........
Radish,.............
Raising Children by Hand, -546
Raisins,...................68
Raspberry,.............69, 633
Rattle root,...............633
Rectum, Stricture of.......600
Red Cedar,................689
    Chickweed,...........689
    Clover,...............689
    Currants,..............67
    Gum,................549
    Lead,.........■
    Oxide of Iron,.........665
    Oxide of Lead,-
    Oxide of Lead Plaster,-736
    Pepper,...............640
    Root,.................689
    Rose,..........
Remittent Fever,..........191
                  ........212
 565
-•53
■ 479
 491
• 495
-35
■ 697
• 624
■ 691
• 652
•691
• 701
•690
• 691
• 691
• 763
• ■92
■ 601
•550
-53
•649
Saffron,
• 691
    Compound  Infusion of -722
Sago, .....................59
Sal Ammoniac,............626
Saleratus,................685
Salicin,...................709
Saline Mixture,...........729
Saline Wash,.............727
Salsify, ...................62
Salt,..................71,696
Salt of Tartar,............684
Saltpetre, ................685
Salt, Rochelle.............697
Salt Rheum,..............491
Salts, Glauber's...........696
Salve, Black..............736
Sanguinarin, ■
Sanguinarina,...........
Sarsaparilla,............
    Syrup, Compound • • •
Sassafras, ..............
Sauces,.................
Sausages,..............
Savin,................•
Scabies,...............■
Scald Head,...........•
Scalds and Burns,.......
Scalp, Ringworm of.....
Scammony,............
Scarlatina, ••..........
Scarlet Fever,.........
Sciatica,...............
Scorbutus,.............
Scrofula,..............
Scrofulous Ophthalmia,-
Scrofulous Syrup,......
Scrotum, Dropsy of  the-
Scullcap,..............
Scutellariae,  ..........
Scurvy,...............
     Land..............
Sea Sickness, ■
    Infantile
Resin,
    Cerate,...............717
    Plaster,..............736
    Plaster, Compound.....735
Restorative Wine Bitters,-728
Retention of Urine,........440
    during Pregnancy,.....525
Rhatany,.................690
    Tincture of...........754
Rheumatic Liniment, "724, 745
    Tincture,.............745
Rheumatism, Chronic......325
    Inflammatory.........320
Rhubarb,..............64,690 Secondary Syphilis,
    and Potassa,  Compound    Seeds, Oily.......
       Powder  of..........738 Seidlitz Powders,..........697
    and Potassa,  Compound    Self-Pollution,............380
       Syrup of...........740 Seneca Snakeroot,.........693
    and Potassa,  Fluid Ext. 7201 Senecin,.................669
635
635
692
740
692
• 75
•39
692
498
493
■613
•495
■693
■ 215
•215
■321
•482
■464
•467
•741
•343
■693
•693
■482
■481
•410
•607
-70 
792
INDEX.
Seneka-.................693
    Syrup of.............742
Senna,...................694
    American.............625
    Compound Clyster of--723
    Comp. Confection of- -718
    Comp. Electuary of---718
    Compound Tincture  of -747
Sesquicarbonate of Potassa,-685
Sesquioxide of Iron,.......665
Seven Barks...............660
Shallot,---...............63
Sheep Laurel,.............694
    Tincture of...........754
Sheet, Dripping...........763
    Rubbing..........••••763
Shingles,.............491
Shoulder, Dislocation of— — 575
Shoulder-blade,Fracture of-561
Shrubby Trefoil,..........694
    Tincture of  ..........755
Sick Headache, ...........427
Sick Room, Fumigation of — 137
Sickness, Milk.............419
    Sea..................410
Signs of Disease in Infants,
      External ...........548
Silkweed,  Common........645
Silver, Ni trate of..........674
Simple Cerate,............718
    Dislocations,..........571
    Fractures,............556
    Incised Wounds,.......552
    Syrup,...............741
Sinew, Weeping.......— ■ • 589
Singultus,................392
Sitz Bath,...........773—774
Skin, Diseases of..........491
Skunk Cabbage,...........695
Sleep,....................117
Slippery Elm,.............695
Small Pox,................224
Small Spikenard,..........695
Smartweed,...............706
Smoked Beef,..............37
Snakeroot, Button........
    Seneka...............693
    Virginia..............705
Snakes, Bites of...........555
Soap,................133,695
    Castile...............695
    Compound Pills of.....734
Soda, Bicarbonate of.......696
    Borate of.............696
    Compound Lotion of" -727
    Hyposulphite of.......697
    Muriate of............696
    Powders,.............696
    Supercarbonate of.....696
    Sulphate of...........696
    Sulphite of...........697
Sodium,......'•...........695
    Chloride of...........696
Solania,..................632
Solidified Milk,...........44
Solomon's Seal,............697
Solution of Iodide of Iron,- -725
    of Iodine, Compound- -725
    of Potassa,............725
Solutions,................725
Soot,...................697
Sore Mouth, Nursing.......540
    Nipples,..............532
    Throaty Clergyman's- -256
Sore Throat, Inflammatory-245
    Throat, Putrid........247
Soup,  Chicken.............42
Soups, ....................43
Sour Krout,................60
Spanish Flies,.........639,697
    Tincture of..........755
Spasmodic Cholera," ••-• "412
Spearmint,  ...............698
Spermaceti,...............698
Spermatorrhea,............384
Sphacelus,................551
Spider's Web,.............698
Spigelia  and Senna, Fluid
       Extract  of..........720
Spikenard,................695
    Compound Syrup of— -740
    Small................695
Spirit of Ammonia, Aromatic 744
    of Nitric Ether,........698
    Vapor Bath,..........698
Spirits of Hartshorn,.......626
    of Lavender, Compound 747
    Turpentine,...........676
Spleen, Chronic Disease  of-299
    Chron. Inflammation of-299
    Inflammation of.......298
Splenitis,.................298
Sponge,..................699
    Bath,................761
    Burnt................
Spotted Fever,............211
Sprains,..................586
Spruce Beer,..............
Spurge, Large Flowering— -667
Spurred  Rye,.............649
Squill,...................699
    Syrup of.............742
    Vinegar of •...........756
St. Anthony's Fire,........232
St. John's Wort,..........692
St. Vitus' Dance,..........363
Starch,....................50
Stewing,..................36
Stiff  Joint,................585
Stillingia,................689
    Compound  Liniment of
      Oil of..............724
    Compound  Syrup of—-741
Stimulating Eye Water, • • • • 726
Stomach, Bleeding from•• • ■ 455
    Chron. Inflammation of 281
    Cramp in.............366
    Inflammation of.......280
Stomatitis,...............248
Stone,....................444
Storax,...................700
Stramonium,............• • 700
    Ointment,............730
    Tincture,.............755
Strangury,...............440
Strawberry,................69
Strengthening Plaster, Com. 735
Stricture of the Urethra,- -609
    of the Rectum,........600
Strong Veg. Caustic,--685, 716
Strophulus Intertinctus,---549
Strychnia,................675
Stye,....................503
Styptic, Pagliari's.........631
Styptic Balsam, Warren's--715;
Styptic Powder,...........666,
Subacetate of Copper,......645|
Subnitrate of Bismuth. ••••632
 Substances in the Windpipe-,
       Nose, or Ears,.......615
 Suckling of Infants,.......545
 Sudorific Tincture,........74s
 Sugar,....................50
 Sugar of Lead,...........668
 Sulphate of Coppor,.......645
    Iron,.................666
    Iron, Dried...........666
    Magnesia,  ............671
    Morphia,.............677
    Quinia,...............680
    Soda, ................69^
    Zinc,.................712
    Zinc, Ointment of.....730
 Sulphite of Soda,..........697
 Sulphur, .................700
     Compound Ointment of 732
    Flowers of............700
    Liver of..............686
 Sulphuret of Potassium,- -686
 Sulphuretted Hydrogen, — 47
 Sulphuric Acid,...........700
 Sumach"^ .................701
    Poison •••............683
 Summer Complaint,.......423
 Sunflower,...............701
 Sunpain,.................186
 Suppressed Monstruation,--509
 Suppression of Urine,......438
    during Pregnancy,.....525
 Surgical Diseases,.........551
 Swamp Dogwood,.........701
    Milkweed,............701
 Sweating Blanket,.........768
 Sweet Fern,..............702
    Flag,.................702
    Gum,................702
 Sweetmeats,...............75
 Sweet  Potato, .............60
 Sweet  Spirits of Nitre, ••••898
 Swelled Breasts during Preg-
      nancy, ............ 526
 Swelled Neck,............486
 Swelling, White..........477
 Swelling of  Breasts in  In-
      fants, ..............550
 Swelling of  Limbs during
      Pregnancy,  ........525
 Sycosis Menti,............496
 Sympathetic Bubo,........319
 Symptoms of Febrile Dis-
      eases, ..............173
Syncope,.................392
Syphilis,.................604
Syphilis, Constitutional — 607
Syphilitic  Warts,.....319,504
Syrup, Alterative.........740
    Lemon...............741
    Balsam Peru,.........741
    Garlic................742
    Ginger,...............742
    Ipecacuanha,..........742
    Partridge-berry, Comp. 739
    Rhubarb  and  Potassa,
      Compound..........740
    Sarsaparilla, Compound 740
    Seneka,-- ..........742
    Spikenard,  Compound  740
    Squill,--............J42
    Stillingia, Compound ■■'41
    Tolu,  ...............742
    Wild Cherry,.......-743
    Yellow Dock, Compound 74J 
INDEX.
795
Syrup, So of i.
   Simplo
Syrups .....
Tacamahac,
Tag Alder,-
Tamarac,
• 741
 741
■ 739

 628
• 702
■ 625
Compound Tincture of 748
 Tamarinds,................70
 Tannic Acid,..............702
 Tannin,..................702
 Tansy,...................703
 Tar,-....................703
 Tar Plaster, Compound---735
 Tartar, Cream of..........684
 Tartar, Salt of............684
 Tartaric Acid,............703
 Tartrate of Iron and Quinia, 666
    Potassa and Soda,.....697
 Tea,......................80
 Tea, Beef.................37
 Tea, Mutton...............38
 Tcoth,  Attentions to the --31
 Temperaments,.............10
 Tetanus,..................367
 Tetter,...................491
 Thigh-bono, Fracture of — 566
Thimble Weed,...........703
Thorough wort,............636
Thrush,..................248
Thrush, White............250
Tic  Doloreux,.............543
Tinoture, Acetous Emetic--744
    Antispasmodic........747
    Golden...............746
    King's Expectorant---747
    Acetate of Iron,.......749
    Aconite Root,.........749
    Arnica,...............749
    Assafetida,...........749
    Assafetida,  Compound 745
    Belladonna,...........749
    Benzoin,..............750
    Benzoin, Compound •• -745
    Black Cohosh,........750
    Black Cohosh, Comp. -745
    Bloodroot,............750
    Bloodroot,  Compound
     Acetated...........744
    Blue Cohosh, Comp. •• -745
    Blue Flag,............750
    Camphor,.............750
    Camphor, Compound • • • 745
    Cantharides,..........755
    Capsicum,............750
    Capsicum, Compound • • 747
    Castor, Ammoniated • • • 744
    Catechu,.............750
    Chloride of Iron,......750
    Cinnamon,............751
    Colchicum, Compound  746
    Colchicum Seed,......751
   Conium  Maculatum,- • -754
   Cotton Bark,..........751
   Digitalis,.............751
   Ergot,................751
   Gelseminum,..........752
   Gontian,........•.....752
   Gentian, Compound -"746
   Ginger,...............752
   Golden Seal, Compound 746
   Grains of Paradise,---752
   Guaiacum, Aromatic --744
   Guaiacum, Volatile ■••756j
 Tincture of Hemlock,  .....752
     Hemlock,  Compound • • • 746
     Henbane,.............752
     High-cranberry, Comp. 746
     Hyoscyamus,........
     Iodine,.............
     Iodine, Compound- ■•
     Lavender, Compound
     Leptandrin, ........
     Lobelia,............
     Lobelia and Capsicum,
       Compound..........747
     Lobelia, Compound---747
     Lupulin,  ...........
     Muriate of Iron,
     Musk,..............
     Myrrh, ............
     Myrrb, Compound ••
     Nux Vomica,  ......
     Opium,............
     Opium, Camphorated
     Podophyllin,........
     Poison Hemlock,......754
     Poke,................754
     Prickly-Ash Berries, • • 754
     Prickly Elder,........754
     Rhatany,............754
     Rhubarb, Compound "747
     Senna, Compound  ""748
     Sheep Laurel,........754
     Shrubby  Trefoil,......755
     Spanish Flies,........755
     Stramonium,..........755
     Tamarac,  Compound "748
     Tolu, ................755
     Toxicodendron,........755
     Virginia Snakeroot, • • • 748
     White Hellebore,......755
     Yarrow,..............755
     Rheumatic...........745
     Sudorific.............748
 Tinctures,................743
 Tinea  Capitis,............493
 Toast Water,..............79
 Toasted Bread,............58
 Tobacco,..................703
 Toe3, Dislocations of......578
 Tolu, Balsam.............629
     Syrup  of............743
     Tincture of  .......... 755
 Tomato,..................62
 Tongue in  Fevers,........182
 Tonsils, Enlarged..........488
 Toothache,  ................32
 Tooth  Washes,............32
 Towel-bath,..............761
 Trailing Arbutus, ........703
    Compound Infusion of  722
 Treatment after  Delivery, • • 532
 Treatment in Fevers, Auxil-
      iary................180
 Trichosis Furfuracea,......495
 Trisnitrate  of  Bismuth,---632
 True Labor Pains,..... -529
 Tulip Tree,..............703
Tumors,..................598
Turkey Corn,..............701
Turn of Life,  ............515
Turner's Cerate,..........717
Turnip, ..................61
Turnip, Indian............662
Turpentine, Spirits of • • • •  676
    Venice..............705
    White  ..............707
Turtle,....................43
Twin Leaf,...............704
Tympanites,..............428
Typhoid  Fever,.........  -207
Typhoid  Pneumonia,......273
Typhus  Pever,............204

Ulcerated Nipples,.........533
Ulcerated Sore Mouth,.....250
Ulcerative Inflammation of
      the Mouth,..........250
Ulcers,...................590
Umbilioal Hernia,.........550
Unicorn Root,.............704
Unicorn Root, False  ......658
Upper Arm,  Fracture of — 562
Urate of Ammonia Deposits, 449
Urethra, Inflammation of --315
    Strictures of the......609
Uric Acid Gravel,.........445
Urinary Organs, Diseases of 432
Urination, Difficulty of dur-
      ing Pregnancy,......525
Urine, Bloody............456
    Incontinence of........442
    Retention of..........440
    Retention of during Preg-
      nancy, ..............525
    Suppression of........438
    Suppression of during
      Pregnancy,.........525
Uroscopists,..............154
Uva Ursi,................704
Vaccination,..............228
Valerian,................704
    Compound Pills of.....734
Valerianate of Bismuth,---632
    Morphia,.............6.77
    Quinia, ..............681
Vapor-bath,..............769
Vapor-bath, Spirit........698
Varicella,  ................230
Varicose Veins during Preg-
      nancy, .............525
Varioloid,................226
Veal,.....................41
Veal Broth,...............41
Vegetable Acids,  .......  "71
Vegetable Caustic, Mild 685,716
    Strong...........685,716
    Gilbert's..............464
Vegetable Diet,............49
Vegetable Gluten,..........49
Vegetable Oyster,..........62
Vegetable Poisons,........616
Venereal Disease,........604
Venereal Warts,......319, 504
Venice Turpentine,........705
Venison, ..................38
Ventilation,...............16
Verdigris,................645
Verrucca,.................503
Vertigo,..................393
Vervain,.................705
Vine, Poison  .............683
Vinegar,..............72, 705
Vinegar of Lobelia,.......756
Vinegar of SquiU, ........756
Vinegars,................756
Virginia Snakeroot,.......705
    Compound Tincture of 748
Vitriol, Blue..............645
    Elixir of..............748 
794
INDEX.
Vitriol, Green.............666
    White.................712
Volatile Tine, of Guaiacum, 756
Vomiting,................410
Vomiting during Pregnancy, 410
Advice to Nurses,.............184
Advice to  People in  the
       Country,.................186
Ague  Bitters,..............21,191
Anodyne Balsam,..............757
Apparent Death from Liq-
       uor,......................101
Ayer's Cherry Pectoral,......757
Baldness, to cure...............141
    Causes of.............106,139
Belly-band of Babes..........545
Blistered Feet,..................143
Brandreth's Pills,..............756
Bute's Rheumatic Liniment,.756
Care of Sick-room,......136, 137
Children need  Air and Ex-
       ercise,......................17
Cleanliness of  Infants,.......547
Cough, to cure.....273, 657, 701
Dressing the Child,......545, 546
Dyspepsia, to cure.............400
Exercise of Infants,...........547
Fahnestock's Vermifuge,....758
Falling of the  Palate,.......654
Feeding Infants,...............546
White Hellebore Ointment, 730
    Tincture of...........755
White Indian  Hemp,......701
    Liniment,............725
    Liquid Physic,........729
    Oak,.................706
    Pond  Lily,-..........707
    Swelling,.............477
    Thrush,..............250
    Turpentine,...........707
    Weed,...............707
    Vitriol,...............712
Whites,..................518
Whitlow,.................588
Whortleberries,........67, 707
Wild Carrot,..............707
    Cherry,...............708
    Cherry, Syrup of......743
    Ginger,...............708
    Indigo,...............708
    Indigo Ointment,.....731
    Yam,  ................708
Willow,..................709
    Black................634
    Pussy ...............634
    Rose.................701
Windpipe, Chronic Inflam-
       mation of...........264
    Inflammation of.......262
    Substances in.........615
Wine,.....................88
Wine Bitters,.............728
Wine Bitters,  Restorative •• 728
Wine of Comfrey, Comp. -728
    Golden Seal, Comp. -• -728
Wines, Medicated.........728
Wintergreen,.............709
Witch Hazle,.............709
Womb, Bleeding from.....534
    Falling of •"...........522
    Hemorrhage from.....534
    Inflammation of......311
    Prolapsus  of..........522
Women, Diseases of.......506
Woodsoot,................697
Woodsoot  Ointment,......731
For Distress after Eating, ..401
For Liver Complaint,.........297
For Rheumatism,..............327
For Spasms, Asthma, ctc.,...659
Fretting of Infants,...........547
Hair Oil,.........................140
Hair Pomatum,................140
Hibben's Nerve and Bone
      Liniment,...............757
How to select a Wet  Nurse,.546
Imprudent use of Cold Wa-
      ter, to remedy..........77
Infants should use no  Sugar,.546
Kitridge's Cough Drops,.....758
Liniment for Painful Affec-
      tions, .....................642
Mothers andDaughters,......507
No Fluid at  Meal Times,......77
Ointment for Chapped Lips,.655
Pill for Liver Complaint,....635
Pitting  in  Small Pox,  to
      prevent..................228
Preparations  for cleansing
      Teeth...................2,83
Putting the Child to Breast,.545
Worm  Powder,............733
Worms, ..................420,
Worms in tho Skin,........501
Wormseed,...............709
Wormwood,...............709
Wounds,.................552
    Contused,............554
    Gunshot,.............554
    Lacerated,............554
    of Arteries,...........553
    Poisoned.............555
    Punctured,...........554
    Simple Incised,.......552
Wrist, Dislocation of......578
    Fractures of..........565

Xanthoxylin,..............687
    Compound Powder of-738

Yam, Wild...............708
Yarrow,..................710
    Tincture of...........755
Yaws,...................484
Yeast,....................710
Yeast Powders,............696
Yellow Dock,.............710
    Compound Syrup of • • -741
Yellow Fever,............199
Yellow Gum,.............549
Yellow Jessamine,.........710
Yellow Ladies' Slipper, — 711
Yellow Barilla,............711

Zinc, Chloride of..........711
    Compound Lotion of-- -726
    Impure Carbonate of -711
    Iodide of ............ 711
    Mild Ointment of......731
    Ointment of Oxide of-730
    Ointment of  Oxide  of,
      Compound..........731
    Ointment of Sulphateof 731)
    Oxide of..............711
    Sulphateof  ..........712
Rules for the Eyes,............148
School-rooms should be ven-
      tilated, .................. 17
Spectacles, to select...........149
Sunflower Syrup,...............701
Sweet's Rheumatic Wash, ...758
To check severe Bleeding
      from a Cut,............558
To cure Toothache,............ 83
To detect fraudulent Vine-
      gar,.........,............. 72
To  manage  those  with
      broken Bones,.........557
To purify the  Air in Sick-
      rooms,....................13"
To remove the  Odor from
      Privies,...................1'
To remove unpleasant Odor
      from Feet,...............143
Tonics for Drunkards' Stom-
      achs,.......................74
Turlington's Balsam,.........758
Washing the new Babe,......545
Weaning the Child,..........547
Worm Remedies,........431,432
Wafer Ash,...............694
Walnut,  Black............638
Warm and hot Fomentations,776
Warm Bath,..............132
Warren's Styptic Balsam,-715
Warts,...................503
Warts, Venereal......319, 504
Wash, Alkaline...........726
Wash, Cooling............726
Wash-down,..............761
Wash, Saline.............727
Wash-tub Bath,...........762
Washes,.................726
Washes,  Tooth.............32
Washing the Child,........545
Water,....................76
    Barley,................52
    Brash,................407
    Camphor,............727
    Hemlock,.............683
    Lime.................670
    Melon,...............706
    Pepper,...............706
    Toast.................79
Waters, Artificial, Mineral, • • 80
    Medicated............727
Wax,....................706
Wax, Bayberry...........630
Weaning the Child,.......547
Weeping Sinew,..........589
Weights and Measures, •• "712
Wens,....................598
Wet Compresses,..........778
Wet Girdle,..............778
Wet Nurses,..............546
Wet Sheet Pack,.........776
Wheat,....................51
Whey,....................80
Whisky,...................93
White Hellebore,•••■  .....706
SUPPLEMENT  TO  THE  INDEX.
END OF DIVISION I. 
HOUSEHOLD    DEPARTMENT.
DIVISION   II.
                        REMARKS.

  From the fact that so many persons reside where it  is difficult to
immediately procure some of the remedies recommended in  the first
Division of this work, especially those living in country places, who are
frequently many miles from a physician or drug-store, and, as my great
object is, to make the present volume one of service and practical util-
ity to all persons, wherever they may dwell, whether in  cities, towns,
or country places, I have deemed it best to prepare a second Division,
from which any person—one who can barely read—will be enabled to
treat most diseases  promptly and successfully; and I sincerely trust
that its pages  may be found of great advantage,  not only in saving
many expensive doctor's bills, but also in being a means of preventing
much sickness, suffering, and pain, and of preserving many valuable
lives, which might otherwise have met with an untimely end.
  In preparing this Division of the Physician, it will be perceived that
I have not confined myself within  any limit, save  that of usefulness.
I have not selected my  medicines  from the Materia Medicas of the
profession alone, but have recommended many of those  excellent and
efficacious articles which were so  successfully  employed in  cases of
disease by the old female nurses  of past years, and by the good moth-
ers of our early childhood.  These  articles may mostly be found either
in the kitchen, the pantry, the garden, the fields, along the roadsides,
or in the woods, throughout our country; they are simple, safe, and  *
harmless, yet will prove of immense advantage in breaking up disease,
if applied in season.
                                                    (D 
2
AMERICAN FAMILY PHYSICIAN.
  It must be recollected that, the more simple the agent which is suc-
cessfully used to arouse nature to a healthy action, when disease is in
the system, the better it is for the patient.   By  all means, therefore,
give the safe  and natural remedies,  herein  recommended, a fair and
timely trial, and do not tarry until the favorable period for breakinir
up disease has passed;  with  the appearance of the first  symptom of
sickness commence the remedy.  Some persons are in the habit of per-
mitting a disease to remain upon them for several days after the first
symptoms  have appeared,  without  adopting any remedial means to
remove it, probably trusting  to the  powers of nature alone for  their
cure; but,  although  such a course is occasionally pursued with im-
punity, it is a very dangerous one,  because, should the powers of the
system unfortunately be not sufficiently energetic to throw off the
malady, this will become much more severe and  obstinate in its char-
acter, as the most favorable time for aiding nature to expel it, that is,
at its commencement, has been lost.
  Again,  persons often  neglect calling in the aid of a physician in the
early stages of illness, from  a fear that he  may use such active and
powerful medicines as will render their malady much more severe in its
character, and they greatly prefer  trusting, at least for a few days,
to the unaided  efforts of nature.  But if  such persons will use the
simple means  herein  advised,  they may almost certainly arrest disease
at its very  outset, thus running no  risk whatever.  No fear need be
entertained  concerning these  agents;  they can not possibly harm any
one, even should they be used in diseases different from those in which
they are recommended.
  The great mass of people  have a mistaken idea in relation to the
administration of medicines, and the removal of disease.  They imagine
there is something sublimely grand and deeply mysterious in the prac-
tice of medicine, and  they consequently fear to make use of the means
to cure themselves—a much-to-be-regretted opinion!  There are four
grand principles recognized by most physicians  in the treatment of
acute diseases, to wit:
  1. The administration of emetics to produce free vomiting, not so
much for  the  removal of unhealthy matters  from the stomach, as to
create a shock upon  the whole nervous system, arousing it in such a
manner as to enable it to supply all diseased parts with the power nec-
essary  to throw off the disease.  From this cause we frequently see
most serious complaints  at once arrested in their  course by the timely
administration of a thorough emetic.
  2. Cathartics, whether given by mouth or  by injection,  not only 
HOUSEHOLD DEPARTMENT.
3
 remove all unhealthy accumulations from the bowels, but also impart a
 species of shock to  the  system, by draining it of more or less of its
 fluid materials,  at the same  time, as it were, drawing  or determining
 the disease from its location, and thus aiding in breaking it up.
   3. Sudorifics, or agents that produce sweating, whether they be used
 internally or externally, open and relax the pores of the skin, enabling
 them to discharge an immense amount of unhealthy matters from the
 system,  and  which is generally followed by a relief of all the severe
 symptoms, if not by a complete breaking up of the  disease itself.  In
 connection with this, may be named bathing the surface of  the body,
 which removes all unhealthy substances  therefrom, stimulates the skin
 and its vessels  to a new action, and aids the action of the sudorific,
 thereby lending an immense influence to the means already named for
 curing disease.
   4. Diuretics,  or agents which increase and improve the character of
 the  urinary discharge, and thus aid in eliminating poisonous and un-
 healthy  substances from the system.
   In all acute  diseases, one or all of these several means or  prin-
 ciples may be adopted  at their  commencement, before the  patient's
 strength has  become reduced, with perfect safety as well as with every
 probability of success;  and that, too, by even  a person not educated
 in a medical  school.   The  only thing required is  not  to  overdose,
 neither to purge too  much, vomit too much, nor sweat too much, and
 this, it would seem, every person of common sense will readily under-
 stand; if not, let them  follow the directions given in this work as to
 the doses of  medicines,  and  the diseases in which they may be used,
 and  it will be impossible for them to  go amiss.   Certainly, a person
 ought as soon to learn the quantity of medicine required to cause its
 peculiar action upon the system, as to ascertain  how much  food can
 be eaten without injury.
  This Household Department  of  the work will be found to  contain a
 plain statement of the ordinary causes of disease, and the reasons why
 diseases  are produced by them.  Rules  are also given as to  the man-
 agement  of the sick-room, and  the proper qualifications of nurses.
 Acute as well as chronic diseases, and all the more common ailments
 of the present day  are referred to, and their simple household treat-
 ment given in language most easily to  be understood by any one; and
 the full  and complete Glossary which  follows is  composed  of words
 entering into both divisions of the work, many of which  are thoroughly
understood by readers, but which it was  judged best to explain here,
in order to avoid any trouble in case one should—as is often the case 
4
AMERICAN FAMILY PHYSICIAN.
with the  best  educated persons—happen, for the time, to forget the
exact meaning of some particular words.  The Index which closes this
division of the work will be found thorough.
  The idea so strenuously promulgated  and sustained by many self-
interested persons, that the people  are  too ignorant to understand
medical subjects, or to  attend to themselves in times of sickness, is
absurd in  the extreme.  Every person is capable of doing much toward
curing disease,  even with the most simple means.  Show me a woman
with a reasonable amount of common sense  who would not be able to
attend to  all ordinary cases of disease in  her own family, provided she
is prepared with a  reliable domestic medical work to consult, and I
will, in return,  show a natural curiosity.  ■
  I am acquainted with a very excellent lady, a wife and mother, who
has, in spite of the prejudices of her relatives, prepared herself to
both nurse and treat disease, when  any of the members of her own
family were attacked by it.  Many obstacles and embarrassments were
thrown in her way by  her relatives,  who were unable to  fathom that
deep love and tender solicitude which induced her to thus undertake
educating herself.   But she  has said to me repeatedly, that  she did
not regret having persevered  to the  end.
  And why  did she not regret this?   Because she had  learned the
falsity of that  view which  makes  of woman a mere enchanting toy,
with whom to pass an idle hour; because she had ascertained her true
mental strength, and had recognized higher spheres in which the intel-
lect of woman  could properly and profitably  range—had learned to
control her feelings  and passions, and to regard objects in their  true
light;  because she had  discovered that to assume the position assigned
to her by her Creator as an help-meet to man, to render  him as well
as herself happy, contented,  and blessed, the most important step is
to educate the  mind, to elevate it  above  mere  sensual  and animal
gratifications.
  Our tenderest years are passed under the guidance and instructions
of our maternal parent, and the impressions then received remain
stamped  upon the mind forever—we  do not readily forget them; and
according to the character  and disposition  of the woman whom we
delight to call mother, will our own course and bearing through life be
regulated; hence, woman is truly said to  rule the world;  and that she
may wield her influence  to our best interests, how imperatively essential
is it that she possess a  refined and cultivated mind.
  Look  at  that aged man whose  locks have been bleached by the
influence  of fourscore years, and whose mind  has become so impaired by 
HOUSEHOLD DEPARTMENT.
5
 the destructive finger of time, that the incidents of the hour are alieady
 nearly forgotten; yet observe how vivid are his recollections of child-
 hood—he recalls them with feelings of delight. The lessons of boyhood,
 the precepts, the examples of his mother arise  as brightly before hi3
 failing perceptions as though they were but the occurrences of yester-
 day ;  they are indelibly engraven upon his brain, to be remembered in
 time, to  be glorified in eternity.  His walk and bearing through life
 have  been regulated and controlled by those early instructions,  and
 he in turn has exerted his influence, for good or for evil, as the case
 may be, upon the community who have hovered around him.  Through
 him the world has felt and acknowledged female power, which, although
 operating silently and invisibly, yet holds every knee  in  respectful
 submission.
   How important  is it, then, to have our women properly educated,
 and especially in those matters which leave a lasting impression upon
 thc mind.   The sick  husband prefers  the kind voice  and soothing
 hand  of his wife; the diseased son expects his mother's attentions,
 and confidently hopes  for a cure therefrom, and while  she is  reliev-
 ing him from racking pains, his whole  soul  expands,  as it were, to
 more  thoroughly envelop her with his never-dying love; the suffering
 daughter confides her  wants  and desires only to a mother's ear,  and
 the draught administered by that parent's hand is of a hundred times
 more efficacy than when presented by a  stranger.
  Why should not our wived  and mothers know how to  nurse,  and
 treat ordinary disease?  What husband  is there who would not prefer
 a thousand times the  attentions of an  educated woman toward  his
 afflicted wife, rather than those of a male?   What father who would
 not rather that  she should listen to the symptoms, and relieve  the
 sufferings of his invalid daughter?  What brother, who would not have
 a lovely sister, in failing health, advise with  the educated and reputable
 woman?  What female is there  in society  so lost to modesty, and to
 the sacredness  of her own sex, as to hesitate  in receiving with open
and confiding arms the intelligent and  pure-minded female, to nurse
and treat her in  sickness?   Reader,  I  leave  the reply to your  own 
AMERICAN FAMILY PHYSICIAN.
PUBLISHERS'  ADDEESS.
   This, above all past ages, is decidedly one of progressive improve-
ment.  Every conceivable idea, invention, material,  or enterprise that
will in any way increase or promote the wealth or  happiness of man
is eagerly sought after, and grasped with an  unshrinking hand.  Thus
the sickle of olden times has long  since given way to  the modern
reaper, with which  the  docile horse paces  along, unconscious of the
rapidity with which he is gathering,  at each advancing step, the cereal
plants, the grains of which, ere  one short moon  shall  have rolled
around, will  have fed millions in far distant lands.   Again,  steam now
takes  the place of the  toilsome laborer, who  formerly wrought pa-
tiently and slowly, with the large drops  of  perspiration  oozing  from
every pore, to separate the chaff from the wheat; but now, as though
infuriated  with passion, that powerful and tireless servant which has
been made subservient to the will of man, unconscious of its boundless
and inexhaustible strength, travels over the fertile  fields  and plains,
not only fitting the  soil for seed-time, but even  wielding the sickle for
the harvester, the flail for the thrasher, and removing the chaff from
the wheat for the winnower.   Nor does it stop here: it  propels the
iron horse at the terrifying  rate of  almost lightning speed over hills,
valleys, and mountains, through dark and dreary tunnels,  across  deep,
fearful ravines, and broad and turbulent  rivers.   On, on it goes, as if
bent  upon death and destruction, puffing and snorting  with apparent
rage, when in reality it is only performing the charitable and benevo-
lent mission  of carrying food to the hungry, clothing to the naked, and
friends to their homes and firesides.   It drives immense floating pala-
ces across the briny deep with incredible rapidity, and is the  great
medium of our national  commerce.    The iron  mills of Birmingham,
and the cotton  looms of Great  Britain are all driven by its gigantic
Dower. 
HOUSEHOLD DEPARTMENT.
7
   The electric fluid, that causes the vivid lightning with all its de-
 structive powers, has been brought into subjection by human ingenuity,
 and compelled to convey instant intelligence  to the  most distant and
 remote points of civilization.  The inmost recesses of old mother Earth,
 and the  bosom of the  briny and raging  deep, have been explored and
 made to yield a portion of their  exhaustless wealth to swell the mighty
 tide of human fortune.
   But, above all, the cultivation of the intellect is a  source from which
 far more precious  gems of boundless wealth and  human happiness
 have been obtained than from  all the others combined—and may we
 not  safely assert that  this source is also an inexhaustible one?   Yet,
 while we are taught to enter the fathomless space of the heavens, and
 measure  the  dimensions and distances of the  countless orbs surround-
 ing us—while we are taught to  estimate, with fractional exactness, the
 orbits and the distances traveled by the sun,  moon, and stars, as well
 as to understand the various laws by which these planets are governed
 —an investigation  and comprehension of those simple yet all-import-
 ant  laws  which  regulate our  physical  systems have  been  entirely
 neglected.   If we converse with men upon any other subject,  espe-
 cially if it be  associated with money-making, we would be led to believe
 they were all professors; but if  we speak to them upon the causes and
 cure of disease,  a change is  instantly observed, and they are either
 confined to generalities alone, or (which is more commonly the case)
 they are  as silent  as mutes.  Why this is  so  is beyond our compre-
 hension, as there is certainly nothing in  this world for which man will
 pay more than for health.   Let the man of wealth become prostrated
 by disease, with strong apprehensions of death, and  he will cheerfully
 yield his  fortune, to the very last farthing, to whoever will restore him
 to the enjoyment of good health and long life; yet if we examine this
 man's library, m nine cases out  if ten, though there may be numerous
 Works upon literature, law, politics, religion, and many of the sciences,
 yet we will not be able to find a single  volume devoted to the highly
 important subject of preventing and  curing  disease, and promoting
 health and longevity.
  In many instances this is owing to  the oft-repeated assertion of
 the so-called  physicians throughout the country,  (whose disinterested-
ness, of course, can not  be called in question,) that " the common people
arc too ignorant to understand the subject;"  which  is very  much
according to the  plan adopted by the priests in certain religions, who
teach their  deluded followers that as they are too  ignorant to  pray,
they  (the priests) will  do all their praying for  them, and for which 
8
AMERICAN FAMILY PHYSICIAN.
they are fully as exorbitant in their charges as are many of the medical
quacks  of the present day.   Are not these two cases, above referred
to, a fair  representation of the existing facts?
  A very natural question  here suggests itself, to wit: What is the
true course to pursue in order to remedy the difficulty just mentioned?
We reply, the proper course and only remedy is for the people to fur-
nish themselves with suitable works upon the subject we are consider-
ing, and educate themselves therefrom, and the result will be a steady
increase of knowledge upon medical subjects  among the people on the
one hand, together  with a  corresponding decrease of imposition and
quackery  on the other.  "But," we hear some  one remark,  "if I had
your book,  or  even all  the necessary works upon this subject,  they
would do  me no good, as I should hardly ever read them."   This is
a very common objection; but a very appropriate reply to it is, "that
without the means you  can  never  accomplish the  object of any
enterprise.
  Politics are  now  very generally understood throughout our entire
country, and why?   Examine the various residences of our  people,
and we  will ascertain that nearly every intelligent man  takes a politi-
cal newspaper; and  this  accounts for  our  countrymen being, as  a mass,
the greatest politicians  in  the world.  And,  in like manner, would it
be upon the subject of health and disease, if every family had a suit-
able amount of  useful reading matter thereon, with which they could
store their minds.  They would then  soon begin to make the laws and
means of  promoting health a theme of thought, action, and conversa-
tion.   Some persons  raise the objection  thus: "Even  though I had
your book I should need a physician."   We agree with this remark to
a certain  extent; but  must be permitted  to suggest to  such the fact,
that they  will not probably need one so  often,  nor  for so long a time
when they do require him.   We suppose, that although a man may
have a Bible in  his family, nevertheless, the aid of  a  good minister
will be occasionally necessary to encourage, counsel, and advise; but
we  do  not suppose that, as  with  the  person possessing  the medical
works, he will  need his assistance, or  require his services  so fre-
quently.  And may we not, with great propriety, say, that the spiritual
advice will be of more lasting benefit to  those  who already possess a
Bible for  their own  study and reference.
  Another person will say:  " Your  book is  all right, but we do not
like to buy  books of agents.   We  have been so  abominably imposed
apon by this class of men,  that we have almost resolved never to buy
as other book  in this way."   Gentlemen, we  are  aware  that gross 
HOUSEHOLD DEPARTMENT.
9
 impositions have been practiced upon parties in various ways, and by
 various persons, and  among  others  by book  agents;  but then, you
 should remember that all the men engaged in any kind of business
 should not be judged nor condemned for the sins of a few vagabondish
 rascals who are similarly engaged.  Would it not be grossly unjust to
 estimate all farmers,  mechanics, or merchants, by the few dishonest
 ones who have given weights and measures to their patrons which fall
 far short of being correct?   This would, certainly, be no standard to
 judge any person by, except those who actually practiced the fraud.
   But, gentlemen, it must be borne in mind, that although book agents
 have occasionally been met with who were vile enough to commit decep-
 tion, and to whom even yourselves have fallen victims, yet much benefit
 and profit has been derived from them as a class of business men.  Re-
 member that the Bible itself had not obtained a general circulation until
 the colporteur system was introduced, and which, by the way, is nothing
 more nor less than simply a book agency.   Now books are necessary,
 for this is  a reading age; but what portion of the books at this  day
 possessed by the people would ever have reached their present locali-
 ties  had it  not  been for the book agents, who are so  hardly judged
 of?  It may be  said, "that by calling at the bookstores books may
 be bought."  This is true;  but it should be remembered  that book
 agents do not prevent any one from buying all the other books  which
 they may desire, notwithstanding that nine-tenths  of all  the  books
 throughout the country have been purchased of agents.
  The truth is, that all valuable and expensive  books, especially of the
 present kind, can be  sold through agents  much cheaper than in any
 other way;  the reason for which is very obvious:  xln agent who starts
 out to  canvass for  books  requires  to  invest but  very little capital;
 he has no   clerk to hire,  no fuel to  buy, nor  heavy  store  rents,
 nor interests to pay;  he can live in the country among  the  farmers
 as cheap  as  he can in a village  or city; yet he can sell  as many, or
 more, dollars' worth of books than can any book merchant with a cap-
 ital of five thousand dollars  invested.   Now, Ave believe that the same
 man would  be no more likely to' deceive, whether selling books in a
 bookstore, or as a traveling  agent;  and  hence,  it will  be perceived, in
 case  of imposition, that it  is the man and not the business that is dis-
 honest.  We guarantee that all our books will  give entire satisfaction,
 and that  they shall be as good as the sample copy exhibited by our
canvassers.
  In conclusion, we desire  to say, that in  offering this  work to the
people we feel assured that  each of our patrons will not  only get the 
10
AMERICAN FAMILY PHYSICIAN.
full value of the money invested in it, but will become the possessor
of a work that will prove a standard and faithful guide in the hours
of trial and difficulty, for years to  come.   The author is well-known
throughout the United States for his high moral character, his success-
ful practice, and scientific medical skill, and as having devoted a great
portion of his life in procuring,  by  close observation and  extensive
experience, the  information which he  has so bountifully  imparted
throughout the  pages of this work.   And although the completion of
the vast labors attending the preparation of so extensive a volume has
been delayed considerably beyond our expectations, yet we trust that
the care and untiring researches which have caused the delay will be
found of more  benefit to  our patrons than damage, as  we  honestly
believe this  to  be not one of the best books, but, above all others, the
very  best  booh upon the matters herein treated, ever yet presented to
the public.
    F                                         A. D. STREIGHT,
Indianapolis, Ind., 1860. 
ORDINARY  CAUSES OF  DISEASE.
   There are very many persons who are not fully aware of the more
 ordinary causes of disease, or who, although  they may have  an in-
 distinct perception of them,  do not so thoroughly  realize  them  as
 to use the proper precautions  to protect  themselves from the more
 common maladies which  an exposure to them produces.  Therefore,
 notwithstanding the remarks on Hygiene, etc., given  in the Introduc-
 tion to this work, we will, for the benefit of our readers, devote a few
 pages  to a consideration of the more common and more readily avoided
 causes of disease, and the  method in which they produce their injurious
 results.
   It is frequently remarked by persons, when the subject of the  causes
 of disease is named to them, that the information which any book can
 impart to them upon' this subject is of little value, as  they understand
 these causes as well as can be explained by a writer.  At  first  sight,
 such a  statement may appear plausible, yet when we come to properly
 examine it, we will observe that it  is only partly correct;  because,
 when the evil  resulting  from  any  source is  thoroughly known and
 appreciated, no sensible person living will expose himself to circum-
 stances which will inevitably prove  harmful.  No one will thrust his
 finger  into the flame of a burning lamp, because he well  knows the
 painful consequences.  The same person may, however, expose himself
 to cold, or other  causes which will  produce fever, not because he is
 unaware that  such exposure is wrong, but because he has never real-
 ized, as in the case of the  burn, a full appreciation of the harmful
 results.  Thus, one man says,  " 0, I know very well  that if I  expose
 myself to cold, I  run the  risk of fever, or rheumatism, etc."   True,
 he knows this, but his  knowledge is like that of the  historical writer
 who relies for his facts upon traditionary report.  Inquire of him how
 or why the exposure creates disease,  and he  is  not  able  to explain.
 Hence,  I say, he  may know, but can  not profitably realize the truth
 of his knowledge; consequently, such a  person is not true to himself
when he denies the value of writings explaining these matters.
                                                       (H) 
12
AMERICAN FAMILY PHYSICIAN.
  Again: most persons have traditionally heard of many of the inci
dents connected with the Revolutionary War of this country, yet how
few are there who, for this reason, would  consider it wise to refuse a
book containing a more  minute and accurate  account of these  same
incidents.  So, although the great mass of people have heard, and even
read, brief statements of the causes of disease, it certainly would be
unwise in them to refuse  to read an essay upon  this  subject which
would more perfectly post  them up, in such a manner, as to lead them
to greater attention in the observance of  all means which would ward
off disease, and promote health and long life.  I therefore believe, that
a reference to these  causes, as well as an explanation of the manner
in which they effect  their evil consequences, will be of great  service
to my readers, both as regards the preservation from  sickness, and in
a pecuniary sense.

                     Exposures  to Cold, etc.
  Cold is undoubtedly one of the  most common causes, if not, indeed,
the most common  cause, of disease.   Colds, catarrhs, fevers, inflam-
mations, consumption, rheumatism, and a host of other equally severe
or serious maladies, are the evils to which the human family is subject
from the influence  of this cause.   To experience the  injurious conse-
quences  of cold, it does not require that one should remain in a cold
atmosphere until chilled through; it is  equally  pernicious to pass
suddenly from a warm apartment to a cold one, especially if the former
be dry and  confined, and the latter be moist and open; or, to change
suddenly from a cold atmosphere  to a warm one;  to stand for a time
upon a cold pavement  or floor,  or upon  snow  or ice,  until the feet
become very  cold,  and particularly if little or  no  exercise  be taken
after the exposure; to remain standing  in a  cold, damp place  for a
long time, as is frequently done by boatmen and fishermen; to remove
the outer garments, as  the coat and vest, when in a state of  profuse
perspiration, even in midsummer;  to toast the feet by a warm fire, and
then get into a cold bed, or stand upon a cold floor, etc., etc., are  all
circumstances which give rise to cold in the system.

                     Exposures  of Children.
  Children, and infants  especially, are frequently  attacked by  affec-
tions, the common results  of  cold, by a  cause too little understood
among parents.   Thus: in all apartments  there will be found a current
of cold air toward the floor, and another current of warm air toward
the ceiling,  while the central space of the room will be of the ordinary 
household department.
13
temperature of the  season, unless it be  artificially warmed, when it
will be of a temperature  somewhat between that of the two currents
above referred to.  This may readily be proved by holding a flame to
the upper and another to the lower part of the door of the room,
when it will be seen that the upper current will drive the flame toward
thc door, while the under one will impel  it from  the door.  Now, an
infant which is held in its nurse's arms for some time, and exposed to
the warmth of the temperature in the central space  of the room, mus
certainly contract cold when subjected  to the sudden influence of the
lower cold current of air by being placed upon the floor,  or in a low
bed or cradle.

                   Exposures of Young Girls.
  Again: how often is it the case that young  females lay the  foun-
dation of some incurable  disease, of a harassing and painful nature,
rendering the balance of life  a perfect burden to them — as,  for
instance, painful menstruation,  excessive menstruation, falling of the
womb, neuralgia of  the  womb,  disease of the  ovaries,  rheumatism,
bronchitis, and even consumption itself, with all its fatality—by expos-
ing themselves  in  an improper manner  while  their menstruation  is
upon  them.   Some  bathe themselves  in cold water at  this time, or
immediately after its  disappearance; some bathe merely their feet and
limbs  in cold water,  thinking that, as the whole person is not bathed,
no danger will result therefrom; some  go too thinly clad,  even in the
warm  summer months, or  in cold weather wear shoes  that are not
sufficiently thick and warm; some attend balls, parties, and the like,
and becoming fatigued, or in a state of perspiration, sit in a cool place;
indeed, I have known consumption to follow a mere riding home in a
coach  on a cold night, even after a rest in a warm room had relieved
the sense of fatigue  and perspiration, because  of  the  thinness and
inappropriateness of the  ball or party-dress worn, and  the  relaxed
condition of the  system following the  exercises  of  the evening.  To
ride in a coach,  especially during the  time  of menstruation,  is fully
as dangerous, on  a cold night, after fatigue, excitement, and increased
perspiration, as would be  an exposure  to the free  air itself; indeed,
the exercise of walking or running home on  such occasions would be
more apt to prevent an attack  of disease, by  keeping up an increased
activity of all the various  organs  of the system, and thereby warding
off the influence of  cold  until a warm  apartment can  be reached.
Mothers and  guardians can not be too particular  in this respect to
instruct  their daughters  and wards in all those matters which' may 
14
AMERICAN FAMILY PHYSICIAN.
exert a deleterious influence upon their healths, especially during the
presence of this monthly function.

                      Functions of the Skin.
  Now, it is  a matter  of  some importance not  only to know that
exposures of this kind are productive of disease, but likewise to under-
stand why they are produced.
  The skin with which the  whole exterior surface  of the body is cov-
ered,  is a dense, thick,  membranous  layer, composed  of  stout fibers,
that are interlaced or plaited together somewhat in the manner of the
woolly substance of which a hat is made.  Numerous nerves and blood-
vessels, called, from their very small size, capillary or hair-like vessels
and nerves, fill the skin so thoroughly, that it is not possible to pierce
any part of it with the finest cambric  needle without causing one or
more  drops of blood to flow out,  and at the same time producing more
or less pain.
  Besides the nerves and blood-vessels, there are numerous other ves-
sels, terminating upon the surface  of the skin in minute openings,
commonly known as the "pores of the skin," whose action is to remove
from  the  blood  an oily substance, together with the matter of which
perspiration is formed, thereby  not  only  keeping  the  surface of  the
skin soft and moist, but likewise removing from the blood  an immense
amount of decomposed or used-up particles, which would  give rise to
serious disease were  they not  purged out, as it were,  from this fluid
by these perspiratory vessels.
  The perspiration passed off through the pores of the skin is of two
kinds, one termed the sensible, and the other the insensible perspiration.
The insensible perspiration is that which passes  off in such minute
amount as to be hardly noticed by a person.  It is constantly passing
from  the skin, when this is  in a healthy condition, as may at any time
be known by placing the hand in a glass vessel which has been wiped
quite dry, and then closing the open end by winding a cloth or towel
around the wrist and mouth of the vessel.   In a short  time, the inner
surface of the glass vessel will become dimmed by the condensation
of the insensible moist perspiration from the skin upon it.
  Sensible perspiration is that which  stands upon, or  flows from  the
skin in drops, and is usually known by the  name of " sweat."  Persons
sweat when they are much warmer than usual, during hot seasons,  and
when there is  a great excitement  of either the mind  or body, from
any cause whatever.   It is often so profuse in quantity  as to com-
pletely saturate the clothes of those from  whom it issues. 
HOUSEHOLD DEPARTMENT.
15
   It may be a matter of astonishment to many to be informed of the
 great amount  of used-up matter that thus passes from  the system.
 According to experiments made by Carpenter, Cruikshanks, and others,
 from eleven to forty grains is eliminated every minute, or  from thirty-
 three to one hundred  and twenty ounces per day.   And this, it must
 be recollected, has only reference to the  insensible perspiration, the
 sensible being of course much greater.

                Disease—How Produced by Cold.
   When one is exposed to the influence of a sudden or long-continued
 cold, the blood-vessels of the skin contract, and are thereby prevented
 from receiving their proper amount of blood.   This interference with
 the circulation in these vessels compels the blood to force itself, as it
 were, upon the internal organs, carrying with it all the used-up parti-
 cles  which should have been passed off, in the form of perspiration,
 through the pores. The contraction produced by the cold is not limited
 to the blood-vessels; the sweat-glands and tubes also become in a state
 of constriction, and cease to give out any more perspiration, and,  in
 common talk, it is said that the "pores are  closed," the party having
 caught cold.
  What, then, is there in this disturbance  of the animal machinery to
 give  rise to disease?   Let us examine.  Between the skin and all the
 organs within the body, there is an intimate sympathy or relation, so
 much so that whenever there is any derangement of the former, the latter
 always present symptoms indicating  that they are aware of and have
 been influenced by the derangement of the former, and these symptoms
 are proportioned to the degree of disturbance produced, and are due to
 the fact that one or more of these internal organs are being called upon
 to atone for the deficient action in the vessels of the skin.   The trouble
 caused is not merely a check  of perspiration and the driving the blood
 from the surface to the central parts of the body, but still more, all the
 decomposed particles it contains are  carried along with it to exert in-
 jurious consequences upon those organs to which the blood is impelled.
 This  disturbance in the condition of the vessels of the skin and in the
 circulation, is usually termed " a want of equilibrium;"  or, in  other
 words, the equilibrium or harmony existing between the various organs
 of the body and  the circulation has  become deranged, and parts are
 made to bear burdens or perform offices which is not required of them
naturally.
  If disease is produced from these circumstances, its form and character
will greatly depend upon the condition of the patient, the influences 
16
AMERICAN FAMILY PHYSICIAN.
  surrounding  him, and the resisting power of his system to  disease.
  For every person has a greater or less power of this kind, as may be
  known by observing the different results upon two persons exposed to
  the same cause of sickness, one of whom feels little or no effect from
  it, while the other is laid up for days or weeks.
    If there is any epidemic or contagious disease in the neighborhood
  the person who exposes himself will be liable to  suffer  an attack from
  one of these, whatever they may be.   Otherwise, some organ weaker
  or more disposed to diseased action, will be the most liable to  yield to
  the injurious influence caused by an increased quantity of blood (con-
  taining an unhealthy amount of decomposed particles) being forced
  upon it.
    Suppose, for instance, this organ is  the lungs—an increased  amount
  of blood passing through  them oppresses them, causing irritation and
  even inflammation—the patient's breathing becomes more or less diffi-
  cult, cough occurs, with or without an expectoration of phlegm or mucus,
  perhaps pain is present, and he becomes attacked with bronchitis, pleu-
  risy, or inflammation of the lungs, according as the disease locates
  itself in the air-tubes, proper substance of the lungs, or their external
  covering.
 ;f  Should  the kidneys be  the organs  attacked, there will be derange-
<f ments  in the color, temperature, and quantity of fluid passed by them
  into  the bladder, or  there may  be an inflammation of the kidneys;
  should the affected part be the brain, more or less severe pain in the
  head will  be  present, or there may be an  active inflammation of the
  brain;  if the muscles or joints are the organs affected, rheumatism will
  be the  result, and so on.

                        Management of Colds.
    When the  resisting power of the system is sufficiently vigorous to
  prevent any injurious effects upon the internal organs, a reaction, as it
  is termed, at once takes place; the blood is driven back to the vessels
  of the skin, distending them to  their natural size,  the  perspiratory
  vessels are thereby excited, perspiration is induced, the various func-
  tions go on aa if nothing  had occurred,  and the person remains free
  from disease.
    But, suppose a chill immediately follows the exposure, with symptoms
  of lassitude, feverishness, etc., can the patient restore himself to health
  without taking medicine?  Yes, in the majority of cases it can be done
  by active labor continued until perspiration  is produced, as by chopping
  wood,  splitting rails, sawing wood,  running,  etc.; or, should this fail, 
HOUSEHOLD DEPARTMENT.
17
 perspiration may be induced by the Spirit Vapor Bath, or by soaking
 the feet in warm water, drinking freely of warm herb teas, and cover-
 ing up in bed, with warm irons or bricks to the feet.   In very severe
 cases, an emetic will be necessary, previous to producing perspiration,
 to be followed by  an active cathartic.   Should  these fail to break up
 the cold, and disease set in, then this must be treated according to its
 character and symptoms.

        Inattention to the  Skin—Bathing the Surface.
   Uncleanliness of person is another common cause of disease, and as
 it is connected with the conditions of the skin, I may as well introduce
 it at this place.
  Almost everybody, I believe, make a practice of bathing the  face
 and hands at least once a day, and some.persons much oftener;  and
 all undoubtedly observe the  peculiar comfort and satisfaction  which
 even this small operation  imparts, not only to the skin itself, but  also
 to the general system.   And from such a pleasing and salutary conse-
 quence  arising from the  bathing  of,  say one-fifteenth  part of  the
 external surface, a person can readily form an idea of the still greater
 beneficial results that must accrue from a general bathing of the whole
 surface, if continued at regular intervals.
  Yet there are many persons, who, although extremely  cleanly with
 their faces, hands, and other  parts which are exposed to the  gaze of
 bystanders, are extremely slovenly with all the remaining parts of their
 bodies, either through carelessness, or an ignorance of the evil effects
 common  to such  filthy conditions.   Again,  there are many  persons
 who, although fully aware of the advantages to health and  comfort
 from proper bathings of the  skin, and  who  practice  it constantly at
 regular intervals, are yet in the habit of pursuing a detrimental course
 by sleeping through the night  in the  undergarments worn through the
 day.   Thus, a hard-working man, who washes his whole person once
 or twice every week, as the case may be, instead of removing his shirt,
 all covered with perspiration, and hanging it up in a proper place to
 dry and air, retains it all night upon his person during the  hours of
 Bleep, thus permitting part of the  unhealthy matters accumulated in
 the garment to act upon the skin, either by closing its pores or being
reabsorbed into the system, as explained below.  And, it may well be
understood that the consequences will be still worse, when, in connec-
tion with this constant wearing of the undergarments, the individual
never washes his  body.  In times of  epidemics, as  ague and  fever,
bilious, or other  fever, measles,  scarlet fever, small-pox, dysenteries, 
18
AMERICAN FAMILY PHYSICIAN.
etc., such persons are almost certain to be among the first ones affected
unless indeed, their constitutions have an uncommon resisting power
to disease.

      Disease—How Produced by Inattention  to the Skin.
  Now, how do these inattentions to the  skin act?  For, in order to
prevent disease, and preserve health and long life, it is a  matter of
great  importance  that every one should understand the method by
which a  neglect of cleanliness engenders disease.   We  have already
explained the character of the vessels or pores of the skin which throw
off perspiration from the body, and the  manner  in which  they may
become closed from cold.  But, it must be recollected, that  they may
also  become closed by an accumulation of filth upon the skin.
   The perspiration which passes from the body is  composed  of a large
proportion of water in connection with an oily or fatty matter, and a
small amount of solid substances.  The water evaporates from the skin
passing off into the surrounding atmosphere, while the fatty and solid
substances  remain upon the skin, eventually filling up its pores,  unless
they be  removed  by occasional washings with soap and water; the
soap being necessary to enable the fatty matter to mix with the  water,
in order  that it may be removed.  Now, in those cases where the sur-
face  of the  body,  with the exception of the  hands and face, is not
bathed at all, there will be, in addition to the  substances just named,
a gathering upon the skin of  the dirt or dust which is constantly float-
ing in the atmosphere, and some of which will necessarily be deposited
upon the body, it  being  so impalpably fine, as even to  pass through
several pieces of the finest clothing that can be worn, as any one can
verify, by washing  his person, and then  examining it some three or
four weeks afterward, not having it bathed in the mean time.
   In cases where the skin is not properly attended to,  these various
materials collect upon it, until finally it becomes  overloaded with the
accumulation, the skin becomes stiff and uneasy, then irritable or easily
irritated, frequently itching so intensely that the person scratches even
until he tears off a portion of  the surface and gives issue to a few drops
of blood.   No one would  for a moment suppose that the destruction of
even a small part of the healthy  structure of the skin can be otherwise
than injurious.  After a time  the skin loses its softness, its suppleness,
its elasticity; its exquisite sensibility becomes very much diminished,
as well as its temperature, especially in the more distant parts, as the
hands and  feet, which are frequently complained of as being cold all
the time.  Of course, with  all this unhealthy action going on, there ia 
HOUSEHOLD DEPARTMENT.
19
 an obstacle to the passing away of the perspiration, or the waste and
 used-up parts of the body; its  quantity gradually becomes less and
 less, while the portions of it which are retained within the system,
 slowly but surely produce disease, in the same manner as when these
 matters are prevented from being thrown off by the influence of cold,
 but less suddenly.
   This, however, is not all; heretofore we have only referred to those
 vessels which remove decomposed matters from  the body through the
 skin—but this organ has still other offices to perform besides removing
 thc used-up particles of the body.  It absorbs or carries substances
 from the surface into the system.  This function of absorption, as a
 general rule, is more active during some diseased or deranged condition
 of thc body  than during health; and, consequently, must  be much
 greater when the skin is in an impaired condition by the accumulation
 of filth upon it  for months, or even years—absorbing and conveying
 into the system  unhealthy matters, which aid considerably, in connec-
 tion with thc above-named conditions, in the production of disease.
  We  may verify  that this  office  of absorption is carried  on  by the
 skin, from  several facts, thus: it is frequently  the case that  certain
 substances constantly worn upon the skin will, after a time, be  carried
 into the circulation and be thrown off from the blood in the  lungs, im-
 parting their peculiar odor to the  breath, as, for instance,  camphor,
 musk, assafcetida, garlic, etc.  Lobelia, tartar emetic, or tobacco placed
 over the stomach, will produce vomiting;  mercury rubbed upon various
 parts of the system in the form of an ointment, will cause salivation;
 croton  oil,  dilute nitro-muriatic acid, etc., rubbed over  the abdomen
 will produce an active operation from the bowels.  Again, persons at
 sea, when  fresh water cannot be had, frequently allay excessive thirst
 by either getting into the sea and remaining  there for a time, or by
 keeping the clothes  they wear constantly moistened  with sea water.
 A small portion of vaccine matter,  or the matter of small-pox, intro-
 duced into a minute part of the skin, will infect the whole system.  We
 might go on in this manner, but enough  has been stated to prove the
 fact that the skin  absorbs as  one of its duties.   And it must  also be
 borne  in mind that this absorbing  power is  more  active when there
 is any  derangement  of the system, from hunger or  thirst, and also
 during  the night.
  When a  person washes the whole surface of his body, who has not
done so previously  for more than a year, he will be somewhat surprised
at the results, if he will pay sufficient attention to them.  In the first
place, he will perceive in the water used an amount of dirt, that he can 
20
AMERICAN FAMILY PHYSICIAN.
hardly believe was attached to his person; in the second place, he will
observe a greater softness and elasticity of the skin; it becomes more
sensitive to  the touch, warmer and more moist from an increased flow
of perspiration, his whole system will feel more light and buoyant, ho
will breathe easier  and with more freedom, and his thoughts will flow
more rapidly and with greater correctness and appreciation of things;
in a word, he will  feel as though the  cleansing  of the whole surface
had really cleansed every internal organ of the body—and, indeed, it
has done this very thing; and he may learn, from these sensations and
effects, the full value  and importance of a proper attention to the skin.

                    Management of  the Skin.
   Many writers  urge the necessity for a daily washing of the  whole
surface; I not only consider this unnecessary, but actually unhealthy,
as it keeps up a constant overexcited  condition of the  skin,  which
ultimately terminates in a debility of the functions of this organ, giving
rise to various unpleasant symptoms.   The body may be sponged daily
with cold water,  followed by drying and slight friction with a towel,
with much  advantage; but there are  even exceptions to this,  as  in
case of some diseased persons, whose systems are extremely susceptible
to external impressions.
   A regular bathing of the whole  body once a week in winter, and
twice a week in summer, is, in all ordinary instances, sufficient for the
prevention of disease, and the preservation  of health.   Many persons
suppose  it impossible for them  to bathe in this manner, unless they
have a river or pond  to get into, or a bathing-tub, or some other con-
trivance prepared especially for the purpose.   But this  is unnecessary;
a common wash-basin, a  flannel  or cotton wash-rag, a piece of soap,
some warm  or cool water, but never  below 60° F., or the  temperature
of river water in summer, and a good towel,  neither too  fine nor too
coarse, are  all the articles required.  The  soap  should be somewhat
alkaline, but not  too  strongly so; and in the  absence  of soap, a little
pearlash, saleratus, sal-soda, or  sal-ammonia  may be dissolved in the
water, just  sufficient  to make  it feel somewhat slippery between the
fingers.   In bathing, first one limb should be washed and dried, and
then the other—one  side of the body,  and  then the other; by this
course we avoid taking cold, which would be apt  to occur  if the whole
body were to  be washed at once, in  consequence of the evaporation
going on from one part of the body while we were engaged in washing
or rubbing another, and which evaporation produces a sensation of cold,
chilling  the whole body; should  such a chilling happen, a little exer- 
household department.
21
 cisc taken after the bathing would be apt to remove it.  In drying, the
 skin should not be rubbed too hard nor too long, but merely sufficient
 to cause a gentle glow without increased redness.
   The  best time for bathing in this manner is in the morning, after
 breakfast; but as laboring  men, especially, cannot  always  spare this
 time for the purpose, they can, without any interference with business,
 or loss of time from other pursuits, practice it in the evening, immedi-
 ately before  going to bed, and which course, indeed, will promote  the
 tendency to sleep.   Let every farmer, every laboring man and woman,
 pursue this course, and they will find it beneficial to the health, and
 profitable to the pocket.

                     Improper  use  of  Food.
   There is probably no one cause to which  disease is more attributable
 than this of improper use  of food, both  as regards quantity, quality,
 mode of eating, etc., and  yet, although  we  find  persons who stren-
 uously oppose what they consider excesses and injurious articles, as
 drinking intoxicating  liquors, chewing tobacco, smoking cigars, drink-
 ing tea and coffee, etc., these same persons  are fully as guilty of dissi-
 pation  and intemperance—because these terms are not limited to any
 one or several articles or mode of living—as manifested in their excess-
 ive eating and drinking, and in the use of articles which do not agree
 with them.
   Food may be improperly used in various ways;  thus, one man may
 eat articles which do  not agree with  his stomach, or which are indi-
 gestible; another may make use of food entirely  too stimulating  for
 his system; a third may  eat too much food, and overload his stomach;
 a fourth combines too much fluid with his food; a fifth mingles  alcoholic
 drink, as wines, brandies, or ales, with his meals; a sixth eats too fast,
 and does not chew  his food sufficiently; a seventh eats immediately
 after active exercise;  an  eighth  hurries off to active exercise as soon
 as his meal is finished; a ninth, having a weak stomach, or from other
 cause, finds his  appetite only moderate, and, more for the purpose of
 pleasing his taste than for giving nourishment to  his body, makes use
 of various means to goad the stomach, so as to cause a forced or arti-
 ficial appetite; and thus we might go on and name more than a hundred
 various ways in which mankind make an improper use of food.   But it
 is not so much  the  design here to enumerate each particular method,
 as to explain how disease is engendered by this cause, and the proper
management of eating and drinking for purposes of nutrition.  And in
order to get at this  explanation correctly, we must first ascertain what 
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AMERICAN FAMILY PHYSICIAN.
constitutes a healthy digestion, and then, how an improper use of food
interferes with this healthy digestion so as to produce disease.

               Importance  of  Chewing Food Well.
   The first operation in the process of digestion  is to chew the food
thoroughly, and it is for this purpose and no  other that we are pro-
vided  with  teeth.   He  who does not use  his teeth  in  the manner
designed by nature, that is, to chew food, instead of tobacco and other
pernicious articles, cannot expect to have good teeth, and without good
teeth the first part of digestion will be but imperfectly performed.
   We must not only chew the food to mash it or divide it into particles
so that we may swallow it easily, but we must chew it finely, at the
same time mixing  it as thoroughly as we can with as much of the saliva,
which flows freely into the  mouth while we are chewing, as possible.
Now, there are many persons who think  that the only object of chew-
ing is, that the food may be swallowed so much the more readily, and
that if once the food gets into  the stomach, no matter as to its con-
dition, this organ will take the proper care of it.   Such may therefore
look somewhat astonished  at the above statement,  and ask what is the
use of taking  so much trouble to chew and mix saliva with the food ?
We reply, it is a well-known fact, that has been verified by actual ex-
periment, that the food, when thoroughly mixed with saliva, is more
readily digested by the stomach than when little or no saliva is mingled
with it.  The  saliva effects a change in the food, even before it reaches
the stomach, which renders the work of this organ a comparatively easy
one.  A man may prove this by thoroughly mixing some boiled starch
with saliva; the starch will be changed into a sugar.
   The object  of the saliva is to favor the expression  of the voice; to
moderate thirst; to  cleanse  the  mucous  membrane of the mouth; to
assist the sense of taste; to stimulate the  stomach and excite it to
activity; to aid the digestion of food by a specific action upon the food
itself, and to  neutralize any unhealthy acidity  of the stomach, as the
saliva is alkaline in its character.
   The great importance of the saliva  during  a meal, to  which much
insignificance  is attached by most persons, may be suspected by observ-
ing how much greater is its quantity, and how much more  freely it
flows while eating; nor is this all: when any choice article of food is
presented to a person, or even when he smells the  vapor from it while
cooking, a great flow of it is sent  into the mouth, and which has given
rise to the saying that " one's mouth waters" at the sight or smell of
any particular thing. 
household department.
23
                     How Food is Digested.
  The  first operation in the process  of digestion, to wit:  a proper
mastication, having been performed, the food passes through the tube
designed for it, and is received into the great pouch, or larger part of
the stomach.   It may be  proper to state here  that  the  size of the
stomach is not invariably the same with all persons, but differs accord-
ing to their habits, the kind of food they eat, etc.; thus: those who live
upon vegetable diet have  larger stomachs than  those who live upon
animal food, because the same amount of nourishment in  the former
occupies a larger amount of bulk or space than in the latter.
  As soon as the food reaches the stomach, this organ at once pours
out a fluid, called the gastric juice, which  is sufficiently powerful to
dissolve the food.   This juice is poured out into the stomach from
glands, in a manner somewhat similar to that by which the saliva flows
or is  poured into  the mouth.  Every particle of the food becomes
moistened by this gastric juice, which dissolves it and changes it  into
a pasty or pulpy-like mass,  which  is called chyme.  No matter what
may be eaten, bread,  meats, fish, milk,  fruits, etc., they are all reduced
to this  pulpy mass, and present the same appearance  to the eye, and
the same analysis to the chemist.
  Now, it must be recollected that the gastric juice does not flow  in a
stream  into the stomach, but only  enough oozes out to moisten each
particle of the food which is actually in the stomach.   This oozing
commences as soon as one mouthful  has been received into the stomach,
and then, as other mouthfuls are swallowed, the stimulation they cause
provokes another flow of the juice, and so on until the meal is finished.
  But nature has so  ordered it, that in a state of  health, the gastric
juice is poured out into the  stomach, not according to the amount of
food thrown  into this organ, but according to the amount of nourish-
ment which the system requires at the time.   Hence, if too great a
quantity of food is  taken,'5tha* is, more than is really needed for the
wants of the system, only a part becomes digested, and the rest remains
undigested, giving rise to pain and a sense of weight or heaviness in
the stomach, and in  passing on through the bowels, it likewise occasions
various unpleasant symptoms.
  The same thing happens when food is  thrown into  the stomach too
rapidly, being imperfectly masticated, if masticated at all.  Before the
first mouthful has been moistened by the gastric juice, a  second and a
third is swallowed,  and long  before the whole of the gastric juice has
been secreted, the meal is finished, and more solid food been swallowed
           52 
24
AMERICAN FAMILY PHYSICIAN.
than can be dissolved and digested—thc person having stopped eating,
not  because his hunger was  satisfied, but because his stomach felt
" swollen  out and filled up to the brim."
   Again,  when drink is taken with food, it either  dilutes the gastric
juice and weakens its  dissolving power,  or  else the fluid swallowed
must first be removed from the~stomach before digestion can take place
in either instance interfering with the digestive process.  Consequently
soups, broths,  etc., which are  supposed  to  digest  easily, and hence
recommended to dyspeptics  and other invalids, are really injurious, as
the  watery portion  requires to  be first removed  from the  stomach
before the nutritious or solid parts of the soups, etc, can be digested.

        Disease—How Caused  by Improper Use of Food.
   With these  remarks, we  are now prepared to understand how an
improper  use  of diet causes disease.   There  are  certain articles of
diet, which though,  as  a general rule, are not injurious, yet  disagree
with certain stomachs, producing unpleasant symptoms;  thus: custard,
which is a nutritious article, commonly  undergoing  digestion without
any  disturbance, will occasionally give rise to sour  stomach, diarrhea,
etc., as I have known in several instances; the same result has followed
the use of milk and other articles  of diet.   It must be evident to every
sensible mind,  that whatever interferes in any way with the digestive
process must be injurious and dispose to disease.
   Again,  there are certain articles  in  common use which are entirely
indigestible, and contain no  nutrition,  as cucumbers, pickles, etc., and
although  these may for a time  be eaten by persons having strong
digestive powers, yet a continuance in their  use will ultimately give
rise  to dyspepsia, sour  stomach, or other diseases;  and  it may be laid
down as a general rule, that  all those articles which dispose to diarrhea,
dysentery, cholera morbus, bilious  colic, etc., are unfit  to be used as
food.
   We  may form  some idea of the injury  to the stomach arising from
indigestible food, by the following explanation.   At the small end of this
organ, just as  it opens into the duodenum, or second stomach, is an
opening termed the pyloric orifice, which is composed of  strong muscu-
lar fibers passing around it, and which, by their contraction, close up the
orifice, and act as a valve, preventing the food from leaving the stomach
until it is perfectly  digested.   As  soon as this  ensues, it opens and
allows only the digested food  to  pass, immediately closing upon that
not yet reduced to chyme.   Now, when an article is indigestible, after
a great but useless effort on the part of the stomach to  digest it, it ia 
household department.
25
  sent to the pyloric orifice—the valve, true to its duty, sends it back to
  the stomach for digestion, and this organ again attempts its digestion,
  until, wearied out by fruitless efforts, it once more thrusts the article
  toward the orifice, to be again sent back for  digestion.   This course
  continues  again and again, for a number of times, until, finally, both
  the stomach and valve become wearied out with their efforts; the latter
  relaxes, and the indigestible article glides through without meeting any
  further resistance.  While these powerful struggles are going on, the
  person is  drowsy, sluggish,  unable to operate clearly with the  mind,
  and feels more or less pain or distress in the neighborhood of the short
  ribs on the right side.  Surely there must be a certainty of disease of
  the stomach, cancer of this  organ, or some other serious affection, if
  such a course be daily persisted in.
   Meats are more stimulating than vegetables, causing an increased
 heat of the body, as well as imparting a greater degree of nourishment.
 Persons who work hard, and thus exhaust the system more rapidly than
 those who  are  sedentary, may use meats with advantage,  while the
 latter class of persons should partake  of them very sparingly.   But if
 these indulge in the more stimulating diet, without laboring or  exercis-
 ing to remove the surplus amount of stimulation produced, fevers  and
 inflammations, skin diseases,  scrofulous diseases, and impurities of the
 blood must inevitably be the  consequence.
   When too much food is taken into the  stomach, as is almost always
 the case with persons who eat too  fast, a portion of it, as explained
 heretofore, does not come in contact with the gastric juice, and hence
 remains undigested.  This portion passes through  the same  process,
 as above mentioned with  regard to indigestible  articles, wearying  out
 both  the stomach  and pyloric valve, and giving  rise to weakness of
 stomach, dyspepsia, and other disagreeable symptoms.
   As regards the  use of much fluid during  a meal, we have  already
 explained how  that may suspend  digestion, and thus enfeeble  the
 stoma^i.
   The use  of alcoholic drinks, and stimulants  to arouse an appetite,
 effect injury by stimulating the stomach to act more energetically than
 is natural, and thereby causing the  gastric juice to be poured out in
 greater quantity than is  required.   This  renders the digestion much
 more active for a time, but, like everything which has been overworked,
 it soon flags, acts feebly, and thus interferes with the process of dissolv-
ing the food into  chyme.  Frequent  overworking of  this character,
followed by a tired and weakened condition of the stomach, must, sooner
or later, inevitably give rise to disease of the  stomach, dyspepsia, etc.
% 
26
AMERICAN FAMILY PHYSICIAN.
All these  articles, then, are  not only useless, but  are exceedingly
pernicious; they destroy the natural sensibility of the taste, so that all
plainly cooked dishes become insipid;  besides, they exhaust the vital
action of the stomach, and give no nourishment nor strength, to say
nothing of the poisonous effects of all alcoholic liquors, when once the
alcohol becomes absorbed into the system.  No man gives his cattle
alcohol or  stimulants to arouse an appetite, or to improve the digestive
powers;  if such a man could  be found, his neighbors would laugh at
him as a simpleton.  And is the human stomach any less valuable, or
of less importance to us than those of our horses and cattle?   When
will men learn to think properly, and act accordingly!
   Active exercise  just before, or immediately after, a hearty meal, is
exceedingly  injurious, and, with some persons, really dangerous.  This
is owing to the fact that while one part of the body is actively engaged
in the performance of its functions, the rest  can only be in a passive
condition.  When  the  mind, or the body is actively engaged, the vital
energy is  necessarily withdrawn  from the stomach, so that if this con-
tains any  food, its digestion is interfered with, and it must lie in the
stomach as a crude, foreign body, irritating and enfeebling the organ to
a great degree.  In order that the  blood may flow to the stomach, and
gently excite its natural digestive action, both mind and body should
be in a  quiet state for some time previous to eating, and continue so
for about  an hour afterward.   Again, when the nervous or muscular
systems are  wearied by excessive labor, just before a meal, the whole
system becomes wearied also, and no part of it feels  disposed to act
even to its usually natural degree; at  least, not until after a period of
repose  and  tranquillity;  because the  exhausted nerves and  muscles
require  all the blood and energy to sustain and restore  them  to their
natural  condition,  and  this blood and  nervous energy is  also required
in the stomach for the purpose  of digestion; but this cannot be, as  it
is contrary to the laws of the system to have healthy energetic action
going on in  two portions of the body at the same time.
   Men generally treat their horses and cattle better than  they do them-
selves, or more in accordance with the laws of nature;  and this they
are obliged  to  do, or else they will lose them;  and if they could only
be made to realize the  injury to their pockets  in their own cases, by an
inattention  to the laws of eating and  digesting,  as, the loss  of time,
suffering, neglect of business, doctor's and drug-shop bills, nurse ex-
penses, etc., they would probably be more careful, and guard themselves
as closely as they do their cattle; for it is a fact that cannot be denied,
that it " does not pay to be sick."  What sensible person allows his 
HOUSEHOLD DEPARTMENT.
27
'  cattle to have  a  hearty  meal immediately after hard  and fatiguing
   exercise ?   On the contrary, is it not the custom to let the animals rest,
   until they have recovered from their fatigue, and become sufficiently
   vigorous for digestion  to go on,  without  any danger of their  being
   foundered ?  What sensible person works  his animals severely imme-
   diately after a hearty meal ?  Indeed, is it not customary to allow them
   a little rest, in order that the process of digestion may not be interfered
   with?  And then how much better prepared are they for active labor!
   In fact,  the natural instinct of animals, when left to themselves, impels
   them to  seek  quiet and rest after a full meal. And have we so little
   care for  ourselves, that we will bestow every attention upon the welfare
   of our dumb beasts, for the sake of the few paltry dollars they may be
   worth, while, at the same time, we sacrifice our own health, happiness,
   and means, by  treating ourselves as if  our physical system was not
   governed and influenced by any natural laws whatever.
     We could go  on, in this manner, explaining how disease is caused by
   not properly attending to diet, but as our space is  limited we must for-
   bear.  The methods above referred to are the  most common.   We will
   now proceed to show how  diseases of the liver, scrofula, and other blood
   diseases, erysipelas, skin  diseases, etc., are produced from the causes
   just named.

   Diseases of  the  Liver,  Skin,  Blood,  etc.—How  Produced  by
                         Inattention to  Diet.
     In the preceding remarks we have confined our investigations to the
   stomach  alone;  but digestion of food  is only the second part of the
   process,  which results  in the formation of chyme.  There is, however,
   a  third part of this process, and which is the  most important of  them
   all, and that is to change the food  into a  substance that will give blood
   globules  to  the blood, nerve-cells to the nerves, muscular tissue to the
   muscles,  bony  matter to the bones, etc.
     The thin, grayish, viscid, somewhat sweetish and insipid pulpy mass
   into which  the food has been changed by its digestion in the stomach,
   called chyme, is passed from the  stomach into the  duodenum, or second
   stomach, where it undergoes another digestive process, changing it into
   a milky fluid called chyle, from which all parts of the body, both  fluids
   and  solids, are nourished and sustained—the 'constant  wastes of the
   body being  as constantly  filled up by it; while those portions of the
   chyme which contain no nutriment, or which are indigestible, are passed
   onward through the bowels to be expelled at the time of stooling.  This
   change into chyle is effected through the combined action of the  liver 
28
AMERICAN FAMILY PHYSICIAN.
of the pancreatic juice, a fluid secreted from the pancreas, or sweet
bread, bearing a strong resemblance to the saliva, of the heat of the
parts,  etc.; and  as  soon as the  chyle  is  formed, it is taken up and
carried into the blood-vessels in the neighborhood of the heart, to enter
into and mix with the circulating blood, by means of numerous small
vessels whose mouths or  openings line the inner walls of the second
stomach, and which are called lacteals.
  From the chyle, as before remarked, all the various tissues of the
body are  supported; but if, by any  interference whatever  with the
process of digestion in the stomach, there is less chyme formed than
should be, there will consequently be less  chyle made in the second
stomach;  and, as  an effect of this, the system  must receive only an
imperfect or insufficient amount of nutrition.   And this result, if kept
up  daily by any of the causes heretofore named,  must eventuate in
disease of the  blood or solids of the system, solely from their being
deprived of the  necessary amount of nourishment to sustain them in a
healthy condition.
  But we may not only have a diminution in the amount of chyme, it
may also be more or less impure or unhealthy,  from the character of
the  food itself,  or from  the imperfect or diseased condition of the
digestive process.   An unhealthy chyme must necessarily give rise to
an  unhealthy chyle—an  unhealthy chyle must afford an unhealthy
nourishment to  the various fluids and solids of the  body—and an un-
healthy nourishment must predispose to  disease.  And all this arises
simply from neglecting to observe what we allow to enter our mouths,
and from neglecting to chew it well before permitting it to  pass into
the stomach.  I am strongly inclined to believe, from years of observ-
ation,  that a simple  attention to  diet, and cleanliness, aided by proper
exercise, will, as a general rule, produce such  a healthy condition of
the system, that one may bid defiance both to disease and doctors.

           Rules  to be Observed with Regard to Diet.
   The first thing for a person to ascertain is,  the kind of  food best
adapted  to his  wants, and  this  can  only be known  by forming an
acquaintance with the laws controlling  digestion and nutrition, as well
as the character,  peculiar formation,  and digestibility of the several
articles used as  food.  For the preservation of health, and the promo-
tion of long life, these principles  or laws must necessarily be submitted
to, and be strictly carried out.   If one wants only a  short life and a
merry one, he may gratify his tastes to his heart's content; but with one
who prizes health and long life, a very different course must be pursued. 
                    HOUSEHOLD DEPARTMENT.                    29

  There are two grand natural divisions of food, to wit: vegetable and
animal, and which appear to be suited not only to the habits  of man,
and thc temperature of the climate he inhabits, but also to his anatomi-
cal formation, his teeth being so formed and arranged that he can chew
articles of food from either of these kingdoms, and his digestive organs
bein*  capable of  digesting either.  Food from the animal kingdom
contains a great amount of nourishment in small bulk, is of a stimulat-
ing qualfcy, increases the  heat of the body, and is better adapted to
cold climates and to laboring persons.  That from the vegetable king-
dom contains a small amount of  nourishment in large bulk, is usually
of a cooling quality, (though there are many stimulating articles to be
met with in this kingdom,) but slightly increases  the heat of the body,
if at all, and is better adapted to warm climates and to sedentary per-
sons.   There is a large class of individuals who believe that man  should
eat only of  the articles  afforded  by the vegetable kingdom, and, as I
think,  without any just grounds for  such conclusion; and, from the
general facts in the case, there is no doubt in my mind, that he  should
make  use of both vegetable and animal food under proper regulations.
  By  referring to nations  living  in the different zones of the earth, it
will be observed that, from some cause, probably from a long experi-
ence and observation, their diet is selected from the vegetable or animal
kingdom, somewhat in accordance with the views above given.  Thus,
the inhabitants of the warmer climates live principally upon vegetables,
and some nations, wholly  so; those in the extremely cold regions, as
the Esquimaux Indians, live entirely upon fat meats, and fish,  the flesh
of which is gross and very oily—the oil from the whale they drink as
frcely^nd relish as  much as we  do milk;  while  in the temperate
climates  the people make  use of  a  mixed diet, part vegetable  and part
animal; and even here, I have no doubt, it would be much better were
the use of animal diet confined to cold weather, among the sedentary,
and to thc hard-working people in warm seasons.
  In relation to  diet, the first thing for a  person to do is to select the
kind which is adapted to his peculiar case; thus, if he be a student, a
clerk, a writer, or  of any  occupation not requiring  much exercise, he
will require  less  animal  and more  vegetable food;  he must use a less
stimulating and less nutritious food, because his system does not use  it
up so  rapidly as  a hard-working  mechanic, or a farmer, who, from his
active bodily exercise, consumes the tissues of his muscles, nerves, and
bones much  faster than  the  man of no labor at all, and hence needs a
more stimulating nutriment, as, for instance, an equal amount from the
animal and vegetable kingdoms;  and, in temperate  climates, the animal 
30
AMERICAN FAMILY PHYSICIAN.
diet should never exceed that of the vegetable, except during intensely
cold weather, when one has to labor very much.
  To make  this selection properly, is of the first importance, and re-
quires  one not to be governed by the taste, but entirely by the rule
just laid down.  The next thing to attend to, after having determined
upon the nature of the food, as to the kingdom from which it should
be selected, is to select those articles from these kingdoms which are
the best suited to the digestive organs, for in this respect, there is some
truth  in the old saying: "What is one  man's meat  is another man's
poison."  The digestibility of food, its influence upon the stomach, and
even upon  the  general system,  varies with  every individual.  That
which will produce costiveness with one, will have no such effect upon
another, and that  which agrees with another  in  every respect, may
cause sour  stomach and flatulency with  others.  Every person must,
therefore, choose for himself—no rule suited to all can be given; the
safe  and proper course to adopt is, to avoid using  all articles of food
and drink which cause too  much stimulation, or too much of a dispo-
sition to sleep, or which give rise to sour stomach, flatulency, costive-
ness, or pain, weight and distress in the stomach soon after eating.
  The third important point concerns the condition of the body, both
immediately before and after a meal.  A meal should never be eaten
while the system is laboring under the fatigue or excitement of active
exercise, either of the body or mind, nor  should such exercise be taken
for at least  an hour after the meal.   The reasons for this have already
been explained.  For an hour  previous to a meal, and an hour after-
ward, a person should keep his system in a state of rest and quiet, in
order that the  digestive organs may have full play, and act with their
greatest power.  But, society is so constituted that  with all laboring
men this cannot be done—they hurry from their work to the meal-table,
and  from this again to their work;  a most  unwise, pernicious, and
health-destroying  course.   But there is  one thing they can  do to ob-
viate, in a considerable measure, the evil effects  arising from this un-
wholesome custom, whether their labor be of the mind or of the body:
for an hour previous to the meal every man can slacken his active
efforts, and allow his system to gradually gain the desirable condition
of non-excitement, and, after the meal, the same course can be pursued,
commencing the labor gently, and gradually increasing it, so  that at
the end of the hour, they will be found as active and  as wide awake as
ever.   Those  who  pursue such  a course will find it not only advant-
ageous  to  their healths, but they will also observe that they will be
able to turn out more work for themselves or their employers than by 
HOUSEHOLD DEPARTMENT.
31
 the course so universally followed at the present day.  It is true that
 we meet  with  many men of rugged  constitutions, with uncommonly
 strong  digestive  powers, capable of  digesting anything  that  can be
 thrown into their stomachs, at any time, and under any circumstances,
 with impunity; but, should one less happily formed attempt to imitate
 these " iron-constitutioned men," as they are popularly called, he would
 soon  find it to be at an expensive cost.  The remarks we make are
 more especially intended  for  those of less robust make, and having
 more delicate digestive organs.
   Having attended to these matters,  and satisfactorily arranged them
 to suit  our especial case, we are now prepared to eat our meals;. and
 from our preceding remarks upon the manner in which an inattention
 to diet  causes  disease, we learn that we must eat slowly, masticating
 the food thoroughly, so as to mix it well with the saliva; that our diet
 should  be  simple and nutritious, and plainly cooked; that we should
 avoid all indigestible articles, should not acquire  a habit of using
 stimulants on every occasion,  and should avoid, as we would a deadly
 poison, the use of alcoholic liquors;  and that the less fluid of any kind
 we employ during a meal the  healthier it is, whether the fluid be  tea,
 coffee, or water;  bearing in mind, at the same time, the remarks made
 in the Introductory part of this work, in relation to cheerfulness at
 meals, etc.
                          Impure Air.
  A fourth very common cause of disease is exposure to,  or residence
 in places  where  the atmosphere  is foul or impure, especially in illy
 ventilated rooms, and upon which subject we have said considerable in
 the Introductory remarks of this  work, where the method by  which
 disease  arises from this cause is explained.
  Where there is a constant flow of  pure air, there is no chance for
 any disease originating from  its  impurity, for a  constant  supply of
 pure air is as necessary to health and life, as a fresh supply of water
 is to a fish.  Confine a fish in  a tank  of water, and he  soon dies, but
 give him constantly, or even daily, a renewal of the water, and he will
 continue to live.  And the same rule holds good in relation to mankind
 and the  atmosphere they breathe.
  Yv e may build houses with many doors and windows, with high ceil-
 ings, and the rooms may be kept perfectly clean, as well as the whole
 house and the adjoining yard, but unless we have a proper ventilation,
a good and full supply of pure  air, we  may rest assured that disease of
some kind will,  sooner or later, make  its appearance.  And if this be
indeed true, how much worse must it be, how much more dangerous, 
32
AMERICAN FAMILY PHYSICIAN.
when in connection with it we have filthy, uncleanly rooms, foul yards
offensive  privies,  etc., all giving  out  most poisonous  and disgusting
odors, in some instances so rank and strong, as almost to knock a per-
son down upon entering the premises.  We cannot understand how it
is that persons whose stomachs would  almost heave at  the thought of
eating stinking meat, can suffer their mouths and teeth to be defiled by
a constant contact with that which is  still more disgusting,  offensive
and destructive to health, to wit: the foul, putrid vapors or gases given
off by the decomposition  of animal and vegetable refuse, which have
been  permitted to accumulate  in  and around a house.   And  yet we
find that persons may so accustom themselves to the presence of such
poisonous air, that  they will hardly be aware of its existence, even
when their attention is called to it.   And I have frequently been called
upon to treat  cases of disease, in  which the cause could be traced to
this  source.
   People living  in  cities generally suppose  that a residence in the
country must necessarily bring them in contact with a constant supply
of fresh air, and  even country people themselves will hardly  believe
that  disease from the above source can find its way to their homes; and,
in some instances, this is true; but, unfortunately, as my own observa-
tions have verified, persons living in the country frequently lack quite
as much pure air in their residences, as do city folks in theirs, owing to
the manner  in which  their dwellings  are built, not being  properly
ventilated.  This  may be due to the fact that  people living in the city
strive to get all the fresh air they can, while those living  in the country,
supposing they have an abundance of pure atmosphere, entirely neglect
an attention to these matters, having their houses built  more as places
to protect them  from  the  changes of the season, than  as places of
health and comfort.
   Many epidemic diseases,  as  scarlet-fever, hooping-cough, measles,
small-pox, etc., occur more especially at those seasons of the year when
houses are not so well aired by leaving doors  and windows open, as in
warm  weather; and there is no doubt in  my  mind, that  if this causo
does not create the  epidemic, it, at least, strongly predisposes  to it.
   The habit  of sleeping in a room with the doors and windows closed
is, as a general rule, very injurious.  People say the night air is bav1
and they must keep it out of the room; true, night air is less whole
some than that acted upon through the day by the sun, yet it is much
better than no air at all, and is vastly superior to the atmosphere of a
confined room, which is surcharged with the  carbonic acid thrown off
from the lungs of its  inhabitants,  and  nearly  deprived  of its oxygen. 
HOUSEHOLD DEPARTMENT.
33
 And under all circumstances, even where it would be inadmissible to
 *t  into the sleeping-rooms a large, or strong draft of the night air-
 as  for instance, in districts where ague and fever, cholera, and other
 epidemic diseases  are rife-the rooms should not be closed so tightly
 as to prevent the circulation of a small portion of the outside air through
 them.  It is equally as bad to crowd too many persons  together in a
 Bleeping-room, and children, especially, are very apt  to suffer from it.

                     Ventilation of Rooms.
  To avoid these  effects,  every house  should be well provided with
 ventilating apparatus, so that the air, as fast as it becomes surcharged
 with poisonous vapors, may pass  off, and its  place be supplied by a
 purer atmosphere.  This can be very readily accomplished in any house,
 and at very little trouble and expense.  The impure air generally rises,
 and if  there be a chimney in the room, much of it will  pass through
 this, but not all.  Hence, to have the impure air escape from a  room,
 an opening six or twelve inches  in diameter may be made in the  chim-
 ney, just below the ceiling, so arranged as to prevent the rain or soot
 from falling in at any time, through which the air may pass; and  if the
 cracks and crevices necessarily present in every house containing  doors
 and windows are not  sufficient to let in  enough air, the doors may be
 opened several times a day for this purpose, or one or two windows be
 raised a little.  In a  kitchen where all the effluvia from  cooking is
 constantly  accumulating, the ventilatory  opening  should  be  much
 larger,  or, a large funnel-shaped tube, inverted, may be placed over
 the stove, which, communicating with a tube or pipe passing to the top
 of the house, will  carry off all the disagreeable vapors.
  It has frequently occurred to  me, in practice,  to be called upon to
 attend  the wife or daughter of a farmer or mechanic laboring  under
 what was  considered  to be a  general nervous  prostration, debility of
 the  stomach, loss  of appetite, sinking  or  fainting feelings, nervous
 headaches, neuralgia,  female difficulties,  or consumption, etc., and who
 had  been  previously treated by physicians, and  drugged with  strong
 medicines until the stomach was nearly torn to tatters, but whose whole
 difficulty originated in the inhalation of impure air, accumulated in the
poorly ventilated apartments of the house, and especially in the kitchen,
the atmosphere of which was constantly loaded  with gases arising from
the  boiling, baking, washing, ironing, etc., and over  which the female
 was incessantly toiling, from morning to night, without a single  breath
of pure air.   A removal to a well-ventilated room, with a few simples,
has,  in the great majority of these cases, effected a permanent cure. 
34
AMERICAN FAMILY PHYSICIAN.
  In closing my remarks upon this very important subject, I feci it to
be my duty to impress as strongly as possible upon the minds of every
husband and father, the pressing necessity for preparing healthful and
well-ventilated apartments for his wife and children;  for while h. may
escape the  common  destructive  consequences of living in a poorly.
ventilated house, yet, he should remember  that his labors generally
require him to be most of the time out in the open air, in the streets
in the fields,  etc.,  while  those who depend  upon him for comfort and
protection, are, from the very nature of their pursuits and household
duties, compelled to remain within doors during the greatest portion of
their time.  Could you hale, hearty,  actively-engaged husbands  know
how many loved ones have been torn from the midst of dearly-beloved
relatives  and much-cherished friends, and  that too,  at an early age
when everything is calculated to attract and render life dear;  could
you realize the deep distress and anguish which has been brought upon
families by a neglect of duty in  this matter, it would arouse your feel-
ings to the keenest degree,  and wring tears from the hardest hearted
among  you, and be  the means  of insuring more attention to  those
hygienic principles which have  for their aim, the happiness, health,
and longevity of the whole human family.  For the sake, then, of your
wives  and children, do  not pass these considerations by, but reflect
carefully upon them, that the truth may so enter your hearts as to lead
you to act in accordance with its precepts and principles.
  The foregoing are the most ordinary  causes of disease, and required
of me a  more  elaborate notice; the other  causes, which are by no
means so common, do  not require me to dwell  especially upon them,
as they are  sufficiently noticed  in the  Introduction to  this work, in
Division I. 
HOUSEHOLD DEPARTMENT.
35
NURSING  THE  SICK.
              The Importance  of a Good Nurse.
  In time of sickness there is no individual so useful and of so much
 value to the patient as a good nurse; and, although the services of the
 physician may be required in  some very severe attacks of disease, and
 may prove highly important to the welfare of patients, yet, it is im-
 possible that much benefit can follow his attentions unless his advice
 and prescriptions be intrusted to the care of a nurse who is thoroughly
 qualified to correctly carry them out.  Indeed, so essentially necessary
 is this, that it is often the case in  serious instances of sickness, where
 the friends and relatives of the patients are constantly  in a state of
 agonizing suspense as to the result, and the physicians scarcely expect-
 ing life to continue  from one visit to another, that the  tender care and
 management of good nurses have,  in seconding the medical treatment,
 Baved the patient's lives, and they have been richly rewarded by hear-
 ing the  physicians  honestly acknowledging that "their patients must
 have died, had it not been for the good nursing they received."
  Again, on  the  other hand,  it is by no means  an uncommon occur-
 rence, that the friends and relatives of the patient having been cheered
 and comforted  by the  favorable prognosis  of a  judicious and  skillful
 physician, were looking  forward to  his speedy  restoration to  health,
 when the ignorance or carelessness of the  nurse, by not attending to
 the  directions of the  physician,  by an improper administration of
 medicines, or by mismanagement in some other way, has thwarted the
 hopes  of the medical  man, and crushed the  happy  anticipations of
 friends, by causing a sudden and unexpected turn to take place, result-
 ing in the patient's death.
  Instances like those just related, are constantly  occurring; there is
 not one of my readers who is not acquainted with one or more  of them,
 which have happened in the circle of his acquaintance; and they go to
prove how highly important it is, not only that the  sick  should have
 nurses, but that those nurses  should be educated in their vocation,
should thoroughly understand their profession in all its bearings, and 
36
AMERICAN FAMILY PHYSICIAN.
thus be prepared to assume the great responsibility of aiding life in
the struggle of nature to overcome suffering, disease, and death.
  We must remark here, that a properly qualified nurse is frequently
able to carry a patient through an attack of sickness without the aid
of a physician; especially in the less serious and malignant forms of
disease, and often even in the commencing stages of these.   How much
misery and sickness, then,  could  be  prevented by mothers qualifying
themselves, as  referred to  below, for the  position of nurses.  They
would  save many dollars to their families  by being thus enabled to
avoid physicians' bills; and, as they are placed where they can observe
the symptoms  of disease from its commencement, they would then bo
able to nip it in the bud, and, perhaps, save the life of a husband, a son
or a daughter,  which would be hazarded by the delay which frequently
occurs between the first symptoms of the disease and the first visit of
the doctor.  To  mothers, especially, this  is a most important matter,
involving money, health, happiness, and life.

                  Who Make the  Best Nurses.
  In large towns and cities, nurses are always to be found in abundance,
some of whom,  feeling the heavy obligation which their pursuit imposes
upon them, make use of all  means to improve and enlighten themselves
in all matters  belonging thereto; while others again, unfortunately,
nurse,  as it were, mechanically, having  no idea of the true nature of
their undertaking, nor  of the great moral obligation which they have
assumed.   Hence, it is a matter of no small importance, that a part of
the education of every man  and woman should be to know how to nurse
the sick, and bestow the proper attentions upon them.
  It may be urged that in  towns and cities, where nurses can be ob-
tained at reasonable rates, this is  unnecessary; to a certain extent this
may be true; but the  same cannot be said in relation to the country,
where the  sick  are  generally nursed by their own immediate relatives,
aided frequently by some of their benevolent and kind-hearted neigh-
bors ; indeed, as a general rule, we observe more of this sympathy and
disinterested kindness among inhabitants of country places than among
those of large towns.
  Persons who properly understand  how to  nurse the sick, are always
cool, calm, collected; indeed, it is highly necessary they should be so;
should subdue  and  conceal  all unpleasant feelings, manifesting only a
spirit of kindness,  a desire to  comfort and aid in the patient's well-
being,  and the  powerful sympathy and interest they have in his recov-
ery; because   this  exerts  a  soothing,  healthful,  pleasantly exciting 
HOUSEHOLD DEPARTMENT.
37
influence upon  the patient which proves a great relief to him adding
new vi-or to his prostrated vital powers, and strongly seconding  his
medical treatment in the direction toward a cure.  It has often been
my lot, and no  doubt  that  of many of my readers  also, to witness an
intelligent  mother, who, from frequent sicknesses  in her family, has
found the necessity for becoming acquainted with the correct rules  for
nursing remaining  day after day, and night after night, by  the sick
bedside of  a beloved child, soothing and comforting him m the midst
of his pains, sufferings, and complaints, with a soft, kind, untremblmg
voice, and  administering to his wants  and necessities with a calmness
and tranquillity depicted upon her countenance, that would  astonish
one unused to  such matters, while, at the same time, her very heart-
strings were almost breaking, from a  certain knowledge that she must
soon part  from her loved  one, to meet in this world no more again,
forever.__On the contrary, individuals unused to sickness, and having
no knowledge  of the  management of a sick-room, lose all self-control
when any symptoms, even  only apparently serious, present themselves,
and,  instead of attempting to relieve or aid the patient, they give vent
to their alarmed feelings  by loud cries, wringing  of hands, throwing
themselves  upon the necks  of the sick  with  sobs,  and moans, and
lamentations, and creating not only confusion  and disorder in every-
thing around the patient, but actually producing such a depression in
his vital energy, that, if death is not the immediate result, the disease,
whatever it may  be, is  always increased  in severity.  Indeed, I have
many times  known such an unwise course to effect a fatal termination
in cases where, but for this, recovery would certainly have happened.
  From these facts, which I may truly say, are almost every day occur-
rences, may  be seen the necessity for educating every man and woman
in the correct method of nursing the sick.  For it is  much better that
a father should nurse his own son, or  a mother her  own daughter, than
to have this  done by a stranger, no matter how kind, how tender, how
attentive, and bow well versed in the rules of nursing he or she may
be.   The father,  the mother may have all this, to which will be added
their natural feelings, their parental love, their  deep interest, and more
than all, their knowledge of the peculiarities  of the patient's mind and
constitution, which will  enable them the better to bestow all those little
attentions and expressions of affection in connection with their nursing
duties, which they cannot expect to find in the  bearing and address of
the stranger, and which do more to tranquilize, console, and cheer the
patient than  all the rest of the whole routine of the  nursery, however
well  this  may  be conducted,  rendering  him  heart-happy, and  thus 
38
AMERICAN FAMILY PHYSICIAN.
greatly contributing to his cure.  Besides, one very great and extremely
important point in this connection, is the excess of confidence naturally
existing between parent and child.   For if a father or mother cannot
realize the implicit and unbounded confidence which their little ones place
in them, they will only have to  revert back, and carry their minds to far
away days, long since past and gone; the days of their own  childhood
when the sweet remembrance of the fathomless and unaffected innocence
of their childlike natures were wont to  believe that when that good old
mother, whose  eyes are  now, perhaps,  closed forever, and whose kind
and feeling heart, once full  of  holy and godlike feeling, has long since
mingled with its mother dust—that when, I say, she  promised them
relief  from pain, sickness, and  suffering, her promises were  always
fulfilled.   And this not once,  but repeatedly,  again and again;  thus
securing their  entire  confidence, without even  a  shadow of  doubt.
A remembrance of  this kind may lead them to appreciate the character
of the implicit  trust reposed in them by their own children.  How all-
important, then, it is to so prepare ourselves that we may not disappoint
that sacred  confidence,  which is  so  unreservedly  bestowed upon us by
the  innocent and tender beings  whom  the Most High  has confided to
our care.  Let it not  then be said, ye fathers and mothers, ye husbands
and wives, that you will deny your partners and your children these
heavenlike  attentions during  sickness,  and turn  them over to the
hands of  strangers, who, however excellent  they may be, yet cannot
possibly have your interest, your solicitude, and your affection—and
this too,  merely because you have not the time to  attend to them, or
because it requires  a  small  outlay to  furnish  yourselves with  the
knowledge of the duties requisite when attending the sick.
  True, I have said that both male  and female should have themselves
instructed in the art and  duties of nursing; but it is  in  the noble
elements of woman's  nature, more especially, that a ready response to
these duties will be  found.  In relieving the afflicted, in curing the sick,
in doing good to others, she is only following out the dictates of her
own spirit; and it is only in the breast  of true and faithful woman that
we find the most perfect combination of charity, patience, devotion, affec-
tion,  gratitude, untiring perseverance  and Christian virtue.   Women,
whose sympathies for and attentions to the sick, are of such an exalted
character, have ever been held in high  estimation by physicians.  And
it always affords the most  unalloyed  pleasure  to the medical  man,
whenever he has succeeded in restoring some loved one to the fond
embrace of a mother, daughter, wife or  sister, even when the last spark
of hope was nigh extinguished,  and despair was casting its dark and 
HOUSEHOLD DEPARTMENT.
89
eomber shadows over some daughter of sorrow.   Then, when despond-
ency yields to hope, and certainty removes doubt, and the bosom heaves
tumultously with joy  and  thankfulness,  the successful physician is
bono- cd and welcomed by the plenitude of woman's heart, which, when
disclosed by her smiles of affection and tears of joy, presents a scene,
and gives rise to emotions which even an angel might envy.
  Without woman,  how blank, how dreary would be life!   To  her do
we owe our present existence; to her do we owe the cultivation of our
plastic minds in childhood, forming us for the pursuits of a more matured
life, giving to us impressions which can never be effaced by the finger
of time, and the remembrance of which calls up the most grateful and
pleasing associations; to her do we truly owe all the happiness attend-
ing a well-spent life.
  In sickness, or on the bed of death, who watches over us with more
care and  solicitude than the mother, wife,  or sister?  Whose words of
kindness  and sympathy cheer and comfort us, and sustain us in afflic-
tion ; or, who smooths the sick-pillow, or relieves the aching brain so
well as the fair hand of Heaven's  best gift to man ?  Through  her in-
fluence, the hour of trial and suffering is made to pass as a shadow—
misfortunes become like golden sunshine—and  the  pangs  of adversity
yield to her smiles and affection.*  She is the polar star of man's exist-
ence, causing him to view all the dangers and terrors surrounding him
as momentary clouds floating by-—and guiding him onward in the road
to virtue and happiness; she is the harbor  of safety, contentment, and
true enjoyment—man's richest treasure—she is, indeed, the lovely link
that binds man forever to his Maker.

                What Constitutes  a Good Nurse.
  There are many  persons who make it a business  to attend upon the
sick; but, unfortunately, few of them are  what may  be termed good
nurses—having a proper understanding and appreciation  of the true
character of the business which  they have chosen.  The object of a
nurse is to second the physician in his endeavors to  remove disease and
restore to health; and for this purpose, a number of qualifications are
requisite, without which there is but little safety for the patient, and no
honor for the physician or medical attendant.
   A man or a woman may qualify themselves to act  as  a nurse; the
man being the most proper attendant upon males, especially in certain.
diseases, as delirium, insanity, etc.   But  as, at the present day, it is
more customary for women to prepare themselves  for this business,  I
will, hereafter, refer to them entirely while writing upon this  subject,
            53 
40
AMERICAN FAMILY PHYSICIAN.
remarking, however,  that the  rules and directions given are equally
applicable to both males and females.
  The first thing required in a nurse is strength, or at least a sufficient
degree of strength to enable her to lift patients in and out of bed, and
attend to the several other wants connected with the management of
the sick, which  require  a certain amount of muscular power.  At an
age younger than twenty-one or two, the physical strength, as a general
rule, is not sufficiently matured for performing those duties in the sick-
room which are frequently  required;  while, after the fifty-sixth year,
and sometimes  even before, the powers of the system begin to fadl, and
debility, both of mind and body, manifests  itself,  greatly interfering
with  the  duties already referred to.  From this,  it will be  observed,
that we consider the  most  appropriate age  for a nurse  to be between
the ages of twenty-one and fifty-six.   However, this is one of the least
important  points  connected with  nursing,  as, in  many families, and
especially in the country, when any duty requiring  mere strength is to
be performed, some able-bodied member of the family is called upon,
and the want of this requirement in the  nurse is not felt in the least.
  The nurse should  be healthy, for a sick  person  can  be but  poorly
attended to by one who is also sick;  if the nurse be deaf, or be labor-
ing under any impairment of sight,' the patient may suffer severely
from  an inattention to his  sufferings  or wants, or from having wrong
potions or drinks administered; if she be disposed to hysterical attacks,
to lowness of spirits,  to hypochondria, or to epilepsy, an attack  of one
of these will not  only prevent her from bestowing proper  care upon
the patient, but may even seriously alarm him; if she be scrofulous,
dyspeptic, disposed to liver complaint, or constipation, she will not only
fill  the atmosphere of the  room with the unhealthy gases emanating
from  her lungs, but will also be too much  occupied in attending to her
own sufferings; if she be subject  to  asthma, difficult breathing, con-
sumption, or habitual cough, these will not  only prove  an annoyance
to the patient, rendering him restless,  and increasing the activity of his
disease, but will themselves demand medication and attention;  and so
on with other diseases, as rheumatism, gout, constant headache, dizzi-
ness, nervous debility, neuralgia, paralysis, spasms, etc.; they must be
absent in a nurse—she must be healthy.   Though even these  excep-
tionable cases  should make themselves acquainted with the rules ot,
nursing, that they may know when a  patient is properly taken care of
and may also frequently give timely and judicious hints and suggestions.
  A very important point requisite to form a good nurse is a good,cher-
ful temper, and a kind, sympathizing  disposition.   Patients frequently 
HOUSEHOLD DEPARTMENT.
41
  complain, fret, worry, scold, accuse, and do other things which are well
  calculated to try both temper and disposition.  If the nurse, instead of
  being calm, unruffled, and pleasing in her speech and manners, endeav-
  oring to soothe and tranquilize the despondent or excited condition of
  the patient, should, on the contrary, show a spirit of anger or resent-
  ment, scolding,  or using  harsh words in return, she not only injures
  the patient, so far as his  disease is concerned, but she injures herself
  in the patient's estimation, losing his confidence and respect, and, in
  some instances, even gaining his aversion and hatred.
    A  pleasant, agreeable  tone  of voice,  never  too low, nor above  a
  certain pitch; a quiet but  cheerful expression of the features; a gentle-
  ness  of manner, joined with at  least an appearance  of interest and
  sympathy; a firmiuess and earnestness, without  rudeness;  a decisive-
  ness,  without domineering; and a cheerful readiness and willingness in
  executing the wishes of the patient, and attending to the sever?1 little
  offices he may request, are all necessary to form a good  nu\ ^ ;.-0
  who can  secure  the respect and confidence of the sick intrust".. .':'. ?iei"
  care,  inspire them with hope, and  second the efforts made by :•>:- >:•;:£;
  cal  attendants to restore  to health.   She must humor  the  ■->-!.;.; in-
  patients laboring under severe  forms of  disease, never con.:;;.,  ••;;•;
  them,  but winning them over by her gentle, kind, persuasive langwge,
  or by  other ways suited to the patient's own  peculiar disposition, to a
 different view  of things, or, to  entirely lose'the  particular  current of
 ideas under which they may be laboring.  Laughing, joking, story-tell-
 ing, loud  talking, gossipings, relating  unpleasant news,  wranglings, or
 sociable  disputes, on medical, political, or any other matters,  are'all
 out  of place  in  the  sick-room,  and the nurse  should  not  only avoid
 these herself, but employ her authority in checking them with others.
   It is hardly necessary to say that a nurse should be honest—I mean
 honest, not  so much in regard  to her employer's  property as to  the
 physician; she should follow his  directions to  the letter,  except in
 cases where she knows that by  so doing it would be injurious to  the
 patient; and  it is in  cases like  these  where she  must  rely upon  her
 own  knowledge and  judgment—it is her  privilege ; but, in all such
 instances,  she should have the  physician  apprised at  once, in order
 that he can promptly make the necessary change in treatment.  Every
 judicious physician expects this from a good nurse, for it is  impossible
 that he can remain all the  time with a patient, to observe the varying
symptoms  of the disease, or the  action of the medicines  prescribed
Indeed, physicians are often thankful  to nurses who have  made judi-
cious and  efficacious   changes in  treatment  during their absence, in 
42
AMERICAN FAMILY PHYSICIAN.
cases of necessity; though, unless it be absolutely necessary, it is, as
a general rule, exceedingly improper, and hazardous to the patient, for
the nurse to make any change, except with the advice and consent of
the medical attendant.
  She should be honest in not concealing from the  medical attendant
any changes which may  have been made in  the  management  of the
patient, either by himself or by his relatives, as well as any neglect in
properly attending to the directions which the attendant may have left.
A neglect of these duties is often done at the cost of the patient's life.
She should  be especially careful not to destroy the confidence  of the
patient and friends by  speaking in any way slightingly or doubtfully
of the medical attendant, or by endeavoring to have him dismissed and
some  medical friend of  her own employed in his stead.  Such a course
is not  only unprincipled, but may  become a  serious  matter to thc
patient.   Yet an educated nurse has an undoubted right to express an
opinion, when she sees, or knows, that the patient's welfare is at  stake;
in which case, she may consult with the family or friends of the sick;
but, in all instances, not in the patient's presence or hearing.
  In  addition to these points, she should  be sober, not addicted to
intemperance; she should be orderly, calm; should keep her person in
a clean and neat condition; avoid  the  use of tobacco, and not  render
her attentions to the patient  disagreeable or annoying.  She  should
have  a "place for everything, and everything in its place."
  Now, although a nurse may have  all the requirements just named,
yet if she has neglected to observe and ascertain  certain symptoms
and circumstances connected with patients and their diseases—if she
is merely a machine in the hands of  the medical attendant—it must
readily be understood by every one, that she will not be able to  recog-
nize the value of changing symptoms, their favorable  or unfavorable
character, and make the proper reports in relation to the course of the
disease during the absence of the physician; neither  will she know
what  symptoms demand the presence of the physician;  unless, indeed,
they  be so  severe as to alarm her; and the patient may lose his life
as a  consequence of this ignorance.   A  good nurse will not only be
able to determine these matters, but will also know, when thrown upoD
her own resources—as, for instance, when the medical man is so situated
that he can not  attend to her call for some hours—how to correctly
treat  and manage the case. 
HOUSEHOLD DEPARTMENT.
43
     Every Wife and Mother Should Know How to  Nurse.
   The preceding remarks apply to nurses in cities and in the country,
 but to the former  more especially, in which  places they are more
 numerous, and are  more apt to properly qualify themselves for their
 vocation.  But  in  country  places, and,  many  times, even in  cities,
 nurses cannot always be had when they are required, perhaps because
 they are  all already engaged, or because the pecuniary circumstances
 of the  patient or his friends will not permit them to employ one.  In
 such cases, a wife,  a mother, or a sister, are the parties  who have  to
 assume this responsible position of waiting upon their sick relatives,
 and unless they  are properly qualified to do this, their want of inform-
 ation may  prove a fatal one for the  patient.   Hence  the  immense
 value and importance  of their being well posted  up; for no  father,
 mother,  husband,  wife, son, or  daughter can know  how  soon the
 moment  may arrive when he or she will be suddenly called upon  to
 attend and nurse some  dearly beloved relative prostrated  by disease.
 How pleasing, how gratifying must it be to a wife,  a mother, a sister*,
 to be able thus  to  bestow her  services  upon a sick relative, than  to
 call in  a .stranger, who, however dutiful and attentive she may be, lacks
 the peculiar interest and sympathy to be found only in the bosoms of
 those who are near and dear to us.
   Still more important is it for females in the  country, especially,  to
 instruct themselves, not only in the requirements of nursing, but like-
 wise in a knowledge of disease and its treatment; for such a knowledge
 is more essential with them than with a city female.   The latter, when
 a relative is stricken with  disease, can  secure a physician  at a few
 minutes'  notice; the former  has frequently to send many miles  before
 the physician's  office can be reached, and, should  he be absent,  in
 attendance  upon some other distant patient, hours  may pass  before
 she can have his attendance.   These hours may bring  death  to the
 sick one,  unless his  wife or mother can, from having  properly informed
 herself, act both  the part of nurse  and of physician.
  "But," says one, "I dare not do this—I am  afraid;" another says,
 "I am  not acquainted enough with medicine; I may do mischief."   I
 will say to  these in reply, that  no harm nor mischief can come from
 properly instructing one's self;  but, on the contrary, much good.  In
 some sections of country, it is unfortunately  the  case, that  the phy-
 sician is a half-educated man, who has never  seen the  inside of  a
medical college, and knows  about as  much of the anatomy and physi-
ology of the human system  as a horse does of his  great grandfather. 
44
AMERICAN FAMILY PHYSICIAN.
He has merely procured a few books on  medicine, and experimented
therefrom  upon the sick of his neighborhood, who have ventured to
call him, until after having obtained some notoriety by losing many
of his patients, and also acquired a degree of experience and observa-
tion, as well as confidence in his own  powers, he devotes  himself to
his profession!  He is relied upon as the doctor, and notwithstanding
his ignorance of the human system, and  its various controlling laws,
health and life  is  intrusted to his care.   Pshaw! is  there a woman
who cannot learn  as much, and  do as well,  both as  to nursing and
doctoring,  as such a man?   Mothers  in the country, wives  in  the
country, are you not capable of doing as well  with your sick husbands
fathers, or sons,  as a doctor thus tutored?

                      The Duties of a Nurse.
   To name all the duties of a nurse would fill a large volume; hence,
as our pages are necessarily limited, we will refer to some of the more
prominent ones.   A  brief reference has been made to this matter in
Division I, pages 183  and 184.  The first duty is to examine the sick-
room, to ascertain  that it is dry and airy, and furnished with a chim-
ney, or  other means of ventilation, and that it is situated as far from
noise as possible.  Indeed, this  is so essential in many diseases, to avoid
disturbing the patient  and thus increasing his disease, that, notwith-
standing a carpet  may be in  the room, the nurse  will be required to
walk round in her stocking feet, to prevent the creaking or other noise
accompanying the  walking; and all conversation between her and the
doctor or members of the family, will have to be conducted in whispers.
This is  owing to the increased susceptibility  of the patient's nervous
system, rendering  the senses  morbidly  acute, so  that, in many cases,
even whispers will render the patient restless, or even occasion delirium,
or aggravate it when present.
   If there can be  a choice in the matter, a  room should be selected
which has large windows, so arranged that both sashes may  be  slid up
or down as the case may require,  high ceilings, and which is furnished
with light from the  north, in order that the rays of the  sun may not be
allowed to enter the room and annoy  the patient.  All unnecessary
articles  of furniture  should be removed,  retaining only such  as  are
absolutely required.  An easy chair for the patient to sit up in, when
he can, or during convalescence,  will be found of some value,  though
this is not absolutely necessary, as other simple  contrivances may be
prepared to answer a similar purpose.   As a  general rule, it is better
not to leave a looking-glass hanging in  the  room, as it is apt to prove a 
household department.
45
 source of great disquietude to the patient.  The bed of the sick person
 should be a mattress, a shuck-bed, or a bed stuffed  with cotton; and,  if
 necessary, a comforter or two may be thrown over these last to render
 them soft;  but, in this case, they will require to be  frequently changed
 and washed.   Of all beds,  a feather-bed is the very worst, because  it
 absorbs all the unhealthy emanations  from both healthy and diseased
 persons  who  may sleep on it;  it is  a constant depot of poisonous
 matters, which, although sufficiently  injurious  to the  well, are trebly
 more so to the sick; and I have no 'doubt that feather-beds, which contain
 thc noxious accumulations from the bodies of  those sleeping on them
 during a course of many years, have, in more instances than we imagine,
 been the sole cause  of  the fatality attending  disease among certain
 patients.  Hair, cotton, woolen, straw or corn-shuck mattresses readily
 admit of the escape of the animal vapors or insensible perspiration, and
 consequently  have none of the deleterious inconveniences  of those
 materials which  retain them.   On the other hand, a  feather-bed not
 only forms  a bath,  as it were, of these vapors, which re-enter the
 system by absorption, but, by the heat and perspiration it produces, it
 excites, relaxes, and weakens the system, not only disposing to disease,
 but increasing its severity, when it is  already present.
   This  is a subject  upon which much has been said  and written by
 physicians and others, and is, I believe, pretty well understood through-
 out community; still, in many instances, we find persons who  continue
 to use feather-beds in total disregard of what has been said, and, as
 it were, in  defiance of disease.   To such I would say:  Consider a few
 minutes, and weigh well the consequences; for though you may thus
 far have escaped with impunity, you know not how near to you disease
 and death may be lurking.  Let the warning of one who has had an
 experience and an observation of many years in this matter, have some
 weight,  some influence upon you, and  induce you to pursue a course
 that will be less hazardous  to your future wellbeing.
   In olden times, in  many cases of disease, as scarlet-fever, small-
 pox, typhus fever, measles, and other  infectious diseases,  the  atmos •
 phere was as religiously kept from the sick-room  as  though it were
 poison to the  patient.  In  the  present day,  we know that a proper
 ventilation of the room, a supply of fresh, pure  air, is not only advan-
 tageous  to  the patient,  but by  diluting, as it were,  the infectious
 effluvia of the sick-room, renders it less liable  to infect  others.  Hence,
not only should the apartment be well ventiiated, but,  in cases of con-
tagion, it should be purified by  the  means referred to  in Vol. 1, page
137.  This is a matter which should be strictly attended to, as a want 
46                  AMERICAN FAMILY PHYSICIAN
of proper care or neglect may involve the health, and even the lives
of all the remaining parties of a family, in which disease has attacked
one of its members.  It is to be regretted, not only that so few people
have been made acquainted with this matter of ventilation, but also
that those who  ought to understand it thoroughly—physicians__do  in
many instances, neglect an attention to it while treating the sick thus
causing a vast amount of suffering which  might have been prevented.
  In  all diseases,  it is  likewise a matter of much  importance  and
particularly so in the more severe and malignant forms of disease to
properly regulate  the temperature of  the  room, which should  never
either  in winter or  summer,  be above 65° Fahrenheit, nor below 55a
Fahrenheit.   This can always be managed, except in very hot seasons
when,  by opening doors and windows, bathing  the patient when not
contraindicated, and fanning him, we  may at least lessen the depress-
ing effects of too much heat upon his system.   But the temperature of
the room should never be allowed to produce a chilly sensation—though
the chilliness of disease  must not be confounded with that from a low
temperature.   In cold seasons the heat of the sick-apartment can be
elevated by artificial heat, which may be regulated by means of a ther-
mometer.  One of  these instruments should  be possessed by every
family, for they are not only useful in sickness,  but in many other in-
stances,* and they can be had for fifty or seventy-five cents apiece.  The
proper regulation of the heat of a sick-room is  an important matter,
and should never be forgotten; it is frequently of  more  service  in
assisting nature to remove disease than all the other means used.
  Order and cleanliness in the apartments of the sick are very neces-
sary and essential points.  Without order nothing will go right, every-
thing will be  in confusion,  to the annoyance of doctor, patient, and
nurse; with  order,  everything will pass along smoothly, which con-
dition  will be more  conducive to the .comfort and welfare of the sick
person.  Cleanliness must be attended to scrupulously, for neither the
patient nor the nurse will be otherwise than harassed by an uncleanly
room.  To effect this, it does not require that the room should be swept
every day so as to raise a dust, nor that any amount of noise and bustle
should be made in arranging  furniture,  neither  that the floors should
be washed every  day; these  are all  injurious to  the patient.  The

  * One of the many things for which a thermometer may be used is in the churning of
butter.  To make butter come quickly, and thus save much time and labor, the tempera-
ture of the cream should be at 60° F.  A thermometer placed in the cream will point out
its temperature.  If the cream be below 60°, it must be warmed to the proper degree; if
above it, it must be cooled. Many farmers find its use ia this respect alone, very valuable. 
HOUSEHOLD DEPARTMENT.
47
 nurse should with a dry cloth wipe all articles requiring  it, and have
 the  room brushed  up when  needed while the  patient sleeps, being
 careful to cause no dust, nor make any noise.  The  stools should be
 removed immediately after being passed.  The bed-linen and the bed
 clothes  of  the  patient should be  changed every two or  threedays,
 effecting this change  in the easiest manner,  and with as  little incon-
 venience to the patient as possible.   Care should be taken to  have
 the elean clothes well  aired and thoroughly dried.  In diseases of long
 standing, and in contagious diseases, even the whole bed  and bedding
 should be changed once or twice during the sickness.   In cases where
 the families have but the one spare bed, a few blankets or comforters
 may be  spread upon a cot or cricket, or some similar  contrivance,
 which any man of ordinary  ability can prepare, and which may be
 occupied by the  patient until the bed  and bedding  have been aired
 and  purified.   I  know this course is  contrary to  the view of many
 persons, and even a few physicians; nevertheless, it is correct, and is
 a point that all persons who value the welfare and life of their sick
 will  by no means neglect.  All spoons, vessels, etc., which  are  used
 by patients should be kept scrupulously clean, being invariably washed
 each time immediately after use.
  Cooking  in the apartments  of the  sick is extremely improper,  not
 only irritating the enfeebled  brain and nerves of the patient by the
 noise and fuss  necessarily  accompanying  it,  as  well  as by the  odors
 arising therefrom, but also proving  detrimental to him by rendering
 the atmosphere of the room more  or less impure.  In cold weather a
 fire in the  room for the benefit of the  nurse, and others who may be
 present, is required, but no  cooking, making tea, or warming drinks for
 the patient or  for the nurse  herself, should  be permitted;  although
 nurses  frequently avail themselves of it for these purposes—but it is
 wrong.   All such matters should be accomplished  in another apart-
 ment, except  during  the  night,  when,  if  warm  preparations  are
 required, a nurse-lamp, common lamp,  or  candle, may be  used.
  No kind  of food whatever, whether  in  the  crude state or already
 prepared for eating, should be  kept in the sick-room, or in its immediate
 vicinity.   In the first place, if such food throws out any  odor, it will
 annoy and injure  the patient; and, in the  second place, the unhealthy
 vapors of the sick-room will pass into it, contaminating it, and render-
 ing it unfit  to eat on account  of its tendency to cause disease among
those who use it.  Many persons  are  in the habit of keeping  their
food in  closets in the sick-room, or in adjoining  rooms which are only
separated from the one occupied by the patient by partitions not suffi- 
48
AMERICAN FAMILY PHYSICIAN.
ciently tight to keep out the diseased vapors;  doing these from an
ignorance of the dangers which may follow such a course.  Much sick-
ness, which could  not be accounted for by the parties, has arisen from
a want of knowledge in this respect, especially in  country places.
  It is not always necessary that  the sick-room should be  darkened
for it  frequently  happens that  a dark room keeps up a species  of
morbid action  of  the brain, which  is at once dispelled as soon as the
light is admitted.  This is  frequently the case where, although not
delirious, the patient  is annoyed by illusions  of sight, fancying he sees
persons and things not  present, etc.   On the other hand, when there
is  a morbid sensitiveness of the sense of sight, as  in the case of some
severe fevers and inflammations, and also in some instances of great
nervous prostration,  attended with restlessness, morbid excitability of
the  brain, or delirium,  a partial or complete  darkening of the room
will prove of great service.   Although these points, as to  the darken-
ing  of the room, are of much importance, no  special rule can be laid
down;  the only guide must be to carefully watch the influence of both
light and darkness upon the patient, and then adopt that plan which
appears to be  the most salutary  and refreshing for  him,  or which
agrees with him the  best.
  A nurse  can materially aid in restoring the sick to health, by being
able to suggest to  the medical attendant, certain measures,  or auxiliary
treatment which she may deem advisable;  for, everybody knows, that it
is frequently the case that the physieian, from the fact of his generally
being with a patient only a few minutes each  day, may overlook, forget,
or omit to  name some very important item  connected with the treat-
ment or the nursing.  No good physician will ever find  fault with any
suggestions which nurses may make; on the contrary, he will consider
whether they are useful or hurtful, and  will recommend them if the
former, and will firmly but kindly prohibit them if the latter.
  A nurse should use such kind, cheerful, persuasive, and consolatory
language, as will tend to draw  the mind  of the patient from  any sub-
ject that seems to annoy him, or cause mental disquietude or distress;
for  it  must be remembered  that  a  calm,  quiet mind will, in many
cases,  do more toward restoring  the patient's health than all  the medi-
cine in the world.  Many persons during sickness, from nervous pros-
tration, morbid excitability, or  other cause, will conjure up strange
fancies which it is difficult to drive from their minds;  thus, one will
imagine he or  his family will  come to  want;  another, that he will
inevitably  die, in  spite of doctors, medicine,  and nurses; a third, that
his business is  going  to ruin, etc.; in fact, a general  despondency seizes 
HOUSEHOLD DEPARTMENT.
49
  apon them, of a character sufficient to make a stout, hearty man sick,
  and, unless this condition of mind  be removed by a proper manage-
  ment on the part of the nurse, the patient will grow worse instead of
  better,  until he  falls into the  arms of death.  Indeed, I have known
  two or  three persons, to all appearance  in the enjoyment of health,
  who, notwithstanding they were uncommonly wealthy, yet were  con-
  stantly  haunted by the idea that they would come  to want, and which
  idea eventually  caused them  to  commit suicide.   Now, whenever a
  person  is thus affected, he requires  medical aid; and although, as was
  the fact in thc cases I refer to, he will not admit  that he is unwell,
  and will hoot at the idea of being attended by a physician, his friends,
  as a matter  of kindness and duty to him, should compel him to receive
  treatment by placing him in a hospital for the  insane, as he is  truly
  laboring under one form of insanity.
   Is it  not our duty to comfort, cherish,  encourage,  and sustain  as
 far  as possible, those who are afflicted with disease and suffering, if
 not from motives  of benevolence and  good-will,  at least 'from  self-
 interest; for who knows  how soon it may become  his lot to undergo
 sickness and pain,  when he will require assistance, and be equally as
 troublesome to those who attend upon him in that trying hour, as are
 they who arc now sick,  and to  whom he  should  devote some care
 attention, and sympathy ?

               Unfavorable  Symptoms  of Disease.
   There are certain symptoms of disease, by which a favorable or an
 unfavorable  change is determined; the nurse should especially under-
 stand the latter, that she may change the treatment  pursued,  or at
 once send for the medical attendant to do so, whenever they present
 themselves during his absence. Not only the nurse, but the friends
 of the patient should understand these symptoms,  because a prompt
 attention to  them will  frequently be the means of saving life.  A
 knowledge of these unfavorable  symptoms  is therefore,  of itself, worth
 the price of  this book, a hundred times over.  The following are the
 principal and most important :
  Great anxiety is an  alarming  symptom in diseases  of the brain,
 Jew** striking m of eruptions, injuries, etc.
  Bleedings from the lungs, nose, stomach, kidneys, bladder, womb
or bowels, are always  dangerous, and should be promptly attended to
whenever they occur.   In some few acute diseases, bLdmg from t^
nose * a favorable symptom, when not too profuse.
  Extreme difficulty of breathing, in  consumption, fevers, inflam- 
50
AMERICAN FAMILY PHYSICIAN.
motion of the lungs, or  of other organs, and in injuries, is an unfavor
able symptom; it may,  however, be present in asthma, even to a sens<
of suffocation, without being necessarily  dangerous, unless it disposes
to some other disease.   In  croup, it is an indication of danger, espe.
cially when the breathing is loud, crowing, rough, croaking, or hiss-
ing.  In hooping-cough, and false croup,  it is dangerous when followec
by  convulsions, inflammation  of the  lungs,  or congestion of the
brain.
  Coma, Lethargy, or a constant disposition to sleep, during fevers
or  acute diseases,  especially when  the more severe symptoms  of tho
case diminish, or following a sudden relief from the pain of rheumatism
or gout, or after the striking in of any eruptive disease, or the stoppage
of customary discharges of blood, or the healing  of old ulcers, or imme-
diately after childbirth, is a dangerous  omen, and energetic measures
should be adopted to overcome it.
   Convulsions are more   dangerous among   children than  adults,
among females than males;  they are especially dangerous when occur-
ring immediately after, before, or during  childbirth, diseases of the head,
during an attack  of fever and some inflammations, when there is  a
striking in of an eruptive disease, in severe hooping-cough, and particu-
larly when they are attended with  a stupid state of the patient, or a
constant disposition  to sleep.   Hysterical convulsions are  rarely
dangerous.
   Confusion of ideas and  thoughts,  loss  of memory, are always
unfavorable symptoms  in acute diseases,  in diseases of the head, and in
cases of eruptive diseases striking in.
   Cough is  an unfavorable  symptom when it suddenly appears after
the suppression of some customary discharge, or  after the striking in of
some eruptive disease.   The  sudden cessation of cough attended with
symptoms oi prostration and nervous debility, is  equally unfavorable.
   Delirium is common to  all acute diseases, and is dangerous only
when it is very severe, or is of  the low, muttering kind; also when it
is present during jaundice, a cessation of the urinary discharge, injuries
to the head, diseases of  the chest, and especially consumption.
   Deafness, when occurring during the  course  of diseases of the chat.
requires attention, but is not  an alarming symptom when manifesting
itself during typhus or continued fevers.
   Diarrhea is sometimes the symptom  of a favorable termination  of
a disease;  more  commonly, however, when it  occurs  during fevert
inflammations, or in the latter  stages of chronic diseases, it  is to  b<
feared 
HOUSEHOLD DEPARTMENT.
51
m
    Difficulty of swallowing is extremely dangerous when occurring
    the course of fevers, diseases of the head,  diseases of the stomach,
  vahy, and affections of the throat.
    Excoriations, or Ulcerations upon the buttocks, hips, shoulder-
  blades, or other parts of the body kept constantly in  contact with the
  bed, are unfavorable, and especially so, if these be dark, purplish, and
  disposed to gangrene or mortification.
    Kmaciation, when continued to a great extent, is  always  unfavor-
  iible.  In acute diseases, and diseases of long standing, when conjoined
  with what is called the Hippocratic countenance, in which the  eyes
  are sunken, the temples hollow, the nose pinched, the ears drawn  back
  and cold, the skin of the forehead tense and dry, the lips hanging or
  open, cold, and relaxed, the complexion dark or purplish, etc., it  is an
  indication  of  approaching  death.  After an acute disease, if a  child
  continues weak, with emaciation, and a large, swollen, drum-like
 condition of the  abdomen, it is an  alarming  symptom,  and demands
 prompt and energetic attention.
   Toxditions of the Eye,  as Squinting, too great a contraction or
 dilation of the pupil, or an immovable  condition of it,  are unfavor-
 able symptoms, when they occur during the course of disease.   When
 the pupils are turned up under the eyelids, it is also a serious  symp-
 tom, as well as wb.cn the eye is set, and the patient does not notice the
 finger when brought suddenly toward it as  if to touch it.
   Falling of the womb may be suspected by the weight and bearing
 down sensations in standing  or walking, pains and distress in the back,
 and difficulty in urinating and stooling.
   Fluor-albus, Leucorrhea, or Whites, may be known  by the more
 or less constant discharge from the vagina, which  is either colorless,
 or of a whitish, yellowish, brownish, or bloody color, with an  accom-
 panying weakness in the back, and indeed,  of the whole -system.
  Fainting, or Syncope, is a serious symptom  when  occurring after
 profuse bleedings from any part,  or with persons laboring under dis-
 ease of the heart.
  Hiccough or Hiccup is an unfavorable symptom when occurring in
 the course of long-standing chronic diseases, or in the advanced stages
 of acute diseases.  Sometimes, however, it may be readily overcome;
 when dangerous it continues in spite of all treatment.
  Hoarseness manifesting itself early in scarlet fever, measles, small-
pox, and  other exanthematous diseases, is an  unfavorable symptom,
especially  when the patient spits considerably at the same time.
  Hooping-cough  is dangerous, when  the paroxysms  of cough are 
52
AMERICAN FAMILY  PHYSICIAN.
very violent, occur frequently and last a long time, the face becoming
purple, the thumbs  clinched in the palms of the hands, the forehead
covered with sweat, and the eyes red and protruded.  Medical assist-
ance should be promptly rendered, lest the patient die from congestion
of the brain, apoplexy, or convulsions.
  Involuntary discharges of either the urine or stools, are always
indicative of danger, whether the stools be of the character of diarrhea
or not, or whether the urinary discharge be profuse or small.
  Paleness  of  countenance, slightly  purplish or darkened, is unfa-
vorable in inflammation of the lungs and air passages.
  Pain in the  bowels during an attack of inflammation, when sud-
denly disappearing, is always unfavorable;  the same may be said of
pains in all inflammatory  attacks of whatever organs.  Sometimes this
disappearance of pain is  an indication  of  mortification having com-
menced,  though not  always;  this may  be  determined pretty satis-
factorily  by observing whether the patient presents symptoms of
sinking or not.
   The patient's position in bed will frequently point out the seri-
ousness of his disease.  A constant lying on the back is very unfavor-
able, especially when, at  the same time, there  is a tendency to sink
toward the foot of the bed.
   Picking the  bedclothes,  or grasping in the air, throwing off
the cover, twitchings of the tendons, gritting the teeth, sleep-
ing with the lids partly open, showing only the whites of the eyes,
muttering during sleep, and awaking with a stare or vacant look,
are symptoms of approaching death.
   Polypus of the womb may be suspected  by the frequent bleedings
occurring  at irregular intervals, paleness of countenance, feeble and
rapid pulse, great debility, occasional  faintings, and sometimes drag-
ging  down sensations which  are  experienced.  It is  rarely that any
pain is present.  Thc breasts sometimes enlarge.
   A  presentiment  of death, when  constant in the patient's mind,
is always to be  feared.
   Purple spots, during measles, small-pox, or scarlet fever, are always
unfavorable  symptoms, and especially when conjoined with a  COLD-
NESS of  the extremities.   Purple spots upon the skin in fevers,
with dark or purplish cheeks and lips, sudden flushings followed
by extreme paleness,  and  slight oozing of blood, indicate that
dissolution is near.
   Rattling of mucus in the throat, called  thc "rattles," in the
advanced stages of disease, is the forerunner of death. 
household department.
53
   A restless eye, constantly  wandering about, with a vacant or in-
 definite expression of the countenance, is unfavorable in all acute and
 longstanding chronic diseases.
   A difficulty in urinating, a retention of urine, or AN entire want
 of urine in the bladder, are, either of them, symptoms of danger.
   Rigors, or severe chills, indicate the formation of matter in some
 internal diseased organ, which  may or may not prove serious.   When
 occurring in the advanced stages of fevers or inflammations, they are
 unfavorable.
   Sighing, when deep and frequent, is an unfavorable symptom in the
 advanced stages of acute disease, and  when occurring after profuse
 bleedings or other  evacuations.
   Small-Pox is dangerous when the pox or pustules on  the body flatten,
 become  dark colored, and those on the face assume a white, pasty ap-
 pearance ; also, when there is violent fever, stupor, or delirium, vomitings,
 and thc pustules are croivded together.—Striking in, or "a recession"
 of eruptions on the skin, as in small-pox,  measles, scarlet-fever, etc.,
 is always dangerous, and requires prompt and efficient treatment.
   Swellings on the legs and skin, which pit on pressure, indicate ap-
 proaching dissolution when they occur in the advanced stages of chronic
 diseases.  So, likewise, does the sudden disappearance of a swelling
 which has existed for some time.
   Ulcers upon the mouth, gums, and  tongue,  of  a whitish, aphthous
 character, occurring in the advanced stages of disease,  when  the sys-
 tem is much exhausted or debilitated, are the forerunners of dissolution.
   Vomitinc, in the advanced stages of disease, when violent and con-
 tinued, is unfavorable, more especially when the  matters vomited up
 are dark, putrid, and offensive,  or filled with excrement.
   As a general rule, death may be known by a combination of symp-
 toms, as: coldness of every part of the system; a doughy sensation of
 the flesh; pulsation can not be detected in the temples, at the wrist,
 nor any other parts of the system; the heart can not be heard to beat
 when the ear is placed upon the  chest over it; no moisture can be
 observed  upon thc  surface of a piece of looking-glass  held for some
 minutes close to thc mouth and  nose; the eye is fixed and glassy, and
 does not recognize the finger, even when placed upon it; and the skin
 is insensible to pain.  Notwithstanding these  symptoms being present,
some persons have recovered from a supposed death; on which account
much care should be taken not  to bury too soon.   In some places the
authorities will  not  permit a body to be buried until putrefaction has
 commenced, which is the only positive symptom of death. 
54                 AMERICAN FAMILY PHYSICIAN
DIET FOR THE SICK AND FOR CONVALESCENTS.
  In  sickness, as well as during convalescence, an attention to diet,
both as regards the kind, the quantity allowed, as well as the number
of times per day in which food may be used, is a matter of much im-
portance.  It is sometimes the case that a person sick with some very
serious disease will crave and eat with impunity meats and other things
that we know would, with most other persons, cause some serious if not
fatal  symptoms; but these instances are rare, and are exceptions to
the general rule.  Great care should be observed in permitting the sick
to eat solid, hearty food, because  it is rarely properly digested; yet
when a patient craves constantly  a particular kind of food, a very
small quantity may be allowed him; if no injury, nor  increase of the
severity of the disease results, a little more may be given: and in thia
manner it may be carefully and gradually increased.   But it should
be remembered that  there  is what is termed a morbid or unnatural
appetite,  in  which, although a patient craves any  article of food or
drink, the first mouthful satisfies him; or if  not, and he continue^ to
partake thereof, dangerous, if not fatal, symptoms may follow. Hence,
much care and prudence is required in permitting patients to use food
craved, which, under general circumstances,  is prohibited on account
of its bad consequences.  The general rule to be adopted with the
sick in relation to diet, is, to feed them some light, nourishing, and
easily digestible food, in small  quantities, repeating it three, four, or
five  times a day;  for the  system,  especially during acute diseases, is
not in a condition to  receive any great amount of nourishment from
food, however excellent this may  be.   When there is  a great amount
of fever or inflammation, the less  food  used the better, because this
aids in lessening these diseased conditions by lowering the system; but
when  the more severe stages of feverish and inflammatory diseases
have been subdued, a light food is allowable.   Relatives, and friends,
and even nurses, sometimes cause much mischief to patients by allow-
ing them to eat of anything they  happen to have on hand, or which
some neighbor has sent to them, and particularly when this is done at 
HOUSEHOLD DEPARTMENT.
55
 such times  as  during  high fever, active inflammation, etc.;  indeed,
 many persons are inclined to think that if a patient can eat, no mat-
 ter how sick he may be, there is no danger.  This is very wrong, anc.
 has  been a great  cause of much suffering and  death.   When the us«
 of any article of  food  whatever will increase the action of the heart
 the quickness of the pulse, or cause headache, or delirium, or pains in
 the  stomach cr bowels, it  is an indication that  such food is improper.
 Why, in acute disease,  the very absence or want of food, is, of itself, a
 medical treatment, as  it were, being followed by  a  lowering of the
 system, and a  consequent improvement of all  the active symptoms.
 Nurses, parents,  husbands,  and wives,  impress this  matter strongly
 upon your minds, lest,  in an unfortunate moment, you may, from a mis-
 taken kindness, kill your  sick friend by allowing him  to eat when he
 should abstain.
   During convalescence, that is, when the patient has  recovered from
 the  disease, but is still  weak, though gradually returning to his former
 strength and health, it  is fully as necessary to  pay strict attention to
 thc diet, as during the sickness itself.  True, more food,  and more kinds
 of food are permitted;  still, we must attend to their quality as well as
 quantity.  While  thc sick may eat one or several times a day, in very
 minute quantity, and at no regular periods, much depending upon the
 feelings and condition  of the patient, the convalescent should only be
 permitted to eat  at regular intervals, perhaps  several times a day at
 first, but gradually bringing him to his original habit  of three  meals
 a day.
   In thc early stages  of convalescence, about as much care should be
 taken with the diet as  during the illness, and this may be increased, as
 to nourishment and amount, as the convalescent  gains strength, and his
 stomach its  energy and digestive power.   I have in  many  instances
 witnessed death to suddenly follow, where parties, just  recovered from
 typhoid fever, or  some  other prostrating and exhausting disease, were
 permitted to eat freely of meats, some  kinds of pie,  mush and milk,
 apple •dumplings, and even articles of a more appropriate character.  I
 will  now name the principal articles allowable during sickness and
 convalescence.  The mode of preparing them, when  not named, will be
 found in the  next section, under the head of " Cooking for the Sick."
  Fruits.—Fruits are  not to be used indiscriminately  ; some are very
 useful, while others are improper.  In  high fever, and severe inflam-
matory diseases, and especially when  the tongue  is  covered with a
yellow, brown,  or dark fur, several acid  fruits are  very beneficial.
Tims, the juice of ripe oranges will be found very salutary and refresh-
            54 
56
AMERICAN FAMILY PHYSICIAN.
ing,  being always  careful to reject the pulpy, indigestible part—the
juice alone must be squeezed or sucked out.   The juice of ripe grape*
is  also beneficial, being careful not to  swallow the seeds or the skin?
Lemon-juice, or lemonade, is likewise serviceable, as well as tart cider
and, in eases where the tongue is black-coated, even vinegar.  Strait
berries, or mulberries, may have their juices pressed out, then strained
through a fine cloth to remove the seeds,  and be given to the patient
Hot  water poured upon prunes, tamarinds, ripe apples, or ripe peaches
and allowed to stand till cold, will be of decided advantage. In all these
cases the fluids used may be sweetened with sugar, or not, to suit thc
patient's  taste.
   The above acid drinks are more useful during the period of sickness
than in the convalescent stage, and may be entirely omitted by conva-
lescents.   Where buttermilk, either alone or diluted with  water,"agrees
with the  patient, it may be used;  sometimes, however, it causes pain
or distress in the stomach, vomiting, or retching, etc., and should not
then be used.
   Tea, coffee,  cocoa, and chocolate, should not be used  by either the
sick or convalescent.  Teas may be made of balm, catnip, sage, pepper-
mint, spearmint, peach-leaves, etc., and drank during the sickness; if
desired, however, common tea, or store tea, made weak, may be taken
during convalescence, in moderate amount, especially among those who
are  in the habit of drinking  it when  they are well.  Water may  be
drank at  all times  when it is found to agree with the stomach, causing
neither pain, distress, nor vomiting; it will be found peculiarly grate-
ful and beneficial in all fevers, and should not be withheld from patients
in these  diseases.   Freestone-water  or clean rain-water are the only
kinds that should be used;  in cases where no other water  can be had
but  hard  or limestone-water, and river-water, this  should be always
boiled before letting either the sick or  convalescent use it.   The flavor
of boiled water may be improved  by  adding a crust of bread, toasted
or not, or a  few pieces of apple-skin to it.   Toast-water, rice-water,
barley-water, apple-water, are  all  useful drinks for the sick-room.  A
roasted apple is  sometimes beneficial, that is, when the patient is per-
mitted to use food at all, and especially when the bowels are costive.
   When  the  more severe feverish or inflammatory  symptoms have
passed away, a more nourishing diet  may be permitted, as, cornmeal-
gruel, oatmeal-gruel,  bran-tea, barley-coffee,  rice-gruel, panada, sago-
gruel, arrowroot-gruel,  tapioca-jelly, beef-tea,  chicken-water, etc.  Ut
course, the strength or thickness of these drinks will depend much on
the  period of the disease, as they may be  made more nutritious toward 
                     HOUSEHOLD DEPARTMENT.                    57

,t» close, and in the early part of convalescence.   All these may be
seasoned with  sugar, or lemon-juice,  grape-juice,  tamarinds, orange-
iuice, efc, to suit the taste of the patient.
  For the convalescent a more nourishing diet will be required, m orde
to impart strength to the system;  but this can not be done suddenly
it must be accomplished gradually, commencing with the lighter nour<
ishing articles first, permitting the stronger kinds by degrees.
  Milk, when drank  immediately after having been  taken from the
cow, is very digestible  and nutritious;  but, after it has stood for a time,
so as to cause a separation of the cream, it is not so readily digested,
and is apt to occasion  flatulency and costiveness.  The same results are
liable to follow the use of cream or whey, though  otherwise they are
quite nutritious.   Milk boiled is  frequently useful.   Sometimes, it will
be required, especially in the  early period of convalescence, to dilute
the milk with  a portion of water.  Cream is frequently serviceable as
a diet to those laboring under dyspepsia, as it does not turn sour  so
readily as milk.   Sour milk should not be used.
  Eggs are  less  digestible when raw  than  when slightly boiled; they
are best boiled by breaking the egg and pouring its contents into boil-
ing water.  They  form a nutritious diet for the convalescent.  In some
cases an egg beaten up with wine is of much service; but this is appli-
cable to only a few cases.
  Boiled Bice is an article easy of digestion, and not apt to turn  sour
on the stomach.   Musn  and Milk is generally of easy digestibility,
and agrees well,  except when eaten in too large quantity.
  1)kef-tea, Mutton-brotii, Chicken-broth, are all useful in  conva-
lescence ; the convalescent  should be allowed that which  is the  most
grateful to his palate; not only  with  these, but with all other articles
which he is allowed to cat.
  Boiled Fish is a non-stimulating, nutritious, and  easily digested
food, and is preferable to fish cooked in any other way.  Oyster-broth
is sometimes advantageous.   But, as  a  general rule, all shell-fish, as,
lobsters, crabs, craw-fish, clams,  raw oysters, prawns,  mussels,  are ex-
ceedingly improper  for either  the sick or convalescent, as well as  for
women during their first week of confinement.
  Vegetable diet, as, boiled potatoes,  well-boiled  onions, boiled  beets,
are sometimes eaten with benefit by convalescents;  they should be
boiled in two waters, as a general rule, and be made quite soft.  Boiled
cabbage, boiled turnips, boiled carrots, fried parsnips, boiled  squash,
hard-boiled eggs, fried pork, or other meats fried, broiled ham or  pork,'
roasted fowls, broiled birds, etc.,  are not always proper for the convales-' 
58
AMERICAN FAMILY PHYSICIAN.
cent, and generally appear to suit those best who have naturally strong
powers of digestion;  much care should be taken in allowing their use •
indeed, with the exception of the birds, it were better not to tse them
at all.   Fresh, ripe  fruits may  be  eaten by  the  convalescent either
raw or cooked;  but the skin and seeds should  never be swallowed.
  When solid animal food may be used by the convalescent, thc most
digestible kinds should be preferred, as: beef, mutton, venison, calves-
foot-jelly, etc.  Bearing in mind, however, that the tender, juicy meats
of middle-aged animals is more nutritious, and much more digestible
than the meat procured from younger ones.—(See remarks on Die/, etc.,
in Division I, pages  22 to 101.)
   A few words further relative to convalescents, and I will  proceed to
the subject of cooking for the sick.   Convalescents require plenty of
pure  air, especially the air of healthy locations in the country; they
also need  exercise, as,  riding  on horseback, or in a  wagon, walking,
etc.;  but these  should be pursued with caution, adapting them to  the
strength and condition of the  person.  Care must be  taken to protect
the convalescent from cold or damp air,  from  sudden changes of tem-
perature, and in winter he should be warmly clad, Wearing flannel next
to his skin, and  having  warm stockings to protect  his feet. If he
reside in a malarial district, his recovery will  take place more rapidly
by being removed to a healthy place ; and frequently, a convalescence
will  continue for many months before perfect recovery  ensues, when
the person is living  in  a  diseased or malarial  location.   In early con-
valescence, after  an  exhausting  disease, the person may sit  up in a
chair, or walk about  the room, frequently lying down  to rest, and thus
proceed  until ultimately he can remain out of bed all day long. It is
very wrong to allow  a convalescent to sit up too often, or for  too long
a time,  although  many persons have  an erroneous  idea that such a
course gives him strength.  Kelapses frequently occur from over-exer-
cise of  convalescents.   No exercise should ever be taken to such a
great degree as to fatigue or cause a hurried breathing.
   No reading, writing, or exertion of the mind must be permitted until
the person is fully recovered;  although some  kinds of light literature
may be  read by some other person,  for him  to listen to.
   If the lungs have  been diseased, he should  be careful  about talking
too long or too loud,* or entering a cold atmosphere, until they have
recovered their full  strength.   If  the stomach  or  bowels were  the
organs  diseased,  he  should be  careful about  his diet and drinks  for
some time after recovery.  If the eyes have been diseased, the person
should be  careful about using them  too much  in reading or writing, or 
HOUSEHOLD DEPARTMENT.
59
 exposing them to strong light, until these organs have recovered their
 full strength.  If the brain has been diseased, the mind should not be
 too much occupied in study  or thought for a considerable  time  after
 recovery.  And so of other organs.  A limb,  or part  of the body,
 should not be kept too long  in one position, but should be  frequently
 changed.   And in cases of fractures or dislocations, after the fractured
 parts have knitted or grown together, and the dislocations have been
 overcome, thc joints should be exercised daily, so as to prevent  them
 from becoming permanently stiff, moving them backward and forward,
 but in all cases without tiring or fatiguing the limb.   Where there is a
 contraction of the muscles from keeping a limb too long in one position,
 the parts where the contraction is should be frequently bathed with oil,
 and  efforts be made, by pulling or lifting,  to  gradually  restore the
 muscles to their proper condition.
   The bowels of a person, during convalescence, should be kept regular
 daily.   In some instances this can be done by the food used; in others,
 a  tea of senna and cream of tartar may be drank :  a wine-glassful to
 be taken three or four times a day, as may  be  required to cause one
 operation every day.  The  American  senna, growing throughout the
 country, may be used—say one ounce, or a handful of the leaves, to a
 tea-spoonful  of cream of tartar, for a pint of tea.  Where this can not
 be had, a tea of mandrake root or may-apple root, may be used with
 cream of tartar;  say a piece of root about the size of the  thumb, cut
 or broken into small pieces, with a tea-spoonful of cream of tartar, for
 a pint of tea.  This should be taken two, three, four, or five times a
 day, in  doses of half a wine-glassful, being careful not to  allow it to
 operate too freely, or like active physic.  A strong tea of butternut
 bark may be  used  where the above can not be had;  or, some rhubarb.
 in powder or tincture, the doses being as named under their appropriate
 heads in Part III,  First Division.
   After a protracted illness there  is sometimes a tendency to swelling
 of the  legs, (like dropsy;) this may be  overcome by sitting Avith the
 legs resting on a chair as high as the one upon  which the patient is
sitting,  and keeping  the  bowels regular.  When the legs are much
swollen, they  should be rubbed with some stimulating lotion or liniment
once or  twice every day, and be bandaged (daily) from the  toes to the
hips—being careful not to apply the bandage so tightly as to interfere
with the circulation of the blood in the limbs. 
60
AMERICAN FAMILY PHYSICIAN.
COOKERY FOR THE  SICK AND CONVALESCENT.
  The diet in all fevers, inflammations, and other acute forms of disease
as already observed, must be very light, and composed principally of
fluids; and in some severe cases, no diet at all will be advantageous.
But  this abstinence must not be continued for too long a time. It
must be remembered that very few healthy men can live over twenty
days without food, and  certainly we can not expect even as much as
this  among persons prostrated by disease; and I have no doubt that,
in low fevers, and prostrating diseases, the exhaustion and debility of
the system are much  increased  from a want of nourishment; and in
such cases, when a person can not swallow, the  nourishment should
be given by injection.   Unless ordered by the medical  attendant, or
required to overcome  certain prostrated conditions of the patient, no
stimulating drinks should be allowed; and, during the continuance of
acute fever, and in the early part of convalescence, as a general rule,
no animal food, in  any  form, should be  gi*ren.   Animal jellies are
exceedingly improper  for the sick, as well as for the  convalescent,
being quite indigestible even with persons in health.
  In acute diseases, the  rule is to feed but little at a time, but as often
as appears to be required.  In convalescence, the person must be grad-
ually introduced to his usual diet.
  The water used in all  these preparations should not be brackish or
limestone-water, but clean rain or river-water, or freestone-water.
  Meats used by convalescents should never be cooked too much, but
rare or underdone, in which condition they are more nutritious, as well
as more digestible.
  In commencing the use of any new articles of  diet  that the friends
may suggest, or the patient desire, too much should not  be given.  A
small quantity at first, and if this is found to agree, gradually increase
the amount.  This rule is applicable to both the sick and eonvalescents.

                     Herb-Teas  for the  Sick.
  Take of the dried leaves of Balm one  ounce or a handful, and put
this in one quart of boiling water; let it stand in  a warm place foi f?f- 
HOUSEHOLD DEPARTMENT.
SI
  teen or twenty minutes, strain off the liquor, and sweeten to suit the
  patient's taste.  Of this tea the patient may drink freely either warm
  or cold.  If drank warm, it will occasion sweating; if cold, it will cause
  the urine to flow.  A little Lemon-juice, or Cream of Tartar, may be
  added  to it in cases  of fever, to  render it slightly sour and  cooling.
  Sometimes a few drops  of sweet Spirits of Nitre is added to increase
  the action of the tea in producing perspiration or increased urine.
   In the same way a tea may be made, for the same purpose, of the
  following  herbs: Catnip, Sage,  Spearmint,  Pennyroyal, Chamomile,
  Honeset,  Scullcap,  Fever-bush, Saffron, etc.  It must be remembered
  that warm Boneset, or  Chamomile-tea, will produce vomiting; while
  Scullcap-tea soothes the nerves and relieves restlessness.

                             Bran-Tea.
   Take new Wheat-Bran,  half a pint; put it into one pint and a half
  of water, and boil down to half a pint; strain, and add Sugar to suit the
  patient's taste.   This is slightly nutritious, and may be used in coughs,
  colds, and fevers, as a common drink, after the more severe symptoms
  have passed away.
                           Rice-Water.
   Boil  an ounce of Rice in a quart of water for an hour and a half;
 strain off the water, and sweeten to suit the patient's taste.  In some
 cases Lemon-juice or Cream of Tartar may be  added,  to render it
 slightly 6our.   In the  beginning  of convalescence, a little nutmeg
 may be added, especially after dysentery,  diarrhea, and cholera mor-
 bus.  It may also be rendered palatable by adding a few stoned Raisins
 to it.  In great debility, when not contraindicated, a small quantity of
 wine may be added to it.
   Rice  boiled in Milk, forms a good  nourishing diet for children, but
 is liable to produce costiveness.

                         Barley-Water.
  Place one ounce of Pearl Barley in a quart  of water, and boil down
 to one pint; strain, and  add Sugar, (and Lemon-juice  if desired,) to
 suit  the  patient's taste.   Useful  as  a common drink in fever  and
 inflammatory diseases.

                          Corn-Coffee.
  Roast or parch  some Corn, in the same manner as Coffee is roasted,
until it is quite brown, and then pound or bruise it to a coarse powder.'
Put a table-spoonful of this to a pint of boiling water, and boil for  five 
62
AMERICAN FAMILY PHYSICIAN.
or ten minutes.   This is nourishing and agreeable, and is frequently
useful to stop obstinate vomiting when not sAveetened.  In other cases
it may be sweetened to suit the patient's taste.

                         Oatmeal-Coffee.
  Mix together  some  Oatmeal and  Avater to form a cake, baking it •
roast, or brown this cake; coarsely  poAvder it, and boil it in water for
five minutes.  This coffee  is very valuable in checking obstinate vom-
iting, especially  in  cholera morbus.

                          Barley-Coffee.
  Roast some Barley  until it is pretty well browned, and boil a table-
spoonful of it in a pint of Avater for  five minutes; strain,  and add a
little Sugar, if desired.  To be used as  a nourishing drink toward the
close of fever, and during: the first stage of convalescence.

                           Toast-Water.
   Slowly toast a slice or two of Wheat-bread, till it is rather brown;
add some boiling water to it, and, if preferred, sweeten.  This may be
drank either warm or  cold, in all diseases Avhere the stomach will bear
it,, and is useful for lying-in Avomen.

           Pleasant and Grateful Drink  for Fevers.
   Take half an  ounce of Prunes, or dried Plums, an ounce of Cranber-
ries,  and half an  ounce of stoned Raisins,  add a quart of water; boil
down to one pint;  then strain, and flavor with Lemon-peel or a little
Essence of Lemon. Keep it closely covered.

                             Another.
   Take a table-spoonful of dried Sage-leaves,  half a table-spoonful of
Balm-leaves, and half  a table-spoonful  of Sorrel-leaves; pour on a pint
and a half of boiling water;  cover, and set in a warm place for fifteen
or twenty minutes ; then swreeten to suit the patient's taste, and flavor,
if desired, with Essence of Lemon, as  in the preceding case.

                             Another.
  Take  one ounce each  of Currants,  Raisins,  and Tamarinds, (or
Prunes,)  and  boil  in  one  quart of  Avater to one  pint, and  flavor with
Lemon-peel, or Essence  of Lemon.
  Currants, Currant-jelly, scalded  Cranberries,  Prunes, or Currants,
make refreshing drinks  when added to  water, and sweetened to  suit
the patient's taste. 
HOUSEHOLD department.
63
                          Apple-Water.
   Cut two large tart Apples into slices, and pour upon them a quart
 of boiling water; when cold, sweeten if desired.  Various articles may
 be added to this to flavor it, if desired, as Essence of Lemon, Vanilla,
 or Cloves, etc.
             A Pleasant Drink for Convalescents.
   Mash a gill of Cranberries in a gill of water, and set it aside until
 the following is prepared:  Add  a table-spoonful of Cornmeal, or Oat-
 meal, to  three  pints of Avater, and  boil for half an hour; flavor with
 Lemon-peel or Essence of Lemon, and add the Cranberry preparation
 above named; sweeten to suit the taste, and add half a gill of Sherry-
 wine ; boil five minutes, and strain.  Currant-wine, Quince-wine, Elder-
 berry-wine, Gooseberry-wine, or Mulberry-wine, may be  substituted
 for the Sherry.
                          Acorn-Coffee.
   Peel some sound, ripe Acorns, and roast them with  a little butter or
 other clean fat; add to them one third their weight of real Coffee,
 roasted,, and grind the whole together.  Make a Coffee of this in the
 usual Avay.  This is nutritious and alterative, and is useful  as a  drink
 in scrofula and other  diseases  where  the blood  needs  purifying; it
 should be used instead  of ordinary Coffee and Tea, at meals.

               Perfumed Vinegar  for Sick-Rooms.
  Take of  the leaves of Sage, Balm, Rue, Summer Savory, Lavender,
 and Pennyroyal, each,  a small handful, or half an ounce, Cloves, half
 a table-spoonful, poAvdered  Camphor, one  ounce.   Pour on these one
 quart of  good,  strong,  boiling hot Vinegar, and cover the vessel con-
 taining them so as to retain  the steam.  When cold  it is fit for use,
 and may  be sprinkled  around the patient and  room, several times a
 day.  If  all the above  herbs can not be obtained, the preparation may
 be made without such,  or other fragrant leaves may be substituted.

                      Cooling  Fever-Drink.
  Take Vinegar, one gill, Water, six gills, and Honey, two gills; mix
 together.   Honey does not agree with all persons, and in cases where
it disagrees, Molasses or Sirup may be substituted.

                          Quince-Wine.
  Add six good-sized Quinces, sliced, to half a gallon of boiling water;
let them  stand  over  night, then boil for  fifteen minutes.   Add one 
64
AMERICAN FAMILY PHYSICIAN.
pound of white Sugar;  let the liquid  ferment, then add one pint of
Whisky or Brandy, and, after straining the liquor, keep it in closely
orked bottles  or jugs.
                          Flaxseed-Tea.
  To two pints of boiling water add one ounce of Flaxseed, one  ounce
and a half of  white Sugar, and two table-spoonfuls of Lemon-juice-
let  them stand in a warm place, and in a closely covered vessel for
two or three  hours.   In cases of cough, bronchitis, etc., the Sugar
may be omitted, and two ounces of Liquorice-root, cut in small pieces
be  substituted.   This tea is soothing in inflammations of the throat
stomach, etc., and is  also nutritious.

                           Water-Gruel.
   Take  of Oatmeal or Cornmeal one table-spoonful, and boil it for
fifteen or  twenty minutes, in a  pint of  water;  strain, sweeten, and
add salt, if the patient desires.   May be  used  freely in  fevers and
acute diseases.
                            Rice-Gruel.
  Take of ground Rice, or bruised Rice, a table-spoonful, boil it gently
for twenty or thirty minutes  in  one quart of water.   Add powdered
Cinnamon a teaspoonful, and sweeten to suit the patient's taste.  This
is useful in the latter stages of fevers, etc.,  for lying-in women, and
during convalescence.   In some cases  Wine may be  added.

                       Gum Arabic Mixture.
  Dissolve four ounces  of Gum Arabic in three  gills of boiling water;
sweeten  to suit  the taste, and  flavor  as may be desired,  with  some
essence.   This is useful in cough, inflammation of the stomach and
bowels, and to allay irritation.

                      Mucilage of Elm-Bark.
   Place a small quantity of Elm-bark  in some cold water, say an
ounce of bark  to a pint of water.   After standing an hour or two, the
water may be  used.  This may be drank freely  in cases of inflamma-
tion of the stomach, bowels, kidneys, or bladder,  etc.   It is  demulcent.
emollient, and nutritious.   In  some  cases  it maybe flavored with
Lemon-juice, or Essence of Lemon, Spearmint,  Sassafras, pr Winter-
green, and sweetened, if desired.

                 Mucilage of  Marshmallow-Root.
May be made in a similar manner, and  be used for the same purposes. 
HOUSEHOLD department.
65
                         Oatmeal-Gruel.
   Take two ounces of Oatmeal, and a pint and a half of water.   With
 the back of a spoon, rub  the  meal in  a  basin, in  some of the water,
 pouring off the fluid after  the grosser particles have settled down; but
 as long as any milkiness is  imparted to  the  water, continue the rub-
 bing these with fresh  portions of water.   Unite the washings thus ob-
 tained, and boil to a  soft, thick  mucilage.   Flavor it  according to
 circumstances.
   This makes an elegant preparation for  the convalescent and lying-in
 woman.   It  is generally made by boiling oatmeal  in water with a few
 raisins, for about twenty minutes, and then flavoring as desired.

                 Restorative Injection  of Eggs.
   Beat up  one Egg with tAvo ounces of Wine, and  then add to it half
 a pint of Beef-tea, Avithout salt.   To be used as a nourishing injection,
 in cases where a patient can  not  swallow, or where food will not re-
 main upon the stomach.  The above is  for one injection, and should
 be repeated as often as required.  If Wine can not be had, a mixture
 of Brandy or Whisky  in Avater may be  substituted, one  part  of the
 liquor to four or five of water.

                    Egg and Brandy Mixture.
   Take of Brandy a gill,  rub it up with the yolks of two eggs, half
 an ounce of Sugar, a gill  of water, and half a teaspoonfu1  of Essence
 of Cinnamon.  This is a good stimulant in the sinking stages of low
 FEVERS.   When Brandy can  not  be had,  Whisky may  be  substituted.
 To be used as freely as the  circumstances require.

                           Sago-Gruel.
  To one  pint of boiling  water add two  table-spoonfuls of Sago, and
 boil gently for twenty  or  thirty minutes, until  it thickens, stirring it
 frequently.   It may be flavored with Sugar, Wine,  and Nutmeg, if not
 contraindicated.  Nourishing for convalescents.  Sometimes the Sago
 is boiled in milk instead of water.

                             Panada.
  Stale Wheat-bread one ounce, water  one pint.   Boil together with
constant  stirring;  add a  tea-spoonful of powdered  Cinnamon, and
sweeten to suit the taste.   This  is nourishing  for convalescents and
lying-in women.  When Wine may be used, a small quantity may be
added to this powder. 
66
AMERICAN FAMILY PHYSICIAN.
                         Arrowroot-Gruel.
  Add a table-spoonful of Arrow-root to half a pint of boiling water;
stir it well together, add  half  a pint of Milk, and boil all together for
two or three minutes.   Sweeten with Loaf  Sugar.  Forms a nourishing
diet  for  children  and others,  AYith irritable  bowels, and also in  very
Aveak conditions of the stomach.   A still more nourishing article may
be made by substituting Beef-tea for the milk and water.   Wine may
be added h)  either of these preparations, when suited to the case.

                           Boiled Flour.
  In a linen  bag, tie up as tightly as  possible,  half a  pound of
Wheat Flour; dip  this a number  of  times  in  cold water, and then
sprinkle flour  upon the  outside, to form a crust or cover, which will
prevent the  water from entering inside while boiling.   Place the bag
thus prepared in  some water,  and  boil for  three or four hours, so that,
on cooling, the flour in the bag will form  a dry, hard mass.  A little
of this may be grated, and be used as a substitute for the Arrow-root
in the preceding preparations.

                          MILK-PORRIDGE.
  Take about  two table-spoonfuls  of  Cornmeal, and  a pint each of
Milk and water.   Thoroughly mix the meal with a  small quantity of
cold water,  so as to form a  thin paste.   Boil the Milk and Avater
together, and,  as  soon as they commence  boiling, add the  thin paste,
stirring all the time.  When not contraindicated this may be flavored
with Cinnamon or Nutmeg, Sugar, and Wine.   It is quite nourishing
for convalescents  or lying-in Avomen.    Wheat Flour or  Oatmeal may
be substituted  for the Cornmeal.

                          Isinglass-Jelly.
  Boil one roll of long staple  Isinglass  in one pint of water until it
is dissolved; then strain,  and add one pint  of sweet Milk; put it again
over the fire, and let  it  just boil  up,  then SAveeten with Loaf Sugar,
and grate Nutmeg upon it.  When properly made it resembles custard.
This  is nourishing  for  convalescents, and is very good for children
laboring under bowel complaints,  or  who  are in the habit of wetting
the bed at night.  A grown person may take a tumblerful for a dose,
repeating it  three or four times a  day.

                            Beef-Tea.
  Take of the lean part of good, tender  beef,  half a pound;  cut it
into  small  pieces, sprinkle a little salt over them, put into a hollow 
HOUSEHOLD DEPARTMENT.
67
Teasel, and pour upon the whole a pint  of boiling water.   Cover the
vessel, and let  it remain  near  a fire for half an hour;  then boil for
fifteen minutes, and strain through a fine sieve.   This forms a nour-
ishing drink  for convalescents  and persons with weak stomachs;  if
there is too much nourishment in it, it can be reduced to the proper
strength by the addition of boiling water.   If a more nourishing prep-
aration be required,  boil the  above  for two  hours, and then strain.
This last is sometimes called " Essence of Beef," and may be flavored
with Spices, Wine, Brandy, etc., when these are allowable.

                           Mutton-Tea.
  Take one pound of good Mutton, remove all the fat from it, and cut
the meat into small pieces; pour half a pint of boiling water over it,
let  it stand near  a fire for half an hour, and  then boil  for one hour.
Strain through a fine sieve or coarse cloth.   Salt to suit the taste.
This forms a nourishing diet for  convalescents.   Sometimes  an ounce
of Pearl-barley or Rice may be boiled with it, to render it more pal-
atable and nutritious.
                            Veal-Tea.
  Veal-tea may be made  in the same manner as Beef-tea, using  a
pound of  the lean  part  of the Veal to  a pint and a half of boiling
water.
                          Mutton-Broth.
  Take one pound of good Mutton, remove all the fat from it, put it
into a vessel with three  pints  of boiling water,  and simmer for two
hours. Then cut up into slices, three  Carrots, three Turnips, and three
Onions, boil  them in  a quart of Avater for half an hour;  strain, and
add thc vegetables to the  mutton liquor.   Then season with salt, and
simmer slowly for four hours.   This forms a very palatable and nu-
tritious diet for convalescents.

                         Chicken-Water.
  After removing all the fat from half a Chicken, as well as the lungs,
liver,  etc.,  cut up the meat into small pieces, and break  the bones.
Put these into  a vessel with three pints  of water, boil  for one hour,
season with salt, and  strain.  Nourishing for convalescents and lying-
in women.
                         Chicken-Panada.
  Take the white meat of a Chicken, freed from the fat  and skin, and
boil it  in a small quantity of Avater, till the flesh  is quite soft.  Pound
the  flesh in a mortar, alone at  first, until it is quite pulpy,  and  then 
68
AMERICAN FAMILY PHYSICIAN.
with an equal weight of stale Wheat-bread, gradually adding some of
the water  in which  the chicken was boiled, until the whole forms a
thin, fluid paste.   Boil  this paste for ten minutes, frequently stirring,
and season  to suit the  taste.
  N. B.—All the above animal and chicken broths, teas, and waters
may be diluted or reduced in strength, when required, or when they
disagree with the  stomach,  by the  addition of a suitable quantity of
boiling water.
                          Vegetable-Soup.
  Take two Tomatoes, two Potatoes, two Onions, and a table-spoonful
of Rice; boil the whole in a quart of water for an hour, and then sea-
son with salt.   Dip  Dry Toast in this, till it  is quite soft, and eat.
This may be used as a substitute for  animal food, when the latter is
inadmissible.
                              Another.
  Take two Potatoes, two Vegetable Oysters or Salsify, one small Pars-
nep, and one Onion; boil in a quart of water for an hour, and prepare
in other respects as the preceding one.   N. B.—Every family  in the
country ought to  raise the Vegetable Oyster in their gardens; it is
very palatable and nutritious.

                             Another.
  Take two Potatoes,  one Turnip,  a table-spoonful of Peas, a table-
spoonful of  Rice,  and  one  Onion.   Boil  in a  quart  of water for an
hour, and prepare, in other respects, as the preceding  ones.

                            Milk-Toast.
  To one pint of Milk, add a large  table-spoonful  of Butter; heat
together until the mixture boils, then put into it several slices of well-
toasted Wheat-bread.   This is useful  in the advanced stages of con-
valescence ; it may also be used  in  the earlier  stages by omitting the
Butter.
                            Suet-Drink.
  Boil  slowly together for  an hour,  one  ounce of Suet or Mutton
TalloAV, quarter of an ounce  of Starch,  and half a pint of  Milk.  Use-
ful in dysentery  and diarrhea, as a common drink.

                          Rennet-Whey.
  Take of good,  sweet Milk a quart, heat it, and then add to it a table-
spoonful of  calfs  Rennet, such  as  is  used in  making cheese.  Boil 
household department.
69
this until the curd separates, and remove it from the Whey, by strain-
ing, or otherwise.  This forms a pleasant, nutritious article to many
convalescents.
                          Alum-Whey.
  To  a pint of Milk add a tea-spoonful of  powdered Alum.  Boil
together and strain.  The Whey is nutritious, and may be used in diar-
rhea, dysentery, in convalescence  from inflammation of the stomach,
bowels, kidneys, or bladder.   The curd forms an excellent poultice in
some inflammations of the  eye.

                         Mustard-Whey.
  To a pint of Milk  add a table-spoonful of coarsely-powdered Mus-
tard Seed; boil for a few minutes, and remove the curd.  This forms
a good drink in  dropsy;  one or two gills may be taken at a time, and
the dose be repeated  three or four times a day.

                          Vinegar-Whey.
  A table-spoonful of Vinegar added to a pint of Milk, and the whole
boiled, forms a good Whey, from  Avhich the  curd must be separated.
This is useful in some Ioav forms  of fever, where the tongue is  dark-
coated; also in mild  cases of fever, and colds.

                          Tapioca-Jelly.
  Gently boil two  table-spoonfuls of Tapioca in one  pint of water for
an hour, or until it becomes of the consistence of jelly.   Add  Sugar,
Wine, and Nutmeg, with Lemon-juice, to suit  the taste of the patient
and thc particular case for Avhich it is prepared.

                      Slippery-Elm  Custard.
  Into half a pint of boiling Avater  put two  tea-spoonfuls of white
Sugar, one tea-spoonful of Slippery-Elm Flour, and a small quantity
of Cinnamon  to flavor;  stir for  a  feAV minutes, until a thick  jelly is
formed.  This is a nourishing article for persons with diarrhea or dys-
entery, or conA'alescents from inflammation of the stomach and bowels;
also for consumptives and children  of weak digestive organs. 
70
AMERICAN FAMILY PHYSICIAN.
GENERAL  TREATMENT   OF  DISEASES

                               WITH

            HOME  OR HOUSEHOLD  REMEDIES.
  In  the foregoing pages I have named  the most common causes of
disease, as  well as the best and safest rules and directions for the man-
agement of the sick and convalescent, referring to  measures which
every man, woman,  or child is  capable of carrying out.  I will now
proceed to the consideration  of the various forms of disease, in the
plainest kind of language ; describing their more prominent symptoms,
not in the  scientific  terms used  by the profession, but as the people
understand them, so  that at a glance any person may  be able to detect
one malady from another, and also giving in the treatment thereof the
most  efficacious  and  more easily obtained Home  or Household Reme-
dies, so that every person may be enabled to  successfully treat their
sick friends, even without a physician.
  I shall not confine myself to the treatment of disease alone, but shall
endeavor to impart such information as will tend to prevent much of the
misery which mars the happiness of the human family.  Unfortunately,
those who  have heretofore undertaken the task  of preparing medical
works for  the people, have confined  their efforts exclusively to the
treatment instead of the prevention of disease.   I have endeavored to
profit by their omissions; and I can truly and confidently say to all
my readers, that the  greatest portion of all the disease, and consequent
misery, suffering, and premature death, which destroys the peace and
harmony of the  domestic circle,  and blasts the fondest hopes of loving
friendship; that carries desolation to the parental  fireside; that withers
the stoutest heart, melting it into tears, could, nay, would be prevented,
were  it customary to avoid, by  all reasonable means, that which we now
tremblingly seek to  cure.
  Friends, parents,  guardians,  husbands, wives,  and all who have an
interest in  the welfare and happiness of the human family, ponder well
upon  this  momentous  subject!   For,  although health, happiness, and 
HOUSEHOLD DEPARTMENT.
71
prosperity may thus far have smiled upon you and your families, you
have no guarantee  or  assurance  that  your imagined future, full of
dazzling and glittering gems of enjoyment, will  not be changed  into
cups of bitter disappointment, filled with the  most heart-rending and
intolerable  anguish that weeping  humanity  was ever compelled to
endure.  Let not the blessings you now enjoy cause you to become
indifferent to,  or regardless of, the laws of health.   In time  of peace,
can we not with  wisdom  prepare for  Avar?   Then,  Avhile prosperity
smiles  upon us, and there is not a cloud to darken our horizon, let us
prepare to  meet adversity, should this overtake  us; while we are in
the enjoyment of health,  let us be prepared  to meet and battle with
disease and death.
  Would it be wise or prudent for a  nation to delay preparing the
necessary means  of defense, until  Avar Avas not only  declared, but even
until the  invading force  was actually  ready  to take immediate and
forcible possession of its country ?  There is but one reply to this :  it
would  neither be  Avise nor prudent; and all nations who should pursue
6uch a course, would certainly be destroyed, sooner or later.
  Again, who Avould think of laying in  a store of food in time of fam-
ine ? or of building a house in a bleak, arctic  winter;  or of preparing
fuel, having the hands  already frozen ?   Nevertheless, a precisely sim-
ilar unwise  course  is pursued in relation  to preparing the  necessary
and indispensable means of preserving life in  case of certain  accidents
or sudden attacks of disease ; and all this seems to be the result of the
palpably false notion Avhich designing  and interested persons take so
much pains to spread  and  sustain, that the people are too ignorant to
understand these  subjects.
  Pshaw !  aAvay, I say, with such nonsense !   Let us look back to the
days of our hardy forefathers, Avhen, as we are told, the  people were
still more ignorant, or  at least less educated than people of the present
age.  What Avas the manner in Avhich they managed thek sick ?   Did
a greater proportion of the people die  then than die now ?  Were not
doctors, then,  almost entirely unknown in  many of the best  families?
And did not the bouncing, robust, rosy-cheeked lads and lasses present
in their constitutions and habits a language easy to be understood, tell-
ing of the health and happiness which everywhere surrounded them ?
  But  how was it,  in those days, when disease made  its  appearance,
and marred the sports and enjoyment of the people ?   Were they then
too ignorant to understand their  cases, and successfully  treat them-
selves ?  Let us see.  Mark that good, sensible, sympathizing wife and
mother; she wends  her Avay not to the doctor, for he lives many miles
          55 
72
AMERICAN FAMILY PHYSICIAN.
away, but to that depository of medical plants with which nature has
so bountifully  supplied mankind:  the fields,  and woods, and river-
banks ;  she selects therefrom the  remedies she wants, such as expe-
rience and observation have taught her were useful in assisting nature
to throw off disease and return to health.  She administers  it to the
suffering invalid, and long before the doctor could possibly have arrived,
the restorative powers of nature,  aided by those  simple and valuable
means which the kind  old lady had carefully  selected, and timely ad-
ministered, have removed all  pain and  anxiety; there is  no  more
redness  of the  eyes, no quick  pulse, no parched  tongue, no insuffer-
able thirst, no burning heat of surface, no difficult breathing—all have
disappeared as if by magic,, and the  stout, active, playful youth has
again resumed his ordinary occupations and enjoyments; the anxious,
inquiring  looks  of the kind-hearted father are no longer visible, but
smiles  and contentment  occupy their place;  while the apprehensive
mother, whose bosom palpitated  with emotions of tender solicitude,
has now become calmed, and rests in  confiding cheerfulness and glad-
ness.   Peace,  joy, health, and happiness are again restored, together
with all the bliss of that domestic  heaven. 
HOUSEHOLD DEPARTMENT.
73
GENERAL  DISEASES.
   N. B.—The  treatment given throughout,  in this part, is equally
 applicable for adults and children; the latter, however, must have the
 doses lessened to suit their age.  Those diseases which are more com-
 mon among children, will be treated upon under the head of Children,
 and their Diseases ; and those more common  among women, will be
 found under the head of Woman, and her Diseases.
   The treatment herein recommended, especially for fever and inflam-
 mation, is designed to break up these diseases at their commencement,
 and thus save much suffering and pain, as well as long and expensive
 doctors' bills.   But it will  sometimes happen that they will continue
 and run  their course, as will often  occur,  even when the patients are
 under the treatment of the most skillful doctor.  In these cases, should
 the disease continue over three days, a physician should be called in;
 and until he arrives, or when one can not be had, the friends must con-
 tinue the course recommended under the head of each fever;  or,  when
 it can be done, and the proper remedies be procured, the course named
 for each disease, in Division I, should be pursued.

                            Fevers.
   Symptoms.—The general symptoms of all fevers are pretty nearly
 the same, though they may vary in severity, and in the particular ones
 which are the most prominent.  They may be named in the following
 order:
   1. Languor or dullness; perhaps a dull headache, and unpleasant
 dreams.
   2. Chills,  more or less severe, with more or less  thirst; small pulse,
 and quick breathing.
   3. White coat on the tongue ;  perhaps nausea or vomiting.
   4. Fever,  or quick pulse, with increased heat of  the body.
   5. Thirst.
   6. Tongue coated brown, or black.
   7. Bowels costive; urine diminished and high-colored.   (See Divi-
sion I, pages 173 to 176.) 
74
AMERICAN FAMILY PHYSICIAN.
   Treatment.—Kb  a general rule,  all  fevers  may  be  successfully
treated alike in their different stages ;  for though physicians have given
many names to  them in their various forms, yet,  after all, it is the
symptoms they must treat, and not the name of the disease.   Whoever
treats diseases merely by their names, makes a very unsuccessful doc-
tor.   By the treatment about to be named, the major part of all forms
of fever may be broken up at their commencement, if the friends will
promptly  pursue the methods  recommended;  and no one  need fear
to make use of  the  means named, for, after  being told how  to employ
them, any one must certainly  be as successful as the physician whc
prescribes them.  These means can be used by any one, and should the
disease be not entirely broken up  by them, the symptoms which remain
may be treated as named in the First Division of the  Avork under their
appropriate heads, and treated, too, just as successfully as if the same
means had been prescribed by a medical man, instead of being recom
mended in  a book.   But  if the methods  here  advised are  promptly
and energetically pursued, the other measures will seldom be required.
   The first thing to be done in the commencement of fever, is to give
an emetic.   If the Compound Powder of Lobelia, named in Division I,
pages 177 and 738, can  not be had, it makes no difference; although
this is an  excellent emetic.   Other ones may be used; there is no need
of despairing because a particular article can not be procured—the
object is to  produce the  effect, to  wit: a good vomiting.  Equal parts
of Lobelia and  Ipecacuanha may be used, or either  of these articles
alone ; or a tea  of Mayvreed or Dog-fennel may be used;  or of either
White or  Blue Vervain; or of Chamomile Flowers;  or of Boneset or
Thorough-Avort; or of even poAvdered Mustard, in Avarm water; it mat-
ters not what the article is, provided it will vomit freely, without being
poisonous.  These teas must be used warm, and should be drank freely
to produce vomiting six or seven times, whether the stomach be empty
or not.  It will  frequently happen that the vomiting alone will break
up the disease, the patient's pulse will become natural, the skin moist
and of natural temperature, and he will feel well, but weak.
   However, should there be any  feverish symptoms lurking  about, the
next thing to accomplish is to bring about a profuse sweating, and this
may almost always  be effected  by  the Spirit Vapor Bath, named in
Division I, pages 180 and 698.    But if, from any cause, this  cannot
be used, there are many other ways of causing sweating, one of which
is named  in Division I, page 670, under the head of Limc.^  Another
plan is, to heat  stones or bricks, and place them at the patient's feet,
knees, hips, and sides, in bed, covering him up warm, and causing him 
HOUSEHOLD DEPARTMENT.
75
 to  drink  freely of teas  as  warm  as  he can swallow, such as tea of
 Sage, Spearmint, Catnip, Balm, Pennyroyal, etc.  As with the emetic,
 to cause vomiting, the object here is to produce sweating, and anything
 that will accomplish this without injuring the patient, will answer.
   While the patient  is sweating, or as soon as his stomach will retain
 it,  a  cathartic  should be given, for which  purpose use the Compound
 Powder of Jalap,  named in Division  I, pages 178 and 737.   If, how-
 ever, this can not be obtained, some other cathartic may be  used, as
 half a tea-spoonful of Jalap in water; or, one fourth of a tea-spoonful
 of  Cream of Tartar may be added to it;  or, a level tea-spoonful of
 powdered Mayapple  or Mandrake-root mixed with the above quantity
 of  Cream of Tartar  may be  given;  or, even Castor Oil may be em-
 ployed  Avhen these others can not  be had.  No matter what the cath-
 artic  is, Avhether in the form of pills, poAvder, or tea, so it produces the
 effect without injuring the patient.  If the cathartic does not  operate
 in three hours, repeat the dose.
   Everything  has now been  done  that can be of service, and in the
 great majority of cases, the  disease  will be broken  up.  If it is not,
 however,  pursue exactly the same  course on the next day, and again
 on  the third day, if the  patient's strength will permit.   Any remain-
 ing symptoms  may  then be treated as named hereafter, under  their
 appropriate heads, on pages 99 to 102.
  Where  a  fever has existed for some time before the patient recovers
 from  it, he should not be alloAved to get out of bed too soon, not until
 he  has gained some considerable degree of strength.  A patient labor-
 ing under any kind  of fever, or inflammation, or severe, prostrating
 disease, should never be annoyed by  callers or visitors, no matter how
 short may be their calls.
  All fevers and inflammations are generally the result of some  inat-
 tention  to the  hygienic measures  named in this  book.   In order to
 prevent attacks of these  diseases, a person should be regular and mod-
 erate  in all his habits;  he  should  avoid exposure to sudden  changes
 from  heat to  cold, and damp;  he  should  chew his  food slowly and
 thoroughly; should keep his bowels regular by the proper kind of diet;
 should keep his person clean by frequent bathings;  and should avoid,
 as much as possible, a damp night air.  Proper and Avell-regulated exer-
 cise in the  open air  is necessary,  especially for  the female who is
 confined most of her  time in the kitchen, doing  the cooking, washing,
 and ironing of the family. And all  exercise, as well as all labor, should
never be overdone.  Sleeping  in close rooms, or in rooms occupied by
many  individuals,  or  in rooms in  which a fire is kept up during the 
76
AMERICAN FAMILY  PHYSICIAN.
night; and, in malarial districts, sleeping in apartments on the ground-
floor, should all be avoided.   Farmers, in fever and ague, bilious fever,
and yellow fever countries, should build their houses so that thc sleep-
ing-rooms may be above the first floor, and so arranged  as to  admit of
a thorough ventilation every fine day; by doing this, they AYOuld not
only save much  sickness and suffering in their families, but also a great
yearly expense for doctors and medicines.  Experience  has fully con-
vinced me, that a strict attention to these points will enable persons
to reside with comparative good health in locations where a lack of
attention to them would render sickness inevitable.
   In cases of epidemic and contagious diseases, of course, the risks
are less when parties keep  aAvay from the  infected places; but even
when exposed to them, the disease, whatever it may be, should it attack
them,  will be less severe in its character,  and susceptible  of quicker
cure among  those who adhere to the  hygienic  principles above re-
ferred to.
                         Fever and Ague.
   1. Severe chills, Avith universal shaking, which returns  every one,
two, or three days, followed by
   2. Increased  heat  of the body; then
   3. More or less  profuse sweating.
   4. In the  period between the sweating stage and chills, the patient
feels and appears Avell, unless the disease has been on a long time.
(See Division I, pages 185 to 191.)
   Treatment.—Pursue the same course as just mentioned for fevers,
giving an emetic at the start, then a sweat, without waiting for either
the hot or sweating  stage, and while sweating, let the patient drink
freely of  warm  Lemonade.  In the period between the sweat and the
next chill, if one of  the preparations named in Division I, pages  189,
190, or 191  can not be procured, then use one of the following:
   a. Take of Wild  Cherry-Bark,  Inner  Bark  of White  Oak, fresh
Horseradish-root, Seneca Snake-root, each, in coarse powder,  or slices,
one  ounce,  Cinnamon,  Cloves,  Sulphur,  each, half an ounce, good
Cider  two quarts.   Steep  them in  a warm  place  near  a  fire, for
three hours.   Dose, when  cold, a wine-glassful three or four times a
day.
   b. Take of Peruvian Bark, in powder, two ounces, powdered Rhu-
barb one ounce, powdered Colombo-root one-fourth of an ounce,  Cay-
enne  or  Red Pepper, powdered Cloves,  each,  ten grains,  Gentian-
root, in coarse  powder, Wormwood, each, half  an ounce, Sugar two
ounces, Whisky or Brandy three pints.   Steep near a fire for twenty- 
HOUSEHOLD DEPARTMENT.
77
four hours.  When cold, the dose is half a wine-glassful three or four
times  a day.
  c. To half a pint of strong Coffee add two table-spoonfuls of Lemon-
juice, and half a gill of good  Brandy  or Whisky.   Drink  this when
the chill is about to come on;  take it on an empty stomach if possible.
  d. Char a Nutmeg, by holding  it in a flame, and permitting it to
burn by itself without disturbance.  When charred, powder it, and add
to it an equal quantity of burnt Alum.   Divide this into three powders
Give one of these in a little water  each time, just before the expected
chill.
   e. Take  of  Prickly Ash-bark,  Dogwood-bark, Wild Cherry-bark,
Rattlcweed or Black Cohosh-root, Black-root or  Culver's-root, Cinna-
mon,  Cloves,   each,  coarsely bruised, one ounce,  good  Cider five
pints.   Steep  in a warm place for twenty-four hours.  When cold, the
dose is  a half Avine-glassful, three or four times a day.
  Ague and Fever is very liable to return  every season, so long as a
person resides in a swampy, marshy country, or places disposed to the
disease; hence, all who are thus  exposed, should  avoid the night air,
and early morning air, and take some one  of the  tonic bitters, just
named,  every spring and fall.  They  should also, if it be  a possible
thing, sleep in an  apartment  upon the second  floor of their houses,
and upon  which the  sun shines the greater part of the day;  always
airing  the sleeping apartments  through the day,  in dry,  pleasant
weather.
  Any person who will follow out the  directions  here laid  down, will
find them  to be worth more to him than the cost of the whole book,
not only in curing, but in preventing this terrible scourge to our farm-
ers, which so frequently prevents  them from inhabiting the most fer-
tile, and otherwise desirable valleys in the West.

                          Bilious Fever.
  1. Languor, headache, loss of appetite, and more or less pain in the
head,  for several days,  with flashes  of heat and cold.
  2. More or less severe chills, felt particularly in the  back, not so
severe nor so long as in fever and  ague.
  3. More or  less heat of body, with dry skin, flushed face,  difficult
breathing, pains in head and  back,  thirst,  sometimes retching, vomit
ing, or delirium.
  4. Costive boAvcls, scanty and high-colored urine, dark-coated tongue.
  5. Stage of  prostration.   (See Division I, pages 191 to 195.)
  In this disease the treatment in the commencement will be the same 
78
AMERICAN FAMILY PHYSICIAN.
as named above for Fevers.   If it be not cured  by this course, then
treat the various symptoms according to the means named hereafter
under their appropriate heads, on pages 99 to 102 *

                        Congestive Fever.
  1. Attacks suddenly, general debility, confusion of mind.
  2. A chill, or only a sense of coolness, though  often the patient is
not aware that the heat of the body is diminished.
  3. Great heat and dryness of the skin to the  touch—sometimes it
will be hot and cold in different  parts at the same time.  Succeeded
by a cold, clammy sensation.
  4. Difficult breathing, dull, glassy eyes, variable pulse, haggard coun-
tenance.
  5. Tongue coated  dark-brown  or  black;  sometimes, in  bad cases,
resembles raw  beef;  at other times dry,  cracked, and bleeding.
  6. Vomiting food,  bowels costive, sometimes loose; urine  scanty,
hot, and high-colored.  Pain in some part of the abdomen on pressure.
  7. Mind more or less disordered all the time; sometimes a low state
of delirium or  stupor.   (See Division I, pages 195 to  198.)
  Treatment.—Same  as named above  for fever, but more energetic,
giving larger doses of the emetics and cathartics.  The body must be
bathed several  times  a day with a weak ley-water, to prepare which,
see Division I, pages 179 and 726; after which some stimulating lini
ment or wash must be rubbed upon  the  legs, arms, and back,  repeat
ing this several times a day, with considerable  friction each time.   A
wash for this purpose may be made by steeping half an ounce of Red
Pepper in a  quart of Avater, to which tAVO table-spoonfuls of Salt  and
half a pint of Whisky may be added.
  Or, a liniment composed of Camphor, Oil of Spearmint, Oil of Horse-
mint, Sweet Oil, each, equal parts.
  Or, any other liniment of a stimulating  nature which may be at hand.
Whipping the soles of the feet with a paddle or flat stick, until they
are quite red, but without hurting the patient, will be found a very
valuable mode of arousing the  action of the system; immediately after
which a  mustard plaster should be applied.
  The emetic,  cathartic, and  sweat should be repeated every  day till
the patient is better, if his strength will permit;  otherwise, continue
only the cathartic and bathings of the body.  If the disease be not
  * Unless otherwise named, all pages named in this part of the work refer only to
Second Division. 
HOUSEHOLD DEPARTMENT.
79
 cured by this course, then treat the various symptoms according to the
 means named hereafter under  their appropriate heads  on pages  99
 to 102.
                         Yellow Fever.
   Symptoms very variable.
   1. Chill  or cold sensation, with nausea, vomiting, pains in head  or
 back.  Frequently these symptoms are  absent.
   2. Full,  quick  pulse; hot  and dry  skin; quick  breathing;  eyes
 watery;  can not bear light;  flushed face;  a burning pain, or great
 tightness at the pit of the stomach; excessive thirst.
   3. BoAvels  costive;  urine scanty, high-colored, and not clear.   Great
 wakefulness.
   4. Pain  in forehead and other parts increases; tongue furred white,
 yelloAV, dark-brown, and often of a bright red color.
   5. Yellowness  of face and eyes, extending over  the whole body,
 with a yelloAvness of the urine.
   6. Pulse becomes weak; pain at stomach, with vomiting of a green,
 or black fluid;  bleeding  from the nose  mouth, etc.  (See Division I,
 pages 199  to 203.)
   Treatment.—Commence the treatment by an emetic, as named here-
 tofore under Fevers;  follow this up  by a sweat, and give  a cathartic
 composed of good Vinegar, Castor Oil, each, two table-spoonfuls, table
 Salt a teaspoonful.   Mix for  one  dose, and repeat the  dose every
 hour until  it purges.  Should this not break up the disease, repeat the
 treatment  on the next day, giving freely to the patient, in the mean-
 time, a Avarm drink of Catnip-tea and Lemon-juice.  The patient may
 also drink  freely of Cider, if he desires  it,  or  Orange-juice,  Cream
 of Tartar water, Vinegar and water, etc.   Buttermilk will frequently
be  found beneficial.   Pursue this course every  day, as long  as the
patient's strength will  allow, not forgetting to bathe the whole surface
several  times a day with a weak ley-Avater.   If the disease be not
cured by this course, then treat the various  symptoms  according  to
the means  hereafter named under their appropriate heads, on  pages
99 to 102.
  To guard against a relapse some tonic should be given during conva-
lescence, as a cold tea of equal parts of  Boneset, Virginia Snake root,
and Dogwood bark; a table-spoonful several times a day.

                         Typhus Fever.
  Symptoms are variable.
  1. Languor, low spirits, loss of appetite, dullness of eyes. 
60
AMERICAN FAMILY PHYSICIAN.
  2. Chills  and flashes of  heat, great  nervous prostration, more or
less headache.
  3. Pulse weak and irregular, sometimes one hundred to one hundred
and sixty beats in a minute ;  tongue coated white or brown, and often the
teeth also; little thirst; boAvels costive; urine like water; the belly is
flat, not swollen out.
  4. Tongue, mouth, teeth,  and lips covered  with  a dark  fur; face
dull  red,  dusky or dingy,  and sometimes  an  eruption  of a  dull
red color, and of small size; low  muttering delirium.  Deafness is
common.
  When the disease is malignant, the symptoms are much more severe.
(See Division I, pages 204  to 207.)
   Treatment. — At  the very  beginning of  the  disease, the course
heretofore named under  Fevers must be  pursued, giving  an emetic
sweat, and cathartic, after which the main treatment must be to sustain
the strength.   Bathing the surface several times a day with a weak,
warm ley-water, to which some Whisky has been added; keeping the
bowels open daily by a mixture of equal parts of Vinegar and Castor
Oil, but  not physicking them—only producing one operation a day;
and, for which purpose, a table-spoonful of the mixture may be given
every two or three hours.   As a tonic, the folloAving tea may be given:
Take of Boneset leaves, Chamomile flowers, Scullcap leaves, and White
Oak bark, each, an ounce, water two pints.  Boil for fifteen or twenty min-
utes, add a  pint of Vinegar, and SAveeten, if desired by the patient, and
allow him to  drink  freely of it.   The  patient will find buttermilk a
healthy and refreshing drink.
  If the disease be  not broken up at the start, then treat the various
symptoms according to the  means named hereafter, under their appro-
priate  heads, on pages  99 to 102.
  In this disease  the stools should ahvays be at once  removed from
the sick-room, and  buried, so as to prevent the effluvia from them
causing sickness in other persons.

                           Typhoid Fever.
  1. A dull, heavy feeling, for some days  or Aveeks, followed by Avea-
riness, soreness in  the limbs, or "aching in the bones,"  and slight
headache.
  2. Flashes  of heat and cold; loss of appetite;  chills  running along
back.
  3. Quick pulse; increased pain in the head; tongue rather  clean;
great thirst, and sometimes vomiting, and bleeding from the nose. 
HOUSEHOLD DEPARTMENT
81
   4. Hot and dry skin;  pain on pressing upon the bowels, and swell
 ing of the bowels, with a tendency more commonly to diarrhea.
   5. BoavcIs swollen and tight, like  a drum; patient lies upon his back
 with knees bent upward; delirium,  but usually of an active kind, re-
 quiring restraint;  a rose-colored  eruption on the body.
   6. Tongue tremulous, not easily protruded; stupor; hard and heavy
 breathing; dry  tongue;  teeth  only covered with a dark substance;
 feet and legs cold, while head is  hot;  no deafness.  (See Division I,
 pages 207 to 211.)
   Treatment.—Pursue the same  course as named  above for  Typhus
 Fever, being careful to give but the one cathartic at the start;  keep-
 ing the  bowels regular subsequently by injections, as a mixture of vin-
 egar—a gill—with half a pint of a strong tea of Boneset and Senna,
 and a gill of molasses ; to be used for one injection.  Any other cathar-
 tic injection may be substituted.

                          Hectic  Fever.
   1. Pulse quick, but weak; flushings of the face, especially after  a
 meal; heat in palms of the hands and  soles of the feet; urine abund-
 ant and high-colored.
   2. Tongue red;  sometimes ulcers on the tongue, gums, and inside of
 cheeks ; night-sweats ; diarrhea.  (See Division I, pages 214 to 215.)
   Treatment.—This  fever  usually  accompanies  some  other  disease,
 which must  first be cured before  the fever can be removed. The best
 practice, aside from this, is to frequently bathe the body with some Salt
 and Avater, or some Vinegar and  water, say once  or twice  a day; and
 give tonics  internally,  as: tea  of Chamomile flowers, two  ounces,
 Peruvian  bark,  tAvo  ounces, and  Crowfoot or Alum root,  one ounce.
 Give a table-spoonful every hour or two.   It may be sweetened if de-
 sired.  Any other tonic  preparation will ansAver as well;  and where
 the patient is very Aveak, and Port wine  agrees with him, or other wines,
 they may be given.
                   Small-Pox and Preventive.
  For this disease  I  can give  no better  treatment than that  already
 named in Division I, pages 224 to 230, which includes Vaccination.

              Erysipelas, or St. Anthony's Fire.
  1.  More or less redness of the skin, with swelling over the whole
body, or only in  portions of it, and attended with  a burning itching or
prickling.
  2.  In  severe cases,  there will be  much sAvelling of the face or parts 
82
AMERICAN FAMILY PHYSICIAN.
attacked; with quick pulse, thirst, pain in head and  back, and some-
times delirium.  (See Division I, pages 232 to 235.)
   Treatment.—Keep the boAvels regular by  giving every day a mix-
ture of powdered  Mandrake or Mayapple root, ten or fifteen grains
and the same  quantity of Cream of Tartar.  The dose must be regu-
lated so as to produce  one  good passage daily, but  never  over two.
After  keeping this  up for a week, tAvo  doses  every week, until the
disease is gone, will then be sufficient.
   To relieve  the  burning and  prickling  sensation, the face or parts
attacked may be  bathed frequently with the following mixture: Dis-
solve a quarter of an ounce  of Sal Ammonia, in two ounces of water
to which add an ounce and a half of Tincture of Lobelia, and an ounce
of Tincture of Poison Hemlock or Poison Parsley.
   Or, instead of  the tinctures of these  articles, an  infusion may  be
made thus : take half a  handful, each,  of Lobelia and Poison Parsley,
pour on three gills  of boiling water, cover, and steep in a warm place
for an hour or two; then squeeze out all the  infusion; strain, and dis-
solve in it half an ounce of  Sal Ammonia.  Use the  same as the pre-
ceding.
   Or, clean, fine  wood-soot  from the chimney may be made  into  an
ointment with lard, spread on  cotton  batting,  and applied  upon the
parts affected.
   When the  erysipelatous swellings or  blisters  break, and the fluid
they contain oozes out, the parts may be washed frequently with a tea
of Elder flowers and Poppy-heads.
   Internally,  the  patient must take half  a  gill of the following tea,
five  or six times a day: take of Maidenhair, (also called Spleen-wort,
and MilkAvaste,) Elder floAvers, each, tAvo  ounces;  Burdock-seed, one
ounce; boiling water, five pints.   Place  in a  closely covered vessel,
and let it  steep for  an hour near a warm  place.  When cold, use  it;
sweeten Avith  sugar, if desired.   All fats, spices, liquors, and sour or
unripe articles of food, must  be avoided.
   Rye-flour boiled in water, and mixed with soft-soap, is a good appli-
cation to lay  on the affected parts, changing it tAvice a day.   Some-
times the burning sensation will be allayed by washing with a solution
 i Copperas, half  an ounce;  water, a pint.
   In the severe forms of Erysipelas, the  face must  be steamed sev-
eral times a  day  Avith the vapor arising  from a decoction  of bitter
herbs, as of Catnip, Wormwood, Hops,  Tansy, etc., and the system
must be supported  by a nourishing  diet,  and  tonics.  A very good
tonic may be  made  of Peruvian bark,  one ounce; Sumach  bark, one 
HOUSEHOLD DEPARTMENT.
83
  ounce; Yellow Dock, one ounce;  Elderberry wine,  or Currant wine,
  or even good Cider, two quarts.  A wine-glassful of this may be given
  every two or three hours, as the strength of the patient will require.
   When  mortification appears, a poultice  may  be applied,  made of
  powdered Slippery Elm bark, two table-spoonfuls; Charcoal, one table-
  spoonful ; powdered Sulphate of Zinc  or White Vitriol, a teaspoonful;
  water, enough to form the poultice.  Change it three times in the course
  of every tAventy-four hours.  If the green Elm bark is used, it must be
  soaked in water until all the mucilage is  extracted; this must be mixed
  with crumbs of  bread, and then the  Charcoal and White Vitriol be
  rubbed in.
   After a patient is  cured of Erysipelas, or where a person is subject
  to it, he should take some  remedy to  remove the  disease from the
  system;  the following is a good one:  Take of Blue Flag-root, Yellow
  Dock root, Burdock root, Bark  of Bittersweet root, Sassafras  bark,
  each, one ounce; Elder flowers, tAvo  ounces;  reduce all  to  a coarse
 powder, and add six  pints of boiling water;  cover  the  vessel  contain-
 ing them, and steep near a fire for twenty-four hours.  Then press the
 herbs, strain all the liquor, and sweeten  to suit the taste.  Keep in a
 cool place.   Dose, half a gill three or four times a day.

          Inflammation of  the Brain, or Brain Fever.
   1.  Pain in the head; confusion of ideas;  fullness in the head; red-
 ness of eyes.
   2.  Quick, full  pulse; increased redness of face  and eyes; eyes can
 not bear  light,  and sound is intolerable; severe  pain  in head,  with
 ringing in the ears.
   3.  Head hot;  extremities  cold;  breathing  difficult;  pupil  of  eyes
 contracted;  more or less delirium; vomiting; bowels  costive;  urine
 scanty and high-colored.  (See Division I, pages 235  to 238.)
   Treatment.—-In this disease the treatment  must be prompt and ener-
 getic.  Immediately give a dose of cathartic medicine; then bathe the
 patient  with  a  weak  ley-water, and sweat him by one of the means
 named under Fevers, on page 74.  Keep the head  cool by cooling
 lotions, as cloths dipped in ice-water or cool well-water, or vinegar and
 water, changing them as fast as they become warm.  Apply  mustard
 poultices to the feet and ankles, and along the lower part of the spinal
 column t>r back-bone.   Repeat the cathartic  and sweat once a  day, for
 two or three  days, if the disease is not  broken up before.   To  pro-
cure sleep, keep the room dark and free  from noise;  give the patien
a tea  of Scullcap, ard have  his head raised rather high.  When the 
84                 AMERICAN FAMILY PHYSICIAN.
inflammation is intense, and delirium very high, the patient may be
held over a tub, and a stream of cold water be poured upon his naked
head, from a watering-pot or other vessel, which should be kept falling
upon one and the same  spot, as much as possible, for ten or tAventy
minutes.  At first, the vessel should be held near the head, gradually
raising it till the  stream flows from a height as high as a man can hold
the vessel; then quickly wipe the patient, and put him in bed.  Repeat
this, if the heat and pain returns.
  The room must be cool, free from noise, and kept dark; and  the
patient must be looked after, lest he get out of bed during an attack of
delirium.  Callers and visitors, no matter how  kind their  intentions
and desires may  be,  must positively be  kept out of the  sick-room.
Their presence always makes the disease worse.
   Any   of the symptoms which  may attend  this disease,  when  not
broken  up by the above-named treatment, must be managed according
to the directions given under its appropriate head, on pages 99  to 102.
   When convalescence takes place,  it must be  remembered that  the
patient  is not out of danger for several weeks.   Too full a meal, over-
exercise, or even  slight  excitement of the mind, may cause  a relapse;
hence, the convalescent should be  kept quiet,  and free from all kinds
of excitement, until his  health is  fully restored, and, in the early part
of  his convalescence, his diet should be light, unstimulating, and mod
erate in quantity.
                    Inflammation of the Eyes.
   1. Blood-vessels  scarlet red; eyes  bloodshot;  heat, smarting  and
pain in  the eyes ; feeling as if sand or dirt  was in the eyes,  which
sensation is increased Avhen the  organs are rubbed; tears flow,  and
light pains the eyes.  (See Division  I, pages 239 to 241.)
   Treatment.—Give one of the cathartics named under Fevers, on
page 75; then soak the feet and legs in warm  water, after which apply
a mustard poultice to the feet and back of the neck, and apply, over
the eyes, cloths wet with an infusion  of Hops and Stramonium or Jim-
son leaves, equal parts, steeped in water.  This may be used cool or
tepid, and, in some cases, quite cold, according to the  sensation of bene-
fit  produced.
   Another good application to the eye is an Alum curd, (see page  69,)
which should be  applied warm or cold, as appears to answer the best,
renewing the preparation two or three times a day.
   Or, take  a handful of Poppy leaves  and  Elm bark; make into an
infusion, and have the fluid applied to the eyes on cloths.
   Or, pour boilino- water on Elder floAvers. and steep them the same as 
household department.
85
tea.  When cold, strain, and to every wine-glass of the infusion add four
drops of Laudanum;  bathe the eyes with this several times a day, let-
ting  some of the fluid run into the eyes.  The patient must  be kept
quiet, in a dark room, upon a light dfet.
  In very severe cases, I have known the application of cold water to
the eyes, on cloths, changing  them every few seconds, to answer an
excellent purpose.
  When the inflammation has subsided, means must be used to arouse
thc absorbent  vessels of the eye  to  increased action, as well as to
strengthen the organ.   For this purpose, an infusion of one or two of
the several named articles following, may be dropped into the eye three
or four times a day: Witch Hazel bark, Beth root, Sweet-fern, Crow
foot  or Alum root, Sumach bark.   In  some cases, the addition of four
grains of White  Vitriol to every ounce of the tea, will improve the effi-
cacy of the wash.  (See Chronic Inflammation of the Eyes, page 143.)

      Inflammation  of  the Eye,  avith Pus or Matter in  it.
  This is a different kind  of inflammation from the preceding one.
  1.  Itching in the eye, and sensation as if a piece of dust were be-
twoen the lids and eyeball; sticking together of the lids in the morning.
  2.  Redness of eyes ; SAvelling of eyelids ;  and discharge of yellowish
matter.   (See Division I, pages 241 to 243.)
  Treatment.—Reduce the inflammation as rapidly as possible; to
effect which give one  of the cathartics named  under Fevers, on page
75;  then  soak the feet and legs in Avarm water, after which apply a
mustard poultice to  the feet, back of the nejk, and along the whole
course of the back-bone.  Cooling applications to the eye, on cloths,
should be constantly used, changing them as fast as they become warm;
as, cold water;  or, an infusion of equal parts  of Hops and  Jimson
leaves; or, an  infusion of Poppy flowers and Elder blows.
  After the inflammation has gone doAvn, apply some tonic and astring-
ent wash, as Witch Hazel leaves, and Golden Seal or Yellow Puccoon,
equal parts, steeped in water, and a little Alum added.
  Or, a tea of Golden Seal and Crowfoot or Alum root.
  Or, add four grains of White Vitriol to an ounce of green Tea.
  Whichever of  these washes is used, must  be dropped into  the eye,
repeating it several times a day.
  Another good  preparation is to make a strong tea of equal parts of
Hyssop leaves and St. John's-wort leaves and flowers, and apply this
to the eye on cloths,  or by letting  a few drops fall in the  eye, two or
three times a day. 
86
AMERICAN FAMILY  PHYSICIAN.
  Keep the patient quiet, in a dark room, upon a light diet, keeping
the bowels regular, during the inflammatory  stage.  During convales-
cence observe the same rules as named in the preceding form of in-
flammation of the eyes.
  A good preparation for the eyes, after all  acute inflammation has
subsided,  is to let a drop or tAvo fall into them, three times a day, of a
fluid made by dissolving three teaspoonfuls of fine table Salt in a pint
and a  half of rain-water or freestone-water;  also dissolving one tea-
spoonful of Copperas in another pint and a half of rain-water; as soon
as the  articles are dissolved, mix the two solutions.
  Another  good wash for  the eye is, to dissolve half a teaspoonful,
each, of White Vitriol and  Loaf Sugar in tAvo gills of a tea of Witch
Hazel  leaves, or of YcIIoav Puccoon or Golden Seal root.  Bathe the
eyes with it every night and morning.                        >
   Another:  Add a pint of boiling water to half a handful, each, of
Lobelia leaves and the pith of Sassafras; let them stand till cold, then
add four table-spoonfuls of the juice of roasted Onions, and half a table-
spoonful  of Honey.  A few drops to  be placed in the eyes three or
four times a day.   This is also good during the inflammatory stage.
  Another: In half a, pint  of rain-Avater place as much White Vitriol
as can  be  heaped  upon half a dime, the same quantity of Sugar of Lead,
and one third the quantify, each, of table Salt, poAvdered Opium, and
powdered Bloodroot or Rod Puccoon.  Let them stand for twenty-foui
hours before using.   To be used in the same manner  as the preceding
one.
               Another Inflammation of  the  Eye.
  This inflammation differs from  either  of  the preceding ones; it is
called  Inflammation of the Iris; the  Iris being that part of the eye
surrounding the  pupil, and by which  Ave determine whether a person
has a blue, black, or gray eye, etc.
  1. Pains in the forehead and eyes; redness of the white part of the
eye; Avatery discharge, and inability to bear the light.
  2. The iris becomes changed in its color; the  pupil contracts; the
sight diminishes.   (See Division I, pages 243 and 244.)
   Treatment.—In the inflammatory stage, commence by giving a cathar-
tic, as in the preceding inflammations of the eye.  Then apply over the
eye  a  poultice made by pounding fresh Jimson or Stramonium leaves,
and then  moisten them by the addition of a little water; change this
poultice three or  four times a day.  If fresh Jimson leaves can not be
procured,  then make a strong tea of Lobelia leaves and  Poppy leaves,
equal parts; to every ounce of which rub  in four grains of the Extract 
HOUSEHOLD DEPARTMENT.
87
 of Stramonium.   This fluid may be applied  over the eyes on cloths,
 frequently changing them.
   Soaking the feet in warm water, applying mustard to the feet and
 back of the neck, and keeping the bowels regular,  as  named in the
 preceding diseases of  the eye, must not be omitted.
   As soon as the inflammatory symptoms have been  subdued, the eye-
 ball should be Avashed, several times a day, by means of a camel's-hair
 pencil, Avith  a strong tea of equal parts of St. John's-wort leaves, Hys-
 sop leaves, and Prickly Ash bark.
   Or, Avhcn  it can be  procured, the following: Dissolve  in two ounces
 of rain-Avater, four grains  of  Iodide of Potash, and half a grain of
 Iodine.
   If this inflammation is connected with gout, rheumatism, or gonor-
 rhea, the  disease, Avhatever it may be, must likewise be treated and
 cured before a permanent cure of the eye can be expected.

                     Quinsy, or Sore Throat.
   1. Flashes of chills  and heat; difficulty of swallowing and breathing;
 hoarse voice; swelling of the  throat  and almonds of  the  ears.
   2. Increased difficulty  of swalloAving and  breuthing;  more or less
 fever;  swelling of the almonds of the ears increases.
   3. SAvelling in  the throat bursts  and discharges matter; Sometimes
 mortification and  small ulcers are present.  (See Division I, pages 245
 to 247.)
   Treatment.—As soon as  the disease shows itself, give one of the
 emetics named under Fevers,  on page 74;  and  after this  has been
 accomplished, follow it up by one of the  cathartics, also named under
 Fevers.   In  very severe  cases it will  also be  useful to sweat the
 patient, according to one of the methods  named heretofore.
  The warm vapor from bitter herbs steeped in equal parts of water and
 Vinegar, should be  inhaled  a number of  times a day;  as, of Hyssop,
 Wormwood,  St. John's-wort, Tansy, etc.  The following forms a very
 good application; take equal parts of  Hops, Mullen leaves,  and St.
 John's-wort  leaves,  and make a  strong decoction  in  the Vinegar and
 water, to every quart  of which  add tAvo table-spoonfuls  of Salt.  The
 vapor from this may be inhaled, from a teapot, for instance; the herbs
 may be applied as a fomentation around the throat, renewing them two
 or three times a day; and the decoction may be given in  table-spoonful
doses every  hour  or two.
  Or, equal  parts of Hops,  Lobelia, and  Mullen  leaves  may be pre-
pared and  used in the same manner, being careful to add the  Lobelia 
88
AMERICAN FAMILY PHYSICIAN.
while the water  is  hot,  so  as not to  boil it, which drives off its
virtues.
  There are many other things which may be applied around the throat
with advantage, as roasted Potatoes, mashed;  Indian Posey, or White
Balsam,  in Vinegar and water;  Carrots  bruised and warmed; fresh
Poke root, roasted and mashed; fresh wild Indigo and Blue Flag roots,
softened in hot water, and mashed, etc.
  The feet should be frequently bathed in warm water, and the whole
surface, of the body should also  be bathed two or three  times a  day
with a warm, weak ley-water.   Any unpleasant accompanying symp-
toms to be treated as named  hereafter,  on pages 99  to 102.  .  The
patient may drink freely of Lemonade, Orange-juice, Vinegar  and
water, Buttermilk, etc.
  After the inflammation has become lessened, or the tumor bursts, the
throat should be frequently gargled with a tea of Sage and Hyssop,
sweetened with Honey, and a little Alum added.
  Or, a  gargle may be made  by pouring a pint of boiling water on
Sumach  berries and Golden  Seal or Yellow Puccoon, half a  handful
of each, a teaspoonful of  Red Pepper, and two  teaspoonfuls of Salt;
gargle the throat with this several times a  day.
  Other articles may be  formed into gargles, using  one  or more of
them together, as Witch  Hazel, Crowfoot  or Alum root, Beth root,
Eyebright, Prim  or Privet leaves, etc.
  When the almonds of the ear grow so large as to come together, the
patient may die from suffocation, and, to prevent this, one or both of
the swellings must be opened.  The diet  in this disease will necessarily
be  light  and fluid.   After a  recovery,  be careful to guard  against
exposures to cold and damp,  for fear of  a relapse.

                       Putrid Sore Throat.
  1. Chills; fever; soreness of the throat.
  2. Pain in the throat, with soreness;   pain increased upon moving
the  neck; whitish or grayish spots seen  in  the  throat, with  dark
ulcers.
  3. Voice  and breathing difficult and  hoarse; pulse sinks; breath
offensive.  (See Division I, pages 247, 248.)
   Treatment.—The  same  as  named for  sore-throat in Scarlet Fevei
on page 219.
                        Acute Laryngitis.
  This is an inflammation of the larynx or upper part of the wind-
pipe. 
HOUSEHOLD DEPARTMENT.
89
   1. Aching in the bones; headache; chills and fever; hoarseness of
 the voice, sometimes reduced to a whisper; more or less difficult breath-
 ing rapid pulse; pain in the upper and fore  part of the throat;  in-
 creased on pressure;  difficult rather than painful  swallowing; harsh,
 wheezing cough; expectoration  of a tough phlegm.   (See Division I,
 pages 254 to 256.)
   Treatment.—In the commencement of the disease,  treat in the same
 manner as recommended under the head  of Fevers, on page 74;
 giving an  emetic, cathartic, and sweat, and repeating it every day for
 tAvo or three  days, if the patient's strength will permit.  The warm
 vapor of Vinegar should be inhaled  several times a day, and the throat
 be likewise frequently gargled with a mixture composed of water half
 a pint, Vinegar a gill, Salt a teaspoonful; at the same time, the throat
 may be bathed with  some  stimulating preparation,  as, a mixture of
 SAveet Oil two table-spoonfuls, Camphor a teaspoonful, and Whisky a
 gill.
  Immediately after the  bathing, apply a Avarm  poultice around the
 throat, as, of Onions pounded and warmed;  or Garlics; or Hops and
 Mullen leaves  steeped in   hot  water;  or  Cranberries mashed and
 warmed; or equal parts of Wormwood and Tansy, steeped in hot
 water.
  To  relieve  the cough  and free the phlegm, a teaspoonful of the
 following mixture may be given as often as required; take of Honey,
 Sweet  Oil, Sweet Spirits of  Nitre, Lemon-juice or Vinegar, of each, a
 table-spoonful;  mix together.
  Flaxseed tea, Avith or without Lemon-juice or Vinegar, will frequently
 be of service.
  Or, an infusion made by steeping, for one hour, in  a covered vessel,.
 Lobelia leaves,  Comfrey root, Skunk  Cabbage root,  and Hoarhound^.
 half a handful  of each, in a  quart of boiling water and half a pint of
 hot Vinegar, and then  sweetening with  Honey.   This may be taken
 frequently in doses of half a wine-glass, or tAvo table-spoonfuls.
  The  diet of the patient should be light, and his room must be kept
 warm.  And if a hoarseness remains after the cure, it may be removed
 by scraping Horseradish root, and Wild Turnip root, in equal  parts of
water  and Vinegar, and sweetening with Honey, or  Loaf Sugar.  A
table-spoonful of this should be  slowly swallowed—repeating, this dose
as often as may be necessary. 
90
AMERICAN FAMILY PHYSICIAN.
  Bronchitis, or  Inflammation of the  Wind-pipe.   Pulmonary
                             Catarrh.
  1. Chilliness and  fever, as  if having  caught cold;  hard, dry, and
painful cough; pain  and soreness at the upper part of the breast bone.
  2. Severe cough;  more or  less raising of phlegm; pain across the
foreheacj, aggravated by coughing.  (See Division I, pages 262 to 204.)
   Treatment.—Commence the treatment by one  of  the emetics, named
under Fevers, on page 74;  soak the feet  in Avarm Aveak ley-water and
then produce a  profuse SAveat.  To relieve the cough,  and aid in re-
moving the phlegm, give one  of the preparations named for this pur-
pose in the  preceding  article, on Inflammation of the  Larynx.  Thc
patient must be kept warm,  in a warm room, and  his diet should be
light.
   In severe cases, the  emetic may be repeated every day, as well as
 the sweating.   In mild cases, Flaxseed tea, or Slippery Elm tea, with
 Lemon-juice or Vinegar added, will be found sufficient, after the first
 emetic and sweat  has been given. If a cough remains after the recov-
 ery, use one of  the  remedies  given for Cough on page  156.

                       Catarrh, or Influenza.
   1.  Sneezing; weight and pain in the head, especially the forehead;
 difficult breathing;  sense of  fullness and stopping of the nose;  eyes
 red and watery; throat sore, and dry cough; aching in the limbs; more
 or  less  fever.
   2. Cough gets more  free, with a  spitting up of phlegm, and a more
or  less  profuse  discharge from the nose  and eyes.  (See Division I,
 pages 266 to 269.)
   Treatment.—Generally speaking, but little medicine is required; the
patient  should be kept quiet in a moderately warm room; the feet may
be  soaked  at two  or three different times in a warm, weak ley-water;
and Avarm Lemonade, warm Gruel, warm  Spearmint tea, etc., be freely
administered.  When the person is cured, he  should  be careful for
some time afterward not to expose himself to  the causes of cold, as
this disease leaves the  system very sensitive to their influences for
many subsequent  days.
  When the disease is severe, an emetiG  should be given at the com-
mencement, as any  one of those named  under  Fever, on  page 74;
after which a sweat may be  produced, and it should be kept up for
some time, say three or four hours.  This should be followed by the
warm drinks above named; and, if required, the emetic  and the  sweat
may be  repeated on  the second or third day. 
                     HOUSEHOLD DEPARTMENT.                   »J

  For the cough, any one of the remedies named under the head of
Cough, on page 156, may be used.
  Persons who are subject to colds and catarrhs, will render themselves
less liable to  them, and perhaps  prevent them altogether, by frictions
upon the throat, neck, and breast, with a flesh-brush or coarse towel,
used every morning,  on  first getting out  of bed, at the same time
sponging the Avhole body with cold water in which a little salt has been
dissolved, and drying themselves  thoroughly.

         Inflammation  of  the Lungs, or  Lung Fever.
  fJhill, or sense of coldness; dull pain in  the  chest, increased by
coughing, or  on drawing  in a full breath;  this pain is, however, less
severe than in pleurisy;  difficult breathing, somewhat relieved on sit-
ting up ;  distressing cough;  quick, hard pulse; fever; face flushed or
purplish; the matter raised in coughing is thick, sticky, and sometimes
streaked with blood;  considerable thirst; sometimes delirium.   (See
Division I, pages 270 to 273.)
  Treatment.—In the commencement of this disease  the  treatment
must be  energetic; an emetic must be given; one  of those named
under the head of Fevers, on page 74, will answer.   This  should be
immediately  folloAved  by  producing  a profuse sweating.  After this
has continued for three or four hours, and  then been allowed to cool
off,  thc Avhole surface of the  body should be bathed with a warm, weak
ley-water, and then be thoroughly dried.   Immediately after this, place
mustard poultices to the  soles of the feet  and along  the whole course
of the back-bone, and cover the Avhole chest, or upper  part of the body,
with a fomentation of Hops, Lobelia leaves, and Tansy, equal parts of
each, steeped for a short time in hot Avater, and applied as  hot as the
patient can bear; this should be changed as often as  it becomes tepid.
If the inflammation continues, this course should be repeated every
day for three or four days, if the patient's strength will bear it.
  If the  bowels  are costive, or if the patient does not soon begin to
raise phlegm, a cathartic  must be given, as any one of those named
under Fevers, on page 75.
  To relieve the cough, the folloAving may be used: Take of Flaxseed,
or Slippery Elm bark, two ounces; Lobelia leaves an ounce; Blood-
root or  Red  Puccoon, in powder, tAvo teaspoonfuls;  add to  these one
quart of boiling Avater, cover the  vessel, and let it steep near a fire for
an hour;  then, when cold, strain,  and SAveeten  with Honey or Molasses.
A table-spoonful of this may be given every hour or two.   Should this
vomit or  nauseate too much,  the dose must be lessened; but  a  slight 
92
AMERICAN FAMILY PHYSICIAN.
degree of sickness at stomach kept up all the time, wil. be found bene-
ficial.
  Whenever the inflammatory symptoms are severe, the Avhole surface
of the body should be bathed as before said, and the mustard be ap-
plied as often as these severe symptoms appear.
  The patient must be kept quiet, and  not be allowed to talk, and all
callers and visitors, and unnecessary persons, must not be permitted to
enter the sick-room,  and the room should be constantly kept at a tem-
perature of 60° Fahrenheit.  The  drinks should  be principally of a
iriucilaginous and acidulous nature.   Great care must be taken during
convalescence to  guard against a relapse, as no inflammation is more
easily renewed than this.

  Typhoid Pneumonia or Winter Fever—Typhoid Lung Fever.
  The symptoms in this  disease are similar to those of Lung Fever,
with the exception of  a  Ioav, typhoid condition or prostration of the
system being present.   (See Division I, pages 273 to 275.)
  Treatment.—In the  early stage of the disease,  treat the  same as
named in the preceding article for Lung Fever.  But as soon as symp-
toms of prostration come on, all reducing or debilitating remedies must
be stopped, and the patient be treated  in the same manner as named
for  Typhus Fever, on  page 79,  according to the peculiar symptoms
present; treating the various symptoms according to the means named
hereafter, under their appropriate heads, on pages 99 to 102.
  The patient should have his head and shoulders somewhat raised in
the bed, not being allowed to keep them, too Ioav ; and his cough should
be kept loose by Flaxseed or Slippery Elm tea, SAveetened, and having
some Lemon-juice or Vinegar added;  at the same time some stimu-
lating mixture should be rubbed upon the  chest and back, several times
a day, as, for instance :  Take of Red Pepper tAvo teaspoonfuls ; Whisky,
half a pint; steep near a hot fire for an hour; then strain; add Cam-
phor, a table-spoonful, and Olive Oil a gill—mix.   Any other stimulat-
ing liniment will answer.
                            Pleurisy.
  Chilliness;  heat; thirst;  quick, hard pulse ; sharp, pricking pain in
one of the sides, which is very much increased upon breathing, obliging
the patient to breathe quick and short;  generally a dry, hacking cough
is present; the patient lies upon  his back, or upon the side which is not
affected.   (See Division I, pages 275 to 277.)
   Treatment.—In ninety-nine cases  out of a hundred, Pleurisy can be
cured, and the pain be relieved, in fifteen  or twenty minutes, by imme- 
household departmem.
93
 diately causing the patient  to sweat  profusely by  one of the  means
 named under Fevers, on page 74, and afterward keeping constantly
 upon the affected side a fomentation of bitter herbs, as hot as can be
 borne, and renewing it as fast as it gets even tepid.  Boneset, Tansy,
 Catnip, Mayweed, Vervain,  St. John's-wort,  Hoarhound,  Wormwood,
 Hops, Lobelia, etc., may be promiscuously used for this purpose, using
 one or more of them, as can be procured.  After the pain and inflam-
 mation has been removed, the patient must be  careful  for a few days
 afterward not to  expose himself to cold, or  eat too much food,  and
 especially improper food.
   Should there be a lurking pain, and some difficulty of breathing left
 after the sweat, the patient should take an emetic, and follow this with
 a cathartic, using either of the articles for these  purposes, named under
 Fevers, on pages 74 and  75.  If the disease returns, repeat the treat-
 ment above given.
   Any cough remaining after the removal of the pain and inflamma-
 tion, may  be cured by the  following  preparation:  Take of Pleurisy
 root, Black Cohosh or  Rattle root, each, in coarse powder, a heap-
 ing table-spoonful; Bloodroot or  Red Puccoon, in coarse powder, a
 heaping teaspoonful;  pour a quart of boiling Rain or Freestone water
 upon them ; cover, and let them steep near a fire for three hours; then,
 when cold,  add two table-spoonfuls of Wild Cherry bark, and allow the
 Avhole to stand six hours; then strain, and sweeten to  suit the taste.
 The dose is a table-spoonful every  hour or two, according to the sever-
 ity of the cough.

                 Inflammation  of the Stomach.
   Burning  pain at  the  pit of the  stomach, increased on  swallowing,
 and by pressure made over the part;  nausea;  vomiting, more or  less
 constantly; urgent thirst; throwing up of everything swallowed; high
 fever; great  dejection  of mind;  great prostration; costive bowels.
 (See Division I, pages 280 to 282.)
   Treatment.—If the inflammation be produced by poisons taken into
 thc stomach, an emetic should be  promptly given, as well as the proper
 antidote to  the poison, Avhen this  is known.  (See Division I, pages
 ill) and 617.)
  Inflammation of the stomach must be treated by  applying  mustard
poultices to the feet, along the whole course of the back-bone, and over
the pit of the stomach;  as soon as they have produced considerable red-
ness, but without blistering, remove them, and reapply them afterward,
from time to time, as the severity of the symptoms appear to require. 
94
AMERICAN FAMILY PHYSICIAN.
   As  soon as the poultice  over  the pit of the stomach  has produced
 considerable redness of the part, remove it, and apply  a fomentation
 of Hops and Stramonium, or Jimson leaves ;  or, of Hops and Lobelia •
 or, of Lobelia and Jimson leaves.   These fomentations must be applied
 as hot as can be borne, and changed as often as they get tepid.  In
 addition to this, the A\'hole surface  of the body  should  be frequently
 bathed with a Avarm, weak ley-Avater, using considerable  friction in
 drying;  this bathing should be especially repeated whenever the pain
 and other inflammatory symptoms grow severe.
   Internally, the patient  may drink, as freely as the stomach will
 admit, of mucilaginous drinks, as Slippery Elm bark and Peach leaves
 equal parts, allowed to stand an hour or two in cold water before using •
 or, MarshmalloAV root  and  Peach leaves; Gum Arabic water; Barley
 water, and, in some cases,,  Orange-juice may be  used with advantage.
 A cold tea of St. John's-Avort and Scullcap will be found beneficial in
 many cases-.
   A very  excellent  preparation  is a tea of Cleavers three parts,  St.
 John's-wort one part, alloAved to stand four hours in cold water before
 using; it may be drank frequently, or as often as the stomach will
 allow.
   No physic should  be given by mouth, but the bowels should be kept
 regular by using every day an  injection as follows: Make a strong
 decoction  of  Mandrake  or Mayapple  root,  and  Boneset,  to   every
 quart of which add a pint of Molasses and tAvo table-spoonfuls of Salt;
 for an injection,  use one quart of this as Avarm as can be borne; and
 repeat it in half an hour, if no operation occurs Avithin this time.
   Any troublesome'  cough may be relieved by the folloAving: take  of
 Comfrey root, Pleurisy root, Sassafras bark, and Wild  Cherry  bark,
 each, in  coarse powder, a table-spoonful, cold water a quart; mix, and
 let all stand for  four hours, and then give a table-spoonful as  often
 as required.  If desired, it  may be  SAveetened Avith  Avhite Sugar or
 Honey.
   The patient should be kept quiet, in a room well ventilated, and not
 be disturbed by visitors or  callers.   As  soon as the patient becomes
 convalescent, he should be kept for some time upon light diet, and great
 care must be taken to gradually accustom the stomach to the presence
 of its original diet.   The following may be administered  to strengthen
 the stomach during  convalescence:  take of Solomon's Seal, in  coarse
powder, St. John's-wort leaves, each, a handful, Sassafras bark, Golden
Seal or Yellow Puccoon each, half a handful, boiling Avater two quarts;
steep in a covered  vessel,  near  a fire, far an hour, and then strain. 
HOUSEHOLD DEPARTMENT.
95
Sweeten, if desired; of this a table-spoonful may be taken every hour
or two.
                 Inflammation of the Bowels.
  Severe pain in the bowels, increased by pressure, shooting in a twist-
ing manner around the navel; swelling of the belly; obstinate costive-
ness; frequent vomitings, according to the location of the inflammation,
whether at the upper or lower part of the  intestines; sometimes diar-
rhea;  more or less fever;  quick pulse; thirst; high-colored and scanty
urine, and prostration.  (See Division I, pages 285 to 287.)
   Treatment.—Bathe the whole surface  of the body  in a warm, weak
ley-water, and dry with considerable friction; then apply mustard poul-
tices to the feet, along the whole course of the back-bone, and over the
whole of the belly, changing them from time to time, as named in the
preceding article on  Inflammation of the  Stomach.  When  the poul-
tice on  the belly has produced considerable redness, remove  it and
apply one of the herb fomentations recommended above for Inflamma-
tion  of  thc Stomach, as  hot  as  can be borne,  and keep using them
constantly until the pain and inflammation  has been subdued.
  The boAvels must be evacuated as soon  as possible, for  which pur-
pose  use tho injection named in the treatment of Inflammation of the
Stomach, in the same manner as  there recommended; and this should
be repeated every  day.   In other respects treat the same as  recom-
mended  for Inflammation of the  Stomach; and any  symptoms which
may appear during  the course of the disease must be treated as named
under their appropriate heads, on pages 99 to 102.

                  Dysentery, or Bloody Flux.
  This is an inflammation of the loAver or large intestines.
  Frequent bloody stools, with considerable phlegm; gripings; bearing
down, and a more or less constant desire  to stool  or strain; natural
excrement in  small amount and, Avhen  present, in hard, small balls;
more or less fever; loss of appetite; nausea, or  vomiting;  stools very
offensive; urine scanty and high-colored ; and great prostration.  (See
Division I, pages 288 to 291.)
  Treatment.—In nine cases out of ten,  dysentery can be cured by
injecting a quart of Avarm water into the bowels, and as soon  as this
has passed, immediately injecting again a solution  of  twenty  grains
of Nitrate  of Silver, or Lunar Caustic, to  one ounce of water.  This
course should  be repeated immediately after every operation from the
bowels;  three or four injections generally effect the  cure.
  But in cases Avhere this can not be procured,  the bowels should first 
96
AMERICAN FAMILY PHYSICIAN.
be cleansed by a cathartic, as one or tAvo table-spoonfuls of Castor Oil
with a teaspoonful of Paregoric; or a tea of Mayapple or Mandrake
root may be  given in table-spoonful doses, every half hour until  it
operates.   If the pain and inflammatory symptoms are  very severe
Mustard-poultices  and herb-fomentations should be  placed  over the
tvhole belly, the  same as named for Inflammation of the  Stomach on
pages 93 and  94.
  Injections into the lower bowels must not be omitted;  they should be
used in  small  quantity, say  from two table-spoonfuls to half a pint of
fluid, and be repeated frequently, at least as often as immediately after
each stool.  The following are good injections, and either  of them can
be used, as  found to agree best with the patient.
  1. A  table-spoonful of  Starch  water, and  a half teaspoonful of
Laudanum.
  2. Two table-spoonfuls of Flaxseed, or Slippery Elm tea, and a half
teaspoonful of Laudanum.
  3. A strong decoction either of Bugleweed,  Beth root,  Crane's-bill,
Marsh-rosemary, or White  Oak bark; one or  more of  these may be
mixed  together,  and used  in  injections containing,  each, two table-
spoonfuls of the decoction or tea, and half a teaspoonful of Laudanum.
  4. In the putrid form of the disease  much benefit will  result  from
preparing the fluids which are taken internally, as well as those used
as injections,  in  the following manner; place  a quantity of red hot
charcoal in a vessel, and immediately pour upon it the fluid which is to
be used.  This imparts an antiseptic, quality to the liquids, rendering
them much more valuable and  efficacious.
  5. In  many instances of dysentery the  following has  proved very
efficacious;  take boiling water a gill, hot  Vinegar half a pint,  com-
mon table Salt, as much as can be dissolved in these fluids.  The dose
is a table-spoonful every hour until the boAvels  are operated upon, and
the bloody discharges cease.
  Internally,  the patient may  drink freely of a tea of Slippery Elm
bark and Raspberry leaves ; or of Marshmallow root and Witch Hazel
leaves;  or any other astringent combined Avith  mucilage.
  The patient must be kept quiet and in the horizontal position during
the whole course of the disease; and  he ought not to give way to the
frequent inclination to stool, but stifle it as  much  as possible.  Thc
stools  should  be  immediately  removed from the  sick-room, and,
in the putrid or malignant form of the disease,  they should be buried,
as the  effluvia from them may give  rise to the disease both  in men
and animals, even when they  have been thrown  into  a  privy.  The. 
HOUSEHOLD DEPARTMENT.
97
 atmospnere  of  the  room should be frequently purified by one of the
 means named in Division I, page 137.
   During the disease the  patient may use Rice water, Barley water,
 ripe Apple water, etc., to which a little Cinnamon, or other aromatic,
 has been added.  And in the putrid form of the disease, the juice of
 good, ripe fruits, either alone or boiled with milk, will be found useful
 After a recovery, great care must be taken to avoid a relapse, to which
 all convalescents are especially liable.
   Dysentery may be entiiely prevented, or, at all events, be much less
 ened in severity, by taking a moderate amount of exercise every day,
 bathing the Avhole surface of the body twice a week, using digestible and
 nourishing food, keeping the bowels regular, keeping away from damp-
 ness, and especially damp night air, and using moderately of fresh, ripe
 fruits.   (See Chronic Dysentery, on page 147.)
                 Inflammation of the  Kidneys.
   Chills; more or less fever;  more or less severe pain in the small of
 the  back, extending to the loins, the bladder, and  the thighs, which
 pain is increased by pressure, by straining, or by taking in a full breath;
 pain and drawing up of the testicle; constant desire to urinate;  pain
 and  difficulty in urinating, and urine scanty, high-colored, and some-
 times bloody.   (See Division I, pages 301 to 304.)
   Treatment.—Produce profuse sweating  as soon as possible, by one
 of the means named under Fevers, on page 74, and repeating it every
 day, if required.   Should  the bowels  be costive, a cathartic must be
 given.   To  relieve  the pain in the kidneys, apply one of the herb fo-
 mentations, named for Inflammation of the Stomach,  on page 94, upon
 the back, just over  the affected organ, renewing it as often as may be
 necessary.   And to aid in urinating,  and at  the same  time lessen
 the inflammation, the patient may drink freely of a cold tea of Cleavers,
 or of Pumpkin-seed, Watermelon-seed, Marshmallows, Elder blows,
 Wild Carrot, String Bean pods, etc.   Use considerable  care  during
 convalescence, to avoid cold, and overloading the stomach.
                 Inflammation of the Bladder.
  Burning and thr- bing pain in the region of the bladder;  constant
 desire to pass water,  which is voided  with pain and much difficulty,
passing often by drops, or  being entirely stopped; feverish symptoms
are present,  with debility and restlessness.   (See Div. I, p. 312 and 313.
   Treatment.—The  disease must be treated similar to  the preceding
one,  keeping the patient quiet, and upon a  diet of a light, thin, cool-
ing nature.  Warm herb fomentations should be applied over the region 
98
AMERICAN FAMILY PHYSICIAN.
 of the bladder, at the lower part of the belly, as long as the acute pain
 and difficulty of passing water continues.  Or, a poultice of bruised
 Onions or Garlics,  slightly warmed, may be applied.  And the patient
 should drink of such teas as are recommended above, in Inflammation
 of the Kidneys.
   Sometimes a poultice of  fresh Stramonium  leaves, pounded,  and
 applied over the  part, with  an injection into the bowels of a tea of
 Lobelia, will be found very useful.

                    Inflammatory Rheumatism.
   Fever; severe  pain; inflammation and swelling of the joints, with
 great tenderness—the pains  shifting about, and being increased on the
 least motion;  when it shifts to the heart, it is apt to prove fatal.  (See
 Division I, pages 320 to 325.)
    Treatment.—The first thing to do, is  to cause profuse  sweating by
 one of the means named under Fevers, on page 74; and, after this, a
 gentle perspiration should be kept up by drinking freely of warm herb
 teas, as of Pennyroyal, Spearmint, Blue Vervain, Spice Bush, Summer
 Savory, Smartweed, Mayweed, Yarrow, Horsemint, Hemlock, etc.;  any
 one or more of these may be made into a tea, and be used warm.  Diu-
 retic teas may also be drank, as of Wild Carrot root or seed, Cleavers,
 Queen of the  Meadow root, Burdock-seed, etc.
    A poultice of bruised Stramonium or Jimson leaves should be placed
 over the painful parts; or, if these can  not be obtained, a fomentation
 of Hops and  Lobelia leaves.  The poultice or fomentation should be
 renewed three or four  times a day.   In some  cases it will be found
 advantageous  to steam the affected parts over the vapor of water and
 vinegar, and afterward  apply the poultice.
    The bowels should be kept open by some mild cathartic, or by injec-
 tions, which should be  repeated every day or two.  The following will
 be found very useful to keep the  bowels open as well as to  relieve the
 inflammation: Take of Black Cohosh or Rattle root, Sassafras bark,
 each, in coarse powder, a table-spoonful; Mayapple or Mandrake  root,
 in coarse powder, half a table-spoonful; boiling water a pint; steep near
 a  fire for two hours, in a covered vessel; and  give for a dose, half a
 fable-spoonful every hour;  lessen the dose, if it operates too freely.
•    The patient should be kept as  quiet as possible, in a horizontal po-
 sition, and his  diet should  be light.   The  room should  be free from
 noise or disturbances, and no visitors be allowed to annoy the patient.
 Great care must be taken during convalescence, not to cause a relapse.
 (See  Chronic Rheumatism, on page 149.) 
HOUSEHOLD DEPARTMENT.
99
SYMPTOMS  OCCURRING  DURING THE  COURSE
       OF FEVERS  AND  INFLAMMATIONS.
  It is frequently the case that when Fevers or Inflammatory Diseases
are  not broken up at  the  start, they will  continue for some days or
weeks, presenting one or more of the following symptoms, which are
frequently so severe or troublesome as to require treatment.
  As these symptoms are to be treated in about the same way, when
ever they occur in any acute disease, I have not named them in the
various acute diseases heretofore  treated upon, but have  merely re-
ferred  to them, preferring to arrange them  here, in order to save con-
siderable space.
      Severe and Distressing Pain in the Head—Delirium.
  Apply mustard poultices, or pounded Garlics or Onions, to the soles
of the  feet, to the wrists, to the back of the neck, and, in very severe
cases, even along  the whole course of the  back-bone.  Whipping the
soles of the feet is also excellent.  The head should also be constantly
bathed with cold water, cold water and Vinegar, or a mixture  of rain-
water, Vinegar, Whisky, each, a gill; table Salt two teaspoonfuls.  In
some cases the pain will not cease until the bowels have  been acted
upon by a cathartic.  (See Division I, pages 180, 194, and 237.)

         Pain and  Savelling in  the Stomach  or Boavels.
  First, apply a mustard poultice over the  pit of the stomach, or over
the whole belly, and when this has caused  considerable redness of the
surface, remove it,  and  apply warm herb  fomentations, as of Hops,
Boneset, Tansy, Wormwood, Lobelia, etc.,  steeped in water, or equal
parts of water and Vinegar, renewing them frequently. (See Division
I, pages 181, 194, and 281.)

                      Nausea or Vomiting.
  This may frequently be relieved by a mustard poultice  over the pit
of the stomach, with the internal  use of some kind of Mint tea.   In 
100
AMERICAN FAMILY PHYSICIAN.
some cases a tea of parched Corn, or some Oat-meal Coffee, will prove
useful.  (See Division I, pages 181,194, and 291.)

               Soreness in  the Mouth or Throat.
  Wash the mouth, or gargle the throat frequently with a decoction of
equal  parts of Sage and Hyssop, sweetened with Honey.
  Or, use an infusion of Yarrow leaves.
  Or, make a tea of Privet  leaves and Beth root,  and sweeten with
Honey.
  Or, make a strong tea of Blue Cohosh and Golden Seal  or Yellow
Puccoon root; sweeten with Honey; and to every pint add half a tea-
spoonful, each, of Alum and Saltpetre.  When the throat is  swollen a
fomentation of Mullen and Lobelia leaves, steeped  in hot water and
Vinegar, may be  applied.   (See Division I, page 181.)

                     Suppression of  Urine.
  Let  the patient drink freely of a tea  of Pumpkin seed, Watermelon
seed, Queen of the Meadow root, Marshmallow root, etc.; and, in some
cases,  a teaspoonful  of Spirits of Nitre  may also be taken every half
hour, until relieved.   At the  same time apply warm  herb fomentations
over the region of the  bladder, as  of Stramonium or Jimson leaves;
Hops'' and Lobelia;  Lobelia and Sassafras leaves; pounded  Onions or
Garlics, etc.   (See Division I, pages 181 and 438.)

             Mortification  of the Mouth  and Face.
  Wash the mouth and parts with a tea of Wild Indigo leaves, or of
Sumach bark, White Oak  bark, Marshmallow root,  Horseweed, etc.,
and apply the same  in the form of poultice,  with Slippery  Elm bark,
Charcoal, and  Yeast.
  Or, in place of Yeast, a strong tea of Wood-soot may be used. (See
Division I, page  181.)
                       Troublesome Cough.
  1. Take of  Pleurisy root, Comfrey root, Lobelia, and Wild Cherry
bark,  each, in coarse powder, a table-spoonful; boiling water a quart;
let them steep for an hour in  a warm place, and sweeten with Honey oi
Avhite Sugar;  of this take a table-spoonful as often as required. (See
Division I, pages 181, 255, 264, 269, 272, 273, and 277.)
  2. Take Sunflower seeds, one pound, bruise them  and  add  them to
two and a half gallons of water; boil slowly doAA'n to one  gallon and a
half;  strain; while hot  add to it four ounces of Wild Cherry bark, in
powder; and four ounces of Solomon's Seal root, in  powder; and sis 
HOUSEHOLD department.
101
pounds of Loaf Sugar;  cover the vessel  tightly, and let it stand for
twenty-four hours, and  add to it  six pints of Holland Gin,  or good
Whisky.   This forms an unrivaled preparation in Coughs and Pulmo-
nary affections.  The dose is one or two tabl'e-spoonfuls three or four
times a day.

Great Debility, Prostration of Strength, Pulse Low, or Weak
                           and  Quick.
   Apply mustard to the legs when cold,  Avith warm stones in the  bed
along the sides of the patient;  and if the head be hot, apply some cool-
ing wash to it.  Internally, good Cider, to which a small quantity of
Brandy or Whisky  is added, may  be  given as  freely as the case re-
quires.
   Or, some Whisky or Brandy-punch may be given.
   Or, add  some Whisky or some Brandy to some Whey, equal parts
of each,  and sweeten.
   Or, Currant wine, Elderberry Avine, etc.   (See Division I, pages 181,
194, 206, 273, and 274.)
                           Diarrhea.
   Diarrhea, in the latter stages of acute diseases, requires injections
of astringents, as a tea of CroAvfoot  or Crane's-bill; of Beth root, White
Oak bark, or Blackberry root, etc.; and the same may be taken inter-
nally.  (See Division I, pages 182, 211, and 287.)

                        Putrid Symptoms.
   Give Cider, or Vinegar and water, or Buttermilk; or  an infusion of
Wild Indigo root, in table-spoonful doses, every two or three hours;
or Charcoal may be given in some Slippery Elm bark tea.  (See Divi-
sion I, page 182.)
                     Dark Furred Tongue.
   When  the tongue is coated yellow,  brown, or black,  let the patient
have Lemon-juice, Cider, Buttermilk, Lemonade, Orange juice, juice
of ripe fruits, and even Vinegar, if he craves it.   (See Division I, pages
182, 194, and  287.)

            Excessive  Restlessness or Wakefulness.
  This symptom may be relieved by giving  the patient a tea of one of
the following  articles:  Scullcap leaves, Ladies' Slipper root, Skunk
Cabbage  root  or  balls,  Pleurisy root, etc.; a table-spoonful  may be
given every hour.  Or, two or more may be combined together to form
a tea.  (Ste Division I,  pages 206, 237, and 240.) 
102                AMERIC&N FAMILY PHYSICIAN.
                    Dark Fur on  the Teeth.
  When the teeth are  covered with  a thick, dark fur, they should be
frequently washed with Vinegar and water.  (See Division I, page 207.)

                 Sleep, or a Comatose Condition.
  Whenever the patient is disposed to lie in a stupid condition, hardly
being aroused by shaking, it is a dangerous symptom, especially if
there be squinting, fixedness of the  eye, or paralysis.   In such cases
the surface of the body should be frequently rubbed with stimulants*
and  tonics,  and nourishment, as  well as wines, etc., may  be given.
(See Division I, page 238.)

               Drum-like Swelling of the Belly.
   This is called Tympanitis, and is sometimes very difficult to remove.
A fomentation of Hops, Lobelia, and Tansy, or of some other bitter
herbs, to which some  Spirits of Turpentine  has been added, may be
applied,  and be renewed three  or four times a day, continuing  them
until all pain as  well as the swelling has gone.  At the same time, a
table-spoonful, each, of Castor Oil and Spirits of Turpentine, and two
teaspoonfuls of Paregoric, may be mixed together, and be injected into
the bowels, repeating it every two or three hours.  Take equal  parts
of Sweet Oil and  Oil  of Sassafras, and  rub upon the belly with the
hand,  rubbing  dowmvard  all the time, for three or  four hours at a
time, and gradually bearing on harder  and harder;. this has often re-
moved the drum-like SAvelling and hardness of the abdomen, even when
very obstinate.   (See Division I, pages 211, 309, and 428.)
  [The following disease, which was omitted in Division I, and which
is now so common throughout this country and Europe, I have deemed
best to insert at this place.]

                           Diphtheria.
  Diphtheria or Diphtheritis is a very fatal disease, which, although
not a new one, is more frequently met with  than in former years.  It
has a tendency to assume an epidemic  form, and is, undoubtedly, con-
tagious or infectious, as it appears to be communicated from one per-
son  to another, although more common among children.   It  is no
respecter of person, age, condition, rank, or temperament, frequently 
household department.
103
 attacks suddenly without any warning, and proves fatal in from twelve
 hours to twenty days.
   Causes.—The causes of this  disease are not  known.   By some it
 has been considered as a malignant form of croup, but it is essentially
 different in its character;  others have viewed it as a dangerous species
 of scarlet fever, but it does not protect those who have it from being
 afterward attacked with scarlet  fever, nor does this fever protect from'
 diphtheria.
  It appears to be a blood  disease, or rather a constitutional one, in
 which the whole system is involved, for it is often the case that when
 thc false membranes have entirely disappeared, and the  patient is  ap-
 parently getting better, he will suddenly sink and die. It also appears
 to arise from  the emanations  from putrid stagnant ponds, sewers,
 privies, and the like.   It apparently depends on a parasitic  fungus—
 the " oi'dium albicans."
  Symptoms.—The symptoms of diphtheria vary considerably in their
 character, both in the  commencing and  advancing stages, though  the
 peculiar characteristics.of the disease are, great prostration,  and  the
 presence of a thick, leathery membrane, which  gradually passes into
 the air passages.                                 •
  In the  majority of cases, it  commences with more or less severe
 chills, followed by feverish  symptoms, among  which headache is  the
 most severe, followed, in a shorter or longer time, by a soreness in the
 throat and difficulty of  swallowing, with an extreme feeling of depres-
 sion.  Sometimes, even in the Avorst cases of the  throat affection, there
 will  be  little or no fever.   The breathing is  hurried  and  catching.
 Upon making an examination, the tongue will  be found  coated white,
 though sometimes it will be moist,  and without any coating at first;  the
 tonsils  and other parts of the throat are SAVollen and covered with the
 peculiar diphtheritic deposit; the tonsils  being hard, and  tender to the
 touch, or presenting, in some cases, a holloAV ulcer with raised  violet
 edges, and a dark,  ash-colored slough on its floor.  The disease gradu-
 ally extends into the air-passages.   The  fever Avhich  accompanies it is
 of an intermittent or remittent type.  The pulse is not  always quick,
 but often slow, Avaving, and very  compressible.   The urine  is  often
 abundant,  and  sometimes albuminous; and  obstinate constipation is
 usually present in the early period, but which is soon  exchanged for an
 offensive diarrhea.   Sometimes the serous or watery  effusion  or swell-
ing in the cellular substance of the neck,  face, etc., will be so great as
to entirely hide  the  eyes, or even  prevent  the patient's own clothes
from comfortably fitting h;m.   Sometimes  the entire surface of  the
          57 
104
AMERICAN FAMILY PHYSICIAN.
body is covered with a rash resembling scarlatina; in strumous patients
the glands of the neck generally swell; and in the more serious forma
of the disease, extensive abscesses form in  the cellular tissue, or, the
feet and legs become perfectly black and  cold, with large  bulla;  or
blister-like  swellings  on  them, containing  a putrid fluid.  The mem
brane which forms in this disease, is whitish or ash-colored, and may
exist  in patches, or these may run together, covering the whole surface
of the parts.  After it is completed it commences to be removed, either
in strips or by becoming  softened, so that it mixes with the fluids  of
the mouth.   It will often be renewed at the same spot several times in
succession, each neAv membrane becoming whiter and thinner.
   When the disease is of a mild  character, there is generally a fever-
ishness, loss of appetite, and, at  first, only slight pain in swallowing;
the tongue is coated with  a white, thick, creamy substance, the papillae
being elevated; the voice somewhat thick and husky; the palate, ton-
sils, and back part of the  throat, are of a glassy, bright-red color, the
tonsils being swollen, with white  patches upon one  or both of them.
The filmy deposit  and  exudation adhere very tenaciously to the sub-
mucous surface, and can not be easily scraped off.
   In  the severe for«a the fever is  high, with a hot, pungent skin, flushed
countenance,  congested  lips,  a rapid, feeble  pulse, great difficulty  in
swallowing, hurried respiration,  and the tongue  coated  with a thick
whitish,  dirty  yellowish-brown, or slate-colored substance, with great
depression  of the  vital powers.   Upon making an  examination, the
whole throat will be found of a deep, husky, erysipelatous redness, and
the tonsils enormously swollen,  with a large ash-colored membrane, likfe
rough leather, spread over the inner side of one or both of them, and
also upon the palate or fauces.   Most commonly, there is a profuse ex-
udation of a jelly-like, tenacious fluid, which hangs in the back part  of
the mouth like a curtain, and bursts when the patient breathes, sending
its particles over the mouth, as  Avell  as over the  instrument used  to
depress the tongue; the next moment another similar curtain is formed,
and so on.
   As the disease advances, these  symptoms increase in severity; thc
breathing becomes  stertorous from the mechanical obstruction present;
the swalloAving becomes so painful that the patient will frequently re-
fuse to swallow; the saliva dribbles from the mouth, and a foul, thin,
acrid, and yelloAvish discharge often flows from  the nostrils in more or
less profuse quantity; the pulse  becomes more rapid and feeble; tho
glands of the neck become swollen and tender; the face also becomes
greatly swollen; an attempt to  open the mouth  causes most excruciat 
HOUSEHOLD DEPARTMENT.
lor
 ting pain; the voice becomes  hoarse and indistinct, with a shjrt, dry
 cough, and a puffed and blushy neck; all the previously red parts in
 the throat become  covered Avith the false membrane,  which extends
 downward along the air-passages.   When the tonsils become livid and
 gangrenous, the  breath is intolerably fetid.  The patient lies upon his
 back in a half comatose condition, or may be restless and tossing about
 in the  bed.   Difficulty of urinating, suppression of urine, or even bloody
 urine  are apt to be  present at this time.  Death, which is often pre-
 ceded  by vomiting, ensues either  from rapid prostration of the vital
 powers, or, by asphyxia from the extension of false membrane into the
 air passages.
   Sometimes, in the beginning of the severe form, the patient is seized,
 more commonly  in  the morning, with violent vomiting of a thin, yel-
 lowish-white, offensive matter, folloAved by purging of a similar fluid.
 These are folloAved by great prostration and stupor;  drink is taken
 with avidity, only to be  throAvn up.  Frequently the patient will lie in
 a long, heavy sleep, and upon  being asked if his throat  is sore, will
 reply,  "Not at  all."  The physician must  not be deceived by this
 answer, but must examine the throat carefully.  Sometimes the disease
 is ushered in with slight diarrhea,  with discharge of blood; sometimes
 a bleeding from the  nose is an early symptom.  In many cases a stupor
 attends from the commencement, which  passes  away in from five to
 eighteen hours, and a delirium comes on,  which is often  of a violent
 character.  The Avhole mouth is lined with the Avhitish deposit, so that,.
 when  open,  it looks as  though  it Avcre  lined Avith  plaster of Paris.
 After  a time the delirium  subsides, and then the powers of life  fail
 rapidly; the horrible sensations of choking and suffocation come on:
 the sufferer tears at his neck with his nails, and tries to open his mouth;
 large,  livid spots form on the extremities; a Avhite, offensive matter is
 incessantly discharged from the boAvels; Ioav, muttering delirium ensues,
 and, in a long, tetanic convulsion, death closes the scene.
   Discrimination.—The  patient has at first a slight cough, perhaps a
 hardly noticeable hoarseness of voice;  the  throat will be observec1
 swollen on the outside.   If the tongue be held doAvn  by a spoon, a
 little patch of membranous exudation or false membrane, will  be seen
 in the fauces; and upon  one or both tonsils will  be observed a whitish
 membrane, about the size of a dime, surrounded by a shining redness.
 The membrane is thieker than that formed in croup, and is composeu
 of the fibrin of the blood, coagulated and forming threads or filaments,
having no cells proper,  but a variable quantity of granules.   Some-
times there are no fibers, the granules being all  mixed up together. 
106
AMERICAN FAMILY PHYSICIAN.
   When the membrane is removed, it leaves the surface from which it
 is taken of a bright red, with an appearance not unlike raAv meat.
   Prognosis.—In strong constitutions,  when the  attack is mild, and
 treatment adopted at an early period, the prognosis is favorable.  But
 m  the  more severe attacks,  the  prognosis  is always  unfavorable  es-
 pecially if treatment has been delayed for a  day or two after the symp-
 toms show themselves.  Vomiting in the latter stage of the disease is
 an indication that the disease has  advanced too  far  to warrant any
 hope of success for the operation of tracheotomy.  When albuminaria
 is found in the urine, the case is unfavorable, though not  necessarily
 fatal.   The longer the process of membranous formation continues, the
 more unfavorable is the prognosis; if it continues to the ninth or tenth
 day, even in apparently light cases, but few will be found to recover.
   After the throat has recovered from the attack, the patient is ex-
 posed to  secondary affections or after consequences, Avhich sometimes
 prove fatal.   The patient becomes pale and colorless, the  limbs  pain
 him, the muscles  become soft and flabby and lose  their power, and he
 becomes very much enfeebled.  Sometimes the arms and legs lose their
 power; the patient can not walk, or merely shuffles along, and is un-
 able to  seize anything with the hand and hold it.  The mind is fre-
 quently depressed;  there may be a want of appetite, with  debility of
 digestive  powers, and costiveness.   Neuralgic pains in various parts
 are  common, sensatio:.. may  be diminished  or entirely lost;  various
 parts of the body becoic. ^edematous, or gangrenous; the  soft palate
 dangles like a dead curtau   swallowing, and even breathing, are ex-
 tremely difficult; the pupils  -..re dilated, and the sight impaired or
 wholly  lost.  The voice  may also  be  nearly destroyed.  All these
 symptoms are not present in any one person, but will be found to  vary
 with different individuals, and the convalescent who escapes even one
of them, will be quite fortunate.
  Dropsical swellings, deafness, or temporary paralysis are, probably,
 the most common among  these after-effects of diphtheria.
   Treatment.—The patient should be removed to a  clean bed, in a dry,
 well-ventilated room, at a moderate temperature, kept sweet and clean,
 and no  one should be allowed to sleep in the room except the attend-
 ant.  All visitors or callers should positively be kept out of the sick-
 room.   The room should be charged with Chlorine  both day and night,
 which may be done by placing dishes of Chloride  of Lime  in its sev-
 eral corners,  and pouring  some  Vinegar thereon, to disengage the
Chlorine.
  If the patient be strong, an emetic  at the commencement of the 
HOUSEHOLD DEPARTMENT.
107
disease will prove highly beneficial; but if he be weakly or debilitated,
or the  disease has progressed,  the  emetic, as well  as  all debilitating
measures, must be prohibited.  If, however, the bowels  have been con-
stipated, they must be acted upon lightly by a mixture of equal parte
of Compound Powder of Rhubarb and Potassa, Compound Powder of
Jalap, and powdered Prickly Elder bark, which may be given in tea-
spoonful doses every two hours, until it operates.
  The  treatment is divided into local and constitutional.  The local
measures are to prevent the formation and extension of the membrane,
for if this extends into the  air-tubes, the patient will be almost certain
to die.   For this purpose, after having cleansed the throat and fauces
of the membrane as much as possible, by  gentle means, a solution of
Nitrate of Silver, one drachm to an ounce of water, should be applied
to all the reddened parts, especially those around the false membrane.
Should the membrane spread, make another application in eight or ten
hours.   These applications  should be repeated, in ordinary cases, every
day or tAvo, weakening the strength of the solution as the membrane
disappears.  When  the mouth is so swollen that the solution can not
be passed to the  parts upon a sponge or camel's-hair pencil, it must be
placed  upon the parts by  means of  a shower-syringe.   During the
time between these applications, tne throat may be frequently gargled,
washed, or showered with the following mixture: Take of Chlorate of
Potash fifteen  grains, Muriatic Acid  fifteen drops,  water one ounce;
mix.
  Or, Salt and Vinegar, a  table-spoonful of each, to a teaspoonful of
hot Avater; this may also be injected up  the nostrils  Avhen they are
becoming obstructed.
  Or, a solution  of Saleratus in water,  Avith some tincture of Prickly
Ash berries added.
  In some cases  it has been recommended  to apply, every six hours, to
the parts affected, a mixture of one part of concentrated Muriatic Acid,
and two parts of Honey.   Borax  and Alum  have also  been  found
efficacious in some.cases.   Borax and Honey, mixed with a little
Brandy and water, has been recommended as a wash and gargle; and,
after the false membrane has peeled off,  a  gargle  made with  Tannic
Acid and water affords great comfort.
  Another valuable agent to destroy  the fungus, is Sulphite of Soda,
six drachms, dissolved in tAvelve ounces of an infusion  of Qu^sia.   A
table-spoonful of this may be given three, four, or six times a day, and
the mouth and throat be frequently washed with it.
  The constitutional treatment is to give* tone and nourishment to the 
108
AMERICAN FAMILY PHYSICIAN.
system.  Thus : good, strong Beef tea, strong Mutton tea, Wine, Wine
Whey, Ale, boiled Milk, etc.  In some cases equal  parts of Beef tea
and Port wine, or, Egg and Port wine, etc., to Avhich some Tincture of
Prickly Ash berries has been added, will be found very useful__giving
either of these in table-spoonful doses every half hour or hour.  In
other cases, Tincture of Muriate of Iron, twenty drops for a dose, may
be given in the wine, and repeated every hour or tAvo; children must
take less.  Again, cases will be met with, and especially those in which
there is a  great fetor of the breath, in which the following will prove
the most beneficial:  Take of Chlorate of Potash half a drachm Tinc-
ture of Muriate of Iron  half a  drachm, Avater one  fluid ounce • mix.
Of this an adult should take  one half, alone  or in wine, repeating the
dose every hour.  The Sesquicarbonate of Ammonia will also prove a
valuable remedy, in half-drachm doses every three hours, for adults; to
be taken in some water or Peruvian Bark syrup.
   Quinine has also been  found useful:  Take of Sulphate  of Quinine
half a drachm, Chlorate of Potash one drachm, dilute Muriatic Acid
half an ounce, Avater half a pint;  mix.  Give one-sixth of this every
hour or two, or even oftener.  Of course, the particular remedies used
in any one case, will be selected  according to the influence they appear
to exert upon the patient.   The chief object being to invigorate the
system, notwithstanding quick pulse, fever, etc., and to remove para-
sites by antiseptics.
   Turpentine, taken every other hour, in doses of half a drachm, and,
also, every alternate  hour, Carbonate of Ammonia, in doses of twenty-
five grains, have proved efficacious.  The Turpentine may be rubbed up,
two drachms,  Avith the yelk of an Egg, to which add enough Syrup to
make an ounce and a half of mixture ; dose for an adult, three-fourths
of a table-spoonful, in milk, every tAvo hours.  The Carbonate of Am-
monia may be dissolved, fifty grains in twelve drachms or an ounce and
a half of water; and one half taken  for  a dose, every two hours, also
in milk.
   In cases where  the patient is so Ioav that he can not swallow, the
Beef tea and Wine, a table-spoonful  of each, with Tincture of Prickly
Ash berries, a teaspoonful, should be injected into the bowels every
hour or two, for a child six years old;  or, the mixture may be thick-
ened with Arrowroot.   Milk, or Mutton broth, may be occasionally sub-
stituted for the Beef tea.  And even where the patient can swallow,
but does  not take  enough  nourishment, these injections  should be
used.
  When malignant or putrid symptoms appear, a gargle of Pyroligne- 
HOUSEHOLD DEPARTMENT.
109
ous Acid and water, equal parts of each; or,  one teaspoonful of Chlo-
ride of Lime, to half a pint of water, will be found very serviceable.
  The after-symptoms, Avhich appear during convalescence, require to
be treated by  tonics, alteratives, stimulants, etc., according to their
character.   Tracheotomy, or opening the windpipe, in order to  admit
air into the lungs, and thus keep up breathing, has occasionally been
performed with success in severe cases of diphtheria.
  The best treatment to pursue in this disease, in the country, until a
physician can be had, is, to apply the solution of Nitrate of Silver to
the  throat,  and give Beef tea with Wine or Whisky added; also, the
Tincture  of Muriate of Iron, in doses of twenty drops every three
hours,  in some Syrup;  and Carbonate  of Ammonia, twenty grains
every hour, in some sweetened water.
  As these  remedies can be had  at any store where medicines are
kept, Avhenever diphtheria makes its appearance in any section of the
country, all the families in the neighborhood should provide themselves
with them, that they may be enabled to treat it promptly,  should any
of their members become attacked with it; for, without promptness and
energetic treatment, patients will almost certainly die. 
110
AMERICAN FAMILY PHYSICIAN.
CHRONIC  DISEASES,  ETC.
                              Dropsy.
  An unhealthy accumulation of a watery fluid beneath the skin, or in
different cavities of the  body, more generally in the legs, and in  the
abdomen.
  In Dropsy of the Skin, or of the cellular membrane, as a general
rule, the  swelling commences first in the feet and ankles, and gradu-
ally ascends toward the' thigh and trunk of the body.  The skin is pale,
dry, and somewhat doughy;  if pressed upon with a finger, a pit is  left
which remains  for some  seconds before it passes away; the bowels  are
generally costive,  and-the urine scanty and high-colored.   (See Divi-
sion I, pages 341  and 342.)
  In Dropsy of the Belly, the belly becomes more or less enlarged and
tense like a drum-head.  If one hand be placed on one  side of  the
swollen belly, and the other be made  to strike  against the  opposite
side with the  finger-ends, directing the  Woavs toward  the hand held
firmly against the abdomen,  a feeling will be  imparted to this hand as
if a wave of Avater had  been thrown against it through the walls  of
the belly.  (See Division I,  page 339 to  341.)
  Treatment.—It  will frequently be the case, if the  system is  yet
strong, and the dropsy has not been upon the person for a long time,
that an emetic, followed by an active purgative, and repeated every day
or two, continuing it for several days, will cause  the Avater to be car-
ried off;  but, under ordinary circumstances, purge the bowels every  day
or two, as the  patient's  strength will bear, with medicines which will
produce large  and copious watery evacuations, as, for instance, a tea-<
spoonful of poAvdered Jalap and half a teaspoonful of Cream of Tartar,
for  a dose, which  may be repeated every six hours, until  it has pro-
duced the desired  effect.                          ^*
  Or a strong  tea may be made of equal parts oi" Mayapple or Man
drake root, and White Ash  bark, to every pint of which  two table-
spoonfuls of Cream of Tartar may be added;  the dos<* of this i'J half
a gill, ^?very three hours, until it operates freely. 
HOUSEHOLD DEPARTMENT.
Ill
   Or, take equal parts of Blue Flag root and Mandrake root, and half
 a  part of Fennel  seed,  or Aniseed;  make  a strong decoction,  and
 give in the same manner as the preceding one.
   If the person is very much debilitated after the operation of either
 of these purgatives, some Wine, Gin, Brandy, or Whisky may be given
 in small doses, merely enough to remove the sense of weakness.
   In connection with this, means must be  employed to carry off some
 of the fluid by urine, and at the same time strengthen  the system; for
 this purpose, any one of the  following preparations may be used:
   1. Take of  White  Pine  tops,  Hoarhound,  Milkweed  roots,  and
 bruised Mustard seeds, a handful;  place them in a new earthen crock
 Avith a handful of rusty  nails or iron, and two gallons of sour Cider.
 Heat till hot, and steep near a fire  for twenty-four hours.   When cold
 it  is ready for use; the dose is a wine-glassful or half a gill, every
 hour or two, as the  stomach  can bear it.
   2. Take of  red  Chickweed,  bruised,  Cockle burrs, [Stickwort or
 Agrimony,] bruised,  each, tAvo  table-spoonfuls, common white Clover
 flowers a handful,  Artichoke  leaves a handful, good Cider two  quarts.
 Prepare in the same manner as the preceding one, and take  in the
 same  doses.
   3. Parsley roots, Horseradish  roots, Milkweed roots, Blue Flag root,
 Bark  of  Sassafras root,  Dogwood  bark, of each, a handful; pour on
 these articles,  coarsely bruised, two quarts of boiling hot cider; add a
 handful of rusty nails, or iron,  and steep near a fire  for twenty-four
 hours.  When cold, use  in the same manner as the preceding ones.
   In treating  dropsy, the surface of the body should  be daily bathed
 with a warm, weak ley-A\ater, followed by  considerable friction with a
 coarse towel;  and when  the  disease  attacks the legs, these  should be
 bandaged as tightly as the patient can comfortably bear, renewing the
 bandaging  every morning, and rubbing  the legs well with a coarse
 toAvel, just before putting it on.   The bandage should extend from the
 toes to the groins.   In Dropsy  of  the Belly, considerable benefit  will
 arise from kneading the  patient's belly every day with the hands,  and
 as the SAvelling goes down, to apply a bandage close around the bowels,
 but not uncomfortably tight.
  The  diet should be nourishing and of easy digestion, using the pun-
 gent vegetables,  as  Garlic,  Onions,  Horse-radish, Mustard, Water
 Cresses, etc.;  gentle exercise should be taken every day.   After the
 water is all gone, the patient should take  a tonic preparation to pre-
 vent its'return, and either of the following may be used for that pur-
pose: 
112
AMERICAN FAMILY PHYSICIAN.
   1.  Take of Gentian root, Elecampane root, Ginseng root, SAvect Flag
or Calamus root, Yellow Dock root, each, in coarse powder, one ounce-
boiling water five pints; steep near a fire  for twenty-four hours then
SAveeten to  suit the  taste, and Avhen cold, take half a gill for a dose
repeating it four or  five  times a day.
   2.  Take  of  Horseradish  root,  Seneca  Snakeroot, inner  bark  of
Elder, Golden  Seal or Yellow Puccoon root, inner bark of White Oak-
each, in coarse powder,  one ounce, boiling  Cider six pints, rusty nails
or iron, a quarter of a pound.   Prepare in the  same manner as the
preceding, and also  use  in the same dose.
   3.  Take  of  Mastenvort, Dandelion root, Rue,  Sassafras bark, Gin-
seng, Prickly  Ash  bark,  each, in coarse  powder,  an ounce;  boiling
Cider six pints.   Prepare and administer in the  same manner as the
preceding preparations.
   It  must  be  recollected that  dropsy is frequently a result  of some
disease, as, of  the liver,  heart, or kidneys, etc., in which case, we must
cure these affections before any permanent cure of the dropsy can be
expected.   Again, a dropsical swelling  of  the legs frequently follows
as a consequence of consumption, great weakness, large discharges of
blood, or matter, or poor, weak  blood; in these cases, purging and
other violent measures must be avoided, the cure  then depending upon
nourishing  diet, gentle  exercise  in the  open  air, and strengthening
medicines, especially those containing  steel  and iron.
   I have known several cases of dropsy cured by the patient's  drink-
ing, every night or two,  a pint of Cider, as  hot as could be borne, and
in which as  much Horseradish root had been infused as the Cider would
take  up.    As  soon as  taken, they covered themselves up warmly in
bed, and sweat profusely.   This, course  continued for a week or two,
carried off  all  the water, aroused the  absorbent  vessels  of the body,
and then all that was required to finish the  cure, Avas some strengthen-
ing preparation taken for several weeks after commencing its  use.

                             Apoplexy.
   The person falls suddenly down, is unconscious, and breathes slowly
and with a kind of snoring noise.   (See Division  I, pages 344 to 347.)
   Treatment.—Instantly raise and support the patient's head, and have
the neckcloth removed, and the shirt-collar  unbuttoned.  Then, having
him where the  cool, free air can  reach him, while one person pours a
stream  of cold water upon the head and neck, another will rub some
common table  Salt  upon  the head and  temples, continuing it until
the person revives.   If the  patient does  not readily revive, the soles 
household department.
113
 of the feet may be whipped, as named below under Sun-stroke.   In
 some cases a cathartic injection, if given promptly, will facilitate the
 recovery.  After the recovery, give a good active cathartic.  The fur-
 ther treatment will be the same as named in Division I, pages 346 and
 347.
                           Sun-stroke.
  This, in some respects, resembles apoplexy.   It is the result of too
 long an exposure of the head  to the action of the  sun's  rays in hot
 weather, occasioning dizziness, headache, thirst, and occasionally vomit-
 ing, and difficult  breathing.   Generally the person falls down  in a
 senseless condition,  and if not  soon  relieved, dies.  Much depends
 upon immediate and energetic measures.
   Treatment.—Take the person at once into a cool, shady situation;
 remove all neckcloths,  etc., the  same  as named above, in Apoplexy,
 and gradually pour cold water upon the head and neck, being careful
 not to give too sudden a shock at first  by pouring a large stream upon
 him.   If it can be obtained in time, also bathe the feet and legs in as
 hot Avater as can be used without scalding; if this can not be procured,
 the soles of the feet may be whipped vigorously with a paddle or the
 sole of a shoe—the object being not to  hurt the patient, but to produce
 a redness and a determination of the blood to the  extremities. This
 beating the feet will be found very valuable in all these difficulties  of
 the head.  As soon as the  patient can swallow, a cathartic should  be
 given; either of those named under Fevers, on page 75, will answer.
  Some persons, after a recovery from Sun-stroke, are left with a weak-
 ness of the mind, more or  less headache, costiveness, great debility,
 loss of appetite, and more  or  less numbness  of various parts. This
 may be gradually overcome by the following methods:
  1. Use a light, and easily digestible but nourishing diet, avoiding  all
 fats, high-seasoned food, green fruits, and liquors.
  2. Bathe the whole surface of the body with a weak Alkaline water,
 and  in drying use considerable friction.  These baths are best taken
 at bedtime, and should be repeated tAvo or three times every week.
  3. Every morning have a stream of tepid water  poured, for ten or
 fifteen minutes, upon the head, and along the whole course of the back-
 bone or spinal column.
  4. Take a Spirit Vapor Bath once in every two weeks.   (See Divi-
 sion I, page 698.)
  5. Keep  the bowels regular, and strengthen the  brain and nervous
system by some internal medicines, as :
  a. Take of Peony root,  Scullcap herb, Skunk Cabbage root, Blue 
114
AMERICAN FAMILY PHYSICIAN.
Flag root,  each, in coarse powder, an ounce; boiling water two pints •
steep near  a hot fire for twenty-four hours and then take from a table-
spoonful to half a gill for a dose, repeating it three or four times a day
  b. Take  of Extract of  Belladonna five grains, Alcoholic Extract of
Black  Cohosh  forty grains, Sulphate of Quinia tAventy grains Podo-
phyllin fifteen  grains; mix, and  divide into forty pills.  Dose  three
pills a day.
  e. Take  of Alcoholic  Extract  of Nux  Vomica  eight grains Phos-
phate of Iron twenty-four grains, Iridin ten grains, Alcoholic Extract
of Unicorn root a sufficient quantity; mix, and divide into twenty-four
pills.  Dose  two or three pills a day.
  d.  Take of  Prickly Ash  bark,  Red Chickweed,  St. John's-wort
White weed, each, one ounce; boiling water a quart; steep near a fire
for five or six hours.  Dose, half a gill three or four times a day.
  Prevention.—Persons who are obliged to be exposed to the sun dur-
ing hot seasons, should frequently wet their heads  with cold water and
retire whenever they can, to shady  places.  They should never eat
hearty meals, nor drink any kind of liquor, when they are shortly after
to be exposed  to the  sun's  rays.   A  piece of cotton cloth, or  silk,
moistened  with cold water, may be constantly worn upon the head,
while  exposed, changing  it as often as it gets warm or dry.  This  may
be also worn in the hat.

                     Epilepsy or Falling Fits.
  The  patient  falls suddenly to the  ground,  with or without a cry
or noise like the  barking of a dog; the eyes roll, the convulsions are
severe, and there  is frothing at the mouth.   (See Division I, pages 350
to 355.)
   Treatment.—To relieve the fit, remove all clothing from around the
neck of the  patient, and place  a pilloAv or something  soft under the
head to raise it; also, as  quickly as possible, roll up a napkin and place
it between the  teeth, so as to prevent the tongue from being bitten—or
a piece of soft wood will answer.  Then throw a piece of black silk
over his face, and, at the  same time, apply cold water to the throat and
upper part of his  chest—it may be sprinkled on, or applied on a cloth.
In most instances this will remove  the  attack.   Should further treat-
ment become necessary, refer to Division I, page 352.     «
  The  following  has been  successfully used  in  epilepsy:  Take of
Phosphate of Zinc four grains, dilute Phosphoric Acid twenty minims,
Tincture of Peruvian bark half a drachm; mix for a dose, to be repeated
three times a day. 
HOUSEHOLD DEPARTMENT.
115
                            Cramps.
  Cramps, or sudden and painful contraction of the muscles of various
parts, drawing themselves, as it were, into knots, may be seated in the
neck, the breast, the belly, the stomach, the  thighs, or the calves of the
legs, etc.  (See Division I, pages 365 and 366.)
  Treatment.—When the cramp is in the calves of the leg, draw up the
foot  strongly  toward the shin-bone, and in  a few seconds the cramps
will pass off.   When they are in the thighs  or arms, tie a towel, cord,
or handkerchief around the limb, just above the cramped part, and then
rub this part with the naked hand alone, or using some stimulating
liniment, as,  for  instance, Spirits  of Camphor, or, Red Pepper and
Whisky; or,  some Red Pepper may be heated in some Whisky, to
which an equal part of Spirits of Camphor may be  added.  This stim-
ulating preparation may also be rubbed upon  the neck, when cramps
attack  this part.   Cramps in the  stomach  may be checked,  by first
strongly  rubbing and kneading over  the stomach, and then  rubbing
upon and around the pit of the stomach, a mixture of equal parts of
Swe»c  Oil or Linseed Oil, Essence  of Peppermint, Laudanum, and
Spirits of Camphor.  A small teaspoonful of this mixture may also be
taken internally, every fifteen or twenty minutes, till the cramp ceases.
If the bowels are  costive, open them at once by an injection of  Soap-
suds one quart, Salt a table-spoonful.   (See Cramps of Limbs during
Pregnancy, on page 190.)

                          Locked Jaw.
  (See Division I, pages 367 and 368,)
  Treatment.—Envelop the injured part in a poultice of Soft-soap and
Lobelia leaves in powder; or, Soft-soap and  common  Scotch  Snuff.
Then pour down the  sides of the patient's mouth as much of the  fol-
lowing infusion as can be made to enter.  Take  of Lobelia, Skunk Cab-
bage root, and Red Pepper, each, a table-spoonfu1-;  boiling water half
a pint; cover the  vessel containing  them, and let the mixture  steep for
half  an hour; when cool, it is ready for use. If the bowels have been
costive, open  them by the injection named above, for Cramps in the
Stomach.
                      Bite of  a  Mad .^og.
  (See Hydrophobia, Division I, pages 368 to 371.)
  Treatment.—As soon as  a person is bitten by a dog, cat  or othei
animal supposed to be mad, the  part  should be immediately  cut out,
and  a cord or handkei %ief tied tightly around the limb, a short dis- 
116                AMERICAN FAMILY PHYSICIAN.

tance above the wound.  If dry cups can be had, apply them over the
wound, drawing out considerable blood; if they can not be had, let some
good, brave felloAV suck the wound, removing as much blood as possible;
he need not be afraid, as no harm can be done by merely sucking out
the poison.  It is dangerous only when it is absorbed into the system
through a cut or  wound—hence a person with  sore lips, gums, tongue,
or mouth, should not perform the suction.
  In the mean time,  and as speedily as possible, procure some strong
Avater of Hartshorn or Aqua Ammonia, or some strong Ley water, and
pour this into the wound, which will neutralize  or destroy the poisonous
virus.  Then apply a poultice over it of Soft-soap and pounded Onions.
Keep the  sore discharging for several days by means of strong Ley
applied to it, or Caustic Potash, and change the poultice  two or three
times a day.  As the limb  swells and becomes dark colored, gradually
loosen the cord around it.
   Be careful not to kill the animal at once, but secure it for a few days,
to ascertain, if it was really mad; much anxiety might be prevented by
knoAving the animal Avas not mad.
   An insect, which is found in large quantities on all rose-trees, called
 " Golden Cenotides," or  common Rose Beetle, (Cetonia aurata,) when
 dried and  powdered, is said to cure hydrophobia upon being given in-
 ternally.  They are  said to relieve excitement of the brain and ner-
 vous system, causing the patient to fall into  a  profound sleep, which
 lasts for the space of thirty-six hours.  Three doses are said to effect
 a cure; a  teaspoonful being  the  dose.   It is a flat bug, copper red
 body, upper part golden  green, with deepened, curved lines across the
 sheath wings, more  or less marked with white  spots.  The bug,  or a
 similar one is said to infest the geranium plant,
   Bite  of Mad  Dogs.—An English journal  says, that an old Saxon
 has been using,  for  fifty years, and with perfect success, a remedy for
 the bite of mad dogs, by the agency of which  "  he has rescued fellow-
 beings and cattle from the fearful death of hydrophobia."  The remedy
 is to wash the Avound immediately with warm  Vinegar or tepid water;
 dry it, and then  apply a few drops of Muriatic Acid, which will destroy
 the poison of the saliva, or neutralize it, and the cure is effected.  (For
 further treatment see Hydrophobia,  Division I, page 369.)

                       Asthma, or Phthisic.
    (See Division I, pages 385 to 388.)
    Treatment.__In most  cases persons can almost immediately relieve
 themselves of an asthmatic attack  by  smoking  in a pipe, Stramonium 
                         household department.                  117

    or Jimson weed leaves, soaked in a solution of Saltpetre, at the same
    time toasting the soles of their feet near a fire.  Every person subject
    to this disease, should keep this article, prepared, on hand, in readi-
    ness to use;  it is easily made, by carefully drying some Stramonium
    leaves, and then placing them in a solution of Saltpetre, made as strong
    as the water will take up of the Saltpetre; then  dry  the leaves,  and
    keep them in a tin or other vessel Avell closed.   Should this fail to give
    relief, it will be necessary to take an emetic.   Lobelia, or Lobelia and
    Ipecacuanha, or a tea of Lobelia and Skunk Cabbage two parts, Blood-
    root half a part, may be used for this purpose.   Among  the many
    agents which have been used for relieving and curing asthma, the fol-
    lowing will be found most valuable :
      1.  Take tAvo table-spoonfuls of Mullen seeds, one  table-spoonful,
    each, of Lobelia, Hyssop, and Skunk Cabbage root; bruise all, and add
    to it  a pint  of boiling water, and one  gill of  good Vinegar; steep it
    near  a fire for six hours, then  sAveeten  with Honey.  Take  half a gill
    three or four  times  a  day,  and Avhenever  the breathing  is difficult
    This should be taken every day for some time, in order to effect a cure.
      2. Phosphorous Acid, in doses of from ten to  twenty drops, in one or
    two table-spoonfuls of Avater, and repeated two or three times a day,
    has afforded marked relief, Avhen  all other remedies had failed.
     3. The expressed Oil of SunfloAver seed, or the seed bruised and in-
    fused in hot water  for  four hours, is a cure for asthma.  It may be
    used freely.
     4. Take of Extract of Indian Hemp one drachm, Extract of Liquor
    ice, Extract of Dandelion, each,  one ounce, Salts of Tartar half an
    ounce, warm Avater  one quart;  mix, and dissolve.   Dose, a table-
    spoonful, three  or four times'a day.  This has frequently proved ben-
    eficial, not only in relieving but also in curing asthma.
     5. Take of Sunflower  leaves, Stramonium leaves, each, one ounce;
    dry them and finely pulverize them, and add  to  them one  ounce  of
    Saltpetre, half  an ounce of Lobelia  leaves, and tAvo drachms of Ben-
    zoic Acid.  Break doAvn some  brown paper pasteboard with hot water,
    so as to form a paste, and mix together equal  parts of this  paste and
   the above mixture of powders.   Form them into conical shaped masses,
   and let them dry.  A feAV of these burned in  a room where an asth-
   matic person is  sitting, Avill give almost instant  relief.   Or, the powder
   may be smoked in a pipe Avithout adding the pasteboard.
     6. Take a table-spoonful of Aqua Ammonia, half a tumbler of water;
   of this, take a table-spoonful every fire minutes;  it will afford relief
f  in asthma. 
118
AMERICAN FAMILY PHYSICIAN.
                       Hiccup or Hiccough.
   (See Division I, page 392.)
   Treatment.—Hiccough may frequently be relieved by a draught of
cold water; or a pinch of Snuff will remove it, by causing the patient
to sneeze; or, the patient may hold his breath as long as  he can; or
some person may press upon the collar bones of the patient as hard as
he can, without injuring him.   A small  teaspoonful of Dill seed will
frequently arrest hiccough.

                      Fainting,  or  Swooning.
   (See Division I, page 392.)
   Treatment.—Place the patient upon his back, in a cool place, remove
all fastenings from  around the neck, and  sprinkle some  cold water,
Spirits  of Camphor,  or Hartshorn water upon the face, also applying
one  of the latter to the nostrils.   The arms and legs should be rubbed
well, and, in obstinate cases, the soles  of the feet and palms of the
hands may be Avhipped.   As  soon as the  patient  can swallow, give
some stimulant, as Spirits of Camphor, Compound Spirits of Lavender,
Brandy, Whisky, etc.   Those who frequently have attacks of fainting,
should attend to  their diet, keeping the bowels regular, and be careful
not to attend croAvded places.

                      Dizziness of the  Head.
   (See Division I, page 393.)
   Treatment.—Apply cold Avater  to the head, and then lie down in a
cool and quiet place;  sometimes a cathartic will be necessary, as, for
instance, an infusion of Blue Flag root, a table-spoonful every hour till
it operates; or,  the same  quantity  of an infusion of Mayapple or
Mandrake root.   Parties who are subject to giddiness of the head, may
frequently remove it, by using a table-spoonful, three or four times a
day, of a strong infusion of Peony root, Scullcap, and Skunk Cabbage
root, each, a handful, in a quart of water;  sweeten to suit the taste.
This  is  especially  useful  when  the  dizziness is owing  to nervous
weakness.
                   Palpitation  of  the Heart.
   (See Division I, page 394.)
   Treatment.__A person laboring under an attack of palpitation  of the
heart, should lie down upon his back, and drink  somewhat freely of a
tea of Skunk Cabbage root, or of Cuckolds, or of equal parts of Mother- 
HOUSEHOLD DEPARTMENT.
119
wort and Skunk Cabbage root.   If the cause of the palpitation can be
ascertained, it should be removed by appropriate treatment.

                    Common  or Wind Colic.
  A griping or twisting pain of the bowels, chiefly about the navel, and
often accompanied Avith a painful swelling of the belly, which is not
increased  on pressure; the pain is  more  severe  at  times  than at
others, and frequently shifts about; costiveness and a rumbling sound
in the  bowels are often present.   (See Division I, pages 403  and
404.)
   Treatment.—Give an emetic  to remove any food or articles that may
be in the stomach ; one of the emetics named under the head of Fevers,
on page 74,  will  ansAver.   After this has operated, give  the patient
freely of a Avarm tea of Pleurisy root,  to each dose of which, ten or
twenty drops, each, of Essence of Peppermint and Spirits  of Camphor
may be added.
   Or, a strong tea of Sweet Flag or Calamus root, Peppermint, and
Red Pepper,  may be drank,  as  often as possible.
  Or, any other aromatic tea, as Caraway, Cloves, Horseradish, Spear-
mint, Ginger, Angelica,  etc.
  Warm Brandy or Whisky in  sweetened water, to Avhich some Essence
of Peppermint has been  added, Avill frequently give relief.
  In severe and obstinate cases, in addition to the  above, the bowels
must be moved by an injection, as the one named under Inflammation
of the  Stomach,  on page  94;  or, make a  warm  soapsuds  of Soft-
soap, and to a quart of it add a table-spoonful of powdered  Ginger, and
a teaspoonful  of powdered Cloves; give  this for one injection, repeat-
ing it in fifteen or tAventy minutes, if necessary.   The bowels  should
also be rubbed considerably with the hands for a long time.  In ex-
treme cases, cloths wet with Avater as hot as can be borne, may be applied
over the boAvels, changing the cloths  frequently; and after  the colic
has disappeared, should  any pain or soreness remain, apply a mustard
poultice over  the whole belly, and give a  dose of Castor Oil with a tea-
spoonful of Essence of Peppermint.
  Take of the green herb, Lycopus Europseus, (Water Hoarhound, bear-
ing Avhite flowers,) enough to fill a  gallon bottle, then fill this with a
mixture of Alcohol tAvo  parts,  water one part; or  Whisky will answer.
In a few days it Avill be fit for use.   The dose  is one or two teaspoon-
fuls three or four times a day.   This is very useful :.n Wind Colic, and
especially efficacious in chronic inflammation of the Spleen, and Ague-
cake, following congestive fever and agues.
          58 
120
AMERICAN FAMILY PHYSICIAN.
                          Bilious Colic
  This is a more serious affection than the preceding one, and in some
respects resembles it.   The pain is similar to that in flatulent colic
though much  more severe; is not constant, but appears by fits of
cramping pain in the belly, chiefly around the navel, and grows more
and more  severe.  With this the pulse becomes more rapid; there is
thirst; the tongue becomes coated, and the belly swells, and becomes
tender and painful on  pressure, which is  not  the case in wind  colic.
(See Division I, pages 404 to 406.)
   Treatment.—At once give a warm injection, as a pint each of Soft-
soapsuds and strong Boneset tea, to Avhich  add a table-spoonful of
powdered Lobelia, and a teaspoonful of powdered Red Pepper, for one
injection; or, any other injection may be given, making it stimulating
by the addition of Red Pepper; repeat the injection every  fifteen or
twenty minutes until it  operates.  As soon as possible give a cathartic;
one of those named under the head of Fevers, page 75,  will answer.
Also apply, the same as in Wind Colic, cloths wet with hot water, to the
belly, changing them often.  Hot fomentations of Hops, Lobelia, Stra-
monium or Jimson leaves, Mayweed or Dog-fennel, Wormwood, Mul-
len, or Boneset, etc., may likewise be used with benefit, either singly
or two or three of them combined.

                          Water Brash.
  (See Division I, pages 407 to  409.)
  Treatment.—One of the best remedies is the Trisnitrate of Bismuth,
in doses of ten or tAventy grains, taken at meal times; and persons
who are subject to this difficulty should take some pains to procure this
article.  In ordinary  cases Water Brash may  be benefited by taking
of Golden Seal, Black Alder bark, each, in coarse powder, two table-
spoonfuls, Crowfoot or Alum root, in coarse powder, one table-spoonful;
make a pint and a half of strong decoction, to which add  a heaping
teaspoonful  of Alum, and sweeten to  suit the taste.   Of this,  half a
gill may be taken three or four  times  a day.
  Or, the following may be prepared and  used: Take of Sweet Gum
half'an ounce, Gum Myrrh a quarter of an ounce, Gum  Guaiacum  a
quarter of an  ounce, Blue Flag root an ounce, good Spirits or Whisky
a pint and a half; heat  these together, and let them steep near  a fire
for  six hours; when cold it may be used.   The dose is a teaspoonful
in half a gill of sweetened water, three times a day, or whenever the
Brash comes on, continuing it for some time, in order to effect a cure. 
HOUSEHOLD department.
121
                           Heartburn.
   (See Division I, pages 409 and 410.)
   Treatment.—As this is caused by acidity of the stomach, it may be
 removed by dissolving a teaspoonful of Saleratus, Chalk, Supercarbo-
 nate of Soda, or Magnesia, in half a tumbler of warm or cold  water,
 and taking the whole at  one draught.  A very good preparation to be
 made and kept in the house for this and other difficulties arising from
 sour stomach, is to make a ley of the ashes of White Ash bark, and
 then add equal parts of  the ley and Lime-water together.  The dose of
 this is a half a teaspoonful in half a tumbler of water, or in milk and
 water, repeating it in an hour or two, if necessary.  Heartburn, after
 being relieved, will continue to return in most cases, until the stomach
 is strengthened, for which use the tonic remedies recommended in Dys-
 pepsia.
        Pain and Distress in the  Stomach after  eating.
   (See Division I, page 401.)
   Treatment.—Take of  Golden Seal a  teaspoonful, Poplar bark two
 teaspoonfuls, Sugar four teaspoonfuls, Red Pepper one-eighth of a tea-
 spoonful.  Have all these in powder;  mix them together, and about
 half an hour, or an hour, after dinner, take half a teaspoonful of the
 mixture in some water, repeating it in half  an hour, or an  hour, if
 necessary.
   Or, take of Pleurisy  root, Devil's bit, Prickly  Ash bark,  each, in
 fine powder,  a table-spoonful, Red  Pepper half  a teaspoonful; mix.
 The dose is the same as the above.
   Either of the above may be used in strong decoction, if preferred,.
 in doses of one or two table-spoonfuls.

               Hk;ii-colored and Scalding Urine.
   (See Division I, page  401.)
   Treatment.—This may be readily relieved by using  freely  of a tea1
 of Marshmallow  root, or Spearmint, Thimble berry, Watermelon seed,
 Pumpkin seed, Cleavers, or Goose grass, Whortle-berry leaves, Queen
 of the MeadoAV root, MilkAveed, Black Currant root, etc.  One or more
 of these may be  combined together in form of  tea, and be  sweetened
with Sugar or Honey, as best agrees with the patient.

                            Vomiting.
  (See Division I, page 410.)
  Treatment.—If owing to disease, it can not be permanently stopped 
122
AMERICAN FAMILY PHYSICIAN.
until the disease, whatever it may be, is first cured by the appropriate
remedies.  When very severe, it may frequently be stopped by a mus-
tard poultice  applied over  the  pit  of the stomach, together with a
table-spoonful of a  strong  infusion of Cloves, every five or ten min-
utes, or  of Ginger and  Cloves.   If  pain is present in the stomach
a few drops of Laudanum may be added  to each  dose, say ei«ht or
ten drops, being careful not  to  give over forty or fifty drops alto-
gether.
  In many instances a  tea of  parched Corn, or  of  Oatmeal coffee
page 62, will check the vomiting.    The patient should, while  under
treatment, lie as still as possible upon his back, with the head upon a
pillow.
                             Jaundice.
   (See Division I, pages 410 to 412.)
   Treatment.—An  emetic, folloAved by a  cathartic, should be  given
once every week, and in the mean time one of the folloAving prepara-
tions may be used.
   1. Take of White Poplar bark, Prickly Ash bark, Wild Cherry bark,
Golden  Seal, tfach,  in  coarse powder, a  handful,  Horseradish  roots,
Mustard seed, each, in coarse  powder, half  a  handful, good  Cider one
gallon.   Mix; steep near a fire for twenty-four hours.  Dose, half a,
gill three or four times a day.
   2. Take of Hardwood soot, Wild Cherry bark,  Prickly Ash bark,
Yellow  Walnut  bark, each, in powder,  one  table-spoonful, Ginger
half a  table-spoonful.  Mix; take a teaspoonful  three times a  day in
■some good Cider.
  &. Take Salt of Tartar, one ounce,  Castile Soap, Gum Arabic, each,
half an ounce, Spirits,  or Whisky, a  pint.   Mix; let them stand four
■or five days, frequently  shaking.  The dose is half a gill every night
and morning.
   4. Or, one of the remedies named in Division I, pages 411, 412.

                         Asiatic Cholera.
   1. Vomiting and purging of a thin,  colorless fluid, looking very
much like rice-water, with severe cramps in the legs, ascending  to the
bowels;  pale  tongue, feeble pulse;  hurried breathing; internal heat,
suspended, or scanty urine.
   2. In  the collapsed  stage,  great  prostration;  pulse at  the wrist
barely perceptible;  hands and frev- wrinkled; skin cold and clammy;
face, neck,  and hands  purplish, ;/<•  dark-colored, which discoloration
takes place all over toe body; excessive desire for ice or cold drink; 
HOUSEHOLD DEPARTMENT.
123
 and great restlessness;  from this stage the  patient seldom recovers.
 (See Division I, pages 412 to 417.)
   Treatment—-Make use of prompt means to check the diarrhea, and
 stop the  vomiting.   For  the first, the following will be found  very
 effectual; take of Cloves, Cinnamon, Gum Guaiacum, each, in powder,
 one ounce, good Brandy one quart; mix.   Of this give a teaspoonful
 in some  hot sweetened water  every half hour, until the diarrhea is
 arrested.  In seasons of cholera every family should have this article
 prepared and on hand, in  readiness to use, in case any of its members
 should be attacked with the disease.  It is very valuable.
   In this disease, the patient should be kept in a lying position upon
 his back constantly; getting up as seldom as possible, for the oftener
 he gets up the  more frequently will he vomit and purge.
   To stop the vomiting, apply a mustard poultice over the Avhole belly
 and  pit of the  stomach, letting it produce considerable redness, and,
 if required, renewing its application occasionally, and also give a table-
 spoonful every  ten minutes of a mixture composed  of  Salt and Black
 Pepper, each, a teaspoonful, Vinegar five teaspoonfuls, hot water half
 a pint; mix.   With the  cessation of the vomiting and purging, the
 cramps will  generally cease;  if they continue, the affected muscles
 should be rubbed with a warm  flannel, and cloths, wet with  hot water,
 be placed around them, changing the cloths  frequently.  These may
 also be applied over the belly Avhen the cramps  affect it.
   After every operation from the boAvels, inject into them Tincture of
 Prickly Ash  berries a table-spoonful, Laudanum twenty drops, and have
 the patient hold it in his boAvels for as long a time as possible. If the
 Tincture of Prickly Ash berries can not be had, use in place of it the
 above mixture of Cloves, Cinnamon, etc., in Brandy.
   In the collapsed stage, the same measures must be pursued, but more
 energetically.  The heat of the surface of the body must be promoted
 by every means in our poAver, by frictions,  warm bricks, or irons, etc.;
 and the patient may  also  be Avrapped up in blankets  wet with hot
 water, and may have ice  placed in his mouth  from time  to time, or
 Gum Arabic  water cooled  by ice.
  Stimulants must be given from  time to time to  sustain the sinking
 powers of the system, as, the above mixture of Cloves, etc., in Brandy,
 or, Brandy  alone, Carbonate  of Ammonia, Tincture of Prickly Ash
berries, etc.   After the patient recovers,  a relapse  must be  carefully
guarded against, and the rules given in Division I, pages 416 and 417,
be closely followed.
  The  following  has been highly recommended as a preventive of 
124
AMERICAN FAMILY PHYSICIAN.
Cholera, and will, no  doubt, prove valuable in those  cases where per-
sons pursue the hygienic rules mentioned in Division I, page 417. Take
of Ox or Beef Gall one gill, Gum Guaiacum, in poAvder, tAvo teaspoon-
fuls, Camphor, in poAvder, half a teaspoonful,  Prickly Ash berries,
bruised,  a table-spoonful, Ginger, in  powder, one  teaspoonful, best
Brandy one pint.  Mix all together in  a bottle, and let them stand for
seven or eight days, frequently shaking them.  The dose is half a tea-
spoonful,  or  a teaspoonful in a little SAveetened water, three or four
times a day.  If the bowels are habitually costive, they must be made
to have one natural, healthy passage  every day, by the use of a small
portion of Rhubarb, say as  much as will lie upon a dime for a dose,
more or less, to be repeated three times a day.

                         Cholera Morbus.
   1. This disease generally attacks  suddenly; the bowels are seized
with griping pains, quickly followed by frequent vomiting and painful
purging of thin, watery, bilious, and  other ill-conditioned fluids; great
thirst and heat, folloAved by cold sweats. (See Division I, pages 417 to
419.
   Treatment.—Apply a mustard poultice  over the whole of the belly
and pit of the stomach, and give a teaspoonful of Saleratus, Pearlash,
or supercarbonate of Soda, (the common  Soda used  in making cakes,
etc.,) in a tumblerful of  Avater, to each dose  of which twenty drops,
each, of Laudanum and Spirits of Camphor may be added.
   Or, a weak ley-water may be used instead of the Saleratus or Soda
water, and with equally as good effect.  Continue giving this regularly,
notwithstanding the  first  four or five doses may be vomited up.  The
patient  must keep as still as possible, lying  upon  his  back all  the
time.
   Should the pains in the boAvels be severe, after the mustard poultice
has been removed, apply cloths, wet with water, as hot as can be borne,
to the belly, changing them every feAV  minutes.  In  nine cases out of
ten this simple course will cure Cholera Morbus; but sometimes there
will  be morbid  or acrid matters  in the intestines, Avhich must  bo
removed  by a dose of Castor  Oil before the patient will promptly
recover.
   1. The following  is a very excellent remedy  for  Cholera Morbus.
Let the  patient take a dose of Castor  Oil.   In two hours afterward
take the folloAving; reduce to  powder one  Nutmeg, one Nutgall, (or in
place thereof a heaping teaspoonful  of Crowfoot, or Alum root,) and
two  heaping teaspoonfuls of  Starch; mix these together, and divido 
HOUSEHOLD DEPARTMENT.
125
 into three powders.  One of these  powders is a dose, to be boiled in
 Milk sweetened with Loaf Sugar, repeating the dose every half hour
 till cured.
    2. Take  of Paregoric, Essence of Peppermint, Spirits of Camphor,
 each, a table-spoonful, and mix together with half a pint of Tincture
 of Rhubarb.  Take a table-spoonful of this every half hour, until the
 vomiting and purging ceases.
    3. Oatmeal Coffee, page 62, will frequently check the vomiting, when
 other means have failed.

                           Milk  Sickness.
    Weakness, especially in the lower  extremities,  impaired appetite,
 offensive breath, severe vomiting, great burning sensation at the pit of
 the stomach, and obstinate costiveness.   (See Division  I, pages- 419
 and  420.)
    Treatment.—First purge the bowels  Avith a mixture  of powdered
 Rhubarb two table-spoonfuls, Saleratus one table-spoonful, Charcoal,
 in  poAvder, one table-spoonful, Oatmeal  Coffee half a pint.  Mix these,
 and give a  table-spoonful  every half hour until it  operates.  At the
 same time put a mustard poultice over the whole belly and pit of the
 stomach.
   As soon as the  boAvels have been purged, give the following: Take
 a handful, each, of Mullen leaves, St. John's-wort, and White Balsam,
 (also called  Indian  Posey, Cudweed,  Life  Everlasting.)  Pour on a
 quart of boiling water, and steep near a fire for four hours.  When
 cold, give a  table-spoonful  every  hour  or half hour, according to the
 severity of the case.
   If the  physic above will not stay on the stomach, the  boAvels must
 be  purged by injections, repeating them every  ten  or fifteen minutes
 until the desired effect is produced—It will be best to open the bowels
 tAvice every day.  The following forms a good injection :  Take of Soft-
 soap two table-spoonfuls, Castor Oil  two table-spoonfuls, powdered Lo-
 belia  a teaspoonful, Red Pepper half a  teaspoonful, boiling water one
 quart; mix, for one injection, and use as soon as it has cooled a little.
  In those cases where physic will not remain on the stomach, it should
 be given as soon as the Irritability of this organ has been  quieted.

                            Diarrhea.
  (See Division I. pages 421 to 423.)
  Treatment.—The  following  excellent  preparations may be used in
this disease: 
126
AMERICAN FAMILY PHYSICIAN.
  1. Take two table-spoonfuls of Castor Oil, half a teaspoonful of Pep-
permint, tAventy drops, each, of Laudanum and Spirits of Camphor, for
a dose; to be repeated in three hours, if necessary.
  2. Take Rhubarb, in powder, half a teaspoonful, Saleratus, in pow-
der, one-fourth of a teaspoonful, powdered Ginger one-fourth of a tea-
spoonful ;  mix for one dose, and repeat it every hour, until the diarrhea
ceases.
  3. Take  of Mayapple or Mandrake root, in coarse powder, half a
table-spoonful, White Oak bark and Mullen leaves, in coarse powder a
table-spoonful, boiling Avater a pint; steep near a fire for an hour or
two, and  sweeten Avith  white Sugar.   Dose, a table-spoonful  every
hour.  If half a  pint of burned Brandy can be added to this, it  will
improve it.   This is very valuable.
  4.  The following articles may be used beneficially in diarrhea, in the
form  of tea or decoction; they may be used singly, or in combination
with two or more : Dried husks and shells of Hazel nuts, Cranesbill or
Crowfoot, Hard Hack or Ox Balm, Oatmeal Coffee, Cudweed or Indian
Posey, Plantain,  Black Alder bark, Comfrey, Cat-tail Flag,  etc.
  To relieve the bearing down pains, when present, or a constant de-
sire to  stool, a table-spoonful of Starch-water, with  twenty drops of
Laudanum,  should be injected into the bowels immediately after each
stool, and retained there as long as possible.
  In  that  form  of diarrhea called bilious, the following has afforded
relief, even  in the last stages: Take of Saltpetre, powdered, half a tea-
spoonful, clean soft or rain-water half a pint; mix.  The dose is a tea-
spoonful every hour.
                            Costiveness.
  (See Division I, pages 425 and 426.)
  Treatment.—The following will  be found an  excellent remedy  for
habitual costiveness :  Take of Mayapple or  Mandrake root, Blue Flag
root,  Golden Seal root or Yellow Puccoon, Prickly  Ash bark,  each,
one ounce, Beef Gall one gill, Whisky one  pint and a half; mix.  Let
them stand  for tAvo weeks, frequently shaking.  Dose, a teaspoonful or
tAvo, tAvo, three,  or four times a day, enough to  merely produce one
natural passage every day, at one certain,  regular hour, say, always
immediately either before or after breakfast.
  If  the bowels  can  be acted upon by injections of cold water, aided
by  exercise, frictions  upon the bowels, and proper diet, it is  better than
all  purgative medicines.   If the costiveness is due to piles or tumors,
or a stricture of the  rectum, these must first be cured before the cos-
tiveness can be removed. 
HOUSEHOLD DEPARTMENT.
127
  The Compound Tincture of Benzoin, Division  I, page 745, is a very
valuable medicine for costiveness in which the large intestines, above
the rectum or lower gut, are much affected; it may, in these cases, be
given in doses of half a teaspoonful two or three times a day, in some
sAveetened water.
                            Headache.
  (See Division I, pages 427 and 428.)
   Treatment.—Headache can often be cured by using the remedy just
named above for Costiveness, especially sick headache.
  In Nervous Headache, exercise on horseback, a cold bath every morn-
ing, an attention to the diet, and to the bowels, together with the fol-
loAving infusion, will effect the cure :  Take of Scullcap, Skunk Cabbage
root, Ladies'  Slipper root, each, in coarse powder, a table-spoonful,
boiling water >i  pint; mix; steep near a hot fire for  an hour or two,
and when  cold, SAveeten.    The dose is a table-spoonful every  two
hours.
  Nervous headache may also be cured by dissolving ten grains of Sul-
phate of Quinine in half a drachm of Elixir Vitriol,  and then adding
three drachms and a half, each, of Tincture  of Rattle-root  or Black
Cohosh, and  Tincture of Belladonna.  Dose, tAventy drops in a table-
spoonful of Avater, three or four times every day, until cured.
  Constant headaches may frequently be cured  by snuffing  certain
articles, as the juice of fresh Blood Beet, or of  Ground Ivy, or smell-
ing fresh Horseradish root.   The folloAving Cephalic Snuff is  also very
useful: Take of finely powdered Bayberry bark, White Hellebore root,
Wild Ginger  or  Colt's-fbot, and YarroAV, each, two teaspoonfuls, pow-
dered Camphor one teaspoonful; mix Avell together, and scent with Oil
of Bergamot.  Some of this may be snuffed several times a day.
  Robust persons, Avho have a great Aoav  of  blood to the head, may
relieve themselves of headache, by dipping  the night-cap in cold water,
wringing it out,  and sleeping in it;  at the same time,  soaking the feet
every night, and then applying  Mustard or Horseradish leaves to them,
and  continuing  this course  till the cure is  effected.   But  whatever
method is pursued, the regulation of the boAvels, and an attention to
diet  and exercise, should never  be neglected.   In very obstinate cases,
an Irritating  Plaster to  the back of the neck, continued for some time,
will prove of  great advantage.

                              Gravel.
  1. A high-colored or pale urine, depositing a sediment like  gravel
upon standing, which  may be white, grayish, red, yellow, etc.   Some- 
128
AMERICAN FAMILY PHYSICIAN.
times a great desire to urinate, but the urine passes only by drops, or
in very small quantities.
  2. A very severe, sharp  pain in the  neighborhood of the kidneys,
caused by  the  gravel  passing  from the kidneys  to the bladder; the
pain often causes sickness at stomach, vomiting, fainting, and even con-
vulsions ; - it passes doAvn to the groin and upper part of  the thigh;
there is also a numbness on the affected side, and a drawing up of the
testicle.   (See Division I, pages 443  to 451.)
   Treatment.—When  the patient is suffering from pain caused by the
gravel passing from the kidney, he should at once be placed in a bath
as hot as he can bear  it, and remain in for some fifteen or twenty min-
utes, until he gets relief.   After Avhich, if necessary, powdered Onions
or Garlics may be warmed  and applied  to the small of the back, over
the region of the pain; at the same time he should drink freely of one
of the following preparations, the use of which,  if persevered in, Avill
effect a  permanent  cure; they are all  valuable and efficacious reme-
dies:
   1.  Take of Cleavers or Goose Grass three or four handfuls, cold rain
or soft water a quart.   Let it stand a couple of hours, and drink freely
of it.
   2.  Take twelve drops of  Oil  of Pumpkin seeds, every three  or four
hours.
   3.  To a  handful  of common Beans,  or Bean Pods, dried and  pow-
dered, add a pint of cold Avater; let it  stand- three or four hours, and
drink freely of it.
   4.  Take  of  Gravel-root,  also called Jacob's Ladder or Job's Tears,
(both the seeds and root may be used,) in coarse powder, one ounce,
boiling water a pint;  steep near a fire for an hour or two, and drink
freely.  If this be continued too long, it will produce an excessive flow
of urine, which must be guarded against by lessening the dose.  It is
a powerful remedy against  gravel.
   5. Take Wild Carrot root or seeds, Queen of the Meadow root, Pars-
ley  root, Thimbleweed, each, in coarse  powder, one  ounce, boiling
water a pint and a half; mix, and let it steep, in a covered vessel, near
a fire for twenty-four hours, and then  sweeten Avith  Sugar or Honey.
Dose, half a gill three or four times a day.
   6. Take of the fresh root of Nephritic plant, or Cutting Almond,  one
ounce, cut it up in  slices, pour a pint of cold water on it, let it stand
two hours, and drink half a gill, repeating it three or four times a day.
   7.  Take of the tops,  twigs, and  roots  of  Bush  Honeysuckle or
G-ravelweed, two  ounces, Milkweed  root one  ounce, Horsemint  onfl 
HOUSEHOLD DEPARTMENT.
129
ounce, boiling water a  quart.  Mix; steep near a  fire, in a covered
vessel for ten or twelve hours, then sweeten, and drink freely.
   8. Beat up Castile Soap half  an ounce, add to it Oil of Sassafras,
Oil of Pumpkin seeds, Oil of  Spearmint, two and a half teaspoonfuls,
and Salt of  Tartar tAvo teaspoonfuls.  Mix well together, and divide
into forty-two pills.  The dose is tAvo pills three times a day.   These
are excellent.
   It is sometimes  the case that a single gravel will  enter the urethra,
and remain there; it may be removed by what is called urethral " for-
ceps ;" or, if  it be too  near the  bladder for this, it  must be carefully
pressed back into  the bladder by means of a bougie.

                   Hemorrhages  or Bleedings.
   These may take place  from the nose, lungs, stomach, kidneys, and
bladder.   (See Division I, pages  451 to 458.)
   Treatment.—When the bleeding is from the nose, apply something cold
to the back of the neck;  or cold  water to the nose;  or, pressing firmly
upon the nostril at the bleeding point, will, in ordinary cases, check the
floAv; in obstinate  cases, let the person have the clotted blood removed,
and the nostril cleansed as much as possible from  blood, and imme-
diately snuff  up a strong  solution of Crane's-bill or Alum root, or of
Bcthroot, or  of Alum;  or a piece  of lint  or cotton may be wet with
one of these  solutions,  and passed  up into the nostril as far as to the
bleeding part.   Common  Nettle seed, poAvdered, and placed in the
nostril, will also stop the bleeding.    (See Division I, pages 452, 453.)
   When the  bleeding is  from the  lungs, called spitting of  blood, the
patient's room should be kept cool, he  should be quiet, and not be
allowed to move about a great deal, nor  to talk; and if he has a cough,
he  must endeavor to suppress it as much as possible.   Give him as
soon as possible,  a half teaspoonful of  Salt, repeating it every fifteen
or twenty minutes, if the bleeding returns; or, the same quantity of
Spirits of Turpentine may be given.  In the mean time, make a strong
tea of equal parts  of Bugle Aveed  or Sweet Bugle, Bethroot, and Crow-
foot or Alum root, and let the patient take half a gill every hour.
  Or, one or  more of the following articles may be  made  into  a  tea,
and used as above; White Oak bark, Loose Strife or WHIoav herb, White
Avens or Throat  root,  Bistort or Snakeweed,  Hardhack  or Meadow-
sweet, Marsh  Rosemary,  Fleabane, Bayberry  bark,  Winterbrake,  Su
mach, etc.
  Where the  following  can be procured, it will be  found very effica-
cious : make  a strong  tea of Witch Hazel leaves, and to every half 
130
AMERICAN FAMILY PHYSICIAN.
pint of it add three table-spoonfuls  of Sage-juice and,the same quan
tity of Nettle-juice.   Take half a gill every hour.  (For further treat-
ment, see Division I, pages 454 and 4&5.)
  When the bleeding occurs from the stomach, called vomiting of blood
in which the  blood is dark-colored and clotted, and in large quantity
bathe the feet in warm water, apply a mustard poultice over the pit of
the stomach, and give the same internal remedies  as  recommended
above for spitting of blood.  And, in addition, after the bleeding has
diminished considerably,  the bowels must be purged  by the following
physic:  Castor Oil  two  table-spoonfuls, Spirits of Turpentine  twenty
drops;  mix, for a  dose.   Repeat  it in three  hours if it should not
operate.   (For further  treatment,  see  Division  I, pages 455 and
456.)
  Bloody Urine may be  owing to a discharge either from the kidneys
or the bladder, and is not, generally, a  serious  disease, unless  pus or
matter be mixed with it.   The patient should have his bowels open
by a cathartic injection, and then be allowed to drink freely of  one of
the following teas:
  1.  Take Queen of the Meadow root, Peach leaves, each, one  hand
ful, boiling water a quart;  mix.   Steep near a fire for one hour.
Drink when  cold, in half gill doses. This, is very  excellent.
  2.  Take of Yarrow  or Milfoil, and Comfrey root, each, an  ounce,
boiling water a quart; mix.   Steep near a fire for an hour, and use
the same as  the preceding.  This is a valuable  remedy.
  3.  To tAvo table-spoonfuls of an  infusion of Marshmallow root, add
six grains of Gallic acid,  and ten drops of Tincture  of Henbane.   Take
this for a dose,  and repeat as often as required.
  4. Take of Yarrow, St. John's-wort, Mullen leaves, and Horsemint,
each, one ounce, boiling water tAvo  quarts; mix, and  steep near a fire
for an hour or two, then  SAveeten to suit the taste,  and drink in half
gill doses every hour or tAvo, according to the  urgency of the case.
This  Avill be found very successful.
  When there is much fever present, Avarm baths will be required, arA
cooling  diuretic teas, as Cleavers  and Yarrow; Pumpkin seed  and
Whortleberry leaves, etc.   (For further treatment, see Division I, pages
457  and 458.
                              Cancer.
  A hard tumor, sometimes being uneven or knotty, and with a prick-
ing, shooting, burning, or lancinating pain, as if a knife or needle was
passing through it.   After  a longer or  shorter time, ulceration takes
place, and a  thin, acrid, offensive matter  is discharged.  The ulceration 
HOUSEHOLD DEPARTMENT.                  131
 extends, and the constitution becomes affected.   (See Division I, pages
 458 to 464.)
   Treatment.—In addition to the  preparations named in Division  I,
 for the treatment of Cancer, I will give a few more at this place, which
 have been highly spoken of by those who have used them.
   1. Make  a ley of the ashes of Red Oak bark, boil down to the con-
 sistence  of  molasses, and cover the cancer with it; in about an hour
 afterward, cover it with a coat of Tar.   Remove this in a  few -days,
 and if any protuberances  remain in the wound, apply more of the Oak
 bark Potash, and the Tar plaster, and so continue until the cancer  is
 cured.  Heal the ulcer left with some  common  salve.
   2. Take  the  juice of Sheep  Sorrel, let it  evaporate  on  a pewter
 plate to  the consistence of a thick extract.  Apply this over the can-
 cer.  It is  very painful in its action.
   3. Take equal parts of Sheep Sorrel, Poke leaves,  and  Yellow Dock
 root; beat them up in a mortar with a little water;  squeeze out all the
 fluid;  place it  on a lead or pewter plate, and let it evaporate until  it
 forms  a thick extract.  Apply it to the cancer.           •
   4. Steep  fresh Sassafras  bark and roots in  boiling water; strain,
 and carefully evaporate to the consistence of an extract;  add to a
 small quantity of this a few drops of Nitric Acid, till it foams  up ;  then
 spread it upon  a piece of lint, and apply to the cancer.  Repeat this
 twice a day.   Each time previous to its application, wash  the ulcer
 with good Brandy and Honey, equal parts of each.  This will  not affect
 the sound parts.  When  the cancer is killed, heal the ulcer which  is
 left with  a  mixture of SAveet  Oil  a  pint,  Beeswax  an  ounce;  melt
 together, and when nearly cold, add Nitric Acid half an ounce.  Apply
 this once or twice  a day, at the same time continuing  the washing
 with Honey and Brandy.
   5. Boil slowly a pound of Oak bark in  two quarts of urine, until  it
 is reduced to one quart; then strain and add a thick paste made of a
 quarter of a pound of wheat Flour, Honey half a pound, White Gum
 Turpentine three-quarters of a pound.   Simmer slowly to a  salve, and
 add White Vitriol in quantity according to the strength required.  Apply
 this to  the cancer twice a day.  Or, instead  of White Vitriol, Chloride
 of Zinc may be  added.
   6. Fell's  cancer  plaster.   Take  of Chloride of Zinc three ounces,
 Bloodroot, in fine powder, one ounce, Bayberry wax half an ounce,
Extract of  Conium, watery  Extract  of Opium, each, three  drachms.
Mix together and form into an ointment.   Remove the skin and apply
this to  the raw tumor;  when it forms an eschar or scab, cut lines ol 
132
AMERICAN FAMILY  PHYSICIAN.
 furrows  in this, about half an inch apart, being  careful not to injury
 the live  skin, and  then  continue the application of the plaster.   He
 uses this alternately  every twelve hours with  the following: take of
 Glycerine two drachms,  Spermaceti ointment  four ounces,  Iodide of
 Lead (Iodide of Cadmium would be better) two scruples.  Mix together
 and form an ointment.  Apply this over the ulcer every twelve hours.
 In connection with these, he gives internally the  following pills: take
 two scruples of powdered Bloodroot, four grains  of Iodide of Arsenic
 four  scruples of  extract  of  Cicuta.   Mix  together, and divide  into
 eighty pills; the  dose  of which is one, to be  repeated three times
 daily.
   I should prefer the preparation  of  Arrow-wood, Buttongrass, etc,
 in Division I, page 462, as an internal remedy.
   7.  Take of good,  hard  wood  Soot sixty  parts, Lard, or Glycerine,
 sixty parts, extract of Belladonna eight parts; mix, and form an oint-
 ment, to be applied to the open cancer.  At the  same time  give Soot
 tea internally.
                     Dyspepsia or Indigestion.
   Sense of oppression or uneasiness at  the stomach after eating;  some-
 times a kind of all-gone feeling is experienced at the pit of the stomach;
 variable  or deficient appetite ; costiveness ;  headache; sallow complex-
 ion ; and depression  of spirits.   (See Division I, pages 395 to 403.)
   Remarks.—Before  entering upon  the treatment of this disease by
 household remedies,  I feel it a  duty to make  a  few remarks for  the
 benefit of those Avho are  troubled with this most harassing and dis-
 tressing  malady.
  Dyspepsia is  a disease  very  easily cured, if properly treated when
 the first  symptoms present themselves, but when  the disease has been
 alloAved to run on for a long time, its cure becomes difficult and tedious,
 and sometimes impossible.   In this malady, the mucous or lining mem-
 brane of the stomach  becomes more or  less inflamed and thickened, or,
 perhaps, very much  deprived of nervous  power,  so that, as must be
 obvious to everybody, digestion can not take place healthily, and there
 must  be, not only a diminished amount of nourishment received into
 the system,  but also an unhealthy or imperfect condition of the  blood.
 Thus  then, Avhen  the stomach, is diseased,  the very citadel of life is
 attacked, for, in proportion to the degree of weakness or imperfection
 of the digestive function, all the  other organs of the body become more
 or less impaired in their functions, and, probably, none more so than
the nervous svstem, as shown by the deranged condition of the nerv-
 ous system  of the dyspeptic, the impaired mind, the  feebleness of 
HOUSEHOLD DEPARTMENT.
133
 muscle, emaciation, discouragement, and  disheartened feelings, under
 which the  poor sufferer gradually pines away, until the whole powers
 of the frame have become  disabled, or until, from want of vital power,
 some of the more important organs can no longer sustain themselves,
 and death steps in to end the warfare between health and disease.
  Dyspepsia frequently continues for a number of years without re-
 sulting fatally, yet most of those laboring under it,  become affected
 with  scrofula, consumption, diseases  of the skin,  cancerous diseases,
 especially of the  stomach,  etc., Avhich cause a premature death;  in the
 majority of these cases, there is no doubt that had the  original disease,
 the Dyspepsia, been removed, the persons could have lived and enjoyed
 life and health to a good old age.
  Indeed, when the stomach is laboring under any disease, the whole
 system is  thereby rendered much more  liable to  the inroads of  un-
 healthy influences, from whatever sources they may arise.  While, on
 the other hand,  a person  Avhose stomach  is healthy, is in much less
 danger from even contagious  diseases, or those which are  " catching."
  If  the above facts be properly reflected upon, it will at once be seen
 how highly important  it is for every person to thoroughly understand
 the slightest symptoms of this disease, especially at its commencement,
 as well as its nature, cause, and cure.
  Many  individuals suppose dyspepsia to be a disease only peculiar to
 the inhabitants of villages, towns, and cities; but this is a great mis-
 take,  as  the experience of  thousands of dyspeptics  throughout  the
 country,  "will testify.   In country places, indigestion is more common
 among females, especially  those Avho  daily toil over cooking-stoves or
 hot fires, in tight, heated  rooms, without enjoying proper exercise, or
 breathing in a sufficient amount of pure and Avholesome air to sustain
 a healthy and A'igorous system.
  No one,  however, is  exempt  from this disease, who fails to obey the
 proper hygienic laAVS, and  hence, avc often observe that strong, hearty,
 robust men, of working and industrious habits, become stricken down by
 it as  a consequence of such disobedience.  But  if a person attacked
 with  it will at once attend to all the principles recommended  in  the
 parts  of this Avork devoted  to diet, eating, exercise, pure air, regularity
 of bowels, etc.,—will put his shoulder to the wheel and be determined
 to live right, he Avill not only soon cure himself, but will also place his
 system in  a condition  capable of preventing  any attacks in future.
 And,  when those  avIio arc thus required to attend to themselves prop-
 erly, in order to recover their  impaired health, will act in accordance
with the  rules I  have  named  heretofore,  in  the Introduction to Divi- 
134
AMERICAN FAMILY PHYSICIAN.
sion I, and in the explanation of the Ordinary Causes of Disease, in
Division II, I feel confident they will be fully satisfied that it is not
only well to understand and attend to these matters in disease, but that
it is -better,  much better,  to do so in health, before sickness  has com-
menced its ravages.
  The foundation of this disease is often laid in infancy and youth, by
the excessive employment of Calomel and other strong medicines, the
use of which has been so fashionable of late years.   And in later years,
the use of tobacco, in snuffing, smoking, as well as chewing, is a very
common cause of dyspepsia and nervousness.
   Treatment.—In the cure of dyspepsia, the medicine required should
have a three-fold effect, namely, to strengthen the stomach, to invigo-
rate the nervous system, and to keep the bowels regular, once a day,
without leaving a tendency to costiveness.  To accomplish these effects,
either one of the  following preparations may be used, as the patient
can the most readily obtain :
   1. Take of Golden Seal or Yellow Puccoon root, Black Alder bark,
Solomon's Seal root, each, in coarse powder, a table-spoonful, boiling
water a pint; mix, and steep near a hot fire for six hours; strain, and
sweeten to suit the taste.  Of this, a table-spoonful may be taken every
two or three hours, in the beginning of the attack.
   2. The following will also be found very efficacious at the commence-
ment of the disease: Take of Mullen leaves four ounces, White Ash
bark two ounces, Corn-snake root  or Button-snake root, (also called
Water Eryngo,) Ginseng  root, each, one ounce; add  them all,  coarsely
powdered, to boiling water one gallon; steep near a fire for six hours;
strain, and sweeten to suit the taste.  Dose, the same as the preceding
one.  Either of these preparations  may  be made into the same quan-
tity of bitters,  by adding to them the proper amount of water and
Whisky, in equal parts, a.nd allowing them to stand several days before
using, frequently shaking.
   3. The remaining preparations are for the more advanced stages of
dyspepsia:  Take Beef  Gall a gill, Golden Seal, Boneset, Prickly Ash
berries, Blue Flag root, each, in  powder,  a table-spoonful, Whisky one
pint; mix, and let it stand for ten days, frequently shaking.   The dose
is from a table-spoonful to half a gill three times a  day.  The dose must
be  sufficient to cause  one good evacuation from the bowels every
day.
   4. Take of St. John's-wort leaves and blossoms, Mullen leaves, Cen-
taury or Rose-pink leaves, each,  in coarse powder, two table-spoonfuls,
Copperas one table-spoonful, Whisky one pint;  mix; let it stand for 
HOUSEHOLD DEPARTMENT.
135
ten iays, frequently shaking.  The dose is a table-spoonful three times
adiy.
   5. Take Hickory ashes half a pint, hard wood Soot half a tea-cup-
ful, boiling Avater a pint;  steep near a fire for four hours.  The dose,
when cold, is a teaspoonful, or more, every two, three, or four hours.
This is  excellent in  cases of acid stomach, and by the addition of a
table-spoonful of Ginger, and half a table-spoonful of powdered Red
Pepper, will  be found unrivaled in  cases of weak stomach, with acid
stomach and  much wind.
   6. Take of Blue Flag root, Mandrake root, Bitter root or Dog's-bane,
each, in very fine powder, one ounce, Bloodroot, in very fine powder,
half an ounce, Red Pepper, in  very fine powder, two drachms, Sal-
eratus an ounce ;  mix together.  The dose of this is from half a tea-
spoonful to a teaspoonful, three or four times a day.  It is an excellent
remedy, adapted to those  long-standing, obstinate cases, in which cos-
tiveness  and distress at stomach  are the prominent  symptoms, and
which ordinary medicines do not appear to touch.
   7. Take of the inner bark of the common wild  Hickory, in small
pieces, two ounces, Bitter-root or Dog's-bane, in coarse  powder, one
ounce, Whisky one pint;  mix, and let them stand ten  or  twelve days,
frequently shaking.   The dose  is a table-spoonful three or four times
a day.  This is also a superior remedy to keep off chills and fever, as
well as to cure it.
   8. Take of Prepared Iron, Calcined Magnesia, powdered Slippery
Elm bark, each, one  ounce, poAvdered Cubebs half an ounce; mix.
Dose, a teaspoonful in half a cupful of water, three  times  a day,  an
hour before each meal.  This is said to prove  very effectual in many
cases.
   I  have named only such valuable medicinal plants  as  can be pro-
cured readily by any  person living in the country, in the recipes for
the above preparations.  I could have given the  recipes for pills, but
as these would require extracts, and careful dividing, besides sending
to the drug-shop, etc., I have omitted them, as the preparations given
are equal  to any pills that can be made, and in this part of the  work I
desire to be as plain  and as useful as possible for the folks at home.
Recipes for pills Avill be found in Division I, pages 400 and 401.
  But it must be remembered that however excellent a medicine may
be, it will not efiect a cure unless  the patient attend to the hygienic
rules; he  must eat no more than can be digested, if it  amount to only
a table-spoonful per day;  he must  chew his food  well before swallow-
ing it;  eat at  regular times and under the  proper circumstances,  as
          59 
lrft>                AMERICAN FAMILY PHYSICIAN.

referred  to  heretofore in Division I, pages 22 to 75, and in Division
II,  pages 21 to 31;  exercise daily in the open air; seek lively and
cheerful  company, laugh heartily, and  not overwork  the  brain with
matters of business or other troubles;  should travel about, if he is able
to ; quit  all business which does not require bodily  action; should pre-
fer mutton,  venison, partridge, fowl, chicken, tender beef, and lamb, to
any other animal diet;  should use no fish, no  soups, or slops; should
bathe the surface every day with cold water, and use considerable fric-
tion in drying; should  at once give up the use of tea, coffee, snuff,
tobacco,  or cigars;  and employ the various means heretofore referred
to in the Introduction to this book.
  Females  must be more out of doors, and less  in the kitchen and
parlor; they must run, walk, and ride;  seek cheerful society; and
adopt  the same rules in all other respects as recommended for males.
For further treatment, see Division I, pages 399 to 403.

                           Consumption.
  1. Cough; raising phlegm  from the throat; debility;  quick pulse;
pains in  the chest on taking in a deep breath.
  2. Cough more severe; matter spit up, perhaps  blood; rapid pulse;
oright, sunken  eyes; hectic  fever; night-sweats; variable appetite;
emaciation.
  3. The above symptoms more severe, with  a debilitating diarrhea;
perhaps  swelling of the  feet; great emaciation; voice hoarse; white
pustules  or ulcers  in the mouth and throat;  senses acute; faculties
entire; cold extremities, and death.  (See Division I, pages 468 to 476.)
  Remarks.—Before proceeding  to  the treatment of this cruel and
fatal disease, I will make a few remarks in relation to it, for the bene-
fit of those  who may be in any way predisposed to it.
  This malady more generally attacks the young, the fair, and the ami-
able, and assumes so many phases that those unacquainted with them are
liable to  be  deceived; hardly two cases are ever seen alike.  The origin
of the disease is unknoAvn, although there is but little doubt that the
human family has been afflicted Avith it from  the most remote times;
as early  as  three thousand three hundred years ago, it was mentioned
in the code  of laws of Menu, who called the consumptive, unclean.
  In  certain zones of northern latitude, it prevails with the greatest
violence, owing very probably  to  the frequent atmospheric changes
from heat to cold, and dryness to dampness, etc.; and it is not uncom-
mon in warm climates, Avhere  it generally proves to be fatal far  more
quickly.    In some climates  it  is deemed  contagious, and  is much 
HOUSEHOLD DEPARTMENT.
137
dreaded, though this contagion is of rare occurrence, and seldom hap-
pens unless there is a previous predisposition to the disease.
  From the fact that the nature, causes, and earlier symptoms of this
terrible malady are but imperfectly understood by the majority of its
victims, its ravages are threefold  what it  would be  otherwise.  The
quick pulse, the hardly noticeable cough, the slight changes in appe-
tite, the inability to much exertion without having a shortness or quick-
ness of breathing, the slight chilly sensations upon the least exposure,
etc., arc scarcely appreciated by the consumptive patient in his early
stage of the disease ;  he delays,  and tarries, and postpones, hoping for
the best,  but  only learns  when too late—when the symptoms  have
manifested themselves in a manner not to be mistaken—that he has
been trifling with himself too long.
  Whatever may be considered the cause  of this disease, a cold, or a
supposed  cold, is generally the  first symptom,  and most people Avith
this complaint, date the beginning of it from wetting their  feet, damp
beds, night air, wet clothes, or something of this kind.   Many people
supposed  to be consumptive, die from the bad treatment of their phy-
sicians rather  than  anything else.  People  with a  cold, and  a few
unpleasant symptoms, send  for the doctor,  thinking they have con-
sumption  ; they are then ordered to be blistered,  bled, take Salts or
Calomel, or perhaps a Tartar emetic vomit, and to diet themselves; a
course of  treatment calculated to undermine the most rugged constitu-
tion.   If  these do not relieve, the patient is declared  in a consumption
past cure, and is ordered into the country  for his health, or to take a
sea voyage, when he is sure to die, unless nature, by some happy crisis,
restores him to health-
   Persons Avho are in any  Avay  predisposed to consumption, should
avoid  cold air, crowded rooms,  salted meats, great labors of body or
mind, loud and vehement  declamation, (though moderate singing and
speaking  tend to strengthen the  lungs,)  cantharides, thin clothing,
repeated blisters, late hours, indulgence of the passions, bleeding, mer-
cury, pickles and unripe fruits,  pork, cucumbers, spices, tea and coffee,
cheese, and  all  quack medicines.   They  should at  once,  by various
methods,  commence to harden the system ; but they can not accomplish
this unless they  inform themselves  upon various hygienic  matters;
as, the best articles of food to  supply good, healthy nourishment to
the system;  the best kinds of employment for the body as  well as the
mind; the proper kind of clothing;  and, indeed, the best influences of
all kinds  that can be brought to bear upon the system, to improve and
strengthen it. 
138
AMERICAN FAMILY PHYSICIAN.
   To employ these measures with any  probability  of  success, they
must not wait until their death-knell  has sounded—until the disease
has firmly fastened itself upon the system, destroying, as it were, their
very vitals; but as soon as the least indication of failing health mani-
fests itself,—the quick pulse, the  slight cough, etc.,—or Avhere there is
a tendency  to take cold upon the least exposure, or Avhere the symp-
toms of the early stage of the disease are decidedly marked—then is
the time to commence—not to take medicines and debilitating treat-
ment—^-but to use hearty, nourishing, and easily digestible diet;  to take
plenty of exercise in the free, open air; to live more out of doors than
in doors ; to clothe the body  comfortably warm, Avith woolen garments
especially next to the  skin; to bathe the body three times a Aveek with
water to which  Salt, Saleratus, or Sal  Ammoniac has been added, and
to dry with considerable friction,  so as to cause a gentle  glow of heat;
to procure  a comfortable and airy sleeping-room, and never to sleep
at night  in any of the clothing  worn through the  day.   The lungs
should also be strengthened  by exercising them ten, fifteen, or thirty
minutes  at  a time, repeating it several times a day,  in  the folloAving
manner:  Slowly but steadily draw in the breath until the lungs have
been filled to their utmost capacity; then, in the same slow and steady
manner let the air pass out from  the lungs to the very last drop; and
so continue  the exercise.  This  course  will be found equal to that
caused by the use of tubes, etc., made to produce a similar result.  A
determined, sensible person, can exercise the lungs in this manner much
better  and with more benefit without  a  tube than Avith one.   If the
patient's  means Avill permit, traveling Avill be found useful, with lively,
cheerful company, and especially along sea-shore routes.  Indeed, I
have  known persons  disposed to  consumption,  to  travel for  their
healths, through the country, as peddlers, exposing themselves, but with
the proper  protection of good shoes, warm  clothing, etc., to all sorts
of weather, and with the  final result of effecting a cure.   But for such
a course to be advantageous, it must be commenced upon the very first
indications of the disease; at an advanced period such a course would
increase the disease and hasten death.
   Before  closing these remarks, I must say a few words relative to the
use of Tobacco.   As heretofore said, when treating upon Dyspepsia,
everything  that retards  or  interferes  with the active  duties  of the
digestive organs, eventually renders the blood impure, from which re-
sults a decided predisposition  to one or more  of the many diseases that
"flesh  is  heir to."  And this is  more especially observable in those
cases where there is already a natural debility of one or more of the 
HOUSEHOLD DEPARTMENT.
139
organs of the body.   Thus  one person  may have  a  debility of the
nervous system, rendering him  more liable to spasms,  neuralgia, con-
vulsions, etc.; another may have a weakness of the liver, disposing him
to liver and bilious complaints; a third may have weak lungs, induced
by tight lacing, either of the patient or  of her maternal  parent, by
repeated colds, by attacks of  inflammation of the lungs, etc., in which
case, whenever  from any cause there  is  a tendency to disease, the
weakest part—the lungs—are the first to suffer.  Every one who has
had any experience in these  matters, must be aware of the truth of
this statement.
  Tobacco is a powerful narcotic poison, its direct action upon the
body  being to  enfeeble the  nervous system, thereby  destroying the
tone of the stomach, and retarding or deranging the digestive function,
to  say nothing of the  immense  drain of the saliva—a fluid which  I
have heretofore shown as being an  important agent  in the process of
digestion—and which drain is continually kept up by the use  of this
filthy and noxious weed. And the debility effected by the employment
of this poison must certainly hasten the manifestation of the symptoms
of those diseases to which the person is disposed, and  most decidedly
so, when those important organs—the lungs—are weak, and liable to
attacks of a consumptive nature.
  It is beyond my comprehension why so vast a number  of civilized
and educated men and women should resort to the use of an article so
positively injurious, uncleanly, and  offensive, and which has  not one
redeeming quality in its favor.  Behold for a moment, that  young man
—for  noAvadays  the  youth  at  ten  considers himself a young  man,
if he can  smoke or chew the weed—behold him, I say, with  his cigar
or his quid of tobacco in his mouth, his hat rowdily cocked on one side
of his head, while he is swelling with a feeling of age and  importance
equal to that of a statesman  of sixty.  His shirt bosom, his vest, and
even his coat and pants are soiled with the brownish, poisonous fluid,
which  every now and then he takes pleasure in discharging from his
mouth in jets, first upon one side of him, and then upon another; Avhile
his teeth present  a foul, dark-colored appearance, as though  they had
been indelibly marked Avith the settlings  of third-rate molasses; and
his  breath—0,  horrible! protect me from that nauseous breath!   Is
not such a sight sufficiently disgusting to cause every person to regret
that  enlightened man should have so readily and so Avillingly learned
the slovenly and beastly lesson from  the wild and untutored savage ?
  Smoking, Avhich is  the more fashionable method of using this  sick-
ening weed, as well as snuffing  and dipping, as it is  called,  are  no less 
140
AMERICAN FAMILY PHYSICIAN.
 injurious to health than chewing, and in some cases they are  infinitclv
 worse.   The breath of the habitual smoker is detestably fetid; nor is
 that of the habitual snuffer in any manner improved by its use.
   Young man, you  whose system is yet uninjured by this plague of
 civilization, reflect Avell before you make the attempt to  use tobacco in
 any form—before you enslave  yourself to  a master Avhose exactings
 and oppressings know no bounds.   You may become a man without
 the use of tobacco; ay, and a much better man  than  with  it.  Hoav
 many of our most eminent men are there who have never become ad-
 dicted to this vile agent of human destruction ?    Its  use marks not
 the man—the gentleman; but the braAvler,  the rowdy, the one without
 grace, polish,  elegance,  discrimination, Avho neither  appreciates  nor
 cares for his own health,  nor for the comfort and  happiness  of those
 around him.
   Above all other articles in common  use, tobacco is one that slowly
 but surely impairs the whole nen-ous system; the taste becomes per-
 verted, so that simple fluids and simple diet become insipid and unpal-
 atable, and the tobacco consumer is  obliged to resort to  stronger fluids
 for a beverage,  and to high-seasoned and  stimulating  food to satisfy
 the benumbed taste which this poison has produced.  Never will tem-
 perance  become a general matter, until tobacco ceases to be an article
 of daily consumption.  Yet some of the most strenuous advocates of
 the suppression of the use of alcoholic liquors as a beverage  are per-
 fect inebriates with regard to tobacco.  Dyspeptics, consumptives, nerv-
 ous persons, in fact, all persons suffering from any disease Avhatever,
 should entirely dispense Avith the use of tobacco, for there is no article
 which is so opposed to a  restoration of  health and vigor to the system.
  Parents, guardians, ministers, friends, and all who feel an interest
 in the health, happiness, and morals  of the rising generation, I beseech
 you to take the advice of  one Avhose long expevience and extensive re-
 searches have fully convinced him  that this scourge  of the human
 family is yearly creating  disease, and  dragging thousands to an  un-
 timely grave; and employ all your influence, accompanied by  example,
 to prevent those who are to Avatch  over you, and Avho  are to become
 your legislators, when your l6cks shall have been  silvered by time,
 and your minds are tottering toAvard a second infancy, from becoming
 the slaves of this  foul, unnatural,  relentless  tyrant—tobacco.
   Treatment.—In the treatment of consumption two great objects must
be held in vieAV, to wit: to impart strength,  vigor, and nourishment to
 the whole system, and to remove the peculiar tuberculous condition of
body which gives rise to the disease.  The  first may be accomplished 
HOUSEHOLD DEPARTMENT.
141
 by attending to the hygienic rules named in the Introductory Remarks
 to Division I of this work, as well as on pages 471 to 476.
   The  second is effected by aiding the first  with  proper medicines,
 some of which I will now proceed to name :
   1. Take of good Whisky, Linseed Oil, each, equal parts ; mix.  To
 ie used in thc first stages.   Commence with a teaspoonful  three times
 a day,  and, as the stomach can bear it, gradually increase to a table-
 spoonful.
   2. To one quart of good Whisky add two ounces of finely powdered
 Copperas.  This is also for the first stages of the disease when asso-
 ciated Avith dyspepsia.  The dose is the same as the  preceding.
   3. Pine sap, or the juice  which flows from the Pine tree when the
 bark is cut, should be  taken in the quantity of from half a pint to  a
 pint every day.   It  purges at  first, but this  effect soon  ceases.  If
 there be spitting of blood, this must first be stopped by giving pow-
 dered  Rue, in doses of fifteen grains every  three  hours, and which
 eauscs  the hemorrhage to  cease  in from five to fifteen days.  Any
 pains in the  chest, may be removed by rubbing upon it, two or three
 times a day, a liniment composed of Oil of Rue four  parts, Essence of
 Rue one part, Concentrated Tincture of Aloes four parts; mix.
   4. Spurred Rye may be given in doses of eight grains of the pow-
 der three times a day, continuing its use for five  days;  then stopping
 it for tAvo days; commencing again, and so on.  This may  be used
 alone, or in combination Avith other blood medicines.
   5. Take twelve eggs, break them in  one quart of Vinegar, and bury
 the vessel containing them in the ground; after two  weeks take it  out
 of the ground.  The dose is  half a gill three or four times  a day.
   6. Take of Hart's tongue, (Scolopendrium offieinarum,) Lung-wort,
 Liverwort, Lobelia,  and  Yellow Dock root,  each,  a small handful,
 White  Clover blossoms a double  handful, good  Wine  three  quarts;
 mix, and steep in a covered vessel near a fire for four hours.   When
 milk-Avarm, squeeze, and strain through a linen cloth.   Dose, half a gill
 three times a day.
  7. Take equal parts  of Honey and  Pine  juice, and mix them well
 together.   Give  a table-spoonful of this mixture three or four  times a
 day, mixed Avith a table-spoonful of the juice of green Hoarhound
leaves.
  8. Take  of  Black  Cohosh  or Rattle-Aveed root, YelloAv Dock  root,
BittersAveet bark  of the root, Wild Cherry bark, each, in powder, two
ounces. Linseed Oil one  pint, Tar or White Gum Turpentine one pound,
Honey one pound, Whisky ten pints; mix;  steep  in a covered vessel, 
142
AMERICAN FAMILY PHYSICIAN.
 near a fire, for six hours;  then strain, and to every pint of the prep-
 aration add an ounce and  a half of Laudanum;  keep in well corked
 bottles.  Dose, a teaspoonful  gradually increased to a table-spoonful
 three times a day.
   9. Take Liquorice Extract one ounce, Rattle-weed root or Black Co-
 hos^i, Wahoo, each, in powder, two ounces, Gum Arabic four ounces
 good  Cider Vinegar half a gallon, Molasses two pints;  mix, and boil
 slowly for six  hours, then strain.   To every pint of the preparation
 add one pint of Tincture of Balsam Tolu, and an ounce and a half of
 Laudanum.   The dose is from a teaspoonful to a table-spoonful, three
 four, or five times a day.
   Either of these preparations may be used in consumption with much
 benefit, especially in the early stages.  In the  latter stages, in addition
 if the cough be very troublesome, the following Anodyne Balsam may
 be used: Rub up thoroughly together two parts of White Castile Soap,
 and one part, each, of powdered Opium and Camphor.  A pill, about
 the size of a pea, may be taken whenever required.   This is also use-
 ful in checking diarrhea.
   When matter is spit up, the following may be used:  Take of Vin-
 egar or crude Pyroligneous  Acid one ounce, Gum Myrrh half an ounce,
 Gum Hemlock two drachms; mix, and dissolve by heat.   Several times
 a day a portion of this must be thrown upon a hot shovel or iron, and
 the warm vapors arising therefrom be breathed or inhaled.
   In addition to what is recommended in Division I, page 474, for night-
 sweats, the following is  ;?;hen, having  proved very efficacious in not
 only relieving, but, in s£&ay instances, entirely suppressing them: Mix
 together thirty grains of Oxide of Zinc, and fifteen grains of Extract
 of Conium, and divide them into ten pills.   The dose is one or two
 every night.
   Or, Oxide  of Zinc, Extract  of Hyoscyamus, same proportions and
 doses as above.
   The diarrhea which is so exhausting in consumption, may frequently
 be  checked by the following  preparation:  Take  of Charcoal  two
 drachms, Tannic Acid and  powdered Kino, each, twenty grains, pow-
 dered Opium two or three grains ;  mix well together.  Put this into a
 pint of Rice water, Barley water, Indian Meal gruel, or Blackberry
 root tea, and take a table-spoonful every hour, stirring it up well each
time before  taking the dose.   In many cases  the Trisnitrate  of Bis-
muth will answer the purpose, in doses of ten, twenty, or  thirty grains,
three times a day.
  For bleeding of the lungs, or spitting of blood, see Division I, page 
HOUSEHOLD DEPARTMENT.
143
453, and Division II, page 129.  For further treatment of Consump-
tion, see Division I, pages 471 to 475.

              Chronic Inflammation  of the Eyes.
  (See Division I, pages 240 to 244.)
  Treatment.—When the disease  is  of the Catarrhal kind, (see page
84), one of the following preparations may be applied to the eye:
  1. Add one teaspoonful of powdered Copperas, and three teaspoon-
fuls of fine table-salt to three pints of rain water.  When dissolved,
put a  drop or tAvo into the eye every night and morning, without shak-
ing the vial.
  2. To  two gills of Rose water add half a  drachm,  each, of White
Vitriol and Loaf Sugar.  When dissolved, wash  the eyes with it two
or three times a day.
  3. To  half  a pint of Rose water, or  instead thereof an infusion of
Witch Hazel leaves, add four grains of Nitrate  of Silver;  dissolve.
Apply a drop or tAvo to the  eye three times a day.
  Where  the  chronic inflammation of the eyes  is accompanied with
some  redness and discharge, one of the following preparations will be
found useful:
  1. Take of Nitrate of Silver ten grains, Sugar of Lead fifteen grains,
good Lard one drachm; mix thoroughly together.  Apply a small por-
tion of this under the  eyelid, and rub it over the lid with the finger.
It pains severely for nearly  an hour, but is a good preparation.
  2. Take of Lapis Caliminaris or impure Carbonate of Zinc two parts,
in bulk, Turmeric three parts, White Vitriol one part;  powder all very
finely, and sift through a piece of fine cambric linen or muslin.  Mix
this with  as much ne\v, unsalted butter, as will make an  ointment of
the color  of Scotch snuff—say the  bulk in butter of a common sized
hen's egg to  a teaspoonful  of the  poAvder.   It  should be applied in
small quantity along the edges of the eyelids every night and morning.
  3.  Wash for chronic idceration of the eyelids.— Take of Carbonate
of Zinc four parts, Laudanum two parts, Tincture of  Camphor three
parts, Rose water  sixty-five parts.   Mix, and wash  the part affected
every night and morning.
  4.  To remove granulations from the lids.—Mix together finely pow-
dered Myrrh four grains, finely powdered Elaterium two  grains, Mut-
ton Tallow one ounce.  To be rubbed upon the inside  of the lids, two
or three times a day.
  5.  To remove minute particles  of iron  and lime from  the eye.—To
two ounces of soft water add one drachm of Mucilage  of Gum Arabic,
/ 
144
AMERICAN FAMILY PHYSICIAN.
and  twenty-four drops of Muriatic Acid.  Apply upon the speck of
iron, by means of a small camel's hair pencil, until it has become so
far dissolved as to be removed by simply drawing one  end of a hand-
kerchief across it.  Be careful to get none of the solution upon any
other part of the eye.
   6. For weakness of the sight, common to persons of  feeble constitu-
tion, as well as to  those who use the eyes much in examining minute
objects, in reading, writing,  etc., in whom there is sometimes a dark
spot floating before the eyes, or specks resembling insects, the best
remedy is  plenty of exercise in the open air, good nourishing diet,
sponging daily with cold water, keeping the bowels regular, bathing the
eyes with a  decoction of equal parts of Golden Seal root and Solomon's
Seal root, and taking internally  a pill composed of Carbonate of Iron
twenty grains, Extract of Gentian ten grains; mix, and divide into ten
pills, of which take one three times a day.
   Dr. Hall, in his excellent Journal of Health, gives the following ad-
mirable rules for the preservation  of sight:
   " One of the most eminent American divines, Avho has for some time
been compelled to forego the pleasure of  reading, has spent some
thousand  dollars  in vain, and  lost years  of  time, in  consequence of
getting up several  hours before  day and  studying by artificial light.
His  eyes will never get well.
   " Multitudes of men and women have made their eyes weak for life,
by the too free use of eyesight  in reading  fine print  and doing fine
sewing.  In vieAV of these things, it will be well  to observe the follow-
ing rules in the use of the eyes:
   " Avoid all sudden changes between light and  darkness.
   " Never begin to read, write, or sew, for several minutes after com-
ing from darkness to a bright light.
   " Never read by twilight, or moonlight, or on a very cloudy day.
   " Never read or  seAv directly in front of  the light, or window, or
door.
   " It is  best to have  the light fall from above, obliquely, over the
left shoulder.
   " Never sleep so that, on the first awakening, the eye shall open on
the light of  a window.
   " Do not  use the eyesight by light so scant that it requires an effort
to discriminate.
   " The moment you are instinctively prompted  to rub the  eyes, that
moment cease  using them.
   "If the eyelids are glued  together, on waking up, do not forcibly 
HOUSEHOLD DEPARTMENT.
145
 open them; but apply the saliva Avith the fingers—it  is the  speediest
 dilutant in the world; then wash your eyes  and face  in warm water."
   Do not gaze for any length of time on bright or glaring objects, as
 the fire, gas-light, sunshine, etc.
   Persons require to use spectacles—when they are obliged to remove
 small objects to a considerable  distance  from the eye, in order to see
 them distinctly—when they find it necessary to get  more light  than
 formerly, as, for instance, to place the candle between the  eye and the
 object—when, on looking at, and attentively considering a near object,
 the eye becomes fatigued  and confused, or appears to have a kind of
 dimness or mist before it—Avhen small printed letters are seen to run
 into  each other,  and hence,  by looking  steadily on them,  appear
 double  or treble—when the eyes become so fatigued  by a little exer-
 cise of them, that Ave are obliged to  shut them from time to time, so as
 to relieve them by looking at different objects.  When  all these circum-
 stances are present, or any one of them, assistance must be sought  from
 glasses, Avhich will ease the eyes, and in some degree check their ten-
 dency to become worse;  whereas, if they be not assisted in  time, the
 weakness will be much increased, and  the  eyes be  impaired by the
 efforts  they are compelled to exert.
   In selecting glasses for spectacles persons must be careful not to get
 them for their magnifying power, but solely because they render letters
 distinct and bright at the usual reading distance.  Many eyes have been
 prematurely destroyed by wearing glasses, on account of their making
 objects look larger than natural.  The rule for every  person to adopt
 in selecting glasses is to take  those  which at the ordinary reading dis-
 tance will enable them to read small print distinctly and clearly,  with
 the least magnifying  of them, and with which the person can  at  the
 same time see  the  most  distinctly at  the  greatest  distance.  Thus
 glasses with which a person can read distinctly at the usual reading
 distance, and with which he can also see objects distinctly at ten feet
 distance, are  to be preferred to those which, although enabling one to
 read as well as the first, yet allow him to see objects distinctly only at
 six or eight feet distant.

                       Chronic Bronchitis.
  Troublesome cough, especially in damp and cold weather, more or
less raising of tough phlegm, sometimes dark or bluish, and sometimes,
in severe cases, tinged with blood.   As the disease  increases, there
will be debility, emaciation, night-sweats,  and  symptoms resembling
those of consumption.  (See Division I, pages 264 to 266.) 
146
AMERICAN FAMILY PHYSICIAN.
   Treatment.—Take a mild emetic  once a week—one of those named
under Fevers, on page 74, will  answer.  Keep the  bowels regular by
diet, if  possible, and use  one of the following preparations:
   1. Take of Squill, Seneca Snake root, Lobelia leaves, each, in coarse
powder, one ounce, boiling water a pint and a half; mix.   Steep in a
covered vessel, near a fire for six hours, then strain.  Add half a pint
of Honey  and two drachms of Iodide of Potash.  Dose, from a tea-
spoonful to a tablespoonful three or four times a day.
   2. Take of Gum Ammoniac two ounces, Balsam of Tolu half  an
ounce, Sulphate of Morphia three grains, Whisky one pint, Molasses
half a pint;  mix.   Let it stand near a fire, in a covered vessel, for
six hours,  and then strain: dose, a half table-spoonful, three, four, or
five times  a day.
   3. Take of Colt's-foot root, Elecampane root, Extract of Liquorice,
each, one  ounce, Bloodroot half an ounce, water half a pint, good
Cider Vinegar half a pint;  mix.  Steep them near a fire, in a covered
vessel,  for six hours;  strain, sweeten with Molasses or  Honey, and
flavor with Essence of Aniseed.  Dose, from  a teaspoonful to a table-
spoonful, three  or  four times  a day.
   4. Dissolve one ounce of Sal Ammoniac in a pint of soft water; add
to this the following:  Honey a table-spoonful, Tar a half table-spoon-
ful, Extract of Liquorice, in powder, a half table-spoonful; steep near
a fire for four hours, in a covered vessel, and strain.   The dose is one
or two teaspoonfuls, three or four  times a day.
   5. Take of Tar  and Honey, each, a  table-spoonful;  mix them to-
gether,  and form them into a pill mass with equal parts of Extract
of Liquorice, Skunk Cabbage root, and Wild Turnip root—all in fine
powder.   Divide into pills of four  grains each, or about the size of a
large pea.  Take two  or three of these, three or four times a day.

                        Chronic Catarrh.
   More or less profuse discharge from the nostrils, or a dropping  of
the discharge into throat;  cough;  offensive breath.   (See Division I,
pages 269 and 270.)
   Treatment.—An attention to the hygienic rules, and one of the fol-
lowing snuffs:
   1. Take of Colt's-foot, Bayberry bark, each, in  poAvder, two tea-
spoonfuls, Bloodroot,  in powder, a teaspoonful, Camphor, in powder,
half a teaspoonful;  mix, and snuff several times a day.
   2. Take of  Bayberry bark, Bloodroot, Golden Seal root, Solomon's 
                    household  department.                  147

Seal  root,  Alum, each, in powder, a teaspoonful.  Mix, and use as a
Bnuff.
  3.  Take Borax twenty grains, water one  ounce; mix and dissolve,
and then add Glycerine one ounce.   A small portion  of this should
be injected into the nostrils and back part of the throat, three or four
times a day.
               Chronic Dysentery and Diarrhea.
  (See Division I, pages 292, 293, and 423.)
  Treatment.—I. Take of Solomon's Seal, Bethroot, Crowfoot or Alum
root, Wild Cherry bark, each, in powder, one  ounce,  Cinnamon, in
powder, half an  ounce, Red Pepper, in powder, half an ounce, boil-
ing water  four pints; mix,  and steep in a covered vessel, near  a fire,
for six  hours; then strain when cold, and  add two ounces  of Lauda-
num, and two ounces of Tincture of Myrrh.  Dose, a table-spoonful three
or four times a day.  Shake well each time  before taking.
  2. Take of Blackberry root, Crowfoot or Alum root, Bayberry bark,
each, in coarse powder, one ounce, water three pints ; boil down to two
pints ;  strain, and add white Sugar half a pound, Laudanum one ounce.
Dose, a table-spoonful three or four  times a day.
  3. Take of Laudanum two  table-spoonfuls, Tincture of  Rhubarb,
Tincture of  Catechu, Tincture of Camphor, each, one  table-spoonful,
Oil of Aniseed a teaspoonful; mix.  Take  a teaspoonful immediately
after each passage from the bowels.
  In connection with the internal remedies, injections should be made
use of; the  following will be found useful: Take of Blue Vitriol one
or two  grains, water one ounce; mix, and inject after each operation.
  Or, take White Vitriol three or four grains, water one ounce; mix,
and  inject after each operation.
  Or, Alum eight  grains to the ounce of water; or, Nitrate of  Silver
ten grains to the ounce of water.  Either of these will be found useful.

                   Chronic Liver Complaint.
  Most of the affections termed Liver Complaint, are, in reality, mere
disorders  of the stomach and bowels.   In Liver  Complaint  the  symp-
toms are:
  1. Weight or uneasiness  in the  right side, perhaps pain; pain at the
top of the shoulder; impaired or capricious appetite; irregular or cos-
tive  bowels;  sallow complexion; gradual debility and emaciation;
quick, regular pulse.  Frequently, there is  cough Avith expectoration;
difficult breathing ; high-colored urine; inability to lie on the left side.
(See Division I, pages 296 to 298.) 
148                AMERICAN FAMILY PHYSICIAN.
   Treatment.—Take  moderate exercise every  day; keep  the  bowels
regular; use a good diet, but such as is easy of digestion and not dis-
posed to cause acid stomach, flatulency, or costiveness;  bathe the sur-
face of the body eyery day with a weak ley water, and  in drying use
sufficient friction to produce a gentle glow of heat; take  a spirit vapor-
bath, (see page 698, Division I,)  once in every two or three weeks • go
to bed  early,  and rise in the morning  at regular hours, and take one
of the following preparations :
   1.  Take of Golden Seal, Bitter root, Blue Flag  root, Mandrake or
Mayapple  root, each, in coarse  powder, a table-spoonful,  Blood-root
half a table-spoonful, Red Pepper a teaspoonful, Whisky two  pints •
mix ; let them stand ten or twelve days,  frequently shaking, and sweeten
if desired.   The dose is one  or  two teaspoonfuls three or  four times
a  day,  or  enough to produce one  operation  from the  bowels  every
day.
   2.  Take of Indian Turnip, Elecampane, and Comfrey roots, each, in
coarse poAvder,  half a table-spoonful, Horseradish root, Yellow Parilla
root,  Hoarhound  leaves and  tops, and Black Cohosh or Rattle root.
each, in coarse powder, a table-spoonful, Whisky or Spirits one quart;
mix; let them stand  ten or twelve  days, frequently  shaking, and
sweeten if desired.  The dose is a table-spoonful, three  or  four times
a day.
   3.  Take of  the  green herb, Lycopus  Europaeus, (Water Hoarhound,
bearing white flowers,) two  parts, fresh inner bark of Wild Hickory,
and fresh inner bark of White Ash, each, coarsely  bruised, one part;
fill a gallon jug Avith these, and then fill with Whisky; let it stand five
or six days, frequently shaking.  The dose is a table-spoonful three or
four times  a day.   This is especially useful in liver and spleen affec-
tions  which folloAv chills and fever.  It will remove "Ague Cake"
when aided by the following ointment  rubbed over the  region of the
hardened spleen three times a day:  Take of Lard,  or Glycerin four
ounces, Iodide of  Potash four drachms; mix, and  rub well together,
and then add tAvo drachms  of powdered  Iodine;  mix all thoroughly.

         Chronic Disease of the  Kidneys and Bladder.
  A dull pain  in the region of the kidneys, with Aveakness in the small
of the back ; urine evacuated at irregular intervals; a sediment at the
bottom of urine on standing a short time.  (See Division I, pages 304
and 305, and pages 313 to  315.)
   Treatment.—1.  Take of  Tar, Queen of the MeadoAV root,  Wild Car-
rot root, Apple tree bark, RagAveed or Stammer-Avort leaves and tops, 
HOUSEHOLD DEPARTMENT.
149
Wild Potato root, each, in coarse powder, one ounce, boiling water two
pints, Whisky one pint; steep in a covered vessel, near a fire, for four
hours;  then  strain and sweeten with Honey.   Dose, half a gill three
or four times a day.
  2.  Take of the tops, twigs, and roots of Bush Honeysuckle or Gravel
weed, Milkweed root, Blue  Flag root, Pipsissiway, Sassafras bark,
each, in coarse powder, one ounce, boiling water two pints, Whisky one
pint; mix.   Prepare  and  use  in  the same manner as the preceding
one.
  In addition  to  these  internal remedies,  the same  measures as to
diet, exercise,  etc., must be pursued  as recommended under Liver
Complaint, page 148.  When there is much pain and weakness in the
small of the back, the Strengthening Plaster named in Division I, page
735, may be  worn.   Or, the following liniment be rubbed  over the
part's three or  four times a day:  Take of Oil of Sassafras, Oil of Ju-
niper, Oil of Spearmint, Camphor, Chloroform, each, one ounce; mix.
Use a small  quantity at a time.
  Or, take of Glycerine one ounce,  Iodide of Potash half an ounce;
mix, 'and rub  thoroughly together;  then  add powdered Iodine two
drachms.  When these have been well mixed together, add Oil of Spear-
mint, Oil of  Sassafras, each,  one ounce; mix.  Use as the preceding.

                       Chronic Rheumatism.
  (See Division I, pages 325 to 328.)
   Treatment.—Chronic Rheumatism is a curable disease, but the great
difficulty is  that patients  take  medicines only when they  suffer pain
from the disease—when, in fact,  it is necessary they should  continue
its use after the pain  has left, and persevere therein until cured.
  The  diet, regularity of boAvels, exercise, spirit vapor-bath,  etc., rec-
ommended uncler  the head  of  Liver Complaint, page 148, must be
observed in  the treatment of Chronic Rheumatism.  As to medicines,
one  of  the following  may be taken:
  1. Take of  Poke root, Blue Flag root, Prickly Ash bark, Black Co-
hosh root, Bitter root, each, in poAvder, one ounce, Whisky two quarts;
mix.   Let it stand for ten or twelve days, frequently shaking.   Dose,
a table-spoonful  three or four times a day, in  a glass of sweetened
water.
   2. Take of White  Pine bark, Poke root, Black Cohosh root, Sassa-
fras bark, Sulphur, each, in coarse powder,  one ounce, Whisky two
pints; mix.   Prepare and use  in the same manner as the preceding.
   3. Take of  pure Nitrate of Soda one ounce, soft water two ounces; 
150
AMERICAN FAMILY PHYSICIAN.
mix.  Give a  table-spoonful three  times a day in some Slippery Elm
tea.
  4. Take green Walnut shells  four ounces, Black Cohosh root two
ounces,  Twin leaf or Ground Squirrel Pea root two ounces; have all
in coarse  powder, and pour on them half a gallon  of water.   Steep
near a fire, in  a covered vessel, for  six hours, then strain, sweeten, and
when cold, add Iodide of Potash tAvo ounces.  Dose, two table-spoon-
fuls three times a day.
  In addition  to the internal means some liniment must be applied to
the affected part.  One of the following may be used:
  1. Take of  Oil of Sassafras, Oil  of Hemlock, Oil  of Origanum and
Laudanum, each, equal parts; mix.
  2. Take one gill  of Whisky,  one gill of Vinegar, two Eggs, one
teaspoonful of Spirits of Turpentine, and two teaspoonfuls of Spirits
of Camphor.    Beat the eggs  first, then add a little of each of the
articles, till all are mixed, stirring continually.
  3. Take of Laudanum, Spirits of Camphor,  Chloroform, each, one
ounce and a half, Sweet Oil half an ounce;  mix.
  4. Take of Buckeyes or Horse Chestnuts any quantity; peel off the
brown covering, and reduce  the  white  interior  to powder; cover this
with tAvice its bulk of Sulphuric Ether, and  let it stand in  a closely
stopped bottle for tAvo weeks, frequently shaking.   Then pour off the
clear fluid, (or filter) and let the Ether evaporate, when  an oil will be
left.   With a camel's hair pencil brush some of this oil over the  pain-
ful part several times, and then cover with flannel.   Repeat the opera-
tion three times a day; keep the patient quiet.  (For further treatment,
see Division I, pages 326 to 328.)

                     Stiffness of the Joints.
  By this is not meant a permanent stiffness, but that which is due to
weakness  of  the muscles,  or some difficulty involving the ligaments,
tendons, etc., around the joint, and which is  frequently curable.   (See
Division I, page 585.)
  Treatment.—Frequently rub  and knead the joints with the fingers,
gently moving them back and forth, but not to produce pain, and repeat
this several times a day.   Also expose them to the vapor arising from
bitter herbs in hot water, for fifteen or twenty minutes each time, after
which apply the herbs around the joint, and let  them remain for an
hour or two; repeat this every night.   After each rubbing and knead-
ing as  above named, apply one of  the  following mixtures, which will
be found very effectual: 
HOUSEHOLD DEPARTMENT.
151
   1. Take of Linseed Oil, Neat's-foot Oil, Beef's Gall, Oil of Sassafras,
each, a table-spoonful, Tincture of Lobelia  four table-spoonfuls; mix.
To be shaken before using it.
   2. Take a gill of Angle or Fish Worms, put them into a bottle with
half an ounce of Oil of Sassafras, a teaspoonful of Spirits of Turpen-
tine, and a table-spoonful of poAvdered Lobelia.  Cork the bottle tightly,
and  expose it to the rays of the sun for five or six days in succession;
or, it may be kept near  a fire  for two or three days, but exposure to
the sun is the best.   Then press and strain through flannel, and keep
in a closed bottle.   This  may be rubbed upon the stiff joint two or
three times a day, and  will be found a superior  liniment  for  this
purpose.
   3. Mud Turtle  Oil, and Rattlesnake  Oil are  powerful relaxants.
When  either of them  can be procured, they may be used  by adding
one  part  to four parts of Neat's-foot Oil, and  rubbing upon the joint
two  or three times a day.

                         Spinal Disease.
   (For Rickets or Curved Spine, see Division I, pages 479, 480.)
   This  is a very common disease, to which many persons are subject,
especially females;  but it is not so much  a disease  of the spinal mar-
row, as of an irritable  condition of the muscles Avhich are  inserted
upon the prominences or processes of the spinal column, as Avell as of
other muscles produced by  overworking  or overstraining the fibers
of the muscles at their insertions or fastenings  to the bones.  And the
weaker the person the greater is the tendency to pain.  This complaint
is very common  among sewing women, milliners, Avriters, authors, hard-
working females, and persons Avhose occupations require them to con-
tinue for a long  time in  one position, either erect or stooping, repeat-
ing it from  day  to day.
   When there is a true spinal disease, that is of the spinal marrow,
there is no pain produced by pressure, but considerable pain when the
backbone  is rapped upon.
   Symptoms.—One of the  most prominent  symptoms is more or less
pain or tenderness along the spinal column, or at  certain parts of it,
which  sometimes extends  to  other parts of the  body, and is often
increased by motion.  In some cases no pains are felt at all, excepting
a soreness or  tenderness upon pressing along  the  spinal column—in
others, there is pain, which is increased by pressure at various points
upon the backbone, by bending,  stooping, or lifting  weights, etc.
These pains, Avhen extending to the  body, are very variable in theii
           60 
152
AMERICAN FAMILY PHYSICIAN.
character and position, and I  will endeavor to describe  those more
commonly met Avith.
  They are described by the patient as aching, hot, or burning pains,
in some instances as if a hot coal were at the part; they are met with—
in the back part of the head and along the neck, sometimes causing the
patient to believe  she  has  caught cold  in  the head; on the top of the
shoulders, with  a  sense of weariness,  and sometimes cramps; at the
lower end of the breast-bone ; just beloAv the breasts; on the back part
of the arms, above the elbows; on the abdomen, complained of  as a
" continual  grasping"  pain  all over the  belly, as  if somebody were
drawing  the patient up, and Avhich pain becomes very severe on walk-
ing ; in  the sides, with tenderness on pressing between  the ribs, or
only a " stitch in the side;" in the loins ;  in  the small of the back;
in the sides, low down; at the bottom of the belly,  on the  pubic bone,.
etc., etc.  Sometimes, instead of pain there is a " tired" or " wearied"
sensation at these parts.  These  pains  are generally absent in the
morning on getting up, and go on, getting worse, until bed-time, when
they cease or get better soon after lying down.  Many times they come
on suddenly, and  are sometimes accompanied with  spasms or cramp-
like feelings.  When they  follow excessive exertion, they come on the
first thing in the morning, and subside gradually.  Of course, one per-
son will  not have all these various locations suffering from pain; but
one or several of them, most certainly.
  In connection with these pains are often symptoms which have led
both patient and physician to believe that the lungs, the stomach, the
heart, the liver, thc kidneys, or the womb was affected, and patients
have been compelled to undergo vomiting, purging, sweating, blistering,
tartar-emetic sores, cupping, salivation,  and other medical tortures,
with the vain hope of  curing an imaginary disease.   These symptoms
will be  found to  vary with  different individuals, no two presenting
exactly  the  same.   There will be dizziness of the head, ringing in the
ears, palpitation of the heart, loss of appetite,  slight cough;  pressing
upon  any part of the  spinal column will  sometimes cause both pais
and cough; failing strength, costiveness,  sometimes diarrhea, loss of
spirits, depression of mind, a morbid appetite,  vitiated taste, love of
sympathy, feigning diseases,  seeing spectres and such things, strange
noises in the ears, strange twitehings or jerkings and twistings of the
body, flatulency, hysterical attacks, difficulty  of  breathing,  difficulty of
swallowing,  nausea after eating, etc.
  Treatment.—The treatment generally pursued for spinal disease ia
not attended with any great amount of success, for the very reason that 
HOUSEHOLD DEPARTMENT.
153
it is debilitating in its character, as every one knows who has witnessed
its treatment by emetics, cathartics, blisters, etc.
  To  efiect a cure, the tried,  overworn muscles must have rest; the
strength of thc  system must be husbanded by diminishing the amount
of labor undertaken, whether this be mental or bodily, or both.
  " Few persons, till they give their unbiased attention  to it, have any
definite idea of the amazing amount of Avork Avomen get through with
by day.  From six or eight in the morning till nine or ten at night,
they are incessantly at work  : Avashing, dressing, scouring, carrying,
cleaning, making  beds, shaking carpets, sweeping floors, ironing, sew-
ing, darning, knitting, nursing, playing with children, teaching; infants
to walk, carrying them in their arms, cooking, etc.  All these require
muscular exertion, and this is sometimes excessive in degree—their
very insignificance, and their daily occurrence, cause them to be ignored.
The laborer, the  farmer, the  man  of business, the doctor, know  little
of them, for they are performed out of their sight.  They all see  their
rooms  pretty nearly  in the same  condition, their linen, etc., in the
proper state,  and never care about, for they do not know,  the trouble
required even in these small details.

                 "' Man's labor ends at set of sun,
                  But woman's work  is never done.'

  " A Avoman herself, knowing that some of her companions in sex get
through their duties without suffering, imagines that the same duties
can have no influence  over  her health or feelings, and she attributes
her complaints  not to Avhat  she has to do, but to something that pre-
vents her doing them, and Avhich may be removed by  art or skill; and
as the abdominal muscles  are commonly affected, the patient  takes
Blue Pill  and  other aperients, and thus makes matters worse.  The
only way to lighten labor under these circumstances,  is to insist on a
rest every day in the recumbent posture for at least half an hour, and
more, if necessary, in the middle of the day.
  It is much easier to knoAV Avhat must be done than to induce our
patients to comply Avith  our recommendations.  For  this we must be
prepared.   One can not take vest, for the  household duties fall  upon
her, and she is  unable to give them up, or to*o poor to  provide a sub-
stitute.   Another will  continue to nurse till she is  physically  inca-
pacitated, putting, in  her own estimation, present suffering against a
probable future contingency, involving greater pain and more expense.
Another, (a very  common occurrence,) has formed her notions con-
cerning her case  from  reading some newspaper  paragraph, from  some 
154
AMERICAN FAMILY PHYSICIAN.
nurse, etc., while  she has been in health.  When she  is in any Avay
debilitated, she is  too Aveak to think,—the mental  labor required to
take up a new train of thought,  hopes, and confidence, is  too  great.
In  her own idea the patient is  firm; in thc opinion of the healthy
jlookers-on, she is obstinate in her resolves, and actually prefers pain
and quiet of the mind, to relief and mental violence."
  But it is absolutely necessary, in order to effect a cure, that rest be
taken: lying upon the back in bed, for at least half an hour at a time,
one, two, or more  times a day, according to the degree of weakness,
and without any occupation of the mind in conversation, reading, writ-
ing, or other exertion.  .Sleep at night must be promoted by Opium,
Morphia, tea of Scullcap, etc.
   Change of air and scene operates  in  tAvo ways :  by removing  the
patient from exhausting labor, and by placing her or him in the most
favorable condition for improving health.  A change anywhere is serv-
iceable, whenever it is attended Avith absence of excessive labor of body
or  mind, and  the  presence of pleasant associations and companions.
Change of air is of little use when the patient carries with him all the
habits, etc., of home. It is of small advantage for a Avorn-doAvn mother
to go to the seaside, or elseAvhere, for her own health, and to take with
her the most chargeable of her younger ones ; or, for an author, editor,
etc., to resort to the country with his pens, ink, and paper in undimin-
ished  array.  Equally useless is it for the victims of hysteria to change
the parties, concerts, etc., of the toAvn, for the assemblies, balls, dinner
parties, picnics, etc., of Avatering and country places.
   Exercise, proportioned to the strength of the patent, must be  taken
every  day in the open air; but never  to fatigue or cause shortness of
breath.  The diet  must be  ample and generous, Avith proper intervals
betAveen the meals.  Long fasts are injurious to the sick.  The food must
be  nourishing, and of easy digestion.  To strengthen the stomach, good
Wine  with the yelk of an Egg and a little Sugar, taken two or three
times  a day, is better than all the tonic medicines that can  be given;
but where Wine can not be had, some simple tonic bitter made  into a
decoction, and sAveetened, may be taken in table-spoonful doses two or
three  times a day; as, for instance, of Golden Seal, Ginseng, Gentian,
Colombo, Chamomile flowers, Peruvian bark, etc.   Or, one of the tonic
bitters named under Dyspepsia,  page 134, may  be used.  Tea and
coffee  must not be  used; these are generally much  craved by this class
of patients, on account of the transient stimulus they impart;  but this
is at a great cost to the patient, ultimately.  They are extremely prej-
udicial to  the  delicate  stomach, especially when taken very  hot and 
HOUSEHOLD DEPARTMENT.
155
very weak.   Milk and water, tea of Raspberry leaves, Peach leaves,
StraAvbcrry leaves, Jersey tea, etc., not too hot, are much better bev-
erages at meals.
  Bathing  the body with a  sponge, and tepid or cool  water, every
morning, is of immense value;  so is sea-bathing, or bathing with salt
and water.   But  Avhen this bathing is  carried beyond  five minutes, it
is then abused, and does positive harm.
  As to the treatment by medicines, they should not be given except
when absolutely required ; the bowels must be kept regular, if possible,
Avithout physic, but if this has to  be used, a little Rhubarb and  Ginger
Avill be found the best.  But  on no account must active purgatives be
taken.
  Tonics ajre sometimes of service, and these have already been refer-
red to.  A very  excellent tonic is composed  of a teaspoonful of Lin-
seed Oil and half a teaspoonful  of Whisky, mixed together;  to be
folloAved, as soon as  taken,  by a draught composed of Tincture of
Muriate of Iron  five drops, Avater half a gill; these may be repeated
three or four times a day, and, if necessary, the Oil irsy be increased
to a table-spoonful, Avith a corresponding increase of the Whisky.  Any
cough, cramps, leucorrhea, neuralgia, Avomb  or throat difficulty, etc.,.
which may be present, must  be treated by  the means named  under
their respective heads.
  Where it is actually impossible for  patients  to  take  the required
rest, they may find much relief, but not a cure, from the use of galvan-
ism, Avhich  has, of itself, effected  permanent cures Avhere the  persons
suspended their mental and  physical  labors, and sought amusement
and rest by change of air and scenery, etc.  Where galvanism can not
bo had, benefit may be derived from the use of one of the  folloAving
liniments, rubbed tAvo or three times  a day along the course  of the
backbone, and over the painful and tired spots  or muscles in other
parts  of the body.
  1.  Take  of  Chloroform, Camphor, Opium, each, an ounce  and a
half,  SAveet or Olive Oil an ounce;  mix.
  2.  Take  of  Extract  of Belladonna one  drachm,  Camphor two
drachms, Glycerine  or Lard one ounce; mix.   Rub thoroughly together
and use in small  quantity.
  3.  Take of Oil of Sassafras, Laudanum, Spirits of Camphor, Goose
Oil, each, a table-spoonful, Spirits of Turpentine a teaspoonful;  mix. 
156
AMERICAN FAMILY PHYSICIAN.
                              Cough.
  (See Division I, pages 264  and 729;  also Division II, pages 100
and 146.)
  1. To  six ounces  of Avater add tAvo drachms, each, Sal Ammoniac
and Extract of Liquorice, half a drachm Extract of Hyoscyamus, and
one ounce Syrup of Tolu;  mix.  Dose, a table-spoonful three or foui
times  a day.
  2. Take six ounces of fresh Comfrey root, and  tAvelve  handfuls of
Plantain  leaves;  cut and beat them Avell;  strain out  the juice, and
with an equal weight of Sugar, boil it  to a  syrup.   Dose,  a table-
spoonful  three times a-day.   This forms an excellent remedy.
  3. Take of  Extract of Liquorice tAvo ounces, Rock Candy, or Loaf
Sugar, two ounces,  Gum Arabic  one ounce, boiling water one  pint;
mix and  dissolve;  when cold, add Paregoric two  ounces.   Dose, a
table-spoonful every two or three hours.  This is also a valuable cough
preparation, and one easily made.
  4. Dissolve  tAvo ounces of Extract of Liquorice in a pint of good
Cider or  Wine Vinegarj  then add one  ounce, each, of Oil of  Sweet
Almonds and Laudanum; mix.   Dose, a teaspoonful several times a
day, whenever the cough is severe.
  5. Take  of  Balm of Gilead buds  two ounces, Balsam  of  Fir one
ounce, good Gin, or Whisky, one  pint; mix.   Let them stand ten or
twelve days, frequently shaking, and  strain.   Also take six ounces of
Sunflower seed, bruise them, and  sloAvly boil them in three  pints  of
Avater down  to half  a pint, then  strain  and  add the  above Gin  Tinc-
ture.  This may be sweetened, if desired, with Honey or Sugar.  Dose,
a table-spoonful four or five times a day.

                    Scrofula or King's Evil.
  Swelling of the  glands or tumors in  various parts of the  body, as
upon  the sides of the neck, beloAv  the  ears, or under the chin, and
sometimes under the arms, in the groins, joints, limbs,  etc.   After a
longer or shorter  time, though generally quite slowly, they  become
softer, break, forming one or more  holes, and  discharge a thin, Avhitish,
curdled matter; the tumor then grows less, while the ulcers  continue
to spread more or less rapidly.  (See Division I, pages 464 to 468.)
  Treatment.—Scrofula  can never be permanently  cured except  by
proper internal treatment; and Avhatever means may be employed
externally to drive away the  tumors, or heal the ulcers,  the  disease
will be liable  to  return  again at any time, unless  the  cure has been 
HOUSEHOLD department.
157
 made by the remedies taken by mouth.   In addition to those  already
 named in Division I, I will here give several formulas which have proved
 very successful in curing this distressing malady:
   1. Take of  Five leaves or False Grape, Bitter root or Dog's-bane,
 Burdock root,  YcIIoav Parilla root, each, in coarse poAvder, an ounce,
 boiling Avater three quarts.   Boil slowly down  to  two quarts, strain,
 add four pounds of Sugar, and then bring to a boil for a few minutes,
 and skim off the scum which rises on the top.    Keep in a cool place
 in Avell-stopped bottles.  The dose is half a gill, three or four  times a
 day.
   2. Take of the bark of False Bitter-sweet or Staff-vine, Buttonsnake
 root or Cornsnake  root, (also called Water Eryngo,) Black Cohosh or
 Rattle root, each, in coarse powder,  one ounce;  Blue Flag root, in
 coarse poAvder, half  an  ounce, boiling water five pints;  mix.   Steep
 together near a fire for tAventy-four hours, then strain; add four pounds
 of Sugar, bring to a boil for a feAV minutes, and remove the scum which
 rises.   This forms  a  valuable syrup for Scrofula and all impurities of
 the  blood, and must be used in the same doses as the preceding one.
   3. Take of  Poke root, Soapwort or Bouncing Bet, Frost weed or
 Rock Rose, each, two ounces, Mayapple or Mandrake root one ounce.
 Reduce  to coarse powder, pour  on  one  gallon of boiling water,  and
 6tecp near a fire for  twenty-four hours.   Strain and add six  pounds
 of Sugar, bring to a boil  for a feAV minutes, and remove the scum which
 rises.   This is to be used in the same manner as the preceding ones,
 and  avill be  found very efficacious.
   4.  Take of Scrofula plant or Rattlesnake's Violet, Yellow Dock root,
 bark of False Bittcr-SAveet root, White Pond Lily root, each, one ounce,
 boiling water five pints.   Prepare and use in the same manner as the
 preceding syrup, adding  four pounds of Sugar to make the syrup.
   I  would remark  here, that all  these syrups Avill be very much  im-
 proved, if the  Iodide of Potassium be dissolved in them, in  the pro-
 portion of half an ounce to every pint of syrup.
   If the scrofulous tumors have not yet discharged  any matter, means
 may be used to disperse  them ; as a poultice of Yellow Dock or Bur-
 dock leaves, pounded, and made  into a poultice with some Cornmeal
 and Vinegar.
   Or, a poultice of Stramonium  or  Jimson leaves, Poke leaves,  and
 Blue  Flag root, equal parts,  may be  pounded together,  and applied
over the tumors, changing them twice a day.
   Or,  if the  above articles can  only  be had dried,  reduce  them to
powder, and  form them into  a poultice  by mixing  a  table-spoonful 
158
AMERICAN FAMILY PHYSICIAN.
 of each Avith a table-spoonful, each, of Soft-soap and  powdered Elm
 bark, (or Cornmeal,) and making the poultice of the proper consistence
 by adding  a sufficient quantity of water.
  When the tumors have broken and formed abscesses or ulcers, it is
 best to heal them as soon as possible, in order to prevent the forma-
 tion of large, unsightly scars.   For this purpose, wash  them two or
 three times a day Avith Castile Soapsuds, to which a small quantity of
 Whisky has been added, and then apply one of the following ointments
 on some lint, changing  it  twice a day.
  1. Take  of Sweet Oil and Linseed Oil,  each, one  ounce, boil them
 in a tin  cup until they will scorch a feather, then gradually sprinkle
 in an  ounce of Red Lead, stirring  it all  the time.   As soon as the
 mixture  is black, or brownish black, (Avhich may be known by dipping
 in a knife, from time to time, and observing the color of the salve as it
 cools,) remove from the fire, set the vessel in some cold water, stirring,
 however, all the  time.  When it  is nearly cold, and not before, add
 gradually half an ounce  of finely-powdered  Camphor, stirring the Avhole
 together thoroughly.  This is also excellent for all kinds  of sores and
 ulcers, and should be  kept ready-made in every family.
  2. Take good, sweet Cream, cut up or scrape some fresh Carrots in
 it, and beat them together; strain off the Cream from the pounded roots,
 by squeezing it in a coarse cloth.
  S. Take  Red Clover heads and St. John's-Avort, equal parts of each, fill
 a large vessel Avith them, and cover with soft, boiling Avater; boil gently
 for an hour; strain off all  the decoction, and add to it as much of thc
 plants as before, and again  boil  for one  hour;.  press  out the liquid,
 strain, and  gently boil over  a sIoav  fire until it is  reduced to the  con-
 sistence of tar.   This  forms  a valuable plaster for all  sores, old ulcers,
 sore eyes, etc.   A small quantity may be made, if desired.
  4. Take of Glycerine  one ounce, Iodide of Potash twenty grains; rub
 together, then add five grains of Iodine, and rub all well together.
  The cure of scrofula is sIoav and tedious, but by persevering in the
 treatment,  a permanent cure will be effected.   During  the treatment,
 diet, exercise, and everything Avhich will strengthen  the  stomach and
invigorate  the system, must  be made use of.  A medical  writer says:
" Constant exercise in an open, dry atmosphere, is of the most import-
ance.  I will venture to assert, that no medicine will succeed in effect-
ing a cure without much daily exercise in a healthy air.  The influence
Avhich deficient exercise has in producing scrofula, is proved to a demon-
stration by  the fact that for one boy afflicted  with this complaint, we
meet with at least four girls.  Noav, boys will have exercise ; they can 
HOUSEHOLD DEPARTMENT.
159
not be kept within doors; but girls are too  often deprived of it, and
thus mothers  and  governesses  make them  scrofulous, rickety,  and
hump-backed,  that  they  may excel in music, drawing, and other ac-
complishments.  It is an indisputable fact, that five cases out of six, of
curved spine and groAving out of  the shoulder, occurring in young girls,
are entirely OAving to the deficiency  of  exercise in the open air;  and
we find there is no cure for  this spinal  curvature, in the majority of
instances, but  in  a skillful  use of  exercise.   Friction is a  species
of exercise, and  is  Avorthy of much confidence in the treatment of
scrofula."
  Scrofulous sore eyes have been cured by heating  a teaspoonful of dry
Sal Ammoniac over a spirit-lamp, the patient inhaling the vapor that
arises, as Avell as allowing some of it to  fall upon his eyes.

                        White Swelling.
  A dull, heavy, deep-seated pain in the joints, generally the knee-
joint, Avhich is not constant or severe, but is increased on  moving the
joint.   At first there is no SAvelling,  but after a time the joint swells,
gradually increasing in size;  the skin preserves its natural color, pre-
senting a smooth, Avhite,  shining appearance, Avith  enlarged veins run-
ning through it, and the limb, both above and below the swelling, grows
smaller.  As the swelling progresses, the pain grows more severe, the
patient keeps his knee bent, merely touching the floor with the ends of
his toes, and after a shorter or longer time, sometimes in a few months,
and again not for several years, the SAvelling bursts, and discharges a
thin, curd-like matter.  Thc constitution of the patient ahvays suffers
more or less.   (See Division I, pages 477 and 478.)
   Treatment.—While the disease is in the state of swelling, keep the
patient in a condition of quiet and rest,  and apply  one  of the following
preparations, to remove the pain and scatter the swelling:
  1. First steam the part with  a mixture of equal parts  of  Stramo-
nium or Jimson leaves, Mayweed or Dog-fennel, Vervain root, and pow-
dered Prickly Ash bark, in some suds made of Soft-soap, and afterward
apply  the herbs around  the joint, as warm  as  can be  borne.   Repeat
this twice every day.
  2. Take  Elder  flowers,  St. John's-wort,  Smartweed,  and  Mullen
leaves.  Prepare and use them the same as the preceding.
  If the swelling has broken, and discharges matter, treat  the same a3
named in Division I, page 478.   The  patient should be constantly tak-
ing medicines to purify his  blood;  one of the syrups named under
Scrofula, page 157, will be found beneficial. 
160
AMERICAN FAMILY PHYSICIAN.
  Hip Disease, or Disease of the Hip Joint, must be treated in a similar
manner.
  The following  is said to be very successful in White  Swelling  and
all other swellings, caked breasts, etc.: Take of SAveet Oil half a pint,
dry White Lead  four ounces; place these in a vessel upon some  hot
coals, and heat them as hot as possible, but Avithout producing simmer-
ing or foaming, stirring continually for four hours ;  then add two ounces
of Litharge,  and continue stirring as  before, with the same degree of
heat,  for about three  hours, or until the Lead and Oil have united per-
manently; then add  of Gum Myrrh,  in very fine poAvder, one ounce
and stir together at the same degree of heat.  Have  in readiness some
strips of starched muslin  or broAvn Hollands, and  draw it through  the
salve, from end to end, as it boils, (for it will now foam,) and drop  the
plaster  thus  prepared into cold water, and when  all is finished, hang
the plaster up to dry.  This is master of White Swelling after it breaks.
Dress it twice a day, by merely Aviping the  sore and the plaster dry,
but being careful not to wash either.  Wear it perseveringly until well.

                            Carbuncles.
  A bluish pimple, rising a little above the  skin, commonly having a
bloody and watery fluid in it, but soon forming a broad, flat, firm, burn-
ing tumor, generally  on the back, neck, or cheek, of  a red color, which
becomes purplish in a few days, and highly gangrenous or mortified, and
lischarges a thin, acrid, offensive  fluid from beneath the  black core,
which  destroys the surrounding  parts.   The constitution suffers  se-
verely.   It may be  knoAvn* from  other swellings by pressure, which
causes a discharge at  several parts of its surface.   (See  Division I,
pages 480 and 481.)
  Treatment.—Open  the carbuncle, either by caustic, or by cutting
through the whole of it, in two directions, in the form of a  cross; then
apply a poultice  of powdered Slippery Elm  bark  two table-spoonfuls,
Bloodroot one table-spoonful, in poAvder, Tincture of Gum  Myrrh half
a table-spoonful, Spirits of Turpentine a teaspoonful,  Avater just enough
to form the Elm bark into  a poultice, Avhen the other  articles are added
to it.
  Or, the following may be used: Peruvian  bark, in powder, a table-
spoonful, Wild Indigo leaves a table-spoonful, Oatmeal a  table-spoon-
ful, Tincture of Muriate of Iron,  water, of each, in   equal quantities,
enough  to form a  poultice.   These poultices must be changed every
three or  four  hours, and as much of the  matter  of the tumor be
squeezed out as can possibly be done without giving  great pain. 
HOUSEHOLD DEPARTMENT.
161
  Another very excellent poultice may be made of Bethroot, in pow-
aer, MarsnmalWw root, in powder, each, two table-spoonfuls,  White
Vitriol two teaspoonfuls, water enough to form a poultice.
  As soon as thc dead parts have fallen off, heal the remaining ulcer
with some simple salve ; as, melt together equal parts of Beeswax, Mut-
ton Tallow, Rosin, and Linseed Oil.   The strength of the patient must
be sustained by a good, generous  diet.
  The following has been recommended to stop a mortification, and may
prove useful in Carbuncle: Mix together, in fine powder, one ounce of
Flowers of Sulphur,  and  two ounces, each, of Alum and Gunpowder;
mix a teaspoonful of this in Vinegar  or Pyroligneous Acid, and apply
to the  part, repeating it  every  two  hours until  the mortification is
stopped.   At the same time, take as  much of the powder internally as
will lie upon a dime, taking it in cream, and repeating it several times
a day.
                             Boils.
   (See Division I, page 503.)
   Treatment.—Boils may frequently be checked in their commence
ment, by  keeping  some  Spirits  of Turpentine upon them constantly,
by means of a rag; or, by some Tincture of Arnica; or, by keeping ice
on them :  or, by touching them with  a stick of Lunar Caustic.
   When boils are coming to a head, and are very painful, apply a poul-
tice of equal parts of Slippery Elm bark, in powder, and Lobelia leaves;
 or a bread and milk  poultice,  to Avhich powdered  Lobelia has been
 added.
   After thc boil has opened, wash it  twice a day with Castile Soapsuds,
 to  which some Whisky has been added, and, if necessary, apply a poul-
 tice of powdered Slippery Elm a table-spoonful, Ginger a teaspoonful,
 powdered  Bloodroot as much as will lie on a dime, water enough to
 form a poultice.
   When persons are subject to boils, they may break up the tendency
 to them by drinking rather freely of an infusion of Burdock seed, Sas-
 safras bark, and St.  John's-wort, equal parts of each.

                       Goitre, or  Big Neck.
    (See Division I, pages 486 and 487.)
    Treatment.—This has been frequently cured by forming an ointment,
 thus : Take of Iodide of Potassium,  or Iodide of Cadmium, one drachm,
 Glycerine two drachms; rub  these  together, and then add powdered
 Iodine one scruple; mix  thoroughly together.  Rub a little  of this
 upon the swelling every night and morning, and take internally twenty 
162
AMERICAN FAMIIf PHYSICIAN.
or thirty drops of the Tincture of Muriate of Iron in half a gill of
water, repeating the dose tAvice every day.
  The seeds of the common Nettle have been highly recommended in
this disease;  about twenty seeds for a dose, repeating it three times a
day.
                             Deafness.
  (See Division I, page  490.)
  Treatment.—Some cases of deafness are capable of being cured bv
very simple means, while others require the most skillful management
when they are at all curable.  Deafness, owing to an accumulation of
wax in the ear, or to a deficiency  of nervous action, can frequently be
cured by the following simple remedies :
  1. Put the  leaves of Houseleek in a vial, place this inside of a loaf
of bread-dough, and bake it along with the bread.  It forms a soft, oily
substance,  which may be dropped  into the ear every night, one or two
drops at a  time.  It causes an indescribable, stimulating sensation.
  2.  Take of Sweet Oil of Almonds four drops, Balsam Copaiba two
drops, Laudanum one drop;  mix.   Let a drop or two of this fall into
the ear, every night and morning.
  3. Take  of Glycerine two drachms, Tannic Acid half a drachm; mix.
A drop  or  tAvo of this in the ear, twice a day, is useful in cases Avhere
the deafness is owing to  a relaxation  of the membrane, commonly
called the drum.
  4. One  or two drops  of Sulphuric Ether placed  in the  ear every
night, is said so have effected remarkable cures of deafness.
  5. Take  of Olive Oil half a pound, Ox Gall, Garlic, and Bay leaves,
each, half  an  ounce; mix;  boil for fifteen minutes, and strain.  Put
some of it  on a little cotton, and apply to the ear.  This is very pop-
ular in France.  Sassafras leaves, or the leaves of Fever-bush or Spice-
wood, may  be used instead of the Bay leaves.
  In  connection Avith the means named above, the patient must keep
his  bowels  regular, have the skin  frequently bathed, take exercise in
the open air every day, attend to the diet, and all other measures that
will tend to strengthen and invigorate the general system.

                     Salt-Rheum or Tetter.
  (See Division I, pages 491 and  492.)
  Treatment.—1. Take Beefs Marrow, Sulphur, Black Pepper, White
Turpentine, of each, equal parts ;  mix together, and make an ointment
to apply to the tetter.
  2. Take  of berries of White Bryony, Yellow Dock  root, and Blood- 
household department.
163
root, each, bruised, one  ounce,  boiling Avater  three  pints; mix,  and
steep near a fire  for twenty-four hours;  then  strain, and boil gently
doAvn to the consistence of tar, having first added a table-spoonful of
Saltpetre.  Apply over the tetter tAvice a day.
   3. Take of fresh Sheep's-sorrel leaves, fresh Celandine leaves,  and
Red Clover leaves and flowers, each, a handful; beat them up Avell in
good Cream, or in fresh Butter that has not been salted.  Then squeeze
off the Cream or  Butter, and use it as an ointment,  applying it over
the tetter tAvo or three times a day.
   4. Take of Bloodroot,  Tag  Alder bark, Plantain leaves, each,  one
ounce, good  Cider, (or  a strong infusion of Barberries,  or Tomato
juice,) one pint;  mix, and steep near a hot fire for twenty-four hours ;
then strain, and  add two  table-spoonfuls of unslacked lime;  let it
stand another  twenty-four  hours,  and  strain.  The parts may  be
washed in this, three or  four times a day.
   5. This has been highly recommended as being  efficacious in Salt-
Rheum, scalds, burns, and bites  of insects :  Take a teacupful of sweet
Cream, carefully tie it up in  a tight piece of thick  linen cloth or can-
vas ; then bury it about a foot deep in the ground, and let it remain
there thirty-six hours, when it will be found as hard as butter.   Apply
this to the affected parts.
   6. Take half a drachm, each,  of Alum and Copperas, place them in
an earthen dish and calcine them, or expose them to a heat which will
drive off the Avater contained in them;  add to these one drachm  of
Blue Vitriol, and  half a drachm,  each, of Alum  and  Copperas, not cal-
cined ; reduce the mixture to a fine powder, and then put them in a cup
containing, half a gill each, of Tar and Honey; simmer them together
for a short time; remove from the fire, and stir constantly till cold.
This forms an excellent application to obstinate cases of Salt-Rheum,
Tetter, etc.
                     Blotches on the Face.
   (See Division I, pages  500 and 501.)
  1. Take of cold  infusion  of Cleavers or  Goose Grass half a pint,
Borax half an ounce;  dissolve the borax.  Wash the face with this
two or three times a day, and let it dry on.
  2. Take of Saleratus and Sal Ammoniac, each, half a drachm, Whisky
half a pint;  mix.   Bathe the parts with this three times a day.

                          Scald Head.
  (See Division I, pages 493 to 495.)
  1. Take of good wood  Soot, Saltpetre, and Sulphur, each, one tea- 
164
AMERICAN FAMILY PHYSICIAN.
spoonful, Lard two table-spoonfuls; mix together  and form an oint-
ment.  Apply to the head every night and morning, first washing with
Castile Soapsuds.
  2. Take  a handful, each,  of Stramonium leaves,  Yellow Dock root
and Mullen leaves, Lard half a pound;  boil together until the leaves
are crisp;  squeeze, and strain out the Lard, and then add six ounces
of Tar.   To be applied as an ointment to the head.
  3. The preparation No. 3, under  Salt-Rheum, page 163, will also
be found efficacious.

                        Warts and  Corns.
  (See Division I, pages 503 and 504.)
  1. Take  of Nitric Acid, Muriatic Acid, Oil of Rosemary, Chloroform
each, two drachms, Alcohol  one ounce; mix.  Soak the corn or wart
in warm Avater, dry it, and touch it with some of this mixture; in a min-
ute or two  a portion of the  corn or wart can be removed by a common
penknife without cutting.   Then apply more of the mixture, and con-
tinue doing so until it is all removed.  After this, spread some brown
Soap in which some Camphor  has been mixed, on a soft piece of buck-
skin, and Avear this over the  corn for some Aveeks, renewing it every
day.  Tight shoes must not be worn.
  2. Manganic Acid also  destroys corns and warts very effectually.
  3. Melt together tAvo ounces, each, of YelloAV Wax and Gum Ammo-
niac ; remove  from the fire, and add six drachms of Verdigris as they
are cooling.  Apply this plaster on  a piece of  linen or soft  leather.
This is good for corns.  The corn must be  rasped away with  a file or
pumice-stone,  as much of it  as possible,  before applying the salve.
Renew it every  two Aveeks till cured.
  4. The bark of thc common WHIoav burned to ashes, and then mixed
Avith strong Vinegar, will, Avhen applied to them, remove all corns and
warts.
                             Bunions.
  A hard and painful swelling at the great toe joint, making this joint
much larger than natural.    The pressure of the shoe  is apt  to cause
pain and inflammation.
  Treatment.—When  there  is inflammation, soak  the foot in Avarm
Avater frequently, and, at other times keep it raised  resting on a chair.
The  shoes must  not be tight, and every night a  plaster  should be worn
upon the joint, composed of  Extract of Stramonium, in Avhich has been
rubbed the  folloAving: Glycerine two  drachms, Iodide of Cadmium one
drachm;  mix  and  rub together, and add  to half an  ounce of the 
HOUSEHOLD DEPARTMENT.
16b
Extract of Stramonium.  The  shoe or boot worn should always be
so made as to exert no  pressure Avhatever upon the  bunion while
walking, having, as it were, a separate apartment or hollow place for
thc toe.   By  persevering in this  course, the bunion will slowly pass
away, Avhen ordinary shoes may be worn, but they should never be toe
tight.
                   Mortification or Gangrene.
   (See Division  I, pages 551  and 552.)
   1. Mix together, in fine poAvder, one ounce of Flowers of Sulphur,
and two  ounces, each, of Alum and Gunpowder;  mix a teaspoonful of
this in Vinegar, and apply to the  part, repeating it every two hours,
until the mortification is  stopped.  At the same time, take as much
of the  powder internally as will lie  upon a dime—taking it in cream,
and repeating it several times  a day.
   2. Make a Bread and Milk poultice, to which add Charcoal, in pow-
der, and some White Vitriol, dissolved in Avater.
   3. Take of  Wild Indigo leaves,  black or Pussy Willow root,  Devil's
bit, each, a handful.  Make a strong ooze or decoction, and add it to
some poAvdered MarshmalloAV root to form a  poultice.
   4. Take of  clean wood Soot four ounces, Vinegar two pints,  boil
for two hours, strain, and add Tincture of Myrrh half a pint, Tincture
of Red Pepper a gill;  form this into a poultice Avith equal  parts  of
Slippery Elm bark and  Charcoal, and apply to the parts both before
and after thc mortification has  actually commenced, changing it three
times a day.
   In cases of mortification, the system  should be sustained  by tonics,
stimulants, and nourishing diet.   When gangrene has actually occurred,
the above agents Avill effect no further benefit than to lessen the stench,
unless they be placed in contact with the healthy, living tissue, beneath
the mortified part—though they may aid in hastening the  dead from
the living part.  When the mortified  part separates and passes  off,
treat the ulcer Avhich  remains, in the  same manner as an  ordinary
simple  ulcer.
                              Piles.
   (See  Division I, pages 595 to 597.)
   1.  Take  four ripe Buckeyes or  Horse Chestnuts, while still fresh,
carefully remove the outer brownish shell from them, and slice them
up finely.  Put them into a tin  cup with a sufficient quantity of melted
Lard to cover them, and let them steep near a fire for one hour.   Then
strain and press out the Lard, and  Avhen cool it is fit for use.   A por- 
166
AMERICAN FAMILY PHYSICIAN.
tion of this ointment must be applied to the pile tumors and within
the lower bowel twice every day.
  2. Take of Stramonium or Jimson leaves, inner bark of Shell-bark
Hickory, each,  a handful;  boil  in water till all the  strength  of the
plants is exhausted, then  strain, and add to the decoction, Lard one
pound, Beeswax four ounces; simmer over a hot fire  till all the Avater
has passed off  in steam.   Then add Flowers  of Sulphur one  ounce,
powdered Alum  a table-spoonful, and stir till cold.   Apply a small
quantity  to the  part, and within the bowel, three times a day.
  3. Take of  poAvdered Galls  one ounce,  Sweet Oil half an  ounce
White Wax an  ounce;  melt them together, and when  cold make them
into pear-shaped  bougies  of suitable size, and wear one  Avithin the
bowel, renewing it ahvays after  stooling.
  4. Take of  Mullen  leaves and Tobacco a handful, each, Lard one
pound; boil till all the strength  i3 extracted, then press out and strain
the Lard, to which add two table-spoonfuls  of Alum, in powder.
  5. A very excellent  preparation for piles, whether blind or bleeding,
is made of Pumpkin-seed Oil, Oil of Fireweed, Oil of Horsemint, and
Linseed Oil, equal parts;  mix.   To  be rubbed  upon the parts twice a
day, and  a piece  of lint or cotton  anointed with it, and worn  over the
fundament.
  6. Rub together in a mortar, or china bowl, two drachms of Tannin,
six  grains of Sulphate of Morphine, and tAvo drachms of Glycerine;
when well mixed, add one ounce of Lard, and mix thoroughly.  To be
applied to the part, two or three times a day.

                         Blistered Feet,
From walking  too much.    Take  of Burgundy Pitch  two ounces,
Beeswax half  an  ounce, Lard, or Sweet Oil, a table-spoonful; melt
together  and strain.  Spread some of this on cotton batting, and apply
to  the  soles of the  feet;  it may be worn in the boot or shoe while
walking.   To relieve the pain and aching of the feet  and ankles from
walking,  pour  cold water on them  every night and morning, and, if
possible,  also at noon.

                            Chafings.
  Bathe  the parts two or three times a day with cold water, dry, and
powder upon them some poAvdered Calamine or Starch.  If this does
not answer, use the salve above  named for blistered feet   (See Divi-
sion I, page 615.) 
household department.
167
                           Hoarseness.
  1. Take Nettle roots, dry them in an oven, pulverize, and mix them
with an equal quantity of Molasses.  Take a teaspoonful two or three
times a day.
  2. Boil a large handful of Wheat Bran in a quart of water; strain,
sweeten with Honey, and sup  of it frequently.
  3. Take of Horseradish root, Boneset leaves, each, an  ounce;  hot
water one pint; mix.   Steep near a fire in a covered  vessel for  two
hours, add half a pint, each, of Vinegar and Molasses, and simmer for
fifteen minutes.   Dose,  a  table-spoonful every one, two,  or  three
hours.
  4. Take three parts of Green Comfrey root, one part of Wild Tur-
nip, and one part of Skunk Cabbage root.    Grate  all into some
Honey, or Molasses, and take  a teaspoonful three or four times a day.
  5. Add five or six drops of Nitric Acid to a glass of sugared water,
and take this dose twice  a day for  five or six days.   This is useful for
the hoarseness of singers and  public speakers.   If, from use,  the acid
seems to lose its original  effect, it  may be increased  to ten or twelve
drops.
                       Rupture  or Burst.
  (See Division I, pages 601 to 604.)
  Treatment.—The only  sure  cure for a rupture, is to return the pro-
truding gut as soon as possible, and then Avear a proper kind of truss
to keep it in  place.  If the gut can not be returned,  no truss  must be
worn.   If the gut be not returned, there is great danger of death to
the patient,  from its becoming strangled, and mortification ensuing in
consequence,
  Mr. William Z. Rkes, No. 71W. Sixth Street, Cincinnati, Ohio, makes
excellent trusses, suitable for all kinds of Rupture.

                      Stunning from  Blows.
  Stunning, or severe concussion of the brain, is most commonly  the
result of falls, blows, kicks,  or other external violence upon the head.
There  is a total  insensibility, loss  of motion, difficult  breathing, cold
extremities, contracted pupil of the eye, and intermitting pulse.
  After a longer or shorter time, there is sickness, perhaps vomiting;
the  pulse and breathing become better, and the  extremities become  a
little warmer, though the  patient, notwithstanding he has some  sensi-
bility, as manifested Avhen his  skin  is pinched, lies  in  a stupid  state.
As  he recovers from this state, inflammation is apt to come on.
           til 
168
AMERICAN FAMILY PHYSICIAN.
   Treatment—Place the patient in a warm bed, and apply cloths wet
 with hot water, over the region of the heart and stomach, changing
 them frequently, and gently rub the legs and arms, and slightly beat
 the  soles of the feet.   As soon as  he  begins to  recover, some warm
 drinks, as Catnip, Balm, Marshmallow, etc., may be given, but no stim-
 ulants of any kind, lest they should render any  inflammation, which
 may come on afterward, much worse; and, as soon as possible, a cathar-
 tic should be given.   If inflammation of the head, or part injured
 comes on, treat the  same as named under the head of Inflammation of
 the particular part.  Any bruised places  must be treated the same as
 named in Division I, page 554.
   If some portion of the skull has been  fractured by the blow or in-
 jury received, it causes what is called compression of the brain, in which
 there are the same  symptoms as in the preceding one of concussion,
 except that the breathing is noisy or snoring-like, and the pupil of the
 eye  dilated.
   In this ease, the surgeon must  be called  in to raise the depressed
 portion of the skull, which, when effected,  is generally followed  by
 sickness.
                   Foreign  Bodies  in the  Ear.
   (See latter part of Deafness, in Division I, pages 490 and 676.)

                   Foreign Bodies  in the  Nose.
   (See Division I, pages 615 and 616.)'

                Foreign Bodies  in the Windpipe.
   (See Division I, pages 615 and 616.)

                  Suffocation from Drowning.
   Whenever a person is suffocated, from any cause whatever, it ia
 termed, "Apparent Death," "Suspended Animation," or "Asphyxia."
 This condition may be caused by remaining under water for some time;
 by hanging; by inhaling  the carbonic acid vapor  from burning char-
 coal, or other noxious vapors ;  by a stroke of lightning;  or, by intense
 cold.
   In case of droAvning,  the death is  not caused by water entering the
lungs, for this does not happen until the person is actually dead, but by
the absence  of air: no oxygen is received into the lungs to consume
the carbonic  acid gas thrown off from the blood in these organs, this
fluid becomes filled Avith the gas, Avhich acts like  a poison, paralyzing
the nervous  system, Avk'-.h vt?u)ts in immediate insensibility and death. 
household department.
169
 As a general rule, persons who have been in the Avater as long as twenty
 minutes, may be resuscitated; and some few instances of recovery have
 occurred where the submersion continued for half an hour.
   In all cases of Asphyxia, returning life is discoverable by the symp-
 toms of sighing, gasping, tAvitching, slight palpitation or beating of the
 heart; and when these appear, our efforts should be redoubled.
   Treatment.—Thc following is  the  usual  course pursued in cases of
 apparent death from drowning:
   1. Treat the patient instantly, on the spot, in the open air, exposing
 the face and chest to the breeze, except in severe weather.
   2. To clear the throat, place the patient gently face downward, with
 one wrist under the forehead; in which position all fluids  will escape
 by the mouth, and the tongue itself will fall forward, leaving  the en-
 trance into the windpipe  free.   Assist this operation by  wiping and
 cleansing the mouth.
   If there be breathing, wait and watch;  if not,  or if it fail, then,
   3. To excite breathing, turn the patient well and instantly on his side,
 and,
   4. Excite  the nostrils with Snuff,  Hartshorn,  Volatile Salts, or the
 throat  tickled with a  feather, etc., and dash cold water on the  face,
 having previously rubbed it warm.
   If there be no success, lose not a moment, but instantly begin
   5. To imitate breathing, by replacing the patient on his face,  raising
 the chest or breast well, and  supporting it on a  folded  coat or other
 article of dress.
   6. Very gently turn the body on the side, and a little beyond, and
 then bring it quickly back  upon the  face, repeating  these  turnings
 deliberately, efficiently,  and perseveringly,  about fifteen  times  in the
 minute, or one turn  back  and forth  every  four  seconds, occasionally
 varying  the  side.   (These motions  produce  artificial  breathing; for
 when the patient is placed upon his  breast or face, the weight of the
 body compresses the  lungs,  and expiration,  or an expelling  of air
 from them, takes place;  and when he is turned on the side, this press-
 ure is removed, and inspiration occurs, or a rush  of air into  the  lungs.)
   7. Every time  the body is replaced upon the face, make regular but
 efficient pressure, Avith  brisk movements,  on  the back  between and
 beloAv the shoulder-blades on each side, stopping or ceasing to continue
 the pressure  immediately before turning the body on the side.   (This
 upAvard gliding pressure aids  in expelling the air from the lungs; by
ceasing it, the air  commences to again  enter  them.  The result is
natural breathing, and, if not  too late, life. 
170
AMERICAN FAMILY  PHYSICIAN.
   8. After breathing has been  restored, promote  the  warmth of the
 body by the application of hot flannels, bottles or bladders of hot water,
 heated bricks  or  stones, etc., to the  pit of the stomach, the  armpits,
 between the thighs, and to the soles of the feet.
   9. To induce circulation and warmth, do not cease rubbing the limbs
 all this time upward, with firm, grasping  pressure, and with energy,
 using  handkerchiefs, flannels, etc.  (This rubbing upward causes the
 blood  in the veins to flow toward the  heart, and  should be done by
 assistants.)           ^
   10.  When the limbs are thus warmed and dried, clothe  the bidy—the
 bystanders supplying the garments.
   On  the  restoration of life, a  teaspoonful of Avarm Avater should be
 given; and then, if the power of swallowing has returned, small quan-
 tities of warm  Coffee, Ginger tea, Wine, Brandy and Avarm water, etc.,
 may be given.  By  pursuing this treatment perseveringly and ener-
 getically for several hours, many persons have been resuscitated; it is
 a mistaken opinion that death has occurred because life  does not make
 its appearance  in half an hour or an hour.
   Cautions to the bystanders.—1. Send at once for a physician, and for
 dry  clothing.   2. Avoid all rough usage,  and be very careful not to
 turn the body on the back.    3.  Do not hold up the body by the feet
 for any reason.  4. Do not roll the body on barrels.  5. Do not rub
 the body Avith Salt or Spirits.  6. Do  not inject Tobacco Smoke, or an
 infusion, into the bowels.  7.  Avoid the continuous warm bath.  8. Be
 especially careful to prevent persons croAvding around the body.

                         Another Method.
   The above is Marshall Hall's uReady  Method"—the following is
 the "Silvester Method:"
   1. Place the  patient on his back, Avith the shoulders raised and sup-
 ported on a folded article of dress.
   2. In order to keep up a free  entrance  of  air into the lungs, draw
 the tongue forward, and keep it projecting  out of the mouth  beyond
 the lips; it may be held in  this  position by the teeth if  the lower jaw
 be raised.    /
   3. To  imitate the movements  of breathing, raise the  patient's arms
upward by the sides of his head, and  then  extend them gently and
steadily upAvard and forward for a few moments.   (This action in-
duces inspiration or the passing  of air  into the lungs, by enlarging the
capacity of the chest.)
  Next, turn doAvn the arms, and press them  gently and firmly for a 
HOUSEHOLD DEPARTMENT.
171
few moments, against the sides of the chest.   (This produces a forced
expulsion of air from the lungs.)
  Repeat these measures alternately, deliberately, and  perseveringly,
fifteen times in a minute, keeping up all the time, by means of assist-
ants, the rubbing upward of the limbs  and body, as named in the pre-
ceding method, section 9.  This is considered the best method.
  Upon the return of life, adopt the same means as named in the first
method above referred to of Marshall Hall.

                   Suffocation from Hanging.
   Treatment—Instantly cut the person down, remove all clothing from
around the  upper part of the body,  and make use of the  same means
to re-establish the breathing as mentioned  above, in  " Suffocation
from droavning."

 Suffocation  from Burning Charcoal or  other Noxious Vapors.
   Treatment—Remove  the  person at once into  the  open air, and
sprinkle cold water upon the face and head, and, in some cases, it may
be dashed upon the face  and  over the whole  body;  and  hold  strong
Vinegar under the nostrils.   But in cases where the suffocation has
been produced by the breathing  of carbonic acid gas from burning
charcoal or otherwise, the best thing to be held to the nostril is a bottle
containing  a solution of  Chloride of Lime, or Chloride of Soda; or a
cloth may be moistened with one  of the solutions  and used;  continue
to hold it under the nostrils until the patient has thoroughly recovered,
and  do not AvithdraAV it  too  soon.   Make use of  the  means  recom-
mended for " Suffocation from Droavning," to restore  breathing, and
as soon as  the patient can  swalloAV, give  some Vinegar and water, or
Lemonade.   If Oxygen  Gas can be procured it should be forced into
the patient's lungs.

              Apparent Death from Intense Cold.
   Treatment—Be careful about employing Avarmth too soon, as its too
quick and free application will undoubtedly produce mortification, and
endanger life.   Rub the body all over, at first with snoAv or very cold
water, continuing this for from  twenty to  thirty minutes, or until it
becomes very red; then Avipe it perfectly dry, and let it be rubbed with
the warm hands of several persons at  one time.  After this  has been
done for a  short time, remove the body to a cool room,  continuing the
friction, and then covering with cold  flannel.  To restore breathing,
make use of the same means as recommended in  " Suffocation from 
172
AMERICAN FAMILY PHYSICIAN.
Drowning."   This course should be pursued for several hours, perse-
veringly, without any relaxation of exertion, and as soon as the patient
can swallow, a little lukewarm water  and Wine,  or Red Pepper, or
Ginger tea, may be given him.   Be careful not to bend a joint of the
patient while he continues stiff with the cold, lest  it be broken.

                Apparent Death from Lightning.
   Treatment.—Immediately throw cold Avater over the head  and along
the whole course of the backbone, repeating it several times.   Restore
breathing by the means named under " Suffocation from Drowning;"
rub the body and limbs upward, Avith stimulating  liniments, and give
stimulants internally, as  soon as the patient can swallow, as Whisky,
or Brandy and water, etc.

                            Starvation.
   Treatment—In  cases  of  starvation, persons  must  not be fed too
freely at first, as it will cause death.   If the patient does not breathe,
inject small portions of Milk, Beef tea, Mutton broth, etc., into the
bowels.   And as  soon as he can swallow, give  him a  teaspoonful of
some light  nourishment  at first,  as  Toast-water, Rice-water, Barley-
water, Milk, etc.,  repeating  it every ten or fifteen minutes—and, as
he improves,  Meat teas, with or without Wine, may be given in small
quantities, as he craves it.  The  rule is to feed a very little  at once,
and at certain regular times—the great danger is giving too  much at
a time.
                         Clothes on  Fire.
   Whenever one's clothes are on fire, great presence  of mind is re-
quired in order to  save  life.   The person should, at  once, lie  doAvn
upon a carpet, rug, blanket, cloak, or  anything handy, and cover her-
self up tightly with it, so as to smother the  fire; and she may also
call for help after this is done, if there is no blaze near her mouth.
   If she runs, she fans  the blaze thereby, and  makes it worse—it
rapidly ascends to her vital parts, and  if she screams  she inhales the
blaze, which is pretty certain to kill her eventually.  The  only course
for any one  to pursue, is, as already stated, to wrap themselves up
tightly  and then lie down upon the floor—this puts out the blaze and
prevents  it from reaching the mouth.
   If parents would impress upon  their children the  importance  of
this  course, and  if females would  accustom  themselves to  talk and
think about it, as the best and only plan of safety upon  such occa- 
HOUSEHOLD DEPARTMENT.
173
eions, they would all adopt it at once, instinctively, and  many a life
would be thereby saved.

                    To KEEP FROM DROWNING.
  Hold the breath, and keep the mouth shut as much as possible;
throw the head  backward, and then endeavor to sink the rest of the
body, by keeping the feet down as much  as possible, throwing out the
chest and pushing the arms downward, as if to touch the bottom of the
river; or, in other words, keep the head  up  and above the water, and,
at the same time, keep the  chest, body, legs, and  arms under water.
A person who does not know how to swim, and can have sufficient
presence of mind to pursue this course, can not sink.

                            Poisoning.
  In addition  to those named in Division I, pages 616 and 617> I wiH
give the following:
  Poisoning by Verdigris.—Use the white of Egg, the same as recom-
mended for poisoning by Corrosive Sublimate, Division I, page 616.
  Poisoning by strong Ley or strong Ammonia, is best treated  by Vin-
egar or Lemon juice.
  Poisoning by Strychnine.—Give freely of Sweet Oil or Lard  Oil, and
Camphor.
                        Bites  of Insects.
  (See Division I, pages 555 and 556.)
  For bites or stings  of fleas, bees, mosquitos,  wasps, spiders, etc.,
the following may be applied to the part:
  1. Tincture of Arnica.
  2. Strong Avater of Ammonia.
  3. Ley water.
  4. Put tAvo table-spoonfuls of Sulphur into half a pint of boiling-hot
Whisky ;  when cold, the parts bitten may be bathed with it.  It is one
of the best things in use to  allay the unpleasant symptoms caused by
the bites of insects.
  5. The expressed juice of  the common  Plantain leaves,  is an effect-
ual  antidote to the bite of venomous spiders.   Apply some of the juice
to thc wound, .and take about a gill of  it  internally;  or, chew the
leaves.
  6. Take of  Olive Oil,  and strong  water of Hartshorn, each, fifteen
parts,  Spirits  of Turpentine, and Lauddtaum, each,  one part;  mix.
This allays the itching and swelling  produced by the bites of musqui-
tos  and other insects. 
174
AMERICAN FAMILY PHYSICIAN.
  7. Take equal parts of GunpoAvder and common Salt, moisten t?iem
with strong Vinegar, and apply to the bites of gnats, bees, wasps, etc.
  8. Mix Pipeclay with water, to the  consistence of paste, and apply
as a poultice, frequently renewing it.   This is good for the stings of
bees, felons, sprains, etc.   (For Bites of Snakes, see Division I, pages
555  and 556.)
                   Rush  of Blood to the  Head.
  Rush of Blood, or Determination of Blood, to the  head, as it is more
generally called, is a very troublesome symptom, and is generally due
to weakness.  There is a constant unpleasant sensation in the head
sometimes amounting to soreness or actual pain; on  taking even slight
exercise, there is  a dizziness of the head, a blurring of the eyes  and
on stooping over these symptoms are still worse  : the face becomes red
pain is produced in the head, and the dizziness is so great that some
seconds will  elapse before the patient  can properly observe anything.
It is not an uncommon result for the patient to fall over while stooping.
   Treatment.—As  this symptom, if permitted to continue, may produce
a serious result, the«patient should pay particular attention to himself.
He must keep his bowels regular, by food, if possible;  but if this can
not be done, then small doses of  Rhubarb should be used, enough to
produce one healthy evacuation daily.   The skin must be bathed every
day, drying with  considerable friction; and if the  patient be of full
habit, he should take a Spirit Vapor-bath once  in every week or two.
A cold foot-bath should be used every night  for ten  or fifteen minutes,
and several times through the day, especially when the head symptoms
are severe ; the head should be bathed  with cool or rather tepid water.
The  patient should avoid stooping over as much as possible: aud every
day  should take  moderate and gentle exercise, increasing  it as his
strength and freedom from the rush of blood to the he?.d  will permit.
Internally, good, nourishing diet, and the use o£ tonics, such as those
recommended under Dyspepsia, page 132. 
HOUSEHOLD DEPARTMENT.
175
WOMAN  AND  HER DISEASES.
   In the preceding pages of this Division of the Physician, under the
 head of General Diseases, I have only treated upon those maladies
 Avhich are common to both sexes.  At this place, I will take up those
 complaints which are peculiar to females, making known such remedies
 therefor as are easily obtained, whether in city  or country places.
 Probably there is  no part of my work from which so much benefit will
 be derived, as from  the present.   The correct management of female
 diseases is a very important and momentous subject, and I enter into
 an exposition of it Avith feelings of great anxiety, in consequence of the
 heavy responsibility resting upon me.
   When we revieAV the dark history of the past, and behold the fairest
 gift of Heaven to man, suffering and pining away from disease, even in
 the midst of blooming and lovely youth, Ave are almost led to  weep at
 the fearful scene,  and with  a sad and trembling heart turn from the
 picture before us.   It recalls to mind  that lovely and joyful sister,
 who, in thc midst of apparent  health—Avhile everything around was
 full  of happiness and smiles—Avas suddenly stricken  down with some
 fatal malady; avc  remember her kind  and patient  endurance,  and the
 mental anxiety and hopeful  feelings Avith Avhich we watched each mo-
 ment's  progress  of  that sIoav,  but, alas, too fatal disease:  and we
 tremble and become  heart-sick at the recollection.   But where is that
 dear  sister now?  We hope, in that place where sickness and  death
 can not enter.  Her dying farewell, her last-expressed wishes and de-
 sires, are indelibly impressed upon our minds.
   Again, Ave survey the melancholy past: that young, lovely, happy,
 and  confiding wife comes before our mental vision  with all the vivid-
 ness of reality.   Time can never blot from memory  those days of bliss
 and happiness, Avhich delighted our  young hearts, so closely bound to-
gether with all the tender ties of youthful love and matrimonial fidelity,
 and in which Ave looked forward to a  bright and joyful  future.  But
those days  of innocence, of  purity, of beauty, of strong affection, of
aspiring hopes, and agreeable  anticipations, have now become the  sad
and melancholy past;  and the  pleasing recollections of them are poi- 
176
AMERICAN FAMILY PHYSICIAN,
 soned and  turned into gall  by the knowledge  of  their sudden and
 mournful termination.
   That little pledge  of affection,  whom death  has deprived of the
 motherly care its age  and nature so much requires, seems to realize its
 sorrowful condition.   Its eye wanders from face to face; at every new
 voice it starts, and listens, and sinks into disappointment; its mother is
 no longer upon earth;  she has gone into the land of spirits, and her
 last blessing still  sounds in its tender ear.  How dreary is that home
 where love, joy, and  happiness once reigned supreme.
   These  are  no imaginary pictures, but are  fair representations  of
 every day's experience.   Ask that bereaved  father, or husband,  or
 brother, or son; he will tell you that they are true, indeed too  true.
 Visit your lonely cemeteries and burial-places, and on those white but
 silent sentinels, over  the remains  of loved and departed friends,  read
 the tale which their inscription unfolds.  You will soon learn from them
 that the greatest proportion of females have died between the ages of
 sixteen and thirty-five—having fallen victims to death at this early age
 from the  want of a correct knowledge of those  subjects which are so
 intimately connected  with  their health, happiness, and life, and  con-
 cerning  which  there  is  so  much  false delicacy among mothers and
 female guardians.
   May I  not then, with propriety, urge upon fathers and mothers,  hus-
 bands and wives, the  great  importance,  nay,  the vital necessity, for
 procuring a suitable work for the perusal of those who are under their
 care and  protection, treating upon those matters more especially  con-
 nected with their sex.   A sense of delicacy prevents mothers, in most
 instances, from having free conversation with their daughters upon
 these subjects ;  and even were it otherwise, there  are few mothers fully
 prepared  to give all the necessary information, because  of the  scarcity
 of suitable books among  the people upon the subject of female health
 and disease.
   I can truly  say, from an extensive  and successful practice among
 them, that many of the difficulties of the female organs  can be readily
 cured if properly treated at the beginning; and it is a  matter of con-
 siderable astonishment that so many inestimable women, whose healths
 and lives are of so much worth and importance to their friends and fami-
lies, should, from a feeling of mistaken delicacy, postpone attending to
their  complaints, until they  become  severe,  and  obstinate or unyield-
ing.  It is well  understood  among all virtuous and sensible Avomen of
the present day, that the  examinations which are  strictly necessary  in
the detection of the diseases  peculiar to their sex, are  not indelicate, 
HOUSEHOLD DEPARTMENT.
177
neither do they tend to produce immorality or licentiousness; and no
right-minded woman will object to those examinations which a physi-
cian of good standing in society and in his profession, may propose.
  There  is one thing I would  refer to here, which is that two-thirds
of the diseases  of women, are due to  excessive  sexual  indulgence.
Men hate to have sickly wives, sickly children—they grumble exceed-
ingly at  the physician's bills, yet will not only keep their wives and
daughters indoors and at work nearly  all the time, not allowing  them
sufficient exercise in the open  air, but, among the married, they  treat
them as if they were mere machines to administer to sensual pleasures
at their husbands' wills.  Should a physician, among other  things, pre-
scribe exercise, the reply is, that the wife or daughter has plenty  of it,
as she does  all the cleaning, washing, and domestic matters  of the fam-
ily—forgetting that  this is not exercise, but labor, and  hard labor at
that.
  " Probably, in no condition do females suffer so much, or become so
subjected to disease and premature decay, as in the  married state; and
this, not because ill health follows as a  necessary result of wedlock, but
because of the excesses to which they are obliged to submit, under the
guise of legality and duty.  A female, who unfortunately  contracts a
matrimonial alliance  with a merely animal, sensual man, is  much to be
pitied.  She is looked upon and treated as a mere plaything, a machine
to administer to his pleasures, independent of her own natural desires;
right or wrong, she must be passively submissive.   It matters not how
much her constitution is undermined thereby,  or  whether disease or
death is  to be the consequence—she is his wife—duty demands of her
submission to her sensual master—the law gives him absolute control
—she must obey.  Her matrimonial life, instead of being  chaste, and
one  of true happiness, is a life of secret lust and degradation;  and
though compelled to learn and undergo lasciviousness in all its shame-
ful  forms, yet it is required of her to cultivate and maintain mental
purity, modest deportment, virtuous principles, and an immaculate rep-
utation.  Nor is  it permitted her to make use  of exercise, and other
means, to reinvigorate the  nervous system, to  oxygenize  and reviv-
ify  thc  blood, and to  strengthen the digestive apparatus, all of which
become  seriously impaired by excessive  sensuality,—at least, without
being subjected to unjust  suspicions,  sneering  remarks, and unkind
ridicule.
  " It is true that, occasionally, females  of excessive animal propensi-
ties are  met with; but their proportion is small  when compared with
the whole sex;  and even these  suffer from constant and unnatural ex- 
178
AMERICAN FAMILY PHYSICIAN.
cesses.   But the principal error, the  root of all the evil, lies in the
early education of the female,  who is trained  from infancy to please
the opposite  sex, to attract their notice and admiration, to rely upon
them as protectors and superiors, and to prepare herself for the slavery
degradation,  and dangers of an  unchaste Avedlock.
  " Is it then to be wondered at that we find disease so common amon»
                                                                 o
women, as fallings of the Avomb, derangements  of the menses, diseases
of the  womb, nervous  debility, and irritability, etc.; or that the off-
spring  are feeble, diseased, imbecile, or deformed, and frequently dying
during the first months of their existence ?  And though sexual abuses
are certain to terminate in a series of evils, these become  more de-
plorable Avhen their cause is persisted in  at improper times, as  during
pregnancy and the suckling of infants.  Man appears willing to pro-
cure his own enjoyment,  even at the  sacrifice  of  the health and life
of his   helpmate,  and  the  deterioration  of his offspring;  but Avhen
disease  and its  accompanying expenses are presented to him  as the
legitimate results of his folly, he complains loudly,  censures his Maker,
exclaims  against  Fate, upbraids his  wife,  condemns everybody and
everything as  the cause of  his misfortunes;  but  seldom  prefers to
investigate his own doings, to learn if his own disregard of the laws
of nature is  not the sole origin of all his grievances.   It  is a great
misfortune for the  human race, that the idea has been popularly sanc-
tioned that excesses in sexual duties are  indications  of manliness and
true affection—while, on the other hand, woman's love is judged of by
her ready and  implicit obedience to all  the lustful  desires  of a lasci-
vious husband.
  " Many of the diseases peculiar to the female sex are not only pro-
duced but perpetuated by the continuance of the above-named cause;
and it is frequently the case that a curable malady  is prevented from
being cured by a persistence in sexual intercourse Avhile the female is
undergoing medical treatment.   And  such we must  expect  always to
be the  case, until man  learns to  use  that principle  which makes him
superior to the brute creation—the mind—through which he  will ascer-
tain the correct  laws  of nature relative to the important function of
reproduction, as well  as the inevitable consequences of transgressing
those laAVS, and  thus be led to control and overcome  all improper or
unhealthy propensities; and to look upon woman as an  equal in all
respects, though fitted for a sphere different from  his own, and  not
requiring her to sacrifice health, happiness, and even life itself, merely
to gratify his oavu selfish, libidinous desires, under  the cloak of legal
rights and matrimonial duties—terms, Avhich on such occasions are mere 
HOUSEHOLD DEPARTMENT.
179
 mockery and insult."  (From the author's  large work on Diseases  of
 W<> i uen.)
   Should the information I am about to impart be the means of bring-
 ing relief to even a few  of  the many fair sufferers  throughout the
 country, it will  richly repay me  for the untiring labors and extensive
 researches in these matters, which I have imposed upon myself for th«
 last fifteen or twenty years.

                 What  Young Girls  should know.
   At the age of  thirteen or fourteen, every girl  should be made  to
 knoAV that:
   1. At about her fourteenth year a  change Avill take  place in her
 system; sometimes a little earlier  than this age, sometimes later.
   2. That this  change consists  in a bloody discharge  which proceeds
 from  her private  parts, and which may, at first, be preceded by pains
 in the back, headache, dizziness,  drowsiness, etc.
   3. That this discharge  in a healthy female comes on regularly once
 in every four Aveeks,  and lasts each time from three to  seven days.
   4. That various names are given  to this discharge, as "courses,"
 "flowers," "change," etc., but that the best terms to  describe it are
 "the menses,"  or  "menstruation," or " catamenia."
   5. That the  derangements to  which this discharge is liable, from
 neglect or carelessness, may lead to the most fatal consequences.
   6. That this discharge is an indication  that the female  is  capable
 of bearing children.
   7. That when this  discharge is upon  them, they should wear a cloth
 or diaper to prevent  it from soiling their linen, or from trickling down
 upon  their feet.
   8. That about the time  this  discharge is expected, or during its pres-
 ence, they should  be  very careful about exposing themselves so as  to
 catch  cold, and especially should they avoid bathing their persons  in
 cold water.
  9. That they  should not run, jump,  or exercise  much in any other
 way, Avhile this discharge.is upon them.
  10. That this discharge is subject to  disease or derangements, from
 various causes ;  as, it may be suppressed, or not appear at all; it may
 be too  profuse ;  or, it may be attended  Avith more or less pain.   De-
rangements Avhich  will be considered hereafter.
  11. That high-living, indolence,  over-stimulus of the mind, use of
strong  drinks, too much exercise,  excessive fatigue, etc., Avill also cause
derangements in this  discharge. 
180
AMERICAN FAMILY PHYSICIAN.
   12.  That there is also another discharge to Avhich Avomen are subject
which  is an indication of disease or Aveakness, and which is  of a whit-
ish or  yellowish color, or like water, and is called the " whites," or in
better  language, " fluor-albus," or " leucorrhea."
   13.  That from heavy lifting, straining, over-exercise, etc., the Avomb
is apt  to fall down from its  natural position  in the lower part of the
body, giving rise to what is termed " a falling of  the womb."
   14.  That in relation  to  all these  matters a female  can not be too
careful, as  a diseased condition  of the female organs  may  lead to a
whole  lifetime of suffering and misery.
   15.  That although a female may menstruate at fourteen, and  even
bear children, yet, in order to insure her future health, happiness, and
long life, she should not  marry until she has, at least, reached her
eighteenth  year.
   16.  That marriages earlier than this are apt to  be a source of much
unhappiness and disease in after life.
   17.  That exercise in the open  air is as essential to  the  health and
strength of a woman, as of a man.
   18.  That a healthy, clean  skin, good appetite,  and  regular bowels
are essential to the healthy  performance of  menstruation, and other
functions peculiar to the  sex, the derangements  of which I am  now
about to treat upon.   (See Division I, page 506.)

                      Absent Menstruation.
   In which Menstruation has not appeared at the  proper age, although
the female  suffers monthly from pains in the back, weight at  the lower
part of the body, dizziness, and  other symptoms.   (See Division  I,
pages  507  to 509.)
   Treatment—We must first ascertain whether the menstrual absence
be due to a want, or deformity, of any of the reproductive organs, to
a closure of the mouth  of the womb, or of the vagina,  etc., in which
cases a cure may sometimes  be  effected by a surgical operation.   If,
however, no difficulty of this  kind can  be  found, and the health of the
young  girl  continues good,  no treatment will be required.
   But  if the health  suffers, means  must be used to  strengthen the
general system, as, by proper exercise in the open air, bathings and
frictions to the body,  nourishing and digestible diet, and an  avoidance
of too  much laboi  of  body or mind.
   A day or two previous to the menstrual time, a Spirit vapor-bath
should be taken, and the feet and legs should be soaked for ten or fif-
teen minutes every night in a Avarm, Aveak ley-Avater, made pungent  by 
                      HOUSEHOLD DEPARTMENT.                  181

 the addition of Red Pepper, or ground Mustard.   And, at the time,
 should the female suffer much from pain, warm fomentations of Hops,
 Tansy, Pennyroyal, etc., may be  applied over the bowels, and some
 infusion  of  Raspberry leaves, Scullcap leaves, or Ladies'-slipper root,
 etc., be drank freely.
   Should these means fail  to bring on the menstrual discharge, then
 one of the  " female tonic bitters," named in the following difficulty
 Suppressed Menstruation, may be used.

                    Suppressed Menstruation,
 In Avhich, after the Menses have appeared, they have, from cold or
 other cause, become suppressed, Avith various symptoms accompanying,
 as, impaired appetite, pains in the back and side, debility of the system,
 etc.   (See Division I,  pages 509 to 511.)
   Treatment.—We must first be sure there is no pregnancy.  Then the
 patient must make use  of all the means heretofore  named for improving
 *he strength and vigor of her constitution, as regards diet, exercise in
 the open air, attentions to the skin, regularity of bowels, etc.  In  ad-
 dition  to these  one of the following " female tonic bitters " should be
 used to  give tone to the organs more immediately concerned in  the
 function  of menstruation; its use  should be continued perseveringly
 for some time.   The feet should be soaked at the menstrual period, as
 advised above in Absent Menstruation.
   1. Take of Smartweed, Wild Sage or Cancerweed, Vervain and Pen-
 nyroyal, each, (the fresh herbs,) equal parts.   Fill a jug or bottle with
 them, and then add as much Whisky as the  vessel will hold.  Let it
 stand a few days, frequently  shaking, when it  will be fit for use.  Dose,
 a table-spoonful three or four times a day, in half a gill of  sweetened
 water.
   2. Take of Horseradish root, Calamus root, Motherwort, Blue Co-
 hosh root, each, coarsely bruised,  an ounce, Whisky three pints; mix;
 let it stand ten  or twelve days, frequently shaking.  Dose, same as the
 preceding one.
   3.  Take of Blue  Cohosh root,  Horseradish root,  each, coarsely
 bruised,  an  ounce, Carbonate of Iron  tAvo  ounces, good  Cider one
 quart;  mix;  steep near  a fire for six  hours; when cold, SAveeten  if
 desired.  Dose, from a table-spoonful to half  a gill three or four times
 a day.
   4.  Take of Blue Flag root, Black Cohosh root, Prickly  Ash bark,
each, in  coarse powder,  an  ounce,  Copperas half an ounce, Whisky
three pints;  mix; let it stand for ten or twelve  days, frequently shaking. 
182
AMERICAN FAMILY PHYSICIAN.
 Dose, a table-spoonful three or four times a day;  if it  purges the
 boAvels, lessen the dose.
   5.  Take of Horseradish root, Yellow Parilla root, Sassafras bark,
 Chamomile flowers, each, half an ounce, Carbonate of Iron one ounce,
 Whisky a pint;  mix; let it stand ten or twelve days, frequently shak-
 ing.  Dose, same as the preceding  one, No. 4.
   All the above  preparations  are readily made,  and will be found
 superior remedies.  It is not  necessary, however, to be confined to
 these articles, as  there  are  many  others Avhich may be employed in
 various combinations with equal efficacy, as Feverfew, Rue, Tansy,
 Pennyroyal,  Savin leaves, Madder, Brook Lime or Water Pimpernel,
 Stinking Orache or Tall Goosefoot, Water Hemp or Water Agrimony,
 etc., which may  be used in decoction, or in the form of bitters, as above.

                      Painful Menstruation.
   The menstrual Aoav may be regular, scanty, or profuse, but there is
 more or less  pain, either just before it comes on, "while it is on, or for
 a short time after it has passed  aAvay.   The pain may be moderate or
 severe,  and may last for a day or  two.  It extends, sometimes, over
 the whole of the lower portion of the  belly,  to the  back and to the
 thighs.   Frequently, a thin membrane is thrown off with the blood in
 thin shreds or substances, having  a " skinny" look.  (See Division
 I, pages 511  to 513.)
   Treatment.—One of  the preparations given  below  will be found
 exceedingly valuable in the treatment of this distressing difficulty:
   1. Take of Pennyroyal a handful; steep in a pint of boiling water
 for half an hour; then add four teaspoonfuls of powdered  Cinnamon,
 and a heaping teaspoonful of powdered Borax;  when the Borax is
 dissolved, it may be sweetened.   Dose,  half a gill every hour  or two,
 until the menses come on  and the pain is relieved.
   2. Take of Gum Guaiacum, Water-pepper or Smartweed, Bloodroot,
 each, coarsely bruised,  an ounce, Mandrake or Mayapple root, bruised,
 half an ounce, Seeds of Stramonium or Jimson weed, bruised, two tea-
 spoonfuls, Whisky three pints;  mix; let it stand  ten or twelve  days,
 frequently shaking.  The dose  is from  half a teaspoonful to a tea-
 spoonful three times a day, continued every day, both during menstrua
 tion and the interval between, and persevered in until a cure is effected
   3. In many cases the following mixture, rubbed  on the neck of the
womb, three  times a day, or  even oftener,  will afford relief:  Take of
Extract of Belladonna one drachm, Glycerine or Lard  one ounce; mix,
and rub thoroughly together. 
HOUSEHOLD DEPARTMENT.
183
   In connection  with these medicines,  at  thc  time of the pain the
 patient must soak her feet in Avarm Avater, and apply cloths, wet with
 water as hot as can be borne, over the belly.  In some cases a Spirit
 vapor-bath will prove of great service.   (See Division I, page 698.)
   In all cases the boAvels must be kept open, using the following injec-
 tion in case it should be required to  remove costiveness:  Take of
 Lobelia leaves, Mayapple or Mandrake root, each, in powder, half an
 ounce, boiling Avater a pint; mix in a covered vessel, and steep near a
 fire for tAvo hours ;  then strain ; add half a pint of Molasses, two table-
 spoonfuls of Castor Oil, and half a teaspoonful of Red Pepper.  Use
 for one injection.
   When thc painful menstruation is caused by a wrong position of the
 womb, this must first be cured before the dysmenorrhea can be removed.
 When  it is  owing to  a narrowing of the neck of the womb,  that is, a
 strictured condition of the  canal which passes  through it, this must
 be overcome by the careful employment of  bougies,  as named in Divi-
 sion I, page 513.   Or, instead of bougies, tents of various sizes may be
 made,  of twine, or silk cord, etc., and, after dipping them in one of the
 folloAving preparations, be introduced into the canal of the neck of the
 womb, and be retained there by plugging up the vagina with soft pieces
 of old  muslin, etc.
   1. Take of Extract of Belladonna ten grains, powdered Borax forty
 grains,  Wax half an ounce;  melt  the  Wax,  rub in the Extract  and
 Borax, and when  cool dip in the tent; Avhen cold, but soft so as not to
 stick to the fingers, smooth it  by passing the fingers  over it.
   2. Take of Oil of Lobelia  ten  drops, Extract of Stramonium  ten
 grains,  burnt Alum forty grains, Wax half an ounce.  Prepare as above.
   3. Take of Extract of Belladonna ten grains, Iodide of Potash  ten
 grains,  Iodine five grains, Laid half a drachm, Wax one ounce; melt
 the Lard and Wax, rub in the Extract, then the Iodide of Potash, and
 lastly the Iodine.   Use the same as the above.
  In the introduction of these tents great care must be observed, and
 if they cause any unpleasant symptoms they must be removed, and  not
 be introduced again until all such symptoms  have passed away.   An
 intelligent  female is just  as capable of  introducing these tents as  a
 physician, if she only will attempt it.  They should  vary in size from
 that of a knitting-needle to that  of a g'oouequill, and about an inch and
 a half in length, ahvays beginning with the smallest first, and in every
 five or ten days  i'.icrea?mg the size.  A piece  of soft wood may be
 whittled doAvn to  the  size  of the little finger,  and  a hole be  made in
one end in  Avhich  to fit the tent.  Pass  one  or two fingers of the left 
184
AMERICAN FAMILY  PHYSICIAN.
hand up to the mouth of the Avomb, and then, with the other hand, by
means of the stick, and using the fingers of the left hand as a guide
carry the tent to the mouth of the womb, and slowly pass it in.  A
piece of thread may be previously fastened to the lower end  of the
tent, by which to remove it, when necessary, from the womb.

                      Profuse Menstruation.
   The menses occur regularly, but are too much in quantity, or last
for too long a time,  eight to twelve days or longer, causing paleness  of
countenance, debility, pains in the back and loins, etc.   Sometimes tho
menses come on every  two or  three  weeks,  instead of four.   (See
Division I, pages 513 to 515.)
   Treatment.—If the difficulty be owing to the presence of polypus in
the womb,  the only cure  is its removal.  If, in connection with the pro-
fuse discharge, there is too great a fulness  of habit, oppression of the
chest, heat, and thirst, a very mild and spare diet must be pursued for
several days, and no animal food be allowed.   The bowels should  be
kept regular by Seidlitz Powders,  which can be had at every place
where medicines are sold; and cloths  wet with cold water and Vine-
gar, may be applied to the belly, loins, and back, to  aid in checking
the  discharge.   Teas of Blackberry root, Bethroot, White Oak bark,
Witch Hazle bark, etc., may also be drank freely during the day.
   If, however, there is considerable debility of the system, invigora-
ting measures must  be used.  At the time of the discharge, one of the
following infusions may be drank freely, the patient being kept quiet
in bed:
   1. Take  of Yarrow and Shepherd's Purse, (CapseUa Bursa-Pastoris,)
each, a handful  of  the fresh plants; boiling water a pint and  a half;
mix.   Steep in a covered Aressel near a fire, for half an hour; Avhen
cold, give half a gill three or four times a day.  This will be found a
superior remedy.
   The Shepherd's Purse is a  plant found everywhere in fields, pas-
tures, etc., groAving  from  six  to  twelve  inches  high.    The stem is
nearly smooth in its upper part, Avith long hairs below, branching and
slightly channeled or furrowed.  The root-leaves are from two to eight
inches long, about one-fourth as wide, divided or  cut  into lobes, the
lobes only  being notched  or  toothed,  and the leaves on winged  or
expanded leaf-stalks;  these  leaves  are sometimes  wanting,  or only
notched when the plant is croAvded. The stem-leaves are much smaller,
very narrow, with  two small,  sharp, ear-shaped lobes at their base,
which half  clasp the stem.  The flowers are small, white, or many  on
• 
HOUSEHOLD DEPARTMENT.
185
one stem, on spikes from three to tAvelve inches in length.  The fruit
is a smooth, small pod, triangular, somewhat wedge-shaped, having a
small notch at the end, containing numerous seeds.
   2. Take of Blackberry root  and Bethroot, each, in coarse  powder,
one ounce, boiling water tAvo pints; mix.  Steep in a covered vessel
near a fire for an hour; Avhen cold, give half a gill four  or  five  times
a day, adding twenty  drops of Elixir of Vitriol to each dose.
   3. Take of Sage, Buglewecd or Water Hoarhound, and Crowfoot or
Alum  root, each, bruised, an ounce,  Red Pepper  two  teaspoonfuls,
boiling water three pints ; mix.  Steep near a fire, in a covered vessel,
for half  an hour.  When cold, give half a gill three  or four times a
day.   To each dose may be added as much poAvdered Alum  as will  lie
heaped upon a  dime.    In severe and obstinate  cases, a solution  of
Alum  in cold Avater may be  injected  into the  parts  by means  of a
female syringe, repeating it three, four, or five times a day, according
to the urgency of the case.
   During the interval  between the menses, the patient must make use
of every means to strengthen the system generally, as well as the
womb.   Good, nourishing  diet, regularity  of  the  bowels, moderate
exercise  in the  open air, sponging of the body  daily with cold water,
using  considerable friction in  drying, and the use of  the following
mixture:  Take of Wine of Spurred Rye, Tincture of Cinnamon, each,
equal parts;  mix.   Dose a teaspoonful three or four times a day, in
half a gill of Avater, in Avhich as much powdered Borax has been dis-
solved as will lie  on  a half-dime.   Or, twenty drops of Tincture  of
Muriate  of Iron may be given  three times a day, in half a  gill of  an
infusion  of equal parts of Cinnamon, Ginger, and Red Pepper.
   When there is much pain at the time of menstruation, the Compound"
Syrup of Partridgeberry, Division I, page 739, taken during the inter--
vals, will be found very beneficial.

                          Turn of Life.
   At this period the menses cease, and  the woman is  no longer capable
of begetting children.   Much care is required, however, to avoid  cold
and other exposures, excessive labor, and all circumstances which may
promote  or continue any symptoms of disease, as, at this period, the
constitution undergoes  a change, during which  there  is often a  ten-
dency to the formation of distressing  and obstinate diseases.   This
change generally occurs betAveen the forty-fifth  and fiftiethiyear.  (See
Division I, pages 515  and 516.)
   Treatment.—At this  period of life the woman should adopt a light 
186
AMERICAN FAMILY PHYSICIAN.
 diet, principally vegetable; she should keep her boAvels regular by the
 use of mild aperients, as, small  doses of Rhubarb, or a tea of Senna
 and Manna, etc., carefully avoiding purging  the boAvels too freely. The
 exercise should be  moderate.   Some tonic should be taken;  thc fol-
 lowing forms a very good one:  take of YelloAV Poplar bark, Dogwood
 bark,  Scullcap  leaves and tops, each,  in  coarse poAvder, one ounce
 boiling Avater three  pints; mix.   Steep in a covered vessel, near a fire
 for  four hours, strain, and  sweeten.  Dose, a table-spoonful four  or
 five times a day.    A  bitters may be made of  this by adding three
 pints of Whisky instead  of the Avater, and  alloAving it to stand ten  or
 twelve days.
   Where the menses cease suddenly, or the patient is attacked with
 headache, dizziness, a suffocating feeling, lights before the  eyes, etc.
 an active  purgative should be given, and  Mustard be applied to the
 feet and legs, and over the lower part of the backbone, keeping up the
 stimulation as long  as may be necessary.   The feet and legs may also
 be frequently soaked in Avarm water to Avhich Mustard or Red Pepper
 has  been added.   A very good purgative may be  made  by  adding
 about  six or  eight  grains  of poAvdered  Aloes to half a teaspoonful
 of powdered  Mandrake  or Mayapple root, and  as  much  Cream of
 Tartar as will lie upon a dime.  Mix for a dose, repeating  it in  four
 hours, if necessary.

                  Chlorosis  or Green Sickness.
   This disease is common to girls about the age of puberty, and more
 rarely is met  Avith among females more advanced in years, and is gen-
 erally associated with menstrual derangement, as a suppression.  The
 skin becomes  pale and greenish, or yelloAvish, Avith languor, depraved
 appetite, impaired digestion, costiveness, debility, indisposition to move,
 swollen feet, depressed spirits, ringing in the ears, acid stomach, etc.
 The disease  is  owing to  lack of nervous  energy, and deficiency of
 iron in the blood.   (See Division I, pages 516 to  518.)
   Treatment.—Arouse the poAvers of the system by horseback exer-
 cise, change of air and scenery, a very nourishing diet, sponging the
 body with tepid water, Avith frictions, cheerful society, etc.   If the girl
 is  going to school, she must be at once taken therefrom.   She may be
 averse to  exercise,  and  the  other measures  recommended, but she
must imperatively  be made  to  attend to them—her  life depends
upon it.
   In addition to these hygienical measures, medicines must be given
to  keep the boAvels open, to improve the appetite and digestive pow- 
HOUSEHOLD DEPARTMENT.
187
 ers, to give tone to the system, and iron to the blood.  To effect these
 purposes one of the folloAving preparations may be given:
   1. Take  of Mandrake or Mayapple  root, SmartAveed, Horseradish
 root, Golden Seal,  each, in coarse powder, or bruised, one ounce, boil-
 ing Cider four pints.   Mix, and steep  in a covered vessel for twelve
 hours; strain and  add Carbonate of Iron one  ounce.  Dose, a table-
 spoonful four or five times a day, to act gently on the bowels.   Shake
 it up avcII each time before using.
   2. Take of Blue Flag root, Prickly Ash bark, Gentian root, Colombo
 root, each,  in  coarse  poAvder,  one  ounce, Whisky two  quarts;  mix.
 Steep in a covered vessel near a fire  for tAvelve hours, then  strain,
 and add  Tincture of Myrrh half a pint, Sulphate of Iron two ounces.
 Dose, same as the preceding.
   Or, Nos. 3 and 4, under  Suppressed Menstruation, page 181, may
 be used.
                     Whites or Leucorrhea.
   Although generally looked  upon as a disease, Whites, Leucorrhea,
 or Fluor Albus, as it has been variously named, is symptomatic of dis-
 ease of the Avomb or the vagina.   It  consists of a discharge which,
 when from the vagina, is  thin  and watery, or thick and AYhite like
 cream, and when from the  Avomb, is somewhat  like the white of  egg;
 being of  a greenish, light-yelloAV, or dark-brown color, Avhen it is asso-
 ciated with  ulceration of the Avomb, and, occasionally, it will be spotted
 with blood.
   The discharge is often very acrid, and highly offensive, and in most
 instances is attended Avith pain and  weakness of the back, languor,
 and  in  long-standing cases, thc countenance presents  an unhealthy
 appearance, the digestive  poAvers become impaired,  and the system
 suffers from debility.  (See Division I, pages 518 to 522.)
   Treatment—As  this discharge is merely a symptom of some exist-
 ing disease, that must be treated by the appropriate means, Avhether it
 be ulceration of the neck of  the Avomb, painful menstruation, falling
 of the womb, etc., the rules for which will be  found in Division  I, as
 above indicated.
   The  application  of medicine to the  parts will always be of  service,
and the following may be employed:
   In a pint of water  dissolve an ounce of  Alum.   Firmly fasten a
piece of  sponge of the size and shape  of a small hen's-egg to one end
of a smooth rod of wood.   First, dip the sponge in Avater, and sloAvly
and carefully pass  it AA'ithin the vagina, as far up as possible, gently
turning it around tAvo or three times, to remove all mucus from  the 
188
AMERICAN FAMILY  PHYSICIAN.
passage—then  withdrawing it,  dip  it in the  solution of Alum, and
slowly pass  it within the vagina as before, turning it around for a few
minutes, and -again withdraAving it.  Repeat this three times a day.
  A very excellent tonic preparation for females to take, Avho are
laboring under the Whites, is the folloAving: Take of Golden Seal, Black
Cohosh, Colombo, Ginseng,  each, in coarse poAvder, one ounce, boiling
water two pints;  mix, and then  let them stand in a covered vessel till
cold.   Add  two pints of Whisky, and let it stand five or six days, fre-
quently shaking.   Then sweeten with Avhite  Sugar to suit the taste.
Dose, two table-spoonfuls three or four times a day.

                      Falling of  the  Womb.
  As common  a  complaint  among  Avomen as the Whites.  A pain in
the back; a dragging sensation  from the navel and loins ; a weight or
bearing down;, a  fullness in the loAver part of the bowels;  more or less
costiveness; urine irregular, scanty, hot, or high-colored.  (See Divi-
sion I, pages 522 and 523.)
  Treatment.—When the falling is not of long standing, and is not
very great,  it  may be  cured by resting for  a time in the recumbent
position, and using injections of Alum water, or  decoction  of White
Oak bark, or Crowfoot root, or Alum root, with the occasional use of a
cool Hip-bath.
  When the falling is of long standing, or is very great, the womb will
have to be carried up to its proper  position, and be retained there by
some kind  of  a  pessary  until the parts have so  far  recovered their
tone that the use of the pessary may be omitted; at the same  time
using the injections to  impart  strength  to the parts, being careful,
however, to remove any irritation,  inflammation, or ul  ration of the
womb, before using the  pessary.   (For further treatment,  see Divlsion
I, pages 522 and  523.)

                     Weakness in the Back.
  Treatment.—Is most  usually associated Avith the Whites, Falling of
the Womb, Dysmenorrhea, or other  disease of the female  organs;  and
when this is the case, the malady  of Avhich  it is a  symptom must first
be removed, and  then the Aveakness Avill pass away.   Sometimes it is
owing to excessive intercourse, and will only disappear by the patient
being more  temperate  and moderate.   Again, it  may be associated
with Spinal  Disease, and must then be treated'as laid down under that
head, on pages  152 to 155.
  Ordinary  Aveakness in the back,  not due to  these  causes, may b* 
HOUSEHOLD department.
189
cured by taking the following tonic:  Take of DeA'il's Bit or Button
Snake root, in coarse poAvder, two  ounces, Buckhorn Brake or Royal
Flowering Fern root, Comfrey root, Solomon's Seal root, White Pop-
lar bark, each, bruised, one ounce, boiling water two pints ;  mix; steep
in a covered vessel, near a fire, for  twelve hours;  then add three pints
of Whisky, tAvo teaspoonfuls of Red Pepper, and an ounce  of Prickly
Ash berries;  let it stand several  days, frequently shaking; strain, and
sweeten.   Thc dose is two table-spoonfuls three times a day.  In con
nection  with  this, the following  strengthening plaster must be worn
across the back: Take of Resin three pounds, Beeswax four  ounces;
melt together; remove from the fire, and when cool, add one ounce of
Camphor dissolved in one ounce,  each, of Oil of Hemlock, Oil of Sassa-
fras, and Olive Oil, and half an  ounce of Spirits of Turpentine; mix
sloAvly, and when cool enough work it thoroughly in cold water.   This
makes an elegant strengthening plaster to be spread upon soft leather.
              DISEASES  OF  PREGNANCY.

   See Division I, pages 524 to 526.)
   The symptoms more  commonly met with among pregnant females,
will now be treated upon, giving such remedies therefor as can be easily
procured by any family, especially those in the country.

                        Morning Sickness.
   Thc sickness or vomiting >vith  which pregnant women are troubled,
may frequently be cheeked or relieved by using freely of a tea of Red
Rose Willow bark.  But unless this symptom be very severe, it is bet-
ter to use no medicine whateA'er for it.  The best course for the female
to pursue, when the vomiting is troublesome, is to take a cup of Coffee,
or a light  breakfast, before getting out of bed in  the morning, after
which take a short nap,  and then arise.
   In the latter months of pregnancy, when  vomiting is so severe as to
render it almost impossible  for the stomach  to retain anything, it may
be checked by placing the female in a position upon her back, in which
the hips are greatly elevated above her head, so as to be almost per-
pendicular.  She can remain in  this  position  long enough for the
stomach to digest any  light food, and thus prevent starvation.  (See
Division L page 410.) 
190
AMERICAN FAMILY PHYSICIAN.
                           Heartburn
May be relieved f by taking some  Magnesia, cheAving Chalk, or Peach
kernels.  The Compound Syrup of Rhubarb and Potassa will be found
very efficacious.   (See Division I, pages 409 and 740.)

                            Headache.
  Headache,  drowsiness, or a sense of fullness in the head, may be
relieved by using  a tea of Scullcap, or of Ladies' Slipper root,  also
making use of diuretics, as a tea of Cleavers, of Queen of the Meadow,
of Sassafras bark,  etc.   (See Division I, page  524.)

                           Costiveness
Should, if possible, be removed by a proper diet; or, injections may
be used daily. But no active  cathartic medicine should be taken.  (See
Division I, page 524.)
                             Cramps.
  Some pregnant females suffer much from Cramps.  These may fre-
quently be relieved by rubbing with cold Vinegar, or with some stimu-
lating Liniment.  The Compound Syrup of Partridge Berry, Division
I, page 739, is the best remedy.   (See Division I, page 366.)

                            Diarrhea.
  When this  occurs during pregnancy, it should be treated in the same
manner as at any other time.   (See Division I, page 421.)

                        Puffy Swellings.
  These  swellings, which attack  the feet,  legs, and  even the private
parts, may be relieved by keeping the patient  at rest, as much as  pos-
sible, in  the  horizontal position.   In some cases diuretics,  and ban-
dages to the limbs, will be advantageous.  (See Division I, page 525.)

                     Troublesome Itchings,
When around the genitals, may be relieved  by  bathing the parts three
or four times a day with the Borax Lotion with Morphia, Division I.
page 726.  (See Division I, page 525.)

                              Piles.
  Piles during pregnancy can not be cured until after confinement, but
they may be much relieved, by keeping the bowels regular, and apply-
ing some one of the ointments named  on pages 165  and 166, and in
Division I, pages 525  and 595. 
HOUSEHOLD DEPARTMENT.
191
                         Enlarged Veins.
   As Avith piles, these can only be relieved  during pregnancy.  The
diet must be light, the bowels kept regular, and the patient be kept in
a recumbent position, as much as possible, Avith bandages on the parts,
or elastic stockings.   (See Division I, page 525.)

                Longings or Capricious Appetite.
   This should ahvays be respected in pregnant Avomen, and the article
longed for be permitted  when it is known to be  not absolutely inju-
rious.  There is no doubt,  in my mind, from the many positive instances
I have seen, that the mind of the mother frequently exerts a power-
ful influence upon the unborn child, even to the extent of disfiguring
it  by marks or othenvise. Too much care, therefore, can not be had
in this matter, because, excessive and unsatisfied longings, sudden shocks
or  alarms, distressing or sickening  sights, disappointments, etc., are
very apt to cause more or  less unpleasant effects upon the child; hence,
Avomen during pregnancy should be carefully guarded against every cir-
cumstance which may possibly exert an unfavorable influence upon their
minds.   The father and husband avIio Avould not have constantly before
him a living curse, in the disfigurations of his  children, must heed these
statements, and  see  that  his  wife be  tenderly and properly managed
during her condition of pregnancy; for though pregnant  women  may
sometimes command their thoughts, actions, and appetites, that no
unhappy  results may arise therefrom,  it is  frequently the case  that
these are absolutely  beyond their control.

                  OVER-DISTENTION OF THE  SlilN.
   When  the skin of  the belly becomes cracked and sore, as in the ad-
vanced months of pregnancy, much relief Avill be afforded by rubbing
it frequently with Avarm SAveet Oil, in which a small quantity of Cam-
phor has  been dissolved.

                          Fainting Fits.
  These  usually come on about the time of quickening, and cause
great annoyance.  The Avonian  should be kept in a state  of quiet and
rest, or Avith cheerful society, and the bowels  be promptly attended to
When the fainting fit  is  on, she should be  placed  in the horizonta
position,  where  the  cool air can reach  her,  and  have  cold water
sprinkled in her  face, and  Hartshorn,  or Vinegar, held to her nose. 
192
AMERICAN FAMILY PHYSICIAN.
               Suppression  or Incontinence of Urine
  May be  benefited by the Avoman frequently lying down upon her back,
  and, if the  urine be scalding, by using freely of a tea of Marshmal-
  Ioavs, Watermelon seeds, Cleavers, or Pumpkin seeds, etc.   (See Divi-
  sion I, page  525.)

                            Sore Nipples.
    During first labors, especially, the nipples are  very apt  to become
  sore, being  a  source of much suffering to the mother,  and frequently
  preventing the infant from  taking its natural nourishment.  This  may
  be prevented  by bathing  the nipples tAvo or three times  daily with a
  decoction of White Oak bark, or of Crowfoot or  Crane's-bill root, or
  a solution of Alum, etc.;  at the  same  time having some  friend to
  gently suck upon them, two or three  times  a day  during this period.
  In this way,  not  only will  soreness of the  nipples be prevented, but
  women with their first children may have their nipples so drawn out
  and  elongated, that there will be  no difficulty in  the  child's " taking
  hold."
    When the nipples become actually sore after confinement, they  may
  have a mixture of two parts Beeswax and one of Oil applied to them;
  or, an ointment, made by grating  fresh Carrot root in sweet Cream;
  or, a very excellent preparation Avith whieh to anoint the nipples,  is a
  mixture  of  Glycerine one drachm, Tannic acid one drachm; or, the
  means recommended in Division I, page 533.
    N. B.—For the management of Miscarriages, and Confinement oi
  Childbirth, see Division I, pages 526 to 534.

                            After Pains
  May be relieved by applying warm fomentations to the belly, of Hops
  and  Tansy,  or other bitter herbs, in Whisky, and the free internal use
  of a tea of  equal part's  of Pleurisy root and red Raspberry leaves, or
  a tea  of Avens  root, Winter Brake,  Blue  Cohosh root, etc.   (See
  Division I, page 532.)

                              Flooding.
    (See Division I, pages 527 and 534 to 537.)
    Floodings from the womb, when due to abortions or childbirth,  may
  frequently be checked by the  application of cold water and Vinegar,
  on cloths, to the belly, the private parts, and the thighs, aided by injec-
•  tions of Alum water into the vagina, and also the  use  of it  by  mouth, 
HOUSEHOLD DEPARTMENT.
193
 say ten or fifteen grains  of Alum  dissolved in a gill of water, one-
 half of which may be given every fifteen or twenty minutes, or every
 hour or two, as the urgency of the case requires.   Other astringents
 may be used, as three  or  four grains of powdered  Gum Kino, every
 half hour or hour; or a strong decoction of White Oak bark, or Crow-
 foot root, etc.   But  alum  is very efficacious, and is the most readily
 obtained.
   In all cases of flooding, promptness of action is necessary, as a few
 minutes' neglect may occasion a loss of the patient's life.  A compe-
 tent physician should invariably be had  as soon as possible.
   Flooding after childbirth can only be  stopped by causing the womb
 to  contract; hence, in addition to the above means, when no physician
 is present, some friend  should seize upon  the soft  womb, through the
 walls of the belly, and carefully and constantly press upon it and knead
 it,  as it were, for a long time,  or until it feels like  a hard ball under
 the hand.  Knead and press deeply upon the parts just above the
 bone at the lower part  of  the belly, whether the womb can be distin-
 guished at first, or not.   (For further treatment, see Division I, pages
 534 to 537.)
                   Suppression of the Lochia.
  The bloody  discharge which follows delivery, and  continues for sev-
 eral days, is called the "Lochia," or "Lochial Discharge." If it stops
 too soon, it may give rise to some serious malady.   A strong infusion
 of  Motherwort,  or  of Winterfern, drank  warm and freely, will usually
 restore it.   (See Division I, page 532.)

                           Milk-Fever
 Usually requires rest and a dose of  Castor Oil—drawing the breasts
 frequently, if any milk  is in them.   (See Division I, page 533.)

                   Inflammation of the Womb.
  Shiverings ; hot, dry  skin; thirst; pain in the head;  severe pain in
 the neighborhood of the womb; rapid pulse.  (See  Division  I, pages
 311 and 312.)
  Treatment.—Keep the bowels open by injections; apply cloths wet
 with hot water over the belly, frequently removing  them, or a fomen-
 tation  of fresh  Stramonium or Jimson leaves, pounded, and moistened
 with hot water.  Give diuretics, as a tea of Cleavers or Melon seeds,
 and promote perspiration by applying Mustard along the whole course
 of the  backbone, and to  the feet and ankles, placing hot rocks or bot-
tles of warm water around the patient, and giving warm herb teas to 
194
AMERICAN FAMILY PHYSICIAN.
 drink, as of Catnip, Balm, Sage, Peach leaves, etc.  In other respects
 treat the same as Childbed  Fever.

                         Childbed Fever,
 Also called Peritonitis, or Inflammation of the Peritoneum, is one of
 the  most  fatal maladies which can attack the lying-in woman.  It
 usually begins Avith more or less severe  chills, followed by fever hot
 skin, rapid pulse, nausea  and vomiting, severe pain in the  back  hips
 and neighborhood of the womb, Avhich is very much increased on pres-
 sure, the lochial discharge diminishes or is checked, and there is severe
 pain across the forehead.  The belly swells  and becomes tense like a
 drum-head, and is very painful  upon the  slightest touch.   (See Divi-
 sion I, pages  305 to 310.)
   Treatment—There is no malady which demands more  skillful treat-
 ment and closer attention than this; a single error or omission  may
 prove fatal.
   When the  disease appears  to be common throughout the  country
 among  lying-in-women, great care is demanded, and the condition  of
 every woman  who has  given  birth to a child should be watched closely
 for several days after  her delivery.   If the pulse be found  quick and
 feeling  like a  cord or wire, and the skin hot, with a slight  diminution
 of the  lochial discharge, and no free Aoav of the milk, and  if upon
 making deep pressure  with the ends of the fingers low down upon the
 sides of the   belly  and over the womb, pain  or soreness is produced
 thereby, no matter how well the female  may say she feels, there is
 danger  of childbed  fever, and the following  powders  should, at once,
 be given to her, continuing their use until all these symptoms have dis-
 appeared.  Take of Prussiate of Iron thirty grains, Sulphate of Quinia
 twenty  grains, Piperin ten grains; mix.   Divide  into twelve powders,
 and  give one every  one, two, or three hours, according to the severity
 of these symptoms.  This preparation can be had at  any respectable
 drug-store.    The chief symptoms here are the  hot  skin,  the quick,
 wiry pulse, and the  pain on pressure.  If the boAvels are costive, one
 of the cathartics named under Fevers, on page  75, should be given.
  But Avhen the disease has  already attacked the  female, her boAvels
 hould be actively purged by  the Compound  Powder  of Jalap, named
under Fevers, page 75, or some other active cathartic,  as  a mixtm^
of equal parts  of powdered Blue  Flag, Mandrake, and Cream  of Tartar;
a teaspoonful  every four hours until the boAvels are freely acted upon.
Profuse perspiration should be kept  up by the means named above for
Inflammation of the Womb ; and cloths  Avet Avith  hot water, or hot 
HOUSEHOLD DEPARTMENT.
195
fomentations of Hops  and Tansy, or other bitter herbs, or a poultice
of fresh Stramonium or Jimson leaves, pounded, and moistened with
hot water, must be kept constantly applied  over the belly, changing
them from time to time, as they become cool or dry.
  In  evacuating the  bowels or  bladder, the patient should not be
allowed to sit up, but must  use a  bed-pan, or old cloths.   Injections
every day will be found beneficial by keeping the bowels open.
  In addition to these measures, the powders named above, (Prussiate
of Iron, Piperin, etc.,) must  be given, and repeated every hour or two :
and the patient should be allowed to drink freely of some diuretic teas,
as of Cleavers, Watermelon seeds, Marshmallow root and Peach leaves,
Elder flowers, Pumpkin seeds,  etc.
  When the tongue is coated brown or yellow, acid drinks should be
alloAved, as Cider, Lemonade, Vinegar and water, Tomato juice  sweet-
ened, Apple  water, etc.  And any other symptoms which  may appear
must be treated in the same manner as named under their appropriate
heads on pages 99 to 102.
  The patient must be kept quiet, and free from noise or  disturbance,
in a cool, airy, someAVhat darkened apartment; must not  be  annoyed
or excited by visitors or  callers, and should use a light, cooling diet.
(For further treatment, see Division I, pages  307 to 310.)

                      Childbed  Convulsions.
  Childbed or Puerperal  Convulsions, sometimes commence with head-
ache, giddiness, dazzling of  the eyes, sudden loss of sight, ringing in
the ears, flushed countenance, confused memory, incoherency of speech,
etc.  As often they come on suddenly.
  The convulsions are powerful; the head is rotated with jerks from
side to side; the limbs are  throAvn spasmodically in every direction;
the eyes roll about; there are  twitehings of the face, which  becomes
dark-colored; frothing  at the  mouth,  and  rapid, violent breathing.
After the  fit leaves, there may be from fifteen minutes to three hours
before another one comes on; but more generally, but a few minutes
pass, before another attack of convulsions comes on.
  Treatment—This is  a dangerous and rapidly fatal disease, and the
physician  should be sent for in haste whenever it  occurs.  Until he
arrives, the  folloAving course may  be pursued:  Tie  a handkerchief or
stout cloth around each arm, close up to the shoulders, and around each
leg close up  to the  groins; pass a stick in one part of these, and twist
them so as to stop the circulation in the veins, but not that in the arte-
ries, which may be ascertained  by finding that the pulse beats  at the 
196
AMERICAN FAMILY PHYSICIAN.
wrists and at the ankles.   Keep up  this stoppage of the venous circu-
lation till  the limbs swell and begin  to  turn purple,  when slightly
slacken it at first;  slackening more and more, however, gradually, till
the limbs return to their natural  size and color;  then,  if the fits still
remain, tighten again;  and so proceed  until the doctor arrives.
  Besides  this, the bowels should be opened as soon as  possible by an
injection composed of half a pint, each, of warm water and Molasses,
to which a table-spoonful of Salt and tAvo table-spoonfuls of Castor Oil
have been  added.  Give the whole of this for  an  injection, and repeat
it every half hour  until a free evacuation from  the bowels  has been
obtained.
  The head and shoulders of the patient should, from time to time,
be drawn beyond the edge of the bed, and held over a tub or other ves-
sel, and cold water be poured upon her head and neck, until two or three
pailfuls have  been  used, or until the features  shrink; then place her
again in bed,  with  the head and shoulders elevated, and as soon as the
face becomes  dark-colored, again apply the cold water;  and so con-
tinue.
  Whenever the patient can  swallow, give her  to  drink freely of a
strong infusion of  the  balls of the common Nettle, also called Cow
Nettle, and Great Stinging Nettle.   It may also  be proper, when the
fits are on, to whip the soles of the feet smartly with a flat stick.
  This is all that can be done by  the friends and bystanders until the
doctor arrives; and it should  be  kept  up  perseveringly until he does
arrive, unless  by it the  patient should fortunately recover.

                             Milk-Leg.
  This is  so  called, because  it has  been  popularly, but  erroneously,
supposed that the Avoman's milk has fallen into the sAvollen leg.  Within
from  a day or two  to three or four weeks  after childbirth, the woman
will experience pain in the lower part of the boAvels, the groins, or the
thigh; this becomes more seArere  as the disease progresses;  the pain
is worse Avhen  the leg is  straitened out; the leg  swells, and the pain
lessens ;  the SAvelling usually proceeds from above downward; the skin
of the leg  is white  and  smooth, and leavet no pit  on pressure.  Fever,
rapid pulse, thirst, Avakefulness,  etc.,  are  generally  present.   (See
Division I, pages 537 to 540.)
  Treatment—Give a cathartic first; after this has operated, place the
patient upon her back, and wrap a flannel bandage around the leg from
the toes to the groin, first having dipped  the  flannel in a mixture of
equal parts of warm water and Tincture of Aconite;  or, if this can not 
HOUSEHOLD DEPARTMENT.
197
 be had, in an infusion  of equal parts of St. John's-wort leaves  and
 Mullen leaves; or,  equal  parts of hot water and Vinegar.  Now  ele-
 vate the leg, so as to  have the foot slightly higher than the hips,  and
 place under it a piece of flannel, or other cloth, so as  to  protect the
 bed from the dampness.   Keep this flannel constantly moistened with
 the fluid,  using it  as warm as can be  borne.   Remove the bandage
 tAvice a day, and again  reapply it, first having bathed the leg with a
 Avarm mixture of equal  parts of Sweet Oil, Laudanum, and Spirits of
 Camphor.   Continue  this until the leg is  well, and the  calf of the leg
 can  be squeezed without causing pain.
   For the fever which  accompanies the disease, Tincture  of Aconite,
 in doses of three or  four drops, every tAvo or three hours, may be given;
 or Tincture ot White  Hellebore root, in doses of five drops every hour
 or two, in either case  in a teaspoonful of water.   Or, a  teaspoonful of
 the Tincture of White Hellebore may  be added to four table-spoonfuls
 of the Tincture of Black Cohosh or Rattle root,  and given in doses of
 twenty or thirty drops every hour.  The bowels  must be kept regular
 by some gentle physic, or hj injections.
  If the leg continues swollou after the inflammation has  been removed,
 treat it as named in Division I, page 539.

                   Caked  of. Broken Breast.
  (See Division I, pages 541 an-i 542.)
   Treatment.—In the first stage of the disease, when the breast is hard
 and painful, apply  flannel cloths to it, moistened with one of the  fol-
 lowing fluids, as warm as can be borire: Equal parts of hot water  and
 Vinegar;  a decoction of St. John's-wort  and Mullen  leaves;  or,  a
 decoction  of equal parts of Smartweed and leaves and tops of Bitter-
 sweet.  These should be  changed frequently, and  be continued until
 all pain and inflammation has been removed, being careful not to  wet
 the clothing nor the bed Avith them, so that the patient may not " catch
a fresh cold."  In  many  instances, these  fomentations,  used cold,  will
ansAver a better purpose, as warm applications are  apt to favor the form-
ation of matter.  If they be used cold,  the  dampened cloths must be
covered with thick  folds of dry ones,  and great  care  be taken not to
needlessly expose the  patient to the risk of cold.
  Occasionally, while  using the hot fomentations, the breast  may be
bathed freely with a  mixture of equal parts of Sweet Oil, Laudanum,  and
Spirits of  Camphor; the boAvels should be kept open by Castor Oil, or
other physic, and the milk should be frequently drawn from the breasts.
  A  very excellent  application to  a hard, tender, and inflamed breast, 
198                AMERICAN FAMILY PHYSICIAN.
is a cold solution of Sal Ammoniac in Vinegar, adding as much of the
Salt as the Vinegar will dissolve.   Apply on cloths, covering them as
stated above.
  If the  breast breaks, and an abscess is formed, the following should
be applied to it  two or three times a day, both by injecting it into the
abscess and applying it upon folds  of linen: Take of Elixir of Vitriol
ten drops, Rose water tAvo table-spoonfuls; mix.   At the  same time the
patient should make use of a good, nourishing diet, and some tonic
bitters, as the Compound Wine of Comfrey, in Division I, page 728, or
any other tonic preparation.

                       Nursing  Sore Mouth.
  (See Division I, pages 540 and 541.)
   Treatment.—Give one of the emetics  named under Fever, on page
74, repeating it twice every week, if  the patient's strength will permit.
Give, internally, a mixture of CroAvfoot root, or Alum root, Blue Cohosh
root, Golden Seal root, Solomon's Seal root, each, in powder, one ounce,
boiling water four pints; mix; steep near a fire for six hours; strain,
add Honey a gill,  and  poAvdered Borax tAvo teaspoonfuls.  A table-
spoonful of this may be given three or four times a day, and the mouth
should be frequently gargled or Avashed with it.  Ten drops of Tinc-
ture of Muriate of Iron should be added to each dose taken internally.
  The bowels  should  be kept regular,  and the diet should be light,
nourishing,  and easy  of digestion.  Attention  to the  skin will  also
prove serviceable.  In  many cases the following will be found useful,
both as a wash, and as an internal medicine : Take of Chlorate of Pot-
ash tAvo ounces, Muriatic Acid forty drops, Avater one  pint; mix.  When
the Chlorate is dissolved, add Tincture of  Muriate of Iron one drachm
and a half.  The dose internally is half a gill three times a day.

                            Hysterics.
  (See Division I, pages 360 to 362.)
   Treatment—To relieve a patient in a fit of Hysterics, the best thing
is one or two teaspoonfuls of Compound Spirits of Lavender in the
same  quantity of SAveetened water.
  Or, the folloAving may be given: Take of Lobelia, Skunk Cabbage
root, each, a table-spoonful, in coarse  powder, boiling water half a pint;
steep for half an hour, and give frequently in tablespoonful doses.  It
must not be sweetened.  In severe hysterical convulsions, Chloroform
may be inhaled till the  system is  quieted, at the same time applying it
to any part where there is severe pain. 
tfOUSEHOLD DEPARTMENT.
199
                            Neuralgia.
  This term is applied to a severe, darting pain, which comes on more
or less suddenly, attacking various parts, and having periods of free-
dom from  pain for a longer or shorter time  during  the attack.   (See
Division I, pages 543 and 544.)
   Treatment.—The bowels must be  kept regular in  this disease; the
skin be bathed, with considerable friction, every morning; and diuretics
be used, as, a  tea  of Cleavers, Kidney-bean pods, Melon  seeds, etc.
The diet must be nourishing but easy of digestion, and moderate exer-
cise should be taken daily in the open air.  Among the  medicines the
following may be used:
   1. Saturated  Tincture  of  Arnica flowers*  one ounce and a half;
Tincture of Aconite root three  drachms; Tincture of Gelseminum six
drachms;  mix.  Dose, half  a teaspoonful every three hours.
   2. Take of  Extract  of Valerian,  Extract of Henbane, each, one
ounce, Extract of Aconite, Sulphate  of Quinia, each, half an ounce;
mix, and divide into four-grain pills.  The dose is one pill every three
or four hours.
   3. Take of finely-powdered Sal Ammoniac two  drachms, Prussiate
of Iron eight grains, Sulphate  of Quinia four grains,  Camphor two
grains; mix, and rub together thoroughly.  Divide into  four powders,
of which  one  is to be taken every one, two, or three hours, according
to the  severity of the attack.   This remedy, aided by the  Compound
Tar Plaster, applied to the tender parts of the spinal column, or behind
the ears, according to the location  of the neuralgia, I have used  for
many years past in the treatment of this agonizing disease, and it has
not yet disappointed me in one  single instance.   It is rarely the case,
when properly  administered, that more than three  powders will be
required to effect a cure, never more than four.   I  now make it public
for the first time; it  is Avorth more than fifty times  the  price of this
book.
  Sometimes neuralgic pains may be relieved by external applications,
as any of the folloAving:
  1. Take of  Veratria  one grain, Lard or Glycerine tAvelve grains;
mix  Avell together.  Rub  upon  the affected parts for fifteen  minutes,
and repeat it three  or four times a day, until a tingling sensation  is
produced after  each rubbing.
 * Made by adding two ounces of Arnica flowers to a pint of Alcohol, allowing them to
stand twc weeks, frequently shaking.
            63 
200
AMERICAN FAMILY PHYSICIAN.
  2. Take of Prussic acid, Glycerine, each,  one drachm, Aconitia one
grain; mix, and apply over the painful parts with a camel's hair pencil.
  3. Take of Chloroform, Tincture of Aconite, Tincture of Camphor,
Laudanum, each, equal  parts;  mix.
  4. Take of Croton Oil, Spirits of Turpentine, Oil of Cinnamon, or
Sassafras, each, two teaspoonfuls, Sweet or Olive Oil four table-spoon-
fuls ; mix.   Rub over the affected part three  or four times a day, some
ten or fifteen minutes at a time. This is also  useful in spinal irritation
or any painful  affection.
  5. Take  of Extract of Belladonna one drachm, Lard  or Glycerine
one ounce;  mix well together, and then add Chloroform one  drachm.
This  is also useful in painful piles, and pain from inflammatory con-
ditions, etc.

          Nervous Weakness and General Prostration.
  This is very  common among females.  It is sometimes owing to the
presence of other  diseases, as Whites, Falling of the Womb, Spinal
Disease, etc., when, in  order to cure it, these diseases  must  first  be
cured by the proper treatment.   One  great cause of it is excessive
sexual indulgence,  which must positively be moderated, and  in some
cases stopped  altogether for a time, before a cure  can be effected.
   Treatment.—Moderate and gentle exercise in the open air, regularity
of bowels, attentions to the skin by frequent bathings with a solution
of one  teaspoonful of  Sal  Ammoniac  in a  quart of water, to which
half a pint of  Whisky must  be  added; a  light and nutritious  diet,
cheerful company,  early hours, no  overworking, or fatiguing  exercise
of body or mind, and moderation in all things, are  very requisite in
treating this difficulty.  Internally, one of the following medicines may
be taken:
  1. Take of Ladies'-slipper root, Pleurisy root, Skunk  Cabbage root,
Scullcap, each, in coarse powder, one table-spoonful, hard Wood Ashes
two  teaspoonfuls, clean Wood  Soot one table-spoonful, boiling water
four pints;  mix.   Steep in a  close vessel, near a fire, for six hours,
then sweeten to suit the taste.   Dose, half  a gill  three or four times
a day.
  2.  Take  of  Black Cohosh  or  Rattle root,  Skunk Cabbage  root,
Golden Seal root, Chamomile flowers, each, coarsely bruised, one table-
spoonful, hard  Wood Ashes two teaspoonfuls, clean Wood Soot, one
table-spoonful,  boiling water two  quarts ; mix.  Prepare and use the
same as abo\Te.
  Any pains or tenderness along the backbone, or other parts, may be 
HOUSEHOLD DEPARTMENT.
201
relieved by bathing them three  or  four times a day with one  of the
liniments named under Chronic Rheumatism, page 149, Stiffness of
the Joints, page 150, or Spinal Disease, page 151, etc.
  Nervous  exhaustion,  with  sadness, depression,  no disposition to
exertion, etc., may  be relieved in  eight or  ten days, or sooner, by
taking twenty-five drops of the following preparation in half a gill of
sweet Milk, repeating it three times a day: Take of Chloroform,
Tincture of Ginger, each, half an ounce, Aromatic Spirit of Ammonia
two drachms; mix. 
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AMERICAN FAMILY PHYSICIAN.
CHILDREN  AND  THEIR  DISEASES.
  From a long' experience in the treatment of diseases of children, I
am well convinced that it is too much the custom to administer stronger
and more active medicines than  are required,  and which is  one  great
reason for the want of success which is so commonly met with in their
management.   These tender little  buds of the human family  have
extremely  susceptible constitutions, and are readily influenced by all
the circumstances which may surround them, and especially so by  large
doses of medicines, or by  articles Avhich exert  a poAverful action.
  In the following pages, devoted to a consideration of the diseases of
children, I shall recommend such simple remedies as may  be readily
procured, many of which may be found groAving  in our gardens, or at
our very doors;  and,will also lay doAvn some hygienic rules, so that
every mother may not only be  enabled to cure,  but likewise, in most
instances, to  prevent the inroads of many maladies which are annually
removing thousands of darling loved ones from their mother's bosoms,
causing fathers with the stoutest hearts to  melt  into tears; for  noth-
ing so deeply shakes the human soul as  the early loss  of its own
offspring.
  Every mother should, as  much as possible,  doctor her own children,
whenever they require the aid of medicine,  for,  as a general rule, she
alone understands their innocent natures, and the peculiarity of their
tender constitutions, far better than any one else.  Through  health and
sickness, no  one is so watchful, so attentive, as the kind, observing
mother; she  watches  over  her  babe, faithfully  and prayerfully, with
the tenderest emotions; the slightest change  in  the symptoms of the
afflicted little sufferer, whether for better  or for Avorse, is instantly
observed by her; and no  one can so well read that countenance upon
which  pain and anguish is  depicted, or so correctly understand the
imperfect  lispings of  that suffering prattler, the  darling of  her  heart.
Indeed, as an evidence that Heaven intended the mother to treat her
own sick children, observe with  what dislike and aversion every child
contemplates the presence  of a stranger or  of  a doctor,  during the
course of its  illness; and mark with what affecting emotions of instinct- 
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203
ive love the confiding innocent clings to its mother's arms for comfort
and protection.
  Mothers, as you love your children, prepare yourselves to treat and
cure  the diseases to which they are subject, and which may carry them
to an untimely grave.   You are as well capable of doing this,  in the
great majority of instances, as any one.  Do not wait until disease and
death are at your door, but at  once commence the task of acquainting
yourselves  with the nature and symptoms of the most common  and
fatal complaints of childhood, so that those Avho are destined by Heaven
to look to  you for relief and protection, shall, as much as possible,
steadfastly  retain that Divine confidence in you which the Most High
has implanted within their susceptible hearts.
  When Ave consider the great want of proper knowledge among moth-
ers upon this subject, and the  comparative little attention they bestow
upon books Avritten expressly for their benefit in relation to this matter,
we can not wonder at the great amount of suffering  and death which
children are annually doomed  to experience, and  we can but feel  that
many bitter tears of hope, anxiety,  and despair, have been Avrung from
sorroAving  hearts—that  the mother has too  often been  compelled to
deliver the  most sacred of all earthly treasures to the gloomy  recesses
of the grave;  treasures  Avhich  might have  been saved, had she ac-
quainted herself with  the proper means  of assistance.   And  the
bereavement is  rendered doubly severe,  by the recollection of  that
tearful, confiding, but mute  appeal of the suffering innocent to the
heart of  its maternal parent for relief from  the terrible scourge with
which  its  very  vitals Avere being  destroyed, and Avhich was rapidly
hurrying it into  the unknoAvn regions of the eternal  hereafter;  but,
alas, no comfort, no relief could be given; the Avork of death  must go
on slowly  but surely, for the mother, with all her  kindness, all her
sympathy,  all her hopes, anxieties  and fears, all her love, has failed to
procure that knowledge  which  might possibly have lessened  the  pains,
and saved  the life of her now departed infant.  How many mothers'
hearts  have been filled to overflowing Avith bitter  anguish, Avhen called
upon to witness the agonizing and expiring moments of the  idols of
their hearts—who, but  yesterday, were full of health and  life, their
rosy cheeks and playful  dispositions  bidding fair to  outlive the most
robust and  hardy of their families.
  There is  no earthly position in which woman appears in such heaven-
like purity  and holiness, as Avhen bestowing the cares of that deep and
sacred love which flows only from  a  mother's heart, upon the tender
and helpless being intrusted to  her care.  Nothing is higher, nobler, 
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AMERICAN FAMILY PHYSICIAN.
nor more elevating;  it is that which  makes  of  Avoman a helpmeet,
indeed,  for man—an  ever-watchful  and  protecting guardian  for his
children.
  A mother's love has a sweet and  holy influence.   In our hours of
affliction, when sorrow and trouble hover over us,  and when our path-
way is strewn with thorns, it is a mother's love that cheers us and bids
us look toward a brighter future ; she stifles her OAvn sorrows in sooth-
ing ours, and regards no sacrifice too great that increases our comfort
and  happiness.  She will rise above misfortune  with an unblanched
cheek, and an unterrified look, so that the child of her affection be
spared.  We can have but one mother; and that mother's love should
be regarded  as the  greatest blessing and holiest gift bestowed *by a
Divine  Being; it should  not be cast carelessly  aside, but  should be
watched and courted with a vigilant eye ; it is not a treasure that  can
be thrown away, and then be found or replaced by  another; it is a love
that survives the grave, and  which eternity  can not obliterate.   A
mother's love  has  stayed many a  child in the  course  of vice,  and
brought him back to virtue.   What would the felons in our prisons give
to have obeyed a mother's wise counsel, and returned her love ? They
would not now be pining in loathsome cells, brooding over their  lost
liberty, but Avould be free, with their souls pure and unspotted  by  sin.
But a mother's love and prayers can not now restore the fallen one;
it were better for her to have  laid him in the  cold grave while yet in
his innocence and purity.
  A mother's  love is not an  April  day, clouds and  sunshine in  the
same  moment, but is clear, calm, and constant, shining to  the latest
hour.   Behold the mariner  on the ocean, when storms and tempests
are around him, and his fortitude is nearly gone—the remembrance of
a mother's love, and of a happy home, nerves his  heart to battle with
peril, and he triumphs in the thought of the bright smiles and happy
looks that will greet his return.  When he nears  his native shore, his
cheeks  glow  and his eyes sparkle, for he knows that happiness dwells
there in a mother's love.  But there is a closing  scene to every life;
the hand of death will separate a  child from a  mother's love;  the
anguish of such a bereavement must  be keenly felt, and  when  we
mourn over the grave of her we loved  so well,- there  is a melancholy
joy in the thought that our love Avas  returned, and that the  influence
of that mother's love will guard  and protect and  be our star  of hope
in our journey through life, and  our inheritance in the land  of bliss.
  Mothers, let me, in closing these remarks, appeal to you in all earn-
estness in behalf of  the  precious  charges  intrusted to youi care; 
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205
Btudy and prepare yourselves for the responsible, high, and holy office
you are destined to fulfill; the fact that you have accepted the respon-
sibility demands that you should fully qualify yourselves to meet  its
requirements,  and though you may  possibly glide smoothly along
through life without any of the trials and  afflictions so  common to
your sphere, you should regard this as the exception and not the rule,
and  still be prepared.   Let  not the healthful appearance of those
playful little ones lull you into a belief that it will be always thus with
them, or that you will always be blessed  with a continuation  of such
health and happiness.   I do  not ask you  to constantly regard the
health of your  children with  fear and trembling, nor  to  anticipate
trouble  and sickness;  but I do  beseech  you to make yourselves ac-
quainted with the nature and treatment of such diseases as may other-
wise steal upon you and your offspring in  an unexpected hour,  and
snatch from  your arms those  whom you regard far above all other
earthly blessings.

     Rules for the Management of Infants and Children.
  In Division I, pages 545 to 550, will be  found all the necessary rules
for the management  of children immediately after birth, as to washing,
clothing, pure  air, exercise, sleeping, weaning, etc., as well as regards
certain difficulties  occurring soon after birth, as red-gum, jaundice or
yellow-gum, a burst at the navel or rupture, soreness of the navel, bleed-
ing from the  cord or navel, and certain signs indicative  of  disease, to
which the reader is referred.  At this place  I  shall merely give a list
of rules, with Avhich  every mother should  thoroughly acquaint herself,
and  then proceed to  give  the household remedies for several  diseases
common to children, Avhich have not yet been treated upon.

   Twenty-four Rules for the General  Management of  the
       Mother  and  of the Child during the First Month.
  1.  Let not the mother allow herself to be persuaded from having her
child put to the breast, as soon as she herself may be  able  to bear
the fatigue.   If, however, the child can not procure  any milk, it must
not be alloAved to suck, as, by so doing, it will give rise to Thrush.   It
may, however, be  fed sparingly until the  milk can  be had from  the
breasts, upon a thin infusion of Slippery Elm bark.
  2.  Let her not delegate to another  the sacred duty of nursing  her
own  child, unless the reasons for so doing are  insurmountable.
  3.  She must scrupulously attend to the  dressing and undressing, or 
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even performing this herself, when her health and strength will permit
this delightful task.
  4. She should never, under  any pretext of convenience, permit her
child to  be  fed, so long as she can supply it with sufficient nourish-
ment  from her own breasts;  and to  secure to herself this important
point, she should pay a scrupulous regard to her diet, and her exercise
in the open air.
  5. The dressing of the child should early engage the attention of the
mother;  it should ahvays be made subservient to  comfort, instead of
show or fashion.
  6. This should consist in part of  flannel; especially during  cold, or
even cool weather.
  7. The dressings of the  child  should  be  changed  as often  as they
become soiled,  when this luxury can be indulged in.
  8. Though it may  be  found that  flannel is the  best substance as a
general  rule, there are cases in which it may be improper; and these
should be carefully distinguished.
  9. The belly band is one of the most important parts of the child's
dress; it should ahvays  be  made  of flannel, and should  always be cut
bias.
  10. The greatest care should be taken  to apply it properly;  and too
tight an  application should  be particularly avoided.
  11. If this bandage be applied  too  tight, it may produce the evil it
is intended to prevent—a rupture or burst  of the  navel.
  12. The child  should be  carefully protected against all unnecessary
wet;  and when it is  discovered to be in this  situation, it  should be
changed as  quickly as possible.
  13. In dressing the child, as feAV pins should be employed as pos-
sible;  three are all  that   are necessary, if the clothes  be properly
arranged.
  14. As a  general rule, the child  should never be fed at this period
of  its life;  there may be  exceptions, however, that  may render  this
necessary.
  15. When an  exception  to  this  rule  exists, the food  of the child
should consist  of Milk, Avater,  and Sugar of Milk, as advised in Divi-
sion I, page  546; or of  a thin infusion of Slippery Elm bark.
  16. If the child be fed by hand, it should have but small quantities
at a time, and  never  be  crammed to surfeit.
  17. The woman  should  exercise in the open  air, as soon as this is
rendered safe by the  state  of her health, the period after  confinement,
and the  state of the Aveather, 
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207
  18. She should never expose herself to partial exposures under the
hope of hardening herself.
  19. A diaper  should never be applied to the child a second time,
after it has been removed and dried, as several evils to the child will
arise therefrom.
  20. The  mother  may  indulge  in  such diet as her  experience  has
proved to be innocent—for when any kind of food perfectly suits  the
mother, it will seldom or never disagree with the child.
  21. As soon as any articles arc found to disagree with the mother, or
to cause any inconvenience, she should at once  stop using them; for
if they  disagree  Avith her, they will be sure to do so with the child.
  22. Should there be a  failure  in  the quantity of milk, the mother
must not attempt to increase it by highly-seasoned food and stimulat-
ing drinks.
  23. She may,  however, use, and sometimes with great advantage, the
ordinary nutritious substances.
  24. In all cases Avhere it can be done, a child in health should sleep
in a bed or  crib  by itself during the night, being, in cold weather, kept
warm by the proper amount of clothing.  This will not only cultivate
a regularity in its sucking through the  night, but will also render both
child  and mother  less liable to cold from  the dampness of the bed,
caused by the child's urinating; besides, the child will  not be liable to
any injury from the mother during her sleep.    The hot steam in the
bed from thc above cause has frequently given rise to sickness  result-
ing in death.

          Sixteen Rules adapted to the  Infant State.
  1. In case of illness of the mother, or a  failure of the breast milk,
the child should be early used to  the spoon.
  2. To preserve health, promote groAvth, and obviate chafing, keep an
infant dry and Avarm.
  3. To give uniform distention to  the stomach, and  thus to obviate
indigestion  and  gripes, the infant should be fed or be  made to suck in
as upright a position as possible.
  4. To obviate  too rapid a distention of the stomach, which occasions
acidities or pukings, the child, while  sucking, should  be frequently
taken from  the breast for a minute or two.
  5. To strengthen a child, and  enable it to withstand colds,  and to
obviate  the  necessity for purging, expose it early to the air.
  6. To prevent Diseases  of the  Skin, Slow  Fever, Rickets,  and
Decline, attend to cleanliness in an infant, as well as to proper exercise. 
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AMERICAN FAMILY PHYSICIAN.
   7. Let an infant's dress be  loose  and easy, and free  from pins-
 this will avert  accidents, glandular obstructions, and impediments to
 growth.
   8. Place an infant, when asleep, on the right side; this favors the
 descent of the  food in the bowels, and obviates indigestion.
   9. Attend strictly to plaintive cries; by this means you may trace
 the  first  cause of illness;  for  an  infant will never cry, if well and
 at ease.
   10. Wash a  strong child in cool water, and dip it in three times a
 week.  Wash a weak one in tepid  water;  this refreshes, promotes
 healthy perspiration, and prevents  skin diseases.
   11. Encourage a child  to  stretch  and  thrust out its limbs  and to
 crawl about, thus promoting the  circulation, strengthening  it,  and
 teaching it active habits  at an early age.
   12. Rub a young child, night and morning, all over with the hand;
 this exercises it, and promotes the circulation of the  blood.
   13. To prevent  Scald  Head,  and painful eruptfions behind the ears
 and on the  neck,  comb  a child's head, and wash it frequently with
 soap and water.
   14. If a child has cut  four  teeth, is in good health, and  its bowels
 are  regular, wean it at nine months, without any previous, preparation.
 Do  this to  obviate numerous  inconveniences both to the mother and
 child.
   15. If a child has been lately weaned, and is attacked with Hooping-
 cough, or any other severe disease,  it may require the breast again; it
 will  be thus  supplied with the diluting nutriment, Avhich it would then
 stand in need of; or, should a weaned child, to which suitable food is
 offered, fall off in its health, decline, and pine away, it may be prudent
 to procure  for  it a good  breast  of milk,  and  to  let the  child suck
 again, to obviate an exhausting fever, Avhich will inevitably prove fatal.
  N. B.  This  rule,  however, must not be  invariably adopted;  and
 ought always first to have the sanction of an able professional man.
  16. An infant should have  three or four  stools daily, of  a bright
 orange  color; a deA'iation from this appearance denotes acidities, and
indigestion, requiring the prompt exhibition  of a little Rhubarb and
Magnesia, or Castor Oil,  etc.

              Three Rules Adapted to Childhood.
  1.  If a young child takes but little exercise, then give it very little
solid food,  increasing it  in  proportion to  the exercise taken,  and
thereby obviating thirst,  fever, headache, and glandular obstructions. 
HOUSEHOLD department.
209
   2. Should a child's breath smell, it is commonly a symptom of a dis-
ordered stomach, or Avorms.    Should its  belly groAV large, its com-
plexion become  pale, and flesh soft, disease has already commenced.
In either  of these  cases, the child  will require good fresh  air, and
medical assistance.
   3. In a fit, untie the clothes, raise  the head, wipe away all froth from
the mouth, and keep it open, pressing  down the tongue and drawing it
forward at the same time.  Let the child be first quickly exposed to
cool, fresh air, and its face sprinkled with cold water; then gently rub,
with a Avarm hand, the belly, back,  and limbs;  apply a succession of
warm flannels to them, or resort to a warm bath, and put warm bricks,
etc., under the  armpits-;  strike the soles  of the feet smartly with a
piece of flat wood;  tickle the nostrils and  inside  of the  ear, with a
feather.   (See treatment  of Fits, on page 216.)  Act for  two hours
according to these directions, and do not allow the child's head to hang
back, nor to lean forward upon the chest.

          Cautions adapted to Infancy and  Childhood.
   1. While sleeping at night, an infant should be frequently examined
to see that it is warm, that it is not  in danger of suffocation, and that
the circulation of blood and the breathing are not suspended.
   2. Never wake an infant out of a sound sleep by rough means, for
fear of causing fits, or a purging.
   3. Avoid using tight bandages, especially  around the  body, for fear
of causing fits, obstruction of the bowels, or decline.
   4. Avoid giving Godfrey's Cordial, Paregoric, Daffy's  Elixir, or any
other warm anodyne, for  fear of causing fits, fever, or palsy, a common
consequence of giving this class of medicines indiscriminately.
   5. Avoid giving any nostrum or patent medicine, for  fear of bring-
ing on decline, or sudden  death.
   6. Avoid feeding  infants  in the night, for fear of bringing  on
the gripes, and  even  Avorse complaints, from  over-distention of the
stomach.
   7. Avoid Avarm nurseries, and close air, for  fear  of making a child
delicate, weakly, and susceptible of cold.
   8. Avoid carrying a child always on the same arm, for fear of mak-
ing it crooked.
   9. Never confine a child's limbs by wrapping its clothes tightly around
it, especially at  night; by inaction  of the muscles, and retention of
moisture, the child will become weak and sickly.
  10. Avoid exposing an infant to the open air, in a cold season, when 
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its  bowels are disordered, or if it has a shortness of breathing  with
fever and cough, for fear of bringing on high inflammation.
  11.  Never allow a child's food to be cheAved;  it is not only a nasty
practice, but if the nurse has a sore mouth or gums, she may communi-
cate disease.
  12.  Never provoke violent laughter, nor disregard violent couching
for  fear of a fit in either case.
  13.  Never wash a child Avith milk, with a view to heal a chafed part *
milk will inflame, and cold  water  will  heal  it.
  14.  Too many  children in a bed,  or in  a close room, is very un-
healthy.
                      Teething or Dentition.
  The time of teething  is a most important period of the infant state,
and subjects it to many complaints and dangers, more especially when
children are raised in a delicate manner, without much exercise.  This
time most generally commences between the fifth and tenth months, and
the process of the first  teething commonly continues  to the sixteenth
year at least, and sometimes much longer.   The first teeth are called
the milk teeth, of which there  are twenty;  the  second are called the
permanent teeth, sixteen in each jaw.
  Teething almost invariably begins with the incisors, cutting or front
teeth of the lower jaw;  usually two of these are cut, and then the cor-
responding ones in the upppr jaw.  After two teeth in each jaAV have
appeared, it is, in some instances, a considerable time before the con-
tiguous ones come out;  but now and then six or eight are cut in" hasty
succession.   The front  teeth are succeeded by  the molars, grinders,
or back teeth, two on each  side of each jaw; then the canine, dog, or
stomach teeth, one on  each  side of the jaw; and the last of all, of an
infant's first  teeth*, are  the  ones opposite to these, the upper canines,
usually known as the eye-teeth.  Thus, there are to each jaw four front
teeth, tAvo stomach or eye-teeth, and four back teeth.
  Among children who are  strong and healthy, the teeth are cut both
easy and soon;  but in  unhealthy  and Aveakly infants, the process is
slow and uncertain.  Accordingly, children sometimes cut their teeth
irregularly or cross, as it is  called, both by the teeth appearing first in
the  upper jaAV, and also at a distance, instead of being close  to each
other; this is considered an indication of difficult or painful teething.
The ease or difficulty of teething may likeAvise be guessed at,  by the
circumstances under which the  first two teeth shall happen to  be cut;
the  succeeding ones frequently  working their way in a similar manner.
  The cutting of teeth is usually preceded and accompanied with various 
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211
symptoms : tne child drivels; the gums swell, spread, and become hot;
there is often a limited redness in the cheeks, and eruptions on the
Bkin, especially on the face and scalp ;  a looseness of the boAvels ; grip-
ings ; pale or greenish stools, or otherwise discolored;  watchings, start-
ings in  the  sleep,  and  spasms of particular parts;  a diminution or
increased secretion of the urine, which is  often of an unnatural color;
now and then a discharge of matter, with pain in making water; in
almost all cases the child is fretful, shrieks often, and thrusts its fingers
into its mouth.  In severe cases there may be ulcerations of the mouth
and gums, mortification, obstinate looseness of the bowels, cough, diffi-
cult breathing, and fits.
  Infants cut their teeth more readily in winter than in summer ; those
who are inclined to be lean cut them  more readily than those that are
very fat;  and children who are loose in the belly most safely of all.
   Treat ment—When a child is  suffering from  cutting teeth, open the
bowels with some of the Compound  Syrup of Rhubarb  and  Potassa,
Division I, page 740, or with a dose  of Castor  Oil.  If the gums are
red  and swollen, from  the advancing teeth pressing upon them, they
must be lanced, cutting from the top of the swollen gum doAvn to the
top of the imprisoned tooth, so  as to set  it at liberty, and relieve the
gums from its pressure.  By doing this, convulsions, serious affections
of the brain, etc., will frequently be prevented or removed. A strength-
ening, slightly stimulating  plaster, worn behind each ear,  will be found
of service;  the  Compound Resin Plaster, Division I, page 735, will
answer  for this purpose.
  The diet  of the child should be simple, digestible, and smaller in
quantity than usual, with plenty of pure air and exercise.  If the child
is sucking, the nurse's diet and boAvels must be particularly attended to,
alloAving her a mild and diluting diet, small in quantity.
  Difficulty  in passing water, may be overcome by a tea of Cleavers,
Melon seeds, Flaxseed, or Slippery Elm bark.
  Droiosincss  of the child  may be removed by bathing the whole sur-
face in  a  ay arm, weak, Ley Avater, and then applying Mustard  to the
feet, and Onions or Garlics, bruised, to the back and belly.
  A diarrhea coming on during the cutting of teeth, should not be
interfered with unless it be excessive, when the Compound  Syrup of
Rhubarb and  Potassa,  above referred to,  may  be given, in half tea-
spoonful or  teaspoonful doses, every hour or two.
  A very fine preparation for children to take during difficult denti-
tion, frequently obviating  the  necessity for cutting the  gums, is the
following: Take of  Phosphate  'if Lime twenty grains,  Carbonate of 
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AMERICAN FAMILY PHYSICIAN.
Magnesia ten grains, Phosphate of Iron five grains, simple Syrup three
gills; mix.  The dose is a teaspoonful three or four times a day, shak-
ing it well before taking.

                      Sore  Eyes of  Infants.
   This  generally comes on  shortly after  birth, and if not  properly
treated may result in a loss of the affected eyes.  The lids are red, and
stick together from the slight discharge ; as the disease progresses, the
discharge becomes profuse, yellowish,  and  like matter, and the eyelids
swell.   (See Division I, page 243.)
   Treatment.—Bathe the eyes  frequently, cleansing them of all the
matter with a wash made of equal parts  of Slippery Elm bark and
Peach leaves  infused in warm  water; and keep  cloths wet  with the
same over the eyes.  When the more severe symptoms have passed
away, frequently bathe  the  eyes with a decoction of equal  parts of
Golden Seal root and Witch  Hazle leaves; or, of Solomon's Seal root
and Bethroot.   The leaves  of Eye-bright, infused in Milk,  will also
be found efficacious.

                   Inflammation of the Gums.
   The gums  become inflamed,  red or  dark-colored, swollen, and more
or less painful; feverish symptoms are apt to be present, as hot skin,
quick pulse, thirsj;, furred tongue, etc.  Sometimes  ulceration occurs,
and as  it progresses the teeth decay and become loosened; the dis-
charges from  the mouth, as well as  the  breath, are  quite offensive.
From the slightest cause the gums bleed.  Inflammation of the  gums
is very  apt to  occur during the  period of teething,  among unhealthy
children, or those Avho are improperly attended to.
   Treatment.—In the early  stage of the disease, the gums should be
frequently washed Avith a solution of Borax in water, or an infusion of
Golden  Seal.   As soon as the  active symptoms of inflammation have
passed away, astringents should be applied to the gums, as  an infusion
of Crowfoot or Alum root; a  solution of Alum:  or, a mixture of equal
parts of Avater and  the Tincture  of Muriate  of Iron.   A solution of
Chlorate of Potash will be found  useful at any period of the inflamma-
tion ; a  drachm of the Chlorate of Potash  may be dissolved  in half a
pint of rain or soft water, to which twenty  drops of Muriatic acid have
been added; wash the gums with this several times a day.  In case of
ulceration use the astringents.  If the  bowels be costive, or loose, give
the Compound Syrup of Rhubarb and Potassa, Division I, page 740.
If there be much weakness  of the child, give an infusion of Golden 
HOUSEHOLD DEPARTMENT.
213
 Seal root, or  Ginseng, or Peruvian  bark,  or  of any  other simple
 tonic.
                       Thrush  or Aphtha.
   White specks upon the tongue, lips,  etc., with dribbling of saliva,
 hot mouth, disagreeable breath,  etc.  These specks  increase in size,
 fall off, and show an ulceration of the part from which they have fallen.
 When the disease is severe, the general system becomes affected; quick
 and weak pulse, bowels out of order,  greenish stools, fretfulness, and
 emaciation.  The pain  occasioned by this disease, very frequently in-
 terferes with the child's  sucking.  (See Division I, pages 248 and 249.)
    Treatment.—Wash the mouth  Avith  a decoction  of Golden Seal or
 Yellow Puccoon root, and Blue Cohosh  root, each, equal parts;  sweeten
 the decoction with Honey, and  add a small quantity of Alum.  The
 child may also be allowed to  swallow some  of it.  If the bowels are
 loose, give the Compound Syrup  of Rhubarb  and Potassa, Division I,
 page 740.   When the symptoms  are severe, pursue the measures rec-
 ommended in Division I, page 249.
   Other articles may be used in the milder forms of this disease, as
 decoction of Sage, or Gold Thread, or Blackberry root, or Witch Hazle
 bark, or Rough IlawkAveed, (with purple leaves and stem—Hieracium
 Scabrum.)
                          White  Thrush
 Commences with more  or less inflammation  of the mouth; specks or
 patches on the mouth, resembling particles of milk;  these become more
 numerous,  and run together, and  Avhen they fall  off leave a bright-red
 surface beneath, but Avithout any ulceration.   They may fall off and be
 renewed several times in succession, and, like Thrush,  may extend into
 the stomach  and boAvels.   The pulse is seldom changed, but the  skin
 will be hot, Avith thirst, and derangement of the bowels.  (See Division
 I, page 250.)
   Treatment—Same as  in the preceding disease, Thrush or Aphthje.
 (For other Diseases of the Mouth  in  children, which occasionally occur,
 see Division I, pages 247 to 253.)

                             Chafing.
  (See Division I, page  615.)
  Treatment—Wash the parts gently and carefully with Castile Soap
and water, and  then dust upon them some powdered Starch, scorched
Wheat or Rye Flour, or  Slippery  Elm Flour;  or, if severe, place  thin
layers of cotton batting between the parts. 
214
AMERICAN FAMILY PHYSICIAN.
                             Snuffles.
   (See Division I, pages 268 and 269.)
   Treatment.—Snuffles or Catarrh in Children, may generally be re-
moved by rubbing the nose and forehead with some warm Goose-grease,
or  Sweet Oil;  or, by placing upon these parts cloths kept Avet with
warm water.
                           Wind  Colic.
   (See Division I, page 404.)
   Treatment.—Keep  Avarm flannel  to  the back and belly  of the child,
and give it some Peppermint or Spearmint tea, slightly sweetened, to
which a small quantity of Saleratus must be added, say a piece the size
of a pea to a small teacupful of the tea.  At the same time place the
child upon its  belly across the knee,  and trot it  for some  time, also
gently tapping it along the whole course of the backbone.  Wood Soot
tea, or a tea of Aniseed,  Caraway seed, or Calamus root, may also be
used with advantage.
                          Green  Stools.
   Treatment-—Give  the  Compound Syrup of Rhubarb and Potassa,
Division I, page 740,  half a teaspoonful, or a  teaspoonful every hour
or two, in the same quantity  of Wood  Soot tea.  In some cases, small
doses of Calcined Magnesia  will be useful.  In obstinate cases,  take
of Culver's Physic or Black root, Calamus or Sweet Flag  root, Black-
berry root, and Golden Seal or Yellow Puccoon root, each, in coarse
powder or slices, a  table-spoonful, boiling water  a pint  and a half;
mix; steep  in  a covered vessel, near a fire, for four  hours; strain;
sweeten with Loaf Sugar.  Give a teaspoonful to a child a year old
every hour  or  two, adding to each dose  a drop or  two of  Spirits of
Camphor.
   If the child be old enough to SAvalloAV powders, the following may be
given in some  Mutton Broth:  Mix together a teaspoonful, each, of
powdered Rhubarb and Charcoal, to which add as much Tartrate of Iron,
(Citrate of Iron, or Carbonate of Iron, will answer,)  as will lie upon  a
dime.  Stir this in a teacup of the  broth, and give from a teaspoonful
to a table-spoonful every hour, stirring it well each time before taking.

                           Costiveness.
   (See Division I, page 426.)
   Treatment—Costiveness in infants may be overcome by introducing
a twisted piece of Paper,  or a piece of Soap into the lower gut; if it 
HOUSEHOLD DEPARTMENT.
215
Continues for  a long time, give injections of Chamomile  flower tea,
once or twice every day.
  In children  the costiveness  should be overcome by exercise in the
open air, the use of cooked fruits, ripe fruits, cornmeal gruel, etc.   If
this does not succeed, then give one of the preparations named in Divi-
sion  I, page 426.
                  Falling Doavn  of the Boavel.
  (See Division I, pages 597 and 598.)
  Treatment.—Gently push the protruding gut back into the body, and
inject into the bowels the following: Take of Crowfoot or Alum root,
White  Oak bark, each, in coarse powder, a table-spoonful; make half
a pint  of strong decoction, to  which add half a table-spoonful of pow-
dered Alum.  This should be injected cold, two or three times  a day.
When very severe, a bandage  will have  to  be worn to keep the bowel
from falling.  Internally, let  the child  drink freely of a tea of equal
parts of Golden Seal and Solomon's Seal.
  The  child should be taught not to strain during the  time of stooling,
and its diet must be  similar to that recommended above, in Costive-
ness. .  If, while the gut be firmly held in place by a tight bandage, the
child be made to lift, several  times every day,  a Aveight proportioned
to its strength, it will aid materially in overcoming the difficulty.

                   Consumption  of the Bowels.
  This is a disease of what are called the " Mesenteric Glands," and is
met with among scrofulous children.  The belly swells and becomes
hard, sometimes without pain,  but as often with  severe pain; the child
becomes thin and emaciated;  the appetite is usually good, if not vora-
cious, and the  bowels  are apt to be loose.  (See Division I, page 477.)
  Treatment.—Make use of a nourishing diet; keep the bowels regular
by the  use of the Compound Syrup  of Rhubarb and Potassa, Division
I, page  740; sponge  the  body daily with  cool  Avater, in which some
Salt, or Sal Ammoniac  has been dissolved, and  have the child take
exercise every day in  the open air.  Internally, give one of the prep-
arations named under Scrofula, on page 157.
  Or, the Syrup of Iodide of Quinine and Iron may be given, when
it can be obtained.

                             Rickets.
  This is also a disease  common to scrofulous children.  (See Division
I, pages 479 and 480.)
  Treatment.— Give a  nourishing  di«+:  k°ep  the  bowels  regular; 
216
AMERICAN FAMILY PHYSICIAN.
sponge the body daily with Salt and water, using considerable friction
in drying; and  have plenty of exercise taken in the open  air.   Give
internally, half  a teaspoonful of Syrup of  the Hypophosphites three
times a day, for three or four weeks, then substitute for it the Hypo-
phosphite of Lime, in two or three-grain doses, in sweetened water, for
about tAvo weeks, then omit this and return to the Syrup, and so con-
tinue alternating.   Both these articles can be procured at any dru»
store.
                       Convulsions  or Fits.
   (See  Division I, pages 856 to 359.)
   Treatment.—Place  the child  in  a warm bath as soon as possible,
allowing it to remain there some ten or fifteen minutes, at  the same
time pouring  cold  water upon  its  head and face, or applying cloths
wet with it to these parts; and give  it an  injection composed of two
table-spoonfuls of warm water, one table-spoonful of Molasses, a tea-
spoonful of powdered Lobelia, and  as much Red Pepper as will lie on
half a dime.   For a child six months old, one-half of this  may be
used, and be repeated every fifteen  minutes until  the fits have disap-
peared.  If it  can be procured, the best remedy is the Compound Tinc-
ture of Lobelia and  Capsicum, Division  I, page 747,  which can be
readily made, and which every family should keep in the house already
prepared for such emergencies.
   After the  fits have  been subdued, ascertain  the cause  of them,
whether due to  cutting teeth, worms, acrid or indigestible substances
in the stomach, or  from commencing Scarlet Fever, Measles, etc., and
treat accordingly, in order to prevent a return of them.   (For further
treatment, see Division I, pages 357 to 359.)

                             Worms.
   (See Division I, pages 429 to 432.)
   Treatment.—Various  articles  will remove  Worms, as  Red Cedar
balls or apples,  Tansy seed, Wormseed Oil, Pink root, Garlic, Snake-
head or Balmony, White Indian Hemp, Black Alder berries, etc.   Sev-
eral very  valuable articles are  given in  the treatment  of Worms, in
Division I.  Tape-worm may be removed by using freely of an infu-
sion  of bruised  Pumpkin seeds;  and Thread-worms  can  only be
removed by injections.   But whatever means may be used to remove
the Worms, they will  return  again  unless the bowels be strengthened
by the use of some tonic.  The  following will be found to answer an
excellent purpose :  Take of Golden  Seal, Ginseng, Chamomile flowers,
or Tansy, White Poplar bark, each,  coarsely bruised, an  ounce, boiling 
HOUSEHOLD DEPARTMENT.
217
water two pints;  mix, and steep in a covered vessel near a  fire  for
an hour or two.  When cold, add a pint of Whisky, and sweeten. The
dose is from  half  a teaspoonful  to  a  table-spoonful, three  or four
times a day, according to  the child's age.
  The folloAving have been found very efficacious in removing Worms :
  1. Take of  Skunk Cabbage roots  and balls three ounces, Black
Alder bark, Indian Hemp  root, green Rinds of Walnuts, each, coarsely
bruised, one ounce, boiling water three pints; mix.  Steep in a  covered
vessel, near a  fire, for six hours; when  cold add one pint of Whisky,
and sweeten.  The dose is from a teaspoonful to a table-spoonful, three
or four times  a day.
  2. Take of  Wormseed Oil half an ounce, Castor  Oil an ounce and a
half, powdered Fern  root, powdered  Skunk  Cabbage root, each, two
drachms;  mix.  Shake well before using.  Dose,  from one-half to a
teaspoonful, three times a day.

                Summer Complaint of  Children.
  (See Division I, pages 423 to 425.)
  Treatment—The best  remedy for this disease is the  Compound
Syrup of Rhubarb and Potassa, Division  I, page 740, and which should
always be kept on hand in every family.  The following  preparations
are also very valuable :
  1. Take of  Ginger, Cinnamon, Cloves, each, in powder, a teaspoon-
ful, Golden Seal root, White Oak bark, each, in coarse powder,  a table-
spoonful, Whisky a pint;  mix.  Let it  stand ten or twelve days, fre-
quently shaking.  The dose is from a teaspoonful  to a table-spoonful
in an equal quantity of sweetened Avater.
  2. Take of Wild Cherry bark, Rhubarb root, Blackberry root,  Prickly
Ash berries, each, coarsely bruised, a table-spoonful, Cloves, Cinna-
mon, each, in  poAvder, a teaspoonful, Whisky a pint; mix.  Prepare
and use in the same manner as the  preceding.
  3. Take of  Culver's Physic  or Black root, Bethroot, Prickly Ash
berries, each,  in coarse poAvder, a table-spoonful, Cinnamon,  Ginger,
each, powdered, a teaspoonful, Whisky a pint;  mix.  Prepare and use
in the same manner as the preceding.
  Children laboring under Summer Complaint should drink freely  of
infusion of Slippery Elm bark, Oatmeal coffee, tea of parched Corn, or
Milk boiled  and thickened with  Wheat  or Rice flour, with powdered.
Cinnamon added, and sweetened. 
218
AMERICAN FAMILY PHYSICIAN.
                            Diarrhea.
  (See Division I, pages 421 to 423.)
  Treatment.—The treatment for children laboring under Diarrhea will
be the same as named for adults, in Division I, referred to above; or,
in Division II,  page 147.   The same remedies may be used, but in
doses suited to the age  of the child.

                   Infantile Remittent Fever.
  1.  Some fever, fretfulness, and languor of the child, for several days;
dry and parched lips ;  thirst; pulse frequent; the symptoms are worse
at night, with startings during sleep.   Sometimes  considerable  drow-
siness and stupidity.   The fever comes  and goes at intervals,  some-
times three or four times a day.
  2.  The fever  increases; pulse more rapid; cheeks become red; child
lies in a kind of stupor, or picks at its nose, eyes, or mouth;  tongue
becomes coated; stools more frequent; belly ssrells ; the fever is usu-
ally off most of the day, but returns at night.  (See Division I, pages
212 to 214.)
   Treatment.—Administer a gentle  cathartic, as Rhubarb and Magne-
sia ;  bathe the skin frequently with Avarm, weak ley water; for  a con-
stant drink give an infusion of Slippery Elm bark and Peach leaves,
equal parts in water, and keep  the feet warm and the head cool, by
Mustard, Garlic, or Onion draughts  to the  feet, and cooling washes to
the head; as, equal parts of Vinegar  and rain water.   Should there
be  much derangement  of the  bowels, give the Compound Syrup of
Rhubarb and Potassa, Division  I, page 740 :  and allow as a diet, light
 fluid drinks, as  Rice water, Barley water, etc.
   Internally, when the  fever is  on, let the child drink freely of warm
 infusions of Catnip, Balm, Elder flowers, etc.   When the fever is off,
 give the following: Take of Solomon's Seal root, Black Cohosh root,
 Chamomile flowers, Peruvian bark, (or in its  stead, Dogwood bark,)
 each, in coarse powder, a table-spoonful, boiling water a quart;  mix.
 Steep in a covered vessel, near  a fire, for four hours ; when cold, strain
 and  slightly sweeten.   Dose, from a  teaspoonful to a table-spoonful,
 according to the child's age, every hour.   (For further treatment, when
 required, see Division I, pages 213  and 214.)
   For the vomiting which occurs in this disease, a tea of parched Corn
 or Oatmeal coffee may be used, with Mustard or Garlic poultices e^yer
 the pit  of the stomach. 
household department.
219
                        Scarlet Fever.
  Scarlet Fever, also termed in some places, " Canker-rash," is a dis-
ease common to both children and adults, but more especially the former.
It commences  with chilliness succeeded by heat, quick pulse, languor,
thirst, more or less headache, redness of the eyes,  and sore  throat,
with  some difficulty of swallowing.
  In two or three days, numerous specks or patches of a fiery red color
appear about the face and neck;  and within twenty-four hours this red
eruption extends over the whole body.   In about four days, a gentle
moisture appears on the skin, the eruption  disappears gradually, and
bran-like scales fall off from the skin.
  When the disease is severe, all  the above symptoms  are more vio-
lent, with  nausea, vomiting, headache, delirium, quick  breathing,  in-
flamed throat, which passes into an ulcerated condition ;  the " almonds
of the ear " swell, and have whitish or grayish ulcers upon them, and
sometimes they become so much enlarged as to seriously interfere with
the breathing.   (See Division I, pages 215 to 221.)
   Treatment—Administer  an emetic promptly; one of those named
under Fevers, on page 74, will answer. After the operation of the
emetic, give a Spirit vapor bath, or make use of other  means to pro-
duce a sweating, as named on page 74, and follow this  with a dose of
Castor  Oil, or other  cathartic.   This course may be pursued  every
day  for the first tAvo or three days of the attack.
   The  Avhole  surface of the body should be bathed frequently with a
cool, weak, ley  water, whenever  it is hot  and dry; and the  patient
 may drink freely of some Avarm herb tea during the course of the dis-
 ease, as of Catnip, Balm, Sage, or Avarm  Lemonade, etc.
   In the severe form of the disease, after the action of the emetics and
 cathartics for the first two or three days, a tonic course must be pur-
 sued.   The folloAving powders may be given with advantage:  Take of
 Prussiate  of  Iron  half a drachm, Sulphate of Quinine  twenty grains,
 Piperin ten grains ; mix, and divide into thirty powders, of which one
 may be given every hour or two to a child four or five years old.
   The sore throat in Scarlet Fever may be benefited by bathing with a
 liniment composed of Sweet Oil and Spirits of Camphor, equal parts;
 or,  an  equal  part of Spirits of Hartshorn may be  added to it.  This
 liniment should be rubbed upon the throat three or four times a  day,
 applying after each rubbing a Avarm fomentation of equal parts of Hops
 and Mullen leaves, around the throat.   When the patient can gargle,
 he may use an infusion of Sumach berries and Golden Seal root, sweet- 
220
AMERICAN FAMILY PHYSICIAN.
 ened with Honey, and some Borax  added.   This  should  be  garbled
 with three or four times a day.   (See Division I, page 219.)
   The various symptoms which attend the disease must be treated as
 named under their respective heads on  pages  99 to 102.   And any
 further treatment in the more malignant cases, as Avashes, gargles etc.
 will require to be the same as named in Division I, pages 218 to 221.
   The room in which a patient with  Scarlet Fever is confined, as well
 as the other rooms of the house, should be frequently purified by plac-
 ing  Chloride of Lime in saucers, in various parts of them, and pouring
 on a little Vinegar from time to time so as to disengage the Chlorine.
   If any spontaneous  bleedings  occur, give the following: To three
 ounces  of cold water add ten drops of Oil of Vitriol, and fifteen grains
 of Alum; when  this is dissolved, a  table-spoonful may be  given to a
 child four or  five years old, and repeated every half hour or hour.
 By  pursuing the course here advised, ninety-nine cases out of a hun-
 dred may be cured.
   For the Dropsy which follows Scarlet Fever, see Division I, page 220.
   Preventive.—Rub up  two grains of the Extract of Belladonna, in an
 ounce of soft water; of Avhich from one to five drops may be given four
 times a  day, to children between one and ten years of age.   Its use
 should be.continued for some three or four weeks, taking as  much care
 as possible to keep the  healthy children from coming into the infected
 apartments.   I prefer,  however, the following as a preventive: Take
 of Tincture of Black Cohosh root six teaspoonfuls,  Tincture of Bella-
 donna, Tincture of Aconite, each, one teaspoonful.  Give two drops of
 this  in a little water for every year of the child's age; thus, five years
 will require  ten drops,  ten years  twenty  drops, etc.  Repeat the dose
 every four hours, night and day, for three weeks.

                            Measles.
  1. Chills; fever; thirst; pains in head  and back;  quick pulse;
 nausea, sometimes vomiting;  tongue  moist and coated white; hurried
 breathing; dry cough  and  hoarseness;  flushed  face; eyes red  and
 watery;  sneezing  and discharge from the  nose.
  2. In  three or  four days red spots, slightly elevated,  appear  first on
 the  forehead and  gradually  extend over  the Avhole  body;  the parts
 where they  are being rough to  the touch.   On the fifth or sixth day
 the swelling or redness  disappears in  the same order in  which it made
its appearance : first on the head, then the face, neck, breast, body, and
limbs.   Branny scales  fall  off from the parts of the skin  where the
eruption existed.   (See  Division I, pages  221 to 224.) 
HOUSEHOLD DEPARTMENT.
221
   Treatment.—In the mild cases but little more  is required than to
 keep the patient in doors, so that he may not " catch cold," giving, if
 necessary, some warm Lemonade, or Flaxseed tea, to relieve any cough
 which may be present.
   In severe cases, give an emetic at the start, (see Fevers, page 74,)
 and follow this by some Slippery Elm infusion, SAveetened with Honey,
 for thc  cough.   Wash the eyes with a cool infusion of Rose leaves, or
 Red Raspberry leaves, or an infusion of Slippery Elm bark.  And if
 there is much soreness  of the throat and chest, let the patient inhale
 the Avarm vapor of Vinegar.
   If the Measles strike in, give some warm Whisky Toddy, and place
 Mustard poultices over the whole belly, to the feet, ankles, and wrists,
 and allow  them to  cause  considerable redness before  removing them.
 For much pain and heat in the head, bathe it with a mixture of equal
 parts of Vinegar, Spirits, and rain Avater.   (For further treatment, see
 Division I, pages 222 to 224.)

                           Lung  Fever.
   Lung Fever, or Inflammation of the Lungs, is known in children by
 the feverish symptoms; pain in the chest; constant and anxious diffi-
 culty of breathing, relieved by sitting or standing up; swollen and
 purple  face or  lips; distressing  and painful cough;  and strong, quick
 pulse.  (See Division I, pages 270 to 273, and Division II, page 91.)
   Treatment.—Administer an emetic, and, if necessary, repeat it every
 day  for two or three days; one of those named under Fevers, page
 74, will answer.  Bathe thc surface of the body with a warm, weak
 ley Avater, several  times  a day, and apply Mustard poultices  to the
 feet, and Avarm fomentations over the painful parts, across the breasts,
 of Hops, Tansy, Wormwood, etc.   In infants, pounded Onions or Gar-
 lics may be applied to the feet and legs, to the breast, and to the back
 betAveen the shoulder  blades.  Give the following internally, to relieve
 ihe cough  and  lessen the  inflammation: Take of  Slippery Elm bark
 tAvo  ounces, Lobelia leaves an ounce, Bloodroot, in  powder,  two  tea-
 spoonfuls ;  add to these one quart of boiling water, cover  the vessel,
 tud let it vsteep  near a fire for an hour; Avhen cold, strain, and sweeten
 with Honey or Molasses.   A teaspoonful or two of this may be given
 every hour or tAvo, but not to cause  vomiting.
  The boAvels may  be kept open by some Castor Oil, or  one  of the
 cathartics named under Fevers, on page 75.   In other respects pursue
 the same course as  recommended in the pages  of the two Divisions
above referred to. 
222
AMERICAN FAMILY PHYSICIAN.
                        Croup or Rattles.
   1. Difficult breathing; a peculiar ringing sound of the voice, as if
 the sound were sent through  a tube  of metal; breathing quick  and
 hissing ; cough ;  quick pulse ; restlessness ; fever; distress exhibited
 in the  countenance.
   2. Cough husky and suffocative; voice whispering;  breathing wheez-
 ing ; countenance pale; head throAvn back; pupils dilated; pulse quick
 and weak;  tongue  coated and  purplish  at  the  edges;  stools dark
 and fetid ; extremities grow cold; countenance sinks;  great restless-
 ness and distress,  followed by death..   (See Division  I, pages 258
 to 262.)
   Treatment—The first thing to do when the child is  attacked, is to
 vomit  it; for this purpose,  an infusion of Lobelia may be given in
 table-spoonful doses ; or, an infusion of Lobelia three parts, Bloodroot
 one part; or, some Wine of Ipecacuanha may be added  to the infusion
 of Lobelia;  or, the Wine of Ipecacuanha may be administered.  Alum,
 given in Molasses or Honey, in doses  of a teaspoonful of the powder,
 and repeated every  ten  or fifteen minutes until it vomits freely, will
 be found beneficial.   Any of the emetics named, must be given every
 few minutes until the child pukes thoroughly.  In fact, anything that
 will produce vomiting may be given.  The best emetic  for children is
 the Compound  Tincture  of Lobelia, Division I,  page 747,  which
 should be  kept on  hand  by every family in  which there  are chil-
 dren;  it is  readily made.   At the same  time that the emetics  are
 being given, cloths Avet Avith Avater, as  hot as can be borne, should be
 applied to  the throat and upper part  of the chest, and be frequently
 reneAved.
  As soon as the breathing  becomes  better,  and  the child is  easier,
 some Lard may be rubbed on a piece of muslin, upon which some yel-
 low or Scotch Snuff must  be sprinkled, and this should be worn con-
 stantly over the throat and upper part of the chest, changing it two
 or three  times a day.  Through the  day, if it be old enough, the child
 should inhale several  times the. warm vapor of Vinegar, or of Vinegar
 and Mullen leaves.   An expectoration  must be kept up by one of the
 following: an infusion of three parts of Lobelia and one of Bloodroot;
an infusion  of Horseradish in Vinegar;  five drops of Rattlesnake's
Oil on Sugar, for a  child two years old;  ten drops of Goose  Oil on
Sugar;  or an infusion of Lobelia,  Skunk Cabbage, and Wild Tur-
nip, equal parts, in  Vinegar.   If the bowels are costive a dose of
Castor Oil may  be  given.   And for  a constant drink  through  the 
HOUSEHOLD DEPARTMENT.
223
day, give  a tea of Flaxseed, or Slippery Elm bark, rendered pleas-
antly sour by  the  addition  of Lemon-juice  or  a small portion of
Vinegar.   Should the attack return on  the next  night, pursue the
same'treatment.
  Great  care  must be taken to keep the feet and body of the child
warm, and to  avoid everything  calculated to bring  on a fresh attack.
If the above vegetable emetics are infused in one  part, each, of water,
Vinegar, and Molasses, they will act much better  than in water alone.
During the attack of  Croup, a child may always be placed in a warm
bath for  fifteen or tAventy minutes, with great benefit.

             False Croup or  Spasm of the Glottis.
  This differs from Croup in the following respects: In Croup there is
fever, cough, no convulsions of the limbs, and the  breathing is  affected
both in drawing in the breath and letting  it out; in False Croup there
is no fever, no cough, but convulsions, or spasmodic contraction of the
muscles of the extremities, and the difficulty is only in drawing in the
breath, and not in letting it out.
   Besides, the child may have several attacks in the course of the day,
and the disease may continue for weeks and months before being per-
manently cured.  The slightest  cause may bring on an attack, as fret-
ting, straining, exercise, and even Avhile feeding. The breathing is free
Avhen the attack is off, Avhich is not the case Avith true Croup, in which
there is more or less  hoarseness all the time.
   Treatment—During the attack, cold Avater should at once be thrown
upon the child's head and face, raising it to a sitting position, and  as
soon as  possible it should be placed in  a warm  bath for  fifteen  or
twenty minutes, still keeping the sitting posture, and sprinkling the cold
AA'ater until it recovers.   Also  strike the child Avell on the  back, and
if Ammonia be at hand,  apply it to the nostrils.
  As soon as the child has recovered from the fit, endeavor to learn
the cause  of  the disease, and treat this  promptly.  If the  child be
teething, and the gums are swollen, cut them;  if  the bowels are loose
or costive, treat them accordingly;  if it has come on shortly after
some great grief, anger,  joy, or other mental emotion of the mother,
prohibit the use of her breast-milk for a feAV days, feeding the child
with coav's milk and water; if it be due to Avorms,  follow the treatment
advised for them.  See that the child has a proper light diet, that its
bowels are regular, and  that it  is never fed except when in a sitting-
up position.
  When  the disease continues for some  time, a poultice of Hops and 
224
AMERICAN FAMILY PHYSICIAN.
Stramonium  leaves should be Avorn  around the throat;  and the child
should use the following:  Take of High Cranberry bark two  ounces
Peony root, Scullcap, and Skunk Cabbage, each, one ounce.   Place all
coarsely bruised, in tAvo quarts of boiling water;  steep in a covered
vessel, near a fire, for six hours;  when cold, strain, sweeten, and give
from  a teaspoonful to a table-spoonful four or five times a day,  accord-
ing to the age  of the  child.   A removal  to a pure air will be of
immense benefit.

                          Hooping-Cough.
   (See Division I, pages 390 to 392.)
   Treatment.—An emetic, at  the commencement of the disease, is
always useful; and it may be  repeated according to the severity and
jbstinacy of the disease, and the strength of the patient.  The  bowels
should be kept regular, and after the first stage has passed, the patient
should, if possible, be  removed to some other place, as a change of
air is always beneficial in  this  disease.  A Burgundy Pitch plaster, or
any other stimulating plaster may be worn between the shoulders with
advantage.   Among the  many  remedies that have  been  used with
benefit  in this  disease, the  following will  be found  some  of  the
best:
   1.  Take of Black Cohosh or Rattle  root, Bloodroot, Skunk Cab-
bage, each, in coarse powder, a table-spoonful, boiling water one pint;
mix.  Steep  in a covered vessel, near a fire, for six hours; when cold,
strain, add thirty  drops of Nitric Acid or Aqua Fortis, and sweeten
with  Sugar.   Dose, from a teaspoonful  to a table-spoonful  several
times a day, whenever  the cough  is  bad.
   2.  Take of Lobelia, Peony  root,  and Ladies'-slipper root, each, in
powder, a tablespoonful, Bloodroot a teaspoonful, boiling water  a pint;
mix.   Steep  in a covered vessel, near  a fire,  for six  hours; when
cold,  strain;  add Alum a teaspoonful  and a half.  Dose, same  as the
preceding.
   3. Rattlesnake's Oil,  five or six  drops on  Sugar,  will  relieve the
cough and loosen the phlegm.
   4. Five or ten drops, each, of Balsam of Sulphur and Oil of Amber,
may be rubbed up with  Sugar, for a dose, repeating it three or four
times a day.   (For other remedies, see  Division I, pages 391 and 392.)

                              Mumps.
   Soreness and  stiffness of the neck,  followed by a painful  tumor of
the glands in one or both sides of the neck ;  the  tumor increases in 
HOUSEHOLD DEPARTMENT.
225
  size for four or five days,  rendering  it difficult and painful to  swal-
  low, or even open  the mouth.  On the fourth or fifth day, it begins
  to  diminish, and disappears entirely by the  eighth  or tenth day.
  Sometimes as the  SAvelling  subsides, the breasts in females, or the
  testicles in males, become  SAvollen.   (See  Division I, pages 253 and
  254.)
    Treatment—Generally,  but little treatment is required, except  to
  keep thc boAvels regular, protect the patient  from cold and damp, and
  to have the SAvollen  parts constantly covered with soft flannel.   When
  severe, the patient should be kept in bed, and drink freely of warm
  herb teas.
    When the testicles or  the breasts swell  upon  the  subsidence  of
  the  disease, a  poultice of common Beans, pounded and boiled, will
  be  found very  valuable.

                            Chicken Pox.
    Slight symptoms of fever;  loss of  appetite; languor;  loss of sleep,
  etc., folloAved by a reddish eruption, Avhich first appears, as a  general
  rule, on the back.  On the second day, the red pimples become  small
  vesicles, containing a watery fluid, which is  sometimes of a yellowish
  color;  on  the  third day,  these vesicles  are  fully ripened; the fluid
  escapes, and dry scabs form; and from the fifth to the tenth day, the
  whole eruption disappears  Avithout leaving any pits behind.  (See Divi-
,  sion I, page 230.)
    Treatment—Seldom  that  any treatment is  necessary, further than
  to keep thc  patient warm, regulate  the  bowels,  and, if the feverish
  symptoms  are  severe, give  some warm herb  teas, as of  Catnip,
  Balm, Pennyroyal, etc.

                  Involuntary Discharge of Urine,
  In Avhich children can not hold their Avater;  it may continue through
  the day, but is more common at night, the children Avetting their bed
  regularly.   (See Division  I, pages 442 and 443.)
    Treatment.—When this difficulty is  owing to Aveakness,  the Isinglass
  mixture, in Division I, page 442,  will be found a most effectual  rem-
  edy.   Other remedies may, however,  be used with benefit, as an infu-
  sion of Queen of the  Meadow  root,  and Crowfoot or  Alum  root,
  equal parts of each ; or, of equal  parts of Bethroot, common  Nettle,
  and  Mullen; or, of equal parts of Button  Snake root,  St.  John's-
  wort, and Blackberry root.  The child should  be  made  to empty the
  bladder every night  before going to bed,  should be alloAved no fluids 
226
AMERICAN FAMILY PHYSICIAN.
during supper, and should not be allowed to  lie on his back during
sleep.
  In  some  cases  the  following Avill prove  very valuable:  Take of
Tincture of Muriate of Iron one  drachm, Tincture of Spanish Flies
half a drachm,  Tincture of Wild Cherry bark  six  drachms;  mix.
Give a child tAvo  or three years  old seven  or eight drops of this m
some  sweetened water, three  times a day;  and others  in proportion
to their age.
                        St. Vitus's Dance.
  This  disease most  commonly appears from  the eighth to the four-
teenth year, though it may occur earlier, but very seldom later.  There
are irregular convulsive motions of the muscles of the face and limbs,
which usually cease during  sleep; unsteady gait in walking;  awkward
and odd gesticulations; variable appetite; obstinate constipation.  (See
Division I, pages 363 to 365.)
   Treatment—The bowels must be kept regular, but not actively phys-
icked.   The surface of the body must  be bathed every day, with con-
siderable friction in drying.   The diet  must be nourishing and of easy
digestion, avoiding all  fats and sour things.  Exercise in the open air,
every fine day, is very essential.  The  child should be  taken from
school, and not be crossed or contradicted  in anything, nor be excited
in any other way.  When worms are present, or are suspected to be
the cause of the disease, they must be removed by the proper remedies;
or, any other cause, when knoAvn, must  first be  cured before attempting
any other treatment.   Should the disease  still persist, or the cause be
unknown, one of the folloAving remedies may be given:
  1. Take of Black Cohosh root tAvo ounces, Peony root, Horseradish,
each,  one ounce, Assafcetida half an ounce, Rust of Iron four ounces,
good Cider three  pints; mix.   Steep in a covered vessel, near a  fire,
for twelve hours.  When cold, the dose for  a  child  eight years old is
a table-spoonful three  or four times a  day.
  2. Take of Flowers  of Sulphur, Gum  Myrrh, in powder, each, an
ounce, Spirits of  Turpentine half a gill, SAveet  Oil or Linseed Oil a
gill; mix.   Simmer over a  gentle fire  until  the mixture becomes red;
let  it  stand until the  fluid is clear, and pour it off into a bottle.   Of
this give from six to tAvelve drops, tAvice  a day, to a child eight years old.
  3. Take of Oxide  of Zinc one drachm,  Flowers of Sulphur  one
drachm,  Red Oxide of Iron one drachm, Extract of Black  Cohosh a
sufficient quantity to  form  into a pill  mass.  Divide into sixty pills.
One pill is a dose for a child ten or tAvelve years of age ; to be repeated
three  times  a day. 
HOUSEHOLD DEPARTMENT.
227
CLASSIFICATION  OF  MEDICINES.
  For the benefit of those of my readers who may live in the country,
[ give the following list of medicines under their different classifications,
such as  may be found in their fields and woods, etc.  Some of these
medicines  have several actions upon the system, but I will give only
the more prominent ones, and any one desiring a cathartic, emetic, diu-
retic, etc., may safely select from among the many named under these
respective heads.   I have given the more common names of the plants,
and where a plant is known by several names, they are all included by
a brace, thus:  {.
Alteratives.
  Tag Alder.
  {American Ivy.
  False Grape.
  Five leaves.
  Dwarf Elder.
  Spikenard.
  Prickly Elder.
  Burdock.
  False Bittersweet.
  Pipsissiway.
  Black Cohosh.
  Turkey Corn.
  Yellow Parilla.
  White Pond Lily.
 *Poke.
  Plantain.
f Mayapple.
\ Mandrake.
  Sarsaparilla.
f Queen's root.
I Stillingia
 Adder's Tongue.
 Wahoo.
 Guaiacum.
 Frostweed.
 Iodine.
 Blue Flag.
f Twin leaf.
I Ground Squirrel Pea.
*Sheep  Laurel.
 Tamarac.
 Sassafras.
f Button Snake root.
I Devil's Bit.
 Iron wood.
 Water Dock.
 Yellow Dock.
 Elder Flowers.
 Soap wort.
 Ironweed.
 Speedwell.
 Indian Cup Plant. 
228                AMERICAN FAMILY PHYSICIAN.
  These articles are  supposed to render the blood pure, and are used
in Scrofula, Rheumatism, Liver Complaint, and in all diseases in which
the  blood  needs purifying.  One or several of them together may be
formed into a cordial or syrup, and be used in doses varying from a
half table-spoonful to half a gill.   Some of them are cathartic in large
doses, some act as diuretics, and others are stimulating.  Those which
are  poisonous in large  doses, have  an asterisk (*) prefixed.  These
agents sometimes require to be used  a long time, changing them occa-
sionally, as the system gets used to their action.

                          Antiperiodics.
         {Black Cohosh.                f Poplar.
         Rattle root.                  \ Aspen.
         Squaw root.                   Apple-tree bark.
         Horse Chestnut.               White Willow bark.
         Dogwood.                     Ironweed.
         Peruvian bark.               f Rosin-weed.
         Wild Hoarhound.             I Compass-weed.
         Iron wood.                    Wild Hickory bark.
  These  articles are used  in Fever and Ague, Remittent Fevers, and
in all diseases where there are intervals of  freedom from any symptom
whatever  of disease.  The dose of the powdered  articles varies from
half a teaspoonful to a teaspoonful three times a day; of the infusion
or decoction, one or two table-spoonfuls.

                           Antiseptics.
         Wild Indigo.                  Bethroot.
         Charcoal.                     Chloride of Sodium.
         Yeast.                       f Smartweed.
          Creosote.                    I Water Pepper.
         Pyroligneous Acid.            Vinegar.
         Lousewort.                    Sulphate of Zinc.
         Sumach bark.                  Marshmallow root.
         White Oak bark.               Saltpetre.
  Antiseptics are useful in cases of mortification,  both internally and
externally; also in the malignant or  putrid conditions  of fevers, in-
flammations, and other diseases.

                          Antispasmodics.
         Assafoetida.                   Blue Cohosh.
        ^Belladonna.                   Black Cohosh. 
HOUSEHOLD DEPARTMENT.
229
  ("Ladies' Slipper.
  \ Nerve root.
* j Stramonium.
  \ Jimson.
   Wild Yam.
   Valerian.
   Masterwort.
   Mullen.
  J Twin leaf.
  \ Ground Squirrel Pea.
  J Whiteweed.
  \ Ox-eye Daisy.
   f High Cranberry.
  \ Cramp bark.
 Lobelia.
 Ice Plant.
 Mistletoe.
 Prickly Ash.
 Catnip.
^Tobacco.
 Peony.
 Water Plantain.
 Rue.
 Scullcap.
 Skunk Cabbage.
 Thyme.
 Wild Turnip.
 Ginseng.
  These articles act as tonics to the nervous system, or as relaxants,
or sedatives, overcoming spasmodic action, removing nervous irritabil-
ity and weakness, and curing convulsions.  The dose of an infusion of
most of them varies  from a teaspoonful to two table-spoonfuls three
times a day.  Those to which an asterisk (*)  is prefixed, are poisonous,
and must be used with great care,  in small doses.
Astringent
 Catechu.
 Alum.
 Hound's-tongue.
 Eyebright.
( White Balsam.
1. Indian Posey.
 Logwood.
 Witch Hazle.
 White Pond Lily.
 White Oak.
 Blackberry.
 Dewberry.
 Raspberry.
 Yarrow.
 Horse Chestnut.
 Agrimony.
 Uva Ursi.
 Blackbirch.
{
  Wintergreen.
J Crowfoot.
\ Alum  root.
  Avens.
  HaAvkweed.
  Striped Bloodroot.
  St. John's-wort.
  Bugle.
  Hardhack.
  Marsh-rosemary.
  Bethroot.
  Cat-tail Flag.
  Common Nettle.
  SAveet Fern.
  Round-leaved Dogwood.
  Persimmon.
  Willow Herb.
  Fireweed. 
230                AMERICAN FAMILY PHYSICIAN.

         Canada Thistle,                 Canada Fleabane.
         Black Ash.                     Bayberry.
         White Ash,                    Spirits of Turpentine.
         Kino.                          Beech-drops.
        f Prim.                          Five Finger.
       \ Privet.                        Black Alder.
         Rockbrake.                    White Willow.
         Sumach bark.                  Hardleaf Golden-rod.
   Astringents are used in excessive Menstruation, Diarrheas, and Dys-
enteries, in spitting  of blood, and other bleedings, in excessive dis-
charges  of  phlegm, in Cholera, and in Chronic Inflammations of the
Eyes, etc.   An infusion of one  or several of the plants together, may
be made and used as a wash, or a gargle, in sore mouth and sore eyes.
Internally,,the  dose varies from a table-spoonful to half a gill, three
or more times a day.  Alum, Kino, and Catechu may be given in pow-
der, in doses of five to ten grains.

                           For Bathing.
         Saleratus.                     Sal Ammoniac.
         Sal Soda.                      Pearl Ash.
   About a teaspoonful of either of these to a pint of water, or enough
to make the water feel slippery.  Used as a wash in Fevers, Inflamma-
tions, Chronic  Diseases, etc.
	Carminatives.
J Calamus. t Sweet Flag.	Wild Carrot seeds.
	Fennel.
Angelica,	Pennyroyal.
Pleurisy,	Peppermint.
Caraway,	Spearmint.
Cloves.	Horsemint.
Cinnamon.	Nutmeg.
Coriander,	Sage.
Catnip.	Summer Savory.
Anise.	Sweet-scented Golden-rod,
Feverfew.	Prickly Ash berries.
Ginger.	Camphor.
Dittany.	Allspice.
  Carminatives  or  aromatics are usually stimulants, and are used to
drive away  wind in flatulent  colics,  etc., to prevent medicines from 
HOUSEHOLD DEPARTMENT.
231
griping or otherwise disagreeing Avith the stomach and bowels, and to
correct the taste of medicines, rendering them pleasant.   The infusion
or tincture of them, or an essence of the oils, is generally used.
                           Cathartics.
         Aloes.
         Bitter root.
         Prickly Elder.
         Senna.
         Wild Potato.
         Jalap.
         Blue Flag.
         Butternut,
        ( Culver's Physic,
        \ Black root.
         Queen's root.
   Cathartics or purgatives  are  used whenever it is  required  to  act
freely upon the bowels; when  given in small doses, to produce  one or
two moderate evacuations, they are called " Laxatives."  The doses of
most of them is a teaspoonful of the powder every three or four hours.
Poke, Aloes, Jalap, Blue Flag, and Croton Oil, require less, as will be
seen by a reference to them  in the Materia Medica, Division I, page
618.  Castor Oil  varies with different persons, requiring from  one to
three table-spoonfuls to  operate.
  Buckbean.
  Castor Oil.
  Croton  Oil.
  Poke.
J Mayapple,
I Mandrake,
  Seneca.
  Buckthorn berries.
  Rhubarb.
  Locust-tree bark.
  White Ash.
Diaphoretics.
 Pleurisy.
 Pennyroyal.
 Peppermint.
 Spearmint.
 Sage.
 Summer Savory.
 Saffron.
 Ginger.
Blue Vervain.
Smartweed.
Yarrow,
Horsemint.
  Catnip.
/ Feverbush.
1 Spicewood.
  Feverfew.
  Golden-rod.
  Balm.
  Virginia Snake root.
  Thyme.
  Chamomile flowers.
  Mountain Mint.
  MayAveed.
  White Vervain.
  Diaphoretics are used in fevers, and inflammations, and whenever it
is required to promote a Aoav of perspiration; Avhen they produce pro-
            6o 
232
AMERICAN FAMILY PHYSICIAN',
fuse sweating, they are called " Sudorifics."  A warm infusion of them
may be drank freely whenever required.  The sweating is much aided
by bathing the surface with a weak ley water.
Diuretics.
  Canada Balsam.
  Water Plantain.
  Garlic.
  Onion.
  Burdock seed*
  Uva Ursi.
  Silkweed.
  Water Chickweed.
  Pipsissiway.
  Horseradish.
 ^Watermelon seed.
 *Pumpkin seed.
  Artichoke.
  Wild Carrot.
  Bush Honeysuckle.
  Tamarac.
  Sassafras.
  Spearmint.
  Horsemint.
f Knot-grass.
I Sickle-weed.
  Apple-tree bark.
  Thimble-weed.
*Elder flowers,
^Slippery Elm.
  Whortleberry.
  Honey.
 ^Marshmallow.
  Sal Ammoniac.
  Indian Hemp.
  Dwarf Elder.
  Mountain Pink.
  Scouring Rush.
  Button Snake root.
  Queen of the Meadow,
 ^Cleavers.
  Sunflower seeds.
  St. John's-wort.
 ( Twin leaf.
\ Ground Squirrel Pea.
  Juniper. .
  Spirits of Turpentine.
  Wild Job's Tears.
  Cutting Almond.
  Parsley.
  Smartweed.
  Haircap moss.
  Balm of Gilead buds.
  Squill.
  Figwort.
  Dandelion.
  Common Nettle.
  Mullen.
 ^Spirits of Nitre.
  Diuretics are used in Gravel, in difficult passing of water, heat and
high color of water, Dropsy, and several other affections.  Some are
stimulating in  their character, some astringent, and others  cooling.
The cooling diuretics have an asterisk (*) prefixed to them, and should
be infused in  cold  Avater.   An  infusion of either of these plants is
about half a gill, three or more times a day.   Spirits of Nitre, Canada
Balsam, Squill, Spirits of Turpentine,  and Sal Ammoniac, have then
loses  named in the  Materia Medica, Division I, page 618. 
HOUSEHOLD DEPARTMENT.
238
Emetics.
 Indian Hemp.
 Prickly Elder.
 Ipecacuanha.
 Boneset.
 Blooming Spurge.
 American Ipecac.
 Lobelia.
 Mayweed.
 Buckbean.
 Poke.
f Mayapple.
Seneca Snake root.
Locust-tree bark.
Bloodroot.
Squill.
Rosin-weed.
Queen's root.
Papaw seeds.
White Vervain.
Blue Vervain.
Chamomile.
Mustard.
Bitter root.
       1 Mandrake.
  Emetics are useful in the commencement of fevers, in colds, coughs,
and diseases of the lungs and  air tubes, in diseases of the liver, and
many other affections.  Most of the herbs named are  to be taken in
warm infusion, from a table-spoonful to half a gill at a  dose, repeating
it every ten or fifteen minutes until free vomiting is produced.   Some
of the articles, as Squill, Bloodroot, Poke, Spurge, etc.,  require less for
a dose.   (See Materia Medica, Division I, page 618.)

                         Emmenagogues.
         Spanish Needles.               Winter-fern.
         Blue Cohosh.
         Black Cohosh.
         Saffron.
         Pennyroyal.
         Savin.
         Motherwort.
         Madder.
         Rue.
         Thyme.
         Pleurisy root.
  These medicines are supposed to so influence the sexual organs as
to bring on and regulate the menstrual function.  The warm infusion
of one or several of them together may be used in half gill doses, three
or four  times  a day, at the period of menstruation, but taken only
when cold, during the intervals.  Spurred Rye must be used with much
care.  Some of these  remedies  giATe strength to the womb, and thus
Mayweed.
Partridge berry.
Origanum.
Smartweed.
Feverfew
Rosemary.
Spurred  Rye.
Life-root.
Tansy.
Cotton bark. 
234
AMERICAN FAMILY PHYSICIAN.
throw off any menstrual difficulty, and even facilitate labor by impart-
ing more tone and energy to the organ.
Expectorants.
Gum Ammoniac.
Spanish Needles.
Liquorice.
Comfrey.
Sunflower seeds.
Cat-tail Flag.
                                       Slippery Elm.
                                       Flaxseed.
                                       Elecampane.
                                       Hoarhound.
                                       Balm of Gilead buds.
                                       Speedwell.
  Expectorants are used in dry Coughs, and Colds, to cause the phlegm
to be thrown off easily and readily.   All the emetics are expectorants
when given in small doses.   The above herbs may be given in warm
infusion, in table-spoonful doses, as aften as required.  Gum Ammo-
niac is given differently.  (See Materia Medica, Division I, page 618.)

                          Fomentations.
         Stramonium.                   Hyssop.
         Hops.                         Hoarhound.
         Lobelia.                       Catnip.
         Wormwood.                    Mullen.
         Smartweed.                    Mayweed.
         Marygold.                     Summer Savory.
         Boneset.                       Hound's Tongue.
         Poppy  flowers.                 St. John's-wort.
        f Whiteweed.                    Yarrow.
       \ Ox-eye Daisy.                 Frostweed.
  Fomentations  are made by steeping one  or several bitter herbs in
boiling water, and then placing them over certain parts as hot as can
be borne, changing them frequently.   They are used in inflammatory
and painful diseases, Spasms, Cramps, etc., to relax parts, and subdue
pain and inflammation.

                      Gargles and Washes.
  Vinegar and Salt.
  Sage.
  Hyssop.
  Bark of Black Haw root.
f Lion's-foot root.
\ Rattlesnake root.
  Sumach bark.
  Golden Seal.
  Blue Cohosh.
  Wild Indigo.
/ Crowfoot.
\ Alum root. 
household department.
235
Witch Hazel.	Avens.
Alum.	f Prim. t Privet.
Borax.	
Red Pepper.	Bayberry.
Sumach berries.	Honey.
  These  articles  are  used in  infusion as a gargle or wash for Sore
Throat and Mouth, Thrush, Inflamed and Ulcerated Gums, Sore Eyes,
Ulcers, etc.  One or more may be combined together for this purpose.
For Aphthae or Thrush, the Lion's-foot root forms the best gargle
known,  and will, probably, be found  effectual in Diphtheritic  Sore
Mouth.
                          Mucilages.
         Gum Arabic.                  White Pond Lily.
         Marshmallow.                  Buckhorn brake.
         Gum Tragacanth.              Polypody.
         Flaxseed.                      Chickweed.
         Solomon's Seal.                Comfrey.
         Quince seed.                  Slippery Elm.
         Low Mallows.                  Bellwort.
         Mullen.                        Blue Violet.
  Mucilages and demulcents are used in  coughs, colds, and inflamma-
tions to soothe  inflamed parts, to increase the discharge of urine, and
to facilitate the raising of phlegm.  One or more may be made into an
infusion AYith cold water and be  drank freely.   They  are  useful in
soreness  of the chest  and stomach, and in hot and high-colored urine.
	Narcotics.	
Opium.		Stramonium.
Belladonna.		Poison Hemlock
Henbane.		Yellow Jasmine.
Tobacco.		Mullen seeds.
Poke.		Camphor.
Aconite.		Indian Hemp.
  Narcotics depress nervous  action and are useful  in high fevers,
inflammations, delirium, severe pains, etc.  In  large  doses  they are
poisonous.  See the dose of each in the  Materia Medica,  Division I,
page 618.
                              Oils
        *Cod Liver.                     Bear.
        *Neat's foot.                    Hen.
        ^Flaxseed.                      Squirrel. 
236
AMERICAN FAMILY PHYSICIAN.
        *01ive.                         Goose.
        *Sweet Almond.                Mud Turtle.
         Skunk.                        Wild Cat.
         Rattlesnake.                   Lard.
  These oils may be used in various diseases.  Those with an asterisk *
prefixed may be taken internally as demulcents or mucilages; they are
also  nutritive, and may be  used as such in  Consumption  and other
diseases of debility.   The other oils may be used externally as relax-
ants, and in Rheumatism and other pains, a small portion rubbed over
the parts two  or three times a day, will frequently  give relief; and
Rattlesnake,  Hen, and Goose Oil are excellent in coughs, colds, croup.
Rattlesnake Oil is very penetrating, stimulating, and relaxing.  Lin-
seed Oil is useful in Worms and Piles, as well as in Consumption.

                     Poultices and Draughts.
         YarroAV.                        Elm bark.
         Adder's Tongue.               ^Burdock leaves.
         Bayberry.                     ^Horseradish leaves.
         Catnip.                       *Mustard seed.
         Flaxseed.                     *Poke leaves.
         Sorrel.                        *White Elder leaves.
         Poke root,  roasted.            *Black Maple leaves.
         Sumach.                      ^Garlics.
         White Pond Lily.              *Onions.
         Yellow Pond Lily.             ^Mullen leaves.
         Comfrey.                      *Walnut leaves.
         Sassafras.                      Hops.
        *Basswood leaves.                Stramonium.
         Black Willow.                  Lobelia leaves.
  Poultices are used for various purposes : to hasten  the formation of
matter in an  abscess, to  relieAre pain, to lessen inflammation, and to
impart warmth to parts.  Some, as Mustard, Garlics, and Onions, are
used to redden the skin and cause counter-irritation, determining the
blood from the diseased part to the  surface where  they are applied.
Drauo-hts are for a similar purpose ; the leaves are wilted and applied
blood-warm to the  legs and soles of the feet, as soon  as they are
wiped dry after bathing.  Those articles with an asterisk (*)  prefixed
are used for draughts  in fevers, inflammation of the head, lungs, or
stomach, and  for headache;  they are especially useful  in cases  of
infants  and children. 
household department.
23*
                         Refrigerants.
        fce<                           Maidenhair.
        Vinegar.                       Elder flowers.
        Citric Acid.                    €ream of Tartar.
        Tartaric Acid.                 Saltpetre.
        Orange juice.                  Sweet Spirits of Nitre.
        Lemon juice.                  Acid fruits.
         Sorrel juice.                   Malic  acid.
         Houseleek leaves.              Cold water.
  Refrigerants, or cooling drinks, are used in fevers to eool the sys-
tem, allay the excessive heat, and promote  the discharge of urine, and
moderate sweating.   They always form a healthy and refreshing drink
for patients, when they can be used.   (For doses, see Materia Medica,
Division I, page 618.)

                        Sedatives.
         Peach leaves.                 St. John's-wort.
         Hound's Tongue,              Sheep Laurel.
         Hops.                        Ice  Plant.
         Bloodroot.                     Wild Cherry.
         White Hellebore.              Bugle-weed.
  Sedatives are used to diminish increased aetion in the system, as
in fevers, inflammations, nervous irritability, spasmodic  irritability,
pains, quick  pulse,  etc.  Narcotics,  given in small doses, act as seda-
tives.  (For  doses, see Materia Medica, Division I, page 618.)

                          SlALAGOGUES.
         Ginger.                       Pellitory of Spain.
         Prickly Ash bark.             Horseradish.
         Tobacco.                      Wild Turnip.
  These produce, when chewed, an  increased flow of saliva, and  are
of service in diseases of the tongue, gums, almonds of the  ear, ear-
ache, etc.
                              Snuffs.
         Bloodroot                    Camphor.
         Bayberry.                     Black Hellebore.
        (Hawkweed.                   Ginger.
       \ Striped Bloodroot             Colt's-foot.
         Myrrh.                       Tobacco.
         Sage.                         Sneezewort
         Prickly Ash bark.              Horaechestnut seed. 
238
AMERICAN FAMILY PHYSICIAN.
  These  augment the secretion  of  mucus  from the nose, and are
useful in chronic diseases  of the eyes and  of  the  brain, headache,
catarrh, and in some cases  of soft polypus of the  nose.
Stimulants—(Internal.)
Prickly Ash bark.
Prickly Ash berries.
Ginger.
Thyme.
Brandy.
Whisky.
Wine.
Alcohol.
Garlic.
Gum  Ammoniac.
Angelica.
Prickly Elder.
Virginia Snake-root,
Wormwood.
Colt's-foot.
Myrrh.
Buchu.
Spicewood.
Benzoin.
Black Birch.
Marygold.
Camphor.
Hyssop.
Guaiacum.
Rue.
Tansy.
Blue Vervain.
Red pepper.
Cinnamon.
Cloves.
Horseradish.
Coffee.
Dittany.
Mustard.
Summer Savory.
Sage.
Rosemary.
Balm of Gilead buds.
Spirits of Turpentine,
Smartweed.
Ground Ivy.
Nutmeg.
Bayberry.
Horsemint.
Peppermint.
Spearmint.
Balm.
Sweet Gum.
Sassafras.
Elecampane.
Masterwort.
Button Snake-root.
Yarrow.
Ginseng.
Allspice.
Manroot.
Black pepper.
Cardamom.
  Stimulants raise an action in the system, invigorating and strength-
ening it for a time in cases of debility, by increasing the action of the
heart and arteries, and of the nervous influence.  They are useful  in
all diseases of debility, and the more active and powerful among them
should not be used in cases of acute inflammation,  high fevers, full
habit, etc.  They are useful in Hysterics, in Nervous debility, Cramps 
HOUSEHOLD DEPARTMENT.
239
want of action in mucous surfaces, cold systems, Dyspepsia, Flatulency,
etc.  (For the doses, see Materia Medica, Division I, page 618.)

                    Stimulants—(Externally.)
Burgundy Pitch.
Garlic.
Onion.
Camphor.
Red Pepper.
Oil of Cinnamon.
Oil of Cloves.
Oil of Sassafras.
Oil of Thyme.
Oil of Origanum.
Mustard.
Horseradish.
Gum Ammoniac.
Rosin.
Pitch Pine.
Hemlock Gum.
White Turpentine.
Canada Balsam.
Water of Hartshorn.
Rattlesnake Oil.
Bloodroot.
Sal Ammoniac.
         Gum Benzoin.
         Spirits of Turpentine.
  These  arc used in the preparation of washes, liniments, ointments,
and plasters, for the  purpose of relieving pain, causing redness of the
skin, and determination to it, strengthening debilitated muscles, check-
ing headache and Aoav of blood to the head, to increase a healthy action
in old, obstinate ulcers, etc.  They are useful in Rheumatism, Neural-
gic pains, Hysterics, flatulent Colic, Coughs, weak Stomachs, Spinal
tenderness, coldness  of the surface, internal pains, etc.
                    Tonics.
Dilute Muriatic Acid.
Dilute Nitric Acid.
Dilute Sulphuric Acid.
Dilute Phosphoric Acid.
Elixir Vitriol.
Unicorn root.
Chamomile.
Maidenhair.
Horse Chestnut.
Agrimony.
Bitter-root.
Virginia Snake root.
Pleurisy root.
Buchu.
Barberry.
Rhubarb.
Sumach.
Soapwort.
Indian Cup-plant.
Tansy.
Dandelion.
Bethroot.
Bellwort.
Bark of root of Black Haw.
Yellow-root.
Swamp Dogwood.
Turkey Corn.
Preparations of Iron.
American Colombo.
Black  Ash. 
240
AMERICAN FAMILY PHYSICIAN.
Bahnony.	White Ash.
Chicory.	False Unicorn root.
Peruvian bark.	Solomon's Seal.
Canada Thistle.	White Poplar.
Colombo.	Buckhorn brake.
Golden Seal.	Ironwood.
Gold-thread.	Peony.
Dogwood.	Ginseng.
Wahoo.	Quassia.
Boneset.	Ground Centaury.
Ox-gall.	Black Alder.
Gentian.	Wild Cherry.
Tamarac.	Apple-tree bark.
Whiteweed.	Locust-tree bark.
Hoarhound.	American Centaury.
Mayweed.	White Willow.
Buckbean.	Common Nettle.
Ice Plant.	Vervain.
Ground Ivy.	Ironweed.
Aspen.	Speedwell.
Five Finger.	Mistletoe.
  Tonics  give  power to the nervous system  to strengthen the whole
frame, and especially those parts.which are more particularly enfeebled;
hence, they are useful  in convalescence from exhausting diseases, in
Spasmodic Diseases,  Dyspepsia, want of appetite, nervous  debility,
nervous irritability, weak muscles, and other diseases where debility is
a prominent symptom.   Some tonics are stimulant, and may be used
where there is excessive weakness; others are free from any stimulat-
ing action, and may  be used Avhere there is a tendency to irregular
action, or nervous and muscular irritability, or where the action of the
heart and arteries is easily excited.  These articles are generally harm-
less and may be used in extract in two or three grain doses; in  infu-
sion  or decoction,  in table-spoonful  doses or more; in  tineturc, in
teaspoonful  doses  or  more.   (See Materia Medica, Division I, page
618, for the doses of most of the above.)

                           Vermifuges.
         Wormwood.                    Spirits of Turpentine.
         Balmony.                      Black Alderberries.
         Wormseed.                     Cedar berries. 
household department.
241
        Polypody.                    ^Pomegranate.
       *Rockbrake.                   *Pumpkin seed.
        Feverfew.                     P^k root.
        Rue#                         jBlack Hellebore.
       fQuassia.                      tAssafcetida-
        Tansy.                       fTobacco.
        Garlic.                       +Salt-
        Onion.                        Peach-tree bark.
        White Poplar.                 Walnut bark.
        *Swamp Milkweed.            *Male Fern.
  Vermifuges or Anthelmintics  are used for the purpose of expelling
worms; they act by removing both the worms and the mucus in which
they live.   Those  prefixed with an asterisk (*)  have removed tape-
worm ; those with a dagger (f) may be used in injection to remove the
thread-worm.  Tobacco, however, used either by mouth or by injection,
is dangerous, and  ought not to be used without  the advice of a phy-
sician.
  A plaster for the removal of worms has been used in some sections
of the country with great success.   It is prepared as follows : Take of
Beefs-gall, and  expressed juice  of fresh  Rue, an ounce of each, to
which add half a teaspoonful of finely  powdered Aloes; mix, and boil
over a moderate  fire, to the consistence of a plaster.  Spread a rather
thick plaster, three or four inches square,  and place it upon the belly,
so that the upper part  of it shall cover the pit of the stomach.  Con-
tinue this plaster three or four days, renewing it daily, and then give
an active dose of physic, as Castor Oil, or Antibilious Physic, etc.
   If thc fresh Rue can not be had, half a pint of a  strong decoction
of the plant may be substituted;  and,  if the Aloes can not be obtained,
a gill of a strong decoction of equal parts of Wormwood and Mandrake
root will answer.   This plaster is especially useful when the worms
are in the stomach.
   Male Fern should be used in a recent state, and the root should be
gathered some time between the months of March and September. 
242
AMERICAN FAMILY PHYSICIAN.
             TO  HEADS  OF  FAMILIES.

  Families living in the country, Avhere most of the medicinal plants
named in this Division of the work, can readily be had, and collected
for the time of need, can, at the very small expense of two dollars, have
the  following articles furnished them,  by means of which they will be
enabled to treat successfully all  the  acute diseases which are more
commonly met with, as well as the principal part of the various dis-
eases named in this book; and these quantities are sufficient to last a
family of five persons for one year; or, if they have but little sickness
among them,  for two years :
  Four ounces of Compound Powder of Jalap, or Antibilious Physic,
for operating on the bowels and liver,  in all Fevers and Inflammatory
Diseases, in Liver  Complaint, Headache, Sour Stomach, Costiveness,
and, indeed, in all diseases where it is  necessary to physic the bowels.
(See Division I, page 737.)
  Two ounces of Compound Powder of Lobelia, or Emetic Powder,
for vomiting  in Fevers, Diseases  of the Chest, Throat, Stomach, and
Liver, and all diseases  in which vomiting is of service.  (See Division
I, page 738.)
  Four ounces of Compound Tincture of Lobelia, or Expectorant
Tincture, for Croup, Hooping Cough, Lung  Fever,  Cough, and all
cases in which expectoration will be useful, as well as for vomiting in-
fants and young children.  (See Division I, page  747.)
  Two ounces of Compound Tincture of Virginia Snake Root, or
Sudorific Drops, to relieve pain, cause sleep, and produce sweating in
Fevers and Inflammations.  (See Division I, page 748.)
  Two ounces of Compound Tincture of Lobelia and Capsicum, or
Antispasmodic Tincture,  for Spasms, Cramps, Fits, LockjaAV, etc.
(See Division I, page 747.)
  Four ounces of Compound  Syrup  of Rhubarb and Potassa,  or
Neutralizing Cordial, for Diarrhea,  Cholera Morbus, Sour Stomach,
and Summer  Complaint of children. (See Division I, page 740.)
  Two ounces of Compound  Tincture of  Camphor,  or Rheumatic
Liniment, for all aches and pains, as Toothache, Rheumatism, Neural-
gia, etc.  (See Division I, page 745.) 
household department.                  243
MISCELLANEOUS  PHARMACY  AND VALUABLE
                          RECIPES.
  All the recipes herein given, will be found correct and fully capa-
ble  of effecting the  results for which they are  recommended;  many
of them are superior to any others known.  The  formulas for the pat-
ent medicines are all from the best sources.

                       Golden Tincture.
  Take of Sulphuric Ether, Sweet Spirits of Nitre, each, one ounce,
Ladies' Slipper root half an ounce, Red Sanders one drachm, Oil of
Cinnamon, Oil of Anise, each, half a drachm, Brandy or good  Whisky
one pint; mix; let  it stand ten  or twelve days, frequently shaking.
This is an excellent nerve  tonic, and antispasmodic, and is useful in
Spasms, Cramps, Nervous Irritability and Debility, Hysterics, and for
weakness from excesses in sexual intercourse.   The dose is a teaspoon-
ful every three or four hours.

                        Pile Ointment.
  Take of Extract  of Belladonna, Extract of  Stramonium, each, one
drachm, Sulphate of Zinc, Sugar of Lead, each, twenty grains, Prussic
Acid, (common strength,) five drops, pure, fresh Lard one ounce; mix
thoroughly together to form an ointment.  To be applied to the pile
tumors or fissures, twice a  day.  The  above has been used with the
most satisfactory results in  all the different varieties of this most dis-
tressing malady, and may be  relied on as truly  valuable in obstinate
cases.  Also good in Tetter and Salt-Rheum.

                  Beddoe's Pills for Gravel.
  Take of Carbonate of Soda, dried without heat, one drachm, White
Castile Soap  four  scruples, Oil of Juniper ten drops, Syrup of Ginger
enough to form the whole into thirty pills.  Dose,  one or two pills three
or four times a day. 
244
AMERICAN FAMILY PHYSICIAN.
                           For Gravel.
   Take equal parts,  each,  of fresh  Broad-leaved Thyme, Ragweed
fresh roots, sliced, of Queen of the Meadow, wild Potato, and Master-
Avort, and fill a gallon bottle with them;  then fill with Whisky.  The
dose is from a table-spoonful to half a gill, three or four times a day
as the stomach can bear.

                     For Broken Chilblains.
   Melt together, in an iron vessel, six ounces each of Lard and Tallow •
add one  ounce of Red Oxide of Iron, and stir with an iron spoon till
the mixture is black; then add one ounce of Venice Turpentine, and
half an ounce  of Bole Armenia, previously rubbed into a paste with
half an  ounce of Olive  Oil.  To be  applied daily, on linen, to frost
sores.  This is Wahler's celebrated ointment for frost sores.

                   Another—Russian  Remedy.
   Dry the peelings of Cucumbers, and when required for use soften
the inner part  with water, and apply it to the part affected.

                         For Consumption.
   Rum  or Whisky  one  gill,  Linseed  Oil  one gill, Honey, Garlic
beaten to  a pulp, Loaf Sugar, of each, two ounces, yelks of three
Eggs ; mix.  Dose, a table-spoonful three or four times a day.   This
is said to have effected some  remarkable  cures.

                       Saveet's Red Poavder.
   Take of Mandrake, or Mayapple root  five ounces,  Bloodroot one
ounce; reduce  them to coarse powder, put them in a bottle and cover
with  Alcohol;  let  the  mixture  stand four  or five  days, frequently
shaking;  then  filter; add  fresh Alcohol  enough to cover the dregs;
filter, and  let this last liquor pass several times  through  the dregs.
Mix the  two filtered liquors, and, in a tin cup placed in a water-bath,
evaporate to the consistence  of molasses; while hot,  add six ounces
of powdered white Sugar, one drachm of  Croton Oil, to Avhich a little
Salt of Tartar has been added to neutralize the acrid principle, and
half a drachm of Oil  of  Cloves:  mix  thoroughly together, and spread
on  a  plate  or glass to dry; then powder.  This forms an  excellent
cathartic and  alterative, useful in nearly  all chronic  diseases.  The
dose  is  from twenty to thirty  grains;   it usually vomits as well  as
purges. 
HOUSEHOLD department.
245
  This powder could  be made as follows:  To six ounces of White
Sugar add one drachm of Croton Oil, prepared as  above, and half a
drachm of Oil of Cloves;  mix, and rub them thoroughly together;
then add  eight scruples  of Podophyllin and forty-six grains  of San-
guinarina.
                        For Toothache.
  Take of finely powdered Alum one drachm, Sweet Spirits of Nitre
seven drachms; mix.  Moisten a little cotton or lint with the liquid,
and introduce  into  the cavity of  the  aching  tooth, first  drying  the
cavity with lint or cotton.  If there is no cavity to be reached readily,
place the liquid on cotton upon the gums surrounding the tooth.

                            Another.
  Mix together half a drachm, each, of Oil of Cloves, Oil of Cajuput,
Oil of Amber, and  Powdered Camphor.   Use the  same as the  pre-
ceding.
                            Another.
  Take  of Camphor  two drachms,  Chloroform  one drachm, Strong
Water of Ammonia  half a drachm; mix.   Use as the preceding.

                        For  Mosquitoes.
  To drive mosquitoes out of a room, take of SaAvdust of Cedar wood
two ounces, Charcoal, Sand, each, one ounce, Benzoin, Camphor, each,
half an ounce,  Saltpetre tAvo drachms, Oil of Pennyroyal one  drachm,
Mucilage  of Gum Tragacanth enough  to  form the whole into a stiff
paste.  Form  into conical masses about the size of prepared chalk,
and  dry them. To  use them, place one or two in  different parts of
the room, in  a saucer, ignite them, and  let  them  slowly consume.
The odor which impregnates the  room will cause  the mosquitoes to
leave.
                            Another.
  Take of SaAvdust of Cedar wood tAvo ounces, Magnesia two drachms,
Oil of Pennyroyal, Camphor, each, one drachm; rub the Oil with the
Magnesia, then with the Sawdust,  and  lastly add the Powdered Cam-
phor.  Sprinkle this powder around the room, and on the bed  between
the sheet and  mattress.

                        Healing Salve.
  Melt together equal parts  of Beeswax, Mutton Tallow, Rosin,  and
Linseed Oil; heat them only hot enough to have them mix. 
246
AMERICAN FAMILY PHYSICIAN.
                  To Check the Floav  of Milk.
  Apply a plaster made  of  powdered  Meadow-Cabbage  or Skunk-
Cabbage and Lard.   This is  useful to check the Aoav of milk in the
breasts, in cases of inflammation, etc.

                    To Cure Fever and  Ague.
  Take of the Juice  of Ale-Hoof, called also Gill-grow-by-the-Ground,
Catfoot, etc., one part, Spirits one part;  mix.  Dose, a  wine-glassful
three times a day.   This may also be made by filling a bottle with the
fresh leaf of the plant, and then adding the Spirits.

                            Another.
  Take  Sal Ammoniac  one  ounce, Sulphate of Quinia twenty-four
grains, water twelve ounces;  mix.   Dose, a  table-spoonful every
hour during the intermission.

                             Another.
  Take of Sulphate  of Quinine, Red Pepper, Prussiate  of Iron, each,
one  drachm, Honey a sufficient quantity to  form  a pill-mass; mix, and
divide into sixty pills. Dose, one every hour or  two before the return
of the expected chill.   At the same time bathe  along the backbone,
three times a day, Avith a mixture of Spirits of Turpentine three ounces
and  a half, Chloroform one drachm.

                          For Epilepsy.
  Take of Oil of Box (Buxus Sempervirens) six drops, repeating the
dose  three times  a day.   The Oil is prepared by rasping Box wood,
putting it into water, distilling the oil, and afterward rectifying it.

                            Another,
  Take  of Box-leaves  and  wood  in  chips, one  ounce,  Smartweed
half an ounce, Stramonium seed two drachms, Assafcetida one drachm,
Oil  of  Amber,  rectified, one  drachm, Alcohol  a  pint and a half;
mix.   Let it stand  ten  or  tAvelve days,  frequently  shaking.   The
dose is from one teaspoonful to a table-spoonful three times a day.

                     For a Whitlow or Felon.
  Take equal parts of Hard Soap, Salt, and Spirits of Turpentine;
work them  together  until they form a salve.   To be applied to the
felon when it first makes  its appearance,  and repeated if necessary. 
HOUSEHOLD DEPARTMENT.
247
                           Ice Cream.
  Take of good Sweet Milk one quart, two Eggs ; beat the Eggs well,
add them to the Milk, and then sweeten to suit—say five or six ounces
of White Sugar; flavor also with a sufficient  quantity of Essence of
Lemon or Essence of Vanilla ; place this mixture into a freezer, around
which  must be placed, in alternate layers, coarsely broken Ice  and
coarse  Salt, which must  reach  high enough up on the outside of the
freezer to be on a level with its contents; move or rotate the freezer
thus arranged in the midst of the Ice and Salt until the Cream is suffi-
ciently frozen.   This  is  a very delicious and refreshing  article for
patients laboring under  fevers, inflammations, etc.,  and for consump-
tives and others.   Tavo table-spoonfuls of Arrowroot rubbed up finely
with some  of the Milk, then boiled, strained, and added, previous to
the freevng, will much improve the Ice Cream.

                       Spitting  of  Blood.
  Make a strong tea of Witch Hazel leaves, and to half a pint of it add
three teaspoonfuls, each,  of Sage Juice and  Common Nettle  Juice.
Dose, a wine-glassful every half hour until the bleeding stops.

                       For  Bilious Colic.
  Take of White Walnut Bark,  Elder Bark, and Dogwood Bark, each,
a handful;  boil them in four  quarts of  Avater  down to  one quart;
strain, and add half a table-spoonful of Saltpetre.  Dose, a teaspoonful
or tAvo three or four times a day.   This has given relief, and also
broken up the disposition to bilious colic, where everything else  has
failed.
                       Salve for Old Sores.
  Take one pint  of Sweet Oil, half an  ounce  of Shaving Soap, and
half a  pound  of Beeswax; melt together, and add one-fourth  of  a
pound  of Red  Lead; keep stirring over the fire until the mixture is
dark-brown or black.  Continue stirring till nearly cold, when add one
ounce of  powdered Camphor.  This will be found a superior article.

                          Frank's Pills.
  Take of  Aloes, Jalap,  each,  one drachm, Rhubarb fifteen grains,
Syrup  of Wormwood  enough to form a pill-mass;  divide  into forty-
five  pills.   Dose, one to  four pills a day.  These  are the celebrated
Grains de  Sante  so  much employed in Europe as dinner pills, and
much used by dyspeptics.
           6Q* 
248                AMERICAN FAMILY PHYSICIAff.
                        For Dysentery.
  Boil together by a gentle heat three pints of good Sweet Milk and
one ounce  of  Mutton Tallow;  then  add gradually Powdered  Starch
half a table-spoonful, stirring constantly, and Loaf Sugar to suit the
taste.  Dose, a wine-glassful several times a day.

                         Shampoo Liquid.
  Dissolve Salt of Tartar two drachms, in  clean rain water one pint.
Rub some of this upon the hair until a lather is formed, and thoroughly
cleanse the scalp and hair from grease and dirt by rubbing well with
it.   Then wash in clean water, and dry the hair as  thoroughly as pos-
sible.  This is a cheap solution for keeping the head clean and healthy,
and is superior to all the more costly articles for this  purpose.

                         Magic Liniment.
  To one pint of Hot Drops made with Alcohol, add two ounces, each,
of Oil of Sassafras, Oil of Hemlock,  Spirits of Turpentine, and Cam-
phor, and one ounce, each, of Oil of Cedar, Oil of Origanum, and Oil of
Cinnamon; when made, add Lard Oil  or Linseed  Oil,  one-sixth part
of the whole bulk, or about one gill.   This forms  a  valuable liniment
in  Sprains, Bruises, Pains, Rheumatism, Neuralgia, and wherever a
liniment is required.

                      To  Cure Drunkenness.
  Take of Quassia, in chips, one ounce, Colombo root, in powder, Oas-
carilla bark,  in chips, Gentian root, in chips, each, two drachms, boil-
ing water one pint; mix;  steep near a hot fire for  twenty-four hours;
strain, sweeten slightly with Sugar,  and add a drachm and a  half of
Elixir Vitriol.   The dose is a table-spoonful three or four times a day.

                              Sprains.
   Take a large spoonful of Honey, the same quantity of Salt,  and the
White of an Egg; beat the Avhole up incessantly for two hours, then
let it stand an hour, and  anoint the place sprained with the oil Avhich
will be produced from the mixture.   This is said to have enabled per-
sons with  sprained ankles to Avalk in tAventy-four  hours, entirely free
from pain.
                             Another.
   Mix together eaua: "a't-s of Saints of  Camphor and Beefs-gall. 
household department.
249
Keep in a closely stopped bottle for use.  Bathe the affected part with
.t plentifully every three or four hours until relief be obtained.

                    For Sprains and Bruises.
  Take of Sal Ammoniac an ounce, Camphor half an ounce, White Soap
six  drachms, Alcohol two pints;  mix; let them stand for a few days,
frequently shaking; then filter.  To be rubbed  over the parts several
times a day.
                     For Weakly Females.
  To one quart of good Whisky add the following:  Pleurisy root,
Blue  Cohosh root, Black Cohosh  root,  each, in  coarse  powder,  one
table-spoonful, Balm of Gilead buds, Tamarac bark, Angelica root, each,
in coarse powder, tAvo teaspoonfuls, Bloodroot,  in coarse  powder,  one
teaspoonful; mix; let it stand ten or twelve days, frequently shaking.
The dose is a teaspoonful three times a day, gradually increased, as the
stomach can bear it, to one or two  table-spoonfuls; it should be taken
in sweetened water.  This is  a most excellent medicine.

                            Another.
  Take of White Snake root six ounces, Poplar bark five ounces, Black
Cherry bark, Hops, and Whitewood bark, each, four ounces.  Boil the
whole in ten quarts of water, until the strength is out; then strain, boil
down to two quarts, and add two pounds of Loaf Sugar.   Dose,  half a
gill, three times a day, on an  empty stomach.

                   Wash to remove Freckles.
  Take of Sal  Ammoniac a teaspoonful, Muriatic Acid thirty drops,
rain Avater a pint, Essence of Lavender two teaspoonfuls ;  mix.   Wash
with a sponge three times a day, and let it dry on the face.

                            Another.
  Take of Oil  of Bitter Almonds, FloAvers  of  Sulphur,  and Tannin,
each,  five  parts, Oil of Origanum or Thyme, Oil of Bergamot, each,
one part, Lard  sixty  parts; mix, and form an ointment, to be rubbed
upon the face every night.
                            Another.
  Take equal parts of green  Sage and green Tansy loaves, and fill a
bottle with them; then  fill the bottle with Alcohol.  In  six or seven
days, press and strain out the Alcohol, and to every gill add one pint
of Avater and half a drachm of Muriatic Acid.  Apply with a sponge
two or three times a day. 
250                AMERICAN FAMILY PHYSICIAN.
                      Davis's  Pain Killer.
  Take of Myrrh one ounce and a half, Guaiacum Resin one ounce,
Camphor half an ounce, Red Pepper, Oil of Aniseed, each, one drachm,
dilute Alcohol or Whisky two pints;  mix; let  them stand  for seven
days, frequently shaking, and then filter.

                        Pettit's Eye-Salve.
  Rub together in a mortar  three ounces of White Precipitate, four
ounces of Oxide of Zinc, two drachms of Benzoic Acid, two scruples
of Sulphate  of Morphia, and  twenty drops of Oil of Rosemary; then
add  gradually to them a warm compound, made by melting together
two pounds of Sweet Oil, twelve ounces of Spermaceti, and four ounces
of White Wax, stirring till cold.

                    Redding's Russia Salve.
  Melt together two parts White Gum Turpentine, and one part Bees-
wax ; then add  Olive Oil to make it of the proper consistence.

                Wistar's Balsam of  Wild Cherry.
  Take of Wild Cherry bark one pound, Brandy one pint: mix; let it
stand five days, frequently shaking, and filter.
  Take  of Dandelion root  four ounces, Bloodroot  one ounce, Tar  an
ounce and a half, water half a gallon;  place over a  slow fire  and evap-
orate to three pints; then  strain; add three pounds of White Sugar,
and  the above  Cherry bark and Brandy mixture.   Dose, one table-
spoonful three or four times a day, in coughs, etc.

                    Rowand's Tonic  Mixture.
  Boil for a quarter of an hour in  one pint of water, half  an ounce,
each, of Rhubarb and Colombo root; strain, and add fifteen grains of
Sulphate of Quinine dissolved  in Alcohol half an ounce,  Spirits of
Spearmint one ounce.   Dose,  from half to one table-spoonful, in Chills
and Fever.
                 Almond  Paste for the Hands.
  Pulverize, four ounces, each, of Sweet Almonds and Bitter Almonds,
add to it two fluid ounces of Lemon juice, and three ounces of Oil of
Sweet Almonds; then  add six ounces of pure  Spirits, and  one ounce
of water.   Keep in  wide-mouthed vials.  After having washed and
dried the face and hands, apply this in small portions.   It renders the
skin supple, white, and soft, and prevents chapping. 
HOUSEHOLD DEPARTMENT.
251
                  Dysentery  Cordial—(Patent.)
  Mix together four teaspoonfuls of Laudanum, and two teaspoonfuls,
each, of Tincture of Rhubarb, Tincture of Catechu, Tincture of Cam-
phor, and twenty drops of Oil of Aniseed.  Dose, 15 to 60 drops after
each operation.
                         Dalley's Salve.
  Mix together  fifteen grains of Sugar of Lead, five grains of Carbo-
nate of Lead, two grains of Acetate of Morphia, and one  ounce of
simple ointment.  For burns, etc.

                         Baking Powder.
  Cream of Tartar two parts, Bread Soda, (Bicarbonate,) one part; mix.

                  %       Ruspini Styptic.
  Mix together  one ounce  of Gallic  Acid,  one  drachm of powdered
Opium, two drachms of Sulphate of Zinc, and four ounces  of Alcohol.
Used to stop bleeding from cuts, wounds, etc.

                       Hair  Dye—(Brown.)
  No. 1. Dissolve one ounce  of  Sulphuret  of Potassium,  (Liver of
Sulphur,) in half a pint of rain or soft Avater.   This has a smell of rot-
ten eggs, but which soon passes aAvay.
  No. 2. Dissolve one ounce of Nitrate of Silver in nine ounces of rain
or soft water.
  First wash the hair with soap and water to free it from grease, dirt,
etc.; then, by means of a tooth-brush kept for the purpose, apply No.
1.  This is best done in the  eArening.   On the next morning, when the
hair is dry, Avith  another tooth-brush, kept also for this purpose, apply
No. 2.   The color takes much better on a clear, dry day, and especially
if the person exposes the head to  the action of the sun, after having
applied No. 2.  By using tooth-brushes, the washes are confined to the
hair, and do not run upon the face and neck, and discolor them.

                        Another—(Black.)
  No. 1. Dissolve one ounce of Sulphuret of Potassium, in six ounces
of soft water.
  No. 2. Dissolve one ounce of Nitrate of Silver in six ounces of soft
water.   Use in the same manner as directed for the preceding one. 
252
AMERICAN FAMILY PHYSICIAN.
                        Another—(Black.)
  No. 1. Sulphuret of Ammonia one ounce, Solution of Potash three
drachms, soft  water one ounce; mix.   This smells  like  rotten effcrg
but which soon passes away after having been applied to the hair.
  No. 2. Nitrate of Silver one drachm, dissolved in soft Avater two
ounces.   These to be used in the same manner as the preceding.

                        Labor-saving  Soap.
  Dissolve a quarter of a pound of Lime in a gallon of Cold Water
then take off the clear lime water, and  add  to it half a pound of Sal-
soda dissolved in a quart of Avater.  To this add one pound of Brown
Soap dissolved in a gallon of Avater.  This  soft soap is excellent for
boiling white linens; it removes all the grease that is in them, because
it contains an excess of caustic ley.   About one quart of this soap is
sufficient for boiling clothes in a ten gallon wash-kettle.  It should be
kept made up on hand for use.

                            Hair  Oil.
  Castor Oil two pounds and a half;  strong Alcohol two pints and a
half; Oil of Bergamot two ounces and  a half.  Mix, and in a day or
two it will be  fit for use.  This  keeps the hair from falling, and  pre-
sents dandruff.
                     Another—(Tricopherus.)
  Mix together one ounce, each, of Sulphuric Ether, Tincture of Span-
ish Flies, and Olive Oil, and  one  pint  of Alcohol.   Brush the head
well each time before applying it.   It may be colored crimson, if
wanted, by putting a few chips of Alkanet Root in  it; and  may also
be perfumed by the  addition of a feAV drops of Oil of Lavender.

                          Face Powder.
  Take of Wheat Starch one  pound, powdered  Orris Root three
ounces,  Oil of Lemon thirty drops, Oil of Bergamot, Oil  of Cloves,
each, fifteen drops.  Rub thoroughly together.

                            Another.
  Take of Flake White half a pound, Citric Acid half a drachm,  Rose
Water two pints.  Reduce  the Flake  to  a  fine powder; dissolve tho
Acid in the Rose Water, and gradually add it to the Flake.

                            Bandoline.
   To one quart of Rose Water add an ounce and a half of Gum Traga- 
HOUSEHOLD DEPARTMENT.
253
canth ; let it stand forty-eight hours, frequently shaking it; then strain
through a coarse linen cloth—let it stand two days, and again strain.
Add to it a drachm of Oil  of Roses, or of Bitter Almond Oil.  Used
by ladies for dressing their hair, to make it lie in any position.

                            Another.
  Take Oil of  Sweet Almonds half an  ounce,  White Wax  half  a
drachm, melt by a gentle heat, then  add Tincture of Gum  Mastic  a
drachm and a half, Oil of Bergamot  half a drachm; strain.  To fix
the hair, and keep it  in place.

                            Another.
  Put an ounce of Quince Seeds in a quart of water, and simmer for
three-quarters of an hour; strain through a fine sieve, and when cold,
perfume  with Oil of Bergamot, or Lavender, etc.

                 Tt>  prevent Hair  Falling out.
  Dissolve in half a  pint of Alcohol  as much Castile Soap  as it will
take up, and to this  add two grains  of Tannin.  Rub this  well into
thc head  every night, applying  some pure  grease  in the  morning.
After the hair has ceased falling out, apply it once a week.

                  Cure for  Offensive  Breath,
  Drop ten drops of  a concentrated solution of Chloride of Soda in a
wine-glassful of clean soft water, and drink it just before  breakfast
every  morning.    Also, put a teaspoonful of the  solution of Chloride
of Soda,  in a tumbler of Avater, and rinse the mouth with it thoroughly
three times every day.
                        Tobacco  Chewers.
  Tobacco chewers who have  had their stomachs injured  by tobacco,
and Avish to leave it off, can do so, and have the tone of their  stomachs
restored  by chewing,  as a substitute, the inner bark of Wild Hickory.

                       Burns and Scalds.
  One drachm of Permanganate of Potash dissolved in a pint  of soft
water, is.a Avonderful  soothing agent for burns and scalds.

            To  prevent Clothes from  Taking Fire.
  After they have been washed, moisten them with a strong solution,
either  of Sulphite of  Ammonia, Phosphate of Ammonia, or Chloride 
254
AMERICAN FAMILY PHYSICIAN.
of Zinc.   Clothes or gauze dresses, thus prepared, will not blaze when
exposed to fire, but will merely char or crumble  to ashes.  Or, these
solutions  may be mixed with the starch water.  N. B.—A mixture of
Alum and Borax injures the clothes.

             Cement for Attaching Metal to  Glass.
   Mix two ounces of a thick solution of Glue with one ounce of Lin-
seed Oil Varnish, and half an ounce of pure Spirits  of  Turpentine;
then boil the Avhole  together  in  a  close vessel.  After  it has been
applied to the glass and  metal, the two should be clamped and held
together for  two  or three days, until the  cement becomes dry,

                      .. Cement for Horn.
   Take equal parts, by weight, of Transparent Glue, and  very strong
Vinegar, two pounds, Alcohol  one quart, Alum a very small quantity;
mix, and  dissolve by means of a water-bath.  This is  useful for unit-
ing horn, pearl, shell, bone, etc.                 •

              Cement for Mending Broken China.
   Take of Curd of Milk, dried and powdered, five ounces, Quicklime
half an ounce, Camphor  one  drachm.  Mix, and keep in a closely-
stopped bottle.   When used, a small portion is to be mixed with a
little water into  a paste, and then applied quickly.

                            Another.
   To- a thick solution  of Gum  Arabic add enough Plaster of Paris to
form a sticky paste.   Apply  with a brush,  and stick the fractured
edges  together.   The china can not readily  be broken in the same
place again.
                            Another.
   Sprinkle Isinglass, two drachms, with Avater, and allow it to stand till
softened, then add as much proof spirit or alcohol as will  rather more
than cover it, and dissolve with a moderate heat.  Also take of Gum
Mastic one drachm, and dissolve it in Alcohol two or three drachms.
Mix the two  solutions,  and stir  in one drachm of finely-poAvdered Gum
Ammoniac first rubbed down with a little Avater.   If necessary, evap-
orate to a proper consistence.  To use this, place the bottle contain-
ino- it  in warm Avater, and  when it  is soft, apply a thin layer  to the
broken edges, and  press  them firmly  together till  cold.  Heat and
moisture combined alone loosens it.   This is the celebrated " Diamond
Cement." 
household department.
255
                            Another.
  Dissolve Isinglass in Glacial Acetic Acid, and reduce it to the con-
sistence of thin jelly.  Applied as the preceding one, but without
heating.
                            Another.
  Take half a pound of the Curd of Skimmed Milk, wash it until the
water passes  aAYay clear;  press out all the water, mix the  Curd with
the White of  six Eggs, and Avhen Avell incorporated, add the expressed
juice of fifteen cloves of Garlic; rub the Avhole together in a mortar,
then gradually add a sufficient quantity of dry and sifted Quicklime to
form a dry paste, and continue the rubbing.   To use this cement, rub
a small portion of it on a piece of glass Avith a little water; when of a
proper  consistence, apply  it to the fragment to be  mended, or the
crack to be filled; bind the parts  together, and let it dry in the shade.
This Avill  resist fire and boiling Avater.  This mixture, pulverized and
mixed Avith an equal  quantity of Quicklime, may  be  kept  for a long
time, in Avell-stopped  bottles.

                     To paste  Paper on Tin.
  Make a thin paste  of Gum Tragacanth and water, to  which  add a
few drops of  Oil of Vitriol.

    Glue  for Prepared  Labels and Self-sealing  Envelopes.
  Take of common Glue,  previously softened in water, an  ounce  and
a half, Rock-candy three ounces,  Gum Arabic three-fourths  of an
ounce, Avater six ounces.   Mix, and  heat all together until perfectly
dissolved.  Spread on paper by means of a brush.

                            Another,
  Coopers' White Glue three ounces, Refined Sugar  an  ounce  and a
half, Water ten  ounces.  Dissolve by heat.

           Holmes's  celebrated Syrup for Bronchitis.
  Take a  pint,  each, of Balm  of Gilead buds, and Thoroughwort or
Boneset;  half a pint, each, of Hoarhound and Skunk Cabbage root;
boiling  Avater tAvo quarts.   Gently simmer down to  three pints;
Btrain,  and when bloodwarm,  add  three pounds  of  Loaf Sugar, or
enough to keep  it from  souring.  The  dose is  two table-spoonfuls
three times a day, or whenever the cough proves troublesome. 
256
AMERICAN FAMILY PHYSICIAN.
            To  remove Rings  from  Swollen Fingers.
  Begin at the end  of the finger, and wind cotton  thread  evenly
round, bringing  each coil of the thread close alongside  of the preced
ing one.  Continue  this  until the ring is reached.  Then  thread a
needle with the cotton and pass it under the ring; then commence
unAvinding the thread  from the finger carefully.   The ring follows
each coil, and, as it is successively unrolled, and by almost impercep-
tible degrees, is brought over  the knuckles and removed.  The thread
must not be too fine lest it be too weak, and if it has not been wound
on evenly, an entanglement will occur in the winding. A small curved
or bent needle will pass more readily under the ring than a straight
one.

               A Truthful  and Cheap Barometer.
  Place a small quantity of  fmely-poAvdered alum  in a clean glass
bottle, and fill it with alcohol.   The alum will be perfectly dissolved by
the Alcohol, and, in clear weather, the liquid will be as transparent as the
purest Avater.   On the  approach of rain, or cloudy weather,  the alum
will be visible in a flaky spiral cloud, in the center of the fluid, reach-
ing from the top of the fluid  to  the bottom.   This cheap and  simple
barometer is placed within the reach of all Avho wish to possess  one.
There is no doubt that farmers Avould find great advantage in consulting
the barometer when harvesting  their  crops.  Several instances of its
usefulness have been made knoAvn to us.  A gentleman Avho  had fixed
a day for commencing haying, found that his barometer indicated  rain,
and he postponed his haying.  It rained during the day, and for two
succeeding days, but he saved his hay, Avhile his neighbors, who had no
means of foretelling the Aveather, cut their grass, and lost by  the oper-
ation.   A farmer at Chatham, N. Y., had a large quantity of hay and
grain cut one day, and on going to dinner noticed that the barometer
indicated rain.   His men went immediately to work, and saved most of
the hay and grain, while his  neighbors, Avho Avere not forewarned in
time,  experienced a loss.  A physician, at Reading, had fixed a day for
his haying; the morning Avas fine, but  the barometer said rain, and he
deferred moAving, and advised  his neighbors to do the same.   But they
laughed at him,  and went to work, and the rain came at noon.  Many
such facts might be given to shoAV the value  of the barometer  to a
farmer.  It will soon be considered as indispensable  in a farmer's
kitchen as a clock or a wife. 
HOUSEHOLD DEPARTMENT.
257
                   To  reduce Obesity or Fat.
  The use of the leaves and stems of the sea-weed Fucus Vesiculosis,
(Sea-ivrack,  or  Yellow-blaolder-wrack,) in decoction, powder,  or  pills,
will rapidly  reduce the flesh, without discomfort or disturbance of the
digestive functions.
                            Another.
  Saturate SAveet Spirits of Nitre with  Squill.  Dose,  from half to a
teaspoonful  every one, two, three, or four hours, until a free discharge
of urine is produced.  This is excellent to counteract that morbid con-
dition of the kidneys and urine, by which the systems of corpulent and
gross men are so often poisoned, and from which they  suffer so much,
(and often die suddenly,) with an almost unaccountable  sickness,  espe-
cially after eating, or drinking liquor.

                   IIaye's Liniment for Piles.
  Melt, to  the  consistency of honey, ten  pints of Lard, then  briskly
stir in ten ounces of Muriatic Acid; when thoroughly  mixed, add two
and  a half ounces of Camphor dissolved  in twenty ounces of Oil of
Turpentine,  and ten ounces of Laudanum.   Stir till cold.

                IIaye's Nerve and Bone Liniment.
  Melt together fifteen pounds, each, of Lard and Tallow, and add to it
four and a half pounds of Muriatic Acid, four and three-quarter pounds
of Laudanum, nine pounds  of Spirits of  Turpentine, and  one pound
and a quarter of Camphor.

                        , ClILORODYNE.
  Take of burnt Sugar one drachm, Muriate of Morphia half a grain,
Alcohol two drachms,  Oil of  Peppermint  six drops, diluted  Prussic
Acid five drops, Tincture of Red Pepper  six drops, Chloroform one
drachm; mix.
                        Another Formula.
  Dissolve eight  grains  of  Muriate of  Morphia in  twenty drops of
Perchloric  Acid; then  add Tincture of Indian Hemp one  drachm,
Tincture of Capsicum half a drachm, Oil of Peppermint three drops,
and Chloroform six drachms ; lastly add  Molasses one drachm, Steele's
Hydrocyanic Acid twelve drops.   Keep  in closely-stopped bottles.
  Chlorodyne is  Anodyne,  Sedative, Diaphoretic, Astringent, Anti-
spasmodic, Diuretic, etc.   Unlike the preparations of  Opium, it does
not produce  Headache, Giddiness, Prostration of Strength, nor Stupor. 
258
AMERICAN FAMILY PHYSICIAN.
A large dose may produce  Nausea, which will be relieved by a small
dose of Carbonate of Ammonia.  It has been used successfully in vari-
ous diseases, producing a gentle heat at the stomach, followed by a
general glow, and total absence of pain, a calm and refreshing sleep,
and an increase in the pulse from  a small, weak, thready, or hurried
one to a full, yielding, elastic, natural sort of one,  decreasing in fre-
quency of beats.  It has cured several marked cases of Consumption.
In Fevers, Inflammations, and Neuralgia, its dose is ten to thirty drops;
in Colds and Coughs, ten to  twenty drops; in Consumption, etc., twenty
to fifty drops; in Gout, Rheumatism, etc., twenty to forty drops;  in
Cholera, Diarrhea, etc., fifty to one hundred  drops.  It is best  given
on lump-sugar, at intervals from every half hour to every four hours.

                Fetid Perspiration from  the Feet
May be removed by bathing the feet every night in a strong solution
of Carbonate of Soda.

                   Mexican Mustang Liniment.
   Take of  Petroleum,  Olive  Oil, and Carbonate of Ammonia,  each,
equal parts; mix.
                           Liquid  Glue.
   Take of  best pale Glue  half a pound, water a pint;  dissolve in a
covered vessel  by the heat of a water-bath.  When cool, add gradually
Acetic Acid seven ounces.
                             Another.
   Dissolve,  in a warm place, and in a well-stopped, large-mouthed vial,
one ounce of the finest pale  Shellac, and two ounces of strong Alcohol.

                             Another.
   Take of best White Glue  half a pound, dry White Lead two ounces,
rain water one  pint; mix together, and dissolve by  placing the vessel
containing them, not over a fire, but in boiling water; then add  Alco-
hol two ounces.  Continue the heat for a few minutes,  and then pour
into bottles.
                            Another.
  Boil four pounds  of White Glue, (or  Gelatine,) and one pound  of
dry White Lead, in four quarts of rain Avater until the Glue is dissolved;
then add one quart of Alcohol, and boil  the whole for a few itinutes.
Pour into wide-mouthed vials while warm.  For cementing gla3<-, china,
wood, leather, etc. 
household department.
259
                       For Scald Head.
  Take Green Rye, when about six  or eight inches high, and  stew it
into a salve with fresh cream.   Apply this to the head every morning
and evening till cured.  Always wash "the head with Castile Soapsuds,
and dry it, each time before using the salve.

                           Another.
  Take equal parts of Soot, Saltpetre, and Sulphur; make into an
ointment  with Lard, and apply as the preceding.

                            Another.
  Melt together equal parts of Sweet Gum and Mutton Tallow; apply
it to the head as the preceding ones.

                     For Sciatic Neuralgia.
  Take of  Extract* of Belladonna five drachms, Sulphate of Morphia
twenty-four grains, Extract of Stramonium two drachms, Oil  of La-
vender half a drachm, Lard two ounces;  mix.   To be applied by gentle
and prolonged friction.

                For those who Perspire Freely.
  Many persons who perspire  freely are  much annoyed by the disa-
greeable odor emanating therefrom.   This may be  readily removed by
adding a table-spoonful of the  Aromatic Spirit of  Ammonia to a pint
of soft water, and washing the body with  it every  night and morning.
This is beneficial to the skin, cleanses it thoroughly, and deprives the
sweat of its strong, disgusting odor.

                    To remove Grease Spots.
  Mix together four ounces of Alcohol, two ounces of Urine, and one
ounce of water of Hartshorn.  This  forms an excellent application for
cleansing clothes, removing grease  spots from them, and otherwise
renovating  them.   It is a cheap and useful preparation.

                            Another.
  Grease spots may be removed from silks and other fabrics by rub-
bing the  spots Avith  Chloroform or  Benzole.  The latter is the best
preparation;  its cost is about the same  as that of  alcohol.

             To  Harden the  Nails when too  Soft.
  Dissolve  as much Mastic in  Spirits of Turpentine as this fluid will 
260
AMERICAN FAMILY PHYSICIAN.
take up.   Take half an ounce of this solution, half a drachm of fine
table Salt, and two scruples, each, of Rosin and Alum; mix, and mako
an ointment by melting them with a little beeswax.  Rub some of this
on the nails twice a day.

           To  remove White Specks from the Nails.
  Melt together equal parts of Pitch and Turpentine;  add to it Vin
egar and flour of Sulphur.  Apply this to the nails.

                    Twiggs' Hair Restorative,
  Take milk of Sulphur one drachm; Sugar of Lead half a  drachm;
Rosewater a gill; mix.   This is the formula of General Twiggs for
returning gray hair to  its former color, and to cure baldness.  Wash
the head with it one or two times  a day.

                          For Dyspepsia.
  Take of the inner skin of Chickens' Gizzards, dried and powdered,
Rosin, and Flower of Sulphur, each, equal parts ;  mix.   Dose, five to
ten grains, three times a day.   This is very useful to improve the
appetite  and digestive  powers.

                 A Certain Remedy for  Cancer.
  " The following remedy for Cancer, so far as I know, has never been
made knoAvn to the public.   From the success which has attended its
use, I most  confidently believe it will thoroughly remove Cancer in
every  instance Avhen used as  directed.  The  Sheep-sorrel has long
been  reputed a  remedy for  Cancer, but the results from the use of
the bruised plant alone, or its juice, have been so  unsatisfactory as to
have  caused  most persons to doubt its efficacy.  It will be seen that
the folloAving preparation  contains the \*irtues of the plant in a con-
centrated form, and also an oxide  of pewter—and has the advantages
of being readily made, and of being easily applied to the affected part,
and kept in contact with it.  Let me appeal to thc afflicted, and ask if it
is not better to endure the pain of this safe and salutary remedy for
one week, than to die of that loathsome disease, Cancer, after lingering
with it months, or even years, in pain and agony ?  Be wise and live-
bo  foolish  and  die.   I give the remedy  reluctantly, knowing that
thousands will read it and turn away, saying, < There is no remedy for
Cancer.'  But, if only  a  few of the victims of this terrible malady
shall be restored by it to the bright prospects of life, and I confidently
believe many will'be, I shall feel amply rewarded by  their  blessings 
HOUSEHOLD DEPARTMENT.
261
for any obloquy with which  the remedy, or even  my own name, may
be treated.   Here it is :
  " Take of Sheep-sorrel, the fresh plant, several handfuls, bruise it,
and press out the juice;  put this  into an old German pewter dish, of
two or three inches in depth, and let it stand in  the sun, exposed to
the  direct sunlight, until it  evaporates to  the thickness of an extract
or salve.  Then put it into a wide-mouthed vial, and keep it well stopped
and away from the light.  A small portion of Alum may be added to
the juice, but I do not think it necessary.
  " Spread  some  of this remedy on a piece of black silk large enough
to cover the Cancer and its larger roots, and apply it over the diseased
part, using strips of sticking-plaster to hold it on if it  will not remain
without.   A neAY plaster must be  spread and applied in the same way,
every  six or eight hours,  or as often as the silk turns brown.   Its
application must be kept up in this way for from six to ten days, when
the body and roots of the Cancer  will turn black and have matter form
between their surfaces and  thc sound flesh, loosening  the whole Can-
cer so that it can be easily removed by simply grasping it with a pair
of forceps or tweezers.   Should any roots remain behind, they may be
removed with the forceps;  but should there  remain any portion  not
yet killed, the plaster must be applied to it again for  a few days.
   " In applying the plaster, it matters not whether the skin over the
Cancer has  been  broken or not.   If the lump be really Cancer, this
remedy will very soon reach it;  if not, it will have little or no effect
upon it.  During thc use  of this  remedy, there will be considerable
inflammation of the parts around the Cancer, giving rise to very great
pain, and calling for all  the fortitude and resolution  the patient  can
 summon to  withstand it.   This  inflammation is  best  overcome by  a
good dose of the Compound Powder of Jalap, say a heaping teaspoon-
ful, which may be mixed with half this quantity of Cream of Tartar,
 and a gill of water; if necessary, this cathartic may be repeated in
 tAvo or three days.
   " During the treatment it may be necessary to  give a dose  of Opium
 or Morphine, to enable the patient to endure its severity.  After the
 Cancer is removed, there remains only a  common ulcer to heal, which
 may be done by first applying a Slippery Elm poultice to reduce the
 inflammation, and then using some  simple healing ointment, as May-
 er's Ointment in your Family Practice, DiA'ision I, page 731; or one
 made  by bruising  and stewing in  fresh Lard the leaves of Garden Live-
 forever.  The above treatment  for  this  opprobrium  of the medical
 profession, is given to the public  in the solemn belief that, if perse- 
262
AMERICAN FAMILY PHYSICIAN.
 veringly used, it  will save hundreds from  one of the most terrible
 forms of death."                            DAVID Adams, M. D.

                        Seven Years'  Itch.
   Wash twice a day with strong Soft  Soap.  This is useful in that form
 of ItcJ so  common in the Western States, and sometimes termed the
 "Prairie Itch."   I  have succeeded by  this simple means  where the
 most active remedies had failed.

                             Another.
   Take of Lard half a pound, Sulphur two ounces, Salt of Tartar one
 ounce; mix,  and form  an ointment.  After bathing as above,  apply
 this ointment every night.

                     Inability to hold Urine.
   Take of Atropia one grain, Acetic Acid six drops, distilled water five
 ounces;  mix.  Dose for an adult, a teaspoonful three times a day,
 until dilation  of the pupil of the eye, and dryness of the throat and
 fauces are  produced.   Children must  take it in proportion to their age.
 This cures in from six to fifty days.                               ,

                      Simple  Cure  for Croup.
   We find in the Journal of Health the following remedy for this dan-
 gerous disease.  Those Avho have passed nights of great agony at the
 bedside of  loved children, will treasure it up as a valuable piece  of in-
 formation :
   " If a child is taken Avith Croup, apply cold water—ice water, if pos-
 sible—suddenly and freely to the neck and chest, with a sponge.  The
 breathing will instantly be relieved.   Soon as possible let the sufferer
 drink as much as it can; then wipe it dry; cover it up warm;  and soon
 a quiet slumber will  relieve the parent's  anxiety, and lead the heart in
 thankfulness to the Power which has given to the pure,  gushing fount-
 ain such medicinal qualities."

                      Syrup for the Blood,
   Take of Yellow Dock root, Yellow Parilla root, each, two ounces, bark
of the root of False Bittersweet, Black  Cohosh, or Rattle root,  each,
one ounce,  Blue Flag root, Poke root, each, half an ounce; reduce the
articles to a coarse poAvder, mix them together, and  place them in a
convenient vessel; cover them with Whisky, and let them stand four 
household department.                  263
days, frequently stirring; strain and pre^s off the Tincture made with
the Whisky, and set it aside.
  Td the  drugs now add a gallon and a half of water, and slowly, by
means of a sIoav fire, boil doAvn to five pints; strain off the decoction,
add to it five pounds of Sugar, and boil doAvn, so that when the above
Whisky Tincture is added, there will be seven pints of Syrup.   When
cold, add  four ounces, each, of Tincture  of Prickly  Ash  berries  and
Essence of Sassafras;  or any other aromatic essence or tincture may
be used to flavor it with, according to the taste.
  N. B.   The Whisky Tincture must not be added until the Syrup is
cool.
  This forms  a  most valuable and poAverful alterative Syrup,  which
will  be  found very efficacious in  all diseases  where an  alterative is
required.   It  may be  beneficially used  in  Chronic Liver Complaint,
Rheumatism, Scrofula  or King's Evil,  Diseases of the Skin, Ulcers,
White SAvellings, Kip Disease, Chronic Disease of the Kidneys, debili-
ity  from long  standing maladies, nervous Aveakness, and most chronic
complaints.
  The dose is  half a gill three times a day.  Its efficacy  may be  still
further improved,  in cases requiring prompt action, by adding half an
ounce of Iodide of Potash to each pint of the  syrup.  In using  this
preparation, the boAvels should be kept regular daily, without physic,
if possible; the skin should be bathed every other day,  drying with
considerable friction; and no sour articles of food, or fats, should be
used as diet, although ripe fruits, Avhen they agree with the person,
may be used.
                     WINTER  RULES

  Never go to bed Avith cold or damp feet; but always toast them by
a fire for some ten or fifteen minutes before going to bed.
  Be very careful never to sleep with the head or chest exposed to the
draft of an open windoAV or door.
  Have enough covering  on the bed to feel comfortably warm,  with
rather more over the feet and lower part of the legs.   It is also a  good
rule  to  have  some extra covering on hand, where it can be easily
reached, in case of a sudden change to colder weather during the night
  When going from a Avarm atmosphere  into a colder one, keep the
           67" 
264
AMERICAN FAMILY PHYSICIAN.
mouth closed, so that the air may be Avarmed by its passage through
the nose, ere it reaches  the  lungs.  A neglect of this matter, by sud-
denly chilling the air vessels, has caused Pleurisy, Inflammation of the
Lungs, etc.
  Never stand still in cold weather, especially after having taken even
a slight degree of exercise.   And always avoid standing upon ice or
snow, or where the  person  is exposed to a cold wind.  Keep moving
all the time.
  After exercise of any kind, and however slight it may be, never ride
in an open carriage, nor near the open window of a car or other vehicle
for a moment; it is  dangerous to health and even life.
  On commencing a journey, always wear an old boot or shoe at first.
  India rubbers  should never be worn, only to protect the feet  from
wet.  When worn too much they dispose to Colds, Coughs, Rheuma-
tism, ete.
  When traveling in the face of an extremely cold wind, wear a hand-
kerchief over the nose and  mouth, so as to  avoid the  chilling influence
of the cold upon the lungs.
  Merely warm the back by a fire or stove, and never continue keep-
ing the back exposed to the  heat, after it has been comfortably warmed.
To  do otherwise is debilitating.
  Never begin a journey until the breakfast has been eaten.
  When hoarse, speak  as little as possible until it is recovered from,
else the voice may be permanently  lost, or  difficulties of the throat be
produced.
  In leaving  a warm room, always  dress warmly, putting on gloves,
cloak,  etc.,  before leaving,  the room;  if possible, swallow some cold
water before  leaving the room.  A  neglect of this  rule  may prove
serious.
  Keep the back well covered, especially between the shoulder-blades.
This can be done by having the vest and coat lined with cotton batting.
  Never lean  Avith the back upon anything  that is cold; rather sit up
erect.
  Never take warm drinks, and then immediately go out into the cold air.
  After having  been exposed to  the  cold air, and " chilled through,"
as for instance, after a  sleigh-ride, never enter  a warm room immedi
ately, but get Avarmed first by throwing the arms about, jumping, and
other exercises; and, if you are  to  go again into the cold  air for  a
time, drink cold Instead  of warm  beverages.   By this means  many
severe and even fatal diseases may be avoided. 
HOUSEHOLD DEPARTMENT.
265
FARMER'S  MISCELLANY.
  As this book may be possessed by many farmers, in order to render
it doubly valuable to  them, I have given in this part many choice and
Belect recipes for their benefit, concerning various matters connected
with farms, cattle, animals, etc., which they will find of great efficacy,
and Avhich, I trust, will be acceptable  to them.   The recipes for the
cure of Hog Cholera, or for the Pleuro-pneumonia of cattle, are  alone
worth twenty times the price of the book to any farmer.

                     For Horse Distemper.
  Take of Flowers  of Sulphur two parts,  Saltpetre  one part; mix
Give two  table-spoonfuls twice a day  until the  symptoms  are better.
Also put a lump of Lard in each ear, about the  size of a hickory nut.
  Mr. Edward F. Morgan, Elgin Co., C. W., a very prominent farmer,
has repeatedly  tried this  remedy, and assures me  that it  is the best
thing he ever tried to relieve horses attacked with this troublesome dis-
ease.
                            Another.
  Take equal  parts  of Elecampane and Burdock roots;  boil for an
hour in sufficient Avater to  cover it thoroughly; when  cold,  mix a pint
of the liquid Avith four quarts of Wheat Bran, to which add two table-
spoonfuls of powdered Rosin.  Repeat this dose twice a day  for a week.
Rub Spirits of Turpentine about the throat or swollen parts.

                       Soft-Shelled Eggs.
  Give the fowl a table-spoonful of Linseed Oil,  three times a day, for
a week or two, feeding very sparingly.

                  To cure Gapes  in Chickens.
  1. Rub  up some Black Pepper and Butter, and make the fowls swal-
low it; for a hen a teaspoon half full is a dose—chickens in propor-
tion.  Repeat the dose every day  or two.
  2. Give small crumbs of Dough  well saturated with  Soft Soap; once
or twice is enough.
  3. Gapes may be prevented as well  as cured,  if it has not gone too 
266
AMERICAN FAMILY PHYSICIAN.
far, by mixing Assafcetida with the food of chickens.  Four ounces
costing about thirty cents, will do for  four hundred chickens per day.

                  To cure  the Pip  in  Poultry.
  This disorder is caused by eating foul meat, by drinking dirty water
or the want of water.   It is known by a thin Avhite scale on the  tip
of the tongue, which prevents  the  fowl  from eating; it  is cured  by
taking off the scale with your nail, and rubbing Salt upon the tongue__
or some Black Pepper, Salt, and Butter.

                   To  remove Lice on Fowls.
  Let them dust themselves in  sand to which some Sulphur has been
added.  Also put Sulphur in their drink.

                    To cure  Grub  in Sheep.
  Inject  into each nostril a  mixture, heated to blood-heat, of Whisky
one quart, Yellow  Snuff two ounces.

                   To  cure Grubs in Horses.
  Put an ounce of Chalk in a pint  of strong Vinegar, and as soon as
the effervescence or bubbling of gas has  ceased, pour the liquid in a
bottle and drench the horse  with it.

       To  cure Galls  on Horses, Broken Chilblains,  etc.
  1. Put Honey twelve ounces in a jar by the  fire.  Melt together.
four ounces of  yellow Beeswax, six ounces of Compound Galbanum
Plaster, and half a pint of  Sweet Oil.   Mix them with  the Honey.
Spread this very thin on linen, apply to the parts, and change twice
a day.
  2. Moisten White  Lead with Milk, Linseed Oil, or Olive Oil, and
apply very thin—changing twice a day.

                    To REMOVE  WlRE-AVORMS.
  If Buckwheat be grown on soil Avhere  wire-worms exist, it will en-
tirely drive them off.

                  To cure  Stretches in Sheep.
  Give them two  doses  a day of Red  Pepper tea.

                   To  CURE HOVEN IN CATTLE.
  This is better prevented by being careful not to turn the  animals into 
HOUSEHOLD DEPARTMENT.
267
a rank pasturage without salting them, or from a dry pasture into juicy
clover, especially while the dew is on.
  To cure it.—Fast  the  animal,  and drench it with one quart of a
strong tea or decoction of Boneset or  Thoroughwort.  If it be attended
with fever, injections and backraking may be necessary.  Afterward
give a few raAV Potatoes well salted,  with good hay or cornstalks.

                          China Berries.
  These are a poison to pigs.  When these have eaten of them, pour
doAvn their throats a mixture of two table-spoonfuls of Salt dissolved
in a teacup  of water.

      To remove Bugs on Vines, Cucumbers, Squashes, etc.
  1. Put a  peck of  Salt-water Fish (recently caught) in a barrel of
water, or in this proportion.  In  a day or tAvo they will be decompos-
ing ; then dampen the leaves with the water from a watering-pot.  Re-
peat this two  or four times in the course of two weeks.  The plants
become green, healthy, and vigorous.  Fish Offal is of equal value; or
Fresh-Avater Fish, put in slightly  salted  water.
  2. Dust Sulphur, from a gauze bag, upon trees, shrubs, and plants,
to remove insects.
  3. To three gallons of water  add one pound, each, of Soft  Soap,
Snuff,  and  Flowers of  Sulphur;  boil  together  for  half an  hour.
Sprinkle upon the vines and shrubs Avhile lukeAvarm, to remove insects.
  4. Sift Charcoal-dust over the  plants, vines, etc., and the bugs will
leave at once.
  5. Where Gas-tar can  be  obtained, smear rags Avith it, and hang
them in the branches of the trees, among fruits, vegetables, etc., likely
to be infested, and they will  soon leave, as the smell is very offensive
to them.
                     To remove Cockroaches.
  Place Cucumber-rinds in plenty around their haunts, renewing them
every week or tAvo.
                      To drive  aavay Flies.
  1. Dip a  bunch of Plantain or FleaAvort, in Milk, and hang it up in
the room, and the flies will leave.
  2. Mix together a teaspoonful  of ground black Pepper, a teaspoon-
ful  of broAvn Sugar, and  two teaspoonfuls of Milk.   Place  it on a
plate Avhere the flies are most troublesome.
  3. Take  half an ounce, each, of Sugar and Quassia in coarse pow-
der, place them in a cup, and add a pint of boiling water. 
268
AMERICAN FAMILY PHYSICIAN.
                         Lice on Cattle.
   1. Wash the back and sides  with a strong decoction or tea of White
 Oak Bark, which will completely tan the lice in twenty-four hours.
   2. Tanners' Oil is also good, to be rubbed  on.   Of course, cattle
 with lice, whatever is used, should always be brushed or curried every
 day or two.
   3. Mix together Scotch Snuff and Soft Soap.  Rub it well on the
 parts.
   4. Bathe the animal all over with  a strong decoction of Larkspur.

             To cure Black Leg, or Bloody Murrain.
   1. Add one pint of Salt to a pint and a half of Vinegar; drench the
 cow, ox, or calf with this—but be  careful not to let the sick get to
 water for twelve hours after it  has been drenched.  After this, drench
 it every hour for thirty-six  hours,  commencing  with one  quart,  and
 continuing  the dose every hour till the animal is well.
   2. Murrain may be prevented in  cattle by  giving  them two table-
 spoonfuls twice a week,  during the prevalence of the disease, of a
 mixture of  equal parts  of Salt and  Slaked Lime.

                   To  cure Heaves in Horses.
   Give a quart of  a strong decoction of Smartweed, or Arsesmart,
 every  day, for eight or ten days.  Or, it may be mixed with Bran or
 Shorts.  During the operation, give green, or  cut-up feed wet with
 water.
        To cure Poll Evil, Fistula, Warts,  and  Corns.
   Mix together one ounce, each, of Nitric Acid, (or Aquafortis); Spirits
 of Turpentine,  Corrosive  Sublimate,  Camphor,  Oil of Spike,  Castile
 Soap, and three gills of Alcohol.   Wash the affected parts with Soap-
 suds once a day, and then apply the  above;  continue  till  cured.

                    Another, for  Poll Evil.
   Take one ounce, each, of Spirits of Turpentine, Laudanum, Spirita
of Hartshorn, Camphor, and Sweet Oil; mix.   This is a certain cure
for Poll Evil, and will prove a valuable liniment in rheumatism and all
painful affections, and for domestic animals can not be surpassed.

                    To remove  Black Ants.
  1. Sprinkle ground Coffee about their haunts. 
HOUSEHOLD DEPARTMENT.
269
  2. Red ants will disappear by  placing  a  small  quantity  of green
Sage in the closet.

                  Cement  for Lining  Cisterns.
  Take Ashes two parts, Clay three parts, Sand one part, and mix with
a sufficient quantity of Linseed Oil.

    Permanent  Ink to write upon Zinc Labels for Plants.
  Take of Verdigris, Sal Ammoniac, each, two drachms, Lampblack one
drachm, Avater a gill; mix well together  in a  mortar, adding the water
gradually.  Keep this in a glass vial well stopped.  Write with a quill
upon  clean, bright Zinc plates,  shaking  the  ink well before using  it.
When dry, it  may be exposed to the weather, or be buried in the ground
for years without the writing being effaced.

                      To cure Hog Cholera.
  1. Take Sulphur  tAvo pounds, Madder two  pounds, Saltpetre one
pound,  Black Ammonia half a pound;  mix.    Give a table-spoonful
twice a day, in milk, gruel, or anything they  will eat it in.   If too far
gone to eat, drench them with it.
  2. As soon as  a hog is attacked, give  him  a teaspoonful of Arsenic,
repeating it twice a day, for two or three days.
  3. Put into a  strong bottle one teaspoonful  of Chlorate of Potash,
and one ounce each  of Muriatic Acid and water; cork tight,  and keep
in a dark place.  Of this add tAvo  teaspoonfuls to a pint of water, and
give to each  hog, in his food, tAvo  or three ounces at a time,  repeating
it frequently.  To destroy the infection  in a pen, wash the posts with
a strong solution of  Sulphate of Iron, or Chloride of Lime, and also
sprinkle it about.
  4. u There are, on the inside of the fore-leg  of every hog, opposite the
knee-joint, three small ducts or  pipes, which  connect directly with the
animal's lungs.   In  every healthy hog,  there is a continual  discharge
from these issues, of a thick, offensive matter, causing the hair to look
greasy  around them.  If these issues get stopped, as  they  often do,
the hog Avill  die in a  short time, unless they are opened, which is done
by  inserting a wire, the size of a knitting-needle, into the issues, from
ten to twelve inches, taking care not to punch through the membranous
lining  near the  lungs.  After the opening process is  finished, anoint
the inside of the leg with Salt-grease, and  rub with  a corncob  until
the skin looks very red, and in nine cases out of ten, if done in season,
the cure is effected. 
270
AMERICAN FAMILY PHYSICIAN.
  " Hogs that are confined in small pens, or together in large numbers,
are most liable to this disease, and they have never been knoAvn to be
affected by it where they have plenty of room, and free  access to a
brook z>r small stream of clear, running water."—Am. Agriculturist.
  5. '' You ask me  for permission to publish my remedy  for curing
the Hog Cholera, in the Household Department  of your  American
Family Physician.   I will cheerfully comply with your request, as I
think the  publication  of  the recipe in  your valuable  and unrivaled
family medical Avork, will  be of immense advantage to all your readers
who may be  raising  hogs in localities  where this terrible disease pre-
sents itself.   When I first tried the remedy, I had lost over one-third
of my entire stock of hogs; but, after giving it, all those that had not
gone too far to eat  of it, recovered, and those that were yet stirring
about did not take the disease; and they all  throve finely soon after I
commenced feeding  them with the preparation.   I am of the opinion
that its use should be commenced  early, or as soon as there are  any
unfavorable symptoms, and  continued for several days.  Since my first
trial of this remedy, I have uniformly been successful  in keeping my
hogs free from the disease, as Avell as my neighbors.
   " The preparation is composed of equal parts of finely powdered Gin
ger and Allspice;  mix it Avith some kind of ground feed, giving two or
three table-spoonfuls three times a day, to a full-grown hog.  There is
#10 danger of giving  too much."                    R. P.  Finney.

                       Fistula in Horses.
   1. Mix together in a tin cup, a table-spoonful of Salt, a table-spoon-
ful of Soft Soap, a table-spoonful of Spirits of Turpentine, and a table-
spoonful of Whisky ; place  a tAvitch on the horse's nose, to prevent his
moving; put .the mixture over the fire, and as soon as it boils up, pour
it immediately upon  the diseased part.   Repeat the operation every ten
or twelve days.   Tavo, three, or four operations will effect a cure.  It
does not take off the hair, nor leave a  scar.
   2.  Take Oil of Vitriol one ounce, and add it gradually to Oil of Spike
one ounce, then add half a gill of Sweet Oil.  If the Acid and Oil be
added together at once, they will burst into a flame.  This  is also good
to remove Corns, Callous Tumors, and stop Hemorrhages.

                          Clean  Milking.
   It is sometimes forgotten that the last gill of milk draAvn  from the
cow's udder  is the  best part of every milking.   Careful experiments
made  in England show (according to a report lately  published) that 
          h           HOUSEHOLD DEPARTMENT.                  271

u the quantity of cream obtained from the last drawn cup from most
cows, exceeds that of  the first in the proportion of twelve to one."
The difference in the quantity, also, is considerable.  Hence a person
who carelessly leaves but half a pint of milk undrawn, loses, in reality,
about as much cream as Avould be afforded by six or eight pints at the
beginning ; and loses, too, that part of the cream which gives the rich-
ness and high flavor to his butter.

          Cattle Plague.—Pleuro-Pneumonia of Cattle.
  The  folloAving  is an  extract of a Report of a Scientific Committee
to the  Governor of Ohio :                           *
  " Symptoms.—This disease presents, like all other diseases, variations
in the  intensity and order of succession of symptoms, so  great that
much care is sometimes required in order to determine the-presence
of the  disease, even when someAvhat advanced; while in other cases
thc violence  of the attack makes the presence of the complaint obvi-
ous to the casual observer.   The general description which  follows
will, hoAvever, be sufficient to give a clear  and intelligible basis of
diagnosis.
  " The period of incubation, or that time intervening betAveen expo-
sure and the attack, is not marked by any obvious symptoms, and the
insidious mode of onset makes it difficult, or impossible, to determine
the length of this first stage.  But, as a general rule, this period may
be considered as extending from two to four weeks.
  " Yet, in some feAV instances, the disease exhibited its first Symptoms
as early as three days after exposure, and in the case of the Maiden
coav seven months  intervened between  the time of exposure and the
development of manifest symptoms.
  " Among  thc  obvious signs of the  disease  are these:  The affected
animal separates itself from the other cattle  during the  early part of
the day, and has a dull  appearance, head drooping, does not eat, sweats,
has the back arched  up ; but, as  the day advances, seems to recover its
usual health, and joins the herd  again.  A slight cough,  somewhat
husky  in character,  Avill sometimes  be  observed, and  the respiration
becomes, at  times, panting and labored, as though the animal had been
making some unusual  exertion.   In  milch  coavs, the quantity of milk
is diminished.
  " As the disease advances, the coat loses its glossy appearance, and
becomes rough,  ragged, and " staring," the cough becomes more fre-
quent  and hoarse, the  breath becomes  more moist and offensive, the
pulse is quick and labored, appetite  and rumination (cud-chewing) are 
272
AMERICAN FAMILY PHYSICIAN.
•
greatly impaired—the latter being often entirely suspended—constipa-
tion of the bowels, excrement or feces almost black and hard; the dif-
ferent parts of the body may have an unequal distribution of heat, or
the whole surface may  be unnaturally cool; the skin is fixed to the
ribs—the animal flinches upon being subjected to pressure  upon the
spine, or percussion upon the chest.   In a still more  advanced stage,
the animal frequently lies down, and while standing looks pinched, with
the head protruded;  the  mouth is  covered with frothy saliva, and the
whole appearance is  haggard and dull;  a  constant dripping of tears
from the eyes ; the  lower  eyelid presents a soft and swollen con-
dition.        -
   " What should be done with Animals  known to have the Disease.—Many
say, ' Slaughter, at once, all  cattle  affected Avith Pleuro-Pneumonia,'
as  they think it costs  more to cure  them than they are worth.  But
the knowledge we have at present is not sufficient to enable the people
to  decide the question  wisely.  In some  countries, as the steppes of
Russia, the sick animals  often recover, so as to be valuable in a short
time; and this might be so here, if time  were alloAved for the purpose
of seeing.  While it is repugnant to our feelings to kill, without trying
to save by medical treatment, we are admonished by the past that some
do  recover by natural effort of constitution, and others  seem to want
only  assistance to recover; and yet judicious  treatment has not been
tried upon any.   Shall  no one try isolation and rational treatment for
a proper length of time, to determine this question ?  The United States
may triumph in this scientific respect, as  it has in others, over the Old
World countries.
   " Now that isolation  of the diseased animal has been recommended,
owners should try what can be done to cure,  beginning with the means
which have proved somewhat successful on the other side of the Atlantic,
and even if the skill  be no greater,  the  climate may make  the same
treatment more  successful.
   " The question, ' Is the flesh of animals, laboring under this disease,
injurious as  food?' is frequently asked.  So far as observation goes,
no  harm has resulted from its occasional use.   The meat looks as well
as that of other  animals of like fatness.   And, indeed, we knoAV of but
one disease capable of being  carried into the system by using the flesh
as food, and that is ' Trembles,' or i Milk  Sickness.'
  " Two reasons present  why the flesh  of diseased animals may not
be  injurious when taken  as  food: first, the effect of cooking;  and
second, of digestion, to  modify and dissipate any unusual quality pos-
sessed by the flesh before undergoing these processes, are very great. 
HOUSEHOLD DEPARTMENT.
273
  " Preventives.—These naturally divide themselves into two classes:
First, those circumstances which call for attention in the management
of a healthy stock, so  as to prevent the introduction of disease from
other stocks, or  its spontaneous generation among the members of a
stock, etc.  There are many things which, if properly attended to, might
go far in the prevention of this disease, especially under peculiar cir-
cumstances, such as the almost universal  coughing, which,  at  times,
prevails among  cattle, especially young stock;  setoning the dewlap
being  the simplest  and best counter-irritant for  slight disorders of
the chest.  Slight doses of physic, to regulate the bowels, will often
do much good.  In severe and changeable weather it is of the utmost
importance that  cattle  be kept comfortable, particularly at the periodi-
cal change of food, such as turning out on  grass,  or in on turnips,
straw, etc.  Stables or cowhouses should never  be overcrowded with
live  stock.
   " Such  houses should be perfectly cleaned out once a day.  They
should be properly ventilated.  Under such circumstances the general
principles of ventilation are: The admission of fresh air as near the base
of the walls as may be, and allowing the contaminated air to escape by
the top of the building.  If the apartments occupied by cattle are very
closely shut at night, they will prove  extremely warm, while  the doors
being necessarily open during a great part of the day, the temperature
falls, and  the  health of the cattle, especially the lungs, suffers by such
changes.
   " On the second class of preventive measures—those necessary to be
adopted after  the disease has appeared in stock, so as to  prevent its
spreading among them—much difference  of opinion exists.  As we
consider this the time when most danger is  to  be apprehended from
contagion, the following precautions will  be followed  with the  best
results.  And, so far  as our reading or other  information goes, we
have reason to believe  that where precautionary and disinfecting meas-
ures  have been  neglected, the disease has  spread; we advise, then,
the careful and immediate separation of the  affected from the healthy,
the moment the  disease is known to exist on a farm.
   " If it is  a  single beast that is affected, if it is very bad,  and if on
careful examination by an experienced  person, none  others can be
detected as having the disease, then we would  advise destroying the
affected beast at once, and bury without opening the carcass; if it is
thought advisable to treat the beast, then remove it to a place as much
apart  as possible from the  general stock.   Set  one person to  attend
the  affected animal, and do  not  allow him to enter any other stable 
274
AMERICAN FAMILY PHYSICIAN.
 about the farm; neither allow any of the other servants to enter the
 affected place.  On the affected beast or beasts being removed  from
 their former house, and secured in the next, be very particular in giving
 the sick beast plenty of fresh air.  Turn out all the animals occupying
 the same house or range  of houses.  Fumigate such  buildings  with
 some disinfectant gas.  Take any quantity of common salt, put  it in
 a shallow vessel; make very dry and hot, pour on it Oil of Vitriol
 (Sulphuric Acid,)  stir it up, and copious fumes of gas will be extricated
 filling the building from top to bottom.   This  should be repeated  from
 day to day.   Or,  take thirty-four parts of the black  Oxide of Man-
 ganese, (which  can be procured  from any druggist,)  mix it intimately
 with fifty-nine parts of dry, common Salt; pour on the mixture ninety-
 eight parts of Sulphuric Acid, previously diluted with half its weight
 of water, and allowed to cool.
   " This mixture  will yield Chlorine Gas, which is particularly distin-
 guished by its power of destroying and decomposing effluvia produced
 by contagious diseases,  or arising from vegetable or animal matter in
 a state of putrefaction.  In addition to this, the walls, furniture, roof
 etc., of the stable (inside) may be washed Avith hot Lime, or Chloride
 of Lime, well cleansing and scrubbing the floor, manger, etc.  These
 washings should also be attended to in the apartment occupied by the
 sick beasts, as they purify the air, which must be beneficial to the dis
 eased, and in some measure prevent the  escape of the effluvia so as to
 affect the healthy.
   "After the disease has really appeared  in the neighborhood, we would
 recommend every one to inoculate all the healthy animals, in addition
 to the foregoing sanitary measures.  As little or nothing is known of
 inoculation in this  country as a preventive of Pleuro-Pneumonia, it may
 be well to give  a  brief sketch of its introduction and success in  con-
 tinental Europe.
   "Inoculation.—If Ave had no other evidence  of the results of inocu-
 lation  as  a prophylactic than the report of Dr. Willems, of Hassalt,
 Belgium—the founder of the system—on the one hand, and the report
 of Professor  Simonds, of the  inefficiency of the system, on  the other
 hand, Ave  might, Avith propriety,  be justified in doubting the  truth of
 Dr. Willems's statement.   But when Ave find that Willems's system
 was practiced almost simultaneously by De Saive, in  Prussia; Wydra,
 in Bohemia;  Niklas,  in Bavaria;  Bartels, in BrunsAYick;  Heinrich,
 Winter, and Karg, in Tyrol; Bartani, Casorati, Cattane, in Lombardy;
 Eckels, in Pavia ; Janich, in Austria, with the best results upon eighty-
five to ninety-seven per cent, of the cattle inoculated,  we can not do 
HOUSEHOLD DEPARTMENT.                  275
otherwise than believe that the experiments of Simonds were made in
an unskillful, improper, or an ' unfriendly' manner, in  order to bring
the system into disrepute.  It is gratifying to your chairman to know
that the other members of the Commission indorse this view.
  "When  Mr. Flint, the Secretary of  the  Massachusetts Board  of
Agriculture, showed the  Rev.  Mr. Lindley (missionary from Africa)
the reports of Mr. Simonds, after looking over them carefully, he (Mr.
Lindley) said that if they should try inoculation in Africa, under such
circumstances, they should not expect  any better results.
  " The Rev. Mr. Lindley, alluded to in the foregoing paragraph, stated
before the Massachusetts  Legislative Committee that 'the cattle that
have  been preserved by inoculation are all  the  cattle we have left
there, (Africa.)  In a country like that, where there are no fences, and
where there  is such a constant  going of cattle, many persons felt
obliged to  inoculate.  Farmers in the  interior, having,  perhaps, some
of them, three thousand  dollars' worth of wool in their house, living
four hundred  miles  from  the seaboard, where it was  to  be  sold, did
not dare to leave their homes unless their oxen were inoculated; and
when they inoculated them, they inoculated whole herds.   Every man
felt obliged to inoculate  his cattle,  and did so,  except some  two  or
three strong-headed men,  who did not believe inoculation would  do any
good.  One such man is a neighbor of mine.  He left it to fate ; and out
of one hundred and twenty head, I believe he has  three or four  left.'
  "At the session of German Agriculturists in 1853, at Niirnberg, Dr.
Kragers said that Hausman, of Hanover, first discovered inoculation in
1819; that recently, in Utrecht and Munich, inoculation was attended
with the best results—out of 5,300, only 86 died.
  " Dr. Zellers stated that, in Rhine-Hessen, it proved a complete pro-
phylactic.
  " Mr. Hirshfield, of Schleswig-Holstein, says that it evidently saved
many cattle in that Province.
  " Mr. Falkenhauser, of Silesia, stated that it was  attended with the
best results in  his neighborhood,
  " Inoculation of the Pleuro-Pneumonia is not intended to introduce
the same disease  in a milder form, as in vaccination or inoculation for
Small-Pox in the human subject, but is intended to introduce a homo-
genous disease into the system, which  shall have the wound caused by
inoculation as its seat of  disease, instead of the lungs.  The lungs of
healthy animals are not affected by inoculation, but the system  under-
goes a change, the consequence of which destroys the susceptibility to
take the disease in the natural way. 
276
AMERICAN FAMILY PHYSICIAN.
   "In Europe the question seems to have claimed  more careful and
scientific investigation, and the result of numerous and well-authenti-
cated experiments would seem to indicate the possibility of successfully
guarding against the disease by inoculation. A Belgian physician Dr.
Willems, of Hassalt, recently submitted a report to  the Belgian gov-
ernment, containing some  interesting facts with reference to this dis-
ease, and  also the results  of his researches and  experiments with a
view to its prevention.    The scourge  appeared first in  Belgium in
1820, in Holland in 1832, in England  in  1842, in Sweden in 1847,
Denmark  in 1848, Finland  in 1850, and since in various parts of Ger-
many, Russia, and Poland.
   " The average mortality among the cattle is ascertained to have been
from thirty to fifty per cent.  In view of this fact,  Mr. Willems, whose
father is the proprietor of large distilleries, and stables containing over
a hundred  head of cattle, resolved to make experiments to determine
the true nature of the disease, and, if possible, to discover  the remedy
and prevention.  From his report to the government, it appears that
his efforts were crowned with entire success.   The cattle in his father's
stables having been  attacked  by the  disease, Dr. Willems,  believing it
contagious in its character,  conceived  the idea of  inoculation  as a
preventive.
   " He  caused a diseased animal to be killed, and  from the lungs, the
seat of the disease, collected the matter necessary to carry out his pur-
poses.  In the prosecution of his experiments, Dr. Willems began by
inoculating the animal about  midway from the extremity  of the tail;
but the  swelling  or inflammation resulting in ten days or  a fortnight,
was-found  to be so great as to cause death.   He then took other cattle,
which he inoculated  at the  extremity  of  the tail, making two incisions.
In a few cases only,  no inflammation  resulted; but  of one hundred and
eight animals subjected to this process of inoculation, not one  was
attacked by the  disease, Avhile out of twenty not so inoculated, seven-
teen Avere attacked and died.   After  these  successful  experiments, all
calves and young animals were subjected to the same process.
   " In consequence of the  report of Dr. Willems to the government, a
commission was instituted,  at  the head  of  which was the famous Dr.
Ferhaille, which,  after numerous experiments and protracted and care-
ful investigation, reported  in  favor of the process  of  inoculation as a
preventive of  the plague.   The question, however, as to the duration
of the effects of inoculation, or when re-inoculation should be resorted to,
they leave  to be determined by future observation.  Under the super-
vision of the commission, five thousand three hundred and one  head 
HOUSEHOLD DEPARTMENT.
277
of cattle were inoculated.  In four thousand three hundred and twenty-
five cases, the virus took effect, resulting in inflammation, while in nine
hundred  and  seventy-six cases,  no inflammation occurred.   Of the
whole number of cases,  eighty-six died from the effects of inoculation,
while in  four hundred  and  seventy-eight cases the tail was injured.
Out of the five thousand three hundred head experimented upon, sixty-
six only were attacked by the disease, and of these all recovered."

                  Remedy for the Peach  Borer.
  We find in the Southern Cultivator an article from H. F. Grant, of
Glynn county, Georgia, in Avhich he gives a " sure remedy against the
peach borer," but Avhich is simply nothing more or less than that which
we have practiced  with our dAvarf pear stocks, (quince,) viz.: " Remove
the earth from around  the  trunk, say four  or five  inches, then wrap
around the same, as far down as practicable, a bandage of cotton  cloth,
so as to  be five  or six inches above the ground when the earth is put
back, having secured the bandage with cotton twine.  This is allowed
to remain on, according to Mr. Grant's plan, as long as it is whole, and
is then replaced with another.  We mentioned that, although never tried,
we had no doubt that this bandage  method would be equally effective
applied to  peach trees,  etc.   We recommended, however, the removal
af the cloths about  the first or  middle of August, and renew them
again as  early in the Spring as the condition of the ground will  admit
of the operation.  We  think so still, as there will then be no chance
of neglecting to reneAV when the old bandages are no longer a pro-
tection."

                  To protect a Roof  from Fire.
  Says the editor of the Albany Knickerbocker: "A wash composed
of Lime, Salt, and fine Sand or Wood Ashes, put on in the  ordinary
way of whiteAvashing, renders  the  roof  fifty-fold more safe against
taking fire from falling cinders or otherwise, in cases  of fire  in the
vicinity.   It  pays  the expense a  hundred fold in its preserving  influ-
ence against the effect  of the weather; the older and more  weather-
beaten the shingles, the  more benefit derived.   Such shingles generally
become more or less warped, rough, and cracked;  the application of
the Avash, by  Avetting the upper surface, restores them at once to their
original or first  form, thereby closing the space between the  shingles,
and the lime  and sand, by filling up  the cracks and pores in the shingle
itself, prevents its warping for years, if not  forever." 
278                AMERICAN FAMILY PHYSICIAN.
                   An  Item for  Housekeepers.
  When clothes are rolled up  in  a  damp state for a  few days, they
become spotted with mildew, consisting of minute " fungi."  These are
very difficult to remove, and they injure both the texture and color of
the clothes.   The only effectual mode known to us for removing such
spots from linen, is by steeping the latter in a weak liquor of Chloride
of Lime.  It is made by obtaining some Chloride of Lime  from the
druggists, say a pound; then stirring it into about four gallons of cold
water; it  is now allowed to settle  for one hour, and the clear liquid is
ready for  the clothes, Avhich should be steeped in it for  two hours, then
washed thoroughly in cold water, and exposed on the grass to the sun.

                HOW  TO MAKE A  BALKY HORSE PULL.
   A correspondent of the Cotton Planter gives a method for making an
obstinate  horse or mule pull up a  hill, or anywhere else, when his mus-
cles are equal to the work : " Take a small rope, double it, make a loop
at the double  end, and  draw it snugly around the under jaw of the
animal, just below  his front teeth, with loop underneath.  Throw the
loose end over your shoulder, and  'walk in the way he should go,'
holding fast and pulling steadily and firmly.   Don't be troubled about
him,  for  he will folloAV Avithout fail, after he has discovered how you
have ' got him.'  This method will compel an animal to stand still and
allow a bridle or collar to be put on him."

      HOW  TO PREVENT SORE  SHOULDERS  IN WORKING HORSES.
   The Boston Journal says: "  The plan we have tried, and never found
to fail, is to get a  piece of leather  and have it cut in such a shape as
to lie  snugly between the shoulders of the horse and the collar.   This
fends off  all the friction, as the collar slips and moves on the leather
and not on  the shoulders of the horse.  Chafing is caused by friction;
hence this  remedy is quite a  plausible one, and is  much better than
tying slips of leather or pads of sheepskin under the collar."

                      Fruit Stains in Linen.
   To remove them, rub the part  on each side with yellow Soap, then
tie up a  piece of  Pearlash in the cloth, and soak well in hot water,
or boil;  afterward expose the stained part to the  sun and air until
removed.
                           Curing  Hams.
   We repeat  here  the excellent recipe of Mr. J. Q. Hewlett, and that 
HOUSEHOLD DEPARTMENT.
279
 of Mr. S. W. Ficklin.   Either will do if well followed.  It will be
 observed, however, that there is a material difference as to the length
 of time which the meat  should lie in salt.  One being six, the other
 three  weeks, and  one from four to six, according to size.  Our im-
 pression is, that for hams weighing, say ten to twelve pounds, three
 weeks in  salt will be found sufficient.  We used Mr. Hewlett's recipe
 last year, and found that time long enough, and that smaller hams
 were too  much  salted.   Heretofore avc have  kept in salt usually as
 long as six weeks.   The advantage of hanging early consists in getting
 the  meat  smoked and secured in bags before the warm days, when the
 fly may get at it.
   The Frederick Recipe.—For  pickling one hundred pounds of pork,
 hams, beef, etc.: Take six gallons of water, nine pounds of Salt, mixed,
 (half fine and half coarse,) three pounds of brown Sugar, and one
 quart of Molasses, three ounces of Saltpetre, and one ounce of Potash.
 Boil and  skim it well, and let it stand till entirely cold; then, having
 rubbed your meat with fine Salt, pour this brine over it;  let it remain
 six Aveeks over it; then hang up and smoke.
  Mr. Fieklin's Recipe.—Eight pounds Salt, two ounces Saltpetre, one
 and  one-half ounces Potash, two pounds brown Sugar or one -fourth gal-
 lon Molasses, one  ounce  red Pepper.   These ingredients, dissolved in
 five  gallons of water, constitute a brine which should be poured on one
 hundred pounds of hams, already packed and closely fitted in a water-
 tight cask; the  hams having been previously  rubbed Avith Salt, and
 thoroughly aired t\vo days before being put into the cask.
  After an immersion from four to six Aveeks, (according to size,) they
 should be hung up  by the skin of the shank, and, Avhen smoked suf-
 ficiently,  covered Avith paper;  then put in bags and hung, hock down-
 ward.  The whole process  completed before the warm days of March.
  Mr.  Hewlett''s Recipe.—To one thousand pounds of meat, put three
 pecks fine Liverpool Salt and four pounds Saltpetre.  Put neither Pep-
 per,  Sugar, nor Molasses Avith the foregoing.  Pack in cask, the bottom
 of which  must be  perforated with holes, to  allow  the drip of bloody
 water  to  pass off.   Let  remain three weeks,  and then smoke every
 morning with good, green hickory wood, using a boxstove placed in a
 room, or elseAvhcre, and  separate from the meat a sufficient distance,
-so that  the smoke may be cooled before it comes in contact Avith the meat,
 SeAv up in canvas bags the latter part of  February, but by no means
 later, for fear the fly should appear some mild day.
          68 
280
AMERICAN FAMILY PHYSICIAN.
                      To EXTERMINATE  RATS.
  1. Take of powdered  Squills two ounces, strong smelling Cheese
half a  pound; mix.   Make this into balls, and throw it where they
visit, and- it will kill them instantly.
  2. Take of Arsenic ten parts, Wheat  Flour, Lard, of each,  ninety
parts, strong Cheese forty parts, Assafoctida five parts, Oil of Aniseed
one part.   Mix, and. make into balls, as above.
  3. A mode of exterminating or expelling rats is mentioned  by the
New York Evening Post as having been  adopted  by a gentleman on
strictly philosophical principles.  Opening the floor at several places
in the upper stories of  his house, he  placed there vessels containing
a mixture  of Sulphuric Acid, black Oxide of Manganese and common
Salt, and- closed down the boards.  The result was a slow chemical
decomposition and recombining of elements, in the progress of which
the heavy, stifling gas, chlorine, was disengaged.   This made its way
along the open spaces and down to the cellar.  A few breaths  of the
poisonous atmosphere served  to convince the rats that danger was  at
hand.   Seizing what  of  their accumulated  plunder they could, they
hastened to abandon the  premises, sneezing and weeping as they went,
from having inhaled the noxious chlorine. Many months passed before
one  of the number  ventured to return.  An army of  ants,  moths,
bugs, roaches, and other pestilent insects, perished from  the fumes.
  4. Do not  kill your weasels.

    To prevent Rats, Mice, and Insects  from  working in the
                             Granary.
  After the grain is in the bin and made level and smooth, put on the
top about four quarts  of fresh,  thoroughly-slaked Lime; let this  be
spread evenly over the grain.  It will  keep out rats and mice in a bin
that contains one  hundred bushels.   This lime must  be  Avell  slaked,
so that it looks  like flour fresh from the miller's  bolt.  The rats and
mice will  not skip and play long before  they have to sneeze, besides
Avhich, some  of the lime  will  adhere to the oily substance on the rat's
feet.   They will not visit a second time.
  To keep out insects, the Lime should  be mixed Avith the  grain as it
is put  in the binr and then put the quantity above-named on the top.
The lime will not hurt, the grain if it is  not taken out,  as  it is good
for  the botts  in horses, neutralizes the acid in hog-swill, and prevents
hoo-s from vomiting.   If the lime is  not wanted in  the grain, this
must be run  through  a fanning-mill as it is required for use. 
HOUSEHOLD DEPARTMENT.                  281
                 To polish  Rusty  Spots in Iron.
   Dissolve in water as much  as it will take up of six parts of Chloride
of Zinc, and five parts of Sal Ammoniac.  With this wash  the  rusty
spots and rub them with it.

             To preserve Iron and Steel  from Rust.
   A piece of linen or cotton cloth, steeped in a saturated Lime-water,
or a saturated solution of Sulphate  of Soda, and carefully dried, will
preserve from moisture and rust all  delicate  iron or steel instruments
Avhich may be wrapped up in  it, as well as parchment and paper.  Steel
instruments  may likeAvise be preserved in  Quicklime.  A magnetic
needle suspended by a silk thread, in Lime-Avater, undergoes no deter-
ioration.
                    Soap to boil Clothes in.
   Take of Soft  Soap four quarts; rain water tAvo  quarts;  Sal  Soda,
(or Borax may be substituted,) one pound; Spirits  of Turpentine one
gill.  Mix together  in an iron kettle, and let them simmer  a little
together.   Rub  a small quantity of this soap upon the clothes, to boil
them in water, as usual.   It aids very effectually in  removing the dirt,
and lessening the labor and time  of  washing.

                  To  clean White Kid Gloves.
   DraAV the Gloves upon  the hand, and, with a clean piece of flannel,.
wet with Alcohol, Chloroform, or Benzole, carefully  rub them until the
soil is removed; then hang them  up to dry.

                             Caution.
   Never enter a sick-room in a state of perspiration, as the moment
you become cool your pores absorb.  Do not  approach contagious dis-
eases with an empty stomach, nor sit between the  sick  and the fire,
because the heat attracts the poisonous Arapor.

                            Fly  Paper.
   Melt Rosin, and while  Avarm add to it  enough SAveet Oil, Lard Oil,
or Lamp Oil, to  make it  of the consistence of molasses.   Spread this
upon Writing Paper with a brush.  It will not dry in a longtime, and
is  so sticky as to hold fast the legs of any insects  that may come  in
contact with it.   It may also  be placed on table-legs, and the prepared
paper be put around trees to  prevent insects from climbing up  them. 
282
AMERICAN FAMILY PHYSICIAN.
                       Magic Razor Paste.
   Take fine flour of Emery one ounce, Yellow Wax three ounces, Tal-
 low one ounce.   Melt the last  two, and stir in the Emery,  and put in
 boxes.   It will keep for several years.

                            Another.
   Take of levigated Oxide of Tin one ounce, Oxalic Acid two drachms
 Gum Arabic twenty grains; make into a stiff paste with water.  Thinly
 and evenly spread this on the strap.  With very little friction it gives
 a fine edge, and its efficacy is increased by moisture.

                            Another.
   Take  of Jeweler's Rouge, Black Lead, and Suet, each, equal parts ;
 mix well together, and spread on the strap.

                            Another.
   Place some Wheat StraAv in a vessel, cover it closely, expose it to a
 fire, and reduce to charcoal.  Finely powder this and sift it.   To use
 it, place a small quantity on a polished piece of steel, with a feAV drops
 of oil—apply the razor.  It will not require any leather stropping, as
 the edge will be perfectly smooth and sharp.

        To remove Stains and Mildews from Furniture.
   Take of Alcohol one pint, Linseed Oil one  pint,  powdered Resin
 one ounce, Oil of Cloves one ounce; mix.  When the Resin is dis-
 solved,  a portion of the mixture is to be rubbed upon the  spot.

                 To fasten Leather upon Metal.
   Wash the metal with a hot Solution of Gelatine or pure  Glue, and,
 having previously steeped the leather in  a  hot infusion of Nut-galls,
 press  it upon the surface of the metal,  and clamp  it until cold.  It
 adheres so firmly that  it can not be removed without tearing.

                    To soften Hard Water.
   A large  handful of poAvdered Borax to ten gallons of water, softens
 the hardest water, so that only one-half  the Soap is required.  It is
 less injurious to fabrics than Soda, and is useful in washing laces and
fine linens.
                         To  cut  Glass.
  Fill the glass vessel with oil exactly to the place where it is intended 
HOUSEHOLD DEPARTMENT.
283
 to be cut.  Immerse a red-hot rod of iron to an inch below the top of
 the oil; the heat will produce combustion, with evaporation, which will
 cut the vessel around at the surface of the oil, so that the upper part
 of the glass vessel may be readily lifted off.

                             Another.
   Mark  the glass around the place where it is to be divided, with a
 file, dip a string in Spirits of Turpentine, tie it around this mark, and
 then set it on fire, and the glass will crack along the line marked.

              To  DRIVE AWAY BED-BUGS, FLEAS, ETC.
   Mix together, in very fine powder, equal parts,  each, of Cedar wood,
 MayAveed leaves, Feverfew leaves, Sneezewort leaves, Fleabane leaves,
 White Hellebore root, and Alum.  Sprinkle or  dust this  about their
 haunts, and it certainly will  drive them away.

                            Another.
   Mix together, in very fine powder,  equal parts, each, of Larkspur
 leaves, False Unicorn root,  common Hemp leaves, Scotch Snuff, and
 Sheep Laurel leaves.  Use as  above.

                For the Bite or Sting of Insects.
   To a teacupful of Alcohol or Whisky, add tAvo heaping table-spoon-
 fuls of Sulphur.   Wash frequently Avith it.

                             Another.
   Apply Spirits of Hartshorn, or Aqua Ammonia, every few minutes.

                            Another.
  Apply the juice of the common Plantain.

                     For Scalds and Burns.
  Apply a plaster of Molasses and Flour.

                          For  Earache.
  Take a green Black Ash  limb, or a  piece of the stem, put one end
into the fire, and Avhen it begins to burn thoroughly there will run from
it a quantity of sap or Avater;  collect this in a spoon or Arial, and drop
a few drops, Avarmed, into the ear.  This  is an excellent remedy. 
284                AMERICAN FAMILY PHYSICIAN.
       To cure  the Scours in Cattle, Horses,  or Sheep.
  Take the bark and limbs of the Wild Cherry, and boil them for one
hour in a sufficient quantity of water to cover them well.  Then pour
off  the liquid, and soak Oats or other grain, to be fed to the animals.
They are very fond of this,  and it has proved to be one  of the best
remedies known for this troublesome disease.

                  To give Horses an Appetite.
  Of the common Tag Alder, growing along the banks of streams and
in damp places, take a piece about eighteen inches long, and three or
four inches in diameter; bore an inch hole  nearly through it length-
wise,  and fill it with Salt.   Bury this in a bed of hot ashes and coals,
and let it remain till thoroughly charred.  Remove the Salt, and reduce
it to powder.  Give tAvo tablespoonfuls for a dose.  This is also good
for  yearling  colts in the  spring of the year, causing them  to  thrive
much better.

       To restore Pork  that has become slightly Soured.
  Many persons  are troubled during the heat of summer, with their
pork and  other salted meats becoming soured.  Salted meats also be-
come  "rusty," as it is termed, by  the brine draining off and leaving
some  portion of the meat uncovered, thus rendering it very unpalat-
able as well as very unwholesome.  In most cases it may be made as
sweet and as good as ever by the following process:
  Take all the meat out of the tub or barrel, and wash it with clean
Avater to which some Saleratus has been added.  Then, to every two
hundred pounds of meat take one bushel of Charcoal; kindle the Char-
coal, and  when thoroughly on fire,  shovel the hot coals into a tub of
water sufficiently  large to hold the meat, which meat must  be  added
as soon as possible.  AHoav it  to  stand for tAventy-four  hours, then
take out the  meat, and wash the coals from  it.  Wash out the barrel,
into which the meat is to be kept, thoroughly, with ashes and water, or
a strong ley; then  build a small fire of Corncobs or any hard wood,
over which place the barrel,  making it  sufficiently tight  around the
bottom to gradually smother the fire out; repeat this operation two or
three  times, when the barrel will be fit for use.   Some persons build
a fire  in the barrel and char the whole inside of it.
  For those Avho  are in the  habit of using  salted meats through the
summer, this recipe Avill be worth more than twice  the whole cost of
the  book—as much of the salt pork, beef, etc., used  through the coun- 
HOUSEHOLD DEPARTMENT.
285
try, is unfit for use during this warm season, and actually causes much
of the disease common at  this  period.   The  above  simple method
renders it as sweet and as good  as when first salted down.

             For Watery Bloodshot Eyes  in Horses.
  Take Alum and White Vitriol, of each, equal  parts; burn or calcine
them separately by exposure to fire in  a vessel, and then dissolve in
three pints of boiling water.   Use as a wash.

     To remove  a False Skin  groaving over a Horse's Eyes.
   Take the  powdered articles above named, Alum and White Vitriol
calcined—say three  parts  of the  burnt Alum, and one part of the
burnt White Vitriol—finely pulverize them, and blow a small quantity
of this into the eye through  a reed or other tube, repeating the oper-
ation every day or two.  This is also good in hurts or bruises of the
eye, after the inflammation has  been removed.

                 Liniment  for Horses and Cattle.
   Take Spirits   of Turpentine,  Oil  of Spike, Spirits of Hartshorn,
 Spirits of Camphor, and Laudanum, each, two ounces; mix.  Useful
 for  sprains, old swellings, rheumatism, etc.

               To  rid Chickens and  Hens of  Lice.
    Make roosts  of Sassafras poles, and scatter  Sassafras bark about
 the hen-house and in the nests.  This  not  only  drives away the lice,
 but keeps the fowls  free from them.

            To  prevent Horses being teased by Flies.
     Take  two or three small handfuls of Walnut leaves, upon  which
 pour  two  or three quarts  of cold water; let it infuse one  night, and
 pour the whole, next morning, into a teakettle  and let it boil a quarter
 of an hour; when cold, it will  be fit for use.   No more is required
 than to moisten a sponge, and before the horse  is  saddled or harnessed,
 let  those parts which are most  irritable be  smeared over with the de-
 coction, namely, betAveen and upon the ears, the neck, the flank, etc.

                        More  about  Rats.
     There is a prescription I have seen tried,  and which I have never
 seen  in print.   Catch a quantity of rats, say from eight to  a  dozen,
 put them in a large kettle, out of which they can not escape, and keep
 them there  without food.  They will presently devour each other, till 
286
AMERICAN FAMILY PHYSICIAN.
there is but one left.   That one, of course, is the strongest.  Let him
out and go about; he  will catch and eat every rat on the place.

                           Corn Beer.
   " To two gallons of water add one  quart of dry Corn, one pint of
Molasses, one  table-spoonful  of Ginger.   Let  it stand in a cask or
demijohn, and  in one Aveek it is  fit  for  use.  The  same corn will
ansAver  for  several brewings,  but  the cask should  be  scalded each
time."
                         Tell your Wife.
  If you are in any trouble or quandary, tell your wife—that is, if you
have one—all about it at once.  Ten to one, her  invention will solve
your difficulty sooner than all your logic.   The wit of woman has been
praised, but her instincts are quicker and keener  than her  reason.
Counsel with your wife, or your mother, or sister, and be assured that
light will  flash upon your darkness.  Women are too commonly  ad-
judged as verdant in all but purely Avomanish affairs. No philosoph-
ical student of  the sex thus judges them.   Their intuitions, or insight,
are the most subtile, and if they can not see a  cat in the  meal, there
is no cat there.  In counseling one to tell his  trouble to his wife, we
would  go further, and advise him  to keep none of his  affairs secret
from her.  Many a home has been happily saved, and many a fortune
retrieved  by man's full confidence  in  his better half.  Woman is  far
more a seer and prophet than man,  if she  be given a fair chance.  As
a general  rule, wives confide the minutest of their plans and thoughts
to their husbands, having no involvements to screen from him.  Why
not reciprocate, if but  for the pleasure of meeting confidence with con-
fidence ?  We  are certain that no  man  succeeds so well in the world
as he who, taking a partner for life, makes her the partner of all his
purposes and hopes.  What is wrong in his impulses or judgment,  she
will  check and set right  with her  almost universally right instincts.
" Helpmeet" was no insignificant title, as applied to man's companion.
She  is a meet help to him in every darkness, difficulty, and sorrow of
life; and  what she most craves  and deserves,  is confidence—without
which  love is never free from a shadow. 
•
                   GLOSSARY,
                                OR
EXPLANATION OF TERMS USED  IN THIS WORK.
  N. B. Many persons do not always have a dictionary at hand, at all times, to consult,
and as it is important that those who read a work should fully understand the meaning of
every term used by the author, I have deemed it best to give a full explanation of all the
words made use of in this work, which were not the every-day words of common conver-
sation;  so that the following  pages will be found quite an extensive Dictionary—and,
although I have explained many words that may seem very simple to some, yet every
one will admit that there are many readers who will need as full an explanation as I have
given.
  PI. before a word means it is the plural of the word which precedes it.
  The names of many articles, etc., are explained  in  the body of the work, and may be
found by referring to the Index, both of Division I and Division II.
Abates, moderates ;  lessens ; decreases in power or strength.
Abdomen, the belly.
Abdominal, belonging to the belly.
Abdominal Cavity,  the cavity  or hollow space included in the belly.
Abdominal Viscera, the organs contained  in the abdominal cavity, as
  the intestines, liver, kidneys, spleen, stomach, etc.
Ablution,  Avashing or bathing the body.
Abnormal, unhealthy; not natural.
Abrasion, Avhen the  skin of any part is rubbed or worn off, it is called
  an abrasion; scraped off.
Abscess, a softened tumor, or cavity, containing matter.
Absorbents, certain  vessels and glands in the system, which absorb or
  take up substances from within, or externally.
Absorption, the act of absorbing or taking  up ; sucking in.
Acarus, pi., Acari, a mite or insect of the  itch kind.
Accelerate, to hasten; to increase in quickness.
Accelerated, hurried or increased in quickness.
Accumulate, to collect together in  a pile or mass; to act with sudden
  and concentrated energy.
Accumulation, the collecting or gathering together in a mass.
                                                       (287) 
288
AMERICAN FAMILY PHYSICIAN.
Acetated, mixed with Vinegar or Acetic Acid.
Acetous, resembling Vinegar;  having a Vinegar taste or smell,
Acicular,  shaped like a needle.
Acid, a name  given  to certain substances which have a more o£ less
  sour taste,  Avhich  form salts  with alkalies,  and redden vegetable
  blues.
Acidulated, having an acid added to render slightly sour.
Acidulous, having a sourish taste.
Acrid, biting;  that which produces a rough, pungent, irritating sensa-
  tion in the mouth and throat.
Acromion  Process, the process or bony projection on the top of the
  shoulder.
Acuminate, having a sharp point.
Acuminated, sharp pointed at  one end.
Acute, sharp ; severe ; violent;  to have a sharp point.
Acutish, somewhat acute.
Acute Diseases, diseases which are severe in  their character, violently
  affecting the whole system in a greater or less degree, and which
  terminate rapidly in a  few days or Aveeks, either in health or death.
Administer, to give medicine to a patient; to prepare and furnish the
  dose or doses of medicine for a patient.
Aerated, in this work means, receiving or absorbing the  oxygen of the
  atmosphere  into  the lungs,  so  as  to oxygenize  the blood; usually
  means, mixed with carbonic acid.
Air Passages, the nose, throat, Avindpipe, bronchia, and  lungs.
Albumen, the white of egg; any substance which partakes of the char-
  acter of  the  white of eggs.
Albuminaria, a term applied to urine, Avhen it  contains  albumen,  and
  which may be knoAvn by  heating the urine, Avhen the albumen  will
  form into hard, whitish flakes or lumps.
Alimentary, belonging to the  food  or  aliment, as the " alimentary
  canal," the canal through which the food passes.
Alkali, a term applied by chemists to substances Avhich  are soluble in
  water, which unite with  acids to form salts, which turn  the blue color
  of vegetables into green, and which are  wholly evaporated by heat.
  The alkalies  in medicine, are Potash, Soda,  and Ammonia.
Alkaline, partaking  of the nature of an alkali, as an " alkaline pur-
  gative,"  an " alkaline solution," etc.
Alkaloid,  a name given to certain substances Avhich are extracted from
  vegetables, because, like alkalies, they neutralize acids.  Thus, Qui-
  nine, Morphine, Strychnine, Veratrine, etc., are alkaloids. 
HOUSEHOLD department.
289
Alluvial, belonging to land formed by the sediment contained in water;
   land formed by the mud deposits of rivers, lakes, etc.
Alluvion, Alluvium, the land formed by the mud deposits of water.
Alterative, see Division I,  page 621.
Alternate, to take place, or act by turns, first one and then the other,
   and so  on.
Alternating, taking place  by turns.
Alvine, pertaining to the  intestines, as  "alvine discharges,"  or dis-
   charges from the boAvels.
Amarous, bitter to the taste.
Amaurosis, likewise called Gutta Serena, a partial or complete loss of
   sight Avithout any apparent alteration in the eye, except an unchange-
   able condition of the pupil.
Amenorrhea, a disease characterized  by a suppression of the monthly
   courses.
Aments, or Catkins, a spike, the  flowers  of which are covered with a
   scaly or chaffy  bract or  flower  leaf,  as with the Hop, White Wil-
   low, etc.
Amniotic Liquid, the fluid surrounding the unborn child in the womb,
   and Avhich is called popularly " the  waters."
Amorphous, having no regular or definite  form;  not crystalline.
Amylaceous, belonging to starch;  like starch;  starchy.
Anaesthesia, insensibility ;  suspended insensibility.
Anaesthetic, an agent Avhich causes insensibility.
Analogy, resemblance ;  similarity ; very much alike.
Analysis, to separate a body and reduce it  to its simple elements.
Anasarca, dropsy of the skin, or cellular tissue.                   "*
Anemia, Anemic, paleness from Avant of  red globules in the  blood;
   bloodlessness.
Aneurism, a swelling caused by an  enlargement  or  dilatation of an
   artery, as " aneurism of the aorta,"  a  dilatation of this artery.
Annoying, worrying;  fretting;  injuring; disturbing.
Anodytste, medicines Avhich remove or lessen pain, as " anodyne plaster,"
   a plaster to relieve pain ; "anodyne  strengthening plaster," a plaster
   which  relieves pain and   strengthens the parts;  see Division  I,
   page  620.
Antaphrodisiac, see Division I, page  621.
Anterior, in front.
Anterior fontanelle, the diamond-shaped, soft-edged space or opening
   in the front part of the newly born child's head, just at the upper
   part of the forehead, and Avhich closes as the infant advances in age. 
290
AMERICAN FAMILY PHYSICIAN.
 Anteriorly, that Avhich is before, or in front of.
 Anthelmintic, see Division I, page 621.
 Antiacid, see Division I, page 621.
 Antidote, that which  destroys or renders harmless the effects  of a
   poison.
 Antiperiodic, see Division I, page 620.
 Antiscorbutic, see Division I, page 621.
 Antiseptic, see Division I, page 621.
 Anus, the fundament; the lower opening of the bowels.
 Aorta, the largest artery of the body, which comes directly from the
   heart, and from which all the principal arteries of the body arise.
 Aperients, see Division J, page 619.
 Aphonia, loss of voice.
 Aphtha, a sore mouth peculiar to infants ; see Division I, page 248.
 Aphthous, belonging to, or of the nature of aphthse.
 Apparatus, a collection of organs which have the same  function, or
   determine to the same result.
 Apparent Death, not dead, but very juuch resembling it.
 Apportioned, divided into parts and parcels; distributed; doled out;
   shared.
 Areola, a colored circle, as around the nipple, or around the base  of a
   pimple.
 Areolar Tissue, cellular tissue; textures composed of cells.
 Aromatic, sweet-scented;  spicy; having a pleasant odor.
 Ascites, dropsy of the belly.
 Aspect,  appearance  of the features;  or, of the  whole person;  condi-
   tion or situation of; point of view.
 Asphyxia, suspended animation ;  apparent death.
 Assimilation, the action common to all organized beings, by virtue of
   which  they change into their oAvn proper substance, the matters with
   which  they are supplied as nourishment.
Asthenic, debility; a disease of debility.
Astringent, see Division I, page 620.
Atrophy, wasting ; decrease in size.
Augment, to  make larger ;  increase ; to add to.
Augmenting, increasing in amount or degree.
 Aura Epileptica, a feeling Avhich persons having epilepsy frequently
   experience just before the fit comes on; it is as  if a cool wind or
  light vapor passed from the legs or body upAvard to the head.
Auricle, the  external ear; the upper cavities of the heart are  also
  called  auricles—they receive the blood from every part of the body. 
HOUSEHOLD DEPARTMENT.
291
Auscultation, listening to the different sounds in the chest and other
  parts of the body, with the naked ear alone, or by means of an in-
  strument called a " stethoscope."
Auxiliary, that which aids or helps; an assistant; a helper or co-op-
  erator.
Axilla, the armpit.
Axillary, about or near the  armpit.
Axis, pi., Axes, a real or imaginary line passing through the middle
  of  a body.
Baffles, frustrates; defeats ; disappoints.
Balsamic, having  the characters of balsam, as warm, and stimulating,
  with a sweet, faint odor of cinnamon.
Basilar, belonging to the base of the head, on the back part.
Bastinado, to beat or whip with a flat stick.
Biennial, lasting only two years;  returning every two years.
Biliary affections, diseases with which the flow of the bile, its char-
  acter, etc., is  connected;  generally applied to diseases of the liver
  and of the digestive organs.
Bilious, due to  a surplus or  increase of bile.
Bistoury, a small knife  used by surgeons, of which there are several
  kinds.
Bland, soft; mild; oily; not harsh or  stimulating.
Borborygmi, the rumbling noise made by wind pent up in the bowels.
Bougies, flexible cylindrical rods, of various  sizes, and  usually made
  of India-rubber, or boiled linseed oil, etc., and which  are employed
  to dilate strictured canals, as the urethra, rectum, gullet, etc.
Bronchia, the tubes which convey the  air into the lungs.
Bronchial, belonging to the air-tubes of the lungs.
Bronchitis, a disease of the air-tubes of the lungs.
Bronchocele, big neck; see  Division I, page 486.
Bulb, a name given to certain parts, which have the shape  or form of
  bulbs or rounded  roots; onions, potatoes, turnips, etc., are bulbous
  roots or bulbs, being rounded, ovoid, or hemispherical.
 Bulb of the Urethra, a dilated part of the canal of the urethra, situ-
  ated toward the root of the penis, and at the commencement of the
   spongy portion.
 Bulla, pi, Bull;e,  a bleb or blister-like elevation of the cuticle, con-
   taining a waterv fluid.
 Cachectic, a deprived habit of body,-due  to certain diseases, as scrof-
   ulous, cancerous, etc.
 Cadaverous, pertaining to the dead body. 
292
AMERICAN FAMILY PHYSICIAN.
Calisthenic, exercises, designed more especially for females, to impart
  strength and gracefulness.
Calcareous, consisting of lime; formed of lime.
Calculus, pi, Calculi, stone, gravel, or solid unorganized substances,
  found in the bladder, kidneys, or other parts  of the body.
Calmative, capable of quieting or calming.
Camel's-hair  Pencil, a small brush made out of the hairs of camels;
  such as the small paint-brushes made use of by children when using
  water-paints.
Cancrum Oris,  a mortifying ulcer of the mouth and face; see Divi-
  sion I, page 251.
Capaciousness, comprehensiveness; vastness; largeness of size ; capa-
  bility of holding a great deal.
Capillary, pi, Capillaries, hair-like ; a term applied to the hair-like
  blood-vessels and nerves of the skin and surfaces of organs.
Capricious, fickle ; not constant; not regular;  changing about.
Capsicum,  red pepper.
Capsules, parts formed like a box or case; also applied to those parts
  of a plant Avhich contain the seed.
Caries, diseased or ulcerated bone.
Carminative, see Division I, page 620.
Cartilage, gristle attached to the extremities of bones.
Catamenia, the monthly Aoav of females.
Cataract,  a loss of sight owing to the formation  of an opaque body
  Avithin the lens of the eye.
Catarrhal, belonging to catarrh;  discharging phlegm or mucus.
Catharsis, purging of the boAvels.
Cathartics, see Division I, page 619.
Catheter,  a holloAv tube for draAving off the urine.
Catkins, see Aments.
Cauterize, to act upon with caustic, or Avith iron heated to whiteness.
  A part thus acted on is said to be " cauterized."
Cellular,  composed of cells.
Cellular Dropsy, dropsy of the cellular membrane.
Cellular Membrane, or Cellular Tissue, membrane or tissue com-
  posed of cells, and which constitutes the fundamental element of all
  the organs  of the body.
Cerebral,  relating or appertaining to the brain, as, " cerebral affec-
  tions"—affections of the brain.
Cervical Vertebr.u, the joints of the backbone, at the neck, being
  the first  seven from the skull. 
HOUSEHOLD DEPARTMENT.
293
Cervix, the neck.
Cervix Uteri, the neck of the womb.
Cessation, a stopping;  a discontinuation.
Chalybeate, a medicine containing iron or steel.
Chancre,  a syphilitic ulcer;  or from the bad disorder.
Chemosis, an inflammatory swelling of the eye,  in which the white of
  the eye projects more or less, with a pit or depression in the center.
Chlorosis, green sickness of females; see Division I, page 516.
Chlorotic, belonging to, or of the nature of chlorosis.
Ciiolagogue, a medicine Avhich causes discharges of bile.
Chordee,  a painful erection of the  penis.
Chorea, Saint Vitus's dance.
Chronic Diseases, diseases  more  or  less severe in their character,
  Avhich affect one or more organs of the body, Avithout causing fever-
  ish or inflammatory symptoms, and Avhich progress  slowly, terminat
  ing in health or in death, after  months and even years.
Ciiurrus, a name for the extract  of Indian Hemp.
Circumscribe, to limit; to  restrain ; inclose; to bind within certain
  limits.
Clonic, spasms not permanent in their rigidity, but  alternating  with
  periods of sudden relaxation.
Coagula,  a clot.
Coagulate, to form into clots ; to become thickened  or solid.
Coagulated, having formed into  a  curd or clot.
Coalesce, running into  each other ; growing together; uniting.
Coccyx, the loAvermost bone of the  spinal column.
Coction, boiling ; simmering ;  exposing a fluid  to  the action of fire;
  the change Avhich the food undergoes in the digestive organs.
Coercion, forcing;  compelling.
Cohabitation, copulation; the act of living together.
Coition, copulation.
Cold Douche, thc  pouring  of cold Avater from a greater  or lesser
  hight upon diseased or other parts;  see Division I, pages 764, 770,
  and 771.
Collapse, complete failure of the strength;  excessive prostration of
  the vital poAvers.
Colliquative, a  term applied to any unhealthy discharges of fluids
  which occasion great  debility and fatigue.
Colon,  the  largest intestine, having an  ascending,  descending,  and
  transverse position.
Coma,  profound lethargic stupor  or sleep. 
294
AMERICAN FAMILY PHYSICIAN.
Comatose, the state of profound stupor, occurring during disease, etc.
Complicated, when several diseases are present at a time, they are said
  to be " complicated;" the same is said of a disease which is attended
  by symptoms or circumstances  not necessarily belonging to it.
Concave, hollow;  more  depressed in  the  center than  at  the edges;
  excavated.
Concrete, formed into a solid body.
Concretions, solid bodies formed  from fluids; thickened or hardened
  substances.
Condiments, articles used Avith food to render it more palatable, as salt,
  pepper, pickles, etc., and  often improperly used to  provoke  an
  appetite.
Condyle, a  knob or projection;  a term  applied to the joint of the
  finger, etc.
Confirm, to  vouch for; to corroborate; to bear witness to; to  prove
  the truth of.
Confluent, not distinct;  running together.
Congenital, existing  from birth.
Congestion,  distention of vessels and parts  by an accumulation of
  blood  in them.             £
Congestive, a term applied to diseases accompanied with great oppres-
  sion and depression, so that it is very  difficult to bring about reac-
  tion,  as in Congestive Fever.
Conjunction, connection ; union ;  copulation.
Conjunctiva, the  external covering of the eye, which also extends to
  line the inner surface of the eyelids.
Constipation, costiveness of the boAvels.
Constricted, narrowed; draAvn together ;  strictured.
Constriction,  a  narroAving  or draAving together; the state of being
  strictured.
Contagion,  the poisonous subtile  matter  that occasions disease; the
  communication  of disease  from  one individual to another, by direct
  or indirect contact.
Contagious, that which is capable of communicating disease by direct
  or indirect contact.
Contiguous, so close  to each other as to  touch or come in contact.
Contortions, twisting about; writhing; violent  unnatural twitehings
  or movements.
Contracted, narrowed; shrunk;  drawn together.  A  disease is con-
  tracted when we suffer from it,  thus—we " catch a cold," or " con-
  tract a cold." 
household department.
295
CoNTRAINDlCATE, net indicate;  qpposed to.   A medicine, or  anything
  whatever, in the course of treatment Avhich makes a disease worse
  or increases its severity, is  said  to be  "contraindicated,"—as  its
  use is improper and injurious.
Convalescence, the condition in which the system  is left after a re
  covery from disease ; or the interval between the disappearance  of
  the disease  and the return to the original health  and strength.
'CoNAfALESCENT, the patient in  a state of convalescence or returning
  health.
Convex, a prominence or bulging  out;  an arched swelling on  the
  external surface ; jutting out in a spherical or globular form.
Copious, abundant; plenty ; profuse.
Copulation, the act of  sexual  intercourse.
Coracoid process, a  projection someAvhat resembling a crow's beak,
  which is situated in  front and on the upper  edge of the shoulder-
  blade.
Cornea, the  front, somewhat horny and  transparent covering of the
  eye, through Avhich the light passes.
Coronal Suture,  thc union or junction of the bones of the forehead
  to those of  the upper part of the head, and which may be detected
  in the infant by feeling the transverse  ridge  or  seam formed by it
  along the upper part of the forehead.
Coryza, cold in  the head; snuffles.
Cosmetics, articles designed to improve and beautify the skin,
Costiveness, the state of being costive, in Avhich the stools  are hard
  and are not passed  every day, nor in sufficient quantity; also when
  much straining is required to empty the boAvels.
Counter-irritation, an irritation  produced in one  part of the body
  for the purpose  of relieving pain or disease located in another part.
  The medicines which cause this effect are called " Counter-irritants;"
  see Division I, page 622.
Crescentic, shaped like the neAv moon.
Crisis, the acme or turning point of a disease.
Critical, a term applied to certain symptoms, and  to certain periods
  of disease, supposed to indicate a favorable or unfavorable change.
Cutaneous, of or belonging to  the skin.
Cuticle, the epidermis,  or scarf-skin.
Cutis Anserina, goose-skin, or goose-pimples, which sIioav themselves
  on the skin  during  a chill, or when cold.
Cryptogamic,  a  term  applied to plants whose sexual organs  are  not
  knoAvn,  or not readily observable.
          6!) 
296
AMERICAN FAMILY PHYSICIAN,
 Debilitated, made weak or feeble.
 Debility, weakness; feebleness.
 Decoction, the product obtained by boiling certain medicines in a fluid
   in order to extract their active properties;  usually  called " a tea
   made by boiling."
 Decomposition, the dividing or separating of parts which, by their com-
   bination, compose a body; the change Avhich takes place in the body
   after death.
 Deliquium, fainting.
 Deliquescent, any salt is so called which forms into a fluid when ex-
   posed to the action of the moisture in the air.
 Delirium, disorder and wandering of the intellect; derangement of the
   mind with ramblings ; bereft of reason; light-headed.
 Dementia, loss or weakness of mind; silliness; incapacity for using
   the mind correctly.
 Demulcent, see Division I, page 621.
 Dendroid, having the appearance  of a small tree.
 Dentition, the period of  cutting teeth.
 Deobstruent, see Division  I, page 621.
 Deplete, to empty the system  of fluids by causing large discharges.
   Also applied to bloodletting.
 Depurative, medicines which cleanse  or purify  the blood.
 Desiccate, to dry an article ; to render dry.
 Desiccative, that Avhich has the power of drying.
 Desquamation, scaling off; separation of the skin in small scales.
 Detergent, see Division I,  page 621.
 Deteriorated, injured in quality;  rendered Avorse; on the decline.
 Deterioration, the state  of being on  the decline, or of becoming less
   healthful or valuable.
 Determination, in medicine, Avhen there is a strong tendency to any
   given part, we say there is a determination to that part;  as, " determ-
   ination of blood  to the head," when the blood tends  to flow more
   strongly to the  bead.
Diabetes, excessive ojsjharges of urine containing sugar; see Division
   I, page 436.
Diagnosis, the distinguishing sjmptoms by which to determine various
   diseases.
Diaphoretic, see Division IT page 620.
Diaphoresis, an increased flov ce perspiration, but not profuse.
Diaphragm, the midriff or transverse muscular partition which separate-a
   the lungs and cavity of the chest from the ^orel' a*»d ^v^r ^*j]\j, 
household department.
297
 Diathesis, any particular disposition or habit of constitution.
 Diffluent, not fixed; easily dissolved; melting or flowing away from
   every part.
 Diffused, spread about; distributed;  scattered;  extending  in every
   direction.
 Digest, to expose medicines to the action of liquids at a heat between
   ninety degrees and one hundred degrees Fahrenheit.
 Dilate, to enlarge or expand in every direction.
 Dilated, enlarged;  swelled out; widened in every direction.
 Dilatation, the act of enlarging or widening.  Also termed Dilation.
 Diluent, see Division I, page 620.
 Diluted, made weaker or thinner; lessened in strength by the addition
   of some other article, generally by water.
 Discriminate, to  tell  one  from the  other;  to  determine  between
   diseases.
 Discutient, see Division I, page 621.
 Disinfectant, see Division I, page 621.
 Dissolution,  death.
 Distended, forcibly  dilated ; stretched out;  swollen ; made more fully
   developed.
 Distention, the condition of being SAvollen or stretched out.
 Distilled Water, water which has been rendered pure by distilling it
   over  from a glass  or silver retort.   In this book, good  clean rain
   Avater, or the Avater from  melted ice, will answer for distilled water
   wherever this is named in any of the recipes.
 Distinct, separate;  spotted; being  alone; not becoming confused or
   running together.                A
 Diuretic, see Division I, page 620.
 Domestic, that which belongs to home or the family.
 Dorsal Vertebrje, the  tAvelve joints of the backbone, situated imme-
   diately beloAv those forming the cervical vertebne.
 Dorsum, the back; the posterior portion of any member.
 Drachm, the eighth part of  an  ounce.   A teaspoonful of fluid is gen-
   erally considered to be equal  to a fluid drachm—also of most pow-
   dered herbs, roots, and barks.
 Drastic Cathartics, see Division I, page 619.
 Dysmenorrhea, painful  menstruation; see Division  I, page 511.
 Dyspnoea, oppressed breathing.
Ebullition, the act of boiling;  effervescence.
Eccentricities,  deviations from the natural  or regular order or con-
   dition of anything. 
298
AMERICAN FAMILY PHYSICIAN
Ecchymosis, effusion of blood beneath the skin, occasioning a " black
  and blue" spot.
Ecstasy, suspension of the senses from  the mind being occupied with
  certain  ideas, generally accompanied with a  diminution of vital
  action.                       ^
Eczema, an eruption of minute vesicles or pimples close together, like
  the prickly eruption from heat.
Edema, or (Edema, a soft, white  swelling, filled with fluid, which pits
  on pressure, and gives no pain.
Edematous, or (Edematous, relating to, or characteristic of, Edema.
Effervesce, to be agitated like boiling water, bubbling up with a hiss-
  ing noise.
Effervescence, the  agitation or  bubbling and hissing produced in a
  fluid by gas escaping through it.
Effete  Matters,  worn-out matters; substances which having been
  used, are cast off as being good for nothing.
Efficacious, having  the effect intended;  effectual; successful.
Efflorescence,  red  eruptions  upon the skin.   The poAvder  which
  forms on  certain bodies when  exposed to  the  air is also called an
  efflorescence ;  it is peculiar to some salts, etc.,  which are thus con-
  verted into a powder by the action of  the air upon them.
Effluvia, the invisible emanations  from diseased bodies,  as well as
  from all other bodies.
Efflux, the egress,  escape, or flowing out of a fluid.  Flowing  out in
  a stream.
Effused, oozed out; poured  out.
Effusion, pouring out;  the  pouring out of blood or  other fluid into
  the cavities of the body.
Ejected, expelled; cast out; vomited up.
Elastic, springy;  having the power of returning at once to its original
  form, when bent, pressed upon, or pulled out, upon the removal of
  the force effecting these conditions.
Elevator, an instrument that lifts up or raises portions of bone, etc.
Eliminate, to remove; to drive  out; to  draw  out; to throw off;  to
  pass out.
Eliminated, removed; driven out.
Elimination, the act of passing out, or being discharged.
Elongated, made longer.
Emaciation,  leanness; meagerness; thinness;  reduced to skin and
  bone.
Emesis, vomiting. 
HOUSEHOLD department.
299
Emetic, see Division I, page 619.
Empirical, that Avhich is ascertained only  by experience, without the
  application of science.  Also employed as belonging to an empiric
  or quack.
Emulsion, a whitish mixture of oil and water, or gum and water, is so
  called;  a soft, whitish liquid.
Encomium, meed or tribute of praise; laudation; commendation.
Endemic,  a disease  peculiar to certain localities or districts.
Endermically, Avhen a medicine is applied into  the skin in the treat-
  ment of disease, it is said to be used " endermically."
Endocarditis, inflammation of the lining membrane of the heart; see
  Division I, page 278.
Enema, an injection.
Engorgement,  congestion of a part, from an accumulation  of blood
  in it.
Ensue, to succeed;  to  come after; to happen.
Enteritis, inflammation of the boAvels; see Division I, page 285.
Envelop,  to surround; cover; wrap around.
Epidemic, a disease prevailing over a large extent of country.
Epidermis, the outer skin.
Epiglottis, the oval cartilage at the root  of  the tongue, Avhich, at the
  moment of swallowing, covers the glottis, and thus prevents the food
  from getting into the Avindpipe.
Epistaxis, bleeding from the nose;  see Division I, page 452.
Epithelial, relating to the epithelium.
Epithelium,  a very thin  covering upon  mucous tissues,  as  the lips,
  throat,  bladder, vagina, etc., and  which consists of minute cells or
  scales, only to be seen Avith the aid of a microscope.
Eradicate, to root  out; to overthrow ; to destroy ; to put an end to.
Eradication, the act of rooting out,  or putting an end to.
Erosion, eating away; the act of gradually destroying a part.
Errhine, see  Division I, page 621.
Eructations, belching or casting up of Avind from the stomach.
Eruptions, the breaking out of pimples,  rashes, etc., upon the skin;
  also, profuse and sudden discharges.
Eruptive, diseases  attended with an eruption of the skin, as  Measles,
  Small-pox, Scarlet Fever.
Erysipelatous, relating to, or characteristic of Erysipelas.
Erythema, a non-contagious class of diseases of the skin, in which the
  redness is  continuous  upon the part affected, and  not in  spots  or
  patches; sometimes applied to local Erysipelas. 
300                AMERICAN FAMILY PHYSICIAN.
Erythematic, of the nature of Erythema.
Eschar, a slough; the dead substance produced by applying caustic,
   arising from mortification, etc.
Escharotic, see Division I, page 622.
Esophagus, the  gullet or canal by Avhich food passes from the mouth
   into the stomach.
Eustachian Tube, a tube  or canal leading from the throat, above and
   behind the palate, to the internal ear.
Evacuations, discharges or stools from the bowels; also, discharges
   from the bladder or other organs.
Everted, turned over, or outAvard.
Evolutions, changes; deArelopments;  unfoldings.
Exacerbation, a paroxysm of disease ; an increase of its symptoms.
Exanthema, diseases  which are accompanied by some kind of an erup-
•   tion upon the skin.
Exanthematous, of the character of exanthema.
Excised, cut out; cut off.
Excoriate, to wear or rub  the skin off; to gall; to flay or peel off.
Excoriated, having the skin worn or  peeled off.
Excrement, the various discharges throAvn  off from the system by stool,
   urine, etc.
Excrescence, a  small  tumor,  as  a  Avart, polypus, or  other foreign
   growth.
Excreting, throAving off the used-up  or decomposed particles of the
   system.
Excretory, that which excretes or throws  off useless matters from the
   body.
Exfoliated, separated or scaled off.
Exfoliation,  to separate or scale off,  as a piece of dead bone separat-
   ing from the living.
Exhalation, emanation ; discharge ;  also  applied to the letting out of
   air from the  lungs in breathing; likeAvise, the act of spreading in
   the areolar  tissue, as with the fluids forming the blood
Exhibit, to show; to display.
Exhibiting a Medicine, means giving it to the patient.
Exhibition, the act of giving a medicine.
Exostosis, a swelling of the bone ; a bony tumor
Expectorant, see Division I, page 620.
Expectorant Doses, doses of expectorant medicines, large enough in
   quantity, or in small quantity at intervals, sufficient  to keep up  ex-
   pectoration. 
household department.
301
Expectoration, the act of removing, by spitting, the various matters
  formed in the throat and air passages.
Expulsion, the act of expelling, turning out, or forcibly removing.
Extremities, the limbs, as the feet, legs, hands, and arms.
Exudation, the act of oozing, flowing, or being discharged through
  pores.
Facilitate, to render more easy;  to enable one to  accomplish  any-
  thing more readily or quickly ; to lessen the trouble or difficulty of
Fahrenheit, the name of a person which is attached to the scale of
  thermometers, to distinguish it from the scales of other persons.
Farinaceous,  of the character of meal.
Fastidious, hard to please; nice;  dainty.
Fauces, the back part  of the mouth, or top of the throat.
Febrile, belonging to fever, thus,  " febrile symptoms," the symptoms
  belonging to fever.
Feces, the discharges from the bowels.
Feculent, unclean ; foul; full of dregs ; like feces.
Ferruginous, containing or belonging  to iron.
Fetal Life, the life of the child  while yet in the womb, before it is
  born.
Fetid, having a bad smell;  offensive.
Fetor,  a stench or disagreeable smell.
Fetus,  a term applied to the child  while yet in the Avomb.
Fiber or Fibre,  a thread-like substance ; slender and long filaments.
Fibrin  or  Fibrine, an odorless, tasteless compound, which sinks in
  water, and which is found in animals and plants; the blood of ani-
  mals  contains it, and it enters as  a principal ingredient of the muscles
  of  some animals.  Clotted  blood is formed of fibrin  and the red
  globules of  the 'blood.
Fibrous, formed of fibres.
Fibula, the splinter-bone, or the long,  small bone at the outer part of
  the loAvcr leg.
Filamentous, composed of fine threads.
Filter, to  strain through paper; to pass a fluid through a porous body
  to free it from sediment.
Fistula in Ano,  a disease situated about the fundament; see Division
  I, page 592.
Flaccid, soft; flimsy;  limber; having no resistance.
Flatulent, windy.
Flatulence, Avind in the stomach  and  bowels.
Flatus, wind  or gas in the stomach or bowels. 
302
AMERICAN FAMILY PHYSICIAN.
Flocculent, adhering in flakes or tufts.
Florid, looking fresh, lively;  ruddy; rosy-colored.
Fluctuate, to  move to and fro like a wave.
Fluctuation, the motion of a fluid contained in any cavity, made by
  striking upon the wall of the cavity on one side, and with the other
  hand feeling  the motion on  the opposite side.
Fluidrachm, one-eighth of a fluid  ounce; or the one-hundred  and
  twenty-eighth part of a pint; an ordinary teaspoonful.  Sixty drops.
Fluid  Ounce,  the sixteenth part  of a pint,  or two  ordinary table-
  spoonfuls ; four fluidrachms.
Fluor Albus, the Avhites ;  a disease of females.
Follicles, little bags,  sacks, or folds, situated in the skin or  mucous
  tissues, from  which a fluid is secreted; they are also called Crypts.
Follicular,  belonging  to, or containing,  follicles;  as  " follicular
  glands," glands composed of follicles.
Fomentation, Avarm fluids, with or without herbs, applied to any  part
  of the body by means of cloths, muslin, flannel,  etc.
Foramen, pi, Foramina, an opening or hole.
Forceps, an instrument to  supply the place of the  hand or the fingers
  in the removal of substances from any part of the body.  There are
  many kinds in use.
Formication, a sensation as if ants Avere creeping upon the skin.
Frenum, a bridle.
Friable, easily broken or  changed into powder.
Friction, rubbing the body or any part of it; the act of rubbing one
  body against another.
Frontal Sinus, tAvo deep openings in the bone of the forehead.
Function, duty;  office; action.
Functional Disease, a disease or deranged state of the functions of
  an organ.
Fungous, soft  excrescences,  of transient  duration, like  mushrooms,
  Avhich grow on ulcers and other parts ; proud-flesh.
Fungus, pi, Fungi, an order  or family of mushroom plants, as toad-
  stools, mildeAV, smut, yeast-plant, etc.
Furfuraceous, branny; in thin, light scales.
Furor Uterinus, a  disease of females; see Division I, page 385.
Gangrene, partial death; mortification.
Gastric, belonging to the stomach; as the " gastric juice," or juice of
  the stomach.
Gelatinous, jelly-like.
Genital, belonging  to the  act or organs of generation. 
HOUSEHOLD DEPARTMENT.
303
Gestation, the period of pregnancy.
Gland, soft, roundish bodies, in various parts of the body, which secrete
  different matters, according  to the situation and functions.
Glandular, pertaining to, or of the nature of a gland.
Glans Penis, the head or conical end of the penis.
Gleet, a thin discharge from the urethra.
Gleety, belonging to gleet; thin, watecy.
Globules, minute particles of matter having a round or globular form.
Glottis, the opening into the windpipe at its upper part, covered by
  the epiglottis.
Glutinous, viscid, like glue.
Goitre, a swelling on the neck ; see Division I, page 486.
Gonorrhea, see Division I, page 315.
Grain, a grain is the smallest part  of weights, not fractional.  Sixty
  grains make one Troy drachm.
Granular, like  small grains.
Granulated, shoAving granulations.
Granulation, the filling up of a wound or ulcer by small conical, red,
  fleshy  formations or elevations.
Granules, small grains.
Hallucination,  mistaken ideas; delusion of the mind; faulty imagin-
  ation.
Hematodes, containing or appearing like blood, as "fungus nematodes,"
  a bleeding fungus or soft cancer.
Hemicrania, pain  on one side of the head.
Hemiplegia, palsy of one side of the body.
Hemoptysis, spitting of blood from the lungs.
Hemorrhage, a  Aoav of blood;  a flooding.
Hemorrhagic, disposed to  hemorrhage.
Hepatic, belonging to the liver.
Hepatization, a term applied to  the lungs, when they are filled up
  with matters,  or  form  into  a liver-like material, so that the air can
  no longer enter them.
Herbaceous, of  the character of an herb.
Heterogeneous, diversified; mixed up ; all sorts and kinds.
Humoral, relating to, or arising from the humors of the system.
Hygiene, that science which relates to the preservation of health.
Hygienic, Hygienical, proceeding  from, or belonging to, Hygiene.
Hydatids, soft,  transparent  sacs or  vesicles  filled with fluid, which
  grow inside of various organs, Avithout being fastened or attached to
  them; formerly supposed to be some kind of animals or worms.
• 
304
AMERICAN FAMILY PHYSICIAN.
Hydragogue, Hydragogue Cathartic, see Division I, page 619.
Hydrocephalus, dropsy of the head.
Hydrothorax, dropsy of the chest.
Hypercatharsis, excessive purging.
Hypertrophical, enlarged unnaturally;  of the nature of hypertrophy.
Hypertrophy, an unhealthy enlargement of an organ, without change
  of structure.    An organ is said to be " hypertrophied" when thus
  enlarged.
Hypochondriacal, having a disease  of  lowness of spirits, imaginary
  aches and pains; illusions of the mind; irritability of temper, etc.,
  usually termed " hyppo," or " hypped."
Hypogastrium, Hypogastric, that portion of the abdomen situated
  between the navel and the share or pubic bone.
Hypothesis, pi, Hypotheses, a guess or conjecture upon the cause of
  anything;  a  presumptive reason ; a  proposition assumed for the
  purpose of discussion.
Ichor, a thin, Avatery, acrid discharge.
Ichorous, of  the nature or appearance of ichor.
Idiopathic, an  original disease, not  depending upon any other; not
  secondary.
Idiosyncrasy, a peculiar susceptibility to the action or influence  of
  certain agents, by which  different or more powerful impressions are
  made than are generally met with.
Implicated, concerned or associated with; connected with.
Impotency, weakness in the reproductive act, or incapability of per-
  forming it.
Impunity, free or exempt from any evil or painful consequences.
Impurity, foulness; filthiness ; not pure.
Incipient, the outset, start, beginning.
Incoherent, rambling in speech or ideas; wanting sense; loose; not
  adhering.
Incoherences, wandering, nonsensical ideas and conversation.
Incontinence, inability to hold the discharges.  Also means lewd or
  unchaste.
Indolent, a term applied to tumors or ulcers whieh progress  slowly
  and without pain.
Indurated, hardened.
Induration, the unnatural hardness of a part.
Infantile, belonging to the infant state.
Infectious, catching; that  may be communicated from one to anothei
  by contact. 
household department.
305
 Inferior, below.
 Inflammation, a diseased condition of a part, attended with heat, red
   ness, swelling,  and pain.
 Inflammatory, pertaining to inflammation.
 Infusion, the pouring a fluid upon  a medicine to extract its virtues,
   having the fluid cold, or kept at a moderate heat, but not boiling it.
   A tea made by steeping an article in either hot or cold water.
 Inhalation, the act of inhaling; also, the articles to be inhaled.
 Inhale, to breathe or draAV air or other substances into the lungs.
 Inhaling, breathing or draAving into the lungs.
 Inoculate,  to communicate a disease by  ingrafting or inserting  some
   of  its virus into the skin, so  that it  may extend  throughout the
   system.
 Inoculation, the operation of inoculating.
 Inodorous,  having no smell or odor.
 Inordinate, enormous ; excessive ;  beyond bounds.
 Insignificant, of no account; not worthy of notice; trifling.
 Inspiration, the  act of breathing or drawing air or other substances
   into the lungs.
 Inspire, to  inhale or draw into the lungs.
 Inspissated, thickened by evaporation.
 Insupportable, not to be endured;  more than one can  bear or support.
 Integrity,  whole;  not  broken  or  injured;  pure,  honorable, and
   truthful.
 Integument, that which covers anything; the skin.
 Intense, in  thc highest degree ; keen; stretched violently; extreme.
 Intensity, the state of being intense.
 Intercostal Space, the space betAveen the ribs.
 Intermittent, stopping at regular or irregular intervals.
 Intermittingly, having regular or irregular pauses or  intermissions.
 Interstitial, betAveen thc  pores or  interstices of an organ.
 Interstitial Deposition, a deposit occupying the interstices (or vacant
   spaces) of an organ, or of cells in contact with each  other.
Intervals, the periods between any two circumstances;  as the inter-
   val betAveen the termination of the last  menstruation and the begin-
   ning of the next;  or, the interval  between the SAveating of Fever and
   Ague, and the next chill, etc.
Intestines,  the bowels.
Intolerance, insolence ;  domineering; bullying;  persecuting ; dicta-
   torial ; not allowing others )f opposite opinions equal privileges and
   rights. 
306
AMERICAN FAMILY PHYSICIAN.
Intoxication, drunkenness.
Inversion, turning over; tilting over; turning inside out.
Invert, to overturn;  to place upside down.
Inverted, turned over, or into an opposite direction.
Iris, a membrane forming a flat, circular partition or diaphragm in the
  front part  of the eye, the opening in the centre  of which is known
  as the " pupil of the eye."  When the iris is gray, blue, or black,
  Ave say the person has a gray, blue, or black eye.
Irritant, anything that irritates or excites.
Isolated, alone;  by itself; separated from others.
Lancinating, sharp  pains  like a cutting instrument passing  through
  the part.
Lancination, a shooting or darting pain; a tearing or lacerating.
Larva, the grub or wormlike condition of some insects immediately
  after leaving the egg.
Laryngitis, inflammation of the larynx; see Division I, page 254.
Larynx, the  top of the windpipe, including the organs of voice.
Lassitude, dullness, heaviness, and weakness  of body.
Latent, diseases  or symptoms Avhich are obscure, or which remain in
  the system a long time before developing themselves.
Lateral, from or belonging to the side.
Lateritious, resembling brick-dust.
Laxative, a mild cathartic; a laxative injection is a mild cathartic in-
  jection ; see Division I, page 619.
Lethargy, unhealthy or profound  sleep, from  which a person is awak-
  ened with much difficulty.
Leucorrhea, the Whites.
Levity, mirthfulness; playsome;  frolicsome; full  of jokes; want of
  dignity and thought.
Libidinous, lewd;  unchaste.
Ligament, an elastic,  tendinous cord.
Ligamentous, resembling or belonging to a ligament.
Ligate; to secure with a ligature;  to tie a cord or thread, etc., around
  a part or vessel.
Ligatures, the cord,  thread, etc., which is used to  tie around various
  parts in different operations, are called ligatures.
Ligature,  Ligation, the act of applying a ligature around a limb, a
  tumor, a blood-vessel, etc.
LiNEA  Alba, a Avhite, tendinous line along the centre of the belly, ex-
  tending from the pit of the stomach to the centre  of the pubic bone.
Linear, exceedingly narrow; marked with lines ;  consisting of lines. 
HOUSEHOLD DEPARTMENT.
307
 Lividity, a black and blue color.
 LoATniNG, looking up Avith dislike or disgust.
 Local,  when only one part of the system is affected, the rest being
   healthy  or  only secondarily  implicated, the disease  is  termed a
   "local" one.  A general disease is when  the whole system is af-
   fected.
 Lochia, the bloody  discharge from the womb  after childbirth; the
   cleansings.                         *
 Lochial, relating to the lochia.
 Lotion, an external application in fluid form; a wash.
 Lucid,  clear;  intelligible ;  plain.
 Lumbago, rheumatism seated in the loins.
 Lupulin, the yellow flour of the common hop.
 Lymph, a thin, whitish fluid in the lymphatics.
 Lymphatics, vessels carrying lymph, as, the " Lymphatic Glands."
 Macerate, to steep or infuse in a fluid without heat, in order to pro-
   cure  the virtues of a solid substance.
 Macule, spots, blemishes.
 Magma, a thick residuum or mass.
 Malady, pi, Maladies, disease; pi, diseases.
 Malaria,  noxious  gases  from decomposing  animal, or  vegetable
   matter.
 Malarial, belonging to, or proceeding from malaria.
 Mal-assimilation, a deranged, faulty, or unhealthy assimilation; see
   Assimilation.
 Malformation, faulty conformation; improperly or unnaturally formed.
 Malignant, a serious  disease; tending to a fatal result; incurable and
   destructive.
 Mamma, pi, Mammje,  the female breast.
 Mandibular, of the jaw.
 Mania,  insanity; madness.
 Marasmus, emaciation;  atrophy; wasting away.
 Masticate, to chew.
 Mastication, the act of chewing.
 Masturbation, polluting one's self with the hand.
 Materia Medica, that department of medicine which treats upon medi-
  cines, their history,  actions upon the system, and doses.
 Maturation, having ripened; ready to discharge matter; come  to  a
  head.
 Maximum, the greatest part or portion in  any given case.
Meconium, the black stools  first passed by the newly born infant. 
308
AMERICAN FAMILY PHYSICIAN.
Median Line, an imaginary line drawn vertically through the centre
  of the body, dividing it into two halves, a right and a left half; also
  called the "mesial line."
Median Nerve, a  nerve  passing from  the lower cervical  vertebrae
  along the inner part of the arm—on each side.
Membranous, having the texture of a membrane or thin skin.
Meningitis, an inflammation of the brain.
Menses, the monthly flow of females.
Menstruation, see Menses,
Mercury, quicksilver.   Medicines prepared from quicksilver, as calo-
  mel, corrosive-sublimate, red precipitate, etc.,  are  called  "mer-
  curials."
Metastasis, shifting of a disease from  one  part to another.
Miasmatic, partaking  of the nature of miasm, or the morbid emana-
  tions from  sickly or  decomposing animals and vegetables.
Minim, a drop ; the sixtieth part of a fluidrachm
Minimum, the least part or portion in any given case.
Mitigation,  soothing; relieATing;  lessening  the  severity of;  mod-
  erating.
Mobility, capability of being moved; excessive nervous susceptibility.
Monobasic, a name given to those acids which, containing one  equiv-
  alent of water, replace it by one equivalent of the base, in order to
  form a neutral salt.
Monomania, a derangement of the mind on one particular subject.
Morbid, unhealthy; diseased.
Morbific, that which gives rise to  disease.
Mottled,  speckled ; spotted ; marbled.
Mucilage, certain  substances  analogous  to  mucus, extracted from
  plants by means  of water, as, gum arabic, slippery elm  bark, flax-
  seed, etc.
Mucilaginous, partaking of the nature of mucilage.
Muco-puriform, partaking of the character of both mucus and pus.
Muco-serolent, partaking of the character of both mucus and serum.
Mucous Membranes or  Tissues, the thin,  delicate membrane which
  lines the mouth, tongue, nose, stomach, bladder, vagina, etc.
Mucus, phlegm; animal mucilage; the discharge from the nose during
  a cold is mucus.
Multifarious, variety ; great diversity ; multiplicity.
Naphtha, a clear or yelloAvish  inflammable liquid, lighter than water,
  procured from bituminous coal,  and also found  existing naturally.
  Wood-naphtha is termed " Acetone," or  "Pyro-acetic Ether." 
H0DSEH0LD DEPARTMENT.
309
Narcotic, see Division I, page 620.
Narcotic Herbs, herbs containing narcotic properties.
Nasal, belonging to the nose.
Nausea, sickness at stomach ;  disposition to vomit.
Nauseants, see Division I, page 620.
Nauseated, made sick at stomach.
Necrosis, mortification or death of a bone.
Nephritic, belonging to the kidneys.
Nephritis, inflammation of the kidneys; see Division I, page 301.
Neurilemma, the delicate membrane Avhich envelops the nerves.
Neutralize, to counteract; to render null or  inert; to reduce to a
  state  of inactivity.
Nodosities, nodes;  hard, insensible tumors forming around diseased
  joints, of a fibrous, chalky, or bony  nature ; also applied to the hard
  swellings formed on bones from inflammation.
Nomenclature, the list of words or terms used in any particular science
  or art.
Nosologists, persons Avho arrange, explain, define, and classify diseases.
Nourishing, that Avhich sustains health and life.
Nucleated, containing nuclei.
Nucleolus, pi, Nucleoli, a simple  spot or granule within a nucleus.
Nucleus, pi, Nuclei, a central spot.
Nutritious, capable of supporting health and life.
Nymphomania, a disease of females ; see Division I, page 385.
Obesity, fatness ; excessive corpulency.
Obliterated,  expunged; effaced; taken out; erased.
Obscenity, vulgarity; unchasteness of speech  or  action; indelicate-
  ness.
Obtuse, dull;  blunt; stupid..
Occipital, relating to the occiput  or back part of  the head.
Odoriferous, having an agreeable or fragrant smell.
(Edema, see Edema and Edematous.
Olecranon Process, the head or projection of the elbow,  upon which
  Ave rest the arm.
Oleo-resin, a term giAren to certain substances obtained from medicinal
  plants, Avhich consist of an oil and a resin combined.
Ominous, foreshowing ; forewarning ; foreboding ;  pointing to ; a sign
  of.
Opacity, darkness;  obscurity.
Opacity of the Cornea,  also termed "Leucoma," or "Albugo," a
  white speck on the eye, the  result of an injury or inflammation. 
310
AMERICAN FAMILY PHYSICIAN.
Opaque, not transparent;  not penetrable by the rays of light.
Ophthalmia, disease of the eye ; see Division I, pages 239 to 244,
Ophthalmic, relating or belonging to the eye.
Opiates, medicines containing some preparation of opium.
Organ, pi, Organs, a part of the body; thus, the nose is the organ of
  smell; the tongue is the organ of taste;  the ears are the organs of
  hearing ; the eyes of sight;  the kidneys of secreting urine;  the
  liver of secreting bile, etc., etc.
Orifice,  a hole; an opening.
Orthopnea, great difficulty in breathing,
Os Uteri, the mouth of the Avomb.
Ossification, the formation of bon&.
Ossified, changed to bone.
Ounce,  eight  drachms, or the  sixteenth part of  a pound;  see Fluil
  Ounce.
Ovaries, the egg-bags or organs in the female in which the human
  eggs are formed; they  are situated one on each side of the womb.
Ovum,pi, Ova, an egg;  the term is also applied to the impregnated
  egg of the woman during its  first days of existence.
Oxygenization of the Blood, the revivifying process or change which
  the blood undergoes in the lungs, under  exposure to the action of
  the oxygen of  the atmosphere.
Palliated, relieved; lessened  in severity.
Palliative,  a medicine  or treatment intended merely to lessen  the
  severity of a disease.
Pallor,  paleness.
Palpi, feelers.
Panada, a kind of pap, formed of bread, or cracker and water sweet-
  ened, designed  for the sick.
Pancreas, a  gland seated behind the  stomach, secreting the pancrea-
  tic juice;  in the calf it  is called the sweet-bread.
Papilla, pi, Papill.e, a term applied to the red, elevated points seen
  under  the mucous covering of  the tongue, vagina, and other parts,
  and which are  seen  more distinctly during certain forms of disease.
Papillated,  covered with papillae.
Paracentesis, the  operation of puncturing or tapping the" bowels in
  cases of Dropsy in the parts.
Paraplegia, palsy of the lower half of the body.
Parasite, one plant or animal growing upon another.
Parasitical, of the nature of a parasite.
Parietes, walls or sides of an  organ. 
HOUSEHOLD department.
311
 PAROTID Glands, the large salivary glands situated near the angle of
   the loAver jaws, under the ears.
 Paroxysm, a fit of disease recurring at regular or irregular periods.
 Parturient, bringing forth, or having just brought forth; giving birth;
   see Division I, page 621.
 Pathological, pertaining to  pathology.
 Pathology, that department of medicine which treats upon the knowl-
   edge of disease.
 Pediculus, pi, Pediculi, a louse.  Pediculi Pubis, lice in the hair of
   the private parts.
 Pelvis, a large bony basin or cavity at thc loAver part of the body, con-
   taining the lower part of the bowels, the womb, the bladder, vagina,
   rectum, etc.
 Pelvis of the Kidney, a small sac in the back part of the fissure of
   the kidney.
 Percussion,  the act of striking over parts to ascertain their condition
   by the peculiar sounds produced thereby.
 Perennial, living more than  tAvo years.
 Pericardium, the membranous sac or bag surrounding the heart.
 Perineum, the part or space between  the anus and the organs of gen-
   eration.
 Periodicity, the tendency  of certain  diseases or  symptoms to return
   at longer  or shorter, and regular or irregular intervals.
 Periosteum, a thin membrane covering the bones.
 Periostitis,  inflammation of the periosteum.
 Peristaltic, the involuntary Avorm-like movements of the bowels, are
   so called.
 Peritoneal,  belonging to or proceeding from the  peritoneum.
 Peritoneum, a serous membrane, lining the abdomen, and covering
   most of the  several organs contained in it;  it  is sometimes termed
   the "Peritoneal coat" of an organ.
 Peritonitis,  inflammation of the peritoneum; see  Division I, page 305.
 Perspiration, sweat.
 Pertussis, hooping cough; see Division I, page 390.
 Pessaries, instruments of sponge, silver, glass, wood, etc., and of va-
   rious shapes, for the purpose  of holding up the womb when it falls
   down.
 Petechle, purple, flea-bite-like  spots, appearing  on the skin during
   low fevers.
Petechial, of the character of petechias.
Phagedenic,  a corroding or eating  ragged ulcer that spreads rapidly.
            70 
312
AMERICAN FAMILY PHYSICIAN.
Pharmaceutical, belonging to medicines; thus, "pharmaceutical treat-
  ment," or treatment by medicines.  It also relates to the prepara-
  tion of medicines.
Pharynx, top of the gullet and windpipe, also called fauces.
Phases, appearances; aspects; features.
Phlegmasia Dolens, milk-leg.
Phlegmonous Inflammation, an inflammation of cellular tissues, with
  redness, heat, pain, swelling, and a tendency to form matter, as a
  common boil.
Phosphates, salts formed of a base and  phosphoric acid.
Phosphoric, of the nature of, or proceeding from phosphorus.
Phraseology, the  particular method of expressing one's self.
Phrenitis, inflammation of the brain; see Division I, page 235.
Phthisical, disposed to asthma.
Phymosis, a contracted state of the foreskin, preventing it from being
  drawn downward behind  the base of  the  glans  penis; it may have
  existed naturally from  birth, or be due to swelling of the foreskin
  itself, or of the  glans.
Physiological, relating to physiology.
Physiology, that part of the science'of life which has for its  subject
  organized bodies in a state of vital activity, and for  its object the
  knowledge of those acts or phenomena which they manifest, as well
  as the relations  existing between these acts and the parts of the
  organism which  accomplish  them;  in other words,  it  includes a
  knowledge of the properties and functions of all organized beings.
Plethoric, having a superabundance of blood in the system; or a full-
  ness of the blood-vessels.
Pleura, pi, Pleura, two thin membranes which line the sides of the
  chtfst internally, and also envelop the lungs.
Pleural Cavity, the pleurae, or the cavity formed by them.
Pleurodynia, false pleurisy; a pain in the side of a spasmodic or rheu-
  matic character; a stitch in the side.
Pneumonia, inflammation  of the lungs;  see Division I, page 270.
Polarization, the act of imparting polarity to  a body;  a modification
  of fiie rays or action of light, effected by certain agents.
Polypus, pi, Polypi, pear-shaped tumors, generally adhering by their
  smaller end, which is called the " neck."
Posterior, behind.
Potent, powerful.
Precede, to go before.
Preceding, going before. 
household department.
313
Preclude, to prevent; hinder; to set or turn aside.
Precursory, introductory; prefatory;  preparatory.
Predisposed, having a tendency beforehand to become affected with a
  certain  disease.
Predominance, size, weight,  or power, etc., over others; to prevail;
  to be in the ascendant.
Pregnancy, the state of being pregnant, or with child.
Premature Labor, the  giving  birth to a child within two or three
  months of the full period of  pregnancy.
Premonitory, admonition before hand; as " premonitory symptoms,"
  the first symptoms which warn us of disease, or of the peculiar dis-
  ease.
Prepared Charcoal ; ordinary charcoal is  not fit for  medical  use;
  as made  for the  sick, it is prepared in covered vessels, and great
  care taken  to keep it as much as possible from the action of the
  air.
Preternatural,  irregular; much more  than  is  natural;  unusual;
  extraordinary.
Priapism, a continued and painful erection of the penis, independent
  of sexual thoughts or desires.
Primary,  original;  first; chief.
Primarily, originally ; at the commencement.
Prismatic, belonging to, or connected with, a prism.
Profuse, copious; abundant.
Progenitors, ancestors;  forefathers.
Prognosis, art of foretelling how diseases will terminate.
Propagate, to beget; to generate.
Prostate Gland, a glandular  body, situated before the neck of the
  bladder.
Protracted, of long duration;  prolonged; delayed.
Protrude, to jut out; to shoot out; to push  out; to project.
Protrusion, the act of pushing or shooting out; projecting.
Prudential, from motives of prudence; resulting from  prudence.
Psoriasis, salt-rheum ; see Division I, page 491.
Psoriasis Palma£ia, tetter or salt-rheum  in the palm of the hand.
Psychological, relating to the  science  of  mind.
Ptyalism, salivation.
Puberty,  the  age  in which one is capable of begetting or bearing
  children.
Pubes, or Pubis, the parts over  the  pubic  bone,  generally covered
  with hair. 
314
AMERICAN FAMILY PHYSICIAN.
Pubic Bone, the front bone  of the lower part of the body, and at the
  upper part of the organs of generation ; it is also called the " share
  bone," or "bar bone."
Puerperal, relating  to,  or connected  with  the  period of  child-
  birth.
Pulmonary, belonging to,  or proceeding from the lungs.
Pulmonary Hemorrhage, discharge of blood from the lungs.
Pulmonic, having a disease  of the lungs; a lung medicine or remedy
  for diseased lungs.
Pulse, beating of the heart and arteries; the latter generally  felt at
  the wrist.  The folloAving is the number of  beats of the pulse in a
  minute, in a state of health:—in a child before birth, 130 to 150; at
  birth, 120 to 135; one month old, 115  to 120; one year old, 106 to
  120;  two years old, 90 to 106; three  years old, 80 to 100; seven
  years old, 70 to 85; twelve years  old, 65 to  70;  at  puberty, 80 to
  85; adult age, 68 to 75 ;  old age,  50 to 65.  Among animals, it is
  per minute  as follows:—the horse, 32 to 38; the  ass, 45 to 48;
  beef cattle, 35 to 42; the  sheep, 70 to  79; the dog, 90 to 100; the
  goat, 72 to 76.   The pulse is generally less strong, and a little more
  rapid among females than males.   The pulse of castrated  males
  resembles that of the females  of the same kind.
Pulse, bounding, where it feels full and elastic, jumping at the fingers,
  as it were, when they are  placed over  the artery.
Pulse, corded, Avhere it feels like a stretched cord striking against
  the fingers.
Pulse, frequent, hurried,  or rapid, when it  strikes or beats fastei
  than ordinarily.
Pulse, full, where  it feels as if the artery was thoroughly full of
  blood, and distended.
Pulse, hard, when the pulse can not be  compressed, but feels as  if it
  indented the pulp of the fingers.
Pulse, intermittent, where the pulsations  cease  momentarily  and
  periodically.
Pulse, irregular, where it changes at  short and unequal intervals,
  both in force and frequency.
Pulse, small, when it strikes feeble and slender.
Pulse, soft, when it is readily compressed by the fingers.
Pulse, strong, when  it strikes the fingers with strength.
Pulse, tense,  same as Corded pulse.
Pulse, unequal, where it is  felt to be irregular or unequal in  its mod«
  of striking,  as well as in its intervals. 
household department.
315
 Pulse, wiry, same as Corded pulse, but feeling more like a wire than
   a cord.
 Pungent, sharp; biting; warm; piquant; racy.
 Pupil, the round, dark aperture in the centre of the eye, which is fre-
   quently seen to enlarge or contract, and through which the luminous
   rays from an object pass  to make their impression upon the retina
   or expanded nerve of sight.
 Purgation, the act of being purged.
 Purgative, see Division I, page 619.
 Puriform, resembling pus.
 Purulent, composed of, or containing pus.
 Pus, matter; a yellowish-white, inodorous, thick fluid.
 Pustules, pimples containing pus.
 Putrescency,  putridity; rottenness; offensiveness ; decomposition.
 Putrid, foul;  rotten; malignant.
 Pyrosis, water-brash.
 Quadruple, increased four times.
 Rancid, rank; strong; musty.
 Reabsorption, absorbing over again; absorbing  again into the system
   that which has been already  secreted or excreted.
 Recession, striking in;  retreating; drawing back.
 Rectum, the lower bowel or intestine.
 Recumbent, lying down; reclining; as the recumbent position, that in
   which one is reclining or  lying down.
 Recurrent, returning ; repeated;  over again ; renewing.
 Reduce, to replace a displaced part in its natural or healthy situation.
 Reduction, the reducing  or replacing  a part in its proper,  natural
   situation.
 Redundant, superabundant; more  than necessary; needless; over-
   much.
 Refrigerant,  see Division I, page 621.
 Regimen, the proper and correct use and regulation of diet and exer-
   cise, to promote health and remove disease.   Sometimes  applied to
   diet  alone.
Remission, a short or transient diminution of the severity of a disease.
Remissions,  a temporary  mitigation  or lessening of the severity of
   symptoms in any disease, especially in fever and inflammations.
Remittent, symptoms or diseases having remissions.
Reproduction, to produce over again;  the act  or  capability which
   organized beings have of producing other beings of the same char-
   acter or species as themselves. 
316
AMERICAN FAMILY PHYSICIAN.
Reproductive Organs, the organs or parts necessary to the reproduc-
  tion of the species.
Requisite, that which is needed or wanted; so indispensable as not to
  be able to do without; the very thing.
Residuum, the dregs or sediment left behind; the remains; the leavings.
Resin, or Rosin, a dry, hard, brittle, inflammable substance procured
  from certain vegetables, which has a slight odor,  or no odor at all;
  is insoluble in water, soluble in alcohol, yelk of egg, and mostly in
  spirits of turpentine; has a smooth or glassy fracture when broken;
  is heavier than water, and Avhen melted, becomes very sticky.  The
  taste varies from insipidity to acrid pungency.
Resinoid, a term applied to active medicinal substances obtained from
  plants, and which, in appearance and character, resemble resin.
Resinous, of the nature of resin.
Resolution, dispersion or scattering of a disease; discussion or disap-
  pearance of an inflammation.
Respiration, breathing; drawing air into the lungs and then expell-
  ing it.
Respiratory, belonging to, or connected with respiration.
Retina, the expanded nerve of sight, which first receives the impres-
  sion of the images of objects;  it is situated in the back part of the
  eye.
Retrocedent, going back.
Retrocedent Gout, when it leaves  the joints, and  attacks other and
  distant parts.
Revulsive, medicines supposed to remove a disease, by causing a de-
  termination from the seat of the disease to some  other part; see
  Division I, page 622.
Rhizoma, that portion of a root Avhich is fleshy or w.oody; also applied
  to a fleshy or woody root, or rooting-stem.
Rigors, coldness with shivering ;  chills.
Rotating, turning around circularly,  or  like  a  wheel; moving in a
  circle.
Rubefacient, see Division I, page 621.
Rubefaction, redness;  the act of causing redness of the skin.
Sacrum, a triangular bone  at the lower part of  the backbone; it  is
  about six inches long, and four broad at its base.
Saliva, the spittle.
Salivation, increased flow of saliva or spittle.
Salutary, beneficial to health; sustaining or promoting health.
Sanguineous, bloody. 
HOUSEHOLD DEPARTMENT.
317
Sanies, a thin, acrid discharge from ulcers.
Sanious, see Ichorous.
Sarcina Ventriculi, a very minute plant found sometimes in the fluid
  thrown up from waterbrash.
Saturated, so that no more  can be taken up; satiated; thus, a satu-
  rated tincture is one which is as strongly  impregnated with the vir-
  tues of the medicine as the alcohol can contain, it being impossible
  for the fluid to take up any more.
Sciatic, the haunch or hip.
Sciatica, Rheumatism or Neuralgia of the sciatic nerve.
Sclerotica, the coat of the  eye  next under the conjunctiva;  it is a
   pearly, Avhite, and tough membrane.
Scrofulous, of the nature of Scrofula or King's Evil.
Scrofulous Habits, conditions  of  the system  which predispose to
   Scrofula.
Scrotum, the bag which  incloses the testicles.
Scruple, one third of a  drachm Troy, or twenty  grains.
Scybala, hard, roundish lumps in the feces.
Sebaceous, of the character  of suet.
Sebaceous Glands, small glands or  hollow organs in the skin which
   secrete  a fatty or sebaceous matter, also called "Sebaceous Fol-
   licles."
Secondary, inferior; not primary;  following  or depending upon  the
   first; thus, a secondary disease, or a secondary symptom, is one which
   succeeds another, or is subordinate to it.
 Secreted, separated;  taken from the blood.
 Secretion, the separation of various fluids  or matters from the blood,
   as the bony matter from the bone, the bile from the liver, the spittle
   from the glands  of the mouth, the milk from the glands of the breast,
   etc. Excretion has  reference to the expulsion of used-up matters
   no  longer wanted in the system.
 Secretions, the matters secreted, as the bile, gastric juice, saliva,  etc.
 Secretory Organs, those organs which secrete materials, as the liver,
   the glands of the mouth, the glands of the breast, etc.
 Sedation, a, diminution of increased action; a quiet or depressed con-
   dition of the vital forces.
 Sedative, see Division I, page 620.
 Sedentary, not active; sitting  most of the time.  Thus, sedentary
   habits means an inactive life, much given to sitting, as  with writers,
   engravers, watchmakers, book-keepers, etc.
 Semi, means half. 
318
AMERICAN FAMILY PHYSICIAN.
 Semiflexion, half-bending; half-flexing;  not perfectly bent or flexed.
 Semilunar Cartilages, semicircular  cartilages situated  between the
   condyles or projections  of  the thigh-bone (at the knee) and the
   upper and movable  surface of the tibia or  shin-bone.
 Semilunar Line, creseentic bands of tendinous  matter, an  inch  or
   more in width, extending the whole  length of the belly, at distances
   varying from one to three or four inches from the linea alba; these
   lines are caused by  a blending of the external and internal oblique
   muscles of the parts.
 Sequel, the after-part; that which comes after;, the result or termin-
   ation.
 Sequence, see Sequel.
 Sero-purulent, partaking of serum and pus.
 Serous, watery.
 Serous Tissues, membranes of the body which secrete  serum;  they
   line cavities not externally open.
 Serum, the thin, watery part of animal fluids.
 Sinapisms, mustard plasters.
 Slough, see Eschar; dead matter caused by mortification, the applica-
   tion of caustics, etc.  Pronounced " Sluff."
 Sloughing, the removal or coming aAvay of a slough.
 Sluggishness, want of healthy action; passiveness; inactivity; slow-
   ness ; torpidity.
 Soluble,  capable of being  dissolved in a liquid.
 Solution, the act of dissolving in a liquid; also,  the liquid after the
   articles have been dissolved  in it.
 Sonorous, emitting sound Avhen struck; producing sound; snoring.
 Soporific, having the power of making one sleep.
 Sordes, the dark  deposits or covering  on  the teeth, lips, and gums, in
   low fevers.
 Speculum, an instrument for examining various parts, as, the vagina,
   the ear, throat, etc.,—there are several kind's for this purpose ;  also,
   a mirror.
Spermatic Cord,  a cord which suspends the testicles, composed of
   nerves, veins,  arteries, etc.;  one passes  upward  along each groin
   into the abdomen.
Spermatorrhea,  a disease of debility,  in which the male semen passes
   away without erection or sexual desires.
Spicula, pi, Spicule,  sharp splinters  or pieces of bone.
Spina-bifida,  a disease of the spinal column, in which there is  an effu-
   sion of serum; usually a transparent tumor filled with water pro- 
HOUBKUULD department.
319
  trudes  from the canal of the backbone.   It is  commonly a fatal
  disease.
Spinal Column, the column of bones which  form the backbone, of
  which there are twenty-four;  the first or upper seven of these bones
  are called " cervical;" the next twelve " dorsal,"  and the remaining
  five " lumbar," beloAv Avhich are the " sacrum" and " coccyx."
Sponge-probang, a straight or curved piece of whalebone, with a small
  piece of sponge fastened to  one end  of it, and  designed  to apply
  caustic solutions  to  the  throat—also, to push bodies down into the
  gullet  which have been stopped in their passage  to the stomach.
Spontaneous, of its own accord; without any other aid.
Spontaneously, acting naturally;  without aid or compulsion.
Sporadic, accidental;  not  due  to contagion or epidemic  causes.
Sphincter, circular or  annular muscles which by their contraction close
  certain openings, as, the " sphincter ani," muscles around  the anus,
  which keep this orifice firmly closed.
Squamous, like  scales  ; having scales.
Stale Bread, bread that is three or four days  old;  bread which has
  become moldy is not fit to use.
Stamina, physical force;  sturdiness;  lustiness; the organs  in plants
  that contain the pollen  or fertilizing powder.
Sterility, barrenness  ; incapability of reproducing.
Sternum, the breast-bone.
Stertorous, noisy breathing, as in apoplexy;  snoring.
Stethoscope, an instrument for examining the chest, to learn the nature
   of its diseases from the  peculiar sounds heard;  it answers as a me-
   dium  between the car and the chest.
 Stools,  the evacuations from the bowels.
 Strangulation, the condition of a part that is too  closely compressed,
   as a "strangulated  hernia,"  when it is so constricted by the opening
   through which the  gut  passes, as to render it almost impossible  to
   return it into the belly,  and  endangering  mortification.
 Strangury, urine passing with difficulty, by drops, and attended with
   heat,  pain, etc.;  see Division I, page 440.
 Stricture, a narrowed or  contracted part of any canal, as a  "stricture
   in the urethra," in  which the canal at one or several points gradually
   becomes  smaller and smaller, until it  becomes impossible to urinate.
 Strumous, disposed to Scrofula, as a "strumous diathesis" or "habit,
   a constitution which has a predisposition to Scrofula.  .
 Subacute,  moderately acute.
 Subcutaneous, under the  skin. 
320
AMERICAN FAMILY PHYSICIAN.
Submaxillary, under the lower jaw, as " submaxillary glands," glands
  under the lower jaw.
Submucous, beneath the mucous membrane.
Subside, to decrease; settle down; to become less severe.
Subsidence, the act of settling down;  the act of becoming less severe.
Subsultus Tendinum, weak twitehings or spasmodic contraction of the
  tendons, which occurs in low fevers, and is more especially observed
  at the wrist.
Succulent, juicy; containing juice.
Succumbing, giving way to; yielding to; sinking under.
Sudamina, small vesicles or blisters upon the skin, containing lymph;
  see Division I, page 208.
Sudorifics, see Division I, page 620.
Suffocation, apparent death from suspended breathing ; choking.
Suffused, overspread, as with a fluid; as,  an escape of blood from the
  blood-vessels, and passing into the neighboring tissues.
Superior, above,  or upper.
Supervene, to come after, or  immediately upon; occurring shortly
  after;  succeeding.
Suppressed, smothered; hushed up ; obstructed;  hindered.
Suppression, a checking or stopping;  an  unhealthy  retention of any
  discharge.
Suppurating, discharging pus or matter..
Suppuration,  production  of pus or  matter; the  act  of discharging
  pus.
Sutures,  stitches taken up in  sewing  a wound;  the union of bones by
  a kind  of saw-like process on their edges, giving to them somewhat
  of a dove-tailed appearance.
Sympathetic, the action by which one organ is affected or influenced
  by another; when a  healthy organ is  affected  or deranged  in its
  condition or functions  by  the  reaction of a diseased organ, it ia
  termed a "sympathetic affection"  or "disease,"  as, for instance,
  when headache occurs from  sour stomach.
Syncope,  fainting.
Synonymous, having the same meaning or idea.
Synovial Fluid, a glairy fluid which lubricates or moistens the joints;
  joint water.
Syphilis, the venereal disease; the bad disorder.
Syphilitic, belonging to or proceeding from Syphilis.
Table-spoonful,  four  teaspoonfuls;  four fluidrachms; half a fluid
  ounce; one-thirty-second part of a  pint. 
household department.
321
Tarsus, the edge of the  eyelid; a term also applied  to the instep o-r
  ankle.
Tart Cider, cider which  is pleasantly sour; not hard cider.
Tartar, a  sour salt procured from wines ; the hard, dark-colored sub-
  stance which forms upon the teeth, especially close  to the gums. "
Teaspoonful,  a fluidrachm ; sixty drops; one-eighth of an ounce.
Temperature, the degree of heat or cold.
Tenacious, sticky; holding fast; cohesive; obstinate.
Tendon, a  sinew; a fibrous  cord  by which a muscle is  fastened to
  a bone.
Tenesmus,  a frequent, ineffectual, and painful symptom, urging one to
  go to stool.
Tense, stretched firmly,  or to the utmost.
Tension, a  strained or stretched condition; the act of firmly stretch-
  ing.
Tetanic, spasms of a permanent and rigid character.
Therapeutics, that department of medicine which  has for its object
  the treatment of the sick by remedial agents.
Therapeutical, belonging to or proceeding from therapeutics.
Thorax, the chest.
Thyroid Gland, the gland lying before the windpipe, and which is the
  seat of bronchocele.
Tibia, the largest bone of the lower leg; the shinbone.
Tincture, a solution of medicinal articles in alcohol or other spirits.
Tissues, textures; or the materials of organized parts of the body;
  thus, the flesh beneath the skin is the cellular tissue ; bone is com-
  posed of bony  matter  or  tissue; the lips are  covered with  mucous
  membrane or tissue; the nails consist of horny tissue, etc.
Tonic, see Division I, page 620.
Tonicity, imparting  or having tone or strength.
Tonsils, the almonds of  the ears.
Tormina, griping pain.
Torpid, inert; stupefied; benumbed;  sluggish; slothful; motionless.
Torpidity,  in  a sluggish  or inert condition.
Torpor, see Torpid.
Torsion, twisting.
Trachea, the  windpipe.
Tracheotomy', the operation of opening the windpipe to admit air into
  the lungs, and thus keep  up breathing  and life,  as in severe cases
  of croup, etc., and to remove  foreign  bodies;  sometimes  called
  " Bronchotomy." 
322
AMERICAN FAMILY PHYSICIAN.
Transient, short lived; temporary;  of short duration.
Transitory, passing away quickly;  short lived.
Translucent, that which allows the  rays of light to pass through it,
  but which can not be seen through  distinctly; not so clear as Trans-
  parent.
Transparent, clear; that may be seen through with distinctness.
Transverse,  running across;  passing  from  side to side;  athwart.
  Generally applied to anything running parallel or nearly so to the
  surface of the earth; a " transverse line," one running in the  direc-
  tion of the earth's surface for a short distance; or,  parallel with
  straight lines running through the centre of the earth.
Translated, changed; shifted; see Metastasis.
Tremors, tremblings; involuntary shaking or trembling.
Triturate, to rub or reduce  to a fine poAvder.
Tubercle, a  tumor of slow growth, usually of a scrofulous character;
  tubercles have been found in nearly all parts of the body; they have
  a cheesy structure internally.
Tubercular, * Tuberculous,  belonging  to,  or proceeding  from  a
  tubercle.
Tumefaction, a transient swelling.
Tympanites,  a windy swelling of the belly; see Division I, page 428.
Tympanitic,  swollen with gas or wind.
Tympanitis,  inflammation of  the middle ear.
Tympanum, the drum of the  ear.
Typhoid, a low, sinking, depressed condition of the  system.
Typhus, a depressed and sinking state of the vital powers.
Ulnar  Nerve, a nerve extending to the inner and front part of the
  forearm, to the inside of the hand, and to the last  two  or  three
  fingers.
Umbilicus, the navel.
Unequal, not regular; not uniform.
Urea, a white, pearly substance, which exists in great quantity  in the
  human urine, forming a material part of this fluid.
Ureters, the long tubes Avhich convey the urine from the kidneys to
  the bladder.
Urethra, the canal through  Avhich  the urine is  discharged from the
  bladder.
Uric  Acid, an acid  Avhich  is  common to human urine;  it frequently
  forms gravel or stone in the bladder.
Vaccinate, to insert some of the matter of cow-pox beneath the skin,
  which produce?  a condition of the system  opposed to  an attack of 
HOUSEHOLD DEPARTMENT.
323
  small-pox, or very much modifying its character, should it be con-
  tracted subsequently.
Vagina, the passage from the womb to the external parts.
Vapor, gas ; steam; smoke ;  fumes.
Varicose, affected with varix.
Varix, pi, Varices, a morbid dilatation or  enlargement of a vein, in
  which the vein presents soft, knotty, and purplish tumors.
Vascular,  supplied with  vessels, as nerves, blood, etc.
Vault of TnE Cranium, the upper concavity or internal surface of the
  skull.
Vegetable Caustic, see Division I, page 716.
Venereal, pertaining to  sexual intercourse.
Venesection, bleeding by means of a lancet or knife.
Venom, a natural  poison, not morbid  or unhealthy.
Venous, belonging to, or proceeding  from the veins.
Ventricle, cavities in the heart and  in the brain.  The right ventricle
  of the heart sends the blood  to the lungs; the left sends it over the
  whole system,
Vermifuge, see Division I, page 621.
Vertebra, pi, Vertebra, the bones  which form  the  backbone  or
  spinal column.
Vertebral, pertaining to the vertebrae;  as, the " vertebral column"
  or backbone.
Vertically, uprightly; perpendicularly.
Vertigo, giddiness;  dizziness.
Vesicant, see Division I, page 622.
Vesicate, to blister.
Vesication, the act of being blistered; blistering.
Vesicles, little blisters or bladders.
Vesicular,  consisting of small cells or bladders; also  applied  to  a
  sound heard in breathing, when the air passes through the air-cells
  of the  lungs.
Veterinary, relating to  the treatment of diseases  among  animals, as-
  horses, coavs, sheep, etc.
Virile, manly; masculine ; strong in the sexual powers.
Virus, the contagious principle of infectious  diseases; an unhealthy
  poison.
Viscid, sticky; ropy;  glutinous.
Viscidity, ropiness; stickiness.
Vitiated, impaired; corrupted; perverted;  deteriorated. 
324               AMERICAN FAMILY PHYSICIAN.

Volatile,  readily passing  off in the form  of vapor or gas;  evap-
  orable.
Voracious, greedy;  rapacious; over-eager.
Wine-glassful, half a gill  or four table-spoonfuls.   One-eighth of a
  pint.
Wont, habitual; custom; usual mode of doing or saying  anything;
  inclined to.
Zones, climates; regions; layers: belts;  girdles. 
fNDEX
DIVISION     II.
N. B.—See Index in Division I.
                      PACIE
A certain remedy for Can-
      cer.....................260
A Good Barometer.........256
A Mother's Love............204
Absent Menstruation......180
Acorn Coffee..................63
Acute Diseases, Coma in..l01
    Dark Fur on thc teeth
      in......................101
    Dark Furred Tongue
      in.....................101
    Debility in.............101
    Delirium in..............99
    Diarrhea in............101
    Drum-like  swelling
      of Belly in..........101
    Laryngitis................88
    Mortification of Mouth
      in.....................100
    Nausea in...............99
    Pain of Bowels in.....99
    Pain of Head  in......99
    Pain of Stomach in...99
    Prostration in.........101
    Putrid Symptoms in.lOl
    Restlessness in........101
    Sleep  in.................101
    Sore Mouth in.........100
    Sore Throat in........100
    Suppression of Urine
      in......................100
    Swelling of Bowels
      in.................99, 101
    Swelling of Stomach
      in........................99
    Symptoms in............99
    Troublesome  Cough
      in.....................100
    Tympanitis in.........101
    Vomiting in............99
    Wakefulness in.......101
                      PAGE
Address, Publishers..........6
After-pains..................192
Ague and  Fever.......76, 246
    Tonic  Bitters for..76, 77
Ague Cake. .................148
    Cure for.................148
Air,  Impure,  in causing
      Disease................31
    Night, better than im-
      pure....................32
    Pure,  for Convales
      cents...................58
Alcoholic Drinks injurious 25
Almond  Paste  for  the
      Hands................250
Alteratives, 82, 83, 112, 122,
       148,140,150,157,227
Alum Curd....................69
Alum AVhey...................69
An Item for Housekeepers 278
Animal Diet..................29
Animal Food, solid.........58
Animal Meats................57
Anodyne Balsam...........142
Antacids,  121, 125, 135, 142,
                   211, 214
Antiperiodics, 70, 77, 194,
          199, 218, 219, 228
Antiseptics, 83, 96, 100, 101,
      106, 107,108, 142,160,
               161, 165, 228
Antispasmodics,  115, 117,
          123, 198. 224, 228
Aphthae........................213
Apoplexy......................112
Apparent  death from Cold 171
    from  Lightning.......172
Appetite,  capricious,  in
       Pregnancy..........191
Apple Water..................63
Arrowroot Gruel.............66
                      PAQB
Asiatic Cholera.............122
Asphyxia.....................168
Asthma.......................116
Astringents, 85,  86, 88, 96,
      100, 101,  124,  126,
      129, 130,  147,  184,
      185, 187,  188,  193,
       212,  225, 226, 229
Attentions during Conva-
      lescence...............58
Author's Remarks............1

Back, weakness in,........188
Baking Powder.............251
Balky Horses,  to make
       pull...................278
Balsam of Wild Cherry,
       Wistar's.............250
Bandoline for the Hair...252
Barley Coffee.................62
Barley Water.................61
Barometer, a good one...256
Bathing.......................230
Bathing prevents taking
       Cold....................91
Bathing the Surface........17
Bedbugs and Fleas........283
Beddoes' Pills for Gravel.243
Beds, Feather, injurious...45
Beef, Essence of..............67
Beef Tea.......................66
Belly, Dropsy of............110
Best Nurses, who make....36
Big Neck.....................161
Biles, see Boils.
Bilious Colic..........120, 247
Bilious Fever..................77
Bite of a Mad Dog.........115
Bites of Insects......173, 283
"Bitters for Ague.........76, 77
     for Dyspepsia...134, 135
(325) 
326
INDEX.
                       PAGE
Black Ants, to remove...268
Black Leg, to cure.........268
Bladder, Bleeding from...130
     Chronic Disease of... 148
     Inflammation of........97
Bleeding from the Blad-
       der....................130
     from the Cord.........205
     from the Kidneys.... 130
     from the Lungs.......129
     from the Navel........205
     from the Nose.........129
     from the Stomach.... 130
     Styptic to stop.........251
Bleedings.....................129
Blistered Feet...............166
Blood,  rush to the Head..l74
     Spitting of.......129, 247
     Syrup for...............262
     Vomiting of............130
Bloodshot Eyes in Horses.285
Bloody  Flux..................95
     Murrain,  to cure.....268
     Urine....................130
Blotches on the Face......163
Blows, Stunning from.....167
Bodies in the  Ear.........168
     in the Nose............168
     in the Windpipe......168
Boiled  Flour..................66
Boils............................161
Bowels, Consumption of..215
     Falling down of......215
     Inflammation of........95
     Pain  in,  in  Acute
       Diseases...............99
     Regularity of...........59
Brain Fever...................83
Brain,  Inflammation  of....83
Bran Tea.......................61
Breath, Cure for offensive 253 j
Breast,  Broken or Caked.197
Bronchitis.....................90
     Chronic.................145
     Holmes's Syrup  for..255
Broth, Mutton.................67
Broths as Diet................24
Bugs from Vines............267
Bunions.......................164
Burns and Scalds..........253
Burst..........................167
     at the Navel...........205
Buttermilk.....................56

Caked  Breast...............197
Cancer........................130
     Remedies.........131, 260
Capricious  Appetite  in
      Pregnancy..........191
Carbuncle....................160
Carminatives... 115, 119, 230
Catarrh..................90, 146
     Pulmonary...............90
                      PAGE
Catarrh Snuff...............146
Cathartics, 75, 79, 80, 82, 96,
      98, 107, 110, 111, 118,
      126,  134,  148,  186,
              194, 218, 231
Cattle, Diseased, what to
      do with...............272
    Lice on..................268
    Plague..................271
    Inoculation in.........274
    Prevention of.........273
Causes of Disease, Ordin-
      ary.....................11
Caustics.........107, 131, 164
Caution........................281
Cautions for Infancy, etc.209
Cement for Broken China.254
    for Cisterns............269
    for Fastening Metals
      to Glass..............254
Cement for  Horn, Bone,
      etc.....................254
Chafing in Infants........213
Chafings......................166
Changing Clothes of the
      Sick.....................47
Charcoal, Suffocation from
      Vapor................171
Check the Flow of Milk..246
Chewing  Food,  Import-
      ance  of................22
Chicken Panada.............67
    Pox.......................225
    AVater.....................67
Chilblains, Broken.........244
    On Horses..............266
Childbed Convulsions.....195
Childbed Fever.............194
Childbirth...................192
Children, and their Dis-
      eases .................202
    Diarrhea of............218
    Exposure of to Cold... 12
    Rules  for  Manage-
      ment of...............205
    Should  be  Doctored
      by Mothers.........202
    Summer Complaint
      of.....................217
    Teething,  Prepara-
      tion  for...............211
Chills ami Fever.............76
China Berries...............267
Chlcrodyne..................257
Chlorosis.........?............186
Chocolate......................56
Cholera, Asiatic............122
Cholera Morbus.............124
Chronic Bronchitis.........145
    Catarrh................146
    Diarrhea...............147
    Disease of Bladder.,148
    Disease of Kidneys..l48
                      paws
Chronic Diseases...........110
    Dysentery..............147
    Inflammation of the
      Eye....................143
    Liver Complaint......147
    Rheumatism............149
Chyle, where formed.......27
Chyme, where formed......23
Cisterns, Cement for Lin-
      ing....................269
Classification  of   Medi-
      cines..................227
Clean Milking..............270
Clean white Kid Gloves...281
Cleanliness in the Sick-
      Room..................46
Clothes from taking Fire..253
Clothes on Fire.............172
Cockroaches, to remove...267
Cocoa...........................56
Coffee............i..............56
    Acorn.....................63
    Barley.....................62
    Corn.....................61
    Oatmeal..................62
Cold,  Apparent   Death
      from..................171
    Exposure of^Children
      to........................12
    Exposure  of   young
      Girls to................13
    Exposure to......v......12
    how  Producing  Dis-
      ease....................15
Colds, Management of......16
    Prevented by Bathing.9l
Colic, Bilious.........120, 247
    in Infants..............214
    Wind....................119
Coma, or Sleep, in Fevers,
      etc.....................101
Common Colic...............119
Confinement.................192
Congestive Fever............78
Consumption................136
    Cough  in...............142
    Medicines for, 141, 142,
                      244
    of Bowels...............215
Convalescence, Attentions
      during.................58
Convalescents,  Cookery
      for.....................60
    Diet for..................54
    Drink  for................63
    Exercise  for.............58
    Pure Air for............58
    Regularity of Bowels,
      with....................59
Convulsions,  Childbed.... 195
    in Children............216
Cookery   for  Convales-
      cents...................60 
INDEX.
327
Cookery for the Sick........60
Cooking prohibited in the
      Sick-room............47
Cooling Fever Drink.......63
Cord, Bleeding  from......205
Cordial for Dysentery....251
Corn Beer....................286
Corn Coffee....................61
Corns, Cure for......164, 268
Costiveness..................126
     during Pregnancy...190|
     in Children............214
Cough,  Hooping............224
Cough in Consumption...142
     Remedies, 89, 90, 91, 92,
       93, 94, 100, 142,  146,
               156, 221, 224
     Troublesome...........100
Cramp..........................115
     During Pregnancy... 190
Croup...................222,262
     False.....................223
 Curd, Alum...................69
 Cure for Ague Cake......148
     for Black-leg..........268
     for Bloody Murrain..268
     for Corns...............268
     for Drunkenness......248
     for Fever and Ague, 76,
                       246
     for Fistula in Horses,268,
                       270
     for Galls on Horses...266
     for Gapes in Chick-
        ens....................265
     for Grubs in Horses.266
     for Grubs in Sheep...266
     for Heaves in Horses.268
     for Hog Cholera......269
     for Hoven in Cattle..266
     for Offensive Breath.253
     for Pip  in Poultry...266
     for Poll  Evil...........268
     for the Scours.........284
     for Warts...............268
     for Stretches in Sheep,
                       266
 Curing of Hams............278
 CuBtard,  Slippery  Elm....69
 Cutting Glass...............282
Dalley's Salve...............251
Danger  of  Sleeping  in
      close Rooms...........32
Dark Fur  on Teeth  in
      Acute  Diseases....101
Dark-furred  Tongue  in
      Acute  Diseases.....101
Darkening the Sick-room..48
Davis's  Pain Killer.......250
Deafness......................162
Debility  in  Acute  Dis-
      eases..................101
          71
Delirium in Acute Diseases 99
Dentition.....................210
Diaphoretics.................231
Diarrhea.....................125
    Chronic.................147
    During Pregnancy...190
    in Acute Diseases....101
    in Consumption.......142
    of Children............218
Diet, Animal..................29
    for the Convalescent..54
    for the Sick.............54
    of different Nations..29
    Rules to  observe......28
    Vegetable...........29, 57
 Diphtheria...................101
 Disease caused by impure
       air...........•...........31
    how produced by Cold.15
    how   by  Improper
       Food....................24
     how by Inattention to
       the Skin...............18
     of the Spine............151
     Ordinary causes of....11
     Unfavorable  Symp-
       toms of................49
 Diseased Cattle, what to
       do  with..............272
 Diseases caused by  inat-
       tention to Diet,  25, 27
     Chronic.................110
     General Treatment of.70
     of Children............202
     of Liver, etc.,  how
       caused............25, 27
     of Pregnancy.........189
     of Women..............175
 Distemper in Horses......265
 Distress at Stomach after
       eating................121
 Dizziness of the Head....118
 Diuretics, 96,97, 98,100, 111,
       121,128,129,130,148,
       149, 193, 199, 225, 232
 Draughts.....................236
 Drink, for Convalescents...63
     for Fevers..........62, 63
     for Suet..................68
 Drinking at Meals..........24
 Drinks, Alcoholic, injuri-
       ous.....................25
 Drive away Bed-bugs and
       Fleas..................283
     Flies.....................267
 Dropsy........................HO
     of Belly.................HO
     of Skin..................HO
 Drowning,   Suffocation
       from..................168
     to keep" from...........173
 Drum-like  Swelling   of
       Belly in Fevers, etc.101
Drunkenness, to cure......248
Duties of a Nurse............44
Dye for the Hair..........251
Dysentery...............95, 248
    Chronic.................147
    Cordial for.............251
Dyspepsia..............132, 260
    Bitters  for......134, 135

Earache......................283
Ear,  foreign bodies in... 168
Egg and Brandy Mixture.65
Eggs.............................57
    Restorative Injection
       of........................65
    Soft-shelled...........265
Elm bark, Mucilage of.....64
Emetics......74, 117,222,233
Emmenagogues.............233
Enlarged Spleen............148
     Veins during Preg-
       nancy.................191
Epilepsy...............114, 246
Erysipelas.....................81
Essence  of Beef..............67
Exercise for the Convales-
       cent.....................58
     injurious about Meal-
       time.....................26
Expectorants, 89, 91, 92, 93,
       100,117,146,156,167,
               222, 224, 234
Exposures of Children to
       cold.....................12
     of Young Girls.........13
     to Cold...................12
 Exterminate Rats..........280
 Every  Wife  and Mother
       should  know  how
       to nurse...............43
 Eye  Applications, 84, 85, 86,
                     87, 143
      Salve, Pettit's.........250
      to remove  Iron  and
       Lime from...........143
 Eyes, Inflammation of, 84,85,
                     86, 143
      Sore, of Infants......212

 Face, Blotches on..........163
      Powder..................252
 Fainting...............118, 191
      during Pregnancy... 191
 Falling  down  of  the
       Bowel.................215
      Fits......................114
      of Womb...............188
      out of Hair............268
 False Croup..................223
 False  Skin  on Horses
       Eyes..................286
 Families, to Heads of.....242
 Farmers' Miscellany......26i 
828
INDEX.
                       PAGE
FasU i Leather on Metal.282
Fat, io reduce...............257
Feathsr-beds injurious......45
Feet, Blistered..............166
Feet, Perspiration from..258
Fell's Cancer Kemedies..l31
Felon,  Cure for.............246
Fetid Perspiration  from
      the Feet..............258
Fever and Ague........76, 246
Fever, Bilious.................77
    Brain.....................83
    Childbed...............194
    Congestive...............78
    Hectic.....................81
    Infantile Remittent..218
    Lung.....................91
    Lung, in Children...221
    Milk.....................193
    Mixture   for   Low
      Stages of...............65
    Scarlet.................219
    Typhoid..................80
    Typhoid  Lung..........92
    Typhus...................79
    Winter....................92
    Yellow....................79
Fevers, Drink for.......62, 63
    Generally...............73
Fire, Clothes  on............172
    to  prevent Clothes
       from taking.........253
    toprotectaRooffrom277
Fish..............................57
Fistula, to cure  on
       Horses........,268,270
Fits,.....................114,216
Flaxseed Tea..................64
Fleas  and Bed-bugs,  to
       drive away.........283
Flies, to drive away.......267
Flooding......................192
Flour, boiled..................66
Flow of Milk, to check...246
Fluor Albus.....'.............187
Flux, Bloody..................95
Fly Paper....................281
Fomentations, 84, 85, 87, 91,
       93, 94, 96, 97, 98,100,
       101,  1C2,   120,  159,
       161,  181,   192,  193,
               197, 221, 234
Food, how  Digested.........23
     Importance-of Chew-
       ing.....................22
     Improper,  how  it
       causes Disease......24
     Improper Use of........21
     Injury from indigest-
       ible.....................24
     Injury from too much.25
     Not to be kept near
       a Sick-room..........47
                       PAGE
Food, Selection of............29
    Solid Animal............58
For Bathing..................230
    Bilious Colic....120, 147
    Bloodshot  Eyes  in
      Horses...............285
    Broken Chilblains....244
    Bronchitis.........90,145
    Consumption... 141, 142,
                       244
    Croup.............222, 262
    Dyspepsfa..............260
  ■  Dysentery...95,147, 248
    Epilepsy................246
    Fastening  Metals  to
      Glass..................254
    Felon or Whitlow....246
    Fistula in  Horses...268,
                       270
    Fleas and Bed-bugs..283
    Flie3......................26
    Gravel......127,-243,244
    Hair...248, 251,252, 253,
                       260
    Horn, etc................254
    Horse Distemper.....265
    Housekeeper...........278
    Mending China.......254
    Mosquitoes.............245
    Offensive Breath......253
    Offensive  Perspira
      tion.............258, 259
    Old Sores...............247
    Scald Head......163, 259
    Sciatic Neuralgia.. .259
    Self-sealing  Enve.-
      opes...................255
    Sprains and Bruises.249
    the Hands..............250
    the Piles...l66, 190, 243,
                       257
    those  who Perspire
      freely.................259
    Toothache...............245
    Weak Sight............144
    AVeakly Females......249
 Foreign bodies in the Ear.168
    in the Nose............168
    in the Windpipe......168
 Fowls, Lice on...............266
 Frank's Pills................247
 Freckles, to remove........249
 Fruit Stains in Linen....278
 Fruits...........................55
 Functions of the Skin......14
 Furniture,  to  remove
      Stains from.........282
 Furred Teeth in Fevers...101
 Furred Tongue in Fevers.101

 Galls on Horses............2(56
 Gangrene.....................165
 Gapes in Chickens.........265
                      P»Oi
Gargles.......88,89, 100, 107,
              198, 213, 234
Gastric Juice..................23
General Prostration......200
General Treatment of Dis-
      eases...................TO
Girls, Exposure of, to cold.13
    what   they   should
      know..................179
Glass fastened to Metal..254
    to cut....................282
Glossary......................287
Gloves, to clean White Kid 281
Glue for Self-sealing En-
      velopes...............256
Glue, Liquid.................258
Goitre.........................161
Golden Tincture............243
Good Barometer............256
Good Nurse, the Import-
       ance of................35
    what constitutes a....39
Granary,  to  keep  Rats
       from..................280
Granulations,   to  take
       from Eyelids........143
Gravel............127,243,244
Grease Spots, to  remove..259
Great Debility in Fevers,
       etc.....................101
Green  Sickness.............186
Green  Stools.................214
Grub in Sheep...............266
Grubs in Horses............266
Gruel, Arrowroot............66
       Oatmeal...............65
       Rice....................64
       Sago....................65
       AVater..................64
Gum Arabic  Mixture......64
GumSj Inflammation of...212

Hair, Bandoline for.......252
     Dyes......................251
     Oil........................252
     Restorative, Twiggs\260
     Shampoo Liquid for. .248
     to  prevent,  falling
       out.....................253
Hams, curing of............278
Hands, Almond Paste for..250
Hanging,  Suffocation
       from..................171
Hard water,  to  soften....282
Harden Nails...............259
Hayes Nerve and Bone
       Liniment............257
Haye's   Liniment   for
       Piles...................257
Head, Dizziness of.........118
     Scald.....................163
     Severe Pain  during
       Acute Disease........C'J 
INDEX.
329
                        PAGE
  Headache.....................127
      During Pregnancy ...190
      Nervous................127
      Sick,.....................127
  Healing Salve...............245
  Heart, Palpitation of......118
  Heartburn...................121
      During Pregnancy...190
  Heaves in Horses..........268
  Hectic  Fever..................81
  Hemorrhages...............129
  Herb Teas................56, 60
  Hiccough.....................118
  Hiccup........................118
  High-colored Urine........121
  Hip  Disease.................160
  Hoarseness..............89,  167
  Hog Cholera, to cure......269
  Holmes's Syrup for Bron-
        chitis..................255
  Hooping Cough..............224
  Horse Distemper............265
  Horses, Bloodshot eyes in.285
      Broken Chilblains on266
      Liniment for...........285
      to give an Appetite.,285
  Housekeepers,  an   item
        for.....................278
  Houses  should  be  well
        Ventilated.............33
  Hoven in Cattle............266
  How Food is Digested......23
» How Injury is produced by
        Food....................24
  How to make a  Balky
        Horse pull...........278
  How to ventilate'Rooms...33
  Hysterics.....................198

  Ice-cream, to make.........247
  Importance of a  good
        Nurse..................35
  Importance of chewing
        Food...................22
  Improper Food causes Dis-
        ease.....................24
  Improper Use of Food......21
  Impure Air, in causingDis-
        ease.....................31
  Inability to hold Urine, 225,
                        262
  Inattention to Diet causes
        Disease...........25, 27
  Inattention  to the Skin....17
  Incontinence  of  Urine
       during Pregnancy.192
  Indigestible Food, how it
       injures................24
  Indigestion..................132
  Infancy, Cautions  for.....209
  Infant State, Rules for...207
  Infantile  Remittent  Fe-
       ver.....................218
                       PAGE
 Infants,  Rules for  Man-
       agement of...205, 207
     Sore Eyes of...........212
 Inflammation of the Brain.83
     of the Bladder.........97
     of the Bowels...........95
     of the Eyes..............84
     of the Eyes, Chronic.143
     of  the  Eyes,  with
       Matter.................85
     of the Gums in Chil-
       dren..................212
     of the Iris...............86
     of the Kidneys.........97
     of the Lungs............91
     of the Lungs in Chil-
       dren..................221
     of the Stomach.........93
     of the Windpipe, 88, 90
     of the Womb..........193
 Inflammatory   Rheuma-
      tism....................98
 Influence of Mother's Mind
      upon the Child.....191
 Influenza.......................90
 Inhalations, 87, 89, 221, 222
 Injections, 65, 81, 94, 95, 96,
      98, 101, 102,  108, 119,
      120,123,125,126,147,
      183,187,188,196,198,
                   215, 216
 Injury from too much Food 25
     how caused by Indi-
      gestible Food..........24
 Ink to write upon Zinc
      Labels................269
 Inoculation  in   Cattle-
       Plague...............274
 Insects, Bites and Stings
      of......................173
 Involuntary Discharge of
      Urine.................225
 Iris, Inflammation of.......86
 Iron and Steel, to preserve _
      from Rust...........281
 Iron, Particles of, to re-
      move from the Eye.148
 Iron, to remove rusty
      Spots on.............281
 Isinglass Jelly...............66
 Itch, Seven Years.........262
 Itchings during Pregnan-
      cy.....................190
 Item for Housekeepers...278

Jaundice.....................122
    in Children............205
Jelly, Isinglass...............66
Jelly, Tapioca................69
Joints, Stiffness of.........150
Juice. Gastric.................23

 Kid  Gloves, to clean......281
                       PAO«
Kidneys, Bleeding from..130
     Chronic Disease of...148
     Inflammation  of........97
King's-Evil..................156

Labor-saving Soap.........25-j
Leather to Fasten on Met-
      al......................282
Leucorrhea...................187
Lice on  Cattle...............268
     on  Chickens...........285
Lightning, Apparent Death
      from..................172
Lime, Particles of to  re-
      move from the Eye.14:-!
Liniment for Horses......285
     for  Piles, Haye's.....257
     Magic...................248
     Mexican Mustang...258
     Nerve  and   Bone,
      Haye's...............257
Liniments, 78, 89, 92,  102,
      114,132,149,150,151,
      155, 162,166,173, 200
     for  Rheumatism......150
     Relaxing...............151
Lining Cisterns, Cement
      for.....................269
Liquid Glue..................258
Liver Complai n t............117
     how caused.........2~>. 27
     Medicines for.........148
Lochia, Suppression of...193
Lockjaw .....................115
Longings  during  Preg-
      nancy ................191
Lotions,  78.  82, 83, 84, 85,
      86, 87, 99,  107, 143,
      162,  163,  173, 174,
          198, 212, 213, 221
Lung Fever...................91
     in Children............221
Lungs, Bleeding from.....129
Lungs, Inflammation of...91
     in Children............221

Mad Dog Bite...............115
Magic Liniment............248
Magic Razor Paste.........282
Management of Colds......16
    of Infants, Rules for.205,
                       207
    of the  Skin..............20'
Marshmallow,  Mucilage
      of........................64
Meals, Drinks during......24
Measles......................220
Meats, Animal...............57
    more Stimulating than
      Vegetable............29
Medicines for the Blood, 82,
      83. 112, 122, 134, 141,
      148,«149, 150, 157, 187 
330
INDEX.
                       PAGE
Medicines  for Consump-
      tion............141, 142
    for Dyspepsia,  134, 135
    for Liver Complaint.148
    for Spinal Disease,  154,
                       155
Menstruation,  Absent....180
    Painful.................182
    Profuse..................184
    Suppressed.............181
Metal upon Leather......282
Metals upon Glass.........254
Mexican Mustang  Lini-
      ment..................258
Mice, to keep, from Gran-
      ary ...................280
Mildew, to remove from
      Furniture............282
Milk,............................57
    Fever....................193
    Leg.......................196
    Porridge..................66
    Sickness ...............125
    to  check  the  Flow
      of......................246
    Toast......................68
    Milking, Clean.......270
Miscarriages................192
Miscellaneous Pharmacy.243
Miscellany, Farmers......265
Mixture for low Stages of
      Fever..................65
    Gum-Arabic............64
Mixtures...............162, 167
More about Rats............285
Morning Sickness in Preg-
      nancy.................189
Mortification, 83,  100,  161,
                       165
    of Mouth and Face...100
    to Stop..................161
Mosquitoes, to drive away.245
Mother's Love...............204
Mother's Mind, Influence
      upon Child.........191
Mothers  should  doctor
      their own Children.202
Mucilage of Elm  bark.....64
    of Marshmallow root.64
Mucilages, 64, 89, 90, 91, 92,
                 94, 96, 235
Mumps........................224
Mustard Whey...............69
Mutton  Broth.................67
Mutton  Tea...................67

Nails, to Harden............259
    to  remove   White
      Specks from........260
Narcotics.....................235
Nausea  in Acute Diseases..99
Navel,  Bleeding  from...205
    Burst  at................205
                       PAGE
Navel, Rupturg at..........205
    Soreness of.............205
Nerve and Bone Liniment,
       Haye's...............257
Nerve  Tonics, 113, 114,  127,
       134,141,199, 200, 224
Nervous Headache.........127
    Weakness..............200
Neuralgia.....................199
    Sciatic..................259
Night Air better than im-
       pure  Air..............32
Nipples, Sore................192
Night Sweats in Consump-
       tion...................142
No Noise in Sick-room....47
Nose, Bleeding from......129
    Foreign Bodies in....168
Noxious Vapors, Suffoca-
       tion from............171
Nurse,  Mothers and AVives
       should know how to.43
    the Duties of............44
    what  constitutes  a
       good....................39
Nurses, the Importance of
       good....................35
    who make the Best...36
Nursing........................35
Nursing Sore Mouth......198

Oatmeal Coffee...............62
    Gruel.....................65
Oil for the Hair............252
Oils............................235
Ointments,  82, 131, 143,  155,
       158,161,162,163,164,
          165,166, 192, 199
Ointments for Piles........243
Old Sores, Salve for.......247
On Tobacco..................138
Order in  the Sick-room...46
Ordinary  Causes of Dis-
      ease ....................11
Over-distention of Skin in
       Pregnancy..........191

Pain in Bowels, in Acute
      Diseases...............99
    in Head,  in  Acute
      Diseases...............99
    in Stomach, after Eat-
      ing....................121
    in Stomach in Acute
      Diseases...............99
Pain-Killer, Davis's.......250
Painful Menstruation.....182
Palpitation of Heart......118
Panada........................65
    Chicken..................67
Paper for Flies.............281
Particles of Iron and Lime
      in  the Eye..........143
                      PAOl
Paste,  Almond,  for the
       Hands................260
    Magic Razor...........282
    Paper on Tin..........255
Peach Borer, Remedy for.277
Perfumed  Vinegar  for
       Sick-rooms............63
Perspiration, Fetid from
       the Feet..............258
Perspire, for those  who...259
Pettit's Eye-Salve..........250
Pharmacy, Miscellaneous 24b
Phthisic......................116
Pile Ointment...............243
Piles...........................165
    During Pregnancy... 190
    Haye's Liniment for.257
Pills for Gravel, Beddoe's.243
    Frank's.................247
Pip in Poultry.............266
Pleasant Drink for Fevers.62
Pleurisy........................92
Pleuro-pneumonia of Cat-
       tle.....................271
Poisoning.....................173
Polish  Rusty Spots  in
       Iron...................281
Pork   that   has  been
       soured...............284
Porridge,  Milk...............66
Poultices, 83, 84, 85, 86, 88,
      93, 96, 98,  99,  100,
      116,157,160,161,165,
                   225,  236
Powder, Baking............251
Powder for the Face.......252
Powder, Sweet's Red......244
Pregnancy,  Costiveness
      in.....................190
    Cramps in..............190
    Diarrhea in............190
    Diseases of.............189
    Enlarged Veins in... 191
    Faintings in...........191
    Heartburn  in.........190
    Incontinence of Urine
      in......................192
    Longings in............191
    Morning Sickness in.189
    Piles in.................190
    Puffy Swellings in...190
    Suppression of Urine
      in.....................192
    Troublesome Itchings
      in.....................190
Preparation for Children
      Teething.............211
Preservation of Sight.....144
Preserve  Iran and  Steel
      from Rust...........281
Prevent Clothes from tak-
      ing Fire.............253
    Hair falling out......258 
INDEX.
331
                      page]
Prevent Rats, etc., from
      working in  Gran-
      ary ..................280
    Sore  Shoulders  in
      Horses...............278
Prevention  of  Cattle
      Plague...............27H
    of Sun-stroke.........114
    of Scarlet Fever......220
Profuse Menstruation.....184
Prostration, General......200
    in Acute Diseases....101
Protect a Roof from Five.277
Publisher's Address..........6
Puerperal Convulsions.... 195
Puffy Swellings in Preg-
       nancy ................190
Pulmonary Catarrh.........90
Pure Air for the Convales-
       cent.....................58
Putrid Sore Throat..........88
Putrid Symptoms in Acute
       Diseases.............101
Quince AVine..................63
Quinsy..........................87
Rut?, to Exterminate......280
Patties........................223
Razor  Paste.................282
Recipes, Valuable.........243
Red Ants,  to remove......269
Red Gum.....................205
Red Powder, Sweet's......244
Redding's Russia Salve...250
Reduce Fat,..................257
Refrigerants................237
Regularity of Bowels with
       Convalescents........50
Relaxing Liniments.......151
Remedy  for  the  Peach
       Borer.................277
Remittent Fever,  Infan-
       tile....................218
Remove Black Ants.......268
    Bugs,  etc.,   from
       Vines.................207
    Cockroaches............267
    Fruit Stains on Lin-
       en.....................-21f
    Granulations  from
       Lids...................143
    Crease Spots..........259
    Iron and  Lime from
       the Eyes.............143
    Lice on Fowls.........266
    Mildew from  Furni-
       ture...................282
    Red Ants...............269
                       PAGE
Rennet Whey.................68
Restlessness in Acute Dis-
      eases.......,.........101
Restorative  Injection  of
      Eggs...................65
Rheumatism, Chronic.....149
    Inflammatory...........98
    Linimeuts for.........150
Rice..............................57
Rice Gruel.....................64
Rice AVater....................61
Rickets........................215
Rings from Swollen  Fin-
      gers ..................256
Roofs,  to  protect  from
      Fire..................277
Rooms, how to Ventilate..33
Rowand's Tonic Mixture.2-30
Rules adapted to Child-
       hood..................208
     to the Infant State...207
     to be observed  with
       Diet.....................28
     to Preserve Sight.....144
     for  Management  of
       Children.............205
     of the Child............205
     for  Management  of
      Infants...............205
Rupture......................167
     at Navel................205
 Rush  of  Blood  to  thc
       Head..................174
 Ruspini's   feuptio   for
       Bleeding;............251
                       PAOl
Seven Yeats' Itch..........262
Shampoo  Liquid  for the
      Hair..................248
Sialagogues..................237
Sick, changing Clothes of..47
    Cookery for the.........60
    Diet for the..............54
    Headache...............127
  •  AVater for the...........56
Sick-room, Cleanliness in.46
    Darkening the.........48
    No Cooking in..........47
    No Food in...............47
    No Noise in.............47
    Order in.................46
    Perfumed Vinegar for.63
    Temperature of.........46
    Ventilation of..........45
Sickness,  Milk.............125
    Morning  ...............189
Sight, rules to preserve...144
    Weak....................144
Simple cure for Croup....262
Skin, disease  by inatten-
       tion  to................18
    Dropsy  of..............110
    Functions of............14
    Inattentions to.........17
    Management  of........20
Sleep in Acute Diseases...101
Sleeping in close Rooms,
      Dangers of............32
Slippery Elm,Custard......69
Small-pox.....................81
Sii utiles.......................214
Russia Salve, Redding's..250!Snuffs.............127, 146,237
Rust, to preserve Iron and
Catarrh................146
      Steel  lioin...........281 Soap, to boil Clothes in...281
Rusty Spots on Iron, to        Labor-saving..........252
      Polish................281 Soft Nails, to harden.. .  .259
                           Soft-shelled Eggs..........265
Sago Gruel.....................65 Soften Hard AVater.......282
Saliva, use of..................221 Solid Animal Food..........58
Salt-rheum...................162! Sore Eyes of Infants......°12
Salve, Dalley's..............2511 Sore Mouth and Throat in
    for Old Sores..........24
    Healing................245
    Pettit's Eye............250
    Redding's  Russia....250
Scald  Head............163,259
Scalding Urine.............121
Scalds and Burns.........253
Scarlet Fever...............219
    Preventive of.........220
Sciatic Neuralgia..........259
Scours, to cure..............284
Scrofula......................156
Sedatives, 101,  142, 197, 220,
                       237
Rings from  Swollen
  Fingers...............256 Selection of Food............29
Stains from  Furni-
  ture...................2821 Self-
Wireworms............266 ■
Selection of Spectacles...
     ealing  Envelopes,
      Glue for..............255
          Acute Diseases....100
    Sore Mouth, Nursing......198
    Sore Nipples.................192
    Sore Shoulders in Horses,
          to prevent...........273
    Sore  Throat...................87
        Putrid.....................88
    Soreness of Navel.........205
    Soup,  vegetable..............68
    Soups, Broths, etc., as Dict.24
    Spasm of the Glottis......223
    Specks  on Nails, to  re-
          move ..................260
    Spectacles, to select.......145
    Spinal Disease...............151
1451 Spine, Disease of............151
    Spitting of Blood....129, 247
    Spleen,  enlarged...........148 
332
INDEX.
 a                     PAGK
 Spots on Iron, to polish...281
 Sprains.......................248
 Sprains  and Bruises......249
 St. Anthony's Fire..........81
 St. Vitus's Dance..........226
 Stains on Furniture,  to
       remove...............282
     on Linen, to remove.278
 Starvation...................172
 Stiffness of  Joints.........150
 Stimulants,   Internal,   101,
       108,111,119,120,123,
       124,125,126,141, J.67,
          201, 217, 221, 238
     External, 78, 87, 89, 92.
       101,115,149,150,155^
       162,189, 197, 200, 239
 Stomach, Bleeding from.,130
     Inflammation of........93
     Pain in, in Acute Dis-
       eases ..................99
 Stools, green.................214
 Stretches in Sheep.........260
 Stunning, from blows......167
 Styptic, to stop Bleeding.251
 Styptics  ......................220
 Sudorifics....74,  98, 218, 232
 Suet Drink....................68
 Suffocation from burning
       Charcoal.............171
     from Drowning.......168
     from Hanging.........171
     from Noxious Vapors 171
 Summer   Complaint   of
       Children.............217
 Sunstroke.....................113
     Prevention of.........114
 Suppressed Menstruation 181
Suppression  of Lochia....193
     of Urine  in  Acute
      Diseases.............100
     in Pregnancy.........192
Surface, bathing  the........17
Sweats, Night...............142
Sweet's Red  Powder.......244
Swelling in Stomach and
      Bowels  in  Acute
      Diseases...............99
Swooning......................118
 Symptoms occurring  in
      Acute Diseases......99
 as,  Dark Furon Teeth....101
     Dark-furred Tongue.101
     Delirium..................99
     Diarrhea................101
     Drum-like   swelling
      of Belly.............101
     Great Debility.........101
     Mortification   of
       Mouth................100
    Nausea...................99
    Pain in  Stomach and
      Bowels.................99
 symptoms  occurring  in
       Acute  Diseases,
 as, Prostration............101
     Putrid Symptoms.....101
     Restlessness...........101
     Severe Pain in  Head..99
     Sleep or Coma.........101
     Sore   Mouth  and
      Throat................100
     Suppression of Urine 100
     Swelling in Stomach
      and Bowels...........99
     Troublesome Cough.,100
     Tympanitis............101
     Vomiting................99
     Wakefulness...........101
 Symptoms of Disease, un-
      favorable.....,........49
 Syrup for Bronchitis......255
     for the Blood..........262

 Tapioca Jelly.................69
 Tea..............................56
     Beef.......................66
     Bran......................61
     Flaxseed..................04
     Mutton...................67
     Veal......................07
 Teas, Herb...............56, 60
 Teething.....................210
 Tell your  wife..............286
 Temperature  of   Sick-
       room...................46
 Tents for the AVomb........183
 Tetter..........................102
 The Duties of a Nurse......44
The Importance of a good
      Nurse..................35
Throat. Sore..............87, 88
Thrush........................213
     AVhite....................213
Tincture, Golden............243
To check the Flow of Milk.240
To   clean  white  Kid
      Gloves................481
To cure Black Leg.........268
     Bloody Murrain......268
     Cattle Plague.........271
     Corns...................268
     Drunkenness .........248
     Fever and Ague, 76, 246
     Fistula  in Horses,  268,
                       270
     Galls on  Horses......266
     Gapes in Chickens...265
     Grub in Sheep........266
    Grubs in Horses......266
    Hams ...„..............278
    Heaves  in  Horses...268
    Hog Cholera...........269
    Hoven in Cattle......266
    Poll Evil...............268
    Stretches ,in Sheep...266
                       PAO«
To cure the Pip in Poultry 266
     the Scours..............284
     Warts....................268
To cut Glass.................282
To  drive away Bed-bugs
       and Fleas............283
     Flies.....................267
To exterminate Rats......280
To  fasten  Leather  upon
       Metal................282
To give Horses an Appe-
       tite....................284
To harden the Nails when
       too soft...............259
To Heads of Families.....242
To keep from Drowning..173
To make a  Balky Horse
       pull...................278
To paste Paper on Tin....255
To Polish Rusty Spots on
       Iron..................281
To preserve Iron and Steel
       from  Rust...........281
To prevent  Clothes from
       taking Fire.........253
 *   Hair,  from  falling
       out.....................253
     Horses  from  being
       teased by Flies....285
     Rats and Mice  from
       working   in   the
       Granary.............280
     Sore  Shoulders  in
       working Horses...278
To protect a Roof  from
       Fire...................277
To reduce Fat...............257
To remove Black Ants...208
     Bugs from Vines.....267
     Cockroaches..........267
     Freckles ...............249
     Fruit stains on Linen 278
     Granulations  from
       Eyelids..............143
     Grease  Spots..........25')
     Lice on  Fowls.........266
     Mildew  on  Furni-
       ture...................282
     Particles of Iron and
       Lime from the Eye.143
     Red Ants...............269
     Rings  from swollen
       Fingers..............256
     Stains  from Furni-
       ture...................282
     AVhite  Specks  from
       the Nails............260
     Wire  Worms..........206
To restore Sour Pork......284
To rid Chickens and  Hens
      of Lice...............285
To select Spectacles......145
To Hoftcn Hard Water....282 
INDEX.
333
                      PAGE
To stop Bleeding...........251
To stop Mortification......161
To write upon Zinc Labels 269
Toast,  Milk....................68
Toast,  Water.............56, 02
Tobacco Chewers...........253
Tobacco, Remarks on......138
Tongue, dark-furred,  in
       Fevers,  etc..........101
Tonic  Astringents,  85,  86,
      100, 108,112,142, 147,
          212, 217,  225, 226
Tonic Bitters for Ague..76, 77
Tonic Mixture, Rowands.250
Tonics, 76, 77, 79, 80, 81, 82,
      94, 108,  112, 114, 121,
       122, 125,134,135,141,
       142, 147,148,149,155.
       181, 182, 185,187, 188',
       189,194,214,  216, 218,
                   219,  239
Toothache.....................245
Treatment  of  diseases,
       General...............70
Troublesome   Cough  in
       Acute Diseases....100
Troublesome Itchings, in
       Pregnancy..........190
Turn of Life.................185
Twigg's Hair Restorative.260
Tympanitis in  Acute Dis-
     .  eases.................101
Typhoid Fever...............80
Typhoid Lung Fever........92
Typhus Fever......„.........79

Ulceration   of Eyelids,
       wash for.............143
Unfavorable Symptoms of
       Disease ...............49
Urine, Bloody...............130
     High-colored..........121
     Inability  to Hold, 225,
                       262
     Incontinence of,  in
       Pregnancy..........192
     Involuntary   dis-
       charge of............225
                       PAGK
Urine, Scalding............121
    Suppression of........100
    in Pregnancy.........192
Use of Gastric Juice........23
Use of Saliva.................22
Uterine Tonics, 181, 182,185


Valuable Recipes..........243
Veal Tea........................67
Vegetable Diet..........29, 57
    Soup.......................68
Veins, enlarged in Preg-
       nancy................191
Ventilate Rooms, how to...33
Ventilation necessary for
       Health.................31
    of the Sick-room.......45
Vermifuges......216,217, 240
Vinegar,  perfumed  for
       Sick-rooms............63
    Whey.....................69
Vines, to remove Bugs
      • from..................267
Vomiting.....................121
    in Acute Diseases......99
    in Pregnancy.........189
    of Blood................130

AVakefulness  in  Acute
       Diseases.............101
Warts...................164, 268
AVash  for ulceration  of
       Eyelids..............143
AVash to remove Freckles.249
Washes, 78, 82 ,83, 84, 85, 86,
       87, 99,  107, 143, 163,
       173,174,198,212,213,
                   221, 234
Water,  Apple.................63
    Barley...................61
    Brash....................120
    Chicken..................67
    for the Sick.............56
    Gruel.....................64
    Rice........................61
    to soften when Hard.282
    Toast.................56, 62
                      PAGB
Weak Sight..................144
AVeakly Females, for......249
Weakness in the Back....188
Weakness, Nervous........200
What constitutes a good
      Nurse..................39
What to do with diseased
      Cattle.................272
What young Girls should
      know..................179
Where Chyie is formed.....27
Where Chyme is formed...23
Whey, Alum..................69
    Mustard..................69
    Rennet....................68
    Vinegar..................69
White  Kid  Gloves,  to
      clean..................281
White Swelling.............159
White Thrush...............213
Whites.........................187
Whitlow......................246
Who make the best Nurses.36
Wind Colic...................119
    in Children............214
Windpipe, foreign bodies
      in.....................168
    Inflammation of...88,  90
Wine, Quince.................63
Winter Fever.................92
Winter Rules...............263
Wireworms, to remov*....266
Wistar's Balsam of Wild
      Cherry...............250
Woman and herDiseases.175
Womb, Inflammation of...193
    Falling of...............183
Worms..................216, 241

Yellow Fever..................79
    Gum.....................205
Young Girls, exposure of
      to  Cold.................13
    what  they  should
      know..................179

Zinc Labels, Ink to write
      upon...................269
THE END. 
I 
             CHRONIC   DISEASES.
                                     AS

Liver Complaint, Scrofula, Rheumatism, Dyspepsia, Fistula, Deafness, Diseases off
         the Eyes, Dropsy, Consumption, Gravel, Kidney Diseases, and
                      all the Diseases of Women, etc.,
                ARE ESPECIALLY  TREATED
                                     BY

                     JOHN  KING,  M. D.,

              No.  245  West Court  Street, Cincinnati, Ohio.
  N. B. All letters for advice, containing a return postage stamp, will be promptly at-
tended to.  Patients from abroad, when required to remain in the city for a short time, can
have good boarding places procured.
NOTICES  AND   RECOMMENDATIONS.
  I have carefully examined Prof. King's "American Family Physician," and pronounce
t the best work of the kind now extant; and if the principles and practice are applied aa
.aid down, it will bo promotive of a vast amount of public good.
  Cleveland, Ind., July 7th, 18G0.                           A. B. BUNDY,  M. D.
                         [From the Evangelical Republican.']
  Dr. King's "American  Physician,"  ok  "Domestic Guide to  Health."—This is  one
among the multitudinous publications of the day that is richly worth a careful perusal by
every lover, not only of health, the greatest gift which a beneficent Providence can bestow,
but of truth, reason, virtue, and temperance.  It is what its title imports, a veritable, infal-
lible "Guide to Health," and as such can not fail to prove invaluable to every family.
                 [From the Hamilton, C. W., Semi-weekly Spectator.]
  A Useful Book for Families.—We have before us the "American Family Physician,"
a work by Professor King, of  Cincinnati, Ohio.  There is probably no work that has yet
appeared, containing as much useful information in relation to health and disease, as the
ono before us.   It would be too tedious a task to mention the many excellencies of the
work.  Though scientific in every sense, it is free from technicality and professional ob-
scurity, enabling those of the most common intellectual capacity to fully understand it.
There is no reasonable person who will pretend to deny the utility of a good, thorough, and
reliable domestic medicgl work, treating upon health and disease; the best means of pro-
moting one and eradicating the other.   There is no subject of which £he great mass of
people are as little informed as on the laws  that  govern health and disease:  and all,
too, will acknowledge that it is a matter of the greatest importance.  There is no reason
why a knowledge of the plain laws of health, of the true remedies for disease, should be
confined to the " Doctor;" and we ere confident that it would be better, both for the phy-
aician and patient, were  this subject more fully understood by  the people. For, as the
author has truthfully said, " How often is it the case that a total ignorance of matters
relating to health, and long life, and a constant timidity, together with bad  management
iu nursing, are the causes of false charges against the physician, and of the death of the
patient 1"  From the  success  that has already been met with by the agents who are now
canvassing this  section of  Canada, for  the above work,  we are confident that  it will be
gladly received by the public.  It has only to be seen and examined to be appreciated.  It
w sold only by subscription, and can not be had at the book-stores.  We would advise all,
but especially our country friends, to give  the Look a thorough examination when the
n^out calls.                           ------
                           [From the Pittsburg Chronicle]
  Here ia a book of sterling and  practical value, and one which is  destined to supply a
want long felt in the community. *  * *  Its main object is to afford  a complete, judi-
cious, and reliable system of medical application to those who may live at a distance from
the doctor, or who may not wish to call him in on every slight occasion happening in the
family.  It contains a vast amount of useful knowledge, written in plain, common sense
language, and free from mystifying terms of art and useless references and quotations.   It
tells  you,  with  admirable  exactness and precision, what iiils the patient; describes  hia
symptoms so aa to enable him to fix his complaint, and ilion gives you the best and most
prudent remedy.  Dr. King's extended reputation  u* a »iife, judicious, and experienced 
 £mlw« »S.° £    ^ J1? b^n la,rgely eng&ged >° ^ education of physicians, is the bcri
 ft»^  a whlc£-cou.ld be offered that this look, which ia the matured product of all hi*
 study and practice is one worfhy of confidence.  *  *  *  Taken altogether, we consider
 *J??°v,* i™0-8t "8eful  compendium of practical medical information ever published,
 and it should be m the hands of every man of family.


                          [From the Muncie, Ind., Journal.]
  We have examined the work carefully, and pronounce it the very best of the kind ever
 offered to the public.  Prof. King's name stands very high, indeed, as a physician;  and for
 a complete knowledge of the diseases of women and children, and a thorough, comprehen-
 sive, and yet simple and easily understood style of writing, he certainly is not surpassed
 if equaled, in America or in Eu/ope.  To all who have families, or who are likely to have,
 we say BUY  IT!  BUY  IT 1! BUY IT 11!


                           [From the Indianapolis Journal.]
  *  *  * As to its origin, it comes from one who certainly stands at the  head of thc
 medical profession in the West.   John King, M. D., and Professor of Medicine, Cincinnati,
 is a man of more than twenty years' experience in the healing art, and stands pre-eminent
 as an educator in the same.  The book deserves much credit for its simplicity of style.  It
 is not written for the purpose of scientific display, but for the good of the people.   It goes
 further toward redeeming those practical facts contained in medical science from the dead
 masses of technical lumber, by which they have heretofore been secluded  from the com-
 prehension of those who have the best right to understand them, than any work extant
 which it has been our privilege to review.  Any man of common sense may *  * * fully
 understand it; and by a still further application of his mother wit, may successfully treat
 almost all forms of disease peculiar to this country, and thereby save much of his hard earn-
 ings.  *  *  *  We commend it to the people generally.

                   [From Dr. G. M. Thompson, Agent for Kansas.]
  Tell Dr. King that I have had the pleasure of selling a copy of his " Physician "  to Ex-
 Governor C. Robinson, Ex-Governor F. P. Stanton, Ex-Governor AVilson Shannon, and all
 the principal men  in the Territory, as far as  I have been able to canvass.

                        [From the Richmond, Ind., Broadaxe.]
  We have looked over the work, and are induced to believe, from its full and comprehen-
sive materials, that it is altogether the best work yet published of this character, and will
entirely supersede the old works of a similar character.

                          [From Prof. A. J. Howe, M. D.]
  I am acquainted  with all the works on Domestic Medicine of any account, and unhesi-
tatingly pronounce " King's American Family Physician "  the best.
  Cincinnati, 0., 1860.                A. Jackson Howe, M. D., Professor-of Surgery.
A GK N T S   WANT K D
  We have opened a Subscription Book Publishing House in this city, and are prepared
to give an unusual opportunity to good, worthy men.  AVe are conducting our business
upon entirely new principles, and from the success  that has thus far attended our efforts,
we feel confident in saying that our Agents are selling more dollars' worth of good and val-
uable books, than any other equal number of men similarly engaged in the United States.
A long, practical experience during the past several years, in various parts of thc country,
enables us to know what kind of books the people want.   And, aa the substance of which
our books are composed ia prepared under the supervision  of one of our firm, expressly for
our publication, we will  stake our reputation in saying that our books will give the people
oetter satisfaction than those  from any other establishment in the country.  Another new
feature in the business will  be found  in the style and durability of the binding.  People
have become go disgusted with the rotten and spongy material used by those who emboss
their binding, that we have resolved to put up our books  in a plain and substantial man-
ner, without covering or co/icealing the quality  of the material with either coloring or
paste, and which will enable every one, whether acquainted with bookbinding or not, to
understand at once the exact  kind  and character of the material used.  This seems to b«
very necessary, especially since there has been so much deception in  the quality of what
is styled "fancy binding."  Those who are desirous of engaging in a  profitable business,
will find it to their interest to call upon, or address,
                                                  A. D. STREIGHT,
                        N. E. corner Washington and Meridian Sts., Indianapolis, Ind. 
 

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