C. HERING'S J f/30 -/ DOMESTIC PHYSICIAN. REVISED, WITH ADDITIONS FROM THE AUTHOR'S MANUSCRIPT SEVENTH GERMAN EDITION, CONTAINING ALSO A TABULAR INDEX OF THE MEDICINES AND THE DISEASES IN WHICH THEY ARE USED. FIFTH AMERICAN EDITION. PHILADELPHIA: PUBLISHED BY RADEMACHER & SHEEK, 239 ARCH STREET. BOSTON: OTIS CLAP&.23 SHOOL ST. PITTSBURGH : J. G. BACKOFEN. 18 5 1. Entered according to Act of Congress, in the year 1850, by CONSTANTIN HERING, M. D., in the clerk's office of the eastern district of Pennsylvania. The medicines prepared by Rademacher & Sheek and neatly put up in cases to suit the Domestic Physician are genuine, and altogether worthy of confidence. Philadelphia, March 1st 1848. C. HERING. W. WILLIAMSON. <5*D PRINTED BY KING & BAIRD, 9 SANSOM STREET. INTRODUCTION. This book is designed as a guide, by the aid of which a cure may be effected, in many cases of disease, with homoeopathic medi- cines. It offers itself to those whom experience has convinced of the inestimable advantages of the new system of Hahnemann, with the familiarity of an old friend; and claims from those who have had no opportunity of testing its merits a candid consideration of its worth. It is intended to be an adviser, to which parents may refer in most cases of indisposition in their families, and which will obviate the necessity of consulting a physician on every trifling occasion. To persons living in remote parts of the country, it will prove par- ticularly valuable—as medical aid, especially at night, is procured not unfrequently with much trouble, expense and delay; but, with this guide at hand, relief can be obtained in most of the ordinary cases of disease. As this work is intended for the great mass of the community, and to make the homoeopathic doctrines intelligible and useful to all, the author has tried to express himself with distinctness and simplicity throughout, in order to be generally comprehended. All being subject to disease, the author has endeavored, in this common- place, familiar style, to enable every one, to a certain extent, to prescribe for himself. But a familiarity with the contents of this book can make no one a homoeopathic physician. It has been said by the opponents of our doctrine, that an acquaintance with the old system of medicine was unnecessary to a homoeopathic physician: but this is a great error. No one can be a successful disciple of Hahnemann, who is not well versed, as Hahnemann himself was, in the learning of the medical schools; and it would be just as impos- sible for him to act judiciously without a knowledge of anatomy, IV ' DIRECTIONS FOR PRESCRIBING. physiology, pathology, surgery, and materia medica, together with chemistry and botany, as for a man ignorant of navigation and sea- manship to carry a vessel with safety into port. If, in giving this work to the public, the author can aid in driving from common use the so-called domestic remedies, such as chamo- mile/catnep, hoarhound and other teas, paregoric, glauber-salts, magnesia, and the whole host of such-like trash, including all the nostrums or patent-medicines, some of which are to be found in almost every nursery, and the habitual use of which is such a pro- lific cause of the almost innumerable drug-diseases, he will have accomplished the chief object of its publication, and have substituted for this irrational and pernicious practice one much more judicious and rational. Directions for Prescribing. Examine the table of contents, until you find the chapter where the complaint is spoken of for which you wish to have advice. Do not look for the common name only, which may be given to such a complaint by the Old-school Doctors. Most of these names are calculated to mislead; but look for the principal symptoms of which the patient complains. In order to facilitate this as much as pos- sible the work is divided into two parts; the first treats of the most common causes of disease; the second, of diseases occurring most frequently in the different parts of the body. Therefore, when the cause of sickness is obvious, or probable, firs* examine what is said of it Part I.; then see what is said of the disease in Part II. The latter are treated of in regular succession, commencing with the head, neck, breast, and so on downward, enumerating under each head the diseases to which that part is principally subject, and con- cluding with General Diseases. By bearing this arrangement in mind, the reader will readily find what he may desire. Suppose a case of cold, attended with headache and diarrhoea; look first for "Cold» in the first part chapter second, then for "Headache" in the second part, chapter first; then for « Diarrhoea" in the same, chapter tenth. If a person is taken sick, and the direct cause be not perceptible, but the pa- tient complains of pains in various parts of the body, examine the ADMINISTRATION OF THE MEDICINES, ETC. T affections to which these several parts are subject; thus you will readily find the remedy applicable. When the patient is ill, and appears to suffer from several com- plaints at the same time, it is well to ascertain and note down all the symptoms, without referring to the book, lest the patient ima- gines, as sometimes happens, something different from what is really the case, and thereby lead to the application of an improper remedy. Having thus noted accurately the complaints of the pa- tient, then inquire minutely into all the attending circumstances. 1st. The precise locality of the pain. 2d. Require of the patient a description of the pain, and to what it may be compared—whether tearing, cutting, beating, throbbing, &c. 3d. The occasion of its getting worse or better, according to the time of day—morning, evening or night—to the weather, whether damp, cold or dry—to the position of the body, whether still, or in motion—whether be- fore or after eating—after sleep, when touched, pressed, &c. 4th. Note the combination of symptoms, if any, for instance, when coughing is accompanied with headache; or headache with incli- nation to vomit; or with this inclination, shivering, &c. Having written down these observations, then look into the book for the principal symptoms and you may find the proper remedy. Do not be discouraged because of the difficulties experienced at first, in finding a suitable remedy, as these difficulties will vanish as soon as you become familiar with the book. Administration of the Medicines and Repetition of Doses. The medicines may either be.administered dry, by placing them upon the tongue, or dissolved in water. In all ordinary complaints, such as headache, toothache, belly- ache, slight affections of the chest, or foul stomach, sickness accom- panied with vomiting, &c, two or three globules of the proper reme- dies should be put on the tongue. In more dangerous cases, or in diseases of long standing, when much medicine has already been taken, and the system injured, and the globules do not answer—the appropriate medicines should be administered in water. For this purpose take a clean tumbler VI REGIMEN OF THE SICK which has contained nothing but milk or water, else you must rinse it first with cold and afterwards with hot water, dry and heat it on a stove as much as the glass will bear, and then suffer it to cool. Half fill it with pure water, or as pure as you can get it, put eight or ten globules—or if the tinctures are used, one to three drops—of the medicine into the water and mix it thoroughly. When thus prepared, a tablespoonful to adults, or a teaspoonful to children may be given at a time. In violent cases the medicine may be repeated every one, two or three hours; but in chronic com- plaint, or those of long standing, not oftener than once or twice a day. When the patient, after taking medicine, begins to feel better, however little, he should discontinue it, lest the healthful progress of the cure be interfered with by taking too much; but as soon as the convalescence ceases the same medicine should be taken again; or in case his symptoms have altered, another more appropriate one. Sometimes the medicine aggravates the symptoms, and makes the patient temporarily worse, which is, nevertheless, a good sign. In such cases, the patient should cease taking it, and wait for the effects. Should the aggravation be violent, it may be relieved by smelling camphor. If the beneficial effects of the medicine be in- terrupted, or cease entirely, and the patient grow worse, in conse- quence of taking cold, eating improper food, &c, he should take a medicine to counteract the cause which occasioned this interruption, and then recur again to the medicine which he had previously taken.« With regard to the external application of the Tinctures of Ar- nica, Ruta, Hypericum, &c, a lotion of sufficient strength for most purposes may be made by putting five or six drops of the tincture in half a tumbler of water. It may be applied to the injured part three or four times a day, or as often as mentioned under each par- ticular case. While taking homoeopathic medicines, strict attention should be paid to the following rules of diet. Regimen of the Sick during Homoeopathic Treatment. The general rule to be observed'is, that patients should partake of light, digestible, nourishing food to satisfy hunger; and of such drink as nature requires to allay thirst; and abstain from every- thing of a medicinal or injurious nature. DURING HOMOEOPATHIC TREATMENT. VII In acute or febrile diseases, only the lightest and most simple kinds of nutriment are proper, viz: Pure cold water in preference to all other drinks ; or water with the addition of some sugar, raspberry or strawberry syrups, or quince and apple jelly prepared without spices. Barley-water, rice- water, thin oatmeal gruel, panada, gum Arabic water, whey, milk and water, preparations of arrow-root, sago, tapioca or the so-called " farina", which is nothing but wheat-grits without the hull; all this without any other seasoning than a little salt or loaf sugar, or one of the syrups above mentioned. Toast-water, provided the toast is made from stale bread, either home-made or from bakers who make use of neither potash, sal- eratus or alum; the slices ought to be thin and thoroughly toasted, but not too brown, and never black. To make a good toast-water pour boiling water on the toast while hot and let it stand. Ice-water is often injurious and increases the thirst. The water, after being filtered if impure, should be cooled if possible without putting the ice in it. If this cannot be conveniently done, put a lump of ice in the water and take it out again as soon as the water is sufficiently cooled. Most kinds of ripe succulent fruits, possessing little or no acidity, fresh or prepared by cooking, and eaten in moderate quantities; as ripe grapes, sweet apples, peaches, raspberries. Most kinds of dried fruits; as apples, quinces, peaches, cherries, prunes, dates, figs, raisins, currants, almonds, &c. All imported dried fruits, especially raisins, figs, &c, ought to be well washed before they are used, first in cold and afterwards in warm water. Sweet oranges with a thick soft peel are allowed, but those having a thin leather-like peel, and all decayed, spotted, and sour ones, ought to be avoided. With regard to apricots, nectarines, plums, gages, watermelons, cantaloupes and cherries, the physician should be consulted. No fruit whatever should be used in cases of colic, diarrhoea, dy- sentery or cholera. When the more violent symptoms of acute disease have subsided, and the appetite calls for more substantial food, a wider range may be gradually taken in the choice of aliment, and all the articles used which are allowed in chronic or long-continued diseases, viz: B VIII REGIMEN OF THE SICK AH kinds of light and not too fresh bread, and plain biscuit con- taining no potash, soda, alum or other similar ingredients; cakes made of meal, eggs, sugar, and a little butter; buckwheat and other cakes not raised with fermenting powders; light puddings and dumplings of wheat, farina, wheat grits, rye, Indian meal, rice, oat- meal or bread, without wines, spices, or rich sauces, hominy, farina, Indian mush, rice, rye mush, groats and pearl barley boiled with water, milk or soup. About using hot corn consult the physician. Potatoes, turnips, carrots, beets, salsify, artichokes, spinach, cab- bage, cauliflower, green peas or beans; and in some cases also, tomatoes, egg-plant, asparagus, squashes, cucumbers, mushrooms, dryed peas, beans, especially lima-beans, lentils, millet, green rye, &c. Milk, raw or boiled, fresh buttermilk, whey, milk posset; but care should be taken not to use milk from cows poisoned with slops from distilleries. Ice-creams with the syrup of strawberries and that of other al- lowed fruits, and not flavoured with aromatics nor coloured with cochineal or other injurious drugs. Pure plain chocolate or cocoa, and in some cases weak black tea. Butter, free from any rancid or unusual taste, cream, cottage cheese, milk cheese, curds, and other simple preparations of milk, plain custards, pure sweet olive oil. Raw or boiled eggs and egg-tea, except in diarrhoea. Soups and broths of animal and vegetable substances elsewhere allowed, seasoned with a little salt only; beef tea, mutton broth, and chicken water after having been boiled for at least half an hour. Beef, mutton, all kinds of tongues, venison and wild game, the lean part of ham, pigeons, chickens and turkeys; the latter only in the winter season and not in all cases. Fresh perch, rock, sea-bass, and small creek fish; salt shad, mackerel and salmon after being well soaked or par-boiled. Oysters, raw, roasted in the shell, or boiled in soup. Salt, and also sugar or molasses, may be used, but always with great moderation. Should any of the allowed articles of diet disagree with the pa- tient, on account of some constitutional peculiarity, or the nature of the disease, they should be avoided by him, though perfectly wholesome for others. DURING H0MCE0PATH1C TREATMENT. IX The patient should not overload his stomach, nor oppress it with various or incongruous dishes. The demands of the appetite for solids are to be satisfied at stated and not too frequent periods, and at no other time. Regularity in the time of eating is of great importance. The diet of children at the breast should not be changed during their sickness; but in such cases, that of the mother should be re- gulated according to the preceding rules. ALIMENT FORBIDDEN, Unless especially allowed by the Physician."1 The flesh of all young animals, and particularly veal; geese, tame ducks; the liver, lungs or tripe of animals, turtles, terrapins, eels, crabs, clambs, old smoked salt meat, sausages, mince-pies, ran- cid butter, strong cheese, lard, fat pork, roast pig, fried oysters. Food prepared from blood and much animal fat. All highly seasoned soups, sauces, drawn butter, pepperpot. Cakes prepared with much fat or with aromatics; pastry, pies, honey, and all kinds of coloured confectionary; all kinds of candies, excepting rock and barley sugar. All kinds of nuts and fruits not mentioned amongst the allowed articles. Vinegar of all kinds, salads or cucumbers prepared with it; pick- les prepared with spices or greened with copper; parsnips, parsley, celery, radishes, horse-radish, garlic onions; all kinds of pepper, catsups, mustard, saffron, nutmeg, ginger, lemon or orange peel, vanilla, laurel-leaves, bitter almonds, peach kernels or peach leaves, cloves, cinnamon, allspice, fennel, aniseed, sage, thyme, mint, &c. All kinds of distilled and fermented liquors; coffee and green tea: lemonade and drinks prepared with acids. All natural and artificial mineral waters. Coloured toys, if the colours are not fixed, are on all occasions to be withheld from children. All perfumery, particularly musk, hartshorn, camphor, baccioli, Cologne water, Eau de Luce, bay rum, or other aromatic waters, flowers used for their odour, cosmetics and tooth-powder must be avoided. Tobacco, if used at all, should be used very moderately. Every medicine, excepting those prescribed by the physician, ought to be avoided; not only all medicines procured at the shops, X REGIMEN OF THE SICK, ETC. and all such as are empirical, but every description of domestic medicines, as all manner of herb teas, syrups, medicated poultices and irritating or medicinal substances applied to the skin. Blood-letting by the lancet, or by leeches and cups, and laxative injections, except those of cold or lukewarm water, are likewise forbidden. The cure is disturbed by cold or hot baths, especially baths im- pregnated with herbs, sulphur, and other medicaments. Linen, cotton, silk or leather, worn next the skin, is preferable to woolens, excepting for persons much exposed to the weather or for little children. The patient should, if possible, use moderate exercise in the open air for an hour or more daily; and his chamber should be well ven- tilated every day. Recovery is frequently dependent on a good moral regimen. Labour, which gives the mind the proper direction to usefulness, while it exercises the body, should be daily used in chronic diseases as far as the strength will allow of it. Homoeopathic medicines should not be taken too soon after eat- ing ; and for about half an hour after taking them the patient had better abstain from eating or the use of tobacco, and, if possible, from much mental or bodily exertion. The medicines are to be kept in a dry and not too warm place, free from odours. LIST OF MEDICINES. * Aeonitum napellus (Aconite). Agaricus muscarius. Alumina. Ammonium carbonicum. Angustura vera. Antimonium crudum. Antimonium crudum. 3. trituration. Arnica montana. Arnica tincture. Arsenicum album. Aurum metallicum. Belladonna. Bichromate of potash. Bromine. Bryonia alba. *■ Calcarea carbonica. Calendula tincture. Camphora. Cannabis sativa. Cantharis. Cantharis tincture. Capsicum annum. i-Carbo vegetabilis. Causticum. Causticum tincture. -Chamomilla. ■China officinalis. Cina. Cinnamomum tincture. Cocculus. Coffea cruda. Colchicum autumnale. - Colocynthis. Conium maculatum. Crocus sativus. Cuprum metallicum. Cuprum metallicum. 1. trituration. Cuprum acetieum. Cuprum acetieum. 3. trituration. Digitalis purpurea. Drosera rotundifolia. Dulcamara. Euphrasia officinalis. Ferrum metallicum. Graphites. Hepar sulphuris calcarea. Hepar sulphuris calc. 3. trituration. Hyoscyamus niger. Hypericum perfoliatum tincture. Ignatia amara. Iodine. Ipecacuanha. Kali carbonicum. Lachesis. Lobelia inflata. Lycopodium. Mercurius sublimatis corrosivus. Mercurius vivus. Mezereum. Natrum muriaticum. Nitri acidum. Nux vomicai. Opium. Petroleum. /Phosphorus. Phosphoric acid. Platina. Pulsatilla. Kheum. ' Khus toxicodendron. Ruta graveolens. Ruta graveolens tincture. Sabina. Sambucus nigr/i. Sanguinaria canadensis. Sassaparilla. Secale cornutum. Senega. Sepiae succus. Silicea. Spigelia anthelmia. Spongia marina tosta. Stannum Staphysagria. Staphysagria tincture. Stramonium. Sulphur. Sulphur. 3. trituration. Symphytum officinalis tincture. Sulphuric acid. Tartarus emeticus. Tartarus emeticus. 1. trituration. Teucrium. Theridion. Urtica urens tincture. •-Veratrum album. Zincum metallicum. #gf For the Antidotes of the above Medicines, their English names, and Diseases used in, see page 485. CONTENTS. Page Introduction............ni Directions for Prescribing.........iv Administration of the Medicines and Repetition of Doses v Regimen of the Sick during homoeopathic Treatment . . . . vi List of Medicines ..........»• xi PART FIRST. OF THE MOST COMMON CAUSES OF DISEASE. CHAPTER I. Affections of the Hind. Sudden Emotions...........* Grief and Sorrow............ 3 Vexation..........•. . 5 Anger.............*> Sensitiveness and Irritability........ . 6 CHAPTER II. Consequences of Colds. Remarks............' Catarrh.............8 Cough.............9 Difficulty of Breathing..........9 Diarrhoea............lu Pain in the Bowels...........10 Headache ............ Affections of the Eyes..........12 " " " Ears..........12 Toothache............13 Sore Throat............13 Nausea and Vomiting..........13 Rheumatic Pains...........14 XIV CONTENTS. CHAPTER III. Consequences of Overheating, immoderate Exertion and great Exhaustion. Page. Overheating............17 Sun-strokes..........• .17 Headache............17 Diarrhoea............18 Fatigue.............18 Sitting up at Night..........19 Confinement and much mental application......20 Loss of Fluids . . . ... . . . . . .22 CHAPTER IV. Consequences of Surfeiting and disordered Stomach. Remarks.............22 Overfeeding of Children......... 24 Headache............25 Vomiting............25 Flatulence ............26 Colic.............26 Diarrhoea............26 Sleeplessness............27 Nightmare............27 Fever.............27 Rash.............27 Indisposition from Ice or cold Water.......27 CHAPTER v. Consequences of spirituous Liquors, Coffee, Tea, Tobacco, Acids, &c. Intoxication............30 Effects of Intoxication..........34 Mania a Potua......... .35 Bad effects of Coffee........ .36 Effects of Tea drinking........ 37 " " smoking Tobacco....... 38 Injurious effects of Acids...... 38 CHAPTER VI. Effects of the Medicines hitherto in general use, and Remedies to counteract these Effects. Remarks...... 0 Effects of Opium or Laudanum .... < n " " Peruvian Bark or Quinine . . ,n " " Magnesia •••••!!!.' 43 CONTENTS. XV Page Effects of Sulphur...........43 " " Mercury...........44 " " Lead...........46 " " Arsenic...........46 " " Iron ...........47 CHAPTER VII. Of Poisoning. Adulteration of Food and Liquors, and how to detect it. Adulteration of Wine..........48 " " Vinegar.........52 " " Beer......... .52 " " Brandy......... .53 " " Sweet OU ........53 " " Milk . . . . .... . .53 " " Butter..........53 " " Flour..........54 " " Bread..........54 Remarks.........• • • .55 Milk............. 56 Meat.............57 Vegetables and Fruits..........58 Mushrooms............58 Kitchen-Salt............59 Kitchen Utensils...........59 Paints.............60 Cosmetics and Washes..........61 Panaceas and Vermifuges.........62 What is to be done in Cases of Poisoning......64 Treatment when the Poison is ascertained......73 Poisonous Gases, their Antidotes and Treatment.....74 Poisoning by mineral and other strong Acids, their Antidotes and Treat- ment ............79 Alkaline Poisons, their Antidotes and Treatment.....80 Other Substances which have a powerful Effect, their Antidotes and Treatment............81 Metallic Substances, their Antidotes and Treatment . . . .83 Vegetable Poisons, their Antidotes and Treatment . . . .85 Animal Poisons, their Antidotes and Treatment.....88 Poison generated by Sickness of any kind......90 Poisoned Wounds...........92 Table of Antidotes to the most powerful Poisons.....98 C XVI CONTENTS. CHAPTER VIII. External Injuries. Concussion, Bruises, Sprains, Dislocations, Fractures, &c. Page Concussion of the Brain.........99 Overlifting............101 Mis-steps.....'.......102 Bruises (Contused Wounds).........102 Bruises of the Eyes..........103 Shocks and Bruises of the Head........103 Sprains.............104 Dislocations, Luxations.........104 Fractures............105 Wounds............ 107 Burns and Scalds...........117 Frozen Limbs...........121 CHAPTER IX. Foreign Substances introduced into the human Body. Into the Eye...........122 " " Ear............123 " " Nose...........124 " " Throat (Oesophagus) . . . . . . . .124 " " Larynx or Windpipe........128 " " Stomach and Intestines........130 " " Skin...........132 PART SECOND. TREATMENT OF DISEASES. CHAPTER I. Affections of the Head. Giddiness, Vertigo....... ,„, Weakness of Memory....... „, Determination of Blood to the Head..... 135 Headache, Cephalalgia...... _„fi " from Determination of Blood to the Head . . ! 136 Causes which lie in the Blood ... 137 caused by Catarrh..... ' 137 Rheumatism ... iqs disordered Stomach and Bowels ... ! 139 Constipation . Sick Headache ... • • • . ld9 Nervous Headache ' " U0 .........142 CONTENTS. XVII Page Headache caused by Suppression of Rheumatism, Gout, &c. . . 147 Loosing the Hair...........148 CHAPTER II. Diseases of the Eyes. General Remarks...........149 Inflammation and Swelling of the Eyelid......150 Sty on the Eyelid...........152 Inflammation of the Eyes (Lritis).......152 Gout affecting the Eyes.........154 Eyes affected by Scrofula.........155 Weakness of Sight, with Remarks on the Use of Spectacles . . 158 Weakness and other Defects of Vision......162 Short-Sightedness..........162 Far-Sightedness...........162 Attacks of Blindness..........162 Shrinking from the Light.........163 Squinting of Children..........163 CHAPTER III. Affections of the Ears. Eruptions.....,......164 Mumps (Parotitis) ..........164 Inflammation in the Ear (Otitis)........165 Earache (Otalgia)...........166 Running of the Ears (Otorrhoea)........168 Buzzing in the Ears . . ........170 Hardness of Hearing.........; 171 CHAPTER IV. Affections of the Nose. Pains and Eruptions..........173 Swelling of the Nose..........173 Bleeding of the Nose (Epistaxis).........174 Polypus of the Nose..........176 Ozoena..............176 Catarrh or Cold in the Head........177 CHAPTER V. Affections of the Chest. Hoarseness............179 Cough.............180 Hooping Cough (Pertussis).........188 Croup (Cynanche Trachealis) . 193 XVIII CONTENTS. Page Congestion of the Chest.........196 Hemorrhage from the Lungs. Spitting of Blood . . • .197 Chronic Inflammation of the Larynx (Chronic Laryngitis. Laryngeal Phthisis) ,..........2°3 Bronchitis (Inflammation of the Bronchia)......204 Palpitation of the Heart.........209 Asthma.............211 Pleurisy. Pleuritis. (Inflammation of the Pleura) .... 215 Pleurodynia. Pseudopleuritis. False Pleurisy. Stitch in the Side . 219 Inflammation of the Lungs (Pneumonia. Pneumonitis) . . . 221 Acute Inflammation of the Lungs......• . 221 Chronic Inflammation of the Lungs.......224 Latent Pneumonia. Peripneumonia Notha ...... 225 Typhoid Inflammation of the Lungs.......227 Consumption of the Lungs.........229 Tubercular Consumption. Pulmonary Consumption .... 229 Contusion or Concussion of the Chest.......231 CHAPTER VI. Affections of the Throat. Sore Throat or Quinsey.........232 CHAPTER VII. Affections of the Teeth. Toothache. Odontalgia.........238 Facial Neuralgia. Tic Douloureux. Prosopalgia..... 253 CHAPTER VIII. Affections of the Mouth. Bad Taste in the Mouth.........256 Offensive Breath......... . 257 Scurvy in the Mouth. Canker of the Mouth. Cancrum Oris . . 258 Inflammation of the Tongue. Glossitis......260 CHAPTER IX. Affections of the Stomach. Want of Appetite . . . . - . . . _ 261 Weakness of the Stomach. Dyspepsia. Indigestion . . . .262 Mucous state of the Stomach .... ' 2fiB Pyrosis. Heartburn. Waterbrash..... ' 267 Nausea and Vomiting..... Sea-Sickness Gastralgia. Spasms in the Stomach ...... 270 ......274 Vomiting of Blood. Hsematemesis CONTENTS. XIX CHAPTER X. Affections of the Alimentary Canal and Urinary and Sexual Organs. Page Colic. Enteralgia...........275 Flatulency............280 Inflammation of the Stomach and Intestines. Gastritis and Enteritis 280 Determination of Blood to the Abdomen.....,. 285 Worms. Helminthiasis..........285 Itching of the Anus..........288 Hemorrhoids, or Piles . .........290 Diarrhoea............294 Dysentery . . . ........ • 299 Cholera Morbus...........302 Asiatic Cholera...........304 Cholerine............308 Constipation............308 Inflammation of the Liver.........313 Acute Inflammation of the Liver. Hepatitis acuta .... 313 Chronic Inflammation of the Liver. Hepatitis chronica . . .316 Jaundice. Icterus . .........317 Inflammation of the Kidney. Nephritis......319 Inflammation of the Bladder. Cystitis......321 Irritability of the Bladder.........324 Urinary Calculus. Stone or Gravel.......325 Discharge from the Urethra.........327 Affections of the Penis. . ........329 Hernia. Rupture...........330 CHAPTER XI. Diseases of Women. Menstruation . . . . ."......333 Tardy Menstruation . ........334 Suppression of the Menses. Amenorrhoea......336 Too Copious Menstruation. Menorrhagia *.....338 Dysmenorrhcea, Painful Menstruation, Menstrual Colic . . . 340 Hysterics. Hysteria..........341 Chlorosis, Green Sickness.........343 Cessation of the Menses.........345 Leucorrhoea. Whites..........346 Prolapsus Uteri. Falling of the Womb......348 Remarks on Pregnancy.........349 Derangements during Pregnancy........350 Menstruation...........351 Vertigo and Headache.........• 351 Morning Sickness...........353 XX CONTENTS. Page Constipation............354 Diarrhoea............355 Pruritus............355 Fainting and Hysteric Fits.........356 Toothache............357 Varicose Veins........... 357 Hemorrhoids or Piles......• . . .359 Pains in the Back and Side during Pregnancy.....359 Cramps.............360 Incontinence of Urine.......... 360 Depression of Spirits . . . ,......360 Miscarriage. Abortion......... 361 Menorrhagia or Flooding.........364 Preparation of the Breasts......... 367 False Pains............367 Labour. Child-Birth..........369 Protracted Labours.......... 370 Spasmodic Pains, Cramps, and Convulsions......372 Treatment after Delivery.........372 Flooding after Delivery.........373 After-Pains............373 Duration of Confinement.........374 Irregularities of the Lochial Discharge......375 Milk Fever............376 Suppressed Secretion of Milk........377 Excessive Secretion of Milk........ 378 Involuntary Emission of Milk....... . 378 Diarrhoea during Confinement........379 Constipation......... t 37g Retention of Urine........ # 379 Sore Nipples........ 380 Gathered Breasts....... 3g0 Falling off of the Hair....... ' 381 The Importance of Mother^ Suckling their Children . . . .382 Choice of a Nurse...... 38o CHAPTER XII. Treatment of Children. Reception at Birth..... Apparent Death...... Washing the Child ......'' !gg Dressing the Navel..... The Meconium .... " Swelling and Elongation of the Head . ' ?!?! Putting the Child to the Breast ••.!.'."' 'JgJ CONTENTS. XXI Page Inflammation of the Eyes.........388 Obstruction of the Nose. " Sniffles." .' . . . • • .389 Sore Mouth. Thrush. Aphthae........389 Jaundice............ 390 Excoriation 391 The Gum.............392 Retention of Urine..........392 Constipation............392 Diarrhoea Colic . 393 394 Swelling of the Breasts.........395 Crying of Infants...........395_ Restlessness and Wakefulness........396 Hiccough............^ Scurf on the Head..........39? Spasms or Convulsions..........397 Dentition............40° Summer complaint. Cholera infantum.......403 Soreness behind the Ears.........405 Running from the Ears. Otorrhcea.......405 Nocturnal Urination. " Wetting the Bed."......406 Rupture of the Navel. Umbilical Hernia......406 HeatSpots. "Prickly Heat."........406 Leucorrhoea of Children.........40' 407 Weaning............. tr • *• . . 408 Vaccination............ CHAPTER XIII. Cutaneous Diseases. Rash.............409 Nettle Rash. Urticaria.........410 Measles-. Rubeola.......... Scarlet Fever. Scarlatina.........415 Scarlet Rash............42° Chicken-Pox. Varicella.........421 Small-Pox. Variola..........422 424 Varioloid........... Erysipelas. St. Anthony's Fire. Rose.......424 Itching of the Skin.......• • -427 Itch. Psora. Scabies........••* Crusta Lactea. Milk-Scab. Milk-Crust . . • • • .429 Scald Head. Tinea Capitis. Ringworm of the Scalp . . • .430 Ringworm. Herpes Circinnatus........ 432 Boil. Furunculus...........433 Carbuncle. Anthrax. Malignant Furunculus.....433 XXII CONTENTS. Page Chilblain. Pernio...........434 Whitlow. Paronychia. Panaris........436 Ulcer.............43r Abscess........• 441 Corns.............443 Warts............. 443 Bed Sores............443 CHAPTER XIV. General Diseases. Gout. Arthritis...........444 Rheumatism. (Rheumatismus.)........445 Acute Rheumatism. (Rheumatismus Acutus.).....445 Chronic Rheumatism. (Rheumatismus Chronicus.) .... 448 Lumbago. (Lumbago Rheumaticus.).......449 Sciatica. (Neuralgia Sciatica.)........450 Crick in the Neck...........450 Cramp in the Limbs..........451 Epilepsy. Epileptic Convulsions . .......451 Night-Mare. Incubus..........452 Sleeplessness...........453 Dropsy. (Hydrops.)..........454 General Dropsy. (Anasarca.) . . . . . . . . 454 Abdominal Dropsy. (Dropsy of the Peritoneum. Ascites.). . . 456 Dropsy of the Chest. (Hydrothorax.).......457 Inflammation of the Brain. Encephalitis......457 Ague. Chills and Fever. Fever and Ague......460 Inflammatory Fever..........470 Typhus, or Nervous Fever.........471 Yellow Fever . .......• . . . 474 Fainting. Swooning. Syncope........475 Apparent Death. Asphyxia......... 476 " " from Hunger........477 " " " a Fall..........477 " " " Suffocation by Hanging, Pressure, Choking . 477 " " " Drowning........478 " " " being frozen. Frost-Bite.....478 " " " Lightning........480 Tetanus . , :.........480 Apoplexy............482 Scrofula............483 Tabular Index of the Remedies used, their English Names, Antidotes and Diseases in which employed . . ... '••"-'■■. 485 PART FIRST. OF THE MOST COMMON CAUSES OF DISEASE. CHAPTER I. AFFECTIONS OF THE MIND. Sudden Emotions. The injurious consequences by which these emotions are often followed may appear immediately, or they may not be manifested for some time after. If the exciting cause be an agreeable surprise, producing pleas- urable sensations, accompanied by great excitement, trembling, fainting, &c, an occurrence happening frequently to women and children, give Coffea. If injurious consequences result from a common fright, caused by a sudden noise, &c, give Opium, if it can be given immedi- ately; but if a half hour, or an hour, should have elapsed, Aconite is preferable. Should the latter, however, produce no effect, give Opium an hour after—then waiting from a half hour to an hour, give both alternately. If the fright was accompanied with great terror, Opium is the best remedy; and afterward, if required, those recommended under "Fear". If the fright was accompanied by vexation, Aconite is a good remedy; if followed by sadness or grief, Ignatia is preferable. If fright is attended by its worst consequences, pains in the forehead, sour vomiting or eructation, weakness and cold perspi- ration, or stupor with internal heat, agitation and heaviness in CHAPTER T. the abdomen, or coldness of the body, with trembling or nervous twitching oppression of the chest, stiffness of the limbs, unnatu- ral sleep with difficulty of breathing, &c, give Opium; if this proves ineffectual, Aconite, which may be repeated every three hours, if necessary. If the fright is followed by twitching of the limbs, or convul- sions, insensibility, momentary blindness, difficulty of breathing, or involuntary evacuations, give Opium; or, if this should have no effect within half an hour, Ignatia. When children have been frightened into^s, and scream, trem- ble, or have twitchings in the arms and legs—if the head is hot, with much perspiration and redness of the face, give Opium; if the desired effect is not produced, give Belladonna; but if they become very pale, Ignatia; if very cold, and they have involun- tary evacuations, give Veratrum. In cases of simple vomiting, or sickness of the stomach, Aco- nite. For simple diarrhoea, caused by sudden mental emotion, give Opium; and if it returns, the patient being excited, Aco- nite. If this proves ineffectual, give Veratrum. For fainting, after a fright, Opium; if the patient becomes cold, sprinkle his face and bathe his feet with cold water; if it returns, let him smell camphor at short intervals. When after a fright there is much determination of blood to the head, give first Opium, if this fails, Aconite, and if it re- turns within 6 or 8 hours, Belladonna. When after a fright a person continues to be greatly agitated, Belladonna will afford relief. If fright or mortification produces derangement of the mind give Belladonna. If this proves insufficient, particularly if the patient is very indifferent, or low spirited, alternating with par- oxysms of laughter, or if he displays much pride an! contempt for others or 1S abated, and fears the approach of death-or when, with females, it is accompanied with a copious menstrual d-harge give Platinum; should the discharg", howTer b trifling, give Pulsatilla. b ' uowever> be If Belladonna has been previously given, and the patient re- AFFECTIONS OF THE MIND. 3 mains much agitated, the least exertion producing trembling and rushing of blood to the head, inability to sleep on account of frightful visions, is worse at night, cannot bear the heat of the bed, wishes to escape, is quarrelsome, complains of his friends and of all about him, give Mercurius vivus. Fear is not unfrequently combined with fright, and the same remedies may be used to which reference has been made under the foregoing head. When children are very timorous, give Aconite in the evening or Belladonna in the morning. For diarrhoea, caused by fear, give Opium or Veratrum—and when the body feels hot and the limbs cold, Pulsatilla. When other symptoms appear, particularly stupefaction, diffi- culty of swallowing, convulsions, laughing when asleep, starting, constant apprehension, a desire to escape, give Hyoscyamxts. Grief and Sorrow. The consequences with which grief and sorrow are attended, are worse than those of other affections of the mind; they either follow soon, and sudden, or they become protracted, if these af- fections are of long continuance. The first may be soon re- moved—the latter not always—and without the proper moral remedy medicines are useless. Whoever cannot find the former, need not expect relief from the latter. For silent, inward grief combined with mortification, for sup- pressed vexation which we cannot quiet, for silent grief caused by misplaced affections, or in consequence of losses which we cannot forget—for something continually preying upon the mind, give Ignatia, which in many cases,, may be continued for a day or two. .^i. When vomiting, sickness of tn^P^mach, or headache and giddiness occur, give also Ignatia; and if this fails, Phosphoric acid. When fits are caused by grief or mortification, give Ignatia first; if this does not relieve, give Opium during the attack, and after it Phosphor iojMcid ; the latter—to be repeated the day after every attack—orj^^it in water every day for a week. When grief is '^Hred by disappointment in love, give Ignatia, 4 CHAPTER I. and after some days, if necessary, Phosphoric acid— particularly when the patient is very quiet, taciturn, or has a slow fever. If the patient is jealous; violent in his motions; quarrelsome or delirious, give Hyoscyamus. If he talk much and discon- nectedly, changing the subject of his conversation abruptly, give Lachesis. When contempt of persons heretofore esteemed is shown in his acts or words, give Platinum. The same if a patient in such a state confesses his temptation to kill such per- sons. After grief and loss of sleep in consequence of watching at the sickbed of dear persons, if headache and nervousness fol- low, give Cocculus; if there be great exhaustion, the patient scarcely able to speak, Phosphoric acid; if entire sleeplessness continuing for many nights, Sulphur. When other kinds of mortification have produced a derange- ment of intellect, give Belladonna; if this fails to relieve, on the following day give Phosphoric acid. In circumstances spoken of under the head "Fright", Mercurius vivus and Platinum may be given. When caused by homesickness, and the patient cannot sleep— is hot and flushed in the face, give Hyoscyamus, and if this should not give sufficient relief within a few days, Capsicum. But if, nevertheless, the patient is evidently wasting away, does not wish to speak, perspires much in the morning, is sleepy and stupid, give Phosphoric acid. When the patient is very weak, trembles, is uneasy, agitated, particularly during the night, is chilly, per- spires during the night, give Mercurius vivus. For protracted effects of grief and sorrow, when the patient is irritable, cross, uneasy, fearful, dejected, anticipating danger, dreads the future, frets anf|^rieves constantly, is sleepy during the day, but cannot rest a*t night, perspires night and day, loses the hair, the voice becomes feeble, give Staphysagria. If he is contemptuous, refuses to speak, is feverish, and loses flesh, give Phosphoric acid. If quarrelsome, obstinate, sensitive, and mani- festing great anxiety, give Mercurius vivus. If the menstrual dis- charges are produced by grief, fright, anxiety or fear, varying much in quantity, give Platinum. id AFFECTIONS OF THE MIND. 5 Vexation. If grief or shame is the consequence of vexation, give Ignatia. If followed by coldness or chills, and the patient remains cross, give Bryonia; should Bryonia not suffice, give Nux vomica. If the vexation is accompanied by just and violent indignation and abhorrence of the occurrence which induced it—if he rejects everything that is offered to him, give Staphysagria; but, in some cases, this medicine will answer only when taken alternate- ly with Colocynth; the latter is to be preferred, when there are pains in the bowels, especially if they occur after meals, or are increased by taking food. Chamomilla generally answers best when the vexation is at- tended with violent fits of anger and great heat. If vexation produces cough, or palpitation of the heart, asthma, spasms in the chest, so that the patient is threatened with suffocation, give Chamomilla. In this case it will be well also, to put the hands for a short time in cold water, and if this fails, to bathe the arms in warm water until he is better. If vexation causes a bitter taste, retching and vomiting of bile, headache, oppression at the heart or stomach, cutting pains in the bowels, diarrhoea, fever with heat and thirst, redness of the face and eyes, agitation, bilious fever or jaundice, give Chamomilla, which may, in some cases, be repeated in from 6 to 12 hours, according to circumstances. If the patient is cold and chilly, give Bryonia, and if it produces no effect in eight hours, give Veratrum. If a person has drunk much chamomile tea, and has afterward been vexed, or if he has taken, improperly, chamomile tea for fever, give Coffea, and if this does not relieve, give Nux vomica. If, after this, pains still remain, give Colocynth. If the patient is naturally of a mild disposition, and Colocynth does not effect a perfect cure, give Pulsatilla. When food or drink, taken immediately after being vexed, produces bad taste, bitter eructations, vomiting of bile, pain in the bowels, heat of the head, uneasiness, disturbed sleep, &c, give Chamomilla once or twice; but if it recurs frequently, and this medicine loses its effect, give Pulsatilla, Nux vomica or Colocynth. 6 CHAPTER I. Anger. When persons of violent temper feel unwell, after having been in a passion, give Nux vomica. If the anger be attended by just indignation, and the person is not of a sanguine tempera- ment, give Staphysagria. If anger and vexation produce mental alienation, give Plati- num. When little children get into so violent a rage as to lose their breath or fall into convulsions, give Chamomilla. If they shriek and weep violently, with frequent attacks of coughing, give Arnica. If they continue to cry and will not be pacified, give Belladonna, and if this fails to relieve, Hepar; the latter medicines but once. Sensitiveness and Irritability. These are causes of indisposition with many persons, who are sensibly affected by the most trifling emotion. If owing to this great sensitiveness there should be inward vexation, sleeplessness, and a disposition to shed tears, at the most trifling and imaginary causes, give Coffea several times. The patient must, of course, abstain from drinking coffee. When there is great irritability of the nervous system, of the organs of sense, agitation, and in- clination to lie down, aversion to fresh air, a stubborn and refrac- tory disposition, and when in females the menstrual periods are irregular, give Nux vomica; but when the patient is tranquil, easily moved to tears, or when the menstrual period is too late with persons of this disposition, and is insufficient or suppressed, give Pulsatilla. If you do not always succeed with this, and the patient is fretful, give Ignatia; if more peevish and passionate still, give Chamomilla. If the patient is greatly excited, forms plans, and is exceedingly lively, particularly in the evening, give China. If the pain is distracting, give Coffea; if this does no good, and the patient has fever and a quick hard pulse, give Aco- nite, and if this fails, to afford relief, give Chamomilla six hours afterward. When persons become flighty or distracted, from excessive pam, and are subject to its recurrence from a change of weather, CONSEQUENCES OF COLDS. 7 or catching cold, and are worse by being touched, give China. Should this prove ineffectual within six hours, give Mercurius vi- vus. If by the pain the affection of the mind is increased to delirium and madness, give Veratrum. CHAPTER II. CONSEQUENCES OF COLDS. The most common results of taking cold are catarrh and cough, sometimes accompanied by fever, colic, diarrhoea, pains in the teeth, ears or limbs. When selecting a medicine, it may be necessary to refer to the chapter where these disorders are more fully treated. Here we shall only mention what is to be done in the most common cases. The first rule to be observed, in order to prevent bad effects from catching cold, is to keep warm, and see that the feet are kept dry; abstain from the use of all spirituous liquors, which almost always aggravate the complaint; and also from animal food and spices, if the cold is already bad. When you feel that you have caught cold, without any decided consequences having yet manifested themselves, take Aconite, or in the evening Nux vomica. Drink a large tumbler of cold water before going to bed, both in winter and summer; cover yourself well and perspire. Either next morning, or before noon, the symptoms will have disappeared. If children cannot be induced to drink water, or when you know from experience that it does not produce perspiration, let them drink milk and water, mixed together in equal quantities, sweetened with sugar, and very warm. Chamomilla, given to females in their confinement, will pro- duce perspiration; if they complain of headache, especially on the right side, occasioned by a draught of cold air,—or of pain in the neck, in consequence of sitting up and being uncovered, give Belladonna; if the pain extends to the shoulders, being 8 CHAPTER II. partly brought on by holding the child, Rhus tox. will remove it; if the pain is more on the left side, is throbbing and shoot- ing, and affects the lower jaw, the arms and the chest, Bryonia will afford relief; but if mostly confined to the temple, the eye, the upper jaw, or to the chest in the region of the heart, Spige- lia should be given. Robust labouring men or women, who, after having overheated themselves, catch cold, may take in the evening, on going to bed, a glass of hot water and sugar with which a small portion of brandy or rum is well mixed. To a person, who, in winter has become quite stiff with cold and wet, give a cup of strong coffee, without milk, and if this should prevent him from sleeping at night, Nux vomica. When perspiration has been checked by taking cold, and it is followed by headache, earache, toothache, or pain in the bowels, give Chamomilla. When a person, perspiring freely, is made wet by a shower of rain, and indisposition follows, give Rhus tox. Should no relief be experienced within ten or twelve hours, and if the patient had previously over-exerted himself, give Bryonia. When in the latter part of summer a sudden change takes place in the weather from hot to cold, and almost everybody complains of having taken cold, Belladonna should be given. If perspiration of the feet has been checked by taking cold or otherwise, heat some bran in an oven, and cover the bottom of a small tub with it to the depth of three or four inches, place your feet upon this and pack the remainder around the legs so as to cover them over the calves. The bran ought to be as hot as it can be borne. Keep the feet in this bran bath for half an hour, and if this does not relieve, take Silicea evening and morn- ing, and if required, once more a week after. When catarrh results from a cold, and the' patient can neither smell nor taste, give Pulsatilla. When the catarrh is accompanied by much heat in the eyes and head and soreness of the nose, give Belladonna. If the nose is entirely stopped up, Nux vomica or Ipecacuanha. CONSEQUENCES OF COLDS. 9 If a catarrh has been checked by fresh exposure to cold, and the symptoms are aggravated in the afternoon, or if the patient is dejected and fretful, give Pulsatilla; if he is worse at night or towards morning, or very cross, sensitive and excited, China. When an eruption has been checked, give Ipecacuanha every two hours, and if that does not avail, give Bryonia once or twice; if this does not relieve, give Pulsatilla ; when the reco- very from catarrh has been impeded by a fresh cold, attended with pain over the eyes, worse on the right side, the face flushed, give Belladonna; if the pain is worse on the left side and the face pale, give Spigelia. Cough. When catarrh is accompanied by cough, or when a dry cough remains after the first symptoms have disappeared under the action of other medicines, give Nux vomica. If the cough is dry and excites vomiting, Ipecacuanha; if it is hollow and causes vomiting, Carbo vegetabilis; if accompanied with tough expec- toration, particularly with children in winter, Chamomilla; if moist, Dulcamara or Pulsatilla; (see cough in part second;) if the cough returns with every blast of cold air, give Phosphoric acid; if it returns every time that a foot or arm is exposed when in bed, and is hollow and fatiguing, give Hepar. When the cough is caused by cold air, is dry and convulsive, with vomiting, or the expectoration is spotted or streaked with blood, if accompanied by a stitch in the side, or by headache, pain under the ribs, or if the cough is caused by a tickling in the throat, and the chest feels sore after it, and when the pulse is hard and quick, give Bryonia ; but when the pulse is not very hard, if there is soreness in the chest after or during the cough, not so much a pricking as a scalding pain, oppression of the chest and palpitation of the heart, give Carbo vegetabilis. Difficulty of Breathing. When taking cold produces difficulty of breathing, and the patient appears as if suffocating, give Ipecacuanha, which may be repeated every half hour or hour if necessary. If not relieved by o IQ CHAPTER II. this, give Arsenicum every hour until the patient is better. Some- times the other remedies prescribed for oppression of the chest are preferable, especially Nux vomica. Diarrhoea. When immediately after taking cold diarrhoea appears, give Opium. If this does no good, or if the diarrhoea does not appear for a day or so after, and it is attended with pain in the bowels, or other symptoms, give Dulcamara. If the diarrhoea is not attended with pain, and continues through the day, or commences in the afternoon, or if it is worse in the day-time and better at night, give Ferrum, but if worse after midnight or towards morning, give Phosphoric acid; if it is pro- duced by eating ice or drinking ice water, look under Part I., Chapter IV. When diarrhoea is caused by taking cold while in a state of perspiration, or by cold bathing, and is accompanied by much heat in the head, preceded by slight pain in the bowels; or if the pit of the stomach and the abdomen are sensitive to pressure, or the stools contain much undigested food, give Bryonia. If the discharges of undigested foot are caused in part, by drinking bad water, and Bryonia proves ineffectual, give China. When the diarrhsea is accompanied by much flatulence, by cutting pains about the naval during the evacuation, much strain- ing and great weakness at the same time, with discharges of mucus and sometimes blood, or if the patient has drunk spir- ituous liquors, give Nux vomica. If there is much blood and mucus discharged, give the reme- dies recommended for dysentery. If it becomes tedious but is not violent, give Sulphur. Pain in the Bowels. If the pain in the bowels is violent, spasmodic, pressing, par- ticularly before evacuations, if the latter are acrid, thin, brownish, and produce burning in the rectum, give China. If the pain in the bowels is violent, tearing, twitching, with a sensation as if the intestines were in motion, so that the patient CONSEQUENCES OF COLDS. 11 cannot remain quiet, but runs about; if it appears to the sufferer, as if a large ball were forming in the side, or as if the whole abdomen were hollow, accompanied by vomiting and sickness at the stomach, the diarrhoea watery, slimy, or greenish, with an odor like bad eggs, give Chamomilla. If the cold is caused by exposure to the evening air, and the diarrhoea is greenish and watery, with much pressure before the discharge, accompanied by a disposition to faint, the pains about the navel are of a pressing nature, below the navel griping, with a constant uneasy sensation, as if to evacuate, rumbling in the belly, griping in the pit of the stomach, tearing pains in the ab- domen, which feels cold, accompanied by nausea, shivering and chills, give Mercurius vivus. If partly caused by a disordered stomach, if the patient has eaten much pork, or rich pastry and the like, if the griping of the bowels is worse in the afternoon, or particularly in the even- ing, or during the night, if the wind rolls about in the stomach, or if the belly is sensitive to pressure, give Pulsatilla. The same to females in the family way, when the pains resemble labour pains. When taking cold produces pains and disposition to cry, great sensitiveness and sleeplessness, give Coffea. When the pains are so violent as to drive the patient almost mad, give Chamomilla. Headache. For violent headache from cold, with determination of blood towards the head, increased by walking or going up stairs, at every step, or in stooping; worse in the draught, with a feeling as if the head would be dissevered, give Belladonna. If the headache is more painful in some particular part than others, with buzzing in the ears, or difficulty of hearing, give Dulcamara. If the headache is caused by a draught of air, and is merely external, give Nux vomica; if internal, give Belladonna; if caused by bathing, and Belladonna does not cure it, if accom- 12 CHAPTER II. panied by nausea and giddiness, disordered stomach, worse when smoking tobacco, give Antimonium crudum. Affections of the Eyes. Affections of the eyes, caused by taking cold, may best be cured by the remedies recommended for "Diseases of the eyes". In general Dulcamara will relieve them. For much pain, heat, inflammation in the eyes, acrid tears and inability to bear the light, give Belladonna, and if this does not cure it, Mercurius virus; if this fails, Hepar. When the pains are less violent, but there is dimness of vision, the patient being unable to read and sees sparks before the eyes, or when the eyes are affected after every cold, give Dulcamara followed by Sulphur. If these fail, or if the patient has taken them already, give Calcarea. Affections of the Ear. These complaints arise frequently from taking cold. If there is constant buzzing in the ears and difficulty of hearing, give Dulcamara; and if not cured, or if it returns again after having left for some weeks, and Dulcamara is no longer efficacious, give Sulphur. If accompanied by violent earache, tearing externally, sting- ing internally, the ear dry, and the patient is peevish, give Cha- momilla, or when there are rending, stinging, aching pains, give Nux vomica; when the mind is more easy, a disposition to cry, the ear moist or running, or very hot and red, and tearing, twitch- ing pains sometimes in the face, give Pulsatilla; or when it tears and stings, with much buzzing, when it is not so hot and red, but is excoriated by matter, or when blood is discharged, when the glands around the ears or of the throat are swelled, give Mercurius vivus, and if that should not effect a complete cure, and the heat, redness and pulsating pain remains, pricking when blow- ing the nose, buzzing and throbbing, give Hepar once. If after the other symptoms are removed, the discharge of matter, the buzzing and burning in the ears still remain, give Sulphur. ' ° CONSEQUENCES OF COLDS. 13 Toothache. Toothache from cold, usually yields to Chamomilla or Rhus tox., see the Chapter on "Toothache", PartII. If these reme- dies, however, should not relieve, give Dulcamara. But if the patient is subject to the toothache whenever he takes cold, he should take a dose of China, and afterwards Sulphur, not of- tener, however, than once a week. Sore Throat. Affections of the throat from cold, will in most cases yield to Belladonna or Dulcamara, but it is necessary to have patience, and await the effect of the medicine. See Part II. When sore throat is caused by drinking cold water, or by ex- posure of the throat, Belladonna is to be preferred; when the cold is general, Dulcamara. When the throat is constantly dry and hot, with frequent efforts at swallowing, much saliva in the mouth, or the tonsils are swollen, and speaking and swallowing are attended with shooting pains; if-the patient hawks much, the swallowing difficult, is in dread of suffocation, the throat seems too narrow, regurgitates what he drinks through the nose, is very hasty, give Belladonna, and if this affords no relief, give Sulphur. When the pains are less violent, the tongue appears paralyzed, there is much perspiration, sometimes offensive, with- out giving any relief, the patient is more quarrelsome, give Dul- camara ; if this fails, give Mercurius vivus, or one of the other remedies prescribed under " Sore Throat" in Part II. Nausea and Vomiting. When these symptoms appear after a cold, particularly when a rash or other eruptions of the skin have been suppressed, they are most readily cured by Ipecacuanha. It may be given, if ne- cessary, every hour, or every two or three hours. If this does not answer, and the vomiting is sour or bitter, with many empty eructations, give Belladonna; if nothing but tough phlegm is thrown up, Dulcamara. If it returns constantly, particularly after exercise, eating, speaking, or when riding, or after sleep, 14 CHAPTER II. give Cocculus. If it returns from every motion of the body, and the patient is, notwithstanding, unable to keep quiet, very weak, thirsty, and unable to partake of drinks, give Arsenicum. See also Chapter IV. Rheumatic Fains. • When such pains result from cold, and the parts affected feel uneasy, so as to require constant change of position, everything feeling as if too hard to rest upon, and the limbs as if be- numbed or strained, the patient apt to complain, even when a person is walking across the room, or is approaching him, give Arnica. But if the pains are attended with fever, give Aconite every three hours until the fever abates; and then, after several hours, give Arnica. In many cases it will be well to give Ar- nica and Aconite alternately, regulating the length of the inter- vals by the increase or decrease of the symptoms. Should they not remedy the evil, refer to what is said under "Rheumatism", Part II. If the pains are worse when lying down, and at night, accom- panied by lameness or coldness of the limbs, with pale swelling or burning in the feet, or with redness and swelling of the big toe, with a stiff neck, the skin very dry, or offensive perspiration which affords no relief, give Dulcamara; and if this no longer affords relief, Mercurius vivus. When the same symptoms return after every cold, with un- easiness at the approach of other persons, or when attempting to swallow; when it is worse while sitting or lying, but better when walking about, with swelling, rending, burning and throbbing pains in the great toe, give Phosphoric acid. If accompanied by swelling of the knees, lumps on the joints of the hands and fingers, give Sulphur, and if that does not answer, Calcarea. When a cold is succeeded by fever, give Aconite. If, after two or three doses, the fever still increases, select one of the fol- lowing medicines, recommended for fevers, unless some other should, from the symptoms, appear more suitable : Nux vom. or Chamomilla ; Belladonna or Dulcamara ; Ignatia or Pulsatilla. CONSEQUENCES OF COLDS. 15 In general, the following medicines answer best in complaints from cold; in acute and inflammatory affections, Coffea, Aconi- tum Chamomilla, Nux vomica, Pulsatilla, Belladonna, Colocyn- this. When less violent, Dulcamara and Ipecacuanha. When tealous and often returning, and the patient has formerly taken too much mercury, Carbo vegetabilis, Sulphur or China. If these do not relieve, Silicea or Hepar. If these affections result from bathing, Antimonium crud. or Sulphur, and if necessary after a few weeks, Carbo vegetabilis or Calcarea. When the patient cannot perspire, Chamomilla or China, Arsenicum or Silicea. When the perspiration is too copious, Mercurius vivus, Phosphoric acid, Carbo vegetabilis, Sulphur, Hepar or Sepia. When a person takes cold very easily, he should abstain from the use of coffee and of all spirituous liquors; use more cold drinks than warm; wash himself frequently in cold water, ^nd accustom himself more and more to the air in every kind ofl^ weather; this custom will gradually diminish the disposition to take cold, and finally remove it entirely, particularly if the patient takes some of the following medicines: Coffea, Bella- donna, Nux vomica, China, Dulcamara; or Silicea, Carbo vege- tabilis, Calcarea. The latter three must not be taken too fre- quently, but only at long intervals. If after using the means recommended above there should be still remaining some predisposition, and the patient is chilled by every draught of cold air, let him take Nux vomica or Chamo- milla. If exposure to cold produces pain, Arsenicum. When the extremities are liable to be frost-bitten, and the patient is not taking any other medicine at the time, let him, before he goes out into the cold, rub himself with spirits of camphor; if he has already chilblains, let him take the remedies prescribed under " Chilblains;" if affected by every blast of cold air, Bryonia or Rhus, Veratrum or Mercurius vivus, and if they do not answer, Carbo vegetabilis or Calcarea, according to circumstances. If he cannot bear the wind, Carbo vegetabilis; if not the draught, Belladonna, Sulphur, Silicea or Calcarea, one after the other, at intervals of five or six weeks. When the night air only is 16 CHAPTER III. injurious, Mercurius vivus will prove beneficial, and after several days have elapsed, Sulphur ; to be followed if necessary by Carbo vegetabilis. If a person feels ill in damp weather, give Dulca- mara, Rhus, or Veratrum, and later Carbo veg. or Calcarea. If it affects the chest, Dulcamara or Carbo veg. *> One who is affected by a thunder-storm, should take Bryonia during the storm, and afterwards Silicea. Sulphur is also recom- mended. If every change of weather aggravates the complaint, give first Mercurius vivus, or Rheum, or Rhus ; and if this does not suf- fice, Sulphur, and later Silicea. When affected by a change from warm to cold, Dulcamara or Rhus; and when from cold to warm, Carbo vegetabilis or Lachesis. ForcpWs occurring in the spring, the remedies most generally indjeated are Veratrum, Rhus and Carbo vegetabilis ; in summer, belladonna, Bryonia and Carbo vegetabilis; in autumn, Vera- trum, Mercurius vivus and Rhus ; in winter, during dry weather Aconitum or Belladonna, Bryonia, Nux vomica, Chamomilla or Sulphur; sometimes Ipecacuanha; but during damp weather, Dulcamara, Veratrum or Carbo vegetabilis. It is, however, necessary to examine closely, under the heads of the different complaints, which remedy is most suitable, as these general remarks are merely intended to guide the patient to which remedy to give the preference in doubtful cases. CHAPTER III. CONSEQUENCES OF OVERHEATING, IMMODERATE EXERTION, AND GREAT EXHAUSTION. After immoderate exertion, great relief will be feltfi om taking a warm bath for half an hour. If the limbs are very painful, or bum, xt W1ilbe removed by rubbing them, whilst in the bath, with spirits of soap. ' CONSEQUENCES OF OVERHEA'J^S} ETC. 17 Overheating. When you have overheated yourself with work in summer, it is well to take a few drops of rum or brandy on sugar, or a small quantity of strong, fiery wine, and refrain from drinking cold water till some time has elapsed. If you are much fatigued, it is advisable to take a cup of weak green tea; if much fatigued in cold weather, and if you have to go out again in the open air, drink cold water or beer ; but if you can remain at home, drink warm mulled beer. Spirituous liquors, when taken in cold weather, only render persons more sensitive to cold, as they will produce a feeling of exhaustion the next day. If a person is easily exhausted in warm weather, let him drink coffee occasionally, but no spirits. When a person, by remaining long in the cold, has brought upon himself a torpid feeling, or an irresistible propensity to sleep, let him take, or frequently smell, a small piece of camphor. Sun-strokes. When a person has exposed his bare head or neck to the rays of the sun, or has slept where the sun has shone upon him, give immediately Aconite, repeating the dose every fifteen minutes till the patient is better, then give Belladonna or Nux vomica. Headache. In cases of severe Headache from heat, accompanied by ful- ness, as if the head would split, worse when stooping, a feeling about the forehead as if the brain were pressing out, increased when walking, and worse from every slight affection of the mind, combined with hot fever, thirst, vomiting and sleeplessness, give Belladonna or Bryonia. If combined with anxiety, uneasiness, rage or great irritation, despondency, fear of things present, lamentation, weeping, &c, give Belladonna. If the sick person is very peevish in the morning, cannot bear his clothes, is more passionate and cross than plaintive and desponding, and is apprehensive of future evil, give Bryonia. If one from being overheated has headache, especially if there be heaviness, throbbing and pressure over the eyes and pains in 18 ' "^ CHAPTER III. the eyes which are aggravated by looking fixedly at anything, give Carbo vegetabilis. When headache is caused by heat or great exertion, while exposed to the sun in summer, or by getting too warm before the fire, or by ironing; when the head feels too full, and there exists a want of appetite, particularly in the morning, with much thirst, fever, trembling, nausea and vomiting, or diarrhoea, give Bryonia. Diarrhoea. In diarrhoea accompanied by fever, caused by excessive heat in summer; and also in colicy pains occasioned by drinking milk, give Bryonia, which may be repeated every three hours. To a person who cannot bear the heat of summer, or cannot work in the heat, particularly when troubled with nocturnal perspiration, who is very sleepy, or suffers from pain in the stomach and abdomen, and where Bryonia does not answer, give Antimonium crudum. If nausea, which is caused by the heat, returns constantly, the remedies prescribed only giving temporary relief, give Silicea. Fatigue. The fatigue after walking a great distance, or after much labour, particularly in summer, is frequently so great that rest does not relieve, but, on the contrary, seems to increase it. If possible, let the sufferer take a warm bath; if that be impracti- cable, let him put his feet into warm water, in which a handful of salt has been thrown. If this does not relieve him, give Cof- fea. A cup of good green tea, not too strong, is also an excellent remedy. Should fatigue produce a sensation of faintness, or actual faint- ing, give Veratrum. For great weakness in consequence of pro- fuse perspiration, give China. If there are symptoms of inter- nal heat, such as a hot breath and quick pulse, give Aconite, and if not relieved by this, Bryonia. If the accelerated circula- tion continues for several days, and the slightest exertion pro- duces a tendency of blood to the head or chest, or if the face is CONSEQUENCES OF OVERHEATING, ETC. 19 flushed, give Mercurius vivus. For soreness in all the limbs, particularly in the muscles, Arnica is the best remedy. If the feet are much swollen, or painful from walking, take Arnica, or wash the feet in water in which some Arnica tincture has been diluted. If the limbs are painful after carrying or lifting something heavy, particularly on moving them, or when at rest, give Rhus; or, especially, when there are shooting pains in the small of the back, on moving, Bryonia; but if it is almost impossible to move the back, on account of excessive pains, give Sulphur. See the remedies for " Overlifting", Part I., Chapter VIII. If a person, who is otherwise in good health, feels tired after the least exertion, even from talking, give Cocculus, and if this does not relieve, Veratrum twice; if this fails also, give Cal- carea. When walking briskly causes loss of breath, or coughing, pain in the side or limbs, give Aconite, if the pain in the side con- tinues, Arnica, and if this does not afford any relief in 12 hours, give Bryonia. If the shortness of breathing continues, or becomes worse by ascending the stairs, attended with coughing and raising of phlegm, give Silicea. Sitting up at Night. This is always debilitating, yet every one should be able to bear it in case of need. If it produces greater weakness than usual, if persons cannot deprive themselves of one hour's sleep, give Cocculus or Phosphoric acid. If sitting up occasions head- ache, or if a person has taken much coffee, wine or spirituous liquors to keep him awake, give Nux vomica before going to bed; if the headache is not caused by spirituous liquors, and the pa- tient is unable to lie down, or has nausea, give Ipecacuanha. If the headache is worse in the evening, but better in the morn- ing, give Pulsatilla. If there is determination of blood to the head or sense of heaviness when moving the eyes, give Nux vo- mica or Pulsatilla; if the symptoms are aggravated in the open 20 CHAPTER III. air, the headache worse when walking, with a booming, shaking sensation, give Nux vomica, to passionate and energetic persons; and the same remedy, if the head feels heavy as if the patient were intoxicated, buzzing and heaviness in the forehead, pale, haggard countenance, feels nausea, is chilly, weak and cross. When the head feels as if empty and light, the patient can- not bear the light, is better in the open air, worse when lying down, give Pulsatilla, particularly to mild persons. When the head trembles, is light, the face flushed, blue circles around the eyes, the mouth perfectly dry, without thirst, loath- ing of food, nausea to fainting, fulness of the stomach, oppressed breathing, if worse in the air, from speaking or drinking of cof- fee, if the patient is very sad and troubled by frightful dreams, give Cocculus; if he is greatly excited in the evening, does not sleep well, is weary when rising, China; if he complain of feel- ing sore all over, Arnica. The effects of late hours and overindulgence, may be counter- acted by Pulsatilla or Nux vom lea, according to the above in- dications, or by Carbo vegetabilis; see "Consequences of Intoxi- cation". Confinement and much Mental Application. If the confinement produces symptoms of Dyspepsia, and if the patient has been accustomed to drink coffee or spirituous li- quors, Nux vomica, taken in the evening, will often have a good effect; if after four or five days it gets worse again, give Sul- phur, which may by repeated in 3 or 4 weeks if necessary. When the head is more affected, Nux vomica is a good remedy, and afterwards Belladonna, sometimes Pulsatilla. See "Head- ache".—If all these medicines prove ineffectual, and if every exertion of the mind causes headache, give Calcarea. If there is merely a sensation of giddiness or intoxication, give to a person of a sanguine temperament, Pulsatilla. Toothache, cough, and other complaints caused by mental application, yield to Nux vo- mica, or to other medicines recommended under their respective heads. CONSEQUENCES OF OVERHEATING, ETC. 21 Excesses injure body and mind more than anything else. If they consist in intemperance in eating or drinking, apply the remedies prescribed under "Disordered Stomach". But if they are such as waste the very marrow and essence of the constitu- tion, the greatest abstemiousness is a most absolute condition, to- gether with which the following remedies may do much good. The principal remedy, and the one which should be given first, but which may be given repeatedly after other remedies, is China. Afterwards, and when the patient regrets much his vicious con- duct, give Phosphoric acid. Look also under the head of the special complaint of the patient, and select in preference such remedies as China, Phosphoric acid, Staphysagria, Nux vomi- ca, or Sulphur and Dxdcamara, the one or the other, whichever may seem to suit best. The same treatment is recommended when the patient has lost his strength by unnatural vices; give in the beginning China, or Staphysagria, or Nux vomica; later Phosphoric acid, Sul- phur or Calcarea. Encourage the patient that he may rouse himself by constant occupation; and by hard work, moderate eating, little sleep, abstinence from all spirituous liquors, bad company and the reading of bad books. Should a morbid irri- tation trouble the patient, as is often the case with children, se- lect in preference among the following medicines: China, Mercu- rius vivus, Carbo vegetabilis, Nux vomica, Pulsatilla, Staphy- sagria or Antimonium crudum, Silicea, Platinum, Calcarea or Colocynth. Frequently, when China and Carbo vegetabilis are insufficient, Mercurius vivus will effect the object; if not, Sul- phur. Among these, which must not be repeated frequently, Coffea, Opium, Aconite, Ignatia, according to circumstances, will be indicated. If these vices have so weakened the constitution that the effects appear even after marriage, although then living moderately, give, if the head is much affected, Calcarea. For great weakness and trembling of the legs, the same; for asthma, Staphysagria; burning in the parts, Mercurius vivus or Carbo vegetabilis. Weak- ness in the feet, heaviness and a feeling of soreness in the limbs, 22 CHAPTER IV. dulness, ill humor and relaxation, may be remedied by Coc- culus. Loss of Fluids. Loss of fluids through much perspiration or purging, or long continued diarrhoea, too long suckling of children, through too great a flow of milk or other fluids, much bleeding by the lancet, or loss of blood by other means, often occasions incurable disea- ses; if not remedied by the timely administration of China. In some cases it may be necessary to give Staphysagria or Sul- phur. If any of the above causes, particularly improper bleed- ing, or with children the bleeding after leech-bites which may occur during the night without it being perceived, should produce fainting, or convulsions, give immediately China, and do nothing else; as soon as the sick person recovers, and if his mouth is very dry, or if he moves the tongue, give him a little cold water; if he faints again, or has spasms, or if he does not recover, en- tirely, give him a teaspoonful of good old wine; after a while repeat, if necessary, the China, and later, the wine. After this give him as much cold water as he wishes to drink, but not too much at once. If some symptoms remain, which the China has not taken away, give Phosphoric acid, and if this does not suffice, a week after, Nux vomica, followed in a day or two by Arse- nicum. CHAPTER IV. CONSEQUENCES OF SURFEITING AND DISORDERED STOMACH. WnEN a person has eaten too much, or partaken of something which is too heavy, and soon after feels that his stomach is out of order, give him strong coffee without milk; should severe headache and nausea follow, yet no vomiting, dip a very soft feather in oil, and tickle the throat with it until he vomits. If this does not produce vomiting, give some lukewarm water. If nothing will make him vomit, and he is retching, feels very hot, CONSEQUENCES OF SURFEITING, ETC. 23 particularly in the head, give Aconite. If he feels chilly, give Pulsatilla, which may be repeated every half hour till relief is obtained. If there remains pressure and heaviness in the stom- ach, and qualmishfless, give Chamomilla; if this fails, Nux vo- mica, two hours afterwards; if there is constant retching, give Ipecacuanha; great coldness and violent pain in the stomach, Veratrum; if the patient has thrown up bile, and there is a bit- ter taste remaining, let him drink a few glasses of cold water and sugar; if the pressure in the stomach continues, give him coffee to drink without milk. If there is no improvement felt on the following morning, and loathing, nausea, inclination to vomit still continuing, rising with a bad, mouldy taste and smell, resembling the smell of the food, which has been taken, give Antimonium crudum; the rising with a bitter taste, Bryonia; or when putrid, Nux vomica; or like rotten eggs, Arnica; greasy, Pulsatilla; and when acrid and bitter, Arsenicum. The patient ought to take no nourish- ment but gruel, barley water, tea and toast, and lastly thin broth for two or three days, to give the stomach time to recover its functions. A disordered stomach produced by eating fat pork, or other meat, pastry, rancid butter, &c, will be relieved by Pulsatilla. If this does not suffice, by Carbo vegetabilis. A disordered stomach from other food, rising, with a taste of what has been eaten, nausea, inclination to vomit, will yield to Antimonium crudum or Pulsatilla; in some cases they must be taken alternately. For a disordered stomach from eating fruit, Pulsatilla. For disordered stomach from bad, sour wine, particularly with much nausea, give Antimonium crudum; from sulphurated wine, Pulsatilla ; from sour beer or vinegar, Aconite gives relief, par- ticularly when there is a pressing pain in the stomach, nausea, inclination to vomit and vomiting of phlegm or blood; but if the vomiting is sour, with burning in the throat, cutting pain in the bowels, and purging, give Hepar. For vomiting of food, burning in the stomach and abdomen, cutting pain in the bowels, 24 CHAPTER IV. with coldness, agitation and thirst, give Arscnicum ; if connected with great debility and sensitiveness to warm and cold, or damp and dry weather, give Carbo vegetabilis. Disordered stomach from stale fish or meat; give forthwith a small quantity of pulverized charcoal, and if this does not re- move all the unpleasant symptoms, China; if there is a corrupt rising, and putrid taste, give Pulsatilla. Disordered stomach from salt victuals, Carbo vegetabilis; ef- fects of long continuance from eating too much salt, may be re- moved by Arsenicum, or by frequent smelling of Sweet Spirits of Nitre. For disordered stomach from eating cabbage, and sour crout especially, give Bryonia. From old cheese, sausages, old spoiled smoked beef, &c.—see under "Poisoning." Overfeeding of Children. Children are not unfrequently made sick by overfeeding, or by giving them indigestible food, such as pap made of flour, crack- ers, bread not sufficiently baked, and the like; especially when they are rocked too much, and are, moreover, filled and purged with rhubarb, salts, castor-oil, &c. All these things should be avoided. To check the vomiting, give Ipecacuanha, particularly if the vomiting is accompanied by purging. If this does not give any relief after several doses, give Pulsatilla. If there is only purging, with a discharge of undigested food, give China. If vomiting is accompanied by constipation, give Nux vomica. The same kind of food ought not always to be given to little children; the milk should be boiled, but not too long; thin gruel agrees better with some; if a more substantial fare is required, they should have grits, made of wheat, corn, buckwheat, &c, in preference to pap made of flour. Or, fill a linen bag with wheat flour as tightly as possible, then tie it up well and keep it in boiling water for 3 hours. After that take it out and let it get cold. Upon removing the bag, you will obtain a hard mass, from which the outer crust must be peeled off. Then grate as much of it as is required for a meal, and have it boiled in water, CONSEQUENCES OF SURFEITING, ETC. 25 milk or broth.—Dry rusk are also good for children, provided they are not too brown, which would be a sign of their having been burnt. Headache. If headache with nausea follows a disordered stomach, and the whole head feels as if everything inside were bruised, give Ipecacuanha. For oppressive headache, with heat in the brain, worse after walking, reading, eating, with putrid taste, give Ar- nica. For throbbing, shooting headache, worse when talking, with much nausea, give Aconite; for dull, general headache, worse whilst going up stairs, and from smoking tobacco; without appetite, with a bitter taste, rising, hiccough, loathing and nau- sea, worse after drinking wine, give Antimonium crud. For burning, pressing, bursting headache, worse when stoop- ing, as if all would fall out through the forehead, throbbing or tearing when walking, or splashing as if from water, worse in the morning early, or with chills, give Bryonia. A rending, throbbing, jerking headache, worse in the evening when lying down, or one sided, attended with a putrid, earthy taste in the mouth, and without thirst, is relieved by Pulsatilla. When there is heaviness in the head, and great soreness of the scalp when touched, with trembling in the jaws, a salty taste, and spasm in the stomach, give Carbo vegetabilis; especially to persons who have taken much mercury. See Part II. Vomiting. When vomiting is occasioned by a disordered stomach, give Ipecacuanha, if the tongue is coated; if it is clean, Tartar emetic; when it is produced by eating too much bread, and attended with great oppression about the pit of the stomach, give Bryonia. If produced by surcharging the stomach, and attended with bitter taste while chewing the food, or when accompanied by a burning sensation in the throat, give Pulsatilla ; if attended with much belching, a hot face and palpitation of the heart, Sepia. 4 26 CHAPTER IV. Flatulence. If flatulency swells the belly, renders breathing asthmatic, and is caused by flatulent food, such as cabbage, sour crout, fresh beer and the like, and particularly when there is a painful tight- ness across the belly, with pains and pressure about the navel, and the patient is chilled, after drinking, give China. When drinking gives rise to pains in the pit of the stomach, which obstruct breathing, the clothes around the ribs feel too tight, and there is a weight as from stones in the abdomen, give Nux vomica. When it is caused by eating fatty food, after which much water has been drunk, when the wind rolls in the bowels, the belly appearing too full and hard, worse in the evening, give Pulsa- tilla. If oppression of the chest proceeds from an accumulation of wind, with jerking and shooting pains, a tension about the pit of the stomach—without exactly swelling the belly—causing a state of utter restlessness, Phosphorus will afford relief. Persons, subject to flatulence may take, with great benefit as much of pulverized charcoal as can lie on the end of a desert- knife, once or twice a day. Colic. Sudden attacks of colic when caused by eating too much, or by a foul stomach, are often cured by taking some coffee without milk; or, if this fails, by Pulsatilla, or some other remedy indi- cated under " Colic." Diarrhoea, When arising from disordered stomach, is generally cured by Pulsatilla; in children, when accompanied with nausea and vomiting by Ipecacuanha; in children who are sleepless, exited andtoohvely, by Coffea; when cutting pains in "the bowels 7ZI if UP 1 Pr°dUCe naUSGa> and there is weakneas CONSEQUENCES OF SURFEITING, ETC. 27 Sleeplessness. The sleeplessness produced by overloading the stomach often yields to Coffea, particularly with children, or to Pulsatilla. If partly caused by strong coffee, to Nux vomica; if by eating too much in the evening, drink a glass of cold water, sweetened with loaf sugar; if this occasions too much acidity, drink merely water. Nightmare. Nightmare, which arises from eating too much, can only be pre- vented by avoiding the cause; drinking sugar-water may some- times remove it. A person who is subject to this complaint, should not eat too much, and should take the medicines recom- mended for "Nightmare," which see. Fever. Fever with much chilliness and coldness, and constant~disor- ders of the stomach, diarrhoea or constipation, in persons of a passionate cros3 temper, may be removed by Bryonia ; to phleg- matic, awkward, irritable persons give Capsicum. If the fever returns every second day, Antimonium crud. or Ipecacuanha, daily. On the days when the patient is clear of fever, give Ipe- cacuanha, 4 times, on those when he has fever give it twice,— except during the paroxysms of heat or cold. On the seventh day let him take Nux vomica. Through this period he must abstain from eating fruit. Rash. A rash, arising from a disordered stomach, accompanied with chills and sulkiness, is often cured by Pulsatilla ; with sickness of the stomach and difficulty of breathing, by Ipecacuanha; if this proves useless, by Bryonia. If caused by noxious food, see "Poisoning." For other remedies, see "Eruptions." Indisposition from Ice or Cold "Water. If a person feels unwell after drinking water, he may take one of the following remedies : If the drinking of water aggravates every complaint, confuses 28 CHAPTER IV. the head, produces nausea and heat, take Cocculus. If it pro- duces cough and headache, Aconite; if cough, vomiting and chills, Arsenicum; if bad taste, as if the water were impure, coldness in the belly, pain in the bowels and chills, China; if nausea and pain in the bowels, Pulsatilla, and if this does not give relief, Rhus. Continuous nausea from drinking water may sometimes be removed by taking a little table salt—as much as will lie on the end of a desert-knife. If water drinking produces hiccough, take Ignatia; oppres- sion at the stomach, Ferrum; if it causes swelling of the abdo- men, as from flatulence, with pressure in the pit of the stomach, difficulty of breathing, and chills, take Nux vomica ; if it-causes constant inclination to go to stool, and purging, Capsicum; pain in the chest and shuddering, Veratrum. If it produces toothache, take Bryonia or Mercurius vivus, or Staphysagria, according to circumstances. If it occasions merely irritability of the teeth, without regular pain, Mercu- rius vivus or Sulphur. When a person habitually takes cold in the stomach from drinking cold water, and has, in consequence, accustomed him- self to mix spirits with the water, and wishes to leave off this dangerous habit, let him try some of the medicines recommended above. If he does not succeed, let him take a drop of pure sul- phuric acid, and mix it with a pint of water, by pouring it for some time from one tumbler into another, and take a table- spoonful of this in the morning, fasting, once or twice. This will warm the stomach, and gradually accustom it to pure water again. When drinking hastily, disorders the stomach, give Silicea. When merely cold drinking causes indisposition, Nux vomica or Staphysagria generally gives relief; if not, Calcarea. Indisposition from ice or very cold water, during great heat, when sudden and dangerous, generally yields to Opium, espe- cially, if accompanied by a tendency of blood to the head, twitching in the face, unconsciousness and giddiness almost to reeling; persons who are in the habit of drinking spirituous li- quors will be benefited by Nux vomica. If the countenance is CONSEQUENCES OF SURFEITING, ETC. 29 pale, if there is a sensation of choking and drooping, a few drops of spirits of camphor, on sugar, or diluted with water, may be administered. Should any symptoms remain, such as head- ache, or tendency of blood to the head, Belladonna will be be- neficial; for very acute pains, Bryonia; for affections of the stomach, fever, &c. Carbo vegetabilis or Arsenicum; refer also to the following passages. For long standing disorders of the stomach, caused by drink- ing ice-water in the summer, attended with great weariness, little appetite; if whatever food is taken, lies like a weight on the stomach, or is thrown off again, sometimes with a sour taste, with soreness of the stomach upon pressure; if the stomach and abdomen are distended by wind, the flatulence becoming very troublesome, the symptoms growing worse in the open air, Carbo vegetabilis will be serviceable. If there are pains in the stomach, or other symptoms arise in consequence of having swallowed pieces of ice, as children are apt to do, Arsenicum will be the remedy, or sometimes Pulsa- tilla. Arsenicum may be administered in cases of oppressive weight on the stomach, particularly, with a burning sensation confined to a small spot, or extending over the stomach and abdomen, with great anxiety and disquietude indicated by the countenance, tongue dry, continual thirst, everything having a saltish taste, nausea produced by motion, or after drinking, even to vomiting and throwing up bile. Pulsatilla should be given, if the affection in the stomach and the pit of the stomach is of a spasmodic nature, worse after eat- ing, in some cases attended by vomiting; the countenance ex- pressing rather a disposition to cry; the tongue slimy, taste in- sipid, no thirst, nausea after eating and drinking, worse in the afternoon and evening, with sour rising, sometimes of wind only, retaining the taste of what the patient has eaten. The same remedies will answer in affections of the stomach, produced by eating cold fruit, ice-cream and the like. Every body should be able to drink milk, and if it does not 30 CHAPTER V. agree, it is an indication of there being something wrong about the stomach. Something should be taken for it. I£ it produces a sour taste, give Nux vomica; if pains in the bowels and diar- rhoea Bryonia or Lycopodium; and if the other medicines do not give relief, and there is rising, vomiting of phlegm and other indisposition, give Sulphur; if it produces constant nausea, give Calcarea. Persons who feel indisposed after drinking malt liquors, will do well to refrain from it, at least from the stronger kinds, which sometimes owe their strength and bitterness to injurious drugs. But if the head should become too easily affected after drinking good beer, &c, take Rhus; if this proves useless, take afterward Belladonna. If the beer causes vomiting, take Ferrum; if nau- sea, Arsenicum; if colic, Colocynth. Whoever feels indisposed after drinking brandy, may con- gratulate himself; the best and most salutary advice we can give him, is to let it alone. CHAPTER v. CONSEQUENCES OF SPIRITUOUS LIQUORS, COFFEE, TEA, TOBACCO, ACIDS, &c. Intoxication. This disgraceful condition, in which we still see so many per- sons, needs no description. Every one knows that, however drunk a person may be, the best way is to let him sleep it off; but sometimes it may be necessary to restore him sooner—at least so far, as to be able to remove him. The best remedy is an external application of cold water. If a person is lying in the road, throw the coldest water that can be procured over him; if this does not succeed, throw water upon him by buckets full, from a height of several feet, so as to hit him with great force. If he is vomiting and retching, give him coffee without milk, as much as he will drink, and very hot. CONSEQUENCES OF SPIRITUOUS LIQUORS, ETC. 81 If he is not quite so far gone, a cloth dipped in cold waterj and wrapped round the abdomen and loins, may afford relief. If the intoxication proceeds from drinking beer, give green tea and milk; if from wine, give him a bitter almond to eat (the latter not to children); if from spirits, give him salt water to drink, and if that does not produce any effect, put grated garlic into his mouth. If the face of a drunken man has a purple hue, his look fixed, he does not come to his senses, the throwing on of cold water producing only a temporary effect—if the muscles of the face are convulsed, or a cramp prevents the opening of the mouth— apply nothing but a piece of cloth, dipped into cold water, to the head, and give Opium every quarter of an hour until he im- proves; if this fails, give Aconite or Belladonna. If children are made tipsy by thoughtless or vile persons—or by accident swallow brandy, wash the head and abdomen with cold water, and give them, every quarter of an hour, a teaspoon- ful of hot water, a pint of which has been poured on a bitter almond. If they do not soon fall into a sound sleep, give Nux vomica. If they fall into a torpid sleep, with snoring, the face red and the head hot, give Opium. If they are too lively and merry, and cannot sleep, give Coffea. If they have fever, give Aconite, and if this does not remove it in two hours, give Bel- ladonna. If they fall into convulsions, give first Opium, if this does not answer, Nux vomica, and if this fails, Chamomilla. Many females, when confined, drink out of ignorance, from habit, or by the advice of stupid midwives, spirituous liquors, to obtain sleep for themselves and the child. This is a horrid, abominable habit; they expose themselves and their child to the greatest danger; and if not attended by immediately bad con- sequences, it may cause the child to become a drunkard, when grown up. Under these circumstances, give to the mother and child the aforesaid medicines. Besides the confirmed drunkard, there are others who only once in a while allow themselves to be led astray and who are ashamed of their conduct afterward. These we advise to put a 32 CHAPTER V. globule of Nux vomica into a glass of water, to stir it up well, and to drink it before going to bed; the next morning they may take the remedies prescribed for the effects of intoxication. There are, however, many who have fallen into this vice from vexation, grief and sorrow. Their own conscience will tell them to what a horrid alternative they have had recourse; and we earn- estly exhort them to touch not, taste not again, under any pre- text, but to force themselves to drink, daily, cold water, until the stomach becomes quite weak from it, and to take the medi- cines recommended for the effects of drinking; also, the medi- cines which suit for vexation and grief. When they have thus become men again, let them, in fervent prayer, implore Him who teaches us to bear with every tribulation, and who has promised that he will give rest unto every one, who calls upon him zeal- ously, earnestly and unceasingly, to strenghen them in their re- solution not to fall back again into a habit so disgraceful and vicious. There are other drunkards who are driven to drinking by a morbid state of their system. These deserve our compassion; but although we may pity, there is not sufficient ground to excul- pate them. For the same morbid state urges one to anger, an- other to laziness, a third to incontinence, but it is no excuse for either. Were it otherwise, every one might find a ready excuse for his favorite vice, and easily imagine that he could wash off his impurity in a sink. When the passionate man does not bridle his anger, the lascivious his cravings, and the intemperate his in- clination to strong drink, their morbid sensibilities will increase. No, they ought to pursue a course directly opposite. He who is given to anger should constrain himself to submit even to un- merited abuse; the voluptuary should repress all vicious thought, and avoid every temptation; the lazy should work until he is per- fectly exhausted; and he who longs for strong drink, should not even smell brandy, wine, or beer, though he were almost dying with thirst. Let every one reason thus:—God has permitted me to be af- flicted with this horrid disease, not that I should give myself up CONSEQUENCES OF SPIRITUOUS LIQUORS, ETC. 33 to sin, but that I should prove my strength, and learn to resist temptation. And he who conquers, will be doubly strong to do good afterwards, and the blessings of Heaven will attend him. To him who has thus fortified his mind we recommend the following remedies, which will contribute to subdue the disease under which he lingers:—Take Sidphur every morning for seven days. Should the craving abate, and return afterwards, let hira take Nux vomica in the evening; and if it returns again in two or three days after, Sulphur, repeating these remedies in the same order. If this does not prove efficacious, give Arsenicum. If this does good but temporarily, give Nux vomica one day, and three days after Arsenicum. Although this treatment will succeed in many cases, yet there may be some, where it will prove unavailing. If so, put a drop of Sulphuric acid into a tumbler of water, mix it, and drink it early in the morning. This may be done two or three days, un- til it produces disagreable symptoms. For these symptoms the patient should frequently smell camphor. Should this, too, prove ineffectual, and he feel seriously disposed to reform, let him con- sult a homoeopathic physician, who will probably be able to re- lieve him. If a person has a craving for liquor, and cannot be induced to refrain, we would advise his unfortunate wife, or children, or sis- ters and friends, to administer to him, secretly, the following remedy:—Take pure Sulphuric acid, mix it with plenty of wa- ter, so as to taste only a little sour, and give it to the drunkard in every thing he eats and drinks, and as much and as often as possible; put some of it in the coffee, tea, soup—into every thing; mix it particularly in sour sauces or lemonade. If it weakens the stomach, give tea made of bitter herbs, bit- ter oranges or roots, continuing at the same time with the Sul- phuric acid, until his mouth gets sore, then stop. If it produ- ces no other bad symptoms, give no medicine but this; but should constant diarrhoea, weakness of the stomach, vomiting and gid- diness appear, give Pulsatilla; if it produces lasting ulcers in 5 34 CHAPTER V. the mouth, give Mercurius vivus. The consequences are not dan- gerous, and can be easily removed. Effects of Intoxication. After drinking too much in the evening, sometimes after tak- ing but a few glasses of wine, we feel unwell, heavy, and stupid in the morning; the face is pale and haggard; the eyes are pained by the light; the mouth is parched and rough; with nausea, pains in the pit of the stomach, hoarseness, heat in the hands and soreness in the limbs, as if sprained; we become weak, sleepy, chilly, languid, cross and passionate; sometimes there is bleeding of the nose, or cramp in the stomach, &c, give Carbo vegetabi- lis or Nux vomica. If the headache is throbbing or attended with pressure over the eyes, or better in the air, take Carbo vegetabilis. If the pain is attended by a feeling, as though a nail were lodged in the head, and is on one side only; worse when walk- ing, at every motion, in the open air; from thinking and stoop- ing, take Nux vomica. If there is only nausea, Carbo vegetabilis; an inclination to vomit, and retching, Nux vomica. If the stools are thin and pale, Carbo vegetabilis. If there is much pressing, and forcing, with slimy purging, Nux vomica. If there is much giddiness, red eyes, with matter in the cor- ners, great sensitiveness to the light, or a dry, hacking cough, take Nux vomica. Should Carbo vegetabilis not produce an immediate effect, smell camphor from time to time. If the headache does not abate in two or three hours after taking Nux vomica, take Cof- fea. If the nausea continues after the above medicines have been taken, and the stomach is very weak, take Antimonium crudum. In indisposition from the repeated use of wine or spirits, which has already continued for some time; in tedious headache, ful- ness and heaviness of the head, or cramp in the stomach, weak- ness of the stomach, constipation, piles, pains in the back, miliary CONSEQUENCES OF SPIRITUOUS LIQUORS, ETC. 35 eruption, or much itching and biting over the whole body, Nux vomica generally proves efficacious. It should be taken in the evening; and whilst the patient keeps improving, he should neither drink wine, spirits or coffee. If Nux vomica should fail to relieve, Carbo vegetabilis or Lachesis may be taken; the former, if the symptoms are worse early in the morning, or in the open air; the latter, if they are worse after sleeping, especially in the afternoon, and if aggra- vated by hot weather. For tedious headache, which has not only been caused by intemperance, but is aggravated by drinking spirituous liquors, by thinking, mental application, speaking, stooping, after read- ing or writing, the patient is very weak, give, if he is plethoric, Calcarea; if of a spare habit, Silicea. Do not repeat the dose until he is worse again, and should the repetition fail, give Lachesis. If the effect of wine is only to irritate, excite and produce trembling, with nervousness, an uncomfortable dry heat and splenetic humor, give Coffea. Mania a Fotu. In this sad and terrible disease, to which drunkards are sub- ject, and which takes the form of delirium in the appearance of animals, monsters, strange human faces, &c, attended with raging and raving, fit3 and convulsions, medical aid is not always effectual. But, instead of worrying the unfortunate being with quantities of irritating, weakening drugs, it is better to give him Opium every hour; and if he does not improve in twenty hours, Nux vomica; and if the attacks return, Opium again. At the same time, drinking cold water may be of service. If these remedies prove ineffectual within two or three days, Calcarea carbonica, given morning and evening, is sometimes serviceable. During this time the patient may drink freely of cold water, taking a little beer, if he desires it and has been accustomed to it. The same with tobacco. If the attacks are less severe, the patient only seeing animals 36 CHAPTER V. or fire at intervals, with fearfulness and a wish to escape, give Belladonna, or alternate with Aconite, giving one each hour, and Calcarea carbonica the following morning. If Belladonna should afford no relief, if the throat is affected, the attacks appearing more in the afternoon, or after sleeping, the patient talks much, flying from one subject to another, is unwilling to bear his shirt or neckhandkerchief, but striving to have them removed, Lachesis will be serviceable. If premonitory symptoms of apoplexy appear in drunkards, Belladonna is often of great use. Bad effects of Coffee. A person who is not accustomed to coffee, who drinks too much, or who drinks it too strong, may feel unpleasant symp- toms in consequence, which he might wish to remove as speedily as possible. For sleeplessness, palpitation of the heart, great irritability of the nervous system, violent spasms in the stomach, Nux vomica almost always suffices. For violent headache, as if a nail were driven into the head, or heaviness, rending pain in the head, give Ignatia or Nux vomica. If it is better when stooping, or if there is a throbbing in the whole head, if the patient is of an undecided, inconstant disposition, give Ignatia ; if it is worse when stooping, or walk- ing, attended with much giddiness, confusion and heaviness in the head, and the patient is of a choleric temperament, give Nux vomica. Violent, one-sided headache yields usually to Nux vomica ; or if accompanied by much weeping, and screaming, and great sensitiveness, to Chamomilla. Tedious effects of the too frequent use of coffee may be removed by the same medicines. Nux vomica is one of the principal medicines in these complaints; if it does not suffice, Coffea may sometimes be given, and then Nux vomica again. Frequent toothache following immediately upon drinking cof- fee, generally yields to Chamomilla. If very violent, when the CONSEQUENCES OF SPIRITUOUS LIQUORS, ETC. 37 patient is almost beside himself, give Coffea, and afterwards Chamomilla; sometimes Nux vomica, and sometimes, though rarely, the following medicines may be required: — Cocculus, Belladonna, Mercurius vivus, Carbo vegetabilis, Pulsatilla and Rhus. Violent spasms in the stomach, if worse after drinking coffee, Nux vomica or Coccidus ; if temporarily relieved by coffee, but worse afterwards, Chamomilla. Violent pain in the bowels, or colic, Chamomilla or Nux vomica ; frequently Colocynthis or Belladonna. If, after the habit of drinking coffee has been abandoned and the above tedious effects will not yield to Nux vomica and Cha- momilla, the following remedies are sometimes useful: — Cocculus, when every motion is attended by debilitating per- spiration, frequent trembling; starting when asleep; sudden heat; frequent toothache when eating; lightness in the head; sadness; agitation; when every indisposition is aggravated by fresh air, exercise, eating, drinking, sleep, or even smoking. Ignatia, when there is much debility; emptiness in the pit of the stomach; frequent spasms in the abdomen; falling asleep or painfulness of the limbs, generally pressing as from hard- pointed substances, the pains oblige the patient to shift his posi- tion constantly, after which he feels better; the disposition is inconstant, sometimes excessively lively, at others depressed and inclined to weeping. If these remedies do not bring about a favorable change in a few days, give Mercurius vivus ; and if this fails, Sulphur, seven days after. Effects of Tea drinking. For indisposition from green tea, take Coffea or Ignatia, and if it does not improve in half an hour, China. For tedious com- plaints from drinking much tea, China is generally the best remedy; Ferrum may also be useful. 38 CHAPTER V. Effects of smoking Tobacco. Those who are not accustomed to smoking will be quickly res- tored by Pulsatilla; violent headache and nausea by Aconite; giddiness and dizziness to fainting, vomiting of bile and diar- rhoea, Chamomilla; and if this does not give immediate relief, and there is much coldness, Veratrum; if this will not answer, let them smell camphor. Violent convulsions and other symp- toms may be removed by Cuprum. For other remedies see "Poisoning." If a person accustomed to smoking feels unwell after it, Coc- culus or Ignatia will generally relieve him. If it occasions toothache, give Bryonia or sometimes China. If it causes sick- ness of the stomach, Ignatia or Pulsatilla; if uneasiness and nausea, Staphysagria. The same remedies may be given for the bad effects of chewing tobacco. Nux vomica, Chamomilla, Pul- satilla or Cocculus, and sometimes Cuprum, will generally be found most useful. Tedious consequences of immoderate smoking are difficult to cure; nervousness and weakness of the stomach are generally removed by Nux vomica or Coccidus; habitual constipation by Nux vomica, Staphysagria, Mercurius vivus. The diseases to which those who manufacture tobacco are subject cannot be re- moved unless the patient forsakes his employment. He should apply to a homoeopathic physician. The foregoing remedies may, however, be tried; and also Arsenicum, Colocynth and Cuprum. For the injurious effects occasioned by spices, such as pepper, ginger and the like, give Nux vomica. Injurious effects of Acids. See what has been said Part I., Chapter IV., on this subject. When other symptoms arise from the use of acids, they yield generally to Arsenicum or Sulphur. When acids aggravate the symptoms, give Belladonna or Lachesis. When a person has a craving for acids and sour food, give Arsenicum, Arnica, Belladonna, China or Lachesis. Arseni- cum is preferable, when there is a loathing of other than sour EFFECTS OF THE MEDICINES HITHERTO, ETC. 39 food; Sulphur, when there is an aversion to anything sweet. If the craving is merely for sour drinks, give Bryonia; Natrum muriaticum for constant sour taste. For heart-burn and vomiting after sour victuals, give Ferrum; for vomiting of a watery fluid after the use of acids, Phosphorus. For disordered stomach from acids, give Arsenicum, and if not relieved by it, Lachesis; or these remedies may be given alternately in obstinate cases. For diarrhoea occasioned by the use of acids and sour fruits, give Lachesis; if from fruits merely, give China. CHAPTER VI. EFFECTS OF THE MEDICINES HITHERTO IN GENE- RAL USE, AND REMEDIES TO COUNTERACT THESE EFFECTS. When sudden and dangerous symptoms appear after adminis- tering a so - called medicine, we may take it for granted the patient is poisoned, and we must look under the head of " Poi- soning." There is no poison in the world which, by the old system of medicine, has not been given as salutary, and been tried on sick persons. It is still worse, however, when some hy- pocritical pretenders profess to be able to cure all diseases by herbs or vegetable substances; for the vegetable poisons are much more deleterious than the mineral,—prussic acid, for instance, is a more powerful poison than mercury, &c, which every well informed physician must know. Animal poisons, again, are worse than vegetable poisons; as, for instance, that of venemous serpents. Whatever is said of the innoxious effect of vegetable medicine is nothing but deception and humbug. It is true, there are some herbs which do not produce any dangerous effects, and some medicines which are not very inju- rious ; but even these should not be given without due consid- eration, nor in large quantities for any length of time. For it is 40 CHAPTER VI. certain that, if you give the proper medicine, very little will suffice and if you give an improper one, the larger the dose the more injurious it will prove. In large and frequently repeated doses every medicine may, therefore, be considered a poison. In Germany more children have died of chamomile tea than of scarlet fever; and more people are, even now, killed by Peruvian bark and Quinine than by the fever and ague. Formerly the cause of their death was not known, and the thing was called by a different name. Of a hundred persons who have died of dropsy, eighty, at least, have been made dropsical by bleeding and the irrational administering of drugs. Ask only, how often such persons have been bled, or what quantities of medicine they have swallowed, such as mer- cury, Peruvian bark, quinine, cathartics, sulphur or saltpetre, laudanum and other narcotics, and you will see how the dropsy has originated. When a person, under the impression that it was all right, has taken such vile trash, or given it to children upon the recom- mendation of an ignorant physician or apothecary, he may often remedy the evil by observing the following directions:— Effects of Opium or Laudanum. This drug often produces dangerous consequences;—see what is said about it under " Poisons." Results are produced by it, which were not anticipated, particularly when an ignorant prac- titioner applies it in injections, where its effects are a great deal more powerful than when taken into the stomach. For the lin- gering effects of laudanum, which never fail to appear, sooner or later, not much can be done without the advice of a judicious physician. It will be well to give, from time to time, Coffea and sometimes Mercurius vivus, which should be allowed to operate a week, or longer. Sometimes Nux vomica or Belladonna may be given. Effects of Peruvian Bark, or Quinine. This is a medicine which, next to opium and mercury, most frequently undermines the constitution, and occasions incurable EFFECTS OF THE MEDICINES HITHERTO, ETC. 41 diseases. Should the patient escape death, he will be troubled for years by the effects of bark. It is more difficult to expel quinine from the system, than mercury; and he who pretends that this can be effected by cathartics, is utterly ignorant of phy- sic. It enters the blood and all the fluids, and no purging in the world will remove it. To relieve the patient from its effects, will require patience, but it may be gradually accomplished by the following means. The chief medicine, in most cases, is Ipecacuanha, taken once or twice a day, until there is an improvement. For rheumatic pains, heaviness, prostration, soreness in all the limbs, drawing pain in the bones, great sensitiveness of every part of the body; when exercise, speaking, blowing the nose or loud sounds aggravate the pains, give Arnica. When the body is cold, with cold perspiration, constipation or diarrhoea, give Veratrum. For consumptive cough and expecto- ration let the patient drink an infusion of Iceland moss. For jaundice give Mercurius vivus, and later, perhaps, Belladonna. For heat in the face, determination of blood to the head, much pain in the head, face and teeth, give Belladonna. For earache, Pulsatilla. For swelling of the feet, Ferrum. For ulcers on the legs, dropsy, short cough and shortness of breath, Arsenicum. If there are other complaints, look under the respective heads, and select the medicine accordingly; the following will in many cases be found preferable: Sulphur, Calcarea, Carbo vegetabi- lis, China. When bark has been given in intermittent fever, and the dis- ease has been bungled, and another and worse complaint than the fever makes its appearance, or the fever remains, which is now more difficult to cure. If the fever has been suppressed, and earache, toothache, head- ache and pains in the limbs make their appearance, give Pulsa- tilla, and if this fails, Calcarea. For affections of the stomach give Ipecacuanha or Pulsatilla; for swelling, Arnica, Arseni- cum or Ferrum, and select, according to circumstances, one of the remedies recommended above. 6 42 CHAPTER VI. If the intermittent fever continues, as it often does, notwith- standing large quantities of barks may have been taken, give first Ipecacuanha, which will mostly prove efficacious; after- wards, if required, Arsenicum or Carbo vegetabilis; sometimes China, Veratrum, Arnica; at others Belladonna, Mercurius vi- vus, Sulphur and Calcarea will effect a cure. When the mixtures which the twice unfortunate patient had to swallow, contained Conium or Cicuta, Digitalis, Laurocerasus or Acidum Hydrocyanicum, it is scarcely possible to save him, unless a good constitution throws it off, assisted by proper living, fresh air and the drinking of much water. Persons who have swallowed much Assafcetida, or much Vale- rian and other drugs which enter largely into the composition of the notorious Morrison's pills, are generally in a very critical situation. China or Mercurius vivus sometimes counteracts the effects of Assafcetida; Coffea, Nux vomica, Chamomilla or Sulphur those of Valerian; Pulsatilla and Nux vomica those of Colchicum; Belladonna, Bryonia and Arnica those of Se- nega; Mercurius vivus or Belladonna those of Sarsaparilla. If a person feels bad effects soon after the application of a blister of spurgelaurel (mezereum), let him first smell camphor, and afterwards, if these effects appear in the mouth or in the bones, give Mercurius vivus; and if they appear more in the limbs, Bryonia or Rhus. If the application of Spanish flies produces bad symptoms, let the patient smell camphor frequently, and if this does not count- eract them, give Aconite or Pulsatilla. When children have taken much rhubarb, and consequently are troubled with much flatulency and slimy diarrhoeas, give Nux vomica; if they have sour vomitings during the night, miry stools and diarrhoea, Pulsatilla; if they have sour stools, green or mixed with blood, Mercurius vivus; bad colic and green evac- uations, Chamomilla, and if the colic does not get better, Colo- cynth. EFFECTS OF MEDICINES HITHERTO, ETC. 43 Effects of Magnesia. If a person has taken magnesia and feels worse, particularly after burnt magnesia, let him smell sweet spirits of nitre; if he cannot sleep, give Coffea; if it produces violent pains in the bowels, give Chamomilla, and if they are very bad, without much or any evacuation, give Colocynth; if no evacuation fol- lows in 24 hours, give Nux vomica; if the patient has violent pains, and is burning with fever, give Arsenicum; but if the magnesia has produced sour, thin purging with colic, give Rheum, and if this fails, Pulsatilla. The same remedies should be given, if similar effects are produced by Epsom salts. Effects of Sulphur. The effects of sulphur are as bad as those of mercury, and the tedious complaints which it produces are as difficult to cure. If a person feels unwell soon after having used it, he should smell camphor; if this does not relieve him and when the pains are violent, particularly in the head, accompanied by heat, let him take Aconite; later, when the complaint has become tedious, Mercurius vivus or Pulsatilla, and sometimes, according to cir- cumstances, Silicea or Sepia. For the bad effects of sulphuric vapors from the lighting of matches, from which children often get coughs, shortness of breath and pains in the throat and chest, Pulsatilla is the best remedy. If sulphur has been given to children, in conformity to a no- tion entertained by some parents of its beneficial effects, especially in the spring of the year, and it occasions fever, with cutting pains in the bowels; or if eruptions, against which it is given, should be driven back; or when very painful boils ensue, Bel- ladonna is very often efficient; care is, however, to be taken af- terwards, to guard the children from taking cold, not by keeping them in warm rooms, but prevent their being in draughts, or sitting on the ground, &c. When patients suffer from Iodine or Iodide of Potash, admin- istered, as is usual, in large doses and for a long time, give Hepar. 44 CHAPTER VI. Effects of Mercury. This is the universal elixir of the quacks in all diseases, who, whilst they pretend to restore their patients to health, destroy their constitution. It is administered as calomel in powders, or dissolved as corrosive sublimate, or in pills—those abominable blue pills. Beware of all prescriptions in which names, like the following, occur: Calomel, Murias, Mercur. subl. corros., Merc. prsecipit., Hydrargyrum, Chloretum hg., Bichloret. hg., Argent. viv. People are frequently imposed upon by being told that Mercury can be expelled again by taking aperient medicines after . it. Those who hold such language, close their eyes to the effects, which ensue from taking Mercury, for, supposing it was as easy to remove the Calomel as it was to swallow it, the effect produced upon the body will certainly remain; just as if you were to drive a nail into a man's leg and then pull it out again; the hole will remain; it will heal after a while, but requires time and a ratio- nal mode of treatment, or the consequence may be very serious. To give aperient medicines then for the effects of Mercury, is about as sensible as if I were to poke a wooden peg into the wound made by the nail, and imagine it to be all right again. Prepared Mercury, however, cannot be expelled again so easi- ly, and least of all, by purgations, as it immediately penetrates every part of the system, the fluids, the glands, and even the bones. This is the reason that the slow poisoning by mercurial medi- cines is far more difficult to cure than any natural disease; it al- ways requires much time, and in many cases mitigation of the sufferings is all that art can effect for the patient. In most cases, as well immediately as long after taking Mer- cury, Hepar will be found of great service, particularly for the following symptoms: headache during the night, loss of hair, painful lumps on the head, inflamed and red eyes, with pains in the nose when pressed, eruption around the mouth, phlegm deep in the throat, much saliva in the mouth and ulcerated gums, swelled tonsils, hard glands on the throat, a pricking pain when EFFECTS OF THE MEDICINES HITHERTO, ETC. 45 swallowing, coughing, breathing, or vertigo in the head, inflamed suppurating boils in the groin or under the arm-pit, or small ones on the chest, thin evacuations, with a great effort, sometimes mixed with blood, slimy and green; the urine dark red, hot and acrid; coughing when a hand or foot has been cold, or after drinking, sometimes accompanied by spitting of blood; whitlow, or other red, inflamed swelling on the hands and fingers, also on the knee, like gout; the skin does not heal well; every little wound or scratch suppurates and spreads; the skin of the hands , and feet bursts; ulcers, which bleed easily, burn in the night, with throbbing and acute pain; chilly in the air; in the night chills and frequent pains in the limbs; also fever, and afterwards clammy, sour perspiration; the patient very sensitive, the pains almost produce fainting. It is advisable to await the effect of Hepar for some days; if it improves slowly, wait a fortnight; if after this the improve- ment does not continue, repeat the same medicine; if the im- provement was but of short duration, and it were absolutely ne- cessary to give something, Belladonna would be the best; the same will answer, when Hepar has been given two or three times, once every fortnight, and has lost its efficacy. For complaints of the mouth and throat, for swelling of the tonsils, and deafness, give Hepar and Belladonna, and if they produce no change, Staphysagria. For great sensitiveness to the weather, violent pains, particu- larly during the night, worse when touched, great weakness, when the patient has been debilitated by much purging and salivation, give China, and if this, after having been administered two or three times with intervals of four or five days, between each ad- ministration has no further effect, give Carbo vegetabilis, par- ticularly if change of weather makes the patient worse. If, after taking some of the remedies recommended above there Still remain, rending pains in the bones and gouty swellings, give Dulcamara, and afterwards Phosphoric acid; for swellings on the bones (nodes), give Phosphoric acid, and afterwards Sta- physagria; and when this ceases to do good, Calcarea. 46 CHAPTER VT. If these medicines have been taken for a considerable time and the complaint is not completely removed, try Sulphur, and sometime after one of the above remedies again. If Sulphur gives relief, take several weeks afterwrard Calcarea, and after that some other suitable medicine, for instance, Lachesis. If a person has taken much Mercury and afterwards Sulphur, it will be well to give Mercurius vivus, and then Belladonna or Pulsatilla. When a person has taken much Mercury, but no Sulphur after it, and Hepar should not seem to be quite indicated, according , to the foregoing description, give Sulphur. In tedious complaints, caused or aggravated by Mercury, select from the following: Hepar, Belladonna, China, Phosphoric acid, Carbo vegetabilis, Dulcamara, Staphysagria, Lachesis. In many cases, where immediate relief is required, Opium, Pul- satilla, or the medicines prescribed under " Poisoning," will an- swer; in some few cases, Arsenicum, Ferrum, Rhus or Sjlicea will be available. ' Effects of Lead. Lead is commonly an ingredient in medicines, such as white ointment, plasters, lead water, &c, which are used to dry up and cure eruptions, ulcers, bruises, burns and wounds. It is as poi- sonous, when it is applied externally, as if it were used internally, and produces constipation, colic, cough and complaints of the lungs. To remove these effects, give Opium, following by Bel- ladonna, and afterwards, if necessary, Belladonna, Platinum or Nux vomica. Effects of Arsenic. If the so-called medicines contain Arsenic, which is mostly given in fever and ague when the quinine powders will not cure it, or for cancers, applied both, internally and externally, and which generally aggravates the disease, give, every hour or two, as often as worse, Ipecacuanha ; and if this does not effect some improvement, give Nux vomica; if these remedies fail, or if, EFFECTS OF THE MEDICINES HITHERTO, ETC. 47 from the symptoms, Veratrum, Ferrum or China seem to suit better, give one of these. Effects of Iron. Iron is frequently given as steel-drops, steel-pills, &c, for in- termittent fever and complaints of the lungs; but instead of cur- ing the evil, it generally makes it much worse. When the men- ses are not regular, and in general, when the patient is weak and pale, there are some who imagine, that if he be painted red in- side, his outside will likewise become the more fascinating, or, that the iron will enter the bones and make him strong. Iron, however, taken in large quantities, as a medicine, is injurious, as well as all the other metals, only it does not kill quite so ra- pidly. A proof of this assertion we find in springs which con- tain iron, and in which rust is formed; neither man nor beast thrives upon this water; and even those who at last become ac- customed to it, will sooner or later suffer from its effects. In cases where speedy relief must be afforded, give Pulsatilla or China, and if they do not avail, give Hepar, and after some time the former medicines again. In all cases of poisoning by medicine, it is necessary to look under the particular complaint, and to give the medicines there recommended in preference. He who has already taken different medicines, and has become worse and worse by their use, will do well to lay them all aside, no matter what they are called, and should his health not im- prove of itself, nor from the medicines which have been recom- mended here, let him apply to a competent homoeopathic physi- cian, and, in view of all the existing circumstances, not expect miracles. It is often very difficult to give relief to the sufferer, and in most cases it takes a year or more, before he begins to improve, provided he has no hidden disease, which neither the old nor the new method can cure. CHAPTER VII. OF POISONING. Wilful murder and suicide, by poison, are but rare occurren- ces ; most cases of poisoning originate in the carelessness with which poisonous things are handled, in the ignorance of their poisonous qualities, or in the wicked adulteration of eatables and of liquors. With the necessary knowledge, we are frequently able to avoid this danger. As it is of importance to every body to be acquainted with the poisonous substances which threaten life, we will in the first place give some directions, how we may discover these adulterations; how we can guard against other kinds of poisoning; and then recapitulate the remedies, which every one is able to apply himself. ADULTERATION OF FOOD AND LIQUORS, AND HOW TO DETECT IT. 1. Adulteration of Wine. Wines are most frequently adulterated, and here more than elsewhere; those imported into this country have either been adulterated already by the shipper, that they might keep, or it is done here when they are near spoiling, or to make them re- semble wines of better quality, or for other purposes. We will give directions how to recognize adulterated wines, that the hon- est dealers and venders of wine may be able to examine the ar- ticles which they purchase, and that all who have to deal with rascals may first test the wine. All those who, by the directions given below, shall discover that wine has been adulterated, if they have but a spark of feeling for their fellow-men, should expose, without the least hesitation or forbearance, the persons so offending, that this horrible practice may be checked in this country. It is true, that the venders may excuse themselves by saying that they have bought the wine in that state. But the OF POISONING. 49 poison is there, and no one should deal in wine who does not know how to discover these adulterations, or who has not trust- worthy people from whom he orders his wines. At all events it ought to be made known that he had been deceived, and particu- larly by whom he had been deceived. Wines may be adulterated with harmless or noxious substan- ces, and whoever employs the former will employ the latter, for the distinction is but too easily overlooked. We will, therefore, first give some directions how to discover the harmless adultera- tions. To improve light wines by an admixture of finer quali- ties cannot be called adulteration, and may be done without any detriment to the health of the consumer. a) By water.—There is water in the wine when a little of it put into boiling water crackles; when small drops adhere to an oiled reed dipped into the wine and when unslacked lime slacks in it. V) By sugar.—There is sugar in the wine, when, on causing a spoonful of it to evaporate over a coal fire, there remains a sweet sticky substance, similar to molasses. c) By brandy.—There is brandy in it, when, on rubbing a little of it between your hands until dried up, it leaves a smell of spirits; also when the wine burns the mouth. d) By coloring matter.—Wine which contains coloring mat—-. ter, is always bad and adulterated. Fill a small vial with the wine, put your finger over its mouth, and hold it in a tumbler full of clean water, with the mouth of the vial downwards; with- draw your finger slowly, and leave the vial for a while without shaking it. If there is coloring matter in the wine, it will gra- dually mix with the water, but the wine will not. Or strain the same wine through white printing paper, and the color will re- main on the paper. Or drop some spirits of sal ammoniac into a glass of wine, if it turn blue it has been colored. Or dissolve green vitriol in water, and mix it with the wine; if it leaves much black sediment the wine has been adulterated with bark. These adulterations cannot do much harm, but they show, that he, from whom the wines are bought, does not sell them pure. 7 50 CHAPTER VII. We will now point out some adulterations which operate as a slow poison, and which may be the cause of many diseases. e) By lime or chalk.—Lime or chalk is often used to restore wine that is spoiled, or to give new wine the appearance and taste of old; this admixture is very injurious to all who drink it. It may be detected by taking a few grains of salts of white sorrel, and dissolving them in two tablespoonfuls of distilled water, or in water obtained by letting the steam from the spout of a tea- pot, filled with boiling water, pass into a cold vessel. This so- lution, itself a poison, drop into a glass of wine; if you perceive in a few minutes a whitish cloud in it, and the next day a white sediment, there is chalk in the wine. Such wine drank frequently, will occasion gravel, hard glands, swellings, ulcers, sore eyes, tedious headache, diarrhoea, &c. /) By sulphur or brimstone.—Sulphur or brimstone is often found in wine, and many pretend that wine cannot keep without it. This, however, is erroneous, and too much sulphur in wine acts as a poison, particularly with persons of a consumptive habit, or who are subject to bowel or liver complaints; in fact, it is in- jurious to every one who drinks it. The presence of sulphur may be easily detected by putting a clean new-laid egg into a tumbler, and filling it with wine; if the wine contains sulphur, the egg will be of a blackish color in a few hours, and well po- lished silver teaspoons will be blackened by the same process. Another test is to drop a little Lapis infernalis, dissolved in water, into the wine; if it leaves a brown sediment, the wine contains sulphur. g) By alum.—Alum is sometimes contained in wine, and ren- ders it very injurious, when drunk often; a single glass will not unfrequently prove hurtful to a person of delicate health. Dis- solve potash in water, strain it through blotting paper, and pour Borne drops of this solution into the wine; if it foams and pre- cipitates a white powder, there is a probability of there being alum in the wine. If you desire a more decisive proof, confer with an Apothecary, or, dissolve the above mentioned white pow- der, in sulphuric acid diluted with water, adding a small portion OF POISONING. 51 of sulphate of potash. Let it evaporate on a stove and crystal- lize. Should this deposit, which resembles salt, have the hard and acrid taste of alum, the proof is positive. K) By lead.—Lead, or some other metal, is often found in sweet wines, sometimes also in other wines, and is indeed a slow poison, worse than any other adulteration.—A nice taste will detect metallic poison in wine, the sweetness of which is dis- agreeable. Dilute sulphuret of lime in water, and drop some of it into a glass of wine—if it turns brown or black, it contains metallic poison. Suspend a bit of polished zinc in the wine— particles of lead will adhere to it, if contained in the wine. Dis- solve Glauber Salts in lukewarm water till it becomes saturated, let it cool, then pour into a tumbler half filled with wine, aa much of it as will fill the tumbler, let it stand over night, and there will remain a white sediment from the lead. If you put into a glass of wine a few drops of sulphuric acid, and the wine becomes turbid and leaves a white sediment, it contains poison. i) By corrosive sublimate.—If you put a few drops of spirits of Sal Ammoniac into a teaspoonful of water, and throw this mixture into a glass of wine and it leaves the least sediment, the wine contains corrosive sublimate. Try this same wine thus: Put a gold coin on a piece of zinc, put both into a split made in a small stick and hold the stick in a large tumbler full of wine. Should a gray dust immediately appear on the coin, there is cor- rosive sublimate in the wine. k) By arsenic.—If you dissolve lime in water till the latter becomes saturated, then pour off what is clear into a clean tum- bler, and drop some wine into it, if the wine occasions white clouds, it is likely that it contains arsenic. To convince yourself still more fully, dissolve sugar of lead in Aquafortis, pour a wineglassful of this solution into a bottle of wine into which a little salt of hartshorn has been previously put, and stir it. The next day pour off what is clear, and with the turbid part wash the sediment well out, and strain it through blotting paper, till the liquid has passed through; then after the sediment has been 52 CHAPTER VII. dried on the paper, put it upon live coals; if it smells like garlic, it is arsenic. It is not meant to imply that arsenic exists in the wine by the intention of the wine dealer or vender; but that vintners, in the fumigation of their casks with sulphur, are ignorant, that the finest sulphur is apt to contain arsenic, which has remained in it from its original preparation. We recommend these last tests most especially to Clergymen and elders, because we know for certain, that adulterated wines have been sold for religious purposes instead of genuine wines. 2. Adulteration of Vinegar. Vinegar is often adulterated. For this reason use cider-vine- gar, which may always be had pure. Wine-vinegar often retains the poison of the adulterated wine, from which it has been made. There is frequently sulphuric acid in it. This you can discover by means of a solution of sugar of lead, which leaves a white sediment. Corroding vegetable poison is also frequently used. Such vinegar will burn on the lips, which pure vinegar will not do; it leaves also an acid taste in the mouth. You can ascer- tain it still more positively by dropping a solution of potash into the vinegar, until litmus paper dipt in it no longer turns red. Pure vinegar will then have lost its sharpness altogether, and only taste like salt or lye, while a fabricated article will remain of a sharp and acrid taste. 3. Adulteration of Beer. Beer is frequently adulterated, but it is difficult to detect the poisonous ingredients, except by their pernicious effects. This is generally the case with the far-famed London brown stout or porter, into the composition of which those deleterious substances, Nux vomica and Cocculus indicus enter, which are probably used lis bv r^0118 °f ^^ "^ Lere- You ™? P-ceive this by a sudden intoxication and headache th» ™jl • afW ri,.;„i • i . ueduacne tne next morning t:t rcte:dnfgnauseainaheaith^^ g a tumbler lull of it on an empty stomach. Anv OF POISONING. 53 brewer who uses other substances in his beer than malt and hops, brews an unwholesome beverage; salt and sugar may pass, but the effects of other substances will sooner or later be felt by those who drink the beer. It is an injurious deception to use bitter roots and herbs instead of sufficient hops and malt; but Coccu- lus indicus is nearly as bad as arsenic. Alum and vitriol are sometimes used; how they may be detected we will show in the sequel, under "Bread". 4. Adulteration of Brandy. Sometimes there is poison in Brandy, with or without the fault of the distiller, particularly if the fermentation proceeds too rap- idly or is continued too long. This you will perceive by boiling the brandy in a bottle put into a kettle full of water, over a slow fire, till all the spirituous parts are evaporated. An acrid, dis- agreeable taste proves the existence of poison; and experiments similar to those recommended for wines will show what it is. It is usually lead. 5. Adulteration of Sweet Oil. Sweet oil is often adulterated with lead or copper. Dissolve liver of sulphur in water and mix the oil with an equal portion of such solution; if it turns brown or black upon being shaken, it is poisonous. 6. Adulteration of Milk. Milk is sometimes mixed with potash or lime; by putting some Aquafortis into it, it will foam. When milk has been adulterated with starch, it will thicken in boiling; or, if you strain it through fine linen, something will remain behind. 7. Adulteration of Butter. Butter often contains chalk, sand or dye-stuffs. Melt it in hot water, and the foreign substance will be precipitated or mix with the water. 54 CHAPTER VII. t 8. Adulteration of Flour. Flour is often adulterated with sand, plaster, &c. Burn some of the flour or bread to ashes, and you will find the white grains in the ashes. 9. Adulteration of Bread. o) By potash.—A trifling admixture of potash can affect only nervous, debilitated persons, but when there is too much, it may prove injurious to the strongest—occasioning dyspepsia and con- sumption. Pour hot water over the bread till it is quite covered, and let it get cold; then put a strip of litmus paper into it, which has previously been reddened by being drawn through weak vinegar. If it turn blue again, there is much potash in it; the quicker it changes the more potash there is in the bread. o) By magnesia.—Magnesia is also used as an admixture to give to bread, baked of bad flour, the appearance of good bread. This is principally injurious to children and to people of weak stomachs; you may perceive it by its taste being more or less bitter. Burn a pound of such bread to ashes, and you will find the magnesia. c) By alum.—Alum is a very pernicious substance, and fre- quently used. In England the bakers make no secret of it, and mixtures of flour and Alum, or Alum and Salt, are sold public- ly, intended to make white bread out of inferior or spoiled flour, which is doubly detrimental to those who eat it, as spoiled flour is of itself unwholesome. Some bakers do it without knowing that they injure the health of their customers. To detect this adulteration, soak the bread in water, knead it till it dissolves, adding enough water to make it thin, let it remain over night, then strain it, boil it down and let it stand; the crystals of Alum will adhere, and you can taste it. d) By copper.-—Copper is the worst of all adulterations, and thousands had been poisoned with it by the bakers in France and Belgium, before the physicians discovered the imposition. When a baker furnishes bread uncommonly white, fine, large and heavy, you should be on your guard. When such bread is burned, the OF POISONING. 55 flame now and then burns green. To convince yourself perfectly, soak some pounds of it in water, and add enough to cover the whole completely, let it get sour and stand until it becomes clear. If you suspend a rod of polished iron in it, and this turns ever so little red, you may be sure that the bread is poisonous, and will seriously injure the health of any one who eats it. We will now call the attention of our readers to some other poisons, which ought to be known, that they may be guarded against. We are apt to inhale poison in the air. Old wells, caves, cel- lars, vaults, and particularly old privies, frequently contain air that is deadly poisonous; we should, therefore, not enter such places without proper caution, and previously purify the air by lighted straw or gunpowder. The fumes of charcoal, in a close room, or the exhalations arising from smouldering woodwork may cause the death of those who sleep, exposed to these dangerous influences. The dry rot in a house, which gradually destroys the timber and walls, can cause dangerous diseases to its inhabit- ants. Buildings in this condition are not tenantable, and ought to be pulled down, unless the dry rot can be removed. The smell of walls, newly whitewashed, of paint in new buildings, or wherever much painting or varnishing has been done, par- ticularly with poisonous green or red colors, consumes the pure, and engenders a mephitic air. Nothing that has a strong odor ought to be suffered in sleeping rooms; no clothes to dry; no flowers, herbs, fermenting substances, fresh hay, poison against vermin, or quicksilver—all of which will prove injurious to the sleeping—and especially to children, and to females in confine- ment. For in sleep, man is more exposed to external influences, and things, which he would hardly notice when awake, or the injurious effects of which he would easily overcome, will affect him seriously, and may kill him. A person may become ill from sleeping on damp ground, exposed to a draught, in sunshine or moonlight, close to a hot stove, or in an atmosphere filled with odours of any kind. 56 CHAPTER VII. Water is often impure, and people fall sick from using it. Springs which are avoided by cattle, and have a reddish or brownish sediment, are injurious. Whoever considers the loss of time which a trifling indisposition may cause to a whole fami- ly, will not deem that time lost which is spent upon improving the water. Drink no water from rivers on which, a little higher up, there are manufactories, from which dye-stuffs and other noxious mat- ters run into it. Spring or well water is hard, or contains par- ticles of lime or iron, if soap will not dissolve in it; such water ought to be boiled before using it. You should, however, not drink too much, nor too often of it, but rather accustom yourself to rain water, which can be preserved in cisterns, or in casks slightly covered. Water containing sulphurous or salty particles, ought never to be used for drinking or culinary purposes, except in cases of the greatest necessity; for water of this kind cannot be improved by boiling. Stagnant water from ponds, pools, &c, ought not to be used; yet, when no other can be had, it may be improved by throwing into it powdered charcoal, shaking it well, and straining it through a double linen or cotton cloth. It commonly contains putrid particles and eggs of insects scarcely visible, which occasion tedious fevers and other diseases; it will avail nothing to mix it with vinegar, molasses or brandy, if it has not been previously cleaned by charcoal. Bad wells ought to be well cleansed and kept covered; for the water is hurtful, when leaves or other vegetable substances are rotting in it. Pipes of copper, lead or zinc, used to convey water, render it injurious. You should always let so much water run out, as may have stood in the pipes. Milk. Milk is often noxious, nay, poisonous, from disease of the cows—and an individual not quite void of conscience, will rather sustain a small loss himself, than subject others to a loss ten times heavier. Distiller's slops, continually used, never fail to produce disease OF POISONING. 57 in the cows, and render the milk highly injurious to the health of the consumer. Hogs, when fed for a length of time upon this innutritious substance, have been known to lose their teeth, and die in consequence. Meat. The meat of sick animals, slaughtered just before they were dying, is very injurious, particularly if the animal had any erup- tion, or disease of the bowels. The consequences may not appear immediately, but they are certain to come some time or other. Meat, badly smoked, or when undergoing the smoking pro- cess, not kept constantly in the smoke, or during that process exposed to frost; sausages smoked badly or kept too long and become greasy in places; hams, not salted sufficiently, or taken too. soon out of the pickle, and smoked at intervals, or in the spring, when they get alternately warm and cold, or kept piled upon each other in boxes, or packed when damp—particularly when they are smeary around the bones, and have a bad, rancid smell,—contain a very violent poison, which, in many cases, may be the cause of incurable disease. The same poison is also generated in hams and meat, when preserved with pyroligneous acid, instead of being smoked. You can easily know the poison which is developed in fat, or cheese, or old ham, by rubbing a portion of them on blue litmus paper, when, if the poison is present, the paper will turn red or reddish. The same poison is contained, though in smaller quantity, in rancid bacon, rancid butter, or rancid sweet oil. It would be best to throw away every thing of this sort—yet, if you must use them, let them be well washed. This should be done first in cold water, then in three or four times as much boiling water; let it boil about ten minutes, take it out of the water, wash it again in fresh water, and try whether it still contains the poison. Whatever has become putrified—meat, blood, eggs, cheese, fruit, &c,—is hurtful, often poisonous, and nothing can be done to improve it. Meat, preserved in summer by ice, and which has acquired a certain red appearance, having no longer the 8 58 CHAPTER VII. proper smell of flesh, is very unwholesome food. Putrid fish, though ever so well dressed, is a very dangerous food. The gall of every animal is poison. Poison is also generated in curds and cheese prepared too damp, or without a sufficient quantity of salt. Vegetables and Fruits. No one should eat vegetables or fruits of any kind, if he does not know them well; and children ought to be early accustomed to partake of no fruits, &c, unknown to them. It is often the case, that poisonous insects infest vegetables, (cabbage in parti- cular,) or leave their slime on them, and consequently render them very injurious. Mildew which blasts vegetables, is also poisonous. Ergot, which is frequently found in rye, is hurtful to man and beast. Also the seeds of many weeds are noxious. Dry vegetables, containing insects and worms, ought to be care- fully avoided. Nuts may taste sweet, and yet contain rank poison. Even walnuts become injurious, when old and rancid, and occa- sion in many a child a dangerous cough or diarrhoea, often ascribed to a cold. Baisins, figs and prunes are a very good relish, provided they are perfectly sound, though there are some persons who think them injurious, or even look upon them only as a kind of cathar- tic. This point is easily settled by a closer examination, which will show that the white dust adhering to the fruit and resem- bling sugar, (though, in some instances, it may be sugar) proves to be a beautiful little grove of coral, thronged by large, bristly animalculae. No wonder, that with children diarrhoea is produced by such bristly guests. All such things ought to be carefully washed, first in cold and then in hot water before they are used. Mushrooms. These fungi are not so good in this country as in Europe, and more than one half of them are poisonous. It is not true, as has been alleged, that poisonous mushrooms cause onions to turn black. OF POISONING. 59 The best precaution in regard to their use is, to eat none from which a milky juice exudes; none that are old or that dis- solve readily. As to all others, make inquiry and learn which are eatable. Taste them raw, and if they have anything acrid or disagreeable either in taste or smell, do not use them. Let them be well washed in cold water, have them pared and all the gnawed parts cut out. When cut up, they should be scalded with boiling water, then allowed to stand a-while, and afterwards be boiled in fresh water. No one should eat fruit which is half ripe on one side and rotten on the other, at least not without first cutting out what- ever is spoiled. If proper attention was given to this matter, we should not be so frequently troubled with bowel complaints in childhood, and weakness of stomach in after years. Kitchen Salt. G-ood kitchen salt being an indispensable article, every father of a family should endeavor to have it pure. When salt exposed to the open air easily becomes moist, it is bad. If an ounce of fine salt does not perfectly dissolve in four ounces of cold rain water, it contains plaster of Paris, and is injurious. Kitchen Utensils. Care should be used in regard to kitchen utensils. Earthen- ware is often glazed with poisonous substances. Let vinegar stand in a vessel of this kind over night, and the next morning mix it with a solution of liver of sulphur in water, and if it turn black, there is poison in the glazing. Nothing acid should stand or be prepared in such a vessel. Caution is to be recommended respecting iron utensils glazed inside. Copper vessels ought never to be used in the preparation of any thing that is sour; they should always be kept clean and polished and whatever is cooked in them ought not to be left in to cool, for while cooling it will be most apt to imbibe the poison. The same precautions should also be observed with regard to tinned utensils. During the process of cooking, the tin should 60 CHAPTER VII. not be suffered to melt off, nor should the bottom of the vessel be scraped by stirring its contents with a spoon. It is owing in no small degree to the neglect of these things, that we hear of so many slow and tedious diseases which no physician can cure. All those who are so ignorant as, when pickling, to give to cucumbers or beans a fine green color by boiling them in copper vessels, and then eat such trash on account of its fine appearance, or to draw vinegar from casks by a brass spigot, must not complain when they suffer from a weak stomach, or colic, cramp, or nervous diseases; nor expect that a phy- sician or any medicine can expel the copper out of the system as readily as it has been introduced. There are those who can bear it for a long time, yet the bad effects will inevitably follow sooner or later. The copper in its metallic state is not necessa- rily injurious when introduced into the body, but copper dis- solved in vinegar is always poisonous. Coppersmiths are not apt to be more sick than other people, and a person swallowing a copper coin gets rid of it without sustaining any injury. You may have a leaden bullet in your flesh for years without detri- ment ; but the same lead dissolved and taken would destroy you in a few hours. Faints. Paints are noxious, because they nearly all consist of injurious metallic substances in a state of solution. White lead and other white colors are nothing but preparations of lead, and are as bad as if prepared from bismuth or tinglass and tin. Red lead is lead combined with oxygen or acids, and vermilion or cinnabar is quicksilver combined with sulphur. Massicot, chrome, Naples and other yellow colors are compositions of lead. King's yellow, tinsel and orpiment are combinations of arsenic. Blue paints contain copper, as ultra-marine or that virulent poison Prussic acid, as Prussian blue, Paris blue, mineral blue, or cobalt, which, though not as pernicious as arsenic, operates badly enough; it is used as smalts, king's blue and blue starch. Green paints consist chiefly of copper, as verdigris, mineral green, Brunswic, OF POISONING. 61 &c. The chrome green is very hurtful, but Swedish green is worse, because it contains arsenic and proves injurious even by exhalation. That it contains arsenic may be seen by strewing some on live coals, when it will smell like garlic. Bronze which is used in gilding and silvering toys is com- posed of copper, quicksilver, zinc, tin and bismuth. Therefore be careful with such paints, do not let their dust fly about, never use paints containing arsenic, nor suffer any to come nigh the things that are used in the kitchen. To small children, no paintboxes, nor painted wooden or leaden toys should be given, because it is actually putting poison into their hands; colored wafers may also prove injurious to children. Although mineral paints are the most poisonous, yet others also contain deleterious substances. Gamboge is a powerful cathartic. Indigo causes violent cramps and swellings. Cochineal causes toothache and obstruction of urine. And we might enu- merate many others. However, where painting is to be done, use in preference chalk, dyed yellow with birch leaves or cur- cuma, or blue with indigo, or green with both; ochre and other iron colors; also woad, madder, Orleans, cochineal and carmine. Cosmetics and "Washes. Of cosmetics and washes we cannot speak with any qualifica- tion, as it is known that all of them contain poison and that of the worst kind. Cosmetics that are not poisonous will not keep long, and such as do keep are poisonous. There is but one true cosmetic: that is, fresh air and water, and a rational mode of living. To induce ladies to leave off the use of these poisons, the fol- lowing method will be found most effectual. Let them, after using paint, wash themselves in the dark with water in which some liver of sulphur has been dissolved. It can do no harm, and will have the desired effect. Oil of vitriol, aqua fortis, spirits of salt, aqua regia, salts of white sorrel (used to take out spots) are dangerous articles, and 62 CHAPTER VII. should never be left within the reach of children. Sulphuric acid much diluted is not poisonous; aqua fortis mixed with strong spirits is not so dangerous; but the others, however much diluted, operate as violent poisons. The common, or caustic potash, lapis infernalis, hartshorn, unslacked and even slacked lime are dan- gerous substances. The injudicious use of these things given through ignorance in too powerful doses to sick or fainting persons, has been highly injurious, and, in some instances, even fatal. They ought never to be given to smell, or otherwise used, except much diluted. Alum, vitriol, saltpetre, sal ammoniac and liver of sulphur used too profusely are also injurious. Not only things containing mercury, arsenic, lead and copper are poisonous, but also those in which there is antimony, sulphur of gold and various powders. Also whatever contains tin, bis- muth, zinc; lapis infernalis (in short almost every thing that is bought at an apothecary's shop), all minerals and chemicals are more or less dangerous. Even harmless things, improperly used, may prove so. Panaceas and Vermifuges. The worst, the most injurious of all poisons are those abom- inable Panaceas, nostrums, pills, &c, which, under numerous enticing names, are palmed upon the public. No physician will deny that sometimes cures have been performed by them, yet every one knows how seldom this has happened. No medicine will do good unless properly applied. From the manner in which Panaceas and other nostrums are extolled and recommended, it is apparent that those who offer them for sale are only anxious to find purchasers. Thus pulmo- nary consumption is no fixed disease, against which a specific can be recommended. It is so very different, and in almost every case so peculiar, that careful consideration is necessary to dis- cover its nature. The remedies must be adapted to the peculia- rities of the disease. One and the same medicine cannot possibly answer in all cases. Nor can you rely upon the certificates which OF POISONING. 63 accompany the recommendations of these universal medicines. A case often appears worse than it actually is, and even medical men may be deceived, while at the same time a trifling medicine, sometimes simply cold water, will cure it. The great number of universal medicines which we see extol- led as specifics against various diseases, certainly reflects no great credit on the inhabitants of this country. It proves the ignorance and credulity of the purchasers. He who buys and uses such articles may be compared to him who buys a lottery ticket. The ticket venders are the only per- sons certain of a large profit. As many blanks as are in a lot- tery, so many are there in these universal medicines; and the number of prizes in the one and of cures in the other are about equal. No man of sense will venture in a lottery, if he cannot spare the money, which in all probability will be lost. But he who ventures in a medical lottery, not only loses his money, but, if he does not get a prize, receives certain injury, rendering his case worse, more obstinate and more difficult to cure. When a physician prescribes medicine for you, you know at least what you get, and should it prove injurious, may at least be counteracted; if you have not taken too much of such medi- cine, or persisted in the use of it for too great a length of time, it is always possible to make good the injury that has been done. But with those unknown universal medicines this is impossible; because we do not know what we are to treat. Whoever relies upon the impudent assertion that nothing injurious is contained in these nostrums, must be credulous indeed. We have men- tioned already, in the preceding pages, that the poison from many plants is far more virulent than that from minerals. Many of these universal medicines contain, also, mineral poison. For instance, the fever drops (diaphoretic tincture) contain ar- senic; the imperial pills, mercury; and so with many others. Many things of this kind are sold at an enormous price, and the ingredients of which they consist may be had in every apothe- cary's shop for a tenth part of their cost; for instance, Harlaem 64 CHAPTER VII. oil is nothing but a combination of sulphur with oil, and the value of a vial is less than half a cent. So it is with all others. There is not a single one of these pretended secret medicines that a real physician might not have discovered and made known. A physician can apply every medicine in its proper place: the vender of nostrums cannot — his object is to make money; whether his medicine kills or cures is a secondary consideration. Beware of giving children the so-called remedies against worms. Whoever is so inconsiderate as to fill the stomachs of his chil- dren with such trash, should first try these nostrums on himself, and every morning take a small spoonful. It will drive his folly from him. This remark applies, also, to remedies for vermin on the head. These remedies in general are poisonous. Cleanliness is the best remedy, and should frequent washing and combing not avail, rub oil or a little tobacco juice into the hair. Cleanliness will also exterminate all other descriptions of domestic vermin, there- fore do not run the risk of having poisonous remedies in the house, for they often contain corrosive sublimate or something similar, and their very smell is injurious. Camphor or even musk is frequently made use of against moths in fur and clothes, but their odour, especially in bed-rooms, is very injurious. Camphor is, likewise, apt to affect colors, and the effects of musk continue even after it has evaporated. Pie- ces of Russia leather, lavender, thyme, spirits of turpentine, or tobacco leaves, will answer equally well. Vermin in grain is more easily expelled by strong smelling plants, and frequent shifting, than by poison; and there are many instances, where notwithstanding the utmost precaution, men have been killed instead of vermin. What is to be done in Cases of Poisoning. The main object is to expel the poison as quickly as possible, and to prevent its spreading; or to render innoxious what cannot be expelled. Much depends upon promptness. Yet too much OF POISONING. 65 haste frequently leads to mistakes, and nervous agitation causes many to act without consideration. The first requisition is, presence of mind. Whoever is pos- sessed of this, should act, and direct what is to be done. Let him despatch the bystanders after what may be wanted, thus rendering those useful who would otherwise be worse than use- less. In most cases, when poison has been taken into the stomach, the principal object is to excite vomiting, particularly when the sufferer feels inclined to it; or if vomiting has already taken place, to promote it. The best means of effecting this is by ad- ministering tepid water, and tickling the throat with a soft feather. Let water be heated as quickly as possible; in the mean time take the whites of eggs and beat them to a froth. Take pure white Castile soap and let suds be made. Let another person procure sugar, vinegar, sweet oil, milk and butter. Have some strong coffee made, and gruel of oatmeal, barley, flaxseed, or meal of any kind. These articles are usually to be found in every family. Whilst you are promoting vomiting and procuring what is re- quisite, ascertain, if possible, what kind of poison the sufferer has taken. Sometimes a sudden case of sickness is erroneously attributed to poison. Consider, therefore, what may be the most probable cause of the attack, and should any uncertainty exist, do not hurry yourself. You may do many things at random without doing any injury; you will have to do this until you attain certainty. There is reason to apprehend poison, when violent, dangerous symptoms, such as are indicated below, occur suddenly, particu- larly if these show themselves at once, or soon after the sufferer has been eating or drinking. The probability will be still greater, if the patient has eaten any thing unusual. Be therefore diligent in inquiring of the sufferer himself, as well as those who are about him, where he has been, with whom, and so forth. Preserve carefully what he has thrown up, and 9 66 CHAPTER VII. likewise whatever may have been left of his meals or drink. Do not suffer these things to be thrown away, although they should become putrified; for mineral poison can be traced notwithstand- ing; a matter which may prove interesting to the patient, or his relatives. Should this be a matter of importance, throw the whole together into one vessel, and pour plenty of strong brandy over it. As in every serious case of the kind an experienced physician, or an apothecary, will no doubt be called in, let him subsequently examine these things. The treatment must not, however, be deferred; the assistance must be immediate, and while it is being rendered, the cause must, if possible, be ascertained. Always consider, that he who is poisoned may die, if you ap- ply too many things, or proceed with too much haste or violence. Reflect, and do one thing after another quietly and soberly, lest by the means applied you hurt the sufferer more than you do him good. When you know, what poison has been taken, or when you are almost certain, have recourse to such medicines, as are pre- scribed against that poison, avoiding such as might prove detri- mental. When you are uncertain, act according to the following direc- tions, proceeding from mild remedies to stronger ones, if the for- mer prove insufficient. In cases of imminent danger you must, of course, use whatever remedy may be at hand. Vomiting, or an inclination for it, is always a most important symptom, and especially so when occurring during, or soon after meals. Yet to administer an emetic is often as noxious as dan- gerous. The best remedy and a harmless one is lukewarm water, without either oil, grease or butter. Let the sufferer swallow as much of it as he possibly can; at least every minute half a tumbler full, and more if possible. Try to induce children to take it first by kindness, then by threats, and if neither will avail, by force, and if the latter has to be resorted to, open the mouth by inserting a finger at the joint of the jawbone, and pour OF POISONING. 67 it in. Or you may, after the child has just been breathing, sud- denly shut its nose and pour the water into its mouth; but be- ware of doing this while the child is breathing. At the same time let the patient put his finger down his throat, or take a feather, put it into the throat, and turn it around till it excites vomiting. Let the patient incline forward, place your hand on his stomach, support his head, beating him softly be- tween the shoulders. Let him rinse his mouth after he has vom- ited, and remain undisturbed for a few minutes. As soon, how- ever, as he feels another attack of pain, or other symptoms, such as retching, hiccough, or uneasiness, let him drink again until it appears probable, that every thing has been ejected. If he cannot be made to vomit, or if he cannot swallow, at least not sufficiently, or if he retches in vain, does not throw up as much as he drinks, or should he absolutely refuse to drink, and you cannot introduce enough, or should he swallow again what has come up; chew some bread and mix with it half a ta- blespoonful of snuff, put it on his tongue till it excites vomiting, and let him drink tepid water after it. With people accustomed to tobacco this will operate but seldom, with such therefore sub- stitute mustard seed finely powdered, mixed with a teaspoonful of kitchen-salt in a tumbler full of water. These means will al- ways suffice, therefore, beware of using any other. In case the sufferer can get nothing down, is quite confused, cannot swallow, his jaws being tightly closed, blow some tobacco smoke into the anus. To do this take a pipe filled with tobacco, light it, grease the point of its mouthpiece with oil or fat, insert it in the anus, not deeper than about an inch, turning it care- fully; then place on the bowl of that pipe the bowl of another empty one, and blow through this into the other, propelling the smoke inward. After blowing three or four times, stop, and then begin again, and so continue until relief is obtained. The next important remedy is the white of eggs. Have the white of several eggs beat up, mixed with cold water, and let them be drank. This will never do any harm and will certainly give relief, if the poison is metallic, or if the patient is suffering 68 CHAPTER VII. with violent pains in the stomach or bowels, feels as though he should purge, especially in cases of poisoning by corrosive subli- mate, quicksilver, verdigris, compounds of tin or lead, alum or vitriol. Give the white of eggs freely and repeatedly, when the substance vomited is of a red or green color, when dogs refuse to eat it, when the patient has a metallic, coppery, or salty taste in his mouth; in general, when you suspect that he has swal- lowed verdigris, red lead, vermilion, corrosive sublimate, &c. If the patient finds relief from taking white of eggs, you will con- tinue it, and should he be affected with diarrhoea and pain in the anus, give him an injection of water and white of eggs. Sub- sequently proceed according to the directions given below. Another very important remedy, in most cases of poisoning, and applicable when the white of eggs are ineffective, is soap- suds. But for this purpose you must not take soft soap, nor any resinous hard soap, except in cases of the utmost necessity, nor any soap which is stained red, as this is done with poisonous in- gredients, but the best white Castile soap. Dissolve this in hot water, and let the patient drink a tea-cup full of it warm every three or four minutes. Soap-suds will only prove injurious when the poison itself was alkaline, such as lye or potash, soda, caustic potash, oil of tartar, spirits of sal ammoniac itself, English smelling salts, salts of hartshorn, lime, slacked or burned, barytes (often sold as rats- bane, under the pretence of its not being injurious, because it is not arsenic). When the substance which the patient vomits, does not smell sour, but like lye; when blue paper which had become reddish from having been drawn through vinegar, is turned blue by it; when it begins to ferment upon Aqua fortis, or oil of vitriol, or sulphuric or muriatic acid being dropped into it—in all these eases you must not use soap-suds, but substitute vinegar. Soap-suds is the principal antidote in poisoning by arsenic, ead, oil of vitriol, aqua fortis, all strong acids, and most metal- lic solutions. You may conclude that the poisoning originated from acids, when the mouth of the patient is as if scalded, when OF POISONING. 69 blue paper dipped in what he vomited turns red on the instant. Soap-suds is also applicable when a person has swallowed alum. It will also prove beneficial in poisoning by plants of a burning, acrid taste, exuding a pungent juice or milk; likewise in dan- gerous accidents from castor oil. Vinegar, as already mentioned, is an antidote against alkaline poison. As soon as this is ascertained by observation, let the patient drink vinegar, and give him injections of it. Let him also eat slimy gruel, which will excite vomiting. But vinegar is injurious after strong vegetable poisons, various salts, all mineral acids, arsenic particularly when the stomach is painful when touched. On the other hand, it is of great service in cases of poisoning by Jamestown weed, aconite, laudanum, mushrooms, all soporifics, carbonic gas, and liver of sulphur. In such cases give alternately gruel to bring on vomiting, and subsequently, after having vomited freely, let the patient drink vinegar again, which will remove the inclination to vomit. Vinegar also an- swers against poisonous clams and fish. It is an important an- tidote against the poison generated in fat. If a person feels sick from having eaten spoiled hams or sausages, and his throat is very dry, and he feels nausea, hasten to give him vinegar to drink, not forgetting, however, the remedies afore-mentioned. Sweet oil is a remedy by far too generally applied; it is taken to be a principal one, which it is not. The same is the case with grease, butter, and similar things, as buttered water. Care should be paid to the kind of oil used. Rancid oil, train oil, or sperm oil, ought not to be applied. Slimy substances will answer far better to envelope the poison, or sugar, which sooner soothes the stomach; or other means to neutralize the poison. When you are sure that the poison is alkaline, and you are applying vine- gar successfully, you may alternate with cream or sweet oil, par- ticularly when the patient complains of burning in his mouth, throat or stomach. Oil, however, may be applied to great advantage, when a strong acid, aqua fortis, oil of vitriol, &c, has got into the eye, 70 CHAPTER VII. the mouth, the throat, or the stomach. Sometimes it is of ser- vice against poisonous mushrooms. Oil is injurious in poisoning by arsenic; useless in most poisonings by metallic substances, and very injurious when can- tharides have got into the eye, or the stomach. It is literally throwing oil into the fire. This is also the case with insects and venomous bugs, which may have got into the eye. Oil, on the contrary, is of great service, when live insects have crept into the ear. Milk is not so good as other slimy substances; but as it is more frequently at hand, it will do well to let the sufferer drink it, instead of waiting for other things. Rich milk is good where- ever oil is good, injurious wherever that is injurious. Sour milk is good wherever vinegar is so, injurious wherever that is. When you have no good oil, rich milk is the best thing; also when oil becomes disgusting to the patient. Sour milk is preferable to bad vinegar; it may also be applied where vinegar has already been used. Milk is very good when the first paroxysm has sub- sided, and yet some pain remains, provided the patient likes it, and feels revived by it. When you cannot ascertain what kind of poison the sufferer has taken, and you cannot, therefore, choose between the antidotes, but have given milk in the first instance, and the patient feels better after it, you may continue with it, on condition, however, that the patient has vomited at the out- set so much, that you may suppose the poison has been ejected. Sugar and sugar-water is in most cases one of the very best remedies. Only when you are certain that the poison is a mine- ral acid, or strong alkaline poison, prefer the remedies prescribed against such poisons. It cannot do much harm, were you to apply sugar improperly. If the person who is poisoned has a craving for sugar, give him as much as he desires. It is the best antidote against metallic poisons, poisonous paints, verdigris, copper, tin, vitriol or alum, and continue with it, if the patient finds relief from it; should he, however, not feel better, alternate with whites of eggs and sugar; or, where it is applicable, with soap-suds. Against arsenic, sugar is also a principal antidote. OF POISONING. 71 When the poisoning has been effected by sharp acrid plants, which occasion a burning or swelling in the mouth, or in the throat, you may give sugar upon other things, letting the patient either put it into his mouth, or giving it to him in water. Coffee is an indispensable antidote in many cases of poisoning. You must be careful that the coffee has not been spoiled in roast- ing ; give it at first very strong, and then somewhat weaker. In the intervals, do not neglect to excite vomiting, should it be still required. When the poison is unknown, coffee is the best thing you can give; when the patient is stupefied, sleepy, sense- less, giddy, as intoxicated, his face red and full, or pale, cold and cadaverous; or when he acts as if he were delirious or rav- ing,—in all these cases, give him plenty of strong coffee, excite vomiting, administer injections of coffee, till he gets better. Even after he has vomited the whole contents of his stomach, continue giving him the coffee with sugar. In all cases of poisoning, give coffee, if the patient desires it. When the poison is known, and the tepid water intended to bring on vomiting, and tickling in the throat for that purpose has been resorted to, give coffee in abundance, as a drink and in injections, particularly where the poison contained Prussic acid, which you will know from its smelling like bitter almonds, or peach kernels, or peach brandy. Also against laudanum, opium, morphium, Jamestown weed, poisonous mushrooms, &c; where a person has swallowed the juice of sumach, or when dangerous symptoms appear after medicine, containing belladonna, colo- cynth, Valeriana, conium (cicuta); or after chamomile tea. Cof- fee is also important in cases of poisoning by wine of antimony, or when antimony, phosphorus or phosphoric acid have been swallowed, and particularly from poisoning by Nux vomica and strychnine. Camphor is a principal antidote in all poisoning by vegetable substances, and particularly sharp, acrid, burning poisons, which cause inflammation and redness; in all cases of poisoning, where the patient suffers from vomiting and diarrhoea, is pale, cold as ice, and almost senseless; in such cases, if you do not know what 72 CHAPTER VIT. kind of poison has been taken, you should prefer giving camphor. It will suffice to let the patient smell it, or rub it on his skin. You can make a salve of it with warm oil, or easily dissolve it in heated brandy. It is the principal remedy for poisons from insects. Against cantharides, (Spanish flies), whether they have been swallowed, or got into the eye, or when used as a plaster, and they have produced poisonous effects, camphor is always the best remedy. Also when venomous insects or infected honey has been swal- lowed ; for swellings or poisoning caused by hairy caterpillars; for violent symptoms after eating food, in which small bugs or worms may have accidentally fallen, or when small moths have been swallowed—likewise in alarming symptoms caused by the sting of insects. When, together with the other symptoms, the patient finds it difficult to make water, or it is very painful to him, and inter- mixed with blood, and you have cause to think that this origin- ates from Spanish flies, or other insects, camphor is the best remedy. Camphor, finally, is applicable to diminish the effects which medicine may have produced; when children fall sick after tak- ing the usual preposterous worm medicines; in accidents from tobacco, bitter almonds, and medicines that have the smell of these things, or cherry stones, peach kernels, .acorns, or nuts. It is very useful for the pains left by the use of phosphorus, poisoning by minerals, or acids, and particularly salty things. When every thing has been ejected from the stomach, let the patient smell camphor from time to time. This may also be done in poisonings by mushrooms, or in accidents caused by inhaling the fumes of coal or charcoal. The ingredients sometimes requisite, such as charcoal, lye, kitchen salt, starch, green tea, tobacco, are in most families; the other things, often as necessary, such as magnesia, spirits of nitre, spirits of sal ammoniac, ought to be kept likewise, being useful not only in cases of poisoning, but in many other diseases. In cases of poisomng, things of this kind can only be serviceable OF POTSONTNG. 73 where the poison is perfectly known. They will be mentioned in their proper place. From the preceding remarks it is evident, that, in cases of poisoning, measures ought to be immediately adopted: 1st. To excite vomiting. 2d. To lessen the effect of the poison. At first you will have to attend to both alternately, subse- quently to the latter object only. The usual emetics are poisonous, and may therefore prove injurious; it is, therefore, best to excite vomiting by the fol- lowing means:— Drinking lukewarm water, as much and as often as possible. Tickling the throat; and only when this proves ineffective. Snuff put upon the tongue; or in cases in which this has no effect. Ground mustard with salt in water; and only in cases where nothing can be introduced into the mouth. Injections of the smoke of tobacco. The principal remedies to lessen the effects of the poison, when it is unknown, are, where there is great pain, water and the white of eggs—where insensibility predominates, coffee. As soon £)jS it is ascertained whether the poison is an acid, a metal, or an alkali—if acids and metals, give soap-suds; if al- kali, give vinegar. All other remedies are only applicable when you know what kind of poison you are treating. Treatment when the Poison is ascertained. Generally, the before-mentioned rules hold good; besides at- tending to the vomiting, however, administer immediately the remedies here recommended. The antidotes recommended against each particular poison, have been arranged according to their efficacy, the most efficaci- ous being mentioned first. When these are not at hand, give 10 74 CHAPTER VTT. Avhat can be first procured. If a person, for instance, has swal- lowed sulphuric acid, it would be folly to wait until magnesia or white soap could be brought from the apothecary; when these cannot be had on the spot, take a handful of wood ashes, stir them in water and let this be drunk immediately, although it will not answer as well. I. Poisoning by Inhaling Gases and by Substances introduced into the Stomach. 1. POISONOUS GASES, THEIR ANTIDOTES AND TREATMENT. a) Gases produced in places deprived of fresh current of air. In deep privies that have not been cleansed for a length of time; in places deprived of a fresh current of air, where offal of ani- mals is suffered to decay, a poisonous gas of a foetid, offensive smell resembling that of rotten eggs, and in which polished me- tal, particularly silver, turns black, is generated. Such gas inhaled will cause nausea, nervousness and difficulty of breathing; the pulse becomes feeble, there is .an expression of languor about the eye; a coldness is felt in the ears, the ab- domen is contracted, and unless the sufferer is speedily removed from its influence, convulsions and apparent death ensue, which latter, if no medical aid is afforded, will terminate in actual death. The best remedy is chloride of lime. Before persons expose themselves they should provide chloride of lime, some of which diluted with water will destroy the foetid gas, and enable them to work in such places without danger. The bad smell is also speedily removed by throwing in a few shovelfuls of quick lime. A person who has become insensible by inhaling this gas, should immediately be brought into the fresh air, undressed, and placed on his back, with the breast elevated, and cold water thrown plentifully on his face and breast. If you have a solu- tion of chloride of lime in water at hand, dip a sponge in it, and hold it occasionally before his nose. The solution should be rather weak, so as not to excite cough in a healthy person who OF POISONING. 75 inhales it. Put a tablespoonful of the strong solution into a tumbler full of water, and put half a teaspoonful of this into the mouth of the sufferer, repeat it every five or ten minutes un- til the patient begins to revive. If vinegar can be had sooner; mix this with an equal portion of water, and sprinkle the faice with it—and hold a sponge dipt in vinegar before the nose and mouth. During this time the patient should be rubbed with hot flan- nel. If his face has been sprinkled with cold water or vinegar, wipe it dry after a little while; then rub it with hot flannel, and repeat the sprinkling. The feet, the abdomen, breast, and arms particularly, ought to be well rubbed. The soles of the feet and the back may be brushed a little with a stiff brush. Be not too hasty, but proceed gently and perseveringly. Life sometimes does not return in less than three or four hours. If the patient, apparently dead, does not breathe at all, it is useless to hold a sponge before his nose; only try from time to time, by holding a light feather there, whether his breathing has recommenced. Occasionally blow breath into his mouth, which is best done by a person inhaling as much as he can, and then placing his mouth on that of the patient, (whose nose should be closed,) and blowing in the breath gradually. If this expands the chest, let the breath go out of itself, and repeat the opera- tion. If the breath will not come out again of itself, place a towel around the chest, and after the breath has been blown in, tighten it gently. By thus producing an artificial respiration, a person apparently dead may often be restored again, but he, who undertakes the operation should himself be healthy, and have a clean breath, and either drink some vinegar, or rinse his mouth with it occa- sionally. As soon as the patient makes an attempt at drawing in his breath, or at exhaling it with a sigh, discontinue these efforts, and gently fan fresh air toward him, and when the breath- ing becomes stronger hold a sponge to his mouth, dipped in a very weak solution of chloride of lime, or vinegar. 76 CHAPTER VII. Care must be taken indeed, lest you extinguish the feeble life which is just returning. If the patient recovers, give him a few drops of a weak solution of chloride of lime or vinegar on his tongue. If he complains of cold, inclination to go to stool, or nausea, and vinegar will not remove these symptoms, or if he is getting tired of the vinegar, give him a little coffee without milk. If he complains of heat and great weakness, give him a little good old wine. The smell of camphor, too, is often bene- ficial ; in this respect consult the wishes of the patient; whatever is most agreeable to him, or affords him relief, deserves the pre- ference. Another mephitic gas, which is suffocating, is generated in deep wells, vaults and lime furnaces. It has not the bad smell of the gas above mentioned, but makes him who inhales it sleepy, giddy, and at last senseless. Persons affected by it will usually revive in a short time, by bringing them speedily into the open air, sprinkling them with cold water and vinegar, and pouring coffee into their mouths. Do not act with too much precipitation —delay is not dangerous in such a case. If respiration does not return, it will be necessary to inflate the lungs, by breathing into the mouth. V) Gas generated by charcoal.—The gas arising from char- coal is a most dangerous poison, particularly to persons sleeping. Never sleep with lighted charcoal in a room which has not an open fire-place. The same applies to stone coal. Old woodwork, too, has been known to glimmer and smoulder for days, without any smoke being perceptible; the inhabitants of the house, paying no attention to the somewhat smoky smell, have been found in the agonies of death, before the smouldering was at all perceptible. It is remarkable that all persons who are exposed to this gas, become so feeble as to be unable to go into the air, to open doors or windows, or to call for aid. They suffer much and know the danger, but cannot make up their mind to move from the spot, in order to save themselves. A similar sensation seizes upon those who, in extremely cold weather, sit down in the open OF POISONING. 77 air to rest themselves—they know the fate that is before them, but want energy to resist it. The symptoms of having been poisoned by gas produced from coal, where animation is not yet suspended, are headache, with nausea, retching and vomiting—sometimes of blood; a heavy burden seems to oppress the chest, the face becomes red, and at last purple and bloated, the patient is seized with involuntary and hysteric weeping, talks incoherently, falls down suddenly, is seized with fits and convulsions, and finally becomes perfectly unconscious, and is seized with apoplexy. Carry the patients into the fresh air, rub them with vinegar, and let them inhale the vapor of vinegar. If the face is already very red, and they begin to rave, throw ice-cold water on the head. In general, it is well to make cold applications to the head, and warm applications to the feet. When the patient has somewhat recovered, it is well to give Opium, and to dispense with the vinegar. If Opium gives relief, but only for a short time, repeat it. After several hours, or earlier, if Opium does not seem very efficacious, give Belladonna, and allow it sufficient time to operate. If the patient is very much excited, talks much and rapidly, complains of shooting pains, or if it seems to him as if he were flying; feels giddy when lying down, give him a little coffee without milk, and continue it until the symptoms require Belladonna or Nux vomica. c) Dry rot in old buildings.—The effect produced by dry rot in old buildings is similar to that produced by coal fire, only it operates less suddenly. It is better if possible to quit such houses, or to rebuild them; but, if people have to live in them, they should try to destroy the dry rot by means of coal dust. Place as much of this as possible, above, below and around the spot where the dry rot appears. The spots themselves may, from time to time, be washed over with a strong solution of blue vitriol or sulphate of copper. To guard against the effects of dry rot,#make use from time to time of a little rain water, in a gallon of which a few drops of sulphuric acid have been mixed. To obviate the bad effects of the gas produced by chloride of 78 CHAPTER VII. lime to which many persons are exposed, smoking tobacco is the best preventive; or you may drop some strong brandy, rum, or spirits of wine on a piece of loaf sugar, and take it in your mouth. The first however is to be preferred. d) Prussic and mineral acids. — For the effects caused by inhaling the poisonous vapors of Prussic acid or mineral acids, the best remedy is spirits of hartshorn, or of sal ammoniac; but by no means apply the vial containing such spirits close to the nose; this would only increase the evil; rather move it slowly to and fro, at the distance of about six or eight inches from the nose and mouth, so as to smell it very faintly, and repeat this as often as necessary, or put a drop upon paper, and introduce the paper into a large empty bottle, and smell the bottle from time to time. If the vapors were from alkali, such as have been mentioned before when speaking of the alkaline poisons, this remedy will not answer. In this case, the patient should inhale the vapor of vinegar. Whether the vapors are from acids or from alkali, may be discovered by litmus paper. Acids will turn it red, alkali will turn that which has been turned red by acids blue again. In cases of poisoning by acid vapors, you may put one drop of spirits of sal ammoniac into a tumbler full of water, and give of this mixture a teaspoonful every ten minutes. In poisoning from vapor of alkali, give from time to time a teaspoonful of vinegar. It is very injurious to sleep in rooms which have not been ventilated, or which have been shut up for a long time. The air has then become stagnant and putrid—we may almost compare it to the water in standing pools—and produces nightmare, fright- ful dreams, visions, depression of spirits, and fearfulness ap- proaching to horror. The best preventive is proper ventilation, not by opening the windows merely, but by introducing a strong draught of air, increased by the waving of towels, or a blazing fire in the fireplace. Water placed in shallow vessels about the room will likewise answer. But, if the purification has been neglected, and the consequences mentioned ensue, give Aconite; for horror, Opium; for continual fear and shuddering, Vera- OF POISONING. 79 trum ; for headache and other effects arising from sleeping in an apartment, where there were flowers emitting a strong scent, or from sleeping on new hay; fresh air and cold washing will be good, and also the smelling of camphor, or Nux vomica. In complaints caused by sleeping in rooms which have been recently white washed, or where clothes have been hung up for drying, or where a large quantity of clothes has been kept after being dried, or where many growing plants are standing in a confined place, and where fruits or vegetables are lying, Bryonia will generally be beneficial, sometimes Belladonna. See also " Headache." If the painting of houses, rooms and furniture has produced complaints which do not altogether disappear upon going into the open air or after washing with cold water, Aconite, Bryo- nia or Sulphur will prove beneficial, and sometimes Opium. It is well to put a tub of cold water into the bedroom; the water should be renewed every evening. It will absorb the poison. In general, painting ought to be done in autumn only, and when the weather is dry and cool; for the smell will then soonest dis- appear, the paint adhere best, become dry sooner, and be less liable to be spoiled by insects and dust. 2. POISONING BY MINERAL AND OTHER STRONG ACIDS, THEIR ANTIDOTES AND TREATMENT. In cases of poisoning by sulphuric acid or oil of vitriol, mu- riatic acid or spirits of salt, nitric acid or aqua-fortis, aqua-regia, salts of wild sorrel, phosphoric acid, acetic acid, wood vinegar, or too much strong wine-vinegar, the symptoms are a sour burn- ing taste and smell, a burning acrid heat in the throat and the stomach, retching and vomiting, acute pains in the stomach and intestines; drinking increases the pains—the breath soon be- comes offensive; what is vomited tastes very sour, ferments, and blue litmus paper dipped into it turns red; frequently the inside of the mouth looks as if scalded and marbled. In this case give : 1. Tepid soapsuds in great abundance. 2. Magnesia—a spoonful in a cup of water—after every fit of 80 CHAPTER VII. vomiting, or repeated when the pains increase. Burnt magnesia is not so good as common. 3. Chalk powdered and mixed in a tumbler full of warm water. 4. Woodashes—a spoonful mixed in a tumbler full of warm water. 5. Potash or soda—dissolve as much as will lie upon the end of a knife in a large tumbler of warm water. Give Nos. 1 and 2 alternately; the others are intended merely as substitutes until the former can be procured. After the patient has vomited sufficiently, let him drink gruel or barley water, pearled barley, decoction of linseed or rice, or any thing else slimy that is at hand, and let him use nothing else for several days. When the worst is past, give after sul- phuric acid, Pulsatilla; after muriatic acid, Bryonia; after nitric acid, Hepar; after phosphoric acid, Coffea; after other acids or wood-vinegar, Aconite. Before administering these medi- cines, try what smelling camphor will do. When strong acids have got into the eye, oil of almonds or fresh unsalted butter should be freely applied to it; occasionally you may apply chalk, mixing it previously with water until the latter assumes a curdled appearance. Pure water is injurious, and should not be used to wash the eyes with until later. For an external scald or burn with strong acids, limewater is good, or a salve made of limewater and sweet oil. 3. ALKALINE TOISONS, THEIR ANTIDOTES AND TREATMENT, Pot and pearl ash, lapis causticus, lye, salts of tartar, soda, ammonia, corrosive spirits of sal ammoniac, spirits of sal ammo- niac, English smelling powders, salts of hartshorn, spirits of hartshorn, burnt and unslacked lime, may be known by their alkaline, urinous, acrid taste; and in vomiting caused by them there is no fermentation of the substances ejected; litmus paper which has been turned red by acids becomes blue again by being dipped into them; the symptoms are nearly the same as from acids, with the exceptions mentioned above, and that what is thrown up is not sour. OF POISONING. 81 1. Stir two tablespoonsful of vinegar in a glass of water, warm, if you have it at hand, and give a wineglassful of it every five minutes. 2. Lemon juice or other acids, but greatly diluted; or sour fruit bruised in water. 3. Sour milk. 4. Mucilaginous drinks and injections. Emetics are danger- ous, and vomiting should only be excited by the above-men- tioned drinks, and by tickling the throat with a feather. In poisoning with barytes (a peculiar kind of heavy, white earth, which is sometimes sold as ratsbane), pure vinegar is in- jurious; in this case give merely mucilaginous things and oil, and endeavor to excite vomiting, until you can procure Glauber salts (sulphate of soda), which should be dissolved in vinegar and then diluted with water and drank freely. Afterwards let the patient sometimes smell of camphor, or if this is of no use, smell sweet spirits of nitre. After poisoning from potash, Coffea may frequently be given, and afterwards Carbo vegetabilis; after spirits of sal ammoniac, Hepar. 4. OTHER SUBSTANCES WHICH HAVE A POWERFUL EFFECT, THEIR «. ANTIDOTES AND TREATMENT. a) Liver of Sulphur.—To counteract the effects of liver of sulphur take water, with some vinegar or lemon juice in it; oily and glutinous drinks and injections. If drinking warm water and tickling the throat does not produce vomiting, give a weak solution of tartar emetic. After the patient has done vomiting, give vinegar, and if it gives no relief, Belladonna, and discontinue the vinegar. 6) Iodine is often given as a medicine, although it sometimes produces sudden and dangerous effects. To remove these effects, give, 1. Starch stirred in water; 2. Paste made out of starch; 3. Wheat flour, and afterwards, thin mucilaginous drinks. For the remaining symptoms give Hepar; sometimes Belladonna. c) Phosphorus.—Oil and fat of all kinds, when given for the bad effects of Phosphorus, are dangerous. Give merely mucila- ginous drinks and excite vomiting as quickly as possible; if you 11 82 CHAPTER VII. cannot succeed in doing this immediately, make use of tobacco or mustard, and afterwards give coffee without milk. Some hours after it a spoonful of magnesia has frequently a good effect. If neither this, nor the smelling of camphor gives relief, take Nux vomica. If the patient desires it, give a little good old wine or brandy, but only a few drops on sugar. d) Alcohol, or strong spirits of wine and ether, taken inad- vertently, may produce dangerous consequences. Generally it suffices to give milk and mucilaginous drinks. If these dont answer, give a drop of corrosive spirit of sal ammoniac in a glass of sugar water, a teaspoonful at a time. Throw, also, cold water on the head; and place wet towels on the region of the stomach. If that does not give relief in a short time, give Nux vomica and, as long as the stomach can bear it, mucilaginous drinks. Afterwards, coffee without milk. e) Prussic acid.—Known by the smell resembling that of bitter almonds. It operates so rapidly that you must lose no time in administering the proper remedies. In such a case there is no time to excite vomiting. Let the patient smell spirits of sal ammoniac, held at a little distance. Drop a little on a hand- kerchief, and hold it so that only a faint exhalation may reach him. Or, put a drop of it into a tumbler full of water, stir it, and give him a teaspoonful of it every three to five minutes. As soon as you can, get coffee made, give plenty of it to drink, and also in injections. If no other remedies are near, let the patient smell camphor or vinegar, and inhale the vapor. After- wards give Coffea or Ipecacuanha ; and if this does not remove all the symptoms, give Nux vomica. /) Alum.—Give soap-suds or sugar-water until vomiting ensues; afterwards Pulsatilla or Veratrum. g) Vitriol, white, green and blue.—Give sugar and warm water, or the white of eggs dissolved in cold water, until the patient has vomited several times; afterwards give gruel, &c. h) Saltpetre and Sal Ammoniac.—Give tepid water or melted butter mixed with water, until the patient vomits co- piously ; then plenty of mucilaginous drink. OF POISONING. 83 5. METALLIC SUBSTANCES, THEIR ANTIDOTES AND TREATMENT. a) Arsenic.—Arsenic is contained in Ratsbane, fly-stone, cobalt, king's yellow and orpiment; in fever drops, salves and plasters for cancers, and numerous secret remedies, particularly in those for horses and cattle. In cases of poisoning with arsenic give, 1. Soap-suds; 2. Water with white of eggs; 3. Sugar water; 4. Milk. As soon as the patient has vomited, repeat the remedy. There is not much danger when copious vomiting brings up everything. Vinegar is of no use, and oil is rather injurious. The best antidote for arsenic is the liquid acetate of iron. If you cannot get this at a druggist's you may easily prepare it yourself, by mixing a hot solution of copperas in water with a hot solution of twice as much carbonate of soda, straining the whole through a piece of linen or muslin and stirring the thick mass, which remains upon the cloth in strong vinegar (2 table- spoonsful to \ tumblerful of vinegar). It is to be taken by the tablespoonful at first every 10 to 15 minutes. Fresh blood has been recommended still more recently as the best antidote to arsenic. Experiments have been made with calf s blood, but, in case of necessity, the blood of pigeons, fowls, &c, will answer; it may also be obtained by bleeding an animal. The proportion recommended is two tablespoonsful of blood to each grain of arsenic taken. Stir it well before administering it, or let the patient drink it slowly that it may not coagulate. After drinking it he must endeavour to retain it on the stomach, as long as possible. Subsequently, give Ipecacuanha several times; if the patient still feels very uneasy and irritable by night, is also feverish, give China; if he is worse during the day, after sleeping—if he is constipated, or has slimy diarrhoea, give Nux vomica. If Ipecacuanha leaves frequent nausea, vomiting, with heat or cold, and great weakness, give Veratrum. The liquid which hatters use in the manufacture of fine hats contains arsenic. The wearing of such hats frequently causes eruptions on the forehead, or sore eyes. To prevent this, have 84 CHAPTER VII. the hat well lined with silk and leather, and for the bad effects give Hepar. b) Corrosive sublimate.—For this poison give, 1. the white of eggs in water; 2. sugar-water; 3. milk; 4. starch made from wheat flour, dissolved or boiled in water; 5. flour paste. White of eggs in water is the principal remedy; you may give it alternately with sugar-water. The remaining symptoms require the same treatment as those from poisoning by medicine. See " Mercury." c) Copper, Verdigris.—For these, or any other preparation of copper, give, 1. white of eggs; 2. sugar—both with or with- out water; 3. milk; 4. other slimy substances. If aid can be rendered immediately after taking the poison, and you have sulphur at hand, take a flat piece of iron and make it red hot. Then, let the sulphur melt on it so that it runs along its surface, and let it drop into water. After that take the sul- phur, grind it, and mix it with water, shaking it well. After the coarser particles have settled, let the patient drink the water quickly, a tablespoonful or even a teacupful at a time. This will, also, answer in cases of poisoning by other metals. But if it can not be given immediately administer the white of eggs forthwith. d) Lead.—In poisoning by lead give, 1. Sulphurated iron, prepared as above; 2. Epsom salts or sulphate of magnesia; 3. Glauber salts or sulphate of soda. The former is the best; when it cannot be had, take the latter. A tablespoonful should be dissolved in a pint of warm water, and drank in abundance if much of the poison has been taken; 4. white of eggs; 5. soap; 6. milk. After the salts or soap give mucilaginous drinks and injections. c) Nitrate of Silver, Lunar Caustic, Lapis Infernalis— Give common salt dissolved in water in abundance; afterward, mucilaginous drinks. /) Antimony.—For poisoning by this taken either as antimo- mal wine or tartar emetic, give, 1. a decoction of gall-nuts, or OF TOISONING. 85 oak bark, or the peel of pomegranates; 2. coffee without milk, in large quantities; 3. mucilaginous drinks. For convulsions give Opium; for nausea and other effects, Ipecacuanha. g) Tin.—For poisoning by tin, give, 1. white of eggs; 2. sugar; 3. milk. Poisoning by tin occurs very often, from sour victuals being left in tin vessels. Things that are sour or sourish should never be allowed to cool or to remain in metal vessels, nor should sil- ver, tinned or tin spoons be left in victuals. Sour things should only be kept in stoneware, porcelain or glass. The chronic effects of tin, which occur so frequently, are mitigated by Pulsatilla. 6. VEGETABLE POISONS, THEIR ANTIDOTES AND TREATMENT. a) Poisonous mushrooms.—These fungi do not generally pro- duce any perceptible effect until several hours after they have been taken. The abdomen then becomes enlarged, with a cutting pain in the region of the stomach; vomiting and purging pre- ceded by thirst, nausea, hiccough, agitation; coldness of the limbs, small pulse, numbness, incoherent talking and convul- sions. If these symptoms appear, promote vomiting, and let the patient drink freely of cold water, as cold as it can be had; from time to time give finely powdered charcoal, made into a sort of paste with sweet oil. Should this not afford sufficient relief, let the patient smell gently of spirits of sal ammoniac. The remaining symptoms may be removed by wine or coffee. b) Blighted corn, Ergot.—Blighted corn, or those thick, black grains in Indian corn, rice, wheat, rye or other grains; also the sweet or black rusty taint in grain is very injurious to man and beast. The ill effects of it however can be counteracted by the common black nightshade, bruised in cold water, and then hot water poured on it. Inhale the vapor of this or wash the cattle with it. External injuries from plants which exude a pungent, milky juice, and which are very common in the country, are cured by 86 CHAPTER VII. washing with soap water and afterwards with brandy. If some of the juice has got into the eye, apply the oil of almonds, un- salted butter or milk; if it has got into the stomach use soap- suds, milk, &c, but neither acids nor emetics. The same holds good of all acrid, burning, corrosive, vegetable substances, as gamboge, euphorbium, &c. c) Intoxicating plants.—For plants which are intoxicating in their effects, making the person who takes them drunk, or de- priving him of consciousness, making him delirious and raving, the principal antidote is, coffee drank in large quantities and given in injections. For some of these substances, such as opium, laudanum, or poppy heads and Jamestown weed, vinegar answers very well. If the patient has a red face, red eyes, looks wild and stares, cold water thrown over him is very useful. For parts of plants which smell of bitter almonds, and con- sequently contain that virulent poison " Prussic acid," such as bitter almonds, peach kernels and laurel leaves; also for cor- dials prepared with them, such as cherry brandy, persico and noyau, and many preparations called medicines; all of which are easily detected by their peculiar smell and bitter taste and by their effects: heaviness, giddiness, oppression, particularly on the chest, first a quick, afterwards a slow pulse, lameness or a feeling as if lameness were about to ensue: for all these coffee without milk is the chief remedy, and in very dangerous cases, spirits of sal ammoniac, of which the patient may smell gently from time to time, or mix a few drops in a tumbler of water and give every ten or fifteen minutes a teaspoonful. d) Opium or laudanum.—For poisoning with opium or lauda- num, the seeds of poppy, or a decoction of poppy heads, which are foolishly given to children to make them sleep, coffee is the best antidote; before this can be got ready give vinegar; if the patient lies insensible, beat him hard on the back and hips until consciousness is restored. Emetics are useless, and if the drink- ing of coffee does not produce vomiting, try to force it with cold water and tickling the throat with a feather. Sometimes a tea made of oats will answer (that is common oats such as are given OF POISONING. 87 to horses), wash well a large handful of these, and then pour two or three cups of boiling water on them. Give a teaspoonful at a time. Some time after, it is well to give Ipecacuanha, repeating it a couple of times, and if the pains remain, after some days, Mercurius vivus. For poisoning with the seeds of Stramonium, called also, thorn-apple or Jamestown weed, or vul- garly Gymson weed; give also coffee and lemon juice or vinegar in large quantities; if no vomiting ensues, tobacco is very appli- cable in this case; for the remaining symptoms give Nux vomica. e) Poison vine.—Poison vine is apt to cause a complaint simi- lar to St. Anthony's fire (erysipelas). Rubbing or scratching should be avoided as much as possible, and strong washes or unguents to drive in the eruption are also highly injurious. If careful washing with soap and water does not relieve the itching, try rubbing with wheaten bran, or dusting with hair powder. Let the patient abstain from every thing that is heating and stimulating, and take Bryonia, to be repeated if the complaint gets worse. If the irritation is in the face, and Bryonia does not give relief, give Belladonna. /) Pink root.—In cases of poisoning by that noxious plant, " Pink root," (Spigelia,) so frequently given for worms, let the patient smell camphor, give him coffee without milk, and if after the expiration of several days, palpitation of the heart, giddi- ness, &c, still remain, give Mercurius vivus. g) Camphor or Saffron.—In cases of poisoning with Cam- phor or saffron give coffee without milk till it brings on vomit- ing, and if all the symptoms do not disappear, Opium every hour until they cease. Spirits of turpentine.—In cases of poisoning with spirits of turpentine, Opium, Belladonna or Bryonia will prove efficacious. For poisoning by all other vegetable substances let the patient smell camphor, and give him coffee to drink if the camphor does not afford relief. If they produce a feeling of numbness, weak vinegar may also be given; if very painful, soap-suds and milk. 88 CHAPTER VII. 7. ANIMAL POISONS. THEIR ANTIDOTES AND TREATMENT. a) Spanish flies.—Spanish flies, (cantharides,) or plasters made thereof, contain a virulent poison, which not unfrequently produces very serious symptoms, especially if it gets into the stomach or into the eyes. It causes violent burning, which is aggravated by oil, fat, milk, &c. The best antidotes to be used, both inwardly and applied to the eyes, are the white of eggs and tepid, slimy substances, such as gruel, &c. Apply these plentifully to the eye, or if you have nothing else, use flour, and do not wash and rub too much. The poisonous substance may often be extracted with a narrow strip of linen rolled into a point, (as you would make a lamp-lighter). For all bad consequences arising from taking cantharides, or from their application in blisters, and for similar poisoning from other insects, camphor is the chief remedy. Let the patient smell it every minute, and rub with spirits of camphor the parts most affected. For headache rub the temples; for violent pains in the kidneys or bladder, rub the loins. V) Poisonous honey. For the injurious effects of poisonous honey, camphor is also most to be recommended. Smell of it and rub with it. Inwardly give warm tea or coffee without milk. c) Hair of caterpillars. The hair of caterpillars is apt to cause violent inflammation. Do not rub, for it will only make it worse; but apply handkerchiefs which have been moistened with spirits of camphor. d) Shellfish and other poisonous fish, &c. Among shellfish, such as clams, muscles, cockles, &c, we sometimes find some which are poisonous and produce troublesome complaints. If there is an inclination to vomit, encourage it; give charcoal with sugar and water, or in molasses: let the patient smell camphor and afterwards drink coffee without milk. For eruptions and swelling of the face give Belladonna. If poisonous fish produce bad symptoms, give finely powdered charcoal with brandy, and if this affords relief, some hours after, coffee without milk; if it does not afford relief, give quantities OF POISONING. 89 of sugar to eat or to drink in water; if this also proves ineffect- ual, give weak vinegar internally and apply it externally. When the poison or urine of toads, frogs or lizards has got into the eye, rub in the saliva of a healthy person, and give Aconite every hour, or as often as it is worse. If the poison has entered the mouth, take as quickly as possible a tablespoonful of finely powdered charcoal with milk or sweet oil. If sudden and dangerous symptoms appear, let the patient smell spirits of nitre. Some time after give Arsenicum. e) Poison of fat in half-putrefied meat. The poison of fat generated in half-putrefied, half-sour meat, blood and fat and also in cheese, particularly in blood-puddings, liver-puddings, sausages, head-cheese, sour pork, bacon and hams, old rancid goose-grease, and substances not sufficiently or regularly smoked is very inju- rious. It is generated very fast, and things which are eatable to-day, may be poisonous to-morrow. The principal symptoms of this poison are: heartburn and nausea; a feeling of dryness in the throat, extending, by degrees, into the mouth, the nose, ears and even the eyes, and which after some days produces cracking of the skin on the eyelids, the sides of the nose and the points of the fingers. The voice becomes hoarse very soon, the pulse is slow and weak; hunger and thirst are very great, but the patient can scarcely swallow any thing. It is generally attended by great weakness, the eyelids seem lamed, the pupil of the eye is distended, and the patient does not see distinctly, but as if he were looking through a fog, or he sees every thing double. The abdomen at the same time is tight, with much pain and constipation; finally, the knees and feet be- come stiff. If the patient does not die in a few days, a tedious, incurable disease will remain. Any one who has eaten of such things, and after some hours notices these symptoms should not be tardy in applying the pro- per remedies. If within four or five hours after the meal he feels disposed to vomit, let him drink tepid water to bring it on. Sometimes the burning and dryness in the throat are supposed to arise from acidity in the stomach, and people take magnesia, 12 90 CHAPTER VII. which does no good; or they imagine it to be from corrosive poison and take oil, which likewise is useless. The only things that can do good are acids. As soon as the stomach has dis- charged its contents, give weak diluted vinegar; let the patient wash himself with it and gargle with it. Lemon juice answers still better. When the patient is getting tired of the acid, give from time to time some sugar. Occasionally you may give a cup of coffee without milk, or, what is still better, strong black tea. If the dryness does not diminish or returns again, if slimy in- jections do not produce any evacuation, give Bryonia, and give it six hours to operate. If a temporary improvement takes place, give Bryonia again, as often as it gets worse. None but slimy injections, with a little acid, ought to be administered. If there are still some symptoms left after the use of Bryonia they may be removed by Phosphoric acid; should the lameness or dryness remain, give Arsenicum. 8. POISON GENERATED BY SICKNESS OF ANY KIND. Sickness of any kind in man or beast generates poison in a similar manner, as putrefaction does in animal substances. These poisons differ as much in their nature as the diseases themselves; some produce but a trifling, others a very considerable effect; some by mere evaporation, but most of them when they enter the blood or the stomach. Every one shuns what a sick person ejects, and thus a natural loathing preserves us from these bane- ful influences. For this reason careful people avoid the garments of those who have for a long time suffered from a dangerous dis- ease. But against diseased animals we are not generally suffi- ciently on our guard; their exhalation alone proves injurious in many cases. Thus, that from a horse which has glanders, may effect a human being with a disease quite different. The excre- ment of sick animals is still worse; their saliva and the pus from sores is always poisonous; but notwithstanding the decidedly dangerous consequences, leprous or measly pigs continue to be killed and eaten. The most dangerous disease in this respect is the disease of the OF POISONING. 91 spleen in cattle. If the blood of such an animal only falls upon the hand, it may prove infectious; the same consequence may result from the skinning of such animals, nay from the tanning of the skins, and yet avarice and ignorance continue to persist in the skinning of these diseased animals. Their flesh, though salted and smoked, is a poison, and always produces death or a lingering incurable disease. The disease of the spleen in cattle is known by a sudden sad- ness and dullness; they stumble and tremble, particularly after drinking; they have a dry hot skin and short breath; during these symptoms inflammatory tumors are formed. Unless such cattle can be saved by throwing frequently large quantities of water on them, they must die. In case the latter event takes place endeavor at least to preserve other animals that may have been exposed, by the use of cold water. Those which perish, should be buried in a very deep pit, without being touched by the hands. Every thing which has been in contact with such animals, should be burnt, buried, or be purified with chloride of lime in water. When a person has been infected with the disease of the spleen, he feels first melancholy, weak and chilly; red spots, black in the centre, show themselves on different parts of the body; these soon become bluish tumors, and eventually inflammatory gan- grenous ulcers. By no means put a poultice on them, nor any thing warm and moist; bleeding is also dangerous. The best remedy is quiet, a strict diet, drinking plentifully of cold water, and frequently throwing it over the patient, and drying him quickly afterward. Internally give Arsenicum, not too frequently repeated. Whatever has been soiled by horses which have had the glan- ders, should be cleansed with chloride of lime; exposing it for a long time to the air and the sun, also, will make it innoxious. If a person has been infected by a glandered horse, give Phos- phoric acid, and if this fails, Arsenicum. Some time after Sul- phur may be taken, if necessary; and if some symptoms still remain, after three or four weeks, give Calcarea. None of these 92 CHAPTER VII. remedies should be given oftener than once every five or ten days __and should not be repeated as long as the case improves. When one has reason to fear he has contracted one of these diseases by contact with the animal, exposure to oppressive heat is recommended. Should the infection be imparted, Lachesis is an excellent remedy. In horses, a cure may often be effected by the administration of Aconite, Rhus and Arsenicum, in the order in which they are named. n. Poisoned Wounds. STINGS AND BITES OF ANIMALS, THEIR ANTIDOTES AND TREATMENT. a) Stings of spiders. The sting of spiders, and of the long, broad, many-footed animals (centipedes) &c, with two fangs in the mouth; that of scorpions with a loose sting at the end of the tail; that of bees, wasps, hornets, humblebees with a sting in the back part of the body; the stings of many flies, musqui- toes, and of bugs furnished with a fine tube for drawing blood, are rarely dangerous, but may become troublesome by their numbers, and produce serious consequences by attacking tender parts; especially when little children, or very delicate persons are thus afflicted. The chief remedy is smelling camphor, and washing with cold water. If you can catch an insect of the same kind, crush it and put it on the wound. A good remedy, if it can be borne, is to hold the injured part to the fire; or bring a red-hot coal, wire, or lighted cigar or pipe as close to the spot as possible, and hold it there until the pain is removed. b) Stings of bees, &c. When pursued by a swarm of bees, take care not to strike at them with a view of keeping them off, for it does no good, and only irritates them the more; make your escape as quickly as possible; but should a swarm follow you notwithstanding, particularly in the bushes, and should many have already alighted on your head, and there be no water near into which to plunge, lie down flat upon the ground, with the face downward, protecting the sides of the head with your hands, and lie still till they are gone. OF POISONING. 93 Moisten the wounds with saliva, and pass your finger nail over them to extract the sting and the poison; then put on black garden mould, renewing it whenever the pain increases; or rub it with honey, scraped chalk, or one of the remedies mentioned. For the sting of a bee in the eye or the mouth, honey is the best application; try to extract the sting from the mouth by scratching with the finger nail; and from the eye by using very delicate pincers; afterward smell camphor, or take Arnica, Bel- ladonna or Pulsatilla, until relieved. The same observations apply to the stinging of wasps, only that in this case the sting does not remain in the wound. Always warn children not to bite imprudently in an apple or a pear in which is a hole; sometimes a wasp is hidden in it, and their sting in the mouth is very dangerous. When a person has been stung in a very tender part, and in- flammation, swelling and fever ensue, give camphor to smell as long as it relieves the sufferer. Should the inflammation, however, continue, give Aconite, and if this does not operate quickly, Ar- nica. If the tongue is much swelled, and Aconite does not pro- duce the desired effect in half an hour, and Arnica in an hour or two, give Belladonna every half hour or hour until relief is obtained. If this should fail, give Mecurius vivus in the same manner. If the eye is much inflamed, give Aconite and Arnica alternately, allowing the former one, and the latter four hours to take effect, extending these periods as long as there is any improvement; externally, apply only cold water. Secondary symptoms, if they continue for several days, are mostly removed by Mercurius vivus. Musquitoes may be driven away by the smoke of brown sugar, strewed upon live coals or red-hot iron; after some time let the smoke pass out, and close the doors and windows. The bites of musquitoes which pain severely, are speedily relieved by the application of lemon juice. Be careful not to remove the effects of the stings or bites of insects too quickly, when they are numerous; the consequences are the same as when an eruption of the skin is too suddenly 94 CHAPTER VTT. checked • rather give Aconite, and some hours after, Arnica. If not better the next day, give Hepar. c) Bites of snakes. Of the bites of snakes, it is well to know immediately, whether they are poisonous or not. All poisonous snakes have in the upper jaw two long, large teeth; all those which have in the upper and lower jaw, each two rows of teeth, are not poisonous. The bite of a venomous snake is generally attended with violent shooting, and sometimes burning pain. When the serpent is not venomous, rub salt or gunpowder into the wound. But if it be venomous, tie two or three inches above the wound a ribbon, cloth, strap, rope, or the like, tightly around the limb, to prevent the blood's returning from the wound to the heart, and leave it as long as the patient can bear it, or until the danger is past. The best remedy is heat. What- ever can be had soonest, red-hot iron or coals—if nothing better, a lighted cigar—must be brought as near to the wound as pos- sible, without causing violent pains, and without burning the skin. Cauterizing, or burning with a hot iron, is useless, because it destroys the smaller vessels. Apply, therefore, the hot iron or coal as close to the wound as the patient can bear it. As soon as the iron or coal cools, have another ready. Place several pieces of iron at once into the fire, and change them frequently; and take care that there is a sufficient supply of red-hot coals. The heat should only operate upon the wound, and on the parts immediately around it, and not on too large a space. Do not blow the coals which you apply, this would cool the skin too much. If you have oil or fat at hand, smear it around the wound for three or four inches, and when absorbed, renew it. If you have no oil or fat, take soap or saliva. Whatever oozes forth from the wound must be carefully wiped away. Continue to apply heat until the patient begins to shudder and to stretch; if this should occur soon, continue the application for an hour if he can bear it, or until the symptoms of the poison give way. If these symptoms return, renew the application. Give, inwardly, as soon as possible, some salt-water, or as much salt or gunpowder, as will lie on the end of a knife, or a OF POISONING. 95 little garlic. If bad symptoms appear notwithstanding, give wine or brandy, a few drops, or half a teaspoonful at once, every two or three seconds, until they disappear again, but resume the treatment as soon as they re-appear. If the shooting pains grow worse—if they are in the direction of the heart—if the spot turns blue or spotted, or swells—if vomiting, giddiness or fainting en- sues, give immediately Arsenicum. If the symptoms become worse notwithstanding, repeat the same half an hour after; if there is no change, repeat it some hours after; if there is im- provement, do not repeat it until worse again. If two or three doses produce no effect, give Belladonna. If ash-root can be had, make a poultice of it, and put it round the limb, and give, also, an infusion of it to drink. Seneca-root, also, is at times serviceable. Phosphoric acid will sometimes remove the remain- ing symptoms, and sometimes Mercurius vivus. The poison may also be sucked out. This can do no harm, unless the person who sucks the wound should have a sore on the lips, or in the mouth. It is, however, well at any rate to take a little garlic or salt in the mouth. The sucking must be strong and continuous, and the wound must be drawn well asunder. Whilst sucking, press your hand hard toward the wound over the adjoining parts, particularly from the side next the heart. Immediately after the wound has been sucked, rub into it fine salt as long as it will receive any, or gunpowder, tobacco ashes, chewing tobacco, wood ashes, whatever of this kind is at hand; salt, however, is the best. At the same time, let the patient keep as quiet as possible; the more motion, or the greater the agitation, the greater will be the danger. d) Bites of mad dogs. The bite of a mad dog, or of other rabid animals, should be in the beginning treated the same as the bite of serpents. Burning, cauterizing, cutting, lacerating, suppurating, and all similar cruelties, are positively useless; the more you lacerate the wound, the more rapidly will the poison enter into and circulate with the blood. The application of radiat- ing heat should be repeated every day three or four times, an hour each time, or until shuddering appears. Let the wound 96 CHAPTER Vn. heal quietly after the above means have been resorted to, and only make use of the following precaution. The before mentioned preventive, or another in which you have confidence ought to be applied until the scar of the wound be- comes of the natural color of the skin. It should be renewed whenever the wound appears hard, dark colored, red or inflamed. Sometimes after seven days, or later, particularly when the patient has a slight fever, a. small blister will appear under the tongue; have this lanced with a pair of finely pointed scissors, or a penknife, and let the patient rinse his mouth with salt water. The vapor bath has proved a very efficient remedy. If there is an opportunity of using it several times, soon after the bite, it will, no doubt, be of benefit to the patient; at any rate, apply it as soon as the least suspicious symptom makes its appearance. These symptoms are, sudden and unusual thirst followed by shud- dering and loathing when drinking; an aversion to any thing bright, and to the wind; great sadness and dejection. The bath may be of service, although convulsions should have commenced. To administer the vapor bath, the patient should be in a place large enough to have sufficient air to breathe, and yet so small as to be easily filled with hot vapor. If the patient is already suffering from convulsions, he should be wrapped in a sheet, to confine his hands and feet, but the neck and head ought to he perfectly free. A small, wainscoted room, which can be tightly closed, is best. Into this room carry red-hot stones, as many as necessary throw water upon them, or if the patient cannot bear this, wet sand. Accordingly, as the stones cool they must be removed, and reheated by a strong fire. Place a tray with wet sand near the door, in which saw a hole to pass the stones through, or place them on a bench or table near the window. It is well to have some one in the room with the patient. All these directions, however, become useless, unless a good fire is kept up, and there is a sufficient number of persons to change the stones and heat them, for the whole room must be closely filled with hot vapor for a sufficient length of time. If the bath is used as OF POISONING. 97 a preventive, one to two hours are requisite; if used after the convulsions have commenced, until they cease. Tincture of Cantharides may also be mentioned as a preventa- tive. Mix one drop of this in a tea-cup full of water, and give one drop of the dilution every day until the effects of the medi- cine become troublesome. If the patient labors already under hydrophobia, give Lachesis at every return of the convulsions. Should the next fit be stronger, wait for two or three more; if they are less intense, give nothing further. As soon as they become more violent, give the same medicine again. If they do not vary, repeat the same medicine after three hours. When Lachesis appears no longer efficacious, give Belladonna or Hyoscyamus. The endless variety of medicines for hydrophobia, to which every country and every year make new contributions, do not deserve much consideration, as not a single mad dog has ever been cured by them. They are mostly recommended as having prevented the disease; but as only about one person in twenty of those who have really been bitten by rabid animals are attacked by hydrophobia, whether medicines have been used or not, this pretended prevention proves nothing. Many persons are attacked by hydrophobia through the imagination, and for such cases any remedy will answer. We ought not to place too much confidence in the methods of cure so often recommended; and to subject every one bitten to the tortures of cauterizing, cutting and bleed- ing to excess, is absurd. In most cases nothing is required; and in the few cases where the poison takes effect, such violent means are of no use whatever. When putrid animal substances have got into a wound, or pus—matter from ulcers of men or animals—give Arsenicum. According to the foregoing remarks, we thought it advisable, to prepare the following table, by referring to which any one can easily find the proper antidotes, in the most dangerous cases of poisoning, where it is necessary to do something immediately, 13 98 CHAPTER VII. TABLE OF ANTIDOTES TO THE MOST POWERFUL POISONS. POISONS. ANTIDOTES. I. GASES. Gas produced in places deprived of fresh air, such as privies, wells, &c........ Vapor of charcoal..... II. ACIDS. Prussic or mineral acids . . . Sulphuric, muriatic, nitric, phos- phoric acid, spirits of vinegar and strong wine vinegar . . III. ALKALINE POISONS. Pot and pearl ashes, lapis infer- nalis, salt and oil of tartar . IV. METALLIC SUBSTAN- CES. Arsenic....... Corrosive sublimate ; copper : verdigris......, Lead.......... Lunar caustic...... Tin ... . Chloride of lime ; vinegar. Vinegar and vapor of vinegar. Spirits of hartshorn. Tepid soap - suds ; magnesia; chalk, powdered and mixed with water; wood-ashes mixed with water, potash or soda.— Vinegar; lemon juice, and other acids ; sour milk; mucilagin- ous drinks and injections. Soap-suds; white of eggs with water ; sugar - water; milk; rust of iron.— White of eggs in water; sugar- water ; milk; starch from wheat flour.— Epsom salt; glauber's salts.— Common salt dissolved in water. Sugar, white of eggs and milk. CHAPTER VHI. EXTERNAL INJURIES. Concussion, Bruises, Sprains, Dislocations, Fractures, &c. Concussion of the brain may be produced by a blow upon the head, a fall, and sometimes by a violent shaking of the body. In cases where the violence is not very severe, there will be some disorder of the intellectual functions, producing vertigo, dimness of vision, trembling of the limbs, sick stomach, &c. The symptoms are different in more severe cases. The acci- dent is immediately followed by insensibility, relaxation of the extremities, coldness of the skin, feebleness and irregularity of pulse, difficulty of breathing and dilatation of the pupil. The breathing, however, though weak and laborious, is usually free from stertor (snoring). After a time, the patient begins to recover from this con- dition, and there is a gradual return of the warmth of the body, the breathing becomes more natural, the pulse rises, and the sensibility is partially restored, so that he may be roused from the apparent sleep or lethargy in which he is generally found, and made to answer questions, especially those relating to his injury. As the stupor and other symptoms gradually wear away, inflammation of the brain of an active character frequently begins to develope itself, which, if not speedily checked by appropriate treatment may terminate fatally in effusion or suppuration. Treatment.—In the treatment of concussion of the brain, as well as in all other cases of injury arising from external violence Arnica is the remedy chiefly to be relied on. It may be given internally by placing two or three pellets upon the tongue or by dissolving a few pellets in a tumbler of cold water and giving a 100 CHAPTER VIII. dessertspoonful of this every half hour to two or three hours, as may be indicated by the urgency of the case. A few teaspoonsful of cold water, immediately after the in- jury, will often be of great service in reviving the patient, and should always be resorted to, as it can do no harm. The appli- cation to the head-of cloths dipped in cold water, and to which in case of external injury a few drops of Tincture of Arnica may be added, will also be of great benefit; keeping the head in an elevated position during the treatment will also be service- able in assisting to prevent and remove inflammation. If the injury has been severe, the patient should be kept quiet—and avoid all kinds of excitement until perfectly recovered. The diet should be of the most simple kinds; and no wine, brandy, coffee, spices, or stimulants of any kind made use of. Bleeding, which is a common practice with the more ignorant of the old school practitioners, should not be resorted to, as in many cases death has ensued from large bleedings, intended to obviate inflammation of the brain. If active inflammation of the brain should set in, notwith- standing the use of the means recommended above, it may he necessary to administer Aconite, Belladonna, and other remedies recommended under that head, which see. Concussion of other parts of the body may occasion a variety of unpleasant effects. Sometimes internal parts are distended or torn; pains arise, which increase the following day; violent headache, giddiness, pains in the chest, asthma, hacking and cough, spitting of blood, pain in the back, descending pains in the belly, &c. In all such cases Arnica is the chief remedy. The patient should be as quiet as possible; drink plenty of wa- ter ; wash the painful parts frequently with cold water, or with water containing a few drops of Arnica Tincture; neither eat nor drink any thing stimulating; make use of no wine, brandy, coffee, tea, or spices, of but little salt, and of nothing sour. If the accident was attended with sudden fright, give, first, Opium, and some hours after Arnica. If the patient faints, wash his head, face and arms with cold water, and give Aconite; EXTERNAL INJURIES. 101 and after he has recovered from the fainting, if necessary Arnica. Bleeding is quite unnecessary; Aconite will generally keep down the inflammation, and Arnica will accelerate the healing. When pregnant females, in consequence of a fall, slip, or other violent concussion, feel pains in the abdomen, a thing which occurs very frequently in the first month of pregnancy, and which may easily bring on a miscarriage, give Arnica and let the patient keep quiet, if possible, in the horizontal posture, and avoid, for several days, every exertion. Should the pains, notwithstanding, become violent some hours after Arnica has been given, give Chamomilla or one of the other medicines re- commended under " miscarriage". In headache from concussion, if Arnica is insufficient, give Belladonna or Phosphoric acid, whatever may suit best accord- ing to the symptoms enumerated under " Headache." Affections of the chest, caused by violent concussion, are removed by Arnica. Sometimes, but not very frequently, Aconite or Rhus is required. Look under " Chest," Part II. Overlifting. If lifting or carrying heavy loads, or any sudden exertion of strength produces pain, give Rhus, which may, in fact, always be given, if the injury was more the result of lifting than of external violence. When, from this cause, very acute pains are felt in the small of the back, which becomes worse on every motion of the body, give Bryonia. If this does not relieve entirely, Sulphur. If headache ensues, and Rhus will not remove it, try Calca- rea once. If a person, by lifting or over-exertion, has strained or other- wise injured himself, in consequence of which he has nausea or a disposition to vomit, with violent pains in the bowels, give Veratrum. For a predisposition to be hurt by lifting, even when there is no over-exertion, give Sepia whenever it takes place. 102 CHAPTER VIII. Mis - Steps. A mis-step sometimes causes pains in the limbs, sick stomach, &c. They will generally be relieved by Bryonia or Rhus, or, if the stomach is much affected, by Pulsatilla. If the injury occurs often, and is caused by debility, it will be cured by Phosphorus, which should be given whenever it returns. Bruises (Contused Wounds). A bruise is generally caused by a blunt instrument, or some hard surface coming in violent contact with a part of the body. There is usually swelling which will be proportionate to the extent of the injury; and more or less discoloration of the skim owing to the rupture of some of the smaller blood vessels and the consequent effusion into the cellular tissue. The pain is not generally very great. When the injury has been extensive, it may be followed by sloughing and mortification. In the treatment of bruises, nothing is more efficacious than the application to the injured part of cloths (linen is to be pre- ferred) dipped in cold water, and the internal administration of Arnica. This will, in most cases, soon remove all traces of the injury. In very severe cases, followed by fever, it will be necessary to give Aconite, which may be alternated with Arnica at inter- vals of from three to six or eight hours. A lotion of Arnica Tincture in the proportion of three or four drops to a tumbler of water may also be used. If a limb is crushed, and flattened or otherwise disfigured, it should be pressed by the hand from time to time until it re- turns to its proper form; or, it may, if necessary, be straightened and kept in its natural position, by means of a piece of paste-board and a roller. Should suppuration (formation of matter) ensue, from neglect, bad management, or impurity of the blood, Hepar must be given. For erysipelatous inflammation, which sometimes makes its appearance, and may be known by the wound assuming a red EXTERNAL INJURIES. 103 appearance, which soon extends to the surrounding integuments, and the affected parts become hot and burning, and are painful to the touch; give Ruta internally, and apply a solution of the tincture in water, externally. But should the incipient signs of mortification present them- selves, as increased swelling and pain, the pain of a pungent burning kind, loss of sensibility, heat and color, and the wound begins to change to a darker hue, give China ; and if the skin assumes a dark, livid color, recourse must be had to Arsenicum and Lachesis, which should be given alternately, at short intervals, and may prevent the loss of life and limb. Amputation should be postponed as long as possible; many a limb has been saved by the reluctance of the patient to have the operation per- formed. Bruises of the Eyes. Bruises of the eye, from blows with the fist, a stick, stone, a flying cork, &c, are to be treated in the manner indicated above; change the piece of linen, as soon as it becomes warm, for a cold one, and tie over both of the eyes a cloth, for the purpose of keeping the light and the air from them. Whenever the pain becomes more severe, give Arnica and Aconite alter- nately. Shocks and Bruises of the Head. When children fall, and their heads receive a considerable shock, and they begin to vomit, crying but little or not loud, and sleep uncommonly sound and long, give Arnica. Do not let them sleep too long, but rouse them up and keep them awake a while. Try also and prevent their taking cold or being over- heated, and dont let them eat or drink anything stimulating. If fever or convulsions should appear give Belladonna; and if not relieved by this and there should be in addition a constant picking at the nose with the finger, China should be given. Belladonna will also be indicated in the following symptoms; constant tossing of the head from side to side; disposition to press the back of the head on the pillow; giddiness or pain after 104 CHAPTER VIII. shaking the head; dilatation of the pupils of the eyes, not only in the dark or after waking from sleep, which is natural, but at all times. Hepar may follow the Belladonna if the latter has failed to afford sufficient relief, and allowed to act for several days. If some of the above mentioned symptoms should remain not- withstanding ; if the head becomes larger, if the skin is elevated on the upper and anterior part of the head, " opening of the head", and there is a perceptible beating there, give Calcarea. Bruises on the head of children should not be compressed with a knife; but treated with applications of cold water, or water with a few drops of Arnica Tincture in it, and the internal ad- ministration of Arnica. Consult also Concussions and Hydrocephalus in their respective chapters. In all cases of this kind, however, it is better to con- sult a homoeopathic physician. Sprains. A limb is sprained when, after a fall or other violence, it pains severely, cannot be moved without pain, swells and turns red. At the commencement of the treatment of these troublesome injuries, apply cold water freely or a lotion of Arnica. Arnica may also be taken internally. After the removal of the more acute symptoms, it may be necessary to resort to the use of Bryonia or Rhus toxicodendron to aid in removing the Btiffness and soreness which may remain. Passive (gentle) motion of the limb will also be beneficial. Dislocations, Luxations. The removal of the head of a bone from its corresponding articular cavity is termed a dislocation or luxation. It is characterized by violent pain, loss of motion, swelling, alteration in the shape, length and direction of the limb. An unnatural depression or prominence can generally be felt in the vicinity of the injured joint; and there will be also a peculiar EXTERNAL INJURIES. 105 rigidity of the limb. By comparing the injured with the sound limb the deformity will at once be apparent. Treatment.—The first thing to be done is to give Arnica, or, if there is already redness and inflammation, Aconitum, and to apply cold water or diluted Tincture of Arnica. You seldom find a person who will undertake to set the joint again ; and as abortive attempts will only make the matter worse, the sooner you send for an experienced surgeon, the better for the patient. In many cases, therefore, it will be more prudent to put the patient on a litter or settee, and have him carried to a physician, in preference to sending for one. Cold applications, and Arnica internally, will always be beneficial. Nor is it ne- cessary to do anything more after the bone has been set; all poultices, salves, bleeding, &c, are injurious. A proper bandage must be applied, and as soon as the inflammation abates, which, after taking Arnica and perhaps Aconite, will soon take place, the limb should be moved often, but carefully, lest it grow stiff. Fractures. The most certain sign of fracture is crepitation, a peculiar grating noise or sensation, produced by the rubbing of two broken surfaces of bone together. When on moving an injured limb you can perceive this sensation, it is a pretty sure indica- tion that it is fractured. In addition to this, there is usually some deformity, pain, swelling, inability to move or use the limb, and sometimes it is shortened. Fractures have been divided into simple, compound, compli- cated, transverse, oblique, comminutive and longitudinal, according to the nature and extent of the injury. By a simple fracture is understood a mere solution of the continuity of the bone, unattended by severe contusion or external wounds. A compound fracture differs from this, in being joined with an external wound or with a protruded bone. When a bone ia broken at more than one place, or combined with luxation, with rupture of tendons, ligaments, &c, with the laceration of one or more large blood vessels, or with a gun-shot wound, the fracture 106 CHAPTER VIII. is termed complicated. A fracture is said to be transverse when its direction is perpendicular to the axis of the bone. It is ob- lique when it deviates from a perpendicular direction. In com- minutive fracture the bone is broken into several pieces; and a longitudinal fracture runs lengthwise of the bone. Treatment.—In all cases where fracture is suspected send for a surgeon, and for a skilful one too; for mistakes committed under these circumstances, can hardly ever be remedied. There- fore, instead of employing, in the first fright and hurry, an in- different practitioner, because he is nearest at hand, rather send for a more skilful one, though it may take a day, before he can arrive. When children are the sufferers, more despatch is re- quired. But in ordinary cases, a couple of days may elapse without incurring any risk, a broken bone does not unite so very readily. Before the arrival of the surgeon the broken limb should be moved as little as possible; on the painful part put linen bandages dipped frequently into cold water, or diluted Arnica Tincture; internally give Aconite, if the patient is very weak or fainting, and some hours after, Arnica. Only when the pains are insufferable, and occasion convulsions, give, first, Chamomilla, and afterwards Arnica. In very rare cases only, when the pains are excruciating, and other bad symptoms appear, will stretching of the limb afford any relief. To accomplish this put a towel around the limb, above the fracture; another below it; fasten these towels to ropes, and these to the bed-post; by these means stretch the limb, and keep it for some time ex- tended. After the arrival of the surgeon, he will take charge of the patient and apply the necessary splints, bandages, &c. Symphytum will also accelerate the recovery of the patient after the bone has been set, and enable him to use the limb much sooner than otherwise. But should the bone not unite readily, but remain loose—as sometimes happens with aged persons- mix a small portion of diluted Phosphoric acid with lime-water, dry the sediment which will be formed in this mixture, and give the patient as much of it as will lie on the end of a penknife, once every 3, 4 days. EXTERNAL INJURIES. 107 Wounds. a) General remarks.—We ought first to know what wounds will heal of themselves, and when treatment is necessary; we ought to know how the cure can be accelerated, and what must be done, in dangerous cases, until a surgeon can be procured. All wounds which are not mortal heal of themselves, without any medicine, unguents, plasters or salves. External applica- tions are almost always injurious, and all rational practitioners have long ago discontinued the use of them. Nothing more is necessary than to apply a proper bandage, and to wet it, from time to time, with cold water. If requisite some medicine should be given internally, and attention be paid to the diet. The most important thing in the healing of a wound is to bring the sides in close contact. Small superficial wounds may be closed by pressing the sides together, and tying a bandage around the limb to keep them in that position. Common, small cuts on the fingers are often troublesome for a considerable time, as they prevent us from using the hand; but they will heal quickly with a healthy person, if sewed together, an operation which after a little practice can be performed easily and without giving pain. Close the wound immediately, to prevent the escape of blood; press till the skin becomes white, that you may see the cut and take hold of it; then take a very fine needle, with a linen, or better, a silk thread, which has been divided, pierce through the skin, either entering near to or at the cut; if it pains, you have gone too deep. When the wound is very small, and not deep, you may stitch from one side to the other, right through, making a common seam, without a knot at the beginning or end. When the cut is deeper, or forms an angle, draw only once through; tie the ends together over the wound and cut them off; proceed in this manner, placing one loop near the other. It is better to take but a short thread, for if you have to pull much, the skin sometimes breaks and gives pain. Sometimes it may be better to take two needles, fasten in each one end of the thread, and pass each needle from the interior edge of the cuticle outwards. 108 CHAPTER VIII. When the wounds are longer, penetrating through the skin into the flesh, this superficial suture will not suffice, but you must use adhesive plaster. Cut this into strips, a few inches long, narrower in the middle than at the ends. Warm them with your breath, or by wrapping them around a bottle filled with hot water, or around your arm, the side on which the plaster is, of course turned out, till the plaster becomes soft. The narrow part must be placed on the wound. In applying them press the wound well together, and draw the strips tightly over it; they should be long enough to extend several inches beyond the wound on each side, otherwise they will not stick well. The hairs ought also to be shaved off from about the wound, and all moisture carefully wiped away. Open spaces ought to be left between the strips, particularly where the wound is deepest, that, in cases of suppuration, the matter may be allowed to escape and prevent the formation of abscesses. In dressing the wound the limb should be put in such a po- sition that the wound will not gape, and should be kept in that position as much as possible. Deep lacerated wounds, or long cuts in the face, lips, eyelids, neck, &c, have sometimes been united by deeper sutures, which a surgeon alone can make properly. Considerable stabs, or other narrow and deep wounds, must not be closed in this manner, as they would heal on the surface, and suppurate at the bottom. But if they are so situated that they can be compressed at the bottom, as well as at the orifice, it may be done until the surgeon arrives, who in all such cases should be consulted. Besides being sewed, every wound ought to be dressed with adhesive plaster, that it may be the more firmly united, and that the air may be prevented from entering it, at the same time the limb ought not to be more compressed and laced than is neces- sary. The bruising of the skin, especially on the knuckles, ends of the fingers and on the shinbone, sometimes causes a bad sore, and often becomes troublesome in children. The best applica- EXTERNAL INJURIES. 109 tion for such sores is obtained by opening a raw egg so that the break extends from butt to point; peeling off the skin with which the shell is lined, in strips as broad as you can make them, and put these with the side which was next to the shell, on the wound until it is entirely covered. b) Hemorrhage caused by ivounds.—Wounds which have been closed and dressed in the aforesaid manner, generally cease to bleed. Sometimes, however, it is necessary to place a compress of linen upon the wound, and to keep it there with bandages. Cold water applied immediately and freely will frequently stop the bleeding, yet there are cases where it does not suffice. When the blood is gushing out of the wound, when the wound is on the throat, the superior and interior part of the thigh or arms, the whole limb or side of the neck should be compressed, and a surgeon procured immediately. The hemorrhage is still more dangerous when light red blood flows from the wound, and the blood squirts at intervals as the pulse beats. Hasten, in such a case, to obtain the assistance of an experienced surgeon ; but as every delay is dangerous, tie a cloth tight around the limb above the wound, in the direction of the heart; above this bandage on the interior part of the limb feel for the artery, which you will know by its beating; place on this spot a cork lengthways, press it well home, put over it a compress two or three inches square, and as thick as a finger, and over this a bandage, which tighten until the bleeding stops, Immediately upon compressing the artery, the blood sometimes flows more freely than before, but it will soon stop. Do not omit frequent applications of cold water or ice to the wound. People are apt to have recourse to very improper and injuri- ous means to stop bleeding; in the fright they tic one cloth over the other, until they exhaust their whole stock of rags and handkerchiefs. But that cannot stop the bleeding—it merely conceals it. When the first firm bandage does not stop it, the rest are useless and pernicious, as they prevent the cold water from penetrating, and conceal the danger. Some persons put upon wounds which bleed profusely a mass 110 CHAPTER VIII. of the most heterogeneous things imaginable; vinegar, cobwebs, balsam, brandy, spunk, lead-water, the white of eggs and sweet oil, charcoal, glue, alum, soot, lemon juice, shoemaker's wax, gum Arabic, tar, urine, tan, oakleaves, salves, unguents, and other trash, to stop the effusion of blood ; all these things render the healing of the wound more difficult, as they soil the surface, and as every thing extraneous entering into a wound has again to be expelled by suppuration. When a proper bandage, the application of cold water and of ice, a quiet and easy position of the patient, does not stop the bleeding, hasten for a surgeon, and until he comes proceed as follows. Put on the tongue a little salt, and if this proves useless, a little vinegar and water; abstain also, as much as possible, from giving the patient drinks, especially any thing warm. Let the wounded part be elevated, and see that there is no more pres- sure on any part of the body than can be avoided. Should he faint, leave him at rest, and do not annoy him with smelling bottles. Fainting may be beneficial, for in this state the blood flows less rapidly, and is more apt to congeal in the wound, espe- cially when aided by applications of cold water. If the patient turns quite pale, and becomes blue in the face, or has jerking on the limbs, however, there is danger, and China should be given im- mediately. After this, if worse again, give him a little good old wine, and after that, if necessary, repeat the China. The same remedies ought to be given after much loss of blood, but when the bleeding has ceased the patient may drink small quantities of cold water as often as he asks for it. ^ To stop the bleeding, when the first bandage and the applica- tion of wet rags does not do it, give Arnica; if this fails, Ipe- cacuanha. The black glutinous drops which hang in chimneys where wood is burnt, will answer, if nothing better can be got. Take a portion of this as large as a pea, dissolve it in a table- spoonful of brandy, until the latter turns brown—mix this with half a tumbler of water, and drop it into the wound. If creosote can be had at the apothecary's, it is to be preferred. EXTERNAL INJURIES. Ill The bites of leeches sometimes bleed too much; children have thus bled to death in the night, when proper attention was not paid to them. The wisest plan is to use no leeches at all; but they who have no knowledge of better remedies, must be expected to have recourse to improper ones. These wounds can be closed by putting in a couple of stitches, in the way before explained —they give no pain whatever. With children who dread this, the bleeding may be stopped by pressing the finger upon the wound for a considerable time, and applying some gardener's or shoemaker's wax. During the night particular attention should, notwithstanding, be paid lest it recommence. After a vein has been opened, the same precaution is necessary. The patient ought to rest undisturbed, and some one should be in attendance to see that the vein does not bleed again. c) Cleansing of the wound.—However well a wound may have been bandaged, it will not heal if it has not been properly cleansed; therefore, before dressing the wound, free it from every thing extraneous. If the wound is full of dirt or sand, or if there are splinters in it, small pieces of glass, fish bones, shot or rags, or if the iron which made it was rusty, it will not heal so easily. All foreign substances should, if possible, be removed, by the forceps and by washing well with water. If you find it impossible to cleanse the wound thoroughly, dress it but lightly, so as to prevent the air from penetrating, without pressing it much, and renew the dressing frequently.—Wounds of this kind, particularly when splinters remain in them, should always be dressed by a surgeon. When a person has run a nail, fish-bones, splinters or glass into his foot, you cannot always remove it entirely, surgeons too, are sometimes apt to cut in every direction, but in vain. Into such a wound drop at once a little vulnerary balsam; balm of Peru is best; but if you have none, use Canada or any other; put over this a compress of linen, and tie it to the sole of the foot. Kenew the application of the balsam every day until the wound has healed from within. At the same time the wounded person should walk occasionally, even though painful to him; 112 CHAPTER VIII. the motion will assist in cleansing the wound. If there is much inflammation, apply cold water externally, and internally the remedies prescribed below. If after a wound in the sole of the foot has healed, violent pain is experienced when walking, we may infer that there is still some foreign substance in the foot. By fastening to the sole of the foot a cork sole, a thick piece of pasteboard, or a thin board with a hole cut in it just where it touches the sore part, and let the patient walk on it frequently; at the same time, give two successive mornings Silicea and Hepar, and after waiting seven days, Silicea again. The extraneous matter will generally soon be brought out. The seeds of the plantain weed, crushed and externally applied, are said to have a good effect. If you can feel any thing plainly under the skin, let an incision be made to take it out, or let the skin be scraped very thin with a sharp knife. c?) Subsequent treatment and diet.—Besides stopping the hemorrhage, and cleansing and dressing the wound, its sub- sequent treatment as well as the diet of the patient, is a matter of importance. When the wound is large, the patient should keep as quiet as possible; he should neither exert his mind nor his body too much; he should drink plenty of cold water, and avoid every thing stimulating—too much salt, spices, smoked food, &c. If the dressing was necessarily put on very tight, loosen it somewhat if it becomes troublesome, the next day. If not too tight, leave it undisturbed for two or three days, if the wound does not suppurate, and remove it gradually. In removing a piece of sticking plaster, always begin at both ends and proceed to the centre; begin to remove the strips at one end of the wound, replace the strip removed immediately by another, and continue in that manner till finished, in order that it may not open again or be dragged asunder. If possible, leave the dressing until the wound is healed; in summer, how- ever, and when wounds suppurate freely, the dressing should be EXTERNAL INJURIES. 113 changed frequently. The threads in the sutures are to remain until they drop off of themselves. Cold water is not only serviceable in stopping the bleeding and cleansing the wound, but also in healing it afterward. Put on a compress of linen, and dip it frequently in cold water—par- ticularly when there is swelling, redness and pain. Or take lint, dip it in water, and cover the wound with it; put over this some paper which has been rubbed over with wax, or thick oiled paper, and tie a handkerchief over it, to keep the adjacent parts dry. As the heat abates and the wound heals, renew it less frequently, and when the heat is gone, discontinue it altogether. All wounds which suppurate badly, are to be treated as ulcers —of which more hereafter. Wounds of this kind should not be treated with cold water dressings, but with applications of warm water and poulticing. All wounds from laceration, bruises, and others which cannot be accurately united, must be drawn together and treated with cold water, unless they suppurate. To all wounds over a bone, on the head, the breast-bone, the elbow, finger-joints or the knee, the shin-bone or the ankle, apply nothing but cold water, without any bandage—unless in the beginning, to stop the bleeding, you may make use of pres- sure; afterward, merely tie something over the wound to keep off the air, particles of dust, &c. All other applications are in- jurious, as they may produce ulcers, which sometimes eat into the bone. The remedies recommended for fractures, may, like- wise, be applied externally in a diluted state. e) Remedies.—By selecting in every case the suitable reme- dies, the cure will be consideraby accelerated. Therefore, as soon as the patient is at rest, give him one of the usual remedies prescribed for wounds. If, after such a medicine, the fever increases and is attended with dryness of the skin and great restlessness, give Aconite; but if the restlessness is accompanied by great excitement, Coffea; should the patient have lost much blood, give China; but if 15 114 CHAPTER VIII. no great improvement takes place within 6, 8, 12 hours, admin- ister one of the following remedies : Arnica, if the injury has more the nature of a bruise than of an open wound, if the parts affected are brown and blue, or be- come so; if the wound can be well united; if it was merely in the skin (remembering that the skin, in some places is very thick); Calendula, if the wound is lacerated, if it is a deep gash, whose sides can be but imperfectly united; if moving causes pain, even after the wound is dressed; if the skin or flesh has come off in pieces; if the wound looks torn and jagged; Staphysagria, if the wounds are clean, deep cuts in the flesh made by a sharp knife, or glass, or consequent upon surgical operations. Hypericum is the most suitable remedy in stabs or cuts and wounds caused by bruises and laceration, when the pain is ex- ceedingly severe, and particularly, if it continues for a long time, resembles that of a violent toothache, and is extending from the wound upward along the limb. The same remedy is also bene- ficial, when children become convulsed after every trifling in- jury- The medicines should be administered in pellets internally. For external application take a few drops of the tincture, dilute it considerably, and with this moisten small pieces of rags and place them on the wound. To persons who have a bad skin, which is irritated by the slightest injury, give Chamomilla, and should it do no good, give Hepar. Sometimes it is necessary to give Silicea and the remedies prescribed for ulcers. f)Lock-jaw.—(Trismus.)—When convulsive symptoms, the result of an injury, appear, and trismus or lock-jaw is to be ap- prehended, it is always best to send at once for a homoeopathic physician. But, if in this emergency none could be obtained, endeavour to render assistance, as you may be able. If the patient complains of much pain in the neck, or of excessive stiff- ness in the neck and back, especially if this is preceded by a EXTERNAL INJURIES. 115 good deal of stretching of all the limbs; if he complains of cramp, or pain resembling cramp, in the joints of the jaw; in the cheeks near the ears; if he feels constant inclination to yawn, and yet is unable to open his mouth sufficiently; if he is fretful, irrita- ble, difficult to please, give Ignatia every two hours, until there is improvement. But if after several doses have been taken he grows worse, if lock-jaw takes place, if his back is stiff and rigid, give Mercurius, if this fails, Belladonna, especially if his face is red; Aconite, if it grows pale and red alternately. In some cases, where the sufferer becomes cold, Bryonia or Veratrum, may be effectual; if warmth makes him worse Secale. A per- son, not a physician, will hardly be able to select the proper remedy among all those which are indicated. Ignatia is the principal remedy, if the patient grows worse whenever he is touched or handled; if the original hurt were the injury of a nerve, Hypericum; if there first appears a redness around the wound, resembling erysipelas Ruta ; if much mercury had pre- viously been given, Angustura, Rhus, Hyoscyamus, Stramo- nium, Camphor, &c, may sometimes be the remedies. In general, it may be said that the choice of the proper medicine often depends on the most minute circumstance. g) Bleeding of the Gums.—Frequently the gums bleed con- siderably after the extraction of a tooth. The application of vinegar in such cases, is always injurious; endeavor to staunch the blood with cold water. If this proves' insufficient, fill the cavity with a small roller of linen or lint; if this will not do, moisten the lint with soot-water, prepared as before described. If there is much pain and swelling, take Arnica; if fever, Aco- nite. Sometimes it is well to give them alternately. If in con- sequence of having taken cold the medicines do not afford any relief, give Rhus or Bryonia. For throbbing pain in the bone, which is so violent that it can hardly be borne, sometimes attended with fever, Hyoscyamus will be beneficial. If the jaw swells, and a tedious suppuration follows, take Silicea once a week until it improves. h) Large wounds on the head.—When the bones of the head 116 CHAPTER VIII. have been injured, or deep wounds have been received in the throat and in the breast, or stabs in the abdomen—all wounds, in short, where the joints have been crushed, or which penetrate into the joints, must absolutely be treated by a surgeon. We will, however, mention here, in a few words, the course to be pursued in case a surgeon is not at hand. When a limb has been partially crushed, it may sometimes be preserved by cold applications, or by putting ice upon it, and .by giving internally Arnica, alternating sometimes with Aco- nite; this is possible even when mortification has already taken place, by giving first China, and afterward, when the skin be- gins to turn black, Lachesis. The surgeon alone can, however, judge what is best to be done, and we only propose this treat- ment when the patient refuses to submit to amputation, when no surgeon who can perform the operation is to be procured, or when it is too late to undertake it. i) Large wounds in the abdomen.—These wounds are often not so desperate as they appear to be; even if the bowels pro- trude and the whole belly is torn open, do not give up the pa- tient. Recovery sometimes takes place contrary to all expecta- tion, from wounds apparently fatal. Replace the entrails as soon as possible, but not without having first cleaned them of sand and dirt, or of whatever else may be adhering to them. This ought to be done with luke-warm water, by merely rinsing and without rubbing. Be careful that no water enters the abdomen. Do not lay hold of the entrails with your hands, but with a clean linen cloth. Let the patient neither smell nor take any spirits or anything strong. If he is quite indifferent or stunned, give him Opium; if greatly excited, Coffea; if he has convul- sions, Ignatia; if he turns pale, if the nose becomes sharp and the limbs cold, give China ; but as soon as the first alarm is over, give, in all cases Arnica or Calendula. When no surgeon can be procured, sew up the wound with a waxed thread, only leav- ing a small opening in the deepest places, and dress it, to pre- vent the air from penetrating, in the manner above described, without giving anything further. If diarrhoea ensues, which is EXTERNAL INJURIES. 117 sometimes the case after surgical operations, give Colocynthis, afterwards, if worse, Staphysagria, they may be taken alter- nately until the symptoms change. If very bad symptoms ap- pear, try Lachesis or Phosphorus. Burns and Scalds. For a superficial burn or scald, the best remedy is to hold the part to the fire, and the worst to put it into cold water, or to apply to it other cooling things, such as potatoes, carrots, tur- nips, &c. It is well known that the latter frequently produce blisters and ulcers. The former, on the contrary, draws out the heat; that is to say, the effects of the burn disappear entirely, and in a short time, by the application of moderate *heat. The application of dry heat, however, is not, at all times, practicable; particularly when the burnt or scalded surface is large, as in this case the heat cannot be applied equally to every part. For children the operation is too painful; and in burns where the skin is destroyed, or when the injury is in the face, it is also in- applicable. Other remedies, therefore, have been proved, which are of easier application, and of which the effect resembles that of moderate heat. The application of spirits of wine, strong brandy, rum, &c, particularly when warmed, is much better. Place a fiat saucer, or other vessel, containing one of these articles upon the stove; in the meantime, set on fire another saucerful and let it burn a few minutes until hot, and then put it out by covering it, and apply it whilst the first saucerful is heating. Continue to moisten the scald or burn with it as long as it aggravates the pain in the least. To extensive scalds and burns it may be applied by dip- ping rags into the spirit and keeping them constantly moist. When half the body is burnt, however, or when the injuries are deep, this remedy cannot be well applied; nor is it of use in the vicinity of the eye, or other sensitive parts—and it will do no good when, in the first confusion, cold water has been applied. In many cases where the scald or burn covers a large surface without being very deep, raw cotton is a very good remedy. It 118 CHAPTER VIII. should be spread in layers over the burn. Blisters if any have arisen should be first punctured—a fine needle answers best for this purpose—and the sores washed with warm water. If the wound suppurates, take off the upper layer, but let the lower one remain, and put fresh cotton on the top; at the same time the whole limb must be properly dressed. The earlier the cotton is applied, the more efficacious it proves; but after the application of cold water or cooling roots, it is of little use. Soap, is one of the best remedies both in superficial and deep ulcerated burns. It is the more valuable as it is easily procured and applied, and will prove serviceable even after other impro- per remedies have been used. Take common white soap (Castile soap), not'the common resinous soap, scrape it fine and make a thick salve with lukewarm water, make a plaster of this by spreading it on pieces of linen or muslin and cover the scalded or burnt surface with it, taking care that it comes in contact with every part. If blisters have already formed puncture them as directed above and cut off as much of the loose skin as possible, and dress the wound so as to keep the surface in contact with the plaster. The dressing may be changed every twenty-four hours, by carefully removing the old plaster and replacing it immediately by a fresh one, without washing or otherwise interfering with the sore. At first the application of the soap plaster will probably in- crease the pain, this however, will be but temporary, and will soon be followed by a decrease of the suffering. This treatment should be continued until the wound is healed. The completion of the cure will, of course, depend upon the extent of the injury —but at all events it will take place much earlier than if you begin by applying cold water, and smearing oil, lead-water, and such things upon the burn. Slight burns and scalds will heal in two or three days, and bad ones in eight or ten. It will effect a cure even where the burn has penetrated to the bone; gene- rally it prevents suppuration, and if skilfully applied, leaves no scars. EXTERNAL INJURIES. 119 Lime-water mixed with sweet oil also makes a very good salve for burns; it may be applied in the same manner as soap, and may be used instead of that in case the latter proves too irritating. In all cases keep the air, as much as possible, from the burn; do not, therefore, dress the wound too often, and leave it unco- vered no longer than is necessary. Cover all the sore places ac- curately and carefully, and do not suffer the linen to lie in folds, lest it stick to the sore, neither attempt to remove the salve which adheres to the wound. Open the blisters where most water has collected, cut off the skin, especially where it is loose and shrunken, and tie the whole up tightly but gently, without using too much covering. Cantharides. The tincture of Cantharides diluted, in the pro- portion of 5 to 8 drops of the tincture to half a tumbler of water, is one of the most efficacious remedies for burns. It may be ap- plied by dipping rags—linen are best—into it, and applying them to the seat of the injury, renewing them two or three times a day cr whenever the pain begins to get worse again. It may be used both in slight and severe burns, immediately after the reception of the injury or at a later period, after proper or improper remedies have been used. In addition to the external application of cantharides, it may be taken internally in pellets, a dose every two or three hours, until the more painful symptoms are alleviated, and then at longer intervals. A good remedy, also, is the tincture of nettles (TJrticaurens); every one can prepare this by expressing the juice of this herb and mixing it in equal parts of spirits of wine, and apply- ing it to fresh burns, mixed with tepid water, in proportion of one fourth of the tincture to three fourths of the tepid water— to be used as above described, with moistened rags. If ulcera- tion, however, has taken place, the pure tincture must be applied as above, changing the moistened rags every three or four hours. In very dangerous cases, put a drop of the tincture on a small piece of sugar and swallow it. The pains may sometimes be removed, and a speedy cure 120 CHAPTER VIII. effected by the tincture of causticum. One or two drops of this may be put in a tumbler of water, well mixed, and applied with moistened rags. Should it produce too much burning, add more water; if, on the contrary, it is not sensibly felt, add one or two drops of the tincture. If it should fail to produce the desired effect, or do so only temporarily, apply Arsenicum, externally and internally. If nothing else is at hand, the violent pains may be mitigated by strewing hair-powder or flour upon the burn or scald. For burns in the mouth, throat or stomach, caused by taking too hot food, or in the rectum, occasioned by taking injections too hot, dissolve a few globules of Causticum in a cup full of water. Take a teaspoonful occasionally, and keep it in the mouth for a while. Use the above medicine also in the form of an injection, and if it does not suffice, try Arsenicum. In some cases Sapo has been beneficial, Rhus likewise and Carbo vegetabilis. In fact, very much probably depends on what produced the burn, as well as on its extent and location. Whether caused by fire, or coal, by a red hot iron, steam, boiling water, or by some other boiling liquid. Although more experience is wanted in regard to the treatment of the different kinds of burns in order to apply to each the most appropriate antidote. Burns from Sulphuric or other acids require lime-water, or chalk mixed with water: if caused by an alkali, vinegar will prove beneficial or scraped apples. In burns from phosphorus there is no better remedy than oil, sweet oil especially; renewing its application until the pains cease. For the fever which sometimes accompanies burns, give Aco- nite. Arnica should not be used in injuries of this kind. In convulsions arising from severe burns, Chamomilla has proved beneficial. Extensive burns are sometimes attended by diarrhoea or costiveness, but nothing should be done for either; unless the latter lasts longer than four or five days, when injections of warm water may be given. If the diarrhoea is attended with pains in the bowels, give Pulsatilla, afterward Sulphur. The EXTERNAL INJURIES. 121 diarrhoea -which sometimes makes its appearances, is essential to the preservation of life, and ought, on no account, to be inter- fered with, unless it continues for weeks after the burn has been cured; in that case give first Ipecacuanha, and after a day or two if required, Bryonia; if this fails, Dulcamara. In most cases it will disappear of itself, if you drink plenty of cold water, and take frequent exercise in the open air; both of which are neces- sary to restore persons who have been severely burned or scalded. Of the application of ointment of lead, or lead-water, I can only assure my readers that it has never done the least good; the horrid suppuration, ulcers, and dreadful scars which it leaves behind, could not be worse if nothing were done. To put a stop to the use of these abominable medicines among rational people, it cannot be too often repeated, that the application of lead- water to any considerable part of the body (in case of a severe burn) almost inevitably proves fatal. Children who have been thus treated with lead-water, when half the body has been burned, have died in consequence—not, as is erroneously supposed, of the burns, but of the poison, of which the symptoms furnish incontrovertible evidence. Frozen Limbs. The treatment required when parts of the body have suffered from cold, is to be found under the head of " Chilblains" and "Frost Bite;" how frozen persons are to be treated, under "Apparent Death;" where rules are also laid down for the treatment of "Suspended animation" from suffocation, hanging, drowning, and other causes. 16 CHAPTER IX. FOREIGN SUBSTANCES INTRODUCED INTO THE HUMAN BODY. 1. Into the Eye. Washing the eye with water will be beneficial if dust or any insoluble substance has got into it, but will be injurious if the substance is soluble, as the washing will only tend to diffuse it. Rubbing the eye should also be avoided, as it merely increases the irritation. Putting the eye immediately in a vessel of cold water and holding it there, will frequently remove the cause of irritation and afford relief.. Sweet-oil will mitigate the irritation, when caustic, sharp acids or salts has caused it; but is injurious when caused by the powder of Spanish flies, or dead insects. The white of eggs is very good when sharp dusty mineral sub- stances, paint, or small pointed particles, get into the eye. For lime, ashes, some kinds of dye-stuffs and perhaps tobacco, cream or sour milk is .the best remedy. ^k, If some hard substance gets into the eye and cannot he removed by the above means, but continues to cause irritation and pain, draw the eyelids apart, roll up a bit of paper, so as to have a soft point; with this, as with a hair pencil, you may seize and take it away. Fine blotting paper will answer best for this purpose, as the foreign body will more readily adhere to it. Should it be necessary to push the pointed paper far back into the eye, moisten it first with saliva. By taking hold of the eye-lids with the thumb and finger, and drawing them out from the eye, and turning them up, while at the same time the eye is slowly moved in every direction, you may ascertain whether there is any thing adhering to the inner part of them. FOREIGN SUBSTANCES, ETC. 123 Particles of iron, particularly those projected hot into the eye, when striking fire, or from a smithy, usually adhere very tena- ciously ; sometimes you may succeed in extracting them with a bent hair, introduced under the eyelid, and moved backward and forward, or with a clean ear-pick. A magnet is seldom of much use, unless the particle should be loose, and in that case paper will answer every purpose. As rubbing is injurious at all times, that it may be avoided it will be well to put on a linen compress dipped in water. Sleep sometimes diminishes the pain. If the eye is red and inflamed after the removal of the foreign body, give Aconite, which is also of service if it cannot be got out, and will diminish the pain until you can procure a surgeon, or till the night is passed, when day-light will enable you to examine more closely. If, after giving Aconite several times, the eye continues sensitive and red, give Sulphur, and in case this does not prove effica- cious, Calcarea. 2. Into the Ear. When an insect has found its way into the ear, place the pa- tient upon the opposite side, and pour sweet-oil into the ear, until the insect becomes visible; then take it out with a small roll of paper, or a pair of delicate forceps. Extraneous bodies, such as gravel, shot, beads, cherry-stones, pieces of wood, peas, beans, &c, are often put into the ear by children. If attended to before they excite inflammation and swelling, they can generally be removed by very slender forceps or by taking a hair pin and bending the curved end so as to form an obtuse angle, like the heel of a spoon—this may be easily done with an ordinary key—and a handle made by putting the points of the needle into a cork. 124 CHAPTER IX. Place yourself behind the ear, draw it up with one hand, and at the same time away from the head, that you may look into it as far as possible; dip the instrument in sweet-oil, and pressing the bent part against the back part of the internal ear, push it in till it passes behind and around the object; then lift a little, and the end of the needle will take hold of it from behind, like a spoon, and bring it out. If pain and inflammation of the ear remain, give Arnica and after a few hours Pulsatilla. If the inflammation is already very considerable, and the ear so much swelled that nothing can be got out, Pulsatilla is also of service. In some cases, where the children are in great pain, have much fever, speak inco- herently, or behave as if delirious, give, if Pulsatilla does not suffice, Belladonna, and afterwards, if there is still some pains left, Sulphur may do good. 3. Into the Nose. Foreign bodies, if not very firmly fixed, may be removed from the nose by taking a full inspiration, closing the mouth, and ex- pelling the air forcibly through the nostrils; or by tickling the nostrils with a feather, or a little dry snuff to bring on sneezing. Sometimes obstructions may be removed from the nose with forceps or by the same instrument recommended for the ear, or a similar one, but somewhat longer, or they may be pushed back, so as to fall into the mouth. Do not make too many experiments, but rather apply to a surgeon who has the necessary instruments. The swelling, which will sometimes prevent the extraction of an object, or which remains after it has been extracted, may be con- siderably lessened by the administration of Aconite and Arnica; or if these do not succeed, by Rhus or Belladonna. For the remaining pain and suppuration, if any, give Sulphur. 4. Into the Throat (Cesophagus). If a foreign substance lodges in the throat, endeavour to make the patient throw up, by beating him between the shoulders; let him open his mouth, press down his tongue with a spoon and FOREIGN SUBSTANCES, ETC. 125 look into the throat, in order to ascertain whether there be any- thing which can be seized and brought out with the fingers. If a large piece of food remains in the throat on account of its size and hardness, it is advisable to excite vomiting, particu- larly if, upon retching, you perceive the obstruction moving upward. Tickling the throat will sometimes effect this, if not, put snuff on the tongue, or give an injection of tobacco. When it can be felt on the outside of the throat, a gentle pressure up- ward may force it out. At first you ought to endeavour to make the sufferer throw up again whatever has been swallowed, but do not proceed with too much violence. If the substance has already descended so far that it cannot be felt in the throat, and it seems as if it were sticking fast in the chest, it must be forced down in the stomach, particularly if it is soft, smooth and soluble, and is only arrested on account of its size. If the sufferer feels that at times it slips down, it should be allowed to glide of itself into the stomach, or assisted by occasionally swallowing a little water, provided, it is a substance which will not swell; other- wise a little melted butter. If the symptoms however become too troublesome, endeavour to push it down. For this purpose take a smooth willow twig, or a small piece of whalebone, scraped perfectly smooth, and tie to the end of it a bit of sponge. To be able to fasten it on well, cut a few notches in the stick, and use waxed thread or silk. Rub some sweet-oil on this instru- ment, and introduce it cautiously into the throat, pushing gently against the back of the throat. If a contraction takes place, which prevents the substance from being moved, or if pains, difficulty of breathing, and other symp- toms make their appearance, give Ignatia; and if this fails to relieve, Chamomilla; then some sweet oil or butter; and after this, try again to push it down. Frequently the sensation of something sticking in the throat will remain, although the substance has already descended into the stomach. This, however, is of no consequence, and will dis- appear of its own accord, or after medicine. You may judge that this is the case when the pain increases no longer, but re- 126 CHAPTER IX. mains the same, and when no other symptoms appear; also when things soft or fluid can be swallowed without coming up again, and which, when passing the sore spot, produce some pain, without making it much worse. In such cases give Arnica, and afterwards, if necessary, Mercurius vivus, or one of the medicines prescribed below. But if, on the other hand, there are small particles still remaining in the throat, producing con- stant irritation, give Silicea. If a bone remains in the throat, which is so large that it can- not go down, extract it in the manner recommended below, or let a surgeon be called in. With sharp, pointed articles, such as pieces of glass, fish bones, small bones, needles, &c, be cautious and use no violence. Frequently swallowing a large mouthful of slightly chewed bread, figs, dried prunes, &c, will remove them; or if they are small pointed articles, which pierce the membrane, pills made of wax as large as a musket ball, dipped in honey; those made of wax, fresh from the hive, and rolled in the honey until they become round and smooth, are to be preferred. When dangerous symptoms, such as violent pain, retching almost to suffocation, great anguish, fits, &c, occur, hasten to remove the obstruction, or at least to loosen it. A violin string, or a fine wire, bent in the middle so as to form a small loop, will answer this purpose. It must be introduced in such a man- ner that the ends of the sling or loop are out of the mouth. Push it forward gently until it is below the painful spot, then move it up and down, and twirl it round several times, and draw it up again slowly. In some cases a piece of whalebone, or a small willow twig, as described above, will answer better. This should be introduced with a rotary motion, until the sponge is below the object, then give a mouthful of water, and after the sponge has swelled a little, draw it up slowly. A feather, tied to a strong thread, may be pushed, barrel foremost, down the throat, so that the feathery part, when pulled up, may press against the sides, and on being turned several times may loosen and bring up the foreign body. Pins, needles, fish-bones, &c, FOREIGN SUBSTANCES, ETC. 127 may sometimes be extracted by tying to a whale-bone or willow twig a number of silk slings, made like those for catching birds, introduced in the manner above described, and turned round several times. A piece of fat meat—bacon—tied to a string, and swallowed, and pulled up again by the string, has also been used successfully. Splinters of glass may be removed from the throat, by taking two or three inches of the upper end of a tallow candle, fastened to a string by the wick, compelling the patient to swallow it and then drawing it up again; this may be repeated several times if necessary. Fish-hooks, with a part of the line attached to them, have been swallowed and successfully removed by drilling a hole in a leaden bullet, passing the line through it and causing the pa- tient to swallow it. The weight of the bullet will disengage the hook, and its point, coming in contact with the lead, will pre- vent it sticking again into the oesophagus, in the act of drawing upon the line, so that both bullet and hook may be drawn out together. In performing operations of this kind, the patient should be seated on a chair, with the head thrown well back, and supported from behind by an assistant; then press the tongue down with the fore-finger of the left hand, and introduce the instrument, previously oiled, slowly and carefully, pressing against the back part of the throat. By the sudden resistance, or the convulsive motion and pain of the sufferer, you may know that the instru- ment is near the obstruction, or at the painful spot. In pulling it up, be careful not to strike against the larynx, and lose again what you have brought up. Rather press the instrument a little against one side, and bend the head quickly forward, as soon as the end of the instrument reaches the top of the throat. In very dangerous cases, where even the experienced practi- tioner is unable to afford relief, the last alternative is to make an incision in the throat, by which, sometimes, persons may be saved who were supposed to be suffocated. 128 CHAPTER IX. 5. Into the Larynx or Windpipe. When a person talks or laughs when swallowing, or breathes rapidly, whilst holding something in his mouth ; or when children in their play, catch something with their mouth which is thrown towards them, and it gets into the larynx or windpipe, (" going the wrong way," as the phrase is,)—beating with the flat hand on the back whilst the sufferer bends forward, or blowing snuff up the nose to induce him to sneeze, or tickling the throat with a feather to produce vomiting, is not always attended with success, and, in trifling cases, it sometimes makes it worse. Neither too many nor too violent attempts of this kind ought to be made. In the beginning you may cause the head to be bent back as far as possible, that the object may be brought up by coughing. Yet not much can be expected from this, if the foreign substance is firmly fixed in the windpipe. You may sometimes ascertain whether there is anything actually in the larynx, by taking hold of the latter and shaking it very gently with your thumb and forefinger once or twice, the obstruction will rattle, if it is loose or sufficiently large. Sometimes the patient will fall asleep, and whilst in that state the extraneous body is dislodged (the head in this case should not be too high). If the danger, however, should continue to increase in spite of the medicines hereafter recommended, an operation must be performed. Hasten, therefore, to call in the nearest experienced surgeon who knows how to make the incision in the windpipe, —the only means which can save the patient,—and which some- times succeeds even when he appears already suffocated. This operation, if properly performed, is by no means so dangerous and difficult as it would appear, for most of those who are ope- rated upon recover; and even when the windpipe has been severed in an attempt at suicide, the patient is not unfrequently restored. It is, therefore, unwise not to have recourse to this operation, if a skilful surgeon can be procured in time. As the symptoms frequently resemble those of obstruction in the throat, you should always look into the mouth, whilst pres- sing down the tongue, and try if you can feel any thing with FOREIGN SUBSTANCES, ETC. 129 your fingers or a spoon; also try with whalebone or a willow twig whether you can feel any substance in the throat. You may likewise know by the following signs that there is some- thing in the windpipe : the pain is more towards the front, so that the sufferer can point it out with his finger; when the obstruction is in the throat, the pain is more back. There is great difficulty in swallowing and breathing in both cases, but when the windpipe is obstructed, the breathing is particularly difficult, the face is bloated and purple, the eyes protrude; the voice is more affected, becomes hoarse, or is lost altogether; the cough is whistling or rattles, and threatens to terminate in suffocation. The symptoms, in some cases, do not at first appear to be of great consequence, but they increase gradually, or sometimes they disappear altogether, and return with greater violence. If the foreign substance is not located in but below the Glot- tis, and respiration is not impeded by it, the patient may seem to be in good health for days and even for weeks, without ex- periencing any cough or other symptoms. Of a sudden, however, he will be taken with violent spells of coughing almost to suffo- cation, the attacks resembling those of croup. In such cases, if Tartar, emetic, or Silicea do not afford immediate relief, there is little hope remaining. Neither will an incision avail, if between the attacks of coughing, the respiration becomes more and more difficult and heaving. By this time the lungs have become hepatized, and the sufferer must die whether an opening be made in the larynx, or not. After having ascertained that the obstruction is in the wind- pipe, give, at once, Ipecacuanha, repeating the dose, if it affords relief, as often as the symptoms become worse again. Nothing besides this but sugar or sugar-water should be given, until me- dical aid can be procured. Belladonna may also have a good effect. When the patient falls asleep, do not disturb him; and if the symptoms re-appear, do not immediately give a fresh dose, but wait until they are really worse. Sometimes the object is ejected during sleep. If Belladonna does not suffice, or if symp- toms remain after the danger is over, you may give Hepar. If, 17 130 CHAPTER IX. despite of all these remedies, the patient should be in danger of suffocation, give Tartar, emetic, first trituration, or, when the pa- tient becomes purple in the face, Opium every quarter of an hour. When dust has been inhaled, which causes violent cough, or hair or feathers have got into the windpipe, Belladonna will bo of service; afterwards give Hepar. The relief will, however, be but gradual. It is well to give, at the same time, some sugar or gum Arabic. If anything has got into the throat of a child, and is located in or near the upper part of the larynx, frequent attacks of a suffocating cough will ensue, which Tartar, emetic, first tritura- tion will greatly relieve. If the attacks return continually, or, if there is a cough attended with an offensive smell, give Silicea in the evening and morning. In almost all instances gradual improvement will thereby be affected, the patient getting rid of the obstruction by coughing, or by swallowing it. In tedious cases Hepar may be given alternately with Silicea. 6. Into the Stomach and Intestines. The introduction into the stomach of foreign bodies such as buttons, coins, rings, &c, a matter of frequent occurrence with children, and which is generally the source of a great deal of uneasiness to the parents, is not usually followed by serious consequences; as they sooner or later pass off through the bowels without much pain or inconvenience. This may be facilitated by eating plentifully of boiled rice, mush, or some farinaceous food which will in its passage dis- tend the stomach and intestines and help to carry off the extra- neous substance. Rubbing and kneading the abdomen softly, or lying on the belly, frequent exercise, without using violent exertion, may also accelerate this event. A person who is dis- posed to be costive should take no aperient medicines, which only weaken the intestines, but should eat light food, plenty of butter, and have, daily, an injection of warm water or milk administered. ^ In order to ascertain whether the article swallowed has been discharged, the excrement may be allowed to fall into a vessel FOREIGN SUBSTANCES, ETC. 131 containing water, and after it has dissolved, strained through a sieve or basket: or, if needles have been swallowed, through a coarse cloth. Needles sometimes make quite a different passage for themselves, and come out without causing any injury; if they remain too long, give, every week, Silicea followed by Hepar. If, some time after needles or coins have been swallowed, bad symptoms make their appearance, such as violent pains in a par- ticular part of the abdomen, as if something were jammed, give Ipecacuanha. If it does good, repeat it as often as the symptoms get worse again; if not, give Nux vomica. Should, notwith- standing, more violent symptoms, severe colic and constipation appear, give Opium in frequently repeated doses; if violent attacks, with a throbbing pain in a particular spot, as if suppura- tion was about to commence, give Lachesis. Sometimes articles which have been swallowed pass through the intestines, without any difficulty, and remain in the anus. The passage from thence will be assisted by injections of linseed oil, olive oil, or milk; or by cutting long, thick strips of bacon, and put them into the rectum, letting one half hang out, or hold them by a thread, that the bacon may protect the anus against the hard substance. In this manner the latter is frequently ex- tracted with much facility, particularly if somebody assists with a piece of rounded whalebone or with the handle of a silver spoon. If you cannot succeed with this, send for a physician, and let him examine the parts; but have recourse to no aperients, which may prove dangerous. If the anus closes convulsively, give Ignatia. Leeches, introduced into the stomach, give rise to painful con- sequences, as burning pain, hiccough, spitting of blood and slow fever, which reduces the patient visibly. These consequences may be prevented or removed by the immediate administration of a quantity of common salt, dissolved in water, and occasion- ally melted butter. In children sugar will sometimes relieve the symptoms. For the remaining symptoms, if any, give Arnica, and, some clays after, Arsenicum. 132 CHAPTER IX. When other live creatures find their way into the stomach; if insects, let the patient swallow some sweet oil or fresh salt butter; and if that fails to relieve him, a bit of camphor, the size of a pea, ground with oil. When worms, snakes, frogs, &c, get into the stomach, let the patient drink sugar-water and eat sugar, until it acts as an aperient. If this does not succeed, give pills made of bread and tobacco, of the size of a pea, in the night before going to bed, and in the morning fasting. To children but one pill; to grown persons, two or three; toper- sons who are in the habit of smoking or chewing, from five to six; the number may be gradually increased if necessary. The bad effects of these pills will be obviated by smelling camphor, and giving Ipecacuanha several times, or Nux vomica in the evening. 7. Into the Skin. When any large substance geis under the skin, proceed as recommended under the head of "Wounds." We shall only mention the best means of removing small, pointed particles, such as thorns, thistles, chestnut-burs, great numbers of which sometimes stick in the skin. Put oil on the spot, and hold it as near to the fire as you can bear; then take a common knife, not too sharp, and scrape the skin slowly, applying the whole blade, as in shaving, and bear on moderately hard. If the thorns have entered obliquely, scrape the skin in such a direction as to press first upon the points. Continue this operation, adding oil and holding it to the fire occasionally, until everything is extracted. The same method may be pursued when splinters of glass get into the skin; but this is very painful, and it is mostly better to let them come out by suppuration, treating the injured part like any other wound. For the inflammation which sometimes ensues give Arnica; for the suppuration Hepar, followed, if necessary, by Silicea, and in case the suppuration should be profuse, and the wound become deep, and neither Silicea nor Hepar bring about improvement, give Lachesis, or Mercurius vivus. PART SECOND. TREATMENT OF DISEASES. CHAPTER I. AFFECTIONS OF THE HEAD. Giddiness, Vertigo. Giddiness sometimes arises from causes which medicine may remove; such are, disordered or foul stomach, profuse eva- cuations, ardent spirits, narcotic medicines, and falls or blows on the head. Sometimes it is connected with other complaints, and can only be removed by attention to the general health of the patient. A person who is subject to giddiness should be moderate in eating and drinking—should rise early, walk frequently in the open air, and use the flesh-brush in the evening. Aconite relieves giddiness with nausea, eructations and vomit- ing, cloudiness of the eyes, loss of consciousness, &c, Pulsatilla or Antimonium crud., if there be disordered stomach, nausea and vomiting, repugnance to food, &c. Arnica, that which arises during dinner, or after hearty meals, with dimness of vision, whirling in the head, flushed face, &c. In this kind of giddiness, which is always alarming, Nux vomica, Chamomilla, Pulsatilla, Rhus and Cocculus, according to the disposition of the patient, will be beneficial. And the strictest temperance is also requisite. Sulphur or Calcarea, sometimes cures the giddiness result- ing from the suppression of inveterate ulcers. Mercurius vivus, if the giddiness appears only in the evening, and is accompanied by dimness of sight; Belladonna, if there 134 CHAPTER I. is sparkling before the eyes when moving, increased by stoop- ing; Cocculus, against vertigo, which is increased by sitting up- right in bed and also that caused by the motion of a carriage. Phosphorus, if the giddiness is accompanied by headache and a feeling of pressure on the top of the head. Giddiness from close thinking is relieved by Nux vomica; from looking up, by Pulsatilla ; on moving—better when lying — China ; in the bed, Nux vomica; on lying down, Rhus toxi- codend.; on rising, Chamomilla; on stooping, Aconite, and afterward, Belladonna; from riding, Hepar, and afterward Silicea; when sitting, Pulsatilla. Giddiness, with partial loss of consciousness, or agitation, Belladonna ; so bad as to make the patient apt to fall, or fear that he is going to die, Rhus toxicodend.; with buzzing in the ear, headache, heat or paleness of the face, dimness of the eyes, Pulsatilla; with weakness in the head, China; with bleeding of the nose, Sulphur; with fainting, Chamomilla, subsequently Hepar. Weakness of Memory. Weakness of memory, from bleeding, purging and other debi- litating causes, China, or Lachesis removes; that from blows on the head, Arnica; from spirituous liquors, Nux vomica; from fright, anger, vexation, select among the remedies recom- mended Part I., Chapter 1., particularly Aconite and Staphysa- gria; from damp air, Veratrum, Rhus toxicodend., or Carbo vegetabilis; with determination of blood to the head, particularly Aconite and Belladonna; and among the remedies prescribed for these causes, China, Rhus toxicodend., Mercurius vivus or Sulphur. Benefit will be derived from washing the head every evening with cold water, and tying a handkerchief round it; and every morning washing the forehead and eyes in very cold water. A better remedy, perhaps, is to place the feet, up to the ankles, before going to bed, in very cold water for two or three minutes, after which rub them well with a coarse towel AFFECTIONS OF THE HEAD. 135 Determination of Blood to the Head. This is a very troublesome, and when of long continuance, a dangerous complaint. The arteries in the head can be felt to beat as the pulse beats; the veins of the head and neck are swelled, the head feels full; frequently giddiness takes place, particularly when stooping or when walking in the sun; as if the head over the eyes would burst—worse when stooping and coughing—give Aconite ; if it does good, repeat it. Cold appli- cations to the feet are also of benefit. At the same time abstain from coffee, wine and ardent spirits, and be moderate in the use of warm drinks—but drink freely of cold water, and wash the neck and head frequently with it. If this should not afford relief, and the patient is very irritable or passionate,—has drank much ardent spirits, or has been much confined, give Nux vomica. Belladonna, if there is severe, jerking, burning, shooting pains on one side of the head or violent pressure in the forehead at every step or motion, increased by stooping, or even by noise, or the glare of light. Aconite, if accompanied by sparkling, flickering before the eyes, seeing double, buzzing in the ears, frequent fainting, stun- ning, heavy sleep; if children are teething, or when girls have arrived at the age of puberty, or if they have caught cold during menstruation, particularly from wet feet, followed in 6, 8 or 12 hours by Belladonna. 1. CAUSED BY JOY OR EXCITEMENT. If occasioned by excess of joy, or accompanied by great excite- ment, give Coffea; after a fright, Opium; after vexation, Cha- momilla; after suppressed vexation, Ignatia; after anger, Nux vomica, as mentioned before, when treating of these causes. When caused by a fall or blow upon the head, Arnica, which may be repeated in 24 hours, if requisite. The bleeding from the nose which is apt to accompany it, should not be interfered with. 136 CHAPTER I. 2. CAUSED BY DEBILITY. If the determination of blood is caused by great debility, give China; if it returns every time after taking cold, Dulca- mara; if it returns after lifting something heavy, Rhus tox.; when at the same time the patient perspires too easily, and too much, Mercurius vivus ; if he feels cold, let him smell camphor a couple of times. If, in spite of all these remedies, it returns, give Sulphur, if the patient has not already had this medicine; if so, give Hepar, and if this fails, a fortnight after, Silicea, but not more than two or three times. If the first mentioned medicines do not speedily afford relief, and there appears to be danger, make a poultice of oat-meal, and wrap it quite warm around the feet; or bathe the feet in very warm water, and repeat it frequently until there is an improve- ment or until a feeling of chilliness comes on; if the bowels are constipated, give injections of milk-warm water. Headache, Cephalalgia. In the treatment of this common complaint, we may frequently be guided by the causes which produce the pain, or by the com- plaints which accompany it; it is, however, necessary to dis- tinguish the different kinds of headache, as the same medicine may prove beneficial or injurious under different circumstances. 1. HEADACHE FROM DETERMINATION OF BLOOD TO THE HEAD. When headache proceeds from a determination of blood to the head, or from inflammation, it is usually throbbing, attended with heat, the arteries on the neck may be seen to beat; if the pain increases, vomiting ensues; the headache becomes worse after shaking, moving the head, lying and stooping; sometimes better when standing. Among the domestic remedies, vinegar is the best; place crusts of bread*which have been soaked in vinegar, on the temples, and give injections of warm water; if this does not afford relief, mix some vinegar with the water; bathe the feet in warm water, and afterwards rub them with flannel. Persons who are liable to this complaint, should accus- tom themselves to drink plenty of cold water, and rub the head AFFECTIONS OF THE HEAD. 137 every morning with a cold, wet cloth, particularly the forehead and temples, and bathe the feet in cold water every evening before going to bed. Aconite may be given, and the vinegar discontinued, when the pain is very severe, with a burning sensation over the whole brain, particularly in the forehead, the face red and bloated, the eyes red; when the pain is accompanied by talking incoherently, or raving. If there should be but little or no improvement, Bel- ladonna may be given in alternation with the Aconite. Belladonna is especially indicated when the pain is deeper seated, is oppressive and heavy, and the face pale and haggard, with unconsciousness, incoherent talking, murmuring, drowsiness. It should not be repeated too often. Pulsatilla is preferable when the pain is dull, oppressive, on one side only, very harassing and weakening; if it commences in the back part of the head or at the root of the nose, and goes back; is mitigated by compression or by lying down; is worse when sitting, better when walking; if the head is heavy, the face pale, with dizziness, agitation, inclination to cry. Rhus tox., when there is burning, throbbing pain, with full- ness of the head, oppressive weight, crawling, or a sensation as if a fluid was rolling inside, or as if every thing were loose, and particularly when it comes on after meals. 2. HEADACHE FROM CAUSES WHICH LIE IN THE BLOOD. When headache, of which the cause lies in the blood, makes its appearance after meals, with great drowsiness, stiffness, and pains in the back of the neck, the speech being thitik, or the face distorted, the mouth drawn to one side, the limbs falling asleep, give Belladonna or Nux vomica; bathe the feet in hot water, send quickly for a physician, and treat the patient as recommended under " Apoplexy." 3. HEADACHE CAUSED BY CATARRH. When caused by catarrh, headache is mostly in the forehead, oppressive, burning, better in the morning, worse in the evening, the eyes full of tears, sneezing, dry heat in the nose, frequent 18 138 CHAPTER I. chills, sometimes a little cough; in this case it is advisable to draw warm water into the nose, and drink cold water before going to bed. Aconite should be given for this kind of headache, if it is better in the air, but worse when talking. China, if it is worse in the air, when reading or thinking; if it presses like a load, is drawing and tearing, Arsenicum; if there is running from the nose, the discharge being acrid, if it causes hoarseness, restlessness, and is accompanied by buzzing in the ears, throbbing in the forehead, nausea; is better in the air or in a warm room. For other remedies, see " Catarrh". 4. HEADACHE FROM RHEUMATISM. Chamomilla is the best remedy for rheumatic pains in the head, especially when the following symptoms are presented; pains of a tearing and drawing character, which change their location frequently. If Chamomilla fails to give relief in a few hours, it may be alternated with Pulsatilla in the morning or Nux vomica in the evening'; if it goes to the nape of the neck, the ears and the temples; the head is pained externally when touched or moved, worse in bed towards midnight, frequent perspiration, &c. Fre- quent bathing of the feet in warm water, combing the hair in the evening, and also drawing hot vapor of water into the nos- trils, is sometimes of service; especially when small swellings appear in different parts, or when vomiting gives relief. Ipecacuanha will be of service when the pains are more of a gouty character, (that is, the gnawing and tearing is more in- tense) and are relieved by heat and vomiting. Ignatia, when but little relief is experienced from Ipeca- cuanha, and particularly when the worst pain is over the nose, or is rooting, piercing, tearing, deep in the head, and better when stooping or lying down. Nux vomica, when there are shooting pains in the side of the head, worse in the air or when stooping. AFFECTIONS OF THE HEAD. 139 Colocynthus will sometimes relieve rheumatic pains of the severest kind, after the failure of other remedies. Relief is also often obtained by drinking some coffee without milk. For rheumatic gout in the head, when the pains are tearing and beating all over the head, with a sensation as if it were coming apart, with agitation, restlessness, tossing about; nausea with rising of wind and retching, Ipecacuanha, Nux vomica and Bryonia will sometimes afford speedy relief; if they do not suffice, Sepia is the best remedy. 5. HEADACHE FROM DISORDERED STOMACH AND BOWELS. Disorders of the stomach and bowels frequently produce headache. When produced by undigested food, strong coffee without milk or sugar is very useful; but if by a foul stomach, give the remedies recommended under that head; if the bowels are constipated, injections of warm water will give relief. The symptoms accompanying this kind of headache are: a furred tongue, bad taste, entire loss of appetite, nausea or vomit- ing, coming on at an early stage, and increasing with the pain. If, on the contrary, the headache is of a neuralgic character, it produces nausea and vomiting at a later and highly aggravated stage. If headache is the cause of the sickness of the stomach, give the remedy for headache; but if the disordered stomach is the cause of the headache, give the remedies for disordered stomach. 6. HEADACHE FROM CONSTIPATION. Constipation causing determination of the blood to the head, and headache is generally cured by Bryonia, Nux vomica or Opium. Nux vomica will be indicated if walking or moving the head makes the brain feel sore, if there is pressing in the temples, and neither sitting up nor lying down gives relief; when the eyes are dull with inclination to shut them, and sleeplessness notwithstand- ing; if the head feels heavy, particularly when moving the eyes, as if it would burst during mental application; when it is worse in the 140 CHAPTER I. morning, in the open air, or after meals; and particularly after coffee, or when there is a loathing of coffee. Pulsatilla, when the pains are only on one side, with little determination of blood, but shivering, no thirst, when persons of a mild and quiet temperament, incline to weep and are agi- tated. Bryonia, when the head feels as if pressed together from both sides, and when on stooping, as if everything would fall out of the forehead; when the nose bleeds, without affording relief> when the eyes water and burn. It may be repeated in 6 or 8 hours. Opium, if the pain is violent, with a tearing, bursting sen- sation in the forehead, visible throbbings in the temples, con- siderable congestion of blood, restlessness of the eye.-2, much thirst, dryness of the mouth, sour eructations, inclination to vomit, and even foul and offensive vomiting. If it does good, repeat it every 2 or 3 hours, or until no longer required, or another remedy is indicated. Mercurius vivus will frequently suit, when the head seems full to bursting, as if tied with a bandage, worse at night, tear- ing, burning, boring, shooting pain. Ipecacuanha, if nausea commences with the headache, if every part of the head to the very tongue feels as if bruised, if there is vomiting or retching. Veratrum, Lycopodium, or Scjria, will be beneficial if continued costiveness occasions a determi- nation of blood to the head, with pains on one side, oppressive throbbing as if the brain were bruised, with a strangling sensa. tion in the throat, or with stomach-ache, with painful stiffness in the neck, frequent emission of pale colored urine, nausea and vomiting. 7. SICK HEADACHE. Sanguinaria will give relief, if the pain comes on periodically, or if it begins in the morning and lasts till night, with a fullness of the head, as if it would split, or as if the eyes were pressed outwards; or if there is a shooting, stinging, beating pain AFFFCTIONS OF THE HEAD. 141 throughout the head, but more in the forehead and worse on the right side, attended with chills, nausea, vomiting, inclination to lie down, and if the symptoms are made worse by motion. Belladonna, is the next best remedy, when the pains are worse on the right side, when the external part of the head is very sensitive, the veins of the head and hands being swelled,—pain- ful waving in the head, buzzing in the ears and dimness of the eyes. It is likewise beneficial in the worst pains, extending to the eyes and nose, on one side of the head, with a pressing, cleaving, rolling sensation, augmented at every motion, at the turning of the eyes, by a bright light, by every noise, the walk- ing of others, in fact at every concussion; when there is a jolt- ing sensation in the head and forehead at every step, or on going up-stairs; also, when the pain returns every afternoon, and continues till after midnight, aggravated by the warmth of the bed, or on lying down; worse when in a draught. Also, in pains which commence like a breath, changing to an acute pain, seizing half the head; sometimes piercing momentarily, but so penetrating as to deprive the sufferer of his senses. Sepia, proves very beneficial in very severe cases where the pain is mostly above the right eye, shooting, and boring, so that the patient screams out, with nausea and vomiting, made worse by shaking or moving the head. Aconite, will remove a similar pain on the left side, and if it is not entirely gone, an hour after having given Aconite, give Sulphur, or Silicea, with which the symptoms may be compared under the head of " nervous headache." Spigelia, is suitable in the worst pains on the left side, if they are attended with an insupportable beating in the temple, and with pain in the whole left side of the head, and sometimes pain in the face and teeth, increasing with the ascending of the sun, or augmented by stooping, and motion, in the open air, with the greatest sensibility to the least noise, and if attended with a fetid odor from the mouth. In selecting a remedy the following indication may be taken as a guide. 142 CHAPTER I. Belladonna, if the pain is accompanied with great sensitive- ness to the light. Spigelia, if the pain is accompanied with great sensitiveness to noise. Sanguinaria, if the pain is accompanied with great sensitive- ness to the walking of others in the room. Sulphur or Aconite, if the pain is accompanied with great sensitiveness to all kinds of odor. Sep>ia, if the patient dislikes to be touched, complains of his bed, is peculiarly sensitive to thunder storms, to the cold air, is easily vexed. 8. NERVOUS HEADACHE. In headache arising from an affection of the nerves, the head is generally cool, the face pale, in the beginning the patient sometimes discharges a colorless urine; vomiting gives relief; the headache, however, returns frequently on one side only, or is boring, as if produced by a nail on particular spots; touch- ing the head increases the pain. Lying down quietly in a dark room mitigates the pain during the paroxysms; it may be pre- vented by frequent washing in cold water, by rubbing and brush- ing the skin, and by using the following medicines. Drinking coffee is so injurious in this kind of headache, even if it should give relief during the attack, that the patient must abstain from it entirely. Coffea will give relief in violent, drawing, pressing pains on one side of the head, as if a nail were driven into it; or, as if the brain were shattered, crushed and torn, recurring on the slightest occasion, after close thinking, vexation, taking cold, eating too much, &c, with a distaste for coffee, sensitiveness at the least noise, even music; the pains appear intolerable, mak- ing the patient fretful; he is almost beside himself, shrieks and cries, tosses about, feels much agitated, dreads the fresh air, and is chilly. It may be repeated frequently, if required; and fol- lowed by Nux vomica, and sometimes Ignatia and Pulsatilla. Aconite, often proves efficacious when the pains are most vio- AFFECTIONS OF THE HEAD. 143 lent; when the patient lies unconscious, with retching, crying and lamenting, and apprehensive of dying; the least noise or motion is intolerable; the pulse very weak and small, stopping at intervals; particularly when the pain is throbbing, shooting or like cramp over the nose, aggravated by the reading and speak- ing of others; also in headache from cold, with catarrh, buzzing in the ears and pains in the abdomen; also with the disagree- able sensation, as if a ball were rising up into the head, pro- ducing a sensation as of cool air. Ignatia, will relieve a pressing pain above the nose, which is mitigated by bending forward; pressing outwards from within, shooting and throbbing; tearing in the forehead, as if a nail were driven through the head, piercing deep into the brain; with nausea, darkness before the eyes, aversion to light, pale face, plenty of colorless urine; the pains often cease for a time when the position is changed, and frequently return after meals, at night after lying down, in the morning after getting up; the patient being very nervous, fickle-minded, taciturn and dejected. Aconite may be given for the symptoms mentioned after Bel- ladonna, under the head of " Sick headache," and if Aconite has not a good effect, give some hours afterwards, Belladonna and leave it act at least from six to twelve hours; if the sensation then continues, as if there were water in the forehead, and does not gradually disperse, Platinum may afford relief, particularly when there is a sensation of coldness in the ears, the eyes, on one side of the face, and about the mouth; or if every thing trembles and flickers before the eyes, and objects appear smaller than usual. You may also give Mercurius vivus when Bella- donna has ceased to operate, or when the pain shoots down into the teeth and neck; acute pains in the ears, only on the left side; or when always very violent at night, with perspiration, which affords no relief. After Mercurius vivus or Belladonna, some- times Hepar, is suitable, especially when the pain is as if a nail were driven into the head, with violent, rending pains during the night, as if the forehead would burst, and when painful lumps appear on the head. 144 CHAPTER I. Veratrum, is frequently of use in nervous headache; when there is painful sensitiveness of the hair; when accompanied by diarrhoea, and the pains are so severe that the patient almost loses his reason, becomes very weak and faint, is worse on getting up, and when lying in bed, with cold perspiration, chills and thirst. For other symptoms see Veratrum under headache from constipation. Pulsatilla, will remove the tearing pains, which grow worse in the evening, or are throbbing and tingling after rising in the morning, and in the evening after lying down; with jerking, shooting, tearings in the temples, particularly when the pain is confined to one side of the head, and is accompanied by frequent giddiness, sickness of the stomach, heaviness of the head, dim- ness of the eyes, which cannot bear the light; buzzing in the ears, or shooting, jerking and tearing; pale, distressed coun- tenance, no appetite, no thirst; chilliness and agitation with occasional bleeding at the nose, and palpitation of the heart. When all the symptoms are worse when at rest or sitting, and become better in the fresh air; the headache is relieved by pressure or a tight bandage. It answers best with mild, phleg- matic persons. Bryonia, is good for burning and oppressive pains in the head, or when, while stooping it seems as if something were about to fall out of the forehead; worse when walking; or more external tearing, extending to the face and temples, or pressing, boring, rending in particular spots, especially with persons suffering from rheumatism, and of petulant, passionate temper. Rhus tox. will frequently be found of service after Bryonia. Nux vomica, as mentioned before, is suitable for headache from constipation and coffee drinking; also, when the pain resembles the piercing of a nail, or stinging jerks, with nausea and sour vomiting; when there is a shooting and oppressive sensation on one side, beginning early in the morning, and grow- wing worse and worse, until the patient is distracted, and well nigh delirious; when the brain feels as if rent asunder, and the face becomes pale and dejected, the head heavy, with a buzzing AFFECTIONS OF THE HEAD. 145 noise and giddiness when walking; worse when moving the eyes, in the air, early in the morning, after meals, or when stooping; also, when the head is externally painful, and worse in cold weather. Chamomilla relieves pains in the head which are caused by a cold, or by drinking coffee, when there is a rending or drawing pain on one side, extending to the jaw; acute, shooting pains in the temples, heaviness over the nose, or very trouble- some throbbing; particularly when one cheek is red and the other pale, or the whole face bloated; when the eyes are painful, attended by a sore throat or cold in the chest, or a bitter, offen- sive taste. It is useful for children, and for persons unable to bear the least pain, and quite unmanageable. China is most suitable for sensitive persons, and when the pain is oppressive, and prevents them from sleeping at night, or when there is tearing in the temples, as if the head were burst- ing ; boring in the vertex, whilst the brain feels as if bruised; jerking, and rending, and rolling, and bursting; worse when walking, at every motion, and on opening the eyes; relieved by lying down and being quiet; the skin is tender to the touch. For discontented persons; stubborn, disobedient children, who are fond of dainties, and have a pale complexion, red and hot only at times ; when they become very talkative, or are restless the whole night. It often suits after Coffea, Antimonium crudum may be given for nervous headache resulting from a disordered stomach or cold, or when an erup- tion has been driven in, and pains ensue; particularly when they are in the bones; for dull boring pains in the temples and fore- head, also rending and tearing; the pains are relieved in the open air, aggravated by going up stairs. It answers well after Pulsatilla, when the disorder of the stomach is obstinate, or when the headache causes the hair to fall out. Colocynthis is efficacious in the most excruciating headache, furiously tearing or when the pain is on one side, tearing, op- pressive, squeezing; pressing in the forehead, aggravated by stooping and lying on the back; in attacks coming every after- 19 146 CHAPTER I. noon or towards evening, on the left side, with great restlessness and agitation; particularly when the perspiration smells like urine, with small or offensive discharges of urine; while during the pain, the discharge of urine is considerable and very clear. Capsicum against throbbing headache, or that which is dis- tending, bursting, pressing outwards, worse when walking or moving; tingling, tearing when at rest; when moving the head or eyes and stooping aggravate it, also worse in the air and cold; with phlegmatic, sluggish persons, who easily take offence, or with children who are very refractory, clumsy and awkward; particularly such as are afraid of the air and of exercise, and are chilly, especially after drinking. When the above medicines do not afford relief, try the fol- lowing, which must always be given in water, in the proportion of one or two globules to a wineglass, of this give a teaspoonful every 2 or 3 hours. Sulphur for throbbing, tearing pains, with heat, principally in the morning and evening; with nausea, worse in the air, better within doors; tearing, with a stunning sensation and pressure; it returns weekly; loss of hair, after suppressed, cutan- eous eruptions, ulcers, or perspiration. Arsenicum for the same kind of pains, if worse within doors and better in the open air. Silicea also, for beating, throbbing pains, with heat and deter- mination of blood to the head; when caused by exertion, speak- ing or stooping, with nightly pains from the neck to the top of the head; for tearing pain every forenoon; when every thing has a tendency towards the forehead and eyes; when swellings appear on fhe head, the hair comes out, the skin is very tender, the pain extending to the nose or face, with perspiration of the head. Sepia for stinging, boring, also throbbing pains, mostly in the region of the temples; or just above the eyes, where there is often a sensitiveness to the slightest touch; the pains so violent as to induce screaming, attended with nausea and vomiting, in- creased by every motion, alleviated by keeping quiet, in the dark AFFECTIONS OF THE HEAD. 147 and with the eyes closed, drowsiness producing a disposition to sleep which, if indulged in long enough, causes the pain to cease entirely. Violent headache, with great weakness, indifference and de- spondency, often indicates the approach of a serious disease which may be prevented either by Veratrum or Arsenicum; or, when they fail, by Phosphoric acid. 8. HEADACHE CAUSED BY SUPPRESSION OF RHEUMATISM, GOUT, ERUPTIONS, &c. When rheumatism, gout, erysipelas, eruptions or ulcers have been suppressed, a dangerous headache frequently follows, which ought not to be neglected. Give the remedies recommended in these complaints; and examine, at the same time, what has been said in the preceding pages relative to medicine for headache. If, in consequence of the suppression of the eruption in scarlet fever, erysipelas, measles, &c, pains in the head ensue, which, by degrees, make the patient unconscious, or if these symptoms occur in fever attendant on a cold in the head, or when a cold in the head has been suppressed, or from difficult dentition in children—there is no time to be lost. Take Cuprum 1., dis- solve as much of it as will lie on the end of a penknife in a tumbler of water, and of this solution give to adults a dessert- spoonful, to children a small teaspoonful, every quarter or half hour; if followed by improvement, lengthen the interval. In all suchcases, however, endeavour to procure a homoeopathic physician, if possible. When the pain is seated deep in the sockets of the eyes, acute shooting pain through the brain, accompanied by weakness of the eyes, it is a symptom of approaching blindness. If neither Belladonna nor Sulphur give relief, apply without delay to a homoeopathic physician. When a pain always re-appears in the same spot, deep in the brain, and there is on the other side of the body lameness, crawl- ing, jerking, or similar symptoms, it can scarcely be cured—but you may apply to a physician. When aged persons have continual headache, and at the same 148 CHAPTER I. time discharge but little urine, which is thick, turbid and offen- sive, it forebodes nothing good. They must drink freely of water, brush the skin well and apply to a physician. For scald head, eruptions in the face, &c, see " Eruptions." Losing the Hair. When the hair comes out, but is immediately replaced by a new growth, no other medicine is required than frequent wash- ing, brushing and combing; but if it becomes thinner have it cut a little once a month, when the moon is increasing. Wash- ing the head frequently in cold water, particularly in the evening, and afterward binding a handkerchief round the head, will he of service when the hair is getting thin; if this fails, try beer. If the hair is too dry, oil, grease, ointments and pomatum are injurious; washing once a week with fine soap is much better; if that should not answer, boil wheat bran, strain it, and wash the head once a week with the decoction. A thin lye made from the ashes of beachwood, is efficacious in some instances where the hair is dry, or where there is dan- druff either loose or adhering very closely. It may be used by dipping a fine tooth-comb or a sponge into it, cleansing the head afterwards with cold water. When the hair splits, it may he advisable to use a little grease or oil—bear's grease is best— and to trim the ends every other day. When single bald spots appear, it may at times be serviceable to shave them and part of the surrounding hair; if this does not succeed after a fortnight's trial, rub the spot once a week with a sliced onion in the evening, or with the pomatum below mentioned. When persons become bald after severe illness, washing the head morning and evening with pure spring water is very serviceable. If the baldness is hereditary, all attempts at preserving the hair are useless. When baldness appears early in life, the following pomatum is very useful; melt the marrow out of beef bones by the fire, put a single drop of tincture of cantharides into a saucer, mix gradually as much marrow with it as will fill the saucer, stirring and beating it up all the time; with this mixture rub the bald spots once every third or fourth evening. AFFECTIONS OF THE HEAD. 149 If the hair falls out from debilitating causes, give China, and afterward Ferrum. Also, for clammy perspiration in the hair, China is sometimes of service. If the hair falls out in conse- quence of profuse perspiration, Mercurius vivus may be given. After the use of quinine or bark, give Belladonna; after mercury, Hepar or Carbo vegetabilis; after much grief and trouble, Staphysagria or Phosphoric acid. After inflammatory diseases and nervous fevers, Hepar, Cal- carea, Silicea or Lycopodium; in chronic headache of an hys- terical or gouty kind, with an aversion to have the head covered, Hepar ; in frequent headache arising from chronic affections of the stomach and bowels, Lycopodium which is also beneficial when the headache is attended with itching, and where there is much dandruff. If all these remedies fail to prevent the loss of hair, take one drop of laurel oil, or oil of bitter almonds, and mix it gradually with two tablespoonsful of beefs marrow, melted over the fire, or still better with oil of sweet almonds. Of this pomatum take very little on your fingers and pass them through the hair. Women are liable to loose their hair either from keeping it untied at night, or from tying it too tightly. CHAPTER II. DISEASES OF THE EYES. General Remarks. All kinds of eye-water, salves and ointments, injure the eyes; almost all of them contain more or less strong poison, and if they accidentally cure one disease, in most cases a new and worse complaint makes its appearance, sooner or later. Whoever values his eyes ought to shun these poisonous, and utterly use- less things; simple remedies internally taken, will generally effect a cure—particularly when the eyes have not been injured by quackery. 150 CHAPTER II. Pure cold water, as an external remedy, is the only whole- some eye-water; it does good in many cases where the eyes are painful, red and burning, when there is cough and catarrh; also in chronic affections of the eyes, with great aversion to light— growing worse on the slightest exposure—particularly to cold winds, or cold, wet weather. It may be used by washing the eye frequently, or by applying cloths or pieces of bread which have been wet with it. In all cases where the patient cannot bear cold water, or where it proves useless, and when not merely burning, and a sensation as if there was sand in them, accompanied by intolerance of light, but where there are also violent pains and a discharge of acrid tears; lukewarm water will be preferable, applied either on a linen rag or with bread which has been soaked in it, renewing the application whenever the pain increases. When the eyes are very dry, and the eye- lids close spasmodically, fresh olive oil is very useful. When erysipelas affects the eyes, which is known by the red- ness which spreads far around them, nothing wet should be applied, but instead, warm bags, filled with bran. When the eyes have been injured by the poisonous sumac, nothing should be applied outwardly; give nothing but the reme- dies which have already been pointed out against this poison. When a salve is insisted upon, take the white of a fresh egg, beat it with a teaspoonful of the finest loaf sugar, and a little camphor, to a froth, and put it on the eye. The most rapid cure, however, can be effected by the following remedies, dis- pensing with the camphor-salve. Inflammation and Swelling of the Eyelid. The eyelids are sometimes red, inflamed and swelled, when the eye-balls are not affected. For red, hard swelling, with burning heat and dryness, give Aconite; if it has a good but merely temporary effect, repeat it; if the eyelids are pale, or of a yellowish red, swelled, shining as if transparent, burning, with tension, and copious secretion in the eyes and nose, and perhaps fever, Aconite is also the first medicine; if not completely cured DISEASES OF THE EYES. 151 in a couple of days, give Hepar, particularly in case the press- ing pain remains, or the lids feel sore. When the swelling is bad, and Aconite does but little good, or when the lids are much inflamed and continue red and hot, and there is a purulent secretion, Sulphur is preferable to Hepar, particularly if the eyes are contracted in the morning and the patient cannot endure the light. If no immediate improvement takes place, repeat the Aconite, which will then have more effect. If Hepar has been given without producing any effect, particularly when the eyelids burn and itch, and are swelled and red—when they stick together and bleed when opened—when the edge is turned inside out, or is heavy and feels as if paralyzed, give Belladonna. When the eyelids are inflamed inside, red and painful, burn- ing violently, and the eyes can scarcely be opened, give Arseni- cum, but if they appear as if forcibly contracted, are swelled, difficult to open, and the pain is more acute, with ulcers on the edges, and scabs on the outside, give Mercurius vivus; and should it not produce a favorable change, Hepar. Rhus toxicodend. is particularly efficacious in inflammation of the inner surface of the eyelids—which occurs with infants, and also with older children—when the eyelids are contracted as if by spasm, and when forced asunder, a thick, red swelling appears, and a secretion of mucus of a yellow color, and resembling pus, is discharged. Euphrasia is beneficial in the ordinary cases of chronic in- flammation of the eyelids, which itch in the day-time and stick together at night, are red and somewhat swelled, the edges ulcer- ated, wet and purulent, with winking, dread of light, constant catarrh, accompanied sometimes by a severe headache and by heat in the head. Nux vomica, when the edges of the lids burn and itch, feel- ing very sore when touched, and adhere toward morning. Nux vomica may be used with advantage after Euphrasia, and Pul- satilla after Nux vomica. Mercurius vivus should be given when the lids turn outwards, 152 CHAPTER II. and there is pricking, burning and itching, or when there is no pain. It may be followed, if necessary, by Hepar or Bella- donna. If these remedies fail, and the lids are quite red, with some mucus in the corners of the eyes, the eyes sensitive to the light, and a pricking pain in them, give Antimonium crud. When the lids burn and smart when reading, and Sulphur affords par- tial relief, let the patient take Calcarea ; when there is a sense of crawling on the inside of the lid, increased in the evening, with running of tears, China. Biting, itching, and stiffness in the lids, as if paralyzed, give Rhus ; convulsive contraction and closing, Hyoscyamus ; the upper lids feeling heavy as lead, give Chamomilla, considerable dryness, running of tears, with diffi- culty of motion and heat, give Veratrum. Sty on the Eyelid. A sty on the eyelid may generally be cured by Pulsatilla, and often disappears soon after taking it; sometimes it may be removed by touching it with a cold key. Cold water is injurious; a warm poultice of bread and milk left on during the night is better. If they appear often, or leave hard spots behind, or do not open but become indurated, particularly when the eyes are apt to close with suppuration, with biting and burning in the corners, where dry pus forms constantly, give Staphysagria; should induration remain, give, after a week or two, Calcarea once, or Sepia. Inflammation of the Eyes. (Iritis.) In inflammation of the eyes, or sore eyes, when not only the lid but the eye itself is affected, or the latter alone, Aconite is generally the best remedy, particularly when the complaint comes on suddenly, and increases rapidly—when the whole eye is red, or full of red veins, runs much, and is very painful. When the eyes are sore from a cold, with catarrh, headache, cough, sore throat, &c, the following remedies will be useful: Nux vomica, when the corners of the lids are more red than DISEASES OF THE EYES. 153 the eyes, or the latter are bloodshot and smart as if there was salt in them—when they burn with a feeling as if there were sand in them, and there is increased secretion of tears—the pa- tient cannot bear the light, particularly in the morning; these symptoms are usually combined with fever, which is worse in the morning and evening. Chamomilla, particularly for children, when there is pricking, pressing, burning in the eyes, as if heat were radiating from them; they are swelled and closed in the morning, or very dry, the patient being much irritated by the pain. Belladonna, when the white of the eye is quite red, or large, red veins can be seen; much heat, a discharge of sharp burning tears, or the eyes are quite dry, and much affected by the light —when the pains are spasmodic or deep-seated, accompanied by a catarrh so severe as to make the nose sore; pimples coming out about the nose and mouth, a short, dry, panting and spas- modic cough, coming on in fits which last for some time. Euphrasia, when there is much pressure in the eyes; increased secretion of mucus and acrid tears; when the lids are contracted, and the eye is very red, accompanied with bad headache and catarrh in the evening. Ignatia, when the pain is very severe, with slight redness, severe pressing, profuse discharge of tears, great dread of the light, catarrh very bad and running. It may be repeated in from 12 to 24 hours, if requisite. Pulsatilla is also useful in this form of disease, against the symptoms described below. If Nux vomica has not been given, it will be serviceable after other remedies in removing the great sensitiveness which is liable to remain. Belladonna also is useful when the sight has suffered, or flickering, sparkling and dimness remain. For rheumatic inflammation of the eyes, the eye itself being red, the light insufferable, much discharge of acrid tears, prick- ing, tearing pains, not only inside, but also around the eyes, always worse in the heat, the following remedies are recom- mended. 20 154 CHAPTER II. Pulsatilla, after the worst inflammation has been removed by Aconite, but there are still severe pains remaining of a piercing, boring, and cutting character; the light is insupportable, the pains worse in the afternoon and evening; when the complaint has returned several times, making the patient fretful, inclined to weep, and becomes worse from weeping. Bryonia may be given, after Pulsatilla has removed the pain, but not the redness; when it burns inside, or presses as from sand, is worse in the evening and at night, when the lids are swollen, and when opened give rise to pain in the head. Rhus tox. against the same symptoms as Bryonia when the latter did not effect a cure; also when the eye continues to smart, presses and pricks, and discharges much water, the eyelid adhering during the night; or when there is swelling resembling St. Anthony's fire (erysipelas). Veratrum, when the pain is tearing, interrupting sleep at night, intolerable headache, much heat in the eyes, and a sensation of dryness. Euphrasia is sometimes suitable, especially when small watery blisters appear on the eye, when the light becomes less offensive, but the pain more violent, and the redness so bad that every vein can be seen. Also Nux vomica, Chamomilla and Ignatia are here suitable remedies for their particular symptoms, also con- sult the foregoing passages; and still more frequently Mercurius vivus and Sulphur. The indications for the choice of which are more particularly pointed out under " Scrofulas Ophthalmia." Gout affecting the Eyes. When gout attacks the eyes, the remedies that will most gene- rally be found beneficial are : Aconite, Antimonium crudum, Cocculus, Belladonna and Colocynthis. Aconite should be given first, especially when there is heat and burning in the eyes with pressive and shooting pains, espe- cially when moving the balls; redness and inflammation with intolerable pains; profuse secretion of tears; sparkling of the DISEASES OF THE EYES. 155 eyes; great dread of the light; with weight and fulness in the forehead, and strokes and beatings in the head. Antimonium crudum, Sulphur or Cocculus may be given with advantage after Aconite, particularly if there is nausea or sick stomach; redness and inflammation of the eyelids or corners of the eyes, with itching and nocturnal agglutination of the eyelids. Belladonna is frequently of service for the symptoms men- tioned under " Inflammation of the eyes," and also when the pain is very oppressive all around the eye, above it or alongside of it; if there is a pricking pain above it, as if the eye were about to be torn out, or pressed in; when the pain is intermit- ting ; there is a flashing before the eyes, or the patient sees sparks or black spots with a bright border, or every thing appears to him as in a fog, or through crape; and when these symptoms are accompanied by giddiness and headache, so bad as to deprive him of consciousness. Colocynthis is serviceable against sore and inflamed eyes, accom- panied with severe cutting pains which penetrate into the head, and press particularly into the forehead, or on one side of the brain; are drawing and tearing, or extend into the nose, or even through the whole body, with great agitation and restlessness. Eyes affected by Scrofula. (Scrofulous Ophthalmia.) Many complaints of the eye arise from scrofula, which may be distinguished by the symptoms enumerated under the fol- lowing medicines; we meet with them in children who suffer from this complaint, or in grown persons who have suffered with scrofula in their childhood. When this disease has once weakened the eyes, they are liable to a relapse from cold and other causes, and dimness of the eye and ulcers on the ball of the eye are much more frequent. The medicines most generally serviceable in this complaint are : Pulsatilla, Belladonna, Mercurius vivus, Hepar, Sulphur, Dulcamara, Calcarea, China and Arsenicum. The particular symptoms which should govern in the choice of each, will be found under the different medicines. 156 CHAPTER II. Pulsatilla often suits in the beginning, when the margins of the eyelids become red, burn, and a secretion of pus causes them to adhere; when there is a profuse secretion of tears, which are so acrid as to make the cheeks sore, and a watery swelling of the lids; when the eyes cannot bear the light. Examine also what has been said of Pulsatilla under " Inflammation of the eyes". If it gives relief, but does not effect a complete cure, give Ferrum a week after. Belladonna, if there is a sensation of severe pressure in the eyes, which is worse when they are turned upward, when many red veins can be seen, and pustules and ulcers appear on the eyeball; when catarrh and other symptoms already mentioned under Belladonna accompany the disease, and arise from a cold, or from damp and cold weather. Mercurius vivus, for children who have not yet taken any mercury; when the pains are cutting, particularly in straining the eyes; worse in the evening and in a warm bed; burning in the open air, the eyes full of tears, light insufferable, the sight clouded, or small pustules make their appearance on the ball of the eye, and return with every fresh cold; it will often be of service after Belladonna has acted for a week or two. Hepar may be given after Belladonna or Mercurius vivus, or to children who have taken much calomel, when the eyelids and eyes are red and sore, and being touched pain as if bruised, close convulsively, can scarcely be moved; the light is insuffer- able in the evening; the eyes appear at times quite dull, at other bright and clear; there is a pressure in the eye as if it were coming out; and also when small pustules or spots appear at the corner, and red spots externally around the eye. Give of this medicine a dose of the third trituration daily for several successive days. Sulphur should be given instead of Hepar, when Belladonna or Mercurius vivus has been given previously; but not after Hepar; in cases where the eyelids are contracted in the morn- ing, and the daylight is particularly odious to the patient, or he is quite blind during the day, and can only see a little during DISEASES OF THE EYES. 157 twilight; when there seems to be a mist before the eyes, the cornea is dim, appearing as if dusty; or when the eyelids are particularly affected, as noticed before. Also, when the white of the eye appears very red, is bloodshot, and there are little spots on it; when there is increased flow of tears and aversion to light, severe pressure in the eyeball, aggravated in the light of the sun. The third trituration may be taken daily or every other day according to circumstances, and will be found very beneficial. Dulcamara is of great use when the soreness of the eyes pro- ceeds from cold, particularly when affected by reading, and every thing appears covered with a^veil; when there is a sensation like flashing of fire from the eyes; at the same time much pain over the eyes. If the patient feels better when quiet, and is disposed to keep so, and worse when moving about, do not give Dulca- mara, but rather Belladonna ; but if worse when at rest, and he likes to walk about, give Dulcamara, allowing it time to operate. Calcarea is sometimes applicable after Dalcamara, or when ulcers and films make their appearance on the eye, accompanied by violent pressure, itching and pricking; or burning and cut- ting when reading in the evening; when there is a dimness and haziness before the eyes, particularly after eating, reading, sew- ing, &c; also when there is a feeling of inward coldness. China should be given when the eyes are much more painful in the evening, feeling as if there were sand in them, or as if something were being forced into them; when the cornea has lost its brilliancy, or when oh looking close into the eyes there appears to be a sort of smoke or fog in the interior. Arsenicum is sometimes of use when the pains are of a burn- ing character, as if produced by red-hot coals, and when spots have already made their appearance on the eye. In affections of this kind the remedies before recommended in "Inflammation of the eyes" are suitable, especially Ignatia and Nux vomica; in spots on the eye, Euphrasia is to be preferred above all other remedies. Sometimes inflammation of the eyes proceeds from the intro- duction of very minute insects. It may be relieved by applying 158 CHAPTER II. pieces of linen moistened with camphor to them, or by the use of the camphor salve before described. Very bad diseases of the eye are caused by the suppression of cutaneous eruptions, ulcers, or other diseases; in such cases apply to a homoeopathic physician. If they are consequent upon smallpox, measles, scarlet fever, see what is said under these different heads. Spots or films on the eyes should never be treated with cor- rosive remedies, as is but too generally the custom, and by which thousands have lost their sight. Rather give the eye rest, and if you cannot consult a physician, make use of the medicines prescribed above, allowing each to operate from a week to a fortnight; Euphrasia, Pulsatilla, Hepar, Belladonna, Sulphur, Calcarea and Silicea are particularly effective. He who is not patient enough to try these remedies may use genuine pure nut oil, obtained by pressure and moderate heat, from walnuts that are not more than a year old; introduce one drop of it into the eye every evening. To white spots which are very thick, and much swollen, apply finely powdered table salt, with a hair pencil. The daily application of finely powdered white sugar will sometimes cause the removal of the film or skin which occasionally extends over the entire eye, beginning at the inner angle. When the entire eye presents the appearance of a pane of dim glass, take the fat of a snake, melt it by a moderate heat, and apply a little of it every morning. The gall of fish, also, is beneficial when the film deprives the patient entirely of sight. Weakness of Sight, with Remarks on the Use of Spectacles. Weakness of sight.—This name is given improperly to all defects of vision. It is correctly used only when the eyes feel weak after the least exertion, refusing their services altogether, or are painful without any perceptible cause appearing in the eye on examination. Short-sightedness is not weakness, for we often find it in the strongest eyes, and principally in young people whose occupation leads them to look on objects very DISEASES OF THE EYES. 159 closely; it is merely an incapacity to distinguish minutely ob- jects at a distance; the more distant the objects are, the more confused they appear, and they can only be distinguished by looking at them for a length of time; anything near appears very distinct, and even the most minute object can be distin- guished accurately. Neither is far-sightedness a weakness, for it belongs to the strongest eyes, chiefly occurring in aged per- sons, whose calling has led them to examine things at a great distance; it is an incapacity to distinguish minutely objects which are near; the nearer small objects are, the less easy are they recognised. When the eyes are really weak, spectacles are always inju- rious; they are only useful for persons either far-sighted or short-sighted. As much mischief has been done by the misuse of spectacles, we will caution our readers against the chief errors which prevail. Let no one who is neither short nor far-sighted ever wear spectacles, not even temporarily. If he is either the one or the other, and has weak eyes besides, let him use spectacles as sel- dom as possible. For weak eyes are always made still weaker by spectacles, of whatever kind they may be; sometimes they injure the eyes irretrievably. Green spectacles are almost without exception extremely in- jurious, and physicians are much to blame when they recommend their use indiscriminately. Every one may convince himself of their injurious effects by looking for a short time through a piece of green glass on white paper lying in the sun; on sud- denly removing the glass he will perceive a red spot on the paper. This proves that the eye is compelled to produce a red color to counteract the green; to do this excites the eye unna- turally, and the power of vision becomes enfeebled. Innumer- able instances of the injury done in this manner are on record. Green glasses are to the eyes what brandy is to the nerves. In very rare cases only can it be of use to excite the eyes for a few hours by green glasses, as in some cases of blindness it is 160 CHAPTER II. of use to expose the eyes to the glare of the mid-day sun; either, when applied improperly, cannot but prove very perni- cious. To protect the eyes against the glare of the light when walk- ing over snow-covered regions, in bright sunshine, or when work- ing near the fire, spectacles made of light wire with large round openings, in which, instead of glass, black crape is fixed tightly, are most useful. Short-sighted persons should use concave glasses, which will present distant objects to them, smaller and better defined. Those who are far-sighted must use convex glasses, which will make objects which are near appear larger and plainer. As all kinds of glasses are adapted to a certain distance, they should only be used for such a distance; remote objects should not be looked at through a glass adapted to near ones, nor glasses used, calculated for a great distance, to look at objects which are very near. Spectacles ought to be selected for the distance for which you most commonly require them. Short-sighted persons should use glasses, which at the distance for which they are intended, diminish but little, the less the better; for those which diminish too much, injure the sight. Far-sighted persons should select glasses, which when used to read with at a proper distance, do not much enlarge the letters, the less the better; for when they magnify too much, they are also injurious to the eyes. It is often necessary to have a different kind of a glass for each eye; the one adapted to the left may injure the right; generally the latter is the stronger; try therefore each eye by itself. This should not be done immediately after meals or after drinking; nor should several pairs of spectacles of different power be tried in succession, for it contracts or dilates the pupil and prevents you from selecting those most suitable. It is bet- ter to try one pair every day, until you find glasses exactly adapted to your eyes. The glasses ought not to make the eyes feels sore, it is a proof that they are too strong, that they are altogether bad, or that DISEASES OF THE EYES. 161 the eyes are too weak to use spectacles at all. It is rare that spectacles which are too weak produce pain in the eyes. Either change the glasses until you suit yourself, or wear none at all. When they cause any uncomfortable feeling, pressure in the eyes, or even in the head; when they make you feel sleepy, produce heat and redness in the eyes; when you are often oblig- ed to allow the eyes to rest, or when, after the removal of the spectacles, some time elapses before you can see properly again; or when the objects appear larger or smaller through the glasses than they used to do, it is high time to have your glasses changed, if you do not wish to injure your eyes. By a proper change of glasses the sight may be much improved. When a short-sighted person sees objects through the glass smaller than he used to do before, he ought to have weaker or less concave ones; if he sees them larger and less plain, he ought to have somewhat stronger or more concave glasses. When to a far-sighted person objects appear smaller and less distinct, he ought to have glasses of greater convexity; if they appear larger, glasses of less convexity. The spectacles used ought to be as light as possible, and have slides to keep them firm without pressing; the larger the glasses are, the better; they should be perfectly clear and transparent, without a red or green shade, without flaws, notches, streaks or cracks; they should be well and uniformly ground. Glasses divided into two or more are injurious. The glasses should always be kept clear and bright, should never be touched with the bare finger, and be frequently wiped with soft buckskin. When taken off, they should be put on the sides, not on the glasses, and when they get scratched, they should be replaced by new ones. A skilful physician will be able to select suitable glasses when he is furnished with the exact distance at which the person can read large letter-press, which ought always to be determined. If they get broken, pieces of the broken glass may also be used, to select others exactly of the power wanted, or a higher or lower number. 21 162 CHAPTER II. Weakness and other Defects of Vision. These may frequently be improved by washing the entire head every day in cold water. Bathing the eyes with a mixture, com- posed of a teaspoonful of old cognac brandy and a tumbler full of water, may sometimes prove serviceable, but not always. Ruta, is of service in weakness caused by excessive reading, sewing, &c, when everything before the eyes appears dusky and foggy, when nothing at a distance can be distinguished, and occasionally spasms of the eyelids occur. It may be taken—in the third dilution—once a day, or every second or third day. Agaricus muscarius, if there be weakness or cloudiness of vision, with brown spots before the eyes; winking of the eye- lids and spasms in the eyes. Short-Sightedness. Short-sightedness which is not of long standing, particularly if occasioned by inflammation of the eyes, may be cured by Pulsatilla ; if the result of taking large quantities of calomel, by Carbo vegetabilis; if occurring after nervous fever, or from other debilitating causes, by Phosphoric acid. Par-Sightedness. Far-sightedness, produced by excessive indulgence in ardent spirits, will be removed by Nux vomica; if accompanied by dimness of sight when reading, or running together of the let- ters, and dazzling of the eyes in the light, by Drosera. Or, if these are not sufficient, by Sulphur; followed, if necessary, by Silicea for lean persons, or Calcarea for corpulent persons. But in all such cases it is better to consult a physician. Attacks of Blindness. Aconite will benefit sudden, temporary attacks of blindness; Mecurius vivus, attacks which return frequently, but if the pa- tient has taken much calomel, Silicea should be given instead. Belladonna is efficacious in night-blindness, when the patient can see nothing after twilight, particularly if something red, or DISEASES OF THE EYES. 163 if sparks appear before the eyes, or a variegated circle around the candle. Veratrum and Hyoscyamus, when black spots or sparkling appears before the eyes. Sulphur, followed by Silicea, is serviceable in attacks of day- blindness, where the patient can only see in the evening. Shrinking from the Light. The shrinking from the light, where the patient can bear nothing bright, is usually connected with other complaints, for which the appropriate remedy must be selected. Where this is not the case, give Aconite for two successive mornings, and wait a few days, at night give Nux vomica ; if no better after three days, give Belladonna; after eight days, Mercurius vivus; and after eight days again, Hepar. When the patient has so great a desire for light, that he cannot have it intense enough, give first Aconite, afterwards, if necessary, Belladonna and Sulphur. Euphrasia may be given against shrinking from the light with headache, and when the light of a candle appears dark and unsteady. Pulsatilla, when a fiery halo or circle appears around the light, or the sight is dim, as if something needed to be wiped away, when everything appears double or is totally obscured. Belladonna, when a variegated halo surrounds the light of the candle, when the patient sees red spots, or a mist; where the objects appear double and there is incipient blindness. Veratrum, for black spots and sparkling before the eyes, and double vision. Staphysagria for dimness of sight, with black flashes and flickering during the day, in the night fiery, meteor-like appear- ances, or a halo around the light. Squinting of Children. Squinting of children, where the head is much heated, is often cured by Belladonna ; when occasioned by worms, by Hyoscya- mus. If it arises, as is very common, from the light always being kept on the same side of the bed of the child, place it for 164 CHAPTER III. some time on the other side, and turn the child in the bed, so as to accustom the eye to the other side; afterwards place the child in such a manner as to have the light in front, which is the proper position. If this cannot be done, put a dark screen before the light. With older children this is seldom of much use. In these cases you may tie up the sound eye first every day for several hours, afterwards for several days at a time, so that they cannot see with it at all, and may thus learn to accustom themselves to use the squinting eye properly. If, in squinting, they turn both eyes outwards, put a bit of black court plaster on the tip of the nose; if inwards, put a screen of shining silk on each side of the head, like winkers. If all this proves unavailing, consult a physician. CHAPTER III. AFFECTIONS OF THE EARS. Eruptions. Eruptions behind or in the ears. See " Eruptions." Mumps (Parotitis). The Mumps, a swelling of the great salivary glands lying under and in front of the ear, frequently occur with children, but are not dangerous, unless they strike in. Sometimes the swelling extends over the whole neck, so that the patient can neither chew nor swallow, and increases for three or four days. Sometimes on the fifth or seventh day the swelling on the neck disappears, and shows itself on the breast or testicles, which become red and painful, and pain in the bowels or other symp- toms make their appearance. This is the most critical time. Treatment.— The patient should be kept warm, not too much so however, and care taken to prevent his taking cold by expos- ure in any way. All stimulating food and drinks should be avoided, and no external application made use of, with the ex- ceptions of tying a cotton or linen handkerchief about the neck. AFFECTIONS OF THE EARS. 165 Mercurius vivus is the principal remedy in this affection, two or three doses of which will in most cases effect a cure. Belladonna will however be indicated if the disease assumes an inflammatory character, or the swelling is very red, resem- bling erysipelas, or when it strikes in, and affects the brain, which may be known by the sudden disappearance of the swell- ing, followed by unconsciousness and delirium of the patient. Carbo vegetabilis when the patient has a slow fever, the swell- ~ ing becoming harder and will not disperse; or when striking in, it falls upon the stomach; and also when Mercurius vivus given in the commencement of the disease has failed in giving relief, or instead of that remedy, if the patient has previously taken much calomel. Should Carbo vegetabilis be insufficient, it may be followed by Cocculus. Hyoscyamus may be given for the symptoms indicated under Belladonna, if the latter fails to produce a favourable change in thirty-six hours. When attended by pain in the throat, see under this com- plaint; when by much hoarseness, Carbo vegetabilis almost always proves efficacious. If the complaint occurs in combination with other affections of the ear or teeth, in scald head, scarlet fever, measles, small- pox, malignant fevers, or after excessive use of mercury, see the remedies for these diseases. Inflammation in the Ear (Otitis). In inflammation of the ear there is generally redness, heat, pain and swelling. The passage or tube is sometimes nearly closed, and the pain so severe, that the patient can scarcely bear the ear to be touched. Treatment.—Pulsatilla is almost specific in this complaint; in severe cases it may be repeated every 3 or 4 hours. Advan- tage will also be derived from covering the ear with cotton, to protect it from the air and noise, if the pain is worse inside than near the surface; sometimes accompanied by so violent a tear- 166 CHAPTER III. ing, boring, throbbing, pricking and burning, that the patient becomes delirious, Pulsatilla will be the appropriate remedy. Belladonna will be required if the pain penetrates into the brain, with great agitation, vomiting, coldness of the extremities and other dangerous symptoms. Earache (Otalgia). In this painful affection the following remedies will generally be found most useful; Chamomilla ; Mercurius vivus ; Pulsa- tilla; Nux vomica ; Arnica montana; China; Belladonna; Hepar; Calcarea ; Sulphur; Platinum; Dulcamara ; and sometimes Phosphoric acid and Antimonium crudum. As regards the particular symptoms: Chamomilla will be most efficacious in single, acute, shoot- ing pains, as if from a knife, in the ears, caused by taking cold and suppressed perspiration; the ear being dry and without wax; with tearing pains in the ears, extending to the lobes; the patient very cross and easily offended; the pains insufferable. Mercurius vivus, if the patient perspires without being relieved; when there is a tearing pain extending to the cheeks, pricking deeply, at the same time tearing, pressing, burning pain; or when it burns externally, or feels cold inwardly, with violent twitches and jerks; particularly when the ear is moist. Pulsatilla, if during the course of a rheumatic attack, the pain falls upon the ear and is attended by jerking, tearing pains, as if something were about to be pressed out; or when the ear is externally red, hot and swelled, the pain passing through the whole side of the face, particularly in persons inclined to dull- ness, and easily moved to tears. Nux vomica, for very violent otalgia occurring in passionate, angry persons. Arnica, to very sensitive persons, who have a return of the pain on the slightest exposure, with oppression and stitches in and behind the ears, also tearing, heat, and irritability at any loud noise. AFFECTIONS OF THE EARS. 167 Oiina, if the pain is more in the external ear, with redness, pricking and tingling inside. Belladonna, against otalgia with stitches in and behind the ears; boring, screwing pain, with tearing and pricking down to the throat, with ringing, buzzing and rushing, particularly when the head and eyes are affected; the pains during the paroxysms being worse when the parts are touched, or on moving about. Hepar, against the same symptoms as Belladonna, when the latter is insufficient and also against shooting pain on blowing the nose, with throbbing and buzzing. Calcarea, if the pains are chiefly confined to one side; deep in the ear, and so violent as almost to drive the sufferer to dis- traction; especially if mostly on the right side, or worse after midnight, towards morning or in the forenoon. Sulphur, if the pain returns frequently; is on the left side, or aggravated in the evening or before midnight. Platinum, if the pains are very severe, like cramps, with a jerking, rumbling and rolling sensation in the ears; the ears feel cold, and as if deafness were about to ensue, with crawling sensation, extending to the face. Dulcamara, against pains which are worse, when the patient is at rest; particularly during the night, and are attended by nausea. Other remedies, such as Phosphoric acid, Antimonium cru- dum, &c, may by required in some cases. Make no external application; even oil may become injurious; hot vapors may burn the ear, and a part that is once injured cannot be restored. A sponge dipped in warm water and tied upon the ear, is the only application which will sometimes miti- gate the pain, without doing any harm. If the medicines are to take effect, no cotton must be cram- med into the ear. This should only be resorted to in case of need, as prescribed under "Running of the ear." When the remedies prescribed do not quickly operate upon children, tie 168 CHAPTER III. a thread dipped in sulphur around the ear; this frequently pro- duces running, and mitigates the pain. Running of the Ears (Otorrhcea). Running of the ears is a complaint which must be born pa- tiently, because the most insignificant running may, when sup- pressed, produce serious consequences. A continued running of the ear is hard to cure. The use of the syringe should be avoided. Oil, even, may be injurious, because some of it always remains in the ear, and becomes rancid. Articles which become hard are still worse. Lukewarm water is the only fluid not injurious; use as much of this as is required for cleanliness. It is also well to put a little fine wool into the ear, in winter, to keep out the cold, and in summer to keep out the flies, which sometimes deposite their eggs in them. When the patient feels the crawl- ing of maggots, drop sweet oil into the ear until it is full, and proceed to remove them as directed pag. 123. But important as it is to have something in the ears, parti- cularly in summer and whilst asleep, when the discharge smells offensively, great caution is to be recommended in its application. When the running of the ear remains after inflammation, or when accompanied by pain, particularly by pain pressing out- wardly ; or the ear is hot and red, or covered with a scabby, itchy eruption; or when the disease succeeds to measles, give Pulsatilla ; if that does not relieve, give Sulphur. For otorrhcea following scarlet fever, give Belladonna; and after a few days, if necessary, Mercurius vivus, and then Bella- donna again; if this be not sufficient, Hepar. In running from the ears occurring after smallpox, which is sometimes bloody, and combined with pricking pain; if out- wardly ulcerated, and the discharge is offensive, give Mercurius vivus. But if the patient has taken much calomel, give Hepar; if he has taken too much sulphur, give Pulsatilla, and, a few days after, Mercurius vivus. Should it, notwithstanding, become very tedious; take as much potash as will lie on the end of a knife, dissolve it in a pint of AFFECTIONS OF THE EARS. 169 rainwater, shake it well, then pour a teaspoonful into the ear every day, until it begins to improve. If the discharge be purulent and tedious, give Mercurius vivus, and eight days later, Sulphur; and this last, repeat once every week. Should it not improve under this treatment, give Calca- rea. If there be a severe headache combined with it, give Mer- curius vivus or Sulphur; if this gives no relief, Belladonna, and afterwards Lachesis. Should no benefit notwithstanding all this accrue, give, two mornings successively, Silicea, and repeat it after one or two weeks, if necessary. A tedious discharge is sometimes relieved by Causticum, particularly when the patient is frequently attacked with rheumatism. But if all these remedies fail, try injections of a weak solution of barax. Should the discharge, whether of long or short standing, be checked suddenly, it is always dangerous. Examine the ear carefully with a hair-pin, and if a crust or other obstruction has been formed, it may be softened by gently introducing into the ear the vapor of warm water. If there be no obstruction, and yet the passage is dry and painful, relief will be obtained by applying pieces of warm bread fresh from the oven to the ear; changing them as often as they get cold; or the ear may be held over a small loaf of warm rye or bran bread, first making a hole through the crust. When the glands of the neck become hard and swollen after the suppression of the discharge, give Pulsatilla; later, Mercu- rius vivus or Belladonna. If severe headache and fever occur, give Belladonna first; if no relief is obtained, then give Bryonia. If it is produced by a violent cold, or wet feet, and the patient is better for exercise, give Dulcamara; but if better by keeping quiet, give Bella- donna. If worse when warm in bed, Mercurius vivus. If, after a suppressed discharge, a swelling like mumps takes place, give the remedies prescribed for mumps. But if the swel- ling be in the genitals, give Nux vomica in the evening; and if that does not relieve, Pulsatilla in the morning. Sometimes a violent headache arises, which becomes dull, with 22 170 CHAPTER" III. a pressure, as if the skull were too small; the eyes become red; the pain is worse when moving, and followed by fever; some- times spasms in the face occur, swelling of the head, loss of memory, &c.; followed by a roaring and rustling in the ears, deafness, and a sudden discharge of matter. This must not be interfered with; only let the ear be cleansed with lukewarm water, and the patient lie on the side affected, having a small cushion or folded napkin placed about the ear. If the malady is perceived before the purulent discharge, give Hepar; if not better in a few days, Mercurius vivus. If this produces no marked result, give Lachesis; after this again Hepar. Wait from four to six hours between each remedy. The same treatment is to be observed when the running ceases suddenly. As soon as there is an escape of matter, the patient is safe, and nothing more is necessary to be done, if this does not take place, the patient may die. The most skillful physician cannot always cure this evil. Buzzing in the Ears. This complaint is generally connected with running of the ears and difficulty of hearing; or with earache. Sometimes with " headache," and " determination of blood to the head." In such cases the appropriate medicines for these diseases should be given. If, however, it is unconnected with other symptoms, and arises from cold, is worse in the morning, Nux vomica is the proper remedy. Pulsatilla, if worse in the evening. Dulcamara, if worse in the night; to persons who perspire much, Mercurius vivus; to those who cannot perspire, Chamo- milla; to very sensitive persons who have taken much mercury, or suffer much from fever, or liver complaints, when the buzzing is more hissing, like a ringing or singing, give China; but if louder, more like the noise of a humming-top, or when China does no good, Carbo vegetabilis. In old persons, especially if it is on one side, with great determination of blood to the head, which seems to cause the buzzing, Arnica 3. or 6. is beneficial, AFFECTIONS OF THE EARS. 171 and must be repeated whenever it becomes worse. If it has been of long continuance, apply to a physician. Sometimes, when the least noise cannot be borne, Sulphur, given once, and afterwards Aconite, several times, will do good. If this fails, give Carbo vegetabilis once, and Coffea several times afterwards. If attended with great sensitiveness when exposed to the wind, or with echoing of every step and word, with persons who suffer frequently from tearing pains in the limbs, give Causticum two successive mornings. Hardness of Hearing. This complaint is generally connected with other diseases, and will only cease when they are removed. When it is of long standing, it cannot easily be cured; but that which is of a recent date, is very easily removed. In children, and not unfrequently in grown persons, it is caused by some obstruction in the ear. The ear should be exam- ined carefully as directed page 123, by placing the patient in such a position, that the light may fall into the ear: introduce an ear pick or hair-pin as far as the patient can bear it, but withdraw it as soon as it gives pain. If the obstruction has become hard, let the vapour of warm milk go into the ear. If too great a dry- ness or want of wax is the cause, sometimes Carbo vegetabilis proves useful. Hardness of hearing, attended with singing, tingling and twit- tering, is sometimes speedily cured by Veratrum. If connected with otorrhcea, give the medecines prescribed for this complaint, especially Pulsatilla, Mercurius vivus, Sulphur, Calcarea, Causticum. If it is in consequence of measles, Pulsatilla or Carbo vege- tabilis; after scarlet fever, Belladonna or Hepar; after small pox, Mercurius vivus or Sulphur. If connected with cold in the head, and its general attendant, a sore throat, which is relieved by swallowing, gargling with 172 chapter m. warm water is advisable; if this does not cure it, give Chamo- milla, or Arsenicum, or Lachesis. If it arises from rheumatism, which has been suppressed by a cold, and has fallen upon the ear, give the medicines proper for the rheumatic pains, and afterwards Dulcamara or Sulphur. If caused by suppressed eruption of the skin, or ulcers healed by salves, &c, give the remedies for these, particularly Sulphur or Antimonium crudum. If the patient has been affected with piles, sometimes Nux vomica gives relief; if with nervous fever, Arnica or Phosphoric acid. If the tonsils are swelled, and cause hardness of hearing, Mer- curius vivus and Staphysagria frequently prove useful. In tedious complaints of this nature, dieting and drinking plenty of cold water is of great importance. If not removed by the means recommended above consult a homoeopathic physician. Besides the above mentioned remedies you may, after com- paring the remaining symptoms, take your choice among the following: Veratrum, Staphysagria, Arsenicum, Hyoscyamus, and in very critical cases, Silicea or Calcarea. Beware of all remedies which, in their application, must be introduced into the ear. It is a great mistake to think that the ear can bear more than the eye. It is more easily affected, only that the effects are not soon apparent. Affections of the ear are generally very tedious and difficult to cure, and sometimes quite incurable; whereas the eye can endure more, and recovers more speedily. CHAPTER IV. AFFECTIONS OF THE NOSE. Pains and Eruptions. For pains in the face, nose and cheeks, see " Toothache". For eruptions and pimples on and about the nose, see " Eruptions." Swelling of the Nose. In this affection the remedies that will most generally be found useful are: Arnica, Belladonna, Hepar, Mercurius vivus, Bryonia, Sul- phur, Phosphoric acid, Causticum, Rhus, and Arsenicum. With regard to the cause and detail of symptoms which govern the selection of each; Arnica will be indicated, when the nose is swelled in con- sequence of having received a blow, or when the swelling occurs without any apparent cause, accompanied by itching, and pain in the superior part of the bone, as if after a blow. Belladonna, when the swelling is attended by catarrh, when the orifice of the nostril is swollen and sore, with redness, heat and pains, sometimes extending inwards, with burning, pricking and dryness; the smell sometimes very sensitive, sometimes too weak; and where it does not suffice, Hepar after it. Mercurius vivus, in watery running from the nose, making it sore, and when the nose is red, having a shining swollen appear- ance, with itching, pains in the bone upon pressure. In these symptoms it is better to begin with this remedy, and to give Hepar afterwards, or perhaps Belladonna. Hepar, in swellings occurring in persons who have taken much calomel; and afterwards Mercurius vivus. 174 CHAPTER IV. Bryonia, is sometimes of service in tedious, painful swelling. Sulphur, in swelling, with black specks on the nose. Phosphoric acid, in chronic swellings, and also against red specks on the nose. Causticum, against warts on the nose. Rhus tox., when the point of the nose is red. Arsenicum, when it presents a coppery redness, accompanied with a craving for spirituous liquors. Bleeding of the Nose (Epistaaris). Bleeding of the nose occurs in the course of many diseases, and frequently benefits the patient considerably. It ought not to be interrupted, unless it be too violent or last too long. Cold water, vinegar, sponges, corks, brandy, tinder, creosote, &c, applied inconsiderately, may have a very injurious effect. Fill- ing up the nose is always useless; it is better merely to com- press it, and to see whether the blood stops, or whether it flows into the throat. The bleeding may be stopped by extending the arm which is on the same side with the bleeding nostril, upwards, perpendi- cularly over the head, though when the arm is taken down again, the bleeding is liable to return. Arnica, is the best remedy for bleeding of the nose occa- sioned by a blow, fall, or any external injury, and also when it is preceded by itching of the nose and forehead; when the nose feels hot, and the blood is of a light red color. It is especially suitable for men. Pulsatilla, for women, especially those of a mild, quiet dis- position, or with such as have too weak a flow at their menstrual periods, and also for that which takes place during a catarrh, with alternate running and stoppage of the nostrils, and when the bleeding recurs in the afternoon, evening, or before midnight. Aconite, against violent epistaxis, brought on in consequence of being over-heated, or that caused by determination of blood to the head, or by drinking wine; it is particularly applicable AFFECTIONS OF THE NOSE. 175 to persons of a plethoric habit with fever, flushed face and strong pulsation of the temporal and carotid arteries. Bryonia, against prolonged hemorrhage, especially in warm weather from over-heating or drinking wine; also when the bleeding occurs chiefly at night causing the patient to wake out of sleep, or in the morning, the disposition irritable or obstinate. Belladonna, is frequently of service after or in alternation with one of the above remedies; when the hemorrhage takes place at night, or returns in the morning, or arises from over- heating, or drinking wine. Rhus tox., if the nasal hemorrhage was brought on by great exertion, overlifting, straining, &c, and is worse every time the patient stoops. Nux vomica, bleeding at the nose which returns in the morning, also that from over-heating, drinking wine, &c, or in habitual drunkards. Lachesis may also be required in the latter case. Mercurius vivus, when bleeding takes place at night during sleep and coagulates immediately in the nostrils in cone shaped clots. Cina, in children who are subject to worms, or when the bleeding is brought on by picking and rooting at the nose. China, in enervated and debilitated subjects who have fre- quent and long continued attacks of hemorrhage, with great paleness of the face, coldness of the extremities, convulsions, &c. Sulphur, Sepia and Carbo vegetabilis will frequently be found beneficial in persons who are subject to repeated attacks of nasal hemorrhage. They may be taken once or twice a week. If the above remedies fail in stopping the hemorrhage after a sufficient time has been allowed them to act, benefit may be de- rived, especially in bleeding consequent upon over-heating or drinking wine, from immersing the hands in warm water, and afterwards keeping quiet. Although plugging the nostrils is in most cases unnecessary, yet when the hemorrhage becomes alarming in consequence of great loss of blood—the remedies given having failed to check 176 CHAPTER IV. it ■ or where the blood passes back into the throat, or where there is danger of suffocation, it may be resorted to. The posterior outlet may be plugged by passing threads up through the nostrils and bring them out at the mouth, fastening a small piece of lint or sponge to them and drawing them back again. The anterior outlet is easily plugged by pushing pieces of lint or sponge into it with a probe or small stick. Polypus of the Nose. A pear-shaped tumor which springs from the lining mem- brane of the nose, is called a polypus. It is usually narrow at its root and expanded below, hence its name. One or both nostrils may be the seat of this disease. In consistence it is in some instances firm, fleshy, and very solid, in others extremely soft and tender. The most common form bears in consistence, shape, color and size, a resemblance to the common oyster. When both nostrils are filled with the disease, the patient breathes with difficulty, and with a peculiar rattling noise. Treatment.—In the treatment of polypus the remedies that have been used with most success are: Calcarea, Phosphorus, Staphysagria, Teucrium, Sepia, Silicea, and perhaps San- guinaria. Ozcena. A troublesome ulceration of the lining membrane of the nos- trils, attended with fetid discharge, and sometimes followed by destruction of the cartilages,-and by caries of the bones of the nose, is termed ozoena. Its origin is probably in most instances connected with syphilis. In other instances however there are marks of a purely scrofulous taint. One of the most troublesome attendants of the disease is the accumulation of thick mucus or incrustations which sometimes block up entirely the passages of the nose. This disease, if not checked, not only attacks the cartilages and bones of the nose, but extends to the cheek. If the patient AFFECTIONS OF THE NOSE. 177 should recover after such ravages, he will be frightfully de- formed. Treatment.—The remedies which have been chiefly employed in the treatment of this disease are: in the commencement Teucrium, Sulphur, Pulsatilla, Belladonna, Lachesis, Lycopo- dium and Causticum; followed, if required, in Syphilitic Ozoena by Mercurius vivus, Hepar, Aurum, Acidum nitricum, Lycopodium, Lachesis and Conium; and in Scrofulous Ozoena by Phosphorus, Silicea, Acidum nitricum and Conium. Arsenicum and Lycopodium have been recommended as almost specific in ozoena, the former when the pains are very severe and of a burning and throbbing character; the latter, when the discharge is thick and yellowish. Catarrh or Cold in the Head. This affection consists of a mild degree of inflammation of the membrane lining the nostrils, larynx, and sometimes that of the bronchia. It is usually characterized by slight fever, sneezing lassitude, pain in the head, back and limbs, obstruction of the nose, soon fol- lowed by discharge of mucus, at first watery, with slight wheezing and difficulty of breathing, and subsequently by hoarseness and cough, preceded generally by chilliness. Mercurius vivus, is the principal remedy in epidemic catarrh, when many persons are affected with it at one time; especially if there is constant sneezing; soreness of the nose with constant watery discharge; offensive smell; profuse perspiration at night: the catarrh worse in the morning and also when accompanied by fever; the patient does not like to be alone, and has much thirst, feels the heat uncomfortable, yet cannot bear the cold. If, after twelve hours the symptoms are milder, give nothing more; if they have been better and become worse again, give Hepar. It is especially serviceable for children, and catarrhs caused by suppressed perspiration with fever and pains in differ- ent parts of the limbs. Hepar may be given instead of Mercurius vivus to persons 23 178 CHAPTER IV. who have previously taken much calomel; and also when the catarrh is renewed by every breath of wind, or when the catarrh affects only one nostril, and the headache is increased by every motion. If, after waiting twelve hours, Hepar does not prove effective, give Belladonna. Lachesis will be useful in catarrhs of the severest kind, with profuse watery running from the nose, accompanied with great soreness and swelling. Arsenicum, when there is not much fever, heat or thirst; the patient is restless, particularly at night; drinks often, though but little at a time; is very weak and easily agitated; the dis- charge acrid and corrosive; excessive soreness of the nostrils and violent burning of the nose, both internally and externally. Exercise and warmth are agreeable, and exposure does not aggra- vate the disease. Nux vomica, for the same symptoms as Arsenicum, when the latter causes no improvement in twelve hours, or when the catarrh is fluid during the day, and dry at night; the mouth dry and parched without much thirst; tightness of the chest and constipation. This remedy is also particularly useful in alternate fever and chilliness, especially in the evening, and also when there is great heat of the head and face. Ipecacuanha, when Arsenicum or Nux vomica appear to be indicated, but are insufficient. Dulcamara, when the patient feels better when in motion and worse when at rest, and the slightest exposure renews the obstruction. Pulsatilla, when there is not so much soreness of the nose, but the patient is at once deprived of appetite and smell; the mucus discharged is thick and yellowish, or sometimes green and offensive. Euphrasia, is serviceable in catarrhs accompanied by a dis- charge of white mucus from the nose, and soreness and watery running of the eyes. Chamomilla frequently cures catarrh with ulcerated nose, AFFECTIONS OF THE NOSE. 179 chapped lips, one cheek being pale and the other red, with chills and thirst. Silicea frequently cures chronic catarrh which is of constant recurrence; and is either running or causes obstruction. It should be given two successive mornings. When the catarrh has been suppressed, and headache is the result, give Aconite, and if the former does not return soon, give Pulsatilla or China. When there is difficulty of breath- ing, give Ipecacuanha a couple of times, and if the patient does not improve, Bryonia; let the patient drink hot water, with milk and sugar, and let the vapor of hot water pass up the nostrils. If none of these medicines afford relief, give Sulphur. If the catarrh is connected with other complaints, particularly with those mentioned in the subsequent chapters—such as affec- tions of the breast or lungs, hoarseness or cough, look under these respective heads for the necessary remedies. CHAPTER v. AFFECTIONS OF THE CHEST. Hoarseness. Among the common domestic remedies for hoarseness, there are many which are decidedly injurious; and others which, if they do good, always leave after them a disposition to a relapse. Hoarseness when it returns frequently is always a serious com- plaint. It may sometimes be relieved by mixing rock-candy with the yolk of a fresh raw egg and taking this two or three times at night; a perfect cure, however, can best be effected by the following remedies. Chamomilla, especially in children, if there be hoarseness with catarrh, tough mucus in the throat, with dryness, burning and thirst; the temper cross, vexed or morose and taciturn. 180 CHAPTER V. Nux vomica, in persons of sulky, quarrelsome, obstinate and headstrong disposition, against a rough, deep, dry cough, arising from dryness in the throat, with tension and sore throat, the mucus not loose, attended by alternate chills and heat. Pulsatilla, for hoarseness accompanied with stinging and sore- ness in the throat and the palate; pain when swallowing, catarrh, with much yellow, green and offensive discharge, a loose cough and pain in the chest, with chills; without thirst; and with a capricious appetite. It is particularly applicable when the patient has been several days unable to raise his voice; if Pulsatilla does not suffice, give Sulphur. Mercurius vivus, is the principal remedy when the voice is hoarse and rough, with burning and tickling in the larynx—a disposition to perspire, which does not, however, relieve the patient, and when every breath of air aggravates the case. Capsicum, in hoarseness accompanied with itching and ob- struction of the nose, or with cough producing pain in different places. Rhus tox., if there be hoarseness with roughness of the throat; sneezing and discharge of mucus from the nose, and difficulty of breathing. Sambucus, against hoarseness with deep, hollow, dry cough, which occasions catching of the breath, or with yawning uneasi- ness and thirst. Carbo vegetabilis, against protracted. hoarseness worse morn- ing and evening, and after talking; it is also efficacious in hoarseness and cough following measles. Silicea, against hoarseness accompanied by tedious catarrh. Drosera, in hoarseness with hollow and deep seated cough. Causticum, in obstinate cases of hoarseness, sometimes com- bined with catarrh; soreness of the chest and occasionally of the throat. Cough. Cough may be either combined with cold in the head, being more or less to the chest, what cold in the head is to the nose; AFFECTIONS OF THE CHEST. 181 or it may arise from other diseases. In the former case the ap- propriate medicine should be selected from among those recom- mended for cold in the head; in the latter, the respective symp- toms with which the disease it attended, must be taken into account. For instance, where there is a dry, hacking cough, vio- lent pain in the chest, which is worse when breathing, if the patient was taken with a chill followed by much heat, the pulse quick and hard : there is inflammation in the chest, and you have to administer the remedies prescribed for that complaint. The medicines which are here first mentioned, will seldom cure a cough of long standing; you must have recourse to those, the effects of which are more enduring, and which are described to- wards the end of the list. It frequently happens that an obstinate cough can be cured only by a homoeopathic physician; and sometimes it is a symptom of a disease which is already incurable. Nux vomica, should be given for a dry cough, which is caused by a rough, scraping, acrid sensation, and itching in the palate; when it is lasting and weakening, with pain, as if the head were being rent asunder, or a sensation as if bruised in the upper part of the abdomen, with pain afterward under the ribs, particularly when the cough awakens the patient early, or is then worse, or only a little mucus is discharged with much trouble. Also, when a slight cough lasts the whole day, with pain in the pit of the throat, and is worse in the evening, but better during the night; when during the night the breathing is oppressed, and there is a feeling of weight upon the chest, and the patient has a heated and parched mouth. For energetic and plethoric patients, who drink much coffee and spirituous liquors, Nux vomica is parti- cularly suitable. It also answers for a dry exhausting cough, which is worse during the night, with trifling expectoration in the morning, or worse from reading, thinking and exercise. Chamomilla should be given for a similar dry cough, which is worse at night, even during sleep, and arises from a tickling in the pit of the throat—something rising in the throat and tak- ing away the breath—particularly in children, and during the winter after taking cold. Also for a tickling cough which is 182 CHAPTER V. caused by speaking, in the morning and evening, but which ceases after the patient gets warm in bed; also when in the morning some tough, bitter mucus is thrown up. Hyoscyamus answers for a dry cough, which is worse at night, and prevents sleeping; also when lying down, with tickling in the windpipe, or when the cough comes in spasms, sometimes attended with stitches over the eyes, or with soreness in the muscles of the abdomen; a rattling noise in the throat, caused by breathing whilst there is mucus in the windpipe. Ipecacuanha frequently answers for children—even for the smallest—when on coughing the mucus almost suffocates them; when the cough is spasmodic, or affects them so much that they can scarcely breathe, and they become purple in the face, and the limbs quite stiff; when there is a tickling sensation in the larynx, with contraction, the cough quite dry, but trifling expec- toration, or of mucus of an offensive taste—or when it causes loathing, nausea and vomiting of mucus; when it is attended with pain in the abdomen, particularly about the navel, or a pres- sure upon the bladder, as if the urine could not pass—or there is a throbbing in the head and pit of the stomach, and soreness of the chest; after the cough, shortness of breath and perspira- tion on the forehead; walking in the cold air excites the cough afresh. This remedy may be repeated after a couple of hours or oftener, if required. Belladonna for a similar spasmodic cough, which does not allow the patient to recover his breath, which shakes the whole body, and is excited by a constant insupportable tickling in the larynx, without any phlegm on the chest; or as if caused by something like down in the throat, producing a splitting sensa- tion in the head, with a feeling of pressure in the neck, as. if it were breaking, or for a cough attended with a trifling discharge of mucus, mixed with blood, with stitches in the chest and on the left side under the ribs; tearing pains in the chest; short, quick, difficult breathing; chapping of the lips, red face, and pain in the head; or when the attacks terminate with sneezing, AFFECTIONS OF THE CHEST. 183 accompanied by catarrh, or stinging pain in the hips and in the abdomen, as if something were giving way. Mercurius vivus for a dry cough, which exhausts and con- vulses the patient much, particularly by night; or a tickling cough before falling asleep; sometimes attended with spitting of blood, shooting pains in the chest; in the case of children fre- quently attended by bleeding of the nose, inclination to vomit, pains as if the chest and head were going to burst, accompanied by hoarseness, running catarrh, or diarrhoea. Carbo vegetabilis for spasmodic cough, coming on several times during the day or evening, attended with retching and vomiting, heat and breaking out of perspiration, soreness of the chest, white, grey or yellow expectoration, coughing up of blood, with burning pains in the chest; pain in the larynx, as from ulceration, shooting pains through the head. Capsicum for a dry cough, worse in the evening and during the night, and which sometimes excites vomiting; pains shooting through different parts of the body, also causing rending head- ache ; sometimes accompanied by oppressive pains in the throat and ears, or with drawing pains from the chest to the throat, stitches in the chest and back, or pressure on the bladder and shooting pains in that region, or stinging and tearing pains from the hips to the knees and feet. Rhus tox. sometimes for a dry, short night-cough, commencing with a tickling in the chest, which causes agitation and asthma, particularly in the evening and before midnight, whereby the head and chest are shaken a great deal; or with tension and shooting pain in the chest, pains in the stomach, sometimes stitches in the thighs; particularly when the air makes it worse, and heat and exercise affect it favorably; also for cough with a taste of blood in the mouth. Cina for a dry cough, at times accompanied by expectoration of mucus; in children who start suddenly as if they were loosing their senses; afterwards with anxious gasping for breath, moan- ing and paleness, or a hoarse, hacking cough every evening, particularly in children who have worms; or at the same time 184 CHAPTER V. running catarrh, with a burning sensation in the nose, and vio- lent sneezing, which makes them cry. Ignatia for a dry cough, during the day as well as by night, with a sensation as if there were something like down in the pit of the throat; worse toward evening, with an irritation increas- ing with the cough, or with a feeling of tightness in the pit of the throat, with a running catarrh; in persons who have been affected by grief, or when it grows worse every day after meals, in the evening after lying down, and in the morning after getting up; it may be given a second time after 6 hours have elapsed. Euphrasia for a cough with a bad catarrh, which also affects the eyes; during the day attended with difficult expectoration, sometimes with difficulty of breathing; when it ceases during the night; in the morning worse again, with considerable dis- charge of mucus. Pulsatilla when the cough is dry in the beginning for half a day, with retching; then attended with expectoration of mucus, which is discharged easily; sometimes streaked with blood; in the morning much yellow, salty, bitter, disgusting expectoration, sometimes accompanied by retching; the windpipe at the same time feeling rough, and the abdomen sore as from a bruise, or there are shooting pains in the arm, shoulder and back; or the urine escapes whilst coughing. Bryonia answers for a dry and for a moist cough; for a dry one, when commencing with a tickling in the throat, or when the spell comes on after eating, and is so bad as to cause vomit- ing ; or for a cough which begins as soon as the patient gets into a warm room ; or with bad stitches in the side, and after- wards a trifling spitting of blood; with a yellowish expectoration; when every fit of coughing is felt in the head, or accompanied with shooting pains in the head, throat and chest. China when there is an inclination to a short, hacking cough, as if caused by sulphur, without any discharge of mucus; which is, however, in the throat, and causes a whistling noise; the ex- pectoration which follows is streaked with blood, with pressing, stinging pains in the chest and the windpipe, or a clear, tough AFFECTIONS OF THE CHEST. 185 mucus, which is difficult to loosen, with pains in the shoulders, sometimes accompanied by vomiting of bile; and for cough after hemorrhage from the lungs. Arnica for cough with expectoration of mucus and coagulated blood, or light, frothy blood, at the same time asthma; the ribs and the abdomen feeling as if bruised and lacerated, shooting pains in the head, the chest, the abdomen, and the small of the back; also for moist and dry cough in children, early in the morning or when asleep, with weeping and screaming. Veratrum, for a deep hollow cough, as if proceeding from the abdomen, with griping, salivation, blue face, involuntary discharge of urine, violent pains in the side, and at the same time difficulty of breathing and great weakness, sometimes accompanied by shooting pains which pass downwards through the abdomen, with a sensation as if a rupture was about to take place. Arsenicum for a moist cough with but little expectoration, which is tough, lying on the chest and causing asthma; cough- ing every time after drinking; for cough during the night, with spitting of blood, and a burning heat all over the body, want of breath, extreme fatigue and weakness; or every evening dry cough, which is very fatiguing; with oppression of the chest when going upstairs and in the cold air; also palpitation of-the heart and agitation during the night. Didcamara for a moist cough, particularly after taking cold, with hoarseness, sometimes accompanied with spitting of light red blood during the night; or a whooping, barking cough, excited by deep breathing; coughing from a cold, aggravated by being in a room, and by lying still; better when moving. Drosera, for a moist cough or for a dry one, accompanied by a hoarseness, pain in the chest and under the ribs, so that the patient is obliged to hold the painful part with his hands; some- times attended by retching and griping in the abdomen, when the expectoration is tardy; vomiting of food, after which, of phlegm and water; discharge of bitter, purulent matter; or 24 186 CHAPTER V. with oppression, as if, while coughing, the breath remained in the chest, so that either coughing or speaking seems impossible. Staphysagria, for cough with expectoration of yellow mucus, resembling pus, particularly during the night, with pains as if caused by ulceration under the breast-bone, collection of water in the mouth, occasional spitting of blood preceded by a feeling of scratching in the breast, and involuntary discharge of urine. Phosphoric acid, for coughs with expectoration, great hoarse- ness, coughing occasioned by a tickling in the pit of the stom- ach or of the throat, dry in the evening, in the morning attended by a white or yellow discharge; cough with oppressive pains in the chest and expectoration of pus; when coughing, a rending headache, inclination to vomit, and burning in the throat and chest. Silicea, for tedious cough, with expectoration of much phlegm, transparent lumps, or yellow pus, with a pressure on the chest, so convulsive as to cause pain in the throat and abdomen; or a deep hollow cough, with spitting of blood; dry cough, with pain and soreness of the chest; or a cough which threatens to suffocate the patient in the night or with asthma and emaciation. Sulphur, for tedious dry cough from tickling in the throat, coughing with contraction of the chest, and retching; only during the night, preventing the patient from sleeping, or dry during the night; by day attended, by yellowish expectoration, or thick mucus, pus and blood; when coughing, single stitches in the chest or under the ribs on the right side, as if the chest were about to burst when coughing or sneezing; the breast tight and full, difficulty of breathing, whistling and rattling in the chest, palpitation of the heart, the patient obliged to sit up during the night; or when the cough is attended by a rending pain in the head, blackness before the eyes, heat in the head and face, but cold hands. Calcarea, for tedious cough caused by a tickling as from down in the throat, so violent in the evening and during the night that every vein throbs, or in the night during sleep, dry cough with pain, or rattling and rumbling in the chest, particularly in AFFECTIONS OF THE CHEST. 187 very fat children, where Ipecacuanha suits, but does not suffice; for cough with copious expectoration, particularly during the day, lumpy, purulent, yellow, greenish, brown, so offensive as to cause vomiting; when coughing, a stitch in the side and chest and burning in the latter; tearing and shooting pain in the head; also a pricking pain in the side when breathing deeply, when moving and bending; in the evening heat, chills and thirst, perspiration during the night, particularly on the breast, great weakness, and much anxiety respecting the malady. Lachesis, for cough excited by pressing the hand upon the chest, the patient unable to bear anything on the neck, coughs during the night in his sleep; or feels a tickling in the throat; the whole chest, up to the shoulders, feeling sore, with stitches in the side, and spitting of blood; or coughing as if something liquid had got into the windpipe; or violent cough from ulcers in the throat, with retching, hawking up of phlegm, and much saliva in the mouth; difficulty in expectorating, the cough bad after meals and after sleeping, after rising; at the same time pain in the throat, ears, head and eyes. Causticum, for a protracted, dry, short cough, or for a hollow one, with excoriating or burning pain in the chest and in the windpipe; scraping in the throat and rattling in the chest; pain in the hip, as if going to burst open, or other rheumatic pains; the urine escapes while coughing. For tedious coughs choose particularly among the remedies recommended last: Causticum, Lachesis, Calcarea, Sulphur, Silicea and Phosphoric acid; but should they not, though agreeing with the symptoms, effect a permanent cure, use Sta- physagria, Dulcamara, Arsenicum or Carbo vegetabilis. The remaining remedies are most efficacious in coughs, which are not of long standing. When a cough which appears suddenly, is accompanied by tension in the chest, difficulty of breathing, pain in the throat and windpipe, attended with soreness and rawness, especially, if after coughing at night a burning sensation remains, the voice rough and hoarse, fever, and a quick, hard pulse, always com- 188 CHAPTER V. mence by giving Aconite, and from 5 to 6 hours after, or the following morning, the suitable remedies for the cough. But when the cough is very exhausting and suffocating, with much phlegm on the chest; give first Ipecacuanha, and a couple of hours after, another suitable remedy. When the cough is rough and hollow, and there is barking, or whistling and wheezing, particularly with children, examine what is said of hooping-cough, croup, and suffocating cough, and compare the remedies there prescribed with those indicated here. In recent coughs, with cold in the head, it is always best to keep warm, and guard against further cold for a few days; but this ought not to be carried to excess, or the patient will become more and more sensitive to cold. For children, it is much better, -to come out every fair day, and to be washed daily in cold water. Children who are liable to get their feet wet should wear no stockings, but have paper in their shoes or half-boots. A person affected with cough should occupy, not a cold damp room which lies to the north or north-east, but a dry room facing the south. Those who are very liable to catarrhs and coughs, or sore throat, will be benefited much by washing and rubbing the whole body every day; it is sometimes of use to wear a black or white silk ribbon around the neck, or a silk stock fitting closely around the neck; cotton should be worn next to the skin, but no wool or flannel, which is only suitable for sailors and others who are frequently drenched to the skin by the rain. Never refuse cold water to a person who suffers from cough, although it should make the cough worse every time; and force no one to take warm and intoxicating drinks—it is a practice which has sent many a patient to the grave, and subjected others to long and severe tortures. Hooping Cough (Pertussis). This affection has been divided into three stages, the first or febrile stage resembling ordinary catarrh, attended with chilli- ness, slight fever, depression, increased flow of tears, sneezing and AFFECTIONS OF THE CHEST. 189 discharge from the nose along with a dry fatiguing cough which returns by fits. The durations of this stage is various, it may last for a few days only, or may continue for weeks. It seldom, however, ex- ceeds a fortnight. In the second—the nervous and spasmodic or convulsive stage —the characteristic symptoms of the disease present themselves. The cough becomes excessively violent and distressing, the patient feeling its approach runs to lay hold of some object to support himself until the paroxysm is ended. These occur more frequently at night and consist of a series of forced, quick and unequal expirations which follow each other so rapidly that in- spiration is impossible. The face becomes swollen and livid; the tears are discharged copiously; the veins of the neck are prominent; a copious perspiration breaks out, and suffocation appears imminent.—Soon, however, short imperfect inspirations are effected, and then a long, slow, and laborious inspiration, accompanied by a peculiar noise, which has been compared to a whoop, and from which the disease takes its name. The par- oxysms sometimes succeed each other every five or ten minutes, at others not more than four or five occur during twenty-four hours. They are usually terminated by a spell of coughing and discharge of ropy mucus or by a fit of vomiting. It is not an uncommon occurrence for blood to be discharged from the nose, and occasionally from the mouth and ears during the paroxysm, and the eyes are also frequently injected with it. The duration of this period is various; sometimes it term- inates in two or three weeks, at others lasting for months. The averge is perhaps from two to four weeks. The third stage, or the stage of decline, is made known by the paroxysms growing shorter and shorter and less violent and frequent; the whoop gradually disappears, and the cough does not differ from that of ordinary catarrh and gradually ceases. Hooping cough is almost entirely a disease of childhood and one which very few individuals escape. It usually prevails as an epidemic, and is by the majority of physicians aknowledged to 190 CHAPTER V. be contagious. It is probably most easily communicated in the second stage, after the disease has become fully formed, and dur- ing the decline. Treatment. In the first or catarrhal stage the remedies that have already been pointed out for cough should be consulted, and if properly selected according to the indications there given the disease may in many cases be checked in its incipiency. Accordingly the remedies most suitable for this purpose are: Aconite, Dulcamara, Pulsatilla, Nux vomica, Ipecacuanha. Belladonna, Mercurius vivus, Bryonia and Phosphorus. Aconite, when at the commencement of the disease, the cough is dry and whistling; accompanied by fever; or for sore throat; the patient complains of a burning pain in the larynx and some- times points to it with the finger. Dulcamara. If the attack was apparently brought on by ex- posure to wet or dampness; the cough loose and expectoration copious, accompanied by hoarseness. Pulsatilla. For loose cough followed by inclination to vomit or vomiting, also with sneezing,, weakness of the eyes, increased lachrymation and slight hoarseness. Nux vomica. Cough dry, accompanied by vomiting and great agitation, blueness of the face, fear of suffocation, and sometimes bleeding from the nose and eyes; the cough coming on parti- cularly after midnight and lasting till morning. Ipecacuanha may advantageously follow Nux vomica, espe- cially if there still appears to be great danger of choking, with blueness of the face, anxiety, &c. Belladonna, if in the beginning the cough is dry and hollow or harsh and barking, worse at night, with congestion to the head and headache or sore throat. Mercurius vivus. Cough mostly at night and occurring in two successive paroxysms which follow each other in quick succes- sion after which there is a considerable interval of repose : also for cough with vomiting and bleeding at the nose, the blood soon coagulates; perspiration at night with great sensitiveness; it is especially suitable for children who have suffered from worms. AFFECTIONS OF THE CHEST. 191 Bryonia and Phosphorus, are serviceable when the whooping- cough is complicated with disease of the chest, with pain, fever, &c. In the second or convulsive stage, Veratrum, Drosera, China, Carbo vegetabilis, and Cuprum acetieum, will be found of most benefit; sometimes it may be necessary to alternate them with Nux vomica or some of the foregoing remedies. Veratrum acts quickly, and may, in most cases, be tried first. Give two or three globules of it immediately after the paroxysm, and wait until the next; if the paroxysms contiuue as severe as at first, or grow worse, give the same, and then wait from twenty- four to thirty-six hours, or as long as the case continues to im- prove ; when it gets worse again, give another remedy. It will be especially indicated when there is great weakness, fever, cold perspiration, particularly on the forehead, with quick, weak pulse and much thirst. And also when during the paroxysm there is involuntary discharge of urine, or when there are pains in the chest, the abdomen and the groin; when between the paroxysms the patient is not very lively, and shuns exercise; when the neck is so weak that it can hardly support the head; when there is great chilliness and much thirst, and no inclination to speak; also when the body is covered with a dry and scattered eruption, or the eruption appears on the hands and face only. After Vera- trum, Drosera or Carbo vegetabilis generally answers best. Drosera is to be administered the same as Veratrum, in two successive doses, then wait, at most, two or three days; if the patient improves, wait as long as he continues to get better; when this ceases to be the case, select another remedy. It will be found most serviceable when the patient is worse at rest than when in motion; when the chills are not accom- panied but followed by thirst,—when the perspiration is not cold but rather warm, and occurs only at night; or when the cough is loud and hoarse, the paroxysms very violent, and either unaccompanied by fever, or with decidedly marked fever, chills and heat, but not for slow fever, as mentioned under Veratrum. Cina is most suitable, when during the cough the children become quite stiff, and after the paroxysms there is a gurgling 192 CHAPTER V. noise which appears to descend from the throat into the ab- domen, and also in children affected with worms, when there is a disposition to pick the nose, with griping in the abdomen, itch- ing of the anus, &c. Cuprum acetieum, has been found most suitable in cases in which entire rigidity of the body or convulsions ensue after each paroxysm, also when there is vomiting after the attacks and rattling of phlegm on the chest while coughing. This remedy will in many cases produce a marked improve- ment, sometimes indeed shortening the duration of the disease very considerably. After it Veratrum generally acts most favourably. Carbo vegetabilis is the chief remedy in spasmodic attacks of cough, occurring twice a day, especially in the evening or fore-part of the night; the cough hollow, with increased lachry- mation, redness of the palate and sore throat, and also in cough accompanied by shooting pains in the head, chest and throat, or with an eruption on the head or body. This is also one of the best remedies in the latter stages of the disease after the more violent paroxysms are subdued. Arnica, is useful when there is considerable hemorrhage from the nose and mouth, or the eyes are injected with blood, and also when each paroxysm of coughing is followed by crying. Hepar, when the cough is diminishing, but is still dry and hoarse, or hollow and ringing, with occasional retching, followed by violent spells of crying. Tartarus emetic, taken at the commencement of the whooping cough, will in some cases cut short the disease, or greatly di- minish its violence. It is also frequently beneficial in the more advanced stages. It may be administered by dissolving a grain of the first trituration in a tumbler of water and giving a table- spoonful of the solution twice a day. The third or declining stage, requires for its treatment the same remedies as have already been recommended in the first stage and in cough or ordinary cold, and must be selected accord- ing to the indications there given. AFFECTIONS OF THE CHEST. 193 During the treatment of hooping cough the diet must be light and digestible, and all kinds of stimulants scrupulously avoided. Emotions of the mind should also as much as possible be guarded against, as they greatly add to the violence, and increase the frequency of the attacks of coughing; this is particularly the case with fits of anger. Croup (Cynanche Trachealis). This dreaded disease can, in most cases, be easily cured with homoeopathic remedies, so that scarcely one-fifth as many cases prove fatal, as when treated by the old method. It requires, however, great attention; parents ought to be well acquainted with the symptoms, as it is always a dangerous disease. Children are usually troubled with a slight cough a few days before it makes its appearance; the voice is hoarse, and some- times the cough is in the beginning somewhat hollow. By selecting one of the remedies recommended for " Cough " the complaint may, in some cases, be prevented. When the cough is hollow and wheezing, Hepar should always be first given. After this Sambucus, Hyoscyamus and. Cina, or Nux vomica, Veratrum, Chamomilla, China and Drosera. If children wake suddenly at night, and begin with a choking cough, either from want of breath, or an accumulation of phlegm in the throat, take one grain of Tartar, emetic, of the first tritu- ration, put it in a glass of water, and after stirring it well, give a teaspoonful every 10, 20 or 30 minutes, according to the vio- lence of the symptoms, until relief is afforded. This medicine should always be kept on hand, but preserved with care, as one grain, taken at once by a child might cause its death. If this cough is not cured, the croup commences. Sometimes it appears without any of these premonitory symptoms. The child awakes about midnight with the croup; the cough has a shrieking, sharp sound, like the braying of an ass, or like the attempt at crowing of a young cock. It sounds very hoarse; somewhat shrill and hissing, or quite rough, deep and, hollow, like the hoarse bark of a dog. The patient inhales with great 25 194 CHAPTER V. difficulty and slowly, and emits the breath in jerks. He is much agitated and tries to obtain relief by stretching out the neck. At this stage the disease is not so alarming as it appears, hut it should not be neglected. The best way to lessen the agita- tion, and make the symptoms yield more easily, is to bathe the arms as quickly as possible in very warm water. Let both arms be immersed in water, as warm as the patient can bear it, and remain until the choking cough ceases. At the same time give Aconite every 10, 20 or 30 minutes, according to the urgency of the case. In most cases this first attack passes off soon, but the child remains cross, and retains the hoarseness of voice. If, during the night, Aconite has been given, give Hepar in the morning. Keep the child warm the next day, and on low diet; flannel may also be put round the neck. If the cure of the disease is not effected in this manner, and the attack returns the second night, the child complains of a burning sensation in the throat, or points with the finger to the larynx, which is very sensitive, particularly when touched, some- what swelled, and very hot. The paroxysms become more vio- lent, as if the patient were in danger of suffocating; accompanied by fever and great thirst. The sufferer falls asleep, but soon awakes again with a worse attack. The breathing, during sleep, is oppressed and heaving; the head is frequently bent back, so that the throat is exposed and very sensitive to the touch. If Aco- nite has not been given last, give it now, and repeat it every thirty minutes for two hours. Bathing the arms in hot water is also serviceable at this stage. Do not cover up the head, but keep the feet warm; give injections of warm water, unless the child is very averse to it. If relief follows the administration of Aconite, and the parox- ysms become less frequent and violent, if the patient perspires, wait from two to six hours, and then repeat it; but if there is no improvement, or if the disease becomes visibly worse not- withstanding the remedies given, and the danger increases, give Spongidyr and if this does not soon effect a change for the bet- AFFECTIONS OF THE CHEST. 195 ter, Hepar. Or these two remedies may be given alternately until some improvement takes place; but do not be in too great a hurry. In all cases, where there is no improvement either after Spongia, or Hpar, give Arsenicum. At the same time keep the child as quiet as possible, and give it from time to time a little mucilaginous drink, if fond of it. When the disease advances, the hands and feet become cold, the pulse quite small, and the sufferer bends back the head as far as possible; the belly expands and contracts considerably at every breath, but not the chest; (by no means force the head forward, as it might cause suffocation,) at the same time a rattling is heard when breathing, as if there were something in the wind- pipe. With the cough comes retching, and finally pieces of membrane are thrown up. The child is no longer red as before, but pale; during the cough it is of a bluish color in the face, the eyes start from the head, as from terror, and the child grasps convulsively with its hands. If the above mentioned medicines, Aconite, Hepar and Spon- gia have been given, and the disease attains this point notwith- ' standing, there is but little hope of saving the patient; though Lachesis and Phosphorus may be given alternately every half- hour, as long as there is any improvement; but should no good effect follow, give Arsenicum, then Sambucus. When the homoeopathic remedies are applied properly, and in time, the disease seldom reaches this stage; but should it prove obstinate, a few leeches may be applied to the larynx, of which the consequence, however, may be that the child remains much weaker and more sensitive, and will have a relapse of croup every now and then, when the medicine will be less effective. The warm bath, however, may be used without" any danger whatever. If these dangerous symptoms should really appear under homoeopathic treatment, try the vapor of sul- phuret of potash, at any rate it will do no harm; but every other application must be avoided while these medicines are used. Any hoarseness that may remain after the more dangerous 196 CHAPTER V. symptoms of an attack of croup have passed, will be removed by Hepar, Belladonna, Carbo vegetabilis or Arnica. Children who are subject to this affection should be guarded carefully against taking cold, and take occasionally a dose of Hepar or Lycopo- dium : by these means the predisposition may be removed. Bichromate of Potash, Bromine and Iodine have been within a few years past highly recommended in croup. The first especially in the most dangerous cases—those with tendency to or actual formation of false membrane—has been used very suc- cessfully. It may be administered either by putting two or three pellets upon the tongue every two or three hours, or by dissolv- ing eight or ten pellets in half a tumbler of cold water, and giving a tablespoonful of the solution every hour or two. Much benefit may also be derived in the treatment of croup from the application of cloths dipped in cold water to the throat. Congestion of the Chest. This affection occurs more frequently about the age of puberty, and a few years before and after that period than at any other time of life. It does not, however, in this respect, differ from other affections of the chest, as there appears to be in early life a greater predisposition to all of these diseases than in more ad- vanced years. This admits of easy explanation by reference to well established physiological laws, but as the treatment of dis- ease rather than the elucidation of points in physiology is the object of this volume, it is unnecessary to enter into the subject here. The most prominent symptoms of congestion of the chest are: Sensation of fulness, throbbing weight or oppression in the chest; and palpitation of the heart attended with anxiety, short sighing, difficult respiration. The symptoms will be more particularly pointed out under the different medicines recommended in the treatment. Treatment.—Aconite is especially serviceable when there is great oppression, with violent heat and thirst, constant hacking AFFECTIONS OF THE CHEST. 197 cough, which disturbs the patient, particularly during sleep, and apprehension of danger. It will be found valuable in plethoric individuals, especially females of sedentary habits, who suffer from congestion before and after menstruation. Belladonna, may be used with advantage for the same symp- toms as Aconite when the latter is insufficient, or if the attacks return frequently, and also when the head is much affected. Nux vomica, when the affection has been brought on by seden- tary habits, too free indulgence in the use of stimulants, such as wine, brandy, beer, &c, and also when it arises in consequence of suppressed hemorrhoids. Ferrum, Pulsatilla, Sulphur and Phosphorus will also be found useful in some cases. Advantage may be sometimes derived from dry cupping on the neck. For other remedies see " Determination of Blood to the Head." Persons subject to this complaint should avoid violent exercise, such as running, dancing, &c, and stimulants of all kinds, as alcoholic, vinous and fermented beverages and coffee: they should use moderate exercise in the open air, drink freely of cold water, bathe the chest and arms daily in cold water, and not sleep too long in the morning. Hemorrhage from the Lungs. Spitting of Blood. When, on coughing, a little blood is expectorated, the danger, in most cases, is not as imminent as many imagine. The blood frequently proceeds from the nose, from hollow teeth, or only from the throat. When it is really from the chest, it is almost at all times accompanied by a sensation as if coming from a considerable depth; it is warm, generally tastes sweet, the taste of it precedes the rising of the blood, or there is, at the same time, a painful and burning sensation in the chest. Under these circumstances avoid everything which might fatigue the lungs, such as long and loud speaking, calling, cry- ing, singing, blowing the horn or the trumpet, all violent exer- cise of the arms, or quick running, ascending, particularly going upstairs. Sometimes this disease is produced by the 198 CHAPTER V. inhaling the dust or exhalations proceeding from such sub- stances as lime, gypsum or plaster of Paris, metal filings, to- bacco, or sulphuric acid. When the discharge of blood is but trifling, and is accompanied with a good deal of cough, a remedy may frequently be found among those recommended for " Cough," especially such among them as Belladonna, Mercurius vivus, Carbo vegetabilis, Pul- satilla, Bryonia, China, Arnica, Dulcamara, Staphysagria, Si- licea and Lachesis. But when the complaint has already existed for some time, and the blood is discharged in considerable quantities, or when it commences with a violent hemorrhage, there is danger, but not to such a degree as to be excessively alarming. Fear only makes the matter worse. It is seldom as bad as it appears. The life of the patient is not in imminent danger unless there has been several previous attacks, or the patient has suffered long from other diseases; the blood is sometimes discharged in large quantities, and is of a blackish color. In other cases it soon ceases of its own accord. The most important object is the cure of the complaint after hemorrhage has ceased, for that is the most critical period, either from a return of the hemorrhage, or from the fixing of an incurable disease upon the lungs. On no account allow a vein to be opened during" or after hemorrhage from the lungs; this remedy is worse than the dis- ease, for it invariably aggravates it. Persons who have had several attacks of hemorrhage, and have each time been treated by blood-letting, are really in a dangerous state, for the bleeding aggravates the principal cause of the disease, and the constitution suffers so much in conse- quence that other remedies do not easily act. Under such cir- cumstances it is best to submit to a regular course of treatment by a homoeopathic physician, while there is yet some prospect of obtaining relief. Blood-letting for hemorrhage of the lungs, is most injurious in the case of individuals who have previously suffered from piles—and where the blood only takes another direction—or of AFFECTIONS OF THE CHEST. 199 women, who, instead of having their monthly changes, have spitting of blood. In these cases there is no danger whatever from the hemorrhage, for it will cease of its own accord, and all the bad consequences may be prevented by medicine. After a heavy fall, blow or thrust on the chest, it is also inju- rious to bleed; in most cases it does more harm than the actual injury, and is nothing but an old custom, which physicians fol- low when they do not know what other means to resort to. In such cases give Arnica, and keep the patient on a low diet; if, after some days, pains in the chest and fever make their ap- pearance, give Aconite ; and if after this it gets worse again, repeat the Arnica, alternating with these two remedies. The first thing that should be done for a violent hemorrhage from the lungs is to tie a handkerchief around the upper part of the left arm, as tightly as the patient can bear it, and another around the upper part of the right thigh, and if this does not arrest it, ligature the right arm and the left thigh in the same way. When the hemorrhage has ceased entirely, loosen the bandages gradually. While the bleeding continues and also for a consider- able time after it has ceased, the patient should remain perfectly quiet in a half sitting, half lying position, with plenty of pillows under the head and chest. The room should be kept cool and well aired and no warm drinks nor stimulants of any kind allowed for eight or ten days. The food should be light and digestible, and the drinks principally mucilaginous. All kinds of mental excitement, and particularly vexation and anger, should be carefully avoided. Advantage will al«o be derived from sleeping awhile during the day, especially before meals. If the bandages do not speedily check the hemorrhage, dry cups may be applied to the abdomen and under the ribs, also on the pit of the stomach. As a substitute for regular cupping glasses, put a small piece of burning paper, cotton, or other light substance, into a tumbler, turn it and let the paper fall out, and apply the tumbler as quickly as possible to the bare skin. A very convenient mode of preparing the glasses, is 200 CHAPTER V. to put a small quantity of guncotton into them; ignite it, and apply them as directed above. The closer the glasses adhere the better; if you do not succeed immediately, repeat the experiment. Cloths dipped in cold water and applied to the lower part of the abdomen will also be beneficial. No other cold application should be made, and no cold water drank, especially if it aggra- vates the cough. A little fine dry table salt is sometimes administered; this may do good, but if it aggravates the cough it should be dis- pensed with. When the cough continues, and brings on fresh attacks of bleeding, give the white of an egg, mixed with sugar, a teaspoon- ful at a time; or put a drop of sulphuric acid into a tumbler of water, and use it as a gargle, or take a teaspoonful every five or ten minutes. In selecting a medicine, we should endeavour to choose one which will not only accelerate the cure, but, as much as possible, prevent a relapse. When there appears to be great danger, the choice will lie between Aconite, Ipecacuanha, Arnica, China and Opium. Aconite will have the preference when the slightest attempt at clearing the throat brings up blood, when the patient pre- viously to the bleeding feels a sensation of ebulition of blood in the chest; the latter seems full, with a burning sensation, pal- pitation of the heart, agitation, uneasiness; is worse when lying down, with an anxious, pale countenance, and when the blood comes by starts, and much at a time. Ipecacuanha may follow the Aconite, if the latter has checked the hemorrhage, but there is remaining a constant taste of blood, with a short cough, discharge of phlegm, mixed with blood, nausea and weakness. Arsenicum, should be given if the Aconite is insufficient and the palpitation of the heart and agitation increase, and prevent the patient from sleeping, or disturb him when asleep, drive him out of the bed, and is accompanied with a dry, burning heat. It should be allowed 3 or 4 hours to operate. If it returns again, give AFFECTIONS OF THE CHEST. 201 Ipecacuanha, Nux vomica, Sulphur, or Arnica. And if, after these remedies, it still grows worse, repeat the Arsenicum. By these means the recurrence of the complaint may sometimes be prevented and the disease entirely cured. China, when the cough which had been very dry, rough and painful, with a taste of blood, becomes violent and is accompanied by constant raising of blood; when the patient feels chilly, with occasional flushes of heat, is very weak, wants to lie down constantly, perspires occasionally but not long at a time, trembles, has dimness of sight, or confusion in the head, or when he has lost so much blood as to become quite faint, or pale and cold with twitches in the hands and face, and wait the result, although it should at first grow a little worse. Ferrum, Arnica and Arsenicum will sometimes be indicated after China. Ferrum met, in slender persons of sallow complexion who do not sleep well at night; if the blood is brought up by a slight hawking, not in very great quantities, is quite pure and of a light red, if there is pain between the shoulders, asthma, particularly during the night, the patient cannot sit, feels better when walking slowly about and yet must frequently lie down; is very weak, particularly after speaking, and cough is produced by any con- siderable exertion. Arnica, when the blood is coagulated, black and raised easily; accompanied by asthma, shooting pains and burning contraction in the chest, palpitation of the heart, great heat over the body, with weakness, almost to faintness, and also when the blood is raised with slight cough, is light red, frothy, mixed with small coagulated clots and mucus, sometimes accompanied by tickling under the breast-bone, coughing produces shooting pains in the bead, and all the ribs feel as if bruised. Pidsatilla, if the complaint has already continued for some time; if the blood is black, coagulated; if the patient becomes very nervous during the night, feels cold, complains of weakness, and pains in the lower part of the breast, with a qualmish sensa- tion in the stomach, is reserved, inclined to weep, and inert. After Pulsatilla, Secale may be beneficial. 26' 202 CHAPTER V. Rhus tox., in cases similar to the last, but when the blood is of a lighter red, or the mind perturbed, uneasy, the symptoms aggravated by the slightest vexation, or when there is much tickling in the chest. Nux vomica, if the disease has been occasioned by the exces- sive use of spirituous liquors, or the suppression of hemorrhoids; especially in passionate persons, and is accompanied by tickling in the chest, and cough which affects the head; and when there is aggravation of the symptoms in the morning. It should be taken in the evening and followed in the morn- ing, if not relieved, by Sulphur, or some other one of the remedies recommended, which appear to suit the symptoms. If the hemorrhage arises from suppressed menstruation, Pul- satilla will be the most appropriate remedy, and afterward, if necessary, Cocculus, to promote the natural discharge. Opium is most suitable, when the discharge of blood is very thick and frothy, mixed with phlegm, particularly in persons addicted to drinking, or when the cough is worse after swallowing, accompanied by difficulty of breathing, asthma and anxiety, with a burning sensation in the region of the heart, trembling of the arms, sometimes weakness of voice, drowsiness and sudden start- ing, coldness, particularly of the extremities, or heat, especially of the breast and abdomen, without perspiration. It may be repeated in two hours, or earlier if necessary. Hyoscyamus, when the hemorrhage is accompanied with dry cough, particularly in the night, which compels the patient to get out of bed; when he starts in his sleep, &c.; also in persons accustomed to ardent spirits; it will follow Opium and Nux vomica, advantageously when they prove insufficient; and may be followed by Arsenicum. Belladonna, when there is a tickling in the throat, which ex- cites coughing and aggravates the hemorrhage, with a sensation as if there was too much blood in the chest, and shooting pains, worse when in motion. AFFECTIONS OF THE CHEST. 203 Dulcamara, for the same symptoms as Belladonna; if they are worse when the patient is at rest, and when the blood is of a bright red colour; the attack brought on by a cold; or when the patient has already suffered from a loose cough for a con- siderable time. Carbo vegetabilis, when there is a burning sensation on the chest, even after the hemorrhage has ceased, particularly with persons who cannot bear the changes of the weather, or who have taken a great deal of calomel. For the weakness which follows bleeding at the lungs, do not give too much medicine, good diet is of more consequence; let the patient eat often, but not much at a time; but little meat, plenty of milk, and eggs occasionally; flour prepared in different ways, and let him take exercise in fine weather. If be remains weak notwithstanding, and too sensitive, give China; if he is weak, but at the same time too lively, give it alternately with Coffea, and if cross and fretful, Ignatia. Chronic Inflammation of the Larynx (Chronic Laryngitis. Laryngeal Phthisis). This disease is often extremely insidious in the commence- ment, and so slow in its progress, that sometimes serious mis- chief is done before any alarm is felt by the patient and he applies for medical advice. The following are its principal symp- toms, pain in the larynx, sometimes extending entirely over it, but at others confined to a small space, a tickling sensation which excites coughing. The pain is increased by coughing, speaking and swallowing, and also by breathing cold air and pressure in the larynx. The voice is changed being hoarse, and at times so weak as to be almost lost; frequent attacks of cough, often hoarse and croupy. In the beginning the cough is dry, but subsequently it is accompanied with expectoration of mucus which is occasionally mixed with pus and blood. There is generally, when the disease has continued for a considerable time, ulceration of the cartilages, composing the 204 CHAPTER V. larynx; and sometimes it ends in hectic fever and loss of gene- ral health, or in consumption. It is this form of disease that is often known under the name of " Clergymen's sore throat." The same causes that give rise to other affections of the larynx and chest may occasion this. Among these are exposure to sud- den changes of temperature, inhalation of irritating substances, the introduction of foreign bodies into the larynx, &c. The habitual and intemperate use of spirituous liquors and also the abuse of mercury are exciting causes. Prolonged action of the voice is also alleged as a cause, hence the frequency of the dis- ease among singers, lawyers, preachers, actors, &c. The medicines which are most efficacious in the treatment of this affection are, Causticum, Calcarea, Carbo vegetabilis, He- par, Lachesis, Phosphorus, Sulphur, Arsenicum, Mercurius vivus and Spongia. Aconite, Phosphorus, Hepar and Lachesis are the most useful remedies in the acute form of Laryngitis. For their proper selection, consult "Croup," "Hoarseness" and also "Cough." Bronchitis (Inflammation of the Bronchia). This disease consists of an inflammation of the mucous mem- brane of the bronchi, and is divided into acute and chronic. Of the former it is intended more particularly to treat. The dis- order is of frequent occurrence, both as a primary affection, and as an accompaniment of measles, scarlatina, smallpox, hooping cough, &c. The most prominent symptoms of acute bronchitis are: Chilli- ness, succeeded by fever; hoarseness; difficulty of respiration; severe, frequent, and distressing cough, at first dry or with scanty expectoration of frothy or viscid mucus, which subsequently becomes copious and sometimes streaked with blood; constric- tion at the chest with a feeling of oppression; general weakness, foul tongue, and loss of appetite; rapid pulse, increased difficulty of respiration; paleness of the lips, cadaverous and AFFECTIONS OF THE CHEST. 205 anxious countenance, loud wheezing, and on applying the ear to the chest, a louder sound than the natural respiration, either rattling, whistling, or droning, or harsh and broken, according to the advance of the disease. In the cases which terminate favourably, the first symptoms of improvement are a greater freedom of breathing, with re- mission of the fever, and an alteration in the expectoration, which becomes thicker, whiter, and diminished in quantity. But when the disease takes an unfavourable turn, the difficulty of breathing increases, a state of excessive debility and collapse supervenes; the face becomes livid, the body covered with a cold and clammy sweat; the mucus accumulates rapidly in the bronchial tubes, and the cough, which has become feeble through the exhausted and sinking energies of the patient, is insufficient for its ejection; aeration of the blood in the cells of the lungs is prevented; cerebral symptoms declare themselves from im- peded circulation, or the effect of unarterialized blood circulating in the brain, and the patient is carried off in a state of asphyxia. In many, and the most dangerous cases of acute bronchitis, although a degree of oppression at the chest be present, no par- ticular pain, heat of skin, nor fever, may exist; this is the most insidious form of the disease, in which it is but too frequently neglected until beyond the power of the physician's art; this occurs most frequently in children who may apparently be only troubled with a slight wheezing, of which scarcely any notice is taken or any medical aid called in, until suddenly suffocation threatens, or some organic lesion is produced, so that an affec- tion which probably might have been easily subdued at the on- set, is now beyond control. The frequency of the disease in infancy and early life deserves a particular notice. It generally commences, as in adults, with the symptoms of a common catarrh; the breathing becomes quick and oppressed, and from the increased action of the dia- phragm, the abdomen becomes prominent; both the shoulders and nostrils are in continual motion, but the wheezing is often more marked than the difficulty of respiration, and on applying 206 CHAPTER V. the ear to the chest, a mucous rattle is heard over almost every part- expectoration sometimes temporarily relieves, and occa- sionally the mucus is expelled from the air-passages by vomit- ing; the countenance is pale and anxious, and somewhat livid: —these symptoms are interrupted and relieved by occasional remissions, during which the child generally appears drowsy; but they return with additional severity, and, if not checked, an accession of extreme dyspnoea ensues, and death takes place from suffocation. When sore throat is also present, coughing produces considerable pain, and the child for that reason fre- quently endeavours to suppress it. There is also impaired appe- tite with thirst, although when the disease has advanced, it is found difficult to take a long draught, from its impeding respi- ration : this is very observable with children at the breast, who, after eagerly seizing the nipple, will bite it, and discontinue sucking, cry, and throw back the head, and after vomiting up the phlegm, continue for some time in that position. In some cases, from the character of the voice and cough, bronchitis has been mistaken for croup. The tubes of one lobe, or of one lung only, may be affected, but sometimes those of both lungs participate. The aggravation of suffering at night is a very remarkable symptom of this complaint. The causes are the same as those of common catarrh. Treatment.—The remedies which are chiefly indicated as most appropriate in ordinary cases of this affection are: Aconite, Spongia, Belladonna, Nux vomica, Bryonia alba, Lachesis, Phosphorus, Pulsatilla, Mercurius vivus, Cannabis, &c. Aconite is the remedy upon which most reliance is to be placed in the inflammatory stage of the disease, and throughout its course, as long as a febrile character exists. Its more marked characteristics are hot, dry skin, with strong, hard and acce- lerated pulse; hoarseness, with roughness of the voice; short, dry, and frequent cough, excited by a tickling in the throat and chest; obstructed respiration, anxiety, restlessness, headache, AFFECTIONS OF THE CHEST. 207 and thirst, with occasionally scanty expectoration of viscid mucus. Spongia is often of great service after the previous adminis- tration of Aconite, when there still remains a considerable degree of inflammation in the bronchial tubes, especially the larger, with hollow, dry cough, day and night, but worse towards even- ing ; or cough with scanty, viscid, ropy expectoration; heat in the chest, burning, tickling irritation in the larynx, quick, anxious, laborious respiration; hoarseness. [Hepar is some- times useful after Spongia when the skin is hot and dry, and the efforts to expectorate ineffectual.) Belladonna. This remedy is useful when there is severe cephalalgia, aggravated by coughing, oppression of the chest, and constriction as if bound, with rattling of mucus in the bronchi; short, anxious, and rapid respiration; dry, fatiguing cough, especially at night, and thirst. Soreness of the throat, (see Sore Throat.) Nux vomica. Difficult breathing with excessive tightness of the chest, particularly at night; hoarseness; dry cough, worse towards morning, attended with a sensation as from a blow, a bruise, in the epigastric or. hypochondriac regions; cough with difficult and scanty expectoration of viscid mucus; dryness of the mouth and lips, thirst, constipation, peevishness. Lachesis. Oppression at the chest, with short and hurried respiration, anxiety, and dejection; dry, fatiguing cough, some- times followed by the expectoration of a little tenacious or frothy mucus, after much effort, occasionally streaked with blood; hoarseness. Bryonia. Difficult and anxious respiration, with constant inclination to make a deep inspiration; hoarseness; headache; cough dry, attended with a sensation of burning, or cough with expectoration of viscid mucus; in some instances tinged with blood; dryness of the mouth and lips, excessive thirst. When, moreover, the respiration is impeded by shootings in the chest, and this affection threatens to become complicated with pleurisy, this remedy is still more particularly called for. 208 CHAPTER V. Plwsphorus. This important remedy is frequently of great utility in this affection when the more inflammatory symptoms have been subdued by Aconite, but the respiration continues much oppressed, accompanied with great anxiety, and heat in the chest; dry cough, excited by tickling in the throat or chest, aggravated by talking or laughing, and followed by expectora- tion of stringy mucus of a saltish taste: Further, when the dis- ease has been neglected, or when, from the phenomena which present themselves at the commencement, we have reason to dread complication, or an extension of the inflammation to the substance of the lungs,—there will be additional reason for ad- ministering Phosphorus. (See Pneumonia.) Pulsatilla. Respiration short, accelerated, and impeded, at- tended with rattling of mucus, heat in the chest, and anxiety; hoarseness; shaking cough, worse towards evening, at night or in the morning, accompanied with considerable expectoration of tenacious, or thick, yellowish mucus, sometimes mixed with blood; cold in the head with copious discharge of thick dis- coloured mucus. Sepia may be selected in preference to Pulsatilla, when the expectoration is very copious, though somewhat difficult, and of a salt taste; exacerbation of cough in the morning and towards evening,—followed by Stannum; if still profuse, but more easy, greenish, and less saline, or of a sweetish taste. Lycopodium, when the cough is materially worse at night, and attended with thirst, quickness of pulse, but moist skin or tendency to sweat; expectoration yellowish gray, and of a saltish taste; oppression at the chest. Mercurius vivus. This remedy may occasionally be found use- ful when the symptoms of bronchitis are found accompanied by excessive perspiration; when the cough is fatiguing, worse in the evening and at night, and excited by a tickling irritation, or sensation of dryness in the chest, with quick, short, oppressed breathing, and louder respiration than ordinary; hoarseness, cold in the h:ad, with watery, acrid discharge; swelling of nose. AFFECTIONS OF THE CHEST. 209 Dulcamara is occasionally serviceable after Mercurius vivus, when there is a continuance of night sweats of an offensive odour. Chamomilla may also be mentioned as a useful remedy in cases of children, after the previous use of Aconite, when a slight degree of whistling still remains; dry cough worse at night, occurring even during sleep. Ipecacuanha is also very valuable in the case of children, but generally at a more advanced stage of the disorder, with mucous rattling in the chest, and when on coughing they are almost suffocated by the excessive secretion of mucus, and become livid in the face; shortness of breath, and perspiration on the forehead after each fit of coughing. Tartarus emeticus is chiefly found useful in those extreme cases where the smaller tubes are clogged with mucus, and suf- focation threatens; when the cough suddenly ceases, either from weakness or other causes. A grain of the first trituration should be dissolved in half a tumbler of water and a tablespoonful ad- ministered every one, two, or three hours, according to the se- verity of the symptoms. Arsenicum is occasionally of the utmost service in those un- favourable cases in which the pulse becomes very quick, feeble and intermitting, and the patient is reduced to a state of extreme debility and collapse. Sulphur is used in winding up a cure, and preventing the disease running on to the chronic form, or when the expectora- tion has increased in quantity and become whitish and less viscid. The most suitable medicines for Chronic Bronchitis and the particular indications for their employment will be found under the head of "Cough". Palpitation of the Heart. The causes of this complaint will frequently indicate the remedies; it is generally produced by violent emotions of the mind, or by the use of ardent spirits; drinking cold water, par- ticularly before going to bed, and eating but little in the evening is the best remedy for young people. Persons who are troubled 210 CHAPTER V. with this complaint sleep better on the right side than on the left, and prefer to have the head rather high. If it is caused by vexation, give Chamomilla ; by fear, Vera- trum ; by joy, Coffea; by sudden fright, Opium or Coffea; by great agitation and anxiety, either Opium or the smell of a bitter almond crushed, will be found to be beneficial. With pregnant females, when connected with weakness of the nervous system, when it returns frequently, give, from time to time, a drop of old wine. During the attack it is sometimes bet- ter to give a spoonful of hot water, particularly when the skin is very dry. Females of a pale complexion may experience some benefit from smelling vinegar. Those who are subject to this complaint should drink no coffee or tea. For plethoric persons Aconite is generally best; after this, Nux vomica or Belladonna. With persons of weak nerves, Ignatia, and when worse on lying on one side, Pulsatilla. China is most suitable for persons who have been much weakened by the loss of fluids. Belladonna, when the palpitation of the heart produces a tingling sensation in the head, when the chest feels full, or when there is an uneasy and throbbing sensation in it, particularly in females, after confinement, or when the milk fails, or after wean- ing. In the latter case give China some time after. Sulphur, for the same symptoms as the latter when that proves insufficient; especially if the palpitation is consequent upon the suppression of an eruption, or the healing of an old ulcer. Also, when going upstairs, or ascending a hill has occasioned palpita- tion for a considerable length of time. Arsenicum may be given after Sulphur when the latter does not suffice, particularly when caused by suppressed eruptions or ulcers. It is also serviceable when the palpitation comes on during the night, with great agitation, is very violent, with burn- ing heat in the chest; with difficulty of breathing, and is worse when lying down, better when in motion. Veratrum, is suitable in cases similar to the latter, when ac- companied by difficulty of breathing and agitation; particularly AFFECTIONS OF THE CHEST. 211 if better on lying down, and worse when rising or in motion. For chronic palpitation of the heart, when the remedies pre- scribed give only temporary relief, apply to a homoeopathic phy- sician, and submit patiently to medical treatment even though no decisive advantage be immediately perceived, otherwise, an incurable disease of the heart may be the result. Asthma. The paroxysms of asthma come on at times without givjng the patient any warning and instantaneously, at others there is a sense of fulness or oppression at the pit of the stomach— which is probably owing to the presence of flatus in that organ —with a feeling of irritation in the air-passages. The paroxysms themselves rarely occur during the day; they usually commence at night and between the hours of ten and two. If the patient be lying down, he immediately rises and remains sitting up, experiencing a sense of violent constriction over the whole chest; the arms are thrown back to facilitate inspiration; the shoulders are raised and the head is often violently straitened on the neck; the patient lays hold of any object that may afford him support; the inspirations are quick, suddenly interrupted and repeated at short intervals; the patient requests the windows or door to be thrown open, that more cool air may be admitted. The face is pale, sometimes livid; the eyes anxious and projecting; there is usually a small, frequent, a»d dry cough, and the body covered with a profuse, cold perspiration. There is frequently more or less disorder of the stomach, and vomiting is not an uncommon occurrence. An attack of asthma of the nervous or spasmodic kind usually lasts about three or four hours; after which the symptoms gradually abate. The difficulty of breathing diminishes, the cough becomes more free and the expectoration usually more copious, the mat- ters expectorated are colourless, transparent and viscid with a salt or sweetish taste; the countenance resumes its natural ex- pression gradually, and the patient exhausted falls asleep. On 212 CHArTER-V. awaking he may find himself entirely restored, but there is generally some difficulty of breathing, with pains about the region of the stomach—which may continue through the fol- lowing day and be succeeded by another paroxysm the next night. Asthma has been divided into several varieties, the prin- cipal, however, are the nervous or spasmodic, and the catarrhal or mucus. In the former the attack is usually sudden, violent and of short duration, the expectoration scanty, appearing only at the termination of the paroxysm, and in some instances entirely wanting. In the latter the paroxysm is gradual and protracted, the expectoration begins early and is at first viscid and scanty, afterwards copious and productive of great relief to the patient. The causes that give rise to paroxysms of asthma are various, atmospheric changes, odors of different kinds—agreeable and disagreeable—smoke; dust; irritating gasses; metallic and other particles floating in the air; chamomile tea; ipecacuanha; vapour of sulphur, &c, have all been enumerated as exciting causes. As well as irregularities of diet, especially taking food in too great a quantity or of improper quality; abuse of alcoholic liquors; the suppression of any accustomed discharge; over- exertion and mental emotions. Asthma attacks all ages, but is more frequent in advanced than in early life, and in men than women. It is rarely fatal. Treatment.—In sudden attacks of asthma relief may be ob- tained by immersing the hands in warm water, or by the appli- cation of dry cups to the abdomen, in the manner recommended under "Hemorrhage from the lungs." Bandaging the arms above the elbow is often beneficial, the left arm first and after- ward, if necessary, the right, and the lower limbs. When the attacks originate from the use of chamomile tea or Ipecacuanha, &c, smelling camphor or sweet spirits of nitre, or taking % little coffee without milk will generally afford relief. If caused by inhaling the vapor of sulphur, Pulsatilla is the best remedy. Attacks which come on immediately after meals, or after a AFFECTIONS OF THE CHEST. 213 nap; when the patient cannot breathe, draws and stretches the neck as if suffocating; the throat feeling dry and too narrow, without much agitation, chewing a little ginger, mixed with sugar, will be beneficial. Weak anis-seed tea, a teaspoonful taken at a time, especially in the evening, is sometimes of benefit when the attack is brought on by a cold, and is accompanied by dry cough. Persons subject to this complaint should take plenty of warm drinks, and brush and rub the body frequently; they may be benefited, also, by smoking tobacco every morning. The remedies which are best calculated to alleviate the parox- ysms of asthma and entirely eradicate the disease, however, are the following : Ipecacuanha, Arsenicum, Bryonia, Nux vomica, Belladonna, Arnica, China, Coffea, Pulsatilla, Chamomilla, Veratrum, Sulphur, Sambucus and Lobelia infiata. With reference to the particular symptoms: Ipecacuanha will be indicated when there is a feeling of con- striction about the chest, panting, rattling in the windpipe, as if full of mucus, which seems to be moving up and down; or the patient feels as if the air were full of dust, which prevents his breathing; gasps anxiously for air, and fears suffocation; the face- pale, and hands and feet cold. It may be given several times at short intervals; after Ipecacuanha it may be necessary to resort to Arsenicum to complete the cure, or in some cases Bryonia, or Nux vomica, will be best adapted to this purpose. Arsenicum, against the most violent attacks of asthma, espe- cially those occurring in consequence of suppressed catarrh, or in persons with weak and narrow chests; when worse about midnight, the breathing becoming more and more difficult, and there is a rattling in the chest, with agitation, moaning, groan- ing, and uneasy tossing about; or when, old people particularly, are attacked by it when walking; when breathing gives them no relief; when there is a pressure at times about-the heart, worse upon the least motion or exercise, particularly when get- ting into bed. If the attack becomes worse again after the administration of 214 CHAPTER V. Arsenicum, Ipecacuanha will be most suitable; or sometimes, when the aggravation takes place in the morning, Nux vomica. Bryonia, is of great benefit after Ipecacuanha, particularly when exercise aggravates the disease and when it arises from sup- pressed eruptions, frequent coughing and sighing; the paroxysms come on at night and are attended by pain in the bowels, with inclination to evacuate. Belladonna is most suitable when the attacks are made worse by motion and the patient is notwithstanding unable to rest; the paroxysms worse by spells; the respiration at times deep and full, at others quick and hurried, accompanied by a dry cough and fulness of the chest. Arnica, is indicated when not only exercise, but even speak- ing or blowing the nose aggravates the symptoms; the respira- tion heaving and oppressed, with shooting .pains in the chest. China, when there is whistling and wheezing on the chest during inspiration; the phlegm on the chest threatens to suffo- cate the patient. If the attack begins on waking at night; in- ability to breathe, unless when lying with the head very high; the patient perspires easily, and is liable to take cold. Coffea in very sensitive persons who are liable to attacks of asthma in consequence of mental emotions; when inspiration can only be performed in short jerks, with agitation, uneasiness, heat, perspiration. If this does not give relief in attacks of this kind, it may be followed by Aconite, or these remedies may he alternated. Pulsatilla, too, at a later period, may be of service for timid, fretful patients; and Nux vomica for those of a vio- lent, passionate temper. If mortification or suppressed vexation is the cause, Ignatia ; if violent vexation and anger or quarrel- ing, Chamomilla. Chamomilla is also serviceable when there is frequent inclina- tion to co«gh, without actual coughing, with great pressure about the chest and heart, or when the patient cannot perspire. Pulsatilla, especially in females or persons of mild character, and the attack is attended with giddiness and weakness in the AFFECTIONS OF THE CHEST. 215 head, drowsiness, palpitation of the heart, heat in the chest; the breath seems to be stopped in the lower part of the chest. Sambucus, quick and laboured respiration, with loud wheez- ing ; sense of weight on the chest, with anguish and dread of suffocation; swelling and blueness of the face, and hands; heat trembling; inability to speak above a whisper; cough suffocat- ing; the symptoms are aggravated by lying down. Lobelia infiata is one of the most efficacious remedies in par- oxysmal asthma; the intimations for its employment are : oppres- sion and general constriction of the chest; respiration short and labourious; sensation of fulness in the chest; frequent short dry cough. Sidphur is a valuable remedy both in acute and chronic asth- ma, its chief indications are : short, wheezing, obstructed respira- tion with anxiety and fear of suffocation; the attacks come on when lying down at night, or during sleep; sensation as if the chest were contracted; rattling of mucus in the chest; fulness, and pressure as if from a stone on the chest; cough sometimes dry and fatiguing, at others moist, with profuse expectoration of thick whitish or yellowish mucus; blueness of the face and in- ability to speak; and palpitation of the heart. Veratrum is often suitable after Ipecacuanha, Arsenicum, China, Arnica; particularly when the patient is almost suffo- cating. Also, if worse when sitting up, and when in motion; with pain in the side, a hollow cough at times; when a cold per- spiration breaks out, or when the face and limbs become cold; particularly when partial relief is obtained by lying quiet. Pleurisy. Pleuritis. (Inflammation of the Pleura.) An inflammation of the serous membrane lining the chest— Pleura costalis—and which is reflected over the lungs—Pleura pulmonalis—is called pleurisy. The chief characters of this disease are acute pain in the side or some part of the chest; cough; difficulty of breathing and fever. Pain is one of the most constant symptoms, yet there 216 CHAPTER V. are cases of what is termed latent pleurisy, occurring chiefly in old persons, and those enfeebled by disease, in which neither the pain nor general symptoms may excite more than suspicion; and nothwithstanding pleurisy may have existed for a long time. Such cases can only be detected by an experienced and skillful physician by means of the physical signs. The pain is most commonly felt in the region of the nipple on one side or the other, and it is generally of an extremely lancinating character, aggravated by the slightest attempt at inspiration. It may how- ever be referred to the margins of the ribs, the armpits under the breast or collar bones, &c. Inspiration, coughing, lying on the affected side, the motions of the body, and when the inflam- mation is seated in the pleura costalis, pressure on the spaces be- tween the ribs, commonly aggravate it; so that the patient makes short and repeated inspirations and dreads the slightest mechan- ical change from the movements referred to. Usually in pleurisy pain exists from the first; but it may not become fixed and constant for a few days. After this takes place, it is for some time excessively severe, and then gradually dimin- ishes in violence, becomes dull, or may cease entirely before the termination of the disease. The difficulty of breathing in the beginning is entirely owing to the pain; the slightest movement of the ribs exciting the severest torture. When it continues after the pain has abated or ceased, it is owing to the effusion of plastic lymph into the cavity of the pleura and the consequent compression of the lungs. The degree of dyspnoea will of course depend upon the quantity of fluid effused. The cough is a very uncertain symptom being in some cases extremly annoying and in others entirely wanting. It is usually short and dry, and never occurs in fits or paroxysms. The position of the patient in bed is, in the majority of in- stances, on the back; and a change to the sound side, if there be much effusion, increases the pain very materially. The rule generally is, however, that the position is at first on the healthy side, but in after periods, when effusion has taken place, it will be AFFECTIONS OF THE CHEST. 217 on the diseased side. But there are numerous exceptions to this. In many cases after the pain has ceased, and copious secretion has occurred, the position is on the sound side. There is usually in inflammation of the pleura a hot and dry skin and fever, the latter at times being exceedingly high with a hard and frequent pulse. # The existence of acute pleuritis will generally be indicated by the above symptoms taken collectively: yet there are cases in which they may nearly all be wanting, and when the existence of the disease can only by detected by a recourse to the physical signs, auscultation and percussion. And which as already re- marked can only by satisfactorily employed by an experienced and skilful physician. The causes of pleurisy are the same as those of other active internal inflammations; one of the most frequent perhaps is ex- posure to sudden vicissitudes of temperature, especially in cold damp seasons, hence it is more frequently met with in the months of spring and autumn and among males than females. It may likewise be induced by severe physical labour, and by mechanical injuries of the chest, as severe contusions, wounds, fracture of the ribs, &c. Diseases of the lungs also occasion it. Thus it occurs in most cases of pulmonary consumption at some stage of that disease, and in inflammation of the lungs it is a common complication. No sex or age is exempt from attacks of pleurisy, it occurs in the youngest infants as well as in the robust and the most aged and decrepid. Treatment.—When well managed, pleurisy is by no means a dangerous disease. Recovery takes place in a large majority of cases. Bleeding which is almost universally resorted to by prac- titioners of the old school is entirely unnecessary and in many instances injurious, as it often lays the foundation of dropsies, consumption, and many other diseases, which the most intelligent and skilful physician finds it difficult or impossible to cure. The disease may generally be easily managed by a proper 28 218 CHAPTER V. selection and administration of the following remedies: Aconite, Bryonia, Sulphur, Belladonna, Mercurius vivus, Phosphorus, Kali carbonicum and China. Aconite is the chief remedy in subduing the febrile symp- toms in this complaint, and in most instances it is sufficient to effect a complete cure. A few pellets should be taken every two or three hours until the pain, heat, thirst and cough have sen- sibly diminished; or if this should not be accomplished in from eight to twelve hours it will be necessary to select another remedy. Generally Bryonia or Sidphur will be most appropriate. Bryonia may advantageously follow Aconite after the reduction of the febrile symptoms by the latter. And it is especially indi- cated in the following symptoms occurring either in acute or chronic pleurisy. Acute shooting pains in the chest increased by inspira- tion or movement of the body; dry cough or cough followed by expectoration of yellowish, dirty or bloody mucus; oppressed res- piration ; yellowish tongue; palpitation of the heart; constipa- tion; bitter taste, nausea and sometimes vomiting of mucus, aching in the limbs; hot skin, violent thirst, cough when lying on the right side. Sulphur will be especially serviceable after Bryonia when that medicine has removed the pain, if there is still some sensi- tiveness remaining, particularly on motion and exposure to the air and will in most cases perfect the cure. It is useful also in cases of pleurisy complicated with inflam- mation of the lungs, and may follow or be alternated with either of the previous remedies when they have not entirely removed the fever, or when the disease has continued for several days without marked improvement. Although these three remedies will in a great majority of cases be sufficient to effect a cure, yet it will in some instances be ne- cessary to resort to one or more of* the following. Belladonna has been recommended in cases where the fever returned or the pain and difficulty of breathing continue not- withstanding the use of Aconite, and it will also be the best AFFECTIONS OF THE CHEST. 219 remedy in those cases in which there is violent pain in the head with great heat; incoherent talking, &c. Arnica against pleurisy resulting from external injury; also in cases in which the fever has been subdued by Aconite, but there is still some pain and difficulty of breathing remaining. Mercurius vivus has been^found of service in cases where the fever has diminished but is not entirely subdued, by Aconite; and where there is still a good deal of pain and oppression accom- panied by exhausting night sweats. Arsenicum is of most value in protracted cases where there is extreme prostration of strength, and where the breathing is pain- fully oppressed and asthmatic. Phosphorus in cases complicated with inflammation of the lungs and bronchitis: for its particular indication consult these articles and also cough. China, chiefly in those cases in which bleeding has been resorted to and the patient is in consequence very weak and de- bilitated. It will aid in restoring the vital energies and may in some instances be followed with advantage by Ferrum met$l Kali carbonicum, Lycopodium and Arsenicum arWne reme- dies chiefly to be relied on in chronic cases of pleurisy, where through neglect, bad management or constitutional predisposition, there is danger of pulmonary consumption being developed, with purulent expectoration, protracted cough, dropsical swellings, &c. Pleurodynia. Pseudopleuritis. False Pleurisy. Stitch in the Side. This painful affection which is often mistaken for true pleu- risy, and which is frequently accompanied by many of the symp- toms of that disease, may be distinguished from it by the follow- ing characteristics. The pain comes on suddenly in some part of the chest, generally in the side, like a stitch, and at times continues very violent for awhile and then passes off. At others it is of longer duration, and may continue for several days, caus- 220 CHAPTER V. ing great suffering to the patient. It is usually, too, unaccom- panied by febrile symptoms, and by cough; there is generally also more or less soreness on pressing the muscles of the chest. These symptoms, with the aid of the physical signs, will always enable the practitioner to discriminate satisfactorily between the two diseases. Treatment.—Arnica, in the majority of cases, is the prin- cipal remedy, and is occasionally sufficient to effect a speedy cure after a single dose. In other instances, however, the disorder does not yield so readily, and one or more of the other remedies enumerated must be had recourse to. Bryonia. When the pain is of an acute darting description, as if from a sharp instrument running into the side, and is oc- casionally almost insupportable during inspiration or even the slightest movement of the body; and when the party affected is of a nervous or bilious temperament. Pulsatilla. This remedy is frequently very useful in alterna- tion with Arnica; it is more particularly indicated when the pain is occasionally of a fugitive character, moving from one part of jm chest to another, becoming increased towards even- ing, andsometimes experienced more during expiration than inspiration. Nux vomica. Shooting pains in the sides increased by the respiratory movements of the chest; especially when the affec- tion occurs in hypochondriacal subjects or in those who are ad- dicted to indulgence in vinous or spirituous drinks. • It is, moreover, one of the best remedies in this complaint; the characteristic indications are as follows, and show a marked resemblance to the symptoms which are so frequently met with in, and are in some respects peculiar to pseudo-pleurisy ; stitch in the side, or shootings, with painful sensibility of the external parts of the chest, but particularly of the intercostal spaces, aggravated by any movement, and especially by taking a deep inspiration, yawning or stretching. AFFECTIONS OF THE CHEST. 221 Inflammation of the Lungs (Pneumonia. Pneumonitis). This disease consists in an inflammation of the parieties of the pulmonary vesicles or air cells, or of the intervesicular cellular tissue, or of both combined. It is usually divided into the acute, the chronic and the typhoid. I. ACUTE INFLAMMATION OF THE LUNGS. The principal symptoms of this variety of pneumonia are fever, cough, tenacious, bloody or purulent expectoration, and short- ness and difficulty of breathing. The fever is generally preceded by shiverings and chills, and is at times very high with a hard, wiry and rapid pulse, and pungent burning skin. The cough at the commencement of the inflammation is dry, short, and distressing, and if the attack has been preceded by some irritation of the bronchia may be at- tended by expectoration of mucus. Usually however about the second or third day of the disease the matter of expectoration assumes a reddish or rusty appearance which is characteristic. It consists of mucus intimately mixed with blood. ^Although the rusty expectoration when present always indicataHfte exist- ence of pneumonia, yet it is by no means constant. The disease may occur without any characteristic expectora- tion, or without any at all, though this is rare. The matter of expectoration as the disease progresses, changes and becomes more copious, dense and transparent, and so tenacious that it adheres to the sides of the vessel, and so remains until the dis- ease is about to terminate; when, if the termination is favourable, the red colour and great tenacity disappears. If the contrary, it becomes watery and small in quantity, is discharged with dif- ficulty, or it may be suppressed entirely. The difficulty of breathing in pneumonia is less than in pleu- risy and bronchitis. When however, as occasionally occurs, there is great oppression of the chest, anxiety of expression and blue- ness of the face with sense of suffocation, a fatal termination is to be apprehended. 222 CHAPTER V. In inflammation of the lungs the pain is less severe than in pleurisy, in some instances indeed it is almost or entirely want- ing. It is most severe at the commencement and may be felt in various parts of the chest. Coughing, inspiration, lying on the affected side and change of posture increase it. Pneumonia rarely takes -place without the pleura being more or less involved; when the latter is unaffected there is a feeling of contraction, a kind of weight and sensation of heat is expe- rienced in the chest. The patients usually lie on the side affected or on the back, perhaps most generally on the latter. These symptoms will generally be sufficient to point out the existence of acute inflammation of the lungs; when any difficulty or obscurity presents itself, however, it will be necessary to resort to the physical signs, which, as remarked under pleurisy, can only be made use of satisfactorly by an experienced physician. Inflammation of the lungs occurs at all ages. Both males and females are subject to it, though the former more so than the latter aftoLthe period of childhood is past. This is owing to the more es^Bd life of men than women. The disease is not a very fatal one; not more than about one person in thirty of those attacked under twenty years of age die. After the twentieth year the mortality is greater; the proportion of deaths being about one in six or seven. The average duration of pneumonia is from twelve to twenty- four days, though recovery may take place in some cases in three or four days, or it may be protracted in others for months. Treatment.—Aconite, Bryonia, Rhus, Sidphur, Phosphorus, Tartarus emetic, and sometimes Belladonna, Mercurius vivus, Arsenicum, Opium, Lycopodium and Hyoscyamus are the re- medies which will be found most successful in effecting a cure. Aconite will mostly be indicated in the first stage, if the in- flammation is of a high grade, with hot burning skin, hard, small and frequent pulse, hot breath, violent thirst; either accompanied or not by pain in the chest. It should be admin- AFFECTIONS OF THE CHEST. 223 istered either by putting three or four pellets on the tongue, or by dissolving a few pellets in half a tumbler of water and giving a teaspoonful of the solution every three or four hours until the more violent febrile symptoms have subsided. Bryonia is especially serviceable after Aconite, when the fever has abated under the influence of that remedy, and also from the beginning in alternation with it when the following symp- toms are present; cough, with expectoration of tenaciouj^mucus of a reddish or rusty colour; great difficulty of breathing, and acute shooting pain in the side or chest; rheumatic j|ains in the limbs or in the muscles of the chest; pain increased by movement; yellowish or dark coated tongue, and constipation. It may be administered the same as Aepnite at intervals of four or six hours. -;, Phosphorus has been highly recommended in every stag? of the disease of late years. It would appear to be best adapted to persons with weak conformation of the chest, who are subject to repeated attacks of inflammation, and especially those of a fair complexion. It may be given from three to six times a day according to the severity of the symptoms. ^Kk Belladonna will be useful,after Aconite if the fl^r returns, after having been subdued by that remedy, and' the oppression and pains in the chest continue, especially if the pain is felt at the lower and middle portion of the chest; the expectoration bloody, scant and difficult; great thirst; flushed face; cracked and dry tongue and lips; restlessness; pain in the head and delirium. Hyoscyamus and Opium will sometimes be indicated after Belladonna^ especially when the head is much affected. Mecurius vivus, when the fever is not so active as to require Aconite or Phosphorus, or when it has been lessened by those remedies; the pain and difficulty of breathing still continuing, with profuse night sweats, which greatly debilitate the patient; the pulse weak but frequent. Tartarus emetic, will be of advantage after the reduction of 224 CHAPTER V. the fever, when there is oppression of the chest, with little or no pain; scanty expectoration of viscid mucus; with great weak- ness, and particularly when there is gastric complication, dis- position to vomit or vomiting of mucus. Sulphur, third trituration, will have the preference in the latter stages of pneumonia, when there is danger of it running into pulmonary consumption, with profuse purulent expectora- tion, shortness of breath, &c.; also in complications with pleu- risy, and obstinate constipation. A grain may be dissolved in half a tumbler of water and a tablespoonful of the solution taken three times a day. Arsenicum, in cases in which there is great debility, with diarrhoea, clammy sweats, anxious expression of countenance, &c. Rhus tox., in cases where there is great congestion with pal- pitation of the heart, restlessness, redness of the face, &c. China will be requisite when bleeding has been resorted to, and the strength of the patient is in consequence very much reduced; and also with Lachesis and Arsenicum in cases of threatened mortification of the lungs, with extremely offensive expectorjUfin and breath. LycopK/Jkm, when the fever has been subdued but the ex- pectoration is copious and mixed with pus, and there is great debility with copious night sweats, will frequently produce a favourable change. Kali carb., Sulphur, Lycopodium and Phosphorus will be found best adapted to the treatment of pneumonia occurring in persons who are predisposed to tuberculous disease. The diet ought to be carefully attended to during the contin- uance of the disease and for a week or two after recovery. The food should be of the simplest kinds, and partaken oT sparingly. The drinks should consist of water, toast-water, rice or barley water sweetened with sugar. II. CHRONIC INFLAMMATION OF THE LUNGS. This form of pneumonia is of rare occurrence as an original disease. But regarded as a sequel of the acute form, or if the AFFECTIONS OF THE CHEST. 225 inflammation which accompanies tuberculous and scrofulous dis- ease and which is chronic in its character can be regarded as chronic pneumonia, is extremely frequent. It may also occur in the course of chronic bronchitis. The symptoms resemble those of acute inflammation of the lungs, but are less violent, the fever and pain is usually but slight; the cough and difficulty of breathing, however, may be considerable. The expectoration but rarely presents the charac- teristic rusty appearance of the acute form, but may be viscid, white or yellowish, purulent and streaked with blood. Treatment.—Phosphorus, Mercurius vivus, Conium macula- turn, Sulphur, Tartarus emetic, Kali carbonicum, Rhus tox., Arsenicum, Bryonia, Causticum, &c, are the medicines which are most generally indicated in the treatment of this affection. For their particular application consult "Bronchitis", "Cough" and also " Acute Inflammation of the Lungs " under their re- spective heads. III. LATENT PNEUMONIA. PERIPNEUMONIA NOTHA. In the first of these, latent pneumonia, intense inflammation may exist, without giving rise to difficulty of brea^Rg, cough or the characteristic rusty expectoration, and even auscultation may afford no sign of its presence. It commonly occurs in the course of other diseases. The treatment will of course be modified by the particular character of the disease with which it is connected. The latter, peripneumonia notha, is found chiefly in old per- sons, and receives its name on account of the more rapid pros- tration with which pneumonia is induced in them than in adults. The same term has been applied to chronic bronchitis of old persons. The latter affection is indeed very apt to be com- plicated with pneumonia, giving rise to violent difficulty of breathing. The approach of peripneumonia notha is insidious, sometimes it may commence like an ordinary attack of catarrh, at others it is merely preceded by a feeling of general prostration. 29 226 OHAPTER V. The pulse is soft but quick; the pain is slight and usually felt only in the side like a stitch on taking a deep inspiration; there is great weight or oppression on the chest, with rapid and labor- ious breathing. The cough from the commencement is loose and almost constant, usually occurring in short quick jerks; the expectoration is of white or yellowish mucus, and generally streaked with blood from the first. These symptoms increase rapidly, the voice becomes weak and low, and sometimes lost entirely; the slightest effort at speaking or exertion of any kind brings on violent attacks of coughing. Usually toward morning there is some remission of the fever, with moist or clammy skin, and sometimes sweating, without however relieving the patient. The head is generally less affected in this than in the acute form of pneumonia, notwithstanding there is considerable agitation of the nervous system. Treatment. The medicines which are mostly to be relied on in the treatment of this affection are : Aconite, Mercurius vivus, Belladonna, Carbo vegetabilis, Chamomilla, Nux vomica, Ipe- cacuanha, Veratrum and Arsenicum. Aconite^at the commencement of the disease if there is con- siderable ^per, will be required and will in many cases afford relief. Mercurius vivus, if there has been some improvement from the use of Aconite, but the patient has become worse again; and in many cases from the very commencement, especially when there is nocturnal perspiration, or cold, clammy skin, will be • beneficial. Belladonna will follow Aconite and Mercurius advantageously, when these remedies have produced more or less improvement, particularly if there remains a dry, hacking cough, accompanied by a contraction of the chest, which obstructs respiration and produces a sensation of suffocation. Carbo vegetabilis will frequently be useful if the foregoing remedies have caused but little or no improvement, and the patient is greatly debilitated, the pulse scarcely perceptible, the AFFECTIONS OF THE CHEST. 227 skin and breath cold, and the expectoration occasionally of a reddish brown color. Chamomilla is suitable in cases where the dangerous symp- toms have been subdued, but the breathing is still difficult and attended by a whistling or wheezing sound; it may, if necessary, be followed by Nux vomica. Ipecacuanha may be given after Mercurius, if the respiration is very rapid and difficult, and the latter remedy fails to afford relief. It may be repeated several times. Veratrum will sometimes be serviceable when the extremities become cold, the constriction of the chest and difficulty of breath- ing increasing. Arsenicum must be resorted to when the patient is apparently in the last stage of the disease, with great prostration of strength and sinking of the vital energies, and will sometimes be success- ful in restoring apparently hopeless cases. In cases where, after the subsidence of the febrile symptoms, profuse purulent expectoration sets in, Mercurius vivus, Hepar, Sulphur, China, Dulcamara, and sometimes Pulsatilla will be of service to check the discharge and prevent a fatal, germination of the disease in rapid consumption. IV. TYPHOID INFLAMMATION OF THE LUNGS. Typhoid pneumonia is often extremely insidious in its ap- proach, the symptoms being so slight that no serious mischief is suspected, till suddenly the supervention of oppression, with great difficulty of respiration, and irregular motions of the chest set in, and death takes place in a very short time from conges- tion of the lungs. The patient, however, generally complains of severe headache, loss of appetite, and inability to sleep for a day or two, and is then suddenly taken with a chill. This is followed by more or less oppression of the chest and shortness of breath, with slow fever, the pulse weak and quick, some heat of surface, the urine high coloured and scanty. As the disease progresses, the mind of the patient begins to wander; he talks and mutters continually, yet when questioned answers correctly. 228 CHAPTER V. The pulse becomes irregular; the respiration still shorter, un- equal and rattling; the evacuations take place involuntarily or are sometimes suppressed entirely; the face assumes a grayish hue, the nose is dry, the lips and tongue dry, black and cracked, and the forehead is covered with a clammy perspiration. The cough even in the beginning of the disease is generally slight, and the expectoration, if any, white or yellowish, and but seldom mixed with blood. This disease is frequently complicated with others, and is masked by the particular symptoms with which they are attended. The complication with gastric and bilious fevers is the most fre- quent. Hence it is in many places known under the name of bilious pleurisy or bilious pneumonia. The head being almost always affected before any of the pul- monary symptoms make their appearance, has caused the name of head pleurisy to be sometimes applied. Cold plague is also another name given to those violent cases which are suddenly taken with a chill and cold skin, and often die without reaction taking place. A favourable indication during the course of the disease is the a ° breaking out of a general odorous perspiration over the.whole body, or the appearance of small shining grains in the urine. Treatment. In the treatment of typhoid pneumonia, Opium, Arnica, Veratrum, Arsenicum and Sulphur have been used with most advantage. Opium is the remedy which will generally be found most appropriate in the commencement or as soon as the character of the disease is clearly established. It may be repeated two or three times. Arnica should follow Opium if the latter does not produce a favourable change. Veratrum, if the foregoing remedies effect no improvement, and the patient becomes exceedingly weak, with clammy per- spiration on the forehead; difficult unequal and rattling respira- tion, and coldness of the extremities. AFFECTIONS OF THE CHEST. 229 Arsenicum may be given after Veratrum, if the weakness and rattling respiration increase, the pulse become irregular, very small and quick, the face of a grayish hue, the tongue dark brown or black, and dry. These two remedies may be given alternately at intervals of two, four or six hours, according to the urgency of the case, and they will frequently be found to effect a decided improvement. Ipecacuanha will sometimes be of advantage after or in alter- nation with Veratrum, in cases in which the latter seems to be of but little service. After Ipecacuanha, Arsenicum is frequently useful. Sulphur should be administered if the improvement from any of the foregoing remedies be but temporary; and then again, Veratrum, Opium, Arsenicum, or any one of them which had previously been followed by a marked degree of improvement. Belladonna will remove temporary attacks of blindness, occur- ring in the course of the disease. Nitrum murialicum, will sometimes remove the increasing weakness and prostration of strength, after the failure of Arse- nicum and the other remedies, and entirely change the aspect of the disease. China and Arsenicum must be administered alternately, if galling or excoriation take place from lying in bed. Consumption of the Lungs. TUBERCULAR CONSUMPTION. PULMONARY CONSUMPTION. The symptoms of this complaint vary very much in different individuals, both in the order in which they present themselves and in their severity,—in some cases they are so prominent as to attract the attention of the most careless observer, while in others they are so slight that they may escape the notice even of the physician. In the first stage the symptoms are chiefly those of catarrh, __as, short, frequent and irritating cough, which is commonly referred to a tickling sensation in the throat, languor, debility, 230 CHAPTER V. some shortness of breath, and sometimes hectic fever and ema- ciation. The expectoration, if there be any, is of nearly trans- parent mucus, occasionally containing specks of blood. There is often, too, along with these symptoms pain in some part of the chest, sometimes constant, at others intermittent. It frequently occupies the shoulder joint. The pulse also is commonly acce- lerated. The second stage is distinguished by the aggravation of all the symptoms of the first. The hectic fever is more marked; chills occur in the evening, followed by fever and sweats at night; the weakness and emaciation is increased; the expecto- ration contains small specks of matter of a pale yellowish or white colour, and resembling curds or cheese. This matter gradually increases in quantity so as to form patches, surrounded by a transparent portion in which they seem to float, or if expectorated into water they fall to the bottom. •Streaks of blood also appear in them and occasionally hemor- rhage to a considerable extent occurs. The oppression or pain in the chest may be diminished or absent in this stage, but the shortness of breath is usually increased. Very often severe pains of a neuralgic character appear, both in this and the next stage, in various parts oi the body—as the limbs, abdomen, head, &c. In the third stage, sometimes called the colliquative stage, in consequence of the wasting produced by the profuse sweats, which are often accompanied by diarrhoea—large caverns exist in the lungs. The expectoration is generally very copious, and purulent in its character, discharged in large globular masses, often of an ash colour, which being heavier than water, sink in it to the bottom of the vessel. The difficulty of breathing becomes so great as occasionally to threaten suffocation. The feet and ankles swell. The shoulders are elevated and brought forward, and the chest, instead of presenting the natural rounded appearance, is flattened. AFFECTIONS OF THE CHEST. 231 These are some of the chief phenomena which are found in the different stages of pulmonary consumption, but as before remarked, the symptoms vary very much in different individuals. And in order to arrive, in many cases, at a satisfactory conclu- sion in regard to the nature of the disease, it will be necessary to have recourse to auscultation and percussion, which, as stated under pleurisy, can be successfully employed by the practised physician only. Treatment.—Aconite, Ammonium carb., Arnica, Arsenicum, Belladonna, Calcarea carb., Carbo vegetabilis, Bryonia, Dul- camara, Ferrum met., Hyoscyamus, Kali carb., Mercurius vivus, Stannum, Lycopodium, Phosphorus, Nitric acid, Rhus tox. and Sulphur, will be indicated and productive of much benefit in the first and second stages. In the third that of purulent expectoration, Calcarea carb., Carbo vegetabilis, China, Co- nium, Dulcamara, Ferrum met., Hepar s., Kali carb., Lache- sis, Lycopodium, Mercurius vivus, Nitric acid., Phosphor%s, Sambucus and Sulphur, will be found to be most serviceable. With regard to the particular symptoms governing the ad- ministration of the medicines; in the first and second stages, see "Cough" and "Hemorrhage from the Lungs" under their re- spective heads. The limits of this work will not admit of enter- ing more at length into the history, causes, treatment, &c, of this most important disease, neither is it necessary, as its manage- ment should always be confided to the care of a homoeopathic physician. Contusion or Concussion of the Chest. In Part First of this book Arnica is prescribed for injuries of this kind, which is always better than bleeding; in hemorrhage it was observed, under what circumstances Arnica ought to alternate with Aconite, viz. : in cases where the fever continues, is worse in the evening, with a pain, as from an ulcer in the chest; afterward, if these are insufficient, give Pulsatilla; but if there be cough with expectoration of thick yellow mucus, 232 CHAPTER VI. Mercurius vivus will be the most appropriate remedy; if the expectoration has a sweet taste and the breathing be asthmatic, Nux vomica ; if other symptoms, such as a dry, hacking cough, oppressed breathing, pale complexion, bad appetite or sleepless- ness, China. CHAPTER VI. AFFECTIONS OF THE THROAT. Sore Throat or Quinsey. The various affections producing a troublesome pain in the throat pass under the general denomination of sore throat. In order to discriminate accurately amongst these affections, the throat should be carefully examined. Place the patient in the light, near a high window, if possible; let him open his mouth wide and push his tongue forward, while you introduce the handle of a spoon and press down the back part of the tongue, but not with too much violence; by this means the whole of the inside may be examined. Persons not familiar with this simple practice, and who, of course, must needs take a longer time in the examination, should first let the patient open his mouth, hold back his head and put out his tongue, that they may examine the upper part of the throat. Then let him rest awhile, after which let him, a second time, open his mouth wide that a spoon handle may be introduced, and the back of the tongue pressed down gently, so that the uvula with the tonsils and the interior part of the throat are exposed to view. In children who will generally resist this examination, it is some- times necessary to put a cork between the teeth; care, however, should be taken that, in pressing down the tongue, no injury is sustained. Then compare the remarks of the patient, and your own ob- AFFECTIONS OF THE THROAT. 233 servations with the symptoms of the medicine recommended. If the other symptoms are accompanied by hoarseness, look un- der this head also. When one remedy does not effect a complete cure, it will always be easy to find a second which answers bet- ter ; at any rate, you will effect much more than with the com- mon domestic remedies. If, nevertheless, you wish to make use of the ordinary reme- dies, wrap up the throat well in flannel or woolen at bed time; it sometimes gives relief. Too much and too long wrapping up of the neck is injurious; it causes the complaint to return the sooner. Persons who have frequently suffered from sore throat, should accustom themselves to go with the neck bare, or with only a light silk handkerchief around it. A worsted ribbon is also said to be good. Gargling the throat with irritating substances, is an old and pernicious habit, which has been abandoned entirely, even by the better physicians of the old school. Any good effects which it would be likely to have, may be attained much more easily by inhaling the vapor of fresh milk. When the throat is dry, swollen and very painful, the patient may inhale the vapor of figs boiled in milk, or take small pieces of the figs in his mouth, or drink some of the milk. If the complaint is of long stand- ing and attended with difficulty of swallowing, starch made of wheat flour and boiled will be beneficial. In the beginning, or when the complaint is of considerable standing, hot brandy and water is sometimes of use. If this makes it worse, give Coffea or Nux vomica. Aconite is frequently of service, and may be repeated after a couple of hours, when the patient experiences difficulty and pain in swallowing or in speaking; when the throat is much more red than usual; and for a burning, pricking, or contracting sen- sation, accompanied with fever, nervousness, impatience and un- easiness. Chamomilla often answers for children, or when the complaint is caused by a cold, from exposure to a draught of air while in 30 234 CHAPTER VI. a state of perspiration. And besides the symptoms mentioned under Aconite, for dryness in the throat, with thirst: feeling of obstruction when swallowing and when bending the neck. It appears to the patient as if something were sticking in the throat which he has a constant desire to remove, but cannot; throbbing pain and swelling of the glands of the lower jaw; fever, generally occurring in the evening, either accompanied with heat or with cold, sometimes with a catarrh and tickling in the throat, a pricking pain in the larynx and hoarseness. After taking this remedy, perspiration not unfrequently ensues, which must not be interfered with by giving other medicines. Ignatia for cases similar to those mentioned under Chamo- milla, when there is a constant feeling as if there were a lump in the throat; a sore spot in the throat when swallowing; acute, shooting pains, which sometimes is experienced only when the patient is not swallowing. Fluids are more difficult to swallow than solid food. The same remedy answers when the tonsils are swollen and inflamed, ulcerated or hard. Before however, deciding on this medicine, compare what is said under Bella- donna and Mercurius vivus, Hepar and Sulphur. For ulcers on the tonsils which do not appear to be deep, give Ignatia and afterwards Lycopodium. Nux vomica in cases similar to those mentioned under Cha- momilla and Ignatia ; especially for a sensation as if there were a plug or lump in the throat, particularly when swallowing; with pains rather pressing than shooting, worse on swallowing the saliva. The throat feels raw and excoriated, or as if scraped and rough; the cold air affects the throat painfully; sometimes the uvula is swollen and red. Pulsatilla for the same sensation on swallowing as described under Nux vomica, or the throat appears too narrow, as if ob- structed from a swelling; redness and sensation of scraping; dryness of the throat without thirst; shooting pains in the throat, worse when swallowing; a feeling of tension in the throat; the glands on the neck are painful when touched; the AFFECTIONS OF THE THROAT. 235 interior of the throat is more of a bluish red; the fever is un- accompanied by thirst; chilliness in the evening, followed by heat. Bryonia when the throat is painful on being touched, or on turning the head; swallowing difficult and painful, as if a hard substance were in the throat; shooting pains and soreness, attended with dryness, or a feeling of dryness, which renders speaking difficult. These symptoms commonly occur after being overheated, or after eating ice or drinking ice-Avater; they are frequently accompanied by fever, either with or without thirst, and great irritability. Rhus toxicodend., for symptoms similar to those under Bry- onia, except that the pains extend further down, and the patient is more inclined to weep, and when Bryonia does not effect a complete cure. Capsicum for symptoms similar to those previously mentioned; it may be given when the other remedies do not suffice; when the fever continues, with chills and thirst, followed by heat; the pains particularly oppressive, the throat spasmodically con- tracted ; excoriation and ulcers in the throat and mouth, with a sensation of burning; at the same time cough, with violent pain in the throat. It is particularly indicated when the patient wants to be always in bed, and is disposed to sleep; is afraid of the air and cold. Coffea for sore throat, accompanied by catarrh, with a dispo- sition to cough; worse in the air; at the same time sleepless- ness, heat, great sensitiveness, inclination to weep. It may be given two or three times. It is particularly applicable when pain passes from the side of the palate into the throat, is con- stant, worse when swallowing; when the soft palate above the uvula is swollen and elongated, feeling as of mucus in the throat with constant efforts at swallowing, also dryness and heat in the throat. Belladonna will be most suitable when the outside of the throat is swollen, and drinking produces spasms in the throat, the fluids returning through the nose; constant disposition to 236 CHAPTER VI. swallow; pricking pain on swallowing and on touching the throat; swallowing difficult, producing spasms, or entirely im- possible ; the throat feels as if there were a plug in it; a dry, burning sensation in the throat, and a disposition to hawk up something; when not swallowing, tearing pain extending to the lower jaws, or up into the head; ulcers in the throat, which appear very suddenly and spread rapidly, tonsils and uvula swollen, and of a bright, sometimes yellowish red colour, or red- ness without swelling; violent pains when swallowing and hawking, sometimes even when speaking; pressing, shooting pain in the tonsils, which seem as if they would burst, the glands swollen outside, accompanied by violent fever, and sometimes thirst; profuse salivation, pain in the forehead, and furred tongue. During the prevalence of scarlet fever, Belladonna is most suit- able for sore throat; sometimes it may be given alternately with Mercurius vivus. Mercurius vivus, in cases similar to Belladonna, when the latter is insufficient, and the throat continues swollen, very red, or becomes ulcerated. When the ulcers are not painful, and come on slowly, Belladonna is of no use, but Mercurius vivus must be given, and may be sometimes alternated with Hepar. In the beginning of the disease, it is more suitable than the pre- ceding remedy, if the pricking pains are very violent when swallowing, extending to the ears or to the glands of the throat, and to the lower jaw; when the burning in the throat scarcely allows the patient to swallow, with stitches in the tonsils, and a very disagreeable taste in the mouth, the gums and back part of the tongue swollen, with abundant discharge of saliva; in the evening chills, or heat, followed by perspiration, which does not relieve, uneasiness, or an aggravation of all the symptoms during the night; also worse in the air; accompanied by bad headache and drawing in the neck; after Belladonna and Mercurius vivus the patient ought to avoid taking cold. Hepar is suitable after Mercurius vivus, particularly after taking fresh cold; after Hepar, Mercurius vivus may be given again, if there is no improvement. AFFECTIONS OF THE THROAT. 237 Lachesis may be given when Belladonna, Mercurius vivus, or Hepar seems to be indicated, but does not suffice; if the palate is swelled around the uvula; continual disposition to swallow; profuse salivation; accumulation of phlegm in the throat; bad ulcers; spasms which prevent drinking; the throat is very sensitive to the slightest touch, even to that of the bed- clothes; all the symptoms are worse in the afternoon, sometimes in the morning and always after sleeping. It is particularly suit- able for persons who have taken much mercury. Veratrum is indicated when the throat is dry and burns, is very rough and sore, with pressure as if swollen; pain and spasms when swallowing. Cocculus, when the complaint is seated deeper in the throat, and attended with pain when the food passes, or dryness extend- ing low down, or when drinking produces a gurgling noise. China, against dryness and pricking in the throat which is painful when swallowing; the complaint is worse after every fresh exposure to the air; pains which change about disturb the patient during the night, and return every time he takes cold. Sulphur, for frequent or continual sore throat, particularly when the inside of the throat, the tonsils and the uvula are swollen ; swallowing is impeded, and beside the usual pains, pe- culiar pricking pains, or a sensation as if there was a lump in the throat, or the throat were too narrow, with soreness or dryness. If there should be a round swelling forming on one side of the throat, attended with stitches and throbbing pain, which may indicate an abscess, the suffering may be relieved, and sup- puration promoted by the repeated external application of warm flax-seed poultices, and by holding in the mouth warm milk or gruel. The patients, especially children, should be carefully watched during the night, to prevent the danger of suffocation in case the abscess should break. Silicea, Hepar, Sulphur, Mercurius vivus and Lachesis are the remedies which will be of most service in such cases. CHAPTER VII. AFFECTIONS OF THE TEETH. Toothache. Odontalgia. Pains originating in the teeth, sometimes affect other parts of the head, as the lower jaw, the ear, the upper jaw, and the bones of the face; and pains which originate in these parts extend likewise to the teeth. We append therefore "The Faceache" to this chapter. This connection between the different parts of the head show that the cause of the complaint should not always be looked for in carious teeth. Hollow teeth are sometimes painful, because they are affected by disease, but their being hollow teeth does not necessarily produce pain; they may get hollow and decay altogether without any pain whatever; if pain were occa- sioned by hollownes, the tooth would ache continually, while, on the other hand, teeth that are not hollow may pain most vio- lently. What is said of exposed nerves producing pain is non- sense ; whoever knows what a nerve is, and will take the trouble to reflect, will soon be convinced of it. Extraction of teeth is only allowable where there exists a fistula, ulcers at the roots, and the like, and as most of these can be cured by homoeopathic remedies, it can only be necessary in the few incurable cases, and in children who are shedding their teeth; in all other cases it is a bad remedy, because the root has to be extracted, and this is injurious to the jaw, as the root may remain in it without causing the least pain, when we know how to treat it. Another reason for deprecating the extraction of teeth is, that, as soon as one has been taken out, another begins to decay. When the teeth remain in the jaw, the decay communicates itself but very AFFECTIONS OF THE TEETH. 239 slowly, except in a few diseases where the decay in a short time destroys all or most of the teeth. But when the disease is of this nature, extracting does no good, not even if all the teeth are taken out, for in this case it will attack the jaw. Let no one believe that one tooth can affect another, make it black, and communicate the caries by contact. This is the doctrine of those who get paid for extracting them, but who cannot cure toothache. The numerous kinds of tooth-powders and tinctures, used as remedies are in almost all cases injurious. The teeth and gums ought not to be picked much, it is a very injurious habit; be careful in drinking to avoid extremes of hot and cold, and keep the teeth clean by rinsing the mouth every morning and after every meal; use, if you like, a tooth brush, and if you think you must have some powder, take sugar of milk, or for which you may sometimes substitute finely powdered dried crumbs of brown bread. Burned bread or charcoal is injurious. The best and most agreeable means of keeping the teeth clean, and removing the tartar, so that the unpleasant use of steel and iron may be dispensed with, is, to clean the teeth with cream which has turned sour. The good effect of this will be increased by rinsing the teeth afterwards with some lukewarm water. If you have toothache, make a timely selection of one of the fol- lowing remedies, and in most cases you will find that they give speedy relief. If they do not cure it, apply to a homoeopathic physician, who will prescribe the proper remedies. The worst of all the common remedies is opium or laudanum. It is always injurious. Pain which has been romoved by opium is sure to return with redoubled violence some time or other. But it is very seldom the true remedy, and when it is, the best way to use it is to tie a piece of opium of the size of a pea on the outside of the cheek. Creosote ought to be used with the greatest caution; in many cases it is of no use, for instance, in the case of females in pregnancy, very rarely; in most cases it only allays the pain for awhile, and produces ulcers in the mouth, the throat, and the stomach; the mere introduction of it into 240 CHAPTER VII. the mouth affects the stomach. For weak lungs it is very in- jurious. Persons who suffer much from toothache should abstain from the use of coffee altogether; it is generally injurious to the teeth. When homoeopathic remedies are used, care should be taken for a long time to avoid every thing that would interfere with their operation. It ought to be observed that one or two globules taken on the tongue, if it is the proper remedy; or, in some cases, merely smelling the medicine will give the patient relief. The pain fre- quently gets worse for a short time after taking the medicine, but wait awhile patiently, and if it begins to abate, take nothing more, until there is no longer any improvement. If it get worse again, and the symptoms resemble the first, take the same medicine ; if they differ, select another. As the torture from toothache is so common, and embitters life so much, and as medicines not suitably chosen will prove ineffectual, we will endeavour, as much as possible, to facilitate the selection of the proper remedy by showing the twofold man- ner in which it must be found ; namely first, by comparing the symptoms with the medicines adapted to them, and then by comparing the medicines with their respective symptoms. In the first place, take note of every symptom complained of by the patient, and note down also the remedies which are re- commended for each; then examine the symptoms under those medicines, which occur most frequently on your list, and see whether they also correspond with the proper symptoms: by these means the proper remedy may generally be easily dis- covered. It should be taken into consideration that not all the symp- toms mentioned under a remedy are necessarily to be found in the patient, but that all, or at least the greater part of the symp- toms of the patient must be found under the remedy selected. To explain this, we will give the following example. A patient has violent tearing or drawing pains in different places, and tear- AFFECTIONS OF THE TEETH. 241 ing in the gums (a); sometimes tearing pain extending into the head (b); cold air makes it worse (c); it is mostly worse in the morning (d) ; accompanied by determination of blood to the head (e). Among the different symptoms, we find for — (a) Pains in the gums: Mercurius vivus, Pulsatilla, Stap>hy- sagria, Hepar, Arsenicum, Carbo vegetabilis, Hyoscyamus, Cal- carea. (6) Which extend into the head: Mercurius vivus, Staphysa- gria, Nux vomica, Chamomilla, Sulphur, Arsenicum, Anti- monium crudum, Rhus tox., Hyoscyamus. (c) Worse in cold air : Belladonna, Mercurius vivus, Staphy- sagria, Sulphur, Hyoscyamus. (d) Worse in the morning: Ignatia, Mercurius vivus, Pulsa- tilla, Phosphoric acid, Staphysagria, Bryonia, Nux vomica, China, Sulphur, Arsenicum, Hyoscyamus. (e) Determination of blood to the head : Aconite, Pulsa- tilla, China, Hyoscyamus, Calcarea. After striking out all the remedies that occur here only once or twice you will find that Pulsatilla, Staphysagria, Sulphur, Arsenicum, occur three times, Mercurius vivus four times, Hyos- cyamus five times; now, examine the symptoms under Hyoscya- mus, and you will find that Hyoscyamus or Mercurius vivus answers best. Swelled gums : Aconite, Belladonna, Mercurius vivus, Phos- phoric acid, Staphysagria, Nux vomica, Hepar, China, Sul- phur, Rhus tox.; painful gums: Mercurius vivus, Pulsatilla, Staphysagria, Hepar, Arsenicum, Carbo vegetabilis, Hyoscya- mus, Calcarea. Teeth loose: Mercurius vivus, Bryonia, Nux vomica, Arse- nicum, Rhus tox., Hyoscyamus; too long, Bryonia, Arnica, Sulphur, Arsenicum; blunt, Phosphoric acid, Sulphur, Dul- camara. Pains particularly in hollow teeth : Mercurius vivus, Pulsa- tilla, Staphysagria, Nux vomica, China, Antimonium crudum; also, Coffea, Phosphoric acid, Bryonia, Chamomilla, Sulphur, 31 242 CHAPTER VII. Silicea, Calcarea ; in the whole row of teeth, Mercurius vivus, Staphysagria, Chamomilla, Rhus tox.; on one side, Mercurius vivus, Pulsatilla, Chamomilla, Rhus tox. Pains extending to the jaw-bones and to the face: Mercurius vivus, Nux vomica, Sulphur, Rhus tox., Hyoscyamus; to the cheeks, Bryonia, Silicea; into the ears, Mercurius vivus, Pul- satilla, Staphysagria, Bryonia, Chamomilla, Sulphur, Arseni- cum, Rhus tox.; into the eyes, Pulsatilla ; into the head, Mercu- rius vivus, Staphysagria, Nux vomica, Chamomilla, Sulphur, Arsenicum, Antimonium crud., Rhus tox., Hyoscyamus. With determination of blood to the head : Aconite, Pulsatilla, China, Hyoscyamus, Calcarea ; swelled veins of the hands and forehead, China; heat in the head, Aconite, Pulsatilla, Hyos- cyamus; burning of the eyes, Belladonna; flushed cheeks, Aconite, Belladonna, Chamomilla; pale face, Pulsatilla, Ar- senicum; swelling of the cheek, Belladonna, Mercurius vivus, Pulsatilla, Staphysagria, Bryonia, Nux vomica, Chamomilla, Arnica, Sulphur, Arsenicum. With much discharge of saliva : Belladonna, Mercurius vivus, Pulsatilla; the mouth dry with thirst, China; without thirst, Pulsatilla; dry throat and thirst, Belladonna; with chills, Pulsatilla. With diarrhoea : Chamomilla, Dulcamara, Rhus tox.; with constipation, Mercurius vivus, Staphysagria, Bryonia, Nux vomica. With nervous excitability : Coffea, Aconite, Belladonna, Hyos- cyamus. From taking cold : Aconite, Ignatia, Belladonna, Mercurius mivus, Pulsatilla, Nux vomica, Chamomilla, Dulcamara, Rhus tox., Hyoscyamus; cold makes it worse, Mercurius vivus, Phos- phoric acid, Sulphur, Arsenicum, Antimonium crudum, Calca- rea ; aggravated by cold air, Belladonna, Mercurius vivus, Sta- physagria, Sulphur, Hyoscyamus; by cold water, Bryonia, Nux vomica, Sulphur, Antimonium, Calcarea; by taking cold drinks, Mercurius vivus, Pulsatilla, Staphysagria, Nux vomica, Chamomilla, Sulphur, Calcarea ; by cold washing, Mrrcuriit* AFFECTIONS OF THE TEETH. 243 vivus, Sulphur, Calcarea; drawing of cold air into the mouth, Belladonna, Mercurius vivus, Phosphoric acid, Bryonia, Nux vomica, Sulphur. Better when applying a cold hand to it, Rhus tox.; tempora- rily better when applying cold water, Bryonia ; when applying the fingers dipped in water, Chamomilla; relieved by cold air, Pulsatilla. Worse in the open air, Belladonna, Staphysagria, Nux vo- mica, China, Sulphur, Rhus tox.; worse in the wind, Pulsa- tilla, Rhus tox.; from draught, China, Sulphur, Calcarea; worse when in the room, Chamomilla, Sulphur, Antimonium crudum. Better in the open air, Pulsatilla, Bryonia, Hepar. Worse from anything hot, Belladonna, Phosphoric acid; from anything warm, Coffea, Pulsatilla, Bryonia, Chamo- milla, Sulphur; from warm drinks, Mercurius vivus, Nux vo- mica, Chamomilla; eating anything warm, Bryonia; in a warm room, or warmth in general, Pulsatilla, Phosphoric acid, Hepar ( Chamomilla, Sulphur); worse when warm in bed, Bel- ladonna, Mercurius vivus, Pulsatilla, Phosphoric acid, Bry- onia, Chamomilla. Better from warmth, Mercurius vivus, Nux vomica, Sulphur, Arsenicum, Rhus tox. Worse from smoking, Ignatia, Bryonia, China; better from smoking, Mercurius vivus. Worse from drinking coffee, Ignatia, Nux vomica, Chamo- milla; from drinking tea, Ignatia; from drinking wine, Nux vomica ; from drinking in general, CJiamomilla. Worse when eating, Belladonna, Mercurius vivus, Pul- satilla, Phosphoric acid, Staphysagria, Bryonia, Hepar, Sulphur, Carbo vegetabilis; after eating, Coffea, Ignatia, Belladonna, Staphysagria, Bryonia, Nux vomica, Chamomilla, Sulphur, Antimonium crudum; some time after eating, Belladonna. Worse when moving the mouth, Nux vomica and Chamo- milla ; when chewing, Mercurius vivus, Staphysagria^Bryonia, 244 CHAPTER VII. Nux vomica, Sulphur, Arsenicum, Carbo vegetabilis, Hyoscya- mus • when biting, Coffea, Belladonna, Pulsatilla, Nux vomica, Hepar, Sulphur, Rhus tox.; when clenching the teeth, Hepar, China; better from clenching the teeth, Coffea, China, Ar- senicum. Worse when touched, Belladonna, Mercurius vivus, Phospho- ric acid, Staphysagria, Bryonia, Nux vomica, Arnica, Hepar, Arsenicum, Carbo vegetabilis; when touched by the tongue, Ignatia, Mercurius vivus, China, Carbo vegetabilis. Better on being pressed, Belladonna, Pulsatilla, China, Rhus tox.; better when rubbed, Mercurius vivus. Worse when picking the teeth, Pulsatilla; better when the gums bleed, Belladonna. Worse when in motion, Bryonia, Nux vomica, China ; better when at rest, Bryonia. Worse when sitting, Pulsatilla, Rhus tox.; better when sit- ting up in bed, Mercurius vivus, Arsenicum, Rhus tox. Worse when lying down, Ignatia ; worse when lying on the painful side, Arsenicum; worse when lying on the sound side, Bryonia. Better when lying down, Mercurius vivus; better when lying on the painful side, Bryonia. When worse at night, Coffea, Belladonna, Mercurius vivus, Phosphoric acid, Staphysagria, Bryonia, Chamomilla, Hepar, Sulphur, Arsenicum, Silicea, Rhus tox., Calcarea; in the evening, in bed, Mercurius vivus, Antimonium crudum; worse when going to sleep, Arsenicum; better when going to sleep, Mercurius vivus; worse before midnight, Bryonia; after mid- night, Mercurius vivus, Staphysagria. Worse when awaking, Belladonna, Nux vomica, Carbo vege- tabilis; in the morning, Ignatia, Mercurius vivus, Pulsatilla, Phosphoric acid, Staphysagria, Bryonia, Nux vomica, China, Sulphur, Arsenicum, Hyoscyamus; in the forenoon, Pulsatilla, Sulphur, Carbo vegetabilis; worse in the afternoon, Mecurius vivus, Pulsatilla, Nux vomica, Sulphur; worse toward even- ing, Pulsatilla; in the evening, Ignatia, Belladonna, Mercurius AFFECTIONS OF THE TEETH. 245 vivus, Pulsatilla, Bryonia, Nux vomica, Sulphur, Antimonium crudum, Rhus tox. Aggravated by noise, Calcarea; when spoken to, Bryonia, Arsenicum; by vexation, Rhus tox.; worse when thinking, Belladonna, Nux vomica; worse when reading, Ignatia, Nux vomica. Toothache, in females especially, Coffea, Aconite, Belladonna, Pulsatilla, China, Hyoscyamus, Calcarea; before, during, or after menstruation, Chamomilla, Carbo vegetabilis, Calcarea; during pregnancy, Belladonna, Pulsatilla, Staphysagria, Rhus tox., Hyoscyamus, Calcarea. Toothache, in children, Coffea, Aconite, Ignatia, Belladonna, Chamomilla, Calcarea. Toothache, in persons who are in the habit of drinking coffee, Nux vomica, Chamomilla, Cocculus, Belladonna, Mercurius vivus, Carbo vegetabilis, Pulsatilla, Rhus tox. Arnica is very useful after the extraction of a tooth; it will stop the bleeding and accelerate the healing of the gums. After the insertion of artificial teeth, it relieves the pain and the swel- ling ; after filing out carious teeth—which is sometimes a very useful operation—mix a few globules of it in a teaspoonful of water, and put some of it on the parts which have been filed. In very intense pain, occurring after a tooth has been drawn, sometimes Hyoscyamus is of use; when the pain is severe after putting in new teeth, give Arnica and Aconite alternately. Arnica is sometimes good for toothache, when attended by throbbing, as if the blood were being forced out of the tooth, or as if it had been started from its socket—worse when touched; it is also frequently of service for hard swelling of the cheeks, which frequently remains after the toothache has been cured. Coffea will remove the severest pains, which drive the patients almost frantic, who cry, tremble and do not know what to do; the pain indescribable; it may be repeated once or twice. If it proves inefficacious, give Aconite, Veratrum, Sulphur, Hyos- cyamus. For stinging, jerking pain, or intermitting pressure, and pain when chewing, it is to be preferred to all other remedies. 246 CHAPTER VII. Aconite must be given in all those cases where the patients are almost frantic with pain, which is indescribable, and which Coffea has failed to relieve; also for throbbing pains, occa- sioned by taking cold, with determination of blood to the head; burning in the face; it is particularly suitable for chil- dren ; it may be repeated several times; when it is no longer efficacious, give Chamomilla or Belladonna. Chamomilla is beneficial in many kinds of toothache, parti- cularly in children—and in persons who are frequently vexed, and who drink much coffee—also in females before menstrua- tion ; pain in the carious teeth, after taking cold when in a per- spiration, or when the patient is very irritable and inclined to cry; when the pain is insupportable, and aggravated periodically; is worse during the night; when no particular tooth can be pointed out as the painful one; or when the tooth is hollow, feels as if too long and seems to move, (for the last symptoms perhaps Bryonia will suit better,) or when the pain extends through the whole set and every tooth feels too long; also when it extends through the jaws to the ear; or through the temples to the eyes; or is mostly on one side, in the teeth, jaws, ears and head; when there is a crawling, sluggish pain continually, or a sensation of scraping and scratching against the nerve of the carious tooth, after which the pain increases; drawing and tearing, or boring and throbbing pain; when at its height, the pain is stinging and jerking, and extends to the ear; the patient cannot bear the warmth of the bed, and the pain generally com- mences soon after meals, particularly after eating or drinking anything warm; when it grows much worse after drinking cold water—also after coffee; cannot be relieved by anything but dipping a finger into cold water and applying it to the tooth j when, while the pain lasts, the cheek is red and hot, or the cheek and gums are swollen and of a light red colour; when the glands under the chin are painful and swollen—if the tooth- ache is accompanied with great weakness, particularly in the joints; pain in the articulation of the jaw on opening the mouth, extending to the teeth—Chamomilla is a certain cure. When AFFECTIONS OF THE TEETH. 247 it is partly adapted to the symptoms and only gives partial relief, and the teeth are hollow, compare Antimonium crud., and then the following: ---1 Nux vomica is useful for toothache in persons of violent tern- ( per, with ruddy complexion, who like coffee and ardent spirits —have little out-door exercise, or who have taken cold; when a healthy tooth is painful and feels loose, or the teeth seem too . I long, with jerking, shooting pains in the lower jaw; a drawing 4, pain extending to the temple, or a pain from a hollow tooth ^ affecting the whole face and even the bones, or extending over the whole side; or for drawing and burning pains in the nervs of a tooth, as if it were being wrenched out, accompanied by violent stitches, which affect the whole body, particularly on inspiration; ^ when a dull pain in the bones changes to a tearing pain, which passes through the teeth and jaws, or there is a boring, gnaw- ing, tearing pain on one side; sometimes for jerking or rheumatic pains, attended with a pricking sensation; when they chiefly commence in bed or in the evening, prevent chewing, grow worse or return as soon as the mouth is opened in the cold air; or when reading and thinking; or when the tearing pains become worse by touching cold liquids, but better when kept warm; in general the pains are worse after eating and exercise; also when along with the tearing pains the glands of the lower jaw are painful, and particularly when a swelling appears on the gum, which is going to burst. Pulsatilla is most suitable for persons of a mild, quiet, timid disposition, or for women and children of a fretful temper; when the pain is only on one side; for toothache, which is prevalent in the spring, accompanied by ear ache and head-ache, confined chiefly to one side; when there is a stinging pain in the decayed tooth, accompanied by great sensitiveness of the left side of the face extending to the ear, with heat in the head and chills over the whole body; but particularly when there is a gnawing pain in the gums, and pricking as of pins, with tearing and jerking in the tooth itself, as if the nerve were strung and then suddenly relaxed; or for jerking or tearing in the tooth as if it would 248 CHAPTER VII. start from the jaw, and aggravated by cold water, the heat of the bed, a warm room, or by taking anything warm into the mouth; cold air relieves it—it is also better when in the open air; worse when sitting, better when walking about—worse from picking the teeth, better from pressure—chewing does not make it any worse; it comes on mostly toward evening, rarely before—and is accompanied by chilliness and pale face, or with congestion of blood to the head; or with heat without thirst; especially for toothache caused by drinking chamomile tea. Ignatia will be serviceable in cases where the foregoing reme- dies appear to be indicated, but are insufficient, and the patient is of a more tender and sensitive disposition, sometimes cheerful, at other times inclined to tears; particularly for persons who grieve much; when the jaw-teeth feel as if crushed; when there is a boring pain in the incisors, and a soreness in all the teeth; worse after drinking coffee, smoking, after dinner, in the even- ing, after lying down, and in the morning on awaking. Hyoscyamus in very sensitive, nervous, excitable persons; the pain almost drives the patient mad—it is a tearing or throbbing, extending to the cheeks and along the lower jaw; or there is a tearing, raging pain in the gums, with a buzzing sensation in the tooth, which is loose, and feels when chewing as if it were coming out; or jerking, throbbing, drawing, tearing, which ex- tends to the forehead; violent tearing pains in different teeth, occasionally accompanied by flushes of heat, with determination of blood to the head; it is aggravated by cold air, generally comes on in the morning, and is sometimes accompanied by jerking in the fingers and arms, especially in persons who are subject to convulsions. Belladonna is frequently best adapted to females or children, particularly when the pain and anguish cause great restlessness, running about, or where there is depression, and a disposition to cry; when the teeth and gums are painfully sensitive; when biting produces a feeling as if there were ulcers at the roots, with stinging, cutting, jerking, tearing pain; and more especially for a drawing pain, which is worse after going to bed, and during AFFECTIONS OF THE TEETH. 249 the night; or for pricking pains in a hollow tooth, day and night; or a pain in a hollow jaw-tooth, as if too much blood were forced into it, with heat in the gums and throbbing in the cheeks—nothing mitigates the pain but picking the tooth until it bleeds; or the gums are swelled, with burning and stinging pains, discharge of much saliva, the cheek swelled, sometimes the eyes hot and the throat dry, with great thirst—frequently the pain returns in the morning on awaking, or re-commences some time after dinner; the teeth ache when exposed to the open air, when touched, from biting, when food or hot liquids come in contact with them—pressing hard upon the cheeka sometimes gives relief. China is particularly suited to toothache in mothers who are nursing—for persons who, otherwise cheerful, become cross and irritable; the pain comes on periodically and is throbbing, tear- ing, jerking or drawing, with great pressure or boring, and numbness about the teeth—worse when in motion, when touched, and returns on exposure to a draught—the gums swell, the mouth is dry, there is thirst, the blood rises to the head, the veins of the forehead and hands swell, and the sleep during the night is uneasy, although the pain is mitigated. Mercurius vivus is frequently suitable for children; when there are tearing pains in several teeth at once adjoining the decayed ones—the pain affects the whole side of the face, or drawing and stinging pains extend to the ear; it is particularly troublesome during the night; or for excruciating jumping pains in the teeth, especially at night, with stitches extending to the ear and the head; also for a stinging pain in a decayed tooth, which is worse after eating or drinking anything cold or warm; the pain is generally increased by cold, and particularly by damp air, is less severe when in a warm place, or when the cheek is rubbed—the air is sometimes painful to the incisors; or the toothache is only felt during the day and ceases during the night, and is followed by perspiration, and in the morning the same pains return again, in paroxysms, with longer or shorter intervals, alternating with giddiness, or tearing in the limbs; 250 CHAPTER VII. the teeth are almost always loosened, the gums swell or become white and ulcerated, are detached from the teeth, burn and ache when touched; or they begin to itch, to bleed and to suppurate, with tearing through the roots of the teeth, of with painful swelling of the cheeks. Hepar will be beneficial after Mercurius vivus or Belladonna, when the painful swelling of the gums continue, or for a throbbing pain as if blood were entering the tooth, or a drawing pain; the pains worse after eating, and in a warm room, or at night. Carbo vegetabilis is sometimes useful when Mercurius vivus or Arsenicum gives some relief, without effecting a perfect cure; also in persons who have taken much calomel, particularly when the gums bleed, and are detached from the teeth; the teeth are loosened, become ulcerated, and ache when touched by the tongue; are worse after eating, with drawing and tearing pains in the incisors. Sulphur is most suitable for jumping pain in hollow teeth— extending to the upper and lower jaw, or to the ear; for swelling of the gums, attended with throbbing pain, bleeding of the gums, and swellings around old stumps; for toothache in the evening, or in the air, from draught, worse when rinsing the mouth with cold water. Arsenicum, when the teeth are loose and elongated, with con- stant jerking or burning, and tearing in the gum, worse when touched, when lying on the affected side, and when at rest, and also from cold; the pains are mitigated by the heat of the stove, by hot applications, or by sitting up in bed; it is particularly indicated when the pains are very debilitating. Antimonium crudum is the principal remedy for pains in carious teeth, of a boring, digging, tearing, jerking character which sometimes penetrate into the head; the pains are aggra- vated in the evening in bed, after eating, by cold water; and better when walking in the open air. Bryonia, for passionate, irritable, cross, obstinate people; the pain occasionally in the carious teeth, but more frequently in the healthy ones; shooting pain with twitches towards the ear; AFFECTIONS OF THE TEETH. 251 tearing pain extending to the cheek, and acute pains, as if caused by an exposed nerve; sensitiveness and pain in the decayed teeth from contact with the air; the teeth feel as if too long and too loose, but are not so, and when chewing they feel as if they would fall out. The pains are aggravated by smoking or chewing tobacco; from the introduction of anything warm into the mouth—better in the open air—sometimes relieved by cold water, but only momentarily, and also when lying on the affected cheek, but worse when lying on the other. Likewise, when the pain shoots from one tooth into the other, and also into the head and cheeks. Rhus tox., for the same painful sensation of elongation of the teeth as Bryonia, and also when they seem to be loose; the hollow teeth sensible to the air; the gums are swollen, burn, and itch like an ulcer, or they are sore and detached from the teeth; for jumping, shooting, or drawing pain, as if the teeth were being torn out, (similar to Pulsatilla), or for slow pricking or throbbing, tearing in all the teeth, extending into the jaws and temporal bones, with a painful soreness of one side of the face—it arises from taking cold, or from vexation, is worse in the air, (Bryonia, toothache is better,) insufferable during the night, and mitigated by heat; sometimes accompanied by an offensive smell from the carious teeth. It suits best for quiet per- sons (unlike Bryonia) who are disposed to sadness and melan- choly, or become agitated and afraid, (similar to Belladonna). Staphysagria, when the teeth become black and hollow, loose the enamel, the gums are pale, white, ulcerated and swollen— ache when touched; throbbing in the gums; the gums are covered with blisters and ulcers; also for intense gnawing, drawing or tearing pains in decayed teeth, particularly in the roots, or extending through a whole row, or the pain shoots from a carious tooth to the ear, with throbbing in the temple—worse in the open air, when drinking anything cold, from eating, and particularly during the night or toward morning. Phosphoric acid is suitable for bleeding and swollen gums; tearing pains which are worse when warm in bed, and also from 252 CHAPTER VII. heat and from cold, burning in the front teeth during the night; pains from carious teeth, extending to the head. Silicea, for tedious, boring, tearing pains day and night, worse during the night, spreading over the whole che.ek, also into the bones of the face; discharge of offensive matter from openings near the roots of the teeth, or from the gums; swelling of the jaw. Dulcamara is sometimes useful for toothache proceeding from cold, particularly when accompanied by diarrhoea, and when Chamomilla does not answer; also when there is at the same time confusion of the head, or when the toothache is accompanied by profuse salivation (similar in this to Belladonna and Mercu- rius vivus,) and the teeth feel blunt. Calcarea, for toothache in pregnant females; pains in hollow teeth, especially around loose stumps; pressing, drawing, jerk- ing, soreness; drawing, pricking, rooting, gnawing, grubbing, throbbing pains, with swelled gums, which are sore, bleed easily, with throbbing and acute pains; it is most suitable when there is determination of blood toward the head, particularly during the night; when the pains are caused by taking cold, or are aggravated by cold or a draught of air; the patient can neither bear warm nor cold drinks—even noise makes it worse. Causticum, for toothache arising from breathing in the open air, generally attended with stinging, throbbing pain and a feel- ing of soreness; or the teeth feel painfully loose and lengthened; when there are ulcers at the roots of the teeth, the gums sup- purating are swollen and very tender. The pain frequently affects the whole of the left side of the face, especially at night when the patient lies on it, and is equally sensitive to heat and cold. When the cheek remains swollen after the toothache has ceased, it may be removed by giving Pulsatilla, if Mercurius vivus or Chamomilla have been previously taken for the pain; or Mer- curius vivus, after Pulsatilla or Belladonna; or Belladonna after Mercurius vivus; or Sulphur after Belladonna, Bryonia, Arsenicum, &c. If the swelling be red as in erysipelas, Mercu- rius vivus should be given; if less red but hard and stiff, Ar- AFFECTIONS OF THE TEETH. 253 nica. Hepar, when the swelling begins to soften, and appears as if about to suppurate, followed by a dose or two of Lachesis if the Hepar does not effect a speedy abatement of the swelling, and then by Hepar again or by Mercurius vivus, if the latter have not been taken before. Benefit will also be derived by putting figs into the mouth which have been boiled in milk. Externally, apply nothing but a handkerchief to keep off the air, except when there is much tension, and the swelling is not extensive; in this case, make a linen compress about the size of a dollar, dip it into warm water, and after squeezing it, apply it to the swelling, and tie a dry handkerchief over it; if the swelling spreads extensingly, or if it becomes yellowish or red, and blistered, a small flat bag of rye flour, moderately heated and applied to the cheek, may be of advantage. If it itches much, hair-powder or wheat starch will be beneficial; if it break exter- nally, apply a rag greased with good fresh tallow, and tie a hand- kerchief over it. Facial Neuralgia. Tic Douloureux. Prosopalgia. This is one of the most painful of the whole catalogue of diseases to which man is subject. It consists of an acute lancinat- ing pain, seated in one or more of the branches of the fifth pair of nerves,—nerves of sensation—which are distributed to the face, head, &c. The pain is sometimes preceded by a slight sensation of itching or heat, or creeping or numbness in the part, which gradually increases in intensity. At other times the attack is preceded by a feeling of coldness and numbness. Usually, how- ever, the pain comes on suddenly without giving any warning whatever. It is generally extremely acute and lancinating in its character, giving rise to the most excruciating agony on the part of the sufferer, taking place instantaneously, and shooting along the course of the nerves like an electric shock. When the pain is at its height, it seems as if burning needles are thrust into the part. It most commonly begins under the eye or in front of the ear, from whence it sometimes shoots over the entire half of the face and head, and frequently into the orbit. When the disease 254 CHAPTER VII. has continued for a length of time, or has been extremely severe, it is often attended by involuntary twitches of the muscles of the face. The paroxysms may continue with more or less intensity for weeks or months in' succession. Neuralgia is often exceedingly difficult to cure, and in some cases quite incurable. Treatment. The remedies which have been employed most successfully are: Aconite, Belladonna, Lachesis, Mercurius vivus, Arnica, Staphysagria, Bryonia, China, Calcarea, Ar- senicum, Colocynthis, Rhus tox., Veratrum, Ferrum met., Pla- tinum, Pulsatilla, Hepar, &c. Aconite will have the preference, if there be redness and heat of the face; the paroxysms preceded by a slight itching or crawling pain; great exasperation with agitation, restlessness, &c.; and especially when the neuralgia is alternated with rheum- atic pains. Belladonna, when the pain is most violent under the eye, and is excited by rubbing the part affected; darting pains in the cheekbones, nose, jaws, or zygomatic process; or cutting and tensive pains, with stiffness at the nape of the neck, and clench- ing of the jaws; twitches in the eyelid, or violent shooting and tearing and dragging pains in the ball of the eye; convulsive jerking in the facial muscles, and distortion of the mouth; heat and redness in the face. The pain is generally preceded by itch- ing and creeping in the affected side of the face, and at times becomes so severe as to be almost insupportable. Platinum, when the attacks are preceded by a feeling of cold- ness and torpor in the affected side of the face, with severe spasmodic pain, or tensive pressure in the cheek, with a sensa- tion of creeping or crawling, and aggravation or renewal of the sufferings in the evening, and when in a state of rest; lachry- mation; redness of the face, &c. Colocynthis, against violent rending and darting pains, which chiefly occupy the left side of the face, are aggravated by the slightest touch and extend to the head, temples, nose, ears, teeth, &c. AFFECTIONS OF THE TEETH. 255 Arsenicum, when the attacks return periodically and the pains are more especially of a burning, pricking, and rending charac- ter, and are experienced chiefly around the eye, and occasionally in the temples, the suffering being occasionally of so severe a description as almost to drive the patient distracted; great anguish; excessive prostration, with desire for the recumbent posture; sensation of coldness in the affected parts; exacerbation during repose, after fatigue, in the evening, when in bed, or after a meal; temporary melioration from external heat. China, also, against periodical attacks of neuralgia, and, when the pains are intense, attended with extreme sensibility of the skin, and consequent aggravation from the slightest touch; sensation of torpor and paralytic weakness in the affected part; great loquacity, with ill-humour, paleness of the face, frequently followed or alternated with redness and transient heat of the face. Mezereum, chiefly against pains which occupy the left side of the face, and are mostly of a spasmodic stupefying description, and extend to the eye, temple, ear, teeth, neck, and shoulder; worse from partaking of warm food or drink, or on coming into a warm room after being in the open air. Veratrum, against insupportable pricking and drawing one- sided pains which almost drive the patient to distraction; ex- cessive weakness even to fainting; general chilliness; exacerba- tion of suffering on getting warm in bed, or towards morning; temporary relief on moving about. Spigelia is a valuable remedy in protracted and periodical attacks of neuralgia; the pains of a burning and tensive char- acter, and located chiefly in the cheek bones and above the eye- brow. For the particular symptoms which indicate the selection of Arnica, Staphysagria, Lachesis, Hepar, Ferrum met., Rhus tox., Pulsatilla, and other remedies which may occasionally be of service, consult " Toothache". Applications of cold water or ice to the part affected in some instances mitigates the sufferings, and in others again more relief is experienced by the application of cloths dipped in warm water. CHAPTER VIII. AFFECTIONS OF THE MOUTH. Bad Taste in the Mouth. Sometimes the taste is affected, without there being any other perceptible symptoms ; in which case we must try the remedies first mentioned below for the different kinds of taste; sometimes the other symptoms, when any exist, are not sufficiently marked to guide us in the selection of a remedy; in that case the selec- tion should be made according to the following table : Bitter taste in the morning, Sulphur, Mercurius vivus, Bryo- nia, Calcarea, Silicea. When solid food tastes bitter, Sulphur, Bryonia, Rheum, Rhus tox., Hepar, Colocynthis, Ferrum metall.; food and drink both bitter, Pulsatilla, China ; bitter taste after eating or drink- ing, Pulsatilla, Bryonia, Arsenicum; in the morning or even- ing, Pulsatilla, Arnica; at different times, or continually, be- sides the above medicines, Aconite, Belladonna, Veratrum, Nux vomica, Chamomilla, Antimonium crudum, Carbo vegetabilis. For sweet taste, Mercurius vivus, Sulphur, Cuprum, Bella- donna, Pulsatilla, Bryonia, China, Ferrum, Spongia; in the morning, Sulphur; when bread leaves a sweet taste, Mercurius vivus; beer, Pulsatilla ; bloodlike, sweetish taste, Ferrum, Sul- phur; when like walnuts, Coffea. For salt taste, Carbo vegetabilis, Rheum, Plwsphoric acid, Nux vomica, Sulphur, Arsenicum, Natrum muriatic, Cuprum; when victuals taste salt, Carbo vegetabilis, Sulphur; salt taste when coughing, Carbo vegetabilis, Cocculus. For sour taste, Rheum, Phosphoric acid, Nux vomica, China, Sulphur, Capsicum, Calcarea, Natrum muriaticum, Cocculus, AFFECTIONS OF THE MOUTH. 257 Cuprum ; the victuals taste sour, China, Calcarea ; after meals, Pulsatilla, Nux vomica, Carbo vegetabilis, Natrum muriatic, Cocculus, Silicea; after drinking water, Nux vomica, Sulphur; after drinking milk, Carbo vegetabilis, Sulphur; in the morn- ing, Nux vomica, Sulphur. Acrid, biting taste, Veratrum, Rhus tox.; burnt, smoky taste, Pulsatilla, Nux vomica, Sulphur; taste like herbs, Veratrum, Nux vomica; taste like peppermint, Veratrum. Earthy taste, Pulsatilla, Hepar, China ; insipid taste, Pulsa- tilla, Rheum, Staphysagria, Bryonia, China, Sulphur, Dulca- mara, Rhus tox., Ipecacuanha, Capsicum; slimy taste, Bella- donna, Rheum, Arnica, Rhus tox., Platina; greasy, oily taste, Silicea, Causticum; smeary taste, Causticum; sticky, Phos- phoric acid; watery taste, Staphysagria, China, Capsicum. Putrid taste, Arnica, Mercurius vivus, Belladonna, Bryonia, Chamomilla, Pulsatilla, Aconite, Veratrum, Phosphoric acid, Sulphur, Rhus tox., Natrum muriatic, Cuprum, Causticum; in the morning, Sulphur, Rhus tox.; after meals, Rhus tox.; taste like pus, Pulsatilla. When tobacco has a sharp taste, Staphysagria ; when bitter, Cocculus ; loathsome, Ipecacuanha ; disagreeable, Ignatia, Pul- satilla, Nux vomica, Arnica, Calcarea, Cocculus. When the victuals have no flavor, Mercurius vivus, Pulsa- tilla, Staphysagria, Bryonia, Nux vomica, Arsenicum ; absence of taste, Veratrum, Belladonna, Pulsatilla, Rheum, Bryonia, Hepar, Hyoscyamus; in chronic cases, Silicea, Natrum mu- riaticum. Offensive Breath. Bad breath may be caused by derangement of the stomach, abuse of mercury, decayed teeth, disease of the gums, aphtha, or want of proper attention to cleanliness, leaving particles of food in the teeth, &c. Treatment. This unpleasant symptom, when arising from uh- cleanliness, will generally be removed by rinsing the mouth and throat after every meal with cold water and brushing the teeth with a soft brush once or twice a day. 33 258 CHAPTER VIII. If a decayed tooth originate the difficulty, a dentist should be consulted; or, if this cannot be conveniently done, the tooth should be carefully cleansed and filled with wax. The tooth can be readily cleaned by making use of a roll of blotting paper of convenient size, and applying it repeatedly to the decayed part. If there is any difficulty in getting the wax to stay in the cavity, a plug cut out of a gall nut may be employed; to fit the plug accurately an impression may be taken by biting on a ball of wax, and then cutting the plug to fit this impression exactly. The shell of the nut should form the outside of the plug. This will sometimes remove both offensive smell and pain from a carious tooth. Benefit is often derived from rinsing the mouth with water containing charcoal. The smell of garlic or horseradish will be destroyed by drink- ing some wine or by eating a pear or some boiled beets. When the offensive breath arises from deranged stomach, or diseased gums, or aphthae, the proper remedy for it will be found under these diseases. But when it is the chief symptom, and its origin can be traced to no apparent cause, the following remedies will frequently remove it: Nux vomica, Silicea, Pulsatilla, Sulphur, Chamomilla, Mercurius vivus, Bryonia, Hyoscyamus and Arsenicum. If the bad breath is only perceived in the morning, Nux vo- mica or Silicea will be found most effectual in affording relief. When it occurs only in the morning and at night, or is worst at these times, Pulsatilla will be of most benefit. If it appears after dinner only, Sulphur or Chamomilla. Scurvy in the Mouth. Canker of the Mouth. Cancrum Oris. In this affection the gums become hot, red, and very sensi- tive ; they swell, become spongy, and shrink from the teeth; small ulcers make their appearance on the gums, the inside of the lips, the cheeks, on the palate and even on the tongue; a putrid, very offensive smell is emitted from the mouth, there is AFFECTIONS OF THE MOUTH. 259 a discharge of tough, bloody phlegm and saliva from the gums; the teeth are usually loosened, and mastication and deglutition consequently difficult; sometimes the glands of the throat swell and become painful; the patient becomes very weak, and suffers from a slow fever. Treatment.—-Mercurius vivus, in almost every case of scurvy, is the most efficacious remedy, and may always be given at the commencement of the disease unless it has been brought on by the abuse of this medicine given in allopathic doses; in which case it wil be necessary to have recourse to Carbo vegetabilis as antidote, to be followed, if necessary, by Hepar s. or Acidum nitricum. If the disorder has arisen from excessive use of salt food, Carbo vegetabilis or Arsenicum will be of most service, and if these fail to produce a favourable change, a drop of sweet spirits of nitre may be taken once or twice a day with benefit; and in protracted cases of this kind, Sepia will be found useful. Capsicum may be indicated as the first remedy when the affection occurs in inert and corpulent persons, and arises from uncleanliness or want of exercise in the open air. Arsenicum may be given as a first remedy if the ulceration is very extensive with violent burning pains, and in alternation with China if gangrene is threatened, the gums becoming black, &c; the patient is very much reduced; or when Mercurius vivus has proved inefficacious. Dulcamara may be given first, when the disorder results from taking cold, and the glands of the throat are swollen and hard; also after Mercurius vivus when that remedy fails to effect a perfect cure. Carbo vegetabilis besides being preferable in all those cases arising from the abuse of mercury or salt, is particularly bene- ficial when the gums bleed very much, and smell very offensively. Natrum muriat. is most suitable when the ulcers spread very slowly, the above remedies having been productive of but little benefit; the gums swollen, bleeding and very sensitive; every thing cold or warm, or eating and drinking, affects them; when 260 CHAPTER VIII. blisters and small ulcers appear on the tongue, which bite and burn, and render talking painful. Among the many domestic remedies in vogue for this com- plaint, the one which is most to be recommended, is rubbing the gums with slices of lemon, or rinsing the mouth with lemon juice; this is productive, in the beginning of the disease, espe- cially in summer and at sea, of a very salutary effect. Sage, also, is almost a specific in many kinds of this disease; rinsing the mouth with brandy is sometimes of service. Inflammation of the Tongue. Glossitis. This affection is characterized by pain, heat, redness and swell- ing ; attempts to move it cause excessive pain. The inflamma- tion at first may be confined to a small part of the tongue, but it gradually extends, the pain becomes acute, lancinating and burning; and the slightest effort at motion of any kind, swal- lowing, speaking, &c, excite excruciating anguish. The swelling of the tongue is so great at times as to threaten suffocation, and hangs out of the mouth. It is frequently coated with a thick fur, and saliva flows copiously from the mouth. Sometimes a tumour is found on the upper surface of the tongue, which is at first hard and slightly painful to the touch; this suppurates and leaves a deep ulcer. At others small ulcers are formed on the surface which may perforate it. The causes are irritating substances taken into the mouth; injuries inflicted by the teeth, or by external bodies. It occurs in the course of small-pox, scarlet fever, &c. And some of the most violent cases result from the abuse of mercury. Treatment.—Aconite, Mercurius vivus, Belladonna, Arnica, Arsenicum, Lachesis and Phosphoric acid are the chief remedies. Aconite, in the commencement of the affection, if accompanied by intense inflammation with fever, acute, lancinating pains, &c. A few doses may be taken at intervals of three or four hours. Mercurius vivus, after Aconite has reduced the more violent febrile symptoms; or at first when there is violent pain, swelling, AFFECTIONS OF THE STOMACH. 261 hardness and salivation; also in ulceration of the tongue it is almost specific. Belladonna, when Mercurius does not effect a cure, and the inflammation extends to other parts of the mouth, and becomes erysipelatous in its character; also when numerous small ulcers make their appearance on the tongue, gums, &c. It may be taken in alternation with Mercurius vivus for induration of the tongue. Arnica and Aconite, taken alternately every 5 to 6 hours, will be most efficacious in inflammations caused by wounds of the teeth or external bodies. Arsenicum and Lachesis in highly dangerous cases, with threatened gangrene, indicated by dark and greenish or black appearance of the tongue, &c. Phosphoric acid, in inflammation produced by biting the tongue during sleep. In some instances when the swelling has become so enormous as to threaten suffocation before a homoeopathic physician has been called, it may be necessary to make free longitudinal in- cisions in the tongue, in order to save life. CHAPTER IX. AFFECTIONS OF THE STOMACH, Want of Appetite. The common remedies for exciting the appetite are, to speak plainly, more calculated to impair it altogether. Articles highly salted, sour or sharp; burning, heating spices, but, in particular, roots, herbs or barks steeped in liquor, and taken as stomachics, are all artificial and cannot furnish nourishment. They are all beneficial medicines when used at the proper time, in the right case, and in appropriate quantities; and every one knows from 262 CHAPTER IX. his own experience, or has witnessed it in others, that they sometimes produce a salutary effect. But as all medicines are injurious when taken in too great quantities, or too frequently, the trying of many of these things must, of course, do more harm than good, and particularly when the patient accustoms himself to their use. Of what benefit is it to awaken the appe- tite for a day or two, if it fails again immediately. As it is the case with all food that it is partly retained in the body and partly thrown off, so it is with these substances also, which, con- taining no nutriment, cannot supply any to the human economy. By degrees, these extraneous substances so accumulate in the system, that they cause incurable diseases; not in the intestines, whence they might be expelled by aperients; not in the blood, whence they might be extracted by bleeding. No, these are popular errors; every physician, who knows anything of phy- siology, is aware that nothing can remain in the intestines any more than in the blood, the latter changing every day; but it is the solid parts of the body which undergo a change. Persons who use these things now and then, in small quanti- ties, cannot do themselves great harm. Sometimes salt fish or acids, particularly in summer, have a good effect, especially when the stomach craves these things, and when this craving ceases for some time after having been satisfied once; but if the same craving returns very soon, it is a sign that their use is injurious. The best remedy is the regular use of cold water. In the morning, particularly fasting, an hour or two before, and a couple of hours after each meal, and in the evening before going to bed, drink regularly a glass of water. At dinner drink mode- rately, and after a heavy meal but small quantities at a time. Weakness of the Stomach. Dyspepsia. Indigestion. The most essential information respecting this complaint, when it is felt very soon after eating, has been given under Chapter IV., Part I. When arising from other causes, see Chapters I., II. and V., Part I. There are, however, many cases where different causes exercise an influence at the same time; or where the causes are AFFECTIONS OF THE STOMACH. 263 not known, or some are of a temporary nature, while others are lasting, the latter generally passing under the name of dyspepsia: some cases of this kind are the commencement of violent and dangerous diseases. We will here mention several kinds which every one can cure himself; but there are others, especially the so called dyspeptic, which need the aid of a homoeopathic phy- sician. The most important condition is a rational mode of living, not adopted for a time merely, but permanently; the food must be wholesome, nutritive, of sufficient quantity, and also varied, to suit the requisitions of the stomach. For all sudden cases of weak stomach, and which are usually attended with want of appetite, nausea, pains, particularly grip- ing, disturbed sleep, weakness, select from among the first me- dicines here prescribed, in chronic cases among those found farther on. Arnica, when the disorder is caused by a blow upon the stom- ach, or by lifting, with pain and cracking in the small of the back; by want of rest, much mental application, and generally when arising from over-excitement and irritability, when the patient is very nervous, the tongue dry, or coated yellowish; the taste putrid or bitter and sour, with a bad smell from the mouth; the patient even, if accustomed to smoking, loathes tobacco; a craving for something acid, eructations sometimes with a taste as of bad eggs; after meals a sense of fullness in the pit of the stomach, inclination to vomit, retching, flatulence in the abdomen; the abdomen is distended; accompanied by a heaviness in all the limbs, weakness in the legs, giddiness, full- ness in the head, particularly over the sockets of the eyes, dull feeling and heat in the head, disagreeable warmth, frequent! awak- ing, starting when asleep, troubled dreams. If Arnica does not suffice in these cases, give Nux vomica or Chamomilla. Nux vomica, if the complaint has been caused by dissipation and late hours, by drinking wine or coffee, particularly if the patient has taken cold besides; when the mouth is dry without thirst, the tongue coated and white; accumulation of phlegm in 264 CHAPTER IX. the mouth, and heart-burn, no taste, or all kinds of food taste insipid, water collects in the mouth, vomiting, pressure on the stomach, the abdomen is distended, slight and hard evacuations, or constipation; reeling, giddiness or dulness in the head, heaviness in the back part of the head, ringing in the ears, drawing in the jaw teeth, sometimes below and sometimes above, drawing in the limbs; want of energy and aversion to thinking; the patient is restless, quarrelsome, sullen; at times there is heat in the face; red pimples on the face. If Nux vomica does not cure it, give Chamomilla. Chamomilla, when the patient has eaten or drunk soon after mental irritation, and in consequence has a bitter taste in his mouth, eructation as from bile, vomiting of green phlegm or light bile; tossing about during sleep, frequent awaking, pain and fullness in the head, the face red and hot, the eyes red and burning, the mind very sensitive. If Chamomilla does not prove efficacious, give Pulsatilla, and if this also fails, Nux vomica. Pulsatilla, when different kinds of meat or drinks, which do not agree with each other, have been taken at the same time, particularly such as produce flatulency; or when much fat has been eaten, especially of pork and mutton or sausages, anything fried in rancid butter, or pies baked in mixed fat; when the taste is bitter, salty, or resembles that of putrid meat or tallow; bread and all other kinds of food produces a bitter taste; distaste to tobacco; and also when there is accumulation of phlegm in the mouth, a grating in the throat, eructation as from bile, or acidity and acrid bile in the stomach, a particular aversion to warm food, the abdomen is distended, tight, particularly under the ribs, rolling and rumbling in the abdomen; slow, trouble- some, small evacuations or diarrhoea; drawing in the limbs, as from fever and ague; the patient feels chilly, weak, is cross, silent, annoyed at every trifle, with little inclination to speak. China is often most suitable when the air is infected with noxious vapors, in spring and autumn, when wet days are suc- ceeded by dry weather; in countries where there are many canals, particularly if recently made, or where there is much drained AFFECTIONS OF THE STOMACH. 265 land, or many fogs; also for persons who are obliged to work where they breathe noxious odors, and have not a sufficient supply of fresh air; it frequently cures the forerunners of fever and ague, and sometimes prevents the fever altogether. There is a constant feeling of having eaten to satiety, indifference to food and drink; after eating, the victuals remain a long time in the stomach; constant eructations, the undigested food is fre- quently thrown off; morbid craving for something strong, sharp or sour; weakness in the body, and a disposition to lie down, without being able to remain quiet; the patient is obliged to bend and stretch his limbs, which are quite stiff in the morning; frequent flushes of heat; chilliness after every breath of air; the urine is dark coloured and deposits a copious sediment; after lying down the patient finds it difficult to go to sleep, and is constantly disturbed; the disposition is melancholy and morose. Antimonium crudum, when the patient feels sick at the stom- ach, the tongue is coated or blistered; frequent eructations which taste of the food last taken; the mouth feels dry, or the saliva flows from it, there is much thirst, particularly during the night; accumulation of phlegm in the throat, or vomiting of phlegm and bile, the stomach feels too full, or is sore when touched; there is besides flatulency and griping, or constipation and diarrhoea. If Antimonium crudum docs not soon produce a favor- able change, give Bryonia. Bryonia, when the stomach is disordered, and the patient feels cold and chilly; the bowels constipated, the tongue coated white or yellow, or blistered as under Antimonium crudum. Thirst, but both night and day; dryness in the throat and the stomach. It is most suitable in summer, or when the weather is warm and damp, and may be repeated in from six to twelve hours, if necessary, and after this, if the patient does not im- prove, give Antimonium crudum. Ipecacuanha, when the stomach is surcharged with phlegm, or is otherwise debilitated; when the tongue is not coated, al- though the patient is sick at the stomach, and vomits; it is par- ticularly indicated when there is loathing of food, of tobacco; 34 266 CHAPTER IX. for easy or violent vomiting, principally when accompanied by diarrhoea; also when the complaint returns every day, or every other day, at the same hour. Hepar, when the stomach is easily disordered, notwithstanding a regular mode of living is followed, or when this occurs despite the utmost care, and frequently, with craving for acids, strong, acrid articles or for wine; when accompanied by nausea, sick- ness of the stomach, and eructations, principally in the morn- ing; at times sour and bilious vomiting and throwing up of phlegm; accumulation of phlegm in the throat, pain in the bowels, and hard, dry stools. It will be particularly useful for weak stomach produced by taking blue pills or other pre- parations of mercury. Lachesis, in cases where Hepar has been insufficient, and when the complaint is worse immediately after meals, or early in the morning; when several days pass without any evacuation. The most tedious cases of dyspepsia may sometimes be cured by Hepar or Sulphur, if these medicines are not given too often. When the administration of one of them is followed by improve- ment, the patient should wait patiently until the symptoms are decidedly worse again, before repeating the remedy. After the good effects of one appears to be worn out, it should be discon- tinued, and the other used in its stead. If both fail to effect a cure after having been continued for a considerable time, a few doses of Belladonna or Mercurius vivus will be of service, and afterwards Sulphur may act more favourably. Mucous state of the Stomach. This malady is characterized by debility of the stomach, at- tended with accumulation ofphlegm in the mouth and throat, or with the throwing up of phlegm. In other respects the symp- toms resemble those of "Disordered Stomach", with the excep- tion that the taste is more insipid or sweetish. Before dinner the patients are usually very weak and miserable, and after din- ner they feel full and uneasy. AFFECTIONS OF THE STOMACH. 267 In the treatment of this complaint, two or three doses of Ipe- cacuanha should be first given, and then one of the following remedies. Rheum, if in addition to the above symptoms there be diar- rhoea of a thin, brown, slimy character, which smells sour or musty. Veratrum, when the symptoms are violent and accompanied by vomiting of bile, or bilious diarrhoea, &c. Capsicum, if accompanied by burning in the throat or stom- ach, or in the anus during the evacuations. Persons afflicted with this affection should take cold water free- ly, 10 to 12 glasses every day, and gargle the throat each time. Pyrosis. Heartburn. Waterbrash. Heartburn consists of a burning or gnawing uneasiness felt principally in the pit of the stomach, and usually followed after a time by sour, or acrid eructations or risings. In some instances it spreads over the whole region of the stomach, and is attended with anxiety, nausea, coldness of the extremities, debility and tendency to faintness. It is frequently connected with dyspepsia and other affections of the stomach, and may be cured by the remedies recommended for these complaints. Generally Nux vomica, Pulsatilla, Chamomilla, China, Cap- sicum, Carbo vegetabilis, Staphysagria and Belladonna will be most efficient. When caused by smoking, Staphysagria; when it occurs chiefly after meals, China; if attended by much thirst, Bella- donna. For the particular indications, however, see " Dys- pepsia", "Spasms of the Stomach" and "Flatulency". When these remedies are ineffectual in pregnant females, a slice of lemon sugared and kept in the mouth is salutary. Some- times drinking sugar-water every morning, and freely of cold water at all times will remove it, although it may make it worse in the beginning. Water crackers also give relief. Care should be taken not to use any lye or wood-ashes, as these often produce 268 CHAPTER IX. dangerous maladies; also avoid chalk, magnesia, prepared oyster shells, &c, which often remain in hard lumps in the stomach, particularly when aperient medicines are taken afterward. Nausea and Vomiting. In this complaint the possible causes ought to be taken into consideration, and the remedies be selected accordingly. Very frequently these symptoms disappear of themselves after vomit- ing, therefore it may be promoted by giving tepid water, tick- ling the throat with a feather, or by giving coffee without milk. No emetics should be taken; they always weaken the stomach. It is much better to give, when the tongue is much coated, white or yellow, Antimonium crudum, or, when the tongue is clean, Ipecacuanha. Sometimes nausea and vomiting are caused by fright, by grief, vexation, by taking cold, by overheating, by sitting up at night, by overloading the stomach, by drinking in- toxicating liquors or chamomile tea, by smoking, or by using rhubarb and other medicines. Having ascertained the causes, look under their respective heads. When nausea and vomiting are caused by a fall which injures the head, Arnica will remove it; when by some foreign body in the throat, see under this head. When connected with giddiness or headache, see Chapt. I, Part II. ("Headache"); when the medicines recommended in such cases do not give relief, give Lachesis once or twice, and afterward Belladonna. For vomiting with cough Ipecacuanha, Mercurius vivus, Capsicum, Pulsatilla, Bryonia, China, Dro- sera, Phosphoric acid, Sulphur, Calcarea, or Lachesis, will generally be indicated. The particular symptoms for the choice of each will be found under " Cough " or. " Hooping Cough ". When caused by riding, give Cocculus once or twice a day. Vomiting from weakness of the stomach, occurring after every meal, is often cured by Pulsatilla or Nux vomica, given alter- nately with Bryonia. Pulsatilla will be beneficial, when the stomach is so weak that only very little food can be taken at a time, and the least surfeit causes vomiting with spasms and AFFECTIONS OF THE STOMACH. 269 cutting pain in the bowels, or giddiness and vomiting of white, tough mucus, diarrhoea, weakness of the limbs, sometimes to fainting. Cocculus, for the same symptoms as the above, when that is insufficient, followed if necessary by Nux vomica and Bryonia. China and Ferrum met., taken alternately, may be in some cases necessary to complete the cure. Sulphur, followed by Arsenicum or Hyoscyamus, may be re- quired in some violent cases which the foregoing remedies have failed to relieve. Calcarea will be serviceable in protracted, tedious cases, espe- cially after Sulphur. Vomiting in children, caused by worms, will most generally be relieved by China, Mercurius vivus, Ferrum met. and Sul- phur ; see also " Complaints caused by Worms". Sea-Sickness. For sea-sickness, Cocculus is the principal remedy; it must, however, be taken in repeated doses. Owing to the differences in men they are differently affected by the motion of the sea, some becoming easily accustomed to it, others, with greater dif- ficulty, and others again, not at all. Hence the remedies must be adapted to the constitutional peculiarities from which the sickness arises. Some persons are benefitted by drinking brandy and water, and others by eating raw ham highly peppered. In most cases benefit will be derived by taking as much exercise as possible, forcing oneself to eat, and placing blotting paper soaked in rum, brandy or whiskey, on the pit of the stomach. For uncomfort- able sensations produced by the peculiar smell of the vessel, or by the odor of the food, take Colchicum ; those who are affected by noises will be relieved by Theridion, especially when suffer- ing from a violent headache; where there is a craving for acids or something piquant, Sepia will be beneficial, taken once or twice; in cases of great debility, Petroleum. In constipation, at- tended with a putrid taste and bloody gums, take Staphysagria. 270 CHAPTER IX. G-astralgia. Spasms in the Stomach. It is well known that in this complaint the old system of medicine is entirely at fault; homoeopathy, on the contrary, can do much. When of long standing and of the worst kind, it is frequently cured in a short time, even in old people ; but at all events, by a regular and continued course of treatment. Among the domestic remedies many are very injurious; opium and morphine pills are in no disease more dangerous and injurious than in this. The following remedies may be tried, and will sometimes alleviate the complaint; from time to time a tablespoonful of milk, and rubbing the region of the stomach with olive or lin- seed oil. Some persons find relief after taking thin chicken soup, some from the application to the region of the stomach of a sheet of blotting paper steeped in rum. The same persons, however, will find greater relief from taking Nux vomica, if they will only refrain from the use of ardent spirits and coffee, and even avoid smelling them. A few handfuls of common roasted oats may be placed warm upon the stomach in a small bag—the oats must not be quite as brown as coffee. This is very useful when the patient has before taken opium or laudanum, which has, as usual, aggravated the complaint. Nux vomica is particularly adapted to spasms occurring in coffee or brandy drinkers—when the pain in the stomach is con- tracting, or pressing, the clothes seem too tight, or there seems to be a collection of wind on the left side under the ribs, worse after eating, after rising early, sometimes disturbing the patient in his sleep. These pains are sometimes accompanied by oppres- sion of the chest, as if a band were drawn around it; sometimes it extends between the shoulders and to the small of the back. The pains are frequently attended by nausea or accumulation of water in the mouth; or sour, bitter, burning water rises in the throat; vomiting of food; sour, putrid taste in the mouth; fla- tulency ; distention of the abdomen, and constipation. Sometimes it is accompanied by one-sided headache, pressing pain in the forehead, or palpitation of the heart and nervousness. AFFECTIONS OF THE STOMACH. 271 In severe cases a dose—2 or 3 globules—may be taken every three or four hours until relief is obtained, or if after taking three or four doses the patient is not better, another remedy must be selected; generally Chamomilla or Cocculus will be most appropriate. When the disease is less severe, and partakes more of a chronic character, a dose of Nux vomica in the even- ing followed by another next morning will frequently be suf- ficient to effect a cure; if, however, there should be but tempo- rary improvement, and the complaint returns again in a few days, a dose of Pulsatilla, Chamomilla or Ignatia—which ever seems best adapted to the symptoms—must be given. After this the Nux vomica may be repeated again, and if the disease returns notwithstanding, Carbo vegetabilis may be given. H drinking coffee aggravates the complaint, Nux vomica will be the proper remedy; if improved by it, Chamomilla. Chamomilla will also be indicated when there is a pressure on the stomach as from a stone; when the pit of the stomach and the parts immediately under the ribs on the left side seem swelled, as if they would burst, accompanied by shortness of breath. The symptoms are worse during the night; the patient is exceedingly uneasy, tosses about in the bed, and perspires profusely; sometimes he is troubled with a throbbing pain on the top of the head which drives him out of the bed. The pain in the stomach is somewhat alleviated when he draws himself up, and lies perfectly quiet. When the pains are very violent, first give Coffea, and afterwards, if necessary, Chamomilla. If Chamomilla is of but little use, give Belladonna. Spasms in the stomach during menstruation can generally be cured by Nux vomica or by Chamomilla ; but if the discharge is very scant, Pulsatilla or Coccidus is more likely to prove of service. Coccidus is indicated when Nux vomica gives some relief, but the pain returns very soon, and is accompanied by hard evacuations, or entire costiveness; when the pain in the stomach is accompanied by a pressing, contracting pain extending over the abdomen, alleviated by the discharge of wind; when there 272 CHAPTER IX. is some sickness of the stomach, and collection of water in the mouth without heartburn; when the patient is not irritable, angry, nor violent, but rather sullen and taciturn. Belladonna, when Chamomilla proves ineffectual, or gives only partial relief, especially in. females who are delicate and sensitive; when there is a gnawing pressure or a spasmodic tightness of the stomach which obliges the patient to lean back or to keep his breath and which mitigates the pain; also, when the pain always returns after dinner; when it is so violent as to deprive the patient of consciousness, or make him faint. It is mostly accompanied by thirst, and drinking increases the pain; evacuations tardy and trifling; the patient cannot sleep at night. Bryonia, for the same kind of pressure as Chamomilla, par- ticularly when it commences during meals, or immediately after, and the pit and region of the stomach seem to be swollen; some- times the pressure changes to a contracting, pinching or cutting pain, which is relieved by pressing upon the stomach, or by eructations of wind; the pains are aggravated by motion. These symptoms are attended with constipation, and a pressure in the temples, the forehead or back part of the head, as if the bones of the head were being forced asunder, which is better when pressed hard or tied tight with a handkerchief. Pulsatilla, when the pains are of a shooting character; are worse when walking, particularly on making a mis-step, and always accompanied by nausea or vomiting; the evacuations loose; no thirst except during the most violent pains; also when there is great tightness of the stomach, with forcing pain, or violent throbbing with anxiety; griping pain, diminished by eating. The symptoms are usually made worse by eating, especially of rich or fatty substances. This remedy is most suitable for per- sons of a mild, quiet disposition. Ignatia will be serviceable in cases of two or three days standing, in which several remedies have been given; the pains resemble those under Nux vomica or Pulsatilla; pressure after AFFECTIONS OF THE STOMACH. 273 every meal in the upper part of the stomach or lower part of the throat; loose evacuations of the bowels, and nausea or vomit- ing. It is suitable in cases brought on by insufficient food or starvation. China, for spasms of the stomach in debilitated persons brought on by using emetics or cathartics, being bled or cupped frequently, or by profuse loss of blood in any way, or by saliva- tion or loss of fluids by other means. It is of the first importance in spasms occurring in females who are nursing, or who are debilitated by nursing their children too long; or from excessive secretion and involuntary emission of milk. Belladonna will follow it in these cases advantageously. It must, therefore, be given first, when females have spasms in the stomach from nursing, particularly when much milk runs away, (here Belladonna is to be given afterwards), or when they continue nursing too long, that is, more than nine months; in the latter case the child ought to be weaned. Generally, when the digestion is not good, with too great a secretion of mucus, acid- ity and acrid bile in the stomach; when the stomach feels sore; when meat and drink cause pressure and inflation of the stom- ach, and when the pains are worse when the patient is at rest, and better when in motion, China will be the best remedy. Car bo vegetabilis, particularly when Nux vomica has proved useful, but only for a short time; when there is a burning pain, or a constant, painful, agitating pressure, worse when touched; or with a contracting, spasmodic sensation, forcing the patient to bend, taking away the breath, and aggravated by lying down. Frequently accompanied by heart-burn and nausea; loathing at the very thought of food; constipation. Calcarea, in chronic cases, or when Belladonna has been of temporary benefit; for oppressive, cutting, spasmodic, pinching, choking pains, with a feeling of anxiety; frequently attended by vomiting of food; worse after eating and at night; with pain from external pressure; it is particularly suitable for women whose changes are, or have been, very copious; or for those who bleed much from the nose. 35 274 CHAPTER IX. Sepia may advantageously follow Pulsatilla, if the pains are caused by suppressed or difficult menstruation; it is indicated in most of the painful symptoms that take place after a meal, by extreme pressure in the stomach, and by a burning pain in the epigastrium. Staphysagria is useful in some cases, and is particularly ap- plicable when there is acute pressure, tension, and squeezing about the pit of the stomach, which sometimes obstructs the breathing, but which is relieved by bending the body forward. Stannum will be found more appropriate, when the pain partakes of a marked tensive character, and extends to the region of the navel, and there is extreme sensibility in the region of the stomach on external pressure, with shortness of breath, anxiety and nausea. Platina, for spasms of the stomach in females, occurring par- ticularly at the monthly period and especially when the cata- menia at the same time are generally very copious and of too long duration. Vomiting of Blood. Hasmatemesis. This affection may be preceded by all or a part only of the following symptoms; weight, pressure, fulness or tensive pain or spasms in the region of the stomach; griping or colic; burn- ing heat in the epigastrium; feeling of anxiety, especially after eating, or drinking, or on pressure on the stomach; appetite impaired; saltish taste in the mouth; giddiness; cold perspira- tion ; fainting. The blood evacuated is sometimes dark (venous), at others bright red (arterial), and it may be either profuse or in small quantity. It is occasionally mixed with food, mucus, bile, &c. The direct cause of Hsematemesis is the rupture of one or more of the blood vessels of the stomach; the exciting causes are numerous, it may occur from debility produced by disease or by the abuse of drastic purgatives or emetics; by poisoning; swallowing irritating or sharp pointed substances. AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 275 The suppression of an accustomed sanguine discharge is, how- ewer, probably the most frequent cause—as a sudden check of the hsemorrhoidal discharge, and the determination of blood to the stomach; or the suppression of the menstrual flow, which is in females a common cause of the affection. The following are the medicines which will be found useful in the treatment, in the majority of instances; Aconite, China, Pulsatilla, Nux vomica, Ipecacuanha, Arsenicum, Sulphur and Arnica. The disease, however, is generally so serious in its character that it will seldom be treated without the advice of a physician; hence it is unnecessary to point out the particular indications for the choice of each remedy. Benefit may be derived from the application of dry cups to the abdomen and under the ribs as recommended in "Hasmorrhage of the Lungs". CHAPTER x. AFFECTIONS OF THE ALIMENTARY CANAL AND URINARY AND SEXUAL ORGANS. Colic. Enteralgia. Colic, or griping, consists of a shooting, gnawing or tearing pain in the bowels, principally confined to the region of the navel, generally attended by painful distension of the abdomen, and sometimes by costiveness and vomiting or diarrhoea. It is often an accompanying symptom of some other disease. It may be excited by partaking of acid fruits and indigestible substances; cold from changes of weather, wet feet, exposure, &c; also from drinking cold water or other cold beverages when heated; worms, constipation, &c. Treatment. In the treatment, it may be necessary to consult " Colic" in part first, and also " Spasms of the Stomach" in the preceding chapter. 276 CHAPTER X. The chief medicines are : Chamomilla, Nux vomica, Mercu- rius vivus Pulsatilla, Colocynthis, Belladonna, Causticum, Cocculus, China, Ignatia and Sulphur. Chamomilla is suitable for children, also for grown persons, when, besides the symptoms given under the head of " Pain in the Bowels" in "Part first", blue circles appear under the eyes, when there is much saliva in the mouth, tearing pain around the navel, and a feeling in the small of the back as if it were broken; if Chamomilla does not answer, give Pulsatilla. Cha- momilla is also suitable for wind pent up in different parts of the abdomen, with a sensation as if it were going to escape there; stitches in the breast; swelling under the ribs and in the pit of the stomach; great agitation, uneasiness, and clammy per- spiration ; rattling and rumbling in the abdomen; frequent in- clination to stool, with small, slimy, watery evacuations. Nux vomica, when there is constipation or difficult evacua- tions, a sensation as of a weight in the abdomen, with rolling and grumbling, and great heat; the pains are pinching, draw- ing, compressing, as if the intestines were pressed by a stone in different parts; oppression in the pit of the stomach; the ab- domen is painful when touched and tense; the breath short and difficult—a general feeling of distention, the parts under the ribs feel as if stuffed; during the most violent paroxysms of pain, the hands and feet are cold ; sometimes the patient is de- prived of consciousness; pain and flatulency deeply seated in the abdomen; a strong pressure on the bladder and rectum as from a blunt knife; the pain makes the patient double himself up and is worse at every step. Better when at rest, when sit- ting and lying. Generally attended by violent headache and pain in the small of the back. A number of these symptoms are attributed by ignorant persons to some obstruction, which they think must be removed by aperient medicines. Refer also to "Constipation". Mercurius vivus, for violent, twisting colic; the region around the navel is hard; jerking pain externally of the abdomen, which is inflated and hard; crawling in the throat, hiccoughing, vo- AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 277 racity, aversion to sweets; nausea, with water rising in the throat, straining evacuations, secretion of slime, great debility; worse attacks of colic about midnight—if Mercurius vivus does not quickly relieve the patient, and the above symptoms are attended with itching of the nose, give China; if this does not effect a complete cure, Sulphur. Pulsatilla, when there is stinging pain in the bowels, with throbbing in the pit of the stomach, a disagreeable tightness in the abdomen, as if it were too full; growling and rumbling; the wind cannot be got rid of; irritation and heat in the abdomen, which is inflated; general heat, the veins on the hands and forehead are swelled, the patient is forced to take off his clothes on account of the heat and tightness, the abdomen is painful when touched, as if bruised; all the symptoms are worse when lying down, somewhat better when walking about; when rising, the small of the back aches as if bruised; also, with the pinch- ing, cutting pains, there is tearing and shooting pains above the navel; uneasiness, heaviness in the belly, with painful tension, when touched it aches; weakness of the stomach, white, frothy saliva in the mouth, diarrhoea; yellow, gray evacuations, with violent pains in the stomach, pale face, blue circles around the eyes; contractions of the whole body; pressing, tensive head- ache ; when caused by an overloaded stomach, first give coffee without milk, and afterwards, if necessary, Pulsatilla; if that does not cure the complaint, give Belladonna. Aconite, in cases like the last mentioned, when in addition the bladder is affected, the patient has violent pains in the region of the bladder, with a constant inclination to make water—the urine, however, does not pass; these symptoms are accompanied by nervousness and uneasiness, and the abdomen is excessively sensitive. It should be given once or twice, and afterwards, if necessary, Nux vomica. Colocynthis is the principal remedy for colic, when the pains are very violent, constant, or only cease for a short time, and then recommencing with greater violence; when the most violent pain is confined to a small spot about the navel, and returns 278 CHAPTER X. periodically every five or ten minutes; or when it commences with a slight drawing pain, tending towards the centre, which increases gradually, and at last changes to a jamming, pressing, or boring and tearing pain, so violent, that the patient cries and shrieks aloud, twists about like a worm, is covered with perspi- ration, presses the abdomen with his hands, pushes furiously against the bedposts or corners of the tables, &c, lies on his face and places pillows under himself, and tries every way to get some ease. For colic, arising from irritation of mind, if Chamomilla proves inefficacious, Colocynthis should be given. Persons who have previously suffered from these attacks for several days, or periodically, and have taken laudanum, which will cause the attacks to return the sooner, may, when they feel the least symptoms of an attack, take Colcocynthis; it is also most suitable when former attacks have weakened the in- testines, which feel as if every part were bruised, and hanging on threads which might break, at every step. If the first dose does not give immediate relief, and if the complaint gets worse, give coffee without milk, a teaspoonful at a time, which may be repeated as long as it alleviates the pain; if it grows worse again, give another dose of Colcocynthis, alternating it with the coffee, until the pain ceases. If, after taking one dose of Colcocynthis, the pain increases no longer, but there is a slow improvement, dispense entirely with the coffee, and let the me- dicine act as long as there is any improvement, or until the dis- ease is cured. The second dose is generally sufficient, almost always the third; in the worst cases I never found it necessary to give more. For any remaining symptoms give Causticum, once in the morning and once in the evening. When the patient has, unfortunately, taken laudanum, a drug most injurious in this complaint, although very commonly taken, give coffee first and then Colocynthis. If that does not answer, try Chamomilla, and then again Colocynthis. There are, how- ever, some cases of violent colic, which Colocynthis will not cure, and in which one of the following remedies must be given. AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 279 Belladonna, when, during the pain, a thick, sausage-like swelling protrudes across the abdomen, and when bending over, or pressing upon it gives some relief; when the pain is griping and bearing down, as if the intestines were about falling out, the symptoms getting worse when the patient is up and walking about; particularly when the stools are thin and watery. In the latter case, Mercurius vivus frequently removes the remain- ing symptoms. Belladonna suits, generally, when the face becomes very red, the blood rises into the head, the veins are swelled, and the pains so violent that the patient is almost dis- tracted. Also, for pains under the navel, when there is a griping, as if produced by taking hold of the parts with the finger nails, and when accompanied by pains in the small of the back. Cocculus, for pains, similar to those described under Nux vomica, particularly when there is a contraction in the abdomen with a downward and outward pressure, attended with some nausea; or when there is a large accumulation of flatus in the stomach and intestines, causing great distension of the upper part of the abdomen, and pain with rattling in the stomach, and pressure under the ribs, all of which symptoms disappear as soon as the wind passes upwards. China is suitable for flatulent colic, resembling that described under Chamomilla and Cocculus ; but when the intestines arc first contracted in the lower part of the abdomen, and press out- ward with oppressive and tensive pain, with tension under the short ribs, and agitation; particularly when the colic begins in the night; in debilitated persons, or after heavy sweats, or in females who are nursing. Ignatia frequently relieves colic, which awakens the patient out of sleep; when there are shooting pains, which extend into the chest and sides, when the wind is discharged with much difficulty, after which the pains moderate; it is suitable for sen- sitive females. When the colic commences in the evening, and the flatulency causes nausea and vomiting, Pidsatilla is better. Colic, preceded by a bitter taste, a yellowish, coated tongue, much thirst, which, as the saying is, is caused by bile, attended 280 CHAPTER X. sometimes by vomiting, or bilious evacuations, may generally be cured by one or two doses of Chamomilla ; or in bad cases by Colocynthis, and when these remedies do not suffice, by Sulphur. Flatulency. Flatulency, or a collection of wind in the intestines, often causes colic, the remedies for which have already been mentioned. When it does not cause violent pain, but heat, uneasiness, and inflation of the abdomen, which interferes with the breathing, as is frequently the case after taking flatulent food, beer, &c, or from drinking water after eating fat meat, give China, and afterwards, if required, to choleric persons, Nux vomica; to quiet, mild tempered persons, Pulsatilla; if caused by pork, also, Pulsatilla when China does not give relief. If it returns often, give Sulphur, if this also fails, send for a homoeopathic physician. Inflammation of the Stomach and Intestines. Gastritis and Enteritis. Although gastritis and enteritis are commonly considered separately, and are, in fact, distinct diseases, yet, as they often run into each other, and the tissues affected are identical, it will be sufficient for our purpose to consider them under the same head. The treatment of this disease by domestic remedies, and that of the common physicians are alike injurious. It is impossible to provide here for all cases, but it will always be better to go by the rules here laid down, than to resort to violent treatment. If a homoeopathic physician can be had, it is always better to consult him. An inflammation of this kind may be supposed to exist, when a burning, sometimes a stinging or tearing pain is felt in any part of the abdomen; which is very tender when pressed upon, and aches at every motion or movement, such as coughing, sneezing, laughing, &c. The part is sometimes tight and swollen, AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 281 when it is near the breast, it produces difficulty of breathing, particularly of inspiration; it is mostly accompanied by vomit- ing or by eructation, which gives no relief—.also by constipation. The latter symptom induces many persons to take aperient medi- cines, which, in this affection, are absolute poisons; the former, to take emetics, which may cause death. The abdomen should be left perfectly undisturbed; the drink should be water, and from time to time some mucilaginous articles—nothing else whatever; the longer the constipation lasts, the better. When the patients are recovering, and begin to eat, the evacuations will recommence of their own accord. I have seen most dan- gerous cases, where no evacuation of the bowels took place for fifteen days, and the patient recovered notwithstanding, and regained his strength rapidly. Besides the above symptoms, there are in some cases the fol- lowing : the face is pale, bluish, sunken; there is violent fever, but a weak pulse, the mind dejected and agitated. When the disease is at its height, the vomiting and the pains are both very violent, the patient is exceedingly weak; the extremities cold; hiccough sets in, and the abdomen is finally distended, and ex- tremely sensitive. When the disease attacks the stomach, the pain is generally in the pit of the stomach, extending under the ribs and towards the back, or through the abdomen; eating and drinking are immediately succeeded by vomiting; with violent thirst, there is sometimes an aversion to water. When the seat of the dis- ease is in the intestines in any part of the abdomen, the vomit- ing does not take place for some time after eating or drinking; the abdomen is swollen and tender, the patient complains of intense burning heat, in the whole or some part of it. There is also usually great thirst, constipation, &c. Aconite is the remedy which will in most cases be required at the commencement. It may be repeated every hour, until there is some improvement, or until an aggravation of the symp- toms render the selection of one of the following remedies neces- sary : 282 CHAPTER X. Ipecacuanha, when the pains are worse in the front part of the abdomen, and extend to the left side under the ribs, whence they spread along the ribs toward the back or the abdomen, with swelling in the region of the stomach, great agitation, and vomiting, which, if it proves efficacious, may be repeated once or twice. Antimonium crudum will be preferable to Ipecacuanha if the tongue is covered with a white or yellowish coating. Pulsatilla, or Nux vomica, if the disease was produced by a disordered stomach. Bryonia, after Aconite or Ipecacuanha, when the pain and fever is very violent, and the complaint has been caused by tak- ing cold, particularly by drinking cold water when the patient was overheated, which may be repeated as often as the symp- toms become worse; when it ceases to be efficacious,"giveNux vomica. When the patient seems stupefied, or speaks uncon- nectedly, or is not aware how sick he is, give Hyoscyamus, and repeat it several times; if it does not give relief, give Bella- donna, and wait a day, if possible. If the extremities become cold, and the patient is evidently sinking, the face becoming very pale, or otherwise much altered, give Veratrum in repeated doses; if this proves unavailing, Arsenicum, which should rarely be given more than twice. After Arsenicum, Aconite may in many cases be given again, and then Arsenicum once more, giving them in this manner alternately. If Arsenicum makes the complaint worse, give Nux vomica. China, immediately after or in alternation with Aconite, when the pain is worse on the left side, under the ribs, whence it extends downward, when there is generally in the beginning vomiting of blood and violent fever. A dose should be given every half hour or hour; or, if improvement follows the first or second * dose, wait until the symptoms become worse before giving it again. Arnica may be given for the above symptoms if Aconite and China are insufficient, and the pains are more of a pressing or AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 283 shooting character, and render the breathing difficult and pain- ful—also when the pains resemble more those of nervous fever —the patient, quite indifferent, dull and stupid, is insensible to his suffering, and insists that there is nothing the matter with him. Nux vomica may be given with advantage after the above remedies, when the disease has continued for some time, without much improvement, and there is a dull pressure on the stomach with constipation. Bryonia, in cases when there is acute pains in the stomach and abdomen, increased by the least motion and which sometimes extend to the chest, and con- stipation. Arsenicum, when there is diarrhoea, with a discharge of much blood, without alleviating the pains; or when they are violent and burning, and the patient is very weak; also when the dis- ease assumes a periodic character; is worse every other day, this remedy, or China, will be most appropriate. When the pain is more under the ribs on the right side, to- ward the front, extends up or down, give one of the following remedies: Chamomilla, if the pains are of a dull character, and not in- creased by external pressure, nor by motion or inspiration, and when there is pressure on the stomach, tension under the ribs, difficulty of breathing, a yellow tongue, bitter taste, yellowish skin and paroxysms of oppression and inquietude; when these paroxysms become more frequent, principally during the night, and are attended with green, slimy diarrhoea and sickness of the stomach, give Pulsatilla; if, on the contrary, the bowels are constipated, the skin less yellow, but the chest more affected, give Bryonia. Of these remedies give two or three globules at a time, and after half an hour, if no improvement has taken place, repeat the dose. Mercurius vivus, for pressing pain, which does not allow the patient to lie on the right side, with bitter taste in the mouth, more thirst than hunger, constant chilliness, very yellow skin and eyes; sometimes it may be alternated with Belladonna, or, in critical cases, with Lachesis. 284 CHAPTER X. Belladonna, for pressing pains which extend to the chest and Bhoulders • when the pit of the stomach is swollen, with tension above the navel across the abdomen; difficulty of breathing and nervousness, attended by determination of blood to the head, with dimness before the eyes, and giddiness almost to fainting, frequently accompanied by violent thirst, uneasy tossing about, and sleeplessness. It may be repeated in two or three hours, if no improvement takes place; if not better the next day, give Lachesis, and repeat it as often as the complaint gets worse; when Lachesis ceases to act favorably, give Belladonna again, or select another remedy. Nux vomica, for acute pain, sometimes attended with throb- bing and stitches, the part affected being very sensitive to the touch; sour or bitter taste; nausea or vomiting; oppression and shortness of breath, as if the clothes were too tight, while the removal of them rather aggravates the sensation than otherwise; thirst, red urine, oppressive headache. Sulphur may be given after Nux vomica, if the.e should be but little or no improvement from the latter—and the stinging pains continue. And also after the other remedies reci mmended when they afford no immediate, or only partial relief. Two or three doses should be given at intervals of from six to twelve hours apart, and allowed to act for seven days if this be pos- sible. If the disease is worse every other day, give China, as prescribed for pains in the left side. When the pain is more in the abdomen, in the middle or lower part; and is aggravated by motion or pressure, and the most painful part is swollen, give Aconite, to be repeated after three or four hours, if the improvement is only temporary. If this gives no relief, and the abdomen continues to be sore when touched, give Lachesis, to be repeated ah hour after; if this fails, give Belladonna. In some cases, Hyoscyamus, Bryonia, Nux vomica, Arsenicum, and sometimes Mercurius vivus may do good—the latter particularly after Lachesis. Refer to what has been previously said of these medicines in this chapter. All aperients ought to be carefully avoided in this complaint, AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 285 though it is mostly attended by violent constipation—the longer this lasts, the sooner will the patient be restored to perfect health; if he takes cathartics or emetics, he may die in con- sequence, or they may produce a tedious malady which is diffi- cult to cure. In this complaint it is, therefore, a good sign when the bowels are constipated, and a very bad sign when the eva- cuations become thin, and still worse when they pass involun- tarily. Even in this dangerous stage of the disease, Hyoscyamus may sometimes save the patient—repeat it in two or three hours, if he does not feel better; after which, if he does not grow de- cidedly worse, give no more, and await the result. Children are frequently subject to attacks of this kind: when the pit of the stomach and the parts under the ribs become dis- tended by pain in the abdomen, give Mercurius vivus or Cha- momilla once or twice. See also " Diseases of Children". Determination of Blood to the Abdomen. This affection consists of a troublesome sensation of heat and burning in the stomach, attended with hardness, tension, dull pain, and symptoms as if arising from a surfeit without any ex- cess having been committed. Hypochondriacs, persons who are of sedentary habits, or those who have the piles, are most liable to it. The principal remedy is Sulphur. If, however, it is ac- companied by pains in the small of the back, with a feeling of great weakness in that region, rendering it almost impossible to walk, Nux vomica will be preferable. If accompanied by diar- rhoea with small, soft, slimy or watery evacuations, Capsicum should be given : or if attended with diarrhoea and great pros- tration of strength, Arsenicum. In addition to the above, the following remedies may be serviceable. Belladonna, Veratrum, Pulsatilla, Bryonia, Chamomilla, Rhus tox. See also "Piles". Worms. Helminthiasis. Many complaints are ascribed to worms which arise from very different causes. When children have been fed upon pap, cakes and similar articles of a hurtful nature, or when the mother, 286 CHAPTER X. whilst nursing, overloads her stomach with meat, fish, salted and fat things, particularly with pies, the children must necessarily become sick in consequence, or a predisposition to sickness be induced. When, besides this, the children are dosed with vermi- fuges, injections, purgatives, &c, the worms cannot fail to pros- per and increase. When children are supposed to have worms, the first thing to be looked to, is a rational mode of living, by which means the worms will soon diminish, and if symptoms of the complaint remain, the remedies will afterwards prove the more effective. Most persons are by far too much afraid of these little animals, which are not nearly as noxious as the remedies usually pre- scribed for them, and particularly as the nostrums puffed in the newspapers. Good natured persons believe these things, and pay for the trash, when, if they knew what they or their children were swallowing, they would rather pay twice as much to keep it out of the house, to say nothing of their bodies. It is true, these things sometimes kill the worms, but too fre- quently they kill the children also, or affect the abdomen in such a manner that the consequences appear many years after. First, it is to be considered that all children have worms, some- times before they are born, and that it is frequently a sign of a dangerous disease when these worms pass off themselves; secondly, that what these worms subsist upon in the body is more hurtful than the worms themselves. Almost all the symp- toms attributed to worms may arise from some general disease in the system, which has a tendency to increase them, especially if aided by an unwise mode of living. When the worms have become very numerous, they give rise to various complaints, which, joined to the symptoms of the original malady, sometimes become dangerous. When the worms are expelled, the symp- toms which they gave rise to, of course disappear, but the real disease may increase. Sometimes diseases subsequently make their appearance which are worse than the first, although slower in their operation, and perhaps not manifesting themselves until the tenth or twelfth AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 287 year. Expelling the worms is of no essential use. The remedies here prescribed will frequently cure the disease itself, and if there are really too many worms, which is but rarely the case, will remove them also. Children who have worms should have enough to eat, but not too much bread, and few or no cakes or pies, but in preference a good deal of ripe, cooked, or dried fruits, and, in particular, carrots. When you are not certain of the existence of worms, and the child becomes emaciated, and vomits frequently, give first Ipe- cacuanha ; but when the tongue is coated, Carbo vegetabilis; if this has no effect, Pulsatilla; if the child has been much troubled with diarrhoea, or has taken much aperient medicine, give China, when the bowels are constipated, Nux vomica. When the child passes worms occasionally, picks its nose much, and the belly is distended, give China, which is one of the chief remedies for all complaints really arising from worms. For colic, caused by worms, with frequent inclination to vomit, when much water collects in the mouth, and the parts around the navel are hard, also when the whole abdomen is hard and distended, with frequent ineffectual straining to evacuate, or secretion of nothing but slime, give first Aconite, some hours later, China; and if this be not sufficient, Mercurius vivus or Silicea. In all complaints caused by worms, Aconite is of great use in the beginning, and if this and the other remedies men- tioned above do not remove them, Sulphur should be given, and will be found to be of great value, particularly after Mercurius vivus. These remedies will generally effect a cure. In rare cases attended with much thirst, sudden starting, and fright, Bella- donna may be required. In very bad cases it may also be neces- sary to give a dose or two of Lachesis. Persons troubled with tape worm—discharge joints of this worm from time to time; these pieces are nearly square, quite flat, about as broad as the little finger. There is no sure sign of the existence of tape worms, except there is a discharge of pieces of this description, which generally pass away about the new and full moon. 288 CHAPTER X. Tape worms may frequently be destroyed by taking, when the moon is waning, two mornings successively a dose of Sulphur, and at the next full moon, Mercurius vivus in the same way, and eight days after, Sulphur again twice; repeat these remedies in the same order several times. Sometimes the tape worm is discharged after taking a few doses of Calcarea. If this treat- ment does not effect a cure, apply to a homoeopathic physician. For ascarides, the small worms which are found in the anus, see " Itching of the Anus." Itching of the Anus. This troublesome affection may generally be cured by one or more of the following remedies: Nux vomica will be applicable when the itching is seated either internally or externally, is worse when sitting, or moving, and also after taking stimulating food and drinks, and is accom- panied with pains, or dry piles, or moist and bleeding piles, or costiveness; also when caused by strong liquors, beer or coffee; or in people who lead a sedentary life, in pregnant females; when caused by ascarides which may be discovered moving about in the sphincter ani upon drawing it apart. Aconite, if the itching arises from ascarides, and Nux vomica is inefficient, and children are very uneasy during the night, and have fever. It should be given in the evening, or during the night, and if ineffectual, followed by Ipecacuanha in the morn- ing. If the children are again troubled in this way, particularly after every full and new moon, give, when the moon is full, Sulphur; and Silicea when it is new. Should there be no im- provement from using the dry pellets, dissolve a few pellets of the same medicines in 6 or 8 teaspoonfuls of water and give a teaspoonful every morning for 6 or 7 successive mornings. If the complaint should return at the next full moon, give Calcarea in the same manner as Sulphur is directed to be given. Let the children eat no pork, and as little pastry and cakes as possible. If there should be no relief notwithstanding the use of the above medicines, give Ferrum. every other morning; if diarrhoea makes AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 289 its appearance, dispense with the medicine, and if the diarrhoea still continues, give China. While children are taking the above remedies, (Sulphur, Cal- carea, Silicea and Ferrum,) nothing else is to be given, unless it be a dose or two of Aconite to remove any febrile symptoms that may arise. The itching may be allayed by rubbing the parts with sweet oil, or by introducing a piece of bacon, about the size of a finger, attached to a string, into the anus; allowing it to remain there for ten or fifteen minutes, and then removing it. Injections of cold water every evening are also serviceable in many cases. Applications of this kind do not disturb the opera- tion of the remedies. When, however, all these means prove abortive, which may be the case with some children, in whom it is hereditary, try small injections of salt water, and if these fail, or cause diarrhoea, weak injections of water and vinegar. Lemon-juice has often proved efficacious in allaying the itching, by applying it once or twice a day. Eating asparagus, when this plant is in season, which is the time that the worms are usually most troublesome, has also been found advantageous. One of the best remedies, however, for children, is a drop of the tincture of Urtica urens, in a little water, every morning for several days. When the itching is caused by piles, swollen, red, or bluish tumors in the anus, give the following remedies : Nux vomica, if, besides the itching, there is a burning and pricking sensation, the anus so contracted that the natural dis- charges are effected with much difficulty, accompanied by dull shooting pains and jerking in the small of the back and around the anus, at every evacuation; or pain in the small of the back as from a bruise, which makes the patient cry out, and bend forward when walking or sitting. It may be followed, if neces- sary, in a day or two by two or three doses of Ignatia. Sulphur, taken night and morning for several days, will be serviceable when, in addition to the itching, there is burning pain and soreness in and around the anus, with stitches; the 37 290 CHAPTER X. tumors are moist; with a sensation of fulness and heaviness, and sometimes protrusion (prolapsus) of the anus; constant straining to evacuate, or thin diarrhoea mixed with blood, with violent stinging pains in the small of the back; stiffness in the small of the back, or feeling of contraction. If this does not effect a cure, give Aconite, and should that also fail, let the patient smell camphor. Hemorrhoids, or Piles. This is a disease which consists principally in the discharge of small quantities of blood at the anus every four or six weeks, preceded by more or less indisposition, and followed by a feeling of great relief. Very often other and more dangerous diseases are prevented by this complaint. Frequently the symptoms which precede the discharge, are very troublesome. Sometimes the discharge ceases in part or entirely, at others again so much blood is discharged that it becomes alarming; tumors are frequently formed in the anus, which become very painful, particularly when no blood is dis- charged. Not unfrequently after a sudden suppression of piles a disease of a more dangerous character appears in their stead. For all these symptoms medicine should be taken, and the manner of living be such as to prevent the disease from assuming a more malignant character. The patient should not sit much, particu- larly on very soft cushions, except during the time the tumors protrude. He must avoid all ardent spirits, strong beer and coffee; drink water freely, and take plenty of exercise. The doctors of the old school, not knowing how to cure piles, have thought it best to cut them off. This is not a very difficult operation, and any one can perform it who has the proper scis- sors; nor is the pain very acute—but it is very unwise, and frequently attended by dangerous consequences. Sometimes the bleeding consequent upon it, can only be stopped by cauterizing the parts or by using creosote, which latter may cause incurable ulcers. AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 291 At all events, cutting off the tumors is of no use but to sus- pend the pain for awhile, as they almost always reappear in a short time higher up in the rectum, where the pain is, of course, more violent, and where it is more difficult to cut them, in attempting which, the rectum is frequently incurably injured; if the operation is repeated, they grow still higher up, and then these operators are at a loss. The patient is in a worse condition than at first, and is then left to his fate. The homoeopathic physicians, on the other hand, possess medicines by which they cure these tumors without cut- ting at all; but the more frequently the patient has been oper- ated on, the more difficult it is to cure him, as the disease has thereby become much more obstinate. Washing the parts with cold water, and injections of half a pint of cold water, once or twice a day, are beneficial, when the piles do not bleed; when they bleed, these means should not be resorted to, as they may suppress the discharge. When they bleed too copiously, the water may, perhaps, be applied, without, however, neglecting to take the medicines recommended. Great care must be taken also in giving the injections; the water must not be too cold, the point of the syringe should be of wood, not too thin, and widening towards the end, which ought to be nearly as thick as the point of the little finger; before in- troducing it, it should be first covered with fresh sweet oil, or with beef or mutton suet; introduce the pipe by slowly and gently turning it, then press the piston with one hand, while, with the other, you hold the syringe near the point, to prevent it entering further into the anus. When the tumors on the anus are too painful to allow of injections, apply a sponge which has been dipped in cold water. Moistening the tumors with saliva is very useful, but this must not be done immediately after meals, nor after smoking tobacco; persons who chew tobacco, or who have ulcers in the mouth, should not try it. When the tumors do not bleed at all, and are very painful, and when they get worse again in a short time after applying cold water, put some boiling water, or water in 292 CHAPTER X. which wheat bran is boiled, into a close stool-pan, and sit over the steam. Sometimes mucilaginous substances are useful, par- ticularly an emulsion of quinces, made of quince-seed soaked in water. The following medicines are, however, chiefly to be depended upon. When there is intense itching in the anus, see under " Itching in the Anus." If the piles are accompanied by colicky pains, give the remedies recommended for " Colic," among which the principal are Pulsatilla, Nux vomica and Colocynthis. Pul- satilla mostly for females; Nux vomica more frequently for persons who drink ardent spirits and are of sedentary habits; Colocynthis, when the pain is very severe. Refer also to " De- termination of blood to the Abdomen." Aconite frequently gives relief when blood is discharged, and there are shooting pains and pressure on the anus, the abdomen feels too full, with tension, pressure and griping; the small of the back feels as if broken or bruised. Nux vomica, when there is a burning, pricking pain in the tumors, the symptoms resembling those mentioned under "Itch- ing of the Anus "; when there is much light colored blood dis- charged after each evacuation, or where there is a constant disposition to evacuate; also, in constipation, and during preg- nancy. If it does not suffice, give Ignatia, and afterwards, if the complaint returns again, Sulphur. Pulsatilla, when blood and mucus are discharged with the fseces, with painful pressure on the tumors; pains in the back, pale countenance, disposition to faint. If it is insufficient, Mer- curius vivus, and afterwards Sulphur, sometimes answer in these cases. Capsicum answers best when the tumors are much swollen, the blood discharged with burning pains, and mixed with slime; also when there is a drawing pain in the back, particularly in the small of the back, and cutting pains in the bowels. Ignatia, against violent stitches which pass upwards, with itching and crawling in the anus, when much blood is discharged, or the rectum protrudes considerably at each evacuation; or AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 293 when after an evacuation there is painful soreness and contrac- tion, particularly when accompanied by ineffectual straining to evacuate, or a discharge of blood and mucus. Chamomilla is most appropriate when the blood flows freely, with contracting pains in the abdomen, frequent straining to evacuate; occasional diarrhoea, particularly when attended with smarting and burning, with tearing pain in the back, especially at night. Antimonium crudum is frequently of service when mucus is discharged from the anus, which stains the linen; in some cases it may be given alternately with Pulsatilla; when with the dis- charge of mucus there is burning pain, Carbo vegetabilis is still better, particularly when accompanied by bleeding of the nose, and great determination of blood toward the head. Carbo vegetabilis, for the symptoms mentioned above—dis- charge of mucus with burning pains; bleeding at the nose; congestion of the head, &c, especially in patients who are very weak; if it proves insufficient, it should be followed by Arseni- cum, or these remedies may be given alternately. Sulphur is one of the principal remedies as well for bleeding as for blind piles; it is particularly suitable when there is con- stant ineffectual inclination to stool, or thin evacuations mixed with blood; when there is an acute, sore pain in the anus, in- ternally and externally; when the tumors burn, are moist, pro- trude considerably, and are pressed back with difficulty; with violent shooting pains in the back, and in the small of the back; stiffness in the small of the back, with a feeling of contraction ; also, with smarting pain on passing water. To persons who have taken much sulphur or Harlem oil, by which many patients suffering in this way injure themselves, give first Mercurius vivus, and after five or six days, Sulphur, morning and evening; but if much calomel and sulphur have been taken, give Lachesis first, once or twice; and if the symp- toms get worse again, Mercurius vivus, and afterwards Sulphur, which may be taken sometimes, alternately with Sepia. Belladonna, against bleeding piles, with intense pain in the 294 CHAPTER X. small of the back, as if it were breaking; if it proves insufficient, give Hepar, and if this does not effect a complete cure, four or five days later, Rhus tox. These remedies should be taken ouly twice, that is, in the evening and morning, or in the morning and evening. When the discharge is excessive, take Aconite; if this does not stop it, do not wait long, but give Ipecacuanha ; and if this is insufficient in ten or fifteen minutes, give Sulphur, and then again Aconite; if it does not then stop, give Belladonna and afterward Calcarea. When after any one of these medicines the discharge abates somewhat, take nothing more unless it grows worse; then take the same medicine again, and when this loses its effect, take another. If the patient is very weak, let him take China in the interval. The above remedies are only for cases of exigency, though sometimes they will radically cure this tedious complaint; if they do not, apply to a homoeopathic physician, or send him an exact description of all these symptoms. Diarrhoea. This complaint frequently arises from causes pointed out in the first part of this work—for instance, from sudden fright, from fear, from vexation, from taking cold, from heat, from a disordered stomach, or after burns or scalds. Most persons are to this day impressed with the erroneous idea that diarrhoea is a cleansing necessary for the recovery of the patient. It is true, that some diseases terminate in a diar- rhoea, but it is also true that diarrhoea is the commencement of other diseases and must always be considered a morbid state of the functions. The mistaken sensation of relief and weakness after purging or after artificial diarrhoea, is, by many persons, looked upon as healthy and necessary, merely because they have previously been in a different and opposite state of disease. Thus, many consider the excitement consequent upon drinking brandy or strong beer as healthy, because they feel uncomfortable without AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 295 it, whereas they are, in reality, in a more unhealthy condition, whilst they imagine themselves better. Persons who think that they cannot remain in good health without aperient medicines or artificial diarrhoea, should, when they feel constipated, try first the medicines pointed out under constipation, and they will find that the latter frequently cure without causing any diarrhoea. Those who have a natural or artificial diarrhoea, however, should not stop it by artificial means, such as wine, brandy, and the like, but should let it make its course, and use those medicines which will effect a cure in a natural manner. Astringents are not always dangerous, but are very frequently so, particularly to children and aged persons, or to individuals who are suffering from another complaint. When the consequences of suppressed diarrhoea make their appearance, they are called dyspepsia, liver complaint, &c, and the worst of it is, that they cannot be so easily removed. To believe, however, that suppressing the diarrhoea is only danger- ous, because it prevents impurities from escaping, is also a mis- taken idea. Suppressing a diarrhoea is dangerous, because it is changing one disease into another—and because we cannot know what that second disease will be; generally, it is a worse one. Most of these impurities exist only in imagination; as to the artificial production of such impurities, refer to what has been said under " Constipation". If, however, there are real impurities in the body, they will be discharged much sooner with the natural secretion than during a diarrhoea, which, in fact, always leaves impurities behind, and which the natural secretion after- ward has to carry off. When the secretion is costive and hard, nothing can remain in the intestines; a fact so evident that every one can understand it. The intestines are a tube, which is first narrow and widens gradually. It is not a hose, as attached to a fire engine, where it is necessary to apply pressure at one end, in order to force the contents out at the other; it is not a dead tube but a living one, which is in constant activity; this act- ivity, when regular, allows nothing to remain—only when it is irregular, or when it ceases, can this be the case. In diarrhoea, 296 CHAPTER X. particularly when produced by aperient medicines, this action is very irregular and hurried, in the attempt to rid the body of the poisonous purgatives—which, when accomplished, leaves the intestines, of course, very weak and relaxed. If the purgative were not a poison, it would not purge at all, for only such things as the body cannot suffer, but ejects, act as aperients. The poisonous effects of these medicines become most evident when they remain in the body; for when the body has not the power to reject them, they show their whole force as a poison. You will be told that it is the disease which produces these symp- toms, but do not believe it—it is false. More persons die of magnesia or castor oil, and more children of rhubarb, than of arsenic, of which every one is afraid. With costive evacuations the action of the intestines is greater, or the excrements could not be ejected—and, consequently, nothing can remain behind —for the hard excrements always fill the intestines completely, which is never the case in diarrhoea. When the action of the intestines stops, it is true, the contents remain stationary; but it can easily be excited again, as has been shown under " Con- stipation." Doctors who dissect thousands of bodies, almost always find impurities in those who have had diarrhoea, but never in those who have been constipated. When loose evacuations relieve a patient who is suffering from some complaint or other, wait awhile before you give medicine —and, only in case it continues so long as to be injurious, make a selection, from among the following remedies, of one which accords with the symptoms : If children, while teething, have diarrhoea, do not interfere with it immediately, but wait a day or two, if they have no other symptoms requiring treatment. At the commencement of a diarrhoea, all acids, coffee, tea, and everything salt should be avoided; fruit, fresh or dried, eggs and chickens, also, are in- jurious; nothing but mucilaginous food is to be taken—oatmeal, rice, hominy, &c. If the appetite is good, the patient may take mutton broth, thickened with wheaten, oatmeal or rice flour; milk fresh from the cow, is also good, if the patient is fond of it, AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 297 but it ought not to be taken in too great quantities, lest it should aggravate the diarrhoea. Ipecacuanha is indicated in diarrhoea, attended by screaming, tossing, uneasiness, profuse salivation, and distention of the abdomen—sometimes ineffectual straining, frequent small yellow stools, with pains in the rectum—or thin mucus, frothy, fer- menting evacuations of a very offensive smell; accompanied by weakness, an inclination to lie down, drowsiness, a pale face, blueness under the eyes, coldness and irritability. When Ipeca- cuanha does not answer, or affords only partial relief, give Rheum ; when the secretions smell sour, it is better to give the latter medicine at first. Chamomilla, particularly for infants when they cry and are uneasy, want to be carried constantly; or for older children, when they are irritable, cry as if crazed, and twist and writhe; when infants draw up their legs; when the belly is tight, and hard—the evacuations very frequent and mostly slimy or watery, or green and brown, or of undigested matter which smells like rotten eggs; accompanied by rumbling in the bowels, loss of appetite, thirst, coated tongue, frequent eructations and retching. Chamomilla is appropriate also for grown persons, particularly when the evacuations are green, watery, hot and offensive, with bitter taste in the mouth, bitter eructations, bilious vomiting, fulness of the pit of the stomach, griping and headache. Pulsatilla, against pap-like or watery and offensive diarrhoea with burning pain and soreness of the anus; accompmied by loathing, nausea, disagreeable eructations and griping, the latter more frequently during the night. For pap-like diarrhoea only occurring after midnight, preceded by pain in the bowels, which ceases after evacuation, give Rhus tox. Pulsatilla is also useful in slimy diarrhoea, when each stool is of a different color. If the diarrhoea occasions great weakness, give Colocynthis, and if this causes disagreeable symptoms, give a little coffee without milk. If the slime is green, or mixed with blood, and attended with straining, give Mercurius vivus. 38 298 CHAPTER X. Mercurius vivus, for diarrhoea attended by spells of screaming and by writhing, with ineffectual urging and pressing; cold per- spiration and trembling; the discharge green, watery and mu- cous, sometimes bilious, or mixed with blood, accompanied by great exhaustion, fetid breath, loss of appetite, and a disposition to vomit, or vomiting and diarrhoea at the same time; also for acrid diarrhoea with burning and itching in the anus. Sulphur, for diarrhoea which is so acrid as to occasion soreness of the parts around the anus, or to produce miliary eruptions; frequently accompanied by emaciation, or, in children, by a hard, distended abdomen; when every fresh exposure renews the diarrhoea. It will be serviceable after the failure of other remedies. Antimonium crudum, for watery diarrhoea with disordered stomach, and whitish thickly coated tongue; but when there is besides soreness of the anus; spasmodic pains in the anus and back; food of every kind causes pressure in the stomach; dul- ness of the eyes; sallow and pale face, give Ferrum, which may also be given in diarrhoeas without pain. For watery diarrhoea which has continued for a long time, other remedies having proved ineffectual, give Phosphoric acid, and repeat it often. Rheum, for sour, thin, slimy, fermented diarrhoea, (compare with Ipecacuanha,) common with children, who cry with pain in the bowels, or are uneasy and draw up the legs—flow of saliva from the mouth, and pale face, (if it is red, give Chamo- milla, and if this does not answer, Belladonna); sometimes there is a sourish smell proceeding from the whole body of the child, which washing will not remove; if, in such cases, Rheum does not give relief, and the pain is very violent, give Chamomilla, and if this does not suffice—the pain abating but the weakness continuing with distension of the abdomen, give Sulphur. China will be serviceable in all kinds of diarrhoea occurring in debilitated persons, and also in other cases, when, during the most violent pains, which are spasmodic, contracting and oppressive, quantities of thin brownish matter are discharged, sometimes accompanied by burning pains in the anus, with great AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 299 weakness in the abdomen, rumbling, flatulency and eructations. Frequently when persons awake during the night with these spasmodic pains, it gives instant relief, and prevents diarrhoea. Bryonia often answers in the heat of summer, particularly in diarrhoea arising from drinking cold water, or from taking cold; or when the diarrhoea is caused by eating too much fruit, or by eating too much in general; likewise, when the diarrhoea occurs immediately after meals, is occasioned by sour-crout; also when produced by mental irritation, and Chamomilla has failed to cure it. Dulcamara, for diarrhoea which is caused by taking cold, particularly in summer and autumn—worse at night, frequent evacuations, which are rather watery, attended by no great pain or by colic; if this does not give relief in six hours, give Bry- onia, and repeat it again after six, eight, or twelve hours. If attended with more weakness than pain—if it comes on imme- diately after meals, the food being passed undigested, China generally gives relief; sometimes Bryonia or Rheum—to which refer; when attended with great weakness and pain in the bowels, give Arsenicum, and if this does not soon give relief, Nux vo- mica. When the food passes undigested, Ferrum is frequently useful, alone, or given alternately with China, or Calcarea. For diarrhoea attended by great weakness, mostly Ipecacuanha, Ve- ratrum or Arsenicum; for diarrhoea without any pain, Ferrum is best. When diarrhoea and constipation come on alternately, as is frequently the case in aged people, Antimonium crudum answers best. For diarrhoea in females during pregnancy, and in confine- ments, refer to " Diseases of Women"; and for diarrhoea with children during summer, to "Summer Complaint", among " Diseases of Children". Dysentery. Dysentery consists of a constant straining and desire to evacuate the bowels, violent pains in the abdomen, more or less fever, and stools of mucus or blood, or both. 300 CHAPTER X. It is usually preceded by loss of appetite, chills, some fever, nausea, or vomiting, costiveness; this condition is soon followed by dull pains in the abdomen, increased fever, loose evacuations, first of mucus, then mixed with blood or pure blood, with intense pains and almost constant desire to stool, with violent straining. Occasionally the disease appears suddenly without any pre- monition. It is most frequent in the latter part of summer or in autumn, and may be caused by eating unripe fruits or vegetables, drink- ing cold water when overheated, sudden check of perspiration, &c. Not unfrequently it occurs in an epidemic form, in particular dis- tricts of country; generally in low, marshy situations. Treatment.—Mercurius vivus, Mercurius subl. corr., Aconite, Chamomilla, Rhus tox., Bryonia, Nux vomica, China, Colo- cynthis, Arsenicum, and Sidphur, are the principal remedies. Aconite will most frequently be indicated in the commence- ment of dysentery when it is accompanied by tearing pains— resembling rheumatism—in the limbs, head, neck and shoulders; violent chills; much heat and thirst; bilious or thin and watery evacuations, sometimes mixed with mucus or slightly tinged with blood; dull or cutting pains in the abdomen. It is parti- cularly valuable in dysenteries occurring in autumn—when the days are hot and the nights cold. A dose may be given every three or four hours until the symptoms change, when another remedy must be selected. Chamomilla, after Aconite, if there is still considerable fever and thirst with rheumatic pains, especially in the head; nausea, foul tongue, bilious stools, bitter taste, &c. And particularly if the disease was produced by a sudden check of perspiration. Usually great agitation and tossing. Pulsatilla, when the stools are chiefly mucus, streaked with blood, with nausea, coated tongue, bitter taste, &c. Bryonia and Nux vomica, are frequently of service after Aconite and Chamomilla. See their symptoms in the preceding article "Diarrhoea". AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 301 Mercurius vivus, when there is an urgent desire to evacuate, as if the intestines were being pressed out; after much pressing, a discharge of light blood; or greenish, broken-up looking matter mixed with blood, and after the evacuation more straining than before; in children accompanied with crying and screaming; infants thus affected, refuse to take the breast. China, against epidemic and periodic dysentery, which affects many persons at the same time in a marshy region, or where canals are being dug; particularly when the complaint is worse every other day. Mercurius subl. corr. is the chief medicine in dysentery occur- ring in autumn, particularly after Aconite, when attended by much straining and colicky pains, where in the beginning much bile is discharged, and afterward blood and mucus; if there is improvement after the first dose, which does not continue, repeat the medicine; if it gives no relief, refer to the other remedies, particularly to Colocynthis. Colocynthis for extreme pain in the bowels, as if the intestines were jammed between stones; the■ patient writhing with pain, the discharge slimy, sometimes mixed with blood, the abdomen much distended, sometimes like a drum; a pressure as if the belly were full; shuddering, commencing in the abdomen and extending over the whole body; the tongue covered with a white mucus. Refer also to " Colic". Sulphur should be given in all protracted cases where the other remedies give relief, but do not effect a complete cure. Arsenicum, when the evacuations have a putrid smell, when they pass involuntarily, when the urine becomes offensive, the patient loses his strength, becoming quite indifferent, his facul- ties benumbed, with a bad smell from the mouth; when here and there red or blue spots appear; also, when the patient tosses about in great agony, is unable to find rest, is preparing to die, &c; when at the same time the breath is very cool, or when he complains of burning; when Arsenicum proves ineffective, after one or two doses, give Carbo vegetabilis. If Arsenicum aggra- vate the symptoms, give Nux vomica. When after Carbo vege- 302 CHAPTER X. tabilis the putrid smell remains, give China; and afterwards again, Carbo vegetabilis; sometimes after Arsenicum, Phos- phorus is the best remedy. Cholera Morbus. This disease is characterized by violent purging and vomiting, griping, thirst, and sometimes by cramps and coldness of the extremities. It is most generally preceded by shivering, headache, nausea, pain in the abdomen, &c. In some cases, however, the disease appears without any premonition—violent vomiting and purging setting in almost simultaneously. The matters first ejected are the contents of the stomach mixed with the mucous secretions, and afterward, when the disease continues, the substances dis- charged become mixed with bile. In severe cases there is con- siderable pain in the abdomen, violent cramps in the muscles of the limbs, paleness of surface, pinched features, sunken eyes, cold and clammy skin, and great anxiety and depression. The disease is generally of short duration, not often continuing but a few hours. Attacks frequently come on at night, and by morning, the patient may be almost or entirely recovered. Cholera morbus is a disease of warm seasons and warm cli- mates ; the latter part of summer and the early part of autumn are the periods at which it occurs most frequently. The exciting causes are chiefly improper quantity or quality of food—cucumbers, for instance, or any unripe fruits or crude vegetables are very apt to induce it—changes of temperature, great fatigue, the too free use of ice or ice water, &c. Treatment.—The following are the principal remedies : Ipeca- cuanha, Arsenicum, Chamomilla, Nux vomica, Veratrum, China and Cuprum. Chamomilla may be employed in the commencement if the attack was induced by a fit of passion; or if the following symp- toms are presented: acute colicky pains, or heavy pressure in the region of the navel, sometimes extending to the heart, with excessive anguish; bilious diarrhoea, cramps in the calves of the AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 303 legs; tongue coated yellow, and sometimes vomiting of acid matter. A few globules may be taken every two, four or six hours according to the urgency of the symptoms. Ipecacuanha may be given after the above, should the attacks of vomiting become more prominent; or it may be selected from the commencement, should vomiting predominate, or at least assume as marked a character in the complaint as the diarrhoea. Nux vomica after Ipecacuanha when there is anxiety, pain in the abdomen, frequent small evacuations and tenesmus, and headaches. Veratrum, should the disease increase, notwithstanding the administration of the preceding remedy, and assume the follow- ing characteristics, violent vomiting with severe diarrhaa, exces- sive weakness, and cramps in the calves of the legs ; eyes hollow or sunken, countenance pale, and expressive of acute suffering ; coldness of the extremities, violent pain in the region of the navel, tenderness of the abdomen when touched; pains and cramps in the fingers, shrivelled appearance of the skin on the palms of the hands. It may be repeated as often as every half hour, or hour, until there is some change in the symptoms; if improvement takes place, the interval should be lengthened; if, on the contrary, the symptoms become more alarming, another remedy must be selected. Arsenicum is useful when this malady assumes a severe charac- ter from the beginning, but it is more particularly indicated when the disease is attended with rapid prostration of strength, insatiable thirst, excessive anxiety, with fear of approaching death, burning sensation in the region of the stomach, almost constant discharge from the bowels, or renewal of the discharge on every occasion that the desire for drink is gratified; suppres- sion of urine or scanty discharge followed by a burning sensa- tion ; violent and painful vomiting, tongue and lips dry, cracked and bluish, or black; hollow cheeks, pointed nose, pulse almost 304 CHAPTER X. imperceptible, or small, weak, intermittent, and trembling; severe spasms in the fingers and toes; clammy perspiration. China is most useful against the weakness which remains after cholera, but is also serviceable occasionally during the course of the disease, particularly when there is vomiting of food, and frequent watery and brownish evacuations containing par- ticles of undigested food; also when there is oppression at the chest with eructations which afford temporary relief; severe pres- sure in the abdomen, especially after partaking of the smallest portion of food; great exhaustion, sometimes amounting to fainting. This remedy is particularly marked when the disease has been excited by indigestible substances, such as unripe fruit, &c, or by inhabiting a marshy situation. Cuprum met. is most valuable in cholera, with violent cramps in the extremities, especially in the calves of the legs, fingers and toes; it is useful also when the evacuations are very fre- quent and whitish, with violent pains in the abdomen, bluish appearance of the skin, &c. Asiatic Cholera. Epidemic cholera is usually preceded by certain premonitory symptoms, which may continue for several days before the more characteristic phenomena present themselves, or they may be of but a few hours duration, or entirely absent. These symptoms consist of great debility, as if the patient had suffered great loss of blood; dimness of vision along with gid- diness and ringing in the ears; there is also much thirst, with loss of appetite and swelling of the abdomen. The principal symptoms, however, are vomiting and purging : the latter com- monly preceding the former for some time. These premonitory symptoms are the first stage of cholera. The evacuations, if the disease is not checked soon, become extremely frequent, and at first they do not present anything unusual, but in a short time they are copious, liquid, almost without smell, and in appearance resemble rice-water; hence they are usually termed rice-water evacuations. The patient as AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 305 these evacuations go on becomes very restless; cramps attack the calves of the legs, the fingers and toes, and sometimes even the muscles of the abdomen. This may be considered the second stage. In the third stage—that of collapse, or as it has been called the blue or cyanosed stage, the pulse is almost or quite imper- ceptible ; the extremities first, and afterwards the face and the whole body become cold; the features are so much changed that the patient can scarcely be recognized by his friends; the eye-balls appear to be sunk into the very bottoms of the orbits; the thirst and restlessness are excessive. Finally the breath becomes cold, the surface of the hands wrinkled, and the whole body shrunken so much, that rings fall from the fingers and shoes from the feet; the urine is sup- pressed, the nose is cold and in some cases becomes gangrenous; the voice is husky; the breathing becomes slower and slower; and hiccough often precedes death. When the disease terminates fatally this is its course ; when however the termination is more favourable, the pulse rises, the blueness disappears, the heat of the body returns, and general reaction takes place, indicated by fever, headache, &c. The re- action is, indeed, in some cases so great, that the utmost efforts of the physician are required to save the patient from fatal con- gestion of the brain or of some of the internal organs. The primary causes of cholera are unknown; among the prin- cipal exciting causes are living in filthy, crowded, and badly ven- tilated parts of cities; errors of diet, making any great change in the usual habits; excessive or even habitual use of intoxicat- ing drinks; the employment of purgative medicines. Intense moral emotions, excesses, and debility of every kind may act as exciting causes. During the prevalence of the epidemic, the alarm which exists not infrequently predisposes to the disease. Treatment.—The remedies of most value in cholera are chiefly Ipecacuanha, Sulphur, Arsenicum, Veratrum, Cuprum, Phos- phorus, Phosphoric acid, Carbo vegetabilis, and Camphor. 306 CHAPTER X. Ipecacuanha, given in the first stage, or when there is some nausea and sick stomach, the diarrhoea slight, will frequently prevent the disease passing into the severe forms. Sulphur is also one of the principal remedies for the cholerine, or diarrhoea of the first stage, especially when there is but little sick-stomach, and when the patient complains of dimness of vision, giddiness, ringing in the ears and want of appetite, with tumid abdomen; the stools mucous, frothy, watery, or some- times whitish or greenish, and occurring more frequently at night. Phosphoric acid has been by some considered almost specific in diarrhoea which precedes cholera, particularly if the evacua- tions are -frequent, loose and slimy, or of a whitish gray colour, or if they consist of undigested substances. For the symptoms of Nux vomica and Chamomilla, which may in some instances be useful, see the preceding article " Cholera morbus." The above remedies, with the exception of Sulphur, should be administered either by placing two or three globules on the tongue, or by dissolving a few of them in half a tumbler of water, and administering a tablespoonful every one, two or three hours, as the urgency of the case may require. The Sulphur should be given in the third trituration about a grain at a time, and repeated as above. Arsenicum will in many cases be found of great value in the second stage of cholera, when the purging and vomiting become very frequent; the evacuations from the bowels being thin, watery, and of a brownish or blackish colour and putrid smell, or light coloured and almost without smell, especially when ac- companied by intense, burning pains or cramps in the stomach and bowels, with violent thirst, and great prostration of strength; also burning in the anus and rectum with tenesmus. It is also worthy of attention in the last stage of the disease. Veratrum is, however, the remedy upon which the chief re- liance is to be placed, when cholera is fully developed;.the dis- charges almost constant and presenting the characteristic rice- water appearance, with cramps in the calves of the legs, fingers, AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 307 toes, and sometimes of the muscles of the abdomen and chest; the patient excessively restless and anxious; the extremities cold, &c. This remedy may be administered every fifteen or twenty minutes until several doses are taken, or there is a decided change in the symptoms; frequently it may be alter- nated advantageously with Arsenicum, especially when the pains are of a burning character; the thirst unquenchable, and the evacuations increased by drinking cold water. Cuprum, after or in alternation with the latter when that remedy has failed to relieve the" cramps, which are very violent, and extend to the whole body, or change to spasms or convul- sions, with constriction of the chest and difficult respiration. Administration the same as Veratrum. Carbo vegetabilis may frequently be of service in the last stage of the disease, when the patient is in a state of collapse, or asphyxia; the pulse almost gone; the surface cold and bluish; the breath cold; or when the evacuations and cramps have ceased, and congestion to the chest takes place. If reaction should ensue after the administration of Carbo vegetabilis, and the purging, vomiting and cramps return, it will be necessary to have recourse again to Veratrum, or some other of the foregoing medicines. Secale cornutum is useful in cholera, with whitish or colour- less evacuations, pains in the limbs, &c, and also after Veratrum and Cuprum when these medicines have failed to relieve the cramps. In the congestions which frequently follow cholera, that to the head will generally be relieved by Aconite, Belladonna and Opium; that to the chest by Phosphorus, Bryonia, Aconite, and other remedies recommended for " Congestion of the Chest", which see. When there is irritability and pain of the urinary organs, Cantharides and Pulsatilla will be required. Phosphorus and Sulphur will generally be found most effica- cious against the looseness of the bowels or diarrhoea, resulting from weakness or irritability, which often occurs after cholera. Camphor, in the proportion of one part of tincture of camphor 308 CHAPTER X. to six of alcohol, has been highly recommended as a preventive to the development of the disease, if taken immediately on the appearance of the premonitory symptoms; and also as a pre- servative against infection along with Cuprum and Veratrum. During the treatment of cholera the patient should be kept in a warm room, and the heat of the body kept up as much as pos- sible by artificial means; among those the best are the applica- tion of bottles of hot water to the feet and abdomen, and frictions with the hand previously dipped in flour to prevent abrasion of the skin. Oats heated and applied to the limbs or over the whole body in suitable bags is also a very good way of keeping up artificial warmth. To quench the violent thirst which gene- rally accompanies the disease, small pieces of ice should be placed in the mouth from time to time; cold water, in small quantities, may also be allowed unless it be found to aggravate the disease. Injections of ice water will be serviceable in some cases to relieve the cramp or colic in the intestines. Cholerine. This term has been applied to diarrhoea occurring during the prevalence of cholera unaccompanied by the more severe symp- toms of the disease. The remedies appropriate to its treatment will be found under " Diarrhoea." Sulphur, as before mentioned, is one of the best. Constipation. The first observation we have to make on this complaint, and which many will consider problematical, is, that every one whose bowels are constipated, may congratulate himself that he has no worse complaint. Whoever has paid attention to the subject, must be aware that nearly all persons who are diposed to costive- ness, live long and keep their strength, except when they injure themselves by taking aperient medicine. Those on the contrary, who are subject to frequent attacks of diarrhoea, are early in life debilitated and seldom grow old. No diarrhoea can appear where there is not some poisonous, noxious matter, or morbid disposition in the body, while, on the AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 309 other hand, much perspiration and the eating of animal food are sufficient to cause constipation. In regard to the notions of impurities remaining in the body, see what is said under " Diar- rhoea." The very popular opinion that purging contributes to health, not only when the body suffers from sickness, but also occasionally, when it is in a healthy state, and that impurities are driven out of the body by it, is entirely erroneous and with- out foundation. It serves to keep up the sale of drugs, and it has been repeated year after year until it is almost universally received. It is a part of the traditionary medical creed of the world, and no one dares to doubt it. Physicians spread and encourage this idea, because their whole art consists chiefly in bleeding, purging, and giving emetics. This creed is the pivot upon which the whole of the old system turns, and patients, deferring to authority, must needs submit When this erroneous method of treatment is prescribed with due confidence and solemnity, heart and purse (but not always the bowels) open, and persons actually in sound health feel a downright longing to be properly scrubbed and cleansed inside. Every one who will make the following experiment upon a horse, or upon himself, will be convinced that our opposition to purging is well founded. Let aperient medicines be taken for a week, and however good may have been the state of health previously, at the termination of this period all sorts of impurities will be discharged, particularly after taking jalap and calomel. As this happens in every instance, either to man or beast, and even to those who have never been ill, it is a proof that these impurities have been artificially produced by drugs. We are frequently able to judge from the nature of the secre- tion, what medicine has been administered. After salts, the eva- cuation always smells like rotten eggs; after drastic gums, they are thin and watery; after mercury, green; and after magnesia and rhubarb, generally sour, &c. When we inquire into the causes which produce this purging, we find that all poisonous substances have a similar effect, and that for this reason we may 310 CHAPTER X. class the purgatives with propriety among the poisons. Some esteem them a real god-send, and imagine that these drugs have been created for this very purpose. It might as well be supposed, that the rattlesnake and the tiger are created to destroy us. But if we admit that these drugs are intended to be used as medicines, it is no reason, because we see them produced in great quantities, that we should make an excessive use of them. Viru- lent poisons, although given but in small portions, produce vomiting and purging, or injure the stomach; the less virulent poisons are called purgatives, merely because they do not kill immediately, but are generally rejected by the efforts of nature. Persons suffering from constipation, and seeking occasionally to be relieved, or suffering from other complaints connected with it, should tSke the remedies hereafter prescribed. At the same time care should be given to the manner of living; moderation in the use of meat, which must not be eaten three times a day, is to be observed; a free use of salted food is to be avoided, mastication attended to, especially if teeth have been lost, the food eaten to be well cut up, and a considerable quantity of vege- tables, fruit and bread to be taken with meat—soup be indulged in, tea avoided and all spirituous liquors and beer which contain narcotics; sour milk or buttermilk to be preferred,—despised as these things are, yet the cow gives us nothing more wholesome, both for children and grown persons. Persons habitually constipated should also always eat fruit at dinner, and dried fruit in preference, or'good ripe apples; instead of butter and cheese, they should use apple sauce or apple butter; they should not chew or smoke before meals, or should give up chewing altogether, which besides being a filthy habit, affects the saliva; finally, they should accustom themselves to drink a glass of water before going to bed. Among the domestic remedies nothing can be recommended, except from time to time an injection. Many persons are afraid if they get into the habit of using injections that they will be compelled to continue them; but there is no danger of this, if the medicines recommended are taken at the same time. The AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 311 injections used should consist of nothing but water, and not be employed too frequently. To accustom oneself to purgatives is infinitely worse. The leather injection tubes, which are sold at Rademacher & Sheek's Homoeopathic Pharmacy, 239 Arch St., Philadelphia, are preferable to the syringes. They should be filled with water before being introduced, and the water be allowed to enter by its own gravity, by lifting up the open end. For other precautions in giving injections, refer to " Piles." Injections, it is true, only relieve the patient for awhile, but in the mean time the cause may be removed by medicine, and the disease cured. Persons who have suffered a long time from constipation, which constantly returns, may sometimes be cured entirely by injections. For this purpose, let the water be as cold as it comes from the spring, about half a pint, or a coffee cup full at a time, and take the injection before going to bed in the evening. It should, if possible, be retained. Persons who continue this treatment for a week or two, frequently become quite regular in their bowels, if they live rationally at the same time. Those who suffer from piles must not have recourse to this remedy. Those who have no tube or syringe may take a pig's bladder. Introduce a cork into the natural opening, tie the bladder to the cork and bore a hole through the latter with a red hot nail, and through this bole fill the bladder with water; after this put into the hole a small tube, around which some tow has been wrapped, or a cigar-holder, or the end of a quill, of which the top has been cut off, then press all the air out of the bladder, and introduce the tube into the anus; gently press the bladder until a little more than half the water has been discharged. All other injec- tions and all admixtures are injurious, except fresh boiled milk, which is sometimes preferable for children. Another remedy is plenty of exercise, walking, particularly up hill, but without getting into a perspiration. Persons who are costive should be regular in attending to the calls of nature, the best time is in the morning before or after breakfast. 312 CHAPTER X. The following medicines, when properly selected, will greatly facilitate the cure. Nux vomica is most suitable for constipation occurring in per- sons of sedentary habits, and those accustomed to drinking ardent spirits; also for that which is occasioned by eating too great a variety of food at once; after a surfeit, or when the constipation is preceded by diarrhoea, or for suppressed diarrhoea, with want of appetite, disagreeable taste, the tongue coated, loathing, sick- ness of the stomach, tightness of the abdomen, pressure in that region, heat, stitches here and there, a feeling as of a weight, cutting pain in the lower part of the abdomen, heat particularly in the face, headache, disinclination to work, uneasy sleep, op- pressed breathing, irritability and frequent complaining. When accompanied by moroseness, taciturnity, and after eating too many cakes, rancid butter, &c, give Pulsatilla; when the pa- tient is irritable and feels chilly, give Bryonia. Bryonia is particularly useful in constipation occurring in warm weather, and in persons who suffer from rheumatism; give a dose in the morning, and one in the evening, and await the result for two or three days. Opium, when there is an inclination to evacuate, but a feeling as if the anus were closed; there is no regular pressure; some- times a sensation as if there were a load in the abdomen; throb- bing in the abdomen; pressure on the stomach; dry mouth, thirst, and want of appetite. It may be given from every three to six hours. Lycopodium is one of the most efficacious remedies in pro- tracted constipation, especially when there are ineffectual efforts to stool, or the evacuations are effected with great difficulty, and accompanied by a great deal of rumbling in the bowels and dis- tention of the abdomen. Platinum, when, after much straining, the faeces are evacuated in but small quantities; straining and itching in the anus; shud- dering over the whole body after every evacuation, accompanied by a feeling of weakness in the abdomen, with contraction, bear- AFFECTIONS OF TnE ALIMENTARY CANAL, ETC. 313 ing down, oppression of the stomach, and ineffectual efforts to throw up wind. Lachesis, for protracted costiveness, with a feeling of weight and oppression at the stomach, and ineffectual eructations. Mercurius vivus, against costiveness accompanied by a dis- agreeable taste in the mouth, with pain in the gums, the appe- tite unimpaired; if Mercurius vivus does not suffice, give Staphysagria. Nit rum muriaticum is of service in tedious cases, where the above remedies have failed, and there is no indication whatever to evacuate. For frequent disposition to go to stool, with inef- fectual efforts, give Sulphur. Inflammation of the Liver. It is usual to consider inflammation of the liver under two forms, the acute and the chronic, although the latter in many cases is the sequel of the former, yet the disease is frequently in its principal phenomena, chronic from the beginning. I. ACUTE INFLAMMATION OF THE LIVER. HEPATITIS ACUTA. This disease is of comparatively rare occurrence in temperate regions, whilst in tropical climates it is frequently met with. The principal symptoms of acute hepatitis are,—pain, acute and lancinating, or dull and heavy in the right hypochondrium, (to the right of the stomach under the " short ribs ") often ex- tending to the chest and shoulder of the same side; the pain in the right side is increased by pressure, coughing, inspiration and lying on the left side; and is relieved by lying on the affected side; the stools are ash or clay coloured; but generally the bowels are constipated; the'urine high coloured, and tinges the linen yellow, the skin and whites of the eyes are yellowish, there is commonly a high fever with a full bounding pulse and hot skin; thirst; bitter taste in the mouth, and yellow furred tongue, with vomiting, pain and tension in the epigastrium. Where the inflammation is seated in the convex surface of the liver, the pain is more acute and lancinating, and more increased 40 314 CHAPTER X. bv coughing, inspiration and pressure; on the contrary when the concave surface is more affected, the pain is deeper seated, and but little if at all augmented by pressure, and greatly in- creased by efforts at vomiting. The termination of acute inflammation of the liver may be in resolution, suppuration, or gangrene, or it may pass into the chronic form. When it terminates in resolution, the symptoms gradually disappear. When about to end in suppuration, the fever becomes hectic, and the patient complains of a feeling of increased weight in the region of the liver, the enlargement of the liver may be distinctly felt, and if the matter is about to make its way to the surface, a sense of fluctuation with pointing may be perceived. Unless the abscess is discharged externally through the walls of the abdomen, or through the stomach, colon, or air passages, the termination in suppuration is generally fatal. The termina- tion in gangrene is of rare occurrence, and always rapidly fatal; it may be recognized by the sudden cessation of the pain, sink- ing of the pulse, cold clammy sweats, coldness of the extremities, and rapid alteration of the features. The causes of hepatitis are exposure to excessive heat, hence it is much more frequently met with in torrid than in temperate climates; too free indulgence in stimulating food and drinks, dram drinkers are very liable to it; mechanical injuries are in temperate regions probably the most fruitful sources of it, as blows over the region of the liver, great efforts at lifting, falls from a height and penetrating wounds. Treatment.—Aconite, Chamomilla, Nux vomica, Mercurius vivus, Bryonia, China, Belladonna, and Lachesis, are the medi- cines most generally indicated in the treatment of acute hepatitis. Aconite will generally be required in the commencement of the treatment, especially if the fever is high, with hot skin, much thirst, and whitish furred tongue, accompanied by moaning, great restlessness, and dread of death; shooting pains in the region of the liver. It may be repeated every three hours. AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 315 Chamomilla, if the pains be of a dull pressive character, and are neither aggravated by pressure, by respiration, nor by move- ment, with a sense of pressure in the stomach, tension in the right hypochondria, oppression of the chest; yellowness of the skin; tongue coated yellow; bitter taste in the mouth, and paroxysms of anguish. Nux vomica, against shooting or pulsative pains with great tenderness of the region of the liver when touched; nausea or vomiting; bitter or sour taste; shortness of breath and sense of pressure under the ribs and in the epigastrium; pressive pain in the head; thirst; high coloured urine; giddiness and par- oxysms of anguish; constipation. Mercurius vivus is of great value in hepatitis, and especially after or in alternation with Belladonna, when the following symptoms are presented; pains under the ribs of a pressive character, which do not allow the patient to lie long on the right side; bitter taste in the mouth; want of appetite; thirst, con- tinued shivering, followed sometimes by clammy perspiration; yellowness of the skin and of the whites of the eyes; also in enlargement and induration (hardening) of the liver, or after the formation of abscesses. Lachesis is frequently suitable after Mercurius vivus. Belladonna, against pains in the region of the liver which extend to the chest and shoulders, particularly of the right side; swelling and tightness at the pit of the stomach; oppressed and anxious respiration; congestion to the head with giddiness, dimness of vision and occasional fainting; great thirst, anxiety, restlessness and sleeplessness. It is often suitable after or alter- nately with Aconite, or with Mercurius vivus and Lachesis. Lachesis will be serviceable in cases in which Mercurius vivus and Belladonna appear to be indicated, but only afford partial relief; and also in obstinate chronic cases occurring in drunkards. Bryonia, when the pains are pressive, with a feeling of ten- sion in the region of the liver; pains aggravated by respiration, couo-hintf and movement; violent oppression of the chest, with 316 CHAPTER X. rapid and anxious respiration; thick yellowish coating on the tongue; constipation. China, when the disease partakes somewhat of a periodic character, and is worse every other day, with shooting and pres- sive pains in the region of the liver; swelling and hardness of the hypochondria and epigastrium; pressive pain in the head; tongue thickly coated, yellowish, and bitter taste in the mouth. Sulphur will be serviceable after any of the preceding reme- dies, when they fail to produce a favourable effect, or when the improvement is but temporary and the disease still continues, though diminished in violence. It is particularly valuable after Nux vomica, to complete the cure. All the foregoing remedies may be administered either by putting two or three globules on the tongue, or by dissolving ten or twelve globules in half a tumbler of water and giving a teaspoonful of the solution at a time, and repeating it every three to six hours according to symptoms. II. CHRONIC INFLAMMATION OF THE LIVER. HEPATITIS CHRONICA. The symptoms of chronic hepatitis differ rather in degree than in kind from those of the acute form. The pain in the right side under the ribs is of a dull heavy character, and is increased by pressure, by shaking of the body, or by lying on the left side : sometimes it is only felt under these circumstances. These symptoms are usually attended with more or less fever, which is frequently worse toward evening. The skin and whites of the eyes are more or less yellow; the stools white or clay coloured, and the urine brown or yellow, depositing a copious sediment. After the disease has existed for some time, by pressing on the abdomen, the liver may be felt extending beneath the short ribs of the right side, and towards the pit of the stomach; frequently the right side is observed to be more distended than the rest of the abdomen. In addition to these symptoms there is generally some derangement of the digestive functions, as loss of appetite; nausea and vomiting; yellow furred tongue and constipation, or AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 317 at times diarrhoea. Chronic hepatitis may, however, exist with but few of the symptoms enumerated—or indeed without any of them being present. The pain in the right side may be the only symptom, or in some cases nothing but great itching of the skin may lead to a suspicion of its presence. The causes are chiefly the same as those of acute hepatitis; the most frequent are intemperance in the use of intoxicating drinks and abuse of mercurial preparations. Treatment.—The best medicines are : Nux vomica and Sul- phur, or in some cases Aurum, Lachesis, Alumina, Lycopodium, Calcarea, China and Silicea. Nux vomica is the remedy which will in most cases be re- quired in the commencement. It should be given once a day in the evening for a few days, and then wait a week or more for the effect. Sulphur may follow Nux vomica with advantage, ad- ministered once a day—in the morning. The particular indica- tions for the use of these medicines will be found under "Acute Inflammation of the Liver." Aurum, Lycopodium, Calcarea, and the other remedies men- tioned, are useful in particular cases. Jaundice. Icterus. An attack of jaundice is generally preceded by loss of appe- tite, giddiness, nausea, and sometimes vomiting, flatulence and tension in the region of the liver and pit of the stomach, with yellow coated tongue. There is usually, too, more or less lassi- tude and depression of spirits. These symptoms are followed, after continuing for a longer or shorter time, by yellowness of the eyes and skin; the urine is usually hot, burning and very high coloured, sometimes of a greenish hue, and discolouring the linen; the stools are clay-coloured and the bowels mostly con- stipated. A feeling of uneasiness is generally experienced at the pit of the stomach, and when pressure is made on that region, there is often some degree of pain felt. There is commonly but little fever in the mild forms of this disease, but in bad cases the febrile excitement may be high, 318 CHAPTER X. and the brain become more or less affected, which is always a serious complication, and especially so when coma (drowsiness, great difficulty in being roused) takes place. Cases in which this symptom is presented but rarely recover, and death may take place in a few hours from oppression of the brain. The colour of the skin sometimes changes from a citron to a dark brown or black, which has given rise to the name of black jaundice, applied in some cases. Generally, too, before the dis- colouration of the skin appears, there is a disagreeable itching or tingling of the whole surface. The disease, when arising from a moral cause, sometimes comes on almost instantaneously, usually however its approach is gradual and often insidious. The causes of jaundice are numerous; it may occur in the course of hepatitis either acute or chronic, or in diseases of the stomach and bowels, fevers, &c. Blows on the region of the liver, and even on the head, may be exciting causes; and also moral emotions, as a sudden fit of passion. Frequently, too, abuse of drugs, as mercury, quinine, rhubarb, give rise to it. Treatment.—Chamomilla, Mercurius vivus, Sulphur, La- chesis, Hepar, China, and Nux vomica, are the chief remedies. Mercurius vivus will of itself be sufficient to cure the majority of cases of jaundice, if the patient has not already been subjected to an abuse of this drug, in that event China will be preferable, which may be followed in obstinate cases by Hepar, Sulphur, or Lachesis. China may advantageously follow Mercurius vivus when the latter remedy is insufficient; or the two may be given in alter- nation. Chamomilla will be preferable for attacks arising from a fit of passion. It may be followed or alternated with Nux vomica. Sulphur and Lachesis will be most suitable for very irritable persons, in whom the symptoms of jaundice manifest themselves upon every trifling occasion. Jaundice produced by abuse of mercury may be combated by China and Hepar, or Lachesis and Sulphur.—That arising from AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 319 abuse of cinchona by Mercurius vivus, or Belladonna, Calcarea, Nux vomica, and that caused by rhubarb, by Chamomilla or Mercurius vivus. Inflammation of the Kidney. Nephritis. This affection is generally known by the following symptoms: a dull heavy pain or weight is experienced on one side in the region of the loins—when one kidney only is implicated. This is fol- lowed sooner or later by an acute pungent or lacerating and deep seated pain, which is accompanied by a sensation of internal heat. The pain frequently extends from the loins along the ureters to the bladder and testicle of the affected side, and often to the groin and thigh, where it gives rise to a numbness or pecu- liar tremulous motion. The testicle is also usually retracted. The pain is aggravated by respiration, by making a quick or false step, or by any kind of shock, and by pressure. In most cases the urine is scanty and high coloured during the first few days; sometimes bloody; and it may be altogether suppressed when both kidneys are affected. In other cases, however, it is clear, watery, and deposits a whitish sediment. The pain is at times intermitting or remitting in its character; when this is the case, and small grains of sand or gravel are found in the urine, the disease is probably caused by a calculus in the kidney. These symptoms are accompanied by more or less fever, and generally also by nausea and vomiting, and often by an uneasy sensation in the abdomen with flatulence, and frequently by diarrhoea. Nephritis commonly ends by resolution; occasionally, how- ever, it ends in suppuration. When this is the case, the pain becomes dull and heavy; the pulse soft and full; there is alter- nate chilliness and fever, followed by sweats; and when, in ad- dition to these symptoms, pus is observed in the urine, there is no doubt of the existence of suppuration. The most frequent causes of nephritis are : blows on the lum- bar region; violent exercise, as dancing, riding on horseback or in a rough carriage without springs; the use of drugs which act 320 CHAPTER X. as irritants to the kidney, such as cantharides, oil of savin, oil of turpentine, &c.; the presence of calculi in the kidney, espe- cially such as are pointed; and it is not unusual to meet with it either preceding or following an attack of rheumatism or gout. The inflammation may also extend to the kidneys from the blad- der or urethra. Treatment.—Aconite, Cantharides, Cannabis, Nux vomica, Pulsatilla, Arnica, Hepar sulphuris, Mercurius vivus, and Sulphur, are the chief remedies in this disease. Aconite will be indicated in the commencement of this affec- tion to combat the inflammatory symptoms. It may be given every one to three hours, according to the violence of the symp- toms, and continued until the fever is abated. Cantharides will most generally be the preferable remedy after Aconite, and especially when the following symptoms are present: difficult and very painful urination, sometimes mixed with blood; burning pain in the urethra; the urine passes in drops; inability to pass the urine; pains of a shooting, cutting or tearing character in the loins and regions of the kidney. It may be repeated every one, two or three hours until relief is obtained, or one of the following remedies appear to be more suitable. Cannabis, when cantharides have been insufficient and the pain is more of a dragging nature, or when it shoots along the ureters,—from the region of the kidney down toward the groin. Nux vomica will be valuable when the disease occurs in per- sons of plethoric habit, who are addicted to too great indulgence in wine and other stimulants; also in persons of sedentary habits, especially if it arise from suppressed hemorrhoids, and there is constipation, nausea or vomiting, sense of faintness, distension of the abdomen, &c. Pulsatilla, in persons of a mild disposition, and especially in females, when the nephritis arises from irregularity or suppres- sion of the menstrual function. Belladonna may be given when the pains extend from the kidney to the bladder and are of a shooting character; and when AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 321 the urine is scanty, of a bright red or yellowish colour, and deposits a red or whitish thick sediment, accompanied by heat and swelling in the region of the kidney and sometimes by colic; also anxiety, restlessness, and periodical aggravation. Arnica, in all cases of nephritis arising from blows, violent concussion of the body or any kind of external violence. It may be taken internally in pellets, and also applied externally in the form of a lotion. Hepar sulphuris and Mercurius vivus are chiefly serviceable in cases where the disease has gone on to suppuration, or to the formation of an abscess, which may generally be known by the following symptoms; alleviation or cessation of the pain; a sen- sation of throbbing in the region of the kidney; a feeling of weight in the loins; alternate chilliness and heat followed by profuse sweats. The Hepar should be administered by dis- solving a grain of the third trituration in a tumbler \ full of water, and giving a teaspoonful of the solution every three or four hours. Unless Hepar speedily produce a decided improve- ment, it may be followed by Mercurius vivus, administered in the same manner, except that the globules instead of the tritura- tion are to be used. These two remedies may be in some cases taken alternally with advantage. Sulphur will be useful in protracted cases of acute nephritis, in which the remedies given have produced but partial relief, and also in the chronic forms of the disease—when the symp- toms are less violent in their character. Nephritis arising from abuse of cantharides in blistering, will be relieved by the use of camphor. A drop or two of the tinc- ture on a lump of sugar may be taken three or four times a day. Inflammation of the Bladder. Cystitis. In this disease there is generally at first some degree of pain experienced in the region of the bladder—the lower and anterior part of the abdomen,—which is increased by pressure, moving the body, the contraction of the abdominal muscles, sneezing, coughing, evacuating the bowels, and by efforts to pass the urine. 41 322 CHAPTER X. More or less tension and swelling of the lower part of the abdomen is also perceptible. There is constant desire to pass the urine and the effort is always extremely painful and ineffectual —but a few drops passing at a time and with great suffering to the patient; sometimes the efforts are entirely ineffectual. The passage of the smallest drop is attended by a sensation of great heat and burning. The bladder gradually becomes distended; the tumour above the pubes is manifest, and very painful to the touch; the pain also extends to the kidneys, perineum, rectum, and often over the whole abdomen. In the commencement of the disease the urine does not differ materially from its usual condition; after a few days, however, it becomes thick, or muddy and reddish, and deposits a quantity of ropy mucus, similar to white of egg. There is usually more or less febrile excitement, which in severe cases is indicated by heat and dryness of the skin, dryness of the mouth, nausea, vomiting, with frequent pulse at first hard, afterward small and contracted. In some cases, instead of the skin being dry, there is profuse sweats having a urinous odour. Cystitis, like nephritis, may terminate by resolution or by suppuration. In the latter case pus may form in the walls of the bladder and be discharged in the abdomen, producing fatal peritonitis; or it may penetrate the intestines, rectum or uterus. The most favourable termination is by the interior of the bladder. Cystitis, like other active inflammations, may be caused by cold; though it is more frequently owing to mechanical or chemical irritants affecting the bladder either directly or in- directly. The operation for stone; the long continued use of the ca- theter ; falls or blows on the bladder, and also protracted and difficult labours may all give rise to inflammation of the bladder. The frequent employment of drugs which affect the urinary organs, especially cantharides, is one of the most common causes of this disease. The presence of calculi in the bladder may also produce it. Occasionally, too, it occurs in the course of an attack of gout or rheumatism, by translation. AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 323 Treatment.—The following remedies are the most useful in the treatment of cystitis : Aconite, Cantharides, Pulsatilla, Nux vomica, Sulphur, Calcarea carb., Hyoscyamus, Digitalis, Carbo vegetabilis, Dulcamara and Arnica. Aconite will have the preference in the inflammatory symp- toms of this affection, and, as in nephritis, should generally be followed by Cantharides, which will generally be found to be productive of great benefit in all cases not arising from the abuse of this drug by blistering or otherwise. Pulsatilla is one of the most serviceable remedies in this com- plaint, especially when occurring in persons of lymphatic tem- perament, and attended by the following symptoms; 'frequent desire to urinate, with painful and scanty discharge of slimy or bloody urine, which deposits a mucous or purulent sediment; cutting pains and burning in the region of the bladder, with external heat and swelling; sometimes suppression of urine. Nux vomica, when occurring in consequence of suppressed hemorrhoids, or in persons addicted to the use of spirituous liquors. Sulphur and Calcarea will follow the last mentioned remedy advantageously; and will also be useful in the treatment of the chronic form of the disease. Hyoscyamus, when the difficult urination appears to arise more from spasms of the neck of the bladder than from acute inflam- mation of the organ. Digitalis is valuable in cases of difficult and painful urination, especially when the pain is of a constrictive character. Carbo vegetabilis and Arsenicum are useful in obstinate cases to allay the irritation and burning in the urethra during urination. Arnica, when the disease arises from mechanical injury. Dulcamara, when it returns on the slightest exposure to cold. When the disease is induced by the abuse of cantharides, by blistering, &c, Camphor is the best remedy given as directed in the preceding article, " Nephritis". 324 CHAPTER X. Irritability of the Bladder. This distressing affection, although it may occur at all ages, is most commonly met with in old persons. There is generally pain in the region of the bladder, which shoots in various direc- tions to the back, anus, thighs, and along the urethra. This is aggravated by the presence of urine in the bladder, and the patient is called upon several times through the night, and more frequently during the day, to evacuate the urine, which is mostly accomplished with great pain and difficulty, and usually drop by drop. The urine at first may not present any unusual appear- ance, but after a time it may become mixed with mucus or pus, or, if the disease extends to the kidneys, a copious precipitate of sand or gravel may be thrown down. When the disease con- tinues for some time, the general health of the patient suffers under the constant irritation; the appetite becomes impaired; the spirits depressed, and all the functions more or less dis- ordered, resulting in general emaciation. Occasionally the pain is acute, with a sense of constriction in the region of the bladder, which sometimes extends along the course of the urethra; with hard and round contraction of the bladder, retention of urine, frequent urgent calls to evacuate the rectum, often attended with prolapsus of the bowel; great anxiety, restlessness, and clammy perspiration, but without fever, or soreness on pressing the region of the bladder. The disease may end fatally in suppression of urine, if not checked by appropriate means. Besides the causes mentioned under "Inflammation of the Kidney and Bladder", irritability of the bladder may arise from spinal irritation and disease of the prostate gland. Treatment.—The best medicines against this affection are : Aconite, Belladonna, Camphora, Cannabis, Cantharides, Colo- cynthis, Colchicum, Dulcamara, Hepar, Mercurius, Nux vomica, Pulsatilla, Sulphur, or in some cases Arsenicum, Ar- nica, Calcarea, Conium, Digitalis, Hyoscyamus, Lycopodium. Examine the symptoms under the two preceding articles for the particular application of most of the remedies. The dis- AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 325 ease, however, will in the majority of instances, require a course of treatment under the direction of a physician. Urinary Calculus. Stone or Gravel. Calculus concretions are mostly formed originally in the kidneys, from whence they pass along the ureters into the blad- der, and, when too large to be discharged with the urine, remain in that organ and serve as nuclei for other depositions of a similar character. The foundation for stone may, however, be laid by extraneous substances lodged in the bladder. A portion of thickened mucus, a drop of blood, a piece of catheter or bougie, &c, has often produced the disease. The form, size, colour, consistence and chemical composition of urinary calculi are exceedingly various. Some are rough on the surface, others quite smooth; most of them are of oval shape, a few round, and others are oblong or angular. In size they vary very much, being met with from the size of a pea to that of a cocoa-nut. The colour of calculi differs as much as their size and form; they are sometimes almost as white as chalk, at others red, or of a deep chocolate colour, and again of a yellowish brown tint. The latter variety is most commonly met with. In consistence, also, there is the greatest variation, for while some are almost hard enough to resist the stroke of a hammer, others crumble into dust at the slightest touch. Urinary calculi may be contained in the kidney, ureter, blad- der, prostate gland or urethra; but the bladder is their most common receptacle. Usually they lie loose in the most dependent part of that organ. Occasionally they are contained in cysts formed between the coats of the bladder at the termination of the ureters, or between the folds of a contracted bladder. The bladder may contain a single stone or a great number. Several hundreds have been taken from the bladder of a single individual. The disease is in many instances hereditary. A stone may sometimes be contained in the kidney and attain 326 CHAPTER X. a large size without subjecting the patient to much incon- venience ; at other times its presence gives rise to so much irri- tation, as to produce suppuration of that gland. The most excruciating pain is caused, in most instances, by the passage of a calculus along the ureter; the patient has frequent desire to make water, and can pass but a few drops at a time, and these mostly very high coloured and sometimes mixed with blood. The pain is at times so severe that the patient finds it impossible to leave the bed, and, in order to obtain temporary relief, is obliged to bend himself double. There is commonly more or less fever, eructation, nausea, vomiting, and retraction of the testicle. These symptoms subside as soon as the stone drops into the bladder. Sometimes there is an intermission of the pain for a few hours before the stone leaves the ureter followed by a relapse. This may occur repeatedly. The presence of a stone in the bladder, unless it be encysted, always gives rise to more or less uneasiness. One of the first symptoms of stone is a frequent desire to pass urine, and severe pain upon passing the last drops of it. Itching of the glans penis (and of the penis) is also a common symptom at the commencement of the disease, and in order to relieve which the patient gets into the habit of pulling the prepuce. Another symptom is the sudden stoppage of the stream of urine. This is owing to the stone being carried to the inner orifice of the urethra, and blocking it up. A proof of which is that by change of position of the patient, by lying down or otherwise, the urine flows again. After these symptoms have continued for some time, the patient becomes troubled with tenesmus and prolapsus of the rectum, induced by the constant straining to evacuate the bladder. Frequently when the stone is rough, there is a good deal of fetid mucus discharged along with the urine, which is occasionally mixed with blood. The causes of stone are obscure; it occurs most frequently in cold, moist and variable climates, and in persons who are subject to dyspeptic affections. As previously mentioned, certain families appear to be peculiarly liable to it. AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 327 Treatment.—In the management of this disease the following remedies will be most efficient: Calcarea, Cannabis, Nux vomica, Phosphorus, Cantharides, Acidum nitricum, Lyco- podium and Sarsaparilla. For calculus in the kidney, Lycopodium and Sarsaparilla have been used with most success. Against calculus in the bladder, Cannabis, Sarsaparilla and Nux vomica have been administered most successfully. The preceding articles "Nephritis" and "Cystitis" should also be examined with reference to the particular indications for the choice of the medicines. Immersing the whole body in a warm bath is a beneficial pal- liative remedy during a "fit of the gravel". Relief may also be obtained in some cases by the administration of spirits of t tur- pentine. Calcarea, Nux vomica, Lycopodium and Sarsaparilla may be given with advantage to persons who are predisposed to this complaint. And in all such cases the diet should be carefully regulated; the food should be of the plainest kind, and spiri- tuous liquors and everything of a stimulating nature scrupu- lously avoided. Discharge from the Urethra. This disease varies much; sometimes it is very trifling, at others of a most dangerous character; sometimes it is produced in the husband by a common leucorrhoea in the wife. We shall here give directions how the more violent kinds can be mitigated, and the milder ones cured, that every one may, as much as pos- sible, be preserved from the horrid treatment to which he ex- poses himself when applying to a common physician—or from the danger which he incurs by trying to cure himself with the common remedies. By improper treatment I have frequently seen an insignificant disease changed to a tedious, painful, and sometimesN incurable malady; and every one ought to be ac- quainted with the horrible consequences of suppressing such a complaint—the result of infection—by strong remedies. 328 CHAPTER X. The patient should be as strict in his diet as in urinary com- plaints—should alleviate the pains by injections into the anus, not into the urethra, these latter generally proving injurious; the penis may be bathed in warm olive oil, or be wrapped in rags which have been dipped in good fresh olive oil. The com- mon remedies, balsam copaiva and cubebs, frequently do much injury, but do not cure, merely because they are given in too great quantities. The patient may, after infection, spread balsam of copaiva of the size of a pea, on the sole of the foot, and draw his stocking over it; or when the complaint is attended with too much inclination to make water, a few leaves of parsley may be placed on the sole of the foot; in tedious cases, a teaspoonful of cubebs may be applied in the same manner. To swallow these things in large quantities is unwise, for the quantity can never effect a cure; and if it does check the discharge, the balsam of copaiva generally produces disease of the lungs, and the cubebs, diseases of the stomach; besides, the effect of these remedies, when applied to the sole of the foot, is much more rapid than through the stomach. If this does not cure it, or when nothing has been adminis- tered, a couple of globules of Aconite will generally relieve the most violent pains—after which Mercurius vivus, if required, may be given for two or three successive mornings; when the pain has subsided, Sulphur, given once or twice a day, generally removes the remaining symptoms in from eight to ten days. Mercurius vivus should be given for very violent burning pain, with a purulent discharge of a greenish color. Capsicum, if the discharge is white, resembling rich milk, particularly when the voiding of urine is accompanied by a scalding pain, and when at other times there is a cutting and pricking pain. Pulsatilla, when the pain is more drawing and pressing, or con- tracting, with difficulty in voiding urine; in tedious cases Nux vomica will frequently remove the remaining symptoms; some- times when the discharge continues to resemble milk, Ferrum met. will be beneficial. In protracted cases, Sepia and Natrum AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 329 muriaticum may be given alternately once or twice a week. When the discharge has been caused by an acrid leucorrhoea in the wife, without any venereal infection, give Natrum muria- ticum ; it must be taken in the evening and morning, by both husband and wife, and the medicine be allowed to operate for a couple of weeks. Discharge of blood from the urethra, when caused by inflam- mation of the kidney or bladder, or by calculus, will require in its treatment the remedies recommended in those complaints. If the result of external violence, Arnica and Aconite will be most appropriate; if in consequence of the use of intoxicating drinks, Nux vomica, and if it be the result of debility produced by a continued course of dissipation, by loss of fluids, &c, China. For a burning pain at the extremity of the urethra, accom- panied by spasmodic retraction of the scrotum, and spasmodic pains in the thighs and knees extending up to the lateral regions of the abdomen, with contracting and cutting pains in the small of the back and in the navel, give Pulsatilla. Affections of the Penis. For swelling, redness and pains of the prepuce, when caused by external injury, such as friction, pressure, &c, give first Aconite, and after some hours Arnica, or these remedies may be taken alternately every three to six hours, Rhus tox. will often be found serviceable, hi Aconite and Arnica are insufficient. Against soreness of the penis caused by want of cleanliness, Aconite followed by Mercurius vivus is most efficient. Small children sometimes are subject to affections of the penis; to these give the same medicines. If the patient has touched poisonous plants, and has afterward put his hands to these parts, give Bryonia and Belladonna; sometimes they may be given with advantage alternately with Aconite. If the symptoms have been produced by the plant called Poison vine, give alternately Hepar and Belladonna, every three or four hours a dose. When purulent matter is discharged from the urethra, give Mercurius vivus, and if this does not alleviate the scalding sensation, Cap- 42 330 CHAPTER X. sicum • if after several days there still remains some discharge, give Hepar ; if parts of the skin remain indurated, give Lache- sis twice; if the complaint is very bad, and bluish spots appear here and there, give Arsenicum once or twice. To small children give Calcarea a couple of times when Aconite and Mercurius vivus do not suffice. For swollen and painful testicles when produced by a blow, a fall, &c, give Aconite and Arnica alternately; when the result of suppressed gonorrhoea, Pulsatilla, and sometimes also Mercurius vivus; when caused by a translation of mumps, refer to that disease; when attended by a squeezing, jamming, strain- ing pain, with violent shooting pains extending toward the abdomen, give Spongia; when the pain is more oppressive, and is shooting and scalding, give Staphysagria; when caused by abuse of calomel, give the remedies prescribed unter " Poisoning by Mercury". If it continues for any length of time, take Sul- phur, and consult a homoeopathic physician. Hernia. Rupture. By hernia is understood the protrusion of any of the abdom- inal viscera, covered by the peritoneum, through natural or pre- ternatural openings in the parieties of the abdomen. Hernia is a very common disease. It is divided into several varieties, designated according to the situation it happens to occupy. Most commonly it makes its appearance in the groin, the navel, the scrotum and the upper and interior part of the thigh. The causes of hernia are numerous. It may be produced by severe exercise on horseback or on foot, by lifting heavy weights, playing on wind instruments, vomiting, costiveness, the hooping cough, crying, tight clothing, parturition, jumping, &c. Frequently hereditary conformation, or preternatural laxity of the abdominal openings are predisposing causes. Treatment.—This complaint may, in most cases, be cured by internal remedies, when it has not been neglected too long; the physicians of the old school deny this—and they are perfectly AFFECTIONS OF THE ALIMENTARY CANAL, ETC. 331 correct when they speak of their own medicines. Trusses have been greatly improved in this country, but bad articles are still common. It is of great importance to get a good truss for a bad one may do great injury; if it does not fit exactly, or if it slips, it may make the rupture incurable. A good truss must not be troublesome, although in the beginning it may feel rather un- comfortable ; it must not be applied until the hernia has been entirely reduced, when the truss ought to keep it in its position. If the patient perceives, after the instrument has been applied, that something protrudes, let him take it off, lie down upon his back, reduce the hernia again, and replace the truss. When the hernia protrudes frequently, the truss is good for nothing. A person afflicted with hernia who does not wear a truss, or who wears a bad one—who exerts himself afterwards too much, or is otherwise imprudent, exposes himself to the danger of having incarcerated or strangulated hernia, and mortification. It is also of great importance to know how a hernia should be reduced. In order to accomplish this properly, the patient should lie down on his back, and place a pillow under the hips, so that the ruptured part may be higher than the rest of the abdomen— he should then incline a little to the side on which the rupture appears, to relax the abdominal muscles as much as possible. Another person can reduce the hernia better, but many can do it for themselves; it is best done by pressing the left hand softly against the part which protrudes, as if for the purpose of grasp- ing it; after this, press the fingers of the right hand on the top, and then rub it softly, by passing the fingers over it; place the flat of the hand from time to time on it, and gradually in- crease the pressure; continue these efforts patiently for half an hour or longer, if the hernia is considerable. The worst kind of strangulated hernia can generally be reduced with facility, after the proper remedies have been taken, particularly Aconite or Nux vomica. When the hernia will not bear pressure, medicine must first be taken to remove the irritability—after which it frequently returns of itself. In some cases, placing a rag dipped in warm water upon the tumour will effect the reduction. Some 332 CHAPTER X. persons apply cold water or ice in a calf's bladder, but this should not be kept on long, and should not be used at all when the parts are hot and red. For violent burning pain in the belly, as from red-hot coals, the least touch giving pain, with sickness of the stomach, bitter bilious vomiting, nervousness and cold perspiration, give Aconite, which may be repeated if the pain returns again. In case Aconite only alleviates the symptoms for a short time, without any other good effect, dissolve a few globules of Veratrum in a wine-glass full of water, and give every two hours a teaspoon full, but do not repeat it oftener than three times. If after this the efforts to reduce it should fail, give Sulphur, which should also be given in the beginning, if the vomiting be sour instead of bitter; leave the patient to rest awhile, and if he falls asleep do not disturb him. If the pain is less violent when the parts are touched, and the vomiting lessened, but the breathing is attended by much diffi- culty ; when taking cold, or overheating, vexation of mind, or improper diet is the cause, give Nux vomica; if there is no improvement in two hours, give it again; when the patient becomes red in the face, when the abdomen is distended, or when bad smelling eructations and vomiting occur, give Opium every quarter of an hour until there is a change; if the vomiting is accompanied by cold sweat, or if the extremities become cold, give Veratrum; and if it does not improve after giving it twice, give Belladonna. As soon as the abdomen becomes sensitive, and cannot endure to be touched without pain, give Aconite and Sulphur, as above. When the rupture has already assumed a bad appearance—when the symptoms are very alarming, and no physician can be had, give Lachesis, and if this gives relief repeat it as often as the symptoms get worse again; if, after a couple of hours, there is no improvement, give Arsenicum, a few globules dissolved in six or eight teasponsful of water, every four hours a teaspoonful. In all cases of strangulated hernia, a physician should im- mediately be sent for, but the above remedies must be taken in the meanwhile; if they prove efficacious before he arrives, so DISEASES OF WOMEN. 333 much the better; if not, the doctor will perform the necessary operation, which he will find to be much easier after the patient has taken the above medicine, as numerous experiments have proved. If he asserts that the effect of the medicine has been injurious, and that he cannot now succeed as well as he might have done if the medicines had not been given, he says what is not true, and is ignorant or prejudiced, and is to be distrusted. CHAPTER XI. DISEASES OF WOMEN. Menstruation. Menstruation is often delayed beyond the period at which we have reason to expect it in healthy females, or when it does appear, is frequently preceded by much suffering, and followed by hysterics and other complaints. These complaints are gene- rally produced by diseases which existed previously, and can only be cured by the continued attendance of a homoeopathic physician. Affections of this class frequently find their origin and support in the mode of living; we can often trace them to insufficiency of clothing, which, especially in a climate like ours, is very injurious; many of the attendant complaints arise from other causes, which medicine alone can remove. The age at which this function first makes its appearance in temperate climates is about the fifteenth year; though in some instances it occurs at a much earliar age, and in others again it is protracted several years later. In warm climates it generally appears as early as the ninth or tenth year, and in cold ones not often earlier than the twentieth. The average duration of a menstrual period is about five days; it varies considerably, however, in different individuals, in some continuing for seven or eight days, and in others not more than 334 CHAPTER XI. two or three. It generally returns regularly in healthy females every twenty-eight days, and usually continues until about the forty-fifth year, when its final cessation takes place, and which is usually attended with a good deal of disturbance of the gene- ral health as well as of irregularity of this function; hence thia period of life has been called the "dodging period" or "change of life". Tardy Menstruation. When menstruation is tardy, weak, or too late in making its appearance, beware of all quack medicines which pretend to induce the discharge; numbers of females have ruined their health forever by using such medicines. In many cases a proper attention to diet, exercise and clothing is all that is necessary to produce a health state of this function. Females subject to menstrual irregularities should carefully avoid all highly seasoned food, and also coffee, green tea, and all spirituous and malt liquors as beverages. Those of sedentary habits should accustom themselves to daily exercise in the open air, either by walking or riding. Sedentary habits and close application to study are both highly injurious. The clothing should be warm, adapted to the season, and changed to suit the variations of tempera- ture. It is of the greatest importance to keep the feet dry and warm by wearing thick soled shoes and warm stockings, espe- cially in wet or damp weather. The neglect of this precaution has destroyed the health and happiness of hundreds. A cheerful disposition should also be cultivated, as all depressing mental and moral emotions have an injurious tendency. There are cases however, in which, in addition to the observ- ance of the above dietetic rules, it will be necessary to make use of one or more of the following remedies, which can be admin- istered without injury; if they fail to effect the desired object, apply to a homoeopathic physician. Pulsatilla, Sulphur, Cocculus, Veratrum, Bryonia, Bella- donna, Lachesis, Lycopodium, Phosphorus, Arsenicum and Sepia. DISEASES OF WOMEN. 335 Pulsatilla will be in the majority of instances the most ap- propriate remedy with which to begin the treatment. It is espe- cially adapted to females of a mild, easy disposition. The fol- lowing are the chief symptoms which guide us to its selection; pain in the lower part of the abdomen and across the small of the back; giddiness, fullness about the head and eyes, paleness of the face with occasional flushes of heat; roaring in the ears, or partial deafness, coldness of the hands and feet, and disposi- tion to general coldness; sour taste in the mouth after eating; nausea and vomiting; alternate crying and laughter; sadness and melancholy; soreness of the breast; palpitation of the heart, especially on going up stairs; loss of appetite, with desire for acids and disinclination to exercise. The symptoms are generally worse in the afternoon and before midnight, and frequently change from one place to another; better in the open air and while exercising. It may be admin- istered either dry or in water once a day for two or three days in succession, and if not followed by some improvement after waiting a week, succeeded by Sulphur. Cocculus, given two or three times a week, will prove bene. ficial when the patient suffers from a complication of nervous symptoms, or against contracting, pinching pain in the lower part of the abdomen, with oppressed respiration; and also against a scanty discharge of black blood, or when the patient is ex- ceedingly weak, with great agitation, sighing or groaning, and is scarcely able to speak. Belladonna, if there be determination of blood to the head with redness, sometimes approaching to blackness of the face; bleeding at the nose; redness of the eyes and intolerance of light; giddiness, especially after stooping, and full, bounding pulse. Advantage will derive in some cases by giving Aconite alternately with Belladonna. Bryonia is indicated when, instead of menstruation, there is bleeding at the nose. It should be given two mornings in suc- cession. Lachesis and Lycopodium are also suitable in similar cases. 336 CHAPTER XI. Cuprum is appropriate in cases of spasms, or threatened spasms, with nausea and vomiting, or when there is cramps in the extremities, with screaming; also in convulsions. Phosphorus will be serviceable in females of a delicate con- stitution, with slight form, weak chest, of lively disposition, and predisposed to lung diseases; when in place of menstruation expectoration of blood in small quantities occurs, with hacking cough and pains in the chest, it should be given two or three times a week. Arsenicum is applicable in cases attended with great weakness, also in swelling of the face, especially round the eyes with pale- ness of the complexion, more particularly in the morning; swelling of the feet and ankles in the evening, and a feeling of heat or burning in the veins. Veratrum will be useful when the patient has cold hands and feet, disposition to diarrhoea, &c. Sulphur will be especially valuable after Pulsatilla, when the latter has been insufficient, and also after any of the above remedies, especially if the patient complain of heat in the head, giddiness, palpitation of the heart, and shortness of breath, par- ticularly on going up stairs; loss of appetite; sick stomach after eating; emaciation and depression of mind. Suppression of the Menses. Amenorrhcea. By this term is understood the sudden stoppage of the men- strual flow. This is frequently consequent upon some accidental cause, such as exposure to cold or dampness without a sufficiency of clothing, particularly of the feet; putting the feet in cold water; powerful mental emotions, &c. It also often occurs in the course of other diseases, especially those of the lungs, liver, and uterus, in rheumatism, &c. In these latter instances the dif- ficulty can only be removed by the cure of the primary disease. The appropriate treatment of which will be found under their respective heads. Treatment.—The medicines which are chiefly valuable in sudden suppression from cold, &c, are : Aconite, Belladonna, DISEASES OF WOMEN. 337 Bryonia, Pulsatilla, Dulcamara, Sepia, Sulphur, Lycopo- dium, Opium, Veratrum, Platinum, Graphites, China, Cau- sticum, and Kali carbonicum. Aconite will have the preference when the affection arises from fright, and especially if there be congestion of blood to the head or chest, with redness of the face; giddiness, sick stomach or faintness; throbbing or acute shooting pains in the head, sometimes attended by delirium or stupor. When the suppres- sion is occasioned by fright, this remedy should be administered immediately, and if not speedily followed by relief, or if the amelioration be but partial or temporary, it may be succeeded with benefit by Lycopodium, Opium or Veratrum. Bryonia is most suitable for unmarried females, and will be indicated when the suppression is followed by a sensation of swimming in the head, with heaviness and pressure toward the forehead, aggravated by stooping and by motion; pains in the chest; dry cough ; bleeding at the nose; bitter or sour eructa- tions ; pain in the pit of the stomach after eating; rising of food; pains in the small of the back, and also pains of a drawing char- acter in the lower part of the abdomen; constipation. Belladonna will be serviceable after or alternately with Aco- nite in plethoric subjects, when there is congestion to the head, bleeding at the nose, and for most of the symptoms mentioned under Aconite when the latter is insufficient. Pulsatilla, however, is the chief remedy in this affection, and will afford relief in the majority of instances, especially when the suppression results from the effects of cold or chill by ex- posure to dampness, and the patient suffers from headache chiefly confined to one side, with shooting pains extending to the face, ears and teeth; palpitation of the heart; feeling of suffocation; flashes of heat; nausea or vomiting; disposition to diarrhoea; pressure in the lower part of the abdomen; frequent desire to void urine, and leucorrhoea. It is best adapted to females of a mild, easy disposition, with inclination to melancholy and tears. Sepia is also a valuable remedy, in this disease, particularly in women of a delicate constitution; the suppression attended by 43 338 CHAPTER XI. sallow complexion or yellowish spots on the face; nervous head- ache worse in the morning; giddiness; toothache; disposition to melancholy and sadness; great liability to catarrhs, especially after getting wet; pains in the limbs as if they were beaten; frequent colic and pain in the loins; nervous debility, and deli- cacy and tenderness of the skin. Veratrum, if there be suppression with nervous headache; hysterical affections; frequent nausea and vomiting; pale, earthy colour of the face; coldness of the hand and feet, or nose; great weakness with fainting fits. Kali carbonicum, in cases attended by difficult respiration; palpitation of the heart; disposition to erysipelatous eruptions and paleness of the face, frequently alternating with redness. Sulphur, against pressive headache chiefly in the back part of the head, extending to the nape of the neck, or one-sided head-ache, or pain over the eyes, with heat and throbbing in the head; heaviness of the head; confusion of the head; giddiness; dimness of vision; bluish circle round the eyes; pimples on the forehead and round the mouth, and red spots on the cheeks; voracious appetite; sour stomach; sour and burning eructations; fulness and heaviness in the stomach and abdomen; constipa- tion, with ineffectual efforts to stool; disposition to hemorrhoids; sometimes loose, slimy evacuations; spasms in the abdomen; leucorrhoea; numbness of the limbs; great disposition to take cold; difficulty of breathing; pain in the loins; great depression after talking; fatigue and weakness of the limbs; irritability of temper or disposition to melancholy and tears. In cases of long standing, especially when occurring in debili- tated subjects, China, Graphites, Causticum, Natrum mur., Conium, Arsenicum and Jodinum will be useful in addition to Sepia and Sulphur. Too Copious- Menstruation. Menorrhagia. When the menstrual discharge is excessive, or continues longer than usual, and is attended by pains in the back, loins, and abdomen, which resemble those of labour, it becomes necessary DISEASES OF WOMEN. 339 to check it by the administration of appropriate remedies, and also to prevent its recurrence. The medicines which are most suitable for this purpose, are : Ipecacuanha, Crocus, Sabina, China, Chamomilla, Nux vomica, Platinum, Ignatia, Sulphur and Calcarea. Rest in the horizontal posture is also in most cases imperative. Ipecacuanha is of great importance in menorrhagia, and also in flooding after labour, especially when there is a profuse dis- charge of bright red blood. It may be repeated every three to six or twelve hours, as the urgency of the symptoms may require. Crocus is one of the most valuable remedies in this complaint, particularly when the discharge is dark coloured, clotted and very copious, and the menses have returned too soon. Platinum will be useful in cases in which the menstrual dis- charge is too great, and consists chiefly of thick, dark coloured blood, and is attended with bearing-down pains, venereal and general excitability. Sabina will be most suitable for robust, plethoric individuals who are liable to miscarry, and when the discharge is excessive and of a bright red colour; accompanied by rheumatic pains in the head and limbs; pains like labour pains in the loins, and great weakness. Chamomilla will be beneficial when the discharge is dark coloured and clotted, accompanied by griping pains which ex- tend from the small of the back forward toward the abdomen; thirst; coldness of the extremities, and sometimes fainting. Nux vomica, when the menstruation is too copious, and returns before the usual time; when it continues too long, or stops and returns again. It is particularly adapted to females who make too free use of coffee, wine or other stimulants, all of which articles should be strictly prohibited for several months. Ignatia is most serviceable in cases in which the discharge continues too long, and is frequently attended by yawning and hysterical symptoms. China, in cases of great debility in consequence of too copious or too long continued menstrual discharge. It may be 340 ' CHAPTER XI. given with advantage, after the discharge has been checked by other remedies, and the patient suffers from weakness only. Sulphur, given during the intervals two or three times, allow- ing ten or twelve days to elapse between the doses, will often be beneficial, after the failure of other remedies. Calcarea, adminis- tered in the same manner, will frequently be found successful. Dysmenorrhcea, Painful Menstruation, Menstrual Colic. The remedies which are most useful in painful and difficult menstruation are: Belladonna, Chamomilla, Pulsatilla, Nux vomica, Lachesis, Coffea, Cocculus, Causticum and Veratrum. Belladonna is indicated when there is severe pain in the back, and strong bearing down in the lower part of the abdomen, as if the parts were about to fall out, accompanied with violent congestion of blood to the head, confusion of sight, frightful visions, great disposition to bite, screaming, redness and bloated appearance of the face and frequent ineffectual efforts to evacuate the rectum with much straining. Chamomilla, when the pains resemble labour pains, with pressure from the small of the back toward the front of the abdomen and downward; colic, with tenderness of the lower part of the abdomen when touched, and discharge of dark-coloured and coagulated blood. Pulsatilla is serviceable when there is a feeling of heaviness as if from a stone in the lower part of the abdomen; violent pressure in the lower part of the abdomen and small of the back, attended with a sensation of drawing and numbness extending down the thighs; the latter feeling is felt more particularly when the patient is in the sitting posture; pressure in the rectum with ineffectual efforts to evacuate; frequent inclination to pass water. Nux vomica is most useful in relieving writhing pains in the abdomen, accompanied by nausea, or pains in the back and loins as if dislocated; feeling as if bruised on the bones of the pubis; spasms and pricking in the lower part of the abdomen; parox- ysms of pressing and drawing pains, frequent desire to evacuate DISEASES OF WOMEN. 341 the bladder, and sensation of distention in the bowels as if they would burst. Coffea will be beneficial if there be much nervous excitement; colic, with feeling of fulness and pressure in the bowels, and violent spasms which extend to the chest; delirium; wringing of the hands, grinding of the teeth; violent screaming; difficulty of breathing and groaning; coldness of the whole body, and numbness and stiffness. Lachesis is of great value in difficult menstruation, especially when accompanied by diarrhoea with violent tenesmus, which generally precedes the menstrual flow, and continues after it has ceased. Cocculus, when there are spasms in the abdomen, cramps in the chest; flatulency; nausea and faintness, and pressive colic. Causticum, if there be cutting pains in the small of the back; spasms in the abdomen; hysterical symptoms, and yel- lowish complexion. Veratrum, against menstrual colic, with nervous headache; nausea and vomiting; coldness of the hands, feet or nose; great weakness; fainting fits and diarrhoea. The foregoing medicines may be given dry or dissolved in water, and repeated every hour until the patient is relieved, or another is selected. Hysterics. Hysteria. This disorder occurs more frequently in single than in married females. The time of life at which it is most common is between the ages of fifteen and thirty-five; and the attacks usually take place about the period of menstruation. The following are some of the most common symptoms; depression of spirits, anxiety, weeping, difficulty of breathing, palpitation of the heart and nausea. There is generally also a pain in the left side, which seems to pass upward to the throat and lodge there, giving rise to the sensation of a ball being there; when it advances further, there is a feeling of suffocation, stupor and insensibility, with spasmodic clenching of the jaws; 342 CHAPTER XI. the body is moved about, sometimes it becomes rigid, and the limbs are agitated; fits of laughing, crying and screaming by turns, with incoherent talking, and foaming at the mouth. Hic- cough is also a common and very distressing symptom. In some cases the attack begins with a violent spasmodic pain in the back, extending to the sternum, which after a time becomes fixed at the pit of the stomach, and is frequently so intense as to produce clammy perspiration, pale, death-like appearance of the countenance, coldness of the extremities, and weak, almost imperceptible pulse. The fit commonly passes off with eructa- tions, sighing and sobbing, and is followed by a feeling of sore- ness of the whole body. Hysteria is easily excited in females who are subject to it by sudden mental emotions. Women of a nervous or sanguine temperament are principally liable to this affection; a predisposition to it is induced by an inactive or sedentary life, depressing mental emotions, excessive haemorrhage, suppressed or painful menstruation, living in damp and badly ventilated houses, or the continued use of spare or unwholesome diet. Treatment.—The most valuable medicines against this com- plaint are: Coffea, Pulsatilla, Cocculus, Cuprum, Ignatia, Lachesis, Platinum, Stramonium, Sulphur, &c. Coffea will prove beneficial, when there are spasms of the ab- domen; jerking in the extremities; agitation; screaming or crying; the patient throws herself on the floor, and is covered with a cold perspiration. Pulsatilla, in patients who are addicted to the daily use of coffee, are excessively chilly and inclined to tears; the symptoms aggravated in the evening. Ignatia is most suitable in cases attended with nausea and fainting; general chilliness; paleness of the face; dimness of sight; intolerance of light and noise; heat of the body; disten- tion and hardness of the abdomen, with digging and winding or pressing and drawing pains. Cocculus, Cuprum and Veratrum, will be indicated in attacks DISEASES OF WOMEN. 343 accompanied by general spasms, with clinching of the jaws, foaming at the mouth, &c. For more particular symptoms of these and other remedies, examine under the heads of "Amenor- rhcca", "Dysmenorrhcea" and "Menorrhagia", which diseases also, frequently give rise to this affection, and their cure will be followed by the removal of the hysterical symptoms. The medicines selected may either be given dry, or a few globules may be dissolved in half an ounce of water of which a teaspoonful may be given at a time, repeated every one to six hours according to the exigency of the case. Chlorosis, Green Sickness. This affection commonly occurs in young girls at the period of puberty—about the fourteenth year—and is most generally owing to some obstruction to the first menstruation. A similar condition may, however, be induced in females of a more ad- vanced age, and of delicate constitution by excessive depletion, sedentary occupation, exposure to dampness and cold, insufficient food and clothing; mental emotions of an unpleasant kind, &c. The disease may be distinguished by excessive paleness of the complexion and lips, the latter appearing at times almost white —sometimes alternately with redness and flushing of heat; general mental and physical languor; the patient complains of being weak and tired; the breathing is hurried; the slightest exertion produces panting respiration and violent palpitation of the heart; this is particularly noticeable by directing the patient to go up stairs quickly; the lower extremities often become swollen; the appetite depraved, with a longing after chalk, charcoal, &c.; flatulent distention of the abdomen, particularly after meals; costiveness or diarrhoea; hectic cough, sometimes attended by expectoration of dark-coloured clotting blood, and emaciation. In the treatment of chlorosis the following medicines have proved to be most useful: Pulsatilla, Sepia, Sulphur, Bryonia, Calcarea carb., Ferrum,, Kali carbonicum, China, Lycopodium and Natrum carb. 341 CHAPTER XI. Pulsatilla is best adapted to females of a mild, easy disposi- tion, disposed to sadness and tears; and particularly if the dis- ease was produced by exposure to cold or dampness, and attended by frequent attacks of one-sided headache, with pains shooting to the ears and teeth; sometimes the pain changes suddenly from one side to the other; aching in the forehead, and pressure on top of the head; sallow complexion alternating with redness and flushes of heat; difficulty of breathing and feeling of suffo- cation after the slightest exertion; palpitation of the heart; coldness or heat of the hands and feet; looseness of the bowels and leucorrhoea; nausea and vomiting; sensation of weight in the abdomen, periodical expectoration of dark coagulated blood; hunger with repugnance to food, and great fatigue, especially in the legs. Sepia will be beneficial after Pulsatilla, when the latter has been insufficient, and especially if there be, in addition to many of the symptoms enumerated above, disposition to hysteria; sal- low complexion, and dark or yellowish spots on the faee; colic, and pain in the limbs as if bruised. Sidphur should have the preference when there is pressive pain in the back of the head, extending to the neck; congestion to the head with throbbing pains; humming in the head; pim- ples round the mouth and on the forehead; paleness of the face, with red spots on the cheeks; emaciation; voracious appetite; sour and burning eructations; pressive fulness and heaviness in the stomach and abdomen; irregularity of the bowels; pain in the loins; difficulty of breathing; great depression after talking; fatigue, especially in the legs; great liability to take cold. It is most suitable for irritable and passionate persons or those inclined to sadness and tears. Bryonia when there is frequent congestion to the head or chest; bleeding at the nose; chilliness, sometimes alternating with heat; dry cough; colic; constipation; bitter taste in the mouth; yellowish coated tongue; feeling of pressure, as if from a blow in the stomach. Calcarea carb. will frequently effect a cure after the failure DISEASES OF WOMEN. 345 of other remedies, when the difficulty of breathing is very great; with swelling of the extremities; excessive emaciation, &c. Ferrum will be serviceable after or in alternation with the latter, when the sallowness continues with great debility, want of appetite, nausea, &c. For the particular indications for the use of the remaining remedies, refer to what has been said under the articles " Ame- norrhoea", "Dysmenorrhcea" and "Suppression". This disease, however, should in all cases where, it is possible, be under the management of a homoeopathic physician, as it is one which, if neglected or improperly treated, will destroy the health and consequently the happiness of the patient. Cessation of the Menses. The period at which menstruation ceases is, as previously mentioned, about the forty-fifth year of age, though in some instances the " change" takes place several years earlier, and in others again it may be postponed to the fiftieth year and even later. Females of delicate constitution and those who "live high" and whose habits are sedentary, generally experience this change earlier than those of a more robust organization, or those who live temperately and make use of plenty of exercise, especially in the open air. As the " change of life" approaches, the menses generally become irregular, both as regards the time of their return and the quantity of the discharge. They may either return too soon, or the interval may be much longer than usual. The quantity discharged is at times much smaller than common, and at others again it may be so profuse as to amount to a hemorrhage. Occasionally the flow comes on suddenly and quite unexpected, continues for a short time, and then stops without being followed by any of the ordinary symptoms of suppression. Sometimes the menstrual fluid discharged is largely mixed with mucus. In the majority of females, while this change is in progress, there is more or less disturbance of the general health, giving 44 346 CHAPTER XI. rise to headache; vertigo; flushes of heat; paleness and debility; nervousness; irregularity in the urinary discharge; sometimes it is frequent and in large quantities, at others scanty and high coloured; pain in the back and loins, which extends down the thighs with a creeping sensation; heat in the lower part of the abdomen; occasional swelling of the abdomen; swelling of the extremities; piles and pruritus (violent itehing of the privates). In some instances, however, the menses gradually cease with- out being attended by any of the unpleasant symptoms enume- rated above. Frequently after the complete cessation of men- struation the health becomes better than it had ever been previously. The remedies that are most useful in combatting the disorders incident to the " change of life" are Pulsatilla and Lachesis. They may be administered alternately once or twice a week, and will be generally found sufficient to remove the abnormal symp- toms. If they should not suffice, the following may prove bene- ficial: Sulphur, Sepia, Ignatia, Cocculus, Cuprum, Bryonia and Calcarea carb. Much benefit will be derived from proper attention to diet, exercise, clothing, &o. The food should be light and digestible, and everything of a stimulating nature carefully avoided. Daily exercises in the open air either by walking or riding, and also bathing, will be productive of great advantage. The clothing should be warm and comfortable, and changed to suit the vicis- situdes of temperature. Leucorrhoea. "Whites. This term is applied to a discharge of mucus, generally whitish, proceeding from the vagina. It is of so common occur- rence that almost all women and not unfrequently small children are subject to it. At first the patient notices a slight discharge of whitish matter, which escapes from the vagina drop by drop, and is unaccompanied by any unpleasant sensation. If neglected, as is most generally the case in the beginning, the discharge increases in quantity, and in some cases it becomes excessive. DISEASES OF WOMEN. 347 The quality, too, is changed, and it becomes greenish, yel- lowish, or of a dark-brown, almost black colour, and gives rise to pains, excoriation, and ulcers of the parts. The general health also suffers; the appetite fails; the pulse becomes weak"; the face pale and bloated; the eyes become dull and heavy, and are surrounded by yellowish circles; vision is impaired; there is constant pain in the back and loins; lowness of spirits; exces- sive debility, &c. The exciting causes of leucorrhoea are numerous; anything which affects the general health may produce it; sometimes it is owing to the presence of foreign bodies in the vagina; some of the worse cases of the disease, for instance, owe their origin to a long continued use of an instrument intended to remedy falling of the womb. Such cases can never be cured until the exciting cause be removed. The disease is sometimes in women, and mostly in children, owing to inattention to cleanliness. In the treatment of this affection much benefit will be derived from syringing the parts frequently with cold water. The medi- cines employed with most advantage are : Calcarea carb., Pul- satilla, Sepia, Sulphur, Natrum muriaticum, Cocculus and Causticum. Calcarea carb. is particularly suited to females of a lymphatic constitution, light complexion, and who have copious menstrua- tion which is liable to return too soon; when the discharge is milky, often passes with the urine, and on lifting, and usually comes on, or is worse immediately before menstruation; is often attended by itching and burning; shooting pains through the parts, and falling of the womb. It is also valuable in corrosive leucorrhoeas of young children. Pulsatilla, when the discharge chiefly takes place immediately before, during and after menstruation; when produced by fright, and when occurring in young girls who have not menstruated; the discharge thick like cream, sometimes corrosive and attended by itching of the parts. Sepia, against yellow, greenish or fetid discharge, which some- times produces excoriations; with bearing-down pains; frequent 348 CHAPTER XI. desire to pass urine; swelling of the abdomen; yellowish com- plexion. Cocculus, if the discharge be mixed with blood during preg- nancy, or like washing of meat, attended by colic and flatulency, and taking place principally before and after menstruation. Causticum, against profuse leucorrhoea, having the smell of the menses, or which flows at night, attended by pain in the back and loins; sallow complexion and excoriation of the parts. Natrum muriaticum, when the discharge is copious, and con- sists of transparent, whitish and thick mucus, or is acrid, with yellow colour of the face; also when accompanied by headache, disposition to diarrhoea with slimy evacuations and colic. Sulphur, for inveterate cases of leucorrhoea; the discharge sometimes yellowish, burning and corrosive, and proceeded by colic; also when it results from repelled eruptions or ulcers. Prolapsus Uteri. Falling of the Womb. This disorder is of very frequent occurrence in females. The chief symptoms are : Sensation of bearing - down or dragging about the groins; pain in the back and loins; feeling of pres- sure low-down in the pelvis; sense of numbness extending down the limbs, and sometimes frequent desire to pass water; nervous debility, faintness, &c. Causes. A relaxed state of the system, either natural, or a consequence of sedentary habits, indulgence in stimulating food and drinks, &c, may predispose to prolapsus of the womb. Dif- ficult labours, or getting up too soon after confinement, severe and long continued coughs; falls; injuries from overlifting; tight lacing; violent vomiting, and numerous other causes might be mentioned as immediate causes of the disorder. The medicines most efficacious in the treatment of prolapsus are: Nux vomica, Sepia, Belladonna, Aurum and Calcarea carbonica. A few doses of Nux vomica taken once a day, in the com- mencement of the complaint, will often remove it. Should it however fail, or should the displacement have existed for some DISEASES OF WOMEN. 349 time, one or more of the other remedies mentioned may be required. They may be administered, one at a time, in the order named, once a day for five or six days, and then discontinued. If ame- lioration follow the use of one of them, nothing more should be given until it cease, when the same medicine may be repeated. If the disease be produced by a fall, overlifting, or external violence of any kind, Arnica will be the remedy most likely to afford relief. Remarks on Pregnancy. The woman whose lot it is to bear within herself a living being, occupies a position of the highest interest. During this period, therefore, she should consider that her most trifling actions may exert a great influence on the future physical, and we may add, moral and intellectual condition of a being bound to her by the fondest ties,—a being that has a right to expect from her, as its parent, so far as it lies in her power to give, a sound constitution. Therefore, to realize such an object, it is the duty of the mother to pay all possible atten- tion to her diet, exercise and dress. Diet. With regard to diet she should observe the greatest simplicity; her food should consist simply of those substances of a purely nutritive nature, and every thing medicinal or stim- ulating, such as food prepared with much seasoning, spirituous, vinous and fermented liquors, strong teas and coffee, should for the most part be avoided. She should also guard against taking too great a quantity of nourishment, as excesses of this kind may give rise to dyspeptic and other troublesome symptoms; which, besides being a source of much, suffering to herself, may seriously affect the health of her future offspring. Exercise. With regard to exercise, here let us say, that in order to enjoy a good degree of health, it is absolutely indis- pensable during the term of pregnancy. Passive exercise, such as riding in a carriage, is not only insufficient at all times, but 350 CHAPTER XI. has often been found particularly injurious during, or towards the end of the second period of gestation; and is frequently the cause of premature or abnormal births. The most desirable kind of exercise is walking in the open air, for this not only brings the muscles of locomotion, but the whole of the organic muscles into play, and by so doing imparts the increasing vigor of the mother to the child. Such exercise must not, however, interfere with the process of digestion, and is therefore most suitable two or three hours after a moderate meal at noon, and during warm weather, towards evening; care being taken to avoid the dampness of the night air by returning home early. Dress. The dress should be strictly suited to the season and not produce the least pressure on any part of the body; even the garters should be worn loosely. Tight lacing is highly in- jurious; it must be evident to the plainest understanding, that serious injury to the health of both mother and child must often result from a continual and forcible compression of the abdomen while nature is at work in gradually enlarging it for the accommodation and development of the foetus; and the result is, no doubt, that there are many who owe their deform- ities to the vanity of their mothers. Derangements during Pregnancy. Although the state of pregnancy is one perfectly natural and perfectly healthy, yet in consequence of the existence of consti- tutions naturally weak, and of those disordered by the excessive use of medicines prescribed under the old system, and from numerous other causes, it often happens that this condition is attended by many deviations from health, which it may be well to notice, together with the best means for removing them. The practice of bleeding, which is so prevalent among old school practitioners, for the plethora or general fulness of the system and tendency to congestions, especially to the head, which usually attend pregnancy, is in all cases to be deprecated. As it not only fails of effecting the object aimed at—the removal DISEASES OF WOMEN. 351 of the plethora—but is besides positively injurious, inasmuch as it reduces the strength and vigour of the patient; thereby render- ing her much more liable to miscarriages, convulsions, nervous disorders, floodings, &c. The more judicious and intelligent of these old school physicians are abandoning this most reprehen- sible practice. Generally a proper attention to diet and exercise, as recommended in the previous articles, will prevent any serious mischief resulting from this plethoric tendency. Or in case that should be insufficient, some of the medicines recommended under the appropriate heads will accomplish the desired purpose. The following are some of the most common of the deviations from health, which are met with during pregnancy. Menstruation. The continuance of menstruation during pregnancy, though of comparatively rare occurrence, is occasionally met with, and may be considered rather a deviation from the ordinary course * of nature, than an actual disease. When a cause of suffering to the female by being too long continued or profuse, producing debility, or when attended by pain, some of the following medicines may be required: Crocus, Platinum, Cocculus, or Phosphorus. For their particular indications, and also for other remedies, see "Painful Menstruation" and "Menorrhagia". Vertigo and Headache. Very often during pregnancy females are troubled with ful- ness, giddiness and pain in the head. Sometimes these symp- toms commence as early as the third or fourth week after con- ception. The feeling of giddiness or lightness is frequently accompanied by dullness and a disinclination to active employ- ment ; sleepiness or sometimes sleeplessness; dimness of sight after stooping; flashes or sparks before the eyes; disposition to fall forward when stooping; headache, with a feeling of weight on the top of the head or in the back of the neck; palpitation of the heart; nervousness, tremblings, &c. These symptoms are commonly worse in the morning. 352 CHAPTER XI. The medicines most useful in alleviating or removing these symptoms, are: Aconite, Belladonna, Nux vomica, Opium, Platinum, Pulsatilla and Sulphur. Aconite is best adapted to persons of a plethoric habit, with a florid complexion and nervous temperament, and especially if there be giddiness on rising from a seat as if intoxicated, often causing one to fall; faintness and dimness of vision on rising from a recumbent posture; determination of blood to the head, and pressure in the forehead; stupefying pains in the head; eyes red and sparkling, with intolerance of light; black spots before the eyes. Belladonna, against congestion to the head, with vertigo, staggering and trembling; buzzing in the ears; intolerance of noise; heaviness and pressive pain on top of the head or in the forehead over the eyes; pain with a sense of expansion of the head, and violent throbbing of the carotid arteries; redness of the face; soreness and redness of the eyes; sparks before the eyes; objects appear double. The symptoms are mostly worse in the morning. Nux vomica is most suitable for females of a hasty temper, and those who are of sedentary habits, or addicted to the use of wine or coffee. The symptoms are generally aggravated in the morning, and better in the open air. It is valuable against gid- diness with a feeling of confusion in the head; with cloudiness of sight and buzzing in the ears; pains in the head of a tearing, drawing or jerking character, or periodical pains; constipation, insipid or acid, bitter and putrid taste, &c. Opium, against giddiness on rising from a stooping or sitting posture; giddiness, with stupidity as if from a debauch; great drowsiness; imperfect sleep, with puffed face, and thick, heavy breathing, and illusions of the imagination. Platinum, if there be headache which increases gradually until it becomes violent, and then diminishes in the same way, and also for headache produced by vexation or passion; constant disposition to spit, the saliva being tasteless or sweetish. It is particularly valuable in sufferings of nervous and hysterical DISEASES OF WOMEN. 353 females. The symptoms are worse during repose, and relieved by motion. Pulsatilla, against giddiness which is worse after stooping with momentary blindness and staggering, throbbing and shoot- ing pains in the head; one-sided cephalalgia; headache every other day. The sufferings are sometimes attended with numb- ness of the limbs, are worse in the afternoon and evening, and better in the morning. It is most suitable for females of a mild disposition. Sulphur, if there be congestion of blood to the head, with pulsative pains and sensation of heat in the head, vertigo and staggering, principally when seated, or after a meal, attended sometimes by nausea, fainting, weakness, and bleeding from the nose; confusion of the head, with difficulty in meditating, worse in the morning or evening; one-sided headaches, or headaches occupying the top of the head, or the back part, or the forehead over the eyes, with dimness of sight; periodical or intermittent headaches, worse in the morning or evening, or at night. The pains in the head are mostly aggravated by movement, walking in the open air, and meditation. The foregoing medicines may be administered by taking two or three globules of the one which seems best adapted to the symp- toms, twice or three times a day, for two or three days in succes- sion, and then waiting a few days for the effect. If improvement follow, nothing else should be taken as long as it continues. If the symptoms grow worse again, the same medicine should be repeated. When there is no improvement, another remedy should be selected. Morning Sickness. Nausea, vomiting, heartburn, &c, are at the same time the most common and most distressing accompaniments of preg- nancy. They usually begin five or six weeks after conception, and continue until the sixteenth week. After which time they generally abate or cease entirely; in some cases, however, they continue with but slight modification to the end of gestation. 45 354 CHAPTER XI. These troublesome symptoms commonly take place imme- diately on rising from bed in the morning, and are often exceed- ingly harasing for two or three hours. Occasionally they return again in the evening. Treatment.—The following medicines have generally been found most efficacious in removing these complaints. Ipeca- cuanha, Nux vomica, Natrum muriaticum, Arsenicum, Pul- satilla, Magnesia and Phosphorus. Ipecacuanha should be given, when there is nausea and vo- miting, with great uneasiness in the stomach and epigastrium; vomiting of drink and undigested food; bilious vomiting, and tendency to relaxation of the bowels. Nux vomica, when there is nausea and vomiting, chiefly in the morning, while eating, or immediately after eating or drink- ing ; acid and bitter eructations and regurgitations; violent hic- cough ; waterbrash; pain and sensation of weight in the pit of the stomach; constipation, and irritable temper. Arsenicum, if there be excessive ^vomiting, especially after eating or drinking, with attacks of fainting; great weakness and emaciation. Pulsatilla. Nausea after eating; vomiting of food; heartburn; eructations, acid, bitter, or with the taste of food; depraved appetite, or craving of acids, wine, &c; whitish coated tongue. Natrum muriaticum will be useful in obstinate cases, accom- panied by loss of appetite and taste; waterbrash, acid stomach; pain and soreness at the pit of the stomach. Phosphorus and Magnesia will be beneficial in cases in which the symptoms are similar to those mentioned under Arsenicum, and which the latter remedy has failed to remove. The remedy selected should be given evening and morning for two or three days in succession, after which, if there be no improvement, another should be substituted. Constipation. ^ Constipation is a very common attendant on pregnancy, espe- cially with persons naturally of a costive habit; when it does DISEASES OF WOMEN. 355 not arise from a mechanical cause, it may frequently be removed by active exercise in the open air, drinking freely of cold water, and eating plentifully of cooked or ripe sweet fruits. When these means are insufficient, one or more of the fol- lowing medicines may be given: Nux vomica, a dose taken in the evening for two or three evenings, and then, if required, fol- lowed by, or alternated with Ignatia; or, in some cases, it may be necessary to give Bryonia, Opium, Lycopodium, or Sulphur. (See "Constipation", page 308.) Diarrhoea. Diarrhoea occurs occasionally during pregnancy, much less frequently, however, than constipation, but is much more injur- ious, and means should be taken to check it speedily, otherwise the health of the female may suffer seriously. The medicines which are mostly beneficial are : Lycopodium, Sepia, Sulphur, Dulcamara and Antimonium crudum. (See also the article " Diarrhoea", page 294.) Pruritus. Not unfrequently during the course of pregnancy, women are at times excessively annoyed and distressed by a very trouble- some itching of the privates. Sometimes this itching arises from a vitiated condition of the mucous secretion of the parts, and at others it is owing to the presence of an aphious eruption resembling the thrush of infants, which occasionally covers entirely the mucous membrane of the vagina. In other instances again, the parts assume a dark red hue, attended with great irritation and excoriation, and almost constant oozing of a thin, watery secretion, the accumulation of which is attended with the most intolerable itching. This affec- tion is not confined alone to the pregnant state, but may occur at any time. Treatment.—Bryonia, Carbo vegetabilis, Mercurius vivus, Pulsatilla, Lycopodium, Sepia, Silicea, Sulphur and Rhus, are the chief remedies in this complaint. 356 CHAPTER XI. The cure will be much accelerated by frequently washing the parts with cold water. A solution of borax in water, applied two or three times a day, will generally remove the itching in a few days. Fainting and Hysteric Fits. Females of a delicate constitution and nervous temperament are frequently attacked with fainting and hysterics during preg- nancy. Generally the attack passes over in a short time without any bad consequences resulting. When the attacks are light, attention to dietetic rules, and plenty of exercise in the open air, will generally prevent their recurrence. But should the attacks be more severe, and these means insufficient for their removal, it may be necessary to trace the cause, and if possible remove it. Frequently they arise from tight lacing, warm rooms, &c. The speediest means of reviving a patient from fainting is to admit fresh air in abundance, and sprinkle the face with cold water. Aconite may be useful in preventing a return of the attacks, when they occur in plethoric individuals. Coffea, in nervous females, with great agitation; spasms in the abdomen; difficult respiration; cold perspiration, &c. China, when caused by general weakness, particularly from hemorrhages. Chamomilla, against hysteria which is excited by a fit of anger. Nux vomica, when those affections occur in choleric persons, and are accompanied by derangement of the stomach. Belladonna is often useful after or in alternation with Aconite, especially when there is congestion of blood to the head. Pulsatilla is best suited to females of a mild, easy disposition, and when the attacks are attended by great excitability, with disposition to hypochondria, &c. Ignatia is one of the most valuable remedies when the patient complains of severe headache, as if a nail were driven into the head ; melancholy, frequent sighing and concealed sorrow. DISEASES OF WOMEN. 357 The remedy selected may be repeated once a day, or every other day, until the patient is relieved, or another remedy is substituted. Toothache. Toothache is a very common affection during pregnancy, and often attacks females who are seldom subject to it at any other time. Frequently it is of exceedingly severe character, partaking of the nature of a neuralgia. It most generally commences in a decayed tooth, whence it may extend to the whole set, darting along the jaw, and also to the face and head. Occasionally, how- ever, it originates in a sound tooth, and consequently care should be taken to consult a physician previously to having teeth ex- tracted. Sometimes the pain in the teeth is symptomatic of some constitutional taint, which can only be removed by appro- priate treatment under the direction of a physician. The medicines which will be most commonly found useful to relieve the sufferings, are the following: Calcarea carb., Sepia, Mercurius viv., Chamomilla, Nux vomica, Pulsatilla and Sta- physagria. For the particular indications governing the choice of these remedies, and also for other remedies which may be useful, see the article " Toothache " in a preceding chapter. Varicose Veins. During pregnancy many females suffer a good deal from a distention of the veins in the lower extremities. The swelling generally commences first about the ankle, and gradually ex- tends upward toward the thigh; it is frequently confined to the leg below the knee, but occasionally the veins of the entire limb are implicated. The disease may involve both limbs, or it may be confined to but one. The enlarged veins lie in general near the surface, and assume at first a reddish hue, and after continuing for some time, become bluish or of a leaden colour, and the large ones become very much knotted. They get larger when the patient is standing, or when the limb is hanging, and the swelling decreases on lying down. This disease, though occurring more frequently during preg- 358 CHAPTER XI. nancy, is not confined to this state, but may take place at any time in the female, and is also met with in the male sex. The disease in the beginning is not painful, but if the swell- ing continues to increase, it may become so, and the veins* may ultimately Imrst, and a large quantity of blood be discharged, either externally, or effused into the cellular tissue. Varicose veins are generally caused by obstruction to the cir- culation arising from the pressure of the enlarged uterus upon the blood-vessels; their occurrence in an aggravated form, however, is indicative of constitutional debility. After delivery, the pressure being removed, the swelling grad- ually disappears, and the veins resume their natural size and appearance. Treatment.—Much good will often result from frequent bath- ing with cold water or diluted alcohol. Having the limb band- aged, or making use of the laced stocking will also afford great relief, especially to persons who are compelled to be much on their feet. The bandage or stocking should be applied in the morning after rising, when there is the least swelling, beginning at the foot and progressing upward with a moderate and equal pressure. The patient should maintain the recumbent posture in severe forms of the complaint. Along with the means recommended above, the following medicines may be given with advantage. Pulsatilla, Arnica, Lachesis, Lycopodium, Nux vomica and Arsenicum. Pulsatilla will in most cases be found useful, especially if there be much swelling of the veins and of the whole limb, with great pain and more or less inflammation, or when the veins, and sometimes the entire limb assume a bluish colour. It may be repeated in severe cases twice a day; in lighter ones twice or three times a week. Arnica, given alternately with Pidsa- tiUa, is very efficacious in some cases. Lachesis may follow Pulsatilla when the latter has produced some relief of the pain and swelling, but the discoloration still remains. DISEASES OF WOMEN. 359 Nux vomica, when attended with constipation, hemorrhoids and irritable temper. Arsenicum, when with the symptoms mentioned under Pul- satilla, there is severe burning pains. Carbo vegetabilis, for the same symptoms as the latter when that has been insufficient. Lycopodium, in cases of long standing after the failure of other remedies. Hemorrhoids or Piles. This affection frequently occurs in females during pregnancy who are not subject to it at any other time. This is chiefly owing to the pressure of the enlarged uterus on the contents of the abdomen causing more or less torpidity of the bowels, and obstruction to the circulation. The appropriate treatment to pursue in this troublesome complaint, will be found under the heading of "Hemorrhoids" in a preceding chapter. Pains in the Back and Side during Pregnancy. Females often suffer very much from pains in the lower part of the back during pregnancy. Occasionally the pain is seated deep in the right side under the ribs. They are usually most troublesome from the fifth to the eighth month. The sensation experienced is that of an almost indescribable aching, or of a dull, heavy pressure, as if caused by a dead weight resting on the part affected. When in the side, it is attended with a feeling of heat. For the pains in the back, Kali carbonicum will generally be found most efficacious; or, in cases in which that is insufficient, benefit will be derived from the use of Bryonia, Rhus tox., Belladonna, Pulsatilla, Nux vomica, Sepia, Causticum, or Sulphur. For that in the side : Aconite, Chamomilla, Pulsatilla, or Phosphorus, will be most serviceable. 360 CHAPTER XI. Cramps. Cramps in the legs, abdomen, hips, or back, are common accompaniments of pregnancy, and, when present, are exceed- ingly painful and annoying. The remedies best calculated to remove cramps in the legs, which are most common, are: Colocynthis, Hyoscyamus, Cal carea carb., Chamomilla, Graphites, Nux vomica, or Sulphur. Those of the back : Ignatia, Rhus, or Opium. Those of the abdomen : Nux vomica, Pulsatilla, Belladonna, Hyoscyamus, or Colocynthis. Incontinence of Urine. Frequent desire to void the urine, or total inability to retain it, are by no means of uncommon occurrence during pregnancy, and are extremely distressing to the patient. The following remedies will generally afford relief: Pulsa- tilla, Belladonna, China, Silicea, or Stramonium. Depression of Spirits. This unhappy state of mind, in which the patient imagines that she is afflicted with all the "ills that flesh is heir to", and that she will certainly never survive her approaching confine- ment, is often aggravated by meddlesome persons relating accounts of dreadful accidents and unfortunate terminations of labours, which in all probability never happened. The patient may be much benefitted under these circumstances by the cheerful conversation of judicious friends, exercise in the open air, proper attention to rules of diet, &c. And also by taking one or more of the following medicines. Aconite, if depression result from fright, and fear of death is the most prominent symptom. Aurum, if there be desire of death; uncontrollable inclination to weep; great anxiety and distress of mind prompting one to commit suicide; despondency; weakness of memory and intellect. Belladonna, if there be great agitation and restlessness at night; fear of ghosts; fear and disposition to hide away and DISEASES OF WOMEN. 361 hide; involuntary laugter; disposition to laugh or sing, or to fall into a passion and rave; frightful visions; indisposition to exertion, &c. Pulsatilla, against depression, with sadness and weeping; uneasiness in the pit of the stomach; sleeplessness; she imagines herself to be oppressed with a multitude of cares; dislike to conversation; headache and heartburn. Sulphur. Lowness of spirits, with great anxiety on the sub- ject of religion; despair of eternal salvation; forgetfulness of proper names and of words when about to speak them; dispo- sition to get angry. Miscarriage. Abortion. Females are liable to miscarry at any period of pregnancy; it occurs most frequently, however, about the third or the begin- ning of the fourth month. When it takes place before or about this period, it is not very dangerous, though repeated miscarriages, from the profuse discharge with which they are mostly accom- panied, impair the constitution, and very often engender some _ chronic malady. Miscarriages occurring at a later period are much more serious, and frequently highly dangerous to the sufferer. Females who have miscarried once, are excedingly liable to its recurrence, which liability is greatly increased, if it have occurred two or three times. The most common causes of miscarriage are : mechanical in- juries, as a fall or blow, &c; sudden and powerful mental emo- tions ; the abuse of purgative drugs; great physical exertion; too free use of stimulating food and drinks; neglect to take air and exercise; late hours, &c. The following symptoms generally precede and attend this affection : chilliness followed by more or less fever and bearing- down pains; severe pains in the abdomen; cutting pains in the loins, or pains resembling labour pains; discharge of mucus and blood, sometimes of a red colour, at others dark and clotted, followed by the emission of a serous fluid. The miscarriage 40 362 CHAPTER XI. generally takes place along with this discharge, which, if not stopped by appropriate means, may continue for hours, and en- danger the life of the patient. In cases of threatened miscarriage the patient should imme- diately assume the horizontal posture, and retain it until the danger has passed; or, in case the miscarriage has taken place, it should still be retained for a few days to guard against a fresh discharge, which is more liable to occur in the upright posture. Treatment.—The medicines recommended in this affection are : Arnica, Chamomilla, Sabina, Secale cornutum, Crocus, Ipecacuanha, Belladonna, Hyoscyamus, Platinum, China, Fer- rum metallicum, Nux vomica and Bryonia. These remedies will be useful both in threatened abortion, and also after it has occurred, when properly selected according to the indications given below. Arnica, when the symptoms arise from a fall, blow, violent concussion, overlifting, or great physical exertion of any kind, this medicine should be given immediately. Chamomilla, when there are periodical pains resembling those of labour, and each pain is followed by a discharge of dark coloured or coagulated blood, or of blood and mucus mixed; also for violent pains in the bowels extending around the sides, ac- companied by a sensation as if an evacuation of the bowels or bladder were about to take place; frequent yawning; coldness and shivering, with thirst. Sabina, when the pains are of a forcing or dragging character, extending to the back and loins; the discharge profuse and consisting of bright-red blood; feeling of sinking or faintness in the abdomen; diarrhoea; frequent inclination to stool; nau- sea or vomiting; fever with chilliness and heat. Secale co%iutum is valuable, after miscarriage has occurred, especially^ debilitated, cachectic persons, or when the discharge consists of dark liquid blood and the pains are but slight. Crocus is particularly serviceable in cases, in which there is a discharge of dark clotted blood, which is increased by the least exertion, with a feeling of fluttering, or as if something were DISEASES OF WOMEN. 363 moving about in the region of the navel. It may be used with advantage in protracted cases, after other remedies have been administered unsuccessfully. Ipecacuanha, against abortion attended with spasms but with- out loss of consciousness; profuse and continuous discharge of bright red blood, accompanied with pressure downward; cutting pains round the navel; nausea or vomiting; disposition to faint- ness ; chills and heat. Belladonna is especially useful in the commencement, and also subsequently when there are violent pains in the loins and the entire abdomen; severe bearing-down as if all the intestines were about to be forced out; pain in the small of the back as if it were broken; pale or flushed face; profuse discharge of blood, neither very bright, nor dark-coloured. Hyoscyamus, against miscarriage attended with spasms or convulsion of the whole body, with loss of consciousness; dis- charge of light red blood; the symptoms are mostly worse at night. Platinum is useful when there is discharge of dark, thick or clotted blood; pains in the back which pass into the groins, and pressing or bearing-down internally toward the privates, which are very sensitive. It is sometimes serviceable after Ipecacuanha. China is particularly valuable in weak and exhausted per- sons ; also when there is blood discharged at intervals, with bearing down pain, or against spasmodic pains in the uterus; giddiness, drowsiness, fainting; loss of consciousness, and cold- ness of the extremities. This remedy is most useful in restoring the energies of the patient, and removing the remaining symp- toms after the discharge has ceased. Ferrum metallicum is useful in cases of abortion accompanied by fev^r, pains like those of labour, and discharge^bf blood. Nux vomica and Bryonia may be given with advantage in eases attended with troublesome constipation. Administration.—The remedy should be selected according to the symptoms, and repeated, in urgent cases, every three or four hours until relief is obtained, or another remedy required. 364 CHAPTER XI. In the first stage, or when the symptoms are not very violent, the medicine should not be given more than two or three times a day, and if the patient be not better the following day, another substituted. Menorrhagia or Flooding. Menorrhagia, or flooding, during pregnancy, or at delivery. Not only the common domestic remedies, but also those ordi- narily prescribed by old-school physicians, do more harm than good, even when they give relief for a period; cold water, for instance, frequently induces inflammation, particularly after the birth of the child, and its application is, consequently, danger- ous ; rubbing with ether causes nervous affections; alum pro- duces induration and other bad symptoms. The introduction into the vagina of pieces of linen (the tampon) is seldom of much benefit, as the bleeding will still continue internally. When an accident of this kind occurs, the woman should lie down quietly, should move as little as possible, her mind be kept free from care, and the greatest quietness be preserved in the room and in the house. At the same time, tie handker- chiefs around the upper part of the thighs, silk are preferable; also around the upper part of the arms. A few mouthfuls of water, and if the face becomes pale, with fainting, a few drops of wine, but no more than a drop at a time, are of great service. The smelling of vinegar, rubbing it on the nose, temples, &c, is also beneficial, only take care not to deluge the patient with it, but only take about a teaspoonful in your hand, or dip your finger into it, that the smell of the vinegar may afterwards be removed with facility. In long continued menorrhagia with females of more advanced age, when not in childbed, it is best to avoid all%arm drinks for a year, and instead to drink milk five or six times a day, which has been cooled in the cellar, or is a little soured. In these menorrhagias, it is necessary, if pos- sible, to procure a homoeopathic physician. During pregnancy, or after delivery, tincture of cinnamon is sometimes of use; put a drop into half a teacup of water, stir it DISEASES OF WOMEN. 365 up well, and give a teaspoonful, or only a few drops of it, as often as the hemorrhage becomes worse; this remedy may be given when the flooding is caused by lifting, carrying, over- reaching, or a false step. If the tincture is not at hand, a piece of cinnamon may be chewed. If this does not soon produce a salutary effect, give sugar, and when the burning sensation is passed, Arnica. The following medicines are also valuable: Arnica, Ipeca- cuanha, Chamomilla, Bryonia, China, Crocus, Hyoscyamus, Belladonna, Platinum and Ferrum metallicum. Arnica, in all cases arising from mechanical injuries, such as a fall, blow, lifting or carrying heavy weights, missteps, over- reaching, &c. This remedy should be given first and repeated two or three times, at intervals of three or four hours, after which the intervals may be lengthened, or the remedy discon- tinued entirely if there be considerable improvement; and if no improvement, another chosen. Ipecacuanha. Very copious continued flooding, particularly when occurring during pregnancy; the blood flowing regularly without interruption, with cutting pains around the navel; great pressure and bearing-down; chills, and coldness of the body; feeling of heat rising into the head; great weakness and incli- nation to die down. This is also a most important remedy in flooding after delivery. Chamomilla may be given after the latter remedy when that has produced little or no improvement, or when the flooding is accompanied by pains resembling labour pains. Bryonia, when dark red blood is discharged in great quanti- ties, with violent, pressive pain in the small of the back, and headache, particularly in the temples, as if the head would burst, and constipation. China is very important in the most dangerous cases of menorrhagia; when heaviness of the head, giddiness, loss of consciousness, and drowsiness appear; for sudden weakness, fainting, coldness of the extremities, paleness of the face, con- vulsions of the mouth, contortions of the eyes, or when the face 366 CHAPTER XI. and hands turn blue, or single jerks pass through the whole body. While giving this remedy, the abdomen may be rubbed gently, or cloths dipped into vinegar or water be applied to it, and a Tew drops of wine may be given afterward. It is also of use, when the blood escapes by starts, with spasms or pains like labor pains in the womb, passing to the anus; the discharge increasing with every pain. Likewise when accompanied by colic, frequent urging to make water, and sore tension of the abdomen. China is always serviceable for the debility or other trouble- some symptoms, which frequently remain after the flooding has ceased. Hyoscyamus, for flooding attended by pains resembling labor pains, with drawing in the thighs and small of the back, or in the limbs; heat over the whole body, with a quick or full pulse; swelling of the veins on the back of the hand or in the face; great uneasiness; excessive liveliness; trembling over the whole body, or numbness of the limbs; loss of consciousness, darkness before the eyes; delirium; twitching in the sinews or in the muscles of the extremities; jerking in one or the other of the limbs, alternating with stiffness of the joints. Belladonna, when the blood discharged is neither particularly dark, nor light coloured, with pressure in the privates, as if they would fall out; violent pains in the small of the back, as if it would break; pale or flushed face; dullness; heat about the head; palpitation of the heart, and thirst. Platinum, when the discharge is dark and thick, but not clotted or coagulated; the pain in the back drawing more to- wards the groins, with pressing-down internally toward the pri- vates, which are excessively sensitive. This remedy is particu- larly applicable to cases of flooding produced by any violent mental emotion. Ferrum metallicum, when the blood is sometimes black and clotted, at others liquid, with pains like labor pains; the face usually red. China follows Ferrum advantageously. Smelling saffron is also beneficial in some instances. DISEASES OF WOMEN. 367 Preparation of the Breasts. By paying a proper attention to the breasts before confinement, mothers will in many instances save themselves much suffering after delivery from sore nipples, gathered breasts, &c. As pregnancy progresses, the breasts gradually increase in size, in order to be fitted for their future important functions, and especially in first pregnancy; the areola) surrounding the nipples become of a darker hue and the nipples themselves larger and more prominent. This development is frequently accom- panied with more or less pain and soreness. The most common affections to which the nipples are subject, are excoriation, cracks, inflammation, branny eruptions, and small abscesses. The struc- ture of the breasts is sometimes irreparably injured by ignorant nurses compressing them in childhood, with the erroneous notion that such a process was necessary to expel some matter contained in them. Serious injury, also, often results, from pressure occasioned by wearing stays, in after life. For several weeks previous to delivery the entire breast and chest should be bathed with cold water daily, and afterward well dried and rubbed with coarse towels. If there be tenderness or slight excoriation, much benefit will be derived from bathing with dilute tincture of Arnica, or brandy, twice a day. When a high degree of inflammation of the nipples exist, with aching, or acute pains, shooting into the mamma, the internal adminis- tration of Aconite, or Chamomilla, will generally afford relief. In some instances Silicea or Sulphur may be required. The swelling, burning, itching, cracks, eruptions and small abscesses will be removed by Graphites, Lycopodium, Mercurius vivus, Hepar or Sulphur. False Pains. Women frequently suffer previously to the setting in of labour, with what is termed false, spurious or intestinal pains. Generally these pains precede labour but a few hours; occasionally, how- ever they come on some days or even weeks before delivery. 368 CHAPTER XI. They differ from labour pains chiefly in the irregularity of their recurrence, in being unconnected with uterine contractions, and principally confined to the abdomen, which is tender to pressure and movement, and in not increasing in intensity as they return. In some instances it is excedingly difficult to dis- criminate between them and genuine labour pains. In such cases the period of gestation will be the chief guide ; and when they come on a week or two before labour is expected, they should be checked by the administration of a suitable remedy. The exciting causes of these pains are congestion of blood to the uterus, a chill affecting the abdomen, mental emotions, errors in diet, clothing, &c. Treatment.—Bryonia, Nux vomica, Pulsatilla, Dulcamara, Aconite and Belladonna are the chief remedies. Bryonia is most suitable, when the symptoms have arisen in consequence of a fit of passion, and consist of pains in the abdomen followed by dragging pains in the back and loins; con- stipation, and irritable temper. They are aggravated by motion. Nux vomica, against pains in the abdomen and back, like those under Bryonia, also when there are pains as if from a bruise in the region of the pubis; constipation. The pains occur chiefly at night. Applicable to passionate persons, and especially when the exciting cause appears to be indulgence in stimulants, such as highly seasoned food, wine, coffee, &c. Pulsatilla. Pains in the abdomen; pains in the loins as if from continued stooping, with a feeling of stiffness and painful dragging and aching in the thighs, constipation or diarrhoea; most applicable to mild tempered persons, and when arising from eating rich or fat indigestible food. Dulcamara, when the pains originate from cold, the effects of chill or dampness, and are acute and violent in their charac- ter, and seated in the small of the back; coming on or aggra- vated at night. Aconite is most suitable for young plethoric persons; when the pains are attended by a full, strong arid frequent pulse, with congestion to the head, flushed face and hot skin. DISEASES OF WOMEN. 369 Belladonna, for symptoms similar to the last, and after or in alternation with that remedy; and also when the pains are spasmodic in their character. The above remedies may be given two or three times a day, or even oftener in violent cases—according to the severity of the symptoms. Labour. Child-Birth. To the whole of the phenomena attendant upon giving birth to a child, the term labour is applied; and when natural, the labour generally takes place at the end of the ninth month of pregnancy. The pains come on at regular intervals of longer or shorter duration, gradually increase in intensity, and the whole process is completed in from four to six hours. Frequently, however, a longer time is required, the sufferings continuing for twenty-four hours, or even a greater length of time; and in other instances again, the labour may not last over half an hour or an hour, it may indeed be terminated by two or three pains— though these latter instances are rare. The ordinary and most correct mode of " reckoning", to fix the time of labour, is from the last menstrual period—two hun- dred and eighty days, or forty weeks, from the last menstruation to labour. Other modes, which are less certain, but which may be useful in assisting to form a reckoning in cases in which there is any uncertainty about the last menstrual period, are: the commencement of morning sickness, which generally sets in about six weeks after conception, and quickening, which usually takes place at four and a half months or twenty weeks from conception. Toward the latter end of pregnancy the child sinks lower down in the abdomen, and the woman becomes smaller round the waist than she had been for some weeks previously. Labour is often preceded by agitation, nervous tremblings, disposition to shed tears, lowness of spirits, &c. Looseness of the bowels for a day or two before labour is also a common symp- tom and should not be interfered with. Flying pains through the abdomen, and frequent inclination to pass water, followed by 47 370 CHAPTER XI. a slight discharge of reddish mucus, called " a show", usher in the regular labour pains. Were it not for the acquired habits of civilized life, such as tight-lacing, improper diet, want of proper air and exercise, &c, we would find child-bearing to be comparatively free from the suffering and danger which now so commonly accompany it. It is almost unattended with pain among the savage tribes of our own country; and those healthy, regular women among us who pay more attention to the natural development of their frames than they do toward forming what some call " a fine figure," are seldom afflicted with the long train of ills, which custom has almost led us to consider the natural concomitants of child-bearing. Protracted Labours. Cases frequently occur in which labour is protracted much beyond the usual period, or is attended with a great deal of suffering; such labours are more likely to take place with women in their first confinement who are already somewhat advanced in life, and those of a slender form and highly nervous and sensi- tive habit. The sufferings in these cases may be greatly alleviated by having recourse to the following medicines. Coffea cruda will generally prove serviceable when the pains are ineffectual and extremely violent, following each other in quick succession, and attended by great agitation, restlessness and tossing about. Aconite, when the above remedy is insufficient, or when the patient has been in the habit of drinking coffee frequently as a beverage. Chamomilla, after the above, if required, especially if there be great mental excitement; excessive sensibility to pain; anguish and discouragement. Belladonna will be of great value in tedious cases of labour arising from a rigid or unyielding state of the parts, which is most liable to occur in the first labour of elderly females; and DISEASES OF WOMEN. 371 especially so when this rigidity appears to be owing to spasms of the neck of the uterus. This remedy is also useful when the labour pains become feeble or cease entirely, after having been extremely violent for some hours. Nux vomica, when the labour is protracted from the irregu- larity and insufficiency of the pains, and there is constant inclina- tion to evacuate the bladder and rectum. Opium should be given, if the pains cease suddenly, and con- gestion of blood to the head with redness of the face, stupor and snoring take place. Pulsatilla, when the pains are feeble, and occur at long inter- vals, or when they diminish in strength and frequency as if from insufficient contractile power in the uterus; sometimes the labour pains are attended by spasms of the stomach and vomit- ing, or with acute pain in the back and loins, and painful drawing sensations in the thighs. Secale cornutum will be beneficial in cases similar to the latter, when that remedy has not proved efficient in increasing the activity of the uterine contractions. Administration.—Two or three globules of the remedy best adapted to the symptoms may be given dry, and repeated every hour until relief is obtained, or it becomes requisite to choose another. Or, ten or twelve globules may be dissolved in about an ounce of water and a teaspoonful given at a time, and repeated as above. During the progress of labour, the use of drugs and stimulants of every kind should be carefully avoided, as they all prove more or less injurious. Spirituous liquors are objectionable on account of their accele- rating the circulation and thereby increasing the danger of too great hemorrhage; Chamomilla, from its tendency to produce metrorrhagia; Coffea, from its causing high nervous excitement; Opium retards delivery by its sedative property; and all drugs and ptisans are in fact more or less of a stimulating or irritative nature and therefore obnoxious. 372 CHAPTER XI. Spasmodic Pains, Cramps, and Convulsions. In complicated labors we occasionally find spasmodic pains set in, which cause considerable suffering, and often materially retard the delivery. For these affections the following remedies will be most efficient: Chamomilla, Belladonna, Hyoscyamus, Stramonium, Ignatia, Ipecacuanha and Cocculus. Chamomilla, if there be very acute pains, mostly of a cutting description, extending from the region of the loins to the hypo- gastrium, and attended with spasmodic convulsions; redness of the face, particularly of one cheek, with great sensitiveness of the nervous system, and excitement. Belladonna, when there are excessively violent bearing-down pains, attended with convulsive movements of the limbs; great agitation and constant tossing; congestion to the head, with throbbing and distension of the blood vessels; red and bloated face and profuse sweating. Hyoscyamus, against severe convulsions with loss of conscious- ness ; great anguish and cries, with oppression of the chest. Stramonium, against tremblings of the limbs, and convul- sions without loss of consciousness. Ignatia, when there is a confused feeling in the head; spas- modic and compressive pains, with sensation of suffocation; convulsions. Ipecacuanha. Spasmodic convulsions; paleness or bloatedness of the face; nausea or vomiting. Cocculus, cramps or convulsions of the limbs or whole body; cramps in the lower part of the abdomen, with heat, redness and puffiness of the face. Treatment after Delivery. The patient should be kept perfectly quiet, both in body and mind, after delivery; everything which may have a tendency to excite her, such as noise, strong light and odors, even loud talking should be carefully guarded against. After the lapse of an hour or two, if no untoward symptoms exist, she may be DISEASES OF WOMEN. 373 "changed" and "put to bed". The bandage should be applied immediately after delivery and without disturbing the patient. If the labour has been at all difficult, and the patient com- plains of general soreness, a few doses of Arnica may be admin- istered internally at intervals of three or four hours. Much benefit will also be derived, in case there be much local pain or soreness, from the external application of a lotion prepared by mixing about twenty drops of the Tincture of Arnica in half a tumbler of water. The nervous excitement which is apt to follow delivery, and prevent the patient from procuring the sleep she so much needs, will generally be removed by a dose or two of Coffea cruda, or, should it mil and any febrile symptoms be present, Aconite will usually suffice. Flooding after Delivery. Directions for the appropriate treatment of this affection will be found under the heading of " Flooding", page 364. The medicines of most value are China, Chamomilla, Cro- cus, Platinum, Sabina, Belladonna and Tinct. of Cinnamon. After-Pains. Very few females escape the suffering occasioned by these extremely annoying pains, although they are of rare occurrence with first children. Generally they become more and more severe after each successive labour; and in some women of nervous temperament who have borne several children, they are very distressing, while others may have a number of children and never experience any suffering of consequence from them. In most instances the administration of one or more of the following remedies will greatly relieve, or remove them entirely. Arnica, when the pains are not very violent, and are accom- panied with a feeling of soreness, with pressure on the bladder and retention of urine. Chamomilla, if Arnica prove insufficient, and the patient is nervous and excitable, with great restlessness, tossing about, &c. 374 CHAPTER XI. Nux vomica, after or alternately with Chamomilla, at inter- vals of an hour between the doses, will often be serviceable, especially when the pains are of an aching or of a violent colicky description, and occur in choleric persons. Coffea cruda is valuable, when there is nervous excitement, and the pain is exceedingly violent in its character, or when the pains are followed by convulsions, with coldness and rigidity of the body. Pulsatilla is indicated in persons of a mild and gentle dispo- sition, when the pains do not return very frequently, but are protracted and continue for several days. Belladonna will be useful in cases attended with much bear- ing-down ; fullness about the head; disposition to sleep; tender- ness and fullness of the abdomen. Secale cornutum, and Cuprum, have been recommended highly for after-pains of the most violent description occurring in females who have borne many children. Duration of Confinement. The mother should remain in bed for the first five or six days after delivery; after that she may rise daily and sit up awhile, at first not longer than while her bed is making, but gradually lengthening the periods. The diet during this time should be light and farinaceous, consisting chiefly of gruel, panada, farina, toast and black tea or Other articles of a similar kind; and everything stimulating, both food and drinks, and all strong odors from flowers or other aromatic substances should be scrupulously avoided. The first two weeks should be mostly spent in bed, or at least in a half-recumbent posture, during which time but few visiters should be admitted. After this period, if the woman feel pretty strong, she may walk about her room, but should not leave it before the expiration of the third week; and ought not to attempt to go up or down stairs until the end of the fourth week after confinement. DISEASES OF WOMEN. 375 Irregularities of the Lochial Discharge. The discharges which take place after confinement, are called lochia, and vary considerably in different females, sometimes they are thin and scanty, and cease in a few days, at others they continue for several weeks, and are so profuse, as almost to amount to a hemorrhage. In the majority of instances, however, they cease about the tenth day. In colour and consistence they at first resemble menstruation, but gradually grow lighter coloured, loose the redness entirely, and become successively yellowish and whitish before their final cessation. When this discharge continues too long, or is too profuse, and also when it is checked suddenly, or suppressed from exposure to cold, errors of diet, or other cause, medical assistance is required. The following are the remedies most generally required in deviations of this function from a natural, healthy condition. Crocus is indicated when the discharge is too long continued in too great quantity, and consists of dark coloured or black blood of viscid consistency. Aconite is also valuable in too profuse lochial discharges of a deep red colour, and will frequently be found sufficient of itself to check them in two or three days without the administration of any other remedies. It may be given two or three times a day. Should Aconite be insufficient, Calcarea carbonica may follow it with advantage, especially if the discharge be attended with a sensation of itching in the uterus. Bryonia will be beneficial in cases of suppressed lochia, accom- panied by headache; fullness and heaviness in the head, with pressure in the forehead and temples; throbbing in the head, aching in the small of the back, and scanty discharge of urine. It is also useful when the lochia are too profuse in quantity and of a deep red colour, with internal burning pains in the region of the uterus. A dose may be taken once or twice a day, dry. Pulsatilla will be most serviceable for sudden suppression of the lochia, from mental emotions, exposure to dampness, or any accidental cause, particularly if it be followed by febrile excite- ment either with or without thirst; headache confined to one 376 CHAPTER XI. side; coldness of the feet; frequent desire to pass water. The symptoms are generally worse toward evening, and better in the morning. This remedy is also useful when the discharge is too scanty without being entirely suppressed. It may be adminis- tered either dry or in water, two or three times a day. Dulcamara will be useful in cases of suppression, occasioned by exposure to cold or dampness, and may either precede or follow Pulsatilla advantageously, and be administered in the same way. Opium and also Aconite, have been recommended for suppres- sion arising from fright and attended by congestion to the head. Platinum, for suppression consequent upon some mental emo- tion, and accompanied by dryness and over-sensitiveness of the sexual organs. Belladonna, followed if required by Carbo animalis, will be serviceable when the discharge continues too long and becomes thin, fetid, and offensive, producing excoriation of the parts. Secale cornutum has also been recommended under the same circumstances. These remedies may be administered night and morning, either dry or by dissolving a few pellets in about an ounce of water, a teaspoonful of which should be taken at a time. Milk Fever. Usually about the third day after delivery, milk makes its appearance; it may, however, be present at the time of, or even previous to delivery, or it may not appear until a later period than the third day. The coming of this secretion is frequently attended by so much suffering as to require medical attention. The following medicines will be found useful, when administered according to the indications mentioned under each. Arnica, given internally and applied to the breast in the form of a lotion once or twice a day, will be beneficial when there is much distension, with soreness or hardness. Aconite, if there be much fever, with hot, dry skin; redness of the face; breasts hard and knotted; restlesness, anxiety and discouragement. It may be given every four to six hours until relief is obtained. DISEASES OF WOMEN. 377 Bryonia, after the latter, when the symptoms have been but partly removed by that remedy, and especially if there be oppres- sion of the chest, violent pain in the head, and constipation. Belladonna may be given after or in alternation with Bryonia, when the latter has not been sufficient to remove the symptoms entirely. Chamomilla will have the preference when there is much nervous excitement, with restlessness; tenderness of the breasts, and inflamed nipples. Pulsatilla, in severe cases, when there is great distension of the breasts, with soreness and rheumatic pains extending to the muscles of the chest, shoulders, axillse, &c. A timely adminis- tration of this remedy will in many instances prevent a threatened attack of child-bed fever. Rhus toxicod., in cases similar to the latter, with rheumatic pains throughout the system; swelling, heat, and hardness of the breasts; headache; stiffness of the joints, and general con- stitutional disturbance. A common and good local application to the breasts, is to bathe them with hot lard and afterward cover them with raw cotton. Suppressed Secretion of Milk. When, from sudden and powerful mental emotions, exposure to cold or dampness, or any cause whatever, the lacteal secretion has been suddenly checked and is followed by some internal or local congestion, determination of blood to the head, and the usual train of symptoms which constitute puerperal fever, the immediate administration of Pulsatilla, ten or twelve globules dissolved in half a tumbler of water, and a teaspoonful given every four, six or twelve hours, according to the violence of the symptoms, will frequently be found sufficient to check the dis- ease at the outset, restore the flow of milk, and re-establish the equilibrium of the organism. If any unpleasant symptoms still remain they will in most cases yield to the administration of Calcarea carbonica, or Zincum. If active feverish symptoms should make their appearance, 48 378 CHAPTER XI. such as dry, hot skin, quick hard pulse, &c, Aconite should be given, repeated at short intervals, until some amelioration of the symptoms take place. When along with the above symptoms there is great restlessness and nervous excitement, benefit will be derived from giving Aconite and Coffea cruda alternately. In some cases, especially when serious metastasis follow the suppression, Bryonia, Belladonna, Rhus toxicod., Arsenicum, or Sulphur, may be called for. Excessive Secretion of Milk. It sometimes happens, that the secretion of milk is too abund- ant, causing painful distension of the breasts and involuntary emission of milk, productive of emaciation and debility, and sometimes developing latent tubercles. In cases of this descrip- tion, Calcarea carbonica will generally give relief, or, if it should fail, Phosphorus. Aconite must be'administered, if high febrile excitement of the whole system arise without apparent cause. Rhus tox., when the febrile symptoms are caused by disten- tion of the breasts induced by excessive secretion. The two last remedies may be given dry, repeated every six or twelve hours; the two first once or twice a day. Involuntary Emission of Milk. Occasionally, females are very much annoyed for some time after confinement by the constant escape of the milk, which keeps them continually wet, and very liable to take cold on the slightest exposure. Unless it be owing to some organic defect of the nipple, the following remedies will generally relieve it. China, when it is caused by debility from loss of fluids. Rhus toxicod., if from over-distention in consequence of exces- sive secretion of milk. Calcarea carb., or Pulsatilla, may also be useful in some instances. DISEASES OF WOMEN. 379 Diarrhoea during Confinement. Diarrhoea in lying-in women is a state to be looked on as highly injurious, and means should be taken to remove it as speedily as possible. The medicines which are generally best adapted to this purpose are, Phosphoric acid, Dulcamara, An- timonium crudum, Hyoscyamus, and Rheum. Dulcamara will generally be sufficient, when the diarrhoea has been caused by a check of perspiration, produced by chill from exposure to cold or dampness. Hyoscyamus, when the evacuations are painless or involuntary. Antimonium crudum and Rheum, against thin and watery or offensive evacuations. Phosphoric acid, in obstinate, protracted cases, when the dis- charge is watery, or painless and almost involuntary. See also the article "Diarrhoea", in a preceding chapter, for other remedies which may be required. Constipation. It is natural for the bowels to remain torpid for a few days after delivery, and nothing should be given to disturb this state, as it is at all times a good symptom and serves to promote the strength of the patient. Purgative medicines should in no case be given during confinement, as they can do no good whatever, and are often highly injurious to the patient. If, after the lapse of five or six days, the patient complains of fullness of the head or pain in the bowels, a dose or two of Bryonia will generally bring about an evacuation and afford relief. Should this be in- sufficient, Nux vomica, Sulphur, or some other of the remedies recommended under " Constipation" may be given. If after waiting a day or two, no evacuation takes place, give an injection of lukewarm water. Retention of Urine. Sometimes after delivery, particularly with first children and in difficult labours, there is retention or painful emission of urine. The administration of one of the following remedies will 380 CHAPTER XI. generally afford relief: Arnica, Pulsatilla, Belladonna, or Nux vomica. Sitting over a chamber which contains warm water, will often have the desired effect. Sore Nipples. The chief difficulty in the way of healing sore nipples, arises from their being constantly torn open afresh, by the efforts of the child in sucking. In the majority of cases, if proper attention is paid to the preparation of the breasts previous to confinement by bathing them with cold water or a weak solution of Tinct. of Arnica, as recommended under the heading of "Preparation of the Breasts", this soreness may be prevented. When, however, there is a tendency to tenderness and excoria- tion, the internal administration of Arnica, in pellets, twice a day; and bathing the nipples with a solution consisting of about ten drops of the Tincture of Arnica to half a tumbler of water, several times daily, will mostly remove it. Should this be insuf- ficient, it will be necessary to resort to Sulphur, Calcarea car- bonica, or some other remedies calculated to correct the consti- tutional taint to which this disease generally owes its origin. Sulphur, when the nipples are sore and chapped, with deep fissures around the base, which bleed and burn like fire. Graphites, for burning, aching, chaps and tenderness of the nipples. Calcarea, in cases similar to Sulphur, when the latter fails to relieve. ^ Nux vomica, for soreness of the nipples with painful excoria- tion of the adjacent parts. In obstinate cases, Lycopodium, Mercurius vivus, Sepia and Silicea will be found valuable. Administration.—The above remedies may be given night and morning, dry. Gathered Breasts. Inflammation and suppuration of the breasts is liable to occur during the whole period of lactation, and may arise from numerous DISEASES OF WOMEN. 381 exciting causes, such as cold, passion, fright, bruise, &c. Putting the child too late to the breast, or the sudden stoppage of suck- ling—from the death of the child or other reasons—frequently occasions distention of the breast followed by inflammation and formation of abscesses. The most effectual means of preventing suppuration is to keep the breasts well drawn; if the child is unable to do this, nipple glasses, a common tobacco pipe, or still better the lips of a nurse, or other adult person, should be made use of. The most valuable medicines in this complaint are Bryonia, Belladonna, Mercurius vivus, Hepar, Phosphorus and Sulphur. Bryonia is the principal remedy in the commencement, espe- cially when the breasts become swollen, hard and feel heavy, with shooting pains, dry skin, thirst, and other febrile symptoms. Belladonna, after or alternately with Bryonia, when there is much swelling and hardness of the breasts; shooting and tearing pains, and redness, sometimes of an erysipelatous appearance of the skin. These two remedies will generally be sufficient to effect a cure; if, however, some degree of hardness still remain, Mer- curius vivus should be given, and repeated a few times, at inter- vals of ten or twelve hours. Hepar will be indicated, when suppuration has already com- menced, which may be known by the appearance of throbbings, frequently preceded by a chill. Phosphorus, when there is profuse discharge of matter after or in alternation with Hepar. Silicea, in cases in which the discharge becomes fetid, thin and watery, and comes from several fistulous openings, which are not disposed to heal. Sulphur, in inveterate cases, when there is profuse discharge of matter, with emaciation, hectic fever, &c. Falling off of the Hair. Some females, while nursing, suffer from a falling off of the hair of the head. This evil generally arises from some delicacy of constitution. 382 CHAPTER XI. The following remedies will generally correct this tendency: Sulphur, Sejria, Lycopodium, or Calcarea. They may be repeated once or twice a week, beginning with Sulphur. The Importance of Mothers Suckling their Children. Conquest's remarks on this subject we deem very appropriate. He says: " Unless very peculiarly urgent reasons prohibit, a mother should support her infant upon the milk she herself secretes. It is the dictate of nature, of common sense, and of reason. Were it otherwise, it is not probable that so abundant a supply of suitable food would be provided to meet the wants of an infant, when it enters upon a new course of existence. " It is difficult to estimate the mischief resulting from infants being deprived of their natural nourishment; for, however near the resemblance may be between food artificially prepared and breast milk, still, reason and observation demonstrate the superi- ority of the latter to the former." And again: — "As a further inducement, it should be remembered that medical men concur in the opinion, that very rarely does a con- stitution suffer from secreting milk; whilst the health of many women is most materially improved by the performance of the duties of nurse." Upon the same subject he says in another place : " But few mothers, comparatively, are to be found, who, if willing, would not be able to support their infants, at least, for a few months, and parental affection and occasional self-denial would be abundantly recompensed by blooming and vigorous children. "Presuming that the laudable determination is formed to indulge the child with that nutriment which is designed for its support, it becomes necessary to state that unless very strong objections should exist, twelve hours should never elapse before the infant has been put to the breast. Instinct directs it what DISEASES OF WOMEN. 383 to do, and the advantages of allowing it to suck soon after birth, are many and important, both to the mother and child. " By this commendable practice, the patient is generally pre- served from fever, from inflamed and broken breasts, and from the distressing and alarming consequences resulting from these complaints. " If the breasts should not have secreted milk previous to delivery, the act of suckling will encourage and expedite the secretion. Thus the mother will be saved from much of the pain connected with distended breasts. Besides which, if the infant be not put to the nipple till the breast become full and tense, the nipple itself will sometimes almost disappear, on account of its being stretched; and without much, and often ineffectual labor on the part of the child, it cannot be laid hold of, and even then the pain endured by the mother is exquisitely severe, and not unfrequently the cause of sore nipples." There are, however, times when reasons peculiarly urgent may prevent the mother from suckling her offspring.—We sub- join a few remarks which may guide- the selection of a nurse in such instances. Choice of a Nurse. The woman who is to assume the responsible care of the infant, should be of about the same age as the mother, and delivered about the same time, or at least within three months of the same period. Let her possess a moderate degree of fullness, with a fresh complexion, clean eyes, and eyelids free from any appearance of redness and swelling. Discover, if possible, if she is free from hereditary taint. Her disposition should be mild, temper even and not irritable, and habit regular; to which qualities, of course, add a fondness for children. Having engaged her, enforce upon her mind by all means, that she must not indulge in food of too nourishing a nature, as it causes the milk to become too rich, and is consequently un- suited to the delicate digestive powers of the infant. 384 CHAPTER XII. She should observe a proper proportion of animal and vege- table food, and be guided by the Homoeopathic Regimen which is found in the beginning of this work. CHAPTER XII. TREATMENT OF CHILDREN. Reception at Birth. When the child is born before the arrival of the physician, it should be removed a little out of the discharges, so as to enable it to breathe freely; and if the cord be coiled around the neck, limbs, or any part of the body, it should be imme- diately disengaged, in order that the circulation between the mother and child may not be obstructed before respiration is fully established in the latter. The mouth and nostrils should also be cleansed from mucus ; the readiest method of doing this is with a piece of fine linen or muslin wrapped round the finger. If after these things are attended to, the child begins to cry strongly, and the skin change from a dull or leaden hue to a pink or rose colour, there is no further cause for alarm, as both, mother and child may remain in this condition without danger. As soon as the respiration of the child is fully established, and the pulsations in the cord have ceased, the child may be removed from the mother, providing there be any person at hand willing to undertake it. The cord should be tied in two places, the first ligature at about an inch and a half from the abdomen of the child, the second three-fourths of an inch from the first, and the cord cut between the two, using for this purpose a pair of scissors. The best ligature is one made of sewing thread, by twisting several strans together; a piece of narrow tape, however, or round bobbin sufficiently strong, will answer. It should be passed but TREATMENT OF CHILDREN. 385 once around the cord, tied firmly in a hard knot, and the ends cut off. Tha child may then be taken up by placing one hand under the head and shoulders, and taking hold of the feet with the other, and wrapped in a blanket or sheet moderately warmed and prepared for this purpose. Apparent Death. In case the new-born infant does not breathe in a few minutes after delivery, and is apparently dead, means should be imme- diately taken to resuscitate it. The body and limbs should be wrapped in warm cloths—flannel is preferable—and the hands and chest gently rubbed with a piece of flannel. If after the lapse of a short time, pulsation can be felt in the cord, and the beatings of the child's heart become perceptible, respiration will soon be fully established, and nothing more need be done. But if after continuing these efforts for five or ten minutes, no pulsa- tion can be felt, the cord should be cut, and the child immersed in a warm bath, being careful to keep the face out of the water. In this bath rub and squeeze the chest and limbs gently. If no signs of animation are manifested after five or ten minutes, dis- solve about as much crude tartar emetic as will lie on the point of a pen-knife, in half a tumbler of water, and after stirring it well, apply a drop of the mixture to the tongue of the child, with the point of the finger. If no change occurs in fifteen minutes, repeat the experiment again. While this is doing, cold water or spirits may be applied to its breast, either with the palm of the hand, or by letting a small stream from the spout of a tea-pot fall upon it from a height of two or three feet. Much benefit will also frequently be derived from placing the mouth over the child's mouth, and blowing gently so as to inflate the lungs, closing the child's nostrils at the same time between the thumb and finger to prevent the air from passing out through the nose. Care should be taken not to force too much air into the child's lungs at once, lest they be injured. After the lungs are filled, the chest should be compressed gently with the hands, or by 380 CHAPTER XII. drawing upon the ends of a napkin which has been previously wrapped round it, to expel the air. These efforts should be repeated several times, allowing a few moments to elapse between each. Infants have sometimes been restored after labouring with them for two or three hours; we should not, therefore, give up our efforts at restoration too speedily, as they may ultimately be successful. Washing the Child. This should be done immediately after birth, using for the purpose luke-warm water, a flannel wash-rag, and but a small portion of fine (white) soap. The white unctious substance, which to a greater or less extent covers the body of every newly-born child, and which adheres with great tenacity, is best removed by rubbing the parts covered with it, previous to wash- ing, freely with hog's lard until the two substances become thoroughly incorporated. After the child has been well washed, it should be wiped perfectly dry with a fine napkin. The practice of bathing children with spirits is highly repre- hensible and should in all cases be prohibited. Intemperance, and blunted moral sensibilities in after-life, have their founda- tions frequently laid in infancy by the improper use of alcoholic liquors. The child should be bathed at least once a day; at first with luke-warm water, gradually lowering the temperature, and after a few weeks using cold water. Dressing the Navel. The proper method of dressing the navel is to fold a piece of soft linen or muslin [into four or six thicknesses, making it six or eight inches long and three or four wide. A hole is to be made through the centre of this, and the cord passed through. The cord should then be tightly wrapped with repeated turns of a narrow strip of linen or muslin, and laid up toward the breast of the child, and the lower end of the linen or muslin folded , TREATMENT OF CHILDREN. 387 over it, and the whole secured by the belly band, which should always be made of a strip of fine flannel. The navel usually comes off from the fifth to the eighth day. The Meconium. The first evacuation from the infant's bowels consists of a dark bottle-green coloured substance, and is called meconium. Generally, the bowels are moved a few hours after birth, and require no artificial aid: the milk of the mother exciting a mechanical action of the alimentary canal, assists in effecting this object. In case, however, the discharge should be too long delayed, and the child become uneasy and restless, a few tea- spoonsful of warm sugar and water may be given to it, which will generally have the effect desired. Should this not be suffi- cient, and the child's bowels are not moved as freely or as fre- quently as they ought to be during the first few days, a dose or two of Nux vomica, Bryonia, or Sulphur, may be administered to both mother and child; to the latter not more than one or two pellets at a time. Laxative medicines should never be given to infants for the purpose of purging off the meconium, as to this too common practice of nurses, many chronic diseases of after-life are to be attributed. Swelling and Elongation of the Head. It is common for the head of the infant to be swollen and elongated immediately after birth, especially when the labour has been difficult and protracted, and occasionally tumours appear on the back or top of the head. This will generally disappear of itself in a few days. In case the swelling should be extensive, repeated washings with cold water, or a weak solution of Tinct. of Arnica—three or four drops to half a tumbler of water—will hasten its removal. Putting the Child to the Breast. The child should be put to the breast in five or six hours after delivery, if the mother be able to bear the fatigue. This 388 CHAPTER XII. , should be done even if the mother have no milk, as the child will be taught to suck, and the secretion of milk hastened by it. There will also be less liability to sore nipples, distended breasts, and milk fever. If the coming of the milk should be delayed for a day or two, the child should be nourished meanwhile with fresh cow's milk, diluted with an equal quantity of warm water, and sweetened with loaf sugar. The milk should always be obtained from the same cow if possible. Young infants should never have gruel, pap, panada, or cooked food of any kind. Always before applying the child the nipple should be moist- ened with milk and water, sweetened water, or saliva. Infants will be benefitted by giving them a few teaspoonsful of cold water every day. See also " Suckling of the Infant" in the pre- ceding chapter. Inflammation of the Eyes. Quite young infants are liable to inflammation of the eyes and eye-lids. In most instances the lids only are affected at first, but the eye-balls soon become involved if the disease is neglected in the commencement. The most common causes of this affection are exposure of the eyes to too strong a light, or from taking cold by exposing the child to a draft of air, &c. The following remedies will generally remove this disorder. Aconite should be given first, especially if the inflammation arises from exposure of the eyes to too much light; and the entire eye becomes red, and runs a good deal. Belladonna, after or alternately with Aconite, when the whites of the eyes are very red; with bleeding from the eye-lids; in- tolerance of light, &c. Ignatia, in cases similar to Aconite, after that remedy has been given without much benefit. Chamomilla, when the eye-lids are swollen, bleed, and are glued together in the morning with a yellowish secretion. Mercurius vivus is one of the most important remedies in this affection, when there is redness of the eyes and eye-lids; small TREATMENT OF CHILDREN. 389 yellowish ulcers along the margins of the lids; with discharge of yellowish matter, &c. Pulsatilla, when there is profuse discharge of purulent matter from the eyes, with redness of the whole eye and interior of the lids. Calcarea carb. and Rhus tox. are useful in cases occurring in scrofulous children, and when the lids are chiefly affected. Euphrasia is also valuable in many cases of this complaint, especially when there is accumulation of matter in the eyes, and intolerance of light. Obstruction of the Nose. "Sniffles". The nostrils of infants often become obstructed from a species of catarrh, which prevents them from breathing while suckling. Nux vomica, given at night, will mostly afford relief; if, however, the complaint still continues in the morning, give Sambucus, and repeat it every six hours until relief is obtained; or one of the following remedies appears to suit better. Chamomilla, if the obstruction is attended with much run- ning of water from the nose. Calcarea, when Chamomilla has been given without success, and the running still continues. Carbo vegetabilis, when the complaint is worse every evening; Dulcamara, when worse in the open air. Tartarus emetic, if there be rattling of mucus in the chest which is worse at night, along with the running from the nose. Sore Mouth. Thrush. Aphthae. This disease commonly makes its appearance about the second or third week after birth, and commences by the formation of small, round, white vesicles, which are at first isolated and scat- tered over the tongue and interior of the mouth, which if not soon checked run together, forming patches, and sometimes become ulcerated and cover the whole of the mucous membrane of the mouth, and in severe cases extend to the throat. This affection, though not dangerous, is often painful to the child, and prevents 390 CHAPTER XII. its suckling. It may also be communicated to the mother, and causes soreness and excoriation of the nipples, &c. The disorder is frequently owing to some constitutional taint and consequently we often find it attacking every child in some families, while other families always escape it. It is most gene- rally, however, produced by want of a proper attention to clean- liness. The use of improper food also gives rise to it; and hence children raised either partially or wholly by hand, are more liable to this affection than those who are nourished exclusively by the mother's milk. In the treatment of aphthae, Mercurius vivus, Sulphur, and in some cases Arsenicum, will be required. The mouth should be well washed several times a day with cold water. Mercurius vivus should be given twice a day, when the disease first makes its appearance, and also in cases when there is much salivation, and the thrush indicate a tendency to ulceration. Sulphur should follow Mercurius vivus when the latter fails to effect a cure after having been continued for a few days. Arsenicum will be indicated in bad cases, the two preceding remedies having failed to check the disease, and the aphthae assume a livid, or bluish appearance, attended with great weak- ness and diarrhoea. Bryonia and Nux vomica may also be useful in some cases. A common remedy in old-school practice, and one which is ho- moeopathic too in many cases of the disease, consists of powdered Borax and loaf sugar mixed in equal parts and applied to the mouth of the child, three or four times a day. Or a few grains of the Borax may be dissolved in a teacupful of water, and the mouth of the child washed with the solution two or three times a day. This remedy should not, however, be continued too long, lest it prove injurious by aggravating the disease. Jaundice. This disease occasionally occurs in infants, and may be known by the yellowness of the whites of the eyes and urine in the commencement, and afterward of the skin of the whole body. TREATMENT OF CHILDREN. 391 The bowels are sometimes costive, and at others loose, and the stools are generally light or clay-coloured. The disease may arise from exposure to cold, or from the injurious practice of administering aperient medicines immediately after birth. Chamomilla, Mercurius vivus, China, and Nux vomica, are the chief remedies in this complaint. Chamomilla may be given first, and in many cases will be of itself sufficient to effect a cure. Mercurius vivus may follow Chamomilla when the symptoms have only been partially removed by the latter, or when that remedy has failed in affording any relief. China, when there are any symptoms remaining after the use of the foregoing remedies. Nux vomica, if the complaint be accompanied by costiveness of the bowels, and the child is extremely irritable. The remedies should be administered twice a day, either dry or by dissolving two or three globules in a teaspoonful of water. After continuing one remedy for four or five days, if there be but little or no improvement, another must be substituted. Excoriation. The best preventitive of this complaint is cleanliness; when it becomes bad, however, the following medicines will be found useful to assist in its removal. Chamomilla will, in most cases, be sufficient for the removal of this affection, when it has not been produced by the use of chamomile-tea, taken either by the mother or child, in which case Pulsatilla, Carbo vegetabilis, or Ignatia, should be given. Mercurius vivus, when the excoriation is extensive, and there is yellowness of the skin, which Chamomilla has failed to remove. Sulphur, and Carbo vegetabilis, in obstinate cases, which the foregoing remedies have failed to cure, will frequently be found efficacious. Sepia, Lycopodium, and Silicea, are also worthy of attention. 392 CHAPTER XII. Bathing frequently with cold water, or with a weak lotion of Tincture of Arnica, will often remove this affection in its in- cipiency. The Gum. The term " gum" is given to an eruption of red pimples, which makes its appearance in early infancy, and chiefly occupies the face, neck, and arms; it may, however, extend to the whole body. The disorder is frequently the result of inattention to clean- liness, keeping the child too warm, and giving it cat-nep, sweet marjorum, and other teas. Children that are properly bathed and clothed, are seldom much troubled with this eruption. A few doses of Rhus tox., or Sulphur, will generally be suf- ficient for the removal of this affection, when it makes its ap- pearance. Aconite may be required if the eruption should be extensive, and accompanied by more or less irritative fever. Retention of Urine. This complaint often occurs in young infants, and requires immediate attention. It will generally be removed by dissolving six or eight pellets of Aconite in half a tumbler of water, and giving the child a teaspoonful of the solution every three or four hours until relieved. Should this fail, Pulsatilla, given in the same way, will generally suffice. Consult also, in obstinate cases, the same article in Chapter X. Constipation. Constipation in children is frequently produced by an improper mode of living, either on the part of the nurse or child; and when it arises from want of exercise, too much animal food, &c, on the part of the nurse, it may be removed by proper attention to these points. As a general rule, there should be an evacua- tion from the bowels at least once a day, in quite young chil- dren ;. and if delayed longer than this, one of the following medi- TREATMENT OF CHILDREN. 393 cines should be given, Bryonia, Nux vomica, or Opium, and will generally produce a change. Sometimes, when the cause appears to be in mother or nurse, it will be necessary to give the medicine to them as well as to the infant. In obstinate cases, injections of warm water may be adminis- tered with benefit. Diarrhoea. Healthy infants, while suckling, usually have from three to six evacuations from the bowels in the twenty-four hours; and only when the discharges become more frequent than this, and are changed in character, becoming green and watery, or yellow, brown; or white and frothy or watery; or mixed with mucus or blood, and the child gives evidence of suffering, does it become necessary to interfere by administering medicines. The medicines most useful in the diarrhoeas of infants are: Ipecacuanha, Rheum, Chamomilla and Belladonna. Ipecacuanha will be indicated, when the diarrhoea has been caused by over-loading the stomach; and especially if accom- panied by nausea and vomiting; paleness of the face; frequent crying; the stools of a bilious, slimy, or greenish yellow colour; sometimes blackish, or streaked with blood, and of a putrid odor. Rheum, when the diarrhoea has arisen from acidity, and is attended by flatulent distention of the abdomen; colic; crying and straining both before and after the evacuations, which are frothy, slimy and watery, and smell sour; a sour smell is also emitted from the body of the child, even when the strictest attention is given to cleanliness. Chamomilla, in diarrhoeas, of a bilious, watery, frothy, or slimy character, and of a whitish, greenish or yellowish colour, sometimes having the appearance of beaten-up eggs, and of an offensive odor, like that of rotten eggs. The diarrhoea is fre- quently attended by colic, with fretfulness, crying, restlessness and drawing up of the legs toward the abdomen; and redness of the face or of one cheek. 50 394 CHAPTER XII. Belladonna is frequently indicated in the commencement, when the child is disposed to sleep a good deal, but is restless, and starts up suddenly; the evacuations greenish, small and frequent. Aconite will be required in diarrhoeas attended with much fever. Opium or Aconite when produced by fright. Colic. Colic is a common affection in young infants. It may be caused by errors of diet on the part of the mother, or by feed- ing the child with food not suited to its digestive organs. As before remarked, young infants should be exclusively nourished from the breast, if it be possible; and any departure from this is very likely to be followed by more or less suffering. Expo- sure to cold, or any cause liable to affect either mother or child injuriously, may induce colic. The attacks are sometimes ex- tremely violent and frequent, so much so as almost to wear out both mother and child; when this is the case, there is generally some constitutional predisposition. It is also frequently attended by diarrhoea. Treatment.—The following medicines are the most serviceable in attacks of infantile colic : Chamomilla, Ipecacuanha, China, Pulsatilla and Nux vo- mica. Chamomilla will be sufficient in most cases, especially if the pain be attended by distention of the abdomen, crying, writhing and twisting, drawing up the legs toward the abdomen, and coldness of the feet. Ipecacuanha when the colic is attended by sick stomach and diarrhoea, the stools fermenting and of a putrid odour. China, against colic with distention and hardness of the ab- domen ; the attacks are more liable to come on toward evening; screaming followed by laughing. Nux vomica, when the attacks of colic are attended by cos- tiveness. Pulsatilla, in flatulent colic, with rumbling of wind in the TREATMENT OF CHILDREN. 395 abdomen; shivering and paleness of the face, and tenderness of the abdomen. The medicines may be administered by dissolving five or six pellets in half a teacupful of water, and giving a teaspoonful every hour or half hour in violent cases; or by giving two or three pellets dry, repeated as above. Swelling of the Breasts. The breasts of infants are sometimes swollen at birth, or some time after; this is frequently caused or aggravated by the highly reprehensible practice, of nurses and others, of squeezing the breast with the mistaken notion that there is milk, or some mat- ter in them, which should be pressed out. Mothers cannot be too careful in guarding their nurses against this practice, as in some instances extensive suppuration has been produced by it, resulting in disorganization of the breasts, and in females, de- stroying their [usefulness for ever. When the breasts are found to be swollen, a linen rag wetted with sweet oil should be applied to them, and in the majority of instances the swelling will disappear in a few days, and nothing else be required. If, however, the swelling should become exten- sive, and be accompanied by redness and inflammation of the breasts, a dose or two of Chamomilla, followed by Belladonna, may be required. It may also be necessary to apply a bread and milk poultice in severe cases. When the inflammation and sore- ness arises from squeezing and pressing the breasts and nipples, Arnica should be given. If suppuration have taken place, a few doses of Hepar should be given, and followed in two or three days by Silicea. Crying of Infants. The occasional crying of infants should not be a cause for alarm, as this is the language, by which their wants are made known. And hence they cry when they are hungry, need changing, or have lain too long in one position, &c. Only in cases where the crying is excessive, and the usually means of 396 CHAPTER XII. pacifying them fail, we may suppose they are suffering from pain, and should immediately endeavour to ascertain the cause, which will frequently be found to be some mechanical cause, such as derangement of the infant's dress, or a pin sticking into the flesh, &c. When, however, the child continues to cry for a long time without any apparent cause,— Belladonna will frequently prove serviceable, and also when it starts suddenly out of sleep and begins to cry violently. Aconite or Coffea, if Belladonna should fail, will often be successful, especially when the crying is accompanied by uneasi- ness and heat. Chamomilla will also frequently be useful, and especially if there be reason to think the crying is caused by earache or headache. Restlessness and Wakefulness. Restlessness and inability to sleep are generally produced by giving the child injurious food, or overloading its stomach, or by the mother's drinking coffee, wine, &c, or making use of some improper article of diet. Coffea will often be sufficient to remove the restlessness, when there appears to be much nervous excitement, with hot skin, &c. Opium, when Coffea is insufficient, and there is redness of the face. Chamomilla, if the restlessness be attended by flatulency and griping, with starts and jerkings of the limbs, or feverishness with redness of one cheek. Belladonna, when the child appears to be drowsy but can't sleep, or falls asleep for a few moments and starts up suddenly and cries. Pulsatilla or Ipecacuanha, when the restlessness arises from over-loading the stomach. Nux vomica, if it be caused by either mother or child taking wine or other stimulants. TREATMENT OF CHILDREN. 397 Hiccough. Hiccough, when long continued, sometimes gives rise to a good deal of uneasiness, especially to young mothers; it is gene- rally caused by exposure of some part, or of the entire body, to the action of the atmosphere, even in a warm room, or while dressing or undressing the child. Wrapping the infant up warmly, or giving it the breast, will generally cause it to cease. Should it however continue, the administration of a teaspoonful of water, sweetened with white sugar, may be given; and in case this should fail, a dose of Nux vomica. Scurf on the Head. Children are sometimes troubled with a dark or dirty looking unsightly incrustation, which generally makes its appearance on top of the head, partially covering the scalp. On removing any part of this crust, the skin will be found red and inflamed. It frequently emits quite an offensive smell, and is always annoying to the child by the irritation and itching it occasions. Removing it forcibly with a fine tooth comb will not cure it, but be more likely to aggravate it; for so long as the diseased state of the scalp remains, it will be reproduced. It is generally caused by keeping the children too warm, or by inattention to cleanliness, and is seldom found in children whose heads are regularly washed every morning, and after being properly dryed, brushed with a soft hairbrush. Sulphur, administered night and morning for several days, will generally correct any tendency that may exist toward this formation. The crust may be removed by anointing it well with lard at night, and washing it off next morning with a solution of borax and water. This application may have to be several times repeated. Spasms or Convulsions. In infancy and early childhood there is always a great pre- disposition to this serious affection. This is owing to the preponderance of the cerebral and nerv- 398 CHAPTER Xn. ous systems over the other parts of the body, and the consequent increased susceptibility of the system generally to the action of injurious influences of all kinds during this period. Hereditary predisposition and living in badly ventilated portions of large and crowded cities may also be mentioned as predisposing causes of this malady. Among the principal exciting causes, dentition, repelled eruptions, the fever attending eruptive diseases, irritat- ing substances in the stomach, worms in the intestines, mechani- cal injuries, such as a fall or blows, particularly upon the head, fright, &c, may be enumerated. When a child is attacked with convulsions, and no physician is at hand, the lower extremities up to the knees, may be im- mersed in water, as hot as it can be borne, for the space of five or ten minutes, or until the paroxysm appears partially subdued; after which the child should be wiped perfectly dry, and placed in a warm wrapper; if the first immersion be followed by no relief, or a second attack speedily follows, it should be repeated, at the same time a small stream of cold water should be poured upon the head of the child from a height of two or three feet; this course several times repeated has often been found to restore children. When irritating substances in the stomach or intestines, or cos- tiveness of the bowels, is the probable cause, an injection of warm water, or molasses and water, should be given as soon as possible. In the absence of the proper homoeopathic medicines, relief may sometimes be obtained by smelling camphor, or by placing a drop or two of the diluted tincture on the tongue. The chief reliance, however, for the cure of the disease is in administration of one or more of the following medicines, carefully selected, according to the symptoms and cause, as nearly as possible. The most favor- able time for giving the medicine is just as the fit is going off, unless it continue a long time or the paroxysms follow each other in quick succession, in which case the medicine must be given immediately without waiting for the fit to terminate. If the first dose produce no change it should be repeated in ten or twelve minutes, but if improvement follow the administration of the TREATMENT OF CHILDREN. 399 first dose nothing more should be given as long as it continues; when the symptoms get worse again or another paroxysm comes on, the same medicine must be repeated. If the remedy first given does not ameliorate or remove the disease after waiting half an hour another must be selected. Chamomilla is indicated, if there be convulsive jerking of the limbs, twitching of the muscles of the face and eyelids, with constant motion of the head from side to side, followed by drow- siness, with the eyes half closed, and loss of consciousness; red- ness of one cheek and paleness of the other, constant moaning, and craving for drink. Belladonna, when the child starts suddenly when asleep, or stares about wildly; the pupils are much dilated; rigidity of one or more of the limbs or of the whole body; dryness and burning heat of the forehead and palms of the hands; involun- tary discharge of urine after the return of consciousness; the slightest touch sometimes provokes a new paroxysm. The fits are sometimes preceded by smiles and laughter. Ignatia is the chief remedy in the convulsions of children, especially when the cause is unknown, and the following symp- toms are presented; sudden and violent starting from a light sleep with loud screaming, and trembling of the whole body: when the muscles of single limbs are convulsed or there is an occasional spasm of a single muscle here and there in different parts of the body; when the fits return every day at the same hour, or every other day about the same time, and are followed by fever and perspiration. Coffea is frequently serviceable in weak and nervous children who are subject to convulsions without any apparent cause, other than weakness. Ipecacuanha, in asthmatic children, when the fits are accom- panied by nausea, retching and vomiting or diarrhoea, and the attack is preceded, attended or followed by stretching of the limbs. Cina is useful in delicate children who are troubled with worms or in the habit of wetting the bed; spasms of the chest 400 CHAPTER Xn. followed by rigidity of the limbs or of the whole body; and itching at the nose and anus. Mercurius vivus, against spasms caused by worms, with dis- tension and hardness of the abdomen; tossing and stiffness of the limbs; eructations, salivation, fever and moist skin, and great weakness after the paroxysms. This remedy may precede or follow Cina advantageously. Opium is particularly suitable in convulsions caused by fright, and attended by much trembling over the whole body, tossing of the limbs, and loud screaming during the paroxysm; also when the child lies unconscious as if stunned, or breathes heavily and with difficulty; distension of the abdomen and suppression of the evacuations. Hyoscyamus, in convulsions caused by sudden fright, with twitching of the muscles of the face and foaming at the mouth. Stramonium, in sudden convulsions from fright, or when oc- curring in fevers or from repelled eruptions, with tossing of the limbs and involuntary evacuations of faeces and urine. Sulphur, is especially serviceable in convulsions arising from repelled chronic eruptions. r Dentition. The period of dentition in children is generally attended with more or less derangement of health. During teething there is always a tendency of blood toward the head, which if not timely attended to by keeping the head cool and administering the suit- able medicines, may lead to inflammation of the brain. The following are some of the most common symptoms attendant upon this period; greater restlessness than usual especially at night; flushes of heat and alternate paleness of the face; the gums become swollen and hot; difficulty in suckling; the child frequently takes hold of the nipple, bites and lets go again; dis- position to bite at everything; constant driveling from the mouth, and looseness of the bowels. The two latter symptoms may be looked upon as salutary, by preventing a tendency to congestion TREATMENT OF CHILDREN. 401 of the brain or lungs to which all children are more or less dis- posed at this time. The first set of teeth are twenty in number, and generally make their appearance in the following order; the two middle lower teeth first, and when the child is about six months old; next, the two middle incisors of the upper jaw in three or four weeks after the first; soon after these the two lower lateral inci- sors below, which are followed speedily by the two lateral incisors above. In about two months after these the first four jaw teeth appear, two below and two above; shortly after these the sto- mach and eye teeth are cut; and finally, at the age of two or two and a half years, the four back jaw teeth, two above and two be- low, completing the set. There is, however, considerable variation from the above regu- lar order, and time of teething; some children get their first teeth two or three weeks after birth or indeed are born with them, while others again do not get any teeth until they are nearly a year old. In healthy children when due attention has been paid to exer- cise, diet, &c, the period of dentition will generally be passed with comparatively little suffering. The mother or nurse during the whole period of dentition should pay particular attention to her regimen, and avoid every thing indigestible or stimulating in its nature. She should es- pecially abstain from the use of spirituous and malt liquors, which from their irritating properties are particularly injurious, and are one of the most frequent causes of the suffering of chil- dren at this period. Lancing the gums, though seldom necessary, may be resorted to in some tedious cases of teething. The best instrument for this purpose is a gum lancet, the blade of which should be placed over the tooth, and an incision made through the gum to the tooth. In the absence of a proper lancet a pen-knife will answer the same end. The following are the medicines most generally required: Aconite, Chamomilla, Coffea, Belladonna, Nux vomica, Cal- ' 51 402 CHAPTER XII. carea carb., Ignatia, Cina, Ipecacuanha, Mercurius vivus, and Sulphur. Aconite, when there is fever with much restlessness, sleepless- ness and pain, as evinced by the child's crying and starting. Belladonna, in convulsions caused by teething; the convul- sion is followed by sound sleep, which continues for a long time, or until another paroxysm comes on. The child starts sud- denly from its sleep as if frightened, and looks around as if ter- rified, with an altered expression of countenance; the pupils of the eyes are enlarged, and the child stares at a particular spot; the whole body becomes stiff; with burning heat in the palms of the hands and in the temples. Calcarea carbon., when the process of dentition is retarded, in children of light complexion, and inclined to be fat. Give the medicine once a week for three or four weeks. Chamomilla is particularly adapted to the various diseases of children during the period of dentition, and especially when a child is very uneasy at night; tosses about; wants drink often; has spasmodic jerks and twitches of the limbs during sleep; starts from the slightest noise; general heat; redness of one cheek and of the eyes; moaning; groaning; agitation; short, quick, noisy respiration and oppression of the chest; hacking cough; mouth dry and hot; diarrhoea, with watery, slimy and greenish evacuations, worse at night. Cina may be given to children who wet the bed at night and grit their teeth during sleep and at other times; have hardness and distention of the abdomen; rub the nose, and have a dry cough, resembling hooping cough. Coffea, when the child is very excitable; does not sleep; is sometimes fretful and at other times too lively, with some fever. Ignatia, when there is convulsive jerkings of single limbs; frequent flushes of heat, sometimes followed by perspiration; the child rouses from a light sleep with piercing cries and trembles all over. Ipecacuanha is very useful in nausea and vomiting with diar- rhoea; the stools are mixed, of different colours. TREATMENT OF CHILDREN. 403 Mercurius vivus is applicable in cases of copious driveling, redness of the gums, and green evacuations from the bowels, with straining. Sulphur^ may be given when the stools are whitish or hot and sour; and excoriate the nates. Summer complaint. Cholera infantum. This disease, so common in infancy, and so often fatal under old school treatment, usually commences with sick stomach and vomiting followed by diarrhoea. The matters ejected consist at first of food and afterwards of mucus; or there may be mere gagging and fruitless efforts to vomit. The evacuations from the bowels are very frequent and may assume various appearances, sometimes they are greenish, thin and watery, or yellowish, at others whitish or slimy and mixed with bloods Often the food is passed undigested, and the odour is occasionally very offensive. If the disease continues for any length of time the child loses its appetite, the flesh becomes soft, and the emaciation frequently so great that the skin hangs in folds about the person, hectic fe- ver with evening aggravation sets in, the eyes are sunken and but half closed during sleep. The thirst for cold water is usu- ally very great, and drinks of all kinds are immediately rejected by the stomach. The hea,d and abdomen are hot and the latter generally distended, while the feet and hands are cold. The most common exciting causes of summer complaint, are, improper diet either on the part of the mother or child, vicissi- tudes of temperature, improper clothing, want of fresh air and teething. The latter is probably the most frequent cause, as children are more liable to this disease during their second summer. At the season in which children are most subject to cholera infantum strict attention should be given to diet, exercise and clothing, both by mother and child. In regard to the diet, every thing stimulating, such as vinous and fermented beverages, acids, all highly seasoned food, and most vegetables should be dispensed with. And in general the homoeopathic regimen as recommended 404 CHAPTER XII. in the beginning of this work, closely adhered to. The clothing should be adapted to the season and changed to suit the vicissi- tudes of temperature, care being taken not to clothe the child too warmly. The apartments should be kept cool and well aired, and the children frequently taken out into the open air. Children living in large cities will be much benefitted by a ride out into the country, or on the water by steamboat. The medicines most efficacious in this complaint are Antimo- nium crudum, Arsenicum, Bryonia, Carbo vegetabilis, Dulca- mara, Ipecacuanha, Mercurius vivus, Nux vomica, Veratrum and Sulphur. The following are the indications governing the choice of each. Antimonium crudum, when the tongue is coated white or yel- low ; dryness of the mouth with thirst; nausea with vomiting, or gagging and cough; distension of the abdomen with flatu- lency ; offensive, slimy stools; and frequent passages of water. Arsenicum, if the child be very weak, pale and emaciated; inflation of the abdomen; cold extremities; loss of appetite; nausea and vomiting; intense thirst; yellow and watery, white or brownish offensive diarrhoea, which is worse after midnight, towards morning, and after eating or drinking. Bryonia, when the diarrhoea comes on in hot weather, and is accompanied by much thirst; vomiting of food; nausea and vomiting after eating; diarrhoea with colic; stools have a putrid smell, are white or brownish and lumpy. Carbo vegetabilis: if Bryonia afford but temporary relief give Carbo vegetabilis, especially if the evacuations be very thin and offensive; and are attended with burning, and much pain. Dulcamara, if the complaint return every time the weather gets cool, or takes place after drinking cold water while in a heat; violent thirst for cold water; diarrhoea of a greenish or brownish mucus, worse at night. Ipecacuanha, if given in the commencement of the disease will generally arrest its progress at once. The symptoms which indicate this remedy are chiefly, nausea and vomiting of food and drink, or of mucus and bile, attended with diarrhoea of fermented TREATMENT OF CHILDREN. 405 stools of white flocks or tinged with blood; coated tongue; dis- like to all food; and raging thirst. Mercurius vivus, when the diarrhoea is worse before midnight and is attended with colic, straining at stool, and perspiration; evacuations scanty, greenish, sour, and attended with nausea and eructations. Nux vomica: if Ipecacuanha should not be efficacious in ar- resting the disease at the outset give one dose of Nux vomica at night and another next morning. Veratrum, when the weakness from the nausea and vomiting is so great as almost to cause fainting; great exhaustion, vomits ing and diarrhoea; vomiting after swallowing the least liquid; the slightest movement excites vomiting; thirst for cold water; sensitiveness over the pit of the stomach; colic, with burning and cutting pains in the abdomen; loose, brownish, and blackish stools; and, small unnoticed evacuations of liquid faeces. Sulphur will be valuable in protracted cases, especially when the evacuations from the bowels are frequent, and greenish, thin and watery, or whitish and slimy. Some inveterate cases of this complaint are said to have been cured by the administration of fresh, unsalted butter, melted, and a tablespoonful given at a time and repeated 3 or 4 times a day. Soreness behind the Ears. For the appropriate treatment of this affection, see " Excoria- tion." The medicines of most value in the complaint are, Cal- carea carb., Graphites and Sulphur. Running from the Ears. Otorrhcea. Abscesses are frequently formed in the ears of young chil- dren. They are generally preceded by violent pain, giving rise to screaming, rolling and tossing of the head, sudden starting out of sleep and more or less fever. As soon as the abscess breaks and matter is discharged the pain ceases. The running is often profuse and difficult to cure. The matter is generally white, but occasionally it becomes greenish or dark coloured and extremely offensive. 406 CHAPTER Xn. Belladonna, Mercurius vivus, Cliamomilla, and Pulsatilla, are the best remedies for the pain. Pulsatilla, Calcarea carb., Rhus tox., and Sulphur, for the discharge. The ear should be frequently washed. See also "Af- fection of the Ears", page 164. Nocturnal Urination. "Wetting the Bed." This, to parents especially, exceedingly troublesome complaint, is generally produced by disease or by constitutional weakness, though in some cases it may result from inattention to cleanli- ness and indulgence in bad habits. It may generally be cured by one or more of the following remedies: Silicea, Sepia, Natrum muriaticum, or Pulsatilla. Rupture of the Navel. Umbilical Hernia. This affection is quite common in young children, and may be known by the unnatural protrusion of the navel. It is not often painful unless it becomes large; when discovered to exist, a piece of pasteboard, sheetlead, or other hard substance should be covered with linen, placed over the navel, and secured there by a broad bandage. This, by being constantly worn, will gene- rally remove it. Another excellent method is to take the half of a nutmeg, cover it with a piece of soft linen or buckskin—like a button— attach this to a broad bandage, so that the convex surface of the covered nutmeg will be placed immediately over the navel, and secured there by the bandage. The cure will be much facilitated by the occasional adminis- tration of a dose of Nux vomica. Heat Spots. "Prickly Heat." Infants and young children are frequently troubled with an eruption consisting of small vesicles, generally about the size of a pin's head; they are red and inflamed at the base, and filled with watery fluid. After breaking they sometimes form into thin scabs and occasionally are disposed to ulcerate. There ia TREATMENT OF CHILDREN. 407 usually more or less fever accompanying the eruption, which is often very annoying to children on account of the itching and burning with which it is attended. The heat of summer is the time at which this eruption is most prevalent; its development is also favoured by warm rooms and an excess of clothing. The disorder will generally be re- moved by frequent bathing, and proper attention to ventilation and dress. When attended by much fever and restlessness, a few doses of Aconite or Chamomilla will afford relief. Rhus tox. may be given, if the eruption is extensive, and Arsenicum or Sulphur, if Rhus should be insufficient. Sulphur, given at long intervals, will correct the tendency to this complaint. Leucorrhoea of Children. Little girls are sometimes subject to a discharge of whitish mucus from the vagina, resembling the leucorrhoea of adults. It may be the result of inattention to cleanliness, or proceed from some constitutional or other cause. Frequent bathing with luke-warm water will generally cause its removal in a short time; or, if this should fail, the internal administration of Calcarea carb., once a day for a few days, followed if necessary by Pulsatilla, will effect a cure. Weaning. Generally the most suitable age to wean children is when they are about eighteen months old; by the time they arrive at this age, the teeth are usually sufficiently developed to masti- cate more solid food, and the milk of the mother may be dis- pensed with. If the mother be delicate, the supply of milk begin to dimin- ish in quantity and deteriorate in quality, or the menstrual dis- charge reappear, the child may be weaned at an earlier period. On the other hand, the child should not be weaned while it is suffering much from the irritation of teething, or any other 408 CHAPTER XII. infantile disease, unless the health of the mother renders it abso- lutely necessary. As the teeth begin to appear the child should gradually be accustomed to other food than the mother's milk, so that, when the period for weaning arrives, its digestive organs will be fully prepared for the change of diet. The most suitable seasons of the year for weaning are the spring and autumn. After weaning, the child's diet should consist of simple but nourishing food, such as bread and milk, arrow root, farina, &c, and the transition to a more substantial fare should be extremely gradual. The mother, also, after the child is taken from the breast, should be particularly careful in her diet, and until the secretion of milk has ceased, live as low as possible. If the breasts become much distended and painful, they should be bathed with hot lard, and wrapped in raw cotton. It will also be necessary to have them drawn occasionally. At the same time the internal administration of Pulsatilla and Rhus tox. will aid materially in stopping the secretion. They may be taken alternately twice a day. Vaccination. Vaccination is a purely homoeopathic operation, and one which from its efficacy in the prevention of small pox, a disease presenting similar symptoms, may be considered one of the most conclusive proofs of the truth of the homoeopathic law. The most suitable age perhaps to vaccinate children, is from the fourth to the sixth month; the operation may, however, be performed at any age, and when the small pox is prevailing as an epidemic, quite young infants may be vaccinated. It is a matter of great importance, to obtain the virus from a healthy child—one that is free from scrofulous taint, and all other hereditary, and especially cutaneous diseases. When the vaccination is successful, the best means of preventing the deve- lopment of eruptions after it, is to administer a few doses of homoeopathic Sulphur. CHAPTER XIII. CUTANEOUS DISEASES. Rash. Of this complaint there are various kinds. When a rash makes its appearance on the skin, and is accompanied by fever, the patient must be careful not to take cold, but at the same time he should not keep himself too warm; either may prove injurious. When there is no fever attending the rash, the com- plaint is not of a serious nature, yet cold should be guarded against; if the patient takes cold notwithstanding, resort should be immediately had to medicine. In all cases of eruptions, attended with fever, which have been suppressed, the same remedy will often be beneficial which is prescribed for the eruption itself; where the kind of eruption is not clearly characterized, give Ipecacuanha, followed by Bryo- nia, Sulphur, or Calcarea ; and in critical cases, when convul- sions, or threatened convulsion occur, Cuprum acetieum, third trituration, must be given; about a grain should be dissolved in a wineglassful of water, and a teaspoonful of the solution taken every fifteen or twenty minutes until relief is obtained. A homoeo- pathic physician will be able to select the proper medicine at once; but if a physician cannot be procured, and there be un- certainty about the selection of the suitable remedy, try the above medicines successively, allowing an hour or more to elapse between the doses. When a rash is prevalent in the neighbourhood, or is even in the house and several individuals are taken ill at the same time without a corresponding eruption, but with a feeling of contraction about the chest, difficulty of breathing, frequent gid- 52 410 CHAPTER Xm. diness loss of vision, trembling, sickness of the stomach, vomit- ing, griping, diarrhoea, great uneasiness, fainting, and other symptoms, give Ipecacuanha immediately, and repeat it after a couple of hours; it will either accelerate the eruption, or pre- vent the disease altogether. Children, and sometimes grown persons, are troubled, after taking cold, with a rash, appearing in red, smooth spots of the size of a pin's head, which are not elevated, but visible in heat and in cold, with itching and biting at night, disturbed sleep, shivering in the evening, and heat during the night; children become very uneasy and irritable, and cry much; in such cases give Aconite, which may be repeated six or twelve hours after, and if no improvement has taken place by the next day, give Chamomilla, and a couple of days later, if necessary, Sulphur. The latter remedies are frequently followed by perspiration, which must not be checked. Nettle Rash. Urticaria. This is a common eruptive disease; and is distinguished by long prominent patches, or wheals of various sizes and irregular shapes. The elevations are generally of a red colour, with white" wheals on the surface. Sometimes, however, there is little or no redness, and the elevated parts are paler than the surface around them. The eruption is always attended by burning and troublesome itching, especially when the patient gets warm in bed; and it is mostly preceded by more or less gastric disturbance, such as nausea or vomiting; loss of appetite, thirst; furred tongue and other signs of febrile excitement. In some instances, indeed, the skin is very hot and dry, and the pulse greatly accelerated. Occasionally, however, it is attended with but little constitutional disturbance. After the eruption makes its appearance, the gas- tric and febrile symptoms subside and the chief irritation is that caused by the burning and itching. This disease may originate from errors of diet, exposure and various other causes. When there exists a constitutional predis- CUTANEOUS DISEASES. 411 position to it, it is frequently found to be excited by some par- ticular article of diet. In some persons shell-fish invariably pro- duce it. In others, it is induced by certain kernels, especially the bitter almond; vinegar, salads, cucumbers, mushrooms, honey, &c. It may indeed be produced by a variety of articles used at the table and as medicines. Treatment.—The medicines mostly required in acute cases of this complaint are, Aconite, Dulcamara, Pulsatilla, Rhus tox., Bryonia, Belladonna, Hepar, Arsenicum, Calcarea, Nux vo- mica and Sulphur. Aconite should be given, if the eruption be preceded by much fever, with hot, dry skin, thirst, furred tongue, hard and very quick pulse, and restlessness and anxiety. Dulcamara, when excited by exposure to cold or dampness, when occurring in wet weather, or when attended with some fever, bitter taste in the mouth, diarrhoea, foul tongue, and violent itching and burning. Pulsatilla, when the eruption has been produced by eating unwholesome food, and is attended by looseness of the bowels. This remedy is particularly suitable for females and persons of ' lymphatic temperament and mild temper. Rhus tox. is also a valuable remedy in this disorder, especially when arising from some peculiarity of constitution, in which the attacks are excited by some particular article of food. Bryonia is serviceable in this disorder, especially when the eruption has suddenly disappeared from the surface, and is fol- lowed by difficulty of breathing, pain in the breast, and other symptoms, which may lead us to fear a translation of the disease to the chest. Belladonna should be given, if the eruption be attended by violent headache and red face. Hepar, when attended by severe catarrhal symptoms, princi- pally affecting the head, and worse on one side. Nux vomica is indicated when the eruption is excited by in- dulgence in spirituous or malt liquors. Arsenicum, in extremely severe cases of this affection, after 412 CHAPTER XIII. the failure of other remedies, also to reproduce the disease after it has been suddenly suppressed. Calcarea: when the eruption has been suddenly repelled, a dose or two of this medicine will frequently cause its re-appear- ance. Urtica urens has been found useful in some cases of urticaria. The above remedies may be repeated in severe cases every three or four hours until relief is obtained. In cases not so vio- lent, twice a day will be sufficiently frequent for their repetition. External applications of all kinds should be avoided in this as well as in other acute eruptive diseases, as their use is liable to cause a sudden repercussion qf the eruption, which is frequently attended by serious or fatal consequences. In the chronic forms of this disease, the remedies which have been found most useful are, Calcarea, Lycopodium, Causticum, Sulphur, Carbo vegetabilis, and Acidum nitricum. Measles. Rubeola. This affection generally prevails as an epidemic, and is com- municable by contagion from one person to another. It usually attacks a person but once, and this attack is commonly in child- hood. Adults who have escaped the disease in childhood and who afterward take it, are generally handled severely. When the disease occurs in childhood, and is properly treated, it is rarely either severe or dangerous. Measles frequently leaves behind it diseases, more dangerous than itself, and consequently great care is required in the after- treatment. In scrofulous children, troublesome swelling and inflamma- tion of the lymphatic glands, especially those of the neck, are apt to occur; or the eyes may be affected with ophthalmia, dif- ficult to cure, and the foundation be laid for consumption of the lungs. An attack of measles is usually preceded by catarrhal symp- toms, such as profuse watery discharges from the eyes and nose; CUTANEOUS DISEASES. 413 short, dry and distressing cough; the eyes present a peculiar watery appearance, and become more or less inflamed. These symptoms, after continuing for two or three days, in- crease in violence; the fever at times becomes very high; nau- sea and vomiting often set in, and there is pain at the pit of the stomach on pressure. The eyes are more sensible to light; the cough more violent and accompanied by hoarseness and difficulty of breathing, and a feeling of tightness across the chest. In from three to five days after the commencement of these symptoms, the eruption makes its appearance under the form of small red spots, about the size of flea bites, circular in shape, slightly raised above the surface, and distinct from each other. It is generally first seen about the head, around the margins of the hair, behind the ears and on the temples; then on the fore- head, face and neck, from whence it spreads in the course of the same or the next day to the trunk and limbs. The red spots generally run together in patches, which are at first small, but gradually enlarge, assume a crescentic or semi- lunar shape. In about thirty-six hours the eruption arrives at its height, and usually in about five days from its first appear- ' ance, it begins to die away, and gradually disappears in the same order as it advanced. The cuticle comes off in small bran-like scales, followed by a troublesome itching of the parts of the skin that had been implicated, and the cough and other catarrhal symptoms finally yield, leaving the patient suffering only from the weakness, induced by the previous attack. This is the usual course of the disease; it however varies; the eruption for instance may appear first on the body, or it may disappear and be reproduced. The catarrhal symptoms, too, are occasionally almost or entirely absent. The period of incubation, as it is called, or the time that elapses between the reception of the poison into the system, and the commencement of the erup- tive fever, varies from six to sixteen days. Treatment.—Aconite, Pulsatilla, Belladonna, Ipecacuanha, Bryonia, Phosphorus, Sulphur, Arnica, and Dulcamara, are the principal remedies in this affection. 414 CHAPTER XIII. Aconite is one of the chief medicines in this complaint, and in some cases is itself sufficient to conquer the disease, or at least materially to shorten its duration. It is especially indicated when the fever is violent, with hot, dry skin; heat in the head; giddiness; redness of the eyes and dread of light, great prostra- tion of strength. It may be repeated in severe cases every four or six hours until several doses have been taken, or there is considerable amelioration of the febrile symptoms. Pulsatilla is exceedingly useful and almost specific in measles, and is generally indicated in the commencement, when the catar- rhal symptoms first appear; also when the eruption is tardy in coming out; but whilst the fever is high, Aconite must be ad- ministered, and if it fails to produce an abatement of the febrile symptoms after a dose or two has been given, Sulphur should be given, and afterwards Aconite again whenever the symptoms grow worse. Aconite and Pulsatilla may frequently be admin- istered alternately with great advantage. Belladonna will be indicated, whefl the throat becomes sore, attended with thirst, difficulty of swallowing on account of the shooting and prickling pains in the throat; and also when there is dry, barking, or spasmodic cough, worse at night, with rattling of mucus; likewise in those cases where the eruption does not appear, but there is headache, catarrh, and inflammation of the eyes. This remedy is also of great value whenever there is con- gestion toward the head, with threatened inflammation of the brain. Ipecacuanha is most serviceable in arresting the vomiting; it is also useful when there is oppression of the chest. Bryonia, when the eruption is imperfectly developed, or when there is congestion to the chest, with shooting pains or stitches, increased by taking a deep inspiration; and violent dry cough. Phosphorus and Sulphur are also useful in cases of congestion or inflammation of the lungs. Arsenicum will be required if the sick stomach or vomiting and oppression of the chest remain after the use of Ipecacuanha. In the severe cases, where typhoid CUTANEOUS DISEASES. 415 symptoms are presented, Arsenicum, Bryonia, Phosphorus and fihus toxicod. will be useful. For the cough which frequently remains after measles, Bry- onia, Sulphur, Causticum, Hyoscyamus, Drosera, and other remedies recommended under " Cough", are serviceable. Swell- ing of the glands in the neck, or Parotitis, require Arnica, Dul- camara, or Mercurius vivus. Burning and itching of the skin, Nux vomica, Sulphur, and Arsenicum. Tenderness of the skin, Mercurius vivus. When measles are prevailing as an epidemic, the administra- tion of Pulsatilla, every two or three days, on the slightest appearance of catarrhal symptoms, will often ward off an attack; or, if it should be taken, render the disease extremely mild. Scarlet Fever. Scarlatina. Scarlet fever in its simplest form is characterized by fever, with swelling of the face, and an efflorescence of the skin, of a raspberry colour, or a hue like that of the shell of a boiled lob- ster, and generally more or less inflammation of the throat. The eruption terminates in about a week by desquamation, or peeling off of the skin. The eruptive fever of simple scarlatina varies both in intensity and duration; sometimes it is very slight; at others violent. At first the patient commonly complains of weakness and general indisposition, with nausea and vomiting; slight chills or creeps, followed by heat of skin and thirst, and occasionally headache, bleeding at the nose, and more or less stupor. Generally on the second—sometimes not until the third or fourth—day of the disease the eruption begins to appear, first on the face, neck and chest, and gradually extending to the rest of the body. The points or spots are at first separated from each other, of a deep red colour, and not raised above the cutaneous surface. They gradually coalesce, so that, on the face, neck and upper extremi- ties, the eruption is uniform and continuous, but over the trunk it is diffused in large irregular patches. On the loins and 416 CHAPTER XIII. bends of the joints it is generally of a deeper hue than on other parts of the body. The skin is burning hot, tense, dry and extremely sensible to the touch. The feet and hands are intensely red, swollen, stiff and painful. About the fourth day the eruption is usually at its height, presenting the boiled lobster-like hue above mentioned. If pressed upon by the finger, a white imprint remains which disappears almost immediately. On the fifth or sixth day it begins to fade; the redness disappears in the order in which it appeared; the swelling of the face subsides; and, by the seventh day it has become indistinct. Itching and desquamation of the skin now take place—the cuticle coming off in large flakes. Whilst the eruption is on the skin, its effects are perceptible on the mucous membranes of the mouth, fauces and nostrils, all of which are of a vivid red colour. The tongue is generally covered with a white coating, through which the elongated red points of the papilla project. This condition of the mouth and fances disappears in simple scarlet fever along with the eruption; the fever too, subsides at the same time, so that in about a week the patient seems to be free from the disease, but is frequently left extremely debilitated. Scarlet fever is often, however, much more violent than this; it is frequently complicated with severe inflammatory or ulcerated sore throat, delirium, &c. In the fever known as Scarlatina anginosa, or that in which the throat is considerably affected,, the symptoms are generally more severe from the commencement, the muscles of the neck and lower jaw suddenly become stiff. On the second day the fauces are inflamed; the voice is hoarse, and swallowing difficult and painful. The tonsils are swollen, and the mucous membrane of the mouth and fauces of a vivid red colour. The whole throat becomes covered with a viscous secretion of a gray, yellowish, or white colour. Sometimes.it assumes a dark hue, and the breath becomes offensive. On the second, third and fourth days the disease is generally at its greatest height; the pulse is frequent but not strong; the CUTANEOUS DISEASES. 417 heat of the skin is intense; the breathing oppressed; the thirst violent; and usually towards evening the fever is aggravated, and often attended with delirium. The eruption does not generally appear so early in this as in the simple variety. Frequently it is not seen until the third day, and then only in patches of a raspberry hue scattered over the body. These patches sometimes disappear on the first day, to recur irregularly at an after period. At times the disease assumes a still more serious type than that of the anginose variety; the symptoms at the very begin- ning are like those of scarlatina anginosa, but soon they assume the malignant character, indicated by fever of the typhous form, with delirium, hot skin, &c. The fauces, when examined, pre- sent a dark red appearance without much swelling; and ulcera- tion or gangrene with extensive sloughing speedily takes place. At the same time an acrid discharge takes place from the nose, and occasionally from the eyes or ears; the breath is foetid; the glands of the mouth and neck become inflamed and swollen, ending at times in the formation of abscesses. The eruption in this form is extremely irregular, both in its appearance and duration. Generally it is paler than in the other varieties, but occasionally it assumes a darker colour. The terms of Scarlatina maligna and gangrenosa have been given to this form of the disease, and in many instances it terminates fatally on the third or fourth day. Scarlet fever sometimes occurs without any eruption on the skin; but instead, the mouth and fauces become affected, and the disease seems to expend itself on the mucous membranes. This form may assume the malignant type, and prove fatal. Scarlatina is sometimes confounded with measles, from the resemblance the two eruptions bear to each other at the com- mencement. They may, however, easily be distinguished, the eruption of scarlet fever being of a diffuse lobster redness, and the spots very large, while in measles there is between the spots numerous small irregular spaces, in which the skin preserves its natural colour. The catarrhal symptoms, too, such as cough 53 418 CHAPTER XIII. sneezing and lachrymation, are a part of measles, whilst in scarlet fever they rarely or never occur. There is also a difference in the desquamation of the cuticle; in measles it takes place in small branny scales; in scarlet fever in large pieces. The greatly accelerated pulse denoting the approach of scarlet fever, and which is seldom found to the same extent in any other disease; as well as the existence of an epidemic of one or the other, and of the probability of exposure to its influence, will aid in the diagnosis. Scarlet fever is generally considered to be contagious. It occurs more frequently in youth than in adult age, seldom attacks the same person twice, and is also, from the fatality attending it, especially in its severe forms, one of the most alarm- ing diseases to which the children of this country are subject. Persons who have had the disease, frequently suffer from sore throat, when they are in attendance upon one labouring under scarlatina. Scarlatina is exceedingly liable to be followed by general and local dropsies, chronic diarrhoea, bronchitis, tubercles in the lungs, and other serious maladies, requiring much discrimination and skill to manage them successfully. Treatment.—Aconite, Belladonna, Mecurius vivus, Lachesis, Arsenicum, Phosphorus, Kali carb., Calcarea carb., Pulsatilla, Cuprum acetieum, Tartar, emetic, Acidum nitricum, Lycopo- dium, and Senega. .Aconite may be administered in the very beginning, before the eruption makes its appearance or during the course of the disease, when the fever is highly inflammatory, with exceedingly rapid pulse, &c. Belladonna: This remedy is almost specific in the simple forms of scarlet fever, and the disease will frequently yield under its influence without the assistance of any other remedy. It may be administered either dry or in water, every three to six hours, ascording to the severity of the symptoms, until some ameliora- CUTANEOUS DISEASES. 419 tion takes place. Great advantage will frequently result from the alternate administration of Aconite and Belladonna. Belladonna should also be administered in Scarlatina angi- nosa as soon as the throat and tongue become affected with dryness and burning, and there is excessive thirst, but inability to swallow; bright red appearance of the throat and tongue, sometimes excoriated, with white specks, or stringy mucus; swelling of the tonsils and stiffness of the jaws and neck, and delirium. Mercurius vivus, after Belladonna, when the latter has failed to produce a favourable change in the disease, and there is an appearance of ulceration commencing, with increase of mucus, and of the swelling of the tongue, throat and tonsils. It may be repeated every three or four hours. Lachesis will also be beneficial in bad cases of the anginose variety, with tendency to ulceration; and also when the disease assumes the malignant form. Cuprum acetieum has been highly recommended in cases, in which the eruption is suddenly repelled, and symptoms of an alarming character ensue; such as quick, small, weak and irre- gular pulse; temperature of the skin reduced, and sometimes chilly and covered with perspiration; convulsive movements of various parts of the body, distention of the eyes, face, mouth, head, &c; spasms of the chest; great restlessness, delirium, &c. After the administration of this remedy, the eruption is often reproduced, the cerebral symptoms disappear, and the disease runs its usual course. Pidsatilla is efficacious when the disease is attended with considerable derangement of the stomach and digestive organs; with pale, red or bloated appearance of the face; constipation, or looseness of the bowels, especially at night; occasionally pains in the bowels and shivering. Arsenicum is valuable, when the ulcers assume a livid appear- ance about the edges, and emit an offensive odor, with great thirst, restlessness and extreme prostration of strength. Kali carb. and Calcarea carb. are also useful in similar cases. 420 CHAPTER Xni. In the malignant form (Scarlatina maligna), Arsenicum, Lycopodium, Acidum nitricum, and Phosphoric acid, will be found of most service. Tartarus emeticus has been recommended in the first stage of the disease, and especially when the following symptoms occur; convulsions which precede the eruption; diarrhoea; cold, clammy skin; hurried respiration; hoarse voice, and retching and vomit- ing of viscid mucus. Senega, in cases when there are offensive ulcers, and accumu- lation of tough, viscid mucus in the mouth. The dropsical swelling following scarlatina, will generally be removed by Bryonia, Belladonna, Arnica, Arsenicum, or Sulphur. See also the article "Dropsy". For the medicines required in the treatment of Diarrhoea, Otorrhcea, Bronchitis, Boils, and other affections, consequent upon scarlet fever, see these articles in their respective chapters. Belladonna is valuable as a preservative against scarlet fever when prevailing as an epidemic; and also in modifying the dis- ease in those persons who are not entirely exempt from its attacks. A dose of the medicine may be taken once a day, or every alternate day. Calcarea and Lachesis have also been recommended as preventitives. Scarlet Rash. This affection is occasionally met in complication with measles, small pox and scarlet fever, more particularly the latter; it appears to be in fact a modified form of scarlet fever. It may be distinguished from genuine scarlatina by the dark, almost purple appearance of the eruption, by the pressure of the finger leaving no white mark, and by the small grains in the skin, which are distinctly felt on passing the hand over it. This form of the disease does not run a regular and definite course like other eruptive fevers. The efflorescence may dis- appear suddenly, and be followed by dangerous symptoms. It may or may not extend over the entire body, and is often attended CUTANEOUS DISEASES. 421 with sweating, which only occurs on the surface covered with the eruption. Persons who have suffered once from this affection are by no means excempt from future attacks. Sore throat is not often so severe a symptom in scarlet rash as in scarlatina. It is chiefly met with when the eruption is wanting, and at its commencement and decline. Aconite will generally remove this disorder unless it be com- plicated with some other affection. Coffea may in some instances be required after or alternately with Aconite, when there is much restlessness and agitation, or pains in the head or extremities, accompanying the malady. Belladonna, when complicated with scarlet fever, with sore throat, cerebral disturbance, &c. Ipecacuanha, followed if necessary by Pulsatilla, when at- tended by nausea and vomiting, or diarrhoea. Bryonia, when there is congestion to the chest, with hurried respiration, pain, &c. It may be given advantageously after Ipecacuanha. Chicken-Pox. Varicella. This disease, owing to the fact of its bearing a considerable resemblance to small-pox, has been considered by some a variety of that disease. There are, however, differences which amply suffice to establish their non-identity. Varicella is non-contagious; and is characterized by a vesi- cular eruption, more or less copious, and generally accompanied by some degree of fever. This eruption, though easily distin- guishable from small-pox, is not so easily distinguished from modified small-pox or varioloid. "The eruption of the latter is pustular; the pustules being small, circular, and commonly depressed in the centre. In chicken-pox the vesicles are at first transparent, but the fluid soon becomes sero-purulent, and is then generally of a light straw-color. Another difference, too, is that chicken-pox can not be communicated by inoculation, whilst the matter of varioloid inserted under the cuticle of a person 422 CHAPTER XIII. who has neither been inoculated nor vaccinated produces genuine small-pox. The eruption of varicella is generally preceded for a day or two by more or less constitutional disturbance, such as fever, nau- sea or vomiting, &c. The pustules are generally fully matured by the third day, and the whole eruption disappears by the end of the fourth or fifth, without being succeeded by the little tubercles which are left after varioloid. They usually, indeed, leave no mark. Treatment.—This disease generally passes off without requir- ing any medical assistance; when, however, the eruption is attended by a considerable degree of fever, a dose or two of Aconite may be given; when there is much headache or con- gestion towards the head, Belladonna. If the eruption be con- siderable, Antimonium crudum, or Mercurius vivus, may be beneficial. Small-Pox. This is one of the most loathsome, and at the same time one of the most malignant diseases, to which a human being is liable. Like other eruptive fevers it is propagated by contagion, and rarely attacks a person more than once in the course of his life. The length of the period of incubation, or the distance be- tween the time of exposure to the contagion, and the accession of the premonitory fever, is generally about twelve days; but, the extremes are seven, and twenty-one days. The fever is ushered in by a chill, accompanied or speedily followed by pain in the back, aching in the bones, general soreness and all the common symptoms of severe cold. When the fever sets in, the skin becomes dry and hot; thirst; pain in the pit of the stom- ach ; light hurts the eyes; intense pain in the head attended with delirium ; anxious expression of countenance, and great prostration of strength; all have a share in the distress of the patient, and help to make up the catalogue of symptoms. In about forty-eight hours after the commencement of the fever, the eruption begins to make its appearance in the form of small red pimple3 on the face and forehead; at first, very much CUTANEOUS DISEASES. 423 resembling measles, but next day the spots are more elevated, and the true character of the disease is made known. The fever usually abates very much when the eruption comes out. On the third or fourth day, the pustules begin to fill; the tops are flattened, and as they pass on to maturity, a depression is ob- servable in the centre; the pustules at first contain whitish lymph, which gradually becomes more and more yellow, until the eighth day of the eruption when the suppuration is at its height. The odor of a small-pox patient is very peculiar, and not likely to be forgotten. After the eighth day the eruption begins to dry up, many of the pustules burst, and scabs begin to form. The pro- cess of desiccation continues to progress until the fourteenth day of the eruption, by which time the fever in favourable cases has subsided, the swelling of the face left, and scabs have fallen off the upper parts of the body, leaving the skin of a reddish brown colour. This is the ordinary course of the disease when the issue is favourable. But, when the disease prevails epidemically, cases are seen in unfavourable subjects, and in hospital practice, that beggar description, on account of their destructiveness. Treatment.—The room of a small-pox patient should be kept well ventilated, but not too warm : and, very little light should be admitted. Aconite is almost always called for in the febrile stage, espe- cially if there be congestions to different parts, as the head or lungs, attended with headache; dullness and sleepiness; bleeding of the nose; injected eyes; fulness in the chest, with increased action of the heart; pain in the back, and general aching in the limbs. Belladonna, if during the precursory fever there be delirium with the headache; suffusion of the countenance; inflammation of the eyes, with anxious look; intolerance of noise; and, in the eruptive stage, if the pustules be too red. Bryonia, if the headache and backache continue; and there be irritability of stomach; cough, with soreness in the chest; constipation; or, the eruption be delayed, with a sensation as if the flesh had been bruised. 424 CHAPTER XIII. Coffea is very useful in the great restlessness which frequently occurs during the progress of the disease. Mercurius vivus is applicable to the sore throat; ulcerations about the eyes and nose; foetid breath; and pains in the bowels, with perspiration, and diarrhoea. Rhus tox. is highly important at the close of the febrile stage and during the eruptive stage. Stramonium should be given if there be loquacious delirium at the time the eruption ought to appear, but does not. Sulphur is especially needed when the pustules begin to fill, and for the itching during the drying stage. Tartarus emeticus is useful if there be drowsiness with gap- ing; coolness and clamminess of the skin; or sick stomach when the eruption ought to appear. Varioloid. Varioloid is a disease which is produced by the action of small-pox on a system that is partially protected by inoculation - or vaccination. It is much milder in its course, and shorter in its duration, than genuine small-pox, and but seldom leaves any marks on the skin. The treatment is essentially the same as in small-pox, except that it is less energetic. Erysipelas. St. Anthony's Fire. Rose. This is a very common affection, and may attack any portion of the person; usually, however, the parts that are exposed to the air are most liable to it; hence erysipelas of the face is by far the most common form. The attack is generally preceded, for a longer or shorter time, by fever and other signs of constitutional disturbance, and the intensity of these mostly bears some relation to the severity of the attack. The first local symptoms are, a circumscribed red- ness of some part of the surface, with swelling, tension, pain, and heat. The redness is restricted to a small space at first, to the tip of the nose for instance, in many cases of erysipelas of the face; CUTANEOUS DISEASES. 425 whence it spreads centrifugally over a greater or less surface, forming a patch with very irregular margins. The shade of red often varies in the course of the disease, but the surface always presents a shining appearance. When pressed upon by the finger, the redness disappears, and immediately returns again when the finger is withdrawn. The pain is not often very acute, but is annoying, and fre- quently accompanied by troublesome itching; and the sense of heat is at times pungent and scalding. The least contact aggravates the pain. About the third or fourth day small vesicles, filled with yel- lowish serum, frequently make their appearance on the affected part; these burst sooner or later, and the surface becomes covered with a crust. The fever, sick-stomach and other constitutional symptoms accompanying the disease are sometimes very severe. Not un- frequently the disease leaves one part and appears in another, changing about many times before it finally disappears. The most favourable and most common termination of erysi- pelas is by resolution. The inflammatory symptoms gradually subside; the redness changes to a yellowish hue, and the cuticle comes off either in the form of a whitish scurf, or in shreds of larger size. It may terminate by the formation of abscesses, or by gangrene. When erysipelas attacks the face, the swelling is often so great that the features cannot be distinguished, and violent cephalalgia, delirium, and in some instances meningitis super- venes. When the face and scalp are both attacked, the disease becomes very serious and requires the utmost attention and dis- crimination in its management. Erysipelas may occur in persons of all ages, though there undoubtedly exists in some persons, from the frequency with which they are attacked, a particular constitutional predisposi- tion. It is excited by derangement of the digestive organs, exposure to cold, the use of stimulating articles of food, such as lobsters, oysters, clams and other shelfish; powerful mental emo- 426 CHAPTER XIII. tion may also occasion it. The most common exciting cause, however, is indulgence in spirituous and fermented liquors; and consequently we find the intemperate, and those persons who are accustomed to the daily use of alcoholic potations, are espe- cially liable to it. A scratch of a pin will sometimes cause in such persons erysipelas very difficult of cure. Treatment.—The following are the principal remedies in the treatment of the most common forms of erysipelas : Aconite, Belladonna, Bryonia, Rhus toxicod., Pulsatilla, Arsenicum, Lachesis and Sulphur. Aconite is indicated in cases attended by much fever, with hot, dry skin, thirst, &c. It may be repeated every four, six, or twelve hours according to the violence of the symptoms. Belladonna, in erysipelas accompanied with acute shooting pains, heat and tingling; the redness commencing in a small spot and extending in rays; swelling. It is particularly valuable in facial erysipelas, with burning heat; excessive swelling, so that the eyes are closed, and the features can scarcely be recog- nized; cephalalgia; thirst; hot, dry skin; restlessness and deli- rium. In some violent cases it may be requisite to give Rhus tox. or Lachesis in alternation with Belladonna. Bryonia will be useful when the disease attacks the joints, and the pain is increased by the least movement. Sulphur is sometimes required after Bryonia. Rhus toxicod. is the main remedy in vesicular erysipelas, and is also useful when there is extensive, watery (oedematous) swelling; Hepar, Sulphur, and Graphites, are also beneficial in this form of the disease. The cure will be facilitated in some instances by giving Belladonna and Rhus tox. alternately. Pulsatilla is efficacious in vesicular erysipelas after Rhus tox.; it is also particularly valuable in erratic or wandering erysipelas (when the redness disappears in one place, to reappear in an- other), and the skin is more of a bluish red. This remedy has also been recommended in erysipelas of the internal or external ear; and also when the attacks are excited by some particular CUTANEOUS DISEASES. 427 articles of food, in persons predisposed to the complaint. Bryo- nia and Rhus tox. are also useful in cases of this kind. Arsenicum will be serviceable when the erysipelas assumes a blackish hue, with a tendency to gangrene, accompanied by great prostration of strength. Carbo vegetabilis may in some instances be advantageously alternated with this remedy. Lachesis and Rhus toxicod. also deserve attention in this form of the disease. Hepar, Mercurius vivus, and Phosphorus, are of importance when the erysipelas terminates in abscess. Arsenicum and Sulphur, in cases terminating in ulceration. And in some of the chronic forms of the complaint, Acidum nitricum, Graphi- tes, Silicea, Sulphur, and Hepar sulph., will prove serviceable. To allay the itching and acrid heat of erysipelas, which is sometimes intolerable, powdered starch may be dusted over the surface. Greasy applications and washes of every kind should be prohibited, as they almost invariably aggravate the disease, and may prove highly dangerous by suddenly repelling the eruption. Persons subject to this complaint should live temperately, abstain from all kinds of stimulating beverages, and highly seasoned food, and take plenty of exercise, make frequent use of the bath, and drink cold water plentifully; by persisting in this course the predisposition to the disease may in many in- stances be overcome. Itching of the Skin. This is usually a symptom of some other disease by which we may be guided in the choice of a remedy. If, however, the itching appears to be the only or chief symptom, try to alleviate the irritation by brushing the whole body; if this does not answer, by washing with warm water; and lastly, use water and soap. If this does not remove it, take Sulphur internally. When it is worse in particular places, and you cannot keep from scratching them until they bleed, rub these parts with fresh olive oil, so as to moisten the skin in the first place, and then dry it again by rubbing it slowly. When the itching is more 428 CHAPTER XIII. troublesome at night, wash the parts in the evening with brandy, when the whole body is affected, or when females or children suffer in this way, take starch of wheat flour and powder the skin thickly with it. In cases where none of these things give relief, take camphor and mix it with the starch, or wash the parts with water in which camphor previously dissolved in spirits has been mixed. Many kinds of itching may be quickly cured by medicines; for instance, if it always commences when undressing, Nux vomica or Arsenicum will generally relieve it; when it is very troublesome after getting into bed, as if caused by flea-bites, and when scratched, moves from one place to another, give Ignatia. When it does not commence until the patient has become warm in bed, Pulsatilla; if this does not answer, Mercurius vivus, particularly when it continues the whole night; if not relieved, give Sulphur a couple of days after, and later, Carbo vegeta- bilis ; when the itching is accompanied by intense burning, give Rhus toxicod., and afterward Hepar; when scratching produces a great deal of bleeding, give Mercurius vivus and Sulphur, alternately, every week, until better. Itch. Psora. Scabies. This affection is characterized by an eruption of small pointed vesicles slightly raised above the level of the skin, transparent at the top, and containing a viscid serous fluid. These vesicles are accompanied by incessant and almost intolerable itching, and hence arises the name of itch given to the disease. They may occur on every part of the body—though they seldom appear on the face—but they are most frequently observed, especially at the commencement, between the fingers, at the wrists and at the bend of the joints. The itching is greatly increased by the warmth of the bed and by alcoholic drinks. The disease is highly infectious, and seldom arises spon- taneously; and if left to itself may run on for years, and even for the whole life. Young persons are most liable to it. Treatment.—It is not difficult, and does not require much CUTANEOUS DISEASES. 429 science to effect an apparent cure of this disease, by salves and unguents; but every suppressed eruption of this kind produces sooner or later another disease, which is often much more danger- ous and difficult to cure than the original affection. It is no part of wisdom to expose oneself to such danger, however trou- blesome the complaint may be. For the itching use the external remedies recommended under " Itching of the skin", and take internally such medicines as will gradually cure the complaint. First, take Mercurius vivus, and follow it in a day or two by Sulphur, and continue taking these remedies, alternately, until there is an improvement, and then discontinue them. If the complaint gets worse, take the above medicines more frequently—as often as twice a day alter- nately. If the character of the disease changes, the eruption becoming small and dry, Carbo vegetabilis is frequently of ser- vice; it may be taken every other day, or alternately with. Hepar, evening and morning. If there is no improvement, take pow- dered Sidphur, shake it up in spirits of wine, and of this mix- ture put one teaspoonful in a wine-bottle filled with water, and wash the parts most affected morning and evening. When the itch seems greasy, and large blisters are formed, take first Mer- curius vivus, then Sulphur, and then Causticum, evening and morning. When the blisters are large, and turn yellow or bluish, take Lachesis. If these remedies do not effect a cure, apply to a homoeopathic physician. One must be willing to wait patiently several weeks for the effectual cure of this disease. In cases where itch has been suppressed by external applications, which may prove very dangerous, give Sulphur or Arsenicum to bring it out again. Crusta Lactea. Milk-scab. Milk-crust. This is mostly an affection of young infants, and is charac- terized by an eruption of numerous small white pustules, appear- ing in clusters upon a red ground. They generally make their appearance first on the face, particularly the cheeks and fore- head, from whence they sometimes spread over the entire body. 430 CHAPTER XIII. In a short time they become yellow, or dark coloured, burst, and form thin yellow crusts. The eruption is often attended by considerable redness and swelling of the surrounding parts, and with troublesome itching, which renders the child exceedingly restless and fretful, and causes it to rub the affected parts constantly, by which the scabs are torn off, and the disease aggravated. Treatment.—Aconite, Rhus toxicod., Sulphur, Hepar sulph.} and Arsenicum, are the chief remedies. Aconite should be administered first, when the eruption is surrounded by redness and inflammation of the skin, and the patient is very restless and uneasy. It may be repeated night and morning. Rhus toxicod. may follow Aconite, if after the lapse of a few days the eruption appears to be but little improved. Repeated same as the last. Sulphur will be beneficial after Rhus toxicod. when the latter fails to produce a favourable change, or when the improvement progresses but slowly. These two remedies may be administered alternately in many cases with great advantage. Hepar, Sulphur, and Arsenicum, will be found useful in ob- stinate or complicated cases. Lycopodium, Sepia, and Graphites, may also be serviceable in tedious cases. Scald Head. Tinea Capitis. Ringworm of the Scalp. This disease is characterized by circular red coloured patches, covered with numerous small yellowish points or pustules, which do not rise above the level of the skin. These pustules soon break, and form thin scabs. The patches frequently unite with adjacent patches, and assume an irregular and extensive appear- ance, and sometimes cover the whole head. These incrustations by accumulation become thick and hard, and when removed, the surface beneath is left red and glossy, but studded with slightly elevated pimples. By the long continuance of this eruption the hair is frequently destroyed. Tinea capitis is commonly found CUTANEOUS DISEASES. 431 in children from the age of two years to that of puberty: it is not confined to the scalp, but appears on the face, neck, and other parts of the body, and in such cases is less difficult to«cure than when located in the scalp. Treatment.—This disease is often extremely obstinate; this is especially the case when it has been neglected in the com- mencement, or treated with washes and unguents, the only effect of which has been to aggravate the complaint, and render the cure much more difficult when proper means are resorted to. The chief homoeopathic remedies are : Rhus toxicod., Sta- physagria, Dulcamara, Bryonia, Hepar sulph., Arsenicum, Antimonium crudum, Calcarea carb., Sulphur, Graphites, and Lycopodium. Rhus toxicod. will generally be the most appropriate remedy with which to commence the treatment, and under its action the disease will often undergo a favourable change. Sulphur may follow Rhus, should the eruption become dry and begin to exfoliate. Staphysagria, should it become moist and offensive, attended with violent itching, followed by Rhus again. Arsenicum must be given, if, notwithstanding the adminis- tration of the above remedies, the disease becomes worse, with corrosive discharge, or formation of ulcers; after the action of which Rhus will frequently produce a salutary effect. Should the foregoing remedies be insufficient to effect a cure, it will be requisite to resort to the use of, Hepar sulph., especially when the disease extends to the fore- head, face and neck, or when the eyes and eyelids become red and inflamed, or Bryonia, when the glands of the neck and throat become swollen, red and painful, or if they are swollen and hard without being painful, Dulcamara. Antimonium crudum, in the third trituration, given once a day for several days, will frequently have a salutary effect, espe- cially when a thick scab is formed on the head and the eruption extends over the entire face, with itching of the whole body. 432 CHAPTER XIII. In protracted cases of the disease, Calcarea carb., Lycopo- dium, Sulphur and Graphites will often prove serviceable. Bene- fit will often result from the alternate administration of two or more of the remedies. In relation to the administration of the remedies, a dose may be given in the commencement once a day, or every other day, until symptoms of improvement occur, after which it must be discontinued as long as the improvement continues, and only renewed when the favourable symptoms become stationary, or the disorder appears to be getting worse. When no improvement follows the administration of a remedy, after waiting for its action for several days, another must be selected. In cases of long standing, the intervals between the repetition of the doses should be lengthened considerably, and not more than one or two doses given in a week. Until the disorder is removed, the strictest attention should be given to cleanliness; the head should be gently sponged with tepid water twice a day, the hair kept closely trimmed, and the homoeopathic rules of diet closely adhered to. Ringworm. Herpes Circinnatus. This is a common affection with children, and consists of an eruption of small circular rings of red spots, the skin within the ring having a natural appearance at first, but subsequently becomes rough of a reddish hue, and scales off as the eruption dies away. The disease generally appears on the face, neck, arms and shoulders, and frequently disappears of itself after two or three weeks duration. Sepia: A dose or two of this remedy will generally remove this affection. Should it fail, the alternate administration of Rhus tox. and Sulphur every four or five days will mostly prove effectual. Calcarea, Causticum, and Sulphur, have also been recom- mended in obstinate cases. CUTANEOUS DISEASES. 433 Boil. Furunculus. A boil consists of a hard, round, or rather a cone-shaped tumor, which inflames slowly, and suppurates; the matter dis- charged being at first mixed with blood, and afterwards com- posed of pus, or morbidly altered cellular membrane, a portion of which is generally formed into a rounded hard mass, called a core. Some persons have a peculiar constitutional predisposition to these troublesome tumors; they also frequently follow after acute fevers, eruptive diseases, itch, &c. Treatment.—Arnica, Aconite, Sulphur, Hepar sulph., and Belladonna, are the chief remedies. Arnica is in the majority of instances the best remedy, and will speedily cause an abatement of the swelling and inflamma- tion, and frequently prevent their recurrence. It may be taken twice a day. Sulphur will be useful in cases where there is a strong pre- disposition, and frequent return of this affliction. By giving Arnica while the boil is inflamed and swollen, and a dose of Sulphur occasionally, after it has healed this predisposition, will be gradually removed. Aconite will be advantageous, if the boil be highly inflamed, and attended with a good deal of fever, restlessness, &c. Belladonna, if it present a fiery-red or erysipelatous appear- ance, or if it be attended by swelling of the glands under the arms, or in the groins, with fever, hot, dry skin, thirst and headache. Hepar sulph. will be useful in cases where the suppuration is profuse. Mercurius vivus, after Hepar, in similar cases to that remedy when it has been insufficient; and also when the swelling remains after the use of the other remedies. Carbuncle. Anthrax. Malignant Furunculus. The carbuncle resembles in some respects the furuncle. It is a deep seated, circumscribed, hard, and excessively painful 55 434 CHAPTER XIII. swelling, of a livid hue, and attended by great itching, and burn- ing heat. It differs from furuncle in having no central core, and in terminating in sloughing instead of suppuration. At the com- mencement, it is usually attended by symptoms of inflammation; but these are soon succeeded by vesications containing an acrid offensive fluid, which is discharged through numerous pores, occupying every part of the tumor, and communicating with cavities in a state of mortification. The disease is generally accompanied by constitutional symp- toms, such as fever, nausea, loss of appetite, great prostration of strength, and inability to sleep, in some cases to such a degree as to destroy the patient. Recovery generally takes place from this affection, after the patient has experienced a great deal of suffering. When seated on the head, carbuncle is apt to prove fatal. Treatment.—In the commencement of this complaint, poul- tices of bread and milk or flax-seed meal should be applied, and continued until vesications appear on the surface. Internally the following medicines will be most efficient: Lachesis, Hepar sulph., Silicea and Arsenicum. Lachesis should be administered when the carbuncle become bluish or livid, and extends rapidly. Hepar sulph., when extensive cavities are formed, and the discharge is profuse and purulent. Silicea, if administered from the commencement, will fre- quently effect a cure; it will also be beneficial after Hepar. Arsenicum will be indicated, when the patient becomes very weak, and symptoms of gangrene are presented. The above medicines may be given either dry or in water, and repeated three or four times a day until some improvement take place, and then at longer intervals. Chilblain. Pernio. This is a common inflammatory affection resulting from cold, or of a sudden transition from cold to heat. It generally attacks the feet, but is also frequently found on the hands, ears, no3e, &c. CUTANEOUS DISEASES. 435 The skin at first becomes pale and shriveled; this condition, however, is speedily succeeded by redness, swelling, more or less pain, and itching; in severe cases the skin assumes a purple hue, the itching becomes intolerable, a serous fluid collects beneath the cuticle, and is soon discharged, leaving an ill-condi- tioned sore, which often penetrates to the bone, and is exceed- ingly difficult to heal. This affection prevails most in moist and temperate climates, and often disappears spontaneously in summer and returns regu- larly in winter. Persons who have once suffered from it are very liable to its recurrence. Treatment.—The mild forms of this complaint may frequently be cured by applications of ice water or snow. They should, however, be used with caution, and are not at all adapted to gouty or phthysical persons, or to delicate females. Covering the part with carded cotton will sometimes, in mild cases, effect a cure in a few days. Another excellent application is common glue, prepared by boiling it with water until it becomes of a proper consistency, and then applying it warm to the affected part. The medicines most beneficial in chilblains are: Pulsatilla, Phosphorus, Nux vomica, Chamomilla, Arsenicum, and Sul- phur. Pulsatilla may be given when the skin assumes a deep-red, bluish or lived hue, and is attended by violent burning and itching. Phosphorus, in cases similar to the above, when that remedy has been insufficient; and also after ulceration has begun. This remedy is almost specific in many cases of the complaint. Nux vomica is especially indicated when the inflammation is of a bright red colour. Sulphur, after Nux vomica, when the latter has been insuf- ficient. Chamomilla, when, in addition to the itching and burning, there are acute pains in the -affected part. Arsenicum, after or alternately with Chamomilla, for the 436 CHAPTER xin. acute, burning pains; also for the irritable, ill-conditioned ulcers, which sometimes occur. These medicines may be repeated once or twice a day, accord- ingly as the urgency of the symptoms require. When the parts become ulcerated, they should be dressed with poultices or other mild applications until the parts are completely healed. Whitlow. Paronychia. Panaris. Whitlow is an affection of very frequent occurrence, and an exceedingly severe one. It usually commences in the extremities of the fingers, in the form of a small abscess, and sometimes extends upward, gradually involving the whole hand and fore- arm. The toes are also accasionally attacked by this disease. The affection usually commences with a pungent, deep seated pain in the end of the finger, which is soon succeeded by con- siderable swelling. The pain increases rapidly, and becomes so intense that in many instances the patient is deprived of sleep for days and nights together. Suppuration takes place very slowly, and the disease may continue for months, and frequently destroys one or more of the small bones of the fingers. Whitlow is generally the result of some local injury, such as pricking the finger with a needle or splinter. Often, however, its cause is entirely unknown, and is referable to some constitu- tional taint. Treatment.—Poultices of bread and milk sometimes give re- lief, and are always useful in softening the skin. The severe pain may often be mitigated by holding the finger affected in a freshly broken egg., Applications of warm soft soap, or common brown soap, to the affected part, will occasionally remove the pain and swelling in a very short time. The following medicines, however, are chiefly to be relied on for the cure of the complaint: Mercurius CUTANEOUS DISEASES. 437 vivus, Hepar sulph., Causticum, Silicea, Arsenicum, Carbo vegetabilis, and Sulphur. Mercurius vivus should be given in the commencement, and will often prevent the disease from going on to suppuration. Sulphur, taken immediately after or alternately with Mercurius vivus, will frequently act beneficially. Hepar sulph., when the above remedies are insufficient to check the disease, and the pain becomes violent, with throbbing and increase of the swelling. Causticum will often be found efficacious after Hepar. Silicea, administered alternately with Hepar, when the pain is intense, and the swelling continues unabated, will frequently prove serviceable. Lachesis in cases when the affected part is of a deep red or bluish colour, with violent pain and swelling. Arsenicum and Carbo vegetabilis should be given alternately, if the sore becomes angry looking or black, with burning pain. The medicines may be repeated every six to twelve hours. Sulphur and Silicea, administered alternately at intervals of six or eight days each, have been recommended in cases where there is a constant tendency to a return of the disease. Causticum and Hepar are also useful in similar cases. It may sometimes be necessary, after matter is formed, in order to relieve the sufferings of the patient, to lay open the parts freely with a knife. Ulcer. The simple ulcer is the result of some injury done to the sound part by a wound, bruise, abscess, or burn. It may occupy any part of the body, and is generally met with in young and healthy persons. The surface of an ulcer of this kind presents a florid appearance, owing to the numerous, small, bright-red pointed granulations which cover it in every direction. From the sore, there is constantly discharged a thick white pus without smell, and easily wiped away. An ulcer of this description will gene- 438 CHAPTER XIH. rally heal of itself in a very short time, provided the constitution is sound, and no additional injury is received; but this species of ulcer may become diseased, and assume an irritable or indolent character. Irritable ulcers, although usually proceeding from local causes, are materially influenced by the state of the constitution and habits of the patient. The edges of the sore are ragged, undermined, and sometimes serrated or notched. The parts around the ulcer for some dis- tance are red and inflamed. Irregular hollows occupy the bot- tom of the ulcer, and, contain a thin, greenish or reddish matter, which is acrid, and excoriates the adjoining skin. A white or dark-red spongy mass is found in the place of the health granula- tions, which is extremely painful, and bleeds on the slightest touch. This disease is frequently found among epicures, large feeders and debauchees. When seated in the leg, which is a common occurrence, the patient suffers greatly from pain, which is most severe at night, and sometimes attended with spasms of the limb. Ulcers of an indolent character are the most common variety, and are almost peculiar to filthy, dissolute and intemperate per- sons. The surface of this form of ulcers has a flat and shining appearance, and is covered with a whitish or dark-gray colored crust, which is exceedingly tenacious. Occasionally the sore is dry or free from matter, but generally there is a profuse dis- charge of viscous cohesive fluid. The edges of the ulcer £ire elevated, smooth and rounded, giving it the appearance of being deep and sunken. For a con- siderable distance around the ulcer, the parts are swollen and hard, and the whole limb enlarged. In almost all cases, the leg is the seat of this kind of ulcer, and it is generally unattended by pain. Varicose veins not unfrequently give rise to ulcers in the leg and thigh. They are generally seated on the inner side of the limb. The appropriate remedies for this variety of ulcers will be found under the head of " Varicose Veins". CUTANEOUS DISEASES. 439 Treatment.—In the treatment of a simple ulcer in a person of sound constitution, all that is necessary is to dress it with some mild and fresh ointment, spread on lint or on a fine linen rag to protect it from external injury, and prevent the evapora- tion of pus. Simple cerate is one of the best applications for this purpose. In some cases the dry lint alone will answer best, and in others cold bread and milk poultices are useful. The warm water dressing, linen rags dipped in warm water and applied to the ulcer, are beneficial in some cases. ■: When ulcers are of a long continuance, it is best to consult a homoeopathic physician. They ought to be healed slowly, other- wise a different and more violent disease will be the consequence. Drying them up with vitriol, or white lead, or lead-water, is ex- ceedingly dangerous. When the pain is very violent, stinging and burning, take malt, pound it very fine, and with yeast make a dough—thin it then with beer—spread it on rags, and apply it fresh two or three times a day. When the ulcers are deep and indolent, and no homoeopathic physician can be procured, turpentine may be applied—not the poisonous spirits of turpentine, but the gum or resin. Melt half an ounce of the best Venetian turpentine over a slow fire, and gradually mix it with two ounces of pure yellow wax; dry the ulcers as much as possible with a linen rag, take a spoon, and just as the melted mass is about to stiffen, pour it into the wound, taking care that it is not too hot. Do this every^ third day; but without homoeopathic treatment this remedy is not always, or not permanently, efficacious. For ulcers which burn badly, give Arsenicum; when they burn and smell offensively, Carbo vegetabilis; when they spread, and are surrounded by pustules or small ulcers, give Lachesis. Ulcers on the toes, especially of old people, commencing with a blister, as if caused by a burn, are cured by Silicea; if at the outset, there are blue black spots, by Arsenicum, especially if warmth is agreeable; but if warmth produces pain, Secale 440 CHAPTER XIII. corn, is most suitable. In all such cases, the use of salves con- taining white lead is very dangerous. Ulcers around an old wart, or around corns and the like, may be cured by Antimonium crudum. Ointments of sulphur or mercury will dry them up speedily, but I have seen fatal con- sequences ensue, as the result of such treatment. Bad ulcers may be caused by the toe nails growing into the flesh. The common remedy is to cut the nail, and particularly on the side where it has grown in; the consequence of this is that the nail grows the faster there, and in a short time the patient is again in the same predicament. Cutting the nail should only be resorted to when it is of consequence that the patient should walk again immediately; when a little lint can be intro- duced with a dull penknife between the nail and the skin, it is to be preferred. A handy person may do this himself; soak the feet previously in warm water, which will facilitate the operation. When there is proud flesh, strew some finely powdered loaf sugar on it twice a day, and use the foot as little as possible, for a couple of days. At the same time scrape the nail in the middle with a sharp knife, and repeat this operation every day until it is as thin as possible. By this means the sides will heal much quicker, and the nail is more easily bent out, so as to in- troduce the lint between the skin and the nail. When the edges of the nail are rough, scrape them smooth, but do not cut them. The only means of curing this evil effectually is to cut the nail frequently, but not in the shape of the toe, so that the middle projects farthest, but the very reverse, leave the sides as they are, and cut the centre out as far as possible. This need . not be done at once, but gradually; bathe the feet every week in warm water, and cut the nail as directed. The nail will, in consequence, grow more in the centre and less on the sides; if, after some time, the edges project too much, a trifle may be cut off; when it injures the stockings, put a leather case over it. Not until after the expiration of a twelve-month, should the nail be allowed to grown out even again, but never cut it very deep or close at the sides, as this is generally the cause of the evil. CUTANEOUS DISEASES. 441 The soreness and inflammation arising from the growing of the nails into the flesh, will mostly disappear as soon as sufficient lint has been introduced between the nail and the flesh, the lint may, in addition, be moistened by water mixed with Tincture of Arnica. If this is not entirely effectual, or if the places'are becoming ulcerated, Nux vomica, taken internally once or twice a day, will act beneficially. Causticum tinct. has been found by some to be the most efficacious medicine, in the proportion of one drop to half an ounce of water; dip a linen rag into this dilution, and apply it three or four times a day; this will remove the proud flesh. If there is already a badly ulcerated sore, and the above remedies should not speedily afford relief, do not be induced to have the nail removed or split. This painful opera- tion may always be avoided, if sufficient pains are taken. Enough may frequently be pared away by degrees to make the sore heal, particularly when homoeopathic remedies are taken at the same time; among these the principal are : Sulphur, Arsenicum, Si- licea and Carbo vegetabilis. By destroying the root of the nail on both sides with caustic, the nail itself may be preserved. Abscess. A collection of purulent matter, contained in a sac or cist in some part- of the body, the result of diseased action, is termed an abscess. There are two kinds of abscess, the acute and the chronic; the former is preceded by sensible inflammation in the affected part, which is speedily followed by suppuration. A boil is a familiar illustration of an acute abscess. When suppuration is about to take place, the character of the pain becomes changed, and is more obscure and throbbing; the swelling is increased; and after the matter is formed, and when the abscess is near the surface, there is perceptible fluctuation. Rigors or chills are also among the first symptoms which denote the commencement of suppuration. When the abscess is matured, the tumour points, or some part of the cutaneous surface over it—generally about the centre * 56 442 CHAPTER XIII. __becomes more prominent; the skin over this spot gradually becomes thin, and finally bursts and allows the contents of the cavity to be discharged. If the abscess be large and the discharge profuse, and kept up for a considerable length of time, hectic fever, and other signs of constitutional disturbance, generally ensue. Chronic abscess is generally unattended by any of the symp- toms which precede the formation of the acute abscess. Fre- quently its existence is not suspected until the attention is called to it by the swelling arising from the approach of the matter to the surface. Treatment.—The acute abscess should be poulticed with warm bread and milk, or flaxseed poultices, and an occasional dose of Hepar sulph. or Mercurius vivus, administered for the purpose of hastening the process of suppuration. Opening the abscess with a lancet to evacuate the pus, will frequently shorten the period of the patient's sufferings, especially if it be extensive. The incision should be made at the most depending point, where this can be done with safety; when this is impracticable in con- sequence of the thickness of the parts between the matter and the skin, the most prominent part should be selected. To accelerate the healing after the matter is discharged, a few doses of Hepar or Sulphur may be given; or, if the suppuration should continue for a considerable length of time, Silicea. When there is induration, an occasional dose of Mercurius vivus will be useful. In chronic abscess, the matter should always be evacuated as early as possible by means of the lancet, to prevent a large accu- mulation, and avoid the constitutional disturbance so likely to ensue from the inflammation following the bursting of the abscess. The opening should be small, and at the base of the abscess. The medicines most useful in preventing or removing unpleasant symptoms, are Mercurius vivus and Hepar, or in some cases Silicea, Calcarea, and Phosphorus. For induration and selling of the lymphatic glands, situated CUTANEOUS DISEASES. 443 in the neck, and under the chin and ears, Mercurius vivus, Dul- camara, Calcarea carbonica, &c, are the principal remedies. Corns. Corns generally arise from some constitutional taint, as is evident from the fact that many persons who wear tight boots and shoes escape having them, while others are constantly trou- bled with them, notwithstanding every precaution may be used. This being the case, it is manifest that we should endeavour to eradicate the predisposing cause by a judicious application of internal remedies. The most useful medicines in effecting this object, are : Antimonium crudum, Phosphorus, Rhus toxicod., Bryonia, Lycopodium, Sepia, Phosphoric acid, and Sulphur. Relief of the suffering may always be obtained, and the corns sometimes permanently cured, by bathing them frequently with a weak solution of Arnica tinct. in water, after previously bathing the feet in warm water and paring the corns closely. The Arnica Plaster, as prepared by Rademacher & Sheek, 239 Arch Street, Philadelphia, is one of the most valuable remedies for corns. Warts. There is always some risk attending cauterizing or cutting warts, for although it may frequently be done without apparent injury, dangerous consequences sometimes ensue, especially to children and old people. They will very frequently disappear; when fleshy or seedy, after Causticum ; when they are flat, hard and brittle upon taking Antimonium crud.; when upon the back of the fingers, Dulcamara; when on the sides, Calcarea carb. Bed Sores. These may frequently be prevented by placing an open vessel filled with water under- the bed of the patient, renewing the water every day. Wetting the red or sore spots with very cold water, or applying wet rags, accelerates the healing. When water alone will not effect a cure, dissolve in it a few drops of Arnica tinct.; and if there appear to be danger of mortification, give China, 444 CHAPTER XIV. and wash the spots'with the same medicine dissolved in a little water, and a day or two afterwards, wash with diluted Arnica tinct. When the wound is large, apply scraped sweet carrots to it. CHAPTER XIV. GENERAL DISEASES. Gout. Arthritis. This disease is usually seated in the joints of the feet, and is characterized by an intense burning or scalding pain, with a feeling as if the joints were dislocated. The affected part becomes excessively hot, red, and swollen. The attacks are usually pre- ceded for a day or two by more or less gastric disturbance, and almost always come on in the evening, or at night. It is difficult to cure the gout, but the pain may at least be mitigated. The complaints, inevitably produced by the common treatment with mercury, calomel, baldrian, digitalis, colchicum, or the fatal drug of opium, or laudanum, and other so-called harmless medicines, destructive of human health, are prevented by homoeopathic treatment, and the patient is likewise spared the many tortures of external applications. In wine and brandy drinkers, the first attack may by alleviated by Nux vomica; for violent fever, give Aconite, which may also be given, after other remedies have been used, particularly Sulphur. When the pain in the joints resembles that of a sprain, with redness, dread of being touched, an uncomfortable feeling, as if whatever the limb rested on was too hard for it, Arnica ; when the redness spreads very much, and is very deep, Belladonna; when the pain flies quickly from one joint to an- other, and relief is felt when the limb is uncovered, give Pulsa- tilla ; when the pain is mitigated upon covering the limb, and the patient is very weak and much reduced by the disease, give Arsenicum; when the face is very pale and haggard, the pain stinging and tearing, worse during the night, and when the GENERAL DISEASES. 445 limbs must continually be moved from one place to another, Ferrum, ox Rhus tox.; when worse from being moved, Bryonia; worse from being touched, China; when the complaint is at- tended with nausea and a white coated tongue, give Antimonium crudum, and afterwards, if necessary, one of the other remedies. When the attacks return at every change of weather, give Cal- carea; if the complaint becomes protracted, always give Sul- phur, and if worse again, Aconite; if the limbs remain stiff afterward, give Colocynthis; if they are stiff from old gouty swellings, give Causticum, morning and evening, and repeat it once a week for four or five weeks. Rheumatism. Rheumatismus. This disease presents itself under two distinct forms—the acute and the chronic—so distinct, that some writers have ques- tioned the propriety of considering them varieties of the same disease, or whether the former ought not to be considered a genuine gout, and the latter a form of neuralgia. Acute Rheumatism. Rheumatismus Acutus. Acute rheumatism usually commences with the ordinary signs of fever, as restlessness, alternating heat and chilliness; thirst, coldness of the extremities, constipation, &c; after which the pyrexia is developed, and the febrile symptoms sometimes ex- ceedingly high, the skin being very hot, and the pulse greatly accelerated, beating occasionally as high as 120 times in a mi- nute. There is from the beginning more or less pain or stiffness in the larger joints, which soon increases to acute pain, so that any attempt to move the joints, causes the severest suffering. The affected parts are generally red, swollen, and extremely painful to the touch. Occasionally, however, the pain is exces- sive, and there is little or no evidence of inflammation. The pain is almost always worse during the night. Profuse sweating of an acid odor is also a frequent accompaniment of the disease. This disease usually affects the larger joints of the extremities, and but rarely confines itself to one; sometimes almost all the 446 CHAPTER XIV. joints of the extremities being implicated, so that the patient is unable to move from the position in which he may be placed. It frequently happens in the course of the disease that it leaves one joint almost entirely, and shifts its seat to another, during which transition there is some remission of the pain. The heart is also frequently implicated, and when this takes place, the disease assumes a more serious character. If there should be a remission of the pain, soon followed by dyspnoea, anxiety, jerk- ing, or feeble and rapid pulse, and acute pain in the region of the heart, together with the physical signs, it may be inferred that there has been a translation, of the disease to that organ, and the treatment should be modified accordingly. The muscular and fibrous tissues are chiefly the seat of this disease, though it not unfrequently attacks the serous and mixed structures; hence we may have rheumatism of the meninges of the brain, stomach, intestines, kidneys, liver, &c, &c. The character and seat of the pain will generally lead to an accurate diagnosis. Causes.—Exposure to cold, sitting in a draught, sleeping in damp sheets, remaining long in wet clothes, or indeed any ex- posure of a part of the body to cold and moisture, especially when other parts are protected against it, or when the body is in a state of active perspiration. There would also seem to be some predisposition to it in organization, as persons whose parents have suffered from acute inflammatory rheumatism, are the most liable to be attacked by it. It may also follow the repurcussion of eruptions, or the stoppage of a long continued flux, &c. Treatment.—The following medicines have been found most efficatious in the treatment of this complaint: Aconite, Arnica, Belladonna, Bryonia, Chamomilla, Hepar sidph., Lachesis, Mercurius vivus, Pulsatilla, Rhus toxicod., China, &c. Aconite is mostly indicated in the commencement, and espe- cially when there is high fever, dry, hot skin, thirst and redness of the cheeks; violent shooting or tearing pains, worse at night; redness, or shining swelling of the part affected; the pains are GENERAL DISEASES. 447 aggravated by the touch; extreme irritability of temper. The remedy may be repeated every four or six hours, until the fever is reduced. Belladonna will be useful when the pains are seated chiefly in the joints and are shooting or burning in their character; worse at night and on movement; excessive swelling, and shin- ing redness of the affected part; fever with determination of blood to the head and redness of the face; hot skin and thirst. Arnica, when the joint feels as if bruised or sprained; hard, red, and shining swelling; sensation in the part affected as if it were resting on some hard substance; feeling as if paralyzed, and crawling in the affected part; the pains are aggravated by the least motion of the limb. Bryonia, if there be shooting, tearing or tensive pains; shift- ing pains, which affect the muscles rather than the bones; red and shining swelling, and rigidity of the parts affected; the pains are worse at night, and on the least movement; profuse perspiration, or coldness and shivering; much heat with head- ache and gastric derangement; peevish or passionate temper. This remedy is often particularly suitable after or in alternation with Aconite or Rhus toxicod. Chamomilla, when there are drawing or tearing pains, with a sensation of numbness or of paralysis in the parts affected; the pains are aggravated at night; fever with burning; partial heat preceded by chilliness; hot perspiration; desire to remain lying down; great agitation and tossing. Mercurius vivus, for shooting, tearing or burning pains, which are aggravated at night, especially towards morning, and by the warmth of the bed, or exposure to damp or cold air; puffy swelling of the affected parts; the pains seem to be seated in the bones or joints; profuse perspiration without amelioration of the sufferings. Lachesis is often serviceable after Mercurius vivus. Rhus toxicod., against tearing and burning pains, or wrenching pains, with a sensation of paralytic weakness and crawling in the affected limb; red and Shining swelling of the joints, with rigid- ity and shootings when touched; the pains are worse during rest, 448 CHAPTER XIV. and in cold or damp weather. Rhus toxicod. is often suitable after or alternately with Aconite, Arnica, or Bryonia. Pulsatilla is serviceable when the pains are aggravated in the evening, or at night in bed, and also in a warm room, or in changing the position; pains which pass quickly from one joint to another; sensation of torpor and paralysis in the parts affected; the pains are relieved by exposure of the part to the cold air; paleness of the face and shivering. China is suitable against pains which are aggravated by the slightest touch; profuse perspiration; great debility, especially from loss of blood. Hepar sulph. and Lachesis are frequently serviceable in pro- tracted cases, after other remedies which appear to be adapted to the case, have been given without much benefit. When a translation of the disease to the heart takes place, Aconite, Arsenicum, Belladonna, Spigelia, and Sulphur, will be found most efficacious. For the stiffness which remains after the subsidence of the more violent symptoms, Colocynthis and Nux vomica. Chronic Rheumatism. Rheumatismus Chronicus. In this form of rheumatism the pain is usually fixed in the part, but is not accompanied by fever, swelling, nor redness, as in acute rheumatism. The affected limbs in process of time lose their power of motion and lameness results; the muscles, too, usually become atrophied from the disease and disuse, and the affected limbs will consequently be found on examination to be smaller than the sound ones. Permanent contraction of the limbs sooner or later takes place, and at times anchylosis of the joints. Causes.—Chronic rheumatism is induced by the same exciting causes as the acute. Remedies.—Sidphur, Lycopodium, Causticum, Hepar sulph., Lachesis, Phosphorus, and Veratrum, are the principal. The remedy selected should be repeated at long intervals— not oftener than once or twice a week—and after having been GENERAL DISEASES. 449 continued for three or four weeks, if no benefit result, another should be selected and given in the same way. For rheumatic pains which are excited or aggravated by the slightest chill, Aconite, Bryonia, Calcarea carb., Dulcamara, Mercurius vivus, and Sulphur, are the best from which to make a selection.—When the attacks are excited by bad weather, Calcarea carb., Dulcamara, Rhus toxicod., Lycopodium, and Hepar sulph. When every change of weather causes a relapse, Calcarea carb., Silicea, Sulphur, Dulcamara, Rhus toxicod., and Lachesis, are generally most efficient. Lumbago. Lumbago Rheumaticus. Diagnosis.—A deep seated violent pain in the loins, some- times attended with very acute symptoms, although rarely accom- panied with the same phenomena as inflammatory rheumatism. There is no swelling or redness of the lumbar region. The most excrutiating pain is induced by any change of posture, and it is difficult to move any part without increasing the sufferings. Remedies.—■Aconite, Bryonia, Nux vomica, Rhus tox., Bel- ladonna, Pulsatilla, and Mercurius vivus, are most serviceable. Aconite must be given at the commencement, especially if the disease be accompanied by much fever. Bryonia, when the pains in the back are exceedingly severe, compelling the patient to walk in a stooping posture; aggravated by the least motion, or draught of air, and attended with a sen- sation of general chilliness. Nux vomica is especially indicated, when the part affected feels as if bruised, or as if caused by excessive fatigue; and when motion, and particularly turning in bed at night aggravate them; also when accompanied by weakness, constipation and irritable temper. Rhus toxicod., when the pains are similar to those described under Nux vomica,, but are aggravated bj rest. ^Belladonna may follow or alternate advantageously with Aconite, particularly when the pains are deep seated, and cause a sensation of heaviness, gnawing, or stiffness. 57 450 CHAPTER XIV. Pulsatilla, when the pains resemble those mentioned under Nux vomica, especially when occurring in females, or persons of a mild disposition. Mercurius vivus, against pains like those described above, but which are aggravated at night. Sciatica. Neuralgia Sciatica. This affection, like lumbago, may be acute, but it is more fre- quently chronic. It is characterized by severe pains in the region of the hip joint, which shoots along the course of the sciatic nerve to the ham, and sometimes extends to the foot, and is ac- cordingly neuralgic in its character. Causes.—The same as in other forms of rheumatism. Remedies.—Aconite, Colocynthis, Rhus toxicod., Nux vomica, Ignatia, Chamomilla, and Arsenicum. Aconite, in the beginning when attended by fever. Colocynthis is particularly useful in this affection, especially when seated in the right hip, and excited by a fit of anger. Rhus toxicod., when the pains are aggravated by rest, and better by motion or warmth. Nux vomica, when the pain is attended by a sensation of stiffness or contraction of the limb; also when a feeling of par- alysis or torpor with chilliness is experienced in the affected part. Ignatia, against cutting pains, particularly on moving the limb. Chamomilla, when the pains are worse at night, and attended with excessive sensibility. Arsenicum, in cases where the pains .are acute and dragging, with a sensation of coldness in the part affected; also when the pains are periodical. It is also useful in cases attended by emaciation. Crick in the Neck. This is a very painful species of rheumatism, affecting the muscles of the neck. It is generally occasioned by exposure of the part to a draught of air, and sometimes by turning the head suddenly round. GENERAL DISEASES. 451 Remedies.—Aconite, Belladonna, Cocculus, and Bryonia. Aconite, followed, or given alternately with Belladonna, every four or six hours, will generally effect a cure. Should they be insufficient, Cocculus, or Bryonia, will mostly suffice. Cramp in the Limbs. Cramp in the calves of the legs, the soles of the feet, and in other parts of the body, frequently disturbs the patient in his sleep; sometimes it is troublesome during the day. The best means of obtaining relief during an attack, is to press the part affected firmly against the bedstead, or the wall, or to press and squeeze it with the hands. The remedies best calculated to remove the disorder are : Veratrum, Sulphur, Colocynthis, Rhus toxicod., Lycopodium, and Sepia. Veratrum, taken at night, before going to bed for a few nights, will generally overcome the predisposition to the com- plaint. Should it, however, be insufficient to prevent the return, it may be succeeded by Sulphur or, Colocynthis. Rhus toxicod. will be found useful in cramps which occur dur- ing the day, especially while sitting, as well as in those which come on at night. Lycopodium and Sepia, in cramps occurring principally when walking. Sulphur, for attacks which come on at night. Colocynthis, against cramps occurring at night, and also for the stiffness and soreness which frequently remains for a con- siderable time after an attack. Epilepsy. Epileptic Convulsions. This affection assumes such a variety of forms that it is im- possible to enter fully into its consideration here. I shall there- fore merely point out the proper treatment to be pursued during an attack; and enumerate some of the remedies which have been most successfully used in its cure. All that is necessary to be done while the patient is in the 452 CHAPTER XIV. fit, is to guard him against injury in his struggles, and to remove any thing from about the neck, which is liable to obstruct the circulation. In some cases when there is considerable congestion to the head, a dose of Aconite, followed if necessary by Bella- donna, will be beneficial. An attack may sometimes be obviated by smelling camphor when the first symptoms of its approach is perceived. The remedies most serviceable in recent cases are: Ignatia, Belladonna, Chamomilla, Nux vomica, Opium, Ipecacuanha, Camphor, Hyoscyamus, &c. In chronic cases, or those of long standing: Sulphur, Calca- rea carbon., Silicea, Causticum, Belladonna, Cuprum met, Hyoscyamus, Stramonium, Veratrum, and Lachesis, deserve the preference. When the disease arises from the sudden repurcussion of an eruption, or the stoppage of a long continued discharge; Sul- phur, Causticum, Calcarea carb., Stramonium, and Lachesis, are most useful. When the malady occurs in the course of other diseases, such as fevers, worms, teething, &c; or is produced by fright or other mental causes, the appropriate remedies will be found under their respective heads. The common practice amongst old-school physicians of bleed- ing in convulsions, is highly injurious, and should never be resorted to, as the almost invariable tendency of this practice, is to cause an increase both in the frequency and violence of the attacks. ■ Night-Mare. Incubus. This complaint is sometimes so frequent, and so injurious in its effects, that medical treatment becomes necessary. Persons subject to it should eat but little in the evening, and take light food at all times; drink no wine, beer, nor coffee; but instead a cup of weak black tea, or, better still, milk or soup. A good preventitive is to bathe in cold water every even- ing; in the summer this is best done in the open air at the hydrant GENERAL DISEASES. 453 or fountain; in winter, by rubbing the face, neck, the back of the head, the throat, shoulders, breast and abdomen with a wet cloth or sponge; afterwards drink a glass of cold water before going to bed; those who cannot take cold water may take water and sugar. Although it should not cure the complaint, continue this treatment, and take the following remedies : Nux vomica, when the night-mare is caused by indulgence in spirituous liquors, strong beer, too high living, too much con- finement, &c. It should be taken in the evening before going to bed. Aconite, especially when the disease occurs in children and women, and is accompanied by much heat, thirst, palpitation of the heart, determination of blood to the head or chest, oppressed breathing, nervousness, uneasiness, &c. This remedy is also use- ful for the headache and febrile excitement, which often follows the attacks. It may be taken night and morning. Opium, when the paroxysms are violent, the patient lying with his eyes half closed, snoring, the mouth wide open, rattling in the throat, the breathing irregular, the face much distorted, and covered with a cold perspiration, and the extremities con- vulsed. Pulsatilla, when there is considerable derangement of the digestive apparatus, arising from high living, &c. Sulphur and Silicea, in repeated doses, will be useful, if the attacks return notwithstanding the administration of the above remedies. Sleeplessness. In most cases, when not the result of diseases, sleeplessness may be attributed to the manner of living. Some persons can- not eat anything in the evening, or but a little, without suffering from loss of sleep. Others only sleep soundly by eating before going to bed. Exercise in the open air is one of the best pre- ventftives, but it must not be taken too late in the evening, or it will have an effect contrary to the one desired. When exciting, agreeable events are the cause, take Coffea; when terrible or frightful ones, Opium; when agitating ones, Aconxte; when the 454 CHAPTER XIV. events are tormenting and cause dejection, Ignatia, &c, always select the remedy according to the cause, if that be possible. The most common causes of sleeplessness are the use of coffee and tea, for which see the remedies. When a surfeit is the cause, give Pulsatilla; when reading or singing causes wake- fulness, Nux vomica; when abdominal complaints and flatu- lency, Chamomilla. When various figures and visions appear before the eyes of the patient, and prevent him from sleeping, Opium, and if this does not soon prove efficacious, Belladonna. Children are generally benefited by Coffea; old people by Opium. Sleeplessness is frequently occasioned by some disease, to which refer under its respective head for the necessary remedies, or consult a homoeopathic physician. Dropsy. Hydrops. A collection of watery fluid in the meshes of the cellular membranes is called Anasarca or General Dropsy. When the collection is found in some of the natural cavities of the body, as the chest (Hydrothorax), abdomen (Ascities), &c, it is termed Special or Partial dropsy. There are certain characteristics which are common to almost all forms of the disease; these are diminished secretion of urine, oedema, watery swelling of the feet and ankles, a paleness of surface with laxity of muscular fibre, and a peculiar expression of countenance, which has been termed leucophlegmatic Causes.—These are numerous; an obstruction to the free circulation of the blood in any large viscus, as the liver, lungs, or heart, either from mechanical pressure, or in consequence of disease, may give rise to dropsy. ^ But perhaps one of the most frequent causes of dropsical effu- sions, is repeated bleedings by the lancet in the hands of indis- creet old-school physicians. General Dropsy, Anasarca, Is characterized by general swelling of the body, paleness, softness, loss of elasticity and coldness of the skin. When the GENERAL DISEASES. 455 swelling is partial, it is called oedema^ The swelling most gene- rally commences in the lower extremities, first of the feet and ankles, whence it gradually extends to the whole body. It is greatest in the evening, when the individual has been on his feet during the day, and is scarcely perceptible in the morning. This is owing to the gravitation of the fluid from the upper parts of the body, which takes place with facility through the different parts of the cellular tissue. By pressing with the thumb or fingers on the swollen parts, a depression is made which remains for a long time. This is owing to the fluid being forced by the pressure into the neighbouring parts of the cellular membrane, and the depressions do not disappear until the cells, from which it has been pressed, become refilled. Treatment.—Arsenicum, Bryonia, Camphora, Cantharides, China, Dulcamara, Kali carb., Mercurius vivus, Phosphorus are the principal remedies. Arsenicum is indicated in general dropsy when accompanied by excessive weakness and general prostration of strength; earthy or pale, and greenish colour of the skin, especially in the face; red and dry tongue ; great thirst; coldness of the extremities, and pains in the back, loins and extremities. It is particularly valuable in oedema of the feet. Bryonia, against oedema of the feet and anasarca; the swel- ling of the feet is increased by day, and diminished at night. Camphora: anasarca, accompanied by red urine, which de- posits a copious sediment. Cantharides, in dropsy attended with irritability or atony of the urinary organs. China, in general dropsy, consequent upon profuse hoemor- rhages; also when accompanied by disease of the liver or spleen. It is particularly suited to dropsy occurring in women of ad- ^dclmara, against anasarca resulting from sudden checks of perspiration by exposure to cold or damp air; or when attended by thirst, violent nocturnal heat, with great agitation, scanty and offensive urine, eructations and emaciation. 456 CHAPTER XIV. Mercurius vivus, against anasarca, accompanying disease of the liver; with oppression of the chest; general heat and per- spiration ; short, hacking cough, and anguish. Phosphorus, especially in dropsical swellings of the feet, hands and face. Kali carb., against anasarca, particularly when occur- ring in aged persons, more especially women. Abdominal Dropsy. Dropsy of the Peritoneum. Ascites. This form of dropsy is known by enlargement of the abdomen, commencing below and gradually ascending upwards, until the abdominal parietes are, at times, so distended as to become ex- tremely thin, and almost transparent, with tortuous veins dis- tinctly to be seen in various parts. If the hand or extremities of the fingers be placed on one side of the abdomen below the level of the fluid, and the opposite side be struck with the other hand, a feeling of fluctuation is perceptible. The only incon- venience complained of by the patient is the feeling of weight in the lower part of the abdomen, until the accumulation of fluid pressing upon the diaphragm excites dyspnoea or difficulty of breathing. There is generally in this, as in other forms of dropsy, diminished secretion of urine, dryness of skin, &c. Treatment.—The following medicines are the most serviceable in this form of dropsy: Arsenicum, China, Mercurius vivus, Sulphur, Bryonia, Kali carb., Sepia, Ferrum metallicum. In ascites occurring in consumptives: Arsenicum, China, and Kali carbonicum. In that resulting from excessive use of spirituous liquors: Arsenicum, China, Sulphur. That arising from great loss of blood, or other debilitating losses: China, Ferrum met., Sulphur, and Mercurius vivus. When caused by abuse of mercury: China and Dulcamara. When following intermittent fevers : Arsenicum, Dulcamara, Ferrum met., Mercurius vivus, and Sulphur. For more particular indications, consult the preceding article, "General Dropsy" or "Anasarca." GENERAL DISEASES. 457 Dropsy of the Chest. (Hydrothorax). This disease may affect both sides, or but one side of the chest. There is difficulty of breathing, which is proportionate to the quantity of fluid effused with inability to lie on the affected side; and when both sides are implicated, scanty respiration, and dif- ficulty of breathing, except when in the sitting posture, energetic action of all the respiratory muscles, and great anxiety of coun- tenance. There is generally, too, more or less swelling of the feet and ankles, and the ordinary evidences of dropsy. Causes.—These are the same as those of dropsies in general, though perhaps it is more commonly symptomatic of disease of the heart or lungs. Treatment.—The principal remedies are: Arsenicum, Bry- onia, Carbo vegetabilis, Kali carb., Lachesis, Mercurius vivus, Spigelia, Aconite. With reference to the cause, and particular symptoms ordering their selection, see the two previous articles, " General Dropsy " and " Abdominal Dropsy". Inflammation of the Brain. Encephalitis. The symptoms of this disease are exceedingly diversified; the extent and duration, the age, sex, constitution and habits of the patient all aid in giving to it a variety of character. In some cases, violent delirium is the main symptom. In others the intellect may remain unaffected. Its commencement is often denoted by fever, or congestion to the head, with redness of the face and eyes, and throbbing of the arteries of the temples and neck. Violent headache is frequently one of the earliest symp- toms, which is increased by light and noise; and at times the skin is unusually sensible. Vomiting usually occurs in the course of the disease, and it may mark its onset. The patient is often extremely irritable and annoyed at trifles, and complains of feverishness with slightly increased pulse and heat of skin, especially at night, attended with restlessness, ring- ing in the ears, flashes or sparks before the eyes, giddiness and feelin" of weight on the top of the head for several days. These ° 58 458 CHAPTER XIV. symptoms, after continuing for a longer or shorter time, are fre- quently succeeded by drowsiness, with slight delirium, or by great mental excitement, with violent paroxysms of delirium, which are aggravated by the slightest noise or light admitted into the chamber. The pulse is generally rapid and hard, but it may become unusually slow if the inflammation is about to terminate in effusion of serous fluid into the ventricles of the brain. The pupil in the first period of the disease is commonly contracted, but as it advances, often becomes dilated and insen- sible to the light. During the progress of encephalitis, the bowels are mostly constipated. When the disease is about to terminate fatally, the delirium gives place to coma and convulsions. Inflammation of the brain occurs much more frequently "in children than in adults; hence the necessity of giving great attention to the following symptoms: pain in the head, which may be inferred to exist in young children when they raise the hands frequently to the head, and also if they scream violently without any apparent cause; inclination of the head to fall back- wards ; irritability or changeable temper; nausea or vomiting; costiveness; dread of light; drowsiness; sleeplessness, or sudden starting from sleep and screaming; boring of the head in the pillow; great excitement; heat in the head; eyes red, sparkling, convulsed, or fixed; pupils contracted or dilated ; redness of the face, with throbbing of vessels of the temples and neck. The duration of the disease is various. In some cases it results in death in a few hours; in others it is protracted for weeks, and ends by restoration to health, or in death, after a long period of suffering. Not unfrequently after it has passed away, the organs of vision or hearing remain impaired. In chil- dren, strabismus which may be permanent, is sometimes met with, and more or less deafness, and disorder of the mental faculties, is noticed. Causes.—External violence; sun-stroke; the use of ardent spirits; repressed eruptions, particularly of the scalp; erysipelas of the face; contagious diseases; mental irritations, &c. Treatment.—Aconite, Belladonna, Bryonia, Opium, Ilyos- GENERAL DISEASES. 459 cyamus, Stramonium, and Cuprum acetieum, are the most valuable remedies. Aconite is indicated in the commencement of the attack, when there is a high degree of fever, evinced by hot, dry skin; quick pulse, &c. It may be repeated every four to six hours. Belladonna is the main remedy in this disease, and should be immediately administered when there is great heat of the head; redness and bloatedness of the face, with violent beating of the carotid and temporal arteries; intense shooting and burning pains in the head; burying of the head in the pillow; the suf- ferings are increased by the least noise; dread of light; eyes red and sparkling, and sometimes protruded, or have a wild expression; pupils contracted or dilated; violent and furious delirium; low mutterings; loss of consciousness; convulsions; vomiting; involuntary evacuation of faeces and urine; constipa- tion. This remedy may be given either dry or in water, and repeated every three to six hours. It may often be administered with excellent effect, alternately with Aconite. Bryonia is often of great service in children, especially while teething, and after Aconite and Bryonia have proved inefficient, and the symptoms indicate a rapid tendency to effusion. Opium, when there is complete apathy; lethargic sleep, with stertorous breathing; congestions to the head; eyes half open, and confusion and giddiness after waking. Hyoscyamus, if there be drowsiness, loss of consciousness; indistinct speech; delirium and talking about one's affairs; white coated tongue, with frothing at the mouth; dilatation of the pupil; staring, fixed vision; red face; dryness of the skin, and picking at the bed clothes. Stramonium, against symptoms similar to those described under Belladonna, but with the exceptions of being more spas- modic in their character, and the pain in the head less acute. It is particularly indicated, when there are startings or jerkings in the limbs; sleep almost natural, followed by absent minded- ness on waking, or sleep attended by moaning and tossing about; 460 CHAPTER XIV. fixed vision; anxiety and dread, with screaming; redness of the face, and feverishness, with moist skin. Cuprum acetieum. This remedy is valuable when the dis- ease arises from suppressed eruptions, or occurs in children during the period of teething; especially against the following symptoms; fretfulness or apathy; restless and disturbed sleep; drowsiness, with inability to sleep; inability to hold the head erect; flushed face; dryness of the mouth without thirst; nau- sea and vomiting; constipation; sometimes diarrhoea; grind- ing of the teeth; shudderings, followed by heat; feverishness with variable pulse, but generally quickened and full; the symptoms are worse toward evening and at night. In chronic cases, Sulphur, Arsenicum, and Lachesis, are generally most useful. When the affection results from external injury, Arnica. From sun-stroke, Aconite, Belladonna, Camphor, and Lachesis. Abuse of ardent spirits, Opium, and Lachesis. Along with the administration of the above remedies, much benefit will be generally obtained in the commencement of the disease by applications to the head of cloths rung out of ice- water. Or in violent and highly dangerous cases, by pouring a stream of cold water out of the spout of a tea-kettle or pit- cher, from a height of two or three feet, on the head. Ague. Ghills and Fever. Fever and Ague. In its simple form, intermittent fever consists of three dis- tinct stages,—a chill or cold stage, followed by a hot, and this again by a sweating stage; after which the patient is generally free from suffering for a time. The three stages constitute a paroxysm or fit; and the interval between the termination of one paroxysm and the commencement of another is called the apyrexia, or intermission, and is usually of a definite duration. When the paroxysms return every day, the intermittent is quotidian; if every other day, it is tertian; if after an inter- val of two days, quartan. These are the chief types, although longer intervals between the attacks have been observed. GENERAL DISEASES. 461 When two paroxysms take place within each interval, the intermittent is said to be doubled, as double quotidian, double tertian, &c. Previous to the accession of the cold stage of an intermittent, the patient usually has more or less general indisposition, las- situde, yawning, headache, pains in the joints or limbs, numb- ness of the fingers and toes, and blueness of the nails. These symptoms are soon followed by a sensation of coldness, either with or without shivering or rigors. It is commonly felt first in the hands and feet, but soon becomes general; or a sensa- tion may be experienced, as if cold water were trickling down the back. The skin becomes pale, yellowish, or purple in spots; and if the cold is excessive, the skin presents the pecu- liar shrivelled appearance known as gooseskin (cutis anserina). There is shaking of the limbs and jaws; chattering of the teeth; feeble and tremulous voice; hurried and oppressed respiration; small pulse. The skin is usually about the natural temperature, notwithstanding the patient complains very much of cold; the urine is clear and copious, and there is often derangement of the stomach, nausea, or vomiting, and occa- sionally pain in the epigastrium. The duration of the cold stage is various, it may last for a few minutes only, or continue for four or five hours. Gene- rally, however, it lasts from half an hour to an hour. In some instances, this stage of the disease is so severe and long con- tinued that reaction never takes place, and the patient dies m the commencement of the paroxysm. The hot stage succeeds the cold without any marked inter- val : the skin gradually loses its paleness and becomes flushed; the thirst becomes violent; the pulse accelerated; the breath- ing hurried; the mouth dry and clammy; the breath and skin hot, and the urine high coloured. The heat is sometimes almost insupportable, and accompanied by intense pain in he head. This stage generally continues from four to twelve hours, and is succeeded by the— „ , . , . ,, Sweating stage. The sweating generally begins about the 462 CHAPTER XIV. head, and afterwards on the chest, back and inner part of the thighs; and soon becomes general. At times it is profuse, soaking the bed; at others it merely constitutes a gentle mois- ture. Its smell is sour or sweetish. As soon as the sweating is established, the pains and uneasy feelings of every kind are relieved, and the patient remains comparatively free from suf- fering until the accession of another paroxysm. The duration of the sweating stage is not usually longer than three or four hours. Such are the phenomena, which are generally considered to constitute a paroxysm of intermittent fever. After the par- oxysm is passed, the patient feels quite well, with the excep- tion of a feeling of fatigue or debility. And until the tendency to periodical recurrence is destroyed by appropriate treatment, he must still be considered to labour under the disease. The period of the day at which paroxysms of the different kinds of intermittents occur is by no means the same. In the quotidian, they generally appear in the morning; in the tertian about noon, and in the quartan after dinner. There is, how- ever, frequent variations from this'rule. The cold stage is usually short in the quotidian; and long in the quartan. The tertian holds the medium place in this respect. The duration of the disease is indefinite. It may terminate in £ few days, or it may run on for months or years. Ague is not often a dangerous disease, unless it continue for a length of time, in which case the c'onstitution may be seriously injured, and the foundation of consumption of the lungs, or some other malady, be laid. Dropsical affections, and also disease of the liver, spleen, &c, are frequently in- duced by it. Causes.—Persons of both sexes and of all ages are liable to intermittents, although it is more frequently seen in males than females, owing to the greater exposure of the former, from their out-door labours, to the exciting cause. The main exciting cause is a peculiar malaria, or bad air,— the nature of which is entirely unknown—chiefly generated in GENERAL DISEASES. 463 A marshy districts, along the course of certain rivers, &c; it may, however, arise from taking cold, indigestion, or peculiar con- stitutional tendency. The latter end of summer and the autumn, are the seasons during which the disease is most prevalent. Treatment.—Families who live in agueish districts, should pay particular attention to their sleeping apartments, which should be kept dry, and opened only in the middle of the day, for two or three hours, for the purpose of being aired. The head of the bed should be turned to the south, if possible, and be kept from the wall. Individuals who are compelled to sleep in damp houses, or on the lower floor of houses badly situated, may be in some measure protected by placing a layer of stone coal, ^broken very small, under their beds. Advantage may also be derived from wearing silk shirts, and by sleeping between silk sheets, which can be made of old dresses. Powdered sulphur, put in the stockings, may like- wise act as a preventative. Particular attention should be paid to the manner of living; eat nothing that lies heavy on the stomach; avoid pastry, things baked or roasted with fat, and all kinds of badly dressed food; eat well cooked meat and vegetables, or meat which has been slowly and properly stewed in a closed vessel, with much gravy without any seasoning, except salt. Whilst the fever prevails, pies are very injurious. Raw ham, with black pepper, is more wholesome than when it has been rendered indigestible by being overdone by frying. Every thing acid and fat should be avoided at such times; acids are good in the heat of summer; fat may be used in the cold of winter. During the cold stage let the patient be well covered with blankets which are perfectly dry; if you have a silk coverlet, wrap it around the lower extremities and abdomen, if the patient finds it agreeable. In the hot stage, linen or muslin makes a better covering. Frequent wiping with a warm, wet cloth also gives much relief in this stage. During the sweating 464 CHAPTER XIV. stage, the patient should not be covered too warmly; and after it is over, the linen and bed should be changed. After the sweat- in"' stage, it is better to change the linen and the bed. The linen should be well aired and warmed, which is best done by a healthy person rubbing it with his hands, until all the smell of soap i3 gone; in fact, this should be done with all linen in- tended for the sick. Those who have not a sufficiency of linen, will do well to lie naked between blankets during the stage of perspiration, and to put on the shirt when this is over. If the patient complains of thirst, give him as much cold water as he wishes, if good spring water can be had; if the water is bad, give toast and water, or put some acid into it; it may be either warm or cold. If he prefers it warm during the cold stage, give him toast and water or mucilaginous djinks, such as boiled oatmeal, hulled barley or grits. When the patient vomits much, and feels very weak, give him coffee without milk. During the hot stage, cold water is the best drink; but if the patient is very ill and craves acids, lemonade may be given in moderate quantities. In the sweating stage the patient should drink nothing but cold water. The following medicines have generally been found most useful in this affection; and they should for the most part be administered in the apyrexia, or interval between the par- oxysms. Ipecacuanha, Arsenicum, China, Ferrum met., Arnica, Vera- trum, Sambucus, Antimonium crudum, Bryonia, Cina, Ignatia, Rhus tox., Nux vomica, Chamomilla, Pulsatilla, Capsicum, Coffea, Cocculus, Staphysagria, Natrum muriaticum, Lachesis, Belladonna, Hyoscyamus, Hepar sulph., Mercurius vivus, Sul- phur, Coicarea carb., Carbo vegetabilis, Aconite, and Opium. Ipecacuanha is useful in most cases of this disease, and will frequently, when properly selected, of itself effect a cure. When there is any doubt in regard to the choice of a remedy, espe- cially at the commencement of the disease, this remedy may be administered with advantage, and continued until another is more clearly indicated. The following symptoms, however, clearly GENERAL DISEASES. 465 point to its employment: much internal chilliness, which is in- creased by external warmth ; little or no thirst in the cold stage, but a great deal in the hot stage; clean or slightly furred tongue; nausea and vomiting, and oppression of the- chest immediately before the accession of the paroxysm, or during the cold and hostages. In the beginning, before the type of the fever is distinctly marked, the remedy may be given every three or four hours, but afterwards only twice during the apyrexia, the first dose soon after the termination of the paroxysm, and the-second about two hours before another attack is expected. Good results will often be obtained by the alternate administration of Ipeca- cuanha and Nux vomica. Arsenicum is indicated when the different stages are not dis- tinctly marked, but the chilliness, heat and fever occur simul- taneously, or when there is frequent changes from chilliness to heat, and vice versa; or a sensation of internal chilliness with external heat; also when the paroxysm is imperfectly developed; further when there is little or no sweating, or at least not for some time after the heat has subsided; great prostration of strength; violent burning pains in the stomach, and insupport- able pains in the limbs, or all over the body; anxiety and rest- lessness; excessive thirst; sensation of uneasiness about the heart, or oppression and spasms of the chest; nausea or sick stomach, and vomiting; bitter taste in the mouth; violent headache, continuing after the hot stage; buzzing in the ears during the sweating stage. All the sufferings of the patient, as the headache, pain in the limbs, &c, are increased in inten-. sity, and others developed during the paroxysm. . China, if the paroxysm be preceded by nausea; voracious appetite; headache; agitation; palpitation of the heart, or sneezing; thirst during the sweating stage, sometimes continu- ing throughout the apyrexia; chills alternating with heat, or when the heat does not come on for some time after the chills have ceased ; sleeplessness or disturbed sleep; great weakness, and sallow complexion. It is contra-indicated when there is 466 CHAPTER XIV. much thirst during the cold or hot stages. This remedy is valu- able in most intermittents originating from marsh miasm, and may be given as soon as the first symptoms show themselves. Ferrum met, against symptoms resembling the preceding, and also when there is determination of blood to the head; throbbing of the arteries in the neck and temples; swelling around the eyes; pressure in the stomach and abdomen, parti- cularly after eating; vomiting of food; tension in the abdomen, and shortness of breath; weakness of the extremities; hardness and fulness m one or both sides of the abdomen, close under the short ribs; swelling of the feet and incipient dropsy. Arnica, when the cold stage generally comes on early in the morning, or in the forenoon, with thirst before the chill; drawing and pain in all the bones preceding the fever; the patient feels uncomfortable in every position, and is constantly changing about; apathy or stupor; perspiration and breath offensive. Veratrum, when there is predominance of external coldness, with internal heat; cold clammy sweat, particularly on the fore- head, and general coldness of the whole body; or chilliness with- out heat, or chilliness and heat by turns; giddiness; constipa- tion of the bowels, or diarrhoea; sometimes nausea, or vomiting, and pains in the back and loins. Sambucus is indicated when the sweating is very profuse, and continues throughout the entire intermission. Antimonium crudum is indicated when the tongue is very much furred; bitter and nauseous taste; eructations; sickness of the stomach; vomiting; little or no thirst, and constipation or diarrhoea. See also Pulsatilla. Bryonia, for symptoms similar to the preceding, but attended with much thirst; or heat before the chills; red cheeks in the cold stage; yawning, and stitches in the side during the heat; more coldness and chills than heat, and constipation or diarrhoea. Cina, vomiting and voracious appetite before, during, or after the fever; thirst either during the hot, or during the cold stage; pale face during the cold and hot stage; constant rubbing of the nose. GENERAL DISEASES. 467 Ignatia, if there be thirst in the cold, but not in the hot stage; mitigation of the chilliness by external warmth; heat of some parts of the body, with coldness and chill of others; heat external only; pain in the bowels during the cold stage, fol- lowed by heat, with debility and sleepiness. Rhus toxicod. is serviceable in intermittents of the double tertian type, with a paroxysm every day; the paroxysms of each day corresponding with others forty-eight hours afterwards; the attacks usually come on in the after part of the day, and consist of heat preceded and followed by chills; coldness of some parts of the body, and heat of others; perspiration after midnight, or toward morning; the heat accompanied by a rash; pain in the bowels, and diarrhoea; pressure at the pit of the stomach; pal- pitation of the heart, and anxiety. Nux vomica, when at the commencement of the paroxysm there is great debility and prostration of strength, with desire to lie down; giddiness, with a feeling in the head as if from in- toxication ; cramps in the muscles of the abdomen or calves of the legs; stitches in the sides; alternate heat and chills, or heat preceding the chills; heat externally, and chilliness inter- nally, or vice versa; desire to be constantly covered, even during the hot and the sweating stages; external warmth affords no relief; heat and pain in the head; buzzing in the ears; redness of the cheeks; thirst and anxiety during the hot stage; consti- pation. Chamomilla is indicated when the tongue is loaded with a white or yellow coating; also when there is nausea and bitter vomiting; loathing of food; much thirst in the hot stage, and even in the sweating stage ; pressure and uneasiness in the region of the heart; predominance of heat and perspiration; pain in the right groin, and loose, watery evacuations from the bowels. This remedy resembles Antimonium crudum and Bryonia. Pulsatilla is particularly valuable in intermittents attended with much gastric derangement, or when the slightest disorder of the stomach brings on a relapse. The particular indications for its employment are: absence of thirst during the entire paro- 468 CHAPTER XIV. xysm, or thirst only during the hot stage; simultaneous heat and chilliness; bitter taste in the mouth; bitter or sour vomit- ing of mucus or bile; the attacks usually come on in the after- noon or evening, and the patient complains of chilliness through- out the intermission. Many of the symptoms of this remedy have a great similarity to those of Antimonium crudum, Bryonia, and Chamomilla. It is, also, in some cases of relapse from indigestion, particularly suitable after Lachesis. Capsicum is indicated in cases in which there is chilliness attended with thirst, followed by heat without thirst, or thirst only during the hot stage; chills violent and long continued; intense burning both internally and externally during the hot stage ; accumulation of mucus in the mouth and throat; slimy, burning diarrhoea, and great intolerance of noise. Coffea, in very sensitive persons, who suffer greatly from nervous excitement, even though the fever be but slight; paro- xysms of heat and thirst, with flushed face, followed by general perspiration ; the thirst frequently continues through the sweat- ing stage; watery diarrhoea. Cocculus is valuable in agues attended with cramp or spasms of the stomach and abdomen, obstinate constipation, and much nervous excitement. Natrum muriaticum is one of the best remedies in intermit- tents, especially when the following symptoms are presented : violent pains in the head during the chilliness and heat; lengthy chills; dimness of vision, and partial loss of consciousness during the hot stage ; impaired vision throughout the apyrexia; chaps and fissures on the lips, particularly at the corners of the mouth ; slight fever, continuing through the intermission. Similar in its action to Arsenicum and Ignatia. Lachesis is indicated when the attacks come on in the after- noon, and are accompanied by violent pains in the small of the back, and limbs; oppression of the chest; violent headache with red face, and loquacity during the hot stage; or internal chilliness and external heat, with ashy or yellowish colour of the GENERAL DISEASES. 469 face. Lachesis is particularly serviceable when a relapse has been produced by the use of salads, vinegar, &c, or after it has been suppressed by quinia frequently, but constantly occurs. Pulsatilla follows or alternates advantageously with Lachesis in such cases. Belladonna has been found useful in double quotidian inter- mittents—when two or more paroxysms occur in the twenty- four hours—the cold stage slight, and the hot stage violent or the reverse, violent chill and slight heat; great sensitiveness, and inclination to shed tears; constipation, or loose and scanty evacuations; sometimes attended with violent effusion to the head, with red face, heat, and severe pain in the head, and dull- ness or stupor. Hyoscyamus, in cases similar to the latter, but attended by a dry cough at night. Hepar, in agues attended by severe catarrhal symptoms affect- ing the head and chest; bitter taste in the mouth; chilliness, with thirst, followed by heat, sleepiness. It is often suitable before or after Belladonna. Mercurius vivus, in quickly alternating chills and heat, with restlessness and thirst; profuse, offensive, sour perspiration, and palpitation of the heart. Sulphur, when the attacks come on in the after part of the day, with evening chills, fever during the night and sweating in the morning; palpitation of the heart. It is appropriate in inter- mittents, following suppressed cutaneous eruptions. Calcarea, when there are alternate chills and heat; external coldness and internal heat; heat in the head and face, with cold- ness of the extremeties, sometimes extending to the abdomen; giddiness; feeling of heaviness in the head and limbs; violent pains in the small of the back, and anxiety. Similar in some respects to Sulphur and Veratrum. Carbo vegetabilis, when the attack is preceded or attended by pains in the teeth and limbs; thirst, only in the cold stage, with vertigo, redness of the face, and sick stomach during the hot stage. 470 CHAPTER XIV. Aconite is indicated when the chills and heat are both violent; or when they appear simultaneously; great external heat, espe- cially of the face and head, and acute pains in the side. A dose or two of this remedy during the hot stage, will generally, materially lessen the violence and duration of the fever. Opium is particularly applicable in intermittents occurring in aged persons, and sometimes also in those of children. The chief symptoms which point its employment are : drowsiness, or heavy sleep, with loud snoring during the cold and hot stages; stertorous respiration, with the mouth open; congestion of blood to the head, with red and puffy appearance of the face; and eonvulsive movements of the limbs. Sepia is often useful in ague3 with predominance of thirst during the cold stage. In intermittents which return annually, Lachesis, Carbo vege- tabilis, and Arsenicum, are generally th§ most useful remedies. Inflammatory Fever. This form of fever is characterized by chill—sometimes vio- lent—followed by burning heat; pulse full and bounding, and greatly accelerated; thirst; hot and dry skin; the mouth dry and clammy; hot breath; tongue of a bright red colour, and in some instances slightly coated with a white fur; urine high coloured and scanty; constipation, and hurried respiration. It usually runs its course rapidly and terminates in a few days, and rarely exceeds a fortnight in duration. The crisis shows itself in profuse perspirations, diarrhoea or hemorrhages mostly epistaxis. Under homoeopathic treatment its duration may gene- rally be considerably shortened, and recovery take place rapidly, instead of the long convalescence inevitable after the usual allo- pathic means. The disease is exceedingly liable to be complicated with in- flammation of the brain, or with congestion of some of the inter- nal organs; or it may change into nervous or typhus fever if not properly treated. GENERAL DISEASES. 471 Young and middle aged individuals of full or plethoric habit are most subject to it. Causes.—Exposure to cold or dampness; sudden check of perspiration; high living, especially abuse of ardent spirits; mental emotions; external injuries; and local inflammations may all act as exciting causes. Treatment.^—Aconite is peculiarly efficacious in this form of fever, and is mostly sufficient of itself entirely to subdue the disease. It may be repeated every one, two, or three hours, accord- ing to the degree of intensity of the fever, and the intervals lengthened as the symptoms subside. Belladonna will, in some cases, be requisite after Aconite when there is congestion to the head; violent cephalalgia, espe- cially in the forehead; heat of the head; redness of the face; violent throbbing of the arteries in the neck and temples; furious delirium; red and fiery eyes; burning thirst, restless- ness, &c. Bryonia will be found useful when there is a heavy stupe- fying headache, with a sensation as if the head would burst, aggravated by every movement; burning heat of the skin; red- ness and swelling of the face; vertigo, especially on rising; delirium; oppression of the chest and at the pit of the stomach; excessive thirst, and sometimes vomiting; constipation; pains in the chest; dry cough, or cough with toUgh expectoration, sometimes streaked with blood; it may be given every four to six hours. If in the course of the disease, it should attack any of the internal organs—a very frequent occurrence—such as the lungs, liver, bowels, &c, the appropriate treatment will be found under the head of the particular organ involved. Typhus, or Nervous Fever. The term typhus has been applied to a variety of fever charac- terized by great disturbance of the mental faculties. It is gene- rally indicated by a small, weak and irregular, but usually fre- 472 CHAPTER XIV. quent pulse, with great prostration of strength and cerebral disturbance. The disease is generally preceded, for a longer or shorter time, by prostration, or languor and lassitude, with a feeling of general indisposition and more or less gastric disturbance; some- times, however, where an epidemic typhus is prevailing, the dis- ease sets in without any premonitory symptoms. Occasionally, for a few days at the commencement, the fever may be of a high grade, with full bounding pulse, hot, dry skin, &c, as in inflammatory fever, but these symptoms rarely continue longer than three or four days, when they subside, and are succeeded by anxiety, restlessness, delirium, ringing in the ears, which are characteristic of typhus, or nervous fever. The symptoms in this, as in most other forms of fever, are increased in violence towards evening, and, in the morning, there is usually some remission; there is frequently, also, an aggravation of the symp- toms every other day. The skin, which is generally hot and dry, is sometimes bathed with a profuse perspiration, even in the beginning of the disease; partial irregular sweats, also, often occur without relieving the patient. The bowels are usually constipated; the eyes heavy and watery; the countenance of dingy hue, and peculiarly ex- pressive of great languor and oppression. As the disease ad- vances, the typhous symptoms augment. There is great drowsi- ness and stupor; at times, deafness, with frequent sighing, and brief and impatient replies if the patient be questioned. The eyes are filled with tears; the nostrils obstructed by tenacious mucus; the lips dry and chapping, and the teeth and gums covered with dark sores; the tongue is brown, dry, and often, also, chapped. In some instances, but not frequently, diarrhoea, tenderness and distention of the abdomen, ensue in the course of typhus. The prostration at times becomes very great, the patient lies upon his back, entirely listless, and unable to prevent himself from sinking down in the bed; the hands are affected with tremors, and the muscles with spasmodic twichings; the evacuations are passed involuntarily, and the countenance is dull GENERAL DISEASES. 473 and void of expression; there is constant low muttering delirium or coma, and frequently hemorrhages from the bowels, nose, stom- ach, or urinary organs, take place. The duration of typhus is rarely less than two weeks, and it frequently goes on for five or six, especially if badly managed; the average is about twenty-one days. Causes.—Residing in densely populated districts, and in filthy, damp and crowded appartments; deficiency and improper quality of food; over-exertion, either of body or mind, or excesses of ^ny kind, act as exciting causes. It is, however, chiefly propa- gated by contagion. Treatment.—Aconite and Belladonna will be indicated in the commencement if there be active inflammatory symptoms. Ipecacuanha, if there be much derangement of the stomach and bowels at the onset of the disease. Pulsatilla and Nux vomica also deserve attention in this stage. Mercurius vivus, in cases attended with profuse debilitating sweats; yellowish tinge of skin; distention and tenderness of the abdomen; foul and thickly-coated tongue; bitter taste, and diarrhoea, with much tenesmus. Bryonia and Rhus toxicod. are, however, the remedies which are generally most useful in typhus, and under their administra- tion the disease will, in most cases, be brought to a successful termination. They may be given alternately, and repeated every four to six hours. China will berfound serviceable in cases attended with pros- tration of strength ; profuse sweats and obstinate diarrhoea. Phosphorus, when complicated with disease of the lungs, with pains in the chest, difficulty of breathing, and profuse mucus expectoration, sometimes streaked with blood. Phosphoric acid, alone, or alternately with Rhus tox., when there is copious watery diarrhoea, or evacuations of blood; low fluttering delirium, great debility, &c. Arsenicum, in malignant cases, attended with extreme debil- ity; pulse intermitting, and almost imperceptible; falling of 474 CHAPTER XIV. the lower jaw ; dull glassy eyes, and burning thirst. It may be repeated every half hour, or hour, until improvement result, when the interval must be lengthened. Carbo vegetabilis, in cases similar to the latter, and after or alternately with that remedy. Hyoscyamus, Stramonium, and Opium, will also be useful in some forms of the disease. In the debility following a severe attack of typhus, China and Sulphur may be given advantageously. Yellow Fever. Yellow fever usually commences with intense headache, accom- panied by chills, shivering pains in the limbs and back, followed by heat, seldom intense, sometimes perspiration; red, animated and in some instances swollen face; red, glittering and suffused eyes; intense thirst, and entire loss of appetite. Pain at the epigastrium, along with nausea and vomiting, set in, in severe attacks, about fifteen or twenty hours from the onset, or in some cases even earlier than this; the substances ejected are at first yellowish, but soon become of a brown or black colour; and the stools also assume a similar appearance. The redness of the skin and eyes gives place to a yellow tinge, which in some cases becomes quite bright. There is generally neither prostration, nor stupor. The pulse is but moderatly accelerated, and the degree of heat comparatively slight. The anxiety and restlessness is at times extreme, the patient being unable to rgmain in any one posture. Delirium, in fatal cases, usually comes on before death. In severe cases of the disease, especially during the prevalence of an epidemic, the great irritability of the stomach, the black vomit, and the yellowness of the skin, are characteristic, and render the diagnosis easy. The average duration of yellow fever is from five to seven days. Treatment. — The remedies to which attention should be chiefly directed in the treatment of this disease, are: Arnica, Carbo vegetabilis, Arsenicum, Bryonia, Rhus toxicod., Ipeca- GENERAL DISEASES. 475 cuanha, Belladonna, Nux vomica, Mercurius vivus, China, and Veratrum. In the early stages, Belladonna, Arnica, Ipecacuanha, and Nux vomica, will generally have the preference. In the latter stages, Arsenicum, Veratrum, China, Mercurius vivus, and Carbo vegetabilis. And should the disease assume a typhoid character, Bryonia and Rhus toxicod. will be indicated. Fainting. Swooning. Syncope. When fainting occurs, it generally produces such alarm in those present, that all kinds of experiments, useless, disagree- able, and even injurious, are resorted to. If too large doses of spirits of hartshorn are administered, the consequences may be fatal. Remember the first thing to be avoided in all such cases is hurry. Loosen the clothing, if tight, about the neck, chest and abdomen; place the patient in a comfortable situation, and remove all objects which, when consciousness returns, might make a disagreeable impression. Sprinkle some fresh spring or hydrant water from a feather gently into his face, apply a little water to the neck, the back part of the head, and to the pit of the stomach. If this does not produce any effect, and if the patient becomes cold, let him smell spirits of camphor. When the cause is known, the remedy may be selected accord- ingly ; for instance, if it arise from fright, Colocynthis, Opium, and Aconite; from loss of blood, or other debilitating causes, China; in such cases wine, too, is useful; but only a few drops should be given at a time; when produced by sudden mental emotions, Ignatia or Chamomilla. When the slightest pain causes fainting, give Hepar; when very violent pain, Aco- nite, sometimes Cocculus or Chamomilla; when the pain pre- ceding the fainting has almost driven the patient to distraction, give Veratrum, the same remedy will answer when debility and fainting are produced by the least exercise; when it occurs in the morning, Nux vomica is frequently of service, particularly in those who use ardent spirits immoderately, or those who have injured themselves by severe application. Carbo vegetabilis, in 476 CHAPTER XIV. cases where too much mercury has been taken;—when it comes on after dinner, Nux vomica generally removes it, or should this fail, try Phosphoric acid. If it be preceded by giddiness, give Chamomilla, or Hepar. These remedies should not be administered more than twice —the second time from five to ten minutes after the first; if no improvement takes place after the second time, select another medicine. When the relief is only temporary, repeat the dose as soon as the patient becomes worse again. When vomiting occurs after recovery from fainting, do not interfere with it at all; when the patient falls asleep after it, do not disturb him; rest will refresh him. Apparent Death. Asphyxia. In regard to instances of apparent death, the same error is usually committed as in cases of fainting. Either too much is done, or too many things are tried at once as in cases of poison- ing, or nothing is done. There may be the appearance of death, especially after some violent external injury, when the functions of life are only suspended. But the appearance may become the reality, by being taken for it too soon. There are many cases where sudden death is not a mere suspension of animation; and others, particularly of females who are pregnant, or in childbed, where apparent death is very common. We know of but one sure sign of death, that is, when internal dissolution has pro- ceeded so far as to become perceptible externally. Whenever there is the least uncertainty, and in all cases where animation has been suddenly suspended, and putrefaction does not com- mence as suddenly, nothing at least ought to be done that may cause actual death, and the interment should be postponed until the third day; on the third day changes always appear on the body, which are decisive; if, at the end of this period, no marks of decay can be perceived, all further proceedings should be arrested until they make their appearance, though a week should elapse. In all cases where animation has been suspended by ex- ternal violence, the body should be treated with the greatest GENERAL DISEASES. 477 care; when this is done, and when to this care the requisite knowledge is added, restoration becomes possible. Apparent Death from Hunger. In cases where animation has been suspended from want of sustenance, give repeatedly small injections of warm milk; when the patient begins to breathe, give milk at first, drop by drop, afterwards a teaspoonful at a time, gradually increasing the quantity; when he begins to ask for food, give him a few spoon- fuls of toast and water, and then some clear broth, after this a few drops of wine. When a sound, healthy sleep succeeds, and not until then, commence giving him solid food—the patient may eat often, but only little at a time—after several days he may return to his usual diet. Eating too much and too rapidly endangers life. Apparent Death from a Fall. Place the sufferer carefully on a bed, with his head elevated, and in a place where he may remain quiet, put a few globules of Arnica dissolved in water on his tongue, and wait quietly until the physician comes on to see if there are any fractures, and whether there are still signs of life. A vein may be opened, but blood must not be let in any large quantity, as is the com- mon practice; for a person who is restored to life by bleeding, would probably have recovered without it—although in some cases bleeding may accelerate restoration. If bleeding proves unsuccessful, or if there be reluctance in resorting to it, repeat the Arnica, and give it also in injections. When the patient recovers after being bled, first give China, and afterwards Arnica, to promote recovery. When the patient has lost much blood from wounds, bleeding is madness; give China, and a little wine, a few drops at a time, and afterwards Arnica. Apparent Death from Suffocation, Hanging, Pressure, Choking. Remove all tight clothing. Place the patient in a proper position, with the head and neck rather high, the neck being 478 CHAPTER XIV. quite easy, neither bent forward nor upward, as is frequently the case when the head alone is too much elevated. Then com- mence rubbing gently but steadily, with warm cloths, and give immediately an injection of ten to twenty globules, or a drop of the tincture of Opium dissolved in half a pint of water, and injected slowly. This may be repeated every quarter of an hour, whilst the limbs are being rubbed, principally on the inside. From time to time hold a looking-glass before the mouth and nose, to see if the breath dims it; open the eyes to see if the pupils contract. Put warm cloths, or hot stones wrapped in cloths, to the feet, between the thighs, to the neck, the sides, and under the shoulders. If in an hour or two no change is produced, take a bitter almond, pound it fine, and mix it in a pint of water, put a few drops into the mouth, or into the nose, and give the rest in injections. Opium or Aconite are generally most suitable for the removal of the symptoms which appear after restoration is established. Apparent Death from Drowning. A person apparently drowned should be immediately un- dressed, the mouth and the throat be cleaned, the upper part of the body and head be bent forward for a few minutes, that the water, if possible, may run out, and then placed on a warm bed, wrapped in warm blankets, or in warm sand or ashes; in sum- mer, place the patient, wrapped in a blanket, if possible, in the sun, with his face turned toward it, and the head slightly covered ; then give injections, and commence rubbing the limbs with warm cloths, and continue this for hours. Bleeding is folly. If the rubbing and injections produce no effect, put a few globules of Lachesis upon the tongue, and give the same remedy—twelve to fifteen globules dissolved in half a pint of water—in injections, and continue the rubbing. Persons, after having been under water half an hour, have been restored to life by continued and unwearied exertions. Apparent Death from being frozen. Frost-Bite. Where animation has been suspended by freezing, it may be restored in some cases even when it has ceased for several days. GENERAL DISEASES. 479 Great care should be taken in moving persons in this condition, so that no part of the body may be injured. Let them be taken from the open air under cover, but consider that even a very moderate heat may kill them; a cold room, or a barn where there is not the least draught, is the best place. Cover them entirely with snow, face and all, leaving merely the mouth and the nostrils free, in such a manner that every part of the body is covered with several inches of it. Place them in such a posi- tion that the melted snow may run off easily, and be replaced by fresh. When there is no snow, put them into a cold bath, the temperature of which has been reduced by ice. If the ice attaches itself to the body or to the clothes, remove it. In this manner thaw the body until every part becomes per- fectly pliable, then gradually remove the clothing, if necessary, by cutting them from the body. As the limbs become soft and pliable, commence rubbing them with snow, and continue it until they become red; then place the patient on a dry bed, and rub him with cold flannel cloths, stockings, old pieces of felt, &c. If signs of returning life do not soon manifest themselves under this treatment, small injections, containing camphor, may be administered every quarter or half hour. If the patient begins to revive during the friction, or after taking the camphor, and gives symptoms of returning animation, administer small injec- tions of lukewarm coffee, without milk—and, as soon as he can swallow, give him some coffee—a teaspoonful at a time. It frequently takes hours to restore life, but we ought not to be sparing of labor. For the violent pains which are felt after the sufferer has revived, give Carbo vegetabilis in repeated doses, and if this proves unavailing, Arsenicum. If heat or stinging pains are felt in the head, a few doses of Aconite will be of ser- vice. If the patient graves wine or brandy, a small quantity may be given to him. A person who has recovered from freezing, must avoid the heat of the stove and of the fire for a considerable time, as serious maladies, particularly disease of the bones, is liable to result therefrom. 480 CHAPTER XIV. Apparent Death from Lightning. A person rendered insensible by a stroke of lightning, should be at once placed in a current of cool fresh air, and fresh water dashed plentifully over him, especially over the face, neck and chest. Internally, a few pellets of Nux vomica should be ad- ministered by placing them upon the tongue, and repeating the dose in half an hour if there be no signs of returning conscious- ness. The same remedy may also be given in injection by dis- solving from fifteen to twenty pellets in half a pint of water. Another method of equal or perhaps superior efficacy, is to place the patient in a half-recumbent, half-sitting posture, with the face turned towards the sun, and to cover him entirely (ex- cept the face) with newly dug earth until there are signs of returning animation, after which Nux vomica should be ad- ministered as recommended above. The morbid symptoms which frequently follow restoration, may generally be removed by Sulphur and Nux vomica. Tetanus. Tetanus consists of a violent and extremely painful contraction of the voluntary muscles. There are several varieties of the affection. It is termed opisthotonos when the body is bent back- wards by the violent contraction of the muscles of the back and posterior part of the neck—emprosthotonos when the body is bend forwards—pleurosthotonos when bent to one side, and trismus, or locked jaw, when the muscles of the lower jaw and throat are affected. The first of these varieties is by far the most common, and is characterized by the following symptoms: painful rigidity of the neck, resembling rheumatism, difficulty of deglution, followed by inability to swallow liquids, and on attempting so to do, by spasms in the throat. These are succeeded, sooner or later, by violent, spasmodic, lancinating pain, which shoots with the rapid- ity of lightning through the chest, from the sternum to the spine, recurring at shorter and shorter intervals, and augmented, at last, to such a degree as to become intolerable. Along with this GENERAL DISEASES. 481 characteristic symptom, the contraction of the muscles of the neck, back, and jaw, keep pace; the head, in particular, is thrown painfully backwards, and cannot be restored to its natural posi- tion ; the respiration is impeded, the pulse is fluttering, small and quick; the face flushed, the forehead wrinkled, the eyes turned upward, or distorted; the nostrils dilated, and the whole counte- nance an expressive of the greatest distress. At last every volun- tary muscle of the body becomes more or less implicated. Some- times the contractions increase to such a degree that the head and heels come in contact. The jaws become immovably fixed, but are in some instances slightly relaxed, and then sud- denly snap together again with a convulsive jerk, that frequently wounds the tongue badly, as that organ is very apt to be pro- truded beyond the lips. The intellect remains unimpaired to the last, although the patient is scarcely a moment free from the most agonizing spasms. In fatal cases, death generally takes place by sudden and violent convulsions. Causes.—The disease may be occasioned by exposure to cold, mental emotions, &c; it is, however, very often produced by wounds (traumatic tetanus). The slightest scratch will, in some cases, give rise to it, and in others it cannot be caused by the most extensive laceration. Tetanus resulting from a wound, generally makes its appearance before the tenth day. It is most common in warm climates, and in the summer months. Treatment.—Arnica, Belladonna, Lachesis, Hyoscyamus, Opium, Ignatia, Rhus toxicod., Stramonium, and Natrum muriaticum. Arnica is valuable in most cases of traumatic tetanus, and should generally be first administered; internally in pellets, and externally in the form of a lotion—a teaspoonful of the tincture to a tumbler of water. Should it not produce a favourable change in twenty-four to forty-eight hours, Opium, Hyoscya- mus, or Belladonna, must be given. Belladonna, is one of the most valuable remedies in this dis- ease, from whatever cause arising. The chief indications for its employment are: a sensation of constriction in the throat, and 482 CHAPTER XIV. tightness of the chest, with grinding of the teeth, spasmodic clenching of the jaws, distortion and foaming at the mouth, dif- ficult deglutition and aggravation of the paroxysms on attempting to swallow. It may sometimes be necessary to give Lachesis or Hyoscyamus alternately with Belladonna. Rhus toxicod. and Ignatia have been used with success in the most violent cases, in which the body has been bent backward in the form of an arch—the head touching the heels. Opium, when the malady is produced by cold, and is of ex- ceedingly violent character, will be found of great value—also when arising from wounds, and from fright. Lachesis, given when the first symptoms make their appear- ance, will often prevent the accession of a more violent attack. Natrum muriaticum has been found useful in tetanus resulting from long continued vexation. The above remedies may be repeated every hour. Apoplexy. Against the premonitory symptoms of this complaint, such as great inclination to sleep; general feeling of dulness or heavi- ness; dimness before the eyes; buzzing in the ears; hardness of hearing; heavy, profound sleep, and stertorous breathing; frequent yawning, and fatigue after the least exertion; acute pains in the head; vertigo or giddiness; fainting; irritability of temper; loss of memory; forgetfulness of words or things; acuteness of vision or double vision; difficulty of swallowing; numbness, torpor, or pricking sensation in the extremities; congestion of blood to the head, with beating of the temporal arteries; red face, and quick, full pulse, &c; the following medi- cines have been used with most success: Aconite, Belladonna, Ignatia, Pulsatilla, Lachesis, and Nux vomica. Some of the most prominent symptoms for the choice of these, and also other remedies, which may sometimes be required, will be found under the heading of " Determination of Blood to the Head", (which see). Aconite, in all cases in which there is congestion to the head GENERAL DISEASES. 483 with full, quick pulse; red face; throbbing of the arteries of the neck and temples, &c. It may be given twice a day. Belladonna, after Aconite, should the latter be insufficient to remove the symptoms of congestion. Nux vomica, against threatened apoplexy in persons of sedentary habits, and those addicted to the use of stimulating drinks, or to too great indulgence at the table. Pulsatilla, in persons of mild disposition, and especially in females. In the treatment of the disease itself, Nux vomica, Lachesis, Opium, Ignatia, Belladonna, Arnica, and Pulsatilla, have proved most serviceable. The disease, however, is one which assumes such a variety of forms, and is so dangerous in its character, that the greatest attention and skill are required on the part of a physician to conduct it to a successful issue. The limits of this work will not admit of a more extended notice of the disorder; nor, in- deed, is that necessary, as the treatment should in all cases be under the management of a homoeopathic physician. Scrofula. The scrofulous constitution is commonly characterized by the following symptoms : an extremely delicate complexion of a lively red colour mixed with a beautiful white, and the red of the lips of a carnation tint; the lips, especially the upper, are thick and protuberant; the eye remarkably clear, and the pupil dilated; drooping of the eyelids, giving to the countenance a melancholy but interesting expression. The head is large and protuberant at the occiput; the neck short, the lower jaw thick and fleshy, the eyes of a light gray or blue colour, and the abdomen swollen and prominent. The hair is generally straight and wiry, and often of a jet black colour. Sometimes, however, it it almost white. The eyes, too are often dark, and, in some instances, extremely black. Children are more subject to scrofula than grown persons, 484 CHAPTER XIV. and the disease may show itself any time between infancy and puberty. The lymphatic glands, especially those of the neck and ab- domen (mesentery), are more susceptible of the disease than other parts. Next to these the lungs and spongy bones are most frequently implicated. In whatever situation a scrofulous tumour may be met with, it always presents the following ap- pearance and symptoms. At first there is simple enlargement without pain or increased heat; in a short time, however, pain is experienced if the tumour be pressed upon, and the warmth of the part is increased. The disease may continue in this state for months or years, and finally disappear spontaneously. Gene- rally it follows a different course—gradually taking on inflam- mation, and at last terminating in abscess and ulceration. For a long time before the abscess breaks, the skin assumes a dark purple or leaden color. The matter discharged from the abscess is thin, and mixed with portions of a substance resembling cheese. The discharge may continue for weeks; or the opening from which it is poured out may rapidly enlarge, and the whole tumour be converted into an ulcer difficult of cure. Causes.—The principal exciting causes of scrofula are : a cold, damp, and variable climate, and derangement of the digestive organs from improper and particular modes of living. Treatment.—Against the scrofulous enlargement of the glands, the most useful remedies are : Mercurius vivus, Dulcamara, Belladonna, Calcarea, Sulphur, Graphites, Hepar sulph., Si- licea, &c. When suppuration or ulceration takes place, Hepar sulph., Lachesis and Silicea, and in some cases Lycopodium and Phos- phorus, will be most serviceable. (See also the articles " Ab- scess " and " Ulcers".) The unsightly scars, which so frequently remain after glandular swellings, may in many instances be materially lessened by the use of Sulphur and Hepar, or Calca- rea and Silicea. TABULAR INDEX REMEDIES USED, THEIR ENGLISH NAMES, ANTIDOTES, AND DISEASES IN WHICH EMPLOYED. Aconitum napellus (Aconite). Monk's Hood. {Camph., Nux Vom., Wine, Vinegar, Paris.) Fright, page 1. Vexation 1. Sickness of the Stomach 2. Fainting 2. Fear 2. Sensitiveness 6. Cold 7. Rheumatism 14. Cold 15. Sun- Stroke 17. Fatigue 18. 19. Excesses 21. Disordered Stomach 23. Headache 25. Effects of lee-water 28. Effects of Liquors 31. Mania a Potua 36. Effects of Tobacco 38. Effects of Spanish Flies 42. Ef- fects of Sulphur 43. Poisoning by Acid 78. 80. Effects of Paint 79. Poison of Frogs & Lizards 89. Poisoning 92. Stings of Bees 93. 94. Inflammation of the Brain 100. 101. Concussion of the Chest 101. 231. Contused Wounds 102. Bruises of the Eyes 103. Dislocations 105. Fractures 106. Wounds 113. Lock Jaw 115. Bleeding of the Gums 115. Wounds on the Head 116. Burns 120. Inflamed Eyes 123. Swelled Nose 124. Giddiness 133. 134. Weak Memory 134. Rush of Blood to the Head 135. Headache 137. 138. Sick Headache 141. Nervous Headache 142. 143. Inflamed Eyelids 150. 151. Iritis 152. Gout affecting the Eyes 154. Attacks of Blindness 162. Shrinking from the Light 163. Buzzing in the Ears 171. Epistaxis 174. Catarrh 179. Hooping Cough 190. Croup 194. Congestion of the Chest 196. Spitting of Blood 199. 200. Laryngitis 204. Bronchitis 206. Palpitation of the Heart. 210. Pleurisy 218. Pneumonia 222. 226. Consumption 231 Quinsey 233. Toothache 246. Faceache 254. Glossitis 260. Vomiting of Blood 275. Colic 277. Gastritis 281. Worms 287. It- ching of the Anus 288. Piles 292. Dysentery 300. Congestions from Cholera 307. Hepatitis Acuta 314. Nephritis 320. Cystitis 323. Ir- ritable Bladder 324. Discharge from the Urethra 328. Affections of Penis 329. 330. Swollen Testicles 330. Hernia 331. 332. Tardy Men- struation 335. Amenorrhcea 337. Vertigo 352. Fainting 356. Pain in the Side 359. Depression of Spirits 360. Preparation of the Breasts 367. False Pains 368. Protracted Labours 370. Fever after Delivery 373. Lochial Discharge 375. Milk Fever 376. Suppression of Milk 378. Excess of Milk 378. Inflammation of the Eyes 388. Eruptions 392. Retention of Urine 392. Crying of Infants 396 Dentition 402 Prickly-Heat 407. Rash 410. Urticaria 411. Measles 414. Scarlatina 418.419. Scarlet Rash 421. Chicken-Pox 422 Varioloid 423 Small. Pox 423. Erysipelas 426. Crusta Lactea 430. Boi s 433 Gout 444. 445 Rheumatism 446. 448. Lumbago 449 Sciatica 450. Crick n, the Neck 451. Epilepsy 452. Nightmare 453 Sleeplessness 453. Dronsv 457 Inflammation of the Brain 459. Fever and Ague 470. Inflammatory Fever 471. Typhus Fever 473 Fainting 475. Appa- rent Death from Choking, Ac. 47S. Apparent Death from being fro- zen 479. Apoplexy 482. 483. 486 TABULAR INDEX Agaricus muscarius. Bug Agaric. (Camph., Coffea, Puis., Wine.) Weakness of Vision, page 162. Alumina. Alumine. {Bryonia, Camph., Cham., Ipecac.) Hepatitis Chronica, page 317. Ammonium carbonicum. Carbonate of Ammonia. {Arnica, Camph., Hepar S.) Consumption, page 231. Angustura vera. Angustura Bark. {Coffea.) Lock Jaw, page 115. Antimonium crudum. Crude Antimony. {Hepar Sulph., Mercury.) Headache from disordered Stomach, page 12. Cold from Bathing 15. Diarrhoea 18. Excesses 21. Disordered Stomach 23. Headache 25. Fever 27. Intoxication 34. Giddiness 133. Nervous Headache 145. In- flammation of the Eyelids 152. Gout affecting the Eyes 155. Hardness of Hearing 172. Toothache 250. Dyspepsia 265. Nausea 268. Gastri- tis 282. Piles 293. Diarrhoea 298. 299. Diarrhoea during Pregnancy 355. Diarrhoea during Confinement 379. Summer-Complaint 404. Chicken-Pox 422. Ulcers 440. Corns 443. Warts 443. Gout 445. Fever and Ague 466. Antimonium crudum. 3. trituration. Scald Head, page 431. Arnica moutana. Leopard's Bane. {Camph., Ignat., Ipecac.) Anger, page 6. Rheumatism 14. Fatigue 19. Disordered Stomach 23. Headache 25. Effects of Acids 38. Effects of Quinine 41. 42. Stings of Bees 93. 94. Concussion of the Brain 99. 100. 101. Concussion of the Chest 101. Contused Wounds 102. Bruises of the Eyes 103. Bruises on the Head 103.104. Sprains 104. Dislocations 105. Fractures 106. Wounds 110. 114. Bleeding of the Gums 115. Wounds of the Head 116. Wounds of the Abdomen 116. Burns 120. Inflamed Ears 124. Swelled Nose 124. Contraction of the Throat 126. Leeches in the Stomach 131. Inflammation of the Skin 132. Giddiness 133. Weak Memory 134. Rush of Blood to the Head 135. Earache 166. Buz- zing in the Ears 170. Hardness of Hearing 172. Swelled Nose 173. Epistaxis 174. Cough 185. Hooping Cough 192. Croup 196. Spit- ting of Blood 198. 199. 200. 201. Asthma 214. Pleurisy 219. False Pleurisy 220. Pneumonia 228. Consumption 231. Concussion of the Chest 231. Toothache 241. Glossitis 261. Dyspepsia 263. Nausea 268. Vomiting of Blood 275. Gastritis 282. Nephritis 321. Cystitis 323. Discharge of Blood from the Urethra 329. Affections of the"Penis 329. Swollen Testicles 330. Falling of the Womb 349. Varicose Veins 358. Miscarriage 362. Flooding 365. Preparation of the Breasts 367. Sore- ness after Delivery 373. Afterpains 373. Milk Fever 376. Retention of Urine 380. Sore Nipples 380. Swelling of the Head 387. Swollen Breasts 395. Parotitis 415. Scarlatina 420. Boils 433. Ulcers 441. Gout 444. Inflammation of the Brain 460. Fever and Ague 466. Yellow Fever 474. Apparent Death from a Fall 477. Traumatic Te- tanus 481. Arnica tincture. Concussion, Fractures 99. 100. 101. Contused Wounds 102, Bruises on the Head 104. Sprains 104. Dislocations 105. Fractures 106. Wounds 114. Boils 433. Corns 443. Bed Sores 443. Rheumatism 447. Traumatic Tetanus 481. OF THE REMEDIES USED, ETC. 481 Arsenicum album. White Arsenic. {China, Ferrum, Graph., Hepar, Ipecac, Kali Carb., Nux Vom., Samb., Veratrum.) Difficult Breathing, page 10. Nausea & Vomiting 14. Cold 15. Loss of Fluids 22. Disordered Stomach 23. 24. Effects of Ice-water 28. 29. Ef- fects of Malt Liquors 30. 33. Effects of Tobacco 38. Effects of Acids 38. 39. Effects of Quinine 41. 42. Effects of Magnesia 43. Effects of Mercury 46. Poison of Frogs & Lizards 89. Poisoning by Meat 90. Poisoning 91. 92. Bites of Snakes 95. Contused Wounds 103. Burns 120. Leeches in the Stomach 131. Headache 138. Nervous Head- ache 146. 147. Inflamed Eyelids 151. Scrofula of the Eyes 157. Hardness of Hearing 172. Swelled Kose 174. Ozoena 177. Catarrh 178. Cough 185. Croup 195. Spitting of Blood 200. 201. Laryngitis 204. Bronchitis 209. Asthma 213. Palpitation of the Heart 219. Pleurisy 219. Pneumonia 224. 225. 227. 229. Consumption 231. Toothache 250. Faceache 255. Offensive Breath 258. Cancer 259. Glossitis 261. Vomiting 269. Vomiting of Blood 275. Gas- tritis 282. 283. Determination of Blood to the Abdomen 285. Diarrhoea 299. Dysentery 300. Cholera Morbus 303. Cholera 306. Cystitis 323. Affections of the Penis 830. Hernia 332. Tardy Menstruation 336. Morning-Sickness 354. Varicose Veins 359. Sup- pression of Milk 378. Thrush 390. Summer-Complaint 304. Prickly- Heat 407. Urticaria 411. Measles 414. 415. Scarlatina 419. 420. Erysipelas 427. Itching of the Skin 428. Scabies 429. Crusta Lac- tea 430. Scald Head 431. Carbuncle 434. Chilblains 435. Whitlow 437. Ulcers 439. 441. Gout 444. Rheumatism 448. Sciatica 450. Dropsy 455. 456. 457. Inflammation of the Brain 460. Fever and Ague 465. Typhus Fever 473. Yellow Fever 494. Apparent Death from being frozen 479. Aurum metallicum. Pure Gold. {Bellad., China, Cuprum, Mercury.) Ozoena, page 177. Hepatitis Chronica 317. Falling of the Womb 348. Depression of Spirits 360. Belladonna. Deadly Nightshade. {Coffea, Hyoscyam., Hepar, Puis.) Fits from Fright, page 2. Fainting 2. Fright during Menstruation 2. Derangement of Intellect 4. Anger 6. Cold 7. 8. 15. Catarrh 8. 9. Headache 11. 17. Sore Eyes 12. Sore Throat 13. Nausea & Vomi- ting 13. Rheumatism 14. Chilblains 15. Sun-Stroke 17. Dyspep- sia 20. Effects of Ice-water 29. Effects of Malt Liquors 30. Ef- fects of Liquors 31. Mania a Potua 36. Bad Effects of Coffee 37. Effects of Acids 38. Effects of Opium 40. Effects of Quinine 41. 42. Effects of Sulphur 43. Effects of Mercury 45. 46. Effects of Lead 46. Poisoning by Coal-Gas 77. Headache from Plants 79. Poisoning by ,Liver\of Sulphur 81. Poisoning by Iodine 81. Effects of Poison ''Vine 87. Effects of Turpentine 87. Effects of Fish 88. Stings of Bees 93. Bites of Snakes 95. Hydrophobia 97. Inflammation of the Brain UHL-Wl. Bruises on the Head 103. 104. Lock Jaw 115. Inflamed Ears- 124. Swelled Nose 124. Obstruction of the Windpipe 129^130. Giddiness 133. 134. Weak Memory 134. Rush of Blood to the Head 135: Headache 137. Sick Headache 141. 1«. Nervoua .Heaclache 143. 147. Loss of Hair 149. Inflamed Eyelids 151. 152. Iritis 153 flftut affeetinsr the Eyes 155. Scrofula of the Eyes 156. Attacks of BlindnSs 162g Shrinking from the Light 163 Squinting 163 Mumps ,5 Otitis 166. Earache 167. Running from the Ears 168.169. Hard- ness of Hearing 171. Swelled Nose 173. Epistaxis 175 Ozoena 177. Catarrh 178. Cough 182. Hooping Cough 190. Croup 196 Congestion of the Chest 197. Spitting of Blood 198. 202. Bronchitis 207. Palpita- tion of the Heart 210. Asthma 214. Pleurisy 218. Pneumonia 223. 226. 488 TABULAR INDEX 229. Consumption 231. Quinsey235. Toothache 248. Faceache 254. Glossitis 261. Dyspepsia 266. Heartburn 267. Nausea 268. Gastralgia 271. Colic 279. Gastritis 282. 284. Determination of Blood to the Ab- domen 285. Worms 287. Piles 293. Congestions from Cholera 307. Hepatitis Acuta 315. Jaundice 319. Nephritis 320. Irritability of the Bladder 324. Affections of the Penis 329. Hernia 332. TardyMenstrua- tion335. Amenorrhcea 337. Dysmenorrhcea 340. Falling of the Womb 348. Vertigo 352. Fainting 356. Pain in the Back 359. Cramps 360. Incontinence of Urine 360. Depression of Spirits 360. Miscarriage 363. Flooding 365. Fals'e Pains 369. Protracted Labours 370. Con- vulsions 372. Afterpains 374. Lochial Discharge 376. Milk Fever 377. Suppression of Milk 378. Retention of Urine 380. Gathered Breasts 381. Inflammation of the Eyes 388. Diarrhoea 394. Swollen Breasts 395. Crying of Infants 396. Restlessness 396. Spasms 399. Dentition 402. Running from the Ears 406. Urticaria 411. Measles 414. Scarlatina 418. 419. 420. Scarlet Rash 421. Chicken-Pox 422. Small-Pox 424. Varioloid 424. Erysipelas 426. Boils 433. Gout 444. Rheumatism 447. 448. Lumbago 449. Epilepsy 452. Sleeplessness 454. Inflammation of the Brain 459. Fever and Ague 469. Inflam- matory/Fever 471. Typhus Fever 473. Yellow Fever 475. Trau- matic Tetanus 481. Apoplexy 482. 483. Scrofula 484. Bichromate of potash. Croup, page 196. Bromine. „ Croup, page 196. Bryonia alba. White Bryony. {Aeon., Chamom., Ignatia, Nux Vom.) Vexation, page 5. Cold 8. Checked Eruptions 9. Dry Cough 9. Diarrhoea 10. 18. Chilblains 15. Headache 17. 18. Fatigue 18. 19. Disordered Stomach 23. 24. Headache 25. Vomiting 25. Fever 27. Rash 27. Effects of Ice-water .28. 29. 30. Effects of Tobacco 38. Effects of Acids 39. Effects of Mezereum 42. Headache from Plants ■ 79. Effects of Paint 79. Poisoning by Muriatic Acid 80. Effects of Poison Vine 87. Effects of Turpentine 87. Poisoning by Meat 90. Overlifting 101. Misteps 102. Sprains 104. Lock Jaw 115. Bleeding of the Gums 115. Burns 121. Gout in the Head 139. Headache from Constipation 139. Nervous Headache 144. Iritis 154. Running of the Ears 169. Swelled Nose 174. Epistaxis 175. Catarrh 179. Cough 184. Hooping Cough 191. Spitting of Blood 198. Bronchitis 207. Asthma 214. Pleurisy 218. False Pleurisy 220. Pneumonia 223. 225. Consumption 231. Quinsey 235. Toothiche 250. Offensive Breath 258. Dyspepsia 265. Nausea 268. Gastralgia 272. Gastritis 282. Determination of Blood to the Abdomen 285. Diarrhoea 299. Dysen- tery 300. Congestions from Cholera 307. Constipation 312. Hepatitis Acuta 315. Affections of the Penis 329. Tardy Menstruation 335. Amenorrhcea 337. Chlorosis 344. Cessation of Menses 346. Consti- pation 355 Pruritus. 355. Pains in the Back 359. Miscarriage 363. Flooding 365. False Pains 368. Lochial Discharge 375. Milk Fever 377. Suppression of Milk 378. Constipation 379. 393. 'i Gathered Breasts 381 Discharge of Meconium 387. Thrush 390.f Summer- Complaint 404. Rash 409. Urticaria 411. Measles 414. 415. Scarla- tina 420 Scarlet Rash 421. Small-Pox 424. Varioloid 424. j»rsi- pelas426 Corns 443. Rheumatism 447. Lumbago 449. CricfiSTthe vtlJ, * ADrOPfry«455T f6- 457' Inflamraation of the Brain 459. Fever and Ague 466. Inflammatory Fever 471. Typhus Fever 473. OF THE REMEDIES USED, ETC. 489 Calcarea carbonica. Carbonate of Lime. {Camph., Nitr. acid, Sulph.) Sore Eyes, page 12. Rheumatism 14. Cold 15. Chilblains 15. 16. Fatigue 19. Dyspepsia 20. Excesses 21. Effects of Ice - water 28. 30. Intoxication 35. Mania a Potua 35. Effects of Quinine 41. 42. Effects of Mercury 45. 46. Poisoning 91. Headache from Overlifting 101. Bruises on the Head 104. Inflamed Eyes 123. Giddiness 133. Loss of Hair 149. Inflammation of the Eyelids 152. Stye 152. Scro- fula of the Eyes 157. Far-Sightedness 162. Earache 167. Hardness of Hearing 171. 172. Polypus of Nose 176. Cough 186. Laryngitis 204. Consumption 231. Toothache 252. Nausea 268. Vomiting 269. Gastralgia 273. Worms 288. Itching of the Anus 288. Piles 294. Diarrhoea 299. Hepatitis Chronica 317. Jaundice 319. Cystitis 323. Gravel 327. Affections of the Penis 330. Chlorosis 344. Cessation of the Menses 346. Whites 347. 407. Falling of the Womb 348. Tooth- ache 357. Cramps 360. Lochial Discharge 375. Suppression of Milk 377. Excess of Milk 378. Involuntary Emission of Milk 378. Sore Nipples 380. Loss of Hair 382. Inflammation of the Eyes 389. Snif- fles 389. Dentition 402. Soreness behind the Ears 405. Running from the Ears 406. Rash 409. Urticaria 412. Scarlatina 419. 420. Scald Head 432. Ringworm 432. Abscess 442. 443. Warts 443. Gout 445. Fever and Ague 469. Scrofula 484. Calendula tincture. Common Marygold. Lacerated Wounds, page 114. 116. Camphora. Camphor. Lock Jaw, page 115. Cholera 307. Cystitis 323. Irritability of the Bladder 324. Epilepsy 452. Dropsy 455. Cannabis sativa. Hemp. {Camphora.) Nephritis, page 320. Irritability of the Bladder 324. Gravel 327. Cantharis. Spanish Flies. {Camphora.) Burns, page 119. Nephritis 320. Cystitis 323. Irritability of the Bladder 324. Gravel 327. Dropsy 455. Cantharis tincture. Burns and Scalds, page 119. Capsicum annum. Cayenne Pepper. {CamjAor.) Home Sickness, page 4. Fever 27. Effects of Ice-water 28. Nervous Headache 146. Hoarseness 180. Cough 182. Quinsey 235. Cancer 259 Mucus state of tho Stomach 267. Heartburn 267. Nausea 268. Determination of Blood'to the Abdomen 285. Piles 292. Discharge from the Urethra 328. Affections of the Penis 330. Fever and Ague 468. Carbo vegetabilis. Vegetable Charcoal. {Ars., Camph., Coff., Lach.) Hollow Cough, page 9. Cough with Palpitation of the Heart 9. Cold 15. CKlblains 15. 16. Headache 18. 25. Excesses 21 Disoiclered Stomafch 23. 24. Effects of Ice-water 29 I^xicaUon 34 3^ Bad Effect of Coffee 37. Effects of Quinine 41. 42. Effect, ot Mercury 45 46 Poisoning by Potash 81. Burns 120. Weak Memory 134. Los* of Hair 149. Short-Sightedness 162 Mumps 16o Buzzing in the Ears 170. Hardness of Hearing 171. Epistaxis 175 Hoarseness SO Cou£hl82. Hooping Cough 192. Croup 196. Spitting of Blood }qt 903 Laryngitis 204. Pneumonia 226. Consumption 231. Tooth- HL 250 Cancer 259. Heartburn 267. Gastralgia 271. 273. Worms 287. PUes 293. Dysentery 301. Cholera 307. Cystitis 323. Pruritus Oh 490 TABULAR INDEX 355. Varicose Veins 359. Sniffles 389. Excoriations 391. Summer- Complaint 404. Urticaria 412. Erysipelas 427. Itching of the Skin 428. Scabies 429. AVhitlow 437. Ulcers 439. 441. Dropsy 457. Fever and Ague 469. Typhus Fever 474. Yellow Fever 474. Fainting 475. Apparent Death from being frozen 479. Causticum. Caustic. {Coffea, Colocynth, Nux Vom.) Burns, page 120. Running of the Ears 169. Hardness of Hearing 171. Swelled Nose 174. Ozoena 177. Hoarseness 180. Cough 187. Laryngitis 204. Chronic Pneumonia 225. Toothache 252. Amenor- rhcea 337. Dysmenorrhcea 341. Whites 348. Pain in the Back 359. Urticaria 412. Measles 415. Scabies 429. Ringworm 430. Whit- low 437. Warts 443. Gout 445. Rheumatism 448. Epilepsy 452. Causticum tincture. Burns and Scalds, page 119. 120. Ulcers 440. Chamomilla. Common Chamomile. {Aeon., Coccid., Coffea, Ignatia, Nux Vom., Pulsat.) Vexation, page 5. Anger 6. Sensitiveness 6. Cold 7. 8. 15. Cough 9. Watery Diarrhoea 11. Earache 12. Toothache 13. Rheumatism 14. Disordered Stomach 23. Effects of Liquors 31. Bad Effects of Coffee 36. 37. Effects of *Tobacco 38. Effects of Valerian 42. Effects of Rhubarb 42. Effects of Magnesia 43. Fractures 106. Wounds 114. Burns 120. Contraction of the Throat 125. Giddiness 133. 134. Rush of Blood to the Head 135. Headache 138. Nervous Headache 145. Inflammation of the Eyelids 152. Iritis 153. Ear- ache 166. Buzzing in the Ears 170. Hardness of Hearing 172. Ca- tarrh 178. Hoarseness 179. Cough 181. Bronchitis 209. Asthma 214. Pneumonia 227. Quinsey 233. Toothache 246. Offensive Breath 258. Dyspepsia 264. Heartburn 267. Gastralgia 271. Colic 276. Gastritis 283. Determination of Blood to the Abdomen 285. Piles 293. Diarrhoea 297. Dysentery 300. Cholera Morbus 302. Hepatitis Acuta 315. Jaundice 318. Menorrhagia 339. Dysmenorrhcea 340. Fainting 356. Toothache during Pregnancy 357. Pain in the Side 359. Cramps 360. Miscarriage 362. Flooding 365. Preparation of the Breasts 367. Protracted Labours 370. Convulsions 372. Afterpains 373. Milk Fever 377. Inflammation of the Eyes 388. Sniffles 389. Jaundice 391. Excoriation 391. Diarrhoea 393. Colic 394. Swollen • ' Breasts 395. Crying of Infants 396. Restlessness 396. Spasms 399. Dentition 402. Running from the Ears 406. Prickly-Heat 407. Rash 410. Chilblains 435. Rheumatism 447. Sciatica 450. Epilepsy 452. Sleeplessness 454. Fever and Ague 467. Fainting 475. 476. China officinalis. Peruvian Bark. {Arnica, Arsen., Bellad., Calcar., Carbo vegetab., Ipecac, Sulphur.) Sensitiveness, page 6. Catarrh 9. Diarrhoea 10. Pain in the Bowels 10. Toothache 13. Cold 15. Fatigue 18. Excesses 21. Loss of Fluids 11' disordered Stomach 24. Overfeeding of Children 24. Flatulence 26. Effects of Ice-water 28. Effects of Tea 37. Effefiis of Tobacco 38. Effects of Acids 38. 39. Effects of Quinine 41. 42. Effects of £?a £?falda P. Effects of Mer<>ury 45. 46. Effects of Arsenic 47. ?ao ™ ? , ^ 47' Contused Wounds 103. Bruises on the Head 103. Wounds 110. 113. Wounds on the Head & Abdomen 116. Gid- diness 134. Weak Memory 134. Rush of Blood to the Head 136. Headache 138. Nervous Headache 145. Loss of Hair 149. Inflam- mation of the Eyelids 152. Scrofula of the Eyes 157. Earache 167. Buzzing in the Ears 170. Epistaxis 175. Catarrh 179. Cough 184. Spitting of Blood 198. 200. 201. Palpitation of the Heart 210 Asthma OF THE REMEDIES USED, ETC. 491 214. Pleurisy 219. Pneumonia 224. 229. Consumption 231. Concus- sion of the Chest 232. Quinsey 237. Toothache 249. Faceache 255. Dyspepsia 264 Heartburn 267. Nausea 268. Gastralgia 273. Vomi- nf°ln lood 275 Colic 279. Flatulency 280. Gastritis 282. Worms w *•!•»; ?,larrhoea 298- Dysentery 301. Cholera Morbus 304. Hepatitis Acuta 316. Hepatitis Chronica 317. Jaundice 318. Dis- charge from the Urethra 329. Amenorrhoea 337. Menorrhagia 339. *ainting356. Incontinence of Urine 360. Miscarriage 363. Flood- ££ ?, , Involuntary Emission of Milk 378. Jaundice 391. Colic 394. Bed Sores 443. Gout 445. Rheumatism 448. Dropsy 455. 456. Fever and Ague 465. Typhus Fever 473. 475. Yellow Fever 475. Fainting 475. Apparent Death from a Fall 477. Cina. Worm Seed. {Ipecac) Epistaxis, page 175. Cough 182. Spasms 399. Dentition 402. Fever and Ague 466. Cinnamomum tincture. Cinnamon. Flooding, page 364. 373. Cocculus. Indian Berries. {Camph., Nux Vom.) Headache from Loss of Sleep, page 4. Nausea & Vomiting 14. Fa- tigue 19. Weakness from Loss of Sleep 19. 20. Excesses 22. Effects of Ice-water 28. Bad Effects of Coffee 37. Effects of Tobacco 38. Giddiness 133. 134. Gout affecting the Eyes 155. Spitting of Blood 202. Quinsey 237. Nausea 268. 269. Sea-Sickness 269. Gastralgia 271. Colic 279. Tardy Menstruation 335. Dysmenorrhcea 341. Hys- teria 342. Cessation of Menses 346. Whites 348. Menstruation dur- ing Pregnancy 351. Convulsions 372. Crick in the Neck 451. Fever and Ague 468. Fainting 475. Coffea cruda. Mocha Coffee. {Aeon., Chain., Nux Vom.) Sudden Emotions, page 1. Vexation 5. Sensitiveness 6.11. Cold 15. Fatigue 18. Excesses 21. Diarrhoea 26. Sleeplessness 27. Effects of Liquors 31. Intoxication 34. 35. Effects of Tea 37. Effects of Opium 40. Effects of Valerian 42. Effects of Magnesia 43. Poisoning by Phosphoric Acid 80. Poisoning by Potash 81. Poisoning by Prussic Acid 82. Wounds 113. Wounds of the Abdomen 116. Rush of Blood to the Head 135. Nervous Headache 142. Buzzing in the Ears 171. Asthma 214. Quinsey 235. Toothache 245. Dysmenorrhoea 341. Hysteria 342. Fainting 356. Protracted Labours 370. Nervous Ex- citement after Delivery 373. Afterpains 374. Suppression of Milk 378. Crying of Infants 396. Restlessness 396. Spasms 399. Denti- tion 402. Scarlet Rash 421. Small-Pox and Varioloid 424. Sleepless- ness 453. Fever and Ague 468. Colchicum autumnale- Meadow Saffron. {Nux Vom., Cocc, Puis.) Sea-Sickness, page 269. Irritability of the Bladder 324. Colocynthis. Colocynth. {Camph., Canst., Coffea, Cham.) Vexation, page 5. Cold 15. Excesses 21. Effects of Malt Liquors 30. Effeets of Tobacco 38. Effects of Rhubarb 42. Effects of Magnesia 43. Wounds of the Abdomen 117. Headache 139. Nervous Head- ache 145. Gout affecting the Eyes 155. Faceache 254. Colic 277. Diarrhoea 297. Dysentery 301. Irritability of the Bladder 324. Cramps 360. Gout 445. Rheumatism 448. Sciatica 450. Cramps 451. Fainting 475. Conium maculatum. Hemlock. {Coffea, Nitri Spiritus Dulds.) Ozoena, page 177. Chronic Pneumonia 225. Consumption 231. Ame- norrhcea 338. 492 TABULAR INDEX Crocus sativus. Saffron. {Aconite, Opium.) Menorrhagia, page 339. Menstruation during Pregnancy 351. Mis- carriage 362. Lochial Discharge 375. Cuprum acetieum. Acetate of Copper. {Bell., China, Ipecac, Merc, Nux Vom.) Hooping Cough, page 192. Scarlatina 419. Inflammation of the Brain 460. Cuprum acetieum. 3. trituration. Rash, page 409. Cuprum metallicum. Pure Copper. {Bell., China, Ipec, Merc, NuxV.) Effects of Tobacco, page 38. Cholera Morbus 304. Cholera 307. 308. Tardy Menstruation 336. Hysteria 342. Cessation of Menses 346. Afterpains 374. Epilepsy 452. Cuprum metallicum. 1. trituration. Headache, page 147. Digitalis purpurea. Fox Glove. {Opium, Nux Vom.) Cystitis, page 323. Drosera rotundifolia. Sundew. {Camph.) Far-Sightedness, page 162. Hoarseness 180. Cough 185. Hooping Cough 191. Nausea 268. Measles 415. Dulcamara. Bitter-sweet. {Camph., Ipecac, Mercury.) Moist Cough, page 9. Diarrhoea from Cold 10. Headache 11. Sore Eyes from Cold 12. Buzzing in the Ears 12. 170. Toothache 13. 252. Sore Throat 13. Nausea & Vomiting 13. Rheumatism 14. Cold 15. 16. Excesses 21. Effects of Mercury 45. 46. Burns 127. Rush of Blood to the Head 136. Scrofula of the Eyes-157. Earache 167. Running from the Ears 170. Hardness of Hearing 172. Catarrh 178. Cough 185. Hooping Cough 190. Spitting of Blood 198. 203. Bronchi- tis 209. Consumption 231. Cancer 259. Diarrhoea 299. Cystitis 323. Irritability of the Bladder 324. Amenorrhoea 337. Diarrhoea during Pregnancy 355. False Pains 368. Lochial Discharge 376. Diarrhoea during Confinement 379. Sniffles 389. Summer-Complaint 404. Ur- ticaria 411. Parotitis 415. Abscess 443. Warts 443. Dropsy 455. Scrofula 484. Euphrasia officinalis. Eye-Bright. {Pulsatilla.) Inflame